URMI VAIDYA-MATHUR, LCSW

Wellness and Epilepsy:Taking care of yourself

Topics we will cover

Common themes for individuals living with chronic illness

The basic steps to caring for yourselfManaging your stressRelaxation TechniquesPrograms available through NEREG

Impact of Living with Chronic Illness

See a period of adjustment that can be emotional

See a potential increase in depression and anxiety like symptoms short term

For some we see depression/anxiety long term

Increase in stress overallSense of loss of “invincibility”Sense of loss of independenceInitially a decrease in one’s quality of life

Our hope…

Our hope is that we can conquer all of these negative impacts and that patients and their families, with a few lifestyle changes, can have their quality of life back…and even in some cases things end up better because of the positive changes that the illness brought about.

“The Basics:

Treatment Adherence: apptmts and medication

Know your medicationsMedical Alert BraceletSafety PlanEat RightExerciseGet enough sleepNo Drugs/No Alcohol

What about the more abstract ways you can care for yourself?

Stress managementDealing with depressionRelaxation TechniquesConnecting with the community at large

Stress Management

It may seem that there is nothing you can do about stress. But you have more control than you might think. In fact, the simple realization that you are in control of your life is the foundation of stress management!

Managing stress is all about taking charge: of your thoughts, emotions, schedule and the way you deal with problems

Identify the sources of stress in your life.

This is not as easy as it sounds, sources of stress are not always obvious and it is easy to overlook your own stress-inducing thoughts, feelings and behaviors.

Do you explain stress away as temporary?Do you define stress as an integral part of

your work or home life?Do you define stress as part of your

personality?Do you blame stress on other people or

outside events?Do you view stress as entirely normal and

unexceptional?

The four As

Until you accept responsibility for the role you play in creating or maintaining stress, your stress level will remain outside of your control.

“Avoiding” the Stressor

Learn how to say “no”Avoid people who stress you outTake control of your environmentAvoid hot button topicsPare down your “to do” list

“Alter” the situation

Express your feelingsBe willing to compromiseBe more assertiveManage your time better

“Adapt” to the stressor

Reframe the problemsLook at the big pictureAdjust your standardsFocus on the positive

“Accept” things you can not change

Don’t try to control the uncontrollableLook for the upsideShare your feelingsLearn to forgive

Dealing with Depression

Over 80% of those treated with depression improve

Depression can affect people of all ages, races, SES and genders.

Nearly half of all depressed people do not receive the appropriate treatment because they are not correctly diagnosed

Severe depression is associated with a decline in mental function as time passes

What are some symptoms of depression?

Depressed mood almost all day longReduced interest in activities/peopleWeight changes (5% in one month)Insomnia/hypersomniaMotor retardation or activationFatigueGuilt or low self worthConcentration problemsSuicidal thoughts or acts

Treatments for depression

Prescription medicationTalk therapy with a psychotherapistClose monitoring be an epileptologist

especially if there is a connection between epilepsy and mood

Family therapy and psycho-educationVagal Nerve StimulatorFor refractory depression: Electroshock

(ECT) or transcranial magnetic stimulation (TMS)

Behavioral interventions to help with depression

Monitoring thoughts and feelingsUsing relaxation techniquesMindfulness based treatment

How can we monitor our thoughts?

Sit quietly…What are you feeling? Breathing, posture,

physical feelings, emotions?Feeling words: afraid, nervous, insecure,

uneasy, worried, out of it, shaky, uptight?What are you thinking? What just happened

before the feeling, how does this affect future?

What am I upset about?What’s the worst that could happen?How might this affect me?How would this affect how others see me?Does this remind me of my past?What would my parents say about this?How does this affect how I see myself?

Have I thought this before? Did it come true?Do I have experiences that contradict this?Is this as awful as I am imagining?A year from now, how important will this be?Do I know anyone who dealt with this

effectively? Can someone help me?Be your own buddy: talk to yourself calmly

like a friend wouldTake the negative thought and come up with

an opposite/positive thought

RELAXATION TECHNIQUES

There are many forms of relaxation that one can practice:

• Yoga• Meditation• Exercise• Mindfulness

Progressive Muscle Relaxation (PMR)

Step One: Tension. The process of applying tension to a muscle is essentially the same regardless of which muscle group you are using. First, focus your mind on the muscle group; for example, your right hand. Then inhale and simply squeeze the muscles as hard as you can for about 8 seconds (e.g., make a tight fist with your hand).

PMR

Step Two: Releasing the Tension. This is the best part because it is actually pleasurable. After the 8 seconds, just quickly and suddenly let go. Let all the tightness and pain flow out of the muscles as you simultaneously exhale. Feel the muscles relax and become loose and limp, tension flowing away like water out of a faucet. Focus on and notice the difference between tension and relaxation.

PMR

Muscle Groups Right foot Right lower leg and foot Entire right leg Left foot Left lower leg and foot Entire left leg Right hand Right forearm and hand

PMR

Entire right arm Left hand Left forearm and hand Entire left arm Abdomen Chest Neck and shoulders Face

Mindfulness Based Cognitive Therapy

Mindfulness Based Cognitive Therapy (MBCT) mindfulness and mindfulness medication focus on becoming aware of all incoming thoughts and feelings and accepting them, but NOT attaching a feeling to them nor reacting to them

The Goal of MBCT

The goal is to interrupt the automatic reactions one has to experiences and to teach participants to focus LESS on reacting to the incoming stimuli and instead to accept and observe them without judgment

The three “C”s

CatchYou want to be able to catch the negative thought that

has entered your mind.You want to stop and be aware of the thought

CheckYou want to check the thought, is it

positive or negative? Can you prove or disprove the thought.

Correct Once you have “caught” the thought and

spent a moment to “check” your response or feelings to the thought/stimuli you want to then modify the way you identify the thought based on the present moment not your past experiences nor your past reactions.

Project UpLift

NEREG offers a distance based 8 week course to help build the skills needed to combat depression with mindfullness.

For more information contact:uvmlcsw@gmail.com

Get Connected

Joining support groups, online or in person, are found to be helpful in promoting wellness and support among those with chronic illness

Volunteer with local organizations that work with people with epilepsy

Take advantage of the wellness programs offered at NEREG through www.epilepsylifelinks.com

Thank you!

For more information please feel free to contact me:

• Urmi Vaidya-Mathur, LCSW• uvmlcsw@gmail.com