Perfectionism: Helpful drive or treacherous trap?

Do you usually strive to do things as perfectly as possible and without any mistakes? Do you often think, “I’m sure this could be better”? If so, you’re certainly not alone. Many people set pretty high standards for themselves, whether at work, school, or home. Perfectionism can affect pretty much every area of life.

And it’s true that perfectionism can, in fact, sometimes be a benefit because it comes with a strong drive to work hard. So, say you have an important exam, as a person prone to perfectionism, you’ll likely prepare very well for it. Those who often strive for perfection do tend to perform exceptionally well and reap lots of praise and recognition as a result.

But what’s typically behind this drive to be perfect? Rather than being a reach for success, more often it’s about responding to a deep fear: Fear of being criticized for mistakes. Fear of being rejected. Or fear of just not being good enough.

And who likes to feel inferior? Who likes to be criticized or, worse, rejected? That perfectionist tendencies would be the response to this fear is absolutely understandable. In a sense, perfectionism in these cases, becomes like an armor against a threat. “If I do it as perfectly and flawlessly as possible, they won’t have any reason to criticize me.”

The perfect is often the enemy of the good

While perfectionism may seem like a good strategy, then, it does come with a price. Striving for perfection in everything takes up a lot of mental space and can be exhausting. With the stress and pressure of needing perfection often comes a fear of starting a task because of a pronounced concern about making a mistake. The result is often less productivity despite a tendency toward overwork and denying oneself breaks and time for relaxation. This sometimes also spells increased conflict with others.

For all these reasons, insisting on absolute perfection increases the risk of depression and anxiety disorders.

Shedding the Armor

Sure, setting high goals and ideals can provide direction and motivation but when “I’d like to achieve this goal” turns into “I absolutely have to do this perfectly no matter what,” stress and tension are the likely results. Noticing your tendency toward perfectionism is the first step toward a positive change.

Take a few moments to reflect on these questions:

• What does perfectionism protect you from?
• Is this protection really necessary and helpful in the here and now?
• What is the worst that could happen if you do something well but not perfectly?
• What is the best that could happen if you do something well but not perfectly?
• What is actually most likely to happen if you do something well but not perfectly?

You might even want to test out the situation and deliberately do something less meticulously than you normally would and see what happens.

Such a reality check can be quite valuable. Often the fears behind perfectionism develop because of earlier experiences in childhood, and are not necessarily related to what’s going on now. In most cases, then, you actually won’t experience either criticism or rejection if what you do is not completely perfect. And isn’t it true that how well (or not) you perform doesn’t really indicate how much you’re worth?

Taking off the armor of perfectionism can be quite challenging, especially if you have been wearing it for a long time. Consider enlisting the support of a mental health practitioner, if you haven’t already.

Fear Out of the Blue: What Happens During a Panic Attack?

Racing heart, dizziness, pressure in the chest, shortness of breath, fear of losing control or even of dying . . . Anyone who’s had a panic attack knows how frightening and uncomfortable it can be. This blog post answers a number of questions about panic and, specifically, panic attacks: What happens in the body and mind during a panic attack? Can a panic attack be harmful? What can help deter such attacks?

Alarm without Danger

When a fire starts in a building, an ear-piercing alarm is tripped, warning occupants of the danger and alerting them to take action to get to safety. In many ways, fear is the human equivalent of such an alarm as it, too, signals danger and motivates an action to deal with the danger. The so-called stress response, prompted first by a perceived danger, primes the body to stay and fight, flee, or freeze.

This innate alarm can be super helpful and, in extreme danger, can mean the difference between life or death. Imagine you’re driving on a mountain highway at night in winter when a heavy snow starts to fall. You can hardly see a thing and the road is quite slick. Fear would be a perfectly normal response in this situation and would probably motivate you to slow way down and concentrate that much harder on the road. It may even prompt you to get off the road completely and wait out the storm.

While fear, then, can serve an important function, there are times for some people when it can actually become a problem. When fear crops up even though there’s no real threat or when the level of fear that arises does not match the threat, fear can bring suffering. This is a lot like a fire alarm that goes off when you’re, say, steaming vegetables or frying something, in other words, an alarm that goes off though there’s not really a fire—a false alarm.

When a panic attack strikes, both body and brain suddenly reach high alert, though almost always there’s no discernible threat. The person experiences strong fear mixed with a whole host of physical reactions like rapid heartbeat, dizziness, or nausea, and racing thoughts such as “I’m going crazy” or “I’m going to die.” This whole response seems to come out of nowhere. Why? What is happening in the body and mind?

The Vicious Cycle of Fear

With a panic attack, physical and cognitive processes play off one another, building and building before peaking and then lessening. Though the exact causes vary from person to person, there are some common conditions that might contribute—heightened stress, lack of sleep, and the consumption of substances such as nicotine, caffeine, alcohol, or drugs.

Then a vicious cycle can be tripped off. Physical sensations like a rapid heartbeat feel frightening and therefore trigger anxiety. The body responds by producing more energy, which then causes the heart to beat even faster. The mind interprets the physical change as “danger,” causing an even faster heart rate, and on and on.

During a panic attack, anxiety usually peaks after a few minutes and, in most cases, wraps up after about 15 to 20 minutes. This is because the body can only maintain this level of intensity for so long before switching into recovery mode. This happens on its own without the person experiencing the attack needing to do anything.

Uncomfortable but Harmless

The physical reactions that occur during a panic attack can feel really scary, and it’s not uncommon for a person experiencing them to call an ambulance or to worry even long after the attack that something is physically wrong.

Yet, most panic attacks do not have a physical cause. Rather, they’re usually the result of a combination of a fairly anxious temperament, heightened stress, and certain experiences. Even so, if you were to have a panic attack, it’s a good idea to get checked out by a doctor to rule out other possibilities. If you’re tempted, though, to go again and again to the doctor about this, don’t. The most likely scenario is that there is no physical cause, especially if a doctor’s already ruled out other conditions.

Bottom line: Even if it doesn’t feel like it, a panic attack is basically a physically harmless false alarm that will subside on its own after a relatively short time.

Panic Disorder: When Panic Attacks Impact Quality of Life

Did you know that panic attacks are actually quite common? Roughly one in three people experience an attack at some point in their lives. The chances that a panic attack or even a few attacks will develop into a true panic disorder, though, are much less common—with about one in twenty people dealing with a true panic disorder.

You may be wondering what the difference is between a panic attack and a panic disorder. Panic attacks are isolated incidents that come and go. With a panic disorder, though, the person will experience repeated panic attacks as well as what’s referred to as “expectation anxiety,” or intense worry or fear that another panic attack will occur. This worry, in turn, prompts the person to change their behavior in some way, such as to avoid any possible triggers of an attack in the hopes that another one won’t occur.

Commonly, people with panic disorder avoid physical exertion or excitement so that pulse and heart rate don’t increase. Some also avoid being alone so as not to be without help in the event of an emergency. Psychologists refer to such behaviors as “avoidance behaviors.”

Additionally, people with panic disorder may look for lots of reassurance that they’re okay. This is where frequent trips to a medical doctor may come into play. Psychologists refer to such behaviors as “safety behaviors.”

What avoidance and safety behaviors have in common is that they provide an initial sense of security and may, in the short term, reduce the fear of having another panic attack. However, they have a huge downside: The more someone gears their life toward avoiding panic attacks, the more threatening these attacks become in their mind—the fear then becomes entrenched and dictates more of their behaviors and thoughts. Avoidance can come with high costs—freedom and quality of life among them.

What can help?

Short Term:

In the case of a panic attack, accepting the physical processes and the fear is most helpful. Instead of fighting the panic, acknowledge what’s happening. Remind yourself that what you’re experiencing is a panic attack and that it’s harmless and will pass on its own in a relatively short time. You can say to yourself something like, “This is a panic attack. My heart is racing. I’m dizzy and flushed. It will pass. I am okay.”

While you’re observing what’s happening, it can also help to slow your breath and consciously take deep breaths. When you panic, breathing automatically becomes shallower and faster which can make some people feel like they can’t quite catch their breath, which can then spark more anxiety. Inhale through your nose while counting to 4, hold your breath for 7, and exhale on a count of 8. The longer exhale will help calm your nervous system. Repeat these breaths until you can feel your body begin to calm.

Long Term:

After a panic attack, make a point of not avoiding possible triggers. So, if you happen to have a panic attack just after cycling, for example, get back on the bike as quickly as possible. This will send a signal to your brain that the panic was a false alarm and there is no need to worry.

If you’re having panic attacks frequently and notice that they’re affecting your life, we strongly recommend that you seek professional support. Therapy is quite effective with most anxiety disorders. Together, you and the therapist can get to the root causes of your panic attacks and confront your fear step by step.

Switching Off after Work

The end of the day, holidays, weekends, vacations: work-free time! At least in theory. In reality, however, it can be hard to turn the mind off from upcoming tasks, looming deadlines, conflicts with others, or any host of issues or problems related to work. So what can help?

First ask yourself how often you find yourself thinking about work in off hours? If it’s occasionally, this is not really a cause for concern. But if thoughts of work are regularly keeping you from relaxing, or if you notice other warning signs related to stress at work, it might be time to take action.

Why Switching Off Is So Important

Every work situation is different, of course. One job may be physically demanding, another emotionally challenging, and still another intellectually taxing (to name a few). What they all have in common, though, is that they take your time and energy. Recharging requires regular rest as well as distance from work. Without this, you may experience a more or less permanent state of stress and, sooner or later, exhaustion.

Those who grow accustomed to little time away from work may even have difficulty switching off when there might be opportunities to do so. To help you get some time away and much needed rest, give these strategies a try:

1. Find your after-work ritual.

To let go of thoughts of work, develop an after-work ritual that signals the end of that day’s work and that it’s time to turn your attention elsewhere.

Try ending each day by writing out a short summary of what happened. Consider: What did you accomplish this day? Was there anything difficult?

Write out a to-do list for the next business day and email it to yourself with a promise that you won’t open the email until you’re ready to start work the next day. Once you hit “send” on the to-do list, get up and leave your work area.

2. Look for activities to take you away from work.

What activities can you do (or do you do) that make you think less about work? Consider doing things that are as opposite to your work as possible. So, if you work hard physically all day, climb into a warm bath with a book or read on the couch. If, on the other hand, you sit in front of a computer all day, go for a brisk walk or stream an exercise class.

3. Say “Stop!”

When you catch yourself thinking about work beyond work hours, tell yourself “Stop!” and direct your attention to the present moment. If you’re standing, focus on where you feel the pressure on the bottoms of your feet. What does this pressure feel like? Is it more in the balls of the feet? Sides? Heels? Slow your breath and pay attention to where you feel it coming in and going out. Take a few deep breaths, focusing on the sensations.

Remember: Most issues at work can be dealt with the following day. And once you’ve had a chance to rest and reset, you’ll have renewed energy to deal with whatever arises more efficiently and from a more clear-headed place.

Take a Moment for Mindfulness

This article addresses ways being mindful can improve your overall well-being when life is too fast or overwhelming. This can include helping alleviate depression. Practical suggestions for integrating mindfulness and meditation into your daily life will help you get started.

What is the first thing you do when you wake up in the morning? Check your phone, take a shower, decide what to wear, eat breakfast, read the news, plan the day? WAIT, from the moment your eyes crack open, life seems to speed ahead at near breakneck speed! Where is the time to realize it’s a new day, collect yourself, and be aware of where you are? Before taking on the outer world, consider slowing down and focusing your attention on your mind and body first. If you haven’t consistently tried mindfulness before, you will likely be surprised at how much it can help your emotional well-being.

Okay, Sounds Nice, but Is This Really Necessary?

While your survival doesn’t exactly depend on you slowing down and bringing attention to your thoughts and physical sensations, it is one really simple and relatively quick way to cope with the stresses of life. As important as it is to take a shower and wash off the dirt and sweat from the long day or night, it is equally as important to “clean” your mind. This means spending a few minutes getting quiet so that you can bring your attention inward, focusing on the thoughts and plans swirling around in your head, without judging them.

While meditation may seem simple, its effects can be fairly profound. For example, after conducting a literature review on the topic, Annels and colleagues (2016), suggest that meditation might be an alternative to medication for some who struggle with depression. They cite studies that support evidence that brain activity related to emotional self-regulation and attention increases through consistent and repeated meditation. More research is needed, however, to determine the long-term effects of meditation on the brain as well as on depression.

What Exactly Is Mindfulness?

Meditation is an old mindfulness practice commonly associated with Buddhism. Mindfulness, according to Prof. Jon Kabat-Zin, the founder of Mindfulness-Based Stress Reduction (MBSR), is “paying attention, on purpose, in the present moment, non-judgmentally.” Not only can meditation and mindfulness help calm the mind and body and bring about a sense of peacefulness, they can also support decision-making and solution-finding skills.Several therapy approaches work in tandem with mindfulness, including cognitive based therapy, such as “Mindfulness-Based Cognitive Therapy” (MBCT) and “Acceptance and Commitment Therapy” (ACT). With these approaches you learn to accept your negative feelings, instead of pushing them away, and understand those emotions that enforce or can predict your depressive mood.

How Can I Integrate Mindfulness into My Daily Life?

Like so many of us, your life may be extremely busy, filled with tasks, responsibilities, and obligations. However, busy-ness is not a reason not to do mindfulness. In fact, if you find even 10 to 15 minutes each day to pause in the midst of your busy life, you’ll likely notice the benefits pretty quickly.

You can practice mindfulness both formally and informally. With formal mindfulness, you make time specifically for meditation, to focus on the present moment and some sort of anchor, such as your breath. Ideally, you’d practice formal mindfulness immediately after getting up in the morning, or directly before going to bed at night, which can also help your sleep quality. If you prefer meditating in a group, search for one near you. They’re more and more common.

We Can Meditate Anywhere, Anytime.

Informal mindfulness can be integrated into your busy schedule easily, without taking up extra time. You direct your attention to how your body feels or what emotions you’re feeling as you’re doing other activities, such as eating or walking.. Ask yourself questions like “What am I doing in this moment?” Describe the actions in your head. You can also ask, What am I experiencing in my body?” and then scan through your body mentally to check to see, say, what the feet are doing . . . legs . . . knees . . . hips, etc.

Finally, Thank You.

“Yesterday is history.
Tomorrow is a mystery.
Today is a gift.
That’s why it is called the present.”
(Alice Morse Earle)

Many also incorporate the act of appreciating in their meditation and mindfulness practices. There are hundreds of opportunities each day to appreciate the small things in life. The sheets on the bed feel nice, the warm shower is comforting, fruit smells delicious, the breeze is refreshing. Paying attention to these seemingly very small things happening all around us, can help incline the mind toward the pleasant and help us to begin to look for what’s good around us. You may also want to thank yourself for the things you do for your well-being, like reading this article today. Perhaps tomorrow you can start the day with a 5-minute meditation, before you turn on your phone. It does take some practice, so be sure to be patient and kind with yourself when your mind wanders, which it will do. Once you build the mindfulness muscle, you’ll begin to notice the positive effects, which will make the time and effort you put into it well worth it.

If you’d like to learn more about how meditation or the practice of mindfulness can help you, read more in our app MindDoc.

What You Need to Know about Insomnia and Depression

Missing a good night’s sleep? Haven’t had good dreams in a long time? Then you probably feel like many other people suffering from sleep problems. This article gives you some insight into how sleep is connected to depression and what we can do to improve our sleep quality.

We all know what it feels like to wake up in the morning after a restless night, how hard it can be to get out of bed at times or to wake up too early but find it impossible to fall asleep again. If any of these are part of your everyday experience and you notice your mood being impacted, you might be at higher risk for developing depression. Impaired sleep can make us restless, have difficulty concentrating, or easily agitated. In the long run, sleep problems or insomnia can lead to serious health problems as a result of an impaired immune system or changes to hormonal functions and can contribute to obesity and heart disease.

In other words, we all need good sleep to function properly and stay healthy!

But What Does “Good Sleep” Actually Mean?

From a medical standpoint, it is easier to illustrate the other side: “bad sleep.” These are the most typical signs for sleep disturbances:

• Disturbed sleep phases
• Problems falling asleep or sleeping throughout the night
• Waking up early
• Feeling tired during the day

But what is “good sleep”? Like with almost everything in life: it means finding a balance! Not too short, not too long. Lack of sleep of sleep can lead to attention and memory problems, whereas sleeping too long can zap us of energy and drag us down. The possible effects of irregular sleep are varied and individually different. Research shows that 6 to 8 hours of sleep every day are ideal. However, every human being is different, and some people need more sleep than others.

Our sleep is characterised by different sleep phases— the light sleep, deep sleep, REM, and a waking phase. In the different stages, our brain processes the information that we have absorbed during the day, the body recovers, and many other important biological events take place during sleep. This can explain why somatic and psychological symptoms appear during disturbed sleep phases. The longer the sleep disorder persists, the clearer the symptoms can be.

“Good sleep” means that none of the phases are disturbed.

So How Can We Get to Deep Sleep?

Even though sleeping is one of our human needs, it might not be as easy for us as breathing or drinking water. If we have problems falling asleep, because our mind is full of thoughts, or we wake up again and again, it might be necessary to actively prepare for our good night’s sleep. Make it a ritual! Take your time to actively calm your mind and body down before you go to bed.

Here are 6 tips for your good-night ritual:

1. Clean your thoughts: Writing things down that keep repeating in your head can create clarity! You can keep a little notebook or diary next to your bed and take 2 to 5 minutes to write down everything that comes to mind. Should the thoughts persist even then, remind yourself:: It is ok for me to stop these thoughts because they are recorded in my notebook and I cannot lose them.
2. Sedate your senses: Lavender doesn’t only smell good, it can actually improve your sleep quality by soothing your senses. You can either use it as an essential oil, lotion, or add it to your bath water for a nice, relaxing bath in the evening.
3. Calm your mind: Have you tried meditation or relaxation techniques before going to bed? They can also help if you feel depressed or lonely. Progressive muscle relaxation (PMR) is one of the most effective techniques to release tension in your body and mind. Just give it a try!
4. Avoid stimulation: Try not to use your phone and don’t read any heavy literature immediately before going to bed. Anything that might stimulate your brain should be avoided to reduce neural activity and prepare for sleep. It is best to turn off your phone and keep it in another room, out of reach of your bed. Similarly, avoid using the TV shortly before going to sleep.
5. Stay cool: Sinking body temperature initiates sleep. Make sure your bedroom has a cool and comfortable temperature (don’t freeze!). In hot summer nights taking a cold shower before you sleep can help your body relax and find the right temperature.
6. No drugs: Alcohol and nicotine are definitely not helpful ways to get good sleep. While it is true that alcohol can help you fall asleep, evidence shows that it greatly reduces the overall sleep quality by inhibiting the REM sleep phase. So if you care about your health (which I’m sure you do), refrain from any kind of alcohol or drugs!

Should We Regulate Our Sleeping Time?

Our body likes regularity. If we don’t work in shifts or need to work at night, we should try and give our body a routine to help it avoid sleep problems. Try and go to bed around the same time every night and set an alarm every morning. Once the alarm rings, it is best to get up quickly rather than staying in bed. For instance, you could stretch or go for a short walk. It’s also best to avoid midday naps.

You might find it helpful to keep a sleep diary to record what you did before going to bed as well as how well and how long you slept. This might help you to find a rhythm as well as identify reasons you’re not sleeping well—perhaps you’ll even discover your secret ingredient to help you reach deep or REM sleep (it will probably not be caffeine!). If your sleep problems are affecting your mood and emotional health, you could also discover reasons you’re feeling sad or depressed at times.

And while sleep disorders can be a sign and risk factor for depression, they can also be the result of depression: Three quarters of people with depression also suffer from sleep problems. If you think you might be affected by clinical depression, our free app, MindDoc which functions as a personal mood journal, can help. You’ll also find resources and a course geared specifically to help you deal with insomnia and find strategies to try for better sleep.

Cognitive Behavioral Therapy for Depression

Are you familiar with one of the most evidence-based psychotherapy approaches, called “cognitive-behavioral therapy”? Have you ever wondered what actually happens in a therapy session? CBT is all about being able to help yourself – and the therapist provides the instructions and tools that you need. Find out if it’s the right approach for you.

How Does CBT Explain Mental Problems?

Throughout life, we learn different patterns of behavior and thought patterns that we use on a daily basis to solve problems and make decisions. These patterns are formed by schemes and core motives, for example our insecure and weak self-image opposed to perceiving others as competent and strong, which can lead to us suppressing our own desires and opinions. However, if we learn these kinds of inappropriate behaviors or develop thinking errors, these can result in mental health problems, like depression. An example of a thinking error could be “I couldn’t do this project. I never do things right!” or “My boss looks mad, I must’ve made a mistake.” This insecurity will be reinforced by negative social interactions in our every-day life, for example with our boss who tends to criticize our work a lot and thus manifest itself in negative thoughts and behavior.

Therefore, the aim of the therapy is to identify current behavioral and thinking patterns and relearn helpful or new ones that help you effectively cope with current problems and actively reduce your unwanted feelings and behaviors. The therapist actively helps you to deeply understand and change your ways of thinking by taking examples from difficult situations in your life.

What Happens in the Therapy Sessions?

The first session is a time for you to get to know the therapist and see if your “chemistry” fits. You should not underestimate the importance of this session, as the connection between you and your therapist is the basis for the success of your treatment. Do you have a good feeling about the therapist? Will she or he be able to understand and help you? Ask yourself these questions before deciding to continue therapy with that person. If all goes well in the first session, you’ll likely meet once a week over the course of several months or years.

The early part of therapy is a time for the therapist to understand the problem and situation you are currently dealing with. In this phase, you’ll explore your depressive symptoms and their consequences on cognitive, behavioral, and emotional levels—in other words, together you and your therapist will explore the ways you think, behave, and feel about your current circumstances. Once this initial phase is done, the therapist will work with you to learn techniques and methods toward helpful behaviors and thinking patterns.

Things Your Therapist Is Likely to Address

• Look for ways to incorporate activities you find pleasing provide opportunities for successful, empowering experiences (e.g., meet old friends or (re)start a hobby)
• Reduce negative experiences (e.g., looping, negative thoughts or lying in bed all day)
  Build skills (e.g., improve social and problem-solving skills and learn relaxation techniques)
• Change negative and biased thinking patterns to learn new ways of approaching problems and evaluating thoughts

By the end of the therapy, the focus will lie on preventing any future depressive episodes. The therapist will help you apply your newly learned skills so that you can successfully cope with future challenges or situations on your own.

What’s New?

CBT is always being further developed and there are a few new approaches that deal with focusing on emotions, values, and acceptance, that have been proven to be successful. One of them is called “Mindfulness Based CBT” and combines CBT with mindfulness meditation. Through mindfulness, you learn to focus on the present moment, identify more easily what makes you feel depressed, and not judge your feelings, such as sadness or worrying.

Another newer approach, “Acceptance and Commitment Therapy (ACT),” focuses, as the title suggests, on accepting your current situation. Through this technique, you learn to accept symptoms of depression, rather than fight against them. Your self-image is an important part of this therapy, as you and your therapist will try to find out what kind of attitudes and values are important in your life and how you can turn them into “ACTion.”

“Cognitive Behavioral Analysis System of Psychotherapy (CBASP)” is a newer approach of CBT. It was specifically developed for long-term and chronic depression and combines CBT with psychodynamic approaches.

Is CBT Appropriate for Me?

As with anything, one shoe does not fit all. The treatment option that is best for your symptoms and current state depends on several factors such as the severity of your symptoms.

Cognitive behavioral therapy (CBT) has been proven to be one of the most helpful methods for treating depression. It also lowers the risk of experiencing another depressive episode.

However, with a moderate or severe depressive episode, it is best to immediately look for long-term depression treatment, such as a combination of psychotherapy and medication. Besides CBT, there are also other common types of therapy which might also be a good alternative for you. Don’t hesitate to get help if you’re feeling overwhelmed by your depression.

If you think you might be experiencing depression, you can read about typical signs of depression and use MindDoc for a free assessment of your symptoms.