Mental Health Topics
As we say goodbye to the year 2015 and welcome 2016, it is normal to reflect upon the past year and to plan for the future. We hope to leave behind the sad or hard times and wish for happier and healthier times in the coming year. The New Year is a time to pause and take stock of our life, our goals and our relationships with a view to make the future better.
The New Year is not the only time that we review our lives and try to make improvements. When we turn another year older, it is common to think about where we have come from and where we are going. Birthdays that end in a zero (like 40) or a five (like 65) may have more of an impact emotionally. When we are young, we imagine what our life will be like and what we will have achieved when we are 40 years old or if we will be able to retire when we are 65 years old.
Experiencing a loss like the death of a loved one or a divorce also leads to re-evaluating our life and re-adjusting our plans for the future as we adapt to our loss. It is important (both emotionally and psychologically) to pay attention to these times in life that lead us to pause and reflect .
Many times we simply begin down the road of life that starts when we finish high school and our life road may include college, military, career, marriage, kids, travel, etc. We can become so focused on staying on our “road” and getting to our destination that we forget to stop periodically and make sure that we are on the right road for us. When the New Year, our birthday or a loss makes us stop for a moment, it is a good opportunity to remind ourselves (or rediscover) what is truly important to us (our values) and our goals in life. Some people may find that they are not living their lives according to their values or that they find their goals have changed somewhat. We can use these pauses to re-adjust our path and maybe change our direction a little bit so that we are living our lives authentically and reach our goals.
As a therapist, I truly love working with clients who have discovered that they need to re-adjust their path in life. These adjustments could be a career change or shift; it could be deciding that a committed relationship has become unhealthy or unhappy; it could be that we are not being the parents that we wish to be to our children. In counseling we get to explore what is truly meaningful to us and forge a path to get there. When we set out in life as young adults, we may fail to take into account that what we truly want in life may change as we age. This is normal process and is only a bad thing when we fail to pay attention to how we have evolved as a person and fail to recognize that we need to change paths a little bit.
I hope that this holiday season and the New Year find my friends, family and clients happy and safe.
Happy New Year!
Dana Nolan MS LMHC NCC
Licensed Mental Health Counselor
Altamonte Springs — Orlando
We all tried very hard to pretend that the foamy bubbles floating from the sky were really snowflakes even though it was a balmy 65 degrees. It was fun to see the facial expressions of the young children in the crowd as the dancing lights came on for the first time! We told some families who had never seen the lights before about finding the Disney characters hidden within the lights. As a family we don’t have too many holiday traditions, but the few that we have mean a lot to us and we have always tried to find the time to make them happen and to be mindful as we celebrate.
During my work as a psychotherapist (mental health therapist), I find that this time of year brings a burst of clients wanting to get it in to see me. It is usually due to depression, anxiety or family/relationship stressors which seem to increase during this busy time of year. Why would so many of us feel emotionally distressed during a time that is supposed to be a joyous? Most of us already have busy schedules and too much on our plate without adding on gift shopping, annual holiday parties and decorating our homes for the season. It is easy to get wrapped up in our “to-do” list and feel stressed so that we aren’t really present during this time of year.
You may have heard of “mindfulness.” It refers to being as aware as possible in your current situation and place. Sometimes we float through life spending too much time ruminating on the past or worrying about the future which means that we aren’t enjoying today. There are many books and research articles about mindfulness and the emotional and physical benefits of practicing it. Rather than try and summarize all that information, I’d like to offer a few tips to help you be mindful during the holidays and all year round, as well.
1. Let go of trying to keep up with the “Jones” this season. Some people feel overwhelmed by trying to have the biggest or best holiday yard decorations or to make the perfect-looking Christmas cookies to give away to friends. Others feel pressured to get their children the latest must-have toys or gadgets (which are always on back order with Amazon!) Comparing our lives and possessions to others usually leads to a lower self esteem and feeling inferior which feeds pressure to “out-do” each other and can sometimes exacerbate underlying issues such as depression and anxiety. It is less stressful and more healthy to simply focus on those few activities that have the most meaning to your family and forget about trying to win the “best holiday decoration” award in your community.
2. Put reminders on your calendar to “Stop what you are doing and be aware of life around you.” Re-read my description above about my family’s visit to see the dancing lights. We stopped and watched the lights and listened to the music. We felt the temperature outside. My husband and I danced and sang in the middle of the crowd and didn’t care what anyone thought about us. We made the effort to interact with people around us that we didn’t even know and will never see again. THAT was how we were mindful…we stopped and simply paid attention and connected with what was around us.
3. Accept that you will probably feel some stress and anxiety in the next coming weeks. If we try to be more self-aware of our thoughts and feelings, then we can better cope with them. Unhelpful thoughts (I like to call them “shoulds”) can lead us to feel pressured to do too much or try and make too many people happy. It is a good idea to question where these “shoulds” come from because they lead us to feel stressed out and also keep us from enjoying the moments of the season.
I hope that all of you have a happy, healthy and MINDFUL holiday season this year!
Licensed Mental Health Counselor
From the Desk of Dana Nolan:
Because I closely monitor my teenage boys’ social media use, I was puzzled several months ago to find one of them refer to their new girlfriend as “Bae.” Concerned that this was something inappropriate, I investigated what it meant. I was relieved to find out that it is a acronym for “Before anyone else” and used like the term “baby” or “honey”…..Awe, isn’t that just sweet?
I do a lot of couples counseling in my practice and find it very sad to see and hear couples tear each other down in an effort to be “right.” They recount stories of their arguments where they verbally attack each other, call each other horrible names and even get physically aggressive. Defensiveness, contempt and dishonesty are all too common in unhealthy marriages. One client told me: “I don’t understand why my wife can be kind, generous and easygoing with neighbors, friends or even complete strangers, but then she comes home and begins to yell at me for not starting dinner or criticizing me for some other trivial issue. I am supposed to be the love of her life and I think she treats me worse than anyone else!” Day after day, couples who vowed to love, honor and cherish each other slowly descind into treating each other like the enemy.
One of the first steps in my marriage counseling sessions is to educate couples how detrimental it is to talk to each other with contempt, to call each other names, curse at each other or to treat their partner like they are lazy, stupid or ugly. Astoundingly, some couples tell me that being married means that you are allowed to talk to each other angrily or disrespectfully because you are together for better or for worse!
I really like the idea of “Bae” in committed relationships or marriage: The concept of putting your partner needs “before anyone else.” Of course, it only works when both people in the relationship make an effort to think of their partner before others. In the long run, I think its much more important that we treat our spouse/partner with respect and kindness and not care so much whether our neighbor thinks we are nice person. Our spouse is the one person we count on to be there for us through thick and thin, so it kind of makes sense that we treat our “bae” like we value their presence in our life.
Marriage is tough at times. Treating your spouse with kindness and respect is only one component of maintaining a healthy relationship. But, I promise that if you treat your partner like your “bae” that you will experience way more happiness than those couples who tear each other down!
For more information on how to improve your marriage (or serious relationship,) I highly recommend Dr. John Gottman’s book “The Seven Principles for Making Marriage Work.” I trained with John Gottman several years ago and have found his work to be very helpful to couples who are williing to do a bit of work (i.e. CHANGE THEIR BAD HABITS) to improve their marriage.
Dana Nolan
Licensed Mental Health Counselor
Owner at Healthy Living Counseling
All too often, there are reports in the news of children being abused or neglected. My heart breaks as I try to fathom what could possess an adult to physically or sexually harm or to fail to provide even most basic care to a child. As a psychotherapist, I am a mandated reporter of abuse or neglect and have made numerous reports to the Department of Children and Families (DCF) over the years. Those calls are never easy to make, but I take comfort in knowing that I may be the only person in a vulnerable person’s life to try to protect them.
Sadly, we tend to hear about reports incidents of abuse where DCF wasn’t able to help a child quickly enough or there wasn’t enough evidence at the time to warrant removing a child to prevent further abuse. However, reports that I have made to DCF have been investigated and acted on properly to further protect the child(ren) I was concerned about.
Governor Scott recently enacted legislation in Florida requiring ANYONE who suspects that a child is being abused or neglected to make a report to DCF. Failure to make a report in those cases is now a felony. I believe that this is a step in the right direction in making everyone accountable to report child abuse.
So what exactly do you do to make a report to DCF? Most people want to do the right thing but don’t know what steps to take. Some people are reluctant to make a report for fear of retaliation from the suspected abuser if they find out who reported the abuse. Others are unsure if they have enough “proof” of abuse and would feel terrible if they falsely accused someone of abuse without being absolutely sure there is abuse going on.
How does DCF define abuse or neglect of a child? According to the Florida Statute 39.01, child abuse means abandonment, abuse, harm, mental injury, neglect, physical injury or sexual abuse of a child. If you are unsure if a particular incident meets the criteria of abuse, review the statute online which provides a very detailed explanation of each term listed above.
Reports to DCF can be made anonymously unless you are a mandated reporter (for example: a physician, nurse, teacher, mental health professional, etc.) However, even if you give your name when you make a report, that information is NOT shared with anyone except the investigator who doesn’t disclose who made the report to the accused or the victim. It is usually helpful to provide your name in case the DCF investigator has further questions about the abuse allegations or has trouble locating the child.
You cannot be held liable if you make a report to DCF in good faith. Let’s say that your child’s friend discloses to you that her uncle molested her last week. It is not necessary to have observed the incident or to investigate if it really happened. All you are required to do is to make the report based on the information you have at that time.
Intentionally and maliciously making a false DCF report is a third degree felony and also carries a fine up to $10,000 per violation.
Making a report to DCF in Florida
There are three ways to make a report to DCF.
Phone: 1-800-96-ABUSE
Fax: 1-800-914-0004
Online: https://reportabuse.dcf.state.fl.us
Before you make your report, it is helpful to write down as many details as you can about the incident of abuse and risk of further abuse. Here are some things you will be asked to provide to in your report:
Name, age or DOB, race, gender for all adults and children involved
Addresses or other means to locate the adults and children involved
Relationship of alleged perpetrator to the child
What abuse or neglect you observed or were told by the victim (when it happened, where it happened, extent of injuries, etc.)
If you do not have all the details listed above, don’t delay making a report using any information you do have. However, it is very helpful to provide as much detailed information as possible to help the investigator do their job. Personally, I prefer to call the Abuse Hotline (1-800-96-ABUSE) and speak to a person about my concerns rather than make a report online or by fax. When you call, you may have to wait on hold for a while before you speak with a DCF representative. After you provide all the details about the suspected abuse, the DCF representative will inform you during your call if your report was “accepted” and will be investigated. If your report was not accepted, it is because what you are reporting is not considered abuse or neglect according to DCF or there is insufficient information to proceed with an investigation.
There are more than 1 million children each year who are victims of abuse or neglect in Florida according to child protective agencies. Many of these victims don’t ever receive help because their abuse wasn’t reported. When parents don’t, won’t or can’t protect or care for their children, the Department of Children and Families step in to help in many ways. But, DCF can’t help if they don’t know about the abuse. Protecting our children is protecting our future!
Every January my local gym has an influx of new members and becomes crowded to the point that I have to wait in line to use the exercise machines. However, I’ve noticed that the crowds thin out considerably after a few weeks. Why does this happen? I believe that people have the best intentions when they decide to get in shape for their New Year’s resolution. But, it seems that keeping many of our New Year’s resolutions is a challenge. Statistically, thirty percent of those who make a New Year’s resolution break them by February. Only 7% of us reach our goal by the year’s end.
Why do many people fail to reach their resolution goals?
Goals are too general
“I want to get healthier.” “I want to get out of debt.” “I need to get a better job.” We are more likely to reach our goals when they are specific and measurable. A better goal is “I want to pay off $2,000 of credit card debt by June.” or “I’d like to lose 10 lbs in 10 weeks.”
Resolutions are unrealistic or inflexible
“I am going to go the gym every day.” “I am going to give up all fried foods and never eat dessert.” Goals need to be realistic AND flexible. It may not be possible to go to the gym EVERY day due to our work schedule or if we get sick. If our goals are not somewhat flexible, then we may get frustrated and feel like a failure if we do slip up and have a slice of birthday cake or can’t make it to the gym one day.
Lack of planning
It is great to set a goal to pay off our bills and get out of debt. But, that will not happen without a plan. It is necessary to make a budget that includes our income and expenses. From there, we need to decide exactly what will need to change in our budget each month to find the money to pay down our debt.
Why is this goal important to me?
It really helps to define why a particular goal is important to us. How will OUR life be better if we reach this goal? Research in human behavior indicates that changes are more likely to be permanent if we are able to identify how we will benefit from making a change. It can be very motivating to recognize that we will be able to retire a few years sooner if we save “X” amount each year.
If feelings of guilt or shame are the primary motivation for our resolution, then we are less likely to be successful. Guilt about being overweight, in debt or a smoker does not promote healthy, long-term behavior changes.
How can we be SUCCESSFUL with our New Year’s Resolutions?
We need to select ONE specific and realistic goal that is truly meaningful to us. From there, we need to write down a plan on how we will accomplish that goal and how we will measure our progress towards that goal. As we take a small step each day towards that goal, we also need to be flexible enough to accommodate those unexpected events in our life that may derail us a little bit from our goal. Most of all, we need to be KIND to ourselves as we adjust to a new routine and allow ourselves to grow into a new way of living.
Best wishes of happiness and success in the 2015!
Dana Nolan
Licensed Mental Health Counselor
Healthy Living Counseling
There are a wide range of thoughts and emotions that accompany a cancer diagnosis that are completely normal. However, these thoughts and feelings may not feel normal because you may not have felt them before. Symptoms of depression, anxiety, sleep problems, and relationship challenges very typically occur along with all the effects of cancer or its treatment. However, discussions about sex are often neglected by health professionals and patients.
Many people are not comfortable discussing sex, especially cancer patients who are dealing with life-changing issues and have more stressful and life-threatening concerns on their minds.
But should the topic of sex be equally important to those with cancer? Of course.
I have often found in my work as a mental health counselor, that couples are very interested in learning about how to have sex comfortably and safely during and after cancer treatment.
A cancer patient and their partner often have questions about sexual intimacy due to a loss in the cancer sufferer’s libido (sex drive) or negative sexual functions that can result from the cancer treatment. As a result, they look for advice from their doctor and/or other health care professionals to gain a better understanding of the affects of treatment and how it affects their sex drive so they can continue to enjoy having sex as they did before diagnosis with cancer.
The difficulty with talking about sex, falls not only upon the patient, but upon doctors too. Many doctors will often avoid the subject or wait for the patient to raise it. Yet, a cancer patients and their caregivers often wants information to understand how treatment will affect their sexual desire and function.
One study suggests, that: “Health professionals may also believe their discussions [about sex] may be construed as disrespectful and inappropriate by the patient, with research suggesting that gender, age, culture, socioeconomic factors, and religion all contribute to health professionals’ avoidance of the topic…” (Asia-Pacific Journal of Clinical Oncology, 2009).
In my experience as a counselor, whom has provided therapy for cancer patients, it’s easy to understand how concerns about sex may go unattended to because both patients and physicians are unwilling to engage in dialogue about the topic.
Raising this issue with your doctor is important because many newly diagnosed patients and their partners may not be aware of the safety issues involving sex, cancer, and treatment.
Whether or not your doctor raises the issue, you should be brave and raise the issues and questions you have about cancer treatment and sex.
As a guide, here are some helpful questions in which you can ask your doctor about sex and mesothelioma:
Do I need to take precautions during intercourse while I am on chemotherapy?
How will treatment affect my energy levels and libido?
How soon after surgery or a procedure can I have sex?
Is it safe for me to physically exert myself during sex while I am on treatment?
Have other patients receiving the same treatment reported side effects that impact sex?
Is oral sex safe during treatment?
How will treatment affect my hormone levels?
Will I be able to have children after I finish treatment?
How will treatment affect my fertility?
When you or a loved one are battling cancer, so many things do not feel normal. Sometimes, sex can return some sense of normalcy. It can also improve a couple’s quality of life during this difficult time. It may take some courage to raise concerns and questions about sex to your doctor, which may not be easy, but most patients find the payoff in having discussions about sex while battling cancer is well worth the
effort.
As a licensed mental health professional, I’ve worked in a variety of hospital settings where I have worked with adults and teens who have tried unsuccessfully to commit suicide. The vast majority of those who survived their suicide attempt were so grateful to have survived their attempt. Almost all of them want to learn how to better cope with life so that they never reach a point that they feel so hopeless, desperate and impulsive again. In working with family members after a loved one’s suicide attempt, it has been challenging to explain how their loved one could reach such a hopeless state of mind that suicide was the only or best option.
As a mother to two teenage boys, one of my goals is to teach them how to manage life’s emotional challenges like not getting that job they really want, not making the varsity team, or the breakup of their first true love. Recently, I was assessing a teenage patient in the ICU who barely survived a very serious suicide attempt after the breakup of his first serious relationship. As I talked to him and his family, I couldn’t help but to ask myself “What if that were my son?” This particular young man had a very bright future academically, yet he felt so emotionally distraught that the only solution in his mind was to take a bottle of pills.
Throughout my years of practice, I’ve learned that when people are unable to acknowledge, understand or cope with emotional pain, anger, sadness, or grief in a healthy way that they typically turn to unhealthy ways of coping like misusing drugs or alcohol to numb their pain. Alternatively, they may engage in impulsive and dangerous behaviors including cutting and suicide. As a therapist, my work with these clients is to help them recognize, understand, and better cope with their emotional pain in a healthier way.
Emotional intelligence is a term that relates to one’s ability to recognize their own emotions, other people’s emotions, AND to manage unpleasant emotions in a healthy way. Studies show that people who have high emotional intelligence and emotional resiliency are much less likely to self harm either by cutting or attempting suicide or to misuse drugs and alcohol. When children demonstrate high emotional intelligence, they are more likely to use healthy coping skills and have healthier relationships with others. However, it is rare that our children’s school curriculum includes teaching about emotional intelligence, so it’s one of those things that we have to learn on our own.
How can parents influence their children’s emotional intelligence?
There are many things that parents can do to teach and model emotional intelligence and emotional resiliency to our children. In addition to teaching our children how to read, tie their shoes, and how to drive a stick shift, we need to also teach them about emotions. We need to show them that it’s okay to ask for help when we are struggling. We can normalize their emotions when they are sad, lonely, or down on themselves. We can be brave enough to share our own pain as children and teenagers like not getting asked to the prom. We can talk to our children as we watch news stories about people who deal with their anger or fear in an unhealthy or illegal way. We can support and encourage our children when they talk to us about something that is bothering them. We can avoid labeling or degrading those who seek counseling or psychiatric care for anxiety, depression or to simply improve their mental health. We need “walk the walk” and not just “talk the talk.” We need to model to our children healthy ways of coping with life’s stressors, challenges and heartbreaks. We need to have conversations about ways to manage stress with our children and encourage them to find their own healthy stress management skills. We need to talk with them about how to forgive ourselves if we make a mistake. We need to teach them to problem solve so that they don’t repeat mistakes. We need to talk to them about healthy relationships and what makes a relationship abusive. These types of conversations may not come as easily to some parents as conversations about their homework and chores. But, the payoff to your child is well-worth your effort.
It is normal to want to protect our children from both physical and emotional pain in life. Of course, most parents acknowledge that we cannot protect them from everything, but we can prepare them for life. We need to do more than tell our children not to cry, to just suck it up, to get over it, to forget about it, or to be strong. As parents, we need to acknowledge and talk about ALL the emotions we experience in life. We need to be human and share with our children how we learned to cope with our disappointments, break-ups/divorces, job losses, financial crises, and deaths of loved ones. When children, teens, and adults feel supported and capable of handling life’s emotional ups and downs, they are much less likely to reach a place of hopelessness, helplessness, and desperation where self-harm or suicide feels like the best option.
Survivor guilt (sometimes incorrectly termed as, survivor’s guilt) is a term often heard in the aftermath of wars, natural disasters, or some type of traumatic event. Unfortunately, this type of guilt occurs frequently and in a variety of situations. Victims of rape or assaults can believe that they are at fault or that they could have prevented the attack. Emergency workers who are unsuccessful in trying to save a life can feel guilt that they should have done things differently or acted more quickly. When a person commits suicide, the surviving loved ones usually believe that they should have done something differently to avert the suicide. The guilt that goes along with these traumatic events can lead to depression. Survivor guilt is also common in people who develop Post Traumatic Stress Disorder (PTSD) as a result of a trauma.
Mental health counselors working with traumatized clients with depression or PTSD begin by helping them sort their emotions out. Often times, these clients don’t even recognize the presence of survivor guilt until it is pointed out by a skilled professional. The guilt that results from the traumatic event or events can leave clients feeling like the event was their fault, or that something could have been done to prevent it.
These feelings of guilt become associated with a perception of some type of wrongdoing. Most times, being able to talk about the experience and gain a better understanding of the trauma itself with a mental health therapist can help people move towards a healthier realization that the event was not their fault, or that there was nothing they could have done to prevent it.
Unresolved feelings of guilt can intensify and create deeper feelings of hopelessness, negative self-worth and self-esteem, which further exacerbate depression. This guilt can intensify during times of stress and can have a negative impact upon relationships and work.
The most difficult part of overcoming guilt after recognizing it, is letting go of the guilt and accepting that there was nothing they could have done differently to have changed the outcome. A counselor can aid in helping one recognize this fact and help the individual work through the issues of self-blame. It is not always an easy journey, and may raise some emotions that one may have spent many years avoiding, but talking about it with a licensed mental health counselor can be an important first step towards alleviating the guilt and depression that one may be suffering from.
It is important to remember that survivor guilt is not experienced by everyone or to the same levels of intensity. It will be different for each individual. However, when guilt and depression begin to interfere with the normal functions of daily life, it may be time to seek the assistance of a counselor.
It is important to find a counselor with whom you feel comfortable sharing your thoughts and feelings AND who has the necessary expertise to help you reach your goals. For that reason, we offer a free brief phone consultation to ensure that we are the right fit for you. If you are feeling depressed, have feelings of guilt, or would like to discuss some other issue(s), please don’t hesitate to contact Dana Nolan at 407-340-2474.
Our office is conveniently located in Altamonte Springs, just north of Orlando.
From the desk of Dana Nolan, Licensed Mental Health Counselor…
April is Child Abuse Prevention month. In my practice, I have way too many clients who suffered childhood abuse and/or neglect and now have ongoing emotional or psychological issues related to trust, self-esteem, depression, anxiety/PTSD and unhealthy relationships. My job as a therapist is to help survivors of childhood abuse work through the abuse to become happy, well-adjusted adults. Ideally, it is always better to prevent a problem than to try and fix it later on.
Florida Governor Scott recently approved laws aimed at reducing childhood abuse. Today, anyone who fails to report incidents of child abuse, neglect or exploitation can be charged with a felony. Previously, only “mandated” reporters (doctors, nurses, mental health professionals and teachers) were obligated to report known or suspected abuse of a child or vulnerable adult. The purpose of this law was to make EVERYONE responsible for reporting abuse. Historically, child abuse was considered a private, family matter and many adults failed to report abuse they observed or suspected because they believed it was “none of my business.” This new Florida law means that it is EVERYONE’S business to look out for our youth and vulnerable adults.
It is really quite easy to make a report to the Department of Children and Families services here in Florida. You simply call 1-800-96-ABUSE (1-800-962-2873) or log onto https://reportabuse.dcf.state.fl.us. It is important to have specific information ready to provide in making the report: Name, date of birth (or approximate,) race, gender, address or location of child and what exactly you observed that leads you to believe that a child is being abused, neglected or exploited. All reports to DCF are confidential and you cannot be held liable for making a report provided it is made in good faith.
Most of my clients who suffered childhood abuse or neglect have said they always wondered why no one ever stuck up for them or reported the abuse when it was observed. Please know that you CAN make a difference in the life of a abused or neglected child by being that ONE person who does stick up for them and makes that phone call to make a report.
The Leukemia and Lymphoma Society presented Dana with the 2013 Healthcare Volunteer of the Year Award. The Leukemia & Lymphoma Society (LLS) is the world’s largest voluntary health agency dedicated to blood cancer. They fund blood cancer research around the world. Their mission is to improve the quality of life for patients and their families who suffer from leukemia, lymphoma, Hodgkin’s disease and Myeloma. Dana, a licensed mental health counselor, who specializes in counseling for cancer patients and other patients with serious illness provides patient and family education programs to the LLS. She is honored to receive such a special thanks from a great organization.