Good Self Care is Not Selfish

“You’ve got to be kidding” is a common response from women when I talk to them about resting. Even young women who’ve never lived independently often do not understand real rest. It isn’t about sleep. It’s about being calm, fully present, and awake to your life. Entire books have been written about women doing too much. We multitask madly, worry about everything, feel guilty about everything, and take care of everybody else better than we do ourselves. These are generalities, but they’re also realities for many women. I’ve seen it more times than I can count over my decades of psychiatric practice. Full time job, full time mothering, partnering, homemaking, and a dozen other things equals one worn out woman with zero sense of herself. Know ye this: Taking care of yourself is not selfish!

True rest is hard to come by in our world of overstimulation and excess. When we have three seconds, we grab our phones to answer an email or send a text. Our days go by faster and faster as we stuff them ever fuller. Sometimes we stay busy to avoid pain—the busy defense. As in, “I’m not anxious. I’m too busy to be anxious.” Or, “I’m not sad. I have too much to do.” Or, “I can’t be depressed. Look how much I get done.”

Physical hunger, emotional hunger, intellectual hunger (boredom), relational hunger (loneliness), and spiritual hunger leave us empty. When we feel empty, we try to fill the hole with an endless, meaningless stream of stuff—drugs, alcohol, food, control over food, perfection, sex, money, relationships, clothes…. None of it covers the emptiness of not living mindfully from our real selves….

Body, mind, and spirit need rest to function. Choose one rest day per week and practice resting. Yes, I’m serious. Don’t read, don’t sleep, don’t listen to music, don’t talk or text or answer the phone. Put the phone in the other room and turn it off if that’s what it takes. The point is to do nothing. Set a timer for 20 minutes so you don’t clock-watch. Sit in a pleasant, quiet place—preferably outside or near a window. Lift your eyes up and out toward the bigger world. Without judging, notice small details—sky, birds, trees, scents, sounds—whatever is there. Just notice. Don’t do anything about it, with it, or to it. When the timer goes off, sit quietly as long as you need and take that peace and quiet with you through your day.

**Excerpted from “90 Ways in 90 Days: A Personal Workshop for Women with Disordered Eating” by Deborah V. Gross, MD. Now available on Amazon

Dr. Deborah Gross is licensed to practice psychiatry in all of Pathway Healthcare office locations (Alabama, Mississippi, Tennessee and Texas). She treats men and women.

Co-Occurring Disorders and Domestic Violence

Co-Occurring Disorders As It Relates to Domestic Violence

October is domestic violence awareness month and it is important to bring to light the issues that cause domestic violence. Domestic violence is much more than physical assault. Domestic violence can also include non-physical behaviors such as: emotional abuse, verbal abuse, sexual abuse, financial abuse, spiritual abuse, and elder abuse.

As a society, we are doing a much better job at not turning a blind eye to domestic violence and the stigma associated with it. However, it is simply not enough to focus on the actions of the perpetrator, but we must also understand what causes the behavior and what the outcomes might be. As we continue to study things such as trauma, PTSD, mental health disorders and substance use disorders, we are continuing to find the relationship between domestic violence and co-occurring substance use and mental health disorders.

As we begin to better understand the correlation between the co-occurring disorders, we can see how there is hope in treating both those who are victims of domestic violence and the people who commit domestic violence. As we study the disease of addiction and mental health, we can determine what genetic and environmental factors contribute to these diseases and how they may present in each person. For instance, a child who was brought up in a home that experienced violence and/or active substance use (drugs or alcohol), would be at an increased risk of becoming a victim or a perpetrator of domestic violence (based on ACE scores).

“The World Health Organization reports that women who reported partner violence at least once in their lifetime are nearly 3 times as likely to have suicidal thoughts and 4 times as likely to attempt suicide. Compared to those who have never been abused, survivors are 6 times as likely to have a substance use disorder.”[1]

Therefore, it is important for a person who has experienced or is experiencing domestic violence to undergo an evaluation by a psychiatrist or licensed counselor to determine the amount of trauma one has experienced and how that may be affecting or could affect decision making or one’s mental health. Additionally, simply incarcerating the offender without properly treating the offender, may result in a re-offense because underlying issues have not been addressed or dealt with.

If children are involved as witnesses to the domestic violence or are also suffering some level of the violence, they will also need evaluation and treatment so to not perpetuate the cycle of abuse (whether as a victim or a perpetrator).

It is important to note, however, that domestic violence isn’t necessarily caused by the substance use, but it can contribute to the violence. Some perpetrators may use drugs or alcohol before committing an act of domestic violence. Substance use and mental health disorders affect a person’s control in some way. Not being able to clearly control one’s behavior and not being able to comprehend the consequences of one’s behavior contributes to domestic violence. Additionally, because people often act differently when under the influence of drugs or alcohol or during a mental health episode, the domestic violence issues can look different for different people, and different from past situations.

The only way to end the cycle is to admit there is a problem and get help. Both parties are affected and one party cannot fix the other by staying in the situation when there is danger involved. Professional help can help determine what is triggering the need for drugs and/or alcohol, as well as diagnose any underlying mental health issues. Once these issues are discovered, a plan of action can be put in place to help everyone involved.

There is hope and we help people. If you are experiencing domestic violence or have experienced past domestic violence, we want to help you find healing and get on a healthy path. We offer individual treatment plans on an outpatient basis to find what is best for you. We also offer family counseling. We have a team of professionals who can help with medical needs, including treatment for substance use and alcohol use, and mental health needs, including psychiatrists and licensed counselors.

We have offices in four states (Alabama, Mississippi, Tennessee and Texas) spread across fourteen locations. We accept most insurance plans, Medicare, Medicaid and cash pay. We are accepting new patients in all our offices. Call 844.728.4929 or visit www.pathwayhealthcare.comfor more information.

If you are not the one suffering from domestic violence but you know someone who is, please share this with them and let them know there is help and hope available.


Suicide and Self-Care: Protect Your Risk From One With the Other

Suicide and Self-Care: Protect Your Risk From One With the Other


Everyday we are faced with any number of stressors that can stretch us emotionally, mentally and physically. Knowing beforehand that these stressors can affect us helps us better understand how to deal with the stressors. Proper self-care is important to keep us healthy. Self-care is not selfish care. It is actually care that will help us help not only ourselves better, but also help others.

Below are some options for proper self-care:

  1. Find a therapist, counselor or psychologist whom you trust and feel free to speak with. Often times, having a trusted non-biased person to talk to about your fears, your struggles, your questions, and your doubts can bring these issues to light so they can be addressed in a safe manner. The more we bottle our feelings and think they have no value or need to be addressed, the larger the crisis can become internally. Be honest with the medical professional you choose. If you only give them part of the story, they can’t help you fully. Remember, they are there to help you because they want to, not because they have to.
  2. Make the time to do something physical: take a walk, a bike ride, exercise, yoga, stretching, hit some golf balls, tennis balls or baseballs to relieve stress and anxiety. Physical activities release endorphins that can help with mental health clarity.
  3. Find stories of hope. Many times when you are struggling with anxiety and hopelessness you feel completely alone. However, there are many who have walked in your shoes and have survived and are thriving. Discover what gave them this hope to live. Don’t dwell on negative stories, but instead find hope in the positive ones.
  4. Find resources that can help you. For many people, stressful times trigger emotional and mental health responses that do not happen when “life is normal.” Unemployment, a health crisis or diagnosis, a move, the loss of a friendship or marriage, or the sickness of a loved one can be hard to balance and manage alone. However, know that there are many resources available to help. 
  5. Do not stop taking prescribed medication. If you are feeling unstable emotionally or mentally at the moment, do not stop taking or increase your dosage without first talking with your medical professional. Sometimes it may be necessary to adjust your medication, but do not make that choice alone. Again, remember, your medical professional is there to help you.
  6. Helpers find help; don’t burn-out. Many people find themselves to be helpers; always helping others but rarely helping themselves. Without proper self-care, helpers can be buried under the weight of it all. Know that you can only help others when you have been helped yourself. Proper self-care is important for the helpers, too.

Even in the darkest of times, there is always hope. Do not try and suffer alone. We would love to be a part of the team that helps you navigate proper self-care. Call us today at 844.728.4929 to schedule an appointment to speak with one of our licensed counselors or psychologists. We are all in this together.

(The suicide prevention line for confidential support available 24/7 for everyone in the United States (1-800-273-8255)).


A Statement From Our CEO for Our Military Members and Their Families


I know that these are hard times for everyone and our veterans and active duty military, and their families, have not been immune from difficulties. Fear, anxiety, depression, anger, and despair are rampant, and an urgent crisis.

I want to remind you there is hope. Please do not struggle alone.

If you need help, call someone – reach out to one of our Pathway Healthcare offices, or some other mental health resource. Help is available and hope remains.

With all sincerity,

Scott Olson

Co-Founder/CEO and United States Air Force Veteran

Why is Depression in Women More Prevalent?

Depressed Female in Dark Room; An Example of Depression in Women

It is widely documented that a woman is twice as likely as a man to experience major depression in her lifetime. This increased risk exists independent of race, geographical residence, or ethnicity. There are several factors explaining why depression is more prevalent in women than in men. These factors can be characterized as hormonal changes, other biological factors, personal life experiences and circumstances, or inherited traits.



It is normal for girls to develop mood swings during puberty, but other factors can also contribute to depression during this period. Among these are conflicts with parents, increased pressure to achieve in different areas of life (such as school or social life), and emerging identity issues. Girls are also more susceptible to depression at an earlier age than boys because they reach puberty earlier.


Women experience hormonal changes during pregnancy, which also contributes to mood swings. However, there several other factors that increase the risk of developing depression during pregnancy. These include lifestyle changes, lack of social encouragement, unplanned pregnancy, relationship problems, stopping antidepressant medications, or miscarriage.

Premenstrual Problems

Typically, the symptoms of Premenstrual syndrome (PMS), such as abdominal bloating, headaches, irritability, and breast tenderness, are short-lived and minor. Yet for some women, PMS can be severe and can greatly disrupt their social lives, work, studies, and even relationships. Women experiencing severe PMS symptoms tend to suffer from a form of depression known as premenstrual dysphoric disorder or PMDD. Other factors, such as adverse life experiences, previous depression episodes or inherited traits, can contribute to depression in women during this premenstrual period.

Postpartum Depression

It’s normal for a new mother to experience the “baby blues” soon after giving birth (within one or two weeks). These symptoms may include anger, sadness, or irritability. Crying spells may occur as well. When, these symptoms of depression in women during this period become severe or last longer, they can develop into the full syndrome of postpartum depression. This illness may include low self-esteem, continuous crying spells, sleeping problems, thoughts of suicide or of harming the baby, anxiety, or an inability to care for the baby. Postpartum depression is serious and requires immediate treatment. It is often the result of major hormonal changes, infant complications, poor social support, or breastfeeding problems.

Perimenopause and Menopause

Most women who transition to menopause or the perimenopause stage don’t develop depression, but certain factors increase a woman’s risk. These include sleeping problems, previous depression episodes, weight gain, adverse life circumstances, early menopause, or the result of a medical procedure like surgical removal of the ovaries.

Life Experiences And Circumstances

According to statistics, there are different life stressors that can contribute to depression. Although these circumstances can also apply to men, they’re more likely to affect women, and can therefore cause higher rates of depression in women. One example of a depressing life experience occurs when women experience a lower position power in their societies, either by earning less, or, at times, by living in poverty. This may lead to anxiety, low self-esteem, and a feeling of negativity, all of which may lead to depression. A sense of overload from an excessive burden of responsibilities, such as single parenthood and a heavy workload, can also lead to depression in women. Additionally, women who were abused as children or adults, either physically or sexually, are more likely to experience depression at some point in their lives.

Common Signs Of Depression In Women

Based on the statistics gathered in 2017 by Our World in Data, the prevalence of major depression in women was 4.7%. For the men, it was 2.7%. Common signs of depression in women include:

  • A feeling of guilt, helplessness, worthlessness, and pessimism
  • Excessive crying, sadness, restlessness, and irritability
  • Suicidal thoughts
  • Sleeping too little or too much
  • Weight loss/gain
  • Difficulty concentrating or failure to remember details
  • Loss of interest in pleasurable activities such as hobbies or even sex
  • Headaches, aches, chronic pain, or digestive issues
  • Anxiety or tension
  • A feeling of being out of control

If a woman, her caregiver, a family member, or friend notices signs of depression, she should seek treatment immediately to improve her quality of life. Depression in women is simple to diagnose and treat. The mental health specialist or patient care coordinator will ask the patient a series of questions to determine the severity and persistence of the depression.

For quality medications and therapy for women suffering from depression, Pathway Healthcare is the ideal choice. We have many qualified and experienced doctors, therapists, and patient care coordinators on staff that will provide any woman suffering from depression the best medication and therapy treatment available. Contact us today.


References 047725