Category: Mental Health Tips

Making Self-Care a Priority 

It is hard to believe 2021 is less than 90 days way. This year, with all of the many challenges, seems to be flying by. With the transition to working from home, many employees have found themselves even busier than when they were working in the office. Add to thatschool-aged and/or college-aged distance learnersand perhaps another adult or two also working from home, you can begin to feel like an afterthought in your own mind. The demands for your attention, your great ideas, your support, your space, your time…can feel endless. It is easy to get caught up in the next thing on your to do lists, help a colleague with the new account at work, volunteer for that special committee, or other ways you prioritize other people’s needs over your own.  

When you continue in these cycles of constant giving, without taking time to refuel or refill yourself back up, the quality of your giving can deteriorate without you realizing it. Your patience may run thin, your temper may shorten, and before long the “giving” that once gave you pleasure, now feels exhausting. Simple acts of self-care can keep you energized and strengthen to thrive even when it feels as though you are constantly giving. 

What is Self-Care?  

Self-care is intentionally being good to yourself; taking care of yourself in a way that is sustaining for youThis will look different from person to person, and that is okay. What I need can be different than what you need because we are different people. Self-care is not being selfish, particularly if there are many people around you that need you and rely on you. It does not have to be an expensive purchase or all-day adventure…although those could certainly qualify as self-careThink about the last time you boarded an airplane and found yourself waiting for the flight to take off. The flight attendants begin their safety presentation and give instructions on how to use the oxygen masks if they become available. The flight attendants instruct you to put on your own oxygen mask before helping anyone else with their oxygen mask. Why? Because to help others, you need to have already been helped yourself. Prioritizing your self-care is essential when there are demands on you to care for others around you. 

How do you do it?  

Start small. With the COVID-19 social distancing restrictions, there may not be very many options available outside of the home, so use what you have or what you can easily obtainIt may be easiest to incorporate self-care in activities you are already doing. Think about ways to enhance the things that you are already doing and be intentional about experiencing the pleasures in the moments. Perhaps use an aromatherapy body wash and inhale the relaxing or rejuvenating scent while showering. Or, take a few extra minutes and run a warm bath and add essential oils, bubble bath, or soothing bath salts. You need to bathe, so why not take a few moments to enhance the experience before going to bed or starting your day? When you have your morning coffee or afternoon tea, take a moment to walk outsidebreath in fresh air and enjoy the flavor of your warm (or iced) beverage. When you are out grocery shopping, pick up a new fresh herb to add to your pasta or saladgrab a new sauce for your protein, or grab that fruit or vegetable you have all ways wanted to try. These small actions can have lasting impact on you, your well-being, and the care your give to others. 

 

What are some ways you can begin to practice self-care? 

 

Written by Takisha Corbett, Ph.D. Dr. Corbett is a clinical psychologist at Pacific Neurobehavioral Clinic, PC.

 

 

Advocating for Your Healthcare Needs

Speaking up to a medical provider for your healthcare needs can feel a bit intimidating. This can become even more uncomfortable if you feel as though your provider is not “hearing you” or appears to dismiss your concerns. This type of experience can lead to retreating and avoiding contact with a medical provider; however, this can be detrimental to your health.

Your health is important and advocating for your healthcare needs is a great way to demonstrate your concerns to your medical provider in a constructive manner. Advocacy can be done with a few simple actions and can increase your awareness regarding the nature of your presenting problem or symptoms. Here are a few suggestions to get you started:

      • Be specific regarding when you experience the symptoms. This includes when the symptoms began or how long you have been experiencing the problem. Sometimes it can be hard to pinpoint exactly when it started, so think back to major events or activities that have occurred (a birthday, work event, holiday, etc.) and determine if you were experiencing the symptoms or problem at that time. This also includes noting if the problem or the symptoms are worse at different times of the day, or after specific activities (i.e. after exercises versus after sitting for several hours).
      • Clarify how the problem impacts you and your overall functioning. For example, what difficulties, pain, or deficits are you experiencing as a result of these symptoms or problem? Does it interfere with your sleep, your appetite, your ability to concentrate, intimacy with your partner, spending time with your children or friends, productive at work, or simply enjoying down time? Sometimes we may not realize how broadly the symptoms or problem has impacted our lives until we take time to think about this question.
      • Describe what interventions you have tried to help alleviate the problem or the symptoms and whether they have been effective. Have you tried pain medication or physical therapy, exercising or stretching, changes in eating habits, or changes in sleeping patterns, etc.? Have you already had imaging, lab work, or an evaluation by a specialist completed? If so, are you able to get these results to your medical provider to incorporate this information into your current assessment? Do you have concerns about these assessments? It is okay to speak up and share your concerns.
      • Ask questions. This is your time with your medical provider, so ask clarifying questions to ensure you understand the recommendations or the next steps. If something doesn’t make sense to you, ask your provider to explain it again. Also, if you feel your provider may have misunderstood something you said, it is important to clarify with him or her so they accurately capture your perspective.
      • It’s okay to do some research. If you want to look up information related to your symptoms or problem, be sure to use reputable websites, such as the websites connected to your provider’s medical group or your insurance provider. If your research suggests a particular course of action, bring up this option with your medical provider. Ask about the pros and cons for this course of action, and what are some alternative options.

    Once you settle on a course of action with your provider, confirm what the next steps should be, including when you will need to follow up to see this provider again.

    Advocating for yourself can be an empowering experience. It also increases your awareness of your lived experience with a problem or symptoms, so you are better able to discuss them with your provider. Please note these suggestions can also be applied when for you advocate for someone else’s healthcare needs. You deserve great healthcare and it is okay to advocate for it.

     

    Written by Takisha Corbett, Ph.D. Dr. Corbett is a psychologist at Pacific Neurobehavioral Clinic, PC. 

Parenting While Coping With Chronic Pain

One of the concerns reported by my chronic pain clients who are also parenting is feeling like they are not as engaged with their children as they would like to be. In addition to generating feelings of guilt and shame around their parenting, this also frequently leads to stress and conflict with the other parent, or the household in general.

Individuals with chronic pain frequently experience symptoms like fear of re-injury, worry about the future and their health, low motivation, and fatigue, to name a few. These can lead to being less active and having no desire to participate in engaging with their children and family. Some of my clients also report that they frequently feel irritable and snap at their immediate family members, including their children, further straining relationships. When this is combined with chronically experiencing pain and coping with various limitations as a result, it can lead to feelings of sadness, hopelessness, low mood, isolation and more.

The biggest challenge for individuals experiencing chronic pain is learning to live in a “new normal.” Shifting their expectations and reframing their thoughts and ideas about what it means to live a fulfilling life, who they are, and how they matter and engage within their families and communities. In reference to parenting in particular, it is important to first have honest, developmentally appropriate conversations with children and family members, about what the person is experiencing in terms of pain and emotionally, as well as how other people in the family are feeling. This helps establish mutual understanding and can lead to having a positive support system for the person experiencing pain.

This is beneficial because it helps create empathy and space for everyone to be able to positively communicate their emotions and needs. If someone is having a particularly tough day with pain, for example, when there is already a foundation of knowledge and understanding, it may be easier to ask for down time, alone time and a break from activities, or whatever else helps the person cope best. It may also help make it easier for family members and children to hear, without internalizing this as a form of rejection.

It is also important to note that with flexibility and some creativity, people experiencing chronic pain can continue to share experiences with their family and play with their children. Many times, we get stuck in thinking that if we can’t do something how we always have, we cannot do it at all. This is what frequently leads to not wanting to engage with children and family. If we shift our focus to what we can do, versus what we can’t, we may discover new ways of doing things that will help us connect with our family and children.

This is not to say we are to ignore our emotions and feelings of grief or loss about what we cannot do, because they are very real and valid. These emotions deserve attention and space for individuals to process and feel them. What it does mean, is that we don’t get stuck there. We flow between giving tough emotions space, and then making room for some positives ones as well, leading to a more balanced state.

Some activities for parents and children to do, which with some adaptation can be done standing, sitting or even laying down, depending on individual needs include:

*Playing with Play-Doh
*Making art
*Making a puzzle
*Reading a book
*Taking the children to the park and watching them play
*Flying a kite
*Legos
*Watching something together
*Cooking together
*Sharing mealtime conversations
*Having a picnic
*Listening to music
*Watering plants
*Going on a nature walk
*Go watch their extracurricular activities
*Take a picture taking walk
*Go swimming

Another consideration is a person’s ability to focus and be present, as well as being able to cope with irritability when in pain. Some ways to cope with this is being spontaneous and taking advantage of the times when they are feeling better or having a ‘good day’, to help balance the days when they need to make themselves a priority and need space for themselves; making these interactions short (quality versus quantity of time), but more frequent; choosing calming or relaxing activates; or having another adult participate so they don’t have to lead or be responsible for full engagement.

Many times, children mainly want a parent’s attention and presence. If parents can adapt to the necessary changes in interaction and find time to engage, while making sure to be as comfortable as possible, they will find that they can be more present with their children, and more active in parenting. This will lead to positive feelings for everyone involved, and a more balanced emotional state for the parent experiencing chronic pain.

 

Written by Taina Aceves, MA, LMFT. Ms. Aceves is a therapist at Pacific Neurobehavioral Clinic, PC.

The Impact of Sheltering in Place on Mental Health and Chronic Pain

Since shelter in place orders began to take effect in March, many of my own clients have seen increases in pain and mental health symptoms. While sheltering in place has placed many restrictions on people, as well as significantly changed how we all experience our day to day lives, there are two things that directly impact pain and mental health: social distancing and restricted, limited or no physical activity. Human connection and physical activity are important parts of managing chronic pain and mental health symptoms. Both are tools and behavioral changes I recommend to my clients in therapy.

First, it is worth noting that following shelter in place orders, including social distancing and mask wearing, is important to help slow the spread of COVID, until a solution can be found. The following are recommendations on how to try and compensate for these restrictions, not a call to avoid following the orders.

Having a support system, being able to have conversations, spending time with friends and loved ones, and connecting with co-workers are important to our overall well-being and help us cope with chronic pain and mental health symptoms, including anxiety, depression and stress. Being able to engage in social activities with others serves as a positive distraction from pain and difficult emotions, and it also helps create positive experiences that improve our mood and outlook, by helping to balance negative focus and thoughts. In addition, the benefits of being able to physically touch or be touched by others are many, and include stress reduction, increases in oxytocin and may even help improve the immune system.

The first question is: how do you cope with not being able to have as much human connection as before, particularly in-person contact?

If you have other members in your household whom you are sheltering in place with, you may have an easier time meeting this need than someone who lives alone. Make time to share quality time with your household members, that do not fall into the ordinary, daily routine. Backyard dates or picnics, movie nights, game nights, and cooking together are some ideas. When appropriate, engage in physical touch, like hugging.

If you live alone, make use of technology to try and stay connected to others. Engage in video or voice conversations, participate in virtual hangouts, game nights or dates, and maybe try virtually cooking new recipes with others. Massaging yourself may also be helpful for both emotional and physical well-being. Shelters across the United States reported a sharp increase in pet adoptions since the pandemic began, so if you have the desire, time and resources to care for a pet, this can also be a great option. Just keep in mind that caring for your pet will still be necessary once the shelter in place orders lift, and you should be willing and prepared to continue to love and care for your pet, even after this is all over.

The second question is: how do you balance sheltering in place and engaging in physical activity?

Many of us are unsure about what is and is not permitted under shelter in place, and this has led to a decrease in physical activity for many of us. The first tip is to work out inside your home, especially if you are having difficulty managing anxiety about leaving your home or are a high-risk individual for COVID. If you are having trouble getting motivated, think about virtually working out with someone. At this point, it is worth mentioning that getting some sun and fresh air does the mind and the body good. Which leads us to the second option: get outdoors. Though it is important to understand that as long as there is a pandemic, there will be risk associated with leaving our homes, it is also important to know that there are ways which decrease the risk of contracting COVID while engaging in outdoor physical activity. These include wearing a mask, avoiding crowded places, going out during ‘off hours’ (for example, avoiding the beach on the weekend) and staying physically distanced from other people. You can start with short walks around your neighborhood, during the times when there are less people out. Schedule these outings into your week to help you follow through. You can also engage in outdoor activity with others, as long as you practice social distancing and wear your masks.

The bottom line is- get creative and make the best of it. Try to find ways in which you can safely practice things that do you good, like socializing and activity. They may not be perfect, ideal, or exactly what you need, but something will be better than nothing, and keeping yourself and others safe during this pandemic is worth it. During shelter in place, it is beneficial to adopt an attitude of adaptation versus all or nothing. It is for your own good, and your mind and body will thank you!

Written by Taina Aceves, MA, LMFT. Taina is a therapist at Pacific Neurobehavioral Clinic, PC, in San Diego, CA.

Practicing Mindfulness

Many people have asked, “what is mindfulness, and can it really help me?” The answers to those questions are simple and developing a mindfulness practice can be relatively easy.  Many mindfulness resources are accessible for free on websites and mobile apps, while other resources are available on a subscription basis or by enrolling in a class or seminar. There are tons of options out there and they are just a few clicks away. As we explore practicing mindfulness, several links to resources are included below. These links are not endorsements of these apps or organizations; there are provided as references and convenience for those looking to access resources to start a mindfulness practice.

Over the past several years there has been a growing body of research on the benefits of mindfulness. The websites for many public and private organizations, such as National Institutes of Health, The Mayo Clinic, and Kaiser Permanente provide information on how to practice mindfulness. Many of these sites also share research outcomes which can help us to better understand the impact of a mindfulness practice across a variety of settings including home, work, sports, medical treatments, etc. In addition, there are many mobile apps, such as Headspace, which offer convenient guides to help establish or further develop a mindfulness practice, as well as information on the science behind mindfulness.

What is mindfulness?

Mindfulness is generally described as being fully present in the current moment. In any given moment, our attention can shift between several topics or tasks. Even when we are “paying attention” or focusing on one object, our attention frequently shifts, even for brief instances. When we practice mindfulness, we learn how to increase our ability to focus, to be fully present in the moment. In other instances, our attention can be divided because we may try to push some thoughts or memories out of our awareness because they may be unpleasant or distressing. Research has shown developing a mindfulness practice can help improve stress tolerance, which also strengthens our ability to be present in the current moment.

So, how do I learn to increase my ability to focus and improve my stress tolerance?

There are many mindfulness techniques to help you get started and learn the basics. Here is a common technique:

  • Mindful breathing—try spending 1 minute focusing on your breathing. Notice the rise and fall of your shoulders, rib cage, or abdomen. Notice if your breathing is shallow or deep, if the rate of your breathing is rapid or slow. If your mind wanders off to other topics, simply recognize it and return your attention back to your breathing. It is very natural for our minds to wander, so this may happen quite a bit; however, the more you practice mindful breathing, over time you are a likely to notice you are better able to catch your attention shifting and turn your attention, your focus back to your breathing.

Mindful breathing is a simple way to begin a mindfulness practice and improve your ability to focus your attention and increase distress tolerance. As you continue this practice, you can increase the length of time you focus on your breathing to 2 minutes, 3 minutes, or 5 minutes. Other mindfulness techniques that my help include another exercise call body scan, focusing your attention on different parts of your body. The University of California, San Diego Center for Mindfulnessoffers several guided audios and videos to help navigate through brief mindfulness sessions, including a 10-minute guide to body scan.

There are many options out there to help you get your mindfulness practice going. Simple chose one and start practicing.

 

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Links:

NIH: (https://www.nccih.nih.gov/research/research-results/new-study-links-mindfulness-brain-changes-and-pain-sensitivity )

Mayo: (https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/mindfulness-exercises/art-20046356),

Kaiser: (https://healthy.kaiserpermanente.org/health-wellness/mental-health/tools-resources/mindfulness )

Headspace: (https://www.headspace.com/mindfulness )

UCSD Center for Mindfulness (https://medschool.ucsd.edu/som/fmph/research/mindfulness/programs/mindfulness-programs/MBSR-programs/Pages/audio.aspx )

Written by Takisha Corbett, Ph.D. Dr. Corbett is a licensed psychologist specializing in health psychology at Pacific Neurobehavioral Clinic, PC.

The Pursuit of Justice: Understanding the Cause and Committing to Action 

The energy in the air has been heightened with tension over the past few months. Initially, this was due to the global pandemic of COVID-19. Now, the United States has become the epicenter of a polarizing movement surrounding race and justice. Video of the gruesome death of George Floyd at the hands of Minneapolis Police officers is heart wrenching and disturbing to watch.

We have become inundated with a variety of charged images and messages from the media, on social media, and in our communities. With such a steady flow of information, it is easy to lose sight of the central message in the pursuit of justice and become distracted or overwhelmed.

The continuum of reactions to this movement is laden with intense emotions including anger, sadness, worry, confusion, ambivalence, and in some cases, indifference. The presence of these powerful emotions can lead one to feel paralyzed or powerless. It is important to know other people may feel the same way. To manage intense emotions, a common reaction may be to withdraw; however, redirecting your focus to the pursuit of justice can help alleviate some of the distressing experience. This pursuit of justice is to address routine police brutality that leads to the death of unarmed black men across this country. Together, we can make a change.  Many people may not know what to do to impact change in the pursuit of justice, or how to navigate difficult and uncomfortable conversations on race or justice. Here are a few tips to keep in mind.

  • Discussions about race can be uncomfortable, and that is okay. Knowing that the rights and freedoms of groups of people are violated daily is also discomforting; so, we can channel that discomfort into action.
  • We can achieve more together: the pursuit of justice for all takes all of us. Over the past several weeks retailers, websites, corporations, social media outlets, universities, and other establishments have posted anti-racism notices and actions plans. The next time you see one, click on it and read it to find out how others are committing to action.
  • Become aware of current opportunities to make change within your sphere of influence. This could be within your community, at your company, or in your city. Search the internet for upcoming events or activities sponsored by reputable local restaurants, businesses, non-profit organizations, universities, advocacy groups, etc. and try to join. Perhaps even invite a friend(s) to go along with you. There are also webinars you can watch, blogs and websites you can read, social media posts, or community activities, committees, or events you can attend or donate. Always practice due diligence and common sense safety practices.
  • Be open to self-reflection, personal growth, and change. We all have blind spots and carry biases. We can typically only see these aspects of ourselves when someone else points them out to us. Simply having blind spots or biases does not mean a person is bad or a racist. We can acknowledge these characteristics are present and be intentional to grow in those areas; to change.
  • Speak up when we witness an injustice. When we see something, we need to say something to bring attention to injustice. Silence creates a cloak for injustice to persist.
  • Remember, change takes time, and the pursuit of justice takes the community.

Written by Takisha Corbett, Ph.D. Dr. Corbett is a licensed psychologist currently open to new patients at Pacific Neurobehavioral Clinic, PC. 

Coping with Hospital Stays During the COVID-19 Pandemic

As the country begins the process of re-opening and lifting some restrictions, we find many activities are resuming. These include medical procedures that may have been postponed, as hospitals and medical facilities everywhere braced and prepared for treating individuals with COVID-19 back in March. If you are one of many patients who are being scheduled for procedures and treatments that require hospitalization, you and your family members are probably being confronted with the likelihood that no one will be allowed to enter the hospital with you, or stay with you during recovery. Medical care facilities around the country are implementing strict policies that ban visitors to try and limit the spread and risk of COVID-19 within their facilities, and there is no sign that these restrictions will be lifted in the near future.

 

Getting medical treatments that require hospital stays are generally anxiety producing for patients and their loved ones. If we add to this that they will likely need to go through this without a support person by their side, and the added concerns due to the COVID-19 pandemic, it is to be expected that patients and their loved ones will experience and increase in worry and anxiety.

Here are some tips that may help decrease some of those worries and anxiety:

 

  • You and your family can inquire as to what precautions are in place to protect patients from COVID, if this is something that you are feeling concerned about. Going into the situation as informed as possible will help you and your loved ones feel more in control and less anxious, setting you up for a better experience.
  • Ensure your family knows who and where to call for information if they are unable to reach you, to help decrease their concern and worry. If they feel more at ease, there is less opportunity that you will be impacted by their anxiety too.
  • Set up reliable communication. Make sure you have a phone, a charger, headphones (if allowed) and that you know how to use them all. If possible, make use of video calls to communicate with your loved ones- you may find they bring more emotional connection and comfort than voice calls or text messages alone.
  • Pack some activities that your doctor pre-approves, and you enjoy, to keep yourself entertained during your stay. Crossword puzzles, art, reading material, or a smart device with downloaded (in case streaming is not possible) shows, movies or games, are some examples. The more entertained you are, the less time you will have to focus on worries or being alone.
  • Be prepared to implement some relaxation techniques during your stay, to use when you feel the need. Some examples are listening to your favorite music, breathing exercises, progressive muscle relaxation, grounding techniques and visualization.
  • If permitted, pack some of your favorite, doctor-approved, non-perishable snacks to enjoy as you recover.
  • Remember that some anxiety around medical procedures and hospital stays is completely normal. Tell yourself this to prevent being critical of yourself or putting yourself down for having these emotions. Instead, focus on taking care of yourself, being kind to yourself and implementing positive coping tools to help you manage these feelings.
  • Sleep! Rest is an important part of recovery. If you find yourself having trouble sleeping, practice some of the relaxation techniques mentioned above. If allowed, come prepared with essential oils that may help you wind down, or request a permitted caffeine free tea to enjoy.

Before implementing any of the above suggestions, be sure to discuss these with your doctor, to ensure everything you want to implement is allowed by the medical facility and approved by your physician. During times of high stress or anxiety, you can help manage how you are feeling by focusing on what you are able to control, such as seeking helpful and necessary information, and implementing tools that help you feel more calm. Keep in mind that the treatment you are receiving is meant to help your body and improve your health outlook, and you will soon be reunited with your loved ones. As the saying goes, “this too shall pass”.

Written by Taina Aceves, LMFT. Ms. Aceves is currently accepting therapy patients via telehealth at Pacific Neurobehavioral Clinic, PC.

 

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Tips on Managing COVID-19 Anxiety

The world is collectively living through an event unlike any other experienced during our lifetimes. The COVID-19 pandemic has changed how we are living our lives. We are living in daily uncertainty, facing something largely unknown to us still, in constant concern over our health and the health of our loved ones, and for some, grief as well as added stress and pressure over finances and meeting our basic needs. All of this while being stuck at home (in some states and countries) and having limited or no access to our support systems (friends, family and other loved ones) and the places and activities we enjoy; it is the perfect recipe for increased mental health symptoms and needs.   

Thankfully, many people can continue to access mental health services via telehealth* (see below for more information). In addition to mental health services, self-Care is something you can do at home to help relieve anxiety, stress and other mental health symptoms you may be experiencing as a result of the pandemic and social distancing regulations.   

Self-care can be defined as things we do that we enjoy and help us relax. These are unique to each individual, but here are some examples of self-care:   

  • Having a video call with your friends and family 
  • Watching a movie or show that brings you positive emotions 
  • Engaging in a creative outlet of your choice 
  • Taking a relaxing bath 
  • Aromatherapy 
  • Reading enjoyable books 
  • Having a virtual book-club 
  • Meditating 
  • Cooking 
  • Getting restful sleep 
  • Playing games 
  • Practicing yoga 
  • Exercising 
  • Getting outdoors, safely, while practicing social distancing and following your local regulations 
  • Skincare 
  • Listening to music 
  • Playing instruments 

It is easy to forget about practicing self-care, so it is important to schedule it into our days. A minimum of one self-care activity a day is recommendable, particularly during high stress or high anxiety times, such as the one we are currently living through.  

First, you can create a growing list of things or activities that are enjoyable and relaxing for you. Then, create a weekly schedule of self-care based on those activities, or, alternatively, pick one activity from that list every morning, to engage in on that day. Writing down or sharing your plan with someone can help you commit and follow through. Having a self-care buddy, even a virtual one, with whom to practice self-care, can also help you follow through and hold yourself accountable, in addition to potentially making the activity more enjoyable. You can face-mask with your friend via FaceTime, do online gaming with a loved one or work out with a buddy, for example. Get creative and make it fun! Practice self-care consistently, on a daily basis, and notice what difference this makes for your mental health. Taking care of ourselves is always important, and even more so when going through difficult times. Make the time to do this, as much as possible, to reap the benefits.    

*You can reach out to your health insurance, medical care provider or mental health care provider, to inquire about telehealth services. You can also search for mental health providers that offer telehealth via Psychology Today or Therapy Den. We are currently accepting new telehealth patients at PNBC.  

 

Additionally, here are some mental health resources available free of cost: 

Disaster Distress Helpline 1 (800) 985-5990 (también disponible en Español) 

Access & Crisis Line 1 (888) 724-7240 (también disponible en Español) 

2-1-1 San Diego Dial 2-1-1 from any phone (también disponible en Español) 

San Diego County Behavioral Health Resources 

 

Additional stress coping tips can be found on the CDC website.

 

Written by Taina Aceves, LMFT.  

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COVID-19 Mental Health Survival Kit

One way or another, the recent coronavirus (COVID-19) outbreak has impacted our daily lifestyle. No more movie theater night outs, meeting up with a friend for coffee, or the usual morning rush to get to school and for some, work. The safety recommendations to stay home and “flatten the curve” is creating a new way of life. We have already seen the changes, particularly, with the increased use of technology serving different needs, including, but not limited to: continuing our socialization while keeping physical distancing, having meals and other necessities delivered to our homes, maintaining remote work, and staying distracted with entertainment. In addition to these changes, we have also experienced a shift in our perspective of the self, the world, and the future. This change in perspective, if not balanced, can bring upon a negative chainlike reaction to different aspects of our lives including our psychological, social, and occupational functioning.

How so, you ask? Well because how we think, affects how we feel and how we act. Fortunately, years of research and contributions from insightful individuals, have gifted us knowledge and tools to help us keep moving forward, especially when we find ourselves drifting away onto the dark side, be it due to fear, panic, overwhelming anxiety, depression, or  numbness. The following recommendations are considered crucial tools and knowledge to have in order to help us survive this COVID-19 crisis.

Tip #1: What are you doing for relaxation and self-care?

Stress management skills should be part of our “essentials package.” We all have an embedded “fight or flight response system” which when triggered, orchestrates a physical phenomenon in our bodies. In its basic form, the fight or flight response is our survival mechanism, allowing us to react quickly to life-threatening situations (Harvard Health Publishing, 2018). However, when this survival mechanism is frequently turned on (e.g., every time we see or hear a new article involving COVID-19), it becomes “chronic stress.” According to research, repeated stress activation can take a toll on our physical and psychological health, that is, chronic stress may contribute to serious medical and mental health problems such as high blood pressure, heart disease, diabetes, obesity, anxiety, depression, and addiction (National Institute of Mental Health, 2020). On the bright side, there are techniques to counter the stress response:

  • Relaxation: This is the time to try meditation, deep breathing exercises, and visualization of calming scenes. I usually recommend patients to visualize a scene of their “paradise vacation” while using their five senses, that is: see the details of the scenery, smell the scents of the scenery, feel the weather of the scenery, hear the sounds of the scenery, and if applicable, taste the scenery (e.g., salty ocean water). Especially during this time of limited access to destinations, the use of visualization exercises can serve as a mental vacation away from home.
  • Exercise: The California statewide stay-at-home order does not necessarily restrict us from exercising outdoors. According to the stay-at-home order invoked on 03/19/20 by Governor Newsom, “…so long as you are maintaining a safe social distance of six feet from people who aren’t part of your household, it is ok to go outside for exercise, a walk or fresh air.” It is recommended that you stay up to date on changes to the current stay-at-home order to avoid a fine or other penalty. In the meantime, while following recommended health precautions (i.e., using a face mask, staying 6 feet away from others outside of your household, etc.) if you can, take a walk outside at least once daily. Get your heart pumping and muscles activated to reduce muscle tension. Speaking of face masks, the Centers for Disease Control and Prevention (CDC) just released a DIY video on how to make your own mask to help fight spread of the virus, you can find it here. Other great ways to get exercise include instructional home-based exercise videos which are now widely available online. Just make sure to check in with your healthcare provider before embarking on any strenuous exercise to avoid injury.
  • Get proper sleep: Sleep deficiency is associated with many chronic health problems, including heart disease, kidney disease, high blood pressure, diabetes, stroke, obesity, and depression (National Institute of Health, 2020). And a deprived immune system is the last thing we want during this crisis. Getting a proper amount of sleep each night can help protect our mental health, physical health, quality of life, and safety. Of course, the amount of sleep needed changes over the course of our lives, but the American Academy of Sleep Medicine (AASM) recommends between 7 and 8 hours of sleep a day for adults. For more tips on how to establish better sleep habits, please visit our “Sleep Hygiene” blog here.
  • Social support: Again, the “social distancing” recommendations are intended towards physical distancing, not socialization per se. Social support can fulfill emotional, tangible, informational, and social needs. Now is the time to reach out to your network of friends, family, and acquaintances. Check in with them and see how they are handling this crisis. Offer support, be it emotional or maybe even just informational. Reminisce on good times and make plans for the future once the crisis becomes more stable. Don’t forget, technology allows us the opportunity to use video and audio as a way to connect with others.

Tip #2: Challenge irrational thoughts

This may be a more difficult task than the rest. The reason being that for most of us, our irrational thoughts have accompanied us for a longtime, settling in as habitual patterns in our minds, emerging automatically from time to time. It may be difficult to pinpoint the irrational thoughts at first. However, with practice, and if needed with support from a mental health professional, we gradually begin to notice these maladaptive thinking patterns that have been impacting our emotions and behaviors. This is the essence of Cognitive Behavioral Therapy (CBT): “how we think influences how we feel and how we behave.” Monitor your thoughts and identify which ones are interfering with your daily functioning during this crisis. Challenge them. Do you tend to think in terms of extremes? Is there a more balanced way to see the situation? Am I looking at all the evidence? Am I confusing my feelings with the facts?

With the increased use of technology, mental health apps have also emerged as a useful healthcare tool. You might find the following phone apps useful in managing your mental health:

Tip #3: If needed, seek professional help

If, after attempting to cope with this crisis using the coping mechanisms you have resorted to for years, or after attempting to incorporate the recommended tools above, you continue to find yourself struggling to cope through this crisis, then by all means, please seek professional support. You are not alone in this struggle, and ensuring your mental health is being managed properly is important. There are different types of mental health treatment available, I recommend you take the first step to learn more about which type would be a good fit for you. Given the COVID-19 outbreak and health recommendations, more mental health providers are providing video-based therapy appointments. At Pacific Neurobehavioral Clinic, we have a variety of providers willing to help and walk you through the process. You can reach us here. The following hotlines also provide free and confidential emotional support 24 hours a day, 7 days a week:

  • National Suicide Prevention Lifeline: English 1-800-273-8255; Spanish 1-888-628-9454
  • Access and Crisis Line: 1-888-724-7240

References:

California Coronavirus (COVID-19) Response, 2020. Stay home except for essential needs. Retrieved from https://covid19.ca.gov/stay-home-except-for-essential-needs/

Beck Cognitive Behavior Therapy, 2019. What is cognitive behavior therapy (CBT)? Retrieved from https://beckinstitute.org/get-informed/what-is-cognitive-therapy/

Harvard Health Publishing, 2018. Understanding the stress response. Retrieved from: https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response

National Institute of Health, 2020. Sleep deprivation and deficiency. Retrieved from https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency

National Institute of Mental Health, 2020. 5 things you should know about stress. Retrieved from https://www.nimh.nih.gov/health/publications/stress/index.shtml

 

Written by Angela Patino, Psy.D. @ Pacific Neurobehavioral Clinic.

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Tips for Managing Chronic Worrying – a Common Symptom of Anxiety

If you find yourself constantly worrying about all the things that could possibly go wrong and trying to find solutions to those hypothetical scenarios- you may find this post helpful.

Most things we do in our daily lives serve some sort of purpose, whether we are aware of it or not. Sometimes the purpose is positive, sometimes negative and sometimes it’s both. When working with clients who experience chronic worrying, I have heard it helps them “feel prepared”, “feel safe”, “feel secure”, “feel more comfortable,” among other things. While this may be true, many of us also experience negative effects from this type of worrying, mainly, increased negative thoughts, increased anxiety symptoms, and it takes a toll on our bodies (we may lose sleep, for example).

Worry can serve a positive purpose in our life; for example, it may serve as a motivator to study if you are worried about how you will do on a test. However, like many things, it can cross a line where it goes from being helpful, to being harmful (you are so worried, you cannot focus or study). For each of us, this threshold is different, and to identify it we must first be aware of the symptoms of anxiety we personally experience, and learn to notice them. When you notice these symptoms spiking, it may be a sign that this threshold was crossed for you.

I would like you to visualize that you are about to go on a run, hike or walk. It is a beautiful day outside- the air is crisp; the sun is out. You are energized and excited. Before you go, you grab one bottle of water, because it is reasonable to expect that you will get thirsty- so you prepare for this. Before you walk out, you go back to grab another one, because what if this one is not enough? Then another one, because what if you accidentally spill one of them? And on, and on, and on. Pretty soon, you are headed out with a backpack full of water bottles, weighing you down. You feel prepared. What else are you feeling? Are you comfortable? Are you feeling calm?

This begs the question- Is it worth being prepared for everything at, potentially, the expense of your mental and physical well-being? That is something only you can decide. Start by asking yourself:

How does worry affect me?
Is it negatively impacting different areas of my life? If so, how?
And most importantly- does it bother me?

If you answered yes to this last one, the following tips may help you manage chronic worry, thereby decreasing or preventing anxiety symptoms from getting worse.

Limit your exposure to things that make you worry (news, crime stories, etc.)- you decide what that limit is. To which point is it helpful, and when does it become harmful for you? This ties back in to knowing your symptoms and being aware of when your they spike.
Prepare yourself, if this helps you, but set limits for yourself. For example, allow yourself to have a plan A and B, but not plans A though Z.
Make it a rule for yourself that you will try to only worry about, and find solutions for, problems that are real, that are happening for you. Try to avoid hypotheticals.
Know that you are a capable human being, and that you can come up with solutions to problems, as they arise. Trust in yourself. Think back on times when you successfully solved difficulties that were unexpected.
Build a support system. Friends, family, and others that you can rely on when you encounter difficulties are a great resource and may provide some relief to worrying about what you will do if something goes wrong.
When you find it difficult to stop worrying thoughts, practice self-care and relaxation techniques. Calm breathing, watching a film you enjoy, socializing, meditating or exercising are a few examples. Crete a list of the self-care and relaxation tools that work for you.

Together, these tips can help you manage worry. As always, if you find that you are struggling to manage any of these symptoms on your own, consult with your primary care provider or mental health provider for additional support.

By Taina Aceves, LMFT

 

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Sleep Hygiene Techniques

7 to 9 Hours of Uninterrupted Sleep

Sounds easy, right? Unless you are part of the 1 in 3 American adults who don’t get enough sleep, according to the CDC.  Sleep deprivation can be caused by many things- sleep disorders, children, work or homework, to name a few.  But do you know the many negative side effects that result from not getting adequate sleep?  You likely know some of the obvious ones, like drowsiness or that extra cup of coffee you’re needing in the morning- but others may surprise you.

Some other common side effects of insufficient sleep include:

  • Learning and memory problems
  • Difficulty with attention and focus
  • Problems with perception and judgement
  • Increased chances of getting into car accidents
  • Mood Disorders (depression or anxiety)
  • Health problems

If you feel that you are not getting adequate sleep at night, talking with your primary care provider is a good idea, particularly if you are also experiencing or have experienced, any of the above.

 

In addition, here are some tips for Sleep Hygiene:

  • Establish a routine of sleep and awake time and stick to it as much as possible (try to go to bed and wake up at about the same time on most days).
  • Expose yourself to natural light and stay active during the day.
  • Do your best to avoid naps.
  • Avoid caffeinated drinks, nicotine or alcohol later in the day as well as large meals close to bedtime.
  • Try practicing relaxation techniques before bed, like meditation or listening to calming music, to help your body relax and calm your mind.
  • Reserve your bed or the spot where you sleep for sleep only (avoid watching television, reading or using technology there).
  • Create a calming and comfortable environment where you sleep (diffusing essential oils or a comfortable pillow may help).
  • Turn off lights and electronic devices, as these can disrupt your sleep.
  • If you are not asleep within 20 minutes, get out of bed to do something calming, like writing, drawing or reading.

Sure, implementing all of these changes at once may seem overwhelming.  If you are able to do it, great!  If not, start with one, and see if that helps.  Slowly incorporate more, as needed, and choose which ones work for you.  Remember that the goal is to establish sleep habits that will get you a better night’s sleep, so you can reap the benefits.

 

Author: Taina Aceves, LMFT

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