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We offer both in person services based in Mission Valley as well as telehealth services via video-conferencing platforms to patients located in California.

We do not accept walk-ins. You must contact our Clinic Coordinator at 858-354-4077 or info@csamsandiego.com before visiting us on site.

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IF YOU WOULD LIKE TO INQUIRE ABOUT TREATMENT AT CSAM, PLEASE FILL OUT THE FORM AND A THERAPIST WILL CONTACT YOU TO MAKE AN APPOINTMENT.

You may also contact us via phone or email:

Phone: 858-354-4077

Email: info@csamsandiego.com

7860 Mission Center Ct, Suite 209
San Diego, CA, 92108

858.354.4077

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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Blog

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

 

Filtering by Tag: sleep problems

Treating Insomnia with Cognitive Behavioral Therapy

Jill Stoddard

By Annabelle Parr and CSAM Insomnia Expert Dr. Melissa Jenkins

We all know what it feels like to get a bad night’s sleep. You know you have a big day tomorrow, but you watch as the minutes and hours tick by as sleep feels elusive. Or you fall asleep but you toss and turn, dreaming about that presentation you have to give at work. You finally fall into a deep sleep and it feels like that is the moment the alarm goes off. A bad night’s sleep on occasion is pretty typical – when we are super stressed it can be harder to sleep soundly.

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When sleep – or lack thereof – becomes a problem…

But for some of us, bad sleep becomes a pattern. It can become a vicious cycle with loads of stress and a lack of sleep where it’s hard to tell what’s causing what. How can you tell if your poor sleep quality is typical or whether it might be time to get some help?

Is it a few bad nights or is it insomnia?

The DSM-V defines insomnia disorder as difficulty falling asleep, difficulty staying asleep, and/or waking up too early and being unable to return to sleep for at least 3 nights per week, lasting at least 3 months. The sleep difficulties must also cause significant impairment in important areas of functioning (such as work, relationships, school, etc.), and occur despite enough opportunity for sleep. It’s also important to rule out whether sleep difficulties are due to another disorder – sleep disorder or otherwise – and are not the result of substance use.

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When to seek help…

Though full clinically diagnosable insomnia has fairly specific criteria, if you are unable to sleep well often enough that it is having a negative effect on your day to day life, it’s worth talking with a professional to see how you might get better sleep. It’s a common misconception that sleep difficulties require medication – such as sleep aids – to be alleviated. However, medication is often a short-term solution, like a band aid; in order to achieve long-term results, it’s important to address the underlying problem.

People don’t often think that therapy can help them with sleep – especially if it feels like sleep is the main problem rather than a byproduct of anxiety. However, there is a particular form of therapy entirely dedicated to the treatment of insomnia: Cognitive Behavioral Therapy for Insomnia (CBT-I).

What is CBT-I?

CBT-I involves a number of elements, and is based on helping the client learn strategies that will help facilitate better sleep. According to Dr. Melissa Jenkins, CSAM’s resident insomnia expert, CBT-I focuses on improving the quality and quantity of one’s sleep. Dr. Jenkins explains some of the core therapy components include… 

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Sleep efficiency therapy: People frequently say there is no pattern to their insomnia, a very common yet frustrating experience. A skilled CBT-I therapist can help make sense of otherwise confusing sleep patterns. By first examining what your current sleep (or lack thereof) looks like, a CBT-I therapist then guides you to change your sleep schedule. This strategy can greatly improve your quality of sleep. It often involves making significant changes to when you go to bed and when you wake up. These changes are often counterintuitive! People with insomnia often find this one of the most difficult but most effective parts of CBT-I. With the help of a skilled therapist, you learn how to regain control over your sleep.

Stimulus control: After extended periods of not being able to sleep in one’s bed, bed often becomes a place of stress (not rest!). The body becomes primed to be alert in bed, the exact opposite of what we need to be able to fall asleep. So, we often say the brain needs to be re-trained!  A CBT-I therapist helps re-train your brain so that you can once again sleep when and where you want to. This involves looking at what you currently do when you cannot sleep as well as things you do in your bed and bedroom that are possibly maintaining insomnia (e.g., watching tv, reading).

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Sleep hygiene and psychoeducation: Another important element of CBT-I is helping you to understand the host of habits that contribute to sleep quality. Sleep hygiene involves everything from the food we eat, to the substances (such as caffeine and alcohol) we consume, the environment in which we sleep, the times of day in which we engage in particular activities such as exercise, our exposure to light (natural and artificial), and our routine leading up to bedtime. It’s not all intuitive, but when we know what can help or hinder our shut eye time, we are empowered to improve our own sleep and our health overall. CBT-I can also help teach natural ways to “trick” the body to either increase sleepiness for bedtime or alertness for optimal daytime functioning.

Relapse prevention: The goal of therapy is to give you the tools you need to create change and empower you going forward. The relapse prevention stage of CBT-I involves consolidating gains made in treatment to maintain good sleep going forward. Helping you to recognize potential triggers for an onset of acute (short term) insomnia and providing you with the tools for preventing relapse back into chronic insomnia is critical. Also, if you need to come back to therapy for a tune up, good news! Clients who return to therapy for a tune up during a relapse tend to recover quickly.

Additional therapy components: Other important aspects of treatment can include stress management and cognitive therapy (how the way you think may be triggering or perpetuating sleep problems).

At the end of CBT-I, the goal is to become your own sleep doctor: To put you back in control of your sleep and to know what to do if problems return in the future. Over the course of CBT-I, you can also learn how to determine your optimal amount of sleep (which is often different than the common myth that everyone needs 8 hours!). CBT-I is short term and typically includes 7 or 8 sessions, but can vary depending on individual needs. Treatment, while structured, is tailored the specific person and their behaviors. CBT-I is offered in individual therapy or group therapy.

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Announcing: CBT-I group therapy is available at CSAM!

Interested in learning more about or receiving CBT-I? Dr. Melissa Jenkins is CSAM’s resident insomnia expert! She offers individual and group CBT-I, and is currently accepting clients for a CBT-I group waitlist in our Carlsbad office. For more information, please contact us at 858-354-4077 or at info@csamsandiego.com

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

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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.

Exercise

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.

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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. 

Sleep

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

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.

CSAM IS HERE TO HELP

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 info@csamsandiego.com

References

Mental Health America. (2018). 2018 Mental Health Month Toolkit. Retrieved from http://www.mentalhealthamerica.net/sites/default/files/Full_2018_MHM_Toolkit_FINAL.pdf

10 Tips to Stop Sleep Anxiety: More Rest, Less Stress (Part 2 of 3)

Jill Stoddard

by Lucas Myers

With people juggling work, school, friends, families, and the 1,001 other things we've got to do everyday, Americans are not getting enough sleep. This week we continue our 3 part series 10 Tips to Stop Sleep Anxiety: More Rest, Less Stress.

4. Practice good habits

Having the same bedtime ritual night after night teaches your body when to expect sleep and eases the transition into a drowsy, bed-ready state. Bright lights, especially those from TV's computers and other electronics promote alertness, so try to avoid them before bedtime. Instead, try reading a book, taking a soothing bath or shower, listening to relaxing music and dimming the lights as you get ready for bed.

5. Eliminate distractions

The bedroom should be your sanctuary for sleep, so avoid watching TV in bed, bringing the laptop to bed, or engaging in any other activities. You want your mind to associate this setting with relaxation and rest rather than stimulating daytime activities. Consider setting limits on children or pets sleeping in your bed with you.

6. Get comfortable

Find bedding that feels comfortable to you. If you share your bed, make sure it is large enough for both of you to sleep comfortably. Most mattresses last 9-10 years; make sure to replace them when they exceed their life expectancy because a good mattress should be comfortable and supportive. Your pillow should support your head without straining your neck. Make sure your bedding is allergen free.

7. Set the mood

Dark curtains can help prevent light from inadvertently resetting your internal clock. Even the tiny light from an alarm clock can be disruptive so seek ways of limiting light pollution. Even small noises can interrupt sleep. Earplugs are helpful for some. A fan, or a free white noise app on your phone can help cover the sounds of noisy neighbors, car alarms, traffic and other disruptive nighttime noises. To keep your bedroom from becoming too hot or dry for comfort consider a fan, air conditioner, or humidifier.

REMEMBER: Having an occasional sleepless night is normal, but if you are experiencing a pattern of restless or sleepless nights, don't hesitate to seek an expert, especially if lack of sleep is beginning to interfere with your normal daytime functioning. Contact your doctor to determine whether physical causes may be contributing to sleep problems. If your physical health is sound, contact a psychologist with experience treating sleep problems. Cognitive behavioral therapy and other evidence-based treatments are highly effective for improving sleep. If you are in the San Diego area and you would like to speak with one of our other qualified therapists, you may contact the Center for Stress and Anxiety Management at 858-354-4077 or csamsandiego@gmail.com.

Want more tips? Subscribe to the CSAM RSS feed, and follow us on Facebook or Twitter (@CSAMSanDiego) so you don't miss Parts 2 and 3 of our 10 Tips to Improve Your Sleep and articles on other hot topics such as stress, anxiety, depression, OCD, PTSD, and more. 

References

Dement, William C; Vaughan, Christopher (1999). The promise of sleep: a pioneer in sleep medicine explores the vital connection between health, happiness, and a good night's sleep. New York: Delacorte Press. ISBN 0-385-32008-6.

Dement, WC (2005). "Sleep extension: getting as much extra sleep as possible". Clinics in Sports Medicine 24 (2): 251–268, viii. doi:10.1016/j.csm.2004.12.014PMID 15892922.

Kryger, Meir H; Roth, Thomas; Dement, William C (2011). Principles and practice of sleep medicine (5th ed.). Philadelphia, PA: Saunders/Elsevier. ISBN 978-1-4160-6645-3.

Sleep Tips: Seven steps for better sleep. Mayo Clinic Staff. Retreived on November 25th, 2013 from: http://www.mayoclinic.com/health/sleep/HQ01387


 

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