How to tell if your evening glass(es) of wine are a problem or not, dealing with a spouse who doesn't seem to like your friends, getting back on your feet after vacation, and anti-depressants and potential weight loss.
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“Don’t be afraid to look at a situation head on. Sometimes we make a decision based on the good of the people for whom we are responsible and sometimes we can make decisions based solely upon our personal happiness.”
"My dear friend’s daughter is not talking to her and says she doesn’t want her in her life anymore. She has been counseling with her church pastor and has uncovered some old issues that she is blaming her mother for. The daughter is not going to a licensed therapist but only counseling with her pastor. Any advice on how we can help the daughter get better help along with patching up her relationship with her mother?"
Signed long-term friend.
There are three issues that need to be addressed in order to answer this question. The relationship between the mother and daughter is estranged. The pastor may or may not be a legitimate counselor, and most important is the fact that the daughter has uncovered ‘issues’ that need addressing.
Pastoral counseling has been accepted as a branch of counseling, which is spiritually based and psychologically informed. I will assume that the daughter’s pastor is trained. He may not wish to involve the mother, preferring to keep the one-on-one relationship with the daughter primary. But there can be no objection to both the mother and the daughter going to a family counselor to discuss their strained relationship. This is not meant to be manipulative, but adjunctive. One can have different counselors for different reasons. I’ve known couples with a separate therapist for each of them and then another for couples therapy.
Being asked to leave a therapist, whether pastoral or secular, is not a small thing. It can cause psychological damage and re-injure a person who has established a bond with the counselor. The daughter must have “established a bond” with the pastor in order to uncover old issues.
"I like to have a few glasses of wine at night to take the edge off the day. I do that most nights and once in a while it turns into the whole bottle of wine. When should I be worried if I am really self-medicating and if I have a problem or not?"
Signed 48-year-old mother of three teens.
I am impressed that you are sufficiently self-aware to ask the question, “Do I have a problem?” Most people in your situation exist in a state of denial that there’s anything wrong at all. Your drinking is a warning to you to take a better and closer look at your life. How did it get out of balance and how much is your drinking aggravating the problem? You speak of taking the “edge off the day,” which is another way of referring to stress in your life. Why does your day have an “edge?” Could that be addressed along with cutting down on alcohol consumption?
There are three basic levels of alcohol use: normal social drinking, problem drinking and alcoholism. When you are a problem drinker, you drink for stress release, usually consistently and often, too much. A full bottle of wine is too much. In fact 3 glasses of wine is too much. I don’t believe that having a glass of wine at the end of the day is a bad thing, but watching consumption carefully is wise.
While you’re not an alcoholic, you do drink more than normal social drinking. Now is the time to address the underlying problem as well as the addiction to alcohol. I really think that therapy would be helpful for you to begin to address both.
"My wife worries all the time. Sometimes she will cancel events just because she is too worried about things going wrong. I know it is something from her childhood because her mother said she has always been like this. It keeps her up a night and keeps her home too much. What can we do about this?"
Signed loving husband.
Excessive worrying is also known as Chronic Anxiety. Anxiety is not good for our health, physically, mentally or emotionally. Some
people believe their anxiety/worrying keeps them safe or keeps bad things from happening. In fact, it does neither. That could be thought of as “magical thinking.” Somehow one’s thoughts alone can control the outside world. I can “think” events to happen or not. This does not work except coincidently.
Chronic anxiety often starts in childhood and raises one’s “anxiety set point” for life. We speak of people being “high strung” as though they were the strings of a violin wound too tight. This is a condition that needs therapy and medication management with antidepressants. They have been found to control anxiety very well. They help to lower the anxiety set point and may help your wife contain her worrying. People with an anxiety disorder do not have the ability to relax and trust in the belief that everything will be all right. We control what we can and give the rest over to the powers that be.
"My husband does not seem to like any of my friends. It gets very hard for me to invite people over that he doesn’t like. I think it is hard on our relationship. Do I really have to give up my friends for a good marriage?"
Signed three-year marriage.
Recently an old high school buddy of 50 years ago came to visit my friend for a week. My friend was worried that his buddy would prove offensive to his wife, as his buddy was often opinionated and “crass” But my friend’s wife was up to the task at hand. She engaged the old high school buddy with wit and humor. They went on to have a fun week of seeing the sights in their town. She was what we used to call a “good sport.” Are women just better at that than men? Are we more adaptable or adjustable or just more willing to put up with someone because he is our husband’s old friend? Or does this not necessarily hold true.
Please don’t give up your friends for the sake of your husband or even your marriage. Doing so will mean that you will disappear and that his desires are more important than yours. After years of being eroded, you will no longer recognize yourself. This is about the art of compromise. How can a marriage survive without give and take? If your husband is averse to going to couple’s counseling, perhaps there are marriage or interpersonal relationship classes in your church or elsewhere in your town. They are often less intimidating than couple’s counseling. It’s a good place to start. You might also consider beginning individual therapy yourself.
"I just got home from a 10-day vacation. It was perfect weather, restful and a great getaway. My problem is that ever since I got home I am just worthless. I am not very motivated to get back to work, get to the gym, to cook or to do much of anything. Not sure if I am just not liking being back in this climate or depressed about being home. Any ideas?"
Signed pooped-out traveler.
Congratulations on having had a good vacation! Many people
have difficulty reentering their regular lives after having a wonderful time elsewhere. Perhaps you could take this opportunity to examine why it is exactly that you are reluctant and ambivalent about returning from vacation. You were able to embrace your time off with gusto, but now your home life is not satisfying. That brings us to that great Greek philosopher, Socrates.
Socrates said “The unexamined life is not worth living.” He meant that self-examination is essential to fully live life with consciousness and intention. I’m not saying that this is easy; in fact, it might be easier to live an unexamined life, asking no questions and simply accepting the status quo. Just follow all the rules and do what everyone else is doing.
Self-examination is not only answering a set of questions in a magazine or online but an attitude. An attitude that involves paying attention to ourselves and our surroundings and what makes us happy and what needs to be changed. Don’t be afraid to look at a situation head on. Sometimes we make a decision based on the good of the people for whom we are responsible and sometimes we can make decisions based solely upon our personal happiness. But it’s important to pay attention to those elements in your life that are making reentry difficult. Is it your job or your relationships? Do you need to take more time off? Or maybe change jobs completely. This is for you to decide finally.
"I am wondering what the guidelines are for getting help. Who do you call? When do you need a psychiatrist, a psychotherapist, a school counselor or even a church pastor?"
Signed looking for help.
If you feel you need help, one of the first decisions will be based on your financial situation. Do you want your health insurance to pay for your therapy and/or medication management or do you want to pay out-of-pocket? If you want your insurance company to pay, then you must go to their website to see who is on their “provider panel,” who they will pay and for what services. For example, some insurance companies will not pay for couples counseling or EMDR.
The next decision involves what kind of therapist or psychiatrist you want to see. Advanced practice nurses and psychiatrists are able to prescribe psychotropic medications. Many times your psychotherapist will refer you to someone else for medication management.
When you call a provider on the panel, you will want to ask them what services they provide: if they provide individual weekly therapy, if they are specially trained in any particular modality such as cognitive behavioral therapy, can they prescribe psychotropic medications and if they are taking new patients.
When you first meet, pay attention to how comfortable you feel with them. They will be assessing you and you must assess them. Even more important than modalities and treatments, you must feel like you “fit” with this person. If you don’t, then make an appointment with someone else. You have a right to shop around. Therapy is an extremely helpful activity and should be supportive and enlightening. Always remember that you are in charge and in the position to decide whom you wish to see. I wish you the best of therapies and therapists.
"I have a friend in her late 60s who is taking Prozac and has lost about 48 pounds. Can antidepressants be used for weight loss generally?"
Just last week a friend of mine was prescribed Prozac for weight loss. I thought about it and it made sense. When we were children our mothers often soothed us with cookies. As adults we continue to treat our anxiety and depression with food. So it logically follows that we could treat our depression with Prozac and not cookies and consequently loose weight.
Prozac is an antidepressant with a long history of success. It helps people manage their moods and keeps them from despairing. It has been recently been shown to ameliorate anxiety as well. Antidepressants such as Prozac are called SSRI’s. They increase the amount of serotonin available in our brain and have a calming effect on our moods. It won’t make us lose weight but it will treat the underlying reason for overeating.
Overeating releases the brain’s natural tranquilizers that have a calming effect. We feel better but we gain weight. We become addicted to this process and Prozac can help treat that addiction. Older drugs like Prozac are cheaper and well studied. There are usually no surprise side effects from older medications.
"When I dropped off my oldest child for out-of-state college I thought I was going to collapse. I can’t stop thinking about his welfare; if he is lonely or scared being at a rather large school. I don’t want to call him, but I really feel uncomfortable. What can I do to feel more in control of this situation?"
Signed freaked-out parent.
I rescued two baby birds a number of years ago. They had no feathers yet! It took months of devoted care to get them to the point where they could be released. When the day came, I couldn’t help but think about the parents of real children, not birds, and how difficult it must be to let them fly away on their own. But just as I could not keep my birds in a cage for the rest of their lives, you cannot deny your son his chance to test his wings and leave the nest.
On the other hand, how can you be happy if your son is unhappy? Mother’s love is not codependent. You will always be concerned about your son’s welfare. Please call him frequently or email him or text, but stay in touch! He needs to know that you are there holding him in your thoughts. I loved my mother’s letters when I went away to school. I still have them 50 years later.
Now you have an empty space to fill. Find other interests. Get a job or volunteer. Fill your life with productive work, a reason to get up in the morning. Make it something that is of service to others. Caring for others has the effect of healing the caregiver. Give it a try.
"My son’s best friend just moved away and he is having a terrible time with it. He is depressed, listless, doesn’t want to go out any where and is turning into a couch potato. What can I do about this?"
Signed Mother of 10-Year-Old.
This may be the first time in his life that your son has suffered a loss of this magnitude. It’s no surprise that he has no idea of how to acknowledge the loss and have the tools to deal with it. First of all, he needs to be allowed to grieve. Don’t tell him to just get over it or to move on. He’s sad and that should be all right. Then remind him that he can and should keep in touch with his friend. In today’s digital age with our phones and tablets, keeping in touch has never been easier. FaceTime or Skype are great tools for communicating. I’ve always wished I had kept more friends from early childhood. They are people who share and understand my early history, as newer friends cannot.
You might enroll him in a karate class or a computer class. Talk to his teacher and school counselor to let them know that he might be depressed. I’m glad that you are keeping an eye on your son, as this may be his first bout of grief and sadness and possible depression. If it doesn’t improve, consider therapy. Children don’t always share the depth of their feelings and we are left to respond to subtler clues.
-Romona Scholder, M.A., RNCS, Psychotherapist