Category Archives: Psychoeducation

Habits

DESPITE the best intentions for the new year, the reality is that by next month, gym memberships will lapse, chocolate will replace carrots and Candy Crush will edge out Moby Dick.

It’s not (only) that we’re undisciplined slugs. It’s that much of what we know — or think we know — about habits is wrong. Here’s a primer that might help keep you off the couch and on the treadmill.

MYTH 1 We fail to change our habits — or start good new ones — because we lack willpower.

Not really, said Wendy Wood, a professor of psychology and business at the University of Southern California. Willpower, she said, is more about looking at those yummy chocolate chip cookies and refusing them. A good habit ensures you’re rarely around those chocolate chip cookies in the first place.

To create or change a habit, you have to think much more about altering your environment and patterns of living than work on steeling your mind, Professor Wood said, because “behavior is very much a product of environment.”

Habits — at least good ones — exist so we don’t have to resist temptation all the time. Imagine if every morning you had a debate with yourself about eating cake or cereal for breakfast. Instead, most of us form the habit of eating something relatively healthy for breakfast, which bypasses the lure of the cake altogether.

That’s why it’s sometimes easiest to start or break a habit during a major transition. This may sound counterintuitive, but a new house, job or relationship breaks old patterns, said Gretchen Rubin, author of the forthcoming book, “Better Than Before: Mastering the Habits of Our Everyday Lives.”

“People say wait a few days to get settled, but don’t,” she said. “Start right away.”

MYTH 2 We fall back on bad habits when stressed. In fact, good habits persist even in times of high anxiety, Professor Wood said. A study of which Professor Wood was one of the co-authors found that students who already had unhealthy diets would eat junk food when stressed, but those who already had the habit of eating well — or of reading a newspaper or of going to the gym — were just as likely to do that.

MYTH 3 It takes about 21 days to break or make a habit.

That number seems to have cropped up in the 1960s and somehow became “fact” with no real proof. But in 2009, researchers in Britain decided to take a deeper look by studying how long it took participants to learn new habits, such as eating fruit daily or going jogging. The average was 66 days.

But individuals’ times varied greatly, from 18 days to 245 days, depending on temperament and, of course, the task involved. It will most likely take far less time to get into the habit of eating an apple every afternoon than of practicing the piano for an hour a day.

MYTH 4 You need positive thinking to break or make a habit.

“We find positive fantasy is not helpful and may even be hurtful when trying to reach a desired future or fulfill a wish,” said Gabriele Oettingen, a professor of psychology at New York University and the University of Hamburg.

Over years of research, she discovered that people need to pair optimistic daydreams about the future with identifying and imagining the obstacles that prevent them from reaching that goal — something she calls mental contrasting.

Say you want to stop being a procrastinator. The first step is easy. Imagine how it will feel if your work is completed with plenty of time to spare, if you can sleep instead of pulling an all-nighter, said Professor Oettingen, author of “Rethinking Positive Thinking.”

But don’t just resolve to stop procrastinating. The second step is to identify what holds you back from changing yourself. Is it fear that you won’t succeed? Is it the adrenaline rush of frantically working at the last minute? Is it because of negative feelings toward a boss or teacher?

The mental contrasting needs to be in the right order. It’s important to “experience our dreams, then switch gears and mentally face reality,” Professor Oettingen said.

Doing it the opposite way — imagining the obstacles and then fantasizing about changing habits — doesn’t seem to work as well, research shows.

MYTH 5 Doing things by rote, or habit, isn’t good in most cases. It’s better to be mindful of everything we do.

Research shows that most people repeat about 40 percent of their activities almost every day.

“We only have so much room in our brain,” said Ian Newby-Clark, an associate professor of psychology at the University of Guelph in Canada. “It would be incredibly taxing if we had to mindfully plan every step of our day.” Habits free us up so we can think about other things.

And while some habits are objectively bad — smoking, say, or being consistently late — most are subjective. “Habits are only good or bad to the extent they’re consistent or inconsistent with your goals,” Professor Wood of U.S.C. said. It’s a bad habit when “it starts interfering with other goals you have.”

For example, many people said their resolution this year was to cut down the time they spend online.

But why? Because it’s an inherently bad thing to do? Or is it an obstacle to spending more time reading books or riding a bike or learning to knit?

After thinking about it, you may choose to spend less time on your computer or phone. Or you might decide it’s not so terrible in limited doses and shed the habit of feeling guilty about it.

MYTH 6 Everything in moderation.

“There’s a real difference among people about how easily they adapt to habits,” Ms. Rubin said. Some see habits as liberating; some see them as a trap. Some prefer to make a huge change all at once; others proceed step by step.

“I’m in the small minority that loves habits,” Ms. Rubin said, adding that she tends to find it easier to abstain from certain things altogether. For example, she eats no carbohydrates.

“People said I was doomed to failure, but it’s not true,” she said. But, she noted, “it’s a mistake to think the abstainer is more disciplined. For me it’s easier to be an abstainer than have to deliberate each time whether I can eat something or not. Others would go nuts if they abstain.”

That’s why you shouldn’t listen to people who tell you you’re doing it wrong if it works for you, she said.

Also, people shouldn’t fear that their habit will dissolve if they don’t practice it daily.

“If you lapse once or twice, you’re not ruined,” Professor Wood said. “That’s a misconception.”

And that leads to …

MYTH 7 Shame and guilt keep you on track.

No. People need to be kinder to themselves, showing self-compassion if they lapse, Ms. Rubin said. But it’s a fine balance between treating yourself kindly and making endless rationalizations and excuses.

“I might mindfully make an exception,” she said, such as choosing to eat a traditional Christmas cake every year. “But I’m not making excuses in the moment: I’ll hurt the hostesses’ feelings. You only live once. It’s the holidays.”

One last piece of advice: If you want to be in better shape, get a dog. Professor Wood said studies show dog owners have lower body mass indexes. But here’s the catch: That’s only true if you walk the animal.

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National Public Health Week

The American Public Health Association champions the health of all people and communities. We strengthen the profession of public health, foster understanding, engagement and support for key public health issues and directly influence public policy to improve global health. Our members represent virtually every public health discipline and are active in more than 40 countries. APHA publishes the American Journal of Public Health and The Nation’s Health, convenes an mindembodiedorangAnnual Meeting and Exposition where thousands of participants share the latest public health research and leads public awareness campaigns such as Get Ready and National Public Health Week.

During the first full week of April each year, APHA brings together communities across the United States to observe National Public Health Week as a time to recognize the contributions of public health and highlight issues that are important to improving our nation. For nearly 20 years, APHA has served as the organizer of NPHW. Every year, the Association develops a national campaign to educate the public, policymakers and practitioners about issues related to each year’s theme. APHA creates new NPHW materials each year that can be used during and after NPHW to raise awareness about public health and prevention.

Men and Depression

In my years f doing groups I have on occasion facilitated men only groups. One issue that comes up is depression. We all have bouts of sadness now and than and when those bouts of sadness interfere with our daily lives than we need to take a step in the direction of change. Below is a handout I often use, particularly with dual diagnosed men.  5241352878_f53a343088

Symptoms of Depression

Not everyone who is depressed or manic experiences every symptom. Some people experience only a few; some people suffer many. The severity of symptoms varies among individuals and also over time.

· Persistent sad, anxious, or “empty” mood.

· Feelings of hopelessness or pessimism.

· Feelings of guilt, worthlessness, or helplessness.

· Loss of interest or pleasure in hobbies and activities that were once enjoyable

· Decreased energy, fatigue; feeling “slowed down.”

· Difficulty concentrating, remembering, or making decisions.

· Trouble sleeping, early-morning awakening, or oversleeping.

· Changes in appetite and/or weight.

· Thoughts of death or suicide, or suicide attempts.

· Restlessness or irritability.

· Persistent physical symptoms, such as headaches, digestive disorders, and chronic pain that do not respond to routine treatment.


Co-Occurrence of Depression with Other Illnesses

Depression can coexist with other illnesses. In such cases, it is important that the depression and each co-occurring illness be appropriately diagnosed and treated. Research has shown that anxiety disorders which include post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, panic disorder, social phobia, and generalized anxiety disorder commonly accompany depression.

Substance use disorders (abuse or dependence) also frequently co-occur with depressive disorders. Research has revealed that people with drug and/or alcohol addiction are almost twice as likely to experience depression.

Depression has been found to occur at a higher rate among people who have other serious illnesses such as heart disease, stroke, cancer, HIV, diabetes, and Parkinson’s.

Causes of Depression

Very often, a combination of cognitive, genetic, and environmental factors is involved in the onset of depression. Modern brain-imaging technologies reveal that, in depression, neural circuits responsible for the regulation of moods, thinking, sleep, appetite, and behavior fail to function properly.

In some families, depressive disorders seem to occur generation after generation; however, they can also occur in people with no family history of these illnesses. Genetics research indicates that risk for depression results from the influence of specific multiple genes acting together with non-genetic factors.

Environmental factors such as trauma, loss of a loved one, a difficult relationship, financial problem, or any stressful change in life patterns, whether the change is unwelcome or desired, can trigger a depressive episode in vulnerable individuals. Once someone experiences a bout of depression later episodes of depression may occur without an obvious cause.

Men and Depression

Men are more likely than women to report alcohol and drug abuse or dependence in their lifetime; however, there is debate among researchers as to whether substance use is a “symptom” of underlying depression in men or a co-occurring condition that more commonly develops in men. Nevertheless, substance use can mask depression, making it harder to recognize depression as a separate illness that needs treatment.

Instead of acknowledging their feelings, asking for help, or seeking appropriate treatment, men may turn to alcohol or drugs when they are depressed, or become frustrated, discouraged, angry, irritable, and, sometimes, violently abusive. Some men deal with depression by throwing themselves compulsively into their work, attempting to hide their depression from themselves, family, and friends. Other men may respond to depression by engaging in reckless behavior, taking risks, and putting themselves in harm’s way.

How to Help Yourself if You Are Depressed

Depressive disorders can make one feel exhausted, worthless, helpless, and hopeless. It is important to realize that these negative views are part of the depression and do not accurately reflect the actual circumstances. Negative thinking fades as treatment begins to take effect. In the meantime:

  • Engage in mild exercise. Go to a movie, a ballgame, or participate in religious, social, AA/NA meetings or other healthy activities.
  • Set realistic goals and assume a reasonable amount of responsibility.
  • Break large tasks into small ones, set some priorities, and what you can as you can.
  • Try to be with other people and to confide in someone; it is usually better than being alone and secretive.
  • Expect your mood to improve gradually, not immediately.
  • Feeling better takes time. Often during treatment of depression, sleep and appetite will begin to improve before depressed mood lifts.
  • Postpone important decisions. Before deciding to make a significant transition–change jobs, get married or divorced–discuss it with others who know you well and have a more objective view of your situation.
  • Do not expect to ‘snap out of’ a depression. But do expect to feel a little better day-by-day.
  • Remember, positive thinking will replace the negative thinking as your depression responds to treatment.
  • Let your family and friends help you.