Overcoming Life's Obstacles

Importance of Downtime for Teens this Summer

2009-06-26T11:11:00.002+12:00

You can read Nancy's latest post on helping teens with overload and get tips to recognize and prevent your kid’s stress overload and to promote a healthy balance...

Related articles:
Overbooked kids

Free Goal Setting Reminder Tool

2009-01-07T11:27:00.002+13:00

Have you set any goals yet?

Some people set goals throughout the year, but many take advantage of the New Year to kick themselves into action.

If you'd like help with your goals, use this Goal Setting Reminder Tool that explains why setting 90 day goals and chunking them down into smaller goals works.

You'll get sent a reminder of your goals, the first action your committed to make, and your goal setting milestones or steps along the way to your 90 day goal.

New Year's Giveaways and Help with New Year's Resolutions

2009-01-04T10:45:00.001+13:00

Happy New Year. To get 2009 off to a good start I’ve found some great giveaways for you, as well as some tips on setting your goals.

The experts tell us we should be setting and reviewing our goals throughout the year, but many of us see the “fresh start” a New Year offers as the best time to create new goals and set New Year’s Resolutions. The best advice I can give is you is to follow Nike’s advice and “just do it”. One of the biggest mistakes people make in goal setting is failing to take action. They wait for the timing to be perfect, or for their plan to be perfect. Obviously jumping in without an iota of planning can lead to unwanted consequences, but spending all your time writing nice neat goals and planning can see opportunities pass you by.

If you want your New Year’s Resolutions to stick - set your goals, prepare your mindset for change, write an action plan and then DO IT!

To help you with your New Year’s Resolutions I’ve found some giveaways on the net that give you free advice on everything from being the next King or Queen of ebay to improving your health and understanding the Law of Attraction.

Self improvement giveaways

777 Self Help - a huge variety of self improvement products on just about any topic you can imagine.

New YOU Year Blast Off - mainly personal improvement (mindset change, weight loss, health, parenting) with a few of the inevitable make money on the internet programs

Happy New Years Giveaway - mainly downloads and ebooks on making money online, as well as software giveaways and graphics packages

New Year Gifts - more downloads and ebooks on making money online, as well as software giveaways and graphics packages

There is also a Daily Software Giveaway that lets you get your hands on software for free, so long as you download it before the day is up. I strongly recommend you read the feedback before you download the software. Some software isn’t worth downloading, but you can also find some gems.

Clothing Size Maketh The Woman

2008-08-09T12:00:00.005+12:00

What’s more important to you - buying clothes that fit you well, or, the label size of those clothes?

You may be surprised to find that in a recent survey by a clothing alteration firm that Australasian customers, and in particular women, would opt not to purchase clothes that fit them well, if the label says it is in a larger size than their usual size. When you consider that most clothes don’t have the size label on the outside, why are we so worried about this invisible measure?

The answer lies in a common body image issue. For many of us our self-esteem is dependent on how our body looks, and how we perceive that our body looks to others. Buying a larger size can lead people to feel dissatisfied with their body, which in turn can lead to emotional eating, yoyo dieting and despondency.

I’m sure a lot of readers can relate to the thrill of finding that they can fit into a smaller size of jeans, and the disappointment when their usual size doesn’t fit. Some people use it as a form of motivation – they intentionally purchase clothing that is too small for them in the hope that this will inspire them to lose weight, but others do it because they can’t bear the thought of purchasing a larger label size.

Canny manufacturers recognising the psychology of clothing sizes often opt for roomy clothes and increasing the measurements to allow people the comfort of purchasing clothes in a smaller label size. This is on top of adjustments that have been made to accommodate the growing girth of the population.

Experts estimate that today’s size clothing in New Zealand is approximately 5cm (2 inches) larger than the same label size 20 years ago.

Two-thirds of customers surveyed by clothing alterations chain LookSmart said they owned clothing in different sizes, and half said sizing variations made them feel frustrated, depressed - or fat.

Mr Hatoum said inconsistent sizing was demoralising to shoppers, many of whom were unwilling to change sizes for emotional reasons.

Hatoum sums it up neatly when he says,

"A size tag is more than a number - it relates to how people see themselves."

So what is the solution? Some in the industry want to see standardised sizing across all apparel manufacturers, but I think the real answer lies in not becoming overly attached to the clothing size label. Scales and clothing sizes are useful measures to help you track your progress toward your goals, but when you get on the rollercoaster of feeling good or bad about yourself depending on the result of those measures, they become self-esteem killers.

If you can learn to be confident and happy with your body and opt to purchase clothes that are comfortable and fit well it will be one less trigger to emotional eating, which can stop people from losing weight and keeping it off.

Free 75 Minute Audio on Why Diets Don't Work

2008-07-14T19:34:00.001+12:00

If you missed the free teleclass with tips on beating mindless eating, emotional eating and overeating by changing your thinking, you can grab a free copy of the audio by registering here.

Free Help for Emotional Eating

2008-06-27T13:30:00.002+12:00

I’ll be conducting a free online training session on emotional eating, common diet myths and why diets don’t work for everyone.

If you’re sick of diets or struggling to get a handle on comfort eating, overeating or binge eating then register for the free seminar and I’ll send you all the details with your passcode, times and dates so you can access the training.

You can tune in via your computer or dial in with your telephone, and you’ll also get the chance to ask me your burning questions about emotional eating and why diets don't work.

Chocolate Manufacturer Most Trusted Brand

2008-06-24T12:27:00.003+12:00

For the fifth year in a row, Reader’s Digest readers have rated chocolate manufacturer, Cadbury the most trusted brand in both Australia and New Zealand.

At a time when governments are worrying about rising obesity, the New Zealand public voted Cadbury the most trusted brand, closely followed by Tip Top, an ice cream manufacturer. In Australia, Cadbury also won for the fifth year in a row.

Reader’s Digest says

It helps that chocolate is one of our most-loved products; a reliably available instant mood lifter.

They go on to add that Cadbury has a solid reputation during its 86 years in Australia for keeping its promises to consumers.

According to social commentator Bernard Salt, it's not always rational - people are emotionally attached to trusted brands. "Curled upon a cold night with a glass of wine and a Cadbury chocolate, you feel great."

Other brands that rated highly in New Zealand include Panadol and whitegoods manufacturer Fisher & Paykel.

The poll gives readers a list of brands to rank, which includes “healthy” brands but it seems Reader’s Digest readers love their junk food.

What do you think about the love affair we have with chocolate Down Under?

Skinny Songs Review

2008-04-04T12:30:00.001+13:00

I love the idea of combining upbeat music with motivational lyrics to help people make lifestyle changes.

Skinny Songs aims to do just that with a collection of songs that Heidi Roizen put together, writing her own lyrics and collaborating with professional musicians and producers. Describing the songs as empowering, tracks include Objects in the Mirror Will Get Thinner Than They Now Appear, The Incredible Shrinking Women, You da’ Boss, I’m a Hottie Now, You Can’t Buy Thin and Skinny Jeans.

Unfortunately, the songs - which she describes as celebrating commitment, strength, and sex appeal - reinforce all the stereotypes that see people’s self-worth dependent on their jean size or their image in the mirror. I’m realistic enough to know that a lot of people feel better when they lose weight, and I applaud anyone who can come up with new tools to help people break old habits and motivate them to make lasting changes.

However, these lyrics just seemed plain silly. I’m sure they reflect the fears and fantasies of many women and more than a few men, but I’d rather not perpetuate them. Some of the songs are positive, but many have negative messages about being unattractive until you lose weight, and the importance of fitting into “skinny jeans”. I’m not convinced that everyone can realistically aim to be thin or skinny (or even desires to be skinny) nor do I think it's within everyone's means to wander into Saks to grab Gucci and Versace clothes.

At the end of the day, it’s about what works for you. Heidi swears this music helped improve her bottom line to the tune of 30 pounds (13.6 kg).

Here is a selection of lyrics. You can check out all the lyrics and listen to samples of the music at Skinny Songs and make your own decision.

I’m a Hottie Now

I spent years in misery
‘Cause everyone who looked at me
Was thinking evil thoughts about my thighs get back, into you somehow

The Incredible Shrinking Woman

You see I'm a superhero, with powers of epic might
I use wills of steel, at every meal, to control my every bite
And with my xray vision I can see without a doubt
There's a skinny girl inside me, I’ve just got to let her out

She’s the Incredible Shrinking Woman! Incredible Shrinking Woman!
Incredible Shrinking Woman! Incredible Shrinking Woman!

Poor Body Image Makes You Unhealthy

2008-02-14T20:06:00.005+13:00

People who are happy with their weight experience fewer physically unhealthy or mentally healthy days, than those that want to lose weight.

Researchers at Columbia University Mailman School of Public Health have concluded that there is a direct correlation between people’s weight loss goals and the number of days they report being unhealthy. They suggest this indicates that pressure to lose weight and low body-esteem is a bigger contributing to mental and physical well-being than body mass index.

Apparently if you’re overweight but don’t give a toss, your health is better than that of people that want to lose even a small amount of weight. For example, if you weigh 180lb (81.8kg) and want to lose 1% of this weight i.e. 1.8lb or 818grams, you will be marginally less healthily than those who are happy with their weight.

However, if you set your sights on losing 10% of your current weight (18lb or 8.2kg) then over a period of a month you’re likely to report almost one extra day of feeling unhealthy compared to your body satisfied counterparts. Over a year it amounts to nearly 11 extra ‘unhealthy’ days.

Ramp it up to a goal to lose 20% of your current weight and the figures jump to an extra 4.3 days per month of reported feelings of being physically or mentally unwell. Extrapolate this over a year and you’re talking about feeling unhealthy on a whopping 51.6 days.

This all points to the need to making changes from the inside out, and to get away from measuring your self-worth as a function of your weight.

Too often I see people going through the emotional roller coaster of battling with the scales. Periods of restraint and feeling pleased with themselves, followed by periods of overindulgence and dealing with the resulting guilt and disappointment. This research suggests that the route to good health comes from loving your body now, rather than making that self-love conditional upon attaining your desired jeans size or weight goal.

“Our data suggest that some of the obesity epidemic may be partially attributable to social constructs that surround ideal body types,” said Peter Muennig, MD, MPH, Mailman School of Public Health assistant professor of Health Policy and Management. “Younger persons, Whites, and women are disproportionately affected by negative body image concerns, and these groups unduly suffer from BMI-associated morbidity and mortality.”

Approximately 66% of the more than 150,000 U.S. adults studied wanted to lose weight, and about 26% were satisfied with their current weight. With respect to BMI, 41% of normal weight people, 20% of overweight people, and 5% of obese people were happy with their weight. Older persons were also more likely to feel positively about their weight than were younger persons. However, in all models, perceived difference was a stronger predictor than was BMI of mentally and physically unhealthy days.

Researchers now conclude that the additional stress that people experience from negative body image is affecting their health. Body image (measured as desired weight loss) was a stronger predictor of poor health than body mass index (BMI). Or, put in simple terms it’s not how much you weigh that matters, it’s how you feel about your weight that influences your physical and emotional health. Not surprisingly, this was found to be more predictive of health in women than men, and in Whites than among African-Americans or Hispanics.

The paper, I Think Therefore I Am: Perceived Ideal Weight as a Determinant of Health, will be published in the March issue of the American Journal of Public Health.

Why Diets Don't Work

2008-01-22T11:30:00.001+13:00

Anyone who battles with periodic bingeing, emotional eating or overeating knows how difficult it is to lose weight and keep it off.

Diets often work well in the short-term, but the majority of people regain their lost weight within the next five years, and some end up weighing more than they did before they started. But why does this happen?

I think there are several reasons why people diets don’t work long-term including:

underlying thinking errors
unhelpful beliefs
feelings of deprivation and restriction
poor body esteem
expecting instant results
lack of motivation
not finding new coping mechanisms to deal with stressful situations

If you want to hear the full list of issues that could be sabotaging your goals and get tips on creating a healthy relationship with food you can call in to my free webinar to find out Why Diets Don’t Work.

I’ll also be discussing the different types of overeating and I’ll be taking questions at the end of the call.

There’s no charge for the tele-training seminar, except for your usual long distance calling charges. If you log in to the simultaneous webcast it's completely free. Just sign in and listen.

Updated:
I'm running another seminar in July, so if you missed out on the last one you can sign up now to receive all the details.

Light Therapy Pros and Cons

2008-01-16T12:03:00.000+13:00

The Mayo Clinic has an excellent article on the use of light therapy for treatment of Seasonal Affective Disorder, depression, obsessive compulsive disorder and some sleep disorders. The article includes the benefits and side-effects of using light boxes as well as instructions on using a light box.

The Mayo Clinic makes the point that the effectiveness of using light boxes vary, from being as good or better than medications for some people, while others get little or no benefit. This is possibly due to the large range of light boxes available and the different theories on the appropriate spectrum of light to use and the duration of treatment.

Light boxes can be expensive to purchase, however it is also possible to rent them on a trial basis to see whether they are effective for you. The Apollo GoLite box is a popular model that a lot of people have recommended (I've never used one as I find the winters here are quite mild and I can usually get enough natural light to keep depression at bay). In addition to using the light boxes there are also special light bulbs and desk lamps you can purchase.

Once you have purchased the light box, most models will last a few years, but it pays to check out the replacement at the end of this time. Some will allow you to replace the bulb, other models require you to replace the entire box which can be costly. However, if you don't have insurance the light box can still be cheaper than medications without the stigma or side-effects of anti-depressants.

This doesn't mean that light boxes don't have side-effects, however most people find them tolerable. Some people with bipolar disorder may experience manic episodes, while others may find that the light box affects their skin, or induces headaches or eyestrain but the majority of people that I've spoken to have nothing but praise for their light box.

Free Happiness Seminar Online

2008-01-10T11:46:00.000+13:00

Marci Shimoff, #1 New York Times Best-selling author has written a new book on happiness, which she says will help people find the feelings of inner peace and life satisfaction which she describes as the "Happy For No Reason" state.

Marci describes experiencing a lot of external factors that she expected to make her happy and couldn't understand why she felt dissatisfied and unhappy. She decided to investigate the source of happiness and find out why some people could be happy for no reason at all!

As part of her quest Marci interviewed people from all walks of life to find out what made them happy. One of the questions she asked was, “What do you think is the most important thing necessary to experience the Happy for No Reason state?” The result was what Marci describes as the 21 Happiness Habits.

You can download a free sample from her book, which includes the 20 key questions that Marci says determine your state of happiness and your "happiness set point" and listen to a replay of her free teleseminar online or download it to your mp3 player. You can also send her your question on being Happy from the inside out in your personal and professional life.

New Year’s Resolutions and Announcements…

2008-01-08T18:28:00.000+13:00

Welcome to 2008. I hope you’ve all had a great break and enjoyed the festive season.

At this time of year people’s thoughts turn to New Year’s Resolutions and gearing themselves up for the new work year. If you’re like me that includes wanting to start the New Year with a fresh start. I like to rummage through all the cupboards and throw out anything I don’t need and get all my files sorted and organised. I always find a good declutter, helps clear the mind as well as the house!

If you’re looking for help with your New Year’s Resolutions, check back on last year’s post which explains the 10 Biggest Mistakes People Make with New Year’s Resolutions and these tips on goal setting.

Blog Changes
This year there will be changes at the Centre for Emotional Well-Being blog. As part of my commitment to keeping my life in balance - not to mention my sanity - I have decided to cut back on the time I spend blogging so you’ll be seeing fewer posts from me. Nancy will also be doing fewer posts as she attends to her growing freelance writing business. Over the next few weeks, I'll be reorganising the index to the blog to help you find any resources you may need in our library and links. Until then, pop your query into the search box at the top left hand side of the blog.

Merry Christmas everyone

2007-12-25T10:09:00.000+13:00

We want to wish everyone a Merry Christmas and safe and happy holidays.

There will be no more posts for the remainder of 2007, but if you're looking for help with anything you can search our archive of articles, or visit the forum for a list of agencies that deal with emergencies, or can provide a friend on the telephone.

Meri Kirihimete (that's Maori for Merry Christmas)

Talia and Nancy

P.S. If you'd like some Christmas cheer check out Talia and her Elves wishing you a Merry Christmas

Overbooked Kids

2007-12-14T06:03:00.000+13:00

My therapy practice includes quite a few adolescents, mainly high school students. Lately, I've been amazed at how packed their schedules are. They practically have to pull out a PDA to make an appointment! When I asked one yesterday if things were winding down before the holidayr break, she looked at me like I had two heads. Evidently, the teachers are piling it on.

Of course, I can't be entirely objective about this topic. I'm a mental health professional and the kids I see are usually being treated for anxiety, depression, substance abuse, etc. So I'm looking for any causes for the pathology I'm seeing.

In an article in Psychology Today, The Overbooked Child, psychologist David Elkins talks about the stress and depression he sees in his young patients. After interviewing his patient Kevin (not his real name) and his mother, the mother dismissed the idea that her son was stressed. She maintained that he enjoyed all the activities in which he was scheduled.

"But Kevin wasn't having a good childhood. He was overscheduled and on the brink of clinical depression. When I talked to him on his own, he confided that he missed playing with his friends in the neighborhood. They used to ride bikes, have water-balloon fights and build forts out of cardboard boxes. Now there wasn't time for those activities. 'I really like being in sports and everything,' he said. 'But not all that much.' "

In the book, The Over-Scheduled Child: Avoiding the Hyper-Parenting Trap, authors Alvin Rosenfield, M.D. and Nicole Wise discuss this issue. Rosenfield believes it's the parents who are driving this, "it's how we parent today."

"Parents feel remiss that they're not being good parents if their kids aren't in all kinds of activities. Children are under pressure to achieve, to be competitive. I know sixth-graders who are already working on their resumes so they'll have an edge when they apply for college."

But what continues to surprise me about this phenomenon is that the kids are doing much of this over-scheduling themselves. They are enrolled in AP (Advanced Placement) courses to get a leg up on college, they have a certain number of hours of community service to fulfill for National Honor Society and to look good on college applications. Then there are the extracurricular things like sports, drama, music-related activities, etc. This is all on top of regular school hours and homework. This schedule leaves very little free time or family and friend time.

When I've asked them about their schedules and whether their parents are pushing it, I often here that most of the activities, including enrolling in AP courses, are their choice.

On the Web site FamilyEducation.com, they suggest ways to help your kids work towards a balance in their activities:

Help Your Kids Strike a Balance

Help your child set priorities.

Help your child develop a realistic schedule to accommodate family, school, sports, and everything else.

Find out at the beginning of the season what the coach's expectations are for the team.

Let the coach know about your child's other commitments.

Encourage your child to get homework done early in the day.

Set aside a certain period every day for quiet study.

Watch for signs of burnout, i.e., falling grades, diminished interest in other activities, and fatigue.

Work with coaches and school officials to minimize sports interference with academics.

Be a good role model: set priorities for yourself and stick to them. Point out athletes who maintain good grades.

This last point is critical. If you, as a parent, are so overscheduled yourself that you can't make time to discuss a healthy balance with your kid, that's an indicator of a problem. I'm amazed when I ask parents to schedule an appointment with me to discuss their child. I will often hear an incredulous, "Both of us?!" That always tells me very important information about the family's priorities. And yes, I insist that they both make time to come in.

Nancy L., LISW, LICDC

Recreational Drugs for Depression?

2007-12-10T11:37:00.000+13:00

A horse tranquiliser could hold the key to treating depression.

Ketamine, which is used as an anaesthetic for humans and animals, and is also sold as a street drug to induce a "high", is being considered as a possible treatment for depression in those that have not responded to conventional treatments.

Researchers may be able to develop an antidepressant which takes effect almost immediately by directly targeting novel molecules in the brain instead of taking a less direct route, which can lead to longer times for medication to take effect, according to a study presented this week at the American College of Neuropsychopharmacology (ACNP) annual meeting.

The antidepressant is also thought to be effective in people for whom previous treatments have been ineffective. This human and rodent research is among the first to examine the effects of rapid antidepressant strategies.

Lead researcher and ACNP member Husseini Manji, M.D., director of the mood and anxiety disorders program at the National Institute of Mental Health (NIMH), says one of the major limitations in existing pharmacological treatments for major depression is the time between starting to take the medication, and when it starts to alleviate the depression, often a period of one month or longer. He adds that strategies that work at much faster rates would have a tremendous impact for Americans who suffer from depression – nearly 21 million annually, according to NIMH.

"Today's antidepressant medications eventually end up doing the same thing, but they go about it the long way around, with a lot of biochemical steps that take time. Now we've shown what the key targets are and that we can get at them rapidly," says Dr. Manji. “This research is leading to some very real possibilities for a whole new generation of antidepressant medications."

The study looked at patients in a “difficult to treat” group, meaning individuals who had not responded to other treatments including psychotherapy, traditional antidepressants or electroconvulsive therapy.

Researchers treated the depressed patients intravenously with ketamine, a general anesthetic usually used for minor surgical procedures in which muscle relaxation is not required. The doses of ketamine used in this study were considerably lower than when it is used as an anesthetic. These tests are part of an ongoing study

Ketamine produced results much more quickly than traditional antidepressants because it acted directly upon critical molecules in important neuronal circuits instead of having to bypass multiple locations en route to those circuits. Typically, currently available antidepressant medications work via serotonin or norepinephrine, neurotransmitters which act within the brain to help regulate emotion and cognition.

The results showed that patients responded after only two hours, and within 24 hours, 71% had responded. Patients were followed over time, and 35% maintained their response for up to one week. Traditional antidepressants usually take many weeks, or even months, to begin to work. “This is intriguing data which suggests that targeting these important molecules in critical circuits would be extremely helpful in treating depression more quickly, before it worsens and becomes more severe,” Dr. Manji said.

The researchers also studied rodents to determine whether they could get medication to highly responsive brain areas more quickly. By looking at different biomarkers – specific physical features used to measure the progress of a disease or condition – in mice and rats, researchers came closer to identifying at what point in the biochemical process medication might become effective, which would ultimately lead to faster treatment.

Treating patients with rapid strategies is essential since some patients who suffer from depression are tempted to stop their medication if it doesn’t work quickly enough.

Ongoing human studies using magnetoencephalography (MEG) are also helping to identify the specific brain circuits through which these rapid antidepressant effects occur. Identifying these precise circuits may lead to the development of molecules with even more precise effects, and therefore fewer side effects.

It's unclear whether Ketamine can be developed as a commercially viable antidepressant due to its side-effects. However, by identifying the underlying actions of the components of Ketamine and correlating these to biomarkers, scientists hope to develop fast-acting safe treatments for depression.

Sources:
American College of Neuropsychopharmacology (ACNP) press release
National Institute of Mental Health (NIMH)press release

Coming to the End of "Guest Hosting"

2007-12-07T09:50:00.000+13:00

I wanted to mention that today's post is the last in my "guest hosting" stint. I have enjoyed filling in the past month for Talia while she tackles other projects.

Thanks to all of you who have read my posts and especially to those who have taken the time to comment.

I look forward to dropping in occasionally to post on topics of interest to me.

Have a safe, sane and enjoyable holiday season!

Nancy L., LISW, LICDC

Colleges to Notify Parents When Students Violate Alcohol/Drug Rules

2007-12-07T07:04:00.000+13:00

Right to privacy vs. duty to inform is a sticky, complicated issue. By law, I must maintain my patients' confidentiality unless they sign a release form indicating I can share information. But what about underage drinking on college campuses? Does the college have a duty to inform parents when a student violates alcohol or drug use policies? Until recently, most universities cited privacy laws - they did not inform parents.

An article in the Wall Street Journal, Colleges Move Boldly on Student Drinking examines a "loop hole" in federal privacy law that is allowing colleges to inform parents when a student violates a campus drinking or drug use policy. The law, Family Educational Rights and Privacy Act (Ferpa), was enacted to protect the privacy of student education records. Under the law, students and/or parents must give written permission before their information can be released. The law was enacted in 1974, but according to the WSJ article,

"The college parental-notification policies for alcohol and drug violations utilize an exception added in 1998 to Ferpa that allows schools to call parents if a student gets an alcohol or drug violation and is under 21 years of age. After the law was changed, some colleges created parental-notification policies, while others insisted that contacting parents would go against their goal of nurturing independence in their students."

College drinking and drug-related incidents are staggering. According to the National Insitute on Alcohol Abuse and Alcoholism (NIAAA),

1700 college students between the ages of 18 and 24 die each year from alcohol-related unintentional injuries, including motor vehicle crashes.

More than 696,000 students between 18 and 24 are assaulted by another student who has been drinking.

More than 97,000 students between 18 and 24 are victims of alcohol-related sexual assaults or date rape.

The Virginia Tech shootings and other recent campus tragedies have made college administrators less sure of their historic stance of protecting students' privacy. But some parents argue that being notified of alcohol/drug violations inhibits their child from learning to make good choices.

As a substance abuse counselor and mental health therapist, I can certainly see both sides of this issue. But I do know that involving family when a student has an alcohol or drug problem can have a very positive effect.

What do you think? Violation of privacy or safety issue that overrides it?

10 Tips to Kick Holiday Stress-Management into High Gear

2007-12-06T05:52:00.000+13:00

Yesterday, as I polished off the remaining 1/4 bag of Maui Onion Kettle Chips (yes, they are as good as they sound!) and became very cranky, I realized I haven't been following my own holiday stress-reduction tips.

Hanukkah began yesterday at sundown. Christmas, Kwanzaa and Boxing Day are three weeks away. The holiday crunch is on us: time for a refresher in slowing it down, regaining our focus and getting re-grounded.

Quit trying to find the "perfect" gift. The teenagers in my life are all getting gift cards from a retail store. Teens like those almost as much as money. Your picky mother-in-law won't appreciate the time you took to select her gift - and she still won't like it. So don't stress about it.

Avoid high-traffic times if possible. Drivers are terribly distracted this time of year. Add that to inclement weather and you have an accident waiting to happen. Stay out of stores at peak times. I call it "shopping psychosis," that look that comes over people as they block store-aisle traffic with their carts. Stay home and order holiday items and gifts online; you still have time.

You do not have to entertain this season. Give yourself permission to NOT have people over for parties, etc. Unless you can afford to cater the event, have a cleaning service and/or it's already in the works - just don't do it. And not worrying about the mess can be very healthy.

Watch your breathing. Most of us don't breathe enough normally; we take shallow breaths and deprive ourselves of oxygen. Add stress to that and we can even become light-headed. Sit in a quiet place, close your eyes and take 10 deep breaths. Inhale slowly and exhale more slowly. You'll be amazed at how relaxed you will feel!

Get enough rest. I have patients tell me that they only sleep 4-5 hours a night. Most research would say they are sleep-deprived. Cut out some TV or computer time at night and get some sleep. And naps are not just for cats. Try one or two...

Make sure you have some quiet, alone time scheduled. The social demands of holiday seasons are high. We are required to interact more with family, co-workers, etc. That can be very tiring, especially if socializing causes you anxiety. Factor in some down-time.

Watch alcohol and food intake. I am not setting a good example by sharing my potato-chip mini-binge above. Spiked eggnog, wine, drinks and high-fat, high-caloric food abound this time of year. Denying yourself any treats this season isn't necessary. But try to eat healthy foods, too.

Plan one fun event just for you. You probably spend much time and effort insuring others are taken care of and entertained this season. Remember to treat yourself - get a manicure, go to a heated driving range, babysit a friend's new puppy or read that new best-seller you've been hoarding.

Watch a favorite holiday movie or show. In an earlier post, I mentioned the film Home for the Holidays. It's great if you want to laugh at family dysfunction. But I'm talking about a sentimental favorite. It's corny and dated, but I love Holiday Inn. Bing Crosby singing "White Christmas" does it for me.

Get some exercise. Most usual exercise routines get abandoned this time of year. We are full of excuses. But exercise is a terrific stress-buster. Take a walk in the snow with your kids or dogs.

Nancy L., LISW, LICDC

Related posts:
Holiday Stress-Reduction Tips - Listen to the Real Experts
Set Realistic Expectations for the Holidays
Strategies for Surviving the Holidays - H.A.L.T.

New Study Shows Anorexics Have Different Brain Patterns

2007-12-04T09:31:00.000+13:00

An article in U.S News & World Report, Brain Activity Points to Origins of Anorexia, cites a study about differences in brain activity between anorexic patients and those who do not have the eating disorder. The study at the University of Pittsburgh School of Medicine did MRI scans of the brains of 13 "normal" women and 13 recovered anorexic patients while they played a computer game.

The brains of the healthy women showed heightened responses to winning and
losing, while the women with a history of anorexia showed little difference
between winning or losing. Dr. Angela Wagner said of the results, "For
anorexics, then, perhaps it is difficult to appreciate immediate pleasure if it
does not feel much different from a negative experience."

The results of this study, published in the December issue of the American Journal of Psychiatry, suggest that the women with a history of anorexia were more focused on the consequences of their choices during the guessing game.

In another report about the study, the BBC News suggests that this may give us more insight in how anorexics are able to deny themselves the reward of food.

Anorexia has always been associated with a distorted body image - anorexics usually see themselves as fat, even when they are grossly underweight. Research such as this study could be very helpful in determining if there are specific causes and in finding successful treatment protocols.

Teens Open Up to Peer about Drinking

2007-12-03T09:56:00.000+13:00

Awhile ago, I worked as the substance abuse counselor for a small school district. There were many challenging aspects to the job, but the biggest hurdle I encountered was the level of denial from parents, school personnel and the community. "It's not that bad," I would hear repeatedly. Surprisingly, the students were more open with me about the level of drinking and drug use. But as an adult in a position of authority, I could never get the honesty that peers share. So I was excited to learn that recently my 16 year old nephew, Evan Trout, wrote an article about teen drinking. Published in the high school's newspaper, The Lion's Roar, he spoke to his peers about their drinking.

Evan's school is in Gahanna, a predominantly middle-class town in central Ohio. His class is 530 students, which is about 2 1/2 times the size of the classes in the school where I worked. Although the settings are much different, Evan's article demonstrates that both communities have a serious problem with teen drinking. His article, which I've edited for length, is below:

A teenager goes to a party at friend’s house after a football game on a Friday. There’s alcohol at the party, and although he’s never gotten drunk before, he decides he’d rather be cool and just go with the flow.

This is a common occurrence among teens these days. Teen drinking these days is a serious problem and often goes to an extent of which most teachers and adults are unaware.

According to the Primary Prevention Awareness, Attitude and Use Survey (PPAUS), an anonymous questionnaire given to high school age students, approximately 33 percent of students between ninth and 12th grade in Gahanna Lincoln High School drink alcohol at least once a month. This is a problem that stretches much further than the big cities. It has become a serious problem in Gahanna, as some students at Lincoln consume alcohol.

Drinking can be evident in settings throughout Gahanna. According to rumors throughout Lincoln, prior to its football game against Upper Arlington, a number of students were found under the influence of alcohol and some were able to get into the game without the knowledge of security.

Sandy Pershing, an administrator at GLHS, said such actions could have serious consequences. Any student caught drinking at a football game, “would probably get suspended from school."

Mary Anne Albanese, the GLHS Safe and Drug-Free Schools Counselor, said alcohol is the most serious threat to high school students “because of the availability, and sometimes they just don’t take the risk seriously. Also, it is so accepted with friends and family. The top three causes of death among teens are alcohol related."

A major problem that leads to alcohol use is the availability. “I drank anything I could get my hands on: beer, tequila, vodka, 151; scotch was easy to get because my dad has some around a lot,” an unnamed male sophomore said. One drink he recalls was “tequila with Bacardi 151 and coke. It tasted like crap, but an hour later when I got home it hit me like ‘whoa’.” He is now, however, proud to say that he has been alcohol free since middle school and plans on staying sober.

"It made me feel worse the day after, not because of hangovers, but because I knew the next day the choices I was making were really bad and it was just taking a toll on me and my grades suffered. I had a realization,” he said.

Most students do not drink very frequently, but when they do drink, it can lead to problems. One female junior said she drinks “just like once every couple months.” She said she most often drinks vodka and mixed drinks, as well as tequila and Jack Daniels. She does not tell many of her friends about her alcohol use, though. “Probably about like ten people know, so it’s not a well-known thing."

Although she chooses not to share her drinking with others, she does not consider it much of a problem. “I think I’m okay with it, because it’s never really been a problem. It’s not like I have to drink to have fun, so no, it’s not to that point yet,” she said.

Another female junior, however, said she has had bad experiences with alcohol use. At times when she has chosen to drink, it has led to some serious consequences. “I was at a friend’s house and their parents were gone and we started playing pong with vodka and lemonade. I got real drunk and started flirting heavily with some guy, so then we went up to a room and all I remember is I woke up the next morning next to him. It was the first time it ever got out of control.” This was not the only time things have ever gotten out of control for her.

“I went to a party once and there was punch and there was a mix and I didn’t know what was in it. I knew I shouldn’t drink it but I did anyway and got real drunk.” When asked about her preferences, she said she normally would have vodka or tequila when she drank and that beer and wine coolers are “for losers.”

Like the other interviewed girl, not many of her friends were ever aware of what she did.“Not many [know] because I don’t tell my friends because they wouldn’t approve. Just my friends I go to parties with. They’re all older, because I need a ride and a way to get home.”

Besides keeping their habits from friends, these students all had other things in common. They all started drinking at an early age, for one. “I had my first sip at nine,” said the sophomore. The first junior girl also started in sixth grade. Another thing in common is the influence of older friends. Both girls started drinking because older friends encouraged it. All of the teen drinkers tended to avoid beer and use harder drinks, such as vodka and tequila, especially. Some adults have such drinks on occasion, but they may not be keeping them from their children well enough, as is evident in the case of the sophomore boy.

Also, most teen drinkers never saw drinking as much of a problem.

When asked about whether she thought her drinking was a problem, the second
junior girl replied, “No, because I can control myself. I only do because I
enjoy it every once in a while, it’s not like an everyday thing.”

With teen drinking as big of a problem as it is, Albanese said that teachers and parents need to intensify alcohol prevention measures. It needs to start at home. “Parents are very important; they impact teen drinking the most. We need to keep telling them, because they don’t realize it,” Albanese said. She then said that the majority of alcohol use among teens could be prevented by parents.There is room for optimism, Albanese said, as alcohol abuse is decreasing both locally and nationally.

Aside from being very proud of my nephew for having his first article published, I was impressed with his ability to get his peers to open up about their drinking. Several things in the article are particularly alarming to me as an addiction specialist; the age of first use, the easy availability of the alcohol and the parents' lack of awareness. The article underscores that parents, teachers, school administrators and other concerned adults need to be much more aware of the seriousness of this problem.

Nancy L., LISW, LICDC

Give a Caregiver a Break

2007-11-30T09:46:00.001+13:00

A recent local news broadcast featured a local man who is a full-time caregiver for his wife, who is in the advanced stages of a chronic illness. Each year, he attends an Ohio State football game (a huge deal in this area) with his adult son. A volunteer from an association that supports the illness (in this case, multiple sclerosis) stays with the man's wife to facilitate his attendance at the football game.

I liked that the news covered such an event: it spotlighted an important issue that most people don't think much about. People who care for ill partners, parents, other family members or friends desperately need a break. Studies have shown that the stress level for these folks, both emotional and physical, is off the charts. In a research article from The Ohio State University, Janice Kiecolt-Glaser, a nationally-known authority on caregiver stress, says that caregiver's life spans are actually shortened by the stress they experience.

“Caregivers showed the same kind of patterns present in the study of mothers of
chronically ill kids,” Glaser said, adding that the changes the team saw
amounted to a shortened lifespan of four to eight years. "We
believe that the changes in these immune cells represent the whole cell
population in the body, suggesting that all the body's cells have aged that same
amount.”

How can caregivers take care of themselves? In an AARP article, Managing the Stress of Caregiving, the following tips are offered:

"Take Care of Your Health

Eat nutritious meals. Don't give in to stress-driven urges for sweets or drink too much alcohol.

Get enough sleep. If you are kept up at night, try a nap during the day to make up some sleep.

Exercise regularly, even if it means finding someone else to provide care while you walk or go to exercise class.

Get regular medical checkups. If you have any symptoms of depression (extreme sadness, trouble concentrating, apathy, hopelessness, thoughts about death), see a doctor right away. Depression is an illness that can, and should, be treated.

Involve Others

Make a list of jobs you need help with. They could include household chores, home repair or maintenance, driving, paying bills, finding information on services you need. Maybe it's simply giving you a break by staying with Mom while you get away for awhile. Ask friends, neighbors and other family members if they could give some time to helping out.

Maintain Social Contacts

Isolation increases stress. Having fun, laughing, and focusing on something besides your problems helps you keep your emotional balance."

What about taking a much-needed break? There are services that provide respite for caregivers. Adult day-care centers can provide care during the week for patients. Volunteers at church organizations will offer to visit and give the caregiver a break. According to a recent Wall Street Journal article, More Resources Help Caregivers Help Themselves, an estimated 45 million people care for a loved one. The article states that new evidence is showing that caregivers can better manage if they are given access to resources, such as "counseling sessions, in-home skills training, support groups and assistance juggling care responsibilities."

It makes sense that the strain of caregiving is especially difficult during the holidays. With everyone busy and celebrating, the usual resources may be unavailable. The WSJ article offers a list of Web sites for organizations that can help:

National Family Caregivers Association

National Alliance for Caregiving

Family Caregiver Alliance

AARP

What can you do to help out a caregiver? Offer to give them a break by arranging someone to stay with the patient while you take them to lunch or out shopping for holiday gifts. Or stay with the patient yourself to allow the cargegiver a well-deserved day off. It's important to ask specifically what you can do. A vague offer "to help" isn't really helpful. There is probably a long list of things you can do.

So extend an offer to a caregiver. Your assistance will be invaluable.

Relapse Prevention - Not Just for Alcoholics

2007-11-28T07:01:00.000+13:00

Relapse prevention is one of the most important aspects of addiction treatment. Most newly-recovering patients are so confident that they will never use again that they don't always take it seriously. It's often not until after they relapse that they see the signs in retrospect.

Terence T. Gorski is a leading addictions expert. On his Web site, he lists a comprehensive, 9-step relapse prevention program. One of the key elements is "warning sign management," which is a list a patient makes of his/her particular warning signs and a strategy to address them.

I don't believe we should limit relapse prevention to addiction. I work with all kinds of patients, especially this time of year, on how to manage their symptoms so they don't relapse. For instance, with a hectic schedule, some depressed patients forget to take their medication. Couples who are trying out new, healthier behaviors often "throw out the rule book" while focusing on their holiday plans. People who have problematic eating issues are often tempted to forgo their treatment plans when presented with so many unhealthy food options.

Earlier this month, I posted an old AA-based, relapse tool, HALT. It's a reminder not to get too Hungry, Angry, Lonely or Tired over the holidays. The following is kind of an addendum to HALT.

1. Identify your "triggers." Are yours crowds or unfamiliar social situations? Being in places with your credit cards where you will overspend? Watching your baby sister play out her princess role yet again?

2. Write down your triggers and how you will address them. Having a very specific plan for each of your triggers will re-direct you to the thinking/logical response instead of the emotional/reactive response.

3. If at all possible, Avoid. Try to avoid the triggers on your list if possible.

4. Use your support systems. Wrestling with your "demons" alone is tough. Make a list of people who you can call or visit when you feel "unsafe" and tempted to ignore your relapse prevention plan.

Now, go work on your own plan.

Is "Cyber Monday" Fueling Your Shopping Addiction?

2007-11-27T08:23:00.000+13:00

In the U.S., "Black Friday" has traditionally been the shopping day after Thanksgiving on which retailers have their highest sales."Cyber Monday," a recent name given to the Monday after Thanksgiving, is a high-traffic day for online shopping. I admit when I started writing this post, I had to pop onto Amazon.com to see if there were any irresistible deals!

Most people joke about the "shop 'til you drop" mentality or "retail therapy" and we're all familiar with the stereotypical woman shopper who cruises the malls, her fist crammed with credit cards. But compulsive shopping behaviors do exist and can be very damaging.

Not Every Behavior is an Addiction

As an substance abuse/dependence specialist, I tire of anything and everything being labeled an "addiction." I would prefer to discuss some of these compulsive behaviors as problematic by degrees. Most of us experience a "high" when we buy something new for ourselves or find the perfect gift. There are definite addictive qualities to serious compulsive shopping. But is it accurate to compare a moderate shopping habit to a heroin addiction? What do other experts have to say?

WebMd.com addresses the difference between a harmless pastime and problem behavior in the article, "Shopping Spree or Addiction?" "Compulsive shopping and spending are defined as inappropriate, excessive, and out of control," says Donald Black, M.D., professor of psychiatry at University of Iowa College of Medicine.

According to Addictions.org, the compulsive spending cycle mimics that of other addictive cycles,

"Because they lose their ability to buy within their means they are constantly in financial trouble and often dogged by collection agencies. When the "high" of shopping dissipates they are left with the guilt and shame so characteristic of the addiction cycle. The guilt and shame may contain the urge
for a short while but ultimately it leads to the need to alleviate the bad feelings through another bout of spending."

Take the Self-Test

If you have concerns that your shopping behavior is becoming problematic, take the following Self-Test at Addicted.com.

My own professional criteria for any compulsive behavior becoming unhealthy is a simple question, "Is the behavior causing problems for you or anyone else?" If you answer "yes," then you might want to consider getting some help.

Getting Help

Start by looking in your local phone book under "Addiction" " to find treatment centers that can help answer your specific questions. 12-Step or Alcoholics Anonymous groups have resources for most addictive behaviors. Do a Web search on "addiction" or "compulsive behaviors."

But keep in mind, the majority of people who enjoy shopping at this time of year do not have addictive, potentially problematic behaviors.

Holiday Stress-Reduction Tips - Listen to the Real Experts

2007-11-26T06:25:00.000+13:00

With Thanksgiving behind us, now we are in the sprint towards Hanukkah, Christmas, Boxing Day, Kwanzaa, New Year's, etc. Take a deeeep breath.

I spent Thanksgiving at a neighbor's where I was able to eat other people's favorite foods and watch family dynamics with an objective eye. It was very enjoyable. But I noticed the conversation inevitably turned to a panicked, "I have so much to do before _____!"

A recent article in the Baltimore Sun, Taking a holiday from the Holiday Stresses, takes a bit of a different approach to the topic. Reporter Meredith Cohn cautions us to be aware of where the stress-reduction tips are coming from and be discriminating when reading advice from so-called "experts." She quotes Thomas J. Capo, a psychology lecturer at the University of Maryland,

"I'd say the No. 1 concern is that you want to be able to discriminate good
advice from the rest of it, most of which tends to be bogus. In order to qualify
as 'good advice,' it needs to be backed by good science, rather than
'testimonials' or so-called 'common sense."

Cohn also spoke with Mark Gorkin, the StressDoc, who points out (somewhat tongue-in-cheek), "Holiday blues is that feeling of loss or sadness that you have over the holiday when, for whatever reason, you can't be with those people who have been or are special and significant. And holiday stress is...when you have to be with some of those people!"

Gorkin, a licensed clinical social worker, author of "Practice Safe Stress" and motivational speaker (The Stress Doc) - who is an expert, elaborates further on holiday stress in his classic holiday article "Four F's of Holiday Friction."

"Here are 'The Four 'F's of Holiday Friction: Fantasies, Family, Food and Finances.'

1. Fantasies. First, the idyllic image of the holidays portrayed by the media seems so out of touch with reality, it's enough to make you overload on eggnog (with or without the alcohol).Another pressure is the internalized memories we carry around. I recall my friend Linda, a single parent at the time, berating herself because she couldn't keep up with the holidays - the cooking, the shopping, the house decorations, etc. - the way her mother had. Of course, Linda's mom did not work outside the home. I also recall Linda observing that, as a successful professional, she now has the money but lacks the time for the season. Previously, when she wasn't working, she had plenty of time and no money: The "Holiday Catch-22."And, finally, this season turns most of us into sentimental jelly fish, just waiting to get entangled in the arms of that "true love." Hey, I'm not saying that Mr. or Ms. Holiday Hopeful is as possible or as real as Santa Claus. (My motto: "I no longer count on nor discount any possibility.") Just don't let childhood longings and memories and voices transform you into a frantic, salivating, love-crazed inner child.The key to managing this friction: gently embrace, don't cling, to magical memories. Discover a blend of magical realism that helps you balance love, work and play in the present.

2. Family. There are so many permutations in families these days, it's got to get a bit confusing. For separated families, a poignant question: which parent (or grandparents) will we be with for Thanksgiving, for Christmas, for New Years? I vividly remember an eight year old's lament: "Why can't we just be one family again?"Another common family issue is when a holiday gathering turns into a competitive arena for sibling rivalry, along with a desire for long-standing recognition and approval. And if you find in these family therapy sessions, I mean holiday reunions, that you can't resist trying to change the attitude and behavior of the parent (sibling or child) that "makes you crazy," patterns which have resisted influence attempts for decades...maybe there's only one solution. Have you thought about getting far out of town for the holidays?

3. Food. The holidays turn most of us into bingeaholics. Running helter skelter, not stopping for lunch, overdosing on the cookies and chocolate that a colleague has brought to work. And discipline at a party is a contradiction in terms. This caloric chaos is not surprising considering the biggest role model of the holidays looks like he hasn't met a single gram of fat in two hundred years that he doesn't love. Hey, Santa Claus hasn't been doing his aerobic workouts either. But wait...Appoint a designated nagger, who will gently remind you when you are overdoing it. Don't chat hovering around the buffet table. Take reasonable portions and move away. Now replace food with some food for thought. And face it, no matter what you do, or don't do, you are likely to add some pounds on the holidays. So go to the malls and walk briskly for thirty minutes before you start the shopping splurge. You'll spend less and, probably, will eat less as well.

4. Finances. The holidays heighten our monetary consciousness -- from the end of the year financial and psychological accounting (did we meet our financial/family security and career goals?) to the never-ending list of holiday gifts. And as the great Russian novelist, Dostoevsky, noted: "Consciousness is depression!" For the first issue, seek a budget counselor, a CPA, a career counselor or even a mental health specialist. For the last, "just say no" to your child's "toy lust." Give your child choices; explain why there are limits. Try this holiday mantra: "Presence not just presents." This season, invest time, not just money. For big families, be creative. Divide up the gift list with other relatives. You shouldn't have to buy something for everyone. Making a gift definitely adds a personal touch. And, finally, don't overlook a very important person. Get a special gift for yourself.So the holidays may be a stressful time; a time of feelings of loss and sadness. But with a little higher power humor it also, can be a source of creative expression and sharing."

So when everyone from your neighbor, the TV news anchor and your mother offers tips on reducing holiday stress, be selective and seek out the experts.