Seasonal Affective Disorder Series Part II: How SAD Impacts Other Conditions

Last week, I briefly defined Seasonal Affective Disorder and the very basics of how it works in the winter, and I outlined some of the symptoms most people tend to complain of. This week, I think it’s important to touch on how SAD can impact other conditions.

 

SAD is sometimes tricky because it can have a temporary impact on other mental health conditions. Those suffering from psychotic symptoms, for example, may notice increases in hallucinations, difficulty focusing, harder time waking up (which can be further impacted by medications), weight gain (also an impacted side-effect of medications), or general lethargy. In my practice, I work almost exclusively with clients suffering from PTSD. A hallmark of PTSD can be extended periods of anxiety or depression, which can also be worsened with less access to natural light. In the earlier part of the winter, around the holidays, many of my clients also face trauma/loss anniversaries, triggers from difficult family dynamics, feeling drained by fuller-than-normal social calendars, end-of-year work stuff, etc. And those suffering from bipolar or other mood disorders are even more at risk of depressive periods despite sticking to strict medication, diet, supplement, and exercise regimens. 

 

Maybe reading this information is teaching you something for the first time, or maybe it’s validating something you’ve experienced or are presently experiencing. Either way, these difficulties can make functioning that much more difficult. Now, let’s take a look at some of the impacts of SAD on physical health:

            -weight gain- lethargy, desire to sleep more, and carb/sugar cravings all contribute. This can have lasting impacts on those at risk for diabetes, heart disease, and thyroid issues. 

            -joint pain- For those with fibromyalgia, tick-bourne diseases such as Lyme, arthritis, lupus, etc., winter can be excruciating. We as humans also just have less natural desire to move around in the winter, because it’s way better to stay indoors where it’s warm and bright, which can increase pain. This can be super frustrating to individuals who are used to a more active lifestyle, which can increase hopelessness, frustration, moodiness, and in extreme cases, suicidality. Check on your friends, help them shovel, and make extra effort to connect with those you love whom are struggling, even if it’s not in person (I will get more into natural remedies in next week’s blog). 

            -Headaches- lack of light, wanting to sleep, dietary changes all create the recipe for headaches!

            -other sleep disturbances- because it gets darker earlier, we expose ourselves to more unnatural/blue light after the sun has gone down, especially with technology. This can severely impact sleep (I’ll discuss this more next week as well). Sleep disturbance can cause further weight gain and lethargy during the day, which impacts all areas of functioning and over time, raises cortisol levels in the blood and creates massive health issues.

 

While many doctors recommend medications, I will get into natural remedies and some of the strategies I use to combat the fatigue and moodiness next week! Please stay tuned, and if any of this sounds like you, know that you’re not alone!

 

Rebecca L. Toner, MA, LPC

Freer of Souls. Connector to Purpose. Healer of Lives.

Rebecca Toner, MA, LPC is a group private practice owner, EMDR therapist and consultant-in-training, and a life coach operating out of Plainville, CT. She specializes in treating clients with chronic attachment trauma and dissociation, and has passion in working with coaching clients who are learning how to reclaim their power after processing trauma.

Rebecca Toner, MA, LPC is a group private practice owner, EMDR therapist and consultant-in-training, and a life coach operating out of Plainville, CT. She specializes in treating clients with chronic attachment trauma and dissociation, and has passion in working with coaching clients who are learning how to reclaim their power after processing trauma.

Spotlight on: Julie Wood, MA. LPC Candidate

It’s my pleasure to introduce Julie Wood, who is this month’s Friday Features clinician! Julie is my supervisee at MHCC, and is in the process of becoming EMDR trained. She sees self-pay clients only, at a low sliding scale, and later this month will be running two groups for Deaf and Hard of Hearing young adults! I am so thrilled to have her on board, and anyone who spends five minutes in the same room as Julie can feel her compassion, sensitivity, and awesome sense of humor. I thought it would be fun to have Julie answer some questions about herself so you all can get to know her better, and I was definitely not disappointed!

1.) When you were a kid, what did you tell people you wanted to be when you grew up?

·     A penguin washer. You know, the people that wash the penguins at the aquarium or go to help out when there is an oil spill!

2.) When did you first know you wanted to be a therapist?

·     During graduate school. I got into the program because it was going to provide me the tools to work with the deaf population. While taking counseling classes, I realized that is what I wanted to do, mental health counseling.

3.) What is one way being a therapist has changed you?

·      I think it has made me more aware. What I mean by that is maybe more understanding to what others may be going through, or that someone may be going through something and that is why they act the way they do. When I am out driving, and someone gives me the finger because they perceive that I cut them off, I am able to remember that that is their stuff, not mine.

4.) What is a population you’re passionate about working with?

·     The deaf, especially youth transitioning from high school to college or work

5.) How did working with that population come to be a passion for you (no client details, please)?

·      I worked for the state as a Vocation Rehabilitation counselor and witnessed the lack of counseling and support that students receive while they go through the transition and when they graduate is appalling. I want to help these kids realize what they can do, what the “real world” means and how to navigate their disability while in it.

6.) What’s one challenge in your life that you’re proud of overcoming?

·     Depression. It is still something I struggle with, but I have survived a particularly terrible episode when it seemed like there was no way out.

7.) What is the best client feedback you’ve ever received?

·     That I took the time to listen and follow through for the client, when no one else did.

8.) What do you wish clients would ask you in an intake?

·     What will be expected from them, or how can they make the most out of their work with me? 

9.) What is the funniest thing you’ve ever said in session that you never thought you would say?

·      I love using humor and personal anecdotes to connect with clients. There is very little I will not say, if I feel that the person is in a place to hear it. I had a client who worked at a gym that my friend went to. He happened to be in one of her pictures she posted on Facebook. When I told him I saw the picture he said something about me coming to workout there. I told him, “Screw that! My wedding is over, I am done with the gym and on to carbs.”  

10.) What is your favorite food/flavor of ice cream?

·     Tacos are life in the Wood household. We celebrate every Tuesday! I do not really like ice cream. Before you gather your pitchforks, I am lactose intolerant and ice cream is one of the foods I really CANNOT tolerate! 

11.) What is your favorite self-care activity?

·     Shopping! But when it is not pay week, I love reading!

12.) What is your favorite thing to do when you’re not at work?

·      I love going to the movies. My husband and I always wear comfy clothes, get popcorn and candy and only go to theaters with the comfy seats so we can really relax. 

13.) What is your favorite book?

·      I have read so many, it is hard to pick!

14.) What is your most recommended book to clients?

·      I would recommend Crazy by Peter Earley. He talks about the societal issues with mental illness, and what we are not doing to help those who experience it. I love what he has to say and how he says it.

15.) Finally, what is a meaningful/favorite quote you’d like to leave our audience with?

·     The quote that I live by, whether in my personal life or professional life, is a Polish proverb, “Not my circus, not my monkeys”. Simply put it means “not my problem”. We spend so much time worrying about what we are doing and how we can help others. I am going to help my clients to the best of my ability, but I can only do so much. I urge everyone to remember these words when there is something that is out of your control, even though you want to do all you can to help. Sometimes, you simply can’t. 

Julie loves working with hearing clients as well! If you like what you read, please contact Julie directly at Juliana@mhccholistichealth.hush.com or 860-431-3825!  Julie is a Licensed Professional Counselor Candidate, under the direct supervision of Rebecca L. Toner, MA, LPC who can be reached at rebecca@mhccholistichealth.hush.com

Julie loves working with hearing clients as well! If you like what you read, please contact Julie directly at Juliana@mhccholistichealth.hush.com or 860-431-3825!

Julie is a Licensed Professional Counselor Candidate, under the direct supervision of Rebecca L. Toner, MA, LPC who can be reached at rebecca@mhccholistichealth.hush.com

Ritual vs. Routine, Part II

Last week, I talked about routine and asked you to write out your daily tasks to be completed, or block off your schedule on your calendar to get a visual idea of how much of your day your routine, or pursuit thereof, actually takes up. I asked you to notice what your mind does and what your body feels during that activity. Where did/does your energy want to go when writing it out and looking at it? Are you making time for yourself?

The answers to these questions may have surprised you, but also are excellent tools to consider ritual. Ritual should be some series of behaviors or activities geared towards a specific goal. Rituals can be small, daily rituals, such as prayers before bedtime to clear the mind, meditating for a few minutes before getting up in the morning, wearing a specific pair of socks to every hockey game because it may draw more luck to help your team win, or taking a power or yin yoga class. Rituals can also be more community-based and bigger or occur less frequently, such as eating turkey with family and friends on Thanksgiving while discussing what we are thankful for, or the funerals and death rituals of any culture. The point isn’t so much the activity, although that definitely matters. The true importance is the intention behind the activity, and connection to self as well as community. For example, Catholic people have funerals when a loved one dies, as a means of saying an individual goodbye, communing with Spirit, and sending off the spirit of their loved one while recapitulating and grieving together. Every culture and religion in the world has rituals around birth or death, and they exist for a reason. These rituals are obviously much bigger than what I’m addressing in the average person’s everyday life, but the takeaway message is the same- we intentionally take time out of our day to connect with ourselves and possibly others, and there may or may not be a spiritual component.

The same ritual mindset is applied to mindfulness and meditation practices, but can be applied to basically everything we do so that we are more present in the moment, and can be aware of the needs of our bodies, minds, and souls- besides only when it feels like something is lacking or there’s a crisis. Rituals can mark the passage of time, and mindful connection to even our small, mundane daily rituals can lead to a greater sense of satisfaction than simply checking items off a to-do list because we feel like we should.

While I don’t want to sound preachy, I do like to use myself as an example in this blog (good and bad, because I’m human and at the end of the day I can only ethically speak to my experience). So, if you’re looking for some ideas for how to incorporate positive rituals into your day, here are some of my favorites:

Morning coffee or other hot beverage- make sure you’re not multitasking and distracting yourself while doing this. Actually sit with yourself, notice each level of flavor, the warmth (or cold if that’s more your thing), maybe find a mantra/quote/intention for your day and think on it for a few, uninterrupted minutes. And don’t do it while you’re driving. Actually make time for yourself the way you would a beloved friend.

Yoga- different classes exist for different purposes. I like to take a power yoga class in the beginning of the day to start positive conversations with my body, and for strength/empowerment, working out anger/other lingering emotions, etc. I like yin classes at the end of my day for deep emotional release, flexibility, and relaxation after a stressful/high activity day or impactful yoga class.

Cooking- can often be like a moving meditation. When considering a meal, don’t just listen to what your taste buds are craving (which is totally one of my biggest struggles, I will admit openly!). Asking myself “what does my body need to refuel?” is a huge help, as des finding something delicious and nourishing. Then, the process of cooking the meal feels almost meditative and I can get lost in the multi-sensory experience. When I don’t have an abundance of time and energy to make food, I usually make sure I’ve prepped enough leftovers to heat up, or I’ll sometimes even treat myself to a nutritious meal out. I know that feeding myself an over-abundance of junk food won’t make me feel energized. But a small treat here or there is OK, as long as I avoid trigger foods for my immune system.

Also, I like to make sure I take care of the day-to-day stuff, like drinking my smoothies, taking my new vitamin regimen (it works miracles, I swear), and drink plenty of water and stretch throughout the day!

Exercise- walking, hiking, some weight lifting, spin classes, yoga classes, whatever! I just take extra care to make sure I’m doing these activities with the intention of loving and caring for my body, rather than punishing and hurting it or being angry at it.

Journaling- every day, even when I don’t know what to write about. Where do you think I find inspiration for blogs? Sometimes, I’ll even do a card pull from my favorite oracle decks, find an inspirational quote online, listen to an audiobook, read a poem, shamanic journey, or meditate for a few minutes for inspiration. Sometimes, tension I didn’t even realize I had gets released and things I didn’t realize I was hanging on to gets processed along the way. 

Body/Energy Work-I cannot recommend massage enough! Along with aromatherapy, energy healing/Reiki, shamanic healing session if I’m feeling off. 

I hope that this two-part series has clarified the importance of ritual within our daily routines, and how it doesn’t necessarily require a major shift in behavior, but more mindful awareness, in order to have a better connection with yourself. If you’re interested in connecting with others who are also looking to connect with themselves, there’s still time to join my Goddess group starting next week! We will be meeting for two hours on Saturdays, for six weeks, discussing our inner goddesses, learning about our needs, how to meet them in our daily lives, and journaling outside of the group to notice the changes in our lives! Contact me directly at rebecca@nestcoaching.org!

Rebecca L. Toner, MA, LPC

Freer of Souls. Connector to Purpose. Healer of Lives.

Rebecca Toner, MA, LPC is a group private practice owner, EMDR therapist and consultant-in-training, and a life coach operating out of Plainville, CT. She specializes in treating clients with chronic attachment trauma and dissociation, and has passion in working with coaching clients who are learning how to reclaim their power after processing trauma.

Rebecca Toner, MA, LPC is a group private practice owner, EMDR therapist and consultant-in-training, and a life coach operating out of Plainville, CT. She specializes in treating clients with chronic attachment trauma and dissociation, and has passion in working with coaching clients who are learning how to reclaim their power after processing trauma.

Preparing For Your First Therapy Session: Part 2

This is the second in a three-part blog series geared to help you prepare for your first session in therapy ever, or just with a new therapist for the first time in a while. This article will cover what to expect from your first session (also called an intake), as well as some things the therapist is assessing for during an intake.

(Bet you didn’t think there was so much to consider before you even walk in the door for your first session! But, you’ve made it this far. So, let’s say you’ve followed some of the advice laid out in the first edition of this topic, you’ve found one or more therapists who seem like they might be the right fit, and maybe you’ve even reached out and scheduled an intake or two. What’s next?

What to Expect in an Intake:

Your therapist is going to have a LOT to get through within the first session. They have to cover intake documents, informed consent, limitations of privacy laws, and tell you all about how they tend to operate and what the attendance expectations are. Then there’s the fact that they have to get an idea of what you’d like to achieve in therapy, and assess your supports, strengths, coping skills, safety, connection to community resources, your day-to-day life, and establish rapport while simultaneously being as genuine as possible and starting to formulate rough ideas for goals and treatment plans if you choose to continue beyond the intake. They also have to make sure they get releases to talk to doctors/lawyers/agencies/other providers if necessary, and assess whether they are the best fit for you and your needs. That’s a TON to get through! Needless to say, it often takes two or three sessions to get a basic idea of what therapy with the clinician would actually be like. To help with some of the time management, many practices are starting to require electronic signatures of paperwork prior to the first session, then quickly covering the necessary points during the intake. My practice does this, and requires the paperwork to be completed with insurance and credit card information submitted electronically a minimum of 24 hours prior to the scheduled appointment, or the appointment will be cancelled. 

            For the rest of the rapport building, treatment planning, clinical assessment, and collaboration on goals- the process can be several sessions long. I have many clients on my caseload for several months where we focus on establishing trust, rapport, and safety- often because there is significant attachment trauma and they need to experience me as consistent and nurturing for a length of time before they’ll truly feel safe exploring further and doing some of the deeper work. Be patient, trust the process, and don’t expect to be cured or even given an idea of how many sessions need to happen before you feel relief from your symptoms. You get out of therapy what you put into it. Don’t give up on the potential right fit therapist before you have a chance to actually start doing the real work to meet your goals. 

 

What Your Therapist is Assessing for:

This is going to vary depending on the type of therapist you’re seeing and the type of therapy you’re looking to do. But some general topics I usually assess for include:

Safety:Is this person going to be able to tolerate deep work? Are they likely to continue their work through daily practices outside of treatment appointments? Do they have the distress tolerance to handle it, or should we first focus on resourcing and rapport building through various interventions before we do the trauma work? What community and natural resources are needed outside of therapy, and how accessible are these things? Does the person need a higher level of care than I’m able to offer? What are their needs, and do they have healthy insight into some ways to get those needs met, or are they too traumatized and invested in more comfortable/maladaptive ways of meeting those needs? Who are supportive people they can turn to? Can we make a plan for when they’re feeling close to a crisis, so that they can call on those people? Are they familiar/in contact with local crisis services?

 

Goodness of Fit:

As a Licensed Professional Counselor, my licensing board and the American Counseling Association, as well as the EMDR International Association all have various versions of the same ethical requirement that states I need to refer clients elsewhere if they’re not a good fit for what I feel able to provide. Most behavioral health governing bodies have some version of this same guideline. If I feel as though my relational style or specialty is very different from what I perceive the client’s needs to be, it’s my duty to best serve the client by referring them to someone much more suited to handling that specific issue than I am. For example, while my license allows me to work with children and I have done so as a pre-licensed therapist, this is not my passion and I have not had continuing education in working with children. I know that I can probably do decent work with children, and that I have before, but I also know that there are some excellent colleagues of mine whom I would feel much more comfortable referring minor clients to (and for the record, I’m more than OK with this- I know I excel at the work I do with my adult clients and I am highly specialized in something I am passionate about). So, rather than taking on minor clients anyway, I refer them to the colleagues whose work I am familiar with, whom I trust and who specialize in working with populations I don’t. The client’s needs are thus met by a provider more equipped to give them what they need. If your new therapist is making it seem like they’re a jack of all trades but a master of none, they may be skilled and intelligent but may not be the best fit for what you specifically need. 

 

From here, the therapist’s assessment will really start to depend on the therapist you’re meeting with. For example, I am a strengths-based, person-centered trauma therapist specializing in attachment trauma and dissociation. So, I’m assessing for trauma, especially hidden or repressed trauma, certain buzzwords and telling phrases, trauma narratives, symptoms and how they are presenting in daily life, what those symptoms are interfering with that caused the client to want to meet with me in the first place, what about me stood out for them in selecting me as their therapist, feelings of being “checked out” or not being able to remember significant periods of time, and ego strength/distress tolerance. If there needs to be some ego strengthening, I’m getting an idea of how we can collaborate on that together in order to set a strong foundation for the deeper trauma work. I’m also assessing for strengths and skills because I believe those are going to provide the foundation to build up some of the things that are in need of improvement to facilitate healing. 

            Other therapists, however, will have different approaches and specialties and will be assessing along those lines. A substance abuse counselor, for example, will want to know about length of use, substances of choice, any periods of sobriety, positives that would help the client maintain sobriety, etc. Those who specialize in working with children will be looking for some indication of boundaries and expectations in the home and at school, social engagement, and possible reasons behind behavioral disturbances (depending on age). 

 

This is certainly not an exhaustive list of what each therapist assesses for or how they operate during intake sessions, but I hope it has provided some useful information that will help you prepare for your first intake. It’s also totally fine to write down some thoughts/lists of things you want to work on, and maybe make some mention of the work you’ve done to start trying to address this stuff on your own. It’s helpful for the therapist to get an idea of what’s realistically going to translate from therapy into your daily life, so this would definitely be a great tool!

Rebecca L. Toner, MA, LPC

Freer of Souls. Connector to Purpose. Healer of Lives.

 

Rebecca Toner, MA, LPC is a group private practice owner, EMDR therapist and consultant-in-training, and a life coach operating out of Plainville, CT. She specializes in treating clients with chronic attachment trauma and dissociation, and has passion in working with coaching clients who are learning how to reclaim their power after processing trauma.

Rebecca Toner, MA, LPC is a group private practice owner, EMDR therapist and consultant-in-training, and a life coach operating out of Plainville, CT. She specializes in treating clients with chronic attachment trauma and dissociation, and has passion in working with coaching clients who are learning how to reclaim their power after processing trauma.

Preparing for Your First Therapy Session: The Search (Part 1)

This is the first in a three-part series to help you in the process of beginning therapy, maybe for the first time, or maybe you’re looking for a different approach to freshen or build on therapy you’ve already been involved in. So, you may be toying with the idea of “talking to someone” in a professional capacity to handle some stressors, life adjustments, or struggles that can be going on in your life. Or, you may be feeling checked out, disconnected, or have some traumas that might need to be addressed. Either way, maybe you’re wondering now how you should go about finding a therapist. There’s a ton of information out there, and so many different kinds of therapists who do amazing work. It can be overwhelming, to say the least. So here’s your go-to guide for some of the main things you should consider in finding a therapist for yourself!

 

The Search:

Google and Psychology Today are probably some of the best guaranteed places to find a listing of local therapists who specialize in certain areas and take your insurance (if you’re choosing to use an insurance). It’s a quick way to generate a list of therapists to get into contact with, but please understand that what’s in someone’s Psychology Today profile is limited through character counts, so there’s not always the chance to capture exactly who they are as a therapist and how they work. It’s wise to continue your research into a possible therapist candidate through their websites, blogs, YouTube channels, business social media posts, etc. The whole point of therapists working so hard to create that content is so that you have a chance to connect with them and their communication style before actually reaching out to them, so use the content to your advantage! Do you feel like they’re speaking directly to you through this content? Therapists who are well-niched in private practice have worked hard to identify and market to their ideal clients. Feeling like they’ve connected with you before you’ve even spoken to them is a vital part of how they run their business and will let you know how invested and passionate the therapist would be in working with you. Somewhere there is a therapist who specializes in exactly what you need (even if you’re not fully clear on what that is yet yourself)!

Don’t: It’s poor boundaries to try to find out personal information about your therapist. Don’t try to comb through their personal social media profiles, don’t try to connect with them on LinkedIn, don’t show up at the office without an appointment (we don’t appreciate drop-ins and many therapists view this behavior as aggressive. This is the fastest way to guarantee you’ll be referred out to a clinic with security staff on hand). Don’t get too bogged down in client reviews (or lack thereof) online. Many governing bodies and licensing boards forbid solicitation of testimonials (even anonymous ones), and often clients (or former clients) leave negative reviews on social media despite warnings about their protected health information being compromised, as a passive-aggressive attack for the therapist setting a necessary boundary (such as not allowing the client to schedule with a significant balance that they haven’t made any effort to pay on, nonadherence to the attendance policy, refusal to accept clients due to inappropriate or threatening behavior on behalf of the client, etc.). Each client’s experience is their own! Be open to the possibility that someone can help you, which brings me to my next point…

Remember…

You are the consumer. You’re free to “shop around” to find the right fit for you. The first therapist(s) you meet with might not be “the one.” Or, you may meet with one for years and just find that they no longer meet your needs because you’ve grown and your needs have changed. Just keep in mind that if you’re using insurance, you may only be allotted a certain number of intakes within a discrete period of time, and additional intakes might not be approved (resulting in out-of-pocket balances that you’re required to pay). That said, I encourage a minimum of 3-5 sessions with the therapist to really determine together if you’re ready for therapy, if it seems likely this therapist can support you in reaching your goals, and if their therapeutic style matches up with your needs and your communication style. A worthwhile therapist is likely to be forthcoming with you regarding your diagnosis (at least in the field of trauma work), and they should be keen to collaborate with you on treatment goals and formulating a clear treatment plan with measurable outcomes and actionable steps, alongside their clients. 

 

Also, don’t forget to keep in mind basic therapist attributes. It’s perfectly acceptable to only want to meet with therapists of a certain gender, age, race, religion, etc. You may know, for example, that you relate to females better than males, or vice versa. Just know that this may limit your search, and sometimes being open-minded to something different can yield amazing results. So have a general idea of who your ideal therapist would be, but be open to some variations within those ideas. 

 

These are just some of the guidelines to consider when searching for a therapist, and certainly is not an all-encompassing checklist of things to consider. Any of these factors can be influenced by location, insurance, schedule, etc. and these are also valid concerns. The goal of this blog post is to discuss some of the points which many clients who are reaching out for the first time may be unaware of!

Rebecca Toner, MA, LPC

Freer of Souls. Connector to Purpose. Healer of Lives.

Rebecca Toner, MA, LPC is a group private practice owner, EMDR therapist and consultant-in-training, and a life coach operating out of Plainville, CT. She specializes in treating clients with chronic attachment trauma and dissociation, and has passion in working with coaching clients who are learning how to reclaim their power after processing trauma.

Rebecca Toner, MA, LPC is a group private practice owner, EMDR therapist and consultant-in-training, and a life coach operating out of Plainville, CT. She specializes in treating clients with chronic attachment trauma and dissociation, and has passion in working with coaching clients who are learning how to reclaim their power after processing trauma.