What Do I Do If I Use Substances During the COVID-19 Coronavirus?

What Do I Do If I Use Substances During the COVID-19 Coronavirus?

The COVID-19 coronavirus pandemic has affected everyone in some way – many of us are unable to work, unable to find access to child care or other important resources (one friend of mine has even been barred from doing laundry in his building). For some, like someone I know of who runs a milk delivery company, the pandemic is like an early Christmas present. Significantly and unfairly, the pandemic most adversely affects those who are most vulnerable: people living in or close to poverty who are out of work, people who are homeless, and those at highest risk to develop illnesses.

An important, but often overlooked group impacted by COVID-19 coronavirus are those who use substances. That includes those who rely on alcohol, cannabis or other drugs for medicinal or functional purposes (such as anxiety management), injecting drug users who rely on access to safe injection sites, and users of a variety of other substances for whom access has now dried up or become increasingly unreliable.

Imagine having to go device-free for a week, or longer – no phone, TV, computer, or other screen. For many of us this would involve literal symptoms of withdrawal, as we have become accustomed to using screens to cope with negative emotions, stress, anxiety, and to connect with others. I’m willing to bet you couldn’t, or wouldn’t, pull it off. A substance user’s drug of choice likely serves a similar function and is very likely quite painful to suddenly lose access to, without any sense of choice or control. My colleague very kindly reminded me of the difficulty some people will go through losing access to substances during a very uncertain and stressful time, and I feel sad to think of the number of us that will go through painful withdrawal symptoms (physical pain, uncontrollable anxiety or panic, and severe depression are just a few) and as a result will be forced to find other ways to cope.

People are incredibly resilient and will generally find ways to get through difficulties whatever the cost. I wanted to talk a little bit about the ways we can cope with difficulties, even in the face of withdrawal from something as mild as social isolation or as severe as substance addiction. Recovery from substance dependency involves building recovery capital, which is a blanket term referring to resources (both external and internal) that allow us to slowly build up capital – a wealth of other ways to cope. There are hundreds of examples, but some key themes are relationships with others, health (physical, mental, and emotional), strategies and tools, and a relationship with oneself.

Substances can be an effective tool in the short-term, but they have shortcomings: they don’t tend to last very long, they take a physical toll, and they can keep us away from some opportunities for the growth that comes from going through difficulty with the right support. Substances are considered part of passive coping, just like video games, junk food, and ignoring a problem. Passive coping is not bad, it is an important resource and we don’t want to overuse it. Active coping is also an important resource: exercise, diet, certain types of social support, therapy, learning, and other health behaviours fall into this category. Simply put, active coping is anything we do to directly cope with a difficulty, and passive coping tends to avoid the implications of a difficulty. The trick is striking a healthy balance between the two.

If you have recently lost access to substances or access to other important habits, I’m really sorry – you didn’t get to have a choice in the matter; an invisible and seemingly uncaring force made the decision for you. That really, really sucks, and now you’re stuck managing as best you can. Some that I have talked to will use tools such as exercise or meditation to achieve another type of “high,” and focus on emotional, spiritual, or intellectual pursuits when they have the energy to do so. When they don’t, they will use whatever means necessary to get through the really hard moments: sleeping a little more, indulging in TV or video games, venting to friends, or eating a little extra sugar.

You will find a sample list of different coping tools and a couple resource links at the bottom of this article. However, I’m not really here to give a bunch of advice, as everyone is different, and there aren’t any one-size-fits-all solutions. If you want help taking care of yourself right now and want to talk about creating a short-term plan, let me know and I can help with that. But you know yourself best, and you know what will get you through this better than anyone else does, and hopefully you know when you might need to seek support. Mostly, we just want to say that whatever your situation, we are thinking of you and rooting for you to get through it, because there is a lot of uncertainty and difficulty for a lot of us right now. Always feel free to reach out, and most of all, take care of yourself.

 

Tips for the “Green Zone” – when we have some energy or motivation:

 

  • Don’t overdo it – quality over quantity. Give yourself a realistic and short amount of quality time (say 15 minutes) to spend on something that your ideal version of yourself would do: go for a walk or a run, listen to some music, do yoga, spend some time reading, writing, singing, or drawing, complete a short work task, organize your cupboards – whatever. When you’re doing this, try to let all your focus rest on the activity at hand. Here’s a quick video tip from a children’s book I’m a fan of.
  • Try meditation. Focus for a few minutes on your breath, and spend some time being curious about yourself: how do I feel at this moment? What physical sensations do I notice? Do I feel anything towards myself or towards those sensations? Try to avoid positive or negative judgments during this time, and if they arise, just notice that they are there. The goal is just to be, to observe yourself internally at that moment.
  • Spend time cooking yourself a healthy meal from scratch, and eating it without any distractions, focusing on how good it tastes, and feeling good about yourself for putting the energy in to make it. If you can, even better to share it with someone.

 

Tips for the “Yellow Zone” – when our stress is present but manageable:

 

  • Notice what thoughts and feelings are coming up with as much compassion as possible. Imagine the things that are happening internally are happening to someone you really care about (real or imaginary). What would you tell them? How would you want to care for them? Try to identify a small way you could care for yourself in that moment. If all else fails, take some deep, slow, breaths.
  • Exercise. Get your blood pumping and get moving, this will give you an adrenaline spike to help you get through the next while. If you are tired later, you’ve earned a break! Take a nap.
  • Put on some music to match your mood, and paint, draw, or write along to it.
  • Call or chat with someone. Most of us have time on our hands – talk (or even vent) about what is stressing you, ask how they are doing and try really hard to listen well. When we share with others, or work hard to understand others, our relationships deepen and we feel closer and more comfortable. If you’re not up for a conversation, just play some online video games together. If you are struggling with something specific, try to find an online chat group that specializes in that type of thing. If substance use is your thing, there are tons of online chat groups full of people who have good advice and good support, all anonymous and for free.
  • If you have a therapist, an online session might be a good idea.

 

Tips for the “Red Zone” – When the bomb hits or is about to hit:

 

  • Breathe. Inhale for 3-5 seconds, hold for 2-3, and exhale slowly for 7-10, like you’re blowing on something to cool it.
  • Douse your head in cold water for a few seconds – this activates a survival “dive reflex” that calms the body. You can also try grabbing some ice cubes and squeezing them in your hands, focussing on that feeling and seeing how long you can go before having to let go. It’s pretty hard, and good at redirecting the brain.
  • Reach out to whoever feels safe to reach out to, in whatever way feels ok.
  • Feel free to use your favourite passive coping mechanism: watch a movie, eat something (preferably deliberately slowly), try to take a nap.
  • Imagine or daydream.
  • Write or draw – destroy some paper with whatever you’re feeling at the time.

 

There are countless other things you can do, and lots of online resources for meditation, emotional regulation, practical addiction support. Again, individuals vary wildly, so if you want help creating a specific plan for yourself, feel free to reach out to a mental health professional. We’re in this together, and we’re rooting for you here at Alongside You.

 

 

Three Practical Ways to Experience Peace this Christmas

Three Practical Ways to Experience Peace this Christmas

Here we are again – that time of year that gets us all excited about lights, smells, food, and relatives. Oh, and friends, cookies, the Stanley Park train, and…

Wait. Why are we excited again? Is anyone else stressed? What is this peace that people keep talking about? What’s the secret, and who actually experiences peace this time of year?
I’m like everyone else. I can let the stress get to me too. So, what I’ve done is some thinking and some research that will hopefully help all of us figure out how to get some peace this year. I don’t know about you, but I think we could use it. Here are three practical ways to experience peace this Christmas, I hope they’re helpful to you!

 

  1. Say “yes” to what matters most to you, and practice presence when you are there.

“It’s crazy. I can’t believe how much I have to do!”

We nod our heads and empathize, “Yes, I know. Me too. It’s just too busy!”

I am guilty of making these kinds of “Christmas complaints.” I am also aware that these rote responses make us feel that we’re “all in this together.” What a shame it is to forget that we often have a choice in the matter and that much of what we’re begrudgingly doing may, in fact, be worth enjoying.

Christmas parties, school performances, family dinners, and year-end activities – everything can be meaningful and life-giving. If you find yourself excited about a particular activity, and you think it is a worthwhile investment of your time and energy, show up with your Ugly Christmas sweater and your party hat on! What a gift it is to be alive!

One of the keys to connecting with the activities in a positive way is to be mindful. The best way to practice mindful presence at your chosen festivity is to set your intention, going in with the knowledge that this event is not imposed upon you, but gratefully chosen by you. Allow yourself to enjoy the people you speak with, the food you choose to eat, the melody and rhythm of the music you hear, and the décor creatively displayed for your aesthetic enjoyment. Breathe deeply, attune to your five senses – sight, smell, touch, sound, taste – and pay attention to what is right in front of you in that moment.1,2

 

  1. Say “No,” to what is not a priority, and learn to be okay with disappointing people.

If it is true that we can choose to be gratefully present at an event, it is also (usually) true that we can gratefully decline to attend. In fact, it can be very liberating to do so. When we choose to simplify our schedules and scale back our commitments, we are giving our enthusiastic ‘yes’ to what we do show up at. We may also disappoint a few people along the way.

It can be very difficult to let someone down; it is even more difficult, long-term, to live with blurry boundaries and residual resentment. We may think that we have to jump when our friends and family say “jump,” and perhaps we’ve done it our entire lives. Perhaps it’s instinctual, and to do otherwise would create tension. Part of our work as humans who work toward self-identity and emotional health is to know what is not for us at this time. It does not mean that we cannot change our minds in the future and show up meaningfully then, but that in this season, at this time, we cannot take it on.3

There is a way to communicate boundaries in a respectful, effective manner. It takes practice, but with new learning and perhaps some help from a counsellor, it is possible to become skilled at lovingly communicating our intentions and expectations to others.

 

  1. Say nothing at all, and take time for solitude.

For some, it will be a challenge to take a break from the busyness, to be alone and recharge. It may feel selfish to have time away from your partner, children, parents, or co-workers, to collect your thoughts in quiet. You may literally be thinking that you will make time for yourself next year. While it is possible to push through and strong-arm this season, we remember that if we feel coerced or obligated to be somewhere (in this case, to be with people), we may find it difficult to remain present with them. One of the best gifts we can give ourselves, and those we love is to take some time alone.

It is also true that for some of us, this season will feel lonely, even when we are in a crowded room of people.4 Or perhaps we will actually be alone more than we’d like, and the idea of choosing to turn down holiday activities out of sheer busyness seems like a happy person’s privilege. There can be peace in this season for you, too. Take very good care of yourself and reach out to one person who makes you feel known.5

Wherever you find yourself this Christmas, and with whomever, you choose to spend your time, try to be intentional about when you say “yes,” what you say “no,” and when to say nothing at all.

 

If you struggle with some of the decisions and boundaries I’ve talked about here, give us a call. We all struggle with these things at times and sometimes an outside perspective, listening ear, and some validation can go a long way in getting us from stress to health; or, as the young people say, from the FOMO (fear of missing out) to the JOMO (joy of missing out). Ok, it’s not that simple, but boundaries don’t have to be complicated. We can help.

 

Reference

 

  1. Goldin, P. R., & Gross, J. J. (2010). Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder. Emotion, 10(1), 83–91.org/10.1037/a0018441
  2. de Vibe M, Bjørndal A, Tipton E, Hammerstrøm KT, Kowalski K. Mindfulness-based stress reduction (MBSR) for improving health, quality of life and social functioning in adults. Campbell Systematic Reviews 2012:3 doi: 10.4073/csr.2012.3
  3. Wuest, J. (1998). Setting boundaries: A strategy for precarious ordering of women’s caring demands. Research in nursing & health21(1), 39-49.
  4. Kar-Purkayastha, I. (2010). An epidemic of loneliness. The Lancet376(9758), 2114-2115.
  5. Wright, R. Coping with Loneliness.
What Can I Do About Seasonal Affective Disorder?

What Can I Do About Seasonal Affective Disorder?

Winter is coming, and so too are shorter days and longer periods of darkness. For a sizable percentage of people (~3% of the Canadian population1), this change to our environment can bring about a seasonal form of depression called Seasonal Affective Disorder, SAD. Those who experience SAD experience an onset of clinical depression in the fall season, which spontaneously improves in the summer, a cycle that usually repeats for at least two calendar years in succession. Interestingly, the symptoms of SAD are not typical of non-seasonal depression.2 Depressed mood, loss of interest in activities, and withdrawal from social interaction is common to both, but where typical depression usually includes insomnia, anxiety and reduced food intake, SAD is characterized by hypersomnia, carbohydrate craving and increased body weight. The symptoms look superficially like seasonal rhythms in animals as they prepare to hibernate.

 

In fact, many of the same biological mechanisms which prompt the onset of hibernation in animals like bears are similar to the processes which give rise to SAD in humans. This is because most organisms have internal body clocks which track daily and annual cycles in the external world. Our body clocks, for example, are capable of tracking how long the sun is present each day. While we don’t yet fully understand why this process affects mood, we know that SAD is associated with day length because data from different American states reveal that the incidence of SAD are higher in more northern states.3 This is also true of the ‘winter blues’, or sub-clinical SAD. We also know that the issue is in terms of day length and not the amount of sunshine a location gets because Calgary (~51° N) has much more winter sunshine than Vancouver (~49° N) but similar daylengths and population rates of SAD. This is particularly important information for us Canadians who live north of the 49th parallel. We may get plenty of sun, but we still experience shorter days.

 

So, as we get less daytime during these seasons, is it possible to trick our body clocks into thinking the days are longer?

 

Remarkably, one of the most effective remedies for SAD is bright light treatment. Introducing bright light in the Fall and Winter can prevent or reverse SAD, with roughly 2/3rd of SAD patients responding to the treatment4. The research indicates that it is as effective an antidepressant as any pharmaceutical used to treat SAD and when used correctly is accompanied by relatively few possible side effects. Importantly, however, bright light therapy may trigger mania in individuals with bipolar disorder5, so please consult with your doctor before considering the treatment. The minimum effective dose is approximately 2500 lux, which is about the intensity of sunrise outdoors.6 Bright light treatments, however, will often exceed 10,000 lux. Indoor, room lighting typically emits 500 lux and is thus an ineffective treatment. Those susceptible to SAD can purchase bright light-emitting visors or, alternatively, there are bright light lamps which allow one to sit or work in an environment containing ambient day-time levels of light. These devices can also be used strategically to ease certain sleep disorders and help realign one’s body clocks during jet lag.7

 

Because many of the symptoms of Major Depression and SAD are shared and the two disorders are often comorbid, traditional psychotherapy is also a highly effective treatment for seasonal depression.2 Research using group-based cognitive-behavioural therapy (CBT), for example, has demonstrated antidepressant effects which nearly mimic 30 minutes of 10,000 lux bright light treatment.8 Health professionals who utilize CBT teach skills to those suffering from various forms of depression which help to change their perceptions of the world.9 Cultivating emotional regulation, developing personal coping strategies, and learning to disrupt patterns of negative thoughts and actions are key constructs of CBT. Bright light treatment and psychotherapies like CBT may be used alongside one another, as well as in conjunction with other therapies like medication or mindfulness practices. Research also suggests that people whose depressive symptoms look more like the ‘winter blues’ than seasonal depression should improve their diets by limiting starches and sugars, exercise frequently, manage stress (especially around the holidays), increase social contact and connection, and spend more time outdoors.10

 

Finally, vitamin D, an essential building block for our bones and muscles, is in short supply in the Canadian Fall and Winter months. A deficiency of vitamin D has been associated with depressive symptoms and some research suggests that taking vitamin D before winter darkness sets in may help prevent symptoms of SAD.11 During the winter months, those living roughly 33 degrees north or 30 degrees south of the equator synthesize very little, if any, vitamin D.12 People beyond these latitudes rely primarily on eating fish and egg yolk or taking nutritional supplements to get the vitamin D needed.13 It is important that most of us, and perhaps especially people experiencing SAD, ensure that we have sufficient levels of vitamin D during these darker months. Thankfully, the Canadian government acknowledges this problem and mandatorily requires that products like cow’s milk, margarine, and calcium-fortified beverages have vitamin D added to them.14 Planning a mid-winter vacation may be valuable for its increased light exposure and onset of vitamin D synthesis, and who doesn’t like taking a vacation as a form of treatment?15

 

Thankfully, there are multiple options for Seasonal Affective Disorder which allow for more personalized treatment plans. If you’re feeling blue this Fall and Winter, Alongside You offers an abundance of counselling and well-being services that can help you if you identify with any of the discussion above regarding SAD.

 

If we can be of help to you, please don’t hesitate to ask. This is why Alongside You exists – because we believe that everyone is worth it. Feel free to contact us to see how we can help!

 

Adam Manz

Adam Manz recently graduated from Simon Fraser University with a Bachelor of Arts majoring in Psychology. He is currently pursuing a master’s degree in clinical psychology while maintaining a love for meditation, podcasts, and hiking. Adam is volunteering with us here at Alongside You and we’re glad to have him on board!

 

References

1Body and Health Canada. (2019). Seasonal affective disorder. Retrieved from https://bodyandhealth.canada.com/healthfeature/gethealthfeature/seasonal-affective-disorder.

7Burgess, H. J., Crowley, S. J., Gazda, C. J., Fogg, L. F., & Eastman, C. I. (2003). Preflight adjustment to eastward travel: 3 days of advancing sleep with and without morning bright light. Journal of Biological Rhythms18(4), 318–328. doi: 10.1177/0748730403253585

9Canadian Mental Health Association. (2013). Seasonal affective disorder. Retrieved from https://cmha.bc.ca/documents/seasonal-affective-disorder-2/.

5Chan, P. K., Lam, R. W., Perry, K. F. (1994). Mania precipitated by light therapy for patients with SAD (letter). Journal of Clinical Psychiatry 55:454

4Golden, R. N., Gaynes, B. N., Ekstrom, R. D., Hamer, R. M., Jacobsen, F. M., Suppes, T., … Nemeroff, C. B. (2005). The efficacy of light therapy in the treatment of mood disorders: A review and meta-analysis of the evidence. American Journal of Psychiatry162(4), 656–662. doi: 10.1176/appi.ajp.162.4.656

13Health Link BC. (2019). Food sources of calcium and vitamin D. Retrieved from https://www.healthlinkbc.ca/healthlinkbc-files/sources-calcium-vitamin-d.

3Horowitz, S. (2008). Shedding light on seasonal affective disorder. Alternative and Complementary Therapies14(6), 282–287. doi: 10.1089/act.2008.14608

14Janz, T., & Pearson, C. (2015). Health at a glance: Vitamin D blood levels of Canadians. Retrieved from https://www150.statcan.gc.ca/n1/pub/82-624-x/2013001/article/11727-eng.htm#n2.

11Kerr, D. C., Zava, D. T., Piper, W. T., Saturn, S. R., Frei, B., & Gombart, A. F. (2015). Associations between vitamin D levels and depressive symptoms in healthy young adult women. Psychiatry Research227(1), 46–51. doi: 10.1016/j.psychres.2015.02.016

10National Health Services. (2018). Treatment of seasonal affective disorder (SAD). Retrieved from https://www.nhs.uk/conditions/seasonal-affective-disorder-sad/treatment/.

8Rohan, K. J., Mahon, J. N., Evans, M., Ho, S.-Y., Meyerhoff, J., Postolache, T. T., & Vacek, P. M. (2015). Randomized trial of cognitive-behavioral therapy versus light therapy for seasonal affective disorder: Acute outcomes. American Journal of Psychiatry172(9), 862–869. doi: 10.1176/appi.ajp.2015.14101293

12Stewart, A. E., Roecklein, K. A., Tanner, S., & Kimlin, M. G. (2014). Possible contributions of skin pigmentation and vitamin D in a polyfactorial model of seasonal affective disorder. Medical Hypotheses83(5), 517–525. doi: 10.1016/j.mehy.2014.09.010

6Tam, E. M., Lam, R. W., & Levitt, A. J. (1995). Treatment of seasonal affective disorder: A review. The Canadian Journal of Psychiatry40(8), 457–466. doi:10.1177/070674379504000806

15Targum, S. D., & Rosenthal, N. (2008). Seasonal affective disorder. Psychiatry (Edgmont)5(5), 31–33.

2The National Institute of Mental Health. (2016). Seasonal Affective Disorder. Retrieved from https://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml.

How can I Support my Child with Anxiety?

How can I Support my Child with Anxiety?

It can be difficult for a parent to watch their child struggle with big worries. As parents, we want to be able to fix our child’s problems – preferably this would happen quickly and easily. If we can’t fix what concerns them (which we often cannot), we are left to support the child through their anxiety. This may sound simplistic, but I assure you, it’s not. Parental support is vitally significant for the child, and often, empowering for the parent. As the saying goes — a good parent prepares the child for the path, not the path for the child. Approached with gentleness and kindness, encouraging support can be a great gift to their developing identity and self-confidence.

 

Practical Ways Parents Can Support Their Anxious Child’s Wellbeing

 

Children require consistent, predictable routines in order to flourish1. These don’t have to be rigid or excessive, but a general structure for the course of a day allows a child to predict what comes next, and to prepare for it. For example, create a rhythm to the bedtime routine that becomes so predictable and soothing that it lulls the child to sleep (figuratively speaking). When a child knows what time they go to bed, and the events that lead up to it, they can begin to gear down and relax, knowing that the adult in charge will be helping this process the same way every night. Avoid screen time two hours prior to bedtime as the emitted blue light inhibits the release of melatonin (the hormone responsible for sleep cycles and circadian rhythm).2 Instead, read books together, discuss a moment of gratitude, ask questions about their day, or speak words of affirmation to your child.

During daytime hours, a child’s pace of life should be slow and sustainable. Children need plenty of time for play and quiet exploration.3 Children who are expected to run at a pace that is beyond their capacity may experience an increase in anxiety. As an adult, you may have a clear perspective on what is manageable for your child. They may be excited to join five different sports teams this fall, but you are the one with the foresight to understand that, within a short time, this may lead to them feeling overwhelmed. This, of course, evolves as children get older, and every child is truly unique in what they can tolerate – much like their adults!

Lastly, create space in your day (or week) to connect with your child. Follow your child’s innate interests and spend one-on-one time enjoying what they do.

Some ideas to get you started:

    • If they’re interested in food, bake cookies
    • If they love sports, kick a soccer ball around, just for fun
    • If they enjoy physical activity, go on a bike ride or for a walk
    • If they’re into music, listen to a new song they’re excited about and show them what you know on the guitar or piano
    • If they’re interested in mechanics, have them help you change the oil, or open the hood of the car to look around together

Intentional investment of time spent with your child will pay dividends when it comes to their behaviour, but more importantly, to their sense of belonging and connection. The attachment that is formed from these positive connections bolster a child’s confidence to face the world, and increases resilience to stress.4,5,6

 

Ways Parents Can Emotionally Support Their Anxious Child’s Wellbeing

 

Emotional support is an extension of practical support. A parent may become overwhelmed by their own feelings (of guilt, or frustration, or panic) when they see their child in the throes of anxiety. It may be important to take a moment to check in with yourself before running to the aide of your child. First, accept that your child is feeling anxious, and notice your own feelings about this. Give yourself some time to regulate your own emotions. When you feel ready, approach your child to validate their feelings, and to name what you see happening for them. For example, “I see that your fists are clenched and your eyes are wide. These must be big worries for you.” Sit with them as they feel the weight of their worry without trying to rush them, or brush it off. Once the child has walked through the experience of their big feelings of worry, re-direct them to calming activities.

Some ideas to get you started:

    • run a warm bath
    • go for a walk together
    • somatic breathing exercises
    • progressive muscle relaxation

Lastly, show your child that you, their hero, can make mistakes, do hard things, go on to survive the experience, and thrive. It can be very helpful to practice self-compassion in a way that is visible to the child.7 For example, if you find yourself running late at the school drop-off, model taking a few deep breaths, smile, and acknowledge, “Wow, we sure are running late today! I can’t get it right every day though, and that’s okay! Today we might be late, but maybe tomorrow will be different.”

It can be soothing for a child to observe their parents set boundaries that guard their own time and self-care in fact, it reinforces that it is acceptable for the child to do the same.

If you or your child would like to come in to discuss their big worries, or yours, please contact us and we would be happy to help! I’d love to work with you while I complete my internship. We also have a whole roster of Registered Clinical Counsellors available to work with you as well.

 

References

 

  1. Spagnola, M., & Fiese, B. H. (2007). Family Routines and Rituals: A Context for Development in the Lives of Young Children. Infants & Young Children, 20(4), 284–299. org/10.1097/01.IYC.0000290352.32170.5a
  2. Fletcher, F. E., Conduit, R., Foster-Owens, M. D., Rinehart, N. J., Rajaratnam, S. M. W., & Cornish, K. M. (2018). The Association Between Anxiety Symptoms and Sleep in School-Aged Children: A Combined Insight From the Children’s Sleep Habits Questionnaire and Actigraphy. Behavioral Sleep Medicine, 16(2), 169–184. https://doi.org/10.1080/15402002.2016.1180522
  3. Mrnjaus, C. (2013). The Child’s Right to Play?! Croatian Journal of Education, 16(1), 217-233.
  4. Neufeld, G., & Maté, G. (2004). Hold on to your kids: Why parents matter.
  5. Priest, J. B. (2013a). Anxiety disorders and the quality of relationships with friends, relatives, and romantic partners: Anxiety disorders and relationship quality. Journal of Clinical Psychology, 69(1), 78–88. https://doi.org/10.1002/jclp.21925
  6. Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. New York, NY: Basic Books
  7. Neff, K. (2013). Self compassion. London: Hodder & Stoughton.
What Is Seasonal Affective Disorder?

What Is Seasonal Affective Disorder?

“I love that it gets dark at 3 pm, that it’s pouring rain constantly, and that I haven’t seen the sun in 4 months!” said no one ever. Although some people may prefer the cold winter weather, there are a lot of us who are counting down the hours until patio season starts up again (okay, maybe that’s just me). So, until then, we are binge-watching TV, sleeping in, indulging in comfort foods, and pretty much avoiding the outdoors unless we absolutely have to go outside. The different seasons and the weather impact what we do and how we feel, which is why many of us prefer indoor activities during this time of year and for the next few months to come. However, on a rare day that the sunlight does shine through or when summer finally rolls around, we are quick to get outside and enjoy the sun. We may notice that our mood improves when the sun comes out and it can be a bit easier to get things done. Other times, we notice that when it’s dark and rainy, it’s a little harder to get out of bed, be alert, or even feel happy.

If you’re relating to this post right now, you’re not alone! Approximately, 17% of Canadians are also feeling pretty low during the winter months (CMHA, 2013). You can thank Seasonal Affective Disorder (SAD) for these mood changes, which is a form of depression that occurs at certain times of the year, specifically between September/October and April/May. It affects anyone and everyone but is more common amongst women, individuals between 15-55, people who live further up north or farther down south away from the equator, or individuals with a family history of SAD or other types of depression (HealthLinkBC, 2017).

 

How Do I Know If Seasonal Affective Disorder is affecting me?

 
You may be experiencing Seasonal Affective Disorder if you identify with these statements:

  • I feel sad, moody, or anxious
  • I feel tired or slowed down all the time
  • I’ve lost of interest in work, friends, or interests
  • I’m gaining weight
  • I’m craving carbohydrates such as “comfort foods” like bread or pasta
  • I’m having trouble concentrating
  • I’ve been experiencing changes in my sleep, such as sleeping too much or not enough

(CMHA, 2013; HealthLinkBC, 2017)

 

Why Do We Struggle With SAD?

 
But why is SAD even an issue to begin with? It is thought that the lack of sunlight creates a change in the chemicals in our brain, specifically serotonin, which is responsible for regulating our mood. Additionally, because it is darker, it can signal to our brain that it’s time to sleep which can cause an increase of melatonin in our brain, which is responsible for regulating our sleep/wake rhythm. The truth is that we’re not completely sure why it happens, just that it does, and to many people in our community.

 

What Can I Do About SAD?

 
It’s great to identify if we have SAD. One of the main ways to help yourself if you’re struggling with SAD is to increase your exposure to the right wavelength of light. This can include:

  • Spending more time outside during daylight hours
  • Opening the curtains or blinds during the day
  • Rearranging the space that you are in to allow more sunlight to enter
  • Arranging office/household furniture so you can sit close to a window
  • Adding lamps into your space
  • Using a SAD Lamp

(CMHA, 2013)

Counselling can help with the symptoms of Seasonal Affective Disorder by giving us a better understanding of how SAD affects us as individuals and helping us to cope with the effects that come about during this time of year. It can also be useful in helping us to look at our thoughts, feelings, and behaviours and how they influence our mood and can aid us in creating strategies for making changes in these areas. In addition to this, being able to talk to someone who is able to empathize and listen to us can be very beneficial.

If you’re struggling with Seasonal Affective Disorder, you’re not alone and you don’t have to go it alone. Seeing a Registered Clinical Counsellor or one of us counselling interns can be a great help!

If you’re not sure if what you’re struggling with is Seasonal Affective Disorder (SAD), please go to your family doctor who can help you determine if this is what you’re dealing with, and can refer you to a specialist if needed.

In the meantime, we’re here and we’d love to support you until the sun comes back! Feel free to contact us!

 

References:


Find Help Now. (2013). Retrieved from https://cmha.bc.ca/documents/seasonal-affective-disorder-2

Seasonal Affective Disorder (SAD). (2017, May). Retrieved from https://www.healthlinkbc.ca/health-topics/hw169553

How Can I Improve My Social Anxiety?

How Can I Improve My Social Anxiety?

In my previous blog post, I talked a bit about what social anxiety is and the many strengths that people prone to social anxiety often show. I recommend reading that post first, but as a little re-cap, people who develop social anxiety are often highly compassionate, conscientious and creative. They tend to feel deeply which can either lead to anxiety or an ability to creatively explore their world with curiosity. What often stands in the way of the ability to creatively explore their world is an intense fear that they are not good enough. If you’re struggling with social anxiety, I’d like to offer some strategies to move past that fear while maintaining your many strengths!

 

How to Hold on to the Good Traits of Social Anxiety and Work Towards Growth

 

Get out of your own head and turn your attention outward

When we feel socially anxious, we tend to turn inward and start monitoring ourselves. Thoughts like “why did I just say that,” or “what if I just offended her,” circle around and around in our heads and take up all of our mental energy so we often then freeze and can’t think of anything to say.

 

When you notice this happening, turn your attention outward. Focus on who you’re talking to and listen closely to what they’re saying. This takes our focus away from what we think we’ve done wrong and frees up our mental capacity to be able to engage in the conversation with natural curiosity. Studies show that doing this dramatically increases a person’s likability, and also combats our fears.

 

Expose yourself to social situations and allow confidence to catch up with you

Don’t wait until you feel ready to give that toast or attend that party! Usually, when we start doing something, our mood follows – you’re more adaptable than you think. If it doesn’t go well the first time, keep practicing. If you persevere, the skill and confidence will catch up with you.

 

This allows you to refute the two lies your anxiety is telling you:

  1. The worst-case scenario will definitely happen
  2. You can’t handle what life throws at you

When we face social fears, we learn that we can live through it and it’s never as bad as we think.

 

tip: sign up for an introductory improv class. In improv, there is no script and you’re put in a situation where you’re forced to make mistakes in front of others. Sounds terrifying right? I thought so too so I tried it at the height of my social anxiety and it ended up being surprisingly safe. At first, it was embarrassing but then I realized everyone was being embarrassed too. Improv helps us to develop the skills to navigate unstructured social situations that cause anxiety in the real world.

 

If you drink at a social engagement, do it because you want to, not because you have to

A lot of people drink to make themselves feel more confident in social engagements; after all, it is called “liquid courage.” The problem is that if you do have a good time while drinking, the tendency is to give the alcohol the credit, not you. In reality, that person who was having a good time navigating an otherwise anxiety-provoking situation was you without inhibition. You have that confidence within yourself and you can access it with practice; in facing your fears, you don’t need the alcohol.

 

Dare to Be Average (Dr. David Burns)

A lot of anxiety comes from our belief that we need to be perfect in social situations. We believe that if we stumble over our words or pause in a conversation, people will see our flaws and reject us. There’s a whole list of “musts” that come with that belief:

“I must be entertaining”

“I must sound smart”

“I must carry the conversation for both of us”

Everyone pauses in conversations, loses their train of thought and says something awkward from time to time; it makes us human and it’s endearing. Dr. David Burns encourages us to “dare to be average.” He reminds us that people are attracted to people who own their averageness because most of us are average. It’s relatable, it’s honest and it’s human. As Dr. Kristin Neff says, “we’re all on this long, awkward journey together.” If you’ve experienced an embarrassing moment, a million other people have had that same embarrassing moment – you’re not alone.

 

Create a structure for yourself in social engagements

Simon Thompson and Ronald M. Rapee (2002) found that in structured social interactions, people with social anxiety showed a much higher level of social skill than in unstructured social engagements. Dealing with the unpredictable creates anxiety for many people so next time you’re in an anxiety-provoking social setting, create a structure for yourself. Dr. Hendricks suggests giving yourself little missions at parties such as taking to 3 people you don’t know and finding out as much as you can about them. This creates some predictability and some direction in the social interaction.

 

Dr. Hendrickson’s Tips for Making New friendships

a) Repetition – Show up!

It takes an average of 6 hangouts for someone to consider a person a friend. Many people with social anxiety become discouraged when they work up the courage to go to a social engagement and don’t come away with a new friend. But in reality, this almost never happens for anyone. The way to make new friends is to keep showing up and to see the same people over and over again. Some options might be joining a fitness class with consistent members, dropping the kids off at school and saying hello to the same parents each day or going to a café at the same time each day.

b) Self-disclosure

Many people with social anxiety have trouble talking about themselves for a variety of reasons that may feel really valid after past hurts. Dr. Hendrickson urges us to push through and to gradually share a bit about what you think, feel and do with a person you want to be friends with. Friendships are reciprocal, so gradually the other person will begin to share about themselves as well. People are generally interested in what the world looks like from another’s point of view.

c) Just be kind

Many people think they need to appear confident and competent in order to make friends. In reality, people are drawn to warmth, kindness and trustworthiness. You don’t have to appear confident, just be nice and curious.

 

Practice self-compassion

Shame feeds social anxiety, but if you can think about yourself in the same way you’d think about another person you care about, it will help you to forgive yourself when you make a social blunder that feels so painful and isolating. Dr. Kristin Neff has an amazing website full of free exercises to help build self-compassion. My favourite is the self-compassion break which is a guided mindfulness exercise that takes only 5 minutes.

Find the exercises here: https://self-compassion.org/category/exercises/#exercises

 

Counselling

Social anxiety can be completely unbearable and painful and so it can be hard to take any of the above steps on your own. A counsellor can help work with you, at a pace that feels safe for you, to remove the blocks of shame and fear that are inhibiting you from living the life you want to live. If you’re struggling, please don’t hesitate to reach out to a counsellor who can help you with this. You’re too important to deprive the world of getting to know you!

 

 

Sources

Burns, D. D. (2008). Feeling Good: The New Mood Therapy. Harper: New York.

Hendrickson, E. (2018). How to Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety. St. Martin’s Press: New York.

Moscovitch, D. A. (2009). What Is the Core Fear in Social Phobia? A New Model to Facilitate Individualized Case Conceptualization and Treatment. Cognitive and Behavioural Practice, 16, 123-124. Available from https://uwaterloo.ca/psychology/sites/ca.psychology/files/uploads/files/moscovitch_2009.pdf

Neff, K. (2018). Self Compassion. https://self-compassion.org/

Richards, T. A. (2018). What is social anxiety? Social Anxiety Institute. Retrieved from https://socialanxietyinstitute.org/what-is-social-anxiety

Thompson, S., & Rapee, R. M. (2002). The effect of situational structure on the social performance of socially anxious and non-anxious participants. Journal of Behaviour Therapy and Experimental Psychiatry, 33(2), 91-102. DOI: 10.1016/S0005-7916(02)00021-6 ·