Living your best life with a chronic illness: five essential coping skills

Living with a chronic medical condition is a circumstance that is very close to my own heart. I have lived with a chronic illness my entire adult life, and I'm not alone. According to the Centers for Disease Control, 129 million Americans currently live with some type of chronic condition, whether it's a physical or mental health condition. That's nearly half the current population of the United States. Therefore, many of us struggle regularly to manage a condition that cannot be cured. For the purposes of this blog, I will focus on chronic physical conditions and how to cope with them while doing your best to sustain your overall health and well-being.

One of the most important things to remember when a chronic illness takes up residence in your body is that you are not imagining an illness. Whether you are diagnosed with a condition that medical doctors are confident they know how to manage, or one that seems to elude medical science in terms of our understanding of its nature and course, it is real. The fact that physicians and scientists have yet to fully understand its origin, symptoms, or impact on your life does not mean that you are exaggerating its impact on your everyday functioning.

It is also important to remember that people who do not live with a chronic physical condition will not fully understand what has happened to you and what will continue to be your battle. They may mean well and sympathize with your pain to an extent. Some of them will give you a lot of advice, like “just reduce your stress” or “get more rest.” But they won't truly grasp how a chronic condition re-shapes your life, impacts your decisions, and affects your relationships. Remember that you don't have to buy into what others tell you about your chronic physical illness. For example, proper diet and exercise won't be the cure for your condition, and just believing that you can isn’t enough to overcome the illness.

It is true, however, that you don't have to be defined by your chronic condition. In most cases, you do not have to completely surrender to its consequences. You can still enjoy life. There are many ways to manage the symptoms and setbacks without missing out on your activities and interests. Of course, there are always exceptions, and some people are severely limited in their functioning as the illness progresses. But there are many ways to adapt to life with a chronic illness, and that's the focus of this blog post.

Here are some things to consider as you navigate life with a chronic physical health condition that will help you maintain your mental health and overall well-being.

1. Practice self compassion. Most of us feel bad about ourselves when our chronic illness delays or changes our plans. We think that if we are just stronger and more resilient, we should be able to push through. However, often the best way to take care of ourselves is not to push ourselves too hard. We can still do many things, but maybe not at the same pace as others or even at the same pace that we used to. The end goal is longevity, but if we push ourselves hard, we end up feeling sicker. Remind yourself that you are still strong even on days that you feel weaker.

2. Determine your daily activities according to your level of pain and symptoms. This may sound basic, but you'd be surprised how many people I talk to who try to do the same activities, regardless of their level of pain. When you wake up in the morning, rate your pain on a scale from one to five. A pain level of two means you may be able to go on about your daily plans. A pain level of four or five means you adjust your activities. For example, if you planned to go for a walk and you woke up feeling tired, achy, or nauseous, you can decide to go for a shorter walk instead, or perhaps skip the walk until later in the day if you feel better. When you live with an illness, you must acknowledge that sometimes plans change, and activities may need to be rescheduled or adjusted.

3. Leave the house prepared. You may wake up feeling pretty good and go on about your day. But later you start feeling exhausted or having other symptoms and you don’t have medicine, water, or a snack. Think about how you may feel at the end of your day before it begins, so that you're prepared to have what you need to take care of yourself and give yourself permission to come home early. Be prepared if you have a long day ahead of you to rearrange plans if necessary. Try to resist being set in your mind that the day has to go a certain way.

4. Gather your best social support. The support system that we acquire overtime is not always prepared to handle our circumstances. We make friends in high school or college that may continue to be our friends, but they might not be the best person to call if we are having a bad health day. Make sure you have friends in your circle who understand your health condition, or at least make an effort to do so. While they may not be able to put themselves in your shoes, they should be able to provide compassion and to give you a pass if you have to change plans.

5. Assemble a medical team who understands you. Similar to your friend group, you want to surround yourself with healthcare providers who do not dismiss or minimize your health condition. Not all trained professionals are as adept at treating chronic conditions. Sometimes, even if they are trained, they don't have enough empathy to adequately support you. For example, you want a doctor who listens to your symptoms without interrupting and considers your unique experience, rather than one who dismisses the reality of your condition and gives you generic advice. We don't always get to choose our healthcare providers, but if you do have a say in the matter, select those who will walk beside you on your journey with chronic illness.

The chronic illness that you live with is your reality. Don’t let other people minimize that. Be true to what you feel and listen to your own body. Get the resources that you need rather than doing what other people think you need to do. By listening to your own instincts, you’ll be able to better manage life with a chronic illness.

This blog was originally published on psychologytoday.com.

Image: mcreynoldsphd via Canvas

How to Prevent Jealousy From Destroying Your Relationships

We've all experienced jealousy at some point. People do not plan to be jealous. But the green monster ultimately rears its head when one of our friends has something that we want, or somebody is in a relationship that we would like to have. Sometimes we are jealous of our romantic partners if we believe they are interested in someone else.

Jealousy, like all other human emotions, is not an abnormal experience. It is an especially common experience if we are feeling insecure about what we have, not getting what we want, or worried that we will not have the life that we desire.

Although it's normal to experience some feelings of jealousy, many people experience it more often, and some people experience jealousy to a point where it becomes destructive to their relationships. Unlike many other emotions, jealousy does not usually result in positive outcomes. Unless we deal with chronic feelings of jealousy, it takes control of how we relate to others, how we think about our relationships, and how we can function.

Jealousy can become all-consuming, and it can distort our sense of reality. When you’re focused on what other people can have, you’re not working on your own goals or growth. Learning to manage feelings of intense jealousy can help you have a more fulfilling life. The purpose of this blog is to provide a roadmap for what that might look like.

The first step: recognizing that jealousy is negatively impacting your life

Perhaps you are scrolling social media, and you become consumed with jealousy when you see an ex in photographs with their new partner. Or you see pictures of your friends, enjoying themselves at an event that you were apparently not invited to attend. For some people, it's more of an overarching sense that others have a life that you do not have but that you want: their house is larger and more beautiful, they take extravagant vacations, or they have the family that you wish you had.

Whatever the reason, you noticed that when you are interacting with people who have things that you don't, you have trouble being happy for them, or your obsession with your ex’s new relationship is preventing you from moving forward and finding someone new.

Give yourself some compassion. Your jealousy is a sign that you are unhappy, and it’s is important to recognize that. It also means that you are struggling with insecurity. You have identified some areas for self-reflection, which is necessary to begin the process of change.

The second step: reflecting on your unmet needs and desires

When dealing with chronic jealousy, you must ask yourself if the things you want, that others have, would truly make you happy. You should also ask yourself what prevents you from obtaining what would make you happy. Then question whether getting what you think you want will be enough to bring you peace and contentment.

For example, say your best friend is getting married, and you’re jealous because they’ve found someone and you don’t understand why you haven’t found a romantic life partner.  Do you need a romantic life partner to be truly happy? What needs does that fill that you aren’t getting in your life? What can you do to find a desirable partner? Will a romantic life partner be enough, or are there other things you need to have or achieve? Examine your values and focus on your own growth and future.

The third step: reframing your distorted jealous thoughts

As you scroll social media or interact with people with whom you are jealous, note that you only see the surface of their lives and what they choose to share. They may share the happy moments and picturesque details because they want to believe they are happy and content. It is far more satisfying to get likes and adoring comments than to evoke pity. When you are standing face to face with friends who think you have it all, it is embarrassing and anxiety-inducing to admit otherwise. Even if they are truly happy and they have everything, no one knows what the future holds.

Just because you don’t have what you want now and they do doesn’t mean that you’ll never have what they have and what you want. Your current state is not a prediction of the future. It doesn’t mean that you’re locked into the life that you have. Instead, think of the happiness and success of others as evidence that you, too, can get what you want. Reframing your thoughts this way can give you hope for your future.

originally posted to psychologytoday.com on 8/13/24

picture via Canva

How to survive and thrive after a hard childhood

We’ve all heard that childhood is supposed to be a magical time, filled with opportunities to play and use our imaginations. To have carefree days, not worrying about the troubles that will inevitably come with adulthood. Developmentally, childhood is a time when our brain is growing, and we are forming our perceptions of the world around us. During childhood we expect that parents will protect us from harm and shelter us from the cruel realities of society. 

Unfortunately, millions of children in the US do not experience this idyllic time of life. Instead, they live through horrendous or tragic conditions in childhood, such as poverty, abuse, or bullying by their peers. Many others may experience pain and suffering through a chronic illness or a disability that begins in childhood. Still others may live through their parents’ highly contentious divorce or in a household filled with daily conflict. 

If you were one of those children, this blog is for you. It will outline some steps you can take to you overcome the circumstances of your childhood live a healthy, productive, and meaningful adult life. I'm not here to say that it's simple or easy, or even a straight and narrow path. But it's possible, and I have lived to talk about it. As a child I struggled with a medical condition that imposed limitations on what I could do and affected the way that others saw me.

The first step: becoming self-aware

Often, those of us who experienced a hard childhood lived in our version of normal. We may have witnessed others around us being happier, fitting in with peers more easily, or having happier home lives. But we may or may not have realized that our personal experience was worse than our peers or that our circumstances would be objectively defined by society as painful, or even traumatic. As we get older, this starts to become clearer, as we are exposed to more people and situations different from ours. It may even be easier growing up to ignore, or at least not admit, how bad our circumstances are or how much hardship we've experienced compared to our peers. This may protect us from becoming hopeless, helpless, or bitter. 

But the healing process requires that we understand that our childhood was harder than most and, in many cases, traumatic. Those experiences shaped us, and it is important to acknowledge how we felt and reflect on how it affected our belief in ourselves, our confidence, and our ability to become a functional adult. 

The next step: working through trauma and pain

Whether you were abused, or experienced hard, painful situations that affected your ability to live the life of a happy and carefree child, you may have experiences to process. Thinking about our childhood as an adult gives us a new perspective on how we survived, how we showed resilience by pulling through and bouncing back, and helps us recognize any family members, friends, teachers, or others who helped us in some way. It also allows us to identify the people who hurt us, rejected us, or treated us unfairly. Some people think it’s best to leave the past in the past. But doing so keeps us from the true healing that will allow us to move forward with resolution. 

There may be relationships that need to be addressed, either through having conversations with estranged family or friends, or deciding that some relationships were toxic, and we can let go of our guilt or anger. You could start by talking to siblings, parents, friends, or others who were around during your childhood about your experiences if you trust those people to support you. Many of us may need to obtain professional help through psychotherapy, especially if there is a lot to unpack. If you were the victim of some type of abuse, seeking therapy from a trained expert in trauma treatment is recommended. You do not have to sweep your hard or painful childhood under the rug and pretend it did not happen. 

The third step: set yourself free

Once you have recognized that your childhood was hard, and you have sought healing from the pain, hardship, or trauma, you can be free from that part of your life. This does not mean you never think about it again. It means that if thoughts of your childhood surface, you can process them without re-experiencing the pain. You can recognize how strong you were, and how resilient you became. You may appreciate those around you who love and support you even more. 

The events of your childhood do not have to define who you are now as an adult. If your parents or others did not support you or handle your pain in ways that encouraged you, you have the ability to handle situations with your own children differently. Many people who struggle tremendously during childhood report that they are capable of much greater empathy toward others because they remember what it felt like as a child to not receive unconditional love and support. 

In my professional career, I’ve supported many children as they dealt with their own medical conditions and limitations and helped them figure out how to lead a healthy life. I was able to draw on my experience to help others.

It would definitely be best if children never had to suffer from abuse, social rejection and bullying, serious illness or any other type of hardship. But because we live in a world where that is often inescapable, it is essential for those who suffered to recognize that they have survived, they can continue to overcome their trials, and they can have a healthy, meaningful life. 

Originally posted to psychologytoday.com.

Photo by Katherine Chase on Unsplash

Five things to consider before taking psychiatric medications

There is no shortage of bad press out there covering medication for mental health conditions, such as ADHD and depression. At least once a year, prominent newspapers publish articles asking whether its worth taking psychiatric medications considering the risks. There is considerable debate among professionals about their efficacy, and most professionals debating this issue have very strong opinions, one way or the other. As a psychologist, I don't prescribe medication for mental health conditions, but many of my patients receive diagnoses that might benefit from medication, at least for a period of time. I believe that patients should be well informed of the risks and benefits of medication and know what to consider to make an informed decision. Mental health conditions improve most with a comprehensive treatment plan, and sometimes that may include medication.

Here are five things to think about if a physician or mental healthcare provider has recommended that you consider medication.

Are your symptoms significantly disrupting your daily life?

Some people with mental health challenges — such as depression, anxiety, or ADHD — may benefit from medication, although they can make it through life without it. They may experience thoughts and feelings that prevent them from having the quality of life they desire, or they may struggle in their relationships to the extent that the relationship is in jeopardy.

Other people may struggle with their symptoms to the extent that they cannot get out of bed in the morning, go to school or work, or get through the day successfully. In these cases, medication is more of a necessity to participate fully in life. 

It is important to take a serious look at your educational, occupational, social, behavioral, and interpersonal life to see whether your mental health condition is preventing you from reaching your goals, achieving your potential, or even just getting through the week without feeling like you're having a mental breakdown. Missing too many days of school or work, missing out on social activities, or feeling isolated can cause bigger problems, and medication may be useful in improving some of your symptoms enough to take better care of yourself and continue functioning.

What other interventions have you tried?

If you are already in therapy, or you've tried therapy but it hasn't been helpful, talking to someone may not be enough to address the gravity of your mental health condition. Sometimes, feeling overwhelmed with intense emotions, anxiety, or challenges in every day functioning prevents people from making the most out of their therapy sessions. For therapy to be effective, you have to put effort into it, and you have to have the energy to do the follow up strategies that you're given. In this case, medication may be effective in reducing the intensity of unwanted thoughts or intense emotions so that it's possible to go to therapy with more energy and optimism. Most of the research on conditions, such as depression, anxiety, and ADHD, supports the notion that therapy and medication work well together as a treatment approach. 

Are your fears about side effects or other consequences of medication preventing you from trying it?

Most people tell me that they are concerned about side effects, such as fatigue, weight gain or loss, changes in appetite, or just not feeling like themselves. These are legitimate concerns, but rather than going to Google or social media, talking with a trusted professional can help answer your questions about potential risks. While primary care physicians, physicians’ assistants, and nurse practitioners are qualified to prescribe these types of medication, if you have serious questions or concerns, it's best to discuss them with a board certified psychiatrist. I would even go a step further to say that if you are diagnosed with ADHD, see a specialist in that area, or if you have chronic depression, talk to a psychiatrist who has extensive experience in treatment resistant depression. Take the time to find the answers that you need to have a well-formed opinion based on clinical experience and scientific evidence.

Are you concerned about stigma?

Many people still believe that taking medication for a mental health condition means that they aren't trying hard enough to get well, or that they just need to have a more positive outlook on life. Taking medication does not mean that you are "taking the easy way out" of your mental health problems. I use this metaphor with my patients and they seem to appreciate it: if you were diagnosed with diabetes, no one would shame you for taking insulin so that your pancreas could function. Your brain is an organ, just like your pancreas. So if there's a medication that can help your brain improve its functioning so that you can live a better life, it makes sense to give it a try.

What is your family history of mental health conditions?

When considering whether a trial of medication is a good next step, it's important to assess your family history, if that's possible. Many mental health conditions run in families, and knowing about your family history can help you make an informed decision. This is especially true if people in your family have taken medications that have resulted in adverse side effects. Due to stigma, not everyone freely discusses whether they have tried medication for depression or other mental health challenges. But if you do have the chance to ask one of your parents or a sibling, it can be an extra piece of information that helps you decide. If you don't have access to your family history, then you can still ask the questions above to make an informed decision. 

Deciding to take medication for any diagnosed condition, whether it's mental or physical, should be based on a thorough assessment of your history, family history, and other factors affecting your daily functioning and quality of life. If you’re considering taking medication for your mental health, do yourself a favor and take these factors into account so that whatever you decide, you know that you have gotten advice based on facts, not myths or fears.

Originally posted on Psychology Today

Photo by Christina Victoria Craft on Unsplash

Autism Acceptance: A New Understanding of Neurodivergence

April is Autism Acceptance Month. Autism, which is one type of neurodivergence, has received a lot of attention from the press and social media in the last several years.

There are many people who speak and write about autism, including autistic individuals. If you are autistic or know someone who is or might be, it's important to recognize that that our understanding of autism is evolving. I hope this blog post contributes to improving awareness of the current conception of what it means to be autistic and the implications of this new knowledge. 

The following are some facts about autism that are often unfamiliar to people, but that are important to acknowledge as we move forward in helping autistic people thrive. 

1. You can be autistic your whole life and not realize it until you're an adult. There has been a sharp increase in the number of individuals seeking an assessment to clearly determine if they are autistic in my practice. Many people would not have "met criteria" according to previous standards and sometimes even the current ones in the DSM 5 (Diagnostic and Statistical Manual). This is why many autistic people prefer to use the term neurodivergent. This term explains that their brain is different, but that it doesn't necessarily fit into the traditional definition of autism. 

2. Autistic people can acquire neurotypical social skills, but this does not mean they are no longer autistic. The behavior they learn by observing others never feels right to them, but they often do it as an attempt to fit in. This is called masking. This doesn't mean that they are comfortable behaving like their peers, or that they find social relationships with their neurotypical peers enjoyable. When autistic people can relax and be themselves without the expectations of typical social exchanges, they can enjoy being with people. For example, the expectation to ask personal questions of a new acquaintance might make them uncomfortable interacting, and that’s not how they typically connect with new people. 

3. Autistic people can have empathy. Sometimes they have quite a bit of empathy, and their emotions can be very intense. They can feel the pain of others tremendously, and it impacts them more deeply than for the average person. So it is not the case that every autistic person lacks empathy and can't relate to others’ pain. It is often the case that they cannot relate to their peers or to the situations that bother or hurt others. 

4. Many experiences that do not bother neurotypical people feel traumatizing for autistic people. The level of trauma and the type of experience varies, but living in a world designed for brains different from theirs can lead to feelings of overwhelm. The school gymnasium, with its bad acoustics and loud voices, a grocery store full of people going in all directions and a large amount of merchandise, or going to an outdoor sporting event that is crowded, such as a stadium where people are loudly cheering and giving each other high-fives, are a few examples of how overstimulation and sensory experiences can negatively affect autistic people. They might not be able to tolerate the situation and might flee physically or withdraw into themselves.  

5. The expectation that autistics can learn to be like everyone else and learn to adjust to environments, and that it's better for them that they do so, is not affirming or in their best interest. Expecting neurodivergent individuals to just deal with the challenges of a neurotypical world is an outdated viewpoint that can be harmful and result in withdrawal and avoidance due to the level of stress it causes. We should let autistic people respond to these situations in the ways that they need to, rather than forcing them to conform to neurotypical behaviors. 

Our developing understanding of autism is the reason that Autism Awareness Month recently became Autism Acceptance Month. The focus has shifted from people teaching autistics how to be neurotypical, to educating neurotypical individuals about neurodivergence. This shift is driven by autistic voices, which includes how to support autistic people as they find ways to engage with the world. This approach does not attempt to correct autism. Instead, neurodiversity affirming care means accepting who they are and supporting them and finding ways to help them become resilient and live a meaningful life. 

This blog was originally posted on Psychology Today.

Image from Canva

How to turn rejection sensitivity into positive growth

Over the last several years, I've had more clients ask me about rejection sensitivity dysphoria (RSD). While it is not a term used by the DSM, which is the manual of mental health conditions, pop culture and social media influencers use the term frequently to refer to an intense emotional reaction to either real or perceived rejection that impacts the person's functioning in relationships. Nobody enjoys being rejected, but rejection sensitive people experience enduring emotional pain, low self-esteem, and decreased motivation to engage in relationships as a result of this challenge. Rejection sensitivity may occur after a breakup, when there is one-sided romantic interest, or even in friendships, where the person feels as though others are less interested in their friendship. There is some recent research in support of the hypothesis that individuals with ADHD are at a higher risk of rejection sensitivity, but one does not have to have ADHD to experience the misery of rejection.

If you notice that you have a much harder time recovering from any form of rejection, the good news is that there are psychological tools you can use to become more adept at dealing with rejection. In addition, the sensitive reaction that you experience as a result of real or perceived rejection can help you empathize with others who have been rejected. But it's not always easy to think about these things in the midst of feeling the sting of rejection and wondering why it hurts so much. Social and relational rejection can literally be physically painful, according to research. In addition, the pain felt by those sensitive to rejection often leads to greater social avoidance and less effort, informing future friendships and relationships.

Although people who experience rejection sensitivity dysphoria will most likely continue to be more sensitive than the average person, it is possible to become less affected and to build resilience. Self-awareness that you are rejection sensitive is the key to using coping strategies. You must enter social interactions with this knowledge so that you're prepared to question your thoughts and emotions before assuming they are accurate. Then you are also prepared to handle rejection when it does occur. Here are some strategies to help lessen the impact of rejection and gain a realistic perspective on how to navigate potential rejection in your relationships.

Cognitive reframing: are you being rejected?

Imagine that you text a friend to see if they're free on Friday night to hang out. They don't reply to you until Friday afternoon, and then they tell you they have plans that evening. You immediately feel the sting of rejection and question the friendship. The first step is to acknowledge how it feels. The second step is to remember there may be other reasons they aren't available. Some people are bad at responding to texts in a timely way. Ask yourself if this is someone who regularly turns you down, in which case you may not want to invite them out again. But if it’s not a  pattern tell yourself that your friend may have had a tough week, and reach out again some other day. This one instance isn’t necessarily a reflection on the relationship or how they feel about you. This strategy involves reframing your thoughts and resisting reaching conclusions without facts.

Accepting the reality of rejection

Sometimes, your impression will be correct. Everyone gets rejected from something or someone. It is an inevitable occurrence in life. Rejection sensitive people perceive that they get rejected much more often, but they will still experience true rejection. If someone is less interested in being friends with you, or they ghost you after a couple of dates, accepting the reality prevents you from continuing to obsess over what happened. Focus on the people in your life who are loyal, loving, and always there for you. You want people in your life who don't play games and who have enough courage to tell you when you do something they don't like. None of us is everyone's cup of tea. The other reality about rejection is that you will ultimately reject others, and that's OK.

Focus on building self-confidence

Whether RSD is directly related to ADHD or not, it is absolutely related to a person's inner sense of self-worth. Believing in yourself will take away the sting of rejection because you know that you are worthy of having great friends, a romantic partner, and a job that you like. The emotional intensity that occurs in RSD can be tempered by taking a step back to remind yourself of your good qualities. Even if everyone doesn't choose you, a strong sense of self-worth reminds you that the reaction may be disproportionate to the rejection. 

Many people who experience RSD don’t know what to do about it. Although RSD can be a painful emotional experience, you can still turn it into a way to grow and increase your self-worth. If you notice that you're hurting deeply from rejection and having trouble moving on from it, take some time to reflect on why you're having this intense reaction, what it means to you to be rejected, and whether the reaction is truly worth the energy that you are expending. You won’t stop being sensitive to rejection, but being aware that you are more sensitive and using these strategies can help you manage the reactivity so you’re not reacting as disproportionately to it.

Originally published March 29, 2024 on psychologytoday.com.

What is emotional well-being and how do we get it?

On January 30, the popular Sesame Street character Elmo was nice enough to ask everyone how they were doing. Elmo and his friends from Sesame Street probably did not realize what would happen next. Thousands of people replied to his tweet with an outpouring of concerns and despair. The replies covered everything from personal woes, such as broken relationships and lost jobs, to deep despair about climate change. In response to the outpouring, Elmo kindly offered a link to a mental health helpline and some compassion for his followers. #EmotionalWellBeing was important, Elmo stated, and that is his hope for everyone.

So let's talk about what exactly emotional well-being is, what it looks like, and how to achieve it. 

Emotional well-being can be defined as “the emotional quality of an individual’s every day experience, including the frequency and intensity of the experience of joy, stress, sadness, anger, and affection that make one’s life pleasant or unpleasant.” While this definition doesn't distinguish positive emotional well-being from negative emotional well-being, let's assume that Elmo’s desire for us all is to have a positive emotional well-being, and we can focus our discussion on that.

Here are five questions to ask yourself to figure out if your emotional well-being could use some improvement, and how to achieve that.

1. Monitor how much you complain. We all have our moments, our bad days, and our bad seasons of life. Our circumstances are not always within our control, but the ways in which we respond to them can make a big difference. If you notice that you are making many more negative statements about your circumstances, your relationships, or just anything that you find unpleasant, your tendency to focus on the negative is going to affect your emotional well-being. If your friends and loved ones have told you that you complain a lot, before you become defensive, listen to them. If you only view the world through a negative lens, you won't have a very nice view. It becomes harder to identify positive experiences when people profoundly focus on what is wrong with their lives. 

2. Intentionally acknowledge what is positive in your life. Feeling good and maintaining emotional well-being involves more than just the absence of complaining and negative thinking. It also involves the awareness of what is going well in your life, or the things that you consider to be good. This doesn't always have to be major achievements or life events. Positive aspects of your life might include your pets, your friends, your steady income, your hobbies, basically anything that gives you joy. Sometimes, when life seems harder, we forget to acknowledge what is positive. But it's important to do so, to speak it out loud, and to reflect on being grateful for what we have. This act reminds your brain that life is not all bad all the time.

3. Surround yourself with loving, kind people. Some of us are born into big, happy families who consistently care about each other. Many of us are not so fortunate. But as we become adults, we can choose who we spend time with, and who we prefer to keep around for companionship and support. Spend some time noticing how others around you behave. When you are with them, notice how you feel. Do you leave their presence feeling uplifted, hopeful, and supported? If so, you definitely want to keep that person as a part of your life. But if you notice you're starting to feel more pessimistic, your thoughts and emotions are more negative, or you feel really stressed, you want to consider whether this relationship should be permanent. Everyone has bad days, so you don't want to abandon people who are going through a hard time. But if you notice regularly feeling discouraged or burdened after spending time with them, perhaps consider if you should do anything about it. This is especially true if most of your friends or the people who are in your life are unable to support you or make you feel good about yourself. We want people who are rooting for us, and who can bear our pain as well as expect us to endure theirs.

4. Refrain from comparing your circumstances to those of others. Social comparison can destroy emotional well-being. Scrolling through social media posts — wondering why some people lead such great lives, why some people are so beautiful and put together, and how some people never seem to struggle — creates a distorted reality about how well other people are doing. Remember that some people prefer to put their best images out on social media, while keeping the rest of their lives private. Also, remember that you do not know what goes on in other people’s lives, unless they tell you. When you find yourself, wishing you had someone else's life because you saw their Instagram posts, catch yourself, and say something like "good for them! I hope they're happy.”Then keep scrolling.

5. Evaluate when you need to make changes. People who do not reflect on how their life is going often end up lacking emotional well-being. They find themselves stuck in a rut, and they are not aware of how it happened or what to do about it. It is important to consistently reflect on how your life is going. For instance, whether or not your job or career is satisfactory, if you like where you're living, whether you have enough emotional support through friends and family, and how much you are enjoying your life. Reflecting on your circumstances allows you to identify what is going well in your life so you can be grateful and also what needs to change. Identifying the problems is the first step in making changes that result in good mental health and emotional well-being.

Emotional well-being won’t just happen on it’s own. You have to be proactive to cultivate and maintain your positive emotional well-being.

Reference: Kahneman D, Deaton A. High income improves evaluation of life but not emotional well-being. Proc Natl Acad Sci U S A. 2010 Sep 21;107(38):16489-93. doi: 10.1073/pnas.1011492107. Epub 2010 Sep 7. PMID: 20823223; PMCID: PMC2944762.

image from Canva

This blog was originally published on psychologytoday.com on 02/28/2024.

https://www.psychologytoday.com/us/blog/from-trial-to-triumph/202402/what-is-emotional-well-being-and-how-do-we-get-it

Are You Constantly Struggling? Try Grit.

According to the news, social media, and the American Psychological Association (APA), more people are struggling with anxiety, depression, and other mental health conditions than ever before. In response, numerous articles and research studies have been published suggesting the best ways to improve mental health. While there isn’t just one thing that we need to do to protect our mental health, or improve it, 18 years of clinical experience has taught me that some strategies work better than others, and some of them are more important. I believe in the power of resilience, which is the ability to bounce back from hardship with strength and tenacity. One essential and specific factor that is part of resilience is called grit. 

Defined as the ability to endure hardship, possessing more grit increases our tolerance for difficult circumstances without stealing our hope that things will get better. Some people naturally possess more grit, and they seem to be able to endure a lot of hardship without it breaking their spirit. But grit is something that you can work to increase, and doing so helps build resistance to depression, anxiety, and other mental health challenges. 

In her book Grit: The Power of Passion and Perseverance, Angela Duckworth discusses how to be gritty. She argues that the ability to endure hardship is part of what constitutes grit, but you also have to have a goal: something that you’re passionate about. While Duckworth focuses on how grit can help you achieve success, as a therapist, I’m interested in how grit can be used to improve mental health.  

If you’re currently experiencing hardship, practicing the following strategies can help you increase your grit to get you through this difficult time while retaining hope and ultimately improving your overall mental health. 

Accept that having grit takes effort

Sometimes you have to be persistent and keep going even if you don’t feel like it. Life isn’t fair, and it often involves more tough times than easy times. In the end, this makes the rewards and the triumphs even sweeter. But we have to get through the process first. This means we have to put on a symbolic suit of armor and remind ourselves on the hardest days that we can do hard things. 

Let go of grudges, mistakes, and disappointments

People with grit must be forward thinkers. Take notes and learn from your mistakes, but let go of the negative thoughts and feelings. Dwelling on past mistakes or broken relationships does not serve a productive purpose in improving your life or your mental health.

Always have a goal in mind

You don’t have to come up with a life-defining goal right now. Perhaps you just want to make it through the days without feeling terrible, or you’d like to have several consecutive days without a panic attack. Those examples are a fair place to start. You can also identify something small you’d like to accomplish. It doesn’t have to be running a marathon or starting your own company. Maybe it’s going to work more days than not or finishing a project that you started. Keeping goals in mind gives our brain a place to focus other than our troubles.

Find a passion that can be your purpose

While nothing may immediately come to mind, think about what you want to get out of life. Find a purpose, whether it’s related to your career, an opportunity to serve others as a volunteer, or a hobby. Find something that you love and pour your energy into it. Having a passion and a purpose gives you a reason to wake up every morning and feel enthusiastic about the day ahead. It also helps you focus on the harder days.

Enduring hardship is definitely an important part of grit, but no one can continuously withstand difficult circumstances without something to feel hopeful about. The strategies listed above can help you find hope through purpose and positivity, and then you’ll feel strong enough to be ready for life’s next challenge.

Photo by Fabrizio Conti on Unsplash

This blog was originally posted on Psychology Today 12/20/23. https://www.psychologytoday.com/us/blog/from-trial-to-triumph/202312/are-you-constantly-struggling-try-grit

How to Get the Most Out of Therapy

In her book Maybe You Should Talk to Someone Lori Gottlieb makes a very good case for going to therapy to deal with life‘s problems. She talks about her own therapy and why it’s important to consider therapy rather than dealing with one’s challenges on your own. The book was a best seller, and her case for therapy convinced thousands of people to give it a try.

While it’s great that more people are going to therapy to get help, they often don’t know what to do when they get there. Friends and clients alike tell me that they didn’t know what to talk about, their therapist just sat and listened and nodded, and they felt like it was a waste of time and money. 

As a psychologist, this is obviously discouraging to hear. This is why my first session with new clients not only gathers background information about them, but it educates them about therapy. I like to give them some things to consider so they use their time and therapy well, whether it’s six sessions, six months, or six years. Because some clients are having their first experience with therapy when they come into my office, I consider it a priority to help them understand how therapy can be helpful and how it looks different than talking to a friend. I like to call it a roadmap because most people who make the initial phone call to schedule an appointment have decided they should be in therapy, but it’s my job to help them learn what to do once they get there and how to make it productive. 

Here are some steps you can take to create your own roadmap for therapy. 

Find someone that you like talking to 

Not everybody can pick any therapist they want. If you can go out of network and get reimbursed or can pay out of pocket, you can chose your favorite out of as many therapists as you can find. If you’re limited by your health insurance network, you may only have a few to chose from. But within those limitations, it’s still important to pick the best therapist for you. 

Once you’ve identified somebody that is a practical, good choice, make sure that you enjoy talking to them. Therapy will be a chore if you don’t feel like you’re connecting or that they understand you. Ask questions on the first visit to make sure they have knowledge of the issues you would like to discuss, and ask how they conduct therapy to make sure you are comfortable with it. For example, some therapists just talk to you and expect you to bring up subjects that you would like to discuss. Other therapists are more interactive, giving advice or using theoretical orientations for which they’ve been trained, such as cognitive behavior therapy. Learn as much as you can about the way that they practice so that you can make a decision about whether to keep looking. 

I advise people to give the same therapist at least three sessions because sometimes it’s hard to fit in all your questions and gather all your info on the first visit.

Identify how you want to use therapy

There are a number of ways that you can use therapy. Ask yourself what you want to accomplish. 

Many people are quite content to go to therapy for an indefinite amount of time and have a safe space to talk about their feelings and thoughts. They may not have anyone at home that can be their unbiased sounding board. Many people also want to find solutions to their challenges, or they want to learn how to behave differently and change patterns of behavior that are unhealthy. Still others want to learn specific skills to cope with difficult and negative thoughts and emotions. Each of these goals for therapy is valuable, and there are therapists out there who can help with all of these things.

 It’s possible that you may not be completely sure how you want to use therapy, so that gives you a good opportunity to ask your therapist for guidance. Explain to them what is hard about your life and what challenges you are facing. A good therapist will help you brainstorm and figure out how you want to get started in making positive changes, or they will validate your desire to talk about subjects that are difficult to discuss with members of your family or your friends.

Think about your therapy when you’re not in session

Many clients have told me that from one session to the next they don’t think about what we’ve discussed or even remember what we discussed. I explain to them that they will find therapy more valuable if they reflect on things that have been discussed in between sessions. If it’s hard for them to remember from one session to the next, I recommend they take notes during the session. Therapy often leads to a process of change for clients, and it becomes harder to make changes if they don’t connect what they’ve talked about in therapy with what happens in the real world. 

Clients also come to the sessions saying it’s hard for them to remember the important things that have happened since the last session. In these cases, I recommend the clients take notes on what happens outside of therapy, so when they come to a session they can describe situations that may have affected them emotionally. Some clients choose to get a “therapy notebook“ where they keep their reflections after sessions and topics for future discussions, so when they come to therapy, they have material to discuss.

Come prepared to be present for the entire session

Some people say it’s hard for them to tune out their lives and make time for therapy sessions. They arrive at the appointment and their phone constantly buzzes with texts and emails. In order for therapy to be helpful, it has to own a space on your calendar. Schedule regular appointments, arrive on time, and turn off your devices while you are in session. Some therapists will start the session with a mindfulness meditation, which can be helpful in tuning out distractions so that you can be fully present in the moment. If your therapist doesn’t offer this, you could ask them about it, or you could do a brief meditation yourself in the waiting room. Feeling distracted during therapy makes it harder to remember what you discussed afterwards, and it may affect your opinion of the value of therapy.

While therapists vary in their level of expertise and experience, the quality of the therapist is not the only reason therapy may not feel valuable. Think about what you’d like to get from therapy and make a plan. Be intentional, and therapy can be a valuable tool in improving the quality of your life and your relationships.

This blog was originally posted on Psychology Today.

image from Canva

Five ways to improve the effectiveness of coping strategies

Many therapists talk about coping strategies. Developing healthy ways to deal with stress, anxiety, pain, depression, and difficult circumstances is a key component of evidence based practices for mental health. While talking about our problems can be useful, it is generally believed by professionals that clients must learn tangible strategies to respond to their thoughts and emotions. These strategies range from meditation and breathing exercises to writing down and challenging our negative thoughts. Cognitive-Behavior Therapy (CBT) and Dialectical Behavior Therapy (DBT) are two interventions that teach coping strategies to clients so they can better manage their intense emotions and learn how to respond, rather than react, to stressful situations and interactions.

Often, though, I hear from my clients that the coping strategies aren’t working. People become frustrated after trying a few times to implement new strategies without success. Sometimes, this is because they haven’t given them enough of a chance. Whenever we are trying something new, we’ve got to give ourselves time to practice it. Additionally, it can be hard to believe that coping strategies will work, especially when we’ve been reacting the same way for a long time. It seems difficult to believe that doing something as simple as pausing to take deep breaths could be helpful. But it’s important to keep trying new ways of coping with our feelings to improve our mental health. Here are some things to consider when it seems like nothing that your therapist suggests is working. 

1. Observe what you are thinking and feeling, when a coping skill hasn’t worked. For example, you tried taking deep breaths, inhaling and exhaling slowly. When you finished, you felt irritated and said to yourself “I don’t feel any better.” Respond to these negative thoughts or judgments about how it went by reminding yourself that it takes time to acquire a new skill. You can also remind yourself not to judge and that some experiences will be more helpful than others. 

2. Set realistic expectations. You don’t want to evaluate the success of coping strategies by how quickly you notice feeling different. Even after new strategies have been helpful, they won’t be as helpful every time. Sometimes, you’ll notice that you feel different right away. At other times, you will wonder whether the coping strategies make a difference at all. You should think about them as a tool for managing your feelings, and you want multiple tools in your toolbox. If one coping mechanism doesn’t seem to be working in a specific situation, try something else. But don’t evaluate their usefulness by how much they make a difference in one specific moment. 

3. Assess your attitude about using coping strategies. Talk with your therapist about your feelings regarding learning and using coping strategies. If you’re pessimistic about whether they’re helpful from the start, it might affect your expectations and your ability to keep trying them. Think about why you are resistant. You may be afraid that if they don’t work, it will be your fault. Or, perhaps, you are afraid to be hopeful. 

4. Reflect on how coping strategies will improve your quality of life and your relationships. While it may be hard to try new things and to keep trying strategies that are difficult, think about the outcome that you desire. For example, if you’re struggling to manage your anger, you may frequently explode when you’re having a disagreement with someone you care about. It would be great to learn how to respond to your anger and gain control over your emotions so that you can resolve conflicts easily and peacefully. Thinking about the outcome that you desire and the ways that it would change your relationships may motivate you to exert more effort in using new strategies. 

5. Reward yourself for success. Give yourself credit when you get the hang of new coping strategies. Remind yourself that you’re working hard and that you’ve done a good job. Feeling better will be its own reward, but it never hurts to treat yourself for a job well done.  

Even though coping strategies are going to be useful, they aren’t going to work easily and immediately. Learning and implementing new coping strategies is hard, and it’s important to acknowledge that it’s hard. However, if you work at it, you will keep learning and get better at using them.