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How To Cope With A Not-So-Happy Holiday

The holiday season is often viewed as a period of joyous celebration with family and friends. The world comes alive with music, smiles with acts of charity, and celebrates togetherness. For some, however, this time of year can trigger feelings of stress, anxiety, and depression. In a survey by National Alliance on Mental Illness (NAMI), 64% of those surveyed confirmed being affected by the “Holiday Blues,” while 24% reported the holidays affect them a lot.

Individuals may experience:

  • fatigue
  • tension
  • frustration
  • loneliness
  • isolation
  • sadness
  • a sense of loss
  • nervousness
  • stress

These symptoms (or increased symptoms, if one is affected by a mental health condition) can be linked to other holiday-related factors as well, such as less sunlight, changes in diet and routine, increased consumption of substances, financial stress related to gift giving, and conflict with family or friends. Although some of these symptoms may be temporary, it is important to identify and practice ways of coping as some of us seemingly trudge through the holidays.

Here are some tips for managing your mental health throughout the holiday season:

Go to Your Therapy Sessions

The holidays are busy, and the idea of brushing off a therapy session in order to cram in an hour’s worth of holiday errands can be incredibly inviting. However, it can also create more stress and frustration. Being able to pause and reflect is important in maintaining mental health, and the holidays may bring up difficult emotions or experiences that are important to process.

Find a Positive Way to Honor Those Lost

The holidays can bring up feelings of grief as we celebrate without loved ones who have passed. Incorporate a tradition that can allow you to remember and celebrate your loved one in a positive manner. Some ideas may be to write a letter, light a candle, share favorite stories, or play the person’s favorite music. Although it may look different, we can still make those passed a part of our celebration.

Stay Active

I know I say this a lot – and I mean A LOT – but I have not found a better stress reliever than exercise. Even if it’s a short walk or 10 minute stretch, take some time to get your blood moving and get those endorphins pumping. This can also be a time for some mindfulness practice, as we can strive to be present with our bodies and minds throughout movement.

Stay organized

During the holidays, it sometimes seems as if the “To Do” lists never end. Make lists, keep a routine, and practice good time management skills. Staying organized can help ease anxieties, develop realistic expectations, and prevent ourselves from biting off more than we can chew.

Do not Go Broke to Show Your Love

Financial concerns can be the bulk of stress throughout the holiday season. Our society puts intense pressure on gift giving as a way to show that we care, which can cause depression, anxiety, and stress for those struggling with finances. If you are struggling with finances, stick to a budget that can assist with money management. If you have very limited funds (we’ve all been there!), the people who love you will understand. Some low cost/no cost gift ideas might include making a CD, writing a poem, printing and framing pictures, doing an activity or an experience, or re-purposing something.

Relax

Spend extra time checking in with yourself to determine what you need to stay stress-free and relaxed. Self care is even more important during times of high stress and feeling overwhelmed.

Play Well With Others

When we spend a lot of time with family it can create tension, specifically when we have differing opinions or turbulent relationships. Make sure to communicate effectively about your experiences and emotions in order to try and make others aware of how you are impacted turbulent relationships or conflict. If you have the time, check out this article titled 5 Ways to Talk About Touchy Topics with Those You Care About to get some ideas on how to make holiday interactions a little smoother.

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What No One Tells You About Being a Therapist

A therapist’s office is intended to be a safe, warm space that allows for others to express and process patterns of thoughts, feelings, and behaviors. It’s a place where people go to feel better. As a helping professional, I have the privilege of being part of the personal development and growth of my clients. I am deeply passionate about what I do, and I’ll be the first one to admit that I still get goosebumps whenever a client experiences an “Aha” moment. That being said, the mental health profession is not one without challenges.

According to the Philadelphia’s Department of Behavioral Health and Intellectual disAbility Services (DBHIDS), it’s estimated that about 22% of adults in the city are diagnosed with Depressive Disorder, 16% of adult Philadelphians experience frequent mental stress, and 13.8% of teens experience suicidal ideation.

To paint a clearer picture, these statistics mean that in Philadelphia 1 in 5 adults are diagnosed with depressive disorder, and 1 in 7 high school students have reported seriously considering suicide. These startling numbers are not counting the undiagnosed or unreported cases. These rates have remained consistent within recent years, with the exception of a wild increase of opioid-related deaths and ER visits for drug overdoses. With the growing severity of the opioid epidemic in the United States, an already overwhelmed system seemingly only has so much wiggle room before it breaks.

Community Behavioral Health (CBH) is a non-profit corporation contracted by the City of Philadelphia to provide mental health and substance use services to Medicaid recipients in Philadelphia County. There are about 144 Community Behavioral Health organizations in Philadelphia, and I have worked for and with many of them. Although I love the work that I do with clients, working in community agencies has created an entirely new perspective on how therapists and participants are treated among the Community Behavioral Health system….. and I think we all deserve better.

I remember learning about proper ethics and counseling techniques in my graduate program, bright eyed as I geared myself up for a future as a helper. Looking back, it seems so naive for me to have thought that it would be easy. Admittedly, I often wish I could go back to school and pay closer attention to discussions on how to avoid burnout, but sometimes it seems that in the community behavioral health field, burnout is inevitable. Although it would not have changed my choice of profession, I wish I had been more prepared for the community mental health world.

Here’s what I wish I had known:

  1. There are not enough mental health therapists in the community behavioral health system. It seems as though a major theme within the therapist community is the feeling of being overwhelmed by a bogged down system. Community Behavioral Health has an incredible amount of participants in need of mental health care and not enough wo/manpower to provide the quality of care necessary to treat severe mental health symptoms. This means that the large number of participants receiving services are divided among the limited mental health professionals that exist, meaning higher burnout rates for therapists.
  2. There is a major focus on productivity. Full time therapists are given a certain number of clinical hours that they must provide per month, typically called productivity. For example, in my organization, the month of October held 160.63 available treatment hours. I need to achieve 66% of that, meaning I needed to provide at least 106 hours of therapy to meet productivity expectations. If I don’t, I risk being written up. So when we get into the nitty-gritty of things, my work performance is not determined by the quality of therapy I provide, but by the quantity of services I provide. Where I try to validate myself, it is sometimes hard to focus on my successes with clients when I am consistently reminded of “my numbers.” It also makes it more difficult to be understanding when clients cancel, which is often framed as one less hour toward productivity.
  3. Many organizations are turning to fee-for-service. Fee-for-service is pretty self-explanatory. In fee-for-service positions, therapists only get paid for the sessions they complete. This means that if a client does not show up, the therapist will either not get paid, or will get paid a small percentage of what they would have received. Oh, and fee-for-service therapists don’t get paid for the paperwork or outreach they do…. and let me tell you, in this field there is always a lot of paperwork and outreach to do.
  4. Community behavioral health is behind. Think about all of the ethical guidelines, evidence-based practices, and sensitivity training we learned about in school. Now, try to imagine trying to implement those practices in an organization that always seems 20 years behind the present status quo. This isn’t necessarily community behavioral health’s fault. It simply takes time to roll out new methods given the amount of education and training they require.
  5. Sometimes people don’t listen. I feel like I can talk about ethical treatment and appropriate care until I’m blue in the face, and it still doesn’t feel like I am heard. I often find myself thinking of therapists as the nurses of the mental health field– we have an incredible amount of knowledge, have spent years studying the subject, and care deeply about making sure our clients are receiving proper care… and it still feels like we are spinning our wheels just to be heard and respected.

And finally, none of this would matter if we didn’t care. Professionals typically don’t join the mental health field if they don’t care about the well being of others. This makes it even more frustrating when we can see that the overall focus is not on the quality of care we provide, but instead, on the success of the business. Although I can recognize that the business aspect is important, it just does not feel right to put the needs of the business before the needs of people. Helpers feel passionately about the injustices within social systems, because we care about the outcomes of the people we work with. It can be incredibly frustrating to see the above factors as barriers to doing what we love most– helping people.

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How to Stay Motivated

My dad always says, “Find something that puts a fire in your belly.” Teenage Me would often roll my eyes, turn up the volume on my latest self-burned punk/emo mix CD and let Travis Barker’s drum beats muffle the unappreciated wise words of my father. As an adult, I can finally understand the sentiment of embracing motivation and passion while pursuing goals. I can also recognize a possibly unintentional deeper meaning here- if left without fuel, fires burn out.

Establishing a goal is the easy part. Hard work comes with actually following through with the steps required to achieve that goal. Maintaining motivation can be difficult, and I always say that building motivation is somewhat of a catch-22. The best way to increase motivation is to just do it (insert Nike symbol here). We feed motivation by reflecting on how we feel as we complete steps toward a goal. Even if the motivation begins as a small flame, we can turn it into a bonfire. Here are some tips for building and maintaining motivation while working toward goals:

  1. Remind yourself of your goals.
    • Write your goals down and display them in a place you look at often. Make sure they are specific and detailed to better organize steps necessary. Take away the “Oh, right, I forgot I wanted to do that” moment and shoot directly for goal achievement. Goals can be easily pushed to the side and forgotten about if we don’t make a point to keep them in our focus.
  2. Discover the WHY.
    • Any task has a number of good reasons behind it. Even small things can be analyzed to find something good. Consider washing dishes. We don’t complete the task for no reason- we complete the dishes in order to have a greater sense of cleanliness and organization (and it helps keep little pestering pests away, but that’s a different blog post). It’s all helpful in creating an image of the bigger picture we are striving for.
  3. Partialize your goals.
    • If we view our goals as one large chunk, it can become overwhelming and cause a person to shut down or give up. By breaking goals down into smaller pieces, we can more easily set targets and obtain a greater sense of achievement. Additionally, developing a deadline for each step can be crucial in maintaining momentum.
  4. Acknowledge your achievements.
    • Track your progress and celebrate benchmarks along the way. Congratulate yourself when you have completing a smaller chunk of the overall goal. Acknowledging progress made toward your goal can propel you forward to the next step.
  5. Be flexible.
    • I have said this so many times that I feel like it should be my new tag line, but: BE GENTLE WITH YOURSELF. If something is not working, be flexible and try it a different way. If you find yourself frustrated, stressed, or overwhelmed, be flexible enough with your deadlines that you can allow yourself a moment to step away and regroup. Achieving a goal looks differently for every person. Don’t just find a process, find YOUR process.

What helps you stay motivated?

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Do You Even Gram?

Follow me on Instagram at @the.wellnesswarrior to get a little snapshot of my day-to-day life.

Here are some examples of what you’ll see:

My food experimentation

Me being active

My travels

My feelings turned into cartoons

My face

Urban exploration

My DIY projects

Positivity

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16 Effortless Ways to Exercise

People exercise for a variety of reasons, such as stress reduction, physical fitness, or recreation. The Center for Disease Control states that individuals should strive for 150 minutes of exercise per week using a combination of aerobic activity and muscle strengthening.

Traditionally, we think of exercise as an intense session filled with blood, sweat, and tears. Don’t let this stereotype scare you away from finding joy in movement. After all, exercise can include anything that gets the body moving, and our legs don’t have to feel like jello in order for an exercise to have health benefits.

Check out these creative ways to find movement, and you might not even realize you’re exercising.

Garden

Climb Stairs Two At A Time

Play With Your Children (or Babysit)

Wash Your Car by Hand

Clean

Complete a Home Improvement Project

Have a Dance Party

Play Active Video Games

Park at the Far End of the Parking Lot

Give More Piggy Back Rides

Use a Standing Desk

Play Yard Games

Get Off Public Transportation a Stop Early and Walk the Rest of the Way to Your Destination

Use a Basket Instead of a Cart While Grocery Shopping

Give Your Partner a Massage

Get Freaky

Rake Leaves (suggested by reader, micahlegare1)

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Can Yoga Help Depression?

Yoga students may present with a variety of physical health concerns, such as chronic pain or injury. As a yoga instructor, it is important to become familiar with student histories so that the teacher can ensure the yoga studio remains a safe space for students. Overall, engagement in yoga practice has been consistently increasing in frequency across the United States. To accommodate the growing practice, yoga sequences can be specifically adapted to serve various populations, such as older individuals, children, or those with physical ailments. This makes it critical that a yoga teacher learn about students in order to provide them with the safest and most inclusive practice (Stephens, 309).

The practice of yoga can be utilized to address and treat many ailments, such as physical health concerns. While some individuals use yoga to treat physical conditions, some find that yoga is a positive tool in treatment emotional and mental health conditions (Stephens, 324). The physical and mindful components of yoga are thought to be meaningful practices for those experiencing emotional disturbances. Students of yoga can utilize the mind-body connection to address mental health concerns, such as anxiety and stress. Breathing techniques and mindfulness can assist in decreasing anxiety. Most commonly among mental health conditions, Americans utilize yoga practice to manage symptoms of depression.

Depression is one of the most common psychological disorders and involves symptoms such as changes in mood, low energy and motivation, loss of interest in preferred activities, increased irritability, physical aches and pains, and changes in sleep and appetite. These symptoms can be acute and can severely impact one’s ability to manage areas of daily life, such as nutrition and sleep. Though depression is incredibly is incredibly common, the causes of depression vary among an array of environmental, biological, or psychological factors. Traditional, evidence-based treatments for depression include medication management and/or psychotherapy. However, there are some barriers that individuals may face when seeking to participate in traditional mental health treatments. Many individuals never receive formal treatment for depression due to various limitations, such as limited access to resources, stigma associated with mental health treatment, or experiencing unwanted side effects of medication (Bridges & Sharma). Additionally, lack of follow through with treatment may be due to financial stressors or poor connection with treatment teams (Prathikanti, et. al.).

Depression that is left untreated may result in worsening chronic symptoms, such as suicidality or psychosis. These symptoms can impact career, education, family life, or interpersonal life, which can cause an individual intense distress. On average, a depressive episode can last from 6-12 months, with some individuals experiencing symptoms of chronic depression lasting several years. Although patterns of depression vary between each person, most individuals who experience one depressive episode in their lives will eventually experience a recurrent episode (Prathikanti, et. al.). The high relapse rate among those who experience depressive symptoms may also contribute to the lack of follow through with traditional treatments.

It is well known that yoga promotes a variety of physical health benefits. Regular yoga practice can improve flexibility, lower heart rate, decrease stress and anxiety, and reduce aches and pains (Bridges $ Sharma). It can also assist in digestion and other areas of physical wellness. However, yoga can also be beneficial in promoting emotional wellness. Where traditional mental health therapies focus on teaching mindfulness, deep breathing techniques, and relaxation skills, these are also important foundational aspects of yoga (Prathikanti, et. al.). This similarity in techniques means that yoga involves many of the skills taught among traditional therapies that treat depression. For example, mindfulness-based therapy focuses on deep breathing, relaxation skills, and mindfulness toward the present moment. These are also factors that are of focus in yoga practice.

The goal of yoga in minimizing symptoms of depression is to assist students in reaching santosa, or contentment. Traditional yoga views depression as a result of an individual experiencing either a rajastic state or a tamasic state. A rajastic state is one in which an individual experiences anxiety and restlessness. An individual experiencing a rajastic state may benefit from yoga practice that includes a slower flow with long holds. Meditation and calming breaths utilized in these types of sequences can assist in alleivating troublesome feelings of anxiety and restlessness. A tamasic state is one in which an individual experiences low energy and hopelessness, which are symptoms most commonly reported among individuals experiencing a depressive episode. An individual experiencing a tamasic state may benefit from a yoga practice that involves more active and stimulating poses, along with encouragement to keep the eyes open and awake (Stephens, 324). This appears to counteract the low energy experienced by individuals struggling with symptoms of depression.

With the growing rate of public interest in yoga, research related to the efficacy of yoga in promoting health and wellness has dramatically increased. According to Pathikanti, et. al., yoga may be a valuable alternative treatment in addressing depression. During a study of the efficacy of treating clinical depression using yoga, 38 individuals were screened to participate in an 8-week Hatha yoga program. These individuals were those who met the diagnostic criteria for major depressive disorder and were not currently receiving any treatment for the condition. Individuals were randomly divided into two groups: a yoga practice group and a yoga education group.

Those who participated in the Hatha yoga practive group participated in a 90-minute yoga practice two times per week for eight weeks. This practice group included breathing techniques and poses that promoted relaxation and mindfulness, with the same yoga sequence being used for each session. The yoga sequence used featured chest-opening poses, which are traditionally incorporated into yoga practice to decrease feelings of depression. The group who participated in the education group completed modules related to yoga history and practice for 90 minutes two times per week. Depression was assessed every two weeks throughout the research study using evidence-based depression scales (Prathikanti, et. al.).

Results indicated that depression decreased among the group that participated in yoga practice when compared to those who participated in the education group. However, researchers noted that the differences in rates did not change until the eighth week of practice, suggesting that consistent and prolonged yoga practice is most effective in promoting positive mood changes. The delay in results also suggests that one requires time to adequately learn and practice yoga poses and skills in order for their practice to be effective in alleviating depressive symptoms (Prathikanti, et. al.).

In another study of the efficacy of yoga in treating depression, a literature review was completed to compare outcomes among several research studies that explored the use of yoga in depression treatment. Eighteen published studies, all of which took place in various yoga studios, were assessed. The most common of these schools were ones that primarily taught from the school of Hatha yoga. In this literature review, interventions that were over the course of 6 weeks or more on average were studied, and measuring tools were used to monitor depression over the course of practice.

These schools utilized different structures of practice over the course of the research. Most schools encouraged participants to practice yoga at least once per week for a duration of time ranging from 12 minutes to 90 minutes (Bridges & Sharma). Although numerous differing yoga methods were used in these studies, results showed that all methods, even those in shorter duration, included participants who reported reductions in depression levels. Although, there was no evidence that showed that one method might be more effective than the others in reducing depression symptoms the study could suggest that regular practice of yoga and meditative skills may relate to decreased depressive symptoms. These results indicate a growing need for more research into the efficacy of mind-body interventions in treating clinical depression (Bridges & Sharma).

More specifically, the literature review found that a study by Marafet, et. al., researched an experimental group and a control group. The experimental group participated in three 60-minute yoga sessions, which included breathing exercises, meditation, relaxation, and physical exercise, while the control group participated in assessments only. The results of the study showed that those who participated in the yoga group experienced markedly decreased depressive symptoms. The outcome determined that yoga interventions were effective in decreasing depressive symptoms. Therefore, while traditional therapies and interventions are recommended, mind-body interventions appear to be an effective complementary interventions (Bridges & Sharma).

Depression is the most commonly diagnosed mental health condition. Although many individuals struggle with symptoms of depression, many do not receive traditional evidence-based treatments to assist with alleviating symptoms. However, studies show that regular practice of yoga and meditation may assist in minimizing symptoms of depression. This may broaden access to mental health treatment among those who experience barriers in accessing traditional therapies. Several research studies show that regular yoga practice has been effective in alleviating depressive symptoms.

References:

Bridges, Ledetra and Manoj Sharma. “The Efficacy of Yoga as a Form of Treatment for Depression. Journal of Evidence-Based Complementary & Alternative Medicine, 30 June 2017.

Prathikanti, Sudha, et. al. “Treating Major Depression With Yoga: A Prospective Randomized, Controlled Pilot Trial.” PLoS One, 16 Mar 2017.

Stephens, Mark. Teaching Yoga: Essential Foundations and Techniques. North Atlantic, 2010.