6 Months or Less Diagnose for a Loved One.

Knowing how to offer comfort and support to a loved one who has a terminal illness can be challenging. What can you say or do? How can you help your loved one cope? How will you deal with your own grief? Get the facts about supporting a loved one who is terminally ill.My loved one has been diagnosed with a terminal illness. How might our relationship change?Your relationship with your loved one might not necessarily change because he or she has a terminal illness. If you're concerned, try to build on your relationship's strengths. It's also important to be open to new possibilities. A loved one's terminal diagnosis might improve your relationship. Or unresolved conflicts might present new challenges.Remember that your loved one is still the same person and will still have the same needs and desires as he or she had before the terminal illness. Many people facing terminal illness want to be treated as normally as possible, without always focusing on the illness.How can I help my loved one cope with a terminal illness?Let your loved one know that you're willing to listen to his or her concerns — and never underestimate the value of your presence. Even if it feels as if you're not doing anything, your presence sends an important message. Don't, however, try to be a counselor.Is there a typical emotional process that a person who has a terminal illness experience?Dying isn't a science. Don't assume that a loved one who has a terminal illness is going to go through a methodical process of coming to terms with death. It might not happen that way.Acceptance or accommodation might be the most desirable outcome of the grieving process — learning to live as fully as possible while accepting the presence of a terminal illness.But does your loved one have to accept that he or she has a terminal illness? Does your loved one have to accept that he or she is going to die before he or she expected? No. There's no right or wrong way to come to terms with death.How do you help a loved one who's in denial about his or her impending death?Denial is an important coping mechanism. Your loved one might be in denial because the reality is too frightening, too overwhelming, or too much of a threat to his or her sense of control. A denial is a form of natural protection that can allow your loved one to let reality in bit by bit and continue living as he or she contemplates death.As long as denial isn't causing your loved one significant harm — such as causing him or her to seek out painful treatments of no therapeutic value — then denial isn't necessarily bad.Your loved one might be afraid of pain. Perhaps your loved one is afraid of losing control of his or her bodily functions, mind or autonomy. Your loved one might also fear failing family or become a burden to others.To provide emotional and spiritual support to your loved one, invite him or her to talk about his or her fears. Sometimes, however, it's easier for a dying person to share what he or she fears and explore it with someone other than a family member, such as a Bereavement Professional as Dr. Nicholas Losito, Ph.D.

8 ways to forgive yourself and let go of your past

 Question:   I enjoyed your articles about forgiving other people, but how do you forgive yourself and move on when you have made many mistakes? That is what I struggle with.

Answer:  You are not alone. Most of us hold on to past mistakes and let them affect our self-esteem for way too long. This is not healthy and does not serve anyone. Here are eight suggestions that may help you to forgive yourself:

1. Look at the past experiences as locations on your journey through life, instead of letting them define who you areIf you were on a road trip and drove through Texas, would the time you spent there make you a Texan? Of course not. It was just the location you drove through; it doesn’t change who you are. Your value is the same no matter what you experience along your journey. Mistakes teach you important lessons, but they don’t define who you are — at least they don't have to. You can see them as locations on your journey if you choose to.

2. Give yourself permission to be a work in progressChoose to see life as a classroom, not a testing center. You have the option to believe that your value isn’t on the line here and you are not being graded — you are just here to learn and grow. Seeing life as a classroom helps you focus on the lessons so you can forgive yourself and try to do better next time.

3. Understand how pointless shame isI believe "shame" stands for: should have already mastered everything. That is ridiculous. You are a student in the classroom of life. There is no way could know it all, all the time. Give yourself permission to be an imperfect work in progress. You are learning and growing and that is enough.

4. Figuratively get rid of it for goodYou could write it down on paper and burn it. You could write what you did, put it in a box and bury it in the backyard. Then make a rule that you can’t bring it up again, unless you dig the box up first. (This exercise is great for couples who keep fighting about the past too.) Bury that stuff deep and let it die there. There is no sense wasting energy on things you can’t change. Focus on the future instead.

5. Learn some new skillsFocus on making your future brighter. This is in your control. Be present and find ways to improve yourself daily. Learning new skills is great for your self-esteem.
6. Imagine there is a dark room in your house where you can stash negative thoughts and emotionsEvery time negative thoughts show up, which aren't worth processing anymore, visualize putting them in the dark room and slamming the door. You can always go in there, if you need to process it some more and dwell in self-pity. But you could also leave the negativity in the dark room forever. This empowers you to have control over what to do with those feelings.

7. Clean out your closets and your houseMost people, who hold on to old stuff, are also holding on to old ways of thinking and feeling. When you get rid of your old stuff, you can send your old beliefs, mistakes and fears out with it. Cleaning your house out will make you feel fresh and new on every level.

8. Change it up and try new thingsBreak out of your old ruts and change some things. Try new outfit combinations, new foods, new restaurants, new sports or new kinds of movies. The more you break out of routine and change it up, you will also open yourself up to feel differently about yourself and your life.Steve Maraboli, in his book "Life, the Truth, and Being Free," said “Incredible change happens in your life when you decide to take control of what you do have power over instead of craving control over what you don’t.” The past is out of your control; there is nothing you can do to change it. Let it go.

Choose joy for today.

You can do this. 

Coping with reminders after a loss

When a loved one dies, you might be faced with grief over your loss again and again — sometimes even years later. Feelings of grief might return on the anniversary of your loved one's death, birthday or other special days throughout the year.

These feelings, sometimes called an anniversary reaction, aren't necessarily a setback in the grieving process. They're a reflection that your loved one's life was important to you.

To continue on the path toward healing, know what to expect — and how to cope with reminders of your loss.

Reminders can be anywhere

Certain reminders of your loved one might be inevitable, especially on holidays, birthdays, anniversaries and other special days that follow your loved one's death.

Reminders aren't just tied to the calendar, though. They can be tied to sights, sounds and smells — and they can ambush you. You might suddenly be flooded with emotions when you drive by the restaurant your partner loved or when you hear your child's favorite song. Even memorial celebrations for others can trigger the pain of your own loss.

What to expect when grief returns

Anniversary reactions can last for days at a time or — in more extreme cases — much longer. During an anniversary reaction you might experience:

• Sadness
• Loneliness
• Anger
• Anxiety
• Trouble sleeping
• Fatigue
• Pain

Anniversary reactions can also evoke powerful memories of the feelings and events surrounding your loved one's death. For example, you might remember in great detail where you were and what you were doing when your loved one died.

Tips to cope with reawakened grief

Even years after a loss, you might continue to feel sadness when you're confronted with reminders of your loved one's death. As you continue healing, take steps to cope with reminders of your loss. For example:

• Be prepared. Anniversary reactions are normal. Knowing that you're likely to experience anniversary reactions can help you understand them and even turn them into opportunities for healing.
• Plan a distraction. Schedule a gathering or a visit with friends or loved ones during times when you're likely to feel alone or be reminded of your loved one's death.
• Reminisce about your relationship. Focus on the good things about your relationship with your loved one and the time you had together, rather than the loss. Write a letter to your loved one or a note about some of your good memories. You can add to this note anytime.
• Start a new tradition. Make a donation to a charitable organization in your loved one's name on birthdays or holidays, or plant a tree in honor of your loved one.
• Connect with others. Draw friends and loved ones close to you, including people who were special to your loved one. Find someone who'll encourage you to talk about your loss. Stay connected to your usual support systems, such as spiritual leaders and social groups. Consider joining a bereavement support group.
• Allow yourself to feel a range of emotions. It's OK to be sad and feel a sense of loss, but also allow yourself to experience joy and happiness. As you celebrate special times, you might find yourself both laughing and crying.

When grief becomes overly intense

There's no time limit for grief, and anniversary reactions can leave you reeling. Still, the intensity of grief tends to lessen with time.

If your grief gets worse over time instead of better or interferes with your ability to function in daily life, consult a grief counselor or other mental health provider. Unresolved or complicated grief can lead to depression and other mental health problems. With professional help, however, you can re-establish a sense of control and direction in your life — and return to the path toward healing.

Contentment over Happiness

Sure, we all want to feel happy.  But seeking contentment is a better goal.  Happiness is a mood state, inevitably fleeting, while contentment is more sustainable.  Here are some thoughts on how to find it.

I define contentment as being able to be in the moment BECAUSE you have a sense of the larger picture–you’re able to appreciate momentary pleasure and shrug off stress and annoyances by virtue of knowing that you are where you want to be on a grander scale (or you can envision yourself getting to where you want to be.)

I know, it sounds deceptively simple.  Sometimes the simplest things are the hardest to do. 

 Like when people tell you “Be in the moment” or “Be spontaneous”–you become all the more self-conscious.

But they also get easier with practice.  Mindfulness and appreciation can be learned skills.  They come more naturally to some than others, but if you stick with it, you will improve.

1)  When your mind wanders, gently bring it back to the present.

I say “gently” because frustration is an enemy of being in the moment.  And contentment involves some degree of present-focus.  So if you’re on, say, a family outing and you’re thinking about all the laundry you have to do, remind yourself to be where you are.  You’ll probably have to remind yourself of this multiple times, and that’s okay.  It’s all practice.

2)  Realize that  happiness–like frustration or irritation or anger–is fleeting.

The reason this is actually a positive realization is that we have a tendency to forget that all emotions pass, given time.  So when we’re in a negative space, we need to pause, breathe deeply, and let it go by.  When we’re happy, we need to embrace it because it’s finite.

3)  Contentment lasts.

That’s because there’s a cognitive component to contentment.  Taking stock of where you are and deciding what you love, what you can change, and what you need to accept is key to contentment.

If you make lists and re-read them, it will help ground you overall.  That will make numbers 1 and 2 on this list easier to practice.  You’ll have something to draw on in that larger scheme.

Self-compassion and the recognition that life is a process, not an outcome, will also be helpful.  Contentment is about cultivating a mindset that promotes happiness.  Then you don’t need to chase it, or to run away from negative emotions, either.

Not the Panacea

Almost 19 million Americans have periods where they feel a lack of pleasure or interest in what was once pleasurable and interesting. They feel tired and heavy, potentially overly emotional or numb, and experience an onslaught of negative and self defeating thoughts that can keep  invading the mind over and over again. The more periods of this depressed mood we have in life, the more likely we are to fall back into them again. Why does this relapse occur and how can mindfulness offer hope?

Falling into a depression feels traumatic and just like getting bit by a dog causes us to be fearful of and oversensitive to dogs, our minds and bodies become oversensitive to associations with the depression causing our brains to flinch at any sign of a relapse.

Feeling low mood is normal for everyone, but if we’ve experienced depression in the past, this may be a trigger for a relapse. If we feel tired or if we notice sadness, the mind pops up with the worry “uh oh, that is how I felt when I was depressed, maybe I’m getting depressed”. Our minds begin to go in overdrive with negative self judgments, “I am a failure” or “I am weak” or “I am worthless”. It then tries to solve the mystery as to why we are becoming depressed again and the more it tries to solve this puzzle, the deeper it sinks into depression. Think of a worried, judging person coming at you trying to solve your problems when you’re already not feeling well. Probably not what you’re looking for. You see, it’s not the low mood that’s the problem here, it’s the way we get stuck in habitually relating to it that pours kerosene on the fire, with our minds continuing to fan the flame rolling us into a full blown depression.

The practice of mindfulness teaches us a different way to relate to our thoughts, feelings, and emotions as they arise. It is about learning to approach and acknowledge whatever is happening in the present moment, setting aside our lenses of judgment and just being with whatever is there, rather than avoiding it or needing to fix it. It’s the mind’s attempt to avoid and fix things in this moment that fuels the negative mood.

With Uncomfortable Emotions

If sadness is there, instead of trying to fix it or figure it out, we might just acknowledge the sadness, let it be and get a better understanding of what we need in the moment.

With Self-Judgments

If self-judgments arise (e.g., I am weak, I am a loser) out of past sensitivities to having been depressed before, we can acknowledge that they are associations from the past, let them be, and then gently bring ourselves back to whatever we were doing. In doing this, we’re stopping the ruminative cycle that might occur between our thoughts, feelings, physical sensations and behaviors that can play off one another leading into another relapse (I call this “The Depression Loop” in the upcoming book Uncovering Happiness).

Now, this is easier said than done and it takes practice.

Confidence with Rumination Practice:

Let’s get our hands (or minds) into it. One way to practice mindfulness is to use the breath as an object of awareness. You can place attention at the tip of the nose or the belly and as you breathe in, just acknowledge the breath coming in and as you breathe out just acknowledge the breath going out. As if you were greeting and saying goodbye to an old friend. When the mind wanders, as it will always do, just say to yourself “wandering” and then gently bring your attention back to the breath just noticing it coming in and going out. Most of us catch the mind wandering and gently bring it back billions of times, so know that it is normal for the mind to wander often. You can do this for as little as 1 minute or as much as 30 minutes or more.

Practice this when you’re feeling well and you’ll be better able to recognize when your mind wanders off to ruminations and self judgments when you’re not feeling well.

What does this have to do with gaining confidence over rumination?

Like learning an instrument, you can develop more skill as you practice. When you’re not feeling well and the mind begins to ruminate, as you practiced with the breath, just label it as “ruminating” and then gently bring your attention back to whatever you were doing. Being more present may also give you the ability see the space between stimulus and response and see the “choice point” to  be more flexible and call a friend or do something that then gives you pleasure or connection with others.  This is what I’ve referred to as The Now Effect. 

Know that practicing is an act of self care and helps stop the cycle of rumination and cultivates more patience, compassion, and peace.  

Mindfulness is not a panacea for depression, but it’s a good foundation for preventing relapse.

As always, please write below with any comments, questions, thoughts, or additions that arise after reading this. Your comments below help provide a living wisdom for us all to share and benefit from.

When to Refer for Medical Treatment

When Grief develops into clinical depression one (1) and family does not know to pinpoint
the Symptoms accurately. For this reason the symptoms and the psychological aspects have been out lined for your education and understanding for this diagnose.

Signs and Symptoms:

Early morning awaking

Serious Weight Loss

Anhedonia:

"The loss of joy," is defined as a lack of the feelings of enjoyment or accomplishment that typically accompany pleasurable events such as socializing with friends, eating a good meal and sex. An individual who is experiencing Anhedonia may no longer feel a desire to go to work, attend classes, manage their health, interact with other people, or engage in hobbies or entertainment. Anhedonia is a common symptom of mood disorders such as major depressive disorder or dysthymic disorder, but it can also be experienced independent from a diagnosed mental health condition. -

Agitation: The Causes

Agitation can come on suddenly or over time. It can last for just a few minutes, or for weeks or even months. Pain, stress, and fever can all increase agitation.
Agitation by itself may not be a sign of a health problem. However, if other symptoms occur, it can be a sign of disease.  Agitation  with a change in alertness (altered consciousness) can be a sign of delirium. Delirium has a medical cause and should be checked by a health care provider right away.
 
Causes

There are many causes of agitation, some of which include:

• Alcohol intoxication or withdrawal
• Allergic reaction
• Caffeine intoxication
• Certain forms of heart, lung, liver, or kidney disease
• Intoxication or withdrawal from drugs of abuse (such as cocaine, marijuana, hallucinogens, PCP, or opiates)
• Hospitalization (older adults often have delirium while in the hospital)
• Hyperthyroidism (overactive thyroid gland)
• Infection (especially in elderly people)
• Nicotine withdrawal
• Poisoning (for example, carbon monoxide poisoning)
• Theophylline, amphetamines, steroids, and certain other medicines
• Trauma
• Vitamin B6 deficiency

Agitation can occur with brain and mental health disorders, such as:

• Anxiety
• Dementia (such as Alzheimer's disease)
• Depression
• Mania
• Schizophrenia

Coping with the Loss

Coping with the loss of a close friend or family member may be one of the hardest challenges that many of us face. When we lose a spouse, sibling or parent our grief can be particularly intense. Loss is understood as a natural part of life, but we can still be overcome by shock and confusion, leading to prolonged periods of sadness or depression. The sadness typically diminishes in intensity as time passes, but grieving is an important process in order to overcome these feelings and continue to embrace the time you had with your loved one.

Everyone reacts differently to death and employs personal coping mechanisms for grief. Research shows that most people can recover from loss on their own through the passage of time if they have social support and healthy habits. It may take months or a year to come to terms with a loss. There is no “normal” time period for someone to grieve. Don’t expect to pass through phases of grief either, as new research suggests that most people do not go through stages as progressive steps.

If your relationship with the deceased was difficult, this will also add another dimension to the grieving process. It may take some time and thought before you are able to look back on the relationship and adjust to the loss.

Human beings are naturally resilient, considering most of us can endure loss and then continue on with our own lives. But some people may struggle with grief for longer periods of time and feel unable to carry out daily activities. Those with severe grief may be experiencing complicated grief. These individuals could benefit from the help of a psychologist or Dr. Nicholas Losito, Ph.D, CISM with a specialization in grief.