The Opioid Crisis in the USA was to be this topic, however, I wanted to continue with Self-Care and Mindfulness today.

(En Inglés y Español–desplazarse hacia abajo para español)

When one practices the breathing techniques listed in Topic #3, combined with sitting or standing still and “savoring” being in the moment, stress is reduced and Cortisol decreases. There are many of us who continue to struggle with finding ways to be in the moment, to appreciate the present, which is a Present. Often we will worry about tomorrow, what will happen next, or be caught up in the daily “to do” lists and lose sight of the here and now.

Take a moment each day to practice this each technique of breathing and taking stock of what is and what is not wholesome (aka, helpful to well-being). FYI: these tips have been shown to increase ones ability for empathy–both toward the self and others. The parts of the Cortex are actually enhanced and can be seen to improve function via MRI and CT scans. In other words, this is great stuff and this exercise can begin this process.

So stand of sit comfortably and begin breathing. Eyes open or shut, taking breaths in through your nose and inhaling deep into your belly (not up into your shoulders). After 10 breaths, repeat this phrase: “No feeling is permanent, all fade with time.” This allows us to realize that any emotion, be it happy or anxious or angry, is passing—-which then leads to being mindful that whatever comes our way is something we can observe, be less reactive, and can handle without avoiding the feeling(s) and making them larger.

I think this link helps demonstrate the goal sought:  Look up “The Fly Meditation” on YouTube.

Tema #5, Continuación del ser consciente

La Crisis Opioid en USA era el tema pero quiero continuar con el auto cuidado y el ser consciente el día de hoy.
Cuando uno practica las técnicas de respiración mencionadas en el tema #3, combinadas con sentarse o pararse y “saborear” estando en el momento, el estrés se reduce y el Cortisol disminuye. Hay muchos de nosotros que le batallamos al encontrar maneras de estar en el momento, de apreciar el presente, que es un Presente. Seguido nos preocupamos por el mañana y que pasara después o nos sumergimos en la lista diaria por hacer y perdemos el sentido del hoy y el ahora.

Tomate un momento cada día para practicar esta técnica de respiración y de hacer un análisis de que no te hace bien. Para tu información: estos tips han mostrado incrementar la habilidad de empatía hacia uno y hacia otros. Las partes del Córtex son actualmente embellecidas y muestran mejoría a través de una resonancia o tomografía. En otras palabras, son cosas maravillosas y este ejercicio puede empezar este proceso.

Entonces siéntate erguido confortablemente y empieza a respirar. Tus ojos abiertos o cerrados, empieza a respirar por tu nariz y exhalar profundo hacia tu estomago (no levantes los hombros). Después de respirar 10 veces, repite esta frase: “Ningún sentimiento es permanente, todo se desvanece con el tiempo.” Esto nos permite darnos cuenta que cualquier emoción, ya sea felicidad, coraje o ansiedad es pasajera y que nos puede llevar a ser darnos cuenta que lo que venga es algo que podemos observar, tener menos reacciones y controlar sin evitar los sentimientos y hacerlos más grandes.

Creo que este link ayuda a demostrar el objetivo en mente:

ABRAZOS!

Consider adding in these options into your diet to help move toward Mindfulness and Well-Being (En Inglés y Español–desplazarse hacia abajo para español):

There are some robust studies that suggest adding in these options into your dietary habits can be helpful.  Moreover, many of my patients and friends have reported that the tonic listed below has been helpful in increasing energy.  So consider trying it out for a couple of weeks and see how you feel.  Of course, be mindful of any medications that may negatively interact with these suggestions—consult your Primary Care Doctor if you have any questions.

1) You read last week, an ounce of dark chocolate (60%) or higher each day has shown a decrease in depressive symptoms.  So enjoy!  I am eating an ounce as I type this.

2)    Add cruciferous vegetables into your diet.  There is data to support that eating 3 to 4 servings a week helps to decrease your chances of developing cancers, and they are great for your latter part of digestion!  Get your kids to start eating them early on—broccoli is a great place to start.  Cruciferous veggies include:  broccoli, Brussel sprouts, cabbage, broccoli, cauliflower, kale, and bok choy. Some have shown the ability to stop the growth of cancer cells for tumors in the breast, uterine lining (endometrium), lung, colon, liver, and cervix, according to the American Institute for Cancer Research. Through different mechanisms, two other compounds found in cruciferous vegetables — indole 3-carbinol and crambene — are also suspected of activating detoxification enzymes. EAT UP!!!

3)    Try this tonic daily and see what it does for your energy levels and liver functions.  The ingredients are common in most of our cabinets.  I tend to drink it in the evenings before bed but some patients and friends report doing so in the morning is better for them.  Add the following into a heated cup of water and enjoy:  lemon or lime juice (tablespoon), apple cider vinegar (tablespoon), pure honey (teaspoon),
turmeric (pinch), cinnamon, (pinch), cayenne pepper (pinch), rosemary (pinch).

Remember, the road to self-care and Mindfulness starts with small steps.  Let’s work to get our stress number below 4 and implement the suggestions provided from Topics 1 -4.

Next Topic:  The Opioid Crisis in the USA.   Again, should you find these postings helpful, please feel free to share them!  Dr. Steven Atkins.

ema #4, Considera agregar estas opciones en tu dieta para que te ayude a ser más consciente y con más bienestar.
Hay más estudios profundos que sugieren agregar estas opciones a tu dieta habitual que te pueden ayudar. Más aun, mucho de mis pacientes y amigos han reportado que la lista tónica enlista a continuación les ha ayudado a incrementar su energía. Entonces intenta probarlo hacerlo por unas semanas y ve cómo te sientes. Claro, se consciente de cualquier medicamente que pueda interactuar negativamente con estas sugerencias, consulta tu medico de cabecera si tienes alguna duda.
1) Al leer el tema de la semana pasada, una onza de chocolate oscuro (60%) o más cada día ha demostrado reducir los síntomas depresivos. Entonces disfruta! Yo estoy comiendo una once mientras escribo esto.

2) Agregar vegetales crucíferos en tu dieta. Hay unos datos que apoyan que el comer de 3 a 4 porciones a la semana ayuda a reducir las oportunidades de desarollar canceres y son grandiosos para la parte de la digestión! Haz que tus hijos los coman desde una edad temprana, pueden empezar con brócoli. Los vegetales cruciferos son los siguientes: brócoli, Bruselas, col, coliflor y lechuga. De acuerdo a una investigación del American Institute for Cancer Research algunos han mostrado que tienen la habilidad de detener el crecimiento de células cancerígenas en tumores de seno, útero, pulmón, colon, hígado y cérvix. A través de mecanismos diferentes, otros dos compuestos se encuentran en vegetales cruciferes—indolo 3-carbinol y crambeno—que se sospecha que activan la desintoxicación de enzimas. Empieza a comerlos!

3) Intenta este tónico diario y ve que hace con tus niveles de energía y funciones de hígado. Los ingredientes son comunices y están en la mayoría de nuestra alacenas. Yo suelo tomarlo en las tardes antes de ir a dormir pero algunos pacientes y amigos reportan hacerlo en la mañana y es mejor para ellos. Agrega lo siguiente a un vaso con agua tibia y disfruta: una cucharada de limón (verde o amarillo), una cucharada de vinagre de manzana, una cucharada de miel, una pizca de cúrcuma, una pizca de canela, una pizca de pimienta de cayena y una pizca de romero.

Recuerda, el camino para el auto-cuidado y el ser consciente empieza con un pequeño paso. Vamos a trabajar para bajar nuestro estrés a un número más bajo que 4 e implementar las sugerencias proveídas de los temas.

4. Proximo tema: La Crisis Opioid en USA. Otra vez, si encuentras los temas interesantes por favor comparte! Dr. Steven Atkins.

(En Inglés y Español–desplazarse hacia abajo para español)

So, we are hoping to learn how to reduce out Stress level to around a 4. Last posting noted that many of us are reporting being in the 7-10 range. Way too high!!

So here are some proven steps for us all to remember and be more MINDFUL of to enhance our sense of well-being and to pass along to others to spread the word:

1) We are animals. Literally. Yet how many of us actually take the time to reconnect with the out-of-doors? Walking barefoot on the ground/grass/beach actually reduces stress levels and Cortisol in out blood streams. Cortisol is a chemical that wreaks havoc on out organs, blood pressure, brains. So take some time every day to reconnect with the wilderness, or the back yard. Watch the birds, hike through the woods, listen to the stream nearby. You will feel the difference!

2) Sleep hygiene: yes, hygiene. We all watch how often we brush our teeth (dental hygiene) but how well do we monitor our sleep patterns? 7 – 9 hours a night is focal and can reduce stress levels. Stay away from blue lights (TV, phones, computers, etc.) 30 minutes before bed to allow the naturally occurring chemical Melatonin to start seeping into your brains. Sleep hygiene is focal to helping reduce stress levels!

3) “When in doubt, spread it out.” I say this when lecturing to mental health professionals about Ethics. Should you have a difficult patient/clinical issue—-seek consultation. This applies when you are stressed. Do not go it alone. Hopefully by the mid 20s each of us has 2 solid and trustworthy friends with whom we can “spread it out”—share your worries and stressors. The act of connecting with another is focal to a stronger sense of well-being. Again, we are animals—social ones. “Lean on me” is one of my FAVORITE songs—its message is salient and true.

4) Exercise, yes get our butts off the couch. On the days I do not feel like going to the gym—-those are the days I make a personal agreement to “just got for 15 minutes.” It works. Exercise when tired (aka a symptom of stress) actually re-invigorates the soul. Take a walk each day (maybe barefoot—see #1) and make sure you get at least 15 – 20 minutes of exercise a day.

5) BREATHE. VERY IMPORTANT. Did you know that many of us do not know how to breathe properly? Do you find yourself awning often? How about sighing often? These can be signs that you are not breathing properly. Watch others when they are stressed and you will see them breathe up—as in, their shoulders will rise. THIS IS BAD. VERY BAD. I know we have all been told we need rock hard stomachs, but we need to learn to breathe into our stomachs—-as in have them look like they are pooching out. Try this now: place your hands on your stomachs and focus on taking 10 deep breaths in while your stomach protrudes out. DO NOT BREATHE UP AND HAVE YOUR SHOULDERS RISE. Exhale slowly, like a balloon that is slowly leaking. Do this 10 times and watch how you feel. It’s nice isn’t it? Practice breathing properly 5 times a day. (BTW, exercise —the cardio type allows for proper breathing). Breathing is the best gift you will give yourself. It reduces stress, cortisol, etc.

6) Eat chocolate! Seriously. BUT it needs to be 60% or higher of dark chocolate— 1 ozs. a day. There are studies out there that has shown doing this can be as effective at taking an antidepressant. Remember, 60% or higher of dark chocolate.

7) Unplug. I know this sounds antithetical given that you are reading this while being plugged in. However, we are social animals and need to connect, face-to-face. (See #3.)

8) Practice SAVORING. It is a Buddhist practice and I find it wonderful for the soul. It is another step toward becoming Mindful. Watch the daily progression of a flowering plant as it flowers. I have several in my yard that I try to watch grow. Currently, there is this out-of-this-world looking fern that is sprouting from the dirt. It grows slowly each day and I practice Savoring it—watching its progress and noticing its changes. Doing exercises like savoring helps to gets us out of our heads—away from our worries, and when you add in being outside, barefoot and breathing—-HELLO! CAN YOU SAY CALMING?

I hope this short list helps to achieve a stress level lower than 4. Next posting will be concrete advice on what to eat, drink and avoid to mange better self-care.

If you find these postings helpful, please feel free to share! Dr. Steven Atkins

ema #3 AUTO AYUDA Esperamos aprender cómo reducir el nivel de estrés a un 4. En el post anterior se comentó que muchos de nosotros estamos en el rango de 7-10. Es demasiado alto!! Aquí tenemos unos pasos para que nos acordemos y seamos más CONCIENTES de mejorar nuestros sentido de bienestar y de compartir con los demás y que pasen la voz de que:

1) Somos animales. Literalmente. Aunque cuantos de nosotros nos tomamos el tiempo de reconectarnos con la naturaleza? Caminar descalzo en el piso/pasto/playa lo cual reducen los niveles de estrés y Cortisol en nuestro flujo sanguíneo. Cortisol es un químico que causa destrucción en nuestros órganos, presión sanguínea y cerebro. Por esto tomate tiempo diariamente para reconectar con la naturaleza o incluso tu jardín. Observa los pájaros, camina en el bosque, escucha el rio cercano. Sentirás una diferencia!

2) Higiene del sueño: si, higiene. Todos nos damos cuenta que tan seguido nos cepillamos los dientes (higiene dental) pero que tan bien monitoreamos nuestros patrones de sueño? 7-9 horas durante la noche es primordial y puede reducir los niveles de estrés. Mantente alejado de luces azules (televisión, teléfonos, computadoras, etc.) Deja que la Melatonina, el químico natural que produce el sueño, haga su labor. Higiene del sueño es importante para reducir los niveles de estrés!

3) “Cuando tengas duda, pregunta.” Yo digo esto cuando doy discursos de ética a los profesionistas de salud mental. Si tienes un paciente difícil/con un problema clínico—busca ayuda. Esto aplica cuando estas estresado. Busca ayuda. Se espera que para cuando cumplimos veinte y cinco años cada uno de nosotros tengamos 2 amigos en quien podamos confiar y a quien podamos “preguntar”—comparte tus preocupaciones y motivos de estrés. El acto de conectar con otros es importante para tener un mejor bienestar. Otra vez, somos animales y sociables. “Lean on Me” es una de mis canciones FAVORITAS—su mensaje es claro y verdadero.

4) Ejercicio, si párate del sillón. Los días que no quiero ir al gimnasio, esos son los días que hago un acuerdo conmigo mismo de ir “solo 15 minutos”. Funciona. Ejercítate cuando estés cansado (también se conoce como un síntoma de estrés) y regenera el alma. Camina diario (talvez descalzo—ve #1) y asegúrate de que por lo menos hagas ejercicio de 15-20 minutos al día.

5) RESPIRA. ES MUY IMPORTANTE. Sabías que muchos de nosotros no sabemos respirar adecuadamente? Te encuentras bostezando frecuentemente? Y suspirando? Estos pueden ser señales de que no estas respirando bien. Observa a otros cuando están estresados y veras que respiran profundo, en otras palabras sus hombros se levantaran. ESTO ES MALO. MUY MALO. Yo sé que a todos nos han dicho que necesitamos un abdomen fuerte, pero necesitamos aprender a respirar con nuestro abdomen, en otras palabras que parezca un bulto. Intenta esto: pon tus manos en tu abdomen y enfócate en respirar profundo 10 veces mientras tu abdomen sobre sale. NO RESPIRES HACIA ARRIBA Y TAMPOCO LEVANTES TUS HOMBROS. Exhala lentamente, como un globo que lentamente se desinfla. Has esto 10 veces y observa cómo te sientes. Apoco no es agradable? Practica respirando adecuadamente 5 veces al día. (Por cierto, al hacer ejercicio cardiovascular permite hacer una respiración adecuada). Respirar es el mejor regalo que te puedes dar a ti mismo. Reduce el estrés y el cortisol, etc.

6) Come chocolate! De verdad. PERO debe de ser 60% o más del chocolate oscuro, 1 oz. por día. Hay estudios que dicen que el hacer esto puede ser tan efectivo como tomar antidepresivos. Recuerda, 60% o más que sea chocolate oscuro.

7) Desconéctate. Sé que esto suena contradictorio dado a que estás leyendo esto mientras te estas sumergiendo. Pero, somos animales sociales y necesitamos conectar, cara a cara (ve #3). 8) Practica SAVOREAR. Es una práctica Budista y lo encuentro maravilloso para el alma. Es otro paso para convertirte consiente. Ve el progreso diariamente de una flor mientras está en proceso de florecer. Tengo varias en mi jardín que trato de observar mientras crecen. Actualmente hay un helecho fuera de este mundo que está saliendo de la tierra. Crece lentamente todos los días y practico el saborear cada momento, verlo progresar y notar sus cambios. Hacer estos ejercicios como el saborear, ayuda a salirnos de nuestras cabezas, lejos de nuestras preocupaciones y cuando le agregas el salir descalzo y respirar….BUENO! ASI O MAS TRANQUILIDAD?

Espero que esta lista corta te ayude a lograr un nivel de estrés menos de 4. El próximo post va a ser un sugerencia concreta de que comer, tomar y evitar para lograr un mejor autocuidado. Si estos post son de ayuda, siéntete con la libertad de compartir! Dr. Steven Atkins.

Are you feeling tired all the time or feeling as if your energy levels are always running low? Take a moment to do this exercise in private before reading any further and see just how “normal” you are compared to recent research done by the APA. Write down in descending order the top 5 things that you feel are making you worry or that are the most stressful issues in your life. The first issue or thing on your list should be the most worrisome and the 5th thing will be your least worrisome stressor. I will provide you with the most-up-to-date information so you can compare your list. So take a moment and then continue reading.

Ahh, now, no peaking!! This exercise is not a test and is not meant to stress you out—it is an exercise to begin the process of becoming more mindful and increasing self-care. Stop reading and write down your top 5 in rank order…….NO ONE NEEDS TO KNOW WHAT YOU WRITE DOWN BUT YOU.

Important findings from the APA (March, 2016):

• Certain populations consistently struggle with stress more than others, such as Hispanic adults, who report the highest stress levels on average. Younger generations, women, adults with disabilities, and adults who are lesbian, gay, bisexual or transgender also report higher average stress levels and are more likely than their counterparts to say that their stress has increased since last year.
  But wait, there is more:
• While average reported stress levels in the United States have increased slightly in the past two years (5.1 in 2015 and 4.9 in 2014 on a 10-point scale, where 1 is “little or no stress” and 10 is “a great deal of stress”).
• Adults are more likely than in past years to report experiencing extreme stress (a rating of 8, 9, or 10 on a 10-point scale). VERY CONCERNING

24% of adults report these levels, compared with 18 % in 2014. Prior to 2014 the reported stress level was at an average of 3.6 out of a 10 point scale.

Results suggest that there are significant disparities in the experience of stress itself, and that stress also may be associated with other health disparities.

The nearly one-quarter (23 %) of adults who report that their health is only “fair” or “poor” have a higher reported stress level on average than those who rate their health as “very good” or “excellent.”

SO here is the listing with #1 being the most worrisome for Americans:

Since 2007 -2015:

1. (2015) MONEY % 67% of Americans have listed this as the #1 stressor
2. (2015) has been WORK @ 65%

   HOWEVER there has been a change for the next 3 in 2015: This year, for the first time

3. FAMILY RESPONSIBILITIES @ 54%
4. PERSONAL HEALTH PROBLEMS 51%
5. HEALTH PROBLEM AFFECTING THEIR FAMILY @ 50%
6. THE ECONOMY @ 50% (so a tie here)

Now look back at your list and you will likely find that it is very similar to one I just provided via the APA, 2016.

It is important to note and for us all to understand that the goal in life is not to have any stress present. In fact, a little amount is a good thing as it increases productivity, zeal to improve, creativity, etc. However, if you feel that your list of 5 stressors puts you above the 3.6 number of current stress, then there are ways to better deal with and reduce your number.

How do you establish your current number? Well, look at your top 5 stressors and then think of a number from 1 to 10, with 10 being extremely stressed over your list of 5. What did you honestly give yourself? Remember, no one will know what you rate for your personal level.

So how do we learn to manage stressors and routinely monitor where we are on the 1 – 10 scale? The first step is learning how to be Mindful. Congratulations, because making your list of top 5 stressors and then giving yourself a score from 1 – 10 is the first step towards becoming Mindful. Studies on Mindfulness are yielding impressive positive behavioral health (mental health) and health outcomes.

Last week’s posting on the increase in completed suicides ties into the need for us all to learn how to be more Mindful and to help those around us to be better at Mindfulness practices, as well. If you find this post helpful please share.

So stay tuned for next week as I share with your some strategies to decrease your overall number associated with stressors in our lives. Let’s work together to get our own personal numbers at or below a 4!

Dr. Steven Atkins

There has been a spike in the number of suicides in this country. What we all need to know is that the increases are across all ages, all levels of SES and races/genders. It is at ITS HIGHEST LEVELS IN MORE THAN 25 YEARS. Teens and especially females and young women are committing suicide at an alarming rate. Please consider when and how often you allow your kids to have access to “smart” phones and computers—-where there is a tremendous amount of flack thrown at others. It is hard for an adult to handle negative and potentially abusive posts/comments BUT IT IS ALMOST IMPOSSIBLE FOR A YOUNG KID OR TWEEN TO KNOW HOW TO DO THIS. Internet access is as stressful and potentially dangerous as handling a firearm. In fact, parents are better at locking up and monitoring firearms than they are at monitoring internet usage.

Every age group since 1999 has seen a dramatic increase in suicide and the most troubling (not to imply that the lesser is least troubling) is young girls and women. Note that girls 10 – 14 have had a 3xs increase in suicide.

Please talk with and listen to your family and friends. Look for the signs of concern: loss of interest in others/activities; poor sleep; diet changes; agitation; drops in grades/work production, changes in friends/withdrawal, etc.

Next week: caring for ourselves to better prepare for caring for others.

I will continue these posts based on sharing/comments. Let me know if this is pertinent as we are all busy and I never want to waste anyone’s time. IF you find this valuable please share on your timeline.

Dr. Steven Atkins