Dr. Holland’s Mental Health Tips

Suicide. Let’s talk about it!

The World Health Organization (WHO) says that more than 700,000 people die due to suicide every year and it’s the fourth leading cause of death in 15 to 19 year-olds. While many suicides happen on impulse as an attempt to escape emotional pain, abuse, or seemingly insurmountable problems, the most vulnerable groups are people who experience discrimination due to sexual preference, as well as migrants, refugees and indigenous persons.

Why suicide?

Suicide might be described as an attempt to escape suffering that has become hopelessly unbearable. Intense feelings of self-loathing and hopelessness can shut a suicidal person down to the point that they feel they can no longer reach out to get help, making death their only option. However, most suicidal people are deeply conflicted when it comes to ending their own lives. They deeply wish there was an alternative to suicide, but for whatever reason, they just can see what that might be.

What can be done?

“In order to be a good clinician, I have found that in addition to a strict adherence to the code of ethics, a duty of care, and empathy, I must be fearless when it comes to talking about sex, money, death, and suicidal ideation,” explains Dr. Jenny Holland, Sonoma County psychologist.

“I think it is essential that we have the ability and opportunity to explore our thoughts, feelings and ideas. Such as what it means to feel like, that we might be better off dead, or that the world might be better off without us. Exploring what it feels like to think, talk and even to fantasize about it can be the first step in diffusing what could be a very bad choice. It is important to have a safe place to talk about suicide and the feelings associated with that idea.”

The WHO says that “the stigma, particularly surrounding mental disorders and suicide, means many people thinking of taking their own life or who have attempted suicide are not seeking help and therefore are not getting the help they need. The prevention of suicide has not been adequately addressed due to a lack of awareness of suicide as a major public health problem and the taboo in many societies to openly discuss it.”

“Obviously, a line is drawn if it goes beyond simply thinking and exploring. If there is a plan, and if there are means to carry out the plan, then an intervention outside the treatment room must be made. Understandably, this causes people to feel hesitant about bringing up the topic at all. For fear of being seen as ‘crazy’ or feeling out of control. But really, people just need to be able to talk about it, to talk about being able to do it, having free will, having the choice, to talk about wanting to do it, sometimes to talk about even how they might do it- so they don’t have to act it out.”

The warning signs

Suicidal individuals usually give warning signs of their intentions. The trick is to recognize these warning signs and know how to respond when they happen. Alert friends, family members, teachers and even co-workers can play an important part in suicide prevention by listening objectively, pointing out the alternatives, showing care and concern, and even getting a doctor or psychologist involved.

Major warning signs for suicide can include talking about killing or harming oneself, writing about death or dying, and most importantly attempting to find anything that could be used facilitate a suicide attempt, such as poison, weapons, and drugs. The importance of these kinds of signals are even more serious in someone who suffers from a mood disorder such as depression or bipolar disorder, is alcohol dependent, has previously attempted suicide, or has a family history of suicide.

Studies have found that hopelessness is a strong predictor of suicide. People who feel hopeless may talk about “unbearable” feelings and say that they have nothing to look forward to, that the world is a hopeless place for them. Dramatic mood swings or sudden personality changes can also be warning signs. A suicidal person may also lose interest in day-to-day activities, neglect their appearance, and have extreme changes in diet or sleeping habits.

“These situations require some fierceness and some fearlessness,” says Dr. Holland. “Sometimes even I am afraid to ask. But I know that I must ask. Every session, every patient. Because talking about suicide and talking about wanting to die by suicide saves lives.”

Suicidal thoughts are scary. If you are feeling like you’ve had enough, but you’re afraid to tell anyone for fear of being seen as crazy, or misunderstood, it is time to talk about it. Or if you know someone who is struggling, and you are afraid that you’ll say the wrong thing, know that there is help available. Taking the risk and talking openly can save a life. Don’t put it off! Reach out today.

Article sources: World Health Organization, The HelpGuide


Dr. Jenny Holland, PsyD

Dr. Holland is a psychotherapist practicing in Sonoma County California, providing cutting edge, integrative and evidence-based mental health care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss, and caring for a parent or loved one during a health crisis or decline.

In-person and Online Video Counseling Services are now available. Short-term sessions, single sessions or ongoing support to meet your needs. Contact Dr. Holland to schedule an appointment at 707-479-2946.

College students experiencing depression, anxiety, loneliness at peak levels

depression and anxiety in young people continues to increase, now reaching its highest levels, a sign of the mounting stress factors due to the coronavirus pandemic, political unrest, and systemic racism and inequality

A survey by a Boston University researcher of nearly 33,000 college students across the country reveals the prevalence of depression and anxiety in young people continues to increase, now reaching its highest levels, a sign of the mounting stress factors due to the coronavirus pandemic, political unrest, and systemic racism and inequality.

“Half of students screened positive for depression and/or anxiety,” says Sarah Ketchen Lipson, a Boston University mental health researcher and a co-principal investigator of the nationwide survey published on Februray 11, 2021, which was administered online during the fall 2020 semester through the Healthy Minds Network. The survey further reveals that 83 percent of students said their mental health had negatively impacted their academic performance within the past month, and that two-thirds of college students are struggling with loneliness and feeling isolated — an all-time high prevalence that reflects the toll of the pandemic and the social distancing necessary to control it.

Lipson, a BU School of Public Health assistant professor of health law, policy, and management, says the survey’s findings underscore the need for university teaching staff and faculty to put mechanisms in place that can accommodate students’ mental health needs.

“Faculty need to be flexible with deadlines and remind students that their talent is not solely demonstrated by their ability to get a top grade during one challenging semester,” Lipson says.

She adds that instructors can protect students’ mental health by having class assignments due at 5 pm, rather than midnight or 9 am, times that Lipson says can encourage students to go to bed later and lose valuable sleep to meet those deadlines.

Especially in smaller classroom settings, where a student’s absence may be more noticeable than in larger lectures, instructors who notice someone missing classes should reach out to that student directly to ask how they are doing.

“Even in larger classes, where 1:1 outreach is more difficult, instructors can send classwide emails reinforcing the idea that they care about their students not just as learners but as people, and circulating information about campus resources for mental health and wellness,” Lipson says.

And, crucially, she says, instructors must bear in mind that the burden of mental health is not the same across all student demographics. “Students of color and low-income students are more likely to be grieving the loss of a loved one due to COVID,” Lipson says. They are also “more likely to be facing financial stress.” All of these factors can negatively impact mental health and academic performance in “profound ways,” she says.

At a higher level within colleges and universities, Lipson says, administrators should focus on providing students with mental health services that emphasize prevention, coping, and resilience. The fall 2020 survey data revealed a significant “treatment gap,” meaning that many students who screen positive for depression or anxiety are not receiving mental health services.

“Often students will only seek help when they find themselves in a mental health crisis, requiring more urgent resources,” Lipson says. “But how can we create systems to foster wellness before they reach that point?” She has a suggestion: “All students should receive mental health education, ideally as part of the required curriculum.”

It’s also important to note, she says, that rising mental health challenges are not unique to the college setting — instead, the survey findings are consistent with a broader trend of declining mental health in adolescents and young adults. “I think mental health is getting worse [across the US population], and on top of that we are now gathering more data on these trends than ever before,” Lipson says. “We know mental health stigma is going down, and that’s one of the biggest reasons we are able to collect better data. People are being more open, having more dialogue about it, and we’re able to better identify that people are struggling.”

The worsening mental health of Americans, more broadly, Lipson says, could be due to a confluence of factors: the pandemic, the impact of social media, and shifting societal values that are becoming more extrinsically motivated (a successful career, making more money, getting more followers and likes), rather than intrinsically motivated (being a good member of the community).

The crushing weight of historic financial pressures is an added burden. “Student debt is so stressful,” Lipson says. “You’re more predisposed to experiencing anxiety the more debt you have. And research indicates that suicidality is directly connected to financial well-being.”

With more than 22 million young people enrolled in US colleges and universities, “and with the traditional college years of life coinciding with the age of onset for lifetime mental illnesses,” Lipson stresses that higher education is a crucial setting where prevention and treatment can make a difference.

One potential bright spot from the survey was that the stigma around mental health continues to fade. The results reveal that 94 percent of students say that they wouldn’t judge someone for seeking out help for mental health, which Lipson says is an indicator that also correlates with those students being likely to seek out help themselves during a personal crisis (although, paradoxically, almost half of students say they perceive that others may think more poorly of them if they did seek help).

“We’re harsher on ourselves and more critical of ourselves than we are with other people — we call that perceived versus personal stigma,” Lipson says. “Students need to realize, your peers are not judging you.”

Read this article on ScienceDaily:Boston University. “Depression, anxiety, loneliness are peaking in college students.” www.sciencedaily.com/releases/2021/02/210219190939.htm


Therapy for Anxiety and Depression, PTSD, Trauma

In these situations, Dr. Holland can help you manage and prevent anxiety using the latest research-based methods to help you get results quickly, providing tools and strategies that work to bring you relief. With these practical tools, Dr. Holland can help you reduce your reliance on medications, if that is your goal. Anxiety, depression and panic are all very responsive to the treatment approaches that are available today. 

Contact Dr. Holland to get help with anxiety today.

Living with uncertainty, pain and compromised physical ability

Living with uncertainty, pain and compromised physical ability

Living with a chronic or life-threatening illness or injury takes a cumulative toll on a person’s emotional and mental health, whether it is lifelong asthma, diabetes, a cancer diagnosis, a disability, or organ failure. Similarly, a sudden injury can leave in its wake life-altering changes and daily struggles that permanently challenges a person’s sense of well-being. Emotional adjustment to life altering changes such as these can cause coping problems due to the chronic stress and uncertainty presented by facing the unknown or having to live with a chronic illness.

Dr. Jenny Holland PsyD was once diagnosed with Neuroendocrine cancer and is now a cancer survivor. She has lived with chronic pain her whole life due to Cerebral Palsy. These experiences give Dr. Holland a unique perspective and a deep understanding of what it is like to live with chronic illness and a life-threatening diagnosis. “As a cancer survivor, I enjoy working with others with cancer to improve quality-of-life while going through treatment, by addressing symptoms that may arise practically and imaginatively,”

Facing a serious diagnosis

When someone undergoes a life-altering health challenge, the immediate reaction can include tears, emotional outbursts, reaching out to loved ones for comfort, or perhaps denial as the newly diagnosed patient chooses to pretend that nothing has changed. Some people may feel emotionally numbed or feel ‘stuck’ as they are unable to process that life has suddenly changed beyond recognition. Some people take the opposite route and leap into action to tackle the health problem head on.

No matter what the reaction, it is important to remember there are no rules for how to respond, nor is there an expectation to what one might feel. Every person’s experience is unique so it is important to allow the process to unfold, and allow yourself to adjust to the situation. A serious health complication is disruptive by nature, and all aspects of what we may consider to be a ‘normal life’ may become challenged. Feelings associated with chronic or life-threatening illness such as cancer, or a major health event such as a stroke, heart attack, long-haul COVID symptoms, or a debilitating injury present challenges, and every individual’s reaction is unique.

You are not alone

There are steps that can be taken to support emotional health during times of crisis and therapies that are designed to help patients cope, and eventually thrive. These therapies can help to ease the stress and anxiety that often accompany serious illness. Working with a trained therapist can help you discover ways to navigate a challenging life situation.

“Living with uncertainty, pain, and compromised physical ability takes a cumulative toll. My practice is process and solution-focused with outcomes aimed at symptom reduction and increased joy,” explains Dr. Holland. “I use a combination of therapeutic approaches and techniques to help patients successfully make the changes they most want to see in themselves. I am here to help.”

Dr. Holland is a psychotherapist providing cutting edge, integrative and evidence-based mental health care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss, and caring for a parent or loved one during a health crisis or decline. She is available for Teletherapy – Online Video Counseling Services — Short-term sessions, single sessions or ongoing support as well as in-person appointment for fully vaccinated clients. Contact Dr. Holland to schedule an appointment at 707-479-2946.

Pets improve mental health and reduce loneliness amid COVID stressors

Owning a Pet Shown to Relieve Stresses Caused by COVID Restrictions

Sharing a home with a pet appeared to act as a buffer against psychological stress during lock-down, a new survey shows. Most people who took part in the research perceived their pets to be a source of considerable support during the lock down period. The study (UK) -- found that having a pet was linked to maintaining better mental health and reducing loneliness. Around 90 per cent of the 6,000 participants had at least one pet. The strength of the human-animal bond did not differ significantly between species with the most common pets being cats and dogs followed by small mammals and fish.

More than 90 per cent of respondents said their pet helped them cope emotionally with the lockdown and 96 per cent said their pet helped keep them fit and active. However, 68 per cent of pet owners reported having been worried about their animals during lock-down, for example due to restrictions on access to veterinary care and exercise or because they wouldn't know who would look after their pet if they fell ill.

Lead researcher, Dr Elena Ratschen from the Department of Health Sciences University of York said: "Findings from this study also demonstrated potential links between people's mental health and the emotional bonds they form with their pets: measures of the strength of the human-animal bond were higher among people who reported lower scores for mental health-related outcomes at baseline. We also discovered that in this study, the strength of the emotional bond with pets did not statistically differ by animal species, meaning that people in our sample felt on average as emotionally close to, for example, their guinea pig as they felt to their dog. It will be important to ensure that pet owners are appropriately supported in caring for their pet during the pandemic."

Co-author, Professor Daniel Mills said: "This work is particularly important at the current time as it indicates how having a companion animal in your home can buffer against some of the psychological stress associated with lock-down. However, it is important that everyone appreciates their pet's needs too, as our other work shows failing to meet these can have a detrimental effect for both people and their pets."

Dr Ratschen added: "While our study showed that having a pet may mitigate some of the detrimental psychological effects of the Covid-19 lock-down, it is important to understand that this finding is unlikely to be of clinical significance and does not warrant any suggestion that people should acquire pets to protect their mental health during the pandemic."

More than 85 million households are estimated to own at least one pet in the U.S.

The study also showed that the most popular interaction with animals that were not pets was bird watching. Almost 55 per cent of people surveyed reported watching and feeding birds in their garden.

READ this article on Science Daily: "Pets linked to maintaining better mental health and reducing loneliness during lock down, new research shows." ScienceDaily, 26 September 2020. www.sciencedaily.com/releases/2020/09/200926145210.htm.


Dr. Holland & Olive

"Pets, especially dogs and cats, have been proven in studies to reduce stress, anxiety, and depression and ease loneliness. Pets naturally encourage exercise and renew a sense of playfulness in pet owners. Some studies clearly show that owing a pet can improve your cardiovascular health. Psychological studies show that caring for an animal can help children grow up feeling more secure while increasing their likelihood of staying active. As I well know, pets also provide valuable companionship for adults of all ages. For me, interacting with my new canine companion Olive brings a real sense of joy and unconditional love that goes both ways."

While we individually and collectively continue to navigate social restrictions imposed by COVID , it is important for everyone’s mental health and emotional well-being to find new, healthy ways to maintain social connections. Virtual communication including phones and video chats with friends and family can help alleviate feelings of loneliness and isolation. And when people find it too difficult to maintain a positive sense of well-being, reaching out to a mental health professional can help. Dr. Holland offers Teletherapy to fit individual needs including; short-term sessions, single sessions or ongoing support. Contact Dr. Holland for more information and to help get you on the path to feeling better. Or call 707-479-2946 to schedule a telehealth video therapy session.

Researchers seek to change behavior by normalizing diversity

"Promoting inclusion and dismantling systemic racism is one of the most important issues of our times."

Scroll Down for Dr. Holland's Perspective on this article

Showing people how their peers feel about diversity in their community can make their actions more inclusive, make members of marginalized groups feel more like they belong, and even help close racial achievement gaps in education, according to a new study. Drawing on strategies that have worked in anti-smoking, safe-sex and energy-saving campaigns, University of Wisconsin-Madison researchers decided to try to change behavior by showing people that positive feelings about diversity are the norm.

"In any other domain of public health -- saving for retirement, sustainability, eating healthy -- it's the key thing to communicate: It's the right thing to do, your peers do it, and your peers would actually approve of you doing it as well," says Markus Brauer, the UW-Madison psychology professor whose lab designed the pro-diversity intervention. It's an effect that's reflected in attitudes about ongoing protests over Black people killed by police officers. Exposed to larger crowds, more frequent news coverage and the opinions of friends and neighbors, more people have expressed support for Black Lives Matter groups and activities.

"People are heavily influenced by finding out what their peers have done," Brauer says. "But in the diversity domain, we haven't been trying this." The researchers, who published their findings today in the journal Nature Human Behaviour, conducted extensive focus groups with UW-Madison students. "We asked them -- students of color and white students, students of the LGBT+ community: What actually is it that decreases your sense of belonging? What are the kinds of behaviors that hurt your feelings, that make you feel excluded?" Brauer says. "And then please tell us, what are the behaviors that would make you feel welcome?"

The non-white students felt like they were kept at a distance from white students -- not included in class groups or projects, not included in activities, not invited to participate in simple interactions. "When we asked about what decreased their sense of belonging, they didn't complain so much about racial slurs or explicit forms of discrimination," says Brauer. "It was the distance, the lack of interest, the lack of caring that affected them."

Brauer, graduate student Mitchell Campbell, and Sohad Murrar, a former graduate student of Brauer's who is now a psychology professor at Governors State University in Illinois, used what they learned to choose their messages. "We used a social marketing approach, where we identify a target audience, we decide what our target behavior is, and then we show people how their peers support that behavior," Brauer says. They designed a relatively simple poster, covered in students' faces and reporting actual survey results -- that 93 percent of students say they "embrace diversity and welcome people from all backgrounds into our UW-Madison community," and that 84 percent of them agreed to be pictured on the poster. They also produced a five-minute video, which described the pro-diversity opinions reported by large majorities in other campus surveys and showed real students answering questions about tolerance and inclusion.

In a series of experiments over several years, hundreds of students were exposed passively to the posters in brief encounters in study waiting rooms or hung day after day on the walls of their classrooms. In other experiments, the video was shown to an entire class during their first meeting. Control groups came and went from waiting rooms and classroom with no posters, or watched videos about cranberry production, or other alternatives to the study materials. Then the researchers surveyed subjects to assess their attitudes about appreciation for diversity, attitudes toward people of color, intergroup anxiety, their peers' behaviors and other measures.

"When we measured 10 or 12 weeks later, the students who were exposed to the interventions report more positive attitudes towards members of other groups and stronger endorsement of diversity," Brauer says. The differences for students from marginalized groups went further. "The students belonging to marginalized groups tell us that they have an enhanced sense of belonging. They are less anxious in interactions with students from other ethnic groups. They tell us that they're less and less the target of discrimination," Brauer says. "They evaluate the classroom climate more positively, and feel that they are treated more respectfully by their classmates."

The researchers tested the effectiveness of their diversity intervention in a series of UW-Madison courses in which white students have historically received better grades than their non-white peers. In course sections that viewed the 5-minute video during their first meeting -- classes including more than 300 students -- the privileged and marginalized students' grades were equal in the end.

"We know the marginalized students experience discrimination; we know their feelings are valid. But we know, too, from the campus climate surveys and our own extensive surveys, that their fellow students report real appreciation for diversity, and tell us that they want to be inclusive," Brauer says. "They stay socially distant, though, because they worry about putting themselves out there. Our experience is that this intervention is changing those perceptions and experiences, and possibly the behavior, of both groups."

It may be the first result of its kind for such a long-running study with so many participants, and the researchers are hopeful that future work will help better reveal whether students actually change the way they treat each other.

"Promoting inclusion and dismantling systemic racism is one of the most important issues of our times. And yet, it turns out that many pro-diversity initiatives are not being evaluated," says Brauer, whose work was supported in part by funding from the office of UW-Madison's vice provost and chief diversity officer. "We really need evidence-based practices, but for a long time we've had no idea whether the things we do in the diversity domain actually have a beneficial effect. We're hoping to change that."


Read this article on Science Daily: University of Wisconsin-Madison. "Showing pro-diversity feelings are the norm makes individuals more tolerant." ScienceDaily. ScienceDaily, 1 July 2020. www.sciencedaily.com/releases/2020/07/200701125448.htm.


Dr. Holland's Perspective

Researchers are only beginning to delve into the psychology of racial stressors.  As a longtime activist I know that conversations about racism, inclusion and cultural bias are long overdue and something we have neglected to confront in meaningful ways. It will take time to bring racial inclusion to a common ground where we can all flourish and grow.

People experience discrimination in different ways, and struggling with this issue can manifest as anxiety, depression, feelings of emotional vulnerability and a full spectrum of emotional and psychological stresses. The bottom line is we all have a right to be healthy, and that includes mental health.

Teletherapy Available - Short-term sessions, single sessions or ongoing support

Contact Dr. Holland for more information and for help, or call 707-479-2946 to schedule a telehealth video therapy session.

 

Video Conference Therapy During Difficult Times

Distance therapy helps to address the stay-at-home trend during flu outbreak

Distance therapy helps to address the stay-at-home trend during flu outbreak

Dr. Holland has offered phone and video conferencing therapy options for patients for some time, and with the rising concerns surrounding the coronavirus, these types of therapy sessions are more relevant than ever.

“Distance therapy using the phone or an online video conferencing system such as FaceTime has long been a good option for my clients who have access issues due to lack of transportation, health or time constraints. And, some clients simply find it more appealing to hold a session outside of an office environment.” Dr. Holland explains. “Now, with the widespread concern over the coronavirus, online therapy is a great way to stay connected with my clients, and a terrific option for new clients that don’t want to put off getting the help they need.” Therapy sessions are one-on-one and individually tailored to the client’s needs.

What is required for online conferencing? New clients will need to go through a screening process that begins with a free 15-minute phone consultation with Dr. Holland. Once the screening process is complete, clients simply need to have access to a reliable computer with a webcam, a smartphone or a tablet equipped with camera and mic. After the appointment is confirmed, Dr. Holland will send a link to the video conference that is used to access the therapist’s private online office room.

Additional Information

As with any new therapy system, it’s a good idea to research and understand the benefits and limits of this form of technology before signing up for a session. It is important to have access to a computer or mobile device with a webcam, a good microphone as well as up-to-date antivirus software and a personal firewall. Clients will also need access to a private space where they will not be overheard. It's also good to create a space that is free from distractions that could interrupt the session such as phone calls, emails, other people or pets in the area.

Please bear in mind that this program is not meant to replace crisis services or hospitalization. New clients who are a good fit for this program are typically eager to get help, they are stable, and they are open to receiving information and guidance for symptom relief.

Please start by booking a free 15-minute phone consultation with Dr. Holland.

 

 

Cancer patient caregivers deal with significant impact to emotional health

Researchers conclude that caregivers for older patients with advanced cancer are a vulnerable group

The number of informal caregivers who look after older adults with cancer is on the rise. Caregivers could be relatives, partners, or even friends who provide assistance to people in order to help them function. Most older people with cancer live at home and are dependent on informal caregivers for support with their cancer treatment, symptom management, and daily activities. Caregiving itself can also take a toll on a caregiver's own physical and emotional well-being, which makes it important to ensure the proper supports are in place.

Until now, no large study has evaluated whether or not caring for older adults with advanced cancer is linked to caregivers' emotional health or to their quality of life. Recently, researchers studied a group of adults aged 70 or older who had advanced cancer (as well as other challenges). This study used information from older patients with advanced cancer and their caregivers from local oncology practices enrolled in the "Improving Communication in Older Cancer Patients and Their Caregivers" study conducted through the University of Rochester National Cancer Institute Community Oncology Research Program Research Base between October 2014 and April 2017. Results from the study were published in the Journal of the American Geriatrics Society.

Cancer patient caregivers deal with impact to emotional and physical health

The researchers learned that the health problems of older patients with cancer were linked to a poorer quality of life for their caregivers, including poorer emotional health. This fact is confirmed by many other studies, which show that caregivers may even experience more emotional health challenges (such as anxiety, depression, and distress) than the people they care for, the researchers added. What's more, poorer patient health (measured by a geriatric assessment) was also associated with higher levels of caregiver distress.

The average caregiver in the study was 66 years old, though 49 percent of the caregivers were aged 70 or older. The majority of caregivers were female and white (non-Hispanic), and 67 percent were the patient's spouse or partner who lived with them. Close to 40 percent of the caregivers had serious chronic illnesses of their own. Nearly half (43.5 percent) said they experienced moderate to high distress, 19 percent reported having symptoms of depression, and 24 percent were anxious.

Interestingly, older caregiver experienced less anxiety and depression and better mental health, said the researchers. However, they were in poorer physical health. Being female was associated with experiencing less distress. An income of more than $50,000 a year also was linked to having better physical and mental health.

The researchers concluded that caregivers for older patients with advanced cancer are a vulnerable group. Thankfully, there are strategies caregivers can incorporate into their routines to help keep their own health and well-being top-of-mind. Talk with a healthcare provider about your own stress related to caregiving. If you prefer, you can ask to talk privately, without the person you care for present. Your healthcare provider may suggest ways to address the burdens you may experience with caregiving. There are strategies that have been found to help with specific tasks and challenges, decrease caregiver stress, and improve quality of life. You can learn more -- and take a free and private assessment of caregiver health -- at HealthinAging.org.

Story Source: Article provided by Science Daily ---> American Geriatrics Society. "Caring for an older adult with cancer comes with emotional challenges for caregivers, too." ScienceDaily,  www.sciencedaily.com/releases/2019/04/190402124355.htm.


Dr. Jenny HollandAccording to the AARP as many as 43.5 million Americans provide unpaid care for an adult or child. It's extremely important that caregivers pay attention to and honor their own needs. Without self-care in mind caregivers risk burning out and becoming unable to care for their loved ones. In fact, one of the most reported factors in a family’s decision to move an ailing relative to a long-term care facility is the caregiver’s own failing physical and emotional health.

Long-term caregivers are also vulnerable to something called compassion fatigue. When this occurs caregivers may experience symptoms including; exhaustion, trouble sleep, increased anxiety, frequent headaches and stomach upset. When irritability, numbness, loss of purpose and emotional disconnection sets in the caregiver may also experience problems with their own personal relationships and suffer health issues. Finding a balance between the needs of family and self is key for caregivers to remain healthy in mind and body. It's important for family caregivers to reach out for help when they need it to create a plan for maintaining health, including tending to their own medical concerns and taking respite from their roles.

Dr. Holland works with caregivers suffering from overwhelm, burnout and caregiver fatigue. She helps clients to creatively work with the situation to discover a renewed sense of meaning and purpose, as well as important ways to stay healthy. Dr. Holland will help you learn how to help yourself so you can continue to do the work you love of helping others. Call 707-479-2946 to schedule a free consultation today.

Pain and Gratitude

Blogging with Dr. Jenny Holland, PsyD

The Dubious Connection between Physical Pain and Depression 

As a psychologist I understand that pain and depression are closely related. Pain can be a two-edged sword, and studies have shown that depression can cause pain just as pain can cause depression. Sometimes this kind of cycle of pain and depression or feeling low, can wear us down, create added stress and interfere with our lives and disturb sleeping patterns. To get symptoms of pain and depression under control, it’s important to take proactive steps to keep yourself on an even keel.

My Own Experience

Though I don’t often talk about it, I live with physical pain every day. When the weather is cold and damp, life becomes even more challenging. This past month has been particularly intense in this way. As such, I notice my own thoughts automatically drifting toward the negative. The mental list of things that are difficult or ‘wrong’ tabulate in my mind without effort. And I understand that the weather will probably be getting worse for the next couple of weeks, at least. As a way to tackle my own discomfort and to lift myself out of the cycle of pain and depression I thought I would blog about gratitude and how this practice has helped me.

The Study of Gratitude

In recent years, the study of how a simple action such as practicing gratitude can boost happiness and alleviate depression has gained attention and momentum among psychologists and mental health professionals all over the world. Scientists say that these techniques shift our thinking from negative ruminations to positive outcomes. Gratitude practice has been shown to produce a surge of feel-good hormones like dopamine, serotonin and oxytocin, and helps to build enduring personal connections.

Count Your Blessings

Many people find putting pen to paper to compile a gratitude list, or to start a gratitude journal provides a sort of ritual experience that lets us focus on the positive events of the day. As we journal, we can write more detail about the events that make us feel appreciative. When I put some energy into focusing on my own situation and turning my thoughts toward what is right about my life, I can begin to build a list of items that I appreciate such as:

  • I am grateful for my children and my husband. Adam and I have been together almost 25 years! That’s almost half of my life now.
  • I am grateful I am healthy and that those that I love are healthy.
  • I am grateful to have a few lifelong friends that support me, always.
  • I am grateful for my Jewish Communities.
  • I am grateful to have a job that allows me to be with people in meaningful and hopefully, in helpful ways

Expanding Gratitude into Work

Showing up and doing what I can do to help make a difference has a strong impact on my experience of pain and helps me to maintain an active, rather than a passive focus. About a year ago, I took a big leap and launched a private pay practice. Today it is thriving, and I am re-invigorated. In addition to seeing individuals, I have started a professional consultation group that is going well.  I also currently run a grief group, and I am starting groups for people with disabilities and their families. I will be traveling a bit in the next few months to spread the word about a book that is coming out in March in which I am a contributor. Fury: Women’s Lived Experiences of the Trump Era. I also started a book club this year that is feisty and fun. And on my favorite weeks, I get to do a little singing with my friends at Ner Shalom.

Gratitude is an Effort Worth Making

To count our blessings or to focus on the positive when dealing with pain, depression and/or anxiety is challenging for everyone and it takes a conscious effort. However, when we adopt the practice of gratitude as a daily habit it can become an important routine and step towards self-empowerment.

Get Started with Your Own Gratitude Practice

Journaling is probably the easiest gratitude enhancing practice we can undertake. Creating a gratitude journal can be as simple as buying a blank notebook and writing down a few things you’re grateful for each night before going to bed. You can enhance your journaling experience by turning it into a ritual such as first lighting a candle, making yourself a cup of tea, sitting quietly for five minutes before you begin, etc. Whatever you choose as a ritual, do it consistently. It strengthens the ability to turn what you’re doing into a positive habit. Anything fun and relaxing, will give you motivation to form a new habit.

 

Parental coaching can help kids navigate peer rejection, bullying and conflict

Parents can offer support and advice to youth as they navigate social challenges

During early adolescence, especially the transition to middle school, kids face a number of challenges both socially and academically. Peer rejection, bullying, and conflict with friends are common social stressors. These challenges can affect adolescents' ability to form positive peer relationships, a key developmental task for this age group. Parents can act as social "coaches," offering support and advice to youth as they navigate these challenges by offering specific suggestions for facing challenges head-on or by encouraging kids' autonomy, to "figure it out" on their own. University of Illinois researchers are finding that not all kids benefit from the same types of parental coaching because kids respond to stress differently.

In a recent study, published in the Journal of Applied Developmental Psychology, researchers report on the connection between how mothers advise their children to respond to specific peer stress scenarios and youth stress responses during conversations about real peer experiences. They also identify what mothers do or say that is particularly helpful in facilitating youth adjustment and well-being in the face of these stressors. "As we're thinking about the transition to middle school, we're looking at the extent to which mothers are encouraging their child to use active, engaged coping strategies, such as problem solving, help-seeking, or reframing or thinking about the situation in less threatening or negative ways," says Kelly Tu, assistant professor of human development and family studies at U of I.

The study also looks at how mothers may recognize that their children are transitioning into adolescence and looking for more autonomy and independence. "We wanted to examine the extent to which mothers are taking a step back, saying, 'I'm going to let you handle this in your own way -- what you think is best or what works for you,'" Tu says. Mothers and youth in the study participated during the transition from fifth grade to sixth grade. Mothers were given hypothetical peer stress scenarios such as peer exclusion, peer victimization or bullying, and anxiety about meeting new peers, as well as a variety of coping suggestions. Mothers were asked to report on how they would typically advise their child to respond.

Researchers also observed conversations between youth and their mothers about real peer stress situations. Common topics that were discussed included being around kids who are rude, having problems with a friend, and being bullied, teased, or hassled by other kids. During the conversations, researchers measured skin conductance level -- the electrical activity happening in the skin as part of the physiological "fight or flight" stress response system -- from youth's hands. "We assessed youths' physiological arousal during these problem-solving discussions to examine how the different levels of reactivity may indicate different needs of the adolescent," Tu explains.

For instance, greater reactivity during the conversations may reflect youths' higher levels of physiological arousal or anxiety in recalling that stressful experience and talking it through with the mother. Whereas less reactivity during the problem-solving conversation might serve as an indicator of youths' insensitivity to the stressful experience. And these different response patterns may require different parenting approaches. "We found that mothers' active, engaged coping suggestions were more beneficial for low reactive youth. Low reactive youth may not be attending to cues in these conversations about stressful or challenging peer experiences, and so they may behave in ways that are unexpected, non-normative, or inappropriate. But when parents give them specific advice for how to manage challenging peer situations, this appears to be helpful," Tu says. However, the same active, engaged approached predicted worse adjustment for kids exhibiting higher arousal. "Instead, self-reliant suggestions actually predicted better adjustment for these kids," Tu explains.

"These findings are interesting because this suggests that a multi-step process might work best for kids who are exhibiting high physiological arousal related to peer problems. If you're anxious or stressed, and your parent is telling you to face the problem head on, that might actually create more anxiety. But when a parent gives a highly aroused youth more autonomy about how to cope with the peer stressor, this seems to be more beneficial because parents are giving them more space and time to work through the situation in their own way," Tu says. Thus, parents may want to consider the match of their coping suggestions with adolescents' stress reactivity.


This article provided by Science Daily: University of Illinois College of Agricultural, Consumer and Environmental Sciences. "Parental coaching adolescents through peer stress."ScienceDaily, 18 December 2019. www.sciencedaily.com/releases/2019/12/191218153402.htm.


Dr. Jenny HollandThere are situations that arise for every child - spanning infancy to adolescence, that benefit from a parents’ ability to acknowledge the worthiness of the child's feelings. To be the loving, compassionate and unflappable parent requires the ability to manage your own feelings and frustrations. Over the years studies have pointed out that the best-adjusted children are nurtured by parents who find a way to combine warmth and sensitivity with clear behavioral expectations.

Dr. Holland has been in private practice for more than 17 years, helping patients to reach new levels of self-understanding and emotional well-being.  Dr. Holland will customize treatment to meet your specific needs. Contact Dr. Holland to learn more and to schedule an appointment, or call 707-479-2946.

 

Caregiver study focuses on the challenges of caring for a partner

Caregivers need to consider their own health as important as their spouse

Study participants had levels of depression symptoms serious enough to suggest a need for treatment

When they said their wedding vows, many of them promised to stand by one another in sickness and in health. But a new study suggests that as married couples age and develop chronic conditions, the daily demands of coping with their own health demands and those of their spouse may take a mental toll.

Depression symptoms increased over time among married men and women who themselves had two or more chronic conditions that need different types of self-care -- such as a special diet and medications for heart disease or diabetes along with pain-reducing therapy for arthritis. When husbands and wives both had chronic health conditions, and needed different kinds of self-care from their partners, husbands fared worse. Their depression symptoms were significantly higher, but this effect was not found for wives.

The new findings, made by a team from the University of Michigan using data from a long-term study of more than 1,110 older opposite-sex married couples from 2006 to 2014, are published in Journals of Gerontology Series B: Psychological Sciences and Social Sciences. While less than 10% of the women and less than 7% of the men in the study had levels of depression symptoms serious enough to suggest a need for treatment, lower-level depression is important for older people, clinicians, caregivers and adult children to understand, says Courtney Polenick, Ph.D., who led the study.

In both husbands and wives, the rise of depressive symptoms didn't begin until a few years after the first assessment of their health and well-being. "Our results suggest that there's a window where, if one or both of you are managing complex conditions that don't have similar self-management goals, it may be possible to intervene and prevent the development or worsening of depression," says Polenick, who is part of the U-M Department of Psychiatry and Institute for Social Research. "This might be the time for couples, and those who care for them, to emphasize broadly beneficial lifestyle behaviors that help to maintain both mental and physical health."

For instance, a woman coping with both high blood pressure and arthritis needs to make changes to her exercise routine, but her husband without such conditions could commit to making those changes along with her. Or a wife with diabetes who does most of the cooking and has a husband with prostate cancer could adopt a healthier menu for both of them. Polenick and her colleagues from U-M's Institute for Healthcare Policy and Innovation looked at data from the Health and Retirement Study, which repeatedly interviews and surveys thousands of American adults in their 50s and beyond over time.
They focused on conditions that have similar treatment goals focused on reducing cardiovascular risk -- diabetes, heart disease, hypertension and stoke -- and those with treatment goals and needs that are different from each of the other conditions- cancer, arthritis and lung disease.

When one person in the couple had at least one condition with different treatment goals and needs, they're considered to have "discordant" conditions. When one member of a couple had at least one condition that has different treatment goals and needs from the other partner, the couple is considered to have discordant conditions. "Research has focused on how individuals with multiple conditions, also called multimorbidity, manage their chronic health needs," says Polenick. "But most people in later life are partnered, with similar health-related habits, and we need to understand how changing health affects the couple dynamic." The fact that both wives and husbands experienced significant increases in depressive symptoms as the years passed, when they were coping with discordant conditions in themselves, is by itself important to understand, Polenick notes. But the fact that wives whose husbands' health needs differed from their own didn't experience an even greater rise in depression is a bit surprising, she adds.

Meanwhile, husbands whose conditions had self-care needs that were different from their wives' conditions did experience an additional rise in depression symptoms. Among individuals who are baby boomers or older, wives may be more used to taking the lead in caring for the health and emotional well-being of both themselves and their husbands, she says. But when husbands have wives who are coping with different health demands than their own, the husbands may experience less of this support than usual, worsening their stress and mental health.

Polenick and her colleagues continue to explore these intra-couple dynamics, and their consequences for mental and physical health. They also hope to expand the range of chronic health conditions they examine, and to look at shorter time frames in conditions that can be managed with lifestyle changes. But in the meantime, she notes that middle-aged and older couples may want to do more now to understand the factors that they can control as they age, and those they cannot, and talk about how they feel as a result.

"This is a reminder to step back and look at what your partner is coping with, to learn about their health conditions, to be conscious of it on a daily basis, and for grown children and clinicians to do the same," she says. "Having that awareness, and helping one another manage health problems while watching for signs of depression, may help both members of a couple over time."


Story Source: Content provided by Science Daily and Michigan Medicine - University of Michigan. "In sickness and in health: Study looks at how married couples face chronic conditions." ScienceDaily. ScienceDaily, 3 December 2019. www.sciencedaily.com/releases/2019/12/191203104756.htm.


Dr. Jenny Holland
Dr. Holland

Caregivers often report feelings of exhaustion and overwhelm. While caring for a loved one can be very rewarding, it also comes with distinct elements of stress. When dealing with a long-term challenge it's extremely important to also provide for your own emotional and physical well-being. When the challenges associated with care giving are not taken into consideration the caregiver's physical health, relationships and mental health can deteriorate over time — eventually leading to burnout and exhaustion. And when it reaches that point, both the caregiver and the person being cared for suffer. Caring for yourself is equally if not more important as making sure your family member gets to their doctor’s appointment or takes their medication on time.

Focused Therapy for Caregivers

If you are having trouble with accepting or adjusting to life's challenges, Dr. Holland can help you find healthy ways of coping. The simple act of expressing what you’re going through can be very cathartic. Dr. Holland will tailor treatment to meet your specific needs. Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.