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Depression and Anxiety: A Social Worker's Perspective

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Finn is a clinician with a Master's in Social Work from CSU Bakersfield. He lives in the Central Valley of California.

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Embrace the Now

When you hear the word mindful, you may think of incense and golden statues, chimes and crystals. You may think of a parental imperative telling you to behave. You might think of manners and codes of ethics on a whiteboard in a room full of stuffed shirts and old fashioned mechanical clocks hung high on wooden awnings, above doors clamped shut, with wrong iron doorknobs.

Mindfulness is not necessarily a mystical séance held in rooms with open windows and candles and light fabric one person carpets. You don't need to follow a higher or holy order. It is not a task that demands your full attention or demeans you with distractions that exhaust your leisure time.


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It's simply living in the moment and not allowing yourself to be distracted by intrusive thoughts that might eventually cause you duress. Emotional pains can lead to unhealthy practices such as poor diet or neglect in other ADLSs (Activities of Daily Living) - eg food, shelter, clothing. Distressful thoughts can lead to health issues even such as high blood pressure, diabetes or much worse.

The mind is a powerful machine and to an extent is sufficient and self regulating. While popular culture says we only use 10% of our brain, and science says it is much more than that; it remains a fact that the organ is an untapped resource.

I want to share with you some ideas concerning mindfulness in this article, discuss two cousins - anxiety and depression - and (hopefully) inspire you to pursue practices to improve your overall mental health.

Depression

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The Past

In our daily lives, there are probably dozens of thoughts that move through our minds at any given moment. You may be driving down the highway on your commute to work and listening to the news blurb about the sensational local event of the day. You might be thinking about what you will do for lunch, about the (unnecessary) information your wife (or husband) provided to you last evening, about whether or not the commuter in the lane next to you should put down their phone, about the tax dollars that are supporting the never ending road construction and whether or not the kosmoceratops lived in the Paleozoic or Mesozoic era.

Random - or automatic - thoughts are part of the normal cognitive process. If you were to try and stop thinking about one particular think - let's say - giraffes - you will find yourself thinking of just that: a giraffe. Having a series of unrelated images moving through your brain is not really considered troublesome until it infringes upon some area of your life.

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Many times we will find ourselves looking back to troublesome periods - perhaps some of these instances are from childhood such as failing to give a public report in front of a class, a jilted friendship, or the time we agreed to a lease on a car that was beyond our budget at the time.

When we look back at the past, we tend to focus on the more negative memories. Shakespeare said "The Evil That Men Do Lives After Them; The Good is Oft Interred with their Bones". Negative thinking leads to the I should haves which will have us questioning not only our judgement, but the concern of where we could have been.

Too much focus can lead us to a state of anhedonia - where we loose pleasure in things that should be enjoyable

Worry

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How Often Do You Think of the Past

Anxiety

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One Day: After Now

Many times we are concerned with the future. This in itself is not necessarily a bad thing. We all have goals that we want to achieve and developing plans to work toward them is a healthy practice. Having goals - such as one day having a house, or a family or even a pet giraffe - are not things which we should easily dismiss and say that they are not worth our concern because they are in the future and have not happened yet.

We may also be working on concerns of body or our careers such as that if we are to eat healthy and exercise we will be able to live longer or that if we work hard and focus on that thing that occupies our time weekdays between the hours of 8 am and 5 pm that we will eventually become healthier and live a longer life and be able to retire one day.

Those are sensible thoughts.

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Future thinking becomes troublesome when we ponder and worry. Planning and dwelling are two different things. Making plans are usually based upon a realistic measure - that has its roots in the present moment. Ponder and worry are concerns such as that they manifest themselves in distorted thinking: I hope I will one day loose that five pounds so I can fit into the pants I wore when I was younger or I hope I live until the year (pick a date fifteen years from now) so that i can see (choose an even that hasn't happened that you think will).

When future thinking becomes a series of hypothetical concerns that cause you distress that is worry, or anxiety. I am planning on attending the interview tomorrow is a goal oriented thought that is realistic. I hope I don't forget the name of the college I attended in the interview tomorrow is an example of an anxiety. Saying to yourself that I always forget important things when I need to know them is not only an anxiety but a cognitive distortion.

Anxiety can raise your blood pressure, cause you aches and pains, inspire forgetfulness and cause you to drop that extremely warm beverage on your lap. It may cause you to make a habit of insomnia and may even encourage you to navigate the vehicle you are driving into the post by your parking garage which will result in unwanted economic burdens.

Present

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Automatic Thoughts

When automatic thoughts based on unrealistic concerns occur, these are referred to as Cognitive Distortions. Cognitive refers to the mind, thinking. Distortions are just as they sound, unrealistic, exaggerated or in some way twisted variations of expectations we place upon ourselves.

Some examples include:

All or Nothing Thinking

Over generalizing

Discounting the positives

Labeling

Personalization or Blame

A list of some cognitive distortions, with examples is included in the link below. One of the ways to address this type of anxiety is to use reframing techniques (also described in the link).

As a clinician, in our office, we use a technique known as CCC:

Catch the thought - what is the distressing thought?

Check it - is it realistic?

Change it - Are there ways I can reframe this thought? What examples can I think of it that change the way I look at my thinking.

A List of Cognitive Distortions and How to Change Them

Practices

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Body Scan

There are other activities that you can use to learn to relax and change your focus and adapt a mindful mentality. Some techniques involve what are called body scans where you focus on one part of your body at a time. There is a lot of literature on this activity and how to complete it available in the professional literature or online. I am also currently working on a write up of some useful methods of putting this technique into practice.

You can start with your toes and focus on them and slowly move up your body, until you have fully covered yourself.

The variation involves tensing each part by tightening your muscles and then relaxing.

Use deep breathing along with this.


Happiness, not in another place but this place… not for another hour, but this hour

— Walt Whitman

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Visualizations

You can also do what are called visualization techniques. These are various approaches, but one of more useful ones that is implemented in clinical practices includes focusing on an image such as a beach scene or a forest. You can even do an urban environment if you find the city images and noises more appealing. With this activity, you imagine the scene and go through each of your five senses and practice focusing on each sense, allowing the imagined stimulation to fill each of the senses one by one.

For example, with a beach:

Sight: picture the color of the sky and the sea and the sand. See the waves move toward the shore....

Sound: Hear the breeze off the sea, the gulls....

Smell: Imagine the aroma of brine

Taste: taste the salty air...

Touch: feel the sun on your face and the sand under your feet...

You have to go through each sense one by one, focusing on each stimulation.

And then bring it all together.

I am currently working on a more thorough and descriptive guide for this method as well.

Depression is Real

SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

CALL 1-800-662-HELP (4357)

— Substance Abuse and Mental Health Services Administratiion

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2022 Finn

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