​​May is Mental Health Awareness Month and it's time to talk about confronting the stigma around therapy.  Many people would benefit from therapy but won't choose it because they feel ashamed and weak when confronted with emotional difficulties.  There is no shame in seeking professional help for emotional difficulties anymore than there is to visit a medical doctor for your physical health.
Physical and Mental Health are entwined.  Ignoring either can lead to greater difficulties.  Early intervention is the key to dealing with both physical and mental problems.
Men are particularly at risk from not talking about emotional issues.  Men can perceive themselves as weak and inferior for feeling anxious, depressed, angry, overwhelmed and other uncomfortable emotions.  Stuffing feelings down or ignoring them can be dangerous to functioning in relationships, can interfere with concentration at work, contribute to fatigue, irritability.
Here are some excerpts from an article by Sean Evans, "Not Talking About Mental Health is Literally Killing Men",  May 2, 2018.
"Your mental health is inseparable from your physical health. Not a revolutionary concept, but what is astounding is the stigmatization that still surrounds men who dare to talk about their emotional struggles.
Men who are vocal about any kind of mental issues can be dismissed as weak.  As inferior.  As flawed, broken guys who are more likely to be ostracized for their honesty, instead of rewarded for their bravery.  Instead of affording a fellow man compassion, we mock, belittle, and turn a blind eye. We freely spit the phrase, 'Man up', as though your gender alone should suffice to guide you through your darkest times.
Or worse the response can be 'Well, that sucks', then change the subject because talking about feelings is just too real.
What’s real is the fact that 9 percent of men experience depression.  That’s more than 6 million men.  More than 3 million men struggle with anxiety, daily.  Of the 3.5 million people diagnosed as schizophrenic by the age of 30, more than 90 percent are men.  An estimated 10 million men in the U.S. will suffer from an eating disorder in their lifetime.  One in five men will develop and alcohol dependency over a lifetime.  Male suicide is rising at such an alarming rate that it’s been classified as a 'silent epidemic.'  It’s the seventh leading cause of death for males.  That’s a staggering statistic. 
It’s okay to feel depressed.  It’s okay to feel overwhelmed.  It’s okay to be sad.  It’s okay to be anxious. It’s okay to be scared. It’s okay to not have everything figured out, to feel a wave of uncertainty come crashing over you and not know which way is up, or when your next gulp of air will come. These are perfectly normal feelings that every man experiences.  And it’s okay to talk about it.  What’s not okay is suffering in silence."  You can read the full article here.
Freud called therapy the Talking Cure.  It's time to talk!
Here are some misconceptions about therapy which may block someone from seeking help.

Most of us, most of the time, want to be nice, to do what is asked and to please those asking for our help. We usually try to be accommodating at work, with our friends, and with our family members.
But sometimes, rather than replying, "Sure," when asked to do an inconvenient favor, or to take on a task beyond your abilities, it may make better sense to say, "No."
It can be difficult to just utter that simple "No." You want to look responsible, helpful and capable. However, the reality is that saying "Yes." to virtually every request can produce a variety of negative results.
Research has shown that the more difficulty someone has in saying "No," the more the person is likely to experience stress, burnout and possibly even depression.  Difficult requests are highly likely to make you feel frustrated or anxious, or even mad at yourself for saying "Yes." in the first place.
The key to saying "No." is to do it in a respectful and courteous manner.  It starts with understanding what your own boundaries are, and not being embarrassed to accept and keep those boundaries. When you see that a request is going to push you into a zone where you'll feel uncomfortable or not fully competent, it's important to make your feelings, and decision, clearly known.
Responding to a request with phrases like, "Gee, I'm not certain I can," makes it clear that you are not being straightforward about your decision. That's also true when your immediate response is to start apologizing or making excuses and explanations for why you can't do what's being requested.
Instead, first make sure that saying "No." is really the only alternative. Politely let the person know you would like to help, but first ask questions to clarify what is really needed. Perhaps there is a way that you can help that wasn't evident when your aid was initially requested. But if it turns out that "No." really is the only right answer, then state your decision clearly. Let the person know you're sorry you can't help, but that it just wouldn't work.
While you want to be helpful, it's important to recognize your own limitations, interests and capabilities. Stepping too far outside those comfort zones will leave you feeling anxious and frustrated, and probably won't be the best help available.
Setting boundaries, and keeping them so you are not manipulated into situations which could cause stress and resentment is a way to use your personal power in a kind and clear way.
Remember, "NO" is a complete sentence.
​Adapted from American Counseling Association’s Counseling Corner Blog.
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Stop, Look, Listen, Smell, Taste, Touch.
What you know of the world comes through the 5 senses.  Paying attention to your sensory input can focus the mind on the present.  Living in the present can, momentarily, lower anxiety, relieve muscle tension and calm the mind.  
Here's a quick exercise, The Senses Check, which takes about a minute to bring you into a tranquil space.

• ​Stand and take a few deep breaths.
• Slowly rotate in place as you take in the visual information around you.  Name everything you see.
• Come back to place and close your eyes and attend to the sounds in your environment.  Name the sounds.  Locate them in your mind's eye.
• Switch your awareness to smell and identify any odors.
• Now, lick your lips to taste whatever is there.
• Next, switch your attention to touch.  How do your clothes feel on your body?  How do they feel when you touch each component; soft/hard, warm/cold, rough/smooth.  How does your body feel?  Notice any kinks, sore spots, muscle tension.
• Inhale deeply and as you exhale release any physical stress.
• Smile!

This one-minute exercise connects you to the immediate environment through your 5 senses.  If you practice often you can lower your stress baseline, clear a cluttered mind, relax the body, even change your viewpoint.​
Do The Senses Check and experience the present moment completely.
Even one episode of mindful practice can be beneficial for your health.

Listening is a skill which can be used to help improve relationships with family, friends and co-workers.
Listening is an important tool in relationships.  By listening carefully, we can usually tell what another person wants out of the relationship.
The purpose of listening is to focus on the other person and learn something about her or him.
We can all become better listeners:

• Decide that you want to listen to the other person
• Let the person know you are listening by making eye-contact.
• Silence encourages a person to share feelings and thoughts.  Don't be afraid of it.
• Listen without judging, not whether you agree or disagree, not whether the person is right or wrong.
• Try to understand what's being said and the underlying feelings.
• Do not think about anything other than what the person is saying.  Avoid thinking about your response.  When you think about your response you are listening to your inner voice and not listening to the other person.
• When the person is finished talking, acknowledge what you heard by paraphrasing what was said and reflecting the feelings you heard, explicitly, or between the lines.
• When we stop, focus and listen we tell other people they are important and what they have to say matters.
• Listening to another and showing understanding is one of the greatest gifts to offer.

This article from the New York Times explains how to become a better listener.

Now that spring is here it’s time to revise or create an outdoor exercise routine.  The list of the benefits of regular aerobic and strength-training exercise is too long to post here.  However, relief of depression is an important one.
Depression is a common disorder that is associated with compromised quality of life, increased health care costs, and greater risk for a variety of medical conditions, particularly coronary heart disease. 
Here are some tips to help you get started and maintain the benefits of regular exercise. 
To use that famous NIKE slogan, “Just Do It.”

1. Choose an activity that you enjoy and stick with it.  The number of activities to choose from can boggle the mind.  Just because you “don’t feel like it” is not a reason not to exercise. Tell yourself the truth that you’ll feel better afterwards. 
2. Make small changes.  Start with one day per week for 20 minutes.  Add more time or add another day.
3. Make a plan.  Don't leave it to chance.  Put your exercise session on your calendar.  Have plan A and plan B depending on weather or other scheduling. 
4. Invest in a good pair of exercise sneakers.  Consult with an expert.  It’s an investment that you won’t regret!  Don't let sore feet provide an excuse to skip your workout.
5. Timing is everything.  Exercise at a time of day that is most convenient.  Do not exercise on a full or empty stomach or just before you go to bed.  People with depression often suffer from insomnia, and night time exercise can leave you feeling energized when you want to sleep.  If possible, exercise during daylight hours to also benefit from sunlight.
6. Watch out for barriers to exercise.  Anticipate them and develop strategies to make exercise as easy and simple as possible.  Brainstorm potential solutions to bad weather, work commitments, fatigue, and any other lame excuse your demons will present.
7. Get a buddy.  Some people who exercise with a partner enjoy it more and are more likely to stick with it.  Also, the additional social support may provide motivation and have other beneficial effects.
8. Think positively. Praise your successes. Keep a record, get a tracking device.  View lapses in your exercise program as learning opportunities and don’t get discouraged if you miss a session.  Succumbing to excuses for one day is not a tragedy but get out there the next day.
9. Enjoy the moment. Take a minute when you are finished with an exercise session to appreciate how you feel in your body, mind and spirit.  A sense of accomplishment can follow you throughout the day.

Exercise appears to be an effective treatment for depression, improving depressive symptoms to a comparable extent as pharmacology and psychotherapy.  Observational studies suggest that active people are less likely to be depressed.  Even modest levels of exercise are associated with improvements in depression.  While the optimal “dose” of exercise is unknown, clearly any exercise is better than no exercise.  "Just Do It." and sustain it.
Here is a recent article from Slate which provides information on the anti-depressant effects of regular exercise.   Exercise and Happiness from The NY Times provides more information.  And another one about exercise to lower blood pressure and reduce fat.
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Everyone has difficulty falling asleep occasionally.  You can improve your sleep hygiene and reorganize your bedtime routines to create an external and internal environment which is more conducive to restful sleep.  
Here is a brief visualization called The Body Scan which can help release tension and quiet the mind.

• Lie on your back and make sure you are comfortable. Adjust your pillows and covers until you are totally comfortable.
• Close your eyes.
• Take some deep breaths and release stress as you exhale.
• Focus your attention on your toes and, without moving, visualize them melting into the mattress.
• Do the same with your insteps, heels, ankles, calves, knees, thighs, butt, spine (each vertebra individually), move upwards through each discreet muscle and body part.
• At each step/exhale tell yourself the story:  I am relaxing my toes, neck, shoulders, arms, etc., my toes are melting into the mattress, my body is releasing tension, I am ready for sleep.
• By the time you reach your head you may be drowsy and dropping-off.

Any repetitive tone or visual image can induce relaxation and sleep.  Mantras, prayers, counting sheep is an old-fashioned and effective remedy.  And don't forget what some "old wives" recommend; a cup of warm milk or chamomile tea can soothe the body and mind.
If your sleep is disturbed for many nights you may be experiencing insomnia which is habitual sleeplessness, wakefulness, restlessness.  Prolonged insomnia can have serious psychological and health problems.  If this is the case, consult a physician.
Researchers at Harvard have developed a list of 12 tips to promote better sleep.  Look them over.

An old adage says knowledge is power.  There is research evidence that writing is a powerful tool to promote living consciously and can improve mental and emotional life; help to cope with stress, anxiety and depression; dispel loneliness; make us more emotionally available to ourselves and others. 
I recommend writing, daily, to all my clients and give them the best-selling book by Julia Cameron, The Artist’s Way.  Julia describes the process she calls “Morning Pages” for writing three pages, stream of consciousness, every morning without censoring, without worries about spelling or sentence structure, just what flows, spontaneously, from heart and mind. 
After several days or even weeks of whining and complaining something shifts; patterns and insights emerge which create opportunities to make different choices, small changes in daily living.  These decisions can enhance life experiences and diminish the problematic ones. 
Over time, the benefits add up to counteract symptoms of stress, depression, anxiety, and other mental health disorders. 
Emotional benefits:

• Manage Stress.  Writing about what’s creating stress and anxiety in your life helps you to identify stressors and pinpoint what’s going on internally. And sometimes you just need to vent, even if it’s only on the page.
• Enhance emotional intelligence.  Writing about how you feel helps you interpret and make sense of your emotions.
• Improve communication skills. Learning to put your thoughts down on paper translates into a better ability to express yourself to others verbally.

Personal benefits:

• Set and achieve goals. Writing down your wishes and dreams signals to your brain that they are important and takes them one step closer to existence. Furthermore, organizing your thoughts into words helps prioritize projects and needs.
• Build self-discipline. Writing every day, even when you’re not necessarily in the mood to do so, strengthens your ability to stick to something on an ongoing basis. Therefore, you’re better able to do other things that require self-discipline.
• Assist in problem-solving. New perspectives become clear when you write—even if you’re not consciously trying to find solutions. Writing helps you look at a situation more objectively and from more than one point of view.
• Create empathy. Writing about an event or relationship helps you see more clearly what others might be feeling or thinking during your interactions with them.
• Become more aware of habits and patterns. What makes you happy? When do you feel most troubled? Writing regularly, and then reading what you’ve written over time, can help identify what creates or detracts from your well-being.
• Increase creativity. Writing prepares you to be creative in other areas of your life, as well as on the page. You learn to be creative in your approaches to dealing with pain, difficult emotions, and challenging relationships.

Writing also supports physical health.  In recent years, research has revealed that writing down your life experiences can create positive physiological changes.
To sum it up, writing makes you happier!
Check out this research summary from Harvard Healthbeat.

There are many factors that can have negative effects on us, but sometimes it's important to focus on those things that can actually improve the quality of our lives. Yes, exercise, eating right, and getting plenty of sleep all can contribute to better physical and mental health, but another even simpler antidote that is often overlooked is making sure to laugh frequently.
Laughing is a natural part of life. As infants, we started smiling within our first few weeks and were laughing out loud within just months. Unfortunately, as we get older and life gets more serious, the ability to laugh can sometimes be diminished. Fortunately, you can learn to laugh again regardless of age.
How does laughing help? In addition to adding joy to your life laughter can:

• Ease anxiety and reduce tension.  Laughter has been shown to be an important stress reducer.
• A good, strong laugh can even help relieve physical tension, leaving muscles relaxed for up to 45 minutes.
• Experts say laughing releases endorphins, the body's "feel good" chemicals.
• Laughter also decreases stress hormones and increases immune cells, improving your body's resistance to disease.  
• One study in Norway found that people with a strong sense of humor tended to outlive those who didn't laugh as much.

So, how to get more laughter in your life?  Start with a smile. Smiling, whether to family, friends, co-workers or even to strangers on the street, sends out a positive message and makes you feel better, too. It's difficult to be smiling and in a bad mood at the same time. Plus, others will smile back, and that's also nice.
You can increase your laughter quota by searching out things that make you happy. Maybe it's playing with a small child or a family pet. Maybe it's taking the time to find a funny movie, TV show or a video on YouTube. Try reading a humorous book, or sharing a good joke or funny story with others. Read the comics, watch a comedian on TV, or have a night out at your local comedy club.  Yes, life can be serious and we can't always be laughing, but putting a little extra effort into trying to find the funny in your life can leave you feeling happier while providing real benefits to your physical health and mental well-being.​
Adapted from The American Counseling Association’s Counseling Corner Blog.

                                    The Dead of Winter Can Leave You Feeling Depressed 
More than 300 million people worldwide suffer from depression, according to the World Health Organization. Twice as many women than men have depression, and all ages are affected.
Depression is especially important to recognize in pregnant or postpartum women, patients who are elderly or have cancer and in children and teenagers, as it can often be overlooked and can lead to devastating consequences.
At its worst, depression can lead to suicide, with more than 800,000 people dying of suicide every year. Notably, people who have gone through unemployment, loss of a loved one, a divorce or separation or even suffered a heart attack can become depressed. Depression also runs in families, so it’s important to know your family history of mental illness.
When patients with depression go to their doctors’ offices, two-thirds will present with symptoms such as a headache, backache or another type of pain, rather than admit they have depression. Often, it takes a direct question, such as “are you depressed?” for it to be recognized.
Common symptoms of depression
The following symptoms are typically present for at least two weeks, and depending on the number of symptoms, one can classify depression as mild, moderate or severe:

1. Feelings of worthlessness, guilt or failure. People interpret minor setbacks in their life as personal failures.
2. Becoming more withdrawn, or not caring to participate in activities that once caused joy.
3. Depression causes loss of energy in routine activities. Sometimes people with depression report feeling exhausted before the day even begins.  Losing that “get up and go” is commonly found in depression.
4. Crying spells, or becoming teary-eyed are easily recognized signs of depression.
5. Eating too much or binge eating, or conversely not having an appetite, can all be signs of depression. While there is no absolute number in weight gain or loss that defines depression, losing or gaining an average of 5 percent of one’s body weight per month is concerning.
6. Sleep is often affected in depression, both in sleeping too much or not being able to fall asleep or stay asleep. This is frequently one of the earliest signs of depression. Depressed persons can feel fatigued despite getting a full night’s sleep.
7. Depressed people often experience a loss of concentration or become easily distracted.

Many times, people won’t admit they’re depressed because they don’t think of depression as a “real” disease, or they might feel as though their doctor will just prescribe antidepressants or refer them to a psychiatrist to have their “head checked.”
The more we understand and talk about depression, the earlier we can recognize it in our friends, families and loved ones. And for someone who’s suffering from this very real and debilitating disease, talking with a doctor can be the first step toward recovery.
Treatment for depression
Treatment depends on the severity of the symptoms. It can range from simple recognition of the disease to medications and, sometimes, admission to a hospital for intensive treatment. Many patients with depression benefit from counseling and behavioral therapy. Regardless, neither counseling nor medications work instantly. It can take up to two weeks to begin to see the beneficial effects of medicine and up to four weeks to see the beneficial effects of counseling.
People with depression have a lower quality of life and a higher risk of suicide than those without depression. Additionally, depressed patients affect the quality of life of those who live and work with them. Recognizing the symptoms of depression and identifying ways to manage and alleviate it can have a profoundly positive impact for the patient and his or her loved ones.
This post is based on one of a series of articles produced by U.S. News & World Report in association with the medical experts at Cleveland Clinic.

​Most people experience a slump in January and February after the frenetic end-of-year and new year festivities.  Some of this is merely fatigue but the Winter Blues can leave you feeling, sad, irritable, unmotivated.  If these feelings intensify and lead to sleep problems, changes in appetite or weight, depression, you may be experiencing Seasonal Affective Disorder (SAD).
If your symptoms are in the milder category of Winter Blues there are several things you can do to help yourself feel better.​

• Since the 1980's light therapy has offered an effective remedy to boost energy.  There are even full-spectrum light visors so you don't have to remain in place to get your dose.  You do need to follow guidelines about when during the day and how long the exposure. There's lots of information on-line to inform you how to use light therapy.
• Cognitive Behavior Therapy (CBT) can teach you coping skills for the short-term seasonal occurrences.  Once you learn the skills you can use them daily throughout the year for your general well-being.  
• Of course, exercise is an effective mood-enhancer.
• Meditation can promote relaxation and mindfulness and enhance cognitive skills.  Future blog posts will present activities to promote mindfulness, stress reduction and relaxation techniques.
• If your symptoms persist for days and light, CBT, exercise and meditation are not effective it may be time to consult a physician or mental health counselor to discuss other interventions.

This brief article from the Mayo Clinic provides more information and this article from The New York Times is also useful.  
​A report from Cornell University found that natural light in an office significantly improves health, wellness and productivity in workers.