Rest, Pleasure, and Peaches: Rethinking Wellness This August

Every August, National Wellness Month arrives with a familiar chorus of reminders — drink more water, move your body, practice mindfulness, build healthy habits. And those things matter. They genuinely do. But this year, I'd like to invite you to set aside the wellness checklist for a moment and ask yourself a simpler, more personal question: what does wellness actually feel like for you?

Because here's what I've noticed, both as a clinician and as a human being navigating a full life: the wellness conversation in our culture has become a little relentless. It can start to feel like one more thing to optimize, one more area where we're falling short. And that, ironically, is not very well.

Wellness Looks Different for Everyone

For some people, wellness is a morning run or a green smoothie. For others, it's an extra hour of sleep, a slow cup of coffee, or an evening walk after dinner when the heat of the day has finally softened. It might be saying no to one more obligation at work so you can say yes to the people who genuinely light you up. It might be a bowl of local strawberries from a farmers market stand, sweet and imperfect and exactly right for the season.

It might be a summer ice cream cone, eaten without guilt, in good company.

All of these things count. Pleasure counts. Rest counts. Delight counts. The research on wellbeing is actually quite clear on this — positive emotion, joy, and genuine rest are not rewards we earn after we've done everything right. They are part of what keeps us healthy. They belong in the conversation just as much as exercise and nutrition do.

Saying No as a Wellness Practice

One of the most underappreciated wellness strategies is the simple act of protecting your time and energy for what actually matters to you. We live in a culture that celebrates busyness, and many of us have internalized the idea that saying yes — to every request, every obligation, every opportunity — is what responsible, caring people do.

But every yes is also a no to something else. When we say yes to one more work commitment, we are often saying no to an evening walk, a phone call with a friend, or an hour of genuine rest. Being intentional about where your time goes is not selfish. It is one of the most meaningful forms of self-care there is.

I recently rearranged my own schedule to make this happen. My dear friend Jen, who I've known since college — we lived together for all four years — is coming to visit on August 28th. She'll be in the area dropping her youngest off at the University of Maryland, and I am honored to get to walk alongside her through that transition, one of the many we have weathered together over the decades. We're spending the day at the pool, and I moved things around to make it possible without a second thought. That kind of friendship — the kind that has seen you through countless seasons of life — is its own form of medicine. I can't wait.

A Different Kind of Wellness Invitation

So this August, rather than adding more to your wellness to-do list, I'd like to offer a different kind of invitation. Take a few minutes to think about what actually restores you. What makes you feel like yourself again after a hard week? What small pleasures have you been skipping because they felt indulgent or unearned? What would it mean to treat those things as essential rather than optional?

Maybe it's evening walks after dinner. Maybe it's the peaches at the farmers market that are only this good for about three weeks a year. Maybe it's an extra hour of sleep on a Saturday morning, or a long phone call with someone you love, or simply sitting on your porch and doing absolutely nothing for twenty minutes.

Whatever it is — it counts. You have permission to count it.

When Wellness Needs a Little More Support

Sometimes, despite our best intentions, wellness feels genuinely out of reach — and that's worth paying attention to. If you're struggling with anxiety, depression, the weight of caregiving, or simply a persistent sense that something isn't right, please don't wait to reach out. At Shore Neurocognitive and Behavioral Health, we provide psychotherapy and psychiatric medication management for adults age 20 and older. We're here when you need us. Visit us at snhealth.net or call 443-746-3698.

Wishing you an August full of rest, pleasure, and at least one really good ice cream cone.

Maggie Black, PsyD, Licensed Psychologist & Owner, SNBH

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Helpful Resources

• Find What’s in Season Near You - Seasonal Food Guide

• August is National Wellness Month: Let’s Make Well-Being a Priority All Year Long - WebMD Health Services

• August is National Wellness Month: 10 Learning Hub Resources - Leading Age

Halfway There: A Kinder Look at the Year So Far

Here we are — July, the heart of summer, and the halfway point of 2026. For many of us, January feels like a lifetime ago. The resolutions we made with such optimism may have quietly faded, the habits we swore we'd build may have slipped, and the goals we set may look a little different now than they did on New Year's Day.

And that's okay. More than okay, actually.

Rather than treating this midpoint as an occasion for self-criticism — a chance to tally up everything we didn't do — I'd like to invite you to approach it differently. What if we used this moment to pause, take stock with genuine kindness, and think about what we actually want the second half of this year to feel like?

Start With What's Going Well

Before you think about what you'd like to change, take a real moment to acknowledge what you've done. Not in a performative way, but genuinely. What are you proud of, even quietly? What habits have you maintained, even imperfectly? What hard things did you show up for? What relationships did you tend to? What did you learn about yourself?

We have a tendency to discount our progress because it doesn't look the way we imagined it would. But growth is rarely linear, and the fact that something didn't go according to plan doesn't mean nothing happened. Something always happens. Give yourself credit for it.

A Word About Bodies and Summer

Since we're in the heart of summer, I want to say something that I think needs to be said more often, especially by those of us in healthcare.

I am 53 years old, and I do not wear a size 6 (or even close). I also don't spend much time wishing I did. What I have is a body that takes me on morning walks alone and evening walks with my teenagers — a body that is capable and present and mine. Our culture is relentless in its messaging that bodies need to be young, thin, and flawless to deserve to be seen. I'd like to respectfully disagree.

I put on my swimsuit and go to the pool. I go to the beach. I don't wait until I look a certain way to participate in my own life. And I'd encourage you to do the same — whatever that looks like for you. Self-kindness in the second half of this year might mean refusing to let an impossible standard keep you from a moment of joy. It might mean appreciating what your body can do rather than criticizing what it looks like. It might mean showing up anyway.

That, to me, is one of the most meaningful forms of self-care there is.

What Would You Like to Tweak?

Now, with that foundation of self-compassion in place, it's worth asking — is there anything you'd genuinely like to do differently in the months ahead? Not because you've failed, but because you're still growing and you get to keep choosing.

Maybe it's something small — getting to bed a little earlier, spending less time on your phone, calling a friend you've been meaning to reach. Maybe it's something more significant — addressing a relationship that needs attention, seeking support you've been putting off, or finally making space for something that brings you joy.

The key is to approach these tweaks from a place of curiosity rather than punishment. Not "I should have done this already" but "I'd like more of this going forward." That shift in framing makes an enormous difference in whether change actually sticks.

Permission to Begin Again

One of the most underrated gifts we can give ourselves is a fresh start — and the beautiful thing is that fresh starts don't require January. They don't require a Monday, or a milestone, or everything to be perfectly in order. July works just fine. Today works just fine.

The second half of 2026 is still unwritten. You get to decide what you want it to hold — and you get to make that decision with kindness toward the person you already are, not the idealized version of yourself you thought you'd be by now.

That person is doing just fine.

When You Need a Little More Support

Sometimes self-kindness means recognizing when we need more help than we can give ourselves. At Shore Neurocognitive and Behavioral Health, we provide psychotherapy and psychiatric medication management for adults age 20 and older, including support for anxiety, depression, relationship challenges, and the emotional weight of caregiving. We're here whenever you're ready. Visit us at snhealth.net or call 443-746-3698.

Maggie Black, PsyD, Licensed Psychologist & Owner, SNBH

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Helpful Resources

• The 26 Keys to Thriving - Psychology Today

• Better Half - The New York Times

• 50 Ways to Make the Most of Summer - Experience Life

June is Alzheimer's & Brain Awareness Month: The Intangible Things That Nourish Your Brain

June is Alzheimer's & Brain Awareness Month: The Intangible Things That Nourish Your Brain

Every June, Alzheimer's & Brain Awareness Month brings a welcome surge of information about how to protect our brain health. You'll find plenty of excellent resources this month about the MIND diet, physical exercise, sleep, and cognitive engagement — and we'll be sharing some of those with you in this newsletter, because they genuinely matter.

But today I want to talk about something a little different. Something less quantifiable, but no less important. The quiet, everyday moments that tell your nervous system — and your brain — that you are safe, at ease, and alive in the best possible way.

What Are Glimmers?

Clinical social worker Deb Dana, in her work with polyvagal theory, gave us a beautiful concept she calls "glimmers." Glimmers are fleeting, everyday micro-moments that spark joy, safety, or calm. They are the direct opposite of stress triggers. Rather than activating a fight-or-flight response, glimmers gently signal to your nervous system that all is well.

A glimmer might be the smell of coffee in the morning. The way light falls through a window at a particular time of day. The sound of a familiar voice. The feeling of soil in your hands. These moments are small, often easy to overlook — but they are doing something real and meaningful in your brain and body.

Why This Matters for Brain Health

Chronic stress is one of the most significant threats to long-term brain health. Sustained elevated cortisol — the primary stress hormone — has been shown to damage the hippocampus, the brain region most critical for memory formation. It contributes to inflammation, disrupts sleep, and over time can accelerate cognitive decline.

Glimmers work in the opposite direction. Moments of genuine joy, safety, and calm activate the parasympathetic nervous system — the body's rest-and-restore mode. They lower cortisol, reduce inflammation, support healthy sleep, and create the neurological conditions in which the brain can repair, consolidate memories, and function at its best. In this sense, tending to your joy is not a luxury. It is brain care.

Finding Your Glimmers

The most important thing about glimmers is that they are deeply personal. What signals safety and joy to one nervous system may mean nothing to another. Part of the work — and it is genuinely worthwhile work — is figuring out what your glimmers actually are.

For me, some of my most reliable glimmers are spending time with someone I love, someone I've known for decades, where the comfort of that history is its own kind of medicine. Planting flowers and watching them grow. Reading a good book on my porch on a quiet afternoon. These aren't grand experiences. They're small, accessible, and available to me most days — if I choose to make space for them.

That last part is the harder piece. Most of us have been conditioned to believe that these kinds of moments are rewards — things we get to do once the to-do list is finished. But here's the truth: the to-do list will never be finished. There will always be one more thing. If we wait for everything to be checked off before we allow ourselves a glimmer, we will wait forever.

Sprinkling Glimmers Into Your Days

The research on positive emotion and brain health suggests that frequency matters more than intensity. It's not the occasional vacation or big celebration that sustains us — it's the small moments of joy and calm woven consistently into ordinary days. A few minutes on the porch. A phone call with someone who knows you well. Pausing to actually notice the flowers rather than rushing past them.

This month, I'd encourage you to do two things. First, take a little time to identify your own glimmers — the specific, personal moments that make your nervous system exhale. Second, make a quiet commitment to stop treating them as optional. They are not a reward for productivity. They are part of how you take care of your brain.

When You Need More Support

At Shore Neurocognitive and Behavioral Health, we provide psychotherapy and psychiatric medication management for adults age 20 and older across a wide range of concerns — including anxiety, depression, relationship challenges, and the very real emotional weight that comes with caring for a loved one with dementia or another serious illness. Whatever you're navigating, our team is here to help.

We also offer cognitive baseline evaluations — and if you have memory concerns or a family history of dementia, this is something I'd encourage you to look into. A cognitive workup doesn't have to be intimidating. Ours are efficient, informative, and designed to give you a clear picture of where things stand. Results are delivered in plain language, with care and compassion, so you leave with real understanding rather than confusion or anxiety. Getting a baseline early means that if anything changes over time, we have something meaningful to compare it to — and that information can make a real difference.

If you'd like to learn more about our cognitive services or any of the care we provide, we'd love to hear from you. Visit us at snhealth.net or give us a call at 443-746-3698. You don't have to figure it out alone.

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Helpful Resources

• The MIND Diet: A Detailed Guide for Beginners - Healthline

• Anti Inflammatory Diet - John Hopkins Medicine

• Tips for Starting Physical Activity - National Institute of Diabetes and Digestive and Kidney Diseases

• 7 Workouts You Can Do While Sitting Down - CNet

May is Mental Health Awareness Month: More Good Days, Together

May is Mental Health Awareness Month: More Good Days, Together

Every May, Mental Health Awareness Month invites us to pause and reflect on something that touches every one of our lives — our mental health. This year's theme, "More Good Days, Together," comes from Mental Health America and SAMHSA (the Substance Abuse and Mental Health Services Administration), two of the leading voices in mental health advocacy in our country. Both organizations offer wonderful resources for individuals, families, and communities, and I encourage you to explore what they have to offer at mentalhealthamerica.net and samhsa.gov.

But what does it actually mean to have more good days? And what does "together" really look like when everyone's needs are so different? Those are the questions I want to sit with today.

Small Things, Real Impact

Good mental health days rarely happen by accident. They tend to be the result of small, intentional choices that accumulate over time. Some of the most well-supported strategies are also the most straightforward — though straightforward doesn't always mean easy.

Getting enough sleep is foundational. When we're sleep-deprived, everything feels harder — our emotions are more reactive, our thinking is less clear, and our resilience takes a hit. Protecting your sleep is one of the most meaningful things you can do for your mental health.

Moving your body regularly, spending time outdoors, limiting alcohol, and maintaining some structure to your days all contribute meaningfully to mood and wellbeing. So does having something to look forward to — even something small, like a good cup of coffee in a quiet moment, a walk with a friend, or a favorite show at the end of a long day. These things matter more than we often give them credit for.

Practicing gratitude — not as a forced exercise, but as a genuine habit of noticing what's good — has a real effect on how we experience our days. And perhaps most importantly, being compassionate with yourself when things don't go well. Good mental health isn't about feeling great all the time. It's about having enough of a foundation that you can weather the hard days without losing yourself.

The Power of Connection

The "together" in this year's theme points to something we know deeply from both research and lived experience — human connection is one of the most protective factors for mental health that we have. Loneliness and social isolation are associated with significantly higher rates of anxiety, depression, and cognitive decline. Meaningful relationships, on the other hand, buffer us against stress, give our lives a sense of purpose, and remind us that we're not navigating this world alone.

Connection doesn't have to be grand or elaborate. A text to check in on someone. A shared meal. A conversation where you feel genuinely heard. These moments of real contact with other people nourish something essential in us.

Honoring How You're Wired

Here's something I think is worth saying out loud, because it doesn't get said often enough: the amount and quality of connection that feels nourishing varies enormously from person to person — and that's not a flaw. It's temperament.

Some people genuinely thrive with a rich social life, frequent gatherings, and lots of contact with others. For them, more connection really does mean more good days. But for others — particularly those who are more introverted by nature — too much social stimulation can be draining rather than restorative. For these individuals, a good day might look like a quiet afternoon alone, a deep one-on-one conversation rather than a group gathering, or simply having enough unstructured time to recharge.

Neither of these is the right or wrong way to be human. Good mental health means knowing yourself well enough to understand what you actually need — and giving yourself permission to honor that, even when the world around you seems to be pushing in a different direction. "Together" can mean many things. What matters is that the connection you seek feels genuine and sustaining to you.

When You Need More Support

Sometimes, despite our best efforts, the good days feel out of reach. If you're struggling with persistent sadness, anxiety, difficulty functioning, or a sense that something just isn't right, please don't wait to reach out for help. At Shore Neurocognitive and Behavioral Health, we provide psychotherapy and psychiatric medication management for adults age 20 and older. You don't have to be in crisis to benefit from support — and asking for help is itself an act of courage and self-care.

This May, I hope you'll take a moment to reflect on what a good day looks like for you — and what small steps might help you have more of them. You deserve that.

Maggie Black, PsyD, Licensed Psychologist & Owner, SNBH

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Helpful Resources

• How to feel better about yourself: Simple steps backed by science - Mental Health America

• Movement for mental health – why it doesn’t have to look like exercise - Mental Health America

• Affirmations for more good days and why they work - Mental Health America

April is National Stress Awareness Month: Understanding Stress and Finding Your Way Back to Calm

Stress is something we all experience, but in today's world, many of us are living with a level of stress that goes far beyond the occasional tough day. Chronic stress — the kind that lingers week after week — can quietly take a significant toll on our minds and bodies. This April, in recognition of National Stress Awareness Month, I want to share some of what we know about how stress affects us, and more importantly, what we can do about it.

What's Actually Happening in Your Body

When you encounter a stressful situation, your brain triggers the release of hormones — primarily cortisol and adrenaline — that prepare your body to respond. Your heart rate increases, your muscles tense, and your senses sharpen. This is your body's stress response at work, and in short bursts, it's actually helpful. It's what helps you meet a deadline, react quickly in an emergency, or rise to a challenge.

The problem arises when this system stays activated over a long period of time. When cortisol levels remain elevated day after day, the body begins to pay a price. Chronic stress has been linked to increased inflammation, disrupted sleep, weakened immune function, high blood pressure, and increased risk of cardiovascular disease. It can also affect digestion, contribute to headaches, and leave you feeling physically depleted even when you haven't done anything physically demanding.

How Chronic Stress Affects Your Mind

The effects of chronic stress on the brain are just as significant as its physical effects — and often more surprising to people. Prolonged elevated cortisol can actually affect the structure and function of the brain over time, particularly in areas responsible for memory and emotional regulation.

Many people under chronic stress notice that their memory feels less sharp, that they struggle to concentrate, or that decisions that used to feel easy now feel overwhelming. This isn't just "being tired" — it reflects real changes in how the brain is functioning under sustained pressure. Mood is affected too. Chronic stress is closely linked to anxiety and depression, and it can make us more reactive, more irritable, and less able to experience the positive moments in our lives.

For those caring for a loved one with a serious illness, or navigating significant life transitions, these effects can be especially pronounced. If you've noticed that your thinking feels foggy or your mood has shifted, chronic stress may be playing a larger role than you realize.

Finding Your Way Back to Calm

The good news is that the stress response is not a one-way street. Just as the brain and body can be pushed into a state of chronic stress, they can also be guided back toward calm — and there are many paths to get there.

Physical movement is one of the most well-researched stress relievers we have. Exercise helps metabolize the stress hormones circulating in your body, releases mood-lifting endorphins, and improves sleep quality. You don't need an intense workout to benefit — a brisk walk, gentle yoga, or even dancing around your kitchen counts.

Mindfulness practices are another avenue worth exploring, and the beauty of mindfulness is how many forms it can take. Formal meditation — even just five to ten minutes of focused breathing — can meaningfully reduce cortisol levels over time. But mindfulness doesn't have to look like sitting quietly with your eyes closed. Any activity that brings you fully into the present moment can serve the same purpose.

For me personally, this time of year, that means planting flowers. There's something about getting my hands in the soil, paying attention to what each plant needs, noticing color and texture and the smell of fresh earth — it pulls me completely out of my head and into the moment. Whatever that activity is for you — cooking, walking, knitting, gardening, painting — it matters, and it counts.

Other strategies worth considering include maintaining consistent sleep habits, limiting caffeine and alcohol (both of which can amplify the stress response), spending time in nature, nurturing social connections, and being intentional about limiting news and social media consumption when the world feels heavy. Journaling can also be a surprisingly effective tool for processing stress, particularly when it helps you identify what's actually within your control and what isn't.

When to Seek Support

Sometimes stress reaches a level where self-care strategies alone aren't enough, and that's not a sign of weakness — it's a sign that you need more support than any one person can provide for themselves. If stress is significantly affecting your sleep, your relationships, your ability to function at work, or your overall sense of wellbeing, talking with a mental health professional can make a real difference. Therapy offers tools specifically designed to address chronic stress and its effects, and you don't have to be in crisis to benefit from it.

At Shore Neurocognitive and Behavioral Health, we provide psychotherapy and psychiatric medication management for adults age 20 and older. Whether you're navigating a difficult season of life or dealing with longer-standing mental health challenges, our team is here to help you find your way forward.

This April, I encourage you to take an honest look at the role stress is playing in your life — and to give yourself permission to take it seriously. Your mind and body are worth the attention.

Maggie Black, PsyD, Licensed Psychologist & Owner, SNBH

Spring as an Invitation: Small Steps Toward Renewal After a Long Winter

If you made it through winter, congratulations. That might sound dramatic, but for many of us, winter is genuinely hard. The short days, the cold that keeps us inside, the social isolation that comes when it's too much effort to leave the house. Add caregiving responsibilities, grief, chronic illness, or just the general weight of life, and winter can feel like something to endure rather than enjoy.

So here we are in March. The days are getting longer. The temperature is warming up. Everything around us seems to be waking up and starting fresh.

And if you're exhausted, that can feel like pressure. Like you're supposed to feel renewed and energized just because the calendar says so. Like everyone else is spring cleaning and starting new routines and you're still just trying to get through the day.

Here's the truth: you don't have to match the energy of spring. You don't have to overhaul your life or become a different person just because the season changed. But spring does offer something worth considering — an invitation. Not a demand, but an invitation to take one small step toward caring for yourself in a way that might actually be sustainable.

Why Winter Takes Such a Toll

Winter is hard on our bodies and our minds in ways we don't always acknowledge. Less sunlight means less vitamin D and disrupted sleep patterns. Cold weather keeps us sedentary. Social connections shrink because it's easier to stay home than to bundle up and go out.

For those managing mental health conditions, winter can intensify symptoms. For caregivers, the isolation is even more pronounced — you're already spending most of your time at home, and winter makes it nearly impossible to get out even when you have a rare opportunity.

And then there's the cumulative effect. By the time March rolls around, we're not just tired from winter. We're tired from everything that came before winter, plus winter itself. We're running on fumes, and the idea of "renewal" can feel laughable.

So if you're feeling depleted right now, that's not a personal failing. That's a reasonable response to several months of difficulty.

What Renewal Actually Means

When we talk about spring renewal, the cultural narrative tends to be about dramatic transformation. New workout routines. Complete diet overhauls. Decluttering your entire house. Starting that project you've been putting off.

That's not what we're talking about here.

Real renewal — the kind that actually sticks and actually helps — is much smaller and much more forgiving. It's about identifying one or two small adjustments that might make your daily life a little more manageable or a little more pleasant. Not because you're broken and need fixing, but because small changes in routine can have outsized effects on how we feel.

Think of it as preventative care for your cognitive and emotional wellness. Not a crisis intervention, but a gentle course correction before things get worse.

Small, Realistic Adjustments That Actually Matter

Here are some examples of what small adjustments might look like. Not a to-do list — just possibilities to consider:

Get outside for ten minutes. Not a walk, not exercise, just standing outside. Sunlight on your face. Fresh air. The research on the mental health benefits of even brief time outdoors is substantial, and spring makes this more accessible than winter did. If you can't get outside, sit near a window with natural light.

Move your body in whatever way feels doable. This doesn't have to be a gym membership or a running program. It can be stretching while you wait for coffee to brew. Taking the stairs once instead of the elevator. Dancing to one song in your kitchen. Movement helps regulate mood and anxiety, but it doesn't have to be formal or intense to count.

Reconnect with one person. Winter isolation is real, and many of us have let relationships drift simply because it was too hard to maintain them. Send one text. Make one phone call. Say yes to one invitation, even if you're not sure you have the energy. Social connection is one of the strongest predictors of mental health, and spring is a good time to rebuild what winter eroded.

Tend to one piece of preventative care you've been avoiding. Schedule that doctor's appointment. Get your teeth cleaned. Refill the prescription you've been putting off. Make the therapy appointment. These things pile up when we're in survival mode, and spring is a natural time to address them before they become urgent.

Adjust your sleep routine by fifteen minutes. Not a complete sleep overhaul, just going to bed fifteen minutes earlier or creating a fifteen-minute wind-down routine. Sleep affects everything — mood, decision-making, physical health, resilience. Small improvements here can have ripple effects everywhere else.

Do one thing that used to bring you pleasure. Read for twenty minutes. Listen to music you love. Cook something you enjoy. Work in the garden. Paint. Write. Whatever it is that used to feel good before life got so heavy — try it once and see if there's anything left there for you.

Notice what all of these have in common: they're small, they're specific, and they're achievable even when you're exhausted. You don't have to do all of them. You don't even have to do one of them every day. You just have to be willing to try one thing and see if it helps.

When Renewal Feels Impossible

Here's what we also need to acknowledge: for some of you, even small adjustments feel like too much right now. You're not just tired — you're depleted. You're not just busy — you're underwater. The idea of adding anything, even something meant to help, feels impossible.

If that's where you are, that's okay. You don't have to force renewal. You don't have to perform wellness. Sometimes the most important thing you can do is simply acknowledge how hard things are and give yourself permission to just keep going.

But if you're in that place, it might also be worth asking: is this the moment to reach out for help? Not to fix everything, but to get some support so you're not carrying it all alone. That might mean talking to your doctor about how you're feeling. It might mean asking a friend to help with one specific task. It might mean calling a therapist to see if there's room for you to start working together.

Asking for help is also a form of self-care, and sometimes it's the only form that's actually accessible when everything else feels out of reach.

Spring as Possibility, Not Pressure

Here's what I hope you take from this: spring doesn't require you to transform. It doesn't demand that you suddenly have energy you don't have or make changes you're not ready for.

But it does offer something. Longer days. Warmer weather. A natural transition point that makes it a little easier to try something new or return to something old.

You get to decide what that means for you. Maybe it's one small habit that makes your days a little more manageable. Maybe it's finally scheduling that appointment you've been avoiding. Maybe it's just noticing that you feel a little less heavy when you step outside into the sunshine.

Whatever it is, it doesn't have to be big to matter. Small steps count. Trying counts. Showing up for yourself in whatever way you can — that counts too.

Winter was long. You made it through. And now spring is here, offering you a chance to take one small step toward feeling a little bit better. Not perfect. Not transformed. Just a little bit better.

That's enough. You're enough. And whatever small step you choose to take — or not take — you're doing better than you think you are.

Finding Your Way Through the Holidays

The holidays arrive each year with a peculiar kind of pressure. For some of us, the calendar fills up fast - parties, gatherings, obligations that pile on top of an already busy life. For others, the calendar stays stubbornly blank, and the silence feels louder than any celebration. Both experiences can be hard in their own way.

If you're feeling overwhelmed by invitations and expectations, give yourself permission to honor who you actually are. If you're an introvert, December doesn't magically change that. Saying yes to every gathering because you think you should will leave you depleted and resentful. It's okay to be selective. It's okay to choose one meaningful dinner over five exhausting parties. It's okay to leave early. Your energy matters, and protecting it isn't selfish - it's smart.

If your calendar is empty and loneliness is settling in, that's hard too. The holidays can amplify what we've lost or what we're missing. But a quiet season doesn't have to mean a meaningless one. Sometimes the most powerful connections happen outside traditional celebrations. 

Volunteering at a food bank or shelter puts you alongside others and reminds you that you have something to offer. Reaching out to someone else who's struggling - a phone call, a text, an invitation for coffee - creates connection for both of you. These small acts of reaching toward others can shift something inside us.

Grief shows up differently for everyone during the holidays. Maybe you've lost someone you love. Maybe your family doesn't gather the way it used to. Maybe your adult children are building their own traditions elsewhere, and the table feels too empty. It's natural to long for holidays past, to remember when things felt full and right. Those memories matter. They're worth honoring.

But here's the thing: when we spend all our energy wishing for what was, we miss what is. 

Resisting the present doesn't bring back the past - it just makes right now feel worse. Accepting that things have changed doesn't mean you're okay with the loss. It means you're making room for something different, maybe even something good, to exist alongside the sadness. You can hold both - gratitude for what was and openness to what might be.

This doesn't mean forcing yourself to feel festive or pretending everything's fine. It's okay to have a quiet holiday. It's okay to feel lonely. It's okay to grieve. We're wired to get through hard things, and sometimes getting through means simply showing up to the day in front of us without demanding that it look a certain way.

If you're already working with a therapist, this might be a good time to check in about whether you need more frequent sessions through the holidays. Don't minimize what's hard or try to power through on your own. Your therapist is there precisely for seasons like this. Be brutally honest about what you're struggling with - the loneliness, the grief, the pressure, whatever it is. And if you're not currently in therapy but finding it hard to function or the sadness feels unmanageable, reaching out for support makes sense. There's no shame in asking for help. In fact, it's one of the bravest things you can do.

However you're moving through this season - overwhelmed, lonely, grieving, or some combination of all three - be gentle with yourself. Honor your limits. Make space for connection where you can. Accept what is, even when it's not what you wanted. And remember that getting through is enough.

National Family Caregivers Month: Acceptance, Grief, and the Impossible Advice

November is National Family Caregivers Month, which means well-intentioned articles are popping up everywhere reminding caregivers to "practice self-care" and "don't forget about yourself." The advice usually sounds something like: Take a relaxing bath. Go for a walk. Meet a friend for coffee. Join a support group. Make time for your hobbies.

And if you're a caregiver reading that list, you might be thinking: With what time? With what energy? And who exactly is going to stay with my loved one while I'm out living my best life?

The gap between the advice and the reality can feel almost cruel. Because the truth is, caregiving often doesn't leave room for the self-care we're told we desperately need. The person you're caring for can't be left alone. The nights are broken. The worry is constant. And even when you do carve out a moment, guilt tends to fill it.

So let's talk about what's actually happening when you're caring for someone you love who is declining. Let's talk about the grief that lives alongside the caregiving, and what it might mean to walk someone home.

The Grief That Comes Before

Caregiving often involves a particular kind of grief that doesn't fit neatly into our cultural understanding of loss. Your loved one is still here, still breathing, still in the room with you. But they're also... not quite here anymore. Not in the way they used to be.

Maybe it's dementia, and the person who raised you no longer recognizes your face. Maybe it's a progressive illness, and each month brings another loss — first the ability to walk, then to feed themselves, then to speak clearly. Maybe it's a stroke or brain injury, and the personality you knew has shifted in ways that are subtle but unmistakable.

This is anticipatory grief, and it's exhausting in a way that's hard to explain to people who haven't lived it. You're grieving while also staying present. You're mourning losses while simultaneously trying to prevent new ones. You're saying goodbye in slow motion, and there's no clear endpoint, no moment when you're allowed to fully feel it because you're still needed, still on duty, still showing up.

And here's what makes it even more complicated: you might feel guilty for grieving someone who's still alive. You might feel selfish for missing who they used to be when you should just be grateful they're still here. The emotional math doesn't add up, and that's because grief doesn't follow logic.

When Self-Care Advice Misses the Mark

This is why the standard self-care advice often falls flat for caregivers. It's not that bubble baths and walks in nature aren't lovely things. It's that they require a kind of freedom and mental space that caregiving simply doesn't allow.

You can't "take a break" from anticipatory grief. You can't schedule your worry for convenient times. And you certainly can't leave your loved one alone so you can go to yoga class when they need help getting to the bathroom every hour.

The advice isn't wrong, exactly. It's just... incomplete. It doesn't account for the reality that caregiving is often a 24/7 role with no backup, no vacation days, and no clear end date.

A Different Kind of Caring for Yourself

So, what does self-care actually look like when traditional self-care isn't possible?

Maybe it's this: acceptance.

Not acceptance in the sense of giving up or resigning yourself to misery. But acceptance of what this season of life actually is. Acceptance that you're doing something incredibly hard. Acceptance that you're going to feel grief and exhaustion and sometimes resentment, and that none of those feelings make you a bad person or a bad caregiver.

Acceptance that you can't do this perfectly. That you're going to lose your patience sometimes. That you're going to feel touched out and tired and like you can't possibly do this for one more day — and then you're going to do it for one more day anyway.

Acceptance that this isn't a problem to be solved with better time management or a more positive attitude. It's a profound human experience that deserves to be honored as such.

When you accept the reality of what you're living through, something shifts. You stop fighting against the impossibility of it all. You stop measuring yourself against advice that was never designed for your situation. You give yourself permission to simply be in it, to feel what you feel, to do what you can do.

And sometimes, self-care in the midst of caregiving looks like asking for help with the specific, concrete things. Not "let me know if you need anything," but "I need someone to sit with Mom on Tuesday afternoon so I can go to my own doctor's appointment." Not trying to do it all but naming one thing that would actually make a difference and letting someone help with that one thing.

The Honor of Walking Someone Home

There's a phrase that's been meaningful to many caregivers: walking someone home. It captures something that "caregiving" doesn't quite convey — the sacred nature of accompanying someone through their final chapter, of being present as they make their way toward whatever comes next.

It's an honor, truly. To be the person someone trusts with their most vulnerable moments. To hold their hand, literally and figuratively, as they navigate loss and decline. To bear witness to their life, even as that life is changing or ending.

But here's what we don't talk about enough: an honor can also be a burden. Both things can be true at once. You can feel privileged to care for someone you love and also feel crushed by the weight of it. You can treasure the moments of connection and also long desperately for it to be over. You can love someone deeply and still feel relief when you imagine your life after their death.

All of it is normal. All of it is human. All of it deserves compassion — especially the parts that feel shameful to admit.

For This Month, and Beyond

So this November, during National Family Caregivers Month, maybe the most important thing we can offer caregivers isn't another reminder to practice self-care. Maybe it's permission to acknowledge how hard this is. Permission to grieve. Permission to feel the full range of what caregiving brings up — the love and the exhaustion, the meaning and the loss, the honor and the burden.

If you're a caregiver, please know: You don't have to do this gracefully. You don't have to find the silver lining. You don't have to be grateful for the opportunity or transformed by the experience. You're allowed to simply survive it, one day at a time, doing the best you can with what you have.

And if you know a caregiver, maybe skip the advice about self-care and instead offer something concrete. Bring a meal. Sit with their loved one for two hours. Send a text that says "I know this is really hard" and nothing more. Show up in the specific, practical ways that actually help.

Because caregiving isn't a problem to be solved with better self-care strategies. It's a profound act of love that deserves to be witnessed, supported, and honored for exactly what it is.

If you’re a caregiver in need of some extra support, we invite you to attend our monthly caregiver support group. SNBH’s Caregiver Support Group offers a welcoming and supportive space where you can share your experiences, connect with others facing similar challenges, and find encouragement.

Understanding Grief: There's No Right Way to Navigate Loss

Grief is one of the most universal human experiences, yet it remains deeply personal and unique to each individual. If you're struggling with loss—whether recent or anticipated—it's important to know that whatever you're feeling is valid, and there's no "correct" way to grieve.

Your Grief is Uniquely Yours

Despite what movies or well-meaning friends might suggest, grief doesn't follow a neat progression of stages. Some days you might feel angry, others overwhelmingly sad, and sometimes you might even feel moments of peace or joy—and that's completely normal. Grief can show up as physical exhaustion, difficulty concentrating, changes in appetite, or waves of emotion that seem to come from nowhere.

There's no timeline for healing. Some people begin to feel more like themselves after weeks, others after years. Your relationship with the person you've lost, your support system, your previous experiences with loss, and countless other factors all influence your journey. Resist the pressure to "move on" according to someone else's schedule.

When Grief Begins Before Death

For families caring for someone with dementia, grief often begins long before death occurs. This is called anticipatory grief, and it's a natural response to watching someone you love gradually slip away. You might find yourself mourning the person they used to be, the conversations you can no longer have, or the future you'd planned together.

Many caregivers feel guilty about grieving someone who's still alive, but this reaction is both common and healthy. You're not giving up on your loved one—you're processing very real losses as they happen. The vibrant parent who raised you, the spouse who was your closest confidant, the friend who shared your inside jokes—in many ways, dementia takes these relationships from us gradually.

Anticipatory grief can actually be protective, allowing you to begin processing your emotions and adjusting to changes while still having time with your loved one. It doesn't mean you love them any less or that you're wishing for their death. It means you're human.

Grief Isn't Linear

One of the most challenging aspects of grief is its unpredictability. You might have a good week followed by a terrible day, or feel like you're "over it" only to be blindsided by a memory or anniversary. This back-and-forth isn't a sign that you're not healing—it's simply how grief works.

Think of grief less like climbing a mountain with a clear summit and more like walking along a winding path. Sometimes you'll feel like you're making progress, other times you'll feel lost, and occasionally you'll find yourself in a beautiful clearing you didn't expect. All of these experiences are part of the journey.

Finding Support

Whether you're anticipating a loss or actively grieving, remember that you don't have to navigate this alone. Professional counseling can provide tools for managing difficult emotions and help you process your experience in a safe space. Support groups connect you with others who truly understand what you're going through. And sometimes, simply having a friend listen without trying to "fix" anything can be profoundly healing.

Grief changes us, but it doesn't have to define us. With time, support, and patience with yourself, it's possible to carry your love for someone alongside your loss, finding meaning and even moments of joy as you move forward.

Resources for grief support groups:

https://talbothospice.org/programs/bereavement/support-groups.html

https://compassregionalhospice.org/what-we-do/grief-support.html

https://health.maryland.gov/bha/pages/grief-and-loss-resources.aspx#:~:text=%E2%80%8B%E2%80%8B%E2%80%8B%E2%80%8B%E2%80%8B,%E2%80%8B%E2%80%8B%E2%80%8B%E2%80%8B%E2%80%8B

Self-Care: Beyond the Bubble Bath

We've all seen the social media posts. The perfectly arranged bath bombs, the spa day selfies, the "treat yourself" mantras. And while there's nothing wrong with a good pedicure, real self-care runs much deeper than what we can schedule or purchase.

True self-care is less about indulgence and more about intention. It's the daily practices that keep us emotionally grounded when life feels overwhelming - which, let's be honest, happens more often than we'd like.

What Self-Care Actually Looks Like

It's setting boundaries with that family member who drains your energy, even when it feels uncomfortable.

It's saying no to commitments that don't align with your values or capacity.

It's checking in with yourself throughout the day and asking, "What do I actually need right now?"

Real self-care might mean having that difficult conversation you've been avoiding, because the stress of not addressing it is eating away at you. It could be establishing a morning routine that centers you before the day takes over, or creating an evening ritual that helps you process what happened. It's learning to recognize your emotional patterns - noticing when you're running on empty before you hit the wall.

In a nutshell, it's developing the skill of self-compassion, treating yourself with the same kindness you'd offer a good friend going through a tough time.

The Daily Difference

The most powerful self-care practices are often the smallest ones. Taking three deep breaths before responding to a stressful email. Stepping outside for five minutes when you feel overwhelmed. Keeping a journal by your bed to capture thoughts that would otherwise keep you awake.

These self-care practices may not be glamorous or make for great social media content, but they're the practices that build genuine resilience - the kind that sustains you through caregiving, through loss, through all the challenges that make us human.

Self-care isn't selfish. It's strategic.

When we tend to our emotional well-being with the same consistency we bring to brushing our teeth, we show up better for everyone in our lives. The pedicure is nice. But the real work happens in the quiet moments when we choose to honor what we truly need.

Recognizing the Early Signs of Alzheimer’s: What to Watch For

Alzheimer’s disease doesn’t begin with a single moment of forgetfulness—it often starts with subtle changes that can easily be mistaken for normal aging or stress. That’s why understanding the early warning signs can be so important for getting support and care as soon as possible. If you’ve noticed any of the following patterns in a loved one—or even in yourself—it might be time to start a conversation with a healthcare provider.

1. Repeating Questions or Stories

One of the most common early signs of memory decline is repetition. You may notice your loved one telling the same story multiple times in one conversation, or asking the same question again and again—such as what time a doctor’s appointment is, or what the plans are for the day.

2. Trouble Managing Daily Tasks

Tasks that once seemed routine—like paying bills, organizing medications, or handling taxes—may suddenly become confusing or take much longer than usual. This shift in mental processing can signal early cognitive changes.

3. Getting Lost in Familiar Places

Another red flag is a sudden difficulty navigating familiar routes. For instance, someone might feel unsure of how to get to the grocery store they’ve visited for years or become confused trying to find a well-known doctor’s office.

4. Losing Track of Time

Occasionally forgetting what day it is can happen to anyone, but if someone frequently doesn’t know the day of the week, the month, or even the current year, it may be more than a simple slip—it could point to a deeper concern.

5. Frequent Falls or Changes in Balance

While falls can occur for many reasons, multiple unexplained falls—especially in combination with other cognitive symptoms—might suggest something neurological, such as early Alzheimer’s or another form of dementia.

6. Withdrawing in Group Settings

It’s common for those in the early stages of cognitive decline to feel overwhelmed in conversations involving multiple people. They may become unusually quiet—not out of shyness, but because following the conversation is becoming more difficult, or because they’re self-conscious about struggling with words.

7. Frequently Losing Items

It’s normal to misplace your keys once in a while. But when someone starts consistently misplacing everyday items—wallets, glasses, phones—and can't retrace their steps to find them, it may be a warning sign.

8. Falling for Scams

A concerning but often overlooked signal is when someone falls victim to a financial scam or phishing scheme—especially if they were once very cautious or financially savvy. Sometimes this is one of the first outward signs that something has changed, even before memory issues are apparent.

9. Losing Interest in Hobbies and Social Groups

When someone suddenly stops showing up to their weekly book club or gives up on hobbies they used to love, it might be more than a lack of interest. Often, people are masking confusion or discomfort. It’s worth digging a little deeper when someone pulls away from previously enjoyed activities.

10. Mood and Memory Are Connected

Mood changes—like depression or increased anxiety—can affect memory, and vice versa. This overlap can make it difficult to know what’s really going on. That’s why a comprehensive evaluation by professionals, like the team at Shore Neurocognitive and Behavioral Health (SNBH), is so crucial. They can help determine whether changes in mood, memory, or behavior are part of a larger picture and help guide next steps.

It’s Not “Just Getting Older”

While aging brings changes, persistent memory issues or behavior shifts aren’t something to ignore. Early detection of Alzheimer’s and other forms of dementia can lead to better planning, more treatment options, and support for both the individual and their loved ones.

If any of these signs sound familiar, reach out to a trusted healthcare provider—or contact our team at SNBH for an expert evaluation. You don’t have to navigate this alone.

Understanding GeneSight® Psychotropic Testing: Personalized Mental Health Treatment Through Genetics

Genetic testing can provide insight For AN EFFECTIVE TREATMENT PLAN

If you've ever struggled to find the right mental health medication, you're not alone. The process of trying different medications and adjusting doses can be frustrating and time-consuming, which can make mental health symptoms worse, not better. That’s where GeneSight Psychotropic Testing comes in—a cutting-edge genetic test that helps guide mental health treatment based on your unique DNA.

What Is GeneSight® Testing?

GeneSight is a clinically validated genetic test that helps healthcare providers understand how your body may respond to certain mental health medications. By analyzing your DNA, the test can predict:

• Which medications might work best for you

• Whether you might need a dose adjustment

• If you're at a higher risk of experiencing side effects

• How lifestyle factors like smoking could affect your medication’s effectiveness

How Does the Test Work?

The testing process is simple and non-invasive:

1. Call SNBH to make an appointment with one of our Nurse Practitioners.

2. A cheek swab is collected at our office.

3. The sample is sent to a specialized lab for genetic analysis.

4. A detailed report is delivered to your clinician, guiding your treatment plan.

What Does It Test For?

GeneSight examines several genetic markers, including:

• CYP450 enzymes – These enzymes play a major role in breaking down many commonly prescribed psychotropic medications.

• MTHFR gene mutations – Variants in this gene can affect how your body processes certain mental health treatments.

Who Should Consider GeneSight® Testing?

GeneSight can be especially helpful for:

• New patients who have tried multiple medications without success

• Patients currently on medication but not seeing desired results

• Those experiencing side effects

• Elderly individuals

• Patients with liver issues that affect drug metabolism

What About the Cost?

• Medicare Part B patients typically pay $0.

• For those with commercial insurance, the cost is $330 or less.

• If the estimated cost exceeds $330, GeneSight will contact you directly to discuss payment options.

Why Choose GeneSight®?

• Personalized treatment based on your genetic makeup

• Faster path to effective medication with reduced trial and error

• Lower risk of side effects and better overall outcomes

• Lifelong relevance – your genes don’t change, so the results can guide mental health treatment decisions for the rest of your life

Final Thoughts

Mental health care isn’t one-size-fits-all—and it shouldn’t have to be. GeneSight Psychotropic Testing empowers you and your provider to make informed, personalized decisions that can lead to faster relief and improved well-being. If you've been struggling with mental health medication, it may be time to consider a new, more tailored approach.

Taking Back Half the Year: Strategies to Move Through Winter with More Joy

Every year, beginning around September, clients begin to talk about “the dread”… the dread of cold weather and the darkness that comes with it.

Here in Maryland, it can stay porch weather warm, at times, into November. So why, one might ask, are we sacrificing our happiness before we even have to dig out our sweaters?

Seasonal Affective Disorder (SAD) affects only 5% of adults in the United States, but 10%-20% of adults have a milder form of SAD, which can be significant enough to impact mood, family relationships, productivity at work, and healthcare costs. Women are four times more likely to be diagnosed with SAD than men.

Symptoms of SAD and its milder forms, often called “winter blues” or “seasonal depression,” include:

• Fatigue and low energy

• Depressed mood most of the day, nearly every day

• Difficulty concentrating and loss of interest in typically enjoyed activities

• Oversleeping (hypersomnia) and changes in appetite (craving carbohydrates like chips and cookies)

• Weight gain

The good news is, there are proven strategies to help manage SAD, no matter the severity. These include:

• Maximize exposure to natural light: bundle up and take a quick walk outside even when it’s cloudy; sit near windows with curtains open when indoors.

• Light therapy: light boxes can be used to mimic natural sunlight. Use for 20-30 minutes each morning. You can find a variety of choices on amazon.com (read those reviews to see which one might be best for you!).

• Exercise regularly: get the happy endorphins going …even when it’s cold, there are lots of ways to exercise indoors. Take advantage of online motivation with low impact, quick walking videos like this one. I also encourage you to brave the cold if conditions are safe – you get the benefit of light AND exercise in one punch!

• Maintain social connections: Schedule zoom meetings, keep in touch with friends and family via email/text, and be intentional about calling someone 2-3 times per week. Don’t wait for people to call you!

• Eat a healthy diet: We tend to crave “quick fix” foods more in winter – our brains want the chips and cookies that give us instant comfort, but this is followed by a blood sugar crash that worsens our mood and decreases energy. Instead, prioritize more sustainable mood boosting foods like omega-3 fatty acids (salmon, walnuts) and complex carbs (like oats and sweet potatoes).

• Prioritize good quality sleep: keep a consistent sleep schedule and limit screen time an hour before bedtime to improve sleep quality.

• Practice mindfulness: use an app like Headspace to learn how simple breathing exercises can promote an overall sense of peace and calm.

• Start a gratitude journal: jotting down one simple thing you are grateful for each day (such as: “it may be cold, but I am grateful to have a warm bed to sleep in”) helps keep your focus on all that is good in your life.

• Embrace the season: There is a Danish concept called “hygge (pronounced Hooga) mindset,” which involves slowing down, being present in the moment, and enjoying the pleasures that we can adopt in cold weather. Think fuzzy clothes, jigsaw puzzles, or curling up with a blanket to watch a favorite movie.

Which of these ideas resonate with you? I encourage you to pick one thing that seems most doable and commit to giving it a try each day this winter. I wish you a more joyful, energized winter – and remember, the spring will come again!

Politics and Mental Health

It saddens me how many of my clients tell me they are estranged from family or friends because of “politics”. Siblings essentially not speaking for months or years. Friendships ended. Fights on social media. How did we get here?

My parents spent the last several years of their lives at a continuing care retirement community. I was having lunch with them one day, probably in 2015, when one of their friends approached. This man had been career Army, ending his career as a General. My parents spoke of him often, touting his intelligence and wit.

This man said to me, “It is my goal to turn your parents into conservatives.” I laughed. My parents were diehard Democrats. I remember responding, “Well, I hope you are eating your kale, because you have years of work ahead of you!” We all chuckled and went about with lunch.

Conversations like that are sadly rare today. In many similar cases across the country, my parents and that General would likely not even sit at a table together, much less be friends. How can that possibly be a good thing?

A polarized or contentious political environment can heighten stress and anxiety among individuals. Constant news cycles and social media filled with conflict and division can lead to feelings of helplessness and overwhelm.

When we are fearful, our brains lose the ability to be reasonable. When we are fearful, we tend to fall into “us and them” thinking. Our fear drives our tendency to demonize people who do not think the way we do.

Here is what I know about politics and mental health:

• Too much news is not good for our mental health. When people tell me they have a news channel, any news channel, on all day, I know we are in trouble. People get paid a lot of money to keep us watching and keep us fearful. Limit news to 30-60 minutes per day. Then turn the TV off and get more exercise, and sunshine, and connection with others.

• Remember that political affiliation does not encompass our humanity. Why, the very woman who publishes this blog is opposite of me politically. Does that make her less human, less of a Mom, less of a friend? It does not.

There is a gentleman who frequents my favorite watering hole (Hi Dink!) who loves taking little jabs at me for my political beliefs. But he would also answer the phone and rescue me if I were stuck out on the water. He helped me sort out my fire inspection at the office here when I didn’t know one thing about regulations and fire codes. Our opposite political beliefs does not make him my enemy.

• In the words of the great Ted Lasso, “Be curious, not judgmental”. Let’s stop demonizing and belittling those who think differently than us and start having conversations that start with “Help me understand your thinking. “We do not have to convince those who think differently that we are right, and they are wrong. Our beliefs are so much more complex and nuanced than “right vs left” or “right vs wrong”.

In this stormy political season, with so much hate and war going on in the world around us, remember to smile at your neighbor and say hi, no matter what political sign she has in her yard. There is no downside to kindness. And as the Dalai Lama tells us, kindness is always possible.

Removing Judgement: Erasing the Stigma of Suicide

September is Suicide Prevention Month. You may have seen signs where you live about walks “Out of the Darkness”, suggestions to reach out to a friend, or call 988 if you are having thoughts of hurting or killing yourself.

As a psychologist, it is a question I ask early on when I meet a new client: “Have you had thoughts of hurting or killing yourself?”

The answers vary widely, from “never!” to “I wish I had the courage”. One answer that triggers resentment in me is, “that’s the coward’s way out”.

Why resentment? Why does this particular judgment hit home for me?

After all, as humans, we are all guilty of judgment to one degree or another. We judge how people look, what they do or say, and certainly we judge others when their beliefs don’t match our own. I take most of these in stride.

So why do I get so prickly when someone calls a suicidal person a coward?

I listened to a presentation on a zoom meeting for Maryland’s mental health providers earlier this year. The guest presenter was the Father of a young man who had killed himself on the Chesapeake Bay Bridge a few years ago.

As I watched his presentation, tears were streaming down my face. His son was a young man in his 20s who had struggled with depression and substance abuse for years. His parents had done everything they could to help him, but in the end, depression won.

This presentation had me thinking of my own son, 15, and I could not even imagine what this man must be feeling, having his son die that way. I watched the presentation with great admiration, that this man has dedicated his life to preventing other parents from experiencing what he had.

In the United States, one person dies by suicide every 11 minutes. 49,000 people died by suicide in our country in 2022. Are all of these people cowards? I say no. By and large, they are so deeply depressed that many of us are lucky we cannot even imagine how difficult it is for them move through the world.

Brain imaging and behavioral studies tell us that people who are suicidal tend to have less flexible and more negative thinking styles.

One of my favorite authors, Matt Haig (The Midnight Library), tells us that depression is “the inability of a mind to access the good around it”. The ability to understand that every storm runs out of rain, the innate will to live, the knowledge that things WILL get better…all of this is gone when someone is thinking about taking their own life.

People who attempt or commit suicide are not any more flawed than any of us. Just as someone who has diabetes deserves treatment to continue living, a suicidal person deserves treatment to combat the inner voice that tells them they are hopeless, worthless, and expendable.

So this month and every other, I encourage all of us to step away from judgment and toward compassion.

DO reach out to a friend if you know they have been struggling with depression.

If you know someone who is behaving erratically, have the courage to say, “Are you ok? I’m here if you want to talk.” And if you are suffering from depression and/or have had thoughts about ending your life, please don’t. Reach out to a friend, or family member, or call 988 today.

#stopsuicide #mentalhealthawareness #suicideprevention #youarenotalone

Is Antidepressant Therapy Right for Me?

Many of our clients wonder if antidepressant therapy is right for them. Clinical depression affects over 18 million people in the United States each year (Hope for Depression Research Foundation) and is the leading cause of disability worldwide.

Symptoms of a major depressive episode include low mood, poor sleep (too little or too much), lack of interest in typically enjoyed activities, disturbed appetite (eating too much or too little), lack of motivation, guilty feelings, irritability/anger, and feelings of hopelessness or worthlessness.

Depression is not a bad day someone can “snap out of,” but a brain disorder that often requires specialized treatment.

Psychotherapy can help those dealing with depression develop strategies and tools that lead to mood improvement. Often, however, the things we need to do to keep depression at bay are the very things depression robs us of.

Let’s give a hypothetical example:
A client we will call “Vicki” has struggled with depression since she was in her 20s and knows that exercise is vital to maintaining her mental health. When depressed, though, she simply cannot force herself off the couch.

Taking an antidepressant can enhance the effectiveness of psychotherapy, improving energy and motivation so clients can more effectively use the tools their therapist provides.

Antidepressants can help mediate depression in other ways:

• Reduce severity of symptoms, making it easier to work through issues with your therapist

• Decrease anxiety: some antidepressants target anxiety as well, making everyday tasks easier and everyday life more peaceful.

• Facilitation of behavioral changes: Those on antidepressants are typically better able to maintain behaviors that prevent depression, such as exercise and meditation.

• Support during crisis: antidepressants can provide crucial support during crisis periods, helping individuals maintain stability and continue psychotherapy, rather than becoming too overwhelmed to participate.

• Synergistic effects: the combination of antidepressant therapy and psychotherapy together results in improved benefits versus either treatment alone.

If you would like an evaluation to see if antidepressant therapy might be right for you, call our office or send us an email to make an appointment.

We look forward to meeting you!

BLOG CONTRIBUTION BY SNBH NURSE PRACTITIONERS:
Amanda Andrew, PMHNP-BC, AGNP-C
Yvonne Liswell, FNP-BC

Chronic Pain – How Can Mindfulness Help?

Chronic pain, or pain lasting longer than three months, impacts more than 50 million adults in the United States, according to the CDC. It affects people’s everyday lives, work, and is linked to depression, dementia syndromes, substance abuse, and higher suicide risk.

Our brains and bodies have a complex system for processing pain.

- First, pain is detected through nociceptors (sensory receptors located throughout the body) and peripheral nerves.

- Second, pain signals are transmitted to the spinal cord and the spinothalamic tract carries the pain signals to the brain, specifically the thalamus.

- Third, various regions of the brain are involved in pain processing.

The limbic system and prefrontal cortex are involved in remembering past experiences and emotional aspects of pain, as well as attention, interpretation, and response to current pain being experienced. It is these brain regions that are impacted when mindfulness-based approaches to pain are practiced.

Mindfulness is the practice of focusing attention on the present moment in a non-judgmental and accepting way. It helps manage and decrease pain through these mechanisms:

1. Attention Regulation:

• Shifting Focus: Mindfulness helps individuals shift their focus away from the pain, reducing the intensity of pain perception.

• Decreased Rumination: By reducing negative thought patterns and rumination aboutpain, mindfulness can diminish the emotional distress associated with it.

2. Emotional Regulation

• Reducing Stress and Anxiety: Mindfulness practices can lower stress and anxiety levels, which can exacerbate the perception of pain.

• Enhanced Emotional Resilience: Improved emotional regulation can help individuals cope better with the emotional aspects of chronic pain.

3. Sensory Modulation

• Pain Perception: Mindfulness can alter the way the brain processes pain signals, potentially reducing the subjective experience of pain.

• Increased Tolerance: By fostering a non-reactive awareness, mindfulness can increase pain tolerance and decrease pain-related distress.

4. Brain Changes

• Neuroplasticity: Regular mindfulness practice can lead to structural and functional changes in the brain, such as increased gray matter density in areas involved in pain modulation and emotional regulation.

• Functional Connectivity: Mindfulness can enhance the connectivity between brain regions involved in attention, sensory processing, and emotional regulation.

HOW?

Many people resist pain, and adopt a punishing or resentful attitude toward their bodies for experiencing it. Instead, mindfulness experts tell us to acknowledge our pain, label it (where, intensity, nature of the pain, such as whether it is shooting or dull), and accept it. Using a mantra such as, “I feel and accept this pain” can be helpful.

Next, redirect your attention to areas of strength. Rather than focusing your attention on what the pain won’t let you do, how have you been strong today? Maybe you were able to fold a load of laundry, maybe just getting out of bed was the victory. However, small, notice, label, and celebrate the ways big and small that you accept your pain and keep going.

It is also helpful to make yourself feel safe and calm in the midst of pain. Breathing exercises and body scans can be helpful to calm the nervous system and reduce reactivity to pain.

Harvard Health Publishing has a body scan practice here

Our brains are skilled at holding on to negative experiences and emotional reactions to pain, so it is important to counteract that by intentionally turning our focus toward the positive. Mantras likes the ones below can help:

 I feel you. I hear you. And I accept you.

 I am strong. I am resilient. I trust my body.

 Is this a mountain or a molehill?

 I am safe, I am loved.

 Look how far I’ve come.

Try saying these, even when it doesn’t feel genuine – you may be surprised at how quickly they begin to feel like your truth. Meditation apps like Headspace have meditations that specifically address pain and may be helpful as you get started.

Know this, though: You are more than your pain, and you can have experiences that aren’t painful. Wishing you pain free moments in the summer ahead!

Sources:

Chronic Pain Among Adults — United States, 2019–2021 | MMWR (cdc.gov)

3 Anxiety Hacks You Can Use Today

I often hear from clients that it is really difficult to apply the tools they learn from my practice, in the midst of severe anxiety symptoms. And they’re right.

When our brains ramp up with anxiety, it behaves in the same way it does if there is a true and immediate emergency. For example, if there is a fire, our brains start the chemical processes to shut everything down in the body except what is needed to RUN.

The frontal lobe, responsible for reasoning and judgment, powers down so that other, more primal instincts (RUN) can power up. That is why, when feeling very anxious, it is hard for us to say, “I need to apply some of the strategies I learned from Dr. Black so that I can curb this anxiety.”

The part of our brain needed to think that and apply it is essentially asleep.

The solution is to try anxiety decreasing practices when we are NOT anxious, so they become instinctive and easier to apply when we ARE.

Below are three simple strategies that you can use at work, in the car, with other people, anytime. I encourage clients to try different strategies, see what works best, and then do those practices 1-3 times/day whether anxious or not.

The strategies I will give you today access the parasympathetic nervous system – that’s the side that tells our brain to calm down and relax. When accessed consistently, the parasympathetic nervous system becomes quicker and more adept at curbing anxiety when we need it.

Try these simple exercises today:

1. Take 5-10 deep breaths, focusing on making the exhale longer than your inhale – this activates your parasympathetic nervous system which essentially tells your brain, “There is no emergency, you’re safe, you can calm down and relax”.

You might inhale to a count of 4, and exhale to a count of 6-8. The number of breaths doesn’t matter, as long as the exhale is longer than the inhale.

2. Put your senses to work and ground yourself in the “now”. You do this by saying, “what are 3 things I can see, what are 2 things I can feel, what is one thing I can smell”?

This is a good exercise to do when your mind is “spinning” on something from the past or future, that you can do nothing about in the present. By using your senses to embrace the present moment, you get out of your head and into your present environment.

3. 4-7-8 breathing: Inhale for a count of 4, hold your breath for a count of 7, exhale like you are blowing out birthday candles for a count of 8.

When done 2-3x/day consistently, this breathing exercise lowers the heart rate, blood pressure, and regulates the hormone cortisol, responsible for the body’s “flight or fight” response.

Remember, it is better to get ahead of anxiety than chase it. Learn what the earliest signs of anxiety are for you and use these strategies before anxiety ramps up and becomes unmanageable.

Enjoy the calm !

Things I’m Leaving Behind

Recently, I ordered a wardrobe for my 13-year-old daughter’s room. To save a couple hundred dollars, I checked “to be assembled” at the online check out. “It will be good for us to build it together – girl power!” I foolishly remember thinking.

Fast forward several weeks – the wardrobe did get built. But poorly, and with much frustration and inappropriate cussing on both our parts. I decided one gift to myself - in this post-50 era I now find myself in – will be pre-assembled furniture.

Shortly after making this landmark decision, a client, recently turned 70, showed me her list of things to leave behind. On it were things like nagging her husband about his to do list, fixing squeaking doors, and being productive every day.

What are some things you could leave behind that would lead to a happier you? See if any on my list might resonate with you:

Maggie’s Things to Leave Behind List

• Purchasing pre-assembled furniture to save a little money
• Believing that my teenagers’ mistakes = my failure as a parent
• Assuming my partner’s wanting to spend more time with friends = he doesn’t enjoy spending time with me
• Expecting that my body at 50 should look like it did at 40.
• Feeling that setting boundaries to take care of myself means I am less of a Mom, friend, or sister.

What habits and thinking patterns would you benefit from leaving behind?

I encourage you to think about things you might be doing or thinking that make your life harder or your heart heavier. Try leaving something behind in the week to come…now if you need me, I’ll be on a walk - Not to punish myself or beat my body into submission, but because it’s fun to enjoy the sunshine on a later winter day. Be well!