Anxiety & Depression

Anxiety can occupy and overwhelm your mind. It can cause a person to repeatedly rehearse events and conversations, diminishing self-confidence and peace of mind. It’s difficult to stay focused and trust yourself when anxiety is in the driver’s seat. In fact, anxiety can sometimes feel like a car stuck in a rut, wheels spinning out of control, going nowhere. Otherwise precious time and energy is spent in worry and concern.

Real life support ranked better than social media for improving mental health

Social media may make it easier for people to engage online, but it does not provide certain benefits of real-life human interactions, according to Michigan State University researcher.

“Problematic social media use has been associated with depression, anxiety and social isolation, and having a good social support system helps insulate people from negative mental health,” said Dar Meshi, an assistant professor in the Department of Advertising and Public Relations at MSU. “We wanted to compare the differences between real-life support and support provided over social media to see if the support provided over social media could have beneficial effects.” The research was published online April 29 in the journal Addictive Behaviors.

While social media support did not negatively impact mental health, it did not positively affect it either.

“Only real-life social support was linked to better overall mental health,” Meshi said. “Typical interactions over social media are limited. We theorize that they don’t allow for more substantial connection, which may be needed to provide the type of support that protects against negative mental health.”

Meshi and Morgan Ellithorpe, an assistant professor in the Department of Communication at the University of Delaware and a co-author on this paper, conducted a survey of 403 university students to identify how problematic their social media use was and their degree of social support in real-life and on social media. The survey also measured depression, anxiety and social isolation, the researchers could see how the students’ social media use and social support related to their mental health.

Problematic social media use is not a recognized addictive disorder, but there are similarities in the symptoms of someone with a substance use disorder and a person displaying excessive social media use. Examples include preoccupation with social media and signs of withdrawal, such as irritability, when prevented from using social media.

“It appears that the more excessive one’s social media use is, the less social support that person gets in real life, which leads to poor mental health,” Ellithorpe said. From these results researchers encourage people who are using too much social media to reach out to people in real life for social support.

Read this article on Science Daily: Michigan State University. “Need to vent? Turn to real-life support, not social media: Research finds social support provided over social media does not improve mental health for excessive social media users.” sciencedaily.com/releases/2021/05/210503104605.htm.


Dr. Jenny Holland, PsyD

Dr. Holland is a psychotherapist practicing in Santa Rosa California, providing cutting edge, integrative and evidence-based mental health care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss, and caring for a parent or loved one during a health crisis or decline.

In-person and Online Video Counseling Services are now available. Short-term sessions, single sessions or ongoing support to meet your needs. Contact Dr. Holland to schedule an appointment at 707-479-2946.

Family well-being at risk during pandemic

When the COVID-19 pandemic hit in early 2020, many families found themselves suddenly isolated together at home. A year later, new research has linked this period with a variety of large, detrimental effects on individuals’ and families’ well-being and functioning. A study — led by Penn State researchers — found that in the first months of the pandemic, parents reported that their children were experiencing much higher levels of “internalizing” problems like depression and anxiety, and “externalizing” problems such as disruptive and aggressive behavior, than before the pandemic. Parents also reported that they themselves were experiencing much higher levels of depression and lower levels of coparenting quality with their partners.

Mark Feinberg, research professor of health and human development give insight into just how devastating periods of family and social stress can be for parents and children, and how important a good coparenting relationship can be for family well-being. “Stress in general — whether daily hassles or acute, crisis-driven stress — typically leads to greater conflict and hostility in family relationships,” Feinberg said. “If parents can support each other in these situations, the evidence from past research indicates that they will be able to be more patient and more supportive with their children, rather than becoming more harsh and angry.”

Feinberg added that understanding what can help parents maintain positive parenting practices, such as a positive coparenting relationship, is key for helping protect children during future crises — whether those crises are pandemics, economic shocks or natural disasters. While cross-sectional studies have suggested there has been a negative impact of the pandemic on families, the researchers said this study is one of the first to measure just how much these factors have changed within families before and after the pandemic hit.

According to the researchers, previous research has found that periods of financial stress, such as the Great Depression and the 2008 recession, have led to higher levels of parent stress, mental health problems and interparental conflict, which can all lead to more harsh, and even abusive, parenting. When the COVID-19 pandemic hit, Feinberg said it led to not only financial stress within families, but also problems related to being isolated together, issues managing work and childcare, and general fear related to the sudden health threat that was poorly understood.

For the study, the researchers used data from 129 families, which included 122 mothers and 84 fathers, with an average of 2.3 children per family. The parents answered an online questionnaire that asked them about their depressive symptoms, anxiety, the quality of their relationship with their coparent, and externalizing and internalizing behavior they observed in their children, among other measures. Because the participants were part of a longer study measuring these factors over prior years, the researchers already had data on these parents and children from before the pandemic.

The researchers found that parents were 2.4 times more likely to report “clinically significant” high levels of depression after the pandemic hit than before. They were also 2.5 times and 4 times more likely to report externalizing and internalizing problems, respectively, in their children at levels high enough that professional help might be needed. Feinberg said that while it makes sense that families would experience these difficulties, he was shocked at the magnitude of the declines in well-being.

“The size of these changes are considered very large in our field and are rarely seen,” Feinberg said. “We saw not just overall shifts, but greater numbers of parents and children who were in the clinical range for depression and behavior problems, which means they were likely struggling with a diagnosable disorder and would benefit from treatment.” Feinberg put the size of the declines in parent and child well-being in perspective by pointing out that the increase in parents’ levels of depressive symptoms in the first months of the pandemic was about twice as large as the average benefit of antidepressants.

The researchers said that as the risk of future pandemics and natural disasters increases with the effects of climate change, so will the likelihood of families facing stressful conditions again in the future. “Getting ready for these types of crises could include helping families prepare — not just by stocking up on supplies, but also by improving family resiliency and psychological coping resources,” Feinberg said. “In my view, that means providing the kinds of family prevention programs we’ve been developing and testing at the Prevention Research Center for the past 20 years.”

Read this article on ScienceDaily: Penn State. “COVID-19 pandemic may have increased mental health issues within families.”


Dr. Jenny Holland, PsyD

Dr. Holland is a psychotherapist practicing in Santa Rosa California, providing cutting edge, integrative and evidence-based mental health care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss, and caring for a parent or loved one during a health crisis or decline.

In-person and Online Video Counseling Services are now available. Short-term sessions, single sessions or ongoing support to meet your needs. Contact Dr. Holland to schedule an appointment at 707-479-2946.

Unresolved disputes can lead to long term health issues

Unresolved disputes can lead to long term health issues

Relationship Therapy

New study reveals the long term impact of an unresolved argument on overall health and well-being.

A recent Oregon State University study found that when people feel they have resolved an argument, the emotional response associated with that disagreement is significantly reduced and, in some situations, almost entirely erased.That reduction in stress may have a major impact on overall health, researchers say.

"Everyone experiences stress in their daily lives. You aren't going to stop stressful things from happening. But the extent to which you can tie them off, bring them to an end and resolve them is definitely going to pay dividends in terms of your well-being," said Robert Stawski, senior author on the study and an associate professor in the College of Public Health and Human Sciences. "Resolving your arguments is quite important for maintaining well-being in daily life."

Researchers have long been aware of how chronic stress can affect health, from mental health problems such as depression and anxiety to physical problems including heart disease, a weakened immune system, reproductive difficulties and gastrointestinal issues. But it's not just major chronic stressors like poverty or violence that can inflict damage.

"Daily stressors -- specifically the minor, small inconveniences that we have throughout the day -- even those have lasting impacts on mortality and things like inflammation and cognitive function," said Dakota Witzel, lead author and a doctoral student in human development and family studies at OSU.

For the study, Stawski and Witzel used data from the National Study of Daily Experiences, an in-depth survey of more than 2,000 people who were interviewed about their feelings and experiences for eight days in a row. The researchers looked at reports of both arguments and avoided arguments, defined as instances where the person could have argued about something but chose to let it slide so as not to have a disagreement. They then measured how the incident affected the person's reported change in negative and positive emotions, both for the day of the encounter and the day after it occurred.

The measure of how an experience affects someone emotionally, an increase in negative emotions or a decrease in positive emotions, on the day it occurs is known as "reactivity," while "residue" is the prolonged emotional toll the day after the experience occurs. Negative and positive affect refer to the degree of negative and positive emotions a person feels on a given day. Results showed that on the day of an argument or avoided argument, people who felt their encounter was resolved reported roughly half the reactivity of those whose encounters were not resolved. On the day following an argument or avoided argument, the results were even starker: People who felt the matter was resolved showed no prolonged elevation of their negative affect the next day.

The study also looked at age-related differences in response to arguments and avoided arguments and found that adults ages 68 and older were more than 40% more likely than people 45 and younger to report their conflicts as resolved. But the impact of resolution status on people's negative and positive affect remained the same regardless of age. The researchers had several explanations for older adults' higher rate of resolution: Older adults may be more motivated to minimize negative and maximize positive emotions as they have fewer years remaining, which is consistent with existing theories of aging and emotion. They may also have more experience navigating arguments and thus be more effective at defusing or avoiding conflict.

"If older adults are really motivated to maximize their emotional well-being, they're going do a better job, or at least a faster job, at resolving stressors in a more timely fashion," Stawski said. While people cannot always control what stressors come into their lives -- and lack of control is itself a stressor in many cases -- they can work on their own emotional response to those stressors, he said. "Some people are more reactive than other people," he said. "But the extent to which you can tie off the stress so it's not having this gnawing impact at you over the course of the day or a few days will help minimize the potential long-term impact."

Read this article on Science Daily: Oregon State University. "Want a longer, healthier life? Resolve your arguments by day's end." www.sciencedaily.com/releases/2021/03/210325084833.htm.


Dr. Jenny Holland, PsyD

Dr. Holland is a psychotherapist practicing in Santa Rosa California, providing cutting edge, integrative and evidence-based mental health care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss, and caring for a parent or loved one during a health crisis or decline.

In-person and Online Video Counseling Services are now available. Short-term sessions, single sessions or ongoing support to meet your needs. Contact Dr. Holland to schedule an appointment at 707-479-2946.

Cognitive behavioral therapy shown to improve job opportunities

If depression is making it more difficult for some unemployed people to land a job, one type of therapy may help, research suggests. In a new study, 41% of unemployed or underemployed people undergoing cognitive behavioral therapy (CBT) found a new job or went from part- to full-time work by the end of the 16-week treatment for depression.Those who had a job but found it difficult to focus on and accomplish work tasks because of depression said the treatment helped to significantly reduce these problems.

“For the most part, researchers have focused on showing that therapy relieves symptoms of depression,” said Daniel Strunk, co-author of the study and professor of psychology at The Ohio State University. “But reducing symptoms isn’t the only goal people have when they start CBT. Many are hoping to find a job or improve their productivity at their current job. Here we found that therapy can help people achieve these goals, as well.”

This study involved 126 people who participated in a 16-week course of CBT at the Ohio State Depression Treatment and Research Clinic. CBT teaches coping skills that help patients counteract and modify their negative beliefs, Strunk said. “It works on the idea that people with depression invariably hold these overly negative views of themselves and their futures,” he said. “For example, if an unemployed patient doesn’t get one job they interviewed for, they may think ‘no one is ever going to hire me.'”

In this study, 27 patients were seeking to improve their employment status (land a job or go from part- to full-time) at the beginning of treatment. Eleven of them (41%) had succeeded by the end of the 16 weeks.

“It is hard to say exactly how good this success rate is since we don’t know how many would have gotten jobs without the treatment,” Strunk said. “But the findings were encouraging and suggest that the CBT is having an impact.”

CBT had a clear impact for those who had jobs and reported at the beginning of the treatment that depression was hurting their effectiveness.

“Working patients reported at the end of treatment that they were much more successful at concentrating and accomplishing tasks at their jobs,” he said. Findings showed that one way CBT had this effect was by reducing patients’ “negative cognitive style,” or the extent to which patients view negative events in overly pessimistic ways, according to Strunk.

“CBT helps patients overcome these views by teaching them that the experience of depression is not their fault and that they can take steps to improve their concentration and accomplish work more successfully even when experiencing depressive symptoms,” Strunk said.

Read this article on Science Daily: Ohio State University. “Depressed and out of work? Therapy may help you find a job: Treatment also helps workers be more effective, study finds.” ScienceDaily www.sciencedaily.com/releases/2021/02/210222164224.htm.


Dr. Jenny Holland PsyD

Dr. Jenny Holland, PsyD

Dr. Holland is a psychotherapist practicing in Santa Rosa California, providing cutting edge, integrative and evidence-based mental health care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss, and caring for a parent or loved one during a health crisis or decline.

Teletherapy – Online Video Counseling Services — Short-term sessions, single sessions or ongoing support. Contact Dr. Holland to schedule an appointment at 707-479-2946.

COVID-19 front line workers vulnerable to mental health problems

COVID Stress Takes a Toll on Mental Health with Health Care Worker

The daily toll of COVID-19, as measured by new cases and the growing number of deaths, overlooks a shadowy set of casualties: the rising risk of mental health problems among health care professionals working on the front lines of the pandemic. A new study, led by University of Utah Health scientists, suggests more than half of doctors, nurses, and emergency responders involved in COVID-19 care could be at risk for one or more mental health problems, including acute traumatic stress, depression, anxiety, problematic alcohol use, and insomnia. The researchers found that the risk of these mental health conditions was comparable to rates observed during natural disasters, such as 9/11 and Hurricane Katrina.

"What health care workers are experiencing is akin to domestic combat," says Andrew J. Smith, Ph.D., director of the U of U Health Occupational Trauma Program at the Huntsman Mental Health Institute and the study's corresponding author. "Although the majority of health care professionals and emergency responders aren't necessarily going to develop PTSD, they are working under severe duress, day after day, with a lot of unknowns. Some will be susceptible to a host of stress-related mental health consequences. By studying both resilient and pathological trajectories, we can build a scaffold for constructing evidence-based interventions for both individuals and public health systems."

The study appears in the Journal of Psychiatric Research. In addition to U of U Health scientists, contributors include researchers from the University of Arkansas for Medical Sciences; University of Colorado, Colorado Springs; Central Arkansas VA Health Care System; Salt Lake City VA Healthcare System; and the National Institute for Human Resilience. The researchers surveyed 571 health care workers, including 473 emergency responders (firefighters, police, EMTs) and 98 hospital staff (doctors, nurses), in the Mountain West between April 1 and May 7, 2020. Overall, 56% of the respondents screened positive for at least one mental health disorder. The prevalence for each specific disorder ranged from 15% to 30% of the respondents, with problematic alcohol use, insomnia, and depression topping the list.

"Front line providers are exhausted, not only from the impact of the pandemic itself, but also in terms of coping day to day," says Charles C. Benight, Ph.D., co-author of the study and a professor of psychology at the University of Colorado, Colorado Springs. "They're trying to make sure that their families are safe [and] they're frustrated over not having the pandemic under control. Those things create the sort of burnout, trauma, and stress that lead to the mental health challenges we're seeing among these caregivers."

In particular, the scientists found that health care workers who were exposed to the virus or who were at greater risk of infection because they were immunocompromised had a significantly increased risk of acute traumatic stress, anxiety, and depression. The researchers suggest that identifying these individuals and offering them alternative roles could reduce anxiety, fear, and the sense of helplessness associated with becoming infected.

Alcohol abuse was another area of concern. About 36% of health care workers reported risky alcohol usage. In comparison, estimates suggest that less than 21% of physicians and 23% of emergency responders abuse alcohol in typical circumstances. Caregivers who provided direct patient care or who were in supervisory positions were at greatest risk, according to the researchers. They say offering these workers preventative education and alcohol abuse treatment is vital. Surprisingly, health care workers in this study felt less anxious as they treated more COVID-19 cases.

"As these health care professionals heard about cases elsewhere before COVID-19 was detected in their communities, their anxiety levels likely rose in anticipation of having to confront the disease," Smith says. "But when the disease started trickling in where they were, perhaps it grounded them back to their mission and purpose. They saw the need and they were in there fighting and working hard to make a difference with their knowledge and skills, even at risk to themselves."

Among the study's limitations are its small sample size. It was also conducted early in the pandemic in a region that wasn't as affected by the disease as other areas with higher infection and death rates. Moving forward, the researchers are in the final stages of a similar but larger study conducted in late 2020 that they hope will build on these findings. "This pandemic, as horrific as it is, offers us the opportunity to better understand the extraordinary mental stress and strains that health care providers are dealing with right now," Smith says. "With that understanding, perhaps we can develop ways to mitigate these problems and help health care workers and emergency responders better cope with these sorts of challenges in the future."

Read this article on Science Daily: Dr. Smith, Hannah M. Wright, Tiffany M. Love, and Scott A. Langenecker of University of Utah Health contributed to this study. The study, "Pandemic-related mental health risk among front line personnel," was published in the Journal of Psychiatric Research.


Teletherapy – Online Video Counseling Services

Short-term sessions, single sessions or ongoing support

Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.

Pandemic Taking a Toll on Mental Health and Addictions

COVID Presents Increased Risk of Addiction for Unusual Groups

The pandemic’s effect on addiction has become a hot topic for researchers and mental health specialists alike. "The COVID-19 pandemic is a particularly grave risk to the millions of Americans with opioid use disorder, who—already vulnerable and marginalized—are heavily dependent on face-to-face health care delivery," researchers stated in "An Epidemic in the Midst of a Pandemic: Opioid Use Disorder and COVID-19," a recent study that examined the effects of the unprecedented situation.

In addition to those wrestling with addiction even before the pandemic created challenges in receiving care, it is now being reported that everyone from retired baby boomers with no preexisting addictions to millennials struggling with job loss and COVID related family challenges are now finding it harder to put a limit on emotion-numbing substances.  According to national surveys alcohol sales are up 250 percent, a trend that is compounding both emerging and preexisting mental health issues such as anxiety, stress, and depression.

“In my practice I have been working with a lot of people during quarantine around addiction,” explains Dr. Jenny Holland, PsyD. “The longer COVID restrictions continue, the more potential there is for temporary behaviors based on escaping emotional turmoil to turn into full blown addictions.”

Addiction is not always about drugs, alcohol, or other substances. It can also take on forms including uncontrolled gambling, shopping, gaming, smoking, food, and sex addiction. When these activities become compulsive or unstoppable, they have essentially hijacked the brain’s otherwise 'normal' pleasure functions. At this point, when a behavior becomes a habit or addiction, getting back to ‘normal’ or getting control over compulsions can be a challenge for most anyone.

The Toll of Long-Term Use

Addiction is defined by the American Society of Addiction Medicine (ASAM) as a brain disease indicated by cravings, an inability to abstain from the behavior or substance, dysfunctional emotional responses, and a loss of behavioral control. Compulsive behaviors are often unconscious and can result in making questionable choices. Although breaking an addiction is tough, it can be done. The sooner it is addressed, the better the chances are for recovery.

With any addiction, the recognition that something that may have started out as a distraction has now become a problem is the first step on the road to recovery. While denial over the loss of control that leads to addiction may be a way of coping with sudden changes in behavior, knowing when to seek help is key to recovery.

Healthy alternatives to addictive behavior

“My job as a mental health professional is to help my patients restore balance by guiding them toward healthier coping mechanisms,” explains Dr. Holland. “The focus of addiction therapy in my practice highlights how attachment and connection is the opposite of addiction.”

Treatment also incorporates behavioral therapies, counseling, and other supportive measures to build new and improved habits and life skills. Through this process stress and anger management as well as communication skills are combined with relapse prevention tools to create new coping mechanisms that support well-being.

As a highly qualified drug and alcohol counselor, Dr. Holland provides the most effective treatments for managing compulsive behaviors and addictions and offers individualized therapy to address the unique behaviors that the client may want to change.

Teletherapy – Online Video Counseling Services

Short-term sessions, single sessions or ongoing support

It’s no question that these are very trying times for all of us, so I want to let you know that you are not alone. No matter what is coming up for you right now it is important to allow yourself to feel what you’re feeling. I invite you reach out to me to see how we can start getting you on the path to feeling better now.

Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.