How to Detect Depression in the Elderly

The Coronavirus pandemic has made words such as social distancing, quarantine, and masks part of our everyday language.  This new normal of doing many things virtually can be daunting for members of the older population.  Many independent living, assisted living, and nursing homes have restricted visitor access too.  This has led to many elderly individuals being isolated from friends and loved ones.  In addition, it has also led to the restriction of many activities they would regularly engage in.

Depression in the elderly can present differently than it does in younger people.  When depression in the elderly is left untreated, its symptoms can mimic other conditions like dementia.  

Here are some ways to detect depression in the elderly:

  • Loss of concentration or other cognitive abilities (not due to a medical condition)
  • Low mood
  • Loss of pleasure in activities
  • Significant weight loss or gain
  • Decrease or increase in appetite
  • Sleeping too much or too little
  • Fatigue
  • Feelings of worthlessness
  • Excessive or inappropriate guilt
  • Thoughts of suicide or death

If an individual has recurring thoughts of suicide or death (or suicide attempts), that would warrant an emergency psychiatric evaluation.  A comprehensive evaluation by a mental healthcare professional will help to determine what an appropriate treatment will be.  Possible interventions may include medications, talk therapy, change in the social environment, focusing on caring for other physical disorders, or changing medications for other conditions the individual may already be prescribed.


Organizational Skills: Cleaning Up Your Life and How to Reap the Benefits (PART II)

Are you familiar with the movie ‘Honey, We Shrunk Ourselves’ and that scene where the kitchen is a complete mess because the daughter wants to throw a party in the parents’ absence? Luckily for them it was just a movie so they had a cleanup crew on standby (I wonder if they would be open to cleaning homes not used for movies…)

Think about your home and how it looks regularly. Any home can look “lived in”, and there is absolutely nothing wrong with that! I’m focusing more on clutter; clutter that seems to accumulate without any warning or notice. It just seems to show up out of nowhere, and it causes you to become overwhelmed or anxious with the state of your household. Your home is supposed to be your safe place, your comfort zone, a place where you can unwind and be away from the hustle and bustle of the outside world. But how are you able to relax when your house causes you anxiety because of the mysterious clutter? Marie Kondo, star of Tidying Up with Marie Kondo, says that “the objective of cleaning is not just to clean, but to feel happiness living within that environment”.

So here are some tips and tricks to organize and declutter your home to maintain your happiness (& sanity!):


1) Ask yourself questions while cleaning!
If it’s clutter you are dealing with, you may be inclined to ask yourself, “Is this item of current use to me? Is there any sentimental value behind this item? Will I need this item 6 month or a year from now?”. When you ask yourself these questions, it helps you realize the use of the item you are questioning and whether or not it’s something worth keeping. It almost provides closure if you choose to discard the item. Now, if you choose to keep it, you may set it to the side and work on how to organize it with other things you choose to keep.

2) Motivate yourself
I think there are a certain percentage of people who truly enjoy the art of cleaning and we applaud those who do! If you are one that needs to be motivated to clean, hop on board with the rest of us! One way I motivate myself to clean is listening to music. I like to listen to 70s, 80s, and 90s music while I clean because I feel it gives me the energy I need, and come on… songs during those decades were pretty great. Another way I motivate myself to clean is that I promise myself a reward at the end. This reward could consist of a favorite snack, watching a good movie, reading my favorite book, or rewarding myself with takeout food for dinner (I just cleaned the kitchen, let me enjoy it!). Now if I don’t clean, I don’t get the reward, and I stick to that! Self-discipline is key with this one if you choose to do so! I challenge you to think of some ways you may motivate yourself to get active and to get those cleaning juices flowing.

3) Bins and totes and storage, oh my!
OK so earlier I mentioned asking yourself questions while cleaning which is a helpful portion of managing the clutter. Now what about the items you choose to keep? Let’s work on that! It’s very easy to keep those items piled on a table and leave them for days, weeks, months, but I want to try to avoid that here. Do you have any bins or totes that you can use to keep these additional items in? If so, great! That would be a great place to store these items and keep them away in a storage closet to prevent less clutter in your household. If you are in need of bins or totes, department stores such as Walmart or Home Depot got you covered! Or, if you check out The Container Store (, they have neat and cheap selections too! When we act on organizing, it provides us with a sense of control that we need in order to maintain our household and its appearance thus allowing us the power to make changes where we see fit.

4) Map it out!
Think of where you would like certain things to go in your house and create a map of each room and what things can be stored in each space. This will not only help keep you organized altogether, but it provides a clearer picture on how you want your house to look and what you can do to achieve those results. You may also use this as a tool when helping your kiddos clean or giving them a chore list that involves cleaning and tidying up.


These are just a few tips and tricks among many that are available to help with organization skills. I hope that you find these to be helpful when you are organizing and cleaning your household. And remember – a clean house is a happy house! 😊

Thank you, and take care!

Jill M.
Graduate Counseling Intern
Step by Step Counseling LLC

Organizational Skills: Cleaning Up Your Life and How to Reap the Benefits (PART I)

Think about your work station or where you complete most of your work tasks…

How does that area look? Do you enjoy working in that area? Given the opportunity, how would you improve that work area? If your responses are favorable to these questions, congratulations! It sounds like you are satisfied with your work area. If your responses were not so favorable, let’s work together to see if we can change those answers.

Marie Kondo, star of Netflix’s Tidying Up with Marie Kondo, states that “tidying isn’t just a physical thing, it’s an emotional thing. You face things around you, and you face your inner self”. Does your work space reflect where you are emotionally, and are you prepared to challenge yourself to essentially ‘reset’ that space and start over?

Here are some ways to improve your work space:

Invest in a calendar
Some people prefer writing information on sticky notes, but what happens to those sticky notes when they are accidentally thrown away or misplaced? We lose that information that we were wanting to keep! Having a calendar where you can write your daily events and ‘to-do’ list helps you stay on track and remained focus during the day.

Ditch the unusable or broken items in your space
Many pens, pencils, highlighters, staplers, and white out tape dispensers have served us all, and, for that, we thank them. BUT, honoring their efforts by keeping them on your desk or shoved in a drawer does not serve you and your workspace. This rule should go for any object that simply does not work anymore. Discard the items (recycling, preferred!) and clear up more of your area.

Compartmentalize your space!
When we say “compartmentalize”, we mean filing, finding places for important things, and recycling or discarding items that you no longer need. Do you have documents that you absolutely NEED to keep? OK, file those! Grab a folder (any one will do!), label it, and place those particular documents in that folder. If you want to get real fancy, you can have different folders for different documents so you don’t have to go rifling through one folder for a specific document.

What if we receive mail that tells me that I ought to think about applying for a credit card because I was pre-approved for one even though I did not ask for it? While that was very kind of that company to do that for you, we will consider that junk mail. Take those documents and either shred them or discard appropriately. This just causes more clutter that you do not need!

Ask yourself again!

Remember those three questions at the beginning of this post? Consider those changes that you made to your work area and ask yourself those questions again. Are the answers any different than what they were before? It’s important to keep asking yourself these questions as you go through physically organizing your work area. It can be hard to part with certain items as they may hold value or some emotional sentiment to you. However, it is important that you are happy in the conditions that you are working in as this will increase productivity, improve your relationships with your coworkers and supervisors, and keep you on your “A” game all day.

We hope you implement these organizational skills into your daily work routine! You spend 1/3 of your life at work, so why not make it a place that you enjoy going to daily? I will be creating more organizational skills content, so be on the lookout for future organizing posts from yours truly.

Written by Jillian Maloney a Stepping Stones Therapist

You Are Not Alone

Written by Sherine Chambers, Therapist
Have you ever felt like a square peg trying to fit onto a round hole? You know, you don’t “look right” or “talk right” or “think like everyone else”? Well, you’re not alone. Looking at our present and recent past, there are many people who’ve made a difference in our world, and they didn’t fit the mold of “normalcy” that is often touted by the majority.

Look, for instance, at Martin Luther King, jr., Mahatma Gandhi, Rosa Parks, Marie Curie, Malala Yousazfai. And I could name many more. These are people who did not accept the status quo, the “norm.” They fought (or are still fighting) for what they believe – in some cases, against seemingly insurmountable odds.

“What does this mean for me?” you may ask. Well, think about the view of mental health. In many cultures and communities, there is still a stigma surrounding mental health disorders and seeking mental health counseling. We may be viewed as “weak” or “crazy” or “not right in the head.”

We’re told to “cheer up” when we experience clinical depression; that we need to “calm our nerves” when we experience anxiety. And so, we bear our distress in silence, not seeking the help that is becoming more readily available, leaving us feeling alone and isolated.

As of 2018, 19% of adults and 16% of children and adolescents ages 6-17 in the US experience mental health illness. You are not alone, and you don’t have to deal with mental health issues by yourself; your kids don’t have to struggle on their own.

Whether it’s anxiety, depression, trauma, or “just stress,” mental health counselors are here to help you through. Your mental health is just as important as your physical health. You do not have to suffer in silence, and you do not have to walk alone on your journey to mental health and wellness.

Helping the Elderly Cope with Isolation During the Pandemic

The Coronavirus pandemic has compelled us to change the way we conduct our daily lives.  The term “social distancing” describes a way to protect ourselves from contracting the virus.  Social distancing is a great way to keep us safe and healthy, but how does it affect our mental health?  The elderly community is a population that is at risk for the virus and safety is vital.  However, with restricted activities and less socialization than they are used to, the effect can be a feeling of isolation.

It is important for individuals in the elderly age category to have and maintain a support system.  Family and friends can be important members of an elderly individual’s support system.  If you have an elderly family member or friend, there are still things you can do to connect with them, even while being socially distant.

  • Make a date for a virtual visit: Set up a Zoom or FaceTime call, even a regular phone call will help them to feel more connected
  • Send mail: Writing a letter, sending flowers, or putting together a care package will let them know you are thinking of them
  • Be mindful of mental health: Encourage them to think positively and do activities that will be relaxing
  • Keep news to a minimum: Encourage them to limit themselves to one or two news programs per day, in order to avoid getting overwhelmed
  • Talk about happy memories: This will remind them of times when things were better.  It will give them hope and comfort about the future.
  • Help out: Let them know that they can always call you if they need anything, or even just to talk

It is important to make sure that the elderly remain safe and healthy physically.  However, it is just as important to make sure that they also remain safe and healthy mentally.  We can all help our elderly family members or friends to cope with the isolation encountered due to this pandemic while still keeping them safe.


LGBTQIA Considerations for College and Employment

Applying to college or getting your first job is a right of passage for most youth and young adults. LGBTQIA youth and young adults (and their families) have extra things to consider when making these big decisions. Below are some considerations, while this is not an exhaustive list, I hope you will find some helpful resources.

College Bound Youth

Considering what colleges to apply to and  ultimately where you attend is a big decision, but factoring in which college is LGBTQIA inclusive, and has protection policies for LGBTQIA students could be the difference between success or failure for some youth. The Campus Pride Index, (, is a great starting place in sorting out which colleges could be a good match. Information regarding inclusivity, financial assistance options, and how to find LGBTQIA inclusive college fairs are among the information provided.

Other questions and things to consider during your college search:

  • Is housing provided based on identified gender, or is there an option for non-gender based housing
  • Are gender neutral restroom available, if needed
  • How does the school handle students wanting to use their preferred name
  • Are there LGBTQIA inclusive heath care options available
  • Are there clubs and organizations that are welcoming, and accepting
  • What are the campus safety efforts, is there crime data available
  • What mental health services are offered to students
  • How will I pay for or finance college, the HRC (Human Rights Campaign) has a LGBTQIA scholarship database: Here

College and University Staff operate under FERPA, Family Education Rights Privacy Act. FERPA protects your privacy. If you decide to disclose your sexual orientation or gender identity to a school staff, they cannot share that information unless:

  • The student or parent (for individuals under 18) has signed a release of information; for the purpose of post-secondary education students under 18 are not required to have information released to their parents once they have begun attending classes
  • A health or safety emergency, disclosure is needed to protect the health or safety of the student or another individual
  • A court order or subpoena

As Always, check with your school regarding your specific situation and to discuss how they implement FERPA policies.

Entering the Workforce

Whether you are seeking your first job, entering your chosen career, or searching for a new job or career path considering an employers inclusion policies and procedures is critical. There are currently no widespread employment protections for LGBTQIA individuals in the United States. Missouri does not include Sexual Orientation or Gender Identity in its non-discrimination policy, which can be found here:  Missouri Labor ( Federally, the EEOC (Equal Employment Opportunity Commission) has ruled that Sexual orientation and gender identity fall under the umbrella of sex discrimination laws, meaning you are able to file a complaint with the EEOC for gender identity or sexual orientation based discrimination.

Starting the job search off by seeking out companies and corporations that are LGBTQIA inclusive can be a good way to go. A great starting point to understanding laws, and non-discrimination policies, is the Gen EQ guide put out by the Human Rights Campaign, click here for PDF. 




Stay Connected: How to Remain Socially Involved during COVID (And Why It Helps!)

2020 was a hectic year for all of us. It was full of uncertainty, canceled plans, new challenges, and a toilet paper shortage.

One important element that is severely impacted due to restrictions placed by COVID-19 is our social interactions and how we connect with other people. As humans, we strive for social connectedness by way of going out to dinner, attending concerts, watching sports, and being around those that desire the same connections that we do. When we eliminate these fun parts of life, we miss out on those opportunities to be with one another both physically and emotionally.

Thankfully, we live in a world where technology is king, and there are many different ways to stay connected with one another during these troubling times. Author, Sonja Lyubomirsky, of The How of Happiness: A Scientific Approach of Getting the Life You Want says “if you begin today to cultivate and improve your relationships, you will reap the gift of positive emotions”. Maintaining our social connections not only helps us keep our friendships but it also allows us to boost our mood, improve our self-esteem, and share our experiences with one another while keeping safe social distances!

Here are some ways to stay connected with others during COVID-19:

Scheduling phone, FaceTime, Skype, or Zoom calls
For those of you who opt for the standard phone call, this is always an option when talking with friends and family. And, it gives you a reason to leave your hair up and stay cozy in your PJs. BUT, when we add the virtual face-to-face interaction, it allows us to not only see one another, but to really be fully immersed in the conversation with whoever you are speaking with as well.

Joining an Online Group or Educational Conference
Now is as good of a time as ever to join that online group that you’ve been thinking about or to may be learn a few new tricks or tidbits of information. is a resource about online groups that are currently meeting.

Did you know that there are plenty of universities offering online classes for free? You have the opportunity to join classes for free and gain more knowledge on different areas of interest. Here are two resources to consider: and

Writing Letters
I know what you are thinking… writing letters is old school. But, there is authenticity and originality behind writing letters whether they be to loved ones or to those you may not know but could use the additional love during this time of year! Love for Our Elders is a nonprofit organization based out of Ohio whose mission is to provide love and support through written words to those who are age 50 years and older. Learn more how to participate at


This is just a short list of what you can do to improve upon and cultivate your relationships now and moving forward! I hope that these resources help you remain connected with one another, extend your love and support, and to immerse yourself with those who share the same challenges during these times.


Written by Jillian Maloney a Stepping Stones Therapist

Work Life Balance: Working from home

Chances are you, or someone close to you has ventured into working from home in the past few months or might be getting ready to transition to working from home. If you are like me, your first reactions may have been of excitement—I mean who doesn’t want to work along side their pets, and with all the comforts of home? While there are certainly some pros to working from home (no drive time=less money on gas) there are also challenges, such as setting boundaries on your time and space.


Boundaries are what help us with balance and help keep us from getting overwhelmed. There are several types of boundaries to consider including, time, space, emotions, and values. When thinking about a work for home situation, most people are likely to struggle with space, emotional and time boundaries.


Space is an important aspect of work. For many, working in a separate environment allows physical and emotional distance from work stress. Once you start working from home, this distance becomes difficult. By finding a dedicated workspace at your home, you can work to achieve a physical separation between work and home. I suggest finding a space that is dedicated only to work, and can be hidden behind a door, partition, or curtain. By closing the space off when you are not using it, you may be able to relax more during non-work hours. While working from bed sounds great, it can train your brain to be focused on work when in that space, which makes sleeping difficult.


When you were heading into the office you may have had a set 9am-5pm workday. While you may be lucky enough to keep that schedule while working from home, it is also possible your daily schedule will change. Be up front with your supervisor about the changes to your schedule, if needed, and prepare to adjust as you get use to the new normal. Working from home can also lead to working at all hours—its easy to check you work email, and answer calls when you have all your supplies at home. Be mindful of ending your workday at a set time and inform others that you will be ending your workday at that time. If you answer your phone at 10:00pm once, people may continue to call you at 10:00pm in the future.

Self Care

Finally, remember to be kind to yourself as you adjust to your new work situation. Emotions are high right now and adjusting to working from home is hard. Be mindful of your emotions, and work on saying no to additional task that may add to your emotional drain. If possible, discuss concerns with your supervisor or workplace to adjust tasks to remove emotional distress, and don’t forget to enjoy the perks of working from home.

Book Recommendation: Hold Me Tight

Hold Me Tight by Dr. Sue Johnson is a friendly, structured tool I recommend for couples looking to enhance their relationship. The book includes seven conversations designed to enhance your understanding of how you show up in your relationship, and how you “dance” with your partner. It covers the three common ways people fight, why some interactions feel so hurtful, how to really work toward forgiveness, and keeping your relationship alive over the long haul.

Who should read it?
Any couple who has been struggling with fighting, feeling distant, or wants to build understanding of themselves and their partner.

Will it be full of all that psych jargon?
I love this book in part because it is so approachable. Dr. Johnson gives clear descriptions and examples to help us understand the common patterns in relationships and ends each chapter with questions to ask yourself and your partner to tie it all together with your own experience.

What if my partner and I start fighting while we’re reading it??
A very common reason for couples to avoid therapy is the fear that shining a light on problems will make them worse. Totally understandable! It can definitely feel safer to stay in the problems you know, rather than risk things escalating. In my work with couples, I’ve found that most of us have the capacity to handle tough conversations, and actually long to share “the hard stuff” with our partners. Sometimes, however, our experiences make it feel impossible to verbalize our feelings to the one we love. If you notice this happening for you I’d recommend seeking out a trained counselor to help you navigate these conversations and walk with you through these painful parts.

Who should we contact if we need help?
I strongly recommend seeking out a therapist trained in Emotionally Focused Therapy. EFT was developed by Dr. Johnson and utilizes the theories she writes about in Hold Me Tight. Reading this book can be a great jump start to therapy and help you prepare for the work you’ll be doing.

What if I hate reading?
No problem! It isn’t a requirement for couples counseling. Also, there are Hold Me Tight workshops lead by trained therapists across the country. This can be a meaningful and fun way to connect with your partner and grow in all the areas covered in the book.

Please reach out to our office for more information or to find out if couples counseling might be a good option for you!

Managing Stress from Social Media and News Outlets

Managing Stress from Social Media and News Outlets

In our world today it seems as though our attention is always being pulled towards a screen. Whether it is a news station telling us the latest updates or social media telling you all the tips and tricks to stay healthy, the constant flow of information can be daunting. Many people who are working from home or trying to follow stay at home guidelines are constantly watching the news to know the latest updates for themselves and their family. However, when everyone can post their opinions it is hard to know what you should consume and not pay attention to.

Here are some tips to help cope with stress from screens and media: 

Limit the Amount of Time Spent on Social Media

This is beneficial because if you are on social media for too long you will be constantly exposed to new stories that can create worry that isn’t necessary.  Examples of limiting time on social media could be not logging into social media sites or apps, setting time limits, leaving devices in another room or charging device in another room.

 Make Sure Your Source of Media is Coming from a Verified Source

How often do you see news sources that are biased towards one side or the other?  Everyone on social media has a personal experience and opinion but what you allow yourself to consume should be factual. Finding credible news sources will allow you to know the information is true so you don’t have to compare it to a contradicting family friend on Facebook.

Connecting With Others Through Technology

We are designed to connect with others.  Connect with friends and family outside of devices.  So much of our screen time is spent on social media that we forget we can stay in touch with family and friends even while we are apart. If you need to use social media or technology to connect video calls, text, email, games are all great ways to connect with one another and keep ourselves from feeling alone. 

Focus on Yourself

Unplug, put your device away – focus on yourself for a set amount of time each day.  Spending too much time in front of screens and getting too wrapped up in media will leave you stressed and unsettled. Self-care is such an important act that many forget when they are overwhelmed.  Little things like physical activity, reading, and meditating can all help lower stress about the world around you and help you feel like you are in control.  


Even though there is a constant flow of information coming at us, filtering that can help us not feel so overwhelmed. Tips like these are helpful to live by constantly, finding a balance between news and social media vs real life experience is crucial to keep yourself less stressed. 


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