anxiety

How to Fall Asleep When your Mind Just Won't Quit

Photo by gbarkz on Unsplash

Photo by gbarkz on Unsplash

Have you ever laid in bed and your mind is racing, thinking about everything from that spreadsheet at work to a comprehensive list of your deepest regrets? Sleep deprivation affects your memory, mood, eating habits and your ability to function effectively. If you struggle to fall asleep or you wake up in the middle of the night and start planning and worrying, it can seem like nothing will get you to the sleep state you crave. And we all know that worrying about not being able to sleep is exactly what makes is impossible to fall asleep. Welcome to the sleep conundrum.

I am not a therapist, but a busy bee like you with a lot of practice tossing and turning at night. But because I struggle, I also want to share a compilation of methods I’ve tried that work for better sleep. I call it a lullaby for grown-ups. 

For better sleep, change habits first

  • Don’t eat or drink alcohol close to bedtime. Have your last meal a few hours before bed.

  • Put away your phone or devices while in bed. Electronics are making your mind overactive.

  • Avoid caffeine and stimulants after a certain point in the day. For coffee drinkers, the cut-off for your last cup will depend on your sensitivity to caffeine. But if you struggle to fall asleep, consider finishing your last cup by 4pm, brewing it a bit weaker, or replacing it with herbal tea.

  • Create a bedtime ritual. You don’t need to devote much time to it to feel the positive effects. Set aside 30 minutes for yourself before bed to decompress. Tuck the kids and put aside obligations, chores, and screens. Meditate, stretch, relax with tea or a hot toddy, listen to soothing music or all of the above!

Get comfortable

Being mindful of your surroundings at night can go a long way. At bedtime, you get to reward yourself with rest for getting through a hard day, and you want to feel good. Have you ever asked yourself if you’re actually comfortable? Before bed, eliminate any physical obstacles that you have control over:

  • Body aches can keep us awake. Do what helps your body to reduce the pain - a cold or hot compress, or pain reducers if your body/doctor allows for that.

  • If you’re too hot or too cold, itchy or scratchy, adjust blankets and sleepwear accordingly.

  • Change your physical surroundings in ways that make you feel restful. If white noise is soothing to you, turn on a fan. If that sliver of light through the window bothers you, put up a light-blocking curtain.

Instead of counting sheep, count your inhales and exhales

Perhaps you’re lying in bed as alert as ever and considering just getting up and starting your day at 1 AM. Before you give up, try some of these tips.

  • Bring your attention to each body part touching the bed. Notice how your stomach rises and falls. How each arm makes contact with the bed. Notice how your neck feels on the pillow, considering the weight of your head. As you notice each joint, muscle and bone, you might feel the sensation that you’re sinking into the bed. Your body might let go more..

  • When thoughts start invading your mind and keeping you awake, redirect them and say “thanks mind.” Replace your thoughts with 5 second counts for each inhale and exhale. Breathe deeply, counting each breath in and out for a few minutes.

Thoughts will continue to come back, because the job of the mind is to generate thoughts. When that happens, “thank” your mind for doing its job and re-focus on your breathing and your body.

The wheels of our mind don’t always know when to quit. If your thoughts keeps creeping up on you, it’s time to reason with it.

Using logic to reason with your brain

Did you know the amygdala is the part of your brain responsible for emotional processing? In our hunting and gathering days, this region of our brain alerted us to predators and dangers. When our ancestors saw a mountain lion, they became hyper-alert, their heart would race, and breathing would speed up.

Today the amygdala continues to alert us to dangers that may not be real threats. Your brain doesn’t distinguish between the sight of a mountain lion and the deadline at work. The fear response is a residual protective mechanism to prepare you for fight or flight.

That said, here’s how to reason with your brain:  

  • Thank your brain for its service, and remember that the anxiety you feel because of your thoughts present no real danger: you will survive that presentation, family function, or interview. If guilt or past pain are the culprits of your emotional state of mind, remember they serve no purpose right now. Forgive yourself and others, even if just in this moment.

  • Ask yourself, “does thinking about this now solve any problems?” If not, your mind will find a way to deal with your source of worry during the day. Life will be there tomorrow. Thinking in terms of the best approach to solve problems, you can acknowledge that losing sleep won’t help anything. That said, don’t be too hard on yourself for having all these thoughts. Remember, they are natural. Your brain is just doing its job.

  • If you absolutely must think about something at night that you don’t want to forget by the morning then keep a notepad by your bed and write it down. Don’t go looking for the Notes app on your phone; pen and paper work best here.

Once you’ve leveled with your brain, get back to breathing

Continue deep breathing and awareness of the sensations in your body.  Breathing with intention is a no-brainer solution to any stress, but it’s amazing how often we forget to do it (or sometimes how to do it). Focus on breathing deeply, and on how your physical body feels. When you feel heavier physically and a little groggier mentally, then you’re closer to being in a sleepier state.
                                                                         …

If sleeplessness is a recurring problem for you, consider talking to your doctor and addressing potential insomnia or other health concerns that can affect sleep. Melatonin can be helpful as an option before turning to pharmaceutical drugs.

We’re all on this journey to make the most out of life but that requires giving our brains and bodies good rest. Wishing you sweet dreams. You can use some peace and a good night’s rest. 


Karen Lenz People Bloom Counseling Redmond Executive Assistant.png

Running a small business is non-stop work, which means Ada’s blog sometimes gets pushed to the back burner. As the Executive Assistant here at People Bloom, I mentioned that I like to write, and Ada kindly offered for me to contribute blogs during busy times. I was thrilled! Now you know I like writing, but I also love to garden, cook, hike with my fiancé, and play on the pottery wheel.
I’m an office admin whiz - not a therapist. I write blog posts as a human navigating this world, a client sitting across from a therapist, much like you. Thank you for letting me share a part of myself. Maybe my journey will resonate with you, and we’ll get through this messy life together.
                                                                        - Karen Lenz

5 Tips for Managing Seasonal Affective Disorder

Alisa Anton/unsplash.com

Alisa Anton/unsplash.com

'Tis the season to be sad

While I don’t wish this upon you, Seasonal Affective Disorder (SAD) is a thing around here. Especially with the end of daylight saving time, we’re feeling the effects of brighter mornings and less evening light. Given how much we love our Seattle summers, the shift into chilly, rainy weather, bare trees and gloomy skies is enough to make many of us want to crawl into bed and stay there.

If you are already struggling with depression, you might feel the effects of it more. If your mood is often weather-dependent or you’re a transplant from a sunnier climate, chances are it’ll affect you too. While winter solstice is less than seven weeks away, let’s help you figure out how to get through this long stretch of fall and winter months.

Before we talk about what to do, let’s address the symptoms of Seasonal Affective Disorder (SAD).

SAD defined

SAD mirrors symptoms of Major Depressive Disorder, also commonly known as Depression. You might have SAD if you:

  • feel depressed
  • don’t want to do the things you used to enjoy
  • have low energy
  • have trouble sleeping, often times oversleeping
  • experience changes in your appetite, often times crave unhealthy comfort foods and experience subsequent weight gain
  • feel agitated or sluggish
  • have difficulty concentrating
  • feel hopeless, worthless or guilty
  • have frequent thoughts of death or suicide

If you have thoughts of wanting to hurt or kill yourself, you need to stop reading this and call the National Suicide Prevention Hotline at (800) 273­-TALK (8255). If you have a milder form of SAD but you’re feeling down, struggling to get out of bed, overeating, gaining weight and saying no to social engagements, then here are some recommendations for you.

5 ways to move through SAD

1. Light therapy

You know that it’s a common purchase when they sell it at Costco. Therapy lamps provide bright, artificial white light during months of diminished sunshine. Keep it in a well-trafficked area and follow instructions for use between 20-60 min. Depending on your circadian rhythm, you might find the light exposure helpful in the morning or the evening. Remember to choose a light box that emits 10,000 lux, which is equivalent to 20x that of usual indoor lighting. With lesser lux units, you might need to use the lamp for longer to get the same effect.

2. Physical activities

I don’t mean exercise. The gym is not for everybody. Rather, there are a lot of fall and winter activities that can get your heart pumping and your brain releasing happy hormones. It can be indoor climbing, yoga, laps in the pool, racquet ball, even housework. Outdoors you have a walk around your office or neighborhood, winter hikes, and snow sports.

Now I understand the fact that you feel SAD means you don’t want to move very much. However, if you wait until you want to do something before you do it, you might never do it! Instead, act the way you want to feel. That said…

3. Positive activities

What activities used to bring you alive? What did you use to enjoy? Or, what is something new you’d like to try? It can be a physical activity listed above or it can be art walks, concerts, a meetup, a good novel, a weekend away. You can be with strangers, close friends or be by yourself. Given the tendency to socially withdraw, I’d recommend doing some activities with others and developing accountability to increase follow-throughs. While there’s no guarantee that you’d feel better afterwards, it’d help you in the long run to stay active and engaged in life.

4. Medication

I don’t know how you feel about taking meds, but sometimes an anti-depressant is necessary to get you past this hump. It doesn’t mean you have to stay on this medication forever; only until you have more tools under your belt to be without it. Also, if you’re currently on an anti-depressant and you’re questioning whether it’s working properly, it’s probably time to visit your prescriber again. Remember that it can take up to 6-8 weeks for the medication’s benefits to kick in, while you might feel the side effects more immediately.

5. Take it in

While this is not the most exciting time of the year for you, can there be any beauty in taking in the vibrant colors of the leaves, the rustling of leaves against the wind, or the crunching of leaves under your feet? What about the beating of rain on pavement, the dancing flame from a crackling fireplace, and the warmth of peppermint tea against your lips?

This will pass

This season is here and it will pass. Since there’s no ushering it away, I hope there’s a part of you that can find it a friend, rather than a foe.

And if you need a therapist to help you ride out this season, I'll be here!


People Bloom Counseling Redmond Couples Cancer Ada Pang.png

Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. This fall, she noticed the changing colors of the leaves more. Her favorite food group this season is all things squash and her favorite activity is baking.

What 9-11 has to Teach us about Human Connection

Tim Marshall/unsplash.com

Tim Marshall/unsplash.com

We all remember

I venture to guess that we all remember where we were on Sept 11, 2011. I had recently moved to Seattle and I was living with my aunt. I got up to get ready for work and turned on the radio for background noise. Then I heard the news. It was surreal. While we were still sleeping in Seattle time, all four planes have crashed and the twin towers have collapsed. I quickly woke up my aunt and we raced downstairs to watch the news. Our hearts sank. As a Chinese Canadian new to living on American soil, “Is this what happens in America?” It was unbelievable.

I have another aunt who lives in Long Island, NY and her husband works in Manhattan. We promptly made calls to all their numbers. Busy tone. We might have made other calls to family members; I no longer remember. Seeing that there was little we could do, I was late, but headed into work. My aunt left work early that day. We got in touch with Aunt Noelle later on that night. The rest was a blur.

What people did that day

It made sense that the phone lines were busy. The cell phone network was overloaded as most people called somebody they knew in NYC. Family, friends, colleagues, past nanny. Somebody.

And the interesting thing is, we did not just call people in NYC. We also called and spoke with others who didn’t live there. I spoke with my parents that night and they live in Vancouver, BC, Canada. We called my Aunt Lisa who lives in town. Where they resided was irrelevant. When we sense fear, and a terrorist attack would do that to us, we reach for connection with the people closest to us. We reach for them because they matter to us and they bring us comfort. If people we know are not around, we reach for strangers because any human connection is better than no human connection.

A culture of self-reliance

But, aren’t we an individualistic society? We’re often self-sufficient and capable and many of us go about our everyday lives with little help from others. Even if we have a need, we might hesitate to speak it. If we ask and don’t get a response, we might decide to do without the help. We pride ourselves in being independent.

Could it be that we need each other more than we’re willing to admit? Could it be that our desire for closeness and connection in times of threat speaks to that need?

Coming together

16 years ago, we sought comfort and connection from each other following one of the worse terrorist attacks in American history. Similar stories follow when we go through other crises: an increase in political unrests bans us together against the many “isms” in our society; the wake of Hurricane Harvey prompted Houston and nearby residents in rescue efforts using boats, stand up paddle boards, or just wading through chest deep water.

And it’s not over yet. Hurricanes Irma and Jose are happening as I type this. There will be many more natural and man-made disasters to come. But, we will have each other. Coming together and seeing the value in being with each other will help buffer us through the storms of life.


People Bloom Counseling Redmond Couples Cancer Ada Pang.png

Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. She can be reached at ada@peoplebloomcounseling.com.

When Depression & Anxiety Come with Cancer

pixelheadsphoto/stock.adobe.com

pixelheadsphoto/stock.adobe.com

Let's face it. It's enough to go through cancer diagnosis and treatment, let alone the emotional ups and downs that often come with it.

Questions that might trouble you

As a result of your cancer, sometimes you have questions about the past: "Did I do something wrong to cause this cancer? Could I have prevented it?" "What if I had __________________ before it got to be too stressful? Would that have made a difference?"

Other times you might have questions about the future: "My neck hurts. Is that cancer?" Will I be able to see my granddaughter graduate from 2nd grade?" "How will my family be without me?"

While it's normal to ask these questions, often times there really isn't a way to answer them. These questions might linger if you struggle with depression and anxiety. 

Depression and anxiety post cancer

What we know from cancer research is that depression and anxiety are common symptoms during and post cancer treatment. While depression might dissipate with time, anxiety lingers as you're reminded of your cancer everyday. 

Some of these symptoms might be treatment related, but could this be you? 

You might be struggling with depression if you experience the following: 

  • feeling down, depressed or hopeless
  • having little interests in things you used to enjoy
  • sleeping too much or too little or have trouble falling asleep or staying asleep
  • having low energy 
  • having little appetite or want to empty the fridge
  • feeling irritable 
  • experiencing mood swings 
  • having trouble concentrating 
  • withdrawing from friends and family 
  • feeling hopeless, guilty and/or angry
  • having thoughts about being better off dead or hurting yourself 

You might be struggling with anxiety if you experience the following: 

  • feeling nervous, anxious or on edge
  • feeling like you cannot stop or control your worries
  • finding yourself worrying too much about different things
  • having trouble relaxing
  • feeling restless and it's difficult to sit still
  • feeling easily annoyed or irritable 
  • anticipating worse case scenarios

Sometimes anxiety is felt in your body. You might be struggling with panic symptoms if you experience the following: 

  • pounding heart 
  • sweating 
  • trembling or shaking
  • shortness of breath 
  • feelings of choking
  • chest pain or discomfort
  • nausea or abdominal distress
  • dizziness/light headed
  • chills or heat sensations
  • muscle tension 
  • feel out of control 
  • fear of going crazy
  • fear of dying

Life after cancer

If you identify with these symptoms that go beyond an occasional sad day or feeling stressed out about something, there is hope! You don't have to settle and let cancer drag your down. Rather than cancer driving your life, you can make meaning choices in the face of cancer. That way, depression and anxiety symptoms, even when they arise, won't bother you as much. 

If you need help putting cancer in the passenger seat, I'll be here


People Bloom Counseling Redmond Ada Pang

Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples and cancer patients. That can also mean couples distressed by a partner’s cancer diagnosis, or couples wishing to use their marriage as a resource during their cancer journey. When she’s not thinking about couples and cancer, she is cognizant about choices that make for a meaningful life. This often involves food. 

Two Approaches to Dealing with your Fears

gretalarosa/stock.adobe.com

gretalarosa/stock.adobe.com

I was born a little skittish. I get startled easily when I see and hear something I don’t expect. I had to tell my husband early on in our marriage to make noises as he enters the room. Otherwise, I’d scream bloody murder, which would freak him out. Oh, and I don’t like scary movies. Husband got into a kick recently and watched the three original Alien movies while I was out-of-town. Good, cuz it ain’t happening when I’m home.

The thing is, we’re all wired a certain way, along the continuum of higher versus lower threshold for fear. It’s not a right or wrong, good or bad. It just is. But, what’s the point of fear? Is it even necessary? Ever wondered where fear came from?

The origin of fear

Too many million years ago during the age of saber-tooth tigers, wonderful men hunted and awesome women gathered. Whether they were out in the fields or back at the shelter, they had to be on hyper alert for wildlife. They were either going to have lunch or be lunch. With that hard-wired alert for danger, those who were careful and watchful procreated and lived on. Those who had a low radar for fear and lived a carefree life did not.

What does this mean for us in 2017?

Real threats

Though we’re no longer living amongst saber-tooth tigers, some threats in our lives are very real. It could be a life threatening illness, an accident, any other traumatic events or threats to our dignity as people. During these moments, our fears make sense and fit the facts of the situation. These threats ought to make us have the automatic reactions of fight, flight or freeze. When our fears are justified, we should take action to effect change where we can. This is for our survival and the survival of people we care deeply about.

Perceived threats

There are real threats and then there are perceived threats. Perceived threats are when you’re no longer in the car accident, in the abusive relationship, in the situation that made you feel so threatened and yet, you live as though you’re still in that life-threatening event. Or, your fears are not tied to something that has happened, but a fear that something might happen. You then avoid places, people and activities that might remind you of your fears, examples being you do less because you fear failing or embarrassing yourself in public. When checking the facts of the situation, you realize the probability of something bad happening is very low, or your fears may be unpleasant, but they’re not life-threatening. What are you to do?

Facing perceived threats one of two ways

When your fears are not justified, it is important that you learn to face your fears. I share two approaches here:

  1. Whatever you’re afraid of doing, do it over and over again.* Not kidding you. When there is little evidence for why you should be afraid of something that has occurred in the past or might occur in the future, the way to overcome that fear is to face it head on. Do the very things you want to avoid with consistency. Is it public speaking? Getting behind the steering wheel? Watching certain shows that might be triggering? Take baby steps to overcome your fears by approaching, rather than withdrawing. Overtime, you’ll feel more in control over your fears.
  2. Harry Potter shows us another way to face our fears during a boggart lesson:

We can have a different relationship with our fears.** Put in its original context, Ron’s afraid of spiders, Harry Dementors, and Professor Lupin a full moon. When they cast the spell Riddikulus and envision something humorous, the shape-shifting boggart assumes a comical form. Followed by outright laughter, they had the power to make the boggart disappear!

While we don’t have this power at our disposal during current times, Professor Lupin’s lesson is for all of us. Can we see our fears differently, and therefore, relate with them differently? What if a natural disaster turned into a ribbon twirling performance, social humiliation took the form of people high fiving you, and the car accident transformed into a scene from Fantasia?

Facing your fears together

Don’t let the fears of your fears hold you back! If you need help facing your fears or otherwise make them ridiculous, well, you know where to find me.

* Borrowed from Cognitive Behavioral Therapy and Dialectical Behavior Therapy
** Borrowed from Acceptance Commitment Therapy


Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She mostly helps unhappy couples and breast cancer patients. She also loves helping people address fears that hold them back in life. Her favorite Harry Potter films are the Order of the Phoenix and the Deathly Hallows: Part 2. Her worse fears are, well, she can identify with Ron. 

Chronic Worrier, Anybody?

Ryu K/stock.adobe.com

Ryu K/stock.adobe.com

No doubt, we all worry. What is that person going to think of me? Am I going to make this work deadline? What if it rains tomorrow and we need to take the party inside? When there's an actual threat of something going awry, worrying can be helpful because it motivates us into planning ahead and changing the things we can.

However, often times, worrying stems from a perception or a fear of things going wrong. It then becomes unhelpful when we're worrying for the sake of worrying, or when we think that worrying can somehow help us cope with life's problems. We get caught up in this endless loop.

Here are some ways to interrupt the cycle of chronic worrying:

  1. Identify your triggers – what gets you worrying in the first place? Then what thoughts and feelings did you have next? If you don't recognize the cycle, you can't stop it.

  2. Ask yourself, “Is there a problem to be solved?” – if you legitimately need to work a few extra hours to meet the deadline or come up with a plan B for the party, do it! If not, notice that your mind is playing the “worry tape” again.

  3. Drop the struggle - “Don't worry, be happy!” If this had worked, we wouldn't have 40 million people in the US struggling with some form of anxiety. Intentionally trying to stop thinking about something only makes you think about it more. Try it now. Don't think about a white polar bear. What happens? You think about a white polar bear. It's not about fighting with your thoughts, but letting them come and go.

  4. Notice your thoughts – is your mind feeding you worries that are “what if's,” unhelpful patterns that you can do little about? If so, acknowledge those thoughts again and again, but choose to not engage further. One way to do so, according to the tradition of Acceptance Commitment Therapy, is to say, “Thanks mind!” This may sound weird at first, but try it! You're re-training your mind and flexing that muscle differently, with time.

  5. Stay in the present – worrying takes you into the future that has not yet happened and that likely won't happen the way you envision it. Thus, when you find your mind drifting to the worries of the unknown future, bring your mind back to the here and now, over and over again. Come back to this moment, the only moment you have to live in and can do something about.

  6. Accept the unknown – you want things to happen a certain way: to arrive home accident-free, for the cake to not topple over, to win the project bid... Who doesn't? Yet, there are so many things you have little control over. Acknowledge that you are limited, still make plans, but hold them loosely. 

Here's an earlier post on what to do with runaway thoughts

Need more? Give me a call!

Reining in my Runaway Thoughts

ave_mario/stock.adobe.com

ave_mario/stock.adobe.com

What do I do with the 60,000 thoughts I have in a day?

Thoughts are poppin' up faster than I have time to type them. What am I having for lunch? Am I hungry? What's going on tomorrow? Where would I squeeze that in? What's the weather like outside? The job of the mind is the generate thoughts and I have A LOT of them! If I follow these string of words everywhere they lead me, I'd be all over the place!

As a psychotherapist with a developing mindfulness practice, I am continuously wrestling with the need to come back to the here and now, because my mind is everywhere but here.

Here are some habits I've picked up along the way to help bring me back to now... I'd touch and sniff most flowers that happen upon my path, or listen in on the crinkling sound of a leaf against my shoe. I'd be curious about the aroma of yummy goodness coming out of a Thai restaurant. I'd come back to noticing my breath, which I thankfully carry around unconsciously, all the time. I'd take a moment to observe what's happening outside of me and how that's affecting what's happening inside of me, and vice versa. All the while, I'd take note of my mind drifting off and invite my mind to come back to this moment that I don't want to miss. 

How do you come back to the present? I'd love to hear!