Senior Isolation and Loneliness Part 2

Last time we looked at Senior isolation, loneliness and depression for our loved ones who are living on their own, or maybe even with you. But, what about those in assisted living? How can they feel isolated when there are other people around them? How can they feel lonely when they are almost never alone? Loneliness among the elderly is not merely a lack of companionship; it’s the absence of meaningful connections that once defined their daily lives. If they don’t feel truly connected to or supported by the people around them, being with them may not provide enough fulfillment to combat loneliness. They may no longer have the relationships that once meant so much to them.

It’s difficult to watch a loved one navigate the waters of loneliness and depression. And loneliness and depression in seniors has some health risks associated with it, including heart disease and stroke. And for those with heart failure, the risk of emergency room visits, or hospitalization increases. So, what can we do to help the people we love deal with these feelings. Keeping a senior active and engaged might seem challenging, especially if you live far away or if your loved one is living with health, cognitive, or mobility limitations. So, what can we do to help? Try some of the following:

• Call them: use the phone, Zoom, or a video phone call.
  Regular contact with loved ones, even phone calls, FaceTime, or Zoom, can help an older adult maintain social connections. If your loved one struggles with technology, a professional caregiver can help with set-up and troubleshooting to get them going.
• Help them feel needed and valued.
  Depression in the elderly sometimes stems from feeling unwanted or not valued. Ask for input or assistance from your loved one — even if they live far away. They will thrive and appreciate the opportunity to assist.
• Participate in favorite activities.
  Find activities you both enjoy, and plan times together to do them. Stay connected through regular visits, weekend dinners, baking cookies, card games, evening walks, or grandchildren’s sporting events. These activities can go a long way toward preventing isolation and depression.
• Create opportunities for companionship.
  Encourage your older loved one to safely engage in activities with community groups, religious organizations, and senior centers to provide opportunities to meet new friends and socialize. If they are in assisted living, they may have planned activities there in which your loved one can participate. If they are living alone, hiring a companion can sometimes help.

But what if this loneliness becomes something more: depression. Depression can be a vicious circle for those who already feel lonely; causing a low mood or lack of motivation which makes it very difficult for them to spend time with others. When they withdraw from others, the feelings of loneliness can increase. This can in turn deepen depression. And the lack of interaction with others may cause other health issues such as: Alzheimer’s, dementia, or other cognitive health problems. Watch for the signs of depression: feelings of hopelessness, loss of interest in activities, changes in sleep or appetite, and thoughts of suicide.

If you suspect your loved one is suffering from depression, talk with them. Let them know they are not alone. If the depression is serious, suggest they see a doctor for medication, or that they speak with a therapist. Offer to go with them to the doctor if they are afraid to go alone. Support them as they take the steps to improve their lives.

Winter Blues

The holidays are over. Lights taken down, decorations packed away, candles blown out. Maybe you’re more aware of the brevity of our days, the darkness or grayness of the weather and short days, or the loneliness as all of the activity has ended and you’re back at work full-time. While some of this is very normal and natural, if feelings of depression, isolation, anxiety or simply “feeling down” are intense or last for more than two weeks can be a symptom of a more serious problem–depression.

Frequently the holidays bring to the surface long avoided feelings of loneliness, discouragement, or dissatisfaction with family relationships. You may find you feel disconnected from others, that you don’t count, or that no one cares for you. Often food, music, and work are used to push away those feelings. But in bed, late at night, you’re aware of the feelings again. And with no holiday to look forward to, it’s even harder to keep going.

It is important to determine whether the blues are temporary or are a symptom of depression. If it’s been more than 10-14 days, it’s time to consider emotional reasons for depression. If they are deep and/or began in November, you might also need to consider whether you have seasonal affective disorder (SAD).

Generally, the holiday blues will resolve with no extra effort within a few weeks. While you may feel sad, tired, or distressed, you are able to handle everyday activities and responsibilities. Spring may become your goal as you deal with rain or spring break is the vacation coming up. You are moving forward.

Depression is more intense than the “blues”. First, the hope in the vacation or spring or some other experience is not present. Depression is interfering with your daily life. What used to be enjoyable may now feel like a burden. In fact, getting out of bed in the morning may be more than you can handle some days.

Other warning signs are:

• Feelings of emptiness, guilt, hopelessness, or despair,
• Lack of energy–even after eight hours of sleep,
• Changes in eating and sleeping patterns,
• Feeling irritable and overwhelmed—life’s responsibilities feel crushing,
• You can’t concentrate or follow through on plans, or
• Memory isn’t as crisp as usual.

The good news is that depression IS treatable. Up to 80% of those who finally seek help are helped. If you have a doctor, nurse practitioner, therapist, or psychiatrist you trust, go, and talk with them about what is going on. Often, we believe we must keep a stiff upper lip and not ask for help for depression. It may be considered a sign of weakness to ask. But the fact is depression is not helped by just ‘thinking positively”. Professional intervention is often necessary, and treatment for depression may be multi-faceted.

First, see a therapist for a complete evaluation. For years studies have indicated that therapy along with anti-depressants is more effective than anti-depressants alone. Naturopaths and others also have good luck with herbal remedies many times. Then, increase physical activity as exercise allows the body to produce more endorphins which increases mood. Minimize the amount of sugar and flour you eat as these foods increase depression. Finally, get adequate but not excessive rest–six to nine hours per night. If this sounds like too much, choose one to try for the next week. If you don’t have success, then call one of the professionals I mentioned above. If you don’t know someone, ask a friend for a referral. You might also try the following:

• Partnering with a friend can be very helpful during these times. Connect with a friend to hold each other accountable to do one thing you’ve avoided. Build on that success.
• -Listen to your heart. Do you need time with a friend, a funny movie, or a day with a child?
• -Often depression is anger turned inward. Consider forgiving yourself.
• -Take care of your physical needs. Set reasonable goals and develop a way to achieve them.
• -Plan an outing for March when it’s warmer and brighter. Or, consider your spring garden and what you will do with that as it warms up.

Hold onto hope. As C.S. Lewis said, “You are never too told to set another goal or to dream a new dream.” It may feel impossible today, but if you reach out to another, accept help, and don’t stop believing, you will find a clearer day ahead.

Managing the Holidays

Is your holiday season different this year?  Maybe you must work and can’t be at events with family or friends.  Perhaps you are feeling depressed and anxious already, and as you are learning to manage it, with holidays upon you, you are feeling you’ll never get hold of the emotions.  It’s possible someone close to you died this year, and the point of holidays seems removed from you.  Or maybe you are struggling with an illness and so the thought of holidays, food, or get-togethers just isn’t as important to you as you deal with the illness.  Whatever may be different this year for you, perhaps we can simplify it a bit and make your holidays not just manageable but truly meaningful.

1   Breathe In, Breathe Out: Finding Calm Amidst the Chaos

Keep calm and take 3 deep, slow breaths.

So, the idea here is to just stop – slow down – breath.  For those of you who have anxiety, pain, or need to take a bit more time, I love this practice and recommend it regularly.  For the breaths:

1. Breath in slowly through your nose to the count of 4.
2. Hold that breath to the count of 7.
3. Release the breath slowly to the count of 8.

2   Perfectionism: Letting Go of Unrealistic Expectations

Consider alternative, stress-free ways for gift-giving, especially if you’re facing health challenges, financial constraints, or a lack of shopping energy. Opt for online orders, catalog browsing, or thoughtful gift cards that can be easily purchased through your computer, tablet, or a simple phone call. Another heartfelt approach is sharing homemade treats or creating personalized gifts, such as notes of appreciation or cherished memories. These gestures can forge connections and bring joy without the need for extensive shopping expeditions.

You can get creative.  Check out Pinterest for ideas.  Ask your friends for their thoughts or what they’ve done.  The goal here is to keep it simple and low stress whatever you choose to purchase or make.

4   Downtime: The Secret Ingredient to a Balanced Holiday

While prioritizing rest may seem mundane, it’s a crucial step, especially when combating fatigue. Fatigue impairs our ability to navigate life effectively. Mental Health America emphasizes that rest isn’t just about regaining energy; it regulates hormones, aids muscle repair, enhances cognitive functions, and acts as a buffer against depression and headaches. Consider the wisdom of our canine companions—experts at ensuring they get the rest they need. As a dog owner, I’ve learned from my dog’s trainer that downtime is essential for both the pet and owner relationship. Just as my dog needs it to relax, I need it to maintain a sense of control and well-being. Therefore, for your own sake, prioritize and book your downtime first.

5   Feelings: Acknowledging and Embracing

Navigating holiday emotions can be challenging when there’s pressure to be constantly cheerful. However, acknowledging and processing your true feelings is essential for a smoother journey through this season. Whether through journaling, confiding in a friend, talking to a therapist, expressing yourself through art, or simply recognizing your emotions, taking these steps helps you own and understand your feelings. Avoiding emotions only delays their expression and may lead to unintended outbursts. Devote just five minutes to journaling or quiet reflection—it can make a significant difference in overcoming emotional bottlenecks.

6   Mindful Consumption: Balancing Indulgence and Wellness

While indulging during the holidays is common, it’s crucial to maintain balance. Remember to stay hydrated, incorporate exercise or walks, limit sugars and alcohol, and uphold your usual vitamin and self-care routines. Even one day of following these guidelines contributes to better overall health. If dealing with addiction, prioritize sobriety, considering extra meetings if needed. Explore available support during Christmas, as many areas offer 24-hour meetings for those struggling. The holiday season isn’t about the quantity of challenges but how we carry them. Embrace spiritual practices, whether through reading, meditation, or attending religious services, to stay grounded. Take time for rest, reflection, and connection with your spiritual beliefs, fostering a sense of peace and vitality. Ensure a day of rest, reflecting on gratitude and spiritual connection, throughout the holiday season. Prioritize self-care amidst the week’s hectic pace, approaching each day in December with a focus on your well-being rather than conforming to perceived expectations.

7   Spiritual Connection: Nourishing the Soul

Don’t forget to take time to connect with and nurture your soul. Whether it’s meditation, reading a spiritual book or the Bible, or taking a walk in nature, feed your soul during this hectic season. Sometimes when the holidays get hectic, we forget to pray and ask for guidance. We tend to put God on a shelf because we would rather be getting things done rather than praying about what needs to be done. But God will never be outdone in generosity. Give time to prayer and meditation and you’ll be amazed at what you can accomplish.

As we embark on this journey together, remember that the holidays are not about the challenges we face but how we live through them. Join us in creating a season of simplicity, mindfulness, and genuine joy. Stay tuned for insights, tips, and a sprinkle of inspiration to make this holiday season your most meaningful one yet.

Take care,

Dr. Beth

The Coming Dawn: Paradox of Expectations

It’s been said that the morning comes with expectations and the evening ends with experiences. Have you ever been asked to go on a hike, and wanted to go, but expected the view in the desert to be brown and very hot, and not terribly exciting?  But the hike sounded wonderful?   

As you keep walking the hot, dry desert there are various twists and turns, and you learn new lessons about the desert and what it is like, what you are capable of hiking.  And then there is turn, perhaps around the small mountain to the right, where you will see a whole new view that opens, like this:

The difference reminds me of how my expectations often are short-sighted and only about now.  It can lead to an experience that seems “unfair” or somehow wrong.  As an example, when I got Finley, my one-year-old Australian shepherd, a year ago, I very much enjoyed much of the love the companionship and fun I wanted.  There also were many days of housebreaking and teaching him to walk on a leash and playing with him when I was exhausted.  On one particularly difficult day, he chose to go and dig up a sprinkler line and come in full of mud (and joy) in the middle of an appointment I had with a client.  Not a happy dog-mama at that moment!  But today, all I need to do is call him when I see him out in the yard and suspect he is digging and he runs right in and comes to me.  And it is rare for him to do it.  So I ended up with a well-behaved dog (most of the time) and I’ve learned more patience, but the middle was not always fun and I wasn’t necessarily anticipating some of how I grew in this first year.  😊

Henri Nouwen spoke about this as the paradox of expectation in his writings.  He wrote of many paradoxes, but in this one we may be expecting something wonderful, and yet receive pain, growth, or challenges in the middle, and the gift comes through that experience.  In being open to this potential growth or gifting we can make it through some very painful days more easily.  As Nouwen aid, “those who believe in tomorrow can better live today…those who expect joy to come out of sadness can discover the beginnings of a new life” (Henri Nouwen Society, March 12, 2019 Daily Meditation).  Finley did grow up – and is much better behaved as a one-year-old than he was 9 months ago.  And when I could remember he would mature and grow out of things I had much happier days. 

I have a couple of friends going through very difficult cancer treatments right now.  And you know I see clients who are often going through hard, hard times.  We are all stressed this year by Covid-19 and the changes it has brought to our lives.  When I turn to the expectation paradox, I get through these experiences so much more easily as I truly do believe good will eventually triumph in health, recovery will follow the sickness of chemotherapy, and when a loved one is near the end I truly do believe my loved one will again have a new life.  I also believe that somehow a new normal in living with Covid-19 will come that allows better treatment or vaccine that will allow more contact and connection with others physically as well as through the virtual sources we often use now. 

Am I being a Pollyanna?  Well, I don’t think so.  What I’ve learned over years is that if I expect that eventually things will work out, whatever happens in the middle is just the middle.  It doesn’t mean I don’t grieve if I lose someone in death.  It doesn’t mean I enjoy it when a doctor has a concern.  And it doesn’t mean that I want to offer shallow compassion.  But I do want to help you, and others, to remember this is but one day in our lives, not all of it.  A Jewish proverb I have read is “He that can’t endure will not live to see the good”.   And aren’t we really talking about the essence of hope as expressed on a save to my Pinterest board, “H.O.P.E.:  Hold On Pain Eases”.  So, what to do in the middle?  One part is dealing with what is in the middle.  If there are treatments we must undergo, we do it.  A little over a year ago I needed to have a biopsy in out-patient surgery.  To not address that would have been very unhelpful.  It would have been closing my eyes and ignoring the situation.  That’s not what I’m talking about.  Instead, it was scheduled, and most fortunately, I was able to find out everything was fine quickly.  For others, it’s going through very difficult treatments.  Either way – we come out the other end – pain does, indeed, ease. 

Another thing I recommend includes self-care methods I’ve written about frequently.  But what about just looking for positive things happening in our world right now?  We tend to over-focus on the election, Covid-19, and other concerns that are valid, but when overly focused upon lead to depression and anxiety and constant unrest within.  We cannot ignore those concerns, but we also need to take time to notice what we are grateful for and what is positive around us.  Angie found several things, and I’ll mention three here:

Take a look at “Cook Like a Firefighter”, an event ongoing through October 17 at https://egivesmart.com/events/ibl/.  Quite a few Arizona fire departments are participating in a fundraiser for burn victims.  You’ll find recipes you can make at home and each department has a separate link to a video to watch them prepare the dish!

A baby gets to hear his mother’s voice for the first time and let me tell you, it is adorable and reminds me of the miracles in medical science! https://abcnews.go.com/WNT/year-hears-mothers-voice-time-reaction-precious/story?id=73083089

Finally, a story for both dog and cat lovers alike, a local rescue group brings together an unlikely family: https://www.abc15.com/news/state/rescued-dog-who-lost-her-puppies-adopts-trio-of-orphaned-kittens

Where to find such stories and information when you just need a breath of fresh air?  Check out https://www.goodnewsnetwork.org .  This allows us to also alter some of our expectations by reminding us that, as my grandma used to tell me, “It’s always darkest before the dawn” – and dawn will eventually arrive no matter how bad it feels or is today. 

May you each remember the paradox of expectation and focus on the joy that will come, the healing, the peace.  As Nouwen says, your heart will be full of joy again.  We are wishing each of you some time of lightness, peace, and rest so you may take on the next challenges to come your way with a renewed spirit.

Take care,

Dr. Beth & Angie

Beth Sikora, PhD and Angie Read, B.S.

Making Decisions: A Time of Challenge but All Shall Be Well

It seems there isn’t a week that goes by that doesn’t demand we make decisions about our safety and health as well as that of our families’, elections, finances, how to better show respect for each other, and what to do about school for our children.  While that is always the case in some way, 2020 has certainly brought all of these issues to a much higher frequency and intensity than we’ve had to deal with in the past.  It’s hardly a surprise, then, that both anxiety and depression are rising at a very high speed and being predicted to be the next pandemic we’ll have to address.  In fact, the Arizona Republic today reported that a warm line that is for those struggling with those feelings has gone from an average of 850 to 1500-2000 calls a week since mid-March.  So, with an awareness of how much stress is on individuals with decisions right now and the anxiety and depression increase I’m including a Part 1 and Part 2 to this blog.  The first is on decision making, and the second on anxiety and depression. 

Part 1:  Decision Making   

Weighty decisions can be difficult to make when the options are clear or there are good arguments to be made for either side. And right now, that is proving especially true. It’s tough to know the right thing to do, isn’t it? Mask wearing. Elections. Going back to school or a workplace. How do you make decisions when there are so many unknowns, and the options are not the best? There was a clip on Good Morning America this past week from a pediatrician who was sharing her advice on making decisions. Her focus was on safety of students returning to school but my takeaway was something that could be expanded to broader decisions: there is no “right” decision.  A person just has to make the best decision for his or her family with the information available at the time  and move on. So, let’s take it back to the basics, and start with the decision-making process itself.

1. Identify the decision: Clearly define the nature of the decision you must make.

2. Gather relevant information: Collect some pertinent information from trusted sources. Some information is internal: you’ll seek it through a process of self-assessment. Other information is external: you’ll find it online, from other people, and from other sources.

3. Identify the alternatives: As you collect information, you will probably identify several possible paths of action, or alternatives. You can also use your imagination and additional information to construct new alternatives. In this step, you will list all possible and desirable alternatives.

4. Weigh the evidence: Draw on your information and emotions to imagine what it would be like if you carried out each of the alternatives to the end. As you go through this difficult internal process, you’ll begin to favor certain alternatives: those that seem to have a higher potential for reaching your goal.

5. Choose from alternatives: Once you have weighed all the evidence, you are ready to select the alternative that seems to be best one for you. You may even choose a combination of alternatives. Your choice in Step 5 may very likely be the same or similar to the alternative you placed at the top of your list at the end of Step 4.

6. Take action: You’re now ready to take some positive action by beginning to implement the alternative you chose in Step 5.

7. Review your decision & its consequences: In this final step, consider the results of your decision and evaluate whether or not it has resolved the need you identified. If the decision has not met the identified need, you may want to repeat certain steps of the process to make a new decision. For example, you might want to gather more detailed or somewhat different information or explore additional alternatives.

This process may be one you already intuitively use, but if you feel you’re more of a gut reaction person, write down the direction you want to take based on your instinct and then try using the process described above. Do you arrive at the same conclusion? Is there a way to blend both conclusions that feels like a well-informed answer for you? Remember that even in times of uncertainty, we can each only do our best. What is right for today may not be what is right for tomorrow, so take some time, consider all options, and trust yourself. We can only make the best decision for today, and with the information we have today.  Know that and try not to question the decision later.  Reassessing later is fine to see if you need to change direction, but it’s again a decision made from the information you have on that day.  The decisions you make will be the right ones for yourselves for today, and that’s the best any of us can expect.

Part 2:  Anxiety and Depression Increasing

Essentially depression is a feeling of hopelessness, sadness, and/or loss of interest in life or activities you would generally enjoy.  It may be situational, i.e.:  related to a current situation in your life; or, clinical, i.e.:  related to a biological change or malfunction from medical, hormonal, genetic, or other reasons over which you may not have control.  Anxiety is a sense of impending doom or reaction to a stressful or situations perceived as dangerous.  The symptoms of each are specific, and you can get more information on anxiety and depression on our website.

Now that you understand it – what do you think?   Are you suffering a bit from it?  I do encourage you to track it for a while to see where you are with it and how it’s trending.  So, get a piece of paper, a notepad in your device, or use a program, and rate it 1 (none at all) to 10 (you could act on suicide today).  If it is 8-10 you need to call your doctor or therapist.  Or, at the bottom are a few crisis lines if you can’t quickly reach someone for help.  Please don’t let your ego or past beliefs get in your way – depression is a high-risk illness – and potentially can be fatal in a small number of cases.  So, get the help you deserve.  How about anxiety?  I would encourage you to again track for a while – what is triggering it?  If it’s decision making – see above.  If it’s getting sick – work on focusing on what you’re already doing to take care of yourself and family.  And if it’s always stuck in your head, ask for help. 

If you are nervous about dealing with both children and work this fall, sit down and speak with your partner or a good friend and work out a plan for your day.  Sometimes using a calendar helps one in organizing the day so you know what the children need to do and where they need to be – whether at school or online for school, work hours, doctor and other appointments, shopping, etc.  And together also brainstorm all the free services or low-cost services you can call on to help save you time – Instant Cart, Door Dash, individual store shop and pick up options, and others.  Also, who can you share with and split the errands or needs?  Perhaps after reviewing your calendar together your spouse or partner can list all the errands for the week, and each agree to handle some of the work.  The same with work around the house.  Often an hour of planning can help save you hours.  And that will mean decreased anxiety and depression.    

Other anxiety and depression prompts can be larger with less tangible solutions.  Things like, will I be laid off?  How will I survive if that happens?  What will happen in the election?  Worry about a parent in an assisted care whom you cannot visit presently.  Or even a lonely feeling of not seeing friends as you have in the past, the isolation many are enduring.  Interestingly the steps are similar to decision making in that we need to first identify what is triggering the feeling.  Next, look for information about that to identify whether you are worrying or anxious about a reality or something that isn’t real at present.  An example might be a fear of being laid off as fear of the economy is in your mind.  Well, check out your company’s financial condition, see what your boss or Human Resources know about potential lay-offs.  They won’t give you concrete assurances, but often you can identify whether things have even been talked about and check the trade periodicals for the same.  Then consider how to make your position and you more valuable to the company and be sure to improve your position through upgrading skills, identifying your successes to more than just yourself, and challenging any negative thoughts that are not grounded in facts.  Even if you are affected by a lay-off by doing these last things you are upgrading your value to other companies.  Then note this on your calendar for 30 days out and reassess.  Each time you want to worry – take yourself back to the calendar and notice you have a “worry date” made for later.  That written task let’s our brain let go of this more easily.  The steps here are:  a) identify the cause of the feelings; b) get information about the reality of the situation; c) determine if there is someone else who can help you gain more information or perspective (often this is a spouse or friend); d) list options you can take to better the situation for you; e) make a date to next evaluate the situation; and f) reassess it on that date. 

Next time I’ll write about loneliness as it is impacting so very many individuals and I believe it is frequently underlying the current depression.  But for now – you have some concrete tools to deal with situational depression and anxiety and decision making.  I also have to encourage you to call on your spiritual resources, support people, creative outlets, and music.  All can improve or worsen our current functioning.  So, consider a step in each of these areas, you may be surprised how much something as simple as listening to music if you haven’t for awhile will help your mood.  Or coloring a mandala.  Or even just doing a walking meditation or online church service.  We’re not made in isolation, folks, we need others to live successfully.  So, use the creations of others (music), the connection spiritually that you have; the friends and close others in your life as well as family; and creation outdoors to bolster you at these times.  And if it is even too much for those resources, see the resources for immediate help if you can’t reach a therapist or physician.  But take care of yourself and reach a therapist or doctor for ongoing care. 

To close I’ll share a prayer that was written during a time of great difficulty 100’s of years ago: 

All shall be well.

And all shall be well.

And all manner of thing shall be well.  (Julian of Norwich)

Be well and take care of yourself,

Dr. Beth

Teen Lifeline:  (for teens) 602-248-8336 or 1-800-248-8336

Maricopa County Suicide and Crisis Hotline:  1-800-631-1314 or 602-222-9444

National Suicide Prevention Line:  1-800-273-8255 and for Spanish:  1-888-628-9454

Crisis Response Network:  602-347-1100

Decision making process excerpts taken from https://www.umassd.edu/fycm/decision-making/process/

An Exercise for a Time of Adversity

I’ve been working on my thoughts for the blog this weekend – one I promised on growth in adversity. And I’ve written it once, had it edited, and am issuing a fully rewritten one now. Obviously, adversity is hard to go through – and challenging in other ways. The meditation that had hit my inbox on Friday that spoke to me about growth in adversity was from Henri Nouwen in “You Are Beloved.”  And what strikes me today in it is the same and yet different after more meditating and doing a finger labyrinth meditation today.  The quote is: 

“The great conversion in our life is to recognize and believe that the many unexpected events are not just disturbing interruptions in our projects [or lives], but the way in which God molds our hearts[.]…Our great temptations are boredom and bitterness. When our good plans are interrupted by poor weather, our well-organized careers by illness or bad luck, our peace of mind by inner turmoil, our hope for peace by a new war, our desire for a stable government by a constant changing of the guards, and our desire for immortality by real death, we are tempted to give in to a paralyzing boredom or to strike back in destructive bitterness. But when we believe that patience can make our expectations grow, then fate can be converted into a vocation, wounds into a call for deeper understanding, and sadness into a birthplace of joy.” [changes mine]

What my labyrinth walk, a talk with a friend this morning, and the above from Nouwen have all pointed me toward is – – release.  Release is necessary to grow in times in adversity.  In fact, it was just in rereading the quote that I realized that the onus was on God and Spirit to mold – not me to change.  And then release of what?  From what?  To what?  Ahhh – there is the rub at times.  From even knowing that. 

What we often want so much during difficult, really adverse life events or times is to KNOW.  Know what we are to do next.  Know why something happened.  Know how to change it.  Know how to prevent it.  Know how to keep life from changing as it has been comfortable for us. And in the last weeks, months, or even days, we each have had to face down varying levels of demons or challenges in our lives.  Think about it for just a moment – what are you facing right now?  Is it illness?  Is it not understanding your partner or spouse?  Is it not knowing what to do next to help someone?  To help yourself?  Is it financial difficulty?  Go ahead, take a few moments to name the situation for yourself. Write it down if you’re open to doing so before you read on.

Now, what is it that you are trying to control in that situation?  For me, often it is outcome.  I want to be able to create a change or gain an insight in order to grow and move.  Or I want to create that space and hold it for another.  But my goal or method is not the answer; often, it is allowing the answer to unfold.  It is … release.  And yet being with someone or sharing the process with someone without knowing is to walk in darkness alongside them knowing that is enough.  As you are aware of what you are trying to control – perhaps a parent from getting Covid or dying from it alone in an ICU; maybe how you will pay the bills in 3 months when the severance runs out or tomorrow when there is no money; maybe how your employer is responding to changes in life recently; or maybe how you are managing your day-to-day life in the midst of a mild or moderate depression.  Give yourself a moment to pause, and again write down whatever outcome you are trying to control.

Next, I’d like you to find an object that reminds you of that issue.  A penny for a financial one; a rock for a stubborn issue you can’t seem to get around or influence; a Bayer Aspirin bottle for a loved one who is ill; these are some ideas to get your mind going.  If you can and choose to do so, take a few minutes to go find it in your home and return to finish reading. Pause here.

Then take the item you have chosen and hold it in your hand. Gently, as the hand is with the birds in the image above. Consider this item as fragile, even if, at first glance it isn’t. Your emotions about the issue this item symbolizes may be fragile, so treat this item with tender care. As you are meditating, look over the item you’re holding and see what feature you might not have noticed previously.  Release what you think you know, and turn it over and look at it with new eyes.  Consider what it has to show you.  I’ve had a very craggy rock Finley brought in the house that I’m using for my exercise in this.  And as I’m looking at it, I’m seeing an eruption in the top of it that is very sharp and discolored and today am aware of that as the focus – not the rock.  It is helping me to see the pain in something from not a heavy place but from the sensitive, hurting place.  What is different about the item in front of you – what hadn’t you noticed about it previously?  What is the message about the situation from that perspective?  Consider spending a few moments writing about that.  You might think about it in these terms if you get stuck on this part. 

I saw the _________________________ as representing _________________.

What I’d never noticed about the ___________ was ___________________________.

I’m aware now that it is possible that ________________________________.

As you finish the above exercise, what is the takeaway for you?  What have you learned by simply looking for the small factor you hadn’t considered or known about or been aware of as clearly?  Does that allow your view of the adversity you experiencing to shift?  And what does that mean to you about moving forward? Take some time to think about this and make some notes about it before moving on. Pause here.

Going back to Henri Nouwen’s writing – adversity, change, growth, understanding, and finally, joy are the stages of movement when moving through adversity and emerging in a new place.  What we must do is release ourselves from having to understand and know — and then, only then, we can begin moving towards the change, growth, understanding and finally joy that comes from that release.  The baby bird in the above picture wasn’t born with the ability to fly, it needed tending to and nurturing until ready to be released from the nest in flight. Only then, after time, after growth, came the release. I hope you can find your way to it through the above exercise too. 

Peace and calm be yours this week.

Take care,

Dr. Beth

Covid-19: Coping with the Changes 3 Months Later

This week has been again more stressful for many than past weeks as we see the number of Covid-19 numbers going up, hospitals filling, and requirements for masks in Maricopa County and many locations throughout the state.  In addition, this isn’t the first time around – this is into month 4 of dealing with this (although just into it) and I’m hearing tempers flaring, patience waning, and what I’ll term “Covid Fatigue” hitting.  What’s a person to do when this is happening?  And it’s now impacting our relationships, we know people with Covid-19, we’ve lost friends or family to it or they have had a serious case of it, and we haven’t been able to socialize or attend church and/or work in the same ways for quite some time.  And even the possibility of in-school education or dorm life is in flux right now for the fall.  And, to top it off, it’s been at or near 109F. (Good news, though, it may be down to 98F for part of this coming week.)  What a June!
 
Well, we are a resilient people, truly, although the level and speed of it varies by person.  Resiliency is the ability to overcome obstacles and move forward.  Resiliency leads to hope – and so we are to hang in there when things seem desperate.  There is an article I wrote a number of years ago about this and it’s on the website.   So, feel free to go there for more information.  But the essence is that to build hope, we must have people around us, spiritual practices, and be aware of possibility.  I’ve always liked Elizabeth Edwards quote:  “She stood in the storm and when the wind did not knock her down, she adjusted her sails”.   It’s time to adjust our sails a bit.  Here are a few ideas that have come to me lately, some of which I’ve shared here in the past or with clients, some are newer:
 
Realize you are just not accomplishing what you want to do – from something small to large?  Download Apalon’s Productive-Habit Tracker to your phone or tablet and choose just one or two things you want to be sure you do daily or weekly.  Build some success before you add more.  And give yourself a break – it is happening to most people as they live and work at home.
 
Concerned your spiritual life is not where you want it to be?  Commit to one thing a day – maybe a meditative walk; perhaps doing a finger labyrinth; spending some time to do a guided relaxation; say a prayer you relate to – a rosary, a personal talk with God, a psalm, or a pray with others through a compline online, keep a gratitude list, or listen to music that is meaningful to your heart or spirit (you choose!).
 
Fearful about the fall and what it will mean for you?  Teaching at school or via Internet?  Needing to teach your children again or sending them to school?  Sending your young adult to live in a dorm or live at home?  Focus on bringing yourself back to the present.  None of us know what August or September will look like.  So, we must stay in today.  Perhaps using a short affirmation for this will help: “I have only this moment”, “Relax in today”, “I find stillness when I live in the present”, or write your own. 
 
Feeling lonely or alone?  First, find a being in your home with whom you can share a hug, pet them, cuddle, or otherwise connect physically for a bit.  No one there and no pet?  Dr. Peter Levine urges us to hold ourselves.  How?  See Dr. Levine’s methods described and directions for several self-hug and holding exercises.  My favorite is to simply put your left arm across your tummy and with your right reach up and pat your left shoulder.  It will repeat what your mama did to you when she held you – and it is extremely calming.  Then reach out to a friend or family member by Facetime, Zoom, WhatsApp, or another method.  It amazed me again how much closer I felt to a friend last Saturday when we spent time talking by WhatsApp rather than only by phone.  Invite one or two friends over and socially distance in the evening while catching up.  Or do a Zoom breakfast or game night.
 
Uncertain or afraid of vacationing and feeling housebound?  Get your family together to brainstorm.  Two people have told me that they are doing camping trips and/or using RV’s to get time away with family.  Brainstorm a stay-home vacation – and here are a few ideas to get you going – https://www.realsimple.com/work-life/life-strategies/staycation?  The larger hotel chains have information out there on what they are doing, National Parks and Recreation has information on traveling to the parks and AAA has some information.   
 
My spouse is driving me nuts!  How do I cope?  We’ve heard about this on TV, in the news, and from our friends, right?  So how do we cope when we are living and working together full-time?  First, communication is essential.  And that is very hard when we’re stressed and misinterpreting the intention of others as well as struggling to find a little alone space.  Or perhaps just tired of the way they work as it’s different than ours or conflicts with our methods. CNN had a few ideas worth looking at. I’m most impressed with the couple who, in a 576 square foot apartment found ways to compromise and parent children.  What bothered you 3 months ago will now be driving you around the corner.  So, take a deep breathe, do something to relax yourself, get away from your spouse or partner, and talk to a friend before you try to talk to your partner. 
 
Feeling bored at home?  Listen to a new podcast (or two), review some of the art galleries we put on our website under Covid-19 resources awhile ago, go swimming, or put some music on and dance.  I’m very much enjoying the “Poetry Unbound” podcast each morning (under 10 minutes usually) and playing in the water with the puppy.  Both are new for me – and take me in different places that open my brain and heart. 
 
Ok, there are a few ideas.  Next Sunday I’m hoping to finish the article on growing in times of adversity.  But for now – I’m hoping these ideas help you just get through the tough moments in life.  I commit to acting on the alone and spirituality ideas above – so what is your choice?  I hope you do it even for 5 minutes. 
 
Take care and be well,
 
Dr. Beth
Beth Sikora, PhD, LPC, NCC

Calming an Anxious Mind

Sometimes it can seem as though our minds never turns off. During these times most recently, we may find that we have ruminating thoughts about the state of our world, our nation, our state, our county, and lastly but certainly not least–our households. Trying to maintain a positive attitude at home or with others may be difficult, let alone being fully present with others.

These are concerns facing many today, and part of a larger theme of anxiety I’m hearing about routinely in my practice. Across our nation, we are seeing re-openings of businesses, and with that comes new decisions of what is truly safe to do. I’ve provided resources in past blogs (found here, here, and here) of reliable sources to look for information as well as tools to get you through this time on my website found here.

Today though, let’s talk about the anxiety itself and how to cope with it. There is a graphic circulating online which shows varying stages of acceptance, take a look below:

This is a great illustration of the process of learning to open oneself up again. In some ways, this re-opening feels a bit like the immediate post-911 world to me. There was fear of going out and resuming “normal” life directly after the attacks because we just weren’t sure it was over. Our nation faced significant losses during that time, and we will never be who we were before that event; but, as time marched on we learned to process the experience and with that, we moved forward. We will do the same with Coronavirus/Covid-19. Take a look at the graphic, see where you think you may fall in the bands radiating off of the circle of Covid–do you see that you’ve made some progress? Or are you still practicing some of the behaviors in the darkest zone, the fear zone? Do you see that some of how you are feeling or acting are examples spread across more than one zone? That is a completely reasonable reaction. Likely where most of us are.

The above graphic also reminds me of the stages of grief, in more than one way. Many of us are familiar with this model of grieving developed by Elizabeth Kubler-Ross and I find the stages apply to more than the loss of a loved one. She defined them as, 1. Denial and isolation, 2. Anger, 3. Bargaining, 4. Depression, 5. Acceptance. Some of those examples look familiar to the handling of this Covid era too, don’t they? The initial denial that this could be happening to the people of our world, our nation; the anger at others who may not be taking the news the same way we have chosen to respond; the bargaining–if only we’d done X, then…; and the isolation which can also bring on depression.

My point to all this? We’ve handled grief likely on a personal basis, but also as a nation before. We’ve been fearful of unknown forces. We have come through it, and maybe we don’t look the same as we did before the catastrophe–on a world or national scale or on an interpersonal, familial one such as after the loss of a loved one–but we humans are resilient and even after a time that feels like it could have been the end of the world, we can again find beauty in things. So, let’s talk about how to move forward.

Mindfulness. Merriam Webster defines mindfulness as: 1: the quality or state of being mindful. 2: the practice of maintaining a nonjudgmental state of heightened or complete awareness of one’s thoughts, emotions, or experiences on a moment-to-moment basis also; a state of awareness. It’s a topic I’ve covered on a recent blog found here because I feel strongly mindfulness is one of our most useful tools in healing.

• I came across some wonderful “attitudes for anxiety” in a blog post on Positive Psychology–to read the full post, click here. The 10 attitudes to practice for anxiety are towards the bottom but there are a number of other tools to practice she highlights–it’s worth the read. The one I find most essential is to: 1. Notice what is going on in your body. What are you feeling? Where? Is it the discomfort of reflux? The heart-pounding of panic? The headache or migraine of muscle tension? 2. Just stay with that feeling and feel it for a moment. Really let yourself become aware of what is going on internally. 3. Recognize what your thoughts are that either preceded the physical issue or are still present with the physical sensation. 4. Take a slow deep soothing breath into that part of your body that is in pain, taught, or uncomfortable. Hold it. Then blow it out as fast and hard as you can. Imagine that breath out as the difficult thoughts and feelings – blow them all out of your body. Do this several times and then attend to the area of the body with some self-care, i.e.: massage the muscles, notice the heart pounding may have slowed down with the breaths, or the reflux released just a little and if not take the medication you have for it.
• Learn to meditate. There are countless videos and apps for meditation, some found on our website here, others a mere google search away. But here’s a good one I learned from a nun at an anxiety workshop many years ago. Spend 5 minutes looking into the flame of a candle. A well done video with an introduction to this meditation and a recorded candle’s flame for this process can be found here.
• Deal with only one day at a time – Jon Kabat-Zinn has discussed this on Oprah’s Super Soul Sunday, the clip may be found here. He proposes checking in on yourself. How do you feel this morning? Are you still upset about a fight last night, or worried about an upcoming meeting? What do you want to achieve today? Understanding how you feel before you embark on your day can help you go through your day more mindfully. “Drop in on yourself and rest for a stretch of time,” Kabat-Zinn says. “And then as you go about your daily life, check in. Once an hour, once a minute. Once a day. You decide”.
• Another technique a trusted colleague recently reminded me of when dealing with anxiety about the future and what is okay to do now or in a week about Covid-19 is to look at your watch. What time is it? What day? This is all you can make decisions about and deal with in this situation – use your watch as your reminder. See this blog for more information.

As I’ve written about before, practice good self-care. Not only the physical in good hand washing practices or wearing masks; but also, the mental self-care. Remember to limit your media consumption, be gentle with yourself, and get outside daily. If you’re dealing with OCD, it can be a tough time to manage your symptoms. If your current techniques aren’t working or you’re becoming worse through this, here’s an article written first person by someone who is handling OCD related to our current pandemic. Take a look at her tips, and if they’re new to you consider implementing the ideas. Even if they were routine previously, it may be time to up your game on using them. There are also some basic self-care principles written about here.

The same basic ideas apply to how to best care for your children during this time, but I cannot underscore this point enough, talk to them. Ask questions about how they’re feeling in an age appropriate way. If they’re older, see if they have questions on the state of things related to the illness and the ability to go out in the world or what your emergency preparedness plans would be. Ask them how they’re really doing at this time, and if they’re isolated from their peers–and consider supporting them in some things you previously may not have been as open to such as gaming on a device. In limited doses, it may be a great way for your kids to stay connected to their friends–it’s often a group activity yet can be played from individual houses. Watch for behavior changes in them–and if you’re seeing signs that are worrisome get them help. At this time of tele-therapy, they may be more open to the idea of talking to someone from the comfort of their own space rather than having to go into an office for counseling. If your children are younger, don’t overlook playtime as moments that feelings surface. Role playing with dolls, or even putting names to favorite play cars and trucks may bring out “feelings” the toys may have–but could really be the feelings your child may be dealing with. Remember, just like it can be hard for us as adults to put a name on a feeling or be forthright when we are having a hard time, children feel that too. Play with your kids when you can make time. No moment is too small–from the bathtub to a walk around the neighborhood, remember to take moments to check in on your littler people. Here’s a quick read from Seattle Children’s hospital on helping children and teens cope with anxiety.

I hope this provides some tools to each of you to calm the anxiety you are facing. Remember that this, too, is just a season. It will pass, and even if we have some longer lasting changes to adapt to, as was said by the late great Maya Angelou, “I can be changed by what happens to me. But I refuse to be reduced by it.”

If you need some professional help, know I’m only a phone call away. Get ahold of Angie, my practice manager, and get yourself scheduled. I’m here for you, reach us by phone at 602.508.9190.

Wishing each of you an easy mind today, a restful night tonight, and a more peaceful tomorrow,

Dr. Beth

Decisions…Difficult but Important to Choose and Own

Our current times continue to present challenges in many ways for all of us.  From the smaller decisions of what to purchase at a grocery store and how to do so: online, via delivery, or in-person; whether we’ll follow the guidance to wear masks; to the no-brainers of breathing in and out each day, and to the largest decisions about when to retire and other big life changes.  We can say that some of these decisions are easy, whereas on others we will not reach agreement with everyone.  As Eleanor Roosevelt said “In the long run, we shape our lives, and we shape ourselves.  The process never ends until we die.  And the choices we make are ultimately our own responsibility”.  There are crucial decisions being made by governors and legislators right now related to COVID-19, the economy and businesses, as well as protecting individuals.  At this time, we are also called upon to make our own choices, and decision-making is often challenging and stressful.

Part of this stress is brought on by hearing multiple conflicting ideas about how to open a country back up, what is too soon, what is too long, how much individual health and lives should be considered versus the economy, and whose guidance should be followed in these areas.  I believe, as Eleanor Roosevelt and others have said, that we are responsible to determine what is in our own or our loved ones’ best interest.  Some of the decisions our leaders make we need to assess and determine what to follow and when, such as the recent ones, and ones to come, about reopening.  So, I thought it was time to review a few basics on decision making.    

First, get yourself in a quiet place, without distractions, and relax yourself.  Hard to do in a Covid-19 world, but perhaps these steps will be taken over a period of a day or two, and that’s fine.  This might be doing some meditation, prayer, deep breathing or yoga, or other ideas you might have.  It’s important to have our brain available, and when we are relaxed, we have more capacity to use our full brain without it being impacted by a fight, flight, or freeze change in brain reaction. 

Second, once you’ve done the above, write down what the decision is that you’re trying to make.  Tie it down to one decision, after all we can’t make more than one decision at a time.  Writing it down helps you to focus.

Third, do the research you need to do.  For decisions about work, going out of the house, deciding whether to go to salons or restaurants, or even just whether to grocery shop versus using pick-up services, I’ve found some sources of information and am providing those here.  These links provide various views so you can consider what the pros and cons are.  But seek out your own sources as well.

1.  CDC suggestions/plan on how to reopen

•  CDC guidance documents on various topics relative to COVID-19. 

• WHO ideas on reopening workplaces

• Arizona Department of Health Services dashboard with statistics of what is occurring in each county in AZ.

• Arizona Department of Health Services blog by Dr. Cara Christ

• Governor Ducey’s page with the current status of things as they change. 

• Governor Andrew Cuomo’s guidelines for reopening New York**

•  Governor Newsome’s plan for reopening California**

**I’m providing several Governors’ plans as it will allow you to see what they are considering and that may help you in making your own decisions.

After reviewing the facts and areas to consider from the above or other information you have, the fourth step is to write down your pros and cons on choosing to take various steps, i.e.:  go out to dinner vs. picking up dinner or having it delivered, going to the hair or nail salon, working in these environments and offices, and the others you’ll be faced with in the next week to months.  Then if it is clear to you what you will do, be clear with yourself how you reached the decision.  We can only make the best decision we can on any one day and with the information available to us.  You’ll want to reassure yourself later why you made a decision if later you question it.  If it is not clear, consider talking it through with your spouse, a significant other, close friend, person you respect, or trusted other.  And then follow the above once your decision is made. 

The fifth step, that will seem familiar to all who have studied science – from junior high forward, is to re-evaluate and make sure the decision still makes sense as you go.  Feel free to change your mind if that makes sense to you later.  For example, as many have suggested from a lot of entities and as we’ve seen in other countries, the numbers are going to go up as we reopen, so you may choose to change your decision if they are going up very rapidly, or begin going back down.

I ran across this in looking for a poem on choice and decision-making.  And in the end, I loved the simplicity of it:

Source credit: quotesgram.com

Having peace during these times is challenging – but remember that with following all the guidelines we already know from so many sources, continue to:

1.  Wash your hands often, with soap and water, for at least 20 seconds.
2.  Wear a mask in public.
3.  Cover your nose with a Kleenex if sneezing anywhere.
4.  Cover your mouth with a Kleenex if coughing.
5.  Socially distance keeping 6’ between you and the other person/people.
6.  Clean and disinfect touched surfaces regularly and throughout the day.
7.  Do not touch your face or wash your hands after you do.

All of these get tiring to hear about at times – but they will be essential for a long time to come.   And they can provide you with peace within that you are doing all you can to protect yourself and others. 

Finally, remember to take time to relax, enjoy your family around you, reach out to friends in socially distant methods, pray, meditate, and use the tools we and others have provided. 

See our website for general resources.

We also have COVID-19 specific resources as well as blogs on ideas in managing these stressors.

You deserve to take care of yourself, and I encourage you to make your own decisions, and take care in all the ways you need to do so during these challenging days.  We’ll be back to the regular blog again on Sunday, but I wanted you to have these thoughts earlier as things are changing rapidly. 

Take care,

Dr. Beth

Caring for Yourself in Times of Fear and Illness

This week has been a stressful one for many people.  The combination of the coronavirus, the stock market, the grey skies and rain, school and college closures, and the world news each day has been very hard.  But . . . in all of this, did you catch any of the good news?  It’s a bit hard to find, I learned, as I went to locate some for you to try to balance the week.  I did finally find a couple of pieces: 

            The La La Land Kindness Café in Dallas has hired 9 foster kids who aged out of the foster care system and were having trouble locating jobs.

            How about the House and the President agreeing, within just a couple of days, to relief legislation for victims of the coronavirus? 

            The Dow started a rebound today – that’s very good news for most!

            All of the fast action employers and schools/universities are taking to protect their employees and students – it seems unprecedented to me, although it may not be.  From Amazon in Washington to ASU to Ford to many others many are limiting exposure by providing employees with laptops and having them work and study virtually.  

All of these are truly ideas that are very positive news – and get covered in the anxiety so many are feeling, and the care for family that is often at the root of this.  Just tonight I learned one of my sisters-in-law may have been exposed to it, and her father likely has it.  Yet of the 16 members of my family nearby, she is the only one, which is good news thus far. (Edit 3/15/20: Good news! Her father’s test results reflected negative results.) See how we can flip it?  In psychology it’s called reframing the bad or difficult situations by looking at life a bit differently, without denying the hard does exist as well.

We sent out notices about Covid-19 procedures for our office this week.  Now it’s time to also offer some concrete help along with the above reframe tool.  The American Psychological Association and the National Association for the Mentally Ill are the two sources I’m using for the ideas that follow.  I wanted you to have some resources to print or click for the coming weeks.  What I know from 911 and other events is that when we are faced with being bombarded on social media and news media with information that is difficult, we tend to seek out more information and stay focused on the difficult situation.  This merely drives fear and anxiety up further.  We do need to know what we can do to try to protect ourselves; but once we know, i.e.:  wash hands to count of 20, do not shake hands and stay a further distance from others, and isolating someone with clear symptoms including fever, cough, and shortness of breath, we need to also look at how we care for our family and selves in a way that minimizes the fear and focuses on good things in life.  And, in the situation we have right now, we also need to know how we can cope with isolation whether from working at home, not going out for social events, not being able to travel to family or friends on trips we have had to cancel, or other reasons.  And we must have a method to deal with the uncertainty, fear, loneliness, depression, resentment, and challenges we face trying to secure things we may need.  So, here goes!

1.  Make sure you have some games to play that are age appropriate for you and your family, and especially if you have children.  If isolated, the family will need ways to entertain themselves, laugh, enjoy each other’s company, and get through the days together.  We know that closeness breeds irritation, so have some things that can break up the days and draw you together, not apart.
2. Have a plan with your doctor.  My physician sent out a text announcement to all of his patients tonight just letting us know he’s there, where to go for trustworthy medical information on the virus, and what to do if we are having symptoms.  Reach out to your pediatrician, cardiologist, pulmonologist, or primary care to know ahead what to do and how their office is managing this.
3. Use the tools that help your mental health on a regular basis.  So…do:
4. Keep up your physical activity – there are some great YouTubes on how to do yoga, walk along with you to keep your steps up (I like Leslie Sansome’s https://www.youtube.com/watch?v=m9yI2LGZRE0), and many others depending on what you prefer to do.
5. Make sure you have enough medication or supplements like Rescue Remedy, Vitamin C and B, and other things around to keep you feeling better and less anxious. 
6. Stay on a schedule.  We can get very loosey-goosey when at home too long or too much.  So make sure you keep an agenda to normalize your life and not fall into the doldrums too much.
7. Make sure you can connect with Messenger, FaceTime, and the others available.  It helps for you to actually see friends, not just text.  We’re learning that the more texting that is done, the lonelier people are becoming.  So, in this time of increased stress – reach out even more and if you can’t touch one another, at least see one another.  I know someone who was separated from a loved one for quite some time, and they would watch a favorite show while connected on Facetime.  Another dad who was away who would play checkers with his children.  Get creative in your connection!
8. I know you get tired of it – but remember to breathe when anxious.  Or start a mindfulness app during this time.  The website has a number of these on the Links page, and this is a great time to learn to do it and practice.
9. Listen to music that uplifts you – for me that might be one thing – but what is it for you?  Listen!  Music does a lot to impact our moods.
10.  Keep some numbers available if you need to reach out to a warm line, i.e.:  you’re not suicidal but you are feeling isolated and need to connect.  See SAMSHA’s line for disasters at 1-800-985-5990 or locally at 602-347-1100.  And remember AA, Al-Anon, and many other groups have online and phone meetings.  Take care of your sobriety as well! 
11.  Pay attention to your spiritual practices.  I love labyrinths and downloaded the Mount Mojo Labyrinth Journey app to my cell phone quite some time ago.  I can walk it by finger on the phone even if I have only 5 minutes and can’t get to one locally.  Or, call a friend to pray.  Watch a Joel O’Steen, Beth Moore, or even your own pastor or rabbi may have something online to watch or even just listen to. 
12. Humor, humor, humor!  You have to laugh!  I go to Bob Newhart videos, Carol Burnett, or Tim Conway as well as Friends and Frazier.  My mom loved SpongeBob Square Pants (I did not ever figure that one out!)  How about funny movies often free on Amazon Prime, Netflix, and other places you may have membership. 

All of these are tools – now you just need to use them.  As I said in my letter to current clients, I’m here and I am available.  Feel free to call and schedule an in-person or video therapy session.  The teletherapy appointment is on an encrypted service that meets HIPAA standards, we don’t use FaceTime or other things that might seem easier – but don’t offer the privacy.  So, if you can’t come – we’ll walk you through how to set it up. 

May you find these ideas helpful – and know there is a hand to reach out to.  And keep reaching out to friends as well.  Do you have other ideas?  Let us know and we can share those on our Facebook page. The disasters end.  The illnesses come to an end in such large proportions.  The blue skies come out again.  Something my mama told me growing up is that “it’s always darkest before the dawn”.  Obvious, right?  But it kind of normalizes problems and difficult times.  And reassures us – that “Joy will come in the morning!” (Psalms 30:5).  And so it will!

Take good care of yourself!

Dr. Beth