Fresh.

2017. A fresh start. A clean slate. Cough Cough, insert inspiring Pinterest quote here.

All jokes aside, I put this blog on the back burner as I transitioned to a new career and it feels like time to begin again. My creative mind was itching for an outlet and I have missed the meditative feeling of pen to paper. Rather…fingers to keyboard.

Speaking of meditation, I want to share a quick update with you all. I transitioned from a nurse to nurse practitioner three months ago and it has been a trying experience. I am experiencing the “from novice to expert” phenomenon and it is exhausting. Exhaustingly beautiful, but exhausting nonetheless. These past three months have left me feeling vulnerable, strong, proud, embarrassed and everything in between. However, personal growth is an intimate evolution of the self and I have been leaning on meditation to cushion the path.

Mediation makes me feel powerfully calm. It also makes me feel incredibly humbled by my brain’s ability to juggle 80,000 thoughts a day (real number…it’s worth a google). It gives me the awareness to recognize my chaotic mind, say hello, and continue about my day. If you have been following my blog, you know that an anxious mind is my natural default setting. I use meditation, not to “fix” my brain, but to acknowledge and support my mental journey.

Insight Timer is an iPhone App that offers thousands of FREE guided mediations. I am currently participating in a 365 day challenge with a million of my closest friends! The app allows people from all over the world to come together (in a virtual sense) and unite with a common goal: mindfulness. Each day, I sit on my yoga mat and meditate. It might be for 3 minutes or for 40 minutes. There is no right way to meditate. The only “right” thing is to show up for yourself and give yourself the peace of mind you deserve. Meditation can be finding awareness in the breath and enjoying 3 deep inhale/exhales.

I challenge you to begin with just 3 deep breaths in the morning at the edge of the bed. How did it change the way you greet the day? Did you feel more grounded and controlled?

Meditation is not a solution for everyone. Just the thought of sitting down with your thoughts for 30 seconds scares people. If you feel that way, then you really should embrace meditation! 🙂 For some, all of this sounds like complete bull. I sound like a liberal millennial who should lay off the incense. And…that is ok. This has worked for me, but it does not work for everyone. My hope is that one person who is struggling with an anxious mind will find this article and give this strategy a try.

It feels good to be back. I want to share my light with the world and this currently feels like the platform…so…stay tuned!

Love and Light.

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Whirling dervish.

I can tell how well I am controlling my stress based on the organization of my home. My room is often a sneak peak into the stability of my anxiety. When I’m pushing myself too hard, our house looks like a tornado tore through. Drawers are open, clothes are on the floor, and the fridge is left ajar. In a sweeping mania, my house begins to unravel. Typically, this phase only lasts a few hours until I sense the unease in my psyche. My fiance has even picked up on the pattern. He can sense the correlation between stress and home destruction and often steps in to intervene.

Our bodies often give us signs to remind us to slow down. A cold might sneak up on you after two difficult months at the office. A heavy fatigue might drip down from your shoulders during a break from school. Eventually, our body warns us that it is time for a break and a mental reprieve. My body slips into a whirling dervish mania that is in constant “GO” mode until I look up and realize I’ve been studying for 14 hours without a break. I attribute this high intensity to my success, but also my stress. The biggest thing I have learned in this past year of healing is to listen to my body’s warning signs.

How I know it is time to take a mental health day:

  • The house is imploding and messy beyond belief
  • My body aches and I don’t feel rested after a decent sleep
  • Somatic issues: nausea or headaches
  • My natural friendliness is replaced with irritability

I have learned to listen to my body in addition to my spirit. When I feel stretched too thin, I take the time to pause, breathe, and regroup. I am still new to this concept, but I know it has helped me juggle the chaos of the past two years. Listen to the messages from within and be gentle with your soul.

My strategies to combat feelings of overwhelming stress:

  • Stop, drop, and yoga
    • I have been known to do yoga in the middle of the nurse’s station to channel my energy in the middle of chaos
  • 3 deep and slow belly breaths
  • Gratitude journel
    • Write down three things you are thankful for each day and feel the shift in your perspective
  • Mantra
    • Pick a few phrases to carry in your heart when those negative thoughts decide to interrupt your flow

This entry was selfishly more for me than you. When I can sit down and think about verbalizing the importance of slowing down, it reminds me of the gift of self-care. Lately, I have been feeling like my coping strategies are not as effective against the stress of life. In the next 6 weeks, I am graduating with my Masters, taking a national board exam, getting married, and changing jobs. I will allow myself to feel the energy of change and remain grounded in my mental strength.Sometimes, being the whirling dervish can be a glorious and exhilarating experience. This will be a great challenge to engage everything I have learned over the past few years. I believe it will be a beautiful journey.

Love and Light

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Spending a lot of time on the mat these days.

“Crazy” is in this year.

Over the past 80 years, there has been a constant rise in the prevalence of anxiety and depression and no one really knows what is causing it. Let that permeate your mind and sink in. This year, I have treated about 1,000 patients in primary care/urgent care settings and 30% of them have a history of anxiety or depression. That data is staggering. My school requires me to input data into a server that organizes information for us to see trends and learn about common themes in healthcare. When I adjusted the settings to display the ratio of patients:mental health issues, I felt a surge of intense questioning. The Association of Anxiety and Depression claims that the prevalence of these disorders is significantly lower. Why?

Perhaps people who are feeling depressed or anxious are more likely to seek medical care, thus skewing the data? Regardless, why are we seeing this dramatic increase and why is this not considered a massive public health crisis? Most of my adult life has been dedicated to questioning things and annoying most of the people around me with my theories…BUT THIS IS A BIG DEAL, Y’ALL.

My database has tangible evidence that suggests about 1/3 people deal with anxiety/depression. I believe that number is even higher because of the lack of accurate reporting. A lot of people do not have the self-awareness to even recognize something is off with the mind and psyche, so who is to say 1/2 of people are actually on this mental health train?

I want to play a guessing game with you. Think back to the last time you saw a medical provider. Perhaps it was your annual physical or an episodic meeting. Did your provider ask you about your mood/stress/energy? As a future provider, I recognize that time is of the essence and you can not perform a full blown psychoanalysis on every patient. With that being said, I value the importance of a handful of screening questions. I try to ask my patients, “how is your energy level during the day/how are you handling your stress/what do you do to for self-care?” It takes about 2-3 minutes and opens the door for a emotional connection.

 

When time permits, I love to teach patients about stress management through alternative methods: belly breathing, guided meditation, and yoga. All this is hunky dory, but back to the point…

What is causing the constant rise in anxiety and depression?

Unsolicited advice/theories I developed that probably hold 7% scientific value:

  • technology
    • after a weekend in the woods, my mind and body are in such a calm state. Being off the grid and “disconnected” is therapeutic for my adrenal glands and neurotransmitters
    • social media (I REALLY spend too much time on that crap) is a forum for “look how amazing I am” and drives feelings of inadequacy
  • food
    • our culture sucks at eating, let’s be honest
    • the era of processed food, sugar, add added hormones is essentially destroying our brain’s ability to regulate emotion and stress hormones…no big deal
    • hypoglycemia can mimic feelings of anxiety and that tends to be an issue when we eat such a high sugar diet–leading to fast metabolism of food and a massive blood sugar crash (you should probably apologize to your pancreas)
  • birth control
    • who doesn’t love good old oral contraceptives…ok, ok, too far, I get it.
    • the estrogen component in most OCP is detrimental to the mind
    • my anxiety was drastically reduced when I changed to a very LOW dose of estrogen
    • all the smart brain docs tell me that estrogen negatively impacts serotonin and norepinephrine
  • lack of community
    • although we are the most “social” generation via social media, we are actually the loneliest
    • in the 1930s-1950s, farming was a critical aspect of society and most people lived on land with many family members and spent very little time alone
    • some people believe that a large social circle will buffer the impact of anxiety/depression, thus serving as protective
    • when is the last time you drove to someone’s house to talk to them instead of text them? Exactly.

My commitment to the medical community is to discover trends and determine how I can make a tiny positive impact in the world. Maybe that is through developing more screening guidelines or writing a self-care novela as a free gift with purchase. “Thanks for getting a Pap today, enjoy your free guide on how to take care of your mind and body.” All jokes aside, I have a lot of questions and a lot of energy to figure them out (thanks to the shit ton of green tea I guzzle). I want to solve this dilemma and save the world. All in a day’s work.

Why do you think we are seeing the consistent rise in anxiety and depression? Comment below!

Love and Light.

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Sources: (http://nymag.com/scienceofus/2016/03/for-80-years-young-americans-have-been-getting-more-anxious-and-depressed.html)

Anticipatory anxiety.

Why does the unknown scare us? Why does the future cause us unrest? Why do we use anxiety as a mental placeholder while we wait for something to happen?

Well, the answer is simple: anticipatory anxiety.

Humans like control. We like to know what is happening, who is doing it, what it will feel like, and when it is supposed to happen. I am speaking for the vast majority of people. I will exclude the true wanderlust hippies who live blissfully in the NOW. Hopefully, the rest of us lay people can join you one day.

Scene: You have a presentation for work at 4:00pm. You wake up that morning, feeling a blend of nausea and excitement. You can’t focus at work and you feel like your brain has taken residence in a cloud high above the office. You might feel foggy, unfocused, on edge. Your brain recognizes the importance of the presentation and (rather unfortunately) decides it is a really BIG SCARY TERRIFYING THING. That is the deal with an anxious brain. It is overstimulated and angry with adrenaline. You might feel your heart rate increase, another sign that the sympathetic nervous system is pre-gaming this event. Why do the hours leading up to something stressful also have to be stressful? Hey Universe, that is not fair.

So, how do you challenge the anticipatory anxiety. I will let you in on a secret. The event is never as scary as you pictured it. You didn’t barf, pass out, or cry. Or maybe you did…but most people are genuine humans and would be empathetic to your struggle. It is never that bad, that scary, that daunting. Your mind and your adrenal glands have been primed to give exaggerated reactions to stress. Let’s talk about how to calm that response system down in the hours leading up to a stressful event.

  • Be mindful of the present
    • focus on what you are doing right now
    • what do you smell, hear, taste, feel, see?
  • Challenge the catastrophic thoughts
    • what is the worst thing that could happen? (thanks to my mom for instilling that great trick, love you!)
  • Make a positive thought for every negative thought?
    • “Ugh, why am I so anxious right now?!”
    • Counter with “I can harness this feeling to give a creative, energetic presentation”
  • Breathe
    • utilize Pranayama breathing techniques to engage that lovely parasympathetic nervous system and slow the mind/body down

Anxiety blows. Why wait precious hours getting anxious about possibly being anxious?  It is a cyclic thought nightmare. Just say stop. Literally, yell the word stop. Embrace the present moment, focus on your breathe, and save your beautiful brain power for something more productive.

I challenge you to try some of these techniques the next time you find yourself ruminating before a stressful event. Your life is beautiful and worthy. You don’t deserve to waste time with worry.

Love and Light.

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Slowing down before a presentation with a 5 minute meditation and some Doterra aromatherapy.

Do hard things.

If you let fear guide you, your world will become very small. Anxiety makes us seek constant control. Anxiety intensifies fear. Anxiety changes your perception of your abilities. However, you are not limited to these feelings. If you push yourself and do hard things, you will overcome anxiety.

When I feel anxious, my sympathetic nervous system says, “get the eff out of here! RED ALERT! BING BING BING RUN AWAY.” You get the point. So how do you challenge those thoughts? You do the hard thing. You take on the challenge. You stay in that fear. You do not retreat. You ride the wave of panic.

My day started off well. I had a nice breakfast, worked out, and went to a local trail to hike. Hiking by myself has always been a trigger. When I know I am alone and far from my car, the anxious thoughts drift into my head.

What if I panic and I’m all alone in the woods? What if I get hurt and no one can come help me?

I challenge those thoughts and stop the pervasive thought cycle. I logically analyze the statement. If I panic, then I panic. It won’t kill me. It just sucks for a few minutes. If I get hurt, I still have cell service to call for help. I’m a seasoned nurse, I can take care of most things that could happen to me.

I try to participate in something anxiety-provoking every week. It helps me work on coping and getting back into the adventurous side of life. Today, I did just that.

There is a long, skinny wall that juts out into the river next to the trail. It is about 6 inches wide and leads to a waterfall. I don’t particularly have a fear of heights, but this wall is thin and goes across a freezing river. The thoughts started…”what if I fall? what if I walk out then can’t walk back? what if…what if…what if…” So, I took a few shaky steps out on the ledge. I could taste the metallic adrenaline in my mouth. I stopped, mouthed a few “mother f*ckers” and promptly walked back to the ground. My fear won. I started walking back towards the parking lot.

A wave of disappointment washed over me. Am I really going to let my actions be dictated by fear? Nope. I turned around, hopped on the ledge, and walked all the way across. I sat down on the wall and meditated. I won. I channelled the fear and converted it into energy to finish the task. My fiance (Iraqi War Vet) always tells me “just finish the drill.” I finished it and it felt pretty damn good.

Challenge yourself to do hard things. It will help you grow emotionally, physically, and spiritually. How can you incorporate challenges into your life? How can you grow from fear?

 

Love and light

Pranayama.

This sounds like a fancy drink that you would get at the local gastro pub. I’ll have a pranayama and the cheese plate. Moving on..

Pranayama is the foundation of yoga breathing. 

It goes all the way back to the beginning of yoga. Many, many, many moons ago. The concept is simple: use certain techniques to enhance your breathing ability. There are various styles of pranayama, but my favorite is the Nadhi Sodhana. That’s a fancy Sanskrit word for “alternate nostril breathing.” Check out this video from my favorite yogi:

As someone who has journeyed with anxiety for many years, the ability to calm my nervous system feels tremendously empowering. If I feel like I am on the verge of panic, I utilize this technique to kick in that lovely parasympathetic nervous system. By slowing the breath, you eliminate the hyperventilation that is often associated with panic. This technique also uses a mudra to aid in the calming. What’s a mudra? Picture it as art through the use of your hand. You use different hand positions to encourage positivity and changes in energy. Think about all of the hand symbols we use in everyday life: thumbs up, peace sign, flipping the bird. Each movement conveys a non-verbal gesture. A mudra is used in the same way. By positioning your hand in a certain way, you are non-verbally sending a message to yourself. OK THIS IS STARTED TO SOUND REAL HOKEY, SARA. Ok, fine..moving on.

To begin the alternate nostril breathing exercise, take your dominate hand and fold down the pointer and middle finger. It should look something like this:

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Place your thumb over your right nostril (or left if you’re all weird and left handed) and block the passage of air. Inhale deeply through your left nostril.

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I know this looks slightly odd, but I’ll take looking odd over anxiety any day of the week, my friend!

Hold your breath for a slight, sweet, delicious moment. Use your ring finger to cover your left nostril. Exhale through your right nostril.

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Inhale through your right nostril.

 

Hold your breath and release air through your left nostril.

 

Repeat as many times as needed to feel calm and grounded. Don’t get crazy and pass out or anything because I don’t have time to squeeze a lawsuit into my daily activities. Enjoy this time. Find the space between the breath and get to know yourself. Spend time in the quiet space.

 

Love and light.

 

 

 

Googlephobia.

I am the queen of Google.

I have removed the Google app from my phone because I morphed into the Dictator of Google.

I feel anxious, therefore I must Google the shit out of these feelings.

Scenario:

I was sitting on a beach with Kemp last summer. We were paddle boarding, drinking cheap beer, and having a blissful time. I left anxiety at home for the day…or so I thought. All of a sudden, I got a cramp in my right calf. The logical side of my brain should have processed the fact we went running earlier and I was probably dehydrated. But the logical side of my brain is boring so clearly I spiraled down the black hole of catastrophic thinking. I immediately took out my phone and started googling “cramp in calf.” Guess what came up? Something along the line of blood clot, cancer, imminent death, etc. Let me casually reiterate something. At this point, I had been a nurse for a few years and had 4 years of medical courses. My logical brain knew that these google revelations were wildly inaccurate. My panic, freak the fuck out, brain had other plans. Five minutes had passed and I was attempting to convince Kemp to chug his beer and take me to the SeaCoast Medical Building. He looked at me, smiled, took my hand and led me into the water. And that was that. I bounced up and out of the dreaded Google hole.

End scene.

I write this in jest, but I imagine a lot of you have been there. The anxious thoughts arise and we seek validation from an external source. My logical brain knew I did not have a blood clot, but my panic brain thought that was reasonable and wanted support by googling ridiculous things on the internet. I also have googled “anxiety quiz” numerous times to simply confirm that I am not losing it. My results always indicate mild-moderate anxiety and that gives me a few minutes of relief, knowing I must be ok compared to others. Why can’t I just process these thoughts without external validation?

We all need someone to look at us and say, “you are calm, you are fine, you are doing well.” I often use Google as that voice, because I’m too broke for therapy every week. Cheers!

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Status post the blood clot meltdown of 2014. Yes, I do have full formed legs. I have not mastered the art of the standing ocean paddle board experience. I can’t help but laugh at that one 🙂