Overcome Obstacles by Removing Self-Doubt

Your anxiety may be physical

Experiencing occasional anxiety is a normal part of life, but you are not alone if you have experienced a mental health challenge over the past few years.

We were already in an epidemic of anxiety before the pandemic, and those rates have continued to climb. The international prevalence of anxiety and depression increased by 25 per cent in the first year of the pandemic, according to the World Health Organization.

Faced with this crisis, the mental health field offers a few suggestions. The presiding agreement is that our mental health struggles are the result of a chemical imbalance written in our DNA. 

The implication is that our anxiety is chemical, and our serotonin level, the feel-good hormone, is determined by our genetic destiny. Mental healthcare professionals offer medications and therapy to change our cognitive rituals to lift our suspected serotonin deficiency.

But what if these options don’t work for you?

While our current offerings help some people, the inaccessibility of therapy is at an all-time high. Far too many people were struggling with their mental health and experiencing disappointing results with medication.

Focusing on brain chemistry has led us to overlook what impacts our mood and behaviour; the body plays a critical and often overlooked function in mental health. This can come as good news for those who have not found satisfactory relief from medication and therapy.

The determinants of our mental well-being go beyond our genes and brain chemistry to include inflammation, gut health, sleep, nutrition, hormones, chronic limbic hyperarousal because of unresolved trauma, and even having our fundamental human needs for community, nature, meaning, and purpose go unmet. 

If we do have what is known as a chemical imbalance, it is probably a downstream consequence of these other states of imbalance.

In other words, anxiety is not all in your head; it’s based mainly on the body, where it should first be addressed.

I believe there are two types of anxiety: genuine anxiety (or purposeful anxiety) and avoidable anxiety.

Genuine anxiety is our inner compass nudging us to pay attention to what’s not right in our personal lives, our communities and the world. It’s not something to suppress or pathologise, and it’s not what’s wrong with us — it’s what’s right with us when we can viscerally connect to what’s wrong in the world.

With genuine anxiety, our symptoms communicate something to us that should be heard and honoured. Instead of asking, “how can I stop feeling so anxious,” we should ask, “what is my anxiety telling me?” There’s often a call to action baked into our genuine anxiety, and when we let our uneasiness fuel purposeful action, we don’t feel so mired in our anxiety.

On the other hand, avoidable anxiety is often as simple as our body getting tripped into a stress response, which transmits a signal to the brain telling us something is wrong. 

And the human brain worries and fears everyday situations.

Your anxiety checklist.

When I work with patients, I start with avoidable anxiety — the low-hanging fruit. We come up with an avoidable anxiety inventory. In a moment of peak anxiety, this list can cue them to reflect on possible causes of a sudden stress response taking over their body, help them identify the particular avoidable anxiety that might be occurring, and understand its straightforward remedy.

An avoidable anxiety inventory could include the following:

• Hunger
• Sleep deprivation
• Being over-caffeinated
• A hangover (what is known as “hang-xiety”)
• Gut issues
• Inflammation
• Long stretches of being sedentary
• Chemical fallout after consuming highly processed food
• Late luteal phase (the days before the bleeding phase of the menstrual cycle)
• Inter-dose withdrawal (the pharmacologic low-point when you’re due for your next dose of a psychiatric medication)

Ellen Vora is an integrative psychiatrist in New York City, and the author of “The Anatomy of Anxiety.”

Melatonin, on the couch

A previous podcast discussed how jet-lag medication was used to treat young people for sleep problems. A dietary supplement containing melatonin was readily available in health shops throughout the United Kingdom until it was banned. In some cases, melatonin supplements may also contain serotonin. Be mindful that the human body can make melatonin from the enzymatic conversion of serotonin into melatonin. There have been reports of poisoning in children who needed hospital care, and several young children died from a melatonin overdose.  

Five of the seven deaths occurred in children younger than one year old. There have also been further concerns about how it might affect a child’s growth, development, and well-being, particularly during puberty. Studies found that morning sleepiness, drowsiness, and perhaps increased urination at night are the most common side effects that occur while taking melatonin. 

Always talk with your paediatrician about the proper dose and timing of melatonin for your child.  And remember, it should be something other than a good bedtime routine, young or old.

Let’s start by looking at this hormone in more detail. 

An article by Amelia Nierenberg wrote in the New York Times states that most people think of melatonin as a natural sleep aid, like chamomile tea in pill form. But melatonin is also a hormone that our brains naturally produce, and like it or not, hormones, even in minuscule amounts, they can have a potent effect throughout the body.

“There are some clinical uses for it, but not the way that it’s been marketed and used by the vast majority of the public,” said Jennifer Martin, a psychologist and professor of medicine at the University of California, Los Angeles.

Experts strongly urge people to consult their doctor or a sleep specialist before taking melatonin, partly because the supplement does not address many underlying health problems that disrupt sleep. Anxiety can cause insomnia, as can a host of other potentially serious ailments, such as sleep apnoea, restless legs syndrome or mood disorders like depression, that may require medical treatment. In short, any stressor, such as sleep apnoea, chronic infections, allergies or psychological-emotional, can therefore raise cortisol levels.  

Melatonin and cortisol are in an opposite relationship; when melatonin is high, cortisol should be low and vice versa. When either of these gets out of balance, our ability to sleep is affected.

Melatonin, however, is relatively inexpensive and readily available at local pharmacies in the United States. However, in the United Kingdom and other countries, it typically requires a prescription, and many people will go out and buy it on their own. So what’s the best approach to taking melatonin? Here’s what experts had to say.

How does melatonin work?

Melatonin, often referred to as the molecular expression of darkness, is a hormone the pineal gland produces in response to darkness that regulates the sleep-wake cycle. During the day, the gland does not create melatonin. After the sun sets, darkness triggers it to secrete the hormone into the bloodstream to bind to receptors in various tissues and therefore enforce circadian rhythms causing drowsiness and other signals that it’s time to sleep. Melatonin is light sensitive and will react to morning light exposure when our brain is signalled to pull back on melatonin release. Morning light also signals the brain to release cortisol, our awake and defence hormone against potential predators. 

During the day, the brain’s pea-sized pineal gland remains inactive. A few hours before our natural sleep time, as it gets dark outside and the light entering our retina fades, the gland switches on to flood the brain with melatonin.

There shouldn’t be any surprise that melatonin is sometimes called the ‘hormone of darkness or ‘vampire hormone’” because it comes out at night,

Learn more

Helping your child sleep better.

Helping your child sleep better.

The number of children being prescribed the previous jet lag hormone melatonin to help their child sleep has nearly tripled in the past seven years.

Melatonin is indeed not a sleep hormone but a biological marker of darkness.” For example, in humans and other diurnal animals, the release of melatonin into the bloodstream helps prepare the body for sleep. 

A recent study from the Netherlands suggested that teenagers’ sleep problems can improve after just one week by limiting evening exposure to light-emitting screens on mobile phones, tablets and computers. 

Overexposure before bedtime to blue light emitted from devices can affect the brain’s clock and the production of the melatonin hormone, resulting in disrupted sleep time and quality.

 So is sleep medication being overused by children?

Speaking to Colin Espie, a professor of sleep medicine in the Nuffield department of clinical neuroscience at the University of Oxford, is one of many leading experts worried by this trend. “We seem to be socialising our youngsters into the idea that sleep is difficult, and you need tablets for it,” he says. Instead, he explains, our focus should be on helping them to establish healthy sleep patterns at home.

As stark new NHS figures show, children are experiencing an epidemic of sleeping problems amid a sharp decline in their mental health triggered by the pandemic. Insomnia can exacerbate an underlying mental or physical health problem. 

Emma Thomas, YoungMinds’ chief executive, said: there is alarming pressure young people face with their mental health, with many experiencing isolation, loneliness, and reduced support caused partly by the pandemic.

Here are some valuable tips. 

Prepare children’s minds for sleep (even your three-year-old can meditate)

If we want children to sleep naturally, teaching simple, mindful noticing skills can be helpful, says Dr Guy Meadows, co-founder and clinical lead at the London clinic Sleep School. At Sleep School, children as young as three are taught to meditate. “You don’t tell them they’re meditating and put their favourite teddy on their tummy, lie on the floor with them, and they just watch the teddy go up and down.” It calms the mind, preparing it for rest.

You might also ask: “What are you grateful for today?” The important thing is that “we’re shifting the mind into a state more conducive to sleep”.

Don’t tell your nine-year-old to ‘go to sleep now!

We see an increase in sleep anxiety in children from the age of six, Meadows says — “an explosion of the mind’s ability to create worry”. Meanwhile, almost all parents tell their children, “It’s time to sleep!” or “Get to sleep now!” If a child is struggling, that can pressure them. Instead, say: “Let’s just see if you can rest.” Every child can rest. Rather than insist they sleep when you know they’re not ready, Espie asks: “How can my child have some quiet wakefulness?”

It’s essential to be a good role model, Meadows says. “You can’t expect your children to be off their devices if you’re sitting in bed watching Netflix, scrolling through your phone.”

Let your anxious seven-year-old sleep in your bed.

When primary-age children are anxious and sleepless, they often seek comfort in their parents’ beds. And many parents let them — for months. They often feel as if this is some failure. It’s the opposite, Espie says. No parent should feel guilty about this. Treating your child’s sleep issue as a shared responsibility takes effort and is the right thing to do. You’re guiding them towards better sleep habits. “This is about habit training,” he says.

In this situation, your child’s initial habit is struggling to settle and be awake alone in bed at night. They are stressed and need reassurance.” Letting him sleep with you solves that problem and breaks that habit.

Let's talk about your inner monologue

Building upon a previous podcast on self-talk because many of us, when we read something, you hear a little voice in our head. Most of us would refer to this as an inner monologue. Just in case you didn’t know, many individuals don’t have one. 

Individuals often make assumptions about someone’s internal experiences, being identical for everyone, such as talking to themselves or seeing words in their heads as images.

According to psychology professor Russell Hurlburt, approximately 70% of people do not have one. However, if you are one of the ones that do not, don’t despair. He teaches this at the University of Nevada. “I’m convinced that inner speech is a robust phenomenon; if you use a proper method, there’s little doubt about whether inner speech is occurring at any given moment.

And I’m confident about the individual differences—some people talk to themselves a lot, some never, some occasionally.

An inner monologue happens when we use language but do not use our mouths; it’s merely thinking and hearing yourself without actually saying anything aloud.

Hurlburt concluded that only 30-50% of people had an inner monologue in a study that he carried out. Hurlburt took a sample of 30 students and then had them describe randomly selected experiences. 

“Five main characteristics emerged, each occurring in about a quarter of all samples (many samples had more than one characteristic). 

Three of those five characteristics may not surprise you: Inner speech occurred in about a quarter of all samples, inner seeing occurred in about a quarter of his specimens, and feelings only occurred throughout a quarter of all samples.”

Additionally, he said that subjects only experienced talking inwardly to themselves 26% of the time, and some never encountered it.

“Inner speech is the product of the default mode network of the brain,” explains Helene Brenner, a psychologist and creator of “My Inner Voice”. “It’s a network of different areas of the brain that become very active, all together, when we’re not engaged in doing anything task-oriented—when we’re just thinking or daydreaming. 

It also appears to be related to drug cravings, and it turns out it never entirely stops either—it just gets suppressed when we become more actively engaged. 

This phenomenon begins in childhood, as we develop language skills. Research believes that those who lack aphantasia (the ability to visualize) are tied into a lack of inner monologues. 

However, there are many theories about why- and more research is still being carried out.

Are you one of the few who have an inner monologue? Perhaps that little voice inside you speaks up every once in a while with tiny, insightful declarations. You would do well to listen to it with reflection and self-awareness. Let it be your friend and not your critic.

Therapy on a budget for generation Z

According to the National Institute of Mental Health, in 2020, young adults aged 18 to 24 had the highest prevalence of mental health issues.

Though mental health issues are common among Gen Z, indi­vid­u­als born between 1995 and 2010 — are grow­ing up in an age of increased stress and anxiety. And been called the most depressed generation are more likely to seek mental health counselling or therapy than their older counterparts.

COVID-19 has significantly impacted on Generation Z. The pandemic has radically changed their educational and social experiences. The American Psychological Association explains that psychotherapy, also known as talk therapy, will help people of all ages live a happier and healthier life with the assistance of a psychologist.

Talk therapy is the most common type of therapy today for mental health. It has numerous benefits, from helping you break unhealthy habits to pinpointing triggers.

However, everyone has varying needs regarding

mental health, and talk therapy isn’t the only outlet for the many different areas of mental health. Here are seven unique types of therapy that can help you take care of your mental health.

ART THERAPY

Sometimes words can’t encapsulate what you genuinely feel, but art can. Art therapy uses creative expression to explore your inner emotions, ultimately fostering healing and increasing self-esteem, self-awareness, and emotional resilience. Art therapy comes in many forms, but the most common are colouring, collaging, painting, photography, and sculpting.  

SAND THERAPY

Sand therapy is precisely what it sounds like. Through sand trays, patients create images that reflect their inner emotions. The presence of sand helps increase patient emotional expression, while also decreasing negative feelings that might arise while discussing traumatic events. Psychotherapists use this technique to assess and treat mental illnesses through a less intimidating space. Sand therapy can be used in cooperation with talk therapy or art therapy. Sand play Therapists of America can help you find a therapist specialising in this treatment closest to you.

GESTALT THERAPY

Rather than talking about experiences, gestalt therapy encourages patients to re-enact them. This therapy helps you dive deeper and experience your feelings rather than just talking through them. After re-enacting, therapists will ask you questions like, “What is going on right now” or “How does this make you feel?” This therapy helps you become more aware of your senses, accept the consequences of your behaviour, and learn to fulfil your needs while respecting others. 

DANCE/MOVEMENT THERAPY

You’re not alone if you need a random dance party to get you through the day — I’m right there with you! You can dance it out in this therapy instead of talking it out. Dance/movement therapy utilises movement to promote social, emotional, and physical responses to improve health and well-being. It taps into psychological and behavioural issues that speaking can’t address. Through exploring your mind-body connection, dance/movement therapy can help you overcome depression and anxiety, combat eating disorders, improve body image, and relieve everyday stress.  

Techniques of this therapy include: 

• Mirroring is the movement of others to develop empathy or to see a reflection of your feelings.
• Using dance to demonstrate a struggle in your life as a way to work through it and celebrate your overcoming it.
• Make a gesture, the therapist told you to do, so you can observe it mindfully and become more aware of your body.

Learn more: