Working Remotely,Part Deux

Working Remotely, Part Deux

Last week I discussed some of the more personal issues I’ve noticed in remote workers, aka digital nomads, and made some suggestions (lectured?) on some things they should be doing for themselves in order to help ensure a better, more fulfilling life. As a global workforce, ‘rona allowed us, or forced us, depending on your point of view, to embrace the remote work concept. So much so, that many companies are progressively implementing it into their current strategies, and/ or incorporating it into their expansion plans. But given my profession, I have to ask, how psychologically healthy is it? It seems to me that as it stands in some companies now, not very. But certain personality types are somewhat uniquely suited to remote work, and thrive in the independence associated with it. Even if you aren’t necessarily one of them, humans are supremely adaptable beings. The questions then become, are you a person that could be happy working remotely, or could you make it work for you? 

Many of my patients say remote work has been an answer to their most ardent prayers. But a disturbing proportion of them say it through a mouth of unbrushed teeth, from a face covered with scraggly unshaven beard, and topped with a head of tangled unkempt hair, so I’m just not buying what they’re selling. So what’s up with that? Why are some digital nomads, who are usually neat and tidy, suddenly messy and… messy?! The answer is deceptively simple: they’re SAD. Stressed, Anxious, and Depressed. But why, when most people’s greatest wish, to ???work from home??? has suddenly been granted? Can you hear the angels sing? Visual sound effects! I’m absolutely positive that it might become a thing. 

Well, as with so many things in life, the remote work format is like an equation, with positives and negatives to take into account. In order to know if it works for you or not, you have to know the factors involved in order to effectively evaluate them. Today will basically focus on the more negative side of that equation, and some of the reasons why some people might feel SAD, even though they ???work from home??? Just wanted to test them to make sure they still worked. 

I know I make a lot of jokes, maybe as the result of a coping mechanism that morphed into a habit, but there can be real and unanticipated mental health consequences as a result of the stresses associated with working remotely, and it is important to be aware of this fact. I should also note that it’s equally important to remain aware of it, as sometimes it can seemingly sneak up on you, or can even be a building phenomenon. While they can have a serious impact on mental health, these effects can also be very subtle, or happen within a dynamic and fluctuating range. The best idea if you start to notice that working from home is bumming you out, is to make some changes to improve your situation right away, because you don’t get extra points for spending more time miserable. Toward that end, next week’s blog will discuss some solutions to the issues I’ll be posing here today, along with the positive side of the remote work equation.

The Work Experience

Clearly, the actual experience of working from home is very different from doing so in a public office. But it also differs amongst each person who works remotely as well. On a basic level, the work experience is vastly different, because the quality of the home working experience largely depends on the home. Captain Obvious says it’s a much better experience for people that have dedicated rooms within their homes than it is for people in small apartments, or those who share homes, and therefore have to work in their bedrooms. Please note the five extra letters denoting the compound word- bedrooms– not beds, people. At any rate, companies must consider what they can do to help even that playing field a bit, if they want to improve productivity in a remote work situation for all of their employees. 

Tech No!

Another huge difference in the remote work experience comes into play when we talk about technology. When it doesn’t work at home, it’s a bigger problem than when that happens at the office.  One specific concern focuses on the speed of technology- or lack thereof- when working remotely. Most organizations demonstrated great agility in switching to remote working nearly overnight, but it’s common knowledge that technology never works as well remotely as it does in an office, where it’s laced together with high-tech cabling and hardware. Here in the good ole US of A, if our wi-fi drops out, we feel pretty indignant, but in some places on the planet, just getting a good enough signal to even access the internet can be challenging enough. It may not sound like a big deal, but internet connectivity is important, because it’s how technology talks. As a human, if you’re speaking with someone, and they choose not to respond for ten or fifteen minutes, or not at all, that would be frustrating, no? Especially if it happened all. the. time! All. day. everyday! That’s why connectivity is a big deal when working remotely; because the lack of it is very frustrating to humans, especially when we’re working. 

If you’re working from home and faced with problems with wi-fi or getting a decent signal, it’s usually a persistent and pervasive issue. Because it can extend timelines and destroy deadlines, it affects your everyday business, and sometimes can even affect your employment. All of that of course impacts your stress levels, so you can’t really afford to underestimate it. The short answer solution is that you have to do whatever you can to mitigate the issue. Communicate with your supervisor, if you have one, and call whomever you need to call to have the issue resolved. Captain Obvious says your supervisor has a vested interest in making sure you’re adequately equipped, because they want you to get your projects done too. Or build an office entirely out of wi-fi hotspots and boosters, and maybe wear a tin foil hat. You decide. 

No Ball

No matter where you are, if your computer decides it doesn’t want to play ball, forget feeling indignant, we feel screwed. If you’re from a conventional office environment, and now working from home, any tech problems you may have probably won’t get resolved as quickly off site as they would in the office, and unfortunately, that can make it difficult- even impossible at times- to work remotely. The time it takes the IT software and people to diagnose and fix any issues further disrupts processes and extends timelines, adding to everyone’s frustrations. That’s if you even have IT people, people. If you’re the IT department, president, and janitor, that makes it a little more frustrating, and time consuming, to solve tech issues. Because bringing the office home depends so much on remote technology, when you multiply networking issues by slow running apps and software, working from home can equal big tech stress. 

MicroManagement

But it’s not just IT that has a long road to hoe in the remote work equation. Management also has to make big changes if the remote work equation is going to balance, because you can’t manage people the same way if you’re not with them. If nothing else, ‘rona proved to management that most employees do have the capability to adapt to remote work, and fairly productively and effectively, to boot. But in reality, management and supervisors themselves have to adapt as well. For it to work effectively, they have to learn to trust and enable their staff, rather than interrogate and demand. One of the biggest complaints I hear from employees is that while working remotely, they sense an implied, or sometimes more direct, mistrust from supervisors and management. They feel like every minute must be accounted for, like they have to prove they were working during the day, not just watching television or doing their nails. That said, one of the biggest complaints I hear from supervisors and management types about working remotely, is that they suspect that their employees are taking advantage of a remote work arrangement. I wonder if maybe they suspect they’re watching television or doing their nails instead of working?

This dichotomy would be funny, if it didn’t have the capacity to be so inherently stressful and anxiety producing in all parties involved in the equation. I think the concept of how to manage a person you’re not watching poses interesting psychological questions. When you feel like you’re “losing control” over something, or someone, a natural human response is to grip it tighter; evolution has built that into our brains. In a remote work environment, when a supervisor can’t see what an employee is doing for eight plus hours every day, that equates to the dreaded micromanagement. And in the minds of the employees or people being supervised, that often comes across as suspicion, and can feel accusatory. Taken together, this tends to breed mistrust; and so the problem begins. If the problem sounds complicated, imagine the solution. Personally, I can easily see both sides of this issue, but I know that traditional management methods aren’t the answer to a modern remote work problem, and that for the equation to balance long term, we have to take big strides on the road toward improving the remote work experience for everyone.

Isolation and Loneliness

As I mentioned briefly last week, isolation and feelings of loneliness are among the most commonly reported issues that remote workers face. While working remotely has some benefits, like allowing you to effectively bypass distracting and/ or annoying coworkers, it also prevents you from sharing pleasantries with your boss, clients, and the coworkers you doenjoy camaraderie with. You miss out on the more social aspects of traditional work life, like water cooler venting, office gossip, and bouncing ideas off of one another. These interactions simply don’t translate to tech like Zoom very well, and this lack of interaction between coworkers can be a detriment to team building and corporate culture. In a prolonged state, such as occurs in a remote work environment, this disconnectivity contributes to isolation and loneliness in individuals, and is associated with higher rates of anxiety and depression, as well as somatic symptoms, such as headache and generalized body pain.

If you’re a person who is already accustomed to, and appreciative of, conventional office life, and the steady rate of social interactions at work, the effects of switching to remote work might have a surprising effect, because our daily interactions help us reinforce our sense of well-being and belonging in a community. Researchers have demonstrated that loneliness as a result of isolation is actually twice as harmful to physical and mental health as obesity. One study I read found that 19 percent of people who work remotely report loneliness; and as with many such conditions or feelings, this poses a bigger risk when it becomes chronic. As you can imagine, people who not only work remotely, but also live alone, are especially at risk for feeling lonely, though I certainly see a fair amount of it in digital nomads who live with others. 

Burnout

Working from home can also feel like never leaving work, and another commonly reported cause for concern is burnout. I read a 2019 US study that polled remote tech workers. It found that 82 percent reported feeling burned out, 52 percent reported that they believed they work longer hours than their in-office counterparts, and 40 percent reported feeling as though they were required to contribute more than their in-office counterparts. These points are very common themes that people considering remote work, and new to remote work, should definitely keep in mind. In my experience with patients, this near compulsion to work longer hours is almost universal. I assume it’s the result of attempts to prove their ability to be productive from home, despite the presence of distractions and the availability of “extracurricular” activities that can accompany working from home. 

For many people, it’s already difficult to maintain a healthy work-life balance when working from an office, and it seems that this is also the first thing to go when work goes remote. The lines start to blur, and every hour in a day becomes a work hour. If you’re behind on a project, you figure you can afford to spend the “extra” hours in your day on completing it. But not for long. After a much shorter period of time than you’d think, that becomes a dangerous practice. Five minutes for one more email becomes hours, and when you stop to look up, you’ve spent far too long working, and you haven’t moved for 13 hours. My response to burned out, remote workers is to remember that home is also your office now, so you’re not really leaving work unless you turn off all communication platforms. You have to make a concerted effort to leave work, just as you would if you worked in an office. So just as you would walk out the office door about nine hours after you walked in, when you’re working from home, you turn off the devices after about the same amount of time…or else risk the ravages of burnout. Besides, when you’re mentally and physically exhausted, you’re not at your sharpest, not doing your best work, and you’re bound to make mistakes. 

Focus, Motivation, Distraction

Any number of factors in a remote work situation can make you lose focus and motivation, and chief among them are distractions. These are the things, intended or not, that distance you from your work. But the reverse is also true. When you’re not focused and motivated, it’s easy to fall prey to the siren’s call of distraction. Remember last week, I said that just because the refrigerator is a short distance away, that doesn’t mean you should constantly make the trip? Eating can be a distraction you act on when you’re bored. If snack o’clock happens every hour, or you’re having multiple versions of lunch, you’re distracted, or maybe looking for something- anything- to do, other than work. When you’re working remotely, you have a lot of freedom, which is generally a good thing in life. But understand that distraction is really the blacksheep cousin to burnout, and it’s all too easy to get sidetracked by it. 

Some other favorite classic distractions include wanting to sleep in, kids, myriad chores, online surfing and social media, calling friends or vice versa, pets thinking playtime is whenever you’re breathing, and good weather tempting you to ditch work and go to the beach, mall, spa, movies, etc. It’s easier to become distracted because you may be the only one managing your time, and this is one of the big reasons why people may not be as productive at home as they would be in a traditional work setting. It’s also the biggest reason why employers and management don’t generally like the idea of working remotely. While it might seem that the only way to be a successful remote worker is to be a self starter with superhuman focus who is impervious to distraction, there are ways to manage distraction, focus, and motivation. I’ll get into all of that next week, but here’s a hint until then: having a door to shut is an incredibly helpful head start. 

Inconsistent Pay

Working remotely can also be stressful because of the inconsistent wages that may be associated with it. The term freelancing is the one most commonly used for positions of this type, though you may better recognize the alternative terminology of independent contractors. It essentially means that they are self-employed, rather than being directly supervised or employed by someone else; as a result, they typically follow a remote arrangement. No matter what you call it, when you compare freelance work to a regular full-time job, there are some important distinctions. In a regular job, you know that no matter what happens, you’ll be paid (at least) the same amount each month; and since you took the job, I can only assume it’s sufficient to cover whatever bills it’s supposed to. But with freelance positions, because getting paid is typically based on contracts and invoices, payments can be pretty variable, and you don’t have any guarantees that your invoices will be paid on time. If the payor is unreliable, or decides to dispute, you have to expend time, and sometimes even money, to collect. Understandably, these variables and unforeseen complexities can result in cash flow concerns, and we all know that can lead straight to stressville. Not only is income variable, but workload is too. The temporary, variable, too much or too little nature of freelance assignments is intensely anxiety producing, and can wreak havoc with your sense of well-being.  

Communication

Communication with coworkers, supervisors, and clients can be a minefield, as things can easily be misconstrued under the best of circumstances. In a remote work arrangement, when you often keep in touch through non-visual methods like email and instant messaging, communication is further complicated, and this can have some very unwanted effects. Fortunately or unfortunately, depending on how you look at it, the amount of damage that can result from ineffective communication falls along a spectrum, from “uh oh” to “oh no!” One big problem in general, not just in a work setting, that may serve you well to remember, is that you can’t really get a sense of a person’s tone via typed electronic communication, because they can’t read facial expressions or hear your tone of voice. To the recipient, words read the same way regardless of whether you were smiling or yelling when you typed them. I can’t tell you how many times I’ve heard a complaint from a patient start with, ‘And then he texted…’ because instant messaging, while convenient, can also be a recipe for instant miscommunication.  

In a work setting, most tone concerns have to do with accuracy; that the words you’re using are literally sending the right message. Do you have a tendency to be very lighthearted and positive, and therefore potentially at risk for sounding like perhaps you’re not serious enough about a certain topic with a client? Or maybe you have a tendency to be sarcastic and risk that same issue? You might be most vulnerable to this when the person doesn’t really know you, or in circumstances where you may be sending an instant message you don’t give as much thought to as you would a more formal email. As you might imagine, these are situations where the smiley face in cool shades emoji doesn’t really cut it. ?

Probably the most common communication issue I hear about is the lack of communication. Just as with the tech issue I mentioned previously, when a coworker is unresponsive, humans get frustrated. And understandably so. When you need an answer, but the person you need it from is uncommunicative via whatever digital channels you try, it can pose a problem. In the office, you could simply visit that individual’s desk and see them in person, but in a remote setting, that’s not an option. Since it’s work, you may have a deadline to complete a project, so not having that answer might make it late, and that may have a negative impact on your reputation. It can be a gnarly domino effect, I get it. But I can tell you that the answer is not to sendthem a message you may regret later, because chances are very good that’ll have an even bigger impact on your reputation, than the original lack of communication on their part would’ve had. 

Another thing to keep in mind when communicating electronically is not to set yourself- or anyone else for that matter- up for disappointment, by asking questions that really can’t be answered satisfactorily via these methods. If you’re seeking appreciation or other “feelings” on job performance in a text, you’re nearly bound to read disappointment in the reply, whether it was intended or not. Save the sticky wickets for more personal communication methods, even if they’re not necessarily the easiest choice. While some sarcasm or jokes may be funny, some people may not think so, and that can lead to all sorts of misunderstandings that can have a serious effect on company culture, productivity, team dynamics, and relationships with coworkers, supervisors, and/ or clients. Remember that nothing dies on the net, and everything leaves a digital trail, especially in a remote work setting, so things can come back to bite you later. Lastly, I would suggest that you always think twice whenever you instant message someone in order to avoid instant embarrassment and instant regret, proofread messages to make sure nothing’s getting in the way of what you’re trying to say, and save the complicated stuff for face to face when possible, or at least for video chat when it’s not.

Next week, the working remotely blog continues- I’ll address some solutions to all of the issues I mentioned today, and then I’ll tell you about the positive side of the remote work equation.

I hope you enjoyed today’s blog and found it to be interesting and educational. If you did, let me know. If you didn’t, let me know that too!

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As always, my book Tales from the Couch has more educational topics and patient stories, and is available in the office and on Amazon. 

Thank you and be well people!

MGA

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How you “Catch” Feelings

How You “Catch” Feelings

You’ve probably heard the expression “Smile and the world smiles with you,” or at least heard Louis Armstrong’s rendition of the song that refers to it, When you’re smiling, in the movie Analyze This with Robert De Niro and Billy Crystal- which, being a shrink, I of course found very amusing. Expressions don’t become embedded in the public’s consciousness for no reason, so where does this one come from? 

Maybe you’ve experienced a situation where “contagious laughter” has swept through a room, or even been the catalyst for it yourself, because of your “infectious laugh.” If you watch the news, you’ll eventually hear a reporter describe how “panic ensued” while covering certain events involving “mob mentality.” But what do these things really mean? How can feelings be shared or transmitted between people, even when they’re all strangers to one another? 

The answer is a phenomenon called emotional contagion, or EC, the subliminal process by which emotions are transferred from one person to another, such that the receiving individual experiences the emotions as their own. Living in a covid-19 world, we’re all too aware that it takes just a cough or a handshake to spread germs from one person to another, but you can “catch” feelings far more easily than you can catch covid, and far faster. The process takes just milliseconds, faster than the blink of an eye. EC is an important and primitive instinctual process that forms the basis of interpersonal communication, but don’t let that confuse you, that doesn’t mean it can’t or doesn’t occur amongst groups, because it absolutely does. I should note that EC can also be induced in people via some inanimate objects and cultural artifacts, such as photographs, movies, cartoons, and music. Think about crying at sappy movies or dancing in the car when your favorite song comes on. Not only that, but EC isn’t a “humans only” phenomenon; studies have demonstrated that it also occurs in all other primates, some birds, and it’s even been demonstrated in rats. 

To further the covid analogy, the “virulence” of EC and the susceptibility to EC vary by individual. That is to say, some people can be more effective at transmitting it, and some can be more prone to feeling its effects, i.e. susceptible, but everyone is essentially both to varying degrees. EC isn’t type specific, meaning that research has found that both positive and negative emotions- enthusiasm, joy, sadness, fear, and anger- are easily passed from person to person, typically without either party being aware of it. You can be going about your business, feeling whatever you’re feeling, and have an encounter with someone doing the same thing; then afterwards, you feel differently, for reasons that you can’t specify. That can be a bad thing or a good thing, depending on a number of factors that I’ll get into. So apparently Forrest Gump’s mama was right… life is like a box of chocolates- you never know what you’re gonna get. Covid and chocolates- it’s a mixed metaphor day, people. 

How Emotional Contagion Happens

At the most basic level, it works like this: if someone is happy and smiles at you, it tends to cause you to smile back, and that act of smiling back actually improves your mood and causes you to feel happier. But how and why? You might’ve noticed I’ve said that EC is a process; in fact, it involves three stages: mimicry, facial feedback, then contagion. 

As people communicate, they express themselves not only through language, but also through gestures and facial expressions. Throughout a communication exchange, individuals constantly read each other’s faces and body language, then instinctively and unconsciously tend to reflect it i.e. copy it; that is called mimicry. When a person then displays the emotion on their face through mimicry, those muscle movements trigger the actual feeling associated with the emotion, and they then get a subjective experience of that emotion i.e. they start to feel the emotion as their own, which is sometimes referred to as adoption. This is because the area of the brain that is activated through the unconscious act of mimicry is the same area that normally would’ve been activated if the person had initiated and performed the action themselves. Same area of brain activated equals same response, regardless of the catalyst for the activation. Handily, this phenomenon is explained by “mirror neurons” in the brain. These neurons fire whether an individual initiates the act themselves, or observes the act being performed by another individual. So the act of mimicry causes the observer’s neurons to fire, and thus “mirror” the activity of the first person’s neurons. It’s sort of like monkey-see, monkey-do for neurons. 

When you put all of the stages of the EC process together, it works like this: when someone is happy and smiles at you, you will typically smile back (mimicry) and that act of smiling back actually improves your mood (facial feedback) and ultimately causes you to experience that happiness as your own feeling (contagion). 

Role of Emotional Contagion

Humans are social beings. We are born equipped with the evolutionary capacity of EC to help synchronize our emotions and express our wants and needs. A simple example would be a newborn baby crying to be fed because it’s the only way they know how to get food from their caregiver. When they cry and are then fed in response, it reinforces the mechanism. In this way, EC acts as a primitive tactic that continues to develop, and later assists in the recognition and processing of feelings, and a cumulative understanding of how to deal with them in an appropriate manner.

Emotional contagion contributes to empathy, and there is a direct correlation between the two. In other words, decreased sensitivity to the EC results in a decrease in empathy. They are also linked by the fact that both involve the monkey-see, monkey-do mirror neurons, but they are not technically the same thing. Empathy is the capability to share and understand another’s emotion and feelings that is often characterized as the ability to “put yourself into another person’s shoes,” in an effort to experience what the other person is feeling. But it is a conscious choice, so you know the source of the emotions you feel. In contrast, EC is an automatic, subconscious and subliminal process, generally mediated through mimicry of facial and/ or vocal expressions, whereby your feelings or emotional states are influenced by those of another person, such that you experience, or adopt, those feelings as your own. This is also termed emotional convergence or synchronization, and the source of the feelings is typically unknown, and often unexamined.

Scientists agree that there is an emotional climate and culture that tells us which emotions we should or should not display and when. Our understanding develops over time, and guides us in making behavioral decisions according to what is and is not socially acceptable. Imagine that you somewhat reluctantly made plans with an acquaintance, but then they see you and tell you they need to cancel them. Inside, you may actually feel some sense of relief, but instead, you noncommittally say, “Well, that’s too bad, but okay.” On the other hand, if you are insensitive to EC, and therefore are lacking empathy, you might say, “Phew, because I didn’t want to go anyway.” But because you realize that saying that would probably hurt the person’s feelings, and/ or would make you look like a cad, you respond appropriately. This is an example, albeit an extreme one, of how EC allows you to instinctively know what is appropriate, and alter your response and exhibit the correct emotional behavior to maintain success in relationships. In fact, because the automatic processes of EC happen so quickly, you have the ability to change your reply on the fly, even mid-sentence, based solely on the other person’s emotional response as communicated by their facial expression, in order to avoid a social faux pas. All brought to you, in a matter of milliseconds, courtesy of emotional contagion. Which gives you an idea of how important it is in avoiding problems and. 

Factors Influencing Emotional Contagion

As I mentioned in the beginning, some people can be more effective at transmitting emotional contagion, and some can be more susceptible to its effects, but nearly everyone is affected, albeit at varying levels and times. There are many factors that influence susceptibility to EC; most of them essentially boil down to the common bases of individual differences, such as age, genetic predisposition, personality traits, gender, and early emotional experience. But it has also been found to vary between interactions, based on the type of interaction, intensity of the expressed emotion, mood at the time of the interaction, and the level of empathy and power dynamics between the individuals involved. All of these influence the intensity of the contagion and have an impact on how likely a person is to “catch” an emotion. 

But in fact, you don’t really have to guess how susceptible you may be to EC, because there is an accepted way to accurately measure it, called The Emotional Contagion Scale. Designed in 1997, it takes the form of 15 questions that measure individual differences across five basic, cross-cultural emotions: love, happiness, fear, anger, and sadness, by determining how likely a person is to mimic those emotions. I’ve included the scale and scoring instructions at the end of this blog if you’re interested in taking it. In the meantime, I’ll continue with the factors that tend to influence EC. 

Some personality types generally have greater awareness of emotional states, their own as well as those of others, and are therefore more open to the process of emotional contagion in general, in both transmitting emotions to, and receiving emotions from, others. They are also generally more sensitive, attentive, and skilled at reading non-verbal cues. 

Other people who are more expressive, meaning that they wear their hearts on their sleeves- and their faces- may be more likely to transmit or share their emotions because they telegraph their feelings more powerfully. Not only that, but the more expressive someone is, the more likely another person is to notice that expression and mimic it. And remember those mirror neurons? They come into play here bigtime, because when that emotion is reflected through mimicry of the associated facial expression, those muscle movements trigger the actual feeling in the brain, brought to you by mirror neurons. On the other hand, people who have a stronger internal response to emotional events- whose hearts may race when they’re nervous, even if they seem calm on the outside- may be more susceptible to catching other people’s moods. 

EC is also influenced by the level of intimacy, and therefore empathy, between the individuals involved. People who know one another well and are in frequent contact are typically more affected by EC; this is generally true whether they are the transmitter or receiver. Have you ever found yourself tearing up when you see someone else crying? It’s perfectly fine if you have, and can even be considered a very good sign in relationships where it serves as an indicator of the level of emotional investment. It is more likely to happen when the person crying is someone close to you, such as a spouse, child, parent, or close friend. In fact, studies have shown that emotional convergence occurs more often in relationships that are more cohesive and less likely to dissolve. Not surprisingly, people living under the same roof are especially likely to catch each other’s emotions and moods, as they are the types of relationships where individuals tend to become more similar in their emotional responses.

That said, studies have shown that mere acquaintances, or even strangers, can catch each other’s moods, though the degree to which it happens does depend more on their individual susceptibility. But if you bump into someone in your neighborhood while getting the mail or taking out the trash, and they smile and just say hello you, they can make you feel a mood boost. Or if you’re in the elevator in the morning on your way to work, and someone is impatient and grumpy because the door opens to let someone new on board, they can easily influence your mood, even if no words are exchanged. Normally that’s not amusing, but loyal blog readers may be chuckling if they recognize that as a little DISC humor from last week. If you don’t know what on earth I’m thinking right now, read last week’s blog on the DISC model, because even this instruction is laced with it! 

Researchers have also found that language and word choice drives some part of the contagion process, as negatively charged words, i.e. strong language, like “hate,” “worthless,” “anger,” and “sad” are more likely to increase susceptibility to the emotion being conveyed. So strong language generally induces a stronger EC response, which isn’t always great news. There’s enough of that in the world, no need to propagate it. 

We’ve learned that age plays a role in influencing EC. Scientists very recently published research describing how the moods of teenagers were affected by those of other teenagers around them. If you’ve ever raised a teenager, this definitely resonates; but more not-so-great news, bad moods were more potent. They also found that when a teenager “catches” a bad mood from a friend, the friend’s outlook becomes more cheerful. That’s a very interesting finding with very mixed news- good for the friend that’s transmitting, but bad for the person that catches it. So much for sharing means caring… more like take this away and don’t stay! Remember that I’m a shrink, not a poet, people. 

EC is influenced by gender as well. I should preface this by saying that the relationship of gender to emotional contagion can be a pretty thorny one, as it’s a complicated issue. You’ve probably noticed that I used the word “appropriate” to describe the ideal effects EC has on the expression of emotion, i.e. behavior. The issue is that behavior is often governed by cultural rules which actually vary according to gender; that makes it difficult to make hard and fast “rules” about which gender “should be” expressing which emotion(s), and how and to what level it “should be” expressed. Using a purely theoretical example, women “should be” nurturing caregivers, so they are more susceptible to EC. In other words, it’s super biased, sexist, and constrictive.

Probably as a result of this issue, the research into gender differences in EC has had mixed results. An early study hypothesised that because women were more emotionally expressive than men, they would be more susceptible to catching emotions; and indeed, the results from the EC scales of the participants confirmed this. In contrast, another study found that there were only minor differences between men and women in their experience of “caught” emotions. However, it also found that both men and women had a stronger emotional response when the emotional model used was female rather than male. Still another study found that gender differences came into play when the expressive model was displaying a threatening emotion, such as anger. They found that women responded to the angry faces with more expression, whereas men suppressed their emotional expression, and some even displayed a tendency to smile in response. The scientists hypothesised that this was due to the effect of socialization in the expression of emotion, with women being more likely to attempt to communicate their distress and men more likely to mask or suppress it. This is consistent with the concept of hegemonic masculinity, which is shrink speak for having stereotypically male dominant traits. Yet another study examined moods, before and after pairs of friends talked about multiple predetermined topics. It found that, after talking with a troubled friend, women’s moods were more likely to deteriorate in general, on both sides of the contagion equation (hey, maybe I am a poet) but men’s moods were far less changed, regardless of whether the troubled friend’s mood improved or not. 

Regardless, all of the differences in these studies can only be interpreted as confirmation of the fact that cultural and behavioral “rules” are actually responsible for the mixed results and ensuing confusion when it comes to attempting to define how gender affects the expression of EC. And that’s pretty much what we figured, right? So now you know for sure.

Emotional Contagion: Practical Applications

Captain Obvious says that if you’re unhappy, being able to adopt the emotions of a happy person may allow you to feel better and more motivated. And clearly, a positive mindset helps you feel less stressed, which has a positive impact on emotional and physical health. By now you know that this phenomenon helps people connect on a basic emotional level, but EC also has some less obvious practical applications and implications as well, and some of these are an argument for how it can be developed as an intentional tool. In fact, some people subscribe to a broader definition of the phenomenon of EC as “a process in which a person or group influences the emotions or behavior of another person or group through the conscious or unconscious induction of emotional states.” I can appreciate the value of applying EC as a tool to motivate others, but I don’t appreciate it when it’s used as a tool to manipulate others into serving personal interests. First I’ll talk about the positive applications and implications of EC, then I’ll address the less than positive. 

Humans generally want to be accepted and understood. To that end, it’s beneficial to know what other people are thinking, if they agree or disagree with you, if they’re understanding what you’re attempting to convey, and whether or not you’re connecting with them on a very basic emotional level. In a way, EC is sort of like a very primitive form of mind reading, as it gives you an idea of what another person is thinking, and therefore feeling.

EC is important to personal relationships because it fosters emotional synchronization. If you want to connect with a person on a deeper level, you want to be “in sync” with them, the euphemism derived from the term, and awareness of the phenomenon can give you an idea of whether your attitudes and beliefs are sympatico with another person’s.  

EC can be developed as a skill for use as a tool for effective communication, and therefore one that would be especially important for public speakers and trial attorneys, and people in motivational type positions like sports coaches, among others. Think about listening to a lecture where the presenter is dynamic and expressive, and clearly believes what they’re saying; then contrast that with a presenter who is monotone, slumped over the podium, not moving, and clearly disinterested. Same idea goes for the coach or captain of any team. If one is animated and motivated and obviously believes and expresses that you’re a valuable and capable player, and that your team will win, will that be more effective than one that is totally unmotivated and seems unconvinced that the team is up to the task? Who would you be more inclined to listen to and believe in either of these situations? Even Captain Obvious says that the answers are so clear that they don’t even require responses. 

EC has survival value as well. It has been conserved, developed, and reinforced throughout human evolution, which doesn’t tend to keep unnecessary processes. In fact, evolutionarily speaking, EC has evolved, in part, to ensure survival. The brain is hard-wired to keep you safe, and that’s one of the reasons it’s especially attuned to pay more attention to negative emotions like fear and pain. Speaking of which, let’s talk about a real world example of EC’s survival value. Imagine that you were on a plane, and (heaven forbid, but just go with it people) there was some emergency; you may not know how serious the situation is or how concerned and prepared you should be, but by paying attention to the emotions expressed on the faces and in the voices of flight attendants and the pilot(s), you can infer signals that may be critical to your survival. Like when to assume the crash position. I say early… very, very early. Like maybe immediately after boarding. Jk, people.

EC can also be useful in work settings, but only when the moods swing the right way. Numerous researchers have found that when business leaders are in a good mood, members of their work group not only experienced more positive moods, they also experienced fewer negative moods. Studies have also demonstrated that groups with leaders in an upbeat mood were more coordinated and actually expended less effort on tasks than groups with more downbeat leaders, which made them more efficient. But keep in mind that this is a double-edged sword, and a co-worker’s or boss’ bad attitude can spread quickly through a company and create a toxic environment for everyone.

Emotional Contagion: Conscious Strategy

We’ve just discussed how EC can be used as a positive tool, but as I mentioned, EC can also be used as a strategy for… let’s say, potentially less altruistic means. 

Emotional Contagion in Marketing

Because it influences thoughts and feelings, EC results in changes to mood, emotions, and behaviors; and studies confirm that this includes consumer behaviors. This was verified by setting up experiments that videotaped participants’ facial expressions before and after exposure to specific photographs. After analyzing the changes in the expressions, these studies concluded the following:

-Participants who saw a smiling model in an advertisement mimicked the picture, smiling back, therefore confirming the process of CE.

-The positive emotion conveyed by the facial expression was also associated with a positive evaluation of the product displayed in the advertisement. 

Therefore, as expected, the advertisement with a positive expression of a smiling model elicited a more positive attitude, sympathy, and increased perceptions of reliability and intentions to purchase, as compared to the neutral condition before the photograph was shown. In other words, if an advertisement can make you smile, laugh, or stimulate EC through any positive means, you will feel more positive about the product that the advertisement features. It will make you believe that you need that product, it is the best, better in every way when compared to similar products; and it will do that as if you thought these points yourself, thanks to the monkey-see, monkey-do mirror neurons. 

Advertising and marketing execs know this and use it. I’m not saying that this is good, bad, right, or wrong; I’m just saying that EC is purposely used as a tool by employing advertisements that feature cute and cuddly babies, beautiful women in bikinis, hunky men in uniforms, and whatever imagery execs think will elicit a positive response, to sell you a product that you may or may not need, and that may or may not actually be as awesome as you might (literally) be led to believe. So be aware. 

Emotional Contagion in Dating

Remember how I used the words “less altruistic” to describe some of the ways EC can be used as a strategy? Well, for this particular application, I’m going to replace those words with “morally reprehensible.” And I suspect many of you will agree. There’s a guy that developed what he calls a “method,” (I use quotation marks because it isn’t actually a method) for men to study and apply EC in an effort to manipulate women into “dating” them (which is actually just a euphemism for having sex with them), and all for the “low, low price of” (my best announcer’s voice) of whatever over-inflated amount he charges for it. 

There are so many faults in this that I almost don’t know where to start. First, given my profession, I find it especially deplorable that a person would intentionally manipulate someone else’s feelings just because they can’t manage to get a date, i.e. have sex, with someone any other way. That said, my views on this would remain the same if I were a garbage man. And, it does bother me that this guy is so sexist that he clearly can’t even envision, much less appreciate, the fact that he developed a program “for men to get women,” and clearly doesn’t recognize that men can love men and women can love women; not that any program like this should exist, regardless. Also, not for nothing, but the light that this casts the users of this “method” in isn’t flattering at all. Helll-ooo, desperation. And that has to be considered, because I can almost guarantee you that eventually, your target will find out that you’re using psychology to manipulate them- which won’t make them very happy- because this program is fake. 

Speaking of fake, who wants to be fake enough, in order to manipulate people long enough, to get them to sleep with you? And people with even an average amount of awareness can usually sniff out fake like two week old fish, because that’s what fake- and this program- smell like. And if your potential target didn’t have enough awareness before reading this blog, they certainly will after. So the solution to this problem is to share this blog and spread the awareness, people. 

Unfortunately, I’m sure that this may cause some of you to want to try to look it up, even though I haven’t given you the name of this program. I say unfortunately, because I don’t want this guy to get any more credit than he already has; and because regardless, you’d be wasting your money. I can save you that, plus a lot of time and fake energy, and tell you that it won’t work, for any number of reasons. I can even make an alternate suggestion if you’re lonely enough to consider paying for something like this “method” which isn’t a method. Why don’t you use that money and make an investment in yourself, see a psychiatrist or psychologist and try to find out why you might not be attracting whatever person you want to be with, because I can say with some authority that attraction really starts with you, so you have to know yourself to attract other people.

I’ll even help you out here and now and tell you that, of the six factors that influence attraction, the most important psychological factor is reciprocity, which basically means that you are more likely to like someone who likes you. Some of the other factors that influence attraction are things like familiarity and similarity, which- guess what- also depend on you knowing yourself. So I suggest you get to know more about you. The very worst that could come of it is that you gain some perspective and some self esteem, and that’s half the battle won. 

I apologize if my opinion is too clear, or offends anyone, but everyone has people they care about- friends and family- and most people wouldn’t want them to be manipulated and conned in this way, just to serve someone else’s purposes. That perspective is empathy at work, by the way, and hopefully it’s contagious. Maybe this guy and his “method” upset me so much because I expend such a huge amount of time and energy undoing the damage caused by manipulation. Just a theory. Anyway, moving on to slightly less manipulative applications of EC as a strategy.

Emotional Contagion in Digital Interactions

Emotions can even spread through all of our digital interactions, because EC doesn’t rely solely on visualizing facial expressions; it can also be influenced by emotions that are implied via language and word choice. All digital interactions are subject to EC, including text messages, emails, instant messages, and most importantly, social networks. It’s the most important because the moods are propagated i.e. spread to, and influenced by, the mood of your friends, that of your friends’ friends, and their friends’ friends, and so on. This has been demonstrated by one study that looked at online social justice movements, and which found a demonstrable “amplification effect,” wherein people more frequently liked replies that were actually more emotional than the original message posted. This would be a very effective method for propagation, because again, language and word choice play a role in the contagiousness of EC. But that’s another double-edged sword.

And speaking of social network studies, one dominant social media site, whose name rhymes with placelook, conducted a particularly controversial study that came to light in 2014, when scientists published a paper revealing that, in 2012, researchers (who were also employed by the same social media site by the way) conducted a study into EC. In the study, they surreptitiously altered the news feeds- the main page that users land on for a stream of updates from friends- of nearly 700,000 users. Feeds were changed to reflect more “positive” or “negative” content, in order to determine if seeing more sad messages makes a person sadder. My response: duh. 

After analyzing more than 3 million posts, the team found that people exposed to fewer positive words made fewer positive posts themselves, whereas those exposed to fewer negative words made fewer negative posts. In other words, you are what you feed, not what you eat, on placelook. The experiment also demonstrated that personal interaction and verbal clues weren’t necessary for emotional contagion. It’s worth noting that both of those things had already been discovered from separate studies, designed and conducted by different researchers, one of which found that the very existence of feeds was making some users sadder. So basically, now we are absolutely sure, as if we didn’t know before, that placelook can manipulate your mood, which does affect your perspective, what you buy, why you buy it, whether you vote, how you vote, and pretty much everything else in your life. It certainly has the biggest effects on how you interact with your social media friends, especially after your news feeds are altered… helll-ooo!!  

If you’re wondering about permission, here’s the scoop on how news feeds were surreptitiously tweaked without warning: placelook users agree to the social giant’s general terms of data use when they create a profile, and researchers tracked emotional responses of test subjects by judging any subsequent changes in their use of language, which is covered in those terms. It’s unclear if you, or I, were tested, and it will remain that way. Ultimately, as users, the check-box agreement gave permission for this kind of psychological experimentation.

I should add something. One reporter that had been aggressively following this story for Forbes got a response from placelook, which stipulated that, “…the research was conducted for a single week and none of the data used were associated with any specific user.” They further explained that they do research to make the content “…as relevant and engaging as possible” and that, “a big part of this is understanding how people respond to different types of content, whether it’s positive or negative in tone, news from friends, or information from pages they follow. We carefully consider what research we do and have a strong internal review process. There is no unnecessary collection of people’s data in connection with these research initiatives and all data is stored securely.”

One last note on this topic: another reporter had apparently spoken with the editor of the placelook study, who is also employed by them, and she reported that even they thought the mood study was creepy. I agree, and I also think that, when it comes to studies, placelook may not know exactly what they’re doing, but they definitely know what they have the power to do, and what a platform with access to the personal interactions of more than a billion users can do. And now I’ve said all I’ll say about the placelook study controversy.

When it comes to the ways emotional contagion can be used as an external tool, potentially on- or against- you, the take home message is be aware and beware.

Emotional Contagion: Final Thoughts

With any luck, people catch all the positive emotions, a colleague’s enthusiasm for a promotion at work, or a friend’s excitement over an engagement, and miss the negative ones. But what goes up must come down. Research suggests that just being around someone who’s stressed can increase your own stress levels. Other studies have found the same to be true for depression. Negative emotions, like sadness, fear, pain, and anger, are more contagious; and on top of that, they can be damaging to your overall health, as they can lead to sadness, depression, fatigue, decreased energy, and stress. Ultimately, negative states of mind may increase the risk for heart disease and other serious health issues over time. You’d think that with such negative impacts, people would always stay away from those who emit negativity. But it’s not that simple. 

While the idea of making yourself impervious to other people’s emotions may be appealing, putting up an emotional barrier isn’t the answer. This is because the cost of it is the loss of empathy. You have to consider that shutting out other people’s dark moods precludes you from catching their good ones as well. So how should you respond to negativity? 

First, consider this: research indicates that people can catch something that isn’t actually there to begin with, for the same reasons why EC confers survival value. Because we are wired to pick up on threats in the environment, we are susceptible to interpreting situations negatively. In addition, humans tend to create our realities in accordance with our beliefs, so if we go into an ambiguous interaction believing the worst of someone, we tend to act in a way that makes the other person more defensive, or worse, antagonistic; and this confirms our original view. The lesson is that reality is what you make it, so try to make it positive, even if it seems negative.

Since you can’t- and shouldn’t- shut out all negativity, what can you do to regulate it, while still ensuring that the positivity comes through loud and clear? There is some strategy involved in managing this, and like EC, it’s a skill you can work on. Take some time and reflect on your own emotional state. 

Now we know how easily so many things can affect our mood, and then affect the moods of others, without us even realizing it. Below are some tips to manage EC if you think your moods “infect” others negatively, or vice versa, and some ways to do yourself a favor when they do.

Awareness is Key

When you become aware of the emotions you exude toward others, it helps you recognize when you’re picking up on the negative or positive emotions of others; this will allow you to create change if needed and protect your own emotional well-being, as well as that of the people around you. Take care of yourself when you need to. If you feel exceptionally stressed, first remember the possibility that you may be feeling something that’s not actually there. If you find it is actually there, then proceed with management. 

Seek Professional Guidance

If you find that you’re more aware or sensitive to the moods of others, you can always evaluate those relationships and those triggers. Talking with a trained professional can help you in thought pattern recognition and guide you into healthy coping skills to ward off EC.

Create Your Happy Place

Surround yourself with things that make you happy. You’re less likely to succumb to someone else’s bad mood if you keep your surrounding environment full of things that bring you joy. So create your own personal happy place, at home and at work, that can help you if you start feeling like you’re coming down with a bad case of negativity. Bring in plants, put up photos of your pet, partner, children, and friends, and listen to your favorite music. 

Accentuate the Positive

Incite radical acts of positive contagion: play upbeat songs on your way home if you’re stressed, like on the way home from work. Find proactive ways to boost your moods, and those of loved ones will increase as well. If you don’t want another person’s negativity to affect you, try turning the tables by smiling and trying to keep your voice cheerful. This not only helps you feel more positive, but the other person might also mimic your body language and catch your mood, making it a win-win situation. 

Laugh

When you feel negativity creeping in, share a funny video, tell a good joke, or enjoy your favorite sitcom or movie for a boost of positivity. Just like offering positivity, laughing can help improve your mood and relieve stress, and it can also spread to people around you.

Engage

One of the best ways of avoiding contagion with people who are down is actually to engage with them. Do things with them that will lift both their mood and yours, like taking a walk, sharing a meal, working out together, or just being generally supportive and talking through things. 

It’s Not Personal

People have their own issues and they have nothing to do with you. Don’t encourage or even engage with bad behavior, or anything else that doesn’t feel right, and that includes online. Bad behavior breeds bad behavior. If you send out calm, positive signals, you are more likely to attract the same, and less likely to attract the opposite.  

Not Changing

Remember that changing the behavior of an adult who thrives on negativity is typically very unlikely to happen, and the attempt can wear you out, especially because you’ll find you’re doing it over and over. If you’re dealing with an angry boss or an anxious father, always remember to take time for yourself to think the situation through before engaging and trying to convince people to change their bad behavior.

Control Yourself

When you’re in a bad mood, there are also ways to avoid infecting other people with your negative emotions. They all boil down to one central theme: control. Realize that you have the power to “infect” a room via contagion, especially in your own home, and use that as an incentive to keep emotions in check and safeguard your colleagues, neighbors, and loved ones from your negativity.

Inoculate

We know what inoculation means, so try to do that first to make yourself less susceptible to bad moods that you can easily pass on to others. This includes the basics, like getting adequate sleep, eating well, exercising, and cultivating a sense of purpose.

Cope

Compartmentalizing can be useful in managing the effects of EC. You might think you have every right to be cranky, but if you consider how it can infringe on other people’s rights to exist in a content state, you might find it easier to set aside your negative thoughts and emotions. So shelve the bad mood when you know you’ll be interacting with other people. You can always choose to wallow in your negativity later, in private.

Feedback

Show some emotional awareness by asking a long-term partner, or someone else you trust implicitly, for input on whether you’re giving off negative vibes too often. If so, work to regulate your sadness, anger, and anxiety through therapy or mindfulness, or by modifying your expectations or looking at the situation from a different perspective.

Quarantine

If you’re particularly irritable, consider isolating yourself. We’re all familiar with this one. You might be better served by watching happy movies or going to bed early.

Ask yourself some questions:

-What types of emotion do I give off and how does that affect the people I interact with, my family, roommates, spouse, colleagues, etc?

-How easily do I let others affect my emotions? Am I even aware when it’s happening? 

-Are the people in my social networks the type of people I really want to surround myself with?

-Whom do I feel my best around? 

-Who reinforces my strengths and best qualities? 

-With whom am I the best version of myself?

-Are there actions or changes I need to make?

Keep in Mind:

-You aren’t responsible for the feelings of others, only your own.

-You may not be able to help other people, but you’ll never be of much help if you’re not feeling well, either. You can always take the time to help yourself, and you’re absolutely worth it.

-People usually share their experiences in the only way they know, and this is especially important to remember when they’re depressed. 

-Check out the Emotional Contagion Scale to see how vulnerable you are to catching and adopting the feelings of others.

The Emotional Contagion Scale 

This examines a person’s tendency to mimic five basic emotions: sadness, fear, anger, happiness, and love. 

If you want to take it, forget everything you’ve just read- temporarily, mind you- and remember that there are no right or wrong answers. Read each question and choose the answer that best applies to you using the key below. Scoring interpretation instructions are at the end.

4 = Always; 3 = Often; 2 = Rarely; 1 = Never

1. If someone I’m talking with begins to cry, I get teary-eyed.

2. Being with a happy person picks me up when I’m feeling down.

3. When someone smiles warmly at me, I smile back and feel warm inside.

4. I get filled with sorrow when people talk about the death of their loved ones.

5. I clench my jaws and my shoulders get tight when I see the angry faces on the news.

6. When I look into the eyes of the one I love, my mind is filled with thoughts of romance.

7. It irritates me to be around angry people.

8. Watching the fearful faces of victims on the news makes me try to imagine how they might be feeling.

9. I melt when the one I love holds me close.

10. I tense up when I overhear an angry quarrel.

11. Being around happy people fills my mind with happy thoughts.

12. I sense my body responding when the one I love touches me.

13. I notice myself getting tense when I’m around people who are stressed out.

14. I cry at sad movies.

15. Listening to the shrill screams of a terrified child in a dentist’s waiting room makes me feel nervous.

The highest possible score is 60, and the higher the score, the more susceptible you are to emotional contagion. 

I hope you enjoyed this blog and found it to be interesting and educational. If you did, let me know. If you didn’t, let me know that too!

Please feel free to share the love! Share blogs and YouTube videos with family and friends. 

Be sure to check out my YouTube channel with all of my videos, and I’d appreciate it if you would like, subscribe, and share those vids too! 

And if you like what you see and want more of it, or if you want a specific topic, leave it in the comments- I love reading them! 

As always, my book Tales from the Couch has more educational topics and patient stories, and is available in the office and on Amazon. 

Thank you and be well people!

MGA

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How To Interact With The Mentally Ill

How to Interact with the Mentally Ill

The purpose of this piece is to help the reader how to interact, both verbally and nonverbally, with people with mental illness; and as a corollary, how to get them the help they need. It’s basically a list of do’s and don’ts that I have compiled in my head over many years of seeing patients and dealing with their loved ones… becomes sometimes the former are far easier to deal with than the latter. Anyway, I’m constantly asked, “What do I do? What do I say?” Well, here is the answer to those.

Look, I understand that it’s very difficult when a loved one has a mental illness. A lot of issues come into play; a lot of balls in the air. So learn to juggle. Please understand that in some cases, logic no longer applies here, because when the mentally ill person is your child, your sister, your brother, your mother, your father, the rules don’t apply anymore; the book is out the window. But yet without it, you still have to figure out how you can help them while also respecting them, maintaining their dignity, and helping them to seek effective treatment. There are always degrees of everything. Some patients may be very independent and autonomous and need little help, and some may require a lot of help to get through their days. For the tougher cases, it may be easy to say, “Oh, just send them away to the hospital,” but that’s not how it this works. If you love them, that’s exactly what you don’t do. No finger snap and off they go, no fuss, no muss. Do be prepared to get appropriately fussy and mussy when, and if, necessary. It may not be necessary. But it may be. 

Denial. Nope. You no longer have this luxury. Don’t pretend that they don’t have an illness. This is one of the most common issues that I see, families and friends sticking their heads in the proverbial sand. “He’s just eccentric!” Ugh, how I hate that word. No. Running naked across the Brooklyn Bridge while chased by half of the NYPD is not eccentricity. It is not a statement. It is not a personality quirk. And turning a blind eye is nothelpful. Loved ones that continuously make excuses for unusual, inappropriate, and/ or dangerous behaviors just allow the illness to flourish, a pretty word for get waaaay worse. I’ve seen too many depressed people make multiple suicide attempts and still not get the help they desperately need. Psychotic people walking around the neighborhood arguing with people only they see, and still the families don’t intervene, because it’s their loved one. They don’t want to interfere or take away that individual’s rights. In the United States, sometimes it’s not until the police finally arrest the person that they are offered help. But a lot of times, not even then. Families make excuses for a lot; too much, really. We live in a system where it is very difficult to give treatment to someone who doesn’t want it. The laws are very weak in terms of forcing people into treatment. So what happens far too often is that these people end up self-medicating with illicit drugs, living on the street, and suffering all of the consequences of being mentally ill without a place to turn to. And if you’re thinking that couldn’t happen to your loved one, you’d be taking a gamble there. Sadly, I’ve had patients belonging to some very wealthy Palm Beach families that managed to find their way from society to sidewalk, just because people were in denial, turned a blind eye, didn’t want to infringe, made excuses, whatever the case was… the end was still the same. If the person in question is a friend, or for some reason you don’t feel it’s your place to discuss treatment with them, then find out who you should talk to, and do so. Also, consider that you might be the only person in a place to see or know what’s really going on. You may be the one who has to make the difference for them, the one standing between them and help. So no denial, no blind eye, no excuses. If you love them, you have to face the issue head on in the appropriate way. It’s the only compassionate thing to do, and the most compassionate thing you can do. 

Get some stick-to-it-itiveness and give some hope. Tell your loved one that they can get better, that treatment is available, and that better days will come. And once you do establish a treatment regime, good follow through is very important. Dounderstand that treatment can take years. It could even be a lifelong kind of deal. It won’t always be hectic and scary, a rollercoaster of loop de loops. Truthfully, it might even get monotonous, this appointment, then that one; this med, then that one. But I can tell you that once you find the right regime, if you stick to it, it will be rewarding. Just be supportive and keep standing by them. It may not always be the easiest thing ever, but it may well be the most rewarding thing ever. 

Education is more than a do, it is a must. Everyone, the primary caregivers, ancillary caregivers, friends, families, associates, everyone should become educated. And as I said above, always instill hope and be supportive. This can and does get better. Be willing to help this person from A to Z, whether these things are obvious or not: to seek help, to help make their appointments, to make their appointments if they can’t for any reason (and yes, sometimes this is hard for them to do), to get to their appointments, to get to the hospital, to get to the day program, to get to the intensive outpatient program, to get to detox, to get to the treatment center, to the ER, wherever or whatever or whenever they need help.  

Always express genuine concern.  It is critical. They have mental illness, but that doesn’t mean they are stupid.  They see through bull#%*£ as easily as you do. If they sense fake concern, they will assume that they’re a burden, you just want to get rid of them, or just want to shut them up. Captain Obvious says that this will be a blockade to their progress. I say that this could be the last blockade of their lives, and not in a good way. You never know when someone is at a tipping point. If you love them, do be honest, caring, and honestly caring. 

Share “simple” insights. I use quotation marks, because sometimes what is simple to you may not be so simple to the person with mental illness. Depressed people may not be able to discern what’s good for them, or may not care what’s good for them. Daily activities tend to fall by the wayside when a human brain is contemplating if it’s worth it to live to see tomorrow, so they may not care what they’ll smell like tomorrow, or if their hair is combed and teeth are brushed tomorrow. It’s not uncommon for ADL’s (activities of daily living) to not make the to-do list. If you note this, do address it, but it’s important to do so in a specific way. Always be gentle. You don’t want to be mean or make them feel any shame. You can say “Maybe you want to take a shower today?” or “Would you like me to run a bubble bath for you? I bet you would feel great after you relax in a hot bath; I know I always do.” Do this in as gentle and open a tone as you can. Or if they’ve made a big mistake on something consequential, “Maybe it’s best to check your oil levels every few months, just to avoid any problems. We could even put it on the calendar if you want” or “I understand you’re upset that you failed your test (or burned the cookies, broke a vase, lost a jacket) but it’s not the end of the world and you’ll do better/ know better next time. Don’t make a mountain out of a molehill, and don’t ever yell or chide them. They have feelings just like you do, but they may not have the capacity to take things on the chin like you do. Obvi they don’t want their car to be overheating, or a failed test, or burned cookies, and they’re probably already giving themselves a hard enough time as it is. There may be situations where inappropriate behavior related to their illness might have consequences from others, ie they may accuse someone of acting against them due to paranoia, eliciting a negative response. Or, maybe they’ve dressed a certain way and they’re made fun of or bullied in some way. Firstly, this can be a teaching moment, where you can educate that other person about mental illness or how all people are different. But then when you discuss it with your loved one, you can say “Maybe next time, try not to be so direct” or “…try to be less accusatory” or “…should dress more appropriately” or “If you were a little more open, it might be easier to make friends.” Whatever the case may be. Don’t demand this or that. Do just make suggestions, easy breezey lemon squeezey. Don’tmake a federal case out of stuff. “You know what, I understand that you believe that there are little aliens in the wall shooting you with energy beam guns, but people would disagree with you, so I don’t think that you should share those thoughts with people, because they may judge you in a negative way if you do.” Don’t put them on the defensive. Always find common ground and let them know that it’s safe to tell you anything and everything through encouragement. If they say, “The CIA have me under surveillance, and they’re reporting me to the president. They’re coming to take me to jail.” The safe common ground is usually that you know they think or believe whatever the thought is, ie “I know that you believe that, and it could happen, but I think it’s unlikely, so I wouldn’t worry too much about it.” You can also add “Do you think you should mention that to Dr. Psychiatrist next time? I think he/ she would like to know that, don’t you?” Do make them feel safe to tell you whatever it is they may be feeling by not being judgemental. Do keep an open mind and once again, remember that mental illness has nothing to do with one’s intelligence.  

Be aware of expressed emotion. It is exactly what it sounds like… how you express your emotion. You’re not a saint or an angel, you’re human, and you’ll have normal emotions like anger and frustration. But do pay attention to how you express it. Do take a breath, take a moment before you respond so that you can control how you express yourself. By the way, this is actually a good idea for everyone, no matter who you are or aren’t dealing with. Don’t ever raise your voice. Doalways speak in a relaxed and calm manner. Don’ttalk quickly. Don’t ever back them into a corner. Do speak in a calm and even tone in a quiet area without distractions. Do communicate in a very straightforward way, addressing one issue at a time. Do be apathetic, compassionate, and respectful. 

Have a reflective listening policy. Do always listen to what they have to say.  Even if you think what they’re saying is totally inappropriate, listen to what they have to say. And yes, I realize that this can be very difficult sometimes, but take a breath and listen. You can even tell them that you have a reflective listening policy, and that means that you will always listen to them before you respond. Then back it up by listening respectfully. Then if they have difficulty listening to you and respecting what you say, you can remind them of your policy and ask them for the same courtesy. It’s honestly just a better way to run your life; it makes it so much simpler. My wife and I told our son about this policy, and followed through and raised him with it, since before he could say the word policy, and it turned out just fine and saved a lot of headaches. I can’t stress how important it is to be a good listener.  

This is a corollary to being a good listener… ask appropriate questions well, appropriately, ie softly or easily. Do ask simple questions: “Did you have breakfast today?” “We aren’t able to find your medicine, is everything okay with your medications?” Don’t say, “Did you take your medicine today?” “Did you eat yet?” It tends to sound accusatory. In a very gentle way, you say, “Everything okay with your medicine? Oh, here’s the bottle. Any problems?”  Let them speak.  Don’t press them.  If they’ve forgotten to eat or take medications, don’t get upset or angry, tale a breath, let them explain. If you have an issue about why they don’t want to take their medication, listen to why. Respect them and let them at least give you an interpretation of the reasons and symptoms. Don’t interpret for them. There may be a side effect that’s intolerable to them, and all of that must be brought to the prescribing physician. It’s all valid information, so do listen. After you have listened, you may then calmly answer “I heard that you don’t like to take your medicine because it makes you xyz, but if you don’t want to take it, we’ll call Dr. Prescriber and explain it and see what he/ she says, okay?” That way they know you listened to what’s going on, they know they’ve been heard, but they also know it’s either take the medication or talk to the doctor.  

I have heard some families make demands, withhold privelleges, make bargains, bark orders, physically intimidate; I’ve heard it all. It makes me a little anxious when I hear things like “Just take your *expletive* medicine!” or “Let’s pray about it.” Don’t get me wrong, I’m all for prayer, but it’s inappropriate in some respects when it comes to should Bobby or Suzie take their medication today, because they don’t feel like it. 

Other don’ts: You need an attitude adjustment. You’ve got a bad attitude. Stop being so negative for once. You need to get a job. Why can’t you do something productive with your life? You need something to do. Your thoughts are totally misguided. Now you’re just being dumb. You really are crazy. Don’t act crazy. 

No. None of those things are appropriate, ever. Especially the word “crazy” or any similar term. That is the ultimate “C word” in my office. Doremove it from your vocabulary, pronto. The goal is to not agitate them. No ultimatums.  No threats.  No punishment. It will get you nowhere except to crisis. Criticizing them or blaming them is a no go. And don’t ever speak rapidly or loudly. And don’tstare at them. It invites defiance. Silence is okay. Pauses are okay. I know you may get frustrated, but any sort of frustration or anger directed at them will not work. Don’t make jokes or be sarcastic, because it’s not funny. I don’t find it funny at all.  Don’t talk at them with a patronizing, condescending tone, as in, “Are you going to take your medicine today, or what?” “Could you shower already, you know you smell?” “Are you going to do anything today besides watch TV and smoke cigarettes?” “Have you gotten a job yet?” “You are so useless” “You don’t work. How about you get a job to pay for things?” “When are you going to stop taking and start giving?” “Do you ever worry about anyone but yourself?” These kinds of comments do not work. If any of my patients report this kind of thing, I always make it a point to correct the situation quickly, because it can be very damaging, especially to an already fragile person. 

You are dealing with a loved one with a mental illness, so do establish rapport, and through that rapport, using some of these do’s and don’ts which I just gave you, try to help them get a psychiatric appointment, get to a psychologist, get to a day program, or at least get them to some medical health practitioner for an evaluation. That may mean making an appointment with primary care for a referral, calling their psychiatrist or mental health therapist, or even taking them to an emergency room if it is an urgent situation. In some cases, it may even be necessary to call 911 and have them taken by police or ambulance if they aren’t willing to go on their own and they’re in crisis. Do be willing to do what it takes. Hopefully you’ll be properly directed to appropriate levels of care, and then do follow through with that. Don’t just let it go. Bottom line is get them somewhere. The most important thing that can happen at that point is that that caregiver establishes a bond with the individual, your loved one, and using that relationship, they can motivate and encourage and direct their care. That’s what you’re looking for: a caregiver (psychiatrist or mental health professional) they trust, that they will be honest and open with. That professional should be able to navigate issues and properly direct them to the appropriate level of care.  

So, you want to do everything in your power to encourage a good relationship between your loved one and that professional. Don’t sabotage that relationship. Work within that relationship. Don’tthreaten that caregiver. Don’t give the caregiver ultimatums. Do everything in your power to maintain a good open relationship between the mental health professional/ caregiver and the patient, your loved one.   

I hope this was helpful to any and all that needed to read it. 

Check out all of my other blogs and feel free to share them. Please check out my YouTube channel (just google YouTube Mark Agresti if all else fails) and hit that subscribe button to get all of my videos. As always, for patient stories and more information, check out my book, “Tales from the Couch” available in my office and on Amazon.com. 

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Why Are young Americans So Unhappy

The majority of my practice is made up of fairly young people, so I’m very well aware of what makes them tick. Over the past few years, I’ve noticed a definite trend of increasing unhappiness, a dissatisfaction with life. It’s enough to where I’ve begun unofficially gathering data on the phenomenon and formulating some conclusions based on hundreds of hours listening to them, and I’ve come up with a set of circumstances and reasons why I believe they aren’t happy. I’m going to share them with you so that you might better understand them. Why is it important? Why should you care? Well, aside from the fact that they may be your sons, daughters, nephews, nieces, grandchildren, or the friends of same, these are the future leaders of our country, the people who are going to be running things when people of my age are sitting in rocking chairs on porches or rotting away in some old folks home. Sad but true. So, why are young Americans so unhappy? In my opinion, the overarching theme is that the institutions and/ or systems that are meant to guide and give direction are essentially failing to do so, and that leaves this group adrift and rudderless. Below is a listing of these institutions and systems, along with an explanation of the issue(s).

Social media: I have discussed the “evils” of social media many times in other blogs and videos, but there is a definite correlation between the amount of time that the average young American spends on social media and depression and anxiety. Believe it or not, that number is six hours per day. That’s the average amount of time spent on social media daily. Studies have shown that anything north of two hours a day is linked to depression and anxiety. As it pertains to this blog, I think the real issue with social media is that it causes loneliness. When you are only electronically connected with someone, you are not actually with that person…you are actually alone. Loneliness is also a by-product of gaming, web surfing, video watching, video sharing, texting, e-mailing, etc. These are solitary pursuits, often leaving users feeling empty.

Patriotism: We now find ourselves in a position where our confidence in our government and its leaders is in serious decline. We have little to no faith in the powers that be, the officials running our country. As a result, the level of patriotism in our country is nowhere near what it was one generation ago. There is little belief in the “American way” and the power of the “red, white, and blue,” not just in the eyes of many Americans, but even worse, in the eyes of people around the globe. One generation ago, the US used to be respected, even feared, as a superpower. These days, the US is a veritable laughing stock, not respected nor feared. For young Americans, this engenders a sense of chaos, a distinct lack of confidence, and mistrust. The government is not fulfilling its role to help guide us, give us meaning, direction, and purpose; or a sense of belonging to something bigger.

Religion: Today, people are much less involved in organized religion as they used to be. The church used to be a pillar in the community, the place where you saw your neighbors and friends every Sunday morning. Today, churches are often a hotbed of controversy and even scandal. They are no longer sacred places of reverence, no longerinstitutions that establish guiding principles and give people direction. Organized religions and churches are now sources of mistrust and outdated principles in the eyes of many young Americans, a far cry from even the previous generation. Today’s young people have an ingrained sense of mistrust of authority, especially when that authority attempts to dictate the way they “should” live their lives. Many are not willing to “confess” to a stranger that has not proved themselves, or turn their lives over to someone or something they cannot see or challenge. The church used to be a tether of sorts, creating a sense of community. That sense is absent in young Americans, so whether realized or not, they are more adrift than previous generations.

Family: Today, young people are marrying less often. Many don’t even subscribe to the ideology of monogamy for life, it is an archaic notion to them. The previous generation had their sexual revolution, but today’s young Americans are in the midst of a far different sexual revolution, one in which you may not even be the gender you were born into. Having children or being part of a family is no longer predicated on marriage for them; they don’t live their lives for a piece of paper, they live them for themselves and the people they love. Marriages are also happening much later in life, after personal goals like education or travel have been fulfilled. Today, the definition of family has changed drastically from that of the previous generations, and it is a fluid definition, not set in stone as masculine father married to feminine mother that are parents to 2.5 biological offspring. The value of having a family is less than the value of having a fulfilled and accomplished life, whatever that may mean or look like to the individual. Today’s young Americans make their own definitions. Previous generations had faith in the institutions of marriage and family, and that faith grounded them. Many young Americans express to me that they don’t feel anchored or rooted in their personal lives, and I believe it’s because of their negative thoughts about marriage and family. Life is often a team sport, so free agents may be left out in the cold. 

Employment security: Individuals from previous generations expected to establish a secure career path, and invest themselves in a company where the boss knows their name. They would start in one position and expect to work hard to move up through the ranks for forty years, and then get the gold watch and retire with a pension. That is decidedly not the case for young Americans today. For them, it’s all about taking jobs that make money now, not jobs that will make money five, ten, or fifteen years from now. They expect they will likely take a series of jobs; they are willing to follow the money. There is no career path or job security. Why? Technology. It’s a double edged sword. It advances our society, but it also dictates career obsolescence. Young people don’t know who will be able to stay in what kind of particular career for any length of time. So they do what works here and now, and they don’t count on having a future doing that same thing. They know that technology or corporate governance will probably erase that job, so they don’t invest themselves in it. They expect it will be outdated,outsourced, taken away by an algorithm or artificial intelligence, a robot, or novel software or methodology. Young Americans know they must make hay while the sun shines. They have no job security, no employer-employee loyalty, and they definitely don’t expect a gold watch. When I talk to young Americans, it’s almost an automatic ‘I‘m screwed attitude’ that I hear from them. It’s pretty clear that the lack of basic job security can lead to undue anxiety and even anger and depression in this group. 

Heroism: It seems that heroism decreases with every generation. It used to be that people idolized movie stars in Hollywood and heroes in the sporting world; but young Americans see these people as false heroes. They are exposed as such on social media and in courtrooms across the country. They’re people who can memorize and spit back lines in a script, but they are anti-human beings on the inside. They are not real heroes.  They are fabricated by Hollywood or idolized on a field simply because they can run fast, catch a ball, or hit hard. Those things don’t make them heroes, don’t make them deserving of idolatry. Look at O.J. Simpson, he got away with double murder because he was a football hero, and that blinded the jury. Or the recent college admissions scandals, where rich actors believed they were above the law and could afford to pay people to lie, cheat, and steal on their behalf in order to get their kids into a specific college. In reality, they’re dirtbags with more money than scruples. Young Americans see through all of that kind of bs and don’t tolerate it, which is a good thing; but it also makes them jaded, which isn’t such a good thing. 

Technology: As I mentioned before, technology is a double-edged sword. For all of its good, it also makes people outdated very quickly. It causes uncertainty to cloud our futures, and leads to complexity and chaos, because we do not know what’s going to happen next or how our livelihoods will be affected by the advances in technology. If you’re a cashier, a bank teller, a retail worker, a postal worker, a UPS driver…anxiety city. Earlier this month, the drug store CVS had a live test for delivery of medications during the coronavirus pamdemic via drone for a huge senior community in Orlando, a job that had employed humans. Evidently it was a great success. Even the practice of medicine is under threat of being replaced by algorithms. There is even an algorithm for the practice of radiology, which has the highest malpractice insurance rates, along with obstetrics. If radiology becomes algorithmic, then that affects insurance companies too. I guess no career path is an island. Think about Detroit- the car companies that all went automated. People were replaced by robotic machines that never get sick, don’t have unions, don’t take vacations, and don’t complain. It became a ghost town overnight. Young people almost need a crystal ball to make a decision on what to do for work, so they don’t think in the long term future, they take a job to make money now, whether they like it or not. They lack security, and that does affect their psyche. 

News Media: The media used to be a trusted organization. When the news came on, previous generations watched and listened and believed. If it was stated or printed, it was so. Nobody trusts the media anymore, their opinions are bought by the highest bidder. It is so biased that if you watch it you are misinformed, but if you don’t watch it,you are ill-informed, so there’s just no way to win. These days, every news outlet has its own agenda, and damn if you can figure out what it is. Where previous generations believed that if it was in print or on the television it was true, today, young Americans have zero faith in the institution of media and news reporting. They take everything with a grain of salt, because they have to. Facts are no longer factual, and truth is no longer subject to reality.  

University educational system: Young Americans see this for what it is…a biased, outdated system to give people a questionable education in return for saddling them with hundreds of thousands of dollars in debt. They overcharge for an archaic teaching methodology, then pronounce graduates “educated.” Those graduates then enter the job market and find that surprise(!) they aren’t really prepared to work anywhere.

. Two year technical degrees are most definitely more appealing to young Americans these days, because at least they walk out of there certified in a trade, able to do something for someone somewhere. Our educational systems are a failure, in desperate need of an overhaul. They don’t do the vast majority of young Americans any justice at all. 

Do you see a pattern here? All of these organizations and systems that are meant to give us direction, give us purpose, and set us up for the future, seem to be failing, becoming less important, less useful, or not worthy of our trust. We have no confidence that what our leaders are saying is worthwhile or applicable to our real life. As a result, we are generally more cynical. It is a precarious situation for young Americans, and there are no google maps to get from here to there or now to then. So I have some suggestions.

Dear Young Americans,

I’m sorry the world is basically stacked against you. Following are some suggestions on how to deal with the hand you’ve been dealt. 

Be original. Create your own moral codes and live by them. Decide which relationships are most important to you, and build them up so as to make them permanent and impermiable. They are the most valuable things in your life. Treat them as such.   

The place where you sleep at night is your home. The area surrounding it is your community. The area surrounding that is your environment. Your home, your community, and your environment are important. Always endeavour to make them a better place. 

You do not require an organized religion or a brick-and-mortar church to live a spiritual life, to believethat there is something greater than you in the universe, or to be grateful to it.

Only you can decide what your work life will look like or what career direction is for you. The job you’re in does not have to dictate your path, it can be a stepping stone to the work life that you wishto create.

You must decide how to approach politics. Don’t let it entrap or bias you. Don’t deal in generalities, only in specifics. Decide what issues matter to you and work toward improving them.  

Some part of your life must be dedicated to a charity or charities of your choice. It’s a two-for-one…by helping others we help ourselves, enriching our lives at the same time. 

Understand the pitfalls of social media. It is a solitary pursuit, born and bearing of loneliness. In healthy measures, social media is a positive andessential part of life, educating us and expanding our horizons. Optimize the positives and eliminate the negatives, don’t overuse and abuse it. 

Remember that by its very nature, life is constantly changing. As such, it must be reexamined andreevaluated on a continual basis.  

Good luck. Make yourself proud of yourself.

Mark Agresti M.D.

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24/7 news Is Stressing Us Out

THIS JUST IN!

24/7 NEWS CAUSES ANXIETY! 

READ ALL ABOUT IT!

I remember when I was a kid, my family used to eat dinner after the news. The news used to be thirty minutes. People tuned in and heard about the church bake sale, the plumbing problem being fixed at the elementary school, road closings, and the weather for the next day, and then they moved on with their lives. In this modern age, we are instead constantly inundated with information. We are bombarded with news, 24/7 – 365. News from CNN, ABC, NBC, CBS, MSNBC, FOX, CNBC, Facebook, Twitter, Instagram, on and on. Even when you go to your email inbox it’s in your face. And it’s mainly negative. Why is this? Because negative gets a reaction. Positive news does not get a lot of attention, but negative news does. People react to it, so the news organizations push negative news. They sensationalize the negative, make it bigger, more fearful, more imposing. Until it raises the hairs at the backs of our necks. News that offends, insults, and shocks our sensabilities…that’s sensationalism.  This kind of news- sensationalism- lures viewers. This sensationalism sells. That equals ratings, which then equals advertisers. It’s a big circle. And you, the watchers, the viewers, you’re the target smack dab at the center of that circle. 

Today, when you turn on the news, you hear about more gun violence, another act of terrorism, a missing child, or a scary health epidemic, and it seems as if the world is getting smaller, but growing ever more frightening at the same time. I’m hearing more and more people tell me they’re finding it harder to feel calm in their day-to-day lives. They feel beleaguered by the never-ending cycle of bad news, and this changes them, changes how they feel about life; these changes range from having a constant low level sense of uneasiness all the way to having full-blown anxiety disorders. The persistent sense of worry is joy-robbing at the very least, and debilitating at worst. This news cycle-related anxiety has become particularly obvious in the 21st century, a time that has been packed with global events that live and breathe on the news cycle, the internet, and social media. 

There have been studies on who is at risk for negative impacts from the news cycle. These show that women are more at risk, because they are better than men at remembering negative news for longer periods, and they also have more persistent physiological reactions to the stress caused by such news. The news makes many women feel personally devalued, unseen, unheard, and unsafe, resulting in them having a sense of dread and mistrust about the future. Age is also a big factor: millennials are the age group most upset by the news cycle, with 3 in 5 millennials saying that they want to stay informed, but that following the news causes them undue stress. That’s compared with 1 in 3 older adults saying the same. But these older adults are more apt to deal with this issue by avoiding the news, with 2 in 5 adults reporting that they have taken steps over the past year to reduce their news consumption in response to the stress and anxiety caused by it. 

Our highly connected culture can exacerbate these feelings of anxiety. The internet and social media add to the illusion that the whole world is right outside your door, ready to get you. It used to be that danger from man-made or natural disasters seemed far away. In some cases, you never heard about it in the first place. Today, we have headlines in the 24-hour news cycle that detail the most horrendous crimes and tragedies, from those that touch a few individuals to those that affect thousands. The saying goes “there’s nothing new under the sun” but in fact, now in the last week of February 2020, there is a new thing under the sun: ‘coronavirus anxiety.’ It’s now a real thing in the psych world. The response to the coronavirus illustrates a point about response to the constant news cycle and the fear it breeds. In the last week of February 2020, the global coronavirus outbreak dominated headlines as it entered the political debate and sent stock markets tumbling. In response, Americans did what they always do when confronted with something new and scary: they hit the internet search bar…and the bar bar, and not necessarily in that order. Aside from “coronavirus,” among the most popular topics searched over the past week was “Lysol,” “dog coronavirus,” and “social isolation.” 

Don’t misunderstand me, some anxiety is a good thing. Low levels of it enables awareness and proactive problem-solving. It motivates you to take sensible steps to protect yourself and your loved ones. News serves to inform us about things that are important to us, and at times to warn us about possible health dangers and empower us to avoid them. But too much news and some types of news content, especially when sensationalized, may lead to worry and anxiety. And when anxiety becomes more than a constructive concern, that’s when we need to slow down, when things need to change. So what can you do if what seems like a constant cycle of negative news throughout every media outlet is getting you down and interfering with your well-being? There are some measures you can take to control how much the news negativity affects your everyday routine and outlook. I have ten suggestions below. 

1. When the news is first reported- there has been a bombing, there has been a shooting, war has been declared, there is a new coronavirus outbreak- turn it off, blow it off immediately. This may seem counter intuitive, but initial news, the first news to be reported, is notoriously inaccurate. Numbers are over-inflated. So wait until the news is organized, fully formulated, until they have multiple sources and they can accurately assess the situation. You’ll typically find that, no, it was not 500 people killed, it was 50. It was not 50 people shot, it was 15 people wounded. So just take a step back. When you hear breaking news, put it down, wait, and look at it in a few hours or the next morning, when the news organizations have multiple accurate reports.  

2. Look for good news. Bad news comes your way free and easy, while you have to look for good news. So look for good news. Dig for it. If you look for positive things, you will find them. The whole world isn’t all bad, there are good things happening, positive things. Look for positive things things that interest you, on social media, on YouTube, on television, on the internet. Literally put ‘positive news’ in the search bar and read what you find. 

3. Don’t leave a news channel on all day long, TV or radio, even if it is just for background noise. Some is bound to permeate your brain. Limit the amount of news you watch each day: 20 to 30 minutes a day is enough. You don’t need to be getting news all day long. Be strategic about news exposure. Maybe check the most recent headlines first thing in the morning and then disconnect for the rest of the day. It may be tempting to read every update of a breaking news story throughout the day, but your mind has a way of thinking that the longer a story goes on, the more you are actually involved in the event, even though it may not even directly affect you. And you don’t need to be checking texts, Facebook, Twitter, YouTube, etc multiple times each day either.  

4. I recommend not getting your news from Facebook, Twitter, Instagram, etc because what they say doesn’t have to be true, and what you see will often be a raw emotional response to something that they just saw, which may or may not even be accurate. Get your news from newspapers, either online or in actual print format. News in newspapers, the printed word, tends to be more accurate. The information has been digested and scrutinized by multiple people, so it is a little more fair and presents a more well-rounded perspective.  

5. Prioritize your sleep. Worry often interrupts sleep, and sleep deprivation increases worry. Short-circuit the vicious cycle by avoiding your television, iPad, laptop, and cell phone for at least an hour before bedtime. That means no more late-night scrolling through Instagram or Facebook, where you might find reminders of heavy topics. Pick a before-bed pastime that doesn’t involve a screen, like reading a book. Get your news dose in the morning or maybe a little bit when you first come home from work. Do not do it before bed, because you will not sleep. Murder, treachery, and deceit make for bad bedtime stories.

6. If you find that social media affects you negatively in any way, delete it. Facebook, Twitter, Pinterest, you really don’t need it, especially if it causes you stress or anxiety. Contrary to popular belief, you can live without it…likely better than you can with it. So just delete it.

7. Give yourself a minimum of two hours per day where you are cut off from text messaging, emails, posting, TV, and radio. Spend that time doing something body-positive, like exercise. Physical activity reduces stress and anxiety in the moment and long-term. Practice mindfulness while you exercise by tuning in to your breathing and the physical movement your body is experiencing. This way you’ll have a conscious train of thought that doesn’t involve worry. Or distract yourself some other way. You can preoccupy your brain with relaxing activities: take a warm bath, listen to music, or meditate. If these low-key methods don’t block out the anxiety, try something more engaging, like playing a card game, or catching up with a friend. Whatever you choose, the idea is to give your mind a break.

8. Do not catastrophize, meaning thinking that because one thing is wrong, the whole world is falling apart. Just because there is a terrible stabbing of a little girl in another state does not mean that everyone is unsafe. If there is a shooting in a church in Georgia, that does not mean that all churches are unsafe. Just because there is a strike by the NY City subway workers does not mean that all subway systems across the country are falling apart. Just because there is a viral outbreak in one country does not mean that the whole world is unsafe and that we should shut ourselves in our homes.   

9. Stop querying fear. When fear first strikes, ask yourself once, “What can I do to solve this problem?” If you have an answer, make a plan and implement that plan as best you can. But if you can’t think of a plan or solution that is logical and realistic, then move on. If you continue to worry and rack your brain, resist those thoughts. Distract yourself. See my #7 above. Eventually, the questions will lose their power, and your mind will stop asking them. 

10. Practice eternal optimism. When you start the day in a positive way, the rest of the day will fall in line. And continuing to go about your life with some degree of positivity and optimism is an important cue to your family and friends, reinforcing the message that you- and they- are okay.

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Mental Health Benefits of Dogs

Mental Health Benefits of Pets

The bond between humans and animals is a powerful one, so much so that there have been numerous books written and movies made centering on the relationships between them. Dogs were the first animals domesticated and kept as pets, as much as 45,000 years ago.Regardless of when pet ownership got started, our long attachment to these animals is still going strong. Americans own some 78 million dogs, 85 million cats, 14 million birds, 12 million small mammals, and 9 million reptiles, according to pet industry statistics. 

Studies have scientifically explored the benefits of the human-animal bond, and a positive correlation between pets and mental health is undeniable. According to a recent poll, 95% of pet owners consider their pet a member of the family. Children, adolescents, adults, and seniors all find joy in their pets, so it follows that pets and mental health go hand in hand.

Pets provide companionship, ease loneliness, bring us joy, and give us unconditional love. They also help decrease depression, anxiety, and stress. While the word “pet” usually conjers up thoughts of dogs and cats, a pet doesn’t necessarily have to be a dog or a cat. Even watching fish in an aquarium has been shown to reduce muscle tension and lower pulse rate. A pet can be a horse, parrot, turtle, rabbit, skunk, lizard, chicken, snake…whatever you love and take care of.

Pets have evolved to become acutely attuned to humans. Dogs, for example, are about as intelligent as a two-year-old human child. Some more doggie fun facts: They are able to understand about 150 human words and most are even capable of following a count of five. They understand spatial relationships and are able to use them to navigate obstacles quickly. Although they can’t see the same color spectrum we can, they can see black, white, blue, and yellow; they can’t see red and green- those just look gray to them. A dog’s smell is like 10 million times better than yours. Dogs can sense if you’re going to have a seizure, they know if your blood sugar is low, and some say they can even sniff out cancer. While they understand many of our words, dogs are even better at interpreting our tone of voice, body language, and gestures. And like any good human friend, a loyal dog will look into your eyes to gauge your emotional state and try to understand what you’re thinking and feeling (and to use their special psychic powers to get you to give them treats and throw their ball, of course). I think dogs have psychic powers. My dog Beluga used to use her psychic powers to get me to do stuff all the time.  

Pets, especially dogs and cats, can reduce stress, anxiety, and depression, ease loneliness, encourage exercise and playfulness, and even improve cardiovascular health. Caring for an animal can help children grow up feeling more secure and being more active. Pets also provide good companionship for older adults. Perhaps most importantly, a pet can add real joy and unconditional love to your life.

Early researchers had discovered physical evidence of the mental health benefits of having pets. They found that pets could fulfill the human need for touch, so when hugging or stroking a pet, the human subject’s blood pressure went down, their heart rate slowed, their breathing became more regular, and their muscle tension relaxed. All of these physical changes are signs of reduced stress, which is indicative of a positive psychological impact. 

Since then, scientists have learned much more about the connection between pets and mental health. As a result, animal-assisted therapy programs have become an important part of mental health treatment. But, by owning a pet, you can experience pet therapy benefits every day in your own home. Below are several ways in which pets support good mental health and how pets are beneficial to people with mental health issues.

Interacting with Pets Lowers Stress and Decreases Anxiety:

Just the sensory act of stroking a pet lowers blood pressure, which reduces stress. Petting and playing with animals also reduces levels of the stress hormone cortisol while stimulating endorphin production and release of the happy hormones serotonin and dopamine, which calm and relax the nervous system. It also increases the production of oxytocin, another chemical that naturally reduces stress. Having the companionship of an animal can offer comfort, help ease anxiety, and build self-confidence for people anxious about going out into the world.

Pets Make Us Feel Needed:

The act of caretaking has mental health benefits. Caring for another living thing gives us a sense of purpose and meaning, so people feel more needed and wanted when they have a pet to care for. This is true even when the pets don’t interact very much with their caregivers. In a very interesting 2016 study about pets and mental health, elderly people were given five crickets in a cage to care for. Researchers monitored their mood over eight weeks and compared them to a control group that was not caring for crickets or other pets. They found that participants that were given the crickets became less depressed after eight weeks than those in the control group, so researchers concluded that caring for living creatures produced the mental health benefits they saw. Simply put, doing things for the good of others reduces depression and loneliness.

Pets Increase Well-Being:

Pet owners lives are enriched and generally better in several areas. They have better self-esteem, they are more physically fit, they are less lonely, they are more conscientious and less preoccupied, they are more extroverted, and they are less fearful. Put simply, pet owners are happier, healthier, and better adjusted than non-owners.

Pets Provide Companionship:

Companionship can help prevent illness and even add years to your life, while isolation and loneliness can trigger symptoms of depression. Caring for a live animal can help you shift your focus away from your problems, especially if you live alone. Most dog and cat owners talk to their pets, and some even use them as a sounding board to work through their troubles. And nothing beats loneliness like coming home to a wagging tail or a purring cat.

Cats and Dogs Are Great Examples:  Because pets live in the moment- not worrying about what happened yesterday or what might happen tomorrow- they can help you appreciate life’s simple joys and help you to be more mindful. Mindfulness is a psychological technique, the process of bringing one’s attention to the present moment. This can help distract you from what might be bothering you and help remind you to try to be more carefree and playful. In people diagnosed with mental illnesses like depression, schizophrenia, bipolar disorder, or post-traumatic stress disorder, pets can be among the most supportive connections they have. They provide a unique form of validation through unconditional support, which they may not have in other relationships.   Patients report that pets help them manage their illness, navigate everyday life, and give them a strong sense of identity, self-worth, and meaning. Caring for a pet gave owners a feeling of being in control as well as a sense of security and routine. Most said that their pets helped them manage their emotions and distract them from their symptoms like hearing voices, habitual rumination, and even suicidal thoughts, because they felt needed by their pet.

Pets Help Us Build Healthy Habits:
Pets need to be taken care of every day, and as a result, they help us build healthy habits and routines and add structure to the day. Many pets, especially dogs, require a regular feeding and exercise schedule. Having a consistent routine keeps an animal balanced and calm, and it’s good for people too. No matter your mood, one plaintive look from your pet and you’ll have to get out of bed to care for them. Caring for a pet can help you adopt healthy lifestyle changes, which play an important role in easing symptoms of depression, anxiety, stress, bipolar disorder, and PTSD. Some examples of these healthy lifestyle changes include:
Physical activity: Dog owners need to take their pets for walks, runs, and/ or hikes regularly, and owners receive the benefits of that exercise. Studies show that dog owners are more likely to meet recommended daily exercise requirements.
Time in nature: Walking a dog or riding a horse gets us outside, so we experience the many mental health benefits of being outdoors.
Getting up in the morning: Dogs and cats need to be fed on a regular schedule. As a result, pet owners need to get up and take care of them, no matter what mood they are in. So in this way, pets give people a reason to get up and start the day.
Pet care leads to self-care: Caring for a dog, horse, or cat reminds us that we must take care of ourselves as well.

Pets Support Social Connection: Pets can be a great social lubricant for their owners, helping to start and maintain new friendships. Pets are able to counteract social isolation and promote social connection by relieving social anxiety, because they provide a common topic to talk about. For example, walking a dog or playing in a dog park often leads to conversations with other dog owners. As a result, dog owners tend to be more socially connected and less isolated. This improves the owners’ mental health, because people who have more social relationships and friendships tend to be mentally healthier. The benefits of having social connections include better self-esteem, lower rates of anxiety and depression, a happier, more optimistic outlook, stronger emotional regulation skills, improved cognitive functioning, and having more empathy and feelings of trust toward others.

Pets Give Us Unconditional Love:
This one is best of all! Dogs and cats and pets of all kinds love their owners no matter what. That’s unconditional love. Pets don’t care how your presentation went, how you did on a test, or if you sold a house. Pets don’t judge you based on what you look like, if you are popular, or if you’re super athletic. They’re simply happy to see you, and they want to spend time with you, no matter what! This kind of unconditional love is good for mental health. It stimulates the brain to release dopamine, the chemical involved in sensing pleasure.

To summarize, the link between pets and mental health is clear. So if you don’t have a pet, think about getting one. For a dog or cat, go to a shelter or humane society and adopt somebody, take them home and make them a member of the family. Or maybe talk to a doctor about finding an emotional support animal. Either way, it’ll do you good and you’ll feel good for it. 

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How To Get People To Like you In Ten Minutes

Through the years I’ve had lots of patients ask me how to interact with people and how to be social, the mechanics of it, so I want to give some rules of the road, social skills 101 if you will. First, let’s talk about why social skills are important. Social skills are the foundation for positive relationships with other people: friends, partners, co-workers, bosses, neighbors, on and on. Social skills allow you to connect with other people on a level that is important in life, a level that allows you to have more in-depth relationships with others rather than meaningless surface relationships that have no benefit to anyone. Once you understand the value of having good social skills, you need to want them for yourself and commit to working on them, because that may mean doing new things that may be uncomfortable at first.  So, how would you start to improve social skills? Well, socialization is an interaction, so you need at least one other person to socialize with. So  the first step is to put yourself among other people. Basically, you have to suit up and show up to socialize. You might feel wierd or shy at first, but don’t let anxiety stop you. If you’re not around other people to socialize with, you’re obviously not going to improve your social skills. So take a breath and dive in.

Step number two, put down the electronics. If you’ve put yourself in a social situation, you may be tempted to fiddle with your phone to avoid the awkwardness of just standing there, but when you’re around people, turn the phone off.  You shouldn’t be disrupted, you can’t be distracted, and you can’t be checking email, messages, notifications, etc. Those things will get you to exactly nowhere. When you’re distracted, you won’t pay proper attention to the social setting you’re in, and since that’s kind of the whole point, put it away and keep it there.

So you’re in a room with plenty of folks to socialize with, your phone is tucked away, so what’s next? Well, if you want to interact with people, socialize with people, you have to look like it. You can’t put yourself in a corner with your arms crossed and a disinterested look on your face. Step three is to demonstrate an open, friendly posture. You need to be inviting to others who may want to talk to you. Put on a friendly face – you’ll be surprised at how many people approach you when you look approachable. 

As they say, the eyes are the entries to the mind. Step four is to always maintain good eye contact. This is hugely important when conversing, but fleeting eye contact also comes in handy when you’re just circulating in a room or looking for someone to strike up a conversation with. Eyes can entirely change a facial expression and easily convey mood and interest. Without eye contact, there is limited communication, and social skills are compromised without appropriate eye contact. Eye contact is so integral to communication that some people say they can tell if someone they’re talking to is being honest or lying by their eye contact, or the lack thereof. 

To communicate well, you must pay attention to your equipment…your speech. So step five is remember your speech: the tone, the pitch, the volume, the tempo, the accent. Right or wrong, people will judge and label you by your voice. A man’s voice that’s too loud is a turnoff, he comes off as a blowhard. A woman’s voice that’s too soft is annoying because people have to try too hard to hear her, and people may say she’s a sexpot, a la Marilyn Monroe. If she speaks at too high a pitch, she’s a bimbo. To some, a southern accent means you’re dumb and a northern accent means you’re a hustler. Speaking too slowly or too fast is annoying, too monotone and you’ll put people to sleep. On the flip side, a singer or actor with perfect pitch or an especially unusual or dulcet tone can build a legacy based just on their voice, a voice that will be instantly recognized for all time. When it comes to the way you speak, be aware and make alterations to be distinct and easily understood. Remember voice inflection, because monotone is a tune-out and turnoff. Speech should be like a story, with highs and lows, ups and downs to hold people’s interest.

After reading step five above, you might think that developing good social skills hinges on everything you say, but that leaves out a key factor…listening. Step six on the path to developing good social skills is to be a good listener. Just listen. Eazy peazy lemon squeazy. Now, if you’ve ever in your entire life enjoyed speaking to someone who clearly wasn’t listening to anything you said, raise your hand. Any takers? Anyone? I thought not. It is annoying AF when it’s so obvious that someone’s not listening to you speak. And you don’t want to be annoying AF, do you? I thought not. Social skills aren’t just about what comes out of a person’s mouth, so listen. 

A great way to deal with nerves that may accompany you when you put yourself in a social situation and talk to people is to find commonality, so this is step seven. When you first meet someone, a sense of commonality is a great way to establish a quick rapport with them. Commonality is something you share. It could be something as simple as going to the same school, a shared interest in sports, same places where you’ve lived or hobbies in common. Step seven is to find commonality with someone; something simple to break the ice and establish a conversation. 

Once you’ve begun a conversation with someone and you want to further it, you need to go beyond just commonalities. You need to relate to the person on a deeper level. How do you do that? Through step eight, empathy. Empathy is the ability to relate to someone by putting yourself in their position in order to understand them better. If someone has a dying parent, has just lost their job, if someone is lonely, has ended a relationship, didn’t get a promotion, or experiences anything that elicits an emotional response, being empathetic is the ultimate understanding of their pain, their sorrow, or their disappointment. Step eight in improving social skills is the ability to put yourself in someone else’s shoes in order to have genuine empathy for that person. A key word here is genuine. As a general rule, good social skills are genuine. Lip service is not part of good social skills.

Step nine is a pretty simple concept, though not so much in practice. Respect. In order to learn good social skills (and have anyone to practice them on) you must respect what other people say. I did not say agree. You can completely disagree with their opinion, but step nine is that you must respect their right to have it and include it in the conversation.  

While in theory you have the right to say anything you want in your social circle, you should watch what you say. Step ten is to consider the content of your conversation. There are certain things that shouldn’t be brought up in some situations. As they say, religion and politics are big no no’s for sure. Gossiping is also on the no list, because it’s really toxic to a conversation and leaves people scratching their heads. If you’re talking about Mary to Connie, Connie’s bound to wonder what you say about her when you’re speaking to Shelly. So it’s best to just not talk about people. But I think it was First Lady Dolly Madison who said “If you don’t have anything nice to say, sit next to me” Some people do like gossip, the jucier the better. But you have to be prepared to pay the piper. A conversation can be like a minefield, with certain subjects as the mines. You have to navigate through the whole conversation without blowing yourself to smithereens.  

In order to have appropriate social skills, you must consider the non-conversational parts of social interaction. If you’re so drunk that you can’t speak or no one can understand what you’re saying, obviously you can’t use good social skills. Same goes for drugs. If you take a Xanax to calm your nerves before the company mixer, you will not have appropriate social skills. You may not think people can tell, but you’d be wrong. Step eleven is  about intoxicants like alcohol, marijuana, benzodiazepines, and Adderall… they all make you act weird and affect your social interactions, and people pick it up right away. They may not know what drug you’re on, but they’ll know you’re on something for sure, because your social interactions will be inappropriate. Rule eleven: you cannot interact appropriately when using drugs or alcohol, so cut both out if you want to have good social skills.

If you follow these steps, you’ll definitely learn better social skills. And a breath mint wouldn’t hurt. Like with anything else, practice makes perfect when it comes to social graces. Be positive, open, honest, empathetic, clear, respectful and sober, and you’ll never be at a loss for people to talk to. You’ll navigate the waters of conversation deftly with give and take, and all included will come out feeling positive about the interaction.

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How To Sleep Better At Night

In this blog, I want to talk about sleep. One of the most common complaints I hear from patients in my practice is that they can’t sleep, and they ask what they can do to sleep better at night. It’s brought up so often that I’ve created a list of rules to follow to get better sleep at night. But first, some facts about sleep… and the lack thereof. 

While sleep requirements vary slightly from person to person, most healthy adults need between 7 to 9 hours of sleep per night to function at their best. Children and teens need even more. And despite the notion that our sleep needs decrease with age, most older people still need at least 7 hours of sleep per night for optimal functioning. 

We all know that good sleep is important. But why? I mean, if we don’t get enough sleep, we’ll be tired, but other than that, it really doesn’t matter, right? Wrong. In terms of importance, getting good sleep, and enough of it, is actually right up there with eating a healthy diet and exercising regularly. Poor or not enough sleep is known to have negative consequences on hormone levels and brain function, and can cause weight gain and increase the risk of obesity and diseases like diabetes and heart disease. On the flip side, adequate or good sleep can keep you healthier, help you maintain physical fitness, and think more clearly and concisely. Unfortunately, sleep quality and quantity have both decreased in recent years, and millions of people battle chronic insomnia for their entire lifetimes. Because it plays such a key role in your health, getting good sleep should be a priority in your life. Toward that end, below are my fourteen rules for good sleep.

Rule 1: Get bright light during the day. Natural sunlight is preferable, but artificial light works too. Your body’s natural clock is called your circadian rhythm; it links your body, brain and hormones, keeping you awake during the day when appropriate and telling you when it’s time to sleep at night. Daytime light exposure keeps your rhythm happy and in sync, improving daytime energy and alertness as well as nighttime sleep quality and duration. 

Rule 2: Avoid blue light in evenings and at night. What is blue light?  Blue light is what is emitted from your computer, laptop, iPad and smartphone. While daytime light exposure is beneficial, nighttime light exposure is not. This is because of its impact on your circadian rhythm; it tricks your brain into thinking that it’s daytime, and this reduces natural hormones like melatonin, hindering sleep. The more blue light you expose yourself to, the more disruption you’ll have in your sleep. There is a solution for this; there’s an app for your smartphone that filters out the blue light. There’s also something called “F.Lux” that you can put on your computer or iPad which will block out the blue light in those devices as well. So remember, blue light is a serious factor. If you are on your iPad or your computer at night, you’re not going to sleep well.  

Rule 3: Avoid caffeine, Captain Obvious. 90% of the US population consumes caffeine on a daily basis, mostly in coffee and energy drinks/ shots. Here are some approximate caffeine counts: an 8 ounce cup of coffee has 95mg of caffeine, a 5-hour energy shot has 75mg and a Red Bull drink has 120mg of caffeine. While caffeine can enhance energy and focus, it can also wreck your sleep. Caffeine stimulates the nervous system, and this can prevent the mind and body from relaxing and falling into a deep sleep. Caffeine can remain elevated in the blood for 6 – 8 hours after ingestion, so consuming caffeine after 2pm is not the best idea, especially if you’re sensitive to it or already have trouble sleeping. In addition, regardless of when you consume it, you should limit caffeine intake to 200mg per day or risk losing sleep over it. 

Rule 4: Watch naps during the day. While short power naps can be beneficial for some, taking long naps during the day can negatively impact  your sleep. How? That wiley circadian rhythm again! Napping during the day confuses your internal clock, disrupting your sleep-wake cycle and potentially leaving you with problems falling asleep at night. 

Rule 5: Try Melatonin. Melatonin is a naturally produced sleep hormone that tells your brain when it’s time to relax and head to bed. Melatonin supplements are an extremely popular over-the-counter sleep aid, helping people to fall asleep more quickly. I usually recommend between 2 and 4mg of melatonin at (or shortly before) bedtime. I find that some patients get daytime hangover from it, so be aware of that and possibly decrease the dose to see if that minimizes the hangover. 

Rule 6: Regulate your sleep-wake cycle. How? By getting up at the same time every day and going to bed at the same time every day…. even on weekends. I know, that last bit is a bummer. Our old friend circadian rhythm is at work again here. The circadian rhythm is basically a loop, and irregular sleep patterns disrupt it and alter the melatonin levels that tell your body to sleep. The result? Not sleeping. I recommend that you go to bed at the same time every night and that you set an alarm to get up at the same time every day, no matter how tired you may be. After some time, you will probably find that you wake up on your own without the alarm and that the consistency of your schedule will give you better sleep quality. 

7. Try additional supplements for sleep. There are a few dietary supplements that have been found to induce relaxation and help you sleep. 

   Glycine: This is a naturally produced amino acid shown to improve sleep quality. I recommend 3 grams at night. 

   Magnesium: This is an important mineral found in the body; it is responsible for over 600 biochemical reactions within the body, and it can improve relaxation and enhance sleep quality. I recommend 100-350mg daily; start at the lower dose and increase gradually if necessary. 

   L-theanine: Another amino acid, L-theanine can induce relaxation and sleep. I recommend 100–200mg before bed. 

   Lavender: A powerful herb with many health benefits, lavender can induce a calming effect on anxiety and help induce sleep. I recommend 160mg at night.   

Rule 8: No alcohol. I’m sure we’ve all heard people say that a nightcap “helps them sleep better.” Don’t ever believe it…it’s total crap. Downing even one drink at night can negatively alter hormone levels like melatonin, disrupting the circadian rhythm and therefore sleep. In addition, alcohol is known to increase, or even cause, the symptoms of sleep apnea such as snoring, which also disrupts sleep patterns and causes poor sleep quality.  

Rule 9: Create a cool, dark and quiet bedroom environment. Minimize external noise and light with heavy blackout curtains and remove devices that emanate artificial light like digital alarm clocks. Make sure your bedroom is a relaxing, clean, calm and enjoyable place. Keep the temperature very cool, I usually recommend 70 – 72 degrees, because the weight of blankets is very comforting. You can even buy weighted blankets for adults and children; I’ve heard many patients say they really relax the body which in turn helps them fall asleep.  

Rule 10: No eating late at night. Late-night eating may negatively impact the natural release of HGH (human growth hormone) and melatonin, which leads to difficulty falling asleep. Also, I think that most of the time, people eat bad things late at night, things with a lot of sugar and things high in fat, like chips, candies, and cereal. These all interfere with sleep. Generally, when the body goes into a digestive mood, as it does after eating, it doesn’t want to sleep.  

Rule 11: Relax and clear your mind.  Many people have a pre-sleep routine that helps them relax to prepare for sleep. Commonly suggested for people with insomnia, pre-sleep relaxation techniques have been shown to improve sleep quality. Strategies can include listening to relaxing music, reading a book, taking a hot bath, meditating, deep breathing and visualization. Stress is a common reason for trouble falling asleep and poor sleep quality and quantity. If your problems are keeping you up at night, you have to come to some resolution on how you’re going to handle those issues in your life so that you can put them to rest, go to bed, and get some sleep.  

Rule 12:  Spend money on a good quality, comfortable mattress, good pillows and good linens. You’re going to spend a third of your life in your bed…don’t cheap out when it comes to the matress and bedding; spend the money. Make sure your mattress is large enough, comfortable and high quality. Studies have shown that quality mattresses significantly reduce back and shoulder pain. And buy good quality, high thread count (800 thread count minimum, but higher if you can) cotton sheets…they’ll get softer with every wash. Find pillows that feel most comfortable and supportive for you. You may have to try multiple pillows before finding the perfect one, but the search and cost are necessary, and your neck will thank you for it. A quality mattress and pillows and great linens can be an investment, but well worth it. You’ll have them for some time and you’ll be happier for it when you get in bed at night and go “Aaaaahhhh.” 

Rule 13: No exercising at night. While daily exercise is key for a good night’s sleep, doing it too late in the day may cause sleep problems. This is because exercise acts like a stimulant, increasing hormones like epinephrine and adrenaline, which increase alertness. Alertness is the antithesis of the relaxation you need to fall asleep. Basically, exercise hypes you up, making it difficult or impossible to fall asleep. 

Rule 14: No fluids before bed. While hydration is an absolute necessity for health, it’s best to restrict fluids for one to two hours before bed. You should also use the bathroom right before going to bed, as this may decrease your chances of waking in the night. The reason for this rule is fairly obvious: a full or partially full bladder will wake you up in the middle of the night to go to the bathroom, and that’s a total drag for you and likely for whomever shares your bed. 

So those are my 14 rules for better sleep. And now I’ll say goodnight, sleep tight, and don’t let the bedbugs bite!

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Millennials:The Blame Game

Most of the patient population in my practice are millennials. There are varying opinions on the age of this group, but for my purposes, I go with 40 and under. It seems like all I hear about these days is that this group, these people, have ruined EVERYTHING, and frankly, I’m sick of it. Listen, the older generation blaming problems on the younger generation is certainly not new; it’s always been that way. But for some reason, millennials are taking a far bigger rap for the problems in the world today than any other generation has in the past. They should be called the “Scapegoat Generation.” Sure, millennials have different priorities, values, and goals than their parents’ generation. No argument there. In general, they value healthy eating habits, spending their money on experiences rather than on physical possessions, and working their butts off to pay down their astronomical student loan debt. And of course, you have to remember that they grew up with the internet, the world at their fingertips. Contrast that with the older generation that had to go to a libraryand check out actual books. And the older generation had to actually drive to a store to buy things, but millennials just order it and it shows up on their doorstop two days later. So the older generation thinks millennials have it too easy. But au contraire, they have to suffer the consequences for the actions of previous generations and take the blame for ruining everything to boot. It drives me so crazy that I just have to talk about it. So below I want to go through some of the things that millennials are blamed for annihilating, some of which are absolutely patently ridiculous. But that’s just my opinion. Read on and decide for yourself.

Restaurant Chain Gangs
Dummy’s Yummies, Fooligan’s, Thank God It’s Fattie’s, yada yada. “Casual dining” restaurants are losing business and having to close stores left and right because those damn millennials don’t want to eat the high cal, high fat, high cholesterol foods that have been expanding waistlines for years. To the “All you can eat all fried everything appetizer!!” they say no. They much prefer to cook healthy and at home so that they actually know what’s in their food. Shame on you, millennials!

Lucy in the Sky With(out) Diamonds 
Remember the De Beers’ ad from years ago that said a reasonable guideline to spend on an engagement ring was six month’s salary?! That might have flown then, but times have changed. Shockingly, De Beers now reports that diamond sales have been steadily dropping, from 32% in 1990 to 27% in 2015, and that sales continue to follow this downward trend. Why? Well, the obvious reason is money money money. Millennials are having a hard enough time making ends meet without adding pricey ice to their already tight budget. A less obvious reason that they’re not buying diamonds is an ethical one…they’re actually concerned with how and where diamonds are mined. It’s very popular now to choose a non-diamond gemstone for engagement ring bling. Silly millennials…thinking independently.

Tears for (Crappy) Beers
Bud, Coors, Natty Light…millennials don’t care for the cheapo pee water that passed for beer that their parents and grandparents drank by the gallon. Instead, they prefer unique craft beers, the smaller the batch the better. They enjoy beer flights with lagers and IPAs that actually taste like something. Expanding your horizons and daring to break beer tradition…bad millennials!  

Bar Soap is Bad Soap?
No, I’m not kidding. Millennials are destroying the bar soap industry. Marketwatch surveys reports that millennials think bar soap is “gross,” and that they prefer to wash up with liquid soap instead. Their statement of findings said, “Almost half (48%) of all U.S. consumers believe bar soaps are covered in germs after use, a feeling that is particularly strong among consumers aged 18-24 (60%), as opposed to just 31% of older consumers aged 65+.”
So nearly twice as many millennials are grossed out by germy bar soap than old people. Pesky millennials, preferring not to wash your hands with germy, gunky, dirty old bars of soap.

Endangered Species: Paper Napkins
These cheap millennials are even killing paper napkins. How do they carry out this dastardly deed? They buy paper towels! And get this…they not only use them for their intended use, they also use them as napkins! Oh, the horror! And why, why, why would they do this?!?! They say it’s because “it’s just one less thing to buy,” but I’m sure it’s a grand conspiracy. 

Boxed Cereal
Seriously? Paper napkins yesterday, boxed cereal today. It’s a very slippery slope, people! What is the world coming to? Evidently, cereal sales have fallen almost 30% in recent years, and it’s all the millennials’ faults. Reports state that “Almost 40 percent of millennials surveyed said cereal was an inconvenient breakfast choice because they had to clean up after eating it.” I assume this clean up involves washing a bowl and a spoon. Painful though it is, I have to side with the old folks on this one….40% of you are lazy millennials!

No “Fore!” Play
Millennials don’t play “the sport of kings,” aka golf, nor do they watch it on TV or waste time thinking about hitting a little white ball into a hole with a metal stick. A very expensive metal stick. They also don’t have respect for the people that hit that little white ball for a living…a very lucrative living. It makes no sense to them. Their apathy is real and ever-growing, so much so that fans of the sport fear that within the next 52 years, millennials will succeed in finally killing golf, making it (poof!) disappear entirely. Don’t ask me how they figured exactly 52 years…I have no clue.

Workin’ 9 to 5…Not the Way to Make a Livin’?
The days of clocking in at 9 AM and out at 5 PM are long gone, but not because millennials are lazy. In fact, thanks to technology, millennials are changing the way the American work force gets stuff done. With technology, they’re working from home more and demanding more work flexibility from employers. Instead of being unreachable and shutting the computer down at the end of the day, employees are never out of touch. That’s great for employers, but not so much for millennial employees. No fun when your boss interupts your binge-watch.

Vacay…Yay or Nay?
Speaking of always working….Travel & Leisure has decided that millennials have destroyed the American vacation, not because they’re poor or lazy as some believe, but because they’re obsessed with work! They say that work pressure and an always-on attitude have increasingly caused many Americans to abandon their vacation days. In 2015, it’s estimated that 55% of working Americans didn’t use all of their vacation days, leaving behind 658 million days of unused PTO on the table. Silly millennials…take your PTO!!!

Movie Madness
You only need one word when it comes to how millennials and their evil technology have destroyed movie theaters…Netflix! Since its advent, the movie industry has been flailing, struggling to justify their own existence. Why spend $12 to sit shoulder to shoulder with loud, popcorn-munching strangers in a crowded, sticky-floored theater when you can Netflix and chill at home in your pajamas? The answer? You wouldn’t! Now who thinks like a millennial? 

Super-Duper Home Improvement Stores
We’ve established that millennials are generally broke. If they aren’t living with mom and dad, most of them rent, meaning they don’t own a home. So they have no use for a home improvement store to buy a bunch of stuff to improve a home they don’t have. As a result, millennials are apparently killing Lowe’s and Home Depot, both of which have reported a huge dip in sales. Naturally, that’s all your fault, millennials!!

Family Ties (That Bind)

Millennials are being blamed for destroying the very fabric of society by choosing not to have children. Why? Kids are freaking expensive, potentially putting them in an 18-plus year financial bind. And we’ve established that millennials are mostly broke, struggling with little pay and humongous educational debt. As established above, most don’t own a home with a big backyard and white picket fence. Many work multiple jobs in a gig economy, (which is also their fault) so they don’t have a lot of the time it takes to raise a small human. And many of them don’t see the brightest future when it comes to finance, government leadership, and the environment. And why would they? They went to college with the surety of graduating to find a fabulous job with amazing benefits and instead graduated to the worst economical slump since the great depression of the 40’s, no jobs, dying oceans, drought, family farms closing, and no bright promise on the horizon. Jaded millennials…but I ask, why shouldn’t they be?  

Football?!?!
Millennials are killing football now too?! Looking into this, I see that it’s not so much that millennials don’t like football; it’s more that they don’t want their kids playing the sport. That’s if they even dare to have kids, a topic which I explored above. There is far more information about the danger of football today. Previous generations smacked their kids on the ass and sent ‘em out to the field and cheered as they tackled the other team’s players. Today we understand the cumulative damage of repetetive concussions, and not surprisingly, many parents are prohibiting their kids from playing tackle football. Eventually, this will lead to a dearth in potential professional football stars hired by the NFL, and that will equate to a lot of unhappy people in the fall and January of every year. Apparently millennials are staunchly against repetitive concussive brain injuries in their children. Go figure.

The American Dream…A Nightmare?
Damn it, millennials! Stop the madness! Now you’re killing off the American Dream? How could you…It’s been around for so long!! I’ve told you that millennials are poor, but let’s get specific. Studies have shown that millennials earn 20% less than their parents did at their ages, and they only own half the total assets as the Baby Boomers did at their age. Financial forecasts show that the idea of buying a home is now way out of reach for most young people today. They’re graduating from college with huge amounts of debt, they’re working longer hours than any previous generation, and they’re getting paid less than their parents made…so much for the American Dream. But somehow, the downfall of that American Dream is their fault. Hmmm…

What have we learned about millennials today? What are the takeaways? 

Millennials are:
– Smart and adaptive
– Hardworking but poor
– Debt-ridden with college loans
– Health-conscious
– Hooked on technology
– Clearly ruining everything!

I cover more in a full chapter about millenials in my book Tales from the Couch, which is available on Amazon.com.

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Let’s Talk About Ambien

Ambien, generic name zolpidem, is the most commonly prescribed sleep aid, accounting for 85% of prescribed sleeping pills. It also ranks in the top 15 on the list of most frequently prescribed drugs in the country. Its popularity is clearly due to its efficacy. Zolpidem works as a hypnotic drug, meaning that it induces a state of unconsciousness, similar to what occurs during natural sleep. How does it do that? Zolpidem affects chemical messengers in the brain called neurotransmitters, specifically a neurotransmitter called GABA. By affecting GABA, it calms the activity of specific parts of the brain. One of the areas in the brain that is affected is the hippocampus. Along with other regions of the brain, the hippocampus is important in the formation of memory. Because of this hippocampal involvement, 

zolpidem can cause memory loss, especially at higher doses, an effect colloquially referred to as “Ambien Amnesia.” If you take it and do not go to bed immediately as recommended, this is more likely to occur. When you get right in bed after taking it, a loss of memory is inconsequential…it doesn’t matter if you can’t remember lying awake for a few minutes before falling asleep. But there are many reports of people taking it and remaining awake and out of bed, and they commonly experience an inability to recall subsequent events shortly after taking it. Because of its effects on memory, there is some concern that zolpidem could affect long-term memory and contribute to the development of dementia or Alzheimer’s disease, though there has been no research to prove or disprove these possible associations. Zolpidem comes with a host of known side effects that range from weird and wacky to illegal and downright dangerous behaviors. Included are hallucinations, decreased awareness, disinhibition, and changes in behavior. Very serious problems may occur when someone who has taken zolpidem gets up during the night. They may exhibit very complex sleep-related behaviors while under the influence of zolpidem. These might include relatively innocuous sleeptalking, sleepwalking, sleep cleaning and sleep eating, to more disturbing behaviors like sleep cooking and sleep sex, to potentially deadly sleep driving. While in a confused state, a person on zolpidem may act in a way that is different from their normal waking behavior. This can lead to legal consequences, such as driving under the influence (DUI) or potentially even sexual assault charges stemming from disinhibited sexually charged behavior. 

I have a long time patient named Deanna that takes zolpidem and regularly sleepwalks, also known as somnambulation for the Scrabble set. It happens that she has been a sleepwalker ever since she had the ability to walk, so being on the zolpidem now makes her nocturnal activities and behaviors really way out there. Just flipping back through her chart, I see she mentions: taking apart electronics and trying to put them back together with no success. Dumping all of her shoes out of their boxes onto her closet floor. Taking all of her clothes off their hangers and throwing them over her dining room chairs. Gathering all sorts of disparate items together, evidently whatever catches her eye at the time, and putting them in her oven. She said she learned that particular lesson the hard way. This one is whacked. She started “painting” a wall in her house….with a purple sharpie. She showed me a picture of that. She once found several pages of her stationery scrawled in words she knew she didn’t consciously write in a letter to someone, she didn’t know who. She brought that in. She said she would evidently clean in her sleep; she put shower gel all over the tile in her shower and “put things away” in odd places they didn’t belong in. She also sleep eats. Cereal, bread, ice cream, whatever she sees that looks good I guess. She regularly wakes up to a mess in the kitchen and destruction in the house. It used to really freak her out to see the evidence of activities she didn’t remember, but now she just feels unsettled as she surveys the damage from her night time escapades. But since it hasn’t ever been anything dangerous and because zolpidem works well for her, she doesn’t want to change it. 

How is it that a person on zolpidem can achieve these complex behaviors while unconscious and asleep? It’s because the parts of the brain that control movement still function, but inhibition, consciousness, and the ability to create memory is turned off. Because of this, the person is disinhibited, and that can lead to unintentional actions and behaviors as discussed above.

Beyond zolpidem’s effects on memory, awareness, and behavior, there may be additional issues associated with its use. Some other common side effects include:

– “Hangover” or carry-over sedation,               especially in women

– Headaches

– Loss of appetite
– Impaired vision
– Slow breathing rates
– Muscle cramps
– Allergic reactions
– Memory loss
– Inability to concentrate
– Disorientation
– Emotional blunting
– Depression and/or suicidal thoughts
– Anxiety
– Nightmares
– Sedation
– Confusion
– Dizziness
– Delirium

– Aggression
– Back pain
– Diarrhea or constipation

– Sinusitis (sinus infection)
– Pharyngitis (sore throat)
– Dry mouth
– Flu-like symptoms
– Seizures

– Breathing difficulties
– Palpitations (irregular heartbeat)
– Rash
– Rebound insomnia

Any of these side effects could be bothersome and may interfere with the continued use of the medication. Sometimes the benefits of zolpidem outweigh the risks and/or side effects. If a symptom is particularly bothersome, discuss this with your prescribing doctor to see if an alternative treatment may be a better option for you.

If you take zolpidem, use it exactly as prescribed and get in bed immediately after taking it. It’s best to allow yourself at least 7 to 8 hours of sleep to help ensure avoidance of morning hangover effects. Keeping a regular sleep-wake schedule will also help. Taking zolpidem with other drugs that depress the central nervous system such as alcohol, opioid pain medications, or tranquilizers intensifies the sedative effects of zolpidem and increases the risk of overdose as a result of respiratory depression. Zolpidem is an abusable drug. Individuals who take it for non-medical reasons or at more than prescribed doses are at risk of experiencing intensification of adverse side effects, including the following:

– Excessive sedation
– Confusion and disorientation
– Lack of motor coordination
– Slow response times
– Delayed reflex reactions
– Dizziness
– Hallucinations
– Impaired judgment
– Aggression
– Seizures

– Withdrawl

Men and women don’t metabolize zolpidem in the same way. Women metabolize it much more slowly, so they often wake up with a zolpidem hang over and feel cloudy in the morning. So an important note for women taking zolpidem is to be extra cautious about allowing at least 8 hours of sleep after taking it and to take lower doses of it due to the potential effects on morning function, especially driving. 

Actor Roseanne Barr had probably taken a little too much when she “Ambien tweeted” a racist statement comparing an Obama aid to an ape. She admitted that she had taken zolpidem shortly before the 2am tweet that caused her eponymous show to be cancelled. Elon Musk, Mr. Tesla, can feel her pain. He shocked investors when he tweeted he was considering taking Tesla private at $420 a share and that funding was secured. He said he sometimes takes zolpidem because it’s either that or no sleep. Good thing he has people to protect him from himself when he’s in a zolpidem daze.

Zolpidem can be a safe and effective medication to treat insomnia, but if it affects your memory or causes sleep behaviors or other adverse side effects, you should probably consider alternative treatments for your insomnia. Hello Roseanne and Elon…that means you!!

I talk more about drugs for sleep like zolpidem and a host of other psychoactive drugs in my book, Tales from the Couch, available on Amazon.com.

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How To Manage Stress

Rather than just introducing you to today’s topic, I want to play a little game of ‘Who am I?’ I’ll give you ten clues and let’s see if you can guess who I am. And no looking down below and cheating!

1. Everyone has me, either intermittently or constantly.

2. I am an unwelcome guest.

3. Some people deal with me better than others do.

4. I keep lots of people up at night.

5. I make some people physically ill.

6. I can shrink your brain. 

7. Some people take drugs to deal with me.

8. I can make some people binge, purge, or starve themselves.

9. I can cause a whole host of medical problems.

10. I have a good side, but nobody ever gives me credit for it!

Last clue: 

I am defined as “a physical, mental, or emotional factor that causes bodily or mental tension.”

So who am I? 

I am STRESS! 

I see so many stressed out people every day that I thought I’d do a little educational primer on stress.

Stress is a normal psychological and physical reaction to life’s everyday demands. A small amount of stress can be good. Positive stress is officially called eustress, and it can motivate you to perform well. But multiple challenges throughout the day such as sitting in traffic, meeting deadlines, managing children, and paying bills can push you beyond your ability to cope.

What’s going on in your brain when you feel stress? Your brain comes hard-wired with an alarm system for your protection. When your brain perceives a threat or a stressor, it signals your body to release a burst of hormones, especially cortisol, that increase your heart rate and raise your blood pressure. This is part of the fight or flight mechanism. But once the threat or stressor is gone, your body is meant to return to a normal, relaxed state. Unfortunately,some people’s alarm systems rarely shut off, causing chronic stress. When chronic stress is experienced, the body makes more cortisol than it has a chance to release. This has been shown to kill brain cells and even reduce the size of the brain. Chronic stress has a shrinking effect on the prefrontal cortex, the area of the brain responsible for memory and learning. So it’s very important to find effective ways to deal with stress. Stress management gives you a range of tools to reset your brain’s alarm system. Without managing stress, your body might always be on high alert, and over time, this can lead to serious health problems and contribute to mental disorders such as anxiety, depression and post-traumatic stress disorder. So don’t wait until stress damages your health, relationships, or quality of life…start practicing some stress management techniques. 

To help combat the negative effects of stress and anxiety, here are five tips to help manage stress in your daily life…

1. Follow a Regular Sleep Routine
It may seem like simple advice, but often the simplest advice is the best advice. Following a regular sleep routine can help you decompress, recharge, and rejuvenate your body and mind after a stressful day. Try going to bed at the same time every night and aim for 7 to 8 hours of sleep. Resist the urge to stay up late watching TV. In fact, avoid screen time altogether before bed, including tablets and smart phones. Studies have proven that reading on a backlit device before bed interrupts the body’s natural process of falling asleep. These devices also impact how sleepy and alert you are the following day.

2. Use Exercise to Combat Stress
Exercising regularly can have an enormous impact on how your body deals with stress, and it is one of the most recommended ways doctors instruct patients to reduce stress. The endorphins released while exercising can help improve your overall health, reduce stress levels, regulate sleep pattern, and improve mood. The key to exercising is to choose something that you truly enjoy. Whether it’s going for a walk, taking an exercise class at the gym, going for a swim, or lifting weights, exercise keeps us healthy. Make sure to mix up your exercise routine to prevent boredom and stay motivated. 

3. Learn How to Meditate
One of the simplest ways to help alleviate stress is to practice deep breathing and meditation. There’s no secret to this, and you don’t have to chant and burn incense or any of that. It’s just about finding a quiet space without distractions. It only takes a few minutes every day, either before bed or first thing in the morning. Breathe in through your nose, letting your abdomen expand. Hold your breath for a count of three, then breathe out slowly through your mouth. Repeat this three times. Focus on your breathing and your heart beat to prevent thinking about everything that you need to do. If doing it in the morning allows stressful thoughts of the upcoming day to intrude, try it at night. Deep breathing is especially important when your stress levels are high. Aim for meditating for at least 15 to 20 minutes, but if you’re feeling pressured during the day, a quick 5-minute meditation session can help you chill out.

4. Take Care of Your Skin
It may not seem like skin care and stress prevention are linked, but they are. Have you ever noticed that your skin is more prone to break out when you’re stressed out? How many times have you gotten up for work all stressed out about a presentation and looked in the mirror only to see a big zit on your nose? For crying out loud…why the heck is that?!!? How does your skin know you have a big presentation? Well, stress causes a chemical response that makes your skin more sensitive. And as we discussed, your body produces more cortisol when stressed, which causes your sebaceous glands to produce more oil. More oil means oily skin that is prone to acne. So it’s important not to neglect your skin care routine, especially when you’re stressed out. This goes for both guys and girls. You may be exhausted at night and want to go straight to bed, but taking an extra few minutes to wash your face and remove daily dirt and any facial products or makeup you’ve worn during the day will make a world of difference. And if you’re prone to oily or dry skin, always choose skin care products that are specifically designed for your skin type. Your skin will thank you for it by surprising you with big red zits less often. 

5. Ask For Help When You Need it
Asking for help may not always be easy, but when you need a shoulder to cry on or someone to listen, it can help put things into perspective.  Seeking support from family and friends or a professional isn’t a sign of weakness. In fact, it takes courage to admit you need help. Many patients that I see for the first time have been needlessly suffering for so long. I feel terrible for them. There is no reason not to seek help for any ailment affecting your health, especially your mental health. Patients who wait until they start to develop multiple physical and psychiatric issues before seeking help have a much harder time recovering than those who seek help sooner. Remember that friends and family are great support, but if you develop any signs of anxiety or depression or other mental health issues, get help from a licensed mental health professional immediately. In my experience, some patients may need medication, but some do not, they find relief through simple talk therapy with me. It’s very much an individualized assessment. While not a replacement for professional help, you can also look for online support groups for stress management. You’re not the only person who’s ever dealt with a specific stressful situation, so why not discover how other people managed their stress and overcame a potentially frustrating situation.

Hopefully after reading this you have a better understanding of what stress is, how it can impact your physical and mental health, and what you can do to start dealing with it effectively to minimize its role in your life. If you feel you need help, call my office for an appointment. I can help you. For more mental health topics and stories, check out my book Tales from the Couch, available on Amazon.com or for purchase in my Palm Beach office. 

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How To Sleep Better At Night

Slumber, shuteye, repose, siesta, snooze…Sometimes we have a love-hate relationship with it…we love it when it’s good and curse it when it’s bad, but we all need it. Whatever you call it, one complaint I hear from patients day in and day out is that they have difficulty sleeping. It’s so prevalent that I want to discuss how to  get better sleep. In my 30 years of practice, I’ve compiled a list of 14 things in no specific order that you can do that should have you snoozing at night night in no time. 

Rule 1: Bright light during the day.  Your body has to have bright light during the day; sunshine is best, but even sitting in a bright room, like by a window, is helpful. Bright light tells your brain that it is day time, time to be awake. Darkness or the absence of bright light tells the brain it is night time, time to sleep. If you’re in a dark room all day, you probably won’t sleep well at night. So remember, in the day time, bright light is right. 

Rule 2: Limit blue light. What is blue light? Blue light is what is emitted from your computer, laptop, and smartphone. The more blue light you are exposed to, especially at night, the more disruption you’ll have in sleep, as it disrupts circadian rhythm. Lots of people climb into bed with their cell phone or iPad, and that’s the worst thing to do. You should avoid looking at bright screens beginning two to three hours before bed. There are apps you can install on your phone that filter out the blue light. There’s also something called “F. Lux” that you can put on your computer or iPad which will block out the blue light. You never hear about it, but blue light exposure, especially at night, is a major factor in hindering sleep. 

Rule 3: Captain Obvious here with a newsflash. Caffeine will keep you up at night. Don’t think you’re going to have coffee or tea after dinner or before bed and expect to sleep. And if you’re drinking sodas, coffee, or iced tea all day, it’ll still disrupt your sleep. I tell patients to limit caffeine consumption to under 250 – 300mg a day. As a guide, an 8oz cup of coffee has about 100mg caffeine, the same amount of tea has 24mg, a 12oz can of soda has 34mg, and those gnarly energy shots have 200mg of caffeine! I strongly advise against consuming caffeine after lunch if you plan on a bedtime between 10pm and midnight.  

Rule 4: No naps! Boo! Hiss! Why is it that as kids, just the word nap sent us into a tizzy tantrum, but as adults we love naps? If anyone has an answer, please let me know. Anyway, as satisfying as it is, napping disrupts your sleep-wake cycle, temporarily resetting it to where you’re not likely to be able to go to bed between 10pm and midnight. Bummer. 

Rule 5: Melatonin. I recommend 2 to 4mg of melatonin at bedtime; it really seems to help a lot of my patients. I do find that some patients get daytime hangover from it though, so you’ll have to see where you fall on that one. But it’s definitely worth a shot if you’re suffering from insomnia. 

Rule 6: Get up at the same time every day, and go to bed at the same time every day. Yeah, it’s kind of a drag not sleeping in on weekends, but a sleep routine can make a big difference in your relationship with Mr. Sandman. You can’t regulate when you’ll fall asleep, but you can regulate when you wake up. So set your alarm and get up at the same time every day, no matter how tired you are. Don’t nap and go to sleep between 10pm and midnight, and you should fall asleep. If sleep still eludes you, stick to the same plan, and you should surely sleep the second night. You can’t decide when you’ll fall asleep at night, but you can regulate your sleep-wake cycle by deciding when you wake up. Stick to setting your alarm for the same time every day, and hopefully your brain will get the idea. 

Rule 7: I recommend taking a glycine or magnesium supplement at night as well as L-theanine and lavender. They don’t make lavender teas, pillow sprays, lotions, and sachets for nothing. I have heard from people that swear by lavender as part of their wind down routine before bed. You can find these supplements on Amazon.com. Shameless plug: handily enough, you can also find my book, Tales from the Couch for sale there too. Check it out. 

Rule 8: This is the Mac Daddy, numero uno, absolute, not-to-be-broken rule. Alcohol. If you consume alcohol before sleep, you will not sleep. Why? As the body metabolizes the alcohol, it goes into a withdrawl-like reaction and disrupts sleep. I know what you’re thinking. You’re thinking that a little nightcap helps you sleep. Wrong. Some people will tell you differently, but trust me…alcohol and sleep do not play well together. 

Rule 9: A comfortable bedroom. Your bedroom should be an oasis of calm serenity. There should be no office or desk in the bedroom. It should be uncluttered. Anything not conducive to sleep should be out. Make sure it’s dark and quiet at bedtime. The weight of multiple blankets can help sleep. You can even purchase weighted blankets expressly for this purpose. The weight is comforting and relaxing to the body. 

Rule 10: This sort of goes hand in hand with #9 above. Try a low temperature in the bedroom. I personally make sure my bedroom is at 70 degrees. The blankets from rule number 9 come into play here too. There’s something very comforting about burrowing under fluffy blankets to go to sleep. I mean, they’re called comforters for a good reason. 

Rule 10: No eating late at night. People seem to mostly make terrible food choices at night, all in the name of snacks…chips, candies, baked goods. Sugary foods are especially bad. When you eat, the body goes into digestive mode, not sleep mode; it is very interfering to sleep. Sugars especially are no bueno. Evening or night snacking is one of the worst things you can do If you want to sleep.  

Rule 11: Relax and clear your mind. There’s an older pop song that has a lyric, Free your mind and the rest will follow. It’s true. We all have problems and stresses throughout the day, and they seem to pop up when your head hits the pillow. You have to come to some resolution on how you’re going to handle the problems in your life and put them to bed so that you can put the rest of you to bed.  

Rule 12: Spend money on a comfortable quality mattress. You’re going to spend a third of your life in your bed. Just suck it up and spend the money on the mattress. Don’t cheap out. Another place to spend money is on good linens. Few things are as inviting as a comfortable mattress covered in minimum 1,000 thread count all-cotton sheets. If you’ve never had nice linens, try them.You can pick them up on a white sale or online. You can thank me later. 

Rule 13: No exercising late at night.  When you exercise late at night, you raise blood pressure and heart rate, which will hype up the body, which is the antithesis of what you want when it’s time to sleep.  

Rule 14: No liquids prior to sleeping. No rocket science here. If you put liquids in, you’re going to need to get liquids out. In other words, you’re going to have to get up in the middle of the night to pee. And you’re probably going to stub your toe. Not good. 

This is my handy dandy guide on the do’s and don’ts when it comes to sleep. Anything is better than counting sheep. I don’t know who came up with that, but I would like to inform them that I have never in 30 years heard of it working. I’ve never before wanted people to fall asleep as a result of reading something I wrote, so this is a first! I hope you’ve learned some things here that will put you out like a light.

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Depression – What Can You do to Help Yourself?

Let’s talk about depression. First, understand that like most things in life, depression is a spectrum; it is not black and white. Some people have situational depression or very mild depression and do really well with therapy and making some simple life changes. Others might need medication to assist them. Some unfortunately suffer from major depression and find it hard to cope with life. No matter where on the spectrum people fall, the following information is helpful to anyone who has experienced depression.

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