Anxiety is a normal reaction to change and children experience change frequently. This is a great article with useful and concrete phrases and strategies to help little ones with their worry and anxiety. 

Friends Wanted

The new year seems to trigger discussions about connections, loneliness and friendships. Perhaps a time for reflection or a reaction to all the expectations of gathering with others around the holidays. This article explores and explains the importance of social connections to our emotional and physical health. New research by psychologists uncovers the health risks of loneliness and the benefits of strong social connections.

By Anna Miller

Monitor Staff

January 2014, Vol 45, No. 1

Print version: page 54

New research by psychologists uncovers the health risks of loneliness and the benefits of strong social connections.

It took a trip to the hospital for Cathryn Jakobson Ramin, 56, to confront a nagging concern she'd had for years: She had no friends. "I didn't have one person who could pick me up," says the journalist in Mill Valley, Calif., who went to the hospital for a small medical procedure.

Ramin does have many friends — those she first met in childhood and in the four cities she's lived in as an adult — but they don't live nearby anymore. She also has a strong marriage, two grown sons and a successful career. But she has few local friends she can call on in a time of need — or for simple companionship.

"I like the sense of sitting in someone's kitchen with a cup of tea and cookies and just shooting the [breeze]," she says, admitting she feels a void. "That to me is a very important part of life."

Psychologists agree. While research on relationships has skirted adult friendships — tending to focus on adolescent friendships and adult romances — the importance of strong social connections throughout life is gaining scientific clout, having been linked with such benefits as a greater pain tolerance, a stronger immune system, and a lower risk of depression and early death.

"For years and years … people speculated that if you felt alone or you lived alone or you were alone a lot, you wouldn't eat good meals, you wouldn't exercise as much, nobody would take you to the doctor," says Laura Carstensen, PhD, who directs Stanford University's Center on Longevity. "But I think what we're learning is that emotions cause physiological processes to activate that are directly bad for your health."

Yet forging platonic relationships isn't always easy. Ramin's situation appears to be increasingly common: According to a meta-analysis with more than 177,000 participants, people's personal and friendship networks have shrunk over the last 35 years (Psychological Bulletin, 2013).

Combine that trend with the United States's rising age of first marriage, a divorce rate nearing 50 percent and a life expectancy that's at an all-time high, and you get "a demographic shift such that there are now [more] people who don't have a marital partner to supply the intimacy they need," says Beverley Fehr, PhD, a social psychologist at the University of Winnipeg and author of the 1996 book "Friendship Processes." "In light of those shifts, I think that friendships are more important today than ever before."

I'm so lonesome I could die

A lack of friends isn't simply an inconvenience when you want a movie partner or a ride to the hospital. A sparse social circle is a significant health risk, research suggests. In one meta-analysis of 148 studies comprising more than 308,000 people, for example, Brigham Young University psychologists found that participants with stronger social relationships were 50 percent more likely to survive over the studies' given periods than those with weaker connections — a risk comparable to smoking up to 15 cigarettes a day and one double that of obesity. And the risks of poor relationships are likely greater, the researchers say, since the studies didn't look at the quality of participants' social connections (PLOS Medicine, 2010).

There's some evidence that more really is merrier. In one recent study tracking 6,500 British men and women ages 52 and older, psychologist Andrew Steptoe, PhD, of the University College London and colleagues found that both feeling lonely and being socially isolated raised the risk of death. However, only social isolation — measured in terms of frequency of contact with family and friends, and participation in organizations outside of work — appeared to be related to increased mortality when the researchers adjusted for demographic factors and baseline health (PNAS, 2013).

But contrary to Steptoe's findings, most research indicates that feeling isolated is more dangerous than being isolated, says psychologist John Cacioppo, PhD, co-author of the 2008 book "Loneliness: Human Nature and the Need for Social Connection." In one 2012 study, he and colleagues looked at data from more than 2,100 adults ages 50 and older and found that feelings of loneliness were associated with increased mortality over a six-year period. The finding was unrelated to marital status and number of relatives and friends nearby, as well as to health behaviors such as smoking and exercise (Social Science and Medicine, 2012).

"It's not being alone or not" that affects your health, Cacioppo says. "You can feel terribly isolated when you're around other people."

In his ongoing Chicago Health Aging and Social Relations Study, funded by the National Institute on Aging, Cacioppo and colleagues have also linked loneliness with depressive symptoms and an increase in blood pressure over time.

Other research indicates positive social connections might accelerate disease recovery. In a study of 200 breast cancer survivors, psychologist Lisa Jaremka, PhD, and colleagues at the Ohio State University found that lonelier women experienced more pain, depression and fatigue than those who had stronger connections to friends and family. The more disconnected women also had elevated levels of a particular antibody associated with the herpes virus — a sign of a weakened immune system (Psychoneuroendocrinology, 2013).

Particular genes may play a role in explaining why our bodies are so attuned to our social lives, says psychologist Steve Cole, PhD, at the University of California, Los Angeles. In one study, he and colleagues including Cacioppo analyzed the gene expression profiles of chronically lonely people and found that genes expressed within two subtypes of white blood cells are uniquely responsive to feelings of loneliness. The cells — plasmacytoid dendritic cells and monocytes — are associated with diseases such as atherosclerosis and cancer, as well as "first line of defense" immune responses (PNAS, 2011).

Cole says the most "biologically toxic" aspect of loneliness is that it can make you feel chronically threatened, an emotion that can wear on the immune system. "It's really that sense of unsafe threat, that vague worry, that's probably what's actually kicking off the fight-or-flight stress responses that affect the immune system most directly," he says.

Friends in adulthood

As researchers work to better understand the link between friendships and health, they're also helping to answer a question familiar to anyone who's ever moved to a new city, lost a spouse or otherwise found themselves feeling alone: How do you make friends as an adult? Here's what the research suggests might work:

  • Be a familiar face. The idea that familiarity breeds attraction is long-established by research, and was again supported in a 2011 study led by psychologist Harry Reis, PhD, at the University of Rochester. In the first experiment, same-sex strangers rated how much they liked one another after having several structured conversations. In the other, strangers chatted freely online. In both cases, the amount participants liked their partners increased with each exchange (Journal of Personality and Social Psychology, 2011).

Rachel Bertsche, a writer in Chicago, witnessed this phenomenon outside of the lab when she joined a weekly comedy class a few years ago. At first, she thought her classmates were strange. But she gradually changed her mind — and soon wound up joining the group for drinks after class. "Consistency is so important," she says.

Fehr agrees. She says sticking to a simple routine — whether it's going to the same coffee shop at the same time every day, joining a class like Bertsche or even just going to the office mailroom when it's most crowded — can help turn strangers into friends.

  • Divulge a secret. There are ways to make fast friends, too, psychologists say. Research by Stony Brook University professor Arthur Aron, PhD, showed that gradually increasing the depth of questions and answers between strangers can spawn friendships in just 45 minutes (Personality and Social Psychology Bulletin, 1997). Fehr and her team are building on this model by directing a couple of college buddies first to ask each other neutral questions, such as, "When did you last go to the zoo?" and slowly build up to more intimate questions such as, "If you knew someone close to you was going to die tomorrow, what would you tell them today — and why haven't you told them yet?"

So far, she's seeing men's friendships getting stronger. "When they do open up to each other, they feel closer to each other and they feel more satisfaction with the relationship," she says.

  • Realize it's in your head. Loneliness is a subjective experience that can often be a self-fulfilling prophecy, says Cacioppo. "When people feel isolated, the brain goes into self-preservation mode," he says, meaning that they become preoccupied with their own — not others' — welfare. While the response is an innate one meant to protect us from threats, over time, it harms physical and mental health and well-being, and makes us more likely to see everything in a negative light. It can also make us seem cold, unfriendly and socially awkward. But recognizing what's in your head can help you get out of it, Cacioppo says.

In a review of interventions to reduce loneliness, he and colleagues found that those that encouraged participants to challenge their own negative thought processes — for example, by sharing a positive part of their day with someone else — were more effective than interventions seeking to improve social skills, enhance social support or increase opportunities for social contact. "It has a surprising effect," Cacioppo says. (Personality and Social Psychology Review, 2010).

  • Log on, with caution. Liz Scherer, a copywriter in Silver Spring, Md., used social media to forge friendships when she moved from New York City to Annapolis, Md., about 10 years ago at age 42. Through Twitter, she connected online with others in her business and met many of them in person at social media conferences. "I've made some really good friends who I talk to … every single day," she says. "They're good social supports and business supports."

Research suggests Scherer's positive experience with social media is most common among people who are already well connected. A review of four studies by psychologist Kennon Sheldon, PhD, of the University of Missouri, and colleagues, for example, found that more time on Facebook was linked to both high and low levels of connectedness. Psychologists posit this may be the case because Facebook supports relationships among those who are already highly socially connected, but might make those who are isolated feel even more so (Journal of Personality and Social Psychology, 2011).

"If you rely on virtual relationships entirely, that's probably bad for you," Carstensen says. "But when you're using email and face time to supplement real relationships, that's a good thing."

  • Don't force it. If the pressure to forge new relationships is more external than internal, put away the "friend wanted" ad and focus on what and who does make you happy, says Carstensen. "If people are not very socially active and they aren't necessarily interested in expanding their social networks, and they seem OK emotionally, then you shouldn't feel alarmed," she says.

After all, being highly connected has its downsides, too, says University of Sheffield psychologist Peter Totterdell, PhD, who studies social networks in organizations. He's found that people with large work-based networks tend to be more anxious than those with fewer connections. "Possibly what's going on there is that you get more possibilities, more resources, but at the same time you've got more responsibility as well," he says.

And trying to change who you are can backfire, since people's likelihood to forge connections seems to be relatively constant throughout life, Totterdell says. "People may have a natural inclination, and to try to change that [may] make them uncomfortable with the results," he says.

The bottom line? Whether you're content with two close friends or prefer to surround yourself with 20 loose acquaintances, what matters is that you feel a part of something greater than yourself, Carstensen says.

"We shouldn't judge people who say, ‘I'm not a party goer, I don't want to make friends, I don't want to hang out in the bars or the clubs' — that's fine," she says. "There's a whole bunch of people who feel the same way."

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Brain's Stress Circuits Undergo Profound Learning Early in Life, Scientists Find

Can stress in the earliest days of our lives set us up for how we cope and our preferences to eating comfort food? This study finds evidence for this.

Apr. 7, 2013 — Researchers at the University of Calgary's Hotchkiss Brain Institute have discovered that stress circuits in the brain undergo profound learning early in life. Using a number of cutting edge approaches, including optogenetics, Jaideep Bains, PhD, and colleagues have shown stress circuits are capable of self-tuning following a single stress. These findings demonstrate that the brain uses stress experience during early life to prepare and optimize for subsequent challenges.

The team was able to show the existence of unique time windows following brief stress challenges during which learning is either increased or decreased. By manipulating specific cellular pathways, they uncovered the key players responsible for learning in stress circuits in an animal model. These discoveries culminated in the publication of two back-to-back studies in the April 7 online edition of Nature Neuroscience.

"These new findings demonstrate that systems thought to be 'hardwired' in the brain, are in fact flexible, particularly early in life," says Bains, a professor in the Department of Physiology and Pharmacology. "Using this information, researchers can now ask questions about the precise cellular and molecular links between early life stress and stress vulnerability or resilience later in life."

Stress vulnerability, or increased sensitivity to stress, has been implicated in numerous health conditions including cardiovascular disease, obesity, diabetes and depression. Although these studies used animal models, similar mechanisms mediate disease progression in humans.

"Our observations provide an important foundation for designing more effective preventative and therapeutic strategies that mitigate the effects of stress and meet society's health challenges," he says.

Story Source:

The above story is based on materials provided by University of Calgary, via EurekAlert!, a service of AAAS.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

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Babies Born to Stressed Mothers More Likely to Be Bullied at School

Can the stress mom's experience while pregnant impact their children into adulthood. There is growing evidence that a baby's wiring and predisposition is strongly influenced by the emotional health of their mother. Read on to discover how.

Nov. 14, 2012 — Children whose mothers were overly stressed during pregnancy are more likely to become victims of bullying at school.

New research from the University of Warwick shows stress and mental health problems in pregnant women may affect the developing baby and directly increases the risk of the child being victimized in later life.

The study has been published in theJournal of Child Psychology and Psychiatry and is based on 8,829 children from the Avon Longtitudinal Study of Parents and Children (ALSPAC).

Professor Dieter Wolke, Professor of Developmental Psychology at University of Warwick and Warwick Medical School headed up the study.

He said: "This is the first study to investigate stress in pregnancy and a child's vulnerability to being bullied. When we are exposed to stress, large quantities of neurohormones are released into the blood stream and in a pregnant woman this can change the developing fetus' own stress response system.

"Changes in the stress response system can affect behaviour and how children react emotionally to stress such as being picked on by a bully. Children who more easily show a stress reaction such as crying, running away, anxiety are then selected by bullies to home in to."

The research team identified the main prenatal stress factors as severe family problems, such as financial difficulty or alcohol/drug abuse, and maternal mental health.

Professor Wolke added: "The whole thing becomes a vicious cycle, a child with an altered stress response system is more likely to be bullied, which affects their stress response even further and increases the likelihood of them developing mental health problems in later life."

Story Source:

The above story is based on materials provided by University of Warwick.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

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In the Brain, Broken Down 'Motors' Cause Anxiety

Having "motors" in the brain not working properly might lead to less serotonin getting to where it needs to go, in turn leading to higher levels of anxiety. This is promising new research that can lead to medication that "fixes" the "motors" and restores serotonin pathways and levels. Read article below for further details.

Feb. 7, 2013 — When motors break down, getting where you want to go becomes a struggle. Problems arise in much the same way for critical brain receptors when the molecular motors they depend on fail to operate. Now, researchers reporting in Cell Reports, a Cell Press publication, on February 7, have shown these broken motors induce stress and anxiety in mice. The discovery may point the way to new kinds of drugs to treat anxiety and other disorders.

The study in mice focuses on one motor in particular, known as KIF13A, which, according to the new evidence, is responsible for ferrying serotonin receptors. Without proper transportation, those receptors fail to reach the surface of neurons and, as a result, animals show signs of heightened anxiety.

In addition to their implications for understanding anxiety, the findings also suggest that defective molecular motors may be a more common and underappreciated cause of disease.

"Most proteins are transported in vesicles or as protein complexes by molecular motors," said Nobutaka Hirokawa of the University of Tokyo. "As shown in this study, defective motors could cause many diseases."

Scientists know that serotonin and serotonin receptors are involved in anxiety, aggression, and mood. But not much is known about how those players get around within cells. When Hirokawa's team discovered KIF13A at high levels in the brain, they wondered what it did.

The researchers discovered that mice lacking KIF13A show greater anxiety in both open-field and maze tests and suggest that this anxious behavior may stem from an underlying loss of serotonin receptor transport, which leads to a lower level of expression of those receptors in critical parts of the brain.

"Collectively, our results suggest a role for this molecular motor in anxiety control," the researchers wrote. Hirokawa says the search should now be on for anti-anxiety drug candidates aimed at restoring the brain's serotonin receptor transport service.

Story Source:

The above story is based on materials provided by Cell Press, via EurekAlert!, a service of AAAS.

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Toxic Teachers: Are teachers the new mean girls? QL Investigates the bullies in front of your blackboard.

When you think about being bullied as a teenager, would you include your teachers as the culprits? I was recently quoted in an article exploring the negative impact of teacher bullying and how to cope. Publication: Girls' Life Author: Abbondanza, Katie Date published: August 1, 2013

"She said a 6-year-old could do better work."

"He criticized every little mistake I made."

"She called me stupid in front of the whole class."

As tough as it is to report, each of those statements came straight from GL readers discussing their very real experiences with bullies. But these bullies aren't fellow classmates - they're teachers.

We grow up thinking that teachers are kind, trustworthy and fair. And most are. But that's why the reports of educators singling out and berating students are troubling. This isn't girls being sensitive or overreacting to one-off comments. Teacher bullying is happening in classrooms across the nation. In fact, a 2012 study found that 45 percent of the 116 teachers surveyed copped to bullying a student. And the effects can be devastating to girls' self-esteem.

Bad Teacher

While it may seem harsh when your teacher doles out a detention after you flaked on the homework for the third time, if that's her rule for everyone, it's not bullying. Rather, teacher bullying is typically defined as using a position of authority to either manipulate or belittle a student past what's accepted as normal discipline, according to Dr. Stuart Twemlow, who has researched this topic.

It's important to remember that teachers are human, so they may lose their cool on a stressful day. But repeatedly lashing out or acting controlling is different. Name-calling, singling someone out, overreacting to the point that a student is afraid or physically intimidating or hitting a student all count as bullying or abusive behaviors.

Miranda H., 17, knows firsthand what it's like to be bullied by a person in power. During her sophomore year, she was harassed by her band instructor after a scheduling conflict didn't allow her to sign up for two periods of music.

Due to her other classes, Miranda, a talented saxophone player, had to take a seat in a less prestigious ensemble.

"I was one of his favorite students freshman year, but he made my sophomore year terrible," she says. "He would yell and be cruel, saying I was a 'disgrace to the band.'"

Just as scary, Miranda's teacher blamed her for his outbursts, a classic trait exhibited by abusers. He told her if she had just done what he wanted, he wouldn't have to call her out all the time.

"It was terrible," she says, adding that she'd go home in tears nearly every day. "I was constantly on edge, and I couldn't concentrate in my other classes."

Miranda's father talked with the band teacher at one point, but he denied any abusive behavior. And though she took all the right steps, his reaction made her feel like she was wrong, which is typical among bullying victims.

"If a teacher is calling you inappropriate names or repeatedly singling you out for minor mistakes [which are different from behavioral issues], know that you did nothing wrong," says Jennifer Musselman, a therapist who works with teens.

Speaking Up

It's easy for students to feel powerless in these situations, but all the experts we spoke with stressed the importance of talking to your teacher before things escalate. In some cases, he or she might simply have high standards for you and be inadvertently treating you differently than the rest of the class. Regardless of the reason, you have to say something.

Where to start? Be direct. You should bring up exactly what's bothering you, whether it's the way your teacher ignores your hand when you raise it or how it hurts your feelings when she teases you, even if she's joking.

Mention that you've noticed it more than once. Maybe your teacher isn't aware her behavior is bothering you, and all it will take is a quick after-class conversation to get her to back off.

Of course, confronting your teacher doesn't always guarantee success. Maggie L., 17, had an eighth-grade art teacher who constantly singled out her work. She loved to draw, but her teacher always criticized her. One day, Maggie spoke up and asked what she could do to improve her piece.

"Well, if I were you, I'd throw it out and start over," the teacher told her, even though she was almost done with the entire assignment.

"Sometimes, her comments hurt my feelings." Maggie confessed. "Teachers are in such a powerful position. No matter if you like them or not, their opinion of you really matters. It's very different from classmates being judgmental or not liking you."

Maggie's thoughts get to the heart of why teacher bullying is so troublingand why girls have to continue to defend themselves even after that initial chat with their teacher.

"[If a teacher's behavior is] starting to affect your self-esteem or your grade, it's time to take your concerns to a trusted adult like your mom, dad, school counselor or another teacher," says Jennifer. She recommends documenting the day, time and what the teacher said so you can have a record of what happened.

"Be very clear on what the teacher is saying or doing that is causing you to feel this way," she says. "If possible, list any classmates who can vouch for you."

Ask your parents to talk to the teacher with you, and give them your written list of concerns and incidents. They might decide it's time to talk with the principal or the vice principal, who will hopefully remedy the situation. In the meantime, focus on your work and, if necessary, ask for extra help from a friend or school counselor.

Damage Control

Truth is, just one semester with a toxic teacher can negatively influence your life for years to come, which is why it's extra important to deal with the damage before it's too late.

Miranda, the one-time band star who was bullied, ended up quitting her instrument altogether by the time junior year rolled around.

After having her teacher read her English paper out loud and then call her stupid, Nina J., 14, is now afraid to make her presence known in class. "I never raise my hand in class anymore, because I'm afraid she will make me feel dumb," she admits.

Nina's case may be extreme, but the psychological effects of dealing with a toxic teacher can linger long after class is dismissed. Dr. Nerina GarciaArcement, a clinical psychologist, says to put your feelings down on paper - either by journaling or writing a letter to your teacher that you don't send. Talking with a school counselor also can help sort through the issue.

A Fresh Start

If all else fails, know you can remove yourself from the situation if you and your parents talk with the school's administration. "If the teacher doesn't change, it may be time to transfer out of that class," says Jennifer.

Take Emily M., 15, who eventually decided to take it one step further. She switched schools after her former school's only drama teacher picked on her endlessly.

"He'd say I'm obnoxious and ugly and annoying and stupid. That there was no way I'd ever be an actress," Emily says.

In the end, Emily made the tough decision to transfer, opting for a fresh start. "As hard as it was to leave, it would have been even harder to continue to deal with that teacher," she says. "I'm finally back to my old cheerful self. I'm a lot happier as a person now."

But even if the cruel comments cease or you remove yourself from dealing with critical remarks by changing classes or schools, check yourself for any persistent habits you may have picked up during that time period - like not speaking up in class or thinking you're not good at a certain subject - just because a bully teacher told you so.

"Try to figure out, 'How did this impact me?'" says Dr. GarciaArcement. And then, if you realize you're scared or are avoiding something you used to love, figure out a plan to get involved again - away from the watchful eye of your toxic teacher.

Miranda, who quit playing saxophone because of her experience, could form a jazz band with some friends outside of school. Maggie, who stopped believing in her artsy abilities, could take a lowpressure drawing class at a ree center.

And remember, while it's unfair that you have to deal with a bullying teacher, know that most educators are supportive, professional people who want to see you go far. So for every toxic teacher in this world, there are hundreds of others out there ready to guide you in the right direction. Keep an eye out for the ones who will truly help you shine.

Read more:

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Anxious? Activate Your Anterior Cingulate Cortex With a Little Meditation

Practicing mindful meditation lights up the parts of the brain that control thinking emotions such as worry are activated. Anxiety levels are reduced.

June 4, 2013 — Scientists, like Buddhist monks and Zen masters, have known for years that meditation can reduce anxiety, but not how. Scientists at Wake Forest Baptist Medical Center, however, have succeeded in identifying the brain functions involved.

"Although we've known that meditation can reduce anxiety, we hadn't identified the specific brain mechanisms involved in relieving anxiety in healthy individuals," said Fadel Zeidan, Ph.D., postdoctoral research fellow in neurobiology and anatomy at Wake Forest Baptist and lead author of the study. "In this study, we were able to see which areas of the brain were activated and which were deactivated during meditation-related anxiety relief."

The study is published in the current edition of the journal Social Cognitive and Affective Neuroscience.

For the study, 15 healthy volunteers with normal levels of everyday anxiety were recruited for the study. These individuals had no previous meditation experience or anxiety disorders. All subjects participated in four 20-minute classes to learn a technique known as mindfulness meditation. In this form of meditation, people are taught to focus on breath and body sensations and to non-judgmentally evaluate distracting thoughts and emotions.

Both before and after meditation training, the study participants' brain activity was examined using a special type of imaging -- arterial spin labeling magnetic resonance imaging -- that is very effective at imaging brain processes, such as meditation. In addition, anxiety reports were measured before and after brain scanning.

The majority of study participants reported decreases in anxiety. Researchers found that meditation reduced anxiety ratings by as much as 39 percent.

"This showed that just a few minutes of mindfulness meditation can help reduce normal everyday anxiety," Zeidan said.

The study revealed that meditation-related anxiety relief is associated with activation of the anterior cingulate cortex and ventromedial prefrontal cortex, areas of the brain involved with executive-level function. During meditation, there was more activity in the ventromedial prefrontal cortex, the area of the brain that controls worrying. In addition, when activity increased in the anterior cingulate cortex -- the area that governs thinking and emotion -- anxiety decreased.

"Mindfulness is premised on sustaining attention in the present moment and controlling the way we react to daily thoughts and feelings," Zeidan said. "Interestingly, the present findings reveal that the brain regions associated with meditation-related anxiety relief are remarkably consistent with the principles of being mindful."

Research at other institutions has shown that meditation can significantly reduce anxiety in patients with generalized anxiety and depression disorders. The results of this neuroimaging experiment complement that body of knowledge by showing the brain mechanisms associated with meditation-related anxiety relief in healthy people, he said.

Support for the study was provided by the Mind and Life Institute's Francisco J. Varela Grant, the National Institutes of Health grant NS3926 and the Biomolecular Imaging Center at Wake Forest Baptist.

Co-authors are Katherine Martucci, Ph.D., Robert Kraft, Ph.D., John McHaffie, Ph.D., and Robert Coghill, Ph.D., of Wake Forest Baptist.


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Young Adults Are The Most Stressed Generation: Survey

Being young does not mean carefree.  Survey finds young Americans, aged 18-33, are among the most stressed. By Steven Reinberg

HealthDay Reporter

THURSDAY, Feb. 7 (HealthDay News) -- Young Americans between 18 and 33 years old -- the so-called millennials -- are more stressed than the rest of the population, according to a new report from the American Psychological Association.

What's stressing them out? Jobs and money mostly, said Norman Anderson, CEO of the American Psychological Association, during a Thursday morning press conference.

On a scale of 1 to 10, the millennial generation stands at 5.4 stress-wise, significantly higher than the national average of 4.9, the association found after surveying more than 2,000 Americans.

"Clearly there are a number of pressures facing young people that might account for this increase in stress," Anderson said. "These individuals are growing up in an era of unprecedented economic upheaval. This coincides with the time they are finishing school and trying to establish themselves in society."

Getting a job, starting a family and repaying student loans are all stressful, he added. "They have great difficulty finding jobs because of the higher unemployment and underemployment rates," Anderson said.

These young adults also don't feel they're getting support from the health system. Only 25 percent of millennials give the health care system an A grade, compared with 32 percent of the rest of the population, according to the report, Stress in America: Missing the Health Care Connection.

In addition, 49 percent said they aren't managing their stress well, and only 23 percent think their doctor helps them make healthy lifestyle and behavior changes "a lot or a great deal." Only 17 percent think their doctor helps them manage their stress.

"When people receive professional help to manage stress and make healthy behavior changes, they do better at achieving their health goals," Anderson said.

On that measure, the United States falls short, he said. To lower the rates of chronic illnesses and reduce the nation's health costs, "we need to improve how we view and treat stress and unhealthy behaviors that are contributing to the high incidence of disease in the United States."

Those who get support for stress from their doctor fare much better than those who don't, the researchers said.

People suffering from chronic illnesses report even less support for stress and lifestyle management than Americans without a chronic condition, according to the survey.

Despite seeing their doctor more often than most people, only 25 percent of those with a chronic illness say they get "a great deal or a lot" of stress management support from their doctor. And 41 percent of these chronically ill people said their stress level had increased in the past year, the researchers found.

The disconnect between what people need to manage stress and what the health care system delivers is evident at all ages, the survey found.

For example, 32 percent of respondents said it is extremely important to talk with their doctor about stress management, but only 17 percent said that happens often or always.

Fifty-three percent said they get little or no help with stress management from their doctor, and 39 percent said they have little or no support for other lifestyle issues. Those who felt unsupported were more likely than others to say their stress had increased during the previous year.

This problem is worse for the 20 percent of Americans who consider themselves extremely stressed, the researchers said. Among these people, 69 percent say their stress increased in the past year. Thirty-three percent, however, never discussed their increasing stress with their doctor, according to the report.

The report did find that many people know that controlling stress is important for good health. But for more than one-third of Americans, stress levels are on the rise, they noted.

More information

For more information on stress, visit the U.S. National Library of Medicine.


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How to Use Social Jujitsu To Snag New Business

How do you grow your client base? I was recently quoted in an article on expanding your business with confidence.

Monday, January 7, 2013

Jujitsu philosophy in the workplace Some executive leaders are born with it; other develop it. “Social Jujitsu” is the charisma that draws people and potential clients to you like a magnet. In the martial arts world, at its base the Japanese martial art of Jiujitsu is a method of defeating an opponent without a weapon. "Ju" is usually translated as "gentle, supple, flexible, pliable." And "Jitsu" is translated to mean "art" or "technique." Some experts say you can use the philosophy of jujitsu in the business world as the way to woo and win over colleagues and new business. But as with any art form, you have to develop and master the techniques.

Become more of who you are

The worse thing is to pretend to be someone you aren´t. So don´t fake it. “You don't develop a winning personality. You have one. Don't try to be someone you're not. The trick is letting it out,” says Mike Schultz, president and founder of RAIN, who is also a second degree black belt in Seirenkai Jujitsu. Adds Shari Goldsmith of Shari- Life Coach for Women, “Be you; true-to-you-authenticity is attractive. People can spot dishonesty a mile away.” The basics matter

Don´t throw common courtesy out of the window. Be polite and engaging. “Smile, offer a firm but not death grip handshake and open body language. Light touch is an HR no-no, but it's connecting,” Schultz points out. Do your homework

All clients appreciate knowing you have taken the time to study their company and their needs. They will be more attracted to you and what you are offering. “Know that you are offering your client something they need. Be aware of how you perceive your product or services. You are not simply asking for something from them but potentially solving a problem they have. Inquire about what they want to improve in their lives or business and explain how you can help them,” says Licensed Clinical Psychologist Dr. Nerina Garcia-Arcement, Clinical Assistant Professor at Dept. of Psychiatry, NYU School of Medicine and of the Williamsburg Therapy and Wellness.

Be all ears

Merely rattling off a sales pitch is an empty gesture. Listen to what is being said to you, what is being asked of you. “Listen more than you talk, but don't make it all listening,” says Schultz.

Apply the personal touch

You don´t need to tell a complete stranger or a potential client your life story, but sprinkle in personal bits into your conversation. “Don't be afraid to talk about personal things,” advises Schultz. “When you let your personality and personal life shine through, it can be very comforting to people who care about the same things. You have to find mutual areas of connection to build rapport.” Goldsmith agrees. “People want to do business with people that they like and trust. Focus on letting others see the real you and be consistently kind and honest,” she adds.

And, when you share, seek out information about your client. “Don't see people as just potential clients, see them as individuals you can get to know on a personal basis. Be friendly, look for potential connections and common interests.  This will help everyone feel more comfortable. For example, you both might have small children or enjoy the same sport,” stresses Dr. Garcia-Arcement. “Once you know your clients on a more personal level, this aids in breaking the ice at the next meeting. Inquire about their family, their favorite sport or recent trip. This will help everyone feel like they are doing business with a friend instead of a stranger.”

Throw out bias and discriminatory tendences

Never make assumptions. Not only is it a good rule in life but business as well. “Treat everyone the same, no matter what their station in life. You never know where your future business is going to come from. Don't judge,” says Goldsmith. Dare to be different

Being cookie cutter is boring. You want people to be excited about doing business with you, about having you around. “Be unique--know what makes you different and play it up,” says Goldsmith.

Do unto others..

The “me” generation has come and gone. When possible, help someone on a project. “Help others succeed. Focus on helping others succeed at their goals, and it will come back to you,” says Goldsmith. Confidence is dynamic

If you're timid about or unsure of yourself, your product/services, then how can you expect a customer to be eager to do business with you? “Feel confident in your product or service. Know why the product is worth selling. If you know the virtues of the product or services, it will show in your sales pitch,” advises Dr. Garcia-Arcement.

On call As a small business owner, you´re always on call. You have to be ready to tell someone about your product at a moment´s notice—and with passion. People tend to respond to this approach just because of the sheer enthusiasm. “Prepare the proverbial elevator speech. This speech is best if you don't have a lot of time and want to get the client's attention. What would you say about the product you are selling if you only had a few moments with a client? If you have that prepared and memorized, it will reduce your anxiety the next time you approach a client,” says Dr.  Garcia-Arcement.

Martial arts mindset

Martial arts philosophies can easily be applied to business and business situations. “As far as jujitsu, the best conversation and connection application is a concept called kuzushi. Kuzushi literally means unbalancing, and it's applied as a redirecting of energy from one direction gently but specifically to another,” explains Schultz, author of the bestseller Rainmaking Conversations. “If you know where you want to go in a conversation, you can gently move it down to that path from wherever it's going. But do it subtly. For example, if you want to talk about an exciting project you're working on, don't just start talking..Just ask the other person, 'What's the most exciting thing you're working on.' They'll share, and then they'll ask you. At the same time, they're thinking 'what a great conversationalist,' and you got them to do what you wanted without forcing it.”

Link to article

Yoga Helps Ease Stress Related Medical and Psychological Conditions, Study Suggests

Yoga might increase GABA activity, low GABA (neurotransmitter) is linked to anxiety disorders, post-traumatic stress disorder, depression, epilepsy, and chronic pain. So practicing yoga might reduce distress from these disorders. Mar. 6, 2012 — An article by researchers from Boston University School of Medicine (BUSM), New York Medical College (NYMC), and the Columbia College of Physicians and Surgeons (CCPS) reviews evidence that yoga may be effective in treating patients with stress-related psychological and medical conditions such as depression, anxiety, high blood pressure and cardiac disease. Their theory, which currently appears online in Medical Hypotheses, could be used to develop specific mind-body practices for the prevention and treatment of these conditions in conjunction with standard treatments.

It is hypothesized that stress causes an imbalance in the autonomic nervous system (parasympathetic under-activity and sympathetic over-activity) as well as under-activity of the inhibitory neurotransmitter, gamma amino-butyric acid (GABA). Low GABA activity occurs in anxiety disorders, post-traumatic stress disorder, depression, epilepsy, and chronic pain. According to the researchers, the hypothesis advanced in this paper could explain why vagal nerve stimulation (VNS) works to decrease both seizure frequency and the symptoms of depression.

"Western and Eastern medicine complement one another. Yoga is known to improve stress-related nervous system imbalances," said Chris Streeter, MD, associate professor of psychiatry at BUSM and Boston Medical Center, who is the study's lead author. Streeter believes that "This paper provides a theory, based on neurophysiology and neuroanatomy, to understand how yoga helps patients feel better by relieving symptoms in many common disorders."

An earlier study by BUSM researchers comparing a walking group and a yoga group over a 12-week period found no increase in GABA levels in the walking group, whereas the yoga group showed increased GABA levels and decreased anxiety. In another 12-week BUSM study, patients with chronic low back pain responded to a yoga intervention with increased GABA levels and significant reduction in pain compared to a group receiving standard care alone.

In crafting this neurophysiological theory of how yoga affects the nervous system, Streeter collaborated with Patricia Gerbarg, MD, assistant clinical professor of psychiatry at NYMC, Domenic A. Ciraulo, MD, chairman of psychiatry at BUSM, Robert Saper, MD MPH, associate professor of family medicine at BUSM, and Richard P. Brown, MD, associate clinical professor of psychiatry at CCPS. They are beginning test these theories by incorporating mind-body therapies such as yoga in their clinical studies of a wide range of stress-related medical and psychological conditions.

Link to article

New Year, New Tips To Handle Work Stress

By Nerina Garcia-Arcement, Ph.D. Stress is on the rise in the United States. In a recent APA survey, Americans reported a 44% increase in their stress over the past five years. What are people worried about?  Money, relationships, work and the economy are at the top of the list.  Work is a popular concern. Not only are individuals worried about losing their jobs in this down economy but also about increased job responsibilities and difficult interpersonal relationships.  All this worry impacts your sleep, physical and mental health, and productivity. It also erodes your ability to be patient when dealing with others—all things that can make working more difficult and put your job at risk.

If this sounds familiar, you are not alone. The good news is you can change this. There are simple steps you can take that will help you manage your stress and improve your quality of life. Below are proven stress reduction suggestions you can use at work and at home.

While at work build into your day these three tips.

1. Walk away from what is stressing you and take regular breaks. Time-outs are not just for toddlers. They are an effective coping strategy that will allow you to clear your mind and refocus, as well as be more productive and creative.

2. Take deep breaths. Shallow breathing increases anxiety, while deep, slow breathing helps calm your mind and body.

3. Stretch your tense muscles. For example, progressive muscle relaxation sends your brain a message that you are safe and relaxed which helps reduce stress and anxiety.

While at home, try these habits regularly to decrease your stress.

1. Practice yoga. Even a few minutes will help calm your mind and relax your body.

2. Use imagery. Imagine yourself in a safe place, such as the beach or a cabin in the mountains. If imagining a peaceful place is difficult, you can use memories from a favorite vacation spot or familiar personal sanctuary (even if it’s just your favorite bench in Central Park).  Your memories will trigger positive feelings and distract you from your stress at the same time.

3. Speak to a trusted friend or family member. Share what is upsetting you, whether in person or over the phone. Social support is a great stress reducer and mood enhancer.

Preventing stress before you feel it is even better. Follow these suggestions to stop the stress before it hits.

1. Have open communication with your supervisors/bosses about what projects you are working on and their status.

2. Ask for help when you need it. We all require assistance at some point. Don't be afraid to ask for what you need.

3. Create a detailed list of work requirements and deadlines. This way you don't waste mental energy keeping track of what needs to get done and instead focus on how to accomplish those tasks.

If these tips are not enough, consider talking to a mental health provider that specializes in stress management.

Visit for more information about stress.

Mental Illness and Marriage

I was interviewed on how mental illness affects marriage and how to cope. Listen to the podcast.

What kind of impact does mental illness have on a marriage?

In today’s society, it’s becoming more and more common for individuals to be living with some sort of mental health condition or illness like anxiety or depression. And while there are many issues and conditions that present themselves in different, unique ways, oftentimes the effects on a marriage are very similar.

In addition to anxiety and depression, some people suffer from more extreme conditions like post-traumatic stress disorder and substance abuse problems. When these issues creep in without the proper treatment, their impact on a marriage and the individual can be fundamentally problematic. In some situations, the partner without the condition will have to pick up the slack for the other. And in many cases, couples will begin to suffer from tension and exhaustion within their marriage.

Our guest today is Dr. Nerina Garcia, a clinical psychologist with Williamsburg Therapy and Wellness in Brooklyn, NY. Nerina is here to give us some advice about how couples and individuals can learn to cope with mental illnesses within marriages while building a network of support.

To find out more about Nerina and her practice, visit her website or call (917) 816-4449.

Podcast: Play in new window | Download

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To Drink or Not To Drink At Holiday Work Parties: Easy Steps to Managing The Stress

By Nerina Garcia-Arcement, Ph.D.

Work place holiday parties can be a time to connect with co-workers in a different friendlier setting. Yet for many it can also be stressful and awkward. Stressful because individuals are familiar with their workplace expectations, they have scripts or rules they follow on a regular basis, yet holiday parties create the opportunity for a different social interactions that does not follow familiar rules.  It is a blending of expectations that can create stress and uncertainty about how to behave. One common way to cope with stress or anxiety is drinking alcohol, sometimes to excess.  Some drink as a way to numb or avoid feeling uncomfortable emotions, yet it can lead to problems if done at work. Over drinking at the holiday party can create problems in the workplace if you behaved inappropriately while drunk. Although this is a "party" it is still work related and those rules of conduct still apply. Sober and drunk behavior reflects upon who you are as an employee.

If you tend to over drink at holiday work parties, here are a few steps you can take to protect yourself from overindulging.

1. Explore what triggers you to drink. Such as: Do you feel anxious when you walk into the party alone? Do you worry about having to speak to certain co-workers? Do you find it difficult to say “no” when encouraged to have another drink by coworkers?

2. Prepare yourself before the event by engaging in stress reduction activities. If you know that interacting socially with co-workers is stressful or anxiety provoking try activities such as deep breathing, imagining yourself in a peaceful place, reading a chapter of a favorite book, and/or progressive muscle relaxation.

3. Create a plan to managing your feelings and triggers before and during the party. Recognize your triggers and walk away from them or surround yourself with positive supportive coworkers that don't encourage excessive drinking.

4. Stick to your specific plan regarding drinking. If you are not going to drink at all then remove yourself from that temptation by holding a cup with soda throughout the party or staying away from the beverage area. Take steps to succeed with the plan, such as letting your coworker friends know you are not drinking at the party. If you decide to set a limit to your drinking, remember that once you start drinking inhibitions lower and you might be tempted to alter your original plan and it becomes more difficult to keep track of how many drinks you had.

5. Invite a friend to attend with you or shorten the length of time you stay at the party if you know the party is a trigger and difficult to manage by yourself. You are not expected to stay for the entire time.

If you are concerned about how stressed and anxious you feel when faced with an invitation to a social gathering or that you over drink when at parties, then you ought to consider speaking to your primary care physician or a mental health provider to evaluate if these actions are a sign of a more serious problem such as depression, an anxiety disorder, or substance abuse disorder.

Childhood Trauma Leaves Mark On DNA of Some Victims: Gene-Environment Interaction Causes Lifelong Dysregulation of Stress Hormones

How we live and what happens to us changes our genes. Trauma in early childhood can change DNA and lead to PTSD, anxiety and depression.

Dec. 2, 2012 from— Abused children are at high risk of anxiety and mood disorders, as traumatic experience induces lasting changes to their gene regulation. Scientists from the Max Planck Institute of Psychiatry in Munich have now documented for the first time that genetic variants of the FKBP5 gene can influence epigenetic alterations in this gene induced by early trauma.

In individuals with a genetic predisposition, trauma causes long-term changes in DNA methylation leading to a lasting dysregulation of the stress hormone system. As a result, those affected find themselves less able to cope with stressful situations throughout their lives, frequently leading to depression, post-traumatic stress disorder or anxiety disorders in adulthood. Doctors and scientists hope these discoveries will yield new treatment strategies tailored to individual patients, as well as increased public awareness of the importance of protecting children from trauma and its consequences.

Many human illnesses arise from the interaction of individual genes and environmental influences. Traumatic events, especially in childhood, constitute high risk factors for the emergence of psychiatric illnesses in later life. However, whether early stress actually leads to a psychiatric disorder depends largely on his or her genetic predisposition.

Research Group Leader Elisabeth Binder of the Max Planck Institute of Psychiatry examined the DNA of almost 2000 Afro-Americans who had been repeatedly and severely traumatised as adults or in childhood. One-third of trauma victims had become ill and was now suffering from post-traumatic stress disorder. The risk of developing post-traumatic stress disorder rose with increasing severity of abuse only in the carriers of a specific genetic variant in the FKBP5 gene. FKPB5 determines how effectively the organism can react to stress, and by this regulates the entire stress hormone system. The scientists hoped to cast light on the mechanisms of this gene-environment interaction by comparing modifications of the DNA sequence of victims who had not become ill with that of those who had.

The Munich-based Max Planck scientists were then able to demonstrate that the genetic FKBP5 variant does make a physiological difference to those affected, also in nerve cells. Extreme stress and the associated high concentrations of stress hormones bring about what is called an epigenetic change. A methyl group is broken off the DNA at this point, causing a marked increase in FKBP5 activity. This lasting epigenetic change is generated primarily through childhood traumatisation. Consequently, no disease-related demethylation of the FKBP5 gene was detected in participants who were traumatised in adulthood only.

Torsten Klengel, a scientist at the Max Planck Institute of Psychiatry, explains the findings of the study as follows: "Depending on genetic predisposition, childhood trauma can leave permanent epigenetic marks on the DNA, further de-repressing FKBP5 transcription. The consequence is a permanent dysregulation of the victim's stress hormone system, which can ultimately lead to psychiatric illness. Decisive for victims of childhood abuse, however, is that the stress-induced epigenetic changes can only occur if their DNA has a specific sequence."

This recent study improves our understanding of psychiatric illnesses which arise from the interaction of environmental and genetic factors. The results will help tailor treatment particularly for patients who were exposed to trauma in early childhood, thereby greatly increasing their risk of illness.

Story Source:

The above story is reprinted from materials provided by Max-Planck-Gesellschaft (2012, December 2). Childhood trauma leaves mark on DNA of some victims: Gene-environment interaction causes lifelong dysregulation of stress hormones. ScienceDaily. Retrieved December 10, 2012, from­ /releases/2012/12/121202164057.htm

Link to article

Naming the Shame that Can Cripple

I was quoted on the causes of shame, how to cope and treatment options. By Marcia G. Yerman

When Amy Ferris asked me to contribute an essay to Dancing at the Shame Prom: Sharing the Stories That Kept Us Small, I wasn't sure that I had any shame. Then, when I thought about it, I realized that I did. I just hadn't framed it that way. I agreed to participate. After I handed in my essay, I heard back from co-editor Hollye Dexter. "I think you are holding back," she said. "Can you go a little deeper?" So I did. Along with twenty-six other women, I wrote openly about issues that had impacted my life.

Now that the book is out, I have taken off my memoirist hat and am writing as health journalist. Reading the stories that encompassed familial alcoholism, sexual abuse, parental suicide, distorted body images, hoarding, alienation, and racial identity anxiety - I wanted to get to the psychological root of how shame shapes who we are and how we live our lives.

I interviewed four practitioners who shared insights that were both clinical and revelatory. We focused on how shame specifically impacts girls and women. Many of their observations and verbiage overlapped. To a person, they all began the conversation by drawing a distinction between shame and guilt.

Shame is a feeling or belief that screams, "I am bad." Guilt is evidenced as, "I did something bad." Shame is feeling worthless. Guilt is external; you can fix it. Specifically, shame is, "I am damaged."

Amber Lewter, EdS., LAPC, whose background includes working as a survivor advocate at a rape crisis center, told me, "When women define themselves as being bad, it creates low self-esteem and a poor sense of self-worth." Treating those who have experienced childhood sexual trauma, Lewter sees women coming in for counseling with a lot of "shoulds" ("I should have told someone.").

She conducts an exploration of shame through expanding awareness of external factors, pointing out that what happened "was beyond the control" of the patient. She believes that shame is more of an issue for women because they are "relationship-centric" and therefore bring childhood shame and a "less than" mindset into their adult relationships.

Ph.D. and Licensed Clinical Psychologist, Nerina Garcia-Arcement, qualifies shame as "an insidious emotion, often at the root of mental health problems like depression and anxiety." She sees shame as creating "a sense of isolation which poisons an individual's self-esteem."

She told me, "My patients feel silenced due to their shame. Often, they can't even speak out loud what they feel ashamed about." Garcia-Arcement defines shame as a reflection of a "core value." Therefore, what results is a need to cover up what we feel ashamed about.

She related, "The power of shame is that it silences us and creates internal negative dialogue, such as, 'I wasn't good enough. I deserved it.' So we want to stay invisible. We don't want to feel vulnerable. This stunts our ability to grow." Garcia-Arcement explained how the fallout of shame translates into a "fear of takings risks."

"A silent killer," is how Lori Freson, Licensed Marriage and Family Therapist, describes shame. Her practice specializes in women's issues and self-esteem.

"Women don't always acknowledge shame as a presenting problem," she said. "Women can have body image problems and not realize it is shame."

She spelled out, "Shame about our bodies can lead to isolation, depression, and eating disorders." Shame about sexual abuse can lead to "avoidance of intimacy, relationships, sexual problems, and self-harm." Shame about an addiction "can delay or sabotage" efforts to recover.

Finally, she added the key observation, "Shame is connected to self-perception and how you think people perceive you."

Founder of the Critical Therapy Center, Silvia M. Dutchevici, spoke at length about how our culture "plays into our perceptions." Her philosophy embraces a holistic approach. "Psychology is not in a vacuum," she emphasized. She referenced the issue of race, class, gender, ideology, and economic status. Her point of view is that "society has issues as well," forcing people to "adapt to a false criteria rather than challenging that criteria."

Dutchevici was crystal clear in her assessment. "For women in particular, depending on the trauma, feelings of shame may arise from our culture's imposition of gender roles and the way women have been socially conditioned regarding their view of themselves. The more a society demands perfectionism," Dutchevici continued, "the more we have shame."

Both Freson and Garcia-Arcement addressed this element as well.

"A lot of shame comes from external societal factors," Freson said. "People want to be accepted. People are afraid of being different. Shame among women and girls is more prevalent because of cultural standards."

Freson pointed to celebrity media and fashion magazines. "People shut shame down because they want to have the perfect image." Her message about shame to young girls is, "You don't have to be perfect. Be your best self."

"The core expectation for women," said Garcia-Arcement, "is that we can do it all. Be beautiful and be everything to everybody." When girls and women buy into cultural norms they "learn to hate their bodies and themselves." It all comes back to not being "good enough." Garcia-Arcement illustrated shame from the ground level of family dynamics, up and outward toward group identification.

"Our family is a reflection of who we are," she said. "So if there is a family behavior [alcoholism, suicide, sexual abuse, domestic violence], it's still a part of us." Treatment by Garcia-Arcement entails the challenges faced by people of color. She identified that if a person from a minority community does something that the rest of the group is not proud of - it is seen as a "personal reflection on who they are."

In tandem, Dutchevici - a political refugee from Romania - touched on the use of shame as a tool of control in promoting a specific ideology. Shame also operates by keeping group memberships and affiliations intact.

So what can be done? All four women I spoke with communicated the need to explore an individual's experience through expanding consciousness.

Lewter articulated about introducing an awareness of "external factors." Freson, who maintains that if "shame is not exposed and dealt with it can destroy your relationships and your life," believes the more exposure the topic gets the more taboos are broken down.

Applauding the premise of the book, Freson sees it functioning as a tool for dialogue while enabling readers to discover, "Oh. It's not just me. I'm not the only one."

Dutchevici agreed. "The more people come out and talk about shame, the less power it has." She reiterated that it was important to "name the emotion."

"The first step is to realize that you are not alone," Garcia-Arcement reiterated. She uses a combination of talk therapy, cognitive behavior therapy, and insight-oriented work. She suggested mindfulness exercises, trying to connect the mind and body, sitting with your feelings, and being in the moment. Garcia-Arcement stressed the power of stories, advising the importance of sharing one's story.

"Empathy is essential to healing. If you can't say it out loud yet, write it down. Excise it from yourself. Writing is a useful tool, as there is no witness to the shame." An important element of eventually sharing the narrative is that it helps individuals "normalize their experience," through a realization that they are not alone and not to blame.

(The Shame Prom has a Tumblr blog where anyone can post a shame narrative, either with her name or anonymously).

Garcia-Arcement said definitively, "Everyone has shame. We just don't want to look at it."

In her essay, Elizabeth Geitz wrote, "I've learned letting go of shame is one of the most freeing things I've ever done. I've learned that I don't have to dance at the Shame Prom forever. The dress, the shoes, the long-wilted corsage are now gone.

"The music has finally stopped."

Link to article

Organizing Your Life

I was recently on the Colin Lively Show, discussing how to declutter your mind.  The entire show was filled with helpful tips on how to better organize your home, office and mind. The description for the show is below:

Oh lord, if this show wasn’t sent from on-high, than it was Hildamae’s dying wish coming true: get Colin to clean his room! So, there it is, the cat is out of my Birkin bag: I can be rather messy. But aren’t we all? Whether it be in mind, life, schedule, desk, purse, closet, or your inbox, somewhere you are a little messy; and a little messy can lead to a great deal of stress. It is, as Dawn Falcone put it, “stuck energy.” For me, Consuelo un-sticks my stuck energy four times a week, but that doesn’t cover all my bases: I still need to go to Dr. Feldheim, my therapist, and Dr. Koplowitz, my psychiatrist, to get my mind in order.

I was stunned to learn that our outer world is very much a reflection of our inner world. For instance, a messy desk can be a sign of a stressful work environment or chronic work overload. It is important to create systems that keep our lives orderly and neat. We do not need to be neat freaks, but organization is one of the keys to happiness. Growing up, we polished the silver under the iron fist of Hildamae, she said the harder we scrubbed the more we would feel her love. Boy was she right! Three hours of polishing spoons made my wrist feel so loved that they were practically stuck in an arthritic state until my mid-40s. “Sheets tight enough on which to bounce a quarter,” she would demand. By the time I went to college, I had had enough Old Dutch Cleanser, Clorox and Bon-Ami running through my blood that I vowed never to clean again. And I have not touched a mop since!

This week I will be speaking with three personal organizers and a psychologist, and we are going see how we can change our state of mind with a Swiffer, or two, or forty-seven.

This week I will be speaking with three personal organizers and a psychologist, and we are going see how we can change our state of mind with a Swiffer, or two, or forty-seven.

Dawn Falcone is not only passionate about organization, she knows it has a HUGE impact on personal sanity, success, and overall stress level. She emphasizes the point that reducing clutter and chaos will ultimately bring reward in the form of clarity, serenity, and time. She works closely with her clients to design spaces that reflect their personality and spirit. Dawn is a proud member of the (National Association of Professional Organizers) and is a certified interior environmental coach. Her work has appeared in many publications including: Real Simple, Woman’s World, Home And Garden Television, and Apartment Therapy.

Bonnie Joy Dewkett is the founder of The Joyful Organizer and is an organizing expert, author, motivational speaker, and radio personality – oh and she is an expert in time management! Boy oh boy does she know how to block-out a day!

Andrea Brundage of Simple Organized Solutions (S.O.S.) offers personalized hands-on organizational solutions to help small-to-medium sized business owners and homeowners function in efficient and organized environments. In partnership with its clients, S.O.S. creates “sensible solutions for your organizational needs.”

Dr. Nerina Garcia-Arcement is a licensed Clinical Psychologist and a Clinical Assistant Professor, in the Dept. of Psychiatry, at NYU School of Medicine. She specializes in challenges associated with life transitions, stress, anxiety, and depression.She provides a holistic therapeutic session by using a combination of Cognitive Behavioral Therapy and insight oriented/psychodynamic techniques to identify current problems, develop individualized strategies to ease stress, and gain insight into understanding one’s patterns in behavior. Dr. Garcia strongly advocates the act of self exploration, which helps us understand the way we think and act, it will also help shed light on our behaviors that worked in the past but are not effective any longer.

Link to podcast/show

Organizing Your Life

How Are You Coping With the Recent Mass Shootings?

I was quoted on the important topic of PTSD and typical reactions to mass shootings and trauma. In this I share tips on how to cope after a trauma.

By Rheyanne Weaver  |

The two mass shootings in the last couple of months have been on the minds of many Americans, especially because they took place in seemingly safe places -- a movie theater and a temple. Experts have suggestions for how the general public and victims can cope with such saddening and scary events.

Nerina Garcia-Arcement, a licensed clinical psychologist, said in an email that she previously worked with 9/11 survivors. “Unfortunately many people do not seek help for mental health problems following a trauma and most people wait an average of 10 years to seek mental help,” Garcia-Arcement said.

“A majority of my 9/11 clients sought help six to 10 years after 9/11. By this point many were isolated from all social support, had difficulties working as they avoided public transportation and public spaces, and suffered from chronic stress due to fear of the ‘next terrorist attack.’"

She hopes that victims of recent shootings get help from mental health professionals sooner in order to cope with trauma. There are a plethora of mental health issues that could result from being a victim of a shooting.

“The closer the person was to the event, the more emotionally impacted they are likely to be,” Garcia-Arcement said.

“For people directly affected by the recent shootings, it is common to experience Post Traumatic Stress Disorder (PTSD), anxiety (including panic attacks, generalized anxiety and phobias related to the attack, such as social phobias or fear of the dark) and depression symptoms.”

“It is a normal reaction for people to re-experience or remember the event, have nightmares, feel sad and scared, be hypervigilant, avoid reminders of their trauma and isolate from people,” she added. “This is the mind trying to process and make sense of what happened.”

“Survivors of the [Colorado] shooting will find that things like the smell of popcorn, popping sounds, the dark, being in crowded spaces or watching a movies might trigger reminders of their experience,” Garcia-Arcement said.

“These are normal reactions that can be managed with deep breathing, relaxation exercises and positive self talk (i.e., ‘this is just a reminder, it is not happening again. I am okay. I am safe.’). For many survivors, those in the theaters and injured, survivor's guilt is common.”

People who were not directly involved in the shooting can still suffer from slight mental health issues as well, such as “sadness, horror and anxiety,” and avoidance of reminders of the shootings.

Here are some tips from Garcia-Arcement to help people cope with the recent shootings:

1) “Offer each other social support, as individuals and as a community.”

2) “Remind yourselves that this was an isolated horrible event that happened to good people. It was not their fault.”

3) “My strongest recommendation is that survivors and the general public do not avoid reminders of the trauma and do not isolate. It is instinctive for people to avoid things that remind them of their trauma. Unfortunately once they begin avoiding going to movies or spending time in crowded spaces, it often escalates to avoiding more and more things. They begin to misinterpret the fact that they are safe simply because they avoided going to the movies, instead of forcing themselves to go to the movie and realizing they are safe.”

4) “A person should seek mental health support if they are feeling overwhelmed by their reactions to the shooting. If after a few months they find they are still experiencing PTSD, anxiety or depression symptoms, they ought to seek a therapist that could help them process their normal reactions.”

Robin Zagurski, a licensed clinical social worker, works with adults and teens who have gone though traumatic experiences. She said in an email that a major indicator that professional mental health is needed after a mass shooting is if people are unable to function in their daily lives.

She suggested keeping the same daily routine in order to distract from thinking about the recent shooting, and taking care of one’s overall health and well being.

She said that it’s difficult to plan for rare shooting situations, but to be aware of any “leakage” statements, where a future shooter may tell someone or post on the Internet what their plans are.

Don’t assume these statements are merely threats. Reporting this to authorities could potentially save lives.

“Think ... of maintaining your safety in all environments, especially for hazards that have a higher likelihood,” Zagurski said.

“For example, always know where the exits are in any building in case of fire. Practice evacuations so that you know how to get out safely. If someone talks to you about hurting themselves or others, report it to authorities immediately.”


Link to article

Mental Health Issues to Be Aware of in Your 20s

I was quoted in this article regarding typical mental health issues for people in their 20s. I discuss the impact of stressful transitions and how to cope. by Rheyanne Weaver |

People in their 20s seem to have it all: youth, energy, health, and looks. But they are also still figuring themselves out, and this time of change can bring certain mental health concerns as well. Experts have information on these issues that tend to impact people in their 20s, and provide some solutions for addressing and coping with these problems.

Clinical psychologist Dean Haddock, a marriage, family, and child counselor and the executive director and founder of Community Counseling and Psychological Services, points to a fairly common activity of 20-somethings that can lead to mental health issues if it’s not checked: alcohol and drug use.

“The first problem that leads to many others is alcohol and chemical abuse, which often leads to dependency,” Haddock said in an email. “The mental disorders that follow are often depression, anxiety, and brain injury. Of course, self-esteem and body-image problems often lead to eating disorders.”

Haddock gives three tips to help people in their 20s prevent and get through some common mental health concerns:

  1. Know your genetic history of mental disorders. Knowing is half the battle to avoid those disorders in yourself.
  2. Be choosey about your friends, as they will influence your decisions. Healthy friends lead to healthier decisions.
  3. Self-esteem is often the result of the people who matter to you. If they do not esteem you, then you will not esteem yourself.

Nerina Garcia-Arcement, a clinical psychologist and clinical assistant professor at NYU School of Medicine, suggests that the many life changes people experience in their 20s can cause mental health issues at times.

“Your 20s are filled with life transitions that can be stressful,” Garcia-Arcement said. “This is a time when young adults are solidifying their personalities, developing their independence from family, starting or finishing college, beginning new jobs, developing a career, forming romantic relationships, and learning to manage their existing family relationships and friendships within these context.”

“Individuals in their 20s don’t have a lifetime of experience to draw on when managing multiple life transitions at once,” she added. “When someone experiences these transitions, anxiety and depressive disorders can occur.”

Here are six of Garcia-Arcement’s tips to help people in their 20s cope with mental health issues more common to that age group:

  1. Seek out and form strong support networks.
  2. Seek out others who are going through similar experiences and share your feelings, whether you are feeling worried, nervous, scared, sad, confused, or excited.
  3. Know that you are not alone in your confusion about your career and relationships.
  4. Seek out mentors who have achieved their goals, and ask for advice.
  5. If you are feeling stress, sadness, or anxiety, engage in activities that will help you manage those feelings such as yoga, meditation, exercise, hobbies, social activities, relaxation exercises, and deep breathing.
  6. If you feel you are not getting the necessary support and feel overwhelmed or depressed, seek out mental health professionals who can help you manage the feelings related to your life transitions.

Stephanie Sarkis, a licensed mental health counselor, said in an email that anxiety and depression are some of the main mental health issues 20-somethings face.

“We have seen an increase in these issues due to the lagging economy and difficulties finding employment,” Sarkis said. “Many people in their 20s have moved back in with their parents, which can trigger feelings of failure and frustration.”

Dr. Maiysha Clairborne, a family physician and wellness and stress management coach, added in an email that eating disorders associated with body dysmorphic disorder and body-image issues are also common for people in their 20s. She has three overall tips for people in this age group:

  1. Talk to someone. The worst thing that a person can do when they are feeling depressed, anxious, or alone is to isolate more. Many times when we talk with someone we trust about what’s going on, we come to realize that we are not the only ones experiencing it and then we can get support.
  2. Get active. Staying physically active not only helps to keep the body fit but also helps release endorphins and serotonin in the brain, which help keep the mood elevated. Physical activity is also a good release for stress and anxiety.
  3. Minimize sugar and junk food. Sugar and processed junk foods can worsen the emotions of stress, anxiety, and depression because they cause erratic changes in your body’s blood sugars. This can disrupt the normal release of hormones in the brain that keep your moods stable.

Scott Carroll, a psychiatrist with dual board certifications in adult and child and adolescent psychiatry, said there are many issues specific to people in their 20s, including problems associated with medication use.

“Many people were on stimulants/meds for their ADHD when they were younger, but they thought it was okay to stop their meds when they were done with school,” Carroll said. “Now they are struggling at work and don’t know why. I’ve also seen young adults stop all kinds of meds like their thyroid meds because they didn’t know why they were even on it, and then they have all kinds of problems.”

Bad habits involving drug and alcohol use can start to become a major substance abuse issue when people are in their 20s, and other mental health issues start coming to the forefront at this time in peoples’ lives. Examples include bipolar disorder and schizophrenia. Also, panic attacks can start for people who have a genetic predisposition and who have higher amounts of stress associated with newfound adulthood.

“The 20s are an important time of social/emotional development,” Carroll said. “Unlike previous generations, identity formation often takes the entire 20s due to the complexity of modern society. It could be said that adolescence lasts until the early 30s in today’s society due to [prolonged] periods of education (grad school, law school, med school, etc.), lack of stable job options, and delays in getting married and starting families.”

Carroll, who is also an assistant professor at the University of New Mexico School of Medicine, suggests that when it comes to serious relationships and marriage, people in their 20s should consider how their choices could eventually affect their mental health and how their brain plays a part in their decision.

“Many 20-somethings are tempted to get married, but it is generally a bad idea because the brain in not done developing until about 25 [years old] … which leaves young adults vulnerable to having their rational mind be overwhelmed by their feelings or stress,” Carroll said. “Relationship choices often dramatically change from the early 20s to the late 20s, so many people find that the person that was perfect at 22 is a disaster at 27.  This can be an incredibly hard transition, to have to break up with your former soul mate that you thought you’d love for life because you’ve changed so much over the last several years.”

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How to Quell the Fears of Childbirth

Anxiety can influence a woman's experience during labor. I was quoted in this article regarding how stress and worry can impact a woman's delivery and how to manage their anxiety. by Rheyanne Weaver |

It’s common to fear to some extent painful experiences we aren’t familiar with yet, such as childbirth for soon-to-be mothers. However, a new study found in BJOG: An International Journal of Obstetrics and Gynaecologysuggests that women who fear childbirth tend to actually be in labor for longer than women who aren’t fearful of giving birth.

A news release on stated that 2,206 women were included in the study. These women were only giving birth to one child vaginally, and 7.5% of these women were determined to be fearful of childbirth at 32 weeks into their pregnancy. The report estimated that between 5% and 20% of pregnant women generally fear childbirth.

For women who feared childbirth, the average labor time was about 1 hour and 32 minutes longer than in women without as much fear. When other factors were considered, the women with fear of childbirth still took 47 minutes longer for labor than women without the same amount of fear. Women who feared childbirth were also more likely to need intervention during labor, such as instrumental vaginal delivery and emergency Caesarean section. However, most women who feared childbirth were still able to have a successful vaginal delivery.

The study added that there are different factors that cause women to fear childbirth, such as having a baby for the first time, being a young mother, having little social support, having a history of abuse, and suffering from psychological issues.  Other experts share their professional opinions on the causes of fear of childbirth and what women can do to decrease that fear.

Julie Hanks, a licensed clinical social worker, the owner and executive director of Wasatch Family Therapy, LLC, and a mother of four children, said in an email that she believes fear of childbirth is actually quite common in our society. “I think it is common for women to fear childbirth because it has become so medicalized in our society,” Hanks said. “Instead of viewing childbirth as a natural process that women’s bodies were created to do, it is viewed as a scary, painful, ‘out of control’ experience that needs medical intervention.”

She said that some women who have gone through specific painful experiences before might be more likely to have a fear of childbirth. “In my clinical practice I have seen a link between childhood sexual trauma and fear of childbirth,” Hanks said. “Since childbirth and sexual abuse involve the same organs, it is often emotionally tied together. Additionally, feelings of helplessness and of being controlled by a man may emerge during the childbirth process (often a male OB).”

General anxiety could also lead to fear of childbirth. “Certain mental illnesses, like anxiety disorders, may predispose certain women to anxiety about the childbirth process, especially with first-time moms,” she said.

The stories of other women who have had bad experiences with childbirth could also add to the fear for first-time moms. “Women may fear childbirth because of family stories surrounding their mother or sister’s childbirth experiences,” Hanks said. “Additionally, women tend to share their birth ‘horror stories’ more frequently than they share uncomplicated birth stories, playing into a cultural fear of childbirth. I think this can impact mental health in general.”

The whole concept of becoming a mother can bring up a lot of issues, not just childbirth itself. “Taking on the new role of becoming a mother is also emotionally loaded and may bring up a woman’s own fear of inadequacy and self-doubt about whether or not she will be able to provide the nurturing that this helpless baby requires,” Hanks said. “If a woman has emotional neglect, abuse, or other unresolved issues with her own mother, those ‘left over’ emotions may surface as a woman now faces becoming her mother.”

There are even more mental health issues that can be associated with pregnancy and childbirth. “Hormonal fluctuations may impact emotional health relating to childbirth,” Hanks said. “Also, family pressures, relatives coming into town to celebrate the birth of a new baby may add to the overall stress of childbirth experiences.”

If physical health is impacted, then mental health is also not far behind. “Eating disorders or distorted body image may play into mental health issues, anxiety, and obsessions around childbirth,” Hanks said. “The physical changes that often accompany pregnancy and childbirth are often frightening to women who have built their self-worth around their appearance.” Hanks shared her thoughts on helping women overcome any fear they may feel in relation to childbirth. She said, “I believe that a cultural shift in viewing childbirth as a normal, natural process that generally doesn’t require intervention would really help women embrace the process without fear. Also, sharing positive childbirth stories openly may help shift women’s views.”

Dr. Ingrid Rodia, an OB-GYN and associate professor of obstetrics and gynecology at Geffen School of Medicine at UCLA, said in an email that some women are more anxious in general, and others do have a higher risk in regard to childbirth, so these can both lead to issues with fear.  She added that the most common fears women have in relation to childbirth are pain, concerns about the baby coming out “normal,” and concerns about surviving childbirth. “Women might fear childbirth because they are already overwhelmed and wonder how they are going to deal with the additional demands,” Rodi said. “Women who did not plan the pregnancy, and especially those who did not want to be pregnant, are particularly at risk for anxiety and depression. Those women with a pre-existing mood or anxiety disorder are at increased risk of anxiety and depression, not only during the pregnancy, but also post partum … Psychological issues before the pregnancy can lead to more fear of childbirth.”

Financial issues, a poor relationship with the father, and psychological issues can add to fear of childbirth as well. “Basically, in order to decrease the fear of childbirth, the pregnancy should be desired, the woman should feel financially and personally supported, and she should have medical and psychiatric problems identified and treated prior to pregnancy,” Rodi said.

Nerina Garcia-Arcement, a licensed clinical psychologist and clinical assistant professor at NYU School of Medicine, said in an email that pain and negativity associated with childbirth tends to be exaggerated in the media and among family and friends, adding to a fear of childbirth. “The media’s portrayal of childbirth with women screaming in agony makes it understandable why women might fear childbirth,” Garcia-Arcement said. “Rarely are stories of childbirth portrayed as calm and peaceful, where women are in control of the experience and the pain. Some women have heard negative stories of long and difficult labor from family and friends. If this is their first child, fear of the unknown is common. Women worry about what might happen, what might go wrong and how they will react to the pain of childbirth. This is an experience perceived as out of their control, which can be scary.”

Women who have mental disorders and have certain personality types might fear childbirth more than others. “Women that are already experiencing anxiety and depression symptoms prior to pregnancy are likely to have those symptoms exacerbated by things like a difficult pregnancy or worry about what to expect during childbirth,” Garcia-Arcement said. “Individuals that like to be in control of their experiences will likely worry about childbirth, an experience that cannot be dictated by a mother but can be managed.”

Women do have real concerns in regard to pregnancy, because each pregnancy and childbirth experience is different, and some women do require C-sections, endure more pain, and have complications with delivery, adding to that fear. However, Garcia-Arcement does have several tips for women who may fear an upcoming childbirth experience.

  1. Become informed about what will happen during labor and childbirth. She said, “Childbirth itself might not be within a woman’s control, but how she reacts to it is. Being informed can be empowering. Avoidance of what is feared will only make it worse.  Becoming an informed consumer will help women feel they can make better choices during childbirth. Women ought to learn about what typical labor medical procedures and medications are used.”
  2. Choose the doctor or midwife who is right for you, and plan to use the hospital or birthing center that matches your beliefs about childbirth.
  3. Create a birth plan and discuss concerns and wishes with your medical provider. This is your baby and your body, so don’t be afraid to ask questions before and during labor.
  4. Learn how to use deep breathing techniques, muscle relaxation exercises, and imagery of a safe peaceful place to reduce anxiety.
  5. Plan to use distraction with positive self-care activities.
  6. Seek support from other women, whether in a group setting or online.

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Coping While You Wait For Medical Test Results

In this article I am quoted on typical reactions to the unknown, such as stress and anxiety, and how to manage your feelings and cope with the uncertainty. By Rheyanne Weaver  |

Waiting for the weekend to come or a long-desired vacation can bring excitement, but what happens when you’re waiting for something nerve-racking, like medical test results and a potential diagnosis?

Experts explore the connection between fearing the unknown (which can happen when you’re waiting for medical test results), and provide tips for how you can keep positive in a potentially negative situation.

Nerina Garcia-Arcement, a licensed clinical psychologist and a clinical assistant professor at the NYU School of Medicine, said in an email that fearing the unknown is something we all experience at some point in life.

“Fear of the unknown (especially when [the] outcome can be negative) is a normal human reaction,” Garcia-Arcement said. “That is why many avoid going to the doctor to begin with. They fear hearing that they are ill or whatever they imagine.”

Besides the common fear and anxiety that can be associated with waiting for medical test results, there are other emotions and thoughts that people can experience.

“Other common emotions are numbness ... worry, sadness and guilt (that they didn't go sooner and now might be ill) and concern about how this might impact their lives, plans and families,” Garcia-Arcement said.

So now that you’re waiting for medical test results, how can you cope with some of these negative emotions you may be experiencing?

“[The] best way is to acknowledge what they are feeling, normalize it/know that it is normal to feel that way, and then use healthy coping strategies to deal with what they are feeling,” Garcia-Arcement said. “If they are anxious and worried, do breathing exercises, distract themselves with activities and people they enjoy, do visualization exercises or any other type of self-care activity that will help them ‘get through’ until they receive their diagnosis.”

If you’re almost positive that the medical test results you’re waiting for will lead to a diagnosis of some kind, there are some ways you can prepare yourself for this potentially devastating situation.

“I have my patients imagine worst case [scenarios],” Garcia-Arcement said.

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