I love this time of year! The sun is out (mostly), the streets are filled with people again, and there is a sense that the end of the year (and for most people a break is on the way!).  Its always amazing to me that within such a short space of time, big changes can happen! Almost all of the people I have seen this week have commented that they are feeling much better since the change in the weather!

Of course, there is still people who are feeling sad and down, and the sun coming out doesnt fix that, but it may help with a little bit of motivation! One of the difficulties with low mood and anxiety is that it often leads people to what we describe as 'all or nothing thinking', meaning their brain tells them, "If I cant do x 100%, then there is no point doing it at all". Of course, we all have these thoughts at times (exercise is a particularly good example), but sometimes doing something small to start actually helps to turn this process around. The nice thing about this time of year is that there can be lots of things which will make you feel better without too much effort, for instance going for a 10 min walk after dinner, or taking the dog outside and throwing the ball around.

A good place to start is to think of a goal that you want to work on - for instance getting some more exercise in. Then think of a really small starting place (for instance walking for 5 mins), and try doing that for a couple of days. If it doesnt work, work out what the barriers are? What is stopping you, and whats getting in the way? As you feel comfortable in doing something, you will find that you will soon be doing more and more, and it will feel much easier. Sometimes having a plan is the most important part of all!

This will work with a whole bunch of things (not just exercise), including eating, practicing meditation, school work, hanging out with friends etc. Go on, give it a try!

My job means that I see people struggling. With illness, breakups, anxiety, grief, sadness and despair. I watch people overcome incredible adversities, physical restrictions, and sometimes facing the end of their lives. 

When we get caught up in life, its hard not to get stuck worrying about everything that we are meant to be worrying about. Are we working hard enough? What if I fail my HSC? Do we have enough money? Should we have kids? What are people thinking about me? There is a lot of pressure on everyone to have the best, be the best and know what they are doing at every turn. The thing that I have learned though, is that no one knows the answer to what the 'best' is, and when you get to what the ideal is, often there is something else to run towards just around the corner.

The most valuable things that I have learned have come from my patients, particularly my young patients. Being in the most difficult situations, often brings with it a sense of clarity. Never once when working with a dying person have they said to me "I wish I had more money" or "I wish I had of worked more". I don't have the answer for what you might say in that space, but I am willing to bet that it is neither of those sentences.

So, my challenge to you for the week. Consciously notice the small things. You know the ones, the kinds of things that we brush aside as we go about our hectic lives. Take out your iPod and listen to the sounds of life, or leave your earphones in and get absorbed into your favourite ever song. Feel what the sun feels like on your skin. Eat ice-cream in the afternoon. Listen to your kids/partner/friends/workmates - no really listen to them, why are they telling you what they are telling you? Are they happy, sad, scared, anxious or worried? Take the dog for a long walk, and notice how happy he/she looks afterwards. Talk to the person you see everyday on your way to work/school. Hold your partners hand. Laugh, just because it feels good. Cry, just because it makes you feel better.

Doing these things won't get rid of the pressure, your stressors or the difficulties that are modern life. But I imagine it will bolster your resources to deal with everything else, and you will probably feel more content and satisfied for it.

What do you do to make the small things matter?

Well, I think its fair to say that Winter has well and truly made its mark on Sydney over the last couple of months. We know that it is going to come every year, and yet it seems surprising when it arrives. The thing that I have noticed the most, as I do every year is that everyone starts to hibernate and delaying things....

Like... "I can't exercise today its too cold" or "I am going to cancel lunch/dinner/plans because I just want to head home to the couch". We have all done it from time to time, and winter provides a great excuse for us.

The reality however is that the more we avoid doing things and engaging in activities, the less energy and motivation that we are likely to have. So that avoidance of walking the dog in the morning, is much more likely to lead to a whole day on the couch watching rubbish tv, not sleeping well, and then feeling more tired the next day. Simple things can make a huge difference, and that 20 min walk/coffee with a friend/or venture to the shops will actually make things feel better!

Remember the golden rule, the less you do, the less you will want to do! But it works just as well in reverse. So this weekend (which is predicted to be a bit cold and miserable), don the jacket, make some plans and stick to them! You will feel better for it come Monday morning, I promise!

What are your tips for staying motivated in the winter?

I am reminded on an almost daily basis about how rubbish things can be sometimes. I meet people in the most horrid and traumatic of times, and am reminded about how the simple things in life are the things that matter, and the things that sustain us.

Our lives are inherently busy and at times chaotic. We find ourselves running from task to task, and stressors and challenges come up when we least expect them. Its easy to be focused on everything that's happening and forget everything else that doesn't require your immediate attention. I don't have a solution to stop things being stressful, and I cant stop difficult things happening. However, I can recommend some strategies to help re-adjust, focus and engage in the little stuff.

For instance, think about the last time that you sat quietly in the sun and just focused on what it feels like to have the sun on your shoulders. Or, the last time you ate chocolate that you let it melt in your mouth without chewing it. When you bring your attention to what you are doing, and really focus on it, its hard for the other things whirring around in your head to get you tangled up in them. Instead, you might spend 10, 20 or 30 seconds just purely focused on the pleasure and sensation of the sunshine, chocolate or anything of your choosing.

My challenge to you this week is to find something that you can put your focus in. It could be walking, it could be eating, it could be as simple as paying attention to the lines on your hands, but its about stopping, refocusing and paying attention.

It won't stop everything else, but it might give your mind a break from thinking about it for a little while.

I was walking around Newtown yesterday and saw the sign to the left on display in one of the cafes near the railway station. It caught my attention, and I thought I would share! Worrying is one of the things we often do without thinking, even though sometimes we wouldn't consider it to be worrying. We might call it, being lost in thought, replaying an argument, having a conversation in our head that hasn't happened yet, or just thinking about the worst case scenario.

As we have talked about before, there are often good reasons why our brains work the way they do. Think about the cave people that came before us, they had to think about the worst case scenario. If they didn't they would be eaten! They developed strategies to help them manage this, you can read about it more here.

Sometimes worrying about something can feel quite helpful, and will give a sense that things are more in control than what they really are. Often what happens though is that we spend tonnes of time thinking through a scenario, all of the possible outcomes and ways that it might go wrong, with no actual control over the outcome. For instance, if you have a fight with someone that you care about, you may spend hours and hours thinking over what you each said, how it was left, and even how you feel. Perhaps you try and call them and they don't respond. So you might get more and more anxious, which will make you think over the details more and more. After all of this, you are probably more anxious and worried than you were just after the argument, and I suspect that nothing will have changed. Ultimately, the outcome is dependent on you and the person you had the argument with, so you can spend all day thinking about it, but you have no control at all over what happens next.

I am not suggesting that you don't worry at all. Its not likely to happen. Worries will pop into your head hundreds of times a day, and sometimes you might not even notice them. If you try not to worry, they will come anyway, and probably more than they had before. Instead, perhaps a more helpful way of managing them is to be ok with them being there. You don't have to like them, you don't have to challenge them, but just notice them. Sometimes they might be loud, sometimes soft. Sometimes they will speed up or slow down, and at 3am they may be scary. When they come, notice that they are worries, and just let them be.

What do you think might happen?

Next week, we are going to talk more about watching and noticing your worries, and the ways that you can manage them.

So it's the holiday season again! It comes around quickly (unless you are under the age of 10!). For many of you, the festive season marks the end of a long year, a time to reflect and have a nice time with people around you. For just as many people though, Christmas and associated stuff is a really stressful time, and for many of my clients, it's a time of firsts. The first Christmas without their partner, the first holiday since someone has become unwell, the first holiday on treatment. Everyone deals with this differently, which is ok, but I think at this time of reflection, it's worth taking stock for everyone about how to make sense of everything that happens for us.

Our instinct is often to busy ourselves so we don't have to deal with difficult and painful emotions and hope that they will go away. Sometimes this can be a good short term strategy. But, perhaps instead a helpful skill is to learn how to sit with the emotions and to not be fearful of them. If we try and block them out and ignore them, they often just keep bouncing back at us. But, if we acknowledge the sadness, happiness, grief, anger and everything else that our brain throws at us we are able to change our relationship with it a little bit. It won't make it go away, but powerful emotions will never just disappear! Instead, by noticing what happens when you feel angry, sad etc then you can change the relationship you have to it. If you google some "sitting with emotions" there will be a heap of exercises come up which will be helpful.

And so, when these difficult things come up over the next couple of weeks (as I am sure they will for everyone), take the time to notice it, pay attention to it, and sit with the discomfort rather than trying to push it aside. This time of year leads to reflection and perhaps for you, it will bring you to decisions about changes or things to do differently. All of these things are good, even if they feel uncomfortable. Most change does.

So, on that note, I am going to sign off for the year, but I am looking forward to what the next one brings! Stay safe, look after yourself and the people around you.

Cheers Toni :)

It must be terrifying to be acutely aware of all of the bad things that might happen to us. If you wake up in the morning and head to work, there are probably hundreds of potentially harmful situations that we don't even think twice about. Unless of course you suffer from anxiety. We are all anxious at times, and there are situations which are inherently anxiety provoking, such as giving a speech, going to the dentist, job interviews, breakups etc. You might even have some that other people don't. That's ok, we all do. Although if you are amongst the group of people who suffer from anxiety on a daily basis, it can be horribly debilitating. On top of that, often unless someone tells you about it, you might not even know about it, so there may be people wandering about who are struggling through everyday, and you might even be one of them. 

Why do we get anxious? 
Well, the cliff notes version is that it keeps us alive. Without anxiety we wouldn't get anything done, wouldn't evolve and would walk ourselves into all kind of danger. If we didn't have these skills, the lions, tigers and bears (oh my!) that were running around in our ancestors past wouldn't have had much of a challenge. Our anxiety keeps us safe, the problem is that in our worlds right now there isn't a whole lot of things chasing us and eating us. But there are lots of other threats, generally fueled by our thoughts and perceptions. To keep us aware of these things, our brains are pretty good at sizing up threat and working out what to do with it. 

Thanks for the history lesson, however I am still anxious... 

First up, you will never get rid of your anxiety completely. No one does. Anxiety is very purposeful, and so getting rid of it would be unhelpful, but if you have lots of it, it's about scaling it down so it feels manageable. There are lots of schools of thought about how to manage your anxiety, and you can read about some of them by googling CBTor ACT. If you find a model that makes sense for you, it helps to find a therapist who works in that model and you are both on the same page. 

Another helpful strategy, and the most effective if you are having panic attacks, is to use your breathing. When you become anxious, your breathing becomes fast and shallow (you may not notice) and tells your brain to get ready to escape or get ready to deal with whatever the problem is. If you slow your breathing down, you can tell your brain that you are ok, and it will reduce those anxious feelings. 

I can guarantee that if you wait until you feel really anxious to try the breathing strategy, it won't work! You need to practice when you are feeling calm!  There are whole bunch of exercises out there, but the one that I like is 6 second breathing, breath in for 3 seconds and then out for 3 seconds. Do this as many times as you like, but usually for at least 10 cycles (1min!).

It's hard to manage anxiety on your own, particularly if it's really bad and eating up a lot of your mind space. If this sounds like you, then I recommend getting some professional support. 

Anyone have any strategies that work really well they would like to share? 

Often people come to see me worried that they are going crazy, or that things are out of control. Despite considerable health promotion efforts, the sense that I get is that there remains a considerable stigma about mental health concerns, particularly for some cultural groups. Often when people walk into the therapy consult, they remain worried that they are going to be judged, minimise their problems and as a result don’t get the help they need. The step that people take to decide to come along is a huge one, and sometimes this gets minimised. You see for psychologists and GPs talking about mood, coping and depression is something that happens every day, so sometimes we forget just how hard it is, if you have never had to talk about it before. 

How do you know if it would be helpful to have therapy?

Lots of things happen in our lives that make them difficult. In fact, I am yet to meet anyone who doesn’t have any difficult things happen in their lives. Sometimes we manage them well, particularly if they happen one at a time, and we have lots of space and time to process whatever is going on. But, generally what happens is that things don’t happen to us one at a time. In fact, in my experience there are always lots of dimensions to our stressors, and
sometimes trying to balance these become very difficult. 

If you are feeling overwhelmed by what’s happening for you, or you are feeling that your mood is a little flat, if you become anxious or worried about things that you have not been worried about before, if you’re sleeping patterns have changed or you have lost interest in things that normally make you happy these are all things which are suggestive that things are becoming harder to manage. Like most things in life, it becomes easier to engage in help when things are starting to get hard, rather than waiting until you feel completely overwhelmed.

Often therapists are happy to chat with you about what you are concerned about, and whether they think therapy would help before you commit to coming along. 

Other than therapy, what can I do?

Some of the things that will make you feel better, are the things that you normally stop doing when you start feeling flat or overwhelmed. One of the best things that you can do is to get your routine back on track, start eating well, and probably most importantly, start doing some exercise. All of these things help manage you mood, bolster your coping strategies and generally help you feel better. In addition to this, the thing to help you manage is to take time for yourself to do something that will make you feel better. It could be easy, it could be a treat or it could just be as simple as taking a nice long shower. But taking that one thing and prioritising it, can make a huge difference to your mood, even if it doesn’t feel like it at first.

However, if things are not feeling any better after you try these things, then you may need additional support. Often talking with your GP in the first instance can give you an idea of what might be helpful. If at any time you feel suicidal or have thoughts about harming yourself, then you need help straight away, and so the best option to the call the community mental health team in your area (easy to find if you google it!) and they can make contact and
engage support very quickly.