Depression – Resilient Responder

December 31, 2016

Values

As I start a new year, I have been thinking a lot about values. This is the time of year when we set goals. New Year’s resolutions, if you will. Most of us will have good intentions, but never see through all of the plans we make.

So what determines whether or not you go through with your goals? How do you push through all of the challenges you will face? What motivates you to keep going?

Values.

Values are the things that set your path. They are the things that are the most important to you. Things you find useful, that have worth. Values keep you moving.

The first of the year is a time for new beginnings. It is a good time to look at your values. To look at the things that make you want to get up in the morning.

Values generally fall into one or more of several categories and sub-categories: circle-of-values

Personal goals (Emotional, Physical, Intellectual)
Financial goals (Budget, Savings)
Family (Marriage, Children, Parents, Other kin)
Relationships (Friends, Community)
Work (Career, Volunteer, Hobbies)
Spiritual (God, Church, Meditation/Prayer)

Some of these have higher priority than others. Sometimes priorities change as things happen to you or around you. You may not even be aware of all the values that shape you and direct your decisions.

But now is a good time to decide if what you do every day aligns with what you feel is important. Are there times when you feel uncomfortable or out of sync? That may be a sign that what you are doing is conflicting with your values.

The thing is, if you are having trouble getting motivated you are probably trying to do something that does not mesh with your values. You are going against the grain, so to speak. Even if it is something you used to enjoy. Remember, as you grow older, you change. That means values change too.

So think about your life right now. Are you happy? Are you doing what you want to do?

Or are you hanging onto something that no longer, or maybe never did, make you feel you are doing something important? Holding on to something just because you think you should is a sure-fire way to make yourself miserable. It might be a good idea to rethink this.

faith-integrity What are your values? How do you figure that out?

Start by making a list of each of the categories listed above. The sub-categories are suggestions. You can add your own.

For each category, write down at least one thing that is important to you. For example, under “Family”, you may write “Spending quality time with my wife/husband and children.” For “Finances” it could be regularly putting money in savings. It does not have to be complicated, but it does have to be what you find useful and worthy of your time.

Does your life reflect the things that are important to you? If not, what can you do this year to change?

Leave a comment below. Follow me and I will let you know when the next blog comes out.

Thanks for reading!

December 13, 2016

Introspection or Rumination? What Does the Cow Do?

You have a patient with respiratory distress, tripod position, BP 220/116, breath sounds diminished, chest pain, diaphoresis, SpO2 88% on room air…classic CHF. You immediately apply CPAP, NTG paste, start an IV, 12-lead, 15-lead. You are on the way to the ED! The patient seems to be improving. You keep monitoring him during transport. His SpO2 is 95% with CPAP. The BP is 200/98. No obvious STEMI on the ECG.

You run through the protocol. Have you missed anything? Is there anything else to look for? Can’t think of anything so you continue what you’re doing until you get to the hospital.

When you transfer the patient to the ED bed, you notice he does not move his left arm. In fact, it is flaccid. He has no history of stroke. You checked. On the scene, he moved all extremities equally because he initially tried to keep you from applying the CPAP. He used both hands at the time. He stood and pivoted from the chair to the stretcher without appearing to stumble.

It must have started during transport. How did you miss it? Great! Now the medical director will want to see you. Just what you need.

So begins the cycle of thinking. What did I do wrong? Did I do anything wrong? Should I have done something different? How did I miss that stroke!?!

Introspection versus Rumination

Two four-syllable words that have deep significance for resilience. One is helpful and the other not so much.

You ruminate when you think about something over and over and over…..

You focus on the bad things. You think about what went wrong. You worry about what someone will say. You worry that you’ll get in trouble. It is rarely productive. You ponder, mull over, cogitate; but never come to any helpful conclusions.

Cows ruminate. Yep. They have four stomachs. When they eat, they chew their food, swallow it, and it enters the first stomach where it begins to be processed. Then the cow regurgitates some of the contents and chews on it again. Yuck! I guess the cow doesn’t mind, though.

Rumination for us is similar. We have a problem. We “swallow” it for a time. Then we bring it back up and chew on it again. Unlike the cow, this is not always a one-time process for us. Our ruminating can get us into a vicious cycle that is hard to break. We end up thinking negative things about ourselves and our abilities and maybe even our worth.

Introspection, on the other hand, gives us the chance to examine the problem so we can find a solution. It sounds similar to rumination, but instead of focusing on the negative parts of the problem, introspection focuses on solutions.

Introspection is productive. Instead of thinking about our self-worth, we work on self-improvement. Rather than focusing on the one thing that went wrong, we remember all the rest that went right.

With introspection we learn. With rumination we make ourselves miserable.

Do you introspect or ruminate?

Leave a comment below. Follow me and I will let you know when the next blog comes out.

Thanks for reading!

December 9, 2016

To Be or Not to Be…Resilient, That Is

Sometimes to understand what something is, it helps to look at what it is not. So let’s talk about what resilience is not. It might be a little surprising.

Being resilient does not mean you never get angry. People get angry. It is a normal, natural response.

Resilience does not mean you never feel depressed. When bad things happen, you feel bad. Your mood gets low. It happens.

Resilient people can feel anxious. Sometimes anxiety is good. It keeps you sharp. Sometimes it comes from anticipation of change, wanted or unwanted. (See the last post for how to manage change.) It is often the fear of the unexpected.

So, resilient people can feel afraid. Fear keeps you safe. You know…fight, flight, or freeze.

Being resilient does not mean you never cry. Come on. You know you have wanted to, but didn’t want anyone to think you were a wimp. God made tear ducts for a reason and it wasn’t just to keep your eyes clear of debris.

Being resilient does not mean you have to always be smiling. (Cue Pharrell Williams here…or NOT.)

Resilience does not mean you get along with everyone all the time. Some people are just not fun to be around. You know who they are…..

Being resilient does not mean you always agree with everyone, even your admin. You might even argue with them or get angry (see number 1).

Resilient people do not “suck it up, buttercup.” They know that doesn’t work anyway.

Ok…can’t think of anything for number 10.

So, what do resilient people do when they experience 1 through 9? They live through it. Duh, right? What I mean is, they pay attention to what they feel. They recognize it is a normal reaction of a normal person to an abnormal situation. Hey…we get some really abnormal stuff in our job!

The trick is to look at the reason you feel the way you do and decide what you want to do about it. Sometimes, there is action you can take. If you disagree with your admin, offer them an alternative solution. They might not take your advice, but at least you are not passively complying. You are being part of the solution rather than the problem.

If you are depressed, angry, sad, or anxious; cut yourself some slack. Again, normal reaction of a normal person to an abnormal situation. Look at what is distressing you. Focus on your breathing. Let the millions of thoughts going through your mind run their course. Give it time, but try not to dwell on the negative parts too long. Make a plan for how you can handle the situation and work your plan.

Resilient people do not push their feelings and emotions down and ignore them completely. (See #9). They know these are normal and let them come. Then they carry on.

What are you doing that is not resilient? What do you want to do instead?

Leave a comment below. Follow me and I will let you know when the next blog comes out.

Thanks for reading!

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Introspection versus Rumination

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