What Is Worse For Your Physical Health
Smoking or Mental Health Problems?
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Smoking.... there aren’t many things you could do, which would cause you to be more vilified than smoking.
I mean, it pretty much comes with a skull and crossbones on the package!
(A warning from the Exterior Packaging of Cigarettes in Ontario)
But could mental health problems actually be worse for your mental health?
Psychiatrists, Dr. Edward Chesney, Dr. Guy Goodwin and Dr. Seena Fazel reviewed studies involving 1.7 million people, and 250,000 reported deaths, related to either smoking 20 or more cigarettes a day or serious mental health problems.
And the results showed that heavy smoking reduced life expectancy by 8 to 10 years, while serious mental health problems shortened life span by 10 - 20 years.
Seriously.
So, how did the researchers define “serious mental health problems” in the study? The breakdown and reduction in life expectancy is as follows:
Recurrent depression: 7 - 11 years
Schizophrenia: 10 - 20 years
Bipolar Disorder: 9 - 20 years
Drug and alcohol abuse: 9 - 24 years
The result that was most surprising to me in this study was the 7 - 11 year reduction in life expectancy for people suffering from recurrent depression.
High risk behaviours are common with people suffering from psychotic disorders such as Bipolar Disorder and Schizophrenia, as well as with people struggling with drug and alcohol abuse, as Dr. Fazel eludes to in the study.
However, why is the reduction in life expectancy so high for recurrent depression?
Dr. Fazel hypothesized that it may have something to do with the stigma surrounding mental health. More specifically, she indicated that people with mental health issues may not be treated as well as patients who present with physical health issues.
Take Home Message
As we move forward in society, studies such as this one really highlight the need for appropriate assessment, diagnosis and treatment of mental health issues. And two critical hurdles to overcome to help achieve this goal will be to increase awareness about mental health and reduce the stigma associated with it.
What Can I Do To Help?
Here are 4 quick tips we can all use to help improve awareness and combat the stigma of mental health.
1. Get Educated
According to the World Health Organization and the World Economic Forum, 450 million people in the world struggle with mental health issues; yet, 60% of people don’t seek treatment.
Need more convincing?
Mental health represents the biggest economic burden of any health issue. In 2010, the cost was 2.5 trillion. By 2030, the cost of mental health is expected to rise to 6 trillion.
That’s how commonplace and impactful mental health has become in society.
2. Watch Out For Mental Health Challenges (It’s All Around You)
Statistics show that approximately 26% of adults and 20% of children experience diagnosable mental health conditions each year.
Simply put, approximately 1 in 4 adults and 1 in 5 children you know are experiencing a significant mental health issue. And these statistics don’t account for people who may be experiencing difficulties with a mental health issue but don’t quite meet the criteria of a diagnosable condition.
Who are these people? They are brothers, sisters, mothers, fathers, grandparents, cousins, nieces, nephews, aunts, uncles and perhaps maybe even someone you know...... personally…… staring back at you in the mirror!
3. Talk about It
Stigma in mental health is widespread. It has been shown to occur within ourselves as individuals, (Perlick et al., 2011), socially (Crisp et al 2006) and even with medical professionals (Wallace, 2010).
As with most erroneous or prejudicial attitudes, change can start by simply talking about it.
Brown (2010) showed that promoting events encouraging participation between individuals with and without mental health issues produced 3 positive results:
- Improved attitudes towards people with mental health issues
- Increased future willingness to disclose mental health problems
- Promote anti-stigma behaviour
4. Do Something About It
If you are experiencing a mental health issue, your journey may very well begin with challenging your own negative perceptions about mental health. For instance, studies show that people often view people with depression as lacking willpower and even as unstable. This is a far cry from what depression really is, which is a neurobiological disorder.
So, if you are struggling with a mental health issue, there is good news. Evidence-based treatments such as medication, psychotherapy and lifestyle behavioural programs have proven to be effective forms of treatment.
If you know someone who is struggling with a mental health issue or you suspect you may be suffering with a mental health issue, the best place to start would likely be with psychoeducation (unless, of course, it is your child or teen, in which case it might be wise to take a more direct approach and discuss booking an appointment with their Physician or with a Psychotherapist).
With most people, it is probably best to avoid trying to be an armchair Psychologist or hitting them over the head with a DSM 5 (this is the Diagnostic and Statistical Manual of Mental Disorders for those of you wondering!).
Instead, providing psychoeducational reading material is a more subtle way to start the conversation that could potentially lead to a follow-up discussion in the future. At that time, you may want to suggest they consider taking the next step to make an appointment to see their Physician or a Psychotherapist if they are continuing to struggle.
From there, the ball is in their court.... but at least you did your part.
Were you surprised that mental health problems can lead to a shorter life expectancy than smoking?
How do you feel about mental health stigma?
Leave a comment below.
Do You Have Mental Health Questions?
The first step to living the life you deserve is to identify issues that are getting in your way.
About Sullivan + Associates
Sullivan + Associates Clinical Psychology is a full-service psychology clinic in Thunder Bay, Ontario. It was founded in 2007, by co-founders Jennifer and Trevor Sullivan, and has since grown to 44 team members including 28 Master and Doctoral Clinicians. In the past 12 years, we have provided services for over 20,000 children, adolescents, and adults. During this time, our Clinicians have been able to serve the community of Thunder Bay and Northwestern Ontario by providing over 100,000 client appointments.
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Why Is Change So?!?! Hard? And What To Do About It!!
Home >> Blog >> Catagory >> Why Is Change So Hard
Change
It’s everywhere.
Think about it for a moment.
Seasons change. Fashions change. Technologies change. Looks change. Laws change.
Songs are written about change.
So, if change is so common, why is it so hard to do? And why is it so hard to change something that we want to change?!?!
I don’t know that there is an easy answer to that question but I have a theory.
Generally speaking, we are creatures of habit. When we find thoughts and behaviours that meet our needs (whether they are healthy or not), we tend to stick with them. And when we find something that works, we are reluctant to change.
So, the key to change is convincing yourself how new thoughts and behaviours can better serve your needs.
And how do you do this?
Let’s start by looking at the two basic driving forces of human behaviour: pain and pleasure. Simply put, we tend to make decisions based on our desire to avoid pain or to seek pleasure.
So, if there is something you want to change in your life, it is helpful to associate as much pain as possible to the behaviour you want to change and create significant pleasure for engaging in a new pattern of behaviour.
So, let’s assume you’ve targeted the area in your life that you want to change. And you are highly motivated to change!
How long do you need to hang in there until the change takes hold? Is it really worth going after?
Recent research out of University of College London shows that in order for a change to become a habit, it takes an average of 66 days (Lally et al., 2009). Smaller changes tend to take less time, bigger changes take more.
All things considered, that’s a pretty short timeframe to create lasting change, especially when you consider that a true force of nature such as evolution often takes thousands of years to create a better version of ourselves (aren’t you happy to be walking upright?!).
But needless to say, creating lasting change in a relatively short period of time is no easy task.
Below I will discuss a 10-step plan to help create change in any area of life that you target.
1. Know Your WHY
You need to know WHY you want to change. Change is hard, so there better be a compelling reason to want to change; otherwise, you are likely to fall short of your goal.
Let’s say, for example, you want to lose weight (which is a common goal I hear from clients).
Your why should include reasons that make avoiding change painful and make the prospect of change, pleasurable.
So, let’s start with possible “pain” examples:
- I hate what it feels like getting winded just walking up the stairs.
- I am going to a wedding in 6 months on a tropical island and I want to look good in my dress.
- I want to be able to play with my grandchildren when I get older. If I don’t lose weight, that won’t be possible.
In case you are wondering how I came up with these, the examples I chose here are actual reasons I have heard from people over the years who wanted to lose weight and went on to achieve their goal.
And although having “pain” underlie your WHY may not be particularly positive, it works. New research in the Psychological Bulletin indicates that one specific type of pain, fear, can be helpful in producing change (Tannenbaum et al., 2007). What is particularly compelling about this study is that their conclusions were drawn by analyzing 127 studies (including 27,000 participants) over the past 50 years.
And for those of you who prefer a more positive, uplifting approach in establishing your WHY for making change, it will be important to focus on the pleasure you will gain by achieving the goal.
And one effective way to accomplish this goal, while also opening your mind to change, is to engage in a self-affirmation exercise where you spend 10 minutes each day focusing on what’s important to you. This could include areas such as physical health, family, mental health, friends, children, career, etc. The key is that the area you select must be meaningful to you.
Once you have selected an area (or areas) to focus on, it is important to create compelling statements that are designed to help you seek pleasure and proper you towards your goal.
In sticking with our weight loss example, here are a few possible WHY reasons.
- I want to run a marathon.
- I need to be in peak physical health to enjoy my life to the fullest.
- I want to look great in a bathing suit when I am out in public (and I suppose we could substitute the word “naked” into that sentence as well…we are in the province of Ontario after all!).
Ideally, I would encourage you to have both “pain” and “pleasure” reasons when establishing your WHY.
You will need it to refer to, particularly when the going gets tough, as life routinely does.
2. Pick a better, had time
You have probably heard sayings such as, “there is no time like the present” or “there is never a good time, so you might as well start now”.
While I do believe it is possible to make a change at any time, I think your chances of making successful lasting change go down exponentially if you pick a particularly difficult time to start.
I’ll use an example to highlight my point.
When my daughter Alexa was born she was colicky for the first 10 months of her life.
That was possibly the longest 10 months of my life!
During that time period, I could have begun a plan to make a change in my life. And to be fair, if it was extremely important to change, I’m sure I could have made it happen.
But without significant leverage (e.g., something impacting the health and safety of myself or my family, etc.), it would have been extremely difficult to change anything in my life at that time.
Instead, I had more meagre goals such as going from one sleep-deprived, irritable day-to-the next praying that the colicky phase would come to an end!
So, needless to say, when it comes to making change, it is important to set yourself up to succeed. Selecting a bad time to make a change, especially if it is a particularly difficult change to make, will likely lead to 2 things: failure to make the change you want and feelings of discouragement about your ability to make the change.
When you decide to change something, ideally you only want to pursue it once and turn it into a habit from there.
And the best way to do that is to pick a time when things are somewhat settled in life.
3. Pick one thing and park the rest (for now)
To be fair, there is research to show that you can make multiple changes at one time.
In reality, this is very difficult to do.
Let’s say, for instance, you would like to quit drinking alcohol, quit smoking, lose weight and learn a new language.
While this would be impressive, it is best to start by picking just one thing to change!
Why?
Because change is usually hard and it is quite difficult to make (and maintain) multiple changes at one time. And with each change you add, there is an increased risk that you will fall prey to “all or nothing thinking” (i.e., if I can’t make all of these changes at once, then I might as well give up on everything I’m attempting to change).
You have nothing but time to make any number of changes in life and you will likely be more successful if you focus on one change at a time.
4. Write it down (and measure it)
There is something about writing down what you want. It’s more than just putting pen to paper (or fingers to a keyboard or touch screen).
It makes it real. It provides a greater sense of commitment. And it is there to review.
And when you write it down, it is important to have a baseline measure for where you are starting.
For example, if you are attempting to quit smoking, it’s important to know how many cigarettes you smoke right now.
Also, be specific about what you want to change. In sticking with the smoking example, what is the goal? Is it to go from smoking a full pack of cigarettes to a half-pack? Is it to be a non-smoker?
This might sound a bit tedious but if you are taking a trip, you need an end destination. Imagine trying to tell your G.P.S. that you want to go Southish. If you’re using an iPhone, Siri will probably scold you for not being specific. Or at the very least, tell you, “I don’t understand. Please try again!”
So, if being vague isn’t good enough for Siri, it isn’t good enough for us! We need to be specific and write downplay if we intend to create a plan for lasting change.
5. Figure out the pattern that isn’t working
Whenever we set a goal to make a change, it is usually because something isn’t working in our lives.
It could be an area in life that was good at one time but has deteriorated, or perhaps it’s just an area that needs to improve as life has become more demanding.
Regardless, there is usually a pattern of thinking and behaving that we are running, that isn’t working well enough.
For instance, let’s say you want to lose 20 pounds. There’s likely a pattern of eating (i.e., overeating or eating too many foods that are full of fat and sugar) and activity (not enough activity or not the right type of activity) that has caused the problem.
So, needless to say, you need a plan. With the above example, you’ll want a plan for eating healthy and exercising out for starters (assuming you are in good physical health and ready to get started).
From there, you are going to want to plan a little further because simply having a plan to eat healthily and exercise regularly probably won’t be enough to get the job done.
For example, other areas you might want to plan for include:
- Establishing a time to have “less than healthy food” (having a plan to never eat junk food again likely isn’t going to work).
- Create a plan to eat healthy when treats and goodies are all around you (perhaps at work, where certain staff members insist on continually bringing this stuff in, or when you go to a restaurant).
- Target times when you are most susceptible to deviating from your healthy eating plan (e.g., between 8-10pm in the evening when you finally sit down after a stressful day and feel like you deserve a treat (or two), likely with a glass of wine (or two) after a hard day).
- Plan to prepare healthy meals.
- Establish a time to fit exercise into your day.
- Get enough sleep so you have energy to exercise.
- Create variety with exercise and nutrition so you can avoid boredom.
- Have a plan to successfully cope with all of the above items so you don’t decide that change is too much work and life is fine just the way it is!
You don’t need to plan for every possible hurdle, but it is important to plan for the ones you expect to come up against.
Chances are this isn’t your first crack at changing something. The good news is that you have the advantage of hindsight and can be better prepared this time.
6. Plan for obstacles
You mean with all of this planning, more obstacles are going to come up?
Didn’t we just finish planning for the usual hurdles?
Didn’t you just joke about how there were quite a few things to prepare for already and encouraged me not to become overwhelmed and give up?
And now you are telling me there is more to prepare for.
Yep.
In all likelihood, there will be more obstacles along the way. Both the expected and the unexpected.
Hey, as we established at the start, change usually isn’t easy. But it’s far from impossible and it comes to the persistent.
In this section, I’ll take a look at 4 of the most common obstacles that usually come up and interfere with our ability to make change.
- Life gets busy
Of course, life is always busy. But it tends to go in fits and starts and there are times when it becomes very busy.
Not surprisingly, life often gets busy shortly after we decide to make a change or set a goal. Life does seem to have a sense of humour.
So, when life gets busy there needs to be a plan of attack to stay the course with whatever it is you intend to change.
- Fatigue
With a busy life, often comes fatigue and a lack of sleep. When you get tired, it can be difficult to continue pushing forward and pursuing change when you feel wiped out.
What is your plan to push through fatigue?
What is the plan to minimize fatigue in the first place?
This is an area that you definitely want to prepare for and consistently monitor, so you don’t fall off track when pursuing your goal.
- Negative emotions
What are negative emotions?
Mad, Sad, Scared, Stressed and Bored would probably cover the 5 most common ones.
And when you feel this way (as we all do, at any one time or another), it can derail change in a hurry.
In order to tackle this area, it is helpful to anticipate which negative emotions have interfered with your ability to make change in the past and develop a plan to manage these emotions successfully.
Ideally, you want to develop a plan to catch these thoughts and feelings quickly, as well as an effective strategy to manage your negative emotions.
For instance, let’s say that feeling sad is the emotion that typically derails your progress. It would be helpful to list common automatic negative thoughts, feelings or situations that arise so you can be prepared.
The next step would be to develop a plan to change how you feel by altering your physiology (body). This could be accomplished by using a relaxation technique such as mindfulness, engaging in deep breathing, using self-soothing strategies, or perhaps, you may decide to radically change your physiology by engaging in a short burst of strenuous physical exercise.
Once you have changed your physiology, it would be helpful to challenge automatic negative thoughts with evidence-based self-talk, as well as prioritizing a bit of time to focus on what is going well in your life. If there is a challenging situation that is negatively impacting your mood, this would be the time to develop a plan to address it.
- Resolve internal conflicts
As if life wasn’t already complicated enough, we have conflicting thoughts.
What are conflicting thoughts?
These thoughts occur when we have two thoughts that oppose one another.
Here are a few examples:
- I want to eat whatever I want but still lose weight.
- I want to spend all of my free time with my family but I need to make time to exercise.
- I want to quit smoking but I don’t want to feel uncomfortable.
You get the idea!
These conflicts need to be resolved quickly; otherwise, you are going to feel conflicted every time you attempt to make change and pursue a new pattern of behaviour.
For instance, let’s use the time example listed above. You want to exercise regularly but you can’t seem to justify the time away from your children. In order to shift this thought (and possibly belief), it will be important to create a compelling reason that will move you to act consistently.
Here are a few possibilities…
It could be that you decide not exercising will ultimately take time away from your children, as simply won’t be around as long to enjoy them.
Perhaps, it is the realization that exercise needs to be shifted from something you do in your spare time to something that is a must, and you need to take the time from somewhere else in your life.
Or possibly, you come to the realization that it needs to be quality over quantity when it comes to spending time with your children. You make peace with the fact that a bit of extra time away from them to exercise does not need to negatively impact the relationship. Rather, it could improve the quality of your relationship, as you come to the realization that your limited time means that the quality of time you spend with your children must improve.
It doesn’t matter what reason you come up with. It just needs to be compelling to you, so you can ultimately settle that internal conflict and consistently follow through with your plan to create change.
7. If you fall off the bandwagon, make it a pit stop.
With any change you attempt to make, chances are you won’t do it perfectly (i.e., there’s a good chance you are going to slip up a time or two, or ten!).
The important thing is when, and probably not if, you stumble on the way, make it a pit stop.
And don’t fall prey to thinking and behaviour traps such as the “What-The-Hell Effect”.
No, I’m not making that up.
The “What-The-Hell Effect” is an actual scientific term used in psychology to describe what happens when we slip up on the way towards achieving a goal and then decide to blow it big time.
For example, let’s say someone is following a healthy eating plan and decides to have a slice of cake they weren’t initially planning to eat.
Realizing that they have now “blown it”, the thought process with the “What-he-Hell Effect” would go something like this, “I’ve blown it now. I might as well have another slice of cake, a bowl of ice cream and a few cookies. Today is just a write-off. I might as well just eat whatever I want.”
So, when the inevitable slip-up does occur, you want to catch it quickly, forgive yourself (self-affirmation has been proven to help with this) and recommit to the change you want to make.
Whenever you are looking to make a change, following a path of progress always needs to be the mantra. As long as you are continuing to make progress towards your goal, it’s working!
You will eventually get to where you need to go.
8. Have a timeline
With any change you intend to make, it is essential to have a timeline.
Without one, the change can seem too big and too difficult. For example, let’s say someone has an issue with drinking alcohol and they say to themselves, “I just need to stop drinking....forever”.
Initially, this is going to feel too big and too daunting to do. Instead, it is better to select a relatively short timeline for starters.
Depending on what you are attempting to change, your timeline could be a day, a week, a month, 2 months or longer.
For example, with someone who struggles with drinking alcohol, they may focus on avoiding alcohol one day at a time; whereas, a professional athlete who is looking to lose 10 pounds to make weight for an upcoming competition, might focus on change with a 12-week timeline.
Generally speaking, a good rule of time is to keep your blocks of time as short as possible when you are setting a goal. Change always feels more achievable when you chunk time into short intervals.
But remember, it is still a good idea to periodically take a peek at the number 66 on the calendar. Of course, this isn’t a magic number but if you can largely maintain a change for 66 days, there is good research that suggests it should become much easier to maintain that change, new thoughts and behaviour become more habitual and less mental energy is required to complete the task.
9. Make time to follow-up
With any change, the only way to know how well you are doing is to assess your progress.
For example, if you were attempting to learn a new skill, such as a martial art, you could measure progress by achieving a higher belt level (or demonstrating progress in that direction). If you are learning cross-stitch, you would expect to be able to do more demanding patterns or should be at a higher belt level. If you are trying to become more physically fit, you should be able to perform or complete a project in a shorter amount of time. You get the idea.
Without measuring, there is no way to know if you are moving towards achieving your goal in a timely manner.
Now, I know some of you are probably thinking, “I’ll just get started and see how it goes.” I implore you not to fall prey to the dreaded “feels like” measurement.
What is a “feels like” measurement?
Well, that isn’t a psychology term (I just made it up), but if it catches on I am happy to take credit! What I mean by the “feels like” measurement” is just using your best guess at whether or not something has improved, as opposed to using a consistent, reliable form of measurement.
For instance, if you want to lose weight, it is a much better idea to use a tape measure to check the size of your waist as opposed to going with the “I think my pants feel a bit looser” form of measurement.
I realize there is some risk with measuring, as there is a fear of feeling disappointed and ultimately giving up on your goal. However, when it comes down to it, you need to know the facts if you hope to successfully achieve your goal.
And if you happen to fall short of where you expect to be, that’s OK. This needs to be viewed as an opportunity. It’s a chance to recommit or to make mid-course corrections and adjustments.
If you are willing to do this, there is an excellent chance that you will eventually achieve the results you want.
And remember, don’t fall prey to the expectation that any change you attempt to make should be achieved on your first attempt.
Life isn’t like that. So, there is no need to be discouraged if you don’t make the change you want on the first attempt.
If the change is worth making, be in it for the long haul.
10. Celebrate
I saved the best for last. Out of all 10 steps, this one should be the easiest. But it is still important.
When you successfully make a change, it is important to celebrate.
Why?
Because you want your brain to associate as you want, it is important to celebrate because you want your brain to have a positive association between putting effort into making change and achieving the goal.
And, of course, when you achieve your goal, don’t celebrate by engaging in the old behaviour you just changed.
For instance, if your goal is to lose 20 pounds, don’t celebrate by going out to your favourite restaurant and tearing up the buffet.
We are going after lasting change here!
CONCLUSION
So, there you have it! A 10-point, step-by-step plan for creating permanent change.
And the single biggest challenge you will have in making any change will be managing your emotions while you stay the course or make mid-course corrections.
But it will be worth it!
The essence of life is change. We are designed to grow and “evolve” for the better.
And another thing that makes change particularly exciting is the opportunity to design your life the way you want it.
As time passes, you are going to change. Why not commit to making the change you want?
Are there any steps you would have added to help create positive, lasting change?