The Four Agreements

Don Miguel Ángel Ruiz, a Mexican author, wrote the book “The Four Agreements” which has sold 5.2 million copies in the U.S. In this widely translated and famous book, he gives the four principles believed to be the key to creating love and happiness.

The Four agreements

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Antidepressants won’t cure your depression, but they can help you manage its symptoms. Still, finding the right medication can take some trial and error. Not all medications work for all people.

It’s important to know the signs that a medication you’re taking may not be right for you.

You feel better right away: It might sound strange, but this could be a sign your medication isn’t working the way it should. Feeling like you’re instantly better may be a placebo effect — you think it’s helping. Real help won’t happen that fast. It takes weeks for your medicine to start working.

No relief after 12 weeks: While you won’t notice changes from these medications overnight, you should start to feel some difference in 4 to 6 weeks, with the best results sometimes coming in 8 to 12 weeks. If you don’t feel better by 3 months or your symptoms get worse, let your doctor know.

Big mood swings: Any serious changes in your emotions, positive or negative, can be a sign that you need to change your medication.

Your depression gets worse: This can happen, especially if you’re taking other medications as well. Some can cause your antidepressants to act differently, and that can make your symptoms worse. Make sure your doctor knows about all medications you are taking.

The side effects are too much for you: As with any medication, antidepressants can come with side effects. The most common ones are nausea and diarrhea. They usually get better in a week or so.

Talk to Your Doctor

Sometimes simple changes can make a big difference. Your doctor may suggest you take half a pill instead of a whole one and gradually increase the dose. Another option may be to change the time you take your medication, like at night instead of during the day. But make sure to talk with your doctor before making any changes to how you take your medication.

What You Can Do

Lifestyle choices can affect how well an antidepressant works for you. It’s important to get enough rest and avoid recreational drugs and alcohol. With some medications, you need to stay away from citrus juices like orange or grapefruit juice.

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The last in the series of High Functioning Depression.

8.  Lack of Energy – If it feels like getting through each day is like walking up a mountain with a backpack of rocks, if you feel like you barely have the mental, emotional and physical energy to handle your life anymore, if your overall energy levels are greatly diminished, this could be a sign of high-functioning depression.

9.  Constant Self-Doubt – You may constantly doubt whether or not you’re on the right career path, whether you’re in the right relationship, doubt what you’re doing with your life and if you can even handle being an adult. This pattern of constant self-doubt may be situational or pervasive, but it’s something that feels like you just can’t get over.

10.  Hyper Critical of Self and Others – You may have a relentless and invasive internal narrative that’s critical of yourself, of others, and of the world in general. You think you’re a failure, you think your boss is an idiot, your partner is the most irritating person to have ever lived, and life’s just one big slog. This chronically negative thought pattern may feel like something you just can’t turn off.

11.  Difficulty Experiencing Pleasure -With high-functioning depression, the things that used to bring you pleasure — whether this is a cherished yoga class or a monthly ritual of getting together with your girlfriends — don’t bring you joy anymore. They may feel like burdens or events you want to avoid because it feels like more of an effort than a support.

While high-functioning depression doesn’t look like the stereotype of depression most of us hold in our heads, this diagnosis nevertheless carries significant risks if left untreated.

But the uniquely tricky thing about high-functioning depression is that it’s hard to spot precisely because the people dealing with it look, from the outside, like they’re holding it all together.

This can lead to a lack of ability to self-identify (or have those around you identify you) as depressed, and moreover, a possible resistance to seeking treatment because of the stigma surrounding more “typical” depression. And this is a big problem.

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Today I will be discussing three more symptoms of High Functioning Depression.

5.  Worrying and Feeling Guilty:  You worry that you chose the wrong career in college, you question whether you’re in the right grad school program, you worry about paying off all those student loans, you worry your biological clock is running out, you worry that you married the wrong partner, you worry about who’s going to care for your folks when they get older, etc. We all have these worries from time to time, but if feelings of guilt and worry over your past and future feel pervasive and dominant, this may be more than “normal” worry.

6.  Little Annoyances Feel Huge:  Similarly, if you find yourself feeling overwhelmed or greatly stressed by an event that happens that maybe wouldn’t have felt like such a huge deal in the past (a friend cancels weekend plans, the grocery bags break when you’re carrying them in, your darn trackpad stops working because you spilled some coffee on it) and it feels like the end of the world instead of the annoyance that it is, if you find your stress responses disproportionate to the event itself, this may well be a sign of high-functioning depression.

7.  Excessive Anger and Irritability: If you find yourself blowing up over small things — your partner says something wrong, your co-worker messed up a project, your kid just broke your favorite coffee mug – if you find yourself exploding in a way that feels disproportionate to the event, if irritability and excessive anger are something you’re wrestling with, this may be a sign.

Do any of these three symptoms sound familiar to you?  Stay tuned for next week, when I will discuss the remaining 4 symptoms.  Have a great week!

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High Functioning Depression Part II

Last week I discussed the definition of High Functioning Depression.  It included 11 symptoms that indicate you might suffer from HFD.  Today I am going to analyze the first three symptoms.

  1. Inability to Slow Down or Rest:  If you need to clean up, tidy, and organize the house after you arrive home from an exhausting day of work before you even consider letting yourself rest, if you find yourself uncomfortable with slowness, stillness, and fallow periods of time because of the uncomfortable thoughts and feelings you come into contact with when you do actually slow down, this could be a sign of high-functioning depression.
  2. Wanting Everything to Be Perfect: This one’s a tough one. In a way our society condones perfectionism — getting good grades, getting into the Ivies, landing that amazing tech job, striving, striving, striving. But perfectionism has a shadow side where striving turns into unrealistic demands of yourself and psychologically beating yourself up when you fall short of the bar you set for yourself. If you find yourself doing this and it’s causing you distress, be curious about whether this a sign of high-functioning depression.
  3. Constant Sadness: If you find yourself feeling a generalized sense of sadness you can’t seem to pinpoint the cause of, if you drop your mask and armors of smiling competency when you close your door behind you, if you feel a subtle sense of hopelessness, this could speak to high-functioning depression.
  4. Turning Towards Coping Mechanisms such as Drugs or Alcohol: If you find yourself needing extensive zone-out time after work and on the weekends, turning toward your coping mechanisms more often than not — such as substances or behaviors like using alcohol, drugs, excessive gaming, constant Netflix, etc. — all in an effort to escape your life, this could speak to underlying depression.

Do any of these symptoms sound familiar to you?  If so, it might be time to take a closer look and seek professional help.  I can testify to the fact that I didn’t realize I was suffering from HFD until I saw a therapist.  I knew something was wrong, but I just couldn’t put it into words.

Stay tuned for next week, as we discuss other symptoms of HFD.

Keep moving forward!

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High functioning depression doesn’t look like you think it does.  Do you picture someone with their head down, not engaging, crying a lot or eating baqs of potatoe chips?  That’s because it’s not.

I suffer from high functioning depression.  For years I got up every morning and went to a demanding job, was a single mother, was in a romantic relationship and regularly got together with friends. I generally handled all of the things that most adults do.  But inside I had symptoms that diminished my quality of life, my career and my relationships.

Here are some symptoms of high functioning depression:

  1.  Inability to slow down or rest
  2. Wanting everything to be perfect
  3. Constant sadness
  4. Turning towards coping mechanisms such as drugs or alcohol
  5. Worrying and feelings of guilt
  6. Little annoyances feel huge
  7. Excessive anger and irritability
  8. Lack of energy
  9. Constant self doubt
  10. Hyper critical of self and others
  11. Difficulty experiencing pleasure.

If several or all of these symptoms are familiar to you, you might be experiencing high functioning depression.  In the coming weeks we will take each one and analyze it more closely.  Stay tuned.

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In Stores Now!

I am officially a published author!  Wow!  The feeling of saying that phrase.  It has taken me five years of hard work to finally get my book published.

I am a bit afraid, though, of judgments I will receive from people after they read the book.  I really bore my heart and soul and tried to be very honest about my mistakes.  No, I am not perfect, and I’m sure I will never be.  But I am in a better place.  Writing the book was healing, but very difficult.

While I wrote the book there were many sleepless nights.  My mind could not turn off the memories of my past while I tried to sleep.  For example, I wrote a long letter to my great aunt yesterday along with a copy of my book.  So my book was on my mind, as well as worries about what she would think of me after reading it.  Even though she is 92 and has probably seen it all, I do not want to disappoint her.  I was restless all night about it.  Then I reminded myself that I am still broken.  I still suffer from depression, anxiety and ptsd.  Worrying is one of the symptoms associated with these disorders.  I will always have them.

On the bright side I have made progress!  I am no longer using alcohol to medicate myself and stomp out these feelings.  That in itself is truly amazing.

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For most people, Christmas represents a time of giving, sharing what you have, spending time with family and people you love, and taking a few days off (not to mention the birth of Christ.)  However, I am reminded every Christmas that for some, it is not a joyful time.  During the holidays there is also more pressure, conflict and financial stress.  People who are being abused do not look forward to this time of year.

Domestic violence typically rises during the holiday season.  This year especially, more people are out of work, times are lean and alcohol/drug use increases.

You ask “Well what can I do?”  You can be more attentive.  You can reach out to someone.  Someone you don’t even know.  Have you seen blue lights going through your neighborhood?  Have you heard loud noises or yelling coming from some one’s house?  Have you seen someone who is bruised, hurt or withdrawn?

These could well be signs of domestic abuse.  The county where I live has had an increase of domestic violence by 12% from last year.  For this quarter, it is up 67% compared to the same period last year.  Do you know the statistics in your county?  I urge you to check it out.

Please make a conscious decision to be more observant of the people around you.  I can assure you that there is someone that lives very close to you, works with you or goes to church with you who needs help.  Reach out!

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Each year more abuse victims, perpetrators and family members seek help from clergy and religious leaders than from all other helping professional combined.  (The Battered Wife: How Christians Confront Family Violence)

Women of faith may feel compelled to stay in abusive relationships by scripture mandating them to “submit to their husbands” or “turn the other cheek.”

Abused women often feel abandoned by God.

Rather than offering resources and alternatives to battered women, some pastors, priests and rabbis may have advised women to return to violent homes and “be better wives.”

Victims often have many spiritual issues that affect their understanding of abuse and their ability or willingness to get help.  When religious leaders deny the problem or blame the victim, religion can be part of the problem.  When they are informed, religious leaders become part of the solution and trusted allies in building peaceful homes.

It is important that the abuser be held responsible for his violence, even if he is a member of the church or a church leader.

The victim is not at fault and has done nothing wrong.

The children of victims do not cause the violence.

Clergy can help ensure the safety of the victim, encourage the batterer to get help and take the lead in preventing family violence in their congregation.

Violence can destroy a person’s faith in God and any sense of feeling like a loved part of God’s creation.  When the whole person is attacked and threatened by violence, there is a great need for the whole person to heal.

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Signs of Elder Abuse

The following are some signs you can look for if you suspect an older adult is being abused.

  • Depression and/or withdrawn behavior
  • Fatigue and/or weight loss
  • Unexplained bruising or illness
  • Timid or hostile behavior
  • Longing for death

If you suspect elder abuse and need assistance, please consult your local directory for Adult Protective Services, the District Attorney’s office, or Senior Citizen advocacy groups.

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