Gut Health Update: Colon Cleanse + My First Endoscopy

Disclaimer: This post is my personal experience and is NOT intended as medical advice in any way. I am not a doctor, so please consult with a medical professional if you have any concerns about your overall health and take what I say with a grain of salt!

I’ve been on quite the journey since my last gut health update – and wow, what a journey it’s been. I’ve seen two different gastroenterologists, embarked on a colon cleanse and even had my small intestine biopsied to test for celiac disease. (Yes, that again.)

I’d be lying if I said that having my stomach pinched, poked and prodded by doctors and scopes all the time wasn’t stressful. But, I don’t regret it at all. Because of what I’ve survived this year, we’ve discovered that I almost certainly have IBS, relieving my worries that my gut health issues could be due to something more sinister than a spastic colon.

Since relocating to Cleveland, I’ve been receiving the bulk of my care at North Shore Gastroenterology under Dr. Mohamed Naem. Dr. Naem has done more for my colon health in one month than all of my previous doctors put together – but that doesn’t mean that my big move hasn’t been littered with challenges for my gut and mental health alike.

Below, I write about undergoing a colon cleanse, getting my first endoscopy and all the treatments, medications and procedures that led me to this point. Most importantly, I write about how they made me feel – because as we IBS patients know, our emotions are half the battle when it comes to our gut.

Before the Big Move

Back in Boston, I finally got into a gastroenterologist’s office at Boston Medical Center. I was impressed with the quality of care I received, but disappointed that my testing failed to reveal answers to what might be making me sick.

At that point. I had already been to an emergency room in Erie, PA while visiting with my boyfriend on winter break. I also visited an NP in Cleveland, Cheryl Brinley, who ordered a CT scan that failed to reveal anything (though we did discover a severe vitamin D deficiency that could be contributing to my low mood through the winter months).

My doctors at BMC ordered a fecal calprotectin test as an alternative to doing a colonoscopy, since it is essentially just as accurate and far less invasive than a scope. The test required me to provide a stool sample to the lab, who analyzed it for markers of inflammation.

This measurement told them with some certainty that I did NOT have IBD. Regardless, I still felt doubtful. My doctors took my symptoms seriously, but my results certainly did not alleviate my anxieties about my gut health. So, when I came to Cleveland, I decided to get in with a gastroenterologist ASAP – not only to establish care in my new city, but also to hopefully find some answers once-and-for-all.

The Colon Cleanse

Upon visiting Dr. Naem for the first time, he immediately suspected IBS-C – the C standing for “constipation type.” Despite the fact that I’d suffered from diarrhea in the past, my doctor suggested that this may have been “overflow diarrhea” from an underlying problem of constipation.

I finally had my answers – but what was a girl to do about them? According to Dr. Naem, it was time to flush out my colon and start over with an empty gut. And that meant laxatives. Lots and lots of laxatives.

For the cleanse, I purchased a bottle of magnesium citrate, which I’d been instructed to drink alongside two Dulcolax tablets to help flush out my colon. It only took about 90 minutes before I began to experience the symptoms of these laxatives.

The results lasted about 48 hours before my gut finally began to calm down and return to normal. But, arguably, my colon has been at its most “regular” since before I suffered from IBS at all.

After the cleanse, my doctor instructed me to begin mixing a capful of Miralax into a drink – my morning coffee, he suggested, though I’ve since begun to drink it with Gatorade so as not to ruin the sacred experience of coffee – each and every day. This practice has maintained the results of my colon cleanse for the past 2-3 weeks, and produced a radical difference in the quality and frequency of my bowel movements.

As I understand it, colon cleansing is a controversial topic in the medical field. While I don’t recommend you perform a colon cleanse without first talking to a qualified professional, I can certainly attest that my colon cleanse worked wonders for my IBS.

Frustrated gastro patients will try anything once – and for all the evidence behind the low FODMAP diet, this simple bowel regimen worked much better for me!

My First Endoscopy

Only, there was a catch: thanks to a twist of events in my gut health journey, I could no longer rule out celiac disease, despite previous tests that showed my IgA and IgG antibodies were normal.

My mom’s doctor began to suspect celiac disease in her, leading me to seek out the advice of a gastroenterologist as to whether I should be worried about my own gut health. Initial test results did not show evidence of celiac, but they did show that I was at high genetic risk, which could only mean one thing: my diagnosis (or lack thereof) must be confirmed via upper endoscopy.

Needless to say, I was terrified. Who wouldn’t be afraid of gagging in front of your doctor – or worse, experiencing the awkward discomfort of having a tube placed in your esophagus? In my case, I was most afraid of undergoing anesthesia, which I’d never done before – and, quite frankly, never expected to need to, outside of the standard wisdom tooth removal all my friends had undergone as teenagers.

To make matters worse, my endoscopy was scheduled far in advance, giving me plenty of time to worry prior to the procedure. The night before, I watched tons of YouTube videos to prepare myself for what to expect. I also could not eat for eight hours and could not drink for four hours prior to the scope.

When I arrived at the hospital, it took about an hour after my scheduled appointment time before the nurse called my name. Once she did, however, the procedure moved quickly. As usual, they took my height, weight, blood pressure and pulse. Then, they had me change into a gown and lie down on a bed.

As they placed IV fluids in my arm, I was so anxious that I began to quiver in fear – but the two nurses by my bedside did an extraordinary job talking me down and reassuring me that the process would be simple and painless.Then, it was go-time: the nurses wheeled my bed into the endoscopy room.

There, I got to quickly wave hello to my doctor and meet the NP who would be handling the anesthetic before being asked to roll onto my left side for the procedure. I barely remember anything past the NP inserting the anesthetic into my IV and the nurses asking me to bite down on a mouthpiece that would be used to insert the tube down my throat.

The next thing I knew, I had woken up in the recovery room with my boyfriend waiting by my bedside. Dr. Naem came to tell us that he had not found evidence of celiac and was 99% certain I did not have it – though technically, we had to wait for the biopsy results before we could be sure. (In fact, just yesterday, I received my results confirming I definitely do NOT have celiac disease!)

For the hour after the procedure, I felt a little woozy. David took me to get a milkshake, which I eagerly devoured. After that, I lost my appetite for most of the afternoon. About two hours later, the numbing anesthetic wore off and my throat began to kill. Luckily, the pain only lasted about a day. But, overall, the procedure was quick, relatively painless and more than worth it to relieve my anxiety and definitively rule out a diagnosis of celiac disease.

Gut Health Products + Resources

As usual, I’ll end this post on a positive note by sharing some of the products that helped me get through this stage of my gut health journey. Once again, I’ll share links so you can purchase some of the staples that saved my life (metaphorically, of course) during my experience with IBS!

  • Suja Digestive Wellness Shot. ($50 for 15, Suja Juice) When I recommend this shot, I do not recommend it for the taste! The shot contains a spicy burst of cayenne pepper, so it burns the whole way down (and trust me when I say, cayenne and pineapple juice make a horrible combination). That being said, these shots got my digestive system M-O-V-I-N-G! When your gut goes stagnant and you need to kick-start your metabolism again, I highly recommend these shots as a quick fix for your gut health woes. Just treat them like medicine, rather than a drink, and you’ll be fine. (My tip: they’re called shots for a reason – so pinch your nose and suck it up, buttercup! The faster you can throw it down, the easier the recovery.)
  • Robyn Youkilis’s Guide to Magical Digestion. (Free with Email) I’m not one for impractical, woo-woo wellness tips – but when a gut health practitioner shares evidence-based advice, I find it best to listen! Robyn’s free guide is full of common-sense tips you may not have thought of (for example, when’s the last time you paid attention to how thoroughly you’re chewing?). Robyn shares a delicious recipe for an aloe vera shot for soothing an angry, inflamed digestive tract. (And, for my fellow ED recovery warriors, I especially love that she points out that “I’m bloated” is often used as a synonym for “I feel fat,” expressing discomfort with our bodies rather than physical pain.)
  • The FODMAP Friendly Kitchen by Emma Hatcher. ($20, Amazon) I discovered this delicious cookbook of low-FODMAP recipes at my local library. Since I recently quit being vegan (post on that later), I appreciated the reintroduction to the vast variety of things one can enjoy on an IBS-friendly diet! My favorite recipe? Polenta with Burst Tomatoes and Mozzarella, which reminds me of my childhood spent frying polenta with my Polish-Italian Mom and Grandma. Mmm, mmm, mmm!
  • Rao’s Homemade Sensitive Formula Marinara Sauce. ($9, Rao’s) I finally splurged for the $9 jar of marinara that everyone with IBS has been talking about – and man, was it worth it. Quick, easy meals are hard to come by when you typically can’t eat anything that comes out of a box. Luckily, Rao’s Sensitive Formula is made without onion or garlic: two of the worst offenders when it comes to sneaky high-FODMAP ingredients! Mix it into some gluten-free pasta with parmesan or spread on a gluten-free pizza crust for a simple dish your whole family will appreciate.
  • Nature’s Fusions advanCBD Tincture in Mixed Berry. ($40, Nature’s Fusions) Before accepting my new job, I was a brand ambassador for Nature’s Fusions – and I can honestly say that their mixed berry flavored CBD tincture is 100% pure, THC-free and delicious! Though I take CBD for my anxiety, those of us with IBS know that the two often go hand-in-hand. In the event that your stress causes an IBS flareup, a couple drops of this edible CBD tincture will help your racing mind calm down naturally.

The True Cost of Low Self-Esteem

Close to $15,000. That’s how much my low self-esteem cost me, anyways – not including my student loans (or my parents’ loans) for the $70,000 tuition at the expensive private university I chose for fear of being perceived as “dumb.” But that’s a post for another time.

For three years, I ran a successful college lifestyle blog called Haley Marie Blog. I initially started blogging as an outlet to talk about my mental health, but quickly fell into the trend of blogging about beauty and fashion I couldn’t afford. Fast forward three years, and my hustling had landed me dozens of national brand partnerships, hundreds of dollars’ worth of free product….and, oh yeah: about $15,000 in credit card debt.

After I heard the powerful story of how one millennial drove herself into debt trying to become an Instagram influencer, I felt inspired to share another side of the die: how poor mental health played a role in my debt story.

More and more people my age are acquiring debt – and more and more of us are becoming brave enough to speak out about it. And as someone who’s always seen herself as smart, responsible and capable, I get it: debt, especially credit card debt, feels like a shameful secret.

Especially when the reason you went into debt wasn’t because you were buying a house, or a car, or because you didn’t understand how a credit card worked, talking about your debt feels like admitting, “Hey, I’m stupid and can’t be trusted to spend my money responsibly!”

Well, here’s a newsflash for you: smart people have credit card debt, too. The average American under 35 carries about $6,000 in credit card debt. We all have, or have had, debt at some point in our lives.

In fact, that was part of the reason I couldn’t face my credit card debt for so long. I was a Dean’s List student, with a prestigious scholarship, attending an expensive private university. Admitting I had fallen into debt would have shattered the “smart girl” image I had spent so long trying to cultivate – which, funnily enough, was how I got myself into debt in the first place!

Personally, I feel that if more of us spoke out about the burden of debt and the role it’s played in our lives, fewer and fewer Americans would continue to spend above their means. So, let’s talk about my credit card debt – because I’m NOT ashamed of it.

To me, my credit card debt is a marker of how far I’ve come and how much I’ve grown as a person. It’s a slow-healing wound from one of the most difficult times in my life, mental health-wise. But it also transformed my self-esteem, the way I view myself and the way I relate to others.

By no means do I recommend getting yourself into debt as a self-help strategy – but as I’ve started to focus more on paying down my debt, I’ve become far more comfortable in who I am.

Rather than acquiring “things” to make myself feel worthy, every item I own is carefully curated to fit the life I want. I no longer hang out with friends who need me to spend money to fit in, but instead spend my time with people who love me the way I am.

My self-esteem contributed to my credit card debt, but my debt also contributed to my self-esteem. Low self-esteem cost me close to $15,000 – but learning to grow my self-esteem as I’ve dug myself out? Priceless.

What’s the most important lesson YOU have learned about money?

Let me know in the comments below!

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!

Social Work Study Materials to Bookmark Before Grad School

Hi, my name is Haley, and I am a last-semester senior who can’t wait to start social work school! So, how do I pass the time between study breaks?

I Google study aids for M.S.W. students, of course.

Confession: I will not be graduating with honors, or even a stellar GPA. Even if I got a 4.0 this semester, which – let’s face it – I probably won’t, I can’t earn higher than a 3.2 cumulative GPA. A couple of rocky semesters, both for my mental health and my grades, combined with the fact that I’m losing two semesters to early graduation mean that my chances of graduating cum laude are behind me.

…or are they? Confession #2: it’s never too late to bring your grades up! Determined to achieve my longtime goal of graduating with honors, I resolved that I would make this semester my best yet and learn the study skills and habits that will carry me through social work school to (hopefully!) graduate with the GPA I wish I had in undergrad.

One of the tricks I’ve learned along my journey toward raising my GPA is that one must never procrastinate if one aims to do well in their classes. Admittedly, this may have led to a bit of over-eager preparation for grad school – but ultimately, it resulted in this handy list of resources for you and me both to use in our journey through social work school!

I’m sure you’re thinking: after admitting that my grades are average at best, why should you take study advice from me of all people? Because it’s not the natural geniuses, for whom 4.0 GPAs and perfect GRE scores come easily to, who know how to teach the rest of us to study. It’s those of us who have been in your shoes, riding the #strugglebus alongside you, that know how difficult it is – and how much sheer will and determination it requires – to bring up your GPA when you’re just not a “school person.”

My advice for navigating this list is to start with the general study aids I’ve chosen. These are study skills and resources you can start using now to apply to graduate school later. Then, the further you progress in your social work career, the more you can explore and peruse the specific resources that will help you flourish in your chosen field.

Last but not least, be sure not to skip the self-care section at the end! Of all the careers you could have chosen, social work is the one with the highest burnout rate: so be sure to take a break for a 10-minute yoga session (or to do nothing for two minutes) to refresh your mind, body and spirit after a couple minutes of scrolling, thinking hard and preparing for your future.

 

General Study Aids

Social Work Scholar (The Official Cozy Counselor Studyblr!)

My Study Life – School Planner (Web – Also Available on iOS/Android)

Trello – Boards, Lists & Cards for Productivity Planning (Web – Also Available on iOS/Android)

Tinycards – Flashcards by Duolingo (Web – Also Available on iOS/Android)

Printable Exam Checklist (PDF)

Academic Memorization Tips for Different Types of Learners (Tumblr)

How I Use Flashcards (Tumblr)

How I Revise Content (Tumblr)

A Guide to Making Effective Slides (Tumblr)

How to Pull an All-Nighter (Tumblr)

How I Got a 4.0 Last Semester (Blog)

 

Licensure Exam

MSW Pocket Prep App (iOS)

ASWB Content Outlines – 2018 Master’s Exam (PDF)

Study Guide: Licensed Clinical Social Worker Exam (PDF)

2013 Licensing Exam Questions (PDF)

 

Theories

Theories, Models & Perspectives Cheat Sheet (PDF)

Overview of Theories (PDF)

Genograms and Ecomaps (PDF)

Crash Course Psychology #12: The Bobo Beatdown (Video)

Erikson’s Psychosocial Stages of Development Summary Chart (PDF)

Psychodynamic Theory: Id, Ego & Superego (Video)

Freud’s Psychosexual Stages of Development (PDF)

Lawrence Kohlberg’s Stages of Moral Development (PDF)

Chapter Three Summary: The Stages of Women’s Moral Development (In a Different Voice by Carol Gilligan) (PDF)

Piaget’s Four Stages (PDF)

Crash Course Sociology #6: Karl Marx & Conflict Theory (Video)

 

Practice Models

SMART Goal Worksheet – Relevant to Task-Centered Practice (PDF)

Solution-Focused Interviewing Skills and Questions (PDF)

Narrative Therapy Worksheet: Life Story (PDF)

Crisis Intervention and Suicide Assessment (Podcast)

CBT: The Cognitive Model (PDF)

The ABC of CBT Worksheet (PDF)

Definitions of Cognitive Distortions – Relevant to CBT (PDF)

Patient Thought Record – Relevant to CBT (PDF)

Trauma-Informed Care Whitepaper (PDF)

 

Ethics & Case Studies

NASW Code of Ethics (PDF)

Social Work Today: Eye on Ethics (Blog)

2018 NASW Code of Ethics (Parts I-III) (Podcast)

The Red Carpet and the Social Work Exam – Free Ethics Practice Questions (Web)

Case Study Template (Word Doc)

CSWE Case Studies: October 2017 (PDF)

Social Work Case Studies: Foundation Year (PDF)

 

DSM-V & Psychopathology

DSM-V Disorders (PDF)

DSM-V Self-Exam Questions (Google Book)

Pearson Clinical: Clinical Assessment (Web – Links to PDFs)

Psychopathology (Video & PDF Questions)

AFP Patient Handouts (Web to PDF – Select “Psychiatric and Psychological” in Drop-Down Menu)

Developing Treatment Plans: The Basics (Podcast)

The Severe and Persistent Mental Illness Progress Notes Planner (PDF)

Sample Treatment Plan (PDF)

NASW Clinical Documentation (PDF)

Quick Reference to Psychotropic Medication (PDF)

 

Self-Care

MHA Stress Screener (Web)

Compassion Fatigue Awareness Project Self-Tests (Web)

Self-Care Assessment (PDF)

Dealing with Academic Burnout (Tumblr)

Self-Care Tips for Social Workers (Web)

Self-Care For Social Workers (Podcast)

My Maintenance Self-Care Worksheet (PDF)

Emergency Self-Care Worksheet (PDF)

My Support System Worksheet (PDF)

Take Action to Control Stress (Web)

Do Nothing for Two Minutes (Web)

10 Minute Yoga for Self-Care (Video)

Lavendaire (Self-Improvement YouTube Channel)

 

For more social work resources & study aids, follow me @cozycounselor on Pinterest!

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!

Related image

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.)

How & Why to Start a Bullet Journal for Self-Care

Happy New Year! Going into 2019, I’m equipped with a secret weapon for productivity, organization, health and self-care. That secret weapon, as it was in 2018, is my bullet journal – and this post is all about how and why to start one of your own in the New Year.

I’ve kept a bullet journal on-and-off since I was sixteen (that makes four-going-on-five years now!), but I wasn’t able to stick with it for long periods of time. Truth is, I followed way too many Instagram, Pinterest and YouTube accounts that put my dinky little bullet journal to shame. Once I gave up on the idea that my bullet journal had to be perfect, I was able to embrace it as the tool for health, productivity and mental well-being that it is – and very well should – be.

Hence, today I am sharing the why and how of starting a bullet journal ritual for self-care, and some of my favorite products and inspiration to get you started. My BuJo journey has been long but rewarding, as I’m sure yours will be, too. Above all else, however, I hope that it will help you manifest everything you want to achieve in 2019!

What is a Bullet Journal?

If you spend way too much time on the Internet (like most of us, including me, probably do!), you’ve definitely seen the words “bullet journaling” and “BuJo” thrown around over the past couple of years. Maybe you’ve even seen some elaborate pictures of hand-illustrated bullet journals and thought, Holy shit, there’s no way I can do that.

Well, I’m here to clear that myth up for you: actually, you can! In truth, there are no hard-and-fast rules for bullet journaling. You can put as little or as much effort and detail as you want into creating a bullet journal.

So, at the end of the day, what is a bullet journal, actually? It’s a DIY planner with “layouts” you sketch in a notebook. Every bullet journal should have a few basic parts (though there’s no rule saying that you have to have all of these in your BuJo):

  • An index, or table-of-contents labeling the page numbers of your bullet journal.
  • future log, or overview of the next few months where you can log important upcoming events (such as birthdays or family vacations).
  • Cover pages to signify the beginning of a new month. (These can be as decorative or as simple as you like.)
  • Weeklies and/or dailies where you can note any to-dos, appointments, notes or events you need to take care of this week/today.
  • Finally, collections, which are pages that don’t fit into any of the above categories. This is a way to incorporate all those random lists you have laying around – such as “movies I want to watch,” “books I want to read” or “goals I have for the future” – into one organized, #aesthetic notebook.

The Mental Benefits of Bullet Journaling

When you treat bullet journaling as something that has to be perfect – something you do for the Instagram likes or Pinterest shares – it isn’t fulfilling its potential to be a tool for mental health and self-care. However, when your BuJo is something you do for yourself and for no one else, it can be a powerful weapon against depression, anxiety and chronic illness.

Because bullet journals are so easily personalized, you can easily add collections to facilitate mental health and recovery. For example, I’ve tried creating Mood Trackers for keeping track of the ebbs and flows of my depression, as well as Anxiety Logs for keeping track of triggering thoughts and reframing them in an organized space. Now that I am struggling with chronic GI symptoms, I keep a Symptom Log in my journal of how I’m feeling, how much pain I’m in and what I’m experiencing on a day-to-day basis.

Not only can this be incredibly helpful for you to gauge how you’re doing, but your self-awareness can even help your healthcare team glean a more accurate picture of what’s going on in your brain or body.

And let’s not forget the benefits of creative projects like bullet journaling on our brains. There’s a reason why art therapy is so popular for depression and anxiety. Sketching, drawing and coloring – as one does in one’s bullet journal – is a mindful, therapeutic activity.

By carving space in your routine for bullet journaling, you’re therefore making time to exercise your creative muscles and give your brain a break from all the stress of the week thus far.

Bullet Journal Inspiration

So, you’ve learned what a bullet journal is and how you can use it for self-care. Now what? If you want to start bullet journaling, but have never made a BuJo before, the process can appear overwhelming!

First thing’s first: don’t search Pinterest for bullet journal inspiration. Take it from someone who has experienced BuJo envy firsthand: the Pinterest FOMO will quickly make you believe your bullet journal is inadequate compared to everyone else’s Insta-worthy pages.

At the end of the day, bullet journaling is about blending function and fun to create something that’s unique and works for YOU. Thus, I don’t recommend making an exact copy of anyone else’s design….but then again, a little carefully-placed inspo never hurt anyone, either!

Below, you’ll find a few snapshots of my favorite simple, clean bullet journal layouts to help jump-start your BuJo journey.

Oh, and if you’re a visual learner and want something to follow along with as you’re creating, I highly recommend watching a tutorial on YouTube! My favorites are Lucie Fink’s 5 Days of Bullet Journaling and Seventeen Magazine’s How to Start a Bullet Journal.

Most importantly, never forget the number one rule of bullet journaling: let go of the idea that you can somehow “mess up” your bullet journal. Because, in the words of the great Bob Ross, there’s no such thing as a mistake in art. Only happy accidents!

(Disclaimer: All the following photos were sourced from Pinterest.com. If you recognize one of these photos as your own and would like it credited or removed, please reach out to let me know!)

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Tag me on Instagram so I can see pics of your Bullet Journal! @cozycounselor

Self-Help Books to Kick Start Your New Year’s Resolutions

Admittedly, my goal of writing more blog posts in 2019 has not been going so well. Why, you ask? Ironically, the answer has to do with the subject of today’s post!

In all honesty, I’ve been reading. Like, a lot. In fact, I’ve made it my goal to read 100 books in 2019 – and I have to admit, I’m pretty sure I’m already falling behind!

Since I don’t get much time to read books for pleasure during the busy semester, I like to catch up on reading for leisure on my breaks. So far, I’ve covered ground ranging from YA fiction to women’s health to Reese Witherspoon’s new cookbook – and I’m proud, dammit!

Because I’ve been so excited about reading lately, I figured I would be just as excited to write about the books I’ve been loving recently. I was right, of course. Since self-help is, admittedly, one of my favorite genres, it didn’t take long to craft a list of self-help books that should be on every young woman’s reading list for 2019.

From candid stories about teaching sex ed to college students to kickstarting creative freedom in a way that screams #bigmagic (eek! Spoilers!), here is my humble list of self-help books (and some “normal” books which helped me, too) that every woman should read during the New Year.

But before I start, a quick disclaimer (TL;DR): I do NOT receive payment of any kind for my promotion of these books. All the opinions featured in this post are my own, and featured without sponsorship from the authors and/or publishers of these books!

If you want to take control of anxiety and/or panic….

The Anxiety Toolkit by Alice Boyes, PhD

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Source: Amazon

Why: This book is like an owner’s manual for anxiety. Each chapter is preceded by a quiz that will determine whether the skills in that chapter are relevant to you or not. You have the choice of reading the entire book, or only those chapters which pertain to you – so it’s easy to customize to your needs. In short, it’s like a mini dose of CBT in 150 pages!

If you struggle with overwhelming emotions and/or urges….

The Dialectical Behavioral Therapy Skills Workbook by Matthew McKay, PhD et. al.

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Source: Walmart

Why: After years of therapy and medication, I still had trouble overcoming overwhelming emotions and resisting self-harm triggers. Then I learned about Dialectical Behavioral Therapy (DBT). I’m not exaggerating when I say that this book literally changed my life. It brought a much-needed dose of zen to my frantic, mile-a-minute brain. Not to mention, you can get it for free as a PDF – run a quick Google search and it shouldn’t take long to find it!

If you’re tired of unwanted, repetitive thoughts and behaviors….

Everyday Mindfulness for OCD by Jon Hershfield, MFT and Shala Nicely, LPC

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Source: Goodreads

Why: Therapies for OCD can be intense. Personally, I find it easier to tackle my exposure hierarchy on my own, at my own pace. That’s where this workbook comes in: it will guide you through challenging, yet rewarding exercises – based both in mindfulness and traditional exposure-response therapy – to help you overcome your OCD.

If your mental health is taking its toll on your romantic relationship….

Anxious in Love by Carolyn Daitch, PhD and Lissah Lorberbaum, MA

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Source: Walmart

Why: If you have anxiety, it affects every relationship in your life. Even if your anxiety isn’t about the relationship itself, teaching someone with a healthy brain to understand how your sick brain functions is never easy – and neither is taking care of someone with anxiety. Hence, this is where Anxious in Love comes in. I recommend it for both partners with anxiety and partners dating someone with anxiety. Its eye-opening suggestions for handling conflict and everyday triggers, without becoming co-dependent on your partner or enabling their anxiety, will make maintaining your relationship 1000x easier.

If you’re stuck on the yo-yo dieting rollercoaster….

Eat What You Love, Love What You Eat by Michelle May, MD

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Source: Amazon

Why: I am NOT exaggerating when I say this book literally changed my life – and potentially saved it. At sixteen, I was two years deep into a spiral of bulimia: periods of intense orthorexic eating and exercise, followed by stomach-churning binges on junk food – you know, “because I’d earned it.” This book reset both my stomach and my brain, and taught me to relearn my body’s natural hunger cues as I recovered from the throngs of my eating disorder.

If you want to make peace with your inner child….

Attached by Amir Levine, MD and Rachel S.F. Heller, MA

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Source: Amazon

Why: My first therapist ever recommended I read this book when I came in complaining of relationship problems with an ex-boyfriend. As I devoured its pages, I quickly learned a lesson I wish every young woman with anxiety was taught in school: if you are anxiously attached (like me, as this attachment style is a common byproduct of having divorced parents), date someone who is securely attached. Do not date another anxiously attached person, or an avoidant person who shies away from commitment, and believe that you can “fix” them. At the end of the day, you can’t – what you need is stability, and this book is all about why.

If you want to laugh (and cry) along to a poignant story of healing….

Fully Functioning Human (Almost) by Melanie Murphy

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Source: Amazon

It’s no secret that Melanie Murphy is one of my favorite – if not the favorite – YouTubers of all time. Melanie is an Irishwoman who talks candidly about sex, body image and mental health – which explains why I vibe with her so well! In 2018, Melanie released her first book, Fully Functioning Human (Almost), which details her journey through disordered eating, unhealthy relationships and learning to #adult. While it’s not a self-help book exactly, it is chock-full of Melanie’s signature positivity – and an excellent reminder that we are never alone in our struggles to achieve optimal mental health.

If you’re passionate about closing the orgasm gap….

Come As You Are by Emily Nagoski

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Source: Simon & Schuster

Why: I first read this book when I discovered the sexual side effects of taking an SSRI (think: the Sahara desert), and have gone back to it at least once a year since. Nagoski is a college sex ed professor whose book should be required reading in all schools. She filled in so many of the gaps in my sexual knowledge, imbuing important tidbits of wisdom – for example, did you know the most important female sex organ is actually the brain? Or that there’s such a thing as being “wet” without being “turned on” – and vice-versa? If your answer is no, as I suspect it is for 99% of the American adult population, then pick up Nagoski’s book and get back to me when you’re done. Period.

If your resolution is to start (or finish) a creative project….

Big Magic by Elizabeth Gilbert

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Source: Goodreads

Why: Yes, I am aware that I am the millionth blogger to recommend this book; in fact, it’s becoming a bit of a self-help cliche. In my opinion, this is rather unfortunate, since Gilbert’s Big Magic is a real gem of a book. As someone who’s ridden the struggle bus of writing a novel from start to finish (yup, you can check out my novel Wilder & Wilder – published in October 2018 – for $2.99 on Amazon!), I could not agree more with the guiding principle behind Gilbert’s book: in hundreds of splendidly-written pages, Gilbert essentially advises, “don’t wait for the perfect time to start. Just do it.”

If you’re a feminist who loves wearing pink and men/women who pay on the first date….

Bad Feminist by Roxane Gay

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Source: Ravishly

Why: Again, this book is a compilation of essays by the author Roxane Gay – not exactly a self-help guide. Nonetheless, I still believe it should be required reading for every woman in 2019. In the political climate we live in today, it’s nearly impossible to be a woman (or a man/nonbinary person who fully embraces gender equality) without identifying as a feminist. As the conservative right continues to launch attacks on women’s rights, there is no better time than the present to read Gay’s thoughtful reconciliation of her feminist ideology with her love of traditional femininity, with all its pink bows and lace frills; her poignant movie reviews as a well-educated Black woman; and, perhaps most memorably, her thoughts on playing Scrabble in a big league tournament.

Last but not least, if your apartment floor hasn’t been visible in months….

The Life-Changing Magic of Tidying Up by Marie Kondo

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Source: Target

Why: I’m a firm believer that our spaces reflect what is going on in our lives. As anyone who knows you well will tell you, my room tends to become a pigsty when I’m stressed – and when I start feeling productive and put-together again, it usually leads to a long, binge-cleaning session. In my opinion, there’s no better time than the New Year to get your sh*t together. By following Kondo’s patented discarding, donating and decorating techniques, you can both build a space you love – and keep it the way you love it, without all the unnecessary clutter blocking out those positive vibes.

Click here to keep up with my journey toward 100 Books in 2019 by following me on Goodreads!