Michael Phelps and His Anxiety

Major sports figures and celebrities often appear to have perfect lives.  But over the years a few have been brave enough to come forward and share personal stories about their anxiety and depression.  Michael Phelps is the latest to come forward and he talks about his anxiety in a new film.  http://people.com/sports/michael-phelps-talks-anxiety-new-film-angst/

Like many people, Michael has admitted to simply ignoring his anxiety.  When he felt anger, depressed, or upset he would ignore it, burying his emotions and not dealing with them until that strategy no longer worked.  

This was not a healthy plan and eventually the problems he was dealing with got too big for him to handle privately.  Michael was arrested for drunk driving and marijuana possession, and he isolated himself by sitting in his room for days on end.  He knew that the anxiety was manifesting in unhealthy ways and he ultimately came to the conclusion that he needed to make a change.  

Phelps message was clear – he didn’t want to recover alone, and you should not suffer alone either.  Phelps mentioned the importance of opening up and talking about his feelings.  He explained that for him, he finally got to the point where he realized it is “ok, not to be ok.”  

When you work with a therapist here in NYC, you develop a partnership with someone who will listen to everything you have to say.  When patients visit my office they know I am there to ensure they are heard in a safe environment that they can trust.  We work to unravel the often confusing and upsetting emotions and then find ways to build up healthy coping mechanisms to help you when you feel anxious.

How can you start to feel more empowered when you feel anxious?  If you are going through an anxious period in your life, it is critical that you develop methods to help you deal with stressful situations.

  1. Breathe – Taking a deep breath in and out can help you relax. There are very specific ways to breathe that can maximize its stress reducing capabilities.
  2. Start to write about your stressors.  Some form of journaling can be very therapeutic and gives you a list that exists outside of yourself of what is making you feel anxious.  There is no right or wrong way to journal so just start writing to find your comfort level.  
  3. Get outside. There is a tremendous benefit to just getting outside and walking around.  It could be interacting with nature, seeing other people or just the physical exercise that makes you feel a bit better.
  4. Exercise.  There are many individuals who feel that regular exercise keeps their mind in balance.  So, with your doctor’s approval, get over to the gym and start sweating.
  5. Talk.  Just like Michael Phelps, talking with a trusted person is important.  We can put in place strategies to ensure that when anxiety creeps up you have a plan on how to handle it.  

Here in Manhattan we live in a very busy environment and it seems that everyone else is doing fine and getting ahead.  The truth is, just like Michael Phelps, many struggle to find some balance.  Just like Michael, find help for yourself so that when you hit bumps in the road you can handle them and succeed.  

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Anxiety When There is a Tragedy

Managing anxiety on a daily basis can be a struggle.  In these last few months the news has reported on several tragedies that can give us each pause and trigger anxiety.  The hurricanes in Florida, Houston, the Virgin Islands and Puerto Rico as well as the mass shootings in Las Vegas and Texas and the terror attack in New York City are very hard to process in an already anxious mind.  If you find yourself endlessly worrying about these recent events, is critical to acknowledge your fears but also make a plan to help you deal with your anxiety.

Initial panic over a horrific event is of course completely normal.  You may be concerned about friends and family who are involved in or live in that area.  If the incident is close to you it may be overwhelming to think that something bad could happen.  You may have thoughts and questions for yourself like “could a storm like that hit where I live?”  “What would we do if we lost power and didn’t have clean water for an extended period of time like in Puerto Rico.”  “How safe are we from more terror attacks here in NYC.”  

These anxious feelings that you are having and questions you are asking are normal when there is a crisis, even far away.  Do not feel that your thought of “could this happen to me” is unfounded.  Acknowledge the reality of what you are thinking as important.  The problem occurs when your thoughts start to spiral.  It is important to recognize the direction your feelings are headed before they cause debilitating anxiety which can create a kind of psychic paralysis that keeps you from living your life.  

Anxiety that is brought about by a sense of impending doom is not uncommon in uncertain times.  And in a bustling city like ours there are certainly many big issues to worry about.  I completely understand and know how are scary these very real threats seem to be.  Over the years NYC has had some tragedies hit close to home and being able to weather these, and other storms, is critical.  

When you work with a psychotherapist, you can start to build a plan so that when fear and panic set in you can deal with the emotions in a positive way.  Isolated incidents that cause panic can be dealt with in a positive way, and I am here to help you figure out the best plan for you.  

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When Anxiety Runs Your Family

If you talk with the loved one of an addict, you know that the addiction tends to dominate the family dynamic.  The same can be true for those suffering from anxiety.  Their anxiety can be driving the dysfunction in your family and you don’t even know it.  Here in New York City we live in tight spaces and family members are around often.  Our living environments can be cramped with few ways to escape the chaos.

Does it ever seem to you like one member of your family is on edge most of the time? The presentation of anxiety can vary greatly but it becomes clear when you sense tension and fear from that family member.  Maybe they want the chores done a certain way in order to feel in control.  Maybe it is a child who constantly panics about homework and the entire family must be quiet and/or available to help.

In these situations, family members often feel that they are walking on eggshells as they try to be very careful of what they say or do so that they do not trigger the anxious person.  They want calm but wind up creating strain.  They give space, but that space, when too big can become unhealthy and create an unwanted sense of distance.

It is important that you do not try to fight the anxiety that seems to be controlling your home.  Sure, you can have quiet hours, and follow certain cleaning procedures.  However, you also need to live a normal life and not feel under scrutiny.  If your family member has a significant problem, they are not going to react well to conflict and will not snap out of it.

It is important that you validate the feelings of the anxious person but not sacrifice the household.  “I’m sorry you feel that way, let’s talk,” can diffuse the situation and show that you care.  They need to understand you are on their side but that they can not run everyone’s lives.  If your child is anxious then maybe they need to go to a local library to do homework or start an exercise program to relieve stress.  There are many options we can explore.

All families experience stress, especially when there are many people, activities and noise.  If you have the feeling that the stress is overwhelming, take a good look at the issues.  Maybe one family member is having some difficulty managing stress and their anxiety is starting to take over your home.  A therapist can work with you and your loved one to ensure that the stress is appropriately managed.

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Is Depression Hereditary?

Depression is a serious mood disorder that can impact every single area of an individual’s life.  Here in New York City we see depression caused by many external factors.  The question has always remained whether or not depression runs in families from one generation to the next. Studies have shown that a child who has parents who are depressed is two to three times more likely to be depressed themselves.  In fact, there’s a forty percent chance that someone suffering from depression can trace it to a member of their family.  

Depression runs in families just like allergies, blood pressure and cancer.  Not everyone in a family needs have suffered with depression to make it a factor in your own depression.  Your uncle, grandmother or sister may have depression while everyone else does not.  Even with the same genetic pool, certain factors for depression are not necessarily found in all family members.  Additionally personality and life events can have a significant impact on if and how depression can manifest.

Members of your family who have struggled with depression may enable you to better understand the signs and symptoms.  Knowing what to look for can spur you on to get help before depression starts to cause significant problems in your life.  However, if there is depression in your family that caused serious problems, you may feel scared about acknowledging your own depression.  Maybe you feel a bit blue one day but do not think it is as bad as your father who stayed in bed for weeks on end.  You decide not to check in with your therapist (or find one).  So, it continues and you struggle.

If you know that it’s possible for the feelings of depression to originate from within you, know that it is never too early to learn ways to manage the stressors that trigger depression.  Practicing techniques such as breathing, meditating as well as finding ways for support will help you feel like you have some sense of control over slipping in to a depressed state.  

When you are depressed, a therapist can make the difference by helping you learn to manage your depression or struggling with it.  I am always available to help you and your loved ones deal with depression to enable you to live as full a life as is uniquely possible for you.


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How Do Men Deal with Infertility?

Remember the old saying, men are from Mars and women are from Venus?  In many ways, men and women are emotionally wired a bit differently.  When dealing with infertility, it is important to understand the different coping mechanisms men and women use as they navigate the highs and lows of an infertility diagnosis and treatment.

Being given a diagnosis of infertility is an extremely significant stressor in your life.  From an early age, both men and women develop ideas around family and parenting that gets derailed when infertility is uncovered. There are many reasons for infertility and testing to determine what is going on affects men and women differently. Male infertility is more common that is typically known so when a man is diagnosed with infertility, it is important to understand the depth of his emotional response.

If you have a low sperm count it may feel like your manhood is in question and that can be a struggle for even the most confident man.  Take note to work through all of the causes with a doctor and then follow the suggestions you are given.  Touch base often with a therapist during this time – we can help you process the feelings that arise from finding out that your body is not doing what it is supposed to do.

Intimacy becomes scheduled and controlled and the sexual relationship you have with your partner is is now something that doctors want and need to know about.  Doctors may have to put your sex life on a schedule for optimal times for conception. Erection problems are not uncommon when a man is told that the reason for infertility lies with him.

Managing your partners emotions during times when she feels like a pin cushion and she herself is extremely anxious can be very stressful for men.  She is watching her friends and relatives start their families and she just wants to have a baby already!  She may try to be strong and she may crumble in tears and you may not know what to do to help her. If infertility drugs are involved then you will most likely see your partner experience a wide range of emotions that she cannot control.

There is no way to just “solve” this problem and this may make you feel helpless. Some men love to fix a problem but this is not a scenario where solutions are immediately available.   Learning to let go and trust nature and doctors may be difficult.  We can work closely together to help you process the emotions you may be feeling such as fear, shame, depression and anxiety.

How to make it through?  Regular communication is the key to your success in managing this emotional situation.  Acknowledge that you want to connect with one another as a couple and give yourselves some space to not talk about making a baby.  Couples therapy can be a great resource for you so together you can learn to build a strong relationship during this incredibly stressful time.

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Dealing with Depression in the Summer

Great weather, lots of fun outside and so much to do. It seems as though most of your friends are at the beach…taking the train down to Belmar or hopping a ride out to Jones Beach and the Hamptons.  And all you want to do is sit inside.  How is this even possible?  Your friends and family are concerned…and you might be as well.

When you think you may be suffering from depression in the summer time – it’s a good idea to schedule a few therapy sessions to help you uncover what is making you feel so sad. Sometimes just talking about your feelings and collaborating with your therapist on what you can do to help yourself can bring about relief. Therapy can help you cope with your feelings and hopefully enable you to take part in enjoyable summer activities.

What can cause summer depression?  New schedules can certainly be a problem for someone who likes routine.  Your colleagues may be on vacation, children are home from school, or maybe your children are all off at summer camp and you really miss them!  The thought of spending time in a bathing suit might cause anxiety and depression for you.  You may have issues about money as summer activities can be more expensive.

All of these are feelings are normal.  The question is, how can you cope with your summer depression so that you don’t shut down during this time of year?

The best thing you can do for yourself is to schedule a therapy appointment. We can spend some time together working through what is holding you back from engaging in life.  As we work through your issues, we will develop the tools you can use to manage your emotions when life becomes stressful.

It may also be a good idea for you to do something you absolutely love that is outside of the house.  Visit a museum, a favorite restaurant, or take a walk through a park.  Getting out and about a bit can help you experience the world beyond what is going on inside your head and it may help ease some of your depression.

Lastly, practice self-care.  Attend a yoga class, get a massage, read a good book or spend some time relaxing and deep breathing.  Take time to sit with and acknowledge all that you are grateful for in your life.  Counter some of your negative thoughts with positive affirmations about what you currently have and are working toward in your life.

It is often hard to process summer depression because it just doesn’t seem like the right season to feel depressed – that seems to happen more in the winter when you are stuck inside.  But being sad during this time is completely normal.  The most important thing is to work through your issues so you can catch the depression early on before it becomes too overwhelming.

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Re-establishing Trust in Your Relationship

Every relationship has its ups and downs throughout the years – in fact there are times you may feel you are both on a on a roller coaster, or even on different roller coasters. One partner may have had an affair (physical or emotional), drained a bank account, or taken any number of other actions that has broken the sacred bond of trust.

How do you re-establish trust in a relationship? In this age of technology it can be even harder to re-establish trust with cell phones, emails and messenger sites. And remember, there are two sides to regaining trust – work must be done by the partner who broke the bond and by the partner who has to look at their role within relationship.

Healing from a break of trust is going to take effort and both partners have to work at this for quite some time. It is imperative for both partners recognize that they have to work together to rebuild the bridge over the chasm that developed between them.

  • Be open and transparent. Do not hide in the house with your cell phone or close your computer every time your spouse walks into a room. Answer questions openly and willingly and remember this may not feel comfortable but it may be what your partner needs.
  • Do what you say you are going to do and be where you say you are going to be. Never give your spouse any indication that you are lying about what you are doing or your whereabouts.
  • Call and inform your spouse when plans change.
  • Explain details that might be misleading or confusing. Always make the time to talk about events.
  • Spend time with your partner. How can you learn to trust again if you were the one who was cheated on? Can you ever trust again? If you want to stay in the relationship then you are going to have to walk down a path that eventually leads to looking at yourself and your partner in order to arrive at a place of forgiveness. This means being open and honest with your partner when you do not trust and telling him/her exactly what you need to ensure you feel safe, heard and comfortable.Couples therapy can be a productive way to work through these issues. When a bond is broken, it tells a story and our work will entail deciphering what the story means and if there is enough of a foundation that can be the groundwork for writing a new and more trusting story.
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Managing Doctors Appointments While Dealing With Infertility

Being diagnosed with infertility is stressful – you want a baby and you have to come to terms with the fact that your body isn’t cooperating.  Once you have been diagnosed with infertility you may begin the process of trying to conceive with assisted reproductive technology and this is when you begin your foray into a world of doctor appointments.  

When you start the process of infertility treatment it may feel overwhelming to have to deal with testing, medications, and endless doctors appointments. There are so many clinics and doctors in NYC to help you through this difficult time so first and foremost, find the doctor and clinic that makes you feel comfortable and at ease.

If working through all of the appointments and directions is overwhelming, take a step back and develop a system for organizing and recording appointments, details, next steps, questions, medications and lab results.

  1. Keep track of each appointment, which doctor you saw and when you need to visit again.  Take detailed notes of what was discussed and directions for what you have to do before  your next appointment.  Review these notes (you can even rewrite them) and make sure to follow-up if you have any questions or concerns.  
  2. Keep a medication chart including dose, times taken and any reactions you experience.  
  3. Maintain a list of all of your medical doctors with name, address, phone number, email and fax number.  Send a copy to each doctor and update when necessary.  When one has a report to share they can easily access all of the information.  
  4. Always ask for copies of your labwork and make sure they are kept by date in a secure place.  You should always have these with you when you visit with a new doctor so they are readily accessible.  
  5. Start a document where you tell the basic details of your infertility journey. When you visit a new doctor you can bring this report with any lab results so your doctor has a complete story that he/she can review.  This is also helpful so you do not have to keep telling the same story over and over – and most importantly, so you do not miss any important details when retelling your story.
  6. Keep one list of questions that you and your partner can share in order have a place to refer to when you are visiting with a doctor.
  7. Don’t forget to validate how you are feeling by keeping a journal or seeing a therapist who can help you process your feelings during this difficult time.

Managing infertility can be a complicated process but one that you can break down into these bite size pieces that hopefully give you some piece of mind.  Sometimes the best way to organize all the pieces is to work with a counselor who has experience guiding others through the process.



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Problems in Your Marriage: Communication

Your marriage is not going to be perfect and there are going to be bumps along the way – afterall, all couples have disagreements.  Regardless of the situation, good communication based on love and respect can help you successfully navigate anything that comes your way. Couples sometimes feel that their marriage is in trouble because they argue. Arguing isn’t the problem as much as stepping in and making loving and productive attempts to solve the problem

Couples who engage in therapy try to look at negative communication patterns that can hurt their marriage. They then work towards creating and using productive strategies to solve problems. No matter what the issue, increasing the quality of your communication can lead to a better resolution of the negative dynamic in your relationship.

  1. Have a plan.  If you are having a serious problem in your relationship that needs to be addressed then really think about how you are going to talk to your partner.  Just don’t blurt out or start screaming at your partner.  Know what you want to say and even practice so you do not get sidetracked.  Do not fill your time with complaining  – simply state the problem and ask for what you want.
  2. Find a good time to sit down with your partner.  This might not be when she walks in the door from work or just as he is finishing the dinner dishes.  Make sure it is a few minutes of distraction free time.
  3. State your position and then allow the other person to respond…or not.  Your significant other might not have a response and may need time to process what you said and form their own opinion.
  4. If the discussion does continue, you need to really listen.  You may feel that your partner is wrong but that does not make you right.  They may have a very different view of the situation and you need to listen carefully to understand their position.
  5. Stop the conversation after a specific amount of time if you have not come to an agreement.  Sometimes one partner wants to keep going until a resolution has been found but the other partner may be tapped out.  Your problem may not be solved but frustration will compound the issues – better to let it rest for a bit. This is time to reconnect as a couple, not go away mad and frustrated. Make sure to make a commitment to revisit the problem at a later time.

Couples who are constantly fighting for long periods of time usually need help working through a process of stating problems, listening and then working towards a resolution.  Sometimes we become stuck in patterns of behavior that are destructive.  It is better to take a bit of time and work through a process with a couples therapist so your future disagreements do not turn into battles that hurt your relationship.

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Financial Mistakes that can Doom a Marriage

When clients visit my office here in NYC for couple’s therapy, they present a particular issue that they would like to deal with or they have a general feeling of unhappiness and dissatisfaction.  There are a few general categories in life that couples struggle with and finances, for some, is at the top of the list.  Money issues are very common in a relationship either because of different values, commitment and/or lack of communication.

What are the common problems couples experience around money?

  1. Hiding:  Hiding issues having to do with money sometimes come from embarrassment, insecurity or a need to hoard/protect wealth.  We usually see this in couples where one individual does not have a substantial amount of money or may have debt that he/she is embarrassed about and/or the partner is scared to share wealth for fear it will be squandered away.
  2. Ignoring:  it is all too common for one or both partners to completely ignore money problems.  When bills are due and the money is not available or you do not want to deal with talking about a budget or the impending bill for college – it can be easier just to ignore the problem.  You may have said “oh, we will talk about it tomorrow,” or “let him/her take care of the finances.”
  3. Different values and styles on money:  If one of you is a saver and the other a spender, your difference in values regarding money can cause significant problems.   If you feel you should go and buy a new suit for work when your partner wants to save money for retirement, or you invest in a mutual fund and your partner wanted to use that money for home renovation, that is going to cause problems.
  4. Jealousy of others:  In today’s world of instant gratification it is hard to see others advancing up the economic ladder when you are not.  It can be hard to be left behind with less purchasing power when friends are in a position to do more because they have more. You may feel that your partner is not pulling his/her weight and that resentment, fueled by your jealously is going to be a problem in your relationship.
  5. Letting the other person handle it:  you may just hate to deal with money.  And not knowing can sometimes feel better than facing reality.  The problem is that since money is how you financially support your life you should be an active participant.  And, to leave all financial decisions and management to your partner may cause them to resent the extra pressure.

As with all parts of your life, you and your partner should discuss financial issues and money management is an important one.  Making decisions together and discussing goals and problems will allow you to support each other as you plan your future and tackle financial obstacles.   I can meet with you individually and also as a couple to find better ways to communicate and help you deal with differences you and your partner face around money.

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