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Managing Depression alongside Chronic Illness

Managing Depression alongside Chronic Illness

If you’re reading this, chances are you or someone you care about is dealing with the challenges of chronic illness or disability, which can often trigger feelings of depression. Today, we’re going to dive into some strategies for navigating this journey with resilience.

1. Understanding Ableism

First things first, let’s address the elephant in the room: ableism. Abelism can be a significant barrier to navigating life with chronic illness and can exacerbate feelings of isolation and depression. Here are some examples of ableism faced by individuals with chronic illness:

  • Minimization: Others may downplay the severity or impact of a chronic illness, dismissing it as “not that bad” or “just a phase.” This minimization can invalidate the individual’s experiences and undermine their need for support and understanding.
  • Lack of Empathy: Some people may struggle to empathize with the daily challenges and limitations faced by individuals with chronic illness. They may fail to recognize the physical and emotional toll of living with a chronic condition, leading to a lack of support and understanding.
  • Comments to “Get Over It”: Individuals with chronic illness may encounter comments suggesting that they should simply “get over it” or “try harder” to overcome their symptoms. This attitude fails to acknowledge the complex nature of chronic illness and the impact it can have on a person’s life, perpetuating stigma and misunderstanding.
  • Inaccessibility: Public spaces, workplaces, and social events may lack accommodations for individuals with chronic illness, such as accessible seating, rest areas, or flexible work arrangements. This lack of accessibility can create additional barriers and challenges for individuals already navigating the complexities of their condition.
  • Stigmatizing Language: Negative stereotypes and stigmatizing language surrounding chronic illness can contribute to external ableism. Terms like “lazy,” “weak,” or “attention-seeking” may be used to describe individuals with chronic conditions, further marginalizing and isolating them.

Addressing external ableism involves advocacy and challenging stereotypes. To combat ableism effectively, we must champion inclusivity and understanding, educating others about diverse disabilities, and promoting empathy and accommodation for all individuals. Remember, your strength and resilience define you, not your limitations.

Keep in mind that abelism can become internalized. Internalized abelism occurs when individuals with chronic conditions come to believe the negative stereotypes and societal messages about their own worth and capabilities. Internally, individuals must confront and unlearn negative beliefs about themselves, fostering self-compassion, honoring their limits, and seeking support.

2. Cultivating Self-Compassion

Living with chronic illness or disability can sometimes feel like waging a constant battle against our own bodies, leading to profound feelings of depression. In these moments, practicing self-compassion becomes essential. Instead of berating ourselves for what we can’t do, let’s celebrate our victories, no matter how small they may seem.

One way to cultivate self-compassion is through mindfulness meditation. Take a few minutes each day to sit quietly, focusing on your breath and offering yourself words of kindness and understanding, especially when you’re feeling discouraged. Remember, you are doing the best you can with the cards you’ve been dealt. Self-compassion can also involve setting achievable goals that align with your current abilities and energy levels. Breaking tasks down into smaller, manageable steps and celebrating progress along the way, even if it’s slower than you’d like. Read more about this concept (often called “Spoon Theory”) here.

3. Prioritizing Self-Care

When dealing with chronic illness or disability, self-care isn’t just a luxury; it’s a necessity, especially in managing depression. This means listening to your body and honoring its needs, whether that’s getting enough rest, eating nourishing foods, or engaging in activities that bring you joy.

Here are some practical steps to prioritize self-care:

  1. Create a daily self-care routine: Set aside dedicated time each day for activities that recharge your batteries, whether it’s taking a bubble bath, going for a walk in nature, or curling up with a good book. These activities can provide relief from the symptoms of depression.
  2. Reach out for support: Don’t be afraid to lean on friends, family, or support groups for help when you need it, especially when depression feels overwhelming. You are not alone in this journey, and there are people who care about you and want to see you thrive.
  3. Practice saying no: Learn to set boundaries and say no to things that drain your energy or don’t align with your priorities, especially when depression makes it difficult to muster the energy for extra tasks. Remember, it’s okay to put yourself first sometimes, especially when it comes to managing depression.

4. Embracing Radical Acceptance

Radical acceptance is about fully embracing reality as it is, rather than fighting against it, even in the face of a chrnoic illness that you did not choose. This doesn’t mean resigning ourselves to a life of suffering, but rather acknowledging the truth of our circumstances and choosing to respond with compassion and equanimity.

In the face of chronic illness or disability, radical acceptance can be a powerful tool for finding peace and contentment in the present moment, even amidst depression. Instead of dwelling on what we’ve lost or longing for a different reality, let’s focus on what we still have and cultivate gratitude for the blessings in our lives.


Navigating chronic illness and disability is no easy feat. By challenging ableism, practicing self-compassion, prioritizing self-care, and embracing radical acceptance, we can cultivate resilience and thrive in the midst of adversity.

If you find yourself struggling to manage depression or cope with the challenges of chronic illness or disability, remember that help is available. Don’t hesitate to reach out and schedule an appointment with a counselor on our team for professional counseling support tailored to your unique needs.

Get Outside For Your Brain

Get Outside For Your Brain

When I am among the trees, Especially the willows and the honey locust, Equally the beech, the oaks and the pines, They give off such hints of gladness I would almost say they save me, and daily. Excerpt, "When I Am Among The Trees" by Mary Oliver We live in a world...

Mindfulness Mastery: Your Ultimate Weapon Against Depression

Mindfulness Mastery: Your Ultimate Weapon Against Depression

Depression can feel like a heavy cloud hanging over your life, making it difficult to find joy or motivation. While therapy and medication are valuable tools in treating depression, incorporating mindfulness skills into your daily routine can offer additional support and relief. In this guide, we’ll explore how mindfulness can help combat depression and provide practical steps to integrate mindfulness into your life.

The Science Behind Mindfulness

Mindfulness isn’t just a trendy practice; it’s grounded in science. Research shows that mindfulness can reshape the brain, increasing activity in regions tied to emotional regulation while decreasing those linked to stress and anxiety. Moreover, it reduces cortisol levels, the stress hormone, promoting relaxation and improved mood. By understanding this science, you gain confidence in mindfulness as a proven method for managing depression and enhancing well-being.

Practical Mindfulness Tools

  1. Embrace Mindful Meditation: Mindful meditation is a powerful tool for managing depression. Find a quiet space where you can sit comfortably and focus on your breath. Close your eyes and take slow, deep breaths, paying attention to the sensation of each inhale and exhale. When your mind wanders, gently bring your focus back to your breath without judgment. Start with just a few minutes each day and gradually increase the duration as you become more comfortable.
  2. Engaging the Senses: Another practical approach to mindfulness is engaging your senses. Take a moment to notice the sights, sounds, smells, tastes, and sensations around you. Whether you’re taking a walk in nature, enjoying a meal, or simply sitting in your backyard, pay attention to the details of your experience. By fully immersing yourself in the present moment, you can find moments of peace and joy even in the midst of depression.
  3. Cultivating Gratitude: Depression often causes people to focus on the negative aspects of their lives, leading to feelings of despair and hopelessness. Practicing gratitude can help shift your perspective and cultivate a sense of appreciation for the good things in your life. Take time each day to reflect on three things you’re grateful for, no matter how small. This simple practice can help train your brain to notice the positive aspects of your life, boosting your mood and resilience.
  4. Mindful Movement: Engaging in mindful movement, such as yoga or tai chi, can also be beneficial for managing depression. These practices combine physical activity with mindfulness, encouraging you to focus on your body and breath as you move through various poses or sequences. Whether you’re following a guided video online or attending a class in person, mindful movement can help alleviate symptoms of depression by promoting relaxation and grounding you in the present moment.

Guided Mindfulness Meditations:

  • Headspace (www.headspace.com) – Offers guided mindfulness meditations for beginners and experienced practitioners alike, with a variety of topics to address specific needs like stress, sleep, and depression.
  • Insight Timer (www.insighttimer.com) – Provides a vast library of free guided meditations, including mindfulness practices tailored for managing depression and anxiety.
  • UCLA Mindful Awareness Research Center (www.uclahealth.org/marc) – Offers free guided mindfulness meditations led by experienced instructors, backed by research from UCLA’s Mindful Awareness Research Center.
  • Calm (www.calm.com) – Features guided meditations, sleep stories, and relaxation techniques designed to promote mindfulness and alleviate symptoms of depression.


Combating depression requires a multi-faceted approach, and mindfulness can be a valuable tool in your toolkit. By practicing mindfulness techniques such as meditation, engaging your senses, and cultivating gratitude, you can develop greater awareness of your thoughts and emotions, breaking free from the grip of depression. Remember, it’s okay to seek professional help if you’re struggling with depression. Our team of counselors is here to support you on your journey toward healing and wellness. Don’t hesitate to reach out and schedule a session today to explore how mindfulness and therapy can work together to help you reclaim your life from depression.

Get Outside For Your Brain

Get Outside For Your Brain

When I am among the trees, Especially the willows and the honey locust, Equally the beech, the oaks and the pines, They give off such hints of gladness I would almost say they save me, and daily. Excerpt, "When I Am Among The Trees" by Mary Oliver We live in a world...

Grief is Not Pathology

Grief is Not Pathology

Grief and loss, whether person or place or part of self, are inevitable. Every one of us will lose someone or something, and every one of us will need to be cared for through it; yet, our culture has no shared language for loss. Grief is a collective experience that...

How to Help a Loved One Process a Miscarriage

How to Help a Loved One Process a Miscarriage

Experiencing a miscarriage can be an incredibly challenging and emotionally overwhelming time for individuals and couples. In this blog post, I will outline four ways you might help someone process their miscarriage. Remember, every person’s experience is unique, so it’s important to approach this process with sensitivity and empathy.


Acknowledge the Grief

If your loved one is opening up about their loss, slow down and listen. Acknowledge the depth of the grief and allow space for them to feel the emotions that arise (perhaps pain, sadness, anger, powerlessness, confusion, and/or numbness). Remind them that it is normal to grieve and that there is no set timeline for how long this process should take. Understand that this was not just a physical event but an emotional one as well, involving dreams, hopes, and expectations for the future.

  • Phrases like “I’m here for you” and “Your feelings are valid” can be supportive during this time.
  • Avoid comments about “trying again” because this can feel invalidating and minimize the significance of their loss.
  • Keep in mind that having a miscarriage can be a traumatic experience. Focus more on supporting them in their feelings and less on probing for details about what happened.


Provide Information and Resources

Empower the individual with knowledge about the grieving process and the physical and emotional aspects of miscarriage. Offer resources such as books, support groups, and online communities where they can find solace and connect with others who have experienced similar losses. Encourage them to seek professional help if they feel it would be beneficial.

Here are some great resources:

Encourage the individual to explore these resources at their own pace, emphasizing that they are not alone in their experience and that there are supportive communities and expert guidance available to them.


 Encourage Self-Care and Compassion

Grieving takes a toll on both the mind and body. Encourage the individual to prioritize self-care activities that promote healing, such as gentle exercise, journaling, meditation, and spending time in nature. Remind them to be patient and compassionate with themselves, acknowledging that healing is a gradual process.


Foster a Sense of Hope and Meaning

While it may seem difficult to imagine at this moment, helping the individual find hope and meaning in their experience can be a powerful step toward healing. Encourage them to explore ways to honor their loss, such as creating a memorial, planting a tree, or participating in a charity event. This process allows them to transform their pain into something meaningful and positive.


Processing a miscarriage is a deeply personal and complex journey. By acknowledging the grief, validating the experience, providing information and resources, encouraging self-care, and fostering a sense of hope, you can guide the individual toward healing and growth. Remember, your role is to offer support, and it’s okay to seek professional advice or refer them to specialized support groups if necessary. Together, you can navigate this difficult journey towards a place of greater understanding and peace.

If you are looking for a therapist that helps folks that have experienced miscarriage, infertility struggles, or postpartum depression, Stephanie Doig is now taking new clients. Reach out now to schedule with Stephanie today!

Get Outside For Your Brain

Get Outside For Your Brain

When I am among the trees, Especially the willows and the honey locust, Equally the beech, the oaks and the pines, They give off such hints of gladness I would almost say they save me, and daily. Excerpt, "When I Am Among The Trees" by Mary Oliver We live in a world...

Seasonal Depression and The PNW Rainy Season

Seasonal Depression and The PNW Rainy Season

What is SAD?

Seasonal Affective Disorder (SAD), often called seasonal depression, is estimated to affect roughly 5% of the population at any given time. Although it can occur with any seasonal change, the predominant timeframe is depressive symptoms starting with a fall to winter onset, and a spring to summer remission.

For areas of the country that experience harsh fall and winter weather, SAD can be especially prominent or severe. For example, research shows that the estimated prevalence in Florida is only 1%, but that number rises to 9% in Alaska. With the Portland-Vancouver metro area receiving an average of 140-160 days of rain a year and especially limited sunlight in the late fall and winter, it’s no wonder we experience some of the highest rates of depression (and seasonally related depression) in the country. Many people who live in the Pacific Northwest find comfort and peace in the gloomy, rainy days, but for others, the seasonal change can bring dread for the impending shift in mood and overall happiness.

If you notice you struggle significantly during the fall to winter months, you are not alone. Some people struggle with a less severe version of the same symptom profile, often called the “winter blues”. If these symptoms start to become intense enough to impact your daily life, it’s worth checking in with a mental health professional and/or primary care provider to help you find the right support.


What does SAD look like?

Symptoms of seasonal affective disorder can look very similar to other forms of depression, but they markedly follow a seasonal pattern. AFAB (assigned female at birth) people appear to be affected at a great rate, though the reason for this difference is unknown. The average age of onset of symptoms is around 20 years old, but it can affect people of all ages. Some symptoms to look out for as we move into fall and winter include:

  • General feelings of sadness
  • Fatigue despite increased sleep
  • Loss of interest in previously enjoyed activities
  • Difficulty concentrating
  • Carbohydrate cravings and increased appetite
  • Irritability
  • Changes in libido
  • Feelings of hopelessness


What causes SAD?

While it is unknown what specifically causes SAD, research shows that sunshine certainly plays a factor, and circadian rhythm, hormonal factors, serotonin levels, genetic factors, and preexisting depression symptoms may all play a role. Some theories speculate that reduced sunlight exposure causes the body to produce and release more melatonin, a naturally occurring hormone that induces sleepiness and helps regulate circadian rhythms.

We may not know the exact biological mechanisms or reasoning for seasonal affective disorder, but because so many people experience similar symptoms, we do have some options can be done to reduce their severity.


What helps?
  • Light therapy and more time outside

Because we know that SAD is at least partially due to reduced sunlight exposure and changing daylight patterns, it stands to reason that increased sunlight can help manage symptoms. In places where natural sunlight is difficult to come by during the fall-winter months, devices called lightboxes can be a great option to try. Check out this guide to picking an appropriate light therapy box.

  • Therapy

Support from a mental health professional is important any time you’re experiencing depressive symptoms that are interfering with your daily activities or quality of life. A variety of therapy modalities can be effective in managing seasonal depression, but cognitive-behavioral therapy has specifically been shown to reduce symptoms. There is strong evidence that the impact of CBT is even greater than that of light therapy and has the power to provide protective benefits in seasonal changes even in future years after initial treatment.

  • Medical Assessment

If you notice symptoms of SAD, it’s important to see a medical provider to rule out other causes (things like anemia, vitamin deficiencies, thyroid issues and other health conditions can present in symptoms that look like depression). If they conclude that SAD is the presenting concern, they may be able to suggest lifestyle or medication changes to support you through this time. They may also refer you to a mental health prescriber (like a psychiatrist or psychiatric nurse practitioner). In some cases, psychotropic medication can be a helpful supplement, and a prescriber with a specialty in this area can help you weigh your options.

If you or someone you care about seems to be experiencing depressive symptoms, (seasonally or otherwise) don’t delay in reaching out for help. There are treatment options available, and people ready to help you get back to feeling well – even during rainy season!

Life Hacks For When Everything Feels Hard

Life Hacks For When Everything Feels Hard

Mental health challenges like depression, anxiety, and ADHD can make for difficult days. Ideally, with the right combination of therapy, coping skills, or medication, there won’t be so many hard days. But sometimes we hit a rough patch or experience a stressor or change in our functioning that leaves us feeling like even the smallest of tasks are impossible. If you’ve ever been there, you probably know the compounding effect and how hard it can feel to care for yourself and your space. There are many resources about how to manage these things from a longer-term perspective, but what do we do when we’re in the thick of it? Below you’ll find some specific examples, but the idea here is to tailor this general framework to what feels manageable in the moment. 


  • Release the expectation of what you “should” be doing
  • Do something even if you can’t do everything
  • Get creative with how it gets done
  • Ask for help 



For a lot of folks, showering can feel like a monumental task, so let’s go through some other options. Some people prefer to take a bath, or just turn on the shower and sit to conserve energy. For some, it’s the idea of getting out of the warm water that feels overwhelming, so picking out comfortable clothes or putting a heating pad on a towel to minimize discomfort does the trick. If all else fails, move to dry shampoo and baby wipes. Is it ideal? No. But you’ll feel better than you did before and that’s an accomplishment. 



Mental health challenges often directly impact appetite and nutrition; the type, frequency, and scheduling of eating and drinking can feel like a never-ending task. If this is you, think about foods that combine convenience and nutrition. Stock a bedside cart with non-perishable items that fuel your body so there’s no planning or preparing needed when you’re having a harder time. Throw out the rules of what’s expected if it sounds good to you and will give you energy. Lasagna for breakfast? Sure! Ham, cheese, and bread eaten separately but not put together into a sandwich? Why not! Keep a list of low-effort meal ideas on your fridge so that if seeing too many options feels overwhelming you can remove the burden of decision-making. Getting enough water can also be a challenge, so try adding flavor, sucking on ice cubes, stocking up on hydration aids/drinks, filling up one large water bottle for the day, or even bringing a water dispenser into your space.  If you find yourself struggling with nutrition long-term or feel like it is tied to other factors, please reach out to a therapist and/or dietician for help. 



Many people find their home environment starts to reflect how they are feeling, and can sometimes begin to exacerbate the original difficulty. Again, we’re throwing out the rules that your space needs to look “perfect”, and instead focusing on the word “functional”. Your definition of functional will be individual, but in general, all it means is that you are physically safe and comfortable and can find the things you need with relative ease. Does it matter if your sheets match? Nope, but having sheets would likely feel better. Does it matter if you fold your clothes? No. But it would probably help to sort them into bins so you can find what you need. Does every surface need to be clutter-free? No. But make sure you can comfortably spend time in your home and have space to do other tasks will help them feel more manageable. 



There is inherent privilege in being able to outsource certain care tasks (laundry, cleaning, meal prep, etc.) If you have the means to be able to do those by hiring someone, now may be the time to consider lowering your burden. That being said, for many people this is where asking for help from your supports must come into play. When you’re struggling, asking for assistance can feel embarrassing and shameful, but most people understand the struggle more than you might think. Ask for help in a way that feels manageable, but that would make an immediate improvement in your functioning. Ask your supports if they can grab a few grocery items on their next trip or run an errand for you, if they can take your dog for a walk or cover school pick-up. Some people find it easier to complete tasks for other people, so see if you and and a friend can swap tasks to benefit you both. 


These are small changes, and while it may not seem like much at first, showing up for yourself in these incremental ways helps to both provide the energy your brain and body need to move through, but also to signal to your brain that you’re worthy of care. It doesn’t matter how you show up for yourself, only that you do. 




Get Outside For Your Brain

Get Outside For Your Brain

When I am among the trees, Especially the willows and the honey locust, Equally the beech, the oaks and the pines, They give off such hints of gladness I would almost say they save me, and daily. Excerpt, "When I Am Among The Trees" by Mary Oliver We live in a world...

How to Disobey “Worthless” Thoughts

How to Disobey “Worthless” Thoughts

If you believe you are “worthless,” it can bring on crushing feelings of depression and shame. But worthlessness doesn’t only impact how you feel. It also profoundly impacts what you do next. When you believe you are “worthless,” you might:

  • Not ask for help
  • Silence your voice
  • Say ‘yes’ when you’d prefer to say ‘no’ (or vice versa)
  • Deny your own needs
  • Stick it out in a toxic workplace or relationship
  • Stop trying
  • Quit things that matter most to you
  • Isolate from friends or family
  • Spend money on others but not yourself
  • Behave recklessly
  • Cover up, conceal, or hide
The trouble is, the more you behave as if you are worthless, the more shame you feel, the more you believe you are worthless. This perpetuates more of the same stuck behavior. It’s a vicious circle.


DISCLAIMER: Before we dive in too deep, as detailed in my post “Why I Think ‘Worthless’ Isn’t a Feeling AND Why that Matters,” I see “worthless” as a judgment NOT a feeling. Worthlessness is a malleable belief system that can be changed as you alter thinking, change behavior (the focus of this article), and heal from past hurts or traumas.


CHALLENGE: Imagine for a moment that a miracle took place while you were sleeping and you wake up in the morning fully believing that you are a person of infinite worth. Really stick with the image for a few minutes even if it’s difficult. Grab a piece of paper and jot down your ideas about how you interact with your day differently if you were to see yourself as WHOLE and WORTHY.


Depending on how deeply the belief of worthlessness has taken hold, perhaps behaving as if you are a person of worth starts with taking care of basic tasks of living, such as:

  • Rolling out of bed (maybe rolling on to the floor if that’s what gets you started)
  • Getting dressed in clean clothes
  • Taking a shower
  • Brushing your teeth
  • Checking the mail
  • Scheduling that doctor’s appointment or dentist appointment you’ve delayed
  • Getting in to see a counselor or psychiatric medication prescriber


If your beliefs about worthlessness have impacted your relationships, behaving as if you were a person of worth might look like:

  • Reaching out to friends or family you find trustworthy
  • Practicing vulnerability (again, with those you find trustworthy)
  • Accepting an invitation (or declining an invitation if your experience of worthlessness involves co-dependent people-pleasing)
  • Putting yourself out there to make a new connection
  • Raising your standards for friendship or dating
  • Setting boundaries with someone causing you harm
  • Speaking up about something you’re needing


If beliefs about worthlessness have impacted you at work or school, behaving as if you are worthy might involve:

  • Requesting accommodations
  • Applying for that promotion or job change you’ve been too scared to try, even if it doesn’t work out; as a student, perhaps trying out for the school play or a position on a team (regardless of outcome)
  • Going back to school later in life
  • Asking for help or more training
  • Giving yourself a break to prevent burnout
  • Making a change to your schedule to accommodate what you’re really needing
  • Living like Teddy Roosevelt’s “Man in the Arena”(however that translates for you)


If body image struggles have been a source of worthless thoughts, perhaps behaving as if you are fully worthy involves:

  • Buying clothes that fit your body comfortably at its current size
  • Nourishing yourself with consistent food intake throughout the day
  • Moving your body in ways that feel joyful but not self-punishing
  • Not letting your body hold you back from living your life (ex. Going swimming, traveling, dating)
  • Asking your doctor not to weigh you unless it’s (truly) needed medically
  • Respecting your body with your thoughts (get your inner bully in check)
  • Reading the book “Body Respect” by Lindo Bacon for even more ideas


These are all only examples. You will customize your behavioral REBELLION against worthless beliefs based on how worthlessness impacts you.

ASK: What action does worthlessness want you to do? You can either obey or disobey. Real change happens when you begin to DISOBEY.

In Dialectical-Behavioral Therapy (DBT), there is a skill called “Opposite Action” that helps shift negative beliefs with different (opposite) behavior. Here’s a video where you can learn more: https://www.youtube.com/watch?v=wkxOICjG2is


The big idea is this– If acted as if you are a person of worth EVEN BEFORE YOU BELIEVE IT’S TRUE– you can impact how you feel about yourself positively. Sometimes Action comes before Belief. Sometimes Action comes before you Feel any differently.


As mentioned above, many folks that experience worthless beliefs have trauma experiences that have contributed to low self-worth. If you’re curious about the impact of past experiences on worthless beliefs, ask yourself..


  • When did you first start to believe you are  “worthless?” Did someone in your life send you this message– directly or indirectly?
  • Did you have experiences of emotional neglect that taught you that your feelings or needs weren’t valuable?
  • Did you experience physical, sexual, verbal, or emotional abuse at anytime in childhood or adulthood?
  • Did you experience other Adverse Childhood Experiences(ACES)?


Let’s not pretend that any of this work is easy, especially if you are feeling depressed! That’s why many people get support from a professional therapist when doing this work. Don’t hesitate to reach out for support. You’re worth it!


4 ADHD Skills That Actually Work

4 ADHD Skills That Actually Work

If you have ADHD, you know that finding the right set of tools and techniques that work for you can be a process of trial and error. What works for you might be the opposite of helpful for someone else. Below you’ll find a few techniques to try that go beyond the...