Noticing Thoughts

                Today I was participating in the cancer support group that I am a part of. One of the other members said something that really struck me. She said when we have thoughts, they are just that, thoughts. They are not necessarily reality. She went on to say that our role is to notice the thought and then move on. In a nutshell this is mindfulness. As I processed her words, I realized that I often get trapped in my thoughts. I need to do a better job of noticing a thought or emotion and then moving on. I think I notice thoughts when I am journaling, but I cannot journal every moment of the day. I need to work on noticing a thought as it occurs and acknowledging it for what it is. Then I should move on to whatever is next. 

                  In the past I have read about mindfulness. Noticing thoughts is a part of mindfulness. Since I was still trying to decide on a topic for today’s post, I thought I would do a quick search on noticing and share what I found.

                  Noticing thoughts is sometimes called meta-cognitive awareness. It has been proven to help reduce symptoms of anxiety, depression, and rumination. It does this by activating the prefrontal cortex, which is responsible for regulation. By activating the prefrontal cortex, it avoids the amygdala, which would be responsible for reactivity. So, noticing thoughts and then moving on helps with thought regulation.

                  There is a practice known as Mindfulness-Based Stress Reduction (MBSR), which was developed by Jon Kabat-Zinn, that teaches people to notice thoughts and feelings without judgement. The main idea with this practice is that we are not our thoughts. 

                  Acceptance and Commitment Therapy (ACT) uses “noticing” to create cognitive defusion, which is seeing thoughts as separate from oneself. This practice teaches people to respond to thoughts by saying “I’m having the thought that…” instead of “This thought is true.” In this way we take a step back from our thoughts and see them as just thoughts not reality.

                  The key to noticing thoughts is bringing awareness to our thoughts. We need to shift from being inside the thought to seeing it as a mental event. We want to try to observe the thought to avoid being consumed by it. 

                  If I were to apply this to my life I could work on noticing anxiety. Instead of saying “I am anxious”, I could work on saying “I am noticing anxiety in my thoughts.” Recognizing the difference between these two statements can help me avoid being consumed by my anxiety. The same process could be used for depression. I would notice that I am feeling depression rather than stating that I am depressed. This separation may seem slight, but it can have a major impact on how I respond to the thought. Noticing thoughts reduces my reactivity to the thoughts. People tend to employ an automatic response to certain thoughts. I know I have this tendency. By noticing thoughts, we can interrupt the automatic responses we have developed. Noticing a thought allows us to pause, reflect, and engage in an intentional response. 

                  I am sure I am not the only one who mistakes thoughts for truths. When we pause to notice a thought, we can recognize that it is just a thought. Thoughts are not commands, predictions, or truths. If we can notice our thoughts, we can weaken the hold negative thoughts have on us. 

                  As I was searching online for information on noticing, I came across a practice that seems like it would be effective. It is called “Name it to tame it”. It is a simple practice. When a thought arises, first pause. Then silently say, “I’m noticing the thought that…” Then return your attention to the present moment. This may be your breath, your surroundings, or whatever you were doing. These steps may not come naturally, but with practice we can get better at it.  I am going to commit to trying this practice. I am hopeful that it will help me especially as I am navigating some difficult times right now. 

                  I encourage everyone to work on noticing their thoughts. We just might find that we can improve our mental health in this way.

 

Can Pets Help Our Mental Health?

                 I have often heard well-meaning people say that I should get a pet, more specifically a dog. They always say a pet would be good for my mental health. “A pet will make you less depressed” or “A dog will make you happy.” I always scoffed at these suggestions. I was sure a pet couldn’t help me. After all, pets usually made me anxious. 

                  I am learning that I may have been wrong about having a pet. My mom is too ill to take care of her dog, Panda, an 11-year-old Maltese-Shih Tzu mix. So, guess who has Panda. That’s right I do. At first my thoughts were “My house isn’t pet-proof” and “I don’t know how to take care of a dog.” My brother has two large dogs. That meant he could not take little Panda. In the two and a half weeks I have had Panda I have grown to enjoy her company. I have learned that I am able to take care of a pet. I have a new walking buddy. Panda loves to walk. We take at least four walks a day. Our daily walks have become longer and longer. Each of the last two days we have walked over 10,000 steps. I am getting the exercise I need. Panda is enjoying every minute of it. 

                  My brother commented that Panda and I both seem to be doing so much better. Is he right? Is a dog improving my mood? I guess she is. My brother also commented that I should write about pets. That surprised me. Not only did he recognize the improvement in me, but he encouraged me to write about it. I did not know my brother was that aware of my writing. So, here it is. I am writing about pets and mental health. 

                  I did a little research and found that there is documented evidence that pets can improve a person’s mental health. This did not surprise me. What surprises me is that a dog is improving my mental health. Back to the research. I discovered seven ways that pets can improve mental health. Here they are:

                  Reduce Stress and Anxiety: Research has found that petting animals can trigger the release of calming hormones, like oxytocin, and reduce levels of the stress hormone, cortisol. I have found that it is soothing to pet Panda. She has taken to sleeping on my bed. I find it relaxing to pet her as I try to fall asleep. This has been helpful because falling asleep is usually a stressor for me. Another way spending time with a pet can reduce stress and anxiety is by creating a sense of routine. It also provides a sense of grounding. Both reduce feelings of anxiety.

                  Combat Loneliness: Pets are a source of companionship. When you live alone or have limited social interaction, pets can provide a sense of companionship. I am finding this to be true. I even talk to Panda as if she were a friend. I guess I am feeling less alone. 

                  Improved Mood: The neurotransmitters dopamine and serotonin increase when interacting with pets. These neurotransmitters regulate mood and pleasure. So, an increase in these is good for a person’s mood. On a less technical level, pets are often a source of joy, laughter, and affection. 

                  Encourage Physical Activity:  Walking and playing with a dog are good sources of regular exercise. It is well-documented that exercise is effective at reducing depression and anxiety. I am finding this to be true. Maybe it’s coincidence or maybe walking Panda is really improving my mood.

                  Enhance Routine and Responsibility: Taking care of pets requires structure. When a person struggles with depression or other mental illness, structure is important. The addition of a pet to one’s life can provide that structure. I have noticed that in just a couple of weeks Panda and I have settled into a structured routine. 

                  Provide Emotional Support: Some people require Emotional Support Animals (ESA). These animals can help a person with mental health challenges by offering stability during emotional distress. Even if your pet is not an ESA, he or she can provide comfort. Just sitting and petting a dog can be soothing.

                  Improve Social Interaction: When you take a dog for a walk or when you head to a pet-friendly park, you have opportunities for social interaction. I have noticed that more people in my neighborhood say hi to me as I walk Panda. The social interaction that stems from walking a dog can lead to improved social skills and a reduction of feelings of alienation. 

                  As I think about these ways pets can improve mental health, I think I am experiencing them. Now, I am not saying that a pet can cure mental illness. Based on my experience of the past two weeks, I think that maybe pets can be a part of improving mental health. I am happy with my experience with Panda. I do not know how long Panda will be with me. Right now, it looks like we will be living together for a while. It is certainly helping me to have Panda around. I do not know what the long-term effects will be on my mental health, but for now, Panda is helping me. I would like to think I am helping her as I am sure she misses my mom. So, I guess, maybe those people who told me I needed a pet were onto something. 

                  

                  

Nurturing Self-Advocacy When You Have a Mental Illness

                  Self-advocacy is an important aspect of our lives. Everyone needs to be able to self-advocate. This is especially true when you have an illness. Self-advocacy is defined as “the action of representing oneself or one’s views or interests. (Oxford Languages) On the surface this sounds like it should be easy, but reading a definition on paper or a screen is a lot easier than putting that definition into action.

                  It took me a long time to develop the skills to self-advocate for my needs as an individual with mental illness. In my late 20s I knew I needed therapy and was able to seek out a therapist. Finding my psychologist, who provides my therapy, was my first step toward self-advocacy. Unfortunately, I allowed myself to stop advocating for myself at that point. Shortly after finding my psychologist, I started seeing a psychiatrist. At first, she seemed like she was meeting my needs. After a couple years, I recognized that there were things I was uncomfortable with when seeing her. Every appointment was the same. I never felt like she was listening or wanted to know how I was really doing. She would always add a prescription and increase the dosage of other medications. This went on for about a decade. 

                  As I have shared in previous posts a physician’s assistant I was seeing for primary care showed me that I was being overmedicated by this psychiatrist. She also taught me that I did not have to keep seeing a psychiatrist who was not helping me. This was really my first step toward self-advocacy for my mental health. I found a new psychiatrist. From there I went through a few psychiatrists because I was looking for the right match for me. I learned what I wanted in a psychiatrist. (Check out this post: Finding the Right Psychiatrist for You) Learning that it was okay to search for the psychiatrist that I felt comfortable with and who had my best interests in mind led to finding the psychiatrist I am currently seeing. Learning that it was okay for me to say what I needed, allowed me to find the best psychiatrist. 

                  In the years since I have learned I could advocate for my mental health needs, I have developed my self-advocacy skills. I had the awful experience of a primary care provider treating me with ignorance and stigma (Turning Hurtful Words into Healing). After initially being hurt by this experience, I soon found that it lit a fire in me that allowed me to really become a self-advocate.

                  What are the steps in self-advocacy? Let’s look at what goes into self-advocacy.

                  Self-awareness: Before we can advocate for ourselves, we need to recognize our needs. In doing this we identify what feel, experience, and struggle with. We should know our triggers and coping strategies. If we have a diagnosis, we should learn about our diagnosis and how it impacts us.

                  Educate Yourself: It is important research mental health conditions and treatments. In addition, we should know our rights. There are laws that protect us. It is important that we are aware of these laws.

                  Communicate Clearly and Confidently: It helps if we practice what we want to say. Using “I” statements when we express our needs keeps the focus on what we need. We need to develop the ability to ask questions. If we have questions for a provider, we need to remember that we have a right to ask those questions. I wish that I had asked questions when so many medications were being prescribed for me. Tied to asking questions is expressing our preferences. We need to let our providers know when something works for us and when something doesn’t. 

                  Build a Support Network: Try to surround yourself with family, friends, support groups, and advocates to help you speak up about mental health. This can be difficult when you have a mental illness. Stigma often prevents us from developing a support network. It took me time to gather people to support me. Don’t worry if it takes time. Sometimes even one person can make a difference. It is the quality of the support network that matters, not the size. Mental health and physical health professionals who respect and listen to us are important. Remember we have a right to find the professionals who fit our needs.

                  Set Boundaries: We need to remember that we can say no. Protecting our energy and mental space is crucial. Our well-being comes first. If something compromises that well-being, we can say no. Setting boundaries includes defining what we need from others. Others may not know what we need from them. It is okay to let them know what we need. 

                  Keep Records: It is helpful to keep records of our symptoms, medications, and side effects. Keep track of what works and what doesn’t. Journaling is one way to maintain records and track our progress. Having everything in writing allows us to share what we are going through and what works and what doesn’t with our providers.

                  Know When to Escalate: If our needs aren’t being met, we have the right to speak up. Our providers won’t know if we don’t tell them. If we struggle with speaking up, it might help to ask someone in our support network to be an ally. This person can go with us to an appointment and help us share our needs. If our needs continue to be unmet, we have a right to file a grievance or find a new provider. 

                  Practice Self-Compassion: Living with a mental illness is difficult. When we add the need to self-advocate, it is easy to become tired or overwhelmed. This is why it is important to practice self-compassion. We need to be kind to ourselves. Remember it is okay to ask for help or to take a break. 

                  Self-advocacy is important when we have a mental illness. It is important with any illness. Stigma exists. Providers who don’t really listen exist. It is up to us to say, “I have needs and I deserve to have my needs met.” It is a process. It takes time to develop self-advocacy skills. We need to be patient with ourselves and give ourselves grace. Self-advocacy leads to wellness. 

I was decades into my mental illness before I learned I could advocate for myself. I lost years of wellness because did not speak up when I needed to. I hope that others can learn from my experience and that others gain self-advocacy skills to help them heal.

 

 

Silencing Your Inner Critic

                  We all have it. That voice inside our heads that tells us we can’t do something or that we are not good. Have you heard it? I am sure you have. That voice is our inner critic. Everyone has it, but when you live with a mental illness that inner critic’s voice often becomes louder and more persistent. 

                  I hear my inner critic often. It has been with me all my life. When my depression and anxiety are at their worst, my inner critic seems to be at its nosiest. At times it feels like it is a scratched record, repeating over and over. This inner critic shows up in all areas of my life. My inner critic has affected my confidence. It has interfered with relationships and work. I wish it would just disappear, but I have learned that my inner critic will always be lurking. The key is to silence it. So, how do we silence our inner critics?

                  There are several things we can do to silence our inner critic. First, we must identify its voice. Once we have identified it, we need to separate it from ourselves. We can do this by giving it a name. By referring to it as a separate entity, we are giving ourselves the knowledge that the voice is not our voice. Once you have identified the inner critic, recognize the triggers that cause the inner critic to be active. Are there certain situations, people, or thoughts that provoke the inner critic? When I am working on this, it helps me to write down this information in my journal. This serves as a reminder to me and makes the information more concrete.

                  It is important to use compassionate self-talk with your inner critic. Respond to these thoughts as a friend would respond. If your inner critic criticizes you for making a mistake, you might respond with “I made a mistake and I am learning.”  By doing this you are taking away the inner critic’s power. You are also being compassionate with yourself.

                  Cognitive behavioral therapy (CBT) offers a tool that can be helpful in dealing with your inner critic. This tool is called thought records. First, write the critical thought down. Then ask the following three questions: 1. What’s the evidence for and against this thought?, 2. Is it a fact or an opinion?, and 3. What would I say to a friend thinking this? Write the answers to these questions down. It will help you reframe the thought.

                  You can also use mindfulness and grounding to deal with your inner critic. Doing this requires you to observe the thought, not absorb it. Allow yourself to notice the thought without believing it. You might say to yourself, “There’s my inner critic again.” Noticing it takes away some of its power. 

                  Another strategy is to create a “counter voice”. Write a list of affirming or neutral responses to common statements by your inner critic. Keep this list visible. Perhaps you can put them on sticky notes or in the note’s app in your phone. You might also write them in your journal and go back and read over them frequently. An example might be: Inner Critic: “You’re lazy.” Counter Voice: “Rest is not laziness. I am doing the best I can.”

                  Going to therapy is another important way to deal with our inner critics. I often share  my inner critic’s statements with my psychologist, who helps me work through them. Different therapists use different approaches. Three common types of therapy that can help us in dealing with our inner critics are CBT, ACT, and IFS. 

                  Medication can help if your inner critic is a part of a mental health disorder. It may quiet the noise enough to allow you to work on strategies to combat your inner critic. Talk to a psychiatrist about possible medications. 

                  Journaling and creative outlets can help in dealing with our inner critics. These activities allow us to externalize the inner critic through writing, drawing, role-play, and other creative activities. You might try a dialogue journal. In this type of journaling your inner critic writes a line and then your wiser self responds. 

                  One last way to deal with our inner critics is to rebuild our self-worth slowly. We can do this by celebrating small wins. Maybe we can track what we do each instead of focusing on what we didn’t do. When rebuilding our self-worth, we may have to start by being neutral. Our thought process might focus on just what we are doing and not giving it value either negative or positive. Then move on to self-compassion, where we tell ourselves positive things about who we are and what we are doing.

                  The inner critic is a powerful beast. It feeds off tearing us down. It develops over time and becomes stronger as time goes by. Since it grows stronger over time, it makes sense that it would take time to silence it. Give yourself grace as you combat your inner critic. It is not easy. I know and understand this because it is something I deal with. There will be good days and bad days. 

We often hear that we need to be kind to others. I would add to that that we need to be kind to ourselves. Our inner critic does not like kindness. So, be kind to yourself. 

 

The Effects of Music on Mental Health

                  I have always found solace in music. In some of the darkest times of my depression I have turned to music to cope with all that I was struggling with. I’ve written before about Grace Slick’s song “Let It Go” and how it saved my life when thoughts of suicide overwhelmed me. To read that post click here: Hope After Suicidal Thoughts

                  I use music as a companion when I am depressed. There are playlists set up on iTunes on my phone. These lists include songs that speak to me and songs that comfort me. I also really enjoy live music. Being at concert calms me. I get lost in the music, especially when the featured act is one of my favorite bands. 

                  Thinking about how music helps me led me to research the effects of music on mental health. Let’s look at the information about music and mental health.

                  Both scientific and clinical research have found that music supports mental health. Areas where music can have an impact include stress reduction, mood enhancement, improved sleep, emotional expression and processing, social connection, mindfulness and presence, cognitive benefits, and depression and anxiety relief. 

                  Music promotes relaxation and stress reduction by lowering cortisol, which is a stress hormone. Research shows that listening to slow, instrumental music reduces heart rate and anxiety by activating parasympathetic nervous system. The song “Weightless” by Marconi Union has been scientifically shown to reduce anxiety by up to 65%. This was found in a 2011 study by Radox Spa and Mindlab International. While this study was not peer reviewed, it has been widely cited in sound therapy circles.

                  Another way music impacts mental health is by stimulating the release of dopamine, which is the “feel-good” neurotransmitter. Mood can be improved by listening to upbeat music. Listening to melancholic music can assist in processing sadness in a healthy way. Listening to “Here Comes the Sun” by the Beatles is a good mood lifting song. There are many others.  

                  Sleep is important to mental health. Listening to calming music before going to bed can lead to improvements to sleep quality. It reduces insomnia and helps a person fall asleep faster. Classical music or nature sounds are good options for improving sleep. I use meditative sleep music to help me fall asleep and stay asleep. I find that when I put this music on, I relax and fall asleep faster.

                  Often, we find it difficult to express our emotions. Music can provide an outlet for expressing emotions. Sometimes when we cannot talk about an emotion, music can do it for us. Whether it is writing lyrics or listening to lyrics that we relate to, music helps us process emotions. For me the lyrics of “Let It Go” provide an opportunity to process emotions. Other songs that provide that outlet for me include “Landslide” by Stevie Nicks, “Crystal Ball” by Styx, and “All I Know So Far” by P!nk. What songs help you? Share in the comments. 

                  Music can lead to social connection when we play music in groups or listen to music with others. Choirs and drum circles are examples of how people can come together to share in music. The act of shared music reduces loneliness and promotes bonding.

                  Music can be a component of mindfulness and presence. During a meditation a person can use music as a focal point. Often, guided meditations use ambient music to enhance focus and inner awareness.  

                  Music can impact our cognitive abilities. Whether you are listening to music or playing music there are benefits such as enhanced memory, attention, and problem solving. Early in my teaching career I read research that showed how listening to the music written by Mozart improved mathematical skills. When I taught math, my students benefitted in many ways from the music. Music can also improve the cognitive functioning of people with dementia or brain injuries. 

                  When music is tailored to the individual, it can reduce the symptoms of depression and anxiety. My own experiences show this to be true. I imagine it is different from person to person. I have a friend who seems to disappear into the music of the Grateful Dead. You can actually see her mood lifting as the music plays. When I am depressed the music of Jefferson Airplane and Styx often envelops me in comfort, which lifts my mood. 

                  I thought about listing songs that can help with mental health. I even did an online search. As I thought about it, I realized we are each going to find different music powerful in our lives. We all have different taste. I think the key is exploring music to find what works for us. In college I knew a guy who lifted his mood by listening to hardcore metal music. That would not work for me, but it worked for him. I like a good classic rock song. Young people today listen to music that many of us older people would never consider listening to. But the music works for these young people. I encourage you to listen to music with the intent to find songs that are comforting to you and songs that have lyrics that are meaningful to you. We all have different music tastes. The song “Let It Go” saved my life because the lyrics spoke to me. Someone else might be turned off by that song. 

                  What’s your song? Share in the comments so we all can listen and possibly find new music that might be helpful to our mental health. 

 

Masks

                “People don’t fake depression. They fake being okay…Remember that. Be kind.”

– Robin Williams

 

                  The above quote by Robin Williams means a lot to me. I remember where I was when I heard that Robin had died by suicide. I was in my psychologist’s office waiting for my appointment. A little television on the receptionist’s desk had the local news on and they announced that he had died. I remember being sad and wondering what had led this man who seemed so happy and spent his life making others laugh to take his own life. 

                  None of us ever really know the pain others go through. We all hold parts of lives inside of us. We all have things we do not share with others even those closest to us. I believe that at times we all consider putting a mask on so that others do not see what we are going through. That mask is often a false positive mask. In other words, we often fake being okay when really, we are struggling. I know I have worn a mask disguising my depression and anxiety often. As I have grown in my understanding and acceptance of my depression, I need that mask less often, but it is still nearby and at the ready. 

                  In the past I had to wear the mask in attempt to hide my depression so that I could function at work or get through family gatherings. Unfortunately, when we live with depression, sometimes we feel like we need to deny it to get by. I have masked my depression when people insinuated that I could “snap out of depression”. Many times, it was easier to escape under the mask than to explain that I could not just snap out of my depression. Of course, this was a bad habit to get into for many reasons. First, it forced me to deny what I was feeling and experiencing. It also gave others a false impression of who I am and what I live with. Another thing wearing a mask did was to perpetuate mental health stigma. Each time I put that mask on I am denying that depression is a legitimate illness. For the most part I no longer use that mask even though it is within reach. I am not ashamed of my depression. It is an illness. People can either accept me with my illness or they can move on. 

                  When we wear a mask to hide our depression, we are faking being okay. No matter how long we wear that mask or how hard we try to mask our depression, it is going to find its way out. The depression will become worse the more we try to hide it. 

                  Back to Robin Williams. Since his death I have read many stories about him. I have learned that he suffered, but did not want his suffering to affect others. He spent his life making people laugh with his movies and other entertainment ventures. What I like best about him is what he did when no one was watching. He would quietly go to hospitals and spend time making kids with serious illnesses smile and laugh. There were never any cameras when he did this. He did not want cameras. He wanted to be fully present for the children. Doctors, nurses, and parents knew the true gift of Robin’s visits. Yes, he was wearing a mask when he made these visits because inside, he was also suffering, but I think making people, especially children, brought him joy. Maybe these visits also brought him some healing. We likely will never know because he kept these visits quiet and did not talk about them. He didn’t need the attention. His sole purpose was to bring joy to children who needed it most. 

                  I have been affected by a few celebrities’ deaths by suicide. It is not the fact that they are celebrities. It is the death; the end of a life that didn’t need to end. We often don’t hear about a suicide unless it makes the news, or it is someone we know. When I hear about someone dying by suicide or struggling with suicidal thoughts, I feel a strange connection. Perhaps because I have been on that edge. Depression has taken me to that edge more times than I would like to admit. I know I have been lucky that I have not fallen off that edge. I think about that when I hear that someone has died by suicide. I wonder if they had worn a mask. I wonder if that mask prevented them from receiving help. 

                  Masks only help others avoid dealing with someone who is struggling. Masks do not help the person with depression. We may feel like we need to wear the mask to get by or to protect ourselves, but in the bigger picture masks prevent us from getting help. 

If others could find it in themselves to be kind to people living with depression life would be easier. More people could reach out for help. Just as important, more of us could be honest about what it is like to live with depression. If we do that, just maybe people could live an easier life with depression and not attempt to end their lives. 

Remember to be kind to others. You do not know what they are going through. Each of us deserves to be treated with kindness. 

Mental Health Maintenance

                   A lot of times when we discuss mental health we focus on the difficult times or the times when the struggle is intense. It is important to focus on these times, but there are other times we should also give attention to in our discussions about mental health. One important aspect of mental health that comes to mind is maintenance. How do we maintain our moods at a stable or good level? 

                  Maintenance of a stable mood is important. Afterall, that is one of the goals of treatment. We receive treatment so that our symptoms improve. Many treatments can get us to this level. So, let’s take a moment to discuss how we can maintain our moods at a stable or even good level. 

                  First, it is important to recognize when we are stable or even in a good place. Sometimes it can be hard to recognize this state because we can get caught up in the bad times. We can even become so used to the hard times that we do not notice a change. That is where mental health providers or loved ones can help us. They might notice a change in us before we do. 

                  Once we acknowledge that we are doing better it is important to create habits that support our mental health with respect to our emotional, psychological, and physical well-being. Let’s look at some strategies we can try.

                  First, we should prioritize sleep and eat balanced meals. Lack of sleep can negatively impact our mood and how we regulate our emotions. Most recommendations I have read say that we should get 7-9 hours of sleep each night. I know this is not easy when we have other responsibilities, but it is a goal to strive towards. Nutrition affects our brains. It is important to eat healthy foods, avoid processed foods, and stay hydrated. These help our brain health, which in turn helps with our mood and emotional regulation.

                  Another area that we should include in our wellness routine is exercise or movement. Depression and anxiety are improved by exercise. That would indicate that when we are stable, exercise can help us maintain that state.  There are many types of exercise we can engage in to find benefits. It can be as simple as walking or stretching. Maybe aim for 20-30 minutes a day a few times a week. I know walking helps me. I feel at my best when I incorporate walking into my daily routine. Is there a type of movement that makes you feel better? Try making it a part of your routine. 

                  Meditation or breathing exercises can also help maintain a positive state of mental health. I struggle with meditation. I have never been able to free my mind in that way. My psychologist taught me a form of self-hypnosis that I find helps me. Self-hypnosis allows me to focus on my breathing and relax my body. There are many mindfulness activities that can help with maintaining our mental health. Maybe there is something you can try.

                  Along the lines of meditation and breathing, I find that journaling and making art also help maintain my mental health. These activities give my brain something else to focus on. Even when I am journaling about my thoughts, I find that written in my journal the thoughts are more concrete and less painful. There is a lot of research that demonstrates the benefits of writing and art on our mental health.

                  Setting boundaries is another way to maintain our mental health. For example, if work is a stressor that impacts our mental health, we can set work time boundaries. Maybe we set a boundary that keeps us from working outside of our contractual time. Or perhaps, we leave work at work and do not bring home work-related tasks. We might also need to set boundaries with the people in our lives. Think about what boundaries will make you feel the most comfortable. Try to set those boundaries. 

                  It is important not to isolate. This is a tough one for me. If left without support, I will self-isolate. I am not great in social situations. Consequently, I will avoid these situations. I know I need to reach out to others to maintain my mental health. As much as I struggle with social situations, I do not do well when I isolate. Isolation can lead to depression. Not isolating is a delicate balance. Despite my difficulties with self-isolating, I know that human connection is important, and we need to be connected to others to maintain our mental health.

                  Another thing that is important is monitoring our mental health. This can be through journaling, discussions with our mental health provider, and/or mood-tracking apps. These are important because they allow us to be on the lookout for changes in our mental health. We need to recognize when our mood is slipping, or our anxiety is increasing so that we can address these changes as soon as possible. We do not want to wait for the crash in our mood to seek help. We should seek help at the first signs of a downward turn. 

                  Here is a step that can be hard in today’s world. We need to limit overstimulation from tech devices. Whether it is social media or television, too much tech can damage our mental health. Too much input from technology can increase anxiety or decrease mood. One way I know my mood is slipping is I start doomscrolling on my phone. When I recognize this is happening, I know it is time to reach out to my mental health team and reach for my journal. I try to take tech breaks by grounding myself in my senses. Sometimes it is lighting a candle and focusing on my breathing. Other times it is listening to music. Another way to disconnect is to create art. You can also go for a walk in nature. I keep telling myself that I am going to get a membership to the Arboretum, so I have a place to head to when I need to disconnect from technology and connect with nature. I also need to make more trips to the beach.

                  Having something to look forward to is another way to maintain our mental health. When we look forward to something we feel good. Looking forward to something gives us hope. When I was looking forward to my trip to Italy, my mood improved. It does not need to be something big. Just looking forward to little things can make a difference. Something as simple as looking forward to a concert or lunch with a friend can help me. Think about what you can look forward to that will help lift your mood.

                  Maintaining our mental health is as important as improving it when we are struggling. As you have read, there are things we can do to maintain our mental health. If you are unsure how you can incorporate these things into your life, talk to a mental health professional. Just as importantly, remember if your mental health starts to slip, reach out for support and help.