Mental Health Monday (1)

Introducing Mental Health Mondays, where we share articles about different mental health challenges or disorders.

Click on the link below for the full article at the site it was first published.

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Seasonal affective disorder treatment: Choosing a light therapy box

Light therapy boxes can offer an effective treatment for seasonal affective disorder. Features such as light intensity, safety, cost and style are important considerations.

By Mayo Clinic Staff

Seasonal affective disorder (SAD) is a type of depression that typically occurs each year during fall and winter. Use of a light therapy box can offer relief. But for some people, light therapy may be more effective when combined with another SAD treatment, such as an antidepressant or psychological counseling (psychotherapy).

Light therapy boxes for SAD treatment are also known as light boxes, bright light therapy boxes and phototherapy boxes. All light therapy boxes for SAD treatment are designed do the same thing, but one may work better for you than another.

Talk with your doctor first

It's best to talk with your health care provider about choosing and using a light therapy box. If you're experiencing both SAD and bipolar disorder, the advisability and timing of using a light box should be carefully reviewed with your doctor. Increasing exposure too fast or using the light box for too long each time may induce manic symptoms if you have bipolar disorder.

If you have past or current eye problems such as glaucoma, cataracts or eye damage from diabetes, get advice from your eye doctor before starting light therapy.

Understanding a light box

A light therapy box mimics outdoor light. Researchers believe this type of light causes a chemical change in the brain that lifts your mood and eases other symptoms of SAD.

Generally, the light box should:

· Provide an exposure to 10,000 lux of light

· Emit as little UV light as possible

Typical recommendations include using the light box:

· Within the first hour of waking up in the morning

· For about 20 to 30 minutes

· At a distance of about 16 to 24 inches (41 to 61 centimeters) from the face

· With eyes open, but not looking directly at the light

Light boxes are designed to be safe and effective, but they aren't approved or regulated by the Food and Drug Administration (FDA) for SAD treatment, so it's important to understand your options.

You can buy a light box without a prescription. Your doctor may recommend a specific light box, but most health insurance plans do not cover the cost.

What to consider

Here are some questions to think about when buying a light box for seasonal affective disorder:

· Is it made specifically to treat SAD? If not, it may not help your depression. Some light therapy lamps are designed for skin disorders — not for SAD. Lamps used for skin disorders primarily emit ultraviolet (UV) light and could damage your eyes if used incorrectly. Light boxes used to treat SAD should filter out most or all UV light.

· How bright is it? Light boxes produce different intensities of light. Brighter boxes will require less time to use each day, compared with dimmer boxes, to achieve the same effect. Typically the recommended intensity of light is 10,000 lux.

· How much UV light does it release? Light boxes for SAD should be designed to filter out most or all UV light. Contact the manufacturer for safety information if you have questions.

· Can it cause eye damage? Some light boxes include features designed to protect the eyes. Make sure the light box filters out most or all UV light to avoid damaging your eyes. Ask your eye doctor for advice on choosing a light box if you have eye problems such as glaucoma, cataracts or eye damage from diabetes.

· Is it the style you need? Light boxes come in different shapes and sizes, with varied features. Some look like upright lamps, while others are small and rectangular. The effectiveness of a light box depends on daily use, so buy one that's convenient for you.

· Can you put it in the right location? Think about where you'll want to place your light box and what you might do during its use, such as reading. Check the manufacturer's instructions, so you receive the right amount of light at the proper distance.

Talk to your health care professional about light box options and recommendations, so you get one that's best suited to your needs.

https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/in-depth/seasonal-affective-disorder-treatment/art-20048298

Funtional Fridays (1)

Welcome to Functional Fridays, where we share articles about integrative or functional medicine.

Exercises for Building Self-Esteem for College Students and Adults

Again, while building self-esteem is a practice best started young, it’s never too late to begin investing in your own self-worth. These worksheets and exercises from www.theranest.com are intended to help adults build up their self-worth.

Sentence Completion Worksheet

This worksheet from leads the reader through a sentence completion exercise for adults. This exercise is exactly what it sounds like: it includes prompts with blank space at the end for you to complete the sentence in the way that feels right to you.

Completing this exercise can help you explore your thoughts and feelings, open up, and share them with others.

The instructions at the top of this worksheet inform the reader that this exercise will help them to become more comfortable sharing their thoughts and feelings with others, making it easier to work through their self-esteem issues.

Next, it instructs the reader to set aside five minutes a few times a week to complete the worksheet. After two weeks of completing this worksheet, you can review your responses to get an idea of your general outlook on life and see how things have changed since you began. The intended result is for your answers to become more positive over time.

After the instructions, the sentence prompts are listed, including:

· My best friend is…

· Sometimes I wish I could…

· The thing I fear most is…

· Today I would like to…

· I’d really enjoy…

· I feel my future is…

· I gain strength from…

· I would never…

· I was really happy when…

· I love when…

· I struggle when…

· I believe that…

· I get angry when…

· Today I fear that…

· Today is going to be…

· I hope that…

· I thrive when…

· Today I would like to…

· I secretly enjoy…

· I don’t like to admit…

· Today I believed that…

Answering these questions can give you helpful insight into yourself, into what makes you happy and what you struggle with.

As a therapist, you can introduce this exercise to your client by filling out a few sample prompts together. This can communicate important messages to your client and help them feel more comfortable with the exercise.

For example, you can finish the prompt “Right now, I’m happy that…” with “my favorite hockey team won last night.” This can be a good way to defuse tension and start off with an easy and relatively harmless example.

If you’d like to see other tips for therapists in administering this worksheet or give it a try yourself, you can find it here or here.

Self-Esteem Journal Template

For those of you who have read about or kept a gratitude journal, this exercise will feel familiar. Not only can journaling help you to find more things in your life to be grateful for, it can also give you the opportunity to reflect on your own thoughts and feelings, leading to discovery and understanding of the self.

The worksheet begins with a short paragraph on the potential benefits of journaling, including improved self-esteem and well-being. The reader is encouraged to use this template to reflect on the meaningful moments of their day, and review the changes in their emotions and general outlook over time.

Next, there are five tables set up with space to write the date and prompts to respond to.

The first table includes the following prompts:

1. 10 things that brought me peace today were:

2. I felt empowered when:

3. I had fun when:

The prompts in the second table are as follows:

1. My loved ones are proud of me because:

2. 5 things that went well today were:

3. I feel happiest when:

The third table includes:

1. My best quality is:

2. 3 things that make me unique are:

3. The best part of today was:

In the fourth table, the prompts read:

1. I’m looking forward to:

2. 10 people or things I am grateful for are:

3. I feel strongest when:

The final table lists these three prompts:

1. I feel best about myself when:

2. My greatest accomplishment today was:

3. The 3 things I love most about my life are:

You have probably noticed that each of these prompts is intended to provoke positive responses. The positive focus of this exercise is what sets it apart from ordinary journaling or writing in a diary. Even when you have a rough day, these prompts can help you find the good things in your life and remind you that no matter how rough the day was, you survived it.

If you are a therapist providing this worksheet to your client(s), encourage them to think critically about what their answers reveal. This exercise can be just a quick and short-term mood boost, or, with commitment and effort, it can facilitate positive growth and development.

To see this worksheet for yourself, click here.

Gratitude Worksheet & Journal Template

If you are not familiar with the gratitude journal technique, this worksheet is an excellent way to give it a try.

Research has linked gratitude to a multitude of positive outcomes, like increasing well-being, improving our relationships, making us more optimistic, and even helping us to find meaning in our work.

Gratitude journaling is one of the best ways to inject more gratitude into your daily life, and it can be done in just a few minutes a day.

The gratitude journal worksheet opens with some tips to help you journal effectively, including recording at least five things you are grateful for each day, aiming for one new thing to be grateful for each day, and reading through old entries to see how far you have come since you began.

The template is simple, with space for the date, five entries below the prompt “Today, I am grateful for…” and space to respond to “Something I need to express gratitude for…” In this last column, you should think of something that you have not yet expressed your gratitude for, such as a teacher who profoundly affected your development that you never thanked or something you may have taken for granted, like good general health.

There are many ways to set up and complete a gratitude journal, but this is a great way to begin.

To give this worksheet a try, click here or here.

Negative Self Talk Worksheet

This exercise is a great way to address negative automatic thoughts and self-talk, common problems that people with low self-esteem or mental health issues face. It’s not surprising that talking down to yourself will lead to and exacerbate self-esteem problems, but the good news is that it is not an unsolvable problem.

Challenging negative self-talk is a core technique in cognitive behavioral therapy (CBT), a type of therapy that has proven effective in a wide range of conditions, diagnoses, and problems. CBT helps clients discover some of their most deeply held, often unconscious, beliefs, allowing them to evaluate these beliefs and challenge those that are not useful.

This thought-stopping worksheet opens with an explanation of negative self-talk and how you can identify and confront it.

Next, the negative thought table is presented. It includes six columns intended to help you understand where your negative thoughts are coming from and help you challenge each one.

Trigger – in this column, you write down what prompted your negative thought. Maybe you noticed a typo in a paper or report you wrote, or caught a glimpse of your reflection when you weren’t looking your best. Whatever it was, think back to the moment the negative thought first popped into your head, and write down whatever immediately preceded it.

Negative Thought – in this column, you are prompted to write down the negative thought. This might be difficult to do, but remember that we are about to challenge it.

Associated Emotion – for this column you think about the emotion(s) that arise when saying the negative thought out loud. Whether it’s anger, sadness, guilt, disgust, or another emotion entirely, write down whatever feelings are provoked by voicing the negative thought.

Evidence That Does Not Support the Thought – this is where you must think hard about the negative thought and decide how well it truly applies to you. Much of our negative self-talk is guilty of a cognitive distortion like exaggeration, all-or-nothing thinking, or focusing only on the negative. You will likely find that, even if there is a sliver of truth behind the negative thought, the thought is a truth taken to an extreme.

For example, you may have gotten some disappointing feedback from your boss on a report you handed in, but if you’re thinking “I’m a failure at everything,” you have fallen prey to taking a single incident and overgeneralizing. Instead of giving in to the thought, write down all of the evidence that does not support the thought, like “I graduated from college. I have turned in several reports that my boss had no problems with.”

Alternative Thought – this is a very important part of the exercise, in which you reflect on the thought and come up with a replacement thought. This thought should be more in line with the truth, but with a positive message. For example, you could write “I made a mistake, but I will not make it again going forward.”

Associated Emotion (Part II) – once you have come up with an alternative thought, say it out loud and write down how it makes you feel. The alternative thought should make you feel more positively than the original negative thought, even if the alternative thought acknowledges that you made a mistake or that your current situation is not ideal.

This tried-and-true technique will help you or your client to recognize negative thoughts and challenge them on the spot, leading to greater self-esteem and peace with the self.

If one of your clients is having trouble coming up with positive responses to their negative thoughts, encourage them to consider what they would say to a dear friend or loved one who was struggling with these thoughts. Sometimes it’s easier to be kind to others than to ourselves, but that is something that can be remedied with time and practice.

Click here or here to view or download this worksheet.

Identifying and Challenging Core Beliefs

Similar to challenging negative thoughts, it can be an extremely effective therapeutic technique to discover, identify, and challenge your core beliefs. We often carry negative or false unconscious or semiconscious beliefs, never stopping to recognize the values and norms that we apply on a daily basis.

This exercise will help you or your client explore and define your most deeply held beliefs, the beliefs that guide your thoughts and behavior every day.

The worksheet begins with an explanation of what core beliefs are:

“Core beliefs can be defined as the very essence of how people see themselves, others, the world, and the future.”

Next, it explains how core beliefs can influence one’s thinking and emotions through an example interaction.

“Interaction: Jesse has a performance review coming up. She is deciding whether or not she deserves the promotion she wants.”

In this situation, Jesse must choose between three shirts to wear to work, each representing a different core belief:

Red shirt – “I am deserving”

Internal thought associated: “I am a hard worker with a strong work ethic. I deserve this promotion.”

Jesse’s reaction: Jesse feels confident as she enters her performance review, and subsequently gets a promotion.

Green Shirt – “I’m not sure I am deserving.”

Internal thought associated: “I work hard, but someone else will probably get the promotion over me.”

Jesse’s reaction: Jesse doesn’t feel great heading into the performance review. She gets a good review but does not get the promotion.

Blue Shirt – “I’m not deserving.”

Internal thought associated: “There’s no way I’m getting a promotion. My coworkers are smarter than me.

Jesse’s reaction: Jesse does not get the promotion.

These examples show that the thoughts we carry with us, everywhere we go, can have a profound impact on our feelings, our behavior, and the associated outcomes.

Finally, the worksheet presents an opportunity to apply what you have learned from these examples to your own life. You are prompted to identify three negative core beliefs, and three reasons that each belief is not true.

It can be difficult to identify the first core belief, especially if you have several very deeply held negative beliefs that you have never even considered challenging before; however, once you get the ball rolling with the first belief, it should get easier as you go.

To give this worksheet a try, follow this or this link.

Assertive Communication Worksheet

Low self-esteem and poor or underdeveloped communication skills often go hand in hand. It can be difficult to share feelings when others if you don’t feel your feelings have value, an all-too-common symptom of low self-esteem.

Learning to communicate assertively will not only help you form better relationships and find new opportunities, it can also facilitate a shift in the way you think about yourself.

To those with low self-esteem, the word “assertive” may make them hesitant. Being assertive might sound overly aggressive, pushy, or just way too out of character for some people to try.

The worksheet addresses this right away with an explanation about how three common communication styles differ:

· Passive Communication Defined by being too nice or weak, overly compliant, avoiding eye contact, speaking softly, putting one’s self down, being emotionally dishonest, and allowing others to trample you in conversation.

· Assertive Communication Defined by being firm but polite, compromising, maintaining warm and friendly eye contact and a conversational tone, building up others and one’s self, being appropriately honest, and standing up for one’s self.

· Aggressive Communication Defined by speaking in a mean, harsh, or sarcastic manner, taking instead of compromising, maintaining glaring eye contact and speaking in loud or threatening tones, putting others down, being inappropriately honest, and bullying or trampling others.

When compared in this way, it is clear that being an assertive communicator is nothing like being an aggressive communicator. Assertive communication is simply expressing yourself “in an open, honest, and direct way.” (TheraNest.com)

The worksheet provides space and instructions to record three instances where you have communicated assertively and list the emotions you felt afterwards. If you can’t think of an instance where you have communicated assertively, don’t worry! You can make that a goal for yourself in the next week.

To see this worksheet for yourself and begin building up your communication skills, click here or here.

You can download the printable version of the PDF here.