depression

Sadness: a Normal Part of Life

 Jordan Whitt/unsplash.com

Jordan Whitt/unsplash.com

In my last post, I wrote about managing Seasonal Affective Disorder (SAD). Sitting at a cafe by the window, the mood lighting inside is definitely brighter than the grey skies outside. The drizzle is constant and the puddles invaded by rain droplets. You can interpret this as being nice and cozy or a real dread. The thing is, if you’re affected by the rainy Seattle weather, chances are, looking outside will not give you the energy boost. It might do the opposite of inducing sadness and low energy.

We don’t like to feel sad, do we?

Ever wonder what good is sadness? Like, why bother? After all, we all want to feel good. We chase after and try to create happy moments like eat at our favorite restaurants, go on vacations and hang out with people who matter to us. On the flip side, we stay away from negative experiences like heart breaks, bad news and surgeries. We’re good at celebrating wins but as a society, we don’t do as well being with sadness.

If you look at a baby who came into the world happy all the time, it’s hard to imagine that we’re not meant to be happy, like all the time.

Sadness is a normal part of life

The thing is, with time, we become acquainted with the pains of life. From abuse to social isolation, job loss to still births, accidents to illness, could sadness and other unpleasant feelings be, sadly, a normal part of the human condition? What if we’re not meant to be happy all the time; rather, it’s about living a full and meaningful life despite our circumstances?! If sh*t will hit the fan and it’s just a matter of when, could a feeling like sadness help us navigate through life’s complexities?

You might beg to differ but Inside Out has something to say about that:

Being with sadness

Here, Joy is trying to cheer up Bing Bong, the imaginary friend who is grieving the changing relationship with coming-of-age Riley. Joy tries hard to get Bing Bong out of his sadness with quick reassurances, tickles, jokes and distractions. She doesn’t get it and thinks if Bing Bong were to feel his grief, things will only get worse.

Sadness, on the other hand, understands his loss. She sits next to Bing Bong, tells him it makes sense for him to feel this way and lets him cry on her shoulder. While in real life, the turn around is often less drastic, Bing Bong feels better after balling candies and was more ready to move on with their journey. For the first time, Joy saw that Sadness made something better.

Sadness has a place in our hearts

Sadness helps us know when something isn’t right. It validates that it’s hard to be where we are but that it also makes sense to feel what we feel where we are. Our situation may stay the same, but we can feel our way through it. And because we’ve been there or can imagine what it’s like to be there, we can empathize with others and share in their pain. We don’t have to be alone in our sorrows.

The next time you feel any degree of sadness, know that it makes sense. You don’t have to hurry up and get over it; nor do you have to be paralyzed by it. Cry your eyes out if you need to. Surround yourself with people who understand. Then still ask yourself, “What would make this moment full and meaningful?” and go do that.

If you're having trouble being with sadness or other difficult feelings and could use some help, let me know.


Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. Here at the cafe, it went from raining to pouring outside and the puddles have turned into little streams. She must go now, knowing that hiking 1.5 blocks back to the car is a part of getting back to the car.

5 Tips for Managing Seasonal Affective Disorder

 Alisa Anton/unsplash.com

Alisa Anton/unsplash.com

'Tis the season to be sad

While I don’t wish this upon you, Seasonal Affective Disorder (SAD) is a thing around here. Especially with the end of daylight saving time, we’re feeling the effects of brighter mornings and less evening light. Given how much we love our Seattle summers, the shift into chilly, rainy weather, bare trees and gloomy skies is enough to make many of us want to crawl into bed and stay there.

If you are already struggling with depression, you might feel the effects of it more. If your mood is often weather-dependent or you’re a transplant from a sunnier climate, chances are it’ll affect you too. While winter solstice is less than seven weeks away, let’s help you figure out how to get through this long stretch of fall and winter months.

Before we talk about what to do, let’s address the symptoms of Seasonal Affective Disorder (SAD).

SAD defined

SAD mirrors symptoms of Major Depressive Disorder, also commonly known as Depression. You might have SAD if you:

  • feel depressed
  • don’t want to do the things you used to enjoy
  • have low energy
  • have trouble sleeping, often times oversleeping
  • experience changes in your appetite, often times crave unhealthy comfort foods and experience subsequent weight gain
  • feel agitated or sluggish
  • have difficulty concentrating
  • feel hopeless, worthless or guilty
  • have frequent thoughts of death or suicide

If you have thoughts of wanting to hurt or kill yourself, you need to stop reading this and call the National Suicide Prevention Hotline at (800) 273­-TALK (8255). If you have a milder form of SAD but you’re feeling down, struggling to get out of bed, overeating, gaining weight and saying no to social engagements, then here are some recommendations for you.

5 ways to move through SAD

1. Light therapy

You know that it’s a common purchase when they sell it at Costco. Therapy lamps provide bright, artificial white light during months of diminished sunshine. Keep it in a well-trafficked area and follow instructions for use between 20-60 min. Depending on your circadian rhythm, you might find the light exposure helpful in the morning or the evening. Remember to choose a light box that emits 10,000 lux, which is equivalent to 20x that of usual indoor lighting. With lesser lux units, you might need to use the lamp for longer to get the same effect.

2. Physical activities

I don’t mean exercise. The gym is not for everybody. Rather, there are a lot of fall and winter activities that can get your heart pumping and your brain releasing happy hormones. It can be indoor climbing, yoga, laps in the pool, racquet ball, even housework. Outdoors you have a walk around your office or neighborhood, winter hikes, and snow sports.

Now I understand the fact that you feel SAD means you don’t want to move very much. However, if you wait until you want to do something before you do it, you might never do it! Instead, act the way you want to feel. That said…

3. Positive activities

What activities used to bring you alive? What did you use to enjoy? Or, what is something new you’d like to try? It can be a physical activity listed above or it can be art walks, concerts, a meetup, a good novel, a weekend away. You can be with strangers, close friends or be by yourself. Given the tendency to socially withdraw, I’d recommend doing some activities with others and developing accountability to increase follow-throughs. While there’s no guarantee that you’d feel better afterwards, it’d help you in the long run to stay active and engaged in life.

4. Medication

I don’t know how you feel about taking meds, but sometimes an anti-depressant is necessary to get you past this hump. It doesn’t mean you have to stay on this medication forever; only until you have more tools under your belt to be without it. Also, if you’re currently on an anti-depressant and you’re questioning whether it’s working properly, it’s probably time to visit your prescriber again. Remember that it can take up to 6-8 weeks for the medication’s benefits to kick in, while you might feel the side effects more immediately.

5. Take it in

While this is not the most exciting time of the year for you, can there be any beauty in taking in the vibrant colors of the leaves, the rustling of leaves against the wind, or the crunching of leaves under your feet? What about the beating of rain on pavement, the dancing flame from a crackling fireplace, and the warmth of peppermint tea against your lips?

This will pass

This season is here and it will pass. Since there’s no ushering it away, I hope there’s a part of you that can find it a friend, rather than a foe.

And if you need a therapist to help you ride out this season, I'll be here!


People Bloom Counseling Redmond Couples Cancer Ada Pang.png

Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. This fall, she noticed the changing colors of the leaves more. Her favorite food group this season is all things squash and her favorite activity is baking.

When Depression & Anxiety Come with Cancer

 pixelheadsphoto/stock.adobe.com

pixelheadsphoto/stock.adobe.com

Let's face it. It's enough to go through cancer diagnosis and treatment, let alone the emotional ups and downs that often come with it.

Questions that might trouble you

As a result of your cancer, sometimes you have questions about the past: "Did I do something wrong to cause this cancer? Could I have prevented it?" "What if I had __________________ before it got to be too stressful? Would that have made a difference?"

Other times you might have questions about the future: "My neck hurts. Is that cancer?" Will I be able to see my granddaughter graduate from 2nd grade?" "How will my family be without me?"

While it's normal to ask these questions, often times there really isn't a way to answer them. These questions might linger if you struggle with depression and anxiety. 

Depression and anxiety post cancer

What we know from cancer research is that depression and anxiety are common symptoms during and post cancer treatment. While depression might dissipate with time, anxiety lingers as you're reminded of your cancer everyday. 

Some of these symptoms might be treatment related, but could this be you? 

You might be struggling with depression if you experience the following: 

  • feeling down, depressed or hopeless
  • having little interests in things you used to enjoy
  • sleeping too much or too little or have trouble falling asleep or staying asleep
  • having low energy 
  • having little appetite or want to empty the fridge
  • feeling irritable 
  • experiencing mood swings 
  • having trouble concentrating 
  • withdrawing from friends and family 
  • feeling hopeless, guilty and/or angry
  • having thoughts about being better off dead or hurting yourself 

You might be struggling with anxiety if you experience the following: 

  • feeling nervous, anxious or on edge
  • feeling like you cannot stop or control your worries
  • finding yourself worrying too much about different things
  • having trouble relaxing
  • feeling restless and it's difficult to sit still
  • feeling easily annoyed or irritable 
  • anticipating worse case scenarios

Sometimes anxiety is felt in your body. You might be struggling with panic symptoms if you experience the following: 

  • pounding heart 
  • sweating 
  • trembling or shaking
  • shortness of breath 
  • feelings of choking
  • chest pain or discomfort
  • nausea or abdominal distress
  • dizziness/light headed
  • chills or heat sensations
  • muscle tension 
  • feel out of control 
  • fear of going crazy
  • fear of dying

Life after cancer

If you identify with these symptoms that go beyond an occasional sad day or feeling stressed out about something, there is hope! You don't have to settle and let cancer drag your down. Rather than cancer driving your life, you can make meaning choices in the face of cancer. That way, depression and anxiety symptoms, even when they arise, won't bother you as much. 

If you need help putting cancer in the passenger seat, I'll be here


People Bloom Counseling Redmond Ada Pang

Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples and cancer patients. That can also mean couples distressed by a partner’s cancer diagnosis, or couples wishing to use their marriage as a resource during their cancer journey. When she’s not thinking about couples and cancer, she is cognizant about choices that make for a meaningful life. This often involves food. 

The Great Divide. I’m not having it.

 maria_savenko/stock.adobe.com

maria_savenko/stock.adobe.com

Way to start the New Year’s

I woke up on Sat Jan 28, 2017 to the start of Jan 1, 2017 on the Chinese lunar calendar. I happened to be in Vancouver, BC, Canada for a two-day training prior to the festivities and stayed with my folks. I had a rather slow morning and came downstairs to my Mama’s homemade CNY brunch. My aunt came over, my sister and niece have spent the night and all was well until I got a text from my husband.

He was asking when I’d be home. Later in the eve, I conveyed, not knowing what’s the hurry. He then mentioned some executive order that Trump has signed that morning. I looked it up and it was f*cking unbelievable.

I am a Hong Kong-born Canadian citizen green card holder living in America and I was shocked. I cannot imagine what it is like for refugees and Muslim brothers and sisters around the world.

I felt very uneasy and after a late lunch, left for the border. For the first time, I didn’t know what to expect. While Canada and the US are allies and I have all my documentation, a “Muslim ban” from selective Muslim-majority countries has me wondering what’s next.

Back on US soil

The border was uneventful, as if nothing has happened. I almost wish that something was different because this is NOT okay. I’m now back on US soil. And for the first time in my 15.5 years of living in the US, I felt different, like I don’t belong here. My countries of origin and naturalization aren’t even on the blacklist. I’m not even Muslim. But to exclude immigrants and non-citizens is to exclude me and to exclude people like me. I realize to make America great again is make America white again.

Pulling away

During my 2-hour drive home, I became increasingly aware of my “other-ness”. I feel threatened by the future possibility of not being welcomed in this country. I find myself emotionally pulling away from my white community. I picture the faces of these people I have come to know and like, and already, I feel further from them.

Suddenly, I realize what was happening. There is a great divide in our country and around the world and to pull away is to concede. In Trump’s promotion of all people white, male, straight, Christian, middle and upper class, able bodied and Euro American, he is shutting down those who don’t fit the bill.

I’m not having it.

Leaning into America

When I realized this, I made a conscious decision to lean in, instead of pull away. It helped that when I got home, my husband, who is 4th-generation Japanese American, hugged me for a long time. It helped that protests rose up at airports and city streets around the country as we stand with each other. It helped that I connected with my community the next day and saw how they were also affected by this news.

It helped that this is not the end; rather, the beginning.

We CAN find safety and shelter in each other. Notice where this was filmed:


Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond therapy practice in WA. At the heart of what she does, she’s about helping people flourish and live compassionate and vital lives. She can be found at PeopleBloomCounseling.com.

How to be with the 2016 US Election Results

 Ezio Gutzemberg/stock.adobe.com

Ezio Gutzemberg/stock.adobe.com

Unexpected results

Wow! What a week and it’s not over yet. Tuesday seems like eons ago. The election results shocked the whole world, leaving some celebrating, others protesting. On the one hand, as an immigrant and a woman of color, I hear and identify with the concerned voices of my fellow brothers and sisters as they face an amplified fear to the already prevalent racism, xenophobia, islamophobia, homophobia and sexism in our society. On the other hand, republican voters speak to the hopelessness and oppression they felt under the Obama administration. Each has a story to tell.

Narrowing the great divide

Our country is facing unprecedented polarization. That leaves a “we” versus “them” mentality with little room to hear the other. Whether you are a distraught Clinton voter who has taken to the streets, a victorious Trump supporter beaming with pride or a secretive Republican supporter afraid to come out of the closet, here are some ways to be post election.

  1. Come together – be with those who share your viewpoint. Find company. Look around you and know that you’re not alone.
  2. Express yourself – silence is dangerous. Speak to your hopes, fears, frustration and disappointment. Use words, art, music, anything.
  3. Let your feelings come and go, come again and go again – if you’re experiencing shock, denial, anguish, sadness, fear, anxiety, anger, joy, thrill or whatever else, acknowledge them. Pushing away unpleasant feelings will only make them stronger; prolonging pleasant feelings will make you miss out on the here and now.
  4. Revisit your values – remind yourself what you’re about and how you want life to be for you, your family, your neighbors, your community, the environment, animal life, and human kind.
  5. Know your impact – your beliefs and thoughts carried out in words and actions will affect another. Your choices have consequences, positive or negative. Imagine the effect of those same choices when done to YOUR father, mother, brother, sister, son, daughter, best friend and those your love.
  6. Listen closely – you come with your worldviews, life experiences and biases as you encounter another’s worldviews, life experiences and biases. Listen and understand another’s perspective even though that has and might never be your reality.
  7. Stand up for justice – give voice to those who are silenced or are afraid to speak up. Stand with those who are treated less than because of their race, gender, sexual orientation, age, religion, class, abilities, looks or ethnicity. Pause to reflect on what each of these even mean. 
  8. Teach the next generation – when your children, grandchildren, nieces and nephews inherit this earth, what do you want them to know about caring for ourselves and each other?
  9. See our humanity – we are first human beings BEFORE our differences divided us. Strip us to the core, we have the same needs for safety, love and connection:

I might not know your story, but let me hear it


Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond therapy practice in WA. At the heart of what she does, she’s about helping people flourish and live compassionate and vital lives. She can be found at PeopleBloomCounseling.com.

“I was Diagnosed with Breast Cancer. What am I to Feel?”

 Laurin Rinder/stock.adobe.com

Laurin Rinder/stock.adobe.com

October is Breast Cancer Awareness Month. I’m putting on hold my blog post on trauma to address the emotional needs facing breast cancer patients. Granted, cancer patients often talk about their experience of cancer to be traumatic, even though many do not meet full criteria of Post-traumatic Stress Disorder.

To hear that, “You’ve got cancer” is enough to unravel any brave soul. The urgency of the news leaves little room for reflection, for contemplation. You’re scheduled with the surgeon, followed by the radiation oncologist and likely the oncologist. Some medical facilities fit all three appointments into a four-hour meeting; others schedule them one at a time. Either way, your head is full and it’s hard to digest information about the stage, tumor size and grade, if it’s hormone dependent and whatever else you’re supposed to know.

All this knowledge; all these next steps, but how are you feelin’?

Facing a loss

Being diagnosed and treated for breast cancer is to face your own mortality. Your vision for what your life would be like is called into question. You thought you would live to hike the Annapurna Circuit, see your kids graduate and hold your grandkids in your arms. All these plans are now up in the air. Even if you were told the type of cancer you have is highly treatable, you’re starting to envision a very different future.

The pendulum through the messiness of grief

Being diagnosed with cancer or other chronic illness is to grieve a loss. Sure, you’re used to your body having some aches and pains, but you’re definitely not as healthy as you had thought. Thus, it makes sense that women going through breast cancer would face different stages of grief in no linear fashion.

Denial

Also known as non-acceptance, denial happens because you’re in shock and overwhelmed by the news of cancer. “Were those really my test results? Did the doctor make a mistake?” You might weep and you might also feel numb. You might wake up in the middle of the night wondering if it was all a dream. It is common for you to feel out of touch with the rest of the world because quite frankly, you would much prefer a life without cancer, thank you very much.

Bargaining

Your mind races through choices that could have detoured cancer. “What if I had lived a healthier lifestyle? What if I had gotten a second opinion? What if I had reconciled that relationship rather than let it eat at me all these years?” There are no answers to these questions but it doesn’t stop you from asking them. Conscious or not, when you consider how you could’ve affected the outcome, it’s a way to take back the control you feel like you’ve lost. Similarly, you might bargain with God or a higher power to give you another chance at a life without cancer. Or, at least not now, though there really isn’t a good time.

Depression

While not all breast cancer patients meet criteria for clinical depression, sadness is very much a part of the grieving process. When you think about how your body is sick, the possible side effects of treatment and how cancer might affect your quality and quantity of life, you understandably would feel sad. Women have often talked about treatment leaving them feeling “disfigured” or “damaged.” This might lead to feelings of shame and negative self-worth and the tendency to isolate and push people away.

Anger

“Why is this happening? Why me? What have I done to deserve this?” are some of the questions that breast cancer patients might ask. Implied in these questions is a sense of unjust, that this shouldn’t be happening. Sometimes, you might feel anger towards yourself, if you think you could’ve somehow prevented cancer. Other times, you might be angry at God or a higher power from “allowing it to happen,” or at your healthcare providers for not doing more to help. Unfortunately, your loved ones might get the blunt of your anger, simply because they’re the closest to you.

Acceptance

If denial is synonymous with non-acceptance, then acceptance is to face the reality of what is: “You have cancer.” It’s hard to read those words and to face them head on, but to keep on denying that fact is to say, “Cancer has you.” To accept something does not mean you have to like it, or that you approve of it; it only means you’re not fighting the reality of cancer diagnosis, treatment and prognosis. You’re more willing to look it in the eye, and say, “Okay, let’s do this.”

The actual stages of grief

The five stages of grief originally coined by Elisabeth Kübler-Ross is actually in the order of denial, anger, bargaining, depression and acceptance. I mixed up the order to show that there really isn’t a right or wrong way to go through grief because mourning a loss is meant to be messy.

You could be accepting the side effects of chemo one moment and then be very angry that you missed the toilet and barfed all over the floor the next. You could have a good cry and feel at peace, and the next crying episode could make you very angry at God. You might want to cancel your MRI and be in denial about what your doctors would want to say to you and the next day, invite a friend to come along to your imaging appointment.

It’s okay

The Kübler-Ross model likely does not encompass the emotional complexity of your cancer journey. Nonetheless, your cancer experience is your experience. It is okay to feel the way you do; all of your feelings are valid and normal. Allow yourself to go to these places; it’s a part of the healing process.

If you need help navigating through the messiness of these feelings, I’m here.


Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps distressed couples and breast cancer patients. That could also mean couples distressed by a partner’s cancer diagnosis, or couples wishing to use their marriage as a resource during their cancer journey. When she’s not thinking about work, she loves spending time with her hubby, eating good food and more recently, watching Harry Potter. 

The Guest House

 Dragan/stock.adobe.com

Dragan/stock.adobe.com

This being human is a guest house.
Every morning a new arrival.

A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.

Welcome and entertain them all!
Even if they're a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still treat each guest honorably.
He may be clearing you out
for some new delight.

The dark thought, the shame, the malice,
meet them at the door laughing,
and invite them in.

Be grateful for whoever comes,
because each has been sent
as a guide from beyond.

- Rumi
 

Sometimes, it Takes a While

 Drew Patrick Miller/unsplash.com

Drew Patrick Miller/unsplash.com

Autobiography in Five Short Chapters

Chapter I

I walk down the street.
There is a deep hole in the sidewalk.
I fall in.
I am lost... I am hopeless.
It isn't my fault.
It takes forever to find a way out. 

Chapter II

I walk down the same street.
There is a deep hole in the sidewalk.
I pretend I don't see it.
I fall in again.
I can't believe I am in this same place.
But it isn't my fault.
It still takes a long time to get out. 

Chapter III

I walk down the same street.
There is a deep hole in the sidewalk.
I see it there.
I still fall in... it's a habit... but,
my eyes are open.
I know where I am.
It is my fault.
I get out immediately. 

 Chapter IV

I walk down the same street.
There is a deep hole in the sidewalk.
I walk around it. 

Chapter V

I walk down another street.

 

- Portia Nelson