It’s hard to build a future when your entire life is paused. For those trapped in visa backlogs and endless immigration processing delays, daily existence often feels like waiting for permission to start living. You may be trying to advance your career, support your loved ones, or simply plan your next year—but instead, you’re held in limbo by a system that offers no timeline, no clarity, and no control.

From a mental health perspective, this kind of uncertainty is profoundly destabilizing. When the mind can’t predict what’s next, it tends to over-anticipate every possible scenario, triggering hypervigilance, hopelessness, and intrusive anxiety. This phenomenon is what we call visa-freeze anxiety—a form of chronic emotional stress experienced by people stuck in prolonged immigration queues.

This article explores how visa delays impact mental health and offers concrete, research-based grounding tools to support emotional regulation and agency.

The Psychological Toll of Living in Limbo

Immigration-related uncertainty is a known psychological stressor. Studies show that prolonged delays in legal status processing are associated with increased symptoms of anxiety, depression, insomnia, and trauma-related stress, particularly in individuals who feel trapped between worlds or unable to plan for the future (Li et al., 2020; Bhugra, 2005).

These long-term delays can chip away at your ability to stay grounded in your identity, your goals, or your relationships. There may be shame in not having “answers,” fear of losing hard-earned opportunities, or exhaustion from constantly checking for updates that never come.

Common mental health symptoms of visa-freeze anxiety include:

• Racing thoughts about “what if” outcomes
• Difficulty sleeping due to uncertainty and hyperarousal
• Social withdrawal from feelings of shame or isolation
• Impaired focus or motivation at work or in relationships
• A sense of identity erosion from being unable to make progress
  

This is not a lack of resilience—it’s a natural psychological response to prolonged, high-stakes uncertainty with no clear resolution.

Why Grounding Tools Matter

When you’re caught in chronic uncertainty, the brain’s threat system is constantly activated. Grounding techniques help regulate this physiological stress response by bringing your attention out of the future—and back into the here and now.

Grounding doesn’t mean pretending the situation isn’t hard. It means offering your nervous system relief from relentless anticipation. The goal is not to “fix” the problem but to reclaim pockets of control that help you live with more peace and agency while the system takes its course.

Evidence-Based Grounding Tools for Visa-Freeze Anxiety

1. Time-Limiting Your Worry Window
   Research shows that scheduled worry periods can reduce generalized anxiety (Borkovec et al., 1993). Set a timer and allow yourself 15 minutes a day to think about your visa case—journal, research, or vent during this time. Outside of that window, gently redirect your focus.
   
   
2. Daily Somatic Anchors
   When anxiety is future-focused, somatic anchors pull you back into the body. Try placing a hand on your chest and one on your stomach while practicing slow breathing (inhale 4 counts, exhale 6 counts) for five minutes. This calms the vagus nerve and activates the parasympathetic system (Porges, 2011).
   
   
3. Naming What’s Out of Your Control—Then What Isn’t
   Using a method from Acceptance and Commitment Therapy (ACT), try writing down two columns: one labeled “Out of My Control,” the other “Within My Control.” Visa processing is out. But your daily routines, boundaries, relationships, and self-care are within. This helps shift your energy toward action.
   
   
4. Micro-Routines for Structure
   When life feels suspended, even small routines—morning stretches, daily walks, or a weekly check-in call—can restore a sense of movement and agency. Research suggests that predictable routines buffer against anxiety and depression during periods of uncertainty (Hobfoll, 2001).
   
   
5. Connection with People Who Get It
   Visa-freeze anxiety often feels invisible to others. Joining online forums or support groups with people in similar situations provides emotional validation. Connection is a protective factor, especially when isolation or shame creep in.
   
   
6. Therapy That Validates Limbo
   Therapists familiar with immigration stress and identity issues can help process the grief and helplessness that arise from extended limbo. Therapy can also support the rebuilding of meaning, confidence, and self-worth during a time when external progress feels impossible.
   

What You’re Experiencing Is Real

Living in legal limbo can undermine your sense of identity, autonomy, and control. People experiencing visa delays often report a sense of “disappearing”—not being seen by the systems around them and not being able to fully show up in their own lives. This invisible struggle can make even basic tasks feel burdensome.

It’s important to know: this experience is real. And you’re not overreacting. A nervous system stuck in a prolonged fight-or-flight state is working overtime, which explains the fatigue, the fog, and the frustration.

Recognizing that your worth is not contingent on progress or productivity is a major emotional shift. You are still worthy, even when your life is paused. You are still you, even if the system hasn’t moved.

You Don’t Need to Wait to Take Care of Your Mind

You may not be able to move forward in the ways you hoped. But you can still reclaim your mental space. You can still build emotional capacity. You can still show up for your relationships, your values, and your well-being.

Visa-freeze anxiety is real. But so is your resilience. Not in the sense of muscling through—but in the quiet strength of grounding, naming your needs, and refusing to disappear while you wait.

You don’t have to put your life on hold to protect your mental health.

Book your appointment today.

Works Cited
Bhugra, D. (2005). Migration and mental health. Acta Psychiatrica Scandinavica, 109(4), 243–258.

Borkovec, T. D., Wilkinson, L., Folensbee, R., & Lerman, C. (1993). Stimulus control applications to the treatment of worry. Behavior Research and Therapy, 31(3), 263–267.

Hobfoll, S. E. (2001). The influence of culture, community, and the nested-self in the stress process: Advancing conservation of resources theory. Applied Psychology, 50(3), 337–421.

Li, S. S. Y., Liddell, B. J., & Nickerson, A. (2020). The relationship between post-migration stress and psychological disorders in refugees and asylum seekers. Transcultural Psychiatry, 53(5), 524–545.

Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. W. W. Norton.

If you’ve ever found yourself overwhelmed by worry or stuck in anxious thoughts, you might have wondered whether you’re dealing with Generalized Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), or something else entirely. Both GAD and OCD involve anxiety, intrusive thinking, and emotional distress. On the surface, they can look alike. But they’re not the same—and understanding the difference is essential for finding the right path to treatment.

GAD often looks like excessive worry about everyday life. OCD, on the other hand, involves distressing, irrational thoughts that often lead to compulsions—mental or behavioral acts performed to relieve the anxiety. Both conditions are treatable, but the tools that work for one don’t always work for the other. This article breaks down the core differences between OCD and GAD so you can better understand your experience or support someone else in theirs.

What Is GAD? What Is OCD?

Generalized Anxiety Disorder is characterized by persistent and excessive worry across many areas of life—finances, health, relationships, work, safety, and more. These worries are difficult to control and are often accompanied by physical symptoms such as fatigue, muscle tension, and trouble sleeping (American Psychiatric Association, 2013). People with GAD often describe a sense that their brain won’t “turn off,” and they may feel that worry is a part of who they are.

Obsessive-Compulsive Disorder involves two main parts: obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images, or urges that cause anxiety. Compulsions are behaviors or mental rituals done to try to make the anxiety go away or prevent something bad from happening. These can include checking, counting, avoiding, confessing, or repeating thoughts silently. The thoughts in OCD are usually irrational or upsetting and may have nothing to do with real-life problems (Abramowitz & Jacoby, 2015).

The Nature of Thoughts: Worry vs. Obsession

One key difference between GAD and OCD is the kind of thoughts that show up. In GAD, people tend to worry about real-life problems. The worries may be excessive or hard to control, but they usually relate to things that could actually happen, like losing a job or getting sick (Dugas et al., 1998).

In OCD, the thoughts often don’t make sense, feel disturbing, or seem completely out of character. For example, someone might have a thought like “What if I hit someone with my car and didn’t notice?” or “What if I accidentally poisoned my partner’s food?” These are not typical worries—they are intrusive thoughts that feel stuck in the brain and cause distress, even though the person doesn’t believe them or want them (Clark, 2004).

The Role of Compulsions

Another major difference is how people respond to their anxiety. In OCD, people often develop specific rituals or behaviors—called compulsions—to deal with the distress caused by their thoughts. These compulsions can be visible (like handwashing or checking the stove) or invisible (like repeating phrases in their head or mentally reviewing past events). The compulsions may temporarily reduce anxiety, but they actually reinforce the obsessive thought and make the cycle worse over time (Rachman, 2002).

In GAD, there are no true compulsions. People may try to feel better by over-preparing, avoiding triggers, or asking for reassurance, but these behaviors are more general and don’t follow a rigid pattern. GAD tends to involve a constant, low-grade sense of worry, not a repetitive cycle of intrusive thoughts followed by rituals.

Emotional Tone and Insight

In GAD, people often feel like their worries are reasonable, even if they recognize that the level of worry is excessive. The thoughts may feel helpful, familiar, or necessary. Someone might say, “I worry because I care,” or “If I didn’t worry, I’d miss something important.”

In OCD, the thoughts often feel foreign and deeply upsetting. People may think, “Why would I have a thought like this? What’s wrong with me?” These thoughts are usually unwanted and don’t match how the person sees themselves. That’s why OCD often leads to shame, guilt, or fear about what the thoughts mean. Even though people with OCD usually know their thoughts aren’t true, the fear that they might be creates intense anxiety (Abramowitz & Jacoby, 2015).

Overlap and Misdiagnosis

Because both conditions involve anxiety, they are sometimes confused—even by clinicians. Someone with OCD may be misdiagnosed with GAD if they don’t mention their compulsions or are too ashamed to describe their intrusive thoughts. This is especially common when the thoughts involve taboo subjects like sex, violence, or religion (Storch et al., 2008).

On the other hand, someone with GAD might be assumed to have OCD if their worry is intense or very repetitive, even though they don’t have true obsessions or compulsions. The result is that people may receive the wrong kind of therapy, which can delay progress or make symptoms worse.

Treatment Considerations

The treatment for GAD and OCD overlaps in some areas, but key differences matter. GAD often responds well to general Cognitive Behavioral Therapy (CBT), which helps people identify and challenge distorted thinking, along with relaxation techniques, mindfulness, and sometimes medication like SSRIs (Stein & Sareen, 2015).

OCD, however, requires a more specialized approach. The most effective treatment is Exposure and Response Prevention (ERP), a specific form of CBT that helps people face their fears without doing compulsions. ERP works by teaching the brain that the feared outcome won’t happen—or doesn’t need to be prevented. General talk therapy, reassurance, or relaxation exercises may actually worsen OCD if they reinforce avoidance or compulsive behavior (Foa et al., 2005).

If you’ve been struggling with anxiety, unwanted thoughts, or repetitive behaviors, it’s important to get clear on what kind of anxiety you’re experiencing. OCD and GAD are both treatable—but they need different tools. An accurate diagnosis can make all the difference in choosing the right path forward.

You’re not overreacting, broken, or weak. These are real conditions with real solutions. If something about your anxiety doesn’t quite fit the label you were given, you’re not alone—and it’s worth asking deeper questions.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Abramowitz, J. S., & Jacoby, R. J. (2015). Obsessive-compulsive disorder in adults. In R. L. Leahy, S. L. Holland, & L. McGinn (Eds.), Treatment plans and interventions for depression and anxiety disorders (2nd ed., pp. 269–321). Guilford Press.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Clark, D. A. (2004). Cognitive-behavioral therapy for OCD. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 147–172). Guilford Press.

Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: A preliminary test of a conceptual model. Behaviour Research and Therapy, 36(2), 215–226.Foa, E. B., Yadin, E., & Lichner, T. K. (2005). Exposure and response prevention for obsessive-compulsive disorder: Therapist guide. Oxford University Press.

Rachman, S. (2002). A cognitive theory of compulsive checking. Behaviour Research and Therapy, 40(6), 625–639.

Stein, M. B., & Sareen, J. (2015). Generalized anxiety disorder. New England Journal of Medicine, 373(21), 2059–2068.

Storch, E. A., Abramowitz, J. S., & Keeley, M. (2008). The effect of co-occurring anxiety disorders on treatment response in pediatric obsessive-compulsive disorder. Depression and Anxiety, 25(6), 547–553.

Dating apps promise connection at your fingertips, but for many users, the experience delivers something very different: disappointment, burnout, and a quiet erosion of hope. It’s not that dating apps don’t “work”—they do for some—but they were not built to prioritize emotional compatibility, self-worth, or long-term wellbeing.

To use dating apps without losing yourself, you need more than a profile and a few good photos. You need a strategy that centers your mental health, boundaries, and emotional energy. This article outlines how to approach dating apps with realistic, sustainable expectations—so you can date without spiraling, compare without collapsing, and swipe without self-loathing.

The Illusion of Limitless Options
Dating apps are designed to simulate abundance—unlimited profiles, constant matches, and the illusion of endless romantic opportunity. But psychologically, this triggers a phenomenon known as the “paradox of choice,” in which having too many options leads to more dissatisfaction and less follow-through (Iyengar & Lepper, 2000).

In reality, most users only engage with a small percentage of matches. The rest become background noise, fostering comparison fatigue and emotional disconnection.

People also tend to forget that swiping is not dating. It’s browsing. And browsing doesn’t always lead to intimacy. Without grounded expectations, many users mistake attention for connection—and then feel confused when conversations fizzle or never move offline.

Rejection on Repeat: The Emotional Cost of Swiping
Dating apps increase exposure to rejection, often in rapid succession. You may never know why someone unmatched or ignored you. Over time, this creates a low-level but persistent sense of being unwanted, even if you’re matching regularly.

Studies have shown that frequent dating app use is associated with lower self-esteem, increased anxiety, and higher levels of body image dissatisfaction, particularly when users tie their sense of worth to responses received through the app (Strubel & Petrie, 2017).

To protect your emotional energy, treat dating apps as a tool, not a mirror. They are not designed to reflect your value or readiness for love. They’re algorithms—not oracles.

Swipe Fatigue and Burnout
Dating app fatigue is real. Many users report feeling emotionally depleted, cynical, or numb after weeks or months of swiping. This is particularly true for those looking for long-term relationships, who may feel they’re engaging in endless small talk with no payoff.

App-based dating can also trigger performance anxiety, especially when users feel pressure to “sell themselves” in a way that’s clever, attractive, or nonchalant—all at once.

Without clear internal boundaries, dating apps can shift from exciting to exhausting. You begin to log in out of boredom, loneliness, or self-doubt, not with genuine relational intent. And that’s when burnout sets in.

Setting Emotionally Sustainable Expectations
Approaching dating apps sustainably requires a shift in mindset. You are not auditioning for approval. You are screening for compatibility.
To keep your experience emotionally grounded:

• Limit time spent swiping. Try 10–15 minutes a day, not hours.
• Don’t expect chemistry from text. Text-based banter rarely predicts real-life connection.
• Set a timeline. If chatting doesn’t lead to a date within 7–10 days, it’s okay to move on.
• Let go of “the one.” Focus on finding someone curious, respectful, and interested in knowing the real you—not just a fantasy match.

Boundaries Are Not Optional
The fastest way to lose yourself in dating apps is to forget your own boundaries. Whether you’re dating casually or seeking a relationship, you need guardrails that protect your time, energy, and sense of self.

Ask yourself:

• What am I available for emotionally and practically?
• How many conversations can I manage at once without feeling overwhelmed?
• What is my plan if I start to feel depleted or discouraged?

Establishing exit strategies (e.g., breaks from the app, accountability check-ins with friends, or journaling your experiences) can help you stay attuned to your own needs.

What Success Actually Looks Like
Success on a dating app doesn’t always mean finding a partner. It can also mean:

• Gaining insight into your preferences and values
• Practicing communication and boundary-setting
• Learning to tolerate rejection without collapsing
• Reaffirming your worth, even when someone else doesn’t see it

By broadening your definition of success, you reduce the pressure to “win” and increase your capacity to show up as yourself—without the emotional whiplash of constant judgment.

Offline Integration: Where Real Connection Lives
It’s important to remember that the app is not the relationship. Sustainable dating means transitioning off the app and into real-world interactions.

Don’t linger in endless texting. Initiate or suggest a phone call. Make low-pressure plans. Pay attention to how you feel before, during, and after—not just whether the date “went well.”

And most importantly, don’t treat matches like scarce resources. If it’s not a fit, trust your gut and move on. Dating is about discernment, not perfection.

Conclusion: Swiping With Sanity
Dating apps are not inherently bad. But they are emotionally loaded, algorithm-driven environments that reward superficiality and fuel insecurity if you’re not careful.

You can use them—but don’t let them use you. Stay grounded in your values. Date with boundaries. Take breaks when needed.

Real connection doesn’t require perfect banter or a polished profile. It requires presence, patience, and the emotional endurance to stay soft—even when the apps make you want to shut down.

Swipe thoughtfully. Love is still possible. But your well-being comes first.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Iyengar, S. S., & Lepper, M. R. (2000). When choice is demotivating: Can one desire too much of a good thing? Journal of Personality and Social Psychology, 79(6), 995–1006.

Strubel, J., & Petrie, T. A. (2017). Love me Tinder: Body image and psychosocial functioning among men and women. Body Image, 21, 34–38.

Modern dating is supposed to make connection easier. But for many men, the current dating landscape—dominated by apps, inconsistent communication, and shifting social norms—is a minefield of anxiety, confusion, and rejection.

What was once a series of face-to-face interactions is now a gamified, algorithm-driven process that can leave men feeling more disposable than desired. Add in changing expectations around gender roles, consent, emotional literacy, and vulnerability, and many men find themselves navigating terrain for which they were never emotionally prepared.

While conversations about dating stress often center women’s safety and emotional labor—important issues in their own right—there’s another side of the story that gets little attention: how dating in the modern era affects men’s mental health. From rising loneliness to identity confusion, the effects are real, and they’re growing.

Dating Apps and the Illusion of Infinite Options
Dating apps have become the default platform for romantic connection. While they offer convenience, they also promote comparison, superficiality, and performance-based self-worth. Research shows that men receive fewer matches and responses on dating apps compared to women, contributing to feelings of inadequacy and low self-esteem (Timmermans & De Caluwé, 2017).

For men, especially those who are neurodivergent, socially anxious, or introverted, apps can create a sense of constant evaluation and rejection. You are swiped left on—not for your values or integrity—but often for arbitrary reasons like height, photos, or word choice.

This repeated micro-rejection can lead to what psychologists call “rejection sensitivity,” a heightened emotional reactivity to perceived rejection that has been linked to depression and social withdrawal (London et al., 2007).

The Pressure to Perform Masculinity
Despite progress in gender equality, many men still feel an unspoken expectation to initiate, lead, and perform confidence in dating—regardless of their actual emotional state. This performance of masculinity can create a significant gap between how men feel internally and how they are supposed to behave externally.

In fact, studies show that men who endorse traditional masculine norms (e.g., emotional control, dominance, risk-taking) report higher rates of psychological distress in romantic relationships (Wong et al., 2017). They’re also less likely to seek help, communicate vulnerability, or admit to confusion or fear in dating.

The result? A paradox in which men are expected to be emotionally intelligent and respectful partners, but still punished—by peers or themselves—for showing emotional need or softness.

Ghosting, Breadcrumbing, and Emotional Burnout
One of the most mentally destabilizing aspects of modern dating is ambiguity. Where relationships once followed a relatively clear set of steps, today’s dating scene is marked by blurred boundaries and inconsistent commitment.

Ghosting—cutting off all contact with no explanation—is now a common experience. So is breadcrumbing (sending intermittent flirty messages with no intent to follow through) and “situationships” (non-committal, undefined connections).

For men seeking meaningful connection, this can lead to emotional burnout. One study found that people who are ghosted experience feelings of worthlessness, confusion, and intrusive thoughts, all of which can worsen anxiety and self-doubt (LeFebvre et al., 2019).

In a context where everyone is supposed to be cool, casual, and unbothered, there’s little room for authentic expression of emotional pain.

Loneliness, Disconnection, and Erosion of Self-Worth
Men are already experiencing a loneliness epidemic. A 2021 report from the Survey Center on American Life found that the percentage of men with no close friends has increased fivefold since 1990 (Cox et al., 2021). When dating becomes another arena of rejection and disconnection, it deepens this emotional void.

For some men, repeated dating failures can trigger a collapse in self-worth, leading to withdrawal from relationships altogether. Others may internalize blame, believing they are “not enough” or unlovable. This cycle of effort → rejection → self-doubt → retreat is especially common in men with a history of social trauma or attachment insecurity.

The Rise of Dating-Related Depression and Anger
While some men respond to dating fatigue with withdrawal, others cope through anger or entitlement, particularly if they’ve been influenced by toxic online spaces like the “manosphere” or incel forums.

These subcultures weaponize dating disappointment into misogyny—but underneath that is often unacknowledged pain, shame, and emotional neglect. The danger is that without constructive spaces to process dating-related grief, many men turn inward (depression) or outward (hostility).

Clinical psychologists are seeing more men report dating-related depression, marked by hopelessness, rumination, low motivation, and social anxiety. In therapy, these men often express confusion: “I’m doing everything right—why am I still alone?”

What Actually Helps: Building Emotional Skills for a Modern Landscape
The mental health toll of dating isn’t solved by quitting apps or memorizing better pickup lines. What’s needed is a deeper internal shift:

• Recognizing that rejection doesn’t reflect worth
• Building emotional resilience and boundaries
• Expanding emotional vocabulary and relational skills
• Learning to tolerate ambiguity without abandoning self-respect 

Men who engage in therapy—particularly emotionally focused or relational therapy—learn how to regulate feelings of rejection, express vulnerability in safe ways, and create more meaningful, values-aligned dating experiences.

It’s also essential to redefine success in dating. Instead of fixating on romantic “wins,” men benefit from evaluating how aligned their behavior is with their values, how much agency they’re exercising, and how authentically they are showing up.

Connection Without Collapse
Dating in the modern era is psychologically demanding—for everyone. But for men raised with rigid emotional norms and social conditioning around performance, the emotional cost can be particularly high.

The solution is not to opt out of dating, but to opt into self-awareness. Men deserve support in navigating emotional pain, romantic uncertainty, and rejection—not shame for struggling.

When men have the space to explore their internal world, they show up in dating—not as performers—but as people. And that’s where true connection begins.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Cox, D., Orrell, B., & Suls, R. (2021). The state of American friendship: Change, challenges, and loss. Survey Center on American Life.

LeFebvre, L. E., Allen, M., Rasner, R. D., Garstad, S., Wilms, A., & Parrish, C. (2019). Ghosting in emerging adults’ romantic relationships: The digital dissolution disappearance strategy. Imagination, Cognition and Personality, 39(2), 125–150.

London, B., Downey, G., Bonica, C., & Paltin, I. (2007). Social causes and consequences of rejection sensitivity. Journal of Research on Adolescence, 17(3), 481–506.

Timmermans, E., & De Caluwé, E. (2017). To Tinder or not to Tinder, that’s the question: An individual differences perspective to Tinder use and motives. Personality and Individual Differences, 110, 74–79.

Wong, Y. J., Ho, M. R., Wang, S. Y., & Miller, I. S. (2017). Meta-analyses of the relationship between conformity to masculine norms and mental health-related outcomes. Journal of Counseling Psychology, 64(1), 80–93.

Mental health treatment has historically pathologized neurodivergence—treating autism, ADHD, and other cognitive differences as deficits to be corrected. Neurodivergent-affirming care takes a radically different approach. Instead of trying to make someone appear or behave neurotypical, this model recognizes neurological differences as valid, meaningful variations in the human brain. In short: neurodivergent-affirming care rejects the idea that being different is being disordered.

At its core, neurodivergent-affirming care is grounded in the principles of the neurodiversity movement (Singer, 1999; Kapp, 2020). It emphasizes acceptance, autonomy, and authenticity over compliance, masking, or assimilation. Clinicians practicing affirming care aim to support the individual’s well-being—not just their functionality in neurotypical systems. For example, instead of teaching an autistic person to make eye contact because it’s socially expected, a neurodivergent-affirming provider would explore whether eye contact causes distress and whether it’s actually necessary for meaningful connection.

This approach matters because traditional interventions, particularly those rooted in behaviorism, have often been harmful to neurodivergent individuals. Research has shown that masking—suppressing natural behaviors to appear neurotypical—is linked to increased anxiety, depression, and suicidality in autistic adults (Cage et al., 2018; Cassidy et al., 2018). Neurodivergent-affirming care provides space to unlearn masking and begin exploring what it means to be one’s true self.

Affirming care also recognizes that many mental health challenges in neurodivergent people are not intrinsic to their neurotype, but rather the result of chronic invalidation, trauma, sensory overwhelm, and inaccessible environments (Botha et al., 2022). Instead of diagnosing these responses as standalone disorders, affirming clinicians take context into account and work collaboratively to build sustainable coping strategies that align with the individual’s needs—not societal expectations.

In practice, neurodivergent-affirming care might look like:

• Supporting stimming as a form of self-regulation rather than discouraging it.
  
• Recognizing that burnout in autistic individuals is real and distinct from depression (Raymaker et al., 2020).
  
• Questioning assumptions around “independence” and instead focusing on interdependence and sustainable living.
  
• Using identity-first language if the client prefers it, based on the growing consensus among autistic adults (Kenny et al., 2016).
  

Neurodivergent-affirming care also invites mental health professionals to challenge their own training and biases. Most clinical models were built without neurodivergent input—and certainly without their leadership. To provide affirming care, therapists must be willing to step outside traditional frameworks and make space for different ways of thinking, feeling, and communicating.

Ultimately, affirming care is not a trend—it’s an ethical imperative. As more adults seek support after a late diagnosis or self-identification, they need care that validates their identity, understands their lived experience, and promotes true well-being—not just superficial functioning.

Call to Action (CTA):
At Refresh Therapy NYC, we offer virtual therapy for adults who are looking for affirming, intelligent, and actionable support. Whether you are newly diagnosed or have known you were different your whole life, we understand the unique challenges of being neurodivergent in a neurotypical world.

Book your appointment today.

Written by: Refresh Interns

Single fatherhood comes with an image: resilient, self-sacrificing, holding the world up for your kids with quiet strength. But behind that image, many single dads are quietly drowning in anxiety. Not the momentary kind that passes after a deadline or a tough day—but a persistent, all-consuming worry that runs beneath the surface of everyday life.

It’s the anxiety of being the only one. The only one to sign the papers. The only one who shows up to parent-teacher conferences. The only one to worry, day after day, if you’re enough. While single motherhood is often publicly acknowledged and socially supported, single fathers are expected to carry the same load—silently. And that silence is costing them their health, their confidence, and in some cases, their sense of self.

Why Anxiety in Single Fathers Is So Common—And So Invisible
Anxiety in single fathers often flies under the radar because it doesn’t look like the media version of panic attacks or emotional breakdowns. Instead, it looks like overworking, chronic irritability, perfectionism, emotional shutdown, or obsessive planning.

Men are socialized to suppress emotion, solve problems alone, and measure success by productivity. Single fathers, already navigating an emotionally demanding situation, may feel they have no space to acknowledge their internal distress. But the numbers tell a different story.

According to a large-scale study, single fathers report higher levels of psychological distress and sleep disturbances than both partnered fathers and single mothers, even when controlling for income and employment status (Weitoft et al., 2003). And yet, they are significantly less likely to seek help.

In part, this is because support systems are rarely built with fathers in mind. Parenting groups, pediatrician visits, and school communications often default to addressing mothers. The absence of space creates a false narrative: that fathers don’t need support, or worse—that asking for it signals failure.

Living With the Pressure to Perform—and Never Break
Single dads are often caught in an impossible contradiction: they’re expected to do it all, but never need help. Many carry the full weight of parenting, finances, emotional labor, and logistics, with no backup and no break.

This level of chronic pressure activates the body’s stress response system—raising cortisol levels, reducing immune function, impairing memory, and increasing vulnerability to anxiety and depression (McEwen, 2000). You might feel “on edge” all the time, unable to relax even when things are going okay.

Some fathers report a specific anxiety around being perceived as an unfit parent. You might feel like every mistake is being watched more closely, every emotional lapse scrutinized. This hypervigilance can lead to self-doubt, obsessive self-monitoring, and isolation.

How Anxiety Shapes Your Relationship With Your Child
Even when you don’t express your anxiety outwardly, your child feels it. Children are incredibly attuned to the emotional states of their caregivers. When a father is stressed, tense, or emotionally withdrawn, kids can become more anxious themselves—mirroring the emotional tone of the home.

A 2016 study found that paternal anxiety and depressive symptoms significantly predict emotional and behavioral problems in children, especially when emotional attunement is low (Gustafsson et al., 2016).

That doesn’t mean your anxiety is harming your child—but it does mean that how you relate to your anxiety matters. When children see their parent acknowledge stress and still show up with care, they learn emotional resilience. When they see their parent deny, suppress, or snap under pressure, they may internalize those same coping patterns.

The Guilt-Anxiety Spiral
One of the most corrosive patterns single fathers fall into is the guilt-anxiety spiral. You feel guilty for not being “enough”—so you try harder, stretch thinner, do more. But that overextension leads to burnout and anxiety, which then triggers more guilt.

This cycle is especially common in fathers who experienced emotionally absent or critical parenting themselves. You may feel driven to give your child a radically different experience—but without adequate support, this goal can lead to perfectionism and emotional exhaustion.

You might believe you have to earn your child’s happiness, your right to rest, or even your legitimacy as a single parent. But guilt is not a good parent. It clouds judgment, narrows perspective, and leads to reactive decisions. What your child needs isn’t more guilt-driven effort—they need you, grounded and emotionally safe.

The Role of Financial and Legal Stress
For many single fathers, anxiety isn’t just emotional—it’s practical. Custody arrangements, child support, legal battles, and job insecurity add another layer of stress that can’t be resolved with mindfulness alone.

Financial pressure is a leading cause of anxiety in single-parent households, with fathers reporting high levels of distress related to housing stability, food security, and medical costs (Kendig & Bianchi, 2008).

You may find yourself constantly calculating, forecasting, and preparing for worst-case scenarios. This kind of anticipatory stress is a hallmark of generalized anxiety disorder and often goes undiagnosed in men who attribute their distress to “just being responsible.”

You’re not just carrying your own future—you’re carrying someone else’s. And that weight can become unbearable without emotional and logistical support.

Why Single Dads Don’t Seek Help—and Why That Has to Change
Despite their vulnerability, single fathers are among the least likely groups to seek mental health support. A 2020 analysis of service utilization found that only 16% of single fathers had accessed therapy in the past year, compared to 32% of single mothers (Langton et al., 2020).

Common barriers include:

• Fear of being judged as emotionally unstable or incapable
• Difficulty finding male-friendly or father-specific services
• Lack of time and financial access to therapy
• Internalized beliefs that “strong dads don’t need help”

But suppressing anxiety doesn’t eliminate it—it relocates it. It turns into irritability, insomnia, disconnection, or hopelessness. Seeking help isn’t just about you. It’s about showing your child that strength includes vulnerability, and that love includes self-respect.

Therapy Is Not Indulgent—It’s Survival
For many single dads, therapy is dismissed as something “extra.” But addressing anxiety is not optional—it’s essential. The cost of untreated anxiety includes cardiovascular strain, lowered immunity, relationship breakdowns, and poor parenting outcomes (Hofmann et al., 2012).

Therapy offers a space to:

• Disentangle thoughts from fear
• Process guilt without letting it define you
• Build strategies for sustainable parenting
• Learn how to soothe your nervous system—not just push through it
• You don’t need to be in crisis to deserve support. You need only be human, raising a child in an overwhelming world.

What Healing Can Look Like—Even If Your Circumstances Don’t Change
Your anxiety may not disappear overnight. Your custody situation may not change. Your financial strain may persist. But healing doesn’t require everything around you to shift. It requires you to shift how you respond to what’s around you.

You can:

• Breathe before reacting
• Name your feelings aloud, even if it’s just to yourself
• Make space each day for something nourishing, no matter how small
• Connect with one other adult who can hear the truth without fixing it
• Anxiety tells you the worst-case scenario is inevitable. Healing reminds you that even in uncertainty, you still have agency, dignity, and worth.

You’re Doing More Than Surviving
You are not just holding it together—you are parenting through pressure most people can’t see. You may feel exhausted, resentful, afraid, or numb. That doesn’t make you weak. It makes you real.

Single fatherhood is hard. Not because you’re doing it wrong, but because it asks everything of you. And while the world may not always recognize your effort, your nervous system does. Your child does. And somewhere inside, you do too.

You don’t have to carry all of this alone. You were never meant to.

Anxiety thrives in silence—but healing begins the moment you tell the truth about what this really feels like.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Cairney, J., Boyle, M., Offord, D. R., & Racine, Y. (2003). Stress, social support and depression in single and married mothers. Social Psychiatry and Psychiatric Epidemiology, 38(8), 442–449.

Coles, R. L. (2015). Single-father families: A review of the literature. Journal of Family Theory & Review, 7(2), 144–166.

Gustafsson, H. C., Sullivan, E. L., & Keenan, K. (2016). Paternal depression and child development: A review. Child Psychiatry & Human Development, 47(3), 397–408.

Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.

Kendig, S. M., & Bianchi, S. M. (2008). Single, cohabiting, and married mothers’ time with children. Journal of Marriage and Family, 70(5), 1228–1240.

Langton, C., Yoshioka-Maxwell, A., & Madkour, A. S. (2020). Mental health service use among U.S. single fathers. Journal of Men’s Health, 16(1), e12–e20.

McEwen, B. S. (2000). Allostasis and allostatic load: Implications for neuropsychopharmacology. Neuropsychopharmacology, 22(2), 108–124.

Weitoft, G. R., Hjern, A., Haglund, B., & Rosén, M. (2003). Mortality, severe morbidity, and injury in children living with single parents in Sweden: A population-based study. The Lancet, 361(9354), 289–295.

Not Just a Midlife Crisis: The Silent Mental Health Struggles of Aging Men
For many men, aging is not just a physical experience—it’s a psychological reckoning. In Western society, aging is often painted as a slow unraveling of relevance. Gray hair, softer bodies, and the creeping aches of time are not just reminders of mortality—they’re framed as signs of diminished masculinity. For men taught to associate their worth with virility, strength, and productivity, aging can feel like a profound identity crisis. But because male emotional pain is so often hidden beneath stoicism and performance, the psychological toll of aging goes largely unspoken—and unaddressed.

This silence is costing lives.

Suicide rates are highest among middle-aged and older men. Yet mental health conversations still tend to center youth or women, bypassing the distinct experiences of men as they age. As roles shift, bodies change, and careers slow down, men face a complex internal world with very few social scripts for navigating it.

This article explores how men’s mental health is shaped by aging—and how psychological tools, cultural shifts, and relational support can help rewrite the aging experience into something far more meaningful than decline.

Aging and the Collapse of Masculine Ideals
From early on, boys receive a clear—if unspoken—message: strength is value, emotion is weakness, and independence is virtue. As long as a man remains physically capable, sexually active, and economically productive, he stays within the safe bounds of culturally sanctioned masculinity.
But what happens when aging disrupts those domains?

Testosterone levels decline gradually starting in a man’s 30s, often accelerating after age 50. This can result in fatigue, irritability, sleep disruption, loss of muscle mass, and a drop in libido (Wu et al., 2008). These physiological changes, though natural, can feel like betrayals—especially in cultures that equate masculinity with physical dominance and sexual prowess.

At the same time, aging brings professional transitions. For men whose identities have been fused with career success, retirement—whether planned or forced—can trigger a loss of purpose and status. One longitudinal study found that men who retire involuntarily experience significant increases in depressive symptoms, especially when retirement is linked to declining health or economic instability (Dave et al., 2008).

In short, aging confronts men with a brutal question: Who am I when I’m no longer the provider, protector, or performer?

The Psychological Toll of Isolation
Research consistently shows that older men tend to have smaller social networks and are less likely to seek emotional support than women (Courtenay, 2000). Many rely heavily on their spouses for emotional intimacy. When relationships shift—due to divorce, widowhood, or illness—men may find themselves adrift without any close confidants.

This lack of emotional scaffolding contributes to increased rates of depression, anxiety, and suicide among aging men. The CDC reports that men over 65 have the highest suicide rate of any demographic in the U.S. (Hedegaard et al., 2023). And because depression in men is often masked by irritability, substance use, or physical complaints, it is frequently missed by both physicians and family members.

The result? An enormous burden of unspoken grief, loneliness, and self-doubt.
Even among those who do have social contact, conversations often remain superficial. Without cultural permission to speak vulnerably, many older men are isolated not by circumstance—but by silence.

Grief, Loss, and the Myth of Resilience
Aging also brings waves of grief—some visible, some invisible.

There is the grief of losing friends or siblings, the grief of changing health, and the grief of missed opportunities or unresolved regrets. But for men, who are often taught to suppress emotion and “push through,” grief can calcify into numbness, anger, or emotional withdrawal.

One insidious myth that haunts older men is that “real men” age gracefully and without complaint. But research shows that unprocessed grief and loss can manifest in somatic symptoms, chronic illness, substance use, or disconnection from others (Galdas et al., 2005).

Emotional suppression may have served earlier in life to navigate demanding careers or societal expectations. But in later life, it becomes a trap—limiting access to healing, connection, and new meaning.

How Men Can Age With Emotional Integrity
Psychological flexibility is key to navigating aging with well-being. This doesn’t mean “thinking positively” or denying real losses. Rather, it means developing the capacity to adapt, reflect, and shift one’s self-concept beyond outdated masculine ideals.

Men who are able to redefine success, find value in relationships over productivity, and embrace emotional complexity report significantly better mental health outcomes in later life (Wurm et al., 2007).

Therapeutic approaches that affirm men’s values—such as Acceptance and Commitment Therapy (ACT), Interpersonal Therapy (IPT), or even existential therapy—can help aging men make meaning of their transitions. These models avoid pathologizing and instead support identity exploration, legacy reflection, and relational depth.

Additionally, behavioral activation—an evidence-based treatment for depression—can be helpful in encouraging older men to engage in pleasurable, meaningful activities, even when motivation is low (Dimidjian et al., 2011).

Reimagining Masculinity in Older Age
To support men’s mental health as they age, we must rewrite the cultural narratives surrounding masculinity. Aging can no longer be seen as a loss of power—it must be reframed as a gain in perspective.

This requires a shift in how we talk about strength. Strength can mean showing up to therapy, crying when it hurts, admitting when you feel lost, and learning how to ask for help. Resilience is not the absence of struggle; it’s the willingness to stay emotionally present through struggle.

Peer groups, social programs, and therapeutic spaces need to be designed with men’s psychological and cultural experiences in mind. For example, “men’s sheds”—a movement originating in Australia—offer low-pressure environments where older men can gather around hobbies, projects, and skill-sharing. These spaces offer indirect pathways to connection and can reduce depression and isolation (Ballinger et al., 2009).

What Loved Ones and Clinicians Can Do
If you’re close to an aging man who seems distant or emotionally withdrawn, know that silence doesn’t mean all is well. Offer consistent presence. Ask open-ended questions without pushing for disclosure. Normalize therapy and speak positively about emotional expression.

For clinicians, don’t wait for men to report sadness. Screen for depression using questions that target irritability, sleep changes, and anhedonia. Explore their views on masculinity, aging, and identity. Many aging men are not afraid of therapy—they just haven’t had the language or models to understand what therapy can offer them.

Aging as Evolution, Not Erosion
Aging is not the enemy. For men willing to reexamine their values and embrace vulnerability, it can be a profoundly liberating phase of life. The challenge lies not in aging itself—but in the cultural narratives that shame men into silence as they age.

Mental health is not about “fixing” what aging has changed. It’s about adapting, grieving, and rebuilding a self that is no longer shackled to outdated ideals.
It’s time to stop asking men to age like machines. Instead, let’s offer them the tools, spaces, and dignity to age like humans.ur whole life, we understand the unique challenges of being neurodivergent in a neurotypical world.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Ballinger, M. L., Talbot, L. A., & Verrinder, G. K. (2009). More than a place to do woodwork: A case study of a community-based Men’s Shed. Journal of Men’s Health, 6(1), 20–27.

Courtenay, W. H. (2000). Constructions of masculinity and their influence on men’s well-being: a theory of gender and health. Social Science & Medicine, 50(10), 1385–1401.

Dave, D., Rashad, I., & Spasojevic, J. (2008). The effects of retirement on physical and mental health outcomes. Southern Economic Journal, 75(2), 497–523.

Dimidjian, S., Barrera, M., Martell, C., Muñoz, R. F., & Lewinsohn, P. M. (2011). The origins and current status of behavioral activation treatments for depression. Annual Review of Clinical Psychology, 7, 1–38.

Galdas, P. M., Cheater, F., & Marshall, P. (2005). Men and health help-seeking behaviour: literature review. Journal of Advanced Nursing, 49(6), 616–623.

Hedegaard, H., Curtin, S. C., & Warner, M. (2023). Suicide mortality in the United States, 2001–2021. National Center for Health Statistics Data Brief, No. 464.

Wu, F. C. W., Tajar, A., Pye, S. R., Silman, A. J., Finn, J. D., O’Neill, T. W., … & EMAS Group. (2008). Hypothalamic–pituitary–testicular axis disruptions in older men are linked to frailty and overall health. The Journal of Clinical Endocrinology & Metabolism, 93(7), 2737–2745.

Wurm, S., Tesch-Römer, C., & Tomasik, M. J. (2007). Longitudinal findings on aging-related cognitions, control beliefs, and health in later life. The Journals of Gerontology: Series B, 62(3), P156–P164.

We live in a world that praises being busy, rewards burnout, and treats rest like a privilege instead of a necessity. The pressure to be constantly productive isn’t just a workplace issue—it’s become a deeply internalized belief system. And it’s quietly harming our mental health.

Productivity culture teaches us that our value lies in what we produce. That rest must be earned. That slowing down is the same as falling behind. But chasing constant output comes at a steep cost: anxiety, disconnection, burnout, and a fragile sense of self-worth that’s entirely performance-based.

The Hidden Cost of Constant Output
For many people, the pressure to keep producing feels personal. It’s not just about work—it’s about being “on” all the time. Answering emails late at night, turning hobbies into side hustles, filling every open hour with tasks. Productivity becomes a coping mechanism for discomfort, uncertainty, or feelings of inadequacy.
But here’s the truth: always doing more doesn’t mean you’re doing well. And constantly pushing yourself doesn’t mean you’re emotionally okay. Over time, living this way leads to:

• Difficulty relaxing without guilt
  
• Feeling behind, even when you’re ahead
  
• Chronic exhaustion and irritability
  
• Disconnection from joy, creativity, or purpose
  

Why We Buy Into It
Productivity culture is seductive. It promises control, certainty, and a sense of accomplishment. It gives us something to point to and say, “See? I’m doing enough.” For people who struggle with self-worth, it can feel like proof that you’re good, valuable, or safe.
And in some environments, being overextended is celebrated. Hustle is glorified. Boundaries are labeled as laziness. Eventually, internal restlessness becomes a lifestyle.

You Don’t Have to Burn Out to Be Valued
Your worth is not tied to how many tasks you complete, how fast you reply, or how much you squeeze into a day. It can feel radical to stop measuring success in output—but that’s where mental health begins to improve.
When you stop equating busyness with value, you make room for:

• Rest that isn’t guilt-ridden
  
• Presence instead of pressure
  
• Boundaries that protect your energy
  
• A deeper connection to what actually matters
  

What to Do Instead
You don’t have to quit your job or abandon your goals. But you can begin to shift your relationship with productivity.
Try this:

• Start noticing when you’re doing something out of fear vs. purpose
  
• Schedule rest like it’s non-negotiable
  
• Take breaks before you’re at capacity, not after
  
• Define success by how aligned you feel, not how exhausted you are
  And if that feels hard, it’s not because you’re failing—it’s because you’ve been taught to ignore your limits. Unlearning that is the real work.
  

Mental Health Isn’t a Productivity Hack
You don’t need to optimize your way out of burnout. You need space to slow down, reconnect with your needs, and stop measuring your value by your output. Therapy can help you unlearn productivity-based self-worth and build a more sustainable, intentional life.

Ready to work with a therapist who understands what it means to feel driven, overwhelmed, and tired of it all?

Book your appointment today.

Written by: Refresh Interns

Discomfort is a part of life, but most of us spend a lot of time and energy trying to avoid it. We stay busy to avoid loneliness. We overthink to avoid uncertainty. We people-please to avoid conflict. But in the effort to escape discomfort, we often make things worse—and we miss the opportunity to build real emotional resilience.

Learning to sit with discomfort is one of the most powerful, underutilized skills in mental health. It doesn’t sound exciting or glamorous, but it’s the foundation for everything from self-trust to boundary setting to lasting growth. Here’s why it matters—and how to start practicing it in real life.

Why We Avoid Discomfort
Discomfort isn’t just unpleasant. For many people, it feels threatening. Our brains are wired to protect us from pain, and discomfort often gets coded as danger. That means we instinctively reach for something—anything—that will make the feeling stop: distraction, reassurance, control, perfectionism, withdrawal, or even numbing behaviors like overworking or scrolling.
The problem is, these coping mechanisms often reinforce the belief that we can’t handle discomfort. Over time, we lose confidence in our ability to feel hard things and survive them.

The Cost of Avoidance
When we avoid discomfort at all costs, we end up:

• Staying stuck in unhealthy patterns
  
• Struggling to set or hold boundaries
  
• Reacting impulsively instead of responding thoughtfully
  
• Missing out on growth because it feels too uncomfortable
  Discomfort isn’t the problem. Our reaction to it is.
  

What It Actually Means to Sit With Discomfort
Sitting with discomfort doesn’t mean forcing yourself to suffer. It means allowing space for an uncomfortable feeling without immediately acting on it, fixing it, or pushing it away. It means recognizing that discomfort isn’t a danger signal—it’s information.
This can look like:

• Noticing the urge to fix something right away—and pausing instead
  
• Letting yourself feel anxious without jumping into overthinking
  
• Saying no to something and tolerating the guilt or fear that follows
  
• Staying present in an awkward or vulnerable moment without shutting down
  

Why This Skill Is So Hard (But So Worth It)
Most people aren’t taught how to tolerate discomfort. If anything, we’re taught to avoid it. But the ability to stay grounded during emotional discomfort is the difference between reacting and responding, between fear-based decisions and intentional ones.
It’s also a major part of what makes therapy transformative. The therapy space helps you learn how to stay with discomfort long enough to understand it—and eventually, to move through it.

How to Start Practicing
You don’t have to dive in headfirst. Start small. When a feeling comes up—anxiety, frustration, guilt—try the following:

• Name the feeling out loud or in your mind
  
• Notice where it shows up in your body
  
• Remind yourself, “This is uncomfortable, but I can tolerate it”
  
• Stay with the feeling for 60 seconds without distracting or acting on it
  Over time, your nervous system will learn that discomfort is survivable—and that you’re capable of navigating it.
  

Discomfort Is Where Growth Happens
Sitting with discomfort doesn’t make the hard parts of life easier. But it makes you stronger. More self-aware. More emotionally flexible. And far more equipped to make choices that align with who you actually are, not just what feels safe in the moment.

Ready to work with a therapist who can help you build emotional resilience from the inside out?ty without losing their drive. If you’re ready for something deeper than coping, let’s talk about what real transformation can look like.

Book your appointment today.

Written by: Refresh Interns

When we think of body image issues, we often think of women. But an increasing number of men are experiencing significant mental health challenges related to body perception—without the public awareness or social support to address it. In fact, research shows that up to 25% of individuals with body dysmorphic disorder (BDD) are male, and men are more likely to struggle with a specific subtype known as muscle dysmorphia, in which they perceive themselves as small or weak, despite being muscular or fit (Olivardia et al., 2000).

The result? A silent crisis—where men chase idealized bodies, restrict eating, overtrain, and spiral into anxiety, depression, or obsessive behavior. But because emotional distress about appearance is considered unmasculine, these issues are often hidden, dismissed, or misunderstood.

The Pressure to Look “Like a Man”
Masculine body ideals have changed dramatically over the last few decades. Where the 1950s ideal emphasized lean athleticism, today’s media presents the ideal man as hyper-muscular, vascular, and low in body fat. Superheroes, action figures, athletes, and even social media influencers all promote an unattainable physique.

This ideal is not just aesthetic—it’s tied to identity, power, and worth. Men who do not align with this image may internalize shame or inadequacy. A study published in JAMA Pediatrics found that adolescent boys who were concerned with muscularity were more likely to develop depressive symptoms and use substances like steroids (Field et al., 2014).

Men are also less likely than women to talk about body dissatisfaction or seek treatment, due to stigma. Body image concerns are often mislabeled as vanity, when in reality they can stem from deep-rooted anxiety, perfectionism, and trauma (Griffiths et al., 2015).

What Is Muscle Dysmorphia?
Muscle dysmorphia (MD) is a subtype of body dysmorphic disorder where individuals obsess over not being muscular or lean enough. It primarily affects men, and often involves compulsive exercise, rigid dieting, anabolic steroid use, and social withdrawal.

In contrast to anorexia nervosa, which is characterized by fear of fatness, muscle dysmorphia centers around the fear of being too small. But both disorders share distorted body image, impaired functioning, and co-occurring depression or anxiety (Pope et al., 2005).

Men with MD may feel intense distress if they miss a workout, avoid situations where their bodies could be judged (like beaches or locker rooms), or structure their entire lives around training and food. Left untreated, this condition can severely impact mental health and social life.

The Mental Health Effects of Poor Body Image in Men
Poor body image in men is associated with a range of mental health issues:

• Low self-esteem
• Social anxiety
• Obsessive-compulsive tendencies
• Eating disorders
• Steroid misuse
• Depression and suicidal ideation

Men who struggle with body image are also more likely to engage in compulsive behaviors like mirror checking, body comparisons, and excessive grooming (Veale et al., 2016). These behaviors are often dismissed as “normal male behavior” but can become obsessive and impair daily life.

Because body image struggles are seen as a “female issue,” men often delay or avoid seeking help. This leads to prolonged suffering and increased risk of co-occurring conditions, such as substance use disorders.

How Social Media and Gym Culture Reinforce Body Anxiety
Instagram, TikTok, and fitness apps flood men with images of shredded abs, bulging biceps, and “transformation” reels. Even fitness communities that claim to promote wellness often encourage overtraining, extreme discipline, and unrealistic goals.

Studies have shown that time spent on appearance-focused social media correlates with higher body dissatisfaction in men, particularly among those prone to social comparison (Rodgers et al., 2020).

 “Gym culture” can also fuel anxiety. While exercise can support mental health, obsessive or identity-driven exercise can worsen it. When fitness becomes a tool to fix a perceived flaw rather than support the body, it turns into punishment—not health.

Treatment and Support: What Actually Helps
Cognitive Behavioral Therapy (CBT) is the most evidence-based treatment for body dysmorphic disorder and body image distress. CBT helps individuals challenge distorted beliefs about appearance and reduce compulsive behaviors.

Other helpful approaches include:

• Exposure and Response Prevention (ERP) for mirror checking and reassurance-seeking
• Acceptance and Commitment Therapy (ACT) to shift focus from control to values
• Medication, such as SSRIs, for severe cases of BDD (Phillips et al., 2002)
  Treatment must also address underlying masculine norms—helping men expand their identity beyond appearance and performance. Therapy is not about “loving your body” in a superficial way. It’s about reclaiming your relationship with your body from shame, fear, and control.
  

What Families, Partners, and Clinicians Can Do
If you suspect a man in your life is struggling with body image:

• Avoid making comments about weight, size, or muscles
• Ask about how he’s feeling, not just how he’s looking
• Normalize therapy and mental health support
• Recognize that excessive gym behavior may be a coping mechanism

For clinicians, screening tools for BDD and eating disorders should be adapted for male presentations. Ask about appearance-related distress, not just weight concerns. Understand that “healthy” gym behavior may be masking significant psychological distress.

Men Deserve Better Than Silence
Men’s mental health and body image issues are real, common, and underrecognized. It’s time to stop framing body dysmorphia as a “women’s problem” and acknowledge the growing number of men suffering in silence.

Every man deserves to age, change, and exist in his body without shame. Muscles don’t define worth. Control doesn’t equal confidence. The most powerful transformation is internal—toward compassion, flexibility, and wholeness.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Works Cited
Field, A. E., Sonneville, K. R., Crosby, R. D., Swanson, S. A., Eddy, K. T., Camargo, C. A., … & Micali, N. (2014). Prospective associations of concerns about physique and the use of anabolic-androgenic steroids in adolescent boys. JAMA Pediatrics, 168(1), 34–39.

Griffiths, S., Murray, S. B., & Touyz, S. (2015). Drive for muscularity and muscularity-oriented disordered eating in men: The role of set shifting difficulties and weak central coherence. Body Image, 15, 116–121.

Olivardia, R., Pope, H. G., & Hudson, J. I. (2000). Muscle dysmorphia in male weightlifters: A case-control study. American Journal of Psychiatry, 157(8), 1291–1296.

Phillips, K. A., Albertini, R. S., & Rasmussen, S. A. (2002). A randomized placebo-controlled trial of fluoxetine in body dysmorphic disorder. Archives of General Psychiatry, 59(4), 381–388.

Pope, H. G., Gruber, A. J., Choi, P., Olivardia, R., & Phillips, K. A. (1997). Muscle dysmorphia: An underrecognized form of body dysmorphic disorder. Psychosomatics, 38(6), 548–557.

Rodgers, R. F., Slater, A., Gordon, C. S., McLean, S. A., & Jarman, H. K. (2020). The role of social media in body image concerns among adolescent boys: A brief review. Current Opinion in Psychology, 36, 86–90.

Veale, D., Gledhill, L. J., Christodoulou, P., & Hodsoll, J. (2016). Body dysmorphic disorder in different settings: A systematic review and estimated weighted prevalence. Body Image, 18, 168–186.

When your child is struggling with depression, your world shrinks to their pain. You might spend nights watching them sleep just to make sure they’re safe, or spend days wondering if anything you say even matters. You try to stay calm, grounded, and supportive—but under the surface, your own mental health may be unraveling.

For fathers, this is often a silent collapse. Many were taught to be protectors, problem-solvers, and providers—not emotional anchors. And yet, when a child is facing depression, what’s needed most is precisely what men are rarely taught to develop: emotional stamina, self-awareness, and grief tolerance.

This article is not about how to fix your child. It’s about what happens to you—your identity, your mental health, and your emotional life—when the child you love is in pain.

The Invisible Toll of Holding It All Together
Most fathers don’t talk about the panic that creeps in when their child won’t get out of bed. Or the shame they feel when they get frustrated instead of compassionate. Or the confusion that comes from doing everything “right” and still watching their child spiral.

Research shows that parents of children with depression are at increased risk for anxiety, depressive symptoms, sleep disturbance, and even PTSD-like experiences, especially if they lack adequate emotional support (Wickersham et al., 2021).

Men are especially vulnerable because they tend to suppress their emotional distress, fearing that breaking down would make them less effective or less useful. But repressing grief, fear, or helplessness doesn’t protect anyone—it just isolates you.

You Can’t Pour From an Empty Self
When your child is in crisis, it can feel selfish to take care of your own well-being. But parenting a child with depression is not a sprint—it’s a marathon. You don’t need to be constantly strong. You need to be sustainable.

Ignoring your own exhaustion, guilt, and emotional confusion will only erode your capacity to parent with clarity. Research on parental burnout shows that unprocessed emotional overload in caregivers leads to detachment, irritability, and emotional numbing (Mikolajczak et al., 2018).

You are allowed to grieve. You are allowed to feel angry. You are allowed to say “I need help too.” None of this makes you a weak father. It makes you an honest one.

Masculinity, Shame, and Silent Suffering
Many fathers feel shame for even admitting how much this hurts. Society rarely gives men permission to collapse under the weight of parenting, especially when the struggle is emotional rather than logistical.

You might feel like you’re failing. You might believe you caused this. You might wonder if you missed the signs. These thoughts are common—and corrosive.

In a qualitative study on fathers of children with mental illness, researchers found that many men experience intense guilt, self-blame, and emotional isolation, yet hesitate to reach out for support due to stigma or internalized masculine norms (Moses, 2010).

But emotional suppression does not make you a better father. Presence does. And presence requires caring for your own mental health with the same dedication you offer your child.

Therapy Isn’t Just for Your Kid
It’s common for fathers to get their child into therapy, but never consider it for themselves. Yet your child’s healing may trigger long-dormant wounds in you—childhood trauma, emotional neglect, or long-held insecurities.

Fathers often report feeling like they’re “not allowed” to fall apart while their child is struggling. But therapy gives you a protected space to feel everything that parenthood has stirred up.

Men in therapy often report improved parenting, better emotional regulation, and a greater sense of meaning—even during ongoing family stress (Feinberg & Kan, 2008). You don’t need to be in crisis to go. You just need to be human.

Redefining Fatherhood During Crisis
When your child is depressed, it’s easy to feel like you’ve lost control. But this is also a powerful moment to redefine what kind of father you want to be—not the one who has all the answers, but the one who shows up with honesty and compassion.

Ask yourself:

• Can I be present, even when I feel powerless?
• Can I soften, even when I want to shut down?
• Can I let go of fixing, and instead build trust through consistency? 

These questions won’t solve everything. But they will move you toward a version of fatherhood that includes your full humanity—not just the parts that feel competent.

You Still Matter, Even Now
You may not be able to make your child feel better today. But you are not powerless. You are not invisible. And your emotional well-being is not secondary to theirs—it’s part of the healing environment they need.

A father’s love never ends. But it can—and must—include love for yourself. You are not just a witness to your child’s depression. You are a man navigating heartbreak, confusion, and uncertainty—and you deserve support too.

You’re not alone. You’re not failing. You’re just finally feeling it.

Book your appointment today.

Written by: Refresh Interns

Works Cited
Feinberg, M. E., & Kan, M. L. (2008). Establishing family foundations: Intervention effects on coparenting, parent/infant well-being, and parent–child relations. Journal of Family Psychology, 22(2), 253–263.

Mikolajczak, M., Gross, J. J., & Roskam, I. (2018). Parental burnout: What is it, and why does it matter? Clinical Psychological Science, 7(6), 1319–1329.

Moses, T. (2010). Being treated differently: Stigma experiences with family, peers, and school staff among adolescents with mental health disorders. Social Science & Medicine, 70(7), 985–993.

Wickersham, A., Sugg, H. V., Epstein, S., Stewart, R., Ford, T., Downs, J., & Fazel, M. (2021). Caregiver burden and mental health difficulties associated with adolescent depression: A systematic review and meta-analysis. European Child & Adolescent Psychiatry, 30(5), 751–761.

You’re successful, driven, and highly dependable—but beneath the polished exterior, anxiety is often calling the shots. If you’re a perfectionist, the pressure to be everything for everyone all the time may be quietly eroding your mental health.

This guide explores the connection between perfectionism and anxiety, why high achievers are more vulnerable than they appear, and how to protect your mental well-being without losing your ambition.

Perfectionism and Anxiety: A Hidden Relationship

Perfectionism isn’t about loving excellence. It’s about fear—of failure, disapproval, or not being enough. For many high achievers, perfectionism began as a coping strategy in childhood and evolved into an identity built on overfunctioning.

But the cost of high-functioning anxiety is steep:

• Constant tension and worry
  
• Fear of disappointing others
  
• An inability to rest without guilt
  
• Feeling like your value depends on performance
  

Despite appearances, high-performing individuals often don’t feel “fine.” They’re simply productive and anxious.

Signs of Perfectionist Burnout

Because perfectionism is often praised, it’s easy to miss the toll it takes. If you recognize yourself in the following, you may be experiencing burnout driven by perfectionism and anxiety:

• You feel behind, even when you’re ahead
  
• You struggle to relax, even when you’ve “earned it”
  
• You dread failure more than you desire success
  
• You procrastinate out of fear of doing something imperfectly
  
• You minimize accomplishments and focus on what’s next
  

High-functioning anxiety is real—and it’s unsustainable.

Can You Be Ambitious and Mentally Healthy? Yes.

The good news: You don’t have to choose between mental health and ambition. The key is redefining how you measure success and learning to meet your own needs without perfection as the price of admission.

How to Support Your Mental Health as a High Achiever

1. Redefine What Success Means
Success isn’t only about flawless execution. Try measuring success by:

• Progress over perfection
  
• Honest effort, even with imperfect results
  
• How aligned your work is with your values
  
• Resting when you need to, not when you’re “allowed”
  

2. Build Discomfort Tolerance
Perfectionism is often a way to avoid discomfort. Challenge yourself to:

• Send that email without triple-checking
  
• Take a break before finishing a task
  
• Leave space for things to be “good enough”
  

Each act of tolerating imperfection strengthens your resilience.

3. Talk Back to Your Inner Critic
Your inner critic might sound convincing, but it’s often just a fear-based habit. Practice asking:

• What am I afraid will happen if I don’t do this perfectly?
  
• Is this expectation reasonable—or punishing?
  
• What would I say to a friend in the same situation?
  

4. Develop Self-Worth Outside of Achievement
Explore who you are outside of what you do. This might mean:

• Trying hobbies with no productivity outcome
  
• Setting boundaries around work
  
• Valuing your presence, not just your performance
  

When your worth is no longer tied to outcomes, anxiety loses power.

5. Consider Therapy for Perfectionism and Anxiety
Working with a therapist who understands high-functioning anxiety and perfectionism can help you untangle these patterns at their root. You don’t need to be in crisis to benefit from therapy—especially when you’re tired of keeping it all together.

You Don’t Have to Earn Peace

Your ambition doesn’t need to disappear—but it shouldn’t come at the cost of your well-being. When you learn to recognize anxiety for what it is—not motivation, but fear—you gain the freedom to move through life with more peace, less pressure, and a deeper sense of self-worth that isn’t up for negotiation.

Ready to work with someone who understands the mental load of high achievement?
I help ambitious professionals untangle perfectionism and anxiety without losing their drive. If you’re ready for something deeper than coping, let’s talk about what real transformation can look like.

Book your appointment today.

Written by: Refresh Interns

Venting can feel good in the moment. You get things off your chest, release some frustration, and maybe even feel validated. But there’s a point where venting stops being helpful—and starts becoming a way to avoid real change.

In therapy and in life, there’s a difference between processing an experience and circling the same story over and over. One creates movement. The other keeps you stuck.

What Venting Does (and Doesn’t Do)
Venting gives us temporary relief. It helps us feel heard, especially if we’re used to suppressing emotions. But on its own, venting rarely leads to clarity, insight, or growth. It’s often reactive, focused on what happened and why it was unfair—without asking, “What now?”

This doesn’t mean you shouldn’t express your emotions. But when venting becomes the only thing you do, it can keep you in a cycle of frustration and powerlessness.

Doing the Work Means Looking Inward
Doing the work means asking yourself harder questions. It means going beyond how something felt and exploring what it triggered in you. It asks, “What patterns am I noticing?” “What do I actually need?” “How can I respond differently next time?”

This process requires emotional honesty, accountability, and a willingness to move through discomfort. That’s why many people avoid it. But it’s also where actual transformation happens.

Venting Looks Like:

• “I can’t believe they did that to me.”
  
• “This always happens to me.”
  
• “They’re the problem.”
  
• “I just needed to get that out.”
  

Doing the Work Looks Like:

• “Why does this pattern keep showing up in my relationships?”
  
• “What boundary was crossed, and how did I respond?”
  
• “What’s my role in this dynamic?”
  
• “What am I feeling underneath the anger or frustration?”
  

You Deserve More Than Temporary Relief
Venting has its place. Sometimes you need to let it out before you can even think clearly. But staying in vent mode can give the illusion of processing—without ever helping you move forward.

Doing the work means committing to self-awareness, emotional growth, and deeper insight. It’s not always comfortable. But it’s the difference between repeating the same story and writing a new one.

Ready to move beyond venting and start making real changes?

Book your appointment today.

Written by: Refresh Interns

Ever feel like you’re the one always checking in, managing emotions, anticipating needs, and holding space—while your partner, friend, or family member just… exists? That’s emotional labor, and it’s quietly exhausting. Often invisible, emotional labor is the mental and emotional energy required to maintain relationships, solve problems, and keep everyone feeling okay—even when you’re not.

While it’s normal for care and support to flow both ways in close relationships, emotional labor becomes a problem when it’s one-sided. If you’re constantly managing the emotional temperature of your relationship, you’re likely carrying more than your fair share—and it’s draining.

What Is Emotional Labor?
Emotional labor in relationships isn’t about performing grand gestures. It’s the subtle, constant effort of making sure everything runs smoothly emotionally. This includes things like:

• Soothing your partner when they’re upset, even if you’re overwhelmed yourself
  
• Anticipating emotional needs before they’re spoken
  
• Keeping the peace to avoid conflict
  
• Suppressing your feelings so others won’t feel uncomfortable
  
• Being the emotional “glue” in every dynamic
  When you’re the one doing most of the emotional tending—without reciprocation—it takes a toll on your nervous system, your self-esteem, and your capacity to actually enjoy the relationship.
  

Signs You’re Carrying Too Much Emotional Labor
You might not call it emotional labor, but you’ll feel it. Common signs include:

• Feeling responsible for other people’s moods
  
• Apologizing often, even when you’re not at fault
  
• Being emotionally exhausted after conversations
  
• Noticing that others rarely ask how you’re doing
  
• Feeling unseen, underappreciated, or taken for granted
  Over time, this kind of imbalance can lead to resentment, disconnection, or even burnout.
  

Why It’s So Hard to Stop
Many people—especially those who were raised to overfunction—find it hard to stop performing emotional labor. You might worry that if you stop holding it all together, everything will fall apart. Or you may have learned early on that being attuned, accommodating, or selfless was the way to earn love or avoid conflict.
But constantly prioritizing other people’s emotions doesn’t create closeness—it creates imbalance. And it teaches the people around you that your needs are optional.

What to Do About It
You don’t have to burn it all down to reset your role in a relationship. But you do have to start doing less of what’s draining you—and tolerating the discomfort that may come with it.
Here’s how to begin:

• Notice when you’re managing someone else’s emotional experience
  
• Pause before jumping in to soothe, fix, or accommodate
  
• Practice expressing your own emotions, even if it feels awkward
  
• Set small boundaries around how much you give—without overexplaining
  It may feel selfish at first. But it’s not. It’s rebalancing a dynamic that was never sustainable to begin with.
  

Healthy Relationships Share the Load
In a healthy relationship, emotional labor is mutual. You check in with each other. You support one another. You both take responsibility for emotional connection—not just one of you.
You don’t have to carry it all. You were never meant to.

Ready to work with a therapist who understands the emotional toll of overfunctioning in relationships?

Book your appointment today.

Written by: Refresh Interns

Despite growing awareness of mental health, therapy still carries stigma and misunderstanding. For many people, outdated beliefs about therapy create hesitation, shame, or unrealistic expectations. These myths don’t just keep people out of therapy—they also prevent those already in it from getting the most out of the experience. Here are the most common myths about therapy—and the truth that might help you see it differently.

Myth #1: Therapy is only for people in crisis
Reality: Therapy isn’t just for when everything falls apart. Many people go to therapy to better understand themselves, process everyday stress, or break patterns that no longer serve them. Therapy can be proactive—not just reactive.

Myth #2: Talking to a friend is the same as therapy
Reality: While friends can offer support, therapy is a professional relationship with boundaries, training, and evidence-based strategies. Therapists are trained to notice blind spots, help you tolerate discomfort, and support you without projecting their own experiences onto you.

Myth #3: Therapy is just talking with no real progress
Reality: Therapy involves reflection, but it’s not aimless. Good therapy helps you recognize patterns, develop insight, and take action. What might feel like “just talking” is often where deep cognitive and emotional shifts begin.

Myth #4: Needing therapy means something is wrong with me
Reality: Going to therapy is a sign of self-awareness, not weakness. Mental health maintenance is part of taking care of yourself. You don’t have to be in crisis to deserve support.

Myth #5: Therapy will fix me
Reality: Therapy doesn’t “fix” you—it gives you the tools to better understand yourself, set boundaries, cope with stress, and move through life more intentionally. The goal is growth and alignment, not perfection.

Myth #6: If it didn’t work before, it won’t work now
Reality: There are many styles of therapy, and not every therapist will be the right fit. If past therapy wasn’t helpful, it may have been the wrong timing, the wrong approach, or simply a mismatch. That doesn’t mean therapy can’t work for you.

Myth #7: Therapy is only for people with a diagnosis
Reality: You don’t need a diagnosis to benefit from therapy. Many people seek therapy for things like burnout, relationship challenges, career transitions, or personal growth. Therapy can help you think clearly and make intentional decisions—no diagnosis required.

Let Go of the Myths. Keep the Insight.
Therapy is not about being broken or weak. It’s about creating space for honest reflection, intentional growth, and mental clarity. The myths about therapy keep people stuck. But the truth? Therapy is one of the most powerful tools you can use to better your life.

Ready to work with a therapist who meets you where you are—without the myths?

Book your appointment today.

Written by: Refresh Interns

While scrolling through Instagram recently, I came across a pair of Irish dancers my son and I often enjoy watching together. To my surprise, I learned they’re currently touring with Beyoncé. Yes—Beyoncé. Something about that moment brought me straight back to my 13-year-old self: completely absorbed in Riverdance, dreaming of becoming a professional Irish dancer, and feeling inspired by the way Irish dance embraced other cultures. I was flooded with joy watching these dancers perform—living the kind of dream I once imagined for myself.

(For the record, that dream didn’t happen. I became a psychotherapist—and later, founded Refresh.)

But alongside that joy came something else. I also remembered the strain Irish dance placed on my mental health. I remembered teachers yelling at us, weighing dancers in front of the entire class and telling some how much they needed to lose before the Oireachtas. I remembered the guilt for not placing at a feis—or in my case, skipping one altogether because I had another commitment, and the criticism that followed.

So when my neurodivergent son showed interest in Irish dance at age three, I was careful about the environment I chose. Many schools turned him away because of his gender, age, or neurodivergence. I found a teacher who welcomed him exactly as he was—no yelling, no shame, no rigid expectations. Her school emphasizes joy, inclusion, and encouragement.

Morgan Bullock, star of Riverdance and Beyonce dancer, poses with my son at his Irish dance class.

That Instagram moment sparked more than nostalgia. It led me to reflect on what it means to process a dance history that, for many adults, is emotionally complicated. I work with high-achieving adults every day—people who, like me, often revisit childhood passions only to uncover both joy and injury.

So what does it mean to care for your mental health as an adult with a history in competitive dance?

What Irish Dance Can Teach Us About Mental Health

1. Acknowledge what it took to survive that culture.
   If you danced competitively as a child, you probably developed certain coping mechanisms to navigate high pressure, public evaluation, and perfectionism. Some of those habits might have helped you succeed—but they may no longer serve you today. It’s okay to outgrow them.
   
2. You’re allowed to grieve what dance took from you.
   Grief doesn’t only come from loss—it comes from absence, too. If your dance years were full of shame, fear, or missed developmental support, you might feel anger or sadness. That doesn’t mean you didn’t love dancing. It means you’re honoring your full experience.
   
3. Joy doesn’t have to be tied to performance.
   Many of us learned to associate joy with external validation—winning, impressing others, getting praise. Relearning what joy feels like without a scorecard is a powerful mental health practice, whether in dance or daily life.
   
4. The body remembers, even when you’ve moved on.
   The stress of being told your body wasn’t “right” for dance doesn’t just go away because you aged out of competition. Adults who grew up in performance-based environments often continue to carry unspoken tension around their bodies, productivity, or worth. Therapy can help untangle that.
   
5. You can reclaim dance on your own terms.
   Maybe that means going back to a class just for fun—or maybe it means never dancing again and finding peace with that decision. Either way, you get to redefine your relationship to dance now, free from the rules that shaped your past.
   
6. Excellence doesn’t have to cost you your well-being.
   You can still be ambitious and have boundaries. Rest and limits don’t make you less serious—they make you sustainable. There’s no prize for burning out.
   
7. Visibility can be healing—but only when it’s on your terms.
   Being seen for who you actually are—not the version others expect—can be profoundly liberating. But it has to feel safe. You’re allowed to choose what parts of yourself you show to the world, and when.
   

As adults, many of us carry childhood experiences that were both beautiful and bruising. Irish dance was one of those for me. Returning to it—even just as a spectator—has become an unexpected window into understanding myself more deeply.

If you’re beginning to reflect on the intensity of your own childhood passions—whether in dance, academics, athletics, or another performance-based environment—therapy can help you explore how those early structures shaped your current patterns.

Book your appointment today.

Written by: Keeley Teemsma, LCSW, MA

Every April, Autism Awareness Month rolls around. We hear calls for “inclusion,” “understanding,” and “support.” But inclusion isn’t about inviting autistic people to sit quietly at the edge of a neurotypical world. It’s about recognizing that the systems, norms, and expectations of that world weren’t built for us—and we shouldn’t be the only ones expected to adapt.

This is what masking is: the lifelong, exhausting effort autistic people make to appear non-autistic.

It’s learning to mimic the tone, rhythm, and pacing of neurotypical speech. It’s suppressing stims. Forcing eye contact. Smiling at the “right” time. Making small talk that feels pointless. Sitting through sensory overload without showing it. Memorizing social rules that change depending on who you’re with. And doing it all while hiding the fact that you’re doing it.

Most people never see it. And that’s the problem.

When autistic people communicate in ways that are considered “normal,” we’re praised for how well we’re doing. When we don’t, we’re dismissed, ignored, or corrected. Either way, the message is the same: adapt.

And we do. Autistic people are trained from an early age to meet the non-disabled world where it is. We’re taught to communicate in their way. To relate on their terms. To work, socialize, and exist in their environments. To push down who we are so we can be more “acceptable.”

But here’s the part no one likes to talk about: the non-disabled world isn’t asked to meet us halfway.

No one teaches neurotypical children how to recognize autistic communication as valid. No one expects non-autistic adults to slow down their conversations, to interpret literal language without judgment, to accept alternate body language as equally meaningful. No one rewrites classroom environments or workplace expectations unless they have to—and even then, it’s met with resistance.

It’s not just that autistic people have to do all the adapting. It’s that we’re expected to do it silently, invisibly, without recognition—and without reciprocal effort from the world around us.

That’s not inclusion. That’s compliance.

The burden to communicate, relate, adjust, and contort falls entirely on the disabled person. And when we can’t—or simply won’t—do that anymore, we’re told we’re difficult, rude, cold, or too sensitive.

So this Autism Awareness Month, let’s stop asking autistic people to do more. Let’s stop celebrating how well someone masks their disability and start asking: Why do they have to?

Why is the non-disabled world so rarely expected to change?

Why do we treat accessibility as a favor instead of a responsibility?

And why are neurodivergent people expected to make themselves understandable, while everyone else is free to stay exactly the same?

It’s time we stop calling this “inclusion” when it’s really just assimilation.

It’s time the world starts doing its share of the work.

—

I’m a neurodivergent psychotherapist, and one of my areas of specialization is working with adults who were diagnosed with autism later in life. I know firsthand how much effort goes unseen—how hard it is to untangle who you are from who you’ve been trained to be. This month isn’t about raising awareness of autism as an abstract concept—it’s about recognizing the people who’ve been here all along, quietly doing the work to fit into a world that rarely makes space for them. We deserve better. And we shouldn’t have to keep asking.If you’re looking for a therapist who truly understands the complexity of late-diagnosed autism and the lifelong experience of masking, our team is here to help.
Book an appointment with one of our therapists today.

Written by: Keeley Teemsma, LCSW, MA

Every day, people in the United States consume news and updates from social media outlets about political, social, environmental, and economic changes. These ongoing changes can often feel overwhelming and frightening, leading to a sense of hopelessness. Such feelings can significantly impact mental health, affecting our sense of stability and safety. During challenging times, it’s essential to seek a safe space to express feelings and process complex emotions. At Refresh, we are committed to protecting all patients, especially those most affected by harmful policies.  Everyone deserves dedicated time and space for safety, advocacy, and healing.

II. Protecting LGBTQIA+ Patients

In the current political climate, we recognize that LGBTQIA+ clients face specific challenges and targets. Our practice is committed to gender-affirming therapy and LGBTQIA+ mental health. At Refresh, we understand the importance of living as your most authentic self and its positive impacts on overall life satisfaction. We will never share private information that could put patients at risk. We can provide referrals to LGBTQIA+ organizations that provide legal support and community resources.

III. Protecting BIPOC Patients

At Refresh, we are committed to providing culturally competent, trauma-informed care that acknowledges and addresses the racial trauma uniquely experienced by BIPOC individuals. We actively foster an anti-racist therapeutic environment where discrimination is never tolerated, and every client feels safe, respected, and heard. Our strong connections with BIPOC-led community organizations ensure our clients can access additional, culturally relevant support resources. By promoting racial equity within therapy, we empower our BIPOC clients on their healing journey and advocate for lasting systemic change.

IV. Protecting Patients with Immigration Concerns

At Refresh, we deeply value the safety and well-being of patients facing immigration concerns. We strictly protect privacy and confidentiality, ensuring that immigration status and patient records remain secure and confidential. Our therapists provide specialized, trauma-informed care to help clients navigate the stress, fear, and uncertainty that often accompany immigration challenges. Additionally, we maintain trusted partnerships with legal experts and immigration advocacy groups, offering reliable referrals to support clients in securing essential legal and social services. Our goal is to foster a secure, compassionate, and informed environment where immigrant clients can confidently pursue their mental health and personal well-being.

V. Protecting Women’s Health and Autonomy

Political uncertainty significantly impacts women’s health and autonomy, particularly as shifting policies around reproductive rights create barriers to essential healthcare. Trauma-informed therapy can play a critical role in supporting individuals affected by abortion restrictions and limited access to reproductive services, helping them process complex emotions and experiences. In addition, addressing gender-based violence remains vital, with accessible resources and therapeutic support needed for survivors of domestic violence and sexual assault. At Refresh, we address mental health advocacy as equally important, as women often face heightened stress and anxiety when navigating policy changes that threaten their rights and personal agency.

VI. Protecting Individuals with Disabilities

We are committed to protecting and supporting individuals with disabilities by recognizing the systemic barriers that impact their daily lives. Our therapists provide care that acknowledges the emotional toll of policy changes affecting healthcare, accessibility, and necessary accommodations. We offer a validating space for clients to process the stress, frustration, and isolation that can come from navigating a society shaped by ableism. By centering the lived experiences of disabled individuals, we provide affirming, inclusive therapy that fosters resilience, self-advocacy, and emotional well-being. Refresh Psychotherapy stands with the disability community, offering compassionate support amidst ongoing systemic challenges.

VII. Protecting Neurodivergent Individuals

We are dedicated to protecting and uplifting neurodivergent individuals by providing therapy that validates and honors their unique experiences. Our clinicians support clients in exploring their neurodivergent identity beyond societal expectations and the pressure to conform, creating space for self-discovery and empowerment. We also help individuals process the emotional toll of masking and the burnout that often results from navigating environments that lack understanding or accommodations. Most importantly, we encourage authentic self-expression, helping clients find ways to be authentic without fear of judgment. At Refresh, we believe in celebrating neurodiversity and fostering a therapeutic space where every mind is respected and supported.

VIII. Protecting Those Affected by Religious and Political Oppression

At Refresh, we understand that religious and political oppression can profoundly impact our clients’ lives and well-being. Our approach is to provide a non-judgmental space where clients can process their experiences of discrimination, family rejection, and/or social isolation. This process involves exploring identity conflicts that can arise as our beliefs shift or evolve in response to changing political or religious views. At Refresh, we support our clients through their emotions, always honoring their authentic selves and personal journeys. We work to strengthen their resilience, especially in the face of religious or political oppression, and to develop coping strategies and emotional tools that build self-worth and confidence.  

IX. How We Take Action

At Refresh, we are committed to advocating for the rights and needs of marginalized communities within the mental health system. We stay engaged with current advocacy efforts, particularly those addressing religious and political oppression, to ensure these issues are recognized and addressed. Our strong partnerships with human rights organizations and support networks provide excellent resources for clients needing additional support. We believe that knowledge is power and are dedicated to informing our clients about their rights, available resources, and support options. Our mission is to empower our clients to make informed decisions about their healing journey and access the range of support services available.At Refresh, we stand firmly by our commitment to your safety, confidentiality, and advocacy. We understand that the decision to seek therapy can be overwhelming, but you’re not alone in this. Many others have felt uncertain and have found the support they needed to heal and grow. You don’t need to go through this alone; our therapy space offers a secure environment for you to heal and grow. To schedule a session or learn more about our services, call (646) 685-4422 or visit www.refreshtherapynyc.com. Remember, we are here to support you every step of the way.

As May unfolds, the United States observes Mental Health Month, a time dedicated to raising awareness, reducing stigma, and promoting mental wellness. In the bustling metropolis of New York City, where the pace is fast and the demands are high, prioritizing mental health is not just an option but a necessity, especially for adults navigating the complexities of urban life.

The Urban Experience and Mental Health

Living in New York City offers a unique blend of opportunities and challenges. The city’s vibrancy, diversity, and endless possibilities attract millions of individuals seeking success, fulfillment, and belonging. However, beneath the glittering skyline lies a landscape of stressors that can take a toll on mental well-being.

The fast-paced lifestyle, competitive work culture, and constant sensory overload can lead to feelings of anxiety, burnout, and isolation. Commuting woes, financial pressures, and the high cost of living further exacerbate stress levels, making it increasingly difficult for adults to maintain mental equilibrium in the city that never sleeps.

Stigma and Seeking Help

Despite the city’s abundance of resources, including mental health clinics, support groups, and therapy services, stigma remains a significant barrier to seeking help for many New Yorkers. The pervasive belief that seeking mental health support is a sign of weakness or failure can prevent individuals from reaching out for assistance when they need it most.

Moreover, the fear of judgment, confidentiality concerns, and logistical challenges, such as finding affordable and accessible care, can deter adults from seeking timely support for their mental health concerns. As a result, many suffer in silence, grappling with their emotional struggles alone, unaware that help is within reach.

Navigating Culturally Diverse Needs

New York City’s population is a melting pot of cultures, languages, and identities, each with its own unique perspectives on mental health and well-being. For adults from immigrant communities or marginalized backgrounds, accessing culturally competent mental health care can be particularly challenging.

Language barriers, cultural differences in understanding and addressing mental health issues, and mistrust of mainstream healthcare systems can all contribute to disparities in mental health outcomes. Recognizing and addressing these diverse needs is essential to ensuring that all New Yorkers have equitable access to mental health support and resources.

Promoting Mental Wellness

As Mental Health Month unfolds, it’s crucial for individuals, communities, and policymakers to come together to prioritize mental wellness in New York City. This includes:

1. Raising Awareness: Increasing public awareness about mental health, reducing stigma, and promoting open dialogue about emotional well-being are essential steps toward fostering a more supportive and inclusive city.
2. Expanding Access to Care: Investing in mental health services, expanding insurance coverage for mental health treatment, and increasing the availability of culturally competent care are vital to ensuring that all New Yorkers can access the support they need.
3. Building Community Support: Creating safe spaces for individuals to connect, share experiences, and seek support can help combat feelings of isolation and foster a sense of belonging in a city known for its hustle and bustle.
4. Prioritizing Self-care: Encouraging individuals to prioritize self-care, set boundaries, and practice mindfulness amid the hustle of urban life can help mitigate stress and improve overall well-being.

In conclusion, as New Yorkers navigate the complexities of urban life, let us remember the importance of prioritizing mental health. By raising awareness, reducing stigma, and fostering a culture of support and resilience, we can create a city where every adult can thrive emotionally, mentally, and socially. This Mental Health Month, let’s commit to prioritizing mental wellness for all New Yorkers.

May marks an important time in the United States as it celebrates Asian American and Pacific Islander (AAPI) Heritage Month, a time dedicated to recognizing the contributions, culture, and history of these diverse communities. However, amidst the celebrations and acknowledgments, it’s crucial to shed light on a significant yet often overlooked aspect: mental health within the AAPI community.

The AAPI community is not a monolith; it encompasses a rich tapestry of cultures, languages, and traditions. Yet, within this diversity lies a shared experience of navigating cultural stigmas, intergenerational conflicts, and systemic barriers that can impact mental well-being.

Cultural Stigma and Silence

Mental health remains a taboo subject in many AAPI communities due to cultural stigmas surrounding mental illness. There’s often pressure to maintain a façade of strength and success, leading individuals to internalize their struggles and suffer in silence. Seeking help for mental health issues can be perceived as a sign of weakness or failure, causing many to forego treatment or support.

Moreover, the model minority myth perpetuates the stereotype that all Asians are academically successful, financially prosperous, and emotionally resilient. This myth not only undermines the diverse experiences of AAPI individuals but also creates unrealistic expectations, further exacerbating mental health challenges.

Intersections of Identity

The AAPI community intersects with various identities, including gender, sexual orientation, immigration status, and generational differences, each influencing mental health experiences uniquely.

For instance, LGBTQ+ AAPI individuals often face additional challenges, including rejection from family, cultural invisibility, and discrimination within both mainstream and LGBTQ+ communities. These intersecting identities can contribute to feelings of isolation, shame, and internalized prejudice, affecting mental well-being.

Similarly, immigrants and refugees within the AAPI community may grapple with acculturation stress, language barriers, and trauma from displacement, all of which can impact mental health outcomes. The pressure to assimilate while preserving cultural heritage can create a sense of identity conflict, leading to psychological distress.

Barriers to Access and Treatment

Despite the growing awareness of mental health issues, AAPI individuals encounter numerous barriers to accessing culturally competent care. Language barriers, lack of culturally sensitive resources, and limited representation of AAPI mental health professionals contribute to the underutilization of mental health services within these communities.

Furthermore, the perpetual foreigner stereotype, which portrays AAPI individuals as perpetual outsiders regardless of their citizenship or cultural integration, can deter seeking help due to fears of discrimination or misunderstanding from healthcare providers.

Cultivating Resilience and Support

Amidst these challenges, it’s essential to highlight the resilience and strength within the AAPI community. Cultivating culturally responsive mental health resources, promoting community-based support networks, and destigmatizing conversations around mental health are critical steps toward fostering well-being.

Encouraging open dialogue within families and communities, providing culturally competent mental health education, and advocating for policies that address systemic inequities can help break down barriers to care and promote holistic wellness.

Conclusion

As we celebrate Asian American and Pacific Islander Heritage Month, let us not forget the importance of addressing mental health within these communities. By acknowledging the complexities of identity, challenging cultural stigmas, and advocating for equitable access to care, we can create a more inclusive and supportive environment where all individuals can thrive mentally, emotionally, and culturally. This month, let’s not only honor the rich heritage of the AAPI community but also commit to prioritizing their mental health and well-being.

As Autism Awareness Month draws to a close, it’s a fitting time to reflect on the progress made and the work that still lies ahead. Throughout April, individuals and organizations around the world have come together to raise awareness about autism spectrum disorder (ASD), advocating for acceptance, understanding, and inclusion. While awareness is crucial, it’s only the first step on the journey towards creating a more supportive and inclusive society for autistic individuals.

Over the years, there has been a significant increase in awareness surrounding autism. More people than ever before recognize the term “autism” and have a basic understanding of what it entails. This increased awareness has led to improved diagnosis rates and access to services for individuals on the spectrum. It has also sparked important conversations about neurodiversity and the unique strengths and challenges of autistic individuals.

However, awareness alone is not enough. We must move beyond awareness to foster genuine understanding and acceptance of autism. Understanding goes beyond recognizing the existence of autism; it involves learning about the diverse experiences of autistic individuals, their strengths, challenges, and perspectives. It requires us to listen to autistic voices and amplify their stories, allowing their insights to shape our perceptions and actions.

Acceptance is perhaps the most crucial aspect of creating an inclusive society for autistic individuals. Acceptance means embracing neurodiversity and recognizing that autism is a natural variation of the human experience, not a defect to be corrected or cured. It means respecting the autonomy and dignity of autistic individuals and valuing their contributions to our communities. Acceptance is about creating environments where autistic individuals can thrive and be their authentic selves without fear of judgment or discrimination.

As we reflect on Autism Awareness Month, let us recommit ourselves to the pursuit of understanding and acceptance. This means advocating for policies and practices that promote inclusivity and support for autistic individuals in education, employment, healthcare, and beyond. It means challenging stereotypes and combating stigma through education and advocacy efforts. It means creating spaces where autistic voices are heard, valued, and included in decision-making processes.

Building a more inclusive society for autistic individuals benefits us all. When we embrace neurodiversity and create environments where everyone can thrive, we unlock the full potential of our communities. We learn from each other, grow together, and create a world that celebrates diversity in all its forms.

So, as Autism Awareness Month comes to a close, let us carry the spirit of understanding and acceptance forward into the months and years ahead. Let us continue to work towards a world where every individual, regardless of their neurotype, is valued, respected, and included. Together, we can create a more compassionate and inclusive future for all.

In our journey through life, our mental health is influenced by a myriad of factors, with hormones playing a pivotal role, especially in women’s health. From the joys of pregnancy to the challenges of menopause, hormonal fluctuations can significantly impact mental well-being. In this blog post, we delve into how hormonal conditions like postpartum depression, pregnancy, Premenstrual Dysphoric Disorder (PMDD), and menopause can affect mental health and explore how psychotherapy can offer support and guidance through these complex times.

The Ripple Effect of Hormonal Changes

Pregnancy: Pregnancy is a time of profound hormonal changes designed to support fetal development and prepare the body for childbirth. However, these hormonal shifts can also affect mood and emotional well-being. While many expectant mothers experience the “glow” of pregnancy, others may struggle with anxiety, depression, or antenatal depression, which can impact their ability to bond with the unborn baby and prepare for the challenges of motherhood.

Postpartum Period: Following childbirth, the sudden drop in hormones like estrogen and progesterone, along with sleep deprivation and the pressures of caring for a newborn, can lead to postpartum depression (PPD). PPD goes beyond the “baby blues,” presenting a more severe and long-lasting form of depression that requires professional support.

Premenstrual Dysphoric Disorder (PMDD): PMDD is a severe form of premenstrual syndrome (PMS) that affects a small percentage of menstruating women. Characterized by debilitating physical and emotional symptoms, PMDD can significantly disrupt daily life and strain personal relationships.

Menopause: The transition to menopause involves a gradual decrease in hormone production, particularly estrogen and progesterone. This period can bring about a range of symptoms, including hot flashes, sleep disturbances, and mood swings, which can contribute to anxiety and depression in some women.

The Role of Psychotherapy

Understanding the interplay between hormones and mental health is crucial in providing effective care. Psychotherapy offers a supportive space to navigate these challenges, employing various strategies tailored to each individual’s needs.

Cognitive-Behavioral Therapy (CBT): CBT is effective in addressing negative thought patterns and behaviors associated with hormonal changes. It can help individuals develop coping strategies to manage symptoms of anxiety and depression, improving overall well-being.

Interpersonal Therapy (IPT): IPT focuses on the interpersonal relationships and social roles that may be affected by hormonal changes. It can be particularly helpful in addressing issues related to the postpartum period and menopause, offering strategies to improve communication and strengthen relationships.

Mindfulness-Based Stress Reduction (MBSR): MBSR techniques can be beneficial in managing the emotional and physical symptoms associated with hormonal conditions. Mindfulness practices encourage present-moment awareness and acceptance, helping to alleviate stress and improve mood.

Lifestyle and Nutritional Counseling: Integrating lifestyle and nutritional counseling into psychotherapy can enhance treatment outcomes. Regular physical activity, a balanced diet, and sufficient sleep can mitigate the impact of hormonal fluctuations on mental health.

Conclusion

Hormonal conditions can profoundly affect mental health, but with the right support and strategies, individuals can navigate these changes more smoothly. At our psychotherapy practice, we are committed to providing compassionate and evidence-based care to help our clients manage the psychological aspects of hormonal conditions. By understanding the complex relationship between hormones and mental health, we empower individuals to take control of their well-being and lead fulfilling lives.

Written By: Kat Heidelberger, LMSW

In the bustling heart of New York City, where the pace of life never seems to slow down, it’s easy to lose touch with the creative spark that ignites joy and vitality in our lives. However, creativity isn’t just an artistic endeavor; it’s a vital component of mental health. Here are some ways that nurturing creativity can enhance overall well-being.

Rediscovering Your Inner Child Through Creativity:

Creativity is often associated with childhood — a time when we freely expressed ourselves without fear of judgment or failure. As adults, especially in a goal-driven city like NYC, we tend to suppress this creative freedom, but it remains a core part of our being.

Engaging in creative activities allows us to revisit the uninhibited joy of our inner child. This might be through painting, writing, dancing, or even cooking. It’s not about the outcome but the process — allowing yourself to play, explore, and make ‘mistakes’ without self-criticism. This reconnection with your inner child can be incredibly healing, offering a sense of freedom and spontaneity that adult life often lacks.

The Therapeutic Power of Being in Flow:

Flow states, a concept popularized by psychologist Mihaly Csikszentmihalyi, occur when you’re fully immersed in an activity, losing track of time and self-consciousness. This state of ‘flow’ or ‘being in the zone’ is not only deeply satisfying but also contributes to mental well-being. 

Creative activities are a perfect gateway to these flow states. Whether it’s through writing a piece of music, getting lost in a drawing, or crafting, these activities can shift your focus away from stressors and negative thoughts, providing a mental break that’s both refreshing and rejuvenating. In flow, the mind gets a chance to rest from the constant chatter of life. It allows for a unique form of mindfulness, where the present moment is all that matters. The result is often a sense of peace, accomplishment, and a deeper connection to self.

Expressing the Inexpressible: 

Another crucial aspect of creativity in mental health is its role in emotional expression and healing. Creative expression offers a unique outlet for hidden underlying emotions, providing a way to articulate and process them when words alone may fall short.

Many times, emotions are complex and layered, making them difficult to verbalize. Creative pursuits enable you to express these feelings in a more abstract yet profoundly personal way. This process can lead to significant insights and catharsis, aiding in emotional release and healing.

Fostering Self- Understanding:

Engaging in creative activities can also be a journey of self-discovery. As you create, you might uncover hidden aspects of yourself, understand your desires and fears better, and cultivate a deeper connection with yourself. This self-discovery can be empowering, leading to greater self-acceptance and a more authentic life.

Creativity in Everyday Life:

You don’t need to be an artist to incorporate creativity into your life. It’s about finding what resonates with you. Simple acts like rearranging your living space, experimenting with new recipes, or journaling can spark creativity. The key is to approach these activities with a sense of curiosity and playfulness.

We are all inherently creative. By embracing these elements, not only do we improve our mental health, but we also enrich our lives with color, passion, and vitality. Let’s start this creative journey together, and rediscover the joy of living in the moment, one brushstroke, word, or dance move at a time.

Written by Kat Heidelberger, LMSW

It is common to experience work-related anxiety when there is so much pressure to perform at a high level while managing the responsibilities and dynamics that exist in professional contexts. While we may already experience stress related to the nature of our jobs, the sources of anxiety at work can be attributed to factors like job security, fear of failure, social hierarchies or environment, and vary across professions.

Anxiety also often spikes when it is time to bring up professional development conversations. This can look like asking for a raise or resigning from your current position. Thankfully, there are ways to feel less anxious when approaching these challenging but necessary exchanges. Here are some places to start:

Evaluate Your Reasons

Reflect on your reasons for having this conversation. How would it support your values and goals on a professional and personal level? Understanding your motivations can help you feel more confident in your choice and express yourself clearly at the time of the discussion.

Prepare Thoroughly & Rehearse

Is there any valuable information you could gather, such as details about the industry standards and the salary structure within your organization to support your points? Who are the right people to approach with your request?  Make sure to do your research ahead of time, document important points, and consult with trusted colleagues and mentors prior to the conversation. Practicing ahead of time can also significantly lower your anxiety around the flow of the conversation and its possible outcome. Write a script and practice it with a trusted friend or family member who can offer you feedback and encouragement.

Choose the Right Time

Make sure to request a private and scheduled meeting with your supervisor or HR professional. This way, you will ensure it receives the attention it deserves. If the conversation is related to a career advancement request or additional opportunities, choosing a time when your performance has been strong may also help.

Be Flexible and Open to Discussion

Approach the subject with flexibility and be prepared for negotiation. Understand that your employer may not be able to meet your initial request, so be open to hearing about other beneficial options or future considerations. Thinking of a backup plan can also lower the pressure and expectations related to the conversation at hand.

Focus on Positive Self-talk

Challenge and reframe negative thoughts by replacing them with positive affirmations or statements. Be kind to yourself and acknowledge your achievements and strengths as an employee. Remind yourself that you are worthy of having your needs met in order to maintain personal and professional fulfillment, and communicate from a place of self-compassion and confidence.

Stay Calm

Practice deep breathing and mindfulness techniques before the meeting to manage anxiety. Meditation, breathwork, writing a gratitude list, journaling, or a quick walk on a lunch break will allow you to feel more grounded and balanced.

Seek Professional Support

Consider speaking with a mental health professional as a highly effective way to manage work-related anxiety, especially when you feel nervous about navigating difficult conversations with your employer. A collaborative therapeutic process will provide you with guidance, support, and strategies for building confidence and effective communication. 

Whatever the professional development conversation you are approaching, you got this!

Written by Natallia Khalpukova, MHC Fellow

Mother’s Day is a day to celebrate our mothers for everything they do; their sacrifice, their love and their care. However, for so many people, even mothers, Mother’s Day presents an emotional challenge.

If you have been consuming social media recently, you have seen some videos of mothers talking about how this day has become a burden for them. One would think that when the day arrives, others would try to take away as much of the burden as possible so mothers can relax and enjoy the day. However, some mothers have found that they have to plan their own celebration. They will be asked, “what do you want to do today?”, which essentially gives mothers the mental workload of having to come up with ideas to plan their own day. Additionally, there are those mothers who have had no events planned for themselves and the other mothers in their life, so they end up having to step up and celebrate with each other.

There are also more painful reasons why Mother’s day is difficult to celebrate. There are those who are often reminded how their mothers are no longer with them. The first Mother’s Day after a loss will be the most difficult. Later, it can become a yearly reminder of this loss. It never gets easier to experience this day, but you will find a way to survive and celebrate positive memories each year.

Lastly, there are those with complicated relationships with their mothers. The relationship might be tumultuous, which makes it painful to see others able to celebrate their mothers. This can bring up unpleasant memories or trauma reactions. These individuals have probably grown up with mothers who are critical, neglectful and even abusive. 

If you identify with any of the above groups, finding community will ease the burden of this day. You are not alone in your discomfort with the day, so seek out others who understand your experience. This could mean joining support groups, reaching out to friends, or leaning on family members. 

Written by Leina Rodriguez,  LMFT

Being a parent is a 24-hour-a-day, 365 days-a-year job. You never stop being a parent; not in your sleep, not at college graduation, not at their wedding, and especially not when they have kids. You will always be this human’s parent; it’s wild! You will always walk this earth wearing your heart outside of your chest. Stress and anxiety may become your forever friends; foreva-eva, foreva-eva¹.

I am a Mom who experiences depression and anxiety. I am also the Mom of a 13-year-old girl who experiences depression and anxiety, so mental health is a daily conversation in our home. 

Anxiety had me in a chokehold at 13. It woke me in the middle of the night and distracted me throughout the day. When I started menstruating, my depression said, “it’s showtime”, throwing on a tophat, tails, tap shoes, and jazz hands-ing its way into my life. No one in my family knew what to do, and for years I suffered. There was a lot of crying, screaming, and panic attacks. When I became an adult, I learned about mental illness, started therapy, and found a psychiatric medication combination that fit me just right. I naively promised myself that my kid would never suffer the way I did.

Thirteen years ago, I gave birth to the most remarkable human being to walk the planet.  She was a great baby, a fun and loving toddler, and my ride-or-die until she was nine years old. At 10, anxiety, depression and puberty (a.k.a the dreaded period) came knocking and she was all, “wait til they get a load of me”. The last three years have turned my world upside down. I have never experienced this type of stress before. My anxiety levels are at an all-time high and on the weekends, I have difficulty getting out of bed.  

I was a fool because I thought I knew how to help my daughter navigate puberty. I thought I could throw on my supersuit and assemble like an Avenger with a child therapist to my right, a pediatric psychiatrist to my left. My personal knowledge and experience with depression and anxiety were my shield made of viburnum. But alas, my daughter Thanos-ed me². 

Some days I truly hate being a parent and want to tap out. There are days when her anxiety triggers my anxiety, my fuse is short, patience thin, and I have an overwhelming urge to scream, “I do not like you. Please leave me alone.” It is on those days that I must dig deep into my mental health reserve and ground myself. If I’m being honest, this doesn’t always work. There are days when the only way to the other side of these feelings is through them. I let myself feel anger, rejection, shame, hurt, and exhaustion; then I get up and I try again. 

There is nothing on earth that could have protected my child for her mental health journey; she came to me hardwired. It’s important to avoid the trap of blame when it comes to our kids’ mental health. Sometimes it feels like guilt and motherhood go hand-in-hand, but then I remember that my job is not to hide her from challenging experiences, it is to help her find the right tools for her mental wellness. I want her to thrive and be happy with her life. 

Every now and then, I get glimpses that she is actually internalizing my guidance in her own way. Recently, I had a severe panic attack. It was my first one in 13 years. My daughter found me in the fetal position, hyper-venting on our kitchen floor. She talked to me, and similar to her own reaction when she is panicked, I told her to leave me alone; and just like me, she didn’t listen. The apple fell pretty close to the tree. My daughter went into action by playing the one song that she knew would calm me. She sat with me and gave me the space to get through until I felt better. When I sat up, I felt exposed and raw. I thought, “how could I let her see me in this state?”. I felt so guilty for having her take care of me. Then I remembered the times that I’ve played music for her, sat with her, and attempted to soothe and ground her came back to me.

That day, my daughter showed me that through every battle she has had at the mercy of brain chemistry, she’s felt safe, secure, and cared for in a way that she wants to replicate for others. To me, that is priceless.

Written By: A Mom

 ¹Outkast, “Ms. Jackson”. Ms. Jackson, 2000.

 ²Whedon, J. (2012). The Avengers. Walt Disney Studios Motion Pictures.

Spring is finally here! Winter can be a challenging season for any of us. The cold weather and gray skies can trigger Seasonal Affective Disorder, lead to depressive feelings, or further social isolation. Spring is all about reawakening; flowers bloom, patios open up, and morning walks begin. 

‘Spring Cleaning’ is a phrase that is used to describe the deep clean we often do as Spring rolls around; winter jackets get stored, dust gets cleared, and closets are cleaned. It’s a time to refresh and look forward to warmer and sunnier days. Though we usually think of ‘Spring Cleaning’ in terms of physical space, the idea can be applied to mental health too! Below are five ways to clean out some of the anxiety of the past few months:

1. Identify Your Stressors

Sometimes we get so caught up in feeling anxious that we forget the reason we started feeling this way. Start thinking about the origins of these feelings. Did you have a stressful day at work? An argument with your partner? Maybe you are anxious about a mistake you made. Recognizing the cause of anxiety can help us understand how to move through it in a healthy way.  

2. Create a ‘Releasing Ritual’

Once you understand where your anxiety is coming from, visualize yourself releasing it. Intentional breathing can be helpful; when you exhale, think about the stressor and picture it falling away. If you want, the ritual can be a bit more physical or literal; write the stressor on a piece of paper, rip it up, and throw it out. Releasing comes in many forms, find the one that feels right for you.

3. Write Down Goals for the Future

Thinking about the future can alleviate anxiety in the present. Try to think of things you are excited for in the future. If that doesn’t work, write about something that you want to achieve, and focus your thoughts and energy on making a plan to get there. 

4. Socialize 

Spending time with friends can be a great anxiety reducing activity. Choose to surround yourself with people who make you feel positive about the future and confident in yourself. If you are comfortable, open up to your friends and family about your anxiety. They may have good resources or tips to help you with your feelings.

5. Organize

If things start to feel chaotic in your brain, organize the physical space around you. The act of organizing can settle feelings of anxiety and be a physical symbol of calmness in your mind. Traditional ‘Spring Cleaning’ might actually help you clean out your anxiety. 

These are just five examples of the many ways that you can take stock of and reduce your anxiety. Use the change in seasons as a turning point for your mental health management.

You may have heard the term “Therapy Animal”, but how much do you know about their role in the world of mental health care? As Animal Assisted Therapy (AAT) becomes more mainstream, it is important that we learn their role, training, and the benefits of the animal-human bond.

First things first, let’s differentiate the titles of working animals:

• Animal Assisted Therapy (AAT): An animal who has the training of a therapy animal (provides comfort, affection to persons in crises) but is accompanied by a handler who is a mental health professional and utilizes the animal in professional therapeutic sessions.
• Emotional Support Animal: A companion animal that provides therapeutic benefits to individuals with a mental and/or psychiatric disability; these animals are NOT pets, (handlers with Anxiety, PTSD, or other psychiatric disabilities).
• Service Animal: An animal who is trained to work and/or perform tasks that directly relate to their handlers’ medical needs. These animals are NOT pets, (handlers with vision or other physical impairments, seizure disorders, Autism, etc.).
• Therapy Animals: Animals specifically trained to provide comfort and affection to people suffering from mental disorders/episodes. Animals handler can be a volunteer with no mental health training (visits hospitals, etc.).
• Working Animal: Animals who perform specific tasks at an expert level, (detection animals or search and rescue animals).

I first knew that Gio was special when I was working with a client who was in extreme crisis. Gio allowed this client to pick him up and he just snuggled in and worked his magic! The client was able to calm themselves and engage in a therapeutic conversation.

From that moment, Gio and I engaged in multiple levels of training, and he was able to get certifications in 3 levels of Canine Good Citizenship. As the handler, I engaged in courses to teach me the skills to professional handle and engage with a therapy animal. As a licensed social worker, I have completed the coursework to be a certified Animal Assisted Intervention Professional.

The animal-human bond has been proven unique and therapeutic. According to a 2020 article from Medical News Today, the benefits of Animal Therapy and mental health can include:

• decreasing anxiety and stress
• decreasing perceptions of pain
• reducing feelings of fear or worry
• increasing feelings of social support
• provided motivation, stimulation, and focus

AAT is more than dogs! Cats, horses, birds, rabbits, have all been known to engage in the therapeutic process. And it is more than mental health; AAT has proven benefits with physical and occupational therapy among others. I have personally found that having Gio with me (in-person or through telehealth) can help the client relax – his antics and super cute face allow people to feel comfortable and calm. Although the concept of AAT is just starting to gain traction, I believe very soon it will become standard practice!

Written by: Melissa Mendez

Sometimes I wish I could be perfect in all aspects of life. Do you ever wish that? Do you find yourself wanting to be the perfect partner, employee, student, brother/sister, or friend? 

While the definition of perfection may vary between us, we ultimately want to achieve success because it makes us feel accomplished, validated, proud, and unstoppable. In some ways, trying to achieve perfection can increase focus and motivation. But what happens when the outcome is not perfect? How do you feel then? 

Realistically, nothing is going to be perfect, especially humans – we are built to make mistakes and learn from them. If you struggle with perfectionism, keep reading as I share five signs that you are a perfectionist and how to navigate the challenges with that come with it: 

‘Failure is Not an Option’

Fear of failure is common. Making mistakes doesn’t feel good and we might feel crummy about the mistake, but one of the best parts about life is that we can try again. If you take a chance and fail, take a lead from Aliyah and, “dust yourself off and try again.” For perfectionists, the idea of failing is paralyzing. Perfectionism hinders a person’s ability to take risks in their career or relationships, which compromises the growth that comes with failure. 

One thing I encourage patients who experience perfectionism to do is ask themselves, “what’s the worst case scenario?”. This allows you to walk through what you think might be the worst outcome(s) and help to ease any anxiety you might feel about taking a risk. The purpose of this exercise is to help you build confidence in your ability to cope with failure. It opens the door to facing your fears. 

Need for Control

Perfectionists feel the need to be in control of every situation or person they come in contact with to ensure a perfect outcome. This is not realistic, so it will often increase anxiety in folks struggling with perfectionism. A bit of advice in learning how to navigate your need for control is to identify what you do have in your control and focus on it. While it doesn’t completely dissolve the anxiety stemming from a lack of control, it is a baby step towards coping with perfectionism. 

The need for control might negatively impact your interpersonal relationships. If you find yourself struggling in your relationships due to your need for control, I encourage you to communicate with your loved ones about the anxiety and/or depression you experience when you feel a lack of control. This allows you to practice vulnerability and allows others to support you in what you need emotionally (i.e. a hug, verbal reassurance, understanding). 

Good vs Bad 

Perfectionism can ignite all-or-nothing thinking, but life does not operate on an all-or-nothing program – it exists in the gray area.  It might be paralyzing for folks with perfectionism to accept more than two outcomes in their life. One way to challenge all or nothing thinking is by reframing all-or-nothing thoughts. Ask yourself: what is another perspective on the situation? Use the answer to this to remind yourself of the variability of each situation.

Critical of Self & Others

Fear of failure, need for control, and all-or-nothing thinking creates a domino effect. For example, if you fail at something because of a lack of control, it might trigger self-critical thoughts. Alternatively, if you are a perfectionist, you might actually be fueled by self-criticism. 

Witnessing others not striving for perfection can evoke critical reactions from a perfectionist, regardless of intent. While some perfectionists thrive off of being self-critical, it is not the same for others. If you find yourself judging someone else because they are not executing a task in the ‘right way’, practice walking away from the situation or de-centering yourself from the situation. 

Self-worth is Dependent on Accomplishments

Recognizing your achievements in life can lead to increased confidence. If you work hard towards a goal and it pays off, you should celebrate that! There is nothing wrong with a desire to achieve your goals in life, whether it be in career, education, or relationships. However, if your self-worth is dependent on only your successes, you might be battling with perfectionism. 

Perfectionists often experience bouts of sadness and self-loathing if they feel they have not successfully accomplished a goal. An exercise that can help you cope with perfectionism is practicing self-compassion. For example, if you start to feel depressed due to perfectionism, talk to yourself as if a loved one was sitting in front of you, needing support. Oftentimes, it is easier for us to have more compassion for others than we do ourselves, which is why this exercise can be challenging but rewarding. 

While this blog highlights five signs of perfectionism, it does not mean you are a ‘bad’ person if you see these signs in your behavior. Anyone can address the parts of themselves that may be impacting their ability to live a fruitful life. I highly recommend you speak to your therapist or schedule an intake session with one of the many brilliant Refresh therapists who can help you work through the difficult memories and emotions that arise when you think of how perfectionism has negatively impacted your life. 

I will leave you with this, “On this sacred path of Radical Acceptance, rather than striving for perfection, we discover how to love ourselves into wholeness.” – Tara Brach (Radical Acceptance: Embracing Your Life With the Heart of a Buddha).