21 Ways To Thriving Mental Health from an Anxiety Specialist
This post is intended for Christians looking to deepen their faith and mental health and may not apply to my entire reader base.
Katherine didn’t understand why this pandemic hit her so hard. In fact, she was embarrassed that it did. “I mean, my routines and orderliness can be a little overboard, but I’ve never had difficulty getting by day-to-day. I cry at the drop of a hat and just don't know what to do." I was so honored that she admitted she was struggling, because in that honest vulnerability, she is now getting help.*
In this time of COVID-19, there is a common expectation: the misconception that "healthy" means we won't feel anxious - or the opposite: success is defined by feeling completely safe, confident, or certain. That's crap.
Though it’s nice to feel less anxious, it’s not always reality, even if we’re doing all the right things. I mostly work with clients by helping them learn to stay focused on things of value, regardless of how they feel. Overall anxiety reduction is a result of various factors and is rarely immediate. In time, with supportive factors, anxiety often will go down. Jesus himself felt greatly distressed and overwhelmed, at times, too, if you didn’t know. He wept, sweated, pleaded, was scared, bled, and got angry and frustrated. He understands because he can actually relate - physically and emotionally. He gets Katherine's suffering - and yours, too.
Life involves not only facing bad things that don't happen, but also bad things that do. The question is, are you trained and ready? Can you still keep your focus even when the world around you and inside of you seems to be in chaos? Here are some quick tips to help you stay grounded in reality.
1. Be assertive. Routines have changed. We have to communicate to make the covert overt, like telling your loved one if you need a break to recharge (they can't read your mind!).
2. Be careful of untrue thoughts. Unrealistic thought patterns negatively impact our entire life, like All-or-Nothing Thinking. For example, "Since I’ve been eating poorly it doesn't make a difference if I exercise.” Katherine, mentioned earlier, fell into this trap by believing she was doing a terrible job simply because she felt overwhelmed. Mental health is based on grasping reality to the extent we can. Watch your thoughts and line them up with reality as much as possible.
3. Don't over-consume on substances. Caffeine and alcohol are certainly the most popular substances to monitor.
4. Downtime/Mindfulness/Quiet. The importance of giving our brain pauses and rest cannot be overstated. During a crisis, we need more intentionality to slow down unhealthy processes that are automatic or deeply ingrained. Learn to be mindful, slow down the process, and/or meditate on something beneficial- like how much God cares for you and promises to never leave or forsake you. Benefits range from increased focus and function to decreased stress and disease.
5. Emotions, Thoughts, and Behaviors - Tune In. Be aware of your thoughts, emotions, and behaviors. God gave you these - learn to pay attention to them and discover how to respond - sometimes in ways you might not expect.
6. Exercise. Exercise is highly connected to mental health. If you’re stuck in the house, there are ways to get creative. Make a game with a fitness tracker! Compete with others! Set up prizes for yourself or children! Get outside where possible and get moving.
7. Get Support. Use trustworthy support. Few things in life (if any) are done well without support. One place to get support is through an online or in-person Live Second Group.
8. Have fun! We all need reminding to pursue fun. Even the term ‘recreation’ is based on the concept 'recreate '- “to give new life.”
9. Medication. Medication can play a necessary role in well-being. You don’t need to feel shame if you can use a physiological boost for your brain health. Consult a health professional if this would be the right option for you.
10. Normal structure. Our brains integrate information we don't need to remember and becomes second nature. So when you change your routine massively, you will feel out of balance. That’s okay! Try to make use of old structures while learning to develop new ones!
11. Nutrition/Diet. Be careful not to overindulge on carbs and sugars - the snacky & sweet food you may feel the urge to “pound,”which can offer quick energy and pleasure, but overconsumption won’t benefit you. In fact, it will impact you negatively.
12. Prayer. Open communication and presence with the God of the universe is what we access through prayer! His power is what I need; it's really good to follow a big God who is over all our circumstances.
13. Prioritize. Limit inputs of information and stimulation or your brain will do its best to force limits and push you back into what’s called “homeostasis” (or balance), which can lead to feeling burnout and depression.
14. Serve others. Loving our neighbor as ourselves is beautiful. Not only does it help them, but we also can find much encouragement and joy. Learning and growth is often solidified when we can teach, pass along, and serve. Win-win.
15. Sleep. As one of the most important contributors to all aspects of health, good sleep is a necessary foundation to good health.
16. Spend/Save/Give money. Work from a budget. Spending money can be satisfying. Giving it away is powerful to others and ourselves. Taking on unnecessary debts, overspending and being miserly or hypervigilant all lead to stress in different ways.
17. Socialize. We are social beings. Direct contact releases neurotransmitters! But so can positive interactions in this time where we can’t touch much. Wow! For the time being, technology, phones, letters, or writing on messages on cardboard goes a long way.
18. Spirituality/Faith. What do you live for? What do you believe? And are you living congruently with it? Are you allowing yourself to ask questions and pursue guidance, support, and practices around what is good and true and beautiful and lovely? To discover more about what it looks like to follow Jesus watch this.
19. Sunlight. Not only is sunlight important in Vitamin D production, natural light is linked with numerous processes ranging from sleep to mood and much more. If you must be indoors or have limitations on natural light, find ways to maximize it.
20. Supplements. There is good evidence that several supplements can aid in mental health; some linked most commonly to mental health are Vitamin D, B Complex, and Omega-3 Fatty Acids (always follow your doctor’s advice).
21. Your context is your context. Don't compare. "Comparison is the thief of joy." When we look at where we are, don't let expectations crowd out what you're supposed to be about.
Keep in mind this is educational content and not intended as a substitute for professional advice, treatment, or diagnosis. Any of these tips will come across as too simple for someone suffering highly.
*All names and details used are obscured to protect patient confidentiality, including using a mixture of case information.
The Guide above is provided entirely for free to newsletter subscribers.
One of my first questions to a professor in my earliest IOCDF BTTI (Exposure Therapy training) at Massachusetts General Hospital was, “What happens if someone actually gets sick after a contamination exposure?” I haven’t forgotten the simplicity of the answer that went something like this: “People get sick all the time. Yes, that might create some additional hesitancy to face exposures at first, but you have an incredible opportunity for learning.” Life involves not only facing bad things that don't happen, but also bad things that do.
Exposure Therapy involves the systematic confrontation of fearful triggers while reducing and eliminating fearful, pathological responses. In the end, it can relieve a lot of suffering.
During this global pandemic of COVID-19, people actually are getting sick. One might not think the principles of exposure therapy would apply (i.e., "Don't you do exposure therapy for risks that don't happen?"). Quite the contrary. I believe exposure therapy provides one of the best evidence-based ways forward, helping us stand up to fear we need to squarely face. So today, whether you have a disorder or not, there is an opportunity for learning and growth in the face of COVID-19.
This guide, "Thriving Mental Health Alongside COVID-19," is dedicated to my clients and the IOCDF and provides a thorough summary of the main steps of Exposure Therapy with me, with key tips for general mental health. May you be enriched by this!
Whether you have a mental disorder or not, there is an opportunity for learning and growth in the face of COVID-19 (SARS-CoV-2). Now, more than ever, we need stable footing to stand on. People go to every extreme. You don't have to. Mental health is about being grounded in reality, insomuch as we can grasp it.
Getting sick will happen. Yes, people die. Relationships break up and fail. Businesses go under. We might get it wrong. However...many people can experience health. Some people live with purpose and to the full (which is not the same as perfect). Relationships can be incredible. Businesses can thrive. We can get things right.
When I utilize the method of Exposure Therapy in counseling (a subset of Behavioral and Cognitive Behavioral Therapy), it involves the systematic confrontation of fearful triggers while reducing and eliminating fearful, pathological responses. It is Gold Standard treatment for OCD & Phobias, and is a first line treatment for all Anxiety Disorders and PTSD. What we think happens is that relearning occurs, which for most increases confidence and decreases disruption in life when they follow the treatment. Exposure, then, gives us two opportunities:
2. To learn we can face it anyway.
Its principles connect us to some of the best of life: face the thing you have reason to face; gain the opportunity to live more fully.
This guide is a very brief summary of the main points of the exposure therapy process with me, particularly with clients who have OCD and Anxiety. Many of my clients actually are faring better in this crisis than people I have talked to and seen in the general public- and why wouldn't they?! They've been training and learning- and now it's game-time.
Click "Read More" for a Summary
This video and guide below were specially formulated to help you be mindful in an "Exposure-Friendly" way.
This one's a bit different from the average mindfulness practice you might be familiar with. The reason it's called "Exposure-Friendly" is that it is specially designed to help a person be mindful of whatever they are experiencing, not just attempting to feel better. This is a hallmark of exposure therapy: being able to tolerate distress without engaging in pathological responses (rituals, safety behaviors) that negatively reinforce fear. Distractions and relaxation when facing our fears can backfire (see the research at the end of the Guide). So if we need a different set of tools to face fear, here's one of them. I hope it helps.
Music: As Leaves Fall
"Ah sugar, ah honey honey. You are my candy girl, and you've got me wanting you." The Archies may have been describing a relationship with their lyrics, but that’s been me with my relationship to actual sugar.
I love added sugar. 5 years ago, I easily would:
I didn’t think much about it. Once I began to shift from a trim guy in my young 20’s to borderline overweight/obese by my late 20’s, I was introduced to research on the deleterious effects of consuming so much added sugar in my diet. But I also gained maybe the most crucial part of any health advice: the support to live it out.
The most significant early clinical and research voice for me was Dr. Mark Hyman, Director, Center for Functional Medicine at the Cleveland Clinic. I was watching a documentary on Netflix in 2015 that featured him significantly. It added to my already growing knowledge and personal experience, which especially helped me a) stop compartmentalizing nutrition (150 calories from Coke ≠ 150 calories from vegetables) and b) look more closely at what I put in my body.
Bolstered by personal recovery in multiple areas of my life, and leaning on my wife who was super supportive of me, these convergences facilitated what I hadn’t been able to do prior:
One of my discoveries is that existing advice often conflicts, and (as with all things) can be driven by profit, greed, and ambition. Instead of getting embroiled in all these details, I began to think critically for myself and make a plan with support. Here’s the simplest advice that’s now supported relatively across the board:
Recommendations for Added Sugar:
Part of a healthy body, mind, and spirit involves an honest look at what we put in our bodies. Nutrition is, of course, one of the most important realities of daily life. Much success and suffering comes from our consumption and discipline around food- and in that regard, it’s not much different from other areas of life such as our thoughts and beliefs, exercise, generosity, and work and rest.
I’m nowhere near an expert in the food realm, and this post is more personal in nature. I hesitated writing it for a while so as not to make another one of those ‘Look at me now!’ posts. The last thing I want is for anyone reading this to feel shamed by a braggadocious post on self-improvement. I personally didn’t have a bunch of shame about my weight prior, nor would that have helped. I want to thank my sister-in-law, Camille, for encouraging me that people might benefit from my personal story. I hope it helps.
As a therapist, I walk with people every day through CBT and counseling to take action. Traditional medicine, articles, and diets all serve their purpose. My job is to help people make change, personalized to them, in the context of reality- that we must all live in, or not- only to our detriment.
If you take nothing else away from this, here are the keys I want to share:
 Added sugar is different than sugar as it naturally occurs, like in fruits and vegetables. See Harvard Health's post here.
 “Fed Up”- not that I endorse everything in it, but there were a couple key lessons that I have incorporated from this documentary.
 This whole resource is quite fabulous with lots of good research and narrative. I nerded out with it!
This post was originally published on 05/26/2016 on my wordpress and is newly updated.
You’re surrounded by setpoints every day. They literally keep you alive. One of them is your set body temperature. If your body drops or rises a mere 15% beyond your core temperature, death occurs. Think of a setpoint like a reference point, a sort of boundary. Medically, it’s called homeostasis. The body regulates internal functioning (temperature, blood flow, oxygen) despite external circumstances. The body is always seeking homeostasis. So is the brain. And you can intentionally take charge for your mental, emotional, and relational health.
In our bodies, we break out in a fever when something is wrong- which is one way the body makes conditions unfavorable to viruses and bacteria- because they are temperature sensitive. In addicts, their brains have faced an onslaught of dopamine rushes- and the brain counters it by producing less dopamine to balance out- even sometimes ELIMINATING dopamine receptors. This is the brain naturally seeking to turn down a party that’s gotten too loud.
Balanced functioning (homeostasis), whether biological, technological, or psychological, will involve three interdependent elements that help reach homeostasis- all centered on a setpoint:
In order to bring a system back to normal, negative feedback is used to regulate it. So when I say, “get negative,” or course I’m not telling you to have a negative outlook on life. What I AM saying is that a system that is out of control will only be put back in control/order by it being regulated by setpoints, carried out by either an internal or external force- and this is negative feedback.
Okay, have I been sufficiently nerdy? Let’s get practical!!
Check out how William uses all three processes of homeostasis as a married entrepreneur with children, who is also dealing with some alcohol abuse (#2 in each is the setpoint).
1) Financial accounts are reconciled daily by William (outside help oversees them weekly). 2) The business plan was developed with a setpoint of no greater than $100,000 debt. Crossing $50,000 debt signals a problem and requires meeting with the board. 3) If the setpoints are not honored, the board has full power and autonomy to enact established strategies.
1) William’s two year old, Thomas, is running a fever- revealed by his behavior, and then it was gauged with a thermometer. 2) If 24 hours pass with a fever over 100 F- or at any point it goes beyond 103 F- the setpoint has been crossed. 3) Visit the doctor immediately.
1) Extra money was left over- discovered in the budget by William’s wife, Katie. 2) They determine no more than $10,000 will be spent on a kitchen remodel. The goal is $8,500; beyond the goal is a warning flag. 3) At the $8,500 mark, a conversation will be held with the contractor to hold to the budget.
1) After running into various troubles with alcohol, William considered his personal/family values and health recommendations. 2) A setpoint was made: only 2 drinks or less daily. 3) If this line is crossed, the commitment is to have an entire month sober. If this cannot be done, it is agreed on with his support team to increase treatment (e.g., go to a group, go to counseling).
Got the hang of it? These steps can be applied to about anything, though I mostly use the Setpoints Exercise (click on the link below to access!) to help increase ownership and boundaries with addictions. It’s a straightforward way to get honest with anything you are facing, the amount of help you need, and what supports can get you there. This concept has helped assist many of my clients to face problems squarely, and in turn, to be more successful and realistic in addressing life challenges. Give it a try!
A Psychotherapists' thoughts on healthy living.
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