Well.. I’m here to tell you that if you don’t take care of yourself, things will only get harder and more difficult. The process is essential to our overall wellbeing and the overall wellbeing of our relationships, work, etc. Though it is helpful anytime, Self care works much better when it is proactive rather than reactive. The 45 minute therapy session each week is great start but it is equally important to make sure you are follow through on the changes in your daily life in the other 23 hours out of the day.

How to make time for self care:

1. Prioritize yourself & set a schedule
2. Start with smaller increments of time 10-15 minutes
3. Start with smaller, more managable goals
4. Pick friends who will help hold you accountable
5. Journal/track changes

If you or someone you know is struggling with mental health and wondering how to take care of oneself properly, please reach out today. We look forward to helping you!

Make an appointment: https://www.specializedtherapy.com/make-an-appointment/

The post Self care is… first appeared on Specialized Therapy.

The post Self care is… appeared first on Specialized Therapy.

• The limits and rules we set for ourselves and within relationships, to protect our well-being
• Knowing our limits in a given situation, knowing what’s acceptable to us,  and what isn’t
• Knowing our values
• Having self-respect, meaning acknowledging our needs, not just another person’s
• Having respect for others, not being self-serving
• Being assertive, saying no without ambiguity

Why are Personal Boundaries important?

• They are a safeguard to overextending yourself.
• They are a self-care practice. 
• They define roles in relationships. 
• They communicate acceptable and unacceptable behaviors in relationships.
• They are parameters for knowing what to expect in relationships. 
• They are a way that you ask people to show up by upholding your needs.
• They are a way to create clarity. 
• They are a way to feel safe. 

How do I know what my Personal Boundaries are and how do I set them?

• Define them
• Examine experiences and notice where boundaries are lacking
• Connect to the intuitive voice (the feelings, sensations in your body, such as feeling pressure in your chest)

Quick Exercise

1. Think about a past, present, or future experience. Example: How do you feel when you think about, say, seeing an old friend?
2. Does your chest tighten? (Think about your feelings, sensations in your body, thoughts)
3. Is there a feeling of resentment leading up to it? (“Ugh I don’t want to go” could be a related thought)
4. How about during the meeting? Do you feel energized, calm, nourished, or depleted, guarded, and limited?

Types of Boundaries

Physical Boundaries

• The amount of personal space, physical contact, that is most comfortable for you and your preferred timing for physical contact
• Your overall comfort with verbal comments on your appearance, sexuality, etc.
• Your overall comfort with sharing your personal space (apartment, bedroom, office, etc.) with others (including friends, partners, colleagues, etc.), sharing personal digital passwords, etc. 

Mental/Emotional Boundaries

• Your overall comfort with sharing your personal thoughts, opinions, and beliefs with others without changing them to match those of another or insisting that others change to match yours
• Your ability to choose which personal thoughts, opinions, and beliefs, you share with others without feeling it necessary to overshare or attempting to insist that they overshare

Resource Boundaries

• Your ability to exercise choice around where and how your time is spent, avoiding any tendency toward people pleasing, etc. and to allow others to have a similar choice
• Your ability to negate personal responsibility for others’ emotions, avoiding the tendency to play the role of “fixer” or to make others responsible for your emotions
• Your ability to limit the amount of time spent on venting problems on the part of either person

Examples:

Physical: Friend makes jokes about other people’s weight

Change needed: You want them to stop

Mental/Emotional: A friend often emotionally dumps about her ex-boyfriend

Change needed: You want a more reciprocal relationship

Resource: Friend insists on a venue closer to their house than to your dwelling

Change needed: You want to meet at a more fair location for consideration of your driving time

Identify the specific commonly crossed boundaries to identify changes you would like to see. Use the following prompts:

My physical self feels uncomfortable/unsafe when _____________ (friend makes comments about my appearance)

To create space for my physical self to feel more comfortable/safe, I_________ (I will no longer be around people who do this)

My mental/emotional self feels uncomfortable/unsafe when _____________ (my family member makes comments about my new health choices)

To create space for my mental/emotional  self to feel more comfortable/safe, I_________ (I will no longer defend, argue about my personal health choices)

My resources feel  uncomfortable/unsafe when _____________ (my cousin call me at all hours to talk)

To create space for my resources to feel more comfortable/safe, I_________ (I will no longer take those calls)

References:

LePera, Nicole. How to do the Work; Recognize your patterns, heal from your past, and create your self: New York, HarperCollins, 2021

Tawwab, Nedra Glover. Set Boundaries, Find Peace: A guide to reclaiming yourself: New York, TarcherPerigee, an imprint of Penguin Random House LLC, 2021

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Let’s think about some of our most prized possessions for a moment: our cars. Whether you’re driving around in a Ferrari or a Ford, your car is probably very important to you! We wouldn’t put diesel fuel into a gas-powered engine and expect it to run well, right? If you are not fueling your body with whole foods such as fruits, vegetables, whole grains, healthy fats, lean proteins, beans and legumes, and adequate amounts of water you might be shorting yourself in the vitamin and mineral department. 

Vitamins and minerals, also known as micronutrients, are needed for all processes in the body from bone and tissue formation to the transmission of nerve impulses through the body. Your metabolism and ability to use food as energy are dependent on your body having enough of certain vitamins and minerals to act as catalysts for these millions of internal chemical reactions. Think of your body as one big science fair where all kinds of different reactions are happening all at once in all parts of your body all of the time — cool right?! 

Let’s go over some of our most in-demand vitamins and minerals:

1) Magnesium

Magnesium is the sixth most abundant element on Earth. It is necessary for over 300 biological processes within the human body, yet it’s one of the most common deficiencies affecting approximately 75% of Americans. Adult men need approximately 420 mg/day and women 320mg/day. What does this look like in a day of eating? 

• ½ cup all-bran cereal for breakfast with 1 banana = 126 mg
• 1 cup brown rice with ½ cup cooked frozen spinach and 4 oz salmon = 195 mg
• ½ cup cooked swiss chard with ½ cup chickpeas topped with ½ oz slivered almonds and 3 oz chicken = 263

 → DAILY TOTAL: 584 mg!

If you are focusing on eating a well-balanced diet rich in whole foods you are likely doing well in the magnesium department!

Magnesium is responsible for energy production inside each one of your 30 trillion cells. Responsibilities also include the synthesis of our own antioxidant production which prevents inflammation from building up within our bodies. Antioxidants also fight off cancer cells and prevent free radicals from doing damage to our DNA. Free radicals come from all kinds of places such as foods, environmental pollution, stress, etc. Magnesium is also needed for the structural integrity of bones, teeth, cell membranes, and chromosomes. Finally, cell signaling and cell migration can be affected by a lack of magnesium. 

Symptoms of deficiency include weak bones, muscle weakness, and spasms, gastrointestinal issues, cardiovascular issues such as irregular heartbeats and high blood pressure, migraines, and mental health conditions such as anxiety, depression, panic attacks, irritability, and difficulty concentrating.

Foods that are rich in magnesium: Green leafy vegetables, unrefined whole grains such as oats and barley, nuts, beans (navy, pinto, kidney, and garbanzo), seafood, and chocolate (yes, that’s right). 

Now Trending: If you’ve been on the famous TikTok app recently you might have seen the videos of people putting aesthetically pleasing green chlorophyll drops in their water. Green leafy vegetables contain chlorophyll. Chlorophyll is a pigment that allows plants and algae to trap light at specific wavelengths. At the center of this pigment is a magnesium molecule, hence why green leafy vegetables are such a great source of magnesium! Keep in mind that naturally occurring chlorophyll is fat-soluble, meaning that we can absorb and store it more efficiently. Naturally occurring chlorophyll is changed into a water-soluble form called chlorophyllin to make drops and supplements such as the ones in the videos. To do this, changes are made to the pigment. The magnesium at the center of the pigment is swapped for a copper atom. This is a semi-synthetic form with added sodium copper salts made from chlorophyll. So, what’s the verdict? Chlorophyll drops (AKA chlorophyllin) have some benefits such as they do still boast antioxidant properties. From a nutritionist’s standpoint — food first! With no tolerable upper limit, chlorophyllin drops are likely safe, but in most cases unnecessary. Keep in mind that there is a tolerable upper limit for copper and too much copper can cause issues within the liver. The benefits many people see from adding this to their regimen most likely come from simply drinking more water, not what’s in the water!

 Always consult your doctor before adding a new supplement, especially if you are pregnant or breastfeeding. 

2) Vitamin D

Vitamin D is one of the most underrated components of optimal physical and mental wellbeing. It’s no coincidence that each of the human body cells is equipped with a Vitamin D receptor (VDR) within the nucleus. Vitamin D plays an active role in managing healthy blood pressure, having a strong immune system, building and maintaining strong bones, proper functioning of the nervous system, healthy cell formation, and may even play a role in insulin secretion in humans, although the data is limited. 

Deficiency is common with approximately 1 billion people worldwide considered deficient while 50% of the population is Vitamin D insufficient. Deficiency is generally defined as levels less than 20ng/mL and insufficiency is less than 30ng/mL. Functional medicine doctors and practitioners prefer to see levels within the 50-70ng/mL range. These levels not only prevent disease but also promote wellness and longevity. 

A diet rich in foods such as wild-caught salmon, mackerel, sardines, eggs, and mushrooms will boast good amounts of Vitamin D. We can also synthesize Vitamin D from the sun. Getting enough sun to turn the skin a slight pink color is an indication that the body is making Vitamin D. The sunlight triggers the skin to produce prohormone Vitamin D and it is then sent to the liver to be turned into its active form where it can then be used throughout the body. 

Those with darker skin tones or those who are typically covered when in the sun are at an increased risk for Vitamin D deficiency. This is most commonly seen in those of African American, Latino, and Middle Eastern descent as well as the elderly population. When opting for a vitamin D supplement, look for a Vitamin D3 + K2 for the most bang for your buck! 

3) Selenium

Selenium is a mineral that is often overlooked as well when it comes to feeling your best. This mineral is responsible for the proper functioning of selenoproteins, which regulate antioxidant function, healthy sperm and reproduction, thyroid function, and muscle metabolism. When it comes to feeling your best, selenium is important as the enzyme that converts thyroid hormone T4 to T3 is a selenium-dependent enzyme. 

The thyroid gland is responsible for controlling the body’s metabolic rate, and poor thyroid function can manifest as low energy, weight gain, trouble losing weight, and temperature dysregulation. Those who are deficient are more likely to respond poorly to psychological stressors making this an important mineral for anyone with a high-stress life or anyone with anxiety or depression.

The deficiency of selenium can exacerbate iron and vitamin E deficiency, leading to even more symptoms such as inflammation, low energy, anemia, poor oxygen saturation, and more. Vitamin E and selenium work in complementary interaction with one another, meaning that high levels of one can mask a deficiency in the other. Eating a diet rich in both can ensure proper levels. Selenium is found in organ meats, seafood, grains, brazil nuts, and some plants. 

Brazil nuts definitely give you the most bang for your buck at 989% Daily Value for a serving of 6-8 nuts! Make it a daily habit to have 2-3 and you should be getting more than enough each day. 

Not sure what vitamins and minerals you might be deficient in? Contact us to run a full micronutrient panel and see where you might need a  supplement of vitamins to get you back to feeling your best!

References

Higdon, J., & Drake, V. J. (2012). An evidence-based approach to vitamins and minerals health benefits and intake recommendations. Stuttgart: Thieme.

Linus Pauling Institute. (2021) Chlorophyll and chlorophyllin. Retrieved from https://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/chlorophyll-chlorophyllin

Office of dietary supplements – selenium. (2021, March 6). Retrieved May 22, 2021, from https://ods.od.nih.gov/factsheets/Selenium-HealthProfessional/

Sizar O, Khare S, Goyal A, et al. Vitamin D Deficiency.

The post Do Vitamins = Vitality? 3 Key Vitamins for Health first appeared on Specialized Therapy.

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Cycling as a form of exercise has been well-documented as an effective way to improve your physical and emotional health. Exercise contributes to many health benefits including improvements in sleep, heightened libido, stress relief, increased energy, weight loss, reductions in fatigue, and improved cardiovascular fitness and cholesterol. Exercise also has been shown to improve anxiety, depression, mood, self-esteem, and cognitive functioning. This because when an individual engages in regular exercise, blood circulation to the brain increases, and the hypothalamic-pituitary-adrenal (HPA) axis, which plays an integral in maintaining our body’s equilibrium and stress response, is able to regulate stress more effectively. Research also demonstrates that the benefits of exercise can be enhanced when combined with environmental stimulation, in other words – exercise in the great outdoors!

Cycling can be an extremely effective way to improve physical and mental health, as it is an accessible, low-impact, and fun way to engage your body and brain.

Benefits of Cycling on Mental Health

1. Cycling improves mood by increasing blood flow to the body, and thus the spread of endorphins and feel-good neurotransmitters, such as dopamine, norepinephrine, and serotonin.
2. Cycling helps improve self-esteem, depression, anxiety, and stress, due to the very nature of the exercise – It is reminiscent of nostalgic childhood experiences and provides environmental exposure and engagement with one’s surroundings.
3. Regular cycling has been shown to help promote better sleep quality and sleep efficiency through synchronizing circadian rhythms and reducing stress hormones that contribute to poor sleep quality, efficiency, and duration.
4. Cycling is good for our brain functioning and memory. The act of cycling contributes to the increased production of new brain cells responsible for memory and recall.
5. Cycling can offer an opportunity to engage in mindfulness. Cyclers can use a ride to concentrate on the rhythm of their breath, each movement of their legs, the wind on their face, and body to center themselves and increase positive thoughts and feelings.

Benefits of Cycling on the Brain

1. Similar to the way bike riding promotes muscle growth, it can also promote brain growth. As cycling promotes increased blood flow to the brain, this helps the brain and body pull in more oxygen and nutrients that can improve cycling performance and brain functioning.
2. Riding a bicycle leads to the production of proteins that help create 2-3x more brain cells than normal patterns of brain cell reproduction.
3. Taking a ride on a bike has also demonstrated efficacy in preventing natural cognitive decline as a result of aging.

30-60 minutes of steady riding, with approximately 75% of our maximum heart rate, 3-5 times a week, is recommended as the best cycling practice to reap the best rewards of this fun and rewarding exercise.

Specialized Therapy Associates offers a breadth of functional medicine and therapeutic services designed for health and wellness for individuals of all ages. For a free consultation with our intake coordinator who will match you to the best provider and service to fit your needs and goals, call 201-488-6678 or visit https://www.specializedtherapy.com/make-an-appointment/ to schedule an appointment.

References:

Leyland, L. A., Spencer, B., Beale, N., Jones, T., & van Reekum, C. M. (2019). The effect of

cycling on cognitive function and well-being in older adults. PloS one, 14(2), e0211779. https://doi.org/10.1371/journal.pone.0211779

MensLine Australia. (2020, May 19). Cycling – The Exercise for Positive Mental Health. https://mensline.org.au/mens-mental-health/cycling-positive-mental-health/#:~:text=Cycling%20for%20positive%20mental%20health&text=Cycling%20pumps%20blood%20around%20your,It%20promotes%20positive%20mental%20health.

Oja, P & Titze, Sylvia & Bauman, Adrian & De Geus, Bas & Krenn, Patricia & Reger-Nash, Bill & Kohlberger, T. (2011). Health benefits of cycling: A systematic review. Scandinavian journal of medicine & science in sports. 21. 496-509. 10.1111/j.1600-0838.2011.01299.x.

Sharma, A., Madaan, V., & Petty, F. D. (2006). Exercise for mental health. Primary care

companion to the Journal of clinical psychiatry, 8(2), 106. https://doi.org/10.4088/pcc.v08n0208a

The post Cycling Improving Mental and Physical Wellness One Ride at a Time first appeared on Specialized Therapy.

The post Cycling Improving Mental and Physical Wellness One Ride at a Time appeared first on Specialized Therapy.

Carbohydrates are often demonized by the media and diet culture as being a source of weight gain. Low-carb diets are more popular than ever. It started with the rise of the Atkins diet in the early 2000s, and by the time that fizzled out the Keto diet came to fame in 2013. Are carbs really the enemy that we have made them out to be? Let’s find out.

Carbs are often avoided by many who are wanting to lose weight. This usually involves skipping processed and simple carbs such as pasta, bread, cookies, cake, donuts — you get the point. However, carbs are virtually impossible to avoid as an entire macronutrient category. They are found in all plant foods including fruits, vegetables, whole grains, nuts and seeds, beans, and legumes. They are also found in dairy products — the only animal food containing carbohydrates in the form of sugars (i.e., lactose). 

Processed carbohydrates are detrimental to our health when consumed on a long-term basis as they often contain high amounts of added sugars, fat, and preservatives. They typically spike blood sugar and over time, erratic blood sugar levels can lead to prediabetes and diabetes, hormone dysregulation, fatigue, weight gain, brain fog, and more. Unprocessed and unrefined carbs in the forms of whole grains, fruits, vegetables, nuts, seeds, beans, and legumes are foods that will digest slowly and allow for a steady supply of energy, avoiding those drastic highs and lows in blood sugar. These foods are typically also rich in fiber as well as carbs.

Let’s look at the 4 different categories of processed foods:

1. Unprocessed or minimally processed foods are slightly altered for the main purpose of preservation without altering the nutritional content of the food. This includes cleaning or removing inedible parts, refrigerating, pasteurization, fermentation, freezing, and vacuum sealing. This category includes many fresh fruits and vegetables, whole grains, nuts, meats, and milk. 
2. Processed culinary ingredients are ingredients derived from a minimally processed food by pressing, refining, grinding, or milling. They are used as ingredients in preparing meals or dishes. Some examples include oils made from seeds, nuts, or plants or flours made from whole grains. These items are typically not eaten on their own.
3. Processed foods are foods that have added salt, sugars, or fats. This includes some canned fruits and vegetables, cheeses, and fresh bread. These foods can be eaten without further preparation and are made from at least 2 or 3 ingredients. 
4. Ultra-processed foods are foods that have the same qualities as processed foods but also have added colors, preservatives, and flavors.  They are more shelf-stable and palatable due to the preservation of tastes and textures through added ingredients. Some examples are chips, cookies, crackers, cereals, lunch meats, and frozen meals. 

Due to the way most food is processed — generally, the more processed the food is, the less of its original benefits it is able to maintain. This includes the loss of vitamins, minerals, and fiber as well as the addition of salt, sugar, fat, preservatives, colors and dyes, and more. 

Food for Thought:

Brown rice is a whole grain that would fall into the unprocessed/minimally processed food category. When brown rice is stripped of the husk, bran, and germ to leave the starchy endosperm we get white rice. This is still a minimally processed food on its own, but when you buy something such as a white rice kit that comes with a spice packet or flavor packet such as Rice-A-Roni, becomes an ultra-processed food. This is a great example of minimally processed food not being the best option and how a minimally processed food can become an ultra-processed food with the addition of a spice or flavoring packet.

Fiber is needed for healthy digestion and elimination. Fiber also acts as a prebiotic; this feeds the good bacteria in our microbiome. Your microbiome is the trillions of bacteria that live in your digestive tract. By feeding these good ‘gut bugs’ they repay us by producing things like:

• Short-chain fatty acids — SCFAs for short, these molecules are vital for maintaining the health and integrity of the gut lining. These are the preferred fuel source for colonocytes AKA the cells that line the inside of your intestines. Unhealthy or weak intestinal walls can lead to issues related to food sensitivities, vitamin and mineral deficiencies, autoimmune diseases, and more.
• Vitamin K — Vitamin K is synthesized within the GI tract, specifically in the large intestine.  Specific bacteria synthesize Vitamin K2 and this vitamin is used in the body for blood clotting and coagulation.
• Vitamin B1— B vitamins are water-soluble, meaning that we do not have the ability to store them within the body as efficiently as fat-soluble vitamins A, D, E, and K. Those of us who are under high stress, taking certain medications, or lacking a diverse diet burn through these B vitamins even faster than usual. Approximately half of the microbes in your microbiome are able to produce thiamin (B1) from scratch using protein building blocks.

How do carbs benefit our mental health? 

Well, some of the most important hormones and neurotransmitters for optimal mental health are also synthesized in the GI. Chemicals such as serotonin (the happy hormone) are synthesized there. The brain and gut have a deep connection that many people do not recognize. There is bidirectional communication between the two through the vagus nerve, immune system, SCFA production, and more. What does this mean? It’s a two-way street. The gut communicates to the brain and the brain to the gut. This is why many people with conditions such as anxiety experience digestive issues. 

If you or someone you know has ever taken medication for depression, there’s a good chance it was as SSRI (selective serotonin reuptake inhibitor). Many people fail to see that without serotonin readily available to reuptake, the patient will get little effect from this medication. Eating a diet rich in complex carbohydrate-rich foods such as fruits, vegetables, whole grains, nuts, seeds, beans, and legumes will feed those good bacteria with fiber and they will benefit you right back.

Sarah’s Story:

Sarah was suffering from anxiety and mild depression and was seeking to try some natural remedies. She had learned about the importance of the microbiome and was looking to focus on this area of her health to help improve her symptoms.  She was taking a high-quality probiotic but saw little improvement.  Upon consulting a nutrition professional, she was guided in switching up her diet to remove processed and ultra-processed foods, inflammatory foods, and foods that came back as reactive on her food sensitivity test. She replaced many of the packaged and prepared foods she was having with unprocessed and minimally processed options. In just a short time she experienced mental clarity, her skin improved, her digestion was better than ever, and overall, she was feeling so much better. By feeding those good ‘gut bugs’ she was able to reap the benefits of the high-quality probiotic because she was not only repopulating with beneficial bacteria but also giving them the food that they want and need to benefit us in return. Sarah now maintains a diet rich in fruits, vegetables, whole grains, lean proteins, nuts, seeds, beans, and legumes. She has seen the value and importance of whole foods, fiber, and taking care of her microbiome through food.

If you are interested in learning more about the interplay between nutrition and mental health, please contact us at 201-488-6678 or visit https://www.specializedtherapy.com/. We look forward to speaking with you!

Bastiaanssen, T., Cowan, C., Claesson, M. J., Dinan, T. G., & Cryan, J. F. (2019). Making Sense of … the Microbiome in Psychiatry. The international journal of neuropsychopharmacology, 22(1), 37–52. https://doi.org/10.1093/ijnp/pyy067

Kazemian, N., Mahmoudi, M., Halperin, F., Wu, J. C., & Pakpour, S. (2020). Gut microbiota and cardiovascular disease: opportunities and challenges. Microbiome, 8(1), 36. https://doi.org/10.1186/s40168-020-00821-0

Putnam, E. E., & Goodman, A. L. (2020). B vitamin acquisition by gut commensal bacteria. PLoS pathogens, 16(1), e1008208. https://doi.org/10.1371/journal.ppat.1008208

Swann, O. G., Kilpatrick, M., Breslin, M., & Oddy, W. H. (2020). Dietary fiber and its associations with depression and inflammation. Nutrition reviews, 78(5), 394–411. https://doi.org/10.1093/nutrit/nuz072

The post Are Carbs Good for our Mental Health? first appeared on Specialized Therapy.

The post Are Carbs Good for our Mental Health? appeared first on Specialized Therapy.

By Taylor Groff Functional Nutritionist

COVID-19 has caused an upheaval of life as we know it, with lasting implications that extend far beyond unwavering case numbers and death tolls. The impact of COVID-19 on physical and psychological well-being has proven to be a lasting one. So much so that the aftermath is now called “long-haul covid”.

Besides the mental anguish from social isolation, unparalleled uncertainty, and multiple layers of grief and loss, those suffering from long-haul covid may experience neurological and psychiatric symptoms even if they have no history of a mental health condition. Those with previous psychiatric diagnoses are at an elevated risk for worsening mental health due to increased inflammation, a physiologic manifestation that directly correlates with depression and anxiety (1).

Risk for Neurological and Psychological Symptoms: Long-haul COVID

The Lancet recently published a study of over 200,000 people diagnosed with COVID-19 and found 33% had long-term neurological or psychiatric diagnoses following infection, with 13% receiving their first such diagnosis. Neurological complications include intracranial hemorrhage, ischemic stroke, Parkinson’s disease, dementia, anxiety, and psychotic disorder, with anxiety disorder topping the charts at an incidence of 19% (2).

The constellation of long haul covid symptoms can range from heart palpitations to shortness of breath, brain fog, dizziness, insomnia, fatigue, fever, gastrointestinal discomfort, anxiety, depression, obsessive-compulsive tendencies, delirium, loss of appetite, headache, rashes, joint pain, persistent cough, hair loss, and more (3,5,6,8). There are also reports of reduced exercise and increased sedentary behavior due to concerns about overexertion causing relapse. These concerns stem from reports that suggest reduced lung capacity in hospitalized covid patients (8,9). One study found that lung damage from COVID-19 correlated with reduced pulmonary function until four months following infection (10).

However, it’s worth mentioning that long-haul symptoms following a respiratory tract infection are not exclusive to COVID-19. There is evidence for similar long-term symptoms following pneumonia (5). Like COVID-19, pneumonia risk, symptoms, and severity are related to age and pre-existing conditions like asthma, diabetes, obesity, and heart disease. Those with type 2 diabetes have a 25-75% higher risk of being hospitalized with pneumonia due to the harmful effects of hyperglycemia on the immune system and inflammation (11). Therefore, the combination of metabolic dysfunction increased risk for infection and inflammation is not exclusive or novel to COVID-19. However, neurological and psychological symptoms appear to be more common in patients diagnosed with COVID-19 than influenza or other respiratory tract infections (2).

How Long Will Long-haul COVID Last?

The truth is, we don’t know yet. The unpredictable nature and interindividual variability of long-haul covid symptoms come with many apprehensions. A new study based in the U.K. found that 1 in 20 people with COVID-19 is likely to suffer from ongoing symptoms that last eight weeks or more, and 1 in 50 people suffer from symptoms lasting 12 weeks or more (3). A study in the U.S. found that 35% of people have not returned to their baseline level of health 14-21 days after having a positive covid test (4). Moreover, females have higher reported anxiety and depression symptoms than men despite having lower inflammatory markers (1).

Additionally, there are reports of a 58% to 224% increase in the likelihood of diagnosis with a psychiatric illness two weeks to three months after a positive COVID-19 test with a drop to 5.8% three months post-diagnosis (12). The most common diagnosis was anxiety disorders at 13%, followed by mood disorders at 10%. Insomnia and dementia in adults 65 or older also came at a significantly higher risk.

Moreover, the likelihood of psychiatric illness diagnoses between two weeks and three months post-COVID-19 diagnosis was 18% for less severe cases and 40% for those requiring in-patient ICU treatment (12).

The Asymptomatic COVID-19 Long-haul

There’s a growing concern for people experiencing long-haul covid who aren’t aware of it because they’ve never had a positive covid test (5).  People who tested positive for COVID-19 with less severe sickness exhibit long haul symptoms after the 2-week quarantine period.  The unclear distinction proposes a new set of challenges for doctors to rightfully identify long-haul covid that manifest as physical and psychological symptoms, or if these symptoms are independent of covid that arose from living through such a chaotic time.

We’re here to help

In any case, psychotherapy, proper nutrition, adequate quality sleep, targeted nutrients, relaxation strategies, connection and support, and other interventions are available for those suffering from anxiety, depression, and trauma stemming from COVID-19. As with mental and physical health conditions in general, community, self-care, and healthy lifestyle habits in addition to proper medical treatment can make all the difference in developing resiliency and even post-traumatic growth. To learn more about how Specialized Therapy Associates and Fx Med Centers can support you, call 201-488-6678.

References:

1. Mario Gennaro Mazza, Rebecca De Lorenzo, Caterina Conte, Sara Poletti, Benedetta Vai, Irene Bollettini, Elisa Maria Teresa Melloni, Roberto Furlan, Fabio Ciceri, Patrizia Rovere-Querini, Francesco Benedetti. Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain, Behavior, and Immunity. Volume 89 (2020): 594-600,
2. Taquet, M., Geddes, J., Husain, M., Luciano, S., Harrison, P. 2021. 6-month neurological and psychiatric outcomes in 236,379 survivors of COVID-19: a retrospective cohort study using electronic health records. The Lancet. https://doi.org/10.1016/S2215-0366(21)00084-5
3. Sudre, C.H., Murray, B., Varsavsky, T. et al.Attributes and predictors of long COVID. Nat Med (2021). https://doi.org/10.1038/s41591-021-01292-y
4. https://www.cdc.gov/mmwr/volumes/69/wr/mm6930e1.htm
5. https://jamanetwork.com/journals/jama/fullarticle/2771111
6. GreenhalghT, Knight M, A’Court C, Buxton M, Husain L. Management of post-acute COVID-19 in primary care BMJ 2020; 370 :m3026 doi:10.1136/bmj.m3026
7. https://doi.org/10.1016/j.bbi.2020.07.037.
8. gov/citizen-scientists-take-challenge-long-haul-COVID-19
9. Bellan M, Soddu D, Balbo PE, et al. Respiratory and Psychophysical Sequelae Among Patients With COVID-19 Four Months After Hospital Discharge. JAMA Netw Open.2021;4(1):e2036142. doi:10.1001/jamanetworkopen.2020.36142
10. https://www.cdc.gov/dotw/pneumonia/index.html#:~:text=Certain%20people%20are%20more%20likely,and%20people%20who%20smoke%20cigarettes.
11. B. Kornum, M. Nørgaard, C. Dethlefsen, K.M. Due, R.W. Thomsen, A. Tjønneland, H.T. Sørensen, K. Overvad. European Respiratory Journal 2010 36: 1330-1336; DOI:10.1183/09031936.00184209.
12. Taquet, M., Luciano, S., Geddes, J.R., Harrison, P. (2020). Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62,354 COVID-19 cases in the USA. The Lancet Psychiatry. DOI:https://doi.org/10.1016/S2215-0366(20)30462-4.

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• Rest & Relaxation: Stress is one of the most prevalent causes of fatigue. We often react to chronic stress with a fight-flight-freeze response. “Fight” may mean increased irritability or reactivity. “Freezing” may look like shutting down or disengagement. And “flight” may entail feeling a need to escape or run away. Day to day threats, whether real or perceived, and the cascade of hormones and neuro-chemicals that follow, can leave your system depleted and in need of serious repair. Implement one new relaxation technique such as meditation, reading, journaling, listening to inspirational music or whatever allows you to feel calm.

• Sleep: Sleep is one of the most underrated tools we have. Clearly, lack of quality sleep can leave you feeling tired, but did you know that over time, being sleep deprived can set you up for mental and physical illness? Sleep is needed for cellular repair, detoxification, brain health, immunity, and balanced mood and hormones. Our non-stop culture and 24/7 access to information and entertainment can trick you into thinking of a full night’s sleep as optional. If you are struggling to fall asleep, waking in the night, or wake up and do not feel rested, start with the basics: eliminate exposure to blue light, have a wind-down routine, make sure your bedroom is sufficiently cool and dark, and avoid working in bed.

• Nutrients: Food is meant to make you feel nourished. But if what you are eating leaves you feeling fatigued, it may be due to a food sensitivity, such as gluten, poor blood sugar balance, or a lack of micro-nutrients such as vitamins, minerals and antioxidants. Beyond avoiding sugar bombs and reading labels, focus on adding in a rainbow of vegetables each day. Eat a combination of fat, fiber and protein from whole-food sources to avoid spikes and crashes in your energy levels. Work with a practitioner to try an elimination diet or get tested to rule out any food sensitivities.

• Movement: Physical activity doesn’t have to mean a grueling workout. In fact, studies show that more moderate exercise is less likely to contribute to inflammation than a more strenuous regimen. Do what you enjoy most, whether that’s walking, biking, tennis, dancing, swimming, yoga or MIIT (moderate- or medium-intensity interval training). Movement is important for your body and mind, supporting detoxification pathways, mood, insulin sensitivity, stress, immunity, longevity, and yes, energy-balance. Speak with your health or medical practitioner prior to starting a new exercise plan, especially if you are recovering from an acute illness, have a chronic condition or suspect adrenal issues.

• Connection: Whether you are still adjusting or have already adapted to life “at home”, this can be a time of significant isolation, even for those with family or friends nearby. Detachment from significant others, withdrawal, or even a feeling of disconnection from yourself, can be read flags. If you don’t feel secure spending time with loved ones even while physically distant, outdoors, with a mask, try spending time in nature. Connection to the natural world can increase perspective, optimism, and take you beyond the four walls of your home, or your mind. Speaking of nature…

• Sunlight: You know how plants need sunlight to thrive? So do we. If you are finding yourself spending days on end indoors, this can definitely contribute to low energy and fatigue. There are plenty of ways to venture out in a safe and secure way. This may mean a walk around the neighborhood. Perhaps a day trip to a botanical garden or beach. Try hiking in a forest, boating on a lake, or even a picnic in a local park. You can even make it a point to have a meal outside on your deck, patio or yard each day. Sunlight is an important source of vitamin D and can help lift your mood, boost immunity and help you get more restful sleep.

• Tech break: More than ever, we are attached to our devices. In addition to excess exposure to blue light and its consequences for sleep, bombardment by media images of danger and suffering, or increased sedentary lifestyles, both the American Academy of Pediatrics and American Heart Association advise dramatically reducing time on tech for both children and adults. This can help combat fatigue. Even if you and your family need to stay connected for work and school, identify certain times each day or places in the home, to have a “screen-free zone” such as the dinner table or between 10pm and 8am. Experiment by staying off media for several hours or even one whole day to sense the difference in how you feel. Focus on what you will gain, such as time or energy, instead of what you will potentially miss out on.

• Functional Medicine: Many illnesses can lead to fatigue, in some cases extreme. Functional medicine uses root-cause assessment and resolution to find out why you are having the symptoms, and provides a more comprehensive plan for how to address them. If you suspect an illness such as autoimmunity, fibromyalgia, anemia, chronic fatigue syndrome, adrenal insufficiency, gut imbalance, infections, or thyroid issues, a functional medicine practitioner can help you combat fatigue and can offer a more lasting solution. Learn more at https://fxmedcenters.com/

• Therapy or coaching: Fatigue and exhaustion can be serious. Don’t ignore the signals. Depression, anxiety, bipolar disorder, alcohol use disorder, and many other conditions can increase fatigue, and if you have fatigue, it can make these conditions harder to manage. If you are struggling with your emotions, mood, relationships, or traumas, consider working with a therapist. If you are interested in implementing some of the above lifestyle suggestions, but aren’t sure how, or would benefit from more support to follow through, a coach can partner with you to work toward your goals and help you make your vision a reality. Call 201-488-6678 to learn more or schedule your first appointment to help combat fatigue.

By Anna Sandbank, LCSW, INHC, CMHIMP, Director of Integrative Mind-Body Health, Specialized Therapy Associates, Fx Med Centers, Xceptional You

Disclaimer: This post is for informational purposes only. It does not constitute medical advice, or replace treatment or intervention by a qualified medical or mental health professional.

The post 9 Powerful Strategies to Combat Fatigue first appeared on Specialized Therapy.

The post 9 Powerful Strategies to Combat Fatigue appeared first on Specialized Therapy.

How much do you think about the future? How much do you care about the future? Understanding a bit about how dopamine, one of the neurotransmitters in our brain, influences our behavior can help us understand our changing experience in a romantic relationship. In the book, The Molecule of More, authors Daniel Lieberman, M.D. and Michael Long explain how dopamine is the neurotransmitter in our brain firing the circuits that make us care about the future and how this changes in a romantic relationship.

How We Experience Pleasure

What is in our immediate grasp is our present; anything beyond that is in our future. Our peripersonal space contains what is in our grasp. Anything beyond that is in our extrapersonal space. The brain evolved two different circuits and neurotransmitters for these two separate parts of our experience.
Serotonin, oxytocin, endorphins, and endocannabinoids mediate our pleasure in the present. They are involved in our feeling good when we reach a goal and sit back to enjoy the fruits or of labor. In the 1950s scientists mistakenly thought that it is dopamine that helps us experience pleasure. Many people still think of dopamine that way.

However, now we know that dopamine cells fire when we react to the unexpected, to possibilities that the future might hold for us. It’s not about pleasure, it’s about anticipation. we’re not focused on what we have now and can enjoy. We’refocused on what we want to have in the future. We are wired to crave the unexpected. We are constantly making predictions about what the future holds for us. When it is better than what we expected, our dopamine cells fire, urging us to pursue that future. Dopamine drives the circuits in our brain that lead us to try to control the world so as to maximize our obtaining the resources we need from it in the future.

Long-Lasting Love

When someone meets another and is attracted to them, the other person often seems like the perfect person to them. The person imagines all kinds of wonderful experiences that they hope will happen with this new person. It’s all so new and exciting. Guess which neurotransmitter is producing that exciting anticipation. Right, it’s dopamine. That head-in-the-clouds feeling, that passionate love, lasts from twelve to eighteen months, according to Rutgers anthropologist Helen Fisher.

After that period of time, the novelty of the relationship fades. The dopamine cells aren’t firing anymore. Some people interpret this as falling out of love and think that it means that they have to move on. It doesn’t mean that love is over, only that the love they experience has changed to what is called companionate love. It’s not about what future fantasies will be realized with the one they love; it’s about loving that person in the here and now, mediated by those neurotransmitters and hormones mentioned above. The person is now satisfied with their present reality in an enduring manner. When a person is driven by dopamine, they aren’t satisfied for long. But someone who has made the transition to companionate love is on the road to long-lasting happiness.

Understanding how the neurotransmitters in our brains influence our behavior certainly helps us make sense of our experiences. Sometimes just understanding is not enough, though. Sometimes it’s helpful to talk to someone who knows about neurotransmitters but also knows a lot about helping someone navigate their way through the transitions that develop as the relationship progresses. If you’re experiencing the painful feelings that also can be a part of a relationship, then you might want to consider speaking to one of the knowledgeable and caring therapists at STA .  If so, give a call to 201-488-6678.

The post What’s love got to do with it?: Love and Dopamine first appeared on Specialized Therapy.

The post What’s love got to do with it?: Love and Dopamine appeared first on Specialized Therapy.

Procrastination is usually discussed as ‘self-sabotage’, a weakness, and shameful. In his Tedx talk, Voge invites his audience to see a different understanding of the question “Why Do We Procrastinate?”. The answer he provided was rooted in the need to feel worthy and competent. It’s something we can expect and predict given we understand human motivation and self-worth theory. When we fear our efforts will not render perfection, high achievement, or the standard we set for ourselves, we choose avoidance instead to protect ourselves from feeling incompetent and unworthy.

Self-Worth Theory of Achievement Motivation

The self-worth theory assumes a simplistic view that ability signifies self-worth (performance=ability=self-worth). If I am able, I am worthy. Thus, if you are afraid of performing poorly, you must protect your self-worth by employing certain strategies. One of those strategies is procrastination.

It’s not just a grade that’s on the line, its our self concept

Here’s a familiar scenario: You are a college student and a paper is due. After a long day of mild productivity, you start to do the paper. All of a sudden, you think “I’ll check my email”. 45 minutes later you say, “I’m tired, I should sleep and do the paper tomorrow. I will wake up extra early.” When the alarm goes off the next morning, you are not refreshed, so you turn the alarm off and sleep more. When you wake up again, you start doing other things that are easier than the paper, such as taking a long lunch with friends, cleaning, etc. The cycle continues until the fear of not getting it done exceeds the fear of failure .

Procrastination is a feeling of stuckness. You can’t sleep but you can’t work, Voge says. Procrastination is a self-protective strategy to deal with competing motivations-the drive for success and the powerful motivation to avoid failure. With procrastination, you can rationalize that it was poor sleep, being busy with other things that left you no choice but to do less at the last minute, not your ability to perform at a high level.

DTC-a helpful acronym to remember some tips for combatting procrastination

• Developing awareness
  • Gaining knowledge of self worth theory will help you combat procrastination because you understand the root
  • Gaining awareness of what you are feeling and notice when you might be avoiding through other activities, such as cleaning, checking emails, etc.
  • Getting to know your thoughts and feelings surrounding procrastination without judgment will help you to overcome it

• Tip the balance
  • It is not that you aren’t doing the task because you “don’t want to” or “don’t feel like it”; rather, it is fear and feeling overwhelmed that dominates the motivation to approach certain tasks, especially if they are particularly meaningful to you.
  • Balance that fear with thinking about the reasons why you want to do something, how doing so fits into your larger goals and mission. For instance, Voge said that he was anxious while preparing his Tedx talk about procrastination. He balanced that anxiety with his goal and mission to “reduce suffering and help people.”

• Challenge your beliefs
  • Acknowledge and challenge the belief that your self-worth comes from your ability to perform.
  • Voge offers these words:
    “Your ability is not equivalent to your worth.”
    “Worth comes from your human qualities of kindness, thoughtfulness, and vulnerabilities.”

If you need help with combatting procrastination and improving your self-worth, please call Specialized Therapy Associates at 201-448-6678 or visit our website at www.specializedtherapy.com

The post Why Do We Procrastinate? first appeared on Specialized Therapy.

The post Why Do We Procrastinate? appeared first on Specialized Therapy.

Being a People Pleaser can hurt your own mental health.

A people pleaser is a type of person who are “too nice”, almost always putting everyone else’s needs before their own. They never say “no”, are always volunteering to help, and make sure that everyone else’s needs are met first before they worry about themselves. It may sound like a good thing to always help others but this can quickly lead to emotional and physical burnout. Common examples include:

• Agreeing to cover a shift or pick up a project at work that you know you cannot do
• Not doing activities that you want to do because it may bother other people
• Doing things that you don’t want to or can’t do because you’re afraid others will be mad at you if you say no
• Experiencing guilt at the thought of saying “no” to someone
• Being afraid people would not like you if they knew the real you
• Having a hard time sharing your true feelings
• Going to great lengths to avoid conflict
• Becoming very uncomfortable at the thought of someone being mad at you

All of these qualities point to the larger theme that you are the last priority in your own life. An important step for healthier well being is learning to put your own needs first. Recognizing that you are not responsible for anyone else’s feelings, not their happiness, sadness, anger, etc.  Sharing your wants and needs in an assertive and healthy way reduces people pleasing behavior  and is a critical step in your own journey of wellness. Meaning, you are able to stand up for your own needs and still be respectful of the other person.

If you’re interested in learning more or taking the next step in avoiding the negative aspects of  being a people pleaser and putting yourself first, please visit us at https://www.specializedtherapy.com/ or call 201-488-6678.

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The post You Don’t Need To Be a People Pleaser first appeared on Specialized Therapy.

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