Sleep Answers

Depression/anxiety

Thank you so much for reaching out with your concerns. While I do not see any questions that you have written, I will do my best to speak on how therapy may assist with the areas of concern and challenges that you are currently dealing with. You mentioned having difficulty in the last few weeks with sleep. I'm wondering what may have been a catalyst to this change. Did something happen? Were you sick? Was there trauma or loss that you recently experienced? One of the most important components of understanding sleep disturbance is the ability to identify what may have caused the disturbance to begin with. What set it into motion? Seasonal changes, daylight savings, or underlying stress and anxiety may be factors as well. There will likely be a lot of discussions to tease out the root causes and identify what is contributing to the unrestful environment. Once those factors are identified, we can begin to work on how to mitigate those risk factors and we can start to formulate a plan for improved sleep. Sometimes, making simple adjustments to an evening routine can be helpful. Turning off devices, darkening the room, using a sound machine and practicing meditation or mindfulness before getting into bed. Creating a predictable routine that you follow may also help. Going to sleep, or trying to go to sleep, at different times each night can hinder our ability to get into a restful state. Predictability can be helpful for our brains to transitioning from awake to rest.    You also indicated issues with eating and focusing. It seems as though there are a lot of areas that you are noticing a change in and would like to see improve. Again, identifying the reason for these changes and the factors contributing to these challenges is the key. Through discussion with a counselor and reflective listening, it may be that a clinician is able to identify some things that you may not be able to see easily. Therapy can help you pinpoint the causes to these disruptions and tackle them from all angles. It is a process that may take time and a lot of energy, but I do think that all of these areas you point our are areas that can be addressed and improved. 
Answered on 01/19/2022

How to get rid of dreams?

Dear Kate,   Thank you for your message and sharing.   I understand how difficult it is to try stopping your thoughts regarding your dreams. I could imagine how hard you have been trying and how frustrating to feel that nothing is working.    We can't stop our thoughts, but the more we practice being mindful of the present, the better we can catch ourselves with our thoughts and develop an alternative response to them, and learn to let go.   During moments like this I remind myself the teachings regarding worries, it is consisted with a 2 part questions:   1. Is this problem within my control? If so, then this problem will be solved given time and the right intervention. 2. Would worrying about it make any difference? If not, then is it worth it to sacrifice our time and mental health worrying over something that (1. can't be solved anyway / 2. will be solved anyway)?   This is definitely easier said than done, therefore as a fellow human being, I am working with you to pay attention to what is good, what is kind rather than our worries.   Obsessive or consuming thoughts can make living miserable when you are plagued by them, but this very situation can become the invitation to transcend mind and be free of suffering forever.   Can you stop obsessive thoughts? - If you could, it would be great, but the truth is that it's slightly more complicated than just suppressing your thoughts which at-most you can do for a few seconds. Plus suppressing thoughts is even worse than enduring thoughts. It builds up a lot of negative energy inside.   So how to stop these stops thoughts? The secret to stopping these thoughts is to detach from the mind because You cannot fight mind with the mind. Let's look at this in more detail.   What Causes Obsessive Thoughts?   If you generated the thoughts, you could've controlled them too.   The truth is that you don't generate thoughts, the mind does. And the mind is on auto-mode most of the time.   You can see this for yourself; can you predict what you will think 30 seconds from now? If you can't how can you assume that you are generating the thoughts?   If you believe that you are your mind, that's a false notion again.   If you are your mind then how can you observe the thoughts? So you must be separate from the mind to see what the mind is doing.   The mind generates thoughts, which are mostly just energy forms. These thoughts pass through like clouds. We identify with some of these thoughts and obsess over them.   So in truth, all thoughts are just neutral energy forms; it's your interest or association with the thoughts that makes them obsessive. If you can understand this truth, you have taken the first step towards getting rid of obsessive thoughts.   How to Stop Obsessive Negative Thoughts?   If you are asking this question, ask yourself another question - "is this question not another thought? It's a thought about killing thoughts".   All your attempts at suppressing and stopping thoughts fail because you are using the mind to stop the mind. The police man and thief are both the mind; so how can the police man catch the thief?   So you cannot kill the mind by force. The mind dies its own death by the poison of disassociation.   What gives power to a thought? - Your interest. If you have no interest in a particular thought then it loses its hold over you.   You can try this out now. Let the thoughts flow through your mind but don't take interest in them. Just stay as a bystander or a watcher and let the thoughts float.   Initially you might have a hard time watching thoughts because of your inherent habit of associating with each thought that arises.   It helps to know that you are not your thoughts, that thoughts are just energy forms created in the mind. Why does the mind create thoughts? No one knows - it's just something it does, why bother. Do you ever ask why does the heart beat?   With a little practice you will get really good at watching thoughts and not involving yourself with them.   You will stop giving power to thoughts by not giving them your interest. Thoughts die immediately when they are deprived of this fuel of interest. If you don't associate with the thought or give power to the thought, it will wither away quickly.   What Are Thoughts?   Past events get stored as memories. Your mind conditioning and beliefs are also stored as memories. All this is unconscious storage; the mind does all this in auto mode.   Perceptions and interpretations are created in the mind based on its past "external" conditioning and also its natural conditioning (genetics). These interpretations, perceptions and judgments come up as thoughts in the mind, and they can be positive or negative depending on the mind's conditioning.   Thoughts are generated based on the past incidents/memories, future projections and interpretations on the present life situation. It's like a computer trying to predict or conjure up projection based on the data it has collected so far.   When thoughts are negative in nature (thoughts of worry, anxiety, stress, lack, resentment, guilt etc.) they produce resistance to the movement of your life, and this resistance is felt as suffering. Negative thoughts will always stand in resistance to the movement of your life, like blocks of stone in the midst of a swift current of water.   Life is a stream of pure positive energy and hence any negative thought will stand in opposition to it, causing friction which is felt as suffering in the body.   The thoughts in your mind gain power from your attention and interest. Your attention is the fuel for your mind. So when you give attention to consuming thoughts in the mind, you are unconsciously fueling it and thus attracting more momentum for these negative thoughts.   The momentum of negative thoughts in your mind will slow down, and ebb away, automatically when you stop feeding your attention to it. Stay as an open space of awareness without focusing your attention on the negative thoughts of the mind, and soon they will lose their momentum.   You can focus on the positive thoughts generated in the mind, and thus develop a positive momentum in your mind. Every time your mind produces some positive thoughts, e.g thoughts of love, joy, excitement, abundance, beauty, appreciation, passion, peace etc, focus on it, milk it, and give attention to it.   This will cause your mind to attract more positive thoughts and thus build a positive momentum.   Whenever the mind thinks negatively, don't give it attention or interest, this will cause the ebbing away of the momentum of negative thinking. It's really that simple. Once you understand the mechanics of how thoughts gain momentum in the mind, you will be in total control of your state of being.   The Practice of Watching the Mind   All you need to do to get rid of obsessive thoughts is to watch the mind without getting involved.   You will get really good at this with just a little practice. This practice, or "sadhana" as called in Hindu scriptures, is the root of awakening from the illusion of mind.   Without trying to understand this practice just implement it. The more you try to understand the more mind gets involved. Just watch the mind and you will soon see that you are not the mind at all.   That the mind is like a machine in your head that generates thoughts based on your attention/interest. Be free of your mind by depriving it of your interest. This is the only direct path of becoming free of the mind.   Please let me know if this is helpful, looking forward to talking with you more :) Jono
(MSW, LICSW, LMHC)
Answered on 01/19/2022

What can help me sleep at night?

Sleep disturbances are common. How much sleep would you say you are getting in a 24-hour period, including napping? Experts generally recommend at least six hours in a 24-hour period for maximum health benefits, although some people require more and some people require less.  If you are not getting the proper amount of sleep, it leads to fatigue during the day, decreased cognitive functioning, memory impairment, irritability, and slower reaction times which puts you at risk for automobile or work-related accidents. If you have been taking the medication prescribed to you for sleep consistently (at the same time everyday) and it is not working after three months, you should contact your doctor as soon as possible.  Counseling can help with sleep disturbances to recognize, challenge, and change stress-related thoughts that can keep you awake at night. Avoid going to bed with a negative mind set, such as 'if I don't get to sleep, I will be worthless tomorrow.'  Practice refocusing on things that you are grateful for, or your accomplishments.  Try journaling your thoughts and feelings, or reading uplifting books or articles. Avoid screens for at least an hour before bed, the blue light that comes from screens tricks our minds into thinking it is still daytime, and it will keep working.  And try to avoid caffeine, alcohol, and tobacco at least four hours before bedtime and during the night. You mentioned you have social anxiety.  Being isolated from friends and family during the lockdowns have affected us all in similar ways.  Building self confidence and learning how to accept yourself is a great way to increase social skills and make you more at ease around others.  One way to build confidence in yourself is to list your accomplishments, or ask friends and family to give you one thing that you are good at doing. There are many self help books, articles, and videos on self confidence as well.  Another social skill that would help is to have empathy for others - try to put someone else's shoes for a minute. What would that look like or feel like? How could you help that person?  Small talk seems out of style these days, but it's a great way for people who don't know each other to 'warm up' to each other and figure out if thye are compatible as allies, friends, or even as romantic partners.  Even if you only start a conversation with that person by asking them an open-ended question, and then stop and let them answer.  When that person is finished, share something about yourself that is not too difficult.  Be sincerely postive and encouraging - this goes a long way to help you feel good about the conversation as well. Our bodies love schedules!  You might try changing your schedule so you can go to sleep about the same time each night, and then set an alarm that will wake you at the same time every morning. Avoid napping during the day, and use your bed only for sleeping at night and intimate relations.  Try not to watch television, eat, work, or use screens in your bedroom. If you are unable to fall asleep within an hour, then get up and do something else for about an hour, then go back and try again.  I like to read a book or watch a TV show in the living room, and I usually get sleepy by then.  Physical health and mental health are partners, one affects the other.  Having an exerise routine helps as well - it can be as easy as walking around the block a couple times up to having a personal trainer.  You can also add relaxation exercises, meditation, biofeedback, or hypnosis to improve sleep patterns. Taking good care of yourself is important, and I hope the explanation I gave helps you. I would love to visit with you more if you have the time!
(MEd, MS, LPC)
Answered on 01/19/2022

What treatment would you follow to help someone who has parasomnias and nigh terrors?

Good afternoon and thank you for your question! I will provide you with a brief explanation of the therapy process.  A Brief Overview Of Therapy Before reviewing the various benefits of therapy, having a general understanding of the practice is a good idea. In a nutshell, therapy is a form of treatment that involves meeting and working with a specialist to solve various issues. The issues in question could involve personal feelings, traumatic events, relationship struggles, the death of a loved one, daily stressors, or something else entirely. Therapy can help with any number of problems or even just navigating life's ups and downs. When working with a therapist, it's important to find one that you feel comfortable trusting and confiding in. Your therapist should focus their time and energy on you during sessions, and help you achieve whatever goals and desired outcomes you want to address. The treatment process and improvements which come from therapy can take different amounts of time depending on your situation. The Benefits Of Therapy There are a variety of benefits associated with therapy. Each one will come in handy at different stages or periods of the process. When it's all said and done, therapy is about self-betterment and self-improvement. If these are processes that you value, then you will certainly appreciate the following benefits. Achievement Of Goals Throughout the process of therapy, your therapist is going to work with you and help you set certain goals which will be beneficial to you. Your therapist will also assist you on your journey of reaching and fulfilling these goals. This is a very impactful part of therapy which sets the precedent for what life will be like after your work with your therapist is complete. The ability to set goals and achieve them matters, not just in therapy, but in everyday life as well. You will find that achieving goals will also contribute to your self-esteem. When you set a goal and accomplish it, you're reinforcing to yourself that you're capable. This increases confidence and makes you likelier to branch out and challenge yourself more often. This plays a pivotal role in living your best life and making the most of the opportunities which present themselves to you. Hopefully, this explanation of therapy is helpful in this process. Please reach out to customer care so you can inquire about options and possibilities regarding your interest in initiating services. You can also contact your local mental health government ara to inquire about services, both free or low cost. In addition, licensed mental health professionals are the ones that provide a diagnosis; this, after having done some sessions to assess your situation.  Having a conversation with a clinician could be the first step towards understanding what is occurring, in terms of your mental health. In addition, you can clarify any concerns connected to your husband's behaviors to possibly seek options. From the information you are presenting I will encourage you to seek a therapist that specializes in sleep disorders.  Good luck in your process!
Answered on 01/19/2022

How do I get over my fear of sleeping alone?

Hi there, It's scary to have dreams like that! Having nightmares can definitely ruin the morning/day after. Thank you for this question!   I hear that you're looking for tips to get over the fear of sleeping alone. I'll provide some below, and then some insight afterwards:   1. Start using the mantra, "I am safe, I am in control, I have options". Say it to yourself before bed, while taking a few deep breaths. Hold this statement as truth. Whether you are alone or not, you are in control. A sense of safety is probably important to you. 2. Have a consistent bedtime routine. Turn off all screens an hour before bed. I know it's common to scroll on our phones at night, but the LED light could keep you awake. And, the content we consume before bed can greatly affect our dreams/nightmares. 3. Could something be added to aid in your comfort at bed time? A familiar stuffed animal or a cute one of your favorite character? Or an extra pillow, maybe an eye mask? Maybe a combination. Sometimes feeling wrapped up and secure in our beds may help.   It may be beneficial to examine the reasons you have these nightmares. Things like your stress levels, interactions, and environment can play a part. It is totally normal to have nightmares, but not to the point that they impact your daily life. Sleep hygiene, especially when consistent, is really helpful. Without good rest, we feel depleted and scared if we're having those nightmares! Remind yourself before bed that you are in control. Maybe talking with a friend or loved one before bed could lower anxiety. I would be curious to know if you're having nightmares related to reality based situations or fantasy. Maybe it's indicating the start of a new chapter in your life! To manage how scary they are, if you wake in the night and can't keep yourself in bed, get a glass of room temperature water and do some stretches. Reconnect your brain with your body. I hope this has been helpful! I think the main point is to decrease your anxiety and implement a consistent bedtime routine. Sweet dreams!
Answered on 01/19/2022

is it ok to not know what you want to do with your life at 18

HI, Nice to meet you. THank you for expressing how you are presently feeling and explaining your present difficulties. To answer your question, it is absolutely "ok" to to now know what you might not want to do at 18 years old, or even 25 years old or 35 years old. We all go through different stages in our life where one day we might have a glimpse of what we would like to do, or where we would like to live, whom we feel we can talk to.  In life we all go through ups and downs and during times of difficulty we might need support to help us. As we experience different things, it can be difficult to see any of the positive things that might be going on in our lives.  From your description of how you are feeling, I see that presently you are feeling a little defeated.  In partnership with Better Help, I would like to say we are here to support you and find at least "1 " positive thing that can help you get through things. The process of beginning the process with a clinican at better help is you will complete some forms, sign some forms and complete a profile.  Once all is processed you will be matched to a clinician that will hopefully be a good "fit for you". Once the clinican reaches out to you, hopefully an introduction can be made and the clinical relationship will begin. The question  is it ok not to know what you want to do at 18, yes it is.  Taking the first step in seeking assistance is hopefully one step closer to help you feel better.  There is no right and no wrong in what someone feels.  I hope you can look at yourself and be proud of yourself that you are taking the first step of getting closer to feeling better! May your journey to undertanding that it is ok not to know what you want to do at 18 years old be successful.  Better Help and the clinicans are here to support you and guide you to a in your life that you can see "it is ok not to know what you want to do at 18".
(LCSW-R)
Answered on 01/19/2022

I have serious problems with nightmare. The wake me up every night . Very stressful. All night long.

Hi Jack.  I agree, nightmares are very stressful... and scary!  Especially if you have no idea why you are having them.  Do they repeat or have a theme?  Have you suffered or are you suffering from any kind of trauma?  Do you have any physical ailments?  Do you live/work in a stressful environment?  Do you live alone or have some sort of emotional support person?  Do you remember your nightmares when you wake up or just wake up feeling some kind of way?  I know this is a lot of questions, but every bit of information you can present will help in recovery.  I highly recommend keeping a dream journal.  Record everything you remember, even if it is just a feeling.  If you do not like to write, draw it.  Review your journal each week to figure out if there are any sort of patterns.  The hope is that at some point you will be able to figure out the underlying source of the nightmares.  Keeping a log about thoughts, emotions, behaviors, memories, and situations each day may help as well.  It could look like, "I am (place, environment, atmosphere, around people...).  I feel ... (physically and emotionally - IE: angry, sick to my stomach, heart beating fast...).  Because ... (the reason why) or I don't know why.  The same idea is behind it, recognizing themes, patterns, and triggers... and allowing yourself to analyze where all this is coming from in order to address the issues.  Getting the information out of your head and onto paper will allow your brain to make the headspace for new memories, experiences, and feelings.  If your mind is full of emotions, there is no room to think logically (the same is true for the opposite, if you are too logical, there is no room for emotion) and it will make you ill, both physically and mentally.  If you are going to bed with a lot on your mind, it will manifest in your subconscious and affect your conscious self.  It sounds like you would benefit from some trauma processing therapy, perhaps EMDR, art therapy, or cognitive processing therapy.  The trauma will not go away, but you can learn how to better manage symptoms.  Also, you should see a psychiatrist and tell them what is going on with you.  They may be able to prescribe some medication to lessen the nightmares.  Just remember that if you do decide to take the medication, you must do therapy as well.  Medication will not work by itself, nor is it meant to be used long term.  It is merely a tool to help you get through this time in therapy until you have learned the skills to manage symptoms on your own.  It is not quick or easy work, but it is really worth your time if you are serious about improving your mental health. I hope this helps or at least gives you some options to think about.  Best wishes on your therapeutic journey.  
(LCMHC, NCC, ATR-BC)
Answered on 01/19/2022

Do you use Cognitive Based Therapy to address sleep issues

Hi!  Thank you for your question.  First off, I'm glad to hear that you will be starting therapy in a couple of weeks so you can continue to explore this issue more in-depth.  It sounds like you have started to try out some strategies, but not having much success.  Have any of these strategies worked for you in the past?  Please know that there is no "one-size-fits-all" model and it sometimes can be a trial and error process to figure out what works best for you. Now to your question around if CBT can be used to addressed sleep issues, it totally can!  Generally speaking, when you look at the CBT model, it looks at how thoughts, feelings and behaviors are all interrelated.  Within the CBT model there are many different types of interventions that can be used, all with the same eventual goal - to improve a desired behavior, in your case, sleep.  In addition to learning about how exactly thoughts, feelings and behaviors are linked to your current sleep issues, you will also learn about various cognitive and behavioral interventions to try.  Cognitive interventions are strategies that will help re-train your brain to think about sleep differently.  A good way to think about it is like this- the brain is just like any other muscle in your body; the longer you have used it in a certain way, the more automatic that way is. And so it takes time to re-train your brain to thinking and doing things differently.  It may feel awkward, contrived or uncomfortable at first and that's to be expected!  Think about the first time you learned how to do something, like walk or ride a bike.  It happened over time with many bumps and falls along the way.  This is the same type of concept.  In additon to the cognitive interventions, there are also behavioral interventions which are tangible strategies that will help you develop a healthy sleep practice.  I know you mentioned several relaxation strategies that you have attempted to no avail, and it might just be that you either need to try out a different type of relaxation strategy or tie these strategies to trying out different ways of thinking about sleeping as well. Here is something to take a look at prior to starting therapy: How long have you had issues falling back to sleep?  Do you remember how it started?  The first step is to take a look at some of the thoughts that cross your mind - could be throughout the day, leading up to sleep or even while you are in bed.  Are you able to articulate any of the thoughts you have? And when you have those thoughts, what emotion(s) do you feel?  Write them down to the best of your ability.  If you are aware of what those thoughts are, over time (and with a lot of practice!) it can start changing your thought-process around falling back to sleep.    I hope this response provides you with a better understanding of how CBT could be used to address sleeping.  Just remember this is a process and you will be play an active role in finding the right answer(s) for you.   
(LMHC, LPC)
Answered on 01/19/2022

Should I be concerned if I had no sleep in 3 days and I am feeling dizzy and I have ringing my ears?

Thank you for your question. I would say this question is more for your primary care physician or a sleep physician specialist, as it is a medical question rather than a mental health question regarding side effects. One of the things I can say is that anything out of the ordinary that you are experiencing is possible that it is related to the medication you are taking if that is the only thing that has recently changed and the side effects have come immediately following this change. If the purpose of the medication is for sleep, and it is not increasing your ability to sleep, you should definitely speak with a doctor, as it is not serving its purpose to support you in sleeping.  The aspect of this that is more within the realm of what a therapist can suggest is you consider the origins of your sleep issues and what your routine before you go to sleep is. Are you drinking caffeine later in the day, try not to do so after 2pm? What are you doing before you try to sleep? You should definitely limit screen time and do more relaxing activities before you go to bed, such as taking a bath with essential oils. Is worry getting in the way of you getting to sleep? If so, I recommend you keep a worry journal or write your thoughts out, so you do not have to waste mental space thinking about these things, as your brain is exerting more effort than it needs to on things that do not have to be internally stored in your memory or your mind. A medication such as the one you are taking us a short-term remedy, so you definitely want to work on sleep hygiene and the underlying sources impacting your sleep. These are the aspects of your issue a therapist can help you with. To understand expected side effects of your medication and whether there is normality to them is a question for the prescribing provider or a sleep specialist. I'm not sure how long you have been taking the medication, but your physician can support you in knowing if this is something that goes away or is normal in adjusting to the medication if you are newly prescribed the medication. I hope you find the answers you are seeking. Best of luck on your quest for more sound sleep utilizing prescribed remedies. 
Answered on 01/19/2022

How to stop having these reoccuring dreams?

Hi,  I am so sorry you are having this terrifying experience with sleep paralysis and recurring dreams. There are many possibilities that may be triggering these such as previous or current traumatic events, hormonal fluctuations, sleep disturbances such as obstructive sleep apnea, or other sleep-wave cycle phenomena that would need to be ruled out by a neurologist who might recommend a sleep study.  In addition, medication, alcohol, or other substances can trigger this phenomenon.   One suggestion I have for you before seeking out assistance from a neurologist to rule out something medical would be to keep a dream journal and write down exactly what you remember, what you see, what you feel, and what you interpret in those experiences--no matter how bizarre it seems.  Our unconscious state processes information in order for us to make sense of our day-to-day experiences and sometimes even gives us answers and solutions to issues that we are struggling with on a conscious level.  We also are wired to be highly intuitive beings, so there may be concerns you are processing on an unconscious level that haven't made their way to the conscious.  This is where dream journaling can really come in handy.  If it is difficult to write or type following waking up from a dream, if you have a recorder nearby, such as your voice memos or camera on your phone, you could record yourself recalling the experience and the dream imagery. Give it a few days and go back and read or listen to what you have recorded.  See if anything matches up with what you may be processing or dealing with in your day-to-day life. I know sleep paralysis, nightmares, and vivid dreaming can all be overwhelming and concerning.  The good news is that our brains are designed to help us process what we struggle with processing on a conscious level so it does work for us when we simply can't. Unfortunately, it can come out in very terrifying ways. That being said, if you are unable to come to a resolution and this issue persists or worsens, I strongly suggest seeking an appointment with a neurologist specializing in sleep disorders as it may be beneficial to have a sleep study. Additionally, if you have a smartwatch, the app autosleep is a great way to track your sleep cycle to get an idea of what your sleep quality looks like. If you have had traumatic events in your life, you might also seek assistance from a qualified trauma professional to help you unpack and heal from memories that are tormenting you in your dream and waking state.   I wish you all the best!
(MA, LMFT)
Answered on 01/19/2022

Why am i having a hard time to sleep? I get mad and sad easily. I really can't control my emotions.

I am so sorry to hear that you are struggling with controlling your emotions and how that is impacting your sleep. It will be important to recognize when your feelings have a purpose versus when they do not.  We of course want positive feelings in our lives, but sometimes negative feelings are there for a reason and we need to live out that purpose in order for it to get better.  If we do not live out the purpose of our feelings, it likely leads us to feel worse.  For example, something as simple as having anxiety about needing to get the chores done has the purpose of getting us motivated to get the chores done.  Therefore, if we do not live out that purpose and the chores remain undone, that can lead to more bad feelings, such as, “I am lazy” or “I am worthless.”  This is a simple example of how if we do not pay attention to our feelings and live out the purpose, they can become much, much worse.  So, I would encourage you to try and separate out the thoughts that have a purpose from the thoughts that do not have a purpose and are more intrusive.    For the ones that do have a purpose, it can be helpful to allow yourself to think through the anxious thoughts because anxiety has a nasty way of going to the worst possible scenario.  If you can wrap your head around that scenario, it can make it less scary.  For example, I had a client that was very anxious daily about being single for the rest of his life.  Thinking to that extreme is clearly anxiety and it just lingers there.  So, then he was able to think through that scenario and come up with a plan to make it less scary.  He then came up with that if he really is going to be single the rest of his life, which is highly unlikely, he is going to work towards being able to live close to the ocean since that is a dream of his.  Thinking about it now does not make him as scared because he recognizes he could be happy with that. So, try to think through specific things you are anxious about that have a purpose and make sure you have a specific plan on how to improve those things. For example, having a specific plan for how to address specific things that make you angry or sad.             Intrusive thoughts tend to not have a purpose and it can be really helpful to try and overpower those before they are accepted as truths.   We can have power over our thoughts and I want to help you not engage in these thoughts that make you so upset.  The easiest example of this that I can think of is if I went skydiving.  If I went skydiving I would have some obvious, rational, anxious thoughts.  If I really have a desire to skydive though I will need to not engage in those thoughts.  I might have thoughts such as, "My parachute could fail, I will hit the ground, I am going to pass out, etc."  However, since I really want to follow through with skydiving, I would want to stop those thoughts in their tracks with, "I know this is going to be really fun, they inspect the parachutes ahead of time, people hardly ever get hurt doing this, etc."  By focusing on those thoughts and not engaging in the others, I would be able to follow through with skydiving. Try to sort through any thoughts that get you down about yourself and that you can’t handle all of this and try to overpower those.  These types of thoughts are very common when dealing with sleeping issues.          As you do those processes it can be helpful to validate yourself as someone of worth and that has been able to get through challenges in your past.  Something that could be helpful for you is what I like to call centering thoughts.  These are thoughts that are predetermined and unique to you for you to turn to in low moments.  They need to be powerful enough to bring you back to your center.  It is important that these thoughts are accessible for you to look at when you need to.  Some clients prefer to read and re-read them and some prefer to write and re-write them until they feel better.  I have clients that write these somewhere they will see daily such as their bathroom mirror or phone background, while others simply have them in their phone to pull out when they need to.  An example of a centering thought would be from a client I had that related to nautical-themed things and her thought was, "I will not let this sink me."  Another example is from an Olympic skier that actually had difficulties with negative thinking getting in the way of her performance so she went to therapy.  She mentioned that she learned about centering thoughts to battle all of the people telling her she “should be” or “should do.”  To battle those thoughts, she uses the simple centering thought of, “I am.”  She can then remind herself that she is good enough, that she is confident, and that she does want to still compete, which really affirms her own feelings and not others.  Hopefully, you can come up with something that helps validate your worth and abilities to move forward.       I hope that some of this is helpful and that you can apply it to your circumstances.  I hope that you can lean on some family and/or friends through this.  Doing so can help take weight off of your shoulders as well as hopefully get some valuable advice from them. Try to take the healing one day at a time and adding one positive thing back into your life each day. I wish you all the best and I hope that you are staying safe.
(MA, LPC, NCC)
Answered on 01/19/2022

How do I overcome nighttime anxiety that creates insomnia?

Hello,   Thank you for reaching out on The Betterhelp Platform with your question: How do I overcome night time anxiety that creates insomnia? I will share some information about night time anxiety and insomnia and some tips to overcome this situation.   Facts About Anxiety and Insomnia   Experiencing occasional bouts of anxiety can be fairly common for most people, as anxiety is just an echo of our past survival mechanism of “fight, flight, or freeze” when faced with danger. Although the dangers have changed from animal predators to a fear of being late for meetings, the physiological components of our brains haven’t changed much: our brains still see the cause of our anxiety as a “danger” and thus kicks into action trying to find a possible solution or escape route.   Occasional anxiety is not a cause for concern, but many Americans experience a much more acute, recurring, and overpowering sense of anxiety, which can be the development of an anxiety disorder.   Anxiety disorders can be caused by very specific triggers (known as “phobias”) or can simply be excessive anxiety for extended periods of time that get in the way of everyday life, regardless of a specific trigger or actually being in danger. In these cases, the brain may flood the body with adrenaline, causing a person to experience heart palpitations, shortness of breath, or causing them to lose their concentration at work or school. Additionally, anxiety can cause serious sleep issues, such as insomnia. While experiencing anxiety attacks may cause many people to feel exhausted or fatigued, the act of falling asleep may actually become harder due to the anxiety and the body’s sense of worry or fear.   Types of Insomnia From a medical standpoint, there are multiple levels to measure the severity of insomnia, as well as different types of insomnia. The severity of insomnia can be broken down into five categories:   highly distressed, often struggling with neuroticism or prone to anxiety, feeling tense. moderately distressed, sensitive to rewards or positive events. moderately distressed, not sensitive to rewards or positive events. slightly distressed, high reactivity, or being very sensitive to stressful life events. slightly distressed, low reactivity, or being lowly sensitive to stressful life events.     Effects of Insomnia Sleep is an essential function that the body needs in order to recuperate, heal, and maintain energy. If you’re struggling to get sleep due to anxiety, insomnia, or a mix of both, this can have some unfortunate side effects on the body if left untreated for an extended period of time.     Mental Health Side Effects Additionally, insomnia can cause adverse mental health side effects, including: Depression. Anxiety. Feelings of confusion, irritability, or frustration. Emotional instability.    Insomnia may also result in an increased risk for accidents due to daytime sleepiness or may cause other issues related to work and school. It may also affect your sex drive, memory, and judgment.   How Anxiety Can Affect Sleep   Lack of sleep can lead to increased chances of anxiety, but anxiety can also cause a lack of sleep. Unfortunately, the two can intertwine quite a bit, causing one to exacerbate the other.   Anxiety can have a negative effect on your body’s ability to fall asleep as your brain is in “fight or flight” mode, thinking of all potential outcomes for whatever is causing the anxiety. Furthermore, anticipatory anxiety and specific anxiety about sleep can lead to sleep disturbance and insomnia, which then creates a feedback loop that can make both conditions worsen. Insomnia can also make you more irritable and more worried, as your brain is not getting all the sleep it needs in order to function at normal levels.   However, it’s not uncommon to experience anxiety related to sleep anxiety is a form of performance anxiety. Many people may stress about not getting enough sleep to function, but the stress alone of trying to sleep can cause people to sit awake for hours. Additionally, other fears such as recurring nightmares, fear of sleep apnea (not breathing while being asleep), and more can all lead to disturbed sleep.   Does Anxiety Go Away?   For those people that are diagnosed with a legitimate anxiety disorder, the condition is unlikely to go away. Some people may be able to better control their anxiety disorder with the help and guidance of a therapist or psychologist, and medications may help further control the condition. There may also be specific coping mechanisms to help manage anxiety disorders, however, a permanent “cure” for anxiety does not currently exist.   For those that do not suffer from an anxiety disorder, but only have occasional or intermittent anxiety from time-to-time, this is normal and healthy behavior for many people. Temporary anxiety is likely to diminish over time, and if it is related to a specific place or person, removing yourself from those situations may help the anxiety go away after some time.   How to Get Rid of Anxiety So You Can Sleep Better   If you’re struggling to fall asleep due to anxiety, it could be that treating the anxiety will help solve your insomnia and lack of sleep as well. Anxiety disorders should only be diagnosed by a licensed therapist or medical professional, and these professionals can also help you find treatment regimens as well as, potentially, medications to control the condition. You should not try to self-medicate for anxiety disorders, and should only medicate per the medical advice and supervision of a psychiatrist.   Therapy   One of the most common and effective treatments for anxiety disorders is continued and guided therapy with a professional counselor or therapist. Cognitive Behavioral Therapy CBT) can be effective for many people, as it helps patients suffering from anxiety disorders create new, positive thought pathways that can help when in anxious situations. There are three different types of CBT, each with an individualized approach in treatment, including interpersonal therapy, thought records, and modern exposure therapy.   Another form of therapy is Accepting and Commitment Therapy (ACT).  This form of therapy is more focused on mindfulness training and taking action based on personal values, and is unique in that it is not focused on symptom reduction.   Mindfulness   Another useful tactic to combat anxiety is the act of mindfulness when faced with certain situations - Acting mindfully can help individuals make radical shifts in how they think and perceive situations by looking at them without judgment.   Mindfulness can be tricky to start, and it may help to have the guidance of a trained healthcare professional, but mindfulness can provide a new perspective that allows you to re-evaluate your anxieties and develop healthy coping mechanisms to rethink situations in which they arise. For sleep, mindfulness can help your body naturally fall into unconsciousness as you focus solely on your breath.   Shifting Your Perspective   Shifting your perspective can help some people gain more sleep. It’s completely normal to have bad nights of sleep, and sometimes it’s unavoidable, but when you can tell yourself that you expect it to happen, your body may be more likely to relax and naturally fall into sleep.   What to Do When You Can’t Sleep: Tips   Prioritizing a good night’s sleep isn’t just important for your general health, it can also help with feelings of anxiety, as your body is less likely to feel overwhelmed or on edge when you’ve slept well.   However, falling asleep can be difficult, so it’s important to build a strategy for a better night's sleep.  Below are some tips to try in order to improve your chances of falling asleep naturally.   Try Staying Awake   Often, one of the most ineffective ways to fall asleep is to try to force yourself to lay down. This will only result in you tossing and turning for hours, unable to fall asleep.   Instead, try avoiding the bedroom until you naturally feel sleepy. If this means spending the whole night awake, not getting any sleep, then try saving this technique for the weekend so you can catch some sleep when your body naturally wants to sleep.   Many people have a different circadian rhythm — the natural clock in our head that helps us fall asleep — and it could be that your rhythm simply occurs at an abnormal hour of the morning. Once you do start feeling sleepy, allow yourself to go to bed and focus on your breathing instead of any other anxieties.   Keep a Sleep Log   Sleep logs can be useful to help you catalog when you fall asleep and how much sleep you were able to get. You can also take note of all the activities you do before you fall asleep, and this may help you notice a pattern.   Get up at the Same Time Daily   Creating a routine can be an effective way to combat sleep anxiety and insomnia. By getting up at the same time every day, your body will naturally start to adjust your internal clock or circadian rhythm.   Getting up at the same time every day helped the participant’s body feel sleepy around the same time every night. Over time, this helped the participant’s bedtimes become consistent.   Creating a nightly routine can help relax your body as it starts to anticipate and expect sleep as you follow through each step. It can also help relieve anxiety, as you know what to expect each night and each morning.   Do a Bedroom Makeover   Another helpful trick is to make your bedroom a place for nothing but sleep. For some people living in small loft apartments, this might be tricky, but by putting up a divider or curtain, you may be able to simulate a similar “separate room” effect.   Regardless, redecorating your bedroom for a more comfortable and quiet environment can do wonders for your sleep health. Consider decluttering the room and regularly changing the bedding or adding a rug to make the space more appealing and comfortable.   If you come into your bedroom and still can’t sleep, don’t just lay there and wait for slumber to hit. Instead, get up after 15 minutes and work on some small projects until your body naturally feels sleepy.   Keep Your Room Cool   Keeping your room dark and cool can also have major effects on your ability to fall asleep. Avoid putting a space heater in your room (unless you really need it) so as to keep the room cooler than the rest of your house. You can also cut out some of the natural light and heat by installing blackout or custom curtains over your windows. The more “cave-like” you can make your bedroom, the easier it may be to fall asleep every night.   Limit Caffeine and Other Stimulants   For many people, cutting out caffeine from their diet can be very difficult, but caffeine can greatly hamper your ability to fall asleep. Additionally, as a stimulant, caffeine can make your anxiety much more pronounced, and you may have a difficult time calming down if you drink excessive amounts of coffee.   It could also be getting in the way of you achieving a good night’s sleep. Try avoiding caffeine at least four to five hours prior to when you want to go to bed.   If you know of any other forms of stimulants that you may be taking, try avoiding those at least a few hours before bedtime.   Use “blue light” (any light that is blue in hue, which is common with televisions, laptops, and smartphones) can keep the brain active, stimulated, and awake, as it suppresses the secretion of the hormone melatonin. This is the hormone responsible for helping you fall asleep, so try avoiding blue light, or wearing amber glasses to suppress the effects of the light, at least two hours prior to bedtime.   Get Rid of Your Clock   Clocks can be a common trigger for anxiety, especially when you’re trying to fall asleep. Instead of having a clock by your bedside — where you can glance at it every time you struggle to fall asleep — keep a clock outside your room instead. Looking at the clock will only cause your anxiety to get worse, so avoid it altogether.   Try Relaxation Techniques Another way to prep your body for bedtime is to practice some relaxation techniques as you prepare for bed. This can include: Creating a warm bath to sit in for a few minutes prior to going to bed. Listen to calming music as you brush your teeth, change, and get ready for bed. Practice some deep breathing exercises or guided meditation.     Combine this tip with going to bed and getting up at the same time every day, and you may be able to create a relaxing sleep routine that will help your body naturally get sleepy. Routines can really do wonders in calming the brain. You can also get meditation-themed bedroom decor to make the space more conducive to relaxation, even when you aren’t trying to sleep.      There is hope and there is help for you - consider reaching out to a mental health therapist for support if you need some guidance with your situation. I wish you the best of luck!   In Kindness, Gaynor     
(MA, LCSW)
Answered on 01/19/2022

Why am I confusing my dreams with reality?

Thank you for your question. Dreams are interesting, as they are generally our subconscious trying to make sense of a reality we cannot clearly understand when awake. I would have many questions in order to understand how to best address this. Aside from this occurring within the past several weeks, is this a familiar experience from a time before that? Also, I would wonder if you are able to confirm your reality when you are awake? In other words, when you wake up, it might be natural to struggle to distinguish the dream from reality, but does the ability to tell the difference shift as the day progresses? If you are still struggling throughout the day to tell the difference, it may cause greater distress and impact functioning to a greater degree than would seek attention. I would encourage you to consider if any part of the dream can be verified in real-time to reassure you and help you differentiate the dream from reality. I also wonder how you approach getting up in the morning after the dream. I know you are asking more about whether this pattern you are identifying is concerning, but I thought I would also give you a few strategies to see if you can tell the difference to a greater degree. You can ask yourself in the morning what about the dream does not seem plausible rather than focusing solely upon how real it seems. You can consider any evidence that does not support the reality of the dream in other words. You can also ground yourself to where you are through imagery or identification of aspects of your environment to bring you back to your present reality. You can also consider what you know for certain and with confidence and attempt to stick to the facts. You can also entertain the meaning of the dream if it is a recurrent theme. For example, if it were a kidnapping dream over and over, you might consider where you felt powerless or helpless in your life and work to resolve that underlying issue to potentially reduce the recurrence of this dream in your sleep. Also, I question what you are doing before you go to sleep. Try to think of calming and soothing images before bedtime, as what we are last processing before we go to sleep may show up in some form or fashion in our dreams. I would also encourage you to create a new ending to your dreams perhaps where you feel more in control. For example, if you were kidnapped to use my example, you could envision you breaking free in the end. We often stay in a state of paralysis because the dream ends in a state of intense fear and anxiety. These are just a few skills to begin practicing to eventually reduce the intensity and frequency of the dreams. However, I do believe it would benefit you to go to a specialist, perhaps even a sleep specialist, to ensure there is not a sleep disorder that is prompting this distortion. Also, going to a psychologist to work through potential underlying issues and for further assessment and evaluation would be in your best interest. I think you are seeking clarity and answers, so while I can provide some feedback via this platform, to truly assess the underlying issues and their severity, seeking support from trained professionals is encouraged. 
Answered on 01/19/2022

How can i overcome challenge of sleeping

Hi David. Welcome to Better Help!  Mental and emotional challenges can indeed cause sleep challenges too!  That feeling of being scared about your future is a particular type of worry called "anticipatory anxiety" which is just a fancy way of saying "worry about something that is coming up in the future" or the future itself.  That kind of worry can make sleep difficult, and then the lack of sleep can magnify the worry, so it's a "feedback loop" of sorts or a case of each problem making the other one worse!  I'm going to give you some sleep tips, but I want to start by saying that you need more help right now than these sleep tips can give you.  You don't say what kind of 'mental disorder' you are dealing with at present, but no matter what kind it is, it sounds like you need some counseling.   You can get that here on Better Help!   If you cannot afford to join the platform, most communities have resources that offer free or very low-cost counseling to those in need.  Ask your doctor for a referral or reach out to governmental agencies in your state/country for information.   Really optimizing your sleep is the main KEY to feeling better emotionally and getting your life in order.  Great sleep also helps immensely with physical health issues, chronic pain, weight management, and disease prevention.   But great sleep isn't just about how many hours of sleep you get per night, it's also about how DEEPLY you sleep… That "deep wave sleep" keeps us healthy and happy!  To get the deepest sleep possible, make sure to get some indirect sunlight to the retinas of your EYES every morning, or use a Nature Bright light for that purpose. That'll help your body release a hormone to help you sleep better and deeper each night. Also, be sure to avoid BLUE LIGHT after the sun goes down.  Blue light is emitted from TV screens, phone screens, and computers/laptops.  It’s even emitted from most types of indoor lighting. Blue light tricks your brain into thinking the sun is still out!  And that RUINS the quality of sleep you're getting each night. That's a big reason so many people don't feel calm, content, and energized, even though they may be getting 8 or more hours of solid sleep at night.  Blue light is hard to avoid.  Using the "night-time" light setting on your electronic devices doesn't solve the problem, because it doesn’t block the blue light adequately.  What solves the problem is staying off ALL electronics after dark, and switching all household lighting to incandescent bulbs, or use candlelight (safely!).  If that doesn't sound like a fun night, there's another option.  You can wear 'blue-blocker' amber glasses after dark. I recommend Spectra brand amber glasses because they block a high percentage of blue light and are reasonably priced.  Plus they are easier to see through than some other types of blue-blocker glasses.  They are available on Amazon.  Remember... if you don't get enough deep sleep, it will be much harder to feel happy and be productive in your daily life.    Sleep is one of the very best coping tools!  Good sleep, much like a healthy diet, can be a big part of achieving mental wellness.  Establish a calming bedtime routine and make every effort to get to bed by 10:30 pm at the latest. Ideally, you will wake before your alarm clock goes off. If your alarm clock is waking you from a sound sleep, that is a sign that you need to get to bed earlier.If you need or want to take a nap during the day, keep it before noon, that way it will not wreak havoc with the quality of your nighttime sleep.  Avoid night-time shift work if at all possible!  Make sure to get daily exercise.  Avoid caffeine after the noon hour.If you are following all of this sleep advice, yet still experiencing trouble drifting off to sleep, or are waking during the night, or having nightmares, or feeling fatigued during the day, do let your doctor and counselor know, so you can get some customized guidance.  Hope this helps, David.  Sleep well!    Maya 
(MS, LMFT)
Answered on 01/19/2022

My question about my mind my mind from last month i notice overthinking and i cant sleep properly

Hello, Thanks for reaching out to ask about how you can stop your mind from overthinking and how if it affecting your sleep and ability to focus. I will share some information on what might be happening with you and some tips on how you can reduce yours overactive mind.  I will also address some specific things you can do when your mind is active at night. How to Stop Overthinking. All of us can overthink at times, and some of us (myself included) are more prone to it than others. Overthinking can take many forms: endlessly deliberating when deciding (and then questioning the decision), attempting to read minds, trying to predict the future, reading into the smallest of details—the list goes on. But all types of overthinking have one thing in common—there’s very little benefit from the time and effort spent thinking. In fact, there are major downsides to spending too much time with our thoughts, as you may know from personal experience. Some common costs of overthinking: Missing out on opportunities - It’s smart to do your research, but if you think for too long about a decision, you’re likely to see opportunities pass you by. For example, a friend of mine delayed buying a house for years as he did endless research, analyzing neighborhoods and market trends and looking for the perfect investment. He finally bought—at the peak of the housing bubble. If he’d bought sooner, he would have paid much less and would have a lot of equity in his home. Are there opportunities waiting for you that you don’t want to miss by overthinking your decision? Perhaps it’s a good time to make your move.  Feeling like you’re spinning your wheels - You probably recognize that you’ve been down the same mental road many times, and yet you continue, like you’re stuck in a loop. It’s frustrating and draining. Overthinking can be a hard habit to break because it feels like doing something. But on some level, you know it’s just wasting your time and effort. Friction with those around you - Just as overthinking can exhaust you, it can exhaust those around you. Your confidantes might get tired of hearing you cover the same ground again and again, and your loved ones might get annoyed when you won’t decide. Your relationships can suffer as a result.  Anxiety - Overthinking is the mental equivalent of pacing the floor, driven by the belief that you should be able to solve a problem by exerting enough mental energy. Not being able to make you feel anxious and agitated and fills you with self-doubt. Antidotes to Overthinking Thankfully there are plenty of ways to address overthinking. Many of these recommendations focus on action, which pulls you out of your head. Look for opportunities to make mistakes - If you’re prone to overthinking because you don’t want to make the wrong decision, be open to the possibility that you very well might. You’re human, and you operate with imperfect knowledge and a lack of clairvoyance. Maybe that thing you buy from Amazon will break. Perhaps the email you send will accidentally offend the recipient. Reframe mistakes as opportunities to learn, rather than as something terrible to be avoided at all costs. Connect with your body - A great way to get out of your head is to get into your body. When you find yourself stuck in thinking mode, get moving—do some exercise, stand up, do a few knees bends—anything to break up the chain of thought. Pay attention to the sensations in your body as you move. You can also follow a guided meditation that directs you step by step using one of the many meditation apps available for download, for example, Headspace or Calm. Identify when you’re overthinking - Sometimes it can be useful just to say it: That’s overthinking. Train your mind to release unnecessary thinking by calling it what it is. Then direct your attention to something tangible, such as the food you’re eating, the work you’re doing, or the person you’re talking to.  Practice the 80/20 rule - The first twenty percent of our time and effort often produce eighty percent of the benefit from a given outcome; the remaining eighty percent of our effort only yields an additional twenty percent of the benefit.  For example, the first hour of research on a new coffeemaker provides the majority of what you need to know to make a sensible purchase; the next four hours are likely to add little value to your decision. Improve your efficiency by moving on after you’ve given a topic or a dilemma a reasonable amount of thought, before wading into continued thinking that brings little return. Own your decisions - Overthinking decisions often comes from the fear that you’ll do something “wrong,” like buying something you regret or booking a bad weekend to travel. Keep in mind that all you can do is make the best possible decision with the information you have. Stand up tall and keep your head up, no matter what the result is. Even if it doesn’t turn out the way you wanted, you might have made an excellent decision at the time. Own it. Watch out for the hindsight bias—also known as “Monday morning quarterbacking”—in which you judge your past decision based on the information you didn’t have at the time. For example, don’t assume you “should have known” a month before that it would rain the whole weekend you were at the beach; meteorologists are less than perfect at predicting the weather even more than a day or two in advance. Be accountable - Allow those close to you to help with your tendency to overthink. You might ask your partner, for example, to point out when you’re overthinking something. They’ll probably be happy to assist you in getting out of your head! Just remember to thank them for bringing it to your attention and resist the urge to get mad at them for doing what you asked them to do. Embrace uncertainty - Overthinking comes from a drive to know something that is probably unknowable—things like what the “best” product is or what someone really thinks of you. Research shows that the more we try to gain certainty about the unknowable, the less confident—and the more anxious—we feel. Instead of trying to gain elusive reassurance, learn to welcome uncertainty. It’s what makes life an adventure. That’s not to say that it’s a comfortable place to live, but it probably beats being stuck in a loop of fruitless mental effort. Practice mindful awareness - Contrary to what the word might sound like, “mindfulness” isn’t about spending more time thinking. Instead, it’s about deliberately focusing on what is real, and opening to whatever your reality is. Rather than trying to solve problems by overthinking, you can develop a different relationship with your thoughts—becoming less identified with them and not taking them so seriously. A mindful response to overthinking might include recognizing it as such, opening to the relevant uncertainty, and then directing your attention toward what you can experience with your five senses. It’s coming home to your present. I will now share some more tips on how to manage overthinking at nighttime so that you can perhaps sleep more easily. How to Quiet the Mental Chatter at night: Our brains love to kick themselves into overdrive at the most inopportune of moments. For you, it may be when you crawl into your toasty bed, exhausted from a long and hard day. But, try as you might, you simply can’t shut your brain off. All manner of thoughts are darting around it, and you simply can’t shake them. The result is sleeping far later than you wanted to, and this means you wake up feeling tired and groggy. Thankfully, learning how to stop overthinking at night isn’t that difficult. I am going to share with you a few tried and tested techniques that will help you to shut your brain off at night. Put these into action, and you will be sleeping well before you know it. Why do we overthink at night? Before we talk about how we can tackle all that overthinking, I think it is worth taking a little bit of time to talk about why it is happening in the first place. I think this will help you to realize that overthinking is normal. It is something that everybody will deal with at some point or another. The brain is an information processing machine. Each day, a load of information is being thrown at you. Information that your brain needs to process at some point. The problem is that our lifestyles are busier than ever before. There is very little downtime, which means that your brain never really gets a rest from that constant barrage of information. The only time it can ‘take a break’ is when you are lying in a bed of an evening. So, when you are overthinking, you will find that your brain is (mostly) processing information. Storing it. Making decisions etc. Honestly, you will find that having a little bit of quiet time to yourself each day will do wonders when it comes to overthinking. Give yourself a rest every few hours, and the amount that you overthink of an evening will shoot all the way down. This leads us neatly onto our first method for how to stop overthinking at night. ·       Give yourself time to relax  About an hour before you head to bed, give yourself time to ‘decompress’. Don’t watch television, it is going to stimulate your brain further. You can probably read a book but make sure that the subject matter isn’t too heavy. The last thing you want is to be thinking about that awesome plotline when you are trying to drift into the land of dreams. Perhaps the best way to decompress try some meditation practices. If you have never meditated before, don’t worry, it is pretty easy. All you need is a quiet room and a comfortable chair to sit on. You may want to light a candle or two for some atmosphere. Then just follow these steps: 1.     Close your eyes and relax them. Take a few deep breaths to get started. 2.     If you have never meditated before, it can be difficult to breathe deeply. You will start warming up to it, though. Breathe in through your nose and out through your mouth. Focus on making your breaths as deep as you can. You will get the hang of it after a while. 3.     The key to meditation is to focus on your breathing. Focus on nothing else. Just focus on the air going in and then coming back out. This will eliminate any thoughts lingering in your mind. That really is it. If you meditate for just five minutes, you will feel so much more relaxed. However, the feeling is so fantastic, that I reckon you will be doing it for at least 10-20 minutes, even at the start. If you are struggling to relax, you may want to listen to some music designed specifically for meditation. It will help to get you in the mood. ·       Talk about your feelings If you have a lot of anxiety or burning thoughts on your mind, then talk about them to a friend or loved one. Talk about your day and any issues that you had with it. Make them feel as if they can talk to you if you want. In most cases, an open and honest discussion like this is more than enough to ensure that you get a good night of rest. If you don’t have anybody to talk to about your feelings to, then you may want to buy a notebook and jot a few of your inner thoughts down into it. ·       Distract your brain evenings will be minimal, but they will still happen. Sometimes, the best you can hope for is to distract your brain with something a bit more positive. When I get anxiety-laden thoughts of an evening, there is one method that works well for me. This is making up a story. When you feel those negative thoughts start to creep into your brain, come up with a story, When I was a kid, I used to love making up stories about my ‘dreams’. For example, I wanted to be a professional football player, so I would imagine myself doing that. Although, you may want to do something different. Just think about something ‘fun’. If you can’t do that, then some people find that making lists up in their minds about what needs to be accomplished the next day is a good distraction. Although, you may find that doing this will cause you to overthink more, so proceed with caution! If you don’t want to make a ‘to-do list, then try and make a random ‘fun’ list up. For example, make a list of your favorite movies or songs. Just something to focus your mind elsewhere. You could also use the ‘tried and tested’ method of counting sheep. You will be asleep before you know it. ·       Be more physically active The final technique will require you to have a few hours free throughout your day, particularly in the run-up to sleeping. If you exercise and tire yourself out, your body simply will not have the energy to ‘overthink’. You are going to be drifting into that slumber before you know it. This is a technique that is probably best used in combination with one of the others on this page. While it is a tremendous method for how to stop overthinking at night, there are some thoughts that will be so powerful and so overwhelming that being dead tired is not enough. Your brain will still somehow manage to muster up the energy to think about your problems.   If you follow these techniques, you will lower the amount of overthinking you do, if not eliminating it completely. You will be surprised at how many daily issues a spot of meditation in the evening can help you to deal with. However, do remember that if you have a ton of anxious thoughts at night that you can’t shake no matter what you try, you may want to talk to your doctor or a mental health therapist. They will be able to provide you with further advice and support you might need.   I wish you luck! Kind Regards, Gaynor 
(MA, LCSW)
Answered on 01/19/2022

How to get a better sleep I fall asleep easy but then up after a few hours for long periods of tim

Hey Sissy,  I hope you are doing well. It seems like that the stress of your job is causing your mind to become overactive at night. I hope to help by listing some relaxation techniques that could possibly help reduce your stress and lead to an overall better night's rest.  By learning a relaxation response a physiological process will follow and positively affect both the mind and body. By reducing stress and anxiety, the relaxation response can enable you to peacefully drift off to sleep. Let’s start with the basics. Start with having a quiet environment. Quiet does not have to mean completely silent. Calming sounds or music can be beneficial. Loud, abrasive sounds or noises should be avoided. A focus of attention. A word, phrase, mantra, breathing pattern, or mental image can all be used to draw your attention and reduce thinking about external concerns. Remember throughout all this to keep a passive attitude. Accepting that it’s normal for your mind to wander allows you to remain at ease and draw your focus back to the object of your attention. Try to get in a comfortable position. Finding a cozy place to relax is critical. Naturally, when relaxing to fall asleep, the recommended position is lying in bed. All of the following methods are ways of achieving these core elements so that you can calmly fall asleep. Keeping these basics in mind empowers you to adjust these methods to suit your preferences. Once you’re lying comfortably in bed, try one of these techniques to put yourself at ease and settle gently into sleep. Controlled Breathing is a series of slow, deep breaths that can enable a sense of calm. This method, also known as pranayama breathing, is believed to help reduce stress and may prepare the brain for a restful night's sleep by reducing excitatory stimulus. How to Do It: Option 1: Counting BreathsInhale slowly and gently through your nose. Exhale slowly and gently through your mouth. Count up. You can count each breath or each cycle of inhalation and exhalation, whichever comes more naturally to you. Option 2: 4-7-8 method (or you can adjust it to 5-4-5 if you find yourself out of breath)  Place the tip of your tongue near the ridge behind your front two teeth and hold it in this location throughout the breathing exercise. With your mouth closed, slowly inhale through your nose while counting to four. Hold your breath while counting to seven. Open your mouth and exhale while counting to eight. Because of the location of your tongue, exhalation should cause a whooshing sound. Repeat this 4-7-8 cycle three more times. Controlled breathing is excellent for people just getting started with relaxation techniques or who have difficulty using other objects of focus like imagery or mantras. Meditation and Mindfulness is another technique that can be incorporated. Mindfulness is centered around slow, steady breathing and a non-judgmental focus on the present moment. By reducing anxiety and rumination, it has been found to have sweeping health benefits including an ability to help reduce insomnia. There are many variations of mindfulness meditation for different situations. One easy-to-use style is the Body Scan Meditation. To do this, focus on slowly inhaling and exhaling at a comfortable pace. Notice the position of your body on the bed. Notice any sensations, good or bad, in your legs and feet. Let your legs be soft. Continue the “body scan,” observing, from your legs up to your head, each region of your body and its sensations. The goal is to stay present and observe your body without judging or reacting and then letting each part of your body relax. After scanning each part of your body, reflect on your body as a whole and allow it to relax. Lastly, try Imagery, This is when you visualize a peaceful image from your past and all of its details engage your attention in order to promote relaxation. With your eyes closed and in a comfortable position, think about a place or experience in your past that feels relaxing, such as a quiet natural setting. While slowly breathing in and out, reflect on the details of this setting and how it looks. Continue focusing on this image by adding details relating to your other senses (smell, sound, taste, touch) and experiencing the calmness of this mental imagery. If after all this you still have not found complete relaxation and keep waking up at night, try to avoid thinking about work in the middle of the night, with these following strategies: Make a to-do list. There is always more work to be done. By creating a to-do list for the following day before bed helps you to fall asleep faster — by virtually as much as taking a sleep aid — as well as helps you to wake up fewer times during the night. Unfinished tasks cycling through your mind stay at a heightened level of cognitive activation. The act of writing down these uncompleted tasks decreases cognitive arousal, rumination, and worry. And if you do wake up in the middle of the night, suddenly remembering a pressing task, keep a piece of paper and pen on your nightstand to capture it so you can let it go from your mind and go back to sleep.  Keep a journal -  Journaling or writing down your thoughts and feelings, rather than just thinking about them, has been shown to help process emotions reduce stress and anxiety, as it requires a greater level of psychological processing. Also including more positive events and what you are grateful for in your writing can help in getting longer, more refreshing sleep. Exercise self-compassion. This can be as easy as repeating positive affirmations to yourself and showing yourself the same kindness, care, and concern you would show a good friend. Practicing self-compassion and recognizing that we are all imperfect human beings allows you to break the cycle of negative thoughts and self-judgment that come with rumination, which is linked to several negative effects, including insomnia   I hope this helps!    All the best,  Tahreer Ahmad, LPC
(LPC, NCC, THTC)
Answered on 01/19/2022

Why can't I fall asleep easily?

A lot of different factors can affect our ability to get a restful night’s sleep. Even the continued frustration of being unable to get a restful night’s sleep can make it more difficult as it can become a preoccupation and feeling like there isn’t a solution in sight. This is especially true when it has been going on for a considerable amount of time. In the past year, many people are reporting more difficulty falling and staying asleep than usual brought on from more than usual stress, interrupted daily routines, uncomfortable work from home situations, and distractions. The constant flood of news and developments can lead to individuals feeling more hypervigilant than usual which leads them to a state of awareness and anxiety that can make it difficult to fall or stay asleep.  As always it's important to check with your primary care doctor for preventative care and yearly checkups to rule out any medical conditions that can be contributing to lack of sleep. Through discussions with an MD, you can explore other options such as medication management therapies the doctor feels may benefit you in assisting you to have a better sleep pattern.  A consultation with a psychiatry practitioner can also provide further evaluation and treatment options that can assist in addressing any mood issues that may be contributing to difficulties with sleep. After an evaluation, a psychiatrist will recommend treatment options and discuss the costs and benefits of medication management therapies.  However, engaging in therapeutic behavioral health services can help you get some of the issues you want to get off your chest that may be subconsciously nagging to address. Often unaddressed issues can manifest in a number of ways including mood disturbances and physical and somatic reactions.  Engaging in therapeutic services can allow you to identify behaviors, patterns, and other issues in your daily life that may be impacting your ability to fall and stay asleep. This can include developing a sleep plan that allows you to engage in mindfulness and track your progress on what works and what doesn’t. Through collaboration, you and your behavioral health practitioner will design a treatment plan and goals that address your difficulties with sleep alongside addressing other issues that also affect it. 
(MA, LMHC)
Answered on 01/19/2022

I have nightmare and I sleep so much I just want to sleep all the time I can't face a single problem

Hello Xamm,  Thank you for taking the time to share this question.  It sounds like you have a few things going on that are disruptive to both your sleep and mental health.  I will try to address each of the problems that you inquired about.   1. Nightmares-There are many different reasons that individuals experience nightmares such as stress and anxiety, insomnia or poor sleep quality, trauma, medications or substance misuse, or exposure to scary materials such as movies or books.  Although they can be relatively common for some individuals, there is a risk of complications such as being excessively tired during daytime hours, sleep avoidance due to fear of having bad dreams, and mental health problems such as depression and anxiety.  You should work with your therapist to determine if your nightmares are problematic.  They may have you practice deep breathing, progressive muscle relaxation, or grounding techniques to reduce your stress and anxiety.  Additionally, nightmare exposure and rescripting is one useful tool when nightmares are ongoing and disruptive.     2. Behavioral Activation-You mentioned that you want to sleep all the time and can't face "a single problem".  This often occurs as a result of depression.  Depression and low mood can result in a lack of motivation.  Clients experiencing these symptoms may become inactive and tend to isolate themselves from others.  Over time, these behaviors increase depression which further works to intensify the cycle of inactivity.  If you find yourself stuck in this cycle, work with your therapist to create a plan to include physical activities in your daily routine such as riding a bike, taking a walk, or dancing. Don't wait until you feel motivated.  The more you move the better you will feel, but it won't be easy to start with.  Motivate yourself with rewards such as taking a relaxing shower, listening to a podcast, or playing a video game.  Be creative and consistent.  Taking small steps, you can change habits and can learn to be active again.     3. Medical Management-The combined use of cannabis and escitalopram may be causing some of the problems that you are experiencing.  According to www.drugs.com, when using this two substances together, individuals may experience "dizziness, drowsiness, confusion, and difficulty concentrating" in addition to "impairment in thinking, judgment, and motor coordination."  It is important to work closely with your medical provider to determine if these two substances are safe to take co-currently for you.   Thank you again for writing. Best wishes! Julie Elizabeth Gallivan, MA, LPC
Answered on 01/19/2022

How do I fix it?

Hello, It's hard to guess what may be happening without having more information. For example, have you always moved around a lot in your sleep? Are you dealing with a particularly high amount of stress right now? It could even be as simple as you feeling too warm or being uncomfortable in bed. There are a lot of potential explanations. In a setting where you'd be participating in therapy, the first thing I'd want to look at is whether you're having nightmares. If you've experienced trauma, you could be having nightmares that you may not even remember the next day. In that event, working on addressing the trauma would be an important place to start. Also, if that was the explanation, there is a medication commonly prescribed for those who have PTSD that reduces nightmares and can reduce the risk of harming someone else in your bed.  If you are experiencing significant stress (and even if this relationship is absolutely healthy, there can be a great amount of stress associated with being in a new relationship, especially when this relationship may mean so much to you). learning to use and incorporate coping skills, mindfulness strategies, and self-care activities during the day could help you have a more restful sleep at night. I suppose there could also be medical explanations, such as sleep apnea. If you have a history of that or suspect that, you should talk with a doctor. You may also want to look at whether there are any routines before bed that could be playing a role. For example, alcohol use can reduce the restfulness of sleep. You could also get a Fitbit or a similar tool that can track how often you are waking up and how much time you are spending in each sleep stage. So again, without knowing more about your background and what is occurring in your life, I can't tell you how to fix it. If you are dealing with a high amount of stress or anxiety or may need to work through some trauma, I highly suggest getting involved in therapy. If this is not the case, you may want to talk with a doctor about having a sleep study was done which could provide more information about what is happening as you sleep. I do suggest though, especially if it appears that you may harm your girlfriend in your sleep, that until this issue is resolved that you not be in the same bed. If you are pushing her in your sleep, it could be possible that you could become more aggressive and actually cause her harm, so the priority needs to be about safety. Anyway, I'm glad you're reaching out for help. I would be happy to work with you if you chose to give mental health therapy a try. Take care. Nick 
(MRC, LPCC-S, LICDC)
Answered on 01/19/2022

Dream control

Hey Grayvorn,  Sorry to hear you dealing with bad/confusing dreams. The symptoms you are feeling are not uncommon when no longer consuming some medications. Many of my clients report similar symptoms when coming off of an array of medications, regardless of whether they are opioids or other psych meds. Everyone's brain/biochemistry is different and the types of symptoms, as well as their severity, also varies from person to person. When experiencing these symptoms (dreams) it is a sign that our brain neurochemistry is attempting to reset to the way it naturally was, prior to beginning medication therapy. Any kind of medication consumption directly alters our brain's neurotransmitters, oftentimes in radical ways. It would make sense that the brain would also make radical adjustments to our neurochemistry to compensate for no longer receiving those medications.  In regards to reducing the frequency/severity of the dreams you are having, you have options. I would first recommend using the knowledge that these symptoms you are experiencing are common amongst those who use prescription medication to help build more acceptance regarding the dreams. As imperfect human beings, there is only so much we can do to directly manipulate our brains and neurochemistry towards feeling how we would prefer. By increasing our sense of acceptance of these dreams/symptoms, we can help take away some of the frustration that often results from having to deal with the life disruptions these symptoms can cause.  I would also recommend that you engage in more physical activity, 30-45 minutes 3-5x weekly, in order to assist with obtaining a better quality of sleep. I understand that it seems confusing as to how physical activity is going to lessen my symptoms. However, physical activity will make it so that the body releases more healthy neurotransmitters, along with other biochemicals, that will not only assist with keeping you asleep but also assist with the resetting of your body's biochemistry. This is another one of the few ways that we can directly manipulate our body's neurotransmitters.  Finally, I would also recommend that you cease the cycle of getting off and then back on, pain medications. As long as you continue to cycle on and off medications, you are going to experience these symptoms. Pain medications were not designed to be used in that manner, in the first place. You are altering your body's neurochemistry in a significant manner when you consume any kind of medication, especially over the long term. If you truly wish to have permanent relief from these symptoms, you will have to stop cycling.    Understand that some of this may not be what you wanted to hear, but I want to help you. Hope you found this information useful. Let me know if you need anything else. Take care!    
(LMHC)
Answered on 01/19/2022