Surviving the Holidays with Anxiety

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According to the Anxiety and Depression Association of America, 40 million people (18%) in the Unites States experience an anxiety disorder in any given year. The rates of anxiety are increasing in children and it is believed that 8% of children are now experiencing anxiety prior to the age of 18. It is the most commonly diagnosed mental health disorder with approximately 1/3 of those struggling with anxiety receiving treatment.

For those with anxiety, the holidays can seem very overwhelming. There are many reasons why this might be the case. Holidays increase the number of tasks required (shopping, cooking, gift giving, preparing the home for guests, less time for physical fitness, etc.) for someone who is already trying to manage day to day life. For those who brave shopping in overcrowded stores, this can present as a trigger all of its own. In addition, holidays can present as a yearly reminder of lost loved ones, changes in families caused by divorce or separation, and can add to already existing financial stressors.

I am sure the first thought must be, how can I add something to my already crazy daily schedule when I am struggling already? If you already experience anxiety and this is speaking to you, I would like to share with you the benefits of including mindfulness into your day with some ideas that can be incorporated in 5-10 minutes or less. I have shared some of these ideas with my clients in sessions and have heard back that they were helpful. I hope that some of the 5 ideas listed below are helpful to you as well.

  • Close your eyes. Take one deep breath in through your nose, hold for a count of three, and release your breath in an audible sigh. Repeat three times, open your eyes, and return to your day. This breath work can be especially helpful for helping to slow an increased heart rate that is often a symptom of anxiety. If shopping in crowded stores is a trigger for you, this exercise may be used in public places too, but perhaps with eyes open.

  • Gentle yoga stretching can offer some relief from muscle tension often associated with anxiety. You needn’t be an experienced yogi to stretch and get benefits, nor does this require a large amount of flexibility. A gentle bending position (you can touch your toes if you like, but if your body does not bend that far, it is ok to not touch them) called forward fold can help reset your breath. As in the first exercise, breathe in through your nose and release through the mouth. Another stretch called “legs at the wall” can be a good relaxation stretch as well. In this stretch, you lie on your back with your bottom up against the wall and your legs resting against the wall. It does not matter if they are flat against the wall. If your hamstrings are tight, this would be uncomfortable, so feel free to give yourself as much space as you need. Both of these stretches are inversion stretches, which means your head is below heart and they are known for inducing relaxation. As in the first exercise, breathe in through your nose and release through the mouth. You might even pay attention to the rise and fall of your chest while you are breathing, and center all of your thoughts there. Take your time getting up from forward fold. Also, for legs at that wall, turn to your right side and pause for a minute or two before pulling back up to a standing position. It is important to take this moment to allow the blood in your body to return to its normal rhythm and lessen any possibility of feeling lightheaded.

  • Body scanning can be a great way to identify where you are storing your stress and anxiety in your body. You can scan in a sitting or lying down, whichever you prefer. If it helps, turn off the lights, and close your eyes. Quiet, instrumental music can be helpful in screening out any outside noise for some people. Begin with your head and pay attention to any sensation. Mentally travel from the top of your head down your forehead, to your cheekbones, down the back of your head and note any sensation. Pay close attention to anything that feels like tension or discomfort. You can maintain a gentle breathing pattern in through your nose and out through your mouth as you travel down your body. Continue until you make your way through your torso, your arms, hands, fingers, upper legs, lower legs, feet, and toes.

  • Use guided visualization to allow your mind to take you somewhere that you typically find a relaxing place. For some, this can be the sounds of the waves crashing at the beach, for others, a wooded landscape, and still others a comfortable place in the home. Close your eyes, picture yourself there, and think of the other sensations you might encounter there that bring you relaxation. It might be a salty sea breeze, or the smell of pines in the forest. As with the other exercises, allow your breath to fall into a gentle movement. You might pair it to the movement in your imagery.

  • Lastly, gratitude journaling can offer a nice alternative for replacing thoughts that are often centered on stressors. You may find this is easiest to do first thing in the morning (in which case, you might reflect on your previous day) or just before bedtime or even sometime in between these times. The goal is to center your thoughts on something positive about your day, and write it down. It can be anything. It might be a nice smell from the garden, a hug from a friend, a compliment from a stranger, or even a cuddle from a pet. If you really enjoy this exercise, you can add to your list. I enjoy making a list of 3, but this is completely up to you.

If you continue to have anxiety symptoms after the holidays it may be time to seek professional help. Central Counseling Services invites you to contact them to set-up an appointment to talk to Colleen or another caring therapist by calling (951) 778-0230. We have two locations, Riverside and Murrieta to serve you.


By Colleen Duggin, LCSW

Colleen Duggin, LCSW has vast experience working with children and families. She is an expert with families and children dealing with Anxiety, ADHD, Autism, and Obsessive-Compulsive Disorder. Colleen feels it’s an honor to help parents and children restore control, peace and calmness back into the family. She is a believer that there are no excuses to not have control of your life

Mindfulness with the Five Senses to Manage Stress and Anxiety

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I often have clients ask me how they can overcome anxiety and stress that feels overwhelming.  One thing I teach to them is the practice of mindfulness with the five senses.  This helps a person slow down and notice what is around them using sight, smell, taste, touch, and sound.  When you do this, your mind gets a break from the stressors of life and allows you to slow things down.

Some examples of ways you can use mindfulness with the five senses are;

  • While you are cooking notice the smells, colors, textures, and tastes of your food.

  • Burning a candle, notice the aroma and watch the flame bounce around.

  • Watch a sunset and notice the sights, smells, sounds, and physical sensations you are experiencing.  Does it feel warm or cool?  Is there a breeze you notice?

  • While you are eating, hold the food in your mouth and notice the flavors and textures.  When you swallow, notice how you can feel the food move down your body.

Another way to use mindfulness with the five senses is through a guided visualization.  You may want to pre-record this guided visualization so you can use it again and again. 

Find a comfortable place for you to lay down or sit.  Close your eyes and imagine a place that is peaceful to you.  Imagine you are there now and take some time to focus on each of the five senses as you experience them.  What do you see there?  Notice the scenery, the colors, and the overall environment.  Pause and take in the view.  Now notice what your body is experiencing as you are there in your peaceful place.  Are you sitting or standing? Is it warm or cool?  Notice what you are touching as you are there now.  Pause and notice that.  Now move to sounds.  What do you hear there?  Can you hear sounds from nature or perhaps there are other people there.  Pause and notice what you would hear if you are in your peaceful place.  Now focus on the smells that would be there.  Are there smells from nature or foods? Pause and take a moment to take in the smells.  Now imagine that you are eating a food that you love while you are in your place of peace.  Notice how the flavors and texture feel as you imagine eating the food.  Take one last moment to notice all of your senses as you are in this place of peace.  Notice how your body may feel more relaxed or at peace.  Take a deep breath and take it in.

The wonderful thing about this guided visualization is that you can access it any time you have a moment to yourself. It can literally take only 5 or 10 minutes of your day.  Use this when you are already relaxed to allow your body and mind to incorporate this into your normal routine.  You can use this practice before going to sleep, when you are sitting in a waiting room, or on a break from work.

If you would like to learn mindfulness with the five senses or other techniques to manage anxiety and stress, please contact me Alicia at Central Counseling Services office to get therapy started today.


By Alicia McCleod, LMFT

I am passionate about helping people feel better and work through the barriers in their life. I completed my graduate work at the University of Phoenix and have been working in the helping field for the last 10 years. I've spent much of that time helping people overcome their depression, anxiety, schizophrenia, trauma, and relationship challenges. My approach is that of compassion, acceptance, and I create a safe space where you can explore those underlying issues getting in your way today.

Therapy with me is unique as I use EMDR, mindfulness, relaxation techniques, solution focused interventions, person centered strategies, and Dialectical Behavior Therapy (DBT) methods to help reduce stress. I also have experience with helping individuals experiencing psychosis (hearing or seeing things others don't), trauma survivors, and people with ongoing mental health challenges. I work primarily with adults and also see teens and couples.

On a personal note, I do like to stay active and I practice mindfulness on a daily basis. I also enjoy hiking, trips to the beach, camping, reading, quilting, and spending time with my family. Please call my office today if you would like to schedule an appointment with me and get started on a healthier you!

Suicide Prevention Awareness Month

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September is Suicide Prevention Awareness Month with September 10 being World Suicide Prevention Day. It is with this purpose that the following is shared to further awareness and continue with the prevention efforts.

 “To anyone who has had suicidal thoughts this past year, I am glad you are here. Keep holding on” - unknown.

According to The American Foundation for Suicide Prevention (AFSP)

  • Suicide is the 10th leading cause of death in the United States

  • Each year 44,965 Americans die by suicide

  • For every suicide, 25 attempts

  • Men die by suicide 3.53x more often than women.

  • On average, there are 123 suicides per day.

  • The rate of suicide is the highest in middle age.

The American Foundation for Suicide Prevention provides the following statistics specific to age, race, ethnicity and suicide methods.

Suicides by Age

In 2016, the highest suicide rate (19.72) was among adults between 45 and 54 years of age. The second highest rate (18.98) occurred in those 85 years or older. Younger groups have had consistently lower suicide rates than middle-aged and older adults. In 2016, adolescents and young adults aged 15 to 24 had a suicide rate of 13.15.

Suicide Rates by Race/Ethnicity

In 2016, the highest U.S. suicide rate (15.17) was among Whites and the second highest rate (13.37) was among American Indians and Alaska Natives (Figure 5). Much lower and roughly similar rates were found among Asians and Pacific Islanders (6.62), and Black or African Americans (6.03). White males accounted for 7 of 10 suicides in 2016.

Suicide Methods

In 2016, firearms were the most common method of death by suicide, accounting for a little more than half (51.01%) of all suicide deaths. The next most common methods were suffocation (including hangings) at 25.89% and poisoning at 14.90%.

Causation

What leads an individual to ultimately make the decision to commit suicide can be summarized as being the loss of hope. The therapists’ main goal is to instill hope in our clients. We do this in various forms based on chosen theoretical frameworks. The altruistic uniting factor that we share for our clients is the simple act of being a non- judgmental presence. Present to journey along and guide clients throughout the other side of the despair that is depression.

“Despair is the price one pays for self-awareness. Look deeply into life, and you’ll always find despair”- Irving D. Yalom.

According to Anxiety and Depression Association of America, “Major Depressive Disorder (MDD) is the leading cause of disability in the U.S. for ages 15 to 44.3. MDD affects more than 16.1 million American adults, or about 6.7%of the U.S. population age 18 and older in a given year. While major depressive disorder can develop at any age, the median age at onset is 32.5 years old. It is more prevalent in women than in men. Persistent depressive disorder (PDD) affects approximately 1.5 percent of the U.S. population age 18 and older in a given year (about 3.3 million American adults). Only 61.7% of adults with MDD are receiving treatment. The average age of onset is 31 years old.”

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The Centers for Disease Control (CDC) list the following as risk factors and protective factors for suicide. They clarify that there is a “combination of individual, relationship, community, and societal factors contribute to the risk of suicide. Risk factors are those characteristics associated with suicide—they might not be direct causes”.

Risk Factors

  • Family history of suicide

  • Family history of child maltreatment

  • Previous suicide attempt(s)

  • History of mental disorders, particularly clinical depression

  • History of alcohol and substance abuse

  • Feelings of hopelessness

  • Impulsive or aggressive tendencies

  • Cultural and religious beliefs (e.g., belief that suicide is noble resolution of personal dilemma)

  • Local epidemics of suicide

  • Isolation, a feeling of being cut off from other people

  • Barriers to accessing mental health treatment

  • Loss (relational, social, work, or financial)

  • Physical illness

  • Easy access to lethal methods

  • Unwillingness to seek help because of the stigma attached to mental health and substance abuse disorders or to suicidal thoughts.

Protective Factors for Suicide

Protective factors buffer individuals from suicidal thoughts and behavior. To date, protective factors have not been studied as extensively or rigorously as risk factors. Identifying and understanding protective factors are, however, equally as important as researching risk factors.

Protective Factors

  • Effective clinical care for mental, physical, and substance abuse disorders

  • Easy access to a variety of clinical interventions and support for help seeking

  • Family and community support (connectedness)

  • Support from ongoing medical and mental health care relationships

  • Skills in problem solving, conflict resolution, and nonviolent ways of handling disputes

  • Cultural and religious beliefs that discourage suicide and support instincts for self preservation (U.S. Public Health Service 1999)

 “Sometime even to live is an act of courage” – Lucius Annaeus Seneca

Resources Local to Murrieta and Surrounding Areas

If you or someone you love are having a psychiatric emergency call 911. 

24/7 Mental Health Urgent Care

24 hour/7 days/365 urgent care mental health screening and assessment services and medications.

Locations:

Riverside: 9990 County Farm Rd. Riverside, CA 92503 (951) 509-2499

Perris: 85 Ramona Expressway, Suites 1-3 Perris, CA 92571 951-349-4195 Main

HELPLINES

HELPLine - 24 Hour Crisis/Suicide Intervention
The HELPline is a free, confidential Crisis/Suicide Intervention service. Operated by highly trained volunteers, the line is open 24-hours a day, seven days a week.

Phone: (951) 686-HELP (4357)

National Suicide Prevention Lifeline
1-800-273-TALK (8255) you’ll be connected to a skilled, trained counselor at a crisis center in your area, anytime 24/7.

Phone: (800) 273-TALK (800-273-8255)

Spanish line: (888) 628-9454

TTY: (800) 799-4TTY (4889)

Veterans Crisis Line 
The Veterans Crisis Line is a Department of Veterans Affairs (VA) resource that connects Veterans in crisis or their families and friends with qualified, caring VA professionals.

Confidential support is available 24 hours a day, 7 days a week.

Phone: (800)-273-8255 Press 1

The Trevor Project Lifeline
National organization providing crisis and suicide prevention services to lesbian, gay, bisexual, transgender and questioning (LGBTQ) Youth

866-4-U-TREVOR (866-488-7386)

EMERGENCY PSYCHIATRIC HOSPITALS AFFILIATED WITH RUHSBH

Riverside University Health System Medical Center Emergency Treatment Services (ETS) 
Provides psychiatric emergency services 24 hours a day, 7 days a week for all ages, which includes evaluation, crisis intervention, and referrals for psychiatric hospitalization, as needed for adults, children, and adolescents. Consumers may be referred to the Inpatient Treatment Facility (ITF) or other private hospitals. 

9990 County Farm Road, Ste. 4

Riverside, CA 92503

Phone: (951) 358-4881

Se Habla Español

*Resource list compiled by Riverside University Mental Health System-Behavioral Health

We at Central Counseling Services Murrieta are looking forward to journey with you on your path to mental wellness. For appointments I may be contacted at 951-778-0230. We are located at 29970 Technology Drive #116 Murrieta, CA 92563.


By Susana Anaya-Baca, LCSW

Susana Anaya-Baca, LCSW joined Central Counseling Services as a therapist in 2018. She is a graduate of California State University Long Beach School of Social Work where she earned her Master in Social Work with a concentration in older adults and families (OAF). She is a Licensed Clinical Social Worker (LCSW#69056) and is licensed to practice psychotherapy in California since 2015. She is fluent in Spanish.

Ms. Anaya-Baca has experience working with a wide range of individuals and settings. Prior to entering private practice, she practiced as a clinical medical social worker with individuals and families facing life-limiting illness in the area of home health, palliative care and hospice. Susana is a member of the National Association of Social Workers.

Do You Have High Functioning Anxiety?

Do You Have High Functioning Anxiety?

You often set you feeling aside or compartmentalize your feelings and you do not where your heart on your sleeve. You are an in-charge type person and often you friends call your “stoic.”  Inside however, that is simply not true, your feelings do get hurt but you push them away because you say to yourself “oh I’m just being a drama queen.”

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What does it mean for me to be “diagnosed?”

What does it mean for me to be “diagnosed?”

Think of a diagnosis as a snapshot of who you are not a life sentence. 

During the course of our lives, it is safe to say that any of us can be identified as having a mental health diagnosis at one point in our lives.  The death of a loved one, job loss, relationship issues are all potential catalysts for concern and they technically may lead to a diagnosis.  This doesn’t mean that we are meant to carry a diagnosis forever or that we cannot recover or live fully functional lives.  A mental health diagnosis is identifiable and agreed upon a cluster of symptoms meant to describe a person’s experience at that moment in their life. 

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Mindfulness For All

Mindfulness For All

It is part of mindfulness practice to realize that suffering comes from believing that things should be other than they are in the given moment. If you are suffering in the present moment—oppression, discrimination, hunger, joblessness, etc— this may seem like a cruel statement, but it's actually not. It's solid advice, allowing you to take action and stay safe.

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Handling Strong Emotions When the Unthinkable Happens—To Someone Else

Warning: this post refers to the December 2, 2015 shooting at the Inland Regional Center in San Bernardino, California. It is meant to help people who were not directly involved in those events, but who are nonetheless experiencing emotional distress.

On the morningof December 2, 2015, the unthinkable happened here in the Inland Empire. Two armed people entered the Inland Regional Center, killed 14 people, and wounded over 20 more. I was talking to Sherry in the waiting room when Jill came out of her office and told us the awful news of what was happening just a few miles away. Stunned as I was, I had clients to see and that's what I concentrated on. As long as I was busy with the problems of others, I was fine. Only when I was about to drive home to Redlands and my husband texted me that the FBI was investigating a house on Center Street did I feel any fear. I arrived home safely, of course, watched the news and took phone calls from family and friends. The next morning I drove past Center Street on my way to an early appointment. The street was cordoned off with yellow tape and police cars. According to the morning news, the house on Center had been a "bomb factory." I was suddenly so nauseated that I had to stop and get a soda to settle my stomach. When I got home I curled up on the couch under a blanket, cried, slept for hours, and woke up feeling like I had been hit by a truck. I watched a little news, talked with my family, went to sleep very early and had nightmares. The next day I was functional again. The whole event seemed surreal.


As a therapist I recognized these as normal stress reactions. I was not at the Regional Center, and I don't know any of the dead or wounded. But this happened in my community and it hit me hard.

Each person reacts to terrible things in her or his own way, and everyone has a different threshold for what constitutes a traumatic event. Some will shake their heads and go on with their day, others will go to a vigil, hug their kids, look at the sunset, or have a stiff drink. Others may react as I did, but think, "I wasn't there. Why am I feeling so bad?" or worse yet, "I shouldn't be feeling so bad." But the fact remains that they are feeling bad. In the wake of a public trauma, it's important to be honest with ourselves about how we are doing. Here are some common reactions:

Depression

Anger

Crying

Emotional numbness

Insomnia or sleeping more than usual

Nightmares

Loss of appetite

Being easily startled

Feeling fearful for no reason

Hypervigilance

For most people, these feelings will soon fade on their own and life will go on. Self care practices such as exercise, time spent with family and friends, meditation, prayer, volunteer work, reading, hobbies, and focusing on the here and now can all help. However, if symptoms persist for more than a few weeks and interfere with your daily life, then it's time to see a therapist to discuss your level of anxiety and/or depression. It's ok to need a little extra help, and talking with a therapist can be very reassuring.

In short, even if you are not directly involved in terrible events, you can still be affected by them. It's part of being human. 

Multitasking is a LIE

It's a Lie we tell ourselves...

We have all heard that multitasking is the best way to be highly efficient and it's the way smart people get things done. We are always trying to find a way to get more tasks accomplished within our 24 hours and multitasking seems to be the answer right? Wrong. We all have been sold a bill of goods; really, we have.  The word multitasking was first used in 1960 to described a computer’s ability to perform many tasks seemly all at once; ultimately, multitasking literally means multiple tasks alternately sharing one resource in this case a CPU. Due to a computer’s fast ability to read code it “looks like” it is doing more than one task at a time. However, even the CPU cannot read two lines of code at a time. What the CPU is actually doing is alternately reading and executing the code by switching back and forth between the codes until the tasks are done.

Multitasking

 

Overtime, this lie of multitasking became synonymous with people doing multiple tasks. Now I hear what you are saying “Hey wait a minute humans can multitask; we can walk and talk, or chew gum and walk, or even drive and listen to music all at the same time.” Yes, you are right those small tasks can be done simultaneously. However, not with equal attention and more importantly our attention bounces between the two tasks. If the tasks have greater focus the harder they are to complete together. Think about driving and talking on the phone. This activity is responsible for over 6000 deaths annually and is the number one cause of death in teens even over alcohol use. http://bit.ly/1LOfHPH Additionally,  I see people that come into my office stressed and feeling over whelmed and I will ask about their sleep schedule, their commute time, family time, personal (alone) time and about their working time. They tell me that almost every moment of their day is planned out and yet they still want to do more. They want to be able to add other things to their schedule or they feel they just can’t juggle anything more. They feel depressed, sad, overwhelmed and stressed, with little life satisfaction. They can’t understand why, “if only I could get more organized they say it would all work out.”  I am here to give you the freedom of doing one thing and doing it well.  No more multitasking; now doesn’t that feel good? So why is multitasking so bad for us? According to a 2009 study at Stanford University, multitasks pay a big mental price. The study found that:

  • Reduces the amount of information you can remember; decreased overall memory
  • Unable to filter out irrelevant information; so tasks actually take longer
  • Unable to focus on the goal at hand
  • Always thinking about  other things but not able to complete the task
  • Inability to concentrate for long periods of time  
  • We become less efficient as we lose time by switching between tasks
  • The stress hormone cortisol increase in the brain when we multitask
  • We actually lose 10 functional IQ points

World expert on divided attention and Neuroscientist, Earl Miller, at MIT states it this way...

                “Our brains are not wired to multitask well.” When people think they’re multitasking, they’re actually just switching from one task to another very rapidly. And every time they do, there’s a cognitive cost in doing so.”

 

 If you suffer from the “shiny object syndrome” or if you're still not convinced to give up multitasking I challenge you to just try for a day. Work on one project until it’s completion. Put the phone on mute, turn off the email pings and solidly work on the task. See if it takes you less time, you have more focus, if your brain is less fatigued and you may even have more energy and a bigger sense of accomplishment.