Julia Louis-Dreyfus 1.13.1961

Posts Tagged ‘anxiety’

Stress Reduction Tip #2: Breathing

10.25.13

Who knew that something so simple could reduce stress?!

 

Yes, we are talking about breathing. Let’s face it, many of us Menopaused Minds are so frazzled because we’re often carrying a lot of stress around with us. Not only is stress unpleasant, but it can really take a toll on our bodies and minds. In fact, recent research has found that high levels of stress in middle age can increase risk for Alzheimer’s disease. From the ordinary daily stressors (managing your hectic schedule, refereeing kid’s fights, work demands, etc.) to life’s whoppers (aging parents, divorce, unemployment, etc.), being stressed has become the new normal for so many of us. The great news is that we are doing something every day, every minute, without even thinking, that can help moderate your body’s response to life’s challenges.

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Breathing has been scientifically proven to be an effective stress reducer. But not just any breathing, we’re talking about deep breathing. Why is that? Our bodies’ stress responses are hardwired physiological reactions that served to protect us back in the early days of humans. Stress is what told us that we were in danger–usually in danger of not having enough food or the danger in becoming something else’s food. The body has two opposing systems that regulate our basic bodily functions (like breathing, organ function, etc.): sympathetic and parasympathetic nervous systems. When we’re in danger, the sympathetic nervous systems kicks in and we go into fight/flight/freeze mode to survive. Our hearts race, certain “non-essential” organ systems shut down  and blood rushes to our muscles in preparation to run away. Once the danger is no longer a threat, our parasympathetic system starts up and basically calms the body down, slows our heart rate, cues the shutdown systems to go back online, etc.

 

The fight/flight/freeze mode was okay when it was short lived – when we needed it because we were being chased by a lion. The problem is that now our stress tends to be more chronic. So, we end up being stuck with our sympathetic nervous system in overdrive. Our body gets tired and glitchy. We get sick more, our energy drops, we’re more irritable, and we even have a harder time losing weight, either from eating more to cope with stress or due to the body holding onto fat b/c of the perceived threat to survival!

 

So, how is breathing going to help? When we engage in deep, slow breathing, we actually cue our parasympathetic system that we’re not in life threatening danger and we can chill out.  Your breathing is strongly tied to our heart rate. Ever notice how when you get worked up about something, either fear or anger, your heart rate picks up, and your breathing becomes faster. So, deep breathing helps slow down the heart, muscle tension eases, pain can even decrease, blood pressure goes down, and mental alertness increases, and even the pH of our blood changes. The amazing thing about all of this is that you can get results even with doing as little as 3 or 5 minutes of deep breathing!

 

Want to try it?

Here’s a very basic example of a 3 minute breathing practice :

(adapted from Breathing, Stretching, Relaxing Program, VA Greater Los Angeles Healthcare System–yes, veterans are doing this and they love it!)

 

Sit upright and gently maintain a natural spine alignment with your hands resting comfortably on your lap.

 

Either close your eyes or gaze at something on the wall or floor.

 

Breathe normally and just notice your breath. Notice how the air feels sweeping into and out of your nose. Notice how your body moves with each breath. Notice the pace of your breath, the length of each inhale and exhale. Your mind might wander. If it does, just bring your attention back to your breath.

 

Start to breath more deeply, from deep down in your abdomen. Count your inhale and exhale length and try to get them to match. Once they’re in sync, try breathing this way three times.

 

The key to stimulating that parasympathic response is to spend some time breathing out longer than you breath in. For example, you can practice by counting your breath rate, say 1, 2, 3, 4 in, and 1, 2, 3, 4 out, a few times. Then do 1, 2, 3, 4, in, and 1, 2, 3, 4, 5 out, a few times. You can work your way up to a count of 8 out and then back down to 4.

 

Here are more resources on breathing exercises and guided practices:

UCLA Mindfulness Research Center
Dr. Weil Guided Breathing Exercises
6 Breathing Exercises to Relax  in 10 min or Less (TIME)

 

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Stress Reduction Tip #1: It’s the Thoughts (& Actions) That Count With Cognitive-Behavioral Therapy

5.18.12

Our first stress reduction tip is brought to us by Daryaneh Badaly, a doctoral student, psychotherapist, and researcher at the University of Southern California (USC). She has worked in the Departments of Psychology and Neurology at USC, as well as at the Kedren Acute Psychiatric Hospital in Los Angeles, California.


Does this scenario sound familiar?

 

“Hi, Carrie. Were you able to finish Mr. McGuire’s report? The doctors need it for feedback.”

 

Oh my gosh! Was I supposed to be working on the McGuire report?!? I haven’t even finished with last week’s reports.

I’m too slow, I should be faster. I’ll bet that if I were younger I’d be sharper, quicker, and more able to focus. I don’t even know where I put the McGuire test results. Did I even test McGuire? I can’t even remember McGuire! If I say that I don’t remember testing McGuire, the doctor will just think I have finally lost it. He’ll stop referring patients to me and start complaining about me to the other doctors. And, then, gradually I’ll lose my practice.  Then, I’ll have to dip into the college fund to pay the mortgage. It’ll be my fault that the kids can’t go to college.  Argh!! I should have been putting more money in the college fund. I fail at being a mother.


“I don’t have those results. Are you sure that I tested McGuire?”

 

“Oh, you’re right. You don’t test him until next week.”

 

Carrie’s benign encounter with a co-worker stressed her out.  When her heart finally stopped racing, she felt exhausted and drained so (naturally) she dug out that bag of mini Snickers bars.

 

When watching someone else, it’s easy to see how anxiety is truly in the eye of the beholder. It’s not necessarily an event or a situation that causes anxiety, but rather our perception of the event – our thoughts and feelings that the event triggers.  Stress and anxiety are most often the product of us “should-ing” all over ourselves. Thinking that you should be working harder, doing better, or looking better can add up overtime resulting in high (and potentially fatal) levels of stress.  Of course, we need to learn to manage our stress. But how do we do it?  How do we turn off those worries when the hot flashes wake you up at 4am?

 

Through Cognitive-Behavioral Therapy (CBT), you can learn tools and techniques to help you manage your thoughts, feelings and behaviors. Although this can be done on your own, most people benefit from working with a therapist who can take an objective view of your thoughts, feelings, and behaviors. If a therapist isn’t an option, chat it out with a friend (but keep in mind this won’t be totally objective). Many research studies have shown that CBT can effectively reduce stress, as well as anxiety, depression, and even menopause symptoms.

 

So, what’s CBT… really?


 

Cognitive-Behavioral Therapy is one approach to stress reduction. It focuses on the interaction between thoughts, feelings, and behaviors. The great thing about CBT is that making a change in any one of these three areas can elicit changes in the others. For example, changing the way you think about a situation can change how your feel and behave in that situation or others like it. When Carrie began thinking that she’s a bad mother, she could stop herself and reevaluate this thought. Is this really true? Isn’t there proof that she’s not a terrible mother? This can make her feel less anxious or disappointed in herself. It could also lead her to figure out a different way to manage her time. Changing a behavior, like Carrie taking a walk instead of downing that chocolate, could lead to more positive emotions and feelings about herself, especially since exercise can help your mood improve. Then her thoughts become less negative, and so on.

 

CBT is a form of psychotherapy, BUT it’s not like psychoanalysis, which can take years involves digging around into negative childhood experiences. CBT is different…

 

It’s usually limited to 12 to 16 sessions.

 

It’s goal-oriented and problem-focused, and emphasizes learning a variety of new skills.

 

Sessions are structured, and homework assignments are given between sessions so skills can be practiced in real-world situations.

 

 

The CBT approach typically focuses on teaching you how to:

 

Identify troubling situations, thoughts, feelings, and behaviors. In treatment, Carrie might be asked to log each time during the day during which she felt stressed, note where she was and what she was doing at the time, and record her thoughts. (You can use your handy spiral notebook for this!).

 

Manage your thoughts. Techniques such as “thought stopping” and “thought substitution” can help to keep negative thoughts from spiraling out-of-control.

 

Reevaluate the probability of a negative event actually happening. Carrie’s therapist might ask her to her to review the probability that doctors would stop referring patients to her.

 

Put things into perspective. Carrie’s therapist might also ask: “So what would happen if you had to cut back your practice?” Yes, this sounds scary but deep down, do you think you can survive this? Our bet is that the answer is yes.

 

Engage in relaxation techniques. For example, deep breathing exercises can dramatically diminish the physical side effects of stress (e.g., headaches and heart racing). Or, by taking a short walk after her encounter at work, Carrie might have been able to avoid those Snickers bars.

 

Reward yourself.


How do you find a therapist who offers CBT?


Finding a therapist can sometimes be tricky and may require some detective work on your part. A good place to start is asking for a referral from your primary care physician or specialist. This is probably the most common approach to therapist hunting, but keep in mind that your physician may just have a name of someone s/he met at a cocktail party, so there’s no quality guarantee here. Personal recommendations are probably better. Then there’s always your health insurance provider list, which will take some trial and error to find a good match for you, but it’s not impossible. Once you get a name, do some research. A simple Google search can get you a therapists training history. Once you make contact, ask about the therapist’s general therapeutic approach and if s/he does CBT. (We’ll have a post coming up with more tips on finding a therapist, so stay tuned!)

 

Read more about cognitive-behavioral therapy:


Online:

Mayo Clinic: Cognitive-Behavioral Therapy

National Alliance on Mental Illness: Cognitive-Behavioral Therapy

These resources are designed to provide background on what cognitive-behavioral therapy is, whom the treatment might be helpful for, and what you might expect from therapy sessions.


In Print:

The Feeling Good Handbook by David Burns

Mind Over Mood: Change How You Feel by Changing the Way You Think by Dennis Greenberger and Christine Padesky


Both of these books can be used alone or in conjunction with psychotherapy. They provide clear instructions for identifying and tracking your thoughts, feelings, and behaviors, changing the thoughts that contribute to problems, and taking action to improve daily living and relationships.


Memory Tip #1 Stop Worrying!

3.17.11

Feeling like your memory has gone MIA? It may be time to… get over it!

Memory declines with age and a few “menopause moments” are completely normal. Now, if you are still thinking: my memory is REALLY bad or I’ve completely lost it …PLEASE STOP!


The worst thing that you can do is to become self-critical. Don’t beat yourself up every time  you’ve forgotten something you think you should have remembered.  All this worrying about your memory and feeling like you’re not as good as you should be can lead to anxiety and depression, both of which are bad for your brain.


In fact, emotional distress can make your memory worse!


If you are very worried that you’re having memory problems or others have complained to you about your memory, you may want to get tested. Ask your primary care physician to refer you to a neuropsychologist for a neuropsychological assessment (doc-speak for memory testing).  A good neuropsychological assessment will take a few hours, but in the end, you’ll have a good sense of how you are performing when compared to other people your age. A word of warning: neuropsychological assessments are expensive. Find out what your insurance will cover before you’re left with a colossal bill, more stress, and even worse memory!


If you are willing to become involved in research you can often get a free neuropsychological assessment at your local Alzheimer’s Disease Research Center (ADRC). These centers are funded by the National Institute on Aging and located throughout the US at major medical institutions.

Here at the University of Southern California our ADRC is part of our Memory and Aging Center (MAC) with locations in Los Angeles, Downey and Rancho Mirage. If you want more information about our center, link to our website or call Nadine Diaz, MSW at (323) 442-7600.


Can Margaritas Improve Memory?

2.11.11

It’s Friday afternoon and the end of a horribly stressful week.  I know that stress is bad for the brain and that this past week brain cells must have been dying off by the dozens.  Sure, I can protect my brain by producing stress-resistant brain cells through aerobic exercise. I know that I should go home and use the elliptical until I can’t stand up any longer. I should, I should, I should… but I don’t want to!  I’d rather get-together with my girlfriends, grumble about my week, laugh and drink a giant Cadillac Margarita. Luckily, there’s evidence that my plan may not be the worst thing for my brain. If fact, it may even protect it… 

 

 Recently, a large, systematic review of research on health behaviors and dementia produced some unexpected results. Moderate alcohol consumption tended to be protective against cognitive decline and dementia. So, it turns out that folks on either extremes of the drinking spectrum, nondrinkers and frequent drinkers, exhibited a higher risk for dementia and cognitive impairment. Is this not a fabulous finding ?

 

 Unfortunately, there isn’t a consensus on how to specify”moderate” drinking.  Some studies defined moderate drinking as up to three glasses of wine a day! The American Heart Association disagrees. In terms of cardiovascular risks, they define moderate drinking as one drink per day, such as 4 oz of wine, 1.5 oz of 80-proof spirits, or 1 oz of 100-proof spirits. They also claim that wine is not necessarily better for us than other types of alcohol.  In their view, the jury is still out on that one.

 

Well, the best known benefit of moderate alcohol consumption is an increase in HDL cholesterol–the good cholesterol. Antioxidants may also play a role. So, if you are concerned about anti-oxidants but you want that margarita instead of a glass of red wine, enhance the antioxidants.  Stay away from those fattening, sugary mixes and use lots of fresh lime juice or make a pomegranate margarita. Fresh limes have lots of Vitamin C and flavinoids. Flavonoids are being studied for their antioxidant, anticarcinogenic and antibiotic properties.  To get the most juice out of those precious limes,  roll them on the counter and make sure that they are at room temperature before juicing.


Be careful not to  smoke or eat lots of chips while drinking your margarita.  The same review showed that a history of smoking elevated the risk for Alzheimer’s disease. Midlife obesity had an adverse effect on cognitive function in later life.


There are added health and brain benefits from spending the evening with my girlfriends, kvetching and laughing, as opposed to alone on my elliptical. Keep an eye out for our post on the health and cognitive benefits of socializing and social support.  I do know that I come home in a much better mood. So, at the very least, my Friday night margaritas improve my family’s health and cognitive functioning.

 Cheers!


Save Your Menopause Brain and Combat Anxiety

2.2.11

Have you become a worry wart? Are you feeling more antsy lately? Well, you’re not alone. Women often complain that as they hit menopause they generally feel more anxious.  Some women get angry at themselves and think that by now they should have their act together. By 50 they should be getting better at managing life’s ups and downs – not worse! Well, even if there aren’t too many downs and plenty of ups, there’s a biological reason for increased jitters. The increase in anxiety is typically attributed to changes in estrogen and progesteron, hormones which have been shown to buffer against the body’s response to stress. After menopause, these hormones just don’t protect against stress like they used to.


Stress isn’t just bad for you mood…it’s bad for your brain, too. When you experience stress, your brain produces steroids to communicate to the rest of your body that there’s a problem. If these steroids stick around too long, they can literally kill your brain cells – especially those in the hippocampus (Remember? It’s the part of your brain that is super critical for memory). Over time, stress may even result in a wasting away or shrinking of the hippocampus.


When you already feel like your mind is turning to mush thanks to menopause, who wants to lose a single cell of their hippocampus??


The good news is that you can combat the effects of stress on your brain through… exercise! Yes, exercise, again.

Research suggests that aerobic exercise can make you less anxious. It looks like the brain cells you produce while exercising are better at dealing with stress.  The bad news is that it takes awhile to produce these stress-resistant cells. For rats, it took somewhere between three and six weeks. It’s still unknown how long it takes for humans.


If you know that you’ll be facing something stressful in the next month or two (like paying taxes or results from your kid’s college applications), do yourself a favor and protect your hippocampus. Start exercising now to get your brain into combat shape!

Hot Flashes, Hot Flushes, Night Sweats: “Hot Women” Takes On New Meaning

5.30.10

 

I will never forget my first major hot flash. I was in my office interviewing a distinguished and very serious couple who were clearly distressed about the wife’s memory problems. As I was addressing their concerns in my most professional manner—WHAMMM! Suddenly my heart began to race, and my whole body was on fire,   I turned bright red and the sweat started pouring down my face.   My wool suit became unbearably itchy and I wanted nothing more than to rip off my clothes and put my head in the sink.  Instead, I calmly took out a tissue, wiped my face and tried to ignore the husband’s horrified expression.


 

Do you know why we have hot flashes during perimenopause? You’re not alone; no one else does either. That’s why there isn’t a pill specifically designed for hot flashes. When a drug company gets close, I’m buying up their stock. Can you imagine the demand?


 

What we call hot flashes, hot flushes and night sweats are all vasomotor symptoms. These vasomotor symptoms occur in about 88% of perimenopausal women and 74% of menipausal women.   For some women they diminish after one year – for some women they last 30 years!!


 

What we do know is that we have a thermostat in our bodies that closely regulates our body temperature.  We have also known for some time that estrogen plays a key role in hot flashes which is why Estrogen Replacement Therapy (ERT) is viewed as the most effective tried and true method for controlling them.


 

Here’s the good news for us “Hot Women”: now that we are beginning to understand how other factors such as neurotransmitters affect our thermostat we have additional ways to combat hot flashes.


 

Anti-depressant medications, specifically those that alter neurotransmitters (such as selective serotonin reuptake inhibitors – SSRIs) can reduce the frequency and severity of hot flashes by up to 50%.  A recent study published in the Journal of Clinical Oncology* reported that SSRIs have been shown to minimize hot flashes, but it seems that citalopram (A.K.A  Celexa or Cipramil) might stand out above the rest. The added benefit is that SSRIs have been shown to improve mood, sleep, anxiety and overall quality of life in menopausal women.


 

Unfortunately, so many women I know refuse to go on SSRI’s because they consider it admitting defeat or failure.  But, like in most areas, women need to let themselves off the hook.  They need to admit that their neurotransmitters are out-of-wack and that it’s not their fault.  The simple fact is that SSRI’s can help to give you back your premenopausal self. So if you’re feeling particularly steamy these days, go make an appointment with your doctor and check out your options.