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Saturday, September 27, 2014

How Do We Know What Is Real?

QUESTION: I believe my husband is bipolar. We have been married for over ten years. He thinks he is just depressed, but he has had major mood swings over the years ranging from very depressed and suicidal to angry rage. He is bothered by life in general,most things are negative as he sees them. He's also very paranoid and thinks of things happening that are unrealistic. when we met he complained a lot, no matter what was happening. These are just some examples, but does this sound like depression, bipolar, or something entirely different?
ANSWER: Sometimes, people have trouble with what we call, "reality testing."  What this means is that some people can not always distinguish between what is real and what may be simply a thought or an assumption.  It sounds like his symptoms of rage, paranoia, and mood swings, are interfering with his life and your life together.  When a person can not distinguish inner thoughts and feelings from the external world, therapy and possibly medications can help reframe a person's understanding of what's real or not real.  I would recommend cognitive behavioral therapy as the technique will help your husband self-assess his internal thoughts and assess their influence on his mood and behavior.  He may need medication too.  There are a variety of medications that may help with his thoughts.  Now the hard part, trying to encourage him to seek counseling!  If he does not think he has a problem, then he will not go for therapy.  It may help you convince him if you take the time to help him assess his thoughts in the moment he verbalizes the thought. For example,  saying something like, "Let's see what evidence might exist to support that thought."  Of course if he has rage issues, please consider your own safety before challenging his thoughts.  There is also the philosophical debate about what is real.  Reality in Buddhism is called Dharma. Buddha says, "We are what we think. All that we are arises with our thoughts. With our thoughts, we make the world."  This means that our thinking pattern determines the ways in which we view all things that happen.  So one could argue that an individual's perception is reality, no matter how skewed others think it appears.  So your husband has a choice to continue thinking his negative thoughts, thus creating his "reality of paranoia and rage," or he can learn new ways of thinking that may, in turn, improve his mood and behavior. There may be several different diagnoses that would fit with his symptoms. Try your best to get him to see a mental health clinician. 

Wednesday, August 27, 2014

Why Am I Sad?

Question: Do I deserve to be sad? Do I deserve to cry? I mean, there are a lot of people out there who have worse problems, worse situations than I do...

Answer:  Many clients often come into therapy asking this same question. The concept of happiness is widely misunderstood. And, the idea of accepting that sadness and crying may be a normal phenomenon is also an area of human feelings that often leads to guilt.  You have guilt that you are sad despite all the good you have in your life.  We suffer because we have so much to experience. We can live deeply in thought and feelings and because of this, we can suffer greatly.  We can not always understand the suffering and this frustrates us.  But, we can decide how we want to respond to the suffering.  You must tell yourself it is ok to be sad, it is ok to cry.  It's normal. When sadness is not normal is when it takes over your life and you are no longer able to function in the realms of work and self-care.  When this happens, it is depression, and it must be treated by a professional.  

Aristotle taught us that happiness is an activity, a process and participation in something that brings us fulfillment.  Happiness Aristotle says, is a byproduct of living a life that has purpose and a life that helps and supports others.  Happiness comes from finding your talents and putting those talents to use for the overall benefit of mankind.  So you see, it's not about the material things you have, it's about your life purpose and helping fellow humans. When you find this within yourself, your sadness will lift. 

And always remember, if it is a sadness that consumes you and keeps you from living, then it is a medical issue called depression. And all medical issues need professional intervention.