Health – Page 22 – Effects of Anxiety

Watch This If You’re Struggling With Your Self-Worth

Lily, Hey Psych2Goers, and welcome to another video. Thank you all so much for the love and support that you’ve given us enabling us to make yet another exploration into everyday psychology. So let’s begin. Loving yourself may sound simple, but we all know how hard it is. Sometimes it can be a roller coaster ride between being happy with yourself and wishing you could change. There are so many things that affect your image of yourself, and some of them may not be good Things such as the media set false expectations and ideals. It can be a long journey to accept this, but it’s worth it. We made this video to remind you that you should never give up on loving yourself because you deserve it and you’re worth it. So here are 12 things that do not determine your self-worth Number one. Your achievements. Can you relate to loving yourself so much when something goes well, but the second something goes wrong? Your self-worth immediately takes the plunge Whether it’s your grades, your job, or a sport. It’s easy to base your worth on what you accomplish, but how much you’re worth does not depend on your achievements, especially when it comes to competitions. You can’t control your competitors, so you don’t need to blame yourself when things don’t go your way. You are more than just a bullet-point list of all of your accomplishments. You’re a complex person with a personality hobbies and so much more than your achievements, And it all makes you worth it Number two, your income and job. Are you second-guessing your career? Do you often think of switching your job While your job plays a big part in your lifestyle? It does not determine your worth. People who have less money, aren’t lesser than others like society and the media sometimes portrays Your job and income are sometimes the result of your situation. There are so many factors that influence them like location, the economy, and competition, So they aren’t a reflection of who you are Number three, is your childhood. Do you avoid thinking about your childhood? Do the memories make you uncomfortable? Your childhood may shape a lot of things about you, but it does not determine your worth. It’s a phase well on its way out and you mustn’t. Let it overwhelm you Your rough childhood does not define who you are. After all, you have no control over who your parents are, and you’re not responsible for their choices. It may take some time to accept this, but your past does not define you Number four, your level of education, Much like your income, your level of education is also the result of so many factors, One of the biggest factors when it comes to deciding whether to Go to college, and where is how much money your family has? You can’t change, how much money your family has or the location of the schools you want na go to. Therefore, you don’t need to feel bad. If you don’t have a higher level of education, it doesn’t mean you’re, less intelligent or worth less than those who do Number Five. How do other people view and treat you? Do you constantly stress about how others see you? Are you constantly trying to live up to their standards? Other people have no way of knowing who you truly are, While family and friends may have a good idea of it. Only you fully know yourself, Knowing this your self-worth: isn’t based upon others, limited and sometimes biased opinions of you. You cannot control what other people think or how they act. Similarly, don’t base your value upon something completely up to others. Trying to please others will ultimately lead you to be miserable, so try not to stress yourself out with other people’s opinions, even if it is difficult. Number six. Other people,’s achievements. Do you compare your achievements to other people?’s? It’s! Okay, because everyone does that occasionally – And it’s so easy to look at what you’ve done and compare it to someone else.’s achievements, especially when the internet gives you access to everyone.’s. Amazing lives. It may be hard to internalize. But what do other people do? Doesn’t define you, You can’t control others.

So the only thing you can do is try your best, Regardless of the result trying your best is enough. After all, everyone is different with varying skill sets and experiences, so it’s no use comparing two unique people. Number seven is your appearance. Are you unhappy with some physical features of yours? Is there anything you wish you could change about your appearance? Chances are, the answer is yes, Almost everyone wants what someone else has, which is the sad truth, especially living in today’s, society. It can be so easy to compare yourself to other people and all the gorgeous models on TV, But try to remember that what you look like doesn’t determine how much you’re worth. You’ve probably heard it before, and we know how hard it is to accept and internalize, but it’s. True You don’t need to feel bad because you might not look the way that people on TV do, because everyone is beautiful in their unique way. Number eight, your relationship status. Are you still looking for the one, But it seems like everyone. You know is getting hitched Nowadays, there’s so much pressure to have a significant other and a picture, perfect relationship. It can feel as if you constantly need to be pursuing someone out of fear of being a desperate lonely single. However, there’s nothing wrong with being single. Doesn’t make you less of a person because it means you’re, taking more time to focus on yourself and what you want na do You will only go for it when it feels right. While a relationship may be nice, it’s, not something you need to have to be valued Nine, the number of friends you have Do you value quantity, over quality when it comes to friends, Or is it difficult for you to keep up with your circle of Friends Having more friends, doesn’t matter what kind of person you are, If you only have a few it doesn’t mean you’re, not sociable or kind, but it means you have a specific taste in people which isn’t a bad thing. You’re invested in finding friends who understand and care for you. On the other hand, having more friends doesn’t mean you’re shallow and only interested in popularity. It means that you’re friendly and open to new people. The number of friends you have doesn’t say anything about your worth. Rather it’s the quality of your friends that matters 10, your social media status. Are you an avid scroller? Do you, post on social media habitually or occasionally With the amount of emphasis? The world seems to revolve around how many likes you get. There is so much pressure to have a picture-perfect, aesthetically pleasing life. However, your worth is not measured by how many people, like your posts, Social media, is for sharing parts of your life and forming connections with people It’s allowed getting likes. May give you the satisfaction it doesn’t determine your self-worth. Social media should be fun and uplifting, not a tool to gain validation. You are valid and worthy regardless of your social media status. Number 11. Your age, Both old and young people, are often judged due to their age. People may think all young people are reckless and selfish, while all older people have their whole lives figured out, But your age, doesn’t control your personality, hobbies, likes dislikes and so much more It’s, not a reflection of who you are so it does. ‘t determine your worth After all Age aint, nothing, but a number Number 12. Your decision to have children There’s a lot of societal pressure to have children to contribute to society, But having children is completely your own decision Not having children. Doesn’t make you less worthy than others who do because it’s a major decision that affects you most of all, so it should be up to you Remember your decision is valid and valued either way. In the end, you’re the only one who determines your self worth Cliche, but it’s, true, Not anyone or anything else, whether it be money, family, or friends. It may be hard, but just try to remember that you are more than any single aspect. We hope we were able to give you insight into some of the things that you should, ‘t base your worth on. Do you use any of these things to measure your self-worth? If so, that’s – okay, we’ve all been there before, and we’re here for you Leave a comment down below and share your experiences and thoughts you have as well. If you find this video helpful be sure to hit the like button and share it with those out there still struggling with their self-worth, Don’t forget to subscribe to Psych2Go and hit the notification bell for more new videos. Thanks for watching – and we’ll see you soon, As found on YouTube The Destroy Depression ꆛ System-Cure Depression Naturally YOUR DEPRESSION HAS BEEN IN CONTROL LONG ENOUGH. It’s Time to Fight Back ☂🗯 “Depression Sufferer Of Over 20 Years Reveals His Simple 7-Step System That Gives You The Power To Destroy Your Depression, End Your Feelings Of Sadness And Hopelessness, And Get Your Life Back.” “This didn’t just change my life, it saved my life.“

Cognitive Behavioral Therapy (CBT) Skills and Counseling Techniques with Dr. Dawn-Elise “Doc” Snipes

CEUs are available for this presentation at AllCEUs.com/CBT-CEU Hi everybody and welcome to today’s presentation on cognitive behavioral therapy skills. Like the other the presentation we did on assert not assertive community treatment acceptance and commitment therapy, which is also based on just providing information about skills that can be used not providing an evidence-based practice we couldn’t cover that in a full hour or just an hour so over the next hour we’re going to define cognitive behavioral therapy and its basic principles a lot of us are familiar with this but it’s going to be a good review and it also may highlight some nuances that you didn’t know about will identify factors impacting people’s choice of behaviors explore causes and impact of thinking errors and identify common thinking errors and their relationships to cognitive distortions so why do we care well as therapists we want to help people figure out the best way to live a happy healthy meaningful goals-driven life for some people that’s going to mean using some cognitive behavioral interventions that can be in addition to mindfulness that can be in addition to a lot of other things but it’s important to help people understand that the way we believe things to be the way we interpret things is going to affect our reactions so for example think about a situation you know you’ve walked into and maybe you walked into it with a small child and it was a different situation it was a new situation but you know it was no big deal you walked in it was not a threatening situation to you because you were like hey I got this the little kid walks in and goes oh wow there are a lot of people walking around here, this is the really scary same situation as two different perceptions you probably didn’t have much of a stress reaction going on whereas the little child probably had this fight-or-flight thing going on grabbing onto your hand like please don’t let go Atlanta Airport is a perfect example if you’ve ever taken a little kid through Atlanta Airport it gives you an idea about how people can perceive things differently and when you enact that fight-or-flight reaction you’re going to have all those stress hormones you’re going to have all either anxiety or anger or whatever that goes with it it may serve to exhaust the person and leave them feeling hopeless and helpless so what we want to do is help people see that but we also want to help them see that when they’re depressed when they’re tired when they’re sick things are going to seem a lot worse a lot of times because they don’t have the energy to perceive it differently I mean when you’re sick it’s overwhelming to think of going through Atlanta Airport so this is what we want to help people start understanding is it’s two sides of the same coin they interact if one is you know kind of going wonky is going to affect the other one the good thing is if one’s going really good the other one’s going to go good if you’re having positive thoughts you’re probably going to feel pretty good there’s an activity and I think we’re going to talk about it later it’s called the coin flip activity and I asked client clients to flip a coin in the morning and in the morning if it turns heads then they have to be the most positive Pollyanna all day long look for the silver lining and everything smile walk with their head up hold those nonverbals up and see how they feel at the end of the day besides a little sore because there are muscles they’re using they haven’t been used in a while if it lands on tails they can just be their normal selves which generally if they’re seeing me means that they are depressed anxious stressed out angry about something in the negative realm then we talk about how did things seem different on the days when you were feeling better when you were walking taller when you were smiling even our nonverbals it doesn’t even have to be sickness it can be our nonverbals that can make us feel or make our body feel heavy and tired and make it seem like it’s a whole lot harder to deal with life as a person who perceives the world generally good and believes they can deal with challenges as they arise that good old self-efficacy will be able to allow their stress response system to function normally so if they’re like you know what I can deal with whatever life throws at me I’ve got it and maybe I need help with it maybe I’ll need to ask for support but I’ve got it it’s not going to completely overwhelm me with people who see the world as hostile unsafe and unpredictable you know for a variety of reasons whatever happened to make their scheme as such that they don’t believe that people or the world is trustworthy are predictable they are always on guard they’re always kind of like a hamster in a cage that has Have you ever had a hamster hamsters don’t recognize you and go hey that’s my own or human contact score hamsters go run under their little house and you just kind of open the cage and stick your hand in there and flip over their house and you’re like come here and give me cuddles and you’re like you know 200 times bigger than they are so the little hamster is like freaking out this is what it’s like for people and obviously, I’m exaggerating but this is what it’s like for people who have a negative perspective a negative view or a hostile view of the world so kind of keep that little hamster in your mind cognitive behavioral therapy we have core beliefs those things that are in our hearts when I talk with my clients about honesty step one and that’s what they’ve got to do to start recovery is get honest with themselves first and then other people we talk about head heart and gut honesty do you think it’s right does it seem like the right thing to do does it feel right in your heart you know does it make you happy it doesn’t make you feel good and then the spidey senses is your gut saying and or is your gut fine if one of those is saying this might not be the right choice and we need to think about what’s going on so we have those core beliefs and I put them in the heart just because that’s the middle of the head heart and gut but you have core beliefs about yourself whether you’re good with you’re bad whether you’re effective at certain things yada yada you have core beliefs about other people same thing good bad effective predictable and you have core beliefs about the future and a lot of that goes with the locus of control but also your past experiences if the world in the past is seemed unfriendly and uncontrollable and you’ve perceived it that way then you’re going to expect the future to be uncontrollable so what we want to do is help people look at their schemas and their core beliefs about themselves others in the future and figure out kind of what they want it to look like these schemas are going to affect your behavior and your thoughts and your feelings and you know you can pick wherever you want to start it doesn’t matter because all three inter interface with one another so if you haven’t let’s start with negative thoughts if you have negative thoughts then you might feel anxious angry stressed dysphoric which will affect the behavior you’re going to do different things than if you have positive thoughts about something you feel excited and energized you’re going to have different behavior the best thing example I can give you is if you’ve ever done public speaking or had to present something some people detest public speaking it’s just terrifying for them to get up in front of a group of people so their thoughts am I going to trip up I going to forget what I’m going to say I’m going to make a fool of myself I’m going to you know it can go on forever that when you get on a roll you can get on a negative roll and go on forever or positive hopefully get on that roll with those thoughts you start holding onto those thoughts remember as we talked about in a CT the other day when you hold those thoughts and you kind of mush them around in your mind and you come to believe them that you’re going to make a fool of yourself and it’s going to be awful you’re going to start feeling terrified likely which is going to likely affect your behavior if you go out on the stage and you’re terrified you’re going to probably stutter you’re probably going to get foggy-headed you’re going to have that fight-or-flight reaction so there’s an the adrenaline rush and you start sweating and you can’t focus and you can’t concentrate you want to away as opposed to somebody like me who loves public speaking and I’m just like cool I get to go out there and try to engage however many people are in the audience it’s a game for me because when I can see your faces I enjoy trying to figure out and make eye contact with people and figure out what it is that they’re there for what is it that’s going to make them tick what resonates with them so my behavior as you can kind of see right now when I go out there I’m excited and I want to engage people and it’s a fun experience for me again just like the airport the same experience for two different people and two very different interpretations and reactions to it so what effects I don’t like the term rational but when we’re talking about CBT irrationally comes up a lot I like to replace it with helpful because every behavior in its weird sort of way is or probably was rational at one time that being said we’re going to get back to that stress affects our behavioral choices if we’re under stress we can have negative emotions negative emotions will affect our thoughts if we’re feeling sad we’re probably going to look at the dark side if we feel sad we’re going to look at the bottom falling out if we’re happy we’re probably going to look for that silver lining physical factors if you’re in pain sick sleep-deprived poorly nourished so your body can’t produce the neurotransmitters it needs to or heaven forbid intoxicated you’re probably not going to make the same decisions as you would if you were comfortable healthy well-rested nourished and not intoxicated any of those things can go impact how you perceive a situation or how you react in a situation, especially the intoxication whereas in your non intoxicated State in your sober state, you may think that you want to do something but then you’ve got that filter that goes not not a good idea in an intoxicated State or even in a manic state if you’re you know if you have somebody with bipolar that filter kind of goes away so the behaviors that someone may normally not do because they have a rational filter that goes you know punching this guy outs probably not the best idea right now the filter goes away when you’re sleep-deprived you’re less generally people are less patient generally people don’t have as much of a filter thing about watching your children if you have children or your grandchildren or even yourself I know myself when I’m sleepy I am giddy as all get-out and things I wouldn’t normally say because they’re you know stupid I’ll just come out and say anyway and my kids just roll their eyes or the mom you’re overtired could go to bed, uh but that’s okay you know I’m okay with that in that situation now if I acted that way at work it would be a worse thing environmentally if you’re introduced to a new or unique situation and you perceive it as stressful because the unknown we know can be stressful then you may not make as rational of a choice or as helpful of a choice because you maybe trying to escape the same thing as exposure to UNPROFOR bellowing for a the word here but UNPROFOR ball is the best I could come up with we all prefer certain situations some people as I said would rather do just about anything then get up in front of a lecture hall of a hundred and fifty people and talk but if they have to do it then they’re going to be under stress which may affect how they do things so we want people to understand that their perception and their feelings are affected by a lot of other things not just you know an emotion here or a particular memory there’s a lot that goes into it and social if peers your family convey irrational thoughts as necessary very standards for social acceptance people may tend to cling more to it to those unhelpful thoughts and unhelpful behaviors you know in CBT they say irrational because quote nobody wants to associate with those people you know who are those people and why can’t we associate with them there are a lot of things if you think back think high school you know high school is pretty rough if we’re going to talk about having irrational thoughts and cognitions if you have to be part of this particular group to be accepted you have to do this you have to do that but do you do those kinds of all-or-nothing statements are cognitive distortions and while they may have served a purpose in some way shape or form in the past we need to encourage our clients to take a look at them now and go are they still helpful ways of thinking is it still helpful for me to think that I am only successful if I live in a million-dollar house in a gated community and do this that and the other or can I be can I define success a different way or do I define success differently and lack supportive peers to buffer stress so we had those peers that caused stress by talking about the half dues and categorizing and lots of attributions but then there’s also not having somebody to go you know does this make any sense because sometimes we are our own worst enemies and if we go to a friend and we go you know this is what I’m thinking and I think I have to do this in order to be acceptable to be loved or you know whatever the case may be most people are not going to use those exact phrases a good friend is probably going to listen and go yeah you’re right or no no that’s way off so supportive peers are essential to reminding us to consciously regularly check in with our cognitions to make sure that they are hopeful and rational so a note about irrationality and this is mine this is not from CBT the origins of most beliefs for rational and helpful given the information, the person had at the time and their cognitive development their ability to process that information so concepts and schemas and core beliefs that people formed when they were five are probably going to be very egocentric you know the person is going to feel like everybody sees it my way because this is how I see it you know just like a five-year-old does a five-year-old doesn’t think well you know let me take Johnny’s perspective is no he assumes that Johnny sees it the same way so it’s going to be egocentric it’s probably going to be focused on only one aspect of the situation because small children can’t focus on multiple aspects and it’s probably going to be dichotomous it’s all-or-nothing Mommy loves me mommy hates me and it could be personalized you know everything a lot of kids think that everything has to do with them so if something happens something bad happens many times children will take it personally or be afraid it’s going to happen to them again you know if hurricane katrina hurricane Andrew those sorts of things you know we saw a lot of trauma in children and they developed very real fears about thunderstorms and hurricane season and if you’ve watched Florida hasn’t had a notable hurricane in years now but there’s a lot of stuff that goes into that but young people during some of those really bad hurricane seasons perceive those situations differently okay so we need to help people understand that if we especially if we use the term irrational those thoughts you formed when you are knee-high to a grasshopper and they made perfect sense to you back then but now that you’re an adult you’ve got more experience and you’re able to take different perspectives your brain is more developed let’s take a look at it and see if you can look at different perspectives and come up with something a little more helpful maybe a different way of perceiving this situation the irrational irrationality or unhelpful Nosov Fox comes when those beliefs are perpetuated without examination so something a belief that you formed when you’re five you’re still holding when you’re 35 and you’ve never questioned it you’ve never gone you know does this make sense is this is helpful to get me to where I want to be most of us don’t know we form these attitudes and beliefs when we’re you know growing up when we’re in elementary school middle school high school from watching TV to being around our peers from being around our family in our community and we get all this input of the way things should be and a lot of times people don’t stop to question and go and go well does this make me happy is this really what I want and they can be irrational if they continue to be held despite causing harm to the person so the person continues to hold this belief even though it is causing them general emotional cognitive harm is making them miserable we need to look at why what’s motivating them to hold on to that belief why is that belief so important and how can we make it so they can live a happy values-driven life emphasis on the happy how can we make it less harmful sometimes it’s more productive for clients to think of these thoughts as unhelpful or helpful instead of irrational sometimes when I say irrational to clients and you know I’m the same way if somebody says you’re being irrational I’m like oh I’m not it elicits this instantaneous defensive reaction it’s like when you tell them they’re being resistant they’re like I am NOT rien resistant so helpful or unhelpful and then we talk about why it is unhelpful in getting them toward their goals basic principles of cognitive behavioral therapy we teach or help clients learn to distinguish between thoughts and feelings I can think something is scary I’ll probably feel it but if I have an automatic you know feeling I walk into Atlanta Airport and I see yeah I went to an airport in New York I can’t even remember which one it was because my plane was diverted and I got off and I walked out there and I have never seen so many people packed in his place like sardines before in my life I was just completely overwhelmed that was kind of an automatic feeling now that was a feeling based on you know who knows it was overwhelming to be surrounded by that many people so then I had to separate the thoughts and go okay what am I thinking that’s making me feel so overwhelmed and at that point you know I didn’t know how to get to my gate and all that other sort of stuff with traveling I don’t travel well but encouraging clients to stop and go okay why am I feeling this way what are my what thoughts am I having that are contributing to these dysphoric feelings CBT helps people become aware of how thoughts can influence feelings in ways that are sometimes not helpful we have hecklers in our gallery the automatic tapes that we plaything memories that we have whatever you want to call them that when you try something when you are just going through daily life you hear these voices in the back of your head and not real voices but that is saying you’re never going to make this or if you would have just blah blah blah then you’d be a the better person helping clients become aware of those thoughts and how they’re negatively influencing their feelings and keeping them kind of stuck is a huge part of CBT we help them learn about thoughts that seem to occur automatically without even realizing how they may affect emotions again those thoughts from they’re saying you’re not good enough you’re not smart enough and nobody’s gonna like you where did that come from and do you believe it you know maybe it came from somebody when you were in high school so was that a valid source maybe it came from somebody yesterday on Facebook was that a valid source taking in those thoughts and then figuring out is this something I’m going to hold because it makes me happy or is this something that I’ve got to deal with because I’m having a negative reaction constructively evaluate whether these automatic thoughts and assumptions are accurate or perhaps biased the other thing to remember is a lot of our clients not all of them but a lot of them hold themselves to a standard there’s like up here and they hold everybody else to a standard that’s down here so they are a failure if they don’t achieve this but everybody else is successful as long as they achieve this so encouraging them to take a look at how accurate and biased or unbiased are the thoughts and like I said they may be their thoughts they may be telling themselves these things evaluate whether the current reactions are a helpful and good use of energy or unhelpful and a waste of energy that could be used to move toward those people and things important not impotent important to the person road-rage you’re in the car you’re driving somebody cuts you off okay natural reaction fight or flight reaction you’re just like slam on the brakes and do whatever you got to do aversive maneuvers you’re good so you could let it go at that point ago got Lucky on that one and keep driving most people not all but most they found that 80% of drivers have reported incidences of road rage which is a high number but most people will start getting all fired up and irritated and grumpy and we and just rageful and so my question would be I hear that and I hear that it made you angry in retrospect did screaming at the person as you pass them at sixty miles an hour in your car with the windows rolled up does any good did it do any good at all what else could you have done with that energy if you wouldn’t have expended it all yesterday we had to wait for the vet to come by and my daughter just completely wore herself out worrying about when the vet was going to get there what he was going to say about her donkeys and was beside herself so by the time it got to evening and it was time for her to go to her martial arts class she didn’t have the energy to go she’s like um wiped out I just want to go to bed in retrospect we’re looking back and saying okay now tell me what it was that you were so stressed out about and let’s talk about whether that was a realistic and helpful line of thought to perseverate on all day long and what could you have done differently because she didn’t bother to mention any of that to me yesterday and then developed the skills to notice interrupt and correct these biased thoughts independently causes of these thinking errors information processing shortcuts when we form schemas and we encounter a situation that reminds us of something in the past like when I go to my grandmother’s house I have a schema I have a belief system I have you know stuff that I know about my grandmother’s house so when I go to my grandmother’s house it’s kind of a shortcut to knowing what to expect when I walk in and how to behave how to do different things and it helps me plan and predict if you’re using outdated or dichotomous all-or-nothing schemas it may cause thinking errors because you may be now incorrectly processing current events mental noise some of us have it a lot of us have it not everybody thinks about trying to focus and study for a final exam in the middle of a really busy sports bar okay this is a cause of thinking or you’re going to miss important things you’re not going to be able to focus you’re not going to necessarily attend to the correct things because there’s just so much else going on your attention is drawn in 17 different directions and or the brain’s limited information processing capacity due to age we talked about that before young kids think all or nothing they think dichotomously egocentric ly middle school-aged kids and older start developing the ability for abstract thinking, by the time we get older, you know as adults theoretically we’re able to you know think pretty well and think pretty clinically about different events but if we’re in crisis when someone is in crisis and it could be like what we think of clinically as a crisis or it could be they’re just completely overwhelmed and burned out and have been burning the candle at both ends for three months they’re not going to process information quite as well they’re not going to take in all this stuff because they’re just like shell-shocked have you ever seen teachers in the hallway of like an elementary school Oh at the end of the second nine weeks they just kind of stand there with this blank look on their face they’re not processing as much as they were the first day of school and you know God loved them they have a lot to deal with but we need to help our clients understand that there are some times that they are going to have to really stop and focus write things down so they can remember or they can make decisions a little more my guess is most of us have times in our life when we’ve been able to think through complex problems but then there are other times where you just can’t keep it all in your head and you’ve got to put it on a whiteboard maybe that’s just me but we want clients to understand that they are not broken they’re not faulty they’re doing the best they can with the tools they have and the knowledge they have and our job is to help them see where some of this might have gone a little awry other causes of thinking errors and emotional motivations I feel bad therefore whatever I’m thinking must be bad if I’m scared that means whatever it’s coming on the other end of the phone is bad news moral motivations I did it because it was the right thing to do and that can be an excuse for doing wrong behaviors as well it can also be you know you can argue on the moral one social influence well everyone else is doing it so it must not be bad set that again a lot of times and this is where the frames approaching the motivational interviewing is helpful f stands for feedback about the reality of what’s going on is everybody doing it let’s look at statistics you know not subjective information let’s look at objective information so the impact of these thinking errors makes people want to fight or flee when they get upset and we use upset as a kind of this all-encompassing garbage term emotionally they get depressed or anxious we don’t want to feel that way anxiety and anger are flee or fight fight or flee it’s our body saying there’s a threat you got to do something depression is your body going I give up I just don’t I don’t even have the energy to do it anymore behaviorally some people withdraw because they shut down we all know people who get frustrated when they get overwhelmed when they start feeling hopeless or helpless they just kind of withdraw from everything and everyone’s addictions numb that out so they don’t have to feel the dysphoria sleeping problem and changes when we start being on that constant fight-or-flight hyper-vigilant sort of thing going on in the body is always sort of turned on which means you’re not going to sleep as well then the circadian rhythms get messed up which starts causing exhaustion and lethargy and then everything seems harder because you’re sleep-deprived and then you start thinking more negatively and more hopelessly you see where this is going it’s a downward spiral and eating changes some people eat a lot more because they’re eating comfort foods some people eat a lot less because their stomach is so torn up from the stress they can’t even think about holding anything down physical stress-related illnesses fibromyalgia gastrointestinal problems headaches neck aches backache you know the whole the gamut of it when you start feeling bad when you start hurting generally it gets frustrating after a while and that frustration makes it kind of raises the the bar brings you up a little bit so you’re that is much closer to kind of just kind of being overwhelmed you don’t have as much of a cushion as you would if you were happy healthy well nourished not in pain and socially a lot of times we will get irritable or impatient with other people or withdrawal when we’re having these negative cognitions these thinking errors that are keeping us in a dysphoric state these effects of thinking errors contribute to fatigue and a sense of hopelessness and helplessness which intensifies thinking errors this is an important concept that I want my clients to understand and I want to drive home in this presentation so thinking errors what are they emotional reasoning feelings are not facts and we want to help people to learn to effectively identify feelings and separate them from facts so if somebody says I’m terrified okay that is a feeling what are the facts supporting that feeling why are you are terrified what is the evidence that you are in some sort of danger right now you know and danger may not be the right word for your client at that a particular point in time but what’s the evidence that there’s a threat in what ways is this similar to other situations maybe it’s triggering something from the past that was scary or you know you were too little to be able to handle it but you can handle it now and how if you dealt with similar situations like this, in the past, we want to help people just step back and get some distance between their feelings and their thoughts and try to figure out you know which thoughts are helpful and productive and even if a sought makes people anxious or angry it can be helpful it may be telling them hey dude you need to get your butt up and get out of there if it’s helpful it means it’s moving them toward where they want to be happy healthy safe and values-driven life so happy and helpful developed a stress tolerance skills when people use emotional reasoning they feel emotions which then they start attributing finding the facts to support those emotions instead of looking at all the facts we want to help them learn to tolerate their distress so they can kind of let that subside for a second they can accept their feeling they can name they can say I’m scared I’m stressed I’m angry and whatever but they don’t have to act on it right then they can tolerate the distress for a minute without having to try to make it go away and emotional regulation skills they can feel a feeling without having to make it go from zero to 120 you know if they feel sad they go I feel kind of sad instead of grabbing onto it and going I wonder what I feel sad about I must feel sad about all these sad things now I’m going to be sad and devastated so we want to help people learn how to regulate their emotions identify them accept them whatever word you want to use and tolerate them because feelings are there for a reason they’re there to tell you your brain thinks something’s going now thankfully we have that higher-order cognition stuff going on so we can contradict our brain and we can go you know maybe that’s not true in this situation cognitive bias negativity mental filter whatever you want to call it people who focus on the negative they walk in they get up in the morning and they look outside and it’s partly cloudy they get to work and they said instead of saying there was it was very light traffic they said there was a fair amount of traffic everything is always the flip side of what somebody who’s optimistic would say so asking them what’s the benefit to focusing on the negative in what ways is this helpful to you you know some people say well it keeps me from getting disappointed because I know it’s going to end up negative anyway so we can trap challenges that know that whatever it is they think they know and see if there have been exceptions when it hasn’t turned out that way what are the positives to this situation I give the example a lot of you know I wash my car or it rains and maybe I wanted to go out on a run that day but I can perceive it I can look at the positives you know the rain washed my car for me so I don’t have to do it now score it watered my garden all the better it knocked down some of the pollen out of there even better I can find and I can encourage people to find positives in a situation yes there are negatives there are negatives to every situation if you want to find them you’re going to find them but if you want to find the positives you can too which takes us down to what are all the facts there’s the positive and the negative and the neutral I told you earlier about the coin toss activity having people toss a coin on the heads days they act like it is just the greatest day to be alive and see how things are different when they do their journal because you know I have my clients do I’m sort of a mindfulness check-in in the morning and in the evening and preferably at lunchtime how are they feeling what’s their emotional state what’s their energy level on the happy days a lot of times it can be less and sometimes they need a little coaching throughout because some of those old patterns kick in but I want them to start challenging some of their automatic thoughts that we’re going to talk about in a minute disqualifying or minimizing the positive most of us can probably say we’ve had a bunch of clients that do this they are more than happy to tell you about all the things that they mess up but then when they do something right they minimize it encouraging people to hold themselves to the same standard they would hold everyone else to and I know I talked about that earlier ask them things like would it minimum would you minimize this if it was your best friend’s experience your best friend came to you and said I just got into such-and-such college would you say awesome or would you say anybody can get in there how would that go ask them what is scary about accepting these positive things that you might have had an accomplishment for some people it means that it might mean other people expect more of them for other people they just don’t know how to accept the positive they don’t know how to accept compliments they don’t know how to be the center of attention and they don’t like it and then we want to look at why that is sometimes we disqualify the positive because it fails to meet someone else’s standards so as people might that be true here you know I know when I was growing up and going through college and going through school and everything got my doctorate but I will always be ever and always being not a real doctor because a Ph.D. is not an MD and I’m like really so is it somebody else’s standards or can I feel good about having a Ph.D. egocentrism my perspective is the only perspective I’ll being egocentric but it doesn’t work most of the time so encouraging people to take alternate perspectives maybe you’re texting with someone and they say something that is not that you interpret as not the nicest thing and this happens in text messages a lot and they get upset now an egocentric thinking error would say that purse is just grumpy today someone that’s taking other perspectives would stop and go back and read the text and go I wonder if maybe this could have been taken some another way you know cuz their reaction is not what I intended so egocentrism if you hold on to that I don’t understand anybody else because you know I don’t see a problem with anything personalizing and mind-reading this is when you assume that everybody’s frowning because of something you did your boss walks down the hallway and looks at you and grimaces and continues to walk on oh I must have done something wrong no maybe he just got out of his senior management meeting that was five hours long and he’s got to go to the bathroom you know there could be a hundred different explanations for why that happened so encourage clients to ask themselves what are some alternate explanations for this event that doesn’t involve me you know why might this have happened if they hold on to that, I must have done something wrong but as soon as their boss calls them up and goes hey can you come to my office for a second you know where their thoughts are going to go I’m getting fired I’m going to get laid off I don’t know what it was that I did wrong but he walked by me two weeks ago in the hallway and grimaced and I’m just I’m the worst person in the whole world but where did that come from so encouraging people to not necessarily assume they know what’s going on in someone else’s mind and not automatically attributing every person’s negative behavior to something they did how often and then ask them how often has it been about you now think about the last 10 times you’ve taken something personally how many of those 10 times has it been about something you did versus something with the other person then the availability heuristic remembering what’s most prominent in your mind so asking clients what are the facts ah the most obvious one that we talk about is plane crashes you know it is way dangerous to fly on a plane because you hear about all those plane crashes well yeah you hear about A few planes crash but you don’t hear about the 20,000 every day that land safely so you remember it and it seems more dangerous because that’s what is in your mind that’s what is available to you that’s what you’ve based your thought processes on because maybe you didn’t know that 20,000 planes or more fly and land just perfectly every day this can also be true with people remembering what’s most prominent in your mind sometimes and this can be very very true in domestically violent relationships if somebody falls in love with someone and that person is just the greatest person since sliced bread for the first four months and then the cycle starts and there’s this little tiny a sliver of the honeymoon period after the battering cycle and the person’s like that’s the person I fell in love with that’s what I remember and they try to focus on that that’s most prominent in their mind and they ignore the rest of the stuff so we need to encourage people to look objectively at the facts magnification are you confusing high and low probability outcomes what are the chances that this is going to happen how many clients have we worked with that have gone to the doctor and gotten in a physical or get a test run and then the doctor had to call them back and this could be true for you too and the doctor had to call them back two or three days later when the tests came back from the lab and that whole three days they were just in a panic because they were afraid they were going to get some terminal diagnosis so thinking about high and low probability outcomes another instance or example of magnification is somebody that thinks this is the end of the world whatever it I think I’ve told you before my little story about um tripping when I was walking down the hall at work and falling and yeah it was embarrassing my folders went everywhere and yeah but in that big scheme of things will it matter that much from now you know are people gonna think oh she is such a clutch she must be a ditz too no I mean they may have thought that at that time I don’t know but you know in six months nobody’s going to remember and then ask them in the past when something like this has happened when you’ve had to get a test done and you’ve had to wait on results or if you’ve done something that was embarrassing and you didn’t think you thought everybody was going to remember it forever.

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How did you tolerate it how did you learn to deal with it building on those strengths that they already have all-or-nothing thinking errors these are things like love versus hate I love them or I hate them it’s all or nothing she does this all the time or she never does it if I’m going to do it I’m going to do it perfectly or I’m not going to do it at all thank you all good intentions or all bad intentions you know sometimes we do things with good intentions that have some bad repercussions so did we do it with all bad intentions are all good intentions and the answer is neither most of the time life is kind of in that middle-ground gray area encouraging clients to look and find examples where something hasn’t been one of the polls when having they do something that they’re proud of that wasn’t perfect or when again when has somebody else do something that they were proud of that wasn’t perfect remembering that with availability heuristic remembering how often something happens and how long it’s been since you’ve seen that behavior and remember that sometimes good times are amazing but how frequent are they compared with the bad times another thinking error is a belief in a just world or a fallacy of fairness I just asked clients to identify for good people you know who’ve had bad things happen and in reality we all have bad things happen good people do bad people do in between people do attributional errors and this is a pet of mine you know labeling yourself is not a behavior so global versus specific and I am stupid versus I’m stupid at math I don’t have good math skills it’s not about me it’s about the skills I can change skills stable I am and I always will be versus it’s something I can change it’s something I can learn internally it’s about me as a person versus it’s about a skill deficit or something I could learn or change and there’s you know lots of information on attributions out there on the internet if you need a refresher on it but we find that a lot of people who have dysphoria have negative global stable internal attributions so questions for clients remember the beliefs equal thoughts and facts plus personal interpretation another way of saying it is reality is 10% perception is 10% reality and 90% interpretation so what are the facts for and against my belief is the belief based on facts or feelings does the belief focus on one aspect or the whole situation does the belief seem to use any thinking errors what are alternate explanations what would you tell your child or best friend if they had this belief how would you want someone to tell what would you want someone to tell you about this belief so if you’re telling somebody about this what are you hoping they’re going to say in return and finally, how is this belief moving you toward what and who is important to you or moving you away from what or who is important to you now they can do a worksheet and have all of these or you can pick one or two of these questions that are most salient for your clients but they can have kind of at their fingertips so as they’re going through the day and something happens they can ask themselves ok what’s an alternate explanation or you know whatever it is this is salient for that client’s irrational thoughts about how to do these thoughts impact the client’s emotions health relationships and perceptions of the world you know this is what we want to ask them how is this thought impacting you globally how may this thought have been helpful in the past where did it come from how does it make sense from when you formed it in the past when you’re dealing with it ask the person if the thought is bringing you closer to those that are important are there any examples of this thought or belief not being true and how can the statement be made less global less all-encompassing so it’s about a specific incident a specific situation less stable which means you can change it and less internal which means it’s not about who you are as a person but maybe something that you do or a skill that you have so we’re going to go through some of these thoughts real quickly here mistakes are never acceptable and if I make one it means that I’m incompetent well never is kind of stable and I am incompetent is kind of global, that’s also that extreme all-or-nothing thinking so you can see where these cognitive distortions end up leading to unhelpful beliefs when somebody disagrees with me it’s a personal attack well there’s personalization if I ever heard it before maybe it’s not about you may be they’re having a bad day and you just happen to be the unlucky target or maybe they’re disagreeing with you because they have a different point of view and it’s not a personal attack it’s just their point of view if someone criticizes or rejects me there must be something wrong with me personalization all-or-nothing thinking global stable and internal something wrong with me as a person to feel good about myself others must approve of me now this is one we’ve talked about external validation before and we can’t control other people to feel good about yourself how can you do that besides necessarily requiring other people to approve of you to be content in life I must be liked by all people Wow I’ve never met anybody who’s liked by all people I’ve never even met anybody who’s been hated by all people but it’s important to help clients see how this is dramatic to say all people and for them to be content then everybody has to like them I mean I like to be liked but if everybody doesn’t like me you know that’s pretty understandable my true value as an individual depends on what others think of me I would challenge this one this is all you know also, very personally internally I would challenge people to look at and say it so your child’s value as an individual depends on what other people think of he or most people would say no but the perspective thing nothing ever turns out the way you want it to okay all-or-nothing thinking and probably availability heuristic if something bad just happened then they may be focusing on that which causes them to focus on all the other bad things in the past that have happened not to focus on that is okay you know bad thing happen but look at all these good things I won’t try anything new unless I will be good at it this fear of failure fear of rejection it just really paralyzes a lot of people when they get stuck with that thinking the area that they have to be perfect I am in total control of anything bad that happens is my fault well that’s egocentric and personal if they think they’re in total control that’s their perception of how the world are they think if they’ve got everybody on marionette strings anything bad in the world that happens is their fault how powerful are they I feel happy about uh if I feel happy about life something will go wrong it happens sometimes but let’s look at times when you’ve been happy that something hasn’t gone wrong you know let’s get rid of that all-or-nothing thinking it’s not my fault my life didn’t go the way I wanted could be true but it seems like that’s making you unhappy so what do we do about that if I’m not in an intimate relationship I’m alone no, again that’s pretty extreme I’m either in an intimate relationship, or I am alone and a loner and you know it’s just me and my 17 cats which follows with there’s no gray area so encouraging people to look at what these beliefs are saying important thoughts impact behaviors and emotional and physical reactions emotional and physical reactions impact thoughts and interpretations of events so if you do something and it’s pleasurable and you have a great physical reaction you know let’s take bungee jumping or skydiving if you go out there and it’s scary but you do it and you’re just like whoa what a rush your interpretation of that is probably going to be good which means you’ll probably do it again if you go out there and it’s just the most horrible experience you’ve ever had you’re probably not going to do it again and your interpretation of it is going to be not good which is going to make it hard to understand why other people would do it irrational thinking patterns are often caused by cognitive distortions so let’s just look back at some of those because there are a lot fewer cognitive distortions or general ways of thinking about the world then there are thinking errors because there are lots and lots of thinking errors cognitive distortions are often schemas which were formed based on faulty inaccurate or immature knowledge or understanding and by identifying the thoughts of the hecklers you know the automatic tapes that are maintaining our unhappiness the person can choose whether to accept those thoughts or change them

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Study with me 24h before my FINAL EXAM (med school vlog)

Hello Kermamedic friends here, and welcome to a new potion… Finally, here it is! In a previous video of my Oski exam in the Faculty of Medicine, I announced a major event in the future. Today is tomorrow!! Let me show you something. That’s what the last two weeks have been about. And tomorrow is Oski’s day. This is Oski’s final week in medical school. The biggest, hardest, most notorious, anxiety-inducing test. … Is tomorrow…And I want to tell you that I have lost the will to live as well as the desire to study for this exam. I am okay You’re done, boy. You’re done. So well, honestly, those last two days have been a solid, rigorous study and I got through it and that’s why I don’t plan on doing that much studying today at all. I have a list of a few things that I still need to reconfirm and after I’m done I have to go through this list I just want to go over the 4 main exams, abdominal scan, cardiovascular, respiratory, cranial nerves, and motor exams of the upper and lower extremities because they are very likely to Come on the exam so I’m going to do it one last time to be in the best shape I can and well and that’s pretty much it after that I’m going to the gym for gym and then I’m going to play video games with my sister and I’m going to rest and relax because I’m over it and I’m almost done I want to…. ah ah Scream, this is what we’re going to do. We’re not going to think, we’re just going to stop thinking I’m going to study another day and I’m going to start studying today and I’ve got some delicious strawberries and I’m about to get some coffee, and let’s do this. Well, let’s do this, put the phone on silent. And we throw him on the bed again, like the last time I was preparing for OSCEs in the fourth year, and if you haven’t seen his fluke I advise you to see it I like it very much and I will put it for you here and I use this book and it is my main and it is completely falling off let me show you as you can see All the pages are falling off and I’ve used and benefited from this book very well so the first thing on my list and I’m going to learn about it are decisions and directions that you can make in advance about your treatment in case of future aphasia and not being able to make those kinds of decisions on your own so I’m going to read this and then Moving on… { …………. ……………… } Today is Mother’s Day in the Arab world so we sent my mom some The flowers and the card she had just received… and I’d run back to her..and say, “Have a nice day.” Anyway, we’re back at work. So I spent about an hour studying. It’s all over for that first little sticky note here. I’m just going to get rid of it and throw it away and now I have this second sticky note with things on it that I didn’t know would make it into the exam until my good friend Georgina told me about it yesterday. This is what we will study now. One of those things is a C spine imaging or C spine X-ray. I’m going to see a random YouTube video about that if you’re wondering what this thing is right here on the side screen on the iPad here. This is a video game that I’ve been running in the background doing something very weird, not necessarily fundamental so I can stay sane here and make my time at this desk more enjoyable. It’s kind of like an incentive for me to sit here and study and every 10 minutes or so I click here a little bit, play a little bit of this game and that’s what’s kept me up for the last day. It is what it is. Anyway, without further ado let’s watch this video and take some notes Honestly, I can’t stress this enough. If there’s something you don’t understand or something you’re learning for the first time, I find watching YouTube videos to be the best way to do it. These are the people who have already learned the thing you are trying to learn and are now trying to explain it in an easy-to-understand way with all kinds of beautiful pictures, maps, locations..etc. This is often much easier than your 50-minute lecture I’m sure many 50-minute lectures cover cervical spine X-rays but you know a lot of detail is going to come out and a lot of research and history coming to where we are now I want to know how to interpret C spine X-ray and spine X-ray. So this is what I need… Well, I’m going to present this as if today is the exam I’m looking at the spine C and the x-ray of patient John Smith a large man of fifty-five years old who was coming to the hospital OK the patient history record and communication is two parts of the Oski exam. We also have things like exams, procedural skills, and assessment stations. So it all involves doing hands-on things with our hands talking to patients and examining them with things like a stethoscope and a tendon hammer also and please avoid everything you see here the exam is tomorrow I don’t want to clean my room right now.. if you recall, inside some of my previous vlogs was We have Sonic the Hedgehog, this big damn game that I can check out and it was actually really useful but I just threw it in the trash. So that’s why it’s gone but instead, what we have is Mr. Chair, oops let me get a patch I found ok Mr. Chair so Mr. The chair is 24 years old and he presented to the emergency department with severe shortness of breath. So I’ll check it out and mark the screen and hope I don’t miss anything. Practice exam skills. What’s funny about this, my friends is that: when we first started preparing for the OSCII exam in year 2, in fact, you probably already knew this if you were watching my videos at the time, I used to complain a lot about the six-minute timer we have to complete these exams is too short and how can we do All we need to do in the six minutes they give us and now when we practice for these exams as final year medical students we only pass it in one minute and sometimes even a minute and a half depending on the exam it’s terrible when you think back on it but I think it’s a testament to show That practice makes perfect. Keep working on something..you’ll get better at it, etc..so let’s get started, and study for the exam Hello good morning, my name is Nasir and I’m a final year medical student in the emergency department I’m going to confirm your name and age please my name is Mr. Chair, I’m 24 years old Hello Mr. Chair, nice to meet you today. I’m going to check your lungs. This would include looking, listening, and examining your hands, your face, and your chest. Is that OK? Yes, sure, well, thank you very much, just to explain a few things to the examiner with me first, if that’s possible. Thank you very much, Mr. Chair. Thank you very much. So, we have a minute and a half left on the timer. Assuming I haven’t missed anything major which is always possible. Let’s go to the marking chart and have a look at, the introduction – patient details, cones, screening of cervical lymph nodes aahhh check the lymph nodes in the back of the patient and feel for the supraclavicular nodes here…… Then we go to the submandibular salivary gland in front of the ear note; Don’t forget to check the lymph gland ooh oh yeah Fremitus Vocal 99 99 99 When you are listening to the patient’s chest in all the different areas you are supposed to listen to him again and ask him to say 99 99 99 99 99 This is a test called Acoustic Fremitus. And if you have coherence or a lump in the chest, then the sound will travel better, so you’ll hear 99% louder over the areas where there is reinforcement versus those where there isn’t, so this test!! Well, I remembered almost everything pretty much I didn’t do a fremitos audio 99 99 and check the lymph nodes and in my humble opinion this would be easy with the station and then of course you have to summarize your findings and you have to report this to the specialists etc. And if you forget these two things. It’s okay, it’s not the end of the world. Well my friends, what’s the deal? With every check I do, it is expected that I will forget some things that are OK. But I have to reduce the number of things I forget. And that’s why we do the exercise. This puts in the big picture. Missing a few things on an exam is expected. It won’t be the end of the world. It certainly won’t let you down. But I want to forget as few things as possible. Hours later, we’re about to get to 1 pm. I have just written down in my diary all kinds of major steps and special tests that are done in all the musculoskeletal, shoulder, ankle, hands, and then also peripheral arterial and vein disease examinations and I feel ready. I feel good. Honestly, I don’t think I would do anything else.

Study wise for the rest of the day I’m going to ask Kenji and Georgina if either of them is rehearsing history to rehearse for a day earlier and later, but other than that I think I’m done with a very nice sunny day today so I’d like to enjoy that at least a little bit. I want to go to the gym, and maybe also play some video games with my sister in the evening. Just relax, take a break, and calm down before the est date. So I’ll get some food, get some lunch, and yeah, we’ll get on with the day. I try to relax and take a break, and tomorrow is tomorrow… When testing, we have to look our best and that means clean shaven and then some formal wear with a shirt. Then confirmation. I have to get all that fluff out and trim those lines a little bit. Let’s do it I don’t know why I would, if I would wear a mask all the time. It won’t make much difference but if you look good, you feel good and it generally gives you confidence. Therefore, I think it is worth it. I am surprised that this camera has not fallen so far, as it is a bit of a miracle. Well, we’re all done. Let’s get some food. Good. We’ll make ourselves lunch. And we’re going to watch the new episodes of Top Boy it’s awesome and as you all know, this is my favorite eating stand that just brings things together and makes everything so much more convenient. It makes me look like a grandfather..That’s the way it is. Sit back, relax, and enjoy the show. By the way, bye to the moderators, not to spoil the show. Hello my friend how are you? Good, and you? I feel like your laptop will fall off the table, not that it is fixed with a stand on the back. Hello, Massad Al-Khair, my name is Nasir Kharma and I am a doctor here. Can you say your name and age, please? My name is Paul and…………!! Well, on my way to the gym, look at the beautiful weather we had here last week. Alas, I have been confined at home studying and preparing for the exam but I kind of went to take advantage of this once the exams are over anyway let’s start with the exercise step the stress of sweating just to rest and rest my head and I’ll see you in peace oh well this is well first day one of my friends, I’m just waiting outside the site which is a very nice place I got myself a quick coffee and my general plan is to get in at the last possible second. To listen to my music as often as I can. That’s what I’m going to do for five minutes and then I’m going to the hall for the exam and I have to take the electronics so I can get in afterward And I’ll see you after that Peace….Oh my God Oh my God Well day one is done I’m not going to lie It was a lot more complex than I thought It wasn’t as straightforward as previous OSCE systems. I believe they deliberately tried to deceive us when going to the Respiratory Check Station, which later turned out to be the ATP Station. Well, then there were other stations where the wording was completely unclear. A lot of students complained about misunderstandings, what they wanted us to check, or what they wanted us to do, and they came and took feedback from all of us on how to change the wording moving forward. So you could have done a better job. But that’s okay, I wasn’t feeling great about two of the six stations we had today. Then there are six more stops tomorrow. But once I get the written feedback from the examiners, I guess it kind of puts me at ease. The comments there were much better than I thought I did I’ll be fine. Anyway, that’s it. The first exam is over and another one is tomorrow. We have to start at 8 am and we have to stay until 11 am and then we do the exam and we are quarantined again until 1 pm until other students are counted in other universities around London and so we stay in quarantine and so that the information is not shared outside I think that’s good I think it good. I think it’s good. This is the end of my walk after the exam… I’m going home, I’m going to do some prescribing practice for today only, it’s possible to take one exam like this and nothing more than that I’m going to sit with Nour, it was very fun yesterday Anyway, see you my friends, peace… … Hey my group (my friends) I’m home on the couch, just chill out and relax a bit. I m going to call Kenji and Georgina just to debrief about the stations we had today and the exam, talk about it a bit and get it off the chest and then maybe do a little practice description. I think I’ll finish it there I’ll pick up the camera again When I start calling it aits me that this is almost over as if medical school and university are finally almost over. Mad madness, well see you in a little while..well, to PDF H 32 or 32, Article 32 or Page 32? Article 32….! Well, let’s say guys, last said before, more studying today won’t make any difference for today. And I think more study won’t make any difference at all for tomorrow. So we’ll end it here. It’s five in the evening, I’m going to rest and pack my bags. I’m ready to fly on Thursday early in the morning. So I can go out and celebrate tomorrow evening with everyone and I won’t have to pack for travel, and yeah, that’s what we’re doing for the day..almost done. See you guys in a little while, Hello, Alright, so I’m going snowboarding tomorrow, not the day after tomorrow with about 10 of my friends from high school to celebrate finishing medical school, hopefully finishing medical undergraduate and all is well Alright tomorrow (let’s grab the wood) But let’s get started Time is running… Well, I’m packing up. It’s pretty much there. I just need to put some last things in tomorrow. Now it’s time to sit down with Noor… and play an episode of Eldon for a few hours. To relax and enjoy the night and that’s it. I’ll see you, my friends, tomorrow morning. Good morning and welcome to the day of the second OSC exam… I will be in a different location today, I am on the train and they separate us in different locations as Kings College London students so that we can see different examiners with different groups and things like that. It’s very popular this video of me releasing it tomorrow I put it on Instagram now I’m simply trying to relax as much as I can for a bit, before the exam I come early and I have some time, … Hello … oh still filming … we are back on the youth campus. I guess today didn’t work as well as yesterday. I think there were a couple of stations that I found challenging and I don’t think I got the intended diagnosis in the end. But I hope my communication skills and everything else in history taken away will make up for it. But anyway, I wouldn’t think about it. I just had a meal with Aaron and Georgina I’m going to put the picture here..now I’m going to go to a coffee shop there and meet some friends to rest and breathe it’s been almost a week since I last logged in I forgot to close the blog and I just realized I hadn’t done it yet during this time I went skiing In Austria I came back..and surgery started this morning, I get up at 5 am everything was so crowded, but that will be another day for Flock. I just want to thank you for taking the time to watch this video. I hope you enjoyed it. And if you enjoyed. it…. please don’t forget to like it and subscribe to my channel for more content to come in the future. And I’ll catch you on the next one, …..Peace…….. I’m done…. peace…… Hello friends Next peace, What’s up guys You’re right. As found on YouTube The Destroy Depression ꆛ System-Cure Depression Naturally YOUR DEPRESSION HAS BEEN IN CONTROL LONG ENOUGH. It’s Time to Fight Back ☂🗯 “Depression Sufferer Of Over 20 Years Reveals His Simple 7-Step System That Gives You The Power To Destroy Your Depression, End Your Feelings Of Sadness And Hopelessness, And Get Your Life Back.” “This didn’t just change my life, it saved my life.“

Herbal Tea Update: Rooibos & Nettle

“Herbal Tea Update: Rooibos & Nettle” Rooibos, or red tea, is anecdotally reported to aid stress-related symptoms but has none of the mood-altering phytonutrients thought responsible for the increased calm and decreased stress after drinking green tea. So, why do some people feel less stressed drinking red tea? Well, researchers recently found human adrenal gland cells in a petri dish produce about four times fewer steroid hormones in the presence of red tea. Yes, this could quite possibly contribute to “the alleviation of negative effects arising from elevated [stress hormone levels]” if it damped down adrenal function that much in real life. But, the effect was so dramatic they became concerned it might adversely affect the production of sex hormones, as well. But, that’s not what they found when they tested it on “human test subjects.” The same may not be true, however, of nettle tea. Nettle is used to relieve symptoms of prostate enlargement by boosting estrogen levels. But, men drinking too much may grow breasts, and women may start lactating. Nettles are often picked wild, so there’s always a risk that someone might accidentally pick something like this, instead of this, and come down with atropine poisoning because the nettle tea you thought you were drinking had some belladonna (deadly nightshade). Also, not a good idea to put the leaves in your mouth fresh. They don’t call them stinging nettles for anything This is a close-up of the impalement of a nettle spicule in the skin— not something you want your tongue. Nettle tea is touted for its high mineral content, which always seemed kind of strange to me. I mean, yes, if you boil dark green leafy vegetables long enough, you do lose minerals in the cooking water. But, how many minerals could we be getting if we just steep some tea? We never knew because it hadn’t been tested—until now.

They compared the mineral content of nettle tea to chamomile tea, mint tea, St. John’s wort, and sage. Nettle tea didn’t seem to have much more than any of the others— but, maybe they’re all high? Well, one cup of nettle tea does have the iron of a dried apricot (that’s more than I expected), the zinc found in one pumpkin seed, one-twentieth of a mushroom’s worth of copper— but four peanuts’ worth of magnesium, and an entire fig’s worth of calcium. I agree with the researchers that, you know, a cup of herbal tea may not be an important source of minerals, but it’s not negligible. You know, greens are so packed with nutrition that you can benefit from just drinking some hot water they’ve been soaking in for a few minutes. As found on YouTube The Destroy Depression ꆛ System-Cure Depression Naturally YOUR DEPRESSION HAS BEEN IN CONTROL LONG ENOUGH. It’s Time to Fight Back ☂🗯 “Depression Sufferer Of Over 20 Years Reveals His Simple 7-Step System That Gives You The Power To Destroy Your Depression, End Your Feelings Of Sadness And Hopelessness, And Get Your Life Back.” “This didn’t just change my life, it saved my life.“

7 Reasons Why You Feel Emotionally Numb

Hi Psych2go family. Have you ever felt emotionally empty before? Or do you just feel empty sometimes? You don’t feel sad or depressed, but you have trouble feeling anything. It’s hard to connect deeply with other people, and you feel isolated from those around you. lost yourself Have you forgotten your goals, passions, and values that make you who you are? You may have lost touch with your inner world, and even dislike the person you’ve become Losing yourself and where you want to go in life can throw you out of control You may be having difficulty processing so many emotions, such as frustration, loneliness and despair all at once, and you end up feeling nothing 2. You are dealing with some mental illness Emotional emptiness is one of the symptoms of mood disorders such as depression, bipolar disorder, dissociative disorder, and trauma-related disorders For example: if you suffer from dissociative disorder, you may experience a loss of your body: feeling that you are not in control of your speech and movements You feel empty in your senses, and emotionally disconnected from the people around you 3. you’ve been through something traumatic When you experience trauma, it’s not uncommon to feel emotionally empty It’s a way to deal with feelings of helplessness, shock, confusion, and anxiety It sounds like a way to protect yourself and gain emotional relief, but it’s not a healthy and effective way to deal with the emotional damage caused by trauma 4. You are recovering from abuse Have you ever been abused by your parents, family, friends, or a partner? Whether physical, emotional, verbal, sexual, or psychological, any type of abuse can do a lot of damage to someone’s mental health. According to a study, abuse can negatively impact your ability to regulate and understand your emotions. way to cope with the stress and pain of being abused 5. you are grieving a major loss Have you lost someone you love? Or are you dealing with the loss of a relationship? Feeling emotionally empty is part of the grieving process Denial is the first stage of grieving and an important step towards acceptance you are stressed all the time Are you always overwhelmed and stressed by work or school? Feeling so much stress all the time can lead to an emotional breakdown which is a negative state of mind, associated with chronic fatigue, problems with creativity and concentration, and loss of interest and motivation.

An emotional void 7. you take too many medications Another reason for emotional void is the use of antidepressants, mood stabilizers and other sedatives which are drugs that disorient your central nervous system Emotional blockage and feelings of apathy are common side effects Some people say no if they feel like themselves when they use medication, then they stop using But it is important to talk to your doctor first so he can change your dose or the medication that best fits your needs Do you identify with any of these signs? If you know someone who needs online guidance, we’ve teamed up with Better Help, an online advice platform you can use. They’re constantly trying to improve their service and terms and conditions. The link is in the description. Thanks for watching. As found on YouTube The Destroy Depression ꆛ System-Cure Depression Naturally YOUR DEPRESSION HAS BEEN IN CONTROL LONG ENOUGH. It’s Time to Fight Back ☂🗯 “Depression Sufferer Of Over 20 Years Reveals His Simple 7-Step System That Gives You The Power To Destroy Your Depression, End Your Feelings Of Sadness And Hopelessness, And Get Your Life Back.” “This didn’t just change my life, it saved my life.“

CAN THIS BOOK HELP WITH SOCIAL ANXIETY?

Social anxiety is absolutely brutal to live with, but can this unconventional book help you out with your social anxiety, stay tuned as we discuss what is up everybody. This is Chris from the rewired soul, where we talk about the problem, but focus on the solution today,’s problem is social anxiety and I haven’t done a book review in a long time. I’ve been kind of just not even really slacking. I’ve just been like picking up books and going through them and not finishing them all the way because they get kind of and all this other stuff. But I’m back and I’m gon na be doing some book. Reviews like the book reading are reignited in me, so, like this book is gon na surprise you, but first let me preface this by talking about my history with social anxiety like so many people who meet me, like they’re, so shocked when I tell them That I used to have social anxiety as I did. It was brutal. My brain was constantly going a million miles a minute. I was so concerned about what I was doing. What I was saying when I was thinking where you were looking at and all these other things I was trying to read you and I didn’t know if I was making you uncomfortable and all sorts of stuff like. I was always worried about saying something that might offend or make somebody uncomfortable like. I was just extremely socially awkward and it made me fumble over my words, even more, which made it even more awkward, and it was just terrible. It was so terrible and, like I just couldn’t talk to people unless there was somebody like that, I knew and if you’re socially anxious, you know exactly what I mean. So what I try to do when I read books, no matter what book it is like, I try to see what we can learn from it and most of the books. I do read our mental health books and this book has been on my list for a while, but I haven’t picked it up. Cuz it’s, not a mental health book. I’m, like you know, I bet this book might be able to help people who are socially anxious and it’s interesting because I don’t think a lot of people’s. Social anxiety would pick up this book if they saw it in a bookstore or on Audible or Amazon or Kindle or whatever it is they might not pick it up, but it’s good. So I’ll be honest with you. I’m only three chapters in I’m, like you, everybody who subscribed to my channel, who has social anxiety, needs to read this book. No, you asked me, Chris. What are you talking about? What book is it? Well, it is called what everybody is Saying by Joe Navarro alright, so I listen to all my books on Audible. I just listen while I’m driving to work or if I’m doing some like tedious tasks at work. I just have an audiobook playing and like so just to preface this book, so this guy Joe Navarro. He is an ex-FBI agent and it was one of the best the reason why it was one of the best is that he’s amazing. Reading body language, this book blends neuroscience with the science of body language, so that’s, something that sold me on this book. For those of you who’ve been around for a while, I’m, really into neuroscience understanding how the brain works helps with understanding how we behave and how we think, and the way we do things in our mental health and all that kind of Stuff, so here’s the thing when it comes to social anxiety. A lot of it is this concern that we don’t know what people are thinking, what’s going through their mind, but think about it for a second. If we could better understand a person,’s body language and what certain things meant, then we could know if, if this person’s enjoying the conversation, if they’re, trying to get out of this conversation, if they’re uncomfortable, if they’re Nervous, like we can read all these different things and that’s just absolutely amazing. So I’m just going to give a few little things that are in this book so far, but I’m only about three chapters in and I’m hustling through it because I joined the psych book club with some buddies. Who I play fortnight with and I was super excited when they told me they were reading this book about you. I need to get this book. I want to join your book club because not many of my friends read you know what I mean, so I’m glad that I get to like talk and discuss this stuff with other people besides you. I love you, but I need some more human interaction, so anyways the book kind of starts with, and it goes through kind of like a curriculum of what this book’s gon na be about, but throughout it like Joe Navarro. He kind of gives some examples of these different cases. He worked and things that he learned and all sorts of stuff and kind of like his childhood and why he became fascinated with understanding body language because he came from another country and didn’t speak English. So he had to learn how to read body language to know if people liked him or didn’t like him, and this kind of helped him out before he learned English. So then, like one of the first chapters, I think it’s, chapter 2. They start to talk about the limbic system and the prefrontal cortex, and things like that.

So the limbic system, which is the most primitive part of the brain, is the strongest part of the brain. It is your emotional part of the brain right so, like he talks about how you can’t always believe what’s coming out of somebody’s mouth or their facial expressions, because, like they’re, actually not a good indicator. You have to look at other cues on their body, which I’ll talk about in a second, and like for me like this book is kind of sold to people like you know, when you’re talking to your boss, you’re talking to A customer or you’re, talking to a client, we’re talking to a loved one or talking to your kids, but like for me. I’m like bad. This could help with social anxiety. You know what I mean so understanding these things. So what are the great things that I want to make some dedicated videos to? This is one of the first things it does. It talks about pacifying, behavior, okay, these are things that we do, unconsciously, that calm us down. Okay, so some people might rub the skin right below their neck or they might rub their neck like this because these are filled with a lot of nerves and it releases calming neurotransmitters in your body, so it calms you down it soothes, you, okay, so I want to make some more videos on that because if you’re somebody who just gets anxious or stressed there are some points on your body that you can touch that calm you down, so you could do it more deliberately. So this next chapter Armand, he talks in an earlier chapter about like what do you think the most telling part of the body is and a lot of people would say face and things like that. But if that was the truth, then why would a poker face even be a thing, so the feet are the best indicator for this, and this is something I’ve heard a very long time ago and it’s something that I noticed. I even notice myself doing it so just some quick examples: if somebody has their feet turned towards the door or an exit. This means that they’re either uncomfortable or they’re in our curry, or they want to leave okay because that’s just our natural fight-or-flight instincts. Okay, so like when, when we get in these situations like our feet, they’re prepared to do something. Okay, then it also talks about how having a wider stance is more confrontational. So we discuss how to kind of diffuse a situation to make sure that your legs are together, because even on that unconscious level, if you, if you have a wider stance – and you’re, like kind of in a heated argument with somebody, they’re, Getting more prepared to attack back right, even if it’s verbally, okay, so it also talks about other things about how, when you cross your legs, you feel comfortable, and the reason this is is is because the brain is not preparing you to leave. So when you cross your legs, you’re actually off balance. So if somebody’s crossing their legs near you, whether it’s, you know one leg over the other and in their lap or if it’s just crossing their ankles. Okay, because our center of gravity changes, so this means they’re very comfortable, so their brains not telling them hey, you might need to get out of this situation so like I find this very, very useful when like having conversations with other people noticing what their Hands are doing their arms are doing like there’s, one part where it talks about if somebody’s cupping their elbow. This is also something that means that they’re uncomfortable. If they move their hand, this means that they’re starting to relax. So there are a lot of great tips in here, and I hope that some of you read it the more you understand about the brain and what we do, the more you will improve your mental health. One of the reasons my mental health is so much better. These days are because I hate myself for this. I’m gon na link a video up in the info card about something called the brain mechanic. Okay, the more you understand about your brain, the better you’ll be able to handle a variety of different situations, whether it’s, anxiety, depression, and things like that. But I like this book because it’s how to tell if other people are uncomfortable or confrontational and all that kind of good stuff. So if you want to join me on this journey and read this book, I’m gon na put a link down in the description below that’s an affiliate link. So if you’re interested in it go ahead and buy it from Amazon, it doesn’t cost you anything and it helps support the channel. But I would love for you to read this book check it out and tell me your thoughts on it and then maybe I’ll do a full book review after I’m done with it. Alright, anyways that’s – all I got for you today. So if you like this video, please give it a thumbs up, and if you are new here, I’m always making videos to help you out with your mental and emotional well being go ahead and click that little round subscribe button and a huge. Thank you to everybody supporting the channel over on Patreon. I love you guys. Alright, you want to check out some more content on this channel. You can click or tap on one of those thumbnails. Alright thanks so much for watching, learn more about your brain today and I’ll see you. As found on YouTube The Destroy Depression ꆛ System-Cure Depression Naturally YOUR DEPRESSION HAS BEEN IN CONTROL LONG ENOUGH. It’s Time to Fight Back ☂🗯 “Depression Sufferer Of Over 20 Years Reveals His Simple 7-Step System That Gives You The Power To Destroy Your Depression, End Your Feelings Of Sadness And Hopelessness, And Get Your Life Back.” “This didn’t just change my life, it saved my life.“

10 Signs of Hidden Anxiety

According to the American Psychological Association People with anxiety have a future-oriented fear which leads them to avoid anything that could potentially trigger a stress response. In 2017, the National Institute of Mental Health reported that approximately forty million people worldwide suffer from anxiety Anxiety disorders are highly treatable but recent surveys show that only 36.9% of those suffering from it seek treatment This might be because most people with anxiety worry about the judgment of others and how the stigma against mental illness might negatively affect their lives. Does this sound familiar to you? Do you worry you might be suffering from anxiety and just don’t realize it? Here are 10 tell-tale signs of hidden anxiety to look out for. 1. You don’t like talking to people face to face. You can easily keep a conversation going for hours when you’re texting or chatting online with a friend but talking to someone in person… No… that’s an entirely different story. Even if you already know them well or have talked to them online you still get tense and nervous talking to them in person You have trouble making eye contact or finding the words to respond and you want to end face-to-face conversations as soon as they begin to 2. You’re always self-conscious. Do you walk into a room and immediately feel like everyone is staring at you, listening to you, and judging your every move? Or perhaps you’re overly conscious of the way you walk, the way you eat, the way you sit, the sound of your voice when you talk and so on This could be a sign that you have hidden anxiety 3. You’re easily upset or irritated. Has anyone ever told you you’re too sensitive? Do you find your feelings getting hurt easily? Are you quick to get angry or upset with others over the littlest things? This kind of emotional volatility may be a sign that you have high-functioning anxiety. As anxiety can often make us easily overwhelmed and emotionally imbalanced frequent mood swings, temper tantrums, and irritability can be expected when you’re overly anxious 4. You’re panicky and easily startled. Anxiety makes you want to be as in control and vigilant as possible. An unexpected phone call, a random knock on the door, an email with no subject, or a forgotten task you can easily finish. Anything is enough to send you reeling with panic. You go into a tailspin whenever something catches you off-guard and you find it hard to relax even when the smallest things don’t go exactly as planned. 5. You’re indecisive. Do you have trouble making even the simplest of choices? Are you afraid of making up your mind about something because you’re so sure that whatever decision you make is gonna be the wrong one? Oftentimes, anxiety can manifest as perfectionist tendencies, fear of failure, or distrust in oneself. If you can’t make your own choices without thinking about it for hours and hours first or consulting with all your friends and family, you might be harboring some hidden anxiety. 6. You overthink past conversations. You tend to get hung up on past conversations no matter how much time has passed since then. You analyze the other person’s body language, facial expressions, choices of words, and even the tone of their voice. You can’t help but think about what you should have done or said instead and it drives you crazy and keeps you on edge every time you remember it 7. You’re always making yourself busy It’s common for people with anxiety to have a strong need to keep themselves busy They’d like to occupy themselves with simple tasks and do as many things as possible in a day because sitting still and doing nothing for a long time can make them feel restless and on edge 8. You talk yourself down all the time.

Life isn’t always kind to us and self-love and a balanced lifestyle don’t come easily. Living with anxiety, especially if it’s hidden or suppressed, can make it hard for us to feel good about ourselves and let ourselves feel happy. It makes us believe that we don’t deserve it and traps us in a vicious cycle of negative self-talk and constant pressure to be perfect. 9. You have a lot of negative thoughts. Are you a pessimist whose quick to find the downsides in every situation? Do you find yourself getting upset or stressing out over even the most minor inconveniences? Is every day a constant battle with yourself against the spiral of panicked and rational thoughts you have? In 1997, famed psychologist and cognitive therapist, Aaron Beck, termed this kind of thought pattern as catastrophic thinking, Which he often observed in his patients who suffered from anxiety. And 10. You experience physical symptoms. Sometimes anxiety can be entirely physical because while your conscious mind may not always be aware of your anxiety it will make itself known to your body. Things like erratic heartbeats, chest palpitations, muscle tension, a clenched jaw, shaky hands up a little sweating are all indicative of anxiety. Your body may be trying to let your mind know that you’re feeling anxious and stop it before it gets any worse. Do you relate to any of the problems listed here? Or do you do your best to seem ok? And hide your symptoms because you feel embarrassed about your anxiety? The truth is: you’re not alone and having mental health issues is nothing to be ashamed of. What do you plan to do next? Let us know in the comments below! Don’t forget to like this video and subscribe to Psych2Go for more psychology content. Thanks for watching and we’ll see you soon. As found on YouTube This solution reverses kidney disease! Guaranteed to be effective or your money back: Beat kidney disease. Just by following a simple treatment plan, you can reverse kidney disease. No matter how old you are! Just listen to what people who have tried this solution have to say. “Thank God I came across your solution by accident! Dad’s kidney function decreased from 36% to 73% in just two months. He’s 90 years old! His doctor said people his age shouldn’t have kidneys that efficient!” Graeme Asham, QLD, Australia, And this… “No more dizzy spells! My creatinine has gone down from a staggering 1800 to 1100. My blood count has greatly improved and I’ve been taken off my blood pressure medication. Your solution works! ” Joe Taliana, 55, Malta Simply follow the scientifically backed solution and restore your kidneys, fast! => This solution reverses kidney disease! ← https://www.facebook.com/100000332115031/videos/590895892954739/ яαℓρн ℓєαмαи

Physiology of Addiction and Mental Health Issues

this episode was pre-recorded as part of a live continuing education webinar on-demand CEUs are still available for this presentation through all CEUs register at allceus.com/counselortoolbox I’d like to welcome everybody to today’s presentation of addiction and co-occurring disorders part two the physiology of addiction and mental health issues over the next hour we’re going to discuss somewhat generally because there’s a a lot of stuff to go over neurotransmitters which we’ve talked about some before but then we’re also going to talk a little bit more today than we’ve talked in the past about sex hormones thyroid hormones and stress hormones and how all of those interact in the body to increase or decrease the availability of certain neurotransmitters we’re going to go on from learning about the different hormones and neurotransmitters to discussing the physics all the physiology of emotion and motivation and again we’ve kind of covered that but we’re going to go over it real quick again we’ll talk about the physiology of sleep what happens during sleep and what happens to those hormones or neurotransmitters when you don’t get enough sleep what happens when you eat why is eating sometimes rewarding what happens when people take stimulants whether it’s caffeine or methamphetamine what happens when we turn up the system and how does that affect the availability of certain neurotransmitters and then we’ll talk about the physiology of depressants so we’re looking in general at what these things do as far as the physiology of addiction we’re going to talk generally about that right at the very end so your inhibitory neurotransmitters are those brain chemicals turn down the system so instead of being hyped up and awake and yadda-yadda your calm you are relaxed you are maybe even sleepy too drowsy so your inhibitory neurotransmitters are the ones that kick in or counteract the excitatory ones serotonin is your primary inhibitory neurotransmitter it’s broken down to make melatonin and help you sleep okay so we know that it’s also responsible for a lot of our bowel function angle and also for not it’s implicated in nausea and motion sickness and they found that there are a lot fewer side effects to serotonin antagonists than there are to dopamine antagonists when we’re talking about helping people who have motion sickness and nausea so anyway just a little aside there but serotonin is 80 percent of it is actually in your GI tract and it is implicated in bowel function so when we’re thinking about clients who may have an imbalance in serotonin and who may have greater pain sensitivity we want to start thinking about you know how is their GI working and is are some of their problems with you know stomach problems pain irritable bowel that kind of stuff is that caused by a serotonin imbalance or is that causing a serotonin imbalance or maybe serotonin is not implicated at all and it’s something completely different serotonin is also implicated in anxiety and aggression if you don’t have enough of it you tend to be more anxious and aggressive because you’re not having the turn down if you will low serotonin has also been implicated in poor impulse control so we like serotonin but we found and we’re gonna talk about that throughout this class of serotonin has often been given the go-ahead or been implicated for a whole lot of things and we’ve said okay if this happens then it’s low serotonin if this happens then it’s low serotonin and as it goes but no the research is finding that that’s rarely true that most of our problems whether it be GI problems or mental health problems or addictive issues don’t necessarily involve serotonin at all there is a subset of people for whom it does but the majority of people which is why antidepressants are ineffective for about 70 percent of the population for them shortie of the people it’s not serotonin so we do want to keep that in the back of our mind yes serotonin is everywhere throughout the body 80% of it is in our gut and our gut is not necessarily going to communicate directly with our brain we cannot measure neurotransmitter levels effectively in a live human being just not how it works right now there are tests out there that say they can measure your neurotransmitter levels and that’s true but it’s not telling you how much of that neurotransmitter is in your gut or your muscles or wherever versus in your brain so those tests for our purposes as mental health clinicians and people who come to us who may want to know well what antidepressant should I be on they’re not all that effective okay so depression has been debunked as being linked to serotonin in the majority of cases serotonin is implicated as one of those neurotransmitters involved in pain control in people with lower serotonin tend to have a lower pain threshold so it hurts more and that doesn’t mean that they’re sissies or anything like that it just means that they are more reactive or they feel more pain because they don’t have the same level of serotonin and maybe endogenous opioids kind of coursing through their system serotonin is also like I said involved in sleep an interesting fact is that alcohol impairs the body’s ability to convert tryptophan which is an amino acid to serotonin so when you have somebody who’s an alcoholic let’s think about how this works if they are drinking and maybe they’re eating a perfectly healthy diet and they just happen to drink a lot if their body can’t convert tryptophan to serotonin then all of these problems up here that may be implicated by low serotonin can start to rear their ugly head because the body can’t To make serotonin out of anything else it has to make it from tryptophan and if it can’t make serotonin then it can’t make melatonin which is involved in sleep and you’re gonna see how important all that is later so the take-home message with that is that alcohol is something to be considered for moderation especially if we have a client who is struggling with depression maybe they’re not an alcoholic but they need to consider the long-term impact if they want to feel better is preventing their body from making using the building blocks to make the neurotransmitters that they may need is it worth that drink remember that serotonin has been found in research to be implicated in low serotonin is implicated in people with generalized anxiety disorders so it hasn’t been completely just been debunked for everything but researchers and clinicians finally are starting to realize that there are a multitude of reasons that somebody could have a mood issue that somebody could have even low serotonin okay if the person has low serotonin alright that’s fine let’s address it but what is causing the low serotonin we’ll look at that more in the next few slides GABA is your other major inhibitory neurotransmitter it has sedative depressive and anti-anxiety properties to them the really interesting thing it’s and when I say depressive I mean it slows down everything it’s not that it makes people depressed but it’s your anti-anti-anxiety natural anti-anxiety neurotransmitter helps improve concentration by filtering out background noise so you’re able to focus a little bit better when you’ve got normal levels of gaba help with impulse control think about when you’re anxious when you’re a little bit revved up when you’re stressed out and somebody scares you maybe you’re a little bit more jumpy well think about if you have GABA at the right levels in your system and you’re not stressed out and somebody scares you are you as jumpy are you as impulsive a lot of our impulses are associated with wanting to make a threat or a pain go away so if you’re not perceiving as many threats you’re probably not going to be as impulsive another little interesting side thing is that glucose you know sugar is necessary for the formation of GABA so people with hypoglycemia can have a reduction in GABA and an increase in anxiety so think about if your blood sugar gets low even if you are not hypoglycemic but you know you got to work back-to-back patients you didn’t take time for lunch yet back-to-back patients you’re on the drive home from the office your blood Sugar’s low you are you more likely to respond with some anxiety or irritability to things that happen versus when you are well nourished and your blood sugar is kind of stable for most people, they’re gonna say yeah I tend to be a little bit cranky err when my blood sugar is low and shake gear alright so those are our two inhibitory neurotransmitters glutamate is generally acknowledged to be the most important neurotransmitter for brain functioning and it’s excitatory it gets you up it gets you going it gives you energy and it’s responsible for helping us learn and remember things so if you’ve got low levels of glutamate you know you might have difficulty concentrating and learning now the interesting thing is that glutamine which is an amino acid you eat glutamine is converted into glutamate all right well that makes sense so you eat something it is turned into this neurotransmitter that’s excitatory the interesting thing is gaba is made by the breakdown of glutamate so you have if you have glutamate then you can have Gaba if you don’t have enough glutamate then you’re not going to have enough GABA so it’s a balance like taking a warm bath and you know this is important to remember simply because we want to know what’s rubbing us up and what’s slowing us down norepinephrine or noradrenaline depending on where you are is what they call a catecholamine it increases arousal and alertness promotes vigilance and focuses attention so you’re hearing a theme here about attention and memory it enhances the formation and retrieval of memories so in your norepinephrine that’s your motivation chemical is secreted it encourages you to pay attention to remember and to be able to go and file things away and access them easily it can also promote restlessness and anxiety if you have too much so it’s all about moderation when I talk about too much or too little of a neurotransmitter everything is always about all of the other neurotransmitters and hormones so we can’t just necessarily get a measurement and go well you’ve got too much of this well we have to know what the levels of everything else are it would be kind of like making a marinara sauce and saying you a teaspoon of garlic is how much you need but that teaspoon would be enough if you were making maybe two quarts of marinara sauce but if you are making 4 gallons all of the other spices and everything would be in much larger proportions so what a teaspoon be enough so we need to know what proportions all the other chemicals are at in order to know how much we need and since we can’t measure them we’re just kind of left guessing dopamine is another catecholamine and it’s broken down to make norepinephrine now normally we think of dopamine as our pleasure reward chemical which it is don’t get me wrong it’s that’s what is there for and it tells us I want to do that again but it’s broken down to make our focus concentration motivation chemical interesting so we need dopamine to make norepinephrine we need norepinephrine to want to get up and go so if we are draining our dopamine system through addictive behaviors or some other reason guess what we’re not going to be able to make enough nor epinephrine or those receptors that usually receive the norepinephrine and the dopamine are going to be basically unresponsive and you’re going to knock on the door and nobody’s going to open so dopamine is broken down to make norepinephrine which is your motivation chemical high levels of dopamine in the brain generally enhance mood and increase body movement too much dopamine may produce nervousness irritability aggressiveness and paranoia so think about cocaine if somebody takes a whole lot of really good cocaine this is probably what we’re going to see because the levels of dopamine in their brain just skyrocketed and everything else didn’t catch up there was no signal to all the other chemicals to go okay we’re gonna have a surge here so we have all of those neurotransmitters that are responsible for helping us feel happy serotonin helps us feel theoretically calm and content and focused gaba is an anti-anxiety medication or not medication but a neurotransmitter and then dopamine glutamate and norepinephrine are all of our excitatory ones they’re the ones that get us guess what excited happy excited mad excited whatever the excited is they Rev us up and that’s what we label with our emotional feeling states so what is this HPA axis thing that I talk about every once in a while in response to stress the level of various hormones change and reactions to stress is associated with an enhanced secretion of several hormones including your gluta Co corticoids which is cortisol your catecholamines to increase mobilization of energy sources which is blah blah blah blah blah you get stressed your body sends out the message that we need some energy we need some fuel for this fight-or-flight response cortisol is activated and it’s a glue to co corticoid which tells your body we need to prepare we need to get some glucose going so got energy for this fight-or-flight thing catecholamines adrenaline and dopamine are released that’s your body going okay we have this energy now let’s get the team revved up the other thing that happens though is jörgen a door opens are suppressed your body goes you know we don’t really have time for sex right now so let’s not worry about it so your sex hormones tend to be suppressed under high stress levels okay well who cares you’re gonna find out in a little while but that’s kind of a big deal because there is a strong relationship between the amount of and the balance of our sex hormones and the availability of serotonin-norepinephrine and dopamine in our bodies oh well sweet this here we are androgen or testosterone what we want to look at is what does it do it helps helps us with concentration mood and not enough of it can result in an increase in belly fat they found that in men depending on the research that you look at somewhere between 30 and 40 years of age they start losing somewhere between 1% and 1.5 percent of their testosterone each year and so you’re thinking well you know that’s not that much but you’ve also got to remember that everything’s in a balance so they’re losing their testosterone but what else is not decreasing estrogen so some articles have kind of termed it manopause if you will the increase in estrogen can increase irritability difficulty concentrating and belly fat as well as Gyna mastika or the development of excess fat in the breast area so something interesting to look at if you’re dealing with patients male patients who are over the age of 40 who are having suddenly if you will depression or anxiety issues or are talking about their midlife crisis that those all of those things could be precipitated by in their neurochemistry because of a drop in testosterone not necessarily but it’s one positive or one possible reason estrogen believe it or not is a neuro stimulant estrogen revs us up receptors for estrogen are very abundant in the emotional center of the brain called the amygdala and the hypothalamus which is involved in what we just talked about the HPA axis which tells us to fight flea or freeze estrogen increases serotonin receptor responsive ‘it increases the number of serotonin receptors in the body and enhances serotonin transport and uptake so we might hypothesize and we don’t know any of this for sure that if someone’s mood disorder started or fluctuates in response to fluctuations in their estrogen then there might be a serotonin component to this mood disorder because estrogen is so intimately connected with serotonin availability high levels of estrogen are associated with anxiety one thing that they found in American culture and industrialized nations but especially American culture is we have a lot of chemicals and stuff that we eat that tend to and habits that we do that tend to increase our levels of estrogen creating something called estrogen dominance but high levels of estrogen are associated with anxiety so one thing clients may want to do especially female clients but you know if you have a male who is feeling like estrogen may be increasing too much I have them look at what they’re doing as far as lifestyle factors to see if there’s anything that might be increasing their estrogen levels low levels of estrogen are associated with depression because there’s not enough serotonin going around but also because estrogen is a neuro stimulant and if it’s not there then there’s no stimulation so alright so now looking at first we started implicating just neurotransmitters and going well if you don’t have enough of this or too much of this then you might be depressed well now we’ve added to the mix and said well guess what these imbalances over here in the neurotransmitters may be caused by something completely different such as sex hormones progesterone is another sex hormone an imbalance in the ratio with estrogen is implicated in mood disorders so progesterone kind of calms down estrogen they’re yin & yang if you will kind of like GABA and glutamate it’s referred to as the relaxation hormone the interesting thing here is synthetic progesterone which is present in a lot of birth control is associated with depression whereas naturally occurring progesterone levels haven’t had that same associate association drawn in the research literature so another thing to look at with our female clients is possibly to ask them have they and if they’re presenting with depressive symptoms have they changed their birth control regimen or have they recently gotten pregnant or had a baby or stopped nursing and that was one I learned you know when I stopped nursing my first child was your body actually maintains different levels of hormones and makes sense maintains different levels of hormones when you’re nursing so you’re producing milk and stuff and then when you stop nursing there’s a whole different hormonal cascade that happens so there are multiple different times that estrogen can change and progesterone levels can change ganado trope ins hormones synthesized and released by the anterior pituitary promote the production of sex hormones so remember earlier I said that when we’re under stress our body releases cortisol and cortisol tells our body you know what we don’t need to produce those sex hormones right now so let’s connect it all if you’re under a lot of stress you may not be producing enough estrogen which is why a lot of women when they’re under a lot of stress tend to have more erratic cycles but even in men when your sex hormones are not being produced because your body’s focused on fight or flee it makes the availability of serotonin and norepinephrine and dopamine less available so chronic stress can alter the availability of sex hormones which alter the availability of neurotransmitters okay you wanted some good news we got some good news oxytocin is our bonding hormone and they found that it can counteract cortisol and vice-versa it’s not just getting a hug though so I mean hugs are great don’t get me wrong but a lot of research has indicated that people who have companion animals and pet their companion animal it can be a horse it can be a dog it can be a cat a bunny rabbit whatever it is that does it for you where you feel that sensation of bonding 15 minutes of petting that animal raises oxytocin levels and which counteracts cortisol sweet thyroid hormones yet a whole nother category so we’re moving off of the sex hormones onto our thyroid you have two types of thyroid hormones thyroxine and the other one that I can’t pronounce t4 and t3 t4 is broken down to make t3 they are always in a balance they’re always in a ratio too much thyroid hormone which typically is t3 speeds things up and too little slows things down so think about somebody who’s hypothyroid they have symptoms of depression one of the things we want to rule out early on with our patients who present with the pressive symptoms is thyroid problems the patients with too much thyroid hormone may present with anxiety symptoms so again we want to look and say is there a physiological cause to the neurotransmitter imbalance the pituitary gland hypothermic hypothalamic-pituitary-adrenal axis so this is the middle of that stress axis here the pituitary gland releases thyroid stimulating hormones to get the thyroid to release t4 and t3 majority of the thyroid hormones produced by the thyroid are t4 but t3 is the most usable form so it sends out t4 which is kind of you know it’s just kind of there it’s not a real hard worker at all but along the way it gets converted to 3 t3 which is a workhorse this conversion is the critical element because a lot of times doctors will test thyroid secreting hormone and t4 alone and they’ll say well you’re secreting enough and there’s plenty of t4 to be broken down to t3 so I don’t know why you have hypothyroid symptoms but the piece that they’re missing is they may not be we may not be adequately converting t4 to active t3 so it’s important if you think you have thyroid issues going on to work with an endocrinologist who’s going to do more than just a superficial test or if you go to a GP you have and they do just a TS h t4 test comes back normal but you’re like no something’s not right there are more tests that can be done to be more specific about what’s available because if we’ve got a client who goes to the doctor and says doc you know I feel awful I can’t wake up I’ve got no energy they run these tests they say well there’s nothing wrong with you that just disempowers the client the clients going well nothing’s wrong with me I don’t know why I feel this way I have no hope for getting better because I don’t know what’s wrong so I want to make sure that we educate them about all the possible things that they might be able to look into I don’t dump all this on my clients at first you know when I go through the assessment I start listening for things and then I encourage them to get a full blood panel done and then we talk about all that when they come back and then narrow it down to other things that they may want to look at further testing for if the general assessment didn’t come back with anything overactive thyroid produces anxiety feelings of nervousness butterflies heart racing trembling irritability and sleep difficulties under activity depressive symptoms the other interesting thing and I don’t know what other word to use is if it’s either overactive or underactive the person can have mood swings and have sleeping difficulties so we don’t want to just say well you’re having mood swings it must be hyper we don’t know so we want to look at maybe the thyroid gland is sputtering and giving a little bit and then not enough and then a little bit and then not enough it’s just important for them to understand what the thyroid hormone does other cognitive issues difficulties with concentration short-term memory lapses and lack of interest and mental alertness are also common in hypothyroid but they’re also common in a whole bunch of other things I mean most of these sound like what the criteria for depression so we’re trying to sort through and figure out what may be going on with that particular client hypothyroidism led to a significant decrease of responsiveness of the serotonin system so again here’s something else if you don’t have enough estrogen or if you don’t have enough thyroid the serotonin system may be implicated and we know that serotonin insufficiency is implicated in generalized anxiety disorder so one of those little paths to kind of be aware of optimal thyroid function may be necessary for optimal response to antidepressants antidepressants mean the serotonin is still there but if estrogen and thyroid are responsible for transporting it around and making sure it gets taken up in the right places then if those two systems aren’t working no matter how much serotonin is in the system of it’s not getting to the right places it’s not do the job hypothyroidism generally increases enzyme activities and GABA levels now you may go well sweet we want more gaba but we don’t too much gaba has too much of a depressive effect so the person may not be motivated may feel apathetic about things they can’t get excited about anything so there is such a thing as being too chill thyroid hormone plays a role in the output of dopamine the precursor to norepinephrine our motivation chemical not enough thyroid hormone not enough excretion of dopamine not enough get up and go and norepinephrine has also insufficient norepinephrine has also been implicated in depression so you know serotonin is not even in there we’re talking about thyroid dopamine and norepinephrine stress hormones so we’ve moved on cortisol it’s released from that HPA axis cortisol triggers a decrease in leptin and an increase in gralen which increases appetite and food intake cortisol is telling you there is a threat we need energy we need to mobilize the sugars because it’s a glucocorticoid but we also need to get more sugars in here so we have energy for the fight-or-flight as long as it goes on which is why a lot of people who are chronically stressed also feel like they’re chronically hungry they’re just like I’m famished all the time and it may not be that their body needs all that energy all those calories right now their body may be hoarding it because they think they’re going to have to it’s gonna have to fight or flight flee for a long time cortisol also affects the endocrine system including thyroids insulin regulating blood sugar and your sex hormones all right well that’s not good so when people are stressed they maintain higher levels of cortisol when they maintain higher levels of cortisol basically every bodily system and all the neurotransmitters are impacted adrenaline is another stress hormone you know we think about it when somebody gets really upset or excited or whatever they have a rush of adrenaline alright sigh Roxon is also released from the kidneys and are from the thyroid and helps you get fatty acids which are long term long term energy fat has nine calories per gram sugar has four calories per gram so fat is a much denser source of energy effective chronically elevated cortisol includes impaired cognitive performance you’re not thinking as well dampen thyroid function yep eventually the body goes there’s no point the stress is not going to go away there’s no point in continuing to fight so I’m going to turn down the sensitivity of the symptom blood sugar imbalances sleep disruption elevated blood pressure lowered immune function and increased abdominal fat so if a client starts talking about how they’re stressed they’re hungry all the time and they keep suddenly gaining all this weight in their belly we might start looking at chronic stress and interventions that we might use for chronic stress including mindfulness meditation exercise you know anything that we can throw their way in addition to having them get a full physical to make sure there’s nothing else going on like you know actual hyper hypothyroid caused by a physiological problem low levels of cortisol brain fog cloudy headedness mild depression low thyroid function again blood sugar imbalances such as hypoglycemia and remember when you’ve got blood sugar imbalances and not enough sugar then your body cannot produce enough gaba which means you’re not going to have enough naturally relaxing chemicals fatigue especially morning and mid-afternoon sleep disruption low blood pressure lowered immune function and inflammation so these are all things that we can produce to work our clients to say cortisol it’s not public enemy number one but it’s pretty close to it so let’s look at how your cortisol levels how you’re sustained chronic stress might be impacting your mood your health and your sleep and think about different ways we can reduce that because that’s more tangible and cortisol is measurable obviously the doctor has to do that but it is measurable in general when we feel emotions a stimulus is received by our peripheral peripheral nervous system the brain responds by triggering the amygdala which is our emotion center and the hypothalamus assesses if you will the need for fight or flee it goes there’s a threat or there’s no emotional memory that helps the brain determine the types of neurochemicals to secrete and in what amounts if the hypothalamus goes yeah no big deal then you’re going to have more inhibitory neurotransmitters then if you have your hypothalamus going that’s a problem what we need to look at and this adds another layer is when there is too much of a chemical or hypersensitive receptors so hypersensitive receptors are like the person that you know that jumps when you tap them on the shoulder somebody who’s hyper vigilant when they are activated they go from 0 to 100 and it’s just like in sensitive receptors on the other hand when they’re activated they may not do anything at all so you may have enough chemical in the system but if the receptors are not receptive then the chemical can’t do its job so if serotonin is sitting outside the receptors door just kind of knocking on it going let me in and that door never gets opened then it doesn’t matter how much serotonin is sitting in the synapse it’s not going to do any good so as I said before all every time I talk about too much and too little it’s always relative to the proportions of the other hormones and neurotransmitters for that person anxiety irritability and anger our fight-or-flight response can be caused by dot dot dot too little serotonin where you have anxiety coming on because serotonin is not there to help the person calm too little GABA again not enough calming too much norepinephrine too much estrogen too much testosterone or too much thyroid so any of these too much is going to cause one symptom either anxiety or irritability or anger and too little will probably produce something more on the depressive continuum now happiness and excitements an interesting one because happiness and excitement are excitatory neurotransmitters they’re going to get your heart rate going they’re gonna get your blood blood flowing they’re gonna get your breathing a little bit faster think about Christmas Christmas morning when you run down the stairs in order to see what’s under the Christmas tree or something else that is really exciting your body is secreting dopamine norepinephrine glutamate and maybe a little bit of serotonin in there but these are the same chemicals that are going out during a stress response it’s how the amygdala processes everything so we still need these excitatory neurotransmitters we can’t just shut them down and go well that’s causing too much problem let’s turn it down well if we turn it down we’re also turning down the body’s ability to Spahn to happy stimuli and like I said depression can be caused by serotonin insufficiency or excess and why is it excess when you have too much serotonin or too little serotonin you can have high levels of anxiety they found and high levels and anxiety trigger the stress response system after a certain period of time the stress response system goes you know what I can’t stay this hyped up for this long I’ve got to turn down my sensitivity I’ve just got a you know let it all go which starts leading to feelings of apathy and depression it can be caused by nor norepinephrine insufficiency dopamine insufficiency thyroid insufficiency or gain too much or too little estrogen the good thing is I Roy dand sex hormones can be measured so we can easily or somewhat easily help the person rule those in and/or rule those out as can cortisol so if they have chronically elevated or chronically low levels of cortisol they’re going to have some mood symptoms but we can figure out that that’s going on and we can help educate the patient to why they’re having the symptoms they are it’s not all in their head the New England Journal of Medicine on major depression said numerous studies of norepinephrine and serotonin in plasma urine and cerebrospinal fluid as well as post mortem Studies on the brains of patients with depression so we’re talking about humans not just rats studies have yet to identify the purported deficiency reliably so while we’re talking about depression being caused by if you will norepinephrine or serotonin deficiency there’s no real research that can reliably say yes this is it 100% of the time or even 95% of the time it’s more like yeah 15 percent of the time so yes deficiencies in norepinephrine and and or serotonin does cause depression in some people but that is a small subset and they found that there are 20 or 30 small subsets of different causative factors estrogen and progesterone modulates sleep and too much estrogen can cause insomnia so again if you have too much estrogen well you may have plenty of serotonin going on you also may not be able to sleep sleep deficiency promotes elevated cortisol and further disrupts our feeding hormones now for cortisol is elevated we’re not going to get good restful sleep sleep deficiency is related to a 30% reduction in thyroid hormone levels so again remember that the body finally after chronic stress will start turning down the thyroid it’s just like there’s no need to exert any more effort because this is a losing proposition with sleep deficiency the thyroid hormone levels go down cortisol levels go up which is your stress chemical so everything’s starting to get out of whack when people eat serotonin suppresses appetite and increases with feeding so as we eat our serotonin levels go up especially for eating carbohydrate-rich foods but anytime we’re eating so if there’s not enough serotonin people’s appetite suppression may be off but that’s also one of the reasons that people eat for comfort is because serotonin helps them feel a little bit better so when they’re eating serotonin goes up dopamine is associated with safety ATP handy which is great but if you don’t have enough dopamine then you may never feel satisfied as we talked about before cortisol increases appetite and neurons involved in the regulation of feeding are located in the hypothalamus so when you’ve got that hypothalamus pituitary adrenal axis all activated all the time the HPA axis you’re feeding is going to be probably way up here because the hypothalamus is going there’s a threat we need food we need we need energy and all of these chemicals are involved in stress response stimulants stimulants set off the stress response system by causing the body to kind of dump if you will sigh roid hormones stress hormones and suppress sex hormones you know that HPA axis it’s activated excitatory neurotransmitters dopamine and norepinephrine gets secreted so if you’ve got a lot of pleasure reward focus and concentration going on and you’re just like woohoo yeah you’re probably gonna want to do that again but when that wears off when stimulants wear off they wear off a whole lot faster than what our normal neuro chemicals would normally do so when they wear off there’s a sudden lack of stimulation pleasure and reward and there’s an excess of gaba and other other neurochemicals when people drink alcohol initially gaba goes way up when they drink the alcohol and they feel relaxed and disinhibited and all that kind of stuff the alcohol wears off and all of a sudden in proportion to everything else there’s way not enough gaba so anxiety goes way up so what we want to remember is when we’re taking substances or engaging it well taking substances specifically they are going to impact and wear off in a much different rate than what would happen from our body normally excreting or causing those neurochemicals to be excreted depressant increase gaba and may increase serotonin so they found that alcohol may increase serotonin it also increases gaba but again when it wears off you got a problem what there are other depressants out there besides alcohol though so it’s important to know what are your clients taking what are they using recreationally not to be judgmental you know if you have a couple drinks in the evening it is what it is what other things are you taking are you using including looking herbs like valerian Valerians are pretty powerful depressant so it’s important to know what what they’re taking so they know what impact is having on their body there are a variety of neurotransmitters that are implicated in moods sex stress and thyroid hormones among others modulate the secretion and absorption that is modulate the availability of these neurotransmitters so if there’s a lack or an insufficiency proportionally speaking of norepinephrine what we want to ask is not how do we increase it but what’s causing it why is there an imbalance in norepinephrine in this particular patient dysphoria is about having an imbalance not necessarily too much or too little you may have too much X in relation to Y too much glutamate in relation to GABA so talking with your clients if they start taking medications talk with them about how they feel and whether it’s getting worse you’re getting better to help understand you know are we targeting the right things here sleep deprivation directly contributes alterations in hormone and neurotransmitter levels and excessive eating may be caused by high cortisol levels because the brain thinks it needs to store energy for the long fight sex hormones impact the availability of serotonin but oxytocin has been shown to inhibit cortisol so pet a dog get a hug do something to promote bonding it will help with stress levels dysphoric moods are caused by a neurotransmitter imbalance but what causes that imbalance in each person berries greatly and they found it even berries greatly among people with PTSD so just like depression PTSD does not have one simple cause a cascade effect can happen when any one of these systems goes offline so if the thyroid system goes offline has a dysfunction for some reason it may negatively impact all the other symptoms because it’s going to change the balance and the ratios of all the other hormones and chemicals involved in those feedback loops so final thoughts chronic stress impairs sleep which causes imbalances and hormones and neurotransmitters involved in eating sleeping mood attention motivation and sex disruptions in nutrition can fail to provide the building blocks for the hormones and neurotransmitters so it could be something as simple as you know eating junk food every day sleep impairment is associated with decreases in thyroid hormones and increases in cortisol and dysregulation of eating so if somebody’s hungry all the time but they’ve got a low mood and you know they present with depressive symptoms we may want to look at what’s going on and could it is a factor contributing to this is sleep um but any of these things could also contribute to problems with sleep estrogen and testosterone, imbalances can cause depression or anxiety like symptoms and thyroid hormone imbalances can also cause depression and anxiety-like symptoms so the the take-home message is this stuff is stinkin complicated but what we know is everything is intimately interconnected so we don’t want to just start by saying well it sounds like you’ve got this and try to pigeonhole everybody into one particular causation we need to understand what’s going on with them and since we can’t measure brain neurochemicals to figure out exactly which one’s out of whack that’s where the part art comes into psychology as part art and part science okay so are there any questions you I think you’re all probably feeling like me when after I wrote this I worked on research for about 20 hours and I was all but drooling at myself by the end I was like really I tackled a pretty deep subject for an hour and you may need to go back and look at the presentation to kind of make all the connections and connect the dots as it applies to your clients but let’s see thinking about autism symptoms and these issues and body functions and hormones yeah I mean certainly autism is correlated and I’m pretty ignorant as to the neurophysiology of autism but I would think that there’s a strong correlation with the neurotransmitters so I would look at other systems to see if there are something that’s going offline that may be contributing to the neuro neurotransmitter imbalance when symptoms are exacerbated which makes me think you know again I don’t know as much I don’t know much about autism but when a client begins stemming I’m wondering if those impulsive behaviors mean there’s high levels of anxiety at that point so I’m wondering what’s happening with the stress response system in the GABA feedback loop I would love after you guys kind of digest this and stuff if you have any thoughts reactions connections I would love to hear back from you I’ll put my email and other than that have a wonderful amazing weekend and I will see you on Tuesday if you enjoy this podcast please like and subscribe either in your podcast player or on YouTube you can attend and participate in our live webinars with doctor Snipes by subscribing at all CEUs comm slash counselor toolbox this episode has been brought to you in part by all CEUs com providing 24/7 multimedia continuing education and pre-certification training to counselors therapists and nurses since 2006 used coupon code consular toolbox to get a 20% discount on your order this month

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Stop Anxiety Attacks – Review

Some people don’t even realize that they are having anxiety attacks until they know what the definition of one is. An anxiety attack is a strong sensation that creates fear in oneself, as the symptoms can seem like you are actually dying. If you are someone who suffers from these kinds of attacks, it is important to know as much as you can about them to help control them. Thus the more you learn and know the quicker you can begin to control your anxiety attacks. The cause of anxiety attacks can vary from person to person. They may be caused by an upsetting event in someone’s life or a fear of something they have experienced growing up. Stress is a big contributor to anxiety attacks, but the possibilities are truly endless. Medication is a known trigger of an anxiety attack, and being less than active is known to be a contributor as well. In reality, there is not a particular known reason for people who experience these attacks, they are in short a body’s way of dealing with an overwhelming feeling in one way or another. One of the main symptoms of anxiety attacks is extreme fear. Now, fear may be acknowledged as a symptom of anxiety, but in reality, it is just the end result of the real symptoms. Before fear sets in, you are likely to experience one or more symptoms of anxiety, which lead you to fear. Chest pain due to a racing heart, shortness of breath, and dizziness are all symptoms you may experience before the fear sets in. In the end, any uncomfortable sensation that is realized which makes you become fearful for your life is considered a symptom of anxiety, and therefore should be treated as such until you can confirm your suspicions. Because so many symptoms that are realized during an anxiety attack are similar if not exactly like those of some other kind of condition, it is almost impossible to determine if what you have been feeling is due to anxiety attacks, or another condition. This is why it’s important to see a doctor and explain your symptoms so that your physician can run the necessary tests in determining whether you have an underlying medical condition that needs to be dealt with or whether it is more than likely anxiety you are dealing with at which point you can work with your doctor in finding ways to control it. Once you and your doctor have worked together you can be on the way to resolving your trouble. If it is an anxiety attack there are many approaches you can take to help. Discuss your approach with your doctor. In many cases, awareness is the first step you can take to stop your anxiety. Check back, as I will be posting other articles on anxiety and will include some of my own experiences. I have posted a link at the top of my website for a book and audio clips that have helped many people to overcome their anxiety and stress. It strongly recommends this guide. Feel free to visit some of my sites Stop Anxiety Now and Stop Panic Attacks

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