Try doing one thing today on purpose that is imperfect

You can also do this by expanding your body’s bandwidth for emotions and change how you interact. If you notice that somatically you lean over, lower your voice or hesitate when engaging with others, you can teach your body to keep going, speak up and stand tall- and notice how empowering it is to try a new way of being.

One of the ways to unravel the shambles of shame is catching yourself when your mind starts spewing negative, shame filled thoughts, and replace them with more appropriate ones.

if you doubt yourself when presenting your work at a conference.

Unnatural and unnecessary desires

He thought the greatest pleasure was ataraxia: a state of tranquility in which we are free from anxiety.

The pre-commitment is important here, because it’s hard to make the call to quit when you’re in the middle of something and don’t want to feel like you’re taking a loss or that you’ve wasted time on it.

This cognitive behavioral therapy technique just asks you to get into bed, leave your eyes open, and focus on staying awake, instead of falling asleep

Realize that the next day is going to get a little bit rough. You're going to be tired, but do your best." And remember that sleep should come much easier the following evening.

it's best to avoid screens (like phones and computers) and strong lights, as they greatly affect your sleep.

"We're classically conditioning our brains to understand that in bed is where insomnia happens. It's not a place where we drift off to sleep, but instead where we toss and turn."

Chukurah Ali says it felt silly to her too, initially. "I'm like, 'OK, I'm talking to a bot, it's not gonna do nothing; I want to talk to a therapist," Ali says, then adds, as if she still cannot believe it herself: "But that bot helped!"

Tekin says there's a risk that teenagers, for example, might attempt AI-driven therapy, find it lacking, then refuse the real thing with a human being. "My worry is they will turn away from other mental health interventions saying, 'Oh well, I already tried this and it didn't work,' " she says.

orthopedist

We should, of course, continue to strive to make it easier for people to open up about their mental health problems in the right setting. But we have to get rid of the rhetoric that pressures people to break the silence without regard for why they are silent or if speaking would benefit them.

Even if you don’t know yet what your purpose in life is, you can take steps towards investigating potential sources of purpose.

this liminal space can also be seen as a playground, full of opportunities for growth and discovery. Enjoy the journey by exploring different paths and learning about yourself along the way.

lack of purpose is associated with depression and self-derogation.

Not because they get something measurable in return, but simply because abundance is a choice. And making choices celebrates our agency and potential.

“Many people have equated my tidying method with minimalism, but it's quite different. ... Minimalism advocates living with less; the KonMari Method™ encourages living among items you truly cherish.

You didn’t start from the inside-out.

You’re exhausted, and you haven’t made any progress. So you end up with a decision that won’t force you to start over. It’s the least offensive choice.

You can use boredom as a guide, scheduling stimulating work during your energized hours and reserving more tiresome tasks for when you need a break.

boredom reveals an important aspect of being human: we have a strong need to be engaged with the world around us,

You can find fascination and reward in your work by entertaining your curiosity or connecting with the meaning behind your job.

One thing for you to try this week

Mixed emotions may bring unhappiness, but they can also bring meaning to life.

Once you are more comfortable with your mixed emotions, start to explore the richness that ambivalence can bring to your understanding of your life.

the independent measure of mixed emotions also pushed well-being down, and by more than negative emotions alone

2. Put a Hand on Your Heart

With self-compassion, you’ll think, I’m going to try because I care about myself and I don’t want to suffer. That kind of motivation “leads to more self-confidence,” Neff says. When you can sit with your pain and think through what you might need to achieve your goal—like waking up earlier for runs or scheduling them on your phone calendar—instead of spiraling over all the ways you’re failing, you’ll overcome challenges, building confidence and belief in yourself as you go

I’ll try harder because I feel inadequate.

To help enhance work detachment and relaxation during the commute, commuters could try to avoid ruminating about the workday and instead focus on personally fulfilling uses of the commute time, such as listening to music or podcasts, or calling a friend.

remote workers may benefit from creating their own form of commute to provide liminal space for recovery and transition—such as a 15-minute walk to mark the beginning and end of the workday.

One woman told the Washington Post that even though she was working from home, she regularly sat in her car in the driveway at the end of the workday in an attempt to carve out some personal time and mark the transition from work to non-work roles.

Accepting negative feelings isn’t always the healthiest choice for your mental well-being.

3. You let personal stress build up inside of you (rather than sharing it)

Have a conversation around how much time the new thing will realistically take and whether it might take away time from something that’s important between the two of you

at each other’s throats

1. You take on the majority of your shared responsibilities

It turns out that for decades we’ve completely been missing that there are a significant segment of people who go on to not only recover but to enjoy key aspects of the good life.”

it meant that depression only reduced people’s chances of thriving by about half.

It’s not uncommon to experience high levels of well-being after mental health problems

we might be judging normal human experiences like nervousness, stress, and discomfort too harshly.

Leaning into uncomfortable feelings could help us achieve bigger life goals

Meaning might seem lofty and unattainable, but this research suggests that we might be able to find it in the small things.

one additional idea is to simply appreciate the everyday pleasure of thinking

awe

Prior research has found that meaning in life is driven by having a sense of purpose, feeling like your life matters, and feeling like the world makes sense. But this paper found that appreciating experiences may be another key driver of meaning.

The researchers found that students who reflected on an experience they appreciated reported a greater sense of meaning compared to students who just reflected on a recent trip

appreciating small moments

“Symptom components and maladaptive traits can be thought of as the constituent parts of broader mental health syndromes.  For example, social anxiety is a syndrome that brings together various expressions of performance and social interaction anxiety… Syndromes are conceptualized as dimensional tendencies to experience related symptoms and maladaptive traits.  In other words, they are continuously distributed concepts, not categories, that span a range of severity.”

The most recent review of antidepressant therapy for depression in cancer patients did not show a significant improvement from placebo,

simply discussing the wish for more rapid death did not cause distress, and that nearly 80% of patients felt it was an important topic for the care team to discuss.

cancers with less than 5-year survival rates correlated to higher suicide risk, leading some to wonder whether the type of cancer is more important than the cancer diagnosis.

cancer population is at higher baseline risk for depression, which has been linked to immunological changes

Thus far, research has not identified consistent risk factors that enable the jump from suicidal ideation to suicide attempts.

Like the HAM-D, it has relatively high sensitivity and low specificity.

Very little information has been collected regarding formal suicide risk assessment in cancer patients (Table 3

Suicide risk in patients with stomach cancer was independently correlated with diarrhea, which can have a significant impact on lifestyle.

penile cancer patients have one of the lowest suicide rates and, in their study, all patients who died by suicide had undergone surgical intervention.

whether the pre-existing mood disorders lead to substance use that increases the risk of cancer.

patients with head and neck cancers have higher depression scores than the general population even before a cancer diagnosis, leading to the question whether this subset of patients are struggling with a biological cause in addition to diagnosis-related symptoms.

. Unique to cancer is that the risk of suicide persists more than 15 years past diagnosis.

Prostate cancer has a higher suicide rate in the first year after diagnosis, but lower overall unless metastatic disease is found

Among cancers with the highest suicide risk are those affecting the head and neck, lung, pancreas, and larynx/pharynx

suicide risk is at least twice that of the general population and is highest immediately after diagnosis

- Cancers with the highest suicide risk include head and neck, lung, and pancreas.

Crisis Resolution Strategy

The wheel-and-spoke format is a useful tool to help develop a formulation that specifies the multiple causes of the crisis and can assist in the development of an effective, prioritized treatment plan.

. An eco map can be used by a family physician to help decide who can help the patient; who needs to be excluded; or what social, religious, legal, or economic resources need to be mobilized to assist the patient in crisis.

Developing a timeline with a patient helps both physician and patient focus on recent events and begins the process of formulating treatment

mandatory crisis intervention in non–life-threatening circumstances, often called critical incident stress management (CISM) or “debriefing” ( Mitchell et al., 1983 ), is not helpful ( Rose et al., 2004 ).

Critical incident stress management (CISM), sometimes called debriefing, is not helpful

These medications can either be a primary form of treatment if the patient does not want TFCBT or can be combined with TFCBT; no evidence yet shows that combined treatment is superior to SSRI or CBT alone

It seems that younger veterans with PTSD from more recent wars are respon­sive to the same SSRIs and SNRIs as non–combat-related patients. However, older veterans from previous wars do not appear to respond to sertraline or fluoxetine. Thus, the common SSRIs may be only somewhat effective for this group

SOR: A

A crisis evaluation strategy using a timeline, eco map, and wheel-and-spoke formulation

Family physicians