Category: General Psychology

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

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

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. 

It happened again. Tonight when you went to take your daughter’s phone for the evening, she argued with you. Even though, you’ve had this conversation for the millionth time yesterday, she pushed back again today. Exasperated by her lack of recall and self-control and expecting a different outcome, you lost it. The evening ended in a collective meltdown.

 Expectations, whether they’re reasonable or unrealistic, often lead to frustration, disappointment and anger. When you wish your child was acting differently, when you notice that they’re unable to consistently perform a task or when you inadvertently set a goal that they can’t achieve, it’s not only discouraging but also demoralizing. Like Goldilocks and the three bears, it can be tough sometimes to know what task levels are just right for your child’s growing capabilities.

Ideally, you want your child or teen with ADHD to have a variety of tasks in their lives. These include things that they can do easily and independently, some things are challenging that require some adult support and a few things that are reach items. Reach items are tasks or chores that kids can’t do without your help and you’d like them to learn. It’s really important that you assess their abilities in relation to these different levels of tasks so that you can express support rather than judgment. Instead of expressing your frustration with their inability to put their clothes in the hamper today when they did it for the past three days, your goal is to notice their efforting–their attempts to work on a desired goal. Is three days in a row better than one day last week? Neutral expectations–ones in which you expect progress amidst inevitable setbacks–are what matters most. You acknowledge when your daughter clears the table without asking tonight but you don’t expect that this is the new normal immediately until you see it unfolding more often than not. It takes extra time, repetition and cueing for the ADHD brain to learn routines and life skills. Paying attention to the positive helps encode these behaviors more effectively.

Life with a child or teen with ADHD is filled with periods of two steps forward and one step back. Rather that being surprised and disappointed by this pattern, expect the stumbles. Remember that your son or daughter is doing the best they can with the resources available to them in a given moment. If they can’t follow through, it’s because they can’t access the right thing to do right then due to their executive functioning skill challenges. These abilities takes more time, repetition and patience to develop than for neurotypical brains.

By reframing your expectations, not abandoning them, you acknowledge your child’s progress and nurture their self-esteem.

For kids with ADHD, managing intense emotions can be extra tough. In the heat of the moment, it’s hard for any of us to hold it together and act the way we’d like to. Breathing techniques, calming phrases or taking a walk are great options that tend to go out the window when you’re angry, frustrated or afraid. Instead, we yell, cry or say inappropriate things.  When confronted by a tidal wave of big feelings, kids with ADHD especially struggle to access the parts of themselves that know how to make effective, positive choices. Their weaker executive functioning skills aren’t yet developed enough to exert emotional and verbal control and they often can’t recall how they should be responding. Instead of trying to stop these strong emotions or argue with your son or daughter about their irrational reaction, we have to help kids notice and respond to what’s happening inside of them.  Practicing and teaching self-regulation requires acting like the GPS in your car: you neutrally observe that you’re off course, stop going in that direction and  choose a new route. You notice the physiological signs that you are activated (increased heart rate, perspiration, louder voice), you pause (take a deep breath, change your location and consider what’s most important right now) and you re-direct (make a choice that’s different than a typical reaction).  Since most children and teens with ADHD are still cultivating self-awareness, they’ll need your help to detect the signs that a tidal wave is building inside of them. By identifying the pattern of what triggers them and the bodily signs that something is off, you work as a team to reduce their reactivity and decrease their triggers. They’ll feel start to feel a greater sense of self-control and you’ll feel less frustrated with their outbursts.  Follow these steps:

1. In a calm moment, talk with your son or daughter about things that set them off.  What are the bodily responses that signal something is escalating? Usually people have a physical reaction when something bothers them, but they can’t catch their reaction fast enough to make a calmer choice. Share a few ways that you can tell when you are agitated. 
2. What would they like to do differently and how could you assist them? How could you cue them to respond differently without being provocative? Offer a few of your observations of their behavior and some ideas for alternative choices. Make a list of these and post it in a space that you can all refer to for support in a tough moment. 
3. Acknowledge all attempts to follow a suggestion on the list as well as successes. Efforting in this area matters a great deal even if it’s not consistent because practice makes progress. Tell them specific ways that you notice this progress and how you appreciate it. 

When you work together to identify triggers and manage the big feelings that accompany them, you’re helping your child or teen build those critical executive functioning skills of self-regulation and self-awareness. It may seem like one slow step at a time but you’re still moving forward!

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