Can Treating My Mood Disorder Be a Little More Fun?

I have to admit that most treatment workbooks are dry… sometimes even boring.  I can recognize several problems with this.

  1.  Even people that are engaged, motivated, energetic, and generally not struggling with their mood are unlikely to get excited workbooks.
  2. Mood disorders (depression and anxiety among others) can make it difficult to concentrate and process information effectively, limiting the usefulness of workbooks.
  3. Most workbooks are designed by therapists.  That usually means the content is pretty solid; unfortunately, therapists are necessarily the greatest and creating engaging materials.

Despite those points, I do like clients to have a tangible resource, something with clear guidelines that they can reach for when they’re ready to work on their mental well-being.  I don’t want to rely entirely on what they remember from our sessions (see number two above).  I’d like to have some options that are a little less dusty.

Many other health initiatives have worked to make themselves more appealing to a general audience.  There are mainstream marketing campaigns for smoking cessation.  There are commercials airing nationwide and streaming online for healthier food options, working to convince people that food can be healthy and delicious. REI wants me to #optoutside. Even the CDC provides colorful infographics online.  They make TV shows immortalizing and glorifying people’s journeys of weight loss and improved fitness (the problems with these programs will have to wait for another blog)

Mental health seems to be a harder sell.   There is no mental health treatment equivalent to Zumba.  The’s no cutting vegetables into fun shapes to make sure we’re having fun while eating healthy.  I’m starting to sound pretty pessimistic, but there’s hope.

Some people have taken it upon themselves to focus on the delivery just as much as the content.  I’ve shared Jane McGonigal’s work with Superbetter previously and haven’t found a better example of gamifying recovery anywhere.  One example of applying the concept of producing an engaging intervention in the written form is a collaboration between clinician Russ Harris and illustrator Bev Aisbett.  The result was The Illustrated Happiness Trap and it’s great for those interested specifically in Acceptance and Commitment Therapy.

A more recent discovery, and probably the more effective example of making a mental health recovery book fun is Rock Steady: Brilliant Advice from My Bipolar Life by graphic artist Ellen Forney.  With humor, pragmatism, and clever visuals she translates the dry academic wisdom of clinicians into something very relatable, accessible, and manageable.  Her book is built upon her experiences with managing her own bipolar disorder.  She acknowledges the struggles inherent associated with emotion regulation and self-care and delivers clinically sound advice.  According to Forney, the foundation of health can be boiled down into SMEDMERTS! (Sleep, Medication, Eating (well), Doctor, Mindfulness, Exercise, Routine, Tools, and Support).  The acronym is solid and the mascot is even better.

If workbooks or traditional self-help books aren’t for you, don’t give up hope.  There is more and more diversity in the options for a structured resource that can help you when you’re not with your therapist.  If you’ve got other suggestions, comment below.

Stress Management and Relaxation Workshops

As I’ve developed as a clinician, I’ve slowly molded my view of mental well-being into what it is today.  My perspective has shifted, expanded, conformed, stretched, and reformed.  Preventative mental health care has become increasingly important.  Diagnosis is not a prerequisite of well-being.  No one has to wait until after a heart attack to initiate an exercise plan.  No one demands that you only see a medical doctor when you’re ill.  In fact, regular check-ups are encouraged.  I’d like to see mental health head in the same direction.  One of the ways I’ve decided to move toward preventative intervention is by offering a stress management and relaxation workshop in my community.  If you’re local, you can register here

The three hour workshop will introduce a variety of relaxation and stress management techniques for those occasionally (or frequently) overwhelmed with significant transitions, work responsibilities, family obligations, or life’s less specific burdens.  By developing a greater understanding of the emotional, mental, physiological, and behavior components of stress, strategies for managing it become much more accessible.  Signing up allows you to join a small group (eight or less) engaging in practical exercises and discussions aimed at cultivating a bit more peace in your life.

Choose any one of the four workshops offered and if you find it useful, feel free to up again to repeat the course.  You can join us in Poulsbo City Hall on:

Saturday April 23rd, 2016 from 9:30am to 12:30pm

Saturday May 7th, 2016 from 9:30am to 12:30pm

Saturday June 18th, 2016 from 9:30am to 12:30pm

Saturday August 20th, 2016 from 9:30am to 12:30pm

If you’d like to have this workshop tailored for staff training or as part of an employee wellness plan, contact me directly to discuss details. [contact-form-7 404 "Not Found"]

 

Think You’re Relaxing? You May Just Be Distracted.

What do you do to relax?

  1. Read a book
  2. Take a bath
  3. Watch a movie
  4. Go for a walk
  5. Talk to a friend
  6. Drink a glass of wine

Those are the most common responses I get when I ask people how they relax.  Video games, social media, television, shopping, eating, and listen to music all make the list of frequent flyers. Everyone gets stressed, anxious, worried, or overwhelmed at some point, and we all find our own ways to cope.  Some strategies, however, are more helpful than others.  If you nodded your head in agreement as you read through the list above, you may be approaching relaxation very inefficiently.

In many circumstance, that temporary reprieve is enough to “reset” your thoughts and feelings back to baseline. 

Reading a book, watching a movie, or chatting with friends functions as a distraction from the physical, mental, and emotional discomfort you’re experiencing.  In many circumstances, that temporary reprieve is enough to “reset” your thoughts and feelings back to baseline.  The movie is over and you’re worries have subsided.  The riveting mystery novel pulls your thoughts away from the dangerous world around you and allows you to ruminate on which character is a red herring and which is the criminal mastermind.  An engaging conversation sometimes provides resolution, occasionally escalates stress, and often allows focus to shift away from your problems onto someone else’s concerns.

Taking a bath by candlelight can provide an alternative, more comfortable, physical experience.  A bath also requires a certain level of unplugging from the day-to-day grind.  Hopefully, you don’t take your laptop or phone into the bath with you.  When you’re in the tub, you’re not expected to cook dinner, fix the faucet, finish homework, fold laundry, pick up the kids, clean the house, or mow the grass.  You’re relieved of those obligations (momentarily).  A brisk walk serves a very similar function in terms of alleviating the sense of obligation and opening yourself up to new sensations – beautiful views, the smell of fresh air, a warm breeze on your face, etc.

The glass of wine chemically alters your experience.  Alcohol is a depressant, so it can mask some of the physical discomfort associated with elevated stress levels.  Some people use wine as an add-on to one of the other strategies.  A good book and wine.  An exciting movie and wine.  A bath and wine.

These strategies are, at best, inefficient methods of relaxation. 

The whole list would best be described as distractions.  Distractions that sometimes help to momentarily reduce stress.  These strategies are, at best, inefficient methods of relaxation.  That’s not to say they don’t work for some people, and they certainly don’t need to be altogether avoided.  Relaxation, I argue, is a skill unto itself.  Therefore, the only proper way to relax is to intentionally and directly practice relaxation.  I know it’s circular logic. “In order to relax, you have to relax.”  Here’s what I mean.  Relaxation is an active reduction in physiological arousal.  It’s a skill you can improve.  With practice, you can achieve deeper relaxation in less time.  All the changes that occur when we are stressed – increased heart rate, muscle tension, altered breathing patterns, increased blood pressure, disruptions to digestion, mental fog, pressured speech, and general unrest – can be actively managed.  Relaxation exercises such as controlled breathing, progressive muscle relaxation, autogenics, mindfulness meditation, and guided imagery offer a concrete tool to reduce the symptoms of stress and anxiety.

By practicing the skill of relaxation, you can effectively move your baseline level of stress.  If you run through your day with baseline stress of 65/100, and when it hits 80, you give yourself permission to regroup with a glass of wine in a warm tub, chances are, by the time you towel off, you’re down to a 65.  Now, 65 is normal, so it feels like you accomplished something and that the bath was effective.  By practicing relaxation skills like the ones listed above, you can shift your baseline.  With consistent practice, 50  (or 40…or 30) becomes the new normal and you’ve got much more bandwidth before you get overwhelmed.  Additionally, the relaxation skills toolbox is filled with strategies that can be applied much more pervasively.  Stressed at work?  Good luck sneaking away to some dark corner to watch a movie.  Anxious about traffic?  There’s no way you’re taking a walk or slipping into a bath.  The most useful strategies for relaxation can be used anywhere at any time (I’m especially talking about controlled breathing here).

This way of looking at relaxation parallels physical fitness.  You don’t go for a jog exclusively when you’re sick, injured, or otherwise sub-optimal in terms of health.  You exercise consistently in order to ensure that your overall fitness helping you enjoy life.  Most days you don’t need to be incredibly fit, but it sure is nice to have it when you need it.  The same goes for relaxation.  You won’t need it every day, but if you haven’t been practicing, you won’t have it when you need it most.

You won’t need it everyday, but if you haven’t been practicing, you won’t have it when you need it most.

Give yourself a week or two, genuinely practicing active relaxation.  Take five to 15 minutes daily to listen to one of the exercises above, and let me know how it changes the way you experience stress.

Say Good Night to Insomnia – Book Review

Dr. Gregg D. Jacobs outlines a detailed six week program for improving sleep and eliminating insomnia in Say Good Night to Insomnia.  The most accurate description of this book is simply, “effective.”  If you’re willing to engage in the programming as prescribed in the book, it is highly likely that your quality and/or quantity of sleep will change in the desired direction.  I’d like to say the book was engaging and compelling…an interesting read, but I can’t.  Dr. Jacobs lead-up to the program includes rather dry sections on “The New State of Sleep Science”, “Some Basic Facts About Sleep and Insomnia”, and “How I Developed the Program.”  I absolutely love a solid explanation of the science and research involved in any intervention I’m trying myself or I’m recommending for clients.  That information, however, needs to be delivered with a little zest and color when aimed at a general audience.  Here…it was not.

Say Goodnight to Insomnia

All criticism aside, I am impressed with the structure and guidance provided by the author.  The six-week program involves an evidence based protocol including written assignments, ongoing assessment, and daily “homework” necessary to succeed.  Through various exercises, thoughts and behaviors pertaining to sleep are systematically altered to support healthy sleep habits.  The author does a great job recognizing and addressing mental and emotional aspects of sleep difficulties.  The program goes well beyond simple suggestions such as ensuring your sleep environment is dark and quiet (thought is does review those strategies as well).  It helps the reader unpack the negative thinking patterns and uncomfortable emotions that maintain poor sleep habits.  Regardless of how tired you are or how badly you want to fall asleep, thoughts like “I’ll never fall asleep” and “I’m going to be wrecked all day tomorrow if I don’t fall asleep right now” only serve to exacerbate stress and insomnia.  Dr. Jacobs uses fundamental strategies from cognitive-behavioral therapy to support participants in identifying and replacing unhelpful thoughts and behaviors with helpful thoughts and behaviors.  Cultivating the ability to relax throughout the day as well as when trying to sleep also becomes a priority in the attempt to find that elusive rest when you really need it.

If you’re interested in the ins-and-out of sleep science research and protocol development, start on page one and enjoy the ride.  If you really just need a concrete plan for sleeping better, start on page 70 and be prepared to commit some time and effort to changing your sleep habits.  This is a hands-on, experiential intervention, so don’t expect to simply gain some knowledge then start sleeping better.  Do the work, and you’ll be sleeping soundly before you know it (or at least at the end of six weeks).

Simple rules for getting Superbetter!

It’s time to get superbetter.

A simple and effective way to cultivate more happiness and resilience in your life is to get SuperBetter by registering for the free website (www.superbetter.com) to constantly be challenged to put more positivity in your life. Based entirely on current research, the “quests” and “power ups” provide concrete actions you can take every day to give your productivity (and all around awesomeness) a boost. A few examples are provided below:

  • Physical Resilience: Get out of your chair right now and do 15 push-ups or lightly stretch for 1 minute
  • Mental Resilience: Take a minute and research that question that’s been nagging you – What do you call a group of ostriches? How can I increase my awesomeness?
  • Emotional Resilience: Write down the best thing that’s happened to you today, and take 10 seconds to enjoy it.
  • Social Resilience: Share this post with someone and let them know you think they’re awesome.

For the whole story behind SuperBetter and how it works, check out the creator’s TEDtalk