My Motivation Is Gone

Several of the people that I saw this week have been struggling with a loss of motivation. A lack of motivation can be one of the most prominent symptoms of a major depression, but there were other aspects of their loss of motivation that I found fascinating. I asked one of these patients, a man in his 40s who is …

Distress Tolerance

I have been doing some blog – surfing and happened upon a wonderful series, on the “disorderly chickadee” site that I have referred to in the past, about the skill of “Distress Tolerance.” In working with patients with depression, we often find ourselves encouraging them to learn about Dialectical Behavior Therapy (DBT). And of the many parts of DBT that …

Bipolar Treatment: The “Quick Fix”

A young woman came in to see me today. She was in a hurry. She wanted to make a change in her medication, and she wanted to make that change now. She told me that medication she was taking for bipolar was making her sedated and sluggish. She said she thought the medication was a “trap.” The medication was why …

Winter Leads to Spring

Someone shared with us a wonderful video about John O’Donohue, a Celtic poet, philosopher and writer. In it we found this quote that resonated very much with our experience. It is about winter. And depression. And how life blossoms from the seeming dreariness of a period of fallowness. We think you might appreciate it. If you like this clip we …

Mania and Depression Aren’t Opposites

Recently I found myself thinking about the similarities between two mood states that appear to be extremely different:  mania and depression. I was talking to a young man who is now quite depressed, and who was sharing with me his incredibly negative internal though processes. One of the things that he said caught my attention.  He said he felt that his illness and …

Hardwiring Happiness

Sometimes it is simple ideas that resonate the most powerfully with our psyches.  This week I have found myself, again and again, thinking about the fairly simple but quite elegantly described ideas in the book Hard Wiring Happiness. I should probably admit that I’ve only gotten about half way through the book, but even so, it has had quite an …

A Deep Shadowy Fear

Most of us have had the feeling that, deep in the recesses of our brain, there lurks some terrible secret or event, some deeply frightening, or even terrifying memory or experience. For some of us there may, indeed, be a past trauma and a repressed childhood memory. But the rest of us are left to wonder, if nothing seems to …

Experience a Sense of Plenty

Nothing can seem more urgent, important, and real than the sense that there is not enough for us. Not enough love. Not enough food. The sense of scarcity may not even connect to any clear sense of what is missing. But that doesn’t take away its power. Regular readers of this blog know that we appreciate the insights of Rick …

Treatment as Punishment

I have spent the last two days mulling over an interaction with a patient and with his therapist. The patient is a brilliant, young man who has somehow entered into a conflictual relationship with me. The nature of that relationship was encapsulated for me in a comment by his therapist. She called to let me know that he was escalating …

Acceptance versus Avoidance

Acceptance and Commitment Therapy (ACT) is based on the belief that five fundamental errors are responsible for much of human distress. One of these errors is the tendency to want to avoid painful feelings at all costs. Our addiction to our cell phones can serve as a distraction from the distress of loneliness. Or drinking. Or smoking. A colleague suggested …

Take Action… Why Do I Have to Pick Up My Room?

Sometimes wrestling with depression can seem an awful lot like having to deal with a truculent eight year old. It is 7:00 in the morning, and the alarm goes off. When you aren’t feeling depressed, that means that you get up without thinking about it too much, and take a shower or make some coffee to start the morning. But when you …