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At The Center for Stress and Anxiety Management, our psychologists have years of experience. Unlike many other providers, our clinicians truly specialize in the diagnosis and treatment of anxiety and related problems. Our mission is to apply only the most effective short-term psychological treatments supported by extensive scientific research. We are located in Rancho Bernardo, Carlsbad, and Mission Valley.

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Read our award-winning blogs for useful information and tips about anxiety, stress, and related disorders.


Filtering by Tag: suicide

Depression: The Autoimmune Disease Of the Mind

Jill Stoddard

Written by Marnie at

Depression: The Autoimmune Disease Of the Mind

I’ve seen so many great tributes to Robin Williams in the past 24 hours. I hope he knows how much he affected others in a positive way. That, despite his inner torment, the fact that he made people laugh was able to penetrate the immense sadness he must have felt and give him some sort of peace … even if only for a little while. In fact, peace is something those of us with depression rarely feel.

I hate the word “depression”.  Frankly, it’s depressing. And I hate the commercials about it. You know those Cymbalta commercials? Depression hurts; Cymbalta can help. They show these scenarios of people having trouble getting out of bed, or not even wanting to play ball with their dogs. The truth is, sometimes depression probably does look a lot like that. But sometimes it looks like Robin Williams. Sometimes it looks like comedy, as that is one of the many coping mechanisms people with depression use. Sadly, with people like Robin, it masks something much deeper and darker. Sometimes it looks like a busy schedule. Sometimes it looks like forgetfulness. Sometimes it looks like the person standing up on the podium, accepting an award. As Glennon Melton from Momastery said in a recent post, “People who need help sometimes look a lot like people who don’t need help.”

A friend of mine recently broke my heart with a Facebook status update that said something about how she has an autoimmune disease and that, while she might look happy and healthy on the outside, the pain can be unbearable. It was such a simple statement and yet really had an impact on me, as my mother has had chronic pain her whole life but, to the outside world, she looks fine. In fact, she’s gotten dirty looks and even comments from people for using her Handicapped placard.

Depression is the same way. It’s an autoimmune disease of the mind. For all intents and purposes, many of us who have it look fine on the outside. We might even be somewhat, if not very, blessed by our life circumstances. Abby Heugel put it perfectly on her recent Scary Mommy post, saying, “These are the times that I should reach out, but the thing about depression is that it comes with the sense that you shouldn’t have it to begin with, that it’s a bunch of self-indulgent navel gazing and not an actual illness like those that everyone can see looking in.”

Despite everything good in our lives, the negative thoughts persist in our minds and hearts. Its attack on ourselves feels silly, embarrassing, ridiculous, hateful, awful, confusing, shameful, and a whole bunch of other emotions. When I’m tired, it attacks the most, sensing the weakness within.

Physically, I’d consider myself one tough mother f*cker. In fact, when I was little, I had an unusually high pain tolerance. I went to bed once on a broken wrist that my parents didn’t even know about until they saw me the next morning with an arm that had swollen to twice its size. I once let a man stand on my fingers at a baseball game until they were completely flattened because I didn’t want to say anything. I sprained my ankle a week before my first marathon but ran it anyway, having to stop and get it taped about three times. And yet the feelings of melancholy can crush me like I’m a cancer-ridden 100-year-old.

I hate saying but the truth is I suffer from depression. Some days are great and others are horrible but, you know what, that’s life. I have to learn to accept myself the way I am and not be afraid to talk to others about it. And if you need someone to listen, I’m your gal. In the meantime, when you’re out and about doing your daily deeds, remember that things are not always as they seem. Be kind. Be gentle. Be aware that others might be suffering beyond belief despite that fancy, new car, perfect hair, or insanely clean house. Give meaningful hugs and warm smiles. You never know what those could do for someone who is feeling at the end of his rope.

RIP, Robin Williams. You were loved.


America's Suicide Problem Pt. 2: Getting Help

Jill Stoddard

by Lucas Myers


In our last blog, we discussed what suicide is and the high rates of suicide impacting many of us nationwide. Now it is time to talk about solutions. If you or someone you care about is thinking about suicide, stop and think for a moment about who you could go to for help. Regardless of your age, think about who the trusted adults and friends are in your life. It isn't an easy conversation to have, so if you or someone you know is struggling, it can be really helpful to have a caring person in your corner. If a person is in need, she may be working hard to hide how she feels, but hoping desperately that someone notices how much she is hurting. If you need someone to talk to and you don't have the words to ask, start with “I need help”.

If someone comes to you for help, the first thing you should do is stay with the person in need. Don’t leave her alone. Unless there is a threat of harm to you, stay with her even if it’s just on the phone. Even if you’re going to be late for work, or school, or dinner at Mom's, stay with her, others will understand.. 

Next, listen; really listen. There is an old saying that we were given 2 ears and 1 mouth so we could listen twice as much as we speak. This is too important to make a joke or dismiss the person’s concerns. Be supportive. There are some tough questions you can ask that will show you care. “Are you ok? Are you thinking of hurting yourself? Will you go with me to get help? Who would you like to talk to?” These questions are about getting the help needed to survive this crisis. 

The most important thing you can do is to get help. Chances are, you aren’t a trained counselor. Getting help is essential because this isn’t a simple situation you can handle on your own. Even though I’ve received training in crisis counseling and suicide assessment, the first thing I do with a person in crisis is to notify my supervisor for backup. It’s always OK to ask for help. It is ALWAYS OK to ask for help. This problem is bigger than one person, so ask “Are you getting help? Can I help you get help?” There are two numbers that you can use to get help. 1-888-724-7240 is a local San Diego crisis line available 24-7. The other number is a national number you can use if the crisis is out of the area and that is 1-800-273-TALK. These numbers are both nation-wide and toll free 24-7. You can call and speak to a professional for immediate help. Also, don’t be afraid to call 911. This is an emergency. 

Your friend may ask you to keep what he’s told you a secret. Don’t do it. This is too important. You are not a friend if you’re letting the person you care about keep all that pain to himself instead of getting help. This secret is not worth dying for.

How do we know if someone needs help? The major warning signs are actually pretty obvious. If you hear someone is threatening to kill himself, looking for ways to kill himself, or talking or writing about suicide or death you need to find help immediately. We can’t afford to ignore statements like “I wish I was dead. I never should have been born. You would be better off without me.” These are cries for help. A person who is contemplating suicide may feel hopeless, angry, or vengeful, and act recklessly without thinking. If something seems wrong and you are worried, get help immediately. For someone in a suicidal crisis, help can’t wait. What happens if your friend was just being dramatic and you called 911? He might be pretty embarrassed, he might have some explaining to do. What if he wasn’t being dramatic? Boom. Embarrassment just became the best-case scenario. Better to lose a friendship than to lose a friend.

Pay attention if your friend suddenly starts using more drugs and alcohol. 50% of those that attempt suicide are under the influence, most frequently alcohol. People who feel suicidal might seem moody, anxious, agitated or sleep all the time or not at all. Often, suicidal people give away their favorite things to their favorite people, or stop participating in their favorite sports and activities. Adults may pay off all the bills or update their will. If a teen quits the team or tries to give away her iPod, surfboard, Xbox, or favorite boots to her best friends, she might be saying goodbye. This is a big one because the adults in a teen's life probably won’t know about it if friends don’t speak up. If someone suddenly doesn’t want to hang out with her friends or avoids talking to her family, she may be withdrawing in preparation for life to end. This is when your friend needs you the most. Take her out to do something she might enjoy, or if she won’t go out, then go to her. Don’t put it off. Spending time with someone who cares is especially important because people who are depressed or suicidal often feel an intense sense of loneliness and worthlessness. 

In addition to warning signs, we can also look at risk factors. Breakups, divorces, major life transitions like changing schools, jobs, or moving away from friends, trauma or loss such as death of loved ones, abuse, or bullying are all potential risk factors for depression or suicide. If you or someone you know is being abused, tell a trusted friend or adult. Nobody should have to put up with physical, sexual, or emotional abuse. These days bullies are on Facebook, in school hallways, at work, and even texting on your cellphone, and it's hard to get away. Many adults and teens don't know that lesbian, gay, bi-sexual, transgender and questioning youth are 4x more likely to attempt suicide than their heterosexual peers because of the way they are treated in their homes, schools, communities, and religious institutions. If you see someone who can’t stand up for himself then stand up for him. We don’t have to tolerate hate. No one should suffer alone.


We’ve got to take care of ourselves too. Everyone feels overwhelmed sometimes, but there are some really simple things we can do to cope. Two of the best things we can do are exercise and eat healthfully. In fact, since the early 1980's, research has shown that regular exercise may be as effective as antidepressant medication for combating depression. Also I highly recommend dark chocolate. Very helpful tool, boosts serotonin, a happy chemical in your brain. Add it to the grocery list. Laughter and keeping your sense of humor is another way to cope. Keeping busy with activities or working with others as a volunteer to make a difference in your community is a great way to feel good about your life. These are good supplements to professional treatment and are good coping strategies even for people who aren’t feeling depressed to decrease overall stress. 

If you would like to speak with a professional at The Center for Stress and Anxiety Management, you may contact us at 858-354-4077 or To see a list of other mental health conditions that we specialize in, click here.


American Association of Suicidology from:

San Diego Unified School District Youth Risk Behavior Survey from:

American Foundation for Suicide Prevention from:

Walcutt, D. (2009). Chocolate and Mood Disorders. Psych Central. Retrieved on September 14, 2013, from disorders/

Pedersen, T. (2013). New Guidelines for Using Exercise as an Antidepressant. Psych Central

Retrieved on September 14, 2013 from: exercise-as-an-antidepressant/54728.html

Tags: anxietytherapymental health treatmentSan Diegosupportdepressionsuicidestigma

America's Suicide Problem, Pt. 1: It's Serious

Jill Stoddard

by Lucas Myers


The week starting September 8th is National Suicide Prevention Week. Did you know we are losing 34,000 Americans every year to suicide? 5,000 of these are teenagers. For every one completed suicide there are 100-200 attempts. If you do the math, that’s 5000 x 100 or 200 = between 500,000 and a million suicide attempts every year by people between 14 and 24 years of age. That’s a big, big, deal especially because we have learned that if someone has attempted suicide once, they are at a much higher risk to attempt it again.

Did you know that suicide is rising faster in youth between 10 and 14 than in any other age group? What grade are you in when you’re 10 years old? 5th right? Some of us probably have family, friends, or neighbors that age. Did you know that suicide is the #2 cause of death for college aged Americans? Right here in San Diego, on average, we lose one teen between 15 and 19 years old to suicide every month. We’re losing children, friends, nieces, nephews, cousins, brothers and sisters to suicide every day, and sometime in your life suicide may affect you or someone you know.

There is a myth about suicide that if you talk about it someone will attempt it. Does that make sense to you?

Of course not.

People that attempt suicide are in pain. They feel alone and they feel that they have no other way out. They need to talk! Some people think that when someone decides to attempt suicide there is nothing you can do to stop them. Well everyone has good days and bad days right? Suicidal feelings are usually temporary, but suicide is permanent. These people have usually had a lot of bad days in a row, and that is called depression, and they need help. As much as 90% of suicides are the result of an undiagnosed mental illness, mostly depression. That is awesome news, because although we can’t see depression, , we can treat it. Suicide can be prevented. Depression treatment has a very high success rate. Medication can be helpful and therapy can teach those suffering from depression methods for getting healthy and feeling good. I’ll tell you more about that later. For now, I want you to remember that you may not be able to help getting depressed, but you can help yourself get help.

If you are concerned that you or someone you know might be thinking about suicide get help! In an emergency, call 911. For information and support there are two numbers that you can use to get help. These numbers are both nation-wide and toll free 24-7. 1-888-724-7240 is a local San Diego crisis line. The other number is a national number you can use if the crisis is out of the area, that is 1-800-273-TALK. 

Over the next few weeks, this blog will be sharing a story about the author's personal encounter with suicide and sharing tips for how to recognize and prevent suicidal behavior. The first step toward preventing suicide is to start conversations and take away the stigma that isolates people with suicidal thoughts. Please check back to learn more and share these blogs with the people you care about.

If you are suffering from anxiety or depression, don't wait until it becomes a crisis. 

If you would like to speak with a professional at The Center for Stress and Anxiety Management, you may contact us at 858-354-4077 or To see a list of other mental health conditions that we specialize in, click here.

If you are interested in spreading awareness on how to prevent suicide in San Diego you can learn more from Yellow Ribbon of San Diego.


American Association of Suicidology from:

San Diego Unified School District Youth Risk Behavior Survey from:

American Foundation for Suicide Prevention from:

County of San Diego Health and Human Services Agency, Emergency Medical Services, Medical Examiner database, 2001-2010.

San Diego Community Health Statistics Suicide Report 2011

Tags: anxietytherapymental health treatmentSan Diegosupportdepressionsuicidestigma