Monday, February 13, 2017

10 Life Hacks for Coping with Anxiety and Depression - Part 1

10 Life Hacks for Coping with Anxiety and Depression

Young, T. (2017). Mental Health BC.

Introduction

Most human beings will go through periods of our lives in which we experience feelings of anxiety from stress in our lives. Most people will not be officially diagnosed with an anxiety disorder, but if we do feel anxious, that impacts our functioning in a variety of ways.

Experiencing feelings of depression can also a be a normal part of the human condition. Most of us will experience things in our lives which will leave us feeling sad, upset, and down. Sometimes we might feel so depressed that we have a difficult time recovering from this state of mind and emotion that depression becomes a clinical issue for us as it leads to more serious problems of functioning.

Rarely will anxiety and depression just spontaneously stop. At times, our symptoms and the impacts they are having on our global functioning can get worse. Fortunately, there are strategies, or what we can call "life hacks" that can actually can make a real difference in helping us cope and recover from our anxiety and depression.

Your Tool Kit

In my clinical work as a counsellor working with clients, I find it helpful to use the analogy of a tool kit to describe the different types of coping strategies and tools we have to help us manage our feelings of anxiety and depression. These can also be referred to as our "life hacks." Many of these are no cost, or low cost interventions. Some life hacks may cost more, but their effectiveness in helping us shift out of ways of being that aren't helpful to us, or which create barriers to better functioning, are worth every penny.

10 Life Hacks for Coping with Anxiety and Depression

1. Sleep 

The single most important intervention that assists people with anxiety and depression is improving the quality of our sleep. Most of us know we do not function at our best when we experience disrupted sleep patterns. In fact, this is so important, this is one of the first questions I ask clients when I am conducting an intake assessment, and ongoing assessments with them. Here are some of the questions I ask:
  • What is the quality of your sleep like? 
  • How many hours of sleep do you typically get? 
  • Has this changed recently? 
  • Do you have any ideas why your sleep pattern might have changed recently? 
  • What impact do you think the change to your sleep has had on you? 
The answers I receive to these important questions tell me a lot about how my client is functioning. Depending on the person's answer, this will lead to other questions about their sleep patterns, such as bed time routines, activities leading up to bedtime, whether the person takes naps, and many other questions.

What I am getting at when I am assessing sleep quality is often related to what is called "sleep hygiene." This is a bit of a fancy way of finding out what kinds of routines and strategies the person is using to prepare for sleep, because with some changes, improvements can be made that contribute to decreases in anxiety and depressive symptoms.

Sleep is also impacted when people experience insomnia. Some of us have a pattern in which we either can't go to sleep, or we wake up, and we're ruminating, or thinking about things too much when we want to be sleeping. Some of the other life hacks on this list can help with this too.

2. Exercise

One thing I have come to understand about exercise is that it is not one-size-fits-all. Functional capacity, interest and commitment to exercise is a very individualized thing.  But, it is at the top of the list as a tool to fight anxiety and depression, because it has so many spin off benefits.

Exercise helps get oxygen moving in our blood. It boosts the chemicals in our brain that are related to anxiety and mood. The right kind of cardio exercise (or sometimes even just any exercise) boosts our endorphins and serotonin levels, which are key hormones and chemicals that improve our mood.

Exercise also plays a key role in supporting our overall health, helping us sleep better, gets our physical body and important organs functioning, rather than just remaining sluggish, or stagnant.

Because depression can demotivate us from engaging in many activities, including exercise, I talk with my clients about taking baby steps. If a client saying they haven't been feeling motivated, and/or comfortable leaving their house, I ask them, or assign them homework, to start off small. Walk one block and back to your home. If you can do that, each day of that week, try to go a little bit further, or, if it is a real struggle, just keep trying to walk that one block until you can build it up.

I will ask clients to also keep a log of the exercise they get each day. Some apps for our smartphones, or things like fitness trackers can also keep track of our walking, and other data. I find those things can be really helpful, as once people start using them it can add to their motivation to track their exercise and help create an external motivator for them.

Some people find participating in yoga an effective and gentle way of getting their body moving. People might be able to find low cost yoga sessions available at a local community centre. The local library might have some yoga DVD's that can be rented for use at home. A search for "yoga videos" on Youtube will also yield a lot of different resources for every level, from beginners to more advanced yoga enthusiasts.

For people with mobility changes, exercise can be more of a challenge. This is where support from medical and community professionals who specialize in your specific physical and health conditions, can provide input into individualized exercise interventions.

3. Relaxation techniques

Almost every one has some sorts of techniques, or activities they engage in which they find relaxing. This is a very individual thing.

I know many people, including myself, who find spending time in nature very relaxing. This could include taking a walk,going for a hike, visiting local lakes, or spending time at a beach. This is one of my favourite, low, or no cost, life hacks. If you have a local park nearby, or can take transit somewhere this accomplishes several different hacks: getting out of the house, getting some exercise, and if you do it with others, this adds to your social support.

Some of us find gardening very helpful as an anxiety and depression buster. If you don't have any space to garden where you live, maybe your community has some community gardening opportunities. Some people can put their name on a list and then can be selected to receive a garden plot they can use.

One thing I recommend to clients is to reflect on and consider activities they have found relaxing in the past, and whether this is something they can see themselves getting involved in again.

There are also some relaxation techniques that people can engage in.

Listening to music that people find calming. 

This is a really individualized thing. Some of us like calming, quiet music, with, or without words. I have also known people who find listening to different types of heavy metal to be calming. None of us in a position to judge what works for another person.

Youtube provides people with endless sources of different types of music, and channels, that specialize in music for relaxation. I don't have any particular favourites to offer. Just type in 'relaxation music' into their search engine. With some trial and error, you will find something that works for you.

Guided Relaxation techniques

There are also various techniques, or guided relaxation resources, which can also support people. These vary from engaging in a guided practice of progressive muscle relaxation which includes tensing and releasing each muscle group, to mindfully focusing on the body and sensations in the body. We will get to the latter in the next life hack. These techniques vary greatly in terms of the length of time involved.

Here is a nice guided progressive muscle relaxation video to try out.


4. Mindfulness and Other Types of Meditation 

Almost every person I have ever worked with, or talked to about meditation has told me something like, "I tried it, but it didn't work for me..." Most of the time I'm not going to argue, or challenge the person about their perception. People just tend to dig their heels in and their resistance grows if you do try to help them shift from that perspective.

However, there is a large and growing body of research and evidence that mindfulness, and other types of meditation practices, provide individuals with many different biopsychosocial benefits.

The reason that mindfulness-based techniques have become some of the most common strategies and interventions that are used with individuals who experience symptoms of anxiety and depression is that THEY WORK REALLY WELL!

There are different definitions of mindfulness. The ones I like best include:
  • the quality or state of being mindful.
  • the practice of maintaining a nonjudgmental state of heightened or complete awareness of one's thoughts, emotions, or experiences on a moment-to-moment basis; also :  such a state of awareness.
  • a state of active, open attention on the present. When you're mindful, you observe your thoughts and feelings from a distance, without judging them good or bad. Instead of letting your life pass you by, mindfulness means living in the moment and awakening to experience.
The reason these techniques work is that they create a defined time and space for the individual to focus on their internal experience of their feelings, emotions, thoughts, and how these impact us in the moment, and specific situations.

As we continue our meditation practice(s), it becomes easier for us to identify the sources of our anxiety, and/or depressive symptoms. We can then begin to learn to become more detached by becoming observers and witnesses of these internal feeling and thinking states. This also helps us step out of our typical learned response, and start to re-wire our bodies and our brain, and add new strategies to our tool kit that we can pull out when we need them.

When we have someone else tell us about some sort of situation that evokes feelings and anxiety, or depression, even when we are really empathetic, supportive, and caring about that person and how they feel, we also have a level of detachment from their narratives, because their lived experience is not ours. It doesn't internally evoke the same types of feelings and thoughts for us that it does for them.

Here is an example of how this works.

I might be a person who feels anxious when confronted by a particular situation. Because I know I have felt so much anxiety about this situation in the past, I start to over-generalize and catastrophize. I train my brain and body to anticipate that I will feel anxiety if I go into that situation. I also anticipate that I will feel overwhelmed and unable to cope with this situation. Most often, when we're not cognitively aware (not mindful) of the level of distress we experience, we will just start to avoid the people, places, situations, and things that trigger our feelings, thoughts, and symptoms of anxiety.

To help me shift this, I need to set aside some time and find a physical space where I can minimize distractions. I begin by doing some deep breathing, centering and grounding myself in the present moment. As I start to do this, my brain will bring all sorts of thoughts and body sensations into my awareness which distract me. Instead of shutting them out, or getting annoyed about this, I can just gently acknowledge the thought, or sensation, and then release it.

Once I feel more grounded, I can then start to think about the anxiety-provoking situation and what has happened in the past when I was confronted by that situation. I will no doubt start to experience and feel the feelings and thoughts in the present moment. That is okay and to be expected. I just need to keep bringing myself back to the present by breathing very deeply. Concentrate on what the physical breath feels like as I breathe in and out.

One thing I find that helps to step outside of the impacted person into the observer, or witness role, is consider what it might look like from an outside perspective (outside of myself), and describe this in third person terms. For instance, I might say to myself, "wow, when Tracey was even just starting to think about that situation, she was starting to feel her heart pounding. As she continued thinking about it, she was feeling more and more stress and tension in her body. These sensations were getting worse as she was getting closer to being in that situation."

This is a more cognitive-mindful approach. I can also be curious about my feelings and thoughts. I  might ask myself, I wonder why Tracey feels so anxious about that situation? What are all of the different feelings and thoughts Tracey has in these kinds of situations? I might want to explore what each feeling feels like and why I might have that feeling triggered by the situation. I might be curious how Tracey has coped with those feelings and thoughts in the past? I might ask what Tracey found helpful and what worked to help her detach from those feelings and thoughts in the past?

As we get used to detaching, exploring, and starting to understand our feelings and thoughts, we will find it easier to begin to do this with the different types

Other types of meditation practices include the following:

Buddhist and/or Zen meditation - These tend to focus on core concepts and spiritual beliefs related to Buddhism. This includes mindfulness and other techniques, such a lessons and teaching on specific topics.

Hindu and/or Vedic meditation techniques - These often combine the use of specific mantras, words, or phrases that are repeated to create a spiritual connection within oneself, and with a particular god, or goddess. Chakra meditation is a form of this type of mediation in which people focus on particular energy centres, or chakras, that may be blocked and causing problems in certain areas of ones' life.

Sound meditation and healing techniques - Different types of sounds are used by enthusiasts of this form of meditation. It is often paired with breathing and mindful presence. Some may use music with certain levels of frequencies of tones that claim to help with focus, and healing. Some may use techniques such as sound healing with the use of certain musical instruments, such as bowls,

Here is a nice, short mindfulness meditation to test out the techniques involved.


Here is an article that provides 5 Meditation Tips for Beginners who are just getting started. 
Boyes, A. (2013). 5 Meditation Tips for Begginers. Psychology Today. Retrieved from: https://www.psychologytoday.com/blog/in-practice/201303/5-meditation-tips-beginners.

5. Spending time talking with and being with people

The tendency to socially isolate ourselves when we are experiencing heightened symptoms of anxiety and depression is pretty common. Our reasons for doing this vary, and can include:

  • We want to keep our personal struggles to ourselves and consider them private. 
  • We could come from a culture that sees mental health struggles as very stigmatizing, for the individual, or the family.  
  • We might feel shame for not being able to cope better. Our socialization in our families may have instilled shame about mental health issues. We might have even experienced others trying to shame us into "getting better." 
  • We might feel like if we share our struggles this will be a burden to others. 
  • We feel negative, and even hopeless, about our situation, and wonder whether things will ever improve. Things seem bleak and we don't want others to really know how bad we are feeling. 
  • We don't want to be seen as a "Negative Nellie," or "Downer Doug" to others. 
  • We might even observe that when we try yo talk to others they aren't really supportive, empathetic, and/or we become aware that they aren't sure how to be helpful, or supportive of us. As a result, we might to start to feel like others are avoiding us, which reinforces our feelings and reasons for socially isolating ourselves. 

Even if we come come up with a long list of reasons to avoid spending time with people, and prefer to socially isolate ourselves, this is one of the most important life hacks we might even have to force ourselves to do.

There is no doubt we may not be at our best during these times of struggle, but spending time with others can provide a very important distraction from our anxious and depressing thoughts and feelings. Think of it as a mini-vacation from your struggles. Give yourself permission to take a break for a couple of hours. Even tell yourself, "Hey, anxiety, I'm going to go to a movie with my friends for a couple of hours today. I will be back later."

We will most likely have to kind of "fake it" a bit (or a lot) that we are the person we used to be, or a person who genuinely cares about what is happening with the people we engage with, or that we want to be where we are. When things are really bad, we often just don't have the emotional energy to support, or care about others, as much as we normally might. However, we have to find a way to step outside of that. Doing so, even for brief periods of time, is helpful.

Some of us are very fortunate to have people in our lives who offer, unconditional positive acceptance, regard, and love. It doesn't matter what we share with them, they will stand by and support us without fail. They are our rocks. They are the first people we think of calling, or do call, when we encounter difficulties, or just need a supportive voice, or a virtual, or real hug.

We do have to be mindful (yes, that word again), to not get caught up in just focusing entirely on ourselves, and our struggles. When we are struggling with anxiety and depressing, our feelings and thoughts can take on an epic, all-encompassing life of their own. When we pair this with the kind of self-centred focus that often happens when we are in this stuck place, this can prevent us from being there for others.

Even in the midst of our personal struggles, we need to consciously engage our support people. We need to ask and find out how they are doing and what's going on in their lives. We need to muster up whatever empathy, care, concern and support we can so that even though the balance might be off, we are still engaging in relationships that involve reciprocity, to some degree. If we do not do this, we may find ourselves burning out the people in our lives who are most supportive, loving and caring to us. Sadly, I have worked with many individuals and family members who have reached this point, and it is not a good place for anyone to be in.

Make an effort to get out to social events, celebrations, and spending time with people. Dress up and show up, even if its mostly just a physical presence for/to you. Often, you may end up having a better time, or even fun, when you started out dreading the entire social situation.

There isn't a person alive who hasn't had to "fake it" that they were interested in being at a certain social, or family function. Draw on that previous experience. You can absolutely know you are going through the motions, others might even sense that too. It doesn't matter. Instead of sitting around at home, being/feeling isolated, emotionally stuck, and maybe bored, or unstimulated, being around people and engaging socially with others, is generally better than the alternative.

In Part 2, we will continue to look at 5 more Life Hacks for Coping with Anxiety and Depression.

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