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Do people take advantage of you in relationships?  Maybe you have a hard time saying “no” or people may simply refuse to accept “no” as an answer from you.  These issues might exist across multiple relationships (friends, co-workers, family, significant others, etc.), or maybe just one person in your life really knows how to push your buttons to get you to do what they want.  If this sounds like you, chances are you have difficulty setting boundaries for yourself.  Many mental health professionals are quick to point out where boundary issues exist, but the gap between recognizing these issues and actually fixing them can be a long and arduous road requiring a good deal of self-reflection and hard work.      

If you have trouble setting boundaries, here are 8 steps you can take to start working toward a happy healthier you:

1. Determine your needs.  You cannot set a boundary if you haven’t defined what you need.  What drains you?  What energizes you? What are you ok with and what is too much?  Where is the line and what crosses it? 
2. Increase your self-awareness.  If aspects of a relationship are leading to feelings of resentment, guilt, discomfort, or burnout- your boundaries are likely off.  These feelings can manifest as anxiety, panic, depression, or anger.
3. Communicate clearly and calmly.  The use of I-statements can be a very helpful strategy for disarming tense conversations.  If you feel the need to over-explain or apologize excessively, your boundaries are off.  You do not need permission to have boundaries for yourself!
4. Be consistent with the boundaries you set, keeping in mind that people will push your limits at first to see how far you will let them go.  Standing firm repeatedly will break negative cycles that have been established in the past.    
5. Start small by setting achievable, lower-stakes boundaries.  The more successes you have, the more confidence you will gain for the bigger things.
6. Give yourself grace.  Setting boundaries will undoubtedly lead to some uncomfortable or awkward situations, but this is a sign of growth.  Remember, setting boundaries ultimately isn’t about THEM, it’s about YOU!
7. Prioritize self-care.  Setting boundaries is a way of protecting your own time, energy, peace, and resources.  Saying “no” to others is saying “yes” to yourself.
8. Seek a support system.  Therapists, friends and family with whom you have a healthy relationship can be instrumental in helping you regain control over your own life.  You need supportive people in your life who can help lift you up after negative people try to tear you down for setting boundaries that are best for you.      

Have you made your New Year’s resolutions for 2025 yet?  With just a few more days remaining in 2024, you still have some time to decide what changes you would like to make in the coming year.  If you are one of the 38% of adults in the United States who makes New Year’s resolutions, chances are your resolutions are related to health/exercise/diet, money/finances, and/or relationships.  According to the Pew Research Center, nearly 80% of 2024 New Year’s resolutions were related to health/exercise/diet. 

But are New Year’s resolutions worth it?  Well, this can depend in large part on where you fall within a schema known as the Transtheoretical Model of Change.  This model consists of five stages.  Individuals in precontemplation are not thinking about making change and may be unaware there is a problem to address.  These people are not making New Year’s resolutions.  In the contemplation phase, individuals are aware there is a problem to be addressed and are considering change, but are not yet ready.  They may make New Year’s resolutions that never get off the ground.  In the preparation phase, people are intending action and making little changes.  Some of these people will start the New Year making changes and will either not last long or they may progress to the maintenance phase, where people are actively working to maintain their changes to prevent relapse of old habits.

Only 36% of people who make New Year’s resolutions keep them beyond January, with fewer than 10% actually seeing their resolutions through.  No matter how far you get with your New Year’s resolutions, failing to meet your goals can be disappointing.  So, what can you do?  If you are not ready to make a goal for the New Year- don’t!  There is nothing about flipping the calendar to new year that requires you to make a change you aren’t ready for.  If you are ready, make realistic goals.  Maybe you want to lose 20 pounds in 2025, but set shorter-term goals within that.  Maybe try to lose 2-3 pounds in January.  If you want to save more money or spend more time exercising, make sure you aren’t making changes that are so drastic that they aren’t sustainable.  There is no quicker way to fail than to make an unrealistic goal.  Lastly, if you fall off the wagon, it’s not a total loss.  Don’t give up!  Nobody is perfect.  Get back on that wagon and keep going.  It’s ok to revise your goals.  We have plenty of 2025 ahead of us to get back on track. 

So, should YOU make a New Year’s resolution?  Maybe- if you are truly ready to make that change.  But there is no rule that says you can’t make a Valentine’s resolution, a summer resolution, or even a Labor Day resolution when YOU are ready.  And if you need a little motivation or someone to cheer you on, mental health professionals can be great assets to help you navigate the complexities of making those changes.             

When it comes to mental healthcare, there are a number of professionals you can turn to, but all of the alphabet soup after our names can be daunting.  Understanding the differences between various types of mental health professionals can help you select the best fit for your needs.  One of the first things to consider is whether you are looking for therapy alone, medication management, or a combination of both.      

A therapist can have any number of different credentials such as licensed clinical social worker (LCSW), licensed professional counselor (LPC), licensed mental health counselor (LMHC), licensed marriage and family therapist (LMFT), or psychologists (PhD or PsyD).  Each discipline brings a unique approach to therapy based on the course of study.  A LCSW, for example, tends to take a holistic approach focusing on the various external factors that drive behavior, whereas a psychologist is more likely to take a scientific approach focusing on internal mental processes. It is important to note that therapists do not prescribe medication. 

Therapy alone is a very powerful tool for many people, and there are several different modalities.  Some of these include talk therapy, where the client has the opportunity to talk through and process thoughts with an objective listener, cognitive behavioral therapy (CBT), which helps clients identify and change negative thinking patterns, and more specialized modalities such as Eye Movement Desensitization and Reprocessing (EMDR), which is a catered approach for processing unresolved trauma and post-traumatic stress disorder (PTSD).  The different types of therapy will be the topic for a future post.

Your primary care provider (PCP) or therapist may suggest that you see a psychiatric professional if medication management is warranted.  For example, some individuals may be able to manage the symptoms of anxiety through CBT alone, whereas others may need medication to improve neurotransmission in the brain.  Professionals licensed to prescribe psychiatric medications include psychiatrists (MD or DO), psychiatric mental health nurse practitioners (PMHNP), or physician’s assistants (PA) specializing in psychiatry.  These professionals can engage in therapy to varying degrees based on training, but most do so sparingly.  Do not be alarmed if a psychiatric professional recommends that you also work with a therapist on various skills or strategies to improve daily functioning just as a therapist may recommend that you see a psychiatric professional to consider medication management.

I had the opportunity to see a very heartwarming stage production of A Charlie Brown Christmas at the Orlando Family Stage last weekend. I am reminded of my favorite sketch where Lucy, for 5 cents, sits at her psychiatric booth and runs through a laundry list of phobias to help Charlie Brown figure out which one is to blame for his lack of holiday spirit. Her list includes climacophobia- a fear of staircases, hypengyophobia- a fear of responsibility, and Charlie Brown’s ultimate diagnosis, pantophobia- a fear of everything.

While this cute little sketch pokes light fun of “phobias” that as many as 9% of us have, such as gephyrophobia- the fear of crossing bridges (have you ever driven across the Sunshine Skyway bridge in St. Petersburg, Florida?!), emetophobia- the fear of vomiting, or hemophobia- fear of the sight of blood, true phobias can absolutely paralyze an individual to the point where they impact daily functioning, and this requires treatment.

Perhaps the most common life-altering phobia is agoraphobia- an intense fear of being in places or situations that may cause feelings of panic, entrapment, hopelessness, or embarrassment. In the most severe cases, people who suffer from agoraphobia are incapable of leaving their homes and doing so results in severe anxiety and panic attacks. As many as 1.3% of individuals suffer from agoraphobia.

The good news is that agoraphobia and other phobias are treatable conditions, but it takes some dedication and willingness to confront your fears. Through therapy, and sometimes medication management, many people are able to get back to doing the things they love after years of reclusive behaviors. If you think you may have agoraphobia, please seek help. There is a lot of life to be lived beyond your front door.

The holiday season is supposed to bring joy, happiness, togetherness, and celebration, but despite the ads of happy smiling people that bombard us on billboards, TV, and social media, why do so many of us still feel so gross?!  Polls suggest that as many as half of Americans actually dread the holiday season due to feelings of grief.  While the most obvious reason for grief is the death of a loved one, grief can also result from broken relationships, lost jobs, financial instability, and a host of other causes.  Even for people who seem to manage their grief well on a day-to-day basis, the holidays can be a huge emotional setback. Traditions have deep emotional roots in the human brain and the holidays are full of them, so sharing a family meal after the loss of a loved one, not being able to afford gifts as in the past, or spending time in a different location than where traditions were formed is enough to lead to some pretty significant depressive symptoms. 

So, how do you combat holiday grief?  First, give yourself some room to feel your feelings.  Second, take control of those feelings!  Try to reframe.  If you baked cookies with your mom every year and she has passed away, bake those cookies in her memory.  If you are away from family, try to set up a video call so that you can still see everyone.  Maybe eat a meal together virtually.  Another option is to deliberately begin a new tradition.  Maybe you have had to make the difficult decision to emotionally distance yourself from family for one reason or another and you can establish new “family” traditions with friends.  All traditions start somewhere! 

If you feel like holiday grief is more than you can handle, please seek help!  As mental health professionals, we can work with you on strategies to help you manage your unique situation and get through this holiday season- maybe even finding a little bit of joy in the process.  Remember, if nearly 50% of Americans are experiencing this, chances are your mental health provider has been through it (or is going through it), too! 

Religious trauma syndrome (RTS) was officially named in 2011 by psychologist Marlene Winell, although this condition has likely existed for hundreds (if not thousands of years).  Individuals with RTS come from high-control religions/denominations that rely heavily on fear as a foundational principle- that not doing the right thing will result in an eternity of torment after death.  Many people with RTS have also experienced spiritual abuse, which is the use of spiritual or religious beliefs to control, manipulate, or instill fear to force conformity.

RTS can occur in any individual who chooses to leave a high control religious group, many of whom lose family and friends in the process.  While RTS is not an official diagnosis YET, the associated symptoms of post-traumatic stress disorder (PTSD), anxiety, depression, substance abuse, and a whole host of other mental health conditions are.  LGBTQIA+ individuals who have spent a lifetime attempting to conform to religious norms and women leaving patriarchal religions are at a disproportionately higher risk for developing RTS.

The good news is that acknowledgement of RTS and its long-term effects are gaining more and more traction in mental health circles and a number of mental health practitioners are now specializing in treating this unique condition.  If you or someone you know is suffering from the effects of RTS or spiritual abuse, don’t be afraid to seek help.  Your experience and feelings are valid and help is available.

You will hear the term “bipolar” used to describe weather that changes drastically from day-to-day, a toddler’s erratic behavior, or you may even have used the term to describe your own emotional ups and downs, but what does bipolar disorder actually look like for the nearly 6 million Americans who are diagnosed annually?  To be diagnosed with bipolar disorder, you must experience depression and at least one episode of mania.  For most people with the disorder, fluctuations between depression and mania do not occur from minute to minute, day-to-day, or even week-to-week.

We are all pretty familiar with what depression looks/feels like, but what is mania?  A manic episode feels like a “high” following or amid a period of depression.  For some individuals, it can actually feel good.  You might suddenly be full of energy to the point where you can function on little to no sleep for days on end.  You may have endless thoughts or ideas that you cannot calm.  Some people feel invincible and engage in risky behaviors (including compulsive shopping, gambling, substance use, and/or unsafe sexual encounters).  The risk for self-harm, whether purposeful or accidental, is very real during these times.  Don’t think that just because you don’t engage in risky behaviors you can’t be experiencing mania, though.  For some people, mania can manifest as irritability, excessively cleaning the house for hours on end, or being unable to put work aside.    

If you think you may have bipolar disorder, please be honest with your mental health provider about your symptoms.  There is no judgement here!  In fact, celebrities such as Mariah Carey, Mel Gibson, Catherine Zeta Jones, and Demi Lovato, and many others have come forward with their diagnosis to help raise awareness.  Treating bipolar disorder as depression (with anti-depressants alone) can actually induce a manic episode, so withholding symptoms of mania from your healthcare provider can have dangerous results.  There are a number of medications available that can simultaneously treat depressive and manic symptoms, helping you safely reach stability so that you feel like YOU again.

With the end of daylight savings time quickly approaching (Sunday 11/3 in case you forgot), this is a good time not only to check those batteries in smoke and carbon monoxide detectors, but it is also a good time to check in on our mental health!  Waking up in the dark combined with the sun setting before the workday ends can really take a toll.

While 20% of adults are likely to experience the winter blues, as many as 5% will experience more serious Seasonal Affective Disorder (SAD), which is accompanied by more severe depressive symptoms affecting everything from mood and sleep to energy and appetite.  Untreated, SAD can have significant impacts on physical health, relationships, and daily functioning. 

If you think you may suffer from SAD or if the winter blues get you down, talk to your mental healthcare provider.  Sometimes a little supplemental Vitamin D is all that is needed (most of us living north of Atlanta are deficient).  Other treatment options may include light therapy, psychotherapy, and/or anti-depressant medications.  The most important thing to remember is that this condition is highly treatable and you can get ahead of it.

So, as this weekend approaches, make sure your smoke and carbon monoxide detectors are working, but also take the time to check your mental health battery as we head into the darkest months of the year!