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May You Live in Interesting Times

Gloriosa by Jitney58 is licensed through CC-BY-2.0

There is conflicting information about the origins of this expression, but it is generally agreed to be a curse. We are watching history be made as each day goes by, and frankly, I wish I lived during a more boring chapter of future history books. At the same time, though, it is through the difficult times that we grow.

As a psychologist, I’m used to walking with people through the difficult times. I usually can’t offer a quick or simple fix, but I can be there with tools, hope, and connection.

My goal in creating this site is to offer resources to a wide audience during these trying times. I want to reach those who share my drive to help children and provide them with the tools to do this effectively: teachers, social workers, counselors, and fellow psychologists. If there are specific resources that you would like to see, please let me know, and if I have the appropriate skills and knowledge, I will do my best to make it happen.

Thank you for joining me during these interesting times. Follow my site to stay up-to-date with resources.

The Weekly Mews with Armani

Hello, friends! Armani wants you to know he finally bested the Libre despite Cone Jail. He managed to kick it off after just 24 hours, so we didn’t get a full curve. Waiting on the vet to tell us if we have to try again or respect this very clear boundary he is setting.

He is very satisfied with himself.

The few readings we got were high, but that was probably stress from getting the Libre put on, so who knows. My plan is to ask the vet for alternatives since he is clearly not having the Libre anymore.

He does still need the cone until his fur grows back over where the Libre was. As much as he hates the cone, I tell him, “I love you too much to let you hurt yourself.”

My little sunflower 🌻

I’m on my phone because the Art Market is today, so if the donation link is tricky just check out last week’s Mews, or just enjoy the pictures and know Armani loves you. Blame any weird formatting issues on my phone.

Nap time!

Oh and today is apparently International Self-Care Day so get rest in whatever way recharges you.

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Proceeds from Armani’s mewsletter help pay for his insulin and vet costs. He also shares 50% of each donation with organizations that help pets.

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Armani thanks you for your donation!

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Ap Review: PTSD Coach

I love bringing my readers new mental health aps they can try! As you might have noticed, I have a lot of positive things to say about these aps. That’s partially because, in general, I have a lot of positive things to say about a lot of things. I want to share with you things that you might find helpful in some way. It’s also in part because I really like not getting sued and would rather not deal with backlash for featuring an ap I don’t like. But mostly, if I am going to have a resources page that links to different aps, it seems like a better use of the space to only link to things I think will help people.

Anyway, I discovered today’s ap through a friend on Twitter. It was created by the VA as a resource for veterans but can help anyone dealing with trauma.

PTSD Coach Logo

PTSD Coach is, as the name implies, a resource to help people with PTSD. It helps with symptom management, tracking, learning about trauma, and connecting with support services. The education components of this ap include resources specifically for friends and family, so it fosters support in the individual’s environment rather than putting everything on the client. I love aps that have a feature that encourage this!

Learn everything you need to know about PTSD – for yourself or someone you care about

If you use the ap to track symptoms, it will chart changes over time, which can help bring your attention to triggers, stressors, and things that help. You can even prompt the ap to remind you to take the assessment to see how you are doing.

Manage symptoms, track progress, learn, get support

Another thing I really like about this ap is that it has resources to connect you to ongoing therapy services for PTSD. It doesn’t pretend to be a substitute for therapy and encourages the user to get additional help where needed. This is a great supplement for anyone undergoing treatment for trauma.

Interview with Felicia Nubivn, LMSW: Butterfly Gardens and Telehealth

Felicia Nubivn is a social worker, researcher, and advocate for social justice. We connected over Twitter, and she shared that she had been using a butterfly garden in telehealth sessions. Since I’m always looking for more telehealth ideas, I reached out, and Felicia was kind enough to take time to talk with me about her butterfly garden.

Felicia Nubivn, LMSW

Butterfly metamorphosis parallels therapeutic change and growth. We can completely transform into something unrecognizable from where we started, and self-care and rest are essential to this change.

Felicia has shared more about her decision to create a butterfly garden on her blog. She created the garden with the intention of healing her own inner child: “Most of our destructive behaviors come from what we learned as children.” She had just started a new job as an outpatient therapist and wanted to work on her own healing as well as that of her clients.

Although a butterfly garden could be a metaphor used in any session, telehealth is an especially apt way to communicate this to clients, since they can literally see the development and lifecycle over several weeks. You are not just talking about growth and transformation; you are seeing it in real time.

In telehealth sessions, Felicia would show kids the different stages of growth in the garden, from caterpillars to cocoons to butterflies. She shared with me, “Metamorphosis is very similar and symbolic of healing.” Kids were intrigued by the butterflies’ growth process, and Felicia tied these stages into the children’s own stages of personal growth and healing.

Butterflies are a great metaphor for moving on and termination in therapy. Young clients especially are often hesitant to stop therapy even when they have made great progress because change is scary. But as we see with butterflies, even though the cocoon feels safe and comfortable, we outgrow it and are ready to move on.

Although the butterfly release can’t feasibly happen during sessions, Felicia shared that her clients love hearing that the butterflies got to move on to their next stage and are ready to be independent because she took such good care of them as they grew.

Photo by Cindy Gustafson on Pexels.com

Growth is important, but change can be scary and painful. We are all becoming something even better than we were before if we can let ourselves leave the safety of what’s familiar.

Felicia has shared blog posts about mental health and social justice, and her website is full of wonderful resources.

You can purchase a kit to create your own butterfly garden on Amazon or check with a local butterfly rescue for resources. If you want to use butterflies in your telehealth sessions but don’t have the space or capacity to create your own garden, the University of Florida offers a live feed of their Chrysalis Cam as well as time-lapsed videos of the different phases.

Interview with Dr. Regine Galanti, Psychologist and Author

Dr. Galanti is a psychologist who practices in New York. She started a private practice that currently has four mental health providers who work primarily with children and adolescents. She also does parenting consultations and work to help the adults caring for her clients be the best parents they can be. In March 2020, she released her book, Anxiety Relief for Teens. It came out not a moment too soon! She shared that it was listed as an “essential good” during lockdown.

Anxiety Relief for Teens is written specifically for adolescents struggling with anxiety and focuses on building coping skills and mindfulness based on cognitive behavioral therapy, and it includes quizzes to help readers learn to identify and recognize their own symptoms. Readers can use the activities and build skills independently or with parental support, which promotes that empowerment.

Dr. Regine Galanti

Dr. Galanti shared with me her experience of overcoming imposter syndrome and worrying that she might not be the right person to write this book. She had to overcome her own worries about being “good enough” to help people work through their anxiety, which I think makes her even more qualified to help people address their own insecurities! If anything, it is essential for mental health professionals to question our own expertise on a regular basis to make sure we are continuing to provide quality care.

In Dr. Galanti’s experience writing the book, she told me, “Exposure works!” She gets to use her own experience of overcoming insecurities and fear. She knows what she’s talking about, both as a professional and from personal experience. I really appreciate how authentic, genuine, and honest that she is about her own experiences.

Dr. Galanti wants to help her clients learn not only how to overcome unpleasant feelings but how to tolerate and sit with those feelings. She told me, “Coping skills only get you so far when you sit with an emotion.” We want to learn appropriate skills to reduce those feelings, but we also need the exposure to those feelings so that we can tolerate them. She teaches her clients to be okay with uncomfortable or undesirable emotions.

Anxiety Relief for Teens

Next month, Dr. Galanti is releasing an anxiety workbook for young kids between ages five and eight. It features an adorable hedgehog, Harley, who teaches children about anxiety and coping skills. The book includes fun activities specifically to help kids learn cognitive behavioral skills for anxiety. You can pre-order When Harley Has Anxiety now. She has future plans to write a book about anxiety in kids for parents, which I am excited to see.

When Harley Has Anxiety

The Weekly Mews with Armani

Good afternoon, friends! We decided to sleep in this morning, and so the Mews is coming out a little later today. Thank you for your patience.

You can’t be mad at this face

Armani is still in his cone, and he will be in it for a few more weeks at least. The vet would like to do one more Libre curve to make sure he is stable, and he has gotten less tolerance of the device. The first time, he ignored it. The second time, he licked at it a lot and pulled it off right after it expired. This time, he pulled it off three days before it expired. So he will be in Cone Jail while wearing the next one to make sure we can get all the information we need to help him be healthy.

Protesting Cone Jail

He does get supervised breaks from the cone, which has incentivized even more cuddles with his humans. He has also gotten lots of time on the balcony, watching a family of geese that lives in the swamp on the property.

Adorable baby

Armani wants to thank everyone who has helped him pay for his insulin and Libres. Like I have mentioned before, he plans to keep giving you weekly updates about how awesome he is, but we will take the donation box down when he is officially in remission. (I’m going to keep manifesting that by repeating it over and over and over.)

If you set up a recurring payment, WordPress should have a link in the payment confirmation emails to stop. If this gives anyone any trouble at all, reach out to me directly and I will try and figure it out on my end.

Blem

Have a great week, remember to relax, stay hydrated, and do what makes you happy!

Get Weekly Mews with Armani in your inbox by subscribing to my blog!

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Proceeds from Armani’s mewsletter help pay for his insulin and vet costs. He also shares 50% of each donation with organizations that help pets.

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Armani thanks you for your donation!

Armani thanks you for your donation!

Armani thanks you for your donation!

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Antidepressants and Children

Antidepressant can be a scary word. This is especially true for children, teens, and their parents. Although I personally cannot prescribe medication in my practice, I often make referrals for medication consults, and I talk many families through their concerns about medication. Today, I want to address some of the concerns I have heard related to Selective Serotonin Reuptake Inhibitors (SSRIs), commonly known as antidepressant medications.

I shared a version of this piece through my group practice a few years ago, but the conversation is still relevant. It is written for parents seeking information about medication for their children, but this information is relevant for anyone considering antidepressant medication.

Talk to your primary physician for more information on antidepressant medication.

Photo by Anna Shvets on Pexels.com

What if the medication changes my/my child’s personality? The goal of any psychotropic medication is not to change who you are, but to treat the mental illness that prevents you from being yourself. I have spoken before about Van Gough, who created some of his most famous paintings while in treatment for his mental illness. This suggests to me that he was his most true self when his underlying illnesses were being treated. Think about it like this: would you tell a diabetic that the insulin changes who they are? Of course not! SSRIs just treat a different organ.

What about side effects? Of course, any medication comes with a risk of side effects. In the case of SSRIs, these risks are relatively mild. The good news is, there are several antidepressant medications that are FDA approved, so if one medication causes sleep problems, there is a high chance that your physician can prescribe a different medication that helps you without this side effect.

It can take a few trials to figure out which SSRI is the best fit, but most people are able to find something that benefits them. New research in genetic testing will make this even easier in the future. Please keep open communication with your prescriber about any side effects you experience.

I don’t want a Band-Aid solution, I want to address the underlying problems. Fantastic! Although there is no one universal treatment plan for any mental illness, I rarely recommend that someone go on antidepressant medication without ongoing therapy intervention. Research of treatment outcomes suggests that a combination of medication and therapy is most beneficial. Not only does this help you work through symptoms on two levels (emotional and physiological), but your therapist can continue to monitor your response to the medication, give you objective information about what to expect, and monitor for side effects. Medication isn’t a Band-Aid for mental illness, especially when combined with therapy.

How long will it take before I start to feel different? SSRIs can take up to four to six weeks before you fully feel their effect. This is because of complicated brain chemistry, which someone with a medical degree can speak to much more effectively than I can. I always advise that people be patient and allow themselves to experience the full effect of the medication (barring side effects that they deem unbearable, of course). Ask your prescriber any and all questions you have about your medication and its effectiveness.

How long will my child have to take medication? It varies. For some people, taking an SSRI for a year or two helps their brain learn how to properly balance the neurotransmitters that affect mood. After a period, they can taper off the medication and not experience symptom relapse. For others, they benefit from the medication for decades at a time. Some people take SSRIs for a while, taper off, and then feel that they need them again in the future. All of these situations are okay. It boils down to what the individual finds helpful, and what they and their doctor decide is best based on their needs.

What happens when I stop taking an SSRI? SSRIs are not psychologically addictive. However, because the medication builds up in your system, it is important to taper rather than going “cold turkey” from an SSRI. Although withdrawal from SSRIs is not dangerous, it can be unpleasant and can include head zaps, insomnia, or flu-like symptoms lasting one to two weeks. Always consult your prescribing physician about changing doses or stopping medication.

I read that SSRIs can cause suicidal thoughts in teenagers. This is a very, very valid concern, and I commend parents for putting their teen’s safety first. SSRI medication comes with a warning that they “may cause suicidal thoughts or actions,” particularly in teenagers. How can medication for mental illness cause suicidality? Suicide is linked to antidepressants because fatigue is a symptom of depression. If someone feels that their life is not worth living but lack the energy to act on their thoughts, an SSRI might increase their energy level before the self-harm thoughts are treated. So, someone who has passive suicidal thoughts might start taking an SSRI and suddenly have the motivation to act on them.

SSRIs will not magically cause you to want to die, so people with no history of passive suicidal ideation are low risk for these behaviors. However, if your teenager has a history of suicide behavior or talks about wanting to die, they will need to be closely monitored during the early stages of treatment. This is typically managed by creating a safety plan, fostering open communication, and committing to ongoing therapy. This does not mean that they can’t benefit from SSRI medication, but the family and treatment team will need to be cautious.

Some people might experience intrusive thoughts as a medication side-effect; sometimes, this can mean they experience intrusive suicidal thoughts. Usually, these thoughts are distressing and not something that the person wants to act on. If your child reports this side effect, talk to their physician right away. They might need an adjustment to their prescription.

SSRI medication, when appropriate, can be a beneficial part of a treatment plan for mental illness. Education is an important piece in helping families and teenagers decide if this is an avenue that they want to pursue.

Ap Review: Breathing

Breath is a huge part of mindfulness. Most guided meditations start by prompting you to check in with your breath, either by taking deliberately big and slow breaths or simply noticing what your breath is doing. I’ve shared some breathing exercises that I use with clients in the past.

Strategic Breathing

Breathing is a free ap by Max Strom that educates about the importance of mindful breaths and teaches how to use your breath to self-regulate and relax. Soothing visuals, animations, and simple instructions make this ap easy to use, and the exercises can be done anywhere.

(I feel obligated to point out that Max Strom is not a mental health professional. He is a philosopher, yoga instructor, author, and several other things according to his website. This does not mean that these exercises aren’t therapeutic, especially since no ap should be used as a substitute for therapy.)

Breathing technique: Ocean Breathing

The free version of Breathing gives education about how our breath affects our emotions, a five-minute standing evolution, and seated evolutions. There is a paid upgrade with more standing evolutions and some “deep relaxation” meditations.

Breathing seems like a great resource for people who are learning about mindful breathing and want to learn from guided meditations.

Breathing with the Waves

Good morning, and welcome to another week! As you might know from Armani’s mewsletter last weekend, we were fortunate to go on a beach getaway over the 4th of July weekend.

Usually, I prefer to stay on the beach and enjoy the sounds and smells of the water rather than actually going in because the ocean is beautiful but terrifying. I also hate the sensation of water in my nose.

Ocean and sky

When you’re in the water and you see the wave coming at you, there is an impulse to take a deep breath. In anticipation of getting pulled under, you want to fill your lungs as much as possible, but this often leads to a mouthful of salt water. It’s better to exhale as the wave hits you, dive under, and come back up.

I saw a social media post a while back that said creating is like breathing: sometimes we are inhaling (producing our own creations), and other times we are exhaling (resting). No one can create constantly – we all need rest.

In times of high stress, it can be tempting to take that big breath, push ourselves to do something, make something, be “productive.” But that can backfire and do more harm than good. It’s not only okay to exhale, but essential.

Low tide at night

You deserve to rest. Let yourself exhale.

The Weekly Mews with Armani

Good morning, friends! Humans are back and giving lots of snuggles! Armani still has to wear his cone because he insists that the Libre needs to come off NOW and the vet disagrees.

Those eyes ❤ ❤ ❤

We try to give him some time without the cone so he can groom himself, but he immediately goes for the Libre or the spot where the last Libre was. So far we’ve managed to keep him from making a new sore, but he is very upset with us for trying. I get it – I also want to do whatever I want all the time with no consequences.

Angry kitty

His sugars still seem to be getting better, and we were able to reduce his insulin. We are cautiously optimistic that he might be going into remission and might not need the insulin much longer. If nothing else, I really hope this can be the last Libre he needs for a while since he hates them so much.

Hey baby 😉

It’s a rainy day in Sioux Falls, which means we get to snuggle on the couch. Take time to rest, friends.

Pure joy

Get Weekly Mews with Armani in your inbox by subscribing to my blog!

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Make a monthly donation

Make a yearly donation

Proceeds from Armani’s mewsletter help pay for his insulin and vet costs. He also shares 50% of each donation with organizations that help pets.

Choose an amount

$5.00
$15.00
$100.00
$5.00
$15.00
$100.00
$5.00
$15.00
$100.00

Or enter a custom amount

$

Armani thanks you for your donation!

Armani thanks you for your donation!

Armani thanks you for your donation!

DonateDonateDonate

Ap Review: Oh Snap

Lately, I have been sharing various mental health aps that teach coping skills, mindfulness, and education about mental health. Most of these aps help you track symptoms and notice patterns in your own life. Today, I am sharing an ap that does exactly one thing.

Oh Snap reminds you to Do The Thing. Pull up the ap, name The Thing you need reminders for, set how often you’d like to be reminded, and Oh Snap does the rest.

Oh Snap Logo

Do you find yourself hyper-focused to the point that you forget to attend to your basic needs? You can ask Oh Snap to remind you to eat, use the bathroom, drink water, or anything else you can imagine. Reminders are randomized, so this isn’t something you would use to remember to take medication, but it could remind you to check in with your feelings periodically. You decide when you want Oh Snap to start sending you notifications and when you want it to stop, so it’s not reminding you to do things when you are asleep.

Since I have been spending so much time doing telehealth sessions, I started using Oh Snap to remind me to get out of my chair and stretch when I am seeing clients back to back. (Of course, my phone is silenced when I’m in sessions, but when a session ends, I can see the notification.)

Create New Reminder

There is a paid version of Oh Snap that lets you have reminders for unlimited things, but honestly, the thought of getting that many notifications overwhelms me. Premium also unlocks Dark Mode, if you prefer that setting.

Oh Snap is a simple and handy way to remember things you have to do periodically.