It’s not news to anyone that the holiday season is one of the most stressful times of the year for many. From conflict with family and financial strain to just plain stress about having an enjoyable time and making sure others do, too, this time of year can present many challenges. The following six tips can keep you feeling more grounded and in control of your emotional response, and that can make all the difference.
Happy Holidays to You and Yours!
Resentment in a relationship can destroy positive feelings, respect, and warmth your partner otherwise felt toward you. Instead of being your cheerleader and biggest fan, they may start to hold you back from opportunities or activities you enjoy. Once a relationship turns competitive, it is in dark territory. Since resentment can be so detrimental to relationships, it is essential to develop an awareness of whether you are starting to feel resentful of your partner or detect if they are starting to feel resentment toward you. Often, resentment can creep up on people in an insidious way and quietly build until there’s an explosion, of sorts, and that is why it is so important to catch it early.
Some early signs your partner resents you:
Our thoughts have a profound impact on our brain chemistry and basic physiology. Our bodies are programmed to respond in certain ways to different situations. Based on your appraisal of, or thought about, a given situation, your brain will have a specific chemical reaction which communicates to your body how to respond. For example, when you are faced with danger, your thought process might be “there is danger and now I need to run,” but more likely than not, the process happens more instantaneously because you have a thought about danger and your brain then takes over. Here are some specific ways that negativity can affect your brain and body:
It is important to know that "thought suppression" or trying to push away a thought is not helpful. It actually can intensify the thoughts. It is important to foster a better, more accepting way to relate to your thoughts. Practice acknowledging your thoughts ("there's that thought again"), simply labeling them ("I am having the thought that...", choosing not to engage with them ("this is not helpful for me to think about right now"), challenge them ("what is the evidence for and against this?") and explore mindfulness techniques. In contrast to negativity, which more often than not, prompts a physical stress/danger response, meditation and mindfulness which teach your mind and body to quiet themselves are associated with a slew of positive health benefits. Certain newer types of Cognitive Behavioral Therapy (CBT) like Acceptance and Commitment Therapy (ACT) and Mindfulness Based Cognitive Therapy (MBCT) can offer more on this style of learning to relate to your thoughts differently. CBT will help you learn how to challenge your thoughts and come up with more effective ways of thinking. The therapists at PVD Psych have training in all of these types of therapy and can help you figure out what might work best for you.
Eating disorders and body image concern are unfortunately very frequently intergenerational, or passed from one generation to the other. We can presume that some of this is due to biological factors that predispose someone to having an eating disorder due to certain personality traits like being overly conscientious or perfectionistic or being more impulsive or more anxious. However, an eating disorders is in very large part determined by environment and learning history, and these are also the only aspects a parent can control when it comes to helping their child avoid developing an eating disorder. According to the cognitive behavioral theory of an eating disorder’s development, it is brought about by an internalization of a thin ideal, perfectionistic standards, and the idea of having more control over one’s body size and shape than may actually be the case. Much of this is shaped by the media and peers, but parents greatly influence their kids as well. Parents are a primary source of teaching their kids about their personal worth, what eating behaviors they pick up, and general ideas about their beliefs about food. Children also learn a lot about food and eating from observing their parents eat and observing how they talk about food and themselves and how they look at each other in the mirror. If you have an eating disorder, or even one in remission, you may not realize it, but chances are there are hundreds of thoughts and behaviors you might engage in during any given day that your child would pick up on.
It can be difficult enough to move on after a breakup, but when there is an established dynamic of continuing to contact your partner (and vice versa) after the relationship ends, this can turn from difficult to toxic. These types of contact can be hurtful and confusing, and ultimately prevent you and your ex from being able to process the break up and move on. In some instances, when there is repeated contact post-breakup, one or both of you may be fishing for some sort of reaction. For example, you might text your ex because you are still angry and trying to provoke them and continue to argue. Another instance might be repeated bids to get your ex to reconsider the break up. If this type of thing is happening, establishing a “no contact” rule for a period of time whether mutually agreed upon or not may be helpful. It is healthy to be able to recognize when a relational dynamic is unproductive or harmful and to set boundaries in response to that. Sometimes once the “no contact” period is up, neither one of you may have any desire to contact the other. In other cases, you might feel like you want to reach out. Before doing so, I would recommend going through the following steps.
Lastly, in some instances it is just not appropriate to have any future contact. If you want to reach out but the relationship was abusive, this would fall into that category and I would recommend blocking your ex’s number, email addresses, and ability to contact you on social media.
As is the case with many behaviors that have an addictive pattern, workaholism is reinforcing, and so you may feel you benefit from the behavior and have difficulty recognizing that it is problematic. Especially in our society, where achievement, independence (as opposed to a relational focus), and work success are very highly valued, success at work, being a high achiever, and taking no breaks... aka workaholism, can be particularly difficult to recognize and/or want to change because the behavior and results of it are, in many ways rewarding, and positive. However, workaholism can lead to problems in relationships, negative physical health consequences, and mental health problems such as increased anxiety and irritability. Often, you may not recognize that you are behaving as such or that it is problematic.
Once you realize you are a workaholic, it is important to try to find more balance in your life. Perhaps there is a reason you are a workaholic, like you are trying to get away from an unhappy home situation, or you are lonely, or you do not pursue other interests so this is the only way to feel worthwhile. It can be helpful to see a therapist for help understanding what is driving the behavior and how to work on the underlying issue(s).
7 Signs You May Be a Workaholic
1. Your relationships outside of work are suffering because you find yourself putting work first. Often this is not because you care more about it, but the anxiety you may experience when you have a task overhanging, can be unbearably uncomfortable. However, if your relationships with your partner, family, and friends are being repeatedly ignored or cast aside in the service of needing to 'finish one last email,' or stay late one more night to finish up, it is worth looking at your behavior and considering a chance. Most workaholics hear complaints from their partners, family, and friends about this and if you find that this is happening to you, it would be wise to take their feedback seriously.
2. You find yourself constantly thinking about work. You are preoccupied with work and never get a break. There is not much separation between work and home, and you are routinely bringing work home with you and even up to bed. As many people now work from home, this difficulty protecting home for relaxation and relationships can be even more common.
3. You engage in checking behaviors. You check your work email excessively to see if that customer has responded or if you get an email from your boss, for example, you feel like you must respond right away. You also check your planner or calendar on your phone frequently to see your to do list and might even be routinely adding to it while outside of work when you could be relaxing.
4. You have a hard time relaxing. You feel guilty if you are not working. You find yourself unable to enjoy being present in the moment even if you really want to be, because your anxiety creeps in and you cannot stop thinking about work.
5. As a result of your difficulty relaxing and potential worries about work, you experience muscle tension, regular headaches, teeth grinding or TMJ, or other health consequences directly related to chronic levels of stress.
6. You receive praise at work for being “always available,” responding immediately to emails, or always going above and beyond. Of course, praise at work is important, but if you notice you are regularly standing out for working harder than anyone else, chances are this is coming at some cost to you.
7. You feel anxious and irritable if something impedes your ability to work or complete a task to your satisfaction. In fact, you may notice that your self-esteem is so closely tied to work alone that you start to worry greatly about what you imagine will happen if you run out of time or do not do as good a job as you would like. You feel resentful of those who get in the way of your work. You don’t take vacation time or sick time when needed, and you certainly do not take a lunch break. You might even work against medical advice. You might find yourself regularly inhaling lunch at your desk or just eating a protein bar.
So now that you have realized that this way of life may not actually be serving you as well as you thought, it is time to consider some changes.
The important thing to realize about making change in this area is that you will experience intense anxiety, irritability, guilt, or resentment when you are first trying to change. This is part of the process of any change. You need to learn or relearn how to take breaks and have balance.
It can be helpful to create a very deliberate work free zone at home, for example, during certain hours. You can gradually increase the hours but start small and realistically.
Put away your phone and computer during your work free zones or first thing in the morning and right before bed to resist the temptation to engage in checking behaviors like seeing if your boss has emailed.
Try to fully engage in your time at home and prioritize your relationship with your partner. Focus on what your partner is saying to you and ask questions about their day. Make a plan to go out on a date.
Do things that help you relax or feel better, such as take a long shower or go to the gym and that can serve as a helpful way to symbolically shift out of work mode.
Start taking breaks at work during lunch, for example. It is important to take time for yourself and not taking any breaks actually hinders productivity. You may find that you feel a lot sharper after the break.
Reward yourself for making positive changes. Also, add other positive activities into your life so you are not just focusing on taking away behaviors. Make plans with your family during the weekend, schedule a vacation, or reignite your passion for an old interest like sports, crafts or religion.
Keep in mind that changing behaviors like workaholism, which likely is deeply ingrained in you, is a big challenge. Therapy can be especially helpful if you believe you are struggling with workaholism and your health and relationships are suffering.
It can be common to experience lowered self-esteem around Valentine’s Day, in particular. Based on your past experiences and what you have learned to emphasize on your life, you have certain aspects of life that you value and which heavily impact self-esteem. For many young women, appearance and being seen as desirable or being in a relationship both strongly influence self-esteem. This is not necessarily a bad thing, but it can put you at the mercy of others and at risk of feeling terrible simply if the wind blows the wrong way, so to speak. Even if those aren’t the most important areas from which you derive your sense of self-worth, the barrage of Valentine’s Day commercialization and media will take a hit on you. After all, how can you read and watch and hear about relationships being the be all end all and not be affected? It is certainly possible to overcome this, but you must be aware that it is happening. If it is happening for you then you may want to consider making some changes to how you think about your sense of self-worth that way it can be both more stable and more in your control as opposed to in others'.
6 Tips for Boosting Your Self-Esteem Right Now
1. Take some time to make a list of the factors that play a role in your self-esteem, such as being seen as desirable by others, being accomplished at work, being physically fit, being a good friend, being a good partner, or whatever else may be there. Be honest with yourself. If how much money you have or how much recognition you get at work is really important, that is necessary information to know. Once you have outlined the factors influencing your self-esteem, note the following things: you do not want it to be all coming from one place. Remember the adage “don’t put all your eggs in one basket.” If you do that, then if one area of your life goes wrong, you will have a major problem and your self-esteem will actually be quite flimsy. Try to think about other factors, factors that are within you, and well within your control, that you value, such as being knowledgeable about world events or having a healthy relationship with food. Emphasize building up those areas in your life.
2. Try to think about other things you value like education or health or having fun. The more the better. And then come up with some measurable and realistic, small ways to move toward those goals. If you are all about physical fitness, make a specific goal for yourself. Next, give yourself credit! Having a sense of accomplishment can go a long way and chances are you do many things each day that you could give yourself a pat on the back for, and which you do not. Look for things that you would give others credit for doing. That can give you some of the distance you may need to see just how much you are doing.
3. Notice negative self-talk and thoughts and be skeptical of it/them. Even just acknowledging that this is your negative self-talk speaking and is not necessarily true can be very helpful. Of course, the goal is to replace the thought with something more accurate and more adaptive, but that can come later.
4. Self-validation is key. Notice how you’re feeling and validate why that might be. Tell yourself that it make perfect sense that x, y, and z. Self care carries implicit self-validation so it is important to focus on that at any time when your self-esteem could use a boost. Some examples might be getting a massage, taking time for you, journaling, taking a relaxing shower or bath and making that a priority, or getting plenty of sleep.
5. Limit your exposure to social media and media outlets that emphasize appearance and relationships. Try to dial down the time on social media during the weeks leading up to Valentine’s Day. What good will it do to reach everyone’s mushy love note status updates on Facebook and pictures on Instagram. The same goes for limiting unhelpful magazines, shows, or movies. Romantic comedies may not be the way to go here, but rather, if you know of a comedy that doesn’t revolve around a relationship or a feel good movie about self-empowerment, take some time to give that a look.
6. Spend extra time with friends and reach out for support. If you tell others you are struggling then you already are one step closer to feeling better. It can be helpful to get into a regular habit of checking in with friends instead of putting on a facade all the time that everything is ok.
The best treatments for anxiety focus on increasing insight into the anxiety that people are experiencing. Through establishing an understanding of the connection between thoughts, feelings, and behaviors, people can begin the process of interrupting the cycle of anxiety. In cognitive behavior therapy (CBT) which is the gold standard treatment for anxiety disorders, individuals learn how to break the cycle of anxiety at each level. They learn how their thoughts can become more accurate instead of catastrophic or worry focused. They also learn what behaviors promote anxiety, such as avoidance. Lastly, they learn about the way their feelings and the physiological experience of them like a racing heart or sweating can lead to more anxiety because many people become anxious about their anxiety or believe they are in physical danger. This phenomenon is called interoceptive sensitivity. In treatment for panic disorder, for example, people learn that the physiological experience of anxiety and anxiety itself is not dangerous and this breaks the snowball effect of panic symptoms during a panic attack. Lastly, with regard to behavior, people learn how avoidance through thought suppression, procrastination, or substance use to escape feelings all lead to increased levels of anxiety.
However, many people do not know what therapy for anxiety actually entails or they are put off by how intimidating it sounds. Here are the four most common misconceptions about anxiety treatment.
The 4 Most Common Myths About Anxiety Treatment
1. I’ll never have anxiety again. You need anxiety, just as you need all your emotions. All emotions serve the functions of motivating individuals to take action, communicating to yourself something important about a situation, and communicating to others. When you experience anxiety, for example, it communicates to you that there is something dangerous in your environment, it motivates you to take action, and it will communicate to others that they should also take action. Anxiety is a completely adaptive evolutionary response that made survival possible for our ancestors. Anxiety enabled our ancestors to hunt without getting eaten by predators. Even today, living without any anxiety would be detrimental.
If while crossing the street you saw an oncoming car headed right for you, instead of experiencing anxiety to motivate you to get out of the way, you would undoubtedly get hit. Similarly, a complete absence of anxiety would leave people directionless and unmotivated to prepare for exams or work. It would also lead to many individuals making poor decisions and putting themselves in risky situations or would lead people to engage in dangerous or violent behaviors because they lack the normal amount of anxiety that motivates them to follow social mores and rules.
Research has shown that there is an optimal level of anxiety that one should experience in order to prepare for an exam, for example. Too much anxiety can lead to paralysis and catastrophic thinking and even the generalization of anxiety to all facets of one’s life, prompting people to avoid situations they believe are dangerous when in actuality they are completely safe. This is when anxiety crosses the line from adaptive, functional, and “normal” to pathological and a psychiatric disorder. In fact, interference in one’s life is the main criterion for the diagnosis of an anxiety disorder.
2. I’m going to have to talk about my childhood or my mother the whole time. Cognitive behavioral therapy will focus on the here and now and helping you learn how your current thoughts, feelings, and behaviors are perpetuating your anxiety. In therapy, you will actually learn how to change your thoughts to more adaptive ones and stop behaving in ways that perpetuate your anxiety. Eventually, you will likely address long-standing beliefs or where your current beliefs are coming from, but you don’t need to focus on the distant past to address anxiety in therapy.
3. I will need to take medication. Some SSRIs have research support for improving anxiety, but benzodiazepines like Ativan and Xanax which people typically associate with treating anxiety can actually perpetuate anxiety and make it worse. Taking benzodiazepines can lead to rebound anxiety and also can perpetuate anxiety by the associates people make to them. For example, if someone becomes reliant on having their medication with them at all times “in case,” then they will end up making their anxiety worse even if they are exposing themselves to anxiety provoking situations because they never learn they can handle the situations on their own. They attribute their success or survival to the medication.
4. Therapy will help me learn to stop having “bad” thoughts. Cognitive therapy does address thoughts that are unhelpful and which perpetuate anxiety but a good therapist will never tell you to “just stop having the thoughts.” Minimizing your anxiety and invalidating yourself is harmful. Often people decide that if they talk themselves through anxiety and somehow convince themselves that whatever they’re fearing is not a realistic fear, they will get over it. What you are doing, in essence, if you are minimizing or invalidating your own feelings is failing to acknowledge them. That itself will perpetuate your anxiety. It is also harmful to chronically invalidate yourself. Instead, in cognitive therapy you will learn how to be skeptical of your thoughts that are contributing to your anxiety and making it worse while still validating your concerns/beliefs. You will learn how to evaluate the evidence for and against your thoughts and replace your thought with a more accurate and helpful thought. It will take some time, but your thought patterns will change and your anxiety will decrease.
Let's say you are not currently in therapy and you are trying to manage your anxiety based on what you have read about treatment for anxiety disorders. Research and self-help can be great, but sometimes the application is not as simple as it seems.
1. It is human nature to avoid what we fear and so often the very things that help us feel better in the moment end up perpetuating and exacerbating your anxiety. If you either do not know how to manage your anxiety or if you think you are doing the right things but your anxiety is negatively impacting you and not decreasing, it may be time to seek therapy. Cognitive-behavioral therapy can be especially helpful for the treatment of anxiety.
2. Engaging in what cognitive behavioral therapists call “safety behaviors” will perpetuate the problem. Let’s say you learn through trial and error or through some research or advice that if you do deep breathing, your anxiety will decrease. Another safety behavior would be fearing enclosed spaces like elevators but being able to manage them as long as you have your cell phone with you.
3. Avoidance through the use of substances. Plenty of people try to manage their anxiety through substance use like having a few drinks to manage an otherwise overwhelming social situation or using other substances like marijuana to calm down before a big event. Substance use to manage your anxiety, even if it isn’t excessive or problematic in and of itself, will only lead to more anxiety in the future because you never confront the situation and learn that you can get through it on your own.
4. White knuckling to get through a situation. Let’s say you have a fear of flying or public speaking and you understand that exposure is helpful in treating your anxiety so you just push through it. That should help, in theory, right? Actually, just forcing yourself to do something you are afraid of while not attending to your feelings or taking deliberate steps to ensure you aren’t doing any subtle things to avoid your anxiety.
5. Minimizing your anxiety and invalidating yourself. Often people decide that if they talk themselves through anxiety and somehow convince themselves that whatever they’re fearing is not a realistic fear, they will get over it. What you are doing, in essence, if you are minimizing or invalidating your own feelings is failing to acknowledge them. That itself will perpetuate your anxiety. It is also harmful to chronically invalidate yourself and demean your own feelings.
In our society, and in the field of psychology, we have largely been taught that it is essential for people to experience their emotions fully and that this is the only way to move forward. Especially within the context of loss and grief, it is important to honor your feelings and who or what you have lost. Research and clinical experience indicates that emotions come and go as waves and it is only by trying to stifle them, avoid them, or push them away that people inadvertently end up perpetuating them. Psychologists work with clients to approach rather than avoid their emotions, sit with their emotions, and develop strategies (such as coping skills or emotion regulation skills) to navigate strong emotions.
A common misconception about grief in particular is that proper grieving should look a certain way and that all people who are doing it properly are 100% in the process, going through Dr. Elisabeth Kubler-Ross’s well known stages of grief ranging from denial to acceptance with a defined path in between that includes anger and bargaining. Prominent trauma experts in the field have also developed treatments for trauma and grief that emphasize exposure to negative emotions and processing the traumatic event or loss fully. The truth is that there is no correct way to grieve or process a loss and that in many instances, it is actually beneficial for people to utilize distraction in order to get through incredibly difficult situations. Psychologist, Dr. George Bonnano, of Columbia University Teacher’s College is a bereavement expert and has done research that backs the concept that not all people process grief or trauma the same way and that the differentiating factor that leads to healthier outcomes is resilience which he describes as the ability to maintain healthy psychological functioning by using emotion regulation and coping skills. Bonnano talks about a range of coping or emotion regulation strategies, including distraction, that are effective and healthy (Bonnano, 2013)
When people are confronted with extraordinarily intense emotions or challenging situations, it is not so easy to just sit with them. Healthy emotional functioning involves utilizing a range of strategies to manage emotions. Distraction is one of many forms of emotion regulation that is adaptive to use. It is helpful when faced with extremely intense emotions, in instances when someone just needs to get through a situation and tolerate distress and there is nothing proactive that can be done at that moment, and in situations when people are just learning how to cope and before they are fluent in a range of strategies.
If someone is experiencing grief or loss (which may be accompanied by trauma), distraction can have the positive effects of keeping people grounded in the present rather than getting lost in grief, developing confidence in their ability to manage the intense feelings, and enabling them to titrate their emotional response so they are able to also experience and honor their feelings. In fact, a psychiatric disorder called Complicated Grief can develop if people are unable to use coping skills with an orientation toward managing the loss and instead maintain a single-minded focus on the loss and nonacceptance of the loss. Complicated Grief can lead to dangerous habits like creating shrines to the person they lost and an unwillingness to live in the present and move forward. In most extreme circumstances, Complicated Grief can lead to feelings of wanting to reunite with their loved one and can result in suicide.
The bottom line is that it is healthiest to respond to difficult situations like loss with cognitive and emotional flexibility and a willingness to use coping skills to manage intense emotions so that people do not either completely block their emotional response or get consumed by it. Seeing a licensed therapist after a loss can be extremely helpful, as therapy can aid in the development of a range of coping skills.
There are plenty of reasons why New Year's Eve can elicit feelings of depression, wistfulness, and even regret about the past year. In our society there is immense pressure to make New Year's Eve the ultimate celebration, watch the ball drop, share a New Year’s kiss at midnight, and set resolutions. But what if you don’t have anyone to share a kiss with, a party to go to, or feel like the past year was a wash? It can be difficult to get motivated to go out and celebrate. It is important to keep in mind that these traditions were brought about by the commercialization of New Year's Eve and it is okay if you don’t feel up for buying into it this year.
Certain people are definitely at higher risk of feeling bad during New Year's Eve such as those who recently experienced a loss or breakup, people who are newly sober, or anyone who is coming out of a particularly tough holiday season. In terms of those who are more susceptible to feeling bad about staying home, NYE at home is the ultimate FOMO. The “shoulds” are endless. Then, to make it worse, you are home alone instead of having all the distractions that being out with others would bring. If you are extroverted and get energized by being around others, it can be especially difficult to feel like you are forced to stay home alone because you don’t have plans with anyone. Lastly, New Year's Eve is the prime opportunity to reflect on your past year. Reflecting on the past can be very difficult for someone who has had a hard year or someone who struggles with feelings of worthlessness or never being good enough.
5 Ways to Reclaim New Year's Eve
1. As an alternative to the usual, you may try attaching personal meaning to New Year's Eve, and reclaiming it with new traditions. Do some research on traditions in other cultures for fresh starts of the new year; start a gratitude journal or just start a journal in general; clean your home; or get a new look. The easiest way to flip the script on New Year's Eve is to think about your values and come up with plans to live more in line with them. You also can reflect on the past year in a different way by writing down all the things you are grateful for, or you can make New Year's Eve the night of fresh starts and purging the old.
2. A life led in line with your personal values is the best way to truly find your authentic self and learn to appreciate it. It is important to give thought to your values and then break them down into achievable and measurable tasks that are in line with them. If you value knowledge but haven’t been in school in years, take a free class or read a new book. Then, give yourself credit for it as such. Far too often, people do things that may be right in line with what they value but because they do not frame it that way, they miss an opportunity to feel a sense of accomplishment.
3. Give yourself permission to spend New Year's Eve however you please. If you want to stay home and watch the ball drop on tv and have your own party with yourself, that would be great. If you do not want to watch any of the news coverage, that is great too. Find something enjoyable to do like watch your favorite movie, indulge in a bubble bath, and/or have your favorite food to eat. Dress up if that will make you feel better or revel in an opportunity to get cozy in PJs.
4. Allow yourself to feel whatever emotions come up. If you are feeling sad or lonely, understand that emotions are not dangerous and they come and go naturally. If you try to push away an emotion, that is when you will actually perpetuate it.
5. Instead of a New Year’s Resolution, most of which end up getting broken anyway, do something to feel better about yourself that is not oriented around this tradition. If you feel the last year was a disaster or just a wash, try to give yourself permission to let that go and move on from it. Make a list of things that you are letting go of as you move into the new year. Aim for a fresh start. Maybe you have been wanting a new hair style or just want to schedule time to pamper yourself. Alternatively (or in addition), you can do a deep cleaning of your home to start the New Year fresh.
The main idea is to have a solid plan in advance for yourself, give yourself permission to feel and do what YOU please, and find your own way of symbolically moving forward. Let 2019 be about you!
When people think about symptoms of anxiety, their minds typically go to worrying, panic/anxiety attacks, and fear or phobias. They might imagine that if they were struggling with anxiety then they would feel their heart racing and feel restless for much of the time. However, there are several lesser-known symptoms of anxiety, which are not necessarily less common, but can more easily be overlooked or discounted as something else. If you notice yourself or someone you care about exhibiting these symptoms, check in with them as they may be struggling with undiagnosed anxiety.
1. Inability to let a thought go. If you just cannot seem to get off of a topic or let it go, it may be because you are anxious. A key component of executive functioning is set-shifting which involves being able to move onto the next idea or task. Anxiety decreases your ability to do this and makes it more likely that you will find yourself perseverating on small details or the same issue for days/weeks/months on end.
2. An increase in symptoms of another psychiatric disorder such as an eating disorder or depression. It may be the case that you struggle with depression or an eating disorder and those symptoms have decreased. If you have a history of an eating disorder and suddenly experience a surge in concerns about body image and eating, you may also be struggling with anxiety and it is manifesting this way. Additionally, depression and worry often go together and anxiety can trigger depression.
3. An increase in relationship problems such as becoming more controlling or nit-picky with your partner. Suddenly everything your partner does becomes really annoying and every little thing is affecting you like nails on a chalkboard. You may find yourself correcting your partner over minor things like word choice or what they are eating or doing. Often this type of critical and controlling behavior comes from a need to focus on something aside from what you are actually anxious about or you may want to feel like you have control over *something,* the latter of which is a more commonly observed and known symptom of anxiety. Another reason for this could be that you are feeling very edgy and are taking it out on the person closest to you.
4. Indecisiveness. If you find you cannot make simple decisions like what you want to eat or which pair of shoes you like, it is highly possible that you are really struggling with anxiety. It is important to ask yourself where the indecisiveness is coming from and if you are, for example, worrying about making the wrong decision and second or triple guessing yourself.
5. Procrastination. Not only might you want to avoid doing work or facing a bill in the mail, which is more common, but if you are putting off or avoiding other things like reaching out to friends or cleaning your home, you may be experiencing anxiety.
6. Sluggishness or feeling very tired can indicate that you are experiencing less restful sleep than usual or are not getting enough sleep. Difficulty sleeping is a commonly known symptom of anxiety. Also, while some get keyed up and agitated when they get anxious, some find themselves slowing down and getting sluggish. Think fight or flight.
7. Frequently getting sick. If you’re under stress, your immune system will certainly take a hit. If you find that you keep getting sick, consider whether you are experiencing anxiety.
8. Weight gain, especially in your midsection. Having heightened cortisol levels for extended periods of time can lead to weight gain and bloating in your stomach. High levels of cortisol can lead to blood sugar drops which leads to craving sweets. Even without “stress eating” or changing your eating habits, you may find that anxiety leads to weight gain. Other symptoms of anxiety like decreased sleep can also lead to weight gain.
Recognizing these lesser-known symptoms of anxiety can of course lead to getting treatment faster, but it is also very important because simply understanding your own behavior and having those close to you understand it can be hugely helpful.
Uncertainty is one of the most certain aspects of life, and yet it is one of the most intolerable emotional states. It is human nature to look for patterns and predictability, to figure out the future, and prepare. Therefore when we are faced with uncertainty, we try to get around it and figure it out ourselves. We immediately get going with the “what ifs,” the “what did that really means,” and wondering if this is it and the person you are dating is “the one.” We also to try to prepare and avoid getting hurt. However, it is really not possible to establish a healthy relationship by bypassing the uncertainty phase. It is important to take your time to figure out if this is “the one,” and discover together over time if you are compatible. Sure, you can try to get around this by jumping into things too intensely and too quickly, but that probably has not worked out so well for you in the past.
So how do you tolerate uncertainty?
1. Embrace it. Practice acceptance that this is a necessary and important phase of dating and your relationship. Enjoy the excitement and butterflies and try to frame it that way instead of seeing your emotional response to uncertainty as uneasiness and intolerable anxiety that must end! You will survive this.
2. Flip the script and use your uncertainty and wondering to figure out how you actually feel. It is easy to get so caught up in trying to figure out the other person’s experience of us that we lose out on the important opportunity to determine the answer for yourself to your own questions. “Are they interested?” can become “Am I interested?” Take your time to figure this out without getting sucked into the trap of just focusing on the other person.
3. Don’t play games. Sometimes people try to avoid the discomfort of uncertainty by exercising control over the situation and deliberately doing things to keep the other person wondering and on their toes. This is not going to do your relationship any good. And if you notice the person you are dating doing this, take a closer look at what is going on and if you want to participate in it.
4. Do NOT become beholden to technology. If you find yourself attached to your phone and constantly checking at it, as if you are willing a text to pop up, that is a warning sign. If you are tracking the other person on social media or looking up their history, just try to stop. The less you start with these things, the better off you will be.
5. Ask for reassurance in a measured way. It is natural to want to know where you stand with someone and how they feel about you. If you notice yourself constantly asking for reassurance, you are going to do your relationship in.
6. Look at the evidence. If you are prone to worrying about whether your partner is interested in you, try making a list of things they say and do that indicate that they are interested. Review the list especially when you might be having a hard time sitting with the anxiety of uncertainty.
7. Continue to tend to your relationship with yourself. You had a life before this person was part of it, and you need to maintain it now. Continue to see your friends, go to the gym, go to work, and do the things you enjoy.
But what happens if you are still lingering in the uncertainty phase after your first anniversary? Sure, there is a normal amount of uncertainty in life and there are no guarantees, so it is normal to not know for sure about some things. However, by your first anniversary, you should know whether or not you enjoy spending time with this person, if you have chemistry, how the other person communicates their feelings, how your partner feels about you, what your long-term plans are, and whether you have shared values. You absolutely should feel comfortable being yourself with this person. It also would be helpful to have a sense of and be on the same page about career goals, where you want to live, how you feel about living together, whether you want kids, and what your priorities are. You should also be certain that there are no deal breakers present in the relationship.
All healthy relationships involve compromise and sacrifice, and some people are more inclined to put their own needs aside in order to please others. Especially if you have a bent toward people-pleasing and being conscientious, it is important for you to know where to draw the line.
5 Things You Should Never Give Up in a Relationship
1. Your family and friends. If your partner is urging you to give up your relationships with your family and friends and trying to isolate you, this is a definite red flag.
2. Your identity. This seems like a no-brainer, but all too often, I see clients who have completely abandoned their identity and sense of self in the service of pleasing their partner and making their relationship work. Usually this is something that does not happen overnight, but once it does happen, it can be extremely damaging for people.
3. Your career. Let’s say your career is important to you but your partner is fed up with how demanding it is. Or, let’s say your partner gets a job elsewhere and expects you to up and leave. You may very well make an informed decision to move with them and get a different job, but that needs to come from you. If you are pressured to give up your career because your partner is threatened by it, wants you available to them at all times, or is repeatedly undermining it and your successes, this is a big problem.
4. Your well-being. Let’s say you regularly engage in self-care that involves exercise, therapy, time alone to decompress, or time with your friends to pursue hobbies. If your partner pushes you to give up these things, especially while knowing that they are important to your health and well-being, run far, far away.
5. Being “you.” If you do not feel comfortable being yourself, and 100% yourself, with your partner, whether this is by request or your own decision, this person is not “The One.” It is essential that you feel comfortable expressing all of your wants, needs, desires, and can be honest with your partner. If you cannot do these things because you don’t feel comfortable and are wanting to be the person you think your partner wants rather than yourself, this is a problem. Similarly, if your partner is subtly pushing you to be someone else by putting you down or telling you what you should like, this is also dangerous territory to step into.
The bottom line is that you should never have to give up or lose who you are, at your core, in order to make your relationship with someone work.
There are many reasons why the holidays might make some people feel sad or lonely. If you have experienced a recent loss like a break up, divorce, or death of a family member, friend, or pet, then you are at heightened risk for experiencing sadness and depression during the holidays. The holidays are designated family and “together times” so if you do not have anyone, this can easily become one of the most challenging times of the year for you. Financial strain and stress also might be a major contributing factor to anxiety and low mood during this time. Especially for individuals who derive the majority of their sense of self worth from work success, difficulties at work or with finances can greatly increase the risk of depression. In addition, many people have time off from work during the holidays and the lack of routine and losing the sense of competence and accomplishment that work might give you can also cause a dip in mood.
The key to combatting sadness and depression during the holiday season, is to plan ahead and do things that have worked for you historically. If you would like to use a new skill, practice it in advance as trying something out for the first time when you're already feeling down makes coping even more difficult.
12 Tips for combatting sadness during the holidays
1. Practice acceptance that you might feel sad or lonely during the holidays. The holidays can be an especially lonely time and can increase sadness and symptoms of depression. There is a societal expectation or pressure to be happy and revel in the holiday spirit. That expectation itself may make someone struggling with loneliness or depression feel even worse because they may get mad at themselves for not being able to “snap out of it.” This being said, it is very important to give yourself permission to feel sadness or loneliness. When people try to avoid emotions or tell themselves that it is not ok to feel a certain way, that very emotion inevitably intensifies, plus there is often added frustration that you cannot will yourself to feel differently. It is also helpful to have a level of acceptance of your emotions because then your emotions do not catch you off guard. Remind yourself that it is ok to feel different emotions, including sadness, and experiencing a range of emotions only makes you human not a (insert self-deprecating adjective here) person.
2. Up your self-care by going back to basics like sleep and diet. Take a look at your sleep and eating habits and make a concerted effort to go to sleep at the same time each night and have a consistent wake up time. If you are having trouble falling asleep or staying asleep, practice good sleep hygiene and avoid things that are activating before bed such as checking your work email or watching the news, and instead do something that you find relaxing. When you get up for the day, even if you do not have anywhere to be, open the shades and turn on the lights, take a shower, and get dressed. Focus on having three balanced meals and two snacks and try not to go more than three hours without eating something as that will help you keep your blood sugar levels even.
3. Self-soothe using the five senses: get in your comfiest sweater or snuggle under a blanket, burn your favorite scented candle, eat or drink something soothing like hot cocoa or herbal tea, look at artwork or pretty landscapes online, listen to music that comforts you or is uplifting
4. Reach out to others. Plan ahead to access the supports that you have, Plan to spend time with friends or talk to them on the phone.
5. Limit your time on social media as it may make you feel even more down to compare yourself to others who look like they’re having the time of their life during the holidays
6. Exercise helps combat depression and sadness. You will release endorphins, feel a sense of accomplishment once you have completed your workout, and doing the opposite of what your sadness is pulling you to do (such as isolate yourself and lay on the couch all day) will help decrease the intensity of that emotion if not turn it around altogether. If you have a regular exercise routine, now is not the time to slack off or change it. If you have been trying to get back to the gym after a hiatus that was forced by work getting hectic or just not feeling motivated, set small goals for yourself like 5 minutes at a time, or just get yourself to the gym to start.
7. Contributing to others can not only give you a sense of accomplishment but it also might just make you feel a bit better. Look into local volunteer opportunities. While it can be very helpful to be with others and volunteer together, if that just feels like too much, volunteer virtually. Check out Operation Warm for some ideas: https://www.operationwarm.org/blog/25-volunteer-jobs-to-do-from-home/
8. If you notice yourself struggling with depression, early intervention is especially important. Consider beginning therapy. This can be challenging during the holidays as many therapists are on vacation and are experiencing their highest volume of calls from people who want to start treatment. Online therapy with a credentialed mental health professional might be a good option. Check with your health insurance to find out what telehealth company they are contracted with. You may have a better shot getting an appointment with one of the therapists through a telehealth company and you don't need to worry about travel time and other difficulties associated with scheduling to get to an appointment.
9. If you will be alone and you can afford to do so, plan a vacation in advance. Preferably go someplace warm and with plenty of sunlight where you can be active.
10. If you also tend to struggle with seasonal depression, consider a light therapy box for a mood boost. Keep in mind that the decreased hours of sunshine during the day give your mood an extra hit.
11. If this is your first holiday season after the loss of a loved one, be deliberate about taking time to honor that person in some way. All emotions naturally rise and fall on their own, and it is only by trying to avoid them or push them away that you will end up perpetuating the emotion.
12. Remind yourself that the holiday season is temporary.
The holidays can present a great opportunity to revisit family relationships that have deteriorated or gone away completely.
7 Tips for Repairing Family Relationships
1. Be prepared to forgive. You may be focusing on asking for forgiveness yourself, but make sure that you give some serious thought to how the relationship ended up deteriorating in the first place and make sure you are able to forgive this person. If you reach out and you are still holding onto old feelings of hurt and anger then this will almost inevitably end up coming out sideways with a snide remark or unconsciously looking for evidence that the person will just end up disappointing you again.
2. Do not underestimate your family members. Perhaps you have drifted from someone and feel guilty about avoiding them. The guiltier you feel and the more you avoid, the more awkward and anxious you will feel about reaching out. Give your family member a fair shot to surprise you by forgiving you or just skipping right to welcoming you with open arms. Sometimes stories get built up in our heads and become even more powerful than reality.
3. Expect that this relationship will require extra energy. You will likely need to reach out more than once and try to really extend yourself. Try to follow up regularly with phone calls and texts to check in. If it is worth it to you to repair this relationship then it is certainly worth prioritizing it and putting forth some extra effort.
4. Be ready to acknowledge happened. Depending on the situation, the other person’s feelings, and their readiness to talk, you should address the falling out. If you don’t address the elephant in the room there is a good chance it will eat away at both of you and create more awkwardness. If you are not ready to talk about it, respectfully ask that you table it for later, but it needs to eventually be acknowledged.
5. Come up with a list of benign conversation topics so that you can have some easy conversation and ways to connect. Think about this person’s interests and regular activities and ask about them.
6. Try to establish a new way of relating that involves expressing your feelings openly and letting the other person know that they are hurting your feelings or doing something that rubs you the wrong way. Gently request a topic change.
7. Have an awareness of your personal limits and boundaries. Make sure that it is truly in your best interest to try to repair the relationship. If this person has been abusive and repeatedly hurtful or if they are not at all open to the idea of reconnecting then it is probably in your best interest to hold off for now. Similarly, if you find yourself repeatedly reaching out and are just getting berated by this person then it is time to pull back. Go into trying to repair the relationship with a solid understanding of what your personal limits are and how you will know if the other person crosses them.
Negative thoughts can be the ultimate relationship killer. We know from research that there is a very tight feedback loop between a person’s thoughts, feelings, and behaviors so having negative thoughts can send you down the rabbit hole. It is important to know your thought patterns that can lead to major relationship problems. For example, you may hold beliefs from early in life or a more recent past experience that no one can be trusted and will take advantage of you or cheat on you. You may believe you are unlovable or that you can change your partner if they love you enough. You also might notice yourself engaging in catastrophic thinking like believing everything is ruined after one argument or all or nothing thinking such as if things aren’t perfect then the whole relationship is a failure.
7 Tips for Stopping Negative Thoughts From Ruining Your Relationship.
1. Make a list of your typical thoughts that lead to fights or breakups. Go through these thoughts and write down evidence for/against each thought.
2. Come up with an alternative thought that is accurate and adaptive. For example, if you believe that the person you just started dating is no longer interested in you because they haven’t responded to your text for several hours, make a list of all the other things that they might be doing. Think about other times they took a while to respond. What is some evidence that they are still interested? The alternative thought here could be as simple as ‘just because I haven’t heard from ______ doesn’t mean they aren’t interested.’ The thought will have more effectiveness if it is more detailed. See my how to guide to cognitive restructuring here.
3. Understand how your thoughts lead you to do things that can be, quite plainly put, intolerable and destructive like going through your partner’s belongings, calling or texting repeatedly, constantly putting yourself down, or criticizing your partner over minor things. To follow the above example, understand that you want to text repeatedly because you want reassurance that they care. Ask yourself, though, will you really get that reassurance? What could be the consequences of calling or texting 25 times to “check in?”
4. When you notice yourself having the urge to do the aforementioned things, take a time out for yourself and practice some skills to help yourself like counting to ten and breathing, reviewing your more adaptive thoughts, and if you are really activated or angry, then try holding a frozen lemon which should help lower the intensity of your emotions.
5. Communication with your partner is particularly useful. Ask for clarification instead of jumping to conclusions. Be mindful of your tone and make sure you bring your own emotional intensity down before attempting a conversation.
6. Think about what makes you feel secure in your relationship and make a list of the relationship and your partner’s positive qualities.
7. Review old photographs from the beginning of your relationship. Think about what drew you to this person in the first place.
It can be anxiety provoking or upsetting to have your therapist go on vacation or on extended leave (i.e., maternity leave) during a time when you may feel you most need to be in therapy. Even if the break occurs during a time when you aren’t under a lot of stress or “needing” to be in therapy, it can be jarring to find out the person you have been counting on and seeing regularly is not going to be available.
Many of us have seen the movie "What About Bob?" which is a hyperbolic and comedic portrayal of a desperate patient who refuses to accept that his therapist is on vacation and ends up following him. Just because you feel sad or angry or anxious about your therapist being on vacation does not mean you are that stereotype. This is a completely normal reaction. It is important to discuss the upcoming leave or vacation with your therapist and express your feelings.
Your therapist should create space in your sessions to discuss any feelings of sadness, anger, or anxiety that you have about the upcoming change. If your therapist doesn’t bring it up and you notice yourself having feelings about it, make sure that you bring it up. It is normal to have a full range of feelings about your therapist being unavailable during a period of time but often times clients feel they cannot or do not have the right to express those feelings because they understand intellectually that their therapist deserves/may need the time off. You also might feel that your reaction is silly or excessive. It is completely normal. Your therapist should understand and anticipate that you may have conflicting feelings about wanting your therapist to have the time off needed while being upset that your therapist will not be there for you.
Make a concrete plan with your therapist. Think about what will be happening during the extended leave or vacation such as a holiday or other potential stressor and write down ideas for how to cope with that time. Recall all the skills you have learned in therapy and plan how you will use them to get through this time. Make a list of supports in your life who you can call for help, if you want to talk to anyone. It can also be helpful to journal during this time either on a daily basis or to keep the weekly therapy hour you had to journal about your thoughts and feelings. Have a concrete plan in place for how to use skills you have learned and protect the gains you have made in therapy during this time.
Find out if your therapist will have someone covering. If your therapist is going on extended leave and you will be seeing someone in their absence, it can be helpful to meet with that person prior to your therapist’s last session with you before the leave in order to make sure it is a good fit. If you will not be seeing the covering therapist for therapy, review with your therapist the specific circumstances under which it would be appropriate to call the covering provider. It is helpful to plan in advance for this because calling someone you don’t know when you are in distress is hard enough.
If you need to find your own therapist to see during a long break like a maternity leave, for example, both ZenCare and Psychology Today are great resources. Make sure that the therapist you find takes your insurance, if that is a necessity. You can also call your insurance provider to find out what local therapists are "in-network" or find out which telehealth company they work with if online therapy is something you would like to try or need to try due to travel or scheduling constraints.
Also, it is important to keep in mind that a break that your therapist takes can provide you with a break as well, and a natural time to consolidate the gains you have made in therapy. It is absolutely essential to recognize how the hard work YOU have put into therapy has helped and to feel a sense of accomplishment, independence, and self-assurance. If you and your therapist agree that a break could help, make a plan with your therapist and discuss reasons/signs you may need to go back to seeing a therapist during that time. I cannot stress enough the importance of working with your therapist and planning in advance to figure out what this break will look like.
It’s not news to anyone that the holiday season is one of the most stressful times of the year, from conflict with family and financial strain to just plain stress about having an enjoyable time and making sure others do, too. In order to better manage the stress of the holiday season, it is important to find ways to lower your baseline anxiety. Lowering your baseline anxiety will help greatly with your ability to regulate your emotions. That is, you will experience less intense increases in anxiety and you will be able to recover more quickly from them.
7 Ways to Lower Your Baseline Anxiety And Manage Holiday Stress
1. Practice mindfulness by tuning into your environment in order to move your focus back to the present and away from your worries. Count holiday decorations in a store, like the number of Santas or ornaments you see while you’re shopping. If you’re at a holiday party or meal, focus on the taste of food. Count how many times you are chewing each bite.
2. Focus on your pet while practicing mindfulness. Spend extra time petting your cat or dog and focusing on the softness of its fur.
3. Reduce overall muscle tension by trying progressive muscle relaxation (PMR) which is when you methodically tense and relax specific muscle groups beginning at your toes and going up to your eyebrows. The theory behind PMR is that during times of prolonged anxiety, your muscles tense up and this can lead to headaches, neck or back problems. When you practice PMR, you (and your body) relearn what it feels like for your muscles to relax. This is one of many YouTube videos that provides a guide to PMR, and you should feel free to use it, or you can search around to find one that you like better.
4. Add self-care to your repertoire in the form of pampering yourself with a bubble bath, enjoying your favorite scented candle, or enjoying a yummy treat. Limit alcohol use and be mindful of its impact on your behavior and thinking. Alcohol is not only a depressant, but it generally reduces one's ability to regulate emotions. However, there is often the temptation to use alcohol to avoid your experience of anxiety. Remember, any form of avoidance of your emotions will only increase their intensity.
5. Try to find ways to keep exercise in your routine as physical activity is essential to managing anxiety and stress. If you do not have time to get to the gym and exercising outdoors is not for you, work on being active at home and give yourself credit for doing so. All of the cleaning and decorating for the holidays "counts." If you live in an apartment with an elevator and taking the stairs is an option, do so. Now is also the time to deliberately park farther away from your destination to get in some extra walking.
6. Lastly, remind yourself that this holiday season and your emotion that you feel in the moment is temporary. Like all emotions, as long as you do not fuel it with avoidance or harmful thinking patterns, this emotion will rise and fall on its own.