MENTAL HEALTH AWARENESS MONTH AND DEPRESSIVE SYMPTOMS

May is Mental Health Awareness Month throughout our country. More people are becoming aware of the potential negative effects of anxiety and depression particularly during the pandemic of this last year But isn’t depression rare you say?. Not so.

Estimates are that approximately 8% of people over the age of 12 suffer from moderate to severe depression.  The signs of serious depression are many and include prolonged sadness or irritability, sleep and appetite disturbances, loss of energy, less interest in pleasurable activities, feelings of guilt and worthlessness, and occasionally thoughts of suicide.  Depression is correlated with problematic medical conditions such as post-stroke recovery and diabetes management, among others. Unfortunately, many people attempt to deal with their depression through problematic alcohol or drug use.   Risk for depression is worsened by stressors. We discuss this in detail in our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. For information about the authors, book, and stress, please visit our website at www.manageyourhealthandstress.com. For now, note that between 2 to 4% of workers in the US suffer from depression and up to 50% of workers with depression experience short term disability.  There are significant financial costs to employers. For example, in studies from the University of Michigan Depression Center, the total economic burden of depression in 2000 was $83 billion and the majority of this cost (62% or $52 billion) was due to lost workplace productivity.  It is not uncommon for depressed workers to have poorer on the job performance.   So should we be doing more to screen for depression?  Apparently the medical establishment has decided yes.  The U.S. Preventive Services Task Force has recommended that general physicians/primary care physicians screen all adults for depression and treat those affected by it with antidepressant medication, refer them to psychotherapy, or both.  The Task Force also recommended that all pregnant and postpartum women be screened for signs of depression as well as older adults.  Pregnant women with depression are recommended a range of treatments including cognitive behavior therapy, an evidence based psychotherapy with demonstrated efficacy in treating depression.  This policy is a departure from previous recommendations which only had recommended that physicians look for signs of depression periodically when resources to treat were in place.  The recommendations were published in the Journal of the American Medical Association several years ago. So should you seek out screening for depression?  Occasional sadness or the "blues" are a part of life for most people.  However, if you or a loved one have been suffering from one or more of the symptoms noted earlier, it would be prudent to seek out screening. Your physician healthcare professional is in a position to use several available depression screening tools as well as assess whether any of your physical/medical conditions may be influencing your self-report.  Your professional can refer you to a mental health professional, who may be a psychiatrist, psychologist, social worker, or mental health trained registered nurse.  But do keep in mind that help is available and ranges from medication to cognitive behavior therapy. The treatment of depression has transitioned into the mainstream of American medical care. There is no excuse for failing to diagnose and treat depression.  

You can change your life but you must take action.  Change your thoughts and change your results. If you believe that you or a loved one is suicidal, please call the National Suicide Prevention Hotline at 800-273-8255.

Good luck on your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com.

ARE CONCUSSIONS AND MILD TRAUMATIC BRAIN INJURY ONLY A PROBLEM FOR ATHLETES AND SOLDIERS?

As the month of March begins, we enter Brain Injury Awareness month. Just yesterday I watched a segment on the television program “60 Minutes” detailing last years ballistic missile shelling of an American base in Iraq. In the piece, there were hundreds of brain injuries secondary to blasts. Military personnel documented both physical and emotional consequences of that attack. My theme here and in another post will be on how often the injuries are not obvious, particularly emotional ones. Concussions have become part of the daily news. We continue to hear about the effects of concussion on athletes in various sports.  Many of you may have watched the movie "Concussion" starring actor Will Smith as pioneering pathologist Dr. Bennet Omalu.  It was Dr. Omalu who identified serious brain changes now known as chronic traumatic encephalopathy (CTE) in the late Pittsburgh Steelers football star Mike Webster.  According to the Centers for Disease Control (CDC), 1.6 to 3 million Americans suffer concussions yearly.  The estimated costs of such injuries including medical costs and lost productivity total over $60 billion annually. But how much have these brain injuries become part of daily life?  Why should you care?  Aren't they restricted to athletes or military personnel?  The answer is no.

In a poll by National Public Radio/Truven Health Analytics of 3009 adults in 2016, it turned out that nearly a quarter of people — 23 percent of those surveyed — reported that they had suffered a concussion at some point in their lives. Among those who said they'd had a concussion, more than three-quarters had sought medical treatment.  While a little under half of the concussions came from sports, the rest of the concussions did not.  Have you known anyone who suffered a concussion if not yourself?  I certainly know acquaintances who have suffered a concussion not in a sports context.  

So what is a concussion?  A concussion, also known as a mild traumatic brain injury (TBI), is caused by a bump, blow, or jolt either to the head or the body that causes the brain to move rapidly inside the skull. Loss of consciousness is not necessary for a concussion to occur.  Not all blows or jolts to the head result in a TBI.  A concussion changes how the brain normally functions.  Concussions can have serious and long-term health effects, and even a seemingly mild 'ding' or a bump on the head can be serious.  A concussion is considered a brain injury. The most frequent causes of non-sport related concussions include falls, being struck by blunt objects, and automobile accidents.  

Signs and symptoms of concussion include headache, nausea, fatigue, confusion or memory problems, concentrational problems, sleep disturbances, or mood changes.  Symptoms are typically noticed right after the injury, but some might not be recognized until days or weeks later.  Sometimes, people do not recognize or admit that they are having problems. Others may not understand their problems and how the symptoms they are experiencing are impacting their daily activities.  Having multiple concussions increases the risk of lasting physical, cognitive, behavioral, and emotional consequences.  These all are stressful for patients and their families. For a fuller discussion of stress management issues, please see our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056 . For additional information about the authors and book, please visit our website at www.manageyourhealthandstress.com

The signs and symptoms of a concussion can be difficult to sort out. Early on, problems may be missed by the person with the concussion, family members, or doctors. People may look fine even though they are acting or feeling differently.  Recovery usually occurs over several months but some research indicates that recovery can take significantly longer.  Emotional outcomes such as depression, anxiety, and apathy can take longer to manifest.  I will discuss these in more detail another time.  

In rare cases, a dangerous blood clot may form on your brain if you have a concussion and crowd the brain against the skull. According to the CDC, contact your health care professional or emergency department right away if you have any of the following danger signs after a bump, blow, or jolt to the head or body:

Headache that gets worse and does not go away.
Weakness, numbness or decreased coordination.
Repeated vomiting or nausea.
Slurred speech.

The people checking on you should take you to an emergency department right away if you:

Look very drowsy or cannot be awakened.
Have one pupil (the black part in the middle of the eye) larger than the other.
Have convulsions or seizures.
Cannot recognize people or places.
Are getting more and more confused, restless, or agitated.
Have unusual behavior.
Lose consciousness (a brief loss of consciousness should be taken seriously and the person should be carefully monitored).

My intent is not to alarm.  Most people recover normally following a concussion.  However, as mentioned, recovery times vary and your symptomatology affects both your family and colleagues in a work setting. Do not hesitate to seek out care for yourself or a friend or loved one should you or they suffer a concussive episode.  

As in all events of life, how you view and explain what happens influences how you feel and behave.  Make all your thoughts helpful ones.  Best of luck on your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com

INCREASED STRESS AND ALCOHOL USE IN A PANDEMIC

One business has continued to boom during this current pandemic. No, it’s not toilet paper. No, it’s not bottled water. Yes, it is alcohol consumption. Apparently, Americans continue to stock up on alcohol. In Seattle, Chicago and Boston, sales of wine, beer and liquor saw increases of up to 300 to 500 percent in the first third of 2020. Also,market research firm Nielsen reported off-premises sales of alcoholic beverages across the United States rose 55% in the week ending March 21. Sales increased the most for tequila, gin and premixed cocktails, followed by wine and then beer. So, in times of challenge and stress, it can be attractive to look to alcohol for stress reduction. In a Los Angeles Times article dated 2/8/21 by Eli Cahan titled “Hospitals see rise in alcohol-related illnesses”, the author described numerous negative consequences occurring from alcohol use and abuse in the last year. The author noted increases in alcohol-related hospital admissions for critical diseases such as alcoholic hepatitis and liver failure. Take alcohol-related liver disease as an example. Before the pandemic, there were 15 million persons diagnosed with the condition in this country. However, medical authorities are seeing 30-50% increases in rates of admission in 2020. Specialists believe that isolation, unemployment, and hopelessness are driving these increases. Rates for women also are increasing as noted in the article. Why is all this happening?

People who feel stressed tend to drink more than people who are less stressed. Alcohol use increases when persons experience disasters of all kinds, e.g. natural disasters. Alcohol does result in a feeling of relaxation. However, after drinking you may feel more anxious. Why is that? This is because alcohol releases brain chemicals that block anxiety. However, our brain rebalances after drinking by reducing the chemicals and getting back to equilibrium, resulting in increased feelings of anxiety. So how does alcohol affect us?

As I’ve written about in past posts, our immune system is impacted negatively by stress. For far more detail about how stress impacts your health, please read our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. For more information about the book, authors, and stress please visit our website at www.manageyourhealthandstress.com. For now, know that Coronavirus also compromises our immune system. Alcohol impacts the immune system, increasing the risk of illness and infections. For example, patients with liver disease die of COVID-19 at rates three times higher than those without it. Even more concerning, it now is occurring that some observers are seeing increased numbers of young adults hospitalized with alcohol-induced liver issues. We know from other virus outbreaks that drinking affects how your immune system works, making you more susceptible to virus infection. So, if you are concerned about the coronavirus, or are at risk of contracting it, you should limit your alcohol intake to give your immune system the best chance of fighting it off. The same applies if you have influenza or the common cold this winter.

What about alcohol and your mood? Drinking can affect your mood, making you prone to symptoms of depression and anxiety. This is because alcohol has a depressant effect on your central nervous system. What about sleep? We know that getting restful sleep assists in stress reduction. However, alcohol can disrupt your sleep. You may fall asleep more quickly from the sedating effects of alcohol. When your body processes alcohol, the sedative effects wear off. You might wake up through the night and find it hard to fall back to sleep. The next day, you can be left feeling increasingly anxious, which can start the process again.

Alcohol reduces the capacity of our brain to monitor and regulate our thoughts and feelings. We can make poor judgments, our inhibitions are reduced. Over time, you can develop a higher tolerance to alcohol leading to the need to drink more alcohol for the same effect. Developing tolerance to alcohol can contribute to the development of alcohol dependence.

How can you manage your alcohol use in this time of pandemic? First, monitor your drinking. American guidelines point to no more than one drink for women and two for men per night. I found the Australian guidelines make sense. This includes having no more than four standard drinks in any one day and no more than ten a week.

As always, the question is how you can manage the stresses of the pandemic without excessive use of alcohol? Consider doing mindfulness meditation or slow your breathing. You can distract yourself with something enjoyable. Try practicing starting your day thinking of three things for which you are grateful. As I’ve noted on many occasions, get as much exercise as you can. Exercise releases brain chemicals that make you feel good. We need exercise even more in times when we are more isolated and staying at home more often. Even if you can’t do your normal exercise routine because the fitness center is closed, go outside for a walk or run (maintaining social distancing and masks as needed). Maintain a good diet. We know good nutrition is important to maintain good mental health. Try to get as much sleep as you can. Worry can disrupt sleep and lack of sleep can worsen mental health. Build in pleasant activities to your day. If you can’t do the normal activities you find enjoyable, seek out something new you can do or try and schedule one each day. It’s good for your brain too as new activities activate brain reward systems.

Change can be disruptive but, as with most things, your mindset determines your reaction. The good part is that you can change what you think. Find ways to deal with the stresses in your life.

Good luck on your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com

HOW CAN WE HELP MEDICAL STAFF HANDLE THE MENTAL HEALTH CHALLENGES OF THE COVID-19 PANDEMIC?

Throughout my long career as a psychologist, issues of emotional and mental health always have taken a back seat to medical issues until it is impossible to ignore them. For example, in my work with NFL players with possible chronic traumatic encephalopathy (CTE) stemming from repeated concussions, the focus was on cognitive issues, i.e. concentration, memory, learning, etc. However, the hidden problems most often were in the areas of emotional and mental health. So many of the players suffered from anxiety and depression along with other challenges. Now we continue in the era of the COVID-19 pandemic. Many front line medical staff daily face herculean challenges in performing their work while being concerned about their own health and that of their families. In a recent article in the Los Angeles Times dated 2/3/21 titled “Health Workers Anguish” by Soumya Carlamangla, the author reviewed the increasing psychological distress experienced by frontline medical workers. She noted the rise of the new ritual born of the pandemic: death by Face Time. In this ritual, families are allowed access mostly by Zoom to seeing their dying relative as they are not allowed into the room. I myself went through this ritual three weeks ago as our niece’s 63 year-old beloved husband expired from COVID-19 as 15 of us were on the Zoom call offering words of remembrance and comfort to one another and to her. Medical workers are going through this on a daily basis. The Times author noted various stories of the emotional trauma, exhaustion, and despair experienced by the medical workers. There are indications of likely higher rates of burnout in these workers as well as ongoing anxiety, depression, and post traumatic stress disorder. As was noted in the article, experts in trauma have stated that we have no way currently of estimating the incidence of these traumatic emotional effects as most models of disaster assume a much shorter time line than is occurring in this pandemic. As stated, burnout always has been a risk for frontline medical workers but likely will be seen more often now and in the future. Symptoms of burnout include:

Sense of failure and self-doubt.

Feeling helpless, trapped, and defeated.

Detachment, feeling alone in the world.

Loss of motivation.

Increasingly cynical and negative outlook.

Decreased satisfaction and sense of accomplishment.

Activities you used to enjoy are no fun any more.

It is known that supporting workers with mental health services is not only an ethical obligation for employers, it’s also a bottom-line issue. More than 60% of workers say their mental health affects their productivity, according to a survey by Mind Share Partners, a nonprofit that works with companies to improve mental health resources. Also, in 2019 the World Health Organization estimated that depression and anxiety cost the global economy $1 trillion per year in lost productivity. Given the emotional toll of the pandemic, that price likely will be much higher this year.

Front line medical staff are suffering from mental health issues. How do we know this? Some information we have comes from studies of the medical staff in China, who already have gone through such challenges. In one survey of 1,257 physicians and nurses during the height of the COVID-19 pandemic in China, it was found that about 50 percent of respondents reported symptoms of depression, 44 percent reported symptoms of anxiety and 34 percent reported insomnia. Medical professionals are already at risk for many of these conditions at baseline—medical occupations have among the highest rates of suicide—yet it has been noted that physicians typically are unlikely to seek help.. Most are just so busy that they do not have the time or flexibility to go see a therapist. However, there also remains a stigma still attached to psychological problems leading many to defer or decline psychological treatment.

Given these problems, what can be done to structure more responsive interventions and means of assistance to frontline medical staff? This was a challenge faced by the Second Xiangya Hospital, a facility in Wuhan, China last year. They too found that medical staff were reluctant to access group and individual psychological interventions. In fact, it was observed that individual nurses showed excitability, irritability, unwillingness to rest, and signs of psychological distress, but refused any psychological help stating that they did not have any problems. Rather, many staff worried more about families, difficult patients, and lack of protective equipment and their own feelings of incapability when faced with critically ill patients. Many staff mentioned that they did not need a psychologist, but needed more rest without interruption and enough protective supplies. Finally, they suggested training on psychological skills to deal with patients' anxiety, panic, and other emotional problems and, if possible, for mental health staff to be on hand to directly help these patients. Therefore, different interventions were offered. These included the hospital providing a place for rest where staff could temporarily isolate themselves from their family. This strategy is being used now in some hospitals in the United States. The hospital also guaranteed food and daily living supplies, and helped staff to video record their routines in the hospital to share with their families and alleviate family members' concerns. Second, training was arranged to address identification of and responses to psychological problems in patients with COVID-19. Third, the hospital developed detailed rules on the use and management of protective equipment to reduce worry. Fourth, leisure activities and training on how to relax were properly arranged to help staff reduce stress. Finally, psychological counselors regularly visited the rest area to listen to difficulties or stories encountered by staff at work, and provide support accordingly. They found that these interventions were well received and staff reported lessened worry and stress. It is worth noting that in the earlier referenced Times article that at Harbor-UCLA Medical Center a psychologist has been offering therapy sessions to medical providers to process their grief and feelings of distress.

To support health care workers, experts need to intervene to help protect their mental health, not just their physical health. This was done in China as we have seen above and we should follow their lead. Some universities, like University of North Carolina Chapel Hill and the University of California, San Francisco, have been leaders in this effort, deploying their psychiatric workforce as volunteers. As has been noted, that appears to be occurring in more medical settings now in this country. What is needed are approaches that are comprehensive and multifaceted. There is a need for preventive measures (stress reduction, mindfulness, and educational materials), in-the-moment measures (hotlines, crisis support), and treatment (telepsychiatry for therapy, and medication if needed). For additional information about stress, please see our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. For additional information about the book, authors and stress, please see our website at www.manageyourhealthandstress.com. Such interventions acknowledge that mental health treatment is not just something that happens urgently or in crisis, but rather is something that needs to continue and be available long into the future. When all the cheering of frontline medical staff diminishes, there likely will be an increase in mental health conditions to include anxiety, depression, and post traumatic stress disorder. This is our professional and societal challenge.

Good luck to all on our collective journey to wellness.

Dr. Paul Longobardi

For information about these and related topics, please see my website at www.successandmindset.com

WHAT CAN WE LEARN ABOUT STRESS MANAGEMENT FROM OUR PRESIDENTS?

This week we set aside a holiday to remember and celebrate all presidents who have served our country. It is clear that presidents deal with endless stressful events. Recent Presidents have had to deal with the pandemic, political friction, economic worries, and global conflicts among many other issues.  How do you keep your own perspective in the midst of such challenges? There are multiple ways to manage stress including proper sleep, diet, maintenance of support systems, and taking time off.  However, I have noticed four stress management strategies which historically I believe have served many of our presidents well and may also serve you.  Consider the following:

1. Eliminate Negative Self-Talk.  When was the last time you heard any President or major leader putting themselves down or voicing negative thoughts about themselves?  It's not that they don't have them. Instead, it is the ability to notice what you're thinking, write it down if needed, and thereby loosen the power you give to the negative thought.  Blair Singer, a coach/trainer I've studied, talks about "little voice management" and how your use of extremes such as "never", "worst", and "overwhelmned" are both not true and interfere with your best functioning.  The brain does not know what is true but rather responds to your degree of negativity.  Eliminate your negative self talk.
2. Restructure your perspective.  When you are feeling stressed, your tendency is to blame the circumstances for your upset and worry.  Would it not be easy for most Presidents to blame external events and crises for why they feel stressed?  However, the key is how you respond to the challenges.  In a famous book titled Man's Search for Meaning, Viktor Frankl described his imprisonment in a Nazi death camp.  He noted that although everything in his life could be controlled, no one but he could control how he reacted to his circumstances.  In taking control to restructure his perspective, he adapted to an exceptionally traumatic and stressful circumstance.  Have you ever heard a President say "I'm a complete failure", or "Nothing will work out"?  I doubt it.  Instead, to correct this tendency to which we are prone, identify and challenge the thoughts/statements/beliefs causing the distress.  After all, none of the above statements are true and your mindset influences your brain.  Presidents have advisors and cabinets to help them with this but you can do it yourself.
3. Practice breathing.  How do you feel when you hurry speaking without taking regular breaths?  Probably more tense.  The practice of being aware of your breathing is common to many relaxation strategies including meditation, yoga, mindfulness, and progressive muscle relaxation. When you feel stressed, focus on your breathing for just a minute or two.  This keeps your mind from straying onto worrisome events and slows you down. Presidents take the time to pace themselves and this helps them generally maintain a calm attitude even in the face of crises.
4. Practice gratitude.  Take time to note, say, write down, or share several things each day for which you are grateful.  It works to help improve mood, lessen tension, and increase energy. Research studies have shown that it helps reduce the stress hormone cortisol, which may be involved in the improvements noted.  
While few of us, including me, face the stresses of a death camp or pressures of life and death world events, our daily world confronts us with many challenges.  How you respond to these challenges influences your mood, energy, well being, and physical health.  The good news is that you have more control over your response than you might have thought.  In our book on stress management (I Can't Take It Anymore: How to Manage Stress so It Doesn't Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at  https://www.amazon.com/dp/1542458056, we discuss these issues and much more.  If you want to know more about the book and authors, please visit our website at www.manageyourhealthandstress.com.  

Let us give thanks for the presidency this week and learn what we can from many of our leaders. While stress is inevitable, your response is a choice.  Best of luck on your journey.  

Dr. Paul Longobardi

For more information on these and related topics, please go to my website at www.successandmindset.com.

HOW PARENTS CAN HELP TEENS NAVIGATE THE STRESSES OF THE PANDEMIC

Being a teenager is difficult enough without the stress of a pandemic. Even under normal circumstances, teenagers worry about school, friendships, families, their future, among many concerns. However, the coronavirus pandemic has made life even harder for teenagers. With school closures and cancelled events, many teenagers are not able to participate in many big moments of adolescence, e.g. parties, graduations, sports events, as well as daily events such as interacting with friends and being in class at school. Recent surveys have noted increased rates of anxiety and depression among teenagers. For teenagers and parents facing stressful life changes due to the pandemic who are feeling anxious, isolated and disappointed, you are not alone. Included below are nine tips for how you can help your teenagers navigate the stresses of this pandemic. I am indebted for some of the tips to an article by Dr. Lisa Damour on the UNICEF website last year titled “How teenagers can protect their mental health during coronavirus (COVID-19)” Some of the tips also are from an earlier post I wrote on 3/27/19 titled “Eight tips to help teens manage stress”. For complete information on stress management, please read our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. For more information about the book, authors, and stress, please visit our website at www.manageyourhealthandstress.com. Here are the nine tips:

1. Recognize that your anxiety is completely normal. If school closures and alarming headlines are making you feel anxious, you are completely normal. “Psychologists have long recognized that anxiety is a normal and healthy function that alerts us to threats and helps us take measures to protect ourselves,” says Dr. Damour in her article. Too much anxiety can be debilitating. However, just enough anxiety helps us make focused decisions, such as to not spend time with other people or in large groups, washing your hands and not touching your face. Seek out reliable sources of information. If you become concerned that you are experiencing symptoms, it is important to speak to your parents about it. Most illness due to coronavirus is generally mild, particularly for children and young adults. Tell your parents or a trusted adult if you’re not feeling well, or if you’re feeling worried about the virus, so they can help.

2. Create distractions and engage in pleasant activities. We know that when we are faced with difficult situations, there are things we can do and things about which we can do nothing. Do the things you can, such as homework through online platforms, watching a favorite movie, reading, taking up something new you’ve wanted to try but have yet to do. It’s important for teens to find activities they find enjoyable. The activity can be almost anything teenagers find enjoyable, to include listening to music, reading for fun, working on projects with their hands.

3. Find new ways to connect with your friends Being a teenager is all about connecting to and spending time with friends. The current pandemic presents challenges but they are surmountable. If you want to spend time with friends while you’re practicing social distancing, social media is a great way to connect.

4. Learn how to do something new . You can start reading a new book or practicing a musical instrument. Now is a good time to do that. Focusing on yourself and finding ways to use your new-found time is a productive way to look after your mental health.

5. Feel your feelings Missing out on events with friends, hobbies, or sports matches is disappointing. Dr. Damour noted that “The best way to deal with this disappointment? Let yourself feel it. When it comes to having a painful feeling, the only way out is through. Go ahead and be sad, and if you can let yourself be sad, you’ll start to feel better faster.” Processing feelings is different for everyone. Dr. Damour observed that “Some kids are going to make art, some kids are going to want to talk to their friends and use their shared sadness as a way to feel connected in a time when they can’t be together in person, and some kids are going to want to find ways to get food to food banks,”. The key is to do what feels right to you.

6. Focus on and connect to family. Teenagers are concerned about and worry about family. Through social distancing they may have fewer opportunities to interact face to face with some family members to include grandparents. This again is a time to use all digital means to include face time, video conferencing, etc. to remain connected to and with grandparents and other family members outside of the immediate home.

7. Physical exercise. One of the more effective stress relief activities is to engage in exercise. It remains important, even in a pandemic, to engage in some exercise. Teens should find activities they enjoy, e.g. running, walking, yoga, skateboarding, etc. Many of these activities can be done outdoors as long as appropriate social distancing is maintained.

8. Sleep. To stay strong and increase resistance to potential viral infections, teens should continue to get their proper sleep, usually defined as approximately 9 hours per night. Surveys by the American Psychological Association show that teens report that they sleep on average only 7.4 hours per school night. Now that schools are out in most places for the current time, there is more opportunity for teenagers to sleep their proper hours. However, usual sleep hygiene recommendations apply. For example, reduce stimulating activities, e.g. TV and computers in the hour before sleep, and don’t drink stimulating beverages too close to bedtime.

9. Breathing/meditation/relaxation/mindfulness. Increasingly, various relaxation and present focusing strategies are being used to reduce stress and anxiety. These can be used to help teens learn how to focus and calm themselves in the face of challenges. This includes yoga, meditation, mindfulness, breathing exercises, many of which are accessible on the internet.

In this time of stress and anxiety over the coronavirus pandemic, there is much that can be done to assist youth in coping with these challenges as well as maintaining good mental health and well being. Let’s help and encourage them in these areas.

Good luck on your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com

HOW DOES STRESS ABOUT CORONAVIRUS AFFECT YOUR BRAIN AND WHAT CAN YOU DO ABOUT IT?

The world wide coronavirus pandemic continues to spread in the United States. We are receiving all sorts of guidance about personal hygiene, social distancing, vulnerable groups, travel restrictions, etc. We are observing occasional panic buying around us. Now, with the vaccines starting to become available, there is significant stress about gaining access to it. All of this continues to reinforce the idea that our ability to withstand with resilience and hardiness the stresses of the current situation as well as adjust our approach to stress will determine our weathering of this health challenge.

As we know, during stressful moments, cortisol levels rise and, together with another hormone called adrenaline, signal the body into making a fight-or-flight response. Specifically, cortisol increases glucose, or sugar, in the bloodstream. That enhances your brain's use of that glucose for energy and suppresses bodily functions that aren't immediately needed during an emergency, such as digestion, reproduction and growth. Once the stressful event passes, cortisol levels should fall. This, however, doesn’t always happen particularly if the stress persists such as our current coronavirus health challenge continues to last. Our bodies may continue to perceive stress or retain high levels of cortisol even past the cessation of the stressor (translate: coronavirus challenge). Consistently higher cortisol levels can cause damage to the heart and other body organs. So, the idea that stress and higher cortisol levels can affect memory and brain functioning is not entirely new. Such levels also can affect our mood and emotional state. We discuss the effects of stress on the brain, body, and emotions in our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. For information about the book, authors, and stress, please visit our website at www.manageyourhealthandstress.com.

So can persistent stressors affect brain connectivity? In an article from the Berkeley News by Robert Sanders titled “New evidence that chronic stress predisposes brain to mental illness”, the author discussed how research has shown that excess of myelin – and thus, white matter – in some areas of the brain disrupts the delicate balance and timing of communication within the brain. In particular, there is indication that high levels of stress interfere with the hippocampus which is involved in the regulation of memory and emotion. The author cited findings suggesting a mechanism that may explain some changes in brain connectivity such as in people with post traumatic stress disorder (PTSD), for example. For people under persistent high levels of stress, they may develop a stronger connectivity between the hippocampus and the amygdala – the seat of the brain’s fight or flight response – and lower than normal connectivity between the hippocampus and prefrontal cortex, which moderates our responses. This means that if your amygdala and hippocampus are better connected, that could mean that your fear responses are much quicker. This can be seen in stress survivors or people subjected to ongoing levels of chronic and persistent stress. If your connections are not so good to the prefrontal cortex, your ability to shut down fearful responses is impaired. So, when you are in a stressful situation, such as the coronavirus pandemic and associated occurrences, the inhibitory pathways from the prefrontal cortex telling you not to get stressed don’t work as well as the amygdala communicating danger to the hippocampus and facilitating an emotional overreaction which the hippocampus retains as a memory. Thus, in some respects, your brain is “stressing you out”.

What causes this anxiety just described? Well, If you’re like most people, uncertainty can cause you tremendous anxiety. In an article in Forbes last year by Bryan Robinson titled “The Psychology of Uncertainty”, the author discussed how the brain, due to its disdain for uncertainty, makes up all sorts of untested stories hundreds of times a day because to the mind, uncertainty equals danger. We humans are hardwired to overestimate threats and underestimate our ability to handle them—all in the name of survival. Robinson explained that when certainty is questioned, your stress response goes awry, instantly arousing your stress response, so that you will take action and return to safety. In fact studies have shown that people are calmer awaiting certain pain than anticipating uncertain pain. Scientists have found that job uncertainty, for example, takes a greater toll on your health than actually losing the job. One thing that is clear about the coronavirus challenge is that it involves high levels of uncertainty about possible adverse health and employment outcomes.

Robinson noted how scientists have long said that “every thought that enters the mind eventually finds a place in the body where it bears the burden. Your mindset during this crisis is everything. Your perspective is the most powerful thing you can control in a situation that is beyond your control”. If we fill our thoughts with panic, there is yet another level of stress which can compromise our immune system. In the article it was noted that molecular scientists have discovered that certain stressful thought patterns, such as rumination and pessimism, can shorten our telomeres—the en-casings at the end of our chromosomes—the stress of which can make us age faster and die sooner. So in addition to washing our hands, we need to cleanse our minds to offset catastrophic thinking. Take some charge of the uncertainty in these times and engage in useful preparation so as to reduce the negative effects on your brain.

What can you do? From a psychological perspective, connect with your friends and loved ones through phone calls, video chats, texts, and emails. It is well known that we are social beings and to deprive ourselves of social connections via social isolation is to risk even more increases in anxiety and disruption of brain functioning. Limit the amount of time each day you tune in to the media for information and updates about the coronavirus, perhaps to the morning and during the evening for brief periods. There’s no need to stay tuned in full time, it will only increase your anxiety. Then there are the basic practical steps you can take to lessen the likelihood of contracting the virus. These include to avoid unnecessary travel and crowds. Wash your hands often with soap and water (or an alcohol-based hand sanitizer) for 20 seconds. Keep your hands away from your face, especially your eyes, mouth, and nose. How can you relax despite worries about the coronavirus? Try relaxation and/or breathing strategies such as yoga, meditation, controlled breathing. There are apps on the internet as well as You Tube videos to help guide. Some apps teach simple forms of meditation such as Headspace. Find other ways you like to relax. Read a book you’ve wanted to do, engage in a home project, watch a favorite relaxing television program. Eat your favorite foods. And, as mentioned above, stay in contact with friends and loved ones. You can help them and they can help you. Relaxation helps stimulate the prefrontal cortical areas thus calming our brains.

Take a breath. Be kind to your brain. We will get through this. Good luck on your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com

LET'S "SUE" OUR WAY TO SUCCESS AND HAPPINESS IN THIS NEW YEAR

While the above may seem an odd title for a post on success and happiness, it has nothing to do with legal approaches.  Rather, "S.U.E." is an acronym for several powerful mindset strategies which will help you overcome most mental obstacles you have so that your thoughts can work for you instead of against you.   You then will be able to lessen the stress associated with such thinking. You can learn more about stress management in detail in our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.) available on Amazon at https://www.amazon.com/dp/1542458056. For more information, please visit our website at www.manageyourhealthandstress.com . Some credit should go to Dr. Martin Seligman, a psychologist.  In his book "Learned Optimism" he showed how we can learn to be more optimistic, while some people think we're just born the way we are.  It is how we explain events that influence how we will perform, whether in business or in our personal lives.  Now here is where my acronym "S.U.E." comes into play.

S - stands for Specific, contrasted with general.  If you are criticized, or if you have a setback, or a customer hangs up in your ear, then there is a specific response you can make.  You could say that was annoying that this person hung up in your ear but that's all, I've had a number of other successful experiences.  The person who becomes demoralized by such events tells themselves that what just happened is general, in contrast to specific.  If you think about setbacks more generally, that then becomes more demoralizing and depressing.  You may become prone to avoiding other similar possible events based on the one.

U - stands for Unstable contrasted with stable.  If you view the upsetting situation as unstable you are saying that it happens from time to time but it's not a regular part of your life.  If your business call did not work out well, you could decide that this is annoying, frustrating, inconveniencing but doesn't always happen and that you often have successful calls.  That's more of an unstable view which is what you want.  A more stable view (and more upsetting), is if you tell yourself that everything bad happens to you, you are a bad businessperson, and nothing works for you. 

E - stands for External contrasted with internal.  The idea is that if the same negative event happens, you view it as more outside yourself and not a permanent negative characteristic or trait of yourself.  Please understand that I am NOT saying to blame everyone else and take no self-responsibility.  What I am saying is to consider that the response you got is external to you, e.g. the prospect may be having a bad day, it may not be the best time for this product or service for them.  This is in contrast to the view that I am an incompetent person (internal view).  These internal self-characterizations cause you more difficulty because you will get down on yourself more often and overgeneralize about your negative aspects. 

So don't go to the courthouse to file legal papers.  Rather "S.U.E." frustrating situations by thinking of them as specific, as unstable, and as external to you and not reflective of your internal capacity or ability.  Learn to identify, dispute, and change your limiting thinking.  You will be less likely to overreact to setbacks and obstacles.

     If you have not already done so, you can go to the Free Download tab on the website www.successandmindset.com, provide your name and email, and download the entire ebook titled "S.U.E. Your Way to Success".  Change your thoughts to change your results.

Good luck on your journey in these challenging times. Happy New Year!

Dr. Paul Longobardi

FIVE TIPS TO MAINTAIN A POSITIVE MINDSET IN THE NEW YEAR

We all intend to keep positive and frequently make New Year's resolutions to do.  This is more likely to occur this year when we’ve experienced so many challenges related to health and societal change. Like so many other resolutions, we often have no specific idea how to do what we resolve and no plan as well.  This often leads to needless stress and frustration.  To help you reduce your stress and maintain your most positive mindset in this new year, see below for five tips which will help you if you implement them.   We discuss all these and more in our book (I Can't Take It Anymore: How to Manage Stress so It Doesn't Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.) available on Amazon at https://www.amazon.com/dp/1542458056

If you would like more information about the book and the authors, please visit our website at   http://www.manageyourhealthandstress.com Help yourself and your loved ones get off to a great start to the new year and consider acquiring the book.  Here are the tips:

1.       Be grateful for what you do have.  Even when you are going through challenges, there are many things for which you can be grateful.  Take several minutes at the start and end of each day to recognize those things. Doing so actually stimulates areas of your brain facilitating positive emotions.

2.      Understand and accept that you will have challenges, everyone does.   Treat the challenge as specific (not general), unstable (doesn’t always happen) and external (not internal and a reflection of your deficiencies). You will get down on yourselves far less often.

3.      Surround yourself with positive people.  The people you have around you have a big impact on you in terms of how you see yourself, how successful you are, and how you spend your time.  If all you hear is negativity that is what you will come to think.  Make a conscious effort to be around more positive people. If the positive people are not in your home, find some others.

4.      Have a clear plan for your day and week.  As the old saying goes, “If you don’t know what route to take to Rome, any one will do but you won’t get there”.  The same is true for your life.  If you know what you want to accomplish, you will focus more on those goals.  Daily plans lead to weekly goals and you will accomplish more. See posts from the previous several weeks.

5.      Have an exercise plan.  It is well known that regular exercise contributes to mental health as well as physical health.  It combats depression and improves your mood.  Build this activity into your daily routine, preferably in the morning. 

     So, I suggest you start by implementing one tip per week over the next five weeks and then incorporate them into your daily routine.  Good luck.  Remember, change your thoughts, change your results. 

Good luck on your journey and Happy New Year!

Dr. Paul Longobardi

For more information on these and related topics, please see my website at www.successandmindset.com

CAN NEUROSCIENCE TELL US ANYTHING ABOUT GOAL SETTING FOR THE NEW YEAR?

Well, it's that time of year again, even in a year of pandemic and significant societal upheaval.  Many of us are setting new goals for ourselves.  Why is it that so often we neither persist with nor achieve them?  Alas, out of the few people who do set goals, most don't take goal setting seriously, don't do it scientifically, and do it only once each year.  In all my work with coaching clients and patients, I always emphasize and teach goal setting and mindset change first.  Only then do I deal with issues of problem solving, decision making, time management, or any other area.  Until your specialized knowledge area is combined with goals and mindset, your knowledge will not allow you to accomplish much or maintain any changes made for very long.  You will feel anxious, frustrated, and stressed. We discuss these issues in our book (I Can’t Take It Anymore; How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D.,and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. For more information about the authors, book, and related information on stress, please visit our website at www.manageyourhealthandstress.com.

So what can neuroscience tell us about goal setting?  

1.  Repetition is a good way to embed a goal in your non-conscious mind.  I've always been told that "repetition is the mother of all learning".  However, it's also true for goal setting as well.  It turns out that neuroimaging of the brain shows us that initially setting a goal is a conscious activity.  However, it is in the non-conscious mind areas that behaviors become consolidated to the point of being unconscious and automatic, what we know as habits.  In fact, becoming unconsciously competent is a cornerstone of success for many people, and occurs through repetition.  New neural patterns form only after they've been repeated enough times.  If you make resolutions and don't continue to repeat and reinforce your desire for these goals, then no new neural connections are made and no new habits occur.  The best example of this is the frequent resolution by people to lose weight in the new year.  The goal is not repeated regularly and does not strengthen in the brain.  It also is true that at least 21-30 days are needed to consolidate a new habit on a neurological basis.  When you repeat your goals again and again, programming occurs in the subconscious mind.  You are best advised to rewrite your goals daily, think about them positively, repeat them, and visualize them occurring.  You can't force this.  It needs to be a process of creating new patterns of thinking and visualizing, as well as clearing away self doubts (mindset issue). So, it's not the resolution that you set once but the thoughts and visual images you focus on all day that create your new long term behavioral change by making the behaviors unconscious and automatic, i.e. a habit.

2.  Use emotion to create energy for your goal.  The strength and number of neural connections associated with a thought or behavior increase when you're in an emotional state. Unfortunately, too often this process occurs for negative thoughts and behaviors reinforcing avoidance and escape.  But it can work as well for positive thoughts and behaviors. Neuroimaging findings indicate that neural connections are stronger when formed with high emotion.  This also is why many "casually" formed resolutions fail as they are set with no emotion.  You're prone to become ambivalent, uncertain, and intermittent in carrying out your goal, particularly at the first obstacle.  Do not take goal setting lightly or casually.  Whatever your goal is, it's about your life and that's important. We know you can rewire your brain.  All the research in brain plasticity tells us so.  

3.  Take your goal setting seriously.  Rewrite goals daily.  Think about them constantly. Visualize yourself accomplishing them.  Then take massive action to accomplish them and soon your behaviors will become automatic.

But for now, make this the most successful year of your life.  After the chaotic year we just experienced, make next year an upward journey for yourself.

Dr. Paul Longobardi

For additional information on these and related topics, please visit my website at www.successandmindset.com.

WHAT IF YOU SCHEDULE YOUR SUCCESS FOR THE COMING NEW YEAR?

Well, after a tumultuous 2020, the New Year is soon upon us and we'll be inundated with talk of resolutions, even though most resolutions are discarded within the first month of the new year.  Why is it that some of what we think of as our best intentions do not happen? What are a few thoughts as to how you can make your goals become a reality for you?  One strategy is to schedule your success. 

I have spent weekend days saying how much I will get done and then find that I spent the time reading the newspaper, checking Facebook, going for a walk, until the day is gone.  I thought that I had made a decision to get some work done.  Alas, neuroscience tells us (and me!) that there is an illusory quality to the concept of "decision making".  It is only an abstract object in our minds. As such, I never really experience the "weekend" but rather one moment after another.  In each moment, I never directed myself behaviorally to take action.  Other actions, as noted above, took precedence, were more comfortable, presented less resistance to me. Often, this results in feeling anxious, stressed, and frustrated. We discuss these issues at length in our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available for purchase on Amazon at https://www.amazon.com/dp/1542458056. If you want more information about the authors, book, and other information related to stress, please visit our website at www.manageyourhealthandstress.com

So when are we the most productive and follow through the most with our intentions?  It is during those times which are scheduled.  When you act based on a schedule, there is nothing better than the desired action.  If I exercise at 7 AM every day, I don't have to think about what should I do or when should I do it.  If you compare this to an intention to "exercise tomorrow", there is all manner of activity in which I can engage, e.g. drinking another cup of coffee, watching the TV news, etc. giving me resistance to my intention to exercise.  When we think about decision making, note that if we have not created a clear, defined, and strong behavioral pattern to perform an action, it does not occur.  This is particularly true when our intended action goes up against well developed patterns of coffee drinking, reading the newspaper, watching TV, etc.  If you want to do a certain act, don't worry about "self discipline" or motivation.  Schedule the act specifically, condition yourself to do it without fail, and after 21 days minimum it will become a habit like so many others we have.

I'm sure you've heard how most people spend more time planning and scheduling their vacation than other areas of their lives such as careers, family, finances, etc.  You don't have to become a "time nut" to schedule your success.  Just pick one or two goal areas important to you, perhaps exercise or improving your financial knowledge, and schedule regular times to do the activity.  The time does not have to be excessive.  In the examples I just gave, starting with 15 minutes a day per activity would be great if you're currently at zero time.  Just schedule it and stay with it for three weeks, you're on your way.

Best wishes for your scheduled success.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com

IS THERE A SCIENCE OF HAPPINESS AND CAN YOU USE IT TO HELP YOU IN 2021?

Well, you made it to 2021. A new year is usually a time of happiness and optimism for the future. This particularly is true given the year we just experienced, one of pandemic and societal challenge. But what is happiness and is there a science of happiness? While there are many different definitions of happiness, I will use the following: “Happiness is the appreciation of life, moments of pleasure, but overall it has to do with the positive experience of emotions”. What would make you happy? I, like many others, often have thought that winning the lottery would do it. However, research by Dr. Dan Gilbert found that after one year of living with change, lottery winners compared to quadriplegic patients leveled out at the same level of happiness. This may be related to how our frontal lobe (prefrontal cortex specifically) helps us generate two types of happiness. One is natural happiness when we get something we want. The other is synthetic happiness or what we make when we don’t get what we wanted. It is possible to create your own happiness despite the common belief that only positive things make us happy.

So, a happy life is not always about getting what you want. It is about learning to enjoy what you get. Natural happiness primarily relies on external factors whereas synthetic happiness primarily relies on internal factors. Synthetic happiness can be a more long term, stable form of happiness than natural happiness.

Chemicals in the brain play a role in happiness. These include Serotonin, Dopamine, and Oxytocin. We can increase these through such activities as focusing on positive memories, exercise, setting and completing goals, and receiving more physical contact.

However, there are other practices associated with happiness in scientific study. One of the clearest findings, per studies at Harvard under Dr. Robert Waldinger, is that good relationships keep us healthier and happier. They protect our bodies and brains as well. How can you develop deeper relationships in your life this year?

Yet another way to foster a happier disposition is to practice gratitude. People who regularly practice gratitude report experiencing more joy, pleasure, optimism, happiness, and higher levels of positive emotions. Consider using a gratitude journal, I use this often with my patients. Practice the motions of smiling and saying thank you. Use prayers of gratitude if it fits with your spiritual traditions.

Another path toward happiness is to practice mindfulness. This practice warrants its own book. It is defined as a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations. Research has shown that those who practice mindfulness regularly are happier because their thoughts are not consumed by fears of things to come, controlling future situations, or analyzing circumstances that have passed.

One of my favorite paths toward happiness is to connect with nature. Research is growing on the connection that nature makes us healthier and happier people. Nature teaches us that there is nothing wrong with us. In nature, time slows down and urgency and deadlines melt away while we surrender control and reinforce acceptance. When were you last in nature? You can even do it socially distanced.

Research also has shown that possessing wealth and material goods does not lead to happiness, giving them away actually does. Studies of people who practice giving, donating, and volunteering show that they have better psychological, mental, and increased longevity.

So, if you would like to be more happy, consider some or all of the following:

Savor the moment

Take control of your time

Act happy

Exercise and make time for sleep

Give time and attention to close relationships

Be mindful

Spend more time in nature

Express gratitude

Give more

The key to happiness is knowing you have the power to choose what to accept and what to let go. As I always say, stress is a choice but so is happiness. May you choose happiness and not stress in this New Year. For information about stress management, please see our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.) available on Amazon at  https://www.amazon.com/dp/1542458056. For details about the book, authors, and other stress related information, please see our website at www.manageyourhealthandstress.com.

Good luck on your journey and Happy New Year!

Dr. Paul Longobardi

For information on these and related topics, please visit my website at www.successandmindset.com

ARE YOU AT RISK FOR MENTAL HEALTH DISORDERS IF YOU CONTRACT COVID-19?

The coronavirus disease 2019 (COVID-19) pandemic itself is stressful for most of us. We are likely to experience fear and anxiety about what could happen to us if we contract the disease. These fears can be overwhelming and cause strong emotions in us.

At the same time, some public health actions, such as social distancing, can result in people feeling isolated and lonely and can increase stress and anxiety. Stress during an infectious disease outbreak can sometimes cause the following: fear and worry about your own health and the health of your loved ones, your financial situation or job, or loss of support services on which you rely. How you cope with your stress will determine how well you manage life in the pandemic.

There has been a recent study of the relationship between a diagnosis of COVID-19 and diagnosis of a psychiatric disorder. The study, titled “Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62,354 COVID-19 cases in the USA”, was published in Lancet Psychiatry. The authors include M. Taquet, S. Luciano, J.R. Geddes, and P.J. Harrison. The investigators found that people recovering from COVID-19 are more likely to be diagnosed with a psychiatric disorder such as anxiety, depression or insomnia within three months of their illness from the virus. "The incidence of any psychiatric diagnosis in the 14 to 90 days after COVID-19 diagnosis was 18.1%," the study found, including 5.8% that was a first diagnosis. Therefore, nearly 1 person in 5 diagnosed with COVID-19 is diagnosed with a psychiatric disorder like anxiety, depression or insomnia within three months.

The analysis was conducted by researchers at the University of Oxford, using electronic health records for 69.8 million patients in the U.S. — including more than 62,000 diagnosed with COVID-19. Compared with patients who had experienced certain other health events this year — such as influenza, kidney stones or a major bone fracture – those diagnosed with COVID-19 were more likely to have a subsequent psychiatric diagnosis in the following 14 to 90 days. To assess the psychiatric sequelae of COVID-19, the authors produced matched cohorts of patients who had been diagnosed with another health event. People recovering from COVID-19 were about twice as likely to be diagnosed with a mental health disorder as compared with someone who had the flu, according to Paul Harrison, professor of psychiatry at Oxford and one of the study's authors. The researchers were able to differentiate somewhat for severity of COVID-19 cases — for instance, they found that someone hospitalized for COVID-19 had a higher risk of getting a psychiatric diagnosis than someone who did not need hospitalization.

In yet another study, QuanQiu Wang and colleagues, in a study published in World Psychiatry, found that there was an increased risk of COVID‐19 infection and mortality in people with mental disorders following an analysis from electronic health records in the United States.

Wang and colleagues sought to determine the effects of a past-year diagnosis of a mental disorder, such as attention deficit disorder with hyperactivity (ADHD), bipolar disorder, depression and schizophrenia, on the risk for COVID-19 infections, as well as related rates of mortality and hospitalization. They analyzed electronic health record data of 61 million adults from 360 hospitals and 317,000 providers across the U.S. up to July 29, 2020.

Results showed a significantly increased risk for COVID-19 infection among those with a recent mental disorder diagnosis, with the effect strongest for depression and schizophrenia 

You might say, “Aren’t most of us experiencing some level of anxiety right now, given the global pandemic?” As I noted earlier, the Oxford study is speaking to a level of anxiety far more severe than the normal anxieties and apprehensions many of us have at this time. As Dr. Harrison noted, "To get a diagnosis of an anxiety disorder, assuming the diagnostic tests were done correctly — this is more than simply the anxiety we're all feeling very, very reasonably because of the circumstances many people have lived through over the last few months."

In another article about the studies, Laurel Wamsley of NPR.org wrote about how “After COVID-19 Diagnosis, Nearly 1 In 5 Are Diagnosed With Mental Disorder”. From a different perspective, the author noted that Dr. Lauri Pasch from UCSF observed that many patients have a different experience, namely the presence of much gratitude. She stated that: "We're seeing a lot of gratefulness — that feeling that friends and family were there for them in a way that they didn't expect, and feeling really grateful for that. Feeling like celebrating life." Dr. Pasch also noted that some patients who had really difficult hospital stays say things like "I feel like I get a second chance at life" and "I'm going to make myself a better person," now that they have survived. She calls this "post-traumatic growth" – the inverse of post-traumatic stress and contends that the post-traumatic stress symptoms of COVID-19 symptoms will attenuate over the longer term. She and her colleagues are gathering data on that subject at UCSF.

So as in so many other areas of life, how we view stressors has much to do with whether we will have a more malignant or a more benign outcome. We discuss these issues in our book on stress management (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. For more information about the book and authors, please visit our website at www.manageyourhealthandstress.com.

You indeed can influence your risk for a mental health disorder if you contract COVID-19. It is not inevitable. Reach out for assistance for yourself and/or loved ones. Practice good strategies such as proper diet, rest, exercise, physical relaxation/meditation, and engage yourself socially as fully as possible.

Good luck on your journey.

Dr. Paul Longobardi

For information on these and related topics, please visit my website at www.successandmindset.com

HOW TO HELP YOUR CHILDREN MANAGE STRESS BETTER AND REDUCE RISK FOR DIABETES

Well, we are at the end of Diabetes Awareness Month. However, the need to remain vigilant for the risks continues past this month. There are numerous challenges to preventing diabetes. We all are experiencing the stresses of living during a pandemic with all the accompanying changes to our lives. It is well known that individuals have been eating far more comfort food and adding weight during this time period. Obesity is a major risk factor for diabetes both in adults and youth. Obesity has multiple causes ranging from genetics to lifestyle. However, stress can play a large role in obesity in youth (children and teens). Recent estimates from the National Health and Nutrition Examination Survey as well as the Center for Disease Control (CDC) indicate that approximately one-third of children in the United States are overweight or obese, with approximately 17-20% meeting criteria for obesity. A recent national longitudinal study in the US indicated that 12.4% of children in kindergarten were obese and another 14.9% overweight; overweight 5-year-olds were four times more likely than normal weight children to become obese later in childhood at age 14. Obesity is a risk factor for the rise in Type 2 diabetes in the young. In the United States, while 29.1 million people are living with diagnosed diabetes, about 208,000 people younger than 20 years are living with diagnosed diabetes. Rates are rising for increased incidence of diabetes in the young.

Stressors can be physiological or psychosocial, such as stress in children, in the family, or in the parents. Physiologically, stress affects primarily the hypothalamic-pituitary-adrenal (HPA) axis and affects such hormones as cortisol, insulin, leptin, ghrelin, serotonin, and catecholamines such as adrenaline, noradrenaline, and dopamine. Psychosocial effects can lead to anxiety/depression and disordered eating behaviors such as emotional and distracted eating, a sedentary lifestyle, and poor sleep. In fact, poor sleep as a factor is associated on its own with incidence of childhood obesity. Perceived stress in the young has been linked to emotional eating. Higher levels of perceived stress have been found to be associated with a larger waist circumference and body mass index, all associated with obesity.

It is clear that young people experience and report significant levels of stress. This was true even before the start of the pandemic earlier this year. In a survey of teen stress concluded before the pandemic, the American Psychological Association found some striking results. Teens worry most about school (83%), getting into a good college (69%), and financial concerns for their families (65%). Many teens state they lie awake at night (35%), feel irritable or angry (40%), or feel overwhelmned by stress during the past month (31%). In that survey, many teens reported that they were curt or snapped at schoolmates (26%) in the past month and 51% of teens noted that others told them they appeared stressed during the last month. Findings are more mixed regarding parental stress and youth weight. There have been some studies linking parents’ perception of their stress to increased fast food consumption in their children but other studies have failed to replicate that finding. In a more recent survey of 1,000 teenagers from the mental health initiative WellBeings.org from October 2020, the findings were bleak. Almost 50 percent of teens said their mental health is much worse or somewhat worse than it was pre-pandemic. More than 50 percent said their social life is worse or somewhat worse, and over 72 percent said that the coronavirus has created a disadvantage for their generation, with climate change and racial strife cited as the biggest societal stressors for them outside of the virus. .Of course, within the family, stress can come from financial strain, the family’s structure, or changes in physical or mental health of family members.

So what can parents do to help youth manage the stress which can lead to obesity and increase the risk for diabetes? Here are some ideas:

1. Help children increase fruit and vegetable intake. Serve fruit with breakfast and offer fruit and/or vegetables as snacks. Include side salads with dinner and encourage fruit as a dessert.

2. Get proper exercise. Exercise can decrease cortisol and trigger release of chemicals that relieve pain and improve mood. It can also help speed metabolism burn off whatever has been eaten.

3. Engage in stress reduction strategies. These can include yoga, meditation, mindfulness, or progressive muscle relaxation. Yes, these can be used with youth. All of these strategies encourage a focus on the immediate reality, help pay better attention to your physical self, and reduce worry and anxiety. I’m fond of using the 4-2-4-2 approach. Inhale through the nose for 4 seconds, hold it for 2 seconds, slowly exhale out the mouth for 4 seconds, hold that state for 2 seconds, repeat as necessary. It really works. I have used it to successfully obtain a quick relaxation response with many patients.

4. Get proper rest and sleep. Avoid overeating in the evening, consuming stimulating beverages, and use stress reduction strategies as discussed above. Children and teens need more sleep than adults and often do not obtain it. Recommendations have been on average for children to sleep up to 10 hours per night while teens can benefit from 8-9 hours per night.

5. Be more aware of what you are eating. Help your young person (as well as yourself) consider when about to eat something whether they actually are hungry or whether a distraction such as television is contributing to the distracted eating. This sometimes is referred to as mindful eating. Pay attention to what you are eating, slow down eating, attend to the feelings of fullness, and avoid emotional overeating. One way to reduce emotional overeating has been to focus on the future rather than on the present when inclined to eat comfort foods. Research has shown that when focusing on the future people make healthier choices in foods.

6. Find Rewarding Activities Unrelated to Food. Take a walk with your young person socially distanced from others, read a book to them if they are of an age to enjoy that, help them increase their socialization with family and friends even through Zoom calls and others technologies. These can help relieve stress without overeating. Some may say that they don't have time with all their stressors. Making and taking the time to do so will help your young person relieve stress, think more clearly, feel happier, and be less likely to overeat.

7. Check your young person for proper mindset. As I always say, become more aware of what you say to yourself about yourself. If your child or teen has too many thoughts like "I can't handle my stresses", "I'm overwhelmned", "I'll never get out from what is stressing me", then it's time to help them with a mindset do-over. Gently challenge the above thoughts and remind them how many times they in fact have handled stressors. Remember that help is available in many forms. Keeping negative thoughts in mind also will result in your reaching for "comfort foods" with all the additional problems that will cause.

If you want more information about stress management, please access our book (I Can’t Take It Anymore; How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D. and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. If you want more information about the authors, book, or other stress information, please visit our website at www.manageyourhealthandstress.com.

Good luck on your journey.

Dr. Paul Longobardi

For information on these and related topics, please visit my website at www.successandmindset.com

MANAGEMENT STRATEGIES FOR DIABETES

We still are in Diabetes Awareness Month. The focus of the month is to help all of us be aware of the risks for diabetes and the need to stay aware of healthy living to either avoid developing the disorder or manage it better if you already are so diagnosed. This is particularly relevant as we experience Thanksgiving this week and the start of holiday eating. In our book on stress (I Can't Take It Anymore: How to Manage Stress so It Doesn't Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon https://www.amazon.com/dp/1542458056, we discussed some stress management tips/strategies to help better manage your diabetic condition. For additional information about the book and authors, please visit our website at www.manageyourhealthandstress.com. These strategies also can help with the stress associated with pandemic related concerns. I include these strategies below directly from the book:

1.  Change stress producing situations, when possible.  For example, it is well known that people reduce stress to the extent that they manage their time well and don’t let themselves overcommit and become overwhelmed by events.  If you improve your organization skills and learn problem-solving skills, you reduce your likelihood of allowing yourself to become excessively stressed and then worsening your diabetic condition. 

2.  Initiate relaxation procedures.  You can try yoga, meditation, mindfulness, deep breathing, or progressive muscle relaxation (PMR).  Our favorite is PMR, in which you practice tensing and relaxing major muscle groups in sequence while combining pleasant visual imagery and proper breathing. In fact, a study published in the journal Diabetes Care showed that just five weekly sessions of a relaxation therapy can reduce blood sugar levels significantly.

3.  Learn about cognitive behavior therapy (CBT) and its benefits.  In addition to learning to relax, CBT assists you in evaluating your problematic, catastrophizing, and often overgeneralized thoughts leading you to feel tense, frustrated, and upset.  You can learn to react differently to the challenging events in your life through re-evaluating your thoughts and thus your emotions.  As we always say, "Change your thoughts and change your results".  

4.  Use your social support network.  Talk to a trusted friend or confidante about your concerns.  Talking about problems can help lessen the stress associated with them.  Don't have a social support network?   Maybe this is a good time to develop one.  Also, you can speak with your spiritual leader or other members at your place of worship.  If nothing is working, consider talking with a mental health professional.

5.  Maintain healthy eating, sleep, and exercise routines. Exercise can help lower blood sugar, so a stressful phase is not the time to stop your program.  Exercises in groups, e.g. aerobics, water aerobics, dance or yoga classes could be a lot of fun and help maintain accountability and comraderie.  In these days of pandemic restrictions on group exercise and fitness centers, walking or jogging can be great ways to get exercise and fresh air at the same time while maintaining social distance from others.

6.  Develop relaxing routines, such as starting a hobby, taking walks, or joining a class you like.  There are online options to learn new skills and connect with others even during these times of pandemic. Such activities will contribute to a more pleasant outlook on life as well.

7.  If the above still is not working, know that there are antianxiety medications available which may help.  You may need the medication for the short term only as some of the medications are addicting.  See your medical care provider.

 
It is very clear that diabetes is a condition possibly initiated by but at least worsened by the presence of stress.  The areas of glycemic control and self-care management both are negatively impacted by stressors.  It is important that individuals take control of their health and one way to do this is by managing effectively the stresses in your life.

Good luck on your journey. 

Dr. Paul Longobardi

For additional information on these and other topics, please see my website at www.successandmindset.com

PANDEMIC STRESS AND DIABETES AWARENESS

We are in Diabetes Awareness Month and facing Thanksgiving challenges to our diets, pertinent to persons with diabetes and pre-diabetes. At the same time, we suffer the stress of the pandemic. These stresses place vulnerable individuals at risk for worsening of their condition at a time when we can not gather in our normal ways. Also, we are entering the holiday season in which depression increases in vulnerable individuals, even more so in this year of COVID-19. As a benchmark, about 23.5 million Americans nationwide  have diabetes, and about 14.8 million Americans have major depressive disorder in a given year, according to research statistics.  However, matters soon may be getting worse.  Estimates are that 55% of adults in California have either diabetes or pre-diabetes.  That's up to 13 million adults in the state (2.5 million with diabetes, the rest pre-diabetic).

It has been known that a comorbidity, or co-occurrence, occurs between depression and diabetes.  Some estimates have been that up to 30% of individuals with Type 2 diabetes have a diagnosable depressive disorder (Katon, Maj, & Santorius, 2010).  In a study in the Annals of Internal Medicine in 2010, Dr. Frank Hu observed that depression increased the risk for diabetes, and diabetes increased the risk for depression. Women who were depressed were 17% more likely to develop diabetes even after the researchers adjusted for other risk factors such as weight and lack of regular exercise.  Women who were taking antidepressants were 25% more likely to develop diabetes than their counterparts who were not depressed.

In the same study, women with diabetes were 29% more likely to develop depression after taking into account other depression risk factors.  Women who took insulin for their diabetes were 53% more likely to develop depression during the 10-year study. Concerns are even higher in this year of pandemic. Under normal circumstances, estimates are that approximately 8-11% of people over the age of 12 suffer from moderate to severe depression. However, during the pandemic, there is evidence that the rate of serious depression has increased. A US Census Bureau survey found that 44% of Californians reported levels of anxiety and depression commonly associated with diagnoses of generalized anxiety disorder or major depression.

Certain factors such as physical activity and body mass index may partially explain the link between depression and diabetes.  However, they do not completely explain the connection.

I agree with the research conclusions that the common denominator may be stress.  I have written frequently about the role of stress in the initiation or exacerbation of multiple medical conditions to include diabetes.  In our book on stress management (I Can't Take It Anymore: How to Manage Stress so It Doesn't Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), we discussed depression and diabetes in detail.  The book is available on Amazon at https://www.amazon.com/dp/1542458056. For more information on the book and authors, please visit our website at www.manageyourhealthandstress.com. 

People who are depressed have elevated levels of stress hormones such as cortisol.  Elevated levels of cortisol  can lead to problems with glucose or blood sugar metabolism, increased insulin resistance, and the accumulation of belly fat.  These all have been noted as diabetes risk factors.  Now if you develop Type 2 diabetes and have not been identified as depressed, you still are faced with the stressors associated with diabetes management such as blood sugar control and treatment for complications.  This can lead to decreased quality of life and increased probability of depression. Research studies have shown that depression leads to poorer physical and mental functioning, so a person is less likely to follow a required diet or medication plan. Over time, thoughts may become more depressive such as "I'll never be healthy again"; "Why did this happen to me?";  "I'll never be happy again". These thoughts can lead you into a spiral of depression and worsen diabetic management. Treating depression with psychotherapy, medication, or a combination of these treatments can improve a patient’s ability to manage diabetes.

But what about the issue of pre-diabetics raised in the first paragraph?  Do you know your status and that of your loved ones?  Perhaps you indeed are pre-diabetic yourself.  Symptoms of diabetes include: 1. Being very thirsty; 2. Urinating frequently; 3. Blurry vision; 4. Being irritable; 5. Tingling or numbness in your hands or feet; 6. Feeling worn out; 7. Wounds that don't heal; 8. Yeast infections that keep coming back. 

Have you had a depression screening or think you may be depressed? Symptoms include: 
1. No longer finding pleasure in activities that you once enjoyed; 2. Insomnia or sleeping too much; 3. Loss of appetite or binge eating; 4. Inability to concentrate; 5. Feeling lethargic; 6. Feeling anxious or nervous all the time; 7. Feeling isolated and alone; 8. Feeling sadness in the morning; 9. Feeling that you "never do anything right"; 10. Having suicidal thoughts.  If you experience four or more of these symptoms for up to two weeks, please consult your primary care provider or a  mental health professional.  If you have suicidal thoughts, please see a professional immediately.  

There is excellent care available but you have to take the first steps.  As noted, evaluate your stressors in life, be aware of your mindset and the possibly depressing thoughts and limiting beliefs you tell yourself, and consult information and experts on diabetes management.  

Again, your good physical and mental health are the results of choices you make.  Stress is a choice.  Don't make it yours.  Good luck on your health journey.

Dr. Paul Longobardi

For information on these and related topics please see my website at www.successandmindset.com

POWER OF HUGS AND THE STRESS OF A PANDEMIC

As we remain in the grips of the pandemic, I came to think about the impact of the pandemic on hugging. We hug far less if at all now as we are encouraged to maintain social distancing. Our manner of greeting has come to include fist bumps, elbow bumps, or any variation thereof. We engage in virtual hugs on Zoom without any physical contact. Recently, our seven-year-old grand daughter said plaintively to us, “I want to hug you so badly I don’t know what to do”. Now you may say, “What’s so important about hugging”? You may be surprised to learn both about the importance and the power of hugs. Let’s look first at the idea of “failure to thrive”.

The concept of “failure to thrive” has been around for many decades. It stemmed from research and study in orphanages in Europe in the 1940s and 1950s following World War II. John Bowlby and Rene Spitz were prominent in noting the high rate of infant deaths (one out of three) not for physical disease but rather for failure to be touched and held. Even among the babies who didn’t die, there were high rates of cognitive, behavioral, and psychological dysfunction. Again, most of the deaths were not due to starvation or disease, but to severe emotional and sensory deprivation – in other words, a lack of love. These babies were fed and medically treated, but they were absolutely deprived of important stimulation, especially touch and affection. This was not because the orphanages were terrible places but because there were too many babies for the staff to manage in the case of the hospitals. In Europe and the US in the first half of the 20th century, nurses were required to cover their faces with surgical masks and not interact with babies. Parents and other family members were prevented from visiting freely as it was believed this would prevent infections from spreading and help keep babies healthy. However, instead of getting better the babies got worse.

How important is touch? Human touch is fundamental for human development and survival. Research conducted by Ruth Feldman and Tiffany Field has shown the positive effects that come from skin-to-skin touch in premature babies and that these effects are still at work after ten years. Significant gains in neurological development, weight gain, and mental development of premature babies have been shown to be triggered by skin-to-skin stimulation.

So what are the benefits of hugging for us adults? There is some research to support the conclusion that hugging and other interpersonal touch can boost a hormone called oxytocin (sometimes known as the “love hormone”) and also affect our endogenous opioid system. What is that? It means that through hugging our brains can produce chemicals that sooth us and help us to feel more safe and less threatened throughout the day. So when something stressful does come up, we don’t have such an aggressive fight-or-flight response to it.

Are there additional benefits of hugging? In a recent article online in Select Health, there were noted four benefits of hugging. I list these with several references to related studies. These benefits include:

1. Hugs ward off illness. A study found that frequent hugs actually protected people from increased susceptibility to the kind of stress that leads to infection. Participants who were sick exhibited fewer symptoms when they were hugged more often. In a study of susceptibility to upper respiratory illness, authors Cohen, Janicki-Deverts, and Turner in an article in PubMed followed 404 healthy adults over two weeks to examine the role of perceived social support and hugs in buffering against interpersonal stress-induced susceptibility to a virus induced infection. Perceived support protected against the rise in infection risk.. A similar stress-buffering effect emerged for hugging, which explained 32% of the attenuating effect of support. Among infected participants, greater perceived support and more-frequent hugs each predicted less-severe illness signs.

2. Hugs release oxytocin. As noted earlier, Oxytocin is often called the “love hormone,” and it’s released when we cuddle or bond. It’s the reason why being hugged feels so good. So when you’re feeling down, give someone a squeeze and feel your mood lift.

3. Hugs make you feel like everything will be okay. We instinctively hug those who are struggling. When you receive a hug from someone you care about or who makes you happy, it can generally leave you feeling safe, and excited for the future. In a study in a retirement home in New York, staff implemented a program called “Embraceable You.” It was a push for more contact between the older residents and staff members so as to improve the residents’ well-being. As it turned out, the residents who received three or more hugs per day felt less depressed, had more energy, could concentrate easier and slept better.

4. Hugs cut down on stress. You probably know that cortisol is a stress hormone, but did you know that hugs can actually combat cortisol? The science of this is pretty involved, but essentially a hug can lower cortisol levels and counteract the physiological consequences around being stressed. For more information about stress and its management, please see our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. For additional information about the book and authors, please visit our website at www.manageyourhealthandstress.com.

As soon as possible, let’s get back to our hugs. As I hope you see, there is great power in hugs. For now, take care of yourselves and stay safe.

Good luck in your journey.

Dr. Paul Longobardi

For additional information on these and related topics, please see my website at www.successandmindset.com

FIVE LESSONS ABOUT LIFE MANAGEMENT AND STRESS TO LEARN FROM CHRISTOPHER COLUMBUS

Well, it still is October. This traditionally has been the month to remember the explorer Christopher Columbus. I am aware that in some areas the day we usually have celebrated as Columbus Day is now Indigenous Peoples Day. As a person of Italian heritage on Columbus Day, and always interested in life and stress management issues, I sometimes ponder what life lessons we can learn from Christopher Columbus.  Well, several years ago I was fortunate enough to come across this enlightening post on the very topic from Mr. Larry Boyer.  He is a regular LinkedIn Top Contributor. I have chosen to reproduce much of it each October. Again, I am aware of the negative legacy of colonialism. However, for its time, the voyage of Columbus was a challenging and dangerous mission given the state of the 15th century world.

More than 500 years ago Christopher Columbus set sail and reached the Americas. Was this a grand achievement for a man, a nation, humanity or generations to come? What are the lesson of personal achievement and leadership that Christopher Columbus has taught us?

Today we focus so much on the activity, the man, his deeds, and the legacy that we can miss the deeper importance of Christopher Columbus. Did Columbus really discover America? Did someone else? Of course, not. After all, the continent was here long before he arrived. And so were the native inhabitants. If he thought he discovered India did he really discover America? Was America in fact really “discovered”? What about the treatment of the natives by Columbus and those who followed him? Christopher Columbus was revered by and inspired generations for reasons that are often overshadowed by today’s critiques.

So, what are life management and stress lessons learned from Columbus which we can use to help us in our own lives today?

5 Leadership Lessons from Christopher Columbus

Luck favors the prepared

Be Bold. Be Different

Ignore Nay Sayers

Find people who believe in you

Let go of the familiar and safe

LESSON ONE: Luck Favors the Prepared

Was Columbus just lucky? One of the first criticisms of successful people is they were just lucky to be at the right place at the right time. Anyone could have done the same thing. It’s just lucky this person did it and someone else didn't. Columbus was trying to sail to India and was just lucky he found something else instead.

What appears to be a lucky happenstance most often is the result of years of work and preparation. Leaders make luck happen through preparation. Columbus spent years developing his idea and going around Europe looking for financial backing. He had to believe and convince others that the world might be round. Like any successful person, Columbus spent a lot of time getting prepared for his opportunity. So, when an opportunity appears for you, be ready to both recognize it and to be able to take advantage of it. This involves planning, goal setting, prioritization, and focus. These are all key elements in managing life well and reducing stress when compared to poor planning, lack of goals, no priorities, and lack of focus. They are among the topics in our book on stress management in your life (I Can’t Take It Anymore: How To Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. For information about the authors, book, and other topics on stress, please visit our website at www.manageyourhealthandstress.com. But let’s get back to Columbus.

LESSON TWO: Be Bold. Be Different.

Columbus had a bold idea. An idea that was different from everyone else around him and certainly different from his seafaring peers. In his day ship captains kept in sight of the shore, ensuring they would not fall off the edge of the Earth or be consumed by sea monsters. Columbus understood that if he continued to do the same thing everyone else was doing, he would at best continue to get the same results as everyone else. If you want to achieve something great it is going to have to be by doing something different than what everyone else is doing.

LESSON THREE: Ignore the Naysayers

Everywhere Christopher Columbus went people laughed at him for his idea that the Earth was round as he traveled Europe looking for support. He was sent away time after time. His peers and colleagues in the sail industry thought him to be a mad man for making such suggestions. Everywhere he went sharing his idea he was dismissed, ridiculed and marginalized. It is very easy to start to listen to the voices of the naysayers. They will always be around. People who believe in their mission will ignore the naysayers and continue moving forward. It’s not just leaders who deal with naysayers. You too likely have people in your life who don’t support your goals and plans. Some of them may even be in your family. Your challenge is nonetheless to move forward with goals and dreams.

LESSON FOUR: Find People Who Believe In You

Leaders know they cannot be successful alone. They need the support of people who believe in them. Even if those people are uncertain themselves they believe enough to put themselves on the line and be part of your team. Queen Isabella and King Ferdinand of Spain were the first. And then there were the people on his crew. Each of his supporters may have had different goals and objectives than Columbus, but they were all aligned in support of him in his efforts. Undoubted some were less supportive than others. It doesn't matter. Successful people use this support, whatever the level, to charge forward. Time and time again, I have discussed the need for a support network that contributes to your success. None of us can accomplish alone all that we want. Build your support network. There’s a chapter in our book on this process.

LESSON FIVE: Let Go Of The Familiar And Safe

Finally, perhaps the greatest lesson from Columbus’ leadership is to let go of what is familiar and safe and have the faith that you and your supporters will have what it takes to face the unknown, adapt, and move forward. Columbus literally did this in ways that we simply cannot replicate in today’s business world or personal world. However, we do know what it means to feel secure and not want to take chances with your career and finances and avoid taking risks. Those who let go and take a chance may fail at first. Getting up and moving forward, past your comfort zone, is where success lies. Leaders in life face their fears and move forward.

What have you learned from Columbus that you apply in your life today? I hope it is to be prepared, differentiate yourself, ignore the naysayers, develop your support network, and move out of your comfort zone. Yes, that can feel stressful but you can do it.

Best wishes in your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com

WORLD MENTAL HEALTH DAY AND OVERUSE OF ALCOHOL IN THE PANDEMIC

I am writing this post on October 10, 2020, World Mental Health Day. It is the day set aside to focus on one of the most neglected areas of public health, specifically mental health. The World Health Organization (WHO) tells us that close to 1 billion people are living with a mental disorder, 3 million people die every year from the harmful use of alcohol and one person dies every 40 seconds by suicide. And now, billions of people around the world have been affected by the COVID-19 pandemic, which is having a further impact on people’s mental health.

Yet, relatively few people around the world have access to quality mental health services. That’s why, for this year’s World Mental Health Day, WHO, together with partner organizations, United for Global Mental Health and the World Federation for Mental Health, is calling for a massive scale-up in investment in mental health.  At the same time, this is National Substance Abuse Awareness Month. The issue of problematic substance use has become more problematic this year in large part secondary to the COVID-19 pandemic. As I wrote, some months ago, one business has been booming during this current pandemic. No, it’s not toilet paper. No, it’s not bottled water. Yes, it is alcohol consumption. Apparently, Americans are stocking up on alcohol. In Seattle, Chicago and Boston, sales of wine, beer and liquor have seen increases of up to 300 to 500 percent compared to sales before the pandemic commenced early this year. Also, the market research firm Nielsen reported off-premises sales of alcoholic beverages across the United States rose 55% in the last few months. Sales increased the most for tequila, gin and premixed cocktails, followed by wine and then beer. So, in times of challenge and stress, it can be attractive to look to alcohol for stress reduction. Why does this happen?

People who feel stressed tend to drink more than people who are less stressed. Alcohol use increases when persons experience disasters of all kinds, e.g. natural disasters. Alcohol does result in a feeling of relaxation. However, after drinking you may feel more anxious. Why is that? This is because alcohol releases brain chemicals that block anxiety. However, our brain rebalances after drinking by reducing the chemicals and getting back to equilibrium, resulting in increased feelings of anxiety. So how does alcohol affect us?

As I’ve written about in past posts, our immune system is impacted negatively by stress. For far more detail about how stress impacts your health, please read our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. For more information about the book, authors, and stress please visit our website at www.manageyourhealthandstress.com. For now, know that Coronavirus also compromises our immune system. Alcohol impacts the immune system, increasing the risk of illness and infections. We know from other virus outbreaks that drinking affects how your immune system works, making you more susceptible to virus infection. So, if you are concerned about the coronavirus, or are at risk of contracting it, you should limit your alcohol intake to give your immune system the best chance of fighting it off. The same applies if you have influenza or the common cold this winter.

What about alcohol and your mood? Drinking can affect your mood, making you prone to symptoms of depression and anxiety. This is because alcohol has a depressant effect on your central nervous system. What about sleep? We know that getting restful sleep assists in stress reduction. However, alcohol can disrupt your sleep. You may fall asleep more quickly from the sedating effects of alcohol. When your body processes alcohol, the sedative effects wear off. You might wake up through the night and find it hard to fall back to sleep. The next day, you can be left feeling increasingly anxious, which can start the process again.

Alcohol reduces the capacity of our brain to monitor and regulate our thoughts and feelings. We can make poor judgments, our inhibitions are reduced. Over time, you can develop a higher tolerance to alcohol leading to the need to drink more alcohol for the same effect. Developing tolerance to alcohol can contribute to the development of alcohol dependence.

How can you manage your alcohol use in this time of pandemic? First, monitor your drinking. American guidelines point to no more than one drink for women and two for men per night. I found the Australian guidelines make sense. This includes having no more than four standard drinks in any one day and no more than ten a week.

As always, the question is how you can manage the stresses of the pandemic without excessive use of alcohol? Consider doing mindfulness meditation or slow your breathing. You can distract yourself with something enjoyable. Try practicing starting your day thinking of three things for which you are grateful. As I’ve noted on many occasions, get as much exercise as you can. Exercise releases brain chemicals that make you feel good. We need exercise even more in times when we are more isolated and staying at home more often. Even if you can’t do your normal exercise routine because the fitness center is closed, go outside for a walk or run (maintaining social distancing and masks as needed). Maintain a good diet. We know good nutrition is important to maintain good mental health. Try to get as much sleep as you can. Worry can disrupt sleep and lack of sleep can worsen mental health. Build in pleasant activities to your day. If you can’t do the normal activities you find enjoyable, seek out something new you can do or try and schedule one each day. It’s good for your brain too as new activities activate brain reward systems.

Change can be disruptive but, as with most things, your mindset determines your reaction. The good part is that you can change what you think. So go ahead and enjoy a drink. However, find ways to deal with the stresses in your life. In this month of substance use awareness and a focus on world mental health, invest in yourself and your health.

Good luck on your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com

THE STRESS OF DOMESTIC VIOLENCE IN A PANDEMIC

This month is Domestic Violence Awareness Month. This focus comes during a time when many family systems are being strained secondary to COVID-19 restrictions. Domestic violence is a serious and challenging public health problem. The National Institute of Health (NIH) estimates that approximately 1 in 3 women and 1 in 10 men 18 years of age or older experience domestic violence. Furthermore, NIH statistics show that family and domestic health violence are estimated to affect 10 million people in the United States every year. .Annually, domestic violence is responsible for over 1500 deaths in the United States. But first, just what is domestic violence? Domestic violence occurs when a person consistently attempts to control their partner through physical, sexual, or emotional abuse. The United States Department of Justice defines domestic violence as “a pattern of abusive behavior in any relationship that is used by one partner to gain or maintain control over another intimate partner.” Domestic violence can be psychological or physical and affect anyone of any age, gender, or sexual orientation. It may include behaviors meant to scare, physically harm, or control a partner. Domestic violence typically involves an unequal power dynamic in which one partner tries to assert control over the other in a variety of ways. This can happen through threats, insults, physical/emotional abuse, and sexual abuse. Victims suffer anxiety, depression, feelings of helplessness, and diminished self-esteem. Domestic violence is the most common cause of injury for women, leading to even more injuries than car accidents. The physical consequences can be short-term, such as bruises, pain, and broken bones, or long term, such as arthritis, hypertension, and cardiovascular disease. More lasting consequences include depression, anxiety, post-traumatic stress disorder, and not infrequently substance use problems.

Why are partners abusive? Abuse is driven by the issues of control and power, usually by men against women. It may involve cultural norms of male primacy as well as lack of differentiation psychologically of the abusing partner from the victim. Abusive partners often isolate their victims from family, friends, work, and any other outside sources of support. They may have explosive tempers and become violent during an abusive episode. Afterward, they become remorseful and try to win their partner back with shows of affection and promises to change. However, the abusive behavior rarely stops. Abuse victims may show both physical and psychological effects. Abuse often leaves physical marks, from bruises and broken bones to shortness of breath and involuntary shaking. Victims can also suffer both short and long-term emotional and psychological effects, including feelings of confusion or hopelessness, depression, anxiety, panic attacks, post-traumatic stress disorder, and substance use problems. While the majority of instances of abuse are by men against women, it is worth noting that nine percent of men suffer such abuse.

Is domestic violence increasing during the pandemic? There is not clear evidence that this is so. However, there is indirect evidence that the rate of murder-suicide, in which a male partner kills a female and then himself, has risen since the same time last year.

If domestic abuse is already a problem in a relationship, the coronavirus pandemic likely makes it worse. An abusive person may use this situation to exert more control over a partner. Also, higher stress in the home may well drive such increased abuse. If there are financial challenges, if the children are at home more, all may increase the risk particularly when domestic abuse already occurs in the home. There still are increased stressors as a result of the pandemic. Families may feel crowded and frustrated that they can’t escape one another. At the same time, they’re isolated from extended family and friends and can no longer participate in many enjoyable and relaxing activities. The abused victim has more difficulty getting away from the perpetrator. There’s plenty to worry about with the threat of COVID-19 itself. Understandably, people fear catching it. However, if they are essential workers and cannot work from home, they still must expose themselves, leading to worsening stress. .

For more information about how stress affects us, please see our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You: Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. For additional information about the book and authors, please visit our website at www.manageyourhealthandstress.com.

As I discussed in a post last week on alcohol use during the pandemic, if household members are consuming more alcohol than usual due to stressors, they might be at higher risk for acting out and causing physical harm to family members. The World Health Organization has noted a strong correlation between alcohol and violence between intimate partners. They noted that alcohol affects both body and mind, and can impair thinking and self-control. People who drink alcohol may be less capable of dealing with relationship conflicts without resorting to violence.

Leaving an abusive relationship is not always as easy as it might seem. Victims often stay in abusive relationships because of financial issues, having no place to live, threats from their abuser, concerns for their children, family pressures, and inconsistent support from authorities. Yet, the victim must recognize and acknowledge that abuse is occurring. They need resources to leave safely and time to process the psychological dimensions of the pain of their experience with a mental health professional. There are good support groups available as well.

If you or a loved one are suffering from domestic violence, the National Domestic Violence Hotline, at 800-799-7233 (SAFE), can provide information and advice.

Good luck on your journey. Be safe.

Dr. Paul Longobardi

For information on these and related topics, please visit my website at www.successandmindset.com