3 Tips to Help Cope with Decision Fatigue from Covid-19

Do I send my kids to school this Fall? We’re out of eggs, should I take a trip to the store just to get one thing? Which store will be emptier? Do we go to my sister’s 40th birthday party?

The questions roll on and on. Some are small, some are big, but one thing’s for sure, they’re coming at us faster than ever and we’re exhausted. We’re suffering from decision fatigue.

This decision fatigue is leading to high levels of anxiety worldwide. According to a Pew Research Center report, one-third of Americans experienced high levels of psychological distress during the COVID-19 outbreak. Each decision feels weighted. Even the smallest decisions take up a lot of mental space now and in the end, no choice seems quite right. The Centers for Disease Control and Prevention has even created a decision-making tool to help parents and guardians weigh the risks and benefits of sending their kids back to school.

Here are some tips to help reduce decision fatigue.

1. Practice Constraint

It’s time to minimize feelings of overwhelm. To do that we need to limit the number of decisions we make each day. This may take a little time on the front end, but when you create a schedule and make a plan for the week, you reduce the amount of time and stress spent on day to day decisions.

• Plan your menu and get your groceries for the week. Whether you’re an excellent cook or someone who celebrates making scrambled eggs (I’m pointing at myself), make yourself sit down, write out the menu and then get the groceries for the whole week so you have the ingredients waiting for you.
• Plan your outfit the day before. (I work from home, so which sweatpants to wear doesn’t take up too much time) Take a tip from Steve Jobs and choose just a couple outfits you wear for work, so you don’t need to spend time thinking about what to wear. It doesn’t have to be a black turtleneck and blue jeans but narrow your choices down and stick with it.
• Anything that you do daily/weekly, get that planned ahead so it’s one less thing on your plate.

2. Time Block

There’s a lot of different ways to set up a schedule. It doesn’t matter how you do it, just do yourself a favor and make one. Sit down at the end of the week or before the next week starts and plan your week.

I like to plan my next week on Friday. I’ll write down a list of everything I need to accomplish. I keep a master list on Evernote (they have a free version). Then I take out my notebook (because I’m a sucker for pen, paper, and crossing things off – it feels so good), and I break my list out through the week.

My favorite kind of scheduling is called Time Blocking. Depending on what’s on the list I block my workday into 30-minute and 1-hour time blocks to get things done. This blog post took up a couple one-hour time blocks. One in the morning and another in the afternoon. There’ll be one more 30-minute time block to go over it one more time before I hit post. If you want more in-depth information about time blocking, I recommend checking out these blog posts on the nitty-gritty of time blocking.

Most people recommend doing the hard stuff on your list first when mental energy is at its peak. We’re all different. You know what works best for you. I have to wait for my daughter to go down for her nap before I can really get focused on the hard stuff, so for me, I work on the hard stuff from 1:30 – 3:30 in the afternoon.

3. Take a walk

When overwhelm sets in, get outside. Take a walk or find a quiet place to sit and take some deep breaths. Give yourself breaks throughout the day. Your body needs it and so does your mind.

What tips do you have to help with decision fatigue? Share them in the comments.

The Strength of Hope

The bad news: Without hope, you won’t achieve your goals.

The good news: Everyone is capable of hope.

What is hope?

Webster’s dictionary defines hope as “desire accompanied by expectation of or belief in fulfillment.” Think of your biggest accomplishment. Now reverse back to the beginning: before you were successful, before taking steps towards achieving that accomplishment, the very beginning when the thought originated. What drove you to take the first step? You believed it was possible. YOU HAD HOPE. Seemingly impossible things have happened in our world because of hope: humans have walked on the moon, cures for different cancers have been found, and the list goes on and on.

Hope is good for the brain

Hopeful patients have higher levels of dopamine and endorphins which promote well-being. Individuals with high hope levels see barriers as challenges to overcome and set about finding alternatives to accomplish their goals. People with low hope levels view the same challenge as a roadblock that can’t be passed. (Snyder, 1994 as cited in Snyder, 2000 p. 10). People who grew up in a household void of hope and full of trauma can have reduced levels of dopamine in the brain. It’s no wonder then that due to those low levels of dopamine, one can turn to drugs and alcohol in order to increase their dopamine levels. Hope is vital to our well-being and survival.

Meet Hope’s best friend, Resilience

Hope and resilience go hand in hand. Resilience means to do well, despite adversity. (Clinton, 2008). Those that are resilient respond to stressful situations in positive and constructive ways. Sounds a bit like hope, doesn’t it? People that are resilient are transformed by adversity and come out changed by the experience. They don’t just cope, but recover and move on in a positive way. Resilience is more than optimism. It’s about facing adversity and continuing in an intentional way to be hopeful. It’s about looking at the hard times in your life and appreciating how you pushed through.

Resilience and hope are not something you’re born with. You can learn to access both.

In a study done at Harvard, professor Stuart Hauser and a group of researchers interviewed 67 teens who had faced serious troubles and were admitted to a locked unit psychiatric facility. They followed them throughout their lives and only 9 of the 67 were doing well after they got out. The others continued to lead troubled lives. Hauser’s group looked at the narratives of each of the teens and found what separated the 9 from the others were three characteristics that are crucial to resilience:

1. Concern to overcome adversity
2. A self-reflective style
3. Commitment to relationships (Hauser et al. 2006, 39)

How to Foster Hope and Resilience

Here are four actionable steps to help strengthen your hope and resilience.

1. Create Goals. The more concrete, achievable, challenging and appealing they are, then the more likely you are to believe that acting on them will make a difference in your life.
2. Accept losses. Anytime you decide to make changes to your life, there will be things (and sometimes people) you will have to say goodbye to. Speak openly about the feeling of loss you’re experiencing so those feelings don’t stay trapped inside.
3. Build a Network. Surround yourself with loved ones and other people who support you and in turn, you support them on their journey. You keep each other honest and remind each other of your strengths when you’re struggling.
4. Know your Family Stories. With the help of your family, climb high into your family tree. How many generations can you go back? What stories do you know? What adversity did your great-great-grandparents face? How did your grandfather provide for his family when he lost his job? Learn your family stories and find the themes of resilience and hope. Those stories are your stories. You carry the genes of your ancestors. They were resilient and so are you.

Transitional Family Therapy and Recovery

Transitional Family Therapy (TFT) helps foster hope and resilience in recovery. “[TFT] is designed to help the family understand its current problems in terms of both present and past relational interactions within the extended family, its natural support system, and its environment (Seaburn et al., 1995).”

The transitional pathway demonstrates the need to create continuity from past, through present, into the future–an unbroken, transitional pathway. When families can look at this flow and discover that the current problems, they’re having had originally begun generations ago as a way to deal with past problems. Those problems are no longer relevant today, so this gives the family hope to find more adaptive solutions for the future. It also allows the family members to develop a sense of competence that amplifies their confidence and effectiveness in dealing with current problems. Remember those family stories we talked about earlier? Find the power of your story.

Never Give Up

All it takes is the smallest sliver of light to see in the darkness. Sometimes that’s all you have, hold on to that light, hold onto that hope. Foster it, do the work. That light will glow brighter and brighter. Once you can see clearly, share that light with others. I promise you, there are many people out there feeling lost in the darkness, void of hope. Remind them of their strength, give them hope by sharing your story of resilience.

Family of Origin Workshop

The ARISE® Network offers classes for those wanting to help their clients access their resilience and learn more about Family of Origin. You will learn about inter-generational patterns, traits, unspoken and spoken rules, stories, relationship dynamics, vulnerabilities and strengths that come from one’s family-of-origin. The workshop builds on the following beliefs:

• Families are intrinsically healthy;
• Every family has both strengths and vulnerabilities;
• Symptomatic behavior has its origins in protection;
• Families are in constant transition and uncompleted life cycle transitions repeat themselves in families unless understood on a conscious level and resolved.

To learn more about our workshops visit our website or email Michelle Johnson at training@arise-network.com.

Sources:

Acharya T, and Agius M. 2017 Sep;29(Suppl 3):619-622. The importance of hope against other factors in the recovery of mental illness. https://www.ncbi.nlm.nih.gov/pubmed/28953841

Gross, Stanley. (2018) ‘Fostering Hope’, PsychCentral, 8 Oct. 2018, https://psychcentral.com/lib/fostering-hope/

Hill, Maria. ‘How to Create a More Hopeful Life’, Lifehacker, https://libguides.ioe.ac.uk/c.php?g=482485&p=3299749

Landau J.L. (2018) Transitional Family Therapy. In: Lebow J., Chambers A., Breunlin D. (eds) Encyclopedia of Couple and Family Therapy. Springer, Cham. First Edition.

Suddaby, K., and Landau, J. (1998). Positive and negative timelines: A technique for restorying. Family Process, 37(3), 287-298, 475.

4 Early Warning Signs of Eating Disorders

Eating disorders have the highest mortality rate of any mental illness. They reach every ethnicity, religion, age, tax bracket, and sex. They don’t discriminate.

• In a classroom of nine and ten-year-old girls, 40% would tell you they were on a diet to lose weight (U.S. News and World Report).
• In 2007, a study reported 25% of anorexia and bulimia cases are males (Hudson, Hiripi, Pope, & Kessler, 2007).
• 13% of women over 50 engage in eating disorder behaviors (Gagne, D. A., Von Holle, A., Brownley, K. A., Runfola, C. D., Hofmeier, S., Branch, K. E., & Bulik, C. M., 2012).
• Lifetime prevalence of binge eating disorder is 3.5% in women, and 2.0% in men (Biological Psychiatry, February 2007 edition)

Unfortunately, only 1 in 10 receives treatment for their condition. For some people they’ve struggled their whole lives, others developed an eating disorder much later in life. Regardless of the timing, early detection is key.

Early warning signs of an eating disorder

A recent large-scale study published in the British Journal of Psychiatry by Swansea University found early warning signs that can help doctors detect eating disorders much sooner. The research team examined health records from 15, 558 people in Wales who had been diagnosed with eating disorders between 1990 and 2017. In the two years before their diagnosis they discovered the individuals had:

1. Higher levels of other mental disorders such as personality or alcohol disorders and depression
2. Higher levels of accidents, injuries, and self-harm
3. Higher rate of prescription for central nervous system drugs such as antipsychotics and antidepressants
4. Higher rate of prescriptions for gastrointestinal drugs (e.g. for constipation and upset stomach) and for dietetic supplements (e.g. multivitamins, iron)

What does this mean for recovery?

These results can help doctors be on the lookout for early warning signs. As with any mental illness, early detection is better for the health of the individual and family. For instance, when adolescents with anorexia nervosa are given family-based treatment within the first three years of the illness onset they have a much greater likelihood of recovery (Lock, Agras, Bryson, & Kraemer, 2005; Loeb et al., 2007; Russell, George, Dare, & Eisler, 1987; Treasure & Russell, 2011).

Whole Family Healing

ARISE® believes family support (whether blood-related or chosen) is one of the keys to recovery. Many times after leaving a treatment facility, the individual can find it hard to cope with everyday challenges and find themselves back where they started.

With ARISE® Comprehensive Care, everyone (including the Person of Concern) collaborate for a minimum of 6 months to work on life skills and healing. This work helps them and their family address their complete bio-psycho-social-cultural-spiritual spectrum of health. The focus may be on communication skills, managing normal life cycle transitions, stress management techniques, resolving unresolved grief and family issues, healthy diet and eating patterns, rebuilding social lives and repairing damaged relationships.

Recovery is possible

With treatment 60 – 85% of people recover. Families who participate in ARISE® Comprehensive Care meetings have great success in helping maintain their loved one’s success into long-term recovery and improving their family relationships. For many people living in recovery from their eating disorder is a lifelong struggle, but recovery is possible.

If you are interested in learning more about ARISE® Comprehensive Care, please email or call us at 1-877-229-5462.

Resources:

• https://anad.org/education-and-awareness/about-eating-disorders/eating-disorders-statistics/
• http://healthland.time.com/2012/06/21/too-old-for-weight-worries-eating-disorders-are-common-among-women-over-50/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3479631/
• https://www.anred.com/stats.html
• https://eurekalert.org/pub_releases/2019-06/su-ews062819.php
• Gagne, D. A., Von Holle, A., Brownley, K. A., Runfola, C. D., Hofmeier, S., Branch, K. E., & Bulik, C. M. (2012). Eating disorder symptoms and weight and shape concerns in a large web‐based convenience sample of women ages 50 and above: Results of the gender and body image (GABI) study. International Journal of Eating Disorders, 45(7), 832-844.

How Can External Agencies Best Support Community Resilience After Mass Trauma?

We’ve all seen the photos and news clips from Hurricane Harvey and Hurricane Irma – whitecaps on the flooded Houston freeway, local heroes literally carrying strangers to safety, boats hauling family pets to dry land. Undeniably, the communities afflicted by these historic hurricanes will be rebuilding for years to come.

“For each episode of mass trauma, the number of people and families impacted is multiplied. Results of a longitudinal study of a past trauma—the Oklahoma City Bombing 10 years ago in the United States—shows that for every one person directly impacted by the trauma, five now show symptoms of stress or post-traumatic stress disorder (PTSD; Brom, Danieli, & Sills, 2005).”

Many times when mass trauma impacts a community, such as Houston following Hurricane Harvey, outside resources flood in. The government grants emergency funds to help with recovery efforts, and the professionals arrive ready to help, ready to “fix” things. They classify the affected people as in need of their services.

Eventually that money dries up and communities are left to fend for themselves again, oftentimes feeling more helpless when the outside sources they relied on are no longer available. Unfortunately, this marginalizes the natural support system of the local community and isolates people, rather than bringing them together at a crucial time.

There is a way to make this transition smoother. Communities must be empowered so they can embrace their own resilience. 

“Families, as the integral unit of the community and the major support of our children, are of vital importance in determining how communities recover in the aftermath of mass trauma.”

Although external resources are necessary after a major crisis, they must support the natural support systems and respect the community’s strengths. Instead of “fixing” a broken system, professionals will do more good by supporting what the community is already doing and capitalizing on the special skills of the community and their leadership.

The LINC (Linking Human Systems) Community Resilience Model (Landau, 2004), provides ways in which communities can prepare, respond, and recover from trauma.

A community’s recovery is stronger when locals can build positive connections by drawing from their inherent resilience. It’s also important for professionals to avoid labeling their behavior as dysfunctional or broken.

LINC believes that by enhancing human connections, people build a sense of continuity with both the past and future. This reminds people of how generations before them have overcome their own troubles and builds a strong sense of solidarity among the community, eliminating “us versus them”.

Another important factor in the LINC Model is the use of Family and Community Links. Links are people who provide a bridge between professionals, families, and communities. They are the people who have natural access to closed communities. They understand the culture and are trusted within the community. Their job is integral to connecting the outside professionals and agencies with the community. Links also ensure that all sides are informed and not holding any secrets.

When community members play a central role in the design of their recovery, the programs have a higher rate of success and help keep communities strong into the future. As outside agencies are brought into hurricane-ravaged areas, they will do a great service to these communities by remembering that each area must be approached differently and appreciated for its own unique skills that make the community great.

If you’re interested in learning more about the LINC Community Resilience Model, you can find more information on the website and also in our LINC® Publications.

Resources:

• Linking Human Systems: Strengthening Individuals, Families, and Communities in the Wake of Mass Trauma
• The LINC Model of Family and Community Resilience: New Approaches to Disaster Response

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Hoarding: A Growing Concern

Dr. Landau reports increasing calls reporting Persons of Concern exhibiting hoarding behaviors. She has summarized the following research from Dr. Stephen Soreff to help you and loved ones identify problematic behaviors and how to get help.

Hoarding disorder is a difficulty discarding possessions. Clinically significant hoarding has an estimated prevalence of 2-6% in the United States and Europe.

Hoarding disorder is a persistent difficulty in discarding or parting with possessions, regardless of their actual value. Many healthy individuals collect material goods, such as stamps and porcelain figurines; others have difficulty parting with objects due to their sentimental or material value. Hoarding disorder occurs when individuals accumulate to such an extent that it affects their ability to use the living areas of their homes, causes distress, places them in danger, or restricts their quality of life. Clinically significant hoarding is estimated to have a prevalence of 2%-6% of the population in the United States and Europe.

Hoarding may not be limited to inanimate objects.

Hoarding may be divided into two subcategories: object hoarding and animal hoarding. The most prominent difference between object hoarding and animal hoarding is the extent of unsanitary conditions and the poorer insight characteristic of animal hoarders. Lacking insight into their behavior and its consequences, they frequently do not comprehend that they are not adequately providing for the animals and are placing them in harm’s way. Most individuals who hoard animals also hoard inanimate objects.

Hoarders rarely recognize their condition and may only be prodded into seeking help by concerned family and friends. Clinical clues regarding the presence of hoarding disorder include cellulitis or skin infections due to living in squalid conditions. Patients may also have fractures due to falls caused by tripping over accumulated objects. The course of hoarding tends to be chronic and progressive, with symptoms starting in the teens and severity increasing with age. Hence, the amount of hoarded material may greatly increase over time.

Hoarding disorder has a significantly greater prevalence among males than among females.

The cause of hoarding disorder is unknown. Although many patients report a family history of hoarding, genetic studies have pointed toward several different genes. Numerous psychological theories concerning the etiology of hoarding disorder point to characteristics often displayed by hoarders, including difficulty initiating and completing tasks, excessive sentimental attachment to possessions, indecisiveness, and impaired memory confidence. In late-onset hoarding, traumatic life events may act as precipitants.

Hoarding disorder is best assessed by Conducting a home visit or viewing photos of the main living areas.

Congested and cluttered living areas are a diagnostic criterion for hoarding disorder, and conducting a home visit and viewing photos of the main living areas are frequently the best ways to assess hoarding disorder. It may also be helpful to speak to friends and family members because hoarders often lack insight into their disorder and frequently do not view their condition as harmful or abnormal. Visits to the residence demonstrate the importance of firsthand observations. If home visits are not conducted, clinicians may fail to comprehend the full extent of the clutter.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, hoarding involves a persistent difficulty discarding or parting with possessions, regardless of their actual value, due to a perceived need to save the items and to distress associated with discarding them. It often leads to an accumulation of possessions that congest and clutter living areas and substantially compromise their intended use. It causes clinically significant distress or impairment in social, occupational, or other important areas of functioning and is not attributable to another medical condition or better explained by the symptoms of another mental disorder.

Hoarding is not highly associated with eating disorders. The disorder does have a high rate of co-occurrence with depressive and anxiety disorders as well as with attention-deficit/hyperactivity disorder (ADHD). Indeed, the thought of discarding one’s possessions can create intense anxiety in the hoarder. Hoarding disorder may also occur as part of obsessive-compulsive disorder (OCD), in which individuals have obsessions in relation to certain items and compulsions to collect these objects.

Hoarding can also occur as a part of organic states such as dementia, cerebrovascular accidents, or alcohol-related brain disorders. In these cases, the hoarding is relatively new in onset and much more disorganized, with more prominent squalor. As in chronic hoarding, patients typically lack insight into their disorder, making input from friends and neighbors critical to diagnosis. Medical review and examination is indicated for acute-onset cases.

The most effective treatment is CBT is typically conducted for 12 months or less.

Approach Considerations

It is important to establish a therapeutic relationship with the patient who may lack awareness of their problem or not be motivated to change their way of life.

Cognitive-Behavioral Therapy

Treatment usually involves psychological therapy in the form of cognitive-behavioral therapy (CBT) with weekly sessions over 20 to 26 weeks. [18] Often these sessions incorporate home visits with a therapist [19] combined with between-session homework. A study of persons with hoarding disorder who received 26 individual sessions of CBT, including frequent home visits, over a 7-12 month period, found adherence to homework assignments was strongly related to symptom improvement. [20]

Research on online CBT sessions that give patients access to educational resources on hoarding, cognitive strategies, and a chat-group has shown promising results.

CBT, the primary form of psychological therapy for hoarding disorder, typically involves weekly sessions over 20-26 weeks. These sessions often incorporate home visits with a therapist combined with between-session homework. Home visits are particularly valuable for monitoring the patient’s progress. A study of persons with hoarding disorder who received 26 individual sessions of CBT, including frequent home visits, over a 7- to 12-month period found that adherence to homework assignments was strongly related to symptom improvement. Online CBT sessions that give patients access to educational resources on hoarding, cognitive strategies, and a chat group have shown promising results.

Selective serotonin reuptake inhibitors (SSRIs) and serotonin/norepinephrine reuptake inhibitors (SNRIs) are most commonly used to treat hoarding disorder. Treatment response to pharmacotherapy is similar to the response in OCD. In addition, pharmacologic treatment of a coexisting anxiety or depressive disorder may be indicated

ARISE® Hoarding Continuing Care with Intervention Support

An ARISE® Intervention is an effective way to help your loved one enter treatment and recover their hijacked brain. ARISE® gets over 83% of individuals into treatment within 3 weeks, 96% into treatment within 6 months and 61% in recovery by the end of the year. Call our no obligation, toll free hotline at 877-229-5462 or contact us now

Source: Psychiatry Fast Five Quiz: Test Your Knowledge of Hoarding Disorder

One Hour at a Time with Mary Woods – A Podcast

Every Monday at 3pm EST (noon PST), the Voice America Health and Wellness Channel broadcasts the show “One Hour at a Time,” hosted by Mary Woods from WestBridge Community Services. On Monday, February 27, 2017, the broadcast featured the special encore “It’s Not Marijuana… It’s MarijuanaX” with special guest Michael R. DeLeon, the director, and producer of the documentary film “MarijuanaX”.

The perception of the drug marijuana has changed drastically over the years. According to a 2015 Pew Research Center study, 56% of American adults believe marijuana should be legalized, while 44% think it should be considered illegal. Additionally, 68% of adults under 35 years of age think marijuana should be legalized. People in our country are referring to the now industrially-produced marijuana as if it were the exact same thing it was in the 80’s when it was being grown by botanists. In the 1980’s, the 2% – 5% flower imported from Colombia that used to get users high is now a wax/oil that can contain upwards of 97% pure THC. Today’s marijuana is drastically different than it once was and is known to be 57-67% more potent than it was in the 1970’s and 1980’s. Every year, more and more states legalize marijuana for medicinal use. Should we be more concerned?

Michael R. DeLeon developed the world’s most relevant and emotional documentary on marijuana, MarijuanaX, after he was the first to address the opiate and heroin epidemic in New Jersey through the film “Kids are Dying”. “Marijuana X” challenges the country and media’s perspective on this drug like it has never been challenged before. It presents the audience with people who have been directly affected by marijuana even though the majority of our country believes it to be harmless. It even features Colorado natives whose lives have been turned upside-down by the drug. “MarijuanaX” will challenge the way you feel about marijuana and the role this drug might play in your life.

According to our friends at WestBridge Community Services, the overall purpose of these weekly podcasts is “to increase awareness about recovery from substance use disorders and mental illness and to decrease the stigma and increase the awareness of the discrimination that exists for people with substance use disorder and mental illness.”

Tune into the podcast Mondays at 3:00pm EST