A Few of My Favorite Things

How many of you are now humming that song from the Sound of Music? I may have done that intentionally because it is one of my favorite movies this time of year (White Christmas starring Bing Crosby is the other). Read through to the end to learn why the song and movie is associated with Christmas. I know that you are so eager to learn about some of my favorite things, so here goes.

Therapy

Okay okay, i’m not biased on this I promise! Participating in therapy is a great tool for so many to find healing, solutions, restore confidence and learn new skills. According to a NAMI report 21% of U.S. adults experienced mental illness in 2020; that’s 52.9 million people, or 1 in 5 adults. Of those adults 46% received treatment. We can undoubtedly guess that during the global pandemic of 2020 these numbers in mental health and therapy needs increased from 2019. What was once very taboo has become a bit more normalized. Thanks in part to the Gen Z-ers who are very vocal about participating in therapy, to the influx of social media posts by lay persons and professionals related to therapeutic benefits. Here’s a tidbit that you may not know; even therapists have therapist. It’s our role to leave our worries outside the therapy room door so that we can be fully present for you. But that means we need someone to helps us process it all too.

Supplements

Let me be very clear before I start talking about this. I am not a licensed medical practitioner, but I am a certified health coach, so always consult your medical practitioner before starting a new supplement. If you want more information about the health coaching I offer, check out the page on my website. Based upon my own experiences using supplements paired with my training as a health coach, there are a few supplements that have proven to be valuable in improving moods, maintaining a healthy brain, and healthy lifestyle.

First up is omega fats. I am not a fish eater; in fact my motto as a child was ‘nothing from the sea.’ This has since changed and I now love mollusks and shellfish. However shellfish does not offer me the healthy omega 3 fats that come from cold water fish (e.g., salmon). Other healthy fats in the omega 6 + 9 variety are more prevalent in my daily diet. So I supplement with omega 3-6-9 pills. This article provides more details on the differences, sources and importance of taking omega fats in supplement form. Other supplements I highly recommend is magnesium and turmeric. Turmeric has many health benefits, the most notable is that it’s a natural anti-inflammatory and antioxidant. Additional benefits include improvements in brain health related to depression and prevention of Alzheimers (source). Lastly is magnesium, essential for brain and body health. It’s the most abundant mineral found in the body yet you’re likely not getting enough through your diet. Check out Dr. James DiNicolantonio’s videos on magnesium here and here.

Pets

If you’ve sat in my office or been in my virtual office, you’ve likely seen my cat. As ornery as she is, my cat is a calming force when I come home. She loves snuggles, has anxious attachment tendencies (is that possible in animals?!) and is a big talker, as are most Siamese cats. Owning a pet certainly comes with disadvantages (financial cost or clean up), yet more and more people own pets. Over half (57%) of the population owns at least one pet (source) which tells us there’s got to be something good for us about owning a pet. One study in particular looked at the wellbeing of owners, conducting 3 separate studies to find their conclusions. Improvements were more significant than originally proposed proving that owning a pet increases the social support aspect of the owner. Consider how many people you have become close with at the dog park because the dogs are playing together! Other benefits more commonly discussed from pet ownership include, reduction in depressive and anxious symptoms, improved self esteem, and increased physical activity. Considering getting a pet? Be sure to do your research on all the expectations and responsibilities of pet ownership. Plus there are opportunities for interactions with pets without the ownership responsibilities through volunteering at a shelter, working with therapy animal trainers, etc.

Laughter

You’ve heard the saying, laughter is the best medicine? And I’m guessing that you’ve even experienced the perks of laughter after a game night with friends. But just how good for you is it to laugh? The idea that laughter as medicine became a subject of interest in 1979 when Norman Cousins spoke about it’s analgesic effects on his own illness is his book An Anatomy of an Illness. Since then multiple studies have shown the psychological benefits of laughter; improving affect, reduction of depression and anxiety symptoms to name a few. In more recent years however there is growing evidence that laughter even has physiological benefits. This article outlines more of the details of the studies conducted. Suffice it to say that you could prescribe laughter for yourself and reap the psychological and physiological benefits. Creating a new weekly habit for 30-minutes belly laughing, a great way to share!

Looking ahead

Now that you’ve had a peak into a few of my favorite things, let’s return to the history of the song. Various stories suggest that the fame of the song, A Few of My Favorite Things, is because of Julie Andrews singing the song on The Garry Moore holiday special back in 1961 before the movie came out in 1964. Another story is that the song was created and performed to be a Billboard hit in preparation for the release of the Sound of Music movie in 1964. Still another story is that the tv stations wanted family friendly movies aired during the holidays when families were most often coming together, and Sound of Music was an easy choice. So as this year draws to a close in the coming weeks, I hope that you will embrace a few of your favorite things and share with others. May your smile be bright, your holidays be peaceful and your hearts be overflowing. Be Well!

Separated by our shared experiences

Blog by Kim Melendy

The 4th Wave of COVID: A Mental Health Crisis

Over the last two years, the pandemic has not only been an ongoing epidemiological crisis, but also a psychological crisis that will linger long after we return to a new normal.  A transformative shift in our collective conscious fueled by collective trauma and ambiguous loss has occurred around the world resulting in what is being called the 4th wave of COVID, a crisis of mental health.   During the height of the pandemic and continuing over the past year, our entire country has experienced what can only be described as a collective trauma.  We were coping together, but separately, throughout the quarantine and lockdowns.    Isolated together and yearning for connections that we took for granted in the past, we gained a newfound respect for all the connections that before COVID wouldn’t get a second thought. Then we felt a profound sense of loss as those connections faded and some even completely disappeared. However, we didn’t just lose the people; we lost the places too.  Those safe places, the places that gave our life structure and meaning.  As we return to normalcy, we are afraid to trust again - are those people, events, and places we once knew still safe?  We ask ourselves is my memory accurate, does reality match my inner perspective of what I lost?  Can what we lost be recaptured, relearning how to live, to reconnect with our friends, with family, and with the places we lost?  

Uniqueness amongst similarity

As we collectively begin to cope with the new normal of post pandemic life, another different wave is now upon us.  Prior to the pandemic, the rates of mental illness rose steadily in the US year over year, but now post-pandemic, the rates have exploded across all population groups.  Not only are we experiencing this explosion due to the costs incurred to our mental health during the pandemic, but also the mounting shift in mental health awareness in the last few years has been accelerated by the pandemic.  For many, the collective trauma of the pandemic sent us flocking to our social media where we found solace in the connections and in supporting each other through the difficult times.  We feel more secure than ever to talk about our struggles with mental health and to offer support to those we know are experiencing mental health issues.   We have experienced a unique group experience; we were experiencing the same isolation, fear, and uncertainty together.  Some of us coped by openly sharing deeply emotional and painful thoughts that in the past would have been brushed off. But now people are more supportive due to this collectively traumatic and slow-moving event.  The views on mental health and mental health treatment are changing dramatically and quickly due to this shift in mental health awareness.  Discussing mental health is now a new conversation that we can all engage in together.

Looming concerns

The emerging transformative discussions around mental health post-COVID can be seen as positive progress for us as a society.  However, this new wave of mental health demand has become a massive strain on an already weakened mental health system in the US.  Per a survey conducted by the APA in October 2021, waitlists are longer than ever and demand is outpacing availability for over 72% of their respondents.  Prospective clients are reaching out for help in navigating their struggles in this post-pandemic new normal yet the overload to both public agency and private practice clinicians in our mental health system force them to be turned away.  The ever present and growing demand for mental health services is not going away, and the implications of not addressing it could be detrimental for many people in our country and around the world.  Mental health struggles and the consequences affect not only us the individual, but also our family, community and institutions that surround us.  We cannot as a country allow our people to become hopeless in the face of this adversity.  We cannot hope to fully heal and recover from the pandemic while only addressing the medical need.  It is imperative that we tackle mental health simultaneously and with an equal amount of fervency and resources.  

My POV

As a graduate counseling student and current private practice intern, the prospect of entering a profession that is evolving and growing so quickly is exciting and at the same time extremely daunting.  The majority of my first client contacts have included a conversation regarding counselor availability, and the prospective clients’ experiences and past inability to find someone, anyone, with openings.  The relief I hear in their voices when I explain that I’m an intern and can offer open availability, brings me a sense of happiness for them that they found me; and in the same moment I am disheartened knowing there are so many others in my community who will be forced to continue searching.  Coming out of the last two years with my own experiences, it’s my goal as a counselor to use my practice to assist my clients with emerging from these difficult times with a new sense of awareness of themselves and of each other.  I’ll be encouraging my clients to seek positive influences in their lives as we return to our new normal and to extend that positivity into the community, in hopes that they will be healing themselves and their community along the way. 

Helpful Tips

If you, or someone you know, are struggling through this transition back to normal and have been unsuccessful in finding a counselor or services.  There are resources in the community and online that you can connect with to help with coping and bringing positive viewpoints into your life.  You can also share with others in your network who could also be struggling.

• Perform an audit of who and what organizations you follow on social media.  Are these connections adding to your life or is the content causing unneeded stress?  

• Seek out individuals and organizations that are producing social media content and providing support that you need at this moment.  This not only will improve your social media experience but also increase the reach of content providers making a difference in your community when you like and/or share posts.

• Reach out to your network for recommendations for digital support groups, this could be on Facebook, Discord or other social media platforms.

• Use these connections to network and be the first to know when a contact is offering counseling openings, forming new support groups, and/or other mental health resources you can take advantage of in the community.

• In the New Year, Total Wellness 365 will be resuming the support group called Women’s Wellness Circles.  This is an opportunity to build connections with other women that have been through similar experiences the last couple of years.  

Getting the ball rolling on building those connections and networks is the first step to healing and for our community to heal together.

A big thank you to our Counselor intern Kimberly Melendy for writing this information blog on how the mental health crisis is impacting our communities and her unique perspective. She can be reached by contacting the office.

How the season changes our moods

Common SADness

It's common for people to experience days when they feel not like themselves, down or a little blue but they can return to feeling energetic and like themselves again rather quickly. Sometimes those sad days start during the winter months and end when the days get longer. When these mood changes have a longer and more significant impact a person's thoughts, feelings and daily life, they may be experiencing what is called SAD or Seasonal Affective Disorder. SAD is not as uncommon as you’d think. It is experienced by millions of people, many of whom may not even realize it.

Here are some factors common in those with SAD: people who live in colder climates (northern states and countries), people who already have a mental illness diagnosis or family history of mental illness, occurs in more women than men, people living in parts of the country with fewer hours of daylight during winter (like New England). Here in Cincinnati it’s now getting dark around the end of the work day. Although that makes it hard to resist going straight to bed when I get home, it also feels unusual to being going out and being social or active after work when my internal clock is telling me it’s midnight!

SAD signs + symptoms

Since SAD is a specific type of depression many of the symptoms will sound much like those of major depression disorder. Now is the time to add my disclaimer for those that don’t read to the end of the blog (you know who you are). Having these symptoms does not equal a diagnosis of seasonal affective disorder; if you have many of these symptoms and you want support please talk to a licensed mental health professional. Now, back to it. Let’s look at the core symptoms of SAD:

• Feeling depressed most of the day, nearly every day

• Losing interest in activities you once enjoyed

• Having low energy

• Having problems with sleeping

• Experiencing changes in your appetite or weight

• Feeling sluggish or agitated

• Having difficulty concentrating

• Feeling hopeless, worthless or guilty

• Having frequent thoughts of death or suicide

Did you know there are two types of SAD, summer-pattern and winter-pattern depression. Of the symptoms that differentiate these, most notable is appetite and sleep changes. Diagnosis requires taking a full history of symptoms during past seasons and ruling out other mental health disorders (again, by a qualified mental health professional).

Why do people develop SAD?

Although there is no definitive scientific explanation for why people develop SAD of SAD-like symptoms, the experiences are still valid. Here is what scientists and clinicians have posited

• Your biological clock or circadian rhythm. Shorter hours of daylight and colder temperatures almost seems to push us to stay inside or under the covers. Fewer hours of daylight may confuse our internal clock of our usual wake/sleep cycle.

• Drop in serotonin levels. Serotonin, A neurotransmitter, is the primary mood stabilizer. Often considered the happy chemical, it is constructed by vitamin D (the ‘sunshine drug’). So less daylight = less vitamin D = less serotonin.

• Intrusive thoughts/feelings. Ruminating on negative thoughts and feelings associated with colder and shorter days such as the limitations of socializing, access or mobility. Additionally, associated memories or events can trigger negative thoughts and feelings and may contribute to associated behaviors of SAD such as isolating, increased sleeping, ruminating.

What can I do?

As I indicated at the start of the blog many people experience these symptoms and may not have realized that they could have SAD. Or they have some of the symptoms but not enough for a diagnosis. Bottom line is if you are experiences mood changes related to the season change, you can make changes to help you feel better. And if you have been successfully managing your SAD-like symptoms thus far, hooray! You can still take a look at the list below and consider making adjustments or additions to having a brighter fall and winter!

1. Stick to your routine. Although it’s harder now, sticking to your routine will help stave off the disruption to your circadian rhythm. Wake up and go to sleep at the same time as you do in summer months.

2. Make plans. Having something or someone to look forward to increases your chances of acting on it. So make those plans in the evening; go to happy hour, walk around downtown with hot cocoa, schedule to snuggle on the couch and watch a movie.

3. Use light therapy. Ever popular and available for quick delivery are light therapy lamps. Its popularity started in the late 1980’s and has been a bright light in effectively treating SAD ever since.

4. Psychotherapy. Yes, I mention it because I’m a therapist but more importantly I mention it because it works! Talking to a therapist about your thoughts and feelings can lighten the load you carry during the season.

5. Supplements. Increase your intake of omega fatty acids and vitamin D and helps improve your moods. Since many of the neurotransmitters associated with our moods are fat soluble, having healthy fats in our body is super important. Supplements are the most common way to absorb more of these nutrients but the best way is through whole food nutrition. Always talk to your doctor first.

Try some of these strategies, share some of your own, talk to your friends, make plans and Be Well!

4 themes in treating porn addiction

Exactly what is involved in treating my porn addiction?

You think you have a porn addiction, or someone you love has told you that you need to get treatment for your porn use. If you are questioning what a porn addiction is or how to determine if you have one, take a look at this previous blog. Or consider this very brief description: If you find that you have a loss of control, tried and failed to stop, lose track of time when engaging in porn use, and continue use despite consequences, you may be have compulsory or addictive porn use.

Yep, that fits

If those factors mentioned above sound familiar then the next step is to decide if you want to stop. Very few people can say they have been successful at stopping a behavior when forced to do so. Even in the most strict environments people still must choose to change. Change takes courage, resources, knowledge and support.

Once you decide to reach out for help there are some components that are essential in effective porn addiction treatment. Let’s take a look.

4 Main Components

technology

Most porn use is accessed through the internet. In fact according to recent statistics, every second:

• 28,258 users are watching pornography on the internet.

• $3,075.64 is being spent on pornography on the internet.

Since pornography is so accessible online, whether at home or work, keeping your internet browsing secure is one way to limit the access to factors that can trigger you. There are multiple apps or programs available to install on your computer/devices that help block, interrupt or report your access and time on pornography sites. Enlisting the help of a loved one is another way to help you.

support

Whether your support system comes from a family member, friend or community they are each an integral piece of building and sustaining recovery. However what some don’t consider is inviting someone into your support system needs to know all those nitty-gritty details of your behavior. Disclosure to a support person is different from disclosure to an intimate partner (something for another blog).

Support persons are ideal when they have characteristics that demand accountability and honesty from the addict. When considering whom could be a support person, consider these factors:

• Accessibility: are they available to you when you need them?

• Accountability: will they hold you responsible for your behaviors or let some slide?

• Openness: will they be honest with you about their own experience and/or limitations when supporting you? Will they be aware of their own opinions and help you develop healthy strategies for you?

• Commitment: will they be there for the whole journey?

A support person may even be someone from the local sex addicts anonymous (SAA) or sex and love addicts anonymous (SLAA) groups.

Abstinence

One of the core guidelines when participating in recovery from porn addiction is abstinence. Abstinence is about purposefully and deliberately choosing not to engage in an action or practice that is wanted or desired. A secondary behavior that coincides with porn addiction is masturbation. Therefore abstinence is creating a ‘clean slate’ behaviorally that includes active steps to cease porn use and masturbation. Many addicts fear that this is a lifetime requirement for sustainable recovery but the bottom line is that a recovery success plan is created in collaboration with your therapist that is uniquely healthy for you.

As hard as it may be to accept or practice, abstinence from the behavior is the most direct route to beginning recovery. A part of recovery is to uncover how your behavior was initially triggered and became the addiction that it is today. Creating emergency plans or behavioral intercessions when those urges arise, is a key conversation with your therapist (and or support person) when starting recovery.

Environmental Cues

Managing your environment and triggers is part of recovery, part of your success. When addiction has its grip on you, it’s hard to be fully aware of the triggers or environmental cues that are increasing your urge to use the porn. Uncovering those environmental cues is essential in creating a safe space for you.

What are environmental cues? These are the sights, sounds, smells and sensations that are present when we engage in a certain behavior. For example, each evening after work you routinely sit in your comfy chair at home, pull a fuzzy blanket over you, grab the remote and sip some wine. Each time you do, these actions are intricately linked in your brain. But then you decide that you want to cut back on your alcohol consumption. The next time you sit in that chair, pull up the fuzzy blanket and grab the remote, you’ll be reaching for that glass of wine that isn’t there. The same idea applies to porn addition. You have created a connection that when you see, smell, hear and feel something, your brain inevitably tells you to start looking at porn.

Working with a therapist, you can dissect the linked behaviors, or rituals, that coincide with your porn use. Then begin to remove and replace those behaviors with something more aligned with your treatment goals.

Now what?

The first step towards recovery is to admit that you are not in control of your porn use; instead, it controls you. Working towards recovery is a marathon, not a race. Reread the sections above and see what changes you can make in your life now. Even one change will make a difference. And that one change can foster hope for more changes to be made. Finally, remember you are not alone in this journey. Finding support through local recovery groups and a therapist specializing in porn, sex and love addiction is essential for your sustained sexual wellness. Be Well.

How to be an expert at identifying your feelings

Emotions vs. feelings

Wait! There’s a difference?! 

In fact there is. 

Emotions are the biochemical reactions (e.g. neurotransmitters) to an external stimulus. The amygdala is primarily responsible for this emotional arousal. The amygdala is at the center of our brain and also where the flight-fight-freeze-fawn responses originate. Like when the hair goes up on our necks, or our stomach drops? That’s emotions; the generalized physical sensation experienced. 

Feelings on the other hand are the conscious experience of the emotion stimulus. The feelings, or labels, we apply are actually our personal interpretation of the emotional response. The interpretation comes from our lived experiences, beliefs, memories, thoughts and awareness of the situation or trigger. 

To get an accurate understanding we must collect information from both our emotions and our feelings. By creating this awareness within ourselves we can then more fully appreciate the experience and more healthfully respond to the trigger. 

Each human experience triggers an emotional response, which in turn triggers our feelings, and responses. So let’s ask a few simple questions to get a better grasp of things. 

Tell me, oh great amygdala, what am I feeling? 

 In my years as a therapist helping others navigate their emotions and feelings, I’ve learned that many are unfamiliar with their own body’s physical response to feelings. So I talk to them about building awareness of their physical sensations in everyday situations. 

What are physical sensations? Those are the biological events occurring in our body, again triggered by our amygdala. Some examples include sweating, hot red cheeks, tingling on our hands, rapid heart rate, or shallow fast breathing. Think back to a time earlier today when there was an increase in tension or excitement. What was happening in your body? I tell my clients to do a mental body scan—head to toe—to see what’s different in that moment. 

Once there is a new awareness of the emotions, or physical sensations, experienced, I then help my clients create an understanding of the feelings associated with it. Here is where we get to label things. 

[pulls out her label maker…]

Did you know that there are approximately 3000 words used to describe feelings in the English language! That’s a lot of labels! How did we get so many? Read on to find out. 

One of the most prominent theories of the 20th century is Robert Plutchik's wheel of emotions. Since we now know that once we label the emotion, it is called a feeling, we will now refer to them as feelings on the Plutchik wheel. Plutchik proposed eight basic feelings—joy, sadness, trust, disgust, fear, anger, surprise, and anticipation. Using colors to represent each basic feeling, the wheel showed that these overlapped and bled into the next like hue on a color wheel. With those 8 basic categories to start, that leads to over 34,000 combinations of feelings! 



Too many choices! I need an easy answer!

Like the Pixar movie, Inside Out, sometimes it’s easiest to identify a fewer number of options. In the movie there are five major categories of feelings portrayed—anger, sadness, joy, fear, and disgust. The key is to collect all the data points possible to identify the final answer. So how do you determine what you’re experiencing? Here are some simple steps to Identifying your Feelings applied to a simple example. 

Picture it. You are at work and the boss stops by your workspace saying, “Come find me later, we need to talk.”

(Gulp. Anyone else having an immediate reaction to this? No? Just me. Okay.)

1. Pay attention to what’s happening in your body. This means creating that awareness of body language and physical sensations. 

   “I immediately notice that my heart rate has increased and I’m starting to sweat. My shoulders have climbed up into my ears (tensing) and I have an awkward smile and am nodding foolishly.”

2. Decide what happened to make you feel this way. This can be the full situation or a portion of the situation. Don’t negate the automatic negative thoughts (ANTs) that come into play. 

   “My boss just unexpectedly came to my work space and asked to see me. I don’t know the reason and it’s an unusual way for her to ask me.”

3. Decide what to call the feeling. Here we get to put all the data points (see step 1) together and out a label on what’s happening. What label do we place on what we are experiencing? 

   “I’m feeling anxious and concerned about my performance on the job.”

 (Note that all the steps of the skill, Identifying your Feelings, are done mentally; not aloud).

Now that you have some clearer steps on how to more accurately and consistently identify our feelings, I hope that you find it useful while navigating everyday situations. If you are experiencing more intense feelings or find it difficult to find a helpful and healthy response to those feelings, I encourage you to find a  therapist who may be able to help.