Tuesday, November 26, 2013

Managing Holiday Stress, or "The Twelve Coping Skills of Christmas"

The holidays are often set aside as a time of joy and peace, of reflection and gratitude. But many people report that the pressure that comes with the holidays makes this the most stressful time of the year. So here are some tips to help you have a happy, healthy holiday season.

1. Set realistic expectations.
In an effort to make the holidays “perfect,” we can run ourselves ragged and accumulate more debt than we would like. This time of year, the media is full of images of the “perfect holiday,” and it is so easy to turn those images into an expectation. Try and avoid the trap of perfectionism. Instead, try telling yourself that the holidays will be wonderful and imperfect all at once.

2. Reach out for help if you need it.
Many people seem to have a desire to be superhuman, and to do everything without any assistance from anyone. Not only is this destructive to your own mental health, it robs your loved ones of a chance to be more connected to you. Instead of “going it alone,” ask for assistance.
Sometimes the holidays can get you down...

3. Acknowledge feelings.
There is a lot of pressure for holidays to be joyful and happy time. But this is also the darkest time of the year here in the northern hemisphere, and many people react to the seasonal cycles with increased depression. Further, the experience of holiday emotions may vary. Some people may be sad; others may be grieving and may miss loved ones. It is OK to feel whatever is going on for you at any time. You are not “supposed to” feel any particular way. Just acknowledge what you are feeling, and remember that you are allowed to have whatever feelings you are actually having.

4. Set aside differences.
One of the major stressors this time of year can be gatherings with other people with whom we do not get along. To reduce stress for yourself, try and set aside your differences. For example, if you and your brother-in-law argue about politics every year, maybe this is the year to call a truce. If you know that you disagree with someone about politics or religion (or whatever) it is a good idea to just let that difference be. Instead, try and connect over things you have in common. If you really feel you need to address something, bring it up at another time of the year, when nerves are not so frazzled.

5. Practice gratitude.
Taking time each day to be aware of what you have that you are grateful for is clinically proven to help reduce depression and anxiety, and to improve overall happiness. Try listing five things you are grateful for each night before you go to sleep. For many people, the holiday season is the perfect time to begin a gratitude practice.

6. Make a plan for difficult situations, and stick to it.
Let's say you're hosting the big family dinner this year, and in the past it's been about as complicated as planning a trip to the moon. Or, let's say you have to spend time with family members who make you uncomfortable. Whatever the challenge, you will be less stressed if you have a plan before you go into the situation. So sit down and make a plan of what is going to happen, and then stick to the plan. Don't change the plan at the last minute to add “just one more thing.”

Further, remember the first item on this list: Resist the urge to strive for perfection in your plans. Acknowledge that you are going to plan a good event, but one that is realistic and achievable. And then do what you plan.

7. Say “No” more often.
This is a great season to practice setting limits. If it is just too much work to pick up some cookies on the way to the kid's holiday concert, then say so. You just can't make it to that one more party? Tell them that you won't be there. And remember, you don't need explanations: “No” is a complete sentence.

8. Take some deep breaths.
This advice has been around for a long time, and for good reason: It works. Stop whatever you are doing and take 10 slow, deep breaths. See what happens if you do this several times a day. Deep breathing slows down our heart-rate and sends a message to our mind and body that “Everything is OK.”

9. Take some time for yourself.
During the holiday season we can find ourselves in a whirlwind of activity, seemingly without any rest. Before you get caught up in that, plan out some time just for you. Maybe a couple of hours of reading, or a massage, or a trip to your favorite restaurant. Make some time for yourself so you can “recharge.” And bonus points: Refuse to feel guilty about it.

10. Get enough sleep.
'Tis the season for competing demands on our time. Holiday parties can run late, and we can stay up late at night baking or wrapping... All of this is a recipe for poor sleep. Our ability to cope with stress is compromised when we aren't sleeping enough. Make sure that you are getting enough sleep each and every night. (Oh, and parents? Make sure your kids get enough sleep, too.)

11. Watch what you eat and drink.
A friend of mine describes this time of year as “pastry season,” because there are more cookies, cakes, pies, candies and other assorted sweets on offer this year than any other time. You will also likely be offered heavy meals, full of rich food. All of this can be a wonderful gustatory experience. At the same time, when our bodies are not feeling well or are not well-fueled, our ability to cope with stress is decreased.

The holidays are also a time of year for celebratory beverages—alcoholic and otherwise. And while alcohol may seem like a good way to relieve stress, its effects are short-term, and the consequences that come with from the decisions we make when intoxicated are long-term.

While parties and feasts are a part of the holidays, it is a good idea to remember moderation.

12. Get some exercise.
Physical activity is one of the best ways we have to cope with stress. During the holiday season we are often so busy that our trips to the gym or walks around the neighborhood often get cut from our schedule. Remember that this time of year, taking care of yourself is even more important than ever. Schedule that gym time or that walk in your calendar, and treat it as an appointment you cannot break.

Hopefully these tips will improve your experience of the holiday season. Remember to take care of yourself. And personally, I wish you and yours all the best this year and every year!

For further reading:
An APA summary of research on holiday stress:

Wednesday, November 13, 2013

Five Thing that People Believe about Anxiety—that actually make it worse.

If you have been anxious for a period of time in your life then you have likely developed some thoughts about your anxiety. You have probably come up with explanations and descriptions of your anxiety. After all, humans naturally look around themselves and try to explain their world. Your internal world is no different.

When I treat anxiety I explore what thoughts the person has about anxiety itself. Some thoughts are helpful and some are neutral. But what I really want to identify here are some of the thoughts that cause anxiety to get worse, or the thoughts that make it more difficult to treat. Below I have listed five common thoughts that people with anxiety have about their anxiety. All five thoughts make anxiety worse or harder to address.

What is particularly interesting is the strength with which people believe these myths! I have noticed that when they are challenged, people rush to defend them. As you read through these five beliefs, ask yourselves which ones you believe—and which ones you want to defend.

1. I can't control my anxiety.

This is the number one myth that I hear from anxious patients. People come to me and say, “I've tried to control my anxiety, and I just can't!” Upon further assessment, the truth usually is “I have tried to control my anxiety and I have not yet succeeded.” Generally, this is a result of the ways that the person has attempted to control the anxiety: Either by ignoring it, numbing, or repressing it. These techniques are not effective, so it's not fair to say that the person can't control anxiety; it's fair to say that they haven't yet tried an effective technique.

Believing that anxiety cannot be controlled means that every intervention the person tries to cope with anxiety will be met with self-sabotage. We know that people put more effort into tasks they believe they can achieve, and less effort when they know they will not succeed. The same is true about mental health: Anxiety is controllable, but if you keep telling yourself that it isn't, you are not going to bring your best effort to the task.

So if you believe this myth, try this instead: It may seem like I cannot control my anxiety, but ultimately I know that I can.

2. My anxiety is genetic.

No, it is not. True, there does seem to be some general genetic component to anxiety, true. But there is a difference between “predisposition” and “reality.” A person's experience of anxiety is more a factor of internal thoughts and external environment than genetic factors. In other words, while your genes may set the stage for your anxiety, your actual anxiety is a factor of your life and your thoughts. Fortunately, you have control over your thoughts and your environment. Frequently, “my anxiety is genetic” is an excuse people use to avoid the difficult work of addressing their anxiety.

If you believe this myth, try this instead: My anxiety is unique to me, and I can do something about it.

3. Worrying about possible tragedies makes me more prepared for them.

No, it does not. Worrying about bad things that might happen just means you are directing your mind to picture all the possible terrible things that might happen. You are making yourself anxious, and you are actually decreasing your ability to problem-solve. If you are looking at a specific task, you are rehearsing all the ways you can fail.

The reality is that if you spend time worrying about a particular bad outcome, and then that outcome actually happens, you will have conditioned yourself to be less effective in handling that outcome, because you will have associated it with worry. In other words, worrying about possible tragedies makes you less prepared for them.

If you believe this myth, try this instead: I can find effective ways to address the things I worry about.

4. Medication is the only way to control anxiety.

No, it is not. While medication can be an effective tool, research has shown that talk therapy is just as effective, and in some cases more effective, than anti-anxiety medication. Additionally, the skills learned in talk therapy can be used at any time, in any circumstance. Further, talk therapy can address the root cause of the anxiety, while reliance on medication alone does not.

Taking anti-anxiety medication is nothing to be ashamed of. And if you need it, then take it.

But believing that medication is the only way to treat anxiety actually makes anxiety worse, because the person comes to believe that they require the medication. In other words, over-reliance on medication makes the experience of anxiety itself something that is beyond the individual's ability to control. Believing anxiety must be medicated away makes anxiety itself something to be frightened of.

If you believe this myth, try this: While my medication helps with symptom relief, I can do things to address my anxiety for myself.

5. If I'm anxious about something, that means that I have something to be frightened of.

No, that is not what anxiety means. Anxiety, as an emotion, is always real and almost always has a specific cause. But that is not the same thing as saying that there is always something that is actually threatening.You can experience anxiety (or fear, for that matter) when there is no actual threat. It happens all the time. You can probably think of several examples in your own life.

In fact, our problem anxiety often arises when our minds believe there is something threatening when there is not.

This myth can cause people to avoid the things that cause them anxiety. But if you avoid the things that make you anxious, you are reinforcing the belief that you have a legitimate reason to be anxious. This can make your anxiety worse, and make the things that trigger your anxiety even more frightening.

If you believe this myth, try this: Anxiety is my emotion, not my reality.

Wednesday, November 6, 2013

Seeing Greener Grass: The negative effects of comparing yourself to other people

Have you ever had thoughts like these:
  • "She is so much prettier than I am."
  • "I want a new car, like the one my neighbors have."
  • "I wish I lived in a bigger house like my cousin."
  • "My friend has a great job. He's always been so lucky in his career." 

If this sounds familiar, you may be falling into the trap of negative social comparison.

Basically, negative social comparison is exactly what it sounds like: Making ourselves feel bad by comparing ourselves to others who we perceive to be more successful than we are.  

Social comparison is one of the most common manifestations of self-judgment.  How common is it? Some psychologists suggest that social comparison is unavoidable, and theorize that comparing ourselves to others is how we measure ourselves objectively. But when we look at the lives of other people and see only their successes, we can start to feel bad about ourselves. We may begin to think that there is something wrong with us that we are not at "the same level " as our peers, or we simply may begin to feel bad that we "are not where we should be."

Negative social comparison decreases our own self-esteem, and a reduction in self-esteem is one of the contributors to depression and other mood disorders. It also damages our self-confidence, and makes it more difficult for us to achieve the kind of life we want.

So what does negative social comparison look like? Recent research suggests that using Facebook (and to be fair, other social networks, like Pintrest) can foster negative body image.  More than half people (men and women, in this study) report that they feel bad about their bodies after seeing pictures of themselves and others on Facebook. 

Further, when all your friends are posting about their great experiences and accomplishments, this can make you feel bad about yourself. Several studies have documented this. Some experts have even suggested limiting the number of friends, which seems to turn down the effect of negative social comparison. 

So how do you stop negative social comparison?

First recognize that you are doing it, and when you are doing it. Ask yourself: When do you feel bad when you think about the accomplishments of others? Do you notice that you feel worse about yourself when you see other people who have something you want? See if you can discover what kinds of situations and circumstances prompt your negative social comparison. For example: I know someone who feels bad when he sees a man who has a more muscular body than he does. For him, the first step is recognizing that this specific behavior (seeing someone who is more muscular and feeling bad) is the negative social comparison in action. 

Second, make a commitment to stop. When you catch yourself doing the comparing, tell yourself, “Stop.” Then, think of something else. It's useful to have something else already in mind that you will distract yourself with—for example, and upcoming trip, or something in the future you are looking forward to. Or, remind yourself that you do not know the whole picture of the other person's life. Maybe, all things considered, that person is unhappy in other ways, and would change places with you if given the chance. 

Third, get big picture. Ask yourself, “Would I really be happier if I had X, or do I just think I'd be happier?” Or, if that doesn't work, ask, “Will any of this matter in 10 years?” I had one client who used to “get big picture” on an astronomical scale: She would say, “How can I care what kind of car my coworkers drive when there are more than 100 billion galaxies in the universe?” In other words, think of a bigger perspective.

Fourth, make it a habit to avoid social comparison. Think of this as a positive step you can take towards your mental wellness. You may want to make it a habit to be grateful for what you have and who you are, which is a great way to avoid social comparison. Remind yourself that everyone in the world is different, and we all have struggles. You can also repeat certain phrases to yourself that reinforce your commitment. One that I like is “Don't compare your insides to other peoples' outsides.”