You’re struggling financially. It might be because you lost your job, you left a relationship that wasn’t working, you’re struggling with addiction, or simply because you’re a young person living on your own for the first time. Whatever your circumstances, you’re having a difficult time making ends meet. You have cut frivolous expenses from your budget, but you’re still struggling to pay for groceries, let alone rent. You’ve stopped spending time with friends and family, because you can’t afford the gas. As a result, you’re feeling frustrated, lonely, isolated, and maybe even ashamed. It probably won’t come as a shock to anyone that faced with financial issues like these, people are much more prone to depression (Patel, 2018). In fact, 6 of the 10 poorest regions of the United States (Oklahoma, Arkansas, Louisiana, Alabama, West Virginia, and the District of Columbia) experience some of the highest rates of depression in this country (Friends Committee on National Legislation, 2022) (Feder, 2020). It’s not just the United States either. Income inequality has been rising steadily over the last thirty years worldwide, with many countries seeing an increase in individuals experiencing symptoms of depression (Patel, 2018). To make matters worse, one-third of US citizens say they cannot afford therapy (Han, 2022). This is to say nothing of the additional costs – such as transportation and childcare – that often accompany therapy sessions (Han, 2022). Is it any wonder, then, that 90% of US adults are convinced that the nation is experiencing a mental health crisis (McPhillips, 2022)? Some are not convinced that the crisis the nation is facing is a mental health one. Dr. Carr (2022), an assistant professor from UCLA’s Institute for Society and Genetics, for example, argues that what we’re facing is a political crisis and that people’s mental health is merely a symptom of a greater disease. She states, “If someone is driving through a crowd, running people over, the smart move is not to declare an epidemic of people suffering from Got Run Over by a Car Syndrome and go searching for the underlying biological mechanism that must be causing it. You have to treat the very real suffering that is happening in the bodies of the people affected but the key point is this: You’re going to have to stop the guy running over people with the car.” While this is a fair analogy, one thing it doesn’t acknowledge is that many of those who need treatment right now can’t get it. If someone doesn’t stop to address that issue, the people injured are the ones who are going to suffer and die needlessly while we’re chasing the guy in the car. Given that, it seems the United States is facing two issues right now: income inequality and healthcare access. We need to address both. For those who are struggling with mental health, access to healthcare is the most immediate concern. If you or someone you know living in California is struggling financially and needs to see a therapist, a good place to start is your County Mental Health Department (DCHS, 2022). They’ll be able to help connect you with resources that can help you pay for services so that you can get the mental health treatment you need. If you are already in treatment, have a conversation with your therapist about what your payment options are. They may be willing to work with your budget, adjust your session schedule, connect you with services that can help cover costs, provide pro-bono sessions, and/or refer you to an agency who is able to provide free or low-cost services. There are also crisis resources, such as the ones available through Riverside County’s Department of Behavioral Health, which are available to everyone 24 hours a day, 7 days a week, many of which are free. At Life Source, we offer several affordable options for people who are struggling. We have trainees who charge a nominal fee for services and even provide free sessions to individuals and families enrolled in the Riverside Police Department’s Opportunities with Education program and Riverside Community College’s Gateway program. For individuals who are needing to complete court-ordered services or are looking for a more experienced mental health professional, we have our associates who can work with you or someone you love. For individuals and families who have been victims of crime and can’t afford mental health services, we accept CalVCB. As for income inequality, it wasn’t that long ago when people believed union influence was on the decline and would never recover (Domhoff, 2013), a $15 minimum wage was a dangerous fantasy (White, 2015), and universal healthcare was little more than a pipe dream (USA Today Editorial Board, 2019). However, recent years have shown us that these dire predictions and proclamations were perhaps a bit hasty and shortsighted. In 2022, the United States saw a massive increase in union petitions, with 68% of adults in the United States saying they approve of labor unions, the highest rate since 71% in 1965. Three states – California, Massachusetts, and Washington – have $15 minimum wages and nearly a dozen more are working to increase their minimum to $15 over the next few years (Janisch, 2022). Meanwhile, California is well on its way to becoming the first state in the United States to offer single payer healthcare to all its citizens (Carter, 2022). These examples stand as proof that we can come together and address the economic issues that are necessary to address the mental health crisis and political crisis the United States appears to be facing. References Carr, D. (2022) Mental Health is Political. New York Times. Retrieved from https://www.nytimes.com/2022/09/20/opinion/us-mental-health-politics.html Carter, K. (2022) The Big Health Care Wins in California’s State Budget. California Health Care Foundation. Retrieved from https://www.chcf.org/blog/big-health-care-wins-state-budget/ DHCS. (2022) Programs for Adults. Retrieved from https://www.dhcs.ca.gov/services/MH/Pages/ProgramsforAdults.aspx Domhoff, G. (2013) The Rise and Fall of Labor Unions in the U.S. Who Rules America? University of California at Santa Cruz. Retrieved from https://whorulesamerica.ucsc.edu/power/history_of_labor_unions.html Elias, J., Lucas, A. (2022) Employees everywhere are organizing. Here’s why it’s happening now. CNBC. Retrieved from https://www.cnbc.com/2022/05/07/why-is-there-a-union-boom.html Feder, S. (2020) Maps Reveal Where Depression, Anxiety, and Suicide Run Highest Across the US. Insider Magazine. Retrieved from https://www.insider.com/how-mental-health-conditions-affect-each-state-suicide-depression-anxiety-2020-2 Han Z. (2022) One-third of Americans say they can’t afford therapy: ‘The gas money that it takes to drive to see the therapist, the money for babysitters has gone up’. Market Watch. Retrieved from https://www.marketwatch.com/story/one-third-of-americans-say-they-cant-afford-therapy-as-u-s-copes-with-ongoing-mental-health-crisis-11657298164 Janisch, K. (2022) How Many States Have a $15 Minimum Wage. GovDocs. Retrieved from https://www.govdocs.com/how-many-states-have-a-15-minimum-wage/ Jones, B. (2020) Increasing share of Americans favor a single government program to provide health care coverage. Pew Research Center. Retrieved from https://www.pewresearch.org/fact-tank/2020/09/29/increasing-share-of-americans-favor-a-single-government-program-to-provide-health-care-coverage/ McPhillips D. (2022) 90% of US Adults Say the United States is Experiencing a Mental Health Crisis, CNN/KFF Poll Finds. CNN. Retrieved from https://www.cnn.com/2022/10/05/health/cnn-kff-mental-health-poll-wellness/index.html Patel, V., Burns, J. K., Dhingra, M., Tarver, L., Kohrt, B. A., & Lund, C. (2018). Income inequality and depression: a systematic review and meta-analysis of the association and a scoping review of mechanisms. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 17(1), 76–89. https://doi.org/10.1002/wps.20492 Ridley, M., Rao G., Schilbach, F., Patel V. (2020) Poverty, Depression, and Anxiety: Causal Evidence and Mechanisms. Science 370(6522). https://doi.org/10.1126/science.aay0214 Scott, M. (2017) Opinion: Medicare for All: Imminent or Pipe Dream? Managed Healthcare Executive. Retrieved from https://www.managedhealthcareexecutive.com/view/opinion-medicare-all-imminent-or-pipe-dream USA Today Editorial Board. (2019) 'Medicare for All': Bernie Sanders' Political Pipe Dream. USA Today. https://www.usatoday.com/story/opinion/2019/05/06/medicare-for-all-bernie-sanders-political-pipe-dream-editorials-debates/1093194001/ White, M. (2015) 'Impossible' Push for $15/Hour Minimum Wage Sees Some Success: A movement for a $15 minimum wage that even some supporters considered a pipe dream is gaining momentum. NBC News. Retrieved from https://www.nbcnews.com/business/economy/impossible-push-15-hour-minimum-wage-sees-some-success-n363201

BETTER MENTAL HEALTH Believe it or not, optimal mental health is inextricably linked to a health-promoting plant-based diet. We can find evidence of this in the copious amounts of research done over the years on the connection between mental health and diets high in plant foods. For example, in a 2015 study, vegans reported less stress and anxiety than omnivores (Beezhold et al., 2015). Another study conducted in 2010 found that the vegan group reported greater improvements in mental health and vitality compared with the control group (Katcher et al., 2010). Similar findings occurred in a 2013 study where overweight or type 2 diabetic GEICO employees were divided into a control group and a vegan group. The vegan group reported less depression, anxiety, and fatigue and an increase in overall well-being and work productivity (Mishra, 2013). In a more recent 2019 study, it was discovered that plant-based diets restore balance in the gut microbiome (Medawar et al., 2019). It’s not surprising. Plants are packed with healing fiber, phytochemicals, antioxidants, vitamins, and minerals. In contrast, animal products (meat, fish, dairy, and eggs) are full of toxic stiff saturated fats, inflammatory omega-6 fats, growth hormones, antibiotics, cholesterol, pathogens, chemicals, contaminants, and unnaturally high levels of the stress hormone cortisol that is released into the animal's bloodstream due to the extreme stress and fear they experience right before they're slaughtered. One study discovered that consuming animal foods increases stress hormone levels in individuals even more than the trauma of losing a spouse (Anderson et al.,1987). PLANTS AS NATURAL ANTIDEPRESSANTS According to the PCRM resource "Food and Mood: Eating Plants to Fight the Blues" a study published in Nutrition Journal discovered that vegetarians reported more positive moods than meat eaters. Fruits and vegetables have protective effects on the human brain, whereas animal products have harmful effects. The antioxidants and phytochemicals in plant foods reduce inflammation in brain cells and regulate neurotransmitters. Many individuals who suffer from depression have high levels of the enzyme monoamine oxidase (MAO), which breaks down key mood-regulating neurotransmitters such as serotonin and dopamine. Low levels of these important neurotransmitters result in depression. Interestingly enough, the phytochemical quercetin, which can be found only in plant foods, reduces the activity of MAO in the brain. Quercetin also works as a natural antidepressant, increasing the amount of these key neurotransmitters for a stabilized mood. If you want to boost your mood naturally, then eat plant-based foods high in this phytochemical. These include apples, kale, berries, grapes, and onions. INFLAMMATION IN THE BRAIN On the other hand, arachidonic acid (a pro-inflammatory compound found only in animal foods), plays a key role in the formation of cancer and inflammatory diseases such as asthma and arthritis (Bei Wang et al., 2021). Animal products high in arachidonic acid (such as eggs, milk, chicken, and pork) can “adversely impact mental health via a cascade of neuroinflammation,” causing an increase in depression and suicide risk, according to a 2010 study (Beezhold et al., 2010). This flood of harmful chemical reactions results in an overreactive immune response as well as inflammation in the body and brain. Studies show that individuals who steer clear of animal foods high in arachidonic acid report less anxiety, stress, and depression and an overall happier mood. GOT PROTEIN? The majority of meat-eaters suffer from “protein anxiety,” a condition in which they constantly worry about not getting enough protein although they’ve never actually experienced a protein deficiency before. According to the Physicians Committee for Responsible Medicine (PCRM), "Of course, the body needs some protein to build and repair body tissues. But protein is widely available in beans, vegetables, and grains. It is almost impossible not to get all the protein you need, even without eating meat, dairy, or eggs." The average woman can absolutely get her 46 grams of protein per day on a plant-based diet, and so can the average man get his needed 56 grams per day. In fact, according to the Centers for Disease Control (CDC), most Americans actually are getting almost double the amount of protein they need. High-protein diets heavily burden the bones, kidneys, and liver, resulting in an increased risk for heart disease and cancer (Delimaris, 2013). Additionally, many omnivores don’t realize that the majority of the animals they eat for protein originally got their protein from plants to begin with. Therefore, it makes logical sense to eat directly from the source and cut out the middlemen (the animals) in order to maximize efficiency and prevent chronic illness. Better mental and physical health aren’t the only benefits of eating a plant-based diet. Vegetarian (and especially vegan) diets are better for the planet, help reverse the climate crisis, reclaim native foods and cultures, dismantle racism, reduce animal cruelty, and create a more compassionate world. If reading this inspires you to eat more plant foods, then check out these delicious plant-powered whole-foods recipes below. You can also follow me, Chiara, on Instagram! @bloom.with.chiara RECIPES Chef Katie Mae, Chef Cathy Fisher, Chef Ramses Bravo, Medical Medium, Luz Calvo and Catriona Rueda Esquibel, The Vegan Nigerian, Mexican Made Meatless, Chef Tabitha Brown, Vegan Richa, Sweet Potato Soul, The Black Vegan Company, WoonHeng, VegNews, Forks Over Knives, PCRM, FullyRaw Kristina, The Plant-Based Wok, Jessica in the Kitchen, Kris Carr, and Dora’s Table. DOCUMENTARIES They’re Trying to Kill Us (Vimeo) What the Health (Netflix) The Game Changers (Netflix) Forks Over Knives (YouTube) Cowspiracy (Netflix) Seaspiracy (Netflix) REFERENCES Anderson, K. E., Rosner, W., Khan, M. S., New, M. I., Pang, S. Y., Wissel, P. S., & Kappas, A. (1987). Diet-hormone interactions: protein/carbohydrate ratio alters reciprocally the plasma levels of testosterone and cortisol and their respective binding globulins in man. Life Sciences, 40(18), 1761–1768. https://doi-org.brandman.idm.oclc.org/10.1016/0024-3205(87)90086-5 Beezhold, B. L., Johnston, C. S., & Daigle, D. R. (2010). Vegetarian diets are associated with healthy mood states: a cross-sectional study in Seventh Day Adventist adults. Nutrition Journal, 9, 26–32. https://doi-org.brandman.idm.oclc.org/10.1186/1475-2891-9-26 Beezhold, B., Radnitz, C., Rinne, A., & DiMatteo, J. (2015). Vegans report less stress and anxiety than omnivores. Nutritional Neuroscience, 18(7), 289–296. https://doi-org.brandman.idm.oclc.org/10.1179/1476830514Y.0000000164 Bei Wang, Lujin Wu, Jing Chen, Lingli Dong, Chen Chen, Zheng Wen, Jiong Hu, Ingrid Fleming, & Dao Wen Wang. (2021). Metabolism pathways of arachidonic acids: mechanisms and potential therapeutic targets. Signal Transduction and Targeted Therapy, 6(1), 1–30. https://doi-org.brandman.idm.oclc.org/10.1038/s41392-020-00443w Delimaris, I. (2013). Adverse Effects Associated with Protein Intake above the Recommended Dietary Allowance for Adults. ISRN Nutrition, 2013, 126929. https://doi-org.brandman.idm.oclc.org/10.5402/2013/126929 Katcher, H. I., Ferdowsian, H. R., Hoover, V. J., Cohen, J. L., & Barnard, N. D. (2010). A worksite vegan nutrition program is well-accepted and improves health-related quality of life and work productivity. Annals of Nutrition & Metabolism, 56(4), 245–252. https://doi-org.brandman.idm.oclc.org/10.1159/000288281 Medawar, E., Huhn, S., Villringer, A., & Veronica Witte, A. (2019). The effects of plant-based diets on the body and the brain: a systematic review. Translational Psychiatry, 9(1), 226. https://doi-org.brandman.idm.oclc.org/10.1038/s41398-019-0552-0 Mishra, S., Xu, J., Agarwal, U., Gonzales, J., Levin, S., & Barnard, N. D. (2013). A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study. European Journal of Clinical Nutrition, 67(7), 718–724. https://doi-org.brandman.idm.oclc.org/10.1038/ejcn.2013.92 Mondala, M. (2020, Oct 9). Going Plant-Based for Your Mental Health? Here Are Some Things to Keep in Mind. Forks Over Knives. https://www.forksoverknives.com/wellness/mental-health-plant-based-doctors-tips/

Parents going through a divorce can often have very different perspectives on what happened that led to their marriage’s dissolution. They can also have different perspectives regarding court proceedings regarding custody and visitation. Often these perspectives paint themselves as the victim and the other parent as the villain. When kids hear these perspectives, they can often have a difficult time knowing what to believe. This is particularly when one parent is telling them one thing and the other is telling them the complete opposite. They might feel confused or even frustrated that they don’t know who to believe. As therapists, we are often faced with the unenviable task of helping clients make sense of these situations for themselves. We may have thoughts about whose perspective is closer to the truth and whose is not, but it’s not our place to tell our clients what those suspicions are. Our goal is to help them figure that out for themselves and to decide what to do with that information once they feel like they understand the situation better. Of course, helping our clients get there can be tricky, particularly when they’re younger. Therapists often find that playing games with young children helps them process information in a way that they can understand. A good game for dealing with a situation like this is the Ultimate Werewolf party game. The premise of the game is pretty simple. A small, medieval village is infested with werewolves. Each night, the werewolves murder an innocent villager. When the villagers awaken, they must choose one among them who they believe is a werewolf and kill that person. If the villagers kill all the werewolves, they win. If the werewolves kill all the villagers, they win. Normally, the game is played with one storyteller and up to 74 other players who take the role of villagers. In a therapeutic setting, where the the therapist and the client are the only two players, the client plays the role of two villagers: The Seer and the Bodyguard. The therapist plays the role of the rest of the villagers, the werewolves, and the lycan. In the game, the client can use the Bodyguard to protect a villager from the werewolves at night. The client can also use the Seer to look at a villager and determine whether that villager has the magical aura of a werewolf. Unfortunately, there’s a catch. The lycan also gives off the magical aura of a werewolf, but is actually an innocent. When the game is over, the therapist can talk with the client about the game and how difficult it is in real life to know who is telling the truth. For example, we may think that someone is lying, when in reality they are just as innocent as the lycan. We may think that someone is telling the truth, when in fact they are lying. Fortunately, we all have resources that we can use to help us determine the truth. Some of those resources are our own internal resources. For example, we may have a gut feeling that can give us the intuitive insight we need to determine who we should believe. We may have had personal experiences that we can rely on to protect us from being deceived. Finally, we have friends and family who have different perspectives who can help us make decisions and stay safe. For teachers, parents, and/or therapists who are interested in using this game in a therapeutic way, you can find it available on Amazon. https://www.youtube.com/watch?v=bKpalHgRff8

Many things have changed since the start of the Covid-19 pandemic, including the way we live our lives, conduct business, even the way we receive therapy. There have been many adjustments we have made during this time, some easier than others. One of the ways we've adjusted to this new way of being in the therapeutic realm is with online therapy known as “telehealth”. As a therapist, telehealth has been a great option to continue working with my clients while under quarantine. It did take some change in the way I did therapy though; and yes, there was definitely a learning curve. Initially, I had some reservations. There are many non-verbal queues that a therapist picks up on in an in-person session; body language, energy in the room, etc. I was worried that I would miss out on that non-verbal communication when I switched to telehealth. I comforted myself by reminding myself that online therapy is better than no therapy; which would have been the case during quarantine without the virtual telehealth option. I quickly learned however that there are many ways to make sure I pick up on all non- verbal communication even in an online session. For example, if a client is becoming anxious or panicky during a session, I can watch their chest movement to see if they are beginning to breathe faster. This is an indicator that I need to provide client with self-regulation/calming tools to utilize during the session and other times of distress. If a client will not maintain eye contact, that can be a sign of distress or discomfort with the topic. These are just two examples of the many ways I learned how to make sure I am not missing out on non-verbal queues when in a virtual session. I also learned that the way for the client to get the best experience during an online session is to coach them on how to mimic, as much as possible, an in-person session. In the beginning, I had clients that would be driving, doing dishes, camera pointed at the ceiling fan, cleaning the refrigerator, you name it! I quickly realized it was part of my new job as an online therapist to help instruct the clients on how to get the most out of each session. I now make it a point in my pre-session consultations to coach my clients on how to have an effective online session. (1) Make sure the client is scheduled during a time when they will be settled at home (2) With a strong internet connection (3) Ideally behind closed doors where they can speak freely and privately. (4) Limiting all possible distractions. It is important that clients are focused on the therapy/therapeutic environment to be able to get the most out of each telehealth session. Therapy is an important part of self-care. Why not get the most out of it? It’s the 50 minutes per week that it gets to be all about the client….when else in life can we say it’s all about us? Not very often. By coaching my clients pre-session, I no longer have distracted clients and they are able to get the most out of each session. There is also a great up-side to online sessions. Clients are able to log on from home which offers much in the way of convenience. It also cuts back on travel time and travel expenses. It also opens up therapy to clients throughout the state of California, not just in my local area. I have gained many clients that are in farther away areas including Northern California, Central California and more southern areas of California. This greatly widens the range of the clients that I can help, which I love! All in all, telehealth has been a great option during the quarantine/pandemic. I am finding that many of my clients want to continue to stay with online therapy even now that the Covid numbers are going down and things are returning (somewhat) to normal. Majority of my clients love the convenience of online therapy and have requested to stay with telehealth for the long-term. This is proving to be the case for many therapists. Telehealth is making its way to becoming our new “normal”.

“Something’s been on my mind and I can’t seem to shake it. The more I think about it the more confused I get. It’s not that big of a deal, and when I try to tell a friend about it, I just end up feeling dumb – and more confused. Like I should be able to figure this out – or let it go – or just get over it. But I can’t…” Not much is worse than feeling stuck in your head – or stuck in your life. Where can you go? Since you can’t get away from yourself it feels like torture. Getting mad at yourself doesn’t really help and there isn’t anyone else to get mad at. Or maybe there is but they don’t know why you’re upset, or maybe they don’t even care. It seems hopeless. Being stuck like this is what they call depression. Or it could be creating anxiety - constantly and excessively worrying about certain things, or things in general. Either condition makes you feel even worse about yourself, like "What’s wrong with me?" The truth is that even before the pandemic hit, over 40 million Americans were suffering from anxiety. This is about the population of California. Probably there were many more than that because those are only the people who went to a doctor or therapist for help. Lots more were – and are suffering - and blaming themselves for being in pain. As children, if we complained to adults many of us were told that we should “get over it.” We probably didn’t know how to do that so we decided that it means to ignore it. Feelings are big, especially when you’re little. It might have felt like listening to these feelings could even make you go crazy. Learning to ignore them means that you stop listening to them. And when we do that, we end up getting lost because they’re only there to give us direction. But what if your feelings are too big? Maybe they’re popping up at the most inconvenient times – even intruding into your life. They come in like a tidal wave wiping out rational thoughts. And when you act on those big feelings it often leaves a big mess to clean up. Like getting too angry, or too scared, and taking it out on those closest to you. And then being hurt or disappointed or even more angry when they don’t (can’t) make us feel better. It may be time to talk to someone who is trained to listen and knows how to help. Helping doesn’t mean telling you what to do - that’s advice. Counseling or therapy is not advice. It’s compassionate listening combined with educated feedback to help you problem-solve it yourself. And in the process, to learn to understand yourself better and develop the self-confidence to move through this problem and any future situations. There might be someone in your life who thinks that therapy is only for “crazy” people. Or that problems should be handled within the family and not involve outsiders who don’t really know you. But what if the problem includes someone close to you, and you’ve tried talking to them and it hasn’t helped? This is when someone on the outside can see things more clearly – more objectively. Every individual is unique, as is every family or relationship. Yet there are basic ways that humans act and interact. Someone trained to identify where support and re-direction is needed can save lots of time and suffering. Even therapists are expected to go to counseling! They are trained to realize that even they can be too close to their own problems to be able to see them clearly. Lots of time can be wasted worrying or feeling hopeless about a situation. Instead, the problem can be solved and turned into a learning experience (so as not to repeat it) and then you get on with life. And the more we practice a skill the better we become at it. Problem-solving is a life skill. Getting good at it means you get better at living your life the way you want it to be – happier, with improved relationships, and better opportunities for your future.