Official blog of Dr. Jerry Kennard, psychologist & author

Tuesday, 11 July 2017

Is Your Mood Affecting Your Quit Smoking Resolve?

Setting a goal to quit smoking is no bad thing. In fact anything that relates to improving your physical health is likely to pay dividends with your mental health. Achieving a goal provides a sense of accomplishment and improves or helps to nurture self-esteem. 

Which of course is great if you suffer with depression, but not so good if your depression is actually serving to block progress towards your goal. It sounds like a double-edged sword but if you understand depression you can work within your limitations and achieve good things.

In terms of health goals one of the best has to be giving up smoking. People who suffer with depression are as keen to kick the habit as anyone else, but success may be short-lived according to a study in the January 2011 edition of the American Journal of Preventive Medicine. According to the study around 40 percent of callers to a California Smokers’ helpline had symptoms of mild or major depression. The follow-up stats after two months showed that around one in five callers with major depression had stayed off cigarettes compared with one in three others.

Depression and smoking are commonly associated. There is also some evidence that cigarettes have antidepressant qualities that mimic the qualities of a group of antidepressants known as monoamine oxidase inhibitors (MAOIs). Little wonder that smoking becomes a significant form of self medication and that withdrawal can be so problematic.

People with depression have a number of issues that conspire to work against progress. Motivation can be dramatically affected and while there may be sufficient willpower to stop smoking, the necessary resilience to continue is often a very different story. Withdrawal symptoms from smoking include anxiety, headaches, sleep disturbances, restlessness and irritability. These are unwelcome symptoms to someone who is already dealing with depression.

So the question is, what can be done? Contacting your local quit-smoking line may not be enough for people who experience depression. Most of these centers have no facilities or expertise in the assessment and treatment of depression. A few however do, so it can be worth checking out the various options before you commit.

Another option is a two-pronged attack on smoking. Support groups are great for kick starting your resolve and keeping you on board but you may need a little help with medication. Bupropion (Zyban) is an approved medication for smoking cessation and an antidepressant that shows promising results. Bupropion affects neurotransmitters and has a blunting effect on the withdrawal symptoms associated with quitting smoking. A doctor has to prescribe the tablet and they are more inclined to do this if you can demonstrate your motivation to succeed by joining some form of stop-smoking program.

Monday, 6 March 2017

Looking Out for Your Depressed Friend

If your friend is depressed you may find them hard to connect with. They may appear moody, rude, ignore you or try to push you away. Nobody likes this and the temptation is to back off and give the space they appear to want. The irony is this is exactly the time they need you the most and there are some things you can do to help:

1.     See to Yourself. It may seem an odd way to start but it’s important that you understand the level of frustration and sheer hard work that can go into supporting a depressed friend. Misery is easily passed on so you must take time for yourself and carry on with your own life and interests.
2.     See to Them. Your depressed friend will be looking at life in the most negative terms. They won’t see the point in anything and they may well be beating themselves up. You may not see all this as quite a lot is going under the surface. My second tip is for you to support anything or anyone that encourages them to seek treatment.
3.     Don’t Try to Solve Their Depression. It’s often very tempting to try and brush away concerns or to drive a coach and horses through their view of the world. These challenges may simply make them feel more inadequate or angry. Just be a friend. Listen to them without judging and without giving direction or attempting to solve their problems.
4.     Listen. There may be times when your friend won’t talk to you. That’s just how it is. Don’t storm off - just be with them. When they do talk, encourage them to work out what needs to change or what they might do to improve their own situation.
5.     Stay in Contact. It’s possible you aren’t able to see your friend every day. That’s fine. Maybe your job or circumstances don’t allow this. A text, a phone call, an email breaks into their isolation and let’s them know you’re thinking about them.
6.     Be Patient. You may find there are days when your friend seems to be in a lighter mood only for the clouds to descend shortly afterwards. Depression can be like this so it’s important you don’t see it as a form of manipulation or act of self-centeredness.
7.     Don’t Snap. Without realizing it you may have your own agenda as to whether their mood has gone on long enough. You’ve bitten your tongue, you’ve put up with their insults, and you’re frustration is rising to the surface. It takes just one more thing to tip you over and this is the danger point. If you point the finger of blame you’ll undo a lot of what you’ve achieved so far. If you’re at this point, return to Tip 1.
8.     Meds Take Time. Antidepressants aren’t like pills for headaches or indigestion in that the effects can be felt quickly. It can take weeks for antidepressants to have an effect and in some people they simply don’t seem to work.
9.     Talk to Others. A severely depressed person may not look after himself or herself. They may try to stay in bed all day. They may not wash, eat, clean their teeth, cook or clean up. Their depression isn’t your problem and while you may feel obliged to do more and more it’s better to liaise with others (relatives, healthcare workers) over what’s feasible and best for your friend.
10. Spot Triggers. If your friend suffers with repeated depression it may be possible to identify the triggers that start an episode. This is when your intervention can be very helpful by encouraging them to seek help before things worsen.

Saturday, 4 March 2017

Problem-Solver or a Worrier?

Answer yes or no to the following questions:

1.     Do you tend to solve problems on impulse?
2.     Do you spend a long time analyzing the implication of decisions?
3.     Do you put off problem solving?
4.     Do you often make decisions and then back off for further reflection?
5.     Do you pre-judge the outcome of your problem-solving efforts?
6.     Do you tend to ask others to solve problems for you?
7.     Do you prefer to put problems to the back of your mind?

These responses all assume you answered 'Yes'

Answer 1. People prone to worrying may attempt to push problems away by making impulsive decisions. It may have short-term benefits but the lack of forethought can also have ramifications that make a modest problem worse.

Answer 2. People who worry a great deal tend to spend a long time mulling over the implications of each possible solution. It perpetuates worry because the person becomes overwhelmed with the alternatives any one of which may be a viable solution.

Answer 3. Worriers tend to avoid tackling problems. They are aware of the need to solve the problem(s) but will prevaricate. The need to pay a bill, for example, may be offset by worries about other financial matters resulting in no progress and increased debt.

Answer 4. Approaching a problem only to back off is a classic worry strategy. The problem(s) may be reviewed, manipulated, calculated and recast into smaller or different components. It appears to be solving the problem but no progress is actually made.

Answer 5. Pre-judging may seem like an intelligent way of assessing the implications of a decision. In some ways it may be but a worrier has a particular style of pre-judging that assumes the solution will turn out badly. This negative pre-judging works on the basis of perceived damage limitation rather than a successful outcome.

Answer 6. It’s easier for people skilled at persuasion, or very needy, to get others to solve problems on their behalf. Avoidance relieves anxiety and passes the responsibilities to others but it also reduces personal confidence for tackling problems and finding solutions.

Answer 7. Okay, a few problems may simply drift into the background if you simply ignore them but most won’t. A problem still remains whether you push it away or not. It may fester, develop and worsen as a result. People who worry may find the sheer quantity of unresolved problems a worry in itself. And so the vicious cycle continues.
Friday, 4 November 2016

Five Gains and Losses with Anxiety

Anxiety affects people in different ways and under different circumstances. It may be mild, moderate or excessive. It may be short term or may come to dominate a life, and that’s when we think of it as an anxiety disorder. In order to understand what’s helpful or not about anxiety we can consider at least five ways in which it appears to be either advantageous to our wellbeing, or not.

1. Our interpretation of situations is the first thing to consider. Anxiety gives us an advantage when there is a real threat to our health or wellbeing. It helps us to become more wary, to take more precautions, or to get away from the danger as quickly as we can. Possible disadvantages are when and if we interpret situations as being far more threatening and dangerous than they actually are.

2. Our behavior is the second issue. Mild to moderate levels of anxiety are rarely likely to stop us doing things. It’s not uncommon to feel these levels of anxiety when entering into a new social situation, or taking an examination, or visiting the dentist for example. If we become so anxious that it prevents us doing such things then our anxiety is placing us at a distinct disadvantage.

3. Time is the third issue. Our bodies are designed to be able to respond to threatening situations and to recover once that threat has past. It gives us a distinct survival advantage and little or no danger follows this fight-or-flight pattern. Other people aren’t so lucky. The off switch appears stuck and high anxiety levels continue way beyond the time a threat has passed.

4. Trigger point is the fourth issue. In a normal situation there is no cause for a surge in anxiety unless or until a threat is known. The disadvantage for some is that their anxiety system is on a hair trigger. It fires up at the slightest hint of a threat and this, again, is a key sign of an anxiety disorder.

5. Finally, we can consider perspective. In someone with no obvious anxiety issues their level of anxiety will appear proportionate to the threat or danger level they are in. This is a clear advantage and it’s the way our anxiety mechanism is supposed to operate. The disadvantage comes when perspective and proportion is lost. Someone with an anxiety disorder will get anxious very easily and his or her anxiety response may be extreme.