Tag: mental health

My Coronavirus Sanity Guide

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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?

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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.

Dry January… and Beyond?

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Did you participate in Dry January? For those that are not familiar, Dry January is choosing not to drink alcohol during the month of January. This has been primarily practiced in the UK, but has gained traction in the US in recent years. The idea behind Dry January is to help your body “reset” after the indulgences of the holidays and to kick start a New Years commitment to health. Whether you participated, continued with your usual habits, or have never heard of it, everyone can benefit from taking a look at their drinking habits and relationship with alcohol.

What is “problem” drinking exactly?

I often hear statements like “I don’t drink alone, so I must not have a problem” or “I don’t drink in the morning, so I am certainly not an alcoholic.” However, problem drinking is more complex and multifaceted than that. Rather than solely focusing on how often and how much you drink, we instead identify the ways in which alcohol may be having a negative impact on your life.

Some questions you can ask yourself to determine if drinking may be a problem for you are:

  • When I drink, do I have more drinks than I planned to? Am I drinking more often than I want to?
  • Have I tried to cut down but haven’t been able to?
  • Am I spending a lot of time drinking, or a lot of time recovering from a hangover?
  • Am I having cravings or urges to drink?
  • Am I neglecting responsibilities at work, home, or school because of drinking?
  • Is drinking contributing to problems in my relationships?
  • Have I given up hobbies, interests, or friendships because of drinking?
  • Have I put myself in dangerous situations when I’m drinking (i.e., driving a car).
  • Do I have physical health problems that are made worse by drinking?
  • Does drinking alcohol negatively impact my mood, anxiety, or other aspects of my mental health?

If you answered yes to 2 or more of these questions, you may want to consider changing your drinking habits. However, change does not necessarily have to mean never drinking again or attending AA meetings (though both are great choices for many!). Below I will discuss some other options.

Sampling Sobriety

This is essentially what Dry January is. Committing to a set amount of time alcohol free (e.g., 2 days per week, 1 week, 1 month), gives you the opportunity to directly experience what life is like without alcohol in it. For those wanting to sample sobriety, I encourage them to track their mood, sleep, and other changes they notice, so that after the sampling period is over they can make an informed decision about their drinking going forward. What if you try to sample sobriety and aren’t able to do it? That may be a sign drinking is a problem for you and it is time to reach out for help.

Harm Reduction

The harm reduction approach involves changing your drinking habits so that they have less of a negative impact on your life. This can be accomplished in a number of different ways, but it almost always involves reducing how much and/or how often you drink. Two strategies that help with this are measuring and counting drinks – often times what you think is 1 drink is more like 2 or 3 because of the quantity of liquor in it or the size of the pour. Also, it is important to make a conscious effort to cultivate activities and hobbies that do not center around drinking. Commit to a morning run when you otherwise may have stayed in bed, meet friends for coffee rather than drinks, or take that hike you haven’t made time for yet because an afternoon at the brewery has sounded more appealing.

If after reading this you are questioning your drinking habits, psychotherapy can provide you a space to explore the pros and cons of change. And, if you decide to move forward with reducing or stopping drinking, it can offer you the support, accountability, and tools to increase your likelihood of success. If you live in the Austin area, I would love to speak with you about your situation and see if I may be able to help. I can be reached by email at laura@drlaurawahlstrom.com or by phone at 512-521-1531.

New Year, New Me

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Happy New Year! Around Thanksgiving, I wrote a blog about how the holidays are difficult for many people. However, most folks I work with tend to feel increasingly optimistic as the calendar rolls over to a new year. Even though there is nothing objectively different between December 31 and January 1, the new year represents a fresh start. Many people also identify areas they want to change and things they want to accomplish, aka “resolutions.”

If you want to change something in your life, not having goals is like setting out on a road trip without a map (or smartphone!). It’s a lot of aimless driving, confusion, frustration, and ultimately not ending up where you want to. When I have used this analogy in the past, some folks have told me “that sounds really fun!” However, the analogy is meant to illustrate that without goals, we are less likely to succeed at making positive changes and moving toward living the life we want to live.

Have you ever heard of SMART goals? SMART is an acronym (more on that in a minute) that outlines criteria for setting effective goals. Adhering to these criteria when setting your goals ensures that you are clear on what you want to achieve, when you will accomplish it by, and how you will make it happen. In other words, it sets you up for a greater likelihood of success! So, let’s walk through what each of the letters stands for and look at an example:

Specific

Your goal should be simple and clearly define what you want to do.

Measurable

Your goal should be able to be objectively measured, so it is crystal clear if you accomplished it or not.

Achievable

Your goal should be a stretch, but not so challenging that it is not realistic to accomplish.

Relevant

Your goal should be related to what you actually want to accomplish.

Time-bound

Set a date by when you will accomplish your goal. Be as specific as possible.

Example: Let’s say you want to get healthier. Health is something that is aspirational in nature (i.e., there is no definitive way to know we have accomplished it, but instead we continue to work toward), but you will likely set several SMART goals to help you achieve better health. One goal may be to lose weight. If we set our goal for that consistent with SMART criteria, we would say “I want to lose 15 pounds by June 1.” Or, another goal may be to get better sleep. A SMART goal would be “I am going to meditate using Headspace for 15 minutes each night before bed.”

Here are some other tips for successful goal setting and achieving those goals:

Consider setting “mini goals.”

If you want to quit smoking, maybe your goal is to completely quit by August. In addition to that “end” goal, each month you set a “mini” goal to reduce the number of cigarettes you have per day by 2. This provides you with more frequent, tangible evidence of your progress, and reinforces your efforts!

Don’t set too many goals.

You may be entering the new year with lots of things you want to change. And, that’s great! However, trying to change too much sets you up for failure (again, the A in SMART is for achievable!). You’re much more likely to succeed if you pick 1 or 2 things you want to accomplish, and also use my previous tip to set mini goals along the way.

Be kind to yourself.

Change is hard. Really hard. And, most of the time when we are working toward something, we experience setbacks. It is easy when these setbacks happen to start to believe we are back at square one, so continue to remind yourself that they are normal and part of the process. Something that helps with this is to journal or write down your progress as you go so you can review it when this happens.

Enlist help.

As I said above, change is hard. And, with anything that is hard, support helps. See if a friend or family member wants to make the change with you. Or, if they have another goal, you can check in with each other on how it is going. Technology is also a great resource – there is an app for just about anything these days. Lastly, consider finding a therapist to help you with the process.

If you are in the Austin area and would benefit from extra support in identifying and sticking with goals for 2019 (and beyond!), I’d love to talk with you and see if I am a good fit. Please contact me at laura@drlaurawahlstrom.com or 512-521-1531.

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.