How Mental Health Professionals Can Prevent Burnout: Self-Care, Mindfulness, and Work-Life Balance

                  In my last post (Why We Must Stop Stigmatizing Suicide: Supporting Mental Health Professionals and Ending the Silence) I shared about a psychiatrist who had taken their life and about the cruel comments that were made on social media. Learning about this incident made realize that there is a need to discuss how mental health care providers can support their own mental health. I am an individual with a depression and anxiety. I am not a mental health professional. The information I am sharing is based on ideas I found online. I think this information can be helpful. I share it in the hopes that mental health professionals will read this post and find at least one thing that is useful for them.

                  Mental health professionals support individuals with various mental health needs. At times they may listen to serious mental health concerns. They see patients at various points on their mental health journey. In a single day they may talk with individuals who are experiencing suicidal ideation, individuals who are managing their mental health well, and everything in between. Mental health professionals are tasked with supporting people in their times of need. They may hear patients talk about very difficult things. 

                  What can mental health professionals do to keep from burning out or experiencing difficulty handling all that they work with? How do they protect their own well-being? One key is maintaining their self-care. For mental health professionals, as with anyone, self-care is not an extra. It is something that needs to be practiced. For mental health care professionals, self-care should be a professional responsibility.

                  Here are some ideas of what that self-care for mental health care professionals might entail:

 

Set clear boundaries: Be sure to maintain reasonable work hours, limit after-hours communication, and only take on the number of cases that can be reasonably managed. It is important that mental health professionals remember that they need to maintain a caseload and work hours that do not interfere with their well-being.

 

Use supervision and consultation: Make sure you have a trusted colleague or supervisor to consult with. Whether it is difficult cases, emotional reactions, ethical concerns, or signs of burnout, having a colleague to discuss things with is vital. No one should try to carry everything all on their own.

 

Monitor your own mental health: It is important for mental health professionals to watch their own mental health for signs of difficulty. This includes monitoring things such as sleep, mood, eating habits, irritability, ability to concentrate, and ability to express empathy. If they see changes, it is important to seek assistance. This can include therapy. It is important to remember that therapy is not a sign of weakness. You would never tell a patient that therapy is a sign of weakness. Remember that when caring for yourself.

 

Create a separation between work and personal life: A start to doing this is by having a transition ritual to engage in at the end of work. Maybe you go for a walk, change clothes, meditate, journal, or listen to music. The important part is to have some way of signaling that you are stepping out of your role as mental health professional and into your personal life. This helps you mentally change your role and leaves the work role on hold for a while. 

 

Prioritize basic health: Your physical health is important. It is important to follow basic health guidelines. Get enough sleep. Eat healthy foods. Exercise is important. Make sure you attend to your physical health by getting regular checkups with your primary care provider. If you have a physical health issue, be sure you are attending to it. 

 

Build supportive relationships: It is important to have healthy relationships in your personal life.  Friendships and relationships with family play a role in maintaining your mental health. They also provide time away from the commitments of work life. Make sure you engage in activities with family and friends that are unrelated to mental health work.

 

Practice mindfulness or reflection: There are many mindful activities that can help provide a separation from work life and can help alleviate the weight of work life. Breathing exercises and meditation are two activities that are helpful. Reflective journaling can provide an outlet and can help you recognize and process and stress. 

 

Take breaks and vacations: It is important to get away from work. Taking breaks can decrease stress and burnout. It does not need to be a long break or an expensive vacation. Just time away from the clinical aspects of work can be beneficial.

 

Accept professional limits: It is important to remember that you cannot fix every patient’s problems. Try to be realistic about what you can and cannot do. Remember that you are human. Be gentle with yourself. Give yourself grace.

 

                  Mental health professionals do important work, but that work cannot be done unless they are caring for themselves. There are times when you are going to be affected by your work. That is okay. You are not expected to be unaffected by all you hear and see. Remember you are human. It is important that you have support when you need it. Boundaries help maintain your ability to carry out your work.  

 

Mindfulness for Mental Health Professionals

                  I have shared activities that mental health professionals can use to protect their own mental health. I would like to spend a few moments offering some mindful activities that can be helpful. 

                  “Leave it at work” visualization: This can be a quick visualization that provides for work/life separation. Sit quietly and close your eyes. Visualize a container. It can be any type of container that appeals to you.  Visualize placing the day’s difficult conversations, emotions, and responsibilities into that container. Allow yourself to visualize leaving that container in your work environment. A powerful sentence you can tell yourself is “I can care about this without carrying it home.”

Sensory Grounding: This is a practice you might have tried with patients and not thought to do it yourself. When you get home, take a moment to deliberately notice five things you see, four things you feel, three things you hear, two things you smell, and one thing you taste. The idea behind this practice is to move you from your mental health role and into your personal life.

Mindful Music: There is a lot of research about the benefits of music. Curate a playlist for yourself. This will be your after-work playlist. Use it only when you are transiting from work. The music becomes a cue that your workday is over, and you are moving into your personal life. There are no rules on the type of music. It can be whatever feels right to you.

Journaling with boundaries: in this type of journaling, you write down anything you are still processing, but you only name it. The goal is not to process what you write down. The purpose is to give the thoughts or what you are still processing a place to reside while you move into your personal life. Close the journal and let whatever you wrote reside in the journal.

Body Scan: Here is another activity you may have done with patients. Sit or lie down comfortably. Scan your body. Notice areas where you are holding tension. Try to consciously soften those areas of tension. 

The “Not Now” Practice: If a work-related issue enters your mind while you are away from work, you can tell yourself something like, “This is important, and I will return to it during my next appropriate work time.”  You may have to repeat this a few times. That is okay.

An Intentional Transition Question: As you enter your personal life setting, take a moment to ask yourself, “What do I need now that I didn’t need during my workday?” The answer may surprise you. Try to give yourself what you need.

 

Final Thoughts              

                  Mental health professionals play a vital role in their patients’ lives, but they still have their own lives. It is important to maintain separation. That does not mean you are not committed to your patients. Separation does not require emotional detachment. You can be supportive of your patients and care about them, while still recognizing that you do not need to carry their stories, emotions, and outcomes with you all the time. In a way it is like the message we hear on airplanes. When there is an issue on an airplane requiring oxygen masks, we are told to put our own on before attempting to help someone else. The idea of caring for yourself as a mental health professional is similar. You will be better able to help your patients if you are caring for your own mental health. You cannot pour from an empty cup. 

 

How Art Helps Depression and Anxiety: Ways Creativity Can Improve Mental Health

        I never thought of myself as being good at art. I am sure my I was terrible at art as a child. I do not remember having confidence in doing anything art related. My attempts at drawing were criticized. A strange thing has happened as I have learned to search for ways to cope with depression. I discovered art. 

                  As I have found art helping me cope with depression and anxiety, I have wanted to learn more about how art helps and different ways I can engage with art. I thought I would share what I have discovered. Art is a tool and a craft. It can be a passion and a distraction. Art can be anything we want it to be. 

                  Creating art and appreciating the arts can help us cope with depression and anxiety. It is important to note that art does not replace mental health treatment. Art can be a useful coping tool when we are struggling or even to keep us doing well. We can add art making and appreciating art to our mental health toolkits.

How Does Art Help with Depression and Anxiety

There are several ways that art helps with depression. Here are a few:

·      Provides Emotional Expression: Art, in its many forms can help us express our emotions when we cannot find the words. Often, expressing emotions can be difficult when we are struggling with depression or anxiety. Art can provide alternate ways to express emotions. Whether it is drawing, painting, sculpting, writing, music, dance, and other forms of art all invite us to express ourselves. Sometimes art allows us to express emotions that are difficult to express in words. 

·      Reduces Stress in the Moment: When we focus on doing art there is a shift in our attention. We can escape the emotions or stresses we are experiencing because of depression or anxiety. We can escape into a painting projects or lose ourselves in a drawing. The thoughts, worries, or feelings of depression or anxiety do not necessarily disappear, instead they take a backseat to whatever we are creating. 

·      Create a Sense of Accomplishment: When we complete even a small art project, we feel a sense of accomplishment. It might be something as simple as a quick drawing or pouring paint on a canvas. We can see what we have created, and this allows us to feel like we have done something. When our motivation is low, it can help to see ourselves making progress on something. 

·      Encourages Mindfulness: When we are engaging in artistic activities, we pay close attention to colors, sounds, textures, and movement. Focusing on these can interrupt thought patterns that are common with depression and anxiety, such as rumination and negative thought patterns. This is a part of mindfulness.

·      Builds Connections: When we engage in art sometimes, we are drawn to share our art or take art classes. This can reduce isolation. We might go to a Paint Nite or go to the local craft store. We might find enjoyment and connection in going to an art exhibit or a concert. 

·      Helps People Understand Themselves: We may find that we understand aspects of our emotions when we look at our art. We may find patterns that help us understand something about ourselves. We may recognize emotional patterns, personal strengths, or changes in mood that we do not recognize in our day-to-day routines. 

 

Process of Creating

                  Using art to help with mood or anxiety is not about the finished product. It is more about the process. It is about how we feel as we are creating. We might simply create art for the sake of creating it. We can focus on how a particular art medium feels in our hands or what it feels like to doodle on a page. 

                  I have a sketchbook that is just for drawing circles in different patterns when I am feeling anxious or need to calm myself. I focus on drawing the circles in a set pattern. This takes away pressure to have a perfect finished product. 

                  Simple activities such as doodling, taking pictures, molding a piece of clay, or practicing an instrument can be calming and distracting. The practice is the important thing is engaging in an art activity. Let’s look at some simple ways we can engage in the process of creating.

                  Simple Ways to Create

·      Doodling for ten minutes

·      Coloring in a coloring book

·      Make a collage using magazine pictures and stickers

·      Journaling – maybe add some sketches

·      Work with clay or play dough

·      Take photos of things you find interesting

·      Pour paint over a glass jar (there are pouring paints for this)

·      Paint a paint by number canvas

·      Crochet or knit

·      Embroider a small square every day

 

We may need to learn some of these forms of art. That is a good thing. Learning a new skill helps us build confidence and encourages us to engage in something. If there is an art form we would like to learn, we can probably find a video or tutorial on YouTube to guide us. We can also venture out to our local craft store if we are up to it.

No Judgement

You do not have to be great at art to benefit. The process is the important part. We are not looking for masterpieces. We can just enjoy the act of making. As we enjoy the process, we will gain benefits from the art. It can be relaxing, distracting, or just fun. The important thing is not to stress over the art. We want to enjoy what we are making. No one is going to judge our art. We can decide if we share it with others. Our art is for us. 

 

Personal Experience

                  As I mentioned, in my younger years, I did not feel like I was good at art. I avoided most art activities. The exception would be writing, but I did not realize writing was art until much later. 

                  My introduction to art came a few years ago when a friend took me to a Paint Nite. I was not sure I would like it, but I wanted to spend time with my friend. So, we went. I followed the teacher’s instructions. It was fun. At the end of the night, I had a painting I was proud of. Slowly, I started trying painting on my own. Eventually, I discovered paint pouring and fell in love with it. Watching the colors mix soothes me and helps ease the anxiety. Now, I try to find time to paint whenever I can. Sometimes it is hard to motivate myself when I am feeling depressed, but I try. I actually enjoy the practice of art, and I am improving. I am branching out into drawing and coloring. Maybe I will try other art forms. I do not create masterpieces in any way, but I enjoy the practice of making art. I like gifting my art even if my art does not meet masterpiece standards.

                  I recognize the benefits of art in my life. It is now a tool in my coping strategies toolkit. I encourage you to give art a try. You may find that you like it and can add it to your coping strategies toolkit.

 

How Dogs Help Depression: What a Walk with My Dog Taught Me About Mental Health

As much as I try to push through my struggles, things have been tough for me mentally and emotionally lately. Sometimes I do not like to admit when I am struggling, but admitting it is the only way to find the path to healing. So, as I admit that I have been struggling, I also share that the struggle has led to some insights.

After a rough day I needed to take my dog, Panda, for a walk. I really did not want to walk. The depression told me to curl up and do nothing. I just wanted to slip into the furniture and disappear. But Panda needed to be walked. It would not be fair to her if I did not take her out to walk. So, off we went. 

She turned in a different direction than we usually walk as soon as I closed the gate. For some reason I decided to just follow her, let her lead. I would not need to think. Well, mu little dog wanted to really walk. Soon, I was not sure exactly where we were. Still, I followed. I figured if I needed to, I could use my phone to find our way home. 

                  As we walked, I found myself just noticing the area around me. While we were in my neighborhood, the area was new to me. This allowed me to notice greenery and houses I had not seen in the past. My mind soon lost its focus on what I had been struggling with and it began focusing on the newness I was walking through. Panda kept walking. I kept following. 

Somehow Panda knew what I needed. We walked and walked. Stopping when she felt the urge to sniff. I did not look at my phone. I was not interrupted by the outside world. I was fully present in our walk. It was a very different experience for me. We walked for 91 minutes. I did not know I was capable of walking that long and definitely did not think Panda’s little legs were capable of walking that long.

Our walk did not make the things weighing on me disappear, but it did relax my tension and calm my mind. I had assumed my thoughts would go wild while we were walking in silence, but oddly my thoughts slowed. They did not completely disappear, but they calmed enough for my anxiety to settle and my depression to lift. My thoughts focused on the presence around me. That presence was both new and beautiful. 

Did Panda really know I needed to walk? I cannot be sure. My gut tells me that she did. She has been staying very close to me lately. Curling up against me in bed. Giving me hugs. So, it would seem this little dog senses that I need her. 

This got me thinking. How can pets affect our mental health? Then I remembered that I wrote about Panda back when I first brought her home. (Can Pets Help Our Mental Health) She was my mom’s dog. She came to live with me when my mom required more care and had to be moved into a care facility. I had never had a pet as an adult. Maybe the timing was right. 

I do not want to rehash that post. You can click on the link and read it. Plus, I feel I should write something new. I thought about what Panda does for me, aside from trying to get my attention like she is right now. 

 

How Do Dogs Affect Our Mental Health?

For starters, Panda and other dogs get us moving when depression tells us to stay still. Depression wants me to stop everything. It wants me to sit in my recliner or lie in my bed and ruminate on all the negative thoughts it is feeding my head. When depression is looming over me, it is difficult to engage in even the simplest of tasks. Dogs do not allow us to be still. Dogs want us to play with them. They want us to walk with them. We cannot keep our dogs inside all day. They need to go outside. Our dogs depend on us. Having a dog depend on us can make us feel needed, which can be a mood lifter and a way to get us up and moving.

With depression we often spiral into darkness. We start to feel down, and we keep going. We need a way to break that spiral. It is possible that small actions such as putting on shoes, grabbing our keys, and stepping out the door can cause an interruption in the depression spiral. We do not need to walk far. Surely, I cannot walk 91 minutes every day. Even a walk around the block can be enough to cause a disruption to the spiral depression throws us into. That one walk can lead to a new habit. We can start walking with our furry friend every day. It starts out being about doing something for our pet, but it becomes a habit that can improve our mental health. 

                  Movement is important for many aspects of our lives. Mental health can be improved with daily movement. It is difficult to do this on our own. Having a dog that depends on us to walk, gets us both moving. In doing this act for our mental health we also help our physical health. We are not just walking our dog, we are exercising.

                  Another way walks with dogs can improve our mental health is by gently guiding us into the present moment. With depression we often lose sight of the present moment, especially the beauty and the good around us. Depression sucks us into the darkness. For dogs that darkness does not exist. Dogs live in the present moment. We can learn to be present from our furry friends. Panda stops and smells anything she notices. It does not matter where we are or how much we have walked, if she wants to sniff, we stop. If she sees something that catches her eyes, she pulls me in that direction. Helping our mental health, requires us to adopt these practices. No, I am not suggesting we sniff everything like dogs. Although, there is nothing wrong with taking a sniff of a beautiful flower or breathing in the salty air at the beach. The lesson here is to be present. Experience all that is around us. If we are focused on being present in the environment, we take the focus away from what depression is telling us. Being present is part of mindfulness. We do not need to get into formal mindfulness practice to benefit from noticing what is around us. We just need to slow down and enjoy our walks, or whatever we are doing, the way dogs do.

                  Dogs can help those of us with depression by providing a sense of being needed and being a friend when we struggle with loneliness. Our furry little friends depend on us. They cannot provide their own food. They need us to feed them and give them water. They need us to take them outside to take care of their biological needs. Dogs need us for exercise. That walk is something we both need. So, when we take our dogs for a walk, we are doing the same thing for them that they do when they take us for a walk. In other words, walks help us both. 

When we are depressed, we often feel a void in our lives. We might feel like we are useless or that we do not contribute anything to the world. Having a dog need us might be just what we need in these moments. Dogs provide companionship. I never thought it would be possible to love a dog. My how that has changed since Panda came into my life. Depression often makes us feel lonely. That loneliness lifts when a dog is curled up next to you or walking beside you. Sometimes when I am feeling really lonely, when the depression is telling me I alone and always will be, Panda moves closer to me, gives me a little snuggle. I do not know how she knows, but she does. She lets me know that even if no one else seems to be around, she is there.

                  Panda and other dogs do not understand depression. They do not have psychology degrees. They do not provide therapy services, at least not the same ones as a psychiatrist, a psychologist, or a therapist. While they do not understand depression, dogs do understand that their humans need them. They see when we are not happy. Dogs recognize when we are not providing them the care they need. Instead of complaining, dogs get us up and moving. They get us snuggling with them. They let us know they depend on us to meet their needs. All these things are the way dogs understand people. They love unconditionally. That is how dogs understand depression. I did not know I needed a dog until Panda started loving me. 

                  By no means am I saying that a dog can cure our depression. When we live with depression, we are living with an illness. We need mental healthcare professionals to provide treatment and therapy. Dogs do, however, make our lives better. When our lives are better, we  can heal.

                                             

                                               

                                            Photos and Grooming by Sharon Raaen          

 

 

 

 

 

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.