10 ways to curb chronic stress

I recently visited The United Way of Greater Rochester to talk about BURNOUT PREVENTION, and we had a fantastic discussion about these 10 chronic stress-busters. I wanted to share these ideas with you.

Some may see super obvious…but if you find yourself thinking “yeah, yeah…I know that already” and yet you have not successfully been able to implement the suggestion, you might want to ask yourself what that’s about.

Which one resonates with you the most? What gets in the way of taking action on certain ones?

  1. Be honest with yourself about what recharges you.

If you’re an extrovert, it’s probably social time with friends; if you’re an introvert, it’s probably alone time. Or maybe you’d like a mix of both. The key here is to find ways to include more restorative time in each and EVERY week, and ideally each and every day, without getting bogged down with guilt. Time to recharge is not a luxury item, it’s a necessity.

  1. Take care of your body with exercise.

Notice how this is phrased: exercise should feel rejuvenating and restorative, not like a punishment. If you love Beachbody workout videos, that’s awesome! But intense workouts are not the only way. Walking is more than acceptable, and if you wear the right clothing, you can even walk in winter. Try adding music or a podcast or audiobook to your routine to make it more appealing. Or find some yoga workouts on YouTube. Or get a jump rope and head out to your driveway or garage. Be creative!

  1. Feed yourself delicious, healthy food that you like to eat.

Eat when you’re hungry, stop when you’re satisfied. If you tend to snack or stress-eat, or see food as a primary source of pleasure or entertainment, you may want to take a closer look at this pattern. Sometimes food seems like the ultimate treat/reward after a long day, but over time turning to food in this way can create weight issues and exacerbate feelings of guilt and powerlessness.

  1. Set better boundaries with technology.

You don’t have to be at the mercy of every text, email and push notification that comes your way. Figure out who the people are that you absolutely have to respond to in real time (your kids, your boss) and manage your phone so that you do not get other alerts. Put limits on social media use. Carve out time when your phone is off or on silent so you can put your full attention on other activities.

  1. Find ways to nourish yourself that truly are nourishing.

There may be nothing wrong with the occasional Netflix binge or margarita, but these aren’t sustainable ways to take care of yourself and can have pretty negative consequences when done too often or too much. One way to get to the bottom of what truly lights you up is to ask yourself what you loved to do as a child that you lost sight of as you became an adult. Coloring? Reading fiction? Playing board games?

  1. Get enough sleep.

What gets in the way of your ability to get a full night’s sleep? Maybe you have a child who doesn’t sleep through the night or maybe you get caught in a worry cycle; maybe you go into perfectionistic mode with work responsibilities or find yourself going down a Facebook rabbit hole every night. Being sleep deprived is like walking around with stress-tinged glasses on all day. Your patience will be low, you’ll be more prone to overreacting or taking out your frustration on the people you love. It’s worth troubleshooting this as much as you possible can so that you are giving yourself the best chance possible of recharging each night.

  1. Pay attention to your dreams and wishes.

This includes acknowledging your deepest desires, no matter how ridiculous or impossible they may seem — a happier marriage, a better relationship with your teen, a healthier body, more rewarding friendships, more money. As adults, we sometimes get used to pushing aside what we want, focusing instead on pleasing others. Your dream may not seem attainable right this second, but even taking small steps toward it each day can feel empowering and energizing. You may even find it helpful to do some journaling: imagine how you’ll feel and what you will think if you get what you want. Can you start acting as though these dreams have already come true? What kinds of think would you think about, feel and do if you were already where you want to be?

  1. Cultivate self-compassion.

Have you ever listened in on the monologue that goes on in your head all day? You may be surprised to realize that you’re not all that nice to yourself, particularly when you make mistakes. But the truth is, if you’re striving for improvement or change in some area of your life, you’re not going to get it perfect — and beating yourself up along the way will not help you get where you’re going any faster. In fact, it will almost definitely stall your progress. Change starts with accepting yourself exactly as you are right now and imagining what you want for yourself, believing you are deserving of good things, and creating the thoughts and feelings you want to have in the here and now. Meditation can really help with this, particularly loving-kindness meditations.

  1. Cut down on decision fatigue.

We make hundreds of decisions every day, and this can really add onto our overall stress levels. You may not think that choosing what to wear or what to eat for breakfast is a big deal, and in and of itself, it’s not… but research shows that we really can use up our mental energy when we bombard ourselves with decisions all day. One way to cut down on decision fatigue is to create routines or protocols for certain things. You may decide to eat the same exact thing for breakfast every day for a week, or have a rotating “schedule” for your outfits. You might not check e-mail until after 10:00 a.m. to give yourself an hour to work on longer-term projects before getting caught in the response-mill. Find ways to make decisions for yourself ahead of time and see how this affects your overall energy level.

  1. Get high-quality therapy.

OK, I’m biased here. But I think therapy is so worth the investment in time and money. Especially if you need another perspective as you sort out some of the above suggestions! The cornerstone to a fulfilling life is mental wellness — i.e. the ability to recognize and regulate your emotions, ask for what you want and need, create healthy and happy relationships. Therapy is so much more than just talking or venting. It’s about exploring the blocks and barriers specific to you and your life, getting your relationships in order, understanding more about why you do the things you do, feeling happier and more in control… the possibilities are endless.

Let me know which ones you’ve tried — which work for you, which have bombed, and which ones you’re going to try to integrate into your life.

Also, quick reminder that my new co-ed process group, Relationships Group, starts on Tuesday 3/6! This is for anyone who could stand to do better with communication, arguing fairly, identifying and expressing emotions…it’s going to be awesome.

I also have a women’s DBT skills group starting on Monday 2/26.

Limited spots remain in both groups. If you’re interested in either, fill out an interest form here.

Beyond sleep hygiene: a 5-step plan to get a better night’s sleep

Sleep problems can cause a fair amount of frustration for healthcare professionals. That’s because sleep hygiene is something that a lot of us — especially those in primary care or mental health/psychiatry — advise patients on every day. So if you’re struggling to get a good night’s sleep yourself, it can be hard to feel authentic in the suggestions you make to patients. You may find yourself having thoughts like “Does any of this really work?” or “I should really take my own advice.”

The truth is, sleep is critical to your ability to function. Without sleep, you’re way more likely to be irritable, short on patience, and low on empathy. This might show up as yelling at your kids, lashing out at your spouse, or making snide comments about difficult patients. Being in so-called “sleep debt” also makes it harder to think clearly and make quick, efficient decisions. You’re at greater risk of making careless medical errors or even getting into a car accident, depending on how badly deprived you are.

You probably know all this on an intellectual level, but so many of us downplay the importance of sleep in our own lives.

There are a few common reasons why physicians, nurses and other helping professionals get inadequate sleep:

  • Home life factors: new baby, disruptive pet, child illness or a child’s chronic sleep problems
  • Environmental factors: bedroom is too hot/too cold (or too light if you work nights and sleep during the day)
  • Mental health factors: chronic anxiety or depression, or attentional/perfectionism issues that cause you to stay up too late
  • Lifestyle factors: poor diet, overconsumption of alcohol, stimulating screen time before bed, insufficient exercise
  • Situational factors: worries about finances, loan debt, aging parents, the threat of a lawsuit, being behind at work, your child’s well being
  • Job factors: shift work, unpredictable or inconsistent schedules, too many demands on time

The culture of health care in some ways perpetuates sleep deprivation. Even with new restrictions in place, many medical residents don’t get enough sleep due to the crushing demands of documentation and other responsibilities. Some of this “I can get by” mentality can end up spilling into the rest of your career. And I hear from a lot of nurses who struggle with the way their employer requires alternating day and night shifts; this can make getting good-quality sleep really difficult.

You know basic sleep hygiene. It’s boilerplate. Here’s what to do if you’re still stuck:

  1. Go through the list of factors above and jot down anything that seems like it’s relevant to your current situation. BE HONEST WITH YOURSELF! You don’t need to commit to changing any of it just yet.
  2. Does anything stand out as relatively easy to change? e.g. If you consistently go to bed too late because you lose track of time, try setting a recurring bedtime alarm on your phone or watch and stick to it for a week. If you are always waking up in a sweat, turn down the thermostat or dress in lighter clothing. These sorts of things may sound obvious, but sometimes we don’t acknowledge the easy tweaks we can do to make sleep come more easily.
  3. Implement a bedtime ritual. Make a commitment to set your phone aside an hour before bed, and use this time to read, take a shower, meditate, listen to music, or otherwise wind down. If you find yourself shooting this idea down because you’re too busy, then start with a 10 minute ritual. The ritual is not only meant to help relax you, but to cue your brain that it’s time to fall asleep. It’s a cognitive-behavioral strategy.
  4. Free write for 5 minutes before bedtime. This is especially helpful if you struggle with anxiety or racing thoughts at bedtime. Jot down anything and everything that’s on your mind: to-do’s, worries, problems. Tell yourself that you will revisit the list in the morning, but at this point you’ve done all you can for today. Fold up the paper and put it in a safe spot.
  5. Choose one of the more complicated interfering factors and begin brainstorming solutions (but not at bedtime). Maybe it’s your alcohol use or your diet… maybe it’s chronic worries about your job or undertreated depression… whatever the “big” or seemingly impossible problem may be, there may be ideas or solutions that you haven’t tried. And if you’re resisting change, it might be worth seeing a therapist to talk through what’s getting in your way.

This isn’t to say that basic sleep hygiene strategies aren’t useful. It never hurts to take a look at the timing and quantity of caffeine consumption, for example. And one of my favorite sleep hygiene suggestions is getting out of bed if you’re having trouble falling asleep. If you are lying in bed getting frantic about how many hours are left in the night, it won’t help to keep lying there for two hours, staring at the clock. You’re better off getting up, putting on some lotion and reading a calming book until you start feeling sleepy again, and then returning to bed.

What works for you? What doesn’t seem to help?