Anxiety + Diabetes

WRITTEN BY: Kristi Caporoso, MSW, LSW

State(s) of Fear

Anxiety has become one of the most commonly diagnosed mental illnesses in the United States. It seems everywhere you turn, someone is talking about it. Whether it’s their child or themselves that are afflicted, everyone and their mother seems to suffer from some level of anxiety. There has been a particular uptick in the level of anxiety reported in children and adolescents. While mental health professionals are trying to put their finger on what exactly is contributing to this – technology, political climate, homework – you don’t have to dig deep to find a reason for increased levels of anxiety in those living with Type 1 diabetes. To begin unpacking this issue, first let’s take a look at what the “A” word actually means.

What is anxiety, exactly?

A certain level of anxiety is healthy – necessary, even. It is what prevents us from engaging in dangerous behaviors, and what keeps us motivated to accomplish the things we need to do. The dictionary definition of anxiety reads as follows: “distress or uneasiness of mind caused by fear of danger or misfortune.”1 When this distress gets too high, or is disproportionate to the situation provoking it, the person tends to suffer from anxiety instead of benefitting from it.

Some of the more common forms of anxiety disorders are:

Generalized Anxiety Disorder (GAD)

A prolonged state of worry or tendency to worry about any and everything. GAD can have physical manifestations, such as GI problems and difficulty sleeping.  Someone living with GAD will have a tendency to view everything through a lens of anxiety, and be bombarded with “what-ifs?”

Panic Disorder

Panic disorder can occur after a person experiences one or multiple panic attacks, and is living in constant fear of the next one occurring. Everyone experiences panic attacks in different ways, but the most common symptoms are shortness of breath, feelings of impending doom, de-personalization (that feeling when you are floating outside your body), and heart palpitations, to name a few.

Social Anxiety Disorder

Basically what it sounds like, social anxiety disorder is when people experience extreme discomfort and anxiety around other people. This anxiety is rooted in the fear of what others think of you, or of embarrassing yourself or looking foolish.

Diabetes & Anxiety

T1D and anxiety are made to exacerbate one another. The fears and thought patterns that fuel anxiety are inherent to managing diabetes. On the flip side, struggling with anxiety can wreak havoc on your blood sugars. The more time I’ve spent working with and trying to pick apart anxiety disorders, the more I’ve realized how counterintuitive diabetes management is to anxiety levels.

What ifs

Running through the back of every anxious mind is a pestering whisper of what if? “What if I die?” “What if I embarrass myself?” “What if I fail?” These persistent questions can be crippling. However, when managing diabetes, it is often necessary to ponder what if. For example, I am about to pre-bolus for my dinner on my way home, but what if I get stuck in traffic? I am preparing for a run by adjusting my dosage and snacking, but what if it rains?

At the forefront of diabetes management is planning. Unfortunately, planning often invites what ifs, and what ifs can easily manifest into anxiety. When you are living with anxiety, it is often difficult to differentiate between rational or helpful what ifs and irrational, detrimental ones. Considering the rain or traffic while planning your insulin dosage can be productive, while repetitively pondering the possibility of going low and passing out during your exercise routine is not.

Living in the present

Similarly, planning for diabetes care can interfere with being present in the current moment. In recent years there has been growing evidence of the efficacy of mindfulness-based stress reduction (MBSR) and meditation for treatment of anxiety2. Much of our worry is rooted in what may or may not happen in the future. But it is hard to focus on the present moment and often difficult to be spontaneous when you’ve got insulin on board (IOB), sensors with downward-pointing arrows, and a fixed amount of juice in your handbag. Even the actual practice of meditation can be interrupted by alerting insulin pumps and CGMs. As mentioned above, diabetes management involves a lot of planning. And a lot of planning means a lot of future-oriented thinking.

Checking

Much like planning, with diabetes checking is essential. Checking you blood sugar, checking your IOB, checking your low supplies. But for someone with anxiety, checking can spiral into an obsessive ritual. People suffering from obsessive-compulsive disorder (OCD) have certain rituals they perform to quiet obsessive thoughts that repeatedly run through their mind. Because checking is so essential for diabetes management, it’s easy for someone susceptible to anxiety to fall into a pattern of over-checking. Picture this: you feel anxious about going low, check your sensor data and see no downward arrows. You feel a temporary wave of relief. But moments later, those thoughts recur. They get louder and louder in your head, until you have to check your sensor again – still no downward arrows. You see how this can fall into a negative thought-behavior cycle.

Where do we go from here?

Fortunately, much like type one, anxiety is manageable. But it takes work. If you feel like anxiety is interfering with you or your child’s everyday life, consider seeing a therapist. There are many therapists who have experience working with people with chronic illness. And if they don’t, BT1 has a helpful guide to teach them about type 13.

Where to start: finding a therapist

Your primary care doctor or pediatrician may have some referrals. Or, if you feel comfortable, ask around. It’s more than likely that many people in your life see a therapist and you have no idea. Or, if you have private insurance, you can try calling the “Member Services” number on the back of the insurance card and asking for referrals to local in-network behavioral health providers. There are also many ways to locate a therapist online:

If you have Medicaid (or Medical, or your state’s equivalent), your state’s Division of Mental Health and Addiction Services should have resources for local community mental health centers that accept this insurance. Your therapist or primary care doctor will also be able to suggest if you should consult a psychiatrist. A psychiatrist can prescribe medications for behavioral health concerns.

While diabetes and anxiety may make a great pair, you don’t have to constantly live at their mercy. As you learn to accept and manage your anxiety, you’ll learn how to live well with it. It won’t be easy, and there’s a lot of trial and error. Of course, having type one means you’re used to that! And always remember, you’re not alone in this.

REFERENCES

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Diabetes Burnout

WRITTEN BY: Mark Heyman, PhD, CDE

Have you ever felt like you are just “done” with diabetes?

Are you sick and tired of doing everything you’re supposed to do, but feel like your blood sugar is still out of control? Do you feel like you don’t care anymore about managing diabetes and want to just give up? If any of these things sound familiar, you may be experiencing diabetes burnout.

Diabetes burnout is a state in which someone with diabetes grows tired of managing their condition, and then simply ignores it for a period of time, or worse, forever. Unfortunately, diabetes burnout is common, and most people with Type 1 diabetes (T1D) have experienced it at some point in their lives. After all, if you have T1D, you have to be “on” 24/7, and as much as we would like one, there are no breaks. People who experience diabetes burnout aren’t necessarily depressed and are certainly not lazy. In fact, almost everyone with diabetes, even those experiencing burnout, want to live long healthy lives. But sometimes diabetes can feel overwhelming and folks can get burned out from all the hard work.

What does diabetes burnout actually look like? While it may look different in people, there are some common signs and symptoms. These include:

  • Strong negative feelings (e.g., overwhelmed, anger, frustration) about diabetes
  • Feeling controlled by diabetes
  • Isolation, or feeling alone with diabetes
  • Avoidance of some, or all diabetes management activities and being unmotivated to change this behavior

If you have T1D and are feeling burned out, please know that there is hope! Diabetes is hard work, and until we have a cure, it will continue to be hard. However, there are some thing you can try that can help you overcome, and even prevent, feelings of burn out.

Manage your expectations

People with T1D tend to be really hard on themselves. They expect a lot from themselves, and when they don’t meet their own expectations, it can be frustrating. Anyone who lives with T1D knows that it is almost impossible to do everything “right” all the time. And even if you do everything “right”, your blood sugar can have a mind of its own and do some crazy things. If you expect perfection, and perfection is not possible, it’s normal to want to give up. Instead, try cutting yourself some slack. It’s ok to strive for perfection, but it’s important to cut yourself some slack sometimes and be ok with slipping up. And remember that sometimes, having wacky blood sugars is part of having diabetes.

Take small steps

Diabetes takes a lot of hard work and sometimes everything can seem overwhelming. When things get overwhelming, you may not even know where to start. Instead of tackling a big task all at once, try breaking it down into small steps that you know you can accomplish. For example, telling yourself you want to reduce your A1C from 8% to 7% may sound like a Herculean task. However, if that is your goal, identify the specific things you can do today to get there. For example, you can check your blood sugar at least 4 times a day and count carbohydrates at every meal and take insulin to cover. Taking small steps can make achieving big goals seem a lot more obtainable.

Get support

Feeling like you’re alone in your life with diabetes is a big risk factor for diabetes burnout. With diabetes, isolation is one the biggest risk factors for becoming burned out. If you feel that nobody understands what you are experiencing or that you are the only person with diabetes that feels this way, life with diabetes can be a lonely place. While feeling supported does not make T1D go away, it can make it easier to live with. Getting support, encouragement and empathy from others can be a critical part of staying motivated to manage your diabetes. Sometimes the people in your life may not know what kind of support you need. Be clear with these people what would be most helpful and what you want them not to do. Remember that other people with T1D can also be a great source of support. These are the folks who know exactly how you’re feeling, because, at some point, they have probably felt the same way. If you don’t know anybody else with T1D, there are resources that can help. Many communities have meet-ups for people with T1D and there is an active diabetes online community on social media.*

If you feel burned out with T1D, you are not alone. Just remember that many people have overcome their burnout and are able to live long, happy and healthy lives with T1D. If you are experiencing diabetes burn out and you feel like you can’t deal with it on your own, it’s important to get help from a mental health professional who understands diabetes. Talk to your endocrinologist to see if s/he can recommend one in your area.

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Depression and Its Relationship to Type 1

Are depression and diabetes related?

The simple answer: yes.

Research shows that if you have diabetes, your risk of developing depression more than doubles. In fact, some studies show, that it could be as high as four times more likely.

And while this information may seem like just one more thing to worry about, it’s important to address and discuss, because doing so has the potential of improving your quality of life. And who doesn’t want that?

Someone once said, “Diabetes is a full-time job that you didn’t apply for, you can’t quit and there’s no vacation or pay.” (We’re nodding.) Agreed — no one lined up for the diabetes merry-go-round or the diabetes loop-dee-loop, because diabetes isn’t fun. Actually, it’s a royal pain. And you never get a break.

You know the drill: count carbs,  administer insulin, (factor in activity, stress and consider what’s happened before),  monitor blood sugars, rest, eat or compensate.

And no matter how vigilant you are and how meticulously carbs are counted and insulin accordingly dosed, you’ll get the rogue BGL, the unexpected zinger that just makes you feel like chucking that juice box or screaming or crying or crawling into a ball and giving up because sometimes you can’t be perfect — no, you aren’t perfect and this diabetes thing is hard, really hard and just when you think you got it right and you’re really hitting your stride … you’re tested, you’re thrown and have to try again then again and again. It’s no wonder the chronic condition can cause anxiety, feelings of frustration and even hopelessness.

Diabetes isn’t just a physical challenge with serious implications; it’s also emotionally demanding and can be extremely difficult to navigate mentally. That’s why the most effective treatments for Type 1 include medical care as well as psychological care.

Everyone at some stage of their life will experience “feeling down.” It’s important to note though, that depression is more than feeling “bummed out.” It’s a persistent feeling (lasting more than two weeks) of sadness or loss of interest, among other symptoms. It can be debilitating, life-altering and throw you down the rabbit hole of self-doubt. It also can be subtle. Perhaps you hadn’t really noticed, and it’s a loved one who’s mentioned the changes, has noted that things aren’t “okay”. Whichever way, don’t worry; take heed! You’ve made it here and you aren’t the first.

If you’re experiencing symptoms in at least three of the following categories, you may be depressed:

Things you may do …

  • Stop doing things you used to enjoy
  • Have trouble getting things done
  • Are unable to focus
  • Remain in your home for long periods of time
  • Pull away from loved ones
  • Use alcohol or sedatives excessively

Things you may think …

  • “I’m worthless”
  • “I’m not good enough”
  • “I deserve to feel like this”
  • “I will never be happy”
  • “This is my fault”
  • “Life is not worth living”

Things you may feel …

  • Guilt
  • Irritability
  • Anger
  • Frustration
  • Unhappiness
  • Indecisiveness
  • Disappointment
  • Sadness

Things you may experience physically:

  • Lethargy
  • Feeling sick and run down
  • Having headaches and body pains
  • Having an upset stomach
  • Irritabile bowels
  • Insomnia or excessive sleeping
  • Extreme weight changes and appetite changes

Note: This is just a short list of symptoms you may be experiencing if you’re depressed. Consult a mental health professional for proper assessment and treatment.

Did you say, yes to all of them? Say, yes to none? Either way: keep reading.

Your mental health affects how you deal with your physical health, so if you become depressed, you’re less likely to manage your diabetes well, which can lead to complications and poor health in general. Essentially, both aspects of care are paramount and affect your well-being in tandem, so don’t neglect either today or tomorrow!

Dr. Diana Naranjo, Assistant Professor of Psychiatry & Behavioral Studies and Dr. Korey Hood, Professor of Pediatrics at Stanford University, work exclusively with diabetes patients and believe that in terms of having optimal mental health with diabetes, depression prevention is key. If you know you are at a higher risk of developing depression or an anxiety disorder, being proactive can also improve your quality of life in the long run.

Planning ahead is all a part of self-care and can include reaching out to the support sources of friends, family, community groups and your credentialed diabetes educator or therapist.

If you have diabetes, it’s normal to experience a wide range of emotions as well as suffer physical setbacks. Especially right after diagnosis, many people report grieving for their health from before and the life they had previously. This is also true for parents or caregivers of those diagnosed with Type 1 diabetes.

The bottom line is that your mental health matters — early in the game and later on — so talking to a health professional can help. Treating your depression or anxiety may require more than talk therapy though. Some people are genetically predisposed to developing mental illness while life circumstances and stress can bring the onset of symptoms. Treatment could include short-term or long-term medication in conjunction with other forms of therapy.

Be sure to ask your therapist if he or she has had experience with clients who have Type 1. If not — and this is most likely the case — you can provide your mental health caregiver with additional information to help her or him understand what Type 1 is and the difficulties you face daily.

“Remember, you’re interviewing and hiring your therapist,” says Dr. Korey Hood. “And the discussion of mental health should not be separate from the discussion about your diabetes.”

In addition to working with a mental healthcare provider, try implementing the following in terms of self-care to help maintain a healthy mental state:

  • Join a community, reach out to other T1D groups and share your story
  • Ask questions of others, learn more about diabetes and depression
  • Perform moderate physical activity (consult your doctor about what would be a healthy level of exercise)
  • Eat healthy foods
  • Maintain a healthy weight
  • Limit your alcohol use

If you think you or someone you know might be contemplating suicide, reach out for additional help here:

Suicide Prevention Lifeline Or call 1 (800) 273-8255 (United States)

Just as much as blood glucose levels are important information in managing your diabetes successfully, so are feelings. Remember that you aren’t alone and there are people out there who understand and have been there. Reach out. Be proactive. And talk about it. There is a wide range of mental health treatments available, so consult a expert today to learn how you can improve your quality of life.

Verified by Dr. Mark Heyman, Director of the Center for Diabetes and Mental Health (CDMH) in Solana Beach, CA. Mark received his PhD in Clinical Psychology from The George Washington University and completed his clinical training at UCSD School of Medicine.

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3 Major Ways to Tackle Stress in Your Life

Everyone agrees: Stress is terrible. It’s the thing that keeps you awake at night and unable to enjoy your day. Sometimes stress helps us prioritize the things that need doing now, but more often than not, it’s a terrible feeling that sucks the life out of you. At its worst, stress can increase your chances of heart attack, harm your immune system, decrease sexual function, and wreck your digestive system. Stress can come from your work, your personal life, or your environment, and it can manifest in a multitude of (not great) ways.

Battling stress is a part of caring for yourself and your body.  How do you get out from under the crushing weight of stress and get your life back on track?

The Art of Self-Care

The best way to combat stress is to practice the art of self-care. Self-care can be hard for a lot of people, especially those with busy lives who are used to putting work and the needs of others ahead of their own needs. Moms are especially prone to struggling with putting themselves first. Self-care is as much a part of thriving as eating and sleeping. It’s caring for yourself mentally, replenishing that spring of mental wellness and energy so that you’re able to do the things you need to do. When you’re busy, schedule time for self-care the way you would a doctor’s appointment.

So what counts as self-care? Anything that leaves you happy, satisfied, and rejuvenated: massages, time spent with a friend or romantic partner, watching a movie you enjoy, or anything that makes you laugh. Examine the things that make you genuinely happy and fulfilled, and when you find yourself lagging, indulge.

Practice Changing the Way You Think

Getting out of a funk is hard to do. When you’re super stressed, it’s easy to fall into a black hole of negative thinking. Practice changing the way you think. If you’re plagued by negative thoughts, flip them around into something positive. It’s hard to do, especially when you feel buried by worry. The more you practice, the more you’ll lean towards positive thinking naturally. You’ll be happier in the long run.

Kick Social Media

There’s a ton of evidence that social media is bad for us. Deleting Facebook from your phone, or drastically reducing your time on Facebook, can lower your cortisol levels (that’s the hormone associated with stress). Increased cortisol can lower your immune system, encourage obesity, and impair memory. Excessive social media use has been linked with anxiety and depression. That’s a lot to put up with just to see what your cousin had for lunch.

Take a 24-hour break from all the noise and pressure from social media. If your hands are still twitching to use your phone, replace Insta with an app designed to help you reduce stress and anxiety. Some apps walk you through mindfulness or meditation. Others help you breathe, or they play soothing sounds.

Take Care of Your Body

There’s definitely a connection between mind and body — just ask anyone who has experienced being hangry. When you’re stressed, taking care of your body can absolutely help get you back to balanced. If you’re working under a deadline, you might be tempted to forgo eating healthy for something quick, like vending machine food. Sugar bursts and crashes can exacerbate stress. Take some time to eat food that will give you energy without burning out quickly, like protein.

Physical activity can help you work through feelings of stress. It’s as simple as taking a quick walk to clear your head. A walk can help you calm down, catch your breath, and head back into a stressful job or project with a much clearer head.

Sleep is a powerful tool to relax and unwind. Follow practices that lead to a good night’s rest:

  • Don’t eat before bed
  • Give yourself time to settle
  • Prime your bed for comfortable sleep
  • Keep distractions or stimulating objects (like your cell phone) far away from your bed.

Like a lot of the other suggestions in this article, they’re small changes. Those small changes can lead to a big difference in your life — one that will leave you more relaxed, fulfilled, and able to take on your goals with increased gusto.

 

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7 Ways You Can Improve Your Concentration

Concentration and memory are the two key focus points for every individual. When you are concentrated, your memory automatically improves as you are able to retain the information for a longer period of time.

Having a sharp memory and good concentration power is useful to people of all ages and all professional domains, whether a student or a CEO. Do you not wish that you could have the memory of an elephant who never forgets anything? So, in this article, we are going to discuss some similar tricks and methods that you can use in your daily life to improve your concentration power and in turn, memory.

1. Play Mind Games

Before you plan to beat me up, listen. Mind games are an amazing method to improve your concentration.

Moreover, it is more effective when you are playing these games offline rather than opening a new tab and searching for the best mind games to improve concentration.

2. Creating a To-Do List

A to-do list is probably the simplest thing that you can do. With the availability of almost everything over the internet, we are now the people who take out the phone and ask Google everything right then and there. But, what about after that?

Also, have you ever noticed that once you ask your Google assistant what’s the weather like tomorrow, you are browsing through your Instagram feed before you realise it?

So, create a to-do list that you can paste right in front of you. Keep it in your view and you will be saved from getting distracted.

3. Meditate

You don’t need to be a sage almighty or you don’t need the peace of nature with a waterfall and chirping birds so that you can meditate peacefully.

Meditation can be done right at your home, at your desk! You just need to calm and focus. Play relaxation music, but take care to not fall asleep. Close your eyes and focus on the one thing that motivates you to go on about your day.

It can be anything, some fictional character, your girlfriend, your parents, money or any other thing. You don’t need to pack your bags and depart for the Himalayas but work here and now.

4. Exercise

A lazy body is the devil’s abode. You should not even cry that you have such a poor concentration when all you do the entire day is eat pizza, drink beer, watch tv and sleep.

The first step to a healthy mind is a healthy body. Dust off the shoes in the shelf, put ‘em on and go jogging. Watch yoga tutorials on YouTube and learn the techniques that will open up the jammed parts of your body.

When you start exercising, you will not restrict your energy to your body but channelise it and allow it to flow. Hence, it will improve your concentration and your memory significantly.

5. Avoid Multitasking

I know it hurts but this is actually a way you can improve your concentration power and your focus.  It is natural that the person want feels the need to juggle so many tasks at once and try to complete them all at once. Though the capabilities of the human brain are not fully known, we do not know very well that how can multitasking become more efficient.

Hence, for the time being, avoid multitasking and focus on one thing at a time. Rather than trying to complete 5 different works with your 20% efficiency, allow your 100% efficiency on one single task.

6. Reduce Dependency on Gadgets

There is a phrase I am fond of – phones are getting smart and humans dumb. This is really true. If you ever look around yourself, you will see that everyone is busy with their necks down and thumbs moving.

These smartphones and other gadgets affect our brain directly and hamper with our decision making capability, our judgment and our concentration.

Whatever be the thing, we simply ask Google assistant to save a reminder. We ask Alexa to create our to-do list for the day. We need to set birthday reminders for the people who are close to us! Such dependency on technology should be reduced and the brain should be made to function more and more.

Trust me, your concentration will improve significantly after a couple of weeks when you start remembering everything and not your phone.

7. Identify Your Learning Style

Every human has a preferred learning style with which they learn everything. Whether you remember better and focus more during a video or by hearing something. Once you identify this, your concentration will improve.

What happens is that you will be able to identify which style of learning suits you more. As a result, you will automatically strive to focus more when your preferred learning style is available. See, your concentration improved.

These 7 tips are easy to incorporate in your daily lives as a way to improve your concentration.

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Ten Tips to Help You Feel Happier

Happiness is an elusive concept, we all want it but not many of us can define what it actually is and even fewer how to get it.

Unfortunately, a lot of us fall into the trap of the ‘I will be happy when’mentality. It’s an easy fix supported by our own psychology and propagated by the modern world. You end up thinking; ‘I will be happy when I have lost 10kg’s’, ‘I will be happy when I find a partner’, ‘I will be happy when I get that new car’ and so on. The difficulty is that you will be happy briefly, or at least you think you will. But this feeling won’t last long and then you will be onto the next thing that you believe you need to feel happy.

Now, don’t get me wrong, being healthier and finding positive relationships are good goals, but when you anchor your entire life onto the ‘i’ll be happy when’ philosophy you will always be left wanting more and the happiness you seek will likely remain elusive.

I am not promising that trying the following tips will immediately fix everything, but remember that you are the author, editor and viewer of your own life. You choose what you do from day to day. You filter experiences based on what you expect to see and you choose what you focus on and remember. So maybe just try some of these and see how you feel, who knows it could really make a difference, they have to me over the years.

  1. Try something new.

Now this doesn’t have to be big, in fact it can be tiny and in any aspect of your life. Try a new route from work and see what different sights there are, or people you meet. Maybe it will simply turn out to be quicker. Try a new restaurant, try a new activity.  Go big and visit a country you have never been to before, go brave and ask that person out, or end a toxic relationship. Novelty can help reinvigorate you, it can give you new perspectives, new experiences. You may meet new people, who in turn give you new ideas. It can give you new things to consider and talk about. Maybe just try one new thing a month and see what changes.

  1. Start Small

This is really important, people often make the mistake of trying to change everything at once. You set yourself giant targets and when you don’t achieve them in a month you start giving up and feel like you have failed. Instead focus on the tiny wins. If you want to lose weight, don’t think “I want to lose 2 stone”, start some exercise and if you feel a bit better then thats your target. Maybe your clothes feel a bit looser or you have little bit more energy. There is nothing wrong with big bold targets, but don’t measure your progress by it. Instead, break it into smaller goals and celebrate when you achieve them (perhaps not with a cheesecake though).

  1. Count the Good Things

Try this experiment with a friend, when you are somewhere you haven’t been before, ask them to look around and memorize everything that is red. Once they have done that, ask them to close their eyes and list all the things around them that are blue. A lot of people will struggle because they simply haven’t paid attention or focussed on the blue things around them. This is how our minds work. Very simply, we see what we expect to see and remember based on our preconceptions, your mind filters to make it more efficient. Now this is great from a survival perspective however it can cause problems. If we expect to have a bad day we will unconsciously only look for the things that confirm this. If we think we are unlucky we will look for things that prove our bad luck streak. Instead try something very simple, everyday before you go to sleep, think through your day and focus on five good things that have happened. They could be anything from ‘a nice walk in the sunshine’ to ‘meeting someone new’. There are always at least five events you can find that haven’t been awful or disastrous. Try this for a while and you may be surprised how it starts to change your mindset. You will start to look for more and more of the good and likely feel more positive.

  1. Say no….and yes more

This might sound like contradictory advice, but a lot of us spend a significant amount of time trying to second guess what other people want us to do. We try and make decisions on their wants and needs. We might do this for lots of reasons; we care for them, love them, live with them, dislike them and so on. Instead I want you to make decisions about how you feel and what you want. Have the confidence to say no to things you don’t want to do and yes to things that you do want to do. You may have avoided things in the past as you are worried that friends and family might judge you or it might change their view of you, but it’s not their life! It’s not about being selfish, just recognising that to be a good friend to others you need to first look after yourself and that you are entitled to do what makes you happy.

  1. Read a Book

In a world of social media and access to non-stop entertainment, books have sometimes fallen out of favour. Books give you a window into a different world or another persons life, a glimpse into history, they stimulate your imagination and mind. The focus required to read without distractions is sometimes considered a form of meditation; you can’t half read like you do with some TV programmes, it requires all of your attention. Books have the time to be more descriptive and delve deeper, ask questions that mass media are unwilling to, they can put you in the shoes of another world changing your perspective on life. Books have literally changed the course of history so why not give one a go.

  1. Stop and Meditate

We spend so much time running around thinking about work, family, friends worrying about what we have to do next, dwelling on something we did last week, rarely just stopping and taking in where we are and how we feel right now. Meditation can be practiced in many forms and its worth learning more about it. Essentially though, meditation asks you to focus on the moment you are in now, your place within it and the internal feelings and thoughts going on at that moment. Acknowledge them and then work to find stillness and quietness. Learn to slow down and quieten your mind to stop if from jumping from thought to thought like a over excited animal. Simply give yourself 5 minutes a few times in your day to just stop and look around you, admire the view and really take it in. Ask yourself, where are you now and how do you actually feel?

  1. Exercise

In anything, anywhere and anytime, just do it. Stop worrying about what to do and stop giving yourself the excuse that you have no time. Everyone has 10 minutes to take a brisk walk even if it’s to pick up the kids, 20 minutes for a run, 15 minutes for some Yoga, weights or just some stretching in your living room before you crash in front of the TV. The physical and psychological benefits of exercise are documented on an almost daily basis and finding information could not be easier online. Just start, today, you will not regret it.

  1. Think about your Food

Like with little changes you don’t have to stop eating all your favourite foods (pizza) immediately but perhaps just cut down on some of the worst offenders. You know what they are. Fast food, packaged cheap food full of salt and sugar. Reduce your meat intake for the sake of your own gut and the environment, eat…….some…….greens. It really isn’t rocket science, you just have to eat a balanced diet, there is so much information online and healthy food isn’t that expensive anymore. Now I know this is difficult when you don’t have time or money to cook, but a bag of salad is instant and chicken takes 10 mins to cook. Like above, focus on little changes that you can maintain and see how you feel after a few weeks. It should be no surprise that the food you put into your body can dramatically affect your internal state.

  1. Give

“No-one is useless in this world who lightens the burdens of another” Charles Dickens

Giving money is great and I applaud you for doing it, but also try and give your time. Stop and talk to people and really listen to them. Volunteer for something nearby.  Your time is the most precious resource you have, far greater than money, and spending it to help others is an amazing way to improve the world around you and you will be surprised how good it makes you feel. Give to charity, help others, give anything you can and as much or as little as you want to. There are always people more and less fortunate than you, don’t judge or compare just give.

  1. Spend time with your Friends and Family

There have been numerous surveys over the years conducted with terminally ill patients each one asking them about the meaning of their life, what made them happy and what they wished they could change about how they lived their lives. With each study there are some things that just keep coming up. For a start “I wish I worked more” is never in the list and almost always at the top is wishing they had spent more time with their friends and family. Good relationships are believed to even lengthen your life and none of us can get through this alone.

Remember though people come and go into your life, don’t be afraid to make new friends or say goodbye to toxic relationships. Never worry about calling that friend or relative you haven’t spoken to for years. They are just like you and will be busy with their lives and wondering if they should call you. Always try and make time for a coffee or beer or just a chat with your friends and family, they are literally the anchors of your life. They reflect who you are and how you live your life and are the ones standing with you in your time of need and you in theirs.

One more thing before you go, another common theme from these studies is patients often comment how they wished they had lived true to themselves and had the bravery to live their lives as they wanted to and not how they thought others wanted them to.

So here is a little experiment to leave you with, in Australia, the life expectancy is just over 82 years which is actually only 718,320 hours, this really doesn’t sound like much does it? But it gets more powerful when you divide that by three. A third for sleep and at least a third for work leaving you with less than 240,000 hours of free time…..then subtract how ever many years you have lived.

Life is genuinely very short and you should strive to live your own life and as positively as possible.

“Happiness is not something you postpone for the future; it is something you design for the present” – Jim Rohn

https://www.pickthebrain.com/

The Power of a Morning Routine

By Laura Greenstein

It’s early. You don’t want to move, let alone get up and start the day. You feel drained. You’re cozy, all wrapped up in blankets. Thoughts about all that you should accomplish today floods your mind. You feel overwhelmed, so you hit “SNOOZE” one more time.

Uh oh, now you’ve overslept. You’re running late. Time to get up and rush into the day.

Sound familiar? Mornings are hard, right? Actually, mornings aren’t definitively hard—they can be made easier.

The key to an easier morning is to keep your first waking hour as consistent as possible throughout the weeks. The more we struggle to make decisions, the more energy we deplete. When first starting the day, it’s important to avoid “decision fatigue” by having a set morning routine.

Having a morning routine can increase your energy, productivity and positivity. It also generates momentum, building up to the brain’s peak time for cognitive work (late morning). Here are a few suggestions to include in your morning routine.

Ease Into The Day

It’s easier to lull yourself out of sleep when you’re not rushing into the day. You feel more motivated to open your eyes and let your body properly wake up when you have a little bit of time to lounge in bed without jumping up. After a few minutes of lounging, follow these steps:

  1. Open your curtains and let the natural light energize you. Exposing yourself to sunlight in the morning can improve your alertness and energy during the day.
  2. Put some upbeat tunes on—music lights up the entire brain.
  3. Do some light stretching to get your blood flowing.

These small things can help you start the day in a positive mood, rather than feeling stressed to get up and out the door.

Eat Breakfast

Research shows that those who eat breakfast have more energy than those who wait until lunch to eat. While coffee will help jolt you awake, your body will eventually crash without food. You don’t need to feast first thing in the morning—a healthy snack and lots of water is all that’s needed to start the day off right.

Read

There are many ways to stimulate your brain, but one of the most recommended methods is reading. Reading a book in the morning can start your day in a richly detailed story, “how-to” or narrative, as opposed to a stressful, overflowing to-do list.

Reading is considered a “mental break,” because the brain is only focusing on one thing rather than the usual eight things. You can’t multitask while reading a book, and what you’re focusing on causes you to think, use imagination and create your own visual imagery. It’s this type of focus that gets our minds more nimble and creative. As the saying goes: “Reading is to the mind what exercise is to the body.”

Stimulate Your Body

Speaking of, you should also exercise in the morning. Exercise increases production of the neurotransmitters serotonin and norepinephrine, which enhances the body’s ability to deal with stressors and creates a post-workout feeling of bliss. Research shows that you are more creative and productive for the two hours following exercise. It also shows that people who exercise regularly are less stressed at work and more able to maintain work-life balance.

Begin Work With A Proactive Mindset

Psychologist Ron Friedman explains in an interview with Harvard Business Review that our usual start to the work day—checking email, answering questions or listening to voicemails—is, as he says, “cognitively expensive.” Starting the day this way puts you into a “reactive” mindset, and while switching from a proactive mindset to a reactive mindset is easy, the reverse is much more challenging. Instead, he suggests starting the workday with a brief planning session: strategize first, execute second.

Using these tips, here’s an example of what a healthy morning routine could look like:

6:55-7:00 – Slowly wake up, and open your eyes.
7:00-7:15 – Open the curtains, put on energizing music and do some light stretching.
7:15-7:30 – Eat some fruit and almonds for breakfast.
7:30-8:00 – Read and drink tea or water to get the mind stimulated and the body hydrated.
8:00-8:30 – Shower (don’t forget to sing!) and get ready for work.
8:30-9:00 – Walk to work to get in some moderate exercise.
9:00-9:15 – Begin work with a planning session to strategize your day.

As you can see, this routine takes two hours from the time you wake up until you get to work. While it may be difficult to find the extra time, you will find yourself reaping only benefits throughout the day. Many people don’t like getting up early, but this is the type of routine that can help you actually enjoy mornings.

 

Laura Greenstein is communications coordinator at NAMI.

https://www.nami.org/Blogs/NAMI-Blog/August-2017/The-Power-of-a-Morning-Routine

Preventing Mental Health Effects Of Divorce On Children

By Michelle Manno

 

Researchers have found that teachers and other school personnel may show bias against children in divorced families without even realizing it. This bias can impact expectations about a student’s academic, social and emotional functioning. Even though children are amazing in their ability to navigate the changes and challenges of life, students who experience this type of bias can be at increased risk for long-term mental health struggles later in life.

Recently, Counseling@NYU released a guide to help with this issue because it is essential for educators and parents to work together to ensure the effects of divorce on a child do not become permanent. Educators can use the guide to identify misconceptions about divorce that may impact their behavior and bias and to better understand their role in working with families going through a divorce.

Sometimes, it can be difficult to assess whether a divorce is negatively impacting a child or whether problem behaviors are just an expected part of the growing process. Knowing the signs of struggle according to age can help parents and educators identify whether a child needs additional support:

Grades K-3:

  • Blame themselves or their “bad behavior” for the divorce
  • Complain of headaches and/or stomach pain
  • Experience separation anxiety and/or emotional outbursts
  • Regress to younger behaviors, like needing a pacifier, wetting the bed or throwing tantrums

Younger children may lack the ability to communicate their thinking about the divorce. Parents should ensure young children that no bad behavior will ever make them leave or stop them from loving their child. In addition to seeking professional support, educators and parents should create space for children to express their fears and worries about the divorce.

Grades 4-6:

  • Most likely to show anger, embarrassment or frustration
  • Might stir up conflict with peers
  • Could show frequent tearful distress and/or lack of interest in activities

Children of this age may feel pressure to “pick a side,” keep both parents happy or take personal responsibility for one parent’s emotional well-being. Educators should work with parents to encourage students to try out new activities that can direct their attention toward play and creativity.

Grades 7-12:

  • Experiment with new and risky behaviors (i.e. substance use)
  • Display extreme moodiness or negativity
  • Begin demonstrating poor school performance and/or disinterest/distraction from their future

Teenagers experiencing the effects of a divorce might feel guilty about leaving home or feel that they have to change or sacrifice their plans. Parents can support teens’ mental health by encouraging them to pursue their goals and to plan for the future. Educators can do the same by listening to their students’ college goals, for example, and helping them plan.

At any age, individual professional counseling can be a useful space for children to express their frustrations outside the home and to get help for extreme changes in behavior. Educators and school counselors can also set up counseling groups for children in changing families so students know that they are not alone. With thoughtful and engaged parents and educators, children can maintain good mental health and healthy relationships later in life, despite divorce.

 

Michelle Manno is the education editor at 2U. She works with programs such as Counseling@NYU’s online master’s in school counseling and online master’s in mental health counseling from NYU Steinhardt to create resources that support K-12 students. Say hi on Twitter @michellermanno.

 

https://www.nami.org/Blogs/NAMI-Blog/August-2017/Preventing-Mental-Health-Effects-of-Divorce-on-Chi

Mental Health In The Workplace: The Value Of Rest

By Jennifer W. Adkins, Ph.D.

 

Earlier this week, I found a scrap of paper while cleaning that stopped me in my tracks. On it, I had written “take a year off” followed by a short list of commitments in my personal and professional life. The list included things I had entered into with excitement—like training other people in my profession and organizing community events—but didn’t have the time or energy needed to continue.

At the time I wrote the list, exhaustion was my norm. I was living with episodic and unpredictable pain, and my work was suffering. I didn’t have the energy to do all the things I normally do. I was keeping my commitments but performing poorly, which made me feel miserable.

What I didn’t know when I wrote that list was that depression would soon be a part of my life. I missed some of the early signs, but eventually it became clear that I was not well. The first clear sign came when I felt no joy during the Night to Shine Prom, an event my friends and I had spent months planning. It’s something we always consider to be “the happiest night of the year.” I thought something might have been “off” with the event, but as I saw joy on everyone’s face except my own, I realized something was “off” with me.

It was then I realized I needed a period of rest for my mental health. And along the way of implementing that rest, I learned a few helpful tips:

It Can Take A While

Some commitments are easy to take a break from, while others require more planning. After the Night to Shine Prom, I let the planning committee know that I wouldn’t be able to help plan the next prom. It was emotionally difficult, but it was quick. However, some of my other commitments took time to transition away from, as I had to identify and train a replacement before I could step down. It took months to fully cross off everything on my list, but each time, I felt a weight lift.

You May Second-Guess Yourself

Each person will face different challenges when preparing for a period of rest. I felt like I would be judged, I felt guilty for being less involved, I worried that important things would be left undone, and I didn’t want my relationships to suffer. These thoughts were common in the beginning, and I had to keep reminding myself how important it was for me to rest and recover.

People May Not Support You

Your colleagues, friends and family probably aren’t fully aware of the reasons rest is necessary for you. If their initial responses aren’t as supportive as you’d hoped for, it might mean they’re just surprised, or they rely on you and will miss your contributions. You may find it helpful to explain why you need to take a break. In some instances, though, the best thing you may be able to do is to quietly try to understand things from their perspective.

Stepping Away Is A Surprisingly Positive Process

Maybe you realize how important it is for you to cut back and have fewer responsibilities. What you may not realize is how positive it can be for other people. During the process of transitioning my responsibilities, I got to see people step up who were just as passionate about these roles as I had been. Almost immediately, the energy they brought to the roles resulted in growth and improvement I hadn’t been able to fully offer for a long time.

Rest Is Hard…

Rest is not accomplished by simply taking time off and then going back to your busy schedule. Rest occurs when you allow yourself to be fully inactive. A period of stillness and rest may be a necessary precursor to a more active mental health recovery. After a period of rest, you may find that you are more motivated to engage in activities like exercise, reading, crafting, praying, journaling or spending time with loved ones. You will be more likely to benefit from those wellness-promoting activities if you have taken time to rest first.

But The Results Are Worth It

When you’re rested, you’ll have energy to enjoy the things you love again. You’ll know you’re on the right track when your response to your personal and professional opportunities changes from “Oh no” to “Heck yes!” Even before I considered myself fully rested, I found I had more energy to be a mom, to be a wife and to commit to my work. After resting for a month, I was thrilled with the quality of my work. I even had energy left over to spend on myself and the things I enjoy.

You May Not Have All The Resources You Need To Rest

I am blessed to have the support of family and friends—and access to paid sick leave. I know these are not resources everyone has and sometimes paying the bills, getting your kids to school or taking care of your loved ones may not be things you can readily disengage from. My advice if you cannot commit several days—or, dare I say, weeks—to rest is to take advantage of whatever opportunities you can. Do what you absolutely have to do and then rest the remainder of the time. Maybe instead of committing a month to complete rest, you start by committing a month to only doing the things you need to, letting non-essential projects wait and accepting help from others when it’s offered.

I am grateful to have experienced firsthand the profound impact rest can have on mental health and work. Its positive impact has influenced me to incorporate continued rest into my regular schedule. I feel great, and I am proud of the work I am doing. I know if I want things to stay this way, I will need to intentionally make time for rest.

Coming across the slip of paper that started my journey toward rest was a shock. As soon as I saw it, memories of how physically and emotionally exhausted I was rushed in. I cried as I recalled all the moments and days I lost to pain and depression. Then I realized how much better I feel now and the role that rest played in me getting to a better place. Seeing that slip of paper strengthened my resolve to rest when I need it.

 

Jennifer Adkins is a wife, a mom, and a psychologist. Her professional interests include treatment of anxiety disorders, improving family relationships, and reducing stigma associated with mental illness. 

 

https://www.nami.org/Blogs/NAMI-Blog/August-2017/Mental-Health-in-the-Workplace-The-Value-of-Rest

How Do I Know If My Therapist Is Effective?

By Laura Greenstein

 

It can be a challenge to find the “right” therapist for you. You might come across someone who has a degree from an impressive school, writes extensively on psychology and mental illness, gives lectures and talks, and still isn’t an effective therapist. And while it is important for therapists to be educated, trained and up-to-date on current practices, there is so much more to a good therapist than just their background and education.

Because the science of therapy is subjective, it can be challenging to tell if your therapeutic relationship is truly “working.” Here’s a list of how effective therapists practice to help you determine whether you’re receiving the best possible care.

Do They Guide You To Your Goals?

Be wary of any therapist who makes promises like: “I can get you to recovery in six months” or “I can help you get rid of your anxiety.” Therapists should guide you towards reaching your goals, not make guarantees about when and how you will reach them. How you improve should be at your own pace. Additionally, they are not there to set your goals for you. This is your treatment—you’re in the driver’s seat.

Do They Show Acceptance And Compassion?

It’s one thing for your therapist to show concern or recommend against certain behaviors, but you shouldn’t feel judged or ashamed after a therapy session. Christine, a young adult living with Borderline Personality Disorder (BPD), tells a story of when she felt shamed by a therapist:

“I went to a therapist to talk about a relationship I was having a hard time getting over. I told her I would do outlandish things to keep this relationship alive, even though this guy made it clear he wanted nothing to do with me. This therapist responded by saying, ‘Christine, men don’t like clingy women. You need to be coy and play hard-to-get.’ She completely invalidated that my fear of abandonment had been triggered; to her, this situation had nothing to do with BPD, I was just making myself too available.”

The most effective therapists make you feel accepted and validated, showing understanding and sympathy/empathy for whatever you’re going through. They will approach you with compassion and kindness, and build enough trust for you to share your darkest thoughts and memories with them.

Do They Challenge You?

It’s important to recognize that therapy is not synonymous with friendship. An effective therapist will challenge you and help you see things from a different perspective, even if it’s hard to hear. They will give you homework that you may not like. For example, when I feel anxious, my reaction is to try to get rid of that anxiety any way that I can. So, my therapist often tells me to “sit with anxiety, accept that anxiety has visited you and observe how you feel.” She pushes me out of my comfort zone to help me overcome my fears and work towards my goal of managing anxiety.

Do They Check-In With You?

It’s important for your therapist to check-in with you about how you think therapy is going. After giving me challenging homework, my therapist will often ask me how it went or if I found it helpful. Since each session is tailored to you, a good therapist should adjust treatment based on your feedback. For instance, if you feel like they pushed you to do something you weren’t ready to do and you say you want smaller, more achievable steps, your therapist should take this into consideration for future exercises.

Do They Help You Learn?

An effective therapist offers different ways to help you learn skills (such as managing difficult emotions, handling stressful situations or practicing acceptance), understand yourself better and encourage healthy communication with the people in your life. “One therapist helped me see that when I like a person, whether it’s a relationship or a friendship, I have a hard time seeing red flags,” says Christine. “She helped me realize this about myself, and now I push myself to see people in a more realistic way.”

At the same time, this doesn’t mean telling you what to do each step of the way. Rather, they help you learn how to handle the stressful situations life throws at you. It’s problematic if you feel dependent on your therapist.

Do They Practice Cultural Competence?

Therapy should be tailored to your specific culture, background and needs. A good therapist is understanding of any cultural barriersyou face and should keep those in mind while advising you. “When I met with my therapist in the first couple sessions, they were interested in learning about my culture and how it has impacted my experience,” says Ryann, a person with lived experience. “Culturally competent therapists say validating statements rather than questioning my upbringing.”

Do They Treat You As An Equal?

An effective therapist works with you and supports you. They’re your partner in bettering your mental health. They’re not the teacher instructing the “right ways” to behave or the parent asserting discipline over a child. There shouldn’t be any kind of power struggle or “doctor-knows-best” attitude in their demeanor. While it is important to respect their wealth of knowledge, you shouldn’t feel inferior to your therapist.

Therapy is one of the few parts of life that is all about you. Therapists are not there to express their own needs—they are there to help you reach your goals. Like any other worthwhile endeavor, the benefits of therapy don’t happen overnight, but over time you should feel like your therapeutic relationship is nothing but beneficial to your well-being.

https://www.nami.org/Blogs/NAMI-Blog/February-2018/How-Do-I-Know-If-My-Therapist-is-Effective