Anxiety Attacks vs Panic Attacks

Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1% of the population every year. (Anxiety and Depression Association of America). Given the high rates of anxiety disorders, It’s common to hear people talk about anxiety attacks and panic attacks interchangeably. This is understandable given that anxiety attacks and panic attacks share common symptoms like increased heart rate and shortness of breath.

Close to 11% of Americans experience a panic attack. Approximately 2% to 3% of them go on to develop panic disorder, per the Cleveland Clinic. According to the DSM-5, a panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes. Common symptoms during a panic attack include physical and mental symptoms.

physical symptoms: pounding heart, sweating, trembling or shaking, shortness of breath, feelings of choking, chest pain or discomfort, nausea or abdominal distress, feeling dizzy, light-headed or faint, chills or heat sensations, numbness or tingling sensations (paresthesia).

mental symptoms: feelings of unreality (derealization) or being detached from oneself (depersonalization), fear of losing control, or fear of dying.

A panic attack is the hallmark feature of a condition called Panic Disorder. Furthermore, panic attacks can occur in the context of any anxiety disorder as well as other mental disorders. Panic attacks can occur suddenly and without warning. The symptoms usually peak within 10 minutes and tend to disappear soon after.

The term ‘anxiety attack’ is not defined in the DSM-5 but is used to describe a core feature of anxiety disorders. Anxiety tends to intensify over a length of time. Anxiety is significantly correlated with a potential danger (real or perceived) or excessive worry. If the anticipation of something escalates and a significant amount of stress becomes overwhelming, it might feel like an anxiety attack. The symptoms of anxiety tend to include the following symptoms:

mental symptoms: restlessness, irritability, difficulties concentrating.

physical symptoms: dizziness, fatigue, muscle tension, increased heart rate, disturbed sleep.

While some of the symptoms of anxiety are similar to panic attacks, the symptoms are generally less intense. The symptoms of anxiety may be persistent, short-lived, or long-lasting.

Psychotherapy especially cognitive behavioral therapy (CBT) is very effective in treating panic attacks and anxiety disorders. CBT helps you understand how your thoughts, feelings, behaviors, and physical symptoms are all inter-connected. In psychotherapy, you can learn various CBT skills that can help feel in control of your anxiety rather than anxiety controlling you.

If you are needing help in dealing with your anxiety, please consider setting up a free phone consultation and we can discuss how therapy can be helpful.

6 Tips to Increase Self - Motivation

Rather than writing about new year's resolutions, I thought why not write about motivation. According to the dictionary, motivation is the general desire or willingness of someone to do something. More specifically self -motivation is our internal drive to achieve, develop, and keep moving forward. Self-motivation is encouraging yourself to continue making progress toward a goal even when it feels challenging. Below is a list of suggestions that remind us that action is what leads to motivation.

1. Practice daily gratitude. Gratitude increases your feelings of abundance. Gratitude can also increase your energy level. Expressing gratitude helps make you more creative which can deepen your motivation.

2. Create empowering beliefs. Change your negative self-limiting beliefs by focusing on your self-talk. Practice daily statements that increase your self-confidence. Catch yourself when you think negatively about yourself and transform those thoughts into empowering thoughts.

3. Set realistic goals. Try practicing SMART goals by Peter Drucker. To make sure your goals are clear and reachable, each one should be:

• Specific (simple, sensible, significant).

• Measurable (meaningful, motivating).

• Achievable (agreed, attainable).

• Relevant (reasonable, realistic, results-based).

• Time-bound (time-limited, , time-sensitive).

4. Spend time outdoors. Going outside and being in nature is a great way to take a break. Being in nature is a wonderful way to boost your energy and feel refreshed when returning to your tasks. Researchers have found that being in nature helps reduce blood pressure, reduces stress, and simply makes us feel happy.

5. Create an action plan. Focus on writing down your goals and create steps to accomplish your goals. Make your action plan visible so that you can refer to it often, especially when things get challenging along the way.

6. Focus on your accomplishments. Pay attention to your process and take mindful moments to notice what you have completed rather than what’s left to do. Celebrate your success which can increase motivation and refocus your mind.

If you are needing help, please consider setting up a free phone consultation and we can discuss how therapy can be helpful.

The Heart-Focused Breathing Technique

HeartMath has developed a research-based system of scientifically validated techniques, tools and technology to increase emotional and mental self-regulation. The tools can help us gain greater self-regulation and a new perspective.  Most of the HeartMath techniques include an intentional shift to a positive emotional state to help gain coherence.  The Heart-Focused Breathing Technique is a powerful tool to practice and gain an ability to neutralize emotions such as anxiety, and anger.   

The Heart-Focused Breathing Technique is an easy to use, energy saving self-regulation strategy.  It is designed to reduce the intensity of a stress reaction and to establish a calm, but alert state. The technique allows you to take a time-out where you can step back and neutralize your depleting emotions. We can benefit from conscious breathing, if we use it to help us shift into and sustain a more balanced state.  Breathing is only the start of what is known as a coherence building process.  

In addition, the Heart-Focused Breathing helps reduce the impact of stress on your mind and body.  It helps us reduce the energy drain in order to feel a bit more renewed.  By going to a neutral state, it helps us to detach from our emotionally charged feelings and racing mind. By practicing this technique, it gives us an opportunity to pause our thoughts and feelings long enough to consider the possible options and consequences.  

Step :

Focus your attention on the area of your heart.  Imagine your breath is flowing in and out of your heart or chest area.  Breathe a little deeper and slower than usual.

Try and inhale for a count of 5, and exhale for a count of 5.  

Once you have become familiar with this step, all you need to remember is the quick step to neutralize stress.  

Suggestions for when to practice the Heart-Focused Breathing Technique:

1. Stop the impact of stress on your body.

2. Help neutralize emotional reactions in the moment.

3. Eliminate the energy drain.

4. Remove the drama or significance of a situation.

For more information on HeartMath or anxiety management, please call me at 858-243-2684.

Source:  Transforming Anxiety by Doc Childre and Deborah Rozman.

ADHD Experiences Among Girls

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children. ADHD also affects many adults. Common symptoms of ADHD include hyperactivity, limited sustained attention, impulsivity, and limited attention to details. Millions of children in the United States have been diagnosed with ADHD. Boys with ADHD outnumber girls approximately three to one, per Dr. Stephen Hinshaw, a leading ADHD expert.  He suggests some girls have been underdiagnosed, particularly those with inattentive ADHD, which seems more prevalent in girls.  According to Dr. Hinshaw, “The inattentive type of ADHD is marked less by disruptive, impulsive behavior and more by disorganized, unfocused performance.”  “The latter isn’t as likely to be recognized or cause as much concern to teachers.”

According to an interactive poll on girls and ADHD by Dr. Patricia Quinn and Dr. Sharon Wigal, ADHD often expresses itself in girls through poor self-esteem, excessive talking, perfectionism, worrying, nosiness, and risk-taking.  These are not the typical symptoms of lack of focus and hyperactivity that is often seen in boys. Dr. Quinn and Dr. Wigal’s poll also found that 4 out of 10 teachers reported more difficulty in recognizing ADHD symptoms in girls than in boys because generally, boys are more likely to exhibit behavioral problems.  As a result,  girls are more likely than boys to be asked to repeat a grade due to poor school performance rather than participating in an evaluation to determine if the student has ADHD or a learning disability.  Per Dr. Quinn, “A year later, the girl is no better off because she still hasn’t figured out the source of her problems.”

ADHD symptoms in girls can be challenging to decipher which is why the condition is often overlooked and underreported by teachers.  Many psychiatrists estimate that nearly half of all children with ADHD are female.  It is estimated that 50% fewer girls are referred for ADHD evaluations and treatment as compared to boys.  Girls with ADHD tend to have less visible symptoms.  Most girls with ADHD don’t tend to squirm, fidget, or get up to sharpen their pencil every two minutes. Instead, most girls with ADHD just sit at their desks and zone out. Those girls have the same ADHD problems of poor impulse control, inattention, and distractibility but few adults rarely suspect these girls have ADHD because they aren’t hyperactive. Furthermore, ADHD often expresses itself in girls through poor self-esteem, excessive talking, risk-taking, worrying, and perfectionism which are not the typical symptoms of hyperactivity and lack of focus for boys.

Much of the research also demonstrates that symptoms of ADHD in females often don’t emerge until puberty, a time when most kids experience emotional ups and downs. Due to cultural expectations and social pressures, girls seem to be more compelled than boys to get their schoolwork done. The research also reveals that generally speaking, girls want to please more than boys do, and they’re usually expected to do well in school. As a result, ADHD symptoms may not become very apparent until middle or high school, when a student’s work requirements increase dramatically.

In conclusion, ADHD is prevalent for boys and girls but the symptoms tend to look differently with girls.  By completing an ADHD evaluation, it can provide more clarity as to how to better assist a student.  ADHD is treatable and managed with proper interventions such as counseling, organizational strategies, behavior management, and medication. 

If you are needing help, please consider setting up a free phone consultation and we can discuss how an evaluation can be helpful.

Navigating Anxiety During Unprecedented Times

Current stressors in this country are increasing more worries given COVID-19, physical distancing, social and racial injustice, riots/looting, financial hardships, climate change and divisiveness.  It’s like the perfect storm. Given the extreme circumstances we currently face, it tends to trigger much uncertainty, loss, anxiety and worries. When we are anxious, we seek a need for safety, predictability, and control which is very challenging given these hectic times.

Many kids, adolescents and adults are impacted by these stressful times in various ways:

• Emotionally: worried, sad, angry, scared, impatient, exhausted, bored.

• Socially: isolated; increase in arguments and frustrations at home and at work; more time on social media.

• Physically:  problems with sleep; tension in body (neck, shoulders, jaw); sitting most of the day at work or school so experiencing limited movement; headaches; limited concentration.

• Behaviorally:  avoid things that cause anxiety; overcompensate; eat more or eat less; increase in substance and alcohol use.

Given the increase in anxiety during these unprecedented times, it’s important to understand the difference between normal anxiety and an anxiety disorder.

Normal anxiety:

• Is related to a specific situation or problem.

• Lasts only as long as the situation or problem.

• Is proportional to the situation or problem.

• Is a realistic response to a realistic problem or situation.

When someone experiences an anxiety disorder:

• Anxiety may come up unexpectedly, for seemingly no reason.

• The anxiety response to a situation or problem may be much stronger than they would expect.

• They may experience unrealistic anxiety, such as fear of a situation that likely will never happen.

• Anxiety may last for a long time, even when the situation or problem has been resolved.

• Anxiety may feel impossible to control or manage.

• They may avoid situations or things that they believe will trigger anxiety symptoms.

• Anxiety is fueled by avoidance.

• Intolerance of uncertainty and distress.

The following are various coping strategies to practice in navigating and tolerating anxiety:

• Pay attention to the content of  thoughts (can help or hurt).

• Challenge negative distorted thoughts.

• Practice rational thinking. 

• Talk back to fears with rational thinking.

• Focus on personal expectations:  are they realistic or unrealistic?

• Practice flexibility in thinking.

• Practice mindful moments.

• Practice deep breathing exercises (inhale for 5 exhale for 5; inhale for 4, hold for 4, exhale for 8.

• Rather than avoid learn how to break tasks up into smaller tasks.

• Practice tolerating emotions.

• Practice identifying your feelings and rating them 1 - 10.

• Create time for daily movement and exercise.

• Eat healthy and colorful food.

• Write by expressing your thoughts and feelings via journaling or poetry.

• Practice creativity:  baking, music, theater…

• Practice random acts of kindness.

• Practice daily gratitude: Before going to bed focus on 3 things you are grateful for during the day.

If you are needing help in dealing with your anxiety, please consider setting up a free phone consultation and we can discuss how therapy can be helpful.

The Power of Mindful Moments

We often hear the word mindfulness but what does it really mean?  As psychologist Dr. Tara Brach once said, “Mindfulness is a way of paying attention moment-to-moment to what's happening within and around us without judgment. So, said differently, when we attend to the moment-to-moment flow of experience, and recognize what's happening…fully allowing it, not adding judgment or commentary, then we are cultivating a mindful awareness.”  

Numerous studies link mindfulness to better health, lower anxiety, and greater resilience to stress. When we’re mindful, we gain insight, reduce stress, enhance performance, and increase awareness by observing our own mind.  

One way to begin practicing mindfulness is recognizing that it is a wonderful way to focus on our self care.  Mindful moments can provide a much needed respite during the current stressful and unprecedented times.  Self care is critical to our mental and physical well being. 

Suggestions for mindful moments:

1. Close your eyes for a few minutes and pay attention to your breath.  Focus on inhaling for a count of 5 and exhaling for a count of 5.

2.  Before getting out of bed in the morning, think of 3 things you are grateful for and focus on your breathing.

3.  Practice 4-4-8 breathing.  Inhale for a count of 4, hold for a count of 4 and exhale for a count of 8.  The deep exhalation helps to access the parasympathetic nervous system known as the rest and digest system.

4. When sitting at work, stand up and practice stretching for a few minutes.  Practice doing forward and backward shoulder rolls, stretch your arms above your head and then try and touch your toes.

5. During lunch, go outside and walk for a few minutes and take a look up at the sky and/or smell a flower.

6.  Take a few minutes to close your eyes and visualize a safe relaxing place while focusing on your senses.  What do you see, hear, smell, taste and touch? Allow yourself to be in the moment at your favorite relaxing space.   

My hope for you is that you make self care a priority in your life. It is also a great way to teach our kids effective ways of navigating daily stressors. Once you practice simple self care strategies, you'll likely recognize the many benefits for your mental and physical well being.

ADHD and COVID-19: 5 Suggestions for Academic Success

During the COVID-19 pandemic, most children are needing some extra guidance on how to navigate this academic school year virtually.  Students who have ADHD already struggle with sustained attention, distractibility, and forgetfulness in daily activities.   Students are missing the social aspect of school and the structure that the classroom provides.  Let’s discuss some helpful tips for our students with ADHD.

Five Suggestions for Academic Success:

1. Daily Routine.  Students with ADHD can really benefit from a visual schedule to help with time management.  Know your student’s virtual school schedule so that you can help your child manage their daily schedule. Find a convenient place to display their daily schedule.  Let your student be creative in designing the schedule with artwork and color.  Suggest color coordinating the schedule per class (for example blue is math, english is green…)   Encourage your student to wake up at the same time and go to bed at the same time.  Make sure to make time for eating breakfast and lunch. Remind them to take breaks in between classes to go to the kitchen for water and a snack and go to the bathroom.  Encourage your child to put in their best effort in completing assignments then reward him/herself with a fun and pleasurable activity.  

2. Distraction free area at home.  Help your child develop a space that is just for school.  Keep minimal items on the desk or table so that only the essentials are available.  Ask you student where they want to put their folders, pens, pencils and help them stay organized. Help your student understand the value in a clutter free space. If possible, have a visible calendar, either daily or weekly, in their study area as mentioned above. 

3. Clear expectations.  All students thrive when they know what to expect especially students with ADHD.  Help your child set realistic daily school goals.  Teach and encourage your student to add an extra 15 - 20 minutes to their schedule for the unknowns like wifi problems or printing problems.  Help your student understand what the teacher expects of him/her and have the same expectations at home. 

4. Movement.   Encourage your child to take movement breaks in between classes.  Research shows that physical activity and movement helps increase decision making, attention and learning. According to Dr. Stephanie Sarkis, with physical activity, executive function performance can improve in about 20 minutes, and ADHD symptoms can reduce in intensity after 30 minutes of exercise.  Remind your student that exercise is also a great stress reliever .

5. Rewards.  Students with ADHD can flourish with rewards.  Ideally use rewards first to improve behavior.  Compromise with your child on rewards for accomplishments. For example, if your student completes his/her homework before dinner time, make his/her favorite meal that day or allow your child to select the movie for family movie night.  Recognize your child often for being on task and getting work done like giving them a high five. Express how proud you are of your child when she/he demonstrates great effort.

If you want additional support, please contact me for a free 15 minute phone consultation.  Call me at 858-243-2684.

6 Benefits of Green Exercise

Have you ever noticed how you feel when you are outside in nature?  What do you notice when you’re walking or exercising outside?  Let’s explore the benefits of exercising in nature.  

Being in nature by itself is known to help you relax, restore your focus and increase your level of happiness.   Green exercise is any type of physical activity completed outdoors. Some examples of green exercise are doing yoga at a park, walking in a canyon or beach, running, cycling or gardening.   

Benefits of Exercising Outdoors:

1.  Green exercise is linked to greater use of the imagination and senses, and cognitive advantages.

2. Some studies have shown that children exercising outdoors have significantly lower levels of cortisol as compared to children exercising indoors.  Cortisol is a hormone released in the body in response to stress.

3.  Exercising outdoors seems to reduce your rating of perceived exertion.  In other words, exercising outside can be experienced as having more fun which helps the exercise seem less difficult.  

4. A study conducted by Barton and Pretty found that the greater the time spent doing green exercise, the greater the benefit in both self-esteem and mood. Thus, the study found that engaging in green exercise showed improvements in mental health.

5.  Exercising outside increases the chances that you will continue to participate in physical activity in the future, and more likely to adhere to a program in general.

6.  Outdoor exercise can enhance our engagement in nature as we learn to pay closer attention and to be mindful of our bodies as we bike on a dirt path or hike a rocky slope. 

In conclusion, there are great benefits to exercising, especially outdoors.  Give yourself permission to exercise outdoors and enjoy being in nature at the same time.  I hope you  make exercise a part of your daily self care.  

3 Ways to Reduce Anxiety with HeartMath

HeartMath is a research based system of scientifically validated techniques, tools and technology to increase mental and emotional self regulation.  You can learn various HeartMath techniques that can create a sustainable emotional shift by shifting the heart rhythm into a coherent pattern.  Coherence is when both branches of the autonomic nervous system, the parasympathetic and sympathetic, become synchronized.  Shifting our attention to the physical area of the heart, combined with generating a sincere positive feeling like love, gratitude or appreciation, is how the heart rhythm pattern creates coherence. 

HeartMath has also developed user-friendly simple techniques to help you make quick, positive emotional shifts.  HeartMath tools can help release anxiety as well as transform familiar anxiety patterns into healthier baseline patterns.  As with any tool or technique, the key is to practice daily.   

3 HeartMath techniques for reducing anxiety:

1. Notice and Ease  

This basic tool helps you admit and name what you’re feeling.  Once you honestly admit you're feeling anxious, you start to diminish its power over you.  Even a  bit of ease can help bring a more balanced perspective.  You can learn to reduce anxiety or other stressful feelings which helps stop their energy drain.

Step 1:  Notice and admit what you’re feeling.

Step 2:  Try to name the feeling.

Step 3:  Tell yourself to e-a-s-e as your gently focus on your heart,relax your breath, and e-a-s-e the stress out.

2. Power of Neutral

This tool helps you learn a simple yet powerful tool for refocusing emotions.  This tool teaches you to use the rhythmic power of your heart to bring your mind, emotions and physiology to a state of neutral which can lessen many anxiety triggers.  This tool helps you to clear your mind and see more options with clarity. 

Step 1:  Take a time-out, breathing slowly and deeply.  Imagine the air entering and leaving through your heart area.

Step 2:  Try to disengage from your stressful thoughts and worried feelings as you continue to breathe.

Step 3:  Continue the steps until you have neutralized the emotional charge.

One thing you can ask yourself is “Do I really want to keep draining my energy and stressing about the situation?”

3. Attitude Breathing

This tool is designed to help you shift out of a negative emotional state into a positive emotional state. Attitude breathing helps you to learn to clear and replace negative attitudes in the midst of feeling stressed or anxious to gain a more intelligent perspective.

Step 1:  Recognize an unwanted attitude; a feeling or attitude that you want to change.  Some feelings or attitudes could be anxiety, anger or guilt.

Step 2:  Identify and breathe a replacement attitude.  Select a positive attitude slowly and casually through your heart area. Do this until you can experience the new feeling.  

Source:  Transforming Anxiety by Doc Childre and Deborah Rozman.

For more information on HeartMath or anxiety management, please call me at 858-243-2684.

5 Ways to Stop Thinking You're Not Good Enough

We live in a culture of comparison and competition which can be fierce. Social media floods us with the belief of not being enough: not pretty enough, not good looking enough, not smart enough and so on.  Our teens’ lives are super focused on competition like getting the best grades, being involved with endless extra curriculars, taking as many AP classes in order to get into the best colleges.  No wonder our society has the highest rates of anxiety and depression for kids and adolescents.  

As the saying goes, we are our worst enemies.  This culture of comparison and competition only fuels anxiety, anger, depression and shame.  It magnifies self defeating thoughts and behaviors.  We need to decide enough is enough.  It’s time for a paradigm shift.  Let us make self care a priority so we can practice taking better care of ourselves and our kids.  

Let’s take a look at 5 strategies that can help us stop thinking “I’m not enough” and learn to acknowledge and focus on our personal strengths.

1.  Practice daily self care.  Make time everyday to get enough sleep, eat healthy balanced meals and get exercise.  Learn to make time for joy, laughter and play.  Begin a gratitude journal first thing in the morning or right before you go to bed. Start small and list 3 things you are grateful for during that day.  Research shows that gratitude is good for our minds, bodies and relationships.

2. Practice challenging your negative, self defeating thoughts. Recognize that you have control over your thoughts.  Cognitive distortions are irrational thoughts that are false, inaccurate and can cause psychological damage.  Common cognitive distortions are all or none thinking, emotional reasoning, personalization, jumping to conclusions and should statements.  With daily practice, you can learn to pay attention to your thoughts, challenge your distorted thinking and learn to think more rationally and balanced.  

3. Learn to talk back to your inner critic.  The inner critic usually is the voice that judges you, belittles you, doubts you and tells you you are not enough.  Usually the inner critic thinks it’s protecting you but it actually robs you of emotional well being and peace of mind.  Start an inner critic log and notice the content of the self criticism.  Learn how to talk back to your inner critic with acceptance and compassion.  An example might be  “I hear you loud and clear, but I'm also going to consider other ways of thinking about this situation."   

4. Learn to focus on your needs and wants.  Someone who feels “not good enough” is usually focused on who they think they’re supposed to be.  If you don’t feel good enough, you may not value yourself enough to see your wants as important.  Give yourself permission to focus on what you need and want for the day.  With practice, you can learn how to ask for what you want and need in your relationships. 

5. Practice being in the present moment.  We tend to focus on the past which fuels guilt and shame or focus on the future which fuels anxiety.  Learn to be present in the here and now.  Practice deep diaphragmatic breaths which help calm the mind and body.  Being in the present moment reminds us that we are ok right here and now.  It helps us to be responsive, not reactive.  Being present allows us to be better engaged in our relationships.  

If you want additional support, please contact me for a free 15 minute phone consultation.  Call me at 858-243-2684.

The Power of Self Care During Uncertain Times

During this COVID-19 health crisis it is normal to feel stressed and anxious.  Every day we hear about more problems and concerns that are impacting everyone everywhere.  Our daily lives have been disrupted by being in quarantine and we are navigating uncharted territory.  

In order to find some order in our lives we really need to focus on creating a daily schedule that allows us to take better care of ourselves given the multiple responsibilities with family and work.  I think one of the greatest gifts we can offer ourselves is self care.

Suggestions for daily self care:

• Focus on what is in our control every single moment of the day which is how we choose to think and behave.  It helps remind us that in the moment we are ok and we do have control of our thoughts and behaviors.

• Take 5 minute breaks a few times a day to practice diaphragmatic breathing.  It allows us to focus on a deep inhalation through the nose and a deep exhalation through the mouth. Deep breathing calms our mind and body and helps us to be in the moment.

• Make sleep a daily priority by trying to go to bed at the same time and wake up at the same time, if possible.  Prior to going to sleep, spend some time doing something relaxing that does not involve a screen. 

• Before you get out of bed in the morning practice a short guided meditation via YouTube or a free app like My Life or Calm.  

• Take 10 minute breaks a few times a day to stretch, walk around and do shoulder rolls, especially if you are sitting on your computer for extended periods of time.  

• Given the stressful circumstances, please practice more self compassion and patience with yourself and others.

• Be mindful of what you are choosing to eat and focus on adding more color to your diet. Also be sure to drink plenty of water. 

• Make time for joy and laughter during the day and learn to laugh at yourself.

• Limit the amount of time reading the news to the morning or afternoon since too much focus on the COVID-19 health crisis can fuel more worries and anxiety.

• Make time to exercise ideally outside if possible.  Being in nature helps us feel better emotionally and it can help reduce blood pressure, heart rate, muscle tension, and the production of stress hormones.

• Given current quarantine restrictions and physical distancing, take time to connect with family and friends virtually on a regular basis to limit the feelings of isolation.

• Limit the amount of time on a screen (phones, Ipads, laptops,...) and instead listen to music, play cards, board games or do a puzzle.

If you are struggling with self care, consider setting up a free phone consultation and we can discuss how counseling can be helpful.

 

10 Study Strategies for Students with ADHD

Common symptoms of ADHD include limited attention to detail, difficulties with sustained attention, easily distracted, and difficulties organizing tasks. A very helpful description of ADHD by Dr. William Benninger describes ADHD as a disorder of performance not skill; doing what you know, not knowing what to do; it is the when and where not the how or what. 

A very common ADHD impairment is working memory.  Dr. Benninger defines working memory as the ability to keep information online for a short period of time and also to be able to use the information in our thinking.  As you can imagine, these ADHD symptoms cause struggles at school and at home. 

Since every student has certain strengths and weaknesses, it is recommended to try different strategies to figure out what works best for each  student. Below are 10 helpful study strategies.

10 Study Strategies:

1. Use a planner.  Find a planner that works best for you (paper planner, calendar on your phone…) so that you can write down all of your assignments, tests, and due dates. It is also recommended to add self care reminders in your planner like when you’ll eat, exercise and decompress.

2. Take mini breaks.  It is recommended that you  take a 5-10 minute break every 30-45 minutes while studying.  An ideal break includes change of scenery (going to a different part of your home) and movement (shoulder rolls, jumping jacks or stretching).

3. Use visual reminders.  Allow your creativity to help you decorate your binders and file folders with artwork and color.  Develop a system of colors to remind you what binder/file.

4. Time management. Find a personal system to help you focus on better navigating your time.  Maybe add a visual reminder in your planner or add a reminder on your phone.  Also, try and get as much homework done at school so you can have some time to decompress at home.

5. Note taking.  Take notes while in class to help you pay attention.  It is also recommended to take notes while reading a chapter in a book or reviewing for a quiz or test. Use a  highlighter or post-its while taking notes. 

6. Realistic expectations.  Be sure to set realistic time frames for completing assignments and preparing for exams.  It is recommended to add 15-20 minutes to all tasks so as to make time for the unexpected (Wifi is not working, difficulties with printing/scanning…)

7. Organization.  Have fun creating a visual system at school and at home to help you stay organized. Use visual cues to help you remember where to store your homework and then turn it in as soon as you walk into your class. Be organized at your table at school and at your desk at home.

8. Ask for help.  Don’t forget that asking for help is a sign of strength.  If you’re not understanding something be sure to ask your teacher, friend or parent for help.  

9. Study daily.  Be sure to study everyday in increments of time ideally 15-20 minutes.  Remind yourself that repetition is the key to learning. Cramming the night before is ineffective. 

10. Self Care.  Always make time to take care of yourself including making time to exercise, decompress without a screen before you get into bed; going to be at a reasonable hour; eating all your meals and being kind to yourself.  

How to Navigate Test Anxiety

Most students experience some level of anxiety when taking an exam.  When the anxiety is intense and interferes with test performance, it is known as test anxiety.  Test anxiety is considered a performance anxiety since there is pressure to do well in a given situation.  

The stress over the exam produces the body’s “fight or flight” response. Your body releases adrenaline but the energy used to access short term memory gets diverted into being on high alert. As a result, the brain prepares for the worst, and it becomes very challenging to imagine being successful in answering questions.

The symptoms of test anxiety include cognitive, physical and emotional.  Cognitive symptoms include mind blanking, racing thoughts and difficulty concentrating.  Physical symptoms can be sweating, increased heart rate, nausea, or tense muscles. Emotional symptoms include worry, frustration, fear or  disappointment.

How to reduce your test anxiety:

1. Practice deep breathing exercises daily.

2. Eat well balanced meals. 

3. Keep hydrated.

4. Exercise to reduce anxiety and stress.

5. Keep organized and maintain a realistic study schedule.

6. Go to bed at a reasonable hour so you can get at least 7 hours of sleep a night.

7. Be proactive and ask your teacher, friend or counselor for help.

What to do on the day of the test:

1. Practice deep breathing as you are walking to your exam and during the exam.

2. Practice positive self talk such as “I’m prepared,” “I can do this,” “Relax and breath.”

3. Be sure to read each item carefully and answer appropriately.

4. If your mind goes blank, put your pen/pencil down, sit up straight and take a few deep breaths.  If you don’t recognize the question, go to the next question.

5. Occasionally stretch so that your body stays relaxed.

6. Remind yourself that some anxiety is normal and that you know the material.

If you need additional support please set up a free phone consultation to discuss how counseling can be helpful.

A New Year: 10 Suggestions for Daily Self-Care

Eighty percent of New Year’s resolutions fail by February, according to U.S. News & World Report.  What a staggering number! I believe that one main reason that most people may not achieve their resolutions are due to unclear and unrealistic goals.  Perhaps we can learn from the 20% of people who do accomplish their realistic goals in taking better care of themselves.  

Ten suggestions for daily self-care:

1. Before getting out of bed in the morning, stretch a little and focus on some deep breathing as you focus on one thing you are grateful for in your life. 

2. When you pick up your phone in the morning, search inspirational quotes and read one before you leave your home.

3. Make sure to eat breakfast every morning.

4. Listen to some relaxing music on your way to school or work. 

5. Talk to yourself as if you were talking to your best friend.

6. Take a 20 walk in nature during lunch break or after work/school.

7. Pay attention to your feelings and name the feelings.  Remind yourself that feelings come and go like waves.

8. Take 10 minutes to journal about your thoughts and feelings in order to process what’s happening and let go of the things you have no control over.

9. Set realistic goals and time frames to complete your goals.  Be sure to include extra time for things that are out of our control (wifi problems, printing problems...)

10. Take time to decompress in the evening, ideally with no screens and think of  two things you are grateful for in your day.

Given our busy and stressful lives, I would recommend that a new year is a wonderful time to reflect on what worked, what didn’t work and what can we do differently.  Time for inner reflection helps us increase our self awareness and focus on what is in our control. I propose making self-care a daily practice. Once we make self care a priority in our life, we are better equipped to take care of our responsibilities, goals and dreams.

If you have any questions, please contact me to schedule a free initial consultation.

What Is ADHD? 3 Tips To Understanding an ADHD Evaluation

Attention Deficit Hyperactivity Disorder is known as ADHD.  The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) is a handbook used by healthcare professionals as a guide for mental health disorders.  According to the DSM-5, ADHD is a “persistent pattern of inattention and or hyperactivity-impulsivity that interferes with functioning or development.” A certain number of symptoms must be met in the areas of inattention and hyperactivity/impulsivity to be diagnosed with the disorder.  Some of the common symptoms include poor attention to detail, difficulty in daily tasks, fidgety, forgetful sustaining attention, easily distracted, restless and impulsive. A very helpful description of ADHD by Dr. William Benninger describes ADHD as a disorder of performance not skill; doing what you know, not knowing what to do; and it is the when and where not the how or what.  

Please note that completing an ADHD screener from a pediatrician is not sufficient to determine if your child meets the criteria for the complexities of the disorder.  In order to be properly diagnosed with ADHD, it is highly recommended that the child and parents participate in ADHD testing. The evaluation and testing is conducted by a psychologist. The testing can provide the parent with a much better understanding of your child’s academic strengths and weaknesses and how to provide the support that your child needs at school and at home.  

The first part of an ADHD evaluation will include a clinical interview with the parents and the child.  A comprehensive biopsychosocial assessment is suggested in order to understand various aspects of the child such as developmental history, sleep, medical conditions, family history of ADHD, social, behavioral and substance use.  

The second part of the ADHD evaluation is completing comprehensive questionnaires that are critical in measuring important factors to better understand the layers of symptoms of inattention, hyperactivity and impulsivity as well as other potential areas of concern.  One of those factors that are measured by these tests is named executive functioning. Important components of executive functioning include self control, self regulation, motivation and working memory. Another important factor to assess in the testing is called working memory also known as “mental workspace”.  Working memory helps facilitate the ability to control attention and resist distractions while completing a task that requires sustained effort. 

Furthermore, the questionnaires are administered to the child, parents and teachers.  It is very important to have multiple data points to determine if your child truly meets the criteria of ADHD.  The child is also provided with other questionnaires to rule out any other concerns such as anxiety and depression.  Once the questionnaires are completed, the psychologist will score the tests and provide the results in a written report.  The last appointment, a feedback session is when the psychologist provides the parents and the child with testing results and comprehensive recommendations.   

If you have any questions, please contact me to schedule a free initial consultation.

8 Suggestions for Navigating Anxiety

Anxiety is very prevalent in today’s society given the endless responsibilities, expectations and divisiness in our country.  According to the Depression and Anxiety Association of America, nearly 18% of the population has an anxiety disorder. Common triggers of anxiety might be unrealistic expectations of ourselves, negative thinking, stress, public speaking and conflict in a relationship .  

Helpful strategies in navigating anxiety:

1. Pay attention to your self talk.  Usually the thoughts are negative and distorted which fuel anxiety.  In cognitive behavioral therapy (CBT), these thoughts are called cognitive distortions. Usually these distortions fall within the categories of exaggerating, catastrophizing, overgeneralizing and ignoring the positives.

2. Learn and practice how to challenge your distorted thoughts with more rational and balanced thinking (“Although I feel overwhelmed, I am working hard and I am completing my school/work responsibilities to the best of my ability.” )   

3. Use a thought stopping technique to lessen your automatic catastrophic thinking. Try and visualize a stop sign and say STOP to yourself.  Replace the anxiety thoughts with realistic and self soothing statements. (“I can get through this, I’ve done this before.”)

4. Practice diaphragmatic breathing such as inhaling through your nose for a count of 5 and exhaling for a count of 5.  With daily practice, you can learn how to calm your nervous system.

5. Distract yourself with visual distractions.  Some suggestions include counting the leaves on a plant or tiles on the ceiling.

6. Auditory distractions can be another form of distraction.  Some ideas include talking with someone on the phone or singing your favorite song.  

7. Movement is another excellent way to lessen your anxiety.  Try going for a walk outside, doing jumping jacks or playing with your pet.   Commit to yourself to exercising at least 20 minutes a day to help lessen your anxiety. 

8. Try practicing mediation with an app or a YouTube video of your choice.  Research shows that meditation can be very effective in reducing your anxiety.

Occasional anxiety is common but chronic feelings of fear, worry and perfectionism are not common.  If you are looking for help with your anxiety, please contact me to schedule a free initial consultation.

15 Self Care Ideas for Teens

As a teen, you have endless responsibilities and stressors on a daily basis.  Learning to navigate your various responsibilities such as school work, extra curricular activities and a job can be overwhelming if you don’t take care of yourself.  Remind yourself that you have 1440 minutes in a day and make self care a part of your daily routine. Try practicing 3 of the following ideas on a daily basis.

1. Set realistic goals for the day.

2. Practice deep breathing:  Inhale for a count of 4 and exhale for a count of  6. 

3. Go for a walk with a friend.

4. Make time to decompress without your phone before you get into bed (try stretching while focusing on what you accomplished today).

5.  Express your thoughts and feelings (talk to a friend, journal, do art).

6.  Exercise (go for a run, ride your bike, or do some calisthenics in your bedroom).

7.  Read a book for pleasure.

8.  LAUGH, and learn to laugh at yourself.

9.  Think of 3 things you’re grateful for every day (ideally start a gratitude journal).

10.  Listen to music.

11.  Spend time in nature (science shows that spending time outside is good for you).

12. Spend time with friends.

13.  Play with your pet or your friend’s pet.

14.  Practice meditation. (If new to meditation, search up a how to meditate 101)

15.  Be kind and patient with yourself.  

Transform Your Stress: Try Quick Coherence Technique

Stress and Coherence

Stress impacts the body emotionally, physically and mentally.  What’s important to remember is that the situation does not create the stress, instead it is how we respond to it.  Emotions directly impact our body. Positive emotions like kindness, love and appreciation feel good and are good for us.  These positive feelings help the systems in our body work more effectively.

Research indicates that when we intentionally shift to a positive emotion, the heart rhythms also change.  This shift in heart rhythms creates a favorable impact on our entire body.

When we are feeling stressed, the body is out of sync.  Depleting feelings, like worry, anxiety and anger negatively impact our nervous system.  Renewing feelings, like kindness, care and appreciation create order. This order is termed coherence.  Coherence leads to self regulation, creativity, mental clarity and resiliency. 

How to Practice Coherence:

The Quick Coherence Technique

Step One:  Focus your attention in the area of the heart, the center of your chest.  Imagine your breath is flowing in and out of your heart, breathing a little slower and deeper than usual.

Suggestion:  Inhale for 5 seconds, exhale for 5 seconds (or whatever rhythm is comfortable for you)

Step Two:  Make a sincere attempt to experience a regenerative feeling such as appreciation or care for someone or something in your life. 

Suggestion:  Try to re-experience a regenerative feeling you have for someone you love or focus on a feeling of calm and ease.   

I recommend practicing the Quick Coherence Technique at least 3 times a day for a few minutes each time.  Ideally try practicing in the morning before you get out of bed, during lunch time and before going to sleep at night. Over time, I encourage you to practice the Quick Coherence Technique multiple times a day.  With practice, you may experience better sleep, mental clarity and more calm.

For more information, please contact Dr. Madeline Polonia at 858-243-2684.

Want Help with ADHD? Try HeartMath

How Heartmath Can Help With ADHD

HeartMath can help people with ADHD identify ways to attain coherence. Coherence is an optimal state in which the mind, heart and emotions operate in sync and are balanced. This state of coherence has been proven to have numerous emotional, mental and physical benefits.

How Does Heartmath Work?

Heartmath is a research based system of scientifically validated tools, techniques and technology to increase mental and emotional self-regulation.  HeartMath includes heart rhythm coherence monitoring and feedback technology called emWave technology. The emWave desktop technology trains kids and adults to gain greater self control, reduce stress and increase resilience.  Using either a finger sensor or an ear sensor connected to a USB module running on emWave software, it monitors and displays an individual's heart rhythm patterns and coherence levels on a computer screen.  

By practicing self regulation techniques with the emWave Pro technology, people can change their coherence levels.  Each individual session is recorded and saved automatically in the program so users can track their progress over time.  

Learning the emWave technology is not done in isolation from real life.  The goal is to transfer what is learned in each session to specific life situations in which a child or adult is required to exercise self control.  Real life applications ensure a higher quality of learning.

HeartMath and ADHD

Behavior treatment for children with ADHD involves changing some aspects of the home and school environments to promote more successful social/emotional interactions and academic growth.  These adjustments typically include creating more structure, encouraging routines and implementing specific goals and daily positive reinforcement. The emWave technology ties in well with behavior management.  HeartMath can be a great addition to teaching kids with ADHD effective coping skills like self control and impulse control. 

Source:  Using emWave Technology for Children with ADHD, Institute of HeartMath

Counseling For Anxiety: Cognitive Behavioral Therapy (CBT)

What is Anxiety?

Anxiety is the anticipation of a future threat and one of the most distressing emotions that people feel. According to the National Institute of Mental Health, anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18% of the population.  Anxiety disorders affect 1 in 8 children. Anxiety disorders are treatable and Cognitive Behavioral Therapy is highly effective in treating various anxiety disorders.

What is Cognitive Behavioral Therapy (CBT)?

CBT is a theoretical orientation that focuses on how our thoughts, feelings and behaviors are influenced by one another.  CBT highlights that each person has a choice as to how to think and behave which directly increases his/her coping skills in dealing with daily life challenges.

A Cognitive Behavioral Profile of Anxiety:

Common Physical Reactions:  sweaty palms, muscle tension, racing heart, flushed cheeks, light headedness.

Anxious Thoughts/Cognitions:  overestimation of danger, underestimation of your ability to cope, worries and catastrophic thoughts, underestimation of help available.

Typical Anxiety Behaviors:  avoiding situations where anxiety might occur, leaving situations when anxiety begins to occur, trying to do things perfectly or trying to control events to prevent danger, shutting down, restlessness, fidgeting.

Anxious Moods/Feelings:  anxious, panicky, nervous, , worried, overwhelmed.

Coping Strategies for Anxiety Using a Cognitive Behavioral Approach:

Coping Strategies for Emotions/Feelings:

Some helpful anxiety coping strategies include the following:  identify the feelings, rate the feelings, learn to let go, daily journaling, and talking with a friend, family member or therapist.

Physical Coping Strategies:

Some of the most helpful physical anxiety coping strategies include diaphragmatic breathing, progressive muscle relaxation, guided imagery/visualizations that focus on your senses, physical exercise, yoga and walking in nature.

Coping Strategies for Cognitions/Thoughts:

The following list includes helpful coping strategies for challenging our distorted anxious thoughts:  healthy distractions (counting, crossword puzzles), scheduled worry time, various cognitive exercises (thought records, cognitive restructuring, worst/best/realistic case scenario) and mindfulness.

Behavioral Coping Strategies:

Behavioral coping strategies to lessen anxiety include: exercise, yoga, meditation, acupuncture, massage, making time to socialize (friends, hobbies, sports), a healthy diet and a healthy sleep hygiene routine.

If you are looking for help with your anxiety, please contact me to schedule a free initial consultation.