Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist

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COVID-Fatigue or Depression: How Can You Tell?

By Lynne Gots, posted on February 9th, 2021.

In the last week, everyone I’ve seen virtually for therapy has voiced increasingly familiar complaints. They are bored; they cannot get motivated to work or study; they have no appetite or have put on pounds from mindless snacking; they cannot practice healthy sleep habits even though they know too much screen time before bed and staying up past midnight will make it harder to function at peak efficiency the next day.

A lack of interest and motivation, along with appetite and sleep changes, can signal depression. And, certainly, we all are experiencing what feels like a collective state of depression after nearly a year of living with the drastic changes raised by a global pandemic, a situation that appears endless to many of us.

So, if your mood is low and you are having trouble concentrating, take heart. You are not alone.

As we know from a large body of research on mindful self-compassion, acknowledging the struggle, rather than beating yourself up for going through a hard time, can help, especially when you can connect with a common humanity (“Life is different for all of us right now.”) Treat yourself with the same kindness you would offer a close friend or family member to ease the unpleasant feelings. 

Other coping strategies include seeking out social interactions, even if they might be less satisfying through a virtual platform, and breaking out of the daily routine by creating some novelty. Try learning a language, experimenting with new recipes, or practicing a different exercise routine. If you have trouble pushing yourself to do anything right now, keep in mind a lesson psychologists have learned from behavioral activation for depression: just doing something – anything, in fact –can pull you out of the doldrums, even if nothing sparks your immediate interest. 

That said, although your current feelings of ennui may be nearly universal, they still could signal the onset of depression. If you have had a history of depression, you may be more vulnerable than someone with no previous episodes. Be on the alert for warning signs: constant rumination, feelings of hopelessness, extreme changes in sleep and appetite, and persistent thoughts of self-harm or suicide. Please seek help if those symptoms persist or worsen. 

If you are just weary from the daily dreariness and not clinically depressed, you might try observing your emotions through the lens of mindfulness. A common approach in meditation is to view your thoughts and feelings as transient, like clouds in the sky or a stormy weather pattern: they change from moment to moment.

I had the opportunity to practice observing my response to an actual meteorological event recently when I woke to a heavy snowfall. My first reaction was irritation at the inconvenience of it. “I won’t be able to walk the dogs without worrying about being pulled over on the ice.” “We’ll have to dig out the cars.” “It’s so annoying.”

But instead of continuing to wish it were different and getting upset about a situation I had no power to change, I decided instead to work on accepting the state of affairs. While I drank my coffee, I gazed out the window at the wooded path behind my house and noticed how peaceful it looked. I bundled up, took the dogs for a walk, and let them enjoy sniffing and digging in the soft mounds of snow. I laughed out loud watching Roland drag a shovel down the stairs and across the yard like a prized game specimen. I stopped my internal grumbling, and my mood lifted.

And, then, much to my surprise, the sun came out, it warmed up, and the snow melted. Of course, the puddles will freeze tonight when the temperature drops. And tomorrow, we will begin, again.




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Posted in Acceptance and Mindfulness, Cognitive-behavior Therapy, COVID-19 Mental Health, Depression, mindfulness |

COVID and Holiday Stress

By Lynne Gots, posted on November 21st, 2020.

Thanksgiving is just a few days away.  The approach of the holidays this year has trapped many of us between the proverbial rock and hard place. How should we celebrate? Is it OK to let down our guard and see family if we’re all being careful? Should we get on a plane? Is it worth risking putting our older relatives in danger of infection in order to be together? 

If we were going strictly by the book, nobody would host or attend a Thanksgiving dinner. The CDC has advised us to avoid travel and not to spend time indoors with people outside our immediate household.  Even so, most families are deciding how closely to follow the guidelines, calculating—and perhaps underestimating—the risks involved. . 

We all want to hold onto cherished traditions and see the loved ones we’ve been separated from during these endless months of COVID.  And, yet…

There is no right answer. 

If you go ahead with your plans and get together with family for Thanksgiving dinner, you may feel guilty about ignoring the various governmental recommendations. And, even worse, you might have to live with the consequences if one of your parents or grandparents or aunts or uncles gets sick.

If you exercise the recommended caution and stay home alone or just with your immediate household, you will feel sad and lonely, and you may regret playing it safe when friends are posting pictures of their family get-togethers on social media.

Either way, you can’ t win.

Several of my patients with OCD have told me, “Now maybe people will understand how hard it is to live with OCD.”  The back-and-forth, the doubt, and the emotional distress many of us are going through right now as we try to decide how to spend the holidays mimic what those with OCD struggle with on a daily basis.

So how do we cope? Approaching an upsetting situation with an attitude of mindful self-compassion can make it more bearable. First, acknowledge that this turmoil is really hard. Then, connect with the “common humanity”: millions of people are sharing the same, challenging experience. Finally, treat yourself with kindness. Accept your decision, whatever it is, and remind yourself, “You’re doing the best you can.”

And think about next year when, with luck and the possibility of a vaccine, we all will be able to bring back our old traditions and appreciate them, perhaps even more than ever.




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Posted in Acceptance and Mindfulness, COVID-19 Mental Health |

Coping with Loneliness While Sheltering in Place

By Lynne Gots, posted on April 16th, 2020.

No matter what your current role is – new teleworker; parent with young children; older retired person; college student back in the parental home – you are facing challenges both mental and physical during these uncertain times. Living in unrelenting proximity with family or roommates can strain even the closest relationships. The loss of your usual, in-person social connections may make you feel lonely in spite of the constant company of others. And if you live alone, you may be experiencing a particularly acute sense of loneliness and isolation that can become overwhelming if you do not address it.

Nothing can take the place of hugging a loved one, high-fiving a friend, giving a teammate an encouraging pat on the back, dancing at a wedding, or welcoming a new colleague with a handshake.  Physical contact with people not in your immediate quarantine circle is not an option right now. But maintaining close connections is possible and, more than ever, vitally important. 

Former Surgeon General Dr. Vivek Murthy has talked extensively and written a soon-to-be published book about the health risks associated with loneliness and ways to bolster feelings of connection. He says we can feel lonely even when we interact with others, if we keep an emotional distance. A lack of authenticity during interpersonal encounters fosters loneliness. Being only partly present – checking social media and texts while talking on the phone, say – can be particularly distancing.

So how can we meet our hard-wired needs for social connection and intimacy from a physical distance?

1)Make virtual connections meaningful.

I’ve begun to see a lot of “Zoom burnout” lately, stemming from the proliferation of online meetings, happy hours, and game nights.  Interacting with friends and colleagues through a grid on a screen can seem like an antidote to loneliness. But too many of those encounters can make us feel even more detached and isolated if we overload our schedules with them, as many of us are doing, either through necessity or desperation. Try incorporating opportunities for more intimate interactions. Even a 5-minute phone call or FaceTime with an old friend, adult child, parent, or grandparent can offer an opportunity to connect with someone who really knows and cares about us, especially if we fully engage in the conversation without diluting our attention by multitasking. 

2) Wave at a stranger.

According to social-psychology research, even seemingly insignificant social interactions, such as making small talk with a stranger in an elevator or chatting with the barista when we order our morning cappuccino, can boost mood and promote a sense of belonging. Elevator greetings and daily coffee runs may be things of the past right now, but we can still create opportunities for casual social exchanges from afar.  Try acknowledging a passerby across the street instead of hurrying along with your head lowered. A nod or a wave can be a way of saying, “We’re all in this together.” You may feel a little less lonely as a result. And the small gesture of camaraderie might help someone else get through the day, which brings me to the next point.

3) Reach out to others.

Helping another person can make you feel good, plain and simple. Instead of dwelling on your own pain, make a small difference in another’s life. It doesn’t have to take much time. Just calling a friend who is alone or offering to buy groceries for an elderly or at-risk neighbor will give you a fresh perspective on your own struggles.

4) Practice mindfulness.

Mindfulness, as defined by the esteemed meditation teacher Jon Kabat-Zinn,is “awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally.” By focusing attention on our bodies and minds right now,without judging our emotional state, we can learn to tolerate difficult emotions, such as loneliness, without struggling against the pain and compounding it. In other words, just become aware of the feeling of being lonely, and try to disengage from the dire messages your mind is sending (“I can’t stand this. If I feel like this for much longer I’ll go crazy. I’ll never be happy again. Nobody else is as miserable as I am.”) The practice of meditation, available through hundreds of apps and YouTube videos, is a way to develop the skill of mindfulness.

5) Cultivate self-compassion.

Doctor Kristen Neff, a psychologist, and colleagues have demonstrated through hundreds of research studies the value of self-compassion for coping with negative emotional states. In a recent interview with Dan Harris on the 10%Happier podcast, she elaborates on how the practice can be particularly helpful for dealing with the challenges we are facing now.

The first step in approaching adversity with self-compassion is, again, mindfulness: become aware of your suffering. The second is to recognize that you are not alone in your struggles, a particularly salient reminder during this global pandemic. Just knowing you are suffering along with all of humanity can help ease feelings of isolation. And the third step, which can be hard for many people, is to comfort and support yourself, as you would a friend or loved one, with a phrase or physical gesture that resonates with you. Dr. Neff recommends putting a hand on your heart, or patting your shoulder reassuringly, or even giving yourself a hug, while you tell yourself, “It’ll be OK,” or “I know you’re hurting right now,” or another statement that rings true for you. It can feel sappy, but the evidence suggests the practice works. And if you are self-isolating right now and are particularly starved for the warmth of a human touch, extending a literal, supportive hand to yourself may help fill the void, if only just a little.

In this moment, we are all struggling to adjust to a new, very surreal way of life. Although we cannot control the situation, we can make it more tolerable by accepting it, even if we don’t like it, rather than trying to fight against it. To differing degrees, we are grappling with a whole range of negative emotions – anxiety, sadness, grief, boredom, anger, frustration, and, yes, loneliness. Our only choice is to cope as best we can, forgive ourselves for having bad days, and remind ourselves it will not be like this forever. 




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Posted in Acceptance and Mindfulness, Anxiety, COVID-19 Mental Health |

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.

Contact Dr. Gots

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If you don't receive a response to an email from Dr. Gots in 48 hours, please call the office and leave a voicemail message.

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