It is disability pride month, and while a lot of disabilities have outward signs, disabilities such as chronic illness and chronic pain are not always visible.
How can you help those close to you who suffer from chronic illness and chronic pain?

​Invisible Chronic Illness and Chronic Pain
Chronic illness can come with invisible sources of pain and discomfort. For example, arthritis comes with pain in the joints, and asthma leaves individuals with difficulty breathing and challenges catching their breath after exercise or even minor activities. Some chronic illnesses, such as autoimmune diseases, lead to reduced overall capacity, high levels of fatigue, and daily body aches.
In addition to their symptoms, those with chronic illness face increased difficulty completing tasks, have the additional responsibility of balancing and managing medication, and have to rearrange priorities daily.  Oftentimes, their illness may prohibit them from fulfilling certain expectations and obligations.
Some chronic illnesses and chronic pain conditions may not be visible but are still affecting those with these conditions on a day-to-day basis.  In order to understand how someone is feeling, communication is key!

Say No to Toxic Positivity.
Toxic Positivity is the misplaced over-promotion of the good in the given event while ignoring that the person is facing tragedy, trauma, or chronic difficulties.
These phrases usually start with “At least” or “Well, it could be worse” and lead to minimized emotion and empathy for what the person is struggling through. Using toxic positivity is invalidating and not supportive.

Listen with compassion and empathy.
Managing chronic pain and maintaining a chronic illness comes with surprising challenges at all stages. Having someone to listen to can help alleviate stress and manage larger emotions that come with a lifelong diagnosis. It's helpful to ask questions about the pain and Illness, and to try to understand what the person is going through.
By listening with empathy, you can help them feel validated and supported.

Ask how you can help.
Due to fatigue, pain, and the overall stress of having a chronic illness, it could be helpful to ask if there is anything you can do to help them.
Whether it be helping them keep their space clean, running errands, or sitting and chatting, having someone to help relieve the demands on their time and energy can help them later be present with family and friends.

When pain flares and fatigue increases, it can be hard for someone to complete the tasks they set out to do for the day, week, or month. Some tasks are not completed at all, as they try to meet the hierarchy of their needs. All they can do is the essentials to survive.
If there is something that you can do to help alleviate the constant pressure, it could be very helpful not only in the moment but in the future for that person.

Written by Jordan Langley, BA, BS, MA, SMFT
​Jordan is a Therapist at Healing Reflections Therapy. She is currently accepting clients.

With the days getting longer and the sun rising earlier, now is a great time to evaluate your sleep hygiene. If you’re struggling to get a good nights rest the some of these tips might be for you!

Get up at the same time EVERY morning, regardless of how much sleep you got the night before. Use an alarm clock. A regular wake-up time will help set your biological clock. If you feel you must sleep in on weekends or holidays, allow yourself up to 1 extra hour.

Restrict your time in bed. Only go to bed when you are drowsy. Get up if you are not feeling close to sleep within 20 minutes. Likewise, when you wake up in the morning, get up. Do not lie awake in bed. You want to consolidate and deepen your sleep by sleeping only as much as you need and not spending too much time awake in bed.

You cannot make yourself fall asleep. If you are in bed 20 minutes and you are still not close to falling asleep, get out of bed, go to another room, engage in a quiet activity (read, listen to music or a podcast, watch a soothing TV show, watch or listen to ASMR) until you feel drowsy, and then return to bed. Do not fall asleep on the couch or in your recliner, but rather return to bed when you feel drowsy. You want to make your bed the place or cue for sleep (not the couch or recliner). You may need to repeat this step more than once throughout the night.

Quiet activities and soothing audio can help your body and brain get ready for sleep. You can try a guided meditation on the Calm app or a music streaming app. On Spotify, check out Sleep Cove or Caverncast podcasts for soothing voices. Look up Restful Rambles or ATMOSPHERE for ASMR on tiktok or youtube. You can also find white noise on most platforms or buy a noise machine.

Use the bed only for sleep and sex. Do not read, watch TV, eat, scroll social media, play video games, worry, talk on the phone, or plan your day in bed. You want to establish the bed as a cue for sleep and not as a cue for other activities that are incompatible with sleep.

Establish a pre-sleep ritual. Schedule some "down" time right before bed. This is not the time to check your email or have that heart-to-heart talk with your partner. Those things need to be done earlier. Schedule time early in the evening for working on problems or planning the next day's "to-do" list. Right before bedtime is the time to relax, calm down, and let your body and mind slow down before hitting the bed. Set up a regular routine before bed: brush teeth, put the dog out, lock the doors, set the alarm, etc.

Do not nap during the day. Sleeping during the day disrupts sleep at night. If you must nap, try to keep naps to less than one hour and finish them by 3 p.m.

Exercise regularly: For insomniacs, the best time to exercise is in the late afternoon or early evening, but not within 3 hours of bedtime. Exercise helps deepen sleep and reduce stress.

Food and Fluids: Do not go to bed hungry; however, avoid a heavy meal before bed. Finish eating your evening meal at least 3 hours before bedtime. Do not snack in the middle of the night, or you may encourage nightly awakenings for food. Decreasing liquids close to bedtime will minimize nighttime bathroom trips.

Caffeine has a half-life of 3-7 hours and interferes with everyone's sleep, even those who deny it. Discontinue caffeine 4-6 hours before bedtime. This includes iced tea, colas, Dr. Pepper, Excedrin, chocolate, Sudafed, and all sorts of other things you never suspected. Read the label.

Alcohol or cannabis near bedtime may help you sleep in the first part of the night, but causes multiple awakenings later in the night and shortens sleep overall. Try to avoid alcohol 2 hours before bedtime.

Nicotine is a stimulant, even though smokers claim it helps them relax. If you must smoke, reduce the rate of smoking before bedtime and do not smoke if you wake up in the middle of the night.

Noise: Insomniacs are usually hypervigilant and thus are more sensitive to noise. Consider earplugs or a white noise machine (or even a bathroom exhaust fan) to block out noises

Temperature in the bedroom: 75° is too hot and increases awakenings; 54° is too cold and can cause bad dreams. Insomniacs often report being hotter than good sleepers. Find a bedroom temperature that works for you. Most people prefer 60°- 68°.

​Comfort: Make sure your bed is comfortable, and you have the right amount of light/darkness in the bedroom that works for you.

Clock Watching: You will either sleep or you won't, and watching the clock does not facilitate sleep. In fact, clock watching usually just causes anger or anxiety, neither of which helps with sleep. Try not to look at the clock if you can't sleep.

Exposure to bright light in the morning will help if you have sleep onset insomnia. Sitting in front of a southern exposure window (without sunglasses) for at least 30 minutes every morning should help decrease your time to fall asleep at night. Try this for 5-7 mornings.

Using cell phones and other devices can contribute to insomnia by reducing the production of melatonin (due to the blue light) and increasing mental stimulation. Stop using your phone at least 30 minutes before getting into bed and put it into do-not-disturb mode. Consider using a classic alarm clock rather than your phone to wake up in the morning if the distraction is too tempting.

Natural sleep aids include melatonin, herbal/sleepy time tea, camomile tea, and valerian root. Some use benzodiazepines (benzos) and THC to induce sleep, but those are habit-forming and can create a dependency. Benzos are not meant for daily use, are highly addictive, and should only be used as prescribed.
Prescription meds may be helpful in some cases. Individuals with PTSD can talk to their doctor about trying Trazodone.

Sleep tight and may you find good rest tonight!


Modernized & Adapted by McKayla Robinson from "Instructions for Better Sleep" by Bertelson Washington University Sleep Center, March 2005

McKayla Kagie Robinson, MS, PLMFT is a therapist at Healing Reflections Therapy, currently accepting clients to help you if you are struggling to manage your sleep challenges.

Our day-to-day lives are chaotic and filled with distressing news, world events, and other causes for stress that we have no control over. Meditation practice has long been established as a path towards mental, emotional, and physical healing. The mind-body connection is one that is often neglected.

You may have tried meditation before and decided it is not for you for one of the following reasons:

• “I can’t make my mind quiet/blank.”
• “I can’t sit still for that long/I don’t have the time.”
• “I try, but I just get frustrated that I’m not doing it right/well enough.”

Meditation has a lot of misconceptions tied to it, and a lot of the concerns people have when trying meditation revolve around those misconceptions and set them up for feeling like failures. The goal of meditation does not have to be to reach the point where you can meditate for hours, with no thoughts, and full control over your mind and body to the point where you can levitate off the ground. We’ll save those aspirations for the Monks.


The goal of therapeutic meditation is simply to practice. Practice checking in with your body, emotions, and thoughts. Practice slowing down enough to be able to communicate with your body, recognize your emotions, hear out your thoughts, and spend some time addressing the concerns brought to your attention. We are not looking for a blank slate- we are looking for what we have been ignoring or neglecting.


Another great benefit to practicing meditation is learning how to engage or disengage with your anxious thoughts. The meditation linked below is called a “Leaves on a Stream” meditation. The idea is to practice observing your thoughts, especially the anxious ones, as they come up, acknowledge them, and then let them continue flowing downstream without attaching any judgment or action to them.


I encourage you to try it out! It is less than 10 minutes long and is something you can do from anywhere during your day. Now, it will not be something that you are automatically good at, and it may go differently each time you practice it, depending on your headspace when you start. However, the only objective here is to try. Try it, practice it, and keep practicing it. If you do that, you have succeeded! You will have connected with your mind and body even for just 6 minutes, and that is 6 more minutes of connection that you would otherwise have.


Despite my encouragement, you may not believe that meditation can make a difference, but I dare you to try it and be curious about what effects it can have."

Author: McKayla Kagie Robinson, MS, PLMFT
McKayla is a Therapist at Healing Reflections Therapy. She is currently accepting clients.
​

3. Meditation: Happier
When I bring up meditation in sessions, I’m met with comments like, “I hate meditation, I get too distracted, and it’s impossible for my thoughts to be quiet.” The mainstream understanding of meditation is that it’s somehow supposed to teach you to be totally devoid of thoughts, but that is simply unrealistic and, in my opinion, not what meditation should be used for. Instead, meditation is a powerful way to process and feel emotions, relax and recenter ourselves when stressed and overwhelmed, and expand our capacity for skillful coping mechanisms. 

Happier, previously known as Ten Percent Happier, is an app that was recommended to me by another therapist. It is now a resource that I use regularly, personally and professionally, primarily because of the quality and variety of meditation practices and tools it provides. The app has free meditations available, but you may choose to purchase their yearly subscription, like I did, for full access. 

The meditations cover many different topics and guide you through many visualization and reflection options. They also do a good job of setting a pace that allows time for reflection and still calls your attention back to the practice in case your thoughts start to wander. Whether you are experienced or new to meditation, this app is one that my clients and I find helpful.
​
Other:
Outside of apps, I recommend Self-Compassion Practices by Dr Kristin Neff. The meditations found on that webpage are geared towards compassion, loving-kindness, and grounding. Her website includes helpful exercises as well, which I suggest checking out.

​

5. Couples: Paired
Lots of people struggle communicating with their partners, and that is normal, even in a healthy relationship. The Paired app is designed to facilitate conversations that you may not think to have. These conversations revolve around topics like sex, sharing responsibility, finances, quality time, communication, LGBTQ+, and more.

​Each conversation prompt or quiz starts with a bit of psychoeducation about relationship dynamics. The prompts and quizzes have thoughtful questions designed to make you think and reflect so that you share insightful information with your partner via the app. You can not see your partner's answers until you submit your own, which I feel helps with authenticity. After each of you has answered, you can continue to discuss in the app with messages and emoji reactions, or if you prefer, you can continue the conversations in person to build on your understanding of each other’s answers. 

​

6. Movement: Bend
Movement is another therapeutic tool! Moving our bodies, in whatever capacity, can have great mental and physical health benefits. Gentle movement, like stretching, is more accessible for some than going on a run or going to the gym, and Bend is a great way to guide yourself through that. The app has stretches categorized by body areas to stretch and by various intentions for stretching. It has guided routines that are as short as four minutes up to thirty minutes. You select a routine based on whether you’re looking for a wake-up stretch, a bedtime stretch, a mid-workday stretch, or you want to stretch your sore lower back, and it presents you with several options varying in length. You can pick according to the amount of time you have or the kinds of stretches it shows in the sequence, if you have a preference. 

Each option has an explanation of its specific focus. Before you start the stretch series, it shows you all the stretches in the order that they will be presented and the length of time intended to hold those stretches. Both before you start or if you need a refresher in the middle of stretching, each movement has a detailed description of how to get into the position (including a video demonstration showing you what it looks like), tips to help you find your footing and prevent injuries, modifications to accommodate movement restrictions, and the areas that benefit from that stretch.
​
I personally love the way that the app guides you through the movements and provides ample support for executing each stretch. You can adjust the time that you hold each stretch if it is too long or too short, and you can pause any time if you need a break to adjust, reread the directions, or sip some water. The app will, of course, send you reminders to stretch if you set it up to, and as with most apps, there are more features available if you pay for the subscription. The unpaid version only does a full guided routine with the timer once a day, but it does not restrict your access to stretches or their instructions if you want to use them with your own timer or at your own pace. 

​Conclusion:
While they are not a fix for our mental health, nor a replacement for trained professionals and community support, apps are a great way to reinforce the things you are working on in therapy. The apps I recommend here may not work for you, and that is okay; they are just options to experiment with. If you find that these are not your vibe, that is just more information to help you determine what you do or do not need in terms of support. It’s all about finding what works for you!

​Author: McKayla Kagie Robinson, MS, PLMFT
McKayla is Provisionally licensed Marriage and Family Therapist with Healing Reflections Therapy, currently accepting new clients for individual, couple, or family therapy.

In doing counseling with clients who have substance abuse concerns and disorders, I
often draw from the world of 12-Step recovery. One of the concepts that comes out of
the wisdom of AA is the idea of People, Places, and Things. In order for someone who
abuses substances or things like food or sex to change their behavior and maintain their
progress, it is usually necessary to change the people with whom they associate, the
places they frequent, and items with which they regularly come in contact. The world
that someone in that situation has created is often filled with other people who abuse
substances, places the person goes to use those substances, and items that are
components of their use pattern.

The comedian Bill Hicks once said that the only things a man needs in order to be come
someone who has an alcohol use disorder are, “the right bar, the right girl, and the right
friends.” I have always liked that quote because it acknowledges that anyone can
become someone who abuses something or other given a few circumstances. While I
appreciate the wisdom of the disease model of addiction and also see people who
abuse substances as having a likely chemical imbalance and a genetic predisposition to
addictive behavior, there is also a role that habit, modeling, and circumstances play in
substance abuse and life in general.

I have always felt that in the “nature versus nurture” debate, the answer is both. As
such, people who abuse substances tend to think in such a way as to maintain the
addiction and the circumstances that give rise to it. Changing people may be the
hardest of the three. It may mean cutting off contact with family or close friends
temporarily or indefinitely. Sometimes new ways of interacting with them can be
negotiated, but sometimes not. When I quit smoking cigarettes many years ago, having
a romantic partner who believed I could and should do and did not smoke herself was a
huge factor in the longevity of my ability to cease and desist from using tobacco. If
someone has a problem with methamphetamine and chooses to stay with their partner
who abuses meth also, one can imagine all of the temptation and other challenges that
will continue to bring into their life while they try to pretend that they are quitting in a
vacuum.

I have seen some of the places people should consider avoiding be the route to the
liquor store they normally go to, places that are trauma triggers that may make them
want to use to self-medicate, childhood homes, their drug dealer’s house and so forth.
Sometimes if avoiding those things is not suggested by a peer or professional, it does
not occur to the user. I have seen numerous people with alcohol problems believe they
can/should work in a bar and have encouraged them to consider other options. There
are countless rituals and routines around using that the person will benefit from
breaking or at least interrupting.

“Things,” can be paraphernalia, numbers in ones phone, the actual substance they use.
I have seen people hold onto a stash of tobacco, drugs, or alcohol because they say
they feel more comfortable still having it if they need it. While this may work as a form
of harm-reduction at first, it is likely not sustainable long-term. Initially keeping alcohol
around with hopes to one day drink in moderation also seems premature in my
experience. In short, every person who abuses substances or struggles with other
compulsive behavior has a list of people, places and things that they need to evaluate
and possibly partially or completely liquidate in order to best prevent relapses into old
behavior. These are always unique to each person.
​
Once someone is far enough along the stages of change to take action, they are more
likely to take this recommendation or see that this work needs to be done without
guidance. Sponsorship within AA/NA, counseling, or just some serious conversations
with concerned loved ones can also wake a substance abuser up to a lot of their
patterns of behavior and once they have this solid information, it is up to them to
personalize it and choose to take it from there.

Avoidance can cause prolonged grief, traumatic reactions and the like and, as such,
therapists typically advise clients to face their fears, explore underlying emotional
responses and the like. By contrast, avoiding people, places, and things is an adaptive
tool for people to use in recovery because they have likely already identified the
underlying emotion, have no sound reason to be around their substance of choice given
the corresponding cravings that may ensue, and are or will become aware that trying to
master regularly being tempted just isn’t worth it.

Author: Chris Scarberry, LPC
Chris is Therapist and CO-founder of Healing Reflections Therapy and is available to see clients in recovery.

A common theme that comes up in therapy is people holding the belief that rest is a bad thing and that they are somehow bad if they allow themselves to rest. Relaxation is often seen as a luxury rather than a necessity. Many people equate being busy with being productive, often neglecting the essential need to rest. Whether it developed from messages passed down in their family, their church, the Puritan work ethic, capitalistic influences on productivity and self-worth, or other cultural influences, the impact is the same- Shame. Shame prohibits people from doing what it is in the very nature to do for their own survival. 

Rest is not a bad thing. 

Is this you? Have you shamed yourself for not working enough? Do you prohibit yourself from taking a day off? Do you force your day off of work to perpetually become days of cleaning and project days at home? Where do you think you got that perspective from? Ok, sure, if you spend weeks in bed, that's probably gonna make you feel worse and is likely a sign of depression, but a couple days here or there won't make the world stop.

Winter is a great time to give yourself permission to relax and have some downtime. Plants and tree go dormant in the winter. Bears, squirrels, turtles, and even the worker bee hibernates and rests in winter. After a period of rest, the world bursts back to life in the spring. If we allow ourselves permission to rest, we may 

Still not convinced? Scientific research strongly supports the idea that relaxation is not only beneficial but crucial for overall health and well-being. 

Psychological Perspective: The Mind Needs Downtime

Psychology has long recognized the importance of relaxation in maintaining mental health. Chronic stress and overwork can lead to burnout, anxiety, and depression. Research in cognitive psychology suggests that taking breaks and engaging in restful activities helps improve attention, creativity, and problem-solving abilities.

Popular Harvard psychiatrist Daniel Siegel proposed the Healthy Mind Platter (see diagram below) that outlines the various key areas for a healthy mind and body, which include not only time for work and physical activities and sleep, but also time for relaxation, social connection and play.

One key neuropsychological theory supporting relaxation is the Default Mode Network (DMN), a set of brain regions active when the mind is at rest. The DMN is crucial for self-reflection, memory consolidation, and emotional regulation. When we relax, our brain shifts into this mode, allowing for better cognitive processing and emotional well-being.

Additionally, relaxation plays a critical role in regulating the autonomic nervous system (ANS). The ANS consists of the sympathetic nervous system (responsible for the fight or flight response) and the parasympathetic nervous system (which promotes rest and digestion). Chronic stress keeps the sympathetic nervous system overactive, leading to anxiety, poor sleep, and even depression. Engaging in relaxation techniques such as mindfulness, deep breathing, or even simple leisure activities helps activate the parasympathetic nervous system, restoring balance and reducing stress-related mental health issues.

Medical Perspective: How Relaxation Benefits the Body

The impact of relaxation on physical health is well-documented in medical research. Chronic stress triggers the release of cortisol, the body's primary stress hormone. While cortisol is essential for survival, prolonged elevation can lead to numerous health issues, including:

•  Cardiovascular disease: High stress levels contribute to hypertension, heart disease, and stroke.
• Weakened immune function: Chronic stress suppresses immune responses, making individuals more susceptible to infections.
• Digestive disorders: Stress is linked to conditions such as irritable bowel syndrome (IBS) and acid reflux.
• Sleep disturbances: High cortisol levels interfere with the body's ability to fall and stay asleep, leading to insomnia.

Medical research has found that relaxation techniques such as meditation, yoga, progressive muscle relaxation, and deep breathing lower blood pressure, improve heart rate variability, reduce inflammation, and boost immune function. Studies in psychoneuroimmunology (the study of how the mind influences the immune system) show that people who engage in regular relaxation activities have stronger immune defenses and better overall health outcomes.

Anthropological Perspective: Rest as a Cultural and Evolutionary Necessity

From an anthropological standpoint, relaxation is not just a modern necessity but an ancient practice essential for survival. Human societies throughout history have recognized the importance of rest and leisure.

Hunter-gatherer societies, for example, structured their lives around periods of intense activity followed by extended rest. Anthropologists have noted that these populations spend significant portions of their day engaged in socializing, storytelling, and leisure activities. Unlike industrialized societies, where work dominates daily life, traditional cultures incorporate relaxation as an integral part of existence.

In many indigenous cultures, rest is tied to communal well-being. Practices such as siestas in Mediterranean societies, tea ceremonies in Japan, and mindfulness in Buddhist traditions highlight the value of structured relaxation. These traditions suggest that relaxation is not merely about physical recovery but also about fostering social bonds and mental clarity.

From an evolutionary perspective, downtime is necessary for learning and adaptation. The brain consolidates experiences, integrates new knowledge, and strengthens neural connections during rest periods. This ability to switch off has likely played a role in human survival by enabling problem-solving, creativity, and resilience in the face of challenges.

Practical Steps to Incorporate Relaxation Into Daily Life

Understanding the necessity of relaxation is the first step; the next is implementing it into daily life. Here are some evidence-based ways to cultivate relaxation:
1. Mindfulness and Meditation -Studies show that mindfulness reduces cortisol levels and enhances emotional regulation.
2. Physical Relaxation Technique -Practices like yoga, progressive muscle relaxation, and deep breathing help reduce stress and promote bodily relaxation.
3. Set Boundaries and say No to things that you do not need to do.
4. Give Yourself Permission- assure yourself you are a good person, doing good things for yourself, and will be able to do more good things for the world when you allow yourself intermittent periods of doing NOTHING.
5. Scheduled Downtime - Setting aside time for non-work-related activities, such as reading, painting, or spending time in nature, improves overall well-being.
6. Social Connection - Engaging in meaningful conversations and social interactions helps reduce stress and fosters a sense of belonging.
7. Quality Sleep - Prioritizing good sleep hygiene (such as limiting screen time before bed and maintaining a regular sleep schedule) allows the brain and body to recover.
8. Nature Exposure - Research shows that spending time in green spaces reduces stress and enhances mental clarity.

Relaxation as a Fundamental Human Need. Relaxation is not a sign of laziness, badness, or inefficiency; it is a scientifically supported necessity for both mental and physical well-being. From a psychological perspective, it enhances cognitive function and emotional resilience. Medically, it lowers stress-related health risks and strengthens the immune system. Anthropologically, relaxation is deeply embedded in human culture and survival. 

By embracing relaxation as a fundamental part of life, individuals can achieve better health, improved productivity, and greater overall happiness. In a world that constantly pushes for more, taking time to slow down is not just beneficial, it is essential. So go ahead, on the next snow or rainy day, listen to your body when it says it wants to stay in bed. Treat yoself! Your body will thank you later.

Author Megan Garza, MA, LMFT
​AI assisted content

The word is out. Winter is in!
The fresh white snow. 
The cozy evenings snuggled inside in the warmth. 
Fire crackling in the fireplace. 
Mug of hot cocoa in hand. 
 
It all sounds great, doesn’t it?
Well for 10-20% of adults in the US, this is not the coziest season of year. But rather, the season of the winter blues or Seasonal Affective Disorder (SAD).
But what causes this?
1. Less sunlight
• It is not just the physical lack of sun on your skin, but a shift in biological clock that occurs when there is less sunlight. This internal clock is responsible for regulating mood, sleep, and hormones.
2. Brain chemical imbalance
• Because sunlight helps regulate serotonin (which contributes to feelings of happiness), a lack of sunlight in the winter can exacerbate feelings of sadness.
3. Melatonin boost
• Melatonin is a chemical that affects your sleep patterns and mood. With the lack of sunshine, an overstimulation of melatonin can occur. Symptoms of this include feeling sluggish and sleepy. 
Ok, the cold dark days are causing my sadness. What can I possibly do about that?
Well. While you can’t control the season or weather, here is what you can do…
1. Start or resume therapy. Our therapists at Healing Reflections Therapy are available to help in-person or virtually. 
2. Spend time with people who bring you glimmers of joy
3. Spend time outside in the limited window the sun is shining
4. Adding light to your space that mimics the sun’s light
5. Discover a new indoor hobby or rediscover one that you have not done in a while. Need ideas? Maybe baking a new recipe, painting, journaling, make a soup, reading a new book, do a home yoga or meditation video.

Reference
https://my.clevelandclinic.org/health/diseases/9293-seasonal-depression

Author: Anne Marie Mathews, MS, SMFT
I am currently accepting therapy clients. Feel free to reach out if you need help.

​In doing my clinical work, I spend much time supporting and processing the reactions of vulnerable clients from marginalized populations to the current and recent political climate in the United States which has included the Supreme Court ruling that took away federal abortion protections.  For myself and among clients I see, many of whom are not female assigned or identified, a fear nonetheless set in that many of the freedoms, values, and protections that came about as the result of tireless fighting and advocacy for workers, women, people of color, and LGBTQIA+ people, and others could/will be on the chopping block. 
 
Doing the clinical work that I do, I especially found many of my transgender and/or Queer clients fearing for the state of their marriages, their employment, their right to a safe abortion and also for their physical safety in ways that they had not since before the Obama administration.  In many cases, this very real fear has led to an exacerbation of mental health symptoms already present or created symptoms of a severity and duration necessary to warrant an Adjustment Disorder Diagnosis or a diagnosis of Major Depressive Disorder.  To look at how some of the composite reactions I've seen have led to symptom creation and exacerbation, let's take a look at the criteria for Major Depressive Disorder as it relates to the experiences of clients and others as reported and observed and discuss how we as clinicians in this practice approach supporting clients with these symptoms and societal concerns.
 
The symptoms that are potentially part of a depressive episode include: depressed mood, loss of interest/pleasure, weight gain or loss, thoughts of death or suicide, feelings of worthlessness/guilt, fatigue, insomnia/hypersomnia, decreased concentration.  These symptoms need to exist in an episode which lasts 2 weeks or more.  I have seen symptoms such as these arise for the first time or be exacerbated by the current circumstances.  In my clinical work, most notably, I have seen these symptoms arise in clients pertaining to both the recent Supreme Court ruling coupled with comments made by a justice that he might be inclined to vote to overturn the past Marriage Equality ruling that federally legalized marriage for Queer-Identified Individuals.  These federal events coupled with Missouri taking steps to orchestrate one of the most rigid statewide abortion bans in the country, led many of my clients to contemplate leaving the state or residing in a more progressive country.
 
In terms of how I’ve seen symptom creation, depressed mood was most frequently caused by negative and invalidating reactions to the local political situation by clients’ loved ones.  The disillusionment caused by this disconnect often leaves Queer and Trans people wondering how their family and purported friends can support politicians, institutions, and businesses that have agendas and take measures that treat marginalized people in invalidating, harmful, personal safety-jeopardizing ways.  Loss of interest/pleasure in activities often relates to limits in the ability to comfortably engage in hobbies.  Clients often have feelings of worthlessness related to feeling as though their safety and value as a person are being undermined when things like so called “bathroom bills” are being voted upon to not allow transgender people to use the bathroom that corresponds with their identified gender or when Queer and Trans client see reproductive rights for women being rolled back and understandably worry that their much more recent/tenuous rights will be next on the chopping block.  All of these concerns can and have disturbed my clients’ sleep, appetite, and made them feel drained and exhausted.  As such, some, in addition to considering relocation are considering trying psych meds for the first time.  We have been processing the resulting elevated symptomology with our clients and, when needed, referring them for additional services like psychiatric care, support groups such as those at MTUG, 12-Step meetings at place such as the Alano Club, and normalizing our client’s fears and concerns related to the ways in which they are understandably symptomatic/experiencing elevated levels of symptoms due to the fear of losing the already unacceptable level of rights and benefits that were fought for during Stonewall and for decades since, and generally assisting in the formulation of “created family” for our clients who are often being harmed by their biological families and systems of power.
 
If you are someone who is hurting or feeling isolated or in-danger as a result of the current political environment, please know that you are not alone and that others are also struggling markedly with their mental health.  Please know also that even though it can be especially scary for people who have been let down and marginalized by people who should have helped and cared about them, there are service providers some of whom are in the community who are open, affirming, and are advocating both in the field and in their personal lives for LGBTQIA+ people, their marriages, their personal safety, their need for safe spaces including bathrooms, and the need for greater awareness of the needs of this community for the competence of service providers.  While many of us feel that these are dark, scary political times and will be for some time, we at Healing Reflections Therapy are dedicated to affirming and defending the rights of the Queer and Trans communities as well as cisgender women and communities of color. 

​~Chris Scarberry, LPC
 

​We know this is a scary and uncertain time for many of us as we worry about our health and economic futures. Being faced with idea on an extended quarantine can bring up a lot of overwhelming feelings. Perhaps you've noticed more headaches, muscle tension, fatigue, or stomach aches? Your body may be trying to tell you that it is in distress and needs help soothing itself. Thankfully, there have been many people and places that have stepped up to meet the public need.

1) Watch a new movie or TV show to distract yourself:

Movies can be a great distraction and escape from our daily frustrations
Universal studios is releasing movies to stream that are still playing in theatres
https://totallythebomb.com/universal-is-releasing-movies-online-that-are-still-in-theaters-including-trolls-world-tour?fbclid=IwAR3ywHth8TXWE1tf__vqs6HMd1OJtvnsISkk2Hk0_b0KVAXuJEdxRSIZYZc

Disney will also be releasing Frozen II 3 months early to stream.

Netflix has an option to watch movies online with friends!
https://www.gamespot.com/articles/netflix-party-lets-you-watch-with-friends-online-l/1100-6474858/?fbclid=IwAR0N4v_crULpvbbbax0IT3tVmRVTzBL9Uj0Ny0lADstQMCk6wLTaSz8LaMw

Or maybe binge a new TV show
https://www.buzzfeed.com/kaylayandoli/tv-shows-to-stream-if-you-need-a-good-laugh?utm_source=dynamic&utm_campaign=bffbbuzzfeed&ref=bffbbuzzfeed&fbclid=IwAR2uH4tBl7swxOmLeu9sj2wbnKfffBO0FxmNq7e6CamYUBmPd5SuFJb_q9Q

2) Meditate
We need time to relax our bodies with all this stress. Artist Lizzo has been leading online meditation sessions to help calm the community.
​https://www.dailydot.com/irl/lizzo-meditation-coronavirus/?fb=dd&fbclid=IwAR0SG_bzGCxshkrEIYEFGHLi3Vm2jFLoOLFPDKsPxZiofyhlVBYuznack3c

There are lots of apps like the Calm app, woebot, headspace and others that can help you learn to meditate.

3) Learn how to Support your community:
Children's Advocacy Services of greater ST. Louis is offering a webinar for supporting children deal with stress of the virus on March 18 at 1:30 pm. http://bit.ly/casgslcoronaviruswebinar.

Check out the united way resources
https://cdn.discordapp.com/attachments/520648293605441541/689550992957505536/united_way.jpg?fbclid=IwAR0CX7kDO3FS0gcDSmpg4L9KI4Si9HGiV8MIYoBf0TCwqqXYOM7ic5sX5dc

Get help for yourself
https://mhanational.org/covid19?fbclid=IwAR1dHEpS-0e12JTSiNc9BiwQR81e0FhS65UM0IUofnS8wzUYMUXLDBGYb4w​

4) Take some new educational classes:

Scholastic is offering free courses to help your child learn  

https://www.cnn.com/2020/03/15/us/scholastic-coronavirus-students-trnd/index.html?ofs=fbia&fbclid=IwAR11BvJuXo9ZhlKiaB14WL6dZGWd3Pk9Decj3JEX6w-1S2-DHeVUVY7PyAo​


Multiple education companies are offering learning opportunities including Harvard
www.amazingeducationalresources.com

Podcasts like Theaboutsexpodcast, TheLastPodcastonTheLeft, AskaMortician, and CreepyClub all provide a wealth in information on unique topics from ghosts to sex, and death.

5) Take a virtual tour of a national park
​https://totallythebomb.com/heres-33-national-park-tours-you-can-take-virtually-from-the-comfort-of-your-home?fbclid=IwAR0H4QNnOOs1FTgFFxrKv9vJcrCHz83DHZ6ciGke2oJpstZEpUwWZHj_9o8


6) Tour a Museum Virtually
https://anamericaninrome.com/wp/2020/03/italy-museums-visit-for-free-online/?fbclid=IwAR2wAdpGiyp7N689FqlA2rY1xp4MmJER57DjMndAfQ9dMSSZ2pXO6FqaG9A

​Check out art from Paris Museums
https://kottke.org/20/01/paris-museums-put-100000-images-online-for-unrestricted-public-use?fbclid=IwAR3890Gvkzki3YuKhKRu_-7dkXIy4DnP6eiTt326_foMIU4nsKMt_MjZGTs

Tour a Historical site too 
​https://totallythebomb.com/33-historic-tours-you-can-take-virtually-from-the-comfort-of-your-home?fbclid=IwAR1X9tw_zx4CPYpw3hfGnGa9aXmOGLL4AiEztqaLLjZGqZzqFHGVL9cRmyI

7) Go on a Virtual Field Trip to the Zoo or even Mars

docs.google.com/document/d/1SvIdgTx9djKO6SjyvPDsoGlkgE3iExmi3qh2KRRku_w/preview?fbclid=IwAR3fcbhWLgJcaQITxB0niiX9fmq0yqWQ1xszKE3Z3sSGBuPfEuAu4yXatxg​

Check out NASAs public library of free images
https://www.diyphotography.net/nasa-makes-entire-media-library-publicly-accessible-copyright-free/?fbclid=IwAR0HReZYiNRQ694JX61SdOWym8MWmcEtJ3otLOG80qGATv_fW2gS1va_22Y

8) Laugh a little
Watch some comedians on youtube or netflix. Laughter is the best medicine they say.

9) Read some books
Your library has free books you can rent and download to your kindle app. 
Audible will also give you a couple audio books free with a subscription.
Amazon frequently offers free books available to download each month, or get the unlimited subscription for $10.

10) Learn a new language
This is a great opportunity to learn that language you always meant to. There are many podcasts dedicated to helping you learn. Check out Coffee Break podcasts.

11) Garden
This is a perfect time to plant some seeds and grow some fruits and vegetables. Start prepping your garden for spring. Get some fresh air. Gardening is great exercise too.

12) Learn a new hobby
This is the perfect time to learn to play that guitar that has been sitting in your basement, to finally figure out how to crochet, to complete the jewelry making project, to finally figure out how leatherworking is done (see Tandy leather), to learn the art of blowing glass or resin making, to hone your cooking, to try out all those projects on your pinterest board, to practice your calligraphy...whatever it is youtube has so many videos on perfecting your craft and facebook has many groups you can join to help you improve your skills.

Perennial St. Louis will be posting online tutorials for crafting and upcycling in a sustainable way.

13) Practice Yoga
Https://m.youtube/watch?feature=share&v=wsfLjSH-q44

​https://totallythebomb.com/15-free-fun-virtual-workouts-to-get-your-exercise-in-while-you-are-at-home?fbclid=IwAR1SziNVATY8Ae8lRTQrVQR3qlZuzAwhla4fv1LvzceprNRi0QXLKzpzY8U

14) Re-connect with Family and Friends
So often in the modern world we have complained about social media and work driving us apart. Take the time to reconnect with your loved ones. Call or skype them, dust off the boardgames from your closet, share a puzzle together, get out that deck of cards, maybe even share stories or poetry.

15) Home renovations
You are home. You probably have projects you've been meaning to get to for a while. Pour your energy into something productive.

16) Scrapbooking 
Whether you have the scrapbook supplies you've been meaning to get to since your kid was born (and they are now 10) or you have an online album you were meaning to create, now is the time to sort and organize your memories into something meaningful.

17) Pet love
Animals can provide great comfort in times of stress. This is a great time to get in those extra snuggles and walks that make you both feel better. Animal videos on youtube are always great. Have you seen the videos of Fiona the baby hippo? Adorable! 
https://www.cnn.com/travel/article/cincinnati-zoo-coronavirus-fiona-hippo/index.html?fbclid=IwAR3cx7BAmPirnLaVEPZcrQKQE1uTyZy_M3WYjoQ7KwoX0TvxkWd4zhZZAk0
​See her here:
https://www.facebook.com/events/2915534028492292/
 
watch other cute animals
https://www.thedailybeast.com/stay-sane-during-your-quarantine-with-these-animal-livestreams?source=TDB&via=FB_Page&fbclid=IwAR1fps5sBAUDFheN7zL0MbhjMwB2GsQvqJwnS0HZhi102OMv--zNp0_PGxw

​Check out these funny cat tik toks
https://www.huffpost.com/entry/cat-tiktoks-we-need-now_n_5e70f0e8c5b6eab7793d3e2f?utm_campaign=hp_fb_pages&ncid=fcbklnkushpmg00000063&utm_medium=facebook&utm_source=main_fb&fbclid=IwAR2oADk1zbYnhMdQivotC1EP-5biS_vehhYrZZbfgs1wjrKQJ8nwZTmDRT8
​
18) Spa Day at home
Your body needs relaxation. Take a warm soothing bubble bath, add those candles and essential oils, maybe turn on some relaxing music. Put a blanket in the dryer and then wrap it around you when it's nice and warm. Make yourself a cup of hot cocoa or tea, and wrap your palms around the mug allowing yourself to feel the soothing warmth while you inhale the pleasant aromas. Maybe add some marshmallows if you have them. Get out your box of nail supplies and pain and buff those nails. Try that paraffin spa or massage cushion that has been sitting in a box for years. You can fill some rice into a sock, infuse eucalyptis oil and you have a nice face mask. Check out pinterest for ideas for homemade spa essentials.

​19) Listen to music

Music is usually one of the most calming things for people. Get out your playlists, maybe bust out your cds, watch some youtube videos, listen to spotify.  Some musicians like the singer from Coldplay have been doing impromptu online concerts. Cellists like Hauser have been creating beautiful peaceful content. Don't forget to sing and dance while you are at it!

Clownvis Presley is also providing online entertainment in upcoming broadcasts online
 https://www.facebook.com/ClownvisPresley/

Enjoy a free concert
https://www.npr.org/2020/03/17/816504058/a-list-of-live-virtual-concerts-to-watch-during-the-coronavirus-shutdown?utm_campaign=npr&utm_source=facebook.com&utm_term=nprnews&utm_medium=social&fbclid=IwAR1GS3yF8sAlvJ6zZNcj7JW8HDcfjfHHlWBPG6PE2AipX6pciez9SAMs4Fw​

More live concert links
https://www.stayathomefest.com/?fbclid=IwAR19yYnShCXaLMHWhmz8IOLMElddnlS8x-MzRVLF2zdWJpPHSdkXj44M6fE

​20) Catch a broadway show
Multiple Broadway, orchestra, operas, and high school theatre companies are continuing their shows, only doing them online for others to enjoy.  It's a great time to take in some free culture.
​https://playbill.com/article/15-broadway-plays-and-musicals-you-can-watch-on-stage-from-home?fbclid=IwAR0Ptyqeh4WCxJ5dy3ntGr-AHDAFZckWAmIzMwEHHqDd2xEhuMusP__mvKw
​
More concerts and performances here
https://www.pbs.org/newshour/arts/the-show-must-go-on-if-youre-isolated-at-home-watch-these-performances?fbclid=IwAR0hTCPzYzmO0V5f5U_L3i7Zx7_t6wwpUm4tD2kWeZws7ZOPYISvc68omeM