How can I find trustworthy friends?

Most of us have had a range of friend experiences.  There's the loyal best friend, who's available at any time to laugh or cry with you.  The occasional acquaintance, who you see in the same social circle but don't know very well.  There's the high school friend who remembers your embarrassing moments as well as your triumphs.  And then most of us have had an experience with the bad friend.  

This could be an experience of betrayal, or one of simply being used up.  It could be as simple as having betrayed a secret, or maybe as complex as turning other friends against you.  These experiences can be extremely painful and can ruin relationships.  

So how do we tell which friends are worth trusting?  Is there a way to know before you work on a relationship?

Sort of.  Naturally, there's no foolproof formula for this.  However, there are certainly some warning signs for those people who are truly toxic.  

  • Look for a person who has other friends.  If he/she has no other friends, there is probably a reason.  This isn't to say that you can't befriend him/her; some people are just shy.  But if the person has no other social life, then you will be the person he/she leans on for everything.  Consider the idea that this person may have alienated his/her other friends.  Even if s/he is very close with family, s/he should have friends, too.  
  • Watch out for a string of unstable or broken relationships in the person's past.  Everyone has a few broken relationships, but your potential friends should not have very many.  It's rare that one needs to truly cut another person out of one's life.  A pattern of short-lived volatile friendships or romantic relationships is not a good sign.  
  • How do you feel after you've been with this person?  Are you energized and happy, or do you feel drained or angry?  Overall, you should feel good about spending time with a potential friend.  You should feel that you have gotten some of your social needs met.  Introvert or extrovert, everyone has some social needs, and your time with a friend should make you feel confident and cared for.  Of course, sometimes you will spend time listening to a friend who is going through a rough time, and this may cause you to feel sadness along with your friend.  
  • Are you compromising your own needs or boundaries for your friend?  Is your friend regularly calling in the middle of the night, or doing something you've asked him/her not to do?  Do you find that you get sucked into doing favors for this person when you don't want to?  A good friend will respect you and your feelings.  S/he won't ask for something that you can't give, or that would take you away from other friends and family.  
  • Is your friend jealous?  Is s/he angry when you spend time with other friends or with your spouse?  A good friend will want you to grow and to have a healthy social and family life.  
  • How much of the time is about you?  50% of time spent with your friend should be spent talking about things that you want to talk about, or doing activities you like.  If you're always doing what the other person wants to do, you can try asking your friend to alternate who talks or who decides on an activity.  A good friend will understand and will be happy to go 50/50 on this.  

Which kind of psychology professional do I need?

The field of psychology is broad and encompasses many different kinds of professionals with many different degrees.  This post will help you think about your needs and whether Sweetwater Counseling is the right choice for you.  These guidelines apply for Pennsylvania.  

  • Psychiatrist: This person has a medical degree and can prescribe medications.  S/he will get an idea of your symptoms and will work with you to try to find a medication-based solution.  S/he will usually also recommend that you work with a therapist or counselor weekly in order to find behavioral and environmental solutions.  You will probably see your psychiatrist about once a month until you find out what prescriptions work for you.  Your psychiatrist may also do some talk therapy with you, but this is rarer.  S/he may recommend some medical testing to find possible causes of your symptoms.  
  • Psychologist: This person has either a doctoral degree in a psychological field (can be anything from Christian Counseling to a Ph.D. in psychology) or was grandfathered in under a previous licensing system and has a Master's Degree in a psychological field.  S/he will use counseling techniques to help you talk about your symptoms and to guide you toward finding solutions.  
  • Counselor: This person has a Master's Degree in a psychological field.  This can be a social work degree, counseling ministries degree, or clinical psychology degree.  S/he will help you to meet your goals using non-pharmaceutical methods.  These can range from traditional talk therapy to solution-focused or art therapy and many things in between.  Can work with families, couples, and individuals.  
  • Marriage and Family Therapist: This person has a Master's Degree in a psychological field, and will use similar techniques to a counselor.  Can work with families, couples, and individuals.  
  • Coach: This field is not as strictly regulated in the state of Pennsylvania.  A coach tends to work for a specified time period to achieve personal and professional goals, and focuses on those goals rather than emotions.  

 

It is very important that you check the kind of degree that your clinician has.  Many people have degrees in social services and counseling fields, but they are not all able to provide the same level of care, and their focus may be different from yours.  It's not enough to determine what level of degree it is, you need to find out what the degree is in.  

  • Clinical Psychology: This course of study encompasses a whole-person paradigm of psychological health.  A degree in this area means that the holder has studied biological, cultural, environmental, and family bases for health and illness.  S/he has studied child and adolescent development, personality psychology, social psychology, family and marital therapy, and counseling skills.  S/he is able to review and understand current scientific research.  S/he will be familiar with many different methods of dealing with anything from life transitions to depression and anxiety.  Depending on the bestowing institution, a faith focus may be included.  Sweetwater Counseling clinicians all have Clinical Psychology degrees.  
  • Counseling: This course of study deals more with counseling skills.  This person will be familiar with several methods of counseling directed at different kinds of illness or life transition.  S/he will often have an empathic focus.  This degree is similar to one in Christian Counseling.  
  • Counseling Ministries/Pastoral Counseling: This degree focuses on a religious framework of counseling.  This person has worked on the integration of counseling skills with relgion, and has studied the field of psychology primarily from a religious perspective rather than a biological one.  These degrees often focus more on using Biblical wisdom as a method to counsel.  
  • Biblical Counseling: This degree is not a psychology degree, but a religious one.  A Biblical counselor will help you apply the wisdom of the Bible to your daily struggles, and can help with spiritual direction.  
  • Social Work: This degree focuses on the cultural and social aspects of problems in living.  This person can often help with family issues and is a good choice for someone who is looking for help navigating possible services available.  S/he is very knowledgable about charitable organizations and govermental services that might be a fit for your needs, and can help you interface with these organizations.  S/he has studied cultural variables that might cause your trouble.  

Anxiety and Caffeine

I look forward to my morning tea with a deep yearning  I can imagine the sound of the heated water, the unfurling steam as it hits my cup, the copper-brown of my beloved Darjeeling, and the first scent of the leaves on the water. 

A lot of us either need the caffeine to get our brains running, or enjoy the ritual and flavor, or maybe both.  Nothing else quite does what caffeine does, which is why humans have cultivated those plants that provide it.  

If you're struggling with anxiety, though, it behooves you to think seriously about how much caffeine is in your diet.  I'm not talking about whether caffeine is unhealthy for you - the science on this comes and goes, but moderate caffeine intake for healthy adults is safe.  

This post has to do not with whether caffeine is permissible, but whether it is beneficial.  If you already fight anxiety symptoms, the last thing that you want to do is to add a stimulant like caffeine (or nicotine, or cocaine, or herbal stimulants).  Stimulants will exacerbate your anxiety symptoms, and are often the trigger for panic attacks.  

I know that deciding to limit or exclude caffeine from your diet isn't easy!  But I have also worked with more that one client who was able to stop panic attacks altoghether simply by eliminating concentrated caffeine from his/her diet (small amounts of chocolate don't seem to be problematic, but every body is different).  

Remember that the half-life for caffeine in the body (the time at which half of the caffeine has been metabolized) is about 4-6 hours.  This means it can be eight or more hours before it's all gone.  If you are experiencing early insomnia, that 2pm latte may be to blame.  

It's not just caffeine that's a problem either: stimulants like ginseng, yerba mate, and guarana can cause the same problems.  Sometimes these plant-based stimulants are included in herbal supplements for energy, or in sports supplements touting strength and endurance.  Nothing harshes your workout buzz like a panic attack!  

In the end, you must decide whether caffeine is worth the anxiety symptoms for you.  If your anxiety gets bad enough, you may be willing to try going without stimulants for a while.  You can put up with it for a week, and make sure to track your anxiety symptoms to see how they change. 

If you decide to try it: find extra energy and stimulation from staying hydrated (dehydration can make us feel drowsy), eating snacks with long-lasting protein energy, and elevating your pulse by keeping your body active.  Do a few jumping jacks to wake up, or take the dog for a walk.  When your attention starts to wane in the early afternoon, walk briskly around the block.  Stretch your muscles to move blood through the body faster.  

Coffee, energy drinks, and sodas are the biggest purveyors of caffeine, but you can certainly get it from other sources.  Black tea, green tea, and white tea all have caffeine, and if you drink enough (two cups of black tea equals one of coffee), you're in for the same possible problems as someone with an energy drink.  

Oh, and just to dispell the myth: if you drink a stimulant plus alcohol, you aren't going to melllow out the anxiety potential.  Sorry.  

Your first steps toward preventative care (and a use of the phrase "fixin' to")

The first thing to address when thinking about a healthy mind has to be the biological brain-as-blob-of-meat issue.  Wait, don't skip this one!

It may seem like you've already heard about how it's important to keep your body healthy.  And it is.  But not just for the nebulous goal of "health and long life".  It's impossible for your brain to function at its peak if your body is poorly maintained.  You can actually contract mental illness just by failing to take care of your body (Moy 2009).  And not just dementia or anorexia nervosa. 

If you're concerned about maintaining your mental health, or if you've struggled with depression or anxiety and you worried that you might relapse, you can't afford to dismiss your physical health.  I'll talk more about what that exactly means.  Yes, I actually talk to myself to help me write.  Shut up, it works. 

This makes sense, if you think about it.  Your brain is an organ, so just like your heart or lungs, it's affected by obesity, high cholesterol, thyroid problems, vitamin and mineral deficiency, and myriad other conditions.  The brain is powered by nutrients in the blood, which come from everything you consume, like food, beverage, drugs, air particles, and chemicals.  If you don't take care of the brain's needs for nutrients and oxygen, it can't possibly serve you properly.  It would be like giving a race horse nothing but corn husks and dirt and then wondering why he doesn't keep up with his peers.  Your brain only gets what you decide to give it.  You have to actively choose to give it the best you can, and your brain will serve you well for years to come. 

I'm fixing to (my mom is from Oklahoma, where that phrase is common) give you some ideas on this in later posts.  The main one I want to emphasize for now is regular check-ups with your doctor.  And while I'm at it, nothing on this blog should be considered as medical advice, because I'm not a doctor and I don't want to get sued.  And I don't have anything worth suing over, except my wonderful family. 

But you should go see your actual doctor.  He/she can do all kinds of helpful things, like checking your blood pressure and BMI, monitoring your prescriptions, answering questions about any symptoms you have (you want to get that rash looked at), and telling you about other tests you should have regularly, like mammograms, prostate screening, and PAP tests.  Although these things don't seem directly linked to your mental health, they absolutely are.  That fatigue you're feeling could be a blood chemistry problem, and the anxiety might be caused by excessive caffeine or sugar.  You could get the mental health symptoms taken care of as easily as a single doctor visit.  So call your PCP (primary care physician, not angel dust.  More about drug use later)! 

Moy, M. L. et al. Multivariate models of determinants of health-related quality of life in severe chronic obstructive pulmonary disease. The Journal of Rehabilitation Research and Development, Vol. 46, 2009, pp. 643-54

What's with the Latin?

Sometimes, when my colleagues and I are in a particularly expansive and idealistic frame of mind, usually aided by some Malbec and a dangerous feeling of daring to stay awake far later than bedtime, we fantasize about a world in which psychological health is broached in the same was as physical health.

Sort of like this - income disparities aside, many of my readers take basic daily actions to care for their bodies and those of their family members. You might make sure to really really try to get eight hours of sleep, or at least insist that your teenager does. You scrub your body free of bacteria and you keep your hands and face especially clean to prevent infection. You brush your teeth, so that when you're older, you still have teeth to brush. You probably give some thought to the nutrition of your breakfast food, at least when you're buying it in the store (you know, when you thought about buying the packet of plain oatmeal and somehow ended up home with Frosted Flakes®).

So by the time you get to starting your day, you've performed several actions that are designed to provide health and long life. Don't forget about your annual doctor visit, your trips to the eye doctor, dentist, GYN, and any specialists you see. These are all just for you – you're also probably taking care of your family's health as well! Those of we with pets even take them to the vet every year.

Now ask yourself this: what was the last thing you did for your brain's health? Did you throw one of those fish oil supplements at it, work half the newspaper crossword two weeks ago and then hope for the best? If so, you're a little bit ahead of the curve.
See, psychological health plays more like emergency care for most people. You're arguing constantly with your teenage daughter, and just about the time you think you will lose your sanity if she slams that door one more time...

you find a therapist in your insurance network, see him/her for ten sessions until the crisis passes, and then you head back to your normal life.

What if it didn't need to be this way? Can you imagine, like my wine-soaked peers, how we might do life differently if we kept tabs, even passively, on our brain health? Even better, are there some simple things that could actually help prevent those crisis situations, so that instead of needing to see a counselor right the hell now, we could be aware of a problem building and defuse it?

I'm so glad you asked.

Insanity Wolf!

Insanity Wolf!