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!

The Art of Self-Nurturing

Feeling tense? Running on empty? Maybe work, finances, relationships, changes in routine, or daily life have you feeling overwhelmed. Warning signs include feeling anxious, irritable, fatigued, and having repeated intrusive thoughts about a stressful situation. Extreme stress can make you feel like there is nothing you can do. The key to regaining control is a radical return to self-nurturing, to recharge your emotional and physical batteries. Here are some strategies to foster the Art of Self-Nurturing.


Admit your stress. Admit when circumstances have got you down and change is needed. Admitting this creates a moment of calm and stillness, a space to breathe, and a space for observation and awareness. Moving forward is difficult unless you recognize the situation and make a commitment to help yourself through it.

Identify Your Hot Buttons. Figure out what is causing the stress–a relationship to a co-worker or loved one, work demands, a financial commitment, uncertainty about the future?  Write this down.

Acceptance. Take a look at your list of stressors and identify the things that can be changed as well as the things that can’t. Accept that some things are always going to be stressful. Then, attention can be focused on the things that can be changed instead. Try focusing on action steps to make the future less uncertain, such as acquiring skills, making friends and setting goals.  This also means not sweating the small stuff - pick your battles and invest your energy wisely.

Notice how you talk to yourself about yourself and others. Observe the language you use to create your reality, to define and judge yourself and others.  For example, you may say to yourself, "Here I go again, stressing out", when a more effective, self-compassionate statement would be, "Stress is part of life and I'm learning to address it effectively by taking it one day at a time."

Get Outside. Taking in natural beauty, along with physical exercise, can reduce stress and improve physical health. The color green has been shown to have soothing effects on body and mind.  Nature can provide a peaceful soundtrack, beautiful scenery and fresh air to help soothe the soul. Try hugging a tree or walking barefoot in the grass.

Let It Out. Bottling up emotions can increase stress through accumulated feelings of loneliness and helplessness. Communication, both with yourself and others, is key in addressing problems quickly and honestly.  If you need help identifying what's causing your stress, and how to effectively address it, talk to a trusted person or mental health professional.

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.

This Holiday Season, Return To Simplicity

The holidays are a time when our inner self may be exposed to more vulnerability than usual.  Much time is focused on the external world – preparations, shopping, responding, caring for, tending to.  Lots of stimuli bombard us, and it’s not only the holiday consumer goods commercials and advertisements that now seem to be starting in October.  Our inner self is now working overtime responding to these stimuli.  There are both internal and external pressures to keep up with. 

So this creates a new layer of stress, or roughness, for our inner self.  Our inner self is our oldest friend, the most tender and vulnerable part of us.   Our inner self is our heart space.  The part that has endured hurts throughout our lifetime – fear, abandonment, unmet needs.   This is the part of us that can feel ravenous with emotional hunger as well as be walled off from potential hurts, all at the same time. 

The holidays are an interesting time.  Our inner self has two conflicting demands – responding to the many external pulls, which at the same time creates an increased internal need for love and protection. 

I’m advocating that at this time, you turn extra kind attention, loving care, and protection towards your inner self.  Like being your own mother responding to her upset (inner) child with care, patience, and compassion.  I may even dare to say that during this time, turn inward first before you turn outward. 

Listen to your inner self’s needs. 

Give the gift of self-compassion.

Sometimes it’s okay if the only thing you did today was breathe.

Trust the process. 

Consider embracing simplicity during the holiday season. For example, this may simply mean spending time with the people we love and who love us back. 

Keep calm and let go (perhaps of the things and circumstances that no longer serve you).

For more holiday coping advice, see:

Self-Care for The Holidays

Stay Sane During The Holidays

Staying Sane During The Holidays - Part II

Simple Tools for Stress Management

Stress is part of everyday life, yet it is also a complex concept. Psychological stress occurs when a person perceives that the demands placed on them exceed their personal and social resources to help them cope.  This means someone can feel little stress when they have the time, experience, and resources to manage a potentially stressful situation. In other words, stress is not an inevitable consequence of an event - it depends on your perceptions of a situation and your ability to cope with it.  

Let's take the common everyday stressor of traffic.  If we perceive it as defeating and frustrating, and that we are helpless against it, we become di-stressed and sit in the car fuming.  If we accept it as just a fact of life, and that it's an opportunity to sit and meditate, catch up with a friend on the phone, or listen to an entertaining program, we create positive emotions for ourselves instead.  The prerequisite of this happening of course means that we have a phone or program available, and that we feel confident that these strategies will help us feel better.

Causes of Stress
To understand stress better, it may be helpful to think it terms of what usually causes people stress.  Here are four main categories that are common stressors in our society.

• Life Transitions (for example, moving, job loss/change, diagnosis of illness, marriage, divorce, pregnancy/childbirth, death of a loved one)
• Work- or school-related (for example, high demand job environment, boredom, team conflict, lack of support)
• Problematic relationships (eg, unreasonable demands, high conflict, persistent sense of being taken advantage of, lack of supportive relationships)
• Your environment (eg, housing problems, transportation problems, chronic traffic problems, noisy neighborhood, living in poverty, living and working in an environment that's not conducive to relaxation and recreation, dangerous living or working environment)

However, it's important to recognize that an accumulation of smaller, minor stressors can be at least as, if not more, detrimental to one's physical and mental health as one or two major life stressors.  Car trouble, an argument with your spouse, an important work deadline, and trying to plan a big family party all in one week can certainly add up.

Signs of Stress
The first step to effective stress management is understanding your own personal stress signals.  Stress can get expressed in many subtle ways.  Here are some examples - see if you recognize yourself in some:

• Feelings: Anxiety, irritability, fear, moodiness, embarrassment, frustration, and anger 
• Thoughts: Self-criticism, difficulty concentrating and making decisions, forgetfulness, preoccupation with the future, repetitive thoughts, fear of failure 
• Behaviors: Crying, being disorganized, sense of time pressure, “snapping” at love ones, acting impulsively, alcohol or other drug use, teeth grinding or jaw clenching, stuttering or speech difficulties, having more accidents 
• Physical: Sleep Disturbance, changes in appetite, tight muscles, headaches, fatigues, cold or sweaty hands, back/neck problems, stomach problems, getting sick more often, rapid breathing, pounding heart, trembling, dry mouth

Think Stress Away
One of the most important ways to bust stress is to practice positive thinking and keeping things in perspective.  Remember, how we perceive an event is a major contributor to stress.  If we can neutralize our initially negative perception of a stressor, we have more control over the impact it has on us.  In other words, re-think how you think about stress.

Here is a simple guideline:
1. Recognize your negative thoughts
2. Stop, breathe
3. Reflect: Is this thought really true? Did I jump to a conclusion? What evidence do I actually have? Am I letting negative thoughts balloon? What’s the worst that could happen? Does it help me to think this way?
4. Choose: Decide how to deal with the source of your stress. Create and write down an action plan. Recognize negative thoughts and let them go.

Here are some simple examples of negative thought patterns during stressful situations, and their more neutral alternative thoughts.

1. Should statements:
•I should be able to deal with stressful situations better.
•Better: I know how to deal with stress and I am having a hard time right now.

2. Disqualifying the positive:
•I hate my life, it always is so difficult.
•Better: There are some things going on right now that are difficult and also some things that are actually going right.

3. Emotional reasoning:
•I don't feel good right now so I can't handle anything.
•Better: I feel like I can't handle things right now and I know that I can.

4. Catastrophizing
•If I don’t do well on this presentation (insert other important task), I will be judged poorly.  I may become jobless and homeless.
•Better: Nobody’s perfect. I’ll do my best on the presentation and know that it’s not the end of the world if I don't do perfectly.

Relax Stress Away
A relaxing activity that provides relief from a stressful activity by reducing physiological activation.  Incorporating relaxation in your daily routine is paramount, as the physical effects of chronic stress can lead to many health problems, such as cardiovascular disease, cancer, and a susceptible immune system.
Healthy examples for relaxation:

• physical exercise
• a hobby
• spending time with friends and family
• a warm bath or shower
• prayer or meditation - here are some great meditation apps
• Guided Imagery/Relaxation - there are many great resources online; here's one example

Finally, talking to a mental health professional about your stress can help you organize your thoughts, determine where to invest your energy, and learn skills in managing stressful situations and people in your life.

Self-Care for the Holidays

Ah, it's that time of year again.  You may have started your holiday planning and shopping, RSVPing to various events, and/or getting ready to host.  For most of us, the holidays are a mix of excitement, gift giving and receiving, and spending time with the ones we love.

On the flip side, it may also involve running harried, stretching ourselves too thin, dealing with competing demands, and family drama.  Relationships may become (more) strained.  Whereas some level of increased stress is to be expected, the holidays can also bring out additional difficult feelings, such as grief and loneliness.

The need for self-care and boundaries is higher than ever at this time of year, although ironically we likely have less time to do so.  Here are some things to consider:

• Be kind and gentle with yourself.  When multiple demands compete for our energy and attention, it becomes increasingly difficult to stay in the present and enjoy the moment.  
• Identify now how you want to take care of yourself.  For some, this means scheduling time with a dear friend.  For others, it could be unwinding with hot tea or cocoa at night and sticking to an exercise routine.
• Notice when you become reactive.  When you notice having a shorter fuse, for example, take a long and gentle moment to reflect on what is really causing it.  What may initially feel like annoyance with slow moving lines or traffic, might really be about pressure to keep up, or feeling taken advantage of, or having familiar buttons pushed by a family member.
• Holiday stress may get acted out in relationships.  This may create a wish to withdraw from others or engage in various escape fantasies.  Be careful not to entirely give in - spending meaningful quality time with others usually leaves us feeling better. 
• Be aware how you respond to interpersonal conflict.  Do you pursue or withdraw?  These patterns may get exacerbated with holiday stress.  Just being aware can help you modify your responses to others.
• Be a clear communicator.  Let others know what you're willing and able to contribute, and also communicate what you are not able to do.  Read this post about assertiveness skills.
• If you are spending the holidays alone, plan quality time for yourself as well as some time to be around others.  Joining a community that has meaning to you, religious or secular, is good for mental health.  Volunteering and giving back during the holidays can be immensely rewarding.  Shifting focus from inward to outward can help put difficult feelings in perspective.  Plan your participation early as volunteer opportunities on holidays fill up quickly.
• Take note of what you are grateful for.  It helps put things in perspective.

Happy holidays to you and yours!

Simple Ways to Boost Your Mood and Confidence

Positivity and confidence are important building blocks in life.  Often they are the prerequisite for other positive changes.  They keep us moving forward (instead of looking backwards) and connected to others.  Here are some simple ways to build mood and confidence boosters into your everyday life:

• Evaluate your choices:  Take inventory about what is currently going on in your life:  in your relationships, workspace and environment.  Determine the aspects of your life that you can change positively, then focus on them.  Also acknowledge the things that you cannot change, and move on. Make sure to only invest energy in the things that are worth your while.  It may help to write them down.
• Eliminate negativity:  If there are people and situations that leave you drained and grumpy on a regular basis, re-evaluate their place in your schedule and your life.  For example - a friendship should leave you energized, rather than drained, most of the time.
• Stop blaming yourself:  When something doesn't go as expected, don't dwell on it.  Rather than beating yourself up about human mistakes, take a deep breath, regroup, and figure out your next steps.
• Make time for exercise:  This helps burn off stress hormones and leaves you feeling relaxed and refreshed.  Exercise is also known to counteract mild to moderate depression and improves confidence.
• Get social support:  Make time for dates with friends.  This helps reduce stress, improves health, and gives you something to look forward to.
• Learn something new:  Novelty is good for the brain and the soul.  Pick up a new hobby, craft, skill, or language.  You will improve your confidence and may meet new people that share your passion.
• Reward yourself:  Break down your goals into small, manageable benchmarks.  When you reach a benchmark, reward yourself with something healthy.  For example, after you finish cleaning a room, make time for a healthy snack or a phone call to a friend.
• Nurture your mind:  Surround yourself with positive music, entertainment, and art.  Avoid movies or TV shows that leave you feeling stressed, anxious, and negative.

Make self-care a priority in your life.  If this is consistently hard for you, you may wish to consult with a licensed mental health professional for support.  Check out my website for information on my services.

Job Burnout - Are You At Risk?

"Without work, all life goes rotten, 
But when work is soulless, life stifles and dies." - Albert Camus


Feeling stressed at work and unfulfilled by one's job is a familiar topic to most people.  But there is a difference between having a difficult set of days or weeks and actual job burnout.  Burnout is not an all or nothing phenomenon.  Fluctuations in motivation and enthusiasm are normal.  Job burnout occurs when enthusiasm and motivation have completely dried up while your job skills and knowledge remain intact - a very frustrating feeling.  Those hardest hit by job burnout are people in the helping and medical professions, those who make high stakes or life and death decisions, and those whose work is very detail oriented.


Burnout is a cumulative process and it is important to be in in tune with early warning signals:
- Loss of interest in work
- Emotional fatigue
- Increased moodiness and irritability in both personal and professional situations
- Increasing frustration with everyday responsibilities at work
- Inability to re-charge your internal batteries while not working
- Interpersonal problems marked by decreased tolerance and patience
- Social withdrawal - becoming aloof and inaccessible
- Indifference towards people and dehumanization of those you work with (eg, thinking of clients as objects not people)
- Health problems as a result of chronic tension or stress
- Substance abuse as a way to cope with difficult feelings
- Declining performance at work
- Being emotionally or physically absent from work
- Ceasing to find meaning in your work

Most people suffering from burnout share an experience of powerlessness, hopelessness, and helplessness.  They lose a sense of being able to control their work and self-confidence takes a major dwindling hit.  Re-establishing a sense of empowerment and confidence is key to addressing job burnout.  Before deciding whether or not to quit a job, it is important that you get yourself to a replenished and rational place first.


Here are some tips to help you reclaim a sense of personal control:
- Learn better ways to manage stress.  Healthy coping is key to replenish those dead batteries and get you to a place where you can clearly assess and evaluate what to do next about your job situation.
- Seek social support.  Even though the first instinct during burnout may be to withdraw from others, it is important to counteract this instinct.  Build a solid network made up of friends, family, and coworkers.
- Increase your knowledge base.  By continuing to build your marketable job skills set, you increase your personal and professional sense of empowerment.
- Manage negative thoughts.  See previous blog entry on Talking Back to Your Internal Chatterbox to learn how to manage types of thinking that can take control of your emotions.
- Develop detached concern.  This means learning to let go of attachment to how things could or ought to be - a skill that becomes immeasurable especially when you are working with serious or impossible situations.
- If all else fails, consider changing jobs.  However, it is paramount that you analyze the source of your job dissatisfaction first and explore what is needed to improve the situation.


Talking to a mental health professional who specializes in job burnout can be a powerful tool to regain a sense of control.  It can help to have a neutral person to process the above topic with.  I am a Houston psychologist and enjoy working with job burnout concerns.  Visit my webpage at DrGortner.com for more information.

Stay Sane During The Holidays

Ah, they are sneaking up on us - signs of imminent holidays.  Decorations are popping up both indoors and outdoors, there is faint hint of a jingle in the air, commercials are calling out, media programming reflects that 'tis the season, and stores are starting to buzz.  The holidays can fill us with excitement, anticipation, joy, and...stress.  There are parties to attend and/or throw, family get-togethers to get through, gifts to buy (if you're giving), homes and spaces to decorate, and work deadlines to meet.

For almost anyone, the holidays are accompanied by mixed feelings.  The season calls for celebration, companionship, and (for many) spiritual reflection.  Yet we also often find ourselves confronted by hastiness, feelings of running out of time, financial challenges, and navigating the minefield of family relationships and related politics.

How can we stay grounded in the next few weeks?  Here are some things to consider:

1.  Set healthy boundaries with yourself and others.  This means knowing when to say no.  It also means not letting yourself get pulled into toxic relationship dynamics, often rekindled at family get-togethers.  Pick and fight your own battles, and let others do the same.  Know when to step out and give yourself time to catch your breath.

2.  Practice self-care.  This means staying in tune with your stress level and practicing active stress-management.  Pay attention to your body - the holidays often pack on the pounds, so set your food goals early on.  This could mean limiting your intake of sweets (just one cookie for me, thanks) and avoiding going back for seconds.  Make time to exercise. Make time to relax with a cup of tea.

3.  Connect meaningfully.  Think about the relationships in your life which leave you filling energized instead of depleted.  In the holiday rush, we may lack time to make that phone call or have coffee with a friend.  Be mindful of your time to allow for meaningful conversations and connections.  Holidays can be a time of sadness and loneliness.  Seek support when needed.

4.  Take time to reflect.  Make sure to allow space for spirituality or meaning, whatever this means to you personally, during this season.

Happy Holidays!

If you are having trouble navigating the many stressors of the holiday season, support is essential.  Sometimes, talking to mental health professional can help.  I'm a Houston psychologist, visit my website at DrGortner.com for more information.

Finding Yourself High and Dry? Navigating Stress During a Financial Crisis

The financial crisis is back on everybody’s mind as we have been watching the news.  Money worry is familiar to most of us.  And it doesn’t help to see this issue illuminated from all angles on our news networks.  No matter what your employment status or how far away you are from retirement.

People deal with financial stress in different ways.  Some take the “head in the sand” (aka ostrich) approach by avoiding thinking or talking about the topic.  This can often backfire – the more we suppress certain thoughts, the more likely they are to pop back up in sneaky ways in our minds (research backs this up).  This approach can also leave us in the dark when we may need to make important decisions. 

Other people become obsessed with the topic and find themselves glued to the TV screen, analyzing each minute detail.  This too can be unhealthy, as it takes away important mental resources from our daily lives and may not help us solve the problem. 

In this, as with many other issues, balance is key when we try to cope.   Here are some things to keep in mind:

Be News Savvy.  While it’s important to stay in the know, don’t get caught up in the media hype prophesizing doom and gloom.  Try to limit your news intake to a certain amount of time per day - for example 15-20 minutes from a trusted news source.  Avoid these news first thing in the morning or right before bedtime.

Take Inventory.  It is important to assess what in life we are in control of, as opposed to what we are not.  All too often we grip onto and waste our energy on things that will run their course.  If you are immediately affected and/or have lost your job, create a written outline on how you and your family can manage expenses and finances differently and more efficiently.  Reaching out to credit counseling services and financial planners can help alleviate anxiety.  Talk to your bank, utility companies, and credit card companies about payment options.  Research options for continuing education to make yourself more marketable.

Notice How You Deal With Stress.  Stress can be sneaky – before we know it, we can turn to food, inactivity, smoking, alcohol, or other substances to somehow manage it.   We may withdraw from family and friends and lose sight of what’s important.

Identify Healthy Choices.  Take a walk with a loved one, try a new recipe at home, call a friend.  Be proactive while taking care of yourself.  Reach out for support.  Make sure to eat right and make some room for exercise and socializing – again, things you can control. 

Be Patient.  Uncertain times leave us with more questions than answers.  It takes courage and tenacity to weather these types of storms.  Having question marks in our lives can help us reflect on what’s important.  And this can leave us richer in the long run.

If you continue to be overwhelmed by the stress, it can be useful to seek professional support.  A career counselor can help you create a concrete vision and goals if you are in a job transition.  A psychologist can help you address the emotions and meanings behind your worries and teach new skills to manage stress.  I am a Houston psychologist – to learn more about my services, visit DrGortner.com.