Pandemic-Related Anxiety

Feelings of increased stress, anxiety, and depression are now a new “normal baseline” for a population finding themselves faced with fear and uncertainty.

Improving Treatment Adherence for Type 1 Diabetes

Despite all the advances in medical science and technology, there is still no cure for diabetes. A person with diabetes has to live with it and manage it all their life. The challenge, of course, is being diligent and consistent with diabetes management. Type 1 diabetes is challenging to manage because it is so comprehensive. Research shows that the adherence rate for chronic conditions is about 50%. Despite extensive studies and research, that number has not changed significantly over the past 3 decades.

What is adherence? How does it apply to people with type 1 diabetes? How can a person with type 1 diabetes improve their adherence? And how can mental health professionals help? These questions were answered by Dr. Katherine Fan, a psychiatrist and pediatrician, at the 2016 Asian Outreach Day. Dr. Fan spoke with attendees about the factors that affect a person’s short and long-term dedication and commitment to managing their diabetes. Here’s a recap of her talk:

 

What is Treatment Adherence?

Adherence is the active, responsible, and flexible process of self care and self management with a goal of overall health and wellness. An adherent patient strives to achieve good health by working in close collaboration with health care staff, instead of simply following rigidly prescribed rules.

In the context of type 1 diabetes, adherence can also be known as “collaborative diabetes management”, “patient empowerment”, or “self care behavior management”.  It can be useful to break down diabetes adherence into a number of areas:

  • Glucose monitoring
  • Administration of medication / insulin
  • Dietary intake / carb counting
  • Physical activity
  • Follow up visits

This may help the patient, medical care providers, and support system prioritize and focus on which parts to work on.

Also, it is important to distinguish between Adherence and Compliance. Compliance implies a paternalistic relationship between and patient and his/her doctor. The patient takes a passive role in diabetes management, simply following doctor’s orders and doing what they say. On the other hand, adherence is more of a partnership between a patient and his/her doctor, as well as his/her support network. In fact, the patient is an active participant in planning and management.

 

Factors Impacting Adherence

What makes a person with diabetes more or less likely to adhere to their diabetes management plan?  There are 4 main types of factors that diabetes adherence:

Treatment and Disease Characteristics

Complexity of treatment: The more complex the regimen, the lower the adherence rate. For example, if a patient has to take 10 different kinds of medication, 4 times per day, it is difficult to integrate this routine into daily life.

Duration of disease: The more chronic the illness, the lower the adherence rate. This may seem counterintuitive, but patients who have been diagnosed longer actually tend to have lower adherence rates than those recently diagnosed. Managing a condition over long periods of time may lead to a more casual attitude, or it may lead to burnout.

Delivery of care: Diabetes care can be delivered a number of ways: via a multidisciplinary team, a single general-care provider, or community treatment, to name a few. Research has shown that patients with diabetes seen specifically for their diabetes received more counselling on diet and adherence than patients with diabetes seen for an acute illness.

Intra-personal factors

Age: The teenage years tend to be hardest time to stick to a diabetes management plan. In contrast, parents of young children with diabetes are more likely to be adherent.

Self-esteem: Research has shown that high levels of self-esteem are related to high levels of adherence to physical activity regimens, adjustment of insulin doses and dental self-care

Self efficacy: Self-efficacy is defined as an individual’s belief in their ability to succeed specific or accomplish a task. A healthy sense of self-efficacy can play a major role in approaching goals, tasks, and challenges. The more a patient is able to advocate for him and herself, the better the outcome.

Stress: Stress and emotional state is also correlated with treatment adherence. The less stresses a person experiences, the more likely he or she will adhere to diabetes management.

Comorbid conditions: A comorbid condition is one that occurs at the same time as another illness or condition. Comorbid conditions such as depression, alcohol abuse, eating disorders, and others can adversely affect diabetes adherence. This effect is not limited to mental conditions: physical comorbidities also tend to lower the adherence rate of diabetes.

Inter-personal factors

Patient-provider relationship: The better the relationship between a patient and his or her provider, the higher the patient’s adherence rate will be. Patients and providers who communicate with each other tend to have improved relationships.

Social support: The benefits to have a social network for a person with type 1 diabetes are well known. Greater social support means better levels of adherence. For children and teens with type 1 diabetes, great parental involvement also means better levels of adherence.

Environmental factors

Stressors:The more stress a person has in their life, the harder it is to prioritize and manage diabetes

Conflicts: People with diabetes are as multifaceted as everyone else. Frequently, they are called upon to choose between giving attention to diabetes self-management or to some other life priority. They can face time pressures and social pressures during school events, work events, family events, holidays, and more.

Lifestyle factors: A person’s lifestyle can directly affect their diabetes adherence levels. Are they sedentary or active at work? Do they work long hours? Do they travel a lot? How much time do they spend in front of the television? Do they have a hobby?  Different circumstances require individuals to adjust and maintain their diabetes management.

Socio-economic status: The economically disadvantaged and ethnic minorities may find it particularly challenging to visit healthcare providers or to live a healthy lifestyle. They may have limited access to fresh fruits and vegetables, small living spaces. Their schools may not provide opportunities for physical activity. What’s more, financial constraints may prevent them from going to a gym. Those factors, combined with their local climate, may make regular exercise challenging.

 

The Diabetes Adherence Team: What can we do?

There are four kinds of players on any diabetes management team: the Patient, the Parents (or family/friends), the Physician, and the Environment. All players have a role to play in diabetes adherence. When each “player” contributes in a positive way, it leads to better adherence and better outcomes. Here are tips on how each team player can work to enhance adherence and wellness:

The Patient

It takes a team to manage diabetes, but adherence starts with the patient. As the person with diabetes, you’re going to be living with your body for a long time, so take care of it! Here are some things the patient can do to make diabetes adherence easier:

  • Be informed and understand your condition. Understand what it does to your body, and understand the complications that can occur if one does not manage the condition and stick to the plan.
  • Identify your strengths and future goals. Don’t see diabetes as something that defines you, but something that is a part of you. You cannot change it but you can manage it.
  • Stress proof your life. Work on areas such as sleep, nutrition, exercise, hobbies, mind-body exercise, healthy coping strategies, and more. Also, develop a support network of family, peers, school, religion, and/or support groups.

The Parents

Parents (and family) play a huge role in enhancing adherence. Here are some things parents can do to help their child with T1D:

  • Understand the developmental needs of your child and recognize where they are. Remember, each child is different! At any given age, a child may be a different levels with respect to cognitive, motor, social-emotional, and physical skills.
  • Be informed and stay involved. Invest in your relationship with your child! Additionally, help your child be informed and involved. Help educate your child’s school, as well as caretakers, friends, and family.
  • Balance “take control” and “letting go”. We all want to be there for our kids, but we want our kids to take responsibility and be independent so that when they leave home, they can take care of themselves.
  • Create a supportive home environment. Avoid judgement words such as “good” or “bad” sugar/A1C. Instead, use phrases like “in or out of range”.
  • Foster a positive attitude about the condition.
  • Model self care. Kids learn by watching!
  • Focus on incentives, not threats or fear tactics. Consequences are for behaviors that you want to stop, while incentives are for behaviors that you want to foster.
  • Don’t be shy about asking for professional help!

The Physician

Physicians play an important role. A physician who can help enhance adherence is one who:

  • Keeps it simple and simplifies treatment regiments as much as possible
  • Makes sure patients understand the consequences of non-adherence
  • Connects with the patient in a way they understant
  • Enhances patient communication via phone, text, etc..
  • Leaves bias out of the relationship and avoids judgement. Patients already feel shame and guilt, and when they feel judged, it negatively affects the doctor-patient relationship.

The Environment

Some environmental factors are difficult, if not impossible, to control, so focus on things that you can control. For example, you may not be able to enhance access to health care, but you can provide diabetes awareness and education. You can educate not only yourself and your family, but also the broader community. Parents can help educate their children’s school teachers and friends. Adult patients can start support groups online and in real life. Technology can also improve diabetes awareness and education.

 

The role of Mental Health Clinicians

How can mental health clinicians help patients achieve overall wellness?

  • They can support the patient and the patient’s family, not just during diagnosis, but throughout their journey.
  • Acceptance is the first step towards adherence. Mental health clinicians can help patients work on accepting their condition and coping with it.
  • Mental Health Clinicians can help the patient process some of the emotional factors that come with diabetes: anger, fear, guilt, shame, stress, sadness
  • They can facilitate communication and conflict resolution, between you and parents and friends, between doctor and patient
  • They can help identify other emotional disorders that can complicate diabetes management, such as depression, anxiety, eating disorders, or substance abuse.

Mental health clinicians can provide treatments such as cognitive behavioral therapy, motivational interviewing, behavior modification plans, or family therapy.  Diabetes affects the mind as well as the body. Mental health is an important step towards the journey to your best self. Never be afraid to ask for help from a mental health professional!

 

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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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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/

Don’t Get Crushed By Anxiety

By Laura Greenstein

Have you ever felt hesitant about approaching someone you met eyes with? Or felt nervous talking to someone you’re interested in? Or felt a knot in your stomach while finding the courage to ask someone on a date? Most likely, you’ve experienced at least one—or maybe all—of these feelings, because anxiety and dating are a difficult pair to separate.

Dating enhances several of our deepest fears: rejection, being judged, getting emotionally wounded. It can be challenging to overcome these fears and put yourself out there. In fact, our dating culture has shaped itself aroundthese fears in an attempt to make the process of dating “easier.” But in many ways, this evolution has made dating more complicated and anxiety-inducing than ever. Take, for example:

Meeting People Online

Many online websites and apps have been created so people can screen potential suitors before ever having to physically meet them. For those who engage in online dating, there is a multitude of new concerns to contend with: Is this person real or are they just “catfishing” (using a fake profile)? How are they going to perceive me based on my profile? What questions can I ask to get to know them? This is all before the anxiety of actually meeting the person.

Knowing “The Rules”

It has become the norm to refrain from showing too much interest in someone you’re getting to know. This standard has produced a set of unspoken “rules” for any person engaging in modern dating culture. Some of these rules include:

  • Don’t double text (i.e. send an additional text before the person responds to your first text). This makes you seem too eager.
  • Don’t call someone. This will likely be met with distaste and confusion because phone calls are essentially obsolete.
  • Don’t respond immediately to a text message. This makes it seem like you were sitting around waiting for them to text you.
  • Don’t “like” any old posts or photos on their social media. Otherwise, they will know you were “Facebook stalking” them, or intently monitoring or looking through their Facebook updates or history.
  • Don’t let them see you typing for too long on systems that show the other person when you are typing a message (e.g. iMessage, Facebook Messenger, etc.). Then they will know you were putting a lot of thought into saying the perfect thing.

If someone breaks these rules, they are typically perceived as desperate and unattractive. So if we like someone, we have to bury it away. It’s almost a competition of who can be less interested. How can our pride be hurt if our attitude is: “Oh I wasn’t really that into you anyway”?

Dealing With “Trendy” Rejections

The way people reject those they are casually dating is constantly changing based on what’s “in.” For a while, the trend was “ghosting,” or abruptly ignoring the person on every channel of communication. This causes the person rejected to anxiously wonder when the other person will respond and what they did so wrong. Similarly, there is also the “slow fade,” which is the same thing, except more drawn-out.

As if those trends weren’t bad enough, there’s a new one coined “breadcrumbing,” which is not being interested in someone, but continuing to lead them on. People who do this are trying to keep a person interested while they seek out other options.

How Can We Make This Easier?

With all these challenges (and more), it’s important to maintain your mental health when trying to connect with someone. And it’s important to remember that dating isn’t hopeless—even if you experience a mental health condition that makes it even harder. Here are a few things you can do to reduce your anxiety while dating:

️ Accept Yourself First

As cliché as it sounds, it is essential to love yourself and be happy with who you are before you add another person to the mix. A lot of dating anxiety happens because of insecurities within ourselves. Learning to be content and fulfilled while single before looking for a relationship is extremely helpful towards dating in a healthy way. When your happiness isn’t dependent on your search, you won’t put as much pressure on the situation or feel as anxious about every person you meet.

“Your relationship with yourself sets the tone for every other relationship you have.” – Robert Holden 

️ Be You Always

Once you have accepted yourself, you will feel comfortable being open and honest about who you are. You will respect yourself and won’t waste your time playing the usual games to pique someone’s interest. If someone doesn’t like you or the fact that you are open with your feelings, then they’re not the type of person you should be with anyways.

️ Dismiss Exaggerated Thoughts

Thoughts that rev up anxious thoughts need to be either ignored or thought through in a logical way. For example: “I’ll be alone forever” is not a rational thought. Yes, you may have to wait to find someone, but most likely, you will not be alone for the entirety of your life. Being able to recognize that a thought is exaggerated can be helpful in minimizing your anxiety.

️ Know It’s Okay to Feel Anxious

It’s okay to feel nervous, awkward and uncomfortable when first meeting someone. And it’s also okay to tell them that when you meet them—chances are they feel the same way. After all, it’s human nature to feel nervous at the prospect of finding a partner.

 

Laura Greenstein is a communications coordinator at NAMI.

 

https://www.nami.org/Blogs/NAMI-Blog/April-2017/Don-t-Get-Crushed-by-Anxiety

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

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

The Pathway To Peace Of Mind

By Larry Shushansky, LICSW

 

To create the roadways of a city, it takes years of planning, developing and building. It’s a never-ending process as new ideas are constantly suggested on how to make everything more efficient and in tune with changing needs.

Peace of mind is developed the same way.

In the 1900’s, scientists believed that our brain was fully developed by age six. We could learn more, sure, but “who we were” was set. Additionally, it was believed that after our teenage years and early years of adulthood, our brain and bodies declined through aging, injury, disease and illness.

“And then,” stated Dr. Lara Boyd, a brain researcher from the University of British Columbia, “studies began to show remarkable amounts of reorganization in the adult brain. And the research has shown us that all of our behaviors change our brain. That these changes are not limited by age…in fact they’re taking place all the time.” Meaning we can reorganize, change and restructure the physical makeup of our brain no matter what age we are.

So, imagine your brain is a city composed of many roadways that have all been under construction since before you were even born. And just like cities, we can create new roadways that enable us to be happier.

I’m sure you’ve heard about the many ways to be happier and healthier, but true change relies on deciding on a new habit or practice and dedicating yourself to it. That’s when your roadways will begin to evolve for good. Here are some important things to keep in mind when you’re working on yourself.

Change

Whatever we decide to think or do, it has to be different than our norm. For example, if we decide to move towards having more peace of mind by going on walks three times a week, and we’re already walking three times a week, we are not going to change. But if we decide to also practice mindfulness while walking, this is different.

Belief

Whether it’s exercise, nutrition, meditation, yoga, tai chi, therapy, medication, religion, spirituality or any other strategies we might use to become happier, we need to believe in what we’re doing and believe we can succeed. Rather than going through the motions, we need to embrace the belief that we are changing our thoughts or behaviors to become happier.

Motivation

“The harder we try, the more we are motivated, the more alert we are, and the better (worse) the outcome, the bigger the brain change,” wrote Dr. Michael Merzenich in Soft WiredTo make a change, it takes commitment and effort. There are times when we just don’t want to get out of bed to do yoga or go for a brisk walk. That’s true for anyone. Occasionally missing an opportunity to practice what we’ve decided to do is okay. But if we allow ourselves to continually take breaks, then we are pausing our progress.

Intention

Our intention should be all-in. I once had a client who listened to guided meditation while he was driving and then later in the day when he was focusing on a project at work. He said he didn’t have time for anything more intensive, and he couldn’t figure out why he wasn’t feeling any better. It takes focus to make change for the better. It helps to set aside specific time so you can focus solely on one thing at that time.

Practice And Repeat

Most of us quit doing what we’re doing once we experience “success.” That’s pretty common. But when we practice beyond “success,” we convert short-term changes into long-term memory and that’s what sticks. It has been found that repetition is effective in helping children learn how to read (imagine if they just stopped after completing their first book?). The same is true when establishing an ever-growing peace of mind.

It’s best to look at creating happiness and peace of mind as an evolving process rather than an end goal. It’s important to keep in mind that we’ll always be moving towards happiness. The roadways to peace are never finished—we’re always under construction.

And we can either let our old pathways determine who we are or keep working on becoming who we want to be. Each step we take enables us to become happier with ourselves, our relationships and with the world. And we can achieve a greater sense of peace and calm as we continue to grow.

 

Larry Shushansky has seen thousands of individuals, couples and families over 35 years as a counselor. Through this and the process he used to get clean from his alcohol and drug addiction, Larry has developed the concept of Independent Enough. Follow him on Facebook here. You can also access his blog through his website at Independentenough.com

https://www.nami.org/Blogs/NAMI-Blog/December-2017/The-Pathway-to-Peace-of-Mind

Self-Help Techniques For Coping With Mental Illness

By Emmie Pombo

 

Living with mental illness is not easy. It’s a consistent problem without a clear solution. While treatments like medication and psychotherapy are incredibly helpful, sometimes people experiencing mental health conditions need to do more day-in and day-out to feel good or even just okay.

Some common self-help suggestions people receive are to exercise, meditate and be more present, which are helpful and work for many people. However, other proven methods aren’t mentioned as often. Many of them are quick and simple techniques that can easily be added to daily routines.

Finding the right coping mechanism takes time and patience, but it can enormously impact how you feel. If you haven’t had success with techniques you’ve tried, or you’re looking to add a few more to your toolkit, here are seven coping mechanisms recommended by mental health professionals worth trying out.

Radical Acceptance

Radical acceptance is “completely and totally accepting something from the depths of your soul, with your heart and your mind,” according to Marsha Linehan (creator of dialectal behavior therapy). Included in this definition is the idea that no matter what, you cannot change a situation. For example, imagine a tornado is coming your way. Obviously, you can’t do anything to stop the tornado; that’s not possible. But if you accept the fact that it’s coming, then you can act, prepare and keep yourself safe. If you sit around trying to will the tornado to stop or pretend that there is no tornado, you’re going to be in real trouble when it comes.

The same applies to mental illness. You cannot change the fact that you have a mental illness, so any time you spend trying to “get rid of it” or pretend it doesn’t exist is only draining you of valuable energy. Accept yourself. Accept your condition. Then take the necessary steps to take care of yourself.

Deep Breathing

Breathing is an annoying cliché at this point, but that’s because the best way to calm anxiety really is to breathe deeply. When battling my own anxiety, I turned to the concept of “5 3 7” breathing:

  • Breathe in for 5 seconds
  • Hold the breath for 3 seconds
  • Breathe out for 7 seconds

This gentle repetition sends a message to the brain that everything is okay (or it will be soon). Before long, your heart will slow its pace and you will begin to relax—sometimes without even realizing it.

Opposite-To-Emotion Thinking

Opposite-to-emotion thinking is how it sounds: You act in the opposite way your emotions tell you to act. Say you’re feeling upset and you have the urge to isolate. Opposite-to-emotion tells you to go out and be around people—the opposite action of isolation. When you feel anxious, combat that with something calming like meditation. When you feel manic, turn to something that stabilizes you. This technique is probably one of the hardest to put into play, but if you can manage it, the results are incredible.

The 5 Senses

Another effective way to use your physical space to ground you through a crisis is by employing a technique called “The 5 Senses.” Instead of focusing on a specific object, with “The 5 Senses” you run through what each of your senses is experiencing in that moment. As an example, imagine a PTSD flashback comes on in the middle of class. Stop! Look around you. See the movement of a clock’s hands. Feel the chair beneath you. Listen to your teacher’s voice. Smell the faint aroma of the chalkboard. Chew a piece of gum.

Running through your senses will take only a few seconds and will help keep you present and focused on what is real, on what is happening right now.

Mental Reframing

Mental reframing involves taking an emotion or stressor and thinking of it in a different way. Take, for example, getting stuck in traffic. Sure, you could think to yourself, “Wow, my life is horrible. I’m going to be late because of this traffic. Why does this always happen to me?”

Or you can reframe that thought, which might look something like, “This traffic is bad, but I’ll still get to where I’m going. There’s nothing I can do about it, so I’ll just listen to music or an audiobook to pass the time.” Perfecting this technique can literally change your perspective in tough situations. But as you might imagine, this skill takes time and practice.

Emotion Awareness

If you live in denial of your emotions, it will take far longer to take care of them, because once we recognize what we’re feeling, we can tackle it or whatever is causing it. So, if you’re feeling anxious, let yourself be anxious for a couple of minutes—then meditate. If you’re feeling angry, let yourself be angry—then listen to some calming music. Be in touch with your emotions. Accept that you are feeling a certain way, let yourself feel that way and then take action to diminish unhealthy feelings.

You can’t control that you have mental illness, but you can control how you respond to your symptoms. This is not simple or easy (like everything else with mental illness), but learning, practicing and perfecting coping techniques can help you feel better emotionally, spiritually and physically. I’ve tried all the above techniques, and they have transformed the way I cope with my mental health struggles.

It takes strength and persistence to recover from mental illness—to keep fighting symptoms in the hopes of feeling better. Even if you feel weak or powerless against the battles you face every day, you are incredibly strong for living through them. Practical and simple methods can help you in your fight. Take these techniques into consideration, and there will be a clear change in the way you feel and live your life.

 

Emmie Pombo is a student striving to crush mental illness and addiction stigma. She also advocates for the people who haven’t yet spoken honestly about their struggles. Rooted in Florida, Emmie hopes to eventually diminish any lies surrounding the treatable mental disorders that are becoming more and more prevalent throughout the world.

https://www.nami.org/Blogs/NAMI-Blog/March-2018/Self-Help-Techniques-for-Coping-with-Mental-Illnes

Exercise For Mental Health: 8 Keys To Get And Stay Moving

Mental illness has deeply impacted my life. I have experienced the flooding of anxiety and the drowning of depression. I have waged, and won, several battles with postpartum depression and been through loss and grief. I know how painful it can be to find oneself in the throes of mental illness and how helpless it can feel when a loved one is caught in its grasp. As a clinical psychologist, I have witnessed the sting of mental illness and the struggle to find healing. People come desperate to learn the tools that can break the chains of mental and emotional symptoms. Too often, individuals and their friends and family are ready to seek and find help, only to find barriers halting their progress.

Barriers To Mental Illness Treatment

An astonishing 60% of American adults, and almost half of children ages 8–15, receive no treatment for their mental illness diagnoses. Though valid treatments—like mental health medications and psychotherapy—are available, too many people encounter barriers to treatment. This occurs for many reasons, but the most common are the stigma of mental illness and its treatments, like medication and therapy; the side effects  of medication treatments; and the cost  of long-term therapy or medical interventions.

Benefits Of Exercise For Mental Health

Exercise has been researched and validated for treating a variety of mental issues and mental health conditions, including depression, anxiety, eating disorders, bipolar disorders, schizophrenia, addictions, grief, relationship problems, dementia and personality disorders. Additionally, exercise alleviates such conditions as bad moods, stress, chronic pain and chronic illnesses.

Exercise is not only free from negative stigma, it is safe when done appropriately, with a doctor’s approval. Any side effects are ultimately positive, and even better, exercise is free of charge, easy to access and available for everyone. Exercise can be used as a stand-alone treatment for some mild-to-moderate conditions or, more effectively, in conjunction with other mental health treatments.

Like medicine in the treatment of mental illness, exercise can increase levels of serotonin, dopamine and norepinephrine in the brain. It improves and normalizes neurotransmitter levels, which ultimately helps us feel mentally healthy. Other important benefits include enhanced mood and energy; reduced stress; deeper relaxation; improved mental clarity, learning, insight, memory and cognitive functioning; enhanced intuition, creativity, assertiveness and enthusiasm for life; and improved social health and relationships, higher self-esteem and increased spiritual connection.

8 Keys To Mental Health Through Exercise

If exercise is so good for physical and mental health, why aren’t more of us exercising for mental health? Why aren’t medical and mental health practitioners not only recommending exercise but also showing us how to safely start and continue exercising for mental health? The following overview of my 8 Keys to Mental Health Through Exercise can help you, your loved ones and those who provide medical and mental health care tackle underlying beliefs about exercise, change exercise-related thinking, overcome barriers and implement an effective exercise program.

1. Heal Your Mind and Body with Exercise

If you struggle with a particular mental illness, exercise has specific abilities to help you, too. From calming the anxious mind to regulating mood swings in bipolar disorder, exercise may be the best thing we can do for mental, physical, emotional, social and spiritual well-being. To receive the benefits of exercise, however, we must first believe that exercise can heal body, mind and soul.

2. Improve Your Self-Esteem with Exercise

Exercise improves self-esteem, which is associated with greater mental health. Exercise has also been shown to increase self-confidence, self-efficacy, self-acceptance and self-concept. When we exercise, we feel more loving, positive and confident.

3. Exercise as a Family

Family has a big influence on how we perceive exercise and mental health. Family beliefs can either promote or impair mental health. Exercising as a family not only gets the entire family moving to reap the benefits of exercise but also models healthy beliefs about physical activity and improves family relationships.

4. Get Motivated

Motivation, or rather lack of it, is probably the biggest block to exercise for mental health. We know we should exercise. We may even want to exercise, but we often can’t make ourselves do it. Remember that motivation is a skill that can be learned and improved upon.

5. Change How You Think about Exercise

What thoughts do you have about exercise? What promotes physical activity? What holds you back? As we identify these thoughts, we can choose to change them. One tool for this is called a “thought record.” As we list our thoughts and feelings about exercise on a thought record, we have the power to question and change our thoughts. We can put new, healthier thoughts into our brains—thoughts like, “I know if I go for a walk, I will feel more energized and less depressed.”

6. Overcome Roadblocks

While exercising can be physically challenging, exercise is just as much, or even more, about mental fortitude. What are your biggest roadblocks to exercise? If you look carefully, you’ll see that almost all of them have to do with mental perceptions and beliefs. Lack of time or energy? Not being able to get to the gym? Perhaps you face the challenge of having young children, or a job that’s taking over your life. Whatever the roadblocks, you can overcome them as you acknowledge and challenge them.

7. Get FITT—Physically and Mentally

To stay with exercise for mental health, you must first build mental fortitude. That’s why I’ve waited until Key 7 to discuss how to set up an exercise program. The FITT Principle shows how. FITT stands for Frequency (how often you exercise), Intensity (how hard you exercise), Type (of exercise you’re doing) and Time (how long you exercise). Through FITT, you can create a tailored program for your unique needs.

8. Implement Your Vision and Flourish

Finally, we need a long-term vision of health and wellness to keep exercising for mental health for the rest of our lives. Exercise is beneficial at all ages and stages; as we look to the future, we find that by exercising for our mental health, we can help overcome mental illness and become who we are meant to be. We will flourish.

Christina G. Hibbert, Psy.D. is a clinical psychologist specializing in women’s mental health, motherhood, grief/loss, selfesteem and personal growth. She is the author of This Is How We Grow, Who Am I Without You?  and 8 Keys to Mental Health Through Exercise , and host of the weekly series “Motherhood” on WebTalkRadio.net. For more on this topic, visit www. DrChristinaHibbert.com and www.Exercise4MentalHealth.com.

https://www.nami.org/Blogs/NAMI-Blog/May-2016/Exercise-for-Mental-Health-8-Keys-to-Get-and-Stay