Jennifer Rollin speaks with Leigh-Ann Larson in today’s Q & A.
Jennifer: So, tell me a little bit about yourself and your practice.
Leigh-Ann: I am a licensed mental health counselor that has worked in private practice for over 10 years. I own a group practice with 20 therapists and three locations in southeastern Mass, called Elevate Counseling Services, Inc. I have worked with dozens of patients that live with depression. I have a bachelor’s degree in physical education with a double minor in health promotion and psychology, and Master’s degree in education, specializing in mental health counseling, and various certificates in Reiki and hypnosis.
Jennifer: What are some important questions that you ask patients who are struggling with depression?
Leigh-Ann: When meeting with a new client, I must first assess for symptoms. I am listening for lack of interest in or enjoyment in life, lack of motivation, sleep difficulties (either too much or too little), thoughts of “not being here anymore” meaning suicidal ideation; either passive (no plan to self-harm) or active (considering self-harm).
I look for a history of mood problems, including prior counseling or medication and watch affect. Congruent affect being what am I seeing in the room versus what a person is saying is matching up.
Anxiety is also a common problem that goes hand in hand with depression and I look for this as well. Symptoms of anxiety include: racing and intrusive thoughts, being easily distracted, pain or somatic symptoms in the body and panic episodes.
Jennifer: How can patients with depression take care of themselves without giving into depressive urges i.e. the balance between sleeping more if tired, but what if oversleeping is contributing to the depression?
Leigh-Ann: Depression symptoms, like all difficulties in life, are on a “continuum.” On a scale of one to 10 we need to assess where a client is, 10 being the highest and attempt to keep the number at steady state or lower it. Hopefully, the client is able to attend to the tasks of daily life: bathing, attending to work or responsibilities at school or at home.
If this is the case we look at the person as “4 Bodies” Physical, Emotional, Mental and Spiritual. It is my attempt to “chunk” self-care into pieces so that my clients do not get overwhelmed by the many aspects and tasks of self-care. The tasks of taking care of the physical body are: hydration, nutrition, movement, and sleep.
The emotional body is expressed through relationship and we explore communicating needs, setting boundaries and internal versus external locus of control to help shift out of depression or co-exist with depression so as to have a healthier way of expressing self in the world.
The mental body is the thought life and this is where the decision making has to happen. If a client is able to complete tasks of daily living for the physical and emotional body and addresses self-care in these areas, it is easier to make decisions to “do the next right thing.” Often times, depression clouds the ability to have the desire to complete tasks of life, but with an eye to self-care and decreasing that depression scale, often-times a person can stay in the moment and do what is in front of them.
Mindfulness strategies and guided meditation are tools I use to help client with the mental body. Finally, the spiritual body and self-care need attention to fully operate on all cylinders. I consider creativity and flow states to be core expression of spiritual self and the ultimate goal is for all patients to get to this state where all aspects of self are engaged and enjoying life to their best potential.
Jennifer: What are some of your top tips for someone who is struggling with depression?
Leigh-Ann: Determine what comes easy for you in self-care and do those things daily and readily. Chose one new area each day: for example, working on reaching out to someone every day to talk, have coffee or get support. Or perhaps, journal every day to express spiritual self.
Once a new strategy for self-care is incorporated, add another one, and another as depression symptoms decrease you will notice your life full of the things that bring you peace and contentment as one new self-care task was added at a time until it became something of a routine and part of a well-rounded day or week.
Jennifer: What are some coping strategies that you might suggest to someone who is struggling with depression?
Leigh-Ann: Find someone to talk to and avoid isolation. Notice the self-talk that endorses being alone, going inward and choose instead to reach out and let someone in. Just because you do not feel like doing something, this does not mean that you can not do it. It is important to be able to rise above feelings at times and do the right thing for yourself instead.
Engaging in a healing community such as a meditation or yoga group, a therapeutic relationship, a sport or dance class is connecting and will help incorporate the physical, emotional, mental, and spiritual bodies.
Jennifer: If someone is struggling with depression and feels like nothing they are trying is helping, what would you say to that person?
Leigh-Ann: If a person does not feel safe, if he or she feels like they can not take care of themselves and get the most basic things accomplished for self care, it is imperative that they tell a trusted friend, family member or counselor and get evaluated by a crisis team to determine if a higher level of care is needed for a short time.
If they are safe but not experiencing improvement, there may be a need to discuss medication, to increase frequency of therapy appointments, to try new modalities of treatment such as group work, getting more physical and getting the endorphins going. By dividing the self into these four bodies and exploring each area of self, it is easier to identify what needs to be addressed and it is not so overwhelming.