Are you feeling stressed, anxious, or depressed right now? Well, you have every right to feel that way. It is a good habit to reflect on all the things you have and not ruminate on all the things going wrong, to keep your mental health balanced. However, sometimes it is okay to just say “hey, I am having a hard time right now” and for someone else to validate how you feel. This is a tough time. Stress about health and worry for loved ones, concerns about personal and global finances, and other greater life concerns that many people are facing may only be part of what is causing issues. There are those who are alone and isolated, those who are overwhelmed by family at home, those missing important life events, and so on. Just because it is not a crisis does not mean it isn’t important and you don’t deserve to have feelings about it. Yeah, maybe someone does have it harder, but that doesn’t mean what you are going through isn’t hard or important. Be well friends.
It is important to acknowledge the impact the current covid-19 pandemic situation has had on our home lives and relationships with our families. Many people are experiencing stress for different reasons and are expressing their stress in different ways, but when we are locked in close quarters, it is hard for it not to all impact the entire family. I want to validate those who are struggling with their home lives and encourage them to keep doing the things they need to do to recharge their batteries and maintain good mental health.
Are you feeling stressed and overwhelmed because of the Covid-19 pandemic? You are not alone my friends. I have had several people ask about suggestions for dealing with the stress of the situation, so I decided to put together a short video with some quick tips to help manage the stress and anxiety you might be experiencing.
Do you have questions or want me to cover specific topics? Email me and I will see what I can do! Be well my friends.
You can’t scroll through the news or social media outlets without being bombarded by the news about COVID-19. Most of us are feeling the effects of the lifestyle changes that have rapidly taken place.
Why are people not doing well emotionally?
We Worry About Loved Ones
Even if you are not concerned about your own health, most of us have people we care about people who fall into the “vulnerable population” category. It is scary to have to sit back and wait, not knowing who could be effected, and feeling helpless to do anything about it.
Financial Crisis
You may be one of the people who are worried about how you are going to get by without pay as workplaces shut down. Even if you are one of the lucky folks who are still being paid, it is scary and sad to know that people you know and love are being hit hard, and we still have yet to know how bad the blow will be.
Lifestyle Limitations
Everyone jokes about how extroverts are a mess but introverts have been preparing for this moment! But the fact of the matter is that introverts are doing just as badly as everyone else. When we lose the ability to choose what we are going to do next, even if it involves just going to the store, that is very difficult to manage emotionally.
The Issues are Control and Connection
It all comes down to we want to feel in control of our lives. We want to be able to help the people we care about, we want to be able to prepare for what is coming next, we want to do something, but our options are limited and the future is uncertain.
On top of that, most humans crave connection with others. You don’t have to be an extrovert to enjoy time with others or just time out and about doing things you enjoy and being around people. Feeling cut off from others, even the small interactions with people you don’t know at the market, can take a serious toll on mental well being.
What to Do
Control what you can.
A routine can help keep the day going and prevent the development of unhealthy habits. Plan out a day that feels productive and rewarding. Some people find cleaning to be relaxing, especially when life feels a little chaotic, so consider doing some tidying up and organizing. Make sure that you are still taking care of your health by eating right and keeping up hygiene practices. No one can see you at home, but if you do have an emergency, do you want to not have showered in 5 days? If you are unsure, no, you do not.
Get outside if you can.
Being outside and getting some movement can have major benefits across many domains, sunshine paired with movement, win win! Plus getting out and doing a “normal” activity can help you regain center. Maybe you will even see people you can wave at from a healthy distance!
Connect with others
It is important to continue to connect with those you care about and who care about you. People often think “I don’t want to bug this person” or “I don’t want to put my problems on them” but it usually makes both people feel better when connection has been made. When possible, do a video chat so you can get the full benefit of time together, face to face.
Try something new
You know how I mention rewarding earlier? Well, try out a new hobby, read a different kind of book, learn to bake, try learning another language, or teach your kids new things. It will help build positive emotion if you are doing things that are interesting and make you feel accomplished.
What Not to Do
Isolate
I know it can be really stressful and you may feel alone, but you aren’t. If you feel alone, reach out to those you care about and just check in; they may need you as much as you need them. If you have limited connections, well now is the time to build them. Connect with people you haven’t talked to as much or try to meet new people through online social resources.
Constant news
It is good to be informed and to know what is going on, but being glued to the news or media that is giving coverage may not be healthy, in fact, it might cause one to panic. Try to not engage in coverage more than a couple times a day. You may also need to cut back on social media if the content is triggering a stress response.
Unhealthy habits
Stress plus being bored can lead to some seriously bad coping skills. I too enjoy the ‘add to cart’ stress relief, but financially, it is a bad idea. Sometimes people do a little too much online shopping, snacking, sleeping, drinking, all nighters gaming, and other activities that may be fine in moderation, but in excess can be quite unhealthy. Try be mindful of your activities because you might not notice the increase until it has gotten to an undesirable state.
Take aways
One important take away is that if you are feeling alone, stress, anxious, or depressed related to this current situation, that is normal. It is not pleasant, but it is a normal response to such an extreme situation. Hopefully following some of the tips above will help the situation stay manageable until this passes.
However, if you feel like you might be slipping beyond what is manageable, reach out to a loved one or mental healthcare professional. There are support services out there to help you.
Many of you know that I have spent the last year and change
researching moral injury in veterans and the impact of learning about moral
injury on clinicians who work with veterans. Today I want to start by just
introducing the concept of moral injury to those who may not be familiar.
What is Moral Injury and how is it different than PTSD?
Most people are familiar with the term Posttraumatic Stress Disorder (PTSD), especially in relation to combat veterans. PTSD is when a person has experienced or witnessed a traumatic event AND then has symptoms such as intrusive thoughts about the traumatic event, avoiding situations that remind them of the event, hyperarousal, and negative or counterproductive thoughts about themselves or the world, lasting longer than a month (APA, 2013). The symptoms of PTSD are fear responses to traumatic memories. Operation Iraqi and Enduring freedom veterans are twice as likely (14%) to experience PTSD than their civilian counterparts (7%) (Tanielian, & Jaycox, 2008; Kessler et al., 2005). Researchers have been working hard to develop and improve current PTSD treatment for veterans with a fair amount of success. However, many veterans, two thirds according to Steenkamp et al. (2015), still meet the PTSD diagnosis criteria after being treated with frontline treatments such as Prolonged Exposure, Cognitive Processing Therapy, and EMDR. So, what are we missing?
It is possible that the problem, or part of the problem, may be some veterans experiencing moral injury. Moral injury is what happens when a person engages in or fails to prevent something that goes against deeply held beliefs and values (Litz et al., 2009). It does not matter if it was part of their job, if they had to do it to save their own lives, or they were commanded to do it, the veterans experience deep guilt and shame about what has transpired. Some examples include killing, torture, damage of property or failing to prevent others from harming people or property. Additionally, moral injury can include instances where a person experienced betrayal from leadership or was the betrayer of others (Shay, 2014). Without being able to process those experiences and separate the events from who they are as a person or make amends in some way, it can cause some serious symptoms such as spiritual concerns, loss of trust of self (Jinkerson, 2016), issues related to meaning of life, depressive symptoms, anxiety symptoms, reexperiencing, avoidance (Jinkerson & Battles, 2019), poor physical health (Yan, 2016), social isolation and interpersonal issues (Litz et al., 2009; Shay, 2014).
So what? You should feel guilty when you do something wrong
Yes, the average person does feel guilt and/or shame when
they do something wrong. Usually that
guilt or shame will help them realize that they should not do that thing again
and possibly try to fix the wrong they have committed. Moral injury is something that is far more
severe. Sure, most of us have done a few
things that continue to randomly pop into our heads at night when we are trying
to sleep, causing negative feelings.
Moral injury does not allow the person to compartmentalize the event to “I
did something wrong”, instead the person sees themselves or the world as bad
and unworthy. They may feel so much
guilt and shame that they isolate themselves from those they love because they
believe they are unworthy or they fear what the person might think of them if
they knew what kind of person they were and what they had done.
Do standard PTSD treatments for Moral Injury?
This is a tough one and the jury is still out. Some of the current PTSD treatments are manualized and so have little room for deviation. Further, it is possible that a clinician might treat moral injury as a cognitive distortion, or inaccurate view of the themselves or what happened, which is really may not be appropriate. A key to working with moral injury is allowing the client to choose what is a true violation of right and wrong. If a person believes it is wrong to take a life, and they took a life, no matter what the circumstances, then according to that person’s values, they did wrong. Instead of fighting that and saying that anyone would have done that in that situation, a clinician must allow the client to then make meaning of that experience and find a way to move forward by either seeking forgiveness, making amends, doing an act of service, or whatever is deemed appropriate by the client and counselor.
That being said, it is possible for a veteran to experience PTSD and moral injury at the same time, and so in this case it would be important to address both the PTSD and moral injury. There are treatment interventions that are currently being developed to specifically do this called Impact of Killing and Adaptive Disclosure.
Do people other than Vets experience Moral Injury?
They certainly do. I
have worked with those in the medical field who care for the sick and dying who
report having done things as directed by superiors that they did not feel was
what the client wanted and caused suffering.
Many case-workers are put into no-win situations where they are trying
to make the best choices on the behalf of children, only to find out the child
is in a worse situation. Those in civil
service often have to bring harm to others in order to do their jobs, and while
it is part of the job, there are those that suffer greatly for having harmed
another or failed to prevent harm. These
are just some jobs in which moral injury occurs, but the list is not exclusive.
What do I do if I or someone I know is suffering from Moral Injury?
Secret suffering only gets worse with time. The best thing you can do is talk about it with someone you trust. Maybe it is a family member, a friend, a counselor, or a spiritual adviser, but holding the pain inside you and suffering alone will not make things better. If you are supporting a person experiencing moral injury, be sure to let them know that you accept them just as they are. If you choose to seek professional help, you can ask your therapist if they have any training in moral injury or specifically search for those who do.
If you have any questions, feel free to message me at
Guidestar Counseling and Consulting on facebook or www.guidestarcounseling.com
Be well friends.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, (5th ed.). Washington, DC: Author.
Finlay, L. D. (2015). Evidence-based trauma treatment: Problems with a cognitive reappraisal of guilt. Journal of Theoretical and Philosophical Psychology, 35(4), 220–229. https://doi.org/10.1037/teo0000021
Jinkerson, J. D. (2016). Defining and assessing moral injury:
A syndrome perspective. Traumatology, 22(2), 122–130.
https://doi.org/10.1037/trm0000069
Jinkerson, J. D., & Battles, A. R. (2019). Relationships
between moral injury syndrome model variables in combat veterans. Traumatology.
https://doi.org/10.1037/trm0000163
Kessler, R.C., Berglund, P., Delmer, O., Jin, R., Merikangas,
K.R., & Walters, E.E. (2005). Lifetime prevalence and age-of-onset
distributions of DSM-IV disorders in the National Comorbidity
Survey Replication. Archives of General Psychiatry, 62(6), 593-602.
Litz,
B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., &
Maguen, S. (2009). Moral injury and moral
repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29(8),
695-706. doi:10.1016/j.cpr.2009.07.003
Shay, J. (2014). Moral injury. Psychoanalytic Psychology, 31(2), 182-191. doi:10.1037/a0036090
Steenkamp, M. M., Litz, B. T., Hoge, C. W., & Marmar, C. R. (2015). Psychotherapy for military-related PTSD: A review of randomized clinical trials. JAMA: Journal of the American Medical Association, 314(5), 489–500. https://doiorg.ezproxy.lib.apsu.edu/10.1001/jama.2015.8370
Yan, G.
W. (2016). The invisible wound: Moral injury and its impact on the health of
Operation Enduring Freedom/Operation Iraqi Freedom veterans. Military
Medicine, 181(5), 451-458. doi:10.7205/MILMED-D-15-00103
Yan, G.
W. (2016). The invisible wound: Moral injury and its impact on the health of
Operation Enduring Freedom/Operation Iraqi Freedom veterans. Military
Medicine, 181(5), 451-458. doi:10.7205/MILMED-D-15-00103
Every January gym memberships soar, health foods are purchased, cigarettes are thrown out, financial savings plans are made, family time is instituted, and stress management strategies are created. People set goals every year to improve their lives, and yet only months later many will have given up on their resolution. Do those that fail to complete their resolutions just have less willpower? The answer is no, they have just either not chosen the right goal or need to plan more effectively. To help increase your chance of success with your resolution, here are some basic success strategies:
Set Meaningful Goals
If you are going to set a goal that will be difficult to achieve, it is critical that it is important to you or that you can see the importance of doing it to improve your life. Basically, when the going gets tough, will you care enough about the goal to keep on keeping on? Goals that are set to make someone else happy or are superficial in nature are often more difficult to achieve. The more meaningful the result of the goal, the easier it is to keep going during hard times. It helps to focus on why the goal is important to you.
Surround Yourself with Reminders
Find a way to set up your surroundings with reminders about the goal and why it is important, to help you stay motivated during difficult times. Carry or display a picture of your family, a letter you wrote to yourself at the beginning of the journey, a medical report, or a picture of that dream item you are saving for, anything that you can look at to remind you of your goal. The constant connection with what your goal is and what it means to you will help you stay motivated.
Set Realistic Goals
Often people want a great radical change but may not have the ability to make that great of a change right away. Huge lifestyle shifts can be difficult, and sometimes life circumstances make drastic changes impossible. Those who adopt an “I am either a success or failure” attitude, are likely to give up completely and label themselves as a failure at the first setback. Consider the amount of time and effort your goal requires and create a plan you can sustain through the most difficult and stressful times of your year.
Dealing with Setbacks
Setbacks happen. You have a busy week and can’t get to the gym, you take a week-long binge on junk foods, you light up a smoke after a stressful day, you made an impulse purchase, or the family has hardly seen one another in weeks, sometimes we just get off track. Does that mean you failed? No, it means you need to revamp that plan so you can be more successful in the future. Ask any great athlete, scholar, actor/actress, or business person and they will tell you their careers are built on learning from failure. So, if you experience a setback, look over your plan and see what you can do to make it better, and get back to it!
Accountability Plan
One way to help stay on top of your plan is to share what you are working on with someone else. Let that person help you look for potential areas where you might struggle for planning purposes. Then encourage them to check in with you regularly to check up on that goal. Just knowing that another person is going to ask you about your goal can sometimes instill motivation to stick with it.
Now Go Forth and Succeed
If you want to be successful in your New Year’s resolution, planning is key. If you choose a meaningful but realistic goal, set your surroundings to remind yourself why that goal is important, plan for difficult times and setbacks, and have some support for your process, you will be better prepared to take on that resolution. Above all else, take a moment to be proud of yourself for trying something new and be kind to yourself when things aren’t going well. Remember, failure only happens when you fail to try. If you have questions, feel free to reach on on the Guidestar Counseling Facebook page or at www.guidestarcounseling.com.
The holiday season often brings out the inner generosity of people; you may have even been on the receiving end of those gestures. Whether it be a cup of coffee at Starbucks, letting you skip ahead in the grocery line, or a loved one making you a special treat, these moments are actually small gifts that can impact your mental well-being. In fact, these experiences can improve your quality of life, increase your experienced happiness, and foster relationship building, when you spend time being grateful for them. When you sit back and reflect on all the good stuff you have, instead of focusing on where you are not or what you do not have, you can feel pretty amazing. So why don’t we do it all year?
What Makes Gratitude Hard?
While I don’t get free coffee all year, good things happen
all the time. So what keeps us from
seeing all the amazing stuff around us? We
as humans naturally tend to notice where things go wrong and spend time focusing
on those things. Thinking about ways we
can improve ourselves or situations is a good thing; it gets us motivated to
make change. However, if you find
yourself constantly thinking about how you are not good enough, comparing
yourself to others on social media, and thinking about all the things you don’t
have, you could feel pretty defeated.
The Good News is, We Can Do Something About It
The good news is, there is something we can do to retrain
our brain to notice the good things in our lives, because they are there, even
in the toughest of times. The use of a
gratitude journal is a great way to start practicing finding the things to be
grateful for and proactively creating more situations that make you happy. A gratitude journal is an activity you can do
every night to think about the good things that happened that day. It is
important to also write down some additional information about how the event
happened, who helped it happen, what about it was so special to you, or ways
you could experience this good thing again.
Spending time thinking about the things you are grateful for is how you
get the biggest effect.
Benefits of Gratitude as a Life Practice
Not only to you get to re-enjoy these experiences through
memory, but by spending the time processing why these things meant so much to
you, you might begin to realize just how many good things you have experienced.
The more you practice, the more that you
will begin to notice the good things that happen throughout the day in real time!
Imagine the impact on your brain to see
so many good things in your life! You
will also learn how to replicate these events when possible. If you know you
felt great after walking your dog, volunteering, or calling a close friend, you
know how to make that positive emotion experience happen again. You then become more in control over your own
happiness.
But Wait, There’s More!
Not only will you experience more positive emotion and see
the world in a better and more accurate light, gratitude is a great way to
improve meaningful relationships. Imagine instead of sitting down with the kids
at dinner and asking, “how was your day” in which you will likely get
“fine”, the family goes around and tells about what good thing
happened today. This helps the whole
family learn to see the positive things in their lives and promotes family
bonding. The atmosphere is usually quite
excited when everyone gets to talk about something that made them happy.
Also, don’t forget to take the time to let someone know when
they have done something that you are grateful for, no matter how small. When people go out of their way to do nice things
and are not acknowledged, especially over time, they may stop doing those small
acts of kindness because they feel they go unnoticed or unappreciated. It takes such little effort to say, “I
noticed that thing you did and it brightened my day”. Practicing gratitude with those we care about
is a great way to build positive emotion in relationships!
Make it a Practice, Not a Season
Gratitude needs to be something we practice every day,
especially the days we don’t feel like it. There is nothing too small to list in your
journal. Sometimes it will be hard,
because some days are hard. When you can
find nuggets of goodness, even in the toughest days, it lightens the stress and
negative emotion you are experiencing. The best way to ensure you don’t start
slacking on your gratitude plan is to make it part of your daily routine. You
can keep a journal and write in it at night, do a nightly or dinner time
sharing session with friends or family, or jot things down through the day to
review at night. So long as you make the practice of doing it every day, you
will be training your brain to be more positive and to notice where things are
going right, all while improving meaningful relationships! Win win win!
Self-care is a buzzword flying around to describe things we do for ourselves in order to ensure our well-being in a high stress world. While a bath bomb, an evening with a good book, or splurging on something special might feel great in the moment, they often don’t have lasting effects on our mental health. When a person lives in a state of high stress, anxiety, and/or depression, one or two self-care acts are not going to be enough to make the impact we need to get our heads in the right space to feel better. Effective self-care is a lifestyle change and requires action every single day. Here are a few areas that I suggest incorporating into a daily self-care plan.
Be Nice to Yourself
Do you ever take time out of your day to just give yourself
a pat on the back for the awesome job you did today? We can be our own worst critics and negative
self-talk is not going to make us feel any better. Take some time out of your day to celebrate your
successes! Not every success has to be a
life altering event. Getting out of bed
in the morning is a success when you really struggled to do it. We spend too much time thinking about ways in
which we are not enough. There is a
difference between working to be better and holding unrealistic standards to
are either unachievable or are achievable, but at great cost to your personal
health.
If you want to engage in self-improvement then I encourage
you to make a practice of taking at least 5 minutes of your day and thinking
only about how you have succeeded today.
Reflect on the things you feel good about having done. Nothing is too small. If you can only list a couple of things,
spend that time really digging into how good that experience was for you. It will give your brain a workout an teach it
too look at yourself in a better and more accurate light.
Get Some Sleep
Despite what you might think, the average person needs 7-8
hours of sleep to function his or her best.
Lack of sleep can negatively affect mental health and reduce performance
and reaction time in important tasks.
Think you can sleep 12 hours on Saturday to make up for only getting 4
hours of shut eye through the week? It
doesn’t quite work like that. Sleep debt
is accrued, and it takes time to pay it back.
So how do we deal with the things that are keeping us up?
Here are some tips: If your thoughts are going 100 miles an hour, write them
down on a list that you can look at later.
Engage in guided meditation or progressive muscle relaxation to relax
the body and help focus the mind; there are a lot of free apps you can
use. Use a sleep routine that helps the
brain recognize when it is bedtime.
Unplug: turn off the phones and other devices at a set time to help
prevent staying up later than intended.
A well-rested brain and body can make a huge difference in
your preparedness to take on the day.
Take Care of Your Body
Have you ever noticed when you have been sitting nonstop or
eating nothing but junk food you start feeling bad? The state of our bodies strongly impacts
mental health. Getting some exercise
every day is important to staying mobile and able to do the things you enjoy while
also getting those happy endorphins kicked up a notch. You don’t have to hit the gym if you don’t
have time; go for a walk, do some yoga, or anything that will get you up and
moving throughout the day. The important
part is that you make movement a regular part of your daily routine and do it
even when you don’t feel like it.
Also pay attention to what you put into your body. We have all had to hit drive-thru because we
are short on time, but constant high fat and unhealthy diets can lead to
physical discomfort and unwanted weight gain.
Try to ensure that you are getting some fresh fruits and vegetables
every day!
Final Thoughts
And there you have it friends! If you want to improve your mental health and
generally try to take better care of yourself, self-care needs to be an
intentional and daily practice. Consider
creating a self-care plan that you can post somewhere and will have to look at
every day as a commitment to yourself.
The key to making gains is continuing with the self-care tasks even when
it isn’t convenient or you don’t feel like it, because that is when you need to
do it most.
Stay tuned to www.guidestarcounseling.com
or follow me on FB at Guidestar Counseling or @guidestarcounseling for more
informative blogs!
