Clinical psychotherapist and author Dr. Michael Adamse discusses anxiety and offers practical advice for maintaining a sense of optimism and overall mental health in pessimistic times. He’s been in private practice for more than 40 years and has spent more than 90,000 hours caring for his clients. 

He uses the insights collected in his years of experience in his writing. Adamse talked to Drugwatch about his fourth and latest book, “Make America Sane Again.”

Born in Sweden, Adamse came to the United States via Ellis Island, New York, in November 1954. He majored in both philosophy and psychology, deciding to meld the two studies together to help people. 

Q: What is your main focus as a private practice therapist?

I do see individual patients, but I see a lot of couples. People come to me for a variety of reasons, including anxiety, depression, phobias, addictions, marital problems and parenting issues. 

I typically tell people that I’m more of a generalist like a family physician in terms of mental health, though I also view myself as kind of doing ER triage. The majority of patients I treat benefit from broad intervention strategies that allow me to successfully treat a variety of conditions. If a patient needs medication, I’ll refer them to a psychiatrist.

If it’s something highly specific, for example someone has been through extensive trauma, I’ll refer that person to a trauma specialist. If you make your client the center of your care and concern, then you do what’s best for them.

Q: Why did you decide to write your latest book on mental health? 

I’ve seen the impact of political, social and economic turmoil in the U.S. in my practice. People are experiencing health disorders, addiction problems, social isolation and more. This cornucopia of mental health issues is really related to two primary things: a response to the events happening in the country and the political divide. 

So, I felt really compelled to write this book to address those problems and address what we’re witnessing. I felt that there wasn’t enough of a balance in the media with too much polarization and fear-based reporting. I really wanted people to see that it’s not as hopeless as some are suggesting. 

I think there’s still room for optimism in America and we desperately need it. That’s why I wrote the book.

Q: Does data indicate rates of mental health conditions have increased in recent years?

There’s no question that rates have gone up. A lot of people are having difficulty finding a therapist now. Most therapists are booked solid and have waiting lists for accepting new clients. It absolutely reflects the rise in mental health issues.

Q: In your book you talk about fear-based messaging and anticipatory anxiety. What is fear-based messaging and how does it affect a person’s well-being?

Unfortunately, much of the media is based on propagating conflict because conflict keeps people interested. The problem is that if we’re watching too much of this it affects us negatively in many ways. Fear, anxiety and depression all suppress your immune system, which makes you much more susceptible to illness. And that’s where it’s dangerous to us. 

We can see higher rates in all kinds of medical conditions, such as high blood pressure. Experiencing fear and anxiety exacerbates these medical issues.

Anxiety is fear that something horrible might happen — to me, my family, my loved ones, our country. I call it feeding the elephant. The more we feed it, the bigger the elephant is going to get. So, what do we do about that? I tell people to go on a news diet.

I always advise people to just be super careful about their news consumption because the overconsumption of negative messaging starts to create a pessimistic worldview. And that’s dangerous. 

America is based on optimism. Succumbing to pessimism is something that we have to be really on guard against.

Q: Aside from a “news diet,” what else can people do to help themselves? 

Simple things like improving diet, getting exercise, and getting out in nature can help. Walking in the park, sitting on the beach or just getting some fresh air can do wonders for people. Music, uplifting movies and books – anything positive can help counter pessimism.

Social connectedness — being connected to other humans through friendships, groups or organizations — is the best predictor of how a person is going to get through life’s stressful situations. Being connected to others is essential. 

In my book, I ask people to do this mental exercise. Imagine yourself as a human cell in the body of America, and there are 330 million cells. You’re one of those cells, but you have a choice. Are you going to be a cell that spreads positive and healing energy or are you going to spread negativity?  

If we focus on our differences too much, we’re going to miss the bigger picture. If you’re a good listener, and people feel understood, that goes a long way to making them feel better. The most powerful thing you can tell another human being is you may not agree with them, but you understand what they’re saying.

Q: If anyone has any mental health concerns, what is the first thing they should do?

Find a therapist. Usually your primary care physician will know a good therapist in the community that they can refer you to. Start with your primary care physician and ask, “Can you recommend somebody to me?” 

In addition to the things we’ve discussed – limiting news consumption, social connections, a healthy diet and fresh air – there’s no question that medications have their place. And whether it’s an antidepressant, anti-anxiety agent or sleep aid –  any of these when properly prescribed can be quite helpful to a lot of people. 

Combination therapy can be very helpful. Studies show, for example, that a combination of medications and talk therapy are more effective for depression than one treatment alone. 

Q: What are your tips for people looking for a therapist? 

Make sure that any therapist you consider seeing is well trained. That means they’ve graduated from a reputable educational program and are properly licensed. In Florida, for example, we have multiple levels of licensure. We have mental health counselors, social workers, psychologists and so forth. 

Make sure that you’re comfortable with the therapist. Find the person that resonates with you. 

One of the biggest red flags is if a therapist spends time talking about their own issues. We have a problem when therapists don’t have good boundaries themselves. 

Q: Any closing thoughts?

Well, the last topic I’d like to talk about from my book is about observing ego. And it’s a very important principle to bear in mind. The observing ego is that part of us that can take a step back and look at ourselves objectively in the world – how we relate to people and how things affect us.

 It’s like being the director of a show and saying, “Okay, I’m going to get off the stage and look at what I’m doing in the world.” 

The better you can distance yourself and reflect, the better positioned you’re going to be to deal with stress. You’ll understand your personality and how you approach things.