Tuesday, June 26, 2018

Taking care of your body and your mind

Many of us put time and effort into our physical health and wellbeing by going to the gym, eating healthy, and drinking more water. Benefits of taking care of our bodies is well known and a normal part of most people’s daily practice. We also are aware that the effort we put into our physical health can keep us emotionally and mentally healthy, however is that really enough?

Prioritizing our mental health is still a subject not widely understood by many people. Psychiatric illness and treatment often comes up in public dialogue after a tragic event. The conversation turns to blaming “psychiatric problems” for tragedies, which perpetuates the stigma associated with mental health treatment and psychiatric disorders. It is believed that mental illness is something that happens to “other people” and is something to be ashamed of and embarrassed by. The negative public perception can be a big part of what stops people from getting the help they need.

If you were to break your leg, you would go to a doctor for treatment. If you had chest pain and shortness of breath, you would see a cardiologist. There is no stigma or taboo about seeing a doctor for a broken bone or a specialist for heart disease. That’s just what we do.

When it comes to anxiety, depression or other psychiatric symptoms we tend to see it differently which leads to lack of diagnosis and treatment. According to the World Health Organization over 800,000 people a year die from suicide and many more attempt it every year.

It does not have to be this way.

Let’s look at the facts about mental health. Here is a link to a poster from the National Alliance for Mental Illness. 1 in 5 adults experience some sort of mental illness, yet more than half of those do not get treatment.

We can do better!

Let’s start by better understanding the warning signs. Here’s a list directly from the NAMI website:
      Excessive worrying or fear
      Feeling excessively sad or low
      Confused thinking or problems concentrating and learning
      Extreme mood changes, including uncontrollable “highs” or feelings of euphoria
      Prolonged or strong feelings of irritability or anger
      Avoiding friends and social activities
      Difficulties understanding or relating to other people
      Changes in sleeping habits or feeling tired and low energy
      Changes in eating habits such as increased hunger or lack of appetite
      Changes in sex drive
      Difficulty perceiving reality (delusions or hallucinations, in which a person experiences and senses things that don't exist in objective reality)
      Inability to perceive changes in one’s own feelings, behavior or personality (”lack of insight” or anosognosia)
      Abuse of substances like alcohol or drugs
      Multiple physical ailments without obvious causes (such as headaches, stomach aches, vague and ongoing “aches and pains”)
      Thinking about suicide
      Inability to carry out daily activities or handle daily problems and stress
      An intense fear of weight gain or concern with appearance (mostly in adolescents)

If these seem familiar to you or someone you love, don’t be afraid to reach out for help. Most therapists, including myself, offer free phone consultations. You can contact me through my website or email. You can also do an internet search of your area using Psychology Today Website and enter zip code in the "find a therapist" section.  NAMI HelpLine is also a wonderful resource to find out what services and supports are available in your community. If you or someone you know is in immediate danger do not wait, call the National Suicide Prevention Lifeline at 1-800-273-8255 or call 911.

Just like we put preventative focus and energy into our physical health and wellness with healthy eating and exercise, it is important to take a look at ways to build resilience and increase our emotional and mental health. This type of self-care can often be overlooked as not important or un-necessary, not unlike historic views on exercise. Going to a gym or for a run was not the norm until more recent history. We now know better about how to take care of our bodies and now it is time to do the same for our emotional and mental wellbeing. Here are some simple ways you may be able to increase positivity and resilience today. 
*Please note that the following tips are guides to increase positivity in your day to day, they are not "treatment" for depression, anxiety or other mental health concerns. It is important to reach out to your health care provider or a therapist in your area.

Start with positive intention.
How we start off our day can made a huge difference on how the rest of the day will go. We set the tone first thing in the morning with where we chose to focus our energy. When we begin consuming negative messages through the news or social media it starts us off in a negative emotional space. Try uplifting stories, like theoptimist.com, thedailygood.org or positivenewsus.org.

Fully engage in fun.
When is the last time you smiled or laughed? Was it today? Are you engaging in activities you enjoy on a regular basis or are you waiting until the weekend or vacation to do something you truly enjoy? How can you add something enjoyable or entertaining to your day, every day? It does not have to be something huge or take up too much of your time. Maybe you could take 20 minutes after work to ride a bike, take a painting class, have coffee with a friend or learn to play guitar. What activities do you do that bring a smile to your face just thinking of them? Make time to enjoy life today.

Connect with others.
When we become overly stressed out or overwhelmed we tend to buckle down and isolate from others. We think we don’t have time and yet that isolation is adding to our stress levels. Positive relationships are one of the five key elements of a life worth living according to Dr. Martin Seligman of UPenn. Are you staying connected to positive relationships in your life in meaningful ways (not just social media)? Make time to connect with a phone call or go out to a movie or an event. I often recommend putting right on your calendar or to do list the names of people you want to call and make an effort to reach out stay connected.

Focus on the Good.
So much of our daily focus and attention is on things that are going wrong or what we believe needs to be fixed that we often miss out on the good and the positive right in front of us. What we focus on often becomes the reality we see. For example, if you were buying a new car you would research a specific make and model. After doing your research you will notice that make and model car everywhere. It seems as if the world has just bought your car. The reality is that your car is as common today as it was before you began to notice it, but your brain is more aware of your interest in the car so you notice it more often. If you want to experience and notice more positive and good in your life, start by consciously looking for it. Spend a few minutes each day taking note of what is good and positive.  Journaling is a great way to do it. There are all kinds of gratitude journals and other tools you can use. The one I created called Fill Your BAG Happy.

Accept yourself as you are today.
This can often be misconstrued as being lazy or not striving in life, but that is not true. Unrealistic expectations and perfectionism can often set people up for failure. So many of the clients I see in my therapy office come in because of a core belief that they need to be perfect and they get derailed and anxious at anything less. Practicing self-compassion and acceptance is not about being complacent and stagnant, but about accepting yourself as you are in order to grow and flourish. Recognizing the fact that being imperfect is a human characteristic all people share can allow you to have more realistic expectations of yourself and frees you to experience growth and insights. For those who are looking for resources and books to help with self-care and self-compassion, here is a link to some of my favorites.

Practice mindfulness.
Mindfulness can be easily misunderstood. The definition of mindfulness that most speaks to me is by founder of MBSR (Mindfulness Based Stress Reduction) Jon Kabat Zinn “The awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment by moment.” Simply put, take time to be present in the current moment. You can start by practicing daily activities mindfully, like taking a shower or brushing your teeth and paying attention to each aspect of the task. For example, when in the shower, have you ever had the experience where you can’t remember if you used the conditioner or not? You were in automatic pilot mode and your mind was elsewhere. Next time, try paying attention to what you are feeling, seeing, smelling and hearing as you take a shower. What is the temperature of the water feel like? What about the smell of the soap? What changes do you hear as the water goes over different areas of your body or shower wall?  When you start to think about other things (which you will) gently and non-judgmentally bring your focus back to the shower experience.
If you would like to learn more about mindfulness, there are some really great basic apps you can try that can guide you through daily practice. I personally use insight timer every day. I highly recommend calm, headspace or 10%happier for beginners. Click here to get links to these another apps you may find helpful.

My hope today is that this post gave you some self-care ideas and got you thinking differently about the importance of preventative mental health care today!

Wednesday, May 23, 2018

10 Therapist's Tips for Better Mental Health...

May being Mental Health Awareness Month, I thought this would be a great time to share 10 tips that can have a positive impact on your physical, emotional and mental health.

1. Take care of your physical health – Food, Exercise, Sleep!

Physical health is such an important part of mental health. Have you ever found yourself "hangry?" If you have, you know that being hungry, tired, or physically ill can take a toll on your emotional health. Humans have a built in "negativity bias" which becomes heightened with lack of proper physical care. We also know that exercise can reduce stress and anxiety and also has been shown to reduce inflammation in the body. Reduced inflammation can increase positive connections within the brain! 

2. Practice Mindfulness

Mindfulness practices, like daily mindful meditation, mantras or TM are practices that involve self-regulation of attention. It doesn't have to be daunting to get started. Simply sitting quietly with your back straight, focus your attention on your breath. Where do you feel it? Use that as an anchor to continue to breathe while just noticing what is happening. Notice your thoughts, emotions, sensations. Don't try to change them, hold them, or push them away. Just notice and gently bring attention to your breath as an anchor. You will find your mind wanders a bit, that's ok, it is supposed to wander. Notice it, perhaps name it "thinking" and refocus on your breathing. Try just a few minutes a day to center yourself and recharge. Although mindfulness is not a new concept, psychology research is now showing correlations with positive affect well-being and can be a protective factor for symptoms of depression. 

3. Focus on the Good – Practice Gratitude

We spend so much time and energy focused on what's wrong in our lives. We do it by continuously solving problems, watching the news, and checking our to do lists. With all of the information around us, we can not possibly notice and experience everything, so our brain needs to act as a bit of a "spam filter" for the world by filtering out unnecessary information. For example, have you ever had the experience of purchasing a car and all of a sudden you notice so many more of that particular make and model car out on the road? Coincidence? Not really. The number of people driving around in that particular car didn't increase, you are just now noticing them because you put conscious attention on that particular car. The same can happen when you put time and effort into what you are grateful for in your life. To start noticing more of the good in your life,  spend some time every day writing down and recognizing what you are grateful for and why it is important to you. By putting energy into the good and the positive, you begin to notice all the good that is already there! Feel free to check out one version of a gratitude practice I use is called #fillyourBAGhappy.

4. Benefit of Negative Emotions

There is a misconception that to be happy and healthy means never experiencing negative emotions. It is important to note that all ranges of emotions have value and purpose. Emotions like sadness help you to better connect with others and feel empathy, anxiety can alert you when there is danger, and anger can motivate you to make needed changes. Without negative emotions, it is harder to truly experience and appreciate the positive ones. *It is important to point out that if you are experiencing continued overwhelming sadness or anxiety that affect your day to day, reach out and talk to your doctor or a mental health professional see if treatment is needed. Mental health concerns, just like physical health concerns, and can be treated with the appropriate care.

5. Forgive

One of the hardest things to do can be to forgive someone who has  done something to hurt you. Forgiveness is NOT about condoning negative behaviors, it is about regaining you own personal power. It allows you to move on without continued emotional baggage and hurt that weighs you down. Forgiveness gives you back control of the situation.


6. Foster Positive Relationships

We all have relationships in our lives that are positive and supportive. Unfortunately when we get busy, stressed, or overwhelmed we tend to put relationships on the back burner for a time being and it can then become harder to re-connect. In the world of social media we have more "friends" but less meaningful connections. Take note of those relationships that are important to you and make them a priority.  Positive psychology research has shown that one of the key areas that make a life worth living is positive relationships with others. 

7. Have Fun

Fun can be something that many of us tend to put off until the weekend or maybe until a planned vacation. People have so many responsibilities between work, family and community, that doing something just for fun becomes a luxury. The reality is, incorporating enjoyable activities into your day can actually increase your productivity, not decrease it. When you can take breaks and enjoy life you are better able to take on tougher challenges! Take some "me time" for yourself today!

8. Find Meaning

Are you a part of something that is bigger than you? Are you a part of a group that gives you a purpose or meaning?  For some, it is can be a religious group or organization, but it does not have to be only about religion. You can find meaning in your work or organization, volunteer work, sports team, or neighborhood group. Take some time to understand your "why" in life and what get involved in something that connects you to your meaningful larger purpose!


9. Help Others

Random acts of kindness can go a long way toward not only helping others, but also helping you. One of my favorite proverbs says; "If you want happiness for an hour - take a nap. If you want happiness for a day - go fishing. If you want happiness for a year - inherit a fortune. If you want happiness for a lifetime - help someone else." There is so much truth to that saying. Researchers in the field of positive psychology have shown that you can boost your overall well-being through helping others! Acts of kindness do not need to be huge or expensive to be important! So look for ways to help someone else out today.


10. Be Kind to Yourself

Kindness to others is important, but are you just as kind to yourself? Practicing self-compassion is something that many people struggle with doing consistently. Do you find your self-talk to be kind, forgiving, and positive, or is it harsh and negative. So many people have unrealistic expectations of themselves and then beat themselves up when they fail to live up to those expectations. A key component of self-compassion research by Psychologist, Kristen Neff, is to speak to yourself the way you would speak to someone else.  Kindness and compassion are important self-care practices for better mental health!

Friday, April 27, 2018

Why it's okay to talk to yourself.

There’s this misconception that talking to yourself is a sign of madness. People who talk to themselves are seen as crazy or unhinged. Entertainment and media often portray unstable characters by showing them having conversations inside their own heads when no one else is around. 

The reality is, talking to yourself is not only normal, but it’s beneficial!

For those of you out there who are thinking that they don’t have conversations with themselves already, you may be surprised to know that your inner dialogue is happening but and you may not even be aware of it. Our minds are constantly creating dialogue or stories to explain the world around us. Many of these thoughts that we have are automatic, which means we aren’t consciously aware what we are thinking. We go into automatic pilot reacting to something we think is outside of us, however our response is more influenced more by our thoughts or interpretations then by the situation itself. Our minds are continuously creating a narrative based on feelings even if we have very little evidence to support the narrative. That thought then becomes a truth and belief. Human brains have evolved to create those stories with a bias toward negativity. This negativity is rooted in the need for survival. Psychologists talk about how early humans needed assume that a noise coming from behind a bush was something stronger, faster, bigger and hungry in order to not become lunch for a hungry saber tooth tiger. Our ancestors evolved with the need to process missing information with the assumptions necessary for survival. 

Another source of negative inner dialogue comes from messages we received as children. We internalized what we were told and that created core beliefs that guide how we interpret the world around us. Research by Carol Dweck does a great job explaining how well-meaning feedback from adults can create a fixed mindset keeping people stuck and limit our ability to grow and thrive. Seemingly benign comments like, “math is not your subject” gets processed as a core belief. The thought “I am not good at math” repeats as a look and negatively affects how we view ourselves and our abilities. Dr. Dweck talks about the power of the word yet and how we can change that negative internal dialogue in our children by saying “math is not your subject, yet”. Creating that opening to growth and learning shows the importance of growth and creates a healthier growth mindset that carries later into life. 

When we have negative feelings we often believe that it is external situations that are the main cause of our feelings. Often times our negative emotions are exacerbated by our thoughts and interpretations that we are hardly aware of. The key is to notice our thoughts and bring them into a more conscious awareness. That’s when we can benefit from having a conversation with ourselves.  This self-talk can improve performance, motivate and elevate mood. 

This self-talk can come in many forms. Informational self-talk is about talking yourself through doing something. Perhaps learning or practicing a new skill. Endurance athletes use self-talk to walk themselves through scenarios as a way to practice or prepare for a game or event.  Motivational self-talk can help encourage and push us toward accomplishing something that we may be fearful about. Interrogative self-talk is about asking ourselves questions to help guide decision making and process events. Researcher Kelly McGonigal has pointed out that research has shown that talking to ourselves in the 2ndperson can have a bigger boost on mood, motivation and follow through than using 1stperson. The self-talk taps into the social brain and increases its’ positive impact.

So next time you find yourself having a conversation in your head, know that it isn’t a sign that something is wrong, but you can change the dialogue to more positive, objective and realistic self-talk which can be good for you!

Thursday, March 22, 2018

Happiness Myths


Did you know March 20 was the International Day of Happiness!

This “Happiness Holiday” began in 2013 following the UN General Assembly resolution  which recognized happiness and well-being as fundamental global goals. This kind of recognition and attention on happiness has found its way into national news programs like this week on Megyn KellyToday 

Here in NJ, I am honored to be a part of a community movement called Paint theTown Yellow. This movement is about brightening the lives and the community through Optimistic Art, Activities and Events. Check out this fantastic video HERE

Riley and Whitny, the founders of UMEWE and Paint the TownYellow, are passionate about optimism, happiness and bringing out the good in their local communities and beyond. Here in Madison, they have the full support of the Mayor, Bob Conley, who has officially declared the following:

WHEREAS, citizens can make a difference by brightening lives and the community through volunteer civic engagement, activities and collaborations in town throughout the months of March through May; we hereby appoint the following as Honorary Ambassadors of Optimism …

It is such an exciting and humbling experience to be an honorary Ambassador of Optimism and to be able to be part of the process here in Madison, NJ! Anyone who wants to get involved or attend one of the fantastic speakers who will be presenting at Short Stories Bookshop and Community Hub, can go to the FACEBOOK@madisonisintoyellow for details. Here's the calendar of events!

As a Clinical Therapist, I often see how the concept of happiness isn't so easy to define for so many people.  Misconceptions and limiting beliefs around happiness can take a toll on our emotional health. So, for that reason, I would like to dispel three common myths I hear about happiness:

Myth 1: I’ll be happy when___________(you fill in the blank).

How would you fill in that blank? Perhaps something like:
  •   I finally lose that last 10lbs
  •  get that promotion at work
  •  finish my home project
  • get through this final exam
Whatever you use to fill in the blank, achieving that goal you will only bring about a temporary boost of happiness, pretty quickly you return to your baseline. Soon after you will have another “I’ll be happy when…” Positive psychology research tells us that external circumstances, like those listed above, account for only about 10% of people’s actual happiness. Researcher and California University Psychology Professor, Sonja Lyubomirsky has shown that we all have a “set point” of happiness that we are born with and that external circumstances do very little to alter that baseline. What does make a difference is intentional activity. We have the capacity to improve our happiness levels by 40% with intentional activities and mindful actions! To learn more about her work, check out her book The How of Happiness. Some really simple intentional activities Dr. Lyubomirsky suggests in her book are; practicing gratitude, savoring life’s joys, letting go of rumination and social comparison, practicing acts of kindness and fostering social connections. A simple gratitude practice you can try right now is called #fillyourBAGhappy. You can learn how to do it by going to this website maximize-wellness.com/fillyourbaghappy .
Another take away from Positive Psychology research that you can implement today is to do something kind for someone else. Random acts of kindness don’t need to be huge or expensive to be meaningful. Little gestures focused on helping others quietly can, not only improve the other person’s day but can improve yours as well. Acts of kindness have been shown to increase and sustain happiness levels. A simple smile at a stranger can go a long way!

Myth 2: Negative emotions are bad. I shouldn’t feel angry or sad and when I do, something is “wrong” with me.

There is a misconception that it is not ok to feel sad, confused or feel angry. Negative emotions are thought to signal defectiveness. The reality is that negative emotions serve an important purpose in our lives. Experiencing a full range of feelings is part of what makes us human. Anxiety can alert us to something dangerous in our environment. Sadness builds empathy and connection with others. When we can feel disappointment or sadness we can become more connected with loved ones and can better provide support and encouragement. Feeling anger can motivates us to step up and right a wrong. It motivates us toward needed change. Look at the recent events in Florida and the action being taken by the Marjory Stoneman Douglas HS student survivors. They are motivated by fear and anger and are channeling those emotions into making what they see as a positive difference in the world. Feeling negative emotions can also help us to appreciate and savor positive emotions and moments in our lives. Experiencing a variety of emotions are a normal and natural part of daily living. The key is to have a healthy balance. If you are interested in learning more about benefits of negative emotions from Positive Psychology practitioners, Todd Kashdan and Robert Biswas-Diener, check out the book Upside of Your Dark Side. Another great resource that depicts this concept is the Disney Pixar movie, Inside Out. Even if you don’t have little kids, this movie is worth watching and provides such an insightful message about finding emotional balance and recognizing that it is okay to not be “all joy, all the time."

It is really important to note that there is a difference between a healthy range of emotions and experiencing depressed mood most of the day or difficulty enjoying pleasurable activities. This level of sadness that may signal something more is going on and you could be experiencing symptoms of clinical depression. Please understand that depression is not a choice or something that is caused by anything anyone did wrong, nor is it a personality flaw. It is a medical illness that can be treated. If you are unsure and think you may be having symptoms of depression or are having thoughts of suicide or self-harm, I urge you to talk with someone right away. NJ Hope line is 855-654-6735 and the National Suicide Hotline is 1-800-784-2433. If you want to speak with a counselor or therapist. PsychologyToday is an excellent resource to find someone in your area. If you are near Chatham NJ, you can always reach out to me at Maximize Wellness. 

Myth 3: Happiness is the ultimate goal.


If we look at happiness as an end goal, we find ourselves missing out on the process and how we got there. We may also never truly find ourselves “arriving”. Try altering your perspective so that happiness becomes a byproduct of a well-lived life. It is the journey, not the destination.  Someone once described it as the difference between being able to enjoy the beauty of the rainbow instead of just seeing it as a means to the pot of gold at the end. Practicing mindfulness and being more aware of being in the moment, versus living life in autopilot, can help you recognize more of the good in the little things in life. Savoring the little moments day to day is a great way to begin to enjoy the journey!