Aaron Leigh Horton, MS, LPC-A, NCC

Everyone knows what it feels like to get the blues once in a while. But depression is a serious illness that is more severe than a bad day and lasts much longer. Symptoms of depression stop a person from being able to function and enjoy daily activities for weeks or months at a time. It can happen to anyone, and it isn't something that people can control by force of will or "snap out of it."

Some common symptoms of depression include:

• Feeling sad, guilty, empty or hopeless
• Fatigue and a lack of energy and motivation
• A loss of pleasure in activities that were previously enjoyed
• Unusual sleep or eating habits
• Mental fog -- trouble concentrating, remembering, or making decisions
• Physical aches and pains
• Suicidal thoughts or a preoccupation with death

Dialectical behavior therapy, or DBT, is a form of cognitive behavior therapy (CBT) that was originally developed to help the most severely mentally ill and depressed patients accept therapy. It relies on the same concept in CBT that examines the relationship between thoughts, feelings, and actions, but in DBT the emphasis is first on acceptance rather than change. There is also an emphasis on mindfulness, 'being in the moment,' and relaxation techniques such as yoga. These are combined with a great deal of validation and encouragement from the therapist.

The word 'dialectical' means acting through opposing forces, and this word refers to a few different opposing concepts in DBT:

• The therapy combines traditional Western psychotherapy techniques with Eastern religious philosophy.
• Patients must learn that life, thoughts, and feelings are not all black and white -- there are many shades of grey.
• The therapy works on accepting and validating the patient for being where they are at the moment while also encouraging them to change for the better.

Narcissistic abuse is a form of emotional abuse that occurs when someone with narcissistic personality disorder (NPD) abuses another person. Narcissistic abusers harm others by using words, behaviors, and actions intended to hurt and manipulate. Not everyone with NPD is abusive, and not all abusers have NPD. However, because NPD is characterized by an inability to understand and respect the feelings of others, it may increase the likelihood of someone becoming abusive. People with NPD believe in an idealized version of themselves, but they also possess deep feelings of self-doubt and shame. The conflict between the inflated self and insecurity may cause people with NPD to employ coping mechanisms that are abusive toward others. For example, narcissistic abusers may derive pleasure from emotionally hurting or manipulating their partners. In other instances, narcissistic abuse manifests as neglect or deliberate isolation. Narcissistic parental abuse is often perpetrated by self-centered caregivers who are unable to meet their children's basic needs or to offer love and support. Narcissistic abuse usually occurs in family, social, and workplace relationships.

Victims of narcissistic abuse may not realize they are experiencing abuse, or even that their perpetrators have narcissistic personality disorder. Common symptoms of narcissistic abuse, as endured by its victims, include:

• Headaches, nausea, body aches
• Anxiety, stress, and depression
• Insomnia or difficulty sleeping
• Diminished self-confidence and self-worth
• Mood swings and paranoia
• Short-term memory loss