Our best expert advice of 2023 for better mental health

Every week on Well+Being, psychiatrists and psychologists suggest ways to improve our mental health. Here are the 10 of the most popular On Your Mind columns of 2023 with a summary of the advice shared by experts.

1. Three ways to stop getting up at night and improve sleep

Everyone wakes up a few times per night. Cycling out of sleep roughly every 90 minutes to two hours is normal. But frequent wakings can affect physical, emotional and mental functioning. We fail to get adequate quantities of the deepest stages of sleep, and react to disruptions with metabolic, inflammatory and stress responses.

Three less well-known solutions for light sleep and wakings can help. Minimize bathroom breaks by aligning your biological clock with your intended sleep schedule. Treat your sleep apnea by desensitizing yourself to your CPAP machine. And relax hypervigilance and work on feeling safer to sleep better.

Read more on reducing frequent night wakings

2. Avoidance, not anxiety, may be sabotaging your life

In my practice, I see many patients beaten down by anxiety.

Anxiety, though, is not the puppeteer pulling the strings in many of our lives. There is a more subtle and insidious one, and it’s called psychological avoidance. When we avoid certain situations and decisions, it can lead to heightened anxiety and more problems.

Psychological avoidance is a powerful enemy, but there are three science-based skills to fight it. Check in with your thoughts and challenge them. Ask yourself: What is one small step I can take toward my fears and anxiety to overcome my avoidance. And let your values, not your emotions, direct your actions.

Read more on fighting psychological avoidance.

3. Gaslighting is emotional abuse. Here’s how to recognize and stop it.

By Robin Stern, PhD, and Marc Brackett, PhD

Gaslighting is an insidious, manipulative and reality-bending form of emotional abuse. Yet when gaslighting is in our own relationships, many of us struggle to identify it, let alone escape it.

Learn to recognize signs of gaslighting, such as persistent denial, reality-spinning, shaming, contradiction and outright lying. Name the abuse. And use strategies such as opting out of the power struggle, checking in with your feelings often and honoring your emotions to stop being subjected to gaslighting.

Read more on recognizing and stopping gaslighting.

4. Some moms are microdosing mushrooms for anxiety and depression

As a therapist who specializes in psychedelics for perinatal mental health, I’ve worked with numerous women who hope to treat their depression, anxiety and trauma with therapeutic psychedelic medicine.

To support my patients in microdosing treatment, I talk with them about their intentions, a dosing protocol and sourcing material. If you’re considering this type of treatment, here are four things to keep in mind.

Educate yourself about the research. Go through a medical evaluation. Find ethical sources of psychedelics. And get support in preparation and integration.

Read more on how some people are microdosing psychedelics for mental health.

5. 4 mistakes to avoid when you’re lonely

By Jelena Kecmanovic, PhD

I recently asked one of my patients if there was anyone he could call if he needed help, and he answered. “There’s nobody.”

His experience is not uncommon. As a clinical psychologist, I’ve noticed that we are becoming more and more isolated from one another.

When I discuss with my lonely patients different ways of meeting new people, connecting with acquaintances and rekindling old friendships, I often hear one or more of the common, if mistaken, beliefs that get in the way. But they and you can take steps to counter these beliefs.

Don’t wait until you’re (thinner, happier, less stressed) before socializing. Start a conversation with the other parents in the school pickup line, checkout clerks in stores, front-desk staff at your dentist or doctor, or the barista at your favorite coffee shop.

Go beyond superficial small talk and engage in deeper conversations. And if you are struggling, ask for help. For those being asked, it often engenders good feelings related to being perceived as a trusted source of support and fulfills the need for being needed.

Read more on the steps to take to alleviate loneliness.

6. 3 skills from psychotherapy that can change your brain

By Christopher W.T. Miller, MD

Different forms of talk therapy can lead to improvements in several subjective areas, including self-esteem, optimism, understanding who one is as a unique person and strengthening interpersonal relationships in matters such as intimacy and reciprocity — the healthy give-and-take we need to have when relating to others. Psychotherapy has also been shown to decrease biological markers of stress and inflammation.

Many people struggling with mental health issues may not be able to access therapy because of the costs and the shortage in therapists and culturally competent care. But there are ways to incorporate some of the lessons from psychotherapy in our everyday lives.

In many ways, it comes down to how we treat our own thinking. Some tips include: Choosing reflection over reflex. Bringing softness, not hostility. And being curious, not judgmental.

Read more on using therapy skills to improve mental health.

7. Don’t try to worry less. Worry smarter.

By Tracy Dennis-Tiwary, PhD

Preventing or squelching worry is exactly the wrong thing to do. Suppressing thoughts and feelings never works — and paradoxically increases anxiety and worries while reinforcing the belief that worries are uncontrollable, and blocking us from figuring out other ways of coping.

We need other approaches so that we can learn to worry well and eventually worry less. Try these steps, in order: Locate worry in your body; make worry concrete and contained; problem solve; and let go of worries.

Read more on worrying well.

8. How to make tough choices in relationships

In almost every relationship, there is an issue where someone is growing increasingly resentful. It could be significant, like a waning sex life. Or it could be small, such as the partner never replacing the empty toilet paper roll. In each of these examples, one person can be stuck in a decision limbo.

To avoid the kinds of faulty decision habits and biases we are all prone to, we can apply tools from both decision science and the therapy room. By slowing down your thinking, clarifying your values, reframing your question and embracing deliberate choice you can counter decision paralysis.

Read more on making tough choices.

9. Happiness is fleeting. Aim for fulfillment.

By Gregory Scott Brown, MD

As a psychiatrist, I think about happiness and how to achieve it. And thousands of conversations with patients who are chasing happiness have taught me that it can be a distraction from what’s really necessary for a better life — fulfillment.

You can begin to cultivate your life in a way that draws you closer to fulfillment, with a few changes: Don’t overreact to highs or lows. Learn to adapt. Develop meaningful relationships. And try not to regret.

Read more on seeking fulfillment.

10. Lost in self-doubt? Here’s how to succeed despite impostor syndrome.

As a therapist, I meet many accomplished individuals who doubt their success despite evidence to the contrary. Commonly known as impostor syndrome, this phenomenon can undermine ambition and lead to stagnation or result in overworking to prove competence.

The fear and self-doubt described by impostor syndrome, however, don’t need to be “cured” before doing what matters. We can be psychologically flexible by choosing effective action in the presence of difficult internal experiences.

Read more on conquering self-doubt.

We welcome your comments on this column at OnYourMind@washpost.com.

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