Coping with Emotional Upheaval During COVD-19

Our world and our individual psyches have been infused with uncertainty in the wake of the COVID-19 pandemic. Plans and routines are increasingly disrupted and collective anxiety – even panic - is palpable in public spaces such as grocery stores.

Feeling some anxiety makes sense right now – it’s a normal reaction to emerging news about the coronavirus. Many of us ponder the uncertainty of the virus’ impact on ourselves and loved ones in the weeks and perhaps even months to come.

Anxiety alerts us to potential threats. It activates us and helps us move toward safety. Our human nervous systems are now more alert and oriented toward survival. If this energy is channeled appropriately, it will help us be prepared. Unwelcome anxiety side effects may include a shorter fuse or feelings of paralysis.

Mindfulness Instructor Stan Merrill made an important distinction between planning and worrying. Planning offers reasonable control and opens up possibility. Worrying closes it down to the same loop of worst cases, playing over and over in our imaginations. Considering this, here are some thoughts on how to mindfully be with the anxiety of the coronavirus:

• Stick with websites that we know are giving us accurate, updated, and fact-checked information. Be mindful of overconsumption of news and social media, and how this may affect your anxiety level
• Focus on what you can control. When washing hands, mindfully breathe in and out five times
• During social distancing, stay in touch with loved ones via phone or video calls.
• If possible, spend time outside and engage in daily movement and exercise.
• Even when routines become disrupted, stick with a daily routine, including wake up times, meal times, and pursuing topics that feed your brain and heart
• Reach out to a mental health professional for support if worry, anxiety, and panic become unmanageable. Many mental health professionals may offer telehealth appointments while social isolation measures are in place.

Stay healthy and well!

Tips to Beat the Winter Blues

You are the sky...Everything else, it's just the weather. ~ Pema Chodron

Winter, with its shorter, colder and darker days, can give rise to occasional feelings of sluggishness, low mood, or Winter Blues. Below are some simple strategies you can use to help these occasional feelings.


Do:

• Try to have regular sleeping patterns. As you feel down, the urge to escape everything by just staying in bed can become stronger. Try to resist this (unless you are genuinely physically tired) as it can make things harder to deal with.
• Try to have a plan of what you need to do day-to-day and week-to-week. Make it realistic and review it regularly. Use it to check your progress. 
• Keep in contact with your friends and loved ones. Cultivate relationships that are close and supportive. If your family is supportive, try to tell them how you feel. Remember you are not alone. Consider the advice and help that others might try to give you as a positive thing in your life.
• Remember to do some of the things that you have enjoyed doing in the past. Reading, movies exercise, playing sport, spending time with friends, getting back to nature, etc. What works for you is what is most important. Sometimes just having a routine to follow can give you a sense of structure in your life.
• Practice ways to distract yourself away from negative patterns of thought. Activity and getting out of the house are good in this respect. 
• Negative thoughts can generate feelings of anxiety. Learning relaxation techniques can help a great deal. A therapist can help you to learn a variety of physical and mental relaxation techniques that will be useful for you in the future.
• Try to explore the way you are feeling. If you can recognize your emotions, talk about them with friends, and/or with a therapist. Write them down, and see how they may relate to your own thinking about yourself or to things that happen in your life. By doing so, you can avoid them controlling you. Then you can begin to get some control back in your life.
• Think of things that have helped in the past, if you've experienced the Blues before. Write these things down and remind yourself to keep using them. Allow yourself the time for them to have an effect.
• Daily exercise and a nutritious diet are important. If your appetite is low, try nutritious smoothies or juices - a liquid diet can be easier to manage if you are prone to gastrointestinal stress.

Don't:

• Don't be passive and allow your mood to take over, if you can help it. Make some plans for each day. 
• Try to avoid falling into the trap of "automatic negative thinking". Identify your negative thoughts, learn to monitor them and learn to challenge them. (i.e., look for evidence to support your negative thoughts or assumptions about yourself). Then you can begin to substitute more positive and therefore more useful patterns of thought. Try writing these things down in a notebook. A therapist can help you to develop this approach so that you can be more realistic about those things in your life that are positive. Click here to learn more about strategies for negative thoughts.
• Don't overindulge on alcohol. It’s a central nervous system depressant and it may make your blues worse.

What distinguishes occasional Winter Blues from Clinical Depression? Check these symptoms of depression or read information about depression. If you check 5 or more of these symptoms for 2 weeks or more, please talk to a mental health or medical professional.

• Frequently feeling sad and/or guilty
• Eating more or less (including significant weight loss)
• Sleeping more or less
• Loss of interest in things you usually enjoy
• Low energy, fatigue
• Irritability
• Difficulty concentrating and making decisions
• Thoughts about death and suicide

While the above signs are more common, everyone is different. The following may also indicate depression for some people:

• Increased use of alcohol and drugs
• Anger
• Difficulty envisioning a hopeful future
• Helplessness
• Increased aches, pains, or bodily ailments

Seeking appropriate mental health care for depression is important and possibly life-saving. Please contact a licensed mental health professional if you are concerned about depression in yourself or a loved one.

Winterize Your Heart for the Holidays

Pain is inevitable. Suffering is optional. - Haruki Murakami

As the cold is upon us, many of us are in the process of winterizing - taking precautions to protect our bodies with extra layers, and our animals, plants, and dwellings with extra heat. The days are getting shorter, darker, and colder, which for many also has emotional effects. For some, it may be a mild and temporary case of the "winter blues" as you adjust to the season.

For others, emotional changes may be more intense. You may feel a lot more tired, your brain may feel sluggish, and your body may feel heavy. You may wake up in the morning only to spend all day looking forward to getting back to bed as soon as possible, with not much energy or motivation to socialize or do more than the bare minimum. There may be habits like spending too much time with electronic devices, and turning to unhealthy food and drink on a more regular basis. With the festivities and chaos of the holidays upon us, this feeling and need to cocoon may get more intense, which can create an extra burden if there's a social expectation to be out, about, and celebrating.

If this sounds familiar, you might have Seasonal Affective Disorder (S.A.D.). S.A.D. is a type of depression that affects some people during the fall and winter season when days become shorter and colder. The exact causes of S.A.D. are not fully understood, but it is likely the body's reaction to outside seasonal changes - causing changes in circadian rhythm and levels of melatonin and serotonin. Women, people with a history of depression, and those who have a family history of S.A.D. and/or depression are at the greatest risk for S.A.D.

Regardless of your susceptibility to the winter blues or S.A.D., it's a good idea to winterize our hearts and souls, if anything, for preparation and prevention's sake. Don't wait until you're caught in the chaos or out of sync. Here are some things you may wish to consider to take care of yourself this season.

• Get outside. Even though the instinct may be to hunker down, just a bit of time spent in daylight can help increase energy levels and improve mood. You can layer up and try a walk, or even jog or run. Even going for a drive, getting a cup of coffee, or meeting up with a friend can help reset your mood and activity level. 
• Move your body. Again, snuggling with Netflix may sound a lot more appealing. However, exercise doesn't have to take long, and joining a friend in an outdoor movement activity can boost positive effects with activity and social support. Or join an exercise class - knowing that others are there sweating with you can boost motivation. A body in motion stays in motion. 
• Eat high quality foods. When it's cold and dark, fast, fatty, and comfort foods become more alluring. Just make sure your food includes healthy components - dark, leafy greens, fruits and veggies across the color spectrum, nuts and seeds, whole grains. Omega 3 fatty acids have been shown to boost brain power. Healthy soups and stews can be made ahead and frozen for later use. Try to avoid alcohol over-use, as it is a depressant and can lead to more sluggishness. 
• Nourish your spirit and soul. Lots of small things are at our fingertips to do so. The trick is to add soothing, positive energy and take away draining energy. Spend time with a quality friend who adds positive energy to your life. Meditation, yoga, hot baths, nice candles, aromatic oils, and a good book can provide much needed nourishment that isolation and electronics cannot give. 
• Reach out to others in need. Stepping outside of ourselves and giving back helps draw attention to the bigger picture in life and away from internal negative rumination. Check in on a friend or smile at random strangers. Buy coffee for someone, or pick up volunteering if you can.
• Practice gratitude. 
• Ask for help. If it is difficult to get out of the winter blues or you believe you may have S.A.D., help is available from physicians, psychologists, counselors, and other healers. By working with a professional, you can determine how to best manage your concerns. 

I am a Houston psychologist. For more information about my practice, visit DrGortner.com.

Help! I Have Intense Emotions!

Feelings are like children:  You don't want them driving the car, but you don't want to stuff them in the trunk either. (Quote from the movie "Thanks for Sharing")

Most of us have been conditioned by our environment that having positive emotions means success, and having negative emotions means failure.  However, both positive and negative emotions are a normal and desirable part of life.  Like children, they can be unpredictable.  Just the same, they can be brutally honest and teach us about ourselves.  Unlike rational thought, the experience of feelings is often non-linear, it can feel like a spiral or circle, or an endless loop.  This can be a challenging experience.

Some emotions can create an intense experience.  Feelings such as anger and fear can leave us with the perceived notion of feeling overwhelmed or out of control. When faced with such intense feelings, we may often feel compelled to stuff them away and supress them. We may have been taught not to listen to, show, or express our feelings.  Most of us believe we shouldn't have negative or challenging emotions or that if we allow ourselves to have them, we may lose control and something "terrible" might happen.  So when we are faced with a difficult situation in our life, we may feel upset or angry, and tell ourselves that we shouldn't be feeling this way.  Our habitual response may be to stuff those emotions in the trunk of our car.  But what happens? The stuffed away emotions start knocking, screaming, and expressing their discontent at being in the trunk.  So we try to block out the noise.  In real life, this manifests as numbing out: by staying busy and filling our lives with escapes, pursuing addictions and distractions such as overworking, substances, food, shopping, sex, getting in and out of relationships, or other impulsive behaviors.  This can give us the false illusion that the emotion has gone away.  This may work...temporarily.

What's the true "fix" for intense emotions?  Some musings and food for thought:

• There is no need for a "fix".  Emotions are merely experiences that are temporary.  Usually they can teach us some important insight about ourselves.  
• It's important to accept there is nothing wrong with having emotions: being afraid, angry, upset, surprised, disgusted, being happy, being excited.
• Try not to get caught up in what your emotions mean about other people, but rather what they mean about yourself.
• If you have a tendency to stuff your emotions in the trunk of your car, play with the notion of putting them in the back seat instead.  Check on them in the rearview mirror - acknowledge that they're there, talk to them every once in a while.  Maybe listen to what they have to say.
• Letting go of the success/failure duality of emotions opens up amazing freedom.  Emotions just "are", without being good or bad, until we tell ourselves a story about what they mean, could be, or should be.
• Don't be scared of emotions, just ride the wave.  They are temporary.

Stop Being Taken Advantage Of: Know Your Rights

By popular demand, here's a little follow up to my previous post Are You Feeling Taken Advantage Of? , which describes basic concepts and skills of assertiveness.  As described before, assertiveness means standing up for your rights and not being taken advantage of. 

Many people, especially women, have difficulty with assertiveness for fear of seeming aggressive or "bitchy", thereby worrying about displeasing others and not being liked.  But how is being assertive different from being aggressive? Aggressive behavior is typically punishing, hostile, blaming, and demanding. It can involve threats, name-calling, and even actual physical contact. It can also involve sarcasm, catty comments, gossip and "slips of the tongue."  Being aggressive means standing up for yourself in ways that violate the rights of others. On the other hand, being assertive means communicating clearly, respecting your own rights and feelings and the rights and feelings of others.

The first step to developing assertiveness is knowing your rights.  This will make it easier to stand up for them.  Often we have difficulty standing up for ourselves because we don't know if we have the right to.  Here is a list of basic rights to consider when standing up for yourself:

• The right to be treated with respect.
• The right to say no without feeling guilty.
• The right to experience your feelings.
• The right to take time to slow down and think.
• The right to change your mind.
• The right to ask for what you want/need.
• The right to ask for information.
• The right to make mistakes.
• The right to say, “I don’t know.”
• The right to be listened to and taken seriously.
• The right to set your own priorities.

If we know and can remind ourselves of these rights, we can then formulate responses to difficult and stressful situations that require assertiveness.  For more tips on assertiveness, feel free to check out again my previous post.  For more information on my private practice in Houston, feel free to check out my practice webpage.

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What to Expect in Therapy and Counseling

Psychotherapy and counseling serves many purposes.  It can provide relief from anxiety, stress and depression.  It can help you work through a personal or professional crisis and productively address conflicts in your life.  It can help you navigate numerous life transitions.  It may help uncover reasons behind recurring patterns in relationships or unproductive behaviors.  It can make it possible for you to change those things you are able to change, and can help you bear those things that can't be changed.  

The decision to enter therapy or counseling often arises from challenging circumstances.  So what is it about therapy that works?  Research has shown that the most consistent aspect of therapy that promotes healthy change is a safe and trusting therapeutic relationship.  It's therefore important that you find a therapist with whom you feel comfortable to be yourself.   Powerful insight and change often happens as a result of a positive relationship between therapist and client.  This doesn't mean that your therapist won't challenge you or at times disagree with you; however, in order for this to happen effectively, there has to be a trusting relationship first.  The therapeutic relationship can be a great model for a healthy relationship.  Your therapist should be attentive and you should feel that they have your best interests at heart.   It may be a good idea to "interview" a few potential therapist candidates over the phone before making a decision about who is right for you.


The first step of the process should involve a thorough evaluation of your concerns and life history. Your therapist will collect factual information about you, including the nature of the problem that prompted you to seek help, a history of past and present emotional and psychological concerns, any medical issues and medications you're taking, and your past and present use of drugs and alcohol.  Your therapist should also ask about your family and social history.  This process is very comparable to first seeing a medical clinician, who gathers your medical history to arrive at a diagnosis and treatment plan.  After the information gathering process is completed, you and your therapist will design a plan for your therapy and establish realistic goals.


The therapy process depends on your therapist's theoretical orientation.  Nowadays, most therapy and counseling consists of a series of interactive conversations.  Most therapists will not present as cooly detached observers, but rather ask questions, make comments, and offer suggestions.  For example, as a therapist, I consider one of my main missions to help each client uncover the best answers and solutions that are uniquely right for them.


As a result of therapy and counseling, you should hopefully understand yourself better, have more positive feelings, and increase healthy behaviors. For more information about my therapy services, please  visit DrGortner.com.