Are You Sabotaging Your Mental Health? Here’s How to Stop

Sometimes, mental illness goes dormant, only to rear its ugly head again. If you’re experiencing a relapse and can’t figure out why, turn to these unexpected triggers to assess how they might be impacting your mental health.

priscilla-du-preez-kgZFViswqxg-unsplash.jpgDisclaimer: I am not a medical professional. Please discuss any mental health or other concerns with your doctor! If you are feeling suicidal, you are not alone. Call 1-800-273-TALK or text ‘HOME’ to 741-741 to talk to a trained volunteer about what you are experiencing.

Sometimes, mental illness tricks you into feeling better – so much better, in fact, that you forget it exists. But having anxiety or depression is more like having cancer than having a cold: it goes into remission, but it’s never really “cured.”

When anxiety rears its ugly head after months and months in remission, my first reaction is usually one of shock: where did this come from? And what have I been doing wrong?

Many times, the sources of anxiety or depression are obvious. A stressor emerges, such as a major exam or big move. Other times, however, we have to dig a little deeper to find the sources of our inner unrest.

If you’ve examined your life and still don’t know where to turn, the sources of your anxiety may be hidden in unexpected places. Here are five red flags you may not have noticed yet – and why you might not realize they’re sabotaging your mental health.

1. Caffeine

Pounding heart, shaking hands, problems sleeping….to anyone with anxiety, these symptoms may sound familiar – but I’m actually talking about the side effects of too much caffeine!

If your anxiety has felt out-of-control lately, your morning latte may be the culprit. Try tracking how many milligrams of caffeine you drink per day for a week. The FDA recommends a daily limit of 400mg – that’s about four cups of coffee, eight cups of black tea or one-and-a-half energy drinks.

If you’ve got anxiety, you might consider drinking even less. I recommend decreasing your caffeine intake by one beverage per day until you find your sweet spot – that is, the number of caffeinated beverages you can drink without experiencing the drug’s ill effects. For me, that’s 2-3 cups of coffee per day – but since everybody metabolizes caffeine differently, based on their age, weight and even their genes, it’s important to observe your own diet to find out what works best for you.

2. Processed Foods

Ever heard of a little thing called the gut-brain axis? In case you haven’t, you should know that the digestive tract produces up to 90% of the body’s serotonin. In other words, what you eat impacts how you feel – not just physically, but mentally, too.

Harvard Health Blog puts it best: “Like an expensive car, your brain functions best when it gets only premium fuel.” Fresh, whole foods that are low in sugar and high in nutrients are like high-octane gas for your brain: they allow your mind to function optimally, minimizing daily wear-and-tear. In other words, a serving of birthday cake or too much cheese off the party platter won’t wreck your mental health – but eating like that all the time could.

Considering mental illnesses like depression impact our ability to prepare fresh, healthy foods for ourselves, eating too much takeout or too many prepared, frozen dishes may be a subtle sign of a downward spiral. Thankfully, you can rectify the damage by incorporating more whole foods into your diet – and repairing your healthy gut bacteria with probiotic and fermented foods. That way, your body’s serotonin factory can go back to operating like a well-oiled machine.

3. Automatic Thoughts

Some negative thoughts are obvious: “No one loves me.” “I don’t deserve this.” “Life isn’t worth living anymore.” Others, like this doggo, show up in disguise….

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Source: Giphy

Dog or hooman? And does bacon cause cancer? The world may never know. My point is, some negative thoughts are learned so deeply that they become virtually impossible to distinguish from ‘normal’ ones. In fact, you may not even realize that you’re having them – or that they’re hindering your progress toward achieving mental health.

Thankfully, just as you learned these automatic negative thoughts over time, you can also learn to recognize and challenge them. Depending on the severity of your anxiety, this may best be done with the guidance of a mental health professional. Mindful meditation could also help, by making you more aware of your thoughts and giving you a window to disrupt negative thought patterns before they can cause you distress.

4. Nutritional Deficiencies

When’s the last time you had your vitamin levels checked? If you’re anything like me, it might have been awhile. Though many health conditions can masquerade as anxiety and depression, vitamin and mineral deficiencies are one of the most easily treatable causes of new mental health complaints. (Among other chronic diseases, hypothyroidism, Lyme disease and even certain cancers have been linked to depression – so be sure to visit your doctor to rule out these medical conditions if you are experiencing new symptoms of a depressive episode.)

Low levels of vitamins B or D may cause symptoms of depression, such as fatigue or negative mood. As for minerals, iron, selenium and magnesium are most commonly responsible for low energy, depressed mood and even irritability. In many cases, the best treatment for a deficiency is a dietary supplement – but to be diagnosed and treated for such deficiencies, you must visit your primary care provider. He or she will probably conduct blood tests to assess the bioavailability of certain vitamins – and if a deficiency is discovered, prescribe a high-dose vitamin for you to take at home.

One word of caution: be careful not to fall for the causation vs. correlation trap. While depression can be a symptom of low vitamins or minerals, it can also be a cause. Many people with depression experience decreased appetite or low motivation to prepare healthy meals for themselves, which can lead to nutritional deficiencies. So, if you find that addressing nutritional gaps doesn’t improve your depression, you may want to consult a mental health professional – ensuring you don’t fall into a vicious cycle of treating the symptoms rather than the disease.

5. Sleep

It’s common to experience sleep disruptions as a symptom of mental illness. For some, that means sleeping too much and finding it difficult to wake up in the morning. Others may describe a pattern of sleeplessness due to racing thoughts, or waking up unexpectedly in the middle of the night after experiencing a vivid nightmare.

Like dietary deficiencies, sleep disruptions can cause depression, and depression can cause sleep disruptions. Problems sleeping could even be due to medical illness. Your primary care doctor can tell you for sure what the best course of action is for your health – but as for steps you can take at home, effective sleep hygiene is crucial to maintaining good mental health.

So, what makes for hygienic sleep? Limiting daytime naps and stimulants such as caffeine, establishing consistent sleeping and waking hours and avoiding environmental triggers, such as a room that’s too hot or artificial light from cell phones, all contribute to healthy sleep patterns. While a good night’s sleep can’t fix all mental health problems, it certainly doesn’t hurt to arrive at your therapist’s office feeling clear-headed, alert and ready to take on your recovery, one baby step at a time.

Can You Go Vegan in Eating Disorder Recovery?

I am more than five years into eating disorder recovery – so you can imagine how scary it was when I thought to myself the other day, “Maybe I’ll just go vegan again.”

To provide some background, I have been eating on the low FODMAP diet for IBS for the past several months. I’ve discovered a (genuine, medical) lactose and gluten intolerance that already makes it difficult for me to sustain my eating disorder recovery. And I recently started being vegetarian again after six months of eating whatever I wanted without question. So, when I recently ran out of lactase pills and thought “Hmmm, maybe I’ll just stop eating animal products altogether,” it brought my day to a screeching halt.

Surely, a radical statement that calls for cutting out entire food groups deserves some curious self-examination on my part. But does it warrant saying I’ve “relapsed” and seeking treatment for my eating disorder once again?

I did some research – for my own sake, and for my future clients’ – to find out what the answer was. Unsurprisingly, I found that there isn’t really a textbook, one-size-fits-all approach to going vegan in ED recovery.

Based on what I’ve read as well as my own experiences, here’s my take on going vegan in eating disorder recovery. I hope this helps you find peace in your own decision “to be or not to be” vegan – whatever that choice may be!

My Story

black and white dairy cow on green grasses during daytimeI first tried going vegan my senior year of high school, after watching the documentary Cowspiracy with my best friend and learning what a profound impact raising livestock has on our environment.  Before that, I had been vegetarian for six years, beginning when I was thirteen.

At those points in my life, my choice not to eat meat or animal products had nothing to do with my eating disorder. When I was fifteen, I adhered to a strict diet in an attempt to get down to my “goal weight” of 105 lbs. I cycled between orthorexic periods of restriction and “cheat days” where I would binge until my stomach hurt.

But I never questioned my decision to eat meat or not to eat meat: my love for animals was a part of who I was, and I thought my decision to be vegetarian/vegan said a lot about who I was.

In college, I quit the vegan diet, only to start it again my second semester of freshman year. My decision to go vegan the second time was deeply linked to my lactose intolerance and my GI symptoms, which you can read more about in my health update here.

You see, I also developed IBS sometime in high school, around the same time that I was dealing with my eating disorder and my decision to be vegetarian/vegan. However, my symptoms would not become intolerable until earlier this year, my third and final year of college, when I would finally see a GI doctor and get diagnosed.

After keeping a food diary, I discovered that a lot of my stomach issues were tied to my decision to start eating meat again as a second-year college student. So, I became vegetarian again, occasionally breaking with that choice at restaurants or family dinners, and found that it helped my IBS symptoms tremendously.

However, I still struggled with my lactose intolerance. Lactase pills helped with the maldigestion and symptoms I experienced when eating dairy products, but they were expensive and made me feel limited in my food choices. I felt like if I went somewhere without my Lactaid, I wasn’t “allowed” to have dairy.

And that’s when the thought popped into my head: “What if I just went vegan again?” I’d save the hassle of buying Lactaid pills every month – and feel like my avoidance of dairy was my “choice,” rather than a product of my IBS. Which is exactly how I ended up starting a vegan diet again – and exactly how I wound up writing this article!

The Facts

As I mentioned previously, I was honestly a little bit frightened when I found myself considering a vegan diet again. After all, I was already worried that eating low FODMAP was causing me to fall into restrictive eating patterns – and I didn’t want veganism to be a “sign” that I was relapsing.

So, to make sure what I was doing was safe, healthy and, above all, right for me, I embarked on a little bit of research about being vegan in eating disorder recovery. In that process, I found that as with anything else, there are both pros and cons to going vegan in eating disorder recovery. Namely….

Pros

  • When done right, veganism is a moral and ethical lifestyle choice, NOT a fad diet. Almost 3x the number of people who go vegan for “health reasons” go vegan for moral concerns about animal rights, according to a global survey conducted in 2019. And it’s no wonder, given the dire living conditions of livestock raised for slaughter in the meat industry!
  • An additional 10% do it for the environment, according to the same survey – which makes sense when you think about it. If you’re passionate about the environment, a vegan diet offers reduced land and water consumption and a smaller carbon footprint. In fact, one medical study shows the vegan diet’s environmental impact is 40-80% smaller than a traditional, omnivorous diet.
  • “Vegan” is NOT a synonym for “healthy” or “low-fat” or “low-calorie.” Duncan Hynes chocolate frosting, Oreo cookies, Fruit by the Foot, Lays Original potato chips, Sour Patch Kids and Ritz crackers are all vegan foods, but not exactly nutritious. Thus, you can still challenge yourself with “fear foods” by seeking out vegan versions of your favorite junk foods or “accidentally vegan” products you already love.
  • For those of us whose eating disorders have been linked to eating vegan in the past, embarking on a vegan diet again, under the advisement of a therapist, can be a way of shunning false “comforts” and ceasing to correlate veganism with your ED. With a little soul searching and a lot of hard work, you can break your mental association between a vegan diet and a restrictive eating pattern, so that veganism is no longer viewed solely as a means of controlling your weight.

Cons

  • Being vegetarian or vegan is a socially acceptable reason to turn down “fear foods.” Alternatively, openly choosing to starve oneself may raise concern from friends and relatives. There is some evidence to show that some people with EDs may adopt vegetarian or vegan labels as a way to avoid certain foods offered to them in social situations.
  • There is a community of researchers who think vegetarian and vegan diets may “mask” ED behaviors, though it is hard to say if they are objectively “right.” One study found that self-reported vegetarianism in college-aged women is a marker for restrictive eating behaviors.
  • The vegan community can be triggering for people recovering from EDs. Jordan Younger, author of Breaking Vegan (who is vegan again, by the way), puts it perfectly when she calls it “vegan bullying, elitism and judgment” as well as “radicalism.” If you “slip up” or leave the lifestyle for any reason, the PETA worshipers will always be there, ready to chew your ass out.
  • It’s difficult to gain weight on a vegan diet, which tends to be high in carbs and low in protein in fat – which is why I DO NOT endorse a vegan diet for anyone who is underweight, in residential treatment or hospitalized for an eating disorder. In those initial steps of recovery, your focus needs to be on your physical state. You can worry about saving the animals when YOUR life is saved!
  • Many residential treatment programs will not allow you to maintain a vegetarian or vegan diet, so it may be difficult to find a professional who will work with your restrictions. Usually, this is not because your vegetarianism or veganism causes an eating disorder, per say, but because the restrictive nature of a vegetarian or vegan diet may be triggering for some of the other individuals utilizing that program. Still other patients may ask why your restricted eating patterns are tolerated, but theirs are not – thus hindering their own recovery process while in treatment.

My Advice

adult golden retriever taking a bathAfter hours of research, my conclusion about whether or not you can go vegan in eating disorder recovery is….it depends. “On what?” you might be thinking. Well, I’m no doctor – but here’s my take on when you should (and shouldn’t) consider a vegan lifestyle in ED recovery:

  • DO have a clear reason for going vegan. If you’re feeling a strong urge to go vegan, but can’t clearly articulate your reasons for doing so, it might be fueled by an unconscious ED mindset. Alternatively, if you have a clear reason for going vegan that isn’t motivated by weight or body image control – for example, ethical concerns for animals or the environment – focusing on that goal will prevent you from spiraling out of control and into a restrictive eating pattern.
  • DON’T go vegan if you’re not in remission, or if you’ve had a recent relapse. Unfortunately, the opinion of many experts is that you should not embark on a restrictive eating pattern until you have been stable in your recovery for many months, or even years.
  • DO allow yourself flexibility on a vegan diet. In my opinion, there’s nothing worse for ED recovery than hard-and-fast food rules. That’s why many recovery warriors turned vegans shy away from the “vegan” label, and instead choose to call themselves “plant-based” or “vegan-ish.” In other words, I believe that if you’re craving a Wendy’s Baconater, the healthiest option for your mental state is to eat the damn Baconater and move on with your life – and your vegan diet – the next day!
  • DON’T engage with radical veganism. Basically, stay away from animal rights marches, PETA events and the comments section of literally any vegan YouTube video or social media post ever. There is a small, yet significant subset of the vegan community dedicated to tearing apart anyone who questions or “cheats on” their vegan lifestyle. As someone in ED recovery, you may be more vulnerable to this type of radical language – so instead of training yourself not to fall for it, I say just avoid the “vegan shaming” altogether. After all, most people who love animals or care about the environment aren’t willing to go vegan – so you’re already making more of an effort than most by eating vegan 80-90% of the time! (And vegan or not, you certainly don’t deserve to be cyberbullied.)
  • DO keep a food and mood journal like this one, at least for the first few weeks of your vegan transition. Keep a careful watch on how selecting vegan foods affects your mindset. If you begin to notice old thoughts or behaviors cropping up as you transition to a vegan diet, it may be a sign that you’re not at a good point in your recovery to go vegan, or that going vegan may be too triggering for you to undertake at this point in time.
  • DON’T go vegan without telling your doctor or therapist. Finally, you should always make your healthcare team aware of any choices you decide to make in your diet – especially if you are in recovery. Your therapist and doctor can both help you decide if a vegan diet is right for you at this point in your ED treatment. Plus, they can hold you accountable by paying attention to your thought patterns and weight respectively, in order to alert you if they feel your vegan diet may be triggering a relapse.

What are your thoughts on adopting a vegan diet in eating disorder recovery? Tweet me your thoughts @cozycounselor!

What to Pack if Travel Makes You Anxious

When I was a little girl, I thought having a purse was the height of womanly sophistication – so much so, in fact, that I became obsessed with “What’s in my Purse” videos and listicles.

Every woman I knew seemed to be prepared for anything with what was inside her purse, so I thought putting more items in my purse would make me infinitely cooler. While the urge to pack my entire house in my Kate Spade has long since passed,  my interest in “What’s in my Bag” videos and blog posts has not subsided.

This “What’s in my Bag” – style post is special, however, because it specifically pertains to those of us traveling with anxiety. Looking back on my purse obsession, my anxiety was definitely a big reason I wanted to make sure I wasn’t missing anything important or potentially useful in my bag.

On top of that, traveling away from home is the last time you would ever want to forget something in your carry-on bag or purse! Which is why I am sharing this post with you in the first place: in honor of my flight home to Boston from spending winter break in Cleveland with my boyfriend David, I’ll be letting you in on all the travel essentials I pack to keep myself from having an anxiety-attack midair.

These items may not be a cure for fear or flying or travel anxiety, but they will certainly brighten your day and make the trip a little bit easier on you, body, mind and soul. So, without further ado, here are the travel essentials I try never to forget as a traveler with anxiety!

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Source: Elle Silk

Sleep Mask

When you’re stuck on a long flight – especially a red eye! – sleep is probably the first thing on your mind. But, if you have anxiety, airplane conditions can make it almost impossible to doze off. A sleep mask is crucial for blocking out all the annoying lights around you, so you can focus on getting the best night’s rest you possibly can. For bonus points, you can also bring or ask for a pair of earplugs, to keep you from focusing on the unseemly whir of the plane’s engine.

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Source: Rogue Wood Supply

Roll-on Essential Oil

Whether or not you’re convinced by the essential oil hype in the blogosphere, scents have a powerful impact on our mood. A soothing roll-on fragrance, like lavender, clary sage or chamomile, gives your body a gentle reminder to relax, even when the last thing you feel is calm.

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Source: Walmart

Pill Organizer

If you take medication for your anxiety, forgetting your meds can put a huge damper on an exciting trip. So you won’t have to spend your entire vacation in line at the pharmacy, try bringing a weekly pill organizer with your medications and dosages already neatly divided and packed. Just be sure to bring your medications in your carry-on bag or purse, so that you won’t worry about missing them if your bag is lost or stolen.

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Source: Urban Outfitters

Portable Charger

When you’re out and about in an unfamiliar city, state or country, your phone is your lifeline. This summer, I spent a week hopping between European countries – I used my phone for everything from translating signage to getting directions when I was lost! That little hunk of metal in your pocket can go a long way toward reassuring you of where you’re going and what you’re doing on vacation. Bring a portable charger and cord everywhere you go, and you’ll never have to worry about it dying unexpectedly!

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Source: Twitter

Dramamine

Thankfully, I don’t get motion sick on planes – just in the car. But, if you do get motion sick on planes, worrying about whether or not you’ll get sick on your flight can cause a lot of additional, unnecessary anxiety. If this sounds like you, I highly recommend bringing some Dramamine tablets along for the ride. They’re made to combat motion sickness, and may even make you drowsy enough to fall asleep during an otherwise anxiety-ridden flight.

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Source: DHgate

Fuzzy Socks

Tight shoes and socks restrict your circulation – which can be dangerous on long flights, especially if you take medication that increases your risk of blood clots (including the birth control pill!). Fuzzy socks will not only keep you warm midair, but they’ll also keep your calves nice and relaxed, enabling blood to flow regularly throughout your legs – and keeping your pesky feet from falling asleep in-flight!

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Source: Crate and Barrel

Comfort Object

You’re never too old to self-soothe, in my opinion – and what better way to feel better than to cuddle a stuffed animal? To me, a warm teddy bear is the next-best thing to a real pet. Since I rarely travel with my furry friends, I never forget to bring a comfort object wherever I go. For me, snuggling up with my Hooty owl-shaped heating pad helps calm me down whenever I get anxious. (Some airplanes have microwaves you can borrow for objects like heating pads – ask the flight attendant nicely and they’re usually happy to help out! This tends to be more likely on international flights where you’re served a hot meal.)

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Source: Yogi Products

Tea Bags

The most soothing, calming beverage of them all is decaffeinated tea. But why spend a fortune on a Starbucks tea when you could pack your own brew from home? BYO empty travel mug through security. Then, ask Starbucks to fill it with hot water – this is usually free, or they may charge you something like $0.15 for the hassle. Finally, dunk your own favorite blend of anti-anxiety teas in the water for a thrifty beverage that’s sure to warm you to your core. My favorite blends for calming down are green tea, chamomile or vanilla – each with a few drops of honey to sweeten them up!

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Source: Blue Star Coloring

Coloring Book

Adult coloring is more than just trendy: it’s a creative activity that promotes mindfulness and relaxation. When you’re wired from the adrenaline of a frightening flight, it’s the perfect time to practice using coping skills like mindfulness to bring down your anxiety levels. Just remember that some TSA agents will count markers toward your allowance of liquids in your carry-on, so you may want to check your toiletries or consider packing fine-liners or gel pens instead.

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Source: Lulus

Wireless Headphones

I love listening to my favorite playlist when I’m on a long flight, because it helps me drown out the sounds of the roaring engine that make me so anxious. However, I hate those cheap plastic earbuds the flight attendants hand out in-flight! That’s why I always pack my own set of Bluetooth wireless headphones – I use this $25.00 pair of Soundpeats, which have stereo quality at an affordable price point. One advantage of wireless headphones? You can still follow along with your in-flight entertainment if you need to leave your seat! (Note: I am not sponsored by Soundpeats.)

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Source: Pinterest

Chewing Gum

Last but not least, ever since I was a kid, I have never gotten on a plane without chewing gum. Growing up, my mom taught me to chew gum when the plane is taking off or landing to prevent the painful change in air pressure. Maybe this is just an old wives’ tale, but I always chew gum when landing, and my ears hardly ever ache when I fly anymore! I am on a low FODMAP diet, which generally discourages chewing gum, as it usually contains a high FODMAP artificial sweetener like sucralose or aspartame. Lately, however, I’ve fallen in love with Glee Gum, a brand that uses real sugar and brown rice syrup in place of artificial sweeteners-  both of which are low FODMAP choices! You probably won’t find it in the airport – but you can get Glee Gum online or at your local health food store, such as Whole Foods Market. (Note: I am not sponsored by Glee Gum.)