Do You Have a Sugar Addiction?

 

Can you tell yourself before dinner that you won’t be eating sweets, even all the way up until you order, and then your mouth spontaneously orders dessert? Or you tell your friend “no thanks” for a cookie, and then find one in your hand, on the way to your mouth? If so, you are not alone. And you may have a sugar addiction.

If you are not sure about the use of the word “addiction” in relation to sugar, chew on this: Recent research is not using the word lightly when it finds that sugar IS biologically addictive in the same sense as heroin. On top of that, studies are finding many more reasons to avoid sugar that we previously have only suspected.

 

addicted to sugar, sugar addiction, health psychologist

 

We now know that sugar poses a threat to your heart health, impairs your ability to feel full, damages your liver, contributes to obesity and you can be genetically predisposed to overuse it. There are numerous important reasons to address sugar addiction, and seemingly no benefit to high sugar consumption. If you find yourself eating or drinking sugary foods and beverages often, it is essential to your health to question if continuing this way is in your best interests.

High-sugar foods and drinks are easily accessible today. It is often quicker and cheaper to find high-sugar foods than it is to find food containing fresh, whole ingredients. Sugary desserts are available in convenience stores, coffee shops, restaurants, and at every company or family party. It feels like the stores and manufacturers are telling us sugar is what most of our diet should be. In short, sugar is hard to quit!

What Can You Do About It?

NONJUDGMENT and REINFORCEMENT

Stop telling yourself that sugar is “bad,” you are “bad” for eating it or otherwise flogging yourself for having sugar in your life. Why? Because punishment is the least effective way to create lasting change. Judging and shaming (punishment) yourself for eating sugar, even after you have committed to calling it quits, may just make it harder to stop.

The brain pairs unpleasant or pleasant experiences with the situations that caused them. If, for example, you try to curb your sugar intake and then end up eating ice cream at the end of the day, your brain will remember what happens next and catalog it for future use. If punishment occurs, the behavior will be harder to change. If you mentally beat yourself up for not succeeding, your mind associates your efforts to limit sugar with this mental punishment and essentially, starts to give up. When you try to put further efforts toward decreasing sugar in your diet, you will find it increasingly hard to motivate yourself, and your brain will tell you, “What’s the use?” while throwing its hands up in the air and then reaching for dessert.

If, however, you end up eating ice cream at the end of the day and instead sigh, acknowledge this behavior is not in line with your goals and your stomach feels uncomfortable (nonjudgmental honesty), you are starting on the path to change. Then turn your mind towards noticing that you turned down that donut earlier in the day and say, “That was fantastic! Good for me. I want more of that.” (reinforcement). Now you are greasing the wheels of change and your brain will remember this too. (Reinforcement is very powerful in creating change and there can be some nuance to it. Check out some of my other articles specifically related to reinforcement for clarification.)

In short, when you find yourself being harshly judgmental about a behavior you want to change, stop, notice what you are doing, and describe it nonjudgmentally, in terms of cause-and-effect (e.g., if I do this, then I suffer that consequence). Then, turn your mind towards a behavior you have recently engaged in that is in line with your goals (or find a behavior in line with your goals to engage in in that moment) and reinforce (reward) yourself. If you are used to being critical toward yourself, you may have to lower your standards here. It is perfectly acceptable to reinforce the smallest of steps, even if you just thought about taking steps to change, the fact that you thought about it can be reinforced.

THERE ARE NO SMALL STEPS

As mentioned above, in our society sugar is practically shoved down your throat and is in almost everything that comes in a package, including savory food. Recovering from an addiction, especially one that is in every store and restaurant across America, is difficult. Don’t expect it all to change overnight. Take small steps and reinforce them (see the NONJUDGMENT and REINFORCEMENT section above). For example, you might start with just reducing (not eliminating) the amount of sugar you put in your coffee or tea or decreasing the amount of soda you drink just by leaving a few sips behind. Reinforce these seemingly small steps and you will gain momentum and watch these steps add up.

ASK FOR SUGAR ADDICTION HELP

If, despite your best efforts, you cannot curb your sugar intake and are experiencing problems as a result, ask for help! You may want to contact your healthcare professional or reach out to a health psychologist, such as myself. Health psychologists help people make sustainable changes to their health. We take the guesswork out and help you move toward your goals in a way that is streamlined and rewarding.

If sugar is causing a problem in your life, take one of the steps mentioned about today and start shifting from surviving to thriving!


3 Signs You Might Be Struggling with Binge Eating

Whether or not you suffer from an eating disorder, it is typical in our society to experience unhappiness with our body or the way we eat. Unfortunately, we exist in a society that is very appearance-focused, and that really does not allow for diversity in the way we look. This is a cultural norm, but we can work to change this by taking one small action today:

The next time you see someone you have not seen in a while, do not comment on how they look. Refrain from saying anything regarding their appearance and instead, make a comment focusing on how you feel about being with them such as, “It is so good to see you,” or, “It’s nice to get to spend some time with you.”

This simple, easy step gives the message that we are focused on seeing the person in front of us, and not evaluating their appearance.

 

Many of us are familiar with eating disorders, perhaps seeing depictions on television or in movies. Some of us are also personally challenged or have friends or loved ones who struggle with their eating. What you may not realize is that eating problems can include a range of behaviors, outside of the more commonly known Anorexia and Bulimia. One eating behavior is sometimes casually called compulsive overeating or food addiction, but when it reaches a diagnosable level, psychologists label this Binge Eating Disorder.

You may have reached this page through an internet search because you are already worried about your eating patterns, or somebody else’s eating behaviors. You may simply be wondering if your own problems with overeating would qualify as binge eating. Let’s look at three signs that you might be struggling with overeating or even binge eating:

  1. You Eat a Lot of Food in A Short Amount of Time

One of the characteristics of Binge Eating Disorder is that you eat quite a lot of food in a very short amount of time. Up to 10,000 or 20,000 calories may be consumed in just one sitting, compared to an average calorie intake of approximately 1,500 – 3,000 calories a day. Consuming this significant amount of food in one sitting is called binging. People often say that during these times they can “zone out” or lose track of what is happening around them. When binge eating, you often feel guilt and shame afterward. You may or may not engage in compensatory behaviors like self-induced vomiting, food restriction, or excessive exercise. In fact, food restriction can trigger the binge in the first place.

What can you do?

Eat regular meals throughout the day. This means that you eat roughly at the same time each day and do not go longer than about four hours without food. Research confirms that episodes of binge eating typically occur after a period of restriction (not receiving enough nourishment). While this suggested step is not sufficient to treat Binge Eating Disorder, it can be a part of eating disorder treatment and help if you struggle with occasional binge eating. Please note: The suggestions given in this article are not a substitute for treatment from a healthcare professional. Seek help if you are suffering from a serious disordered eating condition.

binge eating disorder, overeating problems California therapist

  1. You Have a Hard Time Stopping Eating

Another characteristic of binge eating is that it is hard to stop eating and there is a feeling of a loss of control. Binging is often called compulsive overeating because you may feel compelled to keep eating and as though you are not able to stop. People also call it food addiction because it can feel very much like an addiction, something you need or depend on, and are unable to reduce. Once you have started binging, it can feel impossible to stop eating despite how full you feel. Those suffering from compulsive eating often keep eating past a feeling of fullness, to a feeling of extreme physical discomfort or even in pain from the amount of food.

What can you do?

Seek help. If you find yourself unable to control your eating behaviors, you most likely could benefit from the support of a healthcare professional who specializes in binge eating. This can be a challenging behavior to change, but with the right help, change is possible. Take the guesswork out and get help from someone who knows how to help you extinguish binge eating behavior.

  1. You Have Other Mental Health Concerns

Overeating and Binge Eating are often associated with other mental health concerns. You may also be struggling with anxiety, depression, shame, guilt, self-doubt, or other troubling emotions. The relationship between these sorts of problems and binge eating can be reciprocal. In other words, one can lead the other and vice-versa. Often, we turn to food for comfort or self-soothing to cope with emotions. Finding relief in food feels helpful in the moment, but it is ultimately a maladaptive coping technique. To resolve this concern, you want to learn alternative, more effective coping skills.

What can you do?

If you are worried about your own eating behaviors, then you may consider going to therapy for Binge Eating. There are many ways a therapist can help you. Research has identified Dialectical Behavior Therapy (DBT) as a helpful approach for Binge Eating Disorder therapy. DBT can help you learn new skills, such as mindfulness and behavioral strategies that will allow you to approach food and eating differently. These skills will also provide healthier, more effective ways of coping with your emotions. Consider contacting a DBT therapist and asking about their approach to Binge Eating Disorder treatment today.

 

 

 


4 Tips for Returning to Therapy

For an audio recording of this post, visit here: Dr. Bando on Soundcloud 

When you make the investment of time, energy and money in therapy, you want to experience progress and change. If you’ve been in therapy before but haven’t achieved the results you want, you may be wondering what you can do to make those changes. Talk therapy can feel helpful, allowing you to have some real ‘aha’ moments and gain insight into the cause of your problems. However, talk or what’s called “supportive” therapy often does not help you change and meet your goal. Often, what is needed is to learn practical, concrete skills that will help you foster lasting change and healing. This can be achieved through treatment with a results-oriented therapist.

If you’re thinking about returning to therapy and want to create more effective change, here’s what to do:

Four things to keep in mind.

1st- Know That Returning to Therapy Takes Readiness and Commitment

If you have decided on returning to therapy, that’s a great sign that usually indicates you have some readiness and commitment to do what is needed to make changes. The most important first step is finding a therapist who aligns with your goals and who you feel comfortable working with. This can help you stay committed and focused.

Many clients prefer a results-oriented therapist who will work with them to make specific changes toward goals, rather than attending therapy indefinitely. The right therapist can help you identify and build upon your goals from the start and keep you motivated to do what is needed for lasting change.

returning to therapy, return to therapy again California online

2nd- Develop A Plan

While the idea of planning your therapy might seem strange, having a goal and a plan in place makes it much more likely you will succeed in making changes. Sometimes people attend therapy to just talk or vent, but to transform your life you need to work systematically to plan and implement change.

The therapist you choose to work with should develop a case formulation within your first few sessions. This formulation offers expert reflections and additional insight on your current situation. A skilled therapist will indicate a thorough understanding of your unique situation and collaborate with you to make sure this formulation is on target. By the third or fourth session, you and your therapist should have treatment goals and a treatment plan that will guide your future sessions, help you better understand what to expect out of therapy and ensure you both keep your eyes on the prize and moving toward your goals.

 3rd- Take What You Learn in Therapy Outside the Session

One benefit of therapy can be receiving support from your therapist and leaving sessions feeling relieved or empowered. Keep in mind, this is not enough. If you are working to make changes, then you must take the work done in therapy with you, outside of the session, and into your day-to-day actions. A therapist focused on getting you the results that you want will probably ask you to do “homework” or to practice new skills throughout the week. It is essential to follow the recommendations of your therapist and do your assigned practices so that you can reap the benefits of therapy and translate them into your daily life. Practice in between sessions is imperative to change. It also arms you with information about what happened when you tried these new skills, and you and your therapist can troubleshoot and hone the skills in your next session. Your practice and feedback are invaluable in helping you and your therapist stay on track with moving toward your goals.

Depending on your therapist’s style and theoretical orientation, they may be able to implement additional ways to help you achieve change. For example, therapists that have been trained in Dialectical Behavior Therapy (DBT) might ask you to complete weekly Diary Cards, so you can plan to try out and practice newly learned skills and then keep track of what happened and have a straightforward way of reporting this in your next session.

4th- Discuss Problems with Your Therapist

 Therapy does not always happen on a linear path without hiccups. At times, problems may arise. Whether you felt misunderstood by your therapist, your homework did not seem to hit the mark, or you are not making the changes you expected as quickly as you wanted, it is important to talk about this honestly with your therapist. This can be an excellent time for you and your therapist to revisit your identified goals, refine your treatment plan, and figure out any adjustments that need to be made. Although it might seem like a challenging conversation, talking with your therapist about what is not working may help you discover some factors that are holding you back or halting change, making this a valuable part of your treatment. Do not underestimate the value of the feedback you give to your therapist. Once your therapist knows your experience, thoughts, and feelings, he or she has the opportunity to respond effectively, make any necessary adjustments, and this ensures you can get the quality care you want and need.

With the right approach, you can make effective and lasting changes when returning to therapy, learning new and valuable skills that lead to a more rewarding and satisfying way of life.

Remember, life is too short to just survive, that’s why I help people thrive. I’m Dr. Amanda Gale-Bando, licensed psychologist. Thank you for reading and best wishes to you in making the lasting changes you want.

 


What Happens When You Stop Depressant or Anxiety Medications?

Anti-depressant and anti-anxiety medications work to alter your brain chemistry and support a more balanced mood state. Since psychotropic medication changes your brain chemistry and may also come with side effects, deciding to take medication should not to be made lightly.  It’s helpful to understand how the medication you are prescribed works and what to expect when discontinuing it before deciding to stop. It’s always advised to be under the supervision of a doctor who can ensure your safety and help minimize any side effects before discontinuing psychotropic meds.

(Please skip to the last section of this article if you would like to consider alternatives to psychotropic medication and discuss your options with your prescribing doctor and other healthcare professionals.)

Psychotropic medications, taking medicines, psychotherapist

Why Take Psychotropic Medications?

If you are struggling with depression or anxiety in a way that is significantly affecting your life, your doctor may recommend anti-depressant or anti-anxiety medications. Medications are also sometimes prescribed to alleviate symptoms, making therapy more helpful and useful. When feeling burdened by emotional overwhelm, at times it can be impossible to participate in your therapy in a way that promotes the change you need or motivate yourself to follow up on homework in-between sessions. When this is the case, your doctor may recommend psychotropic medication to help you engage in therapy in the way that you need to give you some relief from the symptoms you are experiencing.

Current-day research supports the use of both psychotropic medication and Cognitive Behavior Therapy (CBT) to treat diagnoses associated with depression. Medication may help you be fully involved and benefit from therapy. CBT will help you make the chemical changes in your brain for the long-term so that if you decide to taper off your medication at some point, you can maintain the brain changes you have worked to achieve in therapy.

In other cases, psychotropic medications may be prescribed to address chronic forms of depression and anxiety. Some people suffer from depression and/or anxiety for years. Despite trying many approaches, they struggle with symptoms on a daily basis. In these cases, medication may be a helpful option. Some people choose to maintain their medication regimen for a lifetime because when the medication is withdrawn, symptoms quickly return. Sometimes, even when engaging in all the behaviors necessary to support your health, the chemical components of the disorder you suffer from are just too strong, and medication is an essential part of your health routine. Each person is unique, as are the type, dosage and length of time prescribed medication works best.

It is very important to note that psychotropic medications may be contraindicated for some anxiety disorders and interfere with treatment and prognosis. Evidence-based treatments for anxiety require that you are able to experience the anxiety to its fullest extent in therapy in order for the treatment to be effective. If you are taking medication to decrease your experience of anxiety, in some case, this may interfere with your therapy. Talk to your treatment provider so that you can collaborate about the most effective treatment for you.

 

How Do Psychotropic Medications Work?

Different anti-depressant and anti-anxiety medication work in distinctive ways. Some medications stimulate the brain to produce more neurotransmitters (chemicals in the brain that regulate mood and other processes). Some help the brain by blocking the effects of neurotransmitters. Others, affect the brain by encouraging it to hold onto extra neurotransmitters. Because it takes some time for these medications to affect and balance the neurotransmitters in the brain, anti-depressant and anti-anxiety medications need to be taken for a minimum period of time before results are noticed. Your prescribing doctor can advise you the time needed to experience the affects from your medication.

 

Why Stop Taking Psychotropic Medications?

People often decide to stop using their medications once they start to feel better. This can be a mistake. It is important to carefully consider this decision and preferably, discuss your desire to discontinue medication with your healthcare professional. Often, it’s wise to wait a while after feeling better before discontinuing your prescription. When people quit taking their medication too soon, symptoms can return and sometimes the medication does not have the same effect or potency on mood symptoms the next time around. It is often preferable to wait until you have made changes in your health behaviors and maintained them for long enough where they have become habits. Once you have made the changes needed to support your sustained mental health, you’ll want to make sure they are engrained and part of your life so that you will continue to be supported in this way after your medication has stopped. Other times, people may find the medication they are taking no longer works and they may need to stop one type of medication to start another. Additionally, people may need to discontinue using their medication due to some other health concern (possible side effects, drug interactions, or in cases of pregnancy).

 

What Happens When You Stop Anti-Depressant or Anti-Anxiety Medications?

If you are taking an anti-depressant medication and suddenly stop, it can cause unpleasant symptoms including nausea, vomiting, headaches, dizziness, nightmares, and paresthesia (unpleasant sensations in the skin). If you are taking an anti-anxiety medication (or anxiolytic) and suddenly stop, symptoms could include nausea, vomiting, seizures, sweating, weight loss, heart palpitations, migraines, muscle pain, insomnia, and even suicidal thoughts. Specific side effects are unique to the medication and the person who is taking it. In either case, you may experience a rebound of psychological symptoms.

Because suddenly stopping anti-depressant or anxiety medication can cause unpleasant side effects, it is very important to consult with a doctor before you stop taking prescribed medications. A doctor can help to assess whether this is the right choice. They will also help you slowly reduce your dosage so that you are weaned off the medication safely, which helps to prevent uncomfortable side effects.

When you start or stop medications, it can be helpful to also seek the services of a qualified therapist who can help you address thoughts, feelings and emotions that may be affecting your mental health. A Dialectical Behavior Therapist (DBT) can provide specific education and skills to help you naturally cope with life’s ups and downs, without medication in some cases. A frequently used DBT slogan is, “Skills over pills.” This means that with learning and practice of DBT skills, often people can reduce or eliminate medication and lean on the DBT strategies they have learned to help them function effectively. The most important thing is to work together with your doctor and therapist to find the healthiest and most effective treatment solution for you.

 

Alternatives to Psychotropic Medications

Taking any type of prescribed medication is a personal choice. While doctors can advise you and make recommendations, ultimately, the decision whether to take psychotropic medication is up to you. Many times, making lifestyle changes can significantly impact your mood and decrease the need for prescription use. However, making these changes can be difficult and requires work. Only you and your wisdom can decide whether you are in a position and have access to the support needed to make these changes, or if now is not the time and medication is a worthwhile option.

If you are interested in making changes to your health behaviors to support a more balanced and stable mood, consider consulting with a Health Psychologist, such as Dr Bando. Health Psychologists are trained to understand all the factors maintaining the ineffective behaviors you are engaging in and help you directly target and change those behaviors to better support you. A good therapist can take out the guesswork and help you move toward your health goals with ease and precision.

Whatever your choice, please consult your wisdom and be gentle with yourself. In a time of difficulty (like experiencing depression or anxiety), increased self-compassion is needed.

Take action today and start shifting from surviving to THRIVING!


Feeling Over-“stuffed”: 3 of 4

How to Focus on What Matters During the Holidays (and Keep Yourself Feeling Merry).

Part 3 of 4 of the Holiday Stress Survival Guide

 

The holiday season is filled with so much extra stuff – packed schedules, gifts to buy, errands, food (more on that in Part 4), and people! You may feel over-“stuffed” yet still experience loneliness. Feeling sadness or struggling to enjoy the holiday season is a common experience. Many people find the holidays a stressful time of year. As mentioned, sometimes you may feel lonely (even in a room full of people), have a history of disappointing holiday memories, or have experienced a loss associated with the holiday season (such as the death of a loved one). It can feel like everyone around you is enjoying time with loved ones and the warmth of the season while you feel left out in the cold. If you find this a particularly difficult and lonesome time of year, take heart and read on for some ideas for finding comfort.

 

MAKE MEANING

Research shows us that even in the direst situations (being held in a concentration camp, surviving 9/11, or losing a loved one) people who are able to make meaning have a better quality of life and report more happiness overall in the years following that event. I mention these heart-wrenching examples because when you are down in the dumps and someone tells you, “everything happens for a reason” or some other encouragement geared toward making meaning, it can often feel invalidating and infuriating. The skill of making meaning or purpose in the midst of a painful experience can get you through and help you thrive. Research with survivors of tragic historic events shows us this is true.

 

Here’s what meaning-making is not: Making meaning out of pain is not forcing a smile and pretending everything is okay. It is not people-pleasing and making everyone else happy and comfortable while you suffer inside. It is not telling yourself that this situation happened for a reason or you must have deserved it.

 

What making meaning does involve, is finding a way to derive some purpose, something you can gain, out of the suffering you are in. In other words, how can you play the terrible hand of cards you have been dealt in the most beneficial way possible? Here is an example: I know a woman who has struggled with infertility and it is not possible for her to have children. This is very painful for her and every time the holidays come around, she aches to have a family. Every ornament that is hung and tradition experienced reminds her that she will not be passing any of this on to her own children. She feels pain. Although at times, she may be angry and want to scream how unfair this is, what brings her the most peace is finding meaning through her own spiritual and meditative practices, which she believes she would not do if she had not been met with so much sadness about something she cannot fix. She views her situation as driving her closer to practicing her spiritual beliefs and, as a result, extending increased compassion toward others. This does not make the state of affairs or her pain go away. What this meaning-making practice does, is help her focus on her values and find something of worth in the midst of her circumstances. When she feels lonely, sad, hopeless, she turns to her spiritual practices and finds comfort. This is making meaning.

 

Meaning making is a skill taught in the Distress Tolerance module of Dialectical Behavior Therapy (DBT). Distress Tolerance skills are designed for getting you through the moment when you cannot immediately solve the problem or source of your pain. At times, the holidays can be painful and because of the circumstances, we cannot completely change this. We feel pain, sadness, and loneliness. Making meaning can help us get through until, as with everything in life, this pain too shall pass. There will come a day that you smile and laugh and find pleasure. Remind yourself of this. Don’t let holiday loneliness get to you. Here are some tips to cope with Holiday Season sadness.

 

Online therapy. Loneliness, DBT, video therapy, California psychlogist

 

ENJOY JUST A MOMENT

Another DBT skill, this time from the Emotion Regulation module, is to engage in pleasant activities. The reasoning is that if you don’t have pleasant activities in your day, you cannot have a pleasant life. Sometimes, when you are very low, as you may feel during the holiday season, it feels like nothing gives you pleasure or joy. This is where you must get creative.

 

Instead of looking for bliss, try adjusting your expectations and finding one small thing that you can somewhat enjoy for a few seconds. Some examples are your first sip of coffee, those first few moments of getting into bed after a long day, taking a moment to inhale the delicious aroma of the food you are about to eat, or stopping to notice a beautiful flower. When times are rough and we cannot feel sustained happiness, it does not eliminate our need to be nourished with joy. When we start to notice the little things, even for a few seconds, we begin to build our emotional bank account with some pleasant experiences.

 

Think about having an empty bucket of loneliness or sadness. Every time you notice something even a little bit pleasant, like the moment you take off your shoes when arriving home, you are filling the bucket with a drop of pleasure. Of course, one drop does not make a big difference in a large, empty bucket. If you keep it up, drop by drop, over time, the bucket fills. Although it can feel like a slow process, every single time you turn your attention towards something even a little bit pleasant, you are a drop closer to filling that bucket. When you have accumulated many pleasant events, you will build the ability to feel more pleasure and happiness. Don’t force it. Just keep practicing and it will happen.

 

TAKE TIME TO REMEMBER

If your holiday season is a sad time because of loss and grief, you can make remembrance and the celebration of a loved one’s life a part of your holiday tradition. My grandmother used to make pies during the holidays. She would roll out the extra pie crust, spread it with butter, sugar, and cinnamon, and make special cookies for me to nibble while the pies baked. Now, whenever I make a pie, I use my grandmother’s fabulous pie crust recipe and say a little “thank you” to her for creating this memory for me. My husband now sometimes joins in, and instead of feeling sadness and lack, it has become a bonding experience that brings up nostalgia and gratitude. Rather than trying to push your pain aside or focus only on the positive, you may find a more authentic and touching experience when you take a few moments to remember those you have lost and commemorate this, even with a little “thank you.”

 

I hope that these strategies and activities make the holiday season a lot more enjoyable. If, however, your holiday blues are more severe or do not seem to reduce even after taking steps to help, then you may want to consider visiting a therapist. Therapists trained in Cognitive Behavior Therapy (CBT) and Dialectical Behavior Therapy (DBT) can be particularly helpful in dealing with the realities of the holiday season and finding effective coping strategies. Get in contact with a therapist to find out how they can provide that extra support to help you get through the holiday season, and perhaps feel even better about it.

 

Happy Holidays! Please remember, life is too short just to survive. Use these practices to help you THRIVE!

Read the whole series

Feeling Over-”stuffed” Part 1: Holiday Stress

Feeling Over-”stuffed” Part 2: Navigating Relationships

Feeling Over-”stuffed” Part 3: Loneliness

Feeling Over-”stuffed” Part 4: Overeating

If you use any of the practices suggested, please feel free to share your experiences and send your comments to contact@drbando.com. While Dr. Bando will not answer personally, your comments and feedback help inform future posts.

 

 

 

 


Telehealth vs. In Person Therapy: Which is Better?

You may be familiar with the image of counseling taking place in a psychologist’s office, client and therapist sitting opposite each other, or perhaps the client lying down on a couch. While this model is well known, our current-day communication technology makes it possible to access psychological services in the comfort of your own space.

Therapy has changed over the years, as has the consumer. As more information about psychological health has become readily available, those seeking treatment have become savvy customers. You value your time, money and energy and want gold-standard care. In therapy, this translates to more people looking for skills-based treatment delivered efficiently. Replacing the tradition of a therapist asking you to lie on a sofa and talk about your childhood, are therapists who view themselves as expert consultants, able to teach you the techniques and strategies needed to get what you want out of life. Therapy has become solution-focused and results-oriented, making video sessions an ideal platform for counseling.

In today’s busy world, many people find it difficult to schedule an hour plus commute to their therapist’s office on a weekly basis. Others do not want to sit in traffic, add another appointment to their day, or may want to see a specialist who is not located in their neighborhood. Telehealth provides a convenient solution.

Telehealth can provide greater ease and flexibility, and research shows it can be just as effective as traditional therapy. So which option should you choose?

How is Telehealth different from In-Person therapy?

In-person therapy means face-to-face in the same room or office with your therapist. The therapist provides the office space for your therapy session. Telehealth services are provided remotely, meaning that you and your therapist could be miles apart. Your sessions are assisted with HIPAA-secure technology, such as phone, video conferencing, email, online chat platforms, and even texts. In this model, you are responsible for making sure your space is private and confidential, and you feel comfortable enough to speak freely and be able to benefit from the session in the environment you have created.

Telehealth offers the advantage of making therapy services accessible to anyone, anywhere. This makes it easier to access the treatment you need. If the distance to travel to a therapist or the desire to see a specialist who is not in your area has held you back from therapy before, Telehealth might be a viable option to explore. If you want clear, directed, results-oriented therapy this can be easily delivered over Telehealth and help you reach your treatment goals quickly and effectively.

Teletherapy session, Telemedicine therapy, telehealth appointement

Who can benefit from Telehealth?

Anyone who is looking for results-focused treatment, in which the therapist serves as a teacher to help you gain the skills, techniques, and confidence to apply new strategies to your life and see the changes you want, can be a good match for Telehealth. In short, treatments focusing on helping you build skills to effect change are easily delivered via Teletherapy. Treatments such as Cognitive Behavior Therapy (CBT) and Dialectical Behavior Therapy (DBT) can help you with anxiety, depression, emotion dysregulation and interpersonal problems in an online format.

Clients who succeed with Teletherapy have the ability to provide a private, confidential space that allows them the focus needed to gain the benefits from their online sessions. Practical considerations such as having a strong internet connection, making sure your space is soundproofed enough so that you can express yourself freely, and having pen and paper handy, will ensure you get the most from your Telehealth treatment. With an online session, you do not have to lug your notebooks, writing materials, etc., to your therapy appointments. Everything you need is already at your fingertips.

Telehealth also allows you the luxury of sitting in your space, taking notes, and thinking or processing after the session has ended. Many people who have experienced face-to-face counseling know how abrupt it can feel to end a session after exploring vulnerable topics and then head out into the busy world again. With Telehealth, you have the opportunity to slowly absorb what you have learned, perhaps make a plan for optimizing your week ahead, and at your pace, slowly transition back into the outside environment.

Telehealth can also help people utilize counseling when they otherwise could not access services. This is especially true for people that live in rural areas or overseas, where they may not be able to find a therapist in their area with the expertise they need. People who have limited mobility due to health problems, age, or chronic illness can also find Telehealth helpful. Busy professionals and parents who may not have access to childcare can find Teletherapy an ideal choice. The goal is to access help with more convenience.

Does Telehealth really work?

When Telehealth was very new, there was some initial concern that it might not work as well as traditional therapy. However, research has found that remote therapy can be just as helpful as in-person treatment, with equivalent patient satisfaction scores. The benefits of convenience and accessibility make Telehealth the ideal solution in our increasingly busy and technology-driven world.

To find out if Teletherapy could be the right fit for you, speak with a therapist who specializes in Telehealth services and start shifting from surviving to thriving today!


How To Prevent Seasonal Depression This Winter

seasonal depression, seasonal affective disorder, SAD

 

Many people find it hard to get going on a gloomy day. The covers feel extra cozy and that cup of hot coffee or tea, extra warm and inviting. The urge to stay in your pajamas and curl up indoors beckons you.

You may notice the weather can influence your mood. You might feel more tired or even down and blue. It might be hard to motivate yourself to get much done. Feeling subdued is nothing to concern yourself with if it happens for a day or two. Relax and put your feet up (as much as your schedule allows) and give yourself permission to chill out and indulge. The key is to soak up the laziness and enjoy, without shirking your responsibilities or feeling pulled farther and farther into hibernation.

This may be easier said than done. For some, seasonal depression is an experience that lasts all winter long.

What is Seasonal Depression?

Seasonal Depression is sometimes called “the winter blues” and psychologists give it the more formal title of Seasonal Affective Disorder (SAD). It is a set of depressive symptoms that occur with a seasonal pattern, typically emerging in the Fall, when the weather gets colder, and remitting in the Spring, with the more frequent sunshine. Occasionally, people experience the opposite, with symptoms during Spring and Summer.

Typical symptoms include having low energy, feeling tired, sad and sluggish, losing interest in activities, difficulty concentrating, and sleep/appetite changes. Additionally, with seasonal depression, you may experience irritability, agitation, anxiety, hypersensitivity, and conflict in getting along with others. Frequently, symptoms start out mild and can become more severe.

What causes Seasonal Depression?

A major cause of seasonally-based depression is biology. Your biological clock (or circadian rhythm) may be partly to blame.  Changing patterns of sunlight and less daylight affect your biological clock. Reduced sunlight can also cause decreases in serotonin, a neurotransmitter (chemical in the brain) which affects and regulates mood. Finally, the body’s balance of melatonin may be disrupted, which also affects mood and sleep.

Another cause of seasonal depression is vulnerability factors. In Dialectical Behavior Therapy (DBT), vulnerability factors are described as circumstances that make you more vulnerable to experiencing intense, unpleasant emotions. These factors may include environmental stress, a diet that isn’t supporting your needs, sleep irregularities (lack of or too much sleep), lack of exercise (or too much or the wrong kind for you), and physical illness. During Winter, as the weather and winter colds and flu make you feel tired, worn down, and depressed, you may become even more vulnerable, less equipped to handle stressors and feel greater amounts of unpleasant emotions more frequently.  When vulnerability factors are high, intense emotions can follow, making you even more vulnerable.

How to prevent Seasonal Depression?

A gold-standard and evidence-based treatment (research shows it works) for any cause of depression is called Behavioral Activation. In short, this means that as soon as you suspect depression may be on its way (or has arrived), you make a plan to get active. In DBT, this is called Opposite Action.

Specifically, identify all of the depressive behaviors you might want to engage in (e.g., call in sick to work, stay in all weekend without socializing, watch more television). Then, identify their opposites (e.g., show up early to work, make plans ahead of time with friends and keep them, have your shoes and jacket by the door ready to go for a walk after work). Next, get busy doing the opposite behaviors that you feel like doing when you are depressed.

The key is to be clear and specific about what Opposite Action you are going to take (make plans with Joe to see a movie on Sunday afternoon, not vaguely: make plans this weekend), and then throw yourself in all-the-way. Don’t expect it to be easy. Combating depression is exactly that, combat. And, do not be discouraged. It is a battle you can win with persistence and encouragement.

When engaging in Opposite Action, do not suppress how you are feeling or your desire to stay home and put your head under the covers. Instead, allow yourself to feel how you feel AND, at the same time, throw yourself all-the-way into the Opposite Action you have identified and let the skill do the work. (Do not wait until you feel like doing Opposite Action. That day may never come, and it allows Depression to take even more of a hold.) Then, do it again and again until you have gone through your list of Opposite Action tasks and Depression has been sent on his not-so-merry way. If you find it hard to get started, pick one very small step you can take, and take it! Last (and definitely not least), remember to reinforce yourself for taking each step. Reinforcement is a powerful change agent. The more you use it immediately after engaging in desired behaviors, the easier those behaviors will become.

Another way to prevent seasonal depression is by managing your vulnerability factors. Identify what is making you more vulnerable to intense, unpleasant emotions. Although this step may seem obvious, we often do not realize the number of stressors present until we say it out loud to someone else or give it some intentional thought. Once you’ve identified your vulnerability factors (e.g., not sleeping well, feeling under the weather, nutrition has been off the past week), you can brainstorm some ways to attend to them and give yourself really good cold-weather care. For example, if you know that you need extra sleep during the winter and without it, you become quite irritable, see if you can brainstorm some ways to get even just a little bit more sleep each night. Your body and emotions will thank you.

Other treatments for seasonally-based depression address the physical causes. To help combat decreases in natural light, you might use Light Therapy. This works with specially designed light therapy boxes, and research shows it can help. Some people also elect to try vitamins and supplements (in consultation with their health provider) as an alternative to psychotropic medications, such as anti-depressants.

If you have noticed that your mood shifts as the season changes, you may find it helpful to seek out therapeutic support in learning to manage it. Therapists can teach you how to send depression into remission, and then prevent or drastically reduce the likelihood of a relapse. Dialectical Behavior Therapy (DBT) is one helpful approach. DBT offers techniques to help you identify your unique vulnerability factors, engage in self-care to reduce and manage them, and notice earlier when they may be affecting you so that you can take steps to mitigate depression. If you think DBT may help you, contact a qualified therapist and start shifting from surviving to thriving today!

 


How To Get The Most Out Of Your Therapy Session

If you are seeking a therapy session, it is likely because you want something in your life to change and you would like expert support and guidance through the process. You want a skilled professional to help take out the guesswork and help get you to your goals.

In the past, this has meant that on top of the stress or problem(s) for which you are seeking help, you must find the time, during business hours, to leave your home or office and make it to a weekly therapy session. Packed schedules, work requirements, and congested commutes present valid obstacles to taking over an hour out of your day every week to drive to your therapist’s office. Not to mention the trouble if the expert you’d like help from lives far away from you. In today’s busy world, many people are turning to TeleHealth or TeleTherapy sessions. These video therapy sessions use HIPAA-secure formats that function similar to Skype or Facetime to make therapy more accessible.

Whatever format you select for your therapy session, your success depends largely upon the work you put in, not just on the effort of the therapist. When attending therapy, your active participation in the process will help you to get the most out of your therapy appointments and ultimately, achieve the results you want.

Treat Therapy As A Collaborative Process

We often view therapists as the expert in the room. Therapists do bring a great deal of knowledge about psychology and new ideas for how to help you. However, you are also an expert in the room. You know best about your history, what you have tried in the past, and what is happening in your present.

A therapy session will be most successful if you work collaboratively and come prepared with what you want to work on in each session. Then, work with your therapist to set goals, explore information, make discoveries, and learn how to apply new skills to your life. Ultimately, you decide what to take away from the therapy session.

 

Make therapy work for you, Get the most of therapy, California therapist

 

Apply What You Learn Outside Of Session

As you and your therapist work together, you will understand yourself better and identify new, more effective ways of behaving. It is essential to apply these new skills outside of session. Whenever possible, ask for homework and then do it. If it is too challenging (usually this is the case when you find yourself not doing the homework), ask your therapist for help. It is your therapist’s job to help you generalize the skills that you learn in the therapy office to making real-time changes in your life. This means the therapist must use their expertise to assign homework in a way that not only challenges you but also is likely that you will engage with and complete the practice(s) they’ve suggested.

Remember to communicate with your therapist about any barriers you face putting the new skills into action. Trying a new skill once and never again will not help you get to that point of lasting change. Every new skill takes practice to become a new habit, and you are paying with your time and money to get help. Use it to your advantage!

Talk To Your Therapist About Your Therapy

When people go to therapy, it is often because they want to address some concern or problem in their life. You may be focused on discussing that problem and finding solutions, which makes sense. In addition, therapy works best when you also talk to your therapist about your therapy.

This means you can reflect on what is working and share those thoughts with your therapist. If you like a new skill, let your provider know. If you are unhappy about something, talk to your therapist about it and see how the two of you can navigate this situation. Giving your therapist this feedback allows them to respond by adjusting their interventions to be more appealing to you or more relevant to your treatment goals.

Find Therapy That Fits Your Lifestyle

Nowadays, most people don’t want to travel to get to therapy appointments or lie on a couch in the room with a therapist. And you don’t have to do these things to get results. With TeleHealth therapy, you can benefit from the skilled, focused attention of a therapist when and where you need it. Even within the comfort of your home, you can access professional therapy with TeleTherapy services via video calls. Making therapy easier to access means you are more likely to stay engaged and on track with your goals.

Once you have started therapy, use these tips to get the most out of your sessions, get the results you want, and start shifting from surviving to THRIVING.


4 New Perspectives To Free You From The Guilt And Shame Drain

Guilt and shame can hold you back from the happiness and freedom you desire, draining your energy and burning you out. Sometimes it can feel like shame is eating away at you from the inside, and you can’t even bear to face family and friends.

Fortunately, there are steps you can take to be free from the guilt and shame drain, starting today. Working one on one with a skilled Dialectical Behavior Therapist is a key way to begin letting go of these painful emotions to live a happier, more fulfilling life. As a part of DBT, you will learn specific techniques to shift your perspectives and see things in new light.

  1. Recognizing Guilt and Shame is the First Step

If you recognize your feelings and are able to label them as guilt or shame, you’ve already begun the journey to cope skillfully with these emotions. Just bringing attention and mindfulness to when you are feeling guilt or shame is a powerful step. When you realize that guilt or shame is what you are feeling, gently label and make a note of it internally, without trying to change or modify it. This act of mindfulness and recognition of emotions works into the further stages of DBT where you can learn to welcome pain and skillfully cope with it, rather than pushing it away, which often increases emotional distress.

  1. Your View May Not Be What Others See

One of the tricks that guilt and shame play on your mind is creating thoughts that things are all your fault or that everyone is blaming you. One of the first steps DBT teaches is to recognize and unglue from your thoughts. This step involves working with a DBT therapist to carefully review how you may be automatically coming to conclusions about situations and staying stuck in a rut. When you are feeling guilt and shame, take a closer look at your thoughts and interpretation of the situation that brought up these painful feelings. Recognizing these biases in interpretation is a first step to using DBT to tap into your wisdom and let go of worry thoughts.

  1. Take A Short Break From Your Feelings

When you are feeling guilt and shame, it can be easy to get stuck in a cycle of self-blame and anger. It is important to give yourself permission to give yourself a break from what can be an endless cycle. Do this intentionally, not to avoid the problem-solving process, rather, just to give yourself a break so you can come back to solve the problem at a different time. Take time off to do an activity you enjoy, to help others, or to just do or think about something else for a while. Taking a break from the intensity of emotions can give you the chance to refresh and gain a new perspective on the situation.

  1. Remember That Emotions Are Temporary

Always remember that “this too shall pass” and nothing lasts forever. Mind states and emotions – no matter how powerful – are  temporary and we can ride them out. (If emotions feel never-ending and do not feel temporary to you, a DBT therapist can help with that!) This doesn’t mean you should avoid problem-solving when necessary. Still, you may not need to treat every thought and emotion as though it is very serious and must be solved immediately. Training the mind is a process. The mind is always changing, and we can learn to let thoughts and emotions come and go gracefully.

An experienced DBT therapist can equip you with essential skills and techniques so you can learn to be free from the guilt and shame drain. Contact me today to work with me on creating a happier and more fulfilling life.


How do I Handle This?

How can we prevent crippling anxiety or depression? We need LOTS of practice welcoming in and feeling unpleasant emotions like sadness, fear, and anger. We need to lay out the red carpet for resentment, despair, and even hopelessness at times, because when we do, these emotions pass. If we open the door wide and set out the welcome mat, these emotions typically dissolve more quickly than we expect. We also don’t cling to these emotions – we feel them and let them go. Depression is that massive cloud of weighted bleh following you around. That cloud is made up of emotional buildup: thick, dense, burdensome emotions that have not been processed.

We forget that we can handle pain. In fact, we can cope with a lot of pain, often more than we expect to survive. Women engage in natural childbirth for hours on end and make it through. We survive break-ups, deaths, personal and societal tragedies, lost jobs, fever, and sickness. Through it all, we survive and usually gain self-respect in the process.

We breathe in-and-out and a new day comes. Sometimes the pain is so great all we can do is focus on just this one breath. Right here, right now. And then you know what happens? The next breath comes, and the next, and the next, and pretty soon we feel differently, and our thoughts change and shift. We welcome a new experience.

Us humans do a lot to get in the way of this process. We push away, avoid, ruminate, argue, distract, anything to not feel what is taking place in our body. (Remember, emotions are a physiological experience and happen in our physical body.) If my friend says something to me and I feel hurt, how do I process this?

  • I could avoid feeling it by thinking about it over and over (ruminating)
  • I could talk with numerous other friends about it to no end
  • I pretend it didn’t happen
  • I choose to ignore my friend hoping for an apology
  • Fill in your favorite way to deal by not dealing here ________________.

Instead, if I want emotional freedom, I could meet HURT at the door laughing and invite him (or her) in. I could treat this guest, HURT, honorably. How would this look? I might do a little self-talk that goes something like this:

“Ugh, I feel kicked in the gut. Where do I feel that? How do I know I feel HURT? What in my body is telling me HURT is here? (Take some breaths and notice sensations in my body.) I feel like the center of my chest is sinking. I almost feel out of breath. (Take some more breaths while paying attention to these sensations in my body and any other feelings that arise.) I think I feel HURT. (Some more breaths while paying attention to sensations in my body. When my mind wanders, or I zone out, I ask myself, ‘Now what is happening in my body? What do I notice?’)”

After maybe a few minutes pass, I gently decide what is most effective for me to do next. Is it to drink a glass of water? Talk to my friend about what they said prompting me to feel hurt? Continue breathing into these feelings and sensations? Get to work and put this aside until later? The key here is that I calmly ask my Wisdom what is most effective, rather than ducking, hiding and getting rid of that emotion as soon as possible. Personally, I sometimes like to set a timer for three minutes. When I do, this means that I have committed to throwing myself into feeling into my body (paying attention to sensations) for three minutes and will gently evaluate what is next when that time is up.

Remember, HURT is a guest, and if we want emotional freedom, we treat each guest honorably. I pour HURT a cup of tea, sit down with him, ask how he’s doing, pay attention when he talks, and we have a visit together. When he’s ready, HURT will decide to go. I won’t rush him out or even turn my back as he leaves. I will thank him for coming, and gently open the door and watch him go, letting him know he is always welcome. I may even thank him for his visit (emotions are very informative). I feel at peace.

When we push away what is uncomfortable, we create stress and even more unpleasant emotional intensity. When we welcome in our emotions and treat them honorably, we may experience pain, discomfort, aching, and we also give ourselves the gift of peace.

As with anything, reading this article will not change your life. What will? PRACTICE, of course! The next time you are feeling a painful emotion and would like help welcoming it in, listen to this short, three-minute, guided meditation to help you along. [Insert meditation link here] In fact, you can use this recording as a daily practice if you’d like to regularly engage in a skill to mitigate emotional buildup. (If you’d like to practice for a little longer, listen to this 8-minute meditation at the end of my article, The Guest House .

LIFE IS TOO SHORT JUST TO SURVIVE. THAT’S WHY I HELP PEOPLE THRIVE!

Thank you,

Amanda Gale-Bando, Ph.D.


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Dr. Amanda Gale-Bando

Dr. Amanda Gale-Bando