Mental Health Awareness Month: Fitness #4Mind4Body

by Annabelle Parr

May is Mental Health Awareness Month. Every year, Mental Health America designates a particular theme for the month to highlight an important aspect of mental health. This year’s theme is Fitness #4Mind4Body, and it focuses on acknowledging the connection between mental and physical wellbeing. #4Mind4Body explores the role of nutrition, exercise, the gut-brain connection, sleep, and stress in our overall wellbeing and examines the ways each of these areas impact our functioning. Below is a summary of the topics covered in the Mental Health Toolkit from Mental Health America.

Diet and Nutrition

Eating a well-balanced, nutritious diet is an integral part of health. Diets high in processed, fried, and sugary foods can increase the risk not only for developing physical health problems like diabetes, heart disease, obesity, and cancer, but are also linked to mental health problems, including increased risk for depression symptoms. A healthy diet consists of a variety of fruits, vegetables, legumes, whole grains, fish, nuts, and olive oil. Maintaining a balanced, nutritious diet is linked with a lower risk for depression and even an improvement in depression symptoms.

Exercise

Regular exercise not only helps control weight, increase strength, and reduce the risk of health problems like high blood pressure, cardiovascular disease, and some cancers, but it also helps boost endorphins and serotonin, among other important proteins and neurotransmitters that impact mental health. Endorphins serve to mitigate pain in the face of stress and increase pleasure in the body. Serotonin affects appetite, sleep, and mood, and is the target of SSRIs, a class of antidepressant commonly used to treat anxiety and depression. Just thirty minutes of exercise per day can help improve mood and mental health.

The Gut-Brain Connection

The gut, also known as the “second brain,” communicates directly with the brain via the vagus nerve and via hormones and neurotransmitters. The communication goes both ways, so anxiety, stress, and depression can impact the gut and result in gastrointestinal symptoms, but changes in the gut microbiome can impact the brain and mood, exacerbating or even resulting in symptoms of anxiety and depression. Eating a nutritious diet that includes prebiotics and probiotics is an important part of maintaining a healthy gut and a healthy mind. 

Sleep

Quality of sleep impacts the immune system, metabolism, appetite, the ability to learn and make new memories, and mood. Good sleep for adults means getting between 7-9 hours of mostly uninterrupted sleep per night. Problems with getting good quality sleep can increase the risk of developing mental health symptoms, and symptoms of anxiety and depression can negatively impact sleep, creating a negative cycle. Cognitive Behavioral Therapy for Insomnia (CBT-I) can help clients reestablish healthy sleep patterns through addressing negative thoughts and worries as well as behavioral patterns that are impacting sleep habits.

Stress

Stress is a normal part of life, and the body is equipped with a fight or flight response designed to help mobilize internal resources to manage stressors. After the stress has passed, the body can return to its regular equilibrium state. However, when stress becomes chronic, it can cause inflammation, impaired immune system functioning, muscle aches, gastrointestinal problems, sexual dysfunction, changes in appetite, and increased risk for heart disease. Too much stress can also impact mental health.

Mental health involves a complex interplay between numerous factors, including but certainly not limited to the areas listed above. Furthermore, though maintaining a healthy diet, regular exercise routine, good sleep habits, and utilizing stress management techniques can help prevent or improve existing mental health symptoms, if you are struggling with mental health issues, it can be difficult to attend to these areas.

If you are struggling with anxiety, stress management, depression, chronic illness, or insomnia, seeking professional assistance can be helpful. Evidence based therapies like Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) can help to address problematic thoughts and behaviors that are contributing to emotional distress. Therapy offers a warm, supportive, safe environment to explore painful issues. A therapist can also provide support in helping the client to develop good self-care habits, like those mentioned above.

This year’s mental health awareness theme reminds us of the importance of recognizing the multiple avenues through which we can approach mental health, and the variety of tools we have at our disposal to improve overall wellbeing.

CSAM IS HERE TO HELP

If you or someone you love might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, depression, stress, PTSD, insomnia, or chronic illness, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at info@csamsandiego.com

References

Mental Health America. (2018). 2018 Mental Health Month Toolkit. Retrieved from http://www.mentalhealthamerica.net/sites/default/files/Full_2018_MHM_Toolkit_FINAL.pdf

How Do I Know What Kind of Therapist to Choose?

by Annabelle Parr

Choosing a therapist can be overwhelming. If you search Google or Psychology Today, you will likely find a long list of different therapists including licensed marriage and family therapists, licensed professional clinical counselors, licensed clinical social workers, psychologists, and psychiatrists. How do you know what kind of therapist will be the best for you? And what is the difference between all those different licenses?

Licensed Marriage and Family Therapists (LMFT):

An LMFT holds a Master’s degree in counseling, which typically involves between two and three years of school. LMFTs are trained to view individuals from a family systems perspective, meaning that they learn to see individuals in the context of their relationships. Relationships include family, friends, significant others, and even your relationship to yourself. Despite what their license seems to imply, LMFTs also work with individual clients; they do not exclusively offer marriage and family therapy. Their license speaks to the lens through which they view clients and the various presenting problems they may bring into therapy. LMFT’s must complete at least 3,000 hours of supervised experience before becoming licensed, and this experience must include working with children, families, and/or couples.

An Associate Marriage and Family Therapist has completed their Master’s but is still working on their 3,000 hours of supervised experience.

Licensed Professional Clinical Counselors (LPCC):

An LPCC also holds a Master’s degree in counseling. Many Master’s programs qualify students to sit for both the LMFT and LPCC licensing exams. However, LPCCs tend to work more generally, with a focus on mental health issues as opposed to relational issues, and tend to focus on the individual rather than the individual in the context of their relationships. LPCCs also must complete 3,000 hours of supervised experience prior to licensure, and a portion of their experience must be in either a hospital or community based mental health setting.

An Associate Professional Clinical Counselor has completed the Master’s degree requirements but is still working toward the 3,000 hours of supervised experience.

Licensed Clinical Social Workers (LCSW):

An LCSW holds a Master’s degree in social work. Their training teaches them to help connect clients with resources, both externally (like community resources, support groups, etc.) and internally (like coping skills). An LCSW must complete 3,200 hours of supervised experience in order to get licensed, and they must be supervised specifically by another LCSW for a portion of their hours. They may also provide individual, family, or couples therapy, but the lens through which they have been trained focuses on ensuring clients have access to all the resources they need to thrive.

An Associate Clinical Social Worker has completed the Master’s degree requirements but is still working toward the 3,200 hours of supervised experience.

Psychologists:

A licensed psychologist holds a doctorate degree, either a Ph.D. (doctor of philosophy in psychology, focused on both research and clinical work) or a Psy.D. (doctor of psychology, more clinically focused than research focused), which can take between four and seven years to complete. Licensed psychologists also require 3,000 hours of supervised clinical experience for licensure. Psychologists typically have more training in psychometric assessment and test administration than an LMFT, LPCC, or LCSW. A psychologist with a Ph.D. is prepared to practice clinical work, conduct research, and/or teach, whereas a Psy.D. is typically primarily focused on clinical work.

Registered Psychological Assistant or Postdoctoral Fellow: A registered psych assistant is still working toward the doctoral degree and receiving supervised clinical experience. A postdoc has already completed the doctorate, but is completing the supervised clinical experience hours toward licensure.

Psychiatrists:

A psychiatrist holds a medical degree, and has completed a period of residency, and fellowship. Psychiatrists are medical doctors and are able to prescribe medications. A psychologist, LMFT, LPCC, and LCSW are not able to prescribe medication. Psychiatrists are also able to provide psychotherapy services, but their training is more medically focused.

What’s the takeaway?

Ultimately, there can be a lot of overlap in the services provided by the above practitioners. They are all qualified to assess, diagnose, and treat the full range of mental and emotional disorders found in the Diagnostic and Statistical Manual (DSM). The specific license under which a therapist operates speaks to the lens through which they have been educated, and the duration of education.

However, the provider’s area of expertise and scope of practice tends to depend upon the clinical experience that they have gained. So when looking for a therapist, it can help to understand what their license means, but it is perhaps more important to understand the specific supervised and licensed experience that the therapist has. Do they have experience working with anxiety, panic, trauma/PTSD, depression, identity issues, couple’s therapy, child therapy, family therapy? What modalities are they trained in? Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Psychodynamic Therapy, EMDR, Emotion Focused Therapy, Somatic Therapy? Do their areas of expertise and treatment modalities align with your needs and goals?

Research consistently shows that the therapeutic relationship is the most important factor in whether therapy is successful. So it’s key that the therapist you choose feels like the right fit for you personally. But it can be hard to try to figure out who might be a good match based on credentials and website information alone. A good place to start in narrowing your search is looking at the therapist’s areas of expertise and preferred treatment modalities. Once you have found someone whose specialties line up with your goals, you can reach out to the provider and ask any questions that may not have been addressed on the practice website. (If they won’t take the time to respond to your questions, they might not be the best fit!) If you feel comfortable with the therapist during the initial contact, you can schedule your first session. You will want to meet with the therapist 2-3 times to evaluate how safe and comfortable you feel working with this person. Choosing a therapist is a process, and it can feel overwhelming at first. But once you know how to narrow your search and find a provider that feels like a good fit, it can be incredibly rewarding.

10 Tips to Stop Sleep Anxiety: More Rest, Less Stress (Part 1 of 3)

by Lucas Myers

Feeling cranky or run down lately? With days getting shorter and the holidays around the corner many of us may feel that we are always running behind. The solution may be more rest through better sleep. In fact, any number of things might be interfering with a good night's sleep. The pressures of family responsabilities and work, unexpected illnesses, relationship issues, or economic hardships can impact anyone. Although many situational factors may be outside your ability to control, there are a few habits that can be adopted which encourage better sleep. By some estimates you may spend as much as a third of your life sleeping. Here are ten simple tips you can start with to make sure you're making the most of it:

1. Timing is everything

Try to go to bed and wake up around the same time every day. Having a consistent schedule reinforces the natural sleeping and waking cycle called the “circadian rhythm” that our bodies have evolved to regulate a good night sleep. Even though it may be tempting, try to maintain your schedule even on weekends and holidays so you don't disrupt that natural pattern. 

1. Don't try to force it

Do something relaxing before bed – if you lay in bed for more than 15 minutes and do not drift off, rise and repeat – agonizing over sleeplessness will only exacerbate the problem. 

1. Eating and drinking shouldn't mix with bedtime

Being too hungry, or too full, can create discomfort that keeps you awake. Wait at least 2-3 hours after dinner before bed. Spicy food can cause heartburn. Pay special attention to use of nicotine, caffeine and alcohol before bed. They contain chemicals which can ruin the quality of your sleep. Limit what you drink before bedtime to prevent disruptive late night trips to the restroom. An exception may be non-caffeinated herbal tea or milk; these are soothing for some. 

Stay tuned for parts 2 and 3 of our 10 Tips to Improve Your Sleep. 

REMEMBER: Having an occasional sleepless night is normal, but if you are experiencing a pattern of restless or sleepless nights, don't hesitate to seek an expert, especially if lack of sleep is beginning to interfere with your normal daytime functioning. Contact your doctor to determine whether physical causes may be contributing to sleep problems. If your physical health is sound, contact a psychologist with experience treating sleep problems. Cognitive behavioral therapy and other evidence-based treatments are highly effective for improving sleep. If you are in the San Diego area and you would like to speak with one of our other qualified therapists, you may contact the Center for Stress and Anxiety Management at 858-354-4077 or csamsandiego@gmail.com.

Want more tips? Subscribe to the CSAM RSS feed, and follow us on Facebook or Twitter (@CSAMSanDiego) so you don't miss Parts 2 and 3 of our 10 Tips to Improve Your Sleep and articles on other hot topics such as stress, anxiety, depression, OCD, PTSD, and more. 

References

Dement, William C; Vaughan, Christopher (1999). The promise of sleep: a pioneer in sleep medicine explores the vital connection between health, happiness, and a good night's sleep. New York: Delacorte Press. ISBN 0-385-32008-6.

Dement, WC (2005). "Sleep extension: getting as much extra sleep as possible". Clinics in Sports Medicine 24 (2): 251–268, viii. doi:10.1016/j.csm.2004.12.014. PMID 15892922.

Kryger, Meir H; Roth, Thomas; Dement, William C (2011). Principles and practice of sleep medicine (5th ed.). Philadelphia, PA: Saunders/Elsevier. ISBN 978-1-4160-6645-3.

Sleep Tips: Seven steps for better sleep. Mayo Clinic Staff. Retreived on November 25th, 2013 from: http://www.mayoclinic.com/health/sleep/HQ01387

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