Insomnia Answers

What can be done if anxiety doesn't let you sleep?

In your case the best way to overcome and deal with this bout of sleep deprivation or disorder you are struggling with is by treating the problem at the exact moments in which it is happening; those hours you lie in bed wondering. You can do this by using one or both parts of this activity I will outline for you to follow on the way to achieving better sleeping habits and longer sleep time. The first part of this activity or treatment approach is physical; please remember, do not attempt any physical activity or exercise unless you are cleared by your medical doctor or a licensed physician to do so and also to stretch and warm-up properly prior to starting any physical routine, and the second part is one or a series of mental exercise. The key to achieving success while using this method is by staying focused on the routine and not allowing your mind to wonder aimlessly about while attempting to fall asleep. You must be willing to invest the time and effort needed and not just try it one time then say it does not or won't work for you as your dedication and commitment to the process are also very intricate in making this work now and overtime. So let us begin your journey to falling asleep faster, sleeping longer and waking up more refresh and alert. When you are ready to go to bed begin by doing a physical activity you are comfortable with until becoming exhausted without overexerting yourself. Aim for at least three repetitions then lie down, inhale and exhale slowly in and out for about three seconds each breath until you begin to breathe naturally. Follow this by doing one or a series of the mental exercise; any of these can be counting from one to a hundred, reciting a poem or quote, narrating a story; fictional or otherwise, or reliving a specific pleasurable moment. Don't worry about time as you will eventually fall asleep just continue until you get the urge to begin again from step one. Please don't forget that I recommend you skip the physical activity part if you're not fit enough, recovering from injuries or medically cleared to do so. Practice this repeatedly until you begin to fall asleep without effort.
(DSW, LCSW, ACSW)
Answered on 10/18/2021

How can I better motivated myself and get a better sleeping pattern?

Dear Dec,   Thank you for your message and sharing with me how you've been interacting with yourself, especially on how you've been handling unpleasant feelings and emotions that affects your sleep. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress/depression) was so terrible (even physically) that our body sort of become traumatized to it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result, we would do everything we can to avoid/fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations, while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like sufferings, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting of life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace, and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because with anything that we do in life that brings us meaning and fulfillment, it always accompany a wide range of emotions, we can't possibly just choose the ones that we like and fight/avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings, or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings and thoughts, while continue to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating, is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths, and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes, until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again, and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 10/18/2021

Can therapy help with insomnia and the anxiety that ultimately becomes associated with sleeping?

Hello MP,    I am so sorry to hear that you have been suffering from insomnia. I would agree that it does seem that it is more the worry about not being able to fall and stay asleep that has you awake. One of the things that will help you is to keep a sleep schedule. I would try to be sure to go to bed at the same time every night and wake up at the same time every morning, even if you are able to sleep in. This helps your body to know when it is time to be asleep, and time to be awake-like muscle memory. Also, going to bed early might cause you to wake up earlier, or sleeping in may lead to fragmented sleep. Trying to avoid caffeine and nicotine will help you, along with avoiding alcohol which can make you wake up in the middle of the night and have difficulty falling back asleep. Getting regular exercise, but being sure that you are not exercising before bed, will also help prevent insomnia. I would also try to develop a routine right before bed, that you do every night, again to use that muscle memory to remind yourself that it is time for bed, maybe taking a warm bath or shower and reading a book. Relaxing about 30 minutes before bed will help you to get in the right mindset for sleep. Also, I would be sure that any screen or phone time has ended well before you begin your nighttime routine.  Although I know you have not identified insomnia in and of itself as an issue, I wanted to go over some of the things that will help with your sleep, so that you can use some of the strategies I will discuss next before going to sleep.  One strategy that you can begin trying when you are laying in bed about to go to sleep, is visualization. This is where a therapist could be extremely beneficial, as using guided imagery can help you to calm your body and mind and help to reduce or eliminate the thoughts that are running through your mind and making it difficult to fall asleep. Practicing relaxation techniques such as meditation with the counselor would be helpful as well.  Lastly, one last thought would be to keep a sleep diary or log that will help you to keep track of your sleep patters and routines that you could then use to make note of trends and discuss when you are in treatment. Sometimes we have stressors that are preventing us from getting a healthy amount of sleep that we may not even realize exists. You are absolutely right when you say that trying not to think about something makes it almost impossible to stop thinking about that very thing! So using the visualization and guided imagery to stop those thoughts will probably be the most successful way in dealing with this issue, and a counselor can absolutely help you on that path. I want to wish you the the best, and I hope that you found this response helpful!Thank you, Melissa   
(MSW, LICSW)
Answered on 10/18/2021

Anxiety, depression, sleeping problems

Hello and thank you so much for reaching out. It sounds like you are having some difficulties with your sleep due to anxious thoughts and the physiological consequences of anxiety such as a racing heart. For you, I would recommend cognitive behavioral therapy for insomnia. This is a structured, evidence-based treatment for disturbed sleep especially insomnia. With this type of therapy, you first start with lots of psychoeducation on how anxiety can negatively impact sleep and start a very vicious cycle that is difficult to get out of. This therapy also includes both sleep hygiene tips and stimulus control which is making sure that you are doing everything to promote good sleep. Stimulus control is really important and helps you associate your bed with good sleep. With this being said, the bed is for sleep and sex only. So you have to be sure to do anything else away from your bed or even outside your bedroom and this includes worries! Every time you worry in bed, you are teaching your brain that you worry in bed. So to teach your brain new associations every time you catch yourself worrying in bed, get up and go to a different room. Write down your worries and wait until you get sleepy again. Once you are sleepy, you return to bed and attempt to fall asleep again. If you find yourself tossing and turning and worrying, get up out of bed and repeat the process. Some folks have to repeat this whole cycle a couple of times but your brain is a great learner and will catch on quickly. Others also find it helpful to write down all their worries in a designated place at a designated time each day. Then leave those worries until you come back to them the next day. After you implement sleep hygiene tips and practice stimulus control, some people engaging in cognitive behavioral therapy for insomnia will be instructed to restrict their sleep. It sounds counterintuitive but it actually helps with resetting your circadian rhythm. You either go to bed later or wake up earlier for a set number of days. This intentional tiredness is called a sleep tsunami and we use it to help you get more quality sleep instead of poor sleep spread across more hours. This way you are more tired and likely to reach those deeper stages of sleep that you are looking for. The final part of cognitive-behavioral therapy for chronic pain is cognitive restructuring where you examine your sleep-related thoughts and emotions and see how to make those better. Because worries about sleep are more likely to lead to negative emotions which can lead to more difficulties with poor sleep. So if you think this is something that would benefit you, I would definitely seek a therapist who is trained to provide cognitive behavioral therapy for insomnia. Good luck with your search! 
Answered on 10/18/2021

I just want a diagnose or what is this why I'm like this. "That is one of the million problèmes"

Dear Tia,   Thank you for your message and sharing with me how you've been interacting with yourself, especially on how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress / depression) was so terrible (even physically) that our body sort of become traumatized to it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result we would do everything we can to avoid / fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations, while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like sufferings, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting of life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because with anything that we do in life that brings us meaning and fulfillment, it always accompany a wide range of emotions, we can't possibly just choose the ones that we like and fight / avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings and thoughts, while continue to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating, is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths, and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes, until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again, and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Does this make sense so far?   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 10/18/2021

How can I get back to sleeping normally and how will I chat with my counselor yet I can't afford to

Hello Ket, I am glad you reached out for support at this time.  I am sorry you are struggling in this moment.  I would encourage you to start to work with a therapist to help you learn skills to help you overcome your struggles.  If we were to meet I would first talk to you about the counseling process through our site and how together we could help you obtain your goals going forward, how I work as a counselor and how I would try to help you through the counseling process.  I would also take the first session to get to know you by asking you a few questions to get a better understanding of your struggles, so that I am able to focus on a plan and goals to work on going forward. I want you to know that you are not alone during this time even through you may feel like you are alone at this time.  During the therapy process you can have support 100% of the time as you are able to reach out and talk to a therapist 24 hours a day 7 days a week.   A few of the questions I would ask would include the following:Can you tell me more about your past history?How long have you been struggling with your sleep? Do you have dreams or nightmears that keep you up at night? You had mentioned having panick attacks in the past, i would like to hear more about what happened and how they stopped for you?I am going to send you some skills and tools to help you during this time of struggle you are having.  If we were to work together we would be going over these and more tools to help you through our struggles and be able to ask for support from others. Insomnia—difficulty in falling or staying asleep—affects as many as 1 in 3 people, and almost anyone could do with better, more restorative sleep. Insomnia usually becomes a problem if it occurs on most nights and causes distress or daytime effects such as fatigue, poor concentration, and irritability.The relationship between insomnia and depression is far from simple, as insomnia can both cause and be caused by depression. Insomnia not only predisposes to depression but also exacerbates existing depressive symptoms, making it harder to pull through. Insomnia also predisposes to other mental disorders such as anxiety disorders and psychotic disorders; to physical problems such as infections, high blood pressure, obesity, and diabetes; and to motoring and other accidents.Aside from depression, common causes or contributors to insomnia include poor sleeping habits, other mental disorders such as anxiety disorders and psychotic disorders, physical problems such as pain or shortness of breath, certain prescription medications, and alcohol and drug misuse. The most important causes of short-term insomnia (the commonest type of insomnia) are a stressful life event, a poor sleeping environment, and an irregular routine.If you are suffering from insomnia, there are a number of simple measures that you can take to resolve or at least reduce the problem:1. Set up a strict routine involving regular and adequate sleeping times (most adults need about seven or eight hours sleep every night). Allocate a time for sleeping, for example, 11pm to 7am, and don’t use this time for anything else. Avoid daytime naps, or make them short and regular. If you have a bad night, avoid sleeping late, as this makes it more difficult to fall asleep the following night.2. Devise a relaxing bedtime routine that enables you to wind down before bedtime. This may involve breathing exercises or meditation or simply reading a book, listening to music, or watching TV.3. Enjoy a hot, non-caffeinated drink such as herbal tea or hot chocolate. In time, your hot drink could become a sleeping cue.4. Sleep in a familiar, dark, and quiet room that is adequately ventilated and neither too hot nor too cold. Try to use this room for sleeping only, so that you come to associate it with sleep. In time, your room could become another sleeping cue.5. If sleep doesn’t come, don’t become anxious or annoyed and try to force yourself to sleep. The more aggravated you become, the less likely you are to fall asleep. Instead, try to clear your mind and relax. For example, I find that making myself feel grateful for something soon sends me off to sleep. Alternatively, get up and do something relaxing and enjoyable for about half an hour before giving it another go.6. Exercise regularly. This will also help you with your low mood. However, don’t workout too close to bedtime as the short-term alerting effects of exercise may make it harder to fall asleep.7. Reduce your overall stress. At the same time, try to do something productive or enjoyable each day. As da Vinci said, a well-spent day brings happy sleep (and a well- spent life brings happy death).8. Eat a wholesome evening meal with a good balance of protein and complex carbohydrates. Eating too much can make it difficult to fall asleep; eating too little can disturb your sleep and decrease its quality.9. Avoid caffeine, alcohol, and tobacco, particularly in the evening. Alcohol may make you fall asleep more readily, but it decreases the overall length and quality of your sleep.10. If insomnia persists despite these measures, speak to your doctor. In some cases, insomnia has a very specific cause such as a physical problem or an adverse effect of your medication that requires your doctor’s attention. Lack of sleep can have major consequences on your mood and productivity as work, and even life-threatening dangerous implications for commuters or individuals operating vehicles or heavy machinery. Lack of sleep has also been linked to the emergence and worsening of many chronic health problems, including type 2 diabetes, cardiovascular disease, obesity and depression.How can you get better sleep to perform better at work and in life? Here are the 10 steps you can take.1. Minimize DistractionsBan TVs and computers from the bedroom. TVs and computers emit blue light that trick the body into believing it’s daytime, making falling asleep more difficult. They are also distracting and might keep you awake even when you’re feeling tired.2. Avoid CaffeineSteer clear of caffeine in beverages and food for six to eight hours before bedtime.3. Minimize Alcohol ConsumptionDrinking may help you feel drowsy, but it has been shown to disrupt sleeping patterns and create a lower quality, less restorative night’s rest. Don’t have alcohol close to bedtime— it can wake you up three to four hours later. (A drink with dinner is OK.)4. Develop a RoutinePick a bedtime and a wake time and stick with them from night to night. Signal to your body that it’s time for bed taking a shower or bath, playing soft music, doing light reading or eating a small snack.5. Establish a Bedtime“I’ll sleep when I’m dead” may sound inspiring, but sleep should be a top priority. Designate seven to eight hours in your daily schedule for sleep.6. Create a Safe SpaceOptimize your bedroom for a good night’s sleep by keeping your bedroom comfortable, dark and quiet. Clean bedding, cool temperatures and serene quiet can make a big difference in helping you fall asleep.7. Use Your Bed Exclusively for SleepJust because you are in bed doesn’t mean that you’re asleep. Many people use their beds as a comfortable place for lounging, browsing the internet on their laptops and scrolling through social media on their phones. Reserve your bedroom exclusively for sleeping and sex. This will help you associate your bed with sleep.8. Power Down the ElectronicsTwenty to 30 minutes before bedtime dim your lights and switch off electronics. Like TVs and computers, cell phones and tablets emit blue light, tricking your body into believing it’s daytime.9. Practice Relaxation TechniquesTry relaxation exercises at bedtime if you need to unwind before hitting the hay. Some activities that can help you fall asleep include yoga, deep breathing or guided meditation.10. Avoid Lying in Bed AwakeFew things feel worse than lying in bed for hours trying to sleep. If you don’t fall asleep within 15 to 20 minutes, get out of bed, leave the bedroom and try some of your calming before-bed activities again.   Think about all the factors that can interfere with a good night's sleep — from work stress and family responsibilities to unexpected challenges, such as illnesses. It's no wonder that quality sleep is sometimes elusive.While you might not be able to control the factors that interfere with your sleep, you can adopt habits that encourage better sleep. Start with these simple tips.1. Stick to a sleep scheduleSet aside no more than eight hours for sleep. The recommended amount of sleep for a healthy adult is at least seven hours. Most people don't need more than eight hours in bed to achieve this goal.Go to bed and get up at the same time every day. Try to limit the difference in your sleep schedule on weeknights and weekends to no more than one hour. Being consistent reinforces your body's sleep-wake cycle.If you don't fall asleep within about 20 minutes, leave your bedroom and do something relaxing. Read or listen to soothing music. Go back to bed when you're tired. Repeat as needed.2. Pay attention to what you eat and drinkDon't go to bed hungry or stuffed. In particular, avoid heavy or large meals within a couple of hours of bedtime. Your discomfort might keep you up.Nicotine, caffeine and alcohol deserve caution, too. The stimulating effects of nicotine and caffeine take hours to wear off and can wreak havoc on quality sleep. And even though alcohol might make you feel sleepy, it can disrupt sleep later in the night.3. Create a restful environmentCreate a room that's ideal for sleeping. Often, this means cool, dark and quiet. Exposure to light might make it more challenging to fall asleep. Avoid prolonged use of light-emitting screens just before bedtime. Consider using room-darkening shades, earplugs, a fan or other devices to create an environment that suits your needs.Doing calming activities before bedtime, such as taking a bath or using relaxation techniques, might promote better sleep.4. Limit daytime napsLong daytime naps can interfere with nighttime sleep. If you choose to nap, limit yourself to up to 30 minutes and avoid doing so late in the day.If you work nights, however, you might need to nap late in the day before work to help make up your sleep debt.5. Include physical activity in your daily routineRegular physical activity can promote better sleep. Avoid being active too close to bedtime, however.Spending time outside every day might be helpful, too.6. Manage worriesTry to resolve your worries or concerns before bedtime. Jot down what's on your mind and then set it aside for tomorrow.Stress management might help. Start with the basics, such as getting organized, setting priorities and delegating tasks. Meditation also can ease anxiety. How can I get a better night’s sleep?Sleeping well directly affects your mental and physical health. Fall short and it can take a serious toll on your daytime energy, productivity, emotional balance, and even your weight. Yet many of us regularly toss and turn at night, struggling to get the sleep we need. Getting a good night’s sleep may seem like an impossible goal when you’re wide awake at 3 a.m., but you have much more control over the quality of your sleep than you probably realize. Just as the way you feel during your waking hours often hinges on how well you sleep at night, so the cure for sleep difficulties can often be found in your daily routine.Unhealthy daytime habits and lifestyle choices can leave you tossing and turning at night and adversely affect your mood, brain and heart health, immune system, creativity, vitality, and weight. But by experimenting with the following tips, you can enjoy better sleep at night, boost your health, and improve how you think and feel during the day.Tip 1: Keep in sync with your body’s natural sleep-wake cycleGetting in sync with your body’s natural sleep-wake cycle, or circadian rhythm, is one of the most important strategies for sleeping better. If you keep a regular sleep-wake schedule, you’ll feel much more refreshed and energized than if you sleep the same number of hours at different times, even if you only alter your sleep schedule by an hour or two.Try to go to sleep and get up at the same time every day. This helps set your body’s internal clock and optimize the quality of your sleep. Choose a bed time when you normally feel tired, so that you don’t toss and turn. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock, you may need an earlier bedtime.Avoid sleeping in—even on weekends. The more your weekend/weekday sleep schedules differ, the worse the jetlag-like symptoms you’ll experience. If you need to make up for a late night, opt for a daytime nap rather than sleeping in. This allows you to pay off your sleep debt without disturbing your natural sleep-wake rhythm.Be smart about napping. While napping is a good way to make up for lost sleep, if you have trouble falling asleep or staying asleep at night, napping can make things worse. Limit naps to 15 to 20 minutes in the early afternoon.Fight after-dinner drowsiness. If you get sleepy way before your bedtime, get off the couch and do something mildly stimulating, such as washing the dishes, calling a friend, or getting clothes ready for the next day. If you give in to the drowsiness, you may wake up later in the night and have trouble getting back to sleep.Tip 2: Control your exposure to lightMelatonin is a naturally occurring hormone controlled by light exposure that helps regulate your sleep-wake cycle. Your brain secretes more melatonin when it’s dark—making you sleepy—and less when it’s light—making you more alert. However, many aspects of modern life can alter your body’s production of melatonin and shift your circadian rhythm.How to influence your exposure to lightDuring the day:Expose yourself to bright sunlight in the morning. The closer to the time you get up, the better. Have your coffee outside, for example, or eat breakfast by a sunny window. The light on your face will help you wake upSpend more time outside during daylight. Take your work breaks outside in sunlight, exercise outside, or walk your dog during the day instead of at night.Let as much natural light into your home or workspace as possible. Keep curtains and blinds open during the day, and try to move your desk closer to the window.If necessary, use a light therapy box. This simulates sunshine and can be especially useful during short winter days.At night:Avoid bright screens within 1-2 hours of your bedtime. The blue light emitted by your phone, tablet, computer, or TV is especially disruptive. You can minimize the impact by using devices with smaller screens, turning the brightness down, or using light-altering software such as f.lux.Say no to late-night television. Not only does the light from a TV suppress melatonin, but many programs are stimulating rather than relaxing. Try listening to music or audio books instead.Don’t read with backlit devices. Tablets that are backlit are more disruptive than e-readers that don’t have their own light source.When it’s time to sleep, make sure the room is dark. Use heavy curtains or shades to block light from windows, or try a sleep mask. Also consider covering up electronics that emit light.Keep the lights down if you get up during the night. If you need some light to move around safely, try installing a dim nightlight in the hall or bathroom or using a small flashlight. This will make it easier for you to fall back to sleep.Tip 3: Exercise during the dayPeople who exercise regularly sleep better at night and feel less sleepy during the day. Regular exercise also improves the symptoms of insomnia and sleep apnea and increases the amount of time you spend in the deep, restorative stages of sleep.·         The more vigorously you exercise, the more powerful the sleep benefits. But even light exercise—such as walking for just 10 minutes a day—improves sleep quality.·         It can take several months of regular activity before you experience the full sleep-promoting effects. So be patient and focus on building an exercise habit that sticks.For better sleep, time your exercise rightExercise speeds up your metabolism, elevates body temperature, and stimulates hormones such as cortisol. This isn’t a problem if you’re exercising in the morning or afternoon, but too close to bed and it can interfere with sleep.Try to finish moderate to vigorous workouts at least three hours before bedtime. If you’re still experiencing sleep difficulties, move your workouts even earlier. Relaxing, low-impact exercises such as yoga or gentle stretching in the evening can help promote sleep.Tip 4: Be smart about what you eat and drinkYour daytime eating habits play a role in how well you sleep, especially in the hours before bedtime.Limit caffeine and nicotine. You might be surprised to know that caffeine can cause sleep problems up to ten to twelve hours after drinking it! Similarly, smoking is another stimulant that can disrupt your sleep, especially if you smoke close to bedtime.Avoid big meals at night. Try to make dinnertime earlier in the evening, and avoid heavy, rich foods within two hours of bed. Spicy or acidic foods can cause stomach trouble and heartburn.Avoid alcohol before bed. While a nightcap may help you relax, it interferes with your sleep cycle once you’re out.Avoid drinking too many liquids in the evening. Drinking lots of fluids may result in frequent bathroom trips throughout the night.Cut back on sugary foods and refined carbs. Eating lots of sugar and refined carbs such as white bread, white rice, and pasta during the day can trigger wakefulness at night and pull you out of the deep, restorative stages of sleep.Nighttime snacks help you sleepFor some people, a light snack before bed can help promote sleep. For others, eating before bed leads to indigestion and make sleeping more difficult. If you need a bedtime snack, try:·         Half a turkey sandwich·         A small bowl of whole-grain, low-sugar cereal·         Milk or yogurt·         A bananaTip 5: Wind down and clear your headDo you often find yourself unable to get to sleep or regularly waking up night after night? Residual stress, worry, and anger from your day can make it very difficult to sleep well. Taking steps to manage your overall stress levels and learning how to curb the worry habit can make it easier to unwind at night. You can also try developing a relaxing bedtime ritual to help you prepare your mind for sleep, such as practicing a relaxation technique, taking a warm bath, or dimming the lights and listening to soft music or an audiobook.Problems clearing you head at night can also stem from your daytime habits. The more overstimulated your brain becomes during the day, the harder it can be slow down and unwind at night. Maybe, like many of us, you’re constantly interrupting tasks during the day to check your phone, email, or social media. Then when it comes to getting to sleep at night, your brain is so accustomed to seeking fresh stimulation, it becomes difficult to unwind. Help yourself by setting aside specific times during the day for checking your phone and social media and, as much as possible, try to focus on one task at a time. You’ll be better able to calm your mind at bedtime.A deep breathing exercise to help you sleepBreathing from your belly rather than your chest can activate the relaxation response and lower your heart rate, blood pressure, and stress levels to help you drift off to sleep.·         Lay down in bed and close your eyes.·         Put one hand on your chest and the other on your stomach.·         Breathe in through your nose. The hand on your stomach should rise. The hand on your chest should move very little.·         Exhale through your mouth, pushing out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, but your other hand should move very little.·         Continue to breathe in through your nose and out through your mouth. Try to inhale enough so that your lower abdomen rises and falls. Count slowly as you exhale.To follow along with a guided deep breathing exercise, click here.A body scan exercise to help you sleepBy focusing your attention on different parts of your body, you can identify where you’re holding any stress or tension, and release it.·         Lie on your back, legs uncrossed, arms relaxed at your sides, eyes closed. Focus on your breathing for about two minutes until you start to feel relaxed.·         Turn your focus to the toes of your right foot. Notice any tension while continuing to also focus on your breathing. Imagine each deep breath flowing to your toes. Remain focused on this area for at least three to five seconds.·         Move your focus to the sole of your right foot. Tune in to any sensations you feel in that part of your body and imagine each breath flowing from the sole of your foot. Then move your focus to your right ankle and repeat. Move to your calf, knee, thigh, hip, and then repeat the sequence for your left leg. From there, move up your torso, through your lower back and abdomen, your upper back and chest, and your shoulders. Pay close attention to any area of the body that feels tense.·         After completing the body scan, relax, noting how your body feels. You should feel so relaxed you can easily fall asleep.For a guided body scan meditation to help you wind down and clear your head at bedtime, click here.Tip 6: Improve your sleep environmentA peaceful bedtime routine sends a powerful signal to your brain that it’s time to wind down and let go of the day’s stresses. Sometimes even small changes to your environment can make a big difference to your quality of sleep.Keep your room dark, cool, and quietKeep noise down. If you can’t avoid or eliminate noise from neighbors, traffic, or other people in your household, try masking it with a fan or sound machine. Earplugs may also help.Keep your room cool. Most people sleep best in a slightly cool room (around 65° F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold can interfere with quality sleep.Make sure your bed is comfortable. Your bed covers should leave you enough room to stretch and turn comfortably without becoming tangled. If you often wake up with a sore back or an aching neck, you may need to experiment with different levels of mattress firmness, foam toppers, and pillows that provide more or less support.Reserve your bed for sleeping and sex. By not working, watching TV, or using your phone, tablet, or computer in bed, your brain will associate the bedroom with just sleep and sex, which makes it easier to wind down at night.Tip 7: Learn ways to get back to sleepIt’s normal to wake briefly during the night but if you’re having trouble falling back asleep, these tips may help:Stay out of your head. Hard as it may be, try not to stress over your inability to fall asleep again, because that stress only encourages your body to stay awake. To stay out of your head, focus on the feelings in your body or practice breathing exercises. Take a breath in, then breathe out slowly while saying or thinking the word, “Ahhh.” Take another breath and repeat.Make relaxation your goal, not sleep. If you find it hard to fall back asleep, try a relaxation technique such as visualization, progressive muscle relaxation, or meditation, which can be done without even getting out of bed. Even though it’s not a replacement for sleep, relaxation can still help rejuvenate your body.Do a quiet, non-stimulating activity. If you’ve been awake for more than 15 minutes, get out of bed and do a quiet, non-stimulating activity, such as reading a book. Keep the lights dim and avoid screens so as not to cue your body that it’s time to wake up.Postpone worrying and brainstorming. If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when it will be easier to resolve. Similarly, if a great idea is keeping you awake, make a note of it on paper and fall back to sleep knowing you’ll be much more productive after a good night’s rest. I hope that these skills have been helpful for you in your struggles you have been facing at this time.  If we were to work together we would work on more skills and tools to help you when you are struggling to fall asleep at night and to help you get back to a positive space.  I encourage you to reach out for support at this time to help you get to the best version of yourself.
Answered on 10/18/2021

What should I do to make myself feel better ?

Hello and thank you for submitting your question.  A year is along time to struggle with sleep and stress. I can only imagine how challenging it must be for you to cope and function daily. I am sorry to hear that you have lost your job due to COVID-19. You are certainly not alone - a significant number of people have lost their jobs in this pandemic, in addition to other impacts. It sounds as thought you were highly passionate and received job satisfaction from your previous job. The feelings you had for your previous job makes coping with the loss all the more challening. Questions for you: Have you talked with a medical provider regarding prolonged sleep challenges? Have you tried over the counter sleep aids? Melatonin? Or any teas that help with sleeping (Chamomile Tea)? If you have not explored the questions I just asked, please consider doing so. To respond to your question about what you can do to make yourself feel better? I suggest establishing a mindfulness practice if you do not already do so. By mindfulness practice I mean: Box Breathing, Diaphragmatic Breathing and/or Progressive Muscle Relaxation. There are also options for Mindful Walking and Mindful Eating. Two apps I often recommend to help with exploring and establishing mindfulness practice are: Calm and Headspace. For the record, I do receive any financial compensation for recommend the previous apps. Bottomline - they are helpful. YouTube is also an excellent resource and provides a wealth of information: audio/video for mindfulness practice. There are specific mindfulness practices for sleep that may be helpful. If and when you decide to begin practicing mindfulness, I suggest you start small/gradually. It may take some time to quiet your mind and thoughts. Give yourself permission to release your thoughts and focus on mindfulness practice. Overtime, you will experience and enjoy the benefits. I also encourage you to seek counseling. Through counseling, you will be able to process depressive symptoms and sleep challenges you are experiencing. Also, you will develop tools to use to cope with presenting symptoms. Aroma therapy (Lavender Oil) is helpful help you relax and potentially prepare you for sleep. I am not sure if you skin can tolerate, Lavender oil. If so, you can rub a small amount on pressure points. Alternatively, you can place on a wash cloth and hand the wash cloth on your shoulder or place in your pillow case to help you relax and possible help you sleep. It sounds as though you and your mother care deeply about each other. However, the stressors you are currently experiencing is causing the relationship to be tense. Talk with your mother about specific support she can provide you to cope with stressors. If you have a strong support network: friends and family, you can engage them as well for support. To begin the transition process, you can slowing explore job opportunities for the future. Although it will be difficult to adjust to a new employer, it is doable. I hope this response has been helpful for to you and you can take some active steps to assist you with addressing your current needs. 
(PhD, MPH, MSW)
Answered on 10/18/2021

Do you have any recommendations for people who have trouble sleeping?

It’s well-established that sleep is essential to our physical and mental health. But despite its importance, a troubling percentage of people find themselves regularly deprived of quality sleep and are notably sleepy during the day. Though there’s a wide range of causes and types of sleeping problems, expert consensus points to a handful of concrete steps that promote more restful sleep. Organizations like the CDC1, the National Institutes of Health2, the National Institute on Aging3, and the American Academy of Family Physicians4 point to the same fundamental tips for getting better rest. For many people, trying to implement all these strategies can be overwhelming. But remember that it’s not all-or-nothing; you can start with small changes and work your way up toward healthier sleep habits, also known as sleep hygiene. To make these sleep hygiene improvements more approachable, we’ve broken them into four categories: Creating a Sleep-Inducing Bedroom Optimizing Your Sleep Schedule Crafting a Pre-Bed time Routine Fostering Pro-Sleep Habits During the Day In each category, you can find specific actions that you can take to make it easier to fall asleep, stay asleep, and wake up well-rested. Creating a Sleep-Inducing Bedroom An essential tip to help fall asleep quickly and easily is to make your bedroom a place of comfort and relaxation. Though this might seem obvious, it’s often overlooked, contributing to difficulties getting to sleep and sleeping through the night. In designing your sleep environment, focus maximizing comfort and minimizing distractions, including with these tips: Use a High-Performance Mattress and Pillow: A quality mattress is vital to making sure that you are comfortable enough to relax. It also ensures, along with your pillow, that your spine gets proper support to avoid aches and pains. Choose Quality Bedding: Your sheets and blankets play a major role in helping your bed feel inviting. Look for bedding that feels comfortable to the touch and that will help maintain a comfortable temperature during the night. Avoid Light Disruption: Excess light exposure can throw off your sleep and circadian rhythm. Blackout curtains over your windows or a sleep mask for over your eyes can block light and prevent it from interfering with your rest. Cultivate Peace and Quiet: Keeping noise to a minimum is an important part of building a sleep-positive bedroom. If you can’t eliminate nearby sources of noise, consider drowning them out with a fan or white noise machine. Earplugs or headphones are another option to stop abrasive sounds from bothering you when you want to sleep. Find an Agreeable Temperature: You don’t want your bedroom temperature to be a distraction by feeling too hot or too cold. The ideal temperature can vary based on the individual, but most research supports sleeping in a cooler room that is around 65 degrees. Introduce Pleasant Aromas: A light scent that you find calming can help ease you into sleep. Essential oils with natural aromas, such as lavender5, can provide a soothing and fresh smell for your bedroom. Optimizing Your Sleep Schedule Taking control of your daily sleep schedule is a powerful step toward getting better sleep. To start harnessing your schedule for your benefit, try implementing these four strategies: Set a Fixed Wake-Up Time: It’s close to impossible for your body to get accustomed to a healthy sleep routine if you’re constantly waking up at different times. Pick a wake-up time and stick with it, even on weekends or other days when you would otherwise be tempted to sleep in. Budget Time for Sleep: If you want to make sure that you’re getting the recommended amount of sleep each night, then you need to build that time into your schedule. Considering your fixed wake-up time, work backwards and identify a target bedtime. Whenever possible, give yourself extra time before bed to wind down and get ready for sleep. Be Careful With Naps: To sleep better at night, it’s important to use caution with naps. If you nap for too long or too late in the day, it can throw off your sleep schedule and make it harder to get to sleep when you want to. The best time to nap is shortly after lunch in the early afternoon, and the best nap length is around 20 minutes. Adjust Your Schedule Gradually: When you need to change your sleep schedule, it’s best to make adjustments little-by-little and over time with a maximum difference of 1-2 hours per night6. This allows your body to get used to the changes so that following your new schedule is more sustainable. Crafting a Pre-Bed Routine If you have a hard time falling asleep, it’s natural to think that the problem starts when you lie down in bed. In reality, though, the lead-up to bedtime plays a crucial role in preparing you to fall asleep quickly and effortlessly. Poor pre-bed habits are a major contributor to insomnia and other sleep problems. Changing these habits7 can take time, but the effort can pay off by making you more relaxed and ready to fall asleep when bedtime rolls around. As much as possible, try to create a consistent routine that you follow each night because this helps reinforce healthy habits and signals to mind and body that bedtime is approaching. As part of that routine, incorporate these three tips: Wind Down For At Least 30 Minutes: It’s much easier to doze off smoothly if you are at-ease. Quiet reading, low-impact stretching, listening to soothing music, and relaxation exercises are examples of ways to get into the right frame of mind for sleep. Lower the Lights: Avoiding bright light can help you transition to bedtime and contribute to your body’s production of melatonin, a hormone that promotes sleep. Disconnect From Devices: Tablets, cell phones, and laptops can keep your brain wired, making it hard to truly wind down. The light from these devices can also suppress your natural production of melatonin. As much as possible, try to disconnect for 30 minutes or more before going to bed. Fostering Pro-Sleep Habits During the Day Setting the table for high-quality sleep is an all-day affair. A handful of steps that you can take during the day can pave the way for better sleep at night. See the Light of Day: Our internal clocks8 are regulated by light exposure. Sunlight has the strongest effect9, so try to take in daylight by getting outside or opening up windows or blinds to natural light. Getting a dose of daylight early in the day can help normalize your circadian rhythm. If natural light isn’t an option, you can talk with your doctor about using a light therapy box. Find Time to Move: Daily exercise has across-the-board benefits for health, and the changes it initiates in energy use and body temperature can promote solid sleep. Most experts advise against intense exercise close to bedtime because it may hinder your body’s ability to effectively settle down before sleep. Monitor Your Caffeine Intake: Caffeinated drinks, including coffee, tea, and sodas, are among the most popular beverages in the world. Some people are tempted to use the jolt of energy from caffeine to try to overcome daytime sleepiness, but that approach isn’t sustainable and can cause long-term sleep deprivation. To avoid this, keep an eye on your caffeine intake and avoid it later in the day when it can be a barrier to falling sleep. Be Mindful of Alcohol: Alcohol can induce drowsiness, so some people are keen on a nightcap before bed. Unfortunately, alcohol affects the brain in ways that can lower sleep quality, and for that reason, it’s best to avoid alcohol in the lead-up to bedtime. Don’t Eat Too Late: It can be harder to fall asleep if your body is still digesting a big dinner. To keep food-based sleep disruptions to a minimum, try to avoid late dinners and minimize especially fatty or spicy foods. If you need an evening snack, opt for something light and healthy. Don’t Smoke: Exposure to smoke, including secondhand smoke, has been associated with a range of sleeping problems10 including difficulty falling asleep and fragmented sleep. Reserve Your Bed for Sleep and Sex Only: If you have a comfortable bed, you may be tempted to hang out there while doing all kinds of activities, but this can actually cause problems at bedtime. You want a strong mental association between your bed and sleep, so try to keep activities in your bed limited strictly to sleep and sex. If You Can’t Fall Asleep Whether it’s when you first get into bed or after waking up in the middle of the night, you may find it hard to drift off to sleep. These tips help explain what to do when you can’t sleep: Try Relaxation Techniques: Don’t focus on trying to fall asleep; instead, focus on just trying to relax11. Controlled breathing, mindfulness meditation, progressive muscle relaxation, and guided imagery are examples of relaxation methods that can help ease you into sleep12. Don’t Stew in Bed: You want to avoid a connection in your mind between your bed and frustration from sleeplessness. This means that if you’ve spent around 20 minutes in bed without being able to fall asleep, get out of bed and do something relaxing in low light. Avoid checking the time during this time. Try to get your mind off of sleep for at least a few minutes before returning to bed. Experiment WIth Different Methods: Sleeping problems can be complex and what works for one person may not work for someone else. As a result, it makes sense to try different approaches to see what works for you. Just remember that it can take some time for new methods to take effect, so give your changes time to kick in before assuming that they aren’t working for you. Keep a Sleep Diary: A daily sleep journal can help you keep track of how well you’re sleeping and identify factors that might be helping or hurting your sleep. If you’re testing out a new sleep schedule or other sleep hygiene changes, the sleep diary can help document how well it’s working. Talk With a Doctor: A doctor is in the best position to offer detailed advice for people with serious difficulties sleeping. Talk with your doctor if you find that your sleep problems are worsening, persisting over the long-term, affecting your health and safety (such as from excessive daytime sleepiness), or if they occur alongside other unexplained health problems.
(MSW, LCSW, CCATP)
Answered on 10/18/2021

Does BetterHelp offer counseling that specializes in sleep psychology?

Thanks for reaching out with your question. That has got to be stressful to be struggling with sleep insomnia! I am glad you are seeking resources to help you with that. BetterHelp has counselors that are specialized In all different areas. When you sign up for a better help you can choose what type of counseling you were looking for as well as the specialties the counselor is specialized in. This way you would be matched with somebody who was specialize in sleep disorders. Many of the counselors are specialize in CBT as it is one of the most evidence-based modalities of counseling. If you are finding it helpful you would want to talk to the counselor about that as well. I would want to rule out any medical condition that is going on so talking to a doctor if you have an already may be your first step even before counseling. I don't know if you've already had a sleep study but they can be very helpful in finding out the cause. There's a lot of neurological connections when it comes to sleep sometimes people have overactive chemicals in their brain that prohibit them from sleeping. One of the natural chemicals is melatonin and a lot of people have to take supplements for that because their body doesn't produce it naturally. All of this a doctor can walk you through and help you with and figure out the root cause. If it is more mental health based account so I would definitely be able to pick up from there and help you. Some suggestions that hopefully your course is talking to you about is about nutrition and how that can affect your sleep or lack there of. Some people report it is helpful to keep the food and drink journal and to compare it with their ability to sleep that day. Having a sleep/wake routine is also very helpful. Going to bed at a certain time each day as well as waking up at the same time each morning can help reprogram the brain. Doing a soothing activity prior to bedtime can also help and get your brain ready to transition to nighttime. Taking a bath, doing some mindfulness exercises, some yoga, reading a book. All of these can send a signal to your brain to start gearing up for night time and sleep. In the morning it could be helpful to wake up and start with some form of exercise. Limit the amount of coffee and caffeine that you may be consuming as well as it can affect everyone differently.  Progressive muscle relaxation can also be helpful at night time when you're laying in bed. This is where you tense up all different muscles in your body one of the time. Some people start coming to head down to their feet and by the time we get to the feet they feel relaxed. Back to your original question though yes, you can find all sorts of counselors that are specialized in different areas with sleep being one of them. I wish you the best of luck!
(M.Ed, LPC)
Answered on 10/18/2021

How can I manage my worries and palpitation, especially my feelings.

Dear Leta, Thanks for your question. I'm sorry to hear that you are having such stress, worry and trouble sleeping. This is a difficult time for many, and it certainly sounds like you have been suffering, additionally - for a long time due to several compounding situations that have caused significant emotional distress, worry and self-doubt. Do not despair! You can make small changes that move you towards physical health and mental wellness. To answer your question directly about developing some ideas to help manage your worries and feelings - please keep reading; My note, in response to your inquiry is packed with suggestions and recommendations; Some you may like and others you may dismiss. That is fine. Changing (bad or unhealthy) habits takes practice, but you have got to start somewhere: Here are some ideas to help you move forward: You asked to have general information, but here is a quick low-risk exercise that may ease some of your current stress and emotional discomfort: Back in February, before the pandemic and US election stress, NPR's podcast Life Kit highlighted an author and mindfulness teacher, Tara Brach. In her new book, "Radical Compassion," she offers a practical guide to dealing with anxiety and chronic worry using mindfulness in a four-step approach called R.A.I.N (This information is adapted from a colleague of mine) When you find yourself in a particular "stuck" moment, or caught in a trance of anxious (other high emotion, like anger) thought, try the R.A.I.N. approach: 📛 1. Recognize: The first step is to become aware that you are stuck in your anxiety and name it for what it is. This can be the hardest step because it requires us to purposefully shift from reacting to responding. Once you realize that you are overwhelmed by a feeling, name the emotion that most stands out to you: "fear", "anger", "hurt", or maybe "confused." ⏯ 2. Allow: Next, give yourself power with a pause. Let the emotion be there; tell yourself it is OK to be like that for a few moments. The emotion is different now because you have now given it a name. Now, you can do something about it. 🔎 3. Investigate: Ask yourself, "what really needs my attention right now?" Check in with your physical body, notice the places where you feel tension or discomfort and address your physiological needs first. Then attend to your emotional needs. Ask, "what am I believing right now?" and then, "what do I need to get through this?"   🌿 4. Nurture: And finally, no matter what you're feeling, be kind to yourself. Emotions are a large part of being a human, so give them space to happen and be mindful about how you respond and what you need to resolve, move forward and make decisions if needed. After you have gone through these steps, notice the difference in your body and mind, and in your quality of being present, from where you started.   Here are some additional and practical ideas to help support you and build your confidence and reduce your distress. I've shared a lot of information below. Please read carefully and thoughtfully. 1. Practice positive self-talk, or self-affirmation (occasionally called a mantra): There is a lot of research to support positively the practice of saying good things to ourselves - practicing positive self-talk; "Researchers have long marveled at the almost-magical power of self-affirmation ....(and) people with bad health habits become more amenable to shaping up. The simple act of focusing on the sources of meaning and purpose in our lives is incredibly effective at lowering defenses and changing behavior" (Falk & O'Donnell, 2015). An example of positive self-talk is, "I am a kind person" or "I deserve joy and happiness" or "I am courageous". You get the idea. At the start, it might feel strange to begin to say these types of words to yourself, but it will become less uncomfortable as you make the practice of positive self-talk your own.  2. Honor your (difficult) emotions and set boundaries for your sadness, worry, and anxious feelings: For example, set aside specific time to worry, freak out or feel anxious - even set a timer, say 15 minutes - devote time to cry, stomp around your room, or write angrily in a journal - you get the idea; Then, when the timer goes off - that is the signal to end the in-the-moment worry/anxiety/self-doubt and begin something that brings you pleasure . This can be a very small thing (ie. make a cup of tea, watch a favorite TV show, take a walk, or listen to music that makes you feel joy or uplifted.). 3. Talk with supportive family/friends/colleagues: DO seek out those supportive individuals who can listen to you and validate your concerns, and perhaps even help you problem-solve. It might be someone you've never reached out to before, for example, an elderly neighbor, or long-lost friend, school-mate or colleague. Remember, they may benefit from your outreach, too. These are tough times. 4. Practice self-compassion/self-kindness (This is different from developing and practicing self-talk.): Notice, write down and reflect on all the components of your life that are going well, even if very minor - For example, I can bake really good cookies, or my fish or plants need me and I take good care of them, or nothing I've done today has been hurtful towards someone else or I've worked hard to be kind to others this week....etc. 5. Access technology - smartly: Check out apps to help ease emotional distress. For example, CALM App or HeadSpace App. Also, a research-based website that has important information about mental health and mental wellness is verywellmind.com.  Be mindful when looking online for information about mental health (or anything else, for that matter) by confirming that the information is peer-reviewed, appropriately cited and is relatively current. 6. Reach out: Though I obviously do not know where you are - could be anywhere in the world - please remember that there are many, many groups (social groups, religious groups, groups through local church or charity organizations, crisis lines and support...poke around and do some research and you may be surprised at the available services and supports available for free to help bring people together in these very difficult and trying times!) for people to join, and all of them - for obvious reasons - are currently online. Additionally, you can always access the National Crisis Hotline (aka. Suicide Prevention Hotline) at  1 800 273-8255 or by text:741741. 7. Connect with medical professionals: Please take time to visit with your medical doctor and/or mental health provider to share authentically how you are feeling and to review your health and wellness goals. Additionally, practice good sleep hygiene, limit social media, eat healthy foods, and (of course) get a reasonable amount of exercise. Finally, limit alcohol (if applicable) consumption, as well. If you'd like to start therapy with BetterHelp, I know that their staff will help connect with you a great therapist. Unfortunately, at this time my caseload is full. Take care. Amanda
(LICSW, MSW, Lic_School_Counselor)
Answered on 10/18/2021

How to deal with insomnia anxiety and depression

Thank-you for reaching out to better help for assistance. I look forward to assisting you. Sounds like you are saying you fall asleep but you wake up in the middle of the night and than you have trouble going back to sleep. Sounds like it becomes more difficult with your anxiety and depression.  I would suggest you get a good physical check up with your medical doctor, to make sure everything is okay physically and see what the medical doctor would suggest. I am sure this is frustrating that you wake up in the middle of the night and than can't get back to sleep. That is a horrible feeling to be lying in bed and not be able to go to sleep. I am sure this makes you more anxious and depressed. Are you taking any medication for your depression and anxiety. If you are, talk with your doctor about possible side effects for these medications. Also are you having dreams or nightmares at night, when you go to sleep. Nightmares and dreams could make it harder to back to sleep. Also you want to have a good sleep hygiene program. You can talk to a medical doctor about a good sleep hygiene program, google one and I will talk about it here some. For good sleep hygiene, you want to have a comfortable and relaxing place to go to sleep, no caffeine or eating after a certain time, prior to bed. You don't want to be looking at a computer screen alot prior to bed. The blue light can affect your sleep. You want to practice some good relaxation skills. Some good relaxation skills are deep breathing and progressive muscle relaxation. With deep breathing, just breath in deeply through your nose, hold for 4 seconds and blow out your mouth. This will get good oxygen to your brain. Oxygen is food for your brain. With progressive muscle relaxation you will get a good deep sleep. I would suggest trying this one. You can download a 15 minute progressive muscle relaxation video, on you tube, lie down on your bed or somewhere else, close your eyes and listen to the person talking your through the progressive muscle relaxation exercise. People say it puts them to sleep and it is a good deep sleep. It also takes away headaches. I would suggest you try both of these relaxation tips but really try the progressive muscle relaxation exercise. I wish you the best and look forward to hearing from you. Thank-you for allowing me to assist you with this problem. 
(LPC, NCC, MS)
Answered on 10/18/2021

Why do I have trouble falling asleep?

Getting good rest at night is sometimes complicated. The things that make us anxious during the day can appear during our sleep. One thing that might be helpful is to deal with those anxious feelings during the day. Often times writing down (journaling) is helpful in recognizing those things that make us anxious. It may be that simply writing them down during the day will reduce the chance of having them surface during our sleep time. Things that might be included in the journal could be simply the anxious thoughts, and what you were doing/thinking when those thoughts started. You could also include things that you did to deal with the anxious thoughts and the outcome. You may already have some solutions that you might discover by doing your journal during the day. It will give you a direction for your wellness journey. Also, just good sleep hygiene can be helpful, doing a sleep journal can be helpful as well. It gives us some clues as to what some of the solutions are. The sleep journal could include the following: the time you went to bed; what time you fell asleep; how many times you woke up and at what time; what your routine was before you went to bed; what thoughts keep you awake or woke you up; what time you finally woke up; your feelings on waking. These are some of the things that might be helpful to look at in better understanding sleep issues. During the day we need to be aware of our eating choices, and our evening schedule to ensure we are setting ourselves up for a more restful night. I think we need to ensure that we become educated about anxiety and how it affects our lives. I would also strongly recommend that if we deal with the anxiety in our lives, we can have a more peaceful day and night. If you are seeing a counselor be sure to include this in your goals as it can improve. As with most issues that we deal with this too can have a positive outcome with some work.
(MSW, PhD, LCSW)
Answered on 10/18/2021

I have severe insomnia and I cannot get sleep at all. What should i do to get my sleep back??

Hello! There is a lot we can do when it comes to maintaining a health sleep routine and good sleep hygiene. Not all things I share here is helpful for everyone, so explore all of them in order to find what may work best for you. Identify any factors that may be precipitating your sleep troubles such as specific stressors, shift work, jet lag Discuss with your doctor whether any underlying medical or psychiatric problems may be contributing to your sleep disturbance Keep a sleep diary: example located at http://yoursleep.aasmnet.org/pdf/sleepdiary.pdf Practice good sleep hygiene What is good sleep hygiene? Here are some tips: Maintain a regular sleep schedule Go to bed and wake up at the same time every day Avoid napping late in the afternoon or for longer than 20-30 minutes Spend no more than 8 hours in bed, and only sleep/stay in bed as long as you need to feel rested (usually 7-8 hours) Expose yourself to regular daytime sun or light Avoid substances Avoid caffeine within 6-8 hours of your bedtime Nicotine is a stimulant and should be avoided especially around bedtime and during night awakenings Avoid using alcohol to help you fall sleep. Alcohol may promote drowsiness but impairs deeper levels of sleep and can fragment sleep Stimulus control Go to bed only when sleepy Keep your bedroom for sleeping and sex only (e.g. avoid reading, watching TV, eating, worrying in bed) If you can’t fall asleep within 30 minutes or if you wake up in the middle of the night, go into another room to read or listen to soothing music. Return only when sleepy. Relaxation therapy Wind down at night (e.g. read a relaxing book or magazine, take a warm bath) Stop working on any task an hour before bedtime to calm mental activity At bedtime, keep your mind off worries and avoid discussing emotional issues in bed If the above recommendations fail, learn a relaxation technique such as meditation, progressive muscle relaxation, or visual imagery and practice it in bed Sleep environment Maintain a quiet, dark bedroom (consider earplugs, heavy curtains, eye mask) Do not turn on bright lights if you get up at night. Use a small night-light instead. Make sure your bed and pillows are comfortable. Keep your bedroom well ventilated and at a comfortable temperature (below 75F and above 54F) Additional tips Avoid large meals within two hours of bedtime. If you are hungry, a glass of milk or a light snack is a good choice Get 20 minutes of aerobic exercise during the day to reduce stress hormones, but avoid anything strenuous within three hours of bedtime. Regular exercise may promote deeper sleep Consider having pets stay outside of your sleeping area as they may wake you up if you have allergies or if they move around on the bed If after trying these things routinely and consistently and not being able to get good sleep, that is when consideration of medication intervention may be necessary. Over-the-counter medications like Melatonin may help, but beyond that, consultation with a physician may be needed. Hope you are able to get some better sleep!
(MA, LPC, CCDP-D)
Answered on 10/18/2021

Help with insomnia

Having a healthy sleep hygiene is critical to your mental health. There are consequences of poor sleep. Brain functioning slows down, your memory starts to be impaired, there is a increase of frequency of accidents, stress levels rise, mood becomes unstable as well as physical health starts to deteriorate: increased blood pressure, etc. The last few days your sleep has been reduced and limited. First you need to consult with your medical provider (psychiatrist or PCP) to reevaluate your condition and needs. It is best you journal or record your nights over a period of time to help the doctor identify the challenges. Here are some other tips: 1. Set a schedule- strengthen your current existing schedule. Do you have a routine? If not, establish one and become consistent. 2. Don't force yourself to sleep- if you fall asleep and notice you are up and alert- do something calming, like listen to some relaxing music or white noise sounds, read a book (non stimulating- no action or thrillers), write in a journal. Try not to get on your cell phone or watch TV because those are stimulating activities which could lead to you becoming more awake. Deep breathing exercises are helpful to relax your nervous systems as well. Square breathing: inhale, hold, exhale, hold. Continue this cycle for 5-10 minutes. As you exhale, do it slowly as if you are breathing through a coffee straw. 3. Avoid caffeine (tea, coffee), alcohol, and nicotine. 4. Avoid napping during the day- napping alters our sleep patterns. 5. Use your bed only for sleeping- try not to watch TV or be entertained by your phone. 6. Consider a weighted blanket/eye mask and 100% essential oil: lavender. Weighted blankets are a great asset. They offer a ton of benefits, especially for anxiety and depression. The weighted blank adds pressure to your body not discomfort. They tend to get warm due, so you may want to consider adjusting your temperature, as it can have an effect on the comfort level. And make sure you get the appropriate weight according to your personal weight. Lavender helps to smooth you for restful sleep.
(LPC)
Answered on 10/18/2021