If you're experiencing physical pain or stomach aches or other things going on and you've been to the doctor and they don't find any diagnosis, they don't find any reason for it - probably they told you to see a therapist and they're considering anxiety. A lot of times anxiety disorders can manifest in your physical body and we call that somatic disorders. And the best way to treat that is to go sort of far back and understand your whole life and your whole psyche and what could be making you anxious that you're not consciously aware of. You usually can't say I'm anxious because of this, so my stomach hurts. Sometimes you can, but not usually. So what you'd want to do is you'd want to go see a therapist and try to understand what anxieties are going on, what depression symptoms you're having that are going on. And if we make them conscious and you talk about them, it generally starts to alleviate the actual physical symptom.
There's a feeling that people describe that's not sadness - it's something that they described as much worse than sadness: it's empty. Like there's no feeling there at all whatsoever. When clients describe that to me, I immediately start to think: okay, maybe this could be a depression. If you feel that feeling for say two weeks or more, you really do need to consider that you could possibly have depression. Let's say you feel it right away and you want to know what to do. First thing you've got to look at is sleep. You have to try to sleep eight to nine hours a night. Next thing you've got to look at is exercise. Try your very best to exercise three times a week, three to four times a week for 30 minutes. You can go bike, you can go run, you can do a yoga video on YouTube - just something really basic is fine. Then if it still doesn't work, I would recommend that you go see a therapist and if that doesn't work, then I would look at some medicine from the psychiatrist.
If you're feeling angry and irritable most of the time, it can be a contributing symptom of depression. Depression in children looks like anger most of the time, so just keep that in the back of your mind. But let's say you feel super angry because somebody did something mean and you just feel like you're going to blow up or something else happened and you just feel really angry and you don't know what to do with it. My best advice for that would be to workout. Do something that absolutely exhausts you. Whatever it is, whatever you have access to: go run, go to the gym, go to a boxing class, join martial arts. Do something that makes you feel like you can use all of the strength in your body and use it up until you're exhausted. Burn up the anger. Another thing is to write it out. Write out everything you're angry about and then edit it. Do it in the notes in your phone and you can edit it so that it gets to the most concise you can get it so you actually know how you feel. When you're angry about something, you don't want to tell the other person and drone on and on and off. They won't hear you and your point will get lost. What you want to do is you want to be able to say it in the least words possible. So that involves a lot of editing and a lot of writing out how you feel, edit down less, less, less and less. And then you can know to yourself how you feel and be able to express to the other person how you feel and hopefully have a much higher chance of them hearing you.
If you're feeling hopeless, like everything is going wrong and nothing's going to get better - what I want you to do is get a piece of paper and start writing. Write out everything that's going wrong. Make a list of it, get it all out of your head so you can see it. It's all the same place. It's all concrete right here. Then it doesn't feel so overwhelming. And then what I want you to do is I want you to sit: today, I'm in ninth grade and I'm blah, blah, blah. This is what I have to do. What do you think comes next? What will high school be like? What do you want college to be like? What do you want your life after college to be like? Where do you want to live? What do you want to do? What kind of people do you want to be around? You know, what kind of job you want to have? Do you want to have grandkids someday? I want you to stretch it out into the future. When you take your vision more wide instead of right now, it's easier to see: okay, right now life sucks, but clearly I won't be in this exact same place forever. When you look into the future, then it becomes not quite so overwhelming or seeming like it's going to last the rest of your life.
I wish there was an easy answer or easy advice for feeling lonely. If there is, I don't know of it. When I see clients in my office that feel lonely, we could say you should make more friends, you should go out more but to be honest with you: they're already out with all their friends. They just are lonely while surrounded by a bunch of people. I think part of the reason this comes up (especially during adolescence) is because you're recognizing who you are as a certain person and that may not be similar to the people you've been friends with growing up. You might feel disconnected, you might feel like you've outgrown your friends and that can lead to loneliness. Another aspect of feeling lonely could just be that you're old enough now to recognize the existential crisis that we are actually all completely separate from other people and we are living our own life and not other people's. So as far as feeling lonely, that's a difficult thing that I usually work with in therapy over a course of many weeks and months to alleviate. It's not something that I think I have a quick tip or advice for.
Sorrow and despair can come from many different things. Some of the most common might be someone in your family passing away, your parents getting divorced, breaking up with your very first true love. I think at some point every adult knows the feeling of I cannot do this. I feel like I'm dying. My chest is so heavy, I feel so awful - so miserable. I do not know how I'm going to get past today. I'm just going to worry about today, one day at a time. What we do with those feelings is: you have to use up the sadness. You have to use up the grieving and you give yourself time. Depending on what it is, if it's a breakup or if it's a death, a death - it's going to take a long, long time and it's going to go up and down. Some days you'll be fine. The next you'll be super sad again and you just sort of have to sit back and watch your emotions process themselves. Don't try to stop them. That's the important part. Do not try to stop how sad you are. You have to keep functioning, but when you're home or when you're in the car, then it's fine to cry and it's fine to still talk about it with somebody else. If you are going through a breakup, then something similar is going to happen and what I recommend to do is set aside a couple hours every night - maybe not a couple, set aside one and a half - and say: okay, from 7:30-9:00, I'm going to sit and I'm going to talk about ex-boyfriend and I'm going to cry. This is the time I have to do it. Outside of that time I cannot talk about him. And then day after day you only have your hour and a half in the evening to talk about him, but you have to use the whole thing. You can't stop early - that's the trick. And after a couple of weeks, you will start to notice yourself being like, ah, screw it. I don't want to sit here and cry anymore. I don't want to sit here and be sad and talk about it anymore. And then you can stop. Otherwise, the sadness can sometimes take over your whole day. You're in the bathroom crying at school when you should be sitting in class. That's what I would recommend if you're going through a breakup. If it's something more severe, like I said, with somebody dying - you want to ask for help and just watch the emotions. Don't try to stop them. Just keep going. After about six months, a year, a year and a half - it will start to get better.
This is a really common question for adolescents. Throughout adolescence, that's the developmental phase where you start to question: Who am I? What do I want to be? What have I been? And you start to look at what kind of person you want to be and you can try on 15 different ways. Where I like to start as a project is I ask clients: who are your grandparents? Tell me about your grandparents. Tell me about your grandparents' relationship with your parents. How were they? Tell me about your parents. Tell me about your parents' relationship to you. And through doing that we start to see: you didn't move out of a vacuum. You do have a history. This is who you are today. It certainly doesn't need to be who you become as you come into your own adult life, but it's something to know so that you're making conscious decisions. You can really sit down and pick apart your parents' values and choose which ones you want to internalize and keep for yourself versus which ones you'd prefer to throw away and that's not really you. One of the things that I really encourage kids is to dream. Be very creative. Think about yourself a lot. Think about your life and what you want. What might you like to do? Where might you like to go to college? Do you want a small school or big school? Do you want to get married? Do you want to have kids? Do you want to go on a lot of vacations or do you like to stay at home and have a simple life? All of these things are really important and you don't get to any of the answers unless you just sit there and dream. You come up with all these crazy ideas and you'd be willing to edit them at any point, but it's important to just sit down and dream.
During teen years, teenagers struggle with a lot of pressure - either from school, from their parents, family, or from their friends. It is important that they have the support they need during those years. Some of them might develop some symptoms of depression and anxiety, and this is where group therapy's a great place for teens to develop some sense of self, develop their identity and boost their self-esteem. It is important that they keep open communication with their parents and the school counselor to be able to ask for the help they need.
There's a symptom of depression called Anhedonia, and what that means is when you lose interest in other activities that you used to enjoy. When you're in adolescence, it can happen in a few different ways: maybe you've lost interest in those activities because you've outgrown them and you want to try on something new and that's obviously not a problem. But if you feel like you wish you wanted to go dancing again, dancing still like you used to, but you just don't - that's more along the lines of Anhedonia. What you want to do is if you've lost interest in things like that, make sure you get enough sleep. Make sure you try exercising even if you don't want to - it might spike your endorphins so that you can start getting back into the habit again. And if that doesn't work, then talk to your parents and perhaps see a therapist or a psychiatrist because that does lead to more along the lines of depression.
Sleep is the most important thing for physical and mental health. A lot of times parents will bring in their kids and we'll sit down and talk. They're suffering from many different symptoms of depression and the first thing I ask is: how many hours do you typically sleep at night? Kids need to sleep eight to nine and when you break that down, that means they have to go to bed at like 9 or 10 so they can get up for school in the morning. That's not happening very often. Sometimes they'll look at their fitbits and they say, oh, I guess I slept four hours last night because I was doing homework. Five hours the night before because I had a soccer game and five and a half the day before that because while I was on Facetime with my best friend. What we want to look at is what symptoms that could be causing that looks like depression but might not be. It can cause irritability and fighting with parents. It can cause social withdrawal and being too tired. It can cause poor concentration and doing poorly in school and it can also cause considerable increase in appetite. So we really want to focus on the sleep. It's worth spending a lot of energy, a lot of time on Google trying to sleep more hours, trying to sleep better. Vice versa, we also need to look at if you do have clinical depression, a symptom of that is an inability to sleep. If that's the case and you just can't sleep, you lay there at night, you go to bed at appropriate time and you just lay there - that's the time to seek out a doctor or a therapist to try and get some medication or get some help sleeping because that might really hinder your depression from getting better.