Personally Speaking is our quarterly newsletter in which we discuss mental health topics.  The purpose of our newsletter is to inform and educate the community on personal issues, concerns facing our community, methods of treatment, and developments in related fields.  It is Avenues intent to not only provide care for individuals but to promote and create a healthy environment for our families.

Teenage Romance: Puppy Love or Addicted Love Disaster?
The Many Faces of Anxiety
Looking to the Mirror to Find Themselves
ADHD vs. the Bipolar Child: Facts vs. Fiction
Self-Mutilation vs. Suicide Attempts: The Tragedy of Mood Instability
Coping with Trauma
The Power of Perception
Sharpen Your Saw this Spring

The Power of Perception

With the current state of the nation nearly 5 months after the September 11th tragedy, we are noticing quite a mixture of events occurring. A marked increase in the number of companies are closing their doors, indicating a high percentage of the population being laid off. Some economists state that our nation is suffering from a recession. Additionally, there have been a handful of other violent, tragic occurrences that has left many of our nation's people with a sense of sadness, despair, and hopelessness. With many of these negative events occurring, it may be difficult to stay focused on what is positive in our lives.

Our perceptions about ourselves, our life and our world can shape the way we think, act and feel. Many events have shaped our own lives and our nation, and some people tend to recover more quickly from those events than others. Those who have a more difficult time recovering may experience depression or another mental health problem. A combination of factors decides how a person will cope, including:

• Genetic predisposition
• Family history
• Age
• Intelligence
• Cultural and religious values
• A person's socioeconomic status
• The availability of supports and resources

It is important to watch for signs of major depression in those who may be more predisposed.

A major depressive episode in adults includes at least 4 of the following symptoms for a 2 week or more period of time:

• depressed mood nearly every day, either indicated by subjective report or report from others
• diminished interest or pleasure in all or almost all activities
• withdrawal from family and friends
• significant weight loss or gain when not dieting
• significant increase or decrease in appetite
• insomnia or hypersomnia
• psychomotor agitation or retardation
• fatigue or loss of energy
• feelings of worthlessness or excessive guilt
• recurrent thoughts of death, or suicidal ideation or attempt.

Additionally, a person can have Depressive Disorder, NOS and not meet all of the above criteria.

Symptoms of depression in children could include any of the above symptoms in addition to:

• increased irritability deterioration of academic performance
• frequent verbalizations of self hatred or low self esteem
• the use of drugs and alcohol to enhance mood
• difficulty getting out of bed in the morning

The feelings we have about ourselves and the world are greatly impacted by how we think. Certain events in our lives can trigger certain emotions based upon our belief system. A faulty belief system can create and perpetuate a variety of mental health problems, such as depression and low self worth. Much of the etiology of depression is based in the distorted perception that one is a victim. If you have victimizing negative self talk, you might be feeling helpless or hopeless. You might be telling yourself that your problems have no solution or are incurable, or that the road to betterment is too long and steep, and nothing will ever change that. The victim has difficulty perceiving anything but insurmountable obstacles between themselves and their goals. Often times, victims tend to blame external circumstances or other people for their problems, thus perpetuating the belief that their problems are out of their control. Victims find themselves using phrases like "I can't..." or "I'll never be able to..." to cope with their problems.

Other distorted, unhealthy thoughts that lead to depression include:

Filtering: focusing on only the negative aspects of a situation while failing to see the positive aspects (ex: "My child is nothing but trouble.")

Emotional reasoning: judging or evaluating something illogically based upon your feelings alone (ex: "It feels impossible to look for a job, I just can't.")

Self-blaming: holding yourself overly responsible for your problems, or for the way others act, think or feel (ex: "It is my fault that our marriage failed...")

Overgeneralization: making a general rule or judgment from a single incident (ex: "My first day was awful, so the whole week is going to be bad.")

Mind reading: believing you know what others are thinking and feeling, without asking them, or thinking that others know how you are thinking (ex: "She must think I am so stupid.")

Self critical statements: constantly putting yourself down or evaluating yourself negatively (ex: "I never do anything right.")

Black/white reasoning: thinking there are only 2 ways to look at a situation, and failing to see any "gray" area (ex: "My friend never called- she is a lousy friend," or "My husband is always coming home late.")

Shoulds: having ironclad rules about how you and others should act, with unrealistic expectations of self (ex: "I should be a better father.")

People who learn these distorted thoughts in childhood often carry them into their adult lives, teaching their own children the same perceptions. However, you are not born with negative thinking: you learn it from

your environment. With therapy from a mental health professional, you can unlearn negative patterns of thinking and relearn healthier, more realistic

thoughts. Learning new ways of thinking will not only improve one's self esteem and outlook on life, it will also enhance family and peer relationships.

Treatment

Treatment for depression can include a combination of drug therapy, cognitive therapy to identify mistaken beliefs and distorted perceptions about self and the world, and intensive psychotherapy to work through family of origin issues and/or abuse history. The most popular drugs for depression are Prozac, Zoloft, Celexa, Wellbutrin, Paxil, Serzone and Effexor. Consult your doctor for more information on these and other antidepressants. Other treatment options for depression include assertion training, anger management training, diet and sleep management, family and couples therapy, and support groups. Children may benefit from art and play therapy to explore feelings related to depression and other mental health disorders.

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