Tag: Mental Health

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Creating a Safety Plan for Times of Suicidal Crisis: Gina Capobianco

I have lived with depression for decades. Suicidal thoughts have accompanied the depression most of my life. While facing a difficult time a couple years ago, the psychiatric nurse practitioner (PMHNP) I was seeing brought up the idea of a safety plan. I had never heard of this type of plan but was willing to try it.

Like many people with suicidal thoughts, when the depression is not bearing down on me, I don’t want to die. It is just when the thoughts get going and the depression turns everything dark that dying seems like my only escape. I needed a plan for dealing with the suicidal thoughts.

My PMHNP explained what a safety plan is and how it works. A safety plan is an intervention that helps a person survive a suicidal crisis by providing them with a set of steps, which they have helped create, to follow during the crisis that will decrease the chances they will engage in the suicidal behavior.  My PMHNP described the plan as my action steps for when I feel that the suicidal thoughts are becoming overwhelming. Together we laid out the plan. It has been necessary for me to use the safety plan a couple of times, and it has been effective each time.

Let’s go through the steps my PMHNP and I used when creating my safety plan.

Purpose of a Safety Plan

First, we identified the purpose of the safety plan. The main purpose of a safety plan is to prevent suicide. The plan provides a way to cope with the crisis of suicidal thoughts using a guide to get help in a way that is comfortable and not overwhelming. The plan allows an individual to reach out to family or friends, who will serve as a support person, as well as provides connections to mental health professionals. The plan lets the support person know how to help you in a crisis.  

It is helpful if the plan is written in the individual’s own words. This ensures the person understands the steps and can enact the plan in a crisis. The words should be simple and easy to follow. The person should keep it in a place that is easily accessible. The people involved in enacting the safety plan should also have a copy. 

Components of a Safety Plan

Identifies When It Will Be Used

The safety plan should spell out when it will be enacted. I discussed this with my PMHNP.  Discussing this with your mental health professional can ensure that you are aware of when to utilize it.  When the plan is used differs for each individual. So, the plan should include when to enact it in language that can be comprehended in a crisis. My plan is enacted when I recognize my thoughts becoming overwhelming and I start thinking about acting on my suicidal thoughts.

Provides Coping Strategies 

Coping strategies are going to vary from person to person. These may include breathing exercises, meditation practice, distractions, or anything that helps the person cope with suicidal thoughts. The plan should include how to know if the strategies are working. If the coping strategies are not working or the person recognizes they are beyond the use of coping strategies, it is time to reach out for support. My coping strategies include journaling and listening to music. When these are not working it means it is time to reach out for help.

Identifies Individual(s) Who Will Support You

When you are in a suicidal crisis, you need to be able to reach out to others for support. When developing your plan, identify a friend or family member who you can reach out to. The individuals on the safety plan need to be willingly involved and consent to being a part of the plan. It is not enough to just be willing to be part of the plan. The individuals need to be able to be an active part of the plan. You need to be able to reach them in a crisis. Share your plan with them and make sure they understand the plan. Your plan should also include who your mental health professionals are and their contact information. In addition, the 988 number, the Suicide and Crisis Lifeline, should be a part of your plan. 

Provides the Questions Your Support Person Will Ask You

Your support person refers to the safety plan when you contact them. My support person has the safety plan on her phone, so she does not have to look for it.  The first question the support person should ask is if you are safe. If you are not safe, they may need to call for emergency support. My plan is set up so that I am asked if I need comfort or support once it is established that I am safe. This gives the person an idea of how severe my suicidal thoughts are at that moment. 

If I respond that I need comfort, my support person will ask me if I need to be listened to or distracted? She then responds accordingly. If I respond that I need support, she will ask me if I need her to help connect me to my mental health professional or if I need her to do it for me.  If I respond that I need help, she reminds me of who to call and may need to provide the number. As I make the call, she stays in contact with me through texting. 

Provides Steps to Be Taken to Get Professional Help

If I need her to make the contact for me, she asks me for my location and what I am thinking. She will relay this information to my mental health professional when she contacts them. 

The 988 Hotline can be called if it seems like I need professional support, and it is at a time when my mental health professionals would not be able to be reached. Some people may not have mental health professionals that can be contacted. In this situation, if the person is not in imminent danger 988 can be contacted. The person can make the call themselves or the support person can call for them. 

If I say or indicate that I am not safe, my support person may need to call 911. While waiting for emergency help to arrive, my support person needs to stay in contact with me. It is important not to leave a person who is in crisis alone. The responders on the 988 hotline and at 911 have the ability to transfer a caller to the other line depending on the need and the level of safety concern.

Plan for Follow-Up

Once intervention has taken place the support person should follow-up with the individual. When my support person does this, it lets me know that I am not alone.  The support person should check in to see how the individual is doing and to ensure that the care provided was helpful. My support person calls me to just talk.

Conclusion

Having a safety plan has made a difference in how I cope with suicidal thoughts. It ensures that I am safe even in my darkest moments. Being a part of a safety plan requires a commitment on the part of the support person. I am grateful that I have a friend who is willing to fill this role. If you deal with suicidal thoughts, talk to your mental health professional about creating a safety plan. Your plan may look different than mine. That is okay. We each have our own needs and cope with our suicidal thoughts in our individual ways. Despite the differences, a safety plan can prevent a suicide attempt and save a life.

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How We Speak Matters: Undoing Stigmatizing Language: Andrew Schreier

Andrew J. Schreier is a licensed professional counselor with over twenty years of experience in substance use, mental health, gambling, and clinical supervision with extensive experience in clinical supervision, counseling, and education. He serves as the Director of Clinical Services for Community Medical Services in Wisconsin and Minnesota, overseeing treatment programs for opioid use disorder. A national speaker and host of the Talking Addiction & Recovery podcast, Andrew explores topics such as substance use, mental health, and gambling to foster meaningful change for individuals seeking care and growth and development for professionals.

The passion for this topic stems from witnessing the profound impact that stigma can have on individuals seeking help. I’ve seen how a single word—uttered carelessly or in written communication—can either empower someone or push them further into isolation. This has driven me to advocate for compassionate, person-first language in every aspect of treatment and recovery for several issues impacting millions of people.

Language is the foundation of human connection. Words can shape people and culture. It’s how we communicate thoughts, share feelings, and build relationships. But when it comes to substance use, mental health, gambling, criminal justice, and recovery, the words we use can do more than just describe; they can harm, stigmatize, or exclude.

What Is Stigma?

Stigma is a negative association with circumstance or trait that can result in discrimination against a person for a certain characteristic(s).  Stigma can also be described as internal feelings of shame or judgment from others.  Language includes words or phrases with negative labels that assign judgment.  

Stigma around addiction may come from old and inaccurate ideas or fear of things that are different or misunderstood. Today, we know that addiction is a chronic, treatable medical condition. We also know that people can recover and continue to lead healthy lives.

The Power of Language

Words matter. Language is not just a tool for communication; it shapes perceptions, influences policies, and defines how individuals are treated. Yet, in relation to substance use, mental health, gambling, and criminal justice spaces, stigmatizing language remains a persistent issue.  Examples of stigmatizing language include: 

  • Terms like “addict,” “junkie,” or “relapse” reduce people to their conditions and perpetuate shame.   
  • Many generations have grown up in a society where language such as “crazy,” “psycho,” “loony,” “nutty,” and “mentally ill” were acceptable words to describe an individual with mental health.  
  • “Pathological,” “compulsive,” “irresponsible gambler,” and “gambling addict” generally attract substantial negative stereotypes, social distancing, emotional reactions, status loss, and discrimination.
  • Designed to desensitize, terms such as “felon,” “convict,” “offender,” and “criminal” replace names and other descriptions, such as “woman,” “daughter,” “father,” “child,” or “person.” These labels compound punishment and ultimately harm by reducing people to their worst moments, fueling stigma and haunting people for years after sentences are served.

The consequences of this language are far-reaching. Stigmatizing terms discourage individuals from seeking help, fearing judgment or discrimination. Feeling stigmatized can reduce the willingness of individuals with substance use disorders to seek treatment.  Stigmatizing views of people with substance use disorders are common; this stereotyping can lead others to feel pity, fear, anger, and a desire for social distance from people with a substance use disorder.  In clinical settings, they can perpetuate bias in documentation and decision-making.  Stigmatizing language can negatively influence healthcare provider perceptions of people with substance use disorders, which can impact the care they provide.  At the community level, such language reinforces negative stereotypes, reducing public support for funding and policy changes that could expand access to treatment.

By addressing this issue, we can create a more inclusive and supportive environment for those struggling with addiction and other behavioral health challenges. Shifting to person-first language—such as “person with a substance use disorder” or “person with a gambling disorder” instead of  “substance abuser” or “gambling addict”—respects the individual’s humanity and acknowledges their capacity for recovery.

Introducing Person-Centered Language 

Person-centered language is a language that puts people first. People are so much more than their substance use disorder, mental illness, or disability. Using person-centered language is about respecting the dignity, worth, unique qualities, and strengths of every individual. 

The solution to this issue begins with awareness and education. Through my work, I’ve identified several actionable strategies that can help professionals, organizations, and communities move toward more supportive language:

  1. Adopt Person-First Language: Referring to individuals as “persons with a substance use disorder” or “persons experiencing gambling-related harm” emphasizes their humanity and potential for recovery. This small change can make a big difference in how people feel about seeking help.
  2. Eliminate Stigmatizing Terms: Words like “relapse” can be replaced with “return to use,” and “addict” with “individual in recovery.” Such shifts reduce shame and promote a more constructive dialogue.
  3. Train Professionals: Regular training for clinicians, social workers, and other providers can help them understand the impact of their words and adopt best practices for communication.
  4. Revise Documentation Practices: Clinical records should reflect person-centered care by avoiding labels and focusing on specific behaviors, needs, and strengths.
  5. Raise Public Awareness: Community education campaigns can dispel myths, challenge stereotypes, and encourage supportive attitudes toward those in recovery.

Letting Go of Stigmatizing Terms

Throughout my career, I have witnessed firsthand how stigmatizing language impacts individuals in treatment. Early in my work, I noticed how terms like “noncompliant” or “frequent flyer” in clinical documentation shaped the attitudes of treatment teams. Patients were often unfairly labeled before they even walked through the door. Recognizing this, I began advocating for changes within my teams, encouraging the use of language that focused on behaviors and needs rather than labels.

Initially, the thought of simply removing stigmatizing words and replacing them with person-centered language appeared easy.  However, after beginning to take on that task it became more apparent at how prevalent stigmatizing language is through policies, procedures, textbooks, sources, narratives, educational materials, and awareness campaigns to name a few.  In asking people to eliminate stigmatizing language meant asking them to let go of words they have come to use on a regular basis.  

Some people used those words to describe themselves in their own recovery with lived experience. Professionals have used stigmatizing terms in how they talked not only to but about people they served. Helping professionals let go of stigmatizing language involves acknowledging past habits, understanding their impact, and actively working through a process that includes reflection, education, and practice. Here are some tips to facilitate this journey, including the idea that it might resemble a grief process:

  1. Acknowledge Past Usage Without Judgment
    1. Normalize Mistakes: Remind professionals that everyone has used stigmatizing language at some point due to societal norms, training, or common phrases.
    2. Create Safe Spaces: Foster environments where professionals can openly discuss their language habits without fear of judgment. Encourage the perspective that improvement begins with self-awareness.
  1. Understand the Emotional Attachment to Language
    1. Recognize Resistance: Letting go of familiar terms can feel uncomfortable. Professionals may associate certain languages with their identity, training, or professional experience.
    2. Embrace the Grief Process: Encourage professionals to view this shift as a form of grief. They might feel denial, anger, or sadness before accepting and embracing change. Support them by discussing these emotions openly.
  1. Educate on the Impact of Language
    1. Highlight Harmful Effects: Show how stigmatizing language perpetuates stereotypes and discourages individuals from seeking help. For example, terms like “addict” increase perceptions of personal blame, leading to worse treatment outcomes.
    2. Use Data and Stories: Share research and real-life examples demonstrating how person-first language fosters dignity and better outcomes for individuals.
  1. Provide Practical Strategies for Change
    1. Use Person-First Language: Train professionals to replace terms like “addict” with “person with a substance use disorder.” This approach focuses on the individual rather than the condition.
    2. Pause and Reflect: Encourage them to pause and consider the potential impact of their words before speaking.
    3. Use Tools and Resources: Offer quick-reference guides or charts that suggest alternatives to stigmatizing terms.
  1. Normalize Continuous Learning
    1. Reframe Learning as Growth: Remind professionals that language evolves. A commitment to lifelong learning aligns with professional ethics and improves patient care.
    2. Practice Role-Playing: Use training sessions to practice reframing conversations and identifying stigmatizing phrases.
  1. Promote Organizational Support
    1. Leadership Modeling: Encourage leaders to adopt and model inclusive language to set an example for their teams.
    2. Policy Updates: Advocate for policies and documentation practices that reflect non-stigmatizing language.
  1. Celebrate Small Wins
    1. Acknowledge progress, even if it’s incremental. Shifting language habits takes time and effort, but every step forward is meaningful and recognizing any positive change provides dignity, compassion, and respect for the people we serve.  

By normalizing the discomfort that comes with change and framing it as part of a growth process, professionals can move toward language that uplifts and empowers those they serve.  

Language as a Tool to Change

Undoing stigmatizing language is about more than changing words; it’s about transforming the culture of substance use, mental health, gambling, criminal justice, and other spaces related to people we serve. By speaking with care and intention, we can create environments where individuals feel valued, supported, and empowered to seek help.

In talking to and about individuals, the best practice and way to eliminate harm is by letting people choose how they want to be described. If you are not sure what words to use, just ask.  Avoid using language that defines someone by their condition. Use updated, accurate terminology instead of outdated terms. Avoid language that makes judgment. Describe without downplaying or becoming overly graphic. Use person-centered language that avoids seeing them as their diagnosis and instead focuses on the whole person.  

Looking ahead, I envision a future where person-first language becomes the standard in all areas of behavioral health. This includes expanding training programs, integrating these principles into policy and advocacy work, and using a multitude of platforms.  

Language has the power to heal or harm. Let’s choose to use it as a tool for connection, compassion, and change.

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Grief: A Journey to Wellness by Rebecca E. Tenzer

Grief is a profound and unapologetic experience that can have an impact on every aspect of a person’s life. Whether it is the loss of a loved one, a pet, a relationship, or even a significant life transition, grief affects us on physical, emotional, and mental levels. It is often thought of as purely emotional, but grief significantly affects our nervous system, mental health, and overall wellness. Understanding the way grief interacts with our nervous system sheds light on why the experience can feel overwhelming, uncontrollable at times, and highlights the importance of approaches that integrate both clinical services and holistic care.

What Is Grief?

Grief is something that everyone will experience at some point in their lifetime; however, each person’s experience will be different. Grief is a journey, often complex, where we may experience different states of emotion, physical symptoms, and even psychological stressors. Grief can affect us on a level that is sometimes even undetected, however there are signs that it is there. Grief can be debilitating for some, it can be subtle for others and sometimes we can even feel “fine.” 

Let us “de-fine” what it means to be “fine.” Although grief is ever present, some days you may be able to get through work, relationships, and daily tasks without being consumed with the thoughts of whatever you are grieving. Grief is still there, it may just show up at various times and in unexpected ways. It could be a song you hear at the grocery store, a scent you recognize while walking past a restaurant, a picture or a memory that pops into your head that could trigger an emotional response. It is not always sadness that we experience, you might find yourself smiling and or laughing while remembering a happy time with that person, place or thing. 

Grief can also be complex. We do not always grieve just those that we have loved. Complicated family dynamics, toxic relationships, or jobs, even an experience that was not pleasant can cause a confusing grief response. I always say to people when they ask, “does grief really get better with time?” Honestly, it doesn’t really get better, in my personal and professional experience, it just gets “different.”

Grief and Mental Health

Grief has a massive impact on both mental and physical health. Specifically, grief heightens emotions like sadness, loneliness and hopelessness. When someone is feeling these emotions, they can often get down, feel blue more often than not or even suffer from depression. It can be challenging to diagnose because grief and depression have such similar characteristics. Grief, like depression, can have an impact on your sleep patterns, appetite, desire to do pleasurable things and cause us to isolate in our sadness. 

Sometimes folks may even experience anxiety and panic attacks thinking about the future without their loved one, relationship, job or whatever loss they have experienced. It can be difficult to imagine what life will look like after the loss. People often begin to question things like, “where will I end up in life now?” They may reconsider an identity they once had or be fearful of future stability and security. It is quite common to have overpowering doubts about the future when coping with a significant loss. All of these characteristics we so often associate with grief can create a stressed and anxious state for both the mind and the body. 

Grief and the Nervous System

When we experience grief, it triggers a trickle effect of responses in our body, particularly within the nervous system. The nervous system is responsible for regulating bodily functions, reacting to stress, and supporting overall well-being. When we experience grief, our nervous system can become stressed, as the intense emotional response to the loss triggers the body’s “fight, flight, or freeze” response. This can lead to increased stress (and an increase in cortisol levels), anxiety, fatigue, insomnia and difficulty focusing. It is important to note that all of these symptoms of grief can profoundly affect our mental health. Grief puts a strain on the nervous system, which changes the overall functioning of our bodies, both mentally and physically.

Understanding and nurturing our nervous system is essential during times of grief. Mindfulness also plays a key role in calming the system by creating a “rest and reset” response. The impact grief has on our bodies, minds and systems helps us to understand why it can be so difficult to “move on” and why people may feel trapped in a cycle of distress, unable to experience calm or relief. Mindfulness practices like breathwork, gentle movement, sound bath, reiki and restorative activities can help us regain balance and promote healing. Taking care of our nervous system supports our ability to process and recover from loss in a healthier way.

What many people do not know is that the nervous system’s involvement in grief is central to this mental health crisis one may be experiencing. The autonomic nervous system’s continued activation during grief can prevent individuals from engaging in healthy coping mechanisms like therapy, engaging socially, moving their bodies, eating healthy and sleeping regularly. 

Sometimes, grief can encourage the use of substances to handle the impacts on the mind and body as an escape from thoughts, feelings and sensations they cannot control. Often, grief reinforces negative thoughts or emotions associated with the loss. Because the nervous system is continuously strained, it becomes difficult for individuals to return to a baseline of mental wellness, meaning that mental health interventions must account for the body’s physiological state alongside the mind’s emotional needs.

The Role of Holistic Services in Alleviating Grief

Holistic services offer unique pathways for individuals to cope with grief in a way that addresses both the body and mind, providing a comprehensive approach that alleviates the nervous system’s strain and supports mental health. Unlike traditional therapies, which may focus primarily on the mind, holistic approaches recognize the interconnectedness of the body and mind, further emphasizing the need for whole-body healing. Techniques such as mindfulness, yoga, breathwork, and Reiki directly engage the nervous system, helping to alleviate the impact of chronic stress and bringing the body back to a state of balance.

1. Mindfulness and Meditation

    Mindfulness meditation is an effective way to bring the nervous system back to equilibrium by helping individuals focus on the present moment rather than ruminating on their loss. Mindfulness techniques stimulate the parasympathetic nervous system, promoting a sense of calm and allowing the body to rest. Through mindful breathing exercises and meditation, individuals can interrupt the body’s fight-or-flight response, offering relief to an overactive nervous system. 

Meditation helps in rewiring the brain’s response to grief, often associated with Cognitive Behavioral Therapy, reducing the intensity of negative emotions, and fostering mental resilience.

2. Yoga and Movement Therapy

Yoga, particularly restorative and gentle practices like mindful movement, plays a vital role in soothing the nervous system during grief. By emphasizing slow, mindful movements and breath, yoga can shift the nervous system to a relaxed state. Restorative poses and guided breathing ease the release of tension and stored emotions in the body, helping individuals process grief on a somatic level. 

Movement therapy in yoga encourages a reconnection with the body, disrupting the feelings of disconnection and numbness that grief often brings. Yoga’s emphasis on bodily awareness allows people to tune into their feelings without judgment, creating a safe space to process and accept their grief. 

3. Breathwork

Breathwork is a powerful tool for managing grief, as it directly impacts the nervous system by activating the parasympathetic response. Conscious breathing techniques, such as diaphragmatic breathing or 4×4 breathing, allows individuals to regulate their heart rate and calm the mind. Breathwork practices help individuals confront the overwhelming emotions associated with grief, empowering them to face their loss without feeling overwhelmed by it. Engaging in regular breathwork can help break the cycle of stress that affects the nervous system, providing relief and helping individuals feel more grounded.

4. Reiki and Energy Healing

Reiki, a form of energy healing, is particularly beneficial for those struggling with the physical symptoms of grief. This practice focuses on balancing the body’s energy, promoting relaxation, and supporting the healing process. By channeling energy into areas of tension, Reiki soothes the nervous system and helps individuals release stored emotions that might otherwise manifest as physical symptoms. 

For many, the calming nature of Reiki helps alleviate the sense of “heaviness” often described in grief, offering a pathway to find lightness and inner peace. People often refer to a Reiki session as a “massage from the inside out” due to the deep healing and stress relief they feel during and afterwards.

5. Sound Therapy

Sound therapy, including sound baths and the use of specific sound frequencies, has shown to be helpful for those experiencing grief. Sound vibrations resonate with the body and help bring about a state of calm and relaxation by slowing down brainwave activity. This shift in brainwave patterns can reduce stress, making it easier for the nervous system to disengage from the fight-or-flight response. 

Sound therapy offers a therapeutic experience that can provide a momentary release from the emotional weight of grief and help individuals find moments of peace within their pain. People often describe sound bath immersion as a full body experience, like taking a nap on the beach, surrounded by soothing sounds of waves, while in a tranquil state of peace.

Embracing a Clinical AND Holistic Path to Healing from Grief

Grief is not a condition to be “cured” from but an experience to be lived through. While traditional mental health treatments like talk therapy and medication can play essential roles, holistic services offer a complementary approach that acknowledges the profound interconnectedness of the body and mind. By focusing on the nervous system and integrating practices that promote physical and emotional balance, holistic services provide a pathway to process grief in a way that respects the complexity of the experience.

For those navigating grief, embracing both clinical intervention and holistic practices can offer a way to honor their loss without becoming overwhelmed by it. These practices help individuals reconnect with their inner strength, cultivating resilience and a renewed sense of hope. 

Grief is a transformative journey, and while it may never fully disappear, therapy with holistic services empowers individuals to move forward with compassion for themselves, honoring their loss while embracing life’s ongoing potential for healing and joy. Holistic approaches, with their focus on the nervous system and whole-body wellness, provide invaluable tools for those facing one of life’s most profound challenges, helping them find peace and balance in the wake of loss.

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The Importance of Sleep for Mental Wellness

Sleep. We all need sleep, and it plays a crucial role in maintaining and promoting mental health. Adequate sleep is essential for cognitive functions, emotional regulation, and overall psychological well-being (Goldstein and Walker 2015). I am a “needs at least 8 hours of sleep a night” girl, but many people feel they don’t need that much sleep. Some even feel they need more than 8 hours to feel rested and ready to tackle the day. No one knows your body and your needs more than you, so recognizing and maintaining the amount of sleep that you need is absolutely in your control. 

Do you have a bedtime routine? For me, that is a must to have successful sleep and help my mental wellness overall. It can look like anything, if it works for you. I take a warm shower and allow the water to wash away the stress from my day, followed by some couch time and watching a show my husband and I can agree on. Side note, that is challenging at times. We have completely different tastes in what we like to watch…and he won’t watch Love Island with me. He’s missing out on quality entertainment, don’t you think? 

In addition to taking a shower and enjoying some TV time with the hubs, I drink a warm cup of sleepy time tea and stay off my phone for the most part. Another way my husband and I differ, which affects both of our sleep, is that I need noise to fall asleep. If I lay in bed with no noise to put my focus on, my thoughts just run wild. I will replay a conversation I had 8 years ago and analyze it, overthink it, and then feel awful and anxious telling myself what I should have said instead or something I said that I shouldn’t have. These messages I’m sending to myself are not necessary, but my brain goes straight to overthinking. If I have noise to focus on, such as a comfort TV show or a sleep story from Calm (Matthew McConaughey anyone??) I can fall asleep quickly and happily. I can’t even tell you how Matthew’s sleep story ends, it is that good. The voice of an angel, I’m telling you. 

Having a routine for winding down at night is especially important for me in managing my Bipolar Disorder. I never knew how much a routine would be beneficial to me, but when I go to bed around the same time each night, after winding down, I am able to awaken in the morning feeling positive and energized. Of course, coffee helps that part too! So why is sleep so important to your mental health? 

Emotional Regulation: Sleep helps regulate emotions by allowing the brain to process and respond to emotional stimuli. Poor sleep can lead to irritability, mood swings, and a decreased ability to cope with stress. Over time, this may contribute to anxiety and depression.

Cognitive Function: Sleep is essential for memory consolidation, learning, and problem-solving. When we sleep, the brain processes information and solidifies memories. Chronic sleep deprivation can impair focus, decision-making, and the ability to think clearly, leading to cognitive deficits that negatively impact daily life.

Stress Reduction: Sufficient sleep helps the body and mind recover from daily stressors. A lack of sleep increases the body’s production of cortisol, a stress hormone, which can heighten feelings of stress and anxiety.

Mental Health Disorders: Like I was speaking about above, a healthy and effective sleep pattern has a strong link to managing mental health conditions. Conditions like depression, anxiety, and bipolar disorder are often associated with sleep disturbances. Sleep deprivation can exacerbate symptoms, while improving sleep can have positive effects on managing these conditions.

Psychiatric Symptoms: Insomnia or other sleep disturbances are common early signs of psychiatric disorders, such as schizophrenia or depression. Addressing sleep problems can often improve the prognosis of these conditions and make treatments more effective.

Brain Restoration: Sleep gives the brain time to repair itself. It helps clear out toxins that accumulate in the brain during waking hours, protecting against neurological diseases like Alzheimer’s. This restorative process is crucial for mental clarity and overall brain health.

Social and Emotional Connections: A lack of sleep can negatively impact relationships, reducing the ability to empathize with others or manage interpersonal conflicts effectively. Feeling emotionally drained or disconnected often accompanies sleep deprivation, straining personal and professional relationships. Improving sleep hygiene can be a key strategy for boosting mental health, improving emotional resilience, and protecting against long-term psychological issues

That’s a lot of info, but it really illustrates why sleep is so central to us. I shared some ways that I wind down for the night, but there are many other options and ideas that you may find helpful. Overall, these are things you can implement to get better sleep:

Create a sleep schedule: Try to stick to a consistent sleep schedule and limit sleep to eight hours or less. 

Avoid screens before bed: Limit or avoid using screens that emit blue light, like your phone, laptop, or TV, for 30–60 minutes before bed. 

Dim the lights: Bright lights can make it harder to fall asleep. You can use a desk lamp or string lights to create a soft glow. 

Wind down: Try a calming activity like reading, stretching, meditation, or listening to relaxing music or a podcast. You can also try journaling to express any concerns you might have. 

Eat and drink well: Avoid heavy meals or caffeine within a couple of hours of bedtime. You can try a small snack that combines protein and carbohydrates, like a banana with peanut butter or a whole wheat cracker with low-fat cheese. 

Exercise regularly: Regular physical activity can help you sleep better, but avoid intense workouts too close to bedtime. 

Prepare your bedroom: Make your bedroom a cool, dark, and quiet place for sleep. You can turn down your bed covers, plump your pillows, and use blackout curtains. I have a fireplace TV stand, and turning that on creates such a pleasing glow as I get comfy in bed, close my eyes, and listen to something enjoyable as I drift off to sleep. 

Get sunlight: Try to get some natural light during the day, like early morning sunlight and sunsets.

No go forth, and sleep well!

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Climate Anxiety: Muskan Lamba

Caring for the Climate and One Another

I’m Muskan Lamba (she/her), a mental health researcher, expert by experience, and facilitator, deeply curious about the impacts of climate change on human well-being. I am conducting the first study on climate anxiety among youth in the Indian subcontinent, particularly in climate-vulnerable communities. With a passion for nurturing communities and anti-burnout culture, I’ve been creating spaces where individuals can confront anxiety and find care amidst the polycrisis affecting the world, destabilizing our connection to nature and one another. 

Witnessing ecological instability firsthand in the form of massive heatwaves, with temperatures reaching 50°C and AQI soaring to 1000+ in Delhi, India, fuels my passion for this work. Through initiatives like hosting Resilience Circles with the Resilience Project UK, I’ve seen firsthand how shared struggles within climate movements—such as the pressure to constantly “do more” or feelings of helplessness—can be transformed when met with communal empathy and conversations that emphasize creativity, connection, and rest as an act of resistance.

What Even Is Climate Anxiety?

Climate anxiety, also sometimes referred to as eco-anxiety or ecological grief, is a psychological distress people experience in response to the existential threat of climate change. It manifests as chronic fear, worry, and a sense of helplessness, triggered by thoughts, or experiences, of environmental threats such as extreme weather events (think flooding, forest fires), rising temperatures, and the destruction of ecosystems. 

Research has shown that this anxiety can lead to physical symptoms like insomnia, loss of appetite, and panic attacks, and more recently, is even being theorized as a Pre-Traumatic Stress Syndrome (PreTSS). While it is not classified as a mental illness, climate anxiety reflects a rational human response to the looming environmental crisis.

The Psychological Toll of Intense Heat

Rising global temperatures and intensifying heat waves are straining the ecosystems, and also our minds and bodies, leaving a profound psychological imprint as people face the upheaval of migration, loss of familiar landscapes, and an insecure, uncertain future.

The lived experience of climate anxiety is particularly pronounced among vulnerable communities struggling with multiple crises at once, yet much of the literature so far comes from High-Income Countries (HICs). In regions where systemic inequalities limit access to mental health resources, the burden is heavier, leaving communities with fewer tools to cope, governmental apathy, and worse, stigma around these troubles.

My research, which surveyed ~300 respondents from South Asian countries, revealed a strong sense of distress amongst young people aged 18-30, with respondents expressing feelings of isolation, helplessness, and frustration. This emotional burden is exacerbated by social inequalities, leading to more vulnerable groups, such as women and minorities, bearing the brunt despite contributing the least to the climate crisis.

In the words of a survey respondent: “Experiencing extreme heat waves, especially those reaching up to 50°C, makes daily life unbearable, often causing physical discomfort and mental stress. The heat disrupts routines, worsens health, and creates an overwhelming sense of helplessness. The stress of managing daily tasks under such harsh conditions, coupled with the anxiety of seeing others suffer, is overwhelming.”’ 

Sensemaking of our Emotional Responses

As we live through multiple crises intertwined—ecological, economic, socio-political—it is slowly, but surely, becoming clear that our emotional selves are not quite okay, and they require a brave space to be acknowledged and nurtured.

Historically, communities have gathered around firesides—sharing stories, singing, and connecting—to process their collective struggles. In some cultures, such as in rural India, the act of storytelling would allow them to process grief and celebrate resilience. In many African cultures, fireside conversations are central to the philosophy of Ubuntu (“I am because we are”). In Native American traditions, too, the council fire served as a place to discuss important matters, resolve conflicts, and honor ancestors. 

In today’s fractured, isolated world, where emotions are as it is stigmatized much of the time, we must recreate safe “third spaces” where individuals can come together to collectively process their emotions and tap into collective wisdom.  Further, the prevailing culture of “do more” has contributed significantly to burnout, and shifting towards a regenerative approach allows individuals to preserve their mental and emotional health while continuing to call for change. 

Resilience Circles

A purposeful and deeply impactful initiative I have been part of is the facilitation of Resilience Circles with the Resilience Project UK. These circles provide a unique opportunity for youth navigating burnout, climate anxiety, and the like, to come together, come undone, and foster a sense of hope amidst the overwhelm as we make sense of the pain, and develop coping strategies. 

By bringing individuals together in a safe, supportive environment, free from jargon or the pressure to perform, these circles allow participants to express themselves openly without fear of judgment or invalidation. These circles are rooted in practices like mindfulness, storytelling, and brainstorming ways to heal, empowering participants to see their emotions not as weaknesses but as sources of curiosity and wonder. For instance, transforming a narrative such as “Vulnerability is a weakness.” to “Vulnerability can be a strength around the right people.”

Climate anxiety can lead people to isolate themselves when they don’t see it as something rational or real. Some describe feeling they must carry the burden alone or be constantly active in the fight against the crisis. However, circles such as this, challenge the notions by encouraging rest and regenerative practices as essential forms of resistance and self-care. For example, in one session, a participant shared feelings of guilt about needing to take a break from activism. This feeling was reframed, through the group’s input, as an important form of sustenance in the movement. 

Closing Thoughts: Tap into Collective Wisdom

Climate anxiety is an evolving concept, with subjective lived experience depending on one’s culture, society, personal stories, and intermingling with other crises. It’s isolationary, but it’s a highly common experience that many are grappling with today.

Community creates a foundation for collective sensemaking, where the burden of climate change may be carried together. By creating more spaces, digital and otherwise, that prioritize rest, creativity, and shared wisdom, we enable more sustainable forms of coping with climate anxiety. 

At the end of the day, this shift requires systemic change, where mental health is seen as integral to action against polycrisis, and emotional well-being is prioritized alongside traditional notions of productivity and achievement.

We must recognize the importance of third spaces—places where individuals can come together to connect, share stories, and find common ground. In doing so, we may create ripples of resilience that extend far beyond ourselves—just as our ancestors did by the firelight. 

Interested in contributing to understanding and addressing topics like climate anxiety? Join CliMind, a youth-centric virtual community focused on exploring the connections between climate change and well-being: https://chat.whatsapp.com/DPW2866mRbfDNZKWo11GUH

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Unlocking Mental Wellness: The Power of Routines: Dr. Sarah Anderson

In our fast-paced world, routines can play a crucial role in improving mental health. Daily routines act as a safety net, providing stability and security amongst chaos. Establishing regular daily habits allows us to bring structure to our surroundings while fostering resilience, resulting in a healthier mindset and a more balanced nervous system.

Studies indicate that children excel in settings with well-defined routines, and their ability to learn may be impacted negatively when these structures are lacking (Montroy et al., 2016). Structured schedules are beneficial for both children and adults, helping to reduce anxiety and stress through predictability. Additionally, routines help us manage our time better and prioritize tasks, leading to greater organization and less overwhelm. Regular routines also promote healthy habits, such as consistent sleep patterns and exercise—key elements for maintaining good mental health. Overall, establishing and maintaining routines can make it easier to navigate challenges and improve emotional well-being.

The Role of Routines in Mental Health

One of the main benefits of routines is their ability to significantly reduce decision fatigue, which arises from facing an overwhelming number of choices each day (Ilies et al., 2010). With research indicating that we make around 35,000 decisions daily, this cognitive overload can lead to stress and anxiety (Sahakian & Labuzetta, 2013). 

By establishing structured routines, we transform decisions into automatic actions, conserving mental energy and enhancing focus on more important tasks. Once routines become instinctive, they not only alleviate cognitive load but also allow us to direct our cognitive resources toward creativity, productivity, or simply enjoying the present moment. In contrast, a lack of routines can result in mental exhaustion and procrastination due to constant decision-making.

Routines and Mental Health Challenges

Routines can be particularly beneficial for people facing mental health challenges. Research has shown that sticking to regular routines can reduce symptoms of depression and anxiety, especially in adolescents and young adults (Muñoz-Fernández & Rodríguez-Meirinhos, 2021). Predictable daily tasks provide comfort and stability. For someone with anxiety, a structured morning routine that includes mindfulness can be grounding. Similarly, for someone dealing with depression, a simple routine like “get up, shower, and have breakfast” can reignite motivation. Creating an effective morning and evening routine can significantly enhance your mental health. 

Routines & Substance Use Recovery 

Routines play a vital role in substance use recovery by providing structure, stability, and a sense of purpose in an individual’s daily life. Engaging in consistent routines allows recovering individuals to establish healthy habits, reduce anxiety, and minimize triggers associated with substance use (Smith et al., 2020). Research indicates that routines can enhance coping strategies and reinforce positive behaviors, facilitating the development of new lifestyles free from substance reliance (Dunn & Tompkins, 2018). 

Many individuals facing substance use challenges also grapple with executive functioning deficits, which can involve difficulties in planning, organization, and self-regulation. Approximately 50% of individuals with substance use disorders exhibit some level of executive dysfunction (Davis et al., 2015). This impairment can complicate recovery efforts by making it harder for individuals to adhere to treatment plans or make healthy choices. Routines help alleviate these challenges by creating a framework that simplifies decision-making and fosters a sense of discipline. Maintaining a predictable daily schedule fosters a sense of control and accomplishment, which is crucial for building self-efficacy and preventing relapse (Witkiewitz & Marlatt, 2004). By effectively addressing issues related to executive functioning, routine management can significantly enhance the recovery process and support long-term sobriety. 

General Tips for Designing Routines

  1. Set Clear Intentions:

Before you start your day, take a moment to write down three things you want to accomplish. This could be as simple as “exercise for 20 minutes,” “complete that work project,” and “call my friend.” Writing them down can solidify your commitment and give you something to refer back to throughout the day.

  1. Start Small:

If a full morning routine feels overwhelming, begin by waking up just ten minutes earlier to dedicate those minutes to something positive, like taking a quick walk outside or sipping a glass of water. Gradually, as you become comfortable, you can extend this time and incorporate additional elements.

  1. Be Consistent, yet Flexible:

While it’s essential to keep a routine, allow room for inevitable life events. If you have to skip a morning workout, don’t stress; perhaps consider adding in a bike ride during lunch or a brief walk after dinner instead.

  1. Incorporate Mindfulness:

Incorporate mindfulness into your daily routines by allowing yourself moments of presence throughout the day. For instance, during your morning routine, take a few moments to engage fully with each activity, whether it’s brushing your teeth, showering, or preparing breakfast. Focus on the sensations, sounds, and smells, and try to immerse yourself in the experience rather than rushing through it. This practice of mindfulness not only helps you appreciate the small moments but also cultivates a sense of calm and awareness that can enhance your overall well-being as you go about your day.

  1. Track Your Progress:

Use a simple bullet journal or an app to keep track of daily achievements as well as challenges you are experiencing. Write down what went well each day, and reflect on any barriers you identify. This habit can help identify patterns that help or hinder progress.

Actions to Incorporate in a Morning Routine

  1. Wake Up at a Consistent Time:

To help regulate your circadian rhythm, choose a wake-up time and stick to it, even on weekends. For example, if you aim to wake up at 7 AM, set your alarm for the same time daily to help reinforce your body’s internal clock (Hirshkowitz et al., 2015). If you find yourself hitting the snooze button, try moving your alarm clock across the room. This will force you to get up and out of bed, making it less likely that you’ll go back to sleep. 

  1. Personal Care:

Enjoy a refreshing shower, and then take some time to groom yourself. Set aside at least 20-30 minutes to wash your hair, brush your teeth, and style yourself in a way that boosts your confidence and sets you up for the day ahead. You might also consider using your favorite scents or skincare products to make the experience more enjoyable.

  1. Remember to Take Your Medications:

Incorporate your medication into your routine by placing it next to your morning beverage or in a visible spot as a consistent reminder. For example, if you take your medication with breakfast, keep it in the kitchen next to the bowls. It’s essential to find a way to habit stack this practice, as taking your medications as prescribed is important for your health.

  1. Engage in a Mindfulness Practice:

Spend five to ten minutes meditating using a guided session. In addition to meditation, you can incorporate practices like a body scan, progressive muscle relaxation, or mindful eating. Research shows that regular mindfulness practice can lead to significant decreases in anxiety levels. These activities not only enhance your mental well-being but also help you cultivate greater awareness and presence in your daily life. (Kabat-Zinn, 2003)

  1. Physical Activity:

Incorporate exercise into your morning routine to jumpstart your day. Whether it’s a 15-minute yoga session to promote flexibility and mindfulness, a brisk walk to enjoy the fresh air and energize your body, or a quick HIIT workout to get your heart pumping, find an activity that resonates with you. Regular physical activity has been consistently linked to improved mood and reduced levels of anxiety. Engaging in exercise not only releases endorphins, which are the body’s natural mood lifters, but it also helps to foster a sense of accomplishment and sets a positive tone for the rest of the day (Craft & Perna, 2004).

Actions to Incorporate in an Evening Routine

  1. Create a Tech-Free Zone:

Commit to powering down screens at least one hour before bed. Instead of scrolling through social media, opt for reading a physical book, journaling, or engaging in puzzles. Establish a cozy nook in your living room or bedroom specifically for these activities. 

  1. Establish a Set Evening Ritual:

Prepare for sleep by making a cup of decaf herbal tea (like chamomile or peppermint). The act of preparing tea can be a calming ritual that signals your brain to wind down. Engaging in this mindful activity has been shown to ease the transition to sleep and reduce nighttime anxiety (McKay & Blumberg (2002).

  1. Incorporate Relaxation Techniques:

After your tea, consider a short yoga session or progressive muscle relaxation meditation for 10-15 minutes. Online resources, like yoga or relaxation apps, can guide you through these exercises. Research suggests that such practices can significantly lower cortisol levels, promoting relaxation and better sleep quality (Hirshkowitz et al., 2015).

  1. Reflect on Your Day:

Spend five minutes journaling about the positive aspects of your day. You might write three things you are grateful for or highlight a meaningful interaction you had. This reflective practice helps to create emotional closure for the day and can provide a buffer against daily stressors (Emmons & McCullough, 2003).

  1. Set a Consistent Sleep Schedule:

Aim to go to bed and wake up at the same time each day. Create a pre-sleep routine such as dimming the lights in your home, playing soft music, or using essential oils (like lavender) to signal that it is time for sleep. Over time, your body will start associating these cues with bedtime, promoting quicker sleep onset (Hirshkowitz et al., 2015).

Overcoming Challenges in Establishing Routines

Establishing a routine can come with its own set of challenges, but with a few tips and tricks, you can overcome obstacles and foster a sustainable practice. One common hurdle is a lack of motivation. If you find it difficult to get going, consider pairing your new routine with activities you already enjoy. For example, you might listen to your favorite music while exercising to make the experience more enjoyable or sip on a beloved beverage while journaling, transforming these tasks into more pleasurable moments. 

Another challenge many face is the fear of failure. It’s essential to understand that setbacks are a natural part of the habit-building process. Instead of perceiving a missed routine as a failure, view it as a valuable learning opportunity. Take time to reflect on what led to the disruption; whether it was time constraints, unexpected events, or lack of energy, identifying the cause will empower you to strategize and plan for similar situations in the future. This proactive approach will help you build resilience and adapt your routine as needed. 

External distractions can also pose significant barriers to maintaining your routine. To counteract these interruptions, create designated spaces for work and relaxation. Minimizing noise and visual distractions is crucial; for instance, consider using noise-canceling headphones or arranging your environment to reduce clutter. If you work from home, it’s helpful to set clear boundaries with housemates or family members during your designated routine times. Communication is key so that everyone understands the importance of these times for your focus and reflection. By cultivating an environment conducive to stability and mindfulness, you’ll be better equipped to establish and maintain a routine that enhances your mental well-being.

Embracing the Routine Revolution

In a chaotic and hectic world, routines provide stability and order. Developing personalized routines can enhance mental health, reduce stress, and create a sense of control. By embracing routines and tailoring them to fit your preferences, you can navigate life with greater ease. Remember, routines are about creating a flexible framework that supports healthier choices and emotional resilience. As you work on establishing your routines, be kind to yourself, acknowledge your successes, and keep building a daily rhythm that nurtures your well-being. Over time, you’ll discover that routines can transform your life for the better.

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Winter Reinvention and Growth: Andrea Mora

Hey there hey! Your girl is back and ready for action in this new article, all about harnessing the power of winter as an ideal time for reinvention and growth. Why might you ask? Ok, here’s the deets on why winter is meant for transformation. First, there is a natural pause and reflection with winter. The colder months often encourage slowing down. With shorter days and longer nights, winter naturally creates space for introspection. It’s a quieter time when people can reflect on the past year, assess their goals, and think about how they want to move forward. This introspective period is perfect for making meaningful changes in your life.

Winter is also a time for rest and recovery. The energy of summer and fall is often spent on socializing, traveling, or working hard. Winter provides an opportunity to rest and recuperate. By recharging during this time, you can be better prepared to take on the challenges of reinvention and set new intentions for the coming months.

There is a symbolism of renewal because winter is often associated with renewal and rebirth in various cultures and traditions. After the stillness of winter comes the vibrancy of spring, which mirrors the process of personal transformation. Just like nature goes through cycles, winter can be seen as a time for planting seeds of change that will blossom later. Also, people tend to spend more time indoors, which can help foster deeper connections with themselves. The physical stillness of winter can prompt a mental stillness, making it a good time to dive into self-discovery, mindfulness, or meditation—practices that support reinvention.

Additionally, there tends to be fewer distractions from social activities, vacations, or outdoor events. This quieter time gives you more opportunities to focus on your personal growth, read, study, or engage in new hobbies that align with the goals you have for yourself. Along with this is the acknowledgement that the turn of the calendar year often sparks a natural desire for change. This cultural phenomenon encourages people to set resolutions and goals for self-improvement, making winter an ideal time to start anew. The sense of a “fresh start” can motivate you to make positive changes. In essence, winter offers a mix of external quiet and internal focus, creating the perfect environment for reinvention. In order to grow ourselves, we need to embrace the unique qualities of the season, which nurture both our inner and outer selves. We can find opportunities for introspection, rest and setting intentions for the future.

Now we are back to another question you may be asking yourself: Howwww do I do this?? Keep reading, it’s good stuff.

1. Own Your Actions

Winter’s stillness provides an excellent opportunity to reflect on the past year, assess your goals, and think about what you want to achieve moving forward. Use the quiet time to journal, meditate, or simply sit with your thoughts. Ask yourself important questions:

  • What worked for me last year, and what didn’t?
  • What am I grateful for, and what could I improve?
  • How do I want to show up in the world next year?

If you sit for a moment and really read these 3 questions, you might feel your mind open and expand. No matter where we are on your journey, we can all reflect on these 3 questions and answer them honestly. You gotta start somewhere, right?

2. Set Goals, but Be Real

Use the transition into the new year to set clear, realistic goals. Break them down into manageable steps and start working toward them slowly. Winter offers the space to focus on personal development without the distractions of warmer months. Whether it’s learning a new skill, starting a hobby, or making healthier choices, winter is a great time to build the foundation for growth.

3. Rest, Reflect and Grow

One of the most important aspects of growth is rest. Winter’s shorter days and longer nights provide an opportunity to slow down. Prioritize sleep and relaxation to replenish your energy. When you take time to rest, you’re better equipped to take on new challenges and grow in the future. This period of downtime will give you the energy and mental clarity needed to focus on personal transformation.

The quiet of winter is perfect for cultivating mindfulness. Regular meditation can help you become more aware of your thoughts and feelings, enabling you to let go of negativity and focus on positive growth. Practices like yoga or deep breathing can also be calming and grounding, helping you align with your intentions for self-improvement.

4. Out With the Old, in With the New

Winter is an excellent time to clear out physical and mental clutter. Tackle areas of your home that have accumulated things you no longer need or create a minimalist space where you can focus on what truly matters. Decluttering can bring a sense of mental clarity and peace, creating an environment that supports growth and intention. Winter can also be an ideal time to pick up new skills or deepen your knowledge in a certain area. Whether it’s learning a language, taking an online course, or engaging in creative activities like writing, drawing, painting, or crafting, just to name a few, the indoor nature of winter allows you to focus on personal development. Creativity can also help you work through complex emotions and tap into deeper layers of your personality.

5. Nourish Your Body, Mind and Spirit

Even though the weather may make outdoor activities more difficult, maintaining your physical health is still crucial. Winter is a great time to focus on nutrition, stay active indoors with exercises like yoga, stretching, or even indoor walking. Prioritize nourishing foods like seasonal vegetables, soups, and teas. A healthy body supports mental clarity and overall well-being. Inspiring your mind is important too, and there’s plenty of inspiration to be found in books, podcasts, or nature. Read books that challenge you or offer new perspectives or find motivational speakers who inspire change. Sometimes, a fresh idea or story can spark your own transformation.

6. Give Yourself Grace and Embrace Your Circle

Winter can be a tough time for some people, with the shorter days and colder weather sometimes causing feelings of sadness or isolation. Use this time to develop self-compassion. Acknowledge your feelings, practice kindness to yourself, and allow yourself to rest and heal when needed. Self-compassion helps you develop resilience and strength in facing life’s challenges. Winter can also be an ideal time to strengthen your connections with the loved ones that feed your soul and lift your spirit. Use the cozy indoor time to connect meaningfully with family and friends, fostering deeper bonds. Our social interactions can make all the difference when it comes to fostering growth and change. And remember, it’s about the quality of your relationships, not the quantity. 

By recognizing that winter’s qualities can be a catalyst for personal growth, you can use this season to deepen your self-awareness, focus on your health, and align your intentions with your life’s path. Through rest, reflection, learning, and nurturing your inner world, you can set the stage for a more fulfilling and successful future.

This article may resonate with you, or perhaps it might not, depending on where you’re on your journey. It’s ok either way, because the information is always here to help you, guide you, inspire you or motivate you. You can take what you need from this and put the rest in your toolbox for when you’re ready to dig it back out. Growth and change are deeply personal decisions; it’s up to you to choose when and how you’re ready to transform. But transforming is truly a gift because it allows you to shed old limitations and step into a version of yourself that’s more aligned with your true potential and way of being. Sending love and light to you all. Until next time…

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The Importance of Neuroaffirming Care in Mental Health and Substance Use Treatment: Dr. Sarah Anderson

In recent discussions surrounding mental health and substance use treatment, the concept of neuroaffirming care has emerged as an essential paradigm shift. A neuroaffirming approach not only emphasizes each person’s individuality but also recognizes and respects the diverse range of neurocognitive profiles within our world. In this article, I will look into why neuroaffirming care matters, share its key ideas, explore its background, and highlight how it’s vital in mental health and substance use treatment.

Understanding Neuroaffirming Care

Neuroaffirming care is a progressive model grounded in an understanding of the diverse ways individuals think, process information, and interact with the world. It recognizes that neurocognitive differences—such as those found in individuals with autism (ASD), ADHD, dyslexia, and other learning disabilities—are not deficits or disorders to be fixed, but rather distinct variations that enrich how individuals perceive and interact with the world around them.

This perspective sees neurodiversity as an integral part of humanity, encouraging a more inclusive approach in therapeutic settings. Unlike traditional care models, which often apply a one-size-fits-all framework, neuroaffirming care tailors interventions to meet the unique needs and preferences of each individual. Traditional approaches may standardize assessments and treatments, potentially overlooking the nuances of a person’s lived experience. In contrast, neuroaffirming care acknowledges that neurodivergent individuals may process sensory information, social cues, and cognitive tasks differently, requiring interventions that are flexible and adaptive. (Chapman & Botha, 2023)

Examples of Neuroaffirming Care:

1. Inclusive Practices: Tailoring treatment plans to align with the client’s cognitive style, preferences, and personal history.

Example: A therapist working with a neurodivergent client adapts a mindfulness exercise by allowing them to focus on a sensory object, such as holding a stress ball or rubbing a textured fabric, instead of expecting them to sit still with their eyes closed, which might feel overwhelming or inaccessible.

2. Respecting Autonomy: Allowing clients to make informed choices about their treatment and respecting those decisions, even when they differ from standardized protocols.

Example: A client with ADHD requests shorter therapy sessions to maintain focus. Rather than insisting on traditional 50-minute sessions, the therapist offers 25-minute sessions and gradually builds toward longer durations as the client feels ready.

Examples of Non-Neuroaffirming Care:

1. Rigid Protocols: Applying standardized treatment methods that do not consider a client’s neurodivergent traits, potentially leading to frustration and disengagement.

Example: Forcing a neurodivergent client to participate in a large group therapy session despite their expressed discomfort in group settings, leading them to withdraw or avoid further sessions.

2. Invalidating Experiences: Dismissing or questioning the lived experiences of neurodivergent individuals, failing to recognize and honor their reality.

Example: A therapist tells a client with sensory sensitivities that their discomfort with bright lights in the therapy room is “just in their head” instead of addressing the environmental trigger.

Statistics on Neurodivergence in Mental Health Treatment

Neurodivergent individuals often encounter significant barriers in accessing effective mental health and substance use treatment. Research indicates that approximately 73% to 81% of adults with autism have at least one co-occurring psychiatric disorder (Buck et al., 2014; Madhavan, & Sambamoorthi, 2016). Additionally, substance use disorder rates are disproportionately higher among neurodivergent individuals. Research indicates that about 50% of individuals with substance use disorders also have ADHD, and people diagnosed with ADHD are six times more likely to face challenges related to substance use (Davis et al., 2015). This statistic emphasizes the need for tailored interventions that specifically address these challenges and underscore the importance of implementing neuroaffirming care. 

While neuroaffirming care is gaining recognition, its adoption in mental health settings varies widely. Some progressive clinics and therapists are beginning to embrace neuroaffirming approaches, especially in environments that prioritize inclusivity and holistic care. However, many traditional mental health settings still rely on standard practices that may not adequately account for neurodiversity and its implications in treatment. Neuroaffirming care is more likely to be found in specialized settings, such as those focusing on developmental disorders, community mental health programs that emphasize inclusivity, and practices run by clinicians who are informed about neurodiversity principles. In contrast, more traditional settings may struggle to integrate these principles into their practices, resulting in ongoing gaps in care for neurodivergent individuals. This inconsistency in the availability of neuroaffirming care further emphasizes the need for systemic changes in mental health and substance use treatment approaches.

Historical Context of Neuroaffirming Care

The emergence of neuroaffirming care can be traced back to the neurodiversity movement, which gained momentum in the late 1990s and early 2000s (Chapman & Botha, 2023). Advocates began challenging the traditional medical model that treated neurological differences solely as deficits or disorders. Instead, they promoted the idea that neurodiversity is a natural variation of human cognition, deserving of respect and understanding. For instance, the neurodiversity movement challenged stereotypes surrounding autism, emphasizing the strengths and unique perspectives that autistic individuals bring to the table, such as innovative problem-solving and attention to detail. This paradigm shift inspired mental health professionals to rethink their approaches, focusing on affirming and accommodating differences rather than attempting to “fix” them.

Neuroaffirming Interventions in Mental Health

Neuroaffirming interventions in mental health can vary widely but generally aim to create a supportive environment that is responsive to the specific cognitive and emotional needs of neurodivergent individuals.

1. Cognitive Behavioral Therapy (CBT) Adaptations

Traditional CBT can be adjusted to incorporate the client’s unique thought processes and emotional responses, making it relevant to their experiences.

Example: A neurodivergent client with autism might struggle with abstract concepts like “challenging negative thoughts.” The therapist adapts CBT by using concrete, visual tools, such as a thought diary with emojis or a color-coded chart, to help the client identify and manage their emotions in a structured way.

In contrast, a non-neuroaffirming approach might involve using overly abstract CBT techniques that leave the client feeling confused and unsupported, causing disengagement.

2. Mindfulness Practices

Mindfulness can be tailored to fit different sensory preferences, allowing clients to engage in exercises in ways that feel comfortable.

Example: A client with sensory sensitivities may find traditional deep-breathing exercises difficult due to the focus on internal bodily sensations. Instead, the therapist encourages them to practice mindfulness by listening to calming music or focusing on a weighted blanket’s pressure.

Non-neuroaffirming practices might force clients to adhere to rigid mindfulness techniques that increase their anxiety, such as insisting on silent meditation in a setting that feels overstimulating.

3. Strength-Based Approaches

Focusing on the individual’s strengths rather than their challenges fosters a sense of empowerment and self-efficacy.

Example: A therapist working with a neurodivergent teenager emphasizes their talent for drawing as a tool for emotional expression and problem-solving, integrating art therapy into their sessions.

Conversely, non-neuroaffirming practices might focus solely on deficits, such as repeatedly pointing out the client’s difficulties with time management, without offering constructive solutions.

Neuroaffirming Care in Substance Use Treatment

Substance use treatment, much like mental health treatment, benefits immensely from a neuroaffirming approach. Individuals with neurodivergent traits may face unique challenges in recovery, including heightened sensitivity to triggers, social cues, and emotional stimuli.

1. Individualized Treatment Plans

Tailoring recovery programs to the cognitive and emotional profile of clients enhances engagement and success rates.

Example: A client with ADHD might struggle with rigid schedules in traditional 12-step programs. A neuroaffirming approach would offer flexible scheduling options or introduce apps for task management to support the client’s executive functioning challenges.

2. Peer Support Alternatives

Creating support networks that resonate with neurodivergent individuals allows them to share their experiences in a safe space.

Example: A recovery program sets up a small, sensory-friendly peer support group for neurodivergent clients, ensuring the environment is free of harsh lighting and loud noises to accommodate sensory sensitivities.

Non-neuroaffirming practices might involve placing neurodivergent clients in large, overstimulating group settings without addressing their needs, potentially driving them away from recovery efforts.

Providing Neuroaffirming Care as a Mental Health Occupational Therapist

As a mental health occupational therapist, I prioritize neuroaffirming care in my practice by actively incorporating the principles of this approach into my therapeutic relationships. This commitment not only fosters a sense of safety and respect but also empowers clients to take an active role in their healing journey.

1. Personalized Assessments:

   In my practice, I conduct thorough and personalized assessments that go beyond standardized tools. For example, I might observe a client’s sensory responses in various environments, such as noting whether fluorescent lighting in the office causes discomfort. These observations inform the design of therapy sessions and treatment goals. Additionally, I encourage clients to share their preferences and experiences, allowing for a more nuanced understanding of their unique needs and challenges.

2. Flexible Therapy Sessions:

   Recognizing that each client has different sensory sensitivities and processing styles, I ensure that my therapy sessions are flexible. For a client with sensory sensitivities, I might introduce noise-canceling headphones or provide breaks during sessions to prevent overstimulation. This adaptability allows clients to engage more comfortably and effectively in their therapy, promoting a collaborative and supportive atmosphere.

3. Collaborative Goal Setting:

   Collaboration is at the heart of my practice. When a client expresses frustration with meeting deadlines, for instance, we work together to create achievable and meaningful goals. By implementing strategies like time-blocking, the client feels ownership and agency in their progress. I emphasize that all goals are client-driven; I will never set goals that clients do not choose for themselves. This process not only fosters a sense of empowerment but also enhances motivation and commitment to the therapeutic process.

4. Creating Safe Spaces:

   A significant aspect of neuroaffirming care involves creating safe and comfortable environments. I maintain a quiet, visually calming therapy room with sensory tools like weighted blankets, fidget toys, and dimmable lights. Clients are encouraged to customize their space and choose the tools that make them feel secure and comfortable. This environment reflects a respect for their individual needs and enhances their ability to focus and engage.

5. Ongoing Feedback:

   I prioritize ongoing feedback throughout our therapeutic relationship. Regularly asking clients how they feel about the therapy process and the strategies we employ allows me to adjust approaches as needed. For example, if a client feels overwhelmed by a particular technique, we can quickly shift to a different method that aligns better with their preferences. This responsiveness is a core component of neuroaffirming care, ensuring that each client feels heard and validated.

Conclusion

Neuroaffirming care represents a critical advancement in mental health and substance use treatment paradigms, offering a more personalized and respectful approach to care that takes into account the diverse neurocognitive profiles of individuals. Specific, practical interventions—such as adapting CBT, tailoring mindfulness, and creating sensory-friendly environments—illustrate how this approach can transform the therapeutic experience for neurodivergent individuals.

With increasing awareness and acknowledgment of neurodiversity, the mental health field must continue to evolve by embracing neuroaffirming principles. In doing so, we can enhance access to treatment and support for neurodivergent individuals, ultimately contributing to their overall wellbeing and quality of life.

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How to Meditate: Billy Wynne

In this article, I will provide core methods for practicing mindfulness meditation. In the first post of this series, I described the substantial evidence supporting the benefits of this tradition. In the second, I explored the definition of mindfulness meditation: the practice of paying attention to the present moment without judgement. Now, it is time to get started meditating. Here’s how you do it.

Body Posture: Upright and Relaxed

The first step in establishing an appropriate posture for meditation is to anchor yourself on three points. If you are meditating on a cushion on the floor, those three points are your knees and your tailbone. If you’re in a chair, it’s your tailbone and your feet. In either case, this tripod orientation is essential to achieving the stability of your body that will support the stability of your mind. 

The most common positions for floor meditation are one of the lotus variations, the Burmese style, or the seiza posture. The quarter lotus, typical for most American meditators (including the author), involves placing one foot on top of the calf of the opposite leg and tucking the other foot underneath the opposite knee. The half lotus entails placing that first foot on top of the opposing thigh, with the opposite foot still tucked under your knee, and the full lotus is putting both feet up on the opposite thighs. If you find the lotus posture unsuitable, I encourage you to explore the other postures mentioned above or to simply sit in a firm chair. 

Despite the assumption that it is a common meditation posture, the ”criss-cross applesauce” style we learned in pre-school is not optimal for this practice. It leaves the knees “floating” up in the air and it requires a tremendous amount of core strength to keep the torso upright when seated this way. 

However you decide to sit, the most important thing is to maintain an upright posture with a straight back. To accomplish this, you might tilt your hips forward so that your lower back curves naturally inward. If you are meditating on the floor, use a meditation cushion so that your hips are raised above your knees. Other types of pillows or even folded towels can also work fine. Then, elongate your spine up through your neck and head. I find it helpful to imagine there is a small hook on the crown of my head with a string tied to it that someone is gently tugging upward. 

As for the rest of your body: relax. Another helpful visualization I often use is to imagine my spine is a coat rack, directly upright, and the rest of my body is a long coat hanging effortlessly from the rack. As you settle into your meditation posture, scan your body for areas of tightness that you might relax by breathing in your awareness of that spot and breathing out whatever tension may be there. 

With most of your body nestled into place, you can allow your hands to rest comfortably in your lap. There are a variety of ways to position your hands. The simplest and most relaxed may be to put your dominant hand on the bottom, palm up, with the other hand placed gently on top, also palm up, with the middle knuckles approximately aligned. You can allow your thumbs to rest naturally or take up the “cosmic mudra” by letting the ends of the thumbs touch each other gently. 

While some meditation traditions call for placing the hands, upturned, on top of the knees, with the thumbs touching the tips of the middle fingers, maintaining that posture for an extended period of time can place unnecessary tension on the hands, arms, and upper back. In the long run, the posture that is most comfortable and relaxed will likely best serve your meditation practice. 

Finally, we get to your noggin and all of its wonderful components. Recalling that little hook, it’s important to keep the head up rather than letting it slouch forward, back, or to the side. Your mouth should be closed with your breath flowing in and out of your nose naturally. Many meditators find it helpful to let the tip of the tongue rest against the back of the top front teeth. (This may seem specific, but I promise the question will come up if you meditate for a while!) Your eyes can be open or closed; there are strong traditions of both. Either way, you want to let your eyes be soft, not focused on any particular thing. Similarly, let your ears be soft. Sounds may arise, but you don’t need to go out and grab them.

Ok, you are all set. Now we get to the trickier part… 

Mind Posture: Attentive and At Ease

Of all of the beautiful pictures you’ve seen of people meditating on hillsides with the sunset behind them, all of that external setting and the posturing of your body only serves one purpose: focusing and easing your mind. Once you have settled into your posture and allowed your breath to begin flowing naturally, it is time to turn your attention to this fascinating place.

As I stated plainly in my prior post, please forget about the idea that meditation is about stopping your thoughts. That would be like trying to stop your heart from beating or your gums from salivating. Secreting thoughts is what the mind does. There is nothing wrong with that. Meditation helps us learn to be with our thoughts in a different way. I will come back to mindfulness of thoughts practice, specifically, in a future post. 

The primary method of mindfulness meditation and numerous other meditation practices is to simply focus your mind’s attention on the sensation of your breath. Again, without feeling the need to alter the pace or depth of your breath, locate the part of your body where you feel your breath most prominently. That might be the tip of your nose, the nasal cavity or inside the mouth, or in the chest or belly. Wherever it is, try to maintain your attention on that place and gently experience the rhythm of your breath’s movement there. With time, you might begin to notice the unique sensations of the in and out breath, as well as the moments when the breath pauses between the two. 

As you can see, this is a simple practice, but it is not easy. Very quickly, your mind will start to wander off into thoughts of what you might have for your next meal, an email you need to answer, or a dream vacation you want to plan. All of this is completely natural and will be a part of your meditation practice forever. Please don’t worry about it. 

To support maintaining your focus on the sensation of the breath, it is recommended to count your breath to yourself. There are some variations on exactly how to do this and you are invited to explore the approach that works best for you. A common technique is to simply treat each full breath (both the in and the out) as one count. Many find it easiest to “mentally verbalize” the number during the full length of the outbreath. In other words, I breathe in all the way and then, in my mind, it’s “oooooone” as I breathe out. Then I breathe in again and, as I start to exhale, it’s “twwwwwwwwwwwo.” And so on. 

If you make it to ten without wandering off into paragraphs of thought, which is rare for beginners, then you can begin again at one. While this device can be very handy in maintaining your focus, it’s just as important to remember that this is not a “test” or, worse, a “contest.” There are no bonus points for making it to ten and that is not the goal. The goal is to give this one breath, the one that is here with you right now, your full attention. The rest – your expectations and doubts, critiques and comparisons – you can set aside for now. Let’s treat our meditation practice as the one sanctuary in our life that might be free from all of our incessant judgment.

The Golden Rule of Gratitude

Building on that last point, I find that the most important ingredient that enables people to maintain a consistent meditation practice is not having a flexible body or highly concentrated mind. It is not fierce dedication to discover “enlightenment” or drill sergeant-like discipline. 

The essential ingredient to maintaining a consistent meditation practice is the decision to simply enjoy the experience of meditating. Here you are, on your mat or chair. You’ve made a good decision to be there, and you’ve carved out some time in your busy life to take good care of yourself. It’s a unique and rare opportunity and, if you just simply let it, it will be relaxing. Pretty soon, you will start to experience your body and mind in a different way, even if for just a passing moment at first. 

So let’s be grateful. This practice is a gift. Our life is a gift. What a joy to simply be here with it intimately for a moment. 

Next Steps

Having examined the Why, What, and How of mindfulness meditation, next we will turn to the very practical considerations of When, Where, and Who (spoiler alert: it’s you). Please tune in next time for tips for integrating this healing practice into your busy daily life.  

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Logged Out: Reclaiming Your Mind from Digital Burnout: Jennifer Chicoine, M.A., LCPC   

What Is Digital Burnout? 

In a world filled with electronics and advanced technology, humans are inevitably drawn to  using their phones and tablets for almost everything they can think of. The reality is alarming if  you think about how often humans use technology. 

Let’s set the scene: You wake up and scroll  through your phone for 30 minutes before getting out of bed. You take time to prepare for the  workday and turn your morning playlist on. As you eat breakfast, you scroll through the news  on your phone. As you drive to work, you connect your phone to your vehicle to listen to  music, listen to a podcast, or call a friend. When you get to work, you automatically log into  and operate a computer for at least 4 hours. You then take your lunch and scroll through your  phone to catch up on social media, answering emails, texts, and phone calls. You’re back to  work, and you log back into your computer. You log off for the day, and then you drive home  while listening to the same music or podcast, or talking on the phone again. When you get  home, you take a break to eat dinner and get things ready for the next day. You then go to bed  and scroll through your phone for 30 minutes to an hour before bed.  

Let’s face it, except for some moments throughout the day, we are constantly operating an electronic device. 

So what exactly is digital burnout? As the name suggests, digital burnout is a phenomenon we  can feel from utilizing electronics too often. Thinking of the timeline of a typical day (described  above), the actions explained can quickly evolve into a behavioral habit, which can then  develop into an obsession with checking emails, notifications, texts, and calls. When operating  at this fast, never-ending pace for extended periods, it is no wonder why we feel defeated and  then think, “What’s the point of doing any of this?” This thought is evident that burnout is  settling in. 

The Harmful Effects of Mindless Scrolling 

Although we may be “mindlessly” scrolling through our phones and tablets as a way to  decompress from a busy day, our minds continue to process all the information that we are  consuming. That information, especially negative information, then rests in our short-term  memory for us to process in our dreams, while in the shower, while driving, or while we lay in  bed. 

When we are constantly filling our free time with electronics usage, which in turn contributes to our incessant need to compare ourselves to others and what we don’t have, we are not allowing our brains to relax and rest from negative thoughts. If humans spend  excessive amounts of time processing negative thoughts, one can inevitably experience social  anxiety, depressed mood, and potentially even suicidal thoughts. 

Setting Mental Boundaries Within Oneself for Electronics Usage 

To truly understand how to accomplish this task of setting boundaries within ourselves, we  must first discuss what boundaries are. Simply put, boundaries are one’s limits. That is, what  one is willing to allow and what one is not willing to allow. Setting boundaries with others  involves telling them if we do not like something. If we set a boundary within ourselves, that  would include telling ourselves what we are uncomfortable with and will no longer allow. 

So, let’s break down how one can set an emotional boundary within oneself regarding  electronic usage: 

STEP 1: Get out a piece of paper and jot down the answer to the following questions: 

• How much time do I spend on my phone each day? Although some of our phones are able  to automatically calculate this, try imagining your day today and complete a mental scan. 

• How often were you on your phone?  

• During breaks or downtime at work?  

• When you first wake up?  

• In the shower? 

• During times you could have been spending with your spouse or children? 

• How does the content I view contribute to negative thinking? For example, how much time do you spend scrolling and proceed to do the following: 

• Compare yourself to others. 

• Wish you had someone else’s life. 

• Look at items you don’t have or cannot afford. 

• How often do I want to spend on electronics each day? If you are unsure, try to only use  your electronic devices when you specifically need it for something rather than just  mindlessly scrolling through it. Ideally, you will cut your current scrolling time in half (or more).  

• Are there times of the day that you specifically want to prohibit yourself from using your phone? i.e., during dinner time, before bed, at lunch 

STEP 2: Once you’ve answered these questions, I want you to then write down this statement  and then say it out loud three times: 

“I honor my boundaries when scrolling on my phone. By honoring my boundaries, I am using my phone responsibly.” 

STEP 3: Make a promise to yourself that you will honor your boundaries each time you decide  you scroll through your phone. Then make sure you follow your boundaries! This can be the  hardest step, but it is also the most important step. If you think about it, no one will respect  your boundaries if you don’t model that behavior first, so make sure you are working at this  every single day. 

The Benefits of Engaging in Mindful, Conscious Activity

Once we accomplish the task of setting boundaries within ourselves, the next step is to replace  this behavior with mindful activity. You may be thinking, “What does that even mean?” Let me  explain.  

Mindful activity means that you are fully participating in the activity you are doing. For example,  while coloring, you are focusing on all of the sensations you may experience during this task.  You may feel excitement like a child does, and that feels good to you. You may feel relaxed  from simply coloring a picture. You may engage in some laughs, and that brings you joy. Being  present means you do not have your phone next to you on standby in case you get bored. You  are keeping all of your energy on coloring and how it makes you feel.  

When we engage in mindful activity, we are connecting to the world around us, and that simple  act of conscious activity can reduce the risk of depression (or disconnecting from your life). You  are also physically slowing down your pace, and by doing so, you are allowing your mind and  body to relax and refocus. Why would that be important? If we spend all our time in a fast paced lifestyle, our bodies never get a chance to truly relax (keep in mind that our bodies and  minds are very active while sleeping, so this cannot be a time we rely on to relax our bodies). If  our body never relaxes, then we may experience gastrointestinal issues, migraines or tension  headaches, back pain, or irritability.  

Wrapping Up: Your Mind Deserves a Digital Detox  

Even though there are so many reasons to use electronics in today’s world, it is so important  that every single human being disciplines themselves enough to not rely so heavily on their  electronics. As we’ve learned, it can be harmful to our minds and our bodies. By learning to  engage in more mindful activities, you may notice great changes in your life.