Winter Blues? Keep Exercising To Boost Your Mood

By Kacie Mitterando, LMSW

Do you struggle to exercise during the winter? The evidence says it’s super important to keep up your exercise routine throughout the colder months.

Weather and activity level have a synergistic and powerful impact on our mood. In one particular study, Bradley Cardinal (an exercise physiologist at Oregon State), observed a decrease in exercise during the colder months. Cardinal reports believing that this decrease is directly due to the environmental change (1). With depression and anxiety on the rise, it is a crucial time to discuss the impact our physical health has on our emotional and mental health.

While exercise and fitness have great external rewards, such as an increase in physical health and physique, the benefits exercise has outside of physical appearance can be drastically more significant.

Mental Health Benefits of Exercise:


1.      Exercise and depression: In the past few years, research has shown that exercise can help to reduce symptoms of mild and moderate depression in a similar effectiveness as antidepressants. Additionally, the maintenance of an exercise program can even decrease symptoms of depression long-term. Overall, exercise has a positive influence on hormones in the brain. After a period of increased activity the brain releases endorphins, which are a hormone linked to an increase in our overall mood and well-being. Interestingly enough, exercise can actually create new activity patterns inside your brain along with aiding in neural growth.

2.      Exercise and anxiety/stress: Exercise is considered one of the most effective forms of anti-anxiety treatment. By getting up and moving your body for 30 minutes a day, mental energy can increase and tension in the body can decrease. As a result, your body and mind can both feel more relaxed after a workout.

3.      Exercise and trauma: For those who have experienced trauma or even have a PTSD diagnosis, the physical symptoms experienced such as the “freeze” response developed in your nervous system can become debilitating. By paying close attention to the sensations in your body during exercise, such as the way your joints and muscles feel when they move, studies have shown that PTSD symptoms can be reduced (2).


OK, so you’re sold on the exercise piece, but what’s the next step?


1.      Find some form of working out that you love: If running is not an activity that you enjoy, then it is OK to not run. In fact, there are tons of different methods of exercise that can be just as effective. More importantly, the most effective exercise routine is the one that you enjoy. Try a spin, barre, pilates, OrangeTheory or CrossFit class! If these options don’t interest you, a simple internet and Pinterest search can give you some great lifting or at home workout routines.

2.      Start slow: Some of the positive mental health effects of an exercise routine will happen immediately! However, it can take around four weeks to begin to see longer-term changes in the brain. It’s important to not dive head first into working out and push yourself too hard. Start by adding in 1-2 days a week for 30 minutes and slowly add in an extra day with 5 more minutes, as you feel comfortable (3).

3.      Balance: Once you find a workout that you love and feel you’ve set a decent routine in place, the most pivotal piece is to place an importance on a balanced approach to working out. Remind yourself that it is OK to skip a day of exercise for a family event, or a work function. Exercise should only be adding to your life, not taking away. Additionally, practice shifting your thought process to focusing on the internal effects you receive from an exercise routine, such as improved sleep, mood, self-esteem and overall well-being!


1. How to Keep Working Out In The Winter. (n.d.). Retrieved from


2. The Mental Health Benefits of Exercise. (n.d.). Retrieved from


3. Why Exercise Is So Essential for Mental Health. (n.d.). Retrieved from

Rituals & How They Help Us Heal Anxiety

What Are Rituals?

Whether we realize it or not, all of us have rituals. Rituals are the perfect activity to relieve anxiety because they are the patterns that keep us feeling like we have some control over our daily lives. Rituals pre date religion as ways of forming structure around individuals and communities.

An incredible article by Nick Hobson outlining his research around rituals explains that [rituals differ from habits because] rituals are:

i) ceremonious, deeply meaningful acts that are shared between people and embedded in a system of historical/cultural significance, but also

ii) arbitrarily structured, highly repetitive set of action sequences that follow a rigid script.

Hobson’s research suggest that when we add a deep layer of meaning to our daily lives we are provided an extra layer of resilience from negative thinking. One amazing study Hobson references states that we are hardwired to pick up rituals even as infants.

Rituals are one of those mental tools we can use not only heal our lives but to thrive. Everyone from individuals struggling with anxiety to high performing athletes and performers can benefit from the conscious, meaningful attention rituals provide our lives.

“This is what rituals are for. We do spiritual ceremonies as human beings in order to create a safe resting place for our most complicated feelings of joy or trauma, so that we don't have to haul those feelings around with us forever, weighing us down. We all need such places of ritual safekeeping. And I do believe that if your culture or tradition doesn't have the specific ritual you are craving, then you are absolutely permitted to make up a ceremony of your own devising, fixing your own broken-down emotional systems with all the do-it-yourself resourcefulness of a generous plumber/poet.”
― Elizabeth Gilbert, Eat, Pray, Love

How To Develop Rituals in Daily Life -

  1. Focus on the cycles in your life. Everything from our daily calendar to our metabolism runs on a schedule. Most traditional medical systems know this and use it as part of their protocols. For example, according to Ayurvedic philosophy every hour corresponds with a different process taking place in the body. Without getting that specific we can very simply start to add sacredness to the different parts of our day by adding ritual. For example, gentle movement, prayer or meditation upon waking may serve as more therapeutic than immediately browsing your smart phone, Additionally, preparing for bed with breath-work and candles help prepare the body for restful sleep.

  2. Make Returning Home From Work Sacred. Many people come home from work and never get out of “work mode”. Rather than jumping on the phone, television or turning to alcohol, try giving yourself 10 minutes of self care independent of your loved ones. This might involve washing your hands, changing your clothes, deep breathing, sitting quietly or stretching. note The important part is that these things be done in quiet with the intention of leaving your workday behind.

  3. Spend Time In Nature. The research on time spend under trees is pretty significant. Nature provides endless opportunity for ritual. From simply sitting under cherry blossom trees (Japanese tradition called Hanami), to taking photos of nature, try finding your favorite way of honoring the plants that help us sustain life.

  4. Improve Your Relationship With Stuff. Japanese culture also provides lots of inspiration for making our relationship with objects very special. Self help author Louise Hay always reminded her audiences to thank their objects before using them. This simple habit can dramatically transform the way we work, shop, and live with stuff. For example, imagine thanking your credit card for being available with funds every time you used it. How might this change your relationship to shopping?

Want to chat about setting up rituals in your life? Schedule a free 15 minute phone consultation today!

Millennials Are Changing Mental Health at Work

According to an article by Forbes contributor Sarah Landrum, Millennials expect certain things from their work environment.  The title of the article, Millennials To Be The Most High-Maintenance In The Workplace, Landrum explains Millennials want to see companies –

  • Providing for their needs

  • Building a comfortable and welcoming work environment

  • Helping them improve their skill sets and become better overall global citizens

The golden thread connecting these three requirements is the idea of self-care. Landrum points out that Millennials are fully aware (and demanding of) the things that allow them to be self actualized. This is what preeminent psychologist Abraham Maslow would refer to as the highest level of psychological evolution for a human.

Essentially, Millennials REALLY value their mental health and are looking for ways to have it supported. Despite mental health being a top priority, depression is a big problem for Millennials at work.  According to a recent white paper published by HR leader Morneau Sheppell which reviewed depression in the workplace, 1 in 5 Millennials in the workforce today struggle with depression.  Additionally, the American Psychiatry Association found that Millennials are the most anxious generation to date.

While workplace culture struggles to catch up to the mental health needs of it’s employees, where do younger workers begin to get the support they need? Fortunately there are several things they can do right away to start to feel better.


Start With A Plan

When someone seeks mental health treatment, a therapist will start with an assessment and development of a plan. Whether or not someone has decided to access professional mental health services, a mental health plan can be a super helpful tool. Mental health plans include things like:

-        Setting up a daily schedule of self care. These can (and should be) simple things you can integrate into your day such as making time for lunch outside of the office and committing to leaving work in time to go to the gym. A therapist can help you overcome barriers to sticking to your daily self care routine.

-        Set goals to increase healthy pleasurable activities. Be mindful not to beat yourself up if you fall short of goals.

-        Work on improving your self talk. Using tools from Cognitive Behavioral Therapy (CBT) can help you become more aware of toxic inner criticism.

Be Open Enough to Get Support

While there can be some concerns about disclosing mental health issues in the workplace, there may be far more benefits.  First, an employer cannot make accommodations for a mental illness (which they are legally required to) if they are unaware it exists. Thinking of having a conversation with your employer is one thing you can ask your therapist to help with. In some cases they can assist you in understanding and advocating for your mental health rights.

Once you start a conversation, accommodations can include changes in one’s schedule to allow for therapy appointments, altering work assignments or providing physical accommodations in the office.

Utilize Resources

In an effort to make the use of Employee Assistance Programs more appealing, many companies are working with online providers of short term mental health services as we Abilto and Talkspace.  It may be helpful to have a fresh conversation with your human resources department about benefits you may have looked over during orientation.

If you have decided to seek out private therapy services, that process can also be extremely daunting. In metropolitan areas such as New York and LA there are a plethora of therapists to choose from which makes finding the right support system a full time job of it’s own.  New services such as My Wellbeing offer a fresh and easy approach by matching therapists through an easy online quiz.

Need to talk to someone? Schedule a Free 15 Minute Consultation with one of our clinicians today.

Anxiety Doesn't Mean You Are Weak

Generalized anxiety, panic, feeling a loss of control and the fear of the unknown can be terrifying experiences, especially if you’re facing it all on your own. Oftentimes anxiety is linked with the character trait of weakness, an inherent failure or flaw in one’s personality. With this notion, anxiety becomes something that needs to be hidden, suppressed, and dealt with behind closed doors.

Have you ever had any of these thoughts about your anxiety? 

“I need to fight through my anxiety.”

“No one can know I am suffering from this.”

“I’m their Dad, I need to protect my kids and they can’t know I go through this.”

“What would my friends think of me?”

If our boss had a panic attack at work they would probably be faced with eye rolls, a sense of distrust and quite possibly, shame. The notion that we need to be strong and un-phased by stress and anxiety has led to an underlining concept of anxiety as a flaw. However, there is dignity in accepting our anxiety and there is true strength in allowing ourselves to know our struggles and work through them constructively, rather than fight and battle them.

If we take a mental assessment of the people in our lives we may notice that some of the best friends, family members and co-workers we have also experience anxiety. Here’s why:

Vulnerability as strength

In recent studies done on anxiety, there has been a link discovered between anxiety and vulnerability. Vulnerability, being capable of exposure to emotional wounds can sound terrible. Mainly because when we think of being vulnerable we think of some terrifying emotions such as shame and fear. Despite this, when we become vulnerable, that is when we allow ourselves to become open to growth, change, love, and ultimately, positive change.


An anxious person, fearful of the failure that might come, can often be a planner and a very good one. For example, if you’re fearful that a birthday party or an outdoor event might be ruined by rain you may be likely to develop a Plan B that will come to the rescue if this were to fall true.  Therefore, if the negative were to happen, you have much less stress to deal with at the time of the event (1).


While those who suffer from anxiety may think they come across terribly, studies show that friends of those who suffer from anxiety are much more positive about their experience in the relationship (2).


You’re less likely to hurt someone else’s feelings when you’re hyper-aware of what someone else’s opinion or judgment may be on you. While taking the judgment or criticism from someone personally is not the goal, people who experience anxiety are mindful of the feelings and emotions of those around them and therefore, more likely to be mindful of their impact on one another.

Allow me to give you the permission to accept that it is OK you are suffering from anxiety, you are not alone, you are not a failure, and it is all right to ask for help.


1.     6 Hidden Benefits of Anxiety. (n.d.). Retrieved from

2.     The 8 Most Unexpected Advantages of Anxiety. (2016, October 16). Retrieved from




Denial of Toxic Love

By Brittany Dursi, LMSW

Denial. Denial. Denial.  What is it?  Could it be our mind claiming something to be untrue, even if the facts say otherwise? Maybe it’s a shield of defense when reality is too much to bear. Or possibly, it’s the fear of surrendering to the truth.  Whichever the case, denial is no stranger to us.  We all have used it in our own unique way: to cope, to avoid, to protect etc.   In love, denial is a common mechanism adopted to protect the relationship in times of distress.  For the time being it encases the relationship in a thin lining, a band aid for when we aren’t ready to clean the wound.

Often times, the foundation of consistency in a destructive relationship is the damaging and deliberate use of manipulation and abuse.  This creates a mask for the partner being victimized, losing parts of their identity.  They may constantly feel guilty when they actually did nothing wrong.  Depending on the relationship, some may report feeling as though they were never good enough for their partner: fighting for acceptance, fighting to prove they deserve them.  Some may feel a heightened sense of emotion, or absence of, due to their lack of control in the relationship and a decrease in self- worth.  Often times the relationship is priority over work, personal interests and family or friends.  So how could anyone stay in this?

Here’s the thing.  When we are faced with isolated and constant real or perceived threat, our body instinctively responds. Stress hormones are released, shutting off the part of our brain used to solve problems (prefrontal cortex) and we enter a stage of fight, flight or freeze. This is great if we are being chased by a lion, the problem is when our stress hormones are activated for too long.  Our brains naturally will put a threatening situation to the forefront and shut down everything that is not necessary for that threat.  If we are constantly feeling threatened by our partner, we are consistently in a state of fight, flight or freeze, making it impossible to function appropriately. 

If we are being faced with infidelity, abuse (physical, mental, verbal, emotional) confusion, lack of self-worth, fear, anxiety etc. it is too much for our brain to sort through.  Manipulation commonly becomes the focal point in destructive relationships, resulting in the vulnerable partner feeling dependent on the toxic one.  The threat also becomes the safety blanket in these relationships.  While we may be living in a state of constant intimidation and emotional distress, the moment validation, intimacy and acceptance is received it stimulates our reward system and we feel safe again, creating a debilitating cycle.  For example, maybe our partner cheats, the facts have been proven, and we become emotionally distressed.  They lie about it but begin to show interest and connectedness to us, we might choose to believe it, because in those moments, they are accepting us.   Somewhere in us we know it is not true but we push it so far down because denial is sometimes perceived easier than facing the facts

Facts are Facts are Facts

If there is concrete factual information, it happened. 

If your significant other hits you because you came home an hour later than expected but then cooks you a three course meal, it does not change the fact they hit you. 

If your significant other calls you cruel names regularly but will also spend quality time with you and makes you feel special, it does not change the fact they verbally hurt you. 

If your significant other is not loyal but will not admit the truth, it does not change the fact they betrayed you. 

If they are hurting you in any way and try to validate their actions based on something you have done in the past it does not change the fact they hurt you and chose to be spiteful. 

You are not to blame for their actions. You cannot alter facts.

Taming Negative Self Talk

Categories: Anxiety Counseling

By Kacie Mitterando, LMSW

7am: *alarm goes off* “annoying… snooze.”

8am: “I’m going to start the water now so it’s warmed up by the time I’m done brushing my teeth.”

8:30am: “This outfit looks ridiculous, next outfit!”

8:32am: “This one too…”

8:45am: “Great, now I’m going to be late, all because I couldn’t find an outfit.”

9:30am: “Whatever, I’m just going to get a bagel with cream cheese… I’ll start eating healthy tomorrow.”

Each morning when we wake up we follow a routine we have set in our subconscious that we don’t necessarily think about. Most of us don’t have to remind ourselves to do the daily tasks like brush our teeth and get dressed. In the majority of cases, that’s because after spending day after day with this routine, it has now become a habit for us. A habit is a behavior that occurs automatically, because it is something that has been performed frequently in the past (2). If we pay close attention we may realize that the self-talk we’re carrying throughout our day has become habit as well, and something we don’t even always notice is there.

Sometimes our self-talk is reasonable, right? It can tell us good things, like how excited we are for the weekend coming up or remind us to make a to-do list for the work week ahead of us. However, this isn’t always the case, because our self-talk can also remind us of the negative without us being aware of it.

Negative self-talk is defined as the expression of our thoughts and feelings. These negative thoughts and feelings are counter-productive and often times have the effect of demotivating ourselves (1). When we’re self-bullying with this negative talk each day, not only is it a runaway train, but it also opens the door for depression and anxiety to set in. While it may not be easy, there are ways in which we can begin to quiet that bully inside of our heads!

Steps to challenging negative self-talk:

As in many other areas of life, the first step is awareness!

Become aware of the voice inside your head when it is talking to you and focus on what it is saying. If you’re a person who likes to make lists and write, jot some of the self-talk in your head down on a piece of paper or in a notebook. Keep a daily or weekly log of your self-talk! Try and take time out of each and every day to focus on the voice inside your head, the good and bad, and the impact that this voice is having on your feelings.

Visualize this voice

What does this voice in your head look like? Is it a clone of you? Does it look like someone you wish to be or someone you don’t like? Put a face to the negative self-talk and even bring it one step further by giving the voice a name! If we imagine this voice as another person, will we still let it beat us up in the way that it currently is?

Reality Test

Try and think reasonably about the things that the voice inside your head is telling you. Is there hard-core evidence against some of the anxious thoughts in your head, or are these thoughts just your personal interpretation of the situation at hand? What would your best friend/mom/family member tell you about this situation?

Talk Back

Don’t be afraid to talk back to this inner voice! You can tell the voice (that now has a name) it needs to leave, or that you don’t care or believe what it has to say. Give yourself the power back that the negative self-talk has taken away from you.

Interested in learning more?

If you’d like to work together to challenge this negative self-talk, call 347.994.9301

1. Nugent, Pam M.S., "NEGATIVE SELF-TALK," in, April 7, 2013,

2. E. (n.d.). The Psychology of Habits: How to Form Habits (and Make Them Stick)., from