Depression is a problem that affects millions of Americans each year, and many more people are not aware that they may be suffering from it. Fatigue, loss of interest in usual activities, malaise, problems eating and sleeping - these all characterize forms of depression.

Here’s some tips on how to fight depression:

1. Recognize that depression may be what you’re experiencing, and decide to deal with it instead of avoiding it; stay open to feedback from friends or loved ones about what they’re seeing from you.

2. Seek out the help of a trained professional. Talk with your doctor, or seek out a psychiatrist or mental health nurse practitioner who can talk with you about a possible antidepressant medication. You may also benefit from talk therapy, or counseling, to deal with the underlying issues associated with your depression.

3. Get active: engage in moderate physical exercise daily to reduce depressed feelings. This can be difficult when you feel fatigued or disinterested, but it helps.

4. Get Vitamin D/get outdoors: vitamin D helps fight depression.

5. Take Omega-3 fatty acids, either in liquid, capsule or food form (cold water fish). Talk with a physician or a nutritionist about what’s right for you.

6. Get support from friends, family, people close to you.

7. Journal your feelings regularly to see what may be the source of your depression, if there are events or people that trigger your depression.

8. Ask yourself if there are things happening in your life that need attention, or if you are not getting any major needs met in your life at the time. Sometimes, situational depression can be a result of events that stoke depression.

There is help from depression, and some of these tips may assist your recovery. Seek our support from those closest to you, and ask for help from professionals who care.

(reprinted from January’s edition of “Mentality” for men)

Healthy self-esteem is a critical component in a well-balanced life. Guys need it just the same, and it’s a consistent practice over time to maintain and refine good self-esteem, or the relationship that we have with ourselves. The way we treat ourselves is a direct reflection of the way we attract others into our lives. Who we attract into our lives is a direct reflection of how we feel about ourselves - good or bad. Let’s take a look at some components to developing better self-esteem for men.

Here’s how this will happen: we’ll look at four common areas affected by self-esteem, and give four tips for each category.

• At Work
  • Feel accomplished by breaking up large projects into easy to manage tasks, and structure your time.
    • Check these free forms out to help get you better organized: http://davidseah.com/
  • Periodically ask for constructive criticism from superiors to do a better job. Don’t wait for your review. It’s not ass kissing if you to want to perform better, and wiser.
  • Use your lunch productively: do some stress management for yourself for thirty minutes
  • Set quarterly goals for yourself on the job, and work towards gradual achievement of them; if you’re unhappy at work, set quarterly goals to get yourself out of there and into a better job or career
• Relationship with Ourself
  • Identify and watch the toxic “self-critic”. Start to watch how it beats you down mentally, and how much of your behavior may be driven to succeed to “show” or compensate. This is the voice inside your mind that tells you “you’re not good enough, smart enough, successful enough.” Yes, that one.
  • Identify your needs and communicate them to the people that can meet them for you. Deal with the ones that can’t.
  • Identify your feelings and communicate them to the people that can listen to them. Deal with the ones that can’t.
  • Know what your limits are. Learning to say “no” is just as important for men as it is for women. Having healthy boundaries - which originate in ourselves first - is the foundation for practicing self-care, and developing good self-esteem.
• Lifestyle
  • List three things you’ve been saying you’re going to do - that you’re not already doing - and develop an action plan to start to do them. This includes interests, hobbies, investment in relationships, etc. Identify the blocks and barriers, and write them down. Repeat.
  • Consider your friendships, and how they should be mutually satisfying for both parties. Do you feel good about them, and feel like you’re getting from them, as well as giving to them? If not, is a change needing to be made? Our friends can be great mirrors of our self-esteem, if we look closely. Research shows that mental health,  like depression, can be socially contagious, so why wouldn’t positive (or negative) self-esteem? Surround yourself with well-intentioned people who are good for your self-esteem.
  • Practice 20-30 minute regular exercise routines and do it not for an end-result, but as a commitment towards greater energy and positive self-esteem. Do it for your partner (or kids) if nothing else. We’re not talking Lance Armstrong here. Shake up those feel good brain juices.
  • Align your values with your behaviors. Are you practicing what you preach? Are you doing things in the world that are consistent with what you believe in? Sometimes, recalibrating them brings improved self-esteem, when we’re living from our core values instead of someone else’s.
• Stress Management

• Practice 10-15 minutes of conscious breathing (you can do this at work) or mindfulness meditation. You’ll be able to “unstick” from negative thinking about yourself through this process. E-mail me for instructions on meditating or breathing exercises.
• • Create a “stress list”, and record the daily items that stress you. Dump the stressors onto that list, and put the list in your desk drawer, or in a glass jar labeled “To Worry About”. Don’t stress: you’ll get to them later.
  • Practice better anger. You can exercise it out, yes, but you can also get in touch with the experience of anger in yourself, and communicate your anger in a healthy way to those that are the cause of it. Don’t stuff your anger, but don’t explode either. Choose “the middle way,” and cool your anger and frustration each time it comes up. But time it well.
  • Don’t smoke, and drink a little less. Both will spike stress, and exacerbate negative thinking about yourself (especially if you then tell yourself you want to quit. This is called “cognitive dissonance”, when stress appears as a product of two competing ideas. (“I want to quit, but I’m still doing it.”)

Self-esteem is a relationship that we build with ourselves over time. It requires some work, and continuing to do the right things over and over again. If you think you have chronic self-esteem problems, and need help, contact me to see how counseling or psychotherapy might benefit you.

(reprinted from January’s edition of “Mentality” for men)

Being the social beings that they are, women are generally more predisposed than men to seek out the support of their close friends when there are problems or challenges. Women are better at seeking out friends, and knowing how to support themselves by doing it.

On the other hand, men are not wired this way. Guys in our culture tend to have more superficial relationships, based on common interests, hobbies, work and sport. Men do have “guys’ night”, but usually entails some male bonding activity through watching sports or playing poker. Men bond with activities outside of their emotions, and our culture has never been supportive of men relating to other men in any other way, especially emotionally.  Look at the abundance of “bromance” movies in the last couple of years, such as “I Love You, Man.” Culture, or more specifically, Hollywood, usually needs a comedic vehicle in which to introduce the idea of men connecting on an emotional level. It’s just too “weird” or “uncomfortable” without the humor. It’s kind of sad, because a lot of guys have nowhere else to turn for support.

On a practical level, many men do state that they want more male friendships. They often don’t know how to go about getting them, or aren’t willing to put the work in to maintain friendships. Again, this is where women do it better than guys. They can not only seek out social support from friends, and learn how to meet their needs in this way, but have the ability to maintain friendships and invest the time and energy than it takes to keep them going.

The older a guy gets, the harder it is to “teach a dog new tricks.” It just becomes “too hard” for a lot of guys to risk seeking out new friendships, and spending the time and energy that it takes to preserve them. Sometimes it’s just a little scary to reach out.

We say to ourselves that we want more friendships, but sometimes we aren’t willing to put the work in that relationships take. Friendships are similar to intimate relationships or marriages in that way: they’re good when you put the work, time and investment into them, and atrophy when there’s no investment. Even if you just “synch” with someone, you still got to put the work in to maintain friendships.

Fear is one way that we get stuck from advancing towards generating an up keeping friendships. Sometimes, fear prevents us from taking the risk of seeking out new male friendships or reigniting old ones. Laziness is also a common roadblock towards developing friendships. We don’t want to put the work in, or “have other things to do,” which is another way to say that we are prioritizing certain things in our lives over developing more room for personal friendships. It’s just one choice over the next choice.

Friendships don’t just come to us; they take a lot of work, energy investment, and mutual willingness. it’s the same as keeping a marriage healthy, and it’s a way of helping keep yourself healthy by learning to meet your needs as a man. Guys need the support just like women do, and friendships are a great way to get that support when they’re mutually satisfying.

You may be struggling with depression and not know it. Here are some of the signs to look out for if you suspect you’re dealing with depression:

1. Lack of pleasure in things you usually find pleasing

2. Significant weight loss or gain

3. Feel sad a lot of the time, for prolonged periods of time

4. Feeling unclear, fuzzy or lacking attention; inability to concentrate

5. Irritable, angry or generally unhappy

6. Feeling worthless

7. Excessive guilt

8. Feeling flat or unmotivated

It’s difficult to actually admit that it might be depression that you’re suffering from. Sometimes, we write these symptoms off to other things, such as stress or interpersonal problems we’re dealing with. For men, it’s harder to put the signs of depression together and admit that they’re depressed; culturally, depression implies a sign of weakness or inferiority, so many men who struggle with depression make it worse by hiding it or putting off treatment.

There is help for depression. A combination of antidepressant medications and professional counseling will help. A change in lifestyle, whether that’s more exercise, better sleep, social support, better dieting and nutrition, or investment in more meaningful activities or deeper relationships also ease the pain of depression. Depression is a multi-facted problem, with many possible causes and treatments. But, first, simply admitting that there’s a problem is the first step.

I think about happiness a lot. I think about it around this time of the year quite a bit, as happiness and the holidays are so closely wedded. I meditate on the nature of happiness, and how we go about seeking it.

Happiness can come from finding meaning: in the work we do, in the friendships we create, and in the intimacy we deepen with our partners. It comes when the roads of the imaginary and reality merge.

Happiness can come from being present: to ourselves, to our thoughts and to our emotions. Being present and undoing the destructive emotions and thoughts that lead to destructive behaviors can lead to happiness. Quieting the self-destructive voice inside our heads, and learning to deal with the pains of life as they arise - and not continually pushing them aside - will lead to being happy.

Happiness comes from the little joys in life, not from always trying to get somewhere or grasping at trying to accumulate more stuff. We’ve tried that as a society, and it’s gotten us into an epidemic of mental health suffering. And medications don’t always help make us happier.

Happiness is about “knowing thyself”; it’s about developing a compassionate eye back at oneself, and learning to accept oneself as one is. It’s about ceasing to compare ourselves to others for a change, and even to stop comparing ourselves to ourselves. Compassion comes when the voice of comparison quiets down.

There are a lot of distractions to happiness, especially during the holiday season. We’ve seen where our surge to happiness has brought us: into the worst economic crisis in 70 years. We buy more, and crave more, and buy more, and never manage to fill ourselves up with more, now matter how big our appetite grows. We seek solace in self-help wisdom, and cultural gurus, yet things don’t always seem to get better.

Happiness is being away of our mortality, yet not succumbing to the fear of it. It’s being aware that our days are numbered, which encourages us to enjoy our relationships, be mindful and enjoy the fleeting nature of things: good music, colors, delicious food and the mystery of nature.

Happiness is there for the taking. It’s those self-imposed obstructions that, with presence and awareness, can free us from the suffering and neurosis that keeps us stuck.

(Press Release)

13 DAYS OF A MERRY CHRISTMAS…RELATIONSHIP!

Men’s Counselor Jason Fierstein Gives 13 Tips to Help Relationships Survive the Holidays

November 30, 2009- Phoenix, AZ – With the holiday season in full swing, emotions, tempers and tantrums can flare. Jason Fierstein, owner and founder of Phoenix Men’s Counseling, has created 13 humorous but practical tips to help all relationships survive this sometimes tumultuous season.

Tip #1 – Avoid Heat Seeking Land Mines! - Every couple should have a strategy between each other on how to troubleshoot potential road hazards; the father that always criticizes, the perfectionist mother-in-law . Anticipate behavior so you and partner know not be REACTIVE. Remember, alcohol and sugar combined can help set off those land mines.

Tip #2 – Pigskin Planning – Communicate with your partner ahead of time how each social scenario is going to play out. For example, first there will be dinner, then everyone gets up from the table and watches football, then there is an intense discussion of what movie to go see…etc. Let your partner know what to expect so that he/she can anticipate what is going to happen.

Tip #3 – Be A Yes Man – Be a “Yes” man especially if you and your partner are hosting festivities in your home. Be aware that this will be a stressful time for your spouse, girlfriend or partner. Get into customer service mode… you can’t lose with “how can I be of help.”

Tip #4 – Don’t Let Credit Cards Pull Your Sleigh – Have the holiday budget talk with your partner. Sit down and come up with a gift giving strategy. Figure out how much you are going to spend per each person and discuss and agree on the budget before shopping.

Tip #5 – The Holidays Can Gobble You Up – there are so many ways that they holidays can erode good will, just trying to find a parking space in a busy mall, can raise ire and frustration. Allow yourself plenty of time to accomplish the tasks at hand and be mindful of keeping realistic expectations.

Tip #6 – Prevent an FUI – Family Under the Influence – The word libation is a word close to liberation and verbal liberation can cause a lot of family strife. You may get yourself in a verbal situation that can become triggers for old family issues. Make a pact with yourself and your spouse or partner to an alcoholic drink maximum (before drinking begins) and vow to not let others who are drinking push your triggers.

Tip #7 – Does This Dress Make Me Look Fat? – Men need to be sensitive to the fact that a woman’s physical appearance and perceptions are highlighted during the holidays. Be complimentary and sincere…and don’t even think about mentioning any holiday weight gain!

Tip #8 – In Case of An Emergency Break the Glass – have an exit strategy with your partner. A key word, phrase or tug of an ear to let the other know that you are at your family, office or holiday party limit and it is time to go.

Tip #9 – Stay in DMZ (the Demilitarized Zone) – Agree to stay on neutral ground whether with family or co-workers. Don’t ask questions or bring up topics that are going to invite pain or conflict. Remember alcohol exacerbates every situation and often not in a good way.

Tip #10 – Call A Delay of Game – If conflict begins, give yourself five minutes to re-center. Don’t buy into the conflict.

Tip #11 – Saddle Up Your Parenting – if you have children don’t let the kids manipulate you or your spouse or partner.

Tip #12 – Check the Pressure Cooker – check-in with your spouse or partner to make sure the pressure of the holidays isn’t negatively affecting them. Do a status check for depression, loneliness, or despair. Offer help, love and support to offset these attributes.

Tip #13 – Embody Your Inner Jimmy Stewart – “It’s A Wonderful Life” – have an attitude of gratitude, ENJOY family and friends, practice random acts of kindness and remember to CELEBRATE the holiday season.

Jason Fierstein is owner and founder of Phoenix Men’s Counseling which focuses on men’s mental health and relationship and marriage issues. Phoenix Men’s Counseling is located at 668 N. 44^th Street, Suite 300 in Phoenix. For more information, visit www.phoenixmenscounseling.com or call 602-309-0568.

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Alcohol has a particularly important presence in our modern American culture. We use it to entertain, connect with others, make family gatherings lighter, engage in business with it and rally around our favorite sports teams while drinking it. Multi-billion-dollar industries have been created around beer, wine and spirits, and popular culture has produced a number of timeless celebrity icons who indulge in: Hemingway, the Rat Pack, Keith Richards, Hank Williams…hell, even Ulysses S. Grant.

Our culture is totally schizophrenic around alcohol: it promotes it to no end, and yet ignores the repercussions of consuming it. Domestic violence, broken marriages, infidelity, depression, and divorce, among other things, result in the overindulgence of booze. Socially, it’s really hard to break away from the attractiveness to it. The parties we go to, the people we hang out with and the advertisements we encounter all promote it, and yet it still continues to get us into trouble.

Men tend to avoid their feelings, and therefore, the problems that those hidden feelings create. Alcohol has always been the socially acceptable avoidance strategy for many men. To find and connect together, alcohol as a social lubricant that allows men to do what comes more naturally to women: seek social support. Women have known this, but to prevent isolation and loneliness, men usually only rally around each other when it involves sports or some like-minded activity. Feelings are rarely discussed, but alcohol allows for “loose lips” contact. Men are much more free and open while drinking to connect to other men emotionally, because it’s not something that men do while sober. Culture doesn’t allow for it, so most men don’t do it. Alcohol provides the social bonding outlet, as well as an opportunity to “speak one’s mind”.

Things to think about:

• Do you find your self drinking alcohol to avoid people, situations, or feelings?
• Have you fought with your wife or girlfriend around alcohol? Do you fight more with her when you both been drinking? Is your relationship taking a hit because of your drinking?
• Are there competing voices in your head, one of which says to slow down or quit drinking?
• Have you experienced the blues, feel down, isolated and alone?
• Do you have a family history of alcohol abuse or dependence? Did you have a mother or father that drank heavily?
• Are you lying to cover up your drinking, or minimizing the number of drinks that you consume?

A friend asked me this really great question: “What are the specific challenges that men face in relationships at during each decade?” The question naturally led me to want to blog about it, and share it with you all. I accounted for three periods: 20’s, 30’s and 40’s, as these are generally the periods of life I work with, but feel free to add your own experiences/other decade challenges.

20-30’s: Still settling down, and finding themselves. Work and jobs are sporadic, so lots of long-distance relationships and conflict as a result. Guys in their 20’s are still into hooking up and partying, so they’re looking more for women who fit this bill (generally). Some get married, but are unhappy because the marriage is too early, or it wasn’t right for them (maturity levels low).

30-40’s: Settling down, getting married and having children. Guys have to deal with their lost youth and death of the “wild horse” mentality. Some guys hold onto youthful entrapments, such as partying, alcohol, video games, etc., which creates relationship/marriage tension and fighting this way. This is where the communication problems and issues start to ferment, for problems later into the next stage. Not knowing how to deal with everything: being a new dad, added responsibilities with their work/careers, and juggling it all creates stress and relationship strain. A lot of guys tend to start having problems, because they didn’t learn how to take care of themselves earlier on, or didn’t really have a need to take care of anyone else (e.g. wife, kid) other than themselves.

40-50’s: Kids are growing, and problems have fermented another decade. Couple has drifted away from each other, and the problems that have arisen in the 10-15 years since marriage have been avoided, or not dealt with. Money, things, trips have all been used as “happiness surrogates,” and are employed to stave off dealing with the real problems of unhappiness, sexual problems, loss of love, etc. Some men start to have affairs (although earlier stages, too) or lose themselves in other diversions other than their marriage, because that’s what they know, and that’s what culture encourages (alcohol, sports, video games, porn, etc.). Couple needs to reinvent their marriage, and create a reason to be together, other than “for the kids”. Men will also lose themselves in work and career, which is a socially-sanctioned place to go, yet slowly erodes a relationship over time. A lot of men who over-identify themselves with their work and careers unconsciously avoid their wives and their problems by dedicating themselves to their work. Phsycial problems can start to manifest as a function of problems not dealt with, with leads to depression, stress, pain, fatigue, etc. The body speaks, even when men are not.

Without a rudder, it becomes really difficult to steer our boat. We get tossed about on the seas, swing this way and that. The sense of direction is lost, and our journey is haphazard and without focus momentum.

Finding purpose — whether that be in our relationships, work, play or friendships — is outfitting your boat with a rudder. Actions and behaviors become intentional, and they become filled with a focused purpose. No longer are we just victims of circumstance or of our own lives.

Many people without that purpose, without that inner knowing, enter and exit situations within their lives in a very indiscriminate way. Without purpose, we are left to our impulsive mind to take over. And often times, that impulsive mind makes decisions for us that are not aligned with our deeper and truer purpose. We get into relationships that we look back on and think, “That was really not good for me in the long run.” we take jobs that we don’t really want to take, and spend money in places that we don’t really mean to.

Developing purpose is like bringing a high-powered laser into the equation. We have a very powerful tool in which to create a focus and energy to direct towards those people, places, and experiences that will enhance our sense of purpose, and fulfill those ideas about how our lives should be led, which makes us happier.

Connecting to that purpose — not just identifying it — is just as important. Learning how to connect regularly to that which brings us purpose is critical to our success and our happiness. Creating a regular relationship with those things that bring us purpose reinforces our sense of purpose and continually teaches us how to spend our precious time, energy and resources. What’s just as important is to identify those roadblocks and barriers to finding our purpose, which in some cases, can be just as much of a pursuit as going directly after our purpose.

A lot of counseling clients that I talk with have difficulties knowing how to take care of themselves. They are so busy taking care of work, family, money and other life stressors that they don’t have the time or the know-how to develop and practice good self-care techniques.

One of the most important ideas to understand is your personal threshold point. At what point do you start to show wear and cracks? Can you recognize when you get to that point? More importantly, how can you remedy those issues before they really start to affect your mind and body wellness?

That personal threshold point is different for every person. Developing an understanding and clear self-awareness about when that point arises is the first step in practicing self-care. Some people have a very high threshold for stress; others start to show wear earlier.

For men and women alike, the concept of saying “no” is one contributing factor to practicing better self-care. We live in a very demanding culture — one that expects constant multitasking and perfectionism. Being able to say “no”– even when our environment beckons that we say “yes” - is a practice in honoring and respecting yourself. It’s knowing your limits, and it’s not giving out more than you can give, which erodes one’s ability to give anything at all.

Another way to understand self-care is to know what blocks or barriers come between you and the healthy image of you in your mind. We can all agree that eating well, exercising, practicing spirituality or contemplation, and the like, are all positive pursuits on the road to self-care. But, what’s more interesting is how we limit ourselves from the inside with negative self-talk.

What negative messages or beliefs keep you in a state of procrastination or lack of motivation? How do you undermine your own efforts, and keep yourself from the ideal healthy you in your mind? I think those questions are much more relevant, because we need only to listen to our culture which tells us to eat better, exercise daily, be happy… we know all this, and yet sometimes we don’t always do what we know is best for us in the long run.

Practicing good self-care is very important, but understanding our motivations and intentions, as well as the roadblocks and barriers to our own success, is even more important. If we create the right motivations and intentions, we are laying a solid foundation for the continued practice of good self-care over the course of a lifetime.