Stress

We’ve probably all felt stress.  Sometimes it’s brief and highly situational, like being in heavy traffic.  Other times, it’s more persistent and complex – relationship problems, an ailing family member, a spouse’s death.  And sometimes, stress can motivate us to accomplish certain tasks.

Dangerous Stress

Stress becomes dangerous when it interferes with your ability to live a normal life for an extended period of time.  You may feel “out of control” and have no idea of what to do, even if the cause is relatively minor.  This in turn, may cause  you to feel continually fatigued, unable to concentrate, or irritable in otherwise relaxed situations.  Prolonged stress may also compound any emotional problems stemming from sudden events such as traumatic experiences in your past, and increase thoughts of suicide.

Natural Reactions

Stress can also affect our physical heath because of the human body’s built-in response mechanisms.  You may have found yourself sweating at the thought of an important date, or felt your heartbeat pick up while watching a scary movie.  These reacts are caused by hormones that scientists believe helped our ancestors cope with the threats and uncertainties of their world.

If the cause of your stress is temporary, the physical effects are usually short-term as well.  In one study, the pressure of taking exams led to increased severity of acne among college students, regardless of how they ate or slept.  The condition diminished after exams were over.  Abdominal pain and irregularity have also been linked to situational stress.

The longer your mind feels stressed; however, the longer your physical reaction system remain activated.  This can lead to more serious health issues.

Physical Wear and Tear

The old saying that stress “ages” a person faster than normal was recently verified in a study of women who had spent many years caring for severely ill and disabled children.  Because their bodies were no longer able to fully regenerate blood cells, these women were found to be physically a decade older than their chronological age.

Extended reactions to stress can alter the body’s immune system in ways that are associated with other “aging” conditions such as frailty, functional decline, cardiovascular disease, osteoporosis, inflammatory arthritis, type 2 diabetes, and certain cancers.

Research also suggests that stress impairs the brain’s ability to block certain toxins and other large, potentially harmful molecules.  This condition is also common to patients suffering from Alzheimer’s Disease.

Pressure Points

Although sudden emotional stress has been linked to severe heart dysfunction in otherwise healthy people, scientists are uncertain whether chronic stress alone causes cardiovascular disease.  What is clear is that excessive stress can worsen existing risk factors such as hypertension and high cholesterol levels.  Studies also show that people who are quick to anger or who display frequent hostility – a behavior common to those under stress – have an increased risk of heart disease.

Feelings of despair that accompany stress can easily worsen into chronic depression, a condition that can lead you to neglect good diet and activity habits.  This, in turn, can put you at a greater risk for heart disease, obesity, and kidney dysfunction.

Stress can also complicate your ability to recover from serious illness.  A Swedish study found that women who have suffered heart attacks tend to have poorer chances of recovery if they are also experiencing marital stressors such as infidelity, alcohol abuse, and a spouse’s physical or psychiatric illness.  On the other hand, stress management training is a proven method for helping speed recovery following a heart attack.

What Can You Do

Learning to deal with stress effectively is a worthwhile effort, even if you already consider yourself capable of handling anything life sends your way.  Many of the most common long-term stressors – family illness, recovery after injury, career pressures – often arise without warning and simultaneously.  Stress management is particularly valuable if your family has a history of hypertension and other forms of heart disease.  There does appear to be a mind and body connection with stress.

Source:  American Psychological Association

 


Attention-Deficit Hyperactivity Disorder

This article provides basic information on attention-deficit hyperactivity disorder (ADHD) in children and describes an approach to getting services and supports, called “systems of care,” that helps children, youth, and families thrive at home, in school, in the community, and throughout life.

In a classroom of 30 children or youth, it is likely that at least two students are affected by ADHD.  This surprisingly common condition makes it hard for children and youth to control their behavior (sit still, think before speaking or acting, etc.) and/or to pay attention.  If left untreated, it can lead to school or job difficulties, depression, relationship problems, and substance abuse.

What is attention-deficit hyperactivity disorder (ADHD)?  There are three types of ADHD:  the hyperactive-impulsive type, the inattentive type, and a type that is a combination of both.  The severity of ADHD varies among children, even siblings, so no two children will have exactly the same symptoms.  Also, you may hear that girls have lower rates and less severe cases of the disorder than boys.  More research is needed on this subject, but girls may have lower rates of the hyperactive type.

ADHD signs of hyperactive and inattentive types are as follows:                                                                                                                                                                                                       beach

Hyperactive-Impulsive – Feeling restless, often fidgeting with hands or feet, or squirming while seated; running, climbing, or getting up in situations where sitting or quiet behavior is expected; blurting out answers before hearing the whole question; and having difficulty waiting in line or taking turns.

Inattentive – May appear not to be listening or seems easily distracted by irrelevant sights and sounds; often failing to pay attention to details, and making careless mistakes; rarely following instructions carefully, and often losing or forgetting things like toys, pencils, books or other tools needed for a task; and often skipping from one uncompleted activity to another.

Experts believe that in some cases, heredity plays a role in whether or not a child has ADHD.  Symptoms of ADHD are first seen in children before age 6 and may cause problems at home, at school, or in relationships.  Sometimes, it is hard to tell if a child has ADHD because symptoms can be mistaken for typical childhood behaviors or other mental health issues, and ADHD often occurs at the same time that other conditions are present.  Equally important are the roles that a family’s culture and language play in how causes and symptoms are perceived and then described to a mental health care provider.  Misperceptions and misunderstandings can lead to delayed diagnoses, misdiagnoses, or no diagnoses – which are serious problems when a child needs help.  That is why only qualified health care or mental health care providers can diagnose ADHD, and why it is important that supports be in place to bridge differences in language and culture.

What happens after an attention-deficit hyperactivity disorder diagnosis?  If a qualified health care or mental health care provider has diagnosed your child with ADHD, he or she may suggest several different treatment options, including a combination of strategies for managing behaviors, medications, and talk therapy.  Your child’s health care or mental heath care provider may also suggest enrolling in a system of care, if one is available.

What is a system of care?  A system of care is a coordinated network of community-based services and supports that are organized to meet the challenges of children and youth with serious mental health needs and their families.  Families – as well as children and youth – work in partnership with public and private organizations so services and supports are effective, build on the strengths of individuals, and address each person’s cultural and linguistic needs.  Specifically, a system of care can help by: tailoring services to the unique needs of your child and family; making services and supports available in your language and connecting you with professionals who respect  your values and beliefs; encouraging you and your child to play as much of a role in the design of a treatment plan as you want; and providing services from within your community, whenever possible.

Data collected nationally suggests that systems of care are effective in treating attention-deficit hyperactivity disorder.

Source – U. S. Department of Health and Human Services

 


Obsessive-Compulsive Disorder (OCD)

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Do you feel the need to check and re-check things over and over?  Do you have the same thoughts constantly?  Do you feel a very strong need to perform certain rituals repeatedly and feel like you have no control over what you are doing?  If so, you may have a type of anxiety disorder called obsessive-compulsive disorder (OCD).

Everyone double checks things sometimes.  For example, you might double check to make sure the stove or iron is turned off before leaving the house.  But people with obsessive-compulsive disorder feel the need to check things repeatedly, or have certain thoughts or perform routines and rituals over and over.  The thoughts and rituals associated with OCD cause distress and get in the way of daily life.

The frequent upsetting thoughts are called obsessions.  To try to control them, a person will feel an overwhelming urge to repeat certain rituals or behaviors called compulsions.  People with OCD can’t control these obsessions and compulsions.

For many people, OCD starts during childhood or the teen years.  Most people are diagnosed by about age 19.  Symptoms of OCD may come and go and be better or worse at different times.

People with obsessive-compulsive disorder have repeated thoughts or images about many different things, such as fear of germs, dirt, or intruders; acts of violence; hurting loved ones; sexual acts; conflicts with religious beliefs; or being overly tidy.  They do the same rituals over and over such as washing hands, locking and unlocking doors, counting, keeping unneeded items, or repeating the same steps again and again.  They can’t control the unwanted thoughts and behaviors.  They don’t get pleasure when performing the behaviors or rituals, but get brief relief from the anxiety the thoughts cause.  They spend at least 1 hour a day on the thoughts and rituals, which cause distress and get in the way of daily life.

OCD sometimes runs in families, but no one knows for sure why some people have it, while others don’t.  Researchers have found that several parts of the brain are involved in fear and anxiety.  By learning more about fear and anxiety in the brain, scientists may be able to create better treatments.  Researchers are also looking for ways in which stress and environmental factors may play a role.

When seeking treatment for OCD, you should talk to your doctor to make sure another physical problem isn’t causing the symptoms.  OCD is generally treated with psychotherapy, medication or both.  Doctors  commonly prescribe anti-anxiety and antidepressants for OCD.  Talk to your doctor about any side effects you may have.  Cognitive behavioral therapy is especially useful for treating OCD.  It teaches a person different ways of thinking, behaving and reacting to situations that help him or her feel less anxious or fearful without having obsessive thoughts or acting compulsively.  Exposure and response therapy can also be helpful in reducing obsessive-compulsive disorder behaviors.

National Institute of Mental Health – Obsessive-Compulsive Disorder:  When Unwanted Thoughts Take Over


Panic Disorder

People with panic disorder have sudden and repeated attacks of fear that last for several minutes.  Sometimes symptoms may last longer.  These are called panic attacks.  Panic attacks are characterized by a fear of disaster or of losing control even when there is no real danger.  A person may also have a strong physical reaction during a panic attack.  It may feel like having a heart attack.  Panic attacks can occur at any time, and many people with panic disorder worry about and dread the possibility of having another attack.

A person with panic disorder may become discouraged and feel ashamed because he or she cannot carry out normal routines like going to the grocery store or driving.  Having panic disorder can also interfere with school or work.

Panic disorder often begins in the late teens or early adulthood.  More women than men have panic disorder.  But not everyone who experiences panic attacks will develop panic disorder.

What are the signs and symptoms of panic disorder?

Sudden and repeated attacks of fearspin

A feeling of being out of control during a panic attack

An intense worry about when the next attack will happen

A fear or avoidance of places where panic attacks have occurred in the past

Physical symptoms during an attack, such as a pounding or racing heart, sweating, breathing problems, weakness or dizziness, feeling hot or a cold chill, tingly or numb hands, chest pain, or stomach pain

 

Panic disorder sometimes runs in families, but no one knows for sure why some people have it, while others don’t.  Researchers have found that several parts of the brain are involved in fear and anxiety.  By learning more about fear and anxiety in the brain, scientists may be able to create better treatments.  Researchers are also looking for ways in which stress and environmental factors may play a role.

The first step in treating panic disorder is to talk to your doctor about symptoms.  Your doctor should do an exam to make sure that another physical problem isn’t causing the symptoms.  The doctor may refer you to a mental health specialist.  Panic disorder is generally treated with psychotherapy, medication, or both.

A type of psychotherapy called cognitive behavior therapy is especially useful for treating panic disorder.  It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious and fearful.  Doctors also may prescribe medication to help treat panic disorder.  The most commonly prescribed medications for panic disorder are anti-anxiety medications and antidepressants.  Anti-anxiety medications are powerful and there are different types.  Many types begin working right away, but they generally should not be taken for long periods.

Antidepressants are used to treat depression, but they also are helpful for panic disorder.  They may take several weeks to start working.  Some of these medications may cause side effects such as headache, nausea, or difficulty sleeping.  These side effects are usually not a problem for most people, especially if the dose starts off low and is increased slowly over time.  Talk to your doctor about any side effect you may have.

It’s important to know that although antidepressants can be safe and effective for many people, they may be risky for some, especially children, teens, and young adults.  A “black box” – the most serious type of warning that a prescription drug can have – has been added to the labels of antidepressant medication.  These labels warn people that antidepressants may cause some people to have suicidal thoughts or make suicide attempts.  Anyone taking antidepressants should be monitored closely, especially when they first start treatment with medications.

Another type of medication called beta-blockers can help control some of the physical symptoms of panic disorder such as excessive sweating, a pounding heart, or dizziness.  Although beta blockers are not commonly prescribed, they may be helpful in certain situations that bring on a panic attack.

Some people do better with cognitive behavior therapy, while others do better with medication.  Still others do best with a combination of talk therapy and medication to treat panic disorder.

National Institute of Mental Health

 

 


Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD) is a real illness.  You can get PTSD after living through or seeing a dangerous event, such as war, a hurricane, or a bad accident.  PTSD makes you feel stressed and afraid after the danger is over.  It affects your life and the people around you.  If you have PTSD, you can get treatment and feel better.

PTSD can happen to anyone at any age.  Children can get PTSD too.  You don’t have to be physically hurt to get PTSD.  You can get if after you see other people, such as a friend or family member, get hurt.

Living through or seeing something that’s upsetting and dangerous can cause PTSD.  This can include death or serious illness of a loved one, war, combat, car accidents, plane crashes, hurricanes, tornadoes, fires, violent crimes – like a robbery or shooting.

There are many other things that can cause PTSD.  Talk to your doctor if you are troubled by something that happened to you or someone you care about.  Call your doctor if you have any of these problems for at least 1 month:

Suffering from bad dreams

Feeling like the scary event is happening again (flashbacks)bythelake

Experiencing scary thoughts you can’t control

Staying away from places and things that remind you of what happened

Feeling worried, guilty or sad

Sleeping too little or too much

Feeling on edge

Fighting with loved ones or frequent angry outbursts

Thoughts of hurting yourself or others

Feeling alone

Children who have PTSD may show other types of problems such as behaving like they did when they were younger, being unable to talk, complaining of stomach problems or headaches a lot, refusing to go places or play with friends.

PTSD starts at different times for different people.  Signs of PTSD may start soon after a frightening event and then continue.  Other people develop new or more severe signs months or even years later.

PTSD can be treated.  A doctor or mental health professional who has experience in treating people with PTSD can help you.  Treatment may include “talk” therapy, medication, or both.  Treatment might take 6 to 12 weeks.  For some people, it takes longer.  Treatment is not the same for everyone.  What works for you might not work for someone else.  Drinking alcohol or using other drugs will not help PTSD go away and may even make it worse.

This article is from NIH – National Institute of Mental Health.


Family Therapy & Substance Abuse Cost Analysis

Family therapy & substance abuse cost analysis shows the value of these interventions.  Substance abuse has the potential for recovery & improved functioning.  The guideline developers reviewed published cost analyses.  Only a few studies have assessed the cost benefits of family therapy or have compared the cost of family therapy to other approaches such as group therapy, individual therapy, or 12-Step programs.  A small but growing body of data; however, has demonstrated the cost benefits of family therapy specifically for substance abuse problems.  Family therapy also has appeared to be superior in situations that might in some key respect be similar to substance abuse contexts.

For example, Sexton and Alexander’s work with functional family therapy (so called because it focuses its interventions on family relationships that influence and are influenced by, and thus are functions of, positive and negative behaviors) for youth offenders found that family therapy nearly halved the rate of re-offending – 19.8 percent in the treatment group compared to 36 percent in a control group.  The cost of the family therapy ranged from $700 to $1,000 per family for the 2-year study period.  The average cost of detention for that period was at least $6,000 per youth; the cost of a residential treatment program was at least $13,500.  In this instance, the cost benefits of family therapy were clear and compelling.  Other studies look at the offset factors; that is, the relationship between family therapy and the use of medical care or social costs.  Fals-Stewart et al. (1997) examined social costs incurred by clients (for example, the cost of substance abuse treatment or public assistance) and found that behavioral couples therapy was considerably more cost effective than individual therapy for substance abuse, with a reduction of costs of $6,628 for clients in couples therapy, compared to a $1,904 reduction for clients in individual therapy.

Similar results were noted in a study by the National Working Group on Family-Based Interventions in Chronic Disease, which found that, 6 months after a family-focused intervention, reimbursement for health services was 50 percent less for the treatment group, compared to a control group.  While this study looked at chronic diseases such as heart disease, cancer, Alzheimer’s disease, and diabetes, substance abuse also is a chronic disease that is in many ways analogous to these physical conditions.  Both chronic diseases and substance abuse:fam

* Are long-standing and progressive

* Often result from behavioral choices

* Are treatable, but not curable

* Have clients inclined to resist treatment

* Have high probability of relapse

Chronic diseases are costly and emotionally draining.  Substance abuse is similar to a chronic disease, with potential for recovery; it even can lead to improvement in family functioning.  Other cost benefits result from preventive aspects of treatment.  While therapy usually is not considered a primary prevention intervention, family-based treatment that is oriented toward addressing risk factors may have a significant preventive effect on other family members.  For example, it may help prevent substance abuse in other family members by correcting maladaptive family dynamics.

Source:  guideline.gov

 


Depression

Everyone occasionally feels blue or sad, but these feelings are usually fleeting and pass within a couple of days.  When a person has a depressive disorder, it interferes with daily life, normal functioning and causes pain for both the person with the disorder and those who care about him or her.  Depression is a common but serious illness and most who experience it need treatment to get better.

girlbylakeMany people with a depressive illness never seek treatment.  But the vast majority, even those

with the most severe depression, can get better with treatment.

What are the symptoms of depression?

The severity, frequency and duration of symptoms will vary depending on the individual and his or her particular illness.

Symptoms my include:

Persistent sad, anxious or “empty” feelings

Feelings of hopelessness and/or pessimism

Feelings of guilt, worthlessness and/or helplessness

Irritability, restlessness

Loss of interest in activities or hobbies once pleasurable, including sex

Fatigue and decreased energy

Difficulty concentrating, remembering details and making decisions

Insomnia, early-morning wakefulness or excessive sleeping

Overeating or appetite loss

Thoughts of suicide, suicide attempts

 

 

What illnesses often co-exist with depression?

Depression often co-exists wit other illnesses.

Anxiety disorders, such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, panic disorder, social phobia and generalized anxiety disorder often accompany depression.  People experiencing PTSD are especially prone to having co-occurring depression.

People with PTSD often re-live the traumatic event in flashbacks, memories or nightmares.  Other symptoms include irritability, anger outbursts, intense guilt and avoidance of thinking or talking about the traumatic ordeal.  Researchers found that more than 40 percent of people with PTSD also had depression at one-month and four-month intervals after the traumatic event.

Alcohol and other substance abuse or dependence may also co-occur with depression.  In fact, research has indicated that the co-existence of mood disorders and substance abuse is pervasive among the U.S. population.

Depression also often co-exists with other serious medical illnesses such as heart disease, stroke, cancer, hiv/aids, diabetes and Parkinson’s disease.  Studies have shown that people who have depression in addition to another serious medical illness tend to have more severe symptoms of both depression and medical illness, more difficulty adapting to their medical condition and more medical costs than those who do not have co-existing depression.  Research has yielded increasing evidence that treating the depression can also help improve the outcome of treating the co-occurring illness.

What causes depression?

There is no single known cause of depression.  Rather, it likely results from a combination of genetic, biochemical, environmental and psychological factors.

Research  indicates that depressive illnesses are disorders of the brain.  Brain imaging technologies , such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression.  The parts of the brain responsible for regulating mood, thinking, sleep, appetite and behavior appear to function abnormally.  In addition, important neurotransmitters – chemicals that brain cells use to communicate – appear to be out of balance.

Some types of depression tend to run in families, suggesting a genetic link.  However, depression can occur in people without family histories of depression as well.  Genetics research indicates that risk for depression results from the influence of multiple genes acting together with environmental or other factors.

In addition, trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode.  Subsequent depressive episodes may occur with or without an obvious trigger.

How is depression detected and treated?

Depression, even the most severe cases, is a highly treatable disorder.  As with many illnesses, the earlier that treatment can begin, the more effective it is and the greater the likelihood that recurrence can be prevented.

The first step to getting appropriate treatment is to visit a doctor.  Certain medications and some medical conditions such as viruses or a thyroid disorder, can cause the same symptoms as depression.  A doctor can rule out these possibilities by conducting a physical examination, interview and lab tests.  If the doctor can eliminate a medical condition as a cause, the patient can be referred to a mental health professional.

The mental health professional will conduct a complete diagnostic evaluation.  He or she should discuss any family history of depression and get a complete history of symptoms, e.g., when they started, how long they have lasted, their severity and whether they have occurred before and if so, how they were treated.  He or she should also ask if the patient is using alcohol or drugs and whether the patient is thinking about death or suicide.

Once diagnosed, a person with depression can be treated with a number of methods.  The most common treatments are medication and psychotherapy.

Psychotherapy

Psychotherapy – or “talk therapy” – can help people with depression.

Some regimens are short-term (10 to 20 weeks) and other regimens are longer-term, depending on the needs of the individual.  Two main types of psychotherapies – cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) – have been shown to be effective in treating depression.  By teaching new ways of thinking and behaving, CBT helps people change negative styles of thinking and behaving that may contribute to their depression.  IPT helps people understand and work through troubled personal relationships that may cause their depression or make it worse.

For mild to moderate depression, psychotherapy may be the best treatment option.

For more information please visit:  http://www.nimh.nih.gov/health/publications/depression/complete-publication.shtml


Coping with Chronic Pain

trainChronic pain is physically and psychologically stressful and its constant discomfort can lead to anger and frustration with yourself and your loved ones.  By definition, chronic pain is pain that lasts longer than six months and affects how a person lives their daily life.  While physicians can provide treatment for the physical dimensions of chronic pain, psychologists are uniquely trained to help you manage the mental and emotional aspects of this often debilitating condition.  The American Psychological Association offers the following tips on coping with chronic pain:

Manage your stress.  Eating well, getting plenty of sleep, and engaging in approved physical activity are all positive ways for you to handle your stress and pain.

Talk to yourself constructively.  Positive thinking is a powerful tool.  Focus on the improvements you are making, i.e. the pain is less today than yesterday or you feel better than you did a week ago, can make a difference in your perceived comfort level.

Become active and engaged.  Distracting yourself from your pain by engaging in activities you enjoy will help you highlight the positive aspects of your life.

Find support.  Reach out to other people who are in your same position and who can share and understand your highs and lows.

Consult a professional.  If you continue to feel overwhelmed by chronic pain at a level that keeps you from performing your daily routine, you may want to talk with a mental health professional, such as a psychologist, who can help you handle the physical and psychological repercussions of your condition.

Author’s content used under license, © 2008 Claire Communications


Help For Anxiety

John grabbed his cell phone and frantically called his mother.  “My mind is racing and I think I may be going crazy” he said when his mom picked up the phone.  “Calm down, son”, “everything will be okay”.

John was a 28 year-old single male living at home with his mom and two sisters.  He never married because he had difficulty going out on dates.  He worried about traffic, he thought about getting in to an accident, he was concerned about spending money.  John had the “worry wart” syndrome that plagues millions of Americans everyday.

girlbywindowWhen anxiety and worry reaches that tipping point of interfering with everyday life, it can grow beyond a nuisance to the point of being debilitating.  That is what happened to John.

He not only worried about driving in traffic, he worried about flying on a plane, getting on a bus, almost any form of transportation presented a new form of worry for John.

As his mind obsessed about all the things that could go wrong, he became restless and his muscles began to tremble and twitch.  Often his mouth would become dry, some nausea or indigestion frequently set in.  He just felt “keyed up” or on edge most of the time.  The irritability interfered with his ability to concentrate and life became more difficult.

John’s mom finally insisted that he seek psychotherapy for his anxiety.  Once he agreed, she even called to make the appointment for him.  After talking with the Psychologist, John began to feel a glimmer of hope.  Perhaps he didn’t need to live with this overwhelming anxiety after all.

For more help and information about anxiety, please visit the National Institute of Mental Health.


Top 10 Ways to Raise Your Self-Esteem

Self-esteem is not a gift bestowed by those outside of us or something that can be taken from us by others. It’s an inside job. Rather than wait passively for good self-esteem to happen, we need to take action. Daily or weekly is best.2people

1. Make a list. What’s good about you? What’s wonderful? Hang your list near your bed so that you see it when you awaken and when you go to sleep.

2. Forgive yourself. Acknowledge a mistake, but let go of self-recrimination. Recognize that you, too, are human and “allowed” to fail.

3. Do one thing you’ve been putting off. It’s amazing how clearing clutter (literal or figurative) can clear a space for better self-esteem.

4. Relax! Meditate, exercise, take a bath. When you’re relaxed, negative things don’t seem so big, and it’s easier to remember the good things about you.

5. Do something you’re good at. The competence and accomplishment you feel when doing that activity are great antidotes to low self-esteem.

6. Learn something new. When we commit to learning, we commit to growth as a way of life. Acknowledge that you are moving forward.

7. Get absorbed in a project or other activity. Taking the focus off yourself can help when you feel low, anxious or lacking in confidence.

8. Assert yourself. Learning this skill goes a long way to improving your self-image.

9. Remember what you’ve achieved. Take a step back and look at the whole of your life.

10. Do a self-esteem “workout.” In a private place and with complete abandon, shout all the things you’re good at, why you matter. It’s surprising how instantly effective this exercise is.

Author’s content used under license, © 2008 Claire Communications