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Ask the Counselor is a column written by Kimara Clarke, an MTSU staff counselor, and offers students the opportunity to ask a licensed mental health professional questions about mental health.  If you would like to submit a question to “Ask the Counselor,” please send an email to Kimara.Clarke@mtsu.edu.  We will contact you to let you know if your question is chosen to be published and if you would like it to be anonymous.  

Archives

February 2021: What are some of the causes of anxiety and what are some helpful ways to deal with it?

Dear Counselor,

I’m just wondering what are some of the causes of anxiety and what are some helpful ways to deal with it?

Signed,
Anxious

Dear Anxious,

Anxiety is a feeling that you might experience for any number of reasons. It may come as a result of our relationships with others, stress related to work or school, and how we view ourselves and the world around us. Anxiety could even be the result of our childhood experiences or due to some form of trauma. Some people might say they experience it because they are “worry warts” who tend to worry about everything. Regardless of the source, anxiety can affect every aspect of your life. When it is activated, it causes physiological changes that affect your breathing and your heart rate. It may cause you to feel pressure or tightness in your chest, muscle tension, headaches, and racing thoughts. When these things happen to you they can be scary. These sensations can cause you to become hyper focused on them and compel you to respond in one of three ways: to want to act in some way (fight), to want to run away (flight), or to not know what to do or which way to turn (freeze). Whatever your individual experience may be, these sensations can feel overwhelming and making functioning difficult. It is important that you build a healthy self-care regimen to help you manage anxiety. Each of the strategies may help aid you in doing so.

  • Acknowledge the feeling
    • First things first, nothing changes without you first acknowledging that something is going on. Our tendency at times is to avoid because that is easier than dealing with what is going on. But usually avoiding does the opposite of what you want it to do. In fact, avoiding may make stronger what you are hoping will be weakened by the fact of your avoidance.
  • Temperature check
    • After acknowledging the feeling of anxiety, scale it. Use a scale from 0 (no anxiety)-10 (the worst anxiety you could feel) to determine its intensity level. Keep this number in mind as you will use it later to help you notice any change in how strongly you feel the anxiety. Once you complete your temperature check, you can now move on to focusing on regulating your body.
  • Body scan
    • The body scan is designed to bring your awareness to areas of tension that you may be having in your body. To begin, start at the top of your head and move down your body noting any tension that you find. Each time you find an area that is tense, try to loosen that area. There are several ways to do this. For instance, you can move around or adjust your sitting or laying down position. Or you can imagine the muscle being a knot that unravels. You could also imagine the tension melting away causing that area to feel as light as a feather. As you move down your body allow yourself to relax, allow your arms to fall to your side, your shoulders to slump, and your legs to go limp. One you have scanned your body now slowly bring your attention to your breath.
  • Relaxation breathing
    • As you bring your focus to your breath, breathe in through your nose, fill up your stomach, breathe out through your mouth, and then rest. It may be helpful for you to count as you move
      through each step of the breathing process. In this way you would breathe in to the count of 4, hold in your diaphragm to the count of 4, breathe out to the count of 4, rest to the count of 4, and then repeat.
  • Grounding
    • Sometimes, depending on how high the anxiety is that you are experiencing, it may be difficult to go through a body scan and engage in relaxation breathing. Higher anxiety levels require something that pulls you outside of your body. This is because when the anxiety is at a high level your attention is drawn to the changes happening in your body, i.e., the rapid breathing, the increased heart rate, the racing thoughts, or perhaps even a feeling of doom - all of which feel as though they may overtake you at any moment. This is where the technique of grounding comes into play. The point of grounding pulls you outside of your body and puts you in your environment. In this way your attention is drawn away from the physiological changes you’re experiencing. It’s a way of gaining back the control that anxiety is trying to say you no longer possess. Grounding is a strategy that can be done in any number of ways. One way of grounding is to name everything you see. Another way of grounding would be to name 5 things you see, 4 things you hear, 3 things you feel, 2 things you smell, and one thing you can taste. You can name everything you see that is the same color. You can even name everything you see that is the same shape. The point is not on how it’s done but on pulling yourself into your environment.
  • Temperature check again
    • After grounding you can do another temperature check to determine any progress you are making in bringing the intensity level of the anxiety down. Use the same scale from before 0 (no anxiety)-10 (worst anxiety). If you don’t notice much of a change, keep doing it. The lack of change may not be that it’s not working. It may be that you need to give it more time to work or you may need to add something else to what you are doing to help it come down. But no matter how minuscule the change may seem, any change in intensity level is a good indication that what you are doing is working. So, be patient and allow it time to work.

If you find that you have tried these things and you have had little success with them there may be an underlying issue that needs to be addressed. If this is the case, it is important that you find a safe place to address it. These strategies are meant to address the symptoms but not what may be the cause. If you need help getting connected, you may contact Counseling Services at 615-898-2670 to help you get started.

Wishing you great calm,
The Counselor

February 2021: I am starting this new semester off stressed already – what can I do?

Dear Counselor,
I am starting this new semester off stressed already. I’m worried about pretty much everything at this point. My grades were ok at the end of the fall semester, but I’m still worried that I won’t do well this semester. I just don’t know what to do to shake this feeling.

Signed,
Worried

Dear Worried,

It sounds like you may be experiencing worst case scenario thinking. This kind of thinking will have you anticipating the worse possible outcomes. These “what ifs” will focus your attention more on what is not working than on what you may be doing that is helping but that your brain may be minimizing. There are some practical things you can do to help set yourself up for success and you can even do these things while feeling worried.

  1. Thoughts are not facts. Thoughts are made up of our judgments, opinions, assumptions, stereotypes, and biases. These things are not facts. Facts are things that actually exist. Our thoughts coupled with our feelings can cause us to feel as though what we are thinking is real, making it hard to distinguish between what is real and what is not. But just because we think something does not make it a fact. It makes it a thought that can be challenged.
  2. Possible vs. likely. All things are possible but how likely are they to happen. There is a difference between something being possible and something being likely. Challenge your thoughts to determine the likelihood of them actually happening.
  3. Set realistic expectations for yourself. The expectations you have for yourself and what you think others want for you can affect your level of worry. Your expectations need to be reasonable and fit who you are as a person. When you set standards that are too high or have standards that move, you end up working against yourself.
  4. Use what worked. How did you get through last semester? What worked? What didn’t work? If you find yourself minimizing your strengths, pause and ask yourself “what benefit am I getting from minimizing my efforts?” “Where is this coming from?” “How is this helping me?” Asking yourself these questions can help you pull the wisdom out of what you are already doing well and apply it to this semester.
  5. Know there will be bad days. There will be some days where you are on top of things. You are getting your work done, you start early on a project, and you get some things done around your apartment or dorm. Then there will be days when your energy level is low and you don’t feel much up to doing anything. Either day is okay. Work with your low energy days and adjust. On these days the focus may need to shift from assignments to self-care. How well did you sleep? Have you eaten well today? Is there some other stressor pulling on you that needs your attention? Address what needs to be dealt with to move it off of your mind and then tackle reading that 30 page chapter.

The worry you feel may be trying to protect you from the fear of failing or fear of not being good enough. But worry can work overtime and cause disruption to daily living. It keeps you focused on the future and out of the present. Work on a plan to calm it to make life simpler for you.

Until next time,
The Counselor

December 2020: How do I motivate myself to finish out this semester and prepare for finals?

Dear Counselor,

This semester has been hard and that’s putting it mildly. I started off ok but as the semester progressed it became harder to stay motivated. Now that the end of the semester is here I still have little energy and even less motivation to get assignments done and the idea of studying for finals makes me even more tired to think about. How do I motivate myself to finish out this semester and prepare for finals?

Yours truly
Over It

Dear Over It,

Abracadabra. Hocus Pocus. Make this semester go out of focus! Deep sigh. It’s still here. But seriously, if I could wave a magic wand I’d do it for you in a heartbeat. I can’t even begin to imagine the mental and emotional toll this semester has had on you. Online classes, quarantining and isolating, social distancing with no break has taken its toll on a number of students. At this point you just want it all to be over. However, you may be over it but there are some loose ends to tie up before you can officially write this semester off as DONE! Here are a few things that might help push you over the finish line:

  1. Make a list. Write down the things you need to get done. Then take each task and break it down into manageable parts. Try not to tackle everything all at once, as doing so will only increase the lack of motivation.
  2. Make a schedule. Once you have your list, set up a schedule for each of the items to complete each day. Start with the easiest assignments first and then work you’re work towards the harder ones. This will not only help build confidence, it will also help to build your energy level.
  3. Schedule breaks in between each task. Try not to push yourself to just get through it. This will wear down your motivation and increase your chances of procrastinating. A simple 10 minute break can go a long way during study time.
  4. Use a reward system. Set up some rewards to give yourself along the way. Sometimes having little things planned you enjoy doing while working on what you have to do can be motivating and energizing all at the same time. It can help you gain the momentum you need to get the work completed. You might even consider planning something for yourself once you have turned in the last assignment. This will give you something to look forward to that can also help build motivation.
  5. Last but certainly not least, breathe. Take some deep relaxing breaths, intentionally focusing on the breath to help regulate any feelings of overwhelm. You’re almost done and have come through a majority of this semester. Breathing helps you focus on what is happening in the moment rather than trying to think about too much at once. It can help redirect your focus from the lack of energy and motivation you are experiencing to taking one thing at a time, completing it, and then moving on to the next thing.

Wishing you the best of luck,
The Counselor

November 2020: How do I turn my brain off so I can get some sleep?

Dear Counselor,

I’ve been under a lot of stress lately. School is overwhelming trying to keep up with all the work I need to get done and it’s affecting my sleep. I have a hard time turning my brain off when it’s time for bed. I end up going to bed but only lying there thinking about everything I don’t want to think about and it takes me a while to fall asleep. If and when I do fall asleep I end up waking up several times during the night. I just want to sleep. How do I turn my brain off so I can get some sleep?

Thanks
Me


Dear Me,
Sleep and rest are important to how we handle stress and our daily lives. The activities of the day can keep us busy and focused solely on what needs to get done. Throughout the day, our bodies are on high alert to meet whatever is being demanded of us. We are sometimes so wound up that by the time bedtime comes our bodies still may be functioning as though it were the middle of the day. There actually aren’t any techniques “to turn your brain off.” This is a misnomer that may be linked to the idea that with meditation, you should be able to rid your brain of thoughts while you meditate. But I’m pretty sure that if you aren’t thinking then you’re brain dead. So, we don’t want to go for not thinking.

What we want is to learn how to control our thoughts rather than being carried away with them. One way we can get a handle on our thoughts is to set up a nighttime routine. Doing the same thing each night signals the brain and the rest of your body that it’s time to wind down and rest. This routine can be anything you make it and may include having a set time to end school work, silencing your phone, journal writing to address things that have been bothering you, or taking a shower. You might even consider finding a meditation app with soothing sounds that can help you drift off to sleep. Make sure your bedroom space is relaxing and you are comfortable. If you have spent all day in your bedroom in bed doing homework or even doing work in your room, your brain can have a hard time deciphering that it’s time to switch from work to rest because it’s been in the same space all day. Try to separate work and sleep spaces. This can also be another signal to the brain that it is time for rest. Limit your use of social media at bedtime.

Some posts, or just being on social media, can activate your nervous system and further cause you not to be able to sleep. Once in bed, minimize lighting and do a body scan. Scan your entire body for areas of tension and then imagine the tension dissolving from your body. With this, you are focusing your mind on becoming relaxed rather than allowing it to retrace what happened during the day. If you find that your mind keeps going back to something in particular, you could use your journal to process through what you are thinking, or if you’re concerned about the next day, make a list of things you need to get done. This way you move the thoughts from your head onto paper, and if they come back up you can remind yourself that it will be taken care of tomorrow. If you wake up during the night, be patient with yourself, and focus your thoughts on relaxing your body and sleeping. It takes time to build new habits. So, be patient with yourself. Be flexible with your needs and adjust accordingly.

Wishing you happy dreams
The Counselor

October 2020: Considering counseling - Can you tell me what to expect or what it will be like?

Dear Counselor,

I’ve been thinking about coming to counseling for a while now. But I just keep putting it off. I’m not really sure I’m ready, I don’t know what to expect, and I’m not sure of the type of counseling I need. Can you tell me what to expect or what it will be like? What is the process for setting up an appointment?

Thanks for your help
Anonymous

Hi Anonymous,

You have taken a big step in even considering coming to counseling. It can be overwhelming to think about what it would be like when you’ve never experienced it before. Counseling is allowing a trained professional who is nonjudgmental and empathetic to listen to your cares and concerns, and help you acknowledge, problem-solve, and accept what is going on in your life. The process to set up an appointment with MTSU Counseling Services is pretty simple. You call the office at 615-898-2670 and will be scheduled for a first-time screen appointment. This brief 30-minute appointment is only to make sure that you get the best possible care.

Sometimes Counseling Services is not the best option for the problems you need to address. In this case, the staff will work with you to get you the help you need by connecting you with providers in the Murfreesboro area. If, however, what you are dealing with can likely be resolved within a short period of time (about six sessions), then you will be scheduled for an intake session. The intake session goes more in-depth than the screen appointment, provides the counselor more information, and gives you and the counselor some time to get to know each other. At the end of the intake session, you set goals for what you want to achieve.

All of the follow-up sessions focus on moving you closer to your goal. Through each step of the process you and your counselor assess how well the process is going. If either of you determine that you are going to need more sessions, then your counselor, who now knows you better, will work with you to get you connected with a community provider. In most cases you can continue seeing your on-campus counselor until you get connected with the off-campus provider.

So, the process isn’t as difficult as you might think. I hope this helps, Anonymous. Only you know when you are ready. It can be easy to keep putting it off waiting for “the right time” or for “when things slow down.” Life doesn’t always afford us those times. It will be up to you to intentionally set aside some time and invest in your personal growth. We hope to hear from you soon.

Yours truly,
The Counselor

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