Note:  This post is quite different from my typical posts and was inspired by the media coverage on Whitney Houston’s death.

As a specialist in anxiety, I am all too familiar with Xanax, one of the prescription drugs that Whitney was prescribed.  Xanax is benzodiazepine,  a class of drugs known to be highly addictive.  Xanax is one of the worst “benzos” because it is fast acting and sedating.  It calms anxiety within minutes – unfortunately the benefits are short term and actually negatively reinforce anxiety (see my post Working Past Panic) often making it worse in the long run and thereby requiring more medication to calm the anxiety. It is physically and psychologically addictive and there is a tolerance effect such that people often need more and more to get the same effect.

The media talked a great deal about how Xanax can be dangerous when mixed with alcohol.  However, I’ve heard very little about the fact that her physician prescribed a highly addictive drug to an addict. Just because a drug can be prescribed, doesn’t mean that it is safe and that it isn’t addictive. Much like alcohol – just because it’s legal, doesn’t mean it isn’t addictive.  We would all gasp if a doctor advised a patient to use alcohol to calm their nerves.  We would gasp even louder if the patient were an addict.  In my opinion, if you wouldn’t prescribe heroine to an addict, you shouldn’t prescribe Xanax either. Regardless of whether Xanax contributed to Whitney’s death or not, the prescribing physician was irresponsible (and my guess is it did play a role – even if it was a springboard to using more illicit drugs).  Xanax is used for anxiety and cognitive-behavioral therapy has been proven to be more effective in treating anxiety disorders than any medication. Nonetheless, SSRIs and other medications that are not addictive can be effective in treating anxiety.  Furthermore, exercise, chiropractic, herbs etc. can be very helpful as well. So if one chooses to not engage in therapy – there are better alternatives than giving Xanax to an addict.

Jennifer L. Abel, Ph.D.
author of Active Relaxation: How to Increase Productivity and Achieve Balance by Decreasing Stress and Anxiety.

Don’t Fall Prey to The Abstinence Violation Effect (AVE)

AVE is when you make a slip and then completely abandon a goal. So for instance, you quit smoking having puffed your last fag at 11:58 on New Year’s Eve and manage to keep from smoking until February 10th. On that date, you go out with a friend who smokes and you have a couple drinks. He smokes the same brand and it looks so good. Your defenses are down and that chemical reaction from the alcohol makes you crave it all the more, so you smoke. As you take those last couple drags you think, “I’ve blown it. I’m a failure and I’m doomed to smoke for the rest of my life” and you immediately go back to the pack a day plus habit.

To avoid falling prey to the AVE, distinguish between a lapse and a relapse. A lapse is a slip and should be considered temporary and human. A relapse is more than a slip. It’s a fall because it is followed by a decision to go back to your old habits, abandoning hope to succeed at your goal. Remember that a lapse does not need to become a relapse.

If you have sworn to only eat sweets on the weekends and you eat a brownie on a Tuesday night, don’t eat 2 more and give up the goal. Tell yourself something like this: “I’ve done really well up until this point and I’m going to continue to do well from here on out. I’m human and had a temporary lapse. I’m not going to relapse. Instead I’m going right back to keeping the resolution.”

Tweak Your Goal if Needed

If you decide that you can’t or don’t want to meet your resolution because it’s just too difficult, rather than abandoning the goal, change it. So, for instance, let’s say that you decide you are going to keep to a budget of $400/month for everything except your rent, utilities, car expenses, and groceries. Then in the last week of the first month you feel you have been pretty good, but have to pass up social plans or a good buy on some shoes and you start to feel frustrated and deprived. Rather than giving up the idea of a budget, loosen it. Maybe $125/week is more reasonable. (Tweaking a goal is not typically recommended for addictions.)

Want vs. Need

We are generally more motivated to do something that we “want to do” rather than something we feel like we “need to do.” So rather than telling yourself that you need to lose weight or you need to go to the gym, think “I want to be thinner” or “I want to get into good shape and I want to feel that sense of well-being after a good workout.”

For continued support w/quick tips to keep your resolution – “LIKE” my FB Active Relaxation Page in the side bar to your right.

Best of Luck with your New Year’s Resolutions and have a Very Happy New Year!
Jennifer
Jennifer L. Abel, Ph.D. author of “Active Relaxation“

HOW TO KEEP YOUR RESOLUTION:

Self-Monitor

Studies show that we are much more likely to meet goals if we monitor them. This helps to hold you accountable and each time you meet the goal and write it out it can be reinforcing. I suggest something very simple, like writing in your calendar YES or NO.

Alternatively, you can make a two or three column sheet that you print out or keep in your computer, Blackberry, or iPhone. In the first column write the date and in the second column write whether you kept the goal by writing YES/NO. In the remaining columns you could write the number of minutes, what type of exercise you did, the number of carbs you ate, etc. If you make the monitoring too complex, it may make your resolution harder to keep.

Share Your Goal and Enlist Support

We are more likely to keep a goal if we tell other people that we are going to meet it. Be positive in your presentation. Also, tell them how they can support you. Only engage people who are positive and supportive. Consider finding someone else who also wants support to keep a goal and keep each other informed of your progress.

The following is an example of an e-mail someone might send out:

Dear Bob, Jill, Grace, and Nick,

Thanks so much and Happy New Year,
Liz

Another Example

To my smoker friends,

Cheers!
Rick

Money Talks

We are more than three times more likely to keep a resolution if money is on the line. The best way to do this is to find one or more friends who are looking to make a resolution and agree to put money into it. You could pay each other for each slip or make it competitive such that the winner takes each monthly contribution. Alternatively, put money into a fund and if someone fails they lose their money to those who keep the resolution. If everyone sticks to it, agree to spend the money together doing something rewarding. This could be at the end of the year, the end of the quarter, or even the end of each month.

If you can’t find a friend who will do this, try StickK.com. You pay them only when you mess up your goal and the proceeds go to a charity of your choice. Add motivation by choosing an “anti-charity,” i.e. a charity that you are against. A compromise is to choose a charity that is somewhat neutral. StickK.com helps you to keep your resolution in other ways too.

By Jennifer L. Abel, Ph.D.
author of Active Relaxation: How to Increase Productivity and Achieve Balance by Decreasing Stress and Anxiety

RESOLUTION FACTS
How many New Year’s Resolutions have you made over the years? How many have you kept? Over 85% of people make a resolution. By February 1st about 30% of people have already ditched the commitment, by July 1st 80% have given up, and only about 6% keep their resolution to the end of the year. Some ways to keep your resolution: be specific, make it attainable, self-monitor, make your commitment public and enlist support, and be willing to tweak the goal in favor of giving up.

HOW TO MAKE A RESOLUTION
Be Specific

I hear a lot of people saying they are going to “exercise more” or “eat healthier” this year. I heard someone say “I’m going to play more golf with my dad this year.” These resolutions are too general. Be specific in your goal, otherwise you’re really not making a commitment and significant change is unlikely.

For instance, if you want to play more golf with your dad this year, consider how many times you played last year. If you only played together twice, committing to at least every other month is probably attainable. Other examples of specific goals are: Exercise for at least 30 minutes three times/wk; Have the house clean before I go to bed at night; Keep unrefined carbs under 50 gm/day.

Make a specific plan to keep your resolution. If the golf example were your resolution, you may decide to commit to the last Saturday of all even dated months. Instead, you might choose to write yourself a reminder at the end of each odd dated month to set up a date before the next month is over.

Make it Attainable

Some people set their sights too high. For example, say someone who is sedentary and complains that they have no free time makes a New Year’s resolution to exercise for at least an hour six times/week. How likely do you think they are to succeed? Three to four times/week for 30 minutes is more likely to be attained. Instead of promising yourself to have the house clean before you go to bed each night you could decide that it will be clean every Sunday night. Similarly, my successful resolution one year was to straighten the house for 10 minutes everyday.

Remember that if you really want to reach the higher goal, you can still do that regardless of your resolution. In other words, if you make the resolution to work out three times/week for at least 30 minutes you can still work out six times for an hour.

If you have already made a resolution it may be in order for you to tweak it to something that is attainable. The key is being honest with yourself about what you know you will be able to do. For instance, are you really going to count the number of carbs you ingest for the next 365 days? Finally, remember that meeting just one resolution is going to be easier than trying to keep more than one. If you insist on making more than one, the importance of keeping them simple and attainable is even more important. Alternatively, prioritize your goals and start with the most important one. If you’re able to keep that one, add one a month.

Check in soon for more tips on making and keeping New Year’s Resolutions!

Jennifer L. Abel, Ph.D.
author of Active Relaxation: How to Increase Productivity and Achieve Balance by Decreasing Stress and Anxiety

Make a Wish Foundation is a fantastic charity that grants last wishes to terminally ill children. Now Thru 12/18, I will be donation more than 1/2 of my profits to The Make a Wish Foundation. I will automatically donate $4 for any paperback book sold thru 12/18. If you purchase a kindle, nook, or general e-book copy of Active Relaxation send a copy of your receipt to me at abelshrink@gmail.com and I will donate $3 to Make a Wish.

10 Facts:
1. Medication is more effective than behavioral strategies for about two weeks.
2. Stimulus control, progressive muscle relaxation, and other behavioral strategies are more effective than medication in the long run. These methods may start to work in a couple of days, but take about two weeks to reach their maximum effectiveness.
3. Taking a pill is much easier than learning useful strategies and developing new habits. Duh!
4. Often, people gain a tolerance to these pills requiring a higher dose to fall asleep.
5. Hangovers from sleeping pills are not uncommon.
6. Progressive Muscle Relaxation decreases sleep onset time by an average of 60% in insomniacs.
7. Medication works best when used on a time-limited basis or infrequently. Sometimes just knowing it’s an option can help people to sleep….however….
8. People can develop both a psychological addiction, as well as a physical addiction, to these medications.
9. Some people sleep well with natural alternatives to sleeping pills such as Melatonin, Kava Kava, or Valerian Root. Check with your physician before using them.
10. Daily exercise helps sleep as long as it is completed more than 2 hours prior to bedtime.

In general, use your bed for sleep and only for sleep (except sexual activity). Do not balance your checkbook, watch movies, or have conversations in your bed. Don’t go to bed until you are sleepy. If you find yourself worrying about not being able to sleep, can tell that you won’t fall asleep soon, or have noticed that you have been awake without sleeping for a longer period of time than it takes you to fall asleep on a good night, get out of bed and do something relaxing elsewhere. If you are worrying about forgetting something the next day start a list of things to do – but do it OUT of bed. If the thing that you are worrying about could be done then and you think it will help you to sleep, do it, particularly if it takes 30 min or less. Then follow that with something relaxing.
EXCEPTIONS – some experts believe that it is useful to read in bed, but only IF you find the reading material relaxing. If you get anxious every time you get into bed, finding a relaxing activity to do in bed might actually help you to sleep. Reading with a dim light directed on the page, not overhead, is usually best. Bright lights and light from a TV or computer can inhibit the release of melatonin which is necessary for sleep onset.
ALSO, if you get anxious when you get into bed, you may want to try sleeping on the couch or in an extra bedroom. If you find you sleep well in the new place, you probably have a stimulus control problem in which your bed has become a trigger for anxiety and wakefulness. As your problem lessens, begin sleeping in your bed more and more.

Jennifer L. Abel, Ph.D.
author of Active Relaxation: How to Increase Productivity and Achieve Balance by Decreasing Stress and Anxiety.

Given that we feel more vulnerable, and therefore more anxious, about our worries after tucked into bed (see previous post) consider addressing the issues you are likely to worry about while you are still up and about. Around 30 min to 2 hours before you go to bed make two columns on a sheet. Under the first column write down what you think you will worry about that night.

In the second column write down what you are going to do about it before you get into bed. In the second column you could write a) “nothing,” b) a specific thing that you are going to do before you go to bed, or c) a plan to do something later. Even when deciding to do nothing, writing it down and thinking about it is giving the worry due diligence. In other words, you have addressed it by thinking about your options before deciding to do nothing about it before bed. When planning to do something, be sure to schedule that plan, or at least write it down somewhere that will allow you to remember.

by Dr. Jennifer L. Abel

author of: Active Relaxation: How to Increase your Productivity and Achieve Balance by Decreasing Stress and Anxiety.

If worrying keeps you awake at night, it’s pretty likely that you have experienced a phenomenon in which your worries seem more manageable by the light of day. Why is this?
Consider this: when you are lying in bed at night you are 1) lying down, 2) it’s dark, 3) you are wearing less clothing, and 4) your eyes are closed. You ARE more vulnerable. When you are more vulnerable physically, it makes sense that you feel more vulnerable emotionally. Therefore, you feel less capable of handling the things you are worried about and these things seem much more overwhelming. Tune in soon to read some suggestions about what to do about it.

by Dr. Jennifer L. Abel

author of: Active Relaxation: How to Increase your Productivity and Achieve Balance by Decreasing Stress and Anxiety.

Most people worry because they are trying to increase the likelihood that good things will happen and decrease the likelihood that bad things will happen. Yet, worry does the opposite. Obviously, it leads to useless anxiety and that’s a bad thing. Research by Michel Dugas and his colleagues found that worriers have the ability to problem solve as well as their more relaxed peers. However, anxious people tend to have myopic vision when faced with problems. In other words, their mental focus is limited to the extent that they miss options that might help them to solve their problems better.

Likewise, think about when you have your best ideas and creative insights. How often do they occur when you’re really stressed? If you’re like most people, your best ideas come when you’re relaxed and often when you’re not even trying to find a solution. So, first de-stress, then fix your mess.

Jennifer L. Abel, Ph.D.
author of “Active Relaxation: How to Increase Productivity and Achieve Balance by Decreasing Stress and Anxiety.”