4 Simple Strategies for Low-Grade Depression

foreign hi everybody Welcome tonight thank you for joining us uh before we get started on this live Workshop I want to mention in honor of world mental health day next week on October 10th this entire month we are offering four of our workshops that are usually members only for free for anybody that would like to try us out you can head to medcircle.com to check out one of those four workshops or they are listed below I'll go into a little more detail about each one that we're offering throughout the workshop tonight but we are very excited to be doing so tonight we have four different doctors on with us uh the first half of this Workshop will be with Dr teslam and Dr Judy ho we're going to go through two techniques each doctor is going to present one for us we're going to discuss a little bit about what is low-grade depression versus severe depression and how this affects our productivity whether that's at work or our everyday life so I'd like to welcome Dr tuslim first and hi Dr teslam how are you good how are you good uh can you explain a little bit about what low grade depression is and um possibly what how it counteracts with severe depression sure so when we're talking about low-grade depression we're really talking about those symptoms that are starting to show up so we may notice things like low mood low energy um less interest in the things that we used to do um or the things that used to bring us enjoyment we may notice that we just don't want to do the things that we typically have enough energy to do and the things that bring us satisfaction we may want to stay in bed more um so it's those typical symptoms of depression but they're not necessarily getting in the way of our daily lives but they're definitely getting in the way of our satisfaction in our daily lives whereas when we think about a severe episode of depression we often see that Folk folks really are struggling to get their daily activities done there's very little or no pleasure or enjoyment in anything that a person is doing there's very little motivation to do things and so we see that a person's ability to actually engage in their lives is severely compromised in a very different way than than what we would see with low grade depression where a person is typically able to do most of the things they're probably not doing those extra things anymore um but they're typically able to do whatever they have to get done thank you for kind of delineating between the two um I myself have had you know bouts of depression uh sometimes it was low grade it was just kind of like this feeling of stagnation or uh you know really couldn't focus on things just kind of had this really indifferent kind of feeling towards life and other times it was definitely more of a severe depression after a significant event like my divorce or um you know a chronic illness diagnosis something like that so uh thank you and I believe uh we have Dr Judy as well I'm not sure yeah there she is hi Dr Judy how are you hi guys nice to be here and thank you so much for putting this together I really hope that our viewers are going to enjoy what we're going to be doing because I think it's going to be so helpful absolutely um we are so excited to dig into both of your exercises uh first though Dr Judy do you want to speak just a little bit about depression like any advice you can give uh or or something that's very important for us to know before we start these exercises well I think what's important to know is that oftentimes when people experience depression they're still beating themselves up which of course makes the depression worse and I just want to really normalize this feeling of depression um whether or not you have brief depression after situations that are stressful or you have a clinical depression where it persists more and you might need treatment it is a normative process a normative emotional experience for many people and so I think it's important for all of us to recognize that whether or not you feel like you're suffering from depression yourself or you have a loved one who is suffering from depression that it's something that is quite normal it is something that is treatable as we're going to demonstrate always there's ways to help yourself but understanding that when you're in that depressed state it can really feel hopeless and futile at times and it can take you away from trying to solve the problem and trying to feel better on a day-to-day basis and obviously sometimes that treatment process is going to be a bit of a journey but if you can every single day do something to improve your mental Wellness I think that that's going to be a really really important aspect of hoping to feel better over the long run and also to develop resilience the next time you find that depression question is setting in again thank you Dr Judy um as you both know we've kind of already discussed we're going to do two different exercises first Dr teslam is going to take Dr Judy and myself through an exercise we're both going to participate and I really highly encourage you to do so as well feel free to drop in the chat whether you're on our member platform or on YouTube as you're going through this what you're experiencing what you're thinking uh it's it's kind of nice to take this journey together so I will leave that now to Dr tussle yeah thanks Mandy so um what we're going to talk about today is a dialectical behavior therapy strategy called ABC please um and it might seem pretty basic pretty logical but one of the things that happens when we start to experience symptoms of depression is that we start to not do the things that help keep us well part of that is related to decreases in motivation and energy part of it is also related to not really feeling that joy and that satisfaction that we usually feel when we do things and so part of what happens is we do less and then because we're doing less we have fewer opportunities to have joy and have excitement and have happiness and so we kind of feel worse and then as a response we're feeling worse so we're doing less and we're feeling less good and then we're doing less and we're feeling less good and that's often what can contribute to for example a low-grade depression of deteriorating worsening um into a full-blown episode of major depressive disorder and so what what ABC please teaches us is that the first so it's an acronym DBT full of acronyms um so let's talk about the ABC part first so the a part is accumulating positive experiences so as Dr Judy mentioned one of the things that we can do to help keep ourselves well when starting to experience some of those first symptoms of a depressive episode is to do fun exciting pleasurable things and so when we can think about all of the things that we could possibly enjoy in our lives start choosing things and planning them into your day they don't need to be productive even if you haven't done the dishes and you haven't done the laundry and you haven't responded to all those emails don't worry about those right now just do the things that are going to bring you any type of happiness joy excitement any type of positive emotion so that's the a um the next is to build Mastery and this is something that we've talked about at Med circle before but building Mastery is really about feeling a sense of accomplishment and a sense of purpose so often when we're younger we have experiences of building Mastery all the time right the first time you take your steps the first time you are able to solve that puzzle but as we get older many of us are on autopilot we're not necessarily building towards new experiences um we're kind of just doing the things that need to get done and so building Mastery is about intentionally working towards things whether that is um you know trying a new recipe out or working out and noticing that you're running faster or you're lifting heavier weights um I know for me I I feel a sense of Mastery when um I really like music and I really like singing music I pretend I'm a pop star sometimes and so when I listen to a song that I haven't heard in years and I can remember the lyrics that brings me a sense of accomplishment and Mastery so that's something that I like to do and then the last part is coping ahead so that's the C of ABC and so when we're coping ahead what we're trying to do is think about any types of stressful situations or problems that may come up in the like immediate-ish feature so this is not about like worrying about the future but rather have this family gathering or hey I have this job interview how do I cope a Hattie what do I need to do to take care of myself how do I minimize the problems that might be practical things like what time do I need to leave home and can I pick out my clothes ahead of time or it might be emotional things like can I practice some grounding while this stressful thing is happening can I make sure that I have a support person around me so let's start with that ABC and um I'll ask Mandy and Dr Judy to come back and we can kind of chat about it all right um I really like that it seems like a pretty easy uh system to follow and remember thanks to the acronym uh Dr Judy I know you know DBT very well as well do you have any thoughts on this well I love this technique because I think it breaks things down pretty uh pretty simply and it's important for when P for when people are especially suffering from depression because everything can feel super overwhelming so going back to the ABCs is a great technique I'm so glad that you shared this and doing Pleasant things I have so funny as you were speaking Dr Chaplin I was thinking about a lot of the things that I find um to be pleasant activities as well and we share some of those things like our investment and interest in music and I love playing music I love singing I love uh playing my instruments uh and it's so helpful that we can learn that sometimes even just five minutes like what you were saying about you know singing as a pop spot in the shower you know that's only 5-10 minutes but it just makes you feel so much better and music can really change the emotional expression that's going on currently it can really tap into your emotional state and actually help you to express emotions better too which is such an important part of the therapeutic process in self-development is that we understand how to identify our own emotions because sometimes that frustration comes when we feel like ah we're just not happy but we don't know what it is you know but um using music as a channel to express your emotions better I love that yeah I think it's funny that you've both brought up music because that that would be in my bees my build Mastery I am not good at music at all it's matter of fact one of the one of the very few things that I'm very challenged at and um I started taking lessons about a year ago to try and get better and um I would I hate to say that the progress is much slower than I'd like but but what's fun is the warm-up exercises uh they can be silly like make siren noises and and do these really different things and that does lighten the mood it kind of takes you out of that funk a little bit or the monotony of the day-to-day so that was kind of cool thanks for the bringing that up Mandy I think one of the things when we're thinking about building Mastery is also to choose the things that are achievable um and so if you're about to start a music class but you know that that's hard for you especially when you're starting to experience those symptoms of depression you're probably going to be harder on yourself if you're probably going to have so much more negative self-talk and you're more likely to give up easily or at least not see the progress that you're making um and so depending on your mindset it might be a great time to start a music class it might not also be the best time to start a music class um so it really just depends on uh how dedicated you are and how much of a challenge you're ready for I'm glad that you brought that up because I think Readiness I think there's that fine line about you know pushing yourself a little bit maybe when you're not ready but then also honoring what your needs really are and not pushing it too much so you get overwhelmed and if either of you have Insight on how to walk that line a little bit better that would be very helpful as well yeah so I mean one of the things that I often encourage folks to do is is to just be experimental and curious about it um and so if it's something that you've wanted to do try it but be gentle right and recognize that if it's not working or if you're getting too frustrated it's not the right time to do it um and I mean just before this we were talking about how we all have kids and one of the things that we teach our kids right is that you want to kind of get at activities right below that super frustrated moment and that's when the optimal learning can happen and that's the same thing for us if we get too frustrated we're going to give up we're going to think that we can't do it and so finding things that are challenging enough that we feel that sense of competence we feel confident in ourselves we feel like we're accomplishing something without finding the things that um we are overly frustrated about and it's not actually about the task itself it's about our mindset right and so that's speaking to the Readiness but that's also speaking to just where we're at with our emotional health because sometimes we can do that really hard puzzle or we can figure out that really challenging problem and sometimes times we just don't have it in us or we're too frustrated and that's a good time kind of check in with ourselves see how we're feeling see what's actually getting in the way of us being able to solve that problem and sometimes reaching out for help whether that's professional Hub or you know just calling a friend to help you figure things out and solve the problem with you excellent uh I have a question just about maybe how to do this um as far as like accumulating those positive experiences do you recommend we write them down do a vision board a journal could it be anything just as long as it's accumulating those experiences yeah it's a great question Mandy so what I usually do with clients is I'll actually provide them with a list of pleasurable activities so on that list could be like like I think there's like 300 things on that list some of them sound awful like I am not a camper but some people love camping so um some things are going to work for us some things are not going to work for us so usually once I provide that list for clients what I'll encourage them to do is to go through it first and just get rid of the things you know are not actually fun for you right because then you're bringing it down it feels way less overwhelming and it feels like a list that's for you then I'll have them go through it a second time um and then kind of identified the things that you could do like right now or this evening versus the things that take a bit more planning um and so then you have a bit more of a tailored list and you can start thinking about future oriented things which is really helpful for when we're experiencing depressive symptoms then we can also think about the things that don't require a whole lot of planning then absolutely plan them and schedule them in so one of the things that I'm sure we have all experienced is the idea that I'm gonna read or I'm gonna you know do some more coloring and then all of a sudden the evening is over and you didn't do the thing you wanted to do but if you decide when you're going to do it what do you need to do it how are you going to do it this allows us to be a bit more committed to actually getting it done and especially when we're experiencing those symptoms of depression that follow through becomes so much more challenging so the prompts the reminders um kind of like thinking about like a little cheerleader that's encouraging you to get the thing done that will hopefully be enjoyable but at worst be kind of neutral um can be really really helpful but on top of that for those who like to do vision boards who like to find Visual ways of representing those fun ideas absolutely create that vision board journal the ideas that you think you're going to have they don't need to come from a generic list they can come from within you but if you're feeling a little bit stuck the the list can be pretty helpful yeah I like that because uh oftentimes just words or or visuals alone can really evoke some positive emotion and get you out of that hopeless State just just by seeing it or hearing it so I really like that we're kind of accumulating the good you spoke a little bit about the B the building Mastery is there anything else you'd like to layer on to that yeah so I think just what we talked about before around making sure that it's especially when the goal is building Mastery that whatever we're trying to do feels manageable so that it's not too overwhelming I think about that be like we can call it building Mastery but I think about it as like what are the things that make me feel like a boss um and so I do my boss things when I'm trying to build Mastery because then I can kind of feel a little good I feel a little tougher feel a little stronger and more capable um yeah so that's what I would say about that I like the C as far as cope ahead um because I think anytime I think of coping it's like in the moment um so so what are some examples of of coping ahead that let's say I'm very overwhelmed you know Mom three kids full-time job uh chronic illness there's a lot on the plate to manage uh and I you could get stressed and kind of you know a little depressed sometimes that maybe I'm not enough or I don't have enough to go around to you know give my best to everybody including myself uh what would Copa head look like in that situation yeah thanks for that Mandy so I think for me when I think about Copa had it's really about reflecting on what are some of the things that are particularly stressful that are coming up so I mean there's the everyday stress and I think some of that can be managed through the pleas that we're going to talk about shortly but let's say it's a day where like you have all of the Parent-Teacher interviews and all of the extracurricular activities and you know you have to have a really hard conversation with a parent or a sibling um and so on those days you know that your stress levels are going to be heightened you know that things might feel a little bit more challenging so those are days where you would maybe want to think about coping ahead and then what that looks like is so person dependent but some of the things we can think about are like all of the planning that you can do reasonably do that right so whether that's looking at your calendar and kind of re-jigging things to make it work whether that's making sure that you're planning out your meals on a day like that whether that's reaching out to the people who have your back and make you feel valued and loved and letting them know what's going on so that if you need them to step in or to help or just to be there that they're ready to do that and you know that they're going to pick up the phone so coping ahead can be all sorts of things but it's really about thinking about those stressful situations recognizing that they are likely to be stressful not too stressful but a little bit stressful and then doing the things you need to do for yourself as well as to help you be successful in that thing I like that I like that thinking ahead before it's maybe even a problem before we're actually in that moment and we don't know how to cope uh that works really well if you're finding this beneficial or you are kind of intrigued at how this is running I mean these are actionable things that you can do in your day-to-day life you don't have to wait to get a therapy appointment you don't have to read through a long book and we we do that intentionally so that you can start to make moves in your life that that you're Desiring uh so if you feel this is useful please share it out on social send the link to your friend I'll text my mom to to get on if she's not already on I hope she's on thanks Mom uh so thank you very much Dr Hustlin for sharing that exercise are there um any final thoughts before we go into our first member question yeah so there's the second part of that which is the place is totally fine and pretty simple so the please stands for uh treating physical illness balance balanced eating avoiding mood altering drugs or substances getting good sleep and having a balanced diet so these are really basic self-care things but things that kind of fall to the Wayside especially when things get hard so the more we can focus on taking care of ourselves especially when we're physically ill making sure we're taking the medication that's been prescribed to us and avoiding any medication or drugs that haven't been prescribed to us if they're not helpful to us making sure that we're getting adequate sleep which of course can be hard especially when we're struggling with our mental health getting enough exercise and physical activity um and then as as balanced of a diet as we can have and eating the portions that feel good for our bodies and that are respectful of our bodies and energy levels I I know for myself personally and I'm not sure if Dr Judy can speak to this as well but uh self-care kind of just unfortunately goes on the back burner sometimes but it's so important to put that first um you know to make sure you're getting enough sleep if you can I mean I know at times when you're depressed you might be getting too much or too little but any little movements that you can make can really make a big difference absolutely and I think that oftentimes self-care like you said does go to the Wayside we think okay that's the thing that can go in all of the things that are on my to-do list but really it should always be at the top of your to-do list I know that's harder said than done but I also want to encourage people to think about self-care as something that can be done in less than five minutes you know it can just be lighting a candle and really savoring that moment having coffee mindfully and not doing your to-do list at the same time or having a work conversation and the most important thing is that it's intentional that this is my moment for self-care whether it's three minutes or 30 minutes make sure you make time for it and that maybe it's the first thing that you have to do maybe it should be part of your morning routine so you make sure that it always gets done uh Dr Judy I believe on your last Workshop that you hosted you actually walked that was one of the exercises you walked us through the different areas of self-care and how to schedule it in uh it was it was amazing it was very very insightful so so thank you for that um all right I think we'll head to our first member question during depressive episodes doing Pleasant things is so challenging because I no longer feel Joy do you recommend doing things you remember brought you happiness thank you yeah thank you for the question um absolutely you know I think some sometimes we are uh afraid or nervous that we're not going to feel the same level of joy that we did prior to our depressive symptoms and so we don't want to because there's a risk there um and yet it's doing those things that can help bring any amount of positive experience and the more we invite those positive experiences the more likely we are to experience more of those positive experiences so kind of the way I had described the like we don't do things our depression gets worse we don't do things more our depression gets worse it works in that opposite way as well so the the few positive experiences that you can have allow for more positive experiences which allow for more positive experiences um and so yes start with the things that you know used to bring you Joy because that's a reliable way to start and worst case scenario you have a neutral experience best case scenario there's a little bit of enjoyment there and you may want to consistently do it some more awesome we talked a little bit just in reference to the last exercise about emotions and feelings and we do have one of the four workshops that are offered on medcircle.com right on the home page that you can try for free till the end of the month is on emotional intelligence so I think a lot of us can you know have mental intelligence we think you know we know this we know that we know we have emotions we may be very in tune with our emotions but um there's always growth that can be done in those and it can just bring awareness to what you're feeling in certain moments and and even how to adjust that and if you are a parent or have a friend or anything it just helps really bring more um more understanding to what those emotions are and how they can affect our life so I I encourage you to check it out uh Dr Judy are you ready to move on to your exercise absolutely very very excited to introduce this exercise and this exercise actually I think dovetails very nicely with the exercise that we just did with Dr toslin because it's all about designing a beautiful day so when people are feeling down and especially when you're struggling with anhedonia and just like this member's question where sometimes you don't even remember the things that brought you Joy and you have to really try to recollect that from your past whatever it is that you're struggling with this is going to be a very helpful exercise for you and I love this exercise because it really helps you to go from you know feeling so-so about your mental health to getting to a place of flourishing so I'm gonna ask our wonderful tech team to bring up the first image that I've prepared which is all about this interesting uh bell-shaped curve about our mental state and how we're feeling and so you know when you are struggling you may feel like I'm being bogged down by my symptoms I'm in the throes of my illness at this point and then when you're feeling better maybe you're in a place of moderate mental health you know you feel pretty good but whenever stress comes your way it can be really difficult to get back on your feet or you find yourself knocked down for a whole weekend and you wonder why that happened so the key is to try to get yourself to a place of flourishing and flourishing has a lot of different definitions when it comes to mental health and the idea is that you are in a state where you're experiencing positive emotions on a regular basis it just does not mean that you should be always happy because nobody is but that you're creating those experiences like to talk to toslin said about having those positive experiences just giving yourself the opportunity to have them and positive psychological functioning helpful social functioning most of the time right so nobody can do this all of the time but the aim is that when you are flourishing you're able to connect with people in a meaningful way experience positive emotions on a regular basis and Achieve good functioning in major areas of your life most of the time and we would call this as living within an optimal range of human functioning and so it's all about this uh inherent idea of feeling good and functioning well and feeling like even if stressful situations are going to come your way you're going to have the ability to handle it because all of us are going to deal with stressful emotions it's really about your belief your self-efficacy on whether or not you can manage what's ahead of you so one practice that I really like doing is the Beautiful Day exercise and my version of this exercise involves five stages so the first stage is to really think a little bit about what you used to like to do or what you enjoy doing now and really thinking through and brainstorming What a Beautiful Day might look like for you so this first step is called reflect and brainstorm you're going to spend some time thinking about the different experiences that you had in the past that brought you Joy and brought you happiness and it's really thinking back to any forgotten details maybe things that you used to enjoy before you started feeling depressed and remembering how much you enjoyed those things obviously when you're thinking about planning one beautiful day you can't do all of those things but in this first stage we're just going to brainstorm all of the different types of scenarios and activities that brought you Joy so again to dovetail on what Dr tasem just shared about building that list of things that bring you Joy you can bring that into this exercise you can think about the activities that bring you happiness and make sure that you write it down during this brainstorming phase so we don't have to necessarily organize them into your beautiful day now but I would just really challenge everybody who is watching this right now to come up with at least five 5 to 10 activities or experiences that used to bring you Joy in the past or you believe can bring you Joy now and they can range anything from things that you can do in under a minute to things that are a bit more involved like going out for a nice sit-down meal to something like dancing to your favorite song it can be anything that is very very short in duration to anything that might take a little bit longer to savor so I would just love to see what the two of you have written down and some of the things that you're thinking about I mean I think I know a couple of the things that are going to be on Dr poslin's list which is going to involve music but I want to know what those specific things are and then Mandy I haven't checked in with you for a while about what your favorite activities and hobbies are lately so anyway I'd love to hear what you guys have put on your lists Dexter teslam go first yeah sure I don't know that I have five to ten but I'm gonna roll with it and we'll see where it leads us um so definitely I would say dancing um I used to be a dance performer I haven't done that in a long time and so um definitely remembering those moments where I was on stage totally free to like feeling um confident and just letting my body move to the music in a really liberating way so that would be one of the things um I also really really like to bake um and so coming up with creative ideas of what I want a cake to be like and then to decorate it and to just have time to spend in that process feels really good to me um I also like the beach and so feeling the sun on my skin hearing the water um and just kind of being at peace for a little while I love my sister and I love spending time with my sister I love hearing my son's laugh um and I love hugs from my husband oh my God you came up with seven so that was awesome and I feel like Dr thousands were like long lost friends because I used to also be a dance performer nice I also love the beach so I don't know I feel like we need to do some kind of like Med Circle doctor meet and greet at some point and do some of these things together we'll see how it goes right Mandy um I know that Kyle would love to be in the dance off too so hi Kyle we'll get that together sometime or something oh that would be Circle slash Mob yeah mental health mid-circle flash mob which is you know we celebrate um uh well I know Dr teslam does not like camping but I love camping I love the outdoors uh I hike every day if I can even when it's 20 below zero uh live in the midwest it can get brutal I love to I love art I am not good at music but I can paint and I can draw pretty well I love to write I love also love to hear my children's laugh or um just now that they're older that they're teens when they just come talk and tell me about their day or what's bothering them or what they're worried about or excited about that's very thrilling to me uh anything that makes me feel like a kid again um I don't care if it's swinging at the playground um or you know zip lining or coloring it could it could really be anything but anything that um I really enjoyed as a child or didn't feel I had enough time to experience as a child um yeah those are those are pretty much it I love those Mandy I'm a huge outdoor person too and I used to hike a lot more when I lived closer to the mountains but now I go out for walks and runs but it's not the same I really enjoy hiking specifically um I love that you mentioned zip lining I love zip lining too and anything that makes me feel like a child I get that completely as you guys know one of my favorite hobbies is uh uh the flying trappy their previously makes me feel like a child um and it's like that Fearless feeling you know even though as an adult you're you're much more fearful than you were when you were a child when I when I watched my son who is almost 11 months he is completely fearless and I'm like oh man I know I remember that feeling and that's really really cool so thank you guys so much for sharing what you guys have prepared for your stage one or your step one of this exercise and I just wanted to ask the second graphic to be put up because I wanted to remind people that as you're coming up with your um activity ideas and this one is a little bit oriented the other away but if you try to turn it to its right by 90 degrees you're aiming for this uh section this yellow section of flow where some of these activities that you're going to choose have a high challenge level but you also have a high skill level so that's something that gets you into that state of psychological flow where essentially you forget about time almost and you're just doing something for the enjoyment of it oh thank you for correcting that right away yeah so essentially aiming for some activities to include that will definitely be in this flow range within your beautiful day is is really really helpful so the second step is to plan is to plan your beautiful day by trying to include the different elements from step one that you think can fit into one day and this includes a plan from when you wake up in the morning on this day until when you sleep at night and you also need to set a date for this beautiful day and make any necessary preparations like if some of your activities are going to involve people people invite them in advance make sure they're available on that day if make sure it's a day that you're not working that you can step away from your computer and just have no distractions so it's really important just to kind of plan out all of these little details and make sure that the day actually happens so I just wanted to ask Dr taslim and also Mandy as you guys are thinking about the plan one of the things I always ask people is do you see any barriers that could get into the way of you actually living out and executing this beautiful day plan so maybe each of you can just speak quickly to one potential barrier that could come up that might interfere with you actually living out this beautiful day that you're planning and what you might do about it so that it doesn't actually get in the way of you being able to finish this beautiful day assignment Mandy do you want to go first do you want me to go first um go ahead Dr teslam doctors first thanks um so I think for me uh my two-year-old um is both a contributor to the beautiful day and could prevent that beautiful day from happening um and so I think figuring out a way for um me to maybe have some space uh so that I could do the baking or I could you know dance for a little bit without having to necessarily attend to him but then also having him be a part of it uh but yeah maybe he's just been planning around when he's gonna be there how he's going to be there um so that he's not the center of the day great thank you so much Mandy um okay I think um one thing that I know often derails and not in a bad way um but anything last minute that's needed from work um I have a tendency to like want to get way more done in a day than possible and if a last minute request comes in I just I add it to the current workload but if I take a step back I think I can take off something of my workload that day to accommodate for the last minute priority that needs to be in uh and just kind of push the workflow on a different project a little out that can give me some anxiety because I worry that I'm not going to get it done but it would also allow me to just focus on that urgent matter and better Pace out the day and then it not interrupt the rest of the Beautiful Day awesome thank you guys both for sharing and Dr Tasman I just want to reflect that I totally understand what you're talking about my 11 almost 11 month old uh is part of my every beautiful day but also can derail things that I've planned like at 10 A.M I'm gonna do this and whoop nope that didn't happen and it's already noon and I still haven't done that thing um so I completely understand that and having to sort of plan ahead and making sure maybe they're people to help and all of those things and then Mandy I know firsthand about your extreme work ethic you and I have worked together and had meetings on weekends which I felt very bad about requesting but you have been so accommodating as I've been coming back into work again full-time from early Parenthood and saying like I'm sorry but the only time I think I might be able to meet to talk about Med Circle stuff might be on this Saturday at like 3 P.M which is later at your time because I'm on Pacific Time and you're like sure I'll be available and I just felt so bad about that but thank you for always being so flexible but obviously as you mentioned it could also get in the way of your beautiful day even if you're passionate about your work and so sometimes people have a lot of guilt coming up during this stage as they're thinking about planning this beautiful day like oh my gosh I want to make sure I include everyone um also oh my gosh what about all of these other responsibilities I do care about these other responsibilities what do I do about that and I think both of you guys have mentioned things that I think a lot of people will understand and can relate to and I think it's important to know that this is not like your one shot you know you can have you you know a beautiful day every month or a beautiful day every two weeks so it doesn't all have to get done on one day so also being realistic in your planning is very important in this step um the third step is to visualize your beautiful day as you're leading up to it so let's say you've planned your beautiful day for a week ahead that say that you're guess seven days before your beautiful day I would challenge you to visualize your beautiful day at least three times before you actually live it why because we know that the neurobiology of our brains is that when we visualize things with as much detail as possible evoking our senses your brain lights up in the same exact area as that it would when you're actually living out those pleasant activities and so it's really important to do that visualization it works and it's so powerful there's tons of research for example that shows that Elite athletes when they're rehearsing their sport in their mind it actually helps them to perform just as well as if they actually got to practice on the fields or in the pool or whatever their sport is so I want to challenge you to visualize your beautiful day put it into your morning routine or make sure that it's part of your um winding down bedtime routine set aside just five minutes to try to visualize specific aspects of your beautiful day what it's going to feel like when you do that activity that you've planned you know when you do that baking when you plan to go to the beach really spend time savoring those details in your mind before you get to your beautiful day the fourth step is to actually living or doing your beautiful day so again you want to make sure that in step two you've written down this plan you know actually put it down on the schedule you know 9 A.M wake up 10 a.m do this right all the way until you get to bed so then when you get to your beautiful day and remember you're setting a date ahead of time you're going to just live that beautiful day really enjoy the moment all of that planning you know anticipating barriers that's all going to pay off because it's going to help you to experience this day as mindfully as possible and whenever you find that you're not being Mindful and worrying about what's going to happen the next day be gentle with yourself just bring your thought process back and just say it's okay we all we all wander it's all right let me just go come back and really re-center myself on this experience the final stage is to reflect and Savor your beautiful day so what I want you guys to do after you live out this beautiful day is to spend some time journaling about your experiences and the feelings that you had and this is really really important because when we're feeling depressed when we're feeling stressed it's very very easy to actually completely negate those positive experiences that we've had and our mind plays selective memory tricks on us so it'll say no I wasn't happy that day or that didn't bring me any joy that wasn't fun at all so it's important that you actually write it down as close to real time as possible so I always ask people to do this generally actively within 24 hours of living their beautiful day and go back and experience those emotions and connect with how it makes them feel and also perhaps reflect on what you might change for the next beautiful day plan that you have coming up so the question that I want to ask Mandy and Dr toslin is what are some of the things that you guys recall feeling when you do some of the positive activities that you've discussed so from past experience we're kind of doing this as a recollection exercise right now for demonstration you know how does it make you feel when you do one of the activities that each of you mentioned and you can pick whatever activity you guys like to reflect right now go ahead Dr teslam yeah I would say um creativity confidence and freedom are what I feel when I'm doing those um activities that I would include in my beautiful day awesome created creativity confidence and freedom those sound like amazing experiences and I would say that when people are feeling depressed it's really hard for them to feel those experiences and those emotions and this just demonstrates the power of you know when you actually go through with some of these activities and and being able to be on the other side and saying wow I was able to feel that again A lot of times when people are depressed they feel like they can't never feel those experiences again so having those experiences will help them to say wow this actually works and encourage them to do other things that are proactive that can help with their mental health Mandy what about you um Peace joy and love so oh um I I think the the feeling I seek the most often is peace just to just to be kind of chill and relaxed and and content with things I I used to be all about joy and happy and then just realizing that that's not attainable all the time but if I can be somewhat at peace even even in the disturbance of depression or anger or you know sadness whatever's going on if I can do something just to skew that scale a little bit and bring it to a more peaceful thing then that allows more um opportunity to feel that joy and to feel love or loved or like I want to give love so that's those are the feelings that I would derive from that and I love the fact that you I just want to point out that in my mind I was like oh it can only be one day whenever and I was like oh yeah you could do that like once a month awesome and that have it whenever you like but I love the feelings that you shared Mandy and I would say that those feelings are so congruent with having loving kindness towards yourself when and that's a very very hard thing for people who are depressed to experience sometimes like they feel so guilty they feel bad about themselves they beat up on themselves and that of course just makes their depression worse but being able to tap into experiences of peace and joy and love um also allows them to have self-compassion which is such an important ingredient to depression recovery so thank you both for sharing your experiences thank you Dr Judy I remember on one of the workshops you we did a loving kindness meditation and I started doing um loving kindness lunch so my lunch break before I eat I would just sit and have like 10 minutes and just kind of go through the meditation you can Google it you can find it wherever it is on one of our workshops um and one of the workshop apps that we are offering on medcircle.com right now free till the end of the month is the inner child workshop and why I mentioned this is that I think getting in tune with your inner child can really give some insight into what can make you happy what can pull you a little bit out of that depressive Funk um Dr Judy can probably speak a minute to that as well but I do think it's very beneficial so if you haven't checked that one out yet just go ahead sign up check it out for free um and and Kyle will also be reaching out to for a gift after that after you do if you'd like to hear more about that please sign up just enter your email it will be sent to you and we look forward to that Dr Judy can you really quick before we um have to conclude here share a little bit maybe about how doing inner child work might give us some insight into what we might be depressed about and how to work through that oh yeah I love inner child work so as a skills-based therapist I was trained primarily in cognitive behavioral therapy and Associated techniques the first time I heard her child I'm like wow what is this like Wahoo business um but it is so powerful and it is such a cool exercise because it teaches you how to repent yourself and also teaches you that your past negative experiences don't have to live with you for your entire life you can change that narrative and you can Empower that younger part of yourself that suffer through pain and even trauma at times to be able to become more resilient and so inner child work not only gives you insight into perhaps the origin of some of your struggles now but inner child work also gives you essentially a chance in the here and now to change that narrative to empower the child to give that child what it needed whether that was support unconditional love uh someone that they could count on you know you can be that person for your your inner child so essentially your adult child is going to be there for your inner child and we can obviously talk a lot more about how those exercises are conducted but you can find them in the med circle library and I've always enjoyed teaching inner child exercises to everyone including them at Circle community I I enjoyed that because for me it um I kind of responded the same way that you did when you first heard about it but when I started doing that it really just gave me insight into what my needs really were and then how to best meet them for myself instead of just always searching outside for answers which can be helpful to some extent but um but it's never ending sometimes so so thank you for sharing that I do think we have one member question about the beautiful day activity if we want to switch to that maybe okay there we go for those who have very demanding jobs with long hours what advice do you have to plan a beautiful day while suffering with depression at work totally understand and I think once the day gets started it just feels like another to do that you have to pile on so I don't suggest that you do this at the end of the day I suggest that you wake up 20 minutes earlier one day to plan your beautiful day and count that as your morning routine or your morning mindfulness exercise and it doesn't take a long time as you saw when we demonstrated just now you can actually plan A Beautiful Day exercise probably with just 15 or 20 minutes you can also plant it in chunks right so you can do step one which is just brainstorming ideas about your beautiful day in one day uh for 10 minutes right the next day wake up 10 minutes earlier again and actually plan the details of that beautiful day set the date think about who you might want to include and maybe send out some invitations for them to be available right so you can do all of those things in chunks and then of course the visualization piece that is going to be done um every five to ten minutes uh you know at each time that you do it so it doesn't have to be long at all when you're visualizing the lead up to your beautiful day excellent thank you very much um are there any brief closing final words that either of you can share with our audience tonight Dr Judy do you want to go first oh thanks yeah well first of all I think that first of all you guys are all here so congratulations for being here and for learning um these techniques and I really hope that you actually take the time to practice these techniques because listening to them is really only one piece of the puzzle but actually doing is engaging all of your mind and body to really trying these techniques and remember it's okay if not all of them work for you but please do try them because you will find your unique toolkit and even if only two or three techniques really work for you then you've got the two or three just keep using them you don't have to keep switching it up I mean for me for example physical exercise is always a great coping strategy and it's one of my big go-to's and it's okay that there's not a lot of variety because that's really an important part for me that really works me too me as well and yeah just kind of going off what Dr Judy said that the importance of savoring the moment um I think so often when we're trying new things or we're trying to do things that we once enjoyed we become focused on the outcome which often is feeling better or feeling peace or feeling Joy or happiness or excitement but when we're too focused on the outcome we lose the opportunity to really experience and be present in the moment so your beautiful day may not pan out exactly the way you're anticipating your pleasurable activities and building those positive experiences may not play out the way you were expecting but that doesn't mean it's bad it doesn't mean it was wrong or a failure it's really about allowing yourself to be there and to experience those moments and allowing life to take you on the journey that it's meant to take you on yeah there's a phrase that goes if nothing changes nothing changes and I love it because it's just a simple reminder that just just one tiny little change or or shift in perspective or um little experiment that you can try sometimes is is all the shift that you need to get that momentum moving forward so I hope that this was helpful for you um thank you both for for coming tonight and um we are going to phase into our next two doctors Dr Lam and Dr Romney so thank you Dr tussam thank you Dr Judy see you both very soon bye thank you bye our next section we will be um joined with Dr Lam and Dr Romney and they each will also be going through a technique to work through a low-grade depression in reference to productivity but hopefully you can see how it can expand beyond that so we will get started with Dr Christy lamb hi Dr Lam how are you I'm great thanks great to see you thank you you too um and uh I think we can bring Dr Romney on for a minute hi Dr Romney how are you it's great to see you uh so I'm gonna have each of you first just speak a little bit to depression you can discuss you know what what makes it low-grade versus severe or whatever message that you want to give our audience tonight about depression and then we will start with Dr Lam we'll do your activity and Dr Romney and I will participate in that and then we will switch Dr Romney will do an activity and Dr Lam and I will participate so let's go ahead and get started uh Dr Romney is there anything that you would like to share about depression I think that depression like so much of what we talk about mental health is on a Continuum and I think because tonight we're talking about sort of maybe depression on the milder end of the spectrum so folks who may still feel that they can go to work and engage in some of their responsibilities there's a tendency for sometimes people to say well you know this isn't the kind of I can't get out of bed I'm not functioning as well maybe this doesn't qualify and almost sort of being self-disparaging in the face of that like I need to get it together there can be more self-blame in that so I think what we have to remember is this is on a Continuum yes at the milder level certainly a person may not have the same level of Social and occupational impairment but that's not to say it's not painful the sad mood the fatigue the negative thoughts the negative feelings definitely take a toll on a person and I think the key is that people don't sort of get into that pain competition that well maybe this isn't enough to be an issue but to understand like any you know any any experience or mental health issue that happens it it's on a on a Continuum from mile to severe and that at the milder ends inclusive that these are issues that require people to seek out the help they need and to be kinder gentler and more self-compassionate with themselves the thank you Dr Romney the Continuum seems to be a theme Dr Judy had shared um a diagram with us that kind of basically said the same thing and that's extremely refreshing and comforting to hear that it that it is a Continuum we all kind of can experience it it can fluctuate it can get worse but it also can get better so thank you for that um Dr Lam how about yourself yeah I think um the this Continuum uh I think it really hits with um uh something that was posted I think on Med circle from a video um that I had done with you all regarding the same concept of the Continuum of how important it is to acknowledge the low end of the Continuum because it helps us see this acknowledgment of the spectrum helps us see that um it can be better and it can be worse and that I can intervene at any one of these stages it is so important to understand that this is part of the normal human kind of condition and that on the low end we don't have to dismiss it we can engage and often when we engage in the lower end we can prevent bigger more major depressive episodes from happening and as importantly we can see okay this isn't just something that comes out of nowhere like lightning that I'm just genetically flawed in some way and there's nothing I can do about this and so in the lower grade of depression when we can get attuned to noticing it um acknowledging when some of the symptoms are coming in we really have an opportunity then to intervene in a place where we aren't as depleted so whether we're talking about anxiety or depression low levels of anxiety noticing little little pops and anxiety and being able to regulate so that it doesn't just build or noticing little bits of lower energy less engagement Detachment or self-attack that's coming in when we can see it in this lower end we have the opportunity to intervene and really kind of cut it off at the past before it becomes something bigger um so such important piece of this I think it is a common theme that we've all been talking about the sense of this being on a spectrum it being part of the human condition and the more that we can look at it pay attention to it and exactly what Dr Romney said that idea of so often when people have low grade they dismiss it or even they attack themselves even more of like okay I'm not really depressed I should just push through this that that's really kind of missing the point here that those low-grade symptoms are a signal flag that can let us know it's time to pay attention it's time to intervene to take care of ourselves in this moment and starting to get aware of when these symptoms are coming up so that we can intervene can make all the difference in regards to symptomatology and kind of the duration of symptoms I really like the fact that it is moldable instead of fixed and that in and of itself just gives um extra hope to to dealing with uh depression whether it's low grade or severe so thank you both for that Dr Lam let's go ahead and dive right into your exercise can you please give the viewers a little bit of background of what this is and why it works and then go ahead and start absolutely so um I loved the transition into inner child work that we were talking about as we transitioned into this group I think the first two exercises that were shown are such useful and helpful exercises that are very behavioral and you know I come from a training background in psychodynamic Psychotherapy which really kind of looks at unconscious processes and looks at the emotional connection to our symptomatology so coupling the behavioral activities that we talked about earlier and then starting to look also at what what might be driving the depression can be really helpful so that we can wrap our heads around what's going on and rather than just treat symptoms potentially get at what might be have having what might have driven the mechanism the engine of the depression to start with so what I mean by that is that when we think psychodynamically about depression depression in and of itself we kind of put in the place of symptoms so when we are depressed we often think about the term that Dr Judy is Right anhedonia feeling just not feeling pleasure and things we used to feel pleasure in often this comes from being detached isolating avoiding in our lives we often have a sense of fatigue lack of motivation lack of concentration and in this space we can start to self-attack start to judge ourselves we can feel helpless and hopeless all the kind of symptoms of depression can come in and we can address those symptoms behaviorally and that I think often is the first step that's really important and helpful to kind of get energy back in the system once we can think clearly about this it's really important and helpful to then look back and see what was it that was driving this and what was it that sparked this depressive episode now certainly sometimes these things can come um can really feel like they come out of nowhere and we might not know the the exact origin of it but most commonly in the work that I do patients come in thinking yeah this Depression started three months ago and they have never made a correlation to what was going on three months ago and the more specific we get the more we look at that time frame what was going on we can often see that there's something going on in their lives that brought up a ton of feelings um I'm always talking about the triangle of conflict which is this notion that if we have deep core feelings that get pushed down if at some point in our lives we were told it's not okay to be sad it's not okay to be angry it's not okay to feel um anything other than Joy if we push feelings down the resultant um uh affect is anxiety so what happens when we push a feeling down as we get anxious if you try and hold back tears our throat gets tight we might get squirmy anxiety comes up in the body and then we do things to try to not feel so anxious and these we call defenses and this is that triangle so if once we've navigated the depressive uh symptoms we can then work back and start to see what is it that was driving this what was going on and that takes a curious look at what specifically was going on at this time that depressive symptoms were coming up and can I start to look at What feelings were being repressed so I have found in my practice um people who have seen my videos before know that I'm a big fan of anger um that very commonly anger gets repressed we've been societally um encouraged to not be angry um it's gotten muddled with aggressive acts so the feeling of anger has been somewhat demonized we push anger down we get anxious and one of the most common things that we can do is turn it back on ourselves and this is where depressive collapse can come in I was working with the patient just today who we started to talk about anger towards her husband and we noticed that she started to hold her breath she started to get weepy and tearful and started to talk about how hopeless the situation was I was asking her about the feelings toward her husband for an egregious act that he had done and she could intellectually say that I was upsetting but immediately we could see this mechanism of self-attack that it started to turn back on herself and she started to feel depressed in the session she started to notice fatigue she started to notice feeling hopeless feeling helpless and feeling like um you know a more of a depressive uh space when we're talking about low-grade depression often there is a closer connection to you know if it if it's kind of coming up um in the moment rather than I've been feeling depressed for five years these lower grade depressions that come in when we can notice a shift in when it started and start to take a look we can start to explore the feelings that come up and it really is the antidote in my um practice two depression is feeling is getting really clear about how you feel even really difficult situations allowing the space for real grief differentiated from a dump into depression um and so it's kind of like Plumbing um which sounds a little bit crude but the idea is that if feelings come up if they aren't allowed to be in the direction that they belong that blockage can make a pipe that gets turned back on ourselves and turns into depression so feelings get um transmutated into self-attack and depression and Hope hopelessness and helplessness so what we're going to do is take a look at um any time that any of us has had an experience of feeling a low-grade depression of when was the last time that some of the symptomatology came in so that we can then take a look at what the inner monologue is noticing the inner monologue can be very helpful so that we can identify oh I'm in that place and then we can start to question um and dismantle some of that inner monologue and see where these feelings actually belong okay so um if anybody wants to start I can I I I'm rightful of my own examples as well so um please feel free if there's if there was a time recently where you may have been in a place where you felt um self-doubting self-attacking um feeling somewhat depressed withdrawn um and if you're open to exploring what was going on at the time we'll start to take a look at that Dr Romney would you like to go first sure I I'm thinking of a time probably the time I felt most like you're describing was the end towards the end of August so multiple things were happening for me and I I really I felt constantly exhausted I wondered why I'm doing what I'm doing I felt helpless I felt hopeless I felt angry I felt like a bad person I felt like a bad mother I I I just felt bad about everything and it I know it was happening at the time I had two daughters been getting ready to move out and all the emotion around that meant they were lashing out at me a lot so I was having to sort of come up against their you know they're like ah you know kind of coming at me I was finishing a book I had a lot of other work to do um and so everything had sort of reached ahead there were a lot of logistics to deal with and so I was just it was too much for one person and um and I was kind of burned out I was burned out on caregiving I was burned out on work King I was burned out on doing you know a lot of it on my own I felt anger that I was having to do it on my own um and uh yeah and so that I was really pretty rung out at the end of August yeah it sounds like it and I mean this is such a perfect example right where as you're letting us know the symptomatology and letting us know when it came up there was a very clear there multiple stimuli that made the Stress and Anxiety higher at Baseline things that you know you might have otherwise enjoyed but a lot on your plate and I think that depression we know is much more likely to happen when our stress levels are really high when our anxiety is high it's very easy for that dump the brain goes on overload and we kind of dump down into a depressive collapse but the thing that was most significant to me was the relationship with your daughters right that people were moving out there were mixed feelings that were coming up and you mentioned saying um I think you said I'm not a good mom right this self-attack was coming in and so some of the questions that we can ask ourselves are could that be a depressing thought so just identifying when I label something could me attacking me can I start to notice could that be a depressing thought could that thought be hurting you yep and when we get clear when these thoughts started the question that we can ask ourselves when we're getting clear about feelings is where might that attack actually belong where might that aggression actually belong and you mentioned you had some anger towards your daughters right that you clearly are supportive caregiving you love them and it's really hard for us to hold mixed feelings and that often when we have feelings towards someone else they get turned back on ourselves especially when we're in high levels of anxiety and so one of the things that we can ask ourselves is where do these feelings belong when I say that it doesn't in any way shape or form mean that we're going to lash out at them or be aggressive towards them but can I just hold these daughters that I love make me angry and I wonder what it's like just to hold the mixed feeling these daughters that I love were lashing out at me and were making me angry what do you notice inside when you say that or when you let that in when I let that in is you know I feel like that's that's you know it's not you're not supposed to do that that's not right there's a lot of social comparison for me you know I I felt a lot of guilt I was actually kind of looking forward to them both moving out and finally getting to sort of enjoy my empty nest and everyone around was like oh I'm so sad my kids are leaving and I was like you know I'm thinking I am kind of how much longer is it and you know what it and it was hard because I felt really guilty about that because I actually was thinking okay it's time for you to go and yet a lot of people around me because a lot of people are going to that same developmental phase of people whose kids moving out we're all really sad and isn't this awful and what am I going to do with myself I'm thinking what am I going to do with myself like where does this list begin otherness you know I was having and so that you know at one level there was kind of like this Defiance to it but at the core of it was a sense of guilt because it was that doesn't feel good and I you know I don't like feeling that and and what is even quadruply painful is it's actually my mood has improved significantly since they've been out of the house you know because there there's not anyone like you know and I was and I thought and then there's these moments like is that bad but I feel so good I feel so much healthier and I feel so much lighter and happier and so I'm trying to lean into the emotion but every so often the guilt wafts in and I'll often go into this place well maybe you weren't meant to be a caregiver like I'll still go to a disparaging space of this very important role in my life of being a mother I then devalue myself in it and that will give me that will definitely put me into more of a negative mood but I have to acknowledge I'm taking better care of myself I'm sleeping better I'm eating better I'm exercise all the things I haven't done for many many years there's actually now time to do it and so I knew things were going to get better for me after they left and that drove a lot of guilt at that time too yeah that thank you so much for acknowledging the guilt piece because I think that um you know in istdp that I've trained in underneath the anger that we talk a lot about is the sense of guilt over having anger towards people we love and then we punish ourselves for feeling anger towards someone that we love as if there is anyone on this planet that we don't have mixed feelings towards especially our children right we love them dearly we want the best for them and they suck the life out of us at certain times right and that um and that they can ABS you know I have a five-year-old who still can tantrum like you know her head is spinning and the love that I have for her and the rage that comes up inside when she's flipping out and the more that we can allow the space for that the more that we can allow it to be normal and okay to have mixed feelings and you know I so appreciate that sense of that societal everyone else is oh my kids are the best and I'm gonna miss them and there's no anger I never have any negative feelings it's all Bliss and love I don't think is always completely I mean if you're out there like put it in the comments what you're taking that makes that happen because I've never met someone who opened up and really looked inside who couldn't say yeah they're of course there are times that I get infuriated or that I I question whether or not um you know I want this and it doesn't mean that we don't want it it means we also want space for ourselves and so I I can't thank you enough for looking at this with us so openly and about the notion that when I can allow myself to feel to know that I have love and anger concurrently and that they don't negate each other and I don't have to feel guilty about my anger anxiety can come down and we don't have to go into that place of self-attack the self-attack comes in almost as a way to try and protect others from our anger but we don't have to protect people from our anger our anger is just a feeling inside that comes up and lets us know gosh there's part of this that's really frustrating and I want some space back beautiful just information from our bodies it's normal it's healthy and being able to create the space for the reality of what is what comes up the mixed feelings we have towards everyone even our children is so healthy and actually preventive in regard to depression allowing more of our feelings to just have access to them to normalize them and know that we actually don't have control over the feelings that come up in us we have control over what we do with those feelings but we don't have control over the feeling that comes up and sometimes we get angry and we don't even know why and it's okay it's okay to have guilt it's okay to have love it's okay to have grief and that these feelings are more than okay so Dr Romney I can't thank you enough for for sharing such a perfect example especially I think parent child having anger towards our children is a really tough thing to to acknowledge and to um talk about and to allow ourselves to feel and so quickly can dump into that self-attack that can lead to depression so I have a perfect great example as you were saying it my anxiety was going up because I know exactly that feeling of like the just that tension between I am feeling this way I shouldn't be feeling this way does it mean I don't doesn't mean I don't want them does it mean this um so thank you all both for just being moms and understanding that uh and and Dr Lam just for validating that we can have mixed feelings and that's okay and that's actually preferred and normal uh to accept that but but they are very difficult to sit with um yeah absolutely that we've been so socialized against it right but um if we just go to buy basic biology before I can think I'm angry my amygdala is firing so before I have any conscious awareness of it I have no control over the amygdala in my brain the part that uh emotion Center in my brain when someone does something egregious to my child my amygdala is gonna fire before I can even know that I'm angry and so the studies around this the fmri studies that show this brain activity and the 200 millisecond difference between our body's reflexive response for an emotion and our conscious awareness of it really kind of takes us off the hook for having feelings we don't have control over them they just come up it's data it's information it's like a fever coming up I don't have control if I get a temperature I don't have control if I get hungry those Sensations just come up inside of me and it's information it helps me know oh gosh yeah I do need some more space in this relationship I felt kind of suffocated or like I've been giving too much so when anger comes up it lets us know I have a need and so it's such a useful um you know data point that we can start to hone in on but only if it's normalized only if it's allowed and so many of us have been just taught that it's not allowed you're not allowed to have mixed feelings towards people that you love and so we push it down we get anxious and then we turn it back on ourselves I I think even um mixed feelings on people that we love relationships or even our work um you know you could you could absolutely love what you do but there's still this toughness to that relationship of just being exhausted by it or feeling burnt out or um just maybe someday not having motivation or creativity within you uh it's good to know that that there there's that Continuum again that we can flux back and forth so thank you Dr Lam absolutely absolutely and Mandy do you have I don't know if we have time for your example or should we we can we can move on um if you want and then I can share in the next um I don't know how many how much do you have more to the exercise no this is this is the exercises being able to take a look at what's been going on what what was the situation beforehand and then starting to ask ourselves right are these could these be depressive thoughts and um when these depressive thoughts come in could these be hurting me right when did they start and where does this actually belong yeah um Bridget said we have time so we'll go ahead um there's some things that happen recently but I think it would be I would like to to maybe dive into something that happened in the past um when there was I could talk about a couple different things but more of a issue I'd had a chronic illness kind of under the surface for a long time nobody could diagnosis to diagnose it it took forever to get a diagnosis then it was you know pill you know do take this pill do this do that and the entire time I was in a ton of pain I Was 80 pounds overweight I I couldn't move I was super depressed very angry I had to my ex was a first responder so he was on shift every third night my mom would have to come over and take care of the kids and and this went on for a while and it and even though I'm naturally a positive person it really ate away at um any hope that I had that anything was ever going to change because everything we were trying just wasn't working and I just felt myself slipping worse and worse and worse that did bring up a lot of anger that did bring up a ton of frustration as I look back on it that had been building for a while but it all seemed to just kind of snap one day um for me like when I just I had just had enough right um yeah and and I did I definitely attacked myself like what is wrong with me why am I why am I not healthy why can no one no one figure this out I must have done something to deserve this uh all sorts of all sorts of negative self-talk no I so appreciate those the specifics on the self-talk right because we can see so clearly how in the midst of a really difficult situation where there's going to be mixed feelings over the loss of function in your life right so potentially some real grief and then also the anger um the you know especially when we're talking about chronic pain and um uh so many of the um uh autoimmune disorders um the medical community at large can be incredibly dismissive some of the advice that is given or the medications that are given can actually make things worse and so um medical trauma is a huge issue in the midst of chronic pain and chronic illness that I don't think gets talked about enough and the amount of feelings that come up towards providers who are dismissive or family members who uh it's just all in your head all of the things that can come up right if we aren't navigating the feelings that are coming up in this in the midst of this really difficult situation again we can get anxious and then we can go to this really helpless hopeless space um gosh that I've had so much empathy come up for you that sense of like what did I do wrong do I that I deserve this in some way right we could I mean and I've had patients who almost had magical thinking around the idea that you know they brought these things on themselves for you know things from their past we can really get into a place of self-attack when we don't allow ourselves to just metabolize the feelings that are coming up as they come up and so allowing the space for grief allowing in the space for the anger that can come up in the midst of a medical workup of having to go through painful treatments or misdiagnosis or again treatments that cause more harm than uh than good can bring up so many feelings and the more that we can allow those feelings to be it doesn't change the situation right it would be lovely I think sometimes with anger with a specific Target of someone who's done something we can have a conversation we can maybe change the situation with chronic pain and chronic illness we can feel kind of impotent in in the midst of our anger but we don't have to feel anxious and we don't have to go to a collapsed depressed place if we can metabolize the feelings that are coming up as they come up to be able to allow the feelings to come through to be able to feel sad to be able to feel the anger to direct the anger where it belongs so that it's not getting turned back on ourselves and this is um something that I think is often very difficult for those of us and I am in this Camp of someone who can really go to town on myself when I'm feeling I'm feeling feeling towards other people or sometimes in the face of grief I can really beat myself up to avoid those deeper feelings but the more that we can practice noticing when we're in that space of self-attack noticing that that means there are some feelings coming up that I'm avoiding I am there it is I will say this as a definitive rule self-attack self-punishment is never useful um we can at times get wedded to it thinking that it makes us stronger or tougher or pushes Us in some way but self-attack is never going to be long-term a useful um mechanism that comes up inside of us and so when we can see ourselves doing it we have the opportunity to kind of work back on our triangle and figure out what is it that was driving this and What feelings are coming up that I need to process then I need to allow myself to metabolize and feel so that I'm not channeling this back on myself that if I can allow myself even to grieve about again the loss of functionality during chronic illness or chronic pain I will actually feel better on the the other side of that grief that isn't getting pushed down and turned into self-attack yeah I eventually learned to do that um by you know focusing more on what I could do instead of and instead of that but I did I defaulted to shaming myself to that guilt that Dr Romney was talking about even even thinking I was crazy maybe I am crazy maybe the doctors maybe maybe I am just depressed uh there was there was a lot of that of second guessing but I also noticed that that had been going on since a very long time from childhood you know just dealing with certain forms of abuse you kind of just take that on that mindset on that you know that victim mentality of like um it's my fault you know I did this I'm being punished I'm doing that um as much as I worked through that I could I still get angry to this day that's I still default to that whenever any stress comes up in my life like immediately I can hear that you're not enough you're never going to be able to handle that you can't do this and and it takes a lot to to defuse that and to work through it in a rational sense and and um and I don't sit with mixed emotions very well I don't know about you [Laughter] but um yeah it's very tough but I but I appreciate you know breaking that down for us and and how we can reflect on this isn't helpful at all to be thinking about this and it's only perpetuating the depression absolutely and I think that one thing we can we have to watch out for for those of us that are self-attackers once we learn this we can then attack ourselves for self-attacking and you brought up such an important point that often we learned to do this protectively in childhood so if I were if I was verbally abused and told I wasn't enough rather than have anger towards a parent where it was not safe to have anger I internalized that and I say I must not be enough then I can just shut down any feelings that I have and I can exist in this dysfunctional but relationship that I'm dependent on as a child so we learn these mechanisms really protectively I mean it's incredible right that we would rather than fight against it and potentially put ourselves at real physical harm potentially in a really you know traumatic childhood experience we learned to just integrate it start telling ourselves this colluding with the perpetrator to keep ourselves safe so this thing that once kept us safe now has become generalized that I'm not allowed to have feelings towards other people so I just turned them back on myselves and when we can see that mechanism in action as adults we can start to say okay wait a second that was protective then this is horribly destructive to me now I don't want to speak to myself this way I don't want to I don't want to be a perpetrator to myself the way that my parent or coach or whoever um the perpetrator was I don't want to internalize that and swallow them whole anymore so acknowledging that and starting to notice this and being able to separate from it is so important so I still appreciate that link to your past yeah um thank you very much for sharing that do you think that you know after we kind of identify maybe back where it was and all these feelings that we're feeling and that I have identified that it's harmful to be believing or thinking these things what what would a Next Step be kind of out of that and learning to reframe or or move forward in some way yeah so I I think that that identification piece is so important can I notice when I'm doing this to myself so can I notice and then for some people it's really helpful when they've identified where where the actual perpetration began we can say okay so is if it was your dad say it do you want your dad in your head on a megaphone at all times is that is that does that sound good to you and most people are like good God no I would never invite him into my head right if it was a traumatic experience right and so when we start to connect it to the destructive past we can start to say oh yeah thanks Dad I'm good I don't need to be right we can actually engage with the thoughts and decide that I am not going to treat myself that way and then it really is so useful to then get clear what are the feelings that are coming up that are getting repressed that are getting turned back on me because it's useful information so if I have anger coming up towards someone I need to know that because it means they're stepping on my boundary in some way it means that I have a need that needs to be articulated right and that um you know with Dr Romney's uh daughters you know she has lots of love for them and they took up a lot of space and time and so she may need more space it's a beautiful and they may not be able to provide that for her or get it but inside of her that frustration gives her information that says oh gosh yeah I have been on overload and giving and giving oh I want to take care of myself beautiful and she's now got the space to do that right or um you know if with a doctor in when you're getting a work up if I notice the self-attack I turn against it I say I'm not going to speak to myself the way I was spoken to and I get clear about what I'm feeling if I'm having anger towards a medical provider that's useful information they may be being very dismissive they may be asking me to continue on a medication that's being more harmful than good and when I can acknowledge I'm not okay with this I can advocate for myself so when we allow ourselves to deeply feel what we feel we have the motivation and energy to move towards healthy action that all of our emotions put us in towards healthy action yeah um thank you very much Dr Lam for kind of guiding us through those next steps uh I know recently we had done a live workshop on anxiety and sleep and we did walk through some similar activities about really identifying what was going on and allowing ourselves to feel that that is one of the free workshops we are offering on our home page now if you just enter your email sign up you can watch it there's some great tips in there so again thank you Dr Lam for sharing and Dr Romney are you ready to walk us through your activity yeah great so you know when one thing I find Working especially with dep clients who are in the more mildly low grade depression they are still getting up and going into life right they're engaging in their caregiving responsibilities they're uh they're going to work but what a lot of folks feel is that the absolutely there's a sort of again that the anhedonia that you said Dr Ho talked about there's a there's an apathy there's almost like a sense of walking in sort of like you're watching walking in half as fast and you feel like you're not getting stuff done and when people aren't getting stuff done they often feel worse about themselves like I'm not productive I'm not doing anything and that can almost play double down on some of that apathy so there's a whole there's a whole world of thought around behavioral therapies for depression and a lot of them in the most simple form is like let's get people out there doing things and anticipating doing pleasurable things and developing a sense of what's called self-efficacy from feeling like they can do things I can get something done because that's really kind of the bane of what many depressed folks go through is that I feel like I'm not getting anything done and I'm just looking at this to-do list getting longer and longer and longer people freeze up more and more and more so we think that what ends up happening too is for many people who are dealing with any level of depression is they'll often put very unrealistic expectations on themselves again that they can't be realized a person who's depressed does have lower energy and the sense of fatigue so it's harder to get things done so the one thing I encourage clients to do is I'm like let's cut the day up into three chunks you can cut them up in any three you want some people will have morning afternoon evening some people might say before I go to work while I'm at work and when I come home it really comes down to how a person's life is sort of designed so I'd say to everyone out there whatever three meaningful ways to just go boom boom boom that these are sort of three distinct areas of my life ahead of doing this exercise I'll often and I'll say try to do this when you have bandwidth one thing that's important to do is the next step is to determine what time of day do you feel like you might have you might feel a little bit more mentally sharper or have a little more energy or whatever it may be what are tasks that need to get done what are other things on your to-do list whatever that may be when you do have a little bit of that vim and vigor a lot of us do have to-do lists and those can feel overwhelming but it's a good idea to sort of keep those on a running list often on a device or something where it's not a piece of paper you can lose and let that kind of accumulate again typically when you're feeling at your best for some folks that's morning some folks this afternoon some it's evening it depends and then what I tell folks is you need only get one thing done in each chunk of the day one manageable thing done so you know some people will say okay I have to answer email so I'll say okay one hour of emails or whatever half an hour of emails and that will go into one of the chunks of the day one of the things that a person may need to get done that day is maybe they have to I don't know read something a report for work okay that's one chunk of the day I'll always suggest to folks who are living with depression or experiencing apathy or anhedonia in the morning try and do something that's efficacy building meaning it's something you know you can do and get done so some people it might be I'm gonna I have to walk the dog or I have to pack some lunches or something you know you can do like this is something you can do without thinking but it's a thing getting done people say well walking the dog doesn't count as something to do yeah it does you don't have enough option dogs got to get walked put those things in your damn people say so I'm only going to get three things done in a day no but at least you know you're going to get three things done in a day so the one hour of emails gets done the report gets written those might be two critical points in your day but instead of saying okay this afternoon I have to do the emails and I have to review the reports and I have to look at the spreadsheet and then I have to email back my daughter's teacher and then and then I have to get the groceries and I'm like slow down three things that groceries are that important then maybe we move report to one of the chunks of the day put the groceries in the evening and so what happens though is some people will say well I got the emails done and I got a few hours here and some people will report sort of an elevation in mood like I got emails done and then they might say oh there's another thing on the list okay for some people to get it going for some people it won't they'll say okay I'm a little tired I need a moment but at the end of the day three things got done I found that this also even been useful for clients who are struggling with attention and concentration which are often impaired in depression so three chunks three things that's it invariably people will get done with more than three things because more often than not people who who are living with depression in fact any of us will say I have to get these 20 things done today then we don't want to start our day but always start with something doable like you know you can get it done I'm going to give you my own personal example I go downstairs because I never do it because I'm always too tired and I I make sure the kitchen is clean I go down and I clean the kitchen dish is done counters wiped kitchen is every single morning that I feed the cat and I feed the hummingbirds one two three and when those three things are done it's as though now I have permission to begin my day and I feel a little less overwhelmed but if I started the day with I've just gotta I've got to get right to these really aversive emails I might not get out of bed but I'm like I'm gonna do the kitchen I got this I can feed a cat I can do some hummingbirds I got this and then even on my most low energy days I can just go and I oh often when I'm working with clients they're depressed I'm like let's track this and they'll say I got five things done I got six things done three is too little I'm like okay you know but let's stick with three and then what people will say is the act of doing begets more doing and then for a person who's depressed it actually shifts their cognition to like I'm I actually do get some things done and um but to give themselves permission after one of them gets done take some rest so that's that's it's very much it almost draw jobs a little bit from behavioral activation therapies and things like that of just doing almost become their own form of healing I I really liked that Dr Romney and the whole time and maybe Dr Lam was doing it as well and we can share out a little bit but I was going through you know all the things I have to do in a typical day and where can I chunk my day and what what can I pick is can you offer us any insight on um picking activities should should that just kind of be like an intuitive thing or something that is urgent or like you said builds efficacy do you have any advice that could be useful you have stuff to do right like you know for example if you're employed you might say okay every day the certain report has to be submitted you know that's every day that has to happen or every Friday so there might be certain things the way your workplace is is constructed it might be like I have to edit this I have to get at least one video edited a day that might be a good thing to put in chunk too to make sure it gets done um some people might say I'm mentally my very sharpest in the morning maybe that that's when you'd want to do maybe the more cognitively demanding task saving for the end of the day when people might say I feel much more fatigued than something that's almost over learned I think it's a good idea for people who are again when they when their bandwidth is strong when they're actually feeling okay to almost sit down and maybe make a calendar every Monday this has to happen Tuesday Wednesday Thursday whatever it is it might be those are certain days in your caregiving responsibility certain things need to happen and listen if on one of those days let's say you have therapy every Wednesday and you have therapy on Wednesday afternoons boom that's junk two done I'm going to therapy I went to therapy I'm done and so again it's that sense of I did the thing I did the thing without it being without it feeling unrealistic and so and and this could also be a useful task to work on with the therapist and some people might even divide the task okay I have a caregiving role I have a work role I have a you know household role whatever those things might be you might be also clear on some of those and and those effici once a day do something you know you can do you like just so that thing gets done you're like okay I am getting things done I am getting through my day I liked that um can that include like something you know you're gonna do every like I have to make my bed every day that's great that could be your morning one of them okay that could be one of them because then I think for some people that becomes almost a benchmark beds made I can keep going and then from bed being made you might say okay and then I'm gonna pull those clothes out of the dryer or there's something else that will come from that but I like the idea of Benchmark tasks like I said for me it's always making sure the kitchen gets tidied in the morning because it's sort of in the middle of my house so when that feels tidier I'm like even the rest of the house is a mess I'm like okay that got done yeah and so whatever that might be how about you Dr Lam are there any what would you consider saying no I love everything that you're talking about I'm nodding the whole time I think that um the idea of for me I I love this idea of getting clear whether or not you are someone who in the morning has a bunch of energy and to set your hardest thing there versus for me um when I'm kind of slow going having that sense of age efficacy like I did something I'm a big make my bed in the morning and it is a benchmark like when I haven't made the bed I know that okay I need to regroup and figure out what's going on why I wasn't taking care of my it's a marker of me taking care because I like walking home and getting into a bed that's made and so I know that I'm taking care of myself when I do that when I think about the other task during the day um the idea of getting the ball rolling is a big one for me and I hadn't really thought about it until you said it this way I love it the idea of for me I can bust out my work notes it's a task that is every day I have notes I have to write it's mundane I it's I don't love it but it's easy um I've been engaged with my patients so it's easy to write the note and sometimes just getting that going before I sit down to work on um a bigger project or a presentation or something like that it gets my brain going it gets me moving and I've got it out of the way and then I'm like okay I can kind of take on the rest of the day so these benchmarks are I think just so helpful yeah I love it how about you thank you thank you so much for sharing that Dr Lam with different kinds of tasks and recognizing that by keeping it to three you're not overwhelming yourself because I'm going to do my work notes and then I'm going to write a manuscript and then I'm going to do this that'd be slow down you'll it's three things one you know there's one two three if you get more things done Bravo that's great but I think for somebody who is dealing with low grade depression even that one thing it's just okay that's done and and it keeps this idea of this overwhelming sense of more and more and more that can overtake a person with depression like oh my gosh nothing's getting done there's 10 loads of laundry whatever it may be that you know now maybe that one load gets done but that's maybe two loads get done for the week it's better than leaving those and now there's eight to do at the end of the week so you're also chipping away like I said doing it begets more doing it how about you Mandy how about you yeah um I'm glad I'm not the only bed maker or kitchen cleaner in the morning but it just it um when there's clutter or mess it just reminds me of all the other things that I have to do so just a little bit of order and structure really helps um I know for me I I and I noticed this a long time ago when I was teaching so when you're a teacher you know you have a very set schedule at Todd high school was you know certain classes were certain periods when I moved into admin I had a lot more flexibility in my day and when I bring that up is I was able to notice like my most creative hours were like 7 30 to 11 30 like clockwork in the morning very creative I I learned not to open my email during that time if possible to disrupt that creativity uh but having a chronic illness I have to have movement every day it helps it helps my pain go down it helps you know just everything get moving and I have the most energy for that in in the beginning part of the day but then I feel like if I do that then the creativity or you know productivity goes to the Wayside and vice versa and um I struggle with this it feels like competing needs and then sometimes it's just I just get frustrated and overwhelmed and not sure what to do I've tried to to give it some variety but but those are some things that have to get done you know getting dinner on the table for the kids they're teenagers now so sometimes thankfully they can cook but just those things and then and then work stuff that I have to have complete those would probably be the bulk of what has to get done every day that I know I could muster to do but even sometimes that's a struggle so but even what you just said work things I need to do in working on this exercise the key becomes pick one yeah so it can't be as wide as if a client said to me I've got workings I'm like pick one and they're like okay I need to make notes on this you know on this on this five page document okay so that's what you're that's going to be as your chunk two activity and and they'll say oh I think I could do my oh my God that's fine for you if you could do more I'm saying that's it that's the thing we're putting on table then they're going to keep going but I think that when you say work things I need to do you could see how a person who is living with depression would feel overwhelmed by that so having someone clear make the bed chunk one read the five page report and give my revisions chunk two put dinner on the table chunk three anything more gets happy anything more happens great but each of those then become the thing for that time of day and you can you people will really find that it's almost like it's a check mark oh I got this thing done check I got this one done check I got I got my three things done today and then a person will feel like some people might say okay I'm gonna double up I'm gonna try to get six done today that there might be a that real idea of reinforcement that's what the behavioral models are very much about oh I feel good I got those done I'm doing something versus I've got this endless list of things otherwise we all feel defeated I think a lot of us do feel defeated by these long to-do lists now it's about making it manageable and um and and then I would also say to the degree you can come up for what come up with what might feel like a real reward at the end of it is it a workout is it a walk is it a is it watching a certain TV show you love is it what it is it reading your a book you love but like something at the end of the day that's sort of like as you do it mindfully you go in and say I got my things done today and I'm going to enjoy what I'm doing rather than feeling like you're playing hooky and like well I'm watching TV no you got your things done today enjoy that yeah what a great approach and I like the fact that you chunked it you know three different parts of the day because it's not like you do it in the morning it feels great and then you're just on a downward slope the rest of the day that we're getting these Peaks throughout the day we're getting something done and then we're rewarding ourselves that that could feel a lot better and I imagine just kind of help pull us out a little bit I do believe uh we have one question ready um if we can get to that I've lived the majority of my life with chronic moderate depression I've been much better with medications for the past year it feels too good to be true I'm afraid it will come back how can I adjust um I'd like to hear from both of you so uh Dr Lam go ahead and start please so I think that um it's very very common for people who have had chronic illness chronic mental health issues to really have anxiety over hope to have anxiety over um a sense that things are better and um that they can trust that they are feeling better that they can allow themselves to not get anxious and you know worry perseverate is it going to get worse when's the shoe going to drop and it makes sense because again I'm always going back to the triangle forgive me for my broken record around this triangle there's real feelings about what you've been through about how painful it's been to have been in a chronic state of depression and that it can be scary to give ourselves permission to feel the relief to feel the joy because we think that maybe we can protect ourselves from future pain of disappointment of when we've had disappoint in the past around treatments that only worked for a little bit or didn't really make a huge difference and so I think there is something you know it sounds almost paradoxical but actually not just let it's a great example of not just letting in the painful feelings but am I willing to also let myself really Embrace and feel Joy and hope and trust that if I am following a regimen that makes clear sense that this has made a difference my medication which has me engaging in my life more which has me building more connections and sleeping better and all of the big pieces that play a role in our are feeling better when I can trust that there's a path to this I can feel a little bit more confident that I can reinstitute this path should things dip I think the other piece is acknowledging that they will dip and people probably don't want to hear that but For Better or Worse life is not about always feeling great and happiness is just not a persistent State and so when we can feel comfortable to know oh no there will be days when I feel crummy and there are going to be days when I feel low energy and low mood and can I trust that the path that I have created with working with a psychiatrist to get the right meds and therapy and exercising and getting good sleep and eating well and all of the pieces that come together that I can pull on these when I need to in different ways when I have a worse day so we can normalize the fact that relapses and symptoms will happen but it's not catastrophic because once you have had a sense that there are things that can get better and you know that there are things that you can do to intervene we can pull on those things so that you can recreate that same situation again and again awesome uh thank you Dr Lam how about you Dr Romney I mean again I want to Echo what Dr Lam says I think that you know one thing that's really important especially with somebody who is who's taking medications and ideally is is not only receiving medication but it's also in therapy is to also work with your mental health practitioner because depression is cyclical and so I think that it is that there is it does it it will come and go now one thing that I know that um clients who've had long-term chronic depression will say is that there's actually some reassurance in knowing that I can feel the signs coming up when maybe another episode is coming along so they're like then I do I cons I we consult with my psychiatrist make sure my meds are where they need to be I talk with my psychologists like in essence it doesn't feel like it's something that's happening to you but like anybody living with a chronic health condition anyone will tell you they're dealing with an autoimmune condition if they're dealing with any diabetes chronic headaches anything they're like okay there's things I know I'm a chronic migraine sufferer I know and one's about to come and I've worked with my physician on the strategy to use rather than okay here we go I'm about to get you know steamrolled by one of these headaches again instead that a person starts to learn sort of some of their rhythms and while it still will be uncomfortable of okay here we go in some ways then knowing that you can mount up a response with your treatment team with your psychiatrist with your therapist that in a way can also help you feel some sense of control which I know is really important to anyone who's living with any chronic illness wonderful Insight very very helpful thank you both um Dr Romney you did a workshop for us on burnout and um stress and I am sure that is something that many many viewers have contended with especially as of late in the past couple years so please check that out at medcircle.com we hope that you really like our Workshop format we really try and make them interactive and give you practical skills to work through some of these common continuums that we find ourselves in would either of you like to leave us with any final words foreign I'm gonna always to ask say to people if you can find it within yourself and it's hard to do and you are feeling depressed if you can fall back on those principles of self-compassion you know the ideas of self-kindness and mindfulness and common Humanity that you know I think that a lot of people talk about self-love like I'm not even going there but self-compassion is like I made a mistake we make mistakes it happens talk to you talk to yourself the way you talk to other people you would never talk to someone else the way you talk to yourself that's the case with a lot of us so when you think of it that way say what would I say to someone who's going through a hard time try to use some of that for yourself and I think that you know I think that sometimes may not be enough when a person's experiencing depression obviously that's not a substitute but in our day-to-day if we could find ways to be gentler with ourselves that can actually sort of help with some of those rough patches and then know when to say no one to quit that on a day when you might have had a lot of difficult interactions a lot of stress there's a point in a day when you're like surrender whatever ever surrender looks like it might be taken it might mean the dishes don't get done it might mean that you go to bed early it might mean you know you just you spend two hours watching TV at night whatever surrender means give that give yourself that escape hatch because I think once we know we have that that's its own form of sort of self-kindness and say okay you know I I feel a little better now I took care of me whatever that looks like and then I can I can sort of get up and fight another day oh I loved that thank you Dr Lam anything else um I think just reiterating that sense of the spectrum of of these um processes and experiences that we have with depression and anxiety and acknowledging that the more that we can start to notice our inner monologue start to notice our low-grade symptoms the more we can intervene and start to build the skill of intervening allowing ourselves to feel allowing ourselves to set ourselves up for Success so that we can catch these symptoms early rather than our common habit of you know I'm fine or I should be fine and just trying to push through really acknowledging addressing and facing these things head on so that we can use all of the great skills that we're taught tonight and and many others that that people have shared on Med Circle in the past excellent thank you both for uh your wisdom and expertise tonight as we kind of walk through this journey together it was great to hear both of your stories that you also are challenged by these things that we all are it gives you know a universality to it that really can help us pull through no matter what so thank you everybody for joining us tonight we hope you found this helpful there's many many more workshops available at medcircle.com please feel free to go to the home page sign up for a free Workshop try us out see if you like us if you're already a member I know we have a bunch of members on as well please feel free to email Carlin at support medcircle.com you can always ask for certain topics to be covered or strategies or anything that you may be interested in we are here to serve you and we value your mental health and well-being so thank you very much for joining us tonight have a great night

Channel: MedCircle

Views: 35,327

Keywords: depression, mental illness, mental health, depression and anxiety, what is depression, clinical depression, major depression, signs of depression, depression symptoms, how to deal with depression, depression motivation, how to overcome depression, manic depression, major depressive disorder, psychology, anxiety, health, brain, depressed, therapy, dr ramani, interview, video, psychologist, discussion, medcircle, bipolar disorder, youtube, podcast

Id: PiQmq0Poqe0

Length: 109min 57sec (6597 seconds)

Published: Tue Oct 04 2022