Blog On Anxiety, Depression, Postpartum, PPD, Weight and Relationships

Sleep – Why It’s Important & How To Get It!

by Dr. Sarah Allen

What is one of the most important things that effects our quality of life? Sleep! A good night’s sleep helps us think more clearly, be more productive and manage our mood better, especially our reactive emotions. This in turn make us feel good about what we have achieved and of course positively effects our relationships.

I have a little picture on the bookcase at my office that says “I am woman! I am tired…..” and it’s so true, many women are existing in a state of constant tiredness. This has a huge impact on our mood and increases both anxiety and depression symptoms.

We all know this, so why aren’t women making it a priority to get adequate sleep? After working all day, whether looking after small children or at the office, then seeing to the kids, dinner and evening routines, I often hear my clients say they stay up late because it is the only way to get everything done. Or it is the only time they can get time for themselves. It’s a vicious cycle though. The later you stay up, the harder it is to get going and the foggier you are.

According to the National Sleep Foundation (NSF) the “walking tired” anger more easily, have problematic relationships and are less likely than those who sleep well to exercise, eat healthfully, have sex and engage in fun leisure activities; all because they are too tired.

If we set up a good night-time routine then our every day “to do list” is much less daunting when we are refreshed! We may also need to work on being either more organized or more likely, less perfectionist, about getting things done, knowing it’s okay to ask and expect help, and knowing it is totally necessary to have “me time”. But not at the expense of sleep!

The National Sleep Foundation states “It’s not uncommon for people who don’t get enough sleep to be depressed or for people who are depressed to not sleep well enough.” This is very ‘chicken and the egg’. Who knows which comes first, but what we do know is that over time, impaired memory, mood and other functions become a chronic way of life. In the long term, this can affect your job and relationships.

So how can we improve sleep? Well, good intentions are not enough. You have to decide to try this for a week and I bet you will see some improvement in your overall mood.

Firstly, you need to keep regular sleeping hours. One or two nights of good habits is not enough to sustain postive change. A bedtime ritual teaches the brain to become familiar with sleep times and wake times and programs the brain and internal body clock to get used to a set routine. Most adults need between six and nine hours of sleep every night. By working out what time you need to wake up, you can work backwards and set a regular bedtime schedule.

Secondly, you can’t expect to “go, go, go”, then be able to fall straight to sleep. Winding down is a critical stage in preparing for bed.

Perhaps the most important thing to remember in getting enough sleep is that your needs are important and putting your need for sleep above the demands of others is the kindest thing you can do for yourself and those who are important to you.

Here Are Some Ways To Relax

Increase Body Temperature

Have a warm bath as this will help your body reach a temperature that’s ideal for rest. Heating ourselves up (wearing bed socks does the same thing) increases serotonin levels and makes you feel calmer and more relaxed.

Relaxation exercises, such as light yoga stretches, help to relax the muscles. Don’t exercise vigorously though, as it will have the opposite effect.

Do A Quiet, Non-Stimulating Activity

It is really important to avoid screens of any kind about an hour before trying to sleep. Computers, TV, phones, tablets etc. emit a type of light that is very stimulating to the brain. Here’s the science behind why. Our brain secretes the hormone melatonin to regulate our sleep-wake cycle. It should secrete more in the evening, when it’s dark, to make you sleepy, and less during the day when it’s light and you want to stay awake and alert. Blue light (the type of light from television, computers, phone etc.) is especially stimulating and can make your brain think that it’s still daytime so it doesn’t secrete melatonin.

If you wake up at night and can’t get back to sleep for more than 15 minutes try doing a quiet, non-stimulating activity, such as reading a book. Keep the lights dim so as not to cue your body clock that it’s time to wake up, a little book light is perfect. Don’t be tempted to read your emails!

Relax Your Body & Stop Over-thinking

The key to getting to sleep (or back to sleep in the middle of the night) is to cue your body for sleep by lying in a relaxed position. Hard as it may be, try not to stress over the fact that you’re awake or your inability to fall asleep again, because that very stress and anxiety encourages your body to stay awake. A good way to stay away from over-thinking things is to focus on the feelings and sensations in your body.

Make relaxation your goal, not sleep. If you find it hard to fall back asleep, try a relaxation technique such as visualization, deep breathing, or meditation, which can be done without even getting out of bed. Remind yourself that although they’re not a replacement for sleep, rest and relaxation still help rejuvenate your body.

Relaxation CDs can help as they use a hypnotic voice to guide you through muscle relaxation and soothing music and sound effects to relax your brain. Ask me for my free CD which has 3 progressive muscle relaxation (PMR) exercises on them which range from 10 – 20 minutes long. If you tend to be anxious anyway, it is good to practice progressive muscle relaxation during the day to re-set your emotional levels throughout the day. Practice also makes it easier to do at nighttime if you need it. If you don’t have a CD to listen to, start with your toes, tense them as you breath in, hold, and relax them as you breathe out. Work your way up and around your body, tensing and relaxing. If you are still awake after going all the way round, start again at your toes….

Go to your “happy place”. Yes, this really works! Visualizing places you associate with a sense of peace, slows down your breathing and distracts your mind from whatever is keeping you awake. Or if you enjoy doing something, imagine yourself going through the steps i.e. if you like to do yoga, picture yourself going through the sequence of poses you do in class or the steps it takes to bake your favorite cake.

Often night time is the first time that day that you have stopped being busy and so your brain starts dwelling on things that have happened, often giving them more importance that they really warrant. Give yourself some time earlier in the evening to process your thoughts about events that have worried or upset you and decide whether you need to take action or not. If the worries still persist acknowledge and then release each worry as it occurs to you i.e. visualize writing the worry on a balloon and in your imagination watch it floating away.

Why Does A Problem Seem So Much Worse At Night?

Spending time earlier in the evening to write “to do” lists for the next day can organize your thoughts and clear your mind of any worrying thoughts that might pop in to your head just before sleep or in the middle of the night. These types of thoughts can seem so very important in the still of the night. We start wondering about how an upcoming event will play out and the primitive ‘alarm bell’ part of our brain called the amygdala whips our idle ruminations into urgent matters that need to be dealt with straight away. This process is called cognitive fusion and it starts an adrenaline rush in the body that makes our muscles tense, breathing more shallow and we start to catastrophize, making everything a bigger deal than it needs to be. This of course prevents getting back to sleep.

Deal with cognitive fusion by keeping a notebook next to your bed and if these types of thoughts are keeping you awake, put on a little night light, write them down so you can tell yourself you won’t forget them and they can wait until morning for you to deal with them. Then do one of the relaxing strategies detailed above.

Every night we wake briefly at the end of a 90-120 minute sleep cycle. Insomnia happens when you habitually start worrying about things during that momentary wake-up period. If you have tried the strategies above but anxiety is keeping you from getting to sleep or waking you up in the middle of the night, read more about challenging worries in my free booklet.

I have put together a booklet with some strategies I am always giving to my clients to help them begin to feel less anxiety and to worry less.

I hope that you will find it helpful too.

Add your first name and email address in the box below and you will be sent the steps to download your FREE book.

If you have questions after reading this article or the booklet or have any questions about how counseling can be useful to your particular circumstances please contact me at 847 791-7722 or on the form below.

I see clients in my Northbrook office or if it is more convenience, via telephone or internet sessions

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Anxiety, The Brain & CBT

by Dr. Sarah Allen

Anxiety, The Brain & Cognitive Therapy (CBT)

Did you know that the human brain is composed of approximately 100 billion neurons? Until recently we thought that the brain is fully developed (and therefore unchangeable) by the end of childhood and once you became an adult it was pretty much downhill for the brain.

Neuroplasticity and the mind’s ability to change the brain

In the past few years though there has been a huge amount of brain research that shows that the brain actually possesses a remarkable capacity to reorganize pathways, create new connections and, in some cases, even create new neurons. We now know our brains are not fixed, they have neuroplasticity. What does this mean? Basically we can change the way we think about things to change our brain to be happier!

So?

You may say that is all very well and good but why would I want to change my brain? The reason I am really interested in all this brain research is that most people who come to see me come because they are fed up of feeling worried, anxious and/or sad. By changing the way we evaluate things and react to them can change these negative pathways the anxious part of our brain has got so used to traveling down.

Are You On Automatic Pilot?

We have all been on automatic pilot when doing something e.g. we drive to a place without thinking how we got there. When our brain is disengaged brain change is switched off. However, when our brain is alert and engaged in an activity our brain’s plasticity switches are turned “on” because chemical neurotransmitters are released and we are then ready to facilitate change.

Is Your Brain Wired To Feel Anxious?

Because of life experiences and genetics some brains are more anxious than others. When we think of doing something that causes us some anxiety our brain tells us “run away, don’t do it!”. Our body listens to the brain and produces adrenaline and amongst other physical sensations our heart beats faster, our hands get sweaty and our breathing gets shallow and this reinforces the idea that we “SHOULDN’T DO IT!” so we avoid that situation.

So How Do I Change This Anxiety Pathway In My Brain?

Brain change is a result of learning, our experiences and memory. Basically, by learning new ways to think and deal with anxious or sad feelings we can develop different connections in our brain.

If we feel the fear and do it anyway this teaches our brain to develop a memory that actually doing this scary thing was manageable, nobody died and it really wasn’t nearly as bad as you thought it would be. We then feel more confident when that situation comes up again our brain says “Yeah, I can do that, it’s manageable”. The more times we do it the less scary it gets because our brain lays down each memory and makes a more positive pathway between our emotions and that type of event.

For example: Jane hates making phone calls (many people do). She thinks about it making that call and her heart beats faster, her fear rises and she gets someone else to call for her.

According to Canadian scientist Donald Hebb, “Neurons that fire together, wire together.” If your thoughts focus on worrying and self-criticism, you’ll develop neural structures of anxiety and a negative sense of self.

Spend 15 Minutes A Day Doing Something New

The really important thing to remember is that to build new pathways in the brain you have to be alert and focused on what you are thinking and doing and to be most effective you need to try new things as the brain grows best when info is novel.

Do Something Scary

When we are doing something that scares us, our brain pays better attention to what is going on.

New habits = brain change. Scary new habits = quicker brain change.

Start small though rather then choosing to tackle something that causes you a lot of anxiety. You need to increase your confidence. I suggest you think of a hierarchy of anxiety-provoking situations then start with the one that is just a little bit out of your comfort zone.

Can Cognitive Behavior Therapy & Brain Science Work Together?

Yes! cognitive behavioral therapy (CBT) and the new brain research really complement each other. I ask clients to recognize when they feel a negative emotion such as anxiety, anger or sadness and “catch” the thought that they are having. These thoughts tend to be automatic and negative and because we are beating up on ourselves without even realizing it, they elicit a negative emotion. Who wouldn’t feel bad if they are telling themselves they can’t do something or they are bad in some way.

We then really focus on what you are thinking and challenge those thoughts so you can change your behavior and find out that the situation isn’t as bad as you are thinking it is. By thinking and doing things differently, especially things that are out of your comfort zone, you build new pathways in the brain.

So What Is Cognitive Therapy?

Step 1: Identify your thoughts or self-talk and they make you feel

Once you catch the negative thought you can learn a new way of thinking about it.

Step 2. Identify thought traps

There are many thought traps but perhaps the most frequent ones that I see are:

Filtering – only taking note of all the bad things that happen, but ignore any good things
Overgeneralizing – using words like “always” or “never” to describe situations or events
All-or-Nothing Thinking – it has to be this way or it’s no good
Mind-Reading – believing that we know what others are thinking or thinking they should know how we feel. Often we assume that they are thinking the worst of us. However, we can’t mind-read so need to communicate with people.
Overestimating – we believe that something that is unlikely to occur is actually about to happen e.g. “I will faint” “I’ll go crazy” “I’m dying”.

Remember – Just thinking something doesn’t mean it’s true or that it will happen.

Step 3: Challenge Your Negative Thoughts

Questions to ask yourself to help challenge your negative thoughts or self-talk:

• Am I falling into a thinking trap (for example, catastrophizing or mind-reading)?
• What is the evidence that this thought is true? What is the evidence that this thought is not true?
• What would I tell a friend if he or she had that thought?
• Am I confusing a “possibility” with a “probability,”? It may be possible, but is it likely?
• Am I 100% sure that _______ will happen?
• How many times has _______ happened before?
• Is really so important that my future depends on it?
• And my all-time favorite – What is the worst that could happen?

I have been using CBT techniques for twenty years and they work! What I find totally fascinating though is that we can look at the recent brain studies about neuroplasticity and now understand the reasons behind why it works.

Summary

1. Being alert and focused when you try to do new things can change your brain.

2. Doing scary things retrains your brain to realize that that doing something anxiety-provoking is associated with Taking Action not Avoidance.

3. CBT strategies help you do new behaviors that cause brain change. You become confident rather than worried.

Harnessing this power is an effective way to achieve brain change and reduce negative emotions.

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So you can read more about reducing anxiety and CBT, I put together a booklet with some strategies I am always giving to my clients to help them begin to feel less anxiety and to worry less.