The Importance of Structure, Routine and Meaningful Activity in Depression and Anxiety

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For many people with depression and anxiety, having a structure and routine can really help. Coping with these conditions can lead to great discomfort. What you need is a plan, a way of coping. Not only will you be dealing with the depression and anxiety using techniques and coping strategies, but you will also be dealing the vast expanse of time, that without structure can seem like an endless ocean of distress. When depressed and anxious life can seem a lonely place where you are at the mercy of your thoughts and negative ruminations. You also need to factor in meaningful activity.

Creating a routine has many benefits. Begin by dividing the week into days, dividing the days into halves, quarters even hourly segments. Look to building up four categories of support:

Addressing your physical needs.
Addressing your mental and emotional needs.
Addressing your spiritual needs.
Addressing the need for human contact.

Here are forty tips that you also may find helpful:

Learn a relaxation method.
Organise your day to include work (or meaningful activity), rest and leisure.
Plan your day to avoid worrying over uncertainties.
Eat small regular healthy meals, ovoid caffeine, sugary and junk foods.
Don’t go too long between meals.
Keep alcohol and smoking to a minimum
Avoid boredom or getting into a rut, this can increase stress and anxiety.
If you do not work, it is very important to find interest and purpose elsewhere.
Find out if there are any organisations, centres or clubs that need volunteers.
If you do work, it is important to have some “you” time.
Make sure that time for you is quality time.
Exercise daily – it will reduce anxiety and raise your mood.
Get some fresh air, even if you cannot get out, open windows.
Spoil yourself while you are not well.
Don’t accept put downs, try to be more assertive.
Learn to say “NO” when you need to. We can’t give all the time.
Let others help, but don’t lean on them.
Find friends you can relax with, rather than wind you up.
Set yourself small goals that you can succeed in, no matter how small.
Be positive!! Positive things happen to positive people.
Be yourself, remember your unique.
If your appetite is down, think nutrient dense.
Try to get plenty of sleep, avoid naps if sleep is difficult.
Sunshine is very good for depression and anxiety.
Humans are the only animals that don’t make their own vitamin C, eat an orange!
Make friends with nature, put out a bird feeder.
Do something creative, cut out pictures from magazines and make a collage.
If you anxious lower external stimuli, dim lights, turn down television volume.
Have a bath with soothing oils.
Cuddle a hot water bottle if your cold.
Keep a journal or diary of your thoughts and feelings.
Get yourself some flowers and put them where you will see them.
Break large tasks into many smaller ones.
Don’t expect too much from yourself.
Stop being a perfectionist.
Do not make major life decisions while you are depressed.
Make lists, they can really help.
Stop blaming yourself, stop saying, “it’s all my fault.”
Every morning, relax, breathe and chant an affirmation for 10 minutes
Keep a positive book and write down two positive things each day, however small.

For more tips check out my book, “50 Tips to beat depression,” available on Amazon.

Until next time, Steve.

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www.facebook.com/yourmentalhealthmatters

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Steve Clifford                                                                                                                             Senior Accredited Integrative Psychotherapist.                                                                 Accredited Cognitive Behavioural Psychotherapist.

Image: http://commons.wikimedia.org/wiki/File%3AL059_-_depressed.jpg

References:

“How to Help Yourself get through Depression on a day-to-day basis” www.metanoia.org/help/helpyourself. htm [Accessed 29/05/13].

“Eight Ways to become an Optimist” by Vera Peiffer, Options, Feb 1993.

“20 Tips on Fighting Anxiety, Depression, and Fatigue Naturally.” www.kellythekitchenkop.com/2011/06/20-tips-on-fighting-anxiety-depression-and-ex... [Accessed 28/02/2014].

“Daily Survival Plan for Living in Hell,” Douglas Bloch. www.healingfromdepression.com/survival-plan.htm [Accessed 06/06/15].

Cutting Club

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Many people reading this blog about cutting will understand just how others feel who cut. They may have cut themselves in the past, have a friend or family member who cuts, or be contemplating the next cut at this very moment.

Cutting is the act of deliberately inflicting a wound, of self-harming and differs from a suicide attempt per se. It could be said that while cutting serves many purposes it is often a way of coping, a way of dealing with emotional distress. It may be that the person cutting feels deep sadness, acute anxiety or emotional numbness. Sometimes cutting can be a way of relieving stress or trying to feel in control. For some, “X” marks the spot, just like a cross on a map, it can signify the presence of something hidden or buried deeply. For some cutting can be a “ritual of purification.” This type of “blood letting” can release perceived “badness,” and it may be a way of inflicting punishment on oneself.

The term “Cutting Club” might be a good metaphor for what young people look for – a “connectedness” with others who may feel alienated from family, peers or society. Cutting becomes a statement and others may identify with them, perhaps forming a friendship group Alternatively, it might be the entry requirement to joining the group itself.

It is not just cutting itself that bonds members of this club together, other forms of self harm serve  the same currency. Scratching, burning, picking, tearing at skin, pulling out hair, swallowing poisonous or toxic substances, even breaking ones own bones, all share the same characteristics with often the same painful underlying themes.

In my experience as a therapist, cutting is frequently linked to underlying child abuse, in particular sexual abuse. It is more common in girls, but boys cut too. While I have seen boys and girls as young as 12 cutting, in my opinion the vast majority of those who do so, are in the 16 plus age group.

It may also be related to depression and anxiety. Quite often those, who cut may also turn to eating disorders or drugs as a way to cope. Sometimes it can be linked to conditions such as post-traumatic stress disorder. Sometimes, perhaps as a result of trauma, individuals feel ” dissociated” or ” numb” and this can be a way of feeling. For some people who have difficulty in regulating their emotions, cutting can be a way to cope when they do not have the personal resources to do so. It is not unusual for people to think about suicide when they are cutting, but it is not often meant as a suicidal act. The biggest danger is that the person cuts through an artery accidentally, seriously endangering their life.

I have seen cutting in all parts of the body including breasts and genitals, however, the most common injury sites are wrists, arms, thighs and sometimes stomach. I would not regard tattoos and body piercing as self- harm, unless of course, it is done deliberately to cause harm.

In most cases cutting is done secretly, often in the privacy of the home and mostly it is done where it can be covered up, perhaps by pulling down sleeves and hidden beneath layers of clothing.
Frequently, people who self- harm tell me that no one knows about this behaviour.

It can be very difficult for parents to deal with because they are so emotionally involved. Often they may blame themselves, sometimes they become angry, often because they feel both helpless and worried.

In my clinic I go to great lengths to try to understand what it is that underpins this behaviour. I know that it often signifies s deep emotional distress. It is a way of coping and I make sure to tell the person cutting that they are not bad and that this is not bad behaviour but merely a way of coping.

I explain that I am not judging them and neither am I going to take away this means of coping. Instead, I suggest that either working together to resolve the underlying conflict and/or providing them with a wider range of coping skills is really the best way to help.

It is very difficult to stop cutting because it can become a habit and ultimately an addiction. The very act of cutting releases “feel good” hormones known as endorphins, or to use the full medical name endogenous morphine.
Identifying the triggers is a key task and then teaching coping strategies other than cutting. Sometimes the addition of medication such as an antidepressant can help greatly. Having an opportunity to talk about the deep problems to a professional within a safe and confidential setting can really help. Sometimes having access to clean dressings and medical help may be needed, particularly if wounds are more than superficial.

If you are concerned about yourself or someone you know,make an appointment to see your doctor. Alternatively you  may find that there is a young persons counselling service near you, and if you are at school or college there may be someone you can talk to in confidence. Please feel free to email me in confidence via my website and I will try to find help in your area.

Until next time, Steve

You may wish to know that Steve is now offering therapy sessions via Skype Please contact us through our website @ www.stevecliffordcbt.com

Visit our facebook sites:

www.facebook.com/yourmentalhealthmatters

www.facebook.com/bexhillmindfulnesscentre

Steve Clifford Senior Accredited Integrative Psychotherapist.                                           Accredited Cognitive Behavioural Psychotherapist.                                                               Registered Mental Nurse.                                                                                                     Registered Nurse for Learning Disabilities.

 

Image ref:http://commons.wikimedia.org/wiki/File%3ASchnittwunden.JPG

Cutting Club

File:Schnittwunden.JPG

Many people reading this blog about cutting will understand just how others feel who cut. They may have cut themselves in the past, have a friend or family member who cuts, or be contemplating the next cut at this very moment.

Cutting is the act of deliberately inflicting a wound, of self-harming and differs from a suicide attempt per se. It could be said that while cutting serves many purposes it is often a way of coping, a way of dealing with emotional distress. It may be that the person cutting feels deep sadness, acute anxiety or emotional numbness. Sometimes cutting can be a way of relieving stress or trying to feel in control. For some, “X” marks the spot, just like a cross on a map, it can signify the presence of something hidden or buried deeply. For some cutting can be a “ritual of purification.” This type of “blood letting” can release perceived “badness,” and it may be a way of inflicting punishment on oneself.

The term “Cutting Club” might be a good metaphor for what young people look for – a “connectedness” with others who may feel alienated from family, peers or society. Cutting becomes a statement and others may identify with them, perhaps forming a friendship group Alternatively, it might be the entry requirement to joining the group itself.

It is not just cutting itself that bonds members of this club together, other forms of self harm serve  the same currency. Scratching, burning, picking, tearing at skin, pulling out hair, swallowing poisonous or toxic substances, even breaking ones own bones, all share the same characteristics with often the same painful underlying themes.

In my experience as a therapist, cutting is frequently linked to underlying child abuse, in particular sexual abuse. It is more common in girls, but boys cut too. While I have seen boys and girls as young as 12 cutting, in my opinion the vast majority of those who do so, are in the 16 plus age group.

It may also be related to depression and anxiety. Quite often those, who cut may also turn to eating disorders or drugs as a way to cope. Sometimes it can be linked to conditions such as post-traumatic stress disorder. Sometimes, perhaps as a result of trauma, individuals feel ” dissociated” or ” numb” and this can be a way of feeling. For some people who have difficulty in regulating their emotions, cutting can be a way to cope when they do not have the personal resources to do so. It is not unusual for people to think about suicide when they are cutting, but it is not often meant as a suicidal act. The biggest danger is that the person cuts through an artery accidentally, seriously endangering their life.

I have seen cutting in all parts of the body including breasts and genitals, however, the most common injury sites are wrists, arms, thighs and sometimes stomach. I would not regard tattoos and body piercing as self- harm, unless of course, it is done deliberately to cause harm.

In most cases cutting is done secretly, often in the privacy of the home and mostly it is done where it can be covered up, perhaps by pulling down sleeves and hidden beneath layers of clothing.
Frequently, people who self- harm tell me that no one knows about this behaviour.

It can be very difficult for parents to deal with because they are so emotionally involved. Often they may blame themselves, sometimes they become angry, often because they feel both helpless and worried.

In my clinic I go to great lengths to try to understand what it is that underpins this behaviour. I know that it often signifies s deep emotional distress. It is a way of coping and I make sure to tell the person cutting that they are not bad and that this is not bad behaviour but merely a way of coping.

I explain that I am not judging them and neither am I going to take away this means of coping. Instead, I suggest that either working together to resolve the underlying conflict and/or providing them with a wider range of coping skills is really the best way to help.

It is very difficult to stop cutting because it can become a habit and ultimately an addiction. The very act of cutting releases “feel good” hormones known as endorphins, or to use the full medical name endogenous morphine.
Identifying the triggers is a key task and then teaching coping strategies other than cutting. Sometimes the addition of medication such as an antidepressant can help greatly. Having an opportunity to talk about the deep problems to a professional within a safe and confidential setting can really help. Sometimes having access to clean dressings and medical help may be needed, particularly if wounds are more than superficial.

If you are concerned about yourself or someone you know,make an appointment to see your doctor. Alternatively you  may find that there is a young persons counselling service near you, and if you are at school or college there may be someone you can talk to in confidence. Please feel free to email me in confidence via my website and I will try to find help in your area.

Until next time, Steve Clifford, Cognitive Behavioural Psychotherapist.

Visit our health blog – www.stevecliffordcbt.com                                                            Like us at Facebook – www.facebook.com/yourmentalhealthmatters                            Tweet us @ cbt4you

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