Psychology Today Blogs - Crisis Center

Holiday Stress: How to Manage It

John A. Call, Ph.D., J.D., A.B.P.P. — Wed, 03 Dec 2008 08:17:08 -0800

The holidays are a great time to relax and spend time with family and friends, but many people find themselves being stressed out during this time. "How am I going to afford that gift?" "How am I going to make it through holiday dinner with bitter Aunt Alma?" "It just won't be the same this year without Grandma here." There are many sources of stress for people during the holiday season, especially with respect to family and money. Recent research suggests that women are more vulnerable to holiday stress, and they may be less likely to take the necessary steps to manage it.

There are several ways to help manage stress during the holidays. Here are a few:

*Find out what stresses you out. Is it a certain situation, a particular person, or that long list of things to do? Realizing what gives you stress is the first step to managing it.

*Find out how you deal with stress personally. Does stress give you a headache? Do you get moody with family members? Do you find yourself needing a drink to get through the day? Recognizing how you handle stress can help you determine if your coping style is an effective one.

*If you determine that your stress management behaviors are not healthy ones, try changing one at a time. Don't be too hard on yourself if you still feel irritated at your loved ones or you still feel that craving to have a drink. It takes time and effort to change!

*Remember to take good care of yourself during stressful times. Try to eat healthy, get out and exercise a bit, and get enough sleep. These things will keep your body healthy, which will cut down on stress.

*Go to your family and friends for support when you need it. Talking to your loved ones during hard times will help decrease the stress on your mind. And if you find yourself needing professional help, don't hesitate to seek out a mental health professional who can help you manage your stress in a more healthy way. Sometimes people benefit from a little help when learning how to handle stress effectively.

Good luck and enjoy the holidays!

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How to Become a Happier Person: Is There a Way?

John A. Call, Ph.D., J.D., A.B.P.P. — Sat, 15 Nov 2008 17:34:38 -0800

Happiness: everyone wants it and most people can't get enough of it. Is there a way to become happier than you are now? Some research indicates that the saying "Think happy thoughts" is the way to go if you are looking for a way to increase your level of happiness. One study found that people who thought about positive events in their own lives for just eight minutes per day for three days felt better about their lives a month later. Their satisfaction with their own lives increased significantly by simply thinking about happy life events. So is that all we have to do? Just think about the day you got married, or the time when your kids were young, or your 16th birthday party when all your friends were there?

Sounds easy enough, but some people believe that there is a "set point" for happiness. A set point is the particular point at which a person tends to stay. Many people believe there is a set point for weight, and it's also been said that there's a set point for hair. Many people find that when they try to lose or gain a significant amount of weight, they usually gravitate back to their "normal" weight. Likewise, a person who usually sports long hair with bangs may cut their hair short, but they will eventually find their way back to that "long hair with bangs" look.

So is your grouchy boss destined to stay grouchy forever? The good news is that people can change their set points if they really work at it. A person who wants to lose a lot of weight and keep it off usually has to change their way of life to do so. They may need to start eating more vegetables and less McDonald's on a regular basis to be able to keep the weight off. In the same way, if you want to become happier, you have to be able to put effort into it. I'm not sure if simply thinking happy thoughts for a few minutes a day will make you happier, but it definitely won't work if you only do it for a few days. If you really want to change your life and make yourself happier, make a plan and stick to it! Take a few minutes every day to reflect on happy times, or take up a new hobby you know you can keep, or decide to go out with good friends once a week. But whatever you do, decide it's worth the effort to stick to your plan of becoming a happier person.

The Truth About Depression

John A. Call, Ph.D., J.D., A.B.P.P. — Fri, 07 Nov 2008 08:39:23 -0800

Depression is a disorder in which a person has thoughts of extreme sadness, hopelessness, and/or despair, and these feelings usually interfere with daily life, such as working, eating, or sleeping. These symptoms must persist for at least two weeks to meet the diagnosis for depression. The causes of depression are varied and range from negative life events to biological factors. Depression can also come about simply from the way a person thinks.

So what are the treatments for depression? Well, if you watch TV at all, you have seen that we now have many different medications for depression. Of course, there's a pill for everything nowadays, and it is my opinion that we have become a ‘pill-popping' society. The truth about medications for depression, though, is that they will not make you happy. They will only make you less sad, and that's only for some people. For people suffering from extreme depression, such as those who are considering suicide, medication may be necessary to correct a hormonal imbalance in the brain. But for many others who are just trying to get through the day, medication may not be the best answer.

Psychotherapy offers a wide range of different types of therapy, from cognitive-behavioral (for those who may benefit from changing the way they think) to family therapy, for those people whose problems involve other people in their support system. There are many treatments that have been "empirically validated," which means they have been researched and found to work for certain populations. Another aspect of therapy that is highly overlooked these days is the therapeutic relationship. How many people simply need someone to talk to who will accept them as they are? A lot of people need this, especially depressed people. A licensed mental health care professional, such as a psychologist or counselor, can help people identify the problem areas in life and work towards repairing those areas.

One thing to remember if you are depressed is that you have options! You don't have to suffer through depression alone, and you don't have to take the pills a doctor throws at you either. The best thing to do is to find a competent professional who will work with you and let you know what options you have for dealing with depression. The same treatment doesn't work for everyone. A personalized plan of action for battling depression could really make the difference in your life. And remember, if one thing doesn't work, there are a lot of other options out there to try.

A controversial treatment for PTSD: Exposure therapy

John A. Call, Ph.D., J.D., A.B.P.P. — Sat, 25 Oct 2008 14:26:03 -0700

Posttraumatic stress disorder (PTSD) is an anxiety disorder that sometimes occurs in victims of trauma, such as those in military combat or severe traffic accidents. This disorder is very distressing to those who experience it, with symptoms ranging from nightmares and flashbacks of the traumatic event to irritability, withdrawal, and insomnia. War veterans are at a much higher risk of developing PTSD than the normal population, because of the prolonged exposure to traumatic scenes and events.

After World War I, many veterans returned home and were labeled as having "shell shock." This layman's term is basically a different name for PTSD, except that it only occurs in veterans of war. Increasing numbers of veterans are being diagnosed with PTSD nowadays, and there are also high numbers of rape victims and refugees who are being diagnosed with it as well. Obviously, this is a big problem in America and worldwide, but the good news is that there are several treatments for the disorder.

One rather controversial treatment for PTSD is called exposure therapy, or in vivo exposure. This treatment aims to reduce anxiety and other disturbing symptoms of PTSD by "flooding" the victim with thoughts of the traumatic event in a controlled setting. If it sounds like it would be scary, it probably is. Many people with this disorder try to avoid thoughts of the event as much as possible. Exposure therapy encourages people to face their fears while in the company of a trained professional. Psychologists and counselors usually have the victim picture the event in great detail, while simultaneously training him or her to relax. After some time, the traumatic event is less disturbing to the individual because they have learned to relax while thinking about it. Reportedly, many people have been greatly helped through exposure therapy.

But if this sounds too good to be true, it may be. Some studies herald this treatment as being one of the most effective for victims of PTSD, while other studies indicate that there is no evidence that it works at all. Still other studies list exposure therapy with treatments that may cause psychological harm. Like many other topics in psychology and science in general, we just don't know yet whether this treatment is a good thing or not. The best bet for a victim of PTSD searching for effective treatments is to talk to a mental health professional who can help you choose the best treatment for your situation and personality.

Posttraumatic Disorder--Temporary or Permanent?

John A. Call, Ph.D., J.D., A.B.P.P. — Fri, 03 Oct 2008 13:19:37 -0700

Posttraumatic stress disorder (PTSD) is a disorder that may develop after a person is exposed to a traumatic event, such as an assault, rape, car accident, terrorist attack, natural disaster, or military combat. These are the most common situations that lead to PTSD, but any life-threatening situation can lead to the disorder as well. Statistics say that about 8% of adults in the US will experience PTSD during their lifetime, and women are about twice as likely to struggle with it.

So what is PTSD? The disorder usually consists of flashbacks of the traumatic event, avoidance of reminders of the event (such as avoiding conversations about it), detachment or withdrawal from their surroundings, and some somatic complaints. Other symptoms, such as insomnia, hypervigilance (being on alert constantly), and increased fears, can accompany the disorder.

Obviously, this disorder is incredibly distressing to those who experience it. And some research seems to indicate that there is no "cure" for it--that PTSD never really goes away. But the good news is that there are several treatments that have been shown to decrease the symptoms of PTSD and improve the lives of its victims. Cognitive-behavioral therapy (CBT) is one treatment that has been very effective in reducing the symptoms. This form of therapy helps people to manage their fears and anxiety that stem from the traumatic event. Other therapies that are being used to treat PTSD include relaxation therapy, in vivo exposure therapy (which helps people re-experience the event while remaining calm), cognitive restructuring (which helps people restructure their thoughts to be more calm and positive), and psychoeducation (which helps people understand PTSD and its effects).

The best thing that people suffering from PTSD can do is to seek treatment. Even though the most natural response of these people is to try to forget what happened, being able to do that is highly unlikely. Those who try to avoid treatment for the disorder often develop substance abuse problems, sleep problems, and difficulties in their relationships. Seeking treatment through therapy is often very beneficial, and there are many competent professionals who are trained to help victims of traumatic events. The mental health community has created several groups and treatment centers specifically for victims of PTSD, and these include the Disaster Response Network of the APA, the National Center on Disaster Psychology and Terrorism, and the Disaster Mental Health Institute. In particular the National Center for PTSD website had a great deal of information on this disorder. You can find it here.

Multitasking--Efficient or a Waste of Time?

John A. Call, Ph.D., J.D., A.B.P.P. — Fri, 26 Sep 2008 07:56:20 -0700

We've all done it. Making breakfast while checking email. Paying bills while having a serious conversation with your significant other. And the most infamous one: driving while talking on a cell phone. It saves time, right? Getting two things done at once is better than just getting one thing done. Or is it?

Research shows that multitasking takes a toll on your mental energy, especially if the tasks are difficult ones. Apparently, the human brain is not designed to be able to do two or more things at once. A study showed that people are much slower when switching between tasks than they are when repeating the same task. Even when given more time between tasks, people were not as efficient when task-switching as when task-repeating. The brain can adjust to a new task, but the old task is still competing for mental energy with the new task. For example, driving while talking on a cell phone can get difficult when someone cuts you off in traffic. If you were mostly focused on your phone conversation, you would have to switch tasks to slam on the brakes. Switching back to the conversation after regaining your driving composure can be difficult - "What was he talking about??"

Multitasking involves two distinct stages: one is goal shifting and the other is rule activation. Goal shifting consists of deciding to focus on another task than the one you are currently focused on. Rule activation consists of turning off the "rules" for one task and turning on the "rules" for another. Going back to our driving example, not only would you have to consciously decide to return to the conversation after the traffic incident, but you would also have to think, "Ok, now that I can return to the gas pedal, I need to concentrate on what my friend was saying and answer him back." Navigating these two stages within your brain can actually take up as much as 40% of your productive time.

So what does all this mean in terms of daily life? Understanding that multitasking can put a serious strain on your mental energy can make a difference in your life. Instead of trying to cram everything into 5 minutes, take your time and do only one thing at a time. It may actually save you time and energy!

Common Reactions to Disasters and Ways to Cope with Them

John A. Call, Ph.D., J.D., A.B.P.P. — Wed, 17 Sep 2008 10:33:47 -0700

On September 1, Labor Day, as a member of the Oklahoma Medical Reserve Corps, I spent the day working with about 2,000 Louisianans who had just been bused to Oklahoma City to shelter from Hurricane Gustav. They were sheltering in a huge unused warehouse-the Lucent Technology Center in southwest Oklahoma City. By far the majority of our "guests" were a stalwart group. In particular I met and talked with a man, about my own age (older rather than younger), who worked as a maintenance man in the courthouse complex in New Orleans. We started the conversation with him teaching me the best way to eat MREs (meals ready to eat)-which menus were the best, how to mix the gravy with the meat, and the best way to open the cheese packets. He had been through Katrina and decided that had been enough; so when the mayor of New Orleans had urged people to evacuate he took him up on it. Even though my new friend was coping I saw that he was also unhappy. Who wouldn't be given his situation? Disasters are an all too common experience nowadays.

You know, natural disasters such as hurricanes can have a huge impact on those who survive them. People usually have strong emotional reactions to these situations. Common responses immediately following the event are denial and shock. Feeling overwhelmed or numb is also common. In the weeks and months following the disaster, people may begin to have varied reactions. All of the following are common reactions to trauma, but everyone is different, so remember to take that into consideration when evaluating yours or a friend's emotional reactions.

*Feelings may become intense, even to the point of having mood swings. Some people become irritable or overly emotional. Feelings such as anxiety and guilt have been reported in many people in the wake of a disaster.

*Behaviors and thoughts are expected to be affected by the disaster. Many people have recurring vivid memories of the disaster, known as flashbacks. Sometimes flashbacks are triggered by images or sounds that bring back memories of the event. Some people have difficulty concentrating, eating, and sleeping.

*Relationships with friends and family may become strained as the survivor goes through this cycle of intense emotions. Some people experience more conflict with loved ones, while others tend to become withdrawn and quiet when around friends and family.

*It is becoming increasingly common for people to experience physical symptoms in response to stress or trauma. Headaches, stomach aches, and rapid heartbeat can take the place of strong emotions about the event or can accompany a person's emotions.

Now that you know about these reactions, you may be thinking, "Ok, how can I cope with all this?" There are several ways to help yourself or a loved one heal emotionally after a disaster. First of all, be patient. Give yourself time to experience these emotions and expect that things will not go back to normal overnight. Let yourself experience emotions and try to deal with them as they come. If you feel like you are alone in this, ask for support from your family and friends or try to find support groups of people who have experienced the same thing. Talking with others about your traumatic experience can help lift a heavy burden. In addition to communicating your experience to others, try to get into a daily routine. People need to experience some sort of stability after trauma, and routines can help to establish stability in your life. Try to get plenty of sleep and remember to eat healthy. Taking care of your body will ease the stress on your mind. If you try these things and still don't experience any relief, remember that contacting a psychologist or counselor for extra support can be very helpful for those who have experienced a traumatic event. And, finally, remember that when opening the cheese packet in an MRE don't open the whole packet, just tear off one corner--that way it's easier to spread the cheese on your MRE crackers.

What to Do Immediately After a Disaster

John A. Call, Ph.D., J.D., A.B.P.P. — Fri, 12 Sep 2008 09:35:07 -0700

The topic of disasters is not one people like to think about, but we all need to be prepared to deal with the aftermath of a disaster if ever caught in that situation. There are several things you can do to help restore peace to yourself and your family immediately after a disaster. First and foremost, deal with any physical injuries you or your loved ones may have. Restoring physical health will aid in restoring your mental health as well.

After taking care of your immediate physical needs, make a plan for you and your family. Where will you sleep tonight? Do you have relatives or good friends that have not been affected by the disaster? Ask them for help. If you don't have anyone you can call to help you, locate the nearest emergency shelter. They can help. After making sure you have somewhere to stay for the next few days, take a deep breath. Realizing all that has happened after a disaster can be very overwhelming. You may want to talk with someone about your feelings and thoughts of the disaster.

In addition to trying to slow things down and take in all that has happened, there are a few things you can do to help cope with the disaster. Limit your exposure to the news media, such as TV and radio, since there will inevitably be extended coverage of the disaster. Try to rest and drink water to restore your health. Accept the help that others may offer you: you need it. Try spending as much time with your loved ones as possible and engaging in things that you all enjoy. Keep in touch with your friends and family in order to maintain your support systems. Last but not least, try to get into a routine for eating and sleeping: this will help give a sense of normalcy to a difficult situation.

The Role of a Psychologist at a Disaster Site

John A. Call, Ph.D., J.D., A.B.P.P. — Tue, 26 Aug 2008 07:31:03 -0700

When a disaster happens, disaster sites are set up to assist people with their immediate needs. Psychologists go to these sites to assist people with their emotional needs-to provide Psychological First Aid. They provide help by talking to people and answering questions they may have about their situation. They may also help people understand their emotions and reassure them that their emotions are normal.

Specifically, what do psychologists do when they offer support at a disaster site? Here are a few duties they may fulfill:

*Listen! It's what psychologists do best, and it's one thing that people really need after being in a disaster: someone to listen to them. Psychologists listen as people talk about their experience and their concerns for the future. They may even listen as people talk about concerns outside the realm of the disaster, such as the recent death of a loved one or the loss of a job. The combination of a disaster and another major life stressor can be especially hard for people to handle.

*Help people in dealing with their immediate living conditions. Psychologists may help people get used to living in a shelter for the present time and they may provide information about other places to go to get food, clothes, and medical care. They may provide direct assistance in helping people meet their physical needs.

*Help people develop resilience. Psychologists may use relaxation techniques or just talk to people and help them cope with their situation. They may educate people on the normal reactions to disasters and help people understand their own reactions. They also may help people solve conflicts within themselves or with others at the disaster site.

*Psychologists may help people develop a recovery plan for themselves and their families. A recovery plan may include developing a new support system or reaching out to a current support system, and making plans for where people are going to live, work, and where children are going to go to school.

*Psychologists may work with children to help them cope with what's going on. Since children may have very different reactions than adults, psychologists can help them manage their stress and determine if they need professional help in the long run.

*Lastly, psychologists provide the necessary information for seeking long-term psychological assistance after the disaster is over if and when people need it.

Does one have to be a licensed mental health professional to provide psychological first aid? Absolutely not! Interested individuals can obtain training in Psychological First Aid from the American Red Cross or from their local Medical Reserve Corp to name just two organizations who provide such training. Then you will be able to deploy with your Voluntary Organization Active in Disaster (VOAD) of choice as a mental health volunteer. To obtain an overview of just what is Psychological First Aid download the Field Operation Guide from the National Center for PTSD. You can find it here.

Stressed? Write About It!

John A. Call, Ph.D., J.D., A.B.P.P. — Sun, 17 Aug 2008 14:11:41 -0700

In this crazy world of fast food, fast driving, and fast living, people are constantly looking for ways to decrease their stress level. Tools such as relaxation training, exercise, yoga, and therapy have all been proven to help people reduce stress. But there's another way to beat stress, and it may be as easy as obtaining a pencil, a pad of paper, and 30 minutes of free time.

A 1988 study found that disclosing information about traumatic things that have happened to people was actually good for them. When 50 college students were asked to write for four days in a row either about superficial things or traumatic experiences they'd had, the students who wrote about their trauma had fewer illnesses and more positive moods six weeks down the line. Another study in 1994 with people who had just lost their jobs found that those who wrote about losing their jobs for five days in a row found new jobs more quickly than those who wrote about what they were going to do that day. In an attempt to reproduce these findings in medical patients in 1999, a study was done on asthma patients and rheumatoid arthritis patients. These patients either wrote about the most stressful event in their lives, or wrote about a more neutral topic. Four months after the writing took place, 47% of the patients who wrote about their stress showed clinical improvement, as opposed to only 24% for the patients who wrote about something neutral.

It appears that writing about your troubles can have an improvement on your health, both mentally and physically. But this phenomenon may not be confined to writing. A study with Holocaust survivors asked the survivors to talk about their experiences in the Holocaust. Those who disclosed more information more fully were found to be significantly healthier than those who disclosed less information when examined a year after the interviews.

So how does writing about stress or talking to others about trauma help a person? It may be that sharing experiences, especially the negative or hurtful ones, with someone else is therapeutic for people. In fact, many psychologists assign "homework" for their patients in the form of writing about their thoughts or feelings. Whatever the reason, it seems that writing or otherwise disclosing your experiences and feelings can help improve your mental and physical health. So, pick up a blank journal and start writing!