5 Positive Steps to Take After a Bipolar Disorder Diagnosis

Receiving a bipolar diagnosis is never easy. While it might be a relief to finally have answers to your symptoms, behaviors, and mood episodes, the diagnosis can cause even more questions. Will you be stigmatized by society? Will you lose your identity when you go through treatment? Is there a way to heal? Here are the first steps you can take.

1. Read up on Bipolar Disorder

Understanding your disorder will help you control it. Learn about how and why the brain cycles between depression and mania (or hypomania) and the symptoms that go along with these shifts. Look for psychiatric and psychological resources online and in print. And while books written by mental health professionals are always good to have, consider also reading memoirs by people who actually have bipolar disorder. You might get started with An Unquiet Mind by Kay Redfield Jamison, Another Kind of Madness by Stephen P. Hinshaw, or even the graphic memoir Marbles written and illustrated by Ellen Forney. These personal stories can hold up a mirror to your own life—getting inside the minds of other people who have gone through what you’re experiencing will help you make more sense of your disorder.

2. Enlist Your Loved Ones

You might not be ready to tell the entire world you’re bipolar just yet. But look around at your friends and family: are there a few close people you can trust? It’s important right now to not feel isolated. Confide in your loved ones and don’t be afraid to ask for help. You might even have people in your inner circle who have gone through the same thing. Maybe somebody close to you also has bipolar disorder, anxiety, depression, post-traumatic stress disorder, or an eating disorder, meaning they can give advice and share their stories too. Being honest about your struggles can make your bonds even stronger.

3. Be Kind to Yourself

The road to healing after a diagnosis is a long one. It’s okay to feel confused, frustrated, angry, ashamed, or hopeless sometimes. You’ll have good days and bad days. What’s most important is that you make a conscious effort to understand your disorder and how it affects you presently and has in the past. Make sure to keep looking forward and practice self-compassion along the way. You don’t need an inner voice criticizing yourself for not getting treatment earlier, or having setbacks along your healing journey. Celebrate your successes—get excited when you consistently take your medication, go to therapy, or eat healthier.

4. Start New Healthy Routines

A diagnosis can be destabilizing. Chaos is terrible for mood disorders—when you feel unmotivated to keep to a routine and take care of your mental health, you might slip into depression or mania. Focus on getting regular sleep, eating balanced meals, and cleaning up your living space. Be sure to get exercise regularly, especially if that means being outside. When you’re stressed, get into a practice of mindfulness and deep breathing to calm your nerves. You might also find space in your routine to attend support groups, either in-person or online. Having a consistent obligation that connects you with other people is good for your mental health.

5. Create a Treatment Plan

To manage bipolar disorder, you need a long-term treatment plan developed by you and a mental health professional. Together you can decide on the appropriate mood stabilizers, antidepressants, or anti-psychotics to treat your disorder. It’s also important to include therapy in your treatment plan. Connect with a therapist who specializes in bipolar disorder. You may benefit from cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), interpersonal therapy (IT), or another approach. With a long-term view, you’ll set yourself up for success even in the face of a bipolar diagnosis.

To find out more about how therapy can help those with a recent bipolar diagnosis, please reach out to me. Book a consultation today and we’ll get started on a management plan that works for you.

Can Ketamine Assisted Psychotherapy Help Manage Depression?

Ketamine was originally developed as an anesthetic and has been used in medicine since the ’60s. But over the past two decades, researchers have discovered that ketamine is also able to relieve depressive symptoms when given in controlled, therapeutic doses. Unlike traditional antidepressants, which often take weeks to show results, ketamine can alleviate depressive symptoms within hours. This has led to growing interest in its potential as a treatment for depression, especially for those who have not responded well to more conventional therapies and medications.

How does ketamine affect the brain?

Depression is often associated with a reduction in the availability of neurotransmitters like serotonin and dopamine. Ketamine acts on a different neural pathway—the glutamate system. Glutamate is a neurotransmitter involved in many brain functions, including mood regulation and cognitive flexibility.

Ketamine is believed to stimulate the production of glutamate, which in turn promotes the growth of new neural connections in the brain. This process can help “reset” the brain’s neural circuitry, which reduces depressive symptoms quickly.

Ketamine also appears to reduce the activity of the brain’s default mode network (DMN), a system associated with self-referential thinking. Overactivity in the DMN has been linked to rumination, a common symptom of depression where someone gets trapped in negative thought patterns. By quieting this network, ketamine may help break this cyclical thinking.

What is ketamine-assisted psychotherapy?

In this approach to therapy, ketamine is used not as a standalone drug, the way we might use traditional antidepressants. The idea is that the altered state of consciousness induced by ketamine can open up new avenues for therapeutic exploration. This allows patients to access and process emotions and memories that might otherwise be difficult to confront.

Ketamine-assisted psychotherapy typically involves a series of sessions in which the patient receives a controlled dose of ketamine. The patient then has a therapy session with a licensed psychotherapist who’s trained in working with altered states of consciousness.

These sessions can be deeply introspective and emotionally intense, but they also offer an opportunity to heal deep wounds. Patients report feeling more open, less guarded, and more able to explore painful emotions without the overwhelming sense of fear or despair that might accompany them in a sober state. For many, this allows for breakthroughs in therapy that can lead to long-lasting changes in their mental health.

Who can benefit from ketamine-assisted psychotherapy?

Ketamine-assisted psychotherapy is not for everyone. It’s generally recommended for people with treatment-resistant depression, meaning they have tried at least two other antidepressants without significant improvement. Those with conditions like post-traumatic stress disorder (PTSD), anxiety, and even chronic pain can also benefit from this treatment.

However, it’s important to note that ketamine is a powerful drug and is not without risks. While it’s generally well-tolerated in a controlled clinical setting, some patients may experience side effects such as dissociation (feeling disconnected from reality), nausea, or an increase in blood pressure. Ketamine also has a history of being used recreationally, and there’s potential for abuse if not administered responsibly.

What does the research say?

The research on ketamine for depression is still in its early stages, but the results so far are promising. Several studies have shown that ketamine can rapidly reduce depressive symptoms, even in patients who have not responded to other treatments. In some cases, the effects of a single ketamine session can last for several weeks, though most patients require a series of treatments to maintain the benefits.

Finding a Therapist

Ketamine-assisted psychotherapy should only be conducted under the supervision of trained medical professionals in a clinical setting. If you have treatment-resistant depression and you’re looking for another method, consult a therapist licensed in ketamine-assisted psychotherapy today.

To learn more about how ketamine can help those with treatment-resistant depression, please reach out to us.

Understanding the Thought Process of a Bipolar Person

Bipolar disorder is a mood disorder characterized by shifts from periods of highs (mania or hypomania) to lows (depression). Media and popular culture is full of misconceptions about people with bipolar disorder. Understanding the thought process of someone with bipolar disorder is important not only for those living with the condition but also for their loved ones, friends, and colleagues.

What is Bipolar Disorder?

Bipolar disorder has several classifications including bipolar I, bipolar II, and cyclothymic disorder. While the symptoms between the three can vary widely, the main features of bipolar disorder are manic or hypomanic episodes and depressive episodes, which can last for days, weeks, or even months.

• Mania involves a period of abnormally elevated mood, energy levels, and activity. During mania, a person may experience grandiose thoughts, a decreased need for sleep, rapid speech, racing thoughts, impulsivity, and risky behavior.

• Hypomania is a less severe form of mania. The symptoms are milder and might not significantly impair daily functioning, but are still noticeable.

• Depression in bipolar disorder is similar to major depressive episodes, characterized by feelings of sadness, hopelessness, fatigue, and a loss of interest in activities and social interactions.

The Thought Process in Manic Episodes

During manic episodes, a person’s thoughts can race at an incredible speed. Their mind will jump from one idea to another without much logical connection. This rapid thought process is known as the “flight of ideas.” It can make a conversation with someone experiencing mania feel chaotic and difficult to follow.

A common feature of mania is grandiosity. People with mania may believe they are invincible, capable of extraordinary feats, or destined for greatness. These thoughts can drive them to take on big projects or make impulsive decisions that seem brilliant at the moment but are likely unrealistic. For example, someone in a manic state might decide to start a new business, quit their job, or engage in risky financial investments without considering the consequences.

The Thought Process in Depressive Episodes

On the other end of the spectrum, depressive episodes are a stark contrast to mania’s energy. During depression, thoughts can become slow, dark, self-critical, and pessimistic. The mind might be consumed with feelings of worthlessness, guilt, and hopelessness. Unlike the creative, expansive thoughts of mania, depressive thoughts get stuck on past failures and perceived flaws.

A person with bipolar disorder often experiences cognitive distortions during a depressive episode. These are irrational thoughts that reinforce negative thinking. For example, they might see situations in black-and-white terms, believing that if they are not perfect, they are a complete failure. Another common distortion is catastrophizing, where they may imagine the worst possible outcomes of a situation, no matter how unlikely they are.

The Role of Mixed Episodes

Some people with bipolar disorder may have mixed episodes, meaning they have symptoms of both mania and depression at the same time. This can lead to a distressing, confusing thought process where the person feels both agitated and hopeless simultaneously. The co-occurrence of high energy with depressive thoughts can increase the risk of dangerous impulsive behaviors, including self-harm or suicide.

Supporting Someone with Bipolar Disorder

Understanding the complicated emotional and mental processes is the first step to helping your loved one. You can also:

• Continue educating yourself about bipolar disorder, including its signs, causes and treatments.

• Allow the person to express their thoughts and feelings without interrupting or dismissing their experiences.

• Be patient and compassionate as they move through their mood swings.

• Encourage them to seek professional help.

Bipolar disorder requires treatment from mental health professionals. Typically, after diagnosis, a person will need to take mood stabilizers or other medications and seek psychotherapy.
To learn more about how to support those with bipolar disorder, please reach out to us.

The Benefits of Ketamine Assisted Psychotherapy for Depression

Depression can be an all-consuming mental health condition. You might be more familiar with its traditional treatment methods. Most people respond well to prescription antidepressants, therapy, and lifestyle changes. However, some struggle with treatment-resistant depression, meaning the go-to options for healing depression don’t work for them. In recent years, ketamine-assisted psychotherapy (KAP) has become a viable option for those who need less conventional treatments for their depression. Here’s how it works and how you can benefit.

How Ketamine Changes the Brain

Ketamine, originally developed as an anesthetic in the 1960s, has gained attention in the psychiatric field for its antidepressant effects. Ketamine works by modulating the brain’s glutamate system, a neurotransmitter involved in mood regulation, cognition, and neural plasticity. By blocking NMDA (N-methyl-D-aspartate) receptors, ketamine helps release more glutamate, which in turn stimulates the growth of new neural connections. This neuroplasticity is thought to be behind ketamine’s rapid antidepressant effects. It helps “reset” the brain and form new neural pathways that may have been lost during long-term depression.

What Happens in a KAP Session?

During a KAP session, patients are typically given a low dose of ketamine under the careful supervision of healthcare providers. It can be ingested through a nasal spray, oral tablet, or IV infusion. Since the dissociative effects of ketamine can lead to altered states of consciousness, the patient should feel more open to introspection and processing their feelings. After the infusion, a trained therapist guides the patient through their ketamine experience by helping them navigate their thoughts and emotions. This is called integration—the therapist opens a dialogue to make sense of the patient’s insights that arose during their ketamine infusion session. They can then go on to integrate these discoveries into their daily life through better communication, healthier coping skills, and a stronger sense of self.

Benefits of KAP

• It strengthens neural pathways

The neuroplastic effects of ketamine help the brain form new connections. This builds resilience against future depressive episodes (and may stop their recurrence altogether). The therapy part of KAP also helps a person understand their emotions, develop healthy coping skills, and process negative experiences. These all give the brain a greater ability to deal with life’s stressors and stay mentally healthy.

• It works quickly

Compared to other medications and therapies, KAP can alleviate symptoms of depression quite fast. Many patients report feeling relief within a few hours rather than a few weeks or months. For those who have felt trapped by their depression, this fast-acting treatment can be life-changing.

• It reduces suicidal ideation

For those at a high risk of suicide, ketamine can be a great treatment option. Some antidepressants have suicidal ideation as a potential side effect (and can take weeks to begin working). Since ketamine works quickly and doesn’t have the potential for suicidal side effects, ketamine therapy can be lifesaving.

• It encourages big breakthroughs

Some people may take months or years to work up to certain topics during traditional therapy. However, the ketamine-induced altered state of consciousness can help a person access and process feelings and memories that may be difficult to deal with in a typical therapeutic setting.

Potential Drawbacks

While KAP has many benefits, it’s important to recognize that it’s not a one-size-fits-all solution. Ketamine does have side effects and potential drug interactions, so it may not work for people on certain medications. Also, it should only be administered by qualified professionals in a controlled setting, since ketamine has the potential for misuse and addiction.

Are you living with treatment-resistant depression?

If you’re one of the many people who haven’t found the right treatment for your depression, you still have options. To try KAP, talk to a licensed therapist trained in ketamine therapy. Together, you can discuss a treatment plan and determine whether KAP is right for you.

To find out more about the benefits of ketamine-assisted psychotherapy for those with depression, please reach out to me.

10 Tips to Reduce and Manage Anxiety

Anxiety affects millions of people worldwide. In our fast-paced society, we often promote behaviors that actually increase anxiety. However, there are small steps you can take to help combat this condition. Here are ten concrete steps you can take toward managing your anxiety responses.

1. Practice Mindfulness

Study after study has shown how effective mindfulness can be against anxious thoughts. It helps you focus on the present moment instead of worrying about the future or past. Start with just a few minutes each day, using guided meditation apps or focusing on your breath. Allow your thoughts to pass through you and simply notice them. Focus on your bodily sensations. Over time, regular mindfulness practice can rewire your brain to respond more calmly to stress.

2. Stay Active

Exercise is one of the most effective natural remedies for anxiety. Physical activity releases endorphins, which are our natural mood elevators. Aim for at least 30 minutes of moderate exercise, such as yoga or jogging, most days of the week. An even better practice is to get outside into nature by hiking, walking in the park, or visiting nature preserves. Breathing fresh air and being part of the natural world will ease your mind.

3. Eat Healthy

A balanced diet rich in fruits, vegetables, lean proteins, and whole grains can help stabilize your mood and energy levels. Avoid too much caffeine and sugar, which can make anxiety worse. Instead, choose foods rich in omega-3 fatty acids, such as salmon and walnuts, which have been shown to reduce anxiety.

4. Get Enough Sleep

Sleep is crucial for mental health. Establish a regular sleep schedule by going to bed and waking up at the same time every day. Create a calming bedtime routine, such as reading a book or taking a warm bath, to signal to your body that it’s time to wind down.

5. Limit Alcohol Intake

While it may be tempting to use alcohol to calm your nerves, it can actually increase anxiety over time. Alcohol can disrupt sleep and affect your mood. Reducing or eliminating alcohol from your life can significantly reduce your anxiety.

6. Practice Deep Breathing

Deep breathing exercises can quickly reduce anxiety by helping you focus on your breath and relax your body. One effective technique is the 4-7-8 method: inhale deeply for four seconds, hold for seven seconds, and exhale slowly for eight seconds.

7. Keep an Active Social Life

Spending time with friends and family can provide emotional support, reduce feelings of isolation, and improve your mood. Make an effort to maintain regular contact with loved ones, whether through in-person visits, phone calls, or video chats.

8. Break Up Your Goals

Anxiety can make even simple tasks seem overwhelming. To combat this, set realistic goals for yourself and break larger tasks into smaller, more manageable steps. This way you’ll feel more in control of your goals. Celebrate every accomplishment to build up your confidence.

9. Learn to Say No

Taking on too many responsibilities can increase anxiety and lead to burnout. Recognize your limits and learn to say no when you can. Prioritize your own tasks and focus on what truly matters by setting healthy boundaries.

10. Seek Professional Help

Some people are unable to manage their anxiety on their own. Whether your anxiety is more general or is linked to specific situations (for example, phobias, intrusive thoughts, or obsessions), you may need a consultation with a mental health professional. Your best treatment may include therapy, anti-anxiety medications, or a combination of the two. It’s also important to determine (or rule out) other co-occurring issues, such as trauma. In therapy, you’ll learn the root cause of your anxiety, how to cope with stressful situations, and how to build your resilience.
To find out more about how therapy can help you reduce your anxiety, please reach out to us.

10 Ways to Deal with Bipolar Depression

Bipolar depression can be tricky to manage. For many people, it’s not as simple as taking an antidepressant, since those medications can sometimes trigger a manic episode. Those with bipolar disorder will also likely experience more than one depressive episode. Here are a few ways to cope with your bipolar depression when it occurs.

1. Actively Participate in Your Treatment Plan

Understanding bipolar disorder, its symptoms, and how it affects your life can be the first step toward managing it. Familiarize yourself with the early warning signs of both manic and depressive episodes so you can anticipate them. This knowledge will also help you be consistent with your treatment plan. Work closely with your doctor to monitor your medications. Aim for regular check-ins to observe your moods and adjust your prescriptions if you’re having unpleasant side effects.

2. Stick to a Routine

Give yourself the stability of a daily routine to keep you from slipping away from your treatment plan. If necessary, write down all your tasks for each day (including mealtimes, bedtimes, and medications). Setting a routine will help you be accountable and motivate you to take care of yourself.

3. Get Enough Sleep

Not getting enough sleep can trigger a manic episode (or be a sign you’re entering one). Sleeping too much can be a sign of depression. Practice good sleep hygiene: create a comfortable sleep environment, avoid caffeine and electronics before bed, and try relaxation techniques like reading or meditation.

4. Eat Well

Nutrition plays an important role in your mental health. Try to eat a balanced diet rich in fruits, vegetables, lean proteins, and whole grains. Avoid excessive sugar and processed foods, which can lead to mood swings and energy crashes.

5. Get Regular Exercise

Physical activity naturally boosts your mood by releasing endorphins. Aim for at least 30 minutes of moderate exercise, such as walking, swimming, or yoga, most days of the week. You’ll see benefits with even short bursts of activity.

6. Build a Support Network

Avoid isolation. Even if you feel like withdrawing, make an effort to see and communicate with the people you love. Talk to people about what you’re going through. You might even look for bipolar support groups in your area or online.

7. Avoid Using Alcohol and Drugs

Substances may provide immediate relief from depressive symptoms. However, they’re much worse for you in the long run. They can negatively interact with medications and actively destabilize your mood. It’s important to stick to healthy coping mechanisms instead.

8. Practice Mindfulness

Getting in touch with your feelings and bodily sensations will help you manage your emotions. Try a daily mindfulness practice. Breathe deeply and allow your thoughts to pass through you without judging yourself. Pay attention to your five senses and focus on relaxing your body. These techniques keep you grounded in the present moment.

9. Have an Emergency Plan

With bipolar disorder, it’s important to have a plan in place for when you do start to feel depressive symptoms. Make sure you have your doctor’s contact information on hand and that your prescriptions are all still valid. Have a list of people you trust who can be called in an emergency. You should also have a plan for what to do if you start to experience suicidal ideation or begin self-harming.

10. Seek Therapy

Bipolar disorder can be managed with medication. That said, those with bipolar disorder have a much better prognosis when their treatment plan combines medication and therapy. Psychotherapies including cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), interpersonal therapy, and other approaches are excellent treatments for bipolar disorder. They’ll help you challenge negative thought loops, manage your emotions, and find healthy outlets for stress and anxiety.
To find out more about how therapy can help treat your bipolar depression, please reach out to us.

Thought Processes Associated With Bipolar Disorder

Bipolar disorder is a mood disorder, formerly known as manic depression. It’s characterized by extreme mood swings from high to low that take place over weeks or months. Contrary to popular belief, a bipolar person doesn’t just “switch” from happy to sad in an instant. These mood swings can affect sleep, energy, behavior, judgment, and the ability to think clearly. Each mood episode has several hallmark thought processes, and understanding them can help those seeking treatment through therapy.

Defining Bipolar Disorder

There are four main types of bipolar disorder: bipolar I, bipolar II, cyclothymia, and unspecified types. Bipolar I is defined by periods of mania followed by depressive episodes. Those with bipolar II experience hypomania, which is a milder type of mania, followed by major depressive episodes. Cyclothymia is defined by hypomanic episodes followed by depressive episodes that don’t meet the criteria for major depressive disorder.

When discussing the thought processes associated with bipolar disorder, it’s important to consider whether they occur during mania/hypomania or depression. Each mood episode has its effects on the brain.

Manic and Hypomanic Processes

During manic or hypomanic episodes, a person with bipolar disorder experiences many symptoms, including:

• An upbeat mood

• Increased energy

• Irritability and agitation

• Euphoria

• Increased self-confidence

• Excessive talkativeness

• Poor decision-making (i.e. spending sprees, gambling, risky sexual behavior, increased drug use)

• Heightened creativity

The thought processes during a manic episode are characterized by moving quickly from idea to impulse. A person may experience:

• Racing thoughts

They may feel an overwhelming flood of ideas and thoughts, often so fast that they have difficulty focusing on one thing. This can make it hard to pay attention and finish daily tasks.

• Grandiosity

During mania, one tends to overestimate abilities or importance. During a manic episode, one may believe they’re invincible, hatch unrealistic plans, or think they’re famous. These delusions of grandeur can fuel impulsive, risky behavior.

• Distractibility or Flights of Ideas

A person experiencing mania has increased sensitivity to external stimuli—for example, traffic lights, passing sirens, or ringing phones. These minor distractions can derail their thoughts. They may also believe that these distractions mean something significant.

Depressive Thought Processes

Depressive episodes are the polar opposite of mania. Typical symptoms include:

• Feeling sad or hopeless

• Feeling worthless, guilty, or ashamed

• Tearfulness

• Fatigue

• Slowed speech

• Changes in weight

• Sleep disturbances

• Indecisiveness

• Self-harm

• Suicidal ideation

Thought patterns during a depressive episode tend to make symptoms worse. These include:

• Cognitive distortions

Depression fuels irrational thought loops and errors in judgment. Cognitive distortions include black-and-white thinking, overgeneralization, mind reading, personalization, and catastrophizing. These all involve relying on feelings rather than facts to reach conclusions about one’s self-worth and relationships with others.

• Rumination

A person in a depressive episode may tend to dwell on negative thoughts or past events. Repetitively focusing on mistakes, traumas, lost relationships, and other difficult moments in life only fuels feelings of despair.

Bipolar Disorder and Memory

Studies have recently shown that bipolar disorder can affect working memory. That is the temporary information the brain holds onto to make connections and decisions in daily life. Those with bipolar disorder report changes in their memory during mood episodes, particularly during depression.

Getting Help

If you’ve been diagnosed with bipolar disorder, or you think you may have it, talk to a mental health professional about your treatment options. Bipolar disorder is typically managed through a combination of prescribed mood stabilizers (and sometimes antidepressants) and psychotherapy. With the help of a therapist, you can learn to recognize these thought processes and challenge them. With the right treatment plan, a person with bipolar disorder can live a fulfilling life.

To find out more about how therapy can ease the symptoms of bipolar disorder, please reach out to us.

Quick support for bipolar and depression stuff: quotes!

I intended to have this ready in time for World Bipolar Day, which was March 30. And it’s months late. This is because my brain is often on fire, and when it is, writing words is hard. When you have 5-50 ideas streaming through your head, you struggle to follow one of them. All the ideas feel equally important and then begin to feel utterly unattainable. Eventually, I cycle into more focused productivity. So here I am—getting the brain fire all over again, so I will save exploring this introductory statement for another post, perhaps about the similarities between ADHD, anxiety, and bipolar spectrum or perhaps about racing thoughts, creative ideas, or energy fluctuations. The complexity and subtle nuances of mood disorders simultaneously fascinate me and make me want to punch a wall. How do you reckon with the nuance, cycles, and mood surprises? Quotes can be a start.

Bipolar disorder affects an estimated 5 million adults every year in America and around 40 million globally. Because of the deep stigma and misunderstanding of the illness as well as the illness’s symptoms, many people living with a bipolar spectrum or mood disorder cycle through feeling very alone, confused, hopeless, and overwhelmed. Our thoughts can be our enemies; our decisions can lead to cleaning up lots of messes, and sometimes when in the throes of an ‘episode,’ we do have the insight to look for support. But during Hard Times, support is often difficult to ask for, and we need something now. Getting a moment of reprieve when reading a quote can make the cycle more bearable.

Quotes can be a refuge, giving someone a sense that they are not alone and that others are having similar challenges. Also, it’s hard for some to read complex sentences and passages when in the throes of a mood event. Quotes lean towards simplicity and efficiency.

Not all of the people quoted have/had a mood disorder; although some did/do. Take what you want from the ideas. Notice what resonates. Notice what doesn’t.

Melancholia is the beginning and a part of mania . . . . The development of a mania is really a worsening of the disease (melancholia) rather than a change into another disease. —Aretaeus of Cappadocia (possibly one of the earliest quotes about mood disorders, 30-90 AD)

Diseases have no eyes. They pick with a dizzy finger anyone, just anyone. –Sandra Cisneros, The House on Mango Street

At times, being bipolar can be an all-consuming challenge, requiring a lot of stamina and even more courage, so if you’re living with this illness and functioning at all, it’s something to be proud of, not ashamed of. —Carrie Fisher

Sometimes I sound like gravel, and sometimes I sound like coffee and cream.—Nina Simone

That's the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it's impossible to ever see the end. —Elizabeth Wurtzel

Those who love you are not fooled by mistakes you have made or dark images you hold about yourself. They remember your beauty when you feel ugly; your wholeness when you are broken; your innocence when you feel guilty; and your purpose when you are confused. –Alan Cohen

I have just now come from a party where I was its life and soul; witticisms streamed from my lips, everyone laughed and admired me, but I went away — yes, the dash should be as long as the radius of the earth's orbit ——————————— and wanted to shoot myself. ― Søren Kierkegaard

My own brain is to me the most unaccountable of machinery - always buzzing, humming, soaring roaring diving, and then buried in mud. And why? What's this passion for? ― Virginia Woolf

Anybody remotely interesting is mad in some way or another. ― Steven Moffat

Being bipolar is like not knowing how to swim. It might be embarrassing to tell people, and it might be hard to take you certain places. But they have arm floaties. And if you just take your arm floaties, you can go wherever the hell you want. —Taylor Tomlison

All that I want is to wake up fine. —Paramore

Do not judge me by my successes, judge me by how many times I fell down and got back up again. —Nelson Mandela

Until recently, I lived in denial and isolation and in constant fear someone would expose me. It was too heavy a burden to carry, and I simply couldn’t do that anymore. I sought and received treatment, I put positive people around me, and I got back to doing what I love. –Mariah Carey

If you’re going through hell, keep going. —Winston Churchill

If you know someone who’s depressed, please resolve never to ask them why. Depression isn’t a straightforward response to a bad situation; depression just is, like the weather. —Stephen Fry

In my episodes, I tend to oscillate quickly between hyper anxiety, paranoia, suicidal thoughts and shame … I have been on medication for 5 years, and that initiated a drastic diminish in the intensity and duration of episodes. —Mary Lambert

Madness is to think of too many things in succession too fast, or of one thing too exclusively. —Voltaire

When I am high I couldn’t worry about money if I tried. So I don’t. The money will come from somewhere; I am entitled; God will provide. Credit cards are disastrous, personal checks worse. Unfortunately, for manics anyway, mania is a natural extension of the economy. What with credit cards and bank accounts there is little beyond reach. —Kay Redfield Jamison

It can be a long and difficult road, but mental illness is treatable. There is hope, even when your brain tells you there isn’t. —John Green

You be so high you can shake hands with somebody in the sky. —Champion Jack Dupree

The cruelest curse of the disease is also its most sacred promise: You will not feel this way forever.
― Terri Cheney

But I can hardly sit still. I keep fidgeting, crossing one leg and then the other. I feel like I could throw off sparks, or break a window--maybe rearrange all the furniture. —Raymond Carver

The difference between hope and despair is a different way of telling stories from the same facts.
― Alain de Botton

Nobody would believe what an effort it is to do what little I am able, - to dress and entertain, and order things. ― Charlotte Perkins Gilman

In the lives of the saddest of us, there are bright days like this, when we feel as if we could take the great world in our arms and kiss it. Then come the gloomy hours, when the fire will neither burn on our hearths nor in our hearts; and all without and within is dismal, cold and dark. Believe me, every heart has its secret sorrows, which the world knows not, and oftentimes we call a man cold, when he is only sad. --Henry Wadsworth Longfellow

First, silence makes us pilgrims. Secondly, silence guards the fire within. Thirdly, silence teaches us to speak.—Henri J.M. Nouwen

One of the oldest human needs is having someone to wonder where you are when you don't come home at night. —Margaret Mead

It’s not the load that breaks you down, it’s the way you carry it. – Lena Horne

Isn’t it nice to think that tomorrow is a new day with no mistakes in it yet? – L. M. Montgomery

I'm not bipolar, I've just had a bipolar life foisted upon me.—Unknown

Meanwhile in my head, I’m undergoing open-heart surgery.—Anne Sexton

Anxiety was born in the very same moment as mankind. And since we will never be able to master it, we will have to learn to live with it—just as we have learned to live with storms. —Paulo Coelho

What's been important in my understanding of myself and others is the fact that each one of us is so much more than any one thing. A sick child is much more than his or her sickness. A person with a disability is much, much more than a handicap. A pediatrician is more than a medical doctor. You're MUCH more than your job description or your age or your income or your output. —Fred Rogers

One of the things so bad about bipolar disorder is that if you don’t have prior awareness, you don’t have any idea what hit you. – Unknown

The mania is like wasps under the skin, like my head’s going to explode with ideas. – Alice Weaver Flaherty

Do I fear the sleepless nights? You have no idea how long the dark lasts when you cannot close your eyes to it. – Tyler Knott Gregson

Sometimes, even to live is an act of courage. – Seneca

Suicide too often results from the impulsive nature and physical speed of mania coupled with depression’s paranoid self-loathing. – Unknown

I’m fine, but I’m bipolar. I’m on seven medications, and I take medication three times a day. This constantly puts me in touch with the illness I have. I’m never quite allowed to be free of that for a day. It’s like being a diabetic. – Carrie Fisher

You may encounter many defeats, but you must not be defeated. In fact, it may be necessary to encounter the defeats, so you can know who you are, what you can rise from, how you can still come out of it. —Maya Angelou

Bipolar disorder thinking is always unreasonable and unrealistic. Always. There are no exceptions. So if your normally reasonable partner is being unreasonable, you know that you are dealing with bipolar disorder and not with a personality flaw.
― Julie A. Fast

That’s my messy, disorganized quote bonanza. Someday, I’ll categorize, and for now, it is what it is. Remember, you are not alone! And reach out if you’d like to talk.

Some ways to clean up the mess of stress

Stress can be a trigger that takes us into more anxiety, more depression, more isolation, more avoidance, worse sleep, more anger, and more substance use.

Then, it can be hard to come up for air, assess the situation, problem solve and take action.

Yet we all live with stress, oftentimes lots of stress. So, how can we cope with the inevitable? Here are some ideas:

• Write down what could set off your stress response and what has set it off in the past. Finances? Illness? Relationships? Work?

• Take one of those things you wrote down, reflect on a past event, and consider what you could now do differently to manage how the stressful event impacted you. For example, when my daughter is tired, she screams more and is tough to handle. The combo of when I am also tired, and she is tired equals me fighting back with her as if she is my adversary. I have recognized that our combined tiredness activates the stress response in me. So, I’m trying to breathe deeper when she is tangry (tired+angry), get her into bed as quickly as possible, and then congratulate myself for staying in my parent role.

• Connect with people, animals, nature. Social support is crucial to help with navigating stress. When we can talk with someone about what is stressing us out, and that person validates our stress, it can help not only decrease the stress but allow us to move through the emotional and mood impacts of tension faster.

• Ideas to increase your sense of connection: talk with the check-out person, smile or nod or say hello to a person you pass when going for a walk, consider joining a support group if you are dealing with a mood disorder, anxiety, trauma, etc..… Move your body (connection to your mind/body), go to a pet store, hang out with the animals, and maybe talk with someone there. If there is a social media situation that feels supportive, interesting, or helpful—make a supportive or positive comment.

• Food and beverage choices. Diet can affect our mood. Stress often increases inflammation in the body. Consider adding some anti-inflammatory foods to your eating routine. Omega’s can also help with mood challenges, especially depression. Fish oil and flaxseed oil are great supplements for your coping toolkit. Stay hydrated. Avoid perfection; consider progress.

• Develop trust in yourself that you can handle stress and the inevitability of change. It takes courage to examine what isn’t working with how you deal with your stress response. And then how to tweak what you can. Finding new ways to look at stress and to believe you can handle it is a process. You aren’t alone, even though it can feel like it.

• If things feel really overwhelming and you don’t know where to start, it may be helpful to seek out some therapy or counseling so you aren’t alone in your suffering. You can express your concerns, feel heard, and begin to make choices and take action steps to change your relationship with stress.

I hope some of these ideas help! For more information if I could possibly support, Contact Me.

How to Break the Avoidance-Anxiety Cycle

“The avoidance of suffering is a form of suffering.”

— Paulo Coelho

Anxiety and avoidance often go hand in hand. When you experience anxiety, you may feel a lot of fear, worry, or heightened body sensations about specific situations and the possible outcomes of being in those situations. To cope with these overwhelming feelings, you might resort to avoidance behaviors. These behaviors involve (you guessed it!) avoiding situations, places, or people that trigger, or activate, your anxiety. As time goes on, you may find more and more people, places, and things that activate worry, fear, or a jittery nervous system.

Here's how anxiety and avoidance are connected:

1. Fear Reinforcement: When you avoid situations that bring on anxiety, you can get short-term relief, and this reprieve reinforces your avoidance behavior, making it more likely and familiar to you. So, you may then start avoiding similar situations more often. However, this avoidance prevents you from learning that the situation might not have been as difficult, dangerous, or scary as you believed. That you can survive going to an event alone, that you can get on an airplane. in the long run, turning away from and avoiding strengthens anxiety because you cannot learn to cope with the situation and the thoughts, emotions, and behaviors leading up to the situation.

2. Narrowing of Activities: Avoidance can lead to a narrowing of your life. You might stop participating in activities you used to enjoy or avoid social interactions, ultimately impacting your quality of life. When you become more isolated from the world, you can become depressed, unhappy, and—yes, more anxious.

3. Increased Sensitivity: Avoidance can increase and expand your anxiety triggers. The more you avoid, the more sensitive and fearful you become to those situations, making it even more challenging to confront them in the future. Your brain and nervous system are primed to believe future events are threatening.

4. Cycle of Anxiety: Anxiety and avoidance are a vicious feedback loop. Anxiety leads to avoidance, which provides relief but reinforces the anxiety, leading to more avoidance. Breaking this cycle often requires confronting the feared situations with the help of therapy and gradual exposure. So, what can you do to confront, re-frame, and build your toolkit? Read on…

1. Mindfulness and Deep Breathing: Sometimes, we can only breathe. Breathing exercises can match the intensity of what you are experiencing. For a quick fix, try straw breath: inhale deeply through your nose, exhale with sound, pursing your lips, and imagine you are blowing out through a straw. For a more complicated breathing activity that may stop your spiraling thoughts, try 4-7-8 breaths: inhale for 4, hold your breath for 7, and exhale for 8. Remain focused on the present moment without judgment (mindfulness) via taking action by engaging your mind and body in a breathing activity.

2. Physical Activity: Do as best you can regular physical activity. Exercise can boost your mood and reduce anxiety. It doesn’t have to be intense – even a short walk can make a difference. But sometimes, doing a complicated and/or intense physical activity can engage you more directly in the here-and-now.

3. Healthy Lifestyle: I’m sure you’ve heard it before—maintain a balanced diet, sleep well, and limit caffeine and alcohol intake. All these factors can significantly impact your anxiety levels. Changing your habits takes time. Celebrate the stepping stones! It’s an opportunity to engage in some authentic positive self-talk. ‘Nice work, Amanda. You are worth the effort’.

   Finding what works for you might take some time and experimentation. Contact me to learn more about how I can support you to transform and break apart the avoidance-anxiety cycle.

Things to consider when looking for a psychedelic assisted therapist.

Trigger warning: trauma memory.

It was during one of the first lectures of my psychedelic assisted therapy training program that I had a change of heart. A best selling author was slated to teach, and I was pretty psyched to learn from him. Granted he’s not a psychotherapist, but he is a damn good writer, and I was hoping to soak up new ideas and glean some wisdom. But when his Zoom screen came on, I was reminded that my expectations were different than the realities at hand. His big exposed, unmade, sheets-in-a-ball messy ass bed was the centerpiece behind him. Icky. Shortly into the lecture, his landline starts ringing, loudly; he commented his wife would probably answer it. OK, message received—he’s not going to be my guide or teacher. And because of my history, he didn’t even feel safe anymore—he felt creepy, uncaring, and unprofessional. I imagine his intention wasn’t to have that kind of impact. But it did.

Some people don’t care what their Zoom background looks like, and some don’t care what Zoom background they are looking at. And some people do. Some have, for example, painful memories attached to super messy beds and older men; and then when someone is not expecting to see a triggering image, it can be quite dysregulating, activating what is called an emotional flashback. Then, calming the nervous system takes the priority over learning and listening to a lecture.

So we have to take care of ourselves; honor and agree with ourselves—that our lived experiences can help dictate who we can have as a teacher or guide.

So how does this story connect with finding the right psychedelic therapist? Bottom line—we get to decide what works for us, what isn’t going to work for us. We can choose our teacher, mentor, therapist based on what our current wants and needs are. What may be a good fit for one person, isn’t going to be a good fit for another. What may be a good fit for a certain time in your life and healing, may not be a good fit for another time.

I really can’t stress enough how important it is to find the psychedelic guide, or therapist, you can trust deeply, you feel safe with, and that has what feels like ‘clean’ energy and clear relationship boundaries with you and themselves. Because during the psychedelic journey, we can be more open and less defended. We may feel expansive joy, deep fear; and to have a trusted person with us makes navigating those murky waters attainable.

Below are some ideas to consider when looking for the right person to work with and support you during your psychedelic journey:

• Do you have a person/people who could refer you to a psychedelic therapist, someone they can vouch for? Granted, what could be a good fit for one person may not be for another—and this could be a good place to start your search.

• We have our own responses and feelings to the behavior and choices other people make. When looking for a psychedelic therapist to work with, notice how you feel when you are consulting with them (and it’s a great idea to have a consultation call). Do you feel comfortable-enough talking with them? Do you feel like they ‘get’ your issues or concerns, and respect them? Listen to any initial, ‘wow, I’m excited to work with them’ or ‘hmmm something doesn’t feel quite right’. Trust that!

• Talk with a few psychedelic assisted therapists. That way you can start to get a feel for the different personalities, training, experience and orientation each therapist has.

• What kind of training do they have? Have they studied with a teacher, taken a course, completed a training program? How aware are they that this work has been part of a myriad of indigenous cultures for thousands of years? Have they studied with particular lineages?

• Do you sense you can become vulnerable with that therapist? Does the therapist seem able to set the conditions to help you feel comfortable-enough in going into the unknown?

• Does their fee fit with your current budget? Therapy is an investment, and yet if you are stressed about how you can afford their fee, that stress may impede your work.

• What is their philosophy on healing, change and growth? Do you click with their outlook and foundational perspectives?

• How much experience do they have working with your specific challenges and goals?

• Are you looking, for example, a gender affirming therapist, a therapist who is a member of your orientation, culture, or background?

• What modalities does the therapist use to help clients prepare for and integrate from the psychedelic journey?

• How much experience does the therapist have working with non-ordinary states of consciousness? Does the therapist have personal experience working with psychedelics?

• When having a psychedelic journey, our usual defenses are either lowered or not there. We can be more vulnerable in comparison to sitting and talking with a therapist. How does the therapist work with this component?

• Do you sense the therapist sees themselves as the ‘expert’? The power differential in psychedelic work can get exaggerated, so notice if you sense they feel like an authority figure to you. Sometimes that is not the most helpful of dynamics.

• If you are feeling confused or conflicted about joining with a teacher, therapist or guide, consider talking it through with a friend, group, family member etc..who can help be a sounding board.

Taking the time to consider and reflect on what you would like to get from the psychedelic work and what type of therapist fits you, sets you up well for this work.

Feel free to contact me with any additional questions or to learn how I work.

How to know if you are ready for psychedelic therapy

Before you have a psychedelic journey, it’s important to understand what to expect and how it may feel. Although it isn’t possible to fully predict what your ketamine (or other psychedelic) journey will be like, it is possible to feel prepared for it. Below are some important things to note when considering ketamine or psychedelic assisted psychotherapy.

How much experience do you have with psychedelics?

To engage in ketamine or psychedelic assisted psychotherapy, you don’t need to have past experiences with psychedelics. However, it is important to consider your level of understanding and comfort with non-ordinary states of consciousness. Like jumping into the deep end of a swimming pool, it’s a good idea to know some things about psychedelics before you dive in.

A psychedelic therapist can cover the questions, fears, concerns and hopes you may have about psychedelic treatment before the experience. This is part of what is called the preparation phase of psychedelic therapy, and is a slice of how you should be supported in order to have a safe and impactful experience.

Do you have a mindfulness practice?

Again, although not mandatory, it is helpful to reflect on current practices you have that help you stay in the present moment. Part of the psychedelic work is facing the hard stuff that can come up. Ways to stay with the possible difficult moments during a journey can be practiced ahead of time via meditation, yoga, movement, exercise, being in nature,etc… During the preparation phase of KAP or PAP treatment, I often lead clients through breathing exercises, simple yoga poses, and other mind-body-spirit connection activities. This builds up the capacity for interoception (perceiving what is going on internally). Since ketamine is a very internal process, it makes sense to get comfortable with inward directed focus ahead of time.

How comfortable are you with not being in control?

It’s normal to want to have control over the outcomes in our lives. Structure, routines, and helpful habits are great, and we can choose to utilize those things in order to thrive. Yet, in a psychedelic journey, the structure, habits and control strategies may very well be inacessible.

What do you feel when you consider the concept of surrender? I know the cliche “go with the flow” can be eyerolling. But cliches were born out of deep truths. How comfortable are you being in “places” you’ve never been before? (You could wonder about this literally or metaphorically). How are you with allowing things to happen, rather than making things happen?

What is your current support system?

Taking time to reflect on the helpful influences and actions you have presently in your life is important to note prior to starting KAP or PAP. This is because things can “come up” afterwards—and having a support plan created ahead of time can really help with your integration and growth goals.

Is there a person you can talk to about your psychedelic experiences, current challenges and future hopes? Do you currently work with a psychotherapist and/or medical provider? Do you belong to a support group? Do you have a supportive person, animal, object, spiritual practice, self care routine you can lean on during and after your psychedelic experience(s)? Are you open to developing some resources before you begin your psychedelic work?

How motivated are you to put in the work?

This can be tricky if you live with depression—depression can squash your energy, hope and motivation. KAP and PAP can be really helpful for some people who experience long-term depression, or cycles of. So if you identify as pretty low energy or motivation, that’s ok. Looking at ourselves with gentleness and love, and knowing that it may take a lot of motivation just to call a therapist IS motivation. For others, you may be bursting with excited/nervous/anxious/desperate energy to start making changes. There’s really not right or wrong answer to this question. It’s more about having the awareness of where your starting point is. And is isn’t uncommon for people to be at their absolute lowest, or coming up out of their absolute lowest, to reach out and ask for help. That is courageous warrior stuff, and we can use that as a motivating factor.

And if you aren’t sure if you really want to begin your psychedelic assisted psychotherapy work yet, that’s ok. It’s good to take an honest inventory of how much time, energy and investment you can do—prior to starting KAP treatment.

If you have more questions or interest, give me a shout.

If you are interested in talking more about if you are a good fit for KAP, contact me. I’d love to support!

Grinning With A Clenched Jaw: How To Get Through the Holidays Unscathed

This time of year can shake up our usual routines and can be more challenging than other times of year. For some, it’s a really ‘bad’ season. For others, it’s pretty bad and a little good—for some about even on the bad and good, and for others, more good than bad.

If you are in any way activated, unbalanced or dysregulated during the holiday season, this post may help you navigate your challenges with more ease. Disclaimer: I do come from a Christmas background, lightly sprinkled with Christianity and Tolstoy from my formative years. My default communication-of-ideas can’t help but be somewhat based in past experiences and current observations within my framework as a therapist. And yet, perhaps some of these themes and tips may transcend culture and identity—being helpful for those who struggle during these months. Consider:

What are your expectations during this season? What you want to get from the holidays? Are these expectations realistic, do they involve how you want other people to behave? What if you didn’t have expectations (easier said than done)?

After a challenging experience (going to a gathering, party, being alone) when things didn’t work out as your hoped (or expected), think about the experience as a partial success rather than a complete failure. This can make it easier to see what you can learn from it, maintaining feeling rational (rather than emotionally dysregulated).

This time of year is temporary—there is an end date to the celebrations, the rituals, the family dynamics, the buying and spending, the indulging…

Practice good old health habits. Rest, sleep, drink water, eat some balanced meals, move your body, avoid the over-indulging, track how substances impact your mind, body and spirit. Talk to a person who helps you feel regulated, more calm.

Notice your early warning signals that your emotions are getting bigger. Emotions can get amplified this time of year—sadness, worry, isolation, loneliness, memories of painful holiday experiences. How can you self-soothe? This may be going inward— taking time on your own to go for a walk, listen to music, journal, breathe. Or it could be helpful to engage outward, have a simple positive interaction with a stranger or neighbor, go to a class, be with others without engaging—going to the library, the grocery store, a craft fair. Acknowledging that you are having an emotion is also key. Once an emotion starts, it needs to run its course. Oftentimes our thinking blocks or intesifies an emotion, leading to an emotion getting stuck, which then leads to some mental messes.

Old dynamics can take front and center—if you suspect or know you will be around a person, group or place that is triggering, or that can regress you to acting in a way that feels younger, Ask yourself— how can I minimize my vulnerabilities before engaging with the person, place or thing? What needs to be accomplished, what really matters, what are your priorities? Planning ahead will also minimize last minute stress. Can you plan ahead, creating a concrete strategy that involves setting boundaries (leaving early, vowing to not ‘take the bait’, excusing yourself to the bathroom, etc…)

Consider reflecting on all the positive things in your life, how far you’ve come in a year, what is going well. Be intentional with this, turning away from ruminating about what is wrong or hard.

Create your own traditions, memories, legacy and/or ritual. What do you want from these months? Connect with what feels good, energizing, empowering.

Quotes to Help with Climate Distress

In 2019, I started writing a book about the complexities of how our mental health can be impacted by climate change, and things to do about that. Then March 2020 hit, and I stopped writing. Fast forward to 2022. I’m looking over the book and wanted to share the myriad of quotes that were inspirational and supportive for me. Maybe some of these quotes will also click with you:

“I think calling it climate change is rather limiting. I would rather call it the everything change.”

— Margaret Atwood

“If you’re treated a certain way you become a certain kind of person. If certain things are described to you as being real they’re real for you whether they’re real or not”

— James Baldwin

“Even a genius cannot completely resist his Zeitgeist, the spirit of his time.”

— Viktor Frankl

“Hope, in this deep and powerful sense, is not the same as joy that things are going well…Hope is not the same thing as optimism. It is not the conviction that something will turn out well, but the certainty that something makes sense, regardless of how it turns out…It is also this hope, above all, that gives us the strength to live and continually to try new things, even in conditions that seem as hopeless as ours do, here and now”

— Vaclav Halvel

“Only to the white man was nature a wilderness and only to him was the land ‘infested’ with ‘wild’ animals and ‘savage’ people. To us it was tame, Earth was bountiful and we were surrounded with the blessings of the Great Mystery.”

— Black Elk

“Climate change is global-scale violence, against places and species as well as against human beings. Once we call it by name, we can start having a real conversation about our priorities and values.”

— Rebecca Solnit

“Sometimes your belief system is really your fears attached to rules.”

— Sharon L. Adler

“It’s never a question of skin pigmentation. It’s never a question of just culture or sexual orientation or civilization. It’s what kind of human being you’re going to choose to be from your mama’s womb to the tomb and what kind of legacy will you leave.”

— Cornel West

“For the meaning of life differs from man to man, from day to day and from hour to hour. What matters, therefore, is not the meaning of life in general but rather the specific meaning of a person’s life at a given moment.”

— Viktor Frankl

“We must learn that passively to accept an unjust system is to cooperate with that system, and thereby to become a participant in its evil.”

— Dr. Martin Luther King Jr.

“Action is the antidote to despair.”

— Edward Abbey

“That is the paradox of the epidemic: that in order to create one contagious movement, you often have to create many small movements first.”

— Malcolm Gladwell

“we need a r/evolution of the mind. we need a r/evolution of the heart. we need a r/evolution of the spirit. the power of the people is stronger than any weapon. a people’s r/evolution can’t be stopped. we need to be weapons of mass construction. weapons of mass love. it’s not enough just to change the system. we need to change ourselves. we have got to make this world user friendly. user friendly.”

— Assata Shakur

“I hate hope. It was hammered into me constantly a few years ago when I was being treated for breast cancer: Think positively! Don’t lose hope! Wear your pink ribbon with pride!…Hope? What about a cure?”

— Barbara Ehrenreich

“Sit, be still, and listen, because you’re drunk and we’re at the edge of the roof.”

— Rumi

“When any of us feels any kind of distressing emotion, there are defense mechanisms that come into play that help try to stabilize us so we don’t feel so much distress. Those defenses are things like denial, numbing, minimizing the problem or intellectualizing it in some way. These help us emotionally on one level, but they also mean we’re more disconnected from the reality, from feeling the energy to want to engage. So the very thing that protects us also prevents us from taking action.”

— Wendy Greenspun

“You can present the material, but you can’t make me care”

— Bill Watterson

“Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare”

— Audre Lorde

“The most important decision we make is whether we believe we live in a friendly or hostile universe.”

— Albert Einstein

“The secret of change is to focus all our energy not on fighting the old, but on building the new.
”

— Dan Millman

“Recovery is the normal adaptational process that follows destruction just like grief is the normal adaptational process that follows loss.”

— Mark Ragins, M.D.

“I used to think that any solution would come from the paradigms that I know. Now I think that the only thing is to think of the unimaginable. For the new generation, the unimaginable is not as unimaginable.”

— Alfonso Cuarón

“Many people think that the point of life is to solve their problems and be happy. But happiness is usually a fleeting sensation, and you never get rid of problems. Your purpose in life may be to become more who you are and more engaged with the people and the life around you, to really live your life. That may sound obvious, yet many people spend their time avoiding life. They are afraid to let it flow through them, and so their vitality gets channeled into ambitions, addictions, and preoccupations that don’t give them anything worth having. A dark night, may appear, paradoxically, as a way to return to living. It pares life down to its essentials and helps you get a new start.”

— Thomas Moore

“Sometimes I think,
I need a spare heart to feel
all the things I feel.”

— Sanober Khan

“Sometimes you have to get angry to get things done.”

— Ang Lee

“Fire really means a certain kind of burning in the soul that one can no longer tolerate when one is pushed against a wall.”

— Cornel West

“For Warmth
I hold my face in my two hands.
No, I am not crying.
I hold my face in my two hands
to keep the loneliness warm—
two hands protecting,
two hands nourishing,
two hand preventing
my soul from leaving me
in anger.”

— Thich Nhat Hanh

“Anxiety was born in the same moment as mankind. And since we will never be able to master it, we will have to learn to live with it—just as we have learned to live with storms.”

— Paulo Coelho

“The universe doesn’t allow perfection.”

— Stephen Hawking

“Anxiety’s like a rocking chair. It gives you something to do, but it doesn’t get you very far.”

— Jodi Picoult

“Our anxiety does not come from thinking about the future, but from wanting to control it.”

— Kahlil Gibran

“No one ever told me that grief felt so like fear.”

— C.S. Lewis

“Climate change is a lot like death. We all understand it is inevitable, but few of us truly accept it.”

— Brian McDermott

“I really can’t say, I guess I laugh to keep from crying
So much going on, people killing, people dying.”

— A Tribe Called Quest

“Our choice is to be in love or to be in fear. But to choose to be in love means to have a mountain inside of you, means to have the heart of the world inside you, means you will feel another’s suffering inside your own body and you will weep. You will have no protection from the world’s pain because it will be your own.”

— China Galland

“Laughter is carbonated holiness.”

— Anne Lamott

“Some days, 24 hours is too much to stay put in, so I take the day hour by hour, moment by moment. I break the task, the challenge, the fear into small, bite-size pieces. I can handle a piece of fear, depression, anger, pain, sadness, loneliness, illness. I actually put my hands up to my face, one next to each eye, like blinders on a horse.”

— Regina Brett

“Until we are able to love and take care of ourselves, we cannot be of much help to others”

— Thich Nhat Hanh

“In many shamanic societies, if you came to a shaman or medicine person complaining of being disheartened, dispirited, or depressed, they would ask one of four questions. When did you stop dancing? When did you stop singing? When did you stop being enchanted by stories? When did you stop finding comfort in the sweet territory of silence? Where we have stopped dancing, singing, being enchanted by stories, or finding comfort in silence is where we have experienced the loss of soul. Dancing, singing, storytelling, and silence are the four universal healing salves.”

— Angeles Arrien

“Art is to console those who are broken by life.”

— Vincent van Gogh

“Be generous with your strengths and skills—they are not your private property.”

— Joanna Macy

Taming the Anger Cycle, One Step at a Time

There are times when I hear it from my daughter and husband: You Are So Angry. This isn’t a compliment or neutral observation—it’s a call to stop doing what I’m doing. It usually doesn’t help because I’ve already lost my ability to reason and think rationally, so a rational observation isn’t enough to bring me back. And coming back to an emotionally regulated state takes time, and is my responsibility to enact.

As I come down from the anger, the sadness often is right there—alongside guilt, shame and worry that I’ve done irreparable harm. So I’m hit with a double arrow; first the actual anger spew, then the fallout from improper displacement.

The cycle sucks, it happens, and I keep working on becoming more skilled. You know the secret, right? Most therapists have some sort of history of being wounded, traumatized, depressed, anxious, etc.. I’m one of them. And angry behavior is my biggest teacher, my biggest indicator that I’m engaging in a survival-based pattern that no longer helps my present-day. The cycle is my biggest opportunity to change and re-do my ways.

I want to share some ideas and practices that may help those of you who get what I’m saying—who are often at a loss around how to cope with the anger cycle.

• Anger is an energy. It can be telling us varying things: something needs to change, action needs to be taken, a boundary needs to be set, an unmet need or want is surfacing, an injustice is happening, and/or our fight-flight response is kicking in.

• It’s damn near impossible to control emotions, especially anger, once it gets rolling. The trick is to either use tools to stop the anger escalating, or doing things to bring the anger or rage back down as efficiently as possible.

• When we’re in full-blown rage or anger, certain things will not help. Deep breaths won’t do shit-neither will counting to 10,20,30, or other mindfulness activities. You need a stronger intervention to jolt your nervous system down a notch:

  • Chew or suck ice. Put an ice pack between your eyebrows, at the back of your neck, or anywhere else that zaps you into feeling what is presently happening.

  • Fill up a sink with cold water, take a big inhale, hold your breath and put your face in the water, hold for 10-30 seconds.

  • Go outside, pull up weeds if there are any, rake, shovel, etc..

  • Get some paper, rip up the paper or ball up the paper.

  • If you can, leave the environment that has you escalating. This could be going into a different room, outside, out for a walk or run. DO NOT DRIVE.

  • Some people find it helpful to decrease stimuli—put in earplugs, noise cancelling headphones, go into a dark room, put a cold washcloth over your eyes while lying down.

• If you do things that do not escalate your anger level, you will eventually start to feel less angry and your brain will eventually come back ‘online’. Then practice more distraction—read something you can focus on, watch something you can track, move your body, get under some covers, allow the transition towards emotionally regulated to happen.

Often, it can be really helpful to work on anger with a therapist, counselor or in a specialized group. Contact me to learn more about working with your anger.

How to understand and cope with climate grief

Grief is normal.  It is a normal response to a loss. Experiencing grief, and the act of grieving, is a natural way to process losing something or someone.  It is important to do, important to feel, and important to understand.  You can move through these feelings and come out on the other side; changed by the experience, yes--but destroyed by it, no.

Grieving the crisis-level change in our climate—be it globally, nationally, locally, culturally, individually--is normal.  It is a normal response to an abnormal situation—the abnormal situation being the rapid change in weather and the consequences that follow.  Experiencing grief around the loss of species, communities, people, cultures, and ways of doing things is nothing new, for oppressed groups have lived, and continue to live, this experience. 

Perhaps it is those of us in privileged positions who are finally waking up to the disaster and the pain so many have already felt, via the experience of climate grief. I see how my privilege extends to having the luxury of time and space to examine what hurts some of us and how to process it. For me, climate grief isn’t just about how to cope with change, loss, and the big feelings.  It’s also about how to use this moment in time to honor and respect the pain and suffering of all people on this planet, past and present--and ultimately, how to make a ‘new normal’ out of the climate crisis that benefits all humans. Because not everybody had it good prior to our weather patterns going rogue. And if our climate becomes dismantled, how about also dismantling lots of harmful systems as well? But I’ll save these ramblings for a different blog post.  Back to narrowing into climate grief…

Climate-related grief can show up in lots of ways for people. For some, it is sadness, which is the common emotion many associate with grief and loss. And yes—you may be feeling sadness about a lived experience, like the afternoon rain and thunderstorms that don’t happen as often anymore, or the smoke-filled summer days that your child experiences so much more than you did as a kid.  It is sad.  It’s a loss of familiarity, a loss of balance, and a loss of control.

Climate-related grief can also take many other forms, in ways that do not include sadness.

Here are some emotions and behaviors people can experience as our climate continues to drastically change:

• Depression and Anxiety: This includes feeling overwhelmed, helpless, hopeless, chronically worried, tired, guilty, and/or unable to stop thinking about information, picture, videos, or lived experiences related to the climate crisis. These symptoms may also lead to pre-trauma or feeling traumatized.

• Denial: Avoiding thinking or talking about it, ignoring the problem, discrediting science or reality, head-in-the-sand type response. This is often one of the early phases of climate grief and can go on for a long time (how long ago did An Inconvenient Truth come out?)

• Anger: impulsive actions, righteous indignation, justifying actions, blaming or demonizing others, feeling irritated all the time. With unacknowledged grief, emotions can come out sideways and not be directly aimed at the actual issue. For example, road rage. Is it really the driver in front of you that is bringing up all this anger? Probably not.

• Defending: Putting a positive spin on everything, defending privilege, unrealistic thinking, token efforts, “toxic positivity”.

• Self-Esteem and Lifestyle: Sleep disturbances, feeling victimized, self-criticism, feeling isolated from others.

• Numbing/Addictions: When something feels unbearable or hopeless, often self-medicating comes to the rescue. Numbing activities such as substance use, binge-watching, over or under-eating, scrolling, shopping, etc…can be ways to cope or self-regulate due to deep grief, fear, or trauma someone is experiencing. Although helpful in the short-term, long-term it isn’t a sustainable solution.

So, what to do?  Here are some ideas.

• When you read the above information, what clicked with you? What do you relate to, or what have you experienced? Part of this grief process is understanding the concept of fluidity. Grief is non-linear; you might feel you are in a phase of grief; however, it is normal to bounce around within the bulleted points. For example, one moment you might be angry at big business, another moment you might feel guilty you haven’t done enough to fight climate change, another moment you might feel sad about the flooding affecting people somewhere.

• Trust this process. Grief is natural, normal, and important. While elements of the climate crisis may feel impossible to bear, feelings do ‘move’ and shift. That said, it is often very helpful to process your feelings with a person or group who gets it.

• Can you remember a time in the past when you experienced a loss and came out the other side? Remembering your strength and ability to navigate grief can help boost your confidence to turn towards pain, rather than away from it.

• Acknowledging and becoming more aware of the connection between climate grief and daily stressors is unique to the individual. For example, if you are working in the environmental field, you may be constantly swimming in bad news and be dealing with a specific set of grief (and burnout) issues. For others, you may get hits of climate grief as you read an article and have different kinds of grief challenges. For some, you may be directly experiencing a weather-related disaster, and this brings yet another possible kind of grief issue. And for many, there is no time or mental space to address these climate grief nuances, because living day-to-day is the most pressing need.

• Know your limits. For many people I work with, climate-related issues exacerbate other mental health challenges or daily stress they already are dealing with. Figuring out ways to navigate the existential as well as the here-and-now often involves consciously setting limits around how much thinking or ruminating on the topic of climate is helpful.

• Ask for help. As talked about earlier, feeling connected to another person or group who understands and empathizes with your feelings is important. As cliché as it sounds, there is no shame in asking for help, and you are not alone. It is courageous to seek out help and, ultimately, speaks to the love you have for something greater than yourself—Mother Earth.

For more information on how I can be of support, feel free to contact me at:

info@amandarebel.com

Think unresolved childhood stuff might be holding you back? See if these common ‘adult child’ characteristics fit your story.

It’s not just the addict or the main dysfunctional person who needs help to become whole or well again—the effects ripple out to all who are invested or a part of that person’s life.

So it makes sense that if you grew up in a home where there was active addiction, lots of dysfunction, or stress, you probably were impacted by it. Especially if you were a kid when it was happening. You probably had to find your own way to live amidst unpredictability. Kids can be resilient adapters, yet often it comes at a cost.

The symptoms of untreated trauma, unresolved stuff, unhelpful habits, patterns you default to, often become more and more troublesome as you age; as you attempt to start or maintain relationships, forge your own path, or start your own family. Old feelings and sensations get stirred up, you may know you don’t want to repeat the past, yet are at a loss around how to break the cycles.

If you are interested in learning more about how childhood trauma or distressing events can show up in adults, I’ve listed below some common characteristics people develop in response to growing up around addiction, dysfunction, and/or the aftereffects of experiencing trauma.

Ideas compiled from my own work with clients, from the work of Dr. Tian Dayton, Ph.D., Dr. Bessel Van der Kolk, M.D., and from ACOA 12-step literature.

• Difficulty with Self-Regulation Big emotional or behavioral swings, going from 0-10 quickly; feeling overwhelmed and flooded with big emotion, to then shutting down or numbing out. Hard to know how to stay in the middle—often because no one modeled it for you growing up.

• Hypervigilance/Negativity Bias Scanning people, places, and things for signs of danger or threat in order to protect yourself—this reflexive ‘being on guard’ or ‘waiting for the other shoe to drop’ can lead to anxiety, worry, and more relationship conflict. Someone or something might not actually be dangerous—you may overreact to a situation or person due to a perceived tone, expression, or action. As a kid, you may have had to be on guard at home, checking to see what mood a parent was in, to then decide how you needed to be in order to feel safe, get your needs met, or avoid.

• Easily Triggered, Reactive You may be more sensitive to stress, especially stress within a relationship. Therefore, you may overreact to conflicts that could be dealt with calmly and pragmatically. You may have witnessed lots of fighting, yelling, or conflict growing up, so reacting quickly feels familiar and somehow comfortable.

  You may get triggered or activated by a stimulus or emotion easily. Navigating traffic, dealing with a slow computer, getting your defiant kid’s shoes on, being criticized, hearing loud noises or yelling, or feeling helpless, confused, or not in control—those current feelings or events may be somehow reminiscent of an earlier event or trauma, which can then quickly bring on a stronger reaction than appropriate.

• Constriction/Rigidity Growing up in a home that did not tolerate emotional expression, operated from a place of numbness or denial, or that defaulted to a ‘stiff upper lip’ or ‘we don’t talk about that’ creed, may result in you showing a restricted range of feelings or behaviors in your adult life—ones that you are comfortable feeling or expressing. You may need to feel like things are under control, stable and predictable, which can lead to less spontaneity and more inflexibility.

• Difficulty Trusting Growing up in an environment that was unreliable, unpredictable, or abusive, you may have lost the ability to trust, or have faith in, people, groups, institutions, yourself. You may especially not like, or trust authority figures, yet also may want those authority figures to love you. Oftentimes, alongside difficulty trusting is a tendency to isolate. If you can’t rely on others, may as well go it alone. Challenges around being vulnerable, forming and maintaining relationships, and communicating wants and needs are common.

• Denying or Defending To manage fear, pain, or feeling trapped, you may have instinctively utilized certain psychological defenses as a kid, that you may still continue to use, perhaps without even knowing it.

  Denial (it didn’t happen) Dissociation (checking out) Repression (stuffing down or pushing away the feelings) Minimization (it really wasn’t that bad) Projection (launching our pain onto someone) Splitting (someone or something is either all good or all bad).

• Relationship Challenges If you have experienced a trauma or repeated dysfunctional pattern within the sphere of a primary relationship (mom, dad, caregiver, sibling) you may re-create those dysfunctional patterns you imprinted growing up. Something in the present may reflect something unresolved from the past.

  You might be a ‘people pleaser’ or seek approval from others, you might look for someone else to help you feel better, or OK about yourself. You might have a really hard time being vulnerable or intimate with another person. You might have a hard time accepting or asking for help. It might be hard to take in love or support from another person. You might try to rescue people. You might be really afraid of being abandoned or left, and you may work very hard to prevent that from happening.

• Shame and Guilt Shame (per Brene Brown’s definition) can be thought of as ‘I am bad’. Guilt can be thought of as ‘I did something bad’. Oftentimes, growing up in an addicted or dysfunctional home, shame and guilt are so pervasive that they can affect your whole makeup. From having a lack of zest for life, impulsivity, inability to make decisions, isolating, feeling unworthy of being loved or giving love, experiencing body sensations—a tense shiver, caved in shoulders or chest, head down when walking. All of these elements often lead back to shame or guilt.

• Depression, Despair, Hopelessness Isolating can increase depression. Feeling alone in your experience—and possibly silenced by stigma or secret-keeping—can increase despair. Also, having a hard time regulating big surges of emotion can lead to feeling that you’ll never be able to escape feeling so bad or that this pattern is never-ending. Because we lived in chaos and often experienced trauma, our limbic system (which regulates mood) has been whacked out for quite some time. There are ways to calm our limbic system and re-wire what feels automatic!

• Self-Medicating, Impulsivity, Drama Self-medicating with substances, food, work, exercise, shopping, shows, can make the pain go away in the short term. And in the long term, it creates more problems than it solves. You may be impulsive or drawn to ‘drama’ or excitement. It may seem natural and normal to ride the surges of energy that these things bring. And sometimes, in dysfunctional homes, drama takes the place of showing love.

• Unresolved Grief and Loss There are so many losses involved in addicted or dysfunctional homes. Often intertwined with sadness and grief are anger, resentment, and depression. You’ve lost parents you could rely on, family members may have died from addiction… the losses are many. It is important to eventually grieve what happened (or what was never able to happen). You may feel surges of grief around the holidays, birthdays, seasons, or rituals.

If you made it this far, you might be feeling some feelings. I want you to know this is normal. I wrote a lot of heavy information—my intention is to help you feel more educated about what the effects are and how they might play out in your life.

Some next steps to feeling better are to start figuring out solutions, maybe by finding a person you feel comfortable with—someone who gets it—who can listen, offer suggestions and encouragement. That could be a therapist, counselor, support group…

If you have unresolved issues from the past, trauma therapy can help. Reach out to me through my contact form to start your healing journey.

Poetry as Therapy: How to Creatively Express the Tough Stuff

By making us stop for a moment, poetry gives us an opportunity to think about ourselves as human beings on this planet and what we mean to each other.

-Rita Dove

I have something incomprehensible to say, like bird song in the time of war

-Odysseus Elytis

Forces beyond your control can take away everything you possess except one thing, your freedom to choose how you will respond to the situation.

-Viktor Frankl

Poetry is not a form of entertainment, and in a certain sense not even a form of art, but our anthropological, genetic goal, our linguistic, evolutionary beacon.

-Joseph Brodsky

Poems distill it all down, capturing the essence of a feeling, a hardship, an experience, a moment of living history. Poetry can be there for you during the most painful, confusing times. Connecting to a poem can provide some solace; you are not alone in your pain.

Poetry doesn’t take long to read, or absorb, or be affected by. Poems can cut through our mind-fog, our worry, depression or overwhelm—and can help us develop a healthier relationship with what pains us the most. Poems have an almost magical way of stirring up emotions, waking up senses—things that almost can’t be put into words—and yet are there, type print on paper or screen.

You can read poems—or you can consider writing one of your own. Writing poems can be revealing, healing and/or restorative. Writing can be a way to process, cope with, or express what is going on with you and what is going on around you. You are in control and hopefully empowered when you are choosing what words to include, delete or re-vamp. You are figuring out what is meaningful to you and expressing it. That can be healing, because it is your truth, your perspective.

In more therap-ish terms, poetry can be a way to externalize the internalized. To get it out. To put a name to what troubles you, inspires you, chases you.

You may be telling yourself you’ve never been interested in reading poems, let alone write one. Or that you don’t have any creative energy to think or write. That’s totally understandable. You don’t have to. And yet maybe the exercise below can ease some of those barriers—or pull those of you who are interested—towards an activity.

Exercise adapted from Poetic Medicine by John Fox:

1. What areas in your life are hard, painful, unresolved—or what is something you’ve been neglecting, yet you want to attend to, or investigate, or work on? Job stuff? Homelife dynamics? Family, spouse, child complexities? Patterns that keep repeating? Problems that haven’t been solved? Fears? Unknowns? Changes? Sorrows?

2. Get paper and pen, and divide paper into two columns.

3. In the left column, write words about the stress, problem, or issue. You might include: difficult memories, how your body feels in that situation or place, qualities of a relationship. For example—tight jaw, no time to self-reflect, work past dinner time, will this ever end, slammed door, apathy and ignorance, when will we wake up? regrets upon regrets…

4. In the right column, write words, images, metaphors that nourish you, bring you relief. For example—spontaneous laughs, purification cry, the protest and the togetherness, letting go, sunrise, it’s not my fault, there’s still the stars at night, lavender smell after a good rain

5. Take words from each of your columns and link them together to make a poem. How can the nourishing words ease the stressful ones?

6. If you feel stuck, try using any of the words below, or ones you think of, to express metaphorically aspects of yourself, your life, your relationships, etc…to insert into your poem—wind, hurricane, drought, wildfire, prison, cell, mask, island, moon, black hole, galaxy, house, peach, apple, well, ditch, underpass, knife, ashes, stone, fountain, glove, jewels, fountain, statue, curtain, stage, concert hall, tower, microchip, virtual, masked, desert scorch, mountain snow…

7. The process of writing and discovering is just as important (if not more) than the product of the finished poem, so go easy on yourself.

If you are struggling with your emotions, therapy for highly sensitive people can help. Reach out to me through my contact form to start your healing journey.

5 Ways to Accept Reality During COVID-19 Times

We are dealing with painful events and more of these are probably coming our way. It can be tough to realize we can’t stop the hard stuff from happening. So how do we cope? By accepting that this is our reality—for now. The adjustments, changes, unknowns, adult tantrums, child tantrums, overwhelm—it’s here. Do we fight against it? Hide? Freeze up? Yes…some of the time. And at other times, we could look at our circumstances straight in the face and reply, “Yes”.

Here are some ideas and tips to help you find a sense of freedom:

1. Learning how to accept things as they are is a skill. It takes practice.

And it’s ok if you aren’t sure you even know how to accept things as they are. That’s part of why I’m writing this—to help you develop strategies that work for you. The first step may be that you don’t know what to do. And that’s ok. Here are a couple questions to start with:

• Can you recall a time when you let go of having to have a certain thing happen, or go your way?

• Can you remember a time when you flat out refused to accept reality, and it lead to even more pain and suffering?

2. If we fight against reality, we can’t take steps to change our reality. We are just stuck fighting an impossible battle. To start getting a grip on accepting reality, in order to then take action and possibly change reality, try this activity (Adapted from DBT Skills Training Manual):

• Consider one or two important things in your current day-to-day life you are having trouble accepting. For example, trouble accepting that my child is cranky, mean and rebellious during lockdown; using my willpower to get her to change, which makes it worse.

• Assign a number from 0-5 to indicate how much or little you are accepting this part of your life, or yourself. 0=no acceptance (fighting against, denying, avoiding) 5=(complete acceptance, embracing chaos, at peace with it)

3.Life (as it is) is worth embracing and living—even when it is painful, scary or overwhelming.

Pain (emotional or physical) is a signal from the Body-Mind, Mother Nature or some other phenomena that something is wrong. And something is wrong right now—very wrong. We are experiencing a pandemic and the impacts it brings. It is natural to experience the pain of this. Basically, it’s normal to feel like soot right now AND it is still possible to embrace living your life as it is.

Here’s the thing—as you accept the raw truth of reality, you may feel worse at first. More sad, more irritated, more off balance. And often times, as you move through the worst of it, you find deeper acceptance, calm and peace on the other side.

4.Acknowledge there were a series of events that led up to this moment. And there were a series of factors that led to where we are right now with COVID-19. It happened and there is nothing we can do to turn back time. This orientation may help if you tend to think, “It shouldn’t be this way!”

5.If you are struggling with accepting, make a pro’s and con’s list

What are the positives of denying, avoiding, fighting against? If things are too overwhelming, denial could be useful to get you through a day, an hour, a conversation. What are the con’s? After a while, if you are avoiding by consistently numbing (say with alcohol) you may start to feel more depressed, hopeless, isolated and confused.

This is just a starter—there is so much more you could do, consider, or implement to help you be able to ride these painful days with grace, honesty and love. Contact me at info@amandarebel.com to learn more. Be well!

If your anxiety is out of control because of the pandemic, anxiety treatment can help. Reach out to me through my contact form to start your healing journey.

10 Ways to Get Better Sleep During COVID-19

I barely slept last night. Clients I’m working with are also struggling with sleep; worrying if they’ll get to sleep, stay asleep, or if they’ll sleep. Sleep is important, basic, and can be so restorative and perspective changing—so I wanted to share some ways to find better sleep during these trying times. Many of these ideas were inspired from Marsha M. Linehan’s book, DBT Skills Training Manual.

1.Try to maintain a consistent sleep schedule all week long.

With less structure, more time at home, and a new way of possibly viewing life and death, your sleep schedule may be reflecting these changes—you may be going to bed at different times. As best you can, try to create a schedule you can stick to. Creating more structure, and making a habit out of getting ready for bed at the same time each night can be soothing for a wacked-out nervous system and frazzled mind.

2. Avoid Using the Bed for Daytime Stuff.

Because you may want to do some deep daytime sleep, which could further mess up your night time sleep schedule and sleep quality.

3. Less Doing and Consuming Before Bed

Are you watching things that are revving you up? Drinking coffee later in the day? Drinking alcohol or smoking tobacco in the evening? Try to curb that a bit, or do it earlier. Also, avoid strenuous exercise 3-4 hours before bedtime.

4. Take Time to Prep Your Bedroom

Does it need a bit of dusting, tidying, re-arranging to make it a more inviting place? Would adding a candle at night be soothing? Sniffing some essential oils? (lavender or cedar are good ones). Consider trying out using a sound machine, eye pillow, earplugs, or a sleep app. And have the room fairly cool in temperature, if possible. Use a fan to increase air circulation.

5. 30-60 Minute Rule

Allow for 30-60 minutes to fall asleep. If you can’t fall asleep, start to notice—what is your mood? Are you thinking a lot about stuff? Are you calm, edgy, excited?

6. Worrying About Not Sleeping=You Won’t Sleep

It is verryyy common to worry and stress about the fact that you can’t sleep—and can become a vicious cycle of insomnia. Try talking yourself down by knowing that you’ll be ok, even if you are just resting and lying in bed. Don’t decide to get up and start your day. Keep resting, see what happens…

7. If It’s Been Over 60 Minutes…

If you’ve done your due diligence and lingered in bed for up to an hour and still no dreamtime, go to another room or area of your bedroom and do a mellow activity (read a book, space out looking at the darkness, hug a pillow, eat a light snack, etc..)

Focus on Body Sensations

Splash cold water on your face, put a cool washcloth over your eyes—especially helpful if you feel keyed-up, overly tired/jittery. Lie down and focus on breathing—see if you can take a longer exhale and shorter inhale. If you are thinking in circles, notice where in your body feels active, tight, or full of thought.

Try the 9-0 Mindfulness Practice

This may help break up over thinking or worrying: As you exhale slowly, say or see in your mind the number 9. On the next exhale say 8, then 7, etc…until you reach 0. Then start over, but say 8 (instead of 9) when you take your first exhale. Continue down the numbers. Then start with 7 and so on …until you reach 0. Start over as many times as you need until you fall asleep.

Reassure Yourself

What seem to be big worries in the middle of the night, or as you are falling asleep, may not seem as big or overwhelming in the morning. Remind yourself of that.

If you can’t stop worrying, or thinking in loops, try these options: Ask yourself, can your worry be solved? If so, then use your mind to solve the problem. If it is a bigger, more existential, unsolvable: go deep into the worry, imagine the worst outcome—and then imagine yourself dealing effectively with the big problem, coping with the issue, and overcoming the worst fear.

If you are experiencing any sleep issues, anxiety treatment can help you. Reach out to me through my contact form to start your healing journey.