Category Archives: Wellness topic

The Gut and Depression

I am fascinated about all the research in the gut biome and our relationship with the microbes that live inside of us.  I am motivated to figure out how to guide clients in improving their mood through their nutrition.  I am not a professional nutritionist but I try very hard to stay up on the latest research.  Subsequently I ran across this article in Psychology Today, October 2017 issue, pg 31-32 on how the microbes in your gut affect your mood.

There were  2 studies mentioned that as I scanned the information grabbed my attention.  The first one was on the transplanting fecal matter from depressed patients into germ-free rats.  The rats then began to develop symptoms of anxiety and anhedonia (not taking interest in the usual things one finds interesting).  The other study involved giving patients prebiotics (material that enhances the grown of beneficial microbes in the gut.)  The researchers discovered one particular type of prebiotics ( galacto-oligosaccharides – GSOs) to decrease cortisol and increase a patient’s attention to positive events.

However what was most intriguing as I looked deeper into the article was the theory of how important fiber is to our gut biome.  Apparently  fibrous material from plants which are more difficult to digest help feed beneficial microbes.  This fermentation that occurs releases energy, gases, and metabolites called “short-chain fatty acids (SCFAs).  These SCFAs are one of the ways our gut communicates with our brain, signaling molecules throughout the body to mobilize hormones and activate nerve pathways to everything from body weight to mood states.  Apparently the material present from these prebiotics in the fiber is extremely important for wellness and something our general Western diet lacks.  Per article our ancestors consumed around 100 grams of fiber while  we consume currently around 15 grams of fiber a day.   This is just another added point toward why nutrition is so important to limiting our stress and increasing well-being.


Back Pain and Exercise


In sessions, I hear a lot about chronic pain, particular back pain.  Many folks are  becoming more and more skeptical to the use of pain killers with all the headlines about the opioid epidemic.  They want to look at other options for pain and/or reduce their personal use of opiates and other pain killers.  Exercise comes up with mixed thoughts and feelings.  On one hand they hear that the increase of exercise can help with circulation, healing, and tension related to pain.  On the other hand, the wrong exercise or the wrong amount can cause serious damage and create more problems.

A recent article in the October 2017 edition of Scientific American highlights some research on this topic.  The research looked at over 300 individuals with chronic back pain and prescription painkillers.  They assigned these individuals to either a program of yoga, physical therapy, or a program of educational materials.  What they discovered is that the individuals in the yoga and physical therapy groups were able to significantly reduce their use on pain killers than the control and education only group.    The author described the yoga that was prescribed in the group as gentle stretches including cat/cow and child’s pose.

The article spoke to the evidence that what seems to work best is an overall combination of tools, which could be medications and movement.  When speaking to one’s primary care physician or pain treating provider, asking about other options for pain relief in addition to medications is recommended.  If there are no structural reasons for the pain or damage to any vertebrae many times movement is preferred over medications.   Although even with structural problems with someone’s skeleton, increasing flexibility and circulation is beneficial and necessary for healing.  Muscle relaxers may help obviously with muscle tightness, but you may get much more with exercise such as overall increase in circulation, relaxation and strengthening of muscles.

Bottom line seems to be that there are benefits to medication but much more for adding the right exercise with or without the medication.   Figuring out the right exercise may take a little research and time.  Speaking to qualified professionals familiar with one’s unique health history and getting a list of options to choose from is the best place to start.   A physical therapist is also a great place to start but if you want to try something at home, one could always begin with asking their healthcare provider to explain first off which exercises they shouldn’t do and why.  Then at least  an individual is able to stay safe while they sample different exercises to try at home.  As with any exercise program, when you find something that works, it’s the consistency that will give you the most benefit.   It’s better to start small and keep going than start too big and feel like you can’t keep it up due to time or energy.

Brain Health


Research on Alzheimer’s was again in Scientific American this month.  This particular article was reviewing research based on a clinical trial by “FINGER” (the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) between 2009 and 2011.  The results of the clinical trials and the study show that it is never too early and in this case  never “too late”  to intervene with cognitive decline through changes in the way one lives.

The changes they were referring to were eating a Mediterranean like diet, getting exercise, and challenging the brain through learning new things and memory challenges.  These recommendations are by no means new to the public but just validates even more this life style.  To be clear the exercise that showed positive results in memory and organization was 2-3 times a week of 60 minute periods of exercise like muscle strength training, aerobic exercise and postural balance and the Mediterranean diet was fruits, vegetables, whole grains, rapeseed oil, a fish meal  at least twice a week.  The only supplement given was Vitamin D.

Of course the groups started slow and built up to this goal which is encouraging.  They started at 30 minutes.  The exercise sometimes is the most difficult to work in.  It’s important to note that the time they give is not straight cardio work, it combines strength building, cardio, and posture improvement such as in physical therapy, physiotherapy, and some types of yoga.

Motivation for change can be a slow process but building up reasons to change is one of the steps.  Looks like this study gives us more to add to that list of pros and cons.  Hopefully also  it will also help us to work through the ambivalence.


Local Support




It can be overwhelming  seeking support outside of your friends and family when you have an addiction.   This is usually a significant step that needs to be made when you have multiple relapses; however, I see many people try to reassure themselves that this time it’s going to be different and not take this step.

They have their plan.  It usually is a decent plan.  We have worked on either a Wellness Action Plan, Crisis Plan, or Relapse Prevention Plan.    In therapy we have also came up with wonderful “tools” to use in their daily maintenance and their “emergency kit”.  We have practiced, role played, and brought in family and friends.  But yet they’ll be another relapse.  Another lie told.  Another promise broken to self or others.  They show back up sometimes beaten down, ashamed, and lower in spirit and energy.  Or they’ll show up determined that this time will “be different” only to end up like the previous scenario eventually.

The piece that is missing is support outside of treatment, friends, and/or family.  It is tapping into something positive that is larger than oneself.  This could be in the form of a religion/faith.  It could be in the form of AA/NA.  I have seen people invest themselves into a close knit wellness communities, like with Rock Climbing or Yoga.    I have seen folks begin to invest in service communities, like with Habit for Humanity, Urban Ministries, etc..  It doesn’t seem to really matter what it is as long as it has a higher principle and has other people to connect with.  This step  of participating with something outside of our individual community touches on the “spiritual” side that so many addictions counselors will talk about.  It touches on this piece of us that is sometimes very difficult to conceptualize.  People think they have to go to church or start praying.  Although this could be a path for some, it doesn’t mean it has to be the path of all searching for that “higher power”.  But one key element in this is the “investment”, the “participation” that makes it work.  Just visiting a community or group is not enough.  One must get involved so that an investment is made.   This investment will bring returns though.

In order to help with this connection, I want to provide some resources below for AA, NA, Al-Aanon.  These are by no means the only I recommend but they are the main ones folks can access easily in our community and have shown to be reliable supports and places people can become involved and invested through working steps, finding a sponsor, sharing story, etc…

Greensboro Al-Aanon

Al-Anon General Site

Greensboro AA meetings

Greensboro NA meetings

How Meditation Affects the Brain

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I’m facilitating a new class, Monday Yoga /Wellness Class, that starts Monday June 20 at 7pm (space is limited so contact me if you are interested.)

This class is aimed at developing an individual wellness/meditation practice.  We will do yoga postures to let go of any tension and to open the body up for relaxation for the first part of the class.  The rest of the class is focused on progressive relaxation, breathing, and a variety of meditative techniques.   (Props, chairs, and mats are available).

I have many people who come to see me that want a meditation or a yoga practice at home.  I created this class to help with that.  We will be exploring not only how and why to prepare before meditation but also will practice different meditative techniques for students to “try out”.

We will also discuss how meditation affects the brain.

The research is suggesting that a regular meditation practice (15-30 minutes a day) can increase gray matter in the brain, build new connections, clean out plaque that causes dementia, reduce the size of the amygdala which causes the fight or flight response, and increase our resiliency to cortisol (stress hormone).

There are many reasons to work on a meditation practice, especially if you are trying to be healthy and/or reduce stress and its effects.  Of course this should be easy enough, right? Why is sitting 15-30 minutes every day so difficult to maintain (and for some even start)?  One is that sitting in general can be painful and uncomfortable. Two, establishing any new habit or change is difficult. Consistency, consistency, consistency.  The mantra for true success ……Oh if developing consistency itself was easy.

Even if you practice now and then, it is better than none at all.  I would encourage everyone to try for 5 minutes and go from there.  You may surprise yourself that you can actually develop your own practice if you keep coming back to it when you think of it, no matter how long the in-between.

One also does not have to just “sit”.  I’m also hoping this new class will educate students on what is meditation by research standards vs other definitions.

Here are some links that discuss the effects on the brain from meditation and the research behind it:

Psychology today

Washington Post

Making “Not-So-Good” Habits Work for You

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“A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” – This is SAMHSA’s working definition of recovery.  this could be recovery from Mental Health or Physical Health concerns.

Recently I have seen  a good many clients that have come in reporting very similar symptoms.  They feel somewhat down or even distressed.  They are functioning relatively okay with work and home but feel like they have lost their way.  They report feeling empty, tired, anxious.  Most of these individuals have been very involved in family and/or community.  They have been the family coordinators, the church volunteers, the community activists.

When looking at the above working definition of recovery, these folks are definitely self directive, but somehow the other two areas of health and wellness and full potential have been overshadowed by others needs (others in their own family and others in the community).  When using the needs assessment tool I incorporate into my practice (the DLA20), it is clear that many facets of their life have been neglected and continue to be drained.  There’s just not enough nourishment and recovery built into their lives to keep pace with all the other routines in their life.

We live in a society of go, go, go.  Ample supplies of caffeine and energy supplements.  Ample supplies of foods and other items to grab quickly from moving to one activity to another.  We more and more are getting out of habits of nourishment and allowing for our bodies to recover.   Recovery is not just a mental feat but very much a physical feat as well.    We have to develop healthy routines to nourish our bodies and brain.  These routines have to be consistent in order to make an impact.   Just like we consistently go to the coffee pot, check Facebook, or volunteer to help another, we need to consistently eat nourishing foods, take time for some quiet,  and get some stress relieving physical activity.  But how?  It sounds simple but if it were that simple we wouldn’t have this problem of course.

The trick is to begin by connecting one activity to another.  The activity can be good or bad.  If you drink coffee every morning or check Facebook before bed on a consistent basis, then these are great activities to link with more nourishing habits like 10 slow breaths or eating an apple.    Once you have successfully linked these habits consistently you can build in more healthy habits like a walk or some yoga.  It’s better to start small though.  Later you may decide to even phase out the original activity, especially if it was doing more harm than good.  Getting overwhelmed and not doing anything at all is not an option if you want to stop the cycle of constant drain, low energy, and feeling like you’re in a fog.

Sometimes we need reminders, so setting timers, getting others involved are great ways to ensure more consistency.  Also subscribing to a blog whether it is mine or another wellness author could also be a good way to get a tickler to continue to work on developing healthier practices.  As with much in life persistence against failure eventually develops consistency regardless, so keep trying.

How to Get a Good Night’s Rest

Recommended Sleep ChartThe above chart comes from the National Sleep Foundation.    It suggests that an adult my age needs 7-9 hours of sleep.  Like good diet and exercise, sleep is a critical component to overall health.

The sleep foundation explains:

“One of the vital roles of sleep is to help us solidify and consolidate memories. As we go about our day, our brains take in an incredible amount of information. Rather than being directly logged and recorded, however, these facts and experiences first need to be processed and stored; and many of these steps happen while we sleep. Overnight, bits and pieces of information are transferred from more tentative, short-term memory to stronger, long-term memory—a process called “consolidation.” Researchers have also shown that after people sleep, they tend to retain information and perform better on memory tasks. Our bodies all require long periods of sleep in order to restore and rejuvenate, to grow muscle, repair tissue, and synthesize hormones.”

Many of us have difficulty sleeping.  Here are some general guidelines to follow in order to have a good night’s rest.

Stick to a sleep schedule , even on weekends.
Practice a relaxing bedtime ritual .
Exercise daily.
Evaluate your bedroom to ensure ideal temperature, sound and light.
Sleep on a comfortable mattress and pillows.
Beware of hidden sleep stealers , like alcohol and caffeine.
Turn off electronics before bed.

For those with an overactive mind:

Keep a notepad/journal and a pen near your bed to write down thoughts or things you want to remember.

You can also use this method to write down worries or concerns and if you’re having a hard time letting them go after writing them down, remind yourself you can just deal with it in the morning after you wake up.

At my practice:

Sleep problems are a common co-occurring issue that I see with my clients.  I usually help each person develop their own individual bedtime routine.  Many times we look at the therapeutic effects of yoga postures and breath techniques.  We practice these techniques in the office to figure out the right practice that will help calm the mind and body enough to allow sleep to take over at night.  Many times coming up with an answer to the individual’s problems will occur after tracking one’s schedule and diet over a week.  It is amazing what “hidden” sleep stealers we encounter throughout our day.  Sometimes changing something like when you have your last caffeinated beverage will be the miraculous fix.  Other times, what might solve the issue is long-term work on developing and keeping more healthy habits like exercise, balanced diet, and meditation.

If you would like to talk about finding your solution, please contact  Amanda.




Work-Life Balance

work in progress

I was asked to do a talk on “Work-Life Balance” the other week.  “Work-Life Balance” is the new catch phrase that’s being used instead of “Burn-out Prevention”.  So in essence my focus was on preventing burnout.  Burnout occurs when someone had once really loved what they do at their job but started giving more and more to the job until it took over more and more of their lives.  After this process starts, the individual then usually starts to resent their work and job to the point where they start to do less and less quality of work.  This usually results in low work performance and increasing resentment for not getting any past rewards they use to get for doing a good job.  It really is a downward spiral if there is no intervention.

The idea of “Work-Life Balance” is getting more to the root issue  in that one must have balance and perspective with the roles they possess in order to not experience burnout.  A good exercise is sitting down and listing all the roles you possess.  If there are roles you don’t want then you may want to take them off the list.  If you can’t get rid of the role then keep it, such as the role of “house keeper” if you are single parent and cannot afford to hire this role out.  So once you have the list of all the roles you have, then list one task to do for each of those roles.  Next get your calendar out and place that task on a day and a time to accomplish it.

This is just one way to help maintain balance during the week, but you will start to feel overwhelmed if you forget the role of “caretaker of self”.  You can’t forget to schedule in time for yourself to do something nurturing, like an hour to read, get a massage, see a movie.   You need time to reconnect to what relaxes and/or inspires you so that you can recharge and be able to do these other tasks in your calendar.  Don’t forget that you need time to let go of the other roles and remember yourself.

Maintaining Progress

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January, the time of resolutions.   Just checking out Facebook or talking to friends or coworkers you are bound to hear about new projects people are attempting.  Eating better, exercising, losing weight are big ones.  Also many people this year are de-cluttering and working on simplifying their life.  Some are doing away with bad habits like smoking or other dependencies.

Most of these resolutions are very admirable and when people first decide on them you can hear the optimism and hope in their voice.  But come March or April, how many are still focused on these resolutions.  How many in August?  December?  It’s difficult maintaining change and progress, especially if change is incremental.  So how does one maintain focus and progress?

I strongly believe that setting solid goals that are specific, measurable, realistic and with a deadline is the best place to start.  In counseling we use the acronym “SMART” to guide us in making goals with clients.  Specific, measurable, attainable, realistic, and time bound.  So if the goal was to lose weight then you would want to set a deadline to lose a certain amount of pounds.  You would need to do some research to find out what is a healthy amount to lose a week (usually no more than 2 lbs is advised) and make sure your amount and deadline are realistic and attainable.  Then you would set small weekly goals and research the best options to lose weight to choose your strategy.

The next step would be incorporating supports.   Would you benefit from joining weight watchers or finding a friend to exercise with?  Do you need to track your diet in a journal or use an app like Myfitness pal..?

The third step is then identifying obstacles like donuts at work or eating leftovers from kids’ plates.  Then you develop strategies for each of these obstacles; like having alternative snacks handy at work or having kids clean up their meal themselves so you are not tempting to grab a bite..

Fourth is evaluation and noting the progress and setting fourth another goal.  This is where most people throw in the towel actually.  The idea of seeing failure is sometimes enough to call it quits.  I like to think of failure as an opportunity to really understand what didn’t work.  What obstacle do I need to prepare more for and what are my options for this obstacle?  This is where breakthroughs are made but so many times we are too fearful of feeling like a failure or we are burned out on the task at hand that we really don’t learn from it or keep the progress we really did make.

Maintaining Peace Through the Holidays

peaceful homer 2

I’ve scheduled a time out in the morning for to do a little breath-work and a gratitude practice.  It has been amazing to see the difference in the mornings that I skip the practice and the days I will myself out of bed for it.   I’ve noticed also how it has helped me roll with all the holiday festivities without feeling as tired or frustrated as in the past.  Actually this season has been amazingly different and I’m attributing a lot to my morning practice.

I think many times we try to only practice meditation and other coping skills when we feel stress.    Our goal may be peace but our focus is actually on the stressful event.   It is what is prompting  our practice. When you are able to make the shift and allow something else prompt your meditation or mindfulness practice then you will make more progress during the stressful times.  I think the key is practicing as much peacefulness as possible and to do that you need to also practice when you are not very stressed.  When we get well attuned and use to having a peaceful moment it’s much easier to take that feeling of peace and apply it to other situations.

What I have learned is that using breath-work and mindfulness techniques to deal with stressful situations does work  but the effects of the practice is not nearly as beneficial  if you only use them in a stressful situation.  It is like playing an instrument only a few times a year, you may be able to play a song but it won’t necessarily be pretty or easy.     However as with anything when you practice over and over; when it comes time to really perform, it will be much easier and successful.