Catherine Nathan, 68, from Chennai joined my online yoga class last month. She had three issues: insomnia, knee pain and back problems. But her topmost concern was lack of sleep for which she had started taking small doses of Restyl.

Within a month of alternate day group yoga, all three problems are almost gone. She is happiest about being able to sleep better. Earlier she managed just three hours of disturbed sleep. Now, she sleeps around 10 pm, gets up around 2 pm to go to the washroom but then she goes back to sleep and wakes up around 6 am. Her sleep too is sound and much better.

Here are some simple asanas, pranayama, breathing and mantra practice.


1. Shashank asana: Shashank means moon in Sanskrit. Like the moon, it induces calming, cooling and a tranquilising effect. It is also good for anger and anxiety management. It improves the functioning of the central nervous system which ensures better communication between the brain and the various systems and organs of the body, resulting in better health and well being.

Shashank means moon in Sanskrit. Like the moon, it induces calming, cooling and a tranquilising effect. Shashank means moon in Sanskrit. Like the moon, it induces calming, cooling and a tranquilising effect.


· Sit in Vajrasana with the hands comfortably on the thighs. Close your eyes and relax your whole body. This is the base position.

· Inhale deep and raise your arms above your head in a straight line, shoulder width apart.

· As you exhale, bend forward from the hips, keeping hands, head and trunk of your body in a straight line.

· In the final position, the head and palms must be on the floor. If your spine is not flexible enough, then just go down as much as possible. Do not strain or force yourself into the final position. With practice it will happen.

· Remain in the final position for at least five seconds, holding the breath outside. If that is not possible then you can hold the position for five rounds of breathing and breathing out.

· Inhale and raise your hands, head and trunk all together just as you did while bending.

· Come back to the base position and relax.

· This is one round. Begin with three rounds and build it up to five rounds.

Caution: Those with high BP, slip disc, vertigo or upper back problem must not practise this asana.

2. Breath awareness: This is very simple and can be practised by all along with the yoga practice or anytime. Those suffering from chronic insomnia must practise this before sleeping, either sitting or lying down on your back on the bed. It helps create thoughtlessness. It evens the breathing which relaxes the whole body-mind system. It helps shut out the outside world and its problems, worries and chain of never ending thoughts. This helps in inducing sleep.

Do not try to manipulate or do deep breathing. Just watching the normal natural flow of breath should be the attempt Do not try to manipulate or do deep breathing. Just watching the normal natural flow of breath should be the attempt

Practice: Whether sitting or lying down, just close your eyes and bring your awareness to your nostrils and watch each and every inhalation and exhalation. Do not try to manipulate or do deep breathing. Just watching the normal natural flow of breath should be the attempt. It’s not easy because the mind wanders off to other things. Then one has to keep getting it back to just observing the flow of each and every inhalation and exhalation.

3. Shambhavi Mudra: This directly impacts the pineal gland which releases melatonin hormone responsible for inducing sleep. The chanting cleans up the sub-conscious and unconscious thus resolving deep, hidden conflicts, fears. A combination of these two powerfully impacts your sleep and wake cycle. Anyone can practise this.

Shambhavi Mudra directly impacts the pineal gland which releases melatonin hormone responsible for inducing sleep. Shambhavi Mudra directly impacts the pineal gland which releases melatonin hormone responsible for inducing sleep.


· Sit comfortably crossed legged, on a chair or a bed. If you have back problems, you can rest your back against the bedpost or the wall.

· Close your eyes and relax your whole body.

· Practise breath awareness for 5-6 rounds of inhalation and exhalation.

· Take a deep inhalation and as you exhale internally, mentally chant Om…A-O-M

· Then internally hitch your awareness on the eye-brow centre behind which is located the pineal gland thus activating it.

· You can chant Om 11 or 28 times.

4. Bhramari pranayama: This is again an excellent simple practice for relaxing the mind. It can be practised before sleeping. It directly impacts the brain and releases stress, cerebral tension and controls anger, anxiety all which directly impacts insomnia. It also impacts the healing capacity of the body.

his directly impacts the pineal gland which releases melatonin hormone responsible for inducing sleep. Bhramari pranayama is an excellent simple practice for relaxing the mind.


· Sit in any comfortable position.

· Plug your ears with your finger.

· Take a deep inhalation and as your exhalation say an Om but with a short first and second syllable, that is A and O, then prolong the last syllable M as long as possible, creating a humming sound inside your head as you keep exhaling.

· This is one round. Do five to ten rounds.

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The Department of Exercise and Sport Sciences at Metropolitan State University of Denver is offering for the first time a two-credit scholarship for students committed to the Korean martial art of taekwondo.

For those interested in less aggressive ways to stay fit, the department offers Yoga for Anxiety classes and has received a minigrant to give students exercise watches that track their activity levels outside of physical-wellness classes.

The two programs are part of a broader effort to help students, who are often stressed out, connect exercise with better mental health. Through its Physical Activity and Lifetime Wellness Program, the department offers several classes that not only consist of physical exercise but also include mental-health aspects to help students, many of whom are juggling classes, jobs and other responsibilities.

“The benefits of physical activity on mental health, sleep, stress levels and self-confidence are well documented,” said Susan Bertelsen, Ph.D., professor of Exercise Science. In addition to the emotional lift from exercise, she added, the hope is that students learn how to incorporate healthy changes into their behavior to lead healthier lives.

MSU Denver instructor Svetlana Lambrozo
MSU Denver instructor Svetlana Lambrozo will be teaching Yoga for Anxiety Management and Yoga for Weight Loss during the summer semester. Photo by Alyson McClaran

Almost nine in every 10 college students say academic challenges affect their mental health, but only four in 10 believe their school is doing enough to support them.

The American Psychological Association says traditional counseling is ill-equipped to handle a surge in demand for students’ mental-health care. Between coursework, relationships, economic strain and the pandemic, students are facing an array of unprecedented challenges, forcing colleges and universities to think creatively to help students.


Better known for developing fighting skills, taekwondo has a lot of benefits similar to yoga. Developed in Korea in the 1940s and ’50s, the martial art can help students reduce stress and anxiety by practicing deep breathing, meditation and mindfulness. Other benefits include emotional regulation, increased self-esteem and personal development.

But taekwondo offers something that yoga doesn’t: screaming and breaking boards.

Bill Pottle, affiliate faculty member in Exercise Science and Physical Activity, tells his students to imagine a board as something they’re struggling with.

“When they break through it, there’s so much relief because they’ve actually shattered the physical manifestation of things that they’re trying to break through in their regular outside lives,” Pottle said.

Ayantu Yemane breaks a wood board in class.
MSU Denver student Ayantu Yemane practices breaking a wood board in taekwondo class. Mental-health benefits of taekwondo include emotional regulation, increased self-esteem and personal development. Photo by Polina Saran

MSU Denver’s taekwondo program started in 1966, making it one of the oldest for-credit taekwondo programs in the United States. The donors of the new two-credit endowed taekwondo scholarship “have a lifelong commitment to and passion for the sport and wish to create an opportunity for students to share that focus,” according to a description on the application page. The deadline to apply for the fall semester is Sept. 14.

Yoga for anxiety

For those not interested in using their fists and feet to reduce stress, the University has for many years offered yoga classes.

In 2018, the school offered for the first time a Yoga for Anxiety course developed by Bertelsen and Svetlana Lambrozo, affiliate faculty member in Exercise Science and Physical Activity, who has taught at the school since 2006. Lambrozo noticed in 2017 that students were struggling with their anxiety levels more than in previous years.

“All of a sudden, more and more students were coming to my classes and sharing that they have anxiety,” Lambrozo said. “And then, I also started doing some research on what’s really happening in the world, and I realize it’s not only my students, it’s at every campus.”

RELATED: Can yoga help with depression?

Lambrozo’s classes help with anxiety by focusing on awareness and encouraging students to communicate with one another, practice the power of positive thinking and set goals for themselves.

“When I turned to yoga before my senior year, I was near a breaking point because of everything going on,” said Garvin Pruneda, who graduated from MSU Denver in May with a degree in Cybersecurity.

“Full-time work and school schedules, while trying to find postgraduate employment and internships throughout, (and) dealing with the more significant issues at large in society,” he said after taking three yoga classes at MSU Denver with Lambrozo. “Yoga made my senior year much less stressful and more enjoyable.”

MSU Denver yoga instructor Svetlana Lambrozo
MSU Denver yoga instructor Svetlana Lambrozo’s classes help with anxiety by teaching students awareness, communication, the power of positive thinking and goal-setting. Photo by Alyson McClaran

Making it accessible

Fewer than 50% of college students are meeting the physical-activity guidelines set by the U.S. Department of Health and Human Services. Helping students better manage stress has been shown to increase their chances of staying in school, said Bertelsen. Yet for many, finances and cramped schedules make it hard to take the needed steps.

MSU Denver students are more likely to not get enough exercise, considering that 87% are working. That doesn’t leave much time to include exercise in their already-sleep-deprived schedules.

RELATED: 7 tips for a healthy morning routine

The taekwondo scholarship will help minimize the cost barrier for some students, and Bertelsen also recently received a small grant to give students fitness watches that track movement for one or two classes during the fall semester, though which ones have yet to be determined. The hypothesis is that the watches encourage students to be more active throughout the day, not just during their physical-wellness classes.

Additionally, the department has started offering more movement classes online.

“There’s socioeconomic barriers that our students face,” Bertelsen said. “They can’t be on campus all day and take as many classes as they want, so we need to break down those barriers.”

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Update Date: May 16, 2023 12:23 PM EDT

Anxiety is a common experience for many people. It can be triggered by a variety of things, such as work stress, relationship issues, or health concerns. While there are many DIY anxiety management practices that can help alleviate symptoms, sometimes these methods may not be enough. If you've tried these practices and still find yourself struggling with anxiety, it's important to know that there are other options available to you.

In this post, we'll explore what to do when DIY anxiety management practices aren't effective. We'll discuss the signs that indicate you need additional support and suggest some alternative approaches that may be helpful.

Two Common Signs Your DIY Anxiety Management Practices Aren't Working

It's normal to experience anxiety from time to time, but if your symptoms persist or worsen despite your best efforts, it may be time to seek additional support. Here are some signs that your DIY anxiety management practices may not be working:

  • Your anxiety is interfering with your daily life: If your anxiety is making it difficult to complete daily tasks, maintain relationships, or enjoy activities you used to love, it may be a sign that your symptoms are too severe to manage on your own.

  • You're experiencing physical symptoms: Anxiety can cause physical symptoms such as headaches, muscle tension, and digestive issues. If these symptoms are persistent or severe, it's important to seek medical attention to rule out any underlying health conditions.

Alternative Approaches to Managing Anxiety

If your DIY anxiety management practices aren't effective, there are several alternative approaches you can explore. Here are some options to consider:

  • Mindfulness practices: Mindfulness practices such as meditation, yoga, and deep breathing can help reduce anxiety symptoms by promoting relaxation and reducing stress. These practices can be done on your own or with the guidance of a teacher.

  • Lifestyle changes: Making lifestyle changes such as getting regular exercise, eating a healthy diet, and getting enough sleep can help reduce anxiety symptoms. These changes can be made gradually over time and can have a significant impact on your overall well-being.

When to Seek Professional Help

If you're experiencing severe anxiety symptoms or if your symptoms are interfering with your daily life, it's important to seek professional help. Here are some signs that it may be time to seek professional support:

  • You're experiencing panic attacks: Panic attacks are sudden, intense episodes of fear that can be accompanied by physical symptoms such as chest pain, rapid heartbeat, and shortness of breath. If you're experiencing panic attacks, it's important to seek medical attention.

  • You're experiencing suicidal thoughts: If you're experiencing suicidal thoughts, it's important to seek immediate help. You can call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text HOME to 741741 to connect with a crisis counselor.

  • You're using substances to cope: If you're using alcohol or drugs to cope with your anxiety, it's important to seek professional help. Substance use can worsen anxiety symptoms and can lead to addiction and other health issues.

When seeking professional help for anxiety, it's important to find a healthcare provider who has experience treating anxiety and who you feel comfortable working with. This may involve seeing a primary care physician, a therapist, or a psychiatrist. It's also important to discuss any concerns you have about medication or therapy with your provider to ensure that you receive the most appropriate treatment for your needs.

In addition to seeking professional help, it's important to continue practicing self-care and healthy lifestyle habits. This may involve making time for relaxation and self-reflection, staying active, eating a balanced diet, and getting enough sleep. These practices can help support your overall well-being and may help reduce anxiety symptoms over time.

Managing anxiety isn't always as simple as meditating, exercising, and eating a healthy diet. If you've tried self-help methods to cope with no such luck it's important to seek additional support. This may involve exploring alternative approaches such as therapy, medication, mindfulness practices, lifestyle changes, or support groups. If you're experiencing severe anxiety symptoms or if your symptoms are interfering with your daily life, it's important to seek professional help. Remember, there are many options available to you, and with the right support, you can manage your anxiety and improve your overall well-being.

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As professionals, we are expected to perform at our best every day, even when we face challenges or setbacks. However, life can be stressful, and work-related pressures can take a toll on our mental health, leaving us feeling overwhelmed and burnt out. The good news is that there are many ways to build emotional resilience, and one effective method is mindfulness meditation.

Mindfulness meditation involves paying attention to the present moment without judgment. This practice can help us become more aware of our thoughts, emotions, and physical sensations, enabling us to manage them in a healthier way. Studies have shown that regular mindfulness practice can reduce stress, anxiety, and depression, and improve cognitive function, emotional regulation, and overall well-being.

While mindfulness meditation can be practiced anywhere and at any time, it can be challenging to maintain a regular practice without external support. This is where mindfulness apps can be helpful. Mindfulness apps are designed to provide guided meditations, mindfulness exercises, and other resources to help users cultivate mindfulness and improve their mental health.

There are many mindfulness apps available on the market, each with its unique features and benefits. Some apps offer free content, while others require a subscription. Some apps focus on specific areas, such as stress reduction, sleep improvement, or workplace productivity. Here are some of the most popular mindfulness apps for promoting emotional resilience in the workplace:

  1. Headspace: This app offers guided meditations, breathing exercises, and mindfulness practices for stress reduction, anxiety management, and sleep improvement. The app also has a feature called "Headspace for Work," which provides workplace-specific content to help employees stay focused, productive, and resilient.
  2. Calm: Calm offers guided meditations, sleep stories, and relaxation exercises to reduce stress, improve sleep, and boost overall well-being. The app also has a "Calm for Business" program that provides mindfulness and wellness resources for employees and employers.
  3. Insight Timer: This app offers a vast library of guided meditations and mindfulness practices from various teachers and traditions. The app also has a timer function for unguided meditation and a community feature for connecting with other meditators.
  4. Ten Percent Happier: This app offers guided meditations, courses, and talks on mindfulness and meditation from leading experts. The app also has a "Ten Percent Happier at Work" program that provides workplace-specific content to help employees manage stress, build resilience, and improve performance.
  5. Smiling Mind: This app offers mindfulness meditations and activities for individuals, schools, and workplaces. The app focuses on promoting positive mental health, reducing stress and anxiety, and improving sleep and focus.

Mindfulness apps can be an effective tool for promoting emotional resilience and improving employee well-being. By providing guided meditations, mindfulness practices, and other resources, these apps can help employees manage stress, reduce anxiety, and build resilience. If you want to learn more about mental health and well-being in the workplace, please submit the contact form on the Corporate Wellness Magazine website, and our team will be happy to assist you.

It is worth noting that while mindfulness apps can be a great addition to a workplace wellness program, they should not replace professional mental health treatment or therapy. If an employee is experiencing severe or persistent mental health symptoms, they should be encouraged to seek help from a mental health professional.

When introducing mindfulness apps to employees, it is essential to provide adequate training and support to ensure that employees use the apps effectively. This may involve offering workshops, webinars, or individual coaching to help employees understand how mindfulness meditation works and how they can integrate it into their daily routine.

Incorporating mindfulness meditation into a workplace wellness program can have several benefits, including improved employee well-being, increased productivity, and reduced healthcare costs. By promoting emotional resilience and stress management, mindfulness meditation can help employees cope with work-related pressures and maintain a healthy work-life balance.

Promoting emotional resilience is crucial to maintaining a healthy workplace environment. Mindfulness apps are an effective tool for improving employee well-being by providing guided meditations, mindfulness practices, and other resources. By incorporating mindfulness meditation into a workplace wellness program, employees can develop the skills they need to manage stress, reduce anxiety, and build resilience. To learn more about mental health and wellness in the workplace, please submit the contact form on the Corporate Wellness Magazine website.

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Long COVID is a complex condition that is still not fully understood. According to the Department of Health and Human Services (opens in new tab), the working definition of long COVID is "signs, symptoms and conditions that continue or develop after initial COVID-19 or SARS-CoV-2 infection." These can affect many organ systems and last for weeks, months or even years.

Dr. Maureen Baker, the chief medical officer at digital care platform Healthily (opens in new tab) and the former chair of the Royal College of General Practitioners in the U.K., told Live Science that understanding what causes long COVID is crucial to helping people manage their symptoms. 

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One of the most common symptoms menopausal women face is hot flushes.

But apart from associating them with menopause, which occurs when periods stop due to lower hormone levels, not everyone realises that hot flushes are not only caused by fluctuating levels of oestrogen - stress can be a big factor too.

To mark World Menopause Day on 18 October, Vitaminology nutritional therapist Sally Duffin explains what causes hot flushes and the triggers to avoid.

"Whenever we experience stress and anxiety, our bodies switch into the 'fight or flight' response," she stated. "The brain instructs the adrenal glands to release the stress hormones cortisol and adrenaline which have a number of effects on breathing and circulation. This rush of blood towards the extremities can also cause vasomotor symptoms like facial flushing and hot flashes."

Duffin noted that anxiety is associated with an increased risk of experiencing menopausal hot flashes because of the combined effect of stress and hormonal fluctuations.

"Practising stress reduction and anxiety management techniques can be especially helpful during perimenopause and menopause," the expert continued.

As for managing hot flushes, Duffin recommended considering whether certain foods or drinks are having an impact on health and wellbeing.

"From a nutritional perspective, cut out caffeine, spices, and alcohol for a few weeks to see if it makes a difference to your hot flashes. Keeping a food diary can help identify other potential food triggers," she added.

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Mental Health Day 2022: Here Are Expert Tips To Tackle Anxiety In Students

Mental health day 2022: Expert tips to tackle stress

New Delhi:

World Mental Health Day 2022 is celebrated annually on October 10. Mental Health Day, recognised by the World Health Organisation (WHO), is also a chance to talk about mental health in general, how to look after it and how important it is to talk about things and get help if one is struggling. The theme of 2022's World Mental Health Day, set by the World Federation for Mental Health, is ‘Make Mental Health And Wellbeing For All A Global Priority’.

In this fast-paced world, where students are struggling to fit into the competitive environment, managing anxiety as a skill should be taught to each student. Anxiety management begins with understanding that it is not only something we experience in our minds but it has physical consequences as well, usually leading to a two-pronged approach that targets both these aspects.

Read More || On World Mental Health Day 2022, Here Are Experts' Take On Mental Health Of School Students

One of the easiest and most effective ways to tackle anxiety, Divyang Sharma, PeakMind Expert says, is learning some form of deep breathing. Deep breathing helps to slow down the heartbeat leading to reduced physical effect of anxiety.

“We recommend Box breathing, as it has proven to be highly effective. Having a list of positive self statements like ‘I am a hard worker, I learn from my mistakes etc’ help students keep a positive mindset,” the expert added.

Scheduling their day also allows the students to focus their attention on the work instead of worrying about what to do next is also one way to reduce stress among students and develop mental health, Mr Sharma added.

Helping the students plan and create their schedules, providing words of encouragement, appreciating the efforts of the student and having an open and constructive line of communication are also some of the ways parents and teachers can help support students in managing anxiety.

Sharing some strategies as to how students can manage anxiety Dr Ranjan Bhattacharyya (Psychiatry) said that taking a balanced diet, doing regular exercises, maintaining hobbies, offline peer interactions and restricting use of social media and online activities can work wonders. Regular exercise Dr Bhattacharya adds secretes ‘feel good’ neurotrophic factor endorphin.

World Mental Health Day 2022: What Parents Can Do To Check Anxiety Among Children

  1. Parents should be friendly
  2. A careful observation about the activities and behavioral symptoms.
  3. Knowledge about features of drug-seeking behaviors and withdrawal symptoms.
  4. No belittling, scolding, making critical comments or giving physical punishments or abusing verbally their children
  5. Positive reinforcements, non-materialistic rewards like patting, hugging, kissing and/or encouraging their children
  6. A word of appreciation can do a miracle

Shalini Sharma, Counselling Psychologist and Therapist at Plaksha University said that over the past few years, mental health has become one of the biggest concerns amongst students. In fact, she added, the recent survey by NCERT shows that 81 per cent students attribute studies, exams and results as major causes of anxiety.

“As an institute dedicated to nurturing the leaders of tomorrow, we strive to introduce initiatives specifically to address the well-being of our students and help elevate constructive mindsets. As part of our wellbeing initiatives, we have been conducting group sessions regularly to build ‘Emotional skills’ of students on significant themes including handling transitions, understanding emotions and building up coping skills. Along with individual therapy sessions, we have initiated an ‘Emotions Lab’ for brief experiments and discussions on topics like attitudes, perceptions, emotions, grief and anxiety,” Dr Sharma added.

The mental health conditions in students can result in the form of lack of interest, absenteeism, withdrawal from social interaction, and loss of productivity. To address issues of mental health among children, Saurav Kasera, co-founder of CLIRNET said: “Providing expert counseling and therapy in a safe and confidential environment in a digital environment (Zoom/WhatsApp) has been a big help as it removes the stigma and brings flexibility and convenience. Positive content, Social and Emotional skills development, and self-help digital tools (self-assessments, guided visualization, mindfulness and breathing activities, expert videos, etc) are proving to be a big help.”

The presence of digital characteristics like mental health screening games, telepsychiatry, teleconsultation, digital therapeutic approaches, virtual clinical support, online peer support forums, personal health trackers and wellness meditation is being explored through digital mental health startups for personalizing mental health care for students’ wellbeing.

e-MANAS is one such application to augment adverse impacts on mental health. Originally launched on April 14, 2021, by the Government of India, it stands for digital Mental Health and Normalcy Augmentation System (MANAS). The app is currently working to develop its multi-lingual functionality and integration with various public health schemes like the National Health Mission (NHM), Poshan Abhiyan and e-Sanjeevani.

MINDS Community Mental Health Worker (CMHW), Muskurayega India, Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Project and Atmiyata are some of the other platforms for better managing stress, anxiety, and depression.

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According to various etymological studies, the origin of the terms “gut feeling” or “follow your heart” is accredited to the vagus nerve. The neurons lining your gut or intestine communicate with the brain via the vagus nerve, which also passes through your chest (hence the latter phrase about the heart). Being the longest nerve in the body, the vagus connects your brain to your large intestine.

When you’re stressed, your heart rate shoots up. Hormones like cortisol and adrenaline then start coursing through your body, which negatively affects your physical and mental wellbeing. If you let this happen frequently, it can cause chronic illnesses like anxiety, diabetes, mood swings, gut inflammation, and many others. In other cases, the nerve may also start dysfunctioning as you age.

The good news is that there are many ways to relieve stress by stimulating your vagal nerve regularly.

Benefits of a Higher Vagal Tone

The vagal nerve is a part of the parasympathetic or your ‘rest and digest’ nervous system. Hence, it plays a pivotal role in ensuring good mental health. A higher vagal tone helps in stress and anxiety management, keeping you from reacting dangerously in problematic situations.

When you maintain good vagal nerve health, your mood stays uplifted more often, mental health is regulated, which in turn enables you to maintain healthy interpersonal relationships with your peers and family members.

It also helps you sleep well and recharge. Matthew Walker, Founder-Director of the Centre for Human Sleep Science, has extensively covered all the benefits of sound sleep on humans beings in his book titled ‘Why We Sleep’.

To help you maintain good vagal tone and gain control over stress, we’ve put together some really effective and easy methods below.

Deep and slow breathing

When you slow down your breathing and take long and intentional breaths, your heart rate also slows down and blood pressure lowers. This relaxes your muscles, which then enables the vagus nerve to send signals to your brain indicating you are safe.

Normally, our breathing cycle involves ten to fourteen breaths every minute. Cut this down to six breaths a minute and watch yourself lose the stress to significant levels. You can even try holding your breath for up to four slow counts every time you inhale or exhale. Regular practice of this equips you with a safe and quick technique to calm down when you feel stressed out.

Humming Or Chanting

Research indicates that singing, humming or chanting ‘Om’ and even gargling can help activate the vagus nerve since it is connected to the vocal chords and also the muscles behind your throat. This increases your heart rate and hold on, yes, increased heart rate in this situation is good because these rhythmic activities again help in increasing your vagal tone.

Regular consumption of specific probiotics

Certain probiotics contribute in maintaining a good gut, which means enhances gut to brain interaction. They help in ensuring there’s ample amounts of ‘good bacteria’ in your gut which in turn improves brain function. However, you must consult your physician before deciding on which probiotics you should start taking.


This is the most-advised routine by any medical practitioner to those wanting to improve their mental wellbeing. Not only does exercise increase your brain’s growth hormone or GH, it’s also known to stimulate the vagus nerve.

Weight lifting twice or four times a week, sprinting twice a week, brisk walking for thirty to sixty minutes every day are all known to stimulate your vagus nerve. You could also choose a sport and play it regularly to promote vagal tone. However, do not over-train or over-exhaust your body with excessive exercise. Always keep it moderate and listen to your body when it tells you to stop.

Sudarshan Kriya and Yoga

A combination of simple yogasanas and meditation, sky yoga or Sudarshan Kriya is a breathing technique that stimulated the vagus nerve and eliminates toxins from the body. The rhythmic breathing during SKY yoga has been scientifically proven to aid in curing symptoms related to Post Traumatic Stress Disorder, panic attacks, stress, and depression.


A quick technique to feel calm and relaxed after a stressful event, meditation also stimulates the vagus nerve. There are several apps available in the app markets to help you get into a state of meditation without much effort. No matter where you are, meditation is a strong tool to help stimulate vagal activity and release stressful emotions.

Cold compress or immersion

Exposure to cold is proven to activate cholinergic neurons that pass through the vagus pathways. A cold shower when you feel stressed or even immersing your face in cold water can instantly reduce your ‘fight or flight’ response. You could also try switching to cold water during the last minute or 30 seconds of your hot water shower.

Regular massage

According to research, good massages taken regularly help increase your vagal tone. Foot reflexology, facial massages, gentle stressing on specific points during a back massage, all contribute towards elevated vagal activity. Be sure to include massages in your self-care routine!


That’s right! Laughing more often on a regular basis ensure good vagus nerve health. Surround yourself with peers who you can have a good laugh with and avoid those who weigh you down with their negative energies. Make a playlist of fun podcasts or feel-good shows that will make you laugh and listen to them or watch them in your free time. It’s the best way to relieve stress instantly.

The vagus nerve is a dual-branched cranial nerve responsible for the most vital functions of the body like digestion, immune response, regulation of the heart rate, breathing, taste and so on. But most importantly, the vagus nerve helps regulate your stress response. Although it’s an issue that starts mentally, stress can be detrimental to your physical well-being since it reduces the body’s healing capacity and makes it difficult to decrease pain. These methods to promote vagal tone will help you stay focussed and ensure your holistic wellbeing in the long run.

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SAM (self-help for anxiety management)

This app is designed to help control your emotions. Unlike the last app, you don’t need to create an account to use this. It also has a rating of your anxiety but is a bit more in-depth. It rates your feelings, thoughts, avoiding things you fear and unpleasant physical sensations. It also tracks this on a graph so you can monitor your anxiety. It has short meditation recordings, but there aren’t a lot of them so you could easily work through them all. It also has thought bubbles where you record what makes you anxious. I couldn’t understand how to add to the anxiety toolkit. I found the app very simple in presentation and approach. It would be good as a starting point but I would soon get bored with it. The only thing I enjoyed about it is the idea behind tracking your anxiety, I found this useful.

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Did you know that a growing body of research has shown that yoga can improve focus, memory, self-esteem, academic performance, and classroom behaviour and even reduce children’s anxiety and stress?

With so many benefits, it makes sense then, that parents would want to encourage their children to do yoga – either as a hobby or as a daily de-stress activity.

What is yoga?

Originating in India, yoga (meaning union or yoke) is the practice of accessing and integrating all aspects of our true nature – body, mind, and spirit – in the pursuit of inner harmony.

Various styles of yoga combine physical postures, breathing techniques, and meditation or relaxation.

While some yoga poses are more suited to adults, several more poses are easy for children to do, too.

Why yoga for kids?

Yoga is not just for adults! In fact, it can give children critical life skills that can help them succeed in the world.

  • Yoga aids youngsters in anxiety management. The breathing exercises and relaxation techniques gained from yoga can assist children in managing stress.
  • Yoga helps emotional regulation in children. It teaches them to remain in the present moment while relaxing and achieving a serene frame of mind, so improving their emotional regulation.
  • Yoga can do wonders for children’s self-esteem. Young children might gain personal strength by perfecting a pose or enhancing their balance and flexibility.
  • Yoga enhances body awareness and mindfulness. Children learn about their bodies and the movements they are capable of by performing various yoga positions.
  • Yoga improves concentration and memory in children. One of the most significant advantages of kids’ yoga is that the varied poses require children to concentrate and work on their memorisation skills, which can transfer to improved academic success.
  • Yoga increases the strength and flexibility of children. Yoga strengthens children’s growing bodies and improves their flexibility, hence decreasing their risk of injury.
  • Yoga teaches self-control and decreases impulsivity. Yoga can minimise disruptive classroom conduct by offering a physical outlet for children’s expression. As they struggle to clear their thoughts and perfect their poses, yoga also teaches children about discipline.
  • Yoga appears to be a promising way to assist with weight loss and management in children who are overweight or obese.

How to get your child excited about yoga

Tamsin Putter, a certified yoga instructor who teaches yoga and is the founder of Yogafull, recommends making yoga playful and fun for kids in the classroom or at home. In her yoga classes, Tamsin weaves in fun games and stories with positive themes like compassion, gratitude, and strength.

“Many kids nowadays battle with extra pressures at school and online that adults didn’t have to deal with back in the day. Yoga can bring them a certain sense of calm and assists in grounding kids, bringing them back to the present moment by helping them focus on their breath and giving them a break from the hours of screen time they endure,” says Tamsin.

“The joy and peace yoga can bring into a child’s life is extremely beneficial; all children could reap the rewards. Moving the body into various poses helps kids focus on what they are doing in the present moment and brings a sense of stillness. It can also be great fun trying to get your body into different shapes while laughing and releasing endorphins. Practising various pranayama (breathing techniques) also helps centre children and teaches them to be quiet and to focus on their breath. This is a valuable tool they can use in the future when they find themselves in stressful situations. It is important to teach children from a young age how to deal with the pressures of life, and yoga can healthily imbue that sense of calm.”

Yoga brings children peace in a fast-paced world

Tamsin continues to say that it is challenging to define in words how much yoga can improve our sense of wellbeing.

“I can only speak from personal experience as a plus-size yoga instructor and say that I wish I could have found yoga when I was a child. Yoga has the most incredible way of teaching us to love and appreciate our bodies; it shows us our strengths and weaknesses and allows us to improve from a place of love. It can drastically improve your self-esteem as you patiently practise the poses and feel yourself getting stronger. It will give them a certain sense of pride and confidence when they finally start achieving the poses they have been practising.”

The health benefits of yoga for kids of all ages
Tamsin Putter, a certified yoga instructor, demonstrates the child-friendly half lotus pose (Ardha Padmasana).

What yoga poses are suitable for kids?

Here is a list of 10 great yoga poses for kids to do:

  1. Easy sitting pose (Sukhasana)
  2. Child’s pose (Balasana)
  3. Half-lotus pose (Ardha Padmasana)
  4. Cobra pose (Bhujangasana)
  5. Wide-angle seated forward Bend (Upavistha Konasana)
  6. Seated forward fold (Paschimottanasana)
  7. Butterfly pose (Baddha Konasana)
  8. Tree pose (Vrksasana)
  9. Warrior I (Virabhadrasana I)
  10. Corpse pose (Savasana)

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This list is about the Best Tips To Tackle Anxiety. We will try our best so that you understand this list Best Tips To Tackle Anxiety. I hope you like this list Best Tips To Tackle Anxiety. So lets begin:

Table of Contents: Best Tips To Tackle Anxiety

We all experience anxiety at some point in our lives, from simple annoyances like traffic jams to more serious concerns like a loved one’s terminal illness. Stress floods your body with hormones, regardless of the cause. Your heart beats faster, your breathing quickens, and your muscles tense. This so-called “stress response” is a natural reaction to stressful events that has evolved over time to help us resist dangers like animal attacks and floods. Today, we are rarely exposed to these types of physical threats, but stressful situations in everyday life can trigger the stress response.

We cannot, and would not want, to avoid all sources of stress in our lives. However, we can learn to respond to them in healthier ways. Techniques to avoid and minimize stress. The opposite of the stress response is the relaxation response. It is a deep state of relaxation that can be induced in a variety of methods. With consistent practice, you will develop a reservoir of calm that you can draw on when you need it. The relaxation strategies listed below can help you elicit the relaxation response and reduce anxiety.

Here is the list of the best tips to combat anxiety

try yoga

If you have ever noticed that people who practice yoga seem to be less stressed, it could be due to the physical impacts of yoga. Yoga focuses on the breath to unite the mind and body. Your body may begin to feel more relaxed as a result of this procedure. Many of the benefits of yoga appear to be based on lowering cortisol and blood pressure, which can help the body cope with stress.

get enough sleep

There is a two-way relationship between sleep and anxiety: According to the American Anxiety and Depression Association, anxiety can cause trouble sleeping (ADAA). Anxiety can be exacerbated by lack of sleep. The average adult needs seven to nine hours of sleep a night. The National Sleep Foundation recommends following a consistent routine that includes going to bed and waking up at the same time each day to get more sleep.

Connect with nature

Spending time in nature is beneficial for both the body and the mind. Helps reduce worry, anxiety and stress. Natural beauty helps us feel good by distracting us from our problems. According to studies, spending time in nature or simply viewing nature scenes reduces anger, fear, and tension while increasing positive feelings. Nature not only improves your emotional well-being, but also improves your physical well-being by reducing blood pressure, heart rate, muscle tension, and the generation of stress chemicals.

connect with friends

We live in a digital age where we may be tempted to use phones and computers to replace face-to-face contact, especially if we feel vulnerable. Humans, on the other hand, are social beings who need to feel supported, appreciated, and connected. According to studies, being socially connected leads to greater happiness, better health, and a longer life. Helps relieve emotions of loneliness and isolation.

Make a list of people you can go to. You should make an effort to communicate with these people on a regular basis, as you trust that they will help you. Contact them and request special assistance. It’s important to remember that your friends can’t read your mind and it’s unreasonable to expect them to. If you are striving to achieve a goal, such as overcoming anxiety or depression, having someone to report to and hold accountable can make all the difference. When someone else is aware of her goal or task and sets a time to report back to her, she has a much better chance of forming new habits, completing tasks, and achieving goals.

Manage social media time

Spending time on social networking sites can be stressful, not only because of what we see there, but also because the time you spend there could be better spent chatting with friends, going out and enjoying the weather, or reading a good book.

focus on the breath

Simply focusing on your breathing or changing the way you breathe can significantly reduce your overall stress level. In just a few minutes, breathing methods can calm your body and mind. The best part is that no one will notice you’re making them. So whether you’re in a tense meeting or a busy theater, breathing exercises may be the secret to lowering your stress levels. 5 While there are numerous breathing exercises to choose from,

exercise regularly

When you train, endorphins are released. These brain chemicals help the body deal with pain and stress. They also produce euphoria, or happiness, in the same way that morphine does. According to the American Diabetes Association, just five minutes of cardiovascular activity can help trigger these anti-anxiety effects. According to the current government Physical Activity Guidelines for Americans, adults should get at least 150 to 300 minutes of moderately vigorous physical activity per week, such as brisk walking. They can also engage in 75 to 150 minutes of vigorous, strenuous activity, such as jogging, horseback riding, or swimming. Aerobic exercise should be done several times during the week.


Stress can set in when you feel overwhelmed by the number of tasks that need to be done or the deadlines that need to be met. Writing out a to-do list or time management strategy can help you focus on seeing each task through to completion. Sit down and write down everything you need to do and each step you’ll need to take to complete each task. Prioritize what needs to be done first and identify what can be left for a later time or assigned to someone else. Be realistic about how long each task will take you to complete, and create room in your schedule to reward yourself for getting the job done.

listen to relaxing music

It is commonly known that music has a calming effect. It has an impact on our emotions and can be a very effective stress reliever. Relaxing music can help us relax by slowing our heart rate and blood pressure, lowering blood pressure and lowering stress hormone levels, as well as distracting us from our problems. According to studies, listening to music can help those suffering from clinical depression or bipolar disorder get through their darkest days.

People tend to avoid actively listening to music when they are anxious or overwhelmed. Perhaps because there is so much to do and worry about that it feels like a waste of time. However, including music in our daily routine is a small effort that can give big results, since our productivity increases when we are less stressed. Play CDs in the car or listen while performing other vital tasks like taking a shower or getting ready for the day to incorporate music into a hectic existence. Take music with you when you go for a walk with the dog, or listen to music instead of watching TV to wind down before the night.

Meditative Movement

The mindfulness of meditation is combined with gentle physical movement and concentrated breathing in the meditative movement. The meditation movement includes yoga, tai chi and qigong. They do not require any specific equipment and can be performed anywhere, making them accessible to the average individual. It has also been shown to promote mental health and ease some bodily ailments.

The other types of movement have had less research on them. However, preliminary data suggests that both tai chi and qigong can help people feel better emotionally9. Symptoms of anxiety and depression are among the things that can be managed in this way. Practitioners of these styles are likely to experience better sleep as well as better anxiety management. These contemplative movements can be performed during the day or as part of your nightly ritual. While the movements themselves may not be perfect for sleep, the mindfulness and breathing techniques used in these activities can be beneficial during times of tension or anxiety at night.

Reduce your caffeine intake

Caffeine can give you the boost you need to get going in the morning, but too much can cause anxiety and tension. Some people can drink numerous cups of coffee or tea without feeling jittery, while others may feel jittery after just one. Caffeine can be found in a variety of foods, not just coffee and tea. Caffeine is also found in chocolate and many energy drinks. If you want to feel less stressed, consider reducing the amount of coffee you drink each day and see if you feel more relaxed as a result.

Final words: Best Tips To Tackle Anxiety

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Learn The 4-7-8 Breathing Technique To Reduce Anxiety

Breathing exercises can help reduce anxiety and boost happy hormones

Breathing exercises are very accessible, effective, and easy to do. Almost anyone from young children to seniors can learn to do them and enjoy their vast benefits. Another good thing is that there are a variety of breathing exercises that can be practised to address different needs. While not all of them have been researched, there's one that was made famous by an American doctor, called the 4-7-8 breathing technique. Inspired by the yogic practice of Pranayama, this technique is relaxing and helps people develop greater control over their breath. 

It is straightforward to do and can be done anywhere. Here's how to get started:

1. Take a comfortable sitting position with your back upright. 

2. Place the tip of your tongue in the area behind your upper teeth. Let it rest there throughout the practice. This helps you breathe easily through the nose. 

3. Before you begin, exhale first. While exhaling, make an audible whooshing sound and empty out the breath. Now we start the practice. 

4. Close your mouth and inhale softly through the nostrils for a count of 4. 

5. Now hold the breath inside for a count of 7 

6. Exhale through the mouth, making than whooshing sound for a count of 8 

7. This completes one round. Continue practising by inhaling silently through the nose, holding the breath, and exhaling audibly through the mouth. 

You can do 4 to 5 rounds of this breathing and eventually increase it to 10. If holding your breath for a count of 7 is too much, you can simply count faster and speed up the practice. Alternatively, you can work on equal breathing first, a 4:4:4 ratio of inhaling, holding, and exhaling. Gradually you can start increasing the count by one after every one or two weeks depending on your capacity. It can be practised twice a day, 5-10 breaths or as and when you need it. 

Within a few rounds of this breathing, you may feel naturally relaxed and calm. This is because this technique helps relax the tense respiratory muscles, thereby reducing the work of breathing. This means you'll find it easier to take each breath, unlike when someone has an anxiety or panic attack where each breath becomes laboured and difficult. That's why this technique is helpful in anxiety and depression, as it counters the typical pattern of shallow breathing seen in these conditions. 

Most deep breathing practices, including 4 7 8 breathing, release chemicals that reduce excessive brain activity, which helps us attain a calm state of mind. In addition, it helps regulate stress hormones like cortisol, positively impacts our heart rate, and improves our breathing patterns. This makes it an excellent activity to include in your Anxiety management toolkit. 

Ms. Namita Piparaiya, Yoga and Ayurveda Lifestyle Specialist, Founder - Yoganama 

Disclaimer: The opinions expressed within this article are the personal opinions of the author. NDTV is not responsible for the accuracy, completeness, suitability, or validity of any information in this article. All information is provided on an as-is basis. The information, facts, or opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

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Anxiety, depression, and stress have become common in everyday modern life, impacting relationships, families, communities, and even the workplace. In fact, mental health problems have an impact on employers and businesses directly through increased absenteeism, and a negative impact on productivity and profits. According to Mental health America (MHA), managing stress and balancing professional and personal demands continues to be a prominent issue for employees.

In 2021, some 80% of employees agreed that the stress from work aff­ects their relationships with friends, family, and co-workers. A further 71% of employees say that they find it difficult to concentrate at work -up by 6% from 2020. Very often anxiety manifests itself in the form of increased heart rate, rapid breathing, restlessness, trouble concentrating, insomnia, and others.

If you experience some of these symptoms perhaps you might want to seek help from a trained mental health professional. But in the meantime, you might consider trying out some mental health apps to help relieve your anxiety.

What is an Anxiety App?

Anxiety apps are tools that help users focus on improving different aspects of their mental health and well-being. They employ a variety of behavioral exercises and relaxation techniques to help you break free from anxious thoughts and feelings. These may include meditation sessions, calming tracks, breathing exercises, mood monitors, sleep therapy, goal setting, courses, and more. With anxiety apps, all you need is your mobile device and a few minutes to focus. Anxiety apps not only help you overcome panic attacks but also help you receive therapy in the comfort of your own home. They make it easier for people to reach out for help and are easily accessible for anyone trying to cope with mental health problems.

Why You Should Download an Anxiety App

Anxiety apps can help you find the right mental health services that suit your needs. They also can help ease any apprehensions when it comes to seeking to address a mental health issue in person. There are many potential benefits of using anxiety apps for alleviating depression and anxiety and including:

  • Affordability: Unlike therapy with a mental health professional anxiety apps come at a relatively low price. However, they may not be the best substitute for treatment if you are dealing with anxiety at work or serious mental health issues.
  • Supplement existing therapy: Anxiety apps can supplement treatment as they help to offer compliance to routine treatment through worksheets and tools.
  • Convenience: Anxiety apps come in the palm of your hands making it easy for you to access some tools to help you cope with depression, anxiety, and insomnia. They also offer convenient ways of practicing strategies learned in face-to-face therapies and include reminders that can be set to increase treatment and continuation of therapy.
  • Gathering data and trends: Some anxiety apps can generate data through graphs or tables showing improvements or areas that need improvement. This can help therapists determine which interventions are working best and which ones should be changed.

Best Free Apps for Anxiety

If you need help coping with anxiety, depression or insomnia try one of the free anxiety apps below:

1. Mindshift

MindShift CBT helps users manage their anxiety and stress using evidence-based anxiety management strategies based on Cognitive Behavioral Therapy (CBT). This free self-help anxiety relief app helps to reduce stress, learn more about anxiety, develop more effective ways of thinking, be mindful, and relax. It comes with a user-friendly intuitive design, tools based on Cognitive Behavioral Therapy (CBT) designed for anxiety relief and self-management; daily check-in to keep track of your anxiety levels and mood tracking; facts and tips to overcome general worry, social anxiety, perfectionism, panic attack, and phobias; goal setting tools to keep users accountable; coping cards and statements to help users deal with anxiety; guided relaxation and mindfulness meditations; tips and tricks for incorporating healthy habits into your life and minimizing anxiety naturally; the ability to share data to streamline sessions with your counselor, therapist, or psychologist; and more.

 Available on: iOS and Android.

 2. Smiling Mind

Smiling Mind is a free app for meditation and mindfulness developed by psychologists and educators to help bring balance to users’ lives. It is designed to assist people in dealing with the pressure, stress, and challenges of daily life. It has dedicated sleep programs for adults, teens, and even kids. The app offers guided meditations that help users wind down at night to assist with both getting to sleep and improving overall sleep quality. It also touts being able to help increase productivity and attention; help in anxiety reduction and stress management; offer clearer and more focused thinking; and increased positive emotion, life satisfaction, and self-esteem beyond the workplace.

Available on: iOS and Android.

3. Dare: Panic & Anxiety Relief

Dare app offers users an interactive experience that helps users overcome anxiety, panic attacks, worry, and insomnia. It comes with information on anxiety, panic attacks and other topics. It has exercises to help users work through their anxieties and offers several meditations too. Users can also download the free audio guides to help them meditate and tackle insomnia. In addition to its free version, its robust paid subscription comes at a price tag of $9.99 a month.

Available on: iOS and Android.

4. Stop Panic & Anxiety Self-Help

Stop Panic & Anxiety Self-Help app helps users monitor and manage symptoms of panic. The app includes articles about anxiety and cognitive behavioral therapy (CBT) and includes tools for relaxation, mindfulness, and teaching audios. With it, users have access to a mood log and analysis, cognitive diary, healthy goals, and more.

Available on: Android.

5. Bearable

Bearable is a simple, customizable health tracker that helps users track trends and patterns in relation to their mood, and symptoms through the use of calendars and graphs. With it, users can understand the impact of different treatments and medications on health issues such as anxiety, depression, pain, fatigue, and mood disorders. Users can also use Bearable to identify triggers, find the cause of flare-ups, help with medical appointments, manage existing health conditions, and to understand correlations between their habits and health. Users can customize reminders for diary entries, medication, and more while being able to sync their health data from Apple Health and Apple Health Kit. The free version comes with a basic version while subscriptions start at $4.49/month,

 Available on: iOS and Android.

6. Shine

Shine app can help you start your mental wellness through daily meditation and Self-Care Courses. It helps users to log and track their mood, y, get support from a diverse community, and explore an audio library of over 800 meditations, bedtime stories, and calming sounds to help you shift your mindset or mood. Its free version offers daily meditations, a daily article and the ability to log your gratitude its more robust paid version comes with a $14.99 a month subscription.

 Available on: iOS and Android.

Best Apps for Anxiety Disorders (Paid)

If you are relooking for anxiety apps that offer robust features and enhanced tools you might want to look towards paid apps where you pay upfront for the app or through subscriptions. Below are our picks of best-paid anxiety apps:

7. Calm App

Calm is a meditation app that helps to relieve anxiety. It achieves this by offering nature sounds and sleep stories to help users get into a relaxed sleep. The app is designed to cater to anyone, whether you’re new to meditation or a seasoned expert. It’s also for anyone who needs a mental break, a soothing sound, or a peaceful night’s rest. It comes with guided meditations that are available in lengths of three to 25 minutes. Additional features include sleep stories narrated by well-known voices like Matthew McConaughey, a music library with exclusive tracks from top artists like Keith Urban and Disney, short videos with mindful movement and gentle stretching for every body type and Masterclasses taught by world-renowned experts in the field of mindfulness, soundscapes and nature sounds to use during meditation or to help you sleep, breathing exercises to help you relax, and more.

Available on: iOS and Android.

Pricing: Calm comes with a $6.99 a month subscription while with the free version, the app offers a limited number of guided exercises and meditative audio to help relieve stress.

8. Sanvello

Sanvello formerly known as Pacifica is a health and wellness app that focuses on stress, anxiety, and depression. Users’ journey with Sanvello journey is customizable meaning the app checks in with how you’re feeling so you can track your emotions and progress over time. As patterns are identified, Sanvello will provide customized tools, rooted in cognitive behavioral therapy, to keep you on the path to feeling better. The app focuses on mindfulness and Cognitive Behavior Therapy (CBT) and comes with audio exercises that focus on meditation, deep breathing, and other activities. Users can also access tools that include a mood tracker, daily challenges, goal tracking, and a health tracker.

Available on: iOS and Android.

Pricing: Sanvello comes with a $3.99 monthly subscription while offering a limited free version.

9. Insight Timer – Meditation App

Insight Timer app offers meditation solutions to calm the mind, reduce anxiety, manage stress, sleep deeply and improve happiness. It comes with free guided meditations for both beginners and experienced practitioners. It also offers short meditation sessions when you are on the go, helping you to build a daily habit in addition to thousands of music tracks and ambient sounds to calm the mind, focus, sleep better and relax. This app also offers statistics and milestones for tracking your progress.

Available on: iOS and Android.

Pricing: Insight Premium Meditation comes with a $9.99 monthly subscription while offering a free version as well.

10. InnerHour

The InnerHour app is created by mental health professionals that offer a self-help tool, which provides users with a digital experience of therapy. The app has specific programs to help with worry, stress, sleeplessness, depression, and anger. It comes with self-help courses on depression, anxiety, sleeplessness, stress, anger, and happiness. Users can also access therapists through the app.

Available on: iOS and Android.

Pricing: InnerHour comes with a $4.99 monthly subscription while offering a limited free version.

11. HeadSpace

The headspace app helps users to meditate and sleep soundly. It offers guides on how to practice mindfulness in your everyday life. With it, you learn how to relax, manage stress, and focus your energy to become more centered and well-rested. Its features include daily meditations, sleep meditations, stress relief, coping meditations, and more. It offers over 40 meditation courses on topics that include stress and sleep

Available on: iOS and Android.

Pricing: Headspace comes with a $12.99 a month subscription while offering a seven-day free trial.

12. BetterMe: Mental Health

BetterMe mediation app helps users by offering simple meditations and guided courses for mental well-being. The app is a product of a collaboration with mental health specialists to offer tools and coping strategies from Cognitive Behavioral Therapy (CBT) to help you tune in to the world surrounding you. The tools available include guided meditations, stress-relief practices, breathwork, and sleep meditations.

Available on: iOS and Android.

Pricing: BetterMe comes with a $9.99 a month subscription while offering a free version as well.

Take Steps to Improve Your Mental Health Today

Mental health issues are a very serious matter, as they affect how we think, feel, and behave in our daily life. They also affect our ability to cope with stress, overcome challenges, build relationships, and deal with life’s setbacks. Strong mental health isn’t simply about the absence of mental health problems but also about being emotionally resilient.

Emotionally and mentally resilient people can cope with difficult situations and maintain a positive outlook. This helps them remain focused, flexible, and productive during both good and bad times. Mental health is not only about mental health issues such as generalized anxiety disorder or elevated anxiety levels but also about making continuous improvements on how we deal with issues and strive to be better versions of ourselves

Speaking to a Mental Health Professional

If you regularly have anxious thoughts or experience anxiety symptoms seeking the help of a mental health professional can help you better understand yourself, your feelings, and generally make sense of everything going on in your life and how that makes you feel. They can also help you resolve complicated feelings or find ways to cope with them.

What is the best app for anxiety?

Calm is considered the best app for anxiety. It helps tackle insomnia that comes with feeling anxious. Through its sleep, meditation, relaxation and other tools Calm helps you not only deal with anxiety but remain productive and emotionally resilient.

Is there an app for people with social anxiety?

Headspace can help people deal with social anxiety. It offers guides on how to practice mindfulness in your everyday life. With it, you learn how to relax, manage stress, and focus your energy to become more centered and well-rested.

Is there a free app to help with anxiety?

MindShift helps users manage anxiety and stress using evidence-based anxiety management strategies based on Cognitive Behavioral Therapy (CBT). This free self-help anxiety relief app helps to reduce stress, learn more about anxiety, develop more effective ways of thinking, be mindful, and relax.

What is a good game for anxiety?

SuperBetter is an app designed by Jane McGonigal and is inspired by her book SuperBetter. It helps to incorporate Role Playing Gaming (RPG) in real life to address challenges such as anxiety, depression insomnia, willpower, and others by offering activities to do to overcome them.

Image: Depositphotos

More in: Software and Apps, Wellness

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Dreams that leave you feeling apprehensive and worried can result from ongoing stressors, or they can come up unexpectedly. With the right tools, you can cope.

Have you ever fallen peacefully asleep, just to wake up hours later in a sweat? The cause was an unpleasant dream that made you experience the type of distress that lingers for a while: an anxiety dream.

These dreams are often uncomfortable and distressing experiences, but you may be able to prevent them with the right strategies.

Anxiety dreams can be considered a type of stress dream, which can often feel intrusive and uncomfortable.

These dreams can be considered reactions to something that’s worrying you, says Arlene B. Englander, a licensed psychotherapist from North Palm Beach, Florida. “They’re a wake-up call to the fact that a situation in our lives is causing us emotional pain and we need to deal with it more effectively,” she says.

Anxiety and stress dreams aren’t the same thing, though. Not all stress dreams cause a sense of apprehension and wariness. By definition, all anxiety dreams do.

Anxiety dreams can also commonly happen to people with certain mental health conditions, like generalized anxiety disorder (GAD).

A 2013 study found that older adults living with GAD had significantly more bad dreams than those living without GAD. In the study, the frequency of bad dreams was also associated with co-occurring symptoms of depression, anxiety, worry, and a perception of poor quality of life.

Stress vs. anxiety

Events that make you feel you’re out of resources to respond adequately can often be defined as sources of stress. That doesn’t mean they are emotionally distressing.

Anxiety, on the other hand, is an emotional response that indicates persistent and abundant worry or fear. Anxiety dreams can lead you to experience these feelings.

For instance, a stress dream about a demanding project at work may not make you feel anxious. But an anxiety dream about that project could be accompanied by worry and dread.

Just as with anxiety, anxiety dreams can be about both real or perceived threats.

Dreaming that your partner was unfaithful might not be grounded in any facts, but it could still have you feeling worried or be a manifestation of a lack of trust in the relationship.

“Yes, anxiety and stress can cause nightmares and anxiety dreams,” says Dr. Roberta Ballard, a clinical psychologist from Marietta, Georgia. “If you are under more stress than usual or there is a big change going on in your life, you might notice more themes of anxiety in your dreams.”

Nightmares, particularly when frequent, can also be signs of mental health conditions like post-traumatic stress disorder (PTSD).

But not all anxiety dreams are considered nightmares. They may be “bad dreams,” but they’re not as intense.

Not all nightmares and anxiety dreams are caused by anxiety, either. For instance, a 2015 study of undergraduate students suggests what you eat may also affect your dream state.

But just because you have anxiety, it doesn’t mean you’ll have nightmares or anxiety dreams. You could have an anxiety disorder and rarely have nightmares.

Anxiety dreams and nightmares may be a part of how your brain aims to process and respond to situations that cause you fear and discomfort.

When it comes to nightmares, research in 2017 suggests adversity, particularly in childhood, may affect your ability to regulate your emotions and could contribute to these spontaneous and intense anxiety dreams.

More research is needed to understand the processes involved in dreaming and dream content.

Anxiety dreams can cause you to feel distressed for a long time after waking up.

Ballard says that in some cases, anxiety dreams may start to negatively affect your mental health, especially if you attach a lot of meaning to your dreams.

“If you focus on the content of a bad dream, worry about it, and fear that it means something significant in your real life, it’s more likely to have a negative effect on your mood or anxiety level,” she says.

Controlling the content of your dreams is rarely possible, unless you master lucid dreaming. But the following tips may help you reduce how often you have anxiety dreams.

1. Figuring out the source of your anxiety

Self-awareness and emotional regulation may help you process your emotional states when you’re awake. This could reduce the chance of anxiety coming up when you’re asleep.

Englander also says it’s important to acknowledge there’s a source of anxiety in your life. She explains that facing real-life challenges as effectively as you can may reduce the intensity and frequency of anxiety dreams.

2. Writing an alternative ending

Ballard says there’s a journaling exercise she asks her clients to do when they’re having anxiety dreams.

“I ask them to write an alternative ending to the bad dream,” she says. “This exercise tends to be really effective at taking the steam out of a bad dream. If it’s been a recurring dream, it stops or changes and becomes less scary.”

In fact, reframing negative or anxious thoughts with positive ones seems to decrease anxiety in general. A 2016 study suggests that focusing on positive mental images or positive affirmations instead of anxious thoughts could help people living with anxiety to worry less.

3. Using relaxation techniques

For those times when you’re feeling overwhelmed, relaxation methods may help reduce anxiety in the moment and prevent it from carrying on throughout the day.

If you’re waking up from an anxiety dream, you can try using one of these relaxation techniques:

  • box breathing
  • progressive muscle relaxation
  • mindful meditation

For ongoing anxiety management, consider:

If anxiety dreams are negatively affecting your sleep quality or ability to function throughout your day, consider reaching out to a mental health professional.

They will be able to help you explore the possible sources of your distress, as well as provide you with tools and coping skills.

We all have bad dreams now and then, but not all bad dreams cause emotional distress. When they do, some experts call these anxiety dreams.

Anxiety dreams can be caused by unresolved distress in your life and when you’re going through emotionally-charged experiences.

Some anxiety dreams — like persistent nightmares — may be signs of an underlying mental health condition like GAD or PTSD.

Figuring out what’s causing anxiety in your life, facing challenges, and practicing relaxation methods may all help lower your chances of having anxiety dreams in the future.

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Chronic diseases are a major public health problem in Lebanon, contributing to 45% and 38.7% of premature deaths in men and women, respectively.1,2 Patients with a chronic disease such as Chronic Obstructive Pulmonary Disease (COPD) face a double constraint: managing the disease and living with it.3 Quality of life is significantly impaired in COPD patients due to the nature of this chronic, disabling disease, which is not well known by the general public.4 However, understanding COPD makes it easier for patients to accept it and contributes to a better living.5 Therapeutic education has been recognized as an integral and permanent part of the management of patients with chronic diseases.6–8 Nevertheless, to date, there are no standard recommendations on the specific educational topics that should be included in the educational programs offered to COPD patients. Furthermore, there is a lack of educational centers or facilities for COPD patients in Lebanon and a near absence of studies related to the quality of life of Lebanese patients living with COPD.

As lung function may worsen over time, even with the best available care,9 systematic follow-up showed to be essential in COPD patients. However, it requires human resources, time, and high expenses. Hence, telehealth is emerging as a new approach to chronic disease management, despite controversies about its effectiveness. Some studies concluded that telehealth in COPD patients does not produce recognizable or statistically significant improvements in the quality of life of these patients,10 while others reveal a positive outcome in terms of hospitalization rates and stabilization of the clinical status of COPD patients.11 In Lebanon, because of the diversity of the population’s health, educational, and economic needs, some means of collaborative networking and remote interventions used in telehealth may be helpful and even necessary.

Therefore, our study aims to evaluate the feasibility, acceptability, and effectiveness of a therapeutic education program coupled with a telemonitoring system for COPD patients in Lebanon.


Study Design

This single-group non-randomized feasibility study was conducted to inform the design of a randomized study. Eligible participants were enrolled in a 6-week home-based educational and telemonitoring program. Quantitative data collection methods were used pre, per, and post-intervention.

Patient Involvement

Participants with COPD were not involved in setting the research question, study design development, or choice of outcome measures. However, it is planned to disseminate the main results to study participants and seek patient involvement in refining the study design prior to a full-scale trial.

Study Population

An empirical convenience sample was recruited based on the judgment of the pulmonologists and the willingness of patients to participate.

No formal calculation of the sample size has been performed since this feasibility study involves an intervention that has never been tested before on the Lebanese population.

Participants were considered eligible if they met the following criteria: age ≥ 18 years, a prior diagnosis of COPD, cognitively capable with a suitable health status to participate in the study according to the clinical consensus between nurses and physicians. Exclusion criteria consisted of participants diagnosed with lung cancer or having cognitive problems related to memory loss or speech disorders that would not allow a constructive exchange.


Our intervention consisted of a home-based, personalized, therapeutic education program and a telemonitoring system. It was conducted in three phases:12

Phase I: The First Nursing Consultation

Phase I is the diagnostic phase, where the patient received the first home visit from the nurse to elaborate an educational diagnosis and define a personalized program. In this stage, the objectives were to get to know patients, identify their needs and expectations, identify the factors that promote learning and those that may limit it, and formulate the skills to be acquired, mobilized, or maintained, taking into account their priorities to plan an individual program. The nurse explained how the patient should use the oximeter to measure daily the oxygen saturation (SpO2), and how the information collected will be transmitted. The oximeter was connected to each patient phones through Bluetooth and the spO2 was collected through internet to an online health platform that allows for frequent health status updates and rapid response, which can be important.

Phase II: The Education and Telemonitoring Sessions

Phase II is the educational phase, where the patient received one home visit per week from the nurse to encourage him/her to self-assess each of his/her risk factors so that he/she becomes aware that his/ her illness is not inevitable and that he/she can be involved in a behavioral change to reduce the risk of exacerbations plans and implements individual educational sessions. These sessions were conducted face-to-face (with/without the presence of a family caregiver), using educational tools such as PowerPoint presentations and videos. Our program consisted of 6 weekly education sessions. Session 1 was about COPD physiopathology, signs, and symptoms, session 2 included an overview of medications, session 3 was about detecting exacerbations, session 4 covered breathing strategies and exercise, session 5 was about adopting and maintaining a healthy lifestyle (smoking, diet, sleep), and session 6 explained stress and anxiety management. Sessions were individualized and conducted in order of patient preference. A booklet summarizing the content of these sessions was given to each participant. Telemonitoring was conducted throughout the program. Patients transmitted their SpO2 to the nurse every day (usually in the morning) and in case of subjective clinical worsening.

Phase III: The Last Nursing Consultation

Phase III is the evaluation phase, where the nurse assesses, face to face, the skills acquired by the patient during her las visit to patients’ home. This stage enabled the nurse to highlight the changes that occurred in the patient and their maintenance over time. A follow-up by telephone was conducted after one month to assess whether the learning was maintained.

Outcomes Measures

Because an intervention will not be effective if it is not implemented well, it is important to know if the intervention is feasible and effective and if it is deployed correctly.13 Based on Proctor’s lists of outcome variables that can assess program implementation,13 this study evaluated the adequacy, acceptability, adoption, fidelity, and cost of the intervention, using various tools adapted to our context: The pre-referral intervention team inventory (PRITI) to measure the acceptability,14 the adoption of information technology innovation scale to measure the adoption,15 parenting strategies questionnaire for adequacy,16 and the utilization and cost questionnaire to evaluate the total cost of the intervention.17

At phases I and III, several tests were performed to pretesting the impact of the intervention: The COPD assessment test (CAT),18 the COPD clinical questionnaire (CCQ),19 and the Hospital Anxiety and Depression Scale (HADS).20

The skills and expertise of the participants were assessed using questions created for each session.


Adequacy is perceived as the appropriateness, relevance, or compatibility of the innovation or practice.13 Therefore, participants were asked three questions to measure intervention adequacy: 1) Is this program appropriate? 2) Is this program helpful in your daily life? 3) Is this program compatible with your daily life? Responses ranged from 0 (not adequate) to 10 (adequate). The adequacy was assessed the first phase during the educational diagnosis (called D1) and in the third phase during the last consultation (called D2).


Acceptability (or “what” is acceptable) is the perception that a given service is pleasant, acceptable, or satisfying.13 Acceptability is different from the broader concept of satisfaction. Acceptability is more specific and refers to particular steps, whereas satisfaction generally refers to the overall experience. Therefore, we assume that the acceptability assessed is dynamic and evolves with experience so we measured acceptability at all stages of the program. The statements selected to assess the acceptability of the intervention from the participants’ perspective were as follows:

  • - To me, this program seems an acceptable way to address COPD issues.
  • - I find this education session acceptable to meet my original goal.
  • - This education session does not negatively impact my daily life.
  • - I like the tools used in this session (videos, power point presentation).
  • - I find the telemonitoring system acceptable to prevent COPD-related problems.
  • - The telemonitoring system does not seem to negatively impact on my daily life.
  • - I prefer other methods to manage COPD problems.
  • - Overall, the program seems beneficial to me.
  • Responses were rated on a 5-point Likert scale from 0 (no opinion) to 4 (strongly agree).


    Adoption is defined as the intention, initial decision, or action to try or employ an innovation or practice.13 The statements assessing adoption were as follows:

  • - My participation in this program is voluntary, or my doctor expects me to use this program.
  • - I have difficulty explaining why this program is beneficial or not, or I have no difficulty telling others about thecontent of the educational sessions.
  • - I am willing to do this session again if needed, or I do not see the point of doing this session again.
  • - I would suggest this program to other COPD patients, or the program does not seem helpful for other people.
  • Fidelity

    Fidelity is defined as the degree to which an intervention is implemented as prescribed by the original protocol. Achieving and measuring fidelity is subject to a number of challenges. Therefore, a second researcher was asked to assess fidelity in the implementation of this intervention, to evaluate whether the intervention was received and faithful to the original protocol, by comparing the original intervention and the implemented intervention in terms of (1) adherence to the program protocol and (2) the amount of program delivered.


    This intervention was measured in terms of;

    (1) general cost of the intervention: materials/patient, (2) Time taken by the nurse to go to the patient, (3) Time spent by the nurse at the patient home, (4) Number of hospitalizations and emergency room visits during the intervention/patient.


    COPD Assessment Test (CAT)

    The CAT consists of eight questions measured on a 5-point scale, with scores ranging from 0 to 40. Higher scores indicate a higher impact of COPD on the patients’ quality of life.18

    Clinical COPD Questionnaire (CCQ)

    The CCQ is a 10-item tool used to assess the quality of life of COPD patients. The total score, calculated by summing the scores of the ten questions and dividing the number obtained by ten (the number of items), ranges from 0 (very good health) to 6 (extremely poor health).19

    Hospital Anxiety and Depression (HADS)

    The HADS aims to measure symptoms of anxiety and depression and consists of 14 items, seven for the anxiety and seven for the depression subscale. Each item is scored on a response-scale with four alternatives ranging between 0 and 3. Recommended cut-off scores are 0–7 for normal, 8–10 for borderline and ≥ 11 for abnormal.20

    Assessment of Knowledge and Skills of Participants

    Knowledge was assessed at the beginning and the end of each educational session through a 5-item true-false questionnaire set by the researcher and related to the session.

    Skills were evaluated at the end of the program through a checklist about the breathing strategies inspired by the technique elaborated by d’Ivernois and Gagnayre, which helps patients master their breathing.21 The criteria sought were whether patients were able to identify the right moment to take the spray, whether they respected the chronology of the gesture, and whether they verified the effectiveness of their gesture. These criteria were evaluated according to the seriousness of the error:

    1) the error or omission had health consequences;

    2) the error or omission was minor with no consequences;

    3) no error or omission; the patient has mastered the quality of the procedure.

    Statistical Analysis

    Five variables were selected to determine the feasibility of this research program: acceptability, adoption, adequacy, fidelity, cost and impact. Analyses were performed on SPSS version 25 (IBM SPSS Statistics for Windows). The Student’s t-test was used to compare normally distributed continuous variables between two groups, the ANOVA to compare three groups or more, and the Chi-square for binary and/or categorical variables. Data were analyzed according to gender, age, stage of the disease, presence of a caregiver, duration of illness and medical coverage. P value less than 0.05 (≤ 0.05) is considered statistically significant.


    Of the 15 patients who agreed to participate in this intervention, 8 lived in the Greater Beirut, 5 in North Lebanon, and 2 in Mount Lebanon. The majority of the participants were females (8/15), with an average age of 77±9.7 years and 9±4 years of COPD diagnosis. Almost half of the respondents had a moderate stage of the disease (6/15), 7 a severe stage, and 2 had a very severe stage of their COPD. Most respondents had a family caregiver (11/15) and were financially responsible for their disease (9/15) (Table 1).

    Table 1 Sociodemographic Characteristics


    At the end of the program, the mean score for all three adoption questions increased. For the question “Is this program appropriate?”, the average score increased from 7.73±0.57 to 8.6±0.6 (P=0.000). The score for the question “Would this program be helpful in your current life?” increased from 7.26±1.28 to 8.2±0.7 (P=0.004). As for the question “Is this program compatible with your current life?”, the average score increased from 7.2±1.27 to 7.8±0.95 (P=0.004).


    All participants found this program an acceptable way to address COPD-related issues. A significant relationship was noted between the age of the participants and the acceptability of this program. Indeed, this program seemed to be more acceptable for participants aged 82 years and younger (3.62±0.51; p=0.05), females (3.57±0.53; p=0.234), those with a severe stage of the disease (3.57±0.53; p=0.368), without a caregiver (3.5±0.57; p=0.662), and without financial coverage for COPD (3.44±0.52; p=0.693) (Table 2). All participants agreed that the educational sessions met their original objective. However, the acceptability, relative to each session, varied. The respiratory strategy and physical exercise session (S4) had a mean score of 3.8±0.4 and the lifestyle session (S5) 3.6±0.47 (Table 3). All participants either strongly agreed (score=4) or agreed (score=3) that education sessions did not negatively impact their daily life. All participants found PowerPoint presentations, videos, and booklet to be quite acceptable tools. As for the telemonitoring system, only eight participants had the necessary equipment for its proper functioning, ie, internet connection and cell phone or IPad. While seven participants agreed to use the telemonitoring system, one patient refused, assuming it would complicate their life. All seven patients who used the telemonitoring system reported that it did not negatively impact their daily lives. One participant was uncompliant in terms of daily monitoring of saturation. None of the participants had an answer to the question “I prefer other methods to help us manage COPD problems”, while five participants mentioned the lack of inhalation devices (treatment) due to the current socioeconomic crisis in the country. Overall, all participants found the program beneficial.

    Table 2 Acceptability and Sociodemographic Variables

    Table 3 Acceptability Score Relative to Each Session


    All participants declared that their participation in this program was voluntary. All participants agreed that they have no difficulty explaining to others the content of the education sessions and that they would suggest this program to other COPD patients.

    As for the question “I am willing to repeat this session if needed” responses varied depending on the educational session. Four participants answered that they would repeat S1 (COPD physiopathology, signs, and symptoms), five participants would repeat S2 (overview of medications), 8 participants would repeat S3 (detecting exacerbations), and almost all participants would repeat S4 (breathing strategies and exercise), S5 (adopting and maintaining a healthy lifestyle), and S6 (stress and anxiety management).


    In the protocol, it was planned that the first and last sessions of the intervention take place in the nurse’s office. This clause was not respected. Given the risk of COVID-19 contamination in the hospital, the entire program took place at the participants’ homes while respecting the protective measures. The educational sessions could not be delivered every week, given the situation in Lebanon and the imposed lockdown due to COVID-19. Some sessions were done every two weeks.

    Furthermore, the material provided to the patients consisted of the booklet and the monitoring material. It did not include the summary sheet of the educational diagnosis, as foreseen in the protocol to limit the risk of contamination due to COVID-19.

    All the educational sessions were completed, except for the telephone follow-up. Only 13 participants could be contacted due to the death of two patients during the month following the intervention.


    The cost of this procedure was measured in terms of time and materials. The total distance traveled by the nurse during the entire intervention period was 5552 Km, each worthing 0.15 USD of gas. The average time spent by the nurse with a patient per eight sessions was 429.56 min. In Lebanon, the wages of a hospital nurse are about 10,000 LBP/60 minutes, equivalent to 6.5 USD/60 minutes at the official rate of 1 USD=1500 LBP. Thus, the cost related to the time the nurse spent per one patient is 46 USD. The cost of materials for educational sessions was 100 USD/patient (cost of booklet, and educational materials), while that for the telemonitoring services was 143 USD/patient (including the cost of the saturomètre). Hence, the overall cost of the intervention was 200 USD/patient (educational sessions only) and 244 USD/patient (including telemonitoring services).

    It is noteworthy that, the intervention throughout this study was free of charge. The patients did not cover any cost.

    During the intervention, one patient was hospitalized for one week due to a condition not related to COPD.



    The CAT questionnaire assess the impact of COPD on the patients’ quality of life.18 The scores ranging from 0 to 40 and a higher scores indicate a higher impact. At the end of the program, 8 patients had the same baseline score after the 6 weeks of the intervention (P1, P3, P4, P7, P8, P9, P12, P14), 6 patients had more effective scores than at baseline (P2, P5, P10, P11, P13, P15) while one patient had a deterioration of his quality of life (P6). Participants with improved CAT scores were in the age range ≤82 years, with severe COPD (GOLD 3), diagnosed for ≤10 years, and with a caregiver (Table 4).

    Table 4 CAT, CCQ and Sociodemographic Variables


    The CCQ tool was also used to assess the quality of life of COPD patients. The score ranges from 0 (very good health) to 6 (extremely poor health).19 At the end of the intervention, a decrease in score was noted in 8 patients (P2, P4, P7, P10, P11, P13, P14, P15), no changes were seen in 4 participants, and a deterioration in health status was identified in 3 patients (P5, P6, P9). Participants with an improvement in the CCQ score belong to the age group ≤ 82 years, female, with severe COPD (GOLD 3), diagnosed for ≤ 10 years, and with a caregiver (Table 4).


    The HADS aims to measure symptoms of anxiety and depression. Scores ranged between 0–7 for normal, 8–10 for borderline and ≥ 11 for abnormal.20 The anxiety score did not change in 6 of the participants after the intervention, 5 patients had an increased score, and 4 patients had a decreased score. Regarding the depression score, the intervention was effective in 5 patients, not effective in 2 patients, and did not induce changes in 8 patients.


    Seven patients agreed to participate in the telemonitoring system in whom an increase in SaO2 value from baseline was noted with distant desaturation periods. P2 had a saturation limit that varied between 89% and 95%; at the end of the program, this value increased to 91–95% (Figure 1). In P3, the saturation at baseline varied between 89% and 93%, reaching 93–95% at the end of the program (Figure 2). P11 joined the program with a saturation between 87% and 92%; it was about 89–93% at the end of the intervention (Figure 3). For P12, the saturation was between 93% and 96% at the end of the program, higher than the baseline value of 92–95% (Figure 4). After having periods of drops to 91%, the saturation of P13 varied between 93% and 95% at the end of the program (Figure 5). The saturation of P14 reached 97% after having varied between 92% and 95% at the beginning of the program (Figure 6). The lower saturation limit of P15 was 93% at the end of the program, after varying between 90 and 91% at baseline (Figure 7).

    Figure 1 SpO2 variation for Patient 2 throughout the program.

    Figure 2 SpO2 variation for Patient 3 throughout the program.

    Figure 3 SpO2 variation for Patient 11 throughout the program.

    Figure 4 SpO2 variation for Patient 12 throughout the program.

    Figure 5 SpO2 variation for Patient 13 throughout the program.

    Figure 6 SpO2 variation for Patient 14 throughout the program.

    Figure 7 SpO2 variation for Patient 15 throughout the program.

    Assessment of Knowledge and Skills

    The knowledge of participants was assessed at the beginning of each educational session and the end of the same session using a 5-item true-false questionnaire. The results showed that all participants had a lack of knowledge related to their disease. At the end of each session, the majority of participants answered all questions correctly (Table 5).

    Table 5 Assessment of Participant’s Knowledge

    The skills of participants were evaluated at the end of the program through a checklist created about respiratory strategies. Participants made no errors that had a health consequence, but five of them made errors with no health consequences regarding the timing of the gesture. Also, 11 participants omitted the gesture verification step.


    The results of this feasibility study show that this program might be feasible and acceptable to the Lebanese population.

    A significant relationship was noted between the age of the participants and the acceptability of this program (≥82 years, 3.62 + 0.51; p=0.05). A previous study has shown that younger individuals with COPD reported more symptoms of anxiety and depression, worse health-related quality of life, and more breathlessness only if they were single, suggesting that young individuals, particularly those who are single, have unique needs due to their young age at onset of severe chronic disease.22 This finding can explain the acceptability of our program by younger participants who do not have a caregiver (3.5±0.57; p=0.662).

    Studies have shown that COPD management can be more difficult in socioeconomically disadvantaged populations.23 Most participants (9/15) in this study indicated that they were not financially supported in managing their disease and having difficulties in accessing medications and transportation. Furthermore, the results have shown that this program was more acceptable for participants without financial coverage for COPD (3.44±0.52; p= 0.693). Therefore, a more comprehensive chronic disease intervention, involving assistance in accessing treatment, may be more acceptable and beneficial for COPD patients in Lebanon.

    The current literature indicates that multidimensional and comprehensive interventions are needed to address the complex and progressive nature of COPD. However, it is unclear which components or combinations of interventions can result in consistent improvements in patient outcomes.23 The results of this study have shown that the respiratory and physical exercises (3.8± 0.4) and lifestyle sessions (3.66±0.47) had the highest acceptability score.

    Recruitment appears to be a global problem. It is considered one of the main challenges and recognized as the most considerable barrier.24 In this intervention, of the 50 patients contacted, only 15 agreed to participate. However, despite all the constraints faced during this year, no dropout has been encountered. When analyzing recruitment figures in our study, it appears that there is variability according to the stage of the disease. Indeed, 13 of the 15 participants had a disease stage that varied from moderate to severe, ie, 6 patients GOLD 2 and 7 patients GOLD 3. Therapeutic education is been shown essential at all stages of the disease.25 However, this feasibility study has shown that this therapeutic intervention could be more accepted and effective in Lebanon for patients with moderate (GOLD 2) and severe COPD (GOLD 3).

    Furthermore, education showed to have an impact on quality of life.26,27 Indeed, our intervention revealed an improvement in quality of life for half of the participants (6 patients for the CAT score and 8 patients for the CCQ score). The incidence of anxiety and depression also decreased after education sessions. However, anxiety and depression are common psychological problems and are associated with poor prognosis in COPD.28,29 A study has suggested that monitoring of indicators could be improve quality of life and anxiety-depression scores in COPD patients.30

    Regarding the telemonitoring system, the use of telehealth in Lebanon is limited.31 Although smartphones (80%) and the internet (76%) are highly used,32 telehealth activities include small-scale interventions for refugees, poor populations,33 and well-defined medical tasks.34 In our study, seven patients used the telemonitoring system and reported that it did not negatively affect their daily life. These patients were satisfied with their participation in this trial. Indeed, the Lebanese population has multiple barriers that can hinder their access to health care. In this context, the adoption of telehealth can help democratize access to health care, increase awareness, and improve education.35 Telehealth services can improve access to health services and reduce health care costs, thus presenting great benefits to all Lebanese residents.35 The widespread adoption and use of telehealth services can also mitigate other social problems, such as traffic and pollution.36 Furthermore, a study has shown that the experience of telehealth during the COVID-19 pandemic appears to have contributed to greater openness and willingness to adopt telehealth in Lebanon.35

    Strengths and Limitations

    This study was a small-scale, single-group, feasibility study using a convenience sample recruited across four sites. As a result, the generalizability of our results to the broader COPD population is limited. However, the primary objective of this study was to determine the feasibility of a home-based educational program with telemonitoring as a novel way to manage COPD in Lebanon. Hawthorne effect37 (defined as a positive effect observed that is not related to the intervention but is simply due to the fact that this group feels observed, hence the modification of its behavior) can be seen in our study because of the absence of blinding inherent to the design of the protocol. Consequently, a telephone follow-up was conducted one month after the intervention to assess retention. Also, to reduce the effect of confirmation bias, the tendency to favor information that confirms preconceived ideas, a second judge was asked to assess whether the intervention was received and faithful to the original protocol.

    Given the current situation in the country and the continuous and rapid change in the value of the Lebanese pound, it was difficult to evaluate the relative cost of this intervention. Therefore, it was decided to keep the official value of 1500 LBP for 1 USD, which may present a bias and an unrealistic view of the current cost of such an intervention in Lebanon.

    On the other hand, our intervention included an online health platform that allows for frequent health status updates and rapid response, which can be important.

    The innovative aspect of this study lies not only in the use of a telemonitoring system but also in the conduct of education sessions at the participants’ homes. In Lebanon, until now, there is no decree governing the organization and conduct of an educational program for patients living with a chronic disease. Educational programs conducted in Lebanon remain limited to the framework of a study in the hospital; until now, no center or structure of education for patients living with COPD exists in Lebanon. Also, to date, no health insurance in Lebanon covers the use of telehealth systems or even educational programs.

    Nerveless, this program is an opportunity for professionals, particularly nurses, to strengthen their capacity. This intervention can be seen as a source of nursing leadership in the care of patients in close cooperation with different health professionals, including physicians, physiotherapists, dieticians, and pharmacists. Also, this intervention could reinforce and make known the importance of the role of the nurse in the out-of-hospital environment, which is not well-recognized in Lebanon.

    Results from this study will serve to inform a larger-scale study which can address some of the limitations noted here.


    Disease-specific education is an essential part of COPD treatment that affects patients’ quality of life and emotional state. This educational program improved patients’ knowledge of the disease. Furthermore, this feasibility study showed that this intervention could be more accepted and effective in Lebanon among younger patients with COPD stages 2 and 3. The results of this study have shown that the sessions concerning respiratory and physical exercises and lifestyle received the highest acceptability score. Our findings suggest that health insurance initiatives covering education programs and telehealth interventions could be of great interest. In addition, with appropriate support, researcher and patient may be able to work together in a constructive and mutually beneficial manner. The patient could participate in the educational session as a peer education method. This collaboration could contribute to new scientific discoveries.


    COPD, chronic obstructive pulmonary disease; SpO2, oxygen saturation; CAT, COPD assessment test; CCQ, COPD clinical questionnaire; HADS, Hospital Anxiety and Depression scale.

    Data Sharing Statement

    The dataset may be available from the corresponding author (Rita Georges Nohra) upon reasonable request.

    Ethics Statement

    This study has been approved by HDF Ethics Committee record (CEHDF 1519, November 4, 2019). All participants were informed about the purpose of the study, that was conducted in accordance with the Declaration of Helsinki. Written consent was obtained from each participant. The study protocol was registered on 11 December 2019, NCT04196699 and published.12


    The authors would like to thank the 15 participants of this study and their families for finding the time to participate to our program. Our acknowledgments to Dr Bassem Haber for his advice.


    The budget for this study is supported by the project funding, including a grant from the Lebanese University.


    The authors report no conflicts of interest in this work.


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    DUBLIN, April 20, 2022--(BUSINESS WIRE)--The "Global Mental Health Apps Market Size, Share & Industry Trends Analysis Report By Application, By Platform Type (iOS, Android, and Others), By Regional Outlook and Forecast, 2021-2027" report has been added to's offering.

    The Global Mental Health Apps Market size is expected to reach $10.2 billion by 2027, rising at a market growth of 16.3% CAGR during the forecast period.

    The market is rising because individuals become more aware of the significance of mental health and as a result of the debut of several mental wellness applications. The advent of significant health campaigns such as the Campaign Against Living Miserably (CALM) to promote awareness about mental health, as well as the rising use of connected gadgets among the youthful population, is driving up market value.

    Furthermore, poor work-life balance and eating habits, social isolation, hectic schedules, and relationship issues are all key factors that are raising the incidence of mental illness among people all over the world, particularly in developed and emerging nations. Moreover, it is expected that increased awareness among people in developing economies, as well as the creation of updated and advanced featured applications, is expected to provide prospective prospects over the forecast period.

    Therapy applications were already gaining traction among people dealing with issues ranging from stress to serious mental disease when the COVID-19 outbreak struck. When offices turned virtual, they carved out a niche for themselves in the mental health industry. While certain apps, such as Talkspace and Betterhelp, pair you with a certified therapist, a large chunk of the industry has gone completely humanless. Friendly chatbots provide cognitive behavioural therapy; mood trackers remind bipolar disorder patients to keep track of their mood; and apps for treating post-traumatic stress disorder claim to assist people to get over acute bouts by guiding them through deep breathing exercises.

    COVID-19 Impact Analysis

    The COVID-19 pandemic resulted in a spike in mental health app downloads as well as greater awareness of mental health as a serious concern. As a result, the digital health and mobile health sectors have shown significant growth potential. According to ORCHA (Organization for the Review of Care and Health Applications) data, mental health app downloads in the United Kingdom climbed by about 200 percent from summer 2019 to summer 2020.

    Due to the many advantages offered by these apps in treating mental health conditions like as stress, sadness, and anxiety, the market for mental health apps saw a rise in adoption during the COVID-19 pandemic. As per Sensor Tower statistics, the top mental wellness apps saw a combined download increase of about 2 million in April 2020 compared to January.

    Market Growth Factors:

    High inclination towards virtual therapies

    For persons suffering from depression, there are literally thousands of apps available. Some are based on exchanging messages or making phone calls with doctors, while others provide recommendations, self-guided mood training programmes, and gamification components. MoodTools, an anti-depression app, treats depression carefully and has a suicide safety plan in place in the event of a crisis. There are additional apps for treating diseases like schizophrenia and psychoses, in addition to depression apps. Doctors, on the other hand, argue that apps for people with psychological illnesses are best used as a supplement to regular therapy; unlike apps for mentally healthy people, applications for persons with psychological disorders must include doctors.

    Increasing stress level among individuals

    People's or society's stress levels are rising as a result of causes such as substance addiction, increased mental health awareness in recent years, and fewer social connections. In addition, over time, the use of advanced linked technologies such as physician-recommended mental health apps, wearables, and self-assessment awareness gadgets has grown. As a result, demand for mental health apps is predicted to increase in recent years. Psychotherapists, other doctors, psychiatrists, and clinical psychologists can use mental apps to examine and monitor their patients' mental health. As a result, the market for mental health applications is fueled by the adoption of such apps by experts.

    Market Restraining Factors

    Privacy and research concerns

    Although there is research on using mobile apps in conjunction with therapy, there is little research about how these apps are developed, with one exception: if the apps are produced by the federal government, such as the Substance Abuse and Mental Health Administration (SAMHSA) or the US Department of Veteran's Affairs (VA)/Department of Defense (DOD), they usually include app development information. There are two types of mental health apps for mobile devices: passive and active. Active apps necessitate direct patient input, like the completion of mood logs, self-symptom ratings, and the recording of personal experiences. Without the patient or provider's knowledge, passive apps can access information and collect data using smartphone functions like GPS. Though it may be advantageous, some people may object to the possible invasion of privacy that such data collection entails.

    Application Outlook

    Based on Application, the market is segmented into Depression & Anxiety Management, Meditation Management, Stress Management, Wellness Management, and Others. The stress management segment witnessed a promising revenue share in the mental health apps market in 2020. The increasing prevalence of stress and related diseases, as well as the growing usage of applications that aid in stress reduction and management, are driving the segment's rise over the forecast period.

    Platform Type Outlook

    Based on Platform Type, the market is segmented into iOS, Android, and Others. In 2020, the iOS segment procured the highest revenue share in the mental health apps market. The growing acceptance of iOS among customers can be linked to the rise of the iOS category. The market share of iOS in the United Kingdom climbed from 47 percent in Q3 2020 to 51.6 percent in Q3 2021, according to data published by Business of Apps in 2021. As a result, such examples show that the segment will grow in the next years.

    Regional Outlook

    Based on Regions, the market is segmented into North America, Europe, Asia Pacific, and Latin America, Middle East & Africa. North America emerged as the leading region in the mental health apps market with the maximum revenue share in 2020. The market is being fueled by prominent factors such as the increasing adoption of smartphones, advancements in coverage networks, and increased penetration of the internet and social media. Smartphone usage in the North American region was around 80% in 2020, according to the GSMA's The Mobile Economy Report 2021, and is anticipated to reach 85 percent by 2025.

    Recent Strategies Deployed in Mental Health Apps Market

    • Feb-2022: Calm announced an agreement to acquire Ripple Health Group, a healthcare technology company. Through this acquisition, the company aimed to strengthen its mental health care ambitions and develop a suite of Calm Health that is expected to combine into the present healthcare technology as well as secure to use.

    • Jan-2022: Headspace Health took over Sayana, mental health, and wellness company driven by AI. Through this acquisition, the company aimed to strengthen its abilities to personalize member experiences for a better understanding, support, and enhancement of feeling and mood.

    Companies Mentioned

    •, Inc.

    • MoodMission Pty. Ltd.

    • Sanvello Health, Inc. (UnitedHealth Group Incorporated)

    • Headspace, Inc.

    • Flow Neuroscience AB

    • Youper, Inc.

    • Urban Massage Ltd.

    • Happify, Inc.

    • SilverCloud Health, Inc. (American Well Corporation)

    For more information about this report visit

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