Dr. Steven Stosny coined the term "election stress disorder” in 2016, with symptoms such as increased anxiety, insomnia, and difficulty concentrating. Dr. Stosny observed that "the pervasive negativity of political campaigns, amplified by the 24-hour news cycle and social media exposure," creates a significant level of stress, anxiety, or anger in many people.

The American American Psychological Association (APA) Stress in America Survey found that more than two-thirds of U.S. adults (68%) say that the 2020 U.S. presidential election is a significant source of stress in their life. This is a substantial increase from the 2016 presidential election when 52% of US adults reported the same.

“This has been a year unlike any other in living memory,” said Arthur C. Evans Jr., PhD, the APA's chief executive officer. “Not only are we in the midst of a global pandemic that has killed more than 200,000 Americans, but we are also facing increasing division and hostility in the presidential election. Add to that racial turmoil in our cities, the unsteady economy and climate change that has fueled widespread wildfires and other natural disasters. The result is an accumulation of stressors that are taking a physical and emotional toll on Americans.”

The APA offers the following evidence-based advice to help people manage their stress related to the election:

• Uncertainty is frequently stressful, and some people are better at dealing with uncertainty than others. The election, the global pandemic and social unrest are all adding to a sense of uncertainty in our lives. Avoid dwelling on things you can’t control. When uncertainty strikes, many people immediately imagine worst-case scenarios. Break the habit of ruminating on bad outcomes.
• Focus on what you can control. If following the news, watching the debates or scrolling through social media is causing you stress, limit your media consumption. Give yourself permission to take a break from the news.
• Engage in meaningful activities. Rather than fixating on news coverage, find an activity that you really enjoy and spend time doing it. Get involved in issues that are meaningful to you. By making a plan on how you will vote, for example — in person, by mail or as part of early voting — you are more likely to follow through.
• Stay socially connected. Go for a walk or spend time with friends and family. Research shows that people who have at least one or two friends or family members to turn to for emotional support during stressful times tend to cope better than people who don’t have such support.
• Stay active. Moving helps us release the energy we experience when we feel stressed.
• Realize that we might not know who won the election on Election Day. If you think this will raise your anxiety, keep busy with things that you enjoy and stay connected to social support so that you aren’t continually checking for what could be viewed as “bad” news.

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. 

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. ​

​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. ​

This divisive political season and election have heightened anxiety throughout the US. A Harris Poll on behalf of the American Psychological Association found that 52 percent of American adults report that the 2016 election is a very or somewhat significant source of stress (read more here).

As we attempt as a country to come together with respect, compassion, and courage, psychologist Guy Winch gives us concrete advice on overcoming post-election anxiety. "Regardless of its source, anxiety tends to operate in similar ways, which means there are clear things you can do to manage post-election anxiety." Guy has recommendations on actions you can take now to begin lowering your anxiety. Read his full article here:

​Three Ways to Lower Post-Election Anxiety

And remember, "sitting with emotional distress of any kind is neither wise nor necessary. If you feel upset, unsettled, and anxious—take action and make decisions that prioritize your emotional health and make you feel better."

You can also view Guy's viral TED Talk on boosting emotional health below.

Take care of yourself and one another out there.

The field of social genomics is granting us new insight into the power of connection and meaning at the level of our DNA. Researchers have known for some time that the stress response stifles the body's immune system and increases the inflammatory response (which in turn promotes the growth of cancer cells, plaque in the arteries, and increases our susceptibility to neurodegenerative disease). Researchers John Cacioppo, professor of psychology and behavioral neuroscience at the University of Chicago, and Steve Cole, professor of medicine at the University of California, Los Angeles, revealed that the brains of many of their participants interpret loneliness as a danger or threat, in short, loneliness triggered a damaging chronic stress-response. Fascinatingly, this response is triggered at the level of genome expression. 

Inspired by Cacioppo and Cole's work, Barbara Fredrickson, noted positive psychologist from the University of North Carolina at Chapel Hill, became curious as to whether the opposite would hold true. The answer was yes. People who described feeling socially connected, engaged in personal projects, or that they were living in a way that fulfilled meaning and purpose showed the opposite response pattern to lonely and chronically stressed participants.

Read more about this Cacioppo, Cole, and Fredrickson's research here.

Today is National Psychotherapy Day, a day to reduce stigma and draw awareness to the effectiveness of therapy.

"People who support psychotherapy – therapists, clients, academics, policymakers, or any other interested party – are encouraged to talk about their own experiences with therapy, contribute to low-fee and community mental health clinics, share therapy effectiveness research, and wear turquoise to show support and start conversations."

If you haven't seen the Moments of Meaning series, they are definitely worth your while. Dr. Ryan Howes, founder of National Psychotherapy Day, and his team released this video series featuring therapists speaking from the heart about the transformations that take place between therapist and patient in psychotherapy. The whole series is well done and provides an insightful and moving glimpse into real therapy sessions (all stories are shared with the permission of individual patients, and altering identifying information).

You can read more about National Psychotherapy Day here, and find the Moments of Meaning video series here.

In anticipation of the 4th annual National Psychotherapy Day, September 25, I invite you to check out this article on why psychotherapy is needed, effective, and lasting. The authors provide links to research on the efficacy of psychotherapy: supporting the science behind the transformative therapeutic relationship. If you or someone you care about is considering psychotherapy, this is a great place to start.

Brené Brown is a wonderfully authentic and moving researcher/storyteller. Her new book, Rising Strong, explores how we find the inner courage and compassion to rise up again when we have fallen. We all fall. The secret is in rising up again. And in the realization that in doing so we are not alone.

Dr. Brené Brown is a professor at the University of Houston Graduate College of Social Work, and a researcher who has spent years studying, writing, and speaking about vulnerability, courage, worthiness, and shame. The video below of her 2010 TEDx Houston talk, The Power of Vulnerability, is one of the top five most viewed TED talks in the world, with over 19 million viewers. If you haven't seen it, or haven't seen it lately, it may be the most inspiring and best spent 20 minutes of your day.

Brené's latest book, Rising Strong, is scheduled for release this week. In describing Rising Strong, she writes, “If we are brave enough, often enough, we will fall. This is a book about what it takes to get back up.”

Many who struggle with social anxiety can tell you that anxiety creates a vicious cycle. The mere thought of interacting with others and imagining how others might negatively judge or evaluate them creates often overwhelming anxiety. If they enter a social interaction in this anxious state they may find themselves more likely to have difficulty joining conversation or interacting comfortably with others. This may bring about uncomfortable social interactions and real or perceived negative evaluations by others, which serves to confirm their fears and may lead them to withdraw from this and future social interactions.

While a reported 7% of the population struggles with social anxiety, the anxiety and fear of judgement often prevents people from reaching out for help. This is particularly a shame as social anxiety responds well to a variety of therapeutic interventions.

But new research by Jennifer Trew and Lynn Alden published in the journal Motivation and Emotion suggests that acts of kindness may effectively break the cycle of social anxiety. In this study, socially anxious participants focused on their own active positive role in a social interaction (performing an act of kindness) and on the other as someone in need, rather than on how they imagined others might respond to or judge them. This led to positive reinforcement in the interaction during which others responded positively to the participants with gratitude, which in turn challenged the participants' negative expectations for this and future social interactions. The participants who engaged in positive social interactions related to their acts of kindness were significantly less likely to avoid social interactions in the weeks that followed. It's a win-win!

Read more about Trew and Alden's study here.
Learn more about social anxiety and social phobia here.

Traumatic Brain Injury (TBI) and concussions have increasingly made headlines, particularly in the context of sports-related injury. An increasing number of hospitals and outpatient clinics have opened units dedicated to improving diagnosis and rehabilitation for TBI patients. As we work to advance research and treatment, it is important to recognize the real people behind the statistics and brain imaging, to understand how these devastating losses impact their everyday lives. 

Artificial Intelligence professor Dr. Clark Elliott suffered what was initially thought to be a mild-traumatic brain injury when his car was rear-ended in 1999, an accident he walked away from. However, in the weeks, months, and years that followed, Dr. Elliott suffered a constellation of cognitive and emotional symptoms resulting from that TBI that threatened his family life and once promising career.

Dr. Elliott's new book, The Ghost in My Brain: How a Concussion Stole My Life and How the New Science of Brain Plasticity Helped Me Get It Back, describes in unblinking detail the often confusing changes that took place in his ability to think and function following the accident. Importantly, the story goes on to examine emerging research in neuroplasticity, the amazing ways in which the brain heals itself, and the innovative behavioral optometry treatment that Dr. Elliott credits for bringing him back to himself. It is a remarkable story, and well worth the read for those who have suffered TBIs, as well as for those who love and treat them.

Click here to learn more about Dr. Elliott's book and experiences.
Click here to listen to an insightful interview with Dr. Elliott by KERA's Kris Boyd.