Break the Circle of Self

Depression, Pain, Anxiety – the Circle of Self

Break the Circle of Self
The Circle of Self can lead you into a dark self-absorbed place with pain, depression, and anxiety.

I was teaching health profession students this week about mental health and pain. The Circle of Self was a good visual way to capture a current phenomenon. One of the very important things we talked about was the LIMITS of MEDICATION! The students were very insightful about the reasons so many people are struggling with depression, anxiety, and pain. And, the more we talked, the more it made sense that this is a common pattern.

STRESS

We made a list of reasons why the incidence of depression, pain, and anxiety are so common. I would love to hear what you would add to this list. Current themes in our society that contribute are:

  • Stress
  • Anxiety
  • Decreased coping skills
  • Social media – most posts are either deceptively positive to look good or very negative
  • News, especially so much bad news
  • Poor sleep hygiene
  • Expectation of instant gratification
  • Reliance of medications or techniques to ‘just fix it’

THE CIRCLE OF SELF

When someone experiences depression, anxiety, and/or pain, several things tend to happen:

  • Less movement – more sitting or lying around
  • Decreased social activities – stay home more, reject offers to get out
  • Nod off or purposefully take a nap during the day
  • Have interrupted sleep at night
  • Experience pain – either pain when there was none or worsening pain

These changes lead to more and more focus on self. How do I feel? What is happening to me? Why me? Why do I feel this way? Why can’t I sleep? Why can’t I get motivated? Woe is me…

This common pattern of self can also impact heart disease, diabetes, obesity, and more.

The role of SLEEP

Most adults need 7-9 hours of sleep per night. As we age, more and more things seem to interrupt this sleep. You might need to go to the bathroom more often during the night.   Pain can wake you up or keep you awake. Napping during the day can mess with your nighttime sleep.

Too little sleep can increase your risk of depression. It can also make your recovery from depression most difficulty.

Too little sleep can limit your ability to manage with pain. Pain can feel worse, be more frustrating, and limit your activities more when you’re extra tired. Also, the more you hurt, the hard it is to sleep, and a vicious cycle is started.

The role of MEDICATION

Low amounts of key neurotransmitters in the brain can lead to depression and/or anxiety. There are medications that can help increase the amounts of those neurotransmitters. Note, this process takes about 8 weeks, so starting medicine doesn’t make you feel better right away. Usually your energy gets better before your depressed or anxious thoughts.

In the studies that showed that these medications can help, counseling was also a key part of therapy. The medications by themselves don’t help as much as they do when you also have counseling. It is the counseling that can help you find some different ways to think, stop the negative thoughts, and help you focus on more positive aspects of your life.

For pain, some medications block some of the pain signals going between the site of the pain and your brain. Others decrease the intensity of those signals. The pain medication should match the type and intensity of the pain. This means the same pain medication is not the best option for all types of pain. There have been huge issues in our society of overuse of pain medicine, especially opiate medications. These have a role in some types of pain. Once the pain starts to decline, the medication should be decreased and stopped. In another blog, I’ll review all of the many types of pain medications and when/how to use each.

Breaking the Cycle

Breaking the circle of self
Think of others to break the circle of self.

Medications are part of breaking the cycle for many people. Note, medication is often helpful to start the process. It might not be needed long term. Ask you doctor about how long it will be helpful for you.

Counseling is part of breaking the cycle. Learning to change your thinking patterns is key. Having support is also key.

Then, I want to share something that has repeatedly been shown to effectively break this cycle. Do something for someone else! Focus on self leads into the negative circle that gets tighter and tighter, isolating you from others. To purposefully think about others can help you out of this dark place. Call to check on a friend. Help someone with a project. Visit an older relative or friend. Take a meal to a new parent or someone who is sick. Make a donation. Write a letter to a soldier. Plan a special outing with a friend. Join a club that works on a social issue.

There are many options! The point is to find someone else you can think about and help. Distraction is helpful for pain tolerance, anxiety reduction, and depression treatment. Thinking about someone else helps you out of the dark focus on self.

For more information about breaking the circle of self, contact us at www.medsmash.com/contact or 410-472-5078.

BIBLICAL APPLICATION

I believe the circle of self can and does impact all of us. It is one of Satan’s best weapons. How distracted do you get when you are in pain? How about when you are feeling down or anxious? Even a common cold can be very distracting. And, once you are distracted, how hard is it to pull back out of the negative cycle?

Peter encourages us to recognize all of this and to learn to think more like Jesus.

1 Peter 4:1-2 MSG

Since Jesus went through everything you’re going through and more, learn to think like him. Think of your sufferings as a weaning from that old sinful habit of always expecting to get your own way. Then you’ll be able to live out your days free to pursue what God wants instead of being tyrannized by what you want.

In these complex times, we are bombarded with information that can keep us stressed, anxious, and/or depressed. Paul tells us to not focus on these things. He encourages us to focus instead on what comes next. How much time do you spend thinking about your future in Heaven?

2 Corinthians 4:14-18 MSG

 We’re not keeping this quiet, not on your life. Just like the psalmist who wrote, “I believed it, so I said it,” we say what we believe. And what we believe is that the One who raised up the Master Jesus will just as certainly raise us up with you, alive. Every detail works to your advantage and to God’s glory: more and more grace, more and more people, more and more praise!

So we’re not giving up. How could we! Even though on the outside it often looks like things are falling apart on us, on the inside, where God is making new life, not a day goes by without his unfolding grace. These hard times are small potatoes compared to the coming good times, the lavish celebration prepared for us. There’s far more here than meets the eye. The things we see now are here today, gone tomorrow. But the things we can’t see now will last forever.

Thinking about others, loving others as much and in ways we love ourselves, and putting others before ourselves are common themes in the Bible.

Philippians 2:3 ESV

Do nothing from rivalry or conceit, but in humility count others more significant than yourselves.

Romans 12:10 ESV

Love one another with brotherly affection. Outdo one another in showing honor.

1 Peter 3:8 ESV

Finally, all of you, have unity of mind, sympathy, brotherly love, a tender heart, and a humble mind.

I’m praying we can all keep our focus outside of ourselves. Love others and keep your eyes on the future – eternity in Heaven!

Blessings,

Michelle

Gratitude

Gratitude – keeps you healthier

Gratitude
Being thankful for what you have improves your health

Gratitude, grateful, thankful, thanksgiving, appreciation

What do these words mean to you? What role do they play in your everyday life?

Wow, I am amazed how much information is available on this important link between being thankful and health. Just search for these two terms and see what all you will find.

What is gratitude?

This is being aware of all of the good things in your life. And it is being thankful for those things. Have you considered being thankful for:

  • A safe place to sleep
  • Food to eat
  • Clothes to cover yourself
  • Having a friend to call
  • Your job – current or past
  • A beautiful day

This simple awareness of and being thankful for these ‘little’ things can boost your health.

Note, it doesn’t have to be the biggest house or the softest bed or the tastiest food or the latest fashion clothing to be grateful. Gratitude focuses on what you have – all of the good things – rather than what you don’t have.

Expressing gratitude can:

  • Boost your spirits and sense of well-being
  • Boost your immune system making you less likely to get sick
  • Decrease your chances of heart disease
  • Improve your performance (grades, work productivity, concentration)
  • Bust your stress

There are many ways you can make gratitude part of your life. Here are a few recommended in a Harvard Mental Health newsletter:

  • Write a thank-you note
  • Go up and thank someone
  • Keep a gratitude journal
  • Pray
  • Meditate
  • Keep a list of your thanks = count your blessings

See your day and your health improve by focusing on the positive.  Try starting your day with a list of things for which you are thankful.  On those nights you can’t sleep, name all of the good things in your life.  Let that override the worries and things you can’t control.

On this Independence Day weekend, as a country, we have much reason for gratitude!

For more information on gratitude and health, contact us at www.medsmash.com.

BIBLICAL APPLICATION

We have so many reasons to be grateful!

Have you ever been in a ‘funk’ having a bad day and then remembered to be grateful? I have done this so many times. When all looks dark and gloomy, make yourself think about all of the things that are good and right.

1 Thessalonians 5:18 ESV

Give thanks in all circumstances; for this is the will of God in Christ Jesus for you.

I’ll quickly admit I don’t always think to do this. I stay in that dark place far too long. Later, once I’m out I realize I had the ‘magic potion’ to leave that darkness behind. It was given to us by Christ when he died to erase our sins. It was given to us by God who maintained His love and focus on the good in the Jews through centuries of missteps (just as we live a series of missteps).

Lamentations 3:23 ESV

They are new every morning; great is your faithfulness.

I don’t even know where to begin selecting Bible verses to draw us closer to the benefits of gratitude. There are so many!!!

Psalm 118:24 ESV

This is the day that the Lord has made; let us rejoice and be glad in it.

Colossians 3:17 ESV

And whatever you do, in word or deed, do everything in the name of the Lord Jesus, giving thanks to God the Father through him.

Psalm 136:1 ESV

Give thanks to the Lord, for he is good, for his steadfast love endures forever.

Ephesians 1:16 ESV

I do not cease to give thanks for you, remembering you in my prayers,

James 1:17 ESV

Every good gift and every perfect gift is from above, coming down from the Father of lights with whom there is no variation or shadow due to change.

I feel energized, positive, and excited just reading these verses full of hope and promise! I am thankful for each person who takes the time to read this. May you be blessed by these assurances from God!

I pray you can stay focused on the many good things in your life this week and that can keep you out of the dark, gloomy places.

Blessings,

Michelle

Sleep – To Medicate or Not to Medicate

sleepingproblems
Regular sleep helps you think clearly and make better decisions

AAAhhhhh, there is nothing like a good night’s sleep. Don’t you feel refreshed and ready to conquer the world when you are well rested? How do you feel when you haven’t been sleeping well? Irritable, short-tempered, unfocused, …?

Feeling extra sleepy is linked to:

  • Motor vehicle accidents
  • Poor test performance
  • Poor decision making
  • Difficulty concentrating
  • Difficulty solving problems
  • Mood changes
  • Pain intolerance
  • Mistakes
  • Errors in judgment

So, it is not all in your head if you think you don’t have such a great day when you don’t sleep well.

The TV commercials tell you to grab one of the over-the-counter sleep medicines. I want to DISCOURAGE you from doing that. Most of the over-the-counter sleep options contain either diphenhydramine (Benadryl) or a sedating antihistamine like doxylamine. These medications are not recommended in people over 60. Not only do they make you really sleepy, they are very anticholinergic.

Anticholinergic

Anticholinergic medications are very drying. They cause dry mouth, dry eyes, constipation, and difficulty urinating. They also make your thought process fuzzy. Medications with anticholinergic side effects greatly increase risk of falls. There are MANY studies showing that people who take these sleep aids are more likely to fall.

Zzz sleep medications

There are some newer prescription sleep medications available. Three are referred to as the ‘zzz’ medications. They are zaleplon (Sonata), exzopiclone (Lunesta), and zolpidem (Ambien). Note the ‘z’ in each name. These are options when all good sleep habits have been tried and failed; or when insomnia occurs regularly or for a prolonged time. When they are used, the lowest possible dose for a short time is best. Each of these medications is linked to falls (especially if you get up during the night to go to the bathroom while sedated). Each is linked to car accidents if you drive while still under the effect of the medication. Each can cause odd behaviors in come people such as sleep driving or other tasks while asleep. I had a patient once who awoke to find Wal-Mart bags full of merchandise all over her living room floor. She had gone to Wal-Mart in her sleep and had a shopping spree. She brought it all home and into the house then went back to bed. She could remember none of it.

So use these medications only when necessary, at the lowest possible dose, for a short time under the careful guidance of a prescriber. Only take one when you are able to stay in bed and sleep for a full night (7-8 hours). These are NOT for a short sleep and get-up-and-go kind of night.

BEST sleep habits

Prior to considering adding medications, these habits can help you sleep better.

  • Keep your sleep schedule regular – Go to bed and get up at the same time each day.
  • Keep your bed for sleep and sex only.
  • Avoid daytime naps.
  • Avoid caffeine, chocolate, alcohol, or spicy food.
  • Avoid TV, reading your phone, using your computer right before bed. The light of the electronics triggers your brain to be active. There are several studies linking use of electronics before bed to poor sleep.
  • Get some exercise during the day so your body is tired as well as your brain.
  • Try deep breathing. Take slow, deep breaths in and slowly blow them out.
  • Try progressive muscle relaxation. Start at your toes. Squeeze your toes tightly then let them relax. Keep going with all of the muscles as you work up your body.
  • There are several other techniques available in the links on this page.

I highly encourage you to try all of the sleep techniques that don’t involve medications first. Then, if you do need medication, get a prescription from your doctor for a low dose. Use it only when truly needed for a very few days. Be sure you can dedicate a full night to sleep before taking a dose.

One other option when good sleep habits aren’t enough is melatonin. Melatonin is a natural product that improves sleep in some people. It takes up to a month to see the full effects. It can help you fall asleep quicker, sleep better, and sleep longer. Each dose won’t necessarily make you feel sleepy. The impact is more gradual over time. The starting dose is 2-3 mg at bedtime.

For more information on sleep options, contact us at www.medsmash.com.

BIBLICAL APPLICATION

It’s amazing how the eternal confidence of unconditional love can enhance sleep.

All of us have our overwhelming days, our painful nights, our frightening challenges.

We also have a source of hope and joy to see us through all circumstances. In Christ, you know who is ultimately in control. You know where you will be spending eternity.

So, on those bad, sleepless nights, give your burdens to the One who is asking you to give them over.

Proverbs 3:24 ESV

If you lie down, you will not be afraid; when you lie down, your sleep will be sweet.

Psalm 4:8 ESV

In peace I will both lie down and sleep; for you alone, O Lord, make me dwell in safety.

Psalm 121 CEV

The Lord Will Protect His People

I look to the hills!

    Where will I find help?

It will come from the Lord,

    who created the heavens

    and the earth.

The Lord is your protector,

    and he won’t go to sleep

    or let you stumble.

The protector of Israel

doesn’t doze

    or ever get drowsy.

The Lord is your protector,

there at your right side

    to shade you from the sun.

You won’t be harmed

by the sun during the day

    or by the moon[a] at night.

The Lord will protect you

    and keep you safe

    from all dangers.

The Lord will protect you

    now and always

    wherever you go.

 

Sweet dreams and blessings,

Michelle

Image source: Source:  National Library of Medicine; National Institutes of Health; U.S. Department of Health and Human Services

Snowed – Are you missing out on life needlessly?

 

Winter
Avoid that ‘snowed’ feeling from medication

 

How often do you feel “snowed”? Do you feel a lack of motivation? Is your thinking sharp? Is it hard to get the energy to get off the couch? Do you nod off when you sit down? Does your thinking seem fuzzy? Do you have trouble keeping up with conversations?

Medications can make you feel ‘snowed’

Now I ask you, do you take medicine for:

Your ‘snowed’ feeling could be a result of your medication. Many of the medicines used to treat these problems have this side effect. This is especially true if you take more than one or if the dose is too high.

Sometimes there are other medicine or non-medication options that will avoid these side effects. At least a trial of a lower dose might help.

Be sure to discuss your concerns with your doctor before making any changes.

Do you wonder if you might be taking one of these medicines or experiencing this type of side effect? Contact us at www.medsmash.com.

As you might imagine, where I live we had about 30 inches of snow recently. Everywhere we look we see snow.   It is beautiful for a while. It is fresh and clean and bright. The ability to take a break is refreshing. When you know you can’t go anywhere, it is easier to give yourself permission to read a book or relax in front of a favorite movie.

There are times, especially with certain injuries or emotional traumas, when medication-induced relaxation is warranted. In these cases, extra care for safety from falls and avoidance of driving are important.

But, this is not a long-term desirable state. So, again, if you are experiencing this ‘snowed’ feeling on your regular daily medication regimen, let’s see what can be done to wake you back up.

BIBLICAL APPLICATION

Do you feel like you’re lacking focus and clarity?

Are you distracted by negative thoughts and/or worries?

Do you find you are working from one to-do to another with no time to think or plan?

Do distractions and daily activities override prayer? This is a common excuse for not spending time with God and in the Bible. I have certainly made this excuse and continue to do so.

Yet, there is more than enough evidence day after day that walking closely with God, daily prayer, surrendering worries is how we are designed to live. Life is more joyful. There is much more peace. Worries don’t slow you down.

There are many Bible verses that reassure us that this is exactly what we are called to do.

Philippians 4:6 ESV

Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.

John 15:7 ESV

If you abide in me, and my words abide in you, ask whatever you wish, and it will be done for you.

Mark 11:24 ESV

Therefore I tell you, whatever you ask in prayer, believe that you have received it, and it will be yours.

1 Thessalonians 5:17 ESV

Pray without ceasing,

Romans 8:26 ESV

Likewise the Spirit helps us in our weakness. For we do not know what to pray for as we ought, but the Spirit himself intercedes for us with groanings too deep for words.

I challenge you to dedicate time each day to God. I challenge myself as well.

God knows you, everything about you, and loves you no matter what. So, hand it all over, accept the peace that is yours, and take a break from the worries.

Blessings,

Michelle

 

Holiday Stress and Anxiety – Your Healthiest Treatment Options

fireworks_black_150_thmThis is such a joyous exciting season! Many faiths have reason to celebrate this time of year. Many people have long-held precious traditions. Family and friends make special effort to be together. Receptions, parties, brunches, gatherings, and meals are planned.

Do find that this season gives you energy and good, warm feelings?

Or, do elements of this season make you anxious?

Do the preparations, busy calendar, and financial outflow give you stress?

I hope not. But if they do, you are definitely not alone. About 44% of women and 31% of men report an increased level of stress at holiday time. Some rate the hype, finances and issues as mentioned above, as the source of their stress. Others point to discomfort with social situations.

I want to share something helpful I recently read. It is interesting that we each feel like others are looking at and judging us in such situations. In reality, all of those people are having the same self-conscious feelings about themselves.

So, if you are feeling additional stress, what are your best alternatives to manage it?

Alcohol may seem like a good option, but it actually puts you at risk for a fall or a driving accident. Then, it makes you feel even more tired the next day. And, alcohol and drugs can make your stress worse rather than better.

A class of medication used for stress for decades is benzodiazepines. These medications include alprazolam, lorazepam, diazepam, and brand names like Valium and Xanax. They have made the lists of medications that are not safe for most people over the age of 65. They aren’t good options for people under age 65 either with very few exceptions. They make it hard to think clearly, increase risk of falling or other injury, and increase risk of driving accidents. When these are taken regularly, dependence develops. Then it becomes hard to get back off of them. So, I recommend you DO NOT use benzodiazepines to manage holiday stress.

A good night of sleep can be very helpful in dealing with stress. But, using medicine to get to sleep can put you at risk. These medicines include zolpidem/Ambien, zaleplan/Sonata, and eszopiclone/Lunesta. This list also includes over-the-counter sleep aids like diphenhydramine found in Benadryl, Tylenol PM, and Aleve PM. Doxylamine is another ingredient found in sleep aids and cold/flu combinations that has strong anticholinergic side effects. This means it can cause constipation, dry eyes, falls, and can cause slowed thinking.

So what are some safer ways to manage holiday stress?

Take care of yourself :-).

Healthy tips

  • Eat healthy foods, including plenty of fruits and vegetables. Limit fattening party foods.
  • Drink plenty of water/fluids to avoid dehydration while running around busy. Limit the caffeine to avoid the ‘crash’ later and to protect your heart.
  • Get some exercise to clear your head and improve your mood.
  • Get a good night’s sleep. Note, the exercise and avoiding alcohol will help with your sleep.
  • Take a break. Taking some time to relax, pray, meditate, or get a massage can help you recalibrate.

For more information about manageing holiday stress, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Does the Bible give any guidance about managing stress? Oh yes, from the dawn of time people have had fears, doubts, stress, and anxiety. Repeatedly, God has called us back to him. He repeatedly tells us that HIS peace is sufficient and beyond our understanding. Let some of these verses bring you a new perspective.

Philippians 4:6 ESV

Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.

John 14:27 ESV

Peace I leave with you; my peace I give to you. Not as the world gives do I give to you. Let not your hearts be troubled, neither let them be afraid.

Psalm 55:22 ESV

Cast your burden on the Lord, and he will sustain you; he will never permit the righteous to be moved.

Psalm 118:5-6 ESV

Out of my distress I called on the Lord; the Lord answered me and set me free. The Lord is on my side; I will not fear. What can man do to me?

Romans 8:31 ESV

What then shall we say to these things? If God is for us, who can be against us?

In addition, an interesting ‘tip’ is given to help us find more peace. Reaching out to other people benefits both them and us.

Galatians 6:10 ESV

So then, as we have opportunity, let us do good to everyone, and especially to those who are of the household of faith.

John 13:35 ESV

By this all people will know that you are my disciples, if you have love for one another.

Proverbs 12:25 ESV

Anxiety in a man’s heart weighs him down, but a good word makes him glad.

The list of related Bible verses goes on and on. We were not created to live in anxiety and stress. May the peace of our Lord and Savior be yours this Christmas!

Blessings,

Michelle

 

Center of Gravity – Preventing Falls

ps_weebles_playPicture a supermodel in her heels walking heel to toe. Now try it. Do you feel unsteady? When your feet are that close together, or even nearly crossing, it is easy to fall. Your center of gravity is very high. The bulk of the weight is up high with a narrow base. Now think of a Weeble – remember those toys with the rounded bottom wider than the top? They have a very low center of gravity (most of the weight in the bottom). They can tip over on their side and still return to standing.

If you’re ever feeling unsteady when walking, think about your center of gravity. Stand and walk with your feet farther apart. Take shorter steps. Lift your feet to avoid catching on grass, rocks, and other low obstacles.

When someone has fallen or is afraid of falling, you can notice these changes. As we become fearful we widen our stance, bend a little, and shuffle.

  • Arthritis in hips, knees, ankles, and feet can increase falls risk.
  • Dizziness, inner ear problems, or medications that make us dizzy can increase risk of falls.
  • Lack of sleep, getting up at night without light, and medications that make us sleepy can increase risk of falls.
  • Not drinking enough, especially during these hot summer months, can lead to dehydration making us dizzy.
  • Medicines that lower blood pressure can make us feel dizzy when we first stand up or turn.
  • Pets under our feet can be a source of tripping. So can throw rugs.

See the home falls prevention checklist under Resources at www.medsmash.com.

Biblical Application

The location of our faith has similar implications. When all of our knowledge of God is in our head, our center of gravity is high. When our center of gravity is high, it is easy to fall. Small things can whip and blow us about. Do you ever feel battered and blown from all directions?

  • work
  • relationships
  • finances
  • too busy
  • not feeling good

But with prayer, reading the Word, study, focus, faith enters our heart. And then it’s in our gut and our whole being.

As our faith gets deeper and deeper, our center of gravity deepens and we can handle heavy blows from any direction. The bad things still happen, but we can maintain our upright faith and dependence on God.

Then Christ will make his home in your hearts as you trust in him. Your roots will grow down into God’s love and keep you strong. Ephesians 3:17 New Living Translation

Let your roots grow down into him, and let your lives be built on him. Then your faith will grow strong in the truth you were taught, and you will overflow with thankfulness. Colossians 2:7 New Living Translation

May you grow deep roots!

Blessings,

Michelle