Setting Your Mind for the New Year

For many people, New Year’s Day represents a clean slate, a time to look back over the past year and look forward to the new one. It’s a time to set goals, from improving overall physical health to finding a new job or starting a new hobby. If thoughtfully conceived, these resolutions can become habits that will be achieved in the new year.

Added Stress

But for people dealing with mental health issues, the new year can bring added stress. Setting goals is one way to combat that stress, according to Washington Township Medical Foundation (WTMF) psychiatrist Suselina Acosta-Goldstein, MD, whose focus includes psychiatry, medication management and psychotherapy.

“A lot of psychotherapy is goal setting,” Dr. Acosta-Goldstein said. “But the goals must be reasonable, attainable, and specific. Large blanket statement goals can be overwhelming, and then they become unachievable.”

For that reason, Dr. Acosta-Goldstein suggested those planning to make changes in their lives need to break things down in their simplest terms and into specific goals. When goals are broken down into manageable pieces, they are more meaningful.

“For example, people say their goal is to ‘be healthy,’ but what does that mean? It can mean very different things to different people,” she said. “Try to give three specific examples of what you can do this week to meet your goal. You can share your goal with someone—not only to help keep yourself accountable—but to brainstorm or to process them.”

Positive Outlook

Facing a new year with the same old problems can be daunting. Dr. Acosta-Goldstein noted just resolving to “get better” won’t eliminate problems for people struggling with mental health issues. Depression and anxiety often go hand-in-hand, so focusing on too large a goal can be overwhelming and won't help people move forward. She does not focus on positive talk alone, but uses a multipronged approach to make every day better for her patients.

“To make positive changes, you have to look at the good, the bad, and the neutral so you can approach life in a balanced manner,” she emphasized. “Self-care is important. You need to treat yourself well, but not at the expense of everything else in your life. It needs to be balanced with taking care of your emotions, your duties and the needs of the people you care about.”

Therapy can offer a lifeline. It’s not just people dealing with chronic mental health issues that can benefit from seeing a psychiatrist. Therapy can also help people dealing with situational depression or anxiety. Choose something you can control, then set a goal, focus on it and work toward reaching it.

For people who are dealing with more significant things like diagnosable depression and anxiety, simply trying to be positive likely won’t be enough.

“Some people need medication, some need therapy, some need both,” Dr. Acosta-Goldstein said. “For some people that means adding something to their life, whether it's volunteer work or a new job, or removing something from their life like extracurricular activities, social obligations, or things they're not really invested in but feel obligated to do. It's OK to let go of friendships that don’t serve you. It's OK to let go of job opportunities. It's OK to let go of being so hard on yourself.”

Small Steps, Big Changes

Goals can be for small changes, or bigger ones. Some people want to make seminal changes in their lives all at the same: lose 100 pounds, quit drinking, quit smoking, be fully compliant with medication management. That might work for one day, but it’s not sustainable and will ultimately lead to frustration. That will lead to increased anxiety and depression–a cycle that could be repeated over and over. The sustainable way to make big changes is to take small steps.

“Choose the thing that’s most important, then work to make that happen,” she said. “Once you’ve achieved success with that, the new goal becomes a habit. Spread out each step until you form a habit from each one, then move on to the next. The adage goes, ‘It takes three weeks to develop a habit,’ so don’t beat yourself up if you don’t have every goal mastered in a month. Give yourself time to fully focus on each step before you move on to the next.”

Great Expectations

For some people, goal setting to change behavior is second nature. Other people struggle to articulate what they want and need to change in their lives. That can be compounded when you add in mental or physical health challenges. It is especially challenging for people with well-meaning family or friends who offer advice.

“People with comorbidities–having a number of medical or mental health conditions–often have trouble separating themselves from their illnesses,” Dr. Acosta-Goldstein explained. “When a loved one, or a friend, offers their opinion about what these people should be focusing on or what they should be doing to 'fix' their lives, it exacerbates the problem. No one wants to hear what they’re feeling isn’t ‘normal,’ or that they should be able to change what someone else feels is wrong. What is normal for one person may not be for another–it’s an assumption that can derail attempts at real change.”

Working with a therapist can be very helpful to find small behavioral changes to counteract those maladaptive expectations. Sometimes, just talking with someone in a similar situation can help. For example, a new mother may feel she’s failing her child because she has no frame of reference as to what’s normal and what’s not in the first few weeks of a baby’s life. Her expectations may be founded on things she’s read online or seen on television. As she worries, her anxiety grows, and along with it, her sense of failure. It isn’t until she finally sees her obstetrician or the baby’s pediatrician or talks with friends who have been through the same situation that she learns she’s not alone and her situation is common–it’s her expectations that were not achievable.

To learn more about Dr. Acosta-Goldstein and other WTMF providers, visit www.mywtmf.com. To learn more about Psychiatry and Behavioral Sciences at WTMF, visit mywtmf.com/psychiatry