Why We Worry: Understanding Anxiety And How To Help It

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Most of us are familiar with the dry mouth, racing heart and knotted stomach that are the hallmarks of feeling anxious. Usually this is a fleeting response to danger and uncertainty. In some people, however, the state of high alert won’t switch off. Their anxiety becomes so draining it is impossible to leave the house or function in daily life.

One woman feels agitated and lightheaded each morning when she wakes. She worries about the accidents that might befall her if she travels to work, but also about what would happen if she had nothing planned for the day. Another avoids work, friends or even walking her dog in case it triggers another panic attack. One man finds it difficult to pick up the phone for fear he will mash his words and be misunderstood.

These are real cases of people who have sought help for their anxiety. Their experiences aren’t unusual. Anxiety disorders – including generalised anxiety, panic attacks, social anxiety and phobias – are the most prevalent mental health problem in the US and Europe, and a growing number of reports from other regions suggest they could be a global concern. In the West, they cost healthcare systems more than $40 billion each year. On average 1 in 6 of us will contend with an anxiety disorder at some stage in our lives – women more than men.

Read more: Brain and mental health

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The damage is real. Anxiety disorders have been linked to depression and increased substance abuse, particularly of alcohol. A recent study found that men who have anxiety disorders are twice as likely to die from cancer as men who don’t, even when factors such as drinking and smoking are taken into account.

So what is the cause of all this anxiety? Is there more of it about, and what is the best way to tackle it?

How much anxiety is normal?

Anxiety is a natural response that evolved over millions of years to make us more vigilant and prime our bodies to flee danger. But feeling anxious because you heard a noise on a dark street isn’t the same thing as having an anxiety disorder. “The key thing we look for in the clinic is whether anxiety is interfering with a person’s day-to-day life, or causing them a lot of distress,” says Nick Grey of King’s College London.

To clinical psychologists like Grey, “maladaptive beliefs” are a hallmark of anxiety disorders and are often used to diagnose the type of anxiety someone has. In social anxiety disorder, the most common anxiety disorder, you might believe that blushing will result in people laughing at or shunning you. People with this type of disorder experience persistent and overwhelming fear before, during and after social events.

If you have panic disorder, you might assume that you are having a heart attack if your heart starts to race. The physical symptoms of anxiety – a pounding heart, difficulty breathing, feeling dizzy or flushed – will then come on in a rush. Everyone can experience such panic attacks from time to time, but in panic disorder the attacks are regular and become a source of anxiety themselves.

Other maladaptive beliefs are less specific. Generalised anxiety disorder is characterised by chronic worrying about a range of different events or activities, for at least six months. If you have this condition, the belief driving your anxiety could, for example, be the feeling it’s your job to take care of other people, or that you have responsibilities that you must meet at all cost. To decide who to refer for further treatment, doctors might use a tool called the GAD7 test.

“Anxiety disorders are the most prevalent mental health problem in the west“

Are we more anxious than we used to be?

The Roman politician and philosopher Cicero was among the first to define anxiety as an illness, in the 1st century BC. Our current medical definition dates to 1980, when the American Psychological Association estimated that between 2 and 4 per cent of people in the US had an anxiety disorder. Today, some studies suggest it’s more like 18 per cent in the US and 14 per cent in Europe.

Such figures have led some to conclude we are in the midst of an anxiety epidemic, fuelled by factors such as economic anxiety, social media and the rise of the 24-hour society. The reality is more complex. The apparent increase is probably due to changes in diagnostics over the years, which make long-term comparisons difficult. “I think we are becoming more stressed and that has to do with having a lot of demands on our time,” says Jennifer Wild of the Oxford Centre for Anxiety Disorder and Trauma in the UK. “But if you’re looking at the prevalence of anxiety disorders, they haven’t gone up.”

There is tentative evidence to support this conclusion. For instance, Olivia Remes and her colleagues at the University of Cambridge found little overall change in the number of people around the world affected by anxiety disorders between 1990 and 2010. Their meta-analysis, published earlier this year, found that roughly 1 in 10 people experience anxiety at any given time, and about 17 per cent are likely to experience it at some stage in their lives.

Remes found that adults under the age of 35 were disproportionately affected by anxiety. Similarly, Borwin Bandelow and Sophie Michaelis at the University Medical Centre in Göttingen, Germany, found evidence that the prevalence of most anxiety disorders peaks in 18 to 34-year-olds before dropping off again. Specific phobias were the exception, peaking in 35 to 50-year-olds.

Even if the overall prevalence of anxiety disorders hasn’t increased, anecdotal evidence suggests that the type of anxiety people are experiencing is changing. When Nicky Lidbetter, chief executive of Anxiety UK, joined the charity 20 years ago, the majority of queries they received were from people with panic disorder or agoraphobia, an extreme fear of open spaces. “Nowadays it is health anxiety [hypochondria] and social anxiety,” she says.

What causes the symptoms of anxiety?

Although we are still a long way from fully understanding what is going on in an anxious brain, recent studies offer some insights into why anxiety seems to take over in some people. Central to it all is the amygdala, a brain region that processes our emotions and triggers the release of the hormones responsible for the fight-or-flight response.

The amygdala is linked to parts of the prefrontal and anterior cingulate cortex that process social information and help us make decisions (see diagram). During bouts of everyday anxiety, this brain circuit switches on and then off again – but Oliver Robinson at University College London and his colleagues have shown that in people with anxiety disorders it seems to get stuck in the on position. “We think it might be amplifying negative information in your surroundings to make sure you pay attention to it, and triggering a fight-or-flight response so you’ll run away,” says Robinson.

Studies suggest that fear memories stored in the amygdala prime us to respond to threats we have previously experienced. This response is normally kept in check by a parallel circuit: in healthy people, inputs from the prefrontal cortex can temper our learned response and even overwrite it with new memories. Occasionally the system fails, however. Psychiatrists have found that war veterans with post-traumatic stress disorder – a kind of anxiety disorder – have abnormally low levels of activity in their prefrontal cortex, and unusually high levels in their amygdala.

Ultimately, an overactive amygdala appears to hype up the familiar symptoms of the fight-or-flight response by stimulating a network of hormonal glands and brain regions called the “HPA axis” – causing rapid heart rate and breathing, a dry mouth, shaking and tense muscles. The fight-or-flight response also has less obvious effects, like slowing digestion and making us more susceptible to pain.

Understanding these interactions will help design better treatments. For instance, Robinson’s circuit switches on when levels of the neurotransmitter serotonin are low, which could explain why a class of antidepressants known as SSRIs can reduce anxiety levels: they increase the availability of serotonin in the brain. “Maybe serotonin is applying the brakes to this particular circuitry,” says Robinson.

Are some people naturally more anxious than others?

Do you calmly navigate life’s bumps or agonise at every turn? Psychologists have long argued that people have innate dispositions that explain how we act, one of which is neuroticism – or proneness to anxiety. A recent study of more than 106,000 people identified nine regions of the genome that seem to correlate with neuroticism. Some of these contain genes previously linked to anxious behaviour, such as CRHR1, which regulates release of the stress hormone cortisol. The same gene has also been associated with anxiety-related behaviour in mice, and panic disorder in humans.

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Some people are therefore naturally more prone to anxiety. But even if you are a natural-born neurotic, this doesn’t mean you will develop an anxiety disorder. “Having a high level of dispositional anxiety is a risk factor for developing an anxiety disorder, but you can be highly anxious and completely healthy,” says Marcus Munafo, a behavioural neuroscientist at the University of Bristol, UK.

Your age (see “Are we more anxious than we used to be”) and sex are factors at play. Population studies show that women are about twice as likely to develop an anxiety disorder as men. In part, this may be down to hormones and their influence on the brain. The surges in oestrogen and progesterone that occur during pregnancy, for instance, have been linked to obsessive compulsive disorder, an anxiety-related condition. Remes points out that there may be other explanations too, such as the fact that women tend to cope with stressful situations differently. “They worry a lot more about what’s going to happen, which can increase their anxiety,” she says. “Men tend to take a more problem-focused approach.”

“Being a natural-born neurotic doesn’t mean you’ll develop anxiety disorder“

The anxious brain

What’s the best way to tackle an anxiety disorder?

If you have an anxiety disorder, cognitive behavioural therapy (CBT) is likely to be the first recommended treatment. Considered the gold standard in treatment, it aims to address the maladaptive beliefs that drive your anxiety. Once they have been identified, CBT helps you challenge them. “If someone is worried about blushing, we might put blusher all over their face and make them have conversations with people to see that they generally don’t even notice,” says Wild. “For panic disorder, you might get someone to run up and down the stairs, to show them that even if they do an extreme behaviour, they aren’t going to have a heart attack.”

A shortage of therapists has spurred the development of online delivery of CBT. In a pilot study of 11 people with social anxiety disorder, Wild found that nine of them responded to online CBT and seven achieved remission, although it is too early to say if this is better or worse than face-to-face therapy.

Therapy isn’t for everyone, however. Some people don’t respond well to therapists or analysing their own behaviour. In this case, a second line of attack is drugs, which can redress chemical imbalances in the brain.

Several studies have shown that people with panic disorder and generalised anxiety disorder tend to have lower levels of a neurotransmitter called GABA, which is thought to help the amygdala filter out unthreatening stimuli. Blocking GABA production in rats has been shown to trigger anxiety-like symptoms.

Benzodiazepines, a class of common anti-anxiety drugs which includes Valium, work on this system but are highly addictive. Doctors may feel more comfortable prescribing antidepressants, says Lidbetter. These can help with the physiology of anxiety as well as the secondary symptoms, which often include depression. However, Lidbetter believes that this is a field that needs to move on. “We need a new benzodiazepine-type drug – something which isn’t addictive,” she says.

Exercise can help with day-to-day anxiety and is a helpful additional strategy for people with anxiety disorders. It triggers the release of mood-boosting endorphins, and forces you to concentrate on something other than your own thoughts. Then there’s diet. A team led by Phil Burnet at the University of Oxford has found that taking a fibre-rich supplement to encourage the growth of beneficial gut bacteria for three weeks caused people to pay more attention to positive words on a computer screen and less attention to negative ones. Upon waking each morning, the volunteers also had lower levels of the stress hormone cortisol in their blood. “We saw a small but significant effect on the underlying psychological mechanisms that contribute to anxiety,” says Burnet.

Modern life may be packed with events outside your control, seemingly designed to foster anxiety and self-doubt. The important thing is to recognise the symptoms and do something about them.

This article appeared in print under the headline “Worry…”

3 Powerful Ways to Gain Control Over Your Emotions

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Have you ever said something out of anger that you later regretted? Do you let fear talk you out of taking the risks that could really benefit you? If so, you’re not alone.

Emotions are powerful. Your mood determines how you interact with people, how much money you spend, how you deal with challenges, and how you spend your time.

Gaining control over your emotions will help you become mentally stronger. Fortunately, anyone can become better at regulating their emotions. Just like any other skill, managing your emotions requires practice and dedication.

Experience Uncomfortable Emotions But Don’t Stay Stuck in Them

Managing your emotions isn’t the same as suppressing them. Ignoring your sadness or pretending you don’t feel pain won’t make those emotions go away.

In fact, unaddressed emotional wounds are likely to get worse over time. And there’s a good chance suppressing your feelings will cause you to turn to unhealthy coping skills—like food or alcohol.

Acknowledge your feelings while also recognizing that your emotions don’t have to control you. If you wake up on the wrong side of the bed, you can take control of your mood and turn your day around. If you are angry, you can choose to calm yourself down.

Here are three ways to regulate your emotions in a healthy way:

1. Label Your Emotions

Before you can change how you feel, label the emotion you’re experiencing right now. Are you nervous? Do you feel disappointed? Are you sad?

Keep in mind that anger sometimes masks emotions that feel vulnerable—like shame or embarrassment. So pay close attention to what’s really going on inside of you.

Put a name your emotions. Keep in mind you might feel a whole bunch of emotions at once—like anxious, frustrated, and impatient.

Labeling how you feel can take a lot of the sting out of the emotion. It can also help you take careful note of how those feelings are likely to affect your decisions.

2. Reframe Your Thoughts

Your emotions affect the way you perceive events. If you’re feeling anxious and you get an email from the boss that says she wants to see you right away, you might assume you’re going to get fired.

If you were feeling happy when you got that same email, your first thought might have been that you’re going to be promoted or congratulated on a job well done.

Consider the emotional filter you’re looking at the world through. Then, reframe your thoughts to develop a more realistic view.

If you catch yourself thinking, “This party is going to be so boring,” remind yourself, “It’s up to me to have fun. I can talk to people about interesting subjects and make the best of my time.”

Sometimes, the easiest way to gain a different perspective is to take a step back and ask yourself, “What would I say to a friend who had this problem?” Answering that question will take some of the emotion out of the equation so you can think more rationally.

If you find yourself dwelling on negative things, you may need to change the channel in your brain. A quick physical activity, like going for a walk or cleaning off your desk, can help you stop ruminating.

3. Engage in a Mood Booster

When you’re in a bad mood, you’re likely to engage in activities that keep you in that state of mind. Isolating yourself, mindlessly scrolling through your phone, or complaining to people around you are just a few of the typical “go-to bad mood behaviors” you might indulge in.

But, those things will keep you stuck. You have to take positive action if you want to feel better.

Think of the things you do when you feel happy. Do those things when you’re in a bad mood and you’ll start to feel better.

Here are a few examples of mood boosters:

  • Call a friend to talk about something pleasant (not to continue complaining).
  • Go for a walk.
  • Meditate for a few minutes.
  • Listen to uplifting music.

Keep Practicing Your Emotional Regulation Skills

Managing your emotions is tough at times. And there will likely be a specific emotion—like anger—that sometimes gets the best of you.

But the more time and attention you spend on regulating your emotions, the mentally stronger you’ll become. You’ll gain confidence in your ability to handle discomfort while also knowing that you can make healthy choices that shift your mood.

This article originally appeared on Inc.com.

The Strange Reason You Aren’t Sleeping

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Whether you’re newly sharing a bed with someone or have been sharing a bed with someone for years, sharing your sleeping space could be messing with your sleep.

A statement on Huelsnitz’s study details the findings.

“The quality of a person’s romantic relationship and the life stress he or she experiences at two key points in early adulthood (at age 23 and 32) are related to sleep quality and quantity in middle adulthood (at age 37),” read the release.

“Sleep is a shared behavior in many romantic relationships, and it is a strong contender for how relationships ‘get under the skin’ to affect long-term health,” it continued.

Previous research has found that sleep can affect us in significant ways when it comes to relationships.

“Poor sleep may make us more selfish as we prioritize our own needs over our partner’s,”  said Amie Gordon social psychologist at the University of California–San Francisco.

Some reports suggest that many people are engaging in “sleep divorces,” which entails sleeping in different beds, either in the same room or in different rooms. Many couples who have tried this have reported an improvement in their relationship as a result.

Mohan Garikiparithi has a degree in medicine from Osmania University (University of Health Sciences). He practiced clinical medicine for over a decade before he shifted his focus to the field of health communications. This article was originally published on BelMarraHealth.com

This Is The Type Of Stress That’s Actually Good For You

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I stress, you stress, we all stress for eustress! What on earth is eustress? You may have heard this mental health buzzword bandied around lately and wondered how exactly it differs from regular old life-is-making-me-crazy stress. But believe it or not, eustress is a kind of stress that’s actually good for us. (Yep, that’s a thing.) We spoke to licensed professional counselor Amanda Ruiz, MS of Pennsylvania’s The Counseling Collective about how to identify the eustresses in life — and get the most out of them.


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Definition

With all we hear about stress raising blood pressure, disturbing sleep, and even bringing on early death (yikes), it may be hard to believe there’s a kind of stress that actually boosts our mental and physical health. So to understand eustress, you may have to dismantle some preconceived notion. Simply put, eustress is any kind of pressure in our lives that actually brings positive results.

“Eustress is the normal amount of stress that you feel when doing a positive challenge, something you feel relatively capable in completing,” explains Ruiz. Happy, exhilarating events in life, like having a baby or starting a new relationship even though they feel good, create their own kind of stress on the body and brain. After all, some of the same hormones — like adrenalin and cortisol — involved in fear are also present in times of excitement. Therefore, experiencing something thrilling or challenging, such as riding a roller coaster, completing a tough project at work, or buying a new home, brings a certain kind of pressure.

The benefits of eustress

This pressure, though it may technically qualify as “stress,” is surprisingly good for us. When we undertake something difficult, it’s an opportunity for personal growth, whether we succeed or fail. And change, a common source of stress, adds a bit of spice to life. “Eustress keeps life exciting,” says Ruiz. “Without it, you might become bored, complacent, and lack motivation.”

Plenty of research has looked at the dramatic effects of positive versus negative stress. The right balance of stress has been shown to increase alertness and cognitive performance, as well as keep us more adaptable. A 2015 study found that people with high levels of good stress had less fatigue in the morning and throughout the day than those who experienced distress (AKA negative stress). And another, conducted on college students, found a connection between the level of eustress and overall life satisfaction.

When is it eustress and when is it destress?

So when is it distress and when is it eustress? Typically, distress makes us feel anxious and overwhelmed. Eustress, on the other hand, brings a feeling of excitement, accomplishment, or a challenge accepted. (The “eu” comes from a Greek word meaning “good, well, pleasant, or true,” as in “euphoria.”) Making cuts to your budget, for example, could be a distress if it’s a struggle to make ends meet — or could be a positive if it’s to save for your spring break trip to Italy. “If you feel competent to cope with the stressful event, then you are most likely experiencing eustress,” says Ruiz. “If you doubt your ability to cope with it, and instead if feels unpleasant, then it’s probably distress.”

Turning distress into eustress

Feel like most of the stressors in your life are the kind that bring you down? There’s hope! Your mindset could go a long way toward actually transforming circumstances you perceive as distress into eustress. A 2013 study found that subjects’ thoughts about their own stress had a major impact on their physical experience of it. In one module of the study, subjects were interviewed about whether they found life stressors to be “enhancing” or “debilitating.” In another, they were shown videos that framed the concept of stress as either one of these two descriptors. All told, people who were able to think of their stress as having potential benefits had less negative physical responses to it.

To get the most out of any stressful situation, try to keep an open mind to how pressures might lead to personal growth. And, regardless of the circumstances, finding a self-care practice that works for you can keep stress at manageable levels. “Learning good stress management techniques can be helpful so you are adequately equipped to cope while going through any stressor,” says Ruiz.

This article originally appeared on Brit + Co. 

On The Days Depression Makes You Feel Nothing At All

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Today is a blah day. It isn’t that there is anything terribly wrong today. There are issues looming, yes, but there are always issues of late. There is nothing pressing, though.

It is just a blah day, a day where I lay in bed, struggling to find a reason to get up. I’ve had to pee for a couple hours now. Yet, the dull ache in my bladder is not enough to pull me from under my covers. I should probably brush my teeth. Maybe get dressed and get a bite to eat. I have been awake for more than five hours now, even before the sun rose. Yet, here I still lay.

I feel blah. While the world around me continues with its hustle and bustle, I have no motivation, no desire to do anything. Nothing seems interesting or important. Nothing is pressing enough to pull me from this funk.

I would go back to sleep if I could, call in sick from life itself. I feel like nothing, not myself. I feel numb.

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Days like this are common with depression. Those who have never struggled often assume that depression is all bouts of random sadness and tears. Yes, I have those days, too, and it is draining when everything and anything feels heart-wrenching and makes me want to cry. Yet, even worse, perhaps, than the days when I feel everything too strongly are the days I feel nothing at all.

On these days, I have trouble pulling myself up or doing anything. I’m not being lazy. I just don’t see the point. I am pulled into a gray abyss, where there’s no purpose, no joy, no motivation, no will to live. It isn’t that I’m suicidal and actively want to die, either. I just have no will to live. The emptiness is all-consuming.

People suggest I should just “try” to be happy or to be positive. If only it were this simple. Again and again, the “should be” and “could be” options roll around in my mind but I’m numb to them all. Deep down, I know I should be getting up, doing something, living life.

Yet, my brain has me in a death lock. “What’s the sense?” and “Why bother?” it parrots to me again and again. Its voice is booming and deafening. I can hear nothing else. I would love to just smile, think a happy thought and have it vanish away like a puff of smoke but it’s solid and real to me. It takes the form of four solid walls, caging me in, holding me hostage, refusing to budge or listen to reason.

Those blah days are the worst because I feel trapped in this numbness. I cannot escape. I never know whether it will last one day or one week. There is never an end in sight, never a scheduled sweet release.

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Blah days drag on and on until at some point I begin to feel everything too strongly again. On blah days, I would welcome the tears, the anguish, the pain and the struggling just to feel anything at all.

It has been more than hours now, and I’ve barely managed to write a few paragraphs. Yet, those feel like a tremendous accomplishment. I call it a victory. I have done something, which is more than I am able to achieve on most blah days. I still have to pee, though the dull ache has grown into a steady cramp. Breakfast time has come and gone, and lunch time has arrived. Yet, I still don’t have any desire to eat anything, let alone get up.

There are calls I should make and things I should be doing. Yet, my depression still echoes in my head that I shouldn’t bother, that nothing is worth the effort. It tells me to stay in bed, just let this day drift on by, that it doesn’t matter.

Nothing matters. It is all I can hear. It is deafening. I am adrift in a sea of hopelessness and emptiness. I feel paralyzed.

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I swear I am not being lazy. I’m just trapped in a battle with my own mind. I feel lost and alone. I feel trapped in this emptiness. I feel nothing. I feel numb. I feel blah. This is what depression feels like.​

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This article was originally published at The Mighty. Reprinted with permission from the author.

If You Can’t Fall Asleep In Under 20 Minutes, It Could Be A Sign Of These 9 Health Issues

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Some nights it’s easier to fall asleep than others. But for certain people, needing over 20 minutes to fall asleep every night is a given — and sometimes others have to wait hours more. The causes of insomnia can be due to all sorts of physical and medical health conditions, so it’s important to examine all of the factors that may be creating your difficulty falling asleep.

Falling asleep can say a lot more about what’s going on with your body than just how tired you are. “The amount of time it takes to fall asleep is known as ‘sleep latency,'” Conor Heneghan, lead research scientist at Fitbit, tells Bustle. “A normal amount of sleep latency is approximately 15-25 minutes, which is considered the ‘sweet spot’ for your body to drift into light sleep stages. However, sleep latency is impacted by [a variety of] factors.” These factors can be anything from what you’ve eaten that day, or whether you’ve altered your bedtime routine, to a more serious underlying medical condition that’s making it difficult for your body to rest at night.

And while having trouble falling asleep can be caused by a myriad of health issues, falling behind on sleep can cause sleep debt and add to these problems. So if you realize you’re taking more than 20 minutes to fall asleep every night, asking your doctor about this problem may get you some relief.

Here are nine health issues that not being able to fall asleep in 20 minutes could be a sign of, according to experts.

1GERD

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GERD, or gastroesophageal reflux disease, can cause symptoms that aren’t quite apparent until you lie down to try to fall asleep.

“When lying down, it’s easier for stomach acids to flow up your esophagus, causing heartburn,” Terry Cralle, RN, clinical sleep educator and sleep consultant for Saatva, tells Bustle. “Heartburn, in turn, can disrupt falling and staying asleep. That’s why many people with GERD experience an increase in symptoms at nighttime and may have trouble finding a comfortable position for sleeping.” Avoiding GERD trigger foods like spicy food, coffee, and alcohol, in the hours before bed, may provide some relief.

2Anxiety

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Anxiety doesn’t exist solely in the mind. If you’ve been dealing with feelings of stress and nervousness in your daily life, it may be building up and causing it to be difficult for you to fall asleep.

“Those who experience anxiety have a complex relationship with sleep,” Dr. Sujay KansagraMattress Firm’s sleep health expert, tells Bustle. “Anxiety can not only prevent someone from falling asleep but it can also be worsened once a person experiences the effects of sleep deprivation.” Dr. Kansagra recommends talking to your doctor if stress or anxiety may be affecting your ability to fall asleep.

3Asthma

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If falling asleep regularly takes more than 20 minutes for you, and you also experience respiratory symptoms, this could be caused by asthma.

“Asthma symptoms often worsen at night, [including symptoms of] nighttime coughing, chest tightness, wheezing and breathlessness: a condition referred to as ‘nocturnal asthma,'” Cralle says. Check in with your doctor if you realize that these sorts of symptoms tend to come along at night.

4“Social Jetlag”

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Keeping a completely different sleep schedule on weekdays and weekends can make falling asleep more difficult in general.

“Another major factor that may contribute to longer sleep latency is ‘social jetlag,’ brought on by the shift in sleep schedules that many experience on days off compared to workdays,” Heneghan says. This issue with your circadian rhythm can be addressed by keeping a more consistent bedtime and wake up time throughout the week.

5Arthritis

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If you have general aches and pains, and they worsen at night enough to make it difficult for you to fall asleep — you may have undiagnosed arthritis. And arthritis doesn’t only affect older people.

“It is estimated that as many as 80 percent of people with arthritis have difficulty sleeping,” Cralle says. “Pain makes it hard to get comfortable and to fall — and stay — asleep. Since sleep deprivation makes pain worse, it’s critical that arthritis sufferers get enough quality sleep.” So talking with your doctor both about your pain and your sleep problems can be a step in the right direction.

6Menopause

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Like arthritis, menopause is associated with aging but can show up in young peopleas well. Since you may not realize this is possible, you may not be connecting the dots between potential gynecological issues and lack of sleep.

“Women are twice as likely to suffer from insomnia than men, according to the National Sleep Foundation, and their sleepless nights have been linked with hormonal changes —especially during menopause, when hormone levels are erratic,” Dr. Kent Smith, founding director of Sleep Dallas, tells Bustle. Making sure you regularly see an OB/GYN, and always tell your doctors about changes to your health, can help you stay on top of these potential issues.

7Restless Leg Syndrome

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Tossing and turning doesn’t have to be something that you ignore. Health issues like restless leg syndrome could be seriously impacting your ability to fall and stay asleep.

“Approximately one in 10 adult Americans suffer from Restless Leg Syndrome, according to the National Sleep Foundation,” Dr. Smith says. “This sleep-related movement disorder causes overwhelming and often unpleasant urges to move the legs while at rest, often making it difficult for sufferers to drift off to sleep.” If you find it particularly hard to lie still at night, it may be best to get in touch with a doctor.

8Sleep Apnea

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While sleep apnea is known to cause disruptions during sleep, it can cause difficulties during the process of falling asleep as well. And since sleep apnea can be difficult to diagnose, you might not connect the dots on this sleep disorder immediately.

“Sleep apnea, a condition in which a person ceases to breathe multiple times per hour when they sleep, can inhibit a person’s ability to fall asleep,” Dr. Smith says. “The brain detects that it is receiving less oxygen during sleep, so, in a life-preserving attempt, it actively prevents the sufferer from falling asleep.” If you have difficulty falling asleep, plus other signs of sleep apnea, then it’s important to see a sleep specialist and seek treatment.

9Vitamin Deficiency

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Sometimes, the root cause of your difficulty falling asleep can be hard to pinpoint but relatively straightforward to treat. One of the examples of this is vitamin deficiency.

“Several common vitamin deficiencies can lead to sleep disturbance,” Arielle Levitan, M.D., co-founder of Vous Vitamin LLC, tells Bustle. “[…] Determining which vitamins to take and in which safe and proper doses is important.” Particular deficiencies like magnesium and iron can cause difficulty falling asleep, Levitan says. To find out if this is a problem, the first step is to speak with your doctor and potentially have them perform blood tests to check for deficiencies.

In order to protect your physical and mental health, it’s important not to normalize your difficulty falling asleep. Taking note of why you may be struggling to fall asleep within 20 minutes or so, and how you feel the next day, may provide you some of the data you need to discuss this issue with your doctor — and find a treatment that works for you.

The 3 Powerful Steps To Develop Your Daily Routine

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“You need to learn how to select your thoughts just the same way you select your clothes every day. This is a power you can cultivate. If you want to control things in your life so bad, work on the mind. That’s the only thing you should be trying to control.” — Elizabeth Gilbert

The winter solstice recently passed and now, we find ourselves deep in the peak of shortened days, cold weather and lots of time inside with family and relatives. The lack of sun can really damper our moods and take away some of our energy. If we let it. Winter can make it challenging to find inspiration at times. But the days of less sunlight can also lead to great opportunities for solitude, reflection and contemplation.

While it may be tough to feel as inspired, I find that wintertime often is great for planning and refocusing our priorities. Some of my best ideas, as well as my most productive planning and actions have taken place at this time of the year. In fact, the majority of the writing that I did for my first book, The Value of You, occurred during the wintertime last year. It was a special time I’ll never forget.

Following the holidays, there are less distractions. And as a result, there are more reasons to find things that inspire and light the fire inside of our hearts.

In this vein, I urge you to develop an inspirational routine each morning. It may come through the power of meditation, prayer, genuine heartfelt interaction with those that you love or from your favorite song. It could be a video that plays back the piano recital you played to perfection that brought the house down.

It may be the words of this article or a book you find so profound and hold in such high esteem, you get the chills before opening the pages.

Develop your routine. I’ll show you what works for me and how you can integrate this into your life.

Here’s How to Develop Your Routine

“Great are they who see that spiritual is stronger than any material force — that thoughts rule the world.” — Ralph Waldo Emerson

Make your routine an every day thing. As I’ve climbed the mountain of productivity this year, I realize that I never want to come down. The ascension — the journey — has been a magical ride and it reassures me that all of my progress toward self-actualization, as well as greater harmony and rhythm in living the life of my destiny has been worth the pain and occasional doubts.

  1. Dedicate 10 minutes of contemplation time, ideally, at the beginning of each day. This sets the tone for your day and gets you feeling inspired. All you need are 10 minutes of deep, powerful thinking without distraction and with a beginner’s mind.
  2. Use this time alone in solitude, in a quiet place. Focus your thoughts on positive, stimulative thoughts such as: romantic love, sexual love for a partner, girlfriend/boyfriend, wife or husband. Also, music, friendship and envisioning yourself attaining success or fame. There’s tremendous power that comes through dreaming and seeing yourself standing “in the winner’s circle.”
  3. Get these positive thoughts going and keep them going. Write down these thoughts that come to mind. Keep referring back to them throughout your work day or school day. Think of them when you’re out in the social world, during moments of difficulty or times of joy. Look at them again before you go to bed at night and reset your mind. Then rest and get read for the new day with excitement, anticipation and a clear mind for fresh, new thoughts.

What has become truer for me by the day is the concept that we control our own destiny through the power of our thoughts. We emotionalize our ideas with the power of love, faith and hope. We take these thoughts and envision ourselves doing what we desire. And we put it into plan and take the action that we’ve dreamed of. It really is that simple. Do this and you will never be denied.

There is no shame in any idea, as long as you believe in it and feel it will add value to your life and the lives of others. Don’t concern yourself with the ingenuity of your idea. Your race, your cause is the one that speaks to the desires and dreams of your heart. That’s what makes you unique and special.

I’ve got a long way to go. Chances are, so do you. The way to cultivate and build momentum — which you can then transform into empowered thought and constructive action is through inspiration — the power of “fire” that lifts your spirit and brings you unbridled enthusiasm. Be inspired everyday.

A Story To Tell

Any idea, plan, or purpose may be placed in the mind through repetition of thought. — Napoleon Hill

This is a story I know well. It’s the story of my best friend, my brother, Kevin. These days my brother is seen on national television five nights each week on ESPN. He’s a broadcast journalist and celebrity in his own right. Everything he has can be attributed to his natural talents, perseverance, desire and faith in himself.

Kevin worked hard until he reached the pinnacle of his profession. He reached the top because he envisioned himself reaching the top. He dreamed big and thought prodigious, stimulative thoughts. He had the mindset of a winner. But keep in mind, Kevin’s success did not come overnight.

Kevin knew when he was in 8th grade what he wanted to do with his life. He started announcing sports scores over the intercom at our middle school. He did the same thing while in high school. Kevin used his basketball-playing ability to earn an athletic scholarship at the college level, where he attended a school with one of the top Radio & TV programs in the United States.

After graduation, he embarked on what is now over a 20-year career in sports broadcasting. He busted his tail for nine long years at a regional television station making meager money. There were moments of doubt, frustration and at times, loneliness. Kevin dreamed of being on national television or working in a big market. But it seemed so far away.

He concentrated on getting better each day. He surrounded himself with inspiring thoughts, stories and images of fellow broadcasters who made the big time, as well powerful stories of athletes. He kept going. Kept believing.

Finally, his big break came in 2006 when he accepted a job with WCBS radio in New York. Less than one year later, he was working on television for WCBS-TV. And in 2008, he reached the big time: he was hired by ESPN. 11 years after graduating from college, with a few lean years in between where he thought about quitting or changing professions, Kevin received an offer to work at the worldwide leader of sports.

Your Journey

Chances are, you will not find success or personal fulfillment in your first job. Few people are blessed with both the talent and foresight to know precisely what they want to do with their lives right after college. Even less people know and possess this ability at a young age. My brother, Kevin, is one of those precious few lads who did know.

We all have unique stories to share with the world. Where are you on your journey? Are you going through the doldrums of doubt and fear? Do you see the proverbial light at the end of the tunnel — the end-vision of your goal? And if you do, are you running into road blocks of creativity? What are your mental challenges? What are your emotional battles?

Perhaps your path is as open as the Pacific Coast Highway at sunset in Laguna Beach. Maybe it’s a Midtown Manhattan traffic jam. It’s all a state of mind. We need inspiration to help us create the beautiful landscapes of limitless possibility in our mind that serve as the foundation for our magical journeys.

You are the creator of your world. When you are safe in the knowledge that you control your worldly destiny, nothing will ever stop you. Those with a winning mindset are never denied. They inspire themselves to achieve great things.

Be inspired. Enjoy this winter season and take some time for yourself to develop a routine that positions you for fulfillment and productivity. As St.Francis of Asisi once wrote, “Start by doing what’s necessary; then do what’s possible; and suddenly you are doing the impossible.”

This article originally appeared on Medium.

8 Physical And Mental Health Benefits Of Owning A Dog

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We can thank our dogs for many things – laughs, companionship and muddy paw prints on the carpet included. But do you ever stop and think about the more long-term impacts that owning a dog can have on your physical and mental health?

This National Love Your Pet Day (20th February), we are thanking our pets for the health benefits they bring to our lives, from exercise to increasing confidence.

8 mental and physical health benefits of owning a dog

1. You might visit the doctor less

An Australian survey found that dog owners make fewer visits to the GP in a year and are less likely to be on medication for heart problems or sleep issues.

2. You could be less anxious

Veterinarian Dr Jo Gale, Mars Petcare Scientific Advisor, says: “Several studies have found that interacting with pet dogs or therapy dogs is associated with reductions in the stress hormone cortisol and reductions in self-reported anxiety.”

2. You could have lower risk of cardiovascular disease

A nationwide 2017 study in Sweden found that owning a dog could be beneficial in reducing the risk of the owner developing cardiovascular disease, thanks to having increased motivation to exercise and a non-human social support network. Interestingly, the study found that owning hunting breeds lowered the risk the most.

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3. You are more sociable

An American study, which looked at three factors of being sociable – getting to know people, friendship formation and social support networks – found that dog owners are five times more likely to know people in their community. They found that dogs, acting as companions, helped owners be more sociable on every level, from one-off interactions to the development of deep friendships.

4. You might live longer

In the Waltham Pocket Book of Human-Animal Interactions there is a wealth of evidence to suggest that the physical benefits of having a dog can lead to a longer, healthier life. Section 8 reads: “The many health benefits of regular physical activity are well documented, and include lower rates of cardiovascular disease, Type 2 diabetes, depression and certain types of cancer.”

5. You have higher self-esteem

2017 study by the University of Liverpool found that growing up with a dog can increase self-esteem in children. It also found young people with pets to be less lonely and have enhanced social skills. Lead author, Rebecca Purewal, states: “Critical ages for the impact of pet ownership on self-esteem, appear to be greatest for children under 6, and preadolescents and adolescents over 10.”

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6. You exercise more

A 2019 study by Lintbells found the average dog owner walks 870 miles every 12 months with their pets. That equates to just four miles less than the distance between John o’Groats in Scotland and Land’s End in Cornwall. Just over half of the 2,000 British adults surveyed owned a dog, and they walk, on average, more than 21 miles a week – 17 of which are with their pet. That’s around seven miles more than non dog owners who only clock up 14 miles a week.

7. Children miss less school

Veterinarian Dr Jo Gale says: “Having pets in the home has been linked to enhanced immune function in children, as evidenced by better school attendance rates due to fewer illness-related absences. The effect was particularly strong for younger children (five to eight-years-old) and, in some cases amounted to nearly three extra weeks of school attendance for children with pets.”

8. You are less likely to be lonely

Studies have shown that, out of any other pet, dogs have the strongest connection to loneliness, mainly because they are on show a lot more. Over 80% 0f people who took part in Mars Petcare’s 2018 research said that, just one month after getting a dog, they felt a lot less lonely.

How To Spend The First Hour Of Your Work Day On High-Value Tasks

Author Article

Don’t begin the activities of your day until you know exactly what you plan to accomplish. Don’t start your day until you have it planned. — Jim RohnEvery morning, get one most important thing done immediately.There is nothing more satisfying than feeling like you’re already in the flow.And the easiest way to trigger this feeling is to work on your most important task in the first hour.Use your mornings for high-value workLean to avoid the busy work that adds no real value to your work, vision or long-term goal.

Low-value activities, including responding to notifications, or reacting to emails keep you busy and stop you from getting real work done. Make time for work that matters.

In his book, Getting Things Done: The Art of Stress-Free Productivity, David Allen says, “If you don’t pay appropriate attention to what has your attention, it will take more of your attention than it deserves.”

Research shows that it takes, on average, more than 23 minutes to fully recover your concentration after a trivial interruption.

Productive mornings start with early wake-up calls

“In a poll of 20 executives cited by Vanderkam, 90% said they wake up before 6 a.m. on weekdays.

PepsiCo CEO Indra Nooyi, for example, wakes at 4 a.m. and is in the office no later than 7 a.m.

Meanwhile, Disney CEO Bob Iger gets up at 4:30 to read, and Square CEO Jack Dorsey is up at 5:30 to jog.”

The first quiet hour of the morning can be the ideal time to focus on an important work project without being interrupted.

Don’t plan your day in the first hour of your morning

Cut the planning and start doing real work. You are most active on a Monday Morning.

Think about it. After a weekend of recovery, you have the most energy, focus and discipline to work on your priorities.

Don’t waste all that mental clarity and energy planning what to do in the next eight hours.

Do your planning the night before.

Think of Sunday as the first chance to prepare yourself for the week’s tasks.

Monday mornings will feel less dreadful and less overwhelming if you prepare the night before.

If you choose to prioritize …

There are one million things you could choose to do in your first hour awake.

If you choose to start your day with a daily check list/to-do list, make sure that next to every task you have the amount of time it will take to complete them.

The value of the of putting time to tasks is that, every time you check something off, you are able to measure how long it took you to get that task done, and how much progress you are making to better plan next time.

Get the uncomfortable out of the way

You probably know about Brian Tracy’s “eat-a-frog” – technique from his classic time-management book, Eat That Frog?

In the morning, right after getting up, you complete the most unwanted task you can think of for that day (= the frog).

Ideally you’ve defined this task in the evening of the previous day.

Completing an uncomfortable or difficult task not only moves it out of your way, but it gives you great energy because you get the feeling you’ve accomplished something worthwhile.

Do you have a plan from yesterday?

Kenneth Chenault, former CEO and Chairman of American Express, once said in an interview that the last thing he does before leaving the office is to write down the top 3 things to accomplish tomorrow, then using that list to start his day the following morning.

This productivity hack works for me.

It helps me focus and work on key tasks. It also helps me disconnect at the end of the day and allow time for my brain to process and reboot.

Trust me, planning your day the night before will give you back a lot wasted hours in the morning and lower your stress levels.

Try this tonight.

If you’re happy with the results, then commit to trying it for a week.

After a week, you’ll be able to decide whether you want to add “night-before planning” to your life.

Want to get more done in less time?

You need systems not goals. I’m creating a new course, Systems For Getting Work Done to help you create a personal productivity system to get 10X more done in less time. Sign up to be notified when it launches.

This article first appeared on Medium.

A Counselor Explains How Introverts Can Banish Social Anxiety

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A young introvert suffers from social anxiety.
I’m a counselor, and many of the introverts I see come to me because of anxiety. Some of the clients I see have diagnosable anxiety disorders, but those who don’t aren’t suffering any less. When I say anxiety, I mean “an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure,” according to the American Psychological Association.Anxiety can come in many forms and have many different causes, but in this article, I’d like to focus on social anxiety. Let’s take a look at the major signs of social anxiety, plus how you can free yourself from it by fixing “thinking errors.”

Signs of Social Anxiety Disorder

According to the American Psychiatric Association, you might have social anxiety if you experience the following:

  1. Feeling anxious or afraid in social settings. You might feel extremely self-conscious, like others are judging or scrutinizing your every move. For an adult, this might happen on a first date or a job interview, or when meeting someone for the first time, delivering an oral presentation, or speaking in a class or meeting. In children, these behaviors must occur in settings with peers — rather than adult interactions — and will be expressed in terms of age appropriate distress, such as cringing, crying, or just generally displaying obvious fear or discomfort.
  2. Worrying quite a bit that you’ll reveal your anxiety and be rejected by others
  3. Consistently feeling distressed during social interactions
  4. Painfully or reluctantly enduring social interaction — or avoiding it altogether
  5. Experiencing fear or anxiety that’s disproportionate to the actual situation
  6. Having fear, anxiety, or other distress around social situations that persist for six months or longer
  7. Finding that your personal life, relationships, or career are negatively affected. In other words, your anxiety makes it quite difficult for you to function in day-to-day life.

For a diagnosis of Social Anxiety Disorder, these symptoms must be present for six months or longer and not be better explained by another mental health or medical diagnosis.

Why Is Social Anxiety Common in Introverts?

If you’re an introvert who experiences social anxiety, you’re not alone. The research shows that introverts are far more likely to suffer from it than extroverts. A small study done in 2011 found that “social phobia patients” were significantly more often introverts (93.7 percent) than not (46.2 percent). Although not all introverts suffer from social anxiety, this study suggests that us “quiet ones,” by nature, may be prone to it in one form or another.

Social anxiety can be excruciating. Introverts, in my practice, struggle with it because they tend to overthink and overanalyze situations. They may find themselves caught in a cycle of planning out a conversation only to have it go differently than their script. This puts them on the spot — an introvert’s nightmare — and creates a high level of anxiety.

They then may fall into the trap of mind-reading. Mind-reading is what some therapies, like Dialectical Behavioral Therapy, call “thinking errors.” These patterns of thinking can be helpful in some situations, but when overused, can actually be quite harmful.

Many introverts (especially highly sensitive introverts) are particularly vulnerable to the “error” of mind-reading because they’re so good at attuning to others’ body language, emotions, and energy that it feels like they always know what someone else is thinking — even though they don’t actually possess telepathy.

When a conversation goes off-script and anxiety is heightened, introverts may assume others are thinking critically of them and take this assumption as fact. The thoughts of “now he thinks I’m an idiot” — though most likely false — create even more anxiety. It’s a vicious and debilitating cycle.

But you can banish social anxiety. Let’s take a look at the power of identifying and correcting thinking errors.

The Power of Fixing Thinking Errors

Let’s take an example from my practice. One young woman who came to me had a hard time making new friends. This girl was more mature than her cohort and seemed to be having trouble initiating conversation. As we talked, it came to light that her introverted trait of thinking before speaking had spiraled out of control. She’d rehearse for hours what she was going to say to a certain person, then be caught off guard when the conversation didn’t go as scripted. She then feared that people thought she was stupid or awkward (she was mind-reading) and became highly anxious.

After a conversation like this, she’d ruminate over what she should have said for days or weeks. Obviously, this left her too anxious to start any new conversations with anyone, which lead to a cycle of reinforcing her anxiety about social situations and her avoidance of them.

What did we do about it? The first step was education; we discussed both overthinking and mind-reading and how they relate to her introverted nature. She discovered that her tendency to overthink was very helpful in situations where she needed to analyze information and come to a conclusion, like schoolwork, but that with friends and family, it was creating a barrier to close relationships.

She was also able to see that while she is very attuned to others’ emotional states, she isn’t telepathic and can’t actually read others’ minds.

This education into the thought patterns that were feeding her anxiety gave her some valuable insights. For instance, she realized that the thoughts of “stupid” weren’t what she feared others would think of her, but what she thought of herself. Once we hit on this critical insight, she began to understand that her overthinking and mind-reading were actually ways to distract her from the mean things she was saying to herself.

It took quite a few sessions to help this girl become more self-compassionate and to lessen her overthinking. However, by the end of the school year, she was able to not only talk to new people, but to tackle intense, conflict-laden conversations she’d always avoided before.

Anxiety Doesn’t Have to Rule Your Life

This example gives us some valuable insight into how the introvert’s natural penchant for deep thinking and attunement to others can sometimes lead to harmful inner states. It also gives us a road map to moving forward and feeling better.

If you’re an introvert who suffers from social anxiety, the first step is to do what you do best: look inside and bring awareness to the thought patterns that are no longer helping you. Some of the best ways to do this are mindfulness, yoga, and journaling. Mindfulness trains the mind to be non-judging and discerning of thoughts and feelings; yoga helps relieve stress and is a moving meditation; and journaling brings up the unconscious thoughts, feelings, and beliefs we aren’t aware of in daily life that may be holding us back.

Ask yourself if there are thinking errors that are contributing to your anxiety. Are you like the girl I described above? The next time you notice yourself committing a thinking error, don’t judge or beat yourself up for it. Instead, simply notice it — there’s power in this alone! You might go a step further and intentionally replace your thinking error with a positive thought (even if you aren’t totally feeling it yourself at the moment). Try something like, “even though I’m scared, it’s going to be okay” or “I’m a likable person, and people enjoy being around me.”

Here are some more tips to help you mindfully control anxiety, and here’s a great explanation of mindfulness for introverts.

Your social anxiety won’t disappear overnight. But by stepping into mindfulness and identifying/correcting thinking errors, you can stop it from ruling your life.