Ask Dr. Pat

The World Is Not Coming to an End

Dear Kate,

This has been a difficult season for many women, no matter what their politics are. First there was a contentious and long political campaign followed by elections that were unpleasant and disturbing to many women, symbolically at least. All of this occurred right before women had to manage their variation of the holiday marathon, beginning at Thanksgiving and ending on New Year’s Day. And after Jan. 1, we often focus on reinvention.

Many of the behaviors you would like to change are interrelated. It is hard to lose weight if you aren’t mindful. It is harder to be mindful if you are exhausted and unfocused due to poor sleep. It is hard to improve sleep if you overeat and drink. Self-care and mindfulness are concepts that are far down the list when you have a tired brain, an anxious mind, a body that is poorly nourished and underexercised, and a life that seems to be a treadmill of taking care of others. When you add your fears about political issues, it can become overwhelming.

Kate, while this may be difficult to schedule, I recommend that you take a week off from work and use it to change the behaviors that are negatively affecting you. You don’t have the time to organize any meaningful change program with the schedule you have. With this gift of a week just for you, you can focus on changing behaviors and forming new habits that can improve the quality of your life. (It takes at least 28 days to form a new habit.)  Nothing will change until you choose to put yourself first. I’m not talking about finding your old self. I think you want to find a better way forward for your authentic self.

Here are some aspects you can focus on:

Fatigue is often a word that patients use to describe being overtired, or overwhelmed. It can also be a symptom of many physical and emotional conditions.  See your healthcare provider to make sure that you are not deficient in important vitamins, like B12, or low in iron. Ask for simple blood tests to check for anemia, diabetes and thyroid disease, all common causes of fatigue.

Get your family involved. You work full time with many responsibilities at work then arrive home to prepare dinner, clean up, prepare for the next day and you wonder why you have fatigue! Divide the chores among all family members and cut your responsibilities in home management way back.

Get serious about your diet. Many Americans increased their weight over the last few months. The holidays are associated with overeating, consuming too much alcohol, having no physical activity, and enduring lots of stress.

Take a break from booze. Alcohol is converted to sugar and increases abdominal fat.  Alcohol increases the appetite; makes it harder to make good food choices; and worsens sleep for many people. Poor sleep impedes weight loss. This is an easy choice for 28 days.

Cut out the sugar and the unhealthy carbohydrates. Food is a temporary fix for fatigue. Stress eaters tend to prefer high-carbohydrate foods because these foods trigger an increase in the brain chemical serotonin, which has a calming effect.

Eat frequently, and eat smaller portions. Avoid late-night eating, since it is bad for the waistline and bad for sleep. And poor sleep is bad for weight loss. Try to leave work on time and avoid eating dinner late at night, but if that is impossible to change, make dinner your smallest meal of the day. Eat lightly in order to sleep better nightly!

Say yes to a nutritionist or to a weight-loss group in your town. A support group is often helpful when weight gain has been a longstanding problem, and mindfulness and planning for meals does not come easily.

Be smart about your sleep. The scientific interest in sleep disorders has improved our understanding of the dangers of poor and inadequate sleep: Daytime fatigue decreases cognitive function, causes impairment in conflict resolution, and, yes, leads to weight gain. Inadequate sleep often results in excessive eating, obesity, and poorer response to many diet plans. Alcohol use impairs the pattern of sleep. People who drink alcohol in the evening often fall asleep easily, but may endure early wakening and daytime fatigue due to impaired quality of sleep. Kate, stopping the nightly alcohol use will improve weight loss, improve sleep, and improve daytime energy.

Exercise. Use your week off to begin an exercise program.  Exercise improves sleep, cardiovascular health, and cognitive health, and will make weight loss easier. An option might be for you to join a walking or running group in your neighborhood. Research your local runners organizations or walking groups. Many women find the sense of community with other women helpful and encouraging.

Meditation. The art of meditation is not easy to master, but learning to let go of ruminating thoughts or attempts to control situations that are out of your control will improve your energy, your mood, your sleep, your cognitive function, and your overall sense of well-being. Try the Oprah and Deepak 21-Day Meditation Challenge. Many of their meditation series are free online.  When you are mindful, you will become more comfortable with the word no as well. When you learn to say no to some of your presumed obligations, you will be learning to say yes to self-care.

Finally, I would suggest that your question, “What should I do to find my old self?” is part of the problem, not the solution. Just as many  Americans may have been looking for a return to the old comfortable ways where the country was managed predictably by politicians in Washington, we have been reminded that democracy flourishes in an environment where citizens are informed and involved on the local, state and national level. It is time for reinvention of participatory democracy in America, not a return to the old ways. The Women’s March on Saturday provided a template for this reinvention.

You can address the negative thinking and ruminating that the world is coming to an end.

While the worst is always possible, expecting and worrying about catastrophe is never useful. We have lived through many dark times and come through all right or even better for it. Our parents’ generation lived through World War II, and our grandparents endured World War I, yet we began the 21st century stronger, more fair and open, and prosperous than ever.

Staying focused on the present, part of what mindfulness is all about, will help you discipline your thoughts and remain calm.

If you take these suggestions and still don’t  improve, you may be clinically depressed and  should see a therapist for psychotherapy and perhaps medication. Sometimes our negative feelings take us to a place we can’t get back from on our own. It’s important to know there is no shame in that and admit it if you need help.

Positive action is an effective antidote to fear and anxiety and keeps us from feeling helpless.

You have many things going for you and you should take this time, Kate, to change the things over which you do have control.  Work with others to bring about change in civic and political life.  Even small steps can help reduce anxiety and worry.

President Barack Obama told reporters at his final press conference that his message to his two daughters after the election was, “ The only thing that’s the end of the world is the end of the world.” Kate, the world is not coming to an end.

Dr. Pat

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  • Patricia Yarberry Allen, M.D. January 23, 2017 at 10:59 am

    Thank you all for joining in the conversation. We make every effort to have women’s voices heard in the big conversations of the day. Do share this post that offers some reassurance that women on both sides of the political aisle have options to be involved in the process. Not to be too preachy about this, but we are all Americans and our country will work best when we take time to really listen to those who are different from us and empathise with their experience and concerns.
    Kate has more going on in her life than politics, however. And most women can empathize with “no time for self care”. I hope that this post helps each of you to focus this January on setting health and wellness goals.
    We remain grateful for your support,
    Dr. Pat

  • hillsmom January 23, 2017 at 10:14 am

    Well said Dr. Pat, but I think Kate needs to know she’s not the only one with feelings of dread. The outpouring Saturday was a step in the right direction regarding things to come. I know I did feel energized especially after hearing Gloria Steinem speak. (Now I’m going to call my senators and will continue to do so every day.
    The phone # is 202-225-3121 should any care to join other women who wish to be heard.)

  • Chris Lombardi January 23, 2017 at 9:52 am

    Dr. Pat, your voice this a.m. was exactly what I needed. We all need it, to survive the work to come.

    Thanks so much.

  • Julie January 23, 2017 at 9:34 am

    All your suggestions are spot-on. However, I doubt she can take a week off. She’s already worried that things aren’t getting done at her job. Because she might not have the vacation time or approval from her employer, she might not implement any of these changes. Advice that could fit her schedule would have been more helpful.