Category: Depression

Movement and Mental Health (Or why that stupid walk is actually pretty smart)

6/7/2023

Research has shown physical movement to be a powerful tool in alleviating symptoms of depression and anxiety, as well as enhancing our overall sense of well-being. As we enter the sunshine and blue skies of Hot Texan Summer (TM), it is helpful to remember the beneficial effects of movement on our mental health and the importance of incorporating physical activity into our daily lives.

In her 2021 book The Joy of Movement, health psychologist and Stanford professor Dr. Kelly McGonigal explores how movement is intertwined with some of the most basic human joys, including mental health, social connection, self-expression, and personal growth. Drawing on scientific research and personal anecdotes, McGonigal emphasizes why movement is a “powerful antidote to the modern epidemics of depression, anxiety, and loneliness.”

Over the years, a growing body of research has shed light on the positive impact of physical activity on individuals experiencing depression and anxiety. These studies highlight several key findings:

Release of Mood-Boosting Chemicals. Engaging in regular physical activity triggers the release of endorphins, neurotransmitters that act as natural painkillers and mood elevators. Endorphins induce feelings of happiness and well-being, counteracting negative emotions. This chemical boost can significantly improve mood and reduce symptoms of anxiety and depression.

Neurogenesis and Neuroplasticity. Movement has been shown to promote neurogenesis, the formation of new neurons, and enhance neuroplasticity, the brain's ability to reorganize and adapt. These processes play a vital role in improving cognitive function, memory, and learning abilities. By stimulating the growth and connectivity of brain cells, physical activity helps create a healthier neural network that supports mental well-being. Several studies indicate that regular exercise may even significantly reduce the risk of developing dementia.

Stress Reduction and Anxiety Management. Movement acts as a natural stress reliever by reducing the levels of stress hormones such as cortisol and promoting relaxation. Regular activity can also help manage anxiety symptoms, which often coexist with depression. Engaging in activities like walking, jogging, yoga, or swimming can provide a much-needed respite from daily stressors, promote a sense of calm and mental clarity, and improve sleep.

Social Interaction and Support. Participating in group activities or team sports provides an opportunity for social interaction and support. Engaging in activity with others can foster a sense of belonging and community, creating a supportive environment that combats loneliness and enhances mental well-being.

Physical activity can be a powerful a complementary tool alongside professional treatment for depression and anxiety. A recent meta-analysis published in JAMA Psychiatry, found that relatively small doses of even moderate physical activity (2 hours per week) were associated with substantially lower risks of depression. (Dr. Roger Seheult examines this and another recent study exploring depressive symptoms and sedentary behavior in adolescence in the video linked below.)

If you are looking to enjoy these benefits by adding more movement into your life, here are some helpful tips:

Find or Rediscover the Joy of Movement. Experiment with different forms of movement until you find activities that you enjoy. Whether it's walking through the neighborhood, learning a TikTok dance, hiking with friends, hula-hooping, kayaking, or playing pickleball, choosing activities you genuinely enjoy will increase the likelihood of incorporating them into your regular routine.

Seek Support and Connection. Consider involving a friend or family member, or joining a club, exercise group or class to provide support and accountability. Sharing activity with others can make it more enjoyable, which will help you want to return to it regularly.

Movement can be a powerful ally in supporting our mental health and overall well-being. By engaging in physical activity, we tap into natural mood-boosting chemicals, promote brain health, and cultivate social connections. Embracing joyful movement as part of our daily life empowers us to take an active role in our mental well-being, helping us on the path towards a healthier, happier life.

Now, please excuse me as I take my not-so-stupid walk. (I hope to see you out there.)

Collective Grief in response to the COVID-19 Pandemic

3/29/2020

This article by Scott Berinato of the HBR explores the different types of grief we are collectively experiencing in the face of this pandemic.

There is a storm coming. There’s something bad out there. With a virus, this kind of grief is so confusing for people. Our primitive mind knows something bad is happening, but you can’t see it. This breaks our sense of safety.

We feel the world has changed, and it has. We know this is temporary, but it doesn’t feel that way, and we realize things will be different. Just as going to the airport is forever different from how it was before 9/11, things will change and this is the point at which they changed. The loss of normalcy; the fear of economic toll; the loss of connection. This is hitting us and we’re grieving. Collectively.

Finding ways to name what we are feeling, to speak it and ask for help, empowers us to experience and then move through the emotion. As the David Kessler states in the interview, “Emotion needs motion.” Kessler suggests grounding and mindfulness techniques to help calm overwhelming anxiety and re-center ourselves in the present and on the aspects of this situation which we can control.

Life in the Time of Corona

3/24/2020

As the number of cases of COVID-19 increase, so does our collective anxiety. It can be difficult to know what tomorrow, next week, or next month will bring. This lack of expectations and being unable to plan can heighten anxiety. Routines we may have worked hard to build and which support our work-life balance and mental health are thrown off. And many of us find ourselves isolated from our usual social supports.

In the video below, clinical psychologist Dr. Alli Mattu addresses important coping skills for working from home, social distancing without feeling isolated, and managing information related to the COVID-19 public health crisis without feeling overwhelmed.

The following additional resources can help individuals and communities navigate this stressful time. Remember, we're all in this together.

CDC: COVID-19 Resources
Latest updates, tips and resources by the US Centers for Disease Control.

Living With Mental Illness During COVID-19 Outbreak– Preparing For Your Wellness
This webpage provides information and wellness tips for individuals living with mental health conditions during the COVID-19 outbreak.

Mental health and wellness during a public health crisis
Dr. LaGenia Bailey, a former DBSA board member, discusses tips on how to stay well during this public health crisis. In this podcast, she addresses the benefits of mindfulness practice, lifestyle habits, and ways to stay connected with others to avoid isolation.

COVID-19 Mental Health Support Line: 833-986-1919
Texas Health and Human Services has launched a 24/7 statewide mental health support line to help Texans experiencing anxiety, stress or emotional challenges due to the COVID-19 pandemic. People can call the Statewide COVID-19 Mental Health Support Line 24 hours a day, 7 days a week toll-free at 833-986-1919. Operated by the Harris Center for Mental Health and IDD, the support line offers trauma-informed support and psychological first aid to those experiencing stress and anxiety related to COVID-19.

Seven Crucial Research Findings that can Help People Deal with COVID-19
Psychological research on past crises can help people cope with the daily — sometimes hourly — news flashes about the coronavirus.

How to Transition to Seeing Your Therapist Online
Continue the work of therapy even from a distance. (And yes, Dr. Novinski offers sessions via Telehealth.)

Psychologists’ Advice for Newly Remote Workers
As employers close offices to slow the spread of COVID-19, here’s advice from I/O psychologists on how both managers and employees can work more effectively during this time.

Dial 2-1-1
If you need assistance finding food, paying for housing bills, accessing free childcare, or other essential services, visit 211.org or dial 211 to speak to someone who can help. Run by the United Way.

COVID-19 Ancillary Costs
The HealthWell Foundation announced a COVID-19 Fund that provides up to $250 in assistance with ancillary costs associated with COVID-19. Grants awarded through the fund will provide reimbursement assistance to at risk or quarantined individuals for delivered food, medication, telehealth copays and transportation costs associated with COVID-19.

Care for your Coronavirus Anxiety

Staying Grounded

Meditations and Calming Exercises

National Domestic Violence Hotline
For any victims and survivors who need support, call 1-800-799-7233 or 1-800-799-7233 for TTY, or if you’re unable to speak safely, you can log onto thehotline.org or text LOVEIS to 22522.

Talking to Kids about the Coronavirus

The Parent Guide to Resilience

Yale University's The Science of Well-Being
Yale's most popular class is now free online via Coursera. The course focuses on how to increase happiness and productivity in your everyday life.

University of Pennsylvania: Positive Psychology Resilience Skills

On the importance of sleep for your mental heath

1/30/2020

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:

Stick to a sleep schedule of the same bedtime and wake up time, even on the weekends. This helps to regulate your body's clock and could help you fall asleep and stay asleep for the night.
Practice a relaxing bedtime ritual. A relaxing, routine activity right before bedtime conducted away from bright lights helps separate your sleep time from activities that can cause excitement, stress or anxiety which can make it more difficult to fall asleep, get sound and deep sleep or remain asleep.
If you have trouble sleeping, avoid naps, especially in the afternoon. Power napping may help you get through the day, but if you find that you can't fall asleep at bedtime, eliminating even short catnaps may help.
Exercise daily. Vigorous exercise is best, but even light exercise is better than no activity. Exercise at any time of day, but not at the expense of your sleep.
Evaluate your room. Design your sleep environment to establish the conditions you need for sleep. Your bedroom should be cool – between 60 and 67 degrees. Your bedroom should also be free from any noise that can disturb your sleep. Finally, your bedroom should be free from any light. Check your room for noises or other distractions. This includes a bed partner's sleep disruptions such as snoring. Consider using blackout curtains, eye shades, ear plugs, "white noise" machines, humidifiers, fans and other devices.
Sleep on a comfortable mattress and pillows. Make sure your mattress is comfortable and supportive. The one you have been using for years may have exceeded its life expectancy – about 9 or 10 years for most good quality mattresses. Have comfortable pillows and make the room attractive and inviting for sleep but also free of allergens that might affect you and objects that might cause you to slip or fall if you have to get up during the night.
Use bright light to help manage your circadian rhythms. Avoid bright light in the evening and expose yourself to sunlight in the morning. This will keep your circadian rhythms in check.
Avoid alcohol, cigarettes, and heavy meals in the evening. Alcohol, cigarettes and caffeine can disrupt sleep. Eating big or spicy meals can cause discomfort from indigestion that can make it hard to sleep. If you can, avoid eating large meals for two to three hours before bedtime.
Wind down. Your body needs time to shift into sleep mode, so spend the last hour before bed doing a calming activity such as reading. For some people, using an electronic device such as a laptop can make it hard to fall asleep, because the particular type of light emanating from the screens of these devices is activating to the brain. If you have trouble sleeping, avoid electronics before bed or in the middle of the night.
If you can't sleep, go into another room and do something relaxing until you feel tired. It is best to take work materials, computers and televisions out of the sleeping environment. Use your bed only for sleep and sex to strengthen the association between bed and sleep. If you associate a particular activity or item with anxiety about sleeping, omit it from your bedtime routine.

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.

Surviving (and Thriving) Through the Holidays

11/27/2019

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:

Psychologist Guy Winch writes a thoughtful column on dealing with loneliness at the holidays, including suggestions on developing your own traditions and tribe. (Guy also has much-loved TED Talks on the importance of emotional first aid and healing a broken heart.)
PsychCentral has compiled a master list of resources to help you navigate the holidays. Find help with everything from reducing holiday stress, maintaining healthy boundaries through the holidays, navigating the holidays when you struggle with depression, and much more.
The Mindfulness and Grief Institute compiles resources to help in managing grief during the holidays.
The American Psychological Association (APA) hosts a Holiday Stress Resource Center covering topics such as managing difficult family conversations (including politics) and dealing with financial stress during the holidays.
Finally, this Psychology Today blog post by Dr. Michelle McQuaid is an oldie-but-goodie, describing small (research-based) changes you can make to help you flourish during the holiday season and throughout the upcoming year.

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.

Raising Mental Health Awareness

4/22/2017

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 to Improve Your Mental Health

1/10/2017

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:

Write every day. Whether you are more comfortable writing page long entries, drawing about your day or feelings, or using bullet points to capture the essentials, writing every day can help you build a consistent practice of mindful reflection. This can begin to change not just how you reflect on experiences after the fact, but also how you live them in the moment. If you have a negative interaction with a co-worker or spouse, you may find yourself thinking, "This is definitely going in the journal." That thought begins to change the experience. You begin to think about how you might write about it. Will your journal entry say that this conversation kicked off a terrible day? Or will you write about how you used the opportunity to practice stopping a spiral of negative thoughts, or how you used other coping skills to turn it around?
Make it easy. Before you set up a goal or "resolution" (e.g., to exercise 5 times a day or get 8 hours of sleep each night) start with tracking where you are now. Be curious, mindful, and take some time to learn about your current baseline. Once you've established that, you'll be better able to set realistic goals.

Photo: @studywithinspo / Via instagram.com

Photo: Kara @ BohoBerry

Photo: Serena @ Bullet Journal

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.

Depression: A Thief in the Night

10/15/2015

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.