Official blog of Dr. Jerry Kennard, psychologist & author

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.
Sunday, 2 October 2016

Does He or She Have Bipolar?

One of the most frequently asked questions about bipolar disorder goes along the lines of, “I suspect my (name/relationship) has bipolar, what should I do?” The question may appear simple but it’s actually loaded with assumptions and potentially different ways it might be answered. In this post I attempt to unpack just some of reasons why answering such a question is actually quite difficult. In so doing I’ll be leapfrogging around a few ideas.

Anyone with an internet connection knows how easy it is to access medical advice and information. Access to health information via the internet represents an acceleration of what was already recognized as a booming industry by television, books, newspapers and magazines.

The movement for self-knowledge and self-empowerment via the internet has both merits and disadvantages. In terms of advantages, people are more aware than ever of their health and its intricacies. In terms of the disadvantages, I’m more aware than ever before of the tendency for people to medicalize sensations, emotions and behaviors even though, to my mind, they fall within the bounds of normality. Awareness and sensitivity to health issues is great, but when it extends to the willingness of people to make lay-diagnoses, I think we move into murky territory. Self-diagnosis can be problematic but at least only one person is affected. Diagnosing others can have all sorts of upsetting consequences.

At least the, ‘I suspect’ question suggests the person has an element of doubt about what they are asking. Increasingly the, ‘I’m absolutely convinced’ question is making its mark. Is there really a difference between the two? Well, that’s yet to be determined, but it perhaps says something about the nature of research via the internet and the type of information most commonly found via search engines for certain types of question. Some of this is well intended, if inaccurate, some is good, some should be trashed.

So, we return to the question. “I suspect my husband/boyfriend has bipolar”, how might we answer? Well, there’s the, ‘see if you can get them to see a doctor’ response; it’s safe and potentially very useful advice. But, very briefly, let me play devil’s advocate with the question. Even if we accept the very real possibility that another person has bipolar, we can’t actually assume anything about that person in terms of their willingness to seek help or treatment. After all, some people with bipolar may never have been diagnosed. Some have, but go through their lives without treatment. Some turn to alternative therapies. Some, of course, sign up to conventional medical treatments and stick with it because in weighing up the costs and benefits they perceive more benefits. It’s not my intention to cause confusion where help is genuinely being sought but I think it is useful to illustrate some different perspectives.

If your partner recognizes their moods or behavior are causing them or others distress and they see some pattern in this, your support in helping them with proper medical diagnosis and treatment options is likely to be one of the most positive and significant things you can do.