Coronavirus, social isolation, civil unrest, soaring unemployment rates, financial stress, racism and politics, to name a few; are all having a significant impact on people’s mental health and well-being. 

It’s easy to understand why many people are reporting feeling overwhelmed, lonely, fearful and helpless. These feelings are a normal response to a crisis situation and the stress is affecting nearly everyone on some level. We must also be aware of the effects of race and racial injustice on mental health.

The sheer rate at which our brains respond to the environment is staggering. We aren’t consciously aware of everything our brains are processing and can’t be expected to feel in control all of the time.

There’s also a whole new vernacular to go along with this pandemic. “Quarantine fatigue” has been generally defined by restlessness and frustration. Most people are feeling this to some extent. 

Despite wanting to stay connected, people are also expressing feelings of being "burned out" on videoconferencing.  This is happening because our brains aren’t wired to videoconference all day and night. There are many faces to process, you have to constantly focus and refocus your attention and you need to mentally shift to figure out who is speaking. It simply takes more mental energy to read faces over video. Keeping this in mind, it's important to take breaks.  Stretch, smile, get some water, take a walk. 

We are in the middle of an epidemic of fear; and a mental health crisis that will likely only get worse. Paying attention to your mental health is crucial and just as important as paying attention to your physical health.  In reality, these aren’t separate. Your stress level affects every aspect of your mind and body. 

Fear can evoke a physiological stress response. In short, stressful thoughts are an important signal to your brain to release certain neurochemicals and hormones to get you moving in case of danger. This is adaptive to promote survival if you are being chased by a tiger for example, but not in your day to day life. When stress is prolonged, it may lead to cortisol disruption.  Chronic stress causes our brains to produce excess stress hormones, which if left unchecked, can wreak havoc on a person’s mind and body. 

The way we think about things has an effect on our minds and bodies. Fear, magnification, rumination, helplessness… these things can incapacitate us. The coronavirus has become a chronic stressor. It’s been here for a while now and is not going away any time soon from what I can tell. 

It’s normal to experience all of the emotions. An important thing about emotional regulation is recovery time, or how long it takes you to, "get back to baseline." It’s healthy to have fluctuations in our heart rate and emotions.  Difficulty with emotional regulation comes when negative emotions happen frequently and for a long period of time. Or, if they put you or those around you in danger.

Data is already showing higher rates of several Covid-related, mental and behavioral health problems that are affecting millions of Americans.  These include: Anxiety, depression, suicidal ideation, substance abuse, post-traumatic stress disorder, violence in the home, cognitive and neurological problems to name a few.  These are all on the rise, as a result of the pandemic and related issues and things are looking even worse for front-line, healthcare workers.

Also, research has shown us that parents who are anxious may model anxious behavior for children or expect children to also be anxious (Aschenbrand & Kendall, 2012). Those of us with children at home want to be very mindful of how our own anxieties are playing out.  Parents and caregivers may need additional support due to the added stress of taking care of another person.

The good news is that, there are many evidence-based, interventions that people can incorporate fairly easily to promote resilience. We must encourage those around us to use positive coping strategies. It is imperative to recognize the social and economic inequalities and advocate for the more vulnerable low-income workers and ethnic and racial minority groups as well as the elderly.

If symptoms add up or become overwhelming, it’s important to get professional help. Many providers are using telehealth at this point if you’re not able or comfortable having visits in person. 

In all of this, we want to find perspective, recognize the silver linings, stay healthy and not give up on coping strategies.  Healthy habits, routines, social connectedness and relaxation can all help with stress management. There's not just one right way to manage stress. Try different things and see what works. You can rate your mood or level of well-being, before and after trying various strategies to get data on what works well for you. You can also ask others what works for them. This doubles as a way to connect socially as well. 

Some of my favorite stress management tips include:

1. Healthy Diet/Exercise/Sleep – what’s good for your body is good for your brain and each of these things can boost the immune system as well as mood. Exercise in particular boosts the feel-good chemicals in your brain. Aim for 30 minutes 5 days a week. 

2. Connecting with pets and nature. Pets can help improve well-being. If you don’t have a pet, focusing on nature has been shown to boost mood and have many health benefits as well.

3. Creating a gratitude practice is certainly worth mentioning and one area that is very well-researched. Gratitude is strongly correlated with greater happiness and better relationships. When we tap into a state of gratitude, we elevate our mood. One way to do this is just to bring to mind 5-10 things you can be grateful for right when you wake up.   Writing these things down helps your brain process more effectively, but you can also just do it in your head. 

4. Pay attention to your thoughts. The way you think about things matters. I mentioned earlier how your thoughts can cause your brain to release stress chemicals.  Reducing negative thoughts that lead to unhelpful feelings and bringing in more positive thinking can actually help you optimize your immune system! Our thoughts, feelings and behaviors are all connected. What you think affects what you do and how you feel! How you talk to yourself matters. So Be kind!  Most of the time people don’t pay attention to how they talk to themselves. When people experiencing a “low” or “anxious” mood start to pay attention, they often notice that an unhelpful or dysfunctional thought came before the feeling. 

5. Socializing (safely). Social support is essential for maintaining our mental health. On that note – try to stay connected – use technology to stay in touch, check in on people often. Here are some tips for increasing social connectedness. Try and be as kind as possible during this time – most people are struggling in some capacity right now. Help people in your life that might be more vulnerable.

6. Bring in more pleasant events. Pleasant and unpleasant events are happening constantly and much of what goes on is beyond our control.  This perceived lack of control as well as the lack of balance between pleasant and unpleasant events can cause frustration, overwhelm and burnout. The good news is that we can make choices about many of the events that happen, and in-turn, improve our well-being.  Pleasant events don’t have to be huge activities that require a lot of planning.  They can be as simple as listening to a song that you love, taking time to smell your coffee grounds before you make your cup of coffee and savoring that first sip.  Self-care can be, simply acknowledging, that you are doing something to take care of yourself. It’s more about the cognitive reframe than what you actually do. Schedule these things into your calendar. If you realize at the end of the day that you forgot to plan your pleasant events, you can take a moment to think about what things you did because you were doing them to take care of yourself. Pat yourself on the back. 

7. Meditation. When we feel overwhelmed, It’s important to remember, that most of the time, nothing terrible is happening in the present moment. If we can come back to our bodies, come back to our breaths, and remind ourselves of that fact; we can take a big step toward feeling better. With our eyes closed and our breath deepened, we tell our physiology that we are safe.  A few minutes of conscious breathing can completely shift our mood and bring a sense of calm. We can directly impact our autonomic nervous system, our mood, our immune system and pain receptors can become less active.  There is so much research out there that champions the benefits of meditation to help everything from: stress-reduction, improved cognition, better sleep, pain reduction, decreased inflammation, disease prevention, anxiety, lower blood pressure and more. A meditation practice can help you realize that you are not your thoughts and can create some space between thinking and reacting. 

Most of us start our days in a rush.  I have a challenge for everyone. Tomorrow, when you wake up, try acknowledging yourself with a smile and a “ good morning.” Take 5 deep breaths before grabbing your phone or doing anything else. Think about what you can be grateful for; think about what you’re going to do to take care of yourself…When we start our day in a calm and grounded way, everything tends to feel more manageable. Thank you and stay safe!

Bringing awareness to ones communication style, can be very helpful. Assertiveness training can improve communication and relationships with others. The goal is to adopt a sense of, “I win, you win” instead of simply trying to, get what you want.

Quiz: What’s your communication style?

Being assertive isn’t only good for your relationships, it’s good for reducing stress and anger, and communicating better according to the Mayo Clinic. It can also help boost self-esteem.

We all have different ways of getting our points across. Most communication styles fall within four categories: Passive, Aggressive, Passive-Aggressive, or Assertive.

Aggressive communication disrespects others’ boundaries: “I win, but you lose.”

With passive communication, boundaries are violated by others: “You win, and I lose.”

Passive aggressive communication action is a deliberate but covert way of expressing anger (Long, Long & Whitson, 2009) and is most often motivated by a person’s fear of expressing anger directly.

In assertive communication, boundaries are mutually respected.

What type of communication style do you typically use? Does your style change depending on your audience? In which situations would you be most likely to try to improve your assertiveness?

When someone comes at you more aggressively, it’s important to consider the source. Why might this person be saying what they are saying? It might have nothing to do with you, maybe they’re just having a bad day, or a hard time. Try and take a moment to reflect before responding. If it is personal, not all criticism is bad. In this case, can any of what they are saying be true and helpful? Is there something to learn and grow from here? If so, maybe say to this person that you hear their perspective, and you would like to do better. Ask if they have any specific feedback you can use to improve. Then remember that this is just someone’s opinion. Sometimes you will want to take that in, and sometimes you won’t.

The next time you draft an email or text message that could be interpreted different ways; re-read it to yourself and imagine someone was sending you the same message. Is there anything you would change?

Read more about assertiveness here

Contact me if you would like to work on your own assertiveness skills, or for a company training.

Research supports that life events influence health and well-being. Pleasant and unpleasant events are happening constantly, and much of what goes on is beyond our control. It’s difficult to turn on the news or read the paper without coming across something very upsetting, that we seemingly have no ability to change.

You get a bill in the mail, someone steps on your foot, rear ends your car, your child is whining and crying, the person in line ahead of you is taking forever… The list can go on and on. The lack of balance between pleasant and unpleasant events can contribute to sadness and anxiety. It’s easy for people to begin to feel frustrated and burned out.

The well-known relationship expert, John Gottman found in his research that the magic ratio for partners is 5:1. This means that for every one negative event, feeling or interaction, five positive feelings or interactions are necessary to neutralize the negative one. Similar numbers were found in the workplace, “Praise to Criticism” ratio. If we take this information and generalize it to life events, it’s easy to see how things can spiral downward fairly quickly in terms of mood and well-being. Pleasant or unpleasant events can contribute to how, “up” or, “down” you feel.

The good news is that there are plenty of things we can control. We can make choices about many of the events that happen in our environment. The key might also be in our perceptions, and a little cognitive reframing can go a long way. I talked a little about cognitive therapy and how our thoughts influence our feelings in previous posts.

You can also help yourself feel better by intervening behaviorally, making sure your day has plenty of pleasant events that bring you pleasure. Pleasant events don’t have to be huge activities that require a lot of planning. These things can be as simple as: Listening to a song you like, taking a short walk, chatting with a friend, appreciating nature, meditating, getting a mani/pedi, getting a massage, massaging yourself, reading, tidying up your house, eating your favorite meal, looking at the clouds… It really doesn’t matter what it is, it matters how you categorize and perceive it. Anything you like to do is a pleasant event!

My wise mentors in graduate school, Drs. Dolores Gallagher-Thompson, Ph.D., and Larry Thompson, Ph.D. implemented the research findings on pleasant events with caregivers of dementia patients to increase well-being in this extremely stressed out population. I’ve used these methods successfully with my clients over the years and have found it to be fairly generalizable. The idea is that at the beginning of each day, you decide on several things you will do to take care of yourself that day. Four (or more) pleasant events a day, that are consciously chosen, and deliberately done, will keep the blues away. This can work retrospectively as well. If you forgot to plan your 4 CCDD things (consciously chosen and deliberately done), you can take a moment to think about what things you did because you were doing them to take care of yourself. Pat yourself on the back for prioritizing self-care. We all need it.

Give it a try and see if your mood improves!

Instead of focusing on maladaptive patterns and behavior, positive psychology focuses on helping people function at an optimal level. Positive psychology aims to better understand and apply factors that help individuals and communities thrive and flourish (Seligman & Csikszentmihay, 2000).

Well-being can be achieved or increased through deliberate interventions.

One of the earliest documented interventions involved guiding people to adopt traits present in happy people (Fordyce, 1977, 1983).

To date, many interventions have been developed that have been shown to increase well-being including:

Practicing forgiveness (McCullough, Pargament, & Thoresen, 2000)

Participating in happiness training (Goldwurm, Baruffi, & Colombo, 2003)

Keeping a gratitude journal (Emmons & McCullough, 2003)

Thinking about positive experiences (Burton & King, 2004)

Writing a gratitude letter (Seligman, Steen, Park, & Peterson, 2005)

Engaging in acts of kindness (Lyubomirsky, Sheldon, & Schkade, 2005)

Counting one’s blessings (Lyubomirsky et al., 2005)

Engaging in productive activities (Baker, Cahalin, Gerst, & Burr, 2005)  

 Reliving positive events (Lyubomirsky, Sousa, & Dickerhoof, 2006)

Nurturing relationships (Lyubomirsky, 2008),

Participating in goal-setting (MacLeod, Coates, & Hetherton, 2008).

One of the first things that comes up when you start researching Positive Psychology is GRATITUDE! Gratitude is strongly correlated with greater happiness and better relationships When we tap into a state of gratitude, we elevate our functioning and see improvement in a variety of areas.

This is a summary of over 40 research studies on gratitude. Click the picture to link to the source.

A simple thing we can do to tap into gratitude is to create a gratitude journal. Just write down 5 things that you are grateful for. You can start a notes page on your phone, or can write these down on a piece of paper. Take a moment to rate your sense of well-being before writing down your gratitude list. Write down your list, then re-rate your sense of well-being.

P.S. This can work even if you go through the list mentally, but better if you write it down.

I was introduced to meditation in 2002, by my mentor Dr. Dolores Gallagher-Thompson. She taught us how to lead guided imagery sessions with caregivers of dementia patients, to help promote relaxation and to relieve stress. Caregivers tend to be an extremely stressed-out population, who are particularly vulnerable to mental and physical illnesses. We emphasized that one must prioritize self-care, in order to better care for others. (This is true for anyone!) I saw first-hand how quickly these techniques worked, and how powerful they were to help promote a sense of well-being. We taught a different meditation tool each week. There are various types of meditation, not every method works for everyone. I’ve used the techniques from our caregiver research with many clients over the years, and for myself. I also use various apps and web based recordings/videos. I love, love, love, how meditation affects me personally. For one thing, I notice that after I meditate, I feel a sense of calm, and I have a little more, mental “space” before reacting. This is so helpful as a parent. This is true even if I only do a, “signal breath.” There is so much research out there that champions the benefits of meditation to help everything from: stress-reduction, improved cognition, better sleep, pain reduction, decreased inflammation, disease prevention, anxiety, to lower blood pressure… the list goes on. Click the Buddha to read some of the research. The benefits of building a meditation practice seem endless. It’s also so, “mainstream” now, Jimmy Fallon even meditated on television.

Please don’t be discouraged if you try it and don’t like it. Try a different method! I really like the Insight Timer app because there are thousands of teachers, it’s free, and you can sort meditations by the length of time you have to practice. You can try for a minute a day and build up!

Click the pictures below for more info.

Science of Meditation - Research

As always, if you are in crisis, experiencing any suicidal or homicidal ideation, please seek immediate medical attention.

The other day, I wrote a little about cognitive distortions. These are unhelpful thoughts that we all tend to have, that are not rational, and can likely cause negative feelings. Most of us do not pay attention to the way we are talking to ourselves; our internal dialogue. Identifying these unhelpful thought patterns is a first step in feeling better. https://www.drericafels.com/building-pathways-for-positive-change/2019/1/16/intro-to-the-cbt-perspective

Today, I present an antidote. Check it out and check yourself!

David Burns is arguably the father of Cognitive Behavioral Therapy and has some amazing books and resources to help people with various mood related concerns. Check out his website, blogs, articles, and podcasts to learn more! https://feelinggood.com/tag/fifty-ways-to-untwist-your-thinking/

As always, if you are experiencing severe distress, any suicidal or homicidal ideation, or anything you need help to cope with, please call 911 or seek professional support as soon as possible.

Mindset = the underlying beliefs people have about intelligence and learning. There is a lot of research on growth mindset and it’s relationship to praise from parents and teachers. After studying thousands of people, Dr. Carol Dweck discovered the tendency for people to have either fixed or growth mindsets, and that people with a growth mindset will learn more, learn faster, and more thoroughly if they believe that intelligence is not fixed. This has huge implications for parenting and teaching!

Today I’ll talk a little about Cognitive Behavioral Therapy. Regarding the cognitive piece, the idea is that our thoughts, affect what we do (behavior), and how we feel. One can intervene at the thought or behavior level, to create a change in functioning. Thoughts are extremely powerful and have the capacity to impact how we feel, what we do, and how we present ourselves to be in the world. One way to keep our thoughts in check, is to start paying attention to how we talk to ourselves. It’s very common to have distortions in our thinking, that impact us in ways that we could never imagine. Today, when something is bothering you, pay attention to your thoughts and see if you can identify any of these common distortions in your thinking. Raising awareness about these common, cognitive distortions, and checking your “self-talk,” might be all you need to do, to have a better day.

This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise provide any clinical opinions. You can call or email for a consultation with Dr. Felsenthal. If you think you need immediate assistance, call your local emergency number or the mental health crisis hotline listed in your local phone book’s government pages.