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Craig Alan Brown, MD
Serving the San Diego Community Since 1975

Recommended Reading: A Critical Piece of Your Mental Health Journey

2/11/2020

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If you're struggling with a mood disorder, looking into the future can be daunting; the road in front of you may seem long, and full of obstacles.  This article from Hope to Cope, A Critical Piece of Your Mental Health Journey, argues that a shift in perspective - making the conscious choice to focus on the here and now, one day at a time - is a vital piece of the puzzle.

A Critical Piece of Your Mental Health Journey, by Carol Rickard

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Isolation: Challenging Yourself to Make a Change

9/29/2017

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          If you’re struggling with a mood disorder like depression or anxiety, it’s tempting to want to keep yourself isolated.  It’s easy.  There’s no pressure involved.  It seems comforting.  It feels like a solution, albeit a temporary one (“I don’t want to see anyone, so I won’t – problem solved!”) and it’s easy to talk yourself into what feels safe.

          As tempting as it may be, it’s important to remember that isolating yourself never actually makes you feel better.  It may feel like a quick fix, but it’s not a solution.  By staying isolated you keep yourself from developing more effective coping tools for handling your mood disorder, and you end up perpetuating a cycle of isolating behaviors that keep you running in place rather than moving forward.
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          It can be difficult to challenge yourself to step outside your comfort zone, but remind yourself that no one grows by staying comfortable.  It’s a willingness to make a change – to sit with feelings of discomfort – that creates room for growth.  In other words,

          “Nothing changes if nothing changes.”

          If you’re feeling unsure of how to make a change, the following suggestions may be helpful in getting you started.  Don’t feel the need to make any huge, drastic changes: baby steps can add up to big progress.

  • It Starts at Home:  If you feel overwhelmed at the prospect of even leaving the house, start small.  Reach out by making a phone call to a friend or family member.  Send an email or a text message.  Ask a friend of family member to visit you at home for a cup of coffee, to watch a movie, or to have dinner.

  • Find a Community:  Finding a support group or community – either online or in your area – can help you feel more connected and less isolated.  The Anxiety and Depression Association of America and the Depression and Bipolar Support Alliance both offer online resources and support.
                           Anxiety and Depression Association of America
                           Depression and Bipolar Support Alliance

  • Keep it Low Pressure:  Challenge yourself to spend some time in public places that don’t require much interaction.  Read a book in a coffee shop.  Go for a walk in the park.  See a movie.  Push yourself to spend some time outside and in public spaces.

  • Make an Appointment: Set a specific date, time, and place to meet someone.  It can be easy to talk yourself out of getting out of the house, but if you schedule something specific, you’re less likely to make an excuse – nor will you want to disappoint the person you’re meeting.

  • Keep Going:  Don’t get discouraged if you feel overwhelmed.  It’s okay to start small – you don’t have to run out the door and sign up to lead a book club or start a class in public speaking.  Try setting some small, manageable goals that will keep you challenged.  Check in with a friend or family member every few days.  Schedule a weekly trip to the park or your local coffee shop to catch up on some reading.  Remember that it’s only through challenging yourself that you can expect things to change.
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Recommended Reading: Overcoming Anxiety

9/1/2017

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Check out this article from Esperanza magazine for tools and recommendations on how to manage your anxiety and/or panic disorder when symptoms arise.

Overcoming Anxiety
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Recommended Reading: When Anxiety and Depression Go Together

7/6/2017

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This article from Esperanza magazine highlights the ways in which mood disorders, specifically anxiety and depression, overlap, and how treatment for your mood disorder may vary based on your needs.  Access the full article via the link below.
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Ask the Doctor: When Anxiety and Depression Go Together
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Mindfulness: Learning to Be Here Now

6/30/2017

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​          When we struggle with a mood disorder we often spend much of our time in our head.  We ruminate over the past.  We fear the future.  In a rush to hit the next milestone in our lives – be it our next vacation, a promotion, buying a home – we’re rarely present in the moment.

​          We think we’re planning ahead and staying one step ahead of the game, but the reality is that by living in this “what’s next?” mentality we end up missing out on actually living our lives.  We forget that life is lived in the in-between moments: brewing our first cup of coffee in the morning, kissing our partner goodbye in the morning, walking from our car to our front door.

​          We write these moments off as stepping stones that get us where we really want to be, and forget to be present in our own lives.  The reality is that we cannot control the future, no matter how much we plan and prepare.  The moments we spend in anticipation, anxiety, and worry do nothing to change what tomorrow will bring.  Practicing mindfulness can help us stop living in the past, and keep us from living for a future we cannot predict.

​          Life will continue to surprise and challenge us.  No one can guarantee that every moment will be thrilling, joyous, or full of satisfaction, but we can challenge ourselves to live them – to be present for them.  We can learn to say goodbye to “what is next?” and embrace “what is now.”

​          The tools and exercises below will help you practice being present, and mindful, encouraging you to find enjoyment and gratitude in each moment as it comes – regardless of what lies behind or before us.
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Mindfulness Exercises
  • Find & Embrace a Mantra: When our thoughts begin to race and anxiety begins to rear its ugly head a mantra can help us slow down, and hit the reset button.  Find one that resonates with you and repeat as necessary.  Some effective mantras may include:
 
                         Be here now.
                         Be present.
                         One thing at a time.

  • Check In: Taking a moment to evaluate where we are and touch base with our feelings can help us stay balanced.  If you feel you need some structure, try using the following format:
 
                         I feel angry that…
                         I feel sad that…
                         I feel afraid that…
                         I feel guilty that…
 
                         I feel happy that…
                         I feel secure that…
                         I feel proud that…
                         I feel grateful that…

  • Sensory Check: Name five things you can see, hear, smell, and feel.
 
  • Breathing Exercises – Combat Tactical Breathing: This breathing technique – used by the military, athletes, and first responders – is an excellent way to reduce your levels of anxiety, gain control, and manage your stress. Find a quiet spot where you can sit or rest comfortably without being disturbed. Bring your attention to your breath.
 
                         Breathe in comfortably to the count of four.
                         Pause and hold the breath (again, comfortable) to the count of four.
                         Exhale slowly and forcefully to the count of four.
                         Take at least three to five breaths as described above, visualizing each number as you count.

  • Stretch: Take a few minutes to connect with your body.  Moving slowly, note any particular areas of tension, and breathe deeply into the stretch.

​          Experiment with different mindfulness exercises, and find what works best for you.  Challenge yourself to be here now.  In the words of Eckhart Tolle, “In today’s rush, we all think too much – seek too much – want to much – and forget about the joy of just being.”  Let yourself be.  It is enough.
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Do I Have Depression, Anxiety, or Both?

10/10/2016

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          Struggling with a mood disorder is like navigating a confusing maze of complicated and overwhelming emotions, and seemingly inexplicable triggers.
 
          Making it all more complicated is the fact that depression and anxiety not only often overlap – people can have anxiety and depression disorder at the same time, just as people can have two or more of any other medical disorders, like high blood pressure and migraines - but they frequently exhibit similar symptoms, leaving you wondering, “Do I have depression, or anxiety?”
 
          Like most medical issues, the answer is rarely simple; people who suffer from anxiety or panic attacks often feel depressed because the anxiety impairs their ability to function normally, complete daily tasks, or even leave the house.
 
          Crying spells, for example, can be especially confusing (women in particular tend to be susceptible, while in early adolescence men lose the ability to try as an emotional release).  While crying can often be a normal and healthy response, persistent crying spells can be an indicator of anxiety and/or depression.
 
          You may think, “I am crying all the time,” or “I feel bad/worthless,” and conclude, “I must be depressed,” but the reality can be more complicated.  Feeling overwhelmed by anxiety and panic attacks can often make you feel depressed, feel bad about yourself, and you may feel even worse because you aren’t able to simply “suck it up,” get a handle on things, and do what you “should” be doing.
 
          Frequent crying spells are indeed one of the signs of depression, but panic attacks and anxiety (including persistent and all-consuming feelings of worry, fear, and dread) leave its victims feeling overwhelmed; crying is an entirely understandable response to these emotions, and may not necessarily mean you have a depressive disorder.  It is “depressing” to feel bad about yourself, and to be unable to function well, but it is not always a sign that you have depression.
 
          Amid all the confusion and overwhelming emotions, the questions inevitably follow: “So how do I know?” and “What do I do?”  Like most medical problems, anxiety and depression are about balance - think of a see-saw; if you have high blood pressure, it’s a sign that your body has not been able to successfully control and keep your blood pressure in balance.  A medication may be prescribed to bring your blood pressure under control, and restore your body’s equilibrium.
 
          ​The same is true for panic attacks and anxiety; the right medication can be used to help control your anxiety – helping your body find balance, leaving you in a position to regain control of your life, and freeing you from the overwhelming feelings of panic, worry, fear, the resulting depression – and even the crying spells.
 
          There is no such thing as a “one-size-fits-all” approach to treating a mood disorder; the ways in which anxiety and depression overlap and present themselves can be confusing, frustrating, and leave you feeling as though you are at the end of your rope.  There is, however, always hope.  The right physician and combination of medications can help you manage your anxiety.  Once your anxiety (however severe) has been successfully managed with medications and the “dust settles,” it will become much easier to differentiate between symptoms related to anxiety and symptoms related to depression.
 
          ​Because the differences between anxiety and depression can be nuanced, and further complicated by the way symptoms of severe anxiety can mimic or cause feelings of depression, it’s important to seek help from an experienced professional.  Though the path to recovery is rarely linear, the right combination of medication and psychotherapy you can help you find balance, manage your symptoms, and get you back on the road to living a life free from panic and anxiety.
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You Are Not Your Disorder

9/7/2016

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          In a society in which mental illness is often misunderstood, we often struggle with depression, anxiety, and other mood disorders behind closed doors for fear of how we may be judged by others.

          The latest data from the National Institute for Mental Health indicates that nearly one in five adults (18%) in the United States battles an anxiety disorder.  Nearly 15 million struggle with major depressive disorder, and yet the stigma of mental illness is alive and well.

          ​With the stigma surrounding mood disorders, it’s so easy to fall into the trap of feeling defective – like a typewriter with a few missing keys.  We isolate ourselves.  We forget that others struggle too (perhaps quietly, as we do).  In moments of despair, keep these words in mind:

          ​You are not your disorder.

          You are not your depression.  You are not your anxiety.  These are things you battle.  They are a result of chemical and biological imbalances – not of your failure to “suck it up” or simply “get better.”  You are not defective or broken, and you do not need to be “fixed.”

          If you were diagnosed with arthritis, would you tell yourself you’re a failure because you have arthritis?  Would you define yourself based on that condition?  Feel inadequate or weak?  You are more than a diagnosis.  By learning to think of your mood disorder the same way you can begin to make changes and develop better coping skills for dealing with your depression or anxiety.
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          ​You are, in fact, a person, and entitled to all the complicated, crazy, wonderful feelings associated with being human.  Practice giving yourself the same compassion and encouragement you’d offer to a friend or loved one.  Give yourself permission to be imperfect, and focus on taking each day as it comes.

          Extend this kindness and compassion to others.  It may feel as though we’re alone in our struggles, but if we delve a bit deeper, we often find others are in the same boat.  Author Ian MacLaren once wrote, “Be kind, for everyone you meet is fighting a hard battle.”
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          ​We all struggle.  We all stumble.  The truth is that no one has it completely figured out, and that is okay.  No one is perfect.  And that is beautifully human.
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    Dr. Craig Alan Brown has been providing the highest quality of care and support to the San Diego community for over forty years.

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Dr. Craig Alan Brown MD
Diplomate American Board of Psychiatry and Neurology

1507 Crest Road
Del Mar, CA 92014
​Phone: (619) 790-9754
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Fax: (619) 393-0615