Midwest Psychiatric Center, Inc. is a private psychiatric practice owned by my colleague, Dr. Rakesh Kaneria. I provide therapy to adults and a small number of children/adolescents at this location. We can accept most commercial insurances, as well as Caresource (of Ohio Medicaid) and Medicare. Adult clients who work with me at MPC also have the option to see Dr. Kaneria for evaluation and medication management if desired or needed. Child psychiatric evaluation and medication management are not available with MPC. We are located in West Chester, OH near the UC West Chester Hospital, just off I-75, between Liberty Way. and Tylersville Rd.
In today’s fast paced busy world, stress, anxiety, and depression abound. It can be scary how quickly distress can consume us. One of the ways I encourage my clients to manage distress is through practicing Mindfulness on a daily basis.
Mindfulness is an approach to daily life in which a person practices awareness of the present moment, as it happens, right here and right now, acknowledging the present with curiosity, acceptance, and an open mind. Mindfulness can benefit us in many ways. By helping us acknowledge the transience and changeability of our circumstances, mindfulness allows us to embrace the impermanence of our stressors. Mindfulness also helps us to have a present-moment experience by staying in the now and avoiding living life on autopilot. It helps us to tolerate discomfort rather than avoiding or escaping. Mindfulness helps us to remain open to new ideas, exercise our creativity, and maintain an attitude of nonjudgment. It helps us to know ourselves – body, mind, and spirit – on a deeper level. Mindfulness has also been found to improve brain function and structure by supporting neuroplasticity and improved memory.
Here are some simple ways to integrate mindfulness into your daily life:
1. Self-observe during activities of daily life (e.g. mindful eating, walking, breathing, brushing teeth, etc.) paying attention to the sensations in the body.
2. Spend one minute practicing deep breathing.
3. “Take 5” deep and mindful breaths upon waking in the morning and again before bed at night.
4. Notice “bells of mindfulness”, the things that subtly get our attention through the course of the day (e.g. stop lights, church bells, waiting in line, door bells, etc.)
5. Notice body posture, sensations in the body, and areas of tension or relaxation.
6. Practice attentive listening to others without multi-tasking or thinking ahead.
7. Speak mindfully. Pause before you speak and ask yourself “is what I wish to say necessary? helpful? true?”
8. Notice automatic thoughts or judgments.
9. Notice when you are multi-tasking and how it feels as compared to when you are working on one thing at a time.
10. Turn off the radio/iPod/television and listen.
11. Take a yoga class. Gentle Yoga, Restorative Yoga, or Yin Yoga are especially mindful.
12. Pause briefly to ask yourself two questions: Where is my body? Where is my mind?
So this Halloween I am passing out “Take 5” candy bars – not only because they are my favorite! I hope to encourage my clients, friends, and family to “Take 5” to check in with themselves in the present moment, here and now. Take 5 breaths. Take 5 minutes. Take time to check in with yourself – your body, mind, and spirit will thank you for it!
Here is a great explanation of Mindfulness by Jon Kabat-Zinn, Professor of Medicine Emeritus and founding director of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School.
8 Tips to Stay Healthy in Today’s Political Climate
Regardless of one’s political perspectives, there is no denying that the political climate in the United States has a lot of us feeling stressed out. It’s not all pictures of puppies and video clips of laughing babies these days! The constant barrage of news alerts and 24/7 access to online debate is causing many to experience an overload of intense feelings. Practically all of the hot topics in today’s political discussion are deeply personal for many us and poke at some of our most central beliefs, fears, and even emotional wounds.
Social media enables unending access to debate, discussion, and even conflict paired with the emotional separation of the screen. Many of us are much bolder in our expression through social media than we might be face-to-face. We use words or make statements that propriety, civility, and courage often stop us from speaking in face-to-face interactions – sometimes even to complete strangers. Impulsive, hurtful, emotionally-driven responses are leading to damaged friendships, conflict in families, sleepless nights, and a whole lot of hurt. Information being labeled fake news, alternative facts, and propaganda have many of us doubting who we can even trust to keep us accurately informed.
Whether participating in online discussion or simply scrolling through our Facebook newsfeed, if you’re online, you’re seeing a lot of negativity. Here are some ideas to help you stay healthy while navigating social media:
Manage exposure. Stay informed while limiting the time you spend reading, watching, listening to, and debating politics. Know what you need to know to be an up-to-date and informed citizen, without overwhelming yourself with too much political drama. Consider giving yourself a limit of political posts or comments you will make in a day. Limit screen time all together by taking digital breaks to do other things. Impose a “news curfew” – a time at which you disengage from the news each night.
Avoid or end unproductive or aggressive discussion. Some people possess the skill to debate intelligently, while others cannot avoid turning things to the personal. If engaging in a discussion, ask yourself if the interaction is fruitful. If it’s not, consider dropping it respectfully. Better to end a conversation than to end a friendship.
Find ways to get involved in the causes you support. Peacefully and productively participate in the process. Write your leaders. Volunteer. Pray. Educate. Join a group. Just be sure that your actions are useful, lawful, and, most importantly, in line with your core values.
Review your US Government notes. A lot of us have forgotten what we learned in 8th grade civics or our high school US Government classes, leading many of us jump to conclusions, make assumptions, catastrophize, or even panic. Unintended ignorance of the political system can lead us to attempt activism that turns out ineffective. Know who your leaders are and their roles. Review the three branches of government (Executive, Legislative, and Judicial), as well as functions of Federal, State, and Local governments. Knowing the basics can help us understand and interact with government systems more effectively – and with less stress.
Feel what you feel. There is nothing wrong with experiencing emotions of any kind – anger, fear, sadness, joy, pride, hope, relief. Feel what you feel, but mind what you do or say. It is our actions that can discredit us or harm others. When feeling a strong emotion, consider taking twice as much time to make a decision as you normally would, buying you time to weigh your options carefully and avoid impulsive actions you might later regret. When considering making a counter-post or commenting on something with which you disagree, try waiting until the next morning to respond.
Take care of yourself – body, mind, and spirit. Hold on to your healthy routines. Eat healthy. Be physically active. Try to keep a healthy sleep schedule. Make time for leisure, recreation, and creativity. (We’re less likely to get bogged down if we’re having fun!) Stick with your usual spiritual practices. Holding on to the constants in life will help keep the feelings of chaos at bay.
Try to find the positives. Unpleasantness and negativity aren’t hard to find. We have to be deliberate to find the positive. Practice gratitude. Identify helpers. Find the humor in things without minimizing important matters. In daily life, tend to the things within your control, rather than ruminating on things you can’t control. If online, try to post something pleasantly non-political from time to time.
Use your manners. Honest self-expression, authenticity, and even activism do not preclude civility. You can take a stand, inform others, call for change, or even agree with someone while still maintaining civility. Stay away from name calling and mudslinging. Avoid generalizations (especially words like “always” or “never”). Especially online – if you wouldn’t say it to the person’s face, you might not want to post it online. It is possible to disagree while still being kind.
Ultimately we’re all in the same boat – liberals, conservatives, and everyone in between – trying to navigate the rough waters of our current political climate. Let’s use social media in healthy helpful ways, together.
When in doubt, post videos of cute cats – or just turn the screens off for a while.
The metaphor of the “black dog” is widely used to describe the experience of depression. Some are surprised to learn that Winston Churchill (and those close to him) used this metaphor to describe periods of melancholy and sadness. http://www.blackdoginstitute.org.au/docs/Foley.pdf
For those of us who struggle with depression, using metaphors like the black dog can be really helpful in identifying strategies for feeling better, and perhaps more importantly, reduce feelings of shame and embarrassment. If you struggle with depression remember: YOU NOT DEPRESSION. It does not define you. It is not who you are. It is a challenge, separate and external from you. You might consider having a conversation with your therapist about metaphors for depression that are helpful to you. Some people see depression as a rain cloud that follows them around – sometimes it’s big and dark, pouring down, while other times the cloud is lighter, maybe only sprinkling. Some people experience depression like a super-villain, and they are the super-hero who mobilizes her/his strengths and powers to defeat the enemy. Similar methods have even been used to help empower and motivate cancer patients to beat the disease!
What metaphor works for you?
5 years ago
·Leah Fogt·Comments Off on 10 Tips to Help with Holiday Stress
The Holiday Season can be a time filled with joy, excitement, celebration, and togetherness, but many of us don’t experience it that way. Some of us feel overwhelmed, stressed, sad, or alone. There is no doubt that the holidays can be stressful, so here are some tips that might help make your holiday a little easier.
1. Be careful with “shoulds.”
All those old Christmas movies seem to bombard us with ideals and images of how the holiday season “should” be, but that’s fiction! There is no certain way that the holidays “should” be done, so go easy on yourself. If you don’t like or want the traditional way, who’s to say you can’t change things up? Allow yourself to make changes, think outside the box, and do things your own way. If you are doing things out of obligation but not finding them meaningful, enjoyable, or useful, maybe you don’t NEED to do them.
2. Reach out.
If you are feeling alone or isolated this holiday season, consider reaching out. Getting involved in a community activity or event, participating in church or temple, or volunteering are great ways to keep from feeling too alone. You may even consider doing something you’ve never done before. Maybe try going to a place of worship if you never have or check out a local community event you’ve always wondered about.
3. Acknowledge your feelings.
Just like we need to watch out for things we do only because we think we “should”, we need to watch out for feelings we think we’re “supposed” to have. If you don’t feel particularly jolly this Christmas, that’s okay. That doesn’t make you the Grinch or Mr. Scrooge. Maybe you’re grieving this year. Maybe you are exhausted. Maybe you have big worries for the coming year. Whatever you’re feeling, acknowledge it and permit the feelings to come, go, and change. Maybe try communicating those emotions to someone you trust. It might help them to understand you, support you, or just be sensitive to your feelings.
4. Set realistic expectations.
We can easily work ourselves to the bone trying to make things just so. We might agonize over creating the best light display on the block, serving the perfect latkes, or buying the perfect present. We might have images of a perfect family meal or the most beautiful party, but the reality is most of our holidays don’t look like “a picture print by Currier and Ives.” Our families are complicated. Our budgets are limited. Be realistic.
5. Say “no” when necessary.
We might be feeling swamped by the magnitude of the season. There seem to be a million events going on in our communities. We might have multiple invitations to gatherings, parties, or functions. Commercials show us a zillion gifts we could buy and our children might have wish lists that seem a mile long. There even seem to be a multitude of charities in need of support this time of year. If we don’t say “no” sometimes, we can easily bust the budget, overfill our calendars, or even overindulge. It’s impossible to do it all, so allow yourself to say “no” from time to time. Decide what your priorities are and focus on those first. Anything else is superfluous.
6. Preserve routines and habits when possible.
Try to maintain a sense of normalcy if you can. Crazy schedules, atypical spending, and special meals can really turn our systems upside down. Whenever possible, try to do things as you normally would. Bedtime routines are a good place to do this – for grown-ups and for kids! Don’t throw all your household rules out the window just because it’s a holiday. Structure and predictability help us stay grounded and keep things from feeling too out of control.
7. Take time out.
The holidays are full of stimulation – special sounds, smells, tastes, colors, sensations, and sights to see. All the lights, tasty treats, songs, etc. mark this special time of year, but sometimes can get a little overwhelming. Every once in a while, give yourself – and your children too! – a break from all the stimulation. Take some time to be quiet. Maybe go for a quiet walk, breathe the fresh winter air. Turn off the music or the TV for a little. Plan for some down time from all the celebrating, and allow yourself and your family members some alone time to decompress. It’ll give your nervous system a bit of a break.
8. Let it go!
(And I’m not talking about Frozen!)
Let’s face it. We all have baggage, complications, and conflict in our lives, so gatherings with family and friends can sometimes be emotionally charged. Now is a good time to set aside any beefs that you may have with others, just briefly. You don’t have to become a doormat or live in denial during the holidays, but having it out with a family member at Christmas dinner probably won’t help you enjoy a stress-free meal. Maybe instead, commit to conflict resolution or healthier boundaries in 2015! Take on some of those challenges carefully in the New Year.
9. Be careful with alcohol.
Celebrations can be full of drinks that we might not get to enjoy year round. The egg nog, fancy wines, cocktails, champagne, and other alcoholic beverages seem to be everywhere we go this time of year! Be careful not to get carried away. Remember what cautions come with any medications you take, know your limits, and certainly make arrangements for a designated driver! There are lots of holiday drinks that you can enjoy that don’t involve booze, too. Hot chocolate, cranberry ginger ale, or a peppermint mocha might make good alternatives. Remember to be sensitive to anyone around you who might be trying to maintain sobriety, and if that person is you, consider fitting an extra AA meeting into your schedule.
10. Accept support.
If you’re struggling, don’t be afraid to let someone help! You might accept an extra hug from a consoling friend, talk with a trusted loved one, chat with your pastor, or even schedule an extra therapy session. Sometimes support comes in a less emotional and more practical form, so consider delegating tasks to others to help lighten your burden. Make use of community resources that might help as well. Accepting kindness from others warms two hearts!
Ultimately, keep your eyes on the prize! Try to focus on the reason for your celebration – whatever holiday you recognize. Celebrate family and friends, history, miracles, accomplishment, heritage, community, salvation, the beauty of creation, and your religious beliefs. Hope and pray for peace and a healthy coming year. If you focus on the reason for your celebration, you’ll be more likely to keep a healthy perspective and remember what really matters to you.
5 years ago
·Leah Fogt·Comments Off on Understanding a Diagnosis
There seems to be a lot of confusion about the whole idea of “diagnosis”, especially when it comes to mental health. I find that many of my clients are confused about what these terms are really all about. I think it’s very important to be informed, so I’d like to try to take some of the mystery out of the matter!
When an individual comes to counseling or psychotherapy, the clinician they are seeing will likely render a diagnosis. A formal diagnosis allows us to demonstrate “medical necessity” and bill your insurance company. A diagnosis is essential a name for a problem. Just like sinusitis, urinary tract infection, or Diabetes are names that describe a medical problem with a specific set of signs and symptoms, a mental health diagnosis has certain criteria that help clinicians to recognize what’s going on. Just like medical problems, some mental health diagnosis are temporary (acute) and some are long-term (chronic).
The tricky thing about a mental health diagnosis is that it is not exact. These terms are somewhat subjective. If you see three different clinicians, you may get three different names for the problem though hopefully they are all in the same ballpark. There are groupings of diagnoses (Mood Disorders, Anxiety Disorders, Psychotic Disorders, Personality Disorders, etc.) which help us begin to zero-in on an accurate name for the problem and over the course of treatment, you may see that the clinician may be able to more specifically define what you’re experiencing. If the general diagnosis is accurate, the therapeutic interventions are likely to be about the same – no matter what the specific name turns out to be. (For example, I will help a person with Dysthymia in about the same way that I would help a person who is having a Major Depressive Episode. We may just know more, the longer we work together.)
While research and technology are making it easier for us to identify and treat mental illness, it’s still not exact. We can’t do a blood test to tell us “it’s this” or “it’s that.” This is why it is CRUCIAL for clients/patients to try to be as honest, direct, and forthcoming as possible when communicating with their providers. The more we know, the easier it will be for us to help. Your doctor may be able to find the right medication for you faster. Your therapist may be able to target the right interventions more quickly to help you make positive changes – which in turn gets you feeling better faster!
A Diagnosis, not YOUR Diagnosis
The most important thing you should know about a diagnosis is that it is JUST A NAME. If your paperwork says “Bipolar Disorder,” (or any other label for that matter) this does not define you. It’s a name for a set of symptoms. It describes moods, thought patterns, or behaviors. You are YOU. You most certainly are NOT A DIAGNOSIS. You are an individual with life experiences, ideas, opinions, and feelings that are unique to you and you alone. Ask questions and educate yourself, but try not to get hung up on labels, names, and terms. Be you and work on being the best you that you can be!
If you want to learn about a particular diagnosis, the National Institute of Mental Health is a great resource. Ask your providers questions. Maybe think about what your strengths are – the capabilities, knowledge, insights, and skills that you bring to the table that make you resilient. Your strengths will be at the heart of your therapeutic experience, and your therapist can help you to mobilize them so you can make the most of all the wonderful things that make you you!
5 years ago
·Leah Fogt·Comments Off on Write it down!
Do you write in a journal or diary? Expressive writing is a habit many people enjoy on a regular basis, and this is a strategy that many counselors and therapists recommend. There are lots of reasons why writing could help improve your quality of life, so it might be something you want to consider!
When we write, we experience our thoughts in a different way that if we are simply thinking or even talking. Different parts of the brain are engaged to translate our ideas into written words and sentences, so writing allows us to observe our thoughts in a different way – as well as gain insight and perspective. Many people also enjoy the idea of expressing feelings in an external way – when we write we can “empty out” our emotions or “unload our feelings”, taking them out of ourselves and placing them somewhere separate, bringing relief from emotional distress, pain, or worry.
Studies suggest a number of physical and emotional benefits that come from expressive writing:
Healthier immune system
Healthier blood pressure, lung functioning, and liver functioning
How many times have you found yourself saying or thinking, “I’m so stressed out!” and not being sure what to do about that feeling? Typically when we say we feel “stressed out” we are referring to a specific type of stress (or arousal) that is better labeled “distress.” Distress is often described as feeling overwhelmed, anxious, or concerned. When we are distressed we are usually less productive and likely experience more physical complaints like muscle tension or headaches. Distress is the negative stress we experience from things like loss, divorce, financial strain, interpersonal conflict, un/underemployment, legal problems, injury/illness, etc.
There is another type of stress we call “eustress,” which is a more positive type of stress. Eustress is when we have enough stimulation to challenge, motivate, and interest us without overwhelming us. It usually results from positive things like starting a new project/job, holidays, learning, moving, receiving an award/promotion, beginning a new relationship, etc. When we experience eustress we are usually motivated, though short-term. We typically believe that the challenge we face is within our abilities – it’s something we can handle. Eustress generally feels exciting and energizing, and our performance/productivity peaks.
The psychological theory call The Yerkes-Dodson Law suggests that the relationship between our performance and stress (arousal or stimulation) has a dramatic impact on our quality of life. If we can individually determine what level of stimulation and challenge “gets us going” and when we “go over the edge” to feeling overwhelmed, we are more likely to have satisfying and productive lives.
So the challenge we have is to find our personal “stress sweet spot” and aim to have enough in our lives to keep us interested, productive, functioning, and stimulated, but not overwhelmed. This sweet spot typically changes depending on our circumstances, age, and health, so it is valuable to monitor where we are at on a regular basis.
The infographic below illustrates these concepts pretty well – for those of us who are visual learners! Essentially our goal with stress is to stay at the top of the curve, where our performance, health status, and motivation all peak. (Click on the image to see it the most clearly.)
Do you ever struggle with feelings of insecurity, self-doubt, or low self-esteem? Many people who have trouble with depression or anxiety struggle with these feelings on a regular basis, and let’s face it, feeling that way can be pretty miserable. These unpleasant emotions often begin with unhelpful thoughts, especially self-criticism or negative self-talk. One way to begin to improve our moods is by challenging these unhelpful ways of thinking.
Every day, all day our minds are forming perspectives and beliefs about ourselves and the world around us. There’s that voice in the back of our heads that gives us a running commentary of the day’s events. Do you ever pay attention to that voice and what it says? If you feel insecure, doubt yourself, or lack confidence, that voice in the back of your head might be saying some pretty mean things to you!
For example, when you look in the mirror in the morning, what do you think? Do you think, “Well this is as good as it’s gonna get” or something more positive like, “I am beautiful because of who I am and the things I can do?” If you make a mistake, are you quick to name-call and put yourself down? Do you call yourself a dummy?
Speaking to ourselves in this way only increases a sense of shame, so it’s important to take charge of this kind of thinking.
Think about it. If a stranger in the grocery store saw you drop a jar of spaghetti sauce making a big sloppy red splatter on the tile, you would likely be offended if they said, “You idiot! Be careful!” We do not tolerate unkindness from others, why do we tolerate if from ourselves?
Consider the little children you might know – perhaps your own child, grandchild, niece/nephew, neighbor, or friend. Imagine that cute little face full of innocence. You probably wouldn’t tell that child they are stupid, ugly, clumsy, or foolish. It would make them cry – not to mention be damaging to them and potentially verbally abusive. Instead you would speak gently and encouragingly to that little one, maybe still making a correction but doing so kindly. The thing is self-criticism is just as damaging to us. If we wouldn’t say it to a little child, we probably shouldn’t say it to ourselves.
If you think you might have a harmful habit of self-criticism, you might want to start to challenge that voice in your head and replace its commentary with something a little more uplifting and charitable. If you observe a moment of negative self-talk, catch yourself doing it and then try to find a more constructive and encouraging thing to say.
Breaking the habit of negative-self talk is a challenging one, and sometimes can require therapy to help identify alternative perspectives and restructure how we think. This doesn’t mean lying to ourselves or sugar-coating things. Rather, it means that we evaluate our perspectives to be sure they are accurate, grounded in reality, and supported by evidence, as opposed to emotions only.
Our words matter. What we say to others can have a great influence on their day and their mood. The same is true for what we say to ourselves! Be kind to yourself!
5 years ago
·Leah Fogt·Comments Off on What is Mindfulness?
One of the most challenging struggles of human existence is to accept and live fully in the present moment. The arts and music show us so many examples of the attempt to surrender and just be. Think of the popularity of songs like “Let it Go” from Frozen and “Let it Be” by the Beatles. Consider how most world religions, in one way or another, emphasize the ideas of surrender and acceptance as key steps of the spiritual journey. These are all versions or variations of the approach to living that many term “Mindfulness.”
Mindfulness is a state of mind in which we are aware of the present moment, living in “the now.” We approach each moment with curiosity and observation – taking in and acknowledging our thoughts, feelings, and even sensations in the body freely and without judgment. I like to think of it as responding to the moment by saying, “huh, how about that?” rather than judging a thought, feeling, or circumstance as good or bad, right or wrong. It simply “IS.”
By practicing mindfulness we can distance ourselves from the habits and automatic responses we have to daily stressors and triggers, and we can increase clarity, insight, and a sense of peace. This is why many mental healthy providers encourage mindful living as a way of decreasing depression and anxiety.
There are a plethora of Mindfulness resources available on the internet, but here is a brief introduction (Intro to Mindfulness) to it’s concepts, as well as some strategies to help you make simple changes to live life more mindfully.
There are several titles in my recommended reading list as well, but I especially recommend “The Power of Now” by Eckhart Tolle.
6 years ago
·Leah Fogt·Comments Off on Feeling stressed out?
Life can be a very intense and stressful. As if juggling all of our usual activities (like paying bills, household chores, parenting, work commitments, etc.) wasn’t enough, life can throw us curve balls that we might not be ready for, sending our stress level through the roof. Even expected stressors can leave us feeling overwhelmed, drained, exhausted, or even afraid – not to mention the negative effects on our bodies, relationships, work performance, and overall quality of life!
Many of my clients identify “coping with stress” as one of their therapy goals. Sometimes it’s because of a specific stressor that is proving to be a major challenge; sometimes it’s a pattern of ongoing stress that has made life feel chronically chaotic.
Harvard Medical Publications has a really great online Stress Resource Center with free resources for coping with stress. I highly recommend visiting the page and exploring the information and techniques they recommend.
In the interview, Dr. Miller recommends 5 fairly simple strategies to help reduce the effects of stress, and he explains the biological and psychological reasons why they work. These are the strategies:
Do one thing at a time.
Use meditative techniques.
Find a creative outlet.
Engage in social activities.
Develop a routine for handling stress.
Sometimes integrating these strategies into daily life isn’t easy as it sounds – sort of like “easier said than done, Dr. Miller!” So if you struggle to fit these skills into your lifestyle, therapy might be a really useful thing for you. If you’re already involved in therapy, consider trouble shooting with your provider on the skills that you’re finding difficult or elusive. You deserve to feel better!