Tuesday, November 6, 2018

Fives Ways to Improve Your Sleep: #3 Stimulus Control Therapy


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Five Ways to Improve Your Sleep: #3 Stimulus Control Therapy


What Is It? 


Stimulus Control Therapy (SCT) helps us develop connections between sleep and things in our surroundings [1]. 

With strong connections, these things can help control sleepiness. They prime our brain to get in sleepiness ‘mode’. Thus, by repeatedly pairing sleep with things around us, we can turn those things into triggers for better sleep.

How Does It Work?


Developing these triggers requires us to make a strong connection between sleep/sleepiness and the things in our surroundings—like our bed!
To make that strong  connection requires two things [2,3]:

  1. Only sleep around/with the surroundings that you’ve chosen to connect with sleep (don’t sleep without a bed, ritual, etc.)  
  2. When awake, limit your time with/around your chosen sleep settings. Even if it’s bedtime but unable to sleep, a quiet break and return can help reset your brain to ‘this place is sleep time'.

How Can I Practice It?


If you wish to connect things in your surroundings with sleep, you have be strict in your pairings. Thus, the most important thing you can do is be strict about when, where, and how you sleep.

Here are some examples:


If you wish to turn your bed into a 'sleep trigger', you must only spend time in your bed when sleeping (the exception being intimacy) [3]. That means that you do not read, relax, or watch TV from your bed. And if you are having trouble falling asleep, you will take a brief, quiet break in another room, rather than lying awake in your bed. It also means that you do not sleep outside of a bed. You will also avoid sleeping at a desk, on the couch, or other places. 

You can turn times into a 'sleep trigger' as well. If you practice going to bed at the same time every night, your body will connect that time with sleepiness. Our bodies are fantastically attuned to a 24-hour cycle, and sleeping at regular times makes use of that cycle. 

You can also connect darkness to sleepiness. Our brains tend to wake up around bright lights, and it tends to settle down when the lights go down [4]. You can put that natural connection to use! 1-2 hours before bedtime, turn off all overhead lighting in your home. Use lamps and low-setting floor lighting. Repeat this for at least two weeks, and you will train your mind to associate those reduced lights with sleepiness. (If you want to make that connection even stronger, try the opposite in the mornings--turn on overhead lights when you get ready in the morning, to connect bright lights with wake up time!).

How Can This Help Insomnia?


Sleep requires us to switch from ‘alert mode’ to ‘rest mode’. However, it’s pretty risky for us to rest during times where we should be alert (like driving, work, exercise, socializing, etc.). Thus, on average, our brain avoids being ready for rest.

However, when we make connections between sleeping and things/places we use for sleep, we can signal our brain that it’s ‘okay’ to sleep. And with strong connections, our minds will start to settle and prepare for sleep before we get under the covers—not after [5].

How Long Does It Take To Work?


Like most treatments for insomnia, the answer is: it depends. 

EVERYONE is different. Some people respond to Stimulus Control Therapy right away, while others will take several weeks to see improvement.  But most people WILL improve! [6]

The highlights of this tool is that it can be self-administered and the benefits grow with time [7]. Even if it isn’t a magic fix, making stronger connections between sleep and a ’sleep setting’ will improve a person’s sleep. Whether their insomnia is complex and treatment resistant, or it's just a case of poor sleep, stimulus control therapy improves sleep quality. It helps users enter rest mode, and they will fall asleep faster and stay asleep longer.

References:


The following studies form the basis of the claims made here! Check them out if you wish to know more about the science of Stimulus Control Therapy.

  1. Bootzin, R. R., & Perlis, M. L. (2011). Stimulus control therapy. In Behavioral Treatments for Sleep Disorders (pp. 21-30). 
  2. Turner, R. M., & Ascher, L. M. (1979). Controlled comparison of progressive relaxation, stimulus control, and paradoxical intention therapies for insomnia. Journal of Consulting and Clinical Psychology, 47(3), 500. 
  3. Bootzin, R. R., Smith, L. J., Franzen, P. L., & Shapiro, S. L. (2016). 24 Stimulus Control Therapy. Diagnosis and Treatment, 268. 
  4. Mishima, K., Okawa, M., Hishikawa, Y., Hozumi, S., Hori, H., & Takahashi, K. (1994). Morning bright light therapy for sleep and behavior disorders in elderly patients with dementia. Acta Psychiatrica Scandinavica, 89(1), 1-7. 
  5. Bootzin R.R., Epstein D., Wood J.M. (1991) Stimulus Control Instructions. In: Hauri P.J. (eds) Case Studies in Insomnia. Critical Issues in Psychiatry (An Educational Series for Residents and Clinicians). Springer, Boston, MA 
  6. Ho, F. Y. Y., Chung, K. F., Yeung, W. F., Ng, T. H., Kwan, K. S., Yung, K. P., & Cheng, S. K. (2015). Self-help cognitive-behavioral therapy for insomnia: a meta-analysis of randomized controlled trials. Sleep medicine reviews, 19, 17-28. 
  7. Zachariae, R., Lyby, M. S., Ritterband, L. M., & O'Toole, M. S. (2016). Efficacy of internet-delivered cognitive-behavioral therapy for insomnia–a systematic review and meta-analysis of randomized controlled trials. Sleep medicine reviews, 30, 1-10. 

NOTE: Vecteezy.com contributed the raw vectors that I used to make the graphics you see here. Check them out, if you are interested in vector design. 

Wednesday, August 8, 2018

Five Ways to Improve Your Sleep: #2 Exercise

Five Ways to Improve Your Sleep: #2 Exercise



Exercise and Sleep?


Physical exercise can help improve several sleep problems, including more restful sleep and reducing sleep onset (6,7). At just 30 minutes every other day, studies show that physical exercise can improve sleep quality (8,9).

Pooh always fit in his Stoutness Exercises (Source: Winnie the Pooh and the Honey Tree)

Why Does Exercise Help Sleep?


Exercise improves our sleep because of the relationship between sleep and our physical and mental states (10,11). How well we sleep is connected to our situations, our personal tendencies, and our emotional well-being. For instance, our sleep is affected by situational stress, how we respond to stress, our levels of anxiety and/or depression, excessive rumination and obsessive thinking (when the mind won’t stop running!), and even being preoccupied with the issue of sleep itself. 

Thankfully, exercise can help reduce the severity of such issues (11,12). Exercise promotes healing effects for negative stress and upsetting emotional states, and it helps to balance our physical states as well. Accordingly, it can help alleviate problems that disrupt sleep wellness, in addition to reducing the power such problems have over our sleep. Furthermore, it can help us achieve better relaxation and calmness as we get into bed.

How to Use Exercise for Better Sleep


Even with as little as 30 minutes of exercise 3x per week, studies show that physical exercise improves sleep quality (8). This benefit applies to both cardiovascular exercise (running, biking, walking) and resistance based exercise (weight lifting, yoga, Pilates) (9). 
If you are already exercising but are still struggling with sleep, there may be some changes that could improve your results. For example, it may be worth exploring additional exercise or more difficult routines, as it’s possible that more exercise will provide more benefits; research shows that increasing the difficulty and frequency of exercise can provide proportionally greater improvements to sleep (13). Another potential change may be the time you exercise; some research shows that it’s more effective to exercise in the late afternoon or evening (2).

Remember: Do What Works and is Safe for YOU!


However, what’s most important is that you find a routine and pattern that works for you and is safe for you to partake in (2). And while exercise is shown to improve sleep to some degree for anyone, it also matters that it comes in the right form and time for you. Moreover, when exploring major changes in your activity level or exercise routine, it can be helpful to consult with a physician. Remember, this is for the benefit of YOUR sleep and YOUR health! 

Thank you for reading today, and keep an eye out for the next entry in the series: Behavioral Training. (And if you missed the first, check out Sleep Hygiene here!)

References

  • 6. Yang, P. Y., Ho, K. H., Chen, H. C., & Chien, M. Y. (2012). Exercise training improves sleep quality in middle-aged and older adults with sleep problems: a systematic review. Journal of physiotherapy58(3), 157-163.
  • 7. Montgomery, P., & Dennis, J. A. (2002). Physical exercise for sleep problems in adults aged 60+. The Cochrane Library.
  • 8. Reid, K. J., Baron, K. G., Lu, B., Naylor, E., Wolfe, L., & Zee, P. C. (2010). Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep medicine11(9), 934-940.
  • 9. Kovacevic, A., Mavros, Y., Heisz, J. J., & Singh, M. A. F. (2017). The effect of resistance exercise on sleep: A systematic review of randomized controlled trials. Sleep medicine reviews.
  • 10. Yao, K. W., Yu, S., Cheng, S. P., & Chen, I. J. (2008). Relationships between personal, depression and social network factors and sleep quality in community-dwelling older adults. Journal of Nursing Research16(2), 131-139.
  • 11. Brand, S., Gerber, M., Beck, J., Hatzinger, M., Pühse, U., & Holsboer-Trachsler, E. (2010). High exercise levels are related to favorable sleep patterns and psychological functioning in adolescents: a comparison of athletes and controls. Journal of Adolescent Health46(2), 133-141.
  • 12. Fox, K. R. (1999). The influence of physical activity on mental well-being. Public health nutrition2(3a), 411-418.
  • 13. Kovacevic, A., Mavros, Y., Heisz, J. J., & Singh, M. A. F. (2017). The effect of resistance exercise on sleep: A systematic review of randomized controlled trials. Sleep medicine reviews.
  • 14. Stepanski, E. J., & Wyatt, J. K. (2003). Use of sleep hygiene in the treatment of insomnia. Sleep medicine reviews7(3), 215-225.

Sunday, August 5, 2018

Five Ways to Improve Your Sleep: #1 Good Sleep Hygiene

Celebrate the Sleep News!
If you follow my page on Facebook, then you've seen the announcements for a new sleep series for this site. And this week, they are rolling out! Hurray!
The theme this month is sleep: sleep problems, sleep disorders, and sleep treatments. Why? Because, I've realized just how pervasive the problem is--sleep questions are the most common topic of the messages I receive.

I've also seen an unfortunate shortage of explanatory resources. Many sites give loads of information on sleep, without citing where that information comes from, or why it works. And for those that do cite, it's often written for medical professionals. Apparently, they don't see a need for a format that provides simplified explanations with research to support them.

So this week, I'm releasing the first phase of my project: a resource that gives simple explanations for sleep treatments. Every entry will have written explanations and a handy graphic. I'll briefly explain what the treatment is, how and why it works, and how it should be practiced.

Of course, these are explanations, not recommendations. Remember, my goal is to share and spread medical research; I am not giving out medical advice. However, I hope these explanations can help you make informed personal decisions and arm you with knowledge when you meet with your personal physician.

Now, without further ado:

Five Ways to Improve Your Sleep: #1: Good Sleep Hygiene 


What is Sleep Hygiene?


Sleep Hygiene is a list of behaviors that are associated with better sleep (1). In addition to shortening the amount of time it takes to fall asleep (sleep latency), the behaviors can also help improve the quality of your sleep (2&3).

In the short term, they help create appropriate sleepiness the day/next day that they are practiced; in the long term, they help condition (train) better alertness during wake times and more restful sleep at sleep times (4).

Why the Name?


You may be used to hearing the word 'hygiene' in reference to sanitation. However, it actually refers to any behaviors/conditions that help people to maintain good health. Thus, the listed behaviors have all been linked to better sleep health. 

Why Does it Work?


Going from 'awake' to 'resting' is a transition that requires physical and chemical changes in our brain. That transition is initiated by a series of bodily and external/situational signals. 

While some people are sensitive enough to simple signals (such as fatigue or darkness), others are less sensitive to common signals; furthermore, some people require more salient signals to trigger sleep. Such people are more prone to sleep problems, including insomnia. 

However, practicing good sleep hygiene can provide more signals for initiating sleep, and it can also make existing signals more salient (2).

How to Do it: 


Review the recommended list of behaviors (see above) and consider integrating them into your daily routine. If you are not currently practicing a large number of these behaviors, it may be helpful to gradually adjust your routine. 

Some changes may require discussion with your personal physician, particularly those that may affect existing conditions or health problems. 

Consistency works best, because the proscribed behaviors affect short term and long term factors for sleep wellness. Sleep hygiene helps give your body sleep signals, and it also conditions your brain to recognize more signals as 'sleep time'. Furthermore, it conditions your brain to be alert during appropriate times. 

For sleep hygiene's conditioning to work, it requires regular practice and exposure to the routine. Thankfully, even just being aware of sleep hygiene can improve our ability to practice healthier sleep behaviors (5).

References:

  1.   Mastin, D. F., Bryson, J., & Corwyn, R. (2006). Assessment of sleep hygiene using the Sleep Hygiene Index. Journal of behavioral medicine, 29(3), 223-227.
  2.   Stepanski, E. J., & Wyatt, J. K. (2003). Use of sleep hygiene in the treatment of insomnia. Sleep medicine reviews, 7(3), 215-225.
  3.   Irish, L. A., Kline, C. E., Gunn, H. E., Buysse, D. J., & Hall, M. H. (2015). The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep medicine reviews, 22, 23-36.
  4.   Guilleminault, C., & Brooks, S. N. (2001). Excessive daytime sleepiness: a challenge for the practising neurologist. Brain, 124(8), 1482-1491.
  5.   Brown, F. C., Buboltz Jr, W. C., & Soper, B. (2002). Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students. Behavioral medicine, 28(1), 33-38.

Tuesday, September 5, 2017

Self-Management: Daily Tools for a Scattered Mind

This post includes my two favorite tools for daily self-management and self-organization.

I greatly benefit from the act of physical writing and actively thinking through my schedule, needs, goals, etc.. Most people benefit from these acts. Behavioral research supports that writing down plans not only helps us better outline and commit to goals, but it also greatly increases the probability of meeting those goals. Establishing implementation intentions (when, how, where, etc.) of our plans has a significant effect on whether we meet the goals we have, big or small (Gollwitzer, 1993; Gollwitzer & Sheeran, 2006; Scholz et al., 2007; Stizmann & Johnson, 2012; Rogers et al., 2015) . It helps us to prioritize and follow through!

My Shared Resources:

I've linked my two favorite, "general", original daily printouts for managing my scatterbrain-self. They're 100% free and available for anyone who would like to try them. They're not specific to any individual needs, just general categories. Please also feel free to share your own favorite tools, and/or critiques on those I've made. 

Because this topic is one of a rather critical and personal meaning, I'm also linking the article that addresses my background for how and why I spend time learning, testing, and customizing many routines, tools, and resources for myself. I wanted to be blunt and sincere in my assessments of how critical such tools are. And to do so, that required me to share a bit about myself. (see: Self-Management of a Scattered Mind).  

For those curious, I hope you find the linked post interesting and informative. For those less inclined, please still feel free to scroll down to the linked PDFs of my favorite "general" self-management tools. They are currently stored on my google drive, though I will be changing this soon to help assure readers that they are PDFs, not random looking google drive addresses. I have full page and half page versions, for regular (A4) and small (A5) binders. I really like a little planner I got cheap from amazon, and will link it here. But I'd also love for any readers to share their own favorites!

Full Size Print Outs:
  1. Daily To-Do 
  2. Daily Schedule
Half Size Print Outs:
  1. Daily To-Do (TBD)
  2. Daily Schedule (TBD)
Half Size Print Out (Same Page):
  1. Daily To-Do & Daily Schedule

I'm also including a guide of how I use these printouts, but my guidelines may not be your guidelines :). Please give it a read if you're curious about the categories/how I use them, and consider whether you might find them helpful.

The Daily Organizational Print Outs and Categories are:
  1. Today's To-Do's
    1. PrioritiesThe most critical items that, should you accomplish nothing else, need to be done. Helps to assess what is most important and what demands the most resources. Also helps to put the lesser things in perspective!
    2. Today's GoalsWhat you want out of the day. Do you want to aim to give more compliments? Be more positive? Drive more safely? Keep up with your scheduled time? Do something artistic? Take criticism gracefully? Do well on a presentation? What are the things you want out of the day.
    3. Task List: Write down all the tasks/items that you need to get done for the day. Sometimes you can check them all off, sometimes you might have to move some to the next day. But it helps to have a list of what you need done. Add check boxes to every item, so you can cross that sucker off when it's done!
    4. Good Things: Yes, I practice Cognitive Behavioral approaches (CBT) and will always preach that we need to practice acknowledging the good things about our days. We notice bad stuff because it is upsetting and alarming. It takes practice to notice the good things as easily. So, write what's good about your day, what good thoughts you've had, what good things you think you can make happen. Maybe at the end of the day, write down the best things that happened. Make a record.
    5. Exercise: writing down goals and recording actual execution of exercise is a valuable way to not only encourage more activity and healthy living, but it helps you to have a record to track progress. Focusing on improvements, not fixed achievements, helps to foster a healthy and positive attitude towards healthier living. Tracking makes it easier to focus on those changes and improvements, rather than a fixed, non-individual measure of 'fit'. Even if you only manage to walk a mile every other day, that is 150+ miles every year, that you might not have walked otherwise. Track it!
    6. Date/Word: The day date and a newly learned word. This can be a new native tongue word (expanding vocabulary!) or a word for a foreign language. I enjoy working on both!
  2. Daily Schedule
    1. ScheduleList the hour-by-hour plan for the day. I like to have each hour listed, except for early morning and late evening. Before 7 am usually involves a fixed pattern of morning rituals, which I can easily list in that line for 'Morning'. Same for 'Evening'. But for every other time, I like to list my plans for the day, preferable the day before. It helps me know what I should aim to do, helps me better understand how I am using my time, and helps me make more realistic estimates for how long something should take. Overall, an hourly schedule helps me use my day more effectively!
    2. Assignments: I like to avoid categories like 'work/school/home', because I often have assignments for all three! I also don't like feeling like one is more important than the other. I list these separately from tasks, because most of my assignments are broken down into daily increments of finishing. By writing current assignments, you can better assign time to complete those increments in your schedule, and can even list the parts of those assignments in the task list of the ToDo Printout. It helps to know what are general 'on the docket' requirements, so you can include them in your planning.
    3. Success?: Again, I like CBT. I think it's important to practice positive thinking, in a way that is realistic and acknowledges what we do well. My assignments, task lists, schedule, etc., are often very full. So I like to write down things that I did particularly well, achieved, or went above and beyond. I like to celebrate my successes, and appreciate where I excel. That's what this box is for.
    4. Notes: Every day, I have odd little add-ons of varying importance, that end up on scrapped papers/receipts/etc., which may do better in a neat little note box. Numbers, grocery items, reminders, etc., all go in here. That way, I can look through my week and have a ready-made collection of important tidbits all in one place!
    5. Date/TIL: the day's date, and something newly learned. Go to a random TIL website or just note something interesting you learned. Writing down a name for what you've learned will help it stick in your mind!

References:

  • Gollwitzer, P. M. (1993). Goal achievement: The role of intentions. European review of social psychology, 4(1), 141-185.
  • Gollwitzer, P. M., & Sheeran, P. (2006). Implementation intentions and goal achievement: A metaanalysis of effects and processes. Advances in experimental social psychology, 38, 69-119.
  • Rogers, T., Milkman, K. L., John, L. K., & Norton, M. I. (2015). Beyond good intentions: Prompting people to make plans improves follow-through on important tasks. Behavioral Science & Policy, 1(2), 33-41.
  • Scholz, U., Sniehotta, F. F., Schüz, B., & Oeberst, A. (2007). Dynamics in SelfRegulation: Plan Execution SelfEfficacy and Mastery of Action Plans. Journal of Applied Social Psychology, 37(11), 2706-2725.
  • Sitzmann, T., & Johnson, S. K. (2012). The best laid plans: Examining the conditions under which a planning intervention improves learning and reduces attrition. Journal of Applied Psychology, 97(5), 967.

Self Management of a Scattered Mind

This article is about self-management and self-organization. I'velinked my two favorite, "general", original printouts for managing myscatterbrain-self HERE. They're 100% free and available for anyone who would like to try them. They're not specific to any individual needs, just general categories. Please also feel free to share your own favorite tools, and/or critiques on those I've made. 

The Value of Planning:

Implementing daily goals and plans helps us to better achieve our plans and goals, both big and small. Behavioral research supports that writing down plans helps us: (1) better outline and commit to goals and (2) greatly increases the probability of meeting those goals. Establishing implementation intentions (when, how, where, etc.) of our plans has a significant effect on whether we meet the goals we have, big or small (Gollwitzer, 1993; Gollwitzer & Sheeran, 2006; Scholz et al., 2007; Stizmann & Johnson, 2012; Rogers et al., 2015) . In summary? When we specify our plans, it helps us to prioritize and follow through!

What does this have to do with me?

I openly preach how much I benefit from the act of physical writing and actively thinking through my schedule, needs, goals, etc.. The act of writing my plans is integral to me being able to meet them. A less commonly known fact about me, is that I was diagnosed with ADHD at the age of 5, again at 14, and again at 18, 20, and 25. So, five times in total. Some of these assessments were for self-confirmation, but I also grew up at a time where many were still convinced ADHD was not real, or that it did not affect girls much, and/or that everyone 'grows out of it'. I can say this much--I did not grow out of it, and I am not alone in that (Kessler, et al., 2006). 

ADHD is really a cluster of different 'executive function disorders', which means it's a broad term for people with neurological issues that impede the structures/functions of attention, motivation, planning, and executing behavior. In layman's terms? The command center that controls conscious thought/planning works a bit different. Different researchers might disagree in the different sub classifications of ADHD, or what causes it, or why it resolves for some and not others. But I'm not going to talk about that. I'm going to talk about why my ADHD forced me to develop seriously structured self-organization and self-management skills. Because they are certainly not something my brain does on its own!

What I Have Learned, From ADHD:

I do not see my struggle with ADHD as an objectively good or bad thing. ADHD is a facet of myself and my personality. What makes it a 'disorder' is not that it's a problem alone, but that it makes functioning in a modern society geared toward the efficient 'average', a bit problematic. So I work hard to make it less problematic. I majored in neuropsychology and did my thesis on ADHD treatments, and I have a passion and fascination for the multi-modal approach (multiple disciplines for management). For my own self-care, I practice meditation, utilize numerous cognitive behavior treatments (CBT) and applied behavioral analysis, do yoga, use medication, and routine, routine, structure, and routine.

Dealing with illness and the demands thereof, ADHD could and does sometimes make self-management more frustrating and difficult. A lot of my differences were/are taken for granted; I lack some abilities that are seen as defaults for most adults. And, for most of my life, there was not much available for someone missing those defaults. I did not have resources to cope, and it made a difficult situation harder to manage. At the height of my sickness and the resultant complications, I was at a doctor's at least five times a week. I was in pain, tired, and filled with anxiety and depression. Remembering all the extra things I needed to do, learning new diets and daily routines, getting to all the appointments (especially on time), and regularly following through with all the therapies and medications, was hard. Hard for anyone, truly. But if I wanted to overcome the beast of unmanaged chronic illness and live, really live, I had to figure out a way to make it work. And I needed to learn how self-manage first (Lorig et al., 1999).

So I sat down, and I made plans. Plans and lists. And strategies. Coping methods to try. I looked at what I struggled with most and came up with countermeasures to make them more manageable. I studied. The amount of articles, books, and reviews I acquired could fill a trunk. Reading became a second job. I spent months and months trying and scrapping new approaches and methods.

Sometimes it felt like a waste of time. I already felt a cold reality of having zero energy and zero time, so I could not understand why I was pouring so much effort into organizing that mess. But I also understood that part of that zero time and energy was due to my inability to make use of the mental and physical resources I had. And I needed to change that. Really, it was part of who I am: I love brains, and I knew mine was not operating at its full potential. I knew I deserved better. 

All that study and my education helped me arrive a lot of conclusions. I need structure. Strict structure. A regular routine. I have to regularly condition my mind to work the way it works best. I cannot just expect my brain to work differently than it does. I have to honor the needs I have and work with them, not against them. I need to be willing to spend time managing myself, not criticizing myself. Slowly, I came up with the methods I use today to make myself the most functional me. And I can 100% say that they are some of the most critical changes I made for making the moderately healthy person I am today.

Why I am Sharing

For a site dedicated to educating and supporting those with illness, I am guessing this may seem like a rather self glorifying and self-focused post. Maybe it comes across as breaking away from the new mantra of this site--to focus less on myself and more on all sorts of people. However, I chose to write this with myself as an example, because I want to be blunt with how critical self-management has been in living a more efficacious and happy life (Wagner et al., 2001). I wanted to be honest with how hard I have struggled to incorporate these valuable changes into my life. Such changes and adjustments did not come easily, and they are still a daily effort. They cannot be an afterthought, or something to deal with once 'everything settles down'. Learning to self-manage is instrumental in establishing a gradual, if tenuous, settling. 

For myself, dealing with my ADHD, anxiety, etc., has been just as important for healing as directly treating physical illness. Self-management is critical for managing illness, and it also does not come easily for everyone. And I want to remind people that it's okay if it's a struggle, it's okay if they need tools and help, it's okay if it does not come easily or quickly, and it's okay if you're not sure where to start. I certainly did not. I felt weak and stupid for not knowing what to do. Through all my struggling, I realized I was wrong; I was anything but weak. That real strength is in pursuing a goal and working towards it, not starting out with everything in hand.

If sharing my journey in learning self-management helps others feel a teeny-bit less alone, I am okay with the possible downside of shining a spotlight on my less-than-perfect self. If it helps motivate just one person to give some resources and tools a shot, then I am happy, and hopefully they will be happy too :).

My Hopes for Sharing Self-Management Resources

I wrote about myself because I also to share some of my self-organizational tools, in hopes that they may be of help to others. Some may find them helpful, and I want to earnestly endorse trying different tools and resources for working out a method for better self-management. My printouts might perfect for one person's self-management toolkit, and absolutely mismatched for another's. People have different circumstances and benefit from various coping methods for dealing with the incessant demands of life!

Additionally, in recognition of the variations in circumstances and needs, I am starting by sharing some of my most general tools: my dailyto-do list and daily schedule printouts. 

I'm not a graphic designer, and these tools can take me a while to make in a general, useful format! So, I will start with sharing my general ones, and then work towards more circumstance-specific versions (e.g., sleep diaries, treatment records, etc.). They're free for any personal use. Try them out, print them, copy them, share them, do whatever you like! (Except trying to charge someone else for them--that's not nice). Also, feel free to share any resources and tools you already like!

I hope you can give daily planning and goal setting an earnest try. They have been an invaluable coping method for myself, and truly help my daily life. If an absolute scatterbrain like myself can eventually make use of some sort of routine and planning, I can't help but have faith in the potential for us all!


References:
  • Gollwitzer, P. M. (1993). Goal achievement: The role of intentions. European review of social psychology, 4(1), 141-185.
  • Gollwitzer, P. M., & Sheeran, P. (2006). Implementation intentions and goal achievement: A metaanalysis of effects and processes. Advances in experimental social psychology, 38, 69-119.
  • Kessler, R. C., Adler, L., Barkley, R., Biederman, J., Conners, C. K., Demler, O., ... & Spencer, T. (2006). The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. American Journal of psychiatry, 163(4), 716-723.
  • Lorig, K. R., Sobel, D. S., Stewart, A. L., Brown Jr, B. W., Bandura, A., Ritter, P., ... & Holman, H. R. (1999). Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Medical care, 37(1), 5-14.
  • Rogers, T., Milkman, K. L., John, L. K., & Norton, M. I. (2015). Beyond good intentions: Prompting people to make plans improves follow-through on important tasks. Behavioral Science & Policy, 1(2), 33-41.
  • Scholz, U., Sniehotta, F. F., Schüz, B., & Oeberst, A. (2007). Dynamics in SelfRegulation: Plan Execution SelfEfficacy and Mastery of Action Plans. Journal of Applied Social Psychology, 37(11), 2706-2725.
  • Sitzmann, T., & Johnson, S. K. (2012). The best laid plans: Examining the conditions under which a planning intervention improves learning and reduces attrition. Journal of Applied Psychology, 97(5), 967.
  • Wagner, E. H., Austin, B. T., Davis, C., Hindmarsh, M., Schaefer, J., & Bonomi, A. (2001). Improving chronic illness care: translating evidence into action. Health affairs, 20(6), 64-78.



Monday, April 10, 2017

Pain is a Warning Signal

This article is a recent addition to my Power of Belief series (an excerpt for Part III). It is a simplified explanation of what pain is and how pain signals 'work'. For those dealing with short term or chronic pain, or trying to learn more about pain in general, I hope you find it a useful overview.

What is Pain Sensation and Pain Perception?                          

Pain is a warning signal. Pain is an alert, which our body uses to warn us about danger and harm. Pain is a fast, unpleasant, intense message that grabs our attention and shouts, "Something is wrong!" These alerts are meant to be uncomfortable, even awful, because their purpose is so incredibly important. They are the quickest way for our body to tell us, 'you are being harmed'. And they are a powerful motivator to avoid potential danger.

Pain is a process. While pain feels instantaneous, it's actually just very fast. Our body alerts us to pain using multiple steps in a special alert system. This system aims to tell us about pain in a way that is (1) fast and (2) informative. To meet these goals, pain sends multiple alerts, which range from simple (immediate) to complex (less immediate). They also operate on different levels of consciousness, working consciously, subconsciously, and unconsciously (Young, 2005). Pain operates at these different levels and complexities for our benefit, in order to help our body and mind make better judgments for injuries and dangers (Flor et al., 1990).

Pain is a manifold message. Pain alerts work in tandem for most injuries. For example, our body often moves from a painful source, like fire, before we even feel it! Your body can process pain more quickly than your mind, so it uses that information to act fast. However, your mind will feel it soon. And that sharp pain of a fresh burn can help remind you to protect your new injury. Extended pain from a burn also helps to encourage keeping it clean and bandaged. For manageable and short-term injuries, pain signals can help you to take proper care and heal faster! Unfortunately, if the source of pain cannot be helped or healed, pain can become problematic and debilitating.

Pain can be helpful. While pain feels bad and is definitely something we wish to avoid, it ultimately functions to improve health, wellness, and lifespan. Pain is valuable, when it is functioning properly. Your body and mind both use pain to guide goals and actions. Pain gives immediate consequences for injury, to help prevent our bodies from getting hurt (or hurt worse), and it helps reduce loss of limb or bodily function (Chapman et al., 2008). As such a critical warning system, its alerts will be loud and the mind is attuned to sensing them. There is even research that supports that pain can intensify when we try to suppress it/resist it (Turner et al., 2002). Pain wants us to 'get' its signal.

Consider zombies in popular shows and fiction; zombies are often unconcerned with limbs getting injured or even falling off. Without pain, they can simply ignore these losses, and their mobility suffers for it. Without basic warnings, their bodies quickly fall apart.

While pain may seem a nuisance, its signals are extremely valuable for our well-being and survival (when properly functioning). How does the process work though, and why is it possible for it to 'go wrong'?

Pain has its uses: it warns us when something is harmful,
and it helps us take care of injuries while they heal

Springtime Announcement: Site Updates

Sunshine and Spring
Hello everybody, and happy spring! After a long, long winter, I have been loving seeing the sun again. I hope you have been able to enjoy and see the sun as well! It's a great motivator for me to get outside and exercise (even a little bit).

Hope and Sunshine (credit: unsplash.com)
Site Redesign Status
I appreciate everyone's patience with the website redevelopment and re-organization. From volunteers for contributions to sustained visits and readers, it has all been so encouraging to receive. I cannot wait to debut the new format, and I truly hope it is beneficial to everyone who visits.

There are still kinks to be worked out, and I am working diligently to smooth them down. Learning coding has been a real journey, and I know that some of the broken links have been more than frustrating. I am also still arranging different contributions from those who are interested. If anyone wishes to contribute, whether one time or repeatedly, or has ideas they wish to share, please let me know! I am working to make this site less me-centric, and ideas from others are key to this goal.

A lot of time and efforts have been refocused for this site's purpose, and it is exciting to work to turn it all back outwards. The ultimate goal is to provide resources and hope to others. Hopefully, the improvements to content and site design will make it all worth it! Thank you, for continuing to value and visit this work. Your support is everything!

Writing for the Meantime
Until I can finalize the behind the scenes, I will resume writing short and/or 'opinion' type posts. While these may be less informative than my more research-oriented than my more time consuming posts (such as those on pain, depression, optimism, etc.), I think they can provide some much needed content.

Little bit 'o writing (credit: unsplash.com)


Wednesday, December 14, 2016

Under Construction


The Bedhead site is under construction! 


I very much apologize for the inconvenience.


Until everything is smoothed out over the next week, you may have some difficulty navigating the site. There are 'placeholder links' in the sub-navigation menu that are stubs at the moment. If there is anything you are struggling to find, please email me: Bedhead@Bedriddenhead.com, and I will email you the appropriate link. 

Thank you so much for your patience and continued support! I am greatly looking forward to all of the upcoming improvements, and I hope they are helpful and useful to you!

Wednesday, December 7, 2016

Health Care

I've been working on a series of posts to share in an orderly/semi-regular way these past few months. For those unaware, I am working to further my education and obtain a more advanced degree. Studying while working, dealing with my ever changing health, and trying to write a book, has kept me more busy than I know how to cope with! I am really looking forward to working with everyone that has expressed interest in the site though, and I am looking forward to the improvements they bring!

Despite the lack of time for more formal posts, I will be sharing some more informal information as often as I can. For Americans particularly, I am concerned about changes in health care and want to offer what information/support I can. If this looks familiar, I am sharing these words as often as I can.

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To everyone that has experienced anxiety regarding the political climate: Please take care of yourselves. Be kind to yourselves. Try to do something nice for yourself.

Many Americans with chronic conditions are frightened about the possible effects this election cycle will have on their health care. Regardless of who you voted for, the truth is that those with chronic illness and disabilities are often lost in the cracks for acceptable health care. You are not alone.

Take deep breaths. Take stock of your location and your state's current options/plans. Many communities have *free* charities/non-profits that provide assisting services. They can help you with your immediate needs. They can provide you information to help you with coverage for this upcoming year.

I cannot comfortably make any statements about what changes are coming for health care in America. I don't know what plans the House, Senate, or President Elect have.

I do know that changes are certainly coming. I can't say which or how or why--only that the current design does not have long term feasibility without restructuring and political cooperation. We cannot even know if the current design could work due to congressional starving, and we do not know if a future plan will work either. There is going to be change.

Change also means opportunities. You do not have to quietly surrender to a future without care. Look up your state/local representatives. Call them. Write them. Tell them of your concerns. Sign petitions that address your concerns. Use peaceful and safe methods to rally those around you to your cause. Try not to get lost in party lines. Whether your representatives 'represent' your politics or not, they were elected to represent *everyone*. Tell them how their policies and/or votes affect *you*.

You cannot succeed if you do not try. You can choose to reject helplessness by taking action. And if you struggle valiantly, you have won at least one battle.

Those who are not at risk for losing your health care, please be aware and considerate of risks others are facing. If you support change, try to advocate/support change that does not leave others without care. If you support those in office, but maybe not all their plans for health policies, let them know. It is empowering to be involved in the political process. And regardless of the current climate's effect on you, it is always possible to be on the other side.

My page/site/email have and always will be a place for people struggling. For those faced with challenges, illness, depression, and/or pain, I will do my best to offer comfort and information. I might be limited in what I can do, but I try my best to offer what I can to anyone that needs it. I do not care where you live, who you vote for, or who you support. I care about you and will do my best to pass on my knowledge and compassion.

Sunday, December 4, 2016

Request for Website Volunteers

I am looking for volunteers!


The site is under revision and is going to be redesigned/expanded. 


Anyone with possible interest in contributing to content of this website, short-term or long-term, please email me at Bedriddenhead. All time, web, and written contributions will be credited appropriately. Advice and critiques are also always welcome.


What Makes This Website Worth Helping:


This site has value as an information resource for individuals with chronic pain and illness. It is unique in its efforts to share both personal and general resources for medical information, using references and resources, while limiting medical jargon. 

Medical science uses its own language and terminology. Sharing resources in a personal, non-medical format can help arm people with valuable information for their well-being and physical/mental health. 


The current Bedriddenhead website design limits the ability of this site to provide information to relevant individuals. The current content is also too limited to a single individual (me). While my studies and work facilitate my work on this site, they also limit the time and effort I can put in. My background is in writing and science, not web design! I have also had some recent health and family issues, which have limited my time on the site. With help, I want to expand this site to make it more useful to others. 

This site has been an invaluable volunteer experience for me, and I wish to extend that opportunity to others. My physical limitations have impacted my ability to volunteer and contribute via more traditional methods. Yet this site has been a consistent platform for me to share my talents in a meaningful way. There are other talented writers, researchers, and bloggers I wish to include! 

While older posts are more personal, the main purpose of this site is to share scientific information in a variety of formats. To help inform individuals that are struggling with illness and pain (whether they have a scientific background or not). Anyone who is interested in furthering that goal, I ask you to please contact me.

The Current Need:


I am restructuring and improving this site and looking for anyone with interest/experience with:


  • Web Design
  • Graphic Design
  • Art
  • Editing
  • Writing
  • Medicine and/or Science 
Help is not limited to those items. If you are interested, please email me

Even if you are unable to make any commitment but are still interested in helping short-term, I appreciate any help that you can give. I understand everyone has limitations for time and resources. I understand this is not a major website. I just want to help the people that use it, and I appreciate any efforts put towards that end. 

I make this request with the mindset that any contribution will be appreciated. Even if you only have time to email me tips, I will appreciate and value the effort put into such an email. 


Goals for the website improvement include: 


  • Fixing site navigation and design
  • Redesigning appearance
  • Reviewing/editing existing content
  • Reorganizing existing content
  • Prioritizing informative/non-personal posts
  • Increasing post number/rate
  • Integrating more contributors (Repeat and Guest Contributors)    


Guest Contributions are Welcome:


Guest writers are being incorporated into the redesigned website. This includes stories and informative posts.

Stories about others' journeys are being incorporated as regular features in the future site. All submissions will be reviewed for approval, prior to publication. Those published will be credited and may choose how/if they wish to appear in their submission. Pseudonyms are welcome. If you are interested in sharing your story, but struggle with writing, please contact me for possible options.

For those interested in contributing as informative posters, one-time and long term contributors are both welcome. Those with education or careers in relative fields are especially encouraged to inquire. Any medical information is shared as non-medical advice, whether contributors work in a relative field or not. I welcome experienced/inexperienced writers, prior publication is not necessary. Cited references are necessary for submission. All submissions are reviewed prior to publication.

Again, the email for this website.


The Current Status of this Site: Why I am Seeking Change 


I am working on redesigning and repurposing this site, to better enhance its value as an information resource.

For those unfamiliar, this is a non-medical advice site, which aims to share health information, resources, and publications in layman's terms. Some posts review research, some give tips on how to prepare for appointments. This site has been a wonderful way for me to contribute to the chronic illness and chronic pain communities. Chronic illness, endometriosis, IBD, asthma, CTDs, anxiety/depression, and pain communities have all been valuable groups for this site (and myself). 

Helping people affected by pain and/or illness has always been the goal for this website. 


I started with the (realistic) goal of reaching or helping just 'one' person. I wrote about my experiences and thought it might make someone feel less alone. After learning more about others, talking with readers, and switching to a more informative approach, I eventually met that goal many times over, and I began to appreciate what an amazing resource a website like this can be. 

This website has allowed me to have an impact I would not have had otherwise. Even during times of sickness and disability, this site has given me the opportunity to reach out to and inform others like me. Working on these articles, sharing my story, and communicating with readers, is such a privilege, as well as an opportunity.  

I can't fulfill these goals alone.


Writing this post, I actually had to fight a strong urge to use my time on one of the dozen posts I have been working on for months. Though if you have been checking the site, you'll notice why I say 'working on' not 'posting'. I have done my best to maintain the Facebook Page, as well as returning messages, emails and phone calls for help, but the site has definitely suffered from lack of activity. My work, school, and health issues are a both a resource and drain for the site. I feel overwhelmed with the resource I started. I want to change this.

I wish to expand the potential this site has. I want to make this site a more usable and valuable resource. I wish to make this site everything it can be; for those who visit, read, write, or subscribe, anyone who has found value in this site, I wish to make it better. I don't want to help just 'one' person--I want to help anyone who chooses to visit this site. Whether through google or shares, I want anyone who comes here to find value in this site. I want to make it time well spent. And I recognize there is only so much I can do to make that happen.

Anyone who has interest in this goal, I would love to hear your ideas or possible methods of contribution. This site has been a precious opportunity for me to contribute to various illness and pain communities and individuals. I love volunteering, and my physical limits can sometimes prevent me from doing more traditional projects. While there are many who do far more work than I, the efforts I have put into this website has been a way for me to help.  If anyone else thinks they could find value in such a contribution, I would love to involve you this site's future. 

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Contact me at bedhead@bedriddenhead.com

About The BedRiddenHead

I want to be happy. And this site is about that chance. How to strive to thrive in the body I've got and maybe turn my experiences into something worthwhile.

This site aims to help educate and reach out to people all over that struggle with pain or illness. To try and make something helpful. I work as a medical research writer, my background is in neuropsychology and biology, and I want to share what I learn in a way that is easy to understand. I am not a doctor. I'm definitely not your doctor. I am just some lady who wants to make someone's (anyone's) life a little bit better. Whether you have endometriosis, a chronic injury, a struggling friend, or just want to learn something new, I hope to make a place that has what you are looking for.

Thank you for stopping by, I wish you strength in your health and happiness.