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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...

What is your “Why”? Core Values Exercises for Anxiety Resiliency

What is your “Why”? Core Values Exercises for Anxiety Resiliency

Anxiety often prompts us to steer clear of situations that trigger fear, causing many to shrink their lives to avoid such triggers. However, understanding and embracing our core values can provide a light through the darkness of anxiety and help us reconnect with a full, engaged life without avoiding the things that scare us. In this guide, we’ll explore how to recognize and integrate our values using principles from Acceptance and Commitment Therapy (ACT). By anchoring ourselves in our values, we can navigate anxiety with resilience and purpose.


Understanding Values:

Values are the guiding principles that define what truly matters to us in life. They represent our deepest desires and aspirations, guiding our decisions and actions. When anxiety strikes, it can be easy to lose sight of these values. However, by connecting with our values, we can find clarity and direction amidst the chaos. Here’s how to identify your values:


  • Reflect on Meaningful Experiences: Take a moment to reflect on past experiences when you felt most fulfilled and aligned with your values. These moments often occur during times of challenge or adversity, highlighting the importance of our values in guiding us through difficult times.
  • Clarify Your Priorities: In the face of anxiety, it’s essential to identify your priorities and align them with your values. What aspects of your life do you prioritize when making decisions? What would your monthly budget say about your priorities? What would your calendar show about what is most important to you?
  • Imagine Your Ideal Life: Envision a life where you are living in alignment with your values. What does this life look like? By visualizing your ideal future, you can gain clarity on the values that are most important to you. This pivotal step anchors you in your motivation to persevere through the demanding process of confronting the fear and avoidance that trap so many in anxiety.



Integrating Values into Daily Life:

Integrating values into your daily life is essential for building resilience. Here’s how you can incorporate your values into your daily routine:

  • Set Goals Aligned with Your Values: Identify goals that are aligned with your core values and take steps to pursue them. By setting goals that are meaningful to you, you can stay focused and motivated, even in the face of anxiety.
  • Take Values-Based Action: Commit to taking action that is consistent with your values, even when it feels challenging. By prioritizing values-based action, you can build resilience and overcome anxiety-triggering situations with confidence.
  • Practice Mindfulness and Acceptance: Cultivate mindfulness and acceptance of your internal experiences, including anxious thoughts and feelings. By practicing mindfulness, you can observe your thoughts without judgment and respond to them in a values-driven manner instead of an anxiety-driven manner.


Embracing your values is a powerful tool for building resilience. By connecting with what truly matters to you and aligning your actions with your values, you can navigate life’s challenges with clarity and purpose. If you’re ready to explore your values further and receive support on your journey, consider reaching out to a therapist on our team who can guide you through this process. Your path to resilience starts by embracing your values 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...

Things You Might Feel Shame For, That Are Actually Very Common!

Things You Might Feel Shame For, That Are Actually Very Common!

As therapists, we hear from people in all walks of life. Every client is different and comes to therapy with varied experiences, but one thing remains true; most people hold shame for things they don’t need to. When we feel shame, our brains will often make us think that we’re the only one who could think or feel this way, or that only terrible people would be. Aside from being a horrifically uncomfortable emotion, intense shame is detrimental to our overall mental health, relationships, and long-term self-esteem. 


While this is nowhere near a comprehensive list, below is a list of things I often hear in therapy, that are entirely normal. If you’ve ever had these thoughts, you are far from alone!


“When ____ died, I felt relieved”


What shame tells you this means: I must be a terrible person to feel a positive emotion after a death. Did I wish this upon them? 


What it actually means: You’re a human capable of compassion fatigue, empathy for an end to suffering, potential safety benefits to yourself or others, awareness of resource strain, etc. Grief is always complex and there are typically many conflicting emotions that can include relief. 


“I lied/cheated/stole in my past”

What shame tells you this means: “I am a liar, cheater, criminal.”


What it actually means: Many people hold shame for very minor mistakes or choices from their past. Barring violent or aggressive actions, most of the time there is a reason for these choices, that once understood, lets in compassion instead of shame. 



“I _____ to cope”


What shame thinks this means: I can’t deal with the stress of my life. 


What it actually means: Substances, “nervous habits”, and impulse spending are just some of the behaviors people often feel significant shame for engaging in when they are feeling difficult emotions. If your behaviors are causing you harm or aren’t working to reduce your distress as you hoped, all that means is that they aren’t quite the right option for you. There is never shame in trying to feel better, there are only things that serve you and things that don’t. 


“I have intrusive thoughts about ________”


What shame tells you this means: “My brain is out of control, I’m disgusting/disturbed for thinking that way”


What it actually means: You have a normal brain, working exactly how a normal brain should. Intrusive thoughts are so common, that it’s more uncommon to be someone who hasn’t experienced an intrusive thought. To be frank, I’ve never met someone who hasn’t experienced intrusive thoughts, only people who felt strong emotion after them, and people who brushed them off and forgot about them. Having intrusive thoughts (even ones that feel totally out of character!) says nothing about who you are. If these thoughts are causing you intense distress it is certainly worth discussing with a mental health provider, but even then, there is no shame in experiencing them. 




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...

Why I Think “Worthless” Isn’t a Feeling AND Why that Matters

Why I Think “Worthless” Isn’t a Feeling AND Why that Matters

Have you ever been so dejected or depressed that you began to question your worth as a person? What triggered that moment for you? Was it:

  • A rejection, break-up, or abandonment?
  • A harsh word or critique that hit like an arrow in the heart?
  • A failure to live up to your own expectations?
  • Feeling in over your head, burned out, or unable to perform?
  • Something else?

As counselors, we often hear clients describe their feeling during these moments as “worthless.” It’s as if some lack of performing, achieving, belonging, or approval could strip away a person’s value as a human, leaving them with a sense of emptiness.

Do you have a sense of self-worth that goes up and down? A conditional self-worth that is dependant on being liked or on your achievements? As you’ve perhaps experienced, having a conditional self-worth can be risky:

  • Perhaps you overwork, overachieve, and compulsively climb ladders trying to prove yourself. Do ever really reach the finish line or are you stuck on a hamster wheel constantly striving? Does that cost you time with your family or friends? If a setback occurs, do you name yourself “failure” and pay a cost with anxiety, depression, or a suicidal urge?
  • Perhaps you base self-worth on the condition of others’ approval (which can go up or down). Do you have a good or bad day depending on if someone else’s reactions to you? Does that ever lead you to over-committing or people-pleasing? Do you hold back, minimizing your voice in relationships? If a subtle rejection occurs, do you notice yourself having a big emotional response?

Perfectionism is the embodiment of achievement-oriented or approval-oriented self worth. Brene Brown describes perfectionism and its cost best:

“Perfectionism is not the same thing has striving to be your best. Perfectionism is not about healthy achievement and growth. Perfectionism is the belief that if we live perfet, look perfect, and act perfect, we can minimize or avoid the pain of blame, judgment, and shame. It’s a shield. Perfectionism is a twenty-ton shield that we lug around thinking it will protect us when, in fact, it’s the thing that’s really preventing us from taking flight.”

-Brene Brown, The Gifts of Imperfection

It’s time to change how we think about WORTH. What if you could experience a form of self-worth that did not ebb and flow with your achievement or approval? Would you step off of the “conditional self-worth” rollercoaster? Wouldn’t it be amazing to experience security in your self-worth despite successes or failures!

I want to suggest two key strategies for revolutionizing your experience of self-worth.

  1. Clarify what you really feel when you say you feel “WORTHLESS.”

I want to suggest that “WORTHLESS” is a judgment NOT a feeling. It’s a proclamation of subjective self-assessment. It is more thought than it is emotion. These judgments are similarly not feelings:

  • Bad
  • Failure
  • Fat
  • Ugly
  • Stupid
  • Crazy

But, you might argue, “I DO feel strongly when I have those thoughts!” YES! A distorted negative self-evaluation would certainly evoke a strong feeling! Let’s see if we can clarify what you are really feeling in those moments. Perhaps one of these feeling words would more accurately describe the emotion that goes with that thought:

  • Disappointment
  • Shame
  • Sadness
  • Anger
  • Fear
  • Worry
  • Guilt

This perspective shifting skill is essential: Instead of going along with the “I’m worthless” judgment, NAME WHAT YOU’RE FEELING and WHY.

For example: “I’m feeling ashamed because I yelled at my kids.” “I am feeling afraid because I lost my job.” “I am feeling sad because she broke up with me.”


The striking reality is that there is no standard measurement of WORTH. There is not a test you can take, a medal you can earn, or a status you must reach. The concept of what defines self-worth is unscientific, self-determined, and deeply personal. YOU HAVE THE POWER to change your self-assessment.

What if you were to intentionally choose to believe WORTH is a birthright, something inherent in your humanness? I think that’s what the founders of our country believed when they wrote these words in the Declaration of Independence:

“We hold these Truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are Life, Liberty, and the Pursuit of Happiness.”

WORTH does not have to be conditional. You can found your self-worth on the powerful certainty that you have sustaining value that can not be earned nor lost.

HYPOCRICY CHECK: Do you apply unconditional worth to other people better than to yourself?  For example, if you’re a parent, your child might make choices that make you lose their trust, but could they ever lose worth in your eyes? Never! You might already believe in unconditional self-worth, as it applies to others. Are you applying the same concept to yourself? If not, now’s the time. Take the leap of faith. It’s worth it!

Now, if we combine the name-your-feelings skill with the concept of unconditional self-worth, you can see how it’s possible to make mistakes, have setbacks, and receive rejection without it meaning anything at all about your worth as a human.

If you’d like help building a secure sense of self-worth (or overcoming your achievement- or approval-oriented perfectionism), a therapist at Star Meadow Counseling may be available to help.

Also check out behavioral strategies for shifting out of worthless thoughts in our latest blog: “How to Disobey ‘Worthless’ Thoughts.” 



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...

How To Stop Beating Yourself Up

How To Stop Beating Yourself Up

When was the last time you heard from your inner critic? You know, that voice in your head that constantly judges you, puts you down and compares you to others. The one that tells you you’re not good enough or smart enough and says things you would never dream of saying to another person.

Now you may think this inner critic, while annoying, is relatively harmless. But this is simply not the case. This inner critical voice limits you and stops you from living the life you truly desire. It hinders your emotional well-being and, if left unchecked, can even lead to depression or anxiety.

Here are some ways you can silence that inner critic and stop beating yourself up.

  1. Give it Attention

That’s right, in order to gain control over your inner critic you have to know that it exists. Most of our thinking is automatic. In other words, we don’t give our thoughts much thought. We barely notice a critical thought has passed. Give attention to your thoughts, all of them. This will help you recognize the critical voice.

Here are some emotional clues the critic has reared its ugly head: whenever you feel doubt, guilt, shame, and worthlessness. These are almost always signs of the critic at work.

  1. Separate Yourself from Your Inner Critic

Your inner critic is like a parasite, feeding off you. You were not born with this parasite but acquired it along the way. Your inner critic hopes it can hide and blend in, and that you’ll think ITS thoughts are your own.

You have to separate yourself from this parasite. One way to do that is to give your critic a name. Have fun with this naming. You could call your inner critic anything from “Todd” to “Miss. Annoying Loudmouth.” It doesn’t matter.

What matters is that you learn to separate it from your authentic self.

  1. Talk Back

In order to take the power away from your inner critic, you’ve got to give it a taste of its own medicine. As soon as you recognize your inner critic is speaking to you, tell it to shut up. Tell it that the jig is up, that you know it is a big, fat liar, and that you want it to go away. If you want to really make this voice recoil, tell it you are choosing to be kind to yourself from now on. A counselor can help you learn to talk back powerfully using strategies like Cognitive Behavioral Therapy (CBT).

Self-compassion to an inner critic is like garlic to a vampire.

  1. Create a New Inner Voice

If you want to defeat an enemy, you need to have a powerful ally on your side. It’s important at this juncture to create an even more powerful inner voice. One that is on your side and acts as your BFF.

To create this new voice, start noticing the good things about yourself. No matter what that nasty critic said about you, the truth is you have fantastic traits and abilities. Start focusing on those. Yes, it will be hard at first to let yourself see you in a positive light, but the more you do it, the easier it will get.


Life is short. To have the most fulfilling one possible, we have to stop wasting time on beating ourselves up. Take these 4 steps and learn to quiet that inner critic. Your best you is waiting to be celebrated.

Some people’s inner critic is stronger than others. Sometimes the greatest ally you can have in your corner is an impartial third-party, a therapist who can see you for who you really are.

If you or a loved one could use some help defeating your inner critic and would like to explore therapy, get in touch with a counselor on our team. We would be happy to speak with you about how we might be able to help.