Dr. Sarah Ravin - Psychologist | Eating Disorders |Body Image Issues | Depression | Anxiety | Obsessive-Compulsive Disorders | Self-Injury
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Dr. Sarah Ravin

Welcome to my professional blog. I am a Florida Licensed Psychologist and trained scientist-practitioner. In 2008, I received my Ph.D. in clinical psychology. A major component of my professional identity is staying informed about recent developments in the field so that I may provide my clients with scientifically sound information and evidence-based treatment. There is a plethora of information on the internet about Eating Disorders, Depression, Anxiety, Psychotherapy. Unfortunately, much of this information is unsubstantiated and some of it is patently false. It is my hope that by sharing my thoughts and opinions on psychological issues, with scientific research and clinical experience sprinkled in for good measure, I can help to bridge the gap between research and treatment.

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December, 2010

Wednesday, December 15th, 2010

Time after Time

“I don’t have time.”

This is an excuse I hear all too often. When I recommend a health-promoting behavior to a patient, such as sleeping at least 8 hours per night, meditating, spending quality time with family and friends, or exercising regularly, some people respond reflexively by stating that they don’t have time. Others will give a more wistful response, such as: “Oh, I would love to, I know it’s good for me, but I just don’t have the time.” There are patients who cancel their therapy appointments because they “don’t have time” to attend, and those who fail to complete their therapy homework citing lack of time. While I sympathize with the feeling, I don’t buy this excuse.

Here’s the thing: time is the great equalizer. We each have different amounts of money, different abilities, different families, and different life circumstances, but we all have the same amount of time. Every single person on this earth is given 24 hours in each day, 7 days in each week, and 52 weeks in each year. What we do with that time is up to us. Believe it or not, you have quite a bit of control over how you spend your time.

When someone claims that they don’t have time to do X, what they really mean is that X is not important enough to make time for it. When you reframe the statement this way, it sounds much more pointed and critical, yet it is startlingly accurate:

“My mental health is not important enough to me to attend weekly therapy sessions.”

“I don’t care enough about my wellbeing to make the time to exercise regularly.”

“I’m choosing not to bring my daughter to therapy every week because attending volleyball practice is more important than her recovery.”

“My family just isn’t significant enough for me to take time out of my day to be with them.”

“I’m not coming to therapy tomorrow because it’s finals week, and my grades are much more important than my recovery.”

It is all a matter of priorities. We define ourselves and create our destiny, in part, by how we choose to spend our time. People spend substantial chunks of time each day twittering, texting, facebooking, watching television, and surfing the internet. There is nothing inherently wrong with any of these activities. When used appropriately, they can be entertaining and life-enhancing. But when a college student tells me she has no time to sleep or exercise, and yet she spends two hours a day on facebook and goes out drinking with friends three nights a week, this says something about her values and priorities. When a parent claims that she “doesn’t have time” to transport her child to weekly therapy appointments, but clearly has the time to transport said child to soccer practice, voice lessons, youth group, and SAT prep classes, this too says something about how much the parent values her child’s mental health.

Most people would take time off from work or school to see their family doctor if they were sick. Most parents wouldn’t think twice about making time for their child to have chemotherapy, dialysis, surgery, or even orthodontist visits. Yet somehow, treatment for mental illness is not viewed with the same urgency. This is a huge mistake.

Individuals living with mental illness have more physical health problems than those who are mentally healthy. Depression costs society billions of dollars each year in lost productivity, not to mention suicide. Eating disorders often become chronic, disabling conditions and have mortality rates close to 20%. Schizophrenia and addiction often lead to homelessness. So why do we continue to view mental health treatment as optional or extracurricular? Why does our behavior suggest that mental health treatment is less important than work, school, sports, or facebook?

The impact of mental illness on individuals, families, and society is enormous, but the benefits of good mental health are immense and immeasurable. Improved mental health means increased productivity, reduced stress, more rewarding relationships, improved physical wellbeing, and overall satisfaction with life.

Achieving and sustaining good mental health is not merely a matter of attending therapy appointments, just as achieving physical health requires far more than visits to your doctor. Successful treatment for mental illness involves significant time, energy, and effort outside the therapist’s office. Many types of mental illness come with a life-long predisposition, so sufferers must be ever mindful of controlling symptoms and preventing relapse, even after complete recovery. Developing good self-care habits, completing therapy homework assignments, and creating a lifestyle conducive to overall wellbeing are all part of a holistic approach to mental wellness.

Think carefully about how you spend your time. Ask yourself if the way you spend your time reflects your true values and priorities. If mental health is a priority for you, don’t just say it – LIVE it – and the benefits of good mental health will be yours to enjoy.

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Friday, December 10th, 2010

Surviving the Holidays When You Have a Mental Illness

For most people, the holidays are a time of joy and celebration. However, for many people with mental illnesses, the yuletide cheer is accompanied by added challenges. This is true for those with various diagnoses. Consider the following:

1. For people with depression, the joy and festivities of the holiday season seem to amplify their own inability to experience pleasure. As families and friends come together, they may withdraw. To make matters worse, Christmas falls right around the shortest day of the year, so the lack of sunlight can be a huge trigger for those with Seasonal Affective Disorder (SAD) – a type of depression which occurs in the fall and winter months.

2. For people with anxiety, being around large groups of unfamiliar people can be terrifying. Christmas parties, crowded shopping malls, even visits with unfamiliar (or unkind) relatives can be extra-stressful.

3. For people with anorexia nervosa or bulimia nervosa, the large amounts of foods, particularly “treats,” that are part and parcel of holiday events can induce major anxiety. So can the enormously triggering “diet talk” that often accompanies holiday feasts and intensifies near New Years.

4. For people with alcoholism, the endless parade of holiday parties and events where alcohol is present makes it difficult to socialize normally or enjoy the typical gatherings with family and friends.

5. For people with ADHD, there is the added stress of final exams, Christmas shopping, decorating, parties, and visiting relatives, which can make them feel more scattered and disorganized than usual.

So how do you cope with mental illness during the holiday season?

Here are some tips which may be helpful, regardless of your particular diagnosis:

1.) Plan ahead. Create a written list of potential problems that could arise around the holidays. Think about various ways that you could handle these situations, and write down your solutions. Visualize yourself handling these difficult situations with grace and strength.

2.) Enlist social support. Talk to people you trust – your therapist, family members, or friends – about your concerns. Let them know how they can help you through this difficult time. People are more than willing to be more generous and charitable than usual at this time of year!

3.) Maintain good health habits. Get at least 8 hours of sleep per night, eat plenty of healthful foods, exercise regularly, and drink in moderation (if at all). Many people stop engaging in health-promoting behaviors around the holidays. If you struggle with a mental illness, this is the time to be extra-conscientious about caring for your physical and mental health.

4.) Focus on the protective factors associated with Christmas. Despite the myth that rates of suicides increase around the holidays, scientific research actually shows that suicide rates are lower than average in the days before Christmas. This may be due to several issues:
• Increased support from family and friends, who tend to gather together around the holidays
• Increased sense of charity and goodwill from others
• More community support – shelters, food banks, charities for the poor
• For many people, Christmas is associated with positive memories of hope and love and family, which can help improve outlook when things seem bleak
• Increase in religious observance and spirituality associated with Christmas

5.) Lower your expectations. Yes, the holidays are seen by many as “the most wonderful time of the year,” as the song goes. But stress and personal problems do not magically disappear during the holidays. It is not realistic to assume that you will be symptom-free simply because it is a holiday.

6.) Keep it simple. The holidays have become so commercialized, and so many demands are placed on people to throw and attend parties, buy and wrap lavish gifts, and cook like Julia Child on steroids, that many people are simply burnt out by the time Christmas arrives. Retailers love to extend the holiday season from Thanksgiving through New Years, but this is mostly for their own profit, and it doesn’t have to be this way. If you feel overwhelmed by stress, simply have a quiet, one-evening celebration with a few people of your choosing who are closest to you. There is no need to spend precious time and money getting people the perfect gifts. A simple card with a thoughtful note is sufficient to let people know you are thinking of them.

7.) Focus on what really matters. Remember the people of Whoville in The Grinch Who Stole Christmas? They showed us that Christmas can be joyful without presents and trees and decorations. These material things have no bearing on our ability to enjoy the holidays.

8.) In keeping with the Dr. Seuss example, think of your mental illness as the Grinch. It is a cold-hearted thief, with a heart three sizes too small, who will attempt to ruin your holiday. Don’t let it.

9.) Remember that parties are supposed to be fun and ARE ALWAYS OPTIONAL. You always dread your annual office party? Just don’t go. Let whomever is in charge know that you aren’t feeling well, or simply that you appreciate the invitation but you won’t be able to make it this year. It’s supposed to be a party, not a punishment.

10.) Do what’s fun; skip what’s not. If you love preparing Christmas dinner for your family, great! Enjoy! If not, hit up your local Chinese restaurant. Jews have had this tradition for decades.

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