Taking a step back – Self Awareness

Whenever I reach out inward, by taking a step back for a moment, I see things very differently from what I have in the go-go-go mode.

Just sitting in a chair or couch works best for me to do this mental exercise of self awareness. I then stay in a state of curiosity. This helps me slow down to get into a relaxed mode. Believing in myself helps me in this state, whatever the state I’m in. Then I explore how I feel, what thoughts cross my mind and bring in some kindness to myself to stay gentle in the whole self awareness process. I tend to do this at least twice a week at peak stress days as part of self care to check in with myself and know I can slow down to be aware of my reactions.

What this reveals is a beautiful picture of my day and my reactions to the various happenings. This in turn helps me write out my process recordings with my supervisor in an authentic fashion and process any anomalous reactions in my mind with openness and curiosity. I slowly realized in this field that curiosity about myself and my environment along with critical thinking alone will help me bring a better work – life balance.

Thanks for reading my process for self awareness !

Best,

Shrivi

Breaking the myths behind Mindfulness practice for the benefit of Trauma Survivors

1. Don’t need to close your eyes during mindfulness meditation.

2. Don’t need to sit still to do mindfulness meditation.

3. Staying present in the moment non-judgmentally, even while walking, eating or working, is what is truly being mindful.

4. Don’t need to shut off your mind as your brain is always going to be active, especially with a trauma history.

5. Don’t need to focus on your breath. Trauma victims find this especially triggering with unpredictable outcomes.

6. Mindfulness meditation is not for quick turnaround of results.

7. Mindfulness meditation is not for everyone!

Cognitive distortions

Cognitive distortions arising from negative core beliefs are something to be deeply analyzed on a daily basis, for the automatic thoughts crossing our minds!

Taking a step back and looking at what just happened in our mind is all it takes to stay present with ourself and really being true to our personality.

Measuring the possibility of our core beliefs to be even slightly incorrect based on the existing evidence shown by the people around us and other environmental factors is very critical!

Here’s to looking closely at our thoughts that sometimes make no sense in hindsight! Lol!

Have a great weekend!

Best,

Srivi

Cbt as I understand it

The premise of cognitive-behavior therapy(CBT) includes the reorganization of an individuals own statements and beliefs to develop a synchronization with his or her behavior.  A relationship exists between thoughts (or cognitions), emotions, and behaviors that create cause and effect in how the individual experiences events and situations.  Human nature, says that individuals have the potential for rational and irrational thinking. This irrational thinking is identified as the basic problem in mental disorders of depression and anxiety where CBT is employed.

The constant rewiring of thoughts using positive rational statements forms the basis of Cognitive behavioral therapy. Examples of rewiring irrational thoughts with positive statements:

Rewire “I’m bad” with “I’m enough”

Rewire “I cant do this” with “I can try this”

Rewire “I’m weak” with “I’m strong enough to go for a walk”

So on and So forth simple translations/rewiring.

Trying to see the goodness in everyday life, when everything seems so gloomy, due to the automatic negative thought script running, is the real deal of cognitive behavioral therapy, as I understand it.

Hope this helps people in actively engaging in the therapy tactics as it is critical for recovery for the client to full engage and involve themselves in this REWIRING process.

Happy thoughts!

Infertility and Mental Health

Infertility is perceived as a problem across virtually all cultures and societies and affects an estimated 10%-15% of couples of reproductive age. In recent years, the number of couples seeking treatment for infertility has dramatically increased due to factors such as postponement of childbearing in women, development of newer and more successful techniques for infertility treatment, and increasing awareness of available services. This increasing participation in fertility treatment has raised awareness and inspired investigation into the psychological ramifications of infertility. Consideration has been given to the association between psychiatric illness and infertility. Researchers have also looked into the psychological impact of infertility and of the prolonged exposure to intrusive infertility treatments on mood and well being. There is less information about effective psychiatric treatments for this population; however, there is some data to support the use of psychotherapeutic interventions.

Psychological Impact of Infertility

Parenthood is one of the major transitions in adult life for both men and women. The stress of the non-fulfillment of a wish for a child has been associated with emotional sequelae such as anger, depression, anxiety, marital problems, sexual dysfunction, and social isolation. Couples experience stigma, sense of loss, and diminished self-esteem in the setting of their infertility (Nachtigall 1992). In general, in infertile couples women show higher levels of distress than their male partners (Wright 1991; Greil 1988); however, men’s responses to infertility closely approximates the intensity of women’s responses when infertility is attributed to a male factor (Nachtigall 1992). Both men and women experience a sense of loss of identity and have pronounced feelings of defectiveness and incompetence.

Psychological Distress, Psychiatric Illness and Infertility: Cause or Effect?

Stress, depression and anxiety are described as common consequences of infertility. A number of studies have found that the incidence of depression in infertile couples presenting for infertility treatment is significantly higher than in fertile controls, with prevalence estimates of major depression in the range of 15%-54% (Domar 1992; Demyttenaere 1998; Parikh 2000; Lukse 1999; Chen 2004). Anxiety has also been shown to be significantly higher in infertile couples when compared to the general population, with 8%-28% of infertile couples reporting clinically significant anxiety (Anderson 2003; Chen 2004; Parikh 2000).

The causal role of psychological disturbances in the development of infertility is still a matter of debate. A study of 58 women from Lapane and colleagues reported a 2-fold increase in risk of infertility among women with a history of depressive symptoms; however, they were unable to control for other factors that may also influence fertility, including cigarette smoking, alcohol use, decreased libido and body mass index (Lapane 1995).

Proposed mechanisms through which depression could directly affect infertility involve the physiology of the depressed state such as elevated prolactin levels, disruption of the hypothalamic-pituitary-adrenal axis, and thyroid dysfunction. One study of 10 depressed and 13 normal women suggests that depression is associated with abnormal regulation of luteinizing hormone, a hormone that regulates ovulation (Meller 1997). Changes in immune function associated with stress and depression may also adversely affect reproductive function (Haimovici 1998). Further studies are needed to distinguish the direct effects of depression or anxiety from associated behaviors (e.g., low libido, smoking, alcohol use) that may interfere with reproductive success. Since stress is also associated with similar physiologic changes, this raises the possibility that a history of high levels of cumulative stress associated with recurrent depression or anxiety may also be a causative factor.

Psychological Distress and Infertility Treatment

While many couples presenting for infertility treatment have high levels of psychological distress associated with infertility, the process of assisted reproduction itself is also associated with increased levels of anxiety, depression and stress (Leiblum 1987). A growing number of research studies have examined the impact of infertility treatment at different stages, with most focusing on the impact of failed IVF trials. Hynes and colleagues assessed women at presentation for IVF and then following failure of IVF. They found that women presenting for IVF were more depressed, had lower self-esteem and were less confident than a control group of fertile women and, after a failed IVF cycle, experienced a further lowering of self-esteem and an increase in depression relative to pre-treatment levels (Hynes 1992). Comparisons between women undergoing repeated IVF cycles and first-time participants have also suggested that ongoing treatment may lead to an increase in depressive symptoms (Thiering 1993). The data, however, is still controversial since other studies have found minimal psychological disturbance induced by the infertility treatment process or IVF failure (Paulson 1988; Boivin 1996). In light of the discrepancy in results, there has been increasing interest in the factors that contribute to dropout from infertility treatment since this population is often not included or decline to participate in studies. Whereas cost or refusal of physicians to continue treatment have been cited as reasons for discontinuing treatment, recent research suggests that a significant number of dropouts are due to psychological factors (Domar 2004; Hammarberg 2001; Olivius 2004).

The outcome of infertility treatment may also be influenced by psychological factors. A number of studies have examined stress and mood state as predictors of outcome in assisted reproduction. The majority of these studies support the theory that distress is associated with lower pregnancy rates among women pursuing infertility treatment (Boivin 1995, Thiering 1993, Demytenaere 1998, Smeenk 2001, Sanders 1999).

Psychological Interventions

In light of data suggesting that psychological symptoms may interfere with fertility, success of infertility treatment, and the ability to tolerate ongoing treatment, interest in addressing these issues during infertility treatment has grown. Some interventions designed to alleviate the symptoms of stress, depression and anxiety in infertile women and men have been researched.

Several studies suggest that cognitive behavioral group psychotherapy and support groups decrease stress and mood symptoms, as well as increase fertility rates. In a study by Domar and colleagues of 52 infertile women, a 10-week group behavioral treatment program significantly reduced anxiety, depression and anger (Domar 1992). In a year-long follow-up study, Domar compared pregnancy rates of women undergoing assisted reproduction who were randomized to a group cognitive behavioral therapy (CBT) designed to decrease depression and anxiety, a support group, or to no group treatment. Viable pregnancy rates were 55% for the cognitive behavioral group, 54% for the support group and 20% for the controls (Domar 2000). A study where the intervention group received couples counseling directed toward education and addressing stress throughout their IVF cycle and the control group received only routine medical care, the intervention patients had lower anxiety and depression scores, in addition to significantly higher pregnancy rates (Terzioglu 2001).

Although there have not been systematic studies in infertile women examining the impact of other types of psychotherapy, treatments that decrease psychiatric symptoms and stress in the general population will likely benefit this population.

While there is little data regarding the pharmacologic treatment of patients with infertility, pharmacotherapy remains an important option for women and men who develop depression in the context of infertility and its treatment. Many women avoid pharmacologic treatment for fear that medication may impact their fertility or may affect the outcome of their pregnancy; however, there are no data to suggest that commonly used antidepressants negatively affect fertility. Furthermore, data accumulated over the last decade suggest that certain antidepressants may be used safely during pregnancy.

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Understanding & managing your anxiety

Understanding your anxiety

According to its medical definition, anxiety is a state consisting of psychological and physical symptoms that are brought about by a sense of apprehension at a perceived threat. These symptoms vary greatly according to the nature and magnitude of the perceived threat, and from one person to another.

Symptoms of anxiety

Psychological symptoms may include feelings of fear, an exaggerated startle reflex or alarm reaction, poor concentration, irritability, and insomnia. In mild anxiety, physical symptoms arise from the body’s so-called fight-or-flight response, a state of high arousal that results from a surge of adrenaline. These physical symptoms include tremor, sweating, muscle tension, a fast heartbeat, and fast breathing. Sometimes people can also develop a dry mouth and the irritating feeling of having a lump in the throat. In severe anxiety, hyperventilation or over-breathing can lead to a fall in the concentration of carbon dioxide in the blood. This gives rise to an additional set of physical symptoms including chest discomfort, numbness or tingling in the hands and feet, dizziness, and faintness.

Panic attacks

In an anxiety disorder, exposure to the feared object or situation can trigger an intense attack of anxiety called a panic attack. During a panic attack, symptoms are so severe that the person begins to fear that she is suffocating, having a heart attack, losing control, or even ‘going crazy’. As a result, she may develop a fear of the panic attacks themselves, and this fear begins to trigger further panic attacks. A vicious circle takes hold, with panic attacks becoming ever more frequent and ever more severe, and even occurring completely out of the blue. This pattern of panic attacks is referred to as ‘panic disorder’, and can in some cases lead to the development of secondary agoraphobia in which the person becomes increasingly homebound so as to minimise the risk and consequences of having a panic attack. Panic attacks can occur not only in anxiety disorders, but also indepression, alcohol and drug misuse, and certain physical conditions such as hyperthyroidism. They can also sometimes occur in people who are not otherwise ill.

Managing your anxiety

The first step in managing anxiety is to learn as much as you can about it, as a thorough understanding of your anxiety can in itself reduce its frequency and intensity. It can be tempting to avoid any objects or situations that provoke or aggravate your anxiety, but in the long term such avoidance behaviour is counterproductive. When anxiety comes, accept it. Do not try to escape from it, but simply wait for it to pass. Easier said than done, of course, but it is important that you should try.

Making a problem list

One effective method of coping with anxiety that is related to a specific object or situation is to make a list of problems to overcome. Then break each problem down into a series of tasks, and rank the tasks in order of difficulty. To take a simple example, a person with a phobia of spiders may first think about spiders, then look at pictures of spiders, then look at real spiders from a safe distance, and so on. Attempt the easiest task first and keep on returning to it day after day until you feel fairly comfortable with it. Give yourself as long as you need, then move on to the next task and do the same thing, and so on. Try to adopt a positive outlook: although the symptoms of anxiety can be terrifying, they cannot harm you.

Using relaxation techniques

If a given task or situation is particularly anxiety-provoking, you can use relaxation techniques to manage your anxiety. These relaxation techniques are very similar to those used to manage stress, and can also be used for generalised anxiety, that is, anxiety that is not related to any particular object or situation, but that is free-floating and non-specific. One common and effective strategy, called ‘deep breathing’, involves modifying and regulating your breathing:

—Breathe in through your nose and hold the air in for several seconds.

—Then purse your lips and gradually let the air out, making sure that you let out as much air as you can.

—Continue doing this until you are feeling more relaxed.

A second strategy that is often used together with deep breathing involves relaxation exercises:

—Lying on your back, tighten the muscles in your toes for 10 seconds and then relax them completely.

—Do the same for your feet, ankles, and calves, gradually working your way up your body until you reach your head and neck.

Other general strategies that you can use for relaxing include listening to classical music, taking a hot bath, reading a book or surfing the internet, calling up or meeting a friend, practising yoga or meditation, and playing sports. As you can see, there is no shortage of things that you can do.

Implementing simple lifestyle changes

Simple lifestyle changes can also help to reduce anxiety. These might include:

—Simplifying your life, even if this means doing less or doing only one thing at a time.

—Having a schedule and keeping to it.

—Getting enough sleep.

—Exercising regularly (for example, walking, swimming, yoga).

—Eating a balanced diet.

—Restricting your intake of coffee or alcohol.

—Taking time out to do the things that you enjoy.

—Connecting with others and sharing your thoughts and feelings with them.

Seeking help

If you continue to suffer with severe anxiety despite implementing some of these measures, you can get in touch with one of several voluntary organisations which, amongst others, organise self-help groups and operate telephone help-lines. You can also speak to your family doctor who may suggest ways of helping you. For example, he or she may suggest referring you for a talking treatment or starting you on antidepressantmedication, which can be used both in the treatment of depression and in the treatment of anxiety.

Sedatives

If your anxiety is especially disabling, your doctor may start you on a benzodiazepine sedative. Such sedatives are not a cure for anxiety, but they can provide short-term relief from some of your symptoms. Their long-term use should be avoided because they carry a high risk of tolerance (needing more and more to produce the same effect) and dependence or addiction. ‘Beta blockers’ are also occasionally prescribed to control some of the symptoms of anxiety, such as palpitations associated with a fast heart rate. However, they should be avoided in certain groups of people, most notably people with a history of asthma or heart problems.

Talking treatments

Medication is usually most effective if it is combined with a talking treatment. Cognitive-behavioural therapy or CBT is commonly used in the treatment of anxiety. CBT for phobias may involve making a list of problems to overcome, and then breaking down each problem into a series of tasks that can be attempted in ascending order of difficulty. Relaxation techniques may also be taught so as to help you manage your anxiety and cope with each task more comfortably. CBT for panic disorder may also involve such graded exposure and relaxation training, but there is often also an added emphasis on modifying how you interpret changes in your body: for example, you may learn to interpret a fast heart rate in terms of the symptoms of anxiety rather than ‘catastrophically’ in terms of having a heart attack. You may also be taught how to control your breathing and thereby prevent some of the more alarming symptoms of anxiety.

Neel Burton is the author of Heaven and Hell: The Psychology of the Emotions and other books.

The Science behind Mindfulness Meditation

 

It is a known fact that meditation helps in many aspects of a person’s life. It can aid you build your immune system, get back your focus and concentration, and of course reduce anxiety levels and other problems that bother the mind. Though said to be effective, so little scientific research has been done to […]

Source: The Science behind Mindfulness Meditation