 I often say that the importance of sleep should be covered in Volume 1 of So You've Decided to go to Therapy. The link between sleep and mood has been seen over and over in research. People with insomnia are 10 times as likely to have clinical depression and 17 times as likely to have clinical anxiety as those who sleep normally. We have long known that sleep difficulties are symptomatic of depression, anxiety, and other mental health conditions. New research is revealing that the relationship between sleep and our physical and mental health is much more complex -- and malleable. For example, the more a person experiences difficulty sleeping and the more frequently they wake at night as a result, the higher the chances of developing depression even if they did not struggle with depression before. More research is being conducted on factors that contribute to difficulty falling and staying asleep, or to shifting nighttime routines. Many studies have explored the connection between screen time (i.e., blue light exposure) and sleep difficulties. The readily available connection to work, social connections, entertainment, and distraction that come from our computers and phones carries with it implications for our sleep and thereby our physical and mental health. Some clever IT professionals and start-ups have found a way to turn technology in our favor when it comes to sleep. Apps like Headspace and Calm have skyrocketed to the top of the Apple App and Google Play stores, due in no small part to their audio features that aid users in falling and staying asleep. If you find that you struggle with getting good quality sleep, consider these sleep hygiene recommendations from the National Sleep Foundation:
Think about (or discuss in therapy!) ways in which you can actively work to prioritize your sleep to help improve your physical and mental health.
 As psychologist Guy Winch explains, "Much as accountants' busiest time of year is tax season in April, we therapists see our practices overflow in November and December. Why? ‘Tis the season of family gatherings."
Family gatherings have the potential to help us feel connected and loved, but even within the best of family dynamics, cooking, cleaning, and coordinating schedules can be stressful. And the fact of the matter is that not every family shares the best dynamics on display in Hallmark Holiday Specials. Family gatherings can bring old wounds to the surface, and leave many feeling less connected, less understood, and alone despite the holiday crowds. For those who live far from family and friends, singles, and those who are newly separated, divorced or grieving, the family-focused holidays can be a painful and lonely time. Add these factors to the days getting shorter, the weather colder, spending less time outdoors in the sun, and it is easy to understand how the holidays can leave us feeling stressed out and blue. The following resources can help you survive and thrive through this holiday season:
If you find yourself feeling overwhelmed with stress or sadness, know that you are not alone. Talking with a therapist about coping with the holidays specifically, or untangling long-standing relationship patterns, can be useful and help you move through the holidays and into the new year with less stress, more understanding of yourself and others, and more skills to navigate this time of year with more grace and less stress in the future. Heads Together is a UK campaign, spearheaded by the Duke and Duchess of Cambridge and Prince Harry to end stigma around mental health. This week the campaign released a video of the Duke, Duchess and Prince discussing their support of the mental health initiative. The Heads Together campaign has partnered with this weekend's London Marathon to help raise awareness and encourage people to speak up about and prioritize their mental health (all the runners will be given Heads Together headbands, modeled by the Royal Family above).  “Since we launched Heads Together last May, we have seen time and time again that shattering stigma on mental health starts with simple conversations. When you realise that mental health problems affect your friends, neighbours, children and spouses, the walls of judgement and prejudice around these issues begin to fall. And we all know that you cannot resolve a mental health issue by staying silent." Here in the US, the OK to Say campaign has been working to encourage people to talk openly about mental health. So often people do not ask for or seek out the help that they need because of stigma. Sharing our stories and working as a community to encourage one another and share resources can improve and save lives.
If you are interested in continuing this conversation and showing your support, consider joining the National Alliance on Mental Illness (NAMI) annual Dallas NAMI Walks 5k coming up in on May 13.  Journaling can be an invaluable resource for therapy. When someone describes an unusually good (or bad) day in session, I often ask them to reflect on what was different. Answers of "I don't know." or "Nothing, I think." are supremely frustrating in that they leave a person feeling helpless, as though a good or bad day comes out of the blue or passes them by completely outside of their control. More often than not, there are concrete things someone did, thought, or felt that either contributed to a better day or perhaps kept a bad day or experience from "taking over" or becoming unmanageable. Take for example the few pounds we all may or may not have added over the holidays. We can be perplexed when we look at the scale now and wonder, "How did that happen?" But we also know that people who log everything that they eat or drink 1) tend to eat and drink more mindfully and healthily, and 2) can readily identify that pumpkin cheesecake or second helping that likely added to the scale come January. Journaling can provide that level of insight for your mental health. Identifying patterns can be empowering and can provide you with your own individual data on what works, and what doesn't, what contributes to a great week, and what behaviors, skills, and experiences help you nip anxiety or depression in the bud. This process can help you clarify thoughts and feelings and solve problems more effectively. Journaling can improve your body as well as your mind. University of Texas social psychologist and researcher, James Pennebaker has found that regular journaling strengthens immune cells (lymphocytes). A study published in Advances in Psychiatric Treatment noted improvements in both physical and psychological health in clinical and non-clinical groups after just 3-5 15-20 minute journaling sessions. Other research suggests that journaling offers not just emotional, but physical benefits to individuals battling terminal or life-threatening illnesses. Perhaps we see these benefits because, as Pennebaker suggests, writing about stressful events helps you come to terms with them and reduces the impact of these stressors on your physical health. Remind you of therapy? Journaling and therapy can beautifully complement one another. The work that you do journaling over the week can build on the momentum, insights, and positive changes you are developing in therapy.  Photo via www.bulletjournal.com How to begin? When many people hear "journal," the embarrassing teenage diary tucked away in a sock drawer comes to mind. But a journal can be much more than a diary (or much less, if you like), and there as many ways to keep a journal as there are journal-ers. For those who don't fancy themselves writers, or who feel overwhelmed at where to begin, the Bullet Journal developed by Ryder Carroll offers a streamlined way of tracking daily activities, including mental health. What to journal? In addition to logging events and experiences, a journal can be used to track moods, how you feel physically (e.g., energy level, headaches), behaviors that can affect your mental and physical health (e.g., sleep, exercise, taking vitamins and medications), and self-care (e.g., socializing, meditation). Tracking can provide valuable data and trends to discuss in therapy. You may also find it useful to include post-therapy session notes (e.g., insights, reminders, topics to discuss or come back to next session).  Photo: Kara @bohoberry via Instagram Adding space for a gratitude journal can provide time and space to reflect on positive thoughts, feelings, and experiences in a way that can actually help re-train your brain to more readily identify (rather than discount) positive experiences. Including self-care ideas for when you notice triggers or early signs of depression or anxiety can help you easily identify tried and true methods to change course or help manage those negative feelings before they become overwhelming. Here are some additional tips to get you started:
Make it yours. Your journal can be as minimalistic and straightforward or artistic and detailed as you want. Are you the type of person (this month) who delights in a To Do list? Or does a listing these tasks and obligations bring you additional stress? If so, you may find you are better served by a "Done" list. Find your own style and what works best for you. The beauty of making a journal your own is that it can change with you from week to week, and month to month. Build on what works for you, and leave what does not behind without guilt (recognizing each of these is progress in and of itself!). Finally, I'm personally a proponent of putting pen to paper. One of the benefits of a journal that you physically create yourself is that you have complete control in customizing it to fit your needs as opposed to having pre-printed pages that you don't love or use in a day planner or maintaining multiple tracking apps. That said, if a physical journal just feels too analog for your life, there are a number of apps out there that track habits, moods, and provide space for journaling. Just be aware of protecting your privacy and online presence if you choose a digital route. Happy journaling! Additional Journaling Resources: BulletJournal.com offers a videos, tips, and tutorials on how to start a bullet journal. Rachel Wilkerson Miller and Anna Borges at Buzzfeed offer a lighthearted and insightful collection of ways to use journaling to track and improve your mental health. Steven Stosney at Psychology Today, describes the research on the results of journaling and gives tips for reaping the benefits of journaling while avoiding the pitfalls.  Mental health practitioners speak of and research common symptoms of depression including avolition and anhedonia. Avolition refers to the loss of motivation to initiate and carry out purposeful activities (e.g., cooking dinner, balancing your checkbook, keeping a dinner date with friends), while anhedonia describes a loss of pleasure in once valued activities. Journalist and author Anneli Rufus published a piece this week which appears on Psychology Today eloquently describing the lived-experience of these losses: depression's theft of one's passion, pleasure, and awe. Depression is a cruel thief that raids your heart, your home, your future, your present, your past. It steals your most precious possessions not to keep or use or give away or sell but just because they're there. Those loves for which you lived become loot burning by the wayside. This is stealthy, silent theft that masquerades as aging, failure, sulkiness, stupidity, ingratitude, unmindfulness, unwillingness to try. This is a monumental crime that masquerades as just another day. ~Anneli Rufus Those who have not endured or born witness to depression often struggle to understand the experience beyond what we think of as ordinary "blues." Rufus's poetic voice speaks to the depth of loss that is at the heart of depression. Her words may move you to a better understanding of those you love who have been robbed by depression, or it may give voice to your own struggle and help you know that you are not alone.
Read Anneli Rufus' full piece here. |
About the AuthorClinical psychologist Dr. Kristy Novinski contributes insights, book and film reviews, discussions of pop culture, and exploration of news and research in the field of psychology. Categories
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