What’s In A Name?

When you are first diagnosed with a mental illness, it can be very confusing regarding the number of people you are going to meet on your journey to better health. All of these people are here to help you, but what exactly are the psychologists, psychiatrists, and therapists doing to help you? Here is a short guide on the difference between all the medical professionals you will meet when you are diagnosed with a mental illness.

A psychotherapist is an umbrella term for any professional trained to treat people for their emotional issues. A psychotherapist can be a psychologist, social worker, counselor, or psychiatrist.

A psychologist is an expert in the field of psychology which is the “science of the mind or of mental states and process”. Psychologists have to attend graduate school and obtain their doctoral degree, a PhD or PsyD. The difference between a PhD and PsyD, is that PsyD psychologists are trained specifically for clinical work, while PhD often focus on research. Psychologists often have to complete years of internships to gain further training and experience. They also must be licensed by their state boards of psychology. Psychologists are not medical doctors and can not prescribe medication. Psychologists are licensed to do counseling, psychotherapy, and provide treatment for mental disorders.

A psychiatrist is a medical doctor that specializes in the diagnosis and treatment of mental illness via medication. A psychiatrist usually has 4 years of medical school, followed by an internship and residency. They have a M.D. A psychiatrist can write prescriptions for medication. Psychiatrists must be licensed as a medical doctor in their state of residency. They must also pass the American Board of Psychiatry and Neurology’s Psychiatry Certification Examination. Many psychiatrists have a special focus such as major depressive disorder, schizophrenia or bipolar disorder. They will often work together with a psychologist to provide treatment for mental illness.

A therapist is a person trained in psychological methods to help patients. Therapists can be psychoanalysts, marriage counselors, social workers and life coaches among others. A therapist provides support and guidance and helps patients make decisions and clarify feelings to solve problems. Selecting a therapist is a personal experience. You should always feel comfortable and welcomed by your therapist, but also consider their licensing and professional credentials. It may take time to find the right therapist for you, so feel free to shop around for the right fit.

A licensed mental health counselor has at least a master’s degree in psychology or counseling. They are focused solely on providing therapy to individuals, families or couples. The mental health counselor has to have 2 years of additional experience working with a mental health professional after graduate school in order to be licensed. They are qualified to evaluate and treat mental health problems, with much of the emphasis on working with problems of normal living rather than mental illness.

A clinical social worker has at least a master’s degree in social work and very specialized training. Social workers provide case management and hospital discharge planning. They can also act as an advocate for the patients. Some social workers also practice psychotherapy. There are many different types of licensure depending on the state in which they are licensed.

Psychiatric or mental health nurses have specialized training in providing mental health services. They often work with the doctors to form an individualized therapy and medication program for their patients. Some nurses can prescribe and monitor medications depending on the states where they practice.

Here is a quick cheat sheet for clarification:

Psychologist Therapists Psychiatrist
  • Advanced degree in psychology
  • Does research or therapy
  • Diagnose disorders or problems with patients
  • Determine appropriate treatments
  • Work in tandem with psychiatrist
  • Help patients make decisions & clarify feelings
  • Provide support & guidance
  • Includes psychologists, psychiatrists, counselors, life coaches & social workers
  • Any number of degrees or certifications
  • Help patients make decisions & clarify feelings
  • Provide support & guidance
  • Medical degree
  • Does research or therapy
  • Diagnose disorders or problems with patients
  • Determine appropriate treatments
  • Work in tandem with psychologist
  • Prescribes medication
  • Help patients make decisions & clarify feelings
  • Provide support & guidance

 

http://www.webmd.com/mental-health/features/psychology-vs-psychiatry-which-is-better

http://www.webmd.com/mental-health/guide-to-psychiatry-and-counseling

http://education-portal.com/articles/Psychologist_vs_Psychiatrist_Whats_the_Difference.html

http://www.allpsychologyschools.com/psychology-careers/article/differences-therapist-psychologist/

https://www.psychologytoday.com/blog/couch-meets-world/201107/psychiatrist-psychotherapist-whos-who-in-mental-health

 

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Rumination

Rumination is the continuous dwelling on issues in our past and difficulties and things that distress us in the present. It is becoming preoccupied with something and not being able to get it out of your mind. There is helpful and unhelpful rumination. The problem comes when you are focusing on what has gone wrong and this leads to negative thinking. Too much negative thinking can lead to depression and maintaining a depressive episode.

Rumination is normal because everyone dwells on their problems to a point. It’s when the circular thinking patterns that are rumination continue in overdrive, that it becomes a problem. Rumination is different than worry in than worry is future focused and often leads to anxiety. Rumination is past focused and leads to depression. Rumination is a learnt strategy for dealing with our problems however unhelpful rumination can lead to inactivity and avoidance of problem-solving.

Unhelpful rumination Helpful rumination
  • Ask my “why…?” questions
  • (Evaluative mode)
  • Why questions tend to focus on the problem, its causes and it consequences
  • “What did I do to deserve this?” & “Will my life ever get better?”
  • Is continuous
  • Asks more “How…?” questions
  • (Process-focused mode)
  • How questions tend to focus on solving problems
  • “How can I make my life better?”
  • Is time-limited. It stops when the problem is solved

One of the biggest strategies for unhelpful rumination is accepting the situation and being mindful in the present moment. Mindfulness is the most useful coping skill for dealing with depression and will be discussed in a future post.

There are many steps to stopping rumination. Some examples would be accepting your situation, being aware that you are ruminating, or distracting yourself. Please follow this link for a list on 11 Steps to Stop Ruminating.

Remember rumination can be helpful if it is time-limited and problem-solving. However, unhelpful rumination can cause and continue depression, so it is better to find ways to stop rumination if you want to continue your road of recovery.

http://jayuhdinger.com/chapters/chapter-3-practice-11-steps-to-stop-ruminating/

http://jayuhdinger.com/chapters/chapter-2-rumination-faulty-thinking/

Accountability & Victimization

Accountability is to take responsibility usually for one’s actions, feelings and beliefs. It is a personal choice to rise above one’s circumstances and demonstrate the ownership necessary for achieving desired results.

Victimization is to become the victim. Victimization occurs naturally when someone is duped, swindled or the necessary enforcements are not followed through. (I.e. victim blaming, etc.) However many people will cast themselves as a victim in order to make themselves feel or look better or to deflect a problem away from them. Victimization is also to deny, ignore, defer, criticize and blame.

Accountable Stance Victim Stance
Sense of reality Excuse Making
Ownership, commitment Projection onto others, Blaming others
Solutions to problems Deflection, Confusion
Determined Action Attitude of helplessness
Implement change Status Quo

People who victimize themselves have stories to explain why things go wrong, while people who hold themselves accountable are empowered by commitment and hard work. These types of victims will ignore their responsibility for a situation, often playing the blame game and creating their own reality where they are always portrayed as the victim. They often feel stuck in life feeling confused, asking for help, claiming that they can’t do something or they will wait to see if a situation will miraculously resolve itself.

There are four steps to moving from victimization to accountability. These can be related back to the Wizard of Oz:

Character Example Action
Lion Courage See It
Tin Man Heart Own It
Scarecrow Wisdom Solve It
Dorothy Means Do It
Wicked Witch Bully (or yourself/mind) Victimization

See It

This first step takes courage and involves acknowledging reality. This can also involve gaining feedback from others to keep yourself on track and gain insight. Accountable people gain other people’s insights and perceptions to add to their own to recognize when you might be acting like the victim

Own It

The second step involves heart and owning your circumstances.Recognize where you are at in life. Are you portraying yourself as the victim? Recognize this and take accountability for your actions and behaviors that have kept you from moving forward.

Solve It

In this step, you must use wisdom to solve the issues. This behavior stems from asking “What else can I do?” It pushes you to find solutions to your problems which leads you to step four.

Do It

This step is the means or way and  means accepting responsibility for your behaviors and actions. you follow through with your plans, implement strategies and execute ideas. Falling short indicates the lack of accountability and responsibility.

According to the Oz Principle, there are 16 traits of accountability. These are:

  1. Obtaining the perspectives of others.
  2. Being open and candid in communication.
  3. Asking for and offering feedback.
  4. Hearing the hard things so that you openly see the reality of the situation.
  5. Being personally invested.
  6. Learning from both successes and failures.
  7. Ensuring that your work is aligned with results.
  8. Acting on the feedback that you receive.
  9. Constantly asking, “What else can I do?”
  10. Collaborating across functional boundaries.
  11. Creatively dealing with obstacles.
  12. Taking the necessary risks.
  13. Doing the things you say you’ll do.
  14. Not blaming others.
  15. Tracking progress with proactive and transparent reporting.
  16. Building an environment of trust.

These steps and traits can be used in your personal and professional life.

https://www.ozprinciple.com/self/steps-to-accountability/

http://www.resourcesinaction.com/articles/PDFs/acctability_vicitm.pdf

Cognitive Distortions: Fixes

Now that we know what cognitive distortions are and how this way of automatic thinking affects our moods, we must now find a way to counteract and change these thought processes. Here is a list of the cognitive distortions and steps that you can take to prevent  these types of thinking.

  1. All or nothing thinking
    1. Instead of categorizing things in black and white, try rating them on a scale from 1-10. By rating the situation, you are considering all sides instead of instantly picking a side.
  2. Overgeneralization
    1. Instead of making a judgment and reacting on that, view the evidence. Examine how others are behaving to the situation and why. Is there another perspective?
  3. Mental filter
    1. Am I only noticing the bad stuff? Am I filtering out the positives? What would be more realistic?
  4. Disqualifying the positive
    1. Am I exaggerating my negatives and minimizing the positives? How would someone else see it? What’s the bigger picture? It can also be helpful to minimize social media usage, where we compare our worst to other people’s best.
  5. Jumping to conclusions
    1. Mind reading
      1. Am I assuming I know what others are thinking? What’s the evidence? Those are my own thoughts, not theirs. Is there another, more balanced way of looking at it?
    2. Fortune teller error
      1. Am I thinking that I can predict the future? How likely is it that that might really happen?
  6. Magnification
    1. Thinking that the worst possible thing will definitely happen isn’t helpful right now. Ask yourself, “ what’s most likely to happen?”
  7. Emotional reasoning
    1. Just because it feels bad, doesn’t necessarily mean it is bad. My feelings are just a reaction to my thoughts – and thoughts are just automatic brain reflexes.
  8. Absolute Statements
    1. Am I putting more pressure on myself, setting up expectations of myself that are almost impossible? What would be more realistic? Avoid using words that have no meaning. Please see the list at the end of this article which shows what words are more helpful than others.
  9. Labeling & Mislabeling
    1. Instead of labeling the situation, look at the evidence. Also avoid double standards, these will only make a situation worse.
  10. Personalization
    1. Would most people who really know me say that about me? Is this something that I am totally responsible for? Instead of blaming yourself or another person, consider the circumstances. Look at the situation and view the evidence.
  11. Memories
    1. This is just a reminder of the past. That was then, and this is now. Even though this memory makes me feel upset, it’s not actually happening again right now.

 

Replace… with…
Should Like or Want
Should not Do not Like or Want
Have to Would Like
Must Wish
Must not Wish would not
Deserve Desire
Always Usually/Frequently
Forever Until/Unless
Never Rarely
Awful Disagreeable
Horrible Unfortunate
Terrible Unfavorable
Perfect Successful

http://jayuhdinger.com/chapters/faulty-thinking/

http://getselfhelp.co.uk/docs/FindingAlternativeThoughts.pdf

 

Cognitive Disorders

Cognitive Distortions are thoughts that cause reality to be inaccurately perceived. These inaccurate thoughts are usually reinforcing negative thoughts or emotions. This can lead to an anxious or depressive mental state when they combine to give an individual a negative outlook on their world. Cognitive distortions are also known as automatic thoughts. These thoughts are ingrained in individuals and affect the way they think. It takes time and patience to overcome these automatic distortions.

Here is a list of just a few of these distortions.

  1. All or nothing thinking:
    1. Also known as black and white thinking, it is ignoring all forms of in between or the ‘shades of grey’. This thinking also involves using absolute terms like ‘always’, ‘every’ or ‘never’. The thing to remember is that there is usually some grey in a situation and all or nothing thinking leads an individual to ignoring that.
  2. Overgeneralization
    1. Also known as categorizing, it is placing judgements or evaluations on an event, person or thing rather than describing the item or person. This thinking usually involves absolute terms such as ‘always’ or ‘never’. Overgeneralization causes individuals to ignore the facts and evidence in favor of their distorted vision.
  3. Mental filter
    1. This filter allows an individual to focus on a single detail (usually negative), about an event or person so that they overlook any positive. This thinking blocks out what doesn’t ‘fit’ with our ‘filter’ and is also known as looking through dark blinkers or ‘gloomy specs’. A mental filter causes individuals to ignore the positive or anything outside of what that filter provides.
  4. Disqualifying the positive
    1. This distortion causes individuals to overlook their positive experiences in favor of negative ones. It is also known as compare and despair, seeing only the good and positive aspects in others and comparing ourselves negatively against them. This can often be seen via Facebook, where people compare their everyday life to their friend’s ‘highlights reel’.
  5. Jumping to conclusions
    1. Mind reading
      1. Mind reading is assuming we know what other people are thinking, usually about ourselves. This distortion causes people to believe they can predict a person’s reaction or attitude.
    2. Fortune teller error
      1. Fortune teller error is assuming that a situation is going to end negatively despite lack of evidence. This can also be known as a self-fulfilling prophecy; because you assume a situation won’t end well, oftentimes it doesn’t because of that mindset.
  6. Magnification
    1. Also known as exaggeration or catastrophizing, this distortion causes individuals to overlook the one side in favor of the other. For example, overlooking the negative in a person by exaggerating the positive. It’s also known as making mountains out of molehills or imagining and believing that the worst possible thing will happen.
  7. Emotional reasoning
    1. This distortion causes individuals to take feelings as fact and base your decisions and actions on them. An example would be ‘I feel bad so it must be bad’. Individuals use this distortion to often put off doing something because they don’t ‘feel’ like doing it.
  8. Absolute Statements
    1. Absolute statements are words such as ‘should’, ‘must’, or ‘ought’. These statements raise expectations, and if these expectations are not met anger, frustration and disappointment occur. Absolute statements set up unrealistic expectations and can make people feel guilty.
  9. Labeling & Mislabeling
    1. Labeling is another form of black and white thinking. This is done by assigning either good or bad labels to yourself or other people. Again, there are no shades of grey and outside circumstances are not taken into consideration.
  10. Personalization
    1. Personalization is blaming yourself or taking responsibility for something that wasn’t your fault. Blaming others for something that is your fault, also falls under this category. This distortion is taking things personally when perhaps they didn’t involve you in the first place.
  11. Memories
    1. This distortion is when current situations or events trigger upsetting memories and lead you to believe that the danger is in the present rather than in the past. This causes distress in the present when the situation isn’t in the present, but in the past.

Perhaps after reading through these cognitive distortions, you realize that your way of thinking tends to lean towards these distortions. The first step to fixing these distortions is to realize that you have them. Please read the following article, Cognitive Distortions: Fixing the Problems for information on how to retrain your thinking away from distorted thoughts.

 

Cognitive Distortions

From: The Feeling Good Handbook

By: Dr. David Burns

 

http://jayuhdinger.com/chapters/faulty-thinking/

http://getselfhelp.co.uk/docs/AutomaticThoughts.pdf

http://getselfhelp.co.uk/docs/UnhelpfulThinkingHabits.pdf

http://getselfhelp.co.uk/docs/FindingAlternativeThoughts.pdf

 

Sleep: It’s Important!

We all grew up knowing that sleep is important. It helps us rejuvenate our bodies for another active day. But why is sleep so important for depressives? Sleep helps our bodies feel better and when we feel better, our minds are less likely to be as negative. The more tired we are, the worse our thoughts get.So here are some quick tips for better sleep.

  • Avoid naps during the day.
  • Sleep only as much as you need.
  • Exercise regularly.
  • Avoid excessive liquids in the evening and cut down on all caffeinated products.
  • Avoid watching television in bed and using a device with a bright screen (e.g. a smartphone, laptop) an hour before bed.
  • If you can’t fall asleep, get about and do something relaxing then try again later.

Remember to make your bedroom a pleasant place to be. Make it dark, make sure the bed is comfortable and make sure the room is a comfortable temperature. These conditions will help you enjoy better sleep.

These are just a few suggestions for enjoying better sleep. Please view the link below for more guidelines for better sleep.

http://media.psychology.tools/worksheets/english_us/guidelines_for_better_sleep_en-us.pdf

How to Deal With Being Mentally Ill Part I

Being diagnosed with a mental illness can seem overwhelming at first. Here are some simple tips for dealing with your mental illness.

  • Take care of yourself. Eat a healthy diet, be physically active and get plenty of sleep.
  • Get exercise. Physical activity reduces depression symptoms. Consider walking, jogging, swimming, gardening or taking up another activity that you enjoy.
  • Get plenty of sleep. Sleeping well is important for both your physical and mental well-being. If you’re having trouble sleeping, talk to your doctor about what you can do.
  • Simplify your life. Cut back on obligations when possible, and set reasonable goals for yourself. Give yourself permission to do less when you feel down.
  • Structure your time. Plan your day. You may find it helps to make a list of daily tasks, use sticky notes as reminders or use a planner to stay organized.
  • Stick to your treatment plan. Don’t skip psychotherapy sessions or appointments. Even if you’re feeling well, don’t skip your medications. If you stop, depression symptoms may come back, and you could also experience withdrawal-like symptoms.
  • Learn about depression. Education about your condition can empower you and motivate you to stick to your treatment plan. Encourage your family to learn about depression to help them understand and be more supportive of you.
  • Learn ways to relax and manage your stress. Examples include meditation, progressive muscle relaxation, yoga and tai chi.
  • Pay attention to warning signs and learn your triggers. Work with your doctor or therapist to learn what might trigger your depression symptoms. Make a plan so you know what to do if your symptoms get worse. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Ask family members or friends to help watch for warning signs.
  • Write in a journal. Journaling may improve mood by allowing you to express pain, anger, fear or other emotions.
  • Avoid alcohol and illegal drugs. It may seem like alcohol or drugs lessen depression symptoms, but in the long run they generally worsen symptoms and make depression harder to treat. Talk with your doctor or therapist if you need help with alcohol or substance abuse.
  • Locate helpful organizations. Many organizations, such as the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Support Alliance (DBSA), offer education, support groups, counseling and other resources to help with depression.
  • Don’t become isolated. Try to participate in social activities, and get together with family or friends regularly.
  • Don’t make important decisions when you’re down. Avoid decision-making when you’re feeling depressed, since you may not be thinking clearly.

http://www.mayoclinic.org/diseases-conditions/depression/basics/treatment/con-20032977