By Douglas Newton, LMFT

Over the past several years, stigma around seeking help for depression, anxiety and other mental health issues has decreased.  And yet.  Partly because of the way depression leads many to self-criticize, many often think that depression is a stain, a black mark against their character, something wrong with them.  

It is time to disentangle depression from this idea of moral failure.  It is time to stop imagining that depression is synonymous with a person’s character.  

What are the general symptoms of depression?

If you experience depression, you have symptoms that occur with that experience.  These can include sadness, stress, anxiety, sleep issues, negative self-talk, low motivation, feelings of hopelessness and failure to take pleasure in everyday activities, or anhedonia.  For severe depression, self-harm and suicidal thoughts can also occur.  

These symptoms help clinicians like me understand your experience.  No one chooses to experience depression.  And confusion around where it comes from can lead to self-criticism, self-blame, shame and isolation.  These factors can make depression worse, and shut someone down emotionally, which can exacerbate depression.

Thankfully there are many approaches to help people who experience depression find relief.  

What will people think of me if they know I am depressed?  What are some stigmas of depression?

Many public figures, most recently Senator John Fetterman, have decided to disclose that they are dealing with depression.  According to this article in the New York Times (gift article that doesn’t require subscription), “Social scientists say there is demonstrable evidence that the public is growing more accepting of people with depression.”  Relatedly, more people recognize the usefulness of seeking help when they experience anxiety, depression or other issues.  

What if depression is just who I am? 

When you are experiencing depression, it can feel like your entire experience.  It can eclipse your sense of self, or even come to feel like your identity.  Disentangling your self-concept from depression is one fundamental step in therapy to help recognize depression as mental illness rather than identity.  Therapy helps you distinguish between depression and your identity.

You are not alone

Millions of people experience depression, with onset resulting from a wide range of interrelated factors.  People from all walks of life experience depression and many of them find a fresh approach to their lives through therapy.  While your experience with depression is unique to you, the symptoms are not, and there are many ways to help.  

It takes courage and humility to recognize you need help and then make the call. Therapy is private, confidential, informed and professional, creating a safe place to address and treat your depression 

SF Stress therapists have deep experience treating depression

Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) are among the effective, evidence-based treatments therapists use.  Research shows that therapy helps people diminish the severity and frequency of their symptoms related to depression.  

Getting help to treat your depression is an act of self respect.  It is a decision to take care of yourself, and an assertion that you matter.  For many people with depression, seeking help can be undermined by depression itself.  Making that call can help.  

Further Reading:

National Institutes of Mental Health on Depression

American Psychiatric Association on Depression

World Health Organization on Depression

‘Working with your inner child’ might sound a bit out there. But it is actually a psychotherapeutic concept that originated with Jung, and many therapists use it to help their clients.

The “inner child” is part of your subconscious that has been picking up messages long before your mind was able to understand them (mentally and emotionally). In addition to holding memories and beliefs from the past, it also holds hopes and dreams for the future. Healing and connecting with our inner child can be a powerful and important way to support our emotional and psychological well-being. 

Why is Inner Child Work Important?

Inner child work focuses on addressing our unmet needs by reparenting ourselves. This kind of self-discovery helps us understand our behaviors, triggers, wants, and needs. When we begin inner child healing work, we tap into a part of ourselves that is vulnerable and impressionable.

Yes, it can seem odd to be ‘talking’ to the ‘child within,’ but the benefits are impressive. They include: 

• accessing repressed memories that are holding you back. 
• being able to feel again after years of being numb. 
• gaining personal power and the ability to set boundaries. 
• learning how to take better care of yourself. 
• feeling self-compassion and liking yourself more. 
• being able to enjoy life and have fun again.
• gaining self-confidence.

It is our inner child who remembers the joy, innocence, freedom, and playfulness of childhood. It also holds our hurts, traumas, and emotional wounds. The more we connect with and heal our inner child, the more compassionate and understanding our relationship with ourselves can become. To help you tap into and heal your inner child, here are a few simple exercises.

Acknowledge your inner child

Acknowledging that you have an inner child is the first step toward connecting with it. We may think of this part of us as a child, or we may not. There may be a vivid image in your head of your inner child, or there may be none at all. There may be a strong sense that you know who this part is, or there may be no clue. Developing a relationship with your inner child takes time, and you should check in with yourself regularly to see how it’s going. If you are not sure if you have an inner child, here are some questions you can ask yourself to check in with this part of you. 

• What words would you use to describe yourself as a child? 
• What emotions do you remember feeling as a child? 
• What do you remember enjoying as a child?
• What do you remember wishing for as a child?

Create a safe space for your Inner child

Having acknowledged the existence of your inner child and an idea of what this part of you looks like, create a safe space for it. Taking some time to breathe and observing yourself can help you sense your inner child’s presence. If you sense your child, you can visualize yourself placing your child in a safe, secure place. In your arms, in the space around you, wherever feels safe to you, you can place this child. You can also imagine yourself in a safe, secure space.

Write a letter to your inner child

Once you have created a safe space for your inner child, you can write a letter to yourself. It can be a wonderful way to develop a relationship with this part of yourself. You could write about anything you wish to communicate to your child. You can write with your adult self and your child self both in your mind, or you can choose to write with one or the other. There is no right or wrong way to write this letter. No matter how much or how little you write, you can do it in whatever way feels right to you. 

Self-Love and Self-Compassion

The final step to bringing all of these things together is to establish a loving and compassionate relationship with your adult self. You can offer your inner child all the love and compassion you need from this point. It is possible for you to provide your inner child with support, kindness, and guidance. Imagine giving your inner child everything you wish you had received as a child. Whether that is positive experiences, skills, or knowledge. 

Conclusion

Healing your inner child can be an incredibly powerful and transformative process. It can help you to heal past wounds, find more self-compassion, and create a more compassionate and understanding relationship with your inner self. The process of connecting with and healing yourself can be as individual as you are. There is no right way to go about this, and it can take as long as it needs to take. There is no time limit for healing, and you do not have to do all of these exercises at once if you don’t feel ready. You can work on connecting with and healing yourself anyway that feels right for you.

Do you…

Feel overwhelmed by intense emotions?

Have behaviors that you want to change?

Do you use food and/or alcohol to cope?

Do you have impulsive or reactive behaviors?

Do you find it difficult to maintain relationships?

Would you like to create a life worth living?

If you answered “yes” to any of these questions, or if you have other concerns about your emotional well-being, then DBT may be helpful to you. 

What Is Dialectical Behavioral Therapy (DBT)?

Dialectical Behavior Therapy aims to find balance and get unstuck from extremes using behavioral-based talk therapy. The D in DBT stands for Dialectics, which means synthesizing or integrating opposite ideas, thoughts, or behaviors. A key goal of DBT is to cultivate acceptance and balance in the world around us by finding the truth in opposing forces. By cultivating balance and acceptance, we decrease suffering and increase acceptance for ourselves and others. DBT is focused on not only creating a life worth living but also a life worth loving.

Through Dialectical Behavior Therapy, we learn to accept thoughts and feelings without judgment while letting go of our past and future so we can live in the present. By focusing on the present, we are able to control and regulate our emotions, resulting in better balance and healthier relationships.

Marsha Linehan created DBT to treat clients who had not responded to other types of therapy. Evidence supports the use of DBT with a wide range of disorders, including borderline personality disorder, anxiety, bulimia, PTSD, substance abuse, bipolar disorder, and many other mental disorders.

What Is Wise Mind?

It is impossible to understand DBT without addressing the three states of mind. The three states of mind are (according to DBT): Reasonable Mind, Emotional Mind, and Wise Mind.

Reasonable mind refers to our rational and intellectual mind; it is the mind that focuses on facts and logic to solve problems. Reasonable mind is beneficial in many ways. Having a reasonable mind helps us solve complex problems, but when we focus exclusively on them, we ignore the importance of our values and emotions.

The opposite of a reasonable mind is an emotional mind. In this mind, you are only motivated by emotions, disregarding logic and reason completely. In the absence of an emotional mind, we would not be able to understand our emotions or how they affect our behaviors and thoughts. Additionally, we would be unable to feel positive emotions such as happiness and love. On the other hand, by focusing only on the emotional mind, we ignore facts and logic, affecting our ability to make effective and adaptive decisions.

A Wise Mind combines both of these minds and values both emotion and reason equally. Our wise mind allows us to make decisions based on reason and values at the same time. In addition, a wise mind allows us to experience emotions (even strong ones) as they arise and pass.

The Four Modules of DBT

DBT has four main modules of skills: Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. Let’s discuss each skill:

Mindfulness – Learning to be present-focused and nonjudgmental of ourselves and others.

In order to practice mindfulness, you must learn how and what it is, be mindful of your current emotions and thoughts, and cultivate love and kindness towards yourself and others.

One way to practice mindfulness in our daily lives is to walk mindfully (observing your surroundings and being present in the moment) or do a task mindfully (one-mindfulness – not multitasking but focusing on one task at a time).

Distress Tolerance – Learning how to tolerate stress and negative emotions when they arise so that they do not become paralyzing It is through Distress Tolerance (DT) skills that we can put space between the event/emotion and ourselves, allowing us to decompress and return to the situation with a wise mind rather than one ruled by emotions. One such skill is STOP (Stop, Take a step back, Observe, and Proceed Mindfully). Before reacting, we need to STOP. Then, we need to physically or mentally distance ourselves from the situation or emotion. After that, we need to pay attention to or observe what is going on both inside and outside of us. By observing, we can tap into our wise mind. Our next step is to use that information to Proceed Mindfully. In this step, we aim to ask ourselves, “How do we want this situation to be resolved? Or “What would be effective in this situation?”

Emotional Regulation – Learning how to better understand and handle our emotions so that we have more control over our thoughts, feelings, and behaviors. Our ability to check the facts is an important emotional regulation skill that can assist us in seeing that our feelings and thoughts are not reality. In turn, this skill allows us to change our emotional response to situations by allowing us to focus on the facts rather than our interpretations.

Interpersonal Effectiveness – Learning how to better navigate relationships.

A person’s interpersonal effectiveness includes communication skills, the ability to build relationships, the ability to set boundaries, the ability to advocate for one’s own needs and wants, and the ability to end toxic relationships.

Among the interpersonal effectiveness skills are GIVE and FAST. When we communicate and interact with others, GIVE (G=Gentle; I=Interest; V=Validate; E=Easy manner) reminds us to validate and respect them, while FAST (F=Fair; A= no Apologies; S=Stick to values; T=Truthful) teaches us to validate and respect ourselves without lying or manipulating them. 

How Is DBT Different From CBT?

Both Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) focus on behavior, but they are also quite different. 

Cognitive Behavioral Therapy focuses on restructuring thoughts to change self-destructive behaviors and is based on the belief that our thoughts and behaviors influence our feelings. In Cognitive Behavioral Therapy, logic and reason are used to direct responses and change emotions.

In contrast, Dialectical Behavior Therapy is more about finding balance through navigating dialectics, getting unstuck from extremes, validating our emotions, and addressing and changing behaviors.

DBT Is a Diverse and Flexible Therapy

DBT is applicable to many issues, concerns, and distress we experience in life. We all navigate dialectical dilemmas more often than we think and run into situations where we are stuck or are having difficulty gaining perspective. Through DBT, we learn concrete, measurable, and validating skills and knowledge that help us overcome our barriers and cope better with life’s challenges. You might enjoy DBT if you prefer a therapist who gently challenges you while remaining aware of your concerns, distress, and experiences. We want to set you up for success, not failure. Small steps lead to big steps, which lead to leaps! No matter what type of counseling or therapy you’re looking for, we can help. Contact us today for a free consultation to learn more.

Perhaps you have heard the saying, “You get out of therapy what you put into therapy.”

Although everyone experiences therapy differently, one thing is true for all: success in therapy requires effort and focus. You will ultimately achieve your goals through the work you put into therapy, but that doesn’t just happen during sessions. The work you do between therapy sessions is just as important for your progress. Here are some things you can do to continue progressing in therapy between sessions. 

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Complete Therapy Assignments

You may be given “homework” to do outside of therapy by your therapist. In these assignments, you may be challenged to put what you’ve learned during sessions into practice. Depending on your circumstances, your therapist may assign you breathing exercises or other self-care activities. They may also focus on practicing new skills, reframing negative beliefs, and practicing coping strategies.

Taking the time to complete tasks outside of therapy may seem daunting, but it’s well worth it. According to research, therapy is more effective when homework is assigned. What’s more? Homework assignments that are consistently completed tend to result in better therapy outcomes.

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Think About Your Most Recent Session

When it feels like there’s a lot to cover in a single therapy session, it can be helpful to review what you covered with your therapist in your last session. Based on your previous discussion with your therapist, what did you learn? Were there any revelations that you would like to keep in mind and work on moving forward, such as reducing or avoiding certain thought patterns or behaviors? Would you like to ask your therapist any questions regarding something you discussed in your previous session? 

As you think about and work on things outside of therapy sessions, questions may arise. Write them down so you will remember to ask them at your next appointment. By reflecting on your sessions and what you discussed with your therapist, you can identify actionable things to work on and keep your therapy goals in mind. 

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Try Therapeutic Journaling

Journaling is beneficial whether you are in therapy or not. By journaling, you can explore and express your thoughts and feelings, identify negative thoughts and behaviors, and more. As an outside-of-session therapy assignment, you might be asked to record your feelings and thoughts each day. Even if your therapist doesn’t assign journaling, it’s something you can do in between sessions to help you make progress toward your therapy goals. If you’re not sure how to get started with journaling, consider using these prompts. 

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Focus on Healthy Habits 

In order to feel better mentally and physically, it is important to incorporate healthy habits into your daily life. Practicing self-care, eating well, exercising, and getting plenty of sleep are all healthy habits. Self-care involves looking after your entire being – your body, your relationships, your emotions, and your spirit. Self-care isn’t just a spa day or a glass of your favorite tea – it’s improving the things you do every day to make them healthier. To get started practicing self-care, consider these tips. 

Improving your overall health also requires eating well. But what does it mean to “eat well”? Choosing nutritious foods such as fruits, vegetables, whole grains, and lean meats is a key component of a healthy diet. The benefits of eating a nutritious diet extend not only to your physical health but also to your mental health. According to studies, diets high in fruits, vegetables, unprocessed grains, and seafood reduce depression risk by 25% to 35% compared to diets high in processed and refined foods. It has also been shown that people with mental health conditions should follow a diet low in refined sugar, as a high-sugar diet has been linked to worsening symptoms.

Physical and mental health can also be improved by exercising regularly – at least 20 minutes a day. In addition to reducing anxiety and depression, exercise improves mood, self-esteem, and cognitive function. It is also important to get enough sleep. Lack of sleep can negatively affect your psychological state and mental health. A healthy diet, regular exercise, and monitoring your caffeine consumption can help you get quality sleep. 

However, if you find that you are consistently having difficulty falling asleep and staying asleep, you may have a sleep disorder. The likelihood of having sleep problems and/or disorders increases if you have anxiety, depression, bipolar disorder, or attention deficit hyperactivity disorder (ADHD). Talk to your therapist if you’re having trouble getting enough restful sleep. If needed, they can refer you to a medical professional for additional treatment for sleep problems. 

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Be Proud of Your Progress

You can’t expect change to happen overnight. Although change may not happen as quickly as you’d like, it’s important to acknowledge and celebrate your progress in therapy. Therapy is a journey, and the more you work toward your goals between sessions, the closer you’ll get to feeling better and achieving your goals. Remember, there is no rush. Progress will happen if you put in your best effort.

If you’re ready to make progress in your mental health journey, SF Stress & Anxiety Center is here to support you. Our experienced therapists offer personalized therapy sessions and can provide guidance on how to make the most of the time between sessions. Contact us today to schedule an appointment and continue your progress towards a happier, healthier life.

Whether you’re exploring the idea of therapy or are certain that it’s time to get some help to support your mental health, the first step can be a challenging one—finding the right therapist. With many different types of mental health professionals to choose from, and different types of therapeutic approaches to consider, just getting started may seem overwhelming. Breaking down the factors to consider can help you figure out how to choose a therapist, getting you on the road to meeting your treatment goals and improving your well-being.

The Importance of a Good Match

Therapy often involves discussing highly personal topics, opening up in ways you never have before, and reexamining old beliefs. By its nature, it tends to be an uncomfortable process that can dredge up unwanted feelings, leaving you feeling vulnerable as you work toward building more positive patterns of thought and behavior. It’s essential to have a therapist you trust and with whom you feel comfortable for therapy to be effective. In fact, research shows that the quality of the therapeutic relationship between a patient and therapist is a reliable predictor of positive outcomes, regardless of the type of therapy.

This means that as you’re searching for a therapist, you can’t ignore what your gut tells you. If you meet with someone who doesn’t feel like the right fit for you after a few therapy sessions, no matter how highly qualified or enthusiastically recommended, it’s okay to say so! Better to continue to look than to force a situation that doesn’t quite work.

Knowing Why You Want Therapy

The reason why you’re looking for a therapist is a key component to narrowing down your search. Are you struggling with a mental health condition like anxiety or depression? Are you having trouble dealing with stress, and would like help developing healthier coping mechanisms? Are you having trouble navigating a significant life change? Have you lost somebody close and are looking for grief counseling? Most therapists specialize to a greater or lesser degree in their practice, so you should check to see that the concerns bringing you to therapy are within their area of expertise.

Certain therapeutic approaches may also be better suited to your issues, goals, and personality than others. For example, cognitive behavioral therapy (CBT), a type of therapy that identifies negative patterns of thought and behavior and replaces them with healthier skills to improve well-being, is effective in treating problems such as anxiety, depression, obsessive compulsive disorder (OCD), eating disorders, and substance abuse. Acceptance and commitment therapy (ACT) is another type of therapy used to treat many of the same issues with a mindfulness approach that changes a person’s relationship with their negative thoughts, rather than trying to change the thoughts themselves. Both can potentially be effective, but it will likely depend a great deal on the individual. Thus, if a certain type of treatment sounds like it might work for you, finding a provider trained in it may also help you find a good fit for therapy.  

Professional Qualifications

As part of considering a potential therapist, you should confirm that they are properly licensed to practice. However, therapists don’t all hold the same credentials—professionals you might be considering could include psychologists, licensed clinical social workers, licensed marriage and family therapists, or licensed professional clinical counselors. In other words, not all therapists are psychologists, and the education level each specialist has will vary depending on the requirements for their professional licensure.

Is one type better than another? Not necessarily. The type of therapist that will be best for you will depend more on whether their specialty aligns with your needs and whether or they’re a good fit for you than it will on what degree is hanging on their office wall.

Finding Possibilities

People looking for a therapist can use any of several resources to find providers that match what they’re looking for. Sometimes, family and friends recommend therapists that they’ve had good experiences with—while that can work, keep in mind that those close to you may not have sought therapy for the same reasons you did. You should give those recommendations the same scrutiny you would to any potential therapist.

Another resource that can be used is the list of providers maintained by your insurance company, if your plan includes mental health coverage. While this can be helpful in determining who might accept your insurance, there’s no guarantee that you’ll be able to find an available specialist in your area without a significant wait. In addition, insurance may apply additional constraints on the amount or frequency of your therapy sessions. Being willing to consider out of network providers may be your best bet for finding the right therapeutic fit both in terms of provider and course of treatment.

Online directories maintained by mental health organizations and other groups may also let you search for therapists in your area. Knowing what condition or issue you’d like to get help for can help refine your search results, but it can still require significant work to create a manageable list of providers who are accepting patients and have the right specialty, to say nothing of finding the right one.

Making It Easy to Find Your Match

Because we know that a good fit is such an important part of setting the stage for success in therapy, at SF Stress each patient starts with a complimentary call with one of our compassionate Care Coordinators. This fifteen-minute intake call is designed to explore what you’re looking for with therapy, what type of therapy is most suited for your needs and preferences, and ultimately, which therapist in our network of over 40 licensed psychologists and counselors will be the right match for you. Rather than waiting endlessly for providers to call you back, you can schedule your consultation right away—we’re usually able to accommodate same-day or next-day consultations. We offer both in-person and online therapy to make treatment accessible and convenient.

If you’re tired of waiting to get started on improving your mental health, SF Stress & Anxiety Center can help. Schedule your free consultation today to find the right therapist for you.

The last few years have been hard on everyone’s mental health. According to a recent report by the Pew Research Center, 41% of U.S. adults have experienced high levels of psychological distress at some point from March 2020 to September 2022. Young adults, ages 18 to 29, were even harder hit, with 58% reporting high psychological distress at least once in that time. The silver lining is that people are becoming more aware of the need to care for their mental health—with an estimated 1 in 5 Americans living with mental illness per the National Institute of Mental Health, it’s a timely reminder for anyone struggling with a challenging situation or negative thoughts that seeking help is a good idea when you’re finding it difficult to cope on your own. Psychotherapy is an effective way to help resolve issues and treat mental health conditions, but people may not have an accurate idea of what it really is and the positive difference it can make.

What Is Psychotherapy and How Does It Work?

Psychotherapy, also known as “talk therapy,” is a broad term for treatment to improve mental health by talking to a mental health professional such as a psychologist, counselor, or other licensed practitioner. Therapeutic approaches that fall under this general umbrella term are intended to help people identify unhealthy emotions, thoughts, and behaviors and learn to replace them with healthy coping skills that improve their ability to function and their well-being. While psychotherapy is recommended for depression, anxiety, personality disorders, eating disorders, and a wide range of other mental health conditions, it can also help people adjust to life changes and stresses that they are finding difficult to manage.

There are many different types of psychotherapy, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), interpersonal therapy, acceptance and commitment therapy and more. Many therapists specialize in one type or blend elements from different approaches to best serve their patients. Psychologists, licensed marriage and family therapists, licensed professional clinical counselors, and licensed clinical social workers are among the mental health professionals qualified to provide psychotherapy.

In addition to individual therapy, psychotherapy can also help when the difficulty lies in a relationship, as in couples therapy or family therapy. In these cases, work is centered around improving communication and patterns of interaction between partners or family members, rather than focusing on one person. Group therapy, in which a therapist leads a group of unrelated people often dealing with similar troubling issues or experiences, is another option. For example, a bereavement group can help participants feel less alone when dealing with the loss of a loved one, while benefiting from the professional guidance of a therapist who can advise them on navigating the grief process. The type of therapy that will be right for you is highly individual—the best measure is what makes you feel comfortable and what works to improve your quality of life.

What Is the Goal of Psychotherapy?

While the specific goals of psychotherapy will vary from person to person, depending on what situation brought them to therapy, the purpose overall is to treat mental disorders and emotional challenges through psychological means. Through conversations with a therapist, the patient gains a better understanding of themselves, learns to change behaviors that are preventing them from living the life they want, and develops healthy coping mechanisms to meet life’s challenges.

How long that takes depends on each case: some patients need only a limited number of sessions to deal with a specific issue, while others who are faced with a chronic condition or complex, long-standing situations may benefit from long-term treatment. The goals you and your therapist set will help determine the treatment plan that is best for you.

How Effective Is Psychotherapy?

Studies indicate that 75% of people who receive psychotherapy benefit from it. Research also shows that psychotherapy is equally effective whether it is delivered through in-person sessions or remotely, via teletherapy. This means that busy schedules and/or limits to how far you can travel to see the right therapist don’t have to be a barrier to getting the help you need.

Of course, psychotherapy requires active, willing participation to be most effective. During treatment, you’ll be learning new ways of looking at difficult situations and new skills for resolving them—attending appointments regularly, completing homework assignments between sessions, and practicing what you’ve learned will help your therapy have the greatest positive effect.

Investing in Your Well-Being

Psychotherapy can help alleviate mental suffering and lay the groundwork for living a healthier, happier life. If you’re ready to make a positive change, the compassionate Care Coordinators at SF Stress can help. With a free complimentary phone consultation, they’ll match you with one of our more than 40 qualified therapists for in-person therapy in one of our California locations or online therapy via a secure, HIPAA-compliant platform. Schedule your free consultation today to get started.