Tag: anxiety

My Coronavirus Sanity Guide

lcwahlstrom

I’m a little late to the game on writing this blog because, frankly, I’m right there with everyone else figuring out how to cope with the rapidly changing situation we are facing right now. I have had to face head-on that a number of recommendations I usually give clients to manage their mood/anxiety (i.e., get out of your house and spend time with people!) are not feasible, safe, or even legal right now. In today’s blog I’m going to take a different approach – I will highlight the ways in which my family and I have been coping with the coronavirus pandemic.

Exercise.

I wrote a blog last April about the profound and robust impact exercise has on us. It is more important now than ever. Even though gyms and group fitness is closed right now, there are other options. Any free morning I have, I put my son in the jogging stroller and we head out on a run in the neighborhood. He enjoys the ride and scenery, and I get an extra challenging workout pushing him up the hills. We are also mixing it up with short bodyweight HIIT workouts and yoga at home. There are a number of free resources available right now!

Maintain a schedule, but be flexible.

Structure is essential in managing mood, anxiety, and stress. But let’s be honest, it’s pretty tough to do right now. My husband and I have continued to maintain our pre-coronavirus sleep schedule, as well as morning and night routines. We have also tried to keep our little guy on his preschool schedule as best we can. Children thrive on repetition and routine, so if he is happy and well rested, it’s good for all of us. It also allows us to work and keep up with (sort of!) household chores.

Practice mindfulness.

Have you heard of mindfulness? The godfather of mindfulness in the psychology world, Jon Kabat-Zinn, defines it as “paying attention to something, in a particular way, on purpose, in the present moment, non-judgmentally.” In other words, be present and don’t get caught up in judging what is going on. Again, in a time when we are limited in terms of what we can do, we always have the ability to be present. Ten percent happier, an awesome mindfulness app I recommend to almost all of my clients, has published a Coronavirus Sanity Guide full of great talks and a few guided meditations. I have been doing the basic relaxation exercise daily to manage stress. Or, if I’m feeling particularly wired at night, I go through one of the guided sleep meditations in the app before bed.

Watch your drinking.

Texans are drinking the most alcohol right now. This fact has been humorous (and a source of pride!) to many folks I am seeing, but drinking more can easily be a slippery slope. It also contributes to poorer sleep, and worsened anxiety and depression. I enjoy wine, but have also kept rules and boundaries in place for drinking during this time. We are continuing to have alcohol-free days. And, on days we do decide to imbibe, I’m limiting it to 2.

If you find you are struggling with this, I suggest waiting until later in the evening to drink. The later you wait, the less you will likely drink. I also suggest that during your grocery store runs pick up non-alcoholic beverage options. Water is great and healthy, but gets boring after a while. You’re also more likely to follow through on an alcohol-free day if you can drink something that feels like a treat. If you are really struggling with drinking, or working hard to maintain sobriety, AA is offering online meetings.

Stay in touch with family and friends.

Everyone is in the same boat right now and craving human connection. Even though we need to be social distancing, it doesn’t mean you have to be out of contact with friends, family, and colleagues. We have been making a point to FaceTime with family and friends almost daily, and have plans to set up a Zoom dinner party here soon!

Set realistic expectations for yourself.

You are not going to be able to be the employee, spouse, parent, friend, etc. that you are under normal circumstances. That is ok. Keep reminding yourself that you are doing a great job. If you are struggling with that, talk it through with a family member, friend, or mental health professional – I guarantee they will help you see that! Another great resource for changing unhelpful thinking patterns is Mind over Mood, a cognitive restructuring workbook.

I’m continuing to provide therapy during the coronavirus pandemic, both in-person and via video. Please reach out to me by phone at 512-521-1531 or email at laura@drlaurawahlstrom.com if you would like to set up a free phone consultation.

Work to Live, or Live to Work?

lcwahlstrom

Happy new year! Is it too late to still be saying that? While a new year represents a fresh start with a renewed focus on goals, it also tends to be a really busy time for folks at work. I see a lot of individuals in my practice, of all ages, who are experiencing work-related stress. My blog today will focus on things related to work stress and burnout to watch out for, and ways to start addressing it.

Did you know that people in the US work more than those in any other country? Did you also know we are one of the only countries that doesn’t limit the number of hours one can work in a week? Some estimates indicate that 85% of men and 66% of women work more than 40 hours per week. Based on my experience, I would guess that these numbers are even higher for those working in tech or finance.

I am certainly not saying that working 40+ hours a week is always bad. If you love your work and feel that the way your time spent is a good fit for you and consistent with your values, continue plugging away. If you’re not sure (or are sure but want some confirmation or direction!), read below.

Is work a problem? Ask yourself the following questions:

Are you burned out?

Ask yourself the following questions (taken from Mayo Clinic):

    1. Have you become cynical or critical at work?
    2. Do you drag yourself to work and have trouble getting started?
    3. Have you become irritable or impatient with co-workers, customers or clients?
    4. Do you lack the energy to be consistently productive?
    5. Do you find it hard to concentrate?
    6. Do you lack satisfaction from your achievements?
    7. Do you feel disillusioned about your job?
    8. Are you using food, drugs or alcohol to feel better or to simply not feel?
    9. Have your sleep habits changed?
    10. Are you troubled by unexplained headaches, stomach or bowel problems, or other physical complaints?

Are you too emotionally invested in your work?

Here is a great article that talks about how meaningful work is contributing to health problems. The article argues that more emotionally connected you are to your work, the more opportunity it has to negatively affect your wellbeing.

Are you doing things outside of work?

Many of us don’t have the luxury or working solely for fun, but have to work to support our family and pay our bills. If we’re lucky, we make enough money to enrich our lives in other ways – i.e., a comfortable home, nice vacations/experiences. If you are finding you don’t have the time or energy to engage in hobbies or with friends/family when you’re not working, then how is that job really serving you?

Steps you can take to address work-related issues.

Clarify expectations.

Sit down with your boss to clarify what is expected of you in terms of hours worked, availability, and productivity. After that, re-evaluate your work schedule and try something different out (i.e., leaving 2 days per week by 5 p.m.). Set aside time each day (and more time on days “off”) to be phone/computer free. This may also include turning off certain notifications on your phone.

Work smarter, not harder.

Research shows that we become less efficient after 50 hours of work in a week. If you’re struggling to get everything done in those hours or fewer, consider learning new strategies to increase efficiency. My clients have found Deep Work to be incredibly helpful.

Consider changing jobs or industries.

If you have tried the above suggestions (and countless other things!) and are still struggling with work stress or burnout, it may be time to change jobs. See what else is out there – the internet these days provides a wealth of insight into specific jobs and companies. Or, consider working with a recruiter or career coach to help you find a better fit.

I’ll end on this note: the Harvard Adult Development Study found that the #1 predictor of later life satisfaction is warm relationships. This was confirmed by my own experience working with the elderly. Very few spoke about their work, but everyone spoke about their family and friends. If your work is interfering with your ability to foster these kind of relationships, consider this a wake up call to change your situation.

If you live in the Austin area and feel like you would benefit from support and guidance on dealing with work stress or burnout, please reach out to me via telephone at 512-521-1531 or email me at laura@drlaurawahlstrom.com to discuss your situation and see if I may be a good fit to help.

A Simple, Yet Not-Always-Easy, Solution to Reducing Depression and Anxiety

lcwahlstrom

Summer is right around the corner, which can be a stressful time for many. Maybe you have kids who will be out of school, which means your home will be noisier and days will be busier. Maybe you have a busy social calendar filled with trips, weddings, and barbecues. Maybe you are dreading the triple-digit Texas temperatures and having to spend more time inside.

During times of stress, healthy habits tend to fall to the wayside. Same is true if we find ourselves increasingly struggling with depression or anxiety. We do things that we think are helping us (i.e., sleeping more, eating more high carb/fat foods, drinking alcohol), and do less of things that actually help us.

Exercise is a powerful, but often overlooked, tool in managing these issues. Research indicates that an exercise regimen is as effective at treating depression as anti-depressant medication. Even better? The effects are immediate – most people feel the mood-boosting effects about 5 minutes after completing their exercise.

The mechanisms whereby exercise improves your mood is two-fold. When you exercise, physiological changes occur in your body that have a direct impact on your mood. Endorphins (natural painkillers) and serotonin (a neurotransmitter that plays a key role in happiness and wellbeing), increase, and stress hormones (cortisol and adrenaline) decrease. Exercise also contributes to improved sleep, which we know plays a key role in both depression and anxiety.

Psychologically, exercise contributes to a feeling of accomplishment (“yay! I did something today besides watch Netflix!”), increases self-efficacy (“when I feel bad I can do something to change it!”), improves healthy coping skills (“wow, a quick run makes me feel a lot better than a couple glasses of wine!”). For those that suffer from anxiety, which is usually marked by a lot of physical symptoms, exercise induces a lot of the feared physical symptoms (heart racing, sweating). The repeated experiencing of these physical symptoms helps you to become less afraid of them and attach new, more helpful, meaning to them.

However, exercise is simple in terms of concept, but not always easy to execute. To overcome this, I have a few suggestions. First, keep in mind the law of inertia. It is far more difficult to get something moving than it is to keep it moving. Try to get started on your new exercise regimen on a day and time that you are feeling most motivated or energized, for example, on Saturday morning after a cup of coffee. From there, set reasonable goals and be consistent. You are not going to be able to run at the same pace you did as a high schooler in cross country if you haven’t gone out for a run in years. Any exercise is progress and movement in the right direction! Also, keep in mind you are not always going to feel like exercising. And, the good news is, you don’t have to in order to do it! Keep a journal and write down the positive effects you feel after you exercise, and revisit those entries when you need some extra motivation. Lastly, be kind to yourself and expect that it isn’t going to go perfectly. You may miss a workout, or fall back into old habits. Acknowledge that this has happened, and resume your routine.

If you live in the Austin area and feel like you would benefit from support and guidance on managing depression or anxiety, please reach out to me via telephone at 512-521-1531 or email me at laura@drlaurawahlstrom.com to discuss your situation and see if I may be a good fit to help.

Common Misconceptions of Cognitive-Behavioral Therapy

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In this previous post I provided an overview of cognitive-behavioral therapy (CBT), a therapeutic approach based on the idea that our thoughts (i.e., running commentary in our heads), feelings (i.e., emotions), and behaviors (i.e., things we “do”) are all related to and influence each other. To follow up, I thought it would be useful to address some of the common misconceptions people have about CBT. Given how popular it is, there is plenty of information about CBT on the web, not all of it good or accurate.

CBT teaches you to think positively.

Because CBT theory emphasizes the interaction of thoughts and emotions, a major component of therapy is challenging unhelpful patterns of thinking (i.e., cognitive distortions), such as all-or-nothing thinking (“My girlfriend recently broke up with me, I’ll never find anyone to love me”) or catastrophizing (“Since I got a bad grade on this test, I’ll likely fail this class and won’t graduate”). Because the vast majority of these distortions are negative, many people assume that one goal of CBT is to replace negative thoughts with positive thoughts. However, that is not quite correct. The key is the word “distortion” – the goal of therapy is to challenge thoughts that are not rational, helpful, or based on evidence, and replace them with more adaptive thinking. See this video from the Beck Institute for a great explanation of this issue.

CBT is rigid and manual-based.

A common misconception of CBT is that it is a rigid, one-size-fits-all therapy based on manuals. I believe this belief is popular because there are a variety of CBT manuals for therapists attempting to learn the technique and for use in clinical trials evaluating the effectiveness of the therapy. However, well-trained therapists are skilled in tailoring the approach to the needs of individual clients, and most will also incorporate techniques from other therapy approaches as needed (see my example below of how to use motivational interviewing and CBT together!).

CBT only works with motivated clients.

Because it often includes exercises (homework!) done outside the therapy session, it’s commonly assumed that CBT is only effective with very motivated clients. There are a few reasons why this is not true. First, any therapist, regardless of their orientation, should be trained in how to engage clients through the careful use of language, matching their interpersonal style to that of the client, or by leveraging the rapport built in the therapeutic relationship.

Second, many therapists are trained in a range of therapeutic approaches and can combine approaches as necessary to meet the needs of their client. One approach I’ve found effective is blending techniques from Motivational Interviewing with CBT. It’s a relatively common approach (common enough for an entire book to be written about it!). The thing I like most about motivational interviewing is that it is a “meet your client where they are at” approach that is supportive, gentle, and non-judgmental.

Lastly, one nice feature of CBT is the notion that the therapist and client work on small, approachable goals throughout therapy. A client is not asked to take on more than feels manageable or reasonable, and they get to quickly see tangible results of their efforts. This is reinforcing and often strengthens motivation.

CBT is only supported for use with anxiety and depression.

Cognitive behavioral therapy was developed by Dr. Aaron Beck, who originally applied his theory to the treatment of depression. Since then, it has also become recognized as the gold standard for the treatment of anxiety. However, CBT is recognized as an effective therapy for a wide range of psychological disorders including schizophrenia, ADHD, and eating disorders. See this analysis by the American Psychological Association evaluating the evidence supporting the use of CBT for a variety of disorders.

I hope that you have found this blog post helpful today. If you are in the Austin area and contemplating starting psychotherapy, I am happy to speak with you on the phone to answer any questions you may have, including those about CBT. Please reach out to me at laura@drlaurawahlstrom.com or 512-521-1531.

3 Tips for Surviving the Holidays

lcwahlstrom

The holidays are upon us! Social media, TV commercials, and Hallmark movies depict it as “the most wonderful time of the year.” While that may be true for many, for others it is a time filled with anxiety, loneliness, and bad memories. Regardless of if you are filled with holiday cheer or can’t wait for January 2, here are some tips that will make the holidays go a little smoother.

Watch your drinking.

Between the holiday parties and cold nights hunkered down at home, people tend to increase their alcohol consumption during the holidays. Not only does drinking (especially excessively) exacerbate depression and anxiety, it also makes it more likely you may embarrass yourself at the company party, get in a fight with Aunt Jean about politics at the dinner table, or skip that morning run that helps you feel energized and ready to tackle the day.

Keep up your healthy habits.

Let’s face it: between the constant supply of cookies at the office, cold weather, and hectic social schedule, healthy habits tend to fall by the wayside during the holidays. The best way to keep your mood stable is to practice moderation and continue with a healthy exercise, diet, and sleep regimen. Haven’t made these things a priority in 2018? No need to put off making a change until January 1 – now is the perfect time to create new healthy habits.

Say no.

When we overextend ourselves and don’t take the time we need to recharge, those holiday parties end up feeling like a chore. You know yourself – if two parties in a weekend is too much, choose the one that is more important to attend and send your regrets to the other. Or decide you are going to go to each for a set amount of time, say 1 hour.

In addition to social and work obligations, family get-togethers can be extremely stressful. If you find that you are emotionally depleted after a trip home for a few days, it may be best for you to limit your time with family. It is better to spend a few hours together and have it be pleasant than stay for several days and end up in an argument or leave feeling depressed.

If adhering to the above suggestions sounds difficult, or you feel too overwhelmed to make those changes on your own, it may be time to enlist help. Just like you don’t need to wait until January 1 to make lifestyle changes, you also do not need to wait until then to start psychotherapy. If you are in the Austin area, please reach out to me at laura@drlaurawahlstrom.com or 512-521-1531 to discuss your situation.