Those of us who are lucky enough to be able-bodied and perfectly capable of putting one foot in front of the other should be walking at least 30 minutes a day, 5 days a week. Why? Because walking brings enormous benefits for our health, both physically and mentally. ​This article from Fresh Daily Health details several ways in which walking can help us lead healthier lives. Benefits of regular walks include: Prevents muscle atrophy Improves blood circulation Builds muscle Builds stronger bones Lowers risk of several diseases such as heart conditions, cancer and diabetes Leads to weight loss Prevents dementia Boosts Vitamin D levels Increases energy levels Extends lifespan Boosts mental health On this last point, it is worth highlighting that walking can help reduce stress, ease anxiety, and combat that nagging desire to do nothing that comes with a clinically significant depression. So, if you can find a few breaks on your calendar daily, even if it is just 10 to 15 minutes two or three times a day, get out there and start putting one foot in front of the other! Your body will thank you.

Often times, it is hard to find the right therapist, at the right location, available on the right days, and at the right price. If you are having trouble finding someone with whom you can connect, keep looking. Ask your friends and medical providers for recommendation.  Search online directories for psychologists near you, such as those from Psychology Today . Look through membership listings at national or regional psychology associations such as the American Psychological Association . Or, if you know you want an evidence-based provider using cutting-edge technology, search for certified TEAM-CBT therapists on the Feeling Good Institute website.    While you go through your research, you want to pay attention to your mood and well-being. Here are some tips for self-care while you wait for your therapy to start: Self-Care “While You Wait” While you are waiting for individual counseling, you may want to implement these tips to try to alleviate some of your distress. (This is for informational purposes only, and is not intended to treat any conditions. These tips are not meant to be substitutes for mental or physical health counseling.)  Find activities that sooth and relax you. Relaxation improves the mind and helps the body recover from stress. Even 10 minutes a day would be helpful! Use deep breathing techniques--take a deep breath slowly and all the way down to your stomach, hold your breath for a few seconds, and slowly breath out by emptying your stomach of your breath. Tell yourself to “let go of any tension” as you breath out. Do this for at least 5 or 6 times in each sitting. Practice yoga, listen to some relaxation tapes, etc.  Do some kind of physical activity , even if you only have 10 minutes. Find a routine that creates a sweat and that fits your style (e.g., walk, swim, tennis). This will help with your stress, anxiety, and depression symptoms.  Keep a journal. Write down your thoughts and feelings in various situations. Note any patterns or questions you’d like to discuss in therapy.  Pay attention to your mind and body. Nourish your body with nutritious food. Skipping meals robs you of the energy to cope. Nurture your spirit. Pray, meditate, practice whatever that fits your spirituality. Sleep and rest when you are tired.  Laugh , especially at yourself and Take time to play. Spend time with those who make you laugh. Watch a comedy or read a funny book. There is evidence that smiling changes your emotions to pleasant and your thoughts to optimism.  Nurture a positive view of self. Catch yourself when you start to think negatively or are putting yourself down. Actively replace these negative thoughts with a positive view. Create a list of affirmations for yourself (e.g., I grow and change; I am open-minded, etc.). Even if you aren’t convinced, fake it until you make it!  Make connections. This will take time to develop. Create and maintain contact with a small group of people you can call on for emotional support. Take turns talking and listening. Isolating yourself can make things worse.  In addition, here is a brief list of resources where you can obtain guidance and assistance in a crisis situation:  National Suicide Prevention Hotline – 1-800-273-8255  Starvista crisis hotline (in San Mateo County) – 1-650-579-0350  Text hotline - Text “START” to 741741.  911 or your nearest emergency room

Dr. Aaron Beck was one of the pioneers in developing the theory and applications behind Cognitive Therapy for the treatment of clinical depression. In Dr. Beck's views, depression does not stem from a 'chemical imbalance in the brain." Instead, it stems from an imbalance in our way of thinking . When someone is depressed, there are usually three common themes to the content of their thoughts: Negative View of Self : "I suck..." Negative View of the World : "The world sucks..." Negative View of the Future : "And it is never going to get better!" He called these ways of thinking the "depressive triad." Depressed individuals often feel a loss of interest in things that were previously pleasurable or important to them and function at lower levels compared to their former selves. They can also experience noticeable changes in levels of energy, appetite, sleep, and ability to concentrate, while having thoughts of low self-worth, guilt, and, in more extreme cases, suicide.  Here is a full list of symptoms of depression as defined by the American Psychiatric Association..  In Cognitive Therapy, client and therapist will partner up to identify common thought patterns for the client that relate to their depression. They can then analyze those patterns together, with openness and curiosity, to see what is 'off' about them. With close collaboration and powerful therapeutic techniques such as those in TEAM-CBT, the "depressive triad" can be annihilated.

My colleague, Dr. Leah Weiss, from the Stanford Graduate School of Business, published this thought-provoking article in the Harvard Business Review. In it, Leah discusses how all of us frequently go through a work day without actually noticing where the time goes or how precisely we are spending our time. That can lead to dissatisfaction at work, driven by inefficiency, disengagement, and potentially health problems. The antidote, as you can imagine, is to add both a sense of purpose and mindful action to our days. It is obviously not easy to do at all times, but it is possible with some deliberate intention. Here are her suggestions to work mindfully:  Act on purpose - focus on how your personal goals connect with the goals of the organization in which you are inserted; Map a plan - understand which tasks, and in what order, will get you closer to your finish line; Avoid distractions - don't fall into the trap of the "mindless accept syndrome." Name your distractions, remember your goals, and gauge where each request for your time falls.

The picture below, from the fantastic website Psychology Tools , shows what happens in our body when our brains perceive a possible threat: Just like our ancestors used to do when living in caves tens of thousands of years ago, whenever we think there is a threat coming our way (e.g. "there comes a sabre-toothed tiger!"), we prepare to fight it or quickly run away from it. Our bodies, being the well-oiled machines that they are, immediately go into survival mode and get ready to deal with the threat by activating an internal "alarm system". In simple terms, this system is called the fight or flight response. Once our brain identifies a possible danger, stress hormones such as cortisol and adrenaline are released by the adrenal glands. I response, muscles tense up, particularly the larger ones, to prepare for a possible battle or long run. The heart starts beating faster, pumping more blood around the body, which elevates its temperature.  The rise in temperature triggers sweating to cool the body down. As blood vessels in the skin contract to force blood towards those all-important major muscle groups, areas such as palms and feet become both cold and sweaty. As breathing becomes faster and shallower to take in more oxygen, we may feel a bit dizzy or lightheaded if the excess oxygen is not being used right away. Thoughts also start racing to keep up with the changes in the environment. As digestive and elimination systems are not vital, they receive less blood and we might feel nausea, butterflies in the stomach, along with urges to use the bathroom. All of these reactions get us ready to deal with that tiger. And in those situations, they are indeed indispensable, life saving. Indeed, if we go back many millennia, we are all descendants of the prehistoric men and women with the best "alarm systems - those that did not get eaten by the tigers! However, nowadays, there aren't many saber-toothed tigers walking around. The perceived threats come from our financial troubles, fear of rejection, loneliness, arguments with a spouse, concerns about a job, memories of a traumatic event, self-doubt, regrets, and many, many other ideas that we ourselves label as dangerous. In those instances, the fight 0r flight response is unnecessary. Worse, it can interfere with just being able to live a fulfilling life. If that is happening to you, talk to a therapist. You can learn to fine tune your fight or flight response so that it works for you, not against you!

If you are dealing with many stressors in your life and feeling overwhelmed from time to time, you may have come across a suggestion to start a 'mindfulness' practice. First of all, what is mindfulness? It is a concept describing a state where we pay full attention to the present moment. We don't obsess about the past, we don't worry about the future, we are just focused on the present, in the here and now.  Even further, we try to clear our mind of thoughts and activity for stretches of time when we can just 'be' rather than 'do.' We observe our internal experiences without judging them or trying to change them. Many people achieve this state of mindfulness through meditation. As I've mentioned in prior posts, there are many confirmed benefits of regular meditation or mindfulness practice. If you want to start a mindfulness practice yourself, here are a few pointers : Find a quiet space where you won’t be distracted. S it down however you want, as long as it’s comfortable (but don’t get too comfortable and fall asleep!).  Set a time goal on your watch or phone so you don't have to worry about checking the time as you go. You can begin with  three or five minutes at first and then gradually go longer if you wish. If don't, that's ok too: any amount of time spent meditating will still have a positive impact. Close your eyes and direct your full attention to your breath. Notice sensations tied to it and the air goes in and out of your body. If your mind wanders, just come back to your breath. Observe your thoughts, feelings, and any sensations without doing anything about it. Observe your thoughts like leaves floating down a stream. No matter where your mind goes, just notice it and come back to your breath and the present moment.  The more you practice the easier it will get. Just notice your sensations, come back to your breath, and enjoy!  And if you don't want to do all of this on your own, I recommend checking out the Google Play or App Store for popular apps such as  Insight Timer ,  Breathe , and  Headspace .

When I worked in Marketing early in my career, one of my PR colleagues used to say "if 4 out of 5 dentists recommend Crest toothpaste, the only one that has something interesting to say is #5!". I often think about that as I am drawn to better understand dissenting views on any given topic. Interpersonal relations and couple's therapy is a complex topic where there are some majority opinions and a few interesting ones that go against the grain. Dr. David Burns, one of the pioneers of cognitive behavioral therapy and mastermind of the T.E.A.M. approach to CBT - and my personal mentor and hero! - has some radically different ideas of why we all have some troubled relationships in our life.   In one of his podcasts, Dr. Burns discusses the prevailing views of why people in close relationships may not get along. Those include theories addressing i) lack of skills, ii) barriers, and iii) self-esteem. In the first one, authors postulate that we all want loving relationships, we just need to learn better communication skills such as assertiveness or non-violent communication to get there. The barriers theory posits that there are just innate barriers to intimacy such as childhood trauma or different cognitive processing approaches between men and women. Finally, the self-esteem angle demands that you love yourself first, before you can love someone else. All of these approaches make sense and have some validity behind them. But they don't tell the full story. The missing link is "motivation."  Sometimes, we have the skills and the self-esteem and there are no great barriers, but we still don't want to get close to the other person...until they change first! The reality is, if they were looking to change, they probably would already have. If we are the ones looking for a new dynamic in an old relationship, it is up to us to take the first step to change the existing patterns of interaction. We can do that by providing empathy, using assertiveness, and demonstrating respect regardless of how the other person is behaving. How to do that? Dr. Burns has a great book on the topic called " Felling Good Together ." I recommend starting by reading the book. And if you still think you can benefit from professional help, find a therapist who can help you increase your motivation and put all of those skills and self-esteem to good use!

Psychiatric conditions are classified in accordance with a manual published by the American Psychiatric Association call the “Diagnostic and Statistical Manual of Mental Disorders.” This thick tome is in its fifth edition, so it is currently referred to as the DSM-5 . There is a section in the DSM dedicated exclusively to Anxiety Disorders, and among them we’ll find Generalized Anxiety Disorder (GAD). In clinical terms, GAD is characterized by excessive anxiety and worry about several domains of life that last for at least six months and is clearly excessive. That is accompanied by physical symptoms such as fatigue, difficulty concentrating, restlessness, muscle pain, difficulty sleeping or irritability. Together, these symptoms make life more difficult to live and enjoy. In everyday terms, GAD is that nagging, annoying, and relentless nasty voice in your head reminding you of everything that can possibly go wrong if you stop trying to control it. It’s exhausting - and no fun. In the US, GAD affects approximately 8 in every 100 adults in their lifetime. Single (unmarried or previously married) females under 60 appear to be diagnosed with GAD more frequently than other demographic groups. That said, GAD affects all ages, genders, and socioeconomic strata, with 25% of all cases onsetting by age 25, 50% by age 39, and 75% by 53 years. Unfortunately, GAD is often recurrent and presenting with other mental health issues such as depression. Interestingly, data from around the world shows us that GAD is more prevalent in high-income, industrialized countries than in developing ones. For example, while the 8% lifetime prevalence applies to the US, Australia and New Zealand, that figure is close to 1% for the population of Nigeria, While we don’t know exactly why that happens, one interesting hypothesis articulated in a large global study is that “individual differences in the propensity to worry may be more evident under conditions of relative wealth and stability, such as those found in high-income countries, than under conditions of relative scarcity and instability, where worry may be expected and widespread.” Despite its high prevalence, GAD is often untreated. Research shows that less than 50% of individuals affected by GAD at the time of the survey had sought mental health treatment in the previous 12 months. That’s too bad, because psychotherapy, and particularly Cognitive Behavioral Therapy (CBT), have been proven effective to treat GAD, with no side effects! If you want to determine if you have GAD and whether CBT may help, talk to a therapist.

Anger is a natural and often healthy emotion, but when it spirals out of control, it can lead to negative consequences in both our personal and professional lives. The good news is that there are various psychological interventions to manage anger, and one surprisingly effective tool is...humor. Humor, an universal language that brings people together, can help us gain perspective, reduce tension, and improve overall well-being. Here's how incorporating humor into psychological interventions can make a positive difference in managing anger. 1. Stress Reduction : Laughter triggers the release of endorphins, the body's natural feel-good chemicals, which can alleviate stress and anxiety. In moments of anger, incorporating humor can help you shift your focus from the source of your anger to something more positive, allowing you to better manage the situation. 2. Perspective Shift: Humor helps us see situations from different angles. When you can find the humor in a challenging situation, it can be easier to reframe your perspective and view the issue as less threatening. This can lead to a more rational and less impulsive response. 3. Communication Improvement : Anger often leads to ineffective communication, making it difficult to resolve conflicts. Humor can act as an icebreaker, easing tension and facilitating more open and constructive conversations. It can also make you more approachable, which encourages others to communicate with you. 4. Emotional Regulation : Humor can be a valuable tool for emotional regulation. When you're able to find humor in frustrating or infuriating situations, you can regain emotional control and make more level-headed decisions. 5. Self-Reflection : By using humor to reflect on your own actions and reactions, you can identify patterns in your behavior and take steps to address them. This self-awareness is a crucial component of anger management. It's important to note that the goal is not to make light of serious issues or dismiss valid concerns. Instead, the aim is to incorporate humor as a coping mechanism to diffuse anger and reduce its negative impact on your mental and physical health.  Humor can break the cycle of distress and promote healthier responses to challenging situations. Yet, humor can only get us so far in neutralizing the anger. The better alternative, if it is available, would be to avoid moments of excessive anger.  That can be done if we understand what is triggering the anger in the first place. That is surprisingly easy to do with good CBT strategies. We look at the situation, the thoughts, emotions, and actions in that particular moment. We figure out what is valid and what can be changed in our thoughts and behaviors. We use targeted techniques and methods to impart that change. We feel different.

Self-care is "in." At work, with friends, and even at home, we often hear about and proclaim the benefits of self-care. Popular self-care ideas range from a hot bath or a manicure to a fancy spa treatment or a vacation in Hawaii. All of those activities are useful and effective ways to take a break or disconnect from everyday life.  However, if you catch yourself yearning for that break all the time, that may be a sign that the life you've built is not the life you need. If you need to escape from reality at regular intervals, your reality may be misaligned with your values. In this thought-provoking article , author Brianna Wiest advocates for taking care of yourself every day, not by pampering and withdrawing from your routine but by including healthy and responsible choices in it. "If you find yourself having to regularly indulge in consumer self-care, it’s because you are disconnected from actual self-care, which has very little to do with “treating yourself” and a whole lot do with parenting yourself and making choices for your long-term wellness." If you're looking to take better care of yourself, start by taking inventory of the values that matter to you and then assessing how well your life is aligned against them. If you need support going through that analysis, find a good therapist who can serve as a sounding board.

Dr. Kristi Neff is one of the pioneers in the study of self-compassion as a tool for psychological wellbeing. There are many definitions of self-compassion out there, but hers hinges on three tenets: 1) Self-kindness vs. judgment Self-compassion involves being kind and understanding to ourselves, just as we would be to a friend or loved one. It means treating ourselves with the same compassion we would treat others when we are going through a difficult time. 2) Common humanity Self-compassion is not about being selfish or self-indulgent. It is about recognizing that we are all human beings who make mistakes, and that we all experience pain and suffering. When we are self-compassionate, we are able to accept ourselves with all of our flaws and imperfections. We are also able to be more understanding of our own limitations and to forgive ourselves for our mistakes. 3) Mindfulness   Mindfulness is the basic human ability to be fully present, aware of where we are and what we're doing, and not overly reactive or overwhelmed by what's going on around us. It entails paying attention to the present moment without judgment. When we are mindful, we observe thoughts and feelings from a distance, without getting caught up in them. This allows us to be aware of our thoughts and feelings while making choices about how to respond to them, without exaggerating or suppressing them. There are many benefits to self-compassion. Studies have shown that self-compassion can lead to: Improved mental and physical health Reduced stress and anxiety Increased resilience Improved self-esteem Increased happiness and well-being There are equally many ways to cultivate self-compassion. You can start by being  kind and accepting to yourself, practicing mindfulness and loving-kindness meditations, spending time with people who are supportive and kind, and engaging in activities that help you feel good about yourself.  You can also practice self-compassion through guided audio exercises such as this one: Self-compassion is a skill that takes time and practice to develop. But it is a skill that is well worth the effort. When we are self-compassionate, we are able to live happier, healthier, and more fulfilling lives.

As we go through our busy days, we are asked to form spur-of-the-moment opinions about the events around us. Someone says hi? [They want something from me!] Someone fails to say hi? [I have done something to offend them!] Car doesn't start? [This always happens to me!] Late for work? [The world is conspiring against me!]. We all have these scripts inside our heads that help us evaluate things that happen in our lives quickly and efficiently. Unfortunately, not always accurately.  In the process of coming up with these quick appraisals of events happening in our lives, we often take 'shortcuts' that we hope make the evaluation process quicker. It might. But the shortcuts often take us in directions that are not helpful. In cognitive psychology, we have grouped these unhelpful shortcuts in categories with labels that describe each one of them. They are called Cognitive Distortions . Dr. David Burns describes them as follows: 1. All-or-nothing thinking  (also known as 'black and white thinking'): You look at things in absolute, black-and-white categories, e.g. "I never do anything right!" (seriously, never ever??) 2. Overgeneralization : You view a negative event as a never-ending pattern of defeat, e.g. "I can't make anyone happy" (when you have a fight with your boyfriend, without remembering how much you mean to your best friend!) 3. Mental filter:  You dwell on the  negatives  and ignore the positives, e.g. "I am really bad at sports" (you lose a soccer game, and forget how good you are at indoor cycling). 4. Discounting the positives:  You insist that your accomplishments or positive qualities don’t count, e.g. "My good grade in this test was a stroke of luck" (after studying two days for it!).   5. Jumping to conclusions : You jump to conclusions not warranted by facts. These include mind-reading (assuming that people are reacting negatively to you) and fortune-telling (predicting that things will turn out badly), e.g. "She doesn't like me" or "I know I will not get this job." 6. Magnification or minimization:  You blow things way out of proportion or you shrink their importance, e.g., "This is the only important interview I will ever have."  7. Emotional reasoning:  You reason from how you feel: “I feel like an idiot, so I must be one.” 8. “Should” statements : You criticize yourself or other people with “shoulds,” “shouldn’ts,” “musts,” “oughts,” and “have-tos,” e.g., "my life should be way more exciting!" 9. Labeling: You give yourself a label on the forehead. E.g., instead of saying, “I made a mistake,” you tell yourself, “I’m a jerk” or “I’m a loser.” 10. Blame:  You blame yourself for something you weren’t entirely responsible for, or you blame other people and overlook ways that you contributed to a problem, e.g., "I am a bad teacher" (when you forget how difficult your students are...) or "They are bad students" (when you fail to analyze your teaching skills beforehand). We all make these thinking errors on a daily basis. At times, they can go unnoticed. More often, they will lead to feelings of sadness, anger, hopelessness, anxiety and more. The good news is that, with practice, it is easy to identify these distortions and learn how to fix them. Cognitive therapy is just the answer if you are looking to learn more about your thought patterns and how to change them.