How To Bolster and Boost Mental Health During a Transition

Transitions can be exciting but also stressful. In my experience, people tend to respond to major life changes in one of two ways: Denial or Distraction. Deniers cling to the past and are flooded with nostalgia. Distractors bury themselves in busywork, hoping to put the upheaval behind them as soon as possible.

Bruce Feiler, author of the bestselling book Life is in the Transitions: Mastering Change in a Nonlinear Age, has made a similar observation:


When most people enter a lifequake, they feel overwhelmed and go to one of two extremes. They either make a 212-item to-do list and say, ‘I’ll get through it in a weekend,’ or they lie in a fetal position and say, ‘I’ll never get through it.’ Neither approach works.”


Feiler offers a healthier alternative plan for dealing with upheaval:

1. Lean into your feelings

Instead of sweeping emotions under the rug, use them as data points. What can you learn from them? How can they help you re-goal? Consider writing about how you are feeling or talking to someone.

2. Reach out

Navigating a transition alone makes it even harder. Seek wisdom from a friend, a colleague, a teacher, or even a stranger. Share your experience with others. Spread the wisdom you have acquired along the way.

3. Mark the occasion

According to Feiler, rituals are effective tools to help us navigate transition. Commemorate the change with a ceremony, a special meal, a toast, or lighting a candle. Rituals help us shed parts of ourselves we are ready to let go of and embrace a new beginning.

4. Be good to your body

When your routine is disrupted, it’s all the more important to take care of yourself. Prioritize sleep, eat nourishing meals, and build movement into your everyday routine. Feeling physically strong will help you stay mentally strong.

5. Get creative

Make the most of the fresh start by tapping into your creativity. Start a new hobby or personal project that engages your imagination and allows for growth and possibility. As Feiler says, “The simple act of imagining — a painting, a poem, a loaf of bread — allows us to imagine a better future.”

Transitions are often tough, messy and uncomfortable. They also mark new beginnings.

As Tom Stoppard remarked, “Look on every exit as being an entrance somewhere else.”

I wish you all the best,

Dr. Samantha Boardman

The Experiences That Make People Happiest

We may be creatures of habit but research suggests that the best way to boost our everyday happiness is to shake up our routine. According to a study published in the journal Nature Neuroscience, we feel happier when we have more variety in our daily lives. The researchers found that regularly going to novel places and having a wider array of experiences reliably boosts positive emotions.

Previous research has shown that rodents raised in “enriched environments” — environments where they are exposed to novel and diverse experiences — are more playful, relate better to fellow rodents, learn better, and demonstrate greater resilience to stress. As the study in Nature Neuroscience shows, the same principle seems to hold true for human beings.

Using GPS, the researchers tracked participants’ daily movement for 3 to 4 months. Each individual’s “roaming entropy” — their level of exploration — was quantified using the location data. Those with low roaming entropy stayed close to home. Those with high roaming entropy were more intrepid, frequently venturing beyond their neighborhood and exposed to novel situations. On days when participants had higher roaming entropy, they reported more positive emotions such as “happy,” “excited,” “strong,” and “relaxed.”

Our results suggest that people feel happier when they have more variety in their daily routines—when they go to novel places and have a wider array of experiences,” explained Catherine Hartley, an assistant professor in New York University’s Department of Psychology and one of the paper’s co-authors.

The benefits of shaking things up linger — those who spent time in different locations and engaged in varied experiences on one day also felt more upbeat the following day.

Low roaming entropy may partially explain why lockdown was so challenging. It may also account for why some people find working from home to be draining or devitalizing. Being locked into a routine that limits exposure to new places, people, or things can take a toll. That said, fresh and diverse experiences can be had without venturing too far. Biking across town, visiting a museum, walking a different path, or trying a new skill are all ways to lean into the unfamiliar. Exploring the unknown has a powerful effect on mood. Take advantage of it. No need to become an intrepid explorer or climb Mount Everest. Just a little variety is enough to give you a boost.

Patients often tell me, “I am who I am.” I remind them that they are who they chose to be.

Bottom Line: As tempting as it is to retreat, remember that the most uplifting moments of the day come from venturing out into the world.

 

I wish you all the best,

Dr. Samantha Boardman

The Mind Shifts in Mysterious Ways After Midnight

When I was a teenager my parents’ favorite response to my requests to stay out late was always the same: “Nothing good ever happens after midnight.” Like most teenagers, I had perfected the art of the eye roll. What did they know? Well apparently quite a lot according to a new study published in the journal Frontiers in Network Physiology, The Mind After Midnight: Nocturnal Wakefulness, Behavioral Dysregulation, and Psychopathology.

The concern that bad things happen after dark now has science behind it. When we are awake during the wee hours, neurophysiological changes in the brain alter the way we interact with the world, especially actions related to impulse control, reward processing, and high risk decision. If you’ve ever stayed up late and sent a regrettable Tweet, wolfed down a box of cookies, polished off another bottle of wine, or gone on a late night QVC shopping spree, you might agree that the mind after midnight is not thinking straight. If you’re awake in the middle of the night, it’s fair to say that your brain is not functioning at its best.

Bad things happen after dark

  • Homicides and violent crime are more common at night
  • People are more at risk for engaging in harmful behavior such as suicide, violent crime and substance abuse at night
  • Our nighttime food choices at night also tend to be unhealthy, as we pursue more carbohydrates, lipids and processed foods and often consume more calories than we need.
    (Source: SciTechDaily.com)

So why does behavior shift at night?

The cloak of darkness offers a partial explanation—it’s easier to commit crimes or indulge in unhealthy habits when fewer people are around and awake to notice or intervene.

But there’s more to it than that. Research shows how the mind shifts in mysterious ways after midnight:

  1. The tendency to experience positive affect — positive emotional states such as joy, energy, and cheerfulness — is highest during morning hours and bottoms out between 1am and 4am.
  2. The tendency to experience negative affect — negative emotional states such as anger, distress, and fear — peaks at night, when positive affect is at rock bottom.
  3. The combination of low positive affect with high negative affect shapes how we attend to and interpret information. In the wee hours, things that are annoying or irritating can feel catastrophic. An ex’s social media post about their new partner might have rankled you at 1pm. At 1am, it’s far more upsetting.
  4. It’s harder to manage a bad mood in the middle of the night. According to the study published in Frontiers in Network Physiology, we are more vulnerable to depressive, anxious, and paranoid thinking after midnight.
  5. Reward processing is out of whack and executive functioning is dysfunctional at night.

Long-term planning and behavioral inhibition are diminished in favor of high-risk decision-making and cognitive inflexibility, leading to repeated, maladaptive behaviors that do not respond to negative feedback,” explain the researchers.

If you are sending a kid off to college for the first time or back to school, have a conversation with them about prioritizing sleep. Remind them that in addition to improving academic performance, getting enough rest will protect their mental health. A study found that teens who got 8 3/4 to nine hours of sleep per night had the lowest levels of mental health issues, including moodiness, feelings of worthlessness, anxiety and depression.

Don’t worry about the eye roll. Unlike our parents, at least you have some concrete data!

Bottom Line: It’s not a good idea to be awake when reason sleeps.

I wish you all the best,

Dr. Samantha Boardman

Spot a Narcissist (Before You Marry, Hire, Date, or Befriend One) By Asking These 2 Questions

Hands down, narcissism is the psychological disorder I get the most questions about. Rarely do people voice concern over their own narcissistic tendencies. In fact, nobody has ever come to my office and said, “Am I a narcissist?” though many have asked if they have depression or anxiety. What they would like to know about is how to deal with the narcissists in their lives. This week’s Dose is about how to spot a narcissist before you marry, hire, date, or befriend one.

It’s worth pointing out that narcissism isn’t always toxic and to a certain extent is adaptive. Desiring admiration, attention, and approval is part of being human and the motivation to maintain positive self-regard is perfectly normal. In fact, it’s healthy to think well of oneself. Interestingly, studies show that most of us think a little
too highly of ourselves. Ninety-three percent of drivers believe they are “more skilled than most drivers.” Eighty-five percent of college students say they “get along better with others than average.” People think their kids are better than other kids.

Just because most of us have exaggerated perceptions of personal superiority doesn’t mean that we are all narcissists.

Normal narcissism is distinct from pathological narcissism.
The two questions I always ask to assess for the presence of pathological narcissism are:
Those with narcissistic personality disorder can typically talk about themselves for hours on end but they have a hard time describing the other people in their lives. They happily provide lively, specific, and usually flattering details about themselves but when pressed to talk about other significant people in their lives, they have little to say.


In contrast to the rich depictions of the self, they typically provide shallow, vague, and oftentimes generic descriptions of the people they are supposedly close to. A narcissistic husband who cheats on his wife might describe her as “a bore” or “not fun to be with” without providing any nuance or depth of understanding of her inner life or acknowledging how his behavior is impacting her.

According to Eve Caligor, clinical professor of psychiatry at Columbia University, people with narcissistic personality disorder have relationships that are transactional and lacking in empathy. Their interest in others is self-serving and viewed through the lens of self-enhancement as in “how can this person elevate my social standing or help me look good?”

For a narcissist, getting ahead is more important than getting along and this exploitative mindset is captured by their inability to imagine or describe the feelings of others.

As insanely obvious as this sounds, this is a reliable way to identify a narcissist. A study found that how people rated themselves on a scale of 1 (not true of me) to 7 (very true of me) aligned closely with other validated measures of narcissism, such as the widely used Narcissistic Personality Inventory.

Brad Bushman, a co-author of the study and professor of communication and psychology at Ohio State University
explained:

“People who are willing to admit they are more narcissistic than others probably actually are more narcissistic. People who are narcissists are almost proud of the fact. You can ask them directly because they don’t see narcissism as a negative quality — they believe they are superior to other people and are fine with saying that publicly.”

One of the many advantages of this simple narcissism litmus test is that it enables narcissist identification so quickly and easily. Of course, you could always ask someone to take the classic
Narcissism Personality Inventory developed by Raskin and Hall but that might be a little awkward.


Bottom line: Healthy narcissism is real. So is toxic narcissism. Ask these two revealing questions to spot the difference.

I wish you all the best,

Dr. Samantha Boardman

Stress Isn’t All Bad: 3 Ways to Get Comfortable With Discomfort

In 1915 a German warship torpedoed the British ocean liner Lusitania off the coast of Ireland, sinking it and drowning almost twelve hundred passengers, including 128 American citizens. A hundred years later my son had to deliver a speech on this attack and its significance to his sixth-grade class. It was a challenging assignment, and he spent stressful weeks rehearsing the presentation, knowing he would be judged by his teachers and peers. His preparation paid off, and when I asked him afterward about the experience, he responded with a smile, “It was really hard, but in a good way.

Stress, we are constantly told, is unequivocally bad for us. If we want to stay healthy, we are advised to banish it from our lives and avoid it at all costs. From divorce to depression to dementia, we point the finger at stress. If only we had less of it, we are led to believe, we would be happy, healthy, and well-adjusted. Missing from the conversation is how hard and challenging experiences help us grow, and that things can be stressful … in a good way.

New research from the Youth Development Institute at the University of Georgia published in Psychiatry Research found that low to moderate levels of stress can help individuals develop resilience and reduce the risk of developing mental health disorders, like depression and antisocial behaviors. According to the authors, stressful situations and environments prompt individuals to be resourceful and cognitively flexible, and as a result learn strategies and skills that help them overcome adversity and thrive. As they conclude, “Our findings highlighted the role of enhanced cognitive functioning as a mechanism through which low-to-moderate levels of psychosocial stress confer psychological and socioemotional strengthening effects that may help individuals cope with current and future stressors.” Put differently, a certain amount of stress can be psychologically beneficial, potentially acting as a kind of inoculation against developing mental health issues down the line.

The belief that stress is debilitating under any circumstance undermines the ability to cope with life’s challenges and promotes avoidance of uncomfortable but also potentially growth experiences. As the research highlights, adverse experiences can actually make us stronger and prepare us for future uncertainty.

Here is how you can build your stress muscle and get comfortable with discomfort:

1. Make a Failure Resume

Tina Seelig, Professor of the Practice in Stanford University’s Department of Management Science and Engineering, encourages her students to create a detailed Failure Resume; a full list of all their failures, as well as what they learned from each one of those missteps. Building failure into the learning process normalizes disappointment and frustration. It’s an antidote for perfectionism and puts mistakes into perspective. Challenges are less stressful when seen through the lens of progress and learning. As Seelig notes, “if you want more successes, you are going to have to tolerate more failure along the way.”

Along these lines, talk to your kids about the times you messed up—personally, professionally, academically. Let them know about the goofs, the gaffes, and the stumbles as well as what you do differently as a result. Stepping off the pedestal of perfection will enable them to see challenges as hurdles instead of road blocks.

2. Adopt a Stress-Can-Be Enhancing Mindset

Believing that all stress is toxic can lead to disengagement from resilience building experiences. Indeed a stress-avoidance mentality ignores the reality that elevated levels of stress are normal, and in many ways, even desirable when acquiring new skills. A recent study published in Nature found that students who learn that people’s stress responses are not harmful but instead can fuel performance by helping them persevere and take on difficult challenges were more resilient. The key is to reframe stress responses away from something negative that needs to be feared and tamped down towards recognizing those responses—sweaty palms, a racing heart, for example—as a positive driving force.

3. Get Awkward

Research suggests that if we shift our attitude towards discomfort, seeing it as a sign of progress and something to strive for rather than avoid, we are more motivated to work towards our goals and more engaged in the process. A new paper in Psychological Science suggests that allowing for awkwardness makes people less stress-avoidant and more willing to embrace challenges: “Instead of avoiding the discomfort inherent to growth, people should seek it as a sign of progress. Growing is often uncomfortable; we find that embracing discomfort can be motivating.” Across a range of situations, including improv classes, expressive journaling, as well as learning about challenging topics such as COVID-19, opposing political viewpoints, and gun violence, people who were invited to embrace discomfort persisted longer, engaged more, and were more curious.

Psychiatrist Richard Friedman, who runs the mental health services for Weill Cornell Medicine of Cornell University in New York, has voiced concern that the emphasis on wellness today is creating unrealistic expectations that everyone should be smiling and stress free at all times. “Though I can’t prove it,” Friedman wrote, “I suspect that my generation suffered less burnout than current students for the simple reason that we expected to have a rough ride.”

Each year Friedman greets incoming first-year medical students by telling them, “These next four years will be exciting and challenging and stressful … It’s entirely natural to feel anxious, overwhelmed at times, and exhausted. In fact, it’s evidence you are alive and engaged in your work.”

We feel stress because we care and because we’re striving. Poet David Whyte describes this succinctly: “In romance, in parenting, and in our professional lives—when we’re fully committed and deeply engaged, we get hurt, feel frustration, upset. And that’s not a bad thing. It means you are sincere and committed.

Bottom Line: Things can be hard and stressful … but in a good way.

I wish you all the best,

Dr. Samantha Boardman

Does the Thought of Winding Down Wind You Up?

Imagine sitting alone at a restaurant waiting for a friend. How do you pass the time? Do you look around? Do you savor the alone time to reflect? Do you allow yourself to daydream? Odds are you do none of the above. You reach for your phone and don’t look up until your friend arrives.

Using our phone as a time-filler whenever there is a free moment is now the norm. Waiting on line, in between conversations at a cocktail party, before a meeting begins, sitting in a taxi, along with every other “in-between” moment, are now invitations to connect with our devices instead of the world around us or ourselves.

Is it really that hard to sit in solitude without anything to do? The short answer is yes. According to research conducted at the University of Virginia, people do not enjoy being left alone with their thoughts. Participants in the study were seated in sparsely furnished rooms for 15 minutes without any distraction—no phone, no book, no paper, no pen. The only diversion was a button they could push to shock themselves. Before the experiment began, the researchers administered a brief zap to demonstrate how it felt. It wasn’t pleasant—all participants said that they wouldn’t want to be shocked again. But this changed once the experiment was underway. In the 15 minutes of solitude, 67% of the men and 25% of the women zapped themselves. Even the researchers were shocked by the shocks.

“What is striking is that simply being alone with their own thoughts for 15 min was apparently so aversive that it drove many participants to self-administer an electric shock that they had earlier said they would pay to avoid.”

It is tempting to blame the overuse of devices to provide non-stop entertainment and distraction. Interestingly, however, difficulty being alone was unrelated to age or use of technology. A grandmother was as miserable as a college freshman when forced to entertain herself. Perhaps the best explanation for this “shocking” behavior is the “scanner hypothesis” which posits that mammals have evolved to monitor their environment for change and to scan for danger and opportunities. As the lead researcher, Timothy Wilson, explains:

“It would be a little odd to see a chimpanzee posed like Rodin’s thinker for extended periods of time.”

Downtime of any kind can be challenging. Few savor the idea of taking time to “just think” or relax. Distraction is our default mode. I have a number of patients who have difficulty winding down. As one patient explained, “the more I try not to think about work, the more I think about work.” Another dreads the peace and quiet: “I miss the energy of the office.” A third rejects the expectation to chill out: “I told my partner I cannot be told to relax on command.” Vacation trepidation affects many who are used to leading “crazy busy” lives.

There may be an evolutionary explanation for feeling uncomfortable when left alone with our thoughts. That said, there is an advantage to learning to sit without distraction. In fact, research shows that solitude is crucial for the development of the self. As highlighted in a study entitled, Solitude: An Exploration of Benefits of Being Alone, solitude is associated with creativity, intimacy, and spirituality. Spending time alone allows for growth and reflection. There is also evidence that it can improve relationships and builds empathy. French philosopher Blaise Pascal said, “All of humanity’s problems stem from man’s inability to sit in a quiet room alone.”

Meditation and other relaxation techniques are well-established strategies to make downtime more tolerable and perhaps even productive. By gaining control over our thoughts, little annoyances like traffic jams and waiting rooms become less stressful and the big questions become less daunting.

Boredom isn’t such a bad thing, especially when you reframe it as an opportunity to use your imagination. In an article in GQ magazine, Lin-Manuel Miranda, the mastermind behind the hit show “Hamilton,” talks about a childhood friend who once spent a three-hour car ride playing with a stick he found in the backyard.

Sometimes the stick was a man, sometimes a piece in a larger game, or he’d give it voices, pretend the stick was a telephone. I remember sitting there next to him with my ‘Donkey Kong’ thinking, ‘Dude, you just entertained yourself for three hours … with a f–king twig!’ And I thought to myself, ‘Wow, I have to raise my imagination game.’

Miranda says “time alone is the gift of self-entertainment—and that is the font of creativity. Because there is nothing better to spur creativity than a blank page or an empty bedroom.

Next time you find yourself with nothing to do, instead of staring at a screen, channel a famous refrain from one of the songs in Hamilton: Look around, look around. How lucky we are to be alive right now.

These days I spend a lot of time talking to my patients about how they spend their days. I prescribe at least fifteen minutes a day, every day, of doing NOTHING. As a result, their mindset about free time has shifted. Instead of thinking of downtime as a source of anxiety, they now think of it as an opportunity. Best of all, they look forward to their vacations.

I wish you all the best,

Dr. Samantha Boardman