How to Manage Your Strong Emotions

Some strong emotions are enjoyable, but some can knock us off balance. Becoming overwhelmed with emotions may lead to unhealthy reactions and misunderstandings, with the potential to get us into trouble at work, at home, or in social settings.

How do emotions get us into trouble?

Common expressions like ”he was blinded by emotion” or “I was so mad I had smoke coming out of my ears” are appropriate metaphors for the way powerful feelings can derail us.

Once triggered, we may be so gripped by the strong feeling that we simply can’t take in any information that doesn’t fit, maintain, or justify the whatever we’re feeling in that moment. In this state of mind, we see only that which affirms our feelings. Thinking becomes distorted, perceptions skew off-base, and memory of the triggering emotion is garbled.

Anger and fear are emotions that usually provoke strong reactions. Let’s look at anger: When I see clients for couple’s therapy, they will come to the session describing a disagreement from totally different points of view.

What may have started as a calm discussion about where to go on vacation escalates to an all-out fight, and as their anger grows, a rational conversation becomes impossible. When our emotions are left unchecked during a conflict, at some point, we reach a tipping point where our nervous system goes into hyper-drive and our internal alarm sounds.

Our heart rate increases, blood flow shifts to the internal organs, and we get an adrenaline rush, rendering us unable to be rational and communicate effectively. This fight, flight, or freeze response is often called “flooding.” Once our emotions have been escalated, we are unable to see the big picture and unable to take in new information.

How do emotions, especially anger, get triggered?

In the scenario I’ve described, a couple wants a good relationship, but a calm discussion escalates quickly. Often this is because cues get misinterpreted; what one person thinks of as an innocent statement is cause for high emotion in the other.

We misinterpret cues for several reasons, but a powerful one—all the more so for being largely unconscious—is the “imported script.” An imported script is a deep-seated pattern from childhood, such as not being listened to, or feeling like our opinions or needs don’t matter.

So when our partner ignores our suggestion for where to go on vacation, we don’t feel heard, leading to the reflective or automatic reaction of anger. We quit listening and react in whatever way is consistent with our personal anger profile.

When one partner gets triggered in this way, then the other is too: the emotional build-up is reciprocal. A strong emotional reaction from a partner will elicit some kind of response even if it is not apparent on the outside.

Each has a role to play in the disagreement. Typical reactions are to yell or scream (the fight response); to run from the room, withdraw, or take a drink (flight); or to refuse engaging in further conversation, creating a stalemate (freeze).

So how can you change these unhelpful reactions?

The aim is to learn to regulate your emotions – and note that regulating emotions is not the same as controlling. Controlling implies suppression, which is unhealthy both physically and mentally.

Regulation is about applying conscious thought to our feelings, giving you the power to reduce their intensity.

The tricky part is becoming aware of our feelings in the moment and taking responsibility for what we bring to the situation. Luckily, effective techniques exist for better emotional regulation. Let’s look at a few.

Practice self-soothing. Once you’re aware that you’re being flooded with an emotion (or that you’re headed in that direction), pause to collect yourself. Focusing on slowing breathing, heart rate, noticing sensations of warmth, and letting go of unnecessary muscle tension can eventually change the way you experience and express strong emotion.

This will allow you to keep working on issues more productively and compassionately. I have seen profound effects from this step alone.

Watch for signs. The first step in slowing down enough to better process information is to become aware of the sometimes subtle cues, such as onset of tension, that signal over-arousal and emotional escalation.

Gaining a clearer understanding of how strong emotions function can help you identify your experience as it is happening.

Look again, and with a different lens. By considering the situation and changing our interpretation of it, we can respond more flexibly.

When we increase our attention to our reactions rather than blaming someone else, or just giving into our typical response, we gain insights about our triggers so that we can express our feelings with strength.

Other helpful techniques include:

  • Increasing insight into imported memories/scripts
  • Changing your relationships to emotions/thoughts
  • Developing the ability to tolerate uncomfortable emotions
  • Returning mind and body to a stable state through deep breathing and learning to bring heart-rate down
  • Increasing understanding of the mind-body relationship
  • Switching from automatic reaction to intentional responding

Emotions, even strong ones, don’t have to derail you—or your relationships. With practice, you can experience them differently.


Brain Tumor Symptoms, Causes, Risk Factors & More

A brain tumor is a mass or growth of abnormal cells in your brain. Many different types of brain tumors exist. Some brain tumors are noncancerous (benign), and some brain tumors are cancerous (malignant). Brain tumors can begin in your brain (primary brain tumors), or cancer can begin in other parts of your body and spread to your brain (secondary, or metastatic, brain tumors).

How quickly a brain tumor grows can vary greatly. The growth rate as well as location of a brain tumor determines how it will affect the function of your nervous system.

Brain tumor treatment options depend on the type of brain tumor you have, as well as its size and location.

The signs and symptoms of a brain tumor vary greatly and depend on the brain tumor’s size, location and rate of growth.

General signs and symptoms caused by brain tumors may include:

  • New onset or change in pattern of headaches
  • Headaches that gradually become more frequent and more severe
  • Unexplained nausea or vomiting
  • Vision problems, such as blurred vision, double vision or loss of peripheral vision
  • Gradual loss of sensation or movement in an arm or a leg
  • Difficulty with balance
  • Speech difficulties
  • Confusion in everyday matters
  • Personality or behavior changes
  • Seizures, especially in someone who doesn’t have a history of seizures
  • Hearing problems

When to see a doctor
Make an appointment with your doctor if you have persistent signs and symptoms that concern you.

Primary brain tumors originate in the brain itself or in tissues close to it, such as in the brain-covering membranes (meninges), cranial nerves, pituitary gland or pineal gland.

Primary brain tumors begin when normal cells acquire errors (mutations) in their DNA. These mutations allow cells to grow and divide at increased rates and to continue living when healthy cells would die. The result is a mass of abnormal cells, which forms a tumor.

In adults, primary brain tumors are much less common than are secondary brain tumors, in which cancer begins elsewhere and spreads to the brain.

Many different types of primary brain tumors exist. Each gets its name from the type of cells involved. Examples include:

  • Gliomas. These tumors begin in the brain or spinal cord and include astrocytomas, ependymomas, glioblastomas, oligoastrocytomas and oligodendrogliomas.
  • Meningiomas. A meningioma is a tumor that arises from the membranes that surround your brain and spinal cord (meninges). Most meningiomas are noncancerous.
  • Acoustic neuromas (schwannomas). These are benign tumors that develop on the nerves that control balance and hearing leading from your inner ear to your brain.
  • Pituitary adenomas. These are mostly benign tumors that develop in the pituitary gland at the base of the brain. These tumors can affect the pituitary hormones with effects throughout the body.
  • Medulloblastomas. These are the most common cancerous brain tumors in children. A medulloblastoma starts in the lower back part of the brain and tends to spread through the spinal fluid. These tumors are less common in adults, but they do occur.
  • Germ cell tumors. Germ cell tumors may develop during childhood where the testicles or ovaries will form. But sometimes germ cell tumors affect other parts of the body, such as the brain.
  • Craniopharyngiomas. These rare, noncancerous tumors start near the brain’s pituitary gland, which secretes hormones that control many body functions. As the craniopharyngioma slowly grows, it can affect the pituitary gland and other structures near the brain.

Cancer that begins elsewhere and spreads to the brain
Secondary (metastatic) brain tumors are tumors that result from cancer that starts elsewhere in your body and then spreads (metastasizes) to your brain.

Secondary brain tumors most often occur in people who have a history of cancer. But in rare cases, a metastatic brain tumor may be the first sign of cancer that began elsewhere in your body.

In adults, secondary brain tumors are far more common than are primary brain tumors.

Any cancer can spread to the brain, but common types include:

  • Breast cancer
  • Colon cancer
  • Kidney cancer
  • Lung cancer
  • Melanoma

Risk factors
In most people with primary brain tumors, the cause of the tumor is not clear. But doctors have identified some factors that may increase your risk of a brain tumor.

Risk factors include:

  • Exposure to radiation. People who have been exposed to a type of radiation called ionizing radiation have an increased risk of brain tumor. Examples of ionizing radiation include radiation therapy used to treat cancer and radiation exposure caused by atomic bombs.
  • Family history of brain tumors. A small portion of brain tumors occurs in people with a family history of brain tumors or a family history of genetic syndromes that increase the risk of brain tumors.


Breast Cysts Overview, Symptoms & Causes

Breast cysts are fluid-filled sacs inside the breast, which are usually not cancerous (benign). You can have one or many breast cysts and they can happen in one or both breasts.

They’re often described as round or oval lumps with distinct edges. A breast cyst usually feels like a grape or a water-filled balloon, but sometimes a breast cyst feels firm.

Breast cysts don’t require treatment unless a cyst is large and painful or uncomfortable. In that case, draining the fluid from a breast cyst can ease symptoms.

Breast cysts are common in women before menopause, between ages 35 and 50. But they can be found in women of any age. They can also occur in postmenopausal women taking hormone therapy.

Breast cysts may be found in one or both breasts. Signs and symptoms of a breast cyst include:

  • A smooth, easily movable round or oval lump with distinct edges (which typically, though not always, indicates it’s benign)
  • Nipple discharge that may be clear, yellow, straw colored or dark brown
  • Breast pain or tenderness in the area of the breast lump
  • Increase in breast lump size and breast tenderness just before your period
  • Decrease in breast lump size and resolution of other symptoms after your period

Having breast cysts doesn’t increase your risk of breast cancer. But having cysts may make it more difficult to find new breast lumps or other changes that might need evaluation by your doctor. Be familiar with how your breasts normally feel so that you’ll know when something changes.

When to see a doctor
Normal breast tissue often feels lumpy or nodular. But if you feel any new breast lumps that persist after a menstrual period, or if an existing breast lump grows or changes, see your doctor right away.

Each of your breasts contains lobes of glandular tissue, arranged like petals of a daisy. The lobes are divided into smaller lobules that produce milk during pregnancy and breast-feeding.

The supporting tissue that gives the breast its shape is made up of fatty tissue and fibrous connective tissue. Breast cysts develop as a result of fluid accumulation inside the glands in the breasts.

Breast cysts may be defined by their size:

  • Microcysts are too small to feel, but may be seen during imaging tests, such as mammography or ultrasound.
  • Macrocysts are large enough to be felt and can grow to about 1 to 2 inches (2.5 to 5 centimeters) in diameter. Large breast cysts can put pressure on nearby breast tissue, causing breast pain or discomfort.

Experts don’t know what causes breast cysts. They may develop as a result of hormonal changes from monthly menstruation. Some evidence suggests that excess estrogen in your body, which can stimulate the breast tissue, may contribute to breast cysts.


10 Questions Your Rheumatologist Wants You to Ask About Psoriatic Arthritis

You’ve been referred to a rheumatologist for psoriatic arthritis (PsA). At this point, you’ve heard about how this type of specialist is essential in properly diagnosing your condition, as well as treating it. However, you likely have a lot of questions about the ins and outs of this process. Consider taking these 10 questions with you to your first appointment, and follow up with your doctor as necessary.

1. What caused my PsA?
The precise cause of PsA is not clear-cut. As an autoimmune disease, PsA can occur when your immune system attacks its own healthy cells and tissues. Autoimmune diseases are often hereditary, and not every family member has the same type. So, for example, if a family member develops rheumatoid arthritis, your chances for getting PsA are increased.

Psoriasis doesn’t necessarily cause PsA, though this puts you at a greater risk. People with psoriasis can develop other forms of arthritis, while others don’t develop arthritis at all.

2. How will you diagnose my condition?
Your rheumatologist first looks at your records to see what tests have been done. They also ask you about your family medical history, as well as whether you have psoriasis or not.

Next, your rheumatologist performs a physical exam. They look for any signs of plaque psoriasis and inflammation. They also examine your joints.

Finally, a PsA diagnosis depends heavily on testing to make sure that you’re not misdiagnosed with another form of arthritis or another type of condition altogether.

A negative blood test for a rheumatoid factor is just one indicator of PsA.

There is no single test for PsA, so a proper diagnosis is often dependent on eliminating other possible conditions.

3. What are the most common symptoms of PsA?
Persistent joint pain is often the first indicator of many types of arthritis, such as PsA. In addition, PsA can cause:

  • swelling and tenderness of your joints
  • reduced range of motion (especially in the morning)
  • back pain
  • changes in your fingers and toes (especially in the nails)
  • conjunctivitis
  • increased fatigue

4. What type of PsA do I have?
PsA is just one form of arthritis. It also has several subtypes that are based on which joints are affected. You may have one of the following types of PsA:

  • Arthritis mutilans is a rare form that primarily affects your hands and feet.
  • Distal interphalangeal arthritis primarily affects toe and finger joints (called distal joints).
  • Oligoarticular arthritis is a milder form that affects fewer joints in a more asymmetrical pattern (both sides of your body, but different joints).
  • Spondylitis is a type of PsA that affects your spine, causing back and neck problems.
  • Symmetric arthritis affects both sides of the body, and affects the same joints on each side.

5. How will you treat my condition?
PsA is typically treated with the following:

  • Biologics are prescription medications such as adalimumab (Humira) and etanercept (Enbrel) that target your immune system to prevent it from attacking healthy tissues.
  • Disease-modifying antirheumatic drugs (DMARDs) are used in severe cases of PsA. These work by slowing the progression of joint and tissue damage. (Many biologics are also DMARDs.)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) work by reducing pain and inflammation. These are available in both over-the-counter and prescription forms.
  • Small-molecule treatments are a new medication that can regulate inflammation associated with PsA.

The type of treatment selected is based on the severity of your condition. Your treatment plan may also be modified based on flare-ups and disease progression.

Your rheumatologist may also recommend physical therapy because PsA causes stiffening in your joints, which leads to discomfort and pain. There are exercises specifically designed for joints that help relieve your pain so that you can manage your PsA on an ongoing basis.

6. Can I take over-the-counter medications?
The only type of over-the-counter medications used for PsA are certain types of NSAIDs. These include ibuprofen (Advil) and aspirin. While over-the-counter NSAIDs may reduce pain and inflammation, they don’t solve the immune system issues that prescription medications can.

Ask your rheumatologist before taking over-the-counter drugs to make sure they won’t interact with any other medicines you take.

7. What lifestyle changes do you recommend?
A nutritious diet can give you more energy while also naturally reducing inflammation from PsA. Though difficult at first, regular exercise can also help. Moderate, low-impact workouts, such as swimming and walking, can help condition and strengthen your joints.

Diet and exercise can also go a long way in helping you lose weight if you need to. Excess weight can heighten joint pain and damage.

If you experience depression, stress, and fatigue from your condition, consider alternative exercises like yoga. Going to bed at the same time each night can also make a difference in daytime tiredness.

8. Do I still need to see my other doctor(s)?
Though paramount in the treatment of PsA, a rheumatologist shouldn’t be the only kind of doctor you see. A primary doctor is still necessary for annual checkups, as well as any other medical needs outside of PsA.

If you had psoriasis prior to receiving a diagnosis for PsA, you’ll also still need to see your dermatologist.

While a rheumatologist treats the underlying inflammation of PsA, skin symptoms are best treated by a dermatologist. Both doctors can work with you to treat a variety of topical and internal symptoms — just be sure that you communicate with each one about the treatments you’re receiving.

9. Will I become disabled?
Seeing a rheumatologist is the first step to preventing a PsA-related disability. Over time, joint wear and tear can cause permanent damage. Disability is a long-term concern with PsA because broken-down joints can significantly limit your range of motion.

PsA doesn’t necessarily lead to disability in all cases. Your chances are greatly reduced with ongoing treatment.

10. How long will I have PsA?
PsA is a lifelong or chronic condition, and it doesn’t have a cure. However, proper treatment can minimize the damaging effects that the underlying inflammation poses to various joints in your body. PsA can range in severity from mild to severe. The types of joints affected can also make a difference in terms of everyday movements and overall quality of life.


10 Ways to Combat Psoriatic Arthritis Fatigue

Managing psoriatic arthritis can be tiring on its own, but for some people, chronic fatigue is an overlooked symptom of the condition. One study suggests that as many as 50 percentTrusted Source of people with skin conditions report having moderate to severe fatigue, while 25 percent experience severe levels of fatigue.

Psoriatic arthritis is marked by inflammation that affects the joints and skin.

Fatigue can be caused by the inflammation itself, but may also be a result of other complications, including:

  • chronic pain
  • anemia
  • reduced physical fitness
  • being overweight
  • fibromyalgia
  • sleeping issues
  • diabetes
  • anxiety and depression

If you’re waking up each morning without energy, here are a few simple tips to get you through the day.

1. Identify your triggers
Identifying your triggers might be challenging, but finding the cause of your fatigue can help you achieve a solution. Fatigue can result from several sources, including:

  • diet
  • environment
  • mood
  • stress level
  • sleeping patterns

It can also be a combination of several of these.

Keep a written or electronic record of your fatigue to identify its cause. Record your fatigue level each day along with what you ate, when you woke up, and when you went to bed, and any activities you did that day.

This can help you find the cause of your fatigue and other symptoms. For example, you may feel fatigue right after taking your medication, or perhaps you feel really tired after eating sugar or dairy. While there might not be a single answer, this is a good starting point.

2. Set medication reminders
Pain and inflammation from psoriatic arthritis can contribute to fatigue. You likely take a prescription medication to keep your condition under control. Many people living with psoriatic arthritis reported a reduction in fatigue when taking medications for psoriatic arthritis.

It’s important to take your medication on schedule and not miss any doses. Set a reminder on your phone to take your medication at the right time each day.

Talk to your doctor if side effects are causing you to avoid taking your medication. Your doctor may want to switch you to a different one.

3. Exercise regularly
It may seem counterintuitive, but exercise is important for warding off fatigue. Exercising improves your heart health and helps increase your muscle mass, strength, and flexibility. This can give you a much-needed energy boost.

The endorphin rush you experience during exercise can also improve your overall quality of life, as well as your sleep. Aim for 30 minutes of exercise per day — even if it’s just a brisk walk. Be sure to stay hydrated during and after your workout, as dehydration can also be a hidden cause of fatigue.

4. Watch your diet
Your diet plays a huge role in how you feel. A diet high in fruits, vegetables, whole grains, healthy fats, and lean protein is the way to go. You should do your best to avoid processed and sugary foods.

Studies show that specific dietary choices can help reduce the severity of psoriatic arthritis symptoms, including fatigue.

Some examples of foods that can decrease inflammation are:

  • those high in omega-3 fatty acids, such as salmon, tuna, nuts, olive oil, and flax
  • those high in antioxidants, such as colorful fruits and vegetables, dark chocolate, tea, and coffee
  • whole grains, like oats and brown rice

The Medical Board of the National Psoriasis Foundation also mentions vitamin D supplementation may benefit people with psoriasis or psoriatic arthritis.

5. Don’t skimp on your mattress
If your mattress isn’t comfortable, your sleep will likely suffer. You spend about a third of your day in bed. Investing in a good mattress can make a world of a difference when it comes to psoriatic arthritis.

6. Stick to a relaxing bedtime routine
A good night’s sleep is essential for combatting fatigue. A relaxing routine at night can set you up for success.

Try taking a warm bath to ease your joint pain each night before bedtime. If possible, go to bed and get up at the same time every day.

Here are a few more tips for a healthy sleep routine:

  • avoid alcohol, nicotine, and caffeine
  • keep your bedroom cool and dark
  • turn off computer, cell phone, and TV screens before bedtime
  • keep electronics out of the bedroom
  • avoid large meals before bedtime

7. Treat other conditions
Many people with psoriatic arthritis have other health conditions, such as diabetes, anemia, insomnia, depression, or anxiety. These conditions could be the cause of your fatigue, or they could be making it worse.

Talk to your doctor and make sure you’re getting the treatment you need. Depending on your case, they might prescribe:

  • iron supplements for anemia
  • sleep aids, such as zolpidem (Ambien), for insomnia
  • multivitamins for nutritional deficiencies
  • antidepressants, such as bupropion (Wellbutrin)
  • medications for diabetes, such as metformin or insulin

8. Reduce stress
The stress of having a chronic illness can be overwhelming. It may also make your symptoms worse. But, there are many options you can try to reduce stress levels. Some excellent mind-body activities that may help lower your stress levels include:

  • yoga
  • tai chi
  • meditation

If you’re still struggling, try speaking to a counselor or mental health specialist.

9. Consider additional medication
You’re likely already taking a few different medications to treat your condition and may be reluctant to add another one. That’s understandable.

But if you can’t figure out how to manage your fatigue levels, you may benefit from a medication that increases energy, sometimes called “activating” medications. These include:

  • selective serotonin reuptake inhibitor (SSRIs) antidepressants,
  • such as fluoxetine (Prozac)
  • psychostimulants, such as modafinil (Provigil)

Ask your doctor to recommend a medication. You might have to try a few before you find one that works for you.

10. Schedule your rest time
When living with a chronic disease, it’s inevitable that you’ll feel tired from time to time. You might find that the best way to manage your fatigue is to schedule it into your daily activities. A quick nap or just lying down in the middle of the day could be just what you need.

You can also plan to do your most intensive tasks when you usually have the most energy. Consider dividing up your exercise or other activities into shorter segments.

Fatigue is a symptom of psoriatic arthritis and may be one of the most troublesome. Fatigue can make your pain and stiffness worse. Your pain can then make you feel more tired, resulting in a fierce cycle of exhaustion.

Work with your doctor to find out if there are any medications you need to be taking. Remember that establishing a routine and seeing results may take some time. You can beat fatigue with the right combination of treatments and lifestyle changes.