What to Do when your Self-Care Activities Don’t Work

Photo by Alex Geerts on Unsplash

Most of us are not doing well

Back in July, I wrote about us entering the chronic stage of this global pandemic. Now a couple more months have passed and things are not much better. The smoke eclipsed the short summer we had left and last night’s first presidential debate was utter chaos. In light of all this, I should mention there are some people who are doing surprisingly well while social distancing, meeting online, and taking things in stride. But, that’s not most of us.

At best, many people are dipping in and out of feeling okay. At worst, they never adjusted and have been struggling since March. In the middle are people who rode the wave of crisis for a while and adapted, except the crisis never let up and they’re on the trajectory to burnout if not already there. 

2020 has been one hell of a year and we still have one more quarter to go. The quarter where Seasonal Affective Disorder (SAD) makes a comeback with the shorter days; the quarter where the next president will be determined; the quarter where some families will grieve their first holiday without their loved ones.

Zoom turkey is just not the same. 

You’re normal

If you’re struggling, you’re human. Some of the most ambitious, competent, adaptable and resilient people I know are struggling. It doesn’t mean you can’t hack it, because you likely have been through other trying times and made it to the other side. This time is different. It is the ripple effects of COVID, the continued disregard for Black and Brown lives, the devastating wildfires and the looming presidential election. There are countless stressful events in between that I initially listed but have decided to leave out because it gave me heart palpitations to write and re-read. If you wonder why you don’t have your shit together, it might be because you’re still processing the ramifications of the last event. Or the last few events. 

Stop trying so hard 

So, before you go off to list the self-care activities you either ought to be doing or have tried with limited results, let’s get something straight: Stop pressuring yourself to feel better. Meal prepping, going out for walks and journaling are great, but not with the undertone: This has got to work! This has helped in the past! Why can’t I get this to work?! It’s like pressuring yourself to fall asleep when you’re wide awake; good luck with that. 

Now I’m not asking you to give up, but I am urging you to approach this series of crises differently. This is not a nail you approach with a hammer or a screw you approach with a Phillips head. Rather, put down your tool and stop trying to fix things. Play Animal Crossing if you think it’s going to help you, but not because it has to. Go for a run cuz it’s a nice day out, not because you felt the runner’s high last time and you’re looking for that same effect this time. Do the activity that’s good for you, period. How you feel afterwards and whether it’ll actually help is secondary. If it does; great! If it doesn’t; it is still beneficial.

A study done on lab rats showed that even when they were forced to exercise, their mental health improved from the exercise as much as if they had chosen to hop on their wheel. How does this apply to you? Well, even if you really don't feel like it and wonder if it's even doing any good, it's better to get up and move than not. And if you can't bring yourself to do it today, there's always tomorrow. 

That brings me to my next point. 

Change your expectations 

If you have high expectations that yoga will leave you feeling all zen, and you feel just as anxious when you started if not more, then maybe you’ve tuned into all that your body was holding. These are not normal times and your usual or new coping strategies are not supposed to have the same effect. You also don’t have to do the right thing all the time. That’s exhausting. If you want some chocolate, have some chocolate. Don’t feel like jumping on that family Zoom call? Skip it. You don’t have it in you to show up for work today? Take a mental health day. You don’t have to be firing on all cylinders right now. Like, what cylinders? 

Do things that actually give you spoons

Lastly, not all coping mechanisms are created equal. If you both like to mow the lawn and you like the outcome of a mowed lawn, then all the power to you. For many other coping skills, we may like the feeling of having done it after the fact but not in the moment. So, if marinating chicken for tomorrow’s dinner feels too effortful at the moment and it will actually take away your spoons, then Trader Joe’s pre-made Koma Fish Curry sounds pretty good and just needs a trip in the microwave. The dishes are too much today? Let’s try again tomorrow. Instead, watch three episodes of Queer Eye over a frozen burrito. It might just replenish your spoons. Might. 

We’re here for you 

If you need help with your self-care activities, our trained therapists are here for you. We understand because there are times when we’re going through the same things and have needed to tap into our toolbox to stay sane. We want to help you develop yours.

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Ada Pang is the owner of People Bloom Counseling, a Redmond psychotherapy practice. 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. She recently dyed her hair at home to switch things up. The last time she dyed her own hair was in high school. While it didn’t make everything better and it wasn’t supposed to, it was something she is reminded of everyday. It did help. A bit.

Outliving our Furry Companions: Tips for Coping with the Loss of a Beloved Pet

Photo by Yerlin Matu on Unsplash

Losing a pet is devastating. It can be so jarring to our daily lives. Our little friend was with us on the daily - we spent every moment at home together, they slept at our feet, and they may have been closer to us than a fellow human being.

But many of us may feel like it’s not socially acceptable to make a big deal of it. Taking time off work, for instance: most of us don’t expect to get bereavement leave when we’ve lost a pet. Not to mention conversations with acquaintances! Have you ever heard this: “Oh, you’ll get over it! Are you going to get another pet?” How is that ever appropriate?! If someone had lost a kid, would they have said the same thing? 

Because that’s what pets are like: a child, a family member, a close friend. 

The sense of loss is constant

A year ago, I lost my cat of 19 years. It was the most disorienting thing. My partner and I had this family unit - it was us two and Tybo. Having him there was such a given, almost like Tybo was part of our house, built into the walls; a complete set.

Coming home to an empty house was heartbreaking. It was so quiet and still. I missed the ringing of his collar; his orangeness slipping past us, nuzzling our necks while we tried to sleep. His meowing, his purring, our meal routines, even our litter cleanup routine. These interactions, or there lack of, were constant reminders that he is no longer with us.  

I imagined how much more heart broken I’d be if Tybo was my main companion, if we were not a trio, but a duo getting through life together, through all the ups and downs. I have all this love, and now all this grief. Where would I put these feelings?

Animals are a wonderful source of support and unconditional love, and losing them is one of the hardest things a person can go through. It’s the kind of life event that’s hard to explain to people who have never experienced it themselves.

The grief is real  

When I lost Tybo, I took my grief seriously. I read about grief and loss and the psychology of these awful feelings. The pain can be as heart wrenching as losing a human loved one. That’s why hearing, “So when are you going to get another pet?” is so insensitive and infuriating. 

Everyone expresses sadness in different ways, but some aspects of grief are universal. I realized I was experiencing all the stages of grief - denial, anger, bargaining, depression, acceptance; sometimes in order and sometimes not. It felt like my grief process was both a classic textbook case: formulaic and predictable, yet deeply personal. Knowing others experience grief in similar ways made me feel less alone. 

I’ve lost a few pets in my life, and I came out okay on the other end. It took a while and it wasn’t easy. However, these are some things that has helped me get through it.  

Tips for coping with losing a pet

1. Let yourself feel all the feels

This is a horrible feeling. Let yourself cry, let yourself take a day off work if you can afford it. It’s your life, and your mental health that needs care and attention. You may feel complete despair, hopelessness, and confusion. Write about it in a journal if it helps you express your emotions fully. Don’t be hard on yourself for feeling this bad. These feelings will pass, but also know that it’s okay to feel what you’re feeling right now. 

2. Do something special to honor your pet

My partner and I planted a peach tree in the back yard in honor of our orange tabby. We also made him a… wooden burial box (calling it a casket doesn’t sound right). We wrote love notes to him on the inside of the box and put his favorite toy in with him. We buried the box under the peach tree. We made a little gravestone out of pottery with his paw print on it and placed it in front of the tree. I think of him often when I look outside. 

I’m getting teary now just thinking about it. It’s been nearly a year, and time helps me look back fondly, rather than from a place of despair. Having a little gravesite to remind us of him makes him feel close to us and us to him. The peaches are delicious, by the way. 

Some people have a ceremony or a shrine in memory of their pets. Others make a photo album, or a scrapbook. And some frame a large photograph for their living room. Do whatever you find meaningful to you as you create something, anything, to represent how important this pet was to you and your family. The loss is real. Let’s honor it.

3. Talk to people about it

I initially felt a bit of shame feeling this bad about my cat. I thought…it’s just a cat (I was raised with the values that animals belong outside. On a farm or in the wild). So getting this attached to my cat was an unexpected life twist. But, considering Tybo was in my life for 11 of his 19 years, that’s a significant chunk of time. I was surprised at how understanding people were when I reached out and told them I was struggling.

Many people have experienced the loss of a pet, so while it’s not often talked about, your animal loving friends and relatives can probably relate to this feeling of loss. They can offer support, kind words, and a reminder that you’re not alone.  If you don’t know anyone who can relate to this feeling and show support, a therapist is a safe person to bring this up with.

4. Remember how you got through difficult times in the past 

Remember the last time you split up with a partner you cared deeply about, you thought you’d never get over them? You couldn’t imagine loving someone else, sharing a bed with someone else, and moving on. The thought made you shudder.

And then what happened? You found ways to live. You found happiness again, in a new way.

For me, the loss of a pet was different from losing a family member. A family member is truly irreplaceable. You’ll never have another mom, grandparent, or brother. And likewise, there will never be another Tybo - the goal is not to replace him or find one just like him. But the difference between losing a family member and a pet was the realization that I can find happiness with another pet. You too can find happiness with another little companion, if that’s what you want.

Another pet can bring you joy like you can’t imagine, in time.

Introducing our new furry companion

Over the summer, we adopted the best little guy from the Humane Society - a one year old yorkie we named Ziggy Stardog. At first I thought I’d feel guilty about Tybo; I was reminded of the loss constantly by the new addition to the house. I think about Tybo more now that Zigg is around. But the feelings that come up aren’t necessarily sad. Tybo would have eaten that, or Ziggy doesn’t open doors like Tybo used to. There will be comparisons, but I actually welcome those thoughts. They come naturally, and the reminders fill me with love for Tybo all over again. 

Ziggy is a bundle of happiness and he is what makes pets amazing! All he wants is to run around and be free and explore. When he hops around the yard sniffing things, chasing bugs and chewing on my zucchini plants, I find myself growing more and more in love with his pure animal innocence and joy. 

I can love Ziggy and have a place in my heart for Tybo, now and always. As I allow my heart to attach to an animal, yet again, I know Ziggy will fill me with much love, companionship, and long walks around our neighborhood. 

There is hope. 

Bringing you hope

If you find yourself struggling with the loss of a pet, or other life transitions, our team of counselors are here to help. It is not silly to be affected by life’s circumstances. Life happens and we can all use a little help along the way. We’d love to be that person for you. 

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Karen Lenz is the Office Whiz Extraordinaire at People Bloom Counseling. She writes blog posts as a human navigating this world, a client sitting across from a therapist, much like you. She hopes this blog helps you get through your pet loss. She finds herself laughing out lout at Ziggy’s silliness, like she just heard a great joke. This blog is written in memory of Tybo and in celebration of Ziggy.

A Life Worth Living: What to Do When Faced with Thoughts of Suicide

Photo by Larisa Birta on Unsplash

Death by suicide

Social media blew up two weeks ago when fashion icon Kate Spade and culinary expert Anthony Bourdain died by suicide days of each other. After all, who doesn’t know the brand Kate Spade, hasn’t walked past one of her stores, or perhaps own one of her purses? Foodie or not, who hasn’t heard of Anthony Bourdain and his culinary storytelling that sparks interest and delight in food and cultures all around the world?

News like this often get the immediacy of the press and then slowly fade away. However, if you are familiar with the feelings of suicide or have lost family, friends and role models to suicide, you do not just recover and move on. These thoughts, feelings and images still consume your mind even when the news has moved to national crises like the horror of separating immigrant children from their families.

Suicide unfortunately happens amongst everyday folks, and this rarely makes the news or causes a social media uproar. While Spade and Bourdain may have been inspiring role models, their deaths didn’t spur this strong reaction because they matter more than the rest of us. It is because high profile celebrity suicides affect our collective consciousness and bring awareness to a problem people face in their small communities. We want to open the discussion about suicide and what we can do to prevent it.

Soapbox about suicide language

As a healthcare professional in the state of Washington, I am required to take a suicide prevention training every six years. One of the most significant takeaways from the last training was changing the way we talk about suicide. We often talk about someone having “committed suicide.” If we really stop to think about it, the closest association of someone having “committed” something is a crime.

While we would never say that someone “committed cancer” or “committed heart disease,” let’s start by saying that it was death by suicide. I understand that suicide implies a choice whereas medical illnesses does not, but it doesn’t help for us to talk about our struggles if we’re loading on the stigma.

Thoughts about ending the pain: a common experience

Recently, I took another suicide and self-harm training. This time, it was with Jack Klott, a suicide prevention consultant. There, I learned that the thoughts of suicide is actually a common experience. Difficult or sometimes chronic life circumstances can create a felt sense of unbearable pain. This then challenges our capacity to cope, and thinking about death is an effort to get rid of this intolerable pain.

The thing is, as a society, we freak out when someone talks about thoughts of suicide. We are quick to talk them off the ledge, which in imminent situations, we need to. But in cases where it took a lot of courage to even admit to having these thoughts, it doesn’t help to be told to not think or feel this way. Rather, we need a be willing to learn about each others’ pain and to encourage the person with suicidal thoughts to get help.

Additional factors to protect against suicide

Indeed, having a support network is a protective factor in preventing suicide. Jack Klott also mentioned the importance of the following factors:

• Resilience. This is about the process of adapting and recovering from significant stress or hardships. In a separate training, I learned and shared about stress-resilience habits.
  

• Hope. Remind yourself how you got through difficult circumstances in the past, because you have. When it’s hard to hold hope, allow and trust others to hold that with you and for you.
  

• Tolerate stress and distress. In moments of despair, it’s about surviving that moment without making matters worse. Dialectical Behavior Therapy (DBT) is a pioneer in teaching you how to tolerate, rather than avoid, distress. Here’s an overview on distress tolerance.
  

• Regulate emotions. In the face of unbearable pain, emotions are strong and overwhelming. This often prevents your pre-frontal cortex from thinking rationally. Learning DBT skills can help you label and regulate your emotions, so you don’t feel so crazy inside.
  

• Social support. I mentioned it above, but I see it’s such a necessity to mention it again. Suicidal thoughts are a common experience. The only way we can feel less alone about it is if we give it a collective voice. Much like the #metoo movement, don’t suffer in silence. Reach out if you’re having a hard time. Reach in if you know someone is struggling. We are each others’ safety net.
  

• A reason for living. Did you know that a lot of amazing things needed to occur for you to be born? The odds of you being born to the parents you were born to required a lot of “coincidences” in the history that preceded them. And I’m not even talking about how babies are made. That math is 1 in 400,000,000,000. You’re uniquely you. While you might not be a Kate Spade or an Anthony Bourdain, this world is not the same without you. You are changing the world by being in it and doing you.

Life is hard; get help

If you’re struggling with thoughts about suicide, share these thoughts with a trusted friend or healthcare professional. Text CONNECT to 741741 in the United States. Call the National Suicide Prevention Hotline at (800) 273-TALK (8255). Visit Now Matters Now to learn helpful ways to deal with your suicidal thoughts.

For people living outside of the US, International Association for Suicide Prevention has a list of resources to help you.

You don’t have to go about this alone. Get help.

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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.

The Origins of Depression and What to Do with your Bad Feelings

Photo by Teddy Kelley on Unsplash

Depression stats 

Did you know that according to the Anxiety and Depression Association of America, Major Depressive Disorder affects as many as 16.1 million adults in our country? That’s 6.7% of our adult population. In fact, it is such a prevalent problem that the World Health Organization made a video about depression, giving it a personality as the Black Dog:

If it’s likely that someone at work, the mom at the soccer game, or the checker at the grocery store struggles with depression, then what do we know about its origin? Perhaps you’re wrestling with the black dog yourself and you want to learn how to live with this uninvited pet.

The thing is, depression didn’t come out of thin air; it isn’t our natural state. Depression has been linked to genetics, chemical imbalances, and environmental causes, making it hard to determine the exact cause of the condition in each person. The good news is that there are things you can do to manage it.

Depression and its origin 

Depression from genes 

Depression can be hereditary. A lot of research has gone into identifying biological factors that seem to coincide with this disorder. Anecdotal evidence also supports this: depressed people often seem to come from depressed families, in a way that can go back generations. This shows there must be some genetic component.

Depression from chemical imbalances 

Depression has also been linked to chemical imbalances. The idea of a "chemical imbalance" is a rather vague one. An imbalance between what and what? No one seems to know for sure. But many of us have heard about the role that too little of the neurotransmitter Serotonin is linked to depressive symptoms. Hence, various anti-depressants are used for alleviating depression, as most of these drugs raise serotonin levels in the brain.

Depression from environmental causes 

Depression can creep in due to difficult life circumstances. A history of abuse, family conflict, bullying, oppression, social isolation, etc. can weigh on anybody. A wise supervisor once said, “Every issue in counseling can be traced to some sense of grief and loss.” Indeed, when life doesn’t happen as expected, you’re wrestling with the gap between the life you want and the life you’re living.

We all want to feel good 

It’s a no-brainer that people like to feel good. We can all agree that feeling bad is something we want to avoid. Some people are better at the game of maximizing "good" over "bad" feelings, in a way that works for them their whole lives. They’re good at “feeling good” and “looking on the bright side,” at “letting problems wash over them like water over a duck’s back”. Maybe they hang around like-minded people. But regardless of how they do it, some people make it look easy.

It’s not easy for everyone.

Advances in the field 

Science and technology constantly make improvements upon our everyday lives, but these advances are limited when trying to help us understand how people can be good at the art of managing feelings. Sure, we can identify triggers to feelings, how it shows up in our bodies, and what urges we have to say or do in response to these feelings. However, there is much more to understanding an emotion than measuring how strong or frequent it is.

The intangibility of feelings 

What is the basic nature of feelings? You can't quantify them very well. You can't show me five pounds' worth. You can talk about how it feels to have a feeling, but you can’t objectively say what one is. It doesn't do it justice to use another word like "sensation" to describe it - that just replaces one vague word with another. Feelings are very real things, but they are also intangible.

Make depression go away! 

Modern culture dodges such a question, because feelings are such poor candidates for objective discussion, especially in scientific circles. Feelings are not "rational”. It seems easier to attribute the bad feelings of depression to something that runs in families that can be treated with the right medication. Indeed, many people who suffer from depression, at best, can only guess at where it came from. They just know that they have "it". You either have "it", or you don't. The most important thing is to make it go away.

Depression is like the black dog. A constant companion, depression is made up of a collection of feeling-loaded problems that, at a certain point, qualify you for the diagnosis. These symptoms include poor mood, lack of motivation, negative thinking, pessimism, inability to enjoy the things you once did, or low self-esteem. Like all other emotions, these bad feelings come from somewhere. For each person struggling with depression, there is a story of how the black dog got there and why he’s staying.

Get to know the black dog 

In order to treat depression on an individual level, we need to delve into the feelings - messy as they may be - and set aside our need to explain our behavior with science and research for a moment. Getting to know the black dog: that part is indeed subjective and hard to define. But those feelings that make up the black dog are a huge part of who you are, a huge part of your life story. If you want to grow as a person and make the most out of life, it would be important to bring the black dog into our therapy room.

Delve into messy feelings

Depression is problematic feelings that begin to take over your life. When you learn about these feelings and how they have fit in to your life story, it makes you more aware of who you are and how you are. As the stories about these feelings get unraveled, you will be equipped with "data" as to how to better handle them. You can end up becoming more and more like those people who are "good at" knowing and managing their feelings.

Emotional life is that way; you can't put numbers to it or objectively explain it. Yet, with practice, you can learn to acknowledge your feelings, get to know them better, understand why you feel the way you do, and what you can do about them. The black dog doesn’t take up as much space in your life; you can have him on a leash, rather than the other way around.

I want to help you with this process. When you're ready, I’ll be in my office.

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Bob Russell recently joined People Bloom Counseling, a Redmond psychotherapy practice in WA. He helps teens and their families thrive through the adolescent years. He also helps twenty somethings figure out their place in life. Having been through rough patches during his teen and young adult years, he knows what it’s like to delve into messy feelings and come out stronger on the other side.

Sadness: a Normal Part of Life

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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.

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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

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'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!

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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

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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. 

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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.

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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:

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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

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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. 

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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?”

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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.

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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.