People have strong opinions about New Year’s resolutions, as I’ve been learning over the past week. In the one camp are the Resolution Deniers, who say that resolutions are stupid, pointless, and scientifically proven to fail. In the other are the diehard Resolution Proponents, who embrace the idea of wiping the slate clean and use the start of another year as a motivation to change their undisciplined ways.
Most Resolution Proponents choose two or three popular areas for improvement: diet, exercise, organization and time management. My own vaguely considered goals for the year—all of which I’ve already failed to meet—include:
But my modest attempts at self-betterment pale alongside those of a couple I met at a New Year’s Eve party last week. Together they had made 310 resolutions for 2019. How is it even possible to find so many personal habits in need of improvement?
They started off the year—and it wasn’t even midnight yet—quarrelling about how to fulfill one of the items on their list (which they had written down lest they forget any). The host, a potter, invited her guests to choose an item from her studio to take home with them so she could start making progress on one of her own resolutions for the year: to declutter. But despite the generous offer, the super-resolution couple couldn’t decide if they should take her up on it because it conflicted with their own decluttering goal. They finally reached an agreement: they would accept a vase but wouldn’t allow themselves to bring it into their house until they first got rid of something else.
I wholeheartedly endorse efforts to change. Modifying behavior is, after all, my stock in trade. But in the therapy I do, I also stress the importance of acceptance. Accepting yourself at any given point in time—new year or not—means acknowledging the reality of what is and using that as the starting point.
So if you haven’t exercised in the last six months, say, deciding to go to the gym for an hour a day would be a recipe for failure. When reality collides with unrealistic expectations, people who don’t allow for acceptance often just give up instead of modifying their goals to make them more realistic.
So go ahead and make those resolutions. Just try to work on them imperfectly. You know you’ll mess up. But you can start again, January 1st or not. If you practice acceptance, you’ll be giving yourself a better chance at achieving those three—or 310—resolutions you made for 2019.
My dog Freddie died last month very suddenly and unexpectedly at the too-young age of 10. Chronically anxious and high-strung, he wasn’t an easy dog to live with. But he was intensely loyal, affectionate, fiercely devoted to the family, and so smart he seemed almost human at times. In spite of–or maybe because of–his issues, we loved him dearly.
One of his most annoying habits was barking at the TV. We tried to train him to watch quietly–and watch he did, eyes fixed on the screen and head moving back and forth, taking in the action–but eventually we gave up, endured his loud objections during scenes containing sex and violence, and got used to relying on closed caption to fill us in on the dialogue he drowned out.
Over the years, as I wrote in a previous post, I longed to be able to relax in front of the TV with my dogs curled up quietly at my side. But as long as Freddie was with us, it never happened.
The night after Freddie died my husband and I sat down on the couch in the family room to catch up on the show we’d been following. We didn’t get past the credits before we had to turn it off. The quiet was deafening.
It was more than a week before we could bring ourselves to watch TV again.
A line from an old Joni Mitchell song comes to mind:
“Don’t it always seem to go
That you don’t know what you’ve got
‘Till it’s gone”
RIP, dear Freddie.
“Many People Taking Antidepressants Discover They Cannot Quit”
Does this headline concern you? If you read the accompanying article in the New York Times and you’re on medication for anxiety or depression, you might feel alarmed. And if you’ve decided to start a medication regimen, you might even change your mind.
The article reflects a bias many people still harbor towards mental health issues and medication: you should be able to deal with your problems by force of will; if you can’t just get on with it, you’re weak. As the Times article suggests, “Daily pill-popping leaves them doubting their own resilience…” Pill-popping? Seriously?
No medication is completely benign. Yet few would question taking drugs commonly prescribed for high blood pressure, seizures, muscle cramps, and infections, many of which can have discontinuation side effects. Clearly, a double standard applies to the pharmacological treatment of psychiatric conditions..
The writer acknowledges that “many, perhaps most, people stop the medications without significant trouble,” but then goes on to relate the personal anecdotes of a handful of individuals who attributed “all the symptoms of withdrawal,” including increased anxiety and insomnia, to medication discontinuation. He neglects to point out one of the most common reasons for deciding to go back on medications for anxiety and depression after trying to come off them: a resurgence of the symptoms being treated.
It’s true, as the article points out, that primary care physicians write the vast majority of prescriptions for antidepressant and antianxiety medications. Follow-up is not as rigorous as it should be, and office visits are typically too short for an adequate assessment of mood changes and side effects. But it’s very misleading to assume, as the writer does, that “a useless [my emphasis] prescription may be continued for years—or a lifetime” because “improvement…is based on the passage of time or placebo effect.”
I’m not in the pocket of Big Pharma. I can’t prescribe medication. I don’t get a kickback from my psychiatrist colleagues for referring patients to them. When someone in my practice expresses a preference for trying cognitive-behavioral therapy without medication, I’m more than happy to oblige—with the understanding that we’ll revisit the decision at a later date if the therapy yields less-than-optimal results.
I believe in helping people find the maximally effective treatment for them. If that means recommending a trial of medication, I’ll suggest a referral to a psychiatrist who can address their concerns fully, monitor them regularly, and work with me to provide the best care.
Medication isn’t a magic bullet. But it can be a powerful tool. Making any health care decision should involve weighing the costs and benefits–with the help of professional guidance and not anecdotal horror stories–to determine the course of treatment.
This blog is intended solely for the purpose of entertainment and education. All remarks are meant as general information and should not be taken as personal diagnostic or therapeutic advice. If you choose to comment on a post, please do not include any information that could identify you as a patient or potential patient. Also, please refrain from making any testimonials about me or my practice, as my professional code of ethics does not permit me to publish such statements. Comments that I deem inappropriate for this forum will not be published.