The year 2024 is coming to an end. Through everything, we have made it here! This is the time of year when we start reviewing how the year has gone and we start looking towards the new year. There are things we want to change or things we want to have stay the same. Many of us make resolutions to achieve these things. But are New Year’s Resolutions always the best answer?
Why We Make Resolutions
Usually, we’re inspired to make these changes in our lives for some reason or another. Maybe we want to get healthier in some way or change habits we feel are holding us back. For some of us, we want to set some kind of goal in a skill we already have. For others, they want to gain a new skill.
We make resolutions because we want to better ourselves in some way. But we also make them so that we can look back on the year and note if we’ve made positive progress towards something. It’s important to many people to feel as if they’ve done something good for themselves or pushed to become a better version of themselves.
However, we also put a lot of pressure on ourselves because of the social importance of New Year’s Day.
Why Many of us Fail
That pressure we put on ourselves is a big contributing factor! We focus less on why we made the goal or resolution in the first place and more on how we’ll feel at the end of the year if we fail. This just sets us up for failure because we’re being motivated by fear and shame instead of something positive.
Another reason is that many of us set vague resolutions and not measurable goals. What does “get healthier” really mean? This is so difficult to measure and understand that it can seem as if we’ve made no progress towards this goal, even if we have! It’s important to set specific goals because of this. The seeming lack of progress can be really disheartening for someone who is working hard towards something.
Negative Mental Health Consequences of Resolutions
When we “fail” at fulfilling our New Year’s resolutions, it can feel as if we’re just stuck. Some of us can feel as if we’ll never achieve anything, never fix a bad habit, or never realize our dreams. This is incredibly difficult to deal with, especially year after year, and it can lead to anxiety and depression in some people. These negative feelings and thoughts can be really detrimental to many people.
If we’ve failed at these same resolutions before, the anticipatory failure can also contribute to greater anxiety and depression. It can be something we dread every year and yet we still set the same goals and approach them in the same way. This generally isn’t good for most people’s mental health and it’s why many of us feel so badly by mid-March.
There’s also an issue with the “new year, new me” approach. This encourages us to make so many changes all at once that it becomes overwhelming. This isn’t a sustainable or long-term way of approaching making positive changes in our lives. Small, incremental changes make for much better and long-lasting effects in our lives.
Is it Possible to Set and Achieve Resolutions?
Of course! Not only is it possible in general, but it’s also possible to approach them in a healthier way that can contribute to better mental health, not worse. In next week’s blog post, we’ll be discussing how to go about setting New Year’s Goals as opposed to New Year’s Resolutions. Not that you need to set goals around a specific time!
That’s another important thing to remember. Sometimes the best time to start working towards a new goal is June 27th, May 18th, or even December 3rd. The point is that the best time to start working towards goals is the time that you’re ready to. Trying to push yourself to set and achieve goals based on a certain day of the year is just setting yourself up for trying to achieve something you may not be mentally ready for, which sets you up for failure.
As we approach the end of the year, there’s so many things on our minds. Many of us are planning holiday parties or get togethers. Many are wondering what to gift, make, or how they’ll spend their time. And often we think about changes we want to make in our lives. The end of the year really makes us sit and think about things ending, changing, or transitioning. Of course it can make us excited or hopeful but these transitions can also be stressful.
Why Do Transitions Feel So Stressful?
The short answer is that we don’t really love change, even if change is good for us. It can be difficult to go from thinking about something one way to then thinking about it a new way. It takes time to adjust to that and it can be stressful, depending on what it is. And if the changes we’re implementing come with new routines or schedules, that can make things even more difficult for us.
We love patterns. It’s how our brains evolved to work and finding patterns in things makes us comfortable. There’s safety in knowing what’s going to happen next. If it’s a transition we weren’t expecting or had no choice over, it can add a feeling of helplessness and loss of control that makes it difficult to cope. This can cause some serious anxiety when thinking about the transition or changes that are coming.
What Kind of Transitions Can Affect Us?
Technically, anything that brings change to our lives can affect us and stress us out. Moving, changing jobs, having a baby, and getting married tend to be the big ones that people think about. But consider how for children, the end of the year signals the end of a school semester. For some of them, it means potentially not having friends in any of their classes when the new semester starts. Maybe it means a new teacher they’re never met before. Even though these things aren’t necessarily bad, they can absolutely affect someone’s mental health.
Making changes to our health can also cause stress. Maybe you’re cutting back on caffeine. Some people experience withdrawals from this that can be pretty unpleasant, including headaches. It also means a change in your routine of not going to the coffee shop as often or making something different in the morning to drink at home. These are little things that can add up if you’re already struggling with other things.
Is There Anything We Can Do?
We can’t avoid change, not forever. Change is good for us in the long run even if it doesn’t feel good at the moment. Some stress management techniques can help in the moment for dealing with these uncomfortable feelings. We’ve explored some of these techniques in a previous post about grounding techniques. These can be used if you feel overwhelmed or very anxious due to these changes.
Another option is to talk to someone you trust. Leaning on social supports during times of transition can be especially helpful. They often understand the impact these things can have on you and are likely to be able to support you through tough transitions. They can be there to remind you of the reasons this will be good in the end and they can also help you cope.
However, if talking to a loved one doesn’t help, consider reaching out to a therapist. Many people go to therapy just to help cope with transitions and changes. It can help to get someone neutral to chime in on what’s going on and to help listen to you.
Change doesn’t have to be difficult to cope with long term and there are options out there for help dealing with them. But do remember that it’s normal to struggle with change and that it’s normal to be anxious during these moments.
Almost every week, we mention how speaking to a therapist or counselor can be of benefit for addressing a variety of needs. However, this is the first time we’ll be addressing the benefits of counseling more closely. Of course it can be used to address specific mental health disorders but it also has more far reaching benefits than just helping people to cope with mental illness.
What is Therapy?
Therapy, or counseling, often refers to talk-therapy or talk-psychotherapy. This is a form of treatment which involves speaking to a trained professional about a problem you’re having. The professional then uses evidence based practices to help you build skills to then address whatever concern brought you to therapy.
One of the main benefits of counseling is that there is no one size fits all approach. There are so many different forms of therapy. For example, cognitive behavioral therapy (CBT) is one of the most well-known forms. And many people often think of psychodynamic or psychoanalytic therapy when they first imagine therapy (you know, Freud and a couch).
However, there is also ACT, DBT, EMDR, ERT, and many, many more. Many of these forms of therapy were developed to target specific mental disorders or problems that people may be having. Motivational Interviewing (MI), for example, was developed for addressing substance use disorder.
What Does Therapy Help With?
There are many benefits of counseling to consider. Of course, it can help with mental illness, such as depression or anxiety disorders. However, it can also help with things like coping with grief or loss, dealing with stress, handling transitions, and other issues people may be facing.
Therapy can also help with working on self-esteem, problem solving skills, self-confidence, and coping with rough patches in your life. Most people who go to therapy only do so for a short period of time, usually to help resolve a current issue such as the death of a loved one.
People also seek out therapy to help with communication skills, relationship problems, and for help addressing conflicts they may be facing in life.
How Do I Find a Therapist?
Word of mouth is an excellent way of finding a therapist. Ask around and see if you can get recommendations from doctors or people you know who have gone to therapy. Your insurance provider is also a great resource for finding a therapist as that will be the easiest way to insure that the cost of your sessions will be covered.
We have a large list of clinicians here that are also an option for those looking into the benefits of counseling and considering getting counseling themselves.
A lot of people struggle with having proper balance between their lives and their work. It can be easy, especially in our always on the go, keep pushing for more, and goals/financially motivated society to feel like work is allowed to take over our lives. But a work-life balance is important. There are a lot of potential negative consequences that can happen when we don’t prioritize our lives outside of work more than or at least as much as our lives at work.
What IS a Work-Life Balance, Anyways?
Simply put, work-life balance is when you’re able to balance your work priorities and obligations with the things you both need and want to do outside of work. It means meeting your deadlines or work goals while also investing time in yourself, getting things done at home, and spending time with the ones you love.
This is going to look different for everyone! We all have our own hierarchy for what matters most to us. This can also change over our lives. What we prioritize at 25 is likely going to look different for when we’re 35. So this is definitely something to assess over time to make sure your work-life still aligns with your needs, values, and goals.
Consequences of Being Out of Balance
Stress, to put it simply, can be one of the most immediate consequences of not having a good work-life balance. Stress can then go on to affect us in other ways.
Like:
Irritability
Depression
Aches and pains, like headaches
Stomach problems
Relationship issues
Productivity problems
More likely to become ill
Blood pressure and other heart problems
Exacerbate chronic health conditions
Trouble sleeping
Problems with eating (too much or too little)
Overspending or risky behavior to cope with stress
Substance use (like drinking more than usual) to cope with stress
Burnout
And that’s not even an exhaustive list! However, it’s clear to see how having a poor work-life balance can affect you not just at home, but at work, too. Looking at the list, it makes it clear how counterproductive it is to focus solely on work at the expense of your mental and physical health. It’ll only affect your work poorly, too!
What Can I Do?
Working on achieving a better work-life balance is going to depend pretty heavily on your specific goals and priorities. However, the first step will be the same for everyone. Step back and really consider how you spend your time every day and every week. Are you happy with it? What areas do you wish you could spend more time in? Is it hobbies, family, or something else? Once you have answers to these questions, it’s easy to see where to tweak things to bring things more in balance with what you personally are looking for in life.
For example, if you feel like you bring work home with you a lot, either literally (finishing paperwork, emailing, etc) or mentally (worrying about projects, thinking about responsibilities, etc) then it may be time to consider setting some boundaries around work when you’re at home. If it’s simply not possible to not bring physical work home with you, set yourself a time limit for how much you’ll spend on it each day. This can help you balance out how you spend the rest of your day.
Do you feel overwhelmed with what you have to do at home? Enlist help from those who live with you, if possible. Splitting up chores so it doesn’t all fall on one or two people who also have busy work lives can really help with alleviating the feelings of “work never ends”, even if it isn’t your job that seems to be following you around.
If you feel comfortable and safe to, talk to your boss or co-workers. You may be surprised to know that others at work also feel the same way you do. Working together to come up with a better workplace culture that can support a healthier work-life balance for everyone can be more effective than trying to tackle it alone.
If even after working on getting your life more balanced you still feel like you’re struggling with stress, overwhelm, depression, or other negative feelings then consider reaching out to a therapist.
That time is looming around the corner yet again. No, we don’t mean the holidays (though that will come in a later blog!). We mean Daylight Savings Time. While some people love getting the extra hour during “fall back”, others don’t find it so great. And almost everyone can agree that “spring forward” is the worst. But why is it that we have such a difficult time with DST?
Daylight Savings Time, the Circadian Rhythm, and You
Why do we even do DST in the first place? Honestly, it’s from a time when energy consumption from lights was a larger drain on the economy than it is today. It was first implemented during the end of WWI, came back during WWII, and then was brought back in the 60’s and never went away. These were originally all conservation efforts due to war time rationing. Currently, we do it mostly out of habit.
The circadian rhythm is an innate clock within every animal. We all have sleep and wake cycles that are controlled by this little part of our brain. Not only does it control that, but we even have cycles for hunger, pain tolerance, strength, and blood sugar. Among many others!
The circadian rhythm controls an awful lot in our bodies and is often triggered by light. Light in the morning triggers most people to be awake and get going while fading light and darkness at night trigger our brains to start slowing down and get ready for bed.
The problem with DST is that it interferes with our natural circadian rhythms. This is why we often have such a difficult time adjusting to these changes. Our bodies have a natural cycle they want to follow and a biological clock that determines these. But then we have a social clock that is inconsistent with these messages and also changes twice a year.
Why DST Feels Bad
The argument for keeping DST in the fall is that it gives us more evening light to enjoy things. The problem with this is that is fundamentally messes with our circadian rhythm! We need the light in the morning to let us know that it’s time to be awake and get things done. By making it so that we start our days in the dark, it can be hard to really get going in the morning for most people.
To make it worse, by having it stay light out later in the day, we don’t get the normal signals we need to go to bed. It tricks us into wanting to stay up later. This makes it hard to get into that new routine.
It’s not surprising that we see an uptick in traffic accidents at night during the beginning of DST in the fall! And in the morning for the spring, we also see an uptick in traffic accidents. Not only this, but doctors have even found that the incidence of heart attacks and strokes go up in the days following the DST switch.
All of this can be attributed to the stress that these changes put on our biological clocks and, subsequently, our bodies. The way it impacts our sleep isn’t healthy. But unfortunately, there isn’t much we can do while it’s still law.
What Can We Do About It?
Keeping to your routine as much as possible is important. Stick with your regular sleeping schedule, even though it may be tempting to stay up later or sleep in later. Buying a lightbox can also help if you’re really feeling the lack of vitamin D and light that we would normally be getting from outside.
Self-care can be really important, especially self-care around sleep. Make sure you’re getting the rest you need, especially in the first week or two of the time change. This can make all the difference in the transition!
If you find you’re prone to winter blues or depression with a seasonal pattern, now is the time to be proactive about it. For those with depression, reach out to your care team about considering medication changes or additions to stay ahead. If it’s winter blue, check out our blog post that discusses both of these!
October is Breast Cancer Awareness Month, which is arguably one of the most discussed cancers in the media. There is a large push to get those assigned female at birth to check themselves regularly for lumps or anything that may feel out of the ordinary. Regular breast screenings are incredibly important to your overall health as early detection of cancer is critical for the best outcomes with treatment. However, one thing that is often not discussed is how cancer and mental health can intersect.
Cancer and Mental Health
Receiving a cancer diagnosis of any kind can be absolutely life changing and devastating. This is not only true for the patient themselves but also for their loved ones. Many of the treatments can be difficult on the body and certain cancers carry with them lower chances of survival, especially if caught late.
Some of the most common concerns with cancer and mental health are anxiety and depression, with social isolation as a result of cancer being a risk factor for worsening mental health.
Many cancer patients experience fear, uncertainty, anger, and disbelief after a cancer diagnosis. There can be a sense of “why me” or “did I do something to deserve this?” This can be especially true for cancers such as lung cancer, which are often related to smoking. However, it is important to understand that no one deserves to get cancer and that doctors are still unsure as to why some people develop it while others don’t.
Because of the serious nature of a cancer diagnosis, it can be difficult to talk to others about it. This can help contribute to isolation and loneliness. Sometimes cancer patients avoid talking about it out of fear of making others uncomfortable and sometimes it’s because they themselves don’t want to talk about it. It can be helpful to broach the topic with those closest to you just to get their support, if you’re comfortable with it.
All the feelings someone could have around a cancer diagnosis are perfectly normal. There is nothing inherently wrong with feeling anxious, sad, angry, or any other negative emotion as a result of a diagnosis of this kind. However, when those feelings start to make life more difficult or are getting in the way of quality of life, it’s time to reach out for more support.
When to Reach Out
Some mental health disorders can be difficult to distinguish from symptoms of cancer or side effects from treatment. For example, depression. Sadness from a cancer diagnosis is perfectly normal and those feelings will wax and wane over time. Depression, however, is much more serious and could require treatment for the best outcomes.
Signs to look out for:
Fatigue
Changes in appetite
Weight loss or gain
Changes in sleep patterns
Irritability
Feeling hopeless
Feeling worthless
Extreme levels of guilt (out of proportion)
If you feel you may want to harm yourself or are thinking of killing yourself, reach out to your care team ASAP to get help with these feelings. There are many options available for help.
The standard treatments for depression are something we’ve covered in our blog post about major depressive disorder. However, it is important to know that when it comes to cancer and mental health, one needs to consider the specific ways in which depression can impact treatment and quality of life and how cancer can contribute to MDD.
Taking care of mental health is associated with better mental health outcomes, possibly because of the likelihood of adhering to treatment and being open to learning more about the diagnosis and what can be done. Being more proactively involved in your treatment plan can make a difference for long-term outcomes.
How Does Cancer Contribute to Depression?
There are many things about a cancer diagnosis that can impact the likelihood of developing depression. One of the major things is the sense of loneliness and feeling like there’s no one you can open to. It’s incredibly isolating to feel as if you have to hide large parts of yourself from loved ones.
Other factors include:
Body image (self conscious because of bodily changes)
Guilt (“Did I do something for this to happen?”)
Change in daily activities and plans
Change in energy levels
Pain
The fear of dying
Anxiety and panic due to uncertainty and fear
Fear of cancer coming back after treatment
Fear of what will happen to family
Anxiety over medical costs
Not being able to work
The need for others to help care for them (loss of independence)
Long hospital stays
It is worth mentioning that these things can also contribute to worsening mental health of the loved ones of a cancer patient. If someone in your life has been diagnosed with cancer and you feel as if you may be becoming depressed, reach out to someone for more support.
What Can Help Support Mental Health?
There are many different things someone can do to help support or improve their mental health after a cancer diagnosis. With cancer and mental health support, it’s important that your cancer care team is part of some of these choices. Depending on your health and needs, some options may not be suitable, so get guidance from your care team before making any major changes.
Keeping to your normal routine within reasonable limitations
It can also be helpful to ask the care team where you go for appointments or treatment about what options they have at the facility to help support cancer and mental health together. It could be that there are options you’re not even aware of that are there!
Things to ask about:
Therapy dogs at the facility you attend for treatment
Counselors at the facility you attend
Social workers who can connect you to counselors, especially those who specialize in the mental health needs of cancer patients
Cancer can be a life changing diagnosis, especially if caught in the later stages. However, people are living longer and with higher quality of life even with advanced cancer than they ever have before. While all feelings around cancer are valid, you don’t have to suffer with poor mental health, too. Make sure to seek out help, whether you’re the patient or a loved one. When it comes to cancer and mental health, you have options to take care of yourself and support the best quality of life for yourself.
In a previous blog post we’ve talked about major depression with a seasonal pattern, better known as SAD. That post was specifically meant to bring awareness to the summer pattern, as it’s less well known. However, this post is for the more common pattern of SAD, which is typically experienced in the fall and winter. This post will also touch on the winter blues, which while similar, is not the same as seasonal depression!
Depression or the Winter Blues?
A lot of people use these terms interchangeably, but technically there is a difference. For most people, the coming of winter signals the end of a lot of things. We don’t spend as much time out of the house doing things, we find ourselves sleeping more, and often we find ourselves eating more. It doesn’t help that winter is packed with a lot of stressful holidays that can be very difficult for some people. All of this can contribute to just generally feeling a bit more down during the winter than usual. Generally, this doesn’t really get in the way of functioning or enjoyment of life.
Seasonal depression, however, is different. A depression diagnosis implies, to some extent, an impact on functioning and enjoyment of life. It goes beyond just a little extra down to feeling quite sad, maybe hopeless, and having a more difficult time enjoying usual activities. That difficulty finding enjoyment with usual activities can also come across as having difficulty concentrating on things like reading, watching TV, or other activities that were not difficult for the person to do before.
Often with winter pattern depression, we see people eat much more than usual, especially high carbohydrates foods. They often sleep much more than normal which gets in the way of doing other activities.
People will also socially isolate. Poor weather and a lack of outdoor activities makes social isolation much easier in the winter than other times of year. It’s not unusual to not want to go out when it’s cold and uncomfortable out. However, for people with SAD, this is often hiding the bigger issue in that the isolation is being fueled by depression.
What can we do? Winter blues.
The general idea of trying to stay on top of the winter blues is pretty similar to SAD. Self-care is one of the biggest things that can contribute to feeling better during the winter months. Now, depending on if you’re experiencing the winter blues or seasonal depression, some aspects of this self-care could look quite different. But the general idea is very similar.
For the winter blues, especially, it’s important to keep as normal a routine as possible. A lot of the general down feeling we get from winter comes from the disruption in our routines and activities we love. If you like being active, try finding a way to make outdoor activities more comfortable for you in the winter or find a new indoor activity to try instead. Try continuing with your regular socializing and keep yourself to a consistent sleep schedule. It can be hard to want to stay awake until your normal sleep time of 10pm if it gets dark at 4pm. For many of us, our brains are partially wired to associate sunset with getting ready for bed!
General mindfulness can also be very helpful. The self-awareness and insight that comes from practicing mindfulness can help us stay ahead of these kinds of feelings. Often we can stop a cycle from progressing further if we notice it in the beginning stages. Mindfulness can help with that!
Of course enjoy all those holiday specialities you love. There’s no reason not to eat your favorite dessert but also make sure to keep eating balanced, nutritious meals. When we feel better physically, it can help boost how we feel mentally, too!
Get out and enjoy some vitamin D! We get it from the sun and while there’s less of it available in the winter, we can still get it by having short periods of time outside. Don’t just take a supplement without doctor’s guidance, though. Not everyone needs to supplement vitamin D!
What about for SAD?
For seasonal depression, all of those tips above are great. They may be difficult to keep up with, as major depressive disorder can be pretty disruptive to people’s lives sometimes, but it’s important to try. Something that could help is to also coordinate with your care team to start an antidepressant (or increase the dose) temporarily a few weeks before your symptoms usually begin. With SAD, it can help to have that little bit of extra help, chemically, to get through the worst of the symptoms. This has been found to be a pretty effective treatment for SAD. Towards the end of when your usual symptoms are present, you can discontinue the medication or go back down to your normal dose (again, all with your care team’s guidance).
Something else that can help is therapy. Cognitive behavioral therapy (CBT) is one of the most well known forms of therapy these days. Most importantly, there is a form of it that has been specially designed for seasonal depression. CBT-SAD has been shown to be an effective treatment for SAD, both winter and summer, and can make a big difference for how people experience these seasons.
What else should we know?
We know a lot more about how the winter tends to affect people than the summer. And to an extent, it is socially normal and expected that winter will bring with it some form of feeling down. However, if you’re struggling with keeping up with your daily routines and you feel you need help, reach out to a doctor or a therapist. Even if you just need to talk to someone during the winter, it can really help.
Winter can be dark and dreary, but we don’t have to feel that way all the time ourselves.
How often do you beat yourself up mentally over mistakes, big or small? If you’re like most people, the answer is “at least sometimes”. For some people, it’s more often. And for others, it’s all the time. The problem with this type of approach to things is that it often doesn’t do much other than make us feel worse. Self-compassion, however, can be a good alternative to this reaction to mistakes, failings, or bad things that sometimes just happen to us.
What is Self-Compassion?
In the most simple of terms, self-compassion is kindness and understanding that you extend to yourself. The type of comfort you would give to a friend, even in the face of a serious mistake, would be the same comfort you would give to yourself through self-compassion. It’s care that you give to yourself in moments of pain or suffering, or even fear through acceptance of the situation as it is.
According to Dr. Kristen Neff, an expert on self-compassion, self-compassion is made up of three main components: self-kindness, common humanity, and mindfulness.
Self-kindness involves supporting ourselves with warmth and comfort through difficult moments we may otherwise be self-critical during. We approach ourselves with a helpful mindframe instead of a cold one. This sometimes is the most difficult part of self-compassion because many of us are actively taught to be very critical of our mistakes.
Common humanity is the understanding that we are not alone and that many people in the world throughout time have dealt with these situations and feelings. Often, when something bad happens to us, we can feel as if we’re the only ones who could have such poor luck. Or that maybe no one could possibly understand how badly we feel about something. Recognizing that others suffer, too, can help us put things into perspective. This is not the same as minimizing or invalidating our feelings by saying “well, other people have it worse so I should suck it up”. It’s saying to ourselves, “other people have dealt with this, too, and I’m not alone in these feelings”.
Mindfulness encourages us to pause and look at the situation through a different perspective. It involves approaching things with acceptance and turning our pain into something more productive through this acceptance. It makes us stop and think about things without attaching moral judgements on them.
What is it NOT?
Self-compassion is not the same as being indulgent, flippant, or selfish. It does not involve just shrugging off mistakes and the harm they could be causing to ourselves and others. Self-compassion doesn’t mean refusing to feel badly about something or refusing to take accountability for it. There is a misconception that being kind to ourselves in moments of difficulty, even if we are the cause of the difficulty, will lead us to being lax and not working to fix things.
People often assume that being hard on ourselves and being super critical is how we push for change. However, that’s counterintuitive. Shame is very rarely an effective motivator for people and often has the opposite effect. We don’t want to handle issues that we’re ashamed of and we want to avoid those feelings as much as possible. Being self-critical can also make us feel much worse than the initial event did. This can make us disheartened and also cause us to lack motivation entirely.
Self-compassion, however, encourages us to take responsibility, accept that the situation is what it is, and understand that we are not failures or bad people just because we made a mistake or something bad happened. It asks that we speak to ourselves gently, like we would with a friend.
What would you say to a loved one? Often, the things we say to ourselves are things we would never say to our friends, partners, children, or anyone else we care about. So why do we think it’s okay to say them in our heads? Self-compassion encourages us to use the same approach to ourselves that we would with a loved one, even when they mess up.
How do we Practice Self-Compassion?
Accept that you make mistakes! This can be really difficult to do, but it’s the first step to really practicing self-compassion. It also makes it easier to talk to yourself in a more gentle, kind way.
Work on self-awareness of inner dialogues. A lot of the time, our responses and internal dialogue are based on deeply ingrained beliefs taught us to us by society, friends, and family. Becoming aware of what our self-talk really looks like is an important aspect of turning it into something kinder.
Work on mindfulness! It’s a big part of the process because so often, we just rush from moment to moment and thought to thought. We have a hard time living in the right now, especially if right now is hard or painful. Sitting with those feelings, however, is important. It’s also important to understand that these feelings are temporary.
Want to know more? Check out Dr. Kristen Neff’s guided practices on self-compassion! Her work into self-compassion has really broadened our understanding of it and her website is full of great resources for those looking to know more or get a starting point.
It can be hard to get started on this sort of thing on your own. If you feel your negative self-talk is having a detrimental effect on your life and you’d like to work on it, consider reaching out to a therapist. Often, they can help with gaining insight and practicing mindfulness that can help turn self-criticism into self-compassion.
We spent the previous two posts discussing sleep disorders. However, what about those who need a bit more help getting better sleep but don’t have a diagnosed sleep disorder? Something that can help is practicing good sleep hygiene.
What is Sleep Hygiene?
Sleep hygiene is essentially a set of behaviors that someone does to try and promote good sleep. For example, this could be something like having a set routine every night at the same time as a way of triggering your brain to know that it’s time to start winding down for sleep. It can also be how you use your room and the temperature you set it to. Not only this, but sleep hygiene can involve daytime habits as well that can pay off later on for better sleep overall.
The reason practicing good sleep hygiene is so important is because it can help you really get into the habit of taking care of and prioritizing your sleep. Many of us just don’t get enough sleep and often the sleep we do get isn’t the greatest quality. Lack of sleep can contribute to anxiety, depression, irritability, and can even make some tasks, like driving, more dangerous. Thinking about your sleep routine and other habits can help you pinpoint where things may be going wrong and getting in the way of the best sleep you could be having.
Of course, as we know, there are things out of our control that can interfere with good sleep. Sleep disorders can make it difficult to sleep regardless of your sleep routines and at that point you would need the help of a sleep professional (like a doctor who specializes in sleep disorders) or a therapist, depending on what exactly is keeping you from being able to sleep well. Therapy can also help if you’re finding you’re having a hard time in implementing routine changes.
In our previous post, we discussed three common types of sleep disorders, their symptoms, and treatments. There are over 70 known sleep disorders that are recognized though some say there could be more than 100. Often, sleep disorders are broken down into six main types: circadian rhythm sleep-wake disorders, insomnia, hypersomnia disorders, parasomnias, sleep-related breathing disorders, and sleep-related movement disorders. In our previous post, we talked about circadian rhythm sleep-wake disorders, insomnia, and hypersomnia disorders. This post will be dedicated to parasomnias, sleep-related breathing disorders, and sleep-related movement disorders.
Parasomnias
Parasomnias are incredibly common and most people experience at least one of them during their lives. They are considered unwanted experiences during sleep that are not controllable by the person experiencing them. Parasomnias are not well understood as to what exactly causes them or any particular risk factors overall, but mood disorders and substance use seems to increase risk for some parasomnias but not others. Many parasomnias resolve on their own over time, which is especially true for children. Parasomnias are very common in children but as they age, the sleep disorders tend to disappear.
Sleep eating disorder and hallucinations
Sleep eating disorder is a parasomnia disorder that involves a person eating while sleeping. This is different from someone who eats excessively after bedtime while aware. An individual experiencing this parasomnia is not aware of what is happening. This can be distressing for the person experiencing it because of the lack of awareness or memory around the event.
A very common sleep disorder is hallucinations that happen right when falling asleep or as someone is waking up. Usually these are visual hallucinations but they can also be sensory or auditory hallucinations. They can sometimes be distressing for the person experiencing them, especially if they occur with sleep paralysis. Often these hallucinations are so vivid it is difficult for the person experiencing them to be able to tell if they are dreaming or not.
Sleep paralysis and night terrors
Sleep paralysis is another common sleep disorder that often is paired with others, like sleep hallucinations and narcolepsy. This disorder can be very distressing for the individual because it involves an inability to move the body or speak while being aware and conscious. If paired with hallucinations, it can be especially upsetting. The paralysis goes away on its own as the person wakes more and more but sometimes an individual can speed this process up by making extreme efforts to move.
Night terrors, or sleep terrors, are a well-known sleep disorder that involves the person sitting up in bed, while asleep, and screaming or thrashing around. Often, the person will be very difficult to wake up and may not recognize where they are or who is around them. When they do wake, many individuals are very confused and disoriented and may still be afraid. Very often, they do not remember what they were dreaming about or what caused the night terrors.
Sleep Walking
Sleep walking is a commonly occuring parasomnia in which the individual will leave bed while asleep and walk around. Sometimes this can just involve walking around the home but can sometimes be dangerous, for example if the person gets into a car to drive or if there is an open window on a second or higher floor. On occasion, the person can end up doing things that are not appropriate within their context (such as urinating in a closet). Often, it is better to gently guide the individual back to bed instead of trying to wake them up. This is especially true for children. If you know a child in your home sleepwalks, make sure that all doors and windows are locked in order to keep them from leaving the home while sleepwalking.
Sleep Apneas
Sleep-related breathing disorders are something many people have heard about but perhaps do not associate them with being sleep disorders. Obstructive sleep apnea is the most well-known by the general public, though there are others, such as central sleep apnea or infant or child sleep apnea. Groaning, snoring, and other related noises during sleep are also considered sleep-related breathing disorders when they occur on their own. In this post, we’ll focus on obstructive sleep apnea as it’s the most likely one that people will encounter.
Obstructive sleep apnea is a disorder in which there is an anatomical issue that is obstructing the airway of an individual while they sleep. This can be excess tissue in the neck or throat, a tongue that falls back, or enlarged tonsils. These obstructions cause the person to temporarily stop breathing in their sleep. This is often characterized by snoring, gasping, choking noises, or being woken up by the inability to breathe. However, the person usually does not remember waking up due to this. More commonly, it is the bed partner who notices these symptoms and encourages the individual to pursue treatment. It can happen either a few times a night or even a few hundred in extreme cases.
It is diagnosed by a sleep doctor, usually with an at home sleep apnea test or in a sleep lab.
Obstructive sleep apnea can have very negative consequences on an individual’s health, which highlights the importance of early diagnosis and treatment. These are related to the lack of oxygen that the person experiences during the night and include: high blood pressure and higher heart disease risk, depression, stroke, and diabetes.
Symptoms of Obstructive Sleep Apnea
Symptoms of obstructive sleep apnea include:
Loud or frequent snoring
Silent pauses in breathing
Choking or gasping sounds
Daytime sleepiness or fatigue
Unrefreshing or restless sleep
Insomnia
Morning headaches
Waking frequently during the night to go to the bathroom
Difficulty concentrating
Memory loss
Decreased sexual desire
Difficulty maintaining an erection
Irritability
There are effective treatments for obstructive sleep apnea. The first line treatment for this disorder is the use of a continuous positive airway pressure (CPAP) machine. This is a machine that uses gentle bursts of air to keep the airway open while the individual sleeps. If the CPAP is not a good fit for an individual, a doctor may recommend the use of oral appliance therapy which is a device that fits in the mouth that holds the tongue in place and keeps the airway from collapsing and looks like a retainer or sports guard. For very severe cases that do not respond to these treatments, surgery may be used to remove some of the excess tissue that is contributing to the obstruction.
Sleep Related Movement Disorders
The final type of sleep disorder we’re going to discuss is the category of sleep-related movement disorders. The most well-known of these is restless leg syndrome, or RLS. RLS is characterized by an urge to move the legs or an uncomfortable feeling in the legs while lying down or resting. It often makes it difficult for someone to fall asleep. Some people describe the feeling as a crawling sensation in the legs. This can also make it difficult for someone to sit down for long periods of time, such as in a car or at work.
RLS very commonly starts after the age of 40, but can affect people of any age. It is twice as common in people assigned female at birth. Some causes of RLS are low iron levels, diabetes, pregnancy, some medications, and can be sometimes linked to kidney problems (such as kidney failure).
Sleep starts are a sleep-related movement disorder that many people do not think of when they think about sleep disorders. It’s something that almost everyone will experience at least once in their lives. Most people compare it to a sense of falling while either going to sleep or waking up. Sleep starts or sleep jerks are caused by the major muscles in the body suddenly contracting all at once. This is usually not a problem for many people but for those who experience it often, or who become anxious due to sleep starts, this may contribute to insomnia. It can also sometimes cause injury if the individual hits a piece of furniture or a bed partner during a sleep start or jerk. They rarely need treatment or management but if they are causing distress or issues for the person experiencing them, they can be managed by reducing stress, making sure to get enough sleep, and avoiding stimulants (like caffeine).
One of the best ways of dealing with many sleep disorders or to just get better sleep in general is to focus on sleep hygiene and getting a regular bedtime routine. Our next post will discuss the ways in which you can contribute to having better sleep!
Feel you may need help with a sleep disorder? Look at our list of clinicians and see if you’d like to make an appointment with us!
