Before you come to therapy, ask yourself “Do I really want to GET RID of my problems?”

I love my clients. I’m sort of “close” to many of them. I have one client who I’ve been seeing for about a year. I’ve watched her build stronger relationships with friends and family. I’ve watched her grow emotionally; I’ve watched her triumphs and losses. I’ve watched her depressive and anxious episodes decrease. I’ve watched her bounce back from major work and marriage issues. I’ve watched her grow. We’ll call her Michelle.

How Michelle made the most out of therapy:

1. She attended all sessions. When she could not make it she quickly alerted me and rescheduled.
2. She showed up on time. Even early!
3. She completed assignments.
4. She kept a journal.
5. She read the books that I recommended.
6. She stepped out of her comfort zone.
7. She took the risks.
8. She was open to a new perspective.

So before you come to therapy, ask yourself:

1. “Am I really ready to embark on some type of change related to how I think and behave?”
2. “Am I amenable to constructive criticism?”
3. “Am I really ready to give 100%?”
4. “Am I being defensive or open?,” and finally
5. “Do I really want to GET RID of my problems?”

Teens & Depression: 5 Behaviors Parents CANNOT Ignore

Rachel, a 16 year old high school girl, has been experimenting with drugs, skipping school, and dieting. Would you suspect depression or dismiss these behaviors as typical “growing pains”?

Teenage depression is more than mood swings and rebellion. Like adults, teenagers encounter daily life stressors. Depressed teens “act out” in many ways. Ignoring behavior indicative of depression could prove detrimental to a teen’s life. Problems at school, drug use, and suicidality are fairly common outcomes when teenage depression is ignored or untreated. The following behaviors may be signs that your teenager is experiencing depression:

1. Substance Abuse: Teens may use drugs and alcohol to self-medicate their depressive feelings. Never dismiss drug and alcohol use as “experimentation.”

2. Rebelliousness: Yes, teens do test boundaries. However consistent rebelliousness at home and school is likely a manifestation of emotional unsteadiness, feelings of being misunderstood, or a desire to fit.

3. Body Image Issues: Body image is a concern for both teens and adults. In today’s ultra vain world teenagers also feel pressure to look a certain way—taller, thinner, more fit. Negative body image is hand in hand with depression and poor self-confidence and self esteem.

4. Cutting: Cutting is a form of self-injury wherein the individual cuts on a part of their body, usually their wrist, arm, leg, or abdomen. Cutting is a way that some people, especially kids and teens, cope with the pain of depressive feelings, past trauma, and emotional withdrawal and isolation. Cutting is a cry for help that should never be dismissed or dismissed.

5. Suicide Gestures & Remarks: “I hate this house! I just want to die.” During an argument, a parent might dismiss these remarks as teenage attention-seeking or dramatics. Any ideas, comments, or attempts related to self harm or suicide should be taken seriously. The Center for Disease Control reports that suicide is the third leading cause of death, behind accidents and homicide, of people aged 15 to 24.

Parents and others (teachers, guidance counselors, family members) in contact with teens displaying these behaviors should immediately consult a mental health professional who can appropriately engage and assess the teen.

Natasha K. Nalls is an expert in the treatment of depression, anxiety, and substance abuse disorders. She works with individuals, couples, families, and groups.

Support your Teen’s Academic Achievement: Six Quick Tips

I’ve noticed a trend among teens and parents during the school year.

The trend is this: parents do not seek support and services for their teen until there is a crisis.

The most challenging scenario is when a parent comes in for psychotherapy three weeks before the end of the school year seeking behavioral modification assistance for their teen, who is weeks away from grade retention.

Many parents fail to notice that their teen is having a “problem” at school until a negative progress report is sent home, the teen is suspended from school, or a parent receives notice that their child may be retained. Yet many signs likely portended the crisis at hand, including poor study habits, behavior problems at school, and/or attention/focus/concentration problems.

Here are a few habits that even a busy parent can adopt to “be in the know” and help keep their teen on track academically:

1. Talk to your teen’s teachers often. Visit in person. Call. Email. It makes a difference when a teacher knows how to reach you and that you are a responsive and concerned parent.

2. Show up. Have you ever just “showed up” at your teen’s school? It gives you a snapshot of what your child’s school day is actually like. It lets your child know that you are familiar with his school setting, and are comfortable interacting with the faculty, staff, and campus.

3. Talk to your teen. Do you know your teen’s closet friends? Do you know their parents? Do you know about your teen’s latest crush? You should. Practice talking to your teen about anything and everything. Open communication doors so that your teen feels more comfortable discussing topics like personal relationships, decision-making, and feelings.

4. Set rules and boundaries. Every piece of research shows that teens need rules and boundaries. They need curfews. They need a routine. They need to know what is expected of them. There should be consequences when rules and agreements are broken.

5. Be emotionally supportive. Like adults, teenagers thrive on attention, emotional support, and positive feedback. Recognize your teen’s accomplishments, and nurture positive behaviors and interests.

6. Seek professional services early on. Procuring mental health services for your child may take time. In many school districts, school psychologists and social workers are extinct. Upon first indication that your teen is struggling, seek guidance from school personnel on identifying a professional in your area. Remember, “An ounce of prevention is worth a pound of cure.”

Natasha K. Nalls, LCSW, ACSW, CAP is an expert in the treatment of epression, anxiety, and substance abuse disorders. She works with individuals, couples, families, and groups.

How to Solve a Problem

Problems cause anxiety, stress, and distress. Problems tend to paralyze and overwhelm us. Wikipedia succinctly summaries a problem as “an obstacle which makes it difficult to achieve a desired goal, objective or purpose.” Generally, the most distressing problems impact us interpersonally and may occur at home, school, or work. Sometimes a problem is clearly your fault and in other moments, you just end up in a bad situation! The ability to problem-solve ongoingly, quickly, and with good success is imperative to healthy and happy living. “Being stuck” impairs our ability to be fully self expressed and successful. I’ve noticed that successful and happy people can move through problems and barriers and create something new QUICKLY. This ability to generate in the face of a problem is steeped in creativity and problem solving acumen.

Often, individuals may seek psychotherapy services to help resolve their personal and social problems, particularly when these problems seem overwhelming, cause depression and anxiety, and generate somatic symptoms (e.g. headaches, back pain, fatigue).

Here are a few tips on how to solve any Problem:

1. Tell people you trust about the problem. Ever notice that you happily discuss successes but are maybe shy and/or ashamed to let someone know about an issue or problem you have? We all want to look good, of course. The problem is that no one person possesses all the resources to resolve every type of problem or barrier that she might experience in life. So, tell your friend about your problem. Tell your sister. Tell your dad. Tell your colleague. These people may have more insight than you, or at least a new perspective. Moreover, maybe they’ve had the exact same experience and can share some wisdom. Maybe they can point you in the direction of someone who has more information.

2. Think. This may seem very obvious. I have personally experienced different “levels” of thinking. So when I do something challenging, or really want to think of a new solution, or really one to be creative, I find myself thinking more and HARDER. This entails objectively considering the problem, looking at my options, identifying old and new resources, and planning. Thinking and telling people about your problem go hand in hand.

3. Write out a plan. Take out a sheet of paper and make a few bullets. Take out your cell phone and make a note to yourself. Scratch down some ideas on a post it. Getting your ideas out of your head is a form of catharsis.

4. Ask an expert. Ask someone who knows more than you for advice. Evaded taxes for the past 10 years? Call a CPA. Chronically depressed? Contact a psychotherapist. Gaining weight? Consult a nutritionist or weight loss expert.

5. Don’t just ruminate, take action. Finally, make some move towards resolving your problem. Sometimes acting or responding too prematurely to a problem only makes the problem worse. On the other hand, avoiding or putting the problem off may make it worse.

6. Repeat steps 1 through 5. A problem sometimes isn’t so easy to solve, that’s why it’s a problem! It may take a while to sort out solutions and next steps to your problems. That’s okay. Change is a process. Decision-making is a process. After a while the processes outlined here become natural.

Natasha K. Nalls is an expert in the treatment of depression, anxiety, and substance abuse disorders. She works with individuals, couples, families, and groups.