Category Archives: Treatment

7 Ways to Begin Managing Stress

Stress is something that happens to us daily.  There’s good stress.  You know the type that makes you show up for a meeting on time and also enabled you to prepare the night before.  There’s also not so good stress.  The kind that wears at you and makes you want to run and hide (or eat chocolate, drink a beer, smoke a cigarette, etc… )  It’s the kind that may start out as good stress but then added to all the other little worries morphs into something that is not helpful.

There are a few things you can do when you start to feel this negative stress come on that may help you gain control and not run and hide.  Some such as the first item may seem deceptively simple. We tend to take these for granted but often they are neglected resulting in a low threshold for negative stress and its effects.

1.Take a drink of water.  Many of us stay dehydrated and when we are dehydrated it is more difficult to reduce stress hormones and that feeling of tension.

2. Take a breathing break.   Concentrate on long slow exhales. When we are stressed we hyperventilate (longer inhales than exhales) which signals the body to go into “fight or flight”.

3.Eat well.  Eat meals with a variety of protein, whole grains, fruits and vegetables.  Attempt to eat something with protein and fiber at least every 4 hours while awake.  This will keep blood sugar from dropping low enough to signal a stress  response.

4. Walk or do some sort of exercise.  Just 15-20 minutes a day will reduce stress hormones in the blood; 30-60 minutes will optimize this.

5. Shrink your to-do list and focus on only the top 3 tasks.  If that’s too much, shrink it to the most important task you can do right now.   Looking at 20 items can be overwhelming but when you are focusing on just the next step, you feel more in control.

6. Nurture close relationships.  Contact someone positive whom you want to keep in your life.  Soak in some of their positive energy to help give you more resilience.

7. Get enough sleep.  Work on things that will help you get better sleep like cutting out caffeine after 5pm.  Getting 4-8 hours of sleep a night enables your body to clean up toxins and excess chemicals like the stress hormone cortisol.  Sleep helps to give you a “clean slate” for the next day.

*If still no relief, reach out to a support group or professional assistance through a counselor or other healthcare provider.

 

Weekly Wellness Post – Burn Out

Burn out, I think on some level we all have experienced.  I am studying for my CCS (Certified Clinical Supervisor) and one of the areas I’m reviewing includes the identified stages of burn out by Edelwich and Brodsky.  What I have found interesting about these stages every time I have read about them in the past is that the first stage involves “Enthusiasm“.  This is described as a tendency to be overly available and to give a lot of oneself due to the motivation and excitement.  I think many people forget when they are burned out that at one time they probably had an excitement for what is burning them out currently.  A lot of time we start our work with a certain idealism or a vision of “how things could be”.

The next stages include “Stagnation“.  This is described  by stating “expectations shrink to normal proportions and person discontentment begins to surface”.  Basically this happens when we have a desire to make something happen or to do our work a certain way and we get thwarted.  Frustrations start to mount up as we realize we can’t do what we had set out to as easily as expected and we see no movement toward our goal or vision.  This can happen when a company also doesn’t encourage collaboration and has a very dictatorship culture.  Or this can happen when a person does not have a full understanding of the field they are going into and only see a small window of the bigger picture until they are actually doing the work.  Other ways this could happen is that environmental factors such as  unexpected reduction of supplies  or resources occur that could be related to a natural disaster or unusual fluctuation in the economy.

The third stage is Frustration.  This is described as “difficulties seem to multiply and the helper becomes bored, less tolerant, less sympathetic, and she or he copes by avoiding and withdrawing.”  So what happens in stage 2 worsens.  No relief or help is available or received and the goal/vision gets further and further away.  At this point feelings of hopeless sink in and people start to give up or not care as much.  This leads to the fourth stage.

Apathy.  Apathy is characterized as “depression and listlessness”.  At this point a person may have forgotten why they entered their line of work in the first place.  They may seek help or quit job.  Some may move on to a more severe form of depression/anger and become harmful to themselves or others.

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I think the main point to take away from these identified stages is that the main culprit is a feeling of lack of control. There is much different companies can do to help a person prevent burn out.  Some things include more collaborative style of decision making and planning in which you not only elicit feedback from your staff but they see you use it.    Other things include having resources like EAP for staff to use to help them personally figure out how to take back control of their lives.  Helping folks have more work/life/family balance like incorporating family events or exercise initiatives into the regular work day.  Some people feel burnout b/c they feel they lost control in another area of their life so if they feel like work is taken over and the vision they had for the family or health is not coming to fruition they can feel burn out and project it onto the work place.  Helping employees work on balancing work and home can be extremely helpful.

Individuals can also retake their lives back by indentifying their roles and what parts of their roles are not meeting their own vision and expectations.  Next step would be examining this vision and expectations to see if they are realistic.  If they are not then taking some time to develop more realistic expectations might be in order.  If they are realistic then breaking the steps toward reaching these goals into manageable and measurable pieces would be helpful.  Once we know what the next step is, how we are going to do it,  and when we are going to do it then we are back in control.  The feelings related to burnout will start to diminish as we make progress.

 

Dyslexia and Visual Talents

I have looked into this topic a great deal due to the fact that my oldest son has had much difficulty knowing left from right and letter reversal issues, for example his 4’s and 9’s look like Ps… A book that made a lot of sense to me although I had questioned how the scientific community held it as factual is the book called ‘The gift of Dyslexia” by   Ronald D. Davis  .  This book describes individuals with Dyslexia to have many talents that those of us who do not have dyslexia are not capable of having.  These talents involve the ability of seeing an object like a cube and being able to turn it around in their mind as if they are seeing it from many different view points instead of the view point of just staring down at it on the table.  The can actually pick it up in thought and turn it around to see accurately the different sides and angles of the cube.  The problem comes in when they are asked to read something on paper that to understand it you have to be looking at it from the same viewpoint as any other person reading it.  Training the brain to look at it from the same view point is the trick.

Well I just stumbled on to an article in Scientific American:Mind, Jan/Feb 2015, on “The Advantages of Dyslexia” which found scientific studies that back this theory up.  So that this ability to see everything 3 dimensional and to be able to  manipulate an object in one’s head without picking it up is quite an asset it areas where one might need to see things in this manner.  In the engineering and sciences this is an extremely helpful talent.

There are many kids that get labeled with a learning disability because of dyslexia.  I believe occupational therapy really helped my son understand how to interpret the perspectives and dimensions of what he is seeing in comparison to what he is expected to see by us 2 dimensional folk.  Also with him he also had difficulty crossing the mid line of his body and I wonder how that all fits in with the dyslexia and his visual/mental ability.  Occupational therapy also fixed that.  He spent a large amount of his occupational therapy time on a “scoot” with his hands moving him in a crawling fashion all around their offices.  He had a blast and it made him do a lot of mid line work.

I’m fascinated by how our brain, visual ability, and physical movement are so interconnected.   We all know this and are taught this but the part our past teachers emphasized was our brain controlling the movement  and not the other way around, our movement controlling/affecting the brain.  Funny how most therapies address the movement aspect last and not first, being that you only get it addressed if sent to a specialist.  It seems like it should just be common knowledge to have our kids do mid line activities and tests that measure “ability” in this spacial/visual talent and less on just sitting in a desk with a sheet of paper and measuring the disability.  It really is a paradigm shift though and that takes time.  The science is there however.

 

Weekly Wellness Post – Follow up on last post

I could not locate the research I mentioned in past post on exercising 3 days a week for 20 minutes for a month equal to that of taking antidepressant for a month but here is some similar research on exercise, mood, and antidepressants.  Looks like the overal result of these studies and research is that you can get the same final result from medications and exercise, but medications will get you there faster while exercise will keep you there longer.   I think exercise is a win-win but of course sometimes you may need help with the initial motivation to get moving and that is where medications can be very helpful.

( This article was first printed in the Special Health Report from Harvard Medical School “Understanding Depression”. For more information  go to www.health.harvard.edu/UD.)

(This one isn’t necessarily research but I like it’s explanations.)

(This one is an actual abstract of a research experiment on aging adults divided into groups of those given antidepressant and those given different exercise routines to follow.)

 

Take Care and nerd up on these studies,

Amanda

 

 

 

Weekly Wellness Topic – Balance and Stress Resiliency

In my clinical practice I always focus on balance with clients, not only so that we are well rounded and resilient to stress but more specifically so that we do not trigger the system that manages stress, our sympathetic nervous system unnecessarily.  Our sympathetic nervous system is important to keep us out of danger and respond quickly to threats.  When our body perceives a threat it activates our stress hormones like cortisol and if enough are released it will turn on our sympathetic nervous system.  When the sympathetic nervous system is on, it’s ON.  It takes control over all major functions, including executive functioning.  More accurately, it limits or stops the majority of executive functioning and goes into the well known fight or flight (or freeze) mode.  This is fine if there is a bear chasing you but when you are sitting at the dinner table with family, not so cool.  We need the other nervous system working when we are sitting at the table with family or friends that love us and support us.  The parasympathetic nervous system is the one we need to promote more. This is the system that helps us prioritize our day, helps us remember where our keys are, helps us learn and retain new information.  It also regulates certain bodily functions like our digestive system…. (Ever wonder why your digestion gets messed up when you are under stress?  It’s because you sympathetic nervous system has decided that you need to prepare yourself to run or fight.  If you don’t do these things quickly then your system has decided you must need to prepare for these things so let’s clean our digestive tract out so we are not be weighed down and will move faster…)

In our modern day culture, stress comes more likely in forms that are not truly life threatening like starvation and predators attacking (although there is still this form of stress as unfortunately we all know).   Most daily stress comes from interpersonal interactions or feeling overwhelmed.  This doesn’t necessarily turn on the sympathetic system directly, it’s what this makes us do or not do that actually will turn the system on.  We have so much at our finger tips with being plugged into our virtual worlds that we have much distraction to ignore important things that our body will interpret as a threat.  This is a double whammy.  Because not only are we dealing with this stress and frustration of all we have to do but we neglect things like eating regularly, drinking enough water, getting regular exercise, and/or getting enough sunlight.  When this happens, our body is more likely to perceive things as a life threatening situation and turn on the sympathetic nervous system.

So it is important to eat regularly.  You need to eat about every 4 hours because no matter what you eat or how much you eat at a sitting, your body has processed it in about 4 hours.  Your blood sugar will drop signaling time to eat again.  If you don’t eat something (preferably fiber and a protein for sustaining level blood sugar) your body will think there’s something wrong with finding food in your environment and perceive this as a threat.  Another problem is that when we are stressed we emotionally eat and many times this is in the form of what is quick and easy and sweet like a donut.  This has very little protein and usually no fiber.  Blood sugar will raise real fast and crash quicker than 4 hours making us hungry, angry, and or spacey.  We may eat again but unless we eat some fiber and protein  our blood sugar will continue to roller coaster.  We will probably either gain weight and/or have stomach issues.

You need to stay hydrated during the day.  Drink the recommended 6-8 glasses of water based fluid thru out a 24 hour period.  Again if your body is dehydrated it will interpret this as well as a threat.  If you are prone to headaches, stomach issues, light headedness, try drinking a glass of water when these symptoms arise as a first line of defense.  (If diabetic obviously sugar will need to be regulated as first line defense.)

When need to exercise 20 minutes (walking like you’re in a hurry  or more) at least 3 times a week.  This is the bare minimum.  To be healthier daily moderate exercise is recommended.  There is a study and I have lost it but will find it again that compared those that did the 20min workout 3 x a week vs a group that took antidepressants.  They discovered that if done regularly both groups had equal results in improving depression.  Of course like an antidepressant, exercise will need to be done regularly over a month before you see the same results.  Why did this happen?  Not only are endorphins (your body’s feel good chemicals)  being released thru exercise, you are also burning off excess stress hormones.   So this will raise your ability to manage stress.  It makes you more resilient.  It makes you healthier.   Cortisol also increases cholesterol, so if you are having trouble with cholesterol, exercise will definitely scientifically help.

You must get 20 minutes of sunshine daily.  This does not mean that you have to have it on your skin although some sun helps with Vitamin D absorbtion which is vital,   Seeing the sunshine (not staring up at the sun itself) but seeing the light around you helps regulate melatonin (necessary for sleep and relaxation) and serotonin (the neurotransmitter that is increased by a majority of antidepressants and helps give you a “duck’s back” where stressful things don’t bother you as much.  Causes you to feel peaceful.) It also helps regulate your biological clock which helps with all kinds of daily bodily functions especially sleep.  And during sleep, guess what happens?  Our body cleans out toxins including excess cortisol.  A recent study I heard on NPR  stated that they have found that people whom get less than 5 hours of sleep have increased cholesterol to those that get at least 7-8 hours of restful sleep.

So if you want to be resilient and not react so much to stress around you, you need to pay attention to these 4 activities in which we actually have some control, which is nice to know we have some say in these things.

Weekly Wellness Post – Trauma Focused Cognitive Behavior Therapy resource update

I had the privilege as serving as a leader for a team of therapists going through the NC TFCBT Learning Collaborative sponsored by the NC Child Treatment Program.  Although due to a job change I will not be able to finish out the year long collaborative, I have gained much resources and information from the time I was involved.  I’m trying to update my resource page with some of these links and materials.  I’ve added a few already but look out for more to come.