The Link Between Insomnia and Mental Illness

“I’ve always envied people who sleep easily. Their brains must be cleaner, the floorboards of the skull well swept, all the little monsters closed up in a steamer trunk at the foot of the bed.”  ~ David Benioff (co-creator of Game of Thrones)

Surely you have experienced a poor night’s sleep. You wake up feeling unrested, groggy, like you got hit by a train… And the fun lasts throughout the day with slow reflexes, foggy brain, inability to concentrate, impatience, stress, worry, anxiety and even headaches. It is absolutely no surprise that sleep quality has a direct impact on your physical and mental health. Today I am going to highlight the connection between insomnia and mental illness, in hopes that those experiencing it can get the help they deserve.

Insomnia is defined as the inability to get the necessary amount of sleep to function efficiently during the daytime. It is a sleep disorder that is characterized by difficulty falling asleep, waking up often throughout the night, having trouble going back to sleep, and waking up too early in the morning. In essence, insomnia results in feeling tired upon waking. Understandably, said fatigue can lead to difficulties functioning during the daytime and have unpleasant effects on work, social and family life. 

You likely already knew all of that about insomnia. But what you may be unaware of is that insomnia can be indicative of more serious issues, including medical issues like sleep apnea, or even mental illnesses like anxiety, depression, schizophrenia, bipolar disorder, and attention deficit hyperactivity disorder (ADHD). Sleep issues can even be a sign of an impending condition such as bipolar disorder. Many existing medical and mental health conditions can be worsened by sleep-related problems because lack of sleep slows recovery from mental illness. People with depression who continue to experience insomnia, for instance, are less likely to respond to treatment for depression. They are also at greater risk of relapse than those without sleeping problems.

Many people do not know there is an undeniable link between insomnia and mental health issues. More than fifty percent of insomnia cases are related to depression, anxiety or psychological stress, and many anxiety disorders are associated with difficulty sleeping. For instance, obsessive-compulsive disorder (OCD) is frequently associated with poor sleep. Panic attacks during sleep may suggest a panic disorder. Poor sleep resulting from nightmares may be associated with post-traumatic stress disorder (PTSD). The severity of sleep issues can determine the type of mental illness a person my experience. For example, early morning wakefulness, low energy, inability to concentrate, sadness and a change in appetite or weight can be indicative of depression. A sudden dramatic decrease in sleep accompanied by an increase in energy (or the lack of need for sleep) may be a sign of mania

Poor sleep patterns can not only be indicative of mental health issues, but it can also significantly worsen them. Insomnia makes it difficult to process and react to appropriately to negative emotions. Severe sleep problems can decrease the effectiveness of certain treatments. Treatment of sleep disorders has also been studied in relationship to schizophrenia, ADHD and other mental illnesses. All of the scientific data shows the connection between medical and mental illnesses: good sleep is necessary for recovery—or prevention—in both types of conditions.

There was a research trial done where fifty-one percent of individuals who overcame depression after psychological treatment (therapy) or medication were still experiencing insomnia. Insomnia tends to persist unless it is directly targeted for treatment. Insomnia can either be short-term or long-term; short-term insomnia is very common and has many causes such as stress, travel or other life events. It can generally be relieved by simple sleep hygiene interventions such as exercise, a hot bath, warm milk or changing your bedroom environment. Long-term insomnia lasts for more than three weeks. This is when you need to be examined by a physician with a potential referral to a sleep disorder specialist (a psychiatrist, neurologist or pulmonologist who have expertise in sleep disorders) for assistance. A balanced diet, regular exercise, meditation and relaxation, good sleeping habits, herbal remedies, medication and therapy are powerful actions that can help relieve insomnia. 

Living with insomnia is hard. The constant exhaustion and inability to sleep is an ailment which may require medical attention to overcome. Remember that insomnia often comes paired with a mental illness. Only as you work through both ailments will you find lasting relief. But it is doable, and I am here to help! Please do not hesitate to contact me today!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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The Toll Lying Takes on Lovers

“If you tell the truth, you don’t have to remember anything.” ~ Mark Twain

Lying begins early in life. Children as young as two begin lying when they discover how powerful their words are. Lying can come naturally; you say your friend’s favorite shirt looks great, knowing how much she loves the ugly thing. You lie in job interviews to increase the chances of being hired. You lie to your children, promising ice cream later if they eat their meal first (although you have zero intention of following through). While this type of lying is relatively benign, prolonged lying can undermine the glue that holds relationships together…trust. Trust is the expectation that another person will not hurt you when you are vulnerable, and humans thrive on having meaningful relationships founded on mutual trust. Take that trust away and you have an unsteady relationship. 

Let’s classify what a lie is. I see it as intentionally deceiving someone, omitting important information or only telling half of the truth. A wife may lie about how much money she spent. A husband may lie about what really happened on his boys night out. The husband I referred to in my previous blog post on gaslighting lied to his wife about turning the lights down (thus creating an alternate reality). A lie can be about anything–from what a person said, to what someone did (or did not do); from whereabouts to motives to goals to grades. The bottom line about a lie is that the truth is purposely left out. 

If you have been lied to by your partner, you likely feel anger, shock, resentment, disappointment, sadness. The whole thing leaves a nasty taste in your mouth. You might have a hard time saying it, but you also feel disrespected, humiliated…even violated. You have been because lying is a violation of your trust! Obviously, some lies are bigger and more devastating than others, but even small, little white lies that accumulate over time can make you feel like a punching bag.

Why do people lie?

According to Karla Ivankovich, PhD, a psychology instructor and clinical counselor at OnePatient Global Health, misrepresentation and fibbing in relationships happens more often than you would think. Studies have shown that people lie frequently to those they care about most. Couples are telling each other little white lies all the time. But why? For starters, they have learned that telling the truth can sometimes start a fight. Although a little lie can avoid a fight temporarily, it is not worth the trust that is broken. Some people lie to save themselves from punishment or conflict, or to gain acceptance from a group or get something else they want. Others lie as a form of self-protection; they want to maintain their image or avoid blame or criticism. Sometimes it might just be easier and require less explanation to not give the full story.

You’ve been lied to. Now what? 

Let’s say you just found out that your significant other has been lying to you. You may wonder how to bring it up. Or if saying anything will even make a difference. Figuring out what the “right” thing to do in the moment is hard because you have been betrayed–which puts you on the defensive. Your instinct may be to lash out, or to humiliate them by calling them out on their lies. Although responding in these ways may give you temporary pleasure, they will not help in building the long-term trust you desire and deserve. Instead, try the following when responding to a partner who has been lying:

  1. Calmly point out the incongruity. Let them speak without becoming reactive and refrain from commentary until they have fully expressed themselves.
  2. Consider the why. Although you are understandably angry, instead try empathizing. See where your partner is coming from. People lie for a reason: insecurity, fear, shame, or because historically this was their way to survive and manage other past relationships. While none of this justifies the lie, trying to understand their perspective can help calm your own emotions and help you decide how best to proceed. 
  3. Establish boundaries. If you do choose to continue in the relationship, you have now established that lying is not acceptable.  Make it clear to your partner that you will only accept honesty. Encourage your partner to always tell the full truth, even if the truth may result in some hurt feelings (and then)…
  4. …Practice what you preach. Make honesty with your partner a conscious decision and a habit. Model the behavior you want your partner to exhibit. If you are ever tempted to fib or give an impartial truth (because many individuals tell small lies at time), don’t! Then give reason: “I am afraid you will be upset with me, but here is what I really think…” or, “It feels like it would be easier to lie to you, but the truth is…”; “I don’t want to hurt your feelings, but since you asked, here is what I really think…” Talk it out. This will honor the boundaries you have established and create an open, safe environment. Hopefully this will inspire your partner to be truthful, too.
  5. Be consistent and patient. If your partner has been lying to you, remember that change is possible, but with time. Be patient with him/her and remember that consistent efforts to be truthful, even with the small things, will help telling the truth come more naturally. Continuing in this pattern will form a habit. When appropriate, remind your partner that the consequences of lying will never be worth the risk of being entirely truthful. For many people, finding a good, trusting relationship is a monumental life task. So if you have it, honor it, stick with it, be true to it, and be patient with it. 

Lies often start as self-preservation but generally turn to self-destruction. It is a fallacy to think that the consequences of telling the truth outweighs the risk of telling a lie; lies damage relationships. Research shows that small lies make it easier to tell bigger lies, which lead to more trouble. No matter the motive behind a lie, deceit is damaging to any relationship. Where lying creates distance and inauthenticity, telling the truth fosters trust and bonding, which strengthens relationships. So where trust has been lost, the most effective way for it to be regained is for the offender to understand the error of his ways, the vital need to be honest, and then to speak honestly, knowing you would rather have the ugly truth than a pretty lie. Look for my next post on how to specifically respond in these types of situations. If you find yourself in a relationship with someone who is struggling to tell the truth , please do not hesitate to contact me personally. My door is always open!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Sticks and Stones Do Hurt…and So Can Words

Feeling insulted and damaged. Never measuring up. Walking on eggshells. These are just a few of many indicators of an emotionally abusive relationship. Emotional abuse is the consistent pattern of abusive words and bullying behaviors that wear down a person’s self-esteem and undermine their mental health. I want to help you recognize this often seemingly invisible, yet very real type of abuse.

The definition of abuse is regularly or repeatedly treating a person with cruelty or violence. In discussing abuse, physical abuse (like shoving, cornering, breaking and throwing things) is likely the first thing that comes to mind. Emotional abuse is often devoid of physical violence; it is speech and/or behavior that’s controlling, punishing, or manipulative. This can include withholding love, communication, support, or money as indirect methods of exerting control and maintaining power. Emotional abuse might also look like someone controlling where you go, to whom you talk, or what you think. Spying, stalking, and invading your personal space or belongings is also abusive because it disregards personal boundaries.

You may be experiencing emotional abuse if someone wants to know what you are doing all the time or requires you to be in constant contact; demands passwords to your phone, email, and social media (digital abuse); acts jealous; frequently accuses you of cheating; prevents or discourages you from seeing friends or family; tries to stop you from going to work or school; gets angry in a way that frightens you; controls your finances or how you spend your money; stops you from seeing a doctor; humiliates you in front of others; calls you insulting names; threatens to hurt you, people or pets you care about; threatens to call the authorities to report you for wrongdoing; threatens to harm himself or herself when upset with you; says things like, “If I can’t have you, then no one can”; decides things for you that you should decide (like what to wear or eat); etc.

The most common form of emotional abuse is verbal, though it often goes unrecognized because it can be subtle. A client recently told me that she remembered a session from years ago when I stopped her now ex-husband from telling her to shut-up as she tried to speak. She did not even hear him say that, but she remembered feeling her body tense up. Research has shown that there is so much more to verbal abuse than people realize; in fact, some people are verbally abused on a regular basis without even recognizing it! Some forms of emotional/verbal use will undermine your self-esteem or make you feel inadequate as a way to establish hierarchy. 

Emotional and verbal abuse may be manifested outright or more insidiously in any of the following manners:

  • Using threats
  • Judging
  • Yelling
  • Patronizing
  • Criticizing
  • Lying
  • Blaming
  • Publicly embarrassing you
  • Ordering
  • Raging (showing violent, uncontrollable anger)
  • Belittling your accomplishments
  • Insulting your appearance
  • Digital spying
  • Tracking your whereabouts
  • Lecturing
  • Denying something you know is true (gaslighting)
  • Trivializing
  • Demanding respect (but not giving it)
  • Keeping you from socializing (isolating you)
  • Interrupting
  • Treating you like a child
  • Name-calling, even using derogatory pet- or nicknames
  • Disguising something hurtful or controlling by saying it in a loving, quiet voice, indirectly, or even concealed as a joke

Whether disguised as play or jokes, sarcasm or teasing that is hurtful is emotional and verbal abuse. There are innumerable signs of emotional abuse–unique to each couple and individual. If you fear you may be being emotionally or verbally abused, please seek help today. 

An emotionally abusive relationship can change you forever. You may feel powerless, controlled, worthless; you may question your memory, live in fear, change how you act to avoid upsetting your partner. Staying in an emotionally or verbally abusive relationship can have long-lasting effects on your physical and mental health, including leading to chronic pain, depression, or anxiety. This is no way to live. Help is available and you DESERVE it. If you suspect your partner, family member or friend may be emotionally abusing you, contact a counselor, an advocate or a pastor for assistance. You can also call the National Domestic Violence Hotline 1−800−799−SAFE(7233) or visit their website (thehotline.org) and chat online with someone right away. I will be posting a follow-up blog discussing what to do if you are in an emotionally abusive relationships in the future. Please, do not suffer through emotional abuse. You and your happiness matter. My door is wide open; allow me to help you! Contact me today!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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The 5 Chairs of Grief

“Should you shield the valleys from the windstorms, you would never see the beauty of their canyons.” ~ Elisabeth Kübler-Ross

No matter where you live, how old you are, what color your skin is, or your career choice, you will experience loss and grief at some point in your life. It is universal. Maybe it will be from the death of a loved one, the loss of a job, the end of a relationship, the diagnosis of a terminal illness, or a life-altering change. In hopes that I can help someone out there, I wish to share what one of my friends is experiencing in relation to the stages of grief.

A dear friend of hers recently passed away. She was young; she had a husband who adored her, an active one year-old daughter, a lively dog, a new apartment, a flourishing photography business, and an entire life ahead of her. Though she had experienced some fairly serious health issues during her short time on earth, no one thought the common cold would be what would ultimately take her while she slept. Her death shook the community, her family, friends, and many loved ones. She is deeply, deeply missed. In dealing with her loss, my friend has had to confront the five stages of grief in a very real, very personal way. 

The five stages of grief was introduced by a Swiss-American psychiatrist named Elisabeth Kübler-Ross. She did research with terminally ill patients, and published a well-known book called On Death and Dying. Through her work, she identified five common stages of grief her patients all experienced–denial/isolation, anger, bargaining, depression and acceptance: 

  1. Denial and isolation: This can’t be happening… Denial is a common defense mechanism that buffers the immediate shock of the loss, and numbs your emotions. You hide from the facts. Denial is the brain’s way of making sure you do not get too high a dose of grief before you are ready. 
  2. Anger: Where is God in this…? Reality and its pain emerge. You likely do not feel ready. The intense emotions are deflected from your vulnerable core, redirected and expressed instead as anger. The anger may be aimed at inanimate objects, complete strangers, friends or family, or even yourself.
  3. Bargaining: If only we had gotten medical attention sooner… This is the need to regain control through a series of “If only” statements. Guilt often accompanies bargaining. You start to believe there was something you could have done differently to have helped save your loved one. You spend time reviewing how different scenarios would have played out, but it does not change your reality.
  4. Depression: She won’t even get the chance to see her kids grow up…Once bargaining no longer feels like an option, you face reality and are hit squarely with an intense sadness. You withdraw from life, left in a fog of intense sadness, wondering if there is any point in going on. When loss fully settles in your soul, the realization that your entire life will be different is understandably depressing.
  5. Acceptance: This is my new reality and I need to learn to live with it… Reaching this stage of grieving is a gift not afforded to everyone. Although most people never stop missing their departed loved ones, the painful emotions they feel shortly after the death nearly always soften with time. This phase is marked by withdrawal and calm. It does not mean you are okay with the loss or that everything is “alright”; this stage is about accepting your new reality without your loved one. You learn to live with it. You accept that life has been forever changed and that you must readjust. You reorganize roles, re-assign them to others or take them on yourself. Finding acceptance may be just having more good days than bad ones. 


The only issue with these stages–what my friend has had to re-learn and what I witness in clients–is that we perceive them to be linear steps. First, you deny it. Then you feel anger. After that you bargain, and so on and so forth until we magically “accept” the loss and all is well in the world. But what happens when you find that you seemed to have digressed back to the first so-called “step” and am in denial again? In her grieving process, she found that she was not progressing neatly from one step to the other. This has helped her see and remember, in a very personal way, that these steps are more like symptoms–they come and go, worsen and lessen with time. And that is okay! 

I like to think of these stages of grief as five chairs. Shortly after loss, you may sit for a solid hour in the denial chair. Then you may get up and move in any direction and sit for any amount of time. Maybe you move from the “denial” chair to sit in “acceptance,” but then you might go back to the denial one for a minute–or anger, or any of the other chairs.  You might feel like you have worked through the anger of losing someone or something valuable, and feel surprised to be feeling anger again. You might think, Wait, I thought I worked through anger. Why is it back all this time later? It is okay. You simply moved chairs. That is normal and you are healing just the way your soul needs to. In your bereavement, you will spend different lengths of time working through each step and express each stage with different levels of intensity. Contrary to popular belief, the five stages of loss do not necessarily occur in any specific order. You will likely play musical chairs and move between stages before achieving a more peaceful acceptance of death. 

If you are experiencing grief, be gentle with yourself. Remember, grief is not a simple process with clean steps that you will complete before moving towards acceptance; rather it is often messy and tangled, with setbacks and delays. People who are grieving do not go through the stages in the same order and may not even experience all of them. So take your time; sit in whatever chair you need to as you work through your loss and know that it is just what you need. As always, please do not hesitate to contact me and schedule a session should you need additional assistance while coping with loss. 

Note: Kubler-Ross herself said that grief does not proceed in a linear and predictable fashion. She regretted that her stages had been misunderstood as steps. The five stages of grief were originally developed to explain what patients go through as they come to terms with their own terminal illnesses; only later were they applied to individuals grieving the loss of someone or something else.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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When Stealing Is a Compulsion, Not a Choice

“A kleptomaniac is a person who helps himself because he can’t help himself.” ~ Henry Morgan

Although kleptomania is a relatively rare mental illness–affecting 6 in 1000 or 1.2 million Americans–you have likely heard someone referred to as a “klepto.”  An example of a public figure, who is thought to struggle with kleptomania, is Winona Ryder, one of the lead actresses from Stranger Things. She was caught stealing over $5,000 worth of designer clothes from Saks Fifth Avenue in 2001.

Kleptomania is a mental health disorder summarized as the recurrent inability to resist urges to steal. Very rarely do kleptomaniacs steal items of great worth; more often than not, they steal items that they do not need, that they could afford to buy, and that have little to no monetary value…like a keychain.  People affected by kleptomania do not compulsively steal for personal gain, on a dare, for revenge or out of rebellion; they steal simply because the urge is so powerful that they cannot resist it. Such episodes nearly always occur spontaneously, with little to no premeditation or forethought. Kleptomaniacs tend to steal from public places like stores and supermarkets. Some may even steal from friends or acquaintances. The stolen items are either stashed away, never to be used, or potentially donated, given away to family or friends, or even secretly returned to the place from which they were stolen. Kleptomania can cause much emotional pain to you and your loved ones if not treated.

Kleptomania vs. Stealing

Kleptomania is different from flat-out stealing. Ordinary theft (regardless of whether it is planned or impulsive) is deliberate and motivated by the usefulness of an object or its monetary worth. Kleptomania, on the other hand, is the recurring impulse to steal items even though said items are not needed for personal use or monetary value. Often a sense of entitlement comes with stealing, a feeling of “I deserve this”. Stealing is driven by need or want; kleptomania is a compulsion. 

Causes

The causes of kleptomania are unknown. Some scientists believe that kleptomania is part of an alcohol or substance addiction. Some think it is due to an imbalance of the brain chemical, serotonin–which helps regulate mood and emotions (low levels of serotonin are common in people prone to impulsive behaviors). Others consider it to be a deviation of an impulse control disorder like eating disorders or obsessive-compulsive disorder.  Although, in theory, anyone can have kleptomania, it seems its onset generally occurs in late adolescence or early adulthood among women. 

Symptoms

Signs of kleptomania are commonly misdiagnosed as everyday theft, but there are a few telltale symptoms and signs that accompany clinical kleptomania, such as the following:

  • Stress
  • Thoughts of intrusion
  • Powerful urges to steal items not needed
  • Inability to resist the compulsion to steal
  • Feeling pleasure, relief or gratification while stealing
  • Release of pressure following the theft
  • Feeling terrible guilt, remorse, self-loathing, shame or fear of arrest after the theft
  • Return of the urges and a repetition of the kleptomania cycle

Effects

Aside from the emotional turmoil that would accompany dealing with the previously listed symptoms, the physical and social effects can include arrest, incarceration, being labeled a thief, developing substance abuse problems, being ostracised from loved ones, losing a job, having poor self-image, and even incurring a criminal record. Additionally, if left untreated, kleptomania can lead to other impulse-control disorders, alcohol/substance abuse, eating disorders, depression, anxiety, and even suicidal thoughts.

Kleptomania comes with a great deal of shame and guilt, as well as the potential for serious legal consequences. Uncontrollable stealing can prevent anyone battling kleptomania from living a productive life. This mood disorder is destructive to both the kleptomaniac and their loved ones, but the good news is that help is available. Although it cannot be cured, kleptomania can be managed with a combination of pharmaceutical and behavioral treatments. I am available to offer professional support to help you or your loved one live a fulfilling life, free from the grips of kleptomania. Please do not hesitate to contact me to today. Help is one click or call away!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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When Someone Else Alters Your Reality: Gaslighting

Gaslighting:  The attempt of one person to overwrite another person’s reality.

In 1938, Patrick Hamilton wrote a mystery thriller play called Gas Light, where a husband manipulates his adoring, trusting wife into believing she can no longer trust her own perceptions of reality. He does this by dimming the gas-powered lights in their home, and then denying that the light changed when his wife points it out. From this the term “gaslighting” was born.

In the last few years, there has been attention around this term. Awareness has been heightened about gaslighting in the media, in politics, and in relationships. Also known as “crazy-making,” gaslighting leaves its victims questioning their very perception of reality.  I frequently see gaslighting in relationships where one of the partners battles an addiction; the supporting partner may suspect a relapse or regression, but the using partner may use gaslighting tactics to protect themselves by convincing the other that their instincts are wrong. My hope is to delve a little deeper into the specifics of gaslighting so my readers are better able to spot it and be armed against it. 

The phrase “to gaslight” refers to the act of undermining another person’s reality by denying facts, the environment around them, or their feelings. Gaslighting can occur in personal relationships, at the workplace, or over an entire society. Targets of gaslighting are manipulated into turning against their cognition, their emotions, and who they fundamentally are. It is an extremely effective form of emotional abuse that causes a victim to question their own feelings, instincts, and sanity, which gives the gaslighter a lot of power. Obtaining power and control is at the heart of gaslighting. 

In relationships, gaslighting typically happens very gradually; in fact, the abusive partner’s actions may seem harmless at first. Over time, however, these abusive patterns continue and a victim can become confused, anxious, isolated, and depressed, and they can lose all sense of what is truly happening. Then they start relying on the abusive partner more and more to define reality, which creates a very difficult situation to escape.

Gaslighting has several faces. The first is withholding–where the gaslighter pretends not to understand or refuses to listen. Second is countering–where the gaslighter questions the victim’s memory of events, even when the victim remembers them accurately. The third is blocking or diverting–where the gaslighter changes the subject and/or questions the victim’s thoughts. The fourth is trivializing–when the gaslighter makes the victim’s needs or feelings seem unimportant. And the final is forgetting or denial–when the gaslighter pretends to have forgotten what actually occurred or denies things like promises made to the victim. 

People are not born gaslighters like some are born introverts or extroverts. A gaslighter is a student of social learning, or nurture. They witness it, feel the effects of it, or happen upon it and see that it is a potent, effective tool. Although some individuals gaslight intentionally–like my previous example of an individual trying to cover up a relapse or slip, in their addiction, from a partner–others may not even know they are being manipulative. I have seen some people unknowingly gaslight because they lack self-awareness and/or simply think they are expressing themselves directly and saying it “like it is.” Whether intentional or unintentional, gaslighting leaves its victims discouraged, resigned, pessimistic, fearful, debilitated, and self-doubting. They also question their own perception, identity, and reality; thus, the gaslighter gains control.

The following are common signs that you may be a victim of gaslighting:

  • You constantly second-guess yourself.
  • You ask yourself, “Am I too sensitive?” multiple times a day.
  • You often feel confused and even crazy.
  • You frequently apologize to your partner.
  • You cannot understand why–with so many apparently good things in your life–you aren’t happier.
  • You frequently make excuses for your partner’s behavior to friends and family.
  • You find yourself withholding information from friends and family so you don’t have to explain or make excuses.
  • You know something is terribly wrong, but you can never quite express what it is–even to yourself.
  • You start lying to avoid the put downs and reality twists.
  • You have trouble making simple decisions.
  • You have the sense that you used to be a very different person–more confident, more fun-loving, more relaxed.
  • You feel hopeless and joyless.
  • You feel as though you cannot do anything right.
  • You wonder if you are a “good enough” partner.

At its extreme, the ultimate objective of a gaslighter is to control, dominate, and take advantage of another individual or a group. But, as I always say, this is not a life sentence. If you have been or are a victim of gaslighting or believe that you have used gaslighting in relationships, you do not have to continue that pattern. Get help. Learn how to break the cycle and create healthy relationships. I am a trained, licensed therapist, and I am here to help. My door is always open! 

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Clear and Present Danger: Teens and Vaping

“We see clear signs that youth use of electronic cigarettes has reached an epidemic proportion, and we must adjust certain aspects of our comprehensive strategy to stem this clear and present danger.” ~ FDA, September, 2018

There’s a new cool kid on the block according to statistics published by Child Mind Institute. Smoking cigarettes has taken a backseat to the accessible and underestimated–yet still highly addictive–e-cigarette. E-cigarettes are now the most frequently used tobacco product among adolescents; some 2.1 million middle and high school students used e-cigarettes in 2017! This is far surpassing traditional combustible cigarettes. What is the e-cigarette? How does it work? Is it harmful? Because so many individuals are using these devices, it is important to be educated on this new behavior, especially popular amongst teens and young adults.

What is vaping?

Vaping devices include e-cigarettes, vape pens and advanced personal vaporizers (also known as ‘MODS’). When the device is used, the battery heats up the heating component, which turns the contents of the e-liquid into an aerosol that is inhaled into the lungs and then exhaled. Vaping is the act of inhaling and exhaling the aerosol, commonly referred to as vapor, which is produced by an e-cigarette. The difference between traditional tobacco cigarettes and e-cigarettes is that e-cigs do not contain nor produce tobacco smoke, but rather an aerosol. The vapor created by e-cigarettes consists of many fine particles which contain varying amounts of toxic chemicals that have been linked to cancer, as well as respiratory and heart disease.

E-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items. E-cigarettes have many names, including e-cigs, JUUL (JUUL Labs, Inc. is the name of the leading electronic-cigarette company), ENDS (electronic nicotine delivery systems), e-hookah, and so much more. JUUL, the newest and most popular vape device, is sleek and tiny (reminiscent of a flash drive), and can be charged in a USB port. It comes in several enticing flavors like crème brûlée, mango and fruit medley. Every JUUL product contains a dose of nicotine, with one pod or flavor cartridge containing about the same amount of nicotine as a whole pack of cigarettes. The JUUL’s subtle design makes it easy to hide, which certainly explains why it has become so popular among middle and high school students. It now accounts for about 72 percent of the market share of vaping products in the United States and more than half of the e-cigarette market. E-cigarette company, JUUL Labs, Inc. recently exceeded a $10 billion valuation faster than any company…including Facebook! 

Is vaping bad for you?

Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic. Though it is speculated that e-cigarettes expose the user to fewer toxic chemicals than traditional cigarettes, nicotine is the primary agent in both and it is highly addictive. Nicotine causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine raises your blood pressure and spikes your adrenaline, which increases your heart rate and the likelihood of having a heart attack.  Additionally, many e-cigarette users get even more nicotine than they would from a tobacco product because you can buy extra-strength cartridges (a higher concentration of nicotine) or you can increase the e-cigarette voltage to get a greater hit of the substance.

Although e-cigarettes have been marketed as an aid to help you quit smoking, they have not been approved by the Food and Drug Administration (FDA) as a smoking cessation device. In fact, a recent study found that most people who intended to use e-cigarettes to kick the nicotine habit ended up continuing to smoke both traditional and e-cigarettes!

Why does vaping appeal to teens?

There are several reasons why e-cigarettes are grabbing the attention of the young people: First, many teens believe that vaping is less harmful than smoking (the packaging does little to convey the risks; it says 5% nicotine, which sounds like nothing, so teens think 95% is water weight or vapor). Second, e-cigarettes have a lower per-use cost than traditional cigarettes. Finally, vape cartridges are often formulated with flavorings such as apple pie and watermelon that appeal and seem less harmful to younger users.

What are the effects of vaping?

Vaping drugs affects how someone thinks, acts, and feels. Some may argue that vaping does not include nicotine, but most do. Even those without nicotine still have chemicals in them that irritate and damage the lungs and other internal organs. Vaping also slows brain development and affects memory, concentration, learning, self-control, attention, and mood. It serves as a gateway drug and increases the risk of other types of addiction later in life. Because this drug was only introduced to the public in 2007, there is limited research on the long-term effects.

If you are vaping, or participating in other addictive behaviors, and want to quit, there is hope! You CAN do it–you can kick this addictive habit and behavior. Start by deciding why you want to quit; own your reason and stick by it. Then, pick a day to quit. Get rid of your vaping supplies.  Avoid your triggers. Tap into available resources like apps, family members, friends, support groups, a therapist, and healthy hobbies. Get the help you need and deserve. I am your cheerleader; please do not hesitate to contact me today to schedule a session! 

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Self-Care is for Men Too!

“When you recover or discover something that nourishes your soul and brings joy, care enough about yourself to make room for it in your life.” ~ Jean Shinoda Bolen

Everywhere you look there are articles, blogs, advertisements, and pictures about how women can become more beautiful or healthy or happy. Just as important, but receiving much less attention, is the topic of self-care for men. 

Self-care is defined as the practice of taking action to preserve and/or improve your health. It has a renewing, refreshing, and sharpening effect. There are many practical benefits to regularly implemented self-care: Improved overall health, sharpened mental health, decreased stress levels, heightened focus, greater levels of resilience, broadened creativity, and a myriad of other advantages. 

Self-care has many faces. Women think of chocolate, sleep, massages, shopping, relaxing by the pool… When men think of self-care, they may not immediately picture a bubble bath with essential oils. So what’s a guy to do for self-care? Here are four practical suggestions:

  1. Make yourself a priority. Sounds simple enough, right? Maybe you really enjoy music: listen to your favorite album on your daily commute. Maybe you know you feel better physically and mentally when you exercise: take a few hours a week to get to the gym. Making time for yourself is not selfish, it is necessary to being at your best…which unavoidably seeps into every other aspect of your life! Making yourself a priority does not mean that you sit lazily on the couch, ignore the important people in your life, or allow screen time to absorb your stress.  It means being intentional with your time and doing what will refuel, refresh, and reinvigorate you for another day. Know what brings you joy, and be proactive about practicing or engaging with these aspects of your life. 
  2. Interact with others. Having meaningful relationships positively influences mental health. These relationships will allow you to share aspects of your own life and also escape from your day to day routine. This might mean grabbing wings during game time from Buffalo Wild Wings, going hunting or fishing, grilling or smoking the results of said hunting or fishing outings, shooting hoops at the gym, or a myriad of other options!
  3. Be healthy. Both men and women need to take care of themselves physically; this is self-care 101. By this I mean eating a balanced diet, getting adequate sleep, exercising regularly, etc. It might also include meditation, practicing gratitude, regularly assessing goals/resolutions, and any form of stress management. Additionally, be sure to make yearly doctors’ appointments with both your primary care physician and specialists (where applicable).  Take care of your body and brain and you will be better equipped to perform to the best of your abilities! 
  4. Recognize burn-out signs. We all have them. Maybe you get snappy, easily irritated, on edge. Or maybe you feel exhausted, lethargic, or depressed. Such symptoms may serve as warning signs that you need to put on the brakes and take a personal day. This is where you might return to number one and repeat the cycle of making yourself a priority, investing time in meaningful relationships, and taking care of your physical and mental health. As you do so, the time in between your warning signs and necessary “reset” will lessen because your manly self-care will become more instinctive and effective.

There are several reasons why men do not practice self-care regularly: First, it is not considered to be terribly masculine in our society, and some men worry it will make them appear weak if they take time for themselves. Also, some men might think it is not for them because not many men are promoting it. Lastly, and most commonly, many men may find it difficult to prioritize self-care with work/life being too demanding, or they may not understand the need. 

Self-care is not just an activity you simply schedule into your daily life (though that is a great place to start if you are not currently doing any self-care!). It is a mindset that requires listening to what your body and mind need, and then regularly practicing those things. As you put yourself first, foster meaningful relationships, live a healthy lifestyle, and avoid burn-out, you will see the many benefits of self-care. Women swear by it…and so should men! In fact, I firmly believe that many of the issues that we face in our relationships would be alleviated if we all simply practiced self-care! If you have questions or feel you need assistance implementing self-care into your life, please do not hesitate to contact me or schedule a session. You will not regret making self-care an important part of your life!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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The Life Defining Practice of Positivity

 Research is revealing that positive thinking is about much more than just being happy or displaying an upbeat attitude. Positive thoughts can create real value in your life and help you build skills that last longer than a smile.

Instead of worrying about what you cannot control, shift your energy to what you can create.”
― Roy T. Bennett

Every single day you face a myriad of situations that will test and prove your outlook on life. Is your glass half-empty or half-full? Do you see changes as setbacks or opportunities? Do you see weakness as a nuisance or a chance to grow? Would you consider yourself to be more of an optimist or a pessimist? Regardless of where you currently stand, you can start today to implement positivity into your life. Everything from your work to your health to your relationships will improve as you try to see the world through an optimistic lens!

Here is the 101 on positive thinking. It helps with stress management and improves your overall physical health (even resistance to the common cold!), it increases your lifespan, lowers your rates of depression and stress, offers greater immunity and better cardiovascular health, and results in more effective and efficient coping skills during hardships and times of stress. In other words, there are no cons to positivity.

Positive thinking does not mean you simply stick your head in the sand and proceed to ignore all of life’s less-than-pleasant situations. No, quite the contrary. Positive thinking simply means that you approach said unpleasantness in a more positive and productive way: You assume the best is going to happen instead of expecting the worst.

If you want to be a more optimistic person, you can! You can learn to turn negative thinking into positive thinking. The process is simple, but it does take time, patience, and practice…after all, you are creating a new habit. Here are some ways to start living a more positive lifestyle:

  1. Start small. If you want to employ more positive thinking, first identify areas of your life that you usually think negatively about. This may be work, your daily commute or a relationship. Start small by focusing on one area to approach in a more positive way.
  2. Have checkpoints. Periodically during the day, stop and evaluate what you are thinking. If you find that your thoughts are mainly negative, try to put a positive spin on them.
  3. Positive self-talk. Self-talk is the endless stream of unspoken thoughts that run through your head. This is where positive thinking often starts. Be careful to not say anything to yourself that you would not say to someone else you care about! Shed the weight that comes from thinking unkindly of others by speaking kindly to yourself.
  4. Follow a healthy lifestyle. Exercise, adequate rest, and a healthy diet can positively affect your stress levels. A healthy body and regulated stress will help you see the world differently.
  5. Try meditation. Recent research has revealed that people who meditate regularly display more positive emotions than those who do not. Meditation can result in mindfulness, purpose in life, social support, and decreased illness symptoms.
  6. Practice gratitude. It is easy to get caught up in the things that are wrong or that you lack in life. But instead, take a look around and count your blessings. Think about the many things you are thankful for. Making a daily list is a great way to practice gratitude!
  7. Try humor. Give yourself permission to smile or laugh, especially during difficult times. Seek humor in everyday happenings. Laughing at life will decrease stress!
  8. Play/decompress. Before a violin is stored, the strings are loosened. If it is put away with the strings tight enough to play, the strings will eventually stretch and snap. You need periodical breaks to have fun and decompress. You will be better able to see life from an optimistic viewpoint if you take time to blow off steam!
  9. Surround yourself with positive people (read: stay away from toxic people). Make sure the people you choose to surround yourself with are positive, happy, and supportive. Negative people may increase your stress level and make you doubt your ability to manage stress in healthy ways.
  10. Be happy NOW. It is easy to think you will be happy when you get that promotion or move out of your apartment or when your kids are out of diapers. I know I am guilty of putting off happiness until I achieve some arbitrary goal. But you can be happy NOW. You can choose to be optimistic and see life with an optimistic perspective now!

If you tend to have a negative outlook on life, take heart. The fact that you are reading this post speaks to your motivation to be a more optimistic person. And it will happen–with practice and patience. You can learn to see life through a positive, glass-half-full lens. You will start to see setbacks, weaknesses, trials, miscommunications, and failures for what they really are: opportunities for growth and happiness.  Practicing positive thinking will also help you become less critical of the world and the people around you. You will notice that positive thinking will bleed into every aspect of your life–including and especially your relationship with yourself. Positive thinking really is the practice that will change your life…for the better! Please feel free to contact me or schedule a session for additional assistance.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Hypochondriasis: When Worrying About Your Health Goes Too Far

“All the powers of imagination combine in hypochondria.” ~ Mason Cooley

If you were to google the symptoms from hunger pains and a low-grade fever, the internet might tell you you have appendicitis or another life-threatening illness. It is likely that you have had something similar happen–thinking a minor sickness is actually something far more concerning. While this may be laughable for many people, some individuals genuinely and subconsciously worry they have contracted (or may contract) a very serious illness from day-to-day life. This type of excessive worry is uncontrollable for some, and is a type of mental illness called hypochondriasis.

While hypochondriasis is the proper name for this illness, you have likely heard of it referred to as health anxiety, illness anxiety disorder, hypochondria, or that someone struggling with this mental illness is a “hypochondriac.” It is defined as the excessive worry of being or becoming seriously ill–even with the absence of worrisome physical symptoms. You may believe that normal body sensations or minor symptoms are signs of severe illness, even if or when a thorough medical exam does not reveal a serious medical condition.

This mental illness, like several others, is difficult in the fact that it is relentless–it never stops. No matter where you go, you worry about germs and contracting deadly sicknesses; it is as if the rest of your life is merely background music to the constant worrying that is hypochondriasis. This severe distress can majorly interrupt your life.

Symptoms of illness anxiety disorder involve preoccupation with the idea that you are seriously ill, based on normal body sensations (like the sounds of a hungry stomach) or minor signs (like a minor rash). Signs and symptoms may include:

  • Being preoccupied with having or getting a serious disease or health condition
  • Worrying that minor symptoms or body sensations are indicative of a serious illness
  • Being easily alarmed about your health status
  • Finding little or no reassurance from doctor visits or negative test results
  • Worrying about a specific medical condition because it runs in your family
  • Having so much distress about possible illnesses that it is hard for you to function
  • Repeatedly checking your body for signs of illness or disease
  • Frequently making medical appointments for reassurance (or even avoiding medical care for fear of being diagnosed with a serious illness)
  • Avoiding people, places or activities for fear of health risks
  • Constantly talking about your health and possible illnesses
  • Frequently searching the internet for causes of symptoms or possible illnesses

The causes for hypochondria are unclear, but there are three common hypothesis. First, you may have a difficult time accepting the uncertainty of an uncomfortable or unusual symptom in your body, which may lead you to search for evidence that would provide a more concrete answer–often resulting in an unnecessarily serious diagnosis. The second option is that you have had a parent or other family member excessively worry about their own or your health. The third possibility is that you have had a past experience with a serious illness that has created an overwhelming fear or paranoia surrounding unusual physical sensations.

The best prevention and treatments for hypochondria are simple. First, see your doctor for your routine check-ups to ensure optimal health. He/she can help reassure you that you are healthy, and this professional diagnosis may be useful to fall back on if you start worrying about your overall health. Second, if you have problems with anxiety, seek professional guidance from a mental health counselor as quickly as possible to help stop symptoms from worsening and impairing your quality of life. Third, learn to recognize when you are feeling stressed, how stress affects your body, and how to manage your stress (think meditation, exercise, a healthy diet, self-care, etc). And lastly, stick with your treatment plan to help prevent relapses or worsening of symptoms.

Just as you would go to a medical doctor with a broken limb or an unresolved alarming health concern, you should see a qualified, trained and experienced therapist to treat your mental needs. Hypochondria is a very real and debilitating mental illness. There is a way to work through your excessive worries and fears of sickness. I am here to help. Please contact me today with questions or to schedule a session.
Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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