Category Archives: strategies for self-care

Personal mantras and mental health

Mantras are ancient, energizing sounds that help uplift mood and the stress or suffering (Dukkha) of the everyday. ‘Mana’ in Hindi translates to mind; a mantra is what takes you ‘beyond the current mind’.

They are traditionally repeated, chanted, or listened to with mindful repetition. Like self-statements in cognitive behavioral therapy (CBT), they help to manage stuck mind: feelings of dread, anxiety, worry, intrusive thoughts.

In my Mindfulness-based therapy practice, I encourage people to find what is meaningful to them. What is your mantra that really speaks to you and your struggles?

Put it on your mirror, your phone, post-its, in your backpack, journal, desk, fridge. Repeat.

Mine is : No One To Be.
For more on mental health and mantras: Mantras as Self-Statements

Sleepy Nation

Microbursts of sleep refers to periods of sudden somnolence that last from a few to several seconds. People who experience these episodes may doze off without realizing it.
It can occur anywhere, such as at work, at school, or while watching TV. Episodes of microsleep can also happen while driving or operating machinery, which makes this a dangerous condition. People may fall asleep at a stoplight, in a restaurant, at the theater, or at a work meeting. In addition to the potential for serious physical harm to self or others, these bursts of sleep can cause embarrassment and secondary problems (hitting your head, work problems, falling on another person, dropping or breaking items).
Microbursts of sleep happen when parts of your brain are asleep and other parts remain awake.
Warning signs of an episode of microsleep include:
  • inability to keep eyes open
  • excessive yawning
  • body jerks and head bobs
  • constantly blinking or widening eyes to stay awake
  • sudden onset of severe fatigue
  • short REM latencies (entering REM sleep very quickly)
  • feeling foggy; not being able to concentrate on a task or conversation
  • making careless mistakes (inattention to detail)
  • slow processing speed and task completion
  • impaired fine motor skills
Why does our brain go into a shut down and reboot? The biggest culprit is sleep deprivation.
Causes can include:
  • medical concerns (sleep apnea, restless leg and movement disorders, perimenopause, chronic pain, frequent urination)
  • shift work: overnight schedules and changing hours make it difficult for our brains to adjust
  • circadian rhythms that are irregular. Even DST can affect sleep for days to weeks
  • medications: stimulants like Concerta and Adderall may result in fatigue and sleepiness when they ‘wear off’.  Others cause excessive sleepiness if not timed properly, including antihistamines and even melatonin
  • alcohol and substance abuse
  • anxiety/worry/depression
  • boredom: repetitive tasks; solitary work; long drives; excessive sitting
  • ‘revenge insomnia’ is the tendency to purposefully stay up late binge watching, scrolling, chatting, gaming, after working all day. It’s reclaiming ‘me time’ with a cost and can be beguiling for those who work long hours
What to do:
  • Address underlying medical issues. Sleep studies may also be required. A single study or examination may only reveal a partial picture.
  • Get enough sleep. Prioritize rest and listen to your body. The average adult becomes sleepy after being awake for about 7-8 hours. Even with formulas for how much you ‘should be sleeping,’ how you sleep is highly individualized. More more info read: Got Sleep.
  • Exercise and get daily sunlight during the day.
  • When you feel tired, don’t push yourself into continuing to work. You’re not getting much work done anyway. Reboot by resting and starting again later.
  • Reframe attitudes about resting. The old adages about ‘toughing it out’ are not helpful for our mental, cognitive, or physical health.
  • Sleep well before road trips or long tasks. If possible, drive with a passenger. Avoid driving at times when you naturally feel tired, such as times you’re normally asleep, near dusk, or during your post-lunch or afternoon lull. Stop often and get out of the car.
  • Talk to other people. Neuropsychological research shows that conversation and social interaction reduce sleepiness. One study also found that hearing your own name was more effective than other auditory input for attention during a vigilance test.
  • Don’t rely on loud music. Loud volume won’t do much to keep you awake while driving. Some research suggests that the brain may not be registering auditory inputs during periods of microsleep.
  • Caffeine helps a little. It takes a while to kick in and only provides a moderate effect for a couple of hours. You can also have a high tolerance if you frequently use caffeine.
  • Take movement breaks. Fidgeting, stretching, and moving keeps the mind more engaged. Take regular breaks and stretch if you are sitting for long periods of time.
  • Rest when you are tired.
  • Most importantly, work with your own circadian rhythms, schedule, and responsibilities as much as possible. These vary. Micro sleep is our brain trying to function and rest at the same time. Work with it, not against it.

Et Tu, Friend?

How to Survive a Friendship Breakup

Surviving the loss of a friend can be even more painful than a romantic breakup. In the mental health profession, a friendship rupture or rift is a frequent reason why people may seek support.

It is possible to heal from the loss; as you work through the pain, you’ll eventually become stronger. Your pain is real. Give yourself the space and time you need, just like you would with a romantic breakup or any other significant loss. A broken friendship may include a lack of trust, lack of communication, feeling disconnected, unresolved conflict, ongoing hurtful behavior, having nothing in common, financial discrepancies, splitting a friend group, possessions left behind, and/or one person taking all the responsibility for the friendship.

What Causes a Friendship Breakup?
We’ve all heard that friendships are like seasons: they come and go at different phases in your life. While that might seem comforting, it denies friendship’s much more complex nature. If you’ve gone through a friendship breakup, you know it hurts more than the inevitable passing of the seasons. You may feel broadsided by the loss, even if it has been culminating over months or even years. But why do friendships end?

Some of the reasons include:

    • Change of interests and values (moving, getting married, political views, having children, religious views)
    • Misunderstandings
    • Breach of trust
    • When one person feels unsupported
    • Feeling used financially or emotionally
    • Clashes with the partner of a friend
    • Attraction to the partner of a friend
    • Abusive behavior
    • Not making time for the relationship
    • Psychological disorders left untreated

Is it a Breakup or a Break?
You may face self-doubt about moving on from your friend, so take time to determine whether this is the right decision. Sometimes, you can save a friendship by investing more in the relationship. But, there has to be a balance between fighting for the people we care about and not tolerating harmful behavior.

You can (and should) be a friend’s support system, but it can cross a line when you become their therapist, bank account, or punching bag. The friendship might shift when one or the other person becomes more “successful.” If your friend is actively present when they need you, but fades away when you are no longer required, it was not a reciprocal relationship to begin with. Your friend might have secret resentments or perceive you as privileged or spoiled.

You’re the one who has to decide to move on or remain in the friendship, but here are some questions to consider:

  • Has there been a betrayal? If so, has my friend made any attempt to make it right?
  • Is this just a misunderstanding?
  • Have I taken steps to talk about how I feel with my friend?
  • Is my friend toxic?
  • Does my friend repeatedly poke at my vulnerabilities and guise it as teasing or joking?
  • Are they taking any steps to become a healthier person?
  • Is my friend repeatedly hurting me even though I’ve talked to them about their behavior?
  • Do I feel judged or belittled by my friend?
  • Does my friend hold me back or help me become a better person?
  • Does my friend say nasty things about me behind my back?
  • Is this disagreement something we can overcome, or will it only cause more harm in the long run?

Prioritize Your Mental Health
Moving on from someone causing you mental and emotional harm is OK. Studies have shown that social relationships can either sabotage or support behavior change. When you begin to experience personal growth, it can be frightening and even threatening to the people around you. Your personal growth and your friend’s inability to grow with you may have triggered the friendship breakup. If that’s the case, I applaud you for your bravery and the growth you are pursuing. A friend will be there for you in good times and bad.
Related post: When Your Friends Are Successful

Where Possible, Seek Resolution
Many people express confusion about a friendship breakup, not understanding why it happened or feeling they never got to say what they needed to. I call the friendship breakup, with ghosting, the “living death”. You don’t know what happened but they’re still out in the world. You may even cross paths with them. We are creatures that crave meaning and explanation. Ghosting is often a reprehensible act.
Related post: Ghosting and Mental Health

When possible, talking to your friend can be a healthy way to promote understanding, express how you were hurt, and even apologize. Remember, your goal isn’t to launch a personal attack on them or be defensive. Make sure you can speak calmly and, if possible, wish them well at the end of the conversation. At some point you genuinely cared for each other and that’s to be honored. If they aren’t open to talking, or it doesn’t feel appropriate or safe to you, try writing out what you’d like to say. Expressing your thoughts on paper or email facilitates a better understanding of what happened. Even if you don’t understand “why,” expressing your emotions in writing can restore a sense of control over a situation where you may have felt helpless.
Related post: Restorative Writing and Mental Health

Reasons you may be struggling to move on:

  • You felt silenced by the friendship and haven’t had a chance to express how you feel.
  • You have experienced abandonment in the past, and losing this friend has brought up those feelings of abandonment.
  • You’re still waiting for them to come back.
  • You feel guilty, and you’re carrying the blame for the friendship ending.
  • The betrayal has so many layers you don’t know how to unpack it.
  • You have so many happy memories of the friendship that it’s bewildering to let it all go.
  • You have so much shared history that you struggle to get the needed space.

How to start:

  • Get a piece of paper and write at the top, “What do I need to let go?”
  • Sit quietly and listen to your intuition to determine what may keep you from moving on.
  • If you aren’t sure, start writing and let your thoughts flow unhindered.
  • As you write, look for what blocks you from moving on.
  • Once you know what that is, explore what you need for resolution.
  • Healing happens in layers, so don’t be discouraged if you identify multiple things.
  • Choose one thing that resonates most strongly and work through that.
  • As time passes, continue to work through the different areas of pain. there is no timeline.

Often, current pain is complicated because it connects to past pain. If you discover the connections to past pain, embrace this as an opportunity for growth. Healing takes time; it is a process. So be gentle with yourself. Permit yourself whatever you need to heal, and don’t push yourself to move on before you are ready. Mourning has no checklist.

Give Yourself the Gift of Forgiveness
Amazingly, forgiveness protects health even in high-stress situations. One study showed the longitudinal impact of forgiveness on stress levels. Another study showed that self-forgiveness increases physical and mental health. Forgiveness is about taking a step forward to healing and moving on.

What Forgiveness Is NOT:

      • Weakness
      • Blind trust
      • Letting the other person get away with wrongdoing
      • Restoration of a relationship
      • Being in close contact with a person who abused you
      • A denial of justice
      • Saying what the other person did was OK or right

Forgiveness takes time and is more of a lifestyle than a one-off event. As you seek to move on from your friendship breakup, you won’t feel (or heal) all the feelings at once.

Part of the pain of losing a friendship is you are losing the possibility for the future. In a few months or years, you may hear your friend is married, moved away, is having a baby, wrote a book, or just got a promotion. Because of the pervasiveness of social media, you might even observe your friend having fun with others. In loving relationships where it is an expectation to share these life events, watching from the sidelines can be incredibly painful. It’s important to forgive and be kind to yourself as new pain surfaces. It can come and go.

Validate Your Emotions
A breakup is a feeling of rejection at the heart of a friendship. Whichever side you are on, there will be a sense that someone you were once so close to no longer values you as a person. One study found that feelings of rejection directly impact self-perception by creating feelings of hurt, loneliness, jealousy, guilt, shame, anxiety, embarrassment, sadness, doubt, and anger.

Society expects you to experience these emotions when you suffer a loss or a romantic breakup. There isn’t always the same understanding for a friendship breakup. So if your social circle isn’t supportive of what you are going through, you have to learn to understand and validate your own emotions. If it feels unbearable, talk to a therapist.

Don’t Let It Follow You
We find it painful and upsetting to see a friend move on because, the truth is, we haven’t. We want to believe we matter enough that they will experience the same amount of pain as we are experiencing. When they seem happy and unaffected, it can feel like we didn’t ever matter to them. Holding on to feelings of injustice may cause the friendship breakup to drag you down and spill over into other areas of your life.

So, ironically, one of the keys to moving on is… moving on. Ultimately you’ll have to let go of the need to know they cared. Instead of holding the pain close, release all of your expectations and disappointments. You’re not letting go of all the good things you shared. Instead, you are letting go of the need for them in your life. There is life apart from this other person. While they may have shaped a part of who you are or been with you through difficult and painful times, you are still a person, and you can recover from this.

Rebuild Your Ability to Trust
You may not notice this immediately, but over time, you may discover your friendship or the friendship breakup has impacted how you view others. Any time there is vulnerability and emotional intimacy, you enter into a relationship of trust. Whether that trust is intentional or not, it impacts your ability to trust others. If you are hesitant to get close to new people or withhold and withdraw from other relationships, it could be because of your friendship breakup.

Invest in Positive Relationships
As you move through the grieving process, there will come a time when it’s essential to begin making new friendships; intentionally investing in creating positive and healthy attachments. As you’ve worked through the steps of moving on, you’ve likely identified some of your own unhealthy behaviors. Take what you’ve learned from this last friendship to prepare you to be a better friend and to set good boundaries so you don’t accept harmful behavior from others. One patient said to me, everything I learned in my last relationship will make me a better person in the next. Friendships teach us a lot.

Form New Habits & Make New Memories
Sometimes, friendships can cause a narrowing of activities and even personality. Whether they were actively holding you back or your friendship allowed you both to become too comfortable or complacent, now is the chance to recognize your potential and expand your horizons. Instead of constantly reflecting on the things you did together, work to build new memories and experiences.

Related post:  On Friendship Pain

Eight ways to show yourself love and nurturance 

  • Buy a new, beautiful journal and pens that you love; use them. (I like Pilot Frixion erasable pens).
  • Schedule a mental health day every other week. That means no commitments, work, family, or social- only time to rest and rejuvenate. The key is putting it on your calendar, not squeezing it in if you have time. Put a big M on your calendar Me time/mental health/mindfulness).
  • Plan a spa day, at home or salon. Pick three services you love.
  • Sign up for an online class or seminar you’ve been wanting to take.
  • Put together the ultimate sleep kit: your favorite essential oil, soft blanket, perfect pillow, sleep mask, noise blocker, hand and body lotion, stuffed animal or other cherished comfort object, mug, soothing beverage, nightlight or lamp with dimmer switch, pajamas or robe, and soothing book/audiobook/podcast. Bedtime rituals are not just for function, they can promote relaxation and self love.
  • Buy yourself a small luxury: a piece of art, a great book, jewelry, your favorite perfume, a decadent candle. Send yourself gorgeous flowers.
  • Take time away. Rent a tiny cabin, go to the ocean, your favorite resort, housesit for a friend, reserve a hotel room for the night or weekend. Giving yourself space away from your usual routines can be very loving.
  • Put together a music playlist that makes you feel incredible. Give it an empowering name. Play it when you feel lonely. You are here, with you.

Happy Valentine’s Day to you, from you.

Related posts:
Self Commitments
The Power of the Self-Hug

On News Anxiety

For as long as people have had widespread access to daily news, there has been news-related anxiety. But the age of social media has dramatically increased the amount of time we spend keeping up on current events. After 9/11, while I was completing my doctoral internship, many clients told me they were watching the news for 8 to 10 hours a day.

Instead of limiting news consumption to once a day, e.g., reading the morning paper or watching the local news before heading to work, many of us are immersed in a neverending news cycle. Alerts throughout the day make it hard to avoid a never ending barrage of information. Neuropsychological research indicates that when we hear a ping on our phone, it may contribute to hypervigilance.

Today, at least 1 in 5 Americans get their news through social media. A conservative estimate is that the average inter-webs user spends more than 4 hours scrolling per day. Every year, that number steadily increases. The term “doomscrolling” describes when the consumption of negative news events leads to information overload and becomes a compulsive habit.

While some amount of worry can be useful for planning ahead, it is easy to cross the line from staying informed to inducing anxiety or exacerbating a dysphoric mood.  Individuals who suffer from anxiety or mood disorders are particularly vulnerable.  The pressure to stay up-to-date on serious topics like COVID-19, civil unrest, violence in every form, and climate change can make it difficult to stop doomscrolling. We are survival driven and searching for information is built into our frontal lobes.

Many empathic people have expressed to me that it might even feel irresponsible to avoid news that is negative. ‘If people are suffering, why am I such a wimp that I can’t even read about it?’ To be informed is important, to be vicariously traumatized saps our energy and will to proceed.

How to Manage News Anxiety; the Clinical Psychology Research:

  • There is no “one size fits all” solution.
    The key is to find an approach that works for you, which starts with recognizing your triggers or personal vulnerabilities. Try to pay attention to what happens right before you feel the urge to reach for your phone or tablet. If your scrolling is brought on by certain thoughts, feelings, or situations, or centers around a particular subject, take note.
  • Acknowledge addiction potential.
    People who experience addiction have a higher likelihood of relapsing when exposed to certain triggers, e.g. walking by the bar they used to frequent, seeing an ashtray, or being near slot machines. The same goes for people with digital addictions like social media or doomscrolling. If you are particularly consumed or obsessed with a specific subject, limit yourself to spending 15-30 minutes reading about it each day. Set a timer.
  • Curate News and Social Media Consumption.
    Swearing off social media altogether can be too big of a leap for most people. Instead, think about ways you can alter the way you use social media. For example, if there are accounts that you notice often cause you anxiety, mute or unfollow them. Also, consider disabling alerts for social media platforms. This way, you will be less tempted to open apps throughout the day.
  • Incorporate Positive Stimuli.
    When breaking a habit like doomscrolling, finding positive activities to supplement the time you spend reading news can make a big difference. Try engaging with something non-educational that simply serves to make you smile. This could be exploring a light-hearted hashtag, like #catsoftiktok, visiting the wholesome page on Reddit, or watching an animated show or movie. Though it may sound silly, empirical studies have shown that watching cute animal videos can measurably lower blood pressure and reduce anxiety.
  • Move and Stretch.
    Disrupting your thought processes with physical movement is another strategy to break a rote scrolling cycle of doomscrolling. Get up and walk around. Set a loud timer that’s across the room, one that forces you to get out of your chair or bed.
  • Seek Professional Help.
    If you are still having trouble gaining control of your scrolling or social media consumption, there are therapists who specialize in helping clients who struggle with social media use and anxiety.

The Takeaway:

  • Timing and dosage.
    Limit your time and the amount of news that you consume. If you tend to have a harder time at night with anxiety, maybe watch/read/scroll news in the morning only. During times of trouble such as the pandemic, insomnia, was a significant symptom of our anxiety and stress. We need to avoid and monitor as much as possible the stimuli that may add to our already dysregulated bodies.
  • QC.
    Pick news material that is factual, thorough, and data driven. Keep it brief and succinct.
  • Balance.
    Mix doom-scrolling with something lighter. watching something that makes you smile is good for you. Those of us of a certain age used to wake up on Saturday mornings and watch cartoons with eager anticipation. They transported us away from the rest of our week, past and upcoming.

Mindful Choices

A good Friday and weekend to everyone as we round out Janvier. It has been an interesting month that feels longer already, for many. You might be amazed, or maybe not, at so many people who are actually in distress, even while looking just ‘fine’ on interwebs. We are really not inclined to tell people that we are vulnerable. Yet. That’s my professional and personal goal and bias, the big yet.

Whether you follow the Gregorian, Corinthian, Islamic, Persian, or the Lunar calendar: It’s been a weird twilight zone.

I often field mental health, clinical psychology, and neuropsychology questions through my various websites.

I’m asked every year why I don’t write psychologically about New Year’s resolution and goals. I’m a big believer in personal agency, and I think people can start whatever they need to do, now. And now. And now. Dates are random. I have seen incredible deeds start at 10:30 AM on a Friday.  Absolutely no association with anything esoteric.

If there’s one small intention I would mention that is doable by all is to make mindful choices, about things that seem not a biggie. The practice of mindfulness is so small and so powerful. People ask me what it means. It’s not a fancy ‘Om’ in an exclusive enclave of yogis and meditators. It’s basically looking around, observing habitually, and making small choices on a daily basis based on what you see. It is the ultimate change mechanism.

Many of us have friends and loved ones who are not doing so great. I’ve been on both sides in my life. People don’t always tell you they need support.  I guess before we go out for that $150 mimosa Sunday brunch, it might be helpful to go to a local delicious taco family owned business and help a friend who might need support with the other $120.

I completely own this bias.  If you know me, IRL, I am far from averse from pleasure. However, it’s possible to have a great time and also help somebody at the same time. Our Frontal Lobes are pretty phenomenal.  But you all asked.  Big love. I’m not shy, but I’m always open to learning. Sorry for the delayed response. A great weekend and February to all.❤️

We are Tired: On Mental fatigue

Her: “It is 7 PM and it feels like midnight.“

Mental fatigue is an all too common feeling these days. Uncertainty, high stress levels, juggling responsibilities, financial hardship, medical problems, and a demanding lifestyle are making our minds feel downright exhausted. In addition to lengthy and tiring days, we have numerous daily hassles that take up hours and hours of time: being on the phone with tech-support after the computer crashed again, the jammed printer, the fraud alert on the credit card, sitting in traffic for hours, standing in line for more hours.

But living in a state of permanent mental fatigue can have consequences on our personal and professional well-being. It is painful and unsustainable.

When your brain feels exhausted and unable to function properly, it leaves you mentally and emotionally drained. This is commonly known as ‘brain fog’ or mental fatigue.

According to neuropsychology research, a tired brain impairs your cognitive abilities. This affects your productivity, decision-making skills, learning, and memory. For example, brain fog makes it hard to concentrate. Even simple household tasks like washing dishes, going to the grocery store, changing kitty litter, or doing the laundry seem cumbersome.

Mental fatigue is a state of tiredness that sets in when your brain’s energy levels are depleted, usually the result of prolonged stressors. Long-term stress can be brought on by a variety of factors, including a challenging life transition, grief/bereavement, a demanding job, feeling unsupported or alone, or executive functioning weaknesses, such as procrastination, poor planning, organizing, or prioritizing.

Long-term mental exhaustion can also affect your professional life. When your symptoms aren’t managed, it can lead to workplace burnout. Symptoms of workplace burnout include a lack of belief in your abilities, decreased job satisfaction, cynicism, and a lack of motivation.

The Covid-19 pandemic has turned mental fatigue into a widespread global issue. The World Health Organization (WHO) describes this “pandemic fatigue” as demotivation, alienation, complacency, disconnection, and feelings of hopelessness. Mental fatigue is insidious — its symptoms develop gradually and are not always noticed. The pandemic created an unprecedented time of stress and uncertainty for millions of people around the world. Many people have been in survival mode.

4 emotional symptoms of mental fatigue:
1) Anxiety
Anxiety is one of the most common symptoms of mental fatigue. It develops because prolonged mental fatigue triggers the sympathetic nervous system. This is also known as your fight/flight/freeze mode. This causes you to be in a constant state of panic or worry about the future, which can lead to impulsive behavior, avoidance, and indecisiveness.  Always feeling anxious should act as an alarm bell, telling you something isn’t right. Anxiety is not an enemy, it’s a signal/warning that something is wrong.

2) Languishing
Languishing can be described as a feeling of emptiness and stagnation. This feeling develops when your mind feels depleted of energy. Someone stuck in a state of languishing frequently feels apathy and a disconnection from friends, partners, and work colleagues. It can manifest as zoning out, variable attention and concentration, and not listening. If this feeling persists, it can gradually isolate you from people in your life who start to think that you just don’t care.

3) Low resilience
When you’re mentally fatigued, challenges seem nearly impossible to overcome. You’re going up the hill that everybody expects you to climb, but with a backpack full of rocks. For example, someone with reduced resilience can easily crumble under the pressure of a challenging work assignment or deadline. They may make mistakes, miss deadlines, or procrastinate.

4) Depression
Mental fatigue and depression are interconnected. Fatigue is a symptom of depression and vice-versa. Depression is a mental health disorder that can have multiple causes, including trauma and stressful life events. It’s characterized by a sense of hopelessness, feelings of low self-worth and a lack of energy to engage in daily life. If low resilience is a backpack full of rocks, depression is the boulder.

4 Physical symptoms of mental fatigue:
The characteristics of mental fatigue aren’t just emotional. They can also show up as physical symptoms that impair your health and well-being.
1) Aches, pains, and muscle tension
Your mental health has a direct effect on your physical health. The high level of stress that causes mental fatigue also causes you to feel tired, weary, achy, sore, and lethargic.

2) Sleep issues
People suffering from mental exhaustion often experience trouble sleeping, insomnia, and even hypersomnia. These sleep problems arise due to the emotional side effects of mental fatigue like anxiety or depression. Being in a constant state of hypervigilance and worry makes it harder to get a good night’s sleep.

3) Increase in illness
A weakened mental and physical state can lead to various health problems. Some of these include:

  • Muscle strains
  • Headaches and migraines
  • Gastrointestinal problems
  • Weakened immune system

4. Poor eating habits
Unhealthy eating habits are common for someone suffering from mental exhaustion. A number of studies indicate that people are more likely to engage in emotional eating or conversely eat less under mental stress and fatigue. Not getting the proper nutrients and indulging in foods high in sugar can slowly impair cognitive abilities. It also contributes to upticks in anxiety and depression (‘crashes’).

Related, what to do about mental fatigue.

Clinical Psychology + Eastern Philosophy + DEI = Mental Health

7 Eastern Concepts for Mental Health

Community of friends practicing together in order to encourage awareness and mindfulness. Buddhist writings state that the water from all the oceans has only one taste, salt. And for all humanity there is only one desire, freedom. This requires community as a practice.

An attitude of kindness and goodwill, wishing other people well with affection, but also realizing that true happiness is something that they ultimately will have to find for themselves. It’s fully loving another without being responsible for the other person‘s happiness. That doesn’t mean you don’t help them. It means you don’t own their stuff.

Impermanence or state of flow. The idea that people are constantly in a process of development/ stages of life. The literal translation from Sanskrit is “a wandering through.” Where we are right now, the good or the bad, it’s not permanent. As the expression goes, the good news: nothing last forever; the bad news, nothing last forever.

Existential suffering. That experiencing the pain of illness, aging, death, loss, abandonment, is part of the human experience. We are not individually cursed with misery. We are in this together. Empathy is required.

Intention or volition. Intention determines whether an action is ethical. We are human and make errors. We may have good intentions (a desire to act) that do not pan out in a desired result/outcome. However, intention encompasses present action regardless of consequence and predicts future behavior. Intention matters.

Compassion, service to others, giving without expectation of return, recognition, or glory.

The most misunderstood of concepts, karma is not a vengeful creature looking to bring down people. It is an accumulation of all events and actions. It is the universal checking account of withdrawals and deposits. Sometimes we are in overdraft, because human, other times, we are earning interest.

Love, health, and peace to you and yours. 🙏🏽

Wishes for the New Year From a Psychologist

If you’ve ever been to see me for a consultation, these will sound familiar.

Rest More
Over 3/4 of my clients report having sleep problems. Whether it’s insomnia, restlessness, nightmares, inconsistent patterns and schedules, or screen interference, we’re not sleeping. Ruthlessly protect your sleep. At Embolden, we also believe in individualized analysis of personal energy patterns and schedules. Work with your circadian rhythms as much as possible. What works for someone may not for another.
See also Got Sleep.

Everything is Therapy
What you consume: eat, watch, read, buy, wear, listen to. Do. Content matters. Make choices that are nourishing.

Find relationships with safe and supportive people. This gives us an anchor and an army. I always say, there’s plenty of troubles out there, don’t seek them in your personal life. Your alliances should be based on loyalty, trust, humor, reciprocity, affection, and great hugs.

Learn how to be alone with you. Sitting, resting, standing, or walking without anyone else or other stimuli is something that we forget how to do. It can feel very weird at first, just doing nothing. Start slow and build it up.

Workout your brain
As we live longer, we have seen a significant uptick in dementia and brain disorders. Recently, I have seen a scary wave of cognitive disorders related to long Covid in my neuropsychology practice. Your brain craves stimulation. Give it something new to do and learn. Engage socially. Oxygenate by cardiovascular activity. Nourish with great food. Minimize alcohol and don’t use tobacco products. Take care of your health- sometimes you can do everything right, but you may have a genetic loading that has to be monitored. For example, the South Asian community has a huge vulnerability for diabetes, that has a cultural basis from times of colonization.

Get out of your comfort zone
If you are right handed, try writing with your left hand. It’s not easy. Do math by hand instead of a calculator, do crosswords, practice a new language, explore safely, put aside the cookbook and make a recipe on your own, read, write, take a different route when driving. Do you know what the date is without looking at your phone? Short cuts do not stimulate us. Challenge your brain, it likes it.

We all have things that intrigue us. Try them. Draw, sing, take a dance class, take jujitsu, write the book that’s been in your head, learn a new language, try a musical instrument try a new cuisine.

In her 40s, Indian writer Jhumpa Lahiri, raised in England and Rhode Island, speaking Bengali and English as her primary languages, decided to learn Italian. After taking numerous classes online, she moved her family to Rome for the full language immersion experience.  She later wrote a book in Italian, a language that she did not learn until middle age. There are no time limitations on learning.

Speak your truth
I tell clients to speak as clearly as they can about what they want to convey. I call it the Occam’s Razor of communication. Oblique communication leaves everyone dissatisfied. Be polite, but you don’t need to make excuses for your needs: “Thank you so much for inviting me, but I’m not going to be able to make it. I really appreciate that you thought of me!”

Talk to people in public
You don’t have to be creepy. Most of us don’t know our neighbors, communities, or even coworkers. It’s OK to say hello, I really like your scarf, and asking your Uber driver, cashier, or takeout person how they are doing. Interaction matters. Insular lives add to our (huge) collective loneliness.
Related:  The Art of the Compliment.

You don’t have to focus on the positive
The gratitude attitude, smile at all costs, I am fine, it does not work for many people. That doesn’t mean you have to vent every detail of your personal angst, but you also don’t have to be fake happy.
Related: Smiling Depression.

Ask for help
We are awful at asking for help. Somehow, a tit-for-tat mentality has created fear of asking for anything.  We would not be here today, as a species, without cooperation and community.
Related: How to Ask for Help Without Feeling Weird.

Don’t Withhold Affection
Whether you were gone for five minutes, five days, or five months, your dog is overjoyed to see you. We are not dogs and we overthink with our frontal lobes, but letting people know that we are extremely fond of them it’s not a bad thing. It creates oxytocin and a sense of well-being for both the giver and the receiver of affection.

Practice Self-Compassion
Self compassion beats self-esteem and even self-efficacy when it comes to mental health. Being kind to yourself also spills over to being kinder to others. Self-esteem is based on skills and external accolades. Self-efficacy comes from the expectation that you will do a good job in the future.  Self-compassion is extending grace, empathy, and kindness to yourself no matter the circumstances.
Related: Why Self-Compassion is More Important Than Self-Esteem.

Dates do not matter. It doesn’t have to be the first of the year, a Monday, your birthday, or some external date. You can start at 11 AM on Wednesday, December 28, setting the intentions for yourself that are meaningful to you.
Related: Me, Myself and I: Self-Care as Daily Practice

Love and Peace to you and yours. ❤️

What is Winter Fatigue?

I enjoy receiving psychology/mental health questions on my website and social media. A couple of times a month, I write a post or article to respond to questions I feel are particularly timely and helpful to many people, including me!

ST writes: Do you have any tips for dealing with endless cloudy, cold, and rainy days? I saw the extended forecast, and it’s not letting up anytime soon. I get very down and cranky, and sometimes even anxious when there is no sun for days and days…

What is Winter Fatigue?

The sky is grey, and the chill wind blows outside. Right now, the best thing in the world feels like curling up in a fluffy blanket with a cup of something hot to drink, a bowl of decadent noodles, and a good book, binge-worthy series, or movie. Sure, there is meal prep to do, work deadlines, appointments to keep, and an elliptical machine to hop on, but you just don’t have the motivation.

There are five types of fatigue—medical (such as chronic illness), physical, mental, emotional, and environmental. Welcome to winter fatigue. According to the American Academy of Family Physicians, at least 20% of people experience a form of winter fatigue, from mild to significant.

Common symptoms may include:

  • Fatigue
  • Weight gain
  • Cravings for carbohydrates (“comfort foods”)
  • Irritability/easily frustrated
  • Anxiety
  • Difficulty with concentration
  • Avoidance of social situations (hibernating)
  • Hunkering down (stock piling snacks, home supplies, and groceries)
  • Difficulty getting out of bed
  • Increased sensitivity to social rejection (feelings easily hurt; loneliness)

Our nervous systems are designed to handle short-term stress and distress- we get hits of adrenaline and cortisol as part of the body’s fight, flight, or freeze response. When acute stress becomes chronic stress, when we become normalized to being in this state, it takes a huge toll on our bodies.

Recently, people have also been experiencing what I call catch-up fatigue. After 2 1/2 years of having to modify lifestyles and juggle uncertainty, people are attempting to celebrate, meet others, travel, be sociable. It takes a lot out of us. There’s been a recent study in the Washington, DC area that there has been an uptick in rage incidents while driving. Frankly, we’re not used to being around other humans. We are slightly socially stunted.

Circadian rhythms and Cortisol Fluctuations
It would be great if your sleep-wake cycle could align with the season/winter’s light-dark cycle. But I don’t think many of us could sustain families or jobs resting from 5 pm to 8 am each day. Being completely aligned with the season’s natural rhythms is not possible with our multiple responsibilities. However, we can certainly take steps to better align with the winter season. At my company, we come up with an individualized daily schedule, that works with commitments, deadlines, and personal biorhythms as much as possible.

Below are some of the best things you can do to remedy winter fatigue:

    • Schedule 8-9 hours of rest/sleep each night.
    • Most of us have morning commitments; therefore, waking up later is not an option. Instead, make your bedtime earlier. This means that if you need to get up at 6 am, ensure your lights are out no later than 10 pm.
    • Make your bedroom a sanctuary.
    • Adjust the temperature of your house: Your body prefers to be slightly cool before bed. Decreasing the temperature of your house a few degrees overnight will likely improve your sleep quality. Do you know how you feel chilly if you’re woken during REM sleep? Our body temperature drops while sleeping. Having cooler air temperature or taking a hot bath and your body cooling after mimics sleep.
    • Avoid bright lights in the evening: Try using accent lighting in your home in place of overhead lights, or use dimming switches. If you’re using electronic devices, install apps like f.lux. to block the blue light from being emitted.
    • Practice relaxation techniques before bed.
    • Reading, audiobooks, podcasts, hot baths, meditation, pranayama, or a cup of tea are a few great ways to unwind in the evening. Turn off screens as much as possible.
    • Stress makes you tired.
    • Much like melatonin, the cortisol hormone follows what is called a diurnal rhythm. In a perfect scenario, cortisol levels peak optimally after waking. After waking, there is a gradual decline in cortisol levels. Cortisol reaches its lowest point of the day shortly before bed. As you sleep, cortisol levels increase and the cycle starts again. However, excessively high levels of cortisol also cause fatigue. Stress causes a surge of cortisol or adrenalin at different times of the day which can be exhausting to the body. Stress cannot be completely avoided, but learning to recognize the buildup and stave it off is so important.
    • Light therapy: During the winter months, exposure to morning sunlight may not be an option. Sometimes it’s dark when leaving the house and it’s dark coming home. Using a light therapy device for 10 minutes immediately after waking can ensure you have the energy needed to get out of bed (a light therapy box mimics outdoor light, which causes a chemical change in the brain that lifts your mood; Amazon offers a wide variety of such products that are well priced). This therapy is an alternative to pushing snooze dozens of times.
    • Get outside: Exposure to sunlight keeps melatonin production under control. Even five minutes of outdoor sun exposure can improve your energy levels. Open your curtains and blinds early in the day to let in as much sunlight as possible. This is a mood booster, but we cannot obtain the necessary Vitamin D that we need through windows. Direct exposure to sunlight, even on a cloudy day, helps us get our required
    • Vitamin D.
    • Mood disturbances and symptoms: Many people struggle with sadness, depression and anxiety during the winter. Add physical distancing, post-holiday blues, and sleep problems to the mix, and it’s no wonder exhaustion sets in. If you have an uptick in symptoms of anxiety or depression, it’s time to talk to your primary care doctor or a mental health specialist.
    • Exercise matters (in addition to outdoor time): Try to fit in 30 minutes of exercise four to six times a week. Whether it’s walking on the treadmill, taking a couple of laps around the block, taking the stairs at the mall, or walking around your office building, exercise keeps endorphins pumping in your body, helping keep you energized to combat the winter blahs.
    • Balance your food: Comfort foods like mashed potatoes, bowls of rice, macaroni and cheese, etc. sound great when the weather is chilly and the days are short. Our bodies crave more sweets and carbohydrates to help us build that insular layer of fat that kept us alive back in our caveman days. However, balanced eating gives you more energy to fight the cold, and a well-rounded diet keeps the cravings at bay. Find comfort foods that boost energy, such as a delicious lentil curry, a veggie frittata, or homemade soup.
    • Relax: Find hobbies and activities that help relieve stress. Meditation can be a great time to let the mind relax and unwind, journaling, crochet/knitting, coloring in an adult coloring book, chatting with a good friend, and yoga can all reduce out of control cortisol levels.
    • Massage Therapy: Therapeutic massage can ease body tension and pain, and wakes up your nervous system, turning on your power so you can fight the winter blues. A great massage can also release oxytocin, the hormone of relaxation and contentment.

Timing and Dosage

    • Time your exercise: Exercise can help combat winter fatigue, particularly if you take your fitness time into the sunlight. Exercising first thing in the morning can help wake up your body and regulate your circadian rhythm. Exercise in the afternoon can get you through that tired slump. Exercise too close to bedtime, and you may have trouble sleeping.
    • Take a power nap: If you can sneak in a 25-30 minute nap between noon and 4 p.m., you’re more likely to power through your day. Snoozing too late in the day could make it more difficult to fall asleep at night.
    • Use caffeine. Judiciously: Well-timed caffeine can help you feel more alert, awake and ready to take on the day. Need to perk up before a presentation? Get some caffeine about an hour before it begins. You can also have a cup of coffee before you take a nap. By the time you wake up, the coffee has kicked in.
    • Monitor sleep patterns: People demonstrate patterns of sleep that are individual. Biphasic or polyphasic sleep was more common before standard office hours. Sleeping two or even three times a day was not uncommon to combat fatigue and complete life tasks. Learn more: Got Sleep?
    • Keep an eye on medical concerns: Are you tired during certain times of the day, all the time, or in specific situations? There can be chronic medical fatigue from a host of significant conditions including sleep apnea, diabetes, fibromyalgia, hypertension, and autoimmune disorders. These conditions and their subsequent fatigue do not necessarily respond to everyday strategies. For example, recently I have started completing evaluations for individuals suffering from Long Covid. The fatigue, cognitive fog, and impaired attention I have assessed has been striking. Getting a medical differential for your fatigue is imperative.

Also see: Pandemic Fatigue.

Embolden Psychology

Embolden offers the ADOS-2, the gold standard assessment for kids on the spectrum.

Combined with psychoeducational testing, it helps provide comprehensive information and recommendations to help children and teens six and up.

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