Category: Wellness

17 Self-Care Ideas for Mental Health Professionals

Prevent burnout and combat compassion fatigue with these 17 self-care ideas and strategies for therapists.

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A recent study found that many mental health professionals do not recognize their own burnout. For therapists and other mental health workers, self-care is essential for preventing burnout and compassion fatigue.

Self-care is never a selfish act—it is simply good stewardship of the only gift I have, the gift I was put on earth to offer to others.

Parker Palmer

This is a list of self-care ideas and strategies for mental health professionals. Please share with anyone who might benefit!

For additional self-care ideas, see 11 Self-Care Ideas You May Not Have Considered and Self-Care Strategies When Your Loved One Has an Addiction.

Self-Care Ideas for Mental Health Professionals

1) Take small breaks throughout the day. Spend a few moments sitting in silence, browse funny memes, joke with a coworker, or take your lunch outside; by the end of your workday, you won’t feel as drained.

2) Meditate. Spend at least 5-10 minutes a day, in the morning or between sessions, meditating or listening to guided imagery recordings.

3) Schedule an appointment weeks in advance for a facial or massage. You’ll have something to look forward to!

4) Don’t neglect your basic needs. Drink water, choose healthy foods, exercise, and get plenty of sleep.

Don’t take your health for granted. Don’t take your body for granted. Do something today that communicates to your body that you desire to care for it. Tomorrow is not promised.

Jada Pinkett Smith

5) Reach out to people in your support network. When experiencing burnout, we have a tendency to think we’re weak or less capable. We may struggle to admit what we’re going through. However, seeking support during these times is more important than ever.

6) Don’t bring your work home with you. It can be difficult to not think about the problems a client is experiencing or to check your email, but it’s crucial to have balance in your life. If you let your work consume you, you’ll soon find yourself depleted and with nothing to give.

7) Take the time to sincerely thank or praise your colleagues. Sometimes, it seems as though we’re in a thankless field. Spread positivity by expressing gratitude and giving compliments. (I also like to pass along the praise I hear for someone else!)

8) Be kind to yourself. Be realistic. Practice positive self-talk and forgive yourself for the mistakes you make. Acknowledge that you’re not always going to know the right thing to say, nor will you be able to help every client you see.

Talk to yourself like you would to someone you love.

Brené Brown

9) Treat yourself to your favorite beverage at least once a week. Enjoy a Starbucks coffee or a kombucha tea during the workday. Consider surprising a coworker with one too!

10) If you work in a shared office space or residential setting, get up and communicate in-person instead of sending an email. (You can always follow-up with an email to recap the convo if needed.) Human interaction throughout the day is far more rewarding than staring at a screen.

11) Take a short “nature bath”! Multiple studies have found that being outdoors improves mood and reduces stress. If you work in an urban setting, nurture a potted plant or listen to nature sounds in your office to promote relaxation.

12. Bring your furry friend to work. Pets make us happy; one study found that having a dog in the office made a positive difference by reducing stress and making the job more satisfying for other employees.

13) Update the lighting in your office. Natural light exposure in the office is linked to a better quality of life. If possible, take advantage of sunlight during the day by keeping the blinds open.

14. Find self-care ideas online. I recommend the Self-Care Starter Kit from University at Buffalo School of Social Work and Dr. Kristen Neff’s Self-Compassion site.

I found in my research that the biggest reason people aren’t more self-compassionate is that they are afraid they’ll become self-indulgent. They believe self-criticism is what keeps them in line. Most people have gotten it wrong because our culture says being hard on yourself is the way to be.

Kristen Neff

15. Stretch! Yoga is known to reduce stress and improve mood. Take a class or simply practice stretching exercises throughout the workday.

16. Listen to music while typing your notes. I love paperwork… Said no therapist ever. Play your favorite tunes to motivate you and make the time pass quickly.

17. Immerse yourself in quiet with a silent commute. After listening to talk all day long, it’s soothing to listen to absolutely nothing on your way home. Recharge with silence.

Post your favorite self-care strategies in a comment!

self-care ideas

For more self-care ideas, visit 11 Self-Care Ideas You May Not Have Considered.

References

8 Easy Strategies for Stress Relief

Feel happy and relaxed with these 8 simple evidence-based strategies for reducing stress and improving mood

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Image by Davidqr from Pixabay

Stress is the body’s reaction to an event or situation. Primarily a physiological response, stress is also experienced psychologically (i.e. worry). Too much stress is associated with mental health issues and chronic health problems.

Because we often have no control over stressors in our lives, it’s important to effectively manage stress.

Here are eight fast-acting stress relievers for short-term relief. (Click here for additional mood boosters.)

8 Fast-Acting Strategies for Stress Relief

1. Swap out sitting with sleep or light activity.

Less time sitting = Better mood and stress relief. A recent study found that replacing sedentary behavior with sleep or light exercise (i.e. walking, gardening, etc.) improved mood. Substituting sleep was associated with decreased stress levels in addition to enhanced mood.

2. Take a 10-minute nature break.

“Nature therapy” is 100% free and highly effective. Research indicates that spending as little as 10 minutes outdoors can improve mood.

3. Become a plant parent.

Keep a plant in your office and place it where it’s easy to see for stress relief. Tending for and gazing at a small indoor plant may reduce stress during the workday.

4. Get a 10-minute massage.

You’ll feel more relaxed and less stressed after receiving a head-and-neck or neck-and-shoulder massage. One study found that participants experienced reduced rates of both physiological and psychological stress after 10 minutes of massage.

5. Flirt!

Casual flirting and light-hearted banter at work may alleviate stress. Research indicates that engaging in flirtatious behaviors can lead to positive feelings about self while enhancing mood.

6. Have a Matcha latte.

Drinking Matcha green tea may lead to feeling less stressed. Researchers found that mice who consumed Matcha powder or extract experienced reductions in anxiety.

7. Stress less with your romantic partner.

When faced with a stressful situation, have your significant other present to ease your anxiety. If your partner is unavailable, visualize him/her; simply thinking of a significant other has comparable positive effects on blood pressure and stress reactivity.

8. LOLOLOL!

Frequent laughter seems to be a buffer for stress; people who laugh a lot experience fewer stress-related symptoms. Researchers found that the more someone laughed, the less likely they were to feel stressed.

stress relief

5 Quick & Easy Mood Boosters

A list of 5 strategies for boosting your mood and improving your overall wellbeing

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Need a boost? Here is a list of five evidence-based, instant mood boosters for when you’re feeling down.

Click here for additional tips to improve mood and reduce stress.

5 INSTANT MOOD BOOSTERS

Listen to music

Turn on the radio or search for your favorite song on YouTube. Music can evoke a powerful emotional response. Listen to something upbeat with a positive message to boost your mood. Music activates areas in the brain that are responsible for processing emotions.

“Music produces a kind of pleasure which human nature cannot do without.” 

Confucius

In one study, participants who listened to upbeat music while actively trying to feel happier experienced improved mood as well as increased happiness over the next two weeks.

A 2017 study indicated that listening to your favorite songs impacts the brain circuit involved in internally focused thought, empathy, and self-awareness. Interestingly, it doesn’t matter what type of music you choose; the mood-boosting effect is consistent across genres.

Music may also play a role in restoring neuroplasticity or as a therapeutic intervention. In 2013, researchers found that listening to uplifting concertos from Vivaldi’s Four Seasons was linked to enhanced cognitive functioning. An additional benefit to listening to music is improved mental alertness; memory and attention in particular may be enhanced.

Find a green space

Go hiking, find a sunny spot to sit outside, or simply open the window and listen to the sound of the rain falling. According the U.S. Forest Service, spending time in nature can reduce stress, improve mood, reduce anger/aggressiveness, and increase overall happiness. If you’re upset or frustrated, you’ll recover more quickly in a natural setting, such as a forest. Nature is a highly effective mood booster!

Alternatively, consider a stroll in the park for a boost. Researchers found that individuals with depression who took an hour-long nature walk experienced significant increases in attention and working memory when compared to individuals who walked in urban areas. Interestingly, both groups of participants experienced similar boosts in mood; walking in an urban area can be just as effective!

More recently, researchers found that people who regularly commute through natural environments (i.e. passing by trees, bodies of water, parks, etc.) reported better mental health compared to those who don’t. This association was even stronger among active commuters (walking or biking to work). If you commute through congested or urban areas, consider an alternate route, especially when you’re feeling down.

Spending time outside does more than just improve your mood. A 2018 report established a link between nature and overall wellness. Living close to nature and spending time outside reduces the risk of type II diabetes, cardiovascular disease, premature death, preterm birth, stress, and high blood pressure. Exposure to green space may also benefit the immune system, reduce inflammation, and increase sleep duration.

Read/view something inspiring or humorous

Do you have a favorite inspirational book or collection of poems? Do you like viewing motivational TED Talks? Do you enjoy comedy shows? Maybe you like watching videos of baby goats or flash mobs on Facebook. (I do!)

One study found that viewing cat videos boosted energy and positive emotions while decreasing negative feelings (such as anxiety, annoyance, and sadness). Internet cats = Instant mood boost. However, if cyber cats are not your thing, search around to find something enjoyable to read or watch for your happiness quick-fix.

Plan your next adventure

I’m happiest when I’m traveling the world. Unfortunately, I have limited vacation days (as well as limited funds), which means I don’t get to travel as often as I’d like. Happily, planning a trip may produce the same mood-boosting effects as going on a trip.

In 2010, researchers found that before taking a trip, vacationers were happier compared to those not planning a trip. A 2002 study indicated that people anticipating a vacation were happier with life in general and experienced more positive/pleasant feelings compared to people who weren’t. In both studies, researchers attributed happiness levels to anticipation. (The brain releases dopamine during certain activities, causing us to feel pleasure. Dopamine is also released in anticipation of a pleasurable activity.) For a mood boost, start planning!

Cuddle a pet

Spending time with your fur baby will instantly boost your mood. According to research, pets are good for your mental health. Teens undergoing treatment for drug and alcohol abuse experienced improved mood, positive affect, attentiveness, and serenity after brushing, feeding, and playing with dogs.

A 2018 study indicated that dog therapy sessions reduced stress and increased happiness and energy in college students. Earlier this year, researchers found that just 10 minutes of interaction with a pet reduced stress by significantly decreasing cortisol (a stress hormone) levels.

Other studies suggest that animal-assisted therapy reduces anxiety and loneliness and combats homesickness.

Research also indicates that pets help seniors and older adults cope with physical and mental health concerns. Dog ownership is also linked to better cardiovascular health and a longer life.

“Happiness is a warm puppy.”

Charles M. Shultz

The next time you’re having a bad day, listen to your favorite song, go hiking in the woods, watch a TED Talks, start planning your next vacation, or spend some quality time with a furry friend… you’ll feel better!

mood

The Remarkable Link Between Diet & Mental Health

What should you eat if you want to boost your mood? Learn what to eat (and what not to eat) for improved mental wellbeing.

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You may have heard of the “food-mood connection.” Research indicates that our diets greatly impact not only physical health, but mental wellbeing. Some foods seem to boost mood and reduce psychiatric symptoms while others are linked to depression and anxiety.

This article is about “mood thugs” and “mood champions.” Mood thugs are foods that can make you feel bad, while mood champions are foods that can give you a mental boost.

Mood Thugs

Sugar: Sugar consumption has been linked to depression, slows memory and learning, and reduces brain volume. Also, a recent study found that the concept of a “sugar rush” is myth. Sugar has virtually no impact on mood, regardless how much you consume. In fact, it can make you feel less alert and more tired.

Sugar is not the only villain; fat can be just as harmful. One study found that a high-fat diet may lead to symptoms of depression and anxiety. Furthermore, trans fat may lead to poor memory function.

Processed meats: If you have bipolar disorder, avoid processed meats such as jerky, hot dogs, etc. Researchers found that nitrates in processed meats are associated with mania.

Mood Champions

Vegetables: A diet high in fiber and vegetables (with limited added sugar) has been linked to improved mood and a reduction in depressive symptoms. Interestingly, women seem to benefit more than men, and the effect is even greater when exercise is added. A vegan or plant-based diet is associated with lower levels of depression, anxiety, and stress.

Raw produce: Fruits and vegetables are good for mood, but raw fruits and veggies are better. A raw diet is associated with higher levels of mental wellbeing and lower levels of psychiatric symptoms.

According to a recent study, the top raw foods associated with mental wellness are apples, bananas, berries, carrots, citrus fruits, cucumbers, grapefruit, kiwi, lettuce, and dark, leafy greens.

So how many servings of fruits and veggies should you eat per day for optimal mental health? At least 8, according to one study that found happiness benefits were evident for each portion for up to 8 servings per day.

Happiness nutrients: What nutrients should you include in your diet for improved mental health? Research indicates the following are important for mental wellbeing:

  • Omega-3 fatty acids (fish, flaxseed, walnuts)
  • Phospholipids (egg yolk, soybeans)
  • Niacin (liver, avocado, brown rice)
  • Folate (legumes, beets, broccoli)
  • Vitamin B6 (chickpeas, tuna)
  • Vitamin B12 (sardines, fortified nutritional yeast)

In sum, skip the fast food and soda; head to the salad bar instead to feed your mood and your belly!

diet

25 Best Mental Health Blogs to Follow in 2020

(Updated 11/1/20) A list of 25+ mental health, wellness, and personal development blogs

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(Updated 11/1/20) Creating Mind Remake Project opened my eyes to a whole world of blogs. There are tons of informative and thought-provoking mental health blogs out there on mental health and related topics.

This is a list of the best mental health blogs to follow in 2020 as well as helpful sites about wellness and personal development.

25 Best Mental Health Blogs to Follow in 2020

1. ACA Counseling Corner Blog | “Thoughtful ideas, suggestions, and strategies for helping you to live a happier and healthier life”

2. Aim Hypnotherapy & Counseling Blog | A blog by therapist Aigin Larki about anxiety, addiction, stress, and related topics

3. Anxiety Free World Blog | A mental health blog about coping with anxiety (by a writer with anxiety)

4. Brave Over Perfect | A blog about personal growth topics by Dr. Christine Carter and Susie Rinehart

5. Brené Brown Blog | A personal growth and development blog

6. David’s Blog | A pharmacology and mental health blog by Dr. David Healy, psychiatrist, psychopharmacologist, scientist, and author

7. David Susman, Ph.D. | A blog with resources and inspiration for better mental health by Dr. Susman, clinical psychologist, mental health advocate, professor

8. Dr. Melissa Welby | A blog about psychiatry and wellbeing by Harvard-trained psychiatrist, Dr. Welby

9. Dr. Sarah Ravin | A professional blog about psychological issues and evidence-based treatments by Dr. Ravin, a licensed psychologist

10. Everything Matters: Beyond Meds | An award-winning mental health blog on topics related to psychotropics and mental illness by Monica Cassani, ex-patient and mental health professional

11. Gardening Love | A unique wellness, ecotherapy, and lifestyle blog about enhancing mental health through gardening

12. Info Counselling: Evidence Based Therapy Techniques | A blog by a professional counselor with the latest evidence-based treatments and downloadable therapy worksheets

13. Love and Life Toolbox | An award-winning blog about relationships and emotional health by Lisa Brookes Kift, marriage and family therapist

14. Mindcology | A blog with mental health and self-help posts written by psychologists, counselors, and other mental health practitioners

15. The Mighty | “A digital health community created to empower and connect people facing health challenges and disabilities”

16. Momentus Institute Blog | A blog dedicated to building and repairing the social emotional health of children

17. MQ News and Blog | A blog about transforming mental health care through research

18. My Brain’s Not Broken | A blog about personal experience with mental illness and reducing stigma

19. NAMI Blog | An advocacy blog from the National Alliance on Mental Illness

20. Our Parent Place: Where Mental Health and Parenting Meet | A place for parents with mental illness to connect and learn

21. Psych Central Network Blogs | A list of mental health blogs by experts, professionals, and ordinary people who share their insights on a variety of mental health topics

22. Psychology Today Blogs | A large collection of blogs on psychology-related topics, including creativity, intelligence, memory, parenting, and more

23. SAMHSA Blog | “A place where up-to-date information including articles from SAMHSA staff, announcements of new programs, links to reports, grant opportunities, and ways to connect to other resources are located”

24. A Splintered Mind | A blog by Douglas Scootey about “overcoming ADHD and depression with lots of humor and attitude”

25. Thriving While Disabled | A blog about living with a disability

Additional Mental Health Blogs to Follow

Blunt Therapy | “Tips, advice, and analysis from a licensed therapist who’s been there”

Healthy Place Blogs | A page with links to other mental health blogs

Janaburson’s Blog | A blog created to help people better understand the medication-assisted treatment of opioid addiction using either buprenorphine (Suboxone) or methadone from a physician, board-certified in Internal Medicine and Addiction Medicine

Pete Earley | Advocacy blog for mental health reform

Your Brain Health | A blog about topics related to mental health and neurology by Dr. Sarah McKay, a neuroscientist

Know of any great mental health blogs not listed? Post in a comment!

mental health blogs

500 Free Online Assessment & Screening Tools

A list of over 500 free online assessment and screening tools for mental health professionals or self-help.

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(Updated 9/20/22) This is a list of over 500 free online assessment screenings for clinical use and for self-help purposes. While an assessment cannot take the place of a diagnosis, it can give you a better idea if what you’re experiencing is “normal.”

Image by GuHyeok Jeong from Pixabay

For additional online assessment tools to use with couples, see Free Marriage & Relationship Assessment Tools.

500 Free Online Assessment & Screening Tools

Addiction & Substance Use Disorders

PDF and interactive online assessment tools for substance use disorders and other addictions

Anxiety & Mood Disorders

PDF and interactive online assessment tools for anxiety, depression, and bipolar disorders

Trauma, Stress, & Related Disorders Online Assessment Tools

Obsessive-Compulsive & Related Disorders Online Assessment Tools

Online Assessment Tools for Eating Disorders

Online Assessment Tools for Personality Disorders

Boundaries & Attachment Styles

Relationships & Communication

For additional relationship and communication assessments, see Free Marriage & Relationship Assessment Tools.

Anger

For additional online assessment tools and resources, see Resources for Anger Management.

Violence & Sexual Assault

Suicide Risk & Self-Injury

  • Columbia-Suicide Severity Rating Scale | PDF scale
  • Deliberate Self-Harm Inventory | Measurement of deliberate self-harm (PDF)
  • Imminent Risk and Action Plan | Assessment/plan (Source: University of Washington Center for Behavioral Technology)
  • Lifetime – Suicide Attempt Self-Injury Count (L-SASI) Instructions Scoring | The L-SASI is an interview to obtain a detailed lifetime history of non-suicidal self-injury and suicidal behavior. Citation: Linehan, M. M. &, Comtois, K. (1996). Lifetime Parasuicide History. University of Washington, Seattle, WA, Unpublished work. (Source: University of Washington Center for Behavioral Technology)
  • Lineham Risk Assessment and Management Protocol | Citation: Linehan, M. M. (2009). University of Washington Risk Assessment Action Protocol: UWRAMP, University of WA, Unpublished work. (Source: University of Washington Center for Behavioral Technology)
  • Non-Suicidal Self-Injury Assessment Tool Brief Version | Full Version | Assessment tool (Source: Cornell Research Program on Self-Injury and Recovery)
  • NSSI Measures Archives | A collection of instruments for self-harm (Source: International Society for the Study of Self-Injury)
  • NSSI Severity Assessment | A PDF assessment tool to assess the severity of non-suicidal self-injury (Source: Cornell Research Program on Self-Injury and Recovery)
  • Reasons for Living Scale Scoring Instructions | RFL Scale (long form – 72 items) | RFL Scale (short form – 48 items) | RFL Scale (Portuguese) | RFL Scale (Romanian) | RFL Scale (Simplified Chinese) | RFL Scale (Traditional Chinese) | RFL Scale (Thai) | The RFL is a self-report questionnaire that measures clients’ expectancies about the consequences of living versus killing oneself and assesses the importance of various reasons for living. The measure has six subscales: Survival and Coping Beliefs, Responsibility to Family, Child-Related Concerns, Fear of Suicide, Fear of Social Disapproval, and Moral Objections. Citation: Linehan M. M., Goodstein J. L., Nielsen S. L., & Chiles J. A. (1983). Reasons for staying alive when you are thinking of killing yourself: The Reasons for Living Inventory. Journal of Consulting and Clinical Psychology, 51, 276-286. (Source: University of Washington Center for Behavioral Technology)
  • Self-Injury Questionnaire | To assess self-harm (PDF, assessment in appendix)
  • Suicidal Behaviors Questionnaire | SBQ with Variable Labels | SBQ Scoring Syntax | The SBQ is a self-report questionnaire designed to assess suicidal ideation, suicide expectancies, suicide threats and communications, and suicidal behavior. Citation: Addis, M. & Linehan, M. M. (1989). Predicting suicidal behavior: Psychometric properties of the Suicidal Behaviors Questionnaire. Poster presented at the Annual Meeting of the Association for the Advancement Behavior Therapy, Washington, DC. (Source: University of Washington Center for Behavioral Technology)
  • Suicide Attempt Self-Injury Interview (SASII) SASII Instructions For Published SASII | SASII Standard Short Form with Supplemental Questions | SASII Short Form with Variable Labels | SASII Scoring Syntax | Detailed Explanation of SPSS Scoring Syntax | The SASII (formerly the PHI) is an interview to collect details of the topography, intent, medical severity, social context, precipitating and concurrent events, and outcomes of non-suicidal self-injury and suicidal behavior during a target time period. Major SASII outcome variables are the frequency of self-injurious and suicidal behaviors, the medical risk of such behaviors, suicide intent, a risk/rescue score, instrumental intent, and impulsiveness. Citation: Linehan, M. M., Comtois, K. A., Brown, M. Z., Heard, H. L., Wagner, A. (2006). Suicide Attempt Self-Injury Interview (SASII): Development, reliability, and validity of a scale to assess suicide attempts and intentional self-injury. Psychological Assessment, 18(3), 303-312. (Source: University of Washington Center for Behavioral Technology)
  • Ask Suicide-Screening Questions (ASQ) Toolkit | Source: National Institute of Mental Health
  • University of WA Suicide Risk/Distress Assessment Protocol | Citations: Reynolds, S. K., Lindenboim, N., Comtois, K. A., Murray, A., & Linehan, M. M. (2006). Risky assessments: Participant suicidality and distress associated with research assessments in a treatment study of suicidal behavior. Suicide and Life-Threatening Behavior, (36)1, 19-33. Linehan, M. M., Comtois, K. A., &, Ward-Ciesielski, E. F. (2012). Assessing and managing risk with suicidal individuals. Cognitive and Behavioral Practice, 19(2), 218-232. (Source: University of Washington Center for Behavioral Technology)

For additional resources for suicide risk, see Resources for Suicide Prevention & Recovery.

Self-Esteem & Self-Compassion

Online Assessment Tools for Personality & Temperament

Emotional Intelligence

Health & Wellness

PDF and interactive online assessment tools for happiness, resiliency, exercise, sleep, nutrition, and other health/wellness topics

Additional Online Assessment & Screening Tools

PDF and interactive online assessment tools for various topics related to mental health, addiction, and other topics

  • Abnormal Involuntary Movement Scale | 2-page PDF (Source: UMASS Medical School) (1998)
  • Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist | A 3-page PDF with scoring instructions (Source: UMASS Medical School/ADD.org)
  • Affect Intensity Measure (AIM) | 40-question and 20-question PDF versions of the assessment (Citation: Larsen, R. J. (1984). Theory and measurement of affect intensity as an individual difference characteristic. Dissertation Abstracts International, 85, 2297B.)
  • APA Online Assessment Measures | PDF screening tools (Source: American Psychiatric Association)
  • Behavioral Tests | A collection of psychiatric assessments (Source: Lamar Soutter Library)
  • Brief Fear of Negative Evaluation Scale (BFNE) | 1-page PDF that can be completed online or printed, scoring instructions not included
  • Brief Psychiatric Rating Scale (BPRS) | 1-page PDF (Source: Psychiatric Times)
  • Buss Lab Research Instruments | Assessments for friendship, sex, jealousy, etc. (Source: Buss Lab)
  • Career Assessments | Self-assessments to assess interests, skills, and work values
  • Clance Impostor Syndrome Scale | 3-page PDF, includes scoring information (Source: The Impostor Phenomenon: When Success Makes You Feel Like A Fake (pp. 20-22), by P.R. Clance, 1985, Toronto: Bantam Books.)
  • Communication Research Measures | Source: James McCroskey, West Virginia University
  • CSDS DP Infant-Toddler Checklist | A PDF printable checklist for identifying early warning signs of autism
  • DBT-WCCL Scale and Scoring | Citation: Neacsiu, A. D., Rizvi, S. L., Vitaliano, P. P., Lynch, T. R., & Linehan, M. M. (2010). The Dialectical Behavior Therapy Ways of Coping Checklist (DBT-WCCL).: Development and psychometric properties. Journal of Clinical Psychology, 66(61), 1-20. (Source: University of Washington Center for Behavioral Technology)
  • Decision Making Individual Differences Inventory
  • The Defeat Scale (D Scale) | 2-page PDF (Source: The Compassionate Mind Foundation)
  • Demographic Data Scale | A self-report questionnaire used to gather extensive demographic information from the client. Citation: Linehan, M. M. (1982). Demographic Data Schedule (DDS). University of Washington, Seattle, WA, Unpublished work. (Source: University of Washington Center for Behavioral Technology)
  • Diary Cards NIMH S-DBT Diary Card NIDA Diary Card CARES Diary Card | Source: University of Washington Center for Behavioral Technology
  • Division 12 Assessment Repository | Source: Society of Clinical Psychology
  • EAP Lifestyle Management Self-Assessments | A small collection of screening tools
  • Emotional Regulation Questionnaire (ERQ) | A short PDF scale to assess emotional regulation
  • The Entrapment Scale | 2-page PDF with scoring information, 1998 (Source: The Compassionate Mind Foundation)
  • Family Accommodation Scale – Anxiety | Family Accommodation Scale – Anxiety (Child Report) | PDF scales, scoring instructions not included
  • Financial Well-Being Questionnaire | Take this 10-question interactive test and receive a score (along with helpful financial tips)
  • Focus on Emotions | PDF assessment instruments for children and adolescents from 9 to 15 years. Includes Empathy Questionnaire (EmQue), Mood List, Alexithymia Questionnaire for Children, Emotion Awareness Questionnaire (EAQ), BARQ, Behavioral Anger Response Questionnaire, Worry / Rumination, Somatic Complaint List, Instrument for Reactive and Proactive Aggression (IRPA) Self-Report, Brief Shame and Guilt Questionnaire for Children, Coping Scale, and Social-Emotional Development Tasks
  • Grief and Loss Quiz | Interactive quiz (Source: PsychCentral)
  • Guilt and Shame Proneness scale (GASP) | 4-page PDF with scoring information, 2011 (Source: Taya R. Cohen)
  • HealthyPlace Psychological Tests | Interactive tests for abuse, anxiety, depression, personality disorders, and more (Source: HealthyPlace)
  • Helpful Questionnaires | Topics are varied (Source: James W. Pennebaker/University of Texas at Austin)
  • IDR Labs Tests | Interactive psychology tests
  • Integrated Biopsychosocial Assessment Form | 16-page PDF assessment form
  • Intellectual Humility Quiz | Online interactive test (Source: Greater Good Magazine) 🆕
  • Internalized Stigma of Mental Illness Inventory (ISMI) | 2-page PDF (Source: J. Ritsher, University of California, San Francisco)
  • Library of Scales | 25 psychiatric scales (PDF documents) to be used by mental health practitioners in clinical practice. Includes Frequency, Intensity, and Burden of Side Effects Ratings; Fagerstrom Test for Nicotine Dependence; Fear Questionnaire; Massachusetts General Hospital Hair Pulling Scale; and more. (Note: Some of the assessments have copyright restrictions for use.) (Source: Outcome Tracker)
  • Measurement Instrument Database for the Social Sciences | A searchable database (Source: MIDSS)
  • Measures and Scales | Source: University of Utah Psychology Faculty
  • Mental Health Screening Tools | Online screenings for depression, anxiety, bipolar, psychosis, eating disorders, PTSD, and addiction. You can also take a parent test (for a parent to assess their child’s symptoms), a youth test (for a youth to report his/her symptoms), or a workplace health test. The site includes resources and self-help tools.
  • Military Health System Assessments | Interactive tests for PTSD, alcohol/drug use, relationships, depression, sleep, anxiety, anger, and stress
  • Mind Diagnostics
  • Mindset Assessment: What’s My Mindset? | Online interactive test, requires email sign-up to view results (Source: Mindsetworks) 🆕
  • Modified Checklist for Autism in Toddlers, Revised, with Follow-Up | Free download and scoring instructions
  • The Multidimensional Experiential Avoidance Questionnaire (MEAQ) | 3-page PDF with scoring information, 2011 (Citation: Gamez, W., Chmielewski, M., Kotov, R., Ruggero, C., & Watson, D. (in press). Development of a measure of experiential avoidance: The Multidimensional Experiential Avoidance Questionnaire (MEAQ), Psychological Assessment.)
  • Open Source Psychometrics Project | This site provides a collection of interactive personality and other tests, including the Open Extended Jungian Type Scales, the Evaluations of Attractiveness Scales, and the Rosenberg Self-Esteem Scale.
  • Other as Shamer Scale (OAS) | 2-page PDF with scoring information, 1994 (Source: The Compassionate Mind Foundation)
  • Parental Affect Test | The Linehan Parental Affect Test is a self-report questionnaire that assesses parent responses to typical child behaviors. Citation: Linehan, M. M., Paul, E., & Egan, K. J. (1983). The Parental Affect Test – Development, validity and reliability. Journal of Clinical Child Psychology, 12, 161-166. (Source: University of Washington Center for Behavioral Technology)
  • Patient Health Questionnaire Screeners | This is a great diagnostic tool for clinicians. Use the drop down arrow to choose a PHQ or GAD screener (which assesses mood, anxiety, eating, sleep, and somatic concerns). The site generates a PDF printable; you can also access the instruction manual. No permission is required to reproduce, translate, display or distribute the screeners.
  • Project Implicit | A variety of interactive assessments that measures your hidden biases
  • Project Teach Rating Scales | PDF assessments for children and youth
  • Psychological Self-Tests and Quizzes | Interactive tests (Source: Counselling Resource)
  • Psychologist World Personality & Psychology Tests | Interactive tests
  • Psychology Scales | Topics are varied, including likability, honesty, expertise, etc.) (Source: Stephen Reysen)
  • Psychology Tools | Online self-assessments for addiction, ADHD, aggression, anxiety, autism spectrum, bipolar, depression, eating disorders, OCD, and personality.
  • PsychTests | Interactive tests for intelligence, personality, career, health, relationships, and lifestyle & attitude
  • PsychTools | Searchable database
  • Psymed Psychological Tests | Interactive tests for addiction, anxiety, mood disorders, personality disorders, and more
  • Questioning Reality Self-Check | Interactive questionnaire (Source: Foundry)
  • Recovery Assessment Scales | A variety of assessments for individuals recovering from psychiatric illnesses
  • Research-Based Psychological Tests | Questionnaires for anxiety, depression, personality, etc. (Source: Excel At Life)
  • Revised Beliefs About Voices Questionnaire (BAVQ-R) | Citation: CHADWICK, P., LEES, S., & BIRCHWOOD, M. (2000). The British Journal of Psychiatry, 177, 229-232.
  • Ruminitive Responses Scale | 1-page PDF (Source: Treynor, Gonzalez, and Nolen-Hoeksema, 2003)
  • Self-Assessment Checklist for Personnel Providing Behavioral Health Services and Supports to Children, Youth and their Families | 4-page PDF (Source: Tawara D. Goode, National Center for Cultural Competence) (1989, revised 2009)
  • Scales | 3 assessments available (Need for Closure, Locomotion, and Assessment) (Source: Motivated Cognition Lab
  • Science of Behavior Change Measures | Assessments for stress, communication, relationships, emotional regulation, and more
  • Screening Tools – Autism Canada | Interactive screening tools for autism for toddlers, children, teens, and adults (Source: Autism Canada) 🆕
  • Sensitivity Test for Adults | A carefully designed questionnaire to measure sensitivity in adults. (There is also a version for children.) 🆕
  • The Shame Inventory | 3-page PDF (Citation: Rizvi, S. L. (2010). Development and preliminary validation of a new measure to assess shame: The Shame Inventory. Journal of Psychopathology and Behavioral Assessment, 32(3), 438-447.)
  • Social History Interview (SHI) | The SHI is an interview to gather information about a client’s significant life events over a desired period of time. The SHI was developed by adapting and modifying the psychosocial functioning portion of both the Social Adjustment Scale-Self Report (SAS-SR) and the Longitudinal Interview Follow-up Evaluation Base Schedule (LIFE) to assess a variety of events (e.g., jobs, moves, relationship endings, jail) during the target timeframe. Using the LIFE, functioning is rated in each of 10 areas (e.g., work, household, social interpersonal relations, global social adjustment) for the worst week in each of the preceding four months and for the best week overall. Self-report ratings using the SAS-SR are used to corroborate interview ratings. Citations: Weissman, M. M., & Bothwell, S. (1976). Assessment of social adjustment by patient self-report. Archives of General Psychiatry, 33, 1111-1115. Keller, M. B., Lavori, P. W., Friedman, B., Nielsen, E. C., Endicott, J., McDonald-Scott, P., & Andreasen, N. C. (1987). The longitudinal interval follow-up evaluation: A comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry, 44, 540-548. (Source: University of Washington Center for Behavioral Technology)
  • Somatoform Dissociation Questionnaire | A PDF assessment, scoring information here
  • Soul Shepherding Assessments | Assess for emotional intelligence, life stress events, and stress overload (3 PDF assessments)
  • Stanford Medicine WellMD | Self-tests for altruism, anxiety, burnout, depression, emotional intelligence, empathy, happiness, mindfulness, physical fitness, PTSD, relationship trust, self-compassion, sleepiness, stress, substance use, and work-life balance
  • Supervisory Relationship Questionnaire (SRQ) | PDF scale with scoring instructions
  • Survey Instruments and Scales | To assess risky sexual behaviors (Source: CAPS)
  • Therapist Interview | The TI is an interview to gather information from a therapist about their treatment for a specific client. Citation: Linehan, M. M. (1987). Therapist Interview. University of Washington, Seattle, WA, Unpublished work. (Source: University of Washington Center for Behavioral Technology)
  • Treatment History Interview | Appendices | The THI is an interview to gather detailed information about a client’s psychiatric and medical treatment over a desired period of time. Citation: Linehan, M. M. &, Heard, H. L. (1987). Treatment history interview (THI). University of Washington, Seattle, WA, Unpublished work. Therapy and Risk Notes – do not use without citation. For clarity of how to implement these items, please see Cognitive-Behavioral Treatment of Borderline Personality Book, Chapter 15. (Source: University of Washington Center for Behavioral Technology)
  • TTM Measures | To assess for self-efficacy, decision-making, process of change, etc. (Source: HABITS Lab)
  • Voice Hearing: A Questionnaire | 17-page PDF questionnaire for hearing voices (Source: South Bay Project Resource)
  • Whirlwind of Psychological Tests | A modest collection of tools (Source: Delroy L. Paulhus)
  • Why Do You Lie? | Interactive quiz (Source: WebMD)
online assessment

If you know of a free assessment for mental health or addiction that’s not listed here, please share in a comment! Contact me if a link is not working.

11 Creative Ideas for Self-Care

A list of 11 creative and unique self-care practices for anyone who wants to expand their self-care horizons.

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Self-care is a vital piece of the wellness puzzle. As a mental health professional, I have to practice self-care to prevent burnout. (If I’m not taking care of myself, how am I going to help someone else?)

To illustrate the importance of self-care, consider a vehicle; it requires ongoing maintenance for optimal performance and safety. Similarly, we require self-care. It’s a concept that encompasses a variety of needs, including health, solitude, human connection, self-love, spiritualty, and more.

Self-care advice seems to be everywhere these days. From endless articles to overflowing Pinterest boards, the internet is a bottomless pit of bubble baths and meditation. But let’s be real, most of it feels… uninspired. Lighting a vanilla candle and calling it a day? Yawn.

While there’s merit in those practices, I’m more about the kind of self-care that doesn’t feel like following a generic recipe. If you’re like me and find most self-care suggestions a bit… bland, then welcome! This post is for the self-care rebels, the ones who crave a bit more and want to expand their self-care horizons.

Here are 11 unique ideas for self-care:

1. Create an inspirational scrapbook or a “bliss book”

Any time you happen upon something that makes you smile, inspires you, or motivates you, add it to your scrapbook (or journal or binder). Maybe it’s a photo, a happy thought you jot down, or a magazine article. Alternatively, you could create a “bliss board” on Pinterest.

Creating a bliss book (or board) has the potential to generate positivity and compassion. Whenever you need an emotional pick-me-up, flip through your scrapbook. Share it with others to generate a double dose of cheer!

2. Plan a trip

If you can’t take a vacation, you can at least plan one! Preparation is half the fun (for me, at least)!

Look up places you’d like to travel and research things to do there. Create an itinerary. Set a tentative travel date (even if it’s years from now) so you have something to look forward to.

3. Poop in public bathrooms

If you’re one of those people who avoid going number 2 in public bathrooms, stop. Holding in your poop is uncomfortable and may result in constipation.

If you’re embarrassed about the smell, carry a travel-sized container of Poo-Pourri. If it’s the sound that makes you anxious, run the water or flush as you go. When your body tells you it’s time to go, listen! 

4. Treat yourself to a monthly subscription box for self-care

I love getting mystery packages in the mail! It’s akin to receiving a care package when you’re a kid at summer camp. And when it comes to subscription boxes, there are many to choose from.

Currently, I subscribe to four: Ispy (5 makeup samples in a cute makeup bag for $10), PLAY! by Sephora (5-6 makeup samples for $10), Trendsend (5-8 clothing items and no styling fee!), and StitchFix (a mix of 5 clothing items, shoes, and accessories with a $20 styling fee – fee is deducted from total).

Subscription boxes are fun and a great way for me to build a professional wardrobe and to try new makeup products. (Disclaimer: I receive a referral bonus if you sign up for Ipsy or StitchFix via one of my links.)

5. Sort through childhood toys or photos

Allow yourself time to reminisce. My sister and I recently went through a box of old dolls and stuffed animals; it was the most fun I’ve had in a long time. It released a flood of happy memories and it felt great to laugh.

We chuckled over my Barbie dolls, which all had short, spiky hair; I was a very literal child, so when my sister declared “Barbie haircut day,” I took it to heart. My sister, on the other hand, only pretended to snip her Barbies’ hair. I cried rivers that day.

I also enjoy looking at old family photos. See below for a pic from the year my mom went on a mission to create the perfect Christmas photo letter (the kind moms send out to impress relatives and old friends). “Fred the Christmas Goose” didn’t make the cut.

6. Create something

Practicing holistic self-care means stretching your mind; you benefit from the challenge. Avoid stagnation by stepping outside your comfort zone. Feed your creative side by building a chair, writing a song, painting a picture, knitting a scarf, or putting together a model.

Personally, I enjoy creating art; while not entirely lacking in talent, I’m no Picasso. Most of my projects are equivalent to the work one would accredit to a moderately talented 8-year old. Every once in awhile, I’m pleasantly surprised. (See below for a sketch I posted on Instagram.) Drawing or painting elicits a sense of accomplishment; it’s something I feel good about. 

Acknowledging your contributions builds self-esteem and confidence.

7. Engage with a stranger, an acquaintance, a friend, or a family member

Establishing meaningful human connection is essential for wellness. To make the most of this tip, try something you normally wouldn’t.

For instance, chatting with a stranger is not my norm. To practice this tip, I’d strike up a conversation with my seatmate on a plane [providing, of course, that they’re open to friendly conversation. 

Practicing self-care means building (or strengthening) connections.

8. Go exploring

As a child, nothing thrilled my soul quite like adventure; I explored by trampling through the woods behind my house, traversing streams and following hidden trails. My adventures often involved the discovery of “treasure,” an odd rock or ruins of some sort.

Today, I’m just as adventurous; however, I spend less time crashing through woods and more time traveling the world.

Exploration promotes curiosity, which is essential for growth. If you’re not a fan of outdoor activities like hiking or backpacking, try exploring a city or neighborhood. Consider driving through unfamiliar developments. Explore restaurants or shops in your town.

Whatever you decide, pursue it with the enthusiasm of the 6-year old adventurer you once were.

9. Redecorate your office or a room in your home to make it soothing, energizing, or inspiring

Every time you’re in the room, you’ll experience positive vibes. Paint the walls, add plants, declutter, hang a portrait, change the curtains, create a rock garden, etc. – whatever promotes positivity.

10. Change something about yourself

There’s a lot to be said for loving yourself, flaws and all. On the flip side, if there’s something you’re extremely unhappy with, consider changing it. 

If you’re overweight and have tried every sort of diet, but still can’t shed those pounds, talk to a doctor about weight loss surgery or schedule an appointment with a plastic surgeon. If you’re tired of feeling sluggish and lacking energy, adjust your sleep schedule, diet, and exercise routine (and make sure you see a doctor to rule out a medical issue). If you’re constantly broke, get a second job or find another way to bring in income; enroll in financial courses or schedule an appointment with a financial advisor.

Sometimes, self-care involves drastic change. If you’re deeply troubled over some aspect of your life, and it’s something you’re unable to accept, change it (while recognizing it will require work!) This is your life; take action.

Note: This tip is only for things you have control over; recognize what you can and cannot change. For example, I don’t like my flabby arms; if this bothered me enough, I could lift weights to develop muscle tone. I also dislike my neck; it’s not long enough. Unfortunately, there’s nothing I can do. It’s not worth brooding over.

That said, when contemplating any major change, especially ones involving surgery or substantial amounts of money, ask, “Is this change for me alone or am I seeking outside approval?” The essence of self-care is the self; it’s for you and you alone.

11. Adopt a new healthy habit (or quit a bad one)

This idea embodies delayed-gratification self-care vs. instant-gratification self-care. And while both types of self-care are important, the rewards associated with a healthy habit are life-changing (vs. “mildly pleasant”).

According to research, there are five lifestyle habits associated with a low risk of illness and longer life expectancy. If you’re serious about self-care (and want more bang for your buck), adopt one (or all) of the following practices:

  • Eat a healthy diet
  • Exercise regularly
  • Maintain a healthy body weight
  • Drink alcohol in moderation (or not at all)
  • Don’t smoke

A healthy lifestyle is the foundation of self-care!

Share your favorite strategies for self-care in a comment!

self-care

Interview: Tips for Health & Sustainable Weight Loss

“We only get one body in life, so it makes sense to treat it well by fueling it with nutritious foods.” An interview with Dr. Lisal Folsom, who discusses optimal health, nutrition, and sustainable weight loss.

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sustainable weight loss

Interview: We Only Get One Body in Life

Tips for Health and Sustainable Weight Loss from an Endocrinologist

On a typical day, what are your patients’ complaints and how do you resolve them?

As an endocrinologist, I care for patients with all types of gland and hormone disorders. The most common reasons patients come to see me include diabetes (both type 1 and type 2), concerns about growth and puberty, thyroid dysfunction, hirsutism (unwanted hair growth), polycystic ovarian syndrome, and adrenal disorders. I also provide gender-affirming hormone therapy for transgender individuals. Depending on the patient’s symptoms and diagnosis, I may order lab tests and/or radiology studies such as thyroid ultrasounds or bone age xrays as part of my evaluation. Once we have a diagnosis, I work with the patient to create a personalized plan for treatment and follow up.

What about common questions or concerns?

Regardless of the reason they’ve come to see me, many patients are concerned about fatigue and weight gain. Everyone loves to blame these symptoms on the thyroid gland, but there are many other possible contributors to both fatigue and weight gain, including lack of quality sleep, sleep apnea, suboptimal eating habits, and infrequent exercise.

How does diet impact health?

A balanced diet and good nutrition are essential for optimal health. The only way to nourish and fuel our bodies is through food, and multiple studies have shown the benefits of good nutrition on health.

People who eat a diet composed of fruits and vegetables, whole grains, and lean proteins have lower blood pressure, better cholesterol, and decreased risk of obesity than those who follow a typical Western diet. There is a lot of research going on right now investigating the health effects of switching to a whole foods plant-based diet. A study comparing gut bacteria found that individuals following vegan and vegetarian diets had a more diverse selection of microbes in the intestines, which can lead to better health.

“People who eat a diet composed of fruits and vegetables, whole grains, and lean proteins have lower blood pressure, better cholesterol, and decreased risk of obesity than those who follow a typical Western diet.

Another study published in Clinical Nutrition this year found that people with high cholesterol had improvement in their cholesterol numbers when they followed a whole foods plant-based diet. Their cholesterol worsened when they switched back to a diet containing animal products and refined carbohydrates.

We only get one body in life, so it makes sense to treat it well by fueling it with the healthiest, most nutritious foods.

What are the main risk factors for diabetes?

Type 2 diabetes is an acquired metabolic disease associated with insulin resistance and high blood sugars. Until relatively recently this was a disease of adults, but in the past few years more and more children have been diagnosed with type 2 diabetes as well, partly because of the increase in obesity.

Risk factors for developing type 2 diabetes include being overweight or obese, carrying extra weight in the abdominal area, lack of regular physical activity, a family history of type 2 diabetes, and being diagnosed with prediabetes. Gestational diabetes during pregnancy is also a risk factor for developing type 2 diabetes later on.

A person will not necessarily develop type 2 diabetes just by eating a lot of sugar, but a long-standing pattern of unhealthy eating, lack of exercise, and weight gain will certainly increase the risk of developing type 2 diabetes down the road.

Can diabetes be treated with lifestyle changes?

Lifestyle changes are vital in diabetes treatment! Medicines can help to lower blood sugar, but the underlying cause of type 2 diabetes is insulin resistance, which is exacerbated by weight and lack of regular activity.

We know that people who exercise on a regular basis tend to have lower blood pressure, better cholesterol, and are more likely to be at a weight considered to be healthy, than people who don’t exercise often. Part of the reason for this is that exercise improves the body’s sensitivity to insulin. When we exercise, our bodies don’t have to work as hard to turn the food we eat into energy and fuel for our cells.

Studies have shown that people with type 2 diabetes who exercise after a meal have lower blood sugar levels than those who don’t. Exercise and a healthy diet are important for everyone, but these elements are especially crucial for people who are looking to improve their health.

Which is worse: Fat or sugar?

Ooh – tough question. I would say both and neither. Both fats and sugars come in healthy and unhealthy forms. Omega-3, polyunsaturated, and monounsaturated fatty acids help lower cholesterol and decrease the risk of heart disease. These healthy fats are found in nuts, peanut butter, avocados, flaxseed, and olive, canola, and soybean oils. Some eggs contain omega-3 fatty acids as well, depending on whether the chickens that laid them were given supplementation.

Unhealthy fats include saturated and trans fats. These types of fats are found in fatty cuts of meat, poultry skin, fried foods, high fat dairy products, processed and prepackaged foods, and solid oils such as shortening and lard.

Healthy sugars include those occurring naturally in fruits and vegetables. A good rule of thumb is to try to choose foods that are as close to their natural state as possible. For example, when you eat an apple, rather than drinking apple juice, you get the added benefits of the fiber from the apple, and vitamins from the skin. These added health benefits of eating whole fruits and vegetables allow the sugars to be absorbed more gradually by your body, and are lost when foods are processed.

What is one food you’d never eat and why?

Cracklins. This southern delicacy consists of fried pieces of pork fat and skin, flavored with Cajun spices. Although I’m sure they’re very tasty, they’re also oozing with saturated and trans fats, contain almost 500 calories per serving, and are high in sodium.

You could eat an entire avocado and two slices of whole wheat toast for fewer calories. This alternative snack is not only delicious, it also comes with the added benefits of healthy fats, whole grains, and fiber.

If given the opportunity, is there anything you’d change about the current dietary recommendations?

The current dietary guidelines are a good place to start. They recommend eating a variety of fruits and vegetables, making at least half of our grains whole, and limiting saturated and trans fats, added sugars, and sodium.

I wish they went a little further though, by emphasizing the health benefits of whole rather than processed foods, and offering alternative options for people looking to follow a plant-based diet. There are some really great dairy alternatives out there, including nut milks (almond, cashew, macadamia), soymilk, plant protein products, and tofu. Many of these are made without added sugar, and are fortified with calcium and vitamin D, so the nutritional content is quite similar to the animal-based versions.

What are your thoughts on the obesity epidemic in America?

Obesity is a growing problem in our country, and it’s going to keep getting worse unless we as a society make some major changes. Obesity is a multifactorial disease, with many different levels of influence.

Personal dietary choices have a role of course, but so does the environment in which people live. If a family lives in a food desert, and the only place to buy groceries is the convenience store where one banana and a 6-pack of ramen noodles each cost $1, parents are veritably forced to choose the less healthy, but inexpensive and filling options to feed their children. Many children in the U.S. eat both breakfast and lunch at school through the federally subsidized National School Lunch Program. This program is underfunded, and as such is unable to provide the highest quality, most nutritious food for the children who need it most.

There are so many barriers to optimal health that exist at societal and cultural levels; it’s going to take a lot of work to tackle obesity. It’s possible, but change will need to happen from the top down.

What advice do you give to patients who are trying to lose weight?

At the end of the day it’s all about math: Energy in = energy out. If we put more calories into our bodies than we burn, our weight will go up. Alternatively, if we burn more calories than we eat, our weight will go down.

“At the end of the day it’s all about math: Energy in = energy out. If we put more calories into our bodies than we burn, our weight will go up.

Metabolism plays a role, certainly, and we all know people who can eat a dozen donuts without gaining a pound, which is just not fair, but overall consistent, purposeful, portion control is the key to sustainable weight loss.

Exercise helps, but it’s really hard to burn enough calories by exercising to offset what we eat. A typical adult woman walking on a treadmill for 30 minutes burns around 150 calories. As a comparison, a pint of Ben & Jerry’s Chunky Money contains 1,160 calories. You would need to spend nearly 4 hours on the treadmill to burn off that pint of deliciousness, and nobody has time for that. It makes more sense to limit your total calorie intake through portion control and careful meal planning.

Everyone should have a treat now and then, just plan for them ahead of time and pay attention to the nutrition label including serving size.

What’s one thing you wish everyone knew about hormones?

It’s probably not your thyroid. Seriously though, endocrinology is an amazing branch of medicine. Since our glands make hormones that then flow into the bloodstream, they have effects on so many different parts of the body. Endocrinologists have to consider the entire person when making a diagnosis, and this makes the field both challenging and exciting.

As an endocrinologist, what are the most useful things you’ve learned?

Weight loss is hard, but possible. Diabetes sucks, but you are strong, so don’t let it take over your life. Everybody loves to talk about food. Patients and physicians work best as a team. Good health is priceless.

Interviewer: Cassie Jewell, M.Ed., LPC

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Dr. Lisal Folsom is a board-certified physician who specializes in endocrinology, diabetes, and metabolism. She also provides gender-affirming hormone therapy for transgender individuals. Dr. Folsom’s medical research has been published in the academic journals Endocrine Practice, The Journal of the South Carolina Medical Association, Current Osteoporosis Reports, Journal of Adolescent Health, and Endocrinology & Metabolism Clinics. She has been practicing for nine years.

Sleep Deprivation: What Dreams May… Cure?

What happens to your mind and body when you’re sleep-deprived? Poor-quality sleep is linked to a variety of health conditions, including obesity and heart disease. Poor sleep leads to cognitive impairment and poor judgment. A lack of sleep can even lead to schizophrenia-like symptoms! Learn why sleep is essential for health and well-being.

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According to the American Academy of Sleep Medicine, about 10% of Americans struggle with chronic insomnia and up to 35% of Americans experience insomnia at least occasionally. I’m part of the 10%. I’ve spent countless nights tossing and turning, dreading the obnoxious sound of “quantum bells” (my cell phone alarm) as daylight slowly creeps in. Due to this, I’ve done quite a bit of research on the subject. (And as a clinician, it’s important for me to know the relationship between restful sleep and mental health so I can educate my clients.)

Sleep recharges us; it makes it possible for us to remember what we learned throughout the day.

We all know that basic sleep hygiene is essential (i.e. having a regular sleep schedule, refraining from watching TV or reading in bed, avoiding alcohol before bedtime, etc.) And if you struggle with insomnia, you’ve probably heard of sleep medications and supplements like Ambien, trazodone, or melatonin. We also know how vital sleep is to health and wellness. Sleep significantly impacts mood, energy levels, and overall well-being. Sleep recharges us; it makes it possible for us to remember what we learned throughout the day.

Knowing how crucial sleep is for both physical and mental fitness, I set out to explore what happens when we don’t get enough. What exactly does a lack of sleep do to a person? I sifted through the research to learn more about the impact of sleep deprivation. This post explores how sleep deprivation affects physical health, perceptions, memory, and critical thinking.

SLEEP AND YOUR PHYSICAL HEALTH

Sleep deprivation is associated with signs of aging

Sleep deprivation has been linked to aging skin. One study found that poor-quality sleepers had more fine lines, uneven pigmentation, and reduced elasticity.

It makes sense that chronic sleep deprivation is associated with signs of aging; sleep is needed for overall rejuvenation (mind and body), which includes skin cell renewal. For smooth and supple skin, high-quality sleep is essential.

Snoring and sleep deprivation are linked to obesity

A 2016 study looked at the relationship between sleep characteristics and body size/weight. Snoring was associated with having a higher BMI, a larger waist, and more body fat. (It should be noted that snoring doesn’t cause obesity; the two are simply related.)

Poor sleep quality and shorter durations of sleep were linked to larger body size and more body fat. The relationship between sleep and obesity is further explored in the next few paragraphs.

If you’re dieting, you’re more likely to lose body fat when you’re getting adequate sleep. Researchers studied participants who slept for either an average of seven and a half hours or five and a quarter hours per night over a 14-day period. Calorie consumption was the same; participants lost similar amounts of weight. However, when participants slept more, they lost more body fat; in fact, about half of the weight they lost was fat. Sleep-deprived participants lost only a pound of fat; the other five pounds were fat-free body mass. Furthermore, it was found that sleep helps with appetite control; this is due to ghrelin, a hormone that stimulates appetite and promotes fat storage. Sleep-deprived participants had higher levels of ghrelin.

If you’re watching what you eat, incorporate healthy sleep habits to maximize your efforts; adequate sleep is needed for optimal weight loss.

Sleep affects our food choices

Other studies have examined specific the ways sleep deprivation affects food choices and calorie intake. Sleep deprivation is associated with especially poor food choices the day following poor-quality or no sleep. One study found that sleep deprivation led to strong cravings for junk food. The researchers measured increased activity in the part of the brain that responds to rewards, but decreased activity in the “decision-making” part of the brain. Study participants choose unhealthy items (i.e. pizza, donuts) over fruits and vegetables.

Another study looked at total calorie intake; sleep-deprived participants consumed an extra 385 calories per day. They also ate higher-fat foods. Additionally, researchers found that a sleep-deprived person purchased items that were higher in calories when grocery shopping.

A 2016 study looked at the relationship between sleep deprivation and the consumption of high-calorie, sugar-sweetened caffeinated beverages in a sample of 18,000 adults. It was found that adults who averaged less than five hours of sleep per night were more likely to consume sugary drinks like soda or energy drinks than their well-rested counterparts. The researchers weren’t able to determine whether drinking caffeinated beverages caused people to sleep less or whether being sleep-deprived caused people to crave more sugar and caffeine; it’s likely that both are true.

Without high-quality sleep, it’s difficult to lose body fat.

Regarding obesity, sleep deprivation plays a significant role. A lack of sleep causes us to feel hungry. We crave junk foods and consume more calories. At the same time, sleep deprivation promotes fat storage while decreasing our energy levels. Without high-quality sleep, it’s difficult to lose body fat.

If you struggle with chronic insomnia, make an active decision to make healthy eating a habit; you’ll be less likely to submit to your cravings. Visit the grocery store only when you’re well-rested. Know that you may not feel like exercising; practice determination. Be mindful to counter some of the health risks associated with sleep deprivation.

In addition to obesity, sleep deprivation is associated with heart disease, high blood pressure, diabetes, and stroke. A lack of sleep takes a toll on the heart. In a recent study, researchers looked at 24-hour shift workers. It was found that sleep deprivation led to a significant increase in cardiac contractility, blood pressure, and heart rate. Furthermore, study participants experienced thyroid changes and an increase in cortisol (the stress hormone).

Research also indicates that chronic sleep deprivation and disrupted sleep are linked to an increased risk of developing or dying from coronary heart disease or stroke. Diabetes and hypertension are associated with sleep deprivation as well.

A lack of sleep may impact women more than men. Researchers found that women who got less than eight hours of sleep per night were at a higher risk of heart disease and other heart-related problems when compared to men who got the same amount of sleep.

Have you ever noticed that you heal slowly or get sick more often when you’re sleep deprived? According to research, chronic sleep deprivation is associated with reduced immune function. If you’re not regularly getting at least six to seven hours of sleep, you’re more susceptible to illness. Your immune system won’t be as effective at eliminating viruses and bacterial infections.

Chronic sleep deprivation is associated with bone loss

Sleep even affects your bones. One study found that chronic sleep deprivation was associated with a loss of bone mass (in rats, at least). The rats underwent sleep restriction measures for three months. A lack of sleep led to significant decreases in bone density, volume, and thickness.

SLEEP AND YOUR BRAIN

Sleep deprivation is associated with increased pain sensitivity

The first part of this post examined sleep’s impact on physical health; the next half will explore how sleep affects the mind, including the way we sense and perceive the world around us. Research indicates that sleep deprivation and/or disruption increase sensitivity to pain. Interestingly, in one study, stimulants like caffeine had the ability to “normalize” the pain sensation (meaning it would feel the way it would with adequate sleep).

Sleep and chronic pain seem to be intricately connected, but the relationship is not fully understood; up to 88% of individuals with chronic pain report sleep issues and nearly 50% of individuals with insomnia have chronic pain..

A lack of sleep affects the way you hear and process sounds

In addition to the sensation of touch, sleep deprivation affects the perception of sound. A lack of sleep impairs central auditory processing (CAP). CAP is crucial for aspects of hearing such as language comprehension, identifying sounds, and recognizing patterns.

In one study, participants took a longer time identifying sounds after being deprived of sleep for 24 hours. It appeared there was a “transfer delay” (from hearing to identifying and then interpreting). To be effective, CAP requires alertness and concentration.

Sleep deprivation affects the formation of memories

We know that sleep deprivation causes cognitive impairment; the brain can only store so much information before it must recalibrate. During sleep, memories are encoded; the brain “consolidates” memories by strengthening them and transforming them from short-term into long-term memories. Without sleep, long-term memories can’t form. Short-term memories are lost and/or altered. Even procedural memories are impacted by sleep deprivation. A lack of sleep leads to forgetfulness and an inability to retain new information.

Sleep affects the way we interpret emotions

Sleep deprivation impairs your ability to interpret facial expressions. A recent study found that a lack of sleep made it difficult for participants to recognize the facial expressions of happiness or sadness. Interestingly, the ability to detect anger, fear, surprise and disgust was not affected. This suggests we’re biologically wired to recognize the emotions related to survival. The researchers hypothesized that the brain preserves functions that perceive life-threatening stimuli while sacrificing functions associated with empathy, bonding, and friendship.

“Real life” implications: If you’re majorly sleep-deprived, you could misinterpret the intentions of others, negatively impacting relationships with co-workers, family, friends, and others. Furthermore, you could read people wrong or miss important social cues; you might not respond appropriately or you could seem lacking in empathy.

When someone is sleep deprived, they’re slower to adopt another’s perspective

In addition to perception and memory formation, sleep deprivation impacts decision-making skills and thoughts, including the ability to accurately assess a situation.

If you have chronic insomnia, you might experience interpersonal problems.

In 2015, researchers hypothesized that sleep deprivation would impair the capacity to recognize sarcasm. Study results didn’t support the hypothesis, but the research generated an unexpected outcome. It was found that someone who was sleep-deprived was slower to adopt another person’s perspective. Implications? If you have chronic insomnia, you might experience interpersonal problems.

Sleep deprivation affects our moral judgment

Sleep deprivation affects moral judgment. In one study, participants were sleep deprived (awake for 53 continuous hours) and then faced with moral dilemmas. They had difficulty solving the dilemmas and making appropriate judgments. Other studies support this as well; a lack of sleep is related to decreased moral awareness. When you’re faced with a tough decision, especially one that involves ethics or morals, be sure to get adequate sleep. You can’t always trust your moral compass.

Sleep deprivation is linked to impaired decision making

Moral decisions are taxing if you’re sleep deprived… the opposite is true with risky ones. Sleep deprivation alters areas in the brain that assess positive and negative outcomes; sensitivity to rewards is enhanced while attention to negative consequences is diminished.

If you haven’t slept, tough decisions can wait.

Researchers found that when gambling, sleep-deprived individuals were more optimistic about their odds of winning. Another study found that sleep deprivation made it difficult for study participants to come to a quick decision when pressured. Sleep-deprived participants also made more mistakes. If you haven’t slept, tough decisions can wait.

A lack of sleep affects optimism

If you’re not getting enough sleep, you could lose your ability to remain positive-minded. Research indicates that individuals with insomnia have lower rates of self-esteem and optimism. In 2017, researchers found that sleep-deprived study participants were less likely to focus on positive stimuli. An inability to think positively is also a symptom of depression.

A lack of sleep can lead to schizophrenia-like symptoms

Sleep deprivation can lead to perceptual distortions, cognitive disorganization, and anhedonia (an inability to feel pleasure).In a 2014 study, participants experienced psychosis after staying awake for 24 hours. The sleep-deprived individuals reported attention deficits and being more sensitive to light, color, and brightness. They exhibited disorganized speech, which is a common symptom of schizophrenia. Participants also reported an altered sense of time and smell. Some of them actually believed they were able to read thoughts; others noticed an altered body perception. Implications? If you miss a night (or two) of sleep, don’t be surprised when you hear voices or when your reality is somewhat altered.

Conclusion

In conclusion, sleep deprivation, especially when it’s chronic, is detrimental to your health. Based on my review of the research, poor-quality sleep can adversely impact your skin, your weight, your cardiovascular system, your immune system, and your bones. (It should be noted that I barely skimmed the surface of an immense body of scientific data on sleep.)

Sleep is also related to brain health. Sleep deprivation impairs sensory perceptions, memory formation, the ability to assess your environment, moral awareness, critical thinking skills, and mood. Sleep deprivation can even induce psychosis.

If you’re like me (the one out of 10 Americans with chronic insomnia), in addition to practicing good sleep hygiene, go ahead and Google “CBT for sleep.” Research suggests that for some, CBT is more effective and longer-lasting than sleep medication. Do a little bit of research. CBT is not a quick fix for insomnia, but it’s worth a try; and your health and wellness are definitely worth it!

sleep deprivation
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4 Keys to a Positive Mindset

This is a list of four simple keys to developing a more positive mindset.

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What are the keys to a positive mindset? In this article, I’ll discuss four simple ways for improving efficacy and managing expectations, and as a result, developing a more balanced outlook.

keys to a positive mindset

Upon learning I’m a therapist, people like to ask for advice. “What do you think I should do about _______________________________?

Unfortunately, I don’t have the answer you’re looking for. And contrary to popular belief, a counselor won’t tell you how to fix your problems.

You are the expert on you. When you bring that expertise with you to therapy and begin to form a collaborative partnership with your therapist, that’s when the process of growth happens.

While I could provide you with a piece of advice, it wouldn’t be what you wanted to hear; counter-arguments would be forming in your head while I speak.

Instead of me telling you what to do, you decide what to do. Not only are you the expert on all things you, you hold the answers to all your problems; they’re just locked away.  And sometimes, all it takes is a simple remark from your therapist for everything to click into place. You have a sudden epiphany or a lightbulb moment of clarity. You realize you’ve known what you need to do; it just took a bit of guidance and support to get there.

While particularly effective at generating lightbulb moments, therapy is not the only way. The “Aha!” moment can be anything, and it can happen in a classroom, while reading a book, at a concert, etc. Sometimes all it takes is a simple remark to change your mindset.

The following is a list of keys that clicked for me. They’re simple – yet lifechanging – keys to a positive mindset.

Four Keys to a Positive Mindset

1. Say what you mean.

How many times have you provided an explanation using partial truths? For example, you cancel on a friend, claiming a migraine. Your head may hurt, but at the same time, you’re embarrassed to go to the bar with her. She can’t seem to go out without getting obnoxiously drunk. Another example would be a wife who tells her husband, “I’m fine,” when she’s not. In both examples, truth is avoided.

When you don’t say what you mean, you deprive yourself. You’ll feel frustrated, and you may lose the chance to explore deeper issues. Your communication becomes second-rate. And if you find yourself saying what you think someone wants to hear, that’s not communicating; the point is to understand each other, not to mislead or appease.

Saying what you mean is one of the keys to a positive mindset; it’s freeing and it allows you to live an authentic life.

2. Just say, ‘okay.’

This is about not engaging with that one person who pushes your buttons (or with your own irrational thoughts).

I’ll use myself as an example. One day, I received an email from my supervisor, instructing me to complete a task ASAP… a task I knew I had finished three days ago. Initially, I panicked, second-guessing myself.

After some investigating, I found that I had indeed completed the task. So, why, why would he send that email? I started silently fuming to myself. How dare he?! Of course I’d completed the task… three days ago when it was due. What, does he think I sit around all day doing nothing? Why would he think I hadn’t done it? Crap… maybe he thinks I’m incompetent? And why wouldn’t he check before sending an email?

I was on an emotional roller coaster. In the span of 5 minutes, I went from panic to self-doubt to a brief moment of relief to self-righteousness to a sense of indignation and then fell to a state of irritation.

I typed and retyped my response to my supervisor.

Draft 1: “Yes, the task was completed three days ago when it was due. Had you checked, you would have known this.” (Too passive aggressive.)

Draft 2: “Thanks for the reminder, but it was completed on [date] at [time]. I can show you how to access the file to view it in case you don’t know how.” (Condescending.)

Draft 3: “Thanks for your email. The project was completed on [date] at [time]. Let me know if you need a copy.”

I asked a co-worker to look it over; I didn’t want my indignation to somehow spill over. (But I needed it to be clear to my boss that I had completed my assignment. On time. Without him asking me to.)

My colleague laughed and asked, “Why don’t you just tell him, ‘okay,’ and leave it at that?”

And she was right. I had allowed myself to get all worked up over something small. I allowed my irrational self (and insecurities) to take over, completely taking me out of my space. Why did I feel like I had to prove myself? The project was done, which is what mattered.

Another case for “okay” is the unhappily married couple who fight constantly. They argue to the point of shouting because neither wants the other to “win.” They can’t let the other have the last word because it would mean admitting defeat, that they were in the wrong. They have to prove themselves, no matter the cost. Instead of arguing every little thing, they could save their energy (and peace of mind – possibly, their marriage) by just saying, “okay,” and leaving it at that.

By linking your self-concept to how others perceive you, your identity is threatened by the idea of admitting defeat. (But you don’t have to live that way anymore!) Instead of feeding into the argument, especially when you’re provoked, just say, “okay,” and leave it at that.

Furthermore, if there’s a toxic person in your life, for example, an ex that you co-parent with, don’t respond to a provoking text or to a barb. You gain nothing by proving you’re right (other than maybe a self-important spark of satisfaction). In the end, you’re still the loser because you took the bait and allowed someone else to orchestrate your emotions.

Don’t sacrifice your peace of mind; just say, “okay,” one of the keys to a positive mindset.

3. This is nothing you can’t handle.

It may not seem like much, but this key lays the foundation for change. It empowers you. A seemingly unsolvable problem can be broken down into manageable solutions. A catastrophe becomes a challenge, not defeat. You don’t have to be a victim when you can be a survivor.

When faced with the impossible, we panic. Our emotional mind has all the control while the rational mind fades to the background. However, the rational mind can be coaxed back from hiding with guidance.

The next time you feel helpless and are thinking, “This is impossible,” remind yourself it’s nothing you can’t handle. This is one of the keys to a positive mindset. Once you’re in that frame of mind, the solutions will come more easily.

4. Always take ownership.

I’ve made many mistakes. It’s uncomfortable to admit when I mess up. Sometimes there are even consequences.

This fourth key is about owning your actions, especially when you make a poor decision. You’re going to make mistakes. Don’t make excuses. Admit fault and apologize when needed.

By placing the blame on someone or something else, you stunt personal growth. You’ll continue to make the same mistakes (because it will never be your fault).

You can’t live an authentic life without taking ownership, nor will you gain the respect of others. Be authentic; take ownership of your mistakes (and achievements!)

If reading about these four keys to a positive mindset “sparked” something for you, think about the changes you need to make in your own life to experience a positive mindset.

key statements