Elisa A. Escalante/ LCSW/ 03-27-2026
Various mental health disorders/ issues require us to do the exact opposite of what we want to do, because we have the disorder. This is the strain of mental health. It isn’t rainbows and butterflies, rather, it’s pushing people to sit in discomfort, or to do the very things that may trigger them. This is why many people run away from treatment or avoid it all together. The idea of change, though hopeful, is very hard to do.
Depression causes people to suffer through low energy, low motivation, lethargy, lack of purpose, numbing, sadness etc. The last thing people with depression want to do is go on walks, get outside, plan social time with others, or explore ways to feel purpose. But, they need to do those things in order to simply ‘manage’ the depressive symptoms. Will they be happy? Not necessarily. They will manage it, still feel somewhat depressed, and tired while pushing themselves. It is vital that they give themselves permission to ‘zombie’ through their coping skills. Zombie walk, zombie chores, zombie shower, zombie hobby, zombie study, socialize in small spurts, and definitely get some rest when they complete their tedious tasks. Affirm that it is quite the accomplishment to still do healthy things even when their minds and bodies are working against them daily. They must always put something on their schedule to look forward to. They must always move, the pace is irrelevant. They need purpose, especially on the days where living life feels pointless. They need to stir up the monotonous/ boring routine with adventures. They need gratitude and positive affirmations as their mind plagues them with pessimism, brain fog, and or numbing. They need comedy and laughter to combat the misery. They need some solitude in order to recharge their social batteries but then have social time in spurts for connection and oxytocin.
Low Self Worth/ Self Love: How does one self love when they are filled with self hatred from their own childhood traumas? They lack the capacity, they were not taught the skills, they may be walking around with shame and the sense that they are burdensome and the abuse was their fault. They have self destructive tendencies, not self love. I believe to start in the right direction, we must recognize that self love could be unattainable, and perhaps starting with self acceptance is a more reasonable goal. It starts with using humanizing language, reframing distorted thoughts, while challenging outdated survival programs that helped solely when the patient was living in survival mode. Behaviorally, these patients will also have to ‘force’ themselves to do self care even when it feels unnatural or pointless. It has a backwards effect. They do not self care because they care, they do it because they ‘have to’, and in turn, it can turn into a habit/ ritual. The healthier self care/ grooming, over time, may change how they see themselves. What may first start as an obnoxious healthy habit that they ‘have to do’, can turn into very real visible benefits that they eventually want to keep up. Looking healthy will help them feel healthy. Feeling healthy will reinforce that the habit is worth the upkeep. Then they can humanize themselves and see that they are deserving of self care, and their body and mind are thanking them for the effort.
Anxiety: Anxiety leads people to talk themselves out of things, shy away from risk, and their minds are tortured due to thinking about all of the worst case scenarios. When it get’s severe, it could turn into full blown agoraphobia where they rarely or never leave their homes.; all to avoid the external danger/ triggers. The reason this perpetuates anxiety, is because if they don’t take risks, they don’t prove to themselves that they are capable of some things, or learning from mistakes without the world ending. If they do not step outside of their home, they do not prove to themselves that they can go out, have fun and stay safe. No proof of safety allows the anxious brain to convince itself that those concrete beliefs, are without a doubt, the reality of their world. Is danger a fact of life? Yes. It is happening everywhere? 24/7? Never. Also, cognitively, it works very much like a stereotype. The anxious brain is wired to danger seek, and therefore will ignore everything that proves it wrong and hyper focus on the danger/ risks that prove the mind correct. They also must remind themselves, through affirmations of safety, that they are living life, breathing, walking, running errands, and doing things where they end up safe, and still alive. They will still need their daily spurts of Non stimulation time where nothing is coming at them, where they can calm their sympathetic nervous system; deep breaths, meditation, aroma/ art therapy, journaling, reading, baths/ showers etc.
Raising kid’s with ODD: We can look at oppositional defiance in kid’s as a ‘survival strategy’. Now, what are they surviving? Too much overwhelming tasks; homework, studying, chores etc. What are they protecting? Their own energy. ODD is about energy conservation. This is why even when the chore in question makes perfect sense, the child might still resist it. Parents will grow impatient and frustrated and likely discipline the ODD child. Unfortunately, this will perpetuate the ODD more. When the child feels and believes they are bad, they act up even more. They also learn to not fear the risks of getting in trouble, so the yelling and discipline is not longer a motivator for them to ‘do better’. They receive lectures and chores from teachers, mentors, parents and coaches daily. But, where is the praise that can reinforce that doing positive things will help them feel positive and confident? Praising a ‘bad’ child sounds… odd, right? Praising them for completing homework, even if we believe it’s something ‘they just oughta do’ no questions ask. Praising them for not yelling/ kicking as much as they did last week. Praising them for when the school doesn’t call again with another complaint. Praising them for doing a chore they hate. Praising them for getting even one of their grades up. Modeling by example and showing them that doing healthy things can improve mood and the dynamics around them. A household that punishes all of the wrong doings, and never praises the accomplishments (even minor ones) will often perpetuate ODD.
Conclusion: This is why mental health work takes time to work. Imagine if in a first session I told a depressed person to ‘just workout and get more sunlight and talk to friends’? Imagine if I told an anxious person they need to push themselves and go out and take the damn risks? Imagine if I told the parent that is struggling with a difficult child to be nice to their child and treat them better? Imagine if I told someone that cannot love themselves to do the self care anyways? They would run away if they were over saturated with interventions that they do not believe they have the capacity to do. And, they would feel insulted. Like I’m throwing blanket solutions at complex problems. And, they are in fact, complex and chronic conditions. Some may require lifelong management. Before behaviorally modifications can even be made, we have to listen to why they exist in the first place. With empathy, with compassion, explore the parts of them that needed their survival strategies in the hardest/ darkest times.
Functionally Mental 