3 Common Anxiety Traps and How to Avoid Them

If you’re an anxious person, you’ve probably been told your whole life not to worry so much—to “stop overthinking things” and “just relax.” By now, you’ve perhaps given up on trying to feel better and resigned yourself to the idea that there’s just something wrong with you.

But that’s not true, says Alice Boyes, PhD, author of the The Anxiety Toolkit ($16, amazon.com). “It’s good that we have some people in our tribe who are bold and some who are cautious—that creates a normal [bell] curve, with different types of people on either end,” Boyes explained in an interview with Health.

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As she argues in her new book, “the problem is when anxiety gets to the point that it’s paralyzing. I think of these bottlenecks as anxiety traps.”

Boyes describes the process of climbing out of these traps as “fine-tuning” your mind. “You’re learning how to work with your own hardware and software in the most effective way,” she says.

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Here, she offers advice on how to escape from three of the most common traps.

You hesitate to act until you’re 100% ready

A large part of anxiety is having an “intolerance of uncertainty,” says Boyes. It involves a fear of failure, and can keep you mired in contemplation mode. You may have a tendency to consider many ideas without ever trying any of them. Or you may find yourself perpetually stuck in the research phase of projects.

Free yourself: “Anxiety-prone people tend to focus on the worst possible outcomes,” so they  worry too much about the risk to take action, explains Boyes. But the truth is, there’s usually a spectrum of possibilities: “When I worked as a therapist, I used to tell my clients to identify the worst thing that could happen, the best thing, and the most realistic thing. And to do it in that order.” The idea is to help yourself acknowledge the opportunities that exist along with the risks, so you feel safer when making a move.

Another trick is to make a plan for how you’d cope if the worst-case scenario came true. “Worriers are always thinking, What if? But they never actually answer that question.” Rather than constantly trying to avoid the negative outcomes, make an action plan. This can boost your perception of yourself as someone who can handle adversity when it strikes, which can be calming.

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You obsess about mistakes

Over-thinking past missteps—meaning you’re replaying them again and again in your mind—is called ruminating, and it can leave you tangled up in knots.

Free yourself: “Sometimes a good way to escape the cycle is to come up with concrete steps for moving forward,” Boyes says. She suggests you start by jotting down three possible actions you can take now. For example, if you’ve recently hired a new employee who isn’t working out, rather than beat yourself up over missing holes in his resume or other signs, define your options: 1) You could give him less responsibility 2) Provide more guidance 3) Fire him.

“Making the list shifts your mind into a more productive mode,” Boyes explains.

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You dread criticism

Anxious people often go out of their way to avoid feedback because they already judge themselves harshly, and criticism from the outside is especially upsetting. “Plus, you may know that you’ll be replaying the critique in your mind for days and weeks to come, and that makes it even harder,” Boyes adds.

Free yourself: Try acting relaxed when you get a review. Even though you may feel crushed or defensive, send physical signals that you’re appreciative, Boyes suggests. Drop your shoulders. Lift your head. Relax your hands. This isn’t just an act: “Your feelings and thoughts will quickly catch up with your nonverbal cues.”

It may help to have some canned responses prepared in case you need to stall. For example, you could say, “Let me think about how best to proceed from here. I’ll email you with some thoughts.” That will buy you some time to mentally process the information and respond in a productive way.

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What You Should Know About Medical Marijuana for Pets

Now that 23 states have given medical marijuana the green light (with even recreational use now allowed in another four states and Washington D.C.), growing weed has become a growing business. The newest frontier: getting Fido and Fluffy on board with the cannabis revolution.

Relax. We’re not talking about rolling doobies with your dog, or seeing “pretty colors” with your cat. Nope, these are cannabis-containing edible treats and capsules that are meant for sick or aging pets.

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“The cannabis plant has many compounds in it,” Matthew J. Cote, brand manager at Auntie Dolores, a San Francisco Bay Area-based edibles manufacturer, told ABC News. Auntie Dolores launched its pet line Treatibles last year. “Most people grow cannabis for the euphoric experience of THC. But they’ve been overlooking cannabidiol—commonly known as CBD—which is non-psychoactive,” he said.

CBD, in fact, does not produce a high, and it’s true that it’s been studied as a potential treatment for epileptic seizures and pain relief for cancer patients.

So, as Cote explained to ABC News, the theory is that since aging canines share a lot of the same health problems as humans, there must be a market for pot-laced dog “medicine.” Sold online ($22 per bag of 40 treats, treatibles.com), Treatibles contain 40 milligrams of CBD per treat and makers advise giving one per 20 pounds of your pet’s weight.

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“What we’ve seen is that some of these dogs respond very rapidly,” Cote told ABC News. “One woman from Fort Bragg was ready to put down her dog due to how sick and in pain he was, but the day before he was scheduled to go under, she administered our treats and just like that the dog was up, walking around, and acting normally again.”

Canna Companion, another pot-for-pets proprietor based in Sultan, Washington, also boasts of amazing results for customers. One such testimonial posted on their website reads: “It seems as though [Canna Companion] is the best kept secret in the animal world for pain management and anxiety issues. I originally ordered it for my cat Robbie for anxiety/inflamed bladder issues and it works! Robbie has had issues for the past year or so, and now they are all but gone.”

High (ahem) praise, indeed.

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Even so, the American Veterinary Medical Association hasn’t taken an official stance, and even in states where marijuana is legal, veterinarians are not allowed to prescribe cannabis products to their patients. (Though that may change: In Nevada, where medical use for humans is legal, the legislature is currently debating a bill that would allow vets to prescribe it to pets.)

Producers of these treats and capsules also have to be careful about any claims they make about their products. According to ABC News, the U.S. Food and Drug Administration sent Canna Companion’s co-owner (and a veterinarian) Sarah Brandon a notice, stating that the capsules were an “unapproved new animal drug and your marketing of it violates the [Federal Food, Drug, and Cosmetic] Act.”

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That kind of cautionary approach makes sense, say some experts, who point out that since these products aren’t regulated by the FDA, there’s no real way of knowing what you’re getting—or what the potential side effects might be. Says Tina Wismer, medical director of the ASPCA Animal Poison Control Center, in an interview with Health: “These products show potential, but there’s not a lot of research at this point. No one is even sure what the correct therapeutic dosage is. For example, in the ‘Frequently Asked Questions’ section on one of the websites, a customer asks, ‘How much should I give my pet?’ And they answer—I’m paraphrasing here: ‘Whatever you think would help.’ Well, that’s extremely vague.”

Not to mention, potentially dangerous: A 2012 study published in the Journal of Veterinary Emergency and Critical Care found that the number of dogs treated for marijuana overdoses at two Colorado veterinary hospitals quadrupled in five years following the legalization of medical marijuana in the state.

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Sometimes it’s a case of owners deliberately administering cannabis products (hash-laced brownies, for example) to their pets, experts note. Other times, ingestion happens by accident—say, animals inhaling second-hand pot smoke or getting into their owner’s unattended stash. Wismer, who hasn’t heard of any problems with Treatibles or Canna Companion specifically, says she has fielded more than a few panicked calls at poison control about accidental exposures to pot in general—with sometimes scary results.

“You would think they’d become sedated and wobbly, but almost a quarter of them become quite agitated,” says Wismer. “They’re trying to pace. They’re panting. You reach out to pet them and they jerk their heads away.” In fact, Wismer adds, dogs that ingest large amounts of THC sometimes need to be put on fluids and have their heart rate monitored. Scary, right? (Although the commercial dog treats contain little or no THC, according the manufacturers.)

The bottom line here: You probably shouldn’t feed your pet cannabis—in any form—without talking to your vet.

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Wait, Congress Has a Meditation Guru?

Think you’re crazy-busy? Meet Tim Ryan, the U.S. representative from the 13th district in Ohio serving his seventh term. Amid the dual demands of lawmaking and diaper-changing (he has a 10-month-old baby with his wife, plus two older stepchildren), he still finds time to meditate 30 minutes each day, a habit he’s kept for the past seven years. This has led Rep. Ryan to become Congress’ de facto mindfulness guru, organizing regular meditation sessions for fellow legislators and staffers.

Aside from providing stress relief and improving concentration, meditation may also help lower heart disease risk, ease anxiety, and even treat chronic pain. And Rep. Ryan, for the record, has other wellness interests, too: On top of his 2013 book A Mindful Nation ($11, amazon.com), he also published a clean food opus last year called The Real Food Revolution ($18, amazon.com).

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May happens to be National Meditation Month, so we spoke with Rep. Ryan to get his tips on beginning a lasting practice and how to sneak it into your day.


How do you make time for your meditation practice?

I used to do it every morning. I’d have a cup of coffee, get myself together, and sit for 30-40 minutes. But now with the baby at home [10-month-old Brady], I just fit it in whenever I can. I still try for 30 minutes at a time, and in the past year I’ve added 5 or 10 minutes of deep breathing beforehand to help my body calm down, give it plenty of oxygen, and balance out the system.

What do you do if you can't meditate every day?

The key thing is to learn how to take mindfulness off the cushion and into your life. Now, whether I’m changing a diaper or chasing Brady around the house, I just try to bring mindfulness to those moments.

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Can you really bring mindfulness to changing a diaper?

Sure. Even if you’re not meditating, mindfulness is about coming back to your breath, coming back into your body, and trying to observe what state the mind and the body are in. You’re working on building a habit in which you’re aware in any situation. Maintaining a sense of humor about life helps, too.

How would you advise getting into meditation if you're a beginner?

They key is to just start. Don’t feel like it has to be 45 minutes, or that you have to go off to a cave in the Himalayas. Just start by taking a minute or two, turn off all your electronic devices, experience a little silence, do some deep breathing. Do it again for a couple of minutes each night. There’s no excuse for not doing some deep breathing before bed.

Even if you start in small increments, you’ll start to notice that things change. You’ll start to say, “Wow, that two minutes in the morning helps me behave differently during the day.” Once you experience that, you might say, “Next time, I’ll do it for or four or five minutes.”

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Why is mindfulness training so important?

If you play sports, like I did, you always hear that the game is 90% mental. If you make time for physical training, like many of us do, why shouldn’t we also make time for mental training? So many feelings of physical anxiety come from the mind, so this mental practice is very important for people’s overall well-being, particularly those of us with hectic lives.

You've been working on bringing mindfulness to schools. What benefit can mindfulness have for children?

One of the keys to being a successful person is regulating one’s emotional state, and to do that, you have to be aware of your emotions. By using mindfulness and breathing, through a process called social and emotional learning (SEL), we can help kids become aware of their emotional state. They learn to answer questions like, “If I’m mad at someone on the playground, how can I express it without punching that person?” By learning to be aware of feelings, and using deep breathing, they’re cultivating the steps they need to handle a variety of situations and problems.

If we want our kids to be leaders, to be independent, to think for themselves, to avoid peer pressure, to get along, and to be connected, we need to teach them how to handle stress properly from a young age.

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What other applications of mindfulness show promise?

The big one for me is working with veterans. Twenty-two veterans a day take their own lives. I’m involved with a project called Welcome Home Troops that brings breathing meditation to vets. We had a group in just the other day, veterans who have served 2 or 3 tours, who have lost friends, who have been in a bad place for 10 years. And having found this approach to mindfulness, they’ve gotten off medication, they’re finally sleeping through the night. We want to get the message out to vets that there are these other methods that can help you better than taking 10 or 12 pills a day.

You're a Democrat. Do you think we can use mindfulness to reach across the political aisle?

Our regular “Quiet Time Caucus” for staffers is pretty well-attended. We get Democrats, Republicans, Tea Partyers, and they’re all curious to learn about the different applications of mindfulness, to hear about the science behind it. I’ll have staffers grab me in the lunch line and say, “I’m a conservative Republican, I’ve been stressed out for a long time, and this is really helping me.”

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How is mindfulness valuable on a societal level?

I believe that the personal anxiousness we experience in our lives is reflected in our collective approach to the issues we face, in our politics and in our public discourse.

There’s so much disconnection in our society today. People are disconnected from their families, from their communities, from each other. We get so wrapped up in our work that we wake up one day and realize our kids are 20 and we don’t know what happened. We put up fences around our backyards and stay away from our neighbors.

Mindfulness, and the practice of slowing down, helps us establish the connection between mind and body, and in turn, helps us reclaim connections to other people, to our loved ones, to our neighbors. When we recognize the connections we have with others and get to work on reconnecting, it will change society for the better.

This interview has been edited and condensed.


5 Time

For many people, the work-family-personal time balance feels like a constant juggling act where one or more components constantly ends up out of sync. Meanwhile, you can’t help but envy that one friend, coworker, neighbor who seems to make time for everything, all while rocking a smile and a skip in her step.

But we all have the same number of hours during the day—how does she do it?

“There is much to learn from seeing how people use their hours to achieve their goals. Learning their strategies can be empowering; it reminds us that we have the power to shape our lives too,” writes Laura Vanderkam in her latest book, I Know How She Does It: How Successful Women Make the Most of Their Time ($16, amazon.com).

In 2013, Vanderkam began asking professional women—who made at least $100,000 a year and had at least one child under the age of 18 living at home—to keep hour-by-hour logs that detailed how they spent each hour of the day from the time they woke up until they turned in for the night. They documented everything from a jam-packed day of meetings to the hour spent picking out a new J. Crew sweater online.

Excerpted below are some of Vanderkam’s takeaways. While time management is never one-size-fits-all, these tips may help inspire you to re-work things in your own life.

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Leave work on time—or even early

It’s easier said than done, but there are ways to shave off hours while maintaining productivity, Vanderkam explains—and a big part of it is simply making this commitment. She writes, “Building the life you want is about having the courage to do it … treating your personal life with the same importance and urgency as your work appointments increases the chance that you will leave on time. You’ll also have a life worth leaving for.”

In various time logs, she noticed that many women worked in “split shifts,” meaning they spent a large chunk of the day in the office, but cut out early to make it to say, kids’ sporting events. Then later on, they’d squeeze in another hour of work after bedtime.

Other tricks? Shorten meetings to get right to the point, while also sending the message that you have a clear agenda. Another idea is to “perform a 4 p.m. triage,” she writes. “An hour before you aim to leave, revisit your to-do list. Pretend an evil villain, laughing maniacally, has informed you he will steal your phone and laptop at 5 p.m. and keep them until the next morning. Knowing that, what would you still do? What wouldn’t you do?”

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Re-think the weekends

In a dream world, Friday night through Sunday evening are blissfully free of work-related duties. But Vanderkam challenges that norm by suggesting that when done mindfully, weekend work can have its upsides. (The women who participated in her time log project also demonstrated this work-on-the-weekend habit: 40% of logs showed work on Saturday, and more than 50% showed work on Sunday.)

“Using the weekends makes a more limited schedule during the workweek possible,” Vanderkam writes. Think of it this way—”If you’re trying to work a certain number of hours, working five hours on the weekend translates to an hour less you need to work every weekday,” Vanderkam writes.

There’s also something to the concept of starting Monday out two steps ahead. “In the context of the whole mosaic, sometimes working on the weekend is less stressful than not working on the weekend,” she continues.

Instead, adopt “the Sabbath concept,” she states. “It’s good to take 24 hours off at some point to clear your head.” This way you still get a real recharging period, and the rest of the days of the week are less stressful overall.

Stop stressing over family dinner

This is part of what Vanderkam calls “the 24-hour trap.” We all feel this pressure to get a certain number of things done each day, including those daily rituals with our families.

But just because you can’t have a picture-perfect family dinner every night doesn’t mean that you’re not around, explains Vanderkam. “Of all the work/life narratives out there, the most insidious is this: success in the larger world requires painful trade-offs at home,” she writes. If you can swing family dinner two or three nights a week, you should view that as a success.

Vanderkam also noted that several busy moms spend their best quality time with their little ones in the early morning. “You can spend time with them first, before the rest of life gets in the way,” she writes.

You can even apply this mindset to your romantic life: date nights don’t have to be, well, at night. “Several women who worked near their husbands got together with them for lunch once a week,” Vanderkam writes. “Date breakfast might work as well.”

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Remember to nurture yourself

This boilerplate advice is, let’s face it, annoying when you’re busy. But that’s again because of the “24-hour trap.” Taking time for yourself doesn’t have to be consistent day to day. Vanderkam writes, “Yes, daily rituals are nice, but they’re not the only strategy for building a productive life.”

If leisure time pops up out of nowhere, you also have to be prepared to seize it, she adds, referencing one woman who found herself caught off guard by free time and just read Facebook and Twitter and ate Girl Scout cookies instead of seizing the moment.

“Whatever your favorite activities are, knowing what they are, and keeping them at the top of your mind, helps you take advantage of the pockets of time we all have in our lives,” she writes. “Time is elastic. It stretches to accommodate what we need or want to do with it.”

Don’t sweat the small stuff

You don’t have to make your kids’ lunches every day unless you choose to, you can skip the long drive to visit an old friend this time, and if you can afford it, go ahead and spend your hard-earned dollars on time-saving perks like that grocery delivery service.

“If you’ve got food, a bed, and a healthy family, there’s really no reason to make life harder than it needs to be,” Vanderkam writes. “The laundry can wait. Contentment shouldn’t.”

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How I Finally Broke Free From a 2

This essay is excerpted from Jen Hatmaker’s new book, Of Mess and Moxie:Wrangling Delight Out of This Wild and Gorgeous Life ($23, amazon.com).

Conversation with my husband, Brandon:

ME: Blah.

B: What’s wrong?

ME: Nothing. Just everything. Everything is bad

B: Specifically?

ME: Just that our kids are probably all going to hate us and struggle with multiple incarcerations, I apparently will gain a pound a month until I die, this house is a craphole of chaos, and my weird quirks are getting worse. I hid in the bathroom at another conference.

B: Is that all?

ME: And also, only two of my kids love to read, so obviously, Failure, your name is Motherhood, and all I do is discipline and put out fires, so I’ve basically come to hate the sound of my own voice. I can’t stand myself, and these kids aren’t faring much better on my Like-O-Meter.

And I’m sorry to tell you, but your scores aren’t great either. I cannot even talk about e-mails. My Bible feels like a useless lead weight. I don’t feel like I’m taking skin care seriously enough. I also ate a tub of pimento cheese. All hope is lost.

 But at least you’re working on that melodramatic tendency.

ME: Just lost another four points, pal. Feels like a dangerous time to mess with me.

I essentially slid into a two-month case of the doldrums, trapped by inertia and overwhelmed by the escape requirements. On my best days, our life is heavy duty, but during my low days, I Google search “fake my own death and disappear,” which Brandon might dub melodramatic, but he is just a man with a stable mind and can’t be trusted.

Here is the bummer about the doldrums: the very efforts needed to lift yourself out are the same things you’ve lost energy to do. The simplest remedies feel like weights drudged up from the bottom of the ocean. Your mind knows to do them, but your will refuses to cooperate. Which makes your mind furious and mired in shame, which makes your will dig its heels and wallow, which makes you realize you are turning on yourself. You are your own worst enemy. No one can oppress me like myself.

How did I eventually get out of this funk? Nothing miraculous happened, except one day I said, This is enough. Virtually nothing changed that day. Or the next. These things aren’t overnight success stories, because if it took three months and 459 lazy, unhealthy choices to get stuck, it takes some time to climb out. Also, the work required is unsexy, ordinary, boring old labor that lacks the appeal of instant gratification and the pizzazz of an unsolicited miracle. I wish I had better news about breaking free, but apparently we just have to grab a shovel and start digging.

Dear one, if you are stuck in the doldrums, let me offer up some of the labors that pulled me through, one teeny moment at a time.

First, I made a list of everything I was behind on. Unfinished tasks are a cloud of doom over my head. The emotional energy they steal from me is unbearable. So I wrote them down to get a handle on them rather than leave them floating around unnamed, unmanaged, unidentified. It was ironic, because each line item could be accomplished in minutes at best, a day at worst: mail these things, return this, make those appointments, answer these e-mails (deliver me, Lord), scan over that contract, send in money for that school thing (this times a zillion, free public school my eye), pick up that stuff, return that phone call, finish writing that article. Overdue responsibilities contribute heavily to my shame spiral, and writing them down and slowly crossing them off was an instant boon, literally. Unbelievable the weight that rolls off when the Behind Pile starts to shrink.

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Second, the house. For the love of Oprah, the house. I am one of those annoying people who requires tidiness and declutterfication. Oh, to peacefully live in chaos among the piles instead of, hypothetically, barking at the humans who live with me and begrudging everyone for being such slobs. But nope. That is not my lot in life. A cluttered, disorganized house has a direct correlation to my cluttered, disorganized mind.

So, we launched another chore chart. But this one was simple and repetitive: Everyone had one chore a day, and it was the same every week. This was not for pay, because the reward was getting to live in my house for free. The kids had done these tasks before but with no regularity and primarily after I turned into a lunatic. Now we had formalized it somewhat, and the house-maintaining was more consistent. Not allowing our abode to slip into entropy was mentally healing. The chart may be imperfect, but even loose structure restores order to my inner turmoil. Simply creating a plan provides some dignity, which is a powerful combatant to the doldrums.

Third, parenting. Obviously my five kids are perfect and make straight As and speak loving words to each other constantly, but clearly their classmates had poorly influenced them, because they turned into maniacs. This surely had nothing to do with their mother’s two-month doldrum disorder, because children are never the thermometer simply displaying the temperature of their parents. I’m sure their digression was just a coincidence.

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So anyway, this thing happened where the kids were horrible and fighting and I went to my room to cry about these terrible children I got stuck with, and I suddenly thought of six—six—lovely moments my kids had engineered that very day and I heard, You are only noticing the bad moments and ignoring the good ones.

So we started the Brag Board. (It’s just a chalkboard, but can we give a quick shout-out to the Chalkboard Paint People for completely rebranding and becoming the darling of Pinterest? I mean, there were chalkboards on Little House on the Prairie. They aren’t new is all I’m saying.) Anytime we catch someone being kind, helpful, gracious, or awesome, we write it down, big or small. It has to be about someone else, because my offspring would write: It was so incredible how I unloaded the dishwasher.

Funny thing: I’m not positive they’ve had more shining moments lately than before, but I’m sure noticing them now. Evidently we will see exactly what we’re looking for. Does this mean I’ve had to follow a kid or two around, searching for one tiny good thing to say? Yep. But catching children in their goodness totally beats reprimanding them only in their struggles, and the Brag Board pulled the whole family up a few degrees.

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Finally, I made a list of all the practices that make me feel healthy. Not surprisingly, I noticed most were absent in my doldrums: cooking, reading good books, limiting screen time, eating well, date nights, taking walks, scheduling time with a counselor, being outside, praying, changing out of my pajamas (this is a thing for work-at-homes), spending time with my friends. All ordinary, nothing new or dramatic. These are mainly bits and pieces that fit in the gaps of life. I simply committed some time back to my staples, maybe just one a day.

None of these were executed immediately. Over a few weeks, I slowly implemented healthier practices, one at a time. It was not revolutionary to sit down with Alan Bradley’s latest novel (“Whenever I’m a little blue I think about cyanide, which so perfectly reflects my mood.”—Flavia), nor was the world righted after the first entry on the Brag Board. The chore chart didn’t solve the crisis, and neither did catching up on e-mails.

But all together, over weeks, just doing the work, bit by bit, digging deep for diligence and grace and best practices, the doldrums receded. These measures make us healthy and whole, because we stop succumbing to disorder and shame. It’s not fancy or quick work, unfortunately, but it is effective.

If you feel stuck today, can I suggest approaching the doldrums in a reasonable way, one tiny element at a time? Alone, none are monumental, but together they lay small paver stones out of the mire, forging a path back to health, back to vibrancy.

Author’s note: This essay does not apply to serious trauma or . The doldrums are a funk, not a severe crisis. Sometimes we require therapy, intervention, and possibly medication, and the practices I describe are inadequate.

Taken from Of Mess and Moxie: Wrangling Delight Out of This Wild and Glorious Life by Jen Hatmaker. Copyright © 2017 by Jen Hatmaker. Used by permission of Thomas Nelson. www.OfMessandMoxie.com.

Fighting in Iraq and Fighting Cancer Have Something in Common

THURSDAY, Sept. 4 (Health.com) — The special terrors of the Iraq war have shone new light on post-traumatic stress disorder (PTSD) as it is suffered by U.S. soldiers. But medical patients undergoing arduous procedures and treatments can experience PTSD symptoms too, according to a California pain expert.

At the PainWeek conference in Las Vegas this week, Thomas Strouse, MD, professor of clinical psychiatry at UCLA, stressed the importance of minimizing pain, fear, and other trauma that accompany cancer treatment, in particular.

Cancer patients, Dr. Strouse says, may feel they are under terrifying physical threat, may feel a loss of control, and may experience prolonged pain or other discomfort such as profound nausea, laying the groundwork for PTSD.

According to Dr. Strouse, PTSD symptoms have been most clearly described in adolescent patients who relive the trauma of childhood cancer treatment when they have to go in for tests and checkups. But, he says, “It can happen in adults who have gone through arduous medical experiences as well. One of the big unanswered questions in PTSD research is: Why do some people exposed to a trauma get PTSD and others don’t?”

Complex genetic and social factors probably spare some patients and burden others, he says. But the lesson for patients going into a traumatic medical experience, such as cancer surgery and chemotherapy, is that all efforts should be made to anticipate and reduce discomfort and the sense of helplessness that these procedures can induce.

“Talk about the procedures,” Dr. Strouse advises patients who deal with doctors. “Talk about both behavioral and medication preparation that will help you get ready for the procedure.”

Although pain is only one aspect of the trauma that can spark PTSD, it is especially relevant in the context of medical treatment, and physicians now recognize that pain control is vitally important in the recovery process.

If you’re slated for an operation (or helping a child through the experience), “Talk about what postoperative pain control will be like,” Dr. Strouse says. “What will be done to reduce my pain? Who can I get in touch with if I don’t like my pain control?”

The goal is not only to reduce the pain of a medical procedure, but to avoid the pain of reliving a bad experience. That message is getting out to doctors, Dr. Strouse says, even if they don’t frame it in terms of PTSD. “I’m not sure it’s discussed in PTSD language, but it’s well understood now that it’s better to reduce the trauma of procedures at every level, right down to treatments on babies.”

By Scott Mowbray


Related Links:The Dangers of Not Treating Cancer PainTake Control of Your Cancer PainDeciding to Get Treatment for PTSD

Violent Video Games Linked to Aggression in Children, Teens

Getty Images

By Anne HardingMONDAY, Nov. 3 (Health.com) — About 90% of Americans ages 8–16 play video games, and they spend about 13 hours a week doing so—even more if they’re boys. Now a new study suggests that virtual violence may make kids more aggressive in real life.

According to the study in the journal Pediatrics, children and teens who reported playing violent video games had more aggressive behavior months later than their peers who did not play the games.

The researchers specifically tried to get to the root of the chicken-or-egg problem: Do children become more aggressive after playing video games or are aggressive kids more attracted to violent games?

It’s a murky—and controversial—issue. Many studies have linked violence in TV shows and video games to violent behavior. In fact, many states have tried to restrict minors’ access to games rated M for mature, but the video game industry, as well as free-speech activists, have often successfully challenged the proposed restrictions in court.

In the new study, Craig A. Anderson, PhD, and his colleagues at Iowa State University, in Ames, looked at the ways that children and teen’s video game habits at one point in time related to their behavior three to six months later.

The study included three groups: 181 Japanese students age 12 to 15; 1,050 Japanese students age 13 to 18; and 364 Americans age 9 to 12.

The U.S. children listed their three favorite games and how often they played them. In the younger Japanese group, the researchers looked at how often the children played five different violent video game genres (fighting action, shooting, adventure, among others). In the older Japanese group, researchers gauged the violence in the teens’ favorite game genres and the time they spent playing them each week.

The Japanese groups rated their own behavior in terms of physical aggression, including violent acts such as hitting, kicking, or getting into fights with other kids; the U.S. children rated themselves too, but the researchers also considered reports from their peers and teachers.

In every group, those exposed to more video game violence did become more aggressive over time, as opposed to their peers who had less exposure. This was true even after the researchers took into account how aggressive the children were at the beginning of the study, a strong predictor of future bad behavior.

Next page: Video violence may desensitize kids

The findings are “pretty good evidence” that violent video games do cause aggressive behavior, says L. Rowell Huesmann, PhD, director of the Research Center for Group Dynamics at the University of Michigan’s Institute for Social Research in Ann Arbor.

There are two ways violent media can spur people to violent actions, says Huesmann, who has been studying violence in media and behavior for more than 30 years.

First is imitation; children who watch violence in the media can internalize the message that the world is a hostile place and that acting aggressively is an OK way to deal with it, he explains. Also, he adds, kids can become desensitized to violence.

“When you’re exposed to violence day in and day out, it loses its emotional impact on you,” Huesmann says. “Once you’re emotionally numb to violence, it’s much easier to engage in violence.”

But Cheryl K. Olson, ScD, codirector of the Center for Mental Health and Media at Massachusetts General Hospital in Boston, isn’t convinced.

“It’s not the violence per se that’s the problem; it’s the context and goals of the violence,” says Olson, citing past research on TV violence and behavior.

There are definitely games kids shouldn’t be playing, she says—for example, those where hunting down people and killing them is the goal. But she argues that the label “violent video games” is too vague. Researchers need to do a better job of defining what is considered a violent video game and what constitutes aggressive behavior, she adds.

“I think there may well be problems with some kinds of violent games for some kinds of kids,” Olson says. “We may find things we should be worried about, but right now we don’t know enough.”

Further, she adds, playing games rated M for mature has become “normative behavior” for adolescents, especially boys. “It’s just a routine part of what they do,” she says.

Her advice to parents? Move the computer and gaming equipment out of kids’ rooms and into public spaces in the home, like the living room. That way, parents can keep an eye on what their child is up to.

David Walsh, PhD, president of the National Institute on Media and the Family, a Minneapolis-based nonprofit, argues that the pervasiveness of violence in media has led to a “culture of disrespect” in which children get the message that it’s acceptable to treat one another rudely and even aggressively.

“It doesn’t necessarily mean that because a kid plays a violent video game, he’s immediately going to go out and beat somebody up,” Walsh says. “The real impact is in shaping norms, shaping attitude. As those gradually shift, the differences start to show up in behavior.”

Related Links:Less Exposure to Violent Media Makes Youths Less AggressiveEstablishing limits with your school-age childComputer Games That Boost Your MemoryBipolar News: Children May Not Outgrow Disorder

Will Smoking Pot Raise Your Risk of Testicular Cancer?


By Kate StinchfieldMONDAY, Feb. 9, 2009 (Health.com) — Do men who frequently smoke pot have a higher risk of testicular cancer than those who do not? It’s possible, according to a new study. However, the researchers say the link is currently a “hypothesis” that needs further testing.

Testicular cancer is relatively rare—a man’s lifetime chance of developing the disease is about 1 in 300 (and dying of it is about 1 in 5,000). But frequent or long-term marijuana smokers could have about double the risk of nonusers, according to the report in the Feb. 9 issue of the journal Cancer.

In the study, a team led by Janet R. Daling, MD, of the Fred Hutchinson Cancer Research Center in Seattle, interviewed 369 men between the ages of 18 and 44 from the Seattle–Puget Sound area who had been diagnosed with testicular cancer. They compared those men to 979 men who lived in the same area but did not have cancer.

Overall, 26% of the testicular cancer patients were pot smokers (15% who used daily or weekly) at the time of diagnosis, compared with 20% of men without cancer (10% who used daily or weekly).

Marijuana users had 2.3 times the risk of a type of testicular cancer known as a nonseminoma as those who were not. Testicular cancer is divided into two types, pure seminomas (60% of cases) and nonseminomas (40% of cases). The link was much weaker in men with seminomas.

These types of studies have one important caveat, however: Cancer patients may be more likely to remember—or may be more honest about—past drug use than men in the general population.

Next: Testicular cancer rates are on the rise

Because marijuana use was more closely associated with one type of tumor rather than testicular cancer in general, it reduces the chances that the study participants were less than honest, Dr. Daling says. “That certainly makes us feel better that the associations are true associations,” she says.

Still, the results are considered preliminary and need to be confirmed with more research. “There have been studies done on testicular cancer, but ours is the first to look at marijuana,” says Dr. Daling.

Scientists believe that most cases of testicular cancer actually get their start in early fetal life. Having an undescended testicle—a relatively common birth defect—is a key risk factor for the disease.

There has been an increase in testicular cancers in the last half of the 20th century, however, which spurred the team to examine other factors that might explain the rise. Marijuana use increased over the same period, and chronic use has been shown to affect sperm formation and fertility, they note.

Some experts say the association is a tenuous one, particularly because seminomas have increased 64% from 1973 to 1998 while nonseminoma rates rose only 24%.

“These researchers have an association that they’ve picked up on, but it’s a weak association,” says Steve Shoptaw, PhD, a professor of family medicine and psychiatry at UCLA. “Marijuana tends to be one of those firebrand issues where people can make statements to get airtime, so I’d like to see these findings replicated.”

The authors note, however, that nonseminoma rates did go up in a couple of places in the world in recent decades. One is Norway and the other is the Netherlands, a country in which cannabis use is tolerated. The next step, says Dr. Daling, is to collect tumor tissue, evaluate it for marijuana receptors, and study how those relate to tumor development. “Certainly we’re going to continue forward with this,” she adds.

Without stronger proof, critics say the study should be taken with a grain of salt. “There’s always been the thought that cannabinoids had some interaction with the reproductive systems, so maybe they’re on to something. Who knows?” says Shoptaw. “But now we need to isolate the actual physiological responses.”

For patients using cannabis for medicinal purposes, the improvement in quality of life may outweigh any potential risk of testicular cancer, says Shoptaw. “The bottom line is that I would not start warning my marijuana smokers that they are going to get testicular cancer,” he says. “I don’t think there’s enough here to go forward with that message—at least not yet.”

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The Secret to Staying Slim? Just Relax

By Shaun ChavisComfort food is on the “hot list” for 2009. You don’t have to guess why—it’s not just a winter-induced urge to snuggle around a bowl of something warm. Comfort food not only makes us feel better, but in many cases it’s also cheaper to make or buy—a nice fit for thin wallets.

Restaurants are clued in. Chefs know we want to be comforted. They may not be waiting with outstretched arms, but they’re revising menus and adding warm, familiar, or creamy dishes: Stews, barbecue ribs, pasta, burgers, classics like Kentucky Hot Brown sandwiches covered in cheesy sauce, thick handmade milkshakes, and slow-cooked anything. Conveniently, comfort food is cheaper for restaurants to serve, too.

Nutrition scientists say that when we’re chronically stressed, our bodies push us toward a preference for sweet, fatty foods. And some of us just learn to eat when stressed. (Take our quiz Are you a stress eater?) My grandmother always carried cherry Lifesavers, and if any of us grandchildren got upset, she pulled them out so fast, there was a Lifesaver in your mouth before you could draw in that deep breath to let out a big cry. Stress can raise your blood sugar and weaken your immune system, and it’s linked to depression, heart disease, and obesity. You’ve probably seen recent news about how chaos at home can contribute to obesity in moms.

These days, economically friendly stress relief is going to be a lifesaver—a lower calorie one than my grandmom’s. Here are a few things I’m trying to stay calm:Getty Images

Simplify life. Make paying bills easier, find ways to spend less time on errands, buy less stuff, and save time for commitments that are really meaningful. Physically simplifying your living spaces help. Read specific tips about how Health readers make their lives simpler.

Relax. Personally, I think relaxing and de-stressing are different. You could go into a spa and relax for an hour, then get dressed and go back to your stressed life, y’know? Making rituals of practices like yoga, tai chi, or meditation can work some valuable relaxation into your life. Or try these other workouts that nourish the body and mind.

Have fun. Play is important for us big kids, too. Don’t choke the fun out of your life while you’re squeezing and stretching dollars. Make time to play with these ideas for leisure activities.

Look for healthier comfort foods. Candy’s the cheapest comfort food. But steer clear of the snack aisle and try some yummy dessert teas instead. Ditto for warm drinks and foods—warm doesn’t have to mean high in calories. Sample these hot, low-cal beverages or try some vitamin C–loaded produce. The C keeps your stress hormones down.

Got some great substitutes for comfort food or ways to relieve stress? Please share them in the comments.

Brain Scans Might Help Spot PTSD

FRIDAY, April 3 (HealthDay News) — Someday, doctors might use brain scans to diagnose post-traumatic stress disorder (PTSD), according to researchers who conducted tests on 42 American soldiers who’d recently served in Iraq or Afghanistan.

The male and female soldiers had comparable levels of combat exposure. They were divided into two groups, those with PTSD (22) and those who didn’t have the condition (20); fMRI was used to examine the brain patterns of the soldiers while they performed a three-part, short-term memory task that included distractions.

The task is designed to measure the ability to stay focused, which is reduced in people with PTSD.

The researchers noted a number of brain activity differences between the PTSD group and the non-PTSD group, such as in the dorsal lateral prefrontal cortex, an area that plays a role in the ability to stay focused. While doing the memory task, the soldiers with PTSD performed more poorly when they were shown both traumatic and neutral photos, while the soldiers without PTSD were only distracted by the traumatic photos.

“This sensitivity to neutral information is consistent with the PTSD symptom of hypervigilance, where those afflicted are on high alert for threats and are more distracted by not only threatening situations that remind them of the trauma, but also by benign situations,” study leader Dr. Rajendra Morey, an assistant professor of psychiatry at Duke University and director of the neuroimaging lab at Durham Veterans Administration Center, said in a news release.

“This has not been seen at the brain level before. If further research confirms this preliminary finding, this pattern could be useful in distinguishing the PTSD brain,” Morey said.

The researchers also noted marked differences in an area in the medial prefrontal cortex that governs sense of self. This area showed a much higher level of activity when the soldiers with PTSD looked at combat photos, but showed little response in those without PTSD.

“This is consistent with what we see behaviorally in PTSD, where people with the disorder are much more likely than others to connect traumatic triggers to events that have increased personal relevance, such as the combat situations in war veterans,” co-author Dr. Florin Dolcos, an assistant professor of psychiatry and neuroscience at the University of Alberta in Canada, said in the news release.

The study was to be presented Friday at a World Psychiatric Association meeting in Florence, Italy.

“As technology improves, imaging research is increasingly providing insights into the brains of people with post-traumatic stress disorder, pointing to potential biological markers distinguishing the PTSD-affected brain,” Dolcos said. “The field is still in its infancy, but this raises the possibility that one day we may be able to see the disorder in the body as plainly as we now can see conditions such as heart disease and cancer.”

More informationThe U.S. National Institute of Mental Health has more about PTSD.

— Robert Preidt

SOURCE: World Psychiatric Association, news release, April 3, 2009

Last Updated: April 03, 2009

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