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As you begin treatment for depression, it may take a bit of time for you to feel like you’re back to your normal self. If your progress is slow, it’s natural to question whether you’re really improving. Your doctor can help you set some goals to use as benchmarks and assess your progress.

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Signs of Recovery From Depression

You can watch for a few things to better understand whether you are on the road to recovery.

Improving Symptoms

Do you notice that you don’t feel sad as often or that you have fewer bouts of anger? Maybe you’re thinking more clearly, your appetite has returned, or you don’t feel as tired. If your symptoms of depression are improving, this is a positive sign.

If you have trouble recognizing changes in your symptoms, ask your doctor, counselor, or therapist. They may notice that you seem less irritable or have more energy during your visits. Sometimes, it’s hard to see these things ourselves.

Improved Daily Function

If you’re having an easier time functioning in your daily activities, this is another good indicator that you’re progressing. This may include noticing that you find it less difficult to:

Limited Relapses

Another important goal of depression treatment is to reduce your chances of having future episodes of depression. If your symptoms remain under control over time, this is an important indicator that you’re getting better.

One way to help achieve this goal is with healthy changes to your lifestyle. Although depression is an illness with a biological basis, the way you live your life can potentially increase your stress and trigger a relapse in your condition.

How to Track Your Progress

In addition to working closely with your doctor, there are a few actions you can take to keep an eye on your progress.

Keep a Journal

Journaling is an easy and effective way to track your symptoms over time, explore your emotions, and manage your feelings. Try using a journal to record your symptoms, your experience with medication, and self-help strategies.

For example, you can use your journal to record what type of activity you tried, such as exercise, meditation, or listening to your favorite music. Also, write down how you felt before and after, noting what you liked or didn’t like.

You may want to consider sharing your journal entries with your mental health care professional. They may be able to help you identify whether your medication should be adjusted or if you should try a different treatment approach.

Take Symptom Questionnaires

Another way to track your progress is to periodically take a test like the Wakefield Questionnaire. This questionnaire asks a series of questions about your depression symptoms and then provides you with a numerical score. The Patient Health Questionnaire (PHQ-9) and Beck’s Depression Inventory (BDI) are similar options.

By comparing your scores over time, you can objectively see whether your symptoms are improving. Maybe they are appearing less often or feeling less intense. These can both be signs that your treatment is working and your depression is getting better.

Monitor Changes in Medication

How long you need to take antidepressants depends on how well they work and whether you’re at risk of a relapse. As you begin to feel better, your doctor may decide to reduce your medication dosage or take you off it completely. This is a positive sign that you’re making progress.

Another medication-related sign to look for is if you’re having fewer side effects with your antidepressant or less severe side effects. Or maybe you’ve found a way to work them into your life so the effects aren’t so bothersome, such as taking them at morning versus night or vice versa. All of these changes are steps in the right direction.

It may take time, but with the right combination of treatment, support, and lifestyle habits, you can feel like your old self again.

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Depression Symptoms to Look For

If you have feelings of depression that don’t seem to be getting better or are getting worse, talk to your doctor. Your treatment plan may need to be changed. Here are a few common symptoms of depression to watch for:

• Crying for no apparent reason
• Difficulty concentrating or staying focused
• Eating too much or too little
• Feeling sad, worthless, and/or having guilt
• Feelings of hopelessness
• Having difficulty doing normal daily activities
• Irritability
• Losing joy in your daily activities or passions
• Overwhelming feelings of anxiety
• Physical symptoms such as stomachaches or headaches
• Restlessness
• Sleeping too much or too little
• Thinking about or trying to commit suicide
• Waking during the night or early in the morning

Undiagnosed and untreated depression can get worse and stop you from living a fulfilling life. So, if you have these symptoms for two weeks or more, or if you are being treated for depression and these symptoms are not getting any better, be sure to consult a mental health professional for help.

Depression can impact every area of your life, so it’s helpful to know whether the treatment you are using is working for your type of depression and its level of severity. If you ever feel like your depression is not getting better, talk to your doctor. Many potential remedies exist. It’s just a matter of finding the right one for you.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder. This means there are differences in the ADHD brain that affect a child’s development. ADHD does not influence intelligence. It does, however, affect a person’s ability to regulate attention and emotions, and it results in hyperactivity and impulsivity as well as organization problems.

While it is classified as a condition, more recent thinking views it as a form of neurodiversity. People with ADHD brain’s process information differently, but that represents a normal variation rather than a disorder that needs to be ‘cured.’ This neurodiversity perspective emphasizes recognizing these differences and valuing strengths instead of focusing solely on challenges or deficits. 

Rather than trying to change ADHD traits to fit into a neurotypical world, this perspective stresses the importance of accommodations and support to help people thrive.

Differences in the ADHD Brain

ADHD has come under a lot of scrutiny over the past few decades, contributing to public misperceptions and stigma. In the past, some naysayers questioned if it was real or said a lack of motivation, willpower, or bad parenting caused it. Then, there was the explosion of stories suggesting that ADHD was overdiagnosed and overmedicated.

None of which is true, of course, but if you or your child has ADHD, you can feel vulnerable to these types of comments.

The differences can be divided into three areas: structure, function, and chemistry.

ADHD vs. Non-ADHD Brain Structure

For many years, research showed there were clear structural differences in the ADHD brain. The largest review ever of ADHD patient brain scans was carried out at Radboud University Nijmegen Medical Centre and published in 2018.

Researchers reported that people with ADHD had smaller brain volume in five subcortical areas, and their total brain size was smaller, too. These differences were greater in children and less in adults.

Another interesting finding was that the amygdala and hippocampus are smaller in the brains of people with ADHD. These areas are responsible for emotional processing and impulsivity and had previously not been definitively connected to ADHD.

ADHD vs. Non-ADHD Brain Function

There are several types of brain imaging techniques that allow researchers to study how the ADHD brain operates and functions. These include:

• Functional magnetic resonance imaging (fMRI)
• Positron emission tomography (PET)
• Single-photon emission computer tomography (SPECT)

There are alterations in blood flow to various areas of the brains in people with ADHD compared to people who do not have ADHD, including decreased blood flow to certain prefrontal areas. Decreased blood flow indicates decreased brain activity.

The prefrontal area of the brain houses the executive functions, which are responsible for many tasks, including planning, organizing, paying attention, remembering, and emotional reactions.

Evidence also suggests that ADHD may be related to dysfunctional brain connectivity. Research using resting-state MRIs suggests that individuals with ADHD may have increased functional connectivity in certain regions of the brain.

ADHD vs. Non-ADHD Brain Chemistry

The brain is a busy communication network where messages are relayed from one neuron (brain cell) to the next. There is a gap between neurons, which is called a synapse. In order for the message to be passed along, the synapse needs to be filled with a neurotransmitter. Neurotransmitters are chemical messengers, and each one is responsible for different functions.

The key neurotransmitters for ADHD are dopamine and noradrenaline. In the ADHD brain, there is dysregulation of the dopamine system. For example, there is either too little dopamine, not enough receptors for it, or the dopamine is not being used efficiently.

How Is ADHD Diagnosed?

Brain scans cannot be used to diagnose ADHD. There is no objective test to diagnose ADHD. The diagnosis of ADHD requires a full evaluation by a qualified doctor, psychologist, or psychiatrist. Diagnosis includes:

• An in-depth interview with the patient
• A review of school reports and medical history
• Tests to measure attention, distractibility, and memory

While PET and fMRI scans can be useful for research, they really only give an insight into how the brain is functioning at the moment the test was performed. Brain scans do not take into account how the brain operates in different situations, unlike a clinical test during a detailed interview.

In addition, the scan data that has been studied is generally based on group averages and may not apply to any particular individual. The results have not been normed, which is when large quantities of data are gathered and compared.

ADHD is diagnosed as a neurodevelopmental condition, but it is important to remember that it represents a normal variation in brain structure, function, and chemistry. These differences can create challenges in your life, but that doesn’t mean that they are something that needs to be “cured.” ADHD also comes with strengths.

Understanding the underlying causes of your ADHD traits can be validating and give you a place to start when it comes to managing some of the challenges you’ll experience living in a society designed for neurotypical brains. Getting an accurate diagnosis is a great place to start. Depending on your unique experience, you may find that medications, therapy, ADHD coaching, accommodations, and social support can help.

Tabula rasa translates to “blank slate.” In therapy, it refers to either the idea that we are solely the product of our upbringing and experiences or to the technique therapists use when they themselves become “blank” and allow the recipient to project their own needs, desires, and beliefs onto them.

In psychology, the term “blank slate,” or tabula rasa, actually has two meanings. The first refers to the belief that all humans are born with the ability to become literally anything or anyone. This belief downplays the effects of genetics and biology on the development of the human personality.

The second definition of “blank slate” refers to a technique that was once heavily used in psychoanalysis and is still employed by some therapists today. When using this technique, the therapist is careful not to reveal any personal information about themselves.

Tabula Rasa in Behaviorism

Behaviorists believe you are born with your mind as a blank slate and you learn all your behavior from your environment. Therefore, therapy focuses on unlearning unproductive behaviors. Behaviorists posit any symptoms of a psychological disorder are the result of classical and operant conditioning.

Classical conditioning is also known as learning by association and causes most phobias. Meanwhile, operant conditioning refers to learning by positive or negative reinforcement and, for example, causes problematic habits, behavior addictions, and eating disorders. Modes of behavior therapy commonly used to treat phobia include:

• Systematic desensitization
• Aversion therapy
• Flooding
• Exposure therapy and virtual reality exposure therapy
• Behavioral rehearsal
• Skills training

Tabula Rasa in Therapy

Tabula rasa is also a principle that underlies several different therapeutic techniques. Such techniques suggest that people are born with a blank slate that is then changed through learning experiences. Therapy then focuses on changing these learned beliefs or behaviors.

For example, tabula rasa suggests that people are blank slates, but a terrifying experience as a child may lead to developing a specific phobia. Therapy would then focus on changing these associations and developing new coping strategies, beliefs, and behaviors.

Exposure Therapy

Systematic Desensitization

Systematic desensitization is a type of exposure therapy that is an effective treatment for specific phobia (a fear of a specific object or situation) and social phobia (social anxiety disorder). The tabula rasa theory suggests that phobia is a learned behavior you impose on your blank slate. Therefore, you can unlearn your feelings of anxiety.

The therapist helps you learn to relax in what is referred to as your “target situation.” After reaching a state of deep relaxation, you vividly imagine or interact with your target situation repeatedly over time.

Since it is systematic, you don’t jump right into the deep end. You create a hierarchy of fears related to the target situation, from least to most fear-invoking. For example, you may start by simply imagining the target and work your way towards looking at pictures, watching a film, and eventually engaging more directly with your feared target.

So, if you’re afraid of spiders, for example, your therapist might start by showing you a picture of one. Later in the process, you might look at a live spider or even hold one. With each step, the “power” of spiders to scare you diminishes until the phobia is gone. A newer form of this is virtual reality exposure, which allows you to accomplish the same goals via virtual reality technology, thereby avoiding the need to, for example, find real spiders.

Behavioral Rehearsal

For patients who fear situations rather than things, a therapist might help them imagine a difficult situation. For example, if they fear a large party, the therapist might guide them through the process of facing and successfully dealing with it, step-by-step.

Flooding

Proponents of flooding believe in confronting fears head-on. The goal is to ameliorate a phobia by flooding the environment with the situation or object a person fears—sort of like teaching someone how to swim by throwing them into the deep end of a pool.

For example, therapy might involve sitting in a closet for several hours if you are claustrophobic. Once you calm down, you’ve changed your negative association with your fear into a positive one. Behaviorists also believe flooding prevents avoidance behaviors, which reinforce your maladaptive condition.

Aversion Therapy

Aversion therapy is helpful in cases where you have an attraction to bad habits and behaviors, and despite the pleasure it brings you, both you and your therapist acknowledge it’s an undesirable trait.

Tabula rasa suggests that you were born with a blank slate but learned a destructive behavior. Aversion therapy may help change your associations and avoid these maladaptive behaviors.

For example, aversion therapy may help a person with an alcohol use disorder (AUD) overcome their addiction. The therapist helps them associate their undesirable behavior with a highly unpleasant stimulus. The therapist might ask the individual to sip an alcoholic drink after they have taken a medication to induce nausea. After vomiting, the hope is the smell of alcohol will trigger this new and unpleasant memory, causing them to skip the alcohol next time.

Skills Training

For some people, phobias develop as a result of not having the appropriate skills to handle certain situations. Cognitive behavioral therapy skills training can take the form of direct instruction or role-playing.

For instance, the therapist might pretend to be an interviewer for a job, and you would pretend to be interviewing for the job. The idea is that you’d have learned some skills to implement during a real job interview.

Criticisms of Tabula Rasa

Not everyone agrees that people are born with a completely blank slate. While behaviorism suggests that learning and experience play a primary role in learning, other theories have stressed the contribution of genetic and biological factors.

For example, while learning may play an important role in developing phobias, other factors, including inherited genes, temperament/personality traits, and brain differences, can create a predisposition for the development of phobias. Research has shown that people who have relatives with phobias or other types of anxiety disorders are at a higher risk of developing similar conditions.

People with anxious personality traits may also be more likely to form fear generalizations, increasing their vulnerability to anxiety disorders.

Ever wonder why your family can trigger your anxiety like nobody else, even when otherwise your anxiety might feel under control? Listen, we get it.

Having your family trigger your anxiety is a very common problem. Read on to learn more about anxiety triggers, how your family might be triggering your anxiety, and how to cope with family when anxiety rears its ugly head.

Understanding Anxiety Triggers

There are lots of things that can easily trigger anxiety, especially when family is involved. 

“It’s common for people to feel triggered or on edge around family members when there are expectations of what people should do, say, think, or feel,” explains Yolanda Renteria, LMFT. “People’s anxiety is often triggered when they’re afraid of making mistakes, making people upset, or disappointing family members.”

Even small things can be anxiety triggers. If you know that a certain aunt is always going to ask you why you aren’t married yet, or if a sibling is definitely going to try to compare the two of you like they always do, that can stir up old and deep-seated anxiety.

Family Dynamics and Anxiety

“Family dynamics” refers to how members of a family relate to and interact with each other. Every family has their own unique dynamics. 

“Family dynamics can have a direct and significant impact on a person’s anxiety,” explains Ivy Kwong, LMFT. “Rigid roles and expectations, poor communication styles, high conflict, ongoing or historic abuse, financial stressors, enmeshment, and cultural and societal pressures in a family can all impact someone’s levels of anxiety.” 

If some of these dynamics feel emotionally upsetting or painful, that can lead to anxiety. 

Unfair Expectations

Maybe your mother always comes to you after a fight or disagreement with your father, expecting you to act as a go-between—that expectation of having to be the mediator can be anxiety-inducing. Or maybe, as the middle child, you feel as though you constantly have to prove yourself and your worth to your parents and siblings—this can also cause anxiety.

Poor Communication

Communication is key. “Poor communication in a family including frequent criticism, lack of emotional support, or unclear expectations can create a stressful environment and lead to misunderstandings and conflicts that increase anxiety,” says Kwong. 

Cultural and Societal Values

“Strong cultural values and societal pressures can define family dynamics and expectations,” explains Kwong. “Cultural and societal values and expectations about gender roles, family duty, and honor, and how success is defined can impose stress and contribute to anxiety, especially if individuals feel they may be punished, unloved, or ostracized for not meeting certain expectations.”

Unconscious Dynamics

Often, these dynamics are unconscious—most people might not realize how their family functions emotionally unless they really take the time and effort to examine patterns of behavior or talk about it in therapy. This means that, often, family members can unknowingly trigger your anxiety. 

“In certain family dynamics there can be unspoken roles that different members are expected to play such as the caregiver, peacemaker, or hero,” explains Kwong. “When unrealistic or excessive expectations are put on an individual like the need to be perfect or to sacrifice their needs and feelings for those of others, this can result in increased stress and anxiety.”

Genetic Predisposition and Anxiety

Anxiety can be hereditary, especially if you experience anxiety symptoms at a young age. So if someone or multiple people in your family have anxiety, it’s likely that you might inherit that trait.

“Individuals with a family history of anxiety may inherit a heightened sensitivity to stressors, making them more prone to anxiety in response to environmental triggers,” explains Kwong. “Research has also shown that if a close family member such as a parent or sibling has an anxiety disorder, an individual is at higher risk of developing anxiety which may be due to environmental or genetic factors, or a combination of both.”

This behavior functions kind of like osmosis—being surrounded by anxiety can teach you how to react to your own anxiety, for better or for worse.

For example: “If a parent exhibits anxious behaviors like hypervigilance, excessive worrying, and avoidance, a child may learn to respond in a similar manner,” says Kwong. “These patterns may be observed, internalized, and adopted from parent to child, from one generation to the next, unless and until there is work done to address and heal the root of the anxiety.”

Regression and Family Triggers

“Regression” means reverting to old patterns of thought and behavior when you’re with your family. This might mean that you start behaving and reacting to triggers like you did when you were younger rather than how you normally behave and react as an adult. This might also mean anxiety triggers from your childhood or a time when you interacted more with your family might return with a vengeance. 

Similarly, your family dynamics might regress as well. Your parents, for example, might treat you like a child rather than the independent adult that you are. They might try to relieve you of the responsibilities you face every day as a grown-up or dismiss your feelings or opinions that differentiate you from them. You also might start interacting with your siblings the way you used to when you were a child, which can result in fighting and jealousy.

It might bring up painful memories and associations that you haven’t had to face in years, which can also trigger anxiety.

Feeling regressed can also affect your decision-making when you’re with your family. “Regression can lead someone to make impulsive or immature decisions they later regret,” explains Renteria, “which is likely to reinforce existing dysfunctional family dynamics and increase regret later on.” 

Coping Strategies for Dealing with Family Triggers

Luckily, there are many different coping strategies when it comes to dealing with family-induced anxiety.

Set Boundaries

One of the best things you can do for yourself when going into a family situation that might trigger anxiety is to set boundaries. But how?

“Start by deciding how often and for how long your body can tolerate interactions with family members with whom you feel anxiety and don’t agree to things outside of your comfort zone just to please others,” suggests Renteria. “Listen to your gut, learn to say no to things that feel uncomfortable, and limit how much time you spend around these family members.”

Honor Your Feelings

Renteria also recommends that you “practice tolerating people’s discomfort when you enforce your boundaries.” If someone disagrees with you or tries to push you past your comfort level, work on not immediately letting it slide just because it seems like the path of least resistance. Honor your feelings and allow yourself to extricate yourself from the situation.

If you can’t escape that situation—maybe you are staying with your parents or are at a family function that doesn’t allow for alone time—taking some deep breaths and going on an extra-long bathroom break can do wonders. Practice self-care by respecting your feelings and letting yourself off the hook for needing things from your family that they might not be able to provide.

Try “I” Statements

If you do feel as though you can address your anxiety with the family members that are triggering you, all the better. Try bringing the subject up gently, using plenty of “I” statements. You could say:

• “It makes me feel bad when you say or do X.”
• “I feel like you aren’t respecting my boundaries when you say or do X.”
• “I want to be able to talk to you about X, but it feels difficult.”
• “I need X from you right now.”

Your family might not know how you are feeling unless you tell them. This can be a great step towards mitigating your family-induced anxiety.

Seeking Professional Help

If you feel as though you cannot handle or improve your anxiety alone, you can always look for a therapist with whom you can address these concerns.

Talking in individual therapy about your anxiety triggers as they relate to your family can be especially helpful. A therapist can help you recognize your triggers and learn to react to them in a way that is healthy and emotionally appropriate.

It might also be useful to engage in family therapy. Family therapy can help you learn to communicate effectively with any member of your family and identify personal and shared triggers that affect your interfamily relationships. Being able to address these issues directly with the help of a therapist as a skilled mediator can lead to insights and improvements that might not otherwise be possible.

However, bear in mind that your family members, especially the ones with whom you might have a more strained relationship, may not be open to family therapy or see the value in it. In spite of this, you can still work on your relationships and anxiety triggers in individual therapy.