Author: Lisa Fernandez

4 Tools to Manage Panic Attacks

Panic attacks are best managed by having a concrete set of steps to follow that you’ve figured out beforehand. When you can identify the triggers and notice the warning signs, you can ground yourself more effectively and won’t be thrown off course as much. In a calm moment, think about what internal changes signal that you are feeling panicked and write these down.  Increased heart-rate, shortness of breath, perspiration, knot in the stomach are common signs that anxiety is rising.

Next, create a list of the following tools and put it on your phone, computer or post-its so you can easily refer to it.

  1. Breathing exercises: Alternate nostril yoga breathing calms you down quickly. Put your index finger on your right nostril: breathe in and out of your left nostril. Now switch and breathe in and out of your right nostril. Do this on both sides until you start to settle down. It might be as many as 10-20 times.
  2. Make a playlist of songs that you love, soothe you or just make you smile. Give the playlist a fun title like “Cooling down tunes.”
  3. Change your environment: If you are inside, go to a different room or step outside. Notice what’s happening around you as you are inhaling in for 4 counts and exhaling for 4 counts. 
  4. Go to the bathroom and wash your face and hands. Tell yourself something encouraging such as: “You’ve got this.” “This has happened before and you’ve survived.” “It’s just your fears trying to run the show. Slow down so you can calm down.” 

Read More about Anxiety Purchase handout: You Can’t Stop Anxiety. You Change Your Relationship with It

Depression Myths

What people get wrong about depression:

  1. You could make it go away if you tried harder.
  2. An incident must have happened to make you depressed. Otherwise you wouldn’t be sad.
  3. If you practiced more gratitude, you’d feel better.
  4. Anxiety and depression are unrelated.

Depression is not a matter of will. People who are depressed would strongly prefer not to feel this way. Depression is usually a combination of several factors: biological, environmental and psychological. People may be biologically pre-disposed (it runs in their family) or their brains lack sufficient neurotransmitters (Serotonin, Dopamine, Norepinephrine) to help them regulate their mood. They may have persistent stressors in their lives which don’t resolve (poverty, trauma, unhappy home or work situations). They may suffer from low self-esteem and lack confidence. While a single event can lead to feeling depressed (loss of a loved one, prolonged unemployment, etc), some people simply become depressed without a ‘cause.’

When you’re struggling with depression, you often don’t see any options for yourself and the depression itself prevents you from seeking assistance from others, including therapy or medication. It can be hard to manage daily living, take care of yourself or appreciate anything. Changing your perspective on things would be great but usually it’s out of reach because everything seems difficult and dark. Sure, more gratitude is always a good thing but a depressed person has to start noticing a few positives in their lives first. They’ve lost a sense of agency and getting back is a top priority.

Untreated anxiety has been found to lead to depression. When people feel worried and powerless over time, they can develop an anxious depression.  They’re preoccupied with things that might go wrong or they can’t control and feel discouraged about their alternatives. It can be overwhelming to act on anything.

More Resources: Why do I cry so easily Anxiety and other conditions Handout: Anxiety

Habits that Hurt Mental Health

I see a few major habits in my clients that hurt their mental health more than help them.

  1. Spending too much time on social media: Social media not only seems to suck up time faster than you notice but it also is built to so that people compare themselves to others. These comparisons are rarely favorable and people walk away with not feeling positive about themselves. As one adolescent girl told me, “No one ever posts pictures of their face mid-menstrual break-out or of their bombed test grade.” People feel pressured to keep up with friends, stay in touch and maintain an image that they’ve created. This creates more stress in their lives which interrupts their  ability to reflect on themselves, what they think and create a sturdy sense of self. 
  2. Eating fast food on the run instead of preparing healthy meals and sitting down to eat them: We are so much of what we eat and we eat non-nutritious food quickly, we’re not providing our brains or bodies with the appropriate fuel needed to think and function well. Sharing a meal is not only good for our physiology but it also provides an opportunity to connect with people face-to-face and talk about our lives. During a sit down meal, our bodies slow down and properly digest our food so we can absorb the nutrients and simultaneously take a much-needed break from the chaos of our lives.
  3. Having arguments via texting or emailing: You can’t take an emotional weather report via electronic communication. If you say something difficult or sensitive this way, there’s no way for you see how your words affected the other person or perceive whatever feelings are brewing inside them. It’s easier to disengage and avoid accountability for your words and actions. People need to learn and practice interactional skills not only for healthy personal relationships but also for work and life situations where they have to deal with others. 

Negative Assumptions about Students with Disabilities

Yes, we are all more than our diagnosis, but negative assumptions about students with disabilities run rampant in our culture.

Often kids with learning disabilities are seen as less intelligent or competent by peers or adults.  Sadly, they may begin to believe that they are ‘less than,’ lower their expectations for themselves and isolate from friends. 

The current trend in US education is towards the integration of different types of learners in elementary and secondary school classrooms, not creating homogeneous learning situations. These diverse environments help break down barriers between young people and offer valuable opportunities for them to connect. They reduce the stigma associated with having a learning disability and being seen as ‘different’ in a judgmental light.  A child who may be dyslexic but quick with math will see other students who also juggle their own strengths and weaknesses. Perhaps someone writes well but spells poorly or another student excels at algebra but struggles with geometry. Maybe the kickball game at recess levels the academic playing field and what happens in the classroom is long forgotten with a winning home run. 

In my book, “What your ADHD child wishes you knew: Working together to empower kids for success in school and life,” I interviewed dozens of kids with ADHD who told me, overwhelmingly, that they do not like being singled out because they have ADHD. They consider it a part of who they are—not the whole story—and they are trying their best to figure out how to accept the brains they have and spend time doing what they love. Often, they turn to non-ADHD friends for feedback, guidance and support. One high school senior told me that she really benefits from doing homework with her non-ADHD boyfriend because he notices when she’s spacing out and calls her back to the task at hand. Another boy is grateful to his group of friends who patiently repeat something in a group conversation if he misses it as they all laugh together. These kids want to do well and fit in as much as any teen. 

Inclusion programs provide essential interactions and relationships between kids, replacing feelings of isolation with normalcy. Ultimately what matters is who a person is, not what they can or can’t do. Kids are much more likely to take this perspective when they have natural, unforced contact with each other.

Academic Support for Teens & College Students

School-based interventions improve academic performance and social relationships.

For high school students with ADHD who already run a higher risk for underachievement and dropping out than neurotypical kids, having support services can make all the difference. This recent study also showed that whatever services kids receive in elementary school are often discontinued as they mature. It’s a sad irony I’ve seen too many times: when kids with ADHD have useful scaffolding and are doing better, the services are later withdrawn because of their success. Instead, these interventions need to remain in place to help with the increasing executive functioning demands for independence in middle and high school. When students receive appropriate levels of support during these years, it makes the transition to college or trade school more successful.

For high school and college students who have a diagnosis of ADHD but have never received psychological testing, I highly recommend that you get this because these assessments will identify your cognitive strengths and challenges….. Read More of my advice in Psychology Today.

Anxiety and Food

Q: What foods might spike anxiety … and why?

A: Although I am not a medical doctor, I’ve observed that especially sugary foods or those with a lot of caffeine can increase someone’s agitation and then make them more prone to anxiety. Sometimes ginseng can do this as well. 

Q: Are there foods we should turn to instead to reduce anxiety?

A: I think herbal teas such as chamomile or those with other calming properties can be extremely useful. 

Q: How much should people be eating?

A: Everyone is different, but we should all eat slowly and mindfully! Often when people eat quickly or standing up, their bodies don’t have a chance to metabolize the food and recognized that they are sated Often overeating happens with rushing. u

Q: Are there any links between how much you eat and your anxiety or when you eat and anxiety?

A: Yes, some people eat when they feel anxious; others can’t eat. It’s really an individual response.  

Q: Is all of this true for people with diagnosed anxiety disorder only or just regular folks who sometimes feel anxious?

Whether or not you have an anxiety disorder or ‘just feel anxious sometimes,’ the feeling of anxiety is the same. The difference is one of frequency and intensity. So yes, it’s true for both sets of folks.

Read more advice from Dr. Saline on anxiety Purchase Anxiety Worksheet

Recent College Grads: Adjustments, Parents’ Role, Jobs and Adult Life

What are some of the adjustments that recent college grad kids will be making?

Recent college grads have many adjustments to make. Not only are they saying good-bye to many of their friends, a familiar surrounding and a student lifestyle, but they are also facing the uncertainty of what comes next. Even if someone has a job and an apartment lined up (these are huge things to swing for many recent college grads), they are leaving behind a structure of  going to school and an identity of being a student. Friends disperse, they are responsible for paying their own bills, and self-sufficient adulthood, while longed for, can be overwhelming. Many new college grads aren’t accustomed to creating and living on a budget, shopping for and cooking meals and making plans to spend time with friends instead of bumping into them at the cafeteria. It’s a huge shift in many areas simultaneously. 

How can parents and loved ones can help ease the transition?

It’s important that parents and loved ones acknowledge the enormity of this transition and don’t compare their own experiences with those of their children. Things have changed a lot and many young adults struggle under the burden of huge financial debt, a high cost of living and a tight job market. Staying compassionate, offering to assist them and collaborate on tasks and being available to talk through emotions related to this change is most helpful. Don’t solve issues: offer your suggestions and avoid getting hurt if they aren’t taken. Young adults often like to figure things out for themselves, which means trial-and-error learning. Sometimes the best support you can give is managing your own frustrations, sharing your feelings without blame or guilt and validating their successes. 

What are some tips for applying to jobs, moving home, and how to adapt a healthy routine in adult life?

Having a daily routine offers structure and freedom. It’s critical to set aside a specific period of time for applying to jobs each day so this activity has boundaries. Looking for job can be exciting but it’s also tedious and sometimes deflating. It can spread into all aspects of your life as the list of things you should be doing keeps growing. Avoidance accompanies discouragement and overwhelm. Talk with your son or daughter about marking off a few hours each day (preferably in the morning to get it over with) for job hunting online, responding to emails or dropping off resumes. This will assist them in feeling accomplished each day and competent as well because they’ve done something in a time frame that they laid out. Then they can do whatever they want. Help young adults limit screen time: advocate for doing other things that interest them and make them feel good. Exercise, time with friends, shopping and cooking with you–these are all activities that contribute to healthy living. Teach them how to shop, balance their bank account, make a budget and understand their health/car insurances. These skills are not necessarily second-nature and it’s very common for recent college grads to need extra support in learning them.

Anxiety and Resilience

Anxiety is a physiological response related to a perceived danger and worried, negative thinking. Basic fight or flight responses are triggered from worries and these reactions are usually disproportionate to the concern at hand.

Worry can be productive or poisonous. Productive worry is worry about doing things–completing homework or getting to work on time –and can be helpful in getting things done. Poisonous worry is worry about things you can’t control–the ultimate demise of the planet or whether people like you–and can be debilitating. The first step to dealing effectively with anxiety is to determine which type of worry you are dealing with. Then, engage the thinking brain to slow down the tidal wave of anxiety and emotion volcano by doing two things:

  1. Rely on past experiences of successfully overcoming anxiety and applying those skills to this moment.
  2. Engage in a worse-case scenario by asking “And then what?” repeatedly until you land at the illogical end.

This process works with kids and adults.  I give you more specifics in this Youtube video and in this handout.

Screens, Summer and Sanity

You are the parent! Repeat. Screens are NOT a right! You are the parent! Repeat. Screens are NOT a right, they are to be earned. Write what you will accept, and then work with your child – now, at the start of summer, to collaborate on a plan that you both agree to. Learn more about my screens and summer advice in this Youtube video.

Teens and Summer Jobs

When teenagers get their first job, they’re very excited to make and have their own money. Managing that money, though, is often a bit of challenge. They may have held small jobs like babysitting or dog-walking before, but they don’t know how to use a bank account, write a check and kept track of what they’re spending. Many of them use debit cards without understanding how to monitor what they’re spending and overdraw their accounts quickly. This is especially true for teens with ADHD. It’s critical for parents to help their kids learn about money management and budgets.

I’ve worked with many kids who come to my psychotherapy office and have no idea how to make a simple budget. They don’t know how to total up monthly expenses and subtract them from their paycheck to see how much spending money they actually have or what they can save because no one has shown them. Several young adults have asked me to teach them how to write a check.

I advise newly employed teens to live in a cash world for a while so they can grasp how much money they actually have and see how they spend it. Forget debit cards: instead, once their checks are deposited, tell them to take out the sum that they’ll need for the week. Help them open up both checking and savings accounts so they can start to put away some portion of their earnings for something special in the future. This teaches how to save. Most kids proudly tell me how much money they are saving. It makes them feel like adults and contributes to the autonomy that teens need (and want) to develop. 

Read other family and parenting topics here.