The Powerful Link Between Insomnia and Depression

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When one has difficulty sleeping, the waking world seems opaque. On top of feeling tired and fatigued, those who experience sleep disturbances can be irritable and have difficulty concentrating. When one has more severe cases of insomnia, one also faces a higher risk of developing heart disease, chronic pain, hypertension, and respiratory disorders. It can also cause some to gain weight.

Sleep disruptions can also have a major impact on one’s emotional well-being. A growing body of research has found that sleep disturbances and depression have an extremely high rate of concurrence, and many researchers are convinced that the two are biconditional—meaning that one can give rise to the other, and vice-versa. A paper that was published in Dialogues in Clinical Neuroscience concluded, “The link between the two is so fundamental that some researchers have suggested that a diagnosis of depression in the absence of sleep complaints should be made with caution.” The paper’s lead author, David Nutt—the Edmond J. Safra Chair in Neuropsychopharmacology at Imperial College London—found that 83 percent of depressed patients experienced some form of insomnia, which was more than double the amount (36 percent) of those without depression.

Bei Bei, Dpsych, PhD, from the Monash School of Psychological Sciences in Clayton, Australia, said the inverse was true, as well: “If a person does not currently have depression but goes through extended periods of time with sleep disturbances or insomnia, the sleep disturbances can potentially contribute to a mood disturbance or to even more severe depression.”

The Mechanisms Behind the Two Diseases

The sleep-wake cycle is regulated by what is known as the circadian process. When working properly, the circadian process operates in rhythm with the typical cycle of a day. One gets tired as the light of the day fades and the body prepares for sleep. One awakes as it becomes light again. The internal mechanisms behind the circadian cycle involve a complex orchestration of the neurochemical and the nuerophysiological presided over by the hypothalamus.

Depression, meanwhile, is a medical condition and a mood disorder. While there are several possible antecedents to depression, as genetic and environmental factors can lead to a depressive episode, the neurophysiological causes of depression pertain to a deficiency of chemicals in the brain that regulate mood: serotonin, dopamine, and norepinephrine.

However, these neurotransmitters do far more than just regulate mood. They have also been found to be integral to sleep efficiency. Disruptions in these brain chemicals can lead to disturbances in sleep, particularly REMsleep, and can also lead to more restlessness during typical times when one should be in bed. This can create a vicious cycle wherein the more severe one’s depression becomes, the more severe one’s insomnia becomes. The inverse can also true: The more severe one’s insomnia becomes, the more severe one’s depression becomes.

Evaluation and Treatment

Because these concurrent afflictions reinforce one another, medical professionals need to address both simultaneously for optimal treatment. However, there is not one cookie-cutter response that can eliminate both depression and insomnia. Many variables, including improper medication, can contribute to insomnia and different symptoms indicate different causes, which is why it is important to provide your mental health professional with any information that can give them with more insight about your condition. Describing your symptoms to your doctor allows them to narrow down the list of likely culprits and prescribe medications with greater precision. For example, letting your doctor know that you wake up in the middle of the night, and then have difficulties falling back to sleep is a distinct symptom from having difficulties falling asleep in the first place.

Though depression and insomnia are commonly linked, they can be independent of one another. Then again, they may be part of a larger array of comorbid disorders that require specific treatment plans to resolve. To determine the best course of action, your doctor may recommend a sleep study, medication, or a behavioral therapy.

Sleep Study

A sleep study is a test that measures how much and how well you sleep. During this test, you will be monitored by a team of sleep specialists who will be able to determine if there are any other disorders, such as restless leg syndrome or sleep apnea, that may be causing your insomnia. Even if the study does not reveal a definitive culprit, the sleep study will also allow your doctor to get a better picture about what is behind your insomnia.


Sleeping pills may help you fall asleep, but they are not long-term solutions to mental health. If you are suffering from a bout of insomnia that is related to a psychiatric disorder, you need to address that disorder to address your insomnia. Oftentimes, this will require a treatment plan that includes a pharmaceutical component. This component will be unique to each patient, as there is not a one-size-fits-all regimen of medication for optimal mental health. Furthermore, there are numerous comorbidities with depression, such as anxiety, that may be contributing to your insomnia and that may not be resolved by certain types of anti-depressants alone.

Another potential treatment involves a combination of medication, light treatment, and melatonin, a hormone that helps regulate the circadian process. The conditions of patients who receive light therapy in conjunction with antidepressant therapy tend to show more improvement than those who are prescribed antidepressants alone. This is true for patients with seasonal and nonseasonal depression.

Cognitive Behavioral Therapy for Insomnia

In other cases, some mental health professionals may recommend you see a sleep specialist to receive cognitive behavioral therapy for insomnia. Cognitive behavioral therapy for insomnia (CBTI) involves numerous non-drug techniques to induce sleep and it can be utilized before resorting to the use of pharmacological sleep aids with surprisingly good results.

Several studies have shown CBTI to be quite effective in treating insomnia and some forms of depression. A paper published in the Journal of Clinical Sleep Medicine in 2006 concluded that “The benefits of CBTI extend beyond insomnia and include improvements in non-sleep outcomes, such as overall well-being and depressive symptom severity, including suicidalideation, among patients with baseline elevations.” A paper published in the International Review of Psychiatry in 2014 found that CBTI may help with other comorbidities beyond depression. These include anxiety, PTSD, and substance abuse issues.

The National Sleep Foundation notes that this type of therapy can still be quite intensive. CBTI requires regular visits to a clinician for assessment, keeping a sleep diary, and, perhaps most importantly, the changing of behaviors that may be felt as though they are firmly part of one’s routine. CBTI may also include some sleep hygiene education, where patients learn how different settings and actions can inhibit or promote sleep. It may also rely on relaxation training, where patients learn methods of calming their bodies and minds.

Concluding Thoughts

If you are struggling with either depression, insomnia, or both, treatments are available. The above studies demonstrate that there are holistic approaches, as well as pharmaceutical remedies, that can help induce sleep without the aid of sleeping pills. It is also a reminder that the most effective treatment plans are tailored to both the individual patient and the patient’s concurrent illnesses.

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How to Select the Right Therapist for You

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It’s not easy to find a good therapist. Therapy can be incredibly cost-prohibitive, for one thing, depending on insurance coverage. Then, there are scheduling constraints (it’s hard to find a therapist with open hours if you work a traditional 9-to-5), location constraints, general time constraints, and trying to suss out whether or not the person you’re spilling all your shit to is the right one to help you unpack and repack it.

There are also hundreds of different types of therapy, which is daunting when you’re not sure what kind will work best for you, in addition to a slew of different categories of mental health professional, all of which come with different credentials and training. It’s a lot to navigate, especially when you’re a first-time client. Here are some tips for selecting the right kind of help.

What kind of therapy do I need?

There are many, many different types of therapy, and mental health professionals don’t necessarily use a one-type-fits-all approach. If you’re suffering from something like generalized anxiety disorder or depression, for instance, your therapist might use a combination of treatments in your sessions. But let’s take a look at some of the most common options:

Cognitive behavioral therapy (CBT):

CBT is a common treatment that focuses on looking at certain behavioral patterns and coming up with a game plan of sorts to break them. “It’s trying to help you change your behavior through thinking differently about your situation,” Ryan Howes, PhD., a clinical psychologist in Pasadena, California, says. “So, for instance, if you get anxious about confronting your boss at work, or anxiety stops you from making any movement, CBT can help you reframe that. Instead of thinking of all the horrible things that could happen, it’ll help you imagine positive outcomes.”

CBT therapy is usually short-term—your therapist helps you determine a specific goal, and will then work with you to help regulate your emotions and develop new personal coping strategies. It can be especially good for treating anxiety and depression.

Psychodynamic therapies:

Psychodynamic therapies like psychoanalysis and Jungian therapy involve digging into your past to look at the root of whatever problems you’re trying to treat. So, for instance, if you’re anxious about confronting a boss, a psychodynamic approach will try to determine when this particular anxiety first took place, and how early traumas and relationships contributed to your current predicament. “The idea is that being able to uncover early thoughts will free you up to be able to act differently,” Howes says.

Psychoanalysis can take a long time (like, years) and many therapists will use it in tandem with a CBT approach, which is something worth bringing up in a consultation.

Specialized therapies for specific disorders:

Both CBT and psychodynamic therapies (or a combination of the two) can be effective for more general mental health disorders, but f you’re struggling with a particular disorder, like an eating disorder or post-traumatic stress, it may be more beneficial to see a mental health professional who specializes in treatments targeting those issues. For instance, if you’ve suffered from trauma, there’s Eye Movement Desensitization and Reprocessing (EMDR) therapy; if you’re mourning a tragic death, there’s grief therapy.

The thing about therapy, though, is that you might think that CBT will help you the best, or that you want deep psychoanalysis, or that only one specific kind of treatment will help you. The reality is that therapists will often use multiple approaches when treating a patient, and though it’s helpful to find a therapist who specializes in a particular disorder, when you start seeing one, you may discover it’s not just anxiety or grief that’s causing you problems.

“Nobody walks in the door with one problem,” Faith Tanney, a psychologist with a private practice in Washington, D.C., says. “You have to be able to switch around with different modalities.”

More importantly, if you like your therapist and feel comfortable opening up to them, the type of treatment they specialize in might not make a difference. “If you think your therapist is healing you, stay with them,” Tanney says. “If you don’t think your therapist is helping you, I don’t care what kind of therapy they’re doing.”

What kind of mental health professional should I see?

There are a few different kinds of people licensed and qualified to provide therapy. Psychologists have PhDs and PsyDs, and are trained in both psychotherapy and assessment testing. Licensed clinical social workers are also trained in psychotherapy and perform functionally similar mental health services to psychologists, but don’t have doctorates. A licensed mental health counselor is also trained in psychotherapy and will treat patients much in the same way as a social worker. Psychiatrists primarily focus on chemical imbalances. They have medical doctorates, and prescribe medication (in some states psychologists can also prescribe medication).

A psychiatrist is the one to see if you’re in the market for mood-correcting meds, but if you’re looking for talk therapy, you’re better off seeing a psychologist, social worker, or counselor. Psychologists tend to see people with serious mental illness, while social workers and counselors can help patients suffering from more common forms of psychological distress. In the long run, though, as long as you’re seeing someone with a valid state-issued license (states have online license lookups for psychologistscounselors, and clinical social works), if you like your therapist, their specific credentials don’t really make a difference.

What research should I do before having a consultation?

There are a lot of different factors that go into finding a therapist. Therapy is expensive, so if your health insurance will cover it, it’s a good idea to search for one through your provider, though some therapists will offer counseling on a sliding scale. Location is also a big factor—if you think it’ll be difficult for you to get to your therapist, you’ll probably be less likely to make your appointments, especially when you’re still in the “feeling it out” stage.

If you’re looking to treat a certain problem, you do want to know your therapist has some experience in that realm. If you struggle with anxiety, your therapist should know how to treat anxiety. If you have bulimia, your therapist should have experience with patients with eating disorders. Websites like therapy.organd Psychology Today will tell you a little about your prospective therapist’s areas of expertise, so you can get an idea of what you’re working with.

Then, you have to take into account your personal preferences. “Some people feel like they want someone who fits in a certain age bracket. Some want someone a little older and wiser, some people feel more comfortable talking to someone around the same age,” Howes says. “Gender is a big part of it, too. I tell people to try to make a list of three therapists that on paper seem to fit their criteria, that are the right age and specialize in that area, and go on a test drive with these therapists.”

What questions should I ask in my first session?

When you’ve selected your three therapists, you should set up a consultation, either by phone or in person. Sometimes therapists won’t charge for consultations, and sometimes they will, so it’s a good idea to suss that out beforehand.

Once you’re at the consultation, though, the most important thing is to get a feel for your therapist. “This is like a first date,” Tanney says. She recommends skipping over the “where did you go to school” part of the standard dating questionnaire—“They’re already licensed, so you can sue them,” she jokes—and getting right into your particular goals and how they might go about helping you achieve them.

“You got my name from someone. You’ve read up on me, and see that I have the skills, I have the techniques, I have the training, I have the experience. Now we’ll see if that works for you,” Tanney says. “We set goals for therapy, I’ll tell you what I think we’re going to work on first, and you say whether or not they make sense to you.”

It’s also a good idea to ask your therapist for their specific policies—some require advance notice if you’re canceling a session, for instance, or will only allow you to take a couple weeks off without being charged. Some will ask that you give them a few weeks’ heads up before you decide to end therapy. “If you feel the time has come to leave, I would ask that you let me know, so we have a couple weeks to discuss that,” Tanney, who has her patients sign a contract, says.

Ultimately, go with your gut

The real key to finding a therapist is exactly like trying to find a romantic partner—there has to be a “click.” After a couple of sessions, if you don’t feel like your therapist is someone you can open up to, then they are not the therapist for you.

“It’s about trusting your gut,” Howes says. “The therapist can be the most highly trained person in the world with years of experience and mountains of books, but if you can’t open up to them, the therapist is worthless. Or they can be a brand new trainee, but if you feel safe and comfortable talking to them, the therapy will be more beneficial.”

So if you’ve test-driven a few therapists, pick the one you felt the most comfortable talking with. And if, after a few sessions, or a few months, or a few years, you decide you’ve lost that connection, it’s okay to leave. “You have the power. This person is in your employ,” Tanney says. Don’t ghost, and do bring up your specific concerns about your therapist to them, since it’s always a good idea to give someone an explanation as to why you think things aren’t working. But you’re the boss. After all, as Tanney says, “This is not your friend, this is your worker bee.”

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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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. 

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.


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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.


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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.


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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.


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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.



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


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


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.

5 Small Changes You Can Make That Have A Positive Impact On Your Health

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Humans are very good at picking out big goals with the best of intentions and then struggling when it comes to sticking with them. Instead of giving yourself a mountain to climb (maybe an actual mountain, if that’s your thing), start off with something manageable. These five small changes are the first steps to eventually making those long-term targets for your health. Just don’t try to do them all at once.

1. Exercise 20 minutes more a week

Forget what phys ed class taught you: Your version of working out doesn’t have to look like anyone else’s. Meghan Stevenson is a certified running coach with the Road Runners of America and founder of virtual training website Your Best Run, whose focus is helping individuals meet their personal goals. “I started my running journey almost 15 years ago with just walking,” Stevenson explains. “I built up from 20 minutes to 90 minutes. When I got bored, I started running. Now I’ve completed marathons, and I run an average of 30 miles each week!” Whether you want to eventually build up to marathons or just want to make running a habit, Stevenson recommends combining running and walking to start. “Twenty minutes is fine!” she encourages. “Schedule it into your calendar like you would lunch with a friend or a meeting at work.”

It doesn’t have to be running: Greg Pignataro, a certified strength and conditioning specialist at Grindset Fitness, says that you don’t even have to go to a gym to start your workout routine. “There are plenty of great exercises that don’t require any equipment and can be done in the comfort of your own home,” he tells us. “A five-minute routine of bodyweight-only exercises performed once a day can be a wonderful catalyst for positive change.” Skipping the hassle of going to the gym can help with the mental leap required to force yourself to work out, he explains. If you do want to go to a gym but are worried about other people judging you, Pignataro reassures us, “You’re not alone! However, between checking themselves out in the mirrors and fretting that someone is judging them, hardly anyone is judging you!”

2. Cut out one cigarette a day

Smokers already know that quitting cigarettes is one of the best ways to improve their health. Licensed clinical social worker Heather Senior Monroe, director of program development at Newport Academy, confirms that people who cut down their cigarette usage can look forward to “improved lung capacity; better blood circulation; stronger immune system; enhanced sense of smell and sense of taste; and reduced risk of gum disease, heart disease, lung cancer, and chronic bronchitis.”

Of course, smokers also know that it’s one of the hardest habits to kick. Reducing your cigarette use by one a day (then two, then three, etc.) is one way to try. “Quitting slow and steady gives a person a much smaller goal to focus on, which is a lot easier for some people to do compared to cutting down quickly or even going cold turkey,” says Cedrina L. Calder, MD, a preventive medicine doctor in Nashville, TN. “Also, cutting back slowly may work better for someone who is not using nicotine replacement therapy (NRT), as it may allow their body to get better adjusted to receiving less nicotine if they slowly reduce the amount over a period of time.”

However, there are some potential drawbacks to quitting cigarettes slowly. “Some people may not actually end up quitting,” Calder cautions. “They may cut down and start smoking less but still struggle to quit.” To refocus your goal, Natasha Bhuyan, MD, a family medicine doctor with One Medical, recommends, “Try setting a final quit date. Write it down and stick it up on your bathroom mirror — it helps to have a goal to work toward, and a recurring reminder will offer you that daily nudge to stay on track.” And give yourself help. “Speak with your doctor about smoking cessation programs, which will help with medication management as well as behavioral therapy and will increase your chance of successfully quitting,” Calder advises.

3. Eat one more fruit or vegetable a day

Instead of restricting what you eat, try introducing more fruits and vegetables. “Think in terms of adding nutrition to your diet rather than taking it out,” encourages Alyssa Lavy, registered dietitian, certified dietitian nutritionist, and owner of Alyssa Lavy Nutrition & Wellness. “Consider how to add vegetables to increase your nutrient intake, rather than using them as a way to decrease calories or replace a food that has a completely different nutrient value.” She recommends following your taste buds: “While someone may love bananas, someone else may not be able to stand them, so it’s best to think about which fruit or vegetable you would be open to incorporating into your diet.”

See it as a chance to get creative! “I always encourage clients to add a new food to one that they love, so that the new food is mixed with something familiar,” Lavy suggests. “For example, if you love mashed potatoes, perhaps add broccoli to them, or try including zucchini ‘zoodles’ in your pasta dish with sauce. Once that food becomes more familiar, preparing it in a variety of ways is helpful, because you may love a certain vegetable raw or roasted, but you may hate it steamed.” Healthy eating just got interesting!

4. Have one fewer drink a week

The line between a safe and fun amount of alcohol and heavy drinking that can lead to addiction is a lot narrower than many people realize. “For women, heavy drinking is more than three drinks a day or more than seven drinks a week, and for men it is more than four drinks a day or more than 14 drinks a week,” explains Indra Cidambi, MD, medical director at the Center for Network Therapy in New Jersey. If you can stick to those limits long-term, you’ll experience better sleep, clearer skin, a reduced risk of breast cancer, and more energy, and you’ll potentially reduce your risk of heart disease and diabetes.

If going teetotal for a full month or longer is too much for you, try saying no to one or two drinks each week. “The benefits of this slow and steady method is that total abstinence is not the immediate goal, and it gives the person time to introduce other fun activities to substitute for alcohol,” says Cidambi. She recommends looking at why you’re drinking more than is good for you: “If it’s due to boredom or lack of alternate activities, try finding different hobbies. If it’s your choice of friends, try expanding your social circle.” That said, as with smoking, some people will find reducing alcohol in this slow way harder than others. “For some, perfect moderation may be harder to achieve than total abstinence,” Cidambi admits. If you regularly find yourself on the “all” side of all or nothing, it might be a good idea to see your doctor for extra advice.

5. Sleep 30 minutes longer every night

Make this the year you finally get that early bedtime your sleepy body has been calling for. “Everyone out there should be getting between seven and nine hours of sleep each night,” asserts Bill Fish, a certified sleep science coach and founder of sleep website “Sleep is now considered the third pillar of wellness to go along with diet and exercise.” And slow and steady works best. “Gradually change your bedtime by even as little at 10 minutes per night,” recommends Fish. “Set a reminder that will alert you at least 45 minutes before you want to be asleep. Give your body and mind time to decompress to ensure you are ready to get to sleep, whether that is with a warm shower, 15 minutes of a good book, some meditation, or any other ritual.”

An extra 30 minutes of sleep might not seem like a lot, but it can really help. Therapist, licensed social worker, and owner of Bright Spot Counseling Ginger Houghton says, “An increase of around 30 minutes of sleep for several nights in a row can help reduce daytime sleepiness, fatigue, and tension. If you can inch closer to an hour of additional sleep for a few consistent nights, studies show an increase in attention span and improved performance and response times. Additionally, people who are getting the right amount of sleep are also less prone to moodiness, binge-eating, and accidents.” When it comes to self-improvement, you can’t rush perfection.

This article originally appeared on Brit + Co.

How To Let Go Of Resentment – Without Giving Anyone A “Pass”

Author Article
You’ve probably heard the adage that holding onto resentment is like drinking poison and expecting other person to die—it’s one of the most meme-able quotes in recent memory and has been attributed to everyone from Buddha and Nelson Mandela to Carrie Fisher. (Thanks, internet.)One thing is clear, though, says New York City-based therapist Jennifer Silvershein: Whoever said it was right.

But once you’re in the throes of remembering and rehashing all the sins of the person who done you wrong—and getting re-pissed off about all of it—it’s hard to stop that mental loop. Even if you know it’s poisonous, remembering why you’re so mad feels good because at least it explains the feelings. And you may even get cheered on by others—hey, every hip-hop beef is fueled as much by applause as anger.

But, as difficult as it is to let go of resentment, it can be done, Silvershein says. And you’ll be the happier for it, as soon as you pull focus from the object of your ire (who, in many cases, is blithely unaware of the whole thing, anyway).

“So often we’re holding onto a negative feeling about someone and they have absolutely no idea. So when we’re spending our time reflecting on whatever bothered us the other person is living their life absolutely unaware,” Silvershein says.

So, how do you actually put the poison down, and stop drinking from it? Here are her 3 pieces of advice.

How to let go of resentmentPIN IT
Photo: Stocksy/Studio Firma

Talk it out—or just let it go

“I recommend to my clients that they should attempt to find resolution when holding onto resentment. So whether that is having a conversation with the individual who hurt or bothered them oradjusting their behaviors [in terms of expectations], either way, at least we are discussing or changing how we’re going about things,” Silvershein says. If you do reach out to the person you feel resentment toward, she suggests talking about what happened, how you’re feeling, and what you’re having difficulty getting over.

Adjust your expectations

“So often we realize that a person doesn’t live up to our expectations and every time they repeat the behavior that disappoints us we use it as evidence that the person is bad or rude,” Silvershein says. “Rather than waiting around for them to do the same behavior that bothers you, instead begin expecting what the individual has historically done and hopefully this will allow the annoyance to dissipate.”

Reflect on your own

This doesn’t have to mean you do it in solitude—but find a friendly ear or another outlet for your thoughts, besides the person who’s triggering your anger and resentment.

“I encourage clients to speak about, journal, and meditate on resentments as well,” Silvershein says. “So often when we can talk through the feelings, reflect through journaling, or begin doing three-minute meditations (my favorite is Headspace), we’re also able to give ourselves the time to heal and process rather than silently suffering.”



9 Unexpected Things That Are Good For Your Mental Health

Author Article

There are so many conventional ways to improve your mental health, such as eating healthy foods, exercising regularly, and seeing a therapist — among other important things. But it never hurts to add in a few habits that are “outside the box,” as a way to take your mental health in an even more positive direction.

“If we are only doing the same things we usually do, with the same point of view, it’s harder to emerge out of depression or release anxiety,” therapist Rev. Connie L. Habash MA, LMFT, tells Bustle. “Sometimes, the best thing to create positive shifts in our mood is to get out of our ingrained habits and try new things.”

That’s not to say you should stop what you’re already doing, especially if it’s working, or if it’s part of a plan designed by your therapist. But you might want to consider adding to your overall mental health routine, in a few small ways. This might include trying new foods, getting dirty, or doing something unconventional, such as jumping on your bed.

“These kind of practices help us step out of the mold, have new experiences, and change our mindset,” Habash says. Anything that’s fun, new, or even slightly uncomfortable, like the things listed below, can be a great supplement to your daily life. And experts say it can even be good for your mental health.

Jump On The Bed

Ashley Batz/Bustle

“Many of us have lost connection with the playful part of ourselves,” Habash says. “We all have an inner child that wants to be silly and spontaneous.” So ask yourself, when was the last time you jumped on the bed?

In some small way, doing fun things like this can help break you out of your usual routine, since you’ll be shaking off your stressful adult life for a while. You can also try riding a bike, playing a game in the park, drawing — the list is endless.

“This is how we access joy,” Habash says. “It’s almost certain to lift your mood.”

Give Your Bathroom A Thorough Scrub

Serhii Krot/Shutterstock

When you’re feeling anxious or stressed, sometimes nothing’s more relaxing than getting down on your hands and knees, and scrubbing around the toilet.

“The bathroom is a small and contained space, so it’s not an overwhelming room to clean and the benefits are amazing,” therapist Rachel Wright, MA, LMFT, tells Bustle. “Yes, it’s gross to clean toilets sometimes and yes, you will be amazed at the grime that comes off of the bottom of your sink or the shelves in your bathroom, but the feeling of completing it and the feeling of seeing a clean bathroom will help with your mental health and your mood.”

Apply A Mud Mask


If you have a go-to skincare routine, it may be beneficial to try something new — and possibly even add in some mud — in order to reap a few benefits.

“Applying a mud treatment on your skin certainly improves your mental health,” licensed psychotherapist Adamaris Mendoza, LPC, MA, tells Bustle. “It relieves muscle and joint aches and pains, helps […] improve circulation, relaxes you, and relieves stress.”

Applying a mud mask at home can be super relaxing, as can simply soaking in a hot bath — especially if you’ve been feeling sore, stressed, or depressed. As Mendoza says, “When your body is operating efficiently you feel good and your mood is enhanced.” And taking time for self-care doesn’t hurt, either.

Eat Something New


Everyone’s different when it comes to how they feel about trying new foods. “The texture of some foods can be off- putting,” Mendoza says, “but [many are] packed with amazing benefits.”

Take mussels and oysters, for example. “Mussels contain a high level of vitamin B-12, which has been found to positively affect mood and other brain functions,” she says. “Oysters are high in zinc, a nutrient that helps ease anxiety and also improve sleep the quality of your sleep.”

But even the act of trying a new food, whether it has a weird texture or not, can be beneficial. “Waking up our taste buds to foods we don’t normally eat can be invigorating to our senses and help us out of [a rut],” therapist Shannon Thomas, LCSW, tells Bustle.

Sing In Public

Hannah Burton/Bustle

If the idea of singing in public terrifies you, then it may be exactly what you need to do. “It may sound counterintuitive, but singing in public is one way for people whostruggle with social anxiety to work on feeling more relaxed around others,” Matt Smith, licensed therapist at Modern Era Counseling, tells Bustle. “This is basically aform of exposure therapy, so the more embarrassing the song the better.”

You can start off by humming, just to get a feel for it. Then work up to bigger songs as your confidence grows. “Singing in public forces you to confront your specific fear — others judging you, public humiliation, etc. — and in the process retrains your brain to stop firing up its built-in fear response in the absence of actual danger,” Smith says. Over time, you might even start to think it’s fun.

Hold A Big Rock


While it might sound strange, holding something natural in your hands — like a rock — can be quite relaxing. “When you’re feeling anxious, agitated, like you’re spinning around and overloaded with stress, you probably need to get grounded,” Habash says. “A great way to do this is to find a large river rock, or any kind of sizable stone.”

Maybe you pick one up on a hike, or find one in the local park. “Hold it in your hands or lap, and feel its weight,” she says. “Let all the stresses and agitation be pulled down into the earth and release them. You, as the solid and steady rock, remain more calm and peaceful.”

Scream Into A Pillow

Andrew Zaeh for Bustle

If you’ve been bottling up your emotions, there’s a good chance you’ll find it quite therapeutic to scream into a pillow.

“Being able to express that pent up emotion is important in working through it,” Jovica Grey, licensed mental health counselor and founder of Grey’s Counseling Services, tells Bustle. “Screaming into a pillow helps to release that pent up emotion by allowing [you] to express it in a less harmful way.”

Of course, it’s also OK to share those emotions with others, or vent it all to a therapist. But sometimes you just need a moment alone, and that’s when a pillow scream can come in handy.

Skip Your Shower

Andrew Zaeh for Bustle

If you have a strict morning routine that includes taking a shower, try skipping it one day as a way of changing things up — just see how it feels.

“Sometimes not going through the motions of our normal hygiene routine can be helpful to our mental health,” Thomas says.

It’s all about allowing yourself the freedom to do something different, which can give you a break from your everyday routine. And that, Thomas says, can be good for your mental health.

Sweat It Out

Andrew Zaeh for Bustle

Sweating is a great way to boost your overall wellbeing, whether it’s by exercising, going outside on a warm day, or sitting in a sauna. Saunas, for instance, may leave you drenched in sweat. But the benefits are pretty amazing.

As Wright says, saunas have been shown to help with sleep, anger management, and even depression. So if you can track one down — possibly at a gym or spa — it may be worth it.

“Even if you’re in therapy, these things can supplement the work you’re doing because their more action-oriented,” Wright says. “Plus, some people just like to do things outside of the box.”

If you find that any of these tips boost your mood, or help improve your overall mental health, don’t be ashamed to do them more often — however odd they may seem.

Secrets, Shame & Mental Health

Author Article

An interesting study published in the journal Emotion this month examines different types of secrets and how we feel about them. In particular, the researchers concentrated on secrets based on feeling shame as well as those rooted in guilt.

Michael Slepian, PhD, of Columbia University was the lead author of the study and clarified the differencebetween shame and guilt, the two most studied self-conscious emotions. While basic emotions such as anger and fear refer to something outside of oneself, guilt and shame focus directly on the self.

Feelings that correlate with shame about a secret include feeling worthless, small and/or powerless. Guilt, on the other hand, stirs up feelings of remorse, tension or regret. According to Slepian, secrets about one’s mental health, traumatic experiences or unhappiness with one’s physical appearance tend to evoke shame. Hurting someone, lying to another person or violating someone’s trust induce more guilt.

While almost all of us keep some secrets, we don’t necessarily realize how harmful they can be to our health, well-being, and relationships. What Slepian and his colleagues found is that people who feel shame are more likely to obsess about their secrets than those who feel guilt. Those who feel shame often think about their secrets constantly.

The study involved 1,000 survey participants who were asked a series of questions about secrets they’ve kept, with many of the questions designed to measure shame and guilt. The participants were also asked about the number of times they concealed their secret over the last month. Interestingly, hiding a secret did not seem to relate to either shame or guilt, but rather how often the person interacted with whomever he or she was keeping the secret from.

What I find most concerning (though not surprising) about this study is that secrets about our mental health typically evoke shame. Of course, this is one of the many complicated reasons why those suffering from brain disorders such as obsessive-compulsivedisorder, trichotillomania, eating disorders — to name only a few — do not seek help. They feel shame and they are embarrassed.

In addition to living with the actual symptoms of these disorders, people with mental health issues might also spend their days hiding their illnesses. This only compounds their problems, not to mention how mentally and physically exhausting it can be.

In this article, the author, a therapist, discusses four hidden ways that people try to defend themselves against shame:

  1. Defensiveness
  2. Perfectionism
  3. Apologizing
  4. Procrastination

The article goes on to say that being mindful of the shame we feel is the first step toward acceptance and healing. Hiding shame only gives it more power, so we need to learn how to bring this often-distressing emotion out into the open. A good therapist can help us recognize how our shame manifests itself, and how we can best move past it.

In regards to shame and our mental health, I think the most helpful thing we can all do is to talk about our issues. I realize this is often easier said than done, but I’ve never come across anyone who has regretted taking this path. The more we open up, the more we can reduce the stigma associated with brain disorders — and the less they will be associated with shame.

Can Blaming Others Ever Be Good For Your Mental Health?

Author Article


Many people tend to blame others for their issues. Prime candidates are parents, partners, friends, bosses, and kids. Perhaps these examples sound familiar?

  • “The reason I don’t have a social life is that my husband is an introvert. If he were more outgoing, I could really get out more.”
  • “My kids are so difficult, it is impossible to have people over the house. They just run wild and I wouldn’t be able to enjoy myself.”
  • “If my dad hadn’t cheated on my mom, I would have a healthy view of relationships now and I wouldn’t keep going for these jerks that treat me poorly.”

It is very tempting to blame others for things going wrong in your life, even personal habits you dislike or your own dysfunctional thought patterns.

However, if you rely on blaming others for your own current emotional and mental issues, you are doing yourself a disservice in a multitude of ways. Here’s why blaming others can sabotage your ability to be happy.

1. Blame keeps you in a negative headspace

Focusing on what others are doing “wrong” keeps you in a negative, pessimistic frame of mind. Instead of looking for solutions, you are lingering on problems. Instead of recognizing what people are doing well, you are looking at their flaws.

In the first example above, the woman is blaming her husband for her own lack of a social life, which makes her see him in a fairly negative and uncharitable way. You can see how this would contribute to feelings of depression and marital discord. If she blames her husband openly for his introversion, he likely will feel attacked and attack her back, which will lead to marital issues both short and long term.

2.Blame stops you from looking at your own contribution to issues

As long as others are “the problem,” you don’t have to do the challenging, but ultimately rewarding, work of examining your own behavior. Your thought patterns and expectations influence the things in your life that you wish were different.

For instance, the parent in the second example above could be exploring ways to work with her kids on improving their behavior, or exploring why it may be familiar or easy for her to limit her socializing. As long as she characterizes the kids as the problem, though, she doesn’t need to do any of this deeper introspection, which would likely be very useful in moving her out of this stuck place.

3.Blame keeps you tethered to the past

Instead of looking for ways that you can work on negative behavior patterns, blame allows you to stay mired in the past.

In the last example above, thinking about your dad’s impact on how your relationship functions may be useful. But continuing to actively blame him may prevent you from digging deep into what’s causing your unfulfilling intimate relationships.

It helps to talk through blame

Of course, this in no way means you should ignore or minimize the ways that others impact you. It is extraordinarily useful to discuss your relationships — past and present — with a therapist, or to introspect about them on your own.

However, it is essential to move from a “blame” stance to an “understanding” stance, which can give you the mental and emotional space you need to get out of old patterns and move forward in more flexible and liberating ways.

This article originally appeared on Talkspace.

4 Mental-Health Journaling Prompts For The Reflective Soul Who Doesn’t Know Where To Start

Author Article

There’s something so inexplicably satisfying about cracking open a brand-new journal. It’s a blank canvas on which you can record your thoughts, your worries, your dreams, and so much more. But beyond simply being a place to chronicle the events of your life and everything you feel about those goings-on, journaling is a great way to nourish your mental health. I may be going out on a limb here, but I’d venture to say that you’d be hard-pressed to find a mental-health professional who wouldn’t recommend journaling as a tool for general healing, coping with depression, and reducing anxiety.

Still, journaling can seem like a daunting task—especially if you’re not in the habit of writing about your feelings regularly. The good news? According to New York–based holistic psychotherapist Alison Stone, LCSW, there’s no such thing as a right or a wrong way to journal—and there’s not a specific amount you have to do it, either.

“For some people, it might be daily, while for others it might be weekly,” Stone says. “Experiment with not only what gives you the most benefit, but what is realistic for you to commit to on a regular basis.”

“Journaling is great for enhancing self-awareness through helping us detect and track patterns of behavior, thoughts, and feelings.” —Alison Stone, LCSW

In other words, if you want to let your thoughts flow freely every day for an hour, great. If it feels more natural to you to express yourself with a combination of words and pictures, bullet-journal-style, once a week, that’s great, too. Maybe you’re all about going out and buying a gorgeous journal that you feel excited to open all the time. Or maybe the thought of writing your feelings by hand is exhausting to you, and you’d prefer to dump them all in a Google Doc. Great, all-around, because, as is the case with so many things in life, the best thing you can do is listen to your own specific wants and needs to do what is authentically best for you.

And, no matter how or how often you choose to journal, there’s no question that it’s great for mental health. Below are a few of the heavy-hitting reasons why.

1. Journaling enhances self-awareness

Sometimes, it can be hard to pinpoint why we do, think, or feel certain ways about certain things. When you start journaling regularly, all of these things become a lot clearer. “Journaling is great for enhancing self-awareness through helping us detect and track patterns of behavior, thoughts, and feelings,” Stone explains.

For example, say you’re a single person (who doesn’t want to be single) whose anxiety spikes at night when you just happen to be scrolling mindlessly through Instagram, double-tapping photos of happy couples. In this case, a regular journaling habit may help you identify a pattern and lead you to change your behavior around Instagram.

2. Journaling can help alleviate stress

By simply jotting things down on paper, whether it’s feelings of anxiety and stress around a specific situation or just getting out the events of the day, journaling can help you get your thoughts and feelings out of your head. This simple act can make it easier to stop obsessing. “Doing this can help get rid of stress, clarify goals, and reduce symptoms of anxiety,” Stone says.

3. Journaling helps cultivate gratitude

Research has shown that gratitude can do quite a bit for our brains, happiness, and overall mental health. And according to Stone, journaling regularly is an effective means for identifying the things you’re grateful for. “This is an excellent benefit to journaling, because gratitude is a crucial part of overall mental health.”

If gratitude doesn’t flow out of you naturally during your day-to-day journaling habit, no big deal. Hey, a journal full of complaints and stressors is still helpful for identifying the things in your life that aren’t serving you—and that’s certainly productive. Still, try setting aside a few minutes of your journaling time to list out the things you’re grateful for.

Need a few prompts to get started on your healing journaling journey? Here are four that just may do wonders for your mental health.

If you’re anxious…

Anxiety is very, very prevalent in the United States. In fact, the condition impacts a whopping 40 million adults, according to the Anxiety and Depression Association of America. While there are a number of effective ways to treat your anxiety, journaling is a great one to start with. In this case, here are two journaling prompts Stone suggests trying:

“When I’m feeling acutely anxious, three strategies I know work for me are…”


“One example of how I successfully navigated my anxiety in a stressful situation in the past is…”

If you’re struggling with depression…

When you’re in the throes of depression, journaling just may be the last activity you’re jonesing to see out. Sure, zonking out with Netflix buzzing in the background or sleeping the day away may sound more appealing. But if you do have it in you to crack open your journal, doing so can help quite a bit. Here are the two prompts Stone suggests starting with:

“Even though I feel down, two to three things I feel thankful for are…”


“One reasonable goal I have for myself this week is…”

So there you have it: Journaling can be a supplemental tool to help you along on your mental-health journey—so get started today. But if you haven’t already, do first seek the help of a professional to devise a personalized plan to treat your condition.

Journaling call also help you crush your fitness goals, and plan dreamy vacations.

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