Anxiety is a problem that the majority of people deal with in one form or another. Yet anxiety is a broad category of disorders which range from generalized anxiety disorder, to social anxiety, to various forms of panic disorders, to mild stress. Keeping in mind, some forms of anxiety are normal, for instance, regular stress can sometimes be beneficial, as it keeps us aware of important things like deadlines and can even motivate us to work hard and excel. However, some forms of anxiety and anxiety disorders are defined as a problem when they begin to interfere with your ability to thrive, achieve your goals, go about daily life and feel well. Some symptoms of anxiety are muscle tension, sleeplessness, worry, agitation, and increased heart rate. Yet some people have a baseline of anxiety that is their normal and they have many coping strategies so that they learn to manage even high levels of anxiety while still managing to function well enough that few people even notice that they are struggling at all. We call this high-functioning anxiety.
Anxiety can be intense, but today I’d like us to learn this difference between stress and high-functioning anxiety. High functioning anxiety is when someone is able to maintain the appearance of calm connectedness by going about their life with the appearance of normalcy, but still the anxiety tends to leak out in subtle ways. Here are three ways to tell if you may have high-functioning anxiety:
- You have a hard time sleeping. When you’re able to internalize your anxiety and hold it together during the day, your anxiety may come out in the form of sleep disturbance. This can include tossing and turning, having trouble falling asleep, or waking up in the middle of the night and having trouble getting back to sleep.
- You focus on perfection. Self-improvement is great; however striving for perfection can be a result of anxiety. This can create issues when you focus on perfection at work, in personal relationships, or expectations of your physical appearance. Perfectionism is a tell tell sign of high functioning anxiety because an anxious person will tend to try to make things perfect as a tool to decrease their anxiety.
- You can’t relax. When there are too many issues on your mind, you may neglect self-care or not even know how to be calm. Nothing is wrong with staying productive, yet some people use endless projects as a diversion from their feeling of inner anxiety.
- Having difficulty letting go of control. There are several personality types and persons with symptomology whom struggle to let go of control, but this can also be a part of high functioning anxiety.
There are other signs of high functioning anxiety. If you find yourself experiencing this, take some time to engage in self-care or get a mental health assessment. Be intentional about relaxing and find ways to come to terms with not being perfect. Remember that the mind and body are connected, there are many physical and mindfulness exercises as well as breathing strategies that you could try to release some of the stress, and other things like working on your sleep hygiene. Ultimately, if you have any concerns about your level of anxiety you should seek out an assessment with a mental health professional who can help you to determine which parts of your anxiety are normal and which parts might be helped with counseling such as cognitive behavioral therapy.Learn More
by Counseling and Wellness Center of PittsburghJanuary 2, 2020 best ways to build self care plan, mental health matters0 comments
We hear lots of people taking about self care these days but what actually is it? Is there a right way to do it? I hope to answer some of these questions for you today because mental health matters and you matter. Self care can be defined as any activity that we do deliberately in order to take care of our mental, emotional, and physical health. Although it’s a simple concept in theory, it’s something we very often overlook. Practicing self-care isn’t always easy. Most of us are crazy busy, we have stressful jobs, are taking care of children or aging family members or are too consumed with technology to make time for ourselves. “Me time” is usually last on our agenda and we can often feel guilty about taking the time required to take care of ourselves. Self care is not selfish. We can’t take care of others well if we don’t take the time to care for ourselves and good self-care is key to improved mood and reduced stress and anxiety. It’s also key to a good relationship with ourselves and others. So, where do you start? It’s important to build a self care plan. Begin by sticking to the basics for now and overtime you’ll find a routine that works for you. Overtime, you can implement more and more specific items into your plan. In the meantime here are some basic principles of self care to help get you started:
- Eat right- the right foods can help improve memory, combat inflammation and promote good gut health. All of which can have a direct impact on your physical and emotional health. If you have questions or want to learn more about this consider setting up a consultation with a nutritionist.
- Sleep- make sure you’re getting 7-8 hours of sleep a night, establishing a healthy bedtime routine can promote deeper and more restful sleep. Avoid sugar and caffeine before bed and help reduce distractions such as light and electronics in your bedroom
- Physical exercise- this can mean lots of different things for different people. This can be a walk with your family in the evening or by yourself at lunch, swimming, or yoga. The type of activity isn’t as important as choosing something you enjoy and can commit to your schedule
- Schedule time away- this can be as simple a taking a half day to spend at the park or an extravagant weekend getaway
- Take care of your spiritual needs- this can be attending religious services, meditation, prayer, spending time in nature or making a gratitude list
- Learning to say “no” and setting boundaries- this can mean you don’t check email after business hours, don’t attend events or gatherings that you don’t want to or don’t take on additional tasks that you don’t have the time or energy for
- Get organized- get a planner for tasks or appointments, this can be especially helpful in scheduling your self care time or spend time prepping lunches so you have more time in the morning for an extra cup of tea and some meditation
- Spend time with loved ones and people that are important to you
- Lastly if you work in a field with high burnout rates seek consultation and supervision from mentors and peers to help reduce stress
Self care will look different for everyone for some it’s getting up 15 minutes earlier to practice deep breathing or journaling before the day begins. For others it’s an evening run, but just like many other things self care takes practice. I challenge you to commit to adding one self care element to your schedule for 2 weeks and see the difference it makes in your life and relationships.
Written By: Nicole Monteleone, MA, LPC, NCC
If you are looking for a counseling center near you, reach out to our reception team monday through friday from 9-5 and we will be glad to get you an appointment with one of our licensed counselors in 4 convenient locations, Counseling Pittsburgh, Counseling Wexford, Counseling Monroeville, Counseling South Hills.Learn More
by Counseling and Wellness Center of PittsburghOctober 1, 2019 anxiety in children, child counseling, child psychologist0 comments
5 Ways to Soothe Anxiety in your Child
Whether your child is anxious or even has a diagnosis of generalized anxiety disorder, you have probably tried everything that you can think of to help them manage their emotions. Your daughter stays up all night worrying about show and tell tomorrow in school, she cries and repeats, ‘I know I am going to mess up, I will say something stupid and everyone will laugh at me!” Of course, you have seen this scenario happen before with your very concerned little one, and like most parents you want your child to see that there is nothing to fear, that they should simply stop thinking about it and go to sleep. Minimizing away worry, is the layman’s most common way of responding to other’s anxieties, we repeat things such as, ‘there is nothing to worry about,’ And at other times ‘try not to think about it.’ Experts have a different approach to managing and responding to anxiety that takes into account scientifically tested psychological methods to become well and relaxed. Below we have compiled a list of the best ways to manage your child’s anxiety according to a team of expert child therapists. These tips are most effective for children over the age of 6.
Start by labeling the emotion that your child is feeling. If we stick with the above example we might say, ‘You are really anxious about your show and tell tomorrow.’ Healthy emotional management always starts by identifying the feelings that are being exhibited instead of masking or shooing away what is being said.
Ask for more information, delve into the feeling with your child. Ask some questions like, ‘what is the scariest part about this for you?’ ‘what do you think could go wrong?’ ‘what do you feel in your body when you think about it?’ This is yet another way that we groom our children to have healthy emotional hygiene by digging in and practicing awareness of their physical responses and having a more global perspective of what is frightening them the most.
Validate the feeling, help them understand that everyone worries, has fears, and tends to think about things like this sometimes. When we are being honest with ourselves we too will realize that we definitely do have moments where our stress and worry are very high. One of the mechanisms which makes anxiety worse is when we build feeling constellations internally and feel ashamed, guilty, and abnormal for our feelings of concern. By helping our child understand that some worry is normal we can help them build a foundation of positive emotional health.
Reframe Can you help them think about some ways that is can be helpful to worry or be anxious about something that is happening in the future? In cognitive behavioral therapy we can this ‘reframe,’ when we change one maladaptive thought and we replace it with a healthier one. It may take some time to think it through with your child, ask them, ‘how can worrying about your performance help you?’ Brainstorm and imagine how sometimes when we worry, we may really want to do a good job with something, that sometimes we can also work hard to prepare when we are concerned.
Make Space for Worry- It is ok for your child to worry a little bit, as much as any parent wants to help their child we can not take away all of their fears and concerns and it may add more stress to the situation if we try too hard to make their anxious feelings vanish.
Remember to pay attention to your own feelings and responses to your child whenever they express their fears or anxieties to you. We know how overwhelming it can be as a parent who wants to make things right, try to take some breaths and notice any stress that you are feeling before you try to soothe your child. Even just by pairing a reflective moment and a long slow inhale into your body, you will be able to approach the situation with your best efforts toward being constructive and relaxed. Acknowledge to yourself how hard it is in your role as the helper and healer to your stressed our little one. When your child is exhibiting signs of high anxiety, you too may be at risk to burn out and have cargiver fatigue, you may even want to ramp up your own self care and find a mindfulness routine to help you find greater calm and clarity through the very real challenges of parenting an anxious child. Always, if your child is constantly anxious, tearful, sleepless, avoids peers, is very withdrawn, consulting a therapist or counselor who specializes in working with children is a good way to help them get the support that they may need.Learn More
by Counseling and Wellness Center of PittsburghOctober 30, 2018 compassion, pittsburgh, positive psychology, resilience to trauma0 comments
Trauma; Honor For Your Healing Journey
The four things your therapist wants you to know about your healing journey. When you’re healing from a grief, trauma, or resultant PTSD, you must be thinking about ‘how will I ever move on from this horrible, unexpected, agonizing reaction to the traumatic situation that I have experienced?’ Remember, PTSD is a reaction to witnessing or experiencing a sudden and unexpected event which caused one to feel powerless by delivering, threatening, or witnessing harm. How can I rise above these feelings and thoughts and create meaningful and complete healing? Maybe you want to go backwards in time and undo all of the harm that you have experienced. A common and reasonable response to all of these above disorders, particularly PTSD, is to try to avoid all triggers associated with the situation which evoked the trauma, hypervigilance, intrusive memories, nightmares, flashbacks and an increased risk for anxiety and depression. This disorder presents a mountain to ascend, and whether you have spend years in therapy or are only beginning to acknowledge the depth of the effects this has had on you, these are some points to keep in mind. These are the 4 things that your therapist wants you to know about healing that are not immediately evident.
Healed but not Forgotten
Some people have the unrealistic expectation that when they reach the end of their healing journey they shouldn’t have any emotional reaction to their memories of the traumatic event which led to grief and loss. That is not how healing works. It is quite likely that you will always have some sort of reaction to the memories and thoughts associated with your grief or trauma. In fact, according to a 2011 study published in NIH by Sherin and Nemeroff, and according to all of science and psychology support the fact that there is potential for long term neuroanatomical and neurochemical changes to the central nervous system resulting from trauma. These changes are especially evident in the way we respond to triggers or trauma associated stimuli. What we should be striving for in the healing from trauma is a ‘new normal.’ Healing means that you are able to function in professional or personal settings and that you are practicing resilience and positive coping when waves of thought and emotion do come.
Healing means Acknowledging Feelings
One of the ways that therapy works is by creating an intentional space for healing warriors to be honest with themselves, to create an understanding of their emotions. After an awareness has been formed adaptive responses to feelings and thoughts can be generated. We create psychopathology by being critical and attempting to repress our internal honest responses. For some people like first responders, police, and paramedics, there may be an extra layer of difficulty and stigma attached to acknowledging ones feelings and seeking mental health support to manage trauma. This can cause further damaging denial of the effects of traumatic experiences, One of the core tenets of psychological theory present in every form of therapy is that the more we repress, judge or avoid our feelings, the more we cause problems. Repression elicits tangled feeling constellations, blocked energies, incomplete and unintegrated shadows. Mindfulness based stress reduction, EMDR, and Cognitive Behavioral Therapy, and Exposure Therapy, have shown efficacy in treating PTSD. Our feelings can turn into psychopathology that are bigger and sometimes socially unacceptable forms of the original emotional response.
Healing Happens in Relationships. Find your Healing Tribe
It is especially true for trauma that happens in relationships, that this same trauma is healed in relationships. When trauma survivors open up to those people who they consider to be safe, there is an incredible potential for healing to happen. Healing relationships are those that resonate compassion, gentle acceptance, warmth, and non-judgement. Think about it, we become close to those who we can be really honest with, those who ask about our feelings and can share in a compassionate interchange, (Mgrath, 2001). Sharing trauma should be exercised with caution. However well-intentioned our healing tribe may be, its members may inadvertently respond in less constructive ways that judge, shame, or put down the survivor for having the pain or scars of trauma. Another risk is not being able to hear or understand what is being shared. What is really needed is non-judgmental acceptance, understanding, and compassionate warmth.
Positive Psychology, Pop Culture and Non-Reality
You may have survived a trauma
but that doesn’t mean you have to fall victim to meme reality. Scroll through a social media forum and you will see many posts and memes which declare that everyone should be happy all the time. That isn’t honest or possible. The healthiest among us are those who are honest with themselves about what they experience and then respond to their vulnerable reality in a constructive way. According to a 2016 study by Elizabeth Kneeland,pop cultures layman positive psychology is damaging. When pop culture got its hands on positive psychology its representatives distorted the message, and now laymen perpetuate unrealistic and uninformed messages which imply that we can think our way into a good mood. It suggests that if we blink our eyes we can make trauma and psychological distress evaporate. Your therapist knows differently. Its ok to be outraged, disgusted, sad, hurt, angry, confused, and it is important to acknowledge where you are in your healing journey today.
No matter where you are today, the best we can do is to risk opening to ourselves, to create an honest internal dialogue that we are eventually able to share with others. We should unabashedly honor our own processes, giving relentless permission to feel, think and be; in reverence of joy, in honor of glorious fury, to the fullest expression of gaiety, to the utterance of insuperable hurt, to fully hone in on repugnant disgust. Keep developing your divine awareness, and eventually you will have created the unique meaning which understands with a lens of compassion, acceptance, and self love all that has happened to you.
With love and hope for resilience,
Stephanie Wijkstrom, MS, LPC, NCC
- Counseling and Wellness Center of Pittsburgh
830 Western Avenue Pittsburgh PA 15233
- Counseling and Wellness Center of Pittsburgh
4108 Monroeville BLVD, Monroeville PA 15146
Accepting new clients, our therapists accept UPMC, Highmark BCBS, United, Cigna, Magellan, Aetna, HSA, Self Paying and Sliding Scale.
Thank you to our Editor, Dr. Stellan Wijkstrom for his ever helpful alterations and contributions.
For More Reading
Kneeland, Elizabeth et al, Positive thinking Newsweek, 2016
McGrath, Ellen. Psychology Today, published November 1, 2001
Sherin, Jonathan E, Charles B. Nemeroff
Dialogues Clin Neurosci. 2011 Sep; 13(3): 263–278.Learn More
by Counseling and Wellness Center of PittsburghSeptember 30, 2018 counseling for anxiety, counseling for PTSD, psychotherapist, touch, yoga for trauma0 comments
Hands off-Please Do Not Touch My Body.
Closeness is sacred and powerful, and we should share it however we would like with a partner or partners with whom we have provided consent. Personally, I am a ‘toucher’, meaning I am a person who enjoys touch with my partner, someone who hugs family and friends and genuinely savors safe closeness. As we all know, touch can feasibly happen in many contexts. A recent trip to a local yoga studio has spurned some inspiration for considering consent and what exactly that means within the context of yoga. Consent is one of the topics of the century, the importance of asking for it, and heeding to it are championed issues with personal, psychological, and legal context. When we are on our yoga mat, we are presumably in a safe zone, we practice yoga to be well, to relax, to be inside of our bodies, to give life and expression to what our physical selves need in the moment to create our highest expression of safety, openness, and comfort. We rely upon the professionalism, understanding, and care of our yoga instructors while we are on the mat. When others take liberties with our bodies, reactions can range from uncomfortable to traumatic, yet we shouldn’t need to rely upon trauma informed yoga instructors to be the only providers who can offer a style of instruction which provides opportunity to say “No thank you, please do not touch my body.’ From chaturanga to shavasana, we find our bodies configuration of the posture as the yoga instructor cues. Without making space for hands off adjustments, one well-intentioned yoga instructor can inadvertently have a negative impact upon his or her student’s practice, day, overall wellness by taking liberties with his or her student’s bodies.
Consent means that one has asked for permission to approach another person in any way, whether that be to touch, to enter an intimate encounter, or even to provide unsolicited verbal feedback, we should always ask before encroaching upon others. After asking for consent, we wait and pause for that person to respond with their response of approach or avoid. A key component of consent is that the other person is truly able to say ‘no,’ if we are in a position of power, or if we are asking a person who is intoxicated, a minor, or incapacitated in any way, then the other can not provide for their own consent. Under normal circumstances, then, if and after we have been given permission to ‘approach’ we take it a step further to check in to be completely sure that non-verbal permission has been granted to continue or deepen the exchange. Physical space, proximity, and closeness are very special, they are exchanges which can lead to bliss, warmth, bonding, relaxation and even orgasm in the right time. When touch is used subversively, to coerce, to control, to harm, physical connection can become shrouded in horror, it also has the potential to instill anxiety, fear, terror, panic, and pain.
Consensual sexual intimacy is the gold standard, we should always be sure that we are well within the green zone of any boundaries of any person who we are touching and to also always note that we are creating safety for others as we strive for mutual enjoyment and pleasure. There are many contexts or situations where touch happens from fitness instruction, personal training, yoga instruction, little league coaching, physical therapy, massage, and medical settings. While there are many of the medical and physical instructors listed above who do check in and ask, ‘is it ok for me to adjust you.’ The best ones who follow this question by ‘does this feel ok for you’ and to them I applaud their insight and wisdom to always, in all settings, to ask first and wait for an enthusiastic ‘yes’ or a clear non-verbal head nod which unambiguously encouraging procession. For other yoga and fitness instructors, it may be less obvious that they should ask for consent before breaking the touch barrier with students. Let us examine consent from a trauma informed perspective and look at some ways that we can be sure we are always providing supportive and caring touch.
Regardless of the setting or context, we do not have permission to touch another person until we have asked for it and they have given it. For a trauma survivor it can be very triggering and alarming to feel a person, even a coach or instructor grabbing at them, or tapping on their body, for another person to move ones legs or touch ones hands. Feeling safe and giving permission for these things to happen is vital and walking into a yoga studio to practice does not provide consent for one’s physical boundaries to be violated. Just as walking into a bar or nightclub in a low-cut blouse is not the same as providing consent for someone to touch our breasts. Being a woman out late having drinks is not an invitation to have sex, we need a society which is built upon making space for ‘Yes’, or ‘No’ by always ask first. Yoga and fitness instructors, we are here, we want to participate in a fun and fulfilling way but ask before touching please. Additionally, for some instructors who may have a style of delivering their teaching that is very directive and assertive, it may feel punitive to some students.
Recently, in an all levels class, the instructor was someone I had never practiced with before. The class was much less than an all level class, it was more of an intro in my experience, we were cued to move into postures without much attention to how we flow through the sequencing. In any event, after 15 minutes or so warming up, we were cued to do some Sun A’s. When forward folding the instructor told everyone to grab a two blocks in anticipation of their hands not hitting the ground. I have long arms, and have been doing forward folds for many, many, years, it does not tax my body to fold forward and I find it delicious and restorative. The teacher stomped back to me and said ‘No! get your blocks, do not go into your deepest fold!’ In knowing my body, and knowing that I did not need the blocks I started to reach for them to appease her as she began grabbing my leg and tapping rapidly and harshly onto the front of my quad with her pointed finger tips and squinted eyes, ‘Move! Move! Move!’ she commanded. What started as a day of wellness, mindfulness, and an attempt to let myself feel peace, quickly became a source of discomfort and anxiety.
Being a yoga instructor is a big responsibility, it is a pathway to open ones consciousness, those blissed out happy vibes and chakras can really open up and make others aware of themselves, their feelings as well as anything happening with the instructor. We should encourage yoga instructors to have a higher level of insight into their style of relating to others so that the instructor is not unconsciously projecting their own unmet needs or style onto all of those who they come into contact with. The yoga instructor should be very aware of how of tone and content of speech particularly as adjustments are being made. If an instructor is simultaneously speaking in a critical or cold tone ‘move!’ ‘faster!’ ‘in, in, in;’ in a style that feels like they are spitting commands to the students, if the instructors speak this way while grabbing at a students body, it may become even more likely that they are making others feel tense, uncomfortable for anyone, and furthermore this kind of tone and motion can even be panic inducing for some trauma survivors.
More than ever, we must seek to create safety, to speak with love, to be sure that we are providing physical touch which is tender, and warm, and supportive or not tender and warm, if that is the kind of touch which is consensual and agreed upon by those who can legally and actually provide consent. Speak and act with awareness and care for other people’s feelings, doing fitness, pilates, doing a forward fold or downward facing dog, or even having a suspicious mole removed from our bodies are things that must happen peacefully and respectfully, and always with particular attention to any person’s ability to state, ‘No thank you- please do not touch my body’.
Stephanie Wijkstrom, MS, LPC, NBCC
830 Western Avenue Pittsburgh Pa
4108 Monroeville Blvd Monroeville Pa 15146
For more reading on the ethics of touch in yoga;
by Counseling and Wellness Center of PittsburghSeptember 16, 2018 benefits of high fat diet, blue cross blue shield, counseling wellness, dietician0 comments
What are the benefits of a high fat diet?
Liz Mckinney, CNS, LDN continues to examine the big fat myth and share some more information and sample mean plan to incorporate the dietary changes of a high fat diet into your busy lifestyle. Our last blog post caused quite a stir and we want to be sure that our readers understand the differences between ‘good fats’ and ‘bad fats.’ One big take home point is that not all dietary fats are created equally. So, what does the science tell us about a high fat diet? To recap our last blog article, research is showing that a high fat made up of healthy fats coupled with a low carbohydrate diet can be beneficial for:
- Heart health
- Boosting the immune system
- Brain function (and reduced risk of Alzheimer’s, cognitive impairment and dementia)
- Blood sugar control
- Weight management
High fat diets, and even ketogenic diets are being studied for their efficacy in treating Parkinson’s, Alzheimer’s, ALS, Epilepsy and even ADHD. More and more, we understand there is a significant effect on our physical and emotional health exerted by our food consumption, even anxiety and depression can be effected by our diet. In particular, of the vital and nourishing micro nutrients, cholesterol is especially protective of brain function. One famous study called the Framingham Heart Study found that those with low serum cholesterol performed less well on cognitive function tests than their counterparts with borderline or high cholesterol levels. We can infer from this correlation that cholesterol does seem to have a protective effect on the brain. Additionally, when we note that their are ramifications for those who take statin drugs to lower their cholesterol. One known side effect of statin drugs are problems with memory and cognition.
What should I eat?
The good news is that it’s easy to start enjoying the benefits of a high fat, low carbohydrate diet. It’s important to limit grains and legumes to maintain the benefits. It is best to try to aim for only about 60 grams of carbohydrates a day. Along with unlimited non-starchy vegetables (think asparagus, cauliflower, broccoli, kale, swiss chard and spinach) and low sugar fruits (grapefruits, oranges, apples, berries, melon, pears, cherries, grapes, kiwis, plums, peaches and nectarines), enjoy ample amounts of these ‘good or healthy fats’ which are foods which will accelerate health and allow you to experience the benefits of a high fat diet:
- Grass fed beef and lamb
- Free range chicken
- Cage free eggs
- Cold pressed oils (walnut, olive, avocado, coconut, and palm)
- Grass fed butter
- Cold water fish (salmon, shrimp, sardines and tuna)
- Nuts (walnut, cashews, macadamia and almonds)
- Cheese (Gruyere, goat cheese, feta cheese, and mozzarella)
Sample One Day Meal Plan*
2 scrambled eggs with 1 oz. goat cheese cheese and stir fried veggies (onions, mushrooms, spinach and red bell pepper)
4 oz. baked chicken or canned tuna with a side of leafy greens dressed in balsamic and olive oil
3 oz. grass fed steak with a side of roasted broccoli and mashed cauliflower
3 squares of 70% dark chocolate
*Adapted from Dr. David Perlmutter’s book Grain Brain
So go ahead and give it a try, of course one should always consult either your PCP or a dietitian or nutritionist before making any changes to your diet, this is especially true if you have preexisting health conditions.
In good health and wellness,
Liz Mckinney, CNS, LDN
Certified Nutritionist, Licensed Dietary Nutritionist for The Counseling and Wellness Center of Pittsburgh
Providing good health and wellness to Western Pennsylvania.
Accepting Self paying clients, Out of Network, and Highmark Blue Cross Blue Shield.
by Counseling and Wellness Center of PittsburghJuly 31, 2018 food for anxiety, food for depression, food for mood0 comments
28 Foods to Decrease Anxiety and Depression and Enhance Positive Moods
Food & Mood Series by Liz Mckinney, CNS, Board Certified Nutritionist
“It is both compelling and daunting to consider that dietary intervention at an individual or population level could reduce rates of psychiatric disorders. There are exciting implications for clinical care, public health, and research” – editorial in the American Journal of Psychiatry https://doi.org/10.1176/appi.ajp.2009.09060881
Mood imbalances like depression and anxiety are on the rise in the U.S. In 2016, the National Institute for Mental Health estimated that 16.2 million Americans have experienced at least one major depressive episode and 42 million have an anxiety disorder of some kind. https://www.nimh.nih.gov/health/topics/depression/index.shtml Additionally, depression is the leading cause of disability globally. Traditionally, depression and anxiety are viewed as being caused by chemical imbalances, due to under production of our feel good neurotransmitters like dopamine, GABA, and serotonin. Lets explore how food is related to emotional health and how we can put ourselves at risk for developing anxiety or depression with our diet, as well as the good news of how diet can increase of mood, energy, and all around wellness.
So what factors contribute to a drop in the production of neurotransmitters? Biologically, this question has a multi-tiered answer. First, genetics and epigenetics (namely, how our environmental exposures affect which of our genes become activated) certainly play a role in a person’s proclivity towards depression and anxiety. For example, a common genetic mutation called MTHFR has a big impact in how we activate the B vitamin folate in our cells. Those with this genetic mutation are more prone to depression because of folate’s role in making serotonin. But, we know that our genetics don’t tell the whole story. The second factor influencing the expression of our genes, are our mental and emotional stressors or triggers, this is the part that can be effected by our social supports and reduced with therapy. Social factors and cognitive perceptions contribute significantly to the onset of these common mood disorders.
The Standard American Diet, which is low in fiber, healthy fats and protein and packed full of cheap, convenient sugar laden foods means we have less of the amino acid building blocks we need to make GABA, serotonin, and dopamine. A second issue to consider is that poor gut health is directly linked to worsened mood disorders thanks to the two-way gut-brain connection. Intake of processed snack foods packed with sugar, flour, and trans fat are like pouring gasoline on the fire and promote overgrowth of pathogenic bacteria and yeast in our gut where up to 80% of our body’s serotonin is produced. Eating poor quality proteins or simply not enough further compound the issue because proteins are the building blocks for these important compounds that keep our moods stable. Grain fed, factory farmed eggs and meats and genetically modified crops are not only loaded with toxins and pesticides that alter our microbiomes, they serve to ramp up that low grade chronic inflammation. Finally, fiber intake has never been lower thanks to the standard American diet. Fiber rich foods serve as probiotics that feed the beneficial bacteria in our large intestine. Without fuel, the good “bugs” are more likely to die off, leaving room for the pathogenic species to flourish. Our bacteria send signals to our brains, so we want our good bacteria to dominate and send signals that promote brain health, not cause further chemical imbalances and inflammation.
Now time for the empowering news! The food we eat can also improve mood, and decrease symptoms of depression and anxiety. Food can be a kind of internal therapy, by nourishing organs, healing of stomach linings and then increasing energy and brain health, they have a huge impact on decreasing ones susceptibility to relapsing from mental health disorders.
- High quality proteins
- Cage-free Eggs
- Grass-fed Beef and
- Chicken raised without growth hormones or antibiotics.
Vegan or vegetarian
- Non-GMO soy
- Vegetable proteins like legumes, pea chia, or hemp.
- Fermented foods like kefir, kombucha, or sauerkraut which contain live organisms that populate the microbiome with beneficial bacteria.
The above mentioned foods promote emotional and physical health by keeping the gut happy and healthy. As a word of caution, avoid processed, packaged snack foods at all costs and focus on whole, unprocessed foods like promote a good mood. Here are some more delicious options to add to your daily diet that calm inflammation and support mood:
- Dark Chocolate (70% or darker)
- Vitamin B rich foods – eggs, raw dairy, grass fed beef, and organic chicken and turkey, leafy greens like kale or Swiss chard, and bananas
- Red, Purple, and Blue Berries – Contain Vitamin C and other antioxidants
- Omega 3s – wild caught fatty fish (2 servings weekly), walnuts and flax seed
- Coconut oil
As a final note, understanding mood disorders is complex and the underlying factors multi-tiered. Everyone is unique and requires and individualized approach that takes into account genetics and epigenetics, mental and emotional health and diet and lifestyle. When all three are addressed, we are better able to address mood disorders and provide the best outcomes. If you want to learn more about health enhancing diets and what foods can support emotional and physical health, meet with a board certified and licensed nutritionist, our nutritionist, Liz Mckinney, CNS accepts Aetna and Blue Cross Blue Shield insurance as well as self paying clients.
by Counseling and Wellness Center of PittsburghJuly 16, 2018 anxiety during pregnancy, depression in pregnancy, postpartum, stress pregnancy0 comments
Anxiety and Depression During Pregnancy, ‘Wellness For People Like Me.’
Writer, blogger, and art therapy graduate Angela Grace Wilt shares some of her experiences in recovering positive coping and mental health including ways to manage anxiety and depression during pregnancy. This is a part of the ‘People Like Me’ Series of our wellness blog, real people, real stories, real ways to incorporate wellness into stages and experiences of everyday normal life.
Being a woman comes with a lot of ups and downs. Women are prone to anxiety and it can be very hard to to admit. For example, women are closely tied to the monthly cycles that their body experiences. Things such as menstruation cause anxiety, depression, mood swings, and intense bodily urges with cravings. Men never will get us or grasp what we go through. We are just that unique. For as long as I could remember, I have felt that as a woman I am special and cursed all at once.
Then of course recently, as I have taken this jump into parenthood with the amazing biological potential of my body, quickly I have learned that while things like premenstrual dysphoria, and the normal anxieties and depression of menstruation are challenging, pregnancy holds a whole long list of unique and larger fears and physical difficulties. In fact, this is true for all women, and according to The American Congress of Obstetricians and Gynecologists (ACOG), between 14-23% of women will struggle with some symptoms of anxiety or depression during pregnancy. The shift in mental health have multiple sources, think about it, there is insomnia because our body is changing so fast that some women can be prone to rapid heartbeat, which makes it harder to fall asleep. There is also the whole list of ‘what ifs.’ Will my baby and I make it to full term? Will my baby be healthy? I can no longer drink alcohol, ride adrenaline driven roller coasters, lift heavy weights, or really take any chances of too adventurous tasks. With each decision I make, I consider the question ‘what will makes my little bump, a healthy or not so healthy baby.’
Physical and emotional changes are also thread within social fears and adjustments, I sometimes wonder, have I planned enough for this pregnancy that has in many ways, just happened. The truth is, I am not some 30 something who has been charting my cycle for 6 months to achieve conception, I didn’t plan to get pregnant just yet. I thought about it sure, but just like most couples we wanted to walk down the aisle with a white dress of lace and flowers all the scenery of our closest friends and family shouting us on, it was always my dream of being that princess and marrying my soul mate! We still will have that for our future, but it will be after we get through the current stresses. In addition to the changes in my timeline, I also care about what our parents think about our having a baby right now. Having a baby out before marriage can be shocking for some religious and cultural values. We were lucky because my family is just fine with it, and with a little time to adjust, my better half’s is now happy about the news.
The list of anxieties and real practical matters which accelerate my concerns are aplenty, even small things have caused me stress, I have had to shop for insurance as a pregnant women, because I am twenty-six, pregnant, and didn’t have any. Finally, babies are expensive, health insurance is also expensive, we have stresses of finding better jobs, I have to go on insurance yet because I am twenty-six and don’t have any. We are cleaning house and making a baby room. When all of these real life stresses start to mount very high, I can feel my heart beating faster, I try to stop and think of the things that we do have, I try to re-frame my anxieties and depressed thoughts in a positive light, I pause and I say to myself, ‘I have my boyfriend, our love together, and I have a supportive family. I have myself and my strengths, and I am strong and able.’That always seems to calm me down and help me to remember that there is much to be excited about as we move forward together as a young family.
With all of these anxious and depressed thoughts swirling in my mind, I have taken the time to put together a small list of ways that I manage and support my emotional health during my pregnancy. Of course if you are struggling with mental health during or after your pregnancy, talk to you PCP or Mental Health provider, get a screening for Postpartum or Baby Blues, every year women die or don’t bond with their babies due to maternal mental health factors. If you are like me and relatively healthy but feeling a little anxious or blue, then read on because these tips may help you as much as they helped me.
Use positive self talk, be your own biggest fan and encourage yourself like you would a friend
I say nice things to myself, I write little notes and post them through out the house, simple thoughts like,’ Rome was built in a day’ ‘We will get everything done in time.’ We’re already almost half way there at twelve weeks. It’s just a wild ride. My body is going through so many beautiful changes. Tune in, all of my emotions are heightened. Hunger is giving me nourishment now. Sleep is always appreciated. Sex is fierce and always wanted. Sadness and anger are intense. I have energy that comes out of nowhere. Its ok if sometimes I can’t stop crying. I love my baby and baby’s daddy and not want anything more than to be with just them and them alone. I want the best by our new child. I want to give it proper nutrition and a good home life. I want to be a good parent and my baby to grow in a family where love is the answer and anger is dealt with in a healthy supportive manner. I will protect this baby with all that I have. This child’s needs and wants are now first. I am ready to teach this baby proper education, morals, respect, and spirituality.
Its normal to be overwhelmed, life is now changing!
Anxiety,stress, and fear are the norm when we are overcoming big changes. ways just important to remember that having a baby is a life changing experience. Normalizing the emotions that I am experiencing helps me by making me not feel the guilty, ashamed, or odd for having these dips and emotional shifts.
Reach for your Tribe!
Please remember, you are not alone. You are a powerhouse and you have many people who will listen and talk. Make a list of 5, if you can not list at least 5 people who will pick up the phone for you, see a therapist and talk about the feelings of isolation and loneliness. Mom, dad, best friends, siblings, make a list and think about who is the best person to talk with through the things that come up. It will likely be a different person for each of situations that one may encounter on the pregnancy journey.
Use your breath
The body and its breathing are powerful, breathing can be used to energize and manage our response to stress. Take some deeps breaths every day.
Make a Wellness Routine
Do calming relaxing type activities like yoga, walking in nature or just walking, stretch, journal, and keep time for yourself to collect your thought and consider the daily experiences that you are managing. Essential oils can help ease the mind and emotions and of course be sure to choose blends that are safe to use during pregnancy.
Bond with your baby
Talk to your baby while its in the womb, there will likely be a time after your baby is born that you are longing to be so closely connected to him or her again, try to cherish these moments and zoom out towards the big picture where you are nurturing a sacred bond right now in your womb. Being a woman is very special, and this connection, with baby snugly centered in my sacral area, right as my mother and my mothers mother have always done, this is something that men can not understand, but I am ok with that.
We are powerful, we are able to make changes that influence the outcomes of our life. Pregnancy like all things, is what you make of it. Do your best to stay positive by thinking of the new exciting things that can be done all in great fun with your new family together. Your love of baby and yourself will take you far. Be gentle with yourself when you notice the stress, anxiety, and fear of the 9 months ahead. This is a special time that can be used to get really healthy and in tune with your bodies needs. As always, seek medical help from a PCP, Gynecologist, or Licensed Professional Counselor if you have concerns about your mental health.
by Counseling and Wellness Center of PittsburghJune 8, 2018 Anthony Bourdain suicide, kate spade suicide, mental health awareness, suicide, suicide prevention, suicide warning signs0 comments
With the suicide of two Hollywood Stars this week, both Kate Spade fashion designer, and beloved Anthony Bourdain, American chef and champion of human rights, we at the Counseling and Wellness Center of Pittsburgh wish to express our condolences to the families, friends, and all of those effected by these tragic losses. According to the National Institute of Health, suicide rates are rising, 40,000 people will die by suicide each year. As a nation, and as people who want to help, we should think about the signs, symptoms, and behaviors of the people around us so that we can do our best in having awareness to prevent suicide. Suicide is a topic which holds personal importance to me, many years ago, when I was an undergraduate student studying psychology, my boyfriend attempted suicide in my bed by placing a bullet into his brain, after months in a coma, he was lucky enough to survive. Yet the act was one which was shocking for all of his friends, his family, and something that impacted me to this day. As a woman who has devoted herself to studying and working in the mental health field, at the time, I did not see the signs that my boyfriend was suicidal.
Suicide is a taboo topic and product of dismal and ill mental health; major depression, bipolar disorder, borderline personality disorder, psychosis, and schizophrenia, are a few of the disorders which are typically associated with an increased risk for suicide. For those who are closest to someone suffering from mental health disorders, the symptoms are very difficult to see for what they are. The thoughts, behaviors, and feelings of a depressed person are a set of treatable symptoms which are a produced by mental illness. Our science and psychology hold diagnostic labels but for the human beings who act out suicide, these symptoms are a daily life experience, they are much more than a label. Mental illness is an often invisible disease causing people to suffer immensely, those who are in the depths of depression or other mental illness, often have not sought treatment with a therapist or mental health professional. A person may walk through life for many years, hollow and bleak, no longer able to experience the hope or purpose to continue living. They may become so overwhelmed that they can no longer imagine the purpose of surviving more days while struggling with their feelings of despair, sadness, conflict, and internal pain. Often the person who commits suicide is one whose self-esteem and thoughts have entered a place of such distortion that they imagine the people who survive them will be better off without them in their lives. Again, this kind of thinking is a product of the illness. Please spend a few moments looking over the suicide warning signs according to the American Foundation for Suicide Prevention.
- Isolating themselves.
- Not returning phone calls.
- Not showing up for family or friends invitations.
- Being withdrawn.
- Giving away possessions.
- Sleeping too much.
- Sleeping too little.
- Using substances to excess.
- Talking about suicide. *Especially sharing that they have a plan and a way to carry it out.
- Saying that friends and family would be better off without them.
- Feeling like a burden.
- Feeling hopeless.
- Feeling that there is no reason to live.
- Talking about deep feelings of depression or anxiety.
- Sudden increase in mood or energy
Environmental Risk Factors
- Relationship problems.
- Financial problems.
- Having access to lethal means such as pills or guns.
- Prolonged stress.
If this sounds like someone you know, or if you have been feeling these things recently, please seek help. Call your local crisis center, here is a number for a national suicide hotline 1-800-273-TALK. Remember that the emotions are temporary and life’s situations which overwhelm us are solvable. Mental health help is around the corner. If your loved one has expressed these things to you, or is exhibiting some of the warning signs, stay with them, ask questions and let them talk about their worries and problems, your presence will help, listen with patience and compassion and be with them while calling the suicide prevention hotline or getting them to a local hospital.
In love and life,
Stephanie Wijkstrom, MS, LPC, NCC
Counseling and Wellness Center of Pittsburgh
830 Western Avenue
Pittsburgh Pa, 15233
4108 Monroeville BLVD
Monroeville Pa, 15146.
Serving Western Pennsylvania with Individual, Marriage, Family, Counseling and Wellness Services.Learn More
by Counseling and Wellness Center of PittsburghMay 10, 2018 addiction, anxiety, cell phone addiction, cell phone anxiety, counseling for addiction, help for cell phone addiction, social media addiction, therapy for addiction, video gaming addiction0 comments
The Dangerous New Addiction that you use Everyday, Hint-It is not a drug!
In a world of highly demanding home lives and work lives, where performance is prized above peace and calm, there is one object which is the focal point of so much of our attention. TO maintain peace, balance, and calm, our human bodies require us to at least sometimes, think without disruption, to look around at the leaves on the trees and to see and be with everyone contained in the horizon around us. To love and care for our spouse and families we need to supply them with attention by unplugging from everything that is not directly in front of us. If we are going to live a life of contentment, balance, and enhance our mindfulness, we must examine the culprit that stands in our way. One very intrusive companion to our feeling of alertness and attention is our cell phones. While they are a way for us to communicate plans and conversations, to manage our work, to find true love and date, as well as find out information about anything in the world that we want to know via the internet, they are also a major problem. There is so much focused awareness placed upon our cell phones that medical community is examining it as an object that can absorb our attention so much, even black out what is around us causing distress and impairment in our physical bodies and relationships. The research community has decided that yes, cell phone use does qualify as a form of addiction and at minimum for most of us, it contributes to our growing levels of stress and anxiety (Desola et al).
The presence of addictive behavior that takes place on our cell phones spans so much more than just compulsive shopping or video gaming. The anxiety that we feel surrounding our cell phone has resulted in new bodies of language, some of our favorite pop terms devoted to describing our responses to not having our most favored objects by our side are; “Nomophobia” meaning that we fear no having our phones, there is also “FOMO” commonly known as the Fear Of Missing Out i.e the fear of being without our cell phone or even disconnected from the Internet, “Textaphrenia” and “Ringxiety” – the false sensation of having received a text message or call that leads to constantly checking the device some of us are so tuned into our cell phones that we hear phantom ringing, imagining that the phones are ringing when they are in fact not. “Phubbing”, meaning to inadvertently ignore someone we are with to check our phone. “Textiety” – the anxiety of receiving and feeling the compulsive urge to then respond immediately to ours texts (De Sola 2016).
Our attachment to our cell phones is so strong that we legitimately feel “separation anxiety” when we are away from them for too long. Bring your awareness to the last time that you lost or misplaced your phone, how did that feel for you in the moment? If you are like many people you felt the typical markers of anxiety including, excessive thoughts and worry, even elevated heart rate and fear that you may be missing something very important out there in our cloud based cyber world. Here are some very good signs that you may have a problem.
9 signs that you or our loved one may be struggling with anxiety or addiction with cell phone use;
- Using cell phones in a dangerous context such as while driving or biking.
- Having had an accident or other incident due to using a cell phone in a dangerous context
- Having problems in relationships, ie your partner or loved one annoys you by criticizing your cell phone use.
- Having problems at work or school because of cell phone use.
- Preferring online, texting, or social media world to real life contact.
- Inability or difficulty sleeping due to cell phone use.
- An inability or difficulty refraining from using cell phones even though attempts have been made to cut back.
- Urgency to respond to messages immediately and having a marked irritability if access to phone is delayed.
- High degrees of anxiety and loneliness and changes in mood due to need to send, respond, or receive messages.
While it is nearly impossible to function in the world without a cell phone, as with all things that are addictive, there are ways to enjoy them and their many functions without being addicted. Whether we are using our phones to be productive or to purchased extra lives on candy crush, what we do is less important than how we do it, and whether or not we meet the diagnostic criteria for problematic use. If you think that you may be experiencing a problem with how you are using your cell phone, or if others suggest that they think you have a problem, spend some time really thinking about whether you do feel balanced or does your attention often get derailed to be plugged into the digital world. The solution may be as easy as trying to cut back or even trying a digital detox. Yet the fact is that if you are experiencing a true addiction or dependence on your cell phone or have developed another anxiety disorder surrounding it, cutting back may be very difficult to do without the support of a therapist or counselor.
The Counseling and Wellness Center of Pittsburgh
830 Western Avenue Pittsburgh Pa 15233
4108 Monroeville BLVD Monroeville Pa 15146
Proudly bringing Wellness Counseling to Western Pennsylvania
De-Sola Gutiérrez, J., Rodríguez de Fonseca, F., & Rubio, G. (2016). Cell-Phone Addiction: A Review. Frontiers in Psychiatry, 7, 175. http://doi.org/10.3389/fpsyt.2016.00175Learn More