by: Dr. Marisa Murray, C.Psych. (Supervised Practice)

You’ve prepared for weeks. Or maybe you haven’t? Your social life–at this point, is non-existent! Whether you’ve studied to the brink of reciting the material in your sleep or if your total exam prep has consisted of overnight cramming, when exam day arrives, the same thing often happens. Thoughts of uncertainty begin to kick in, leaving you feeling overwhelmed and anxious.

It’s natural to feel some butterflies in your stomach before an exam. It’s similar to the way you might feel before playing in the big game, performing on stage, or engaging in public speaking. Pre-exam jitters can be channeled to help motivate us to perform at our best. This is known as a helpful kind of anxiety. It helps us view the exam as an exciting challenge!

It’s the unhelpful kind of anxiety–the one that causes us to fear the exam, to have difficulty concentrating, to second guess ourselves or to have physical symptoms, like a headache or a racing heart–that interferes with our performance.

With exam season fast approaching, here are some helpful tips for managing your pre-exam anxiety: 

1. Use your time effectively: No matter how hard you try, it can feel like there is ‘never enough time’ around exam season. Fine-tuning your time-management skills can include: using a calendar or a checklist to set goals, avoiding potential distractions (e.g., phone, your guilty pleasure on television) during study time, and keeping a consistent yet flexible study routine while rewarding yourself for meeting your study goals.
2. Engage in self-care: Take care of yourself to manage your stress levels. Getting a good night’s sleep, taking breaks (typically ones that allow for stretching, moving around, replenishing food and water intake), engaging in social interactions, and/or practicing a relaxation activity are examples of how you can release some of the pre-exam stress. Just as you schedule your study time, schedule time for yourself!
3. Develop a study plan: Consider putting together a realistic study plan that allows for flexibility. In developing your study plan, figure out which exams require more prep time. Also, try to factor in some wiggle room for potential obstacles that might interfere with the study plan (e.g., coming down with the flu!). Most importantly, figure out what helps you reach your optimal studying – do you study better alone? Or do you better achieve your studying goals in a group setting? Do you like to study in the comfort of your own home? Or do you prefer the silence of the library? Do you learn better visually? Auditorily? What time of day do you retain information best? Try to answer these questions and incorporate the answers into your study plan.
4. Monitor your negative thoughts: Telling yourself, “I’m going to fail this exam,” can be very convincing to the powerful mind and, yes, exacerbate anxiety! Keep in mind that there will be questions you know and others you don’t. You cannot learn everything! Try to view your upcoming exam as a new experience. Perhaps the midterm didn’t go as well as you wanted – this is a new exam. Work on convincing your mind that you will “try your best.”
5. Make use of available resources: Many schools offer workshops and presentations related to stress management, test-taking strategies, and time-management. Look into what’s available on campus. Also, make use of your professors’ and teaching assistants’ office hours to get a better grasp on challenging course material. Finally, consider reaching out to a mental health professional for assistance in managing unhelpful exam anxiety.

Dr. Marisa Murray, C.Psych. (Supervised Practice) is a psychologist in supervised practice at the Centre for Interpersonal Relationships (CFIR) in Toronto, Canada, under the supervision of Dr. Cassandra Pasiak, C.Psych. Dr. Murray supports children, adolescents, and adults with psychological treatment and assessment services, including psychoeducational assessments and treatment for eating disorders and body image-related issues.

by: Dr. Brianna Jaris, C.Psych.

The holiday season is an incredibly stressful time for many people. There are some things that we may not be able to avoid – congested malls, traffic and travel, holiday gatherings and parties, buying gifts, etc… but, throughout it all, the best thing that we can do is to give ourselves the gift of self-care. Here are a few things that we can do to make the best out of this holiday season:

1) Make a plan – Be prepared by making a plan. For example, make a grocery list or plan out when you can do your holiday shopping. Having a plan is the first step in preventing the added stress of forgetting something or having to do things last minute. 

2) Be proactive – Don’t wait until the last minute to shop for groceries for a holiday dinner or shop for gifts. Getting things done ahead of time can give you a great sense of accomplishment and can help avoid the stress of overwhelming yourself with having to do too much at once. 

3) Be realistic – For example, plan for there to be traffic or for the shopping centres to be busy. Also, set a budget and don’t go overboard. It’s important to realize that you may not be able to do it all yourself, so don’t be afraid to enlist help if you need to as well.

4) Set up appropriate boundaries – Establish a timeline for visitation – don’t let guests overstay their welcome. Do certain topics of conversation need to be set as “off-limits”? Don’t forget that setting up healthy boundaries also means being able to say “no” to people or demands. Remember that in order to be healthy, sometimes you have to risk disappointing other people.

5) Build time in for yourself – The most important thing of all this holiday season is to take care of you. Take breaks and build in time to relax as necessary. Self-Care is the best gift you can give.

Stay ahead of stress this holiday season by sticking to a plan, recognizing your limits, and not letting others dictate your holiday. We all want to make the holiday season special for the ones we love, but don’t forget to take care of YOU this holiday season!

Dr. Brianna Jaris, C.Psych. is a clinical psychologist at CFIR.  She has extensive experience in psychological assessment and diagnosis and the treatment of a wide range of psychological issues, including trauma, depression, anxiety.  She is currently the head of CFIR’s Trauma and PTSD service. You can visit www.cfir.ca to find out more about Dr. Jaris.

In our modern commuting lives, there may be nothing less infuriating than traffic and congestion. No doubt, in recent years there has been a notable jump in commute times across most Canadian cities and as a result a more significant presence of “road rage”. You might be all too familiar with the trademark experiences of road rage: the honking horns, the screams from passing cars, or the casual use of the middle finger. However, we’re less likely to have ways to help deal with the stress caused by traffic and congestion.

Here are some great tips to put the brakes on road rage: 

1. Listen to audiobooks – Find and explore new subjects of interest to you that will both expand your mind as well as allow you to focus on something other than the cars around you.

2. Take Deep Breaths – This simple strategy can be quite effective in reducing stress. Try this: Get comfortable in your car seat, take in a deep breath in for four seconds, then hold this breath for seven seconds, and slowly breath out for another eight seconds. Try to relax your body as you slowly release this breath. 

3. Get out of your head and into your body –  Sometimes we get so wrapped up in our heads we forget about the rest of our experiences. Try this: While paying attention to traffic get comfortable in your car seat, start to notice where your body is making contact with the car, focus on a particular sensation, try to hold your concentration on the feeling, note any distractions, and then try to move your attention back to the sensation. To deepen this exercise, include deep breaths. 

4. Be curious about the experiences of those in the cars around you – When we are face-to-face with someone, we can more easily experience empathy for others – but when they’re a car-length away, understanding can sometimes become difficult. When driving, try to imagine the lives and faces of the individuals in the cars around you. Like you, they’re bound to make mistakes. This empathy technique can help reduce feelings of anger and frustration.

5. Explore your musical tastes – Music can be an excellent way to decompress and bring feelings of happiness to commuting. However, it’s best to take notice of what type of music you’re playing. Is it aggressive or angry? It might not be the best time to explore this type of music when you’re behind the wheel. Try something more uplifting, relaxing, or neutral to keep calm and avoid anger. 

6. Take the scenic route – Though not always possible, occasionally adding a few minutes onto your commute may be worth it to avoid congestion. Sometimes an extra ten minutes down a picturesque tree-lined street is ideal in comparison to a gloomy and congested highway. 

7. Make congestion part of your decompression – This cognitive shuffle can help turnaround the way you feel about your commute home. Try looking at this period as a time you can leverage. Shift this time from being lost to instead being a valuable part of your day to disconnect, explore, or grow using some of the other strategies discussed in this article. 

These tips should help you lessen some of the effects of road rage and traffic congestion. However, if you feel like your anger still feels out of control, it might be time to seek help. Skilled clinicians at CFIR can help you understand your experiences of anger and support you to build a more resilient and healthy self. Click here to book your free consultation now.

by: Joshua Peters, M.A., R.P.

In our modern commuting lives, there may be nothing less infuriating than traffic and congestion. No doubt, in recent years there has been a notable jump in commute times across most Canadian cities and as a result a more significant presence of “road rage”. You might be all too familiar with the trademark experiences of road rage: the honking horns, the screams from passing cars, or the casual use of the middle finger. However, we’re less likely to have ways to help deal with the stress caused by traffic and congestion.

Here are some great tips to put the brakes on road rage: 

1. Listen to audiobooks – Find and explore new subjects of interest to you that will both expand your mind as well as allow you to focus on something other than the cars around you.

2. Take Deep Breaths – This simple strategy can be quite effective in reducing stress. Try this: Get comfortable in your car seat, take in a deep breath in for four seconds, then hold this breath for seven seconds, and slowly breath out for another eight seconds. Try to relax your body as you slowly release this breath. 

3. Get out of your head and into your body –  Sometimes we get so wrapped up in our heads we forget about the rest of our experiences. Try this: While paying attention to traffic get comfortable in your car seat, start to notice where your body is making contact with the car, focus on a particular sensation, try to hold your concentration on the feeling, note any distractions, and then try to move your attention back to the sensation. To deepen this exercise, include deep breaths. 

4. Be curious about the experiences of those in the cars around you – When we are face-to-face with someone, we can more easily experience empathy for others – but when they’re a car-length away, understanding can sometimes become difficult. When driving, try to imagine the lives and faces of the individuals in the cars around you. Like you, they’re bound to make mistakes. This empathy technique can help reduce feelings of anger and frustration.

5. Explore your musical tastes – Music can be an excellent way to decompress and bring feelings of happiness to commuting. However, it’s best to take notice of what type of music you’re playing. Is it aggressive or angry? It might not be the best time to explore this type of music when you’re behind the wheel. Try something more uplifting, relaxing, or neutral to keep calm and avoid anger. 

6. Take the scenic route – Though not always possible, occasionally adding a few minutes onto your commute may be worth it to avoid congestion. Sometimes an extra ten minutes down a picturesque tree-lined street is ideal in comparison to a gloomy and congested highway. 

7. Make congestion part of your decompression – This cognitive shuffle can help turnaround the way you feel about your commute home. Try looking at this period as a time you can leverage. Shift this time from being lost to instead being a valuable part of your day to disconnect, explore, or grow using some of the other strategies discussed in this article. 

These tips should help you lessen some of the effects of road rage and traffic congestion. However, if you feel like your anger still feels out of control, it might be time to seek help. Skilled clinicians at CFIR can help you understand your experiences of anger and support you to build a more resilient and healthy self. Click here to book your free consultation now.

by: Dr. Tracy Dalgleish, C. Psych.

Holidays bring us a lot of joy. But the increased demands and events at this time of year can also bring us a lot of stress. We tend to say that we are ‘too busy’ to tackle stress and instead of trying to manage it, we push ourselves to get through each day. Come January, many clients end up in my office burnt out. Managing your stress does not have to take hours each day. Just a few short minutes each day can help you not only cope during this busy time, but also prevent burn out down the road.
Here are ten tips that take less than 15 minutes each day to help you manage stress.

1. Go for a 15-minute brisk walk. It could be around the building during a break, or around the block when you get home.
2. Take ten, slow, intentional breaths. Breathe in through your nose counting to six, and exhale slowly through your nose counting to six. Try this while taking a shower, or standing in line at a store.
3. Notice five things. Whether you are sitting in your office, in traffic, or watching your children play, say to yourself, ‘I notice the license plate in front of me,’ ‘I notice the red book on my shelf,’ or ‘I notice the colour of the lights.’
4. 5-4-3-2-1 with your senses. Notice five things with your sense of sight (see previous). Notice four things with your sense of touch – the roughness of the chair you are sitting on, the smooth edge of the table, the warmth of your coffee cup. Notice three things you hear – the hum of the computer, a car buzzing by, a door opening. Notice two things with your sense of taste (e.g., the taste of toothpaste left in your mouth after brushing your teeth) and smell (e.g., the smell of fresh air). Take one deep breath in through the nose and slowly out through the nose.
5. Talk to a friend, lover, or co-worker. Sharing with a significant other about what is contributing to your stress can help you problem solve or work through your emotions.
6. Listen to music. It can be soothing to listen to music that puts you in a good mood.
7. Try a guided relaxation or mindfulness exercise. I recommend this “Leaves on the Stream” exercise on YouTube. You can also download the app Head Space and get ten free short exercises to try each day.
8. Let go of unhelpful thoughts. We all have them – the thoughts of worry, the thoughts of “what if,” the thoughts of the worst-case scenario, or predicting the future. First acknowledge that you are having these unhelpful thoughts, then try letting go of your thoughts and focusing on what you are doing in the moment.
9. Stretch. We could learn a lot from watching a dog or cat. Every time they move, they stretch! Try lifting your arms over your head with a breath in, and as you let the breath out bringing your arms back down.
10. Make a list. Writing out your to-do items can help unload the mental energy of trying to remember everything you want to get done. Try breaking items down into small, achievable tasks, and prioritizing items.

Finally, if stress becomes too difficult to manage, reach out for help. Trained psychologists and therapists are available at CFIR to help you manage stress, depression, and anxiety.

by: Dr. Lila Z. Hakim, C.Psych.

“Mood and anxiety disorders are among the most common types of mental disorders in Canada and have been shown to have a major impact on the daily lives of those affected.“

SOURCE: Mood and anxiety disorders in Canada | canada.ca

Anxiety tends to be accompanied by a wide range of physical and psychological symptoms. Individuals experiencing anxiety may have physical complaints such as shortness of breath, heart palpitations, sweating profusely, or feeling dizzy. Chronic fearful arousal can interfere with sleep, concentration, and attention, and affect overall functioning. These physical symptoms are often accompanied by negative and self-critical thoughts about oneself, catastrophic fears, and thoughts of terrible things happening to oneself or loved ones. Some individuals will engage in certain behaviours (e.g., checking, counting, handwashing), or avoid certain places or social situations to deal with their anxiety.  Anxiety can manifest in different ways — individuals can struggle with different types of anxiety, including agoraphobia, generalized anxiety, panic, social anxiety, and specific phobias.

Anxiety may be rooted in difficult early or present-day life situations. For some of us, early childhood experiences in which we lacked appropriate and sufficient nurturance and support may have resulted in a vulnerable sense of self that is prone to anxiety in everyday life. For others, challenging, negative life experiences with family, friends, peers, and relationship partners may have undermined our safety and security in such a way that our confidence in our selves and others has been drastically altered.

Deep self-vulnerability may emerge when the unprocessed emotions and unmet needs associated with these past and present-day life events are not addressed. As a result of these experiences, we begin to think about, or emotionally react to our selves, others, and the world, in ways that constrict us from being able to move freely in the world or create relationships with others. We can begin to overly anticipate danger, or bad things happening to us, and engage in behaviours to cope with the anxiety. These behaviours then stop us from participating fully in life and become a further source of distress.
Sometimes stress, particularly when long-lasting, can overwhelm us and result in us feeling anxious. Some individuals have stress for days before tests, public speaking, or appointments, which impairs their ability to cope with life’s daily tasks. Their functioning becomes significantly diminished and our anxiety response to life increases. Being able to manage stress increases our sense of confidence, and improves the quality of our lives, and reduces our anxiety.

Work stress can also undermine our sense of emotional and physical well-being, and as a result, bring about chronic anxious feelings. Burnout can result from long-term stressors that are unresolved. Being able to cope with work stress is essential to prevent burnout. Work stress and exhaustion are caused by multiple factors that require attention to ensure we are creating a good quality of life in our work lives. Work stress and burnout can have a long-lasting impact on our sense of selves and our relationships when not addressed. When we are overly stressed and experiencing burnout, life’s smallest tasks can bring about anxious feelings. 

The Anxiety, Stress & Obsessive-Compulsive Service at CFIR offers clients a comprehensive assessment and diagnosis of your anxiety issues to facilitate appropriate treatment planning. We employ short-term and long-term, scientifically-validated interventions to address the specific type of anxiety you are experiencing. Cognitive-behavioural, psychodynamic, and experiential approaches are employed to help you resolve issues related to anxiety or stress.

Read more about our Anxiety, Stress & Obsessive-Compulsive Treatment Service.

by: Ali Goldfield, M.A.

We all have stress in our daily lives. So much so that we often think nothing of running from place to place, eating on the go, and juggling work and family life. You have probably already heard that stress can wreak havoc with our immune systems, our sleep patterns and our ability to enjoy the things we used to, but did you know that stress can actually affect the size of your brain? 

Researchers know that trauma can significantly affect brain structure but one study done by researchers at Yale University now shows that everyday stressors, like a divorce, job loss, the death of a loved one or a serious illness can also affect our brain in the same way that one traumatic event can. These cumulative stressors, it seems, can lead to shrinkage in our brains, reducing the volume of grey matter and lowering our ability to further cope with adversity and may even lead to self-destructive behaviours such as addiction, overeating and depression. 

Past studies have shown that the stress response involves a brain region known as the amygdala, which sends out signals alerting us to any kind of threat. This results in the release of hormones, including cortisol, which prepare us for the flight or fight response to fend off the threat. Prolonged exposure to cortisol can cause brain neurons to shrink and it also interferes with their ability to send and receive information efficiently. This is just another piece of the puzzle in how prolonged stress can impair our ability to think and act in creative, flexible and healthy ways.

And it’s not only about stress shrinking our brains. In another study from Yale University, researchers compared the genetic makeup of donated brain tissue from deceased humans with and without major depression. Scientists found that only the depressed patients’ brain tissues showed activation of a particular genetic transcription factor, or “switch” that basically stops the genes from communicating. This lack of communication leads to a loss of brain mass in the prefrontal cortex. The scientists hypothesized that in the depressed patients’ brain, prolonged stress exposure led to disruption of brain systems. The depressed brains appeared to have more limited and fragmented information processing abilities. This finding may explain the pattern of repetitive negative thinking that depressed people exhibit. It’s as if their brains get stuck in a negative groove of self-criticism and pessimism. They are unable to envision more positive outcomes or more compassionate interpretations of their actions.

While the evidence is not conclusive, it makes a pretty good argument that stress and mental health issues that lead to stress do kill off our brain cells through the damaging effects of cortisol and through the disruption of the genes that facilitate neuronal connections. This shrinkage affects our cognitive abilities, our focus and our ability to concentrate. Since much in our lives is beyond our control, how can we prevent this type of cumulative stress from affecting our ability to deal with what life throws at us? 

The most important thing to remember is that the brain is plastic, meaning that there are ways to reverse the negative impact of stress on the brain. With the right tools and techniques, like meditation, exercise, proper diet (think Omega-3s), yoga and by maintaining strong social and emotional relationships, we can, in fact, counterbalance the damaging effects of stress and stop our brains from shrinking.

Read more about our Anxiety, Stress & Obsessive-Compulsive Treatment Service.

by: Dr. Dino Zuccarini and Tatijana Busic

Finding a path toward recovery from your depression symptoms can be challenging, but is doable! In this third post in our depression blogs, we provide strategies to help you deal with depression symptoms associated with your thinking and how you might be processing your feelings, emotions, and needs.

We’ve offered you some tips to help take the first few steps toward feeling better. We suggest that you start your recovery journey by employing strategies for your self first, and then once you’ve started on those, our fourth blog post offers you strategies for your relationships.

Strategies for Your Self: Develop Structure, Routine, and Self-Care into Your Life

When we are depressed, we tend to become depleted of energy. We move less and feel tired. These circumstances can drain us of important mental and physical stimulation that we need for our well-being.

Put structure and everyday routine back into your life and begin to increase your level of self-care. Create a routine. Make sure to schedule activities that are meaningful or pleasurable to you. Include 20 minutes of physical exercise each day. Prepare healthy meals that will nourish your body and mind. Get good rest. If you are having difficulties sleeping, consult resources that will assist you to develop a soothing nightly ritual that will help you to unwind and relax and ultimately improve your sleep.

Learn How to Regulate and Soothe Stress, Negative Feelings and Emotions

With depression, we can struggle with our feelings and emotions – we feel too much or too little. When we are overwhelmed by strong, intense feelings and emotions, it is important to develop practices and strategies to effectively deal with these internal reactions.

Pause before you act on your thoughts and feelings and try to restore a sense of calm and ease. Learning how to restore calm and ease within ourselves is an important life skill. Make a list of activities that are calming and soothing for you, and engage in these activities when you are emotionally distressed. For example, sipping tea in a peaceful place, going for a walk, engaging in deep body and muscle relaxation, taking a warm bath, learning how to breathe rhythmically and deeply, visualizing peaceful and tranquil settings, quietly reading a book, and listening to calming music are examples of ways to enhance coping.

Try to remember, intense feelings and emotions mellow with time. Try to reassure yourself that these feelings and emotions will pass and you will be okay once again. Once we are calmer, we can begin to think about the thoughts and feelings we are experiencing that are contributing to our depression.

Challenge Negative Thoughts and Feelings about Your Self and Others

Negative views of our ‘self’ and of other people can create a deep sense of hopelessness, as discussed previously. In the midst of feeling depressed, pay attention to the thoughts, interpretations, assumptions, and beliefs you have about yourself or others. Do you notice a negative bias in how you are thinking or feeling about yourself and others?

Try to challenge these negative views and find counter-examples to these negative thoughts. Try to recognize good things about yourself and others at home, work, and in play. Practice noticing positive attributes about you and other people—at least once a day. You can also develop a list of positive things about yourself and other people in your life. Have your list handy and read it whenever you are feeling negative. Do not be surprised if your list of good things begins to grow as you start to engage in this exercise of positive appreciation.

Sometimes our negative thoughts and feelings towards others are grounded in real experiences in which others are behaving inappropriately toward us. If people are behaving toward you in a negative manner that is harmful (i.e., verbal, physical, emotional or sexual abuse), it is important to seek out support and professional help to find a way to address these circumstances.

Develop Self-Compassion in Place of Harsh Self-Criticism and Perfectionism

Sometimes a negative, critical voice toward our ‘self’ and others may be at the root of our depression. When left unchecked, this voice can make life unbearable.

Do you notice a highly critical or perfectionistic inner voice that pervades your life? How do you feel while and after you have berated, attacked, or criticized yourself? Probably not very good. Try to develop a more compassionate and understanding counter-voice at these times. Making mistakes and not meeting expectations and demands are bound to happen throughout our lives. It is part of being human. Remind yourself that no one is perfect nor do we need to be in order to be worthy, lovable, and valuable as human beings. Ask yourself if you would be as harsh toward others, such as a family member, partner or friend if they had not met an expectation? Would you be more understanding of others? Try to develop a kind, gentle, understanding and reassuring voice toward yourself in these moments.

Try to lighten the impact of this oppressive voice by reframing the self-criticism in positive terms. For example, ask yourself what you can learn from the present situation that may help you grow as a person in the future as opposed to harshly attacking yourself. Try to find constructive solutions to your mistakes or problems, rather than senselessly depleting your energy and berating yourself.

Try to find ways to challenge harsh self-criticism. Ask yourself, “How realistic are the expectations and demands that I hold of myself and others?”. Remember that human beings are limited in terms of what we can achieve. We can’t always meet all of our or others’ expectations or needs. In addition to negotiating our needs with those of other people in our lives, we also have to balance a lot of competing needs in different contexts, including work, family, and play.

Find counter-examples that contradict the extreme and global way you are putting yourself down. Create a more balanced and accurate view of yourself. Think about what is good enough and possible in your current life situation rather than how things should be in order to be perfect.

Be Mindful, Build Awareness of the Present Moment

When we are depressed our thoughts are often focused on worrying about the future or ruminating about the past. Depression impedes on our ability to live in the present moment, which often further aggravates the cycle of worry and negative rumination.

Try to notice these moments as they are happening without any judgment. Simply notice your ‘self’ thinking or feeling something that is connected to worry about the future or rumination about something that happened in the past. As you notice what is happening, try to gently shift your attention to your body. For example, if you are walking notice how the soles of your feet feel with every step you take. Practice using your senses to notice how things look, feel, taste and smell around you.

By gently shifting your attention to the present moment, you rest your awareness in the here and now of being alive. This mindful practice can help you to build an inner sense of refuge from the stresses of life. Also, this practice can occur under any circumstances and over time, will help you to develop greater resilience and freedom from the negative thought and emotional patterns associated with depression.

Identify, Label, and Access Emotions and Needs and Make a Plan of Action

Emotions provide us with important information about what our concerns, goals, and needs are for ourselves and in our relationships with others in the world around us. Depression is a signal, calling for us to listen to what our feelings are telling us about what concerns or goals have gone unmet, or what we might want or need for ourselves or in our relationships with others.

Being able to identify, label, and express these feelings in words is important if we are to appreciate what our concerns are and what we might need as individuals and from our relationships. When we figure out what our emotions are telling us, we can then develop a plan of action toward taking care of ourselves more effectively. We can develop strategies to address our goals and concerns, and meet our wants and needs in a manner that does not create further difficulties for us.

Try to identify and label your emotions. Pay close attention to the feelings that underlie what you are experiencing. For example, you may be feeling numb, but masked underneath resides hurt and sadness. Or you may feel outwardly sad, but are also angry deep down. This may not be easy to do at first and takes practice.

Also, try to tune into what the concerns, unmet goals or needs are that come with these feelings and emotions. What do you need for yourself in your sadness or anger? Write about your feelings in a journal with a particular focus on what these feelings are telling you about what you might need for yourself or in your relationships with others.

Begin to plan and create strategies of how you can go about meeting your goals, wants, needs, or desires in a manner that is constructive for you and for those around you. You may require support from others to help you organize your thoughts and to develop plans to have your goals, wants, or needs met.

Seek out Professional Support: Consulting with your Physician and a Registered Clinical Psychologist

Consulting with a physician may also be an important first step to assess your current mental health status. Depression can be associated with many biological and medical causes that require medical interventions.

Seeking the professional support of a registered clinical psychologist may be important to help you address the negative thoughts and feelings you are having about yourself, or others. Learning how to address perfectionism, self-criticalness, and process your emotions and clarify wants, needs, and goals can be challenging. Contact a registered clinical psychologist if you find that dealing with your thoughts and feelings on your own has become unmanageable.

Read more additional posts from the ‘Depression’ series:

• Depression: How Your Thinking Can Lead to the ‘Blues’ (Part One)
• Depression: The Role of Unprocessed Feelings and Emotions (Part Two)
• Combatting Depression: Strategies for Your Relationships (Part Four)

Learn more about our Depression, Mood & Grief Treatment Service.