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At The Center for Stress and Anxiety Management, our psychologists have years of experience. Unlike many other providers, our clinicians truly specialize in the diagnosis and treatment of anxiety and related problems. Our mission is to apply only the most effective short-term psychological treatments supported by extensive scientific research. We are located in Rancho Bernardo, Carlsbad, and Mission Valley.

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Read our award-winning blogs for useful information and tips about anxiety, stress, and related disorders.


Filtering by Tag: resolutions

Mental Health Awareness Month: Fitness #4Mind4Body

Jill Stoddard

by Annabelle Parr

May is Mental Health Awareness Month. Every year, Mental Health America designates a particular theme for the month to highlight an important aspect of mental health. This year’s theme is Fitness #4Mind4Body, and it focuses on acknowledging the connection between mental and physical wellbeing. #4Mind4Body explores the role of nutrition, exercise, the gut-brain connection, sleep, and stress in our overall wellbeing and examines the ways each of these areas impact our functioning. Below is a summary of the topics covered in the Mental Health Toolkit from Mental Health America.

Diet and Nutrition


Eating a well-balanced, nutritious diet is an integral part of health. Diets high in processed, fried, and sugary foods can increase the risk not only for developing physical health problems like diabetes, heart disease, obesity, and cancer, but are also linked to mental health problems, including increased risk for depression symptoms. A healthy diet consists of a variety of fruits, vegetables, legumes, whole grains, fish, nuts, and olive oil. Maintaining a balanced, nutritious diet is linked with a lower risk for depression and even an improvement in depression symptoms.


Regular exercise not only helps control weight, increase strength, and reduce the risk of health problems like high blood pressure, cardiovascular disease, and some cancers, but it also helps boost endorphins and serotonin, among other important proteins and neurotransmitters that impact mental health. Endorphins serve to mitigate pain in the face of stress and increase pleasure in the body. Serotonin affects appetite, sleep, and mood, and is the target of SSRIs, a class of antidepressant commonly used to treat anxiety and depression. Just thirty minutes of exercise per day can help improve mood and mental health.


The Gut-Brain Connection

The gut, also known as the “second brain,” communicates directly with the brain via the vagus nerve and via hormones and neurotransmitters. The communication goes both ways, so anxiety, stress, and depression can impact the gut and result in gastrointestinal symptoms, but changes in the gut microbiome can impact the brain and mood, exacerbating or even resulting in symptoms of anxiety and depression. Eating a nutritious diet that includes prebiotics and probiotics is an important part of maintaining a healthy gut and a healthy mind. 


Quality of sleep impacts the immune system, metabolism, appetite, the ability to learn and make new memories, and mood. Good sleep for adults means getting between 7-9 hours of mostly uninterrupted sleep per night. Problems with getting good quality sleep can increase the risk of developing mental health symptoms, and symptoms of anxiety and depression can negatively impact sleep, creating a negative cycle. Cognitive Behavioral Therapy for Insomnia (CBT-I) can help clients reestablish healthy sleep patterns through addressing negative thoughts and worries as well as behavioral patterns that are impacting sleep habits.


Stress is a normal part of life, and the body is equipped with a fight or flight response designed to help mobilize internal resources to manage stressors. After the stress has passed, the body can return to its regular equilibrium state. However, when stress becomes chronic, it can cause inflammation, impaired immune system functioning, muscle aches, gastrointestinal problems, sexual dysfunction, changes in appetite, and increased risk for heart disease. Too much stress can also impact mental health.

Mental health involves a complex interplay between numerous factors, including but certainly not limited to the areas listed above. Furthermore, though maintaining a healthy diet, regular exercise routine, good sleep habits, and utilizing stress management techniques can help prevent or improve existing mental health symptoms, if you are struggling with mental health issues, it can be difficult to attend to these areas.

If you are struggling with anxiety, stress management, depression, chronic illness, or insomnia, seeking professional assistance can be helpful. Evidence based therapies like Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) can help to address problematic thoughts and behaviors that are contributing to emotional distress. Therapy offers a warm, supportive, safe environment to explore painful issues. A therapist can also provide support in helping the client to develop good self-care habits, like those mentioned above.

This year’s mental health awareness theme reminds us of the importance of recognizing the multiple avenues through which we can approach mental health, and the variety of tools we have at our disposal to improve overall wellbeing.


If you or someone you love might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, depression, stress, PTSD, insomnia, or chronic illness, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at


Mental Health America. (2018). 2018 Mental Health Month Toolkit. Retrieved from

An Acceptance and Commitment Therapy Approach to New Year's Resolutions

Jill Stoddard

by Annabelle Parr

As we enter another new year, many of us have set our 2017 resolutions. Maybe you make resolutions, maybe not, but either way this is generally a time of reflection. In what ways do we hope this year will be different from last? What are we hoping to change in our lives? What goals do we have going forward?

 The new year always seems to be a good time to think about making some changes because it gives us the chance to start fresh in some ways. But in other ways it is simply just another day. Nothing changed automatically on January first. What can change is our perspective, and it is our job to ensure that our actions follow. This is the tough part. Do you find yourself already struggling to maintain your resolution? Do you wonder why we have such a hard time keeping our resolutions for more than a few weeks? How do we make our resolutions stick?

The truth is, change is often slow. Occasionally we are able to make huge changes immediately, but more often than not change takes time. New year's resolutions often fail to take into account that it may actually take you all year to create the change you were hoping to see on January second. When we fail to recognize all the small steps on the road toward change, we set ourselves up for disappointment and failure. A new year's resolution sounds like an easy solution: set a major goal for the new year ahead. But our resolutions are empty unless they are backed by action, and creating a resolution doesn't necessarily help us to make an action plan.

Acceptance and Commitment Therapy (ACT) offers some ideas and tools that can be very helpful in guiding us along the process of change. Whether you come in to see a therapist for Acceptance and Commitment Therapy, or whether you apply the wisdom it can offer to your life on your own, this model can help us to keep our resolutions all year long.

ACT aims to increase psychological flexibility, which means that you are able to connect to the present moment consciously and choose to behave in a manner as consistent with your values as the situation allows. Part of the purpose behind ACT is to get in touch with your personal values (not those determined for you by society, family, friends, or any other external source), and then use these values to guide your actions and formulate specific goals. This is usually what we are aiming for with our new year's resolutions.

For example, if my resolution is that I want to eat healthier, a good place to start is to examine my values. Do I feel like I "should" eat healthier because I feel pressured by our health conscious culture or by my friends, family or partner? Or do I want to eat healthier because I value my physical health, deep in my heart? Or perhaps I value my role as a model to my children, and want to eat healthier for this reason. Once I determine my values and make sure that my resolution is driven by my own intrinsic motivation, then I can create a concrete plan of action to move forward.

The Choice Point Model, another helpful ACT tool, offers us a framework to use when we face a decision. A choice point is a moment in time where we can choose to act in a manner that is either consistent or inconsistent with our values. The Choice Point is about identifying the hundreds of moments in a day where we can be on autopilot and be driven by thoughts and feelings, or we can make a conscious, deliberate choice that is in the service of our values. When in this moment, we can use the acronym STOP:

S: Slow down. Take 3 mindful breaths.

T: Take notice. What are you thinking and feeling?

O: Open up. Make room for those thoughts and feelings instead of trying to avoid the discomfort.

P: Pursue values. Do what matters to you.

Sometimes, in a Choice Point, we will choose to avoid or procrastinate acting in a values consistent manner, and that is okay. Give yourself grace when this happens. But remember that though avoidance may provide relief for the moment, in the long run it will make us feel worse. So if we can STOP and choose to act in accordance with our values as frequently as possible, it will serve us.

As you approach this new year and begin thinking about your potential resolutions, remember that big change happens slowly, choice point by choice point. Remember to consider your values, and to STOP when you hit a choice point. If you feel you need some extra support along the road to change or healing...


If you or someone you love might benefit from acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), or biofeedback for anxiety, depression, stress, or PTSD, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at

Why Adult Learning Anxiety is like Learning to Fish in Phoenix:

Jill Stoddard

5 Tips and 6 Resources for Adult Students

by Lucas Myers


In difficult economic times, many adults are returning to school in order to seek out new opportunities or transition into a second career. This can prove to be a tremendous challenge. Have you ever heard the saying “You can’t teach an old dog new tricks”? There may be a grain of truth to the saying but take it with a grain of salt. In this case you might say two grains are better than one. Knowing about the challenges facing an adult learner and having a plan to overcome them is the ticket to success.

Yes, as we age learning becomes more difficult and can become more anxiety provoking. Adults may be even more sensitive to failure in learning situations than children. Often, previous negative experiences with education may contribute to self-doubt and fear surrounding ability. Adults returning to school or any in-depth learning project are likely to feel that they are in unfamiliar territory in spite of education level or socioeconomic status. Frequent sources of adult learning anxiety may include feeling intimidated by unfamiliar new technology, out of place in online learning environments, a lack of confidence in rusty study skills, and concerns related to how school will impact already hectic schedules and limited finances. Returning to school later in life can make an adult as nervous as a fish on Friday.

However, regardless of the challenges that face adult learners, their differences create areas of opportunity in which they excel. A key to success in learning is the source of motivation. It is widely believed that motivation that is inspired by external factors, or extrinsic motivation, is much less powerful than motivation that comes from someone’s internal needs and desires. This intrinsic motivation is particularly important to create the best results with adult learners. Experts believe that adults are strongly motivated to learn in areas that are relevant to their growth in society, social roles, addressing life crises, and managing transitional periods. What I'm telling you is this: no amount of nagging and cajoling will get an adult to hit the books, but if you have an iron clad argument for how education will help him get a raise, a promotion, a new career, a tax break, or a hot dinner, you may find yourself a star pupil.

Unlike young learners who are focused on a postponed application of knowledge (e.g. “I'm going to be an ocean explorer one day”), adults’ time perspective has changed to one of immediate applications (e.g. “I want fish for dinner tonight”). This involves a shift from subject-oriented learning (i.e. marine biology) to problem-oriented learning (i.e. feeding the kids). Research supports the perspective that adults undertaking an educational project hope to solve a problem rather than learn about a subject. Because adult learners will engage better with material that they can relate to their own experiences, they will also learn faster and better. If the educator and learner are able to integrate new and difficult concepts with helping present and future personal experiences, the learner will maximize her chances for success. During transitional periods of life, adults who find themselves in need of knowledge in service of family life or new job skills are triggered to initiate learning. In other words, adults ask of their education “Hey Bub, what have you done for me lately?” Does what you're learning apply to your life now? Learning to fish doesn't help you much in downtown Phoenix, but a hungry man on a lifeboat in the middle of the Pacific is a motivated fisherman.

As a rule, adults are inclined to devote energy and engagement to the quality and quantity of learning that they see as the most immediately beneficial to their future (after all, finding an air conditioner is probably more important than fishing if you live in Phoenix). Therefore, it is vital that an adult learner feel empowered in influencing learning goals to ensure that his or her goals meet specific needs in his or her life. Because adults tend to have a broad base of experience, they are usually well equipped to identify what they need to learn. For most, there are responsibilities that will compete for time and attention. Does the average person need to know the migration patterns of salmon? No. Do they need to know how to bait a hook? Maybe. Do they need to put dinner on the table for the kids tonight? Absolutely. Part of setting goals must then be balancing the expenditure of time with the importance of completing educational objectives.

What can you take away from this for those who are seeking out a new degree, certification or career training? 

  • Caution them that they may feel more challenged by learning than they once did and it is normal to feel anxiety about returning to school. Many adult students incorrectly believe that they do not have the study skills that are necessary to be successful. The truth is that most adults in their forties and fifties possess about the same level of learning ability as they did in their twenties and thirties. In fact experts agree that if there is an age limit on learning performance it is unlikely to be seen before the age of seventy-five. “Bill, you're never too old to learn to fish”.

  • Remind adult learners often to think about their motivation for seeking education and to focus on how it will have direct and immediate impacts on helping them to achieve their goals. Reflecting on what new knowledge will bring to a student’s life, particularly the hows and whys, is a great way to inspire dedication and focus. If the rewards are seen as valuable enough then sacrifices will be borne more willingly and easily. “Bill, your kids are gonna love them fishsticks and tonight we're gonna have the best darn Cajun-style Catfish you ever tasted!”

ADDITIONAL TIP: One way to stay motivated is to seek out a mentor, someone who is a little farther along the path to her educational and career goals that can share inspiration, advice, and support.

An adult learner must actively look for ways to manage stress. Going back to school, and learning new skills, especially when added to adult responsibilities like caring for a family and paying bills, can be a major source of stress. Like all stress, it is important to be aware of how going to school is going to impact your life, and to make a plan to maintain balance. 

  • Self care such as diet, exercise, and sleep are particularly important to achieving this balance. 

  • Making time to participate in activities that one enjoys is a great way to relieve tension (like fishing!).

  • Reconnecting with friends and family ensures that the busy schedule of an adult student doesn’t lead to isolation and becoming overwhelmed. 

With the many demands facing an adult learner it can be tempting to put his personal needs on the back burner and it is particularly important to remember that self care is not just a momentary impulse now but it part of the journey to a successful education experience and therefore it is an investment in the future.

So why IS adult learning anxiety like learning to fish in Phoenix? They both give you something to do but they don't put dinner on the table.

Adult students, remember: 

  1. Relate lessons to your life to remain motivated.

  2. Remember motivation to increase engagement and focus. 

  3. Maintain balance; take time to care for yourself now so you can be successful later. 

  4. If you are finding yourself feeling alone and overwhelmed reach out to a friend, teacher, adult family member or classmate. 

  5. If anxiety has become too overwhelming, don’t be afraid to ask for help.

If you are suffering from stress or anxiety and would like to speak with a professional, please contact us at the Center for Stress and Anxiety Management at or by dialing 858-

BONUS: Learning Resources for Mature Students

Learn 2 Type ( – In order to write, you must possess basic typing (or keyboarding) skills.  Learning to type faster will help you compose your thoughts more quickly, saving time and making you more efficient!  Learn 2 Type is an excellent typing tutor and is free to use.

The Purdue OWL (Online Writing Lab) ( – This is the most famous writing website I have found.  You will find help with APA formatting, avoiding plagiarism, grammar, mechanics, etc.

Daily Grammar ( – Provides a great refresher of basic grammar rules.

The Oatmeal ( – A website that offers humorous and strange examples to help you remember grammar concepts.  The lessons on using an apostrophe and a semicolon properly are my favorites.

Guide to Writing a Basic Essay ( – Steps you through the writing process. 

James ESL Free English Lessons  ( – James has had over 7 million people watch his videos.  Scroll through his lessons and find the one that will be most helpful to you!


Brookfield, S. (1985). Self-directed learning : from theory to practice. San Francisco: Jossey-Bass.

Cross, K. (1981). Adults as learners. San Francisco: Jossey-Bass.

Darkenwald, G., & Merriam, S. B. (1982). Adult education: Foundations of practice. New York: 

Harper & Row.

Jones, H. E, & Conrad, H. (1933). The growth and decline of intelligence: A study of a 

homogeneous group between the ages of l0 and 60. Genetic Psychological Monographs, 

13, 223-298.

Kidd, J. (1973). How adults learn. New York: Association Press.

Knowles, M. (1980). The modern practice of adult education : from pedagogy to andragogy

Wilton, Conn. Chicago: Association Press Follett Pub. Co.

Knowles, M., Holton, E. & Swanson, R. (2011). The Adult Learner : The Definitive Classic in 

Adult Education and Human Resource Development. Amsterdam Boston: Elsevier.

Knox, A. B. (1977). Adult development and learning. San Francisco: Jossey-Bass.

Maxine E. Rossman and Mark H. Rossman. (1990). The Rossman Adult Learning Inventory: 

Creating awareness of adult development. New Directions for Adult and Continuing Education.

Smith, J., & Baltes, P B. (1990). Wisdom-related knowledge: Age/cohort differences in response 

to life- planning problems. Developmental Psychology, 26, 494-505.

Tags: anxietyCBTanxiety therapy san diegofeartherapystress and anxiety in san diegoCognitive Behavioral TherapyCBT San Diegotherapy in san diegoresolutionsacademic stressAdult Leaning Anxiety

How to Form Healthy, Anxiety-Free New Year's Resolutions

Jill Stoddard

by Anna Remus 

As 2012 beings to come to a close, friends and coworkers will no doubt begin to talk about their New Year's resolutions--often with negative, despairing attitudes. It is unfortunate that this time of year, meant to be an invigorating, fresh start, often turns into a dreaded ritual.

The problem with New Year's resolutions is that we often fall into the same bad habits when forming them--we form an unrealistic number of them, we spend all enthusiasm for our goals too quickly, or we try to go "cold turkey" and change ourselves in unrealistic ways, completely overnight. 


In order to achieve your goals for the new year, it's important to stop thinking of resolutions as a 100-yard dash, and start thinking of them like a marathon. If you start "sprinting" for the first month or so, it's difficult to achieve the long-term results you're after. Instead, it's important to make small, sustainable changes that will form habits quickly and lead to greater progess in the long run. Although it does take longer to see results this way, it is also less likely that one small misstep causes you to panic and lose all of your hard work!

In order to get the fresh start you need for healthy changes, here are some tips to keep in mind when January 1st rolls around:


  • Break the attitude cycle

There are a lot of negative attitudes surrounding the idea of New Year's resolutions, and listening to all of this negativity can hurt your efforts. Before you begin forming your resolutions, actively try to keep a positive attitude, and keep faith that you can achieve the goals you'll set for yourself.  

  • Be specific and realistic

 When forming your resolutions, try to be as specific as possible to avoid biting off more than you can chew. If you would like to exercise more, try to think of specific times/days that would work with your schedule, or write down new classes at your gym that you've been meaning to try. Thinking of a specific plan of attack can make daunting goals seem much more manageable. 

  • Work on one at a time

Don't write a huge laundry list of resolutions, but instead keep it very short (under 5), and stick to one at a time for a shorter period (for example, 2 months). Whittle your list down to only the very top things you would like to improve, then order them by importance, and form your scheduling of them in December, rather than New Years Day. Planning ahead will help you not become overwhelmed, and dividing the work load over several months will keep a healthy pace for your progress.   

  • Ease into it gradually

Instead of taking your "Lose 15 pounds" resolution cold turkey, consider spreading smaller goals over a period of weeks or months. For example, if you need to change your diet for your goal of getting healthier, start by eliminating fast food in Week 1, then also eliminating alcohol in Week 2, etc. Stacking smaller goals makes the transition easier, and leaves you less likely to feel deprived. 

  • Piggyback

One way to make habit-changing easier is to "piggyback" desired habits with existing habits. For example, if your new goal is to take a vitamin everyday, stick your bottle of them in your coffee cup for the next morning, so when you are getting ready to drink your morning java, you won't forget your goal. Using already-formed habits is a great way to easily adapt new ones!

Whatever your New Years resolutions, we here at CSAM San Diego wish you the best! Have a great holiday season and a happy, healthy new year! 

Tags: resolutionsnew years resolutionsnew yearsnew years eve