Is Stress Good or Will My Brain Explode?

What if I told you that stress is not a bad thing?

What if I even told you that stress is good?

Okay, you have to understand what I'm talkin' about. Modern lives are so driven by stress that we're all walking around like ticking time bombs. Except for those meditators out there. (But are they even for real?)

via GIPHY

It turns out that a little bit of stress is just the ticket to feel good and accomplish a lot of good things.

I'm talking about challenge. I'm talking about excitement. Yes, I'm even talking about...


Deadlines

Tips for Successfully Managing Your Stress and Anxiety

Anxiety and stress are simply parts of life for most people, especially when we try to juggle multiple responsibilities. However, if your stress and anxiety attacks have begun to impact your ability to function in everyday life, then you need to seek out ways to manage these emotions. ProzacMonologues.com explains the importance of finding strategies that help you to manage your anxiety both at the moment it occurs and long-term.

Guest blogger Julia Mitchell, lifestyle expert at outspiration.net contributes this piece about tips to manage stress and anxiety. I (Willa) have added a few links to previously posted pieces from ProzacMonologues.

Develop Skills to Proactively Manage Stress

Raising children, earning a living, maintaining family harmony and wellness, and pursuing your passions can all be stressful. While each of these things may contribute to creating the life you want, they can also undermine your overall well-being, if they cause you too much stress. The Anxiety and Depression Association of America notes that you can equip yourself to manage stress and prevent anxiety attacks by building healthy habits with sleep, exercise, food, work, play, attitude, and self-fulfillment.

You can also pick up a new hobby like gardening, which has been shown to help mitigate stress. Not only do you have the opportunity to get your hands dirty while watching what you've planted grow into healthy edibles, you'll be getting much-needed Vitamin D as you spend extra time outside. For expert advice and pointers, go online and visit Home Garden Hero.

Identify and Manage Your Triggers


It's a good idea to identify the situations that trigger your anxiety so you can take constructive steps when you encounter those things or avoid them. Triggers are external events, large or small, that prompt your body and mind to respond in a seemingly irrational way. The response is generally flight, fight, fawn, or freeze. As Be Calm with Tati explains, you have to learn your triggers in order to disrupt this cycle. Then you need to implement some deep breathing exercises so you can calm down and focus on what happened and why.

This Prozac Monologues post, Tips for Surviving the Holidays, was originally written for the specific event of an extended family gathering. But its suggestions for managing triggers can be applied in a variety of contexts.


Create a Low-Stress Work Environment


There are things you can do to make your workspace less stress-inducing, particularly if you work from a home office. Reduce clutter by putting items in designated bins labeled "to do," "to read," and "to file." Make sure the lighting is adequate and easy on your eyes. Use a planning system that works for you, whether paper or electronic. Evaluate your office desk and chair for ergonomic comfort. It's well worth making the investment in a good office chair that places you at the proper height to use your computer easily.

You can also manage work-related anxiety in other ways. If your current job is what's making you anxious, consider a new position or different career path. Just remember that before seeking new opportunities, creating an updated resume by utilizing a type of free resume maker is a good idea. You can use a free online resume template to customize with your own copy, profile photos, and color scheme.

Dealing with Anxiety in the Moment


When you're in the grip of anxiety or a full-blown panic attack, it can be difficult to know how best to handle the situation, which is why it is best to develop strategies ahead of time. Do some deep, abdominal breathing. Focusing on your breath can have a calming effect. As you inhale, allow your abdomen to expand, and then try to make the exhale slightly longer and allow your abdomen to relax. The University of Texas MD Anderson Cancer Center suggests using guided imagery to fill your mind with thoughts, images, sounds, and smells of positive experiences.

You can also go for a walk, do yoga or tai chi, or engage in vigorous exercise, such as dancing or running. Take a moment to question any catastrophic thoughts that are running through your mind. As the saying goes, "Don't believe everything you think."

Here is a Prozac Monologues post, Recovery in Progress, that walks the reader through my own experience of an anxiety attack at a NAMI conventions, and the tools I (Willa) used to manage the incident.


Find Long-Term Stress Management Strategies


If you're prone to anxiety attacks, then it's important to have a long-term plan for managing the stress of daily life. Establishing an ongoing practice of meditation and/or a slow deliberate movement, such as tai chi, qi gong, or yoga can be helpful. If your anxiety has resulted in sleep disturbances, irritability, difficulty focusing, or ongoing muscle tension that last for more than a month or so, it's time to seek professional help.

Journaling and cultivating your sense of humor may also be helpful. Evaluate your responsibilities and consider whether you can realistically fulfill them; you may find that you need to delegate some tasks. Develop the habit of taking breaks from stressful activities. Make sure to spend some time outdoors whether hiking, running, walking, or simply enjoying a park bench in the sunshine.

In this post, Frazzled Cafe and Ruby Wax, the comedian, with master's degrees in psychotherapy and mindfulness-based therapy, describes how these activities can be used to channel the brain's functioning to relieve stress.


Find and Implement Your Anxiety Solutions


Anxiety can be present at any phase of life, whether you're a parent, student, worker, or retiree. It's important to develop constructive ways to manage stress so that you can live your life and meet your responsibilities. There are many methods of managing and prreventing anxiety, ranging from exercise to finding a less stressful job to journaling and to professional therapy. Figure out what works best for you and build some healthy habits that will be useful in both preventing and managing anxiety when it occurs.

If you are dealing with stress, anxiety, or other mental health disorders, join Willa Goodfellow on her journey to research and process these issues in her own world through ProzacMonologues.com.

Note: Many thanks to Julia Mitchell for this, my first foray into guest contributors. You may have noticed the different voice. Less... loony? Julia is a lifestyle writer, not quite my wheelhouse. But there is a lot of interest in mental health lately that is not about mental illness. Those two terms do get used interchangeably. Julia inspires me to continue the conversation with another post about how stress and anxiety differ and what the brain has to do with it. See ya next week.

photo courtesy of Pexels
clipart by Microsoft online
photo of toolbox by Eric Strandberg and used under the Creative commons license
flair from Facebook

Getting My Brain Back -- I'm Still Excited by BDNF

Learning has been fundamental to my mental health recovery. It started with this blog itself. I wanted to know What the hell happened to my brain?!!! So I read the research and used ProzacMonologues.com to keep track of my notes.

For a while I added piano to my recovery regimen. Not for music therapy, but for brain development. Okay, I didn't keep at it. I can sort of play Desperado. But it did get me a few more miles down the road.

Lately I am learning a new language. Five minutes a day of Irish on Duolingo -- I don't expect to be fluent any time this decade. I don't need to be fluent. For those five minutes a day, I am building my brain.

Which is always a good thing.

I did a search in my blog for BDNF. And found something I wrote in 2011, right after I wrote that review of Ellen Frank's Treating Bipolar Disorder. Now you, kind reader, have no idea the struggle it took back then to write these paragraphs. I am proud of it both for the accomplishment and for the content itself. I present it to you again:

Getting My Brain Back -- In Praise of BDNF


Interpersonal Social Rhythms Therapy: Good, Bad, and Ugly (Mostly Good)

Following #bipolar on Twitter for the last few years, I am often dismayed. So many people seem to spend so much time struggling with their medications and so little time focused on anything else that could help.

Don't get me wrong. Medication is an important tool for managing bipolar disorder. But it can't do the whole job. Education and life style changes are crucial for getting off the roller coaster of constant med adjustments to address the episode du jour.

I decided it was time to revisit my 2011 review of Ellen Frank's Treating Bipolar DisorderIt was a four-part review. The last three posts describe the treatment itself, Interpersonal Social Rhythms Therapy, IPSRT.

Part I laid the educational foundation, describing the relationship between circadian rhythms (our interior physiological clocks) and mood disorders.

Part II outlined Frank's Social Zeitgeber Theory and the treatment that proceeds logically from it, a process of establishing regular daily rhythms that set our interior clocks and keep them running on time. (Zeitgeber means timekeeper.)

Part III explained how work on interpersonal issues helps people reduce stressors and prevent disruptions to their social rhythms.

This last post will pull together my appreciation, my reservations and my hopes for future directions.

Social Zeitgeber Theory


How Does Interpersonal Therapy Help People with Bipolar Disorder?

Ellen Frank - Treating Bipolar Disorder, Part 3

Lately I have been reposting my 2011 review of Treating Bipolar Disorder by Ellen Frank. It was originally recommended to me by a friend who was researching hypomania. Part I described the basis of Interpersonal Social Rhythms Therapy (IPSRT) in circadian rhythms that control the many physiological symptoms of mood disorders. Part II outlined the Social Zeitgeber Theory and described the early stages of the therapy process, history taking and stabilizing social rhythms. Today I pick up with the later stages, interpersonal therapy and maintenance.


Interpersonal Social Rhythms Therapy came to Ellen Frank in an epiphany on her birthday, July 14, 1990. Personally, I like that. I especially like that it was the day that she participated in a conference for people with bipolar, and listened to them.

Frank and her colleagues were already using interpersonal therapy for people with recurrent unipolar depression. Their theory was that certain life events, particularly losses could result in lost social zeitgebers, (timekeepers), with subsequent disruption of circadian rhythms, leading to eventual relapse into another episode of depression.

IPSRT took up from there as an adaptation specifically for people with bipolar disorder, integrating the work on issues (as in, you've got issues) with greater focus on behavioral changes to achieve and maintain daily rhythms, time of rising, time of first human contact, work, main meal, etc. The purpose of IPSRT is to help people achieve stability and then to avoid relapses into either depression or mania/hypomania.

Why Do People Relapse?

How the Social Zeitgeber Theory Works, for Good or Ill - IPSRT

This -- this system is the gift I wish I could give to the people I meet on Twitter who struggle with their bipolar, who are in endless rounds of medication adjustments and medication failures and medication despair. Medication isn't the only thing you can do. I'm not saying quit your meds. I'm saying, add social rhythms therapy. Originally posted in 2011:

Ellen Frank - Treating Bipolar Disorder, Part 2

So you have bipolar. You know you have bipolar. You are way past the denial stage. You are into the pulling out your hair, screaming with frustration stage. Or maybe moved on to despair stage. Because:


  1. The medication sucks.
  2. You keep getting sick again anyway.

But contrary to what everybody has been telling you, medication is not the only thing that works. It may be essential to your recovery and continued functioning. But you can do better if you do more. From my last post:

IPSRT [Interpersonal Social Rhythms Therapy] is one of three psychotherapies tested by the National Institute on Mental Health in its recent major study of best practices for treatment of bipolar disorder. The Systematic Treatment Enhancement Program for Bipolar Disorder, STEP-BD discovered that Patients taking medications to treat bipolar disorder are more likely to get well faster and stay well if they receive intensive psychotherapy.

Do I have your attention? Today we continue with Ellen Frank's Treating Bipolar Disorderin which she describes this therapy of her invention.

What Happens In IPSRT

Do Your Meds Work? There's More You Can Do to Treat Bipolar

Ellen Frank: Treating Bipolar Disorder - A Review

Ellen Frank changed my life. When I was diagnosed on the bipolar spectrum, and hadn't found a medication regime that I could tolerate, her Interpersonal and Social Rhythms Therapy gave me a way to get a handle on my wildly fluctuating condition.

She and I corresponded in 2011, as I was writing a four-part review of her book and her therapy. I published with her assurance that I got it right.

I was over the moon when she agreed to endorse Prozac Monologues: A Voice from the Edge. She wrote:

Brilliantly written, engaging from the first page, Prozac Monologues is a bit like a great evening at a first-rate comedy club…except that it is deadly serious.  Goodfellow’s painful and all too common journey to finding the right treatment for her bipolar disorder points her to the ultimate realization that doing well with this illness requires the right medication, the right psychotherapy, and the specific lifestyle modifications that support wellness.

Ellen Frank, Ph.D.Distinguished Professor Emeritus of Psychiatry, 

University of Pittsburg School of Medicine

Pretty cool, huh! She even wrote privately to her listserv to recommend it.

So many people I read on Twitter struggle to manage their bipolar disorder. I figure it's time to bring this four part series out again. So here is Part 1 - from April 4, 2011.

Medication And Mental Illness


Medication for mental illness is just like medication for anything else. It works better when you don't ask it to do all the work itself.

In the case of bipolar, once lithium and the chemical imbalance theory came along, the thinking was that medication was the only thing that worked. Therapy by itself certainly didn't. I wonder if therapists, worn out by their bipolar patients, were simply relieved to believe that medication was the only thing that worked. I wonder if therapists today, worn out by their recurrent depression patients, are secretly relieved to terminate when the diagnosis changes to bipolar, because medication is the only thing that works.

Frankly, there is a lot of wishful thinking out there in pharmacotherapy land. If only our brains were a chemical stew and the illnesses of the brain could be treated by adjusting the recipe. If only.

But people with mental illness, especially people with bipolar, can't afford the wishful thinking behind the better living through chemistry fantasy. Sometimes the medications do work. But not as well nor as often as your doctor would like to think.

I have a friend who is a psychiatrist. He challenges his colleagues who keep trying to solve this noncompliance issue, to get their patients to comply. He reminds them, if the medication (antidepressants, in this example) worked for 40% of those who took it in the trial, and the placebo worked for 30%, that means only one out of ten people benefit from the medication itself. So what's the big deal about nine who quit?

He says they just look at him funny.

Treating Bipolar Disorder by Ellen Frank


This same friend, God bless him, loaned me a book about a psychotherapy designed specifically for bipolar disorder titled, appropriately enough, Treating Bipolar Disorder. The author Ellen Frank, professor of psychiatry and psychology at the University of Pittsburgh School of Medicine and director of the Depression and Manic Depression Prevention program at Western Psychiatric Institute and Clinic, and her colleagues invented Interpersonal Social Rhythms Therapy (IPSRT), a kind of mash-up between talk therapy and regulating circadian rhythms.  It gets my next few posts.

In A Nutshell... 


IPSRT [is] a treatment that seeks to improve outcomes that are usually obtained with pharmacotherapy alone for patients suffering from bipolar I disorder by integrating efforts to regularize their social rhythms (in the hope of protecting their circadian rhythms from disruption) with efforts to improve the quality of their interpersonal relationships and social role functioning.

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