Health Topics

Seasonal Affective Disorder Expand

CAPS has a number of full-spectrum lights for student checkout (please contact CAPS for current availability). If you’ve already checked one of our lamps out, access the documents below for instructions regarding use, and read below for information about Seasonal Affective Disorder.

Verilux Instructions
Using Light Therapy
Winter Blues SAD Handout

Now that Daylight Savings Time is over, most of us go to work and return home in darkness. And for some people, the loss of light causes their moods to dim as well.

The Academy of Family Practice explains that 10% of the U.S. population may suffer from winter depression (Seasonal Affective Disorder or SAD). And as many as 25% feel the “winter blahs,” a condition of less severity, but with many of SAD’s symptoms. Think of a scale from 1 to 10.  At 1 – 4, a person may feel blue, having lost the joy he or she normally experiences. From 5 – 8, the person is likely in full-blown SAD. At 9 – 10, a crisis may occur; people can become so depressed they consider suicide.

People are sometimes surprised when they reflect on past years and recognize their moods have darkened as winter has approached.

Seasonal Affective Disorder is caused, not by the cold, but by diminished light. The problem is worse in northern latitudes where days are shorter. For example, in Florida only about 1.5% of people have SAD. In Washington State, it is 7 times higher, beginning around October and ending about April. In Spokane, during the months between November and March the majority of the days are cloudy, thus compounding the problem.

Symptoms of SAD include:

Depression beginning in the autumn and remitting in the spring, heavier alcohol use to “self-medicate,” craving junk food and soft drinks, increased need for sleep, difficulty concentrating, carbohydrate cravings, decreased sex drive, decreased energy, suicidal thoughts, social isolation, weight gain, listlessness, loss of joy, pessimism, irritability, sadness, and fatigue.

Why do people get SAD? The answer is not known exactly, but researchers believe lack of sunlight affects the body’s chemistry. With shorter days, melatonin (the “hormone of darkness”) is secreted in higher levels, resulting in a disturbance of the body’s natural rhythms. Declining light also decreases serotonin (“the happiness hormone”). It may be that the body’s inability to produce Vitamin D, (the “sunshine vitamin”) in the winter causes mood to plummet. SAD may be the result of any or all of these situations.

Dr. Norman Rosenthal, Clinical Professor of Psychiatry at Georgetown Medical School, has researched SAD for 25 years. He says, “For some people, it seems as if they have two different personalities. The summer person is energetic, cheerful and productive. But the winter person has little energy and finds it difficult to cope with every day tasks. As days grow longer again in March to April, the energetic person reappears.”

If lack of light is the cause of winter depression, then it makes sense that adding more light can be therapeutic. Rosenthal has found this to be true. Research shows that increasing light can help with SAD. In fact, light therapy, or phototherapy, is as effective as taking an anti-depressant medication, and may help more quickly and with fewer side effects. Rosenthal says, “Although it varies from person to person, most feel effects of light therapy in 2 to 4 days.” He adds, “Don’t give up on light until you have used it consistently for several weeks.” As time passes, 80 – 95% of people can continue their journeys to a normal mood state, even on dark, cold days.

But not just any light will do. Most studies have shown that depressive symptoms can be lifted by exposure to a particular type of bulb that provides intense light. Recommended treatment is to sit next to a special fluorescent light that provides 10,000 lux (a unit of measuring the light’s intensity).

To get a feeling for light intensity, a typical living room might have lighting at 50 lux. A business office might have about 320 -500 lux. On a December day in Spokane there may be 1000 lux. In direct sunlight on a summer day, there would be greater than 100,000 lux.

SAD lamps have filters to remove damaging UV rays. Rosenthal suggests starting with 15 to 20 minutes a day, and to work up to about 30 minutes. Place the lamp at a distance of about 12 – 15 inches from the face, with the light shining from above. The light should pass in front of the face; don’t stare into the light. People often use these lights at the breakfast table, to apply makeup, or on the desk next to the computer.

Most people need the light first thing in the morning. These lamps come in several styles: as desk lamps, floor lamps, light boxes, and even as bulbs embedded in visors so that a person can move around and take the light with them.

There can be negative effects from using light therapy. Some people experience headaches, insomnia or dry eyes. It might require an adjustment of the time spent with the light, or with the distance from the lamp, to obtain alleviation of depressive symptoms. Discuss using light therapy with a medical professional if you have bipolar disorder. In some studies, patients undergoing light treatment have become manic as a result. Check with your medical provider if you are taking any medications that react poorly to bright light (certain antibiotics or anti-inflammatories).

The lights can be expensive (between $180.00 to $300.00), but the lamps are generally used beginning about October and ending when daylight lengthens in the spring. The lamps can then be put away until the next fall. The bulbs have 1000s of hours of light capacity and will likely last for years.

David Avery, MD, psychiatrist at The University of Washington, has done research with dawn simulators. This is also light therapy, but delivered in a different way. Dawn simulators are set to gradually fill the bedroom with light, approximately 90 minutes prior to the normal waking time, thus imitating a natural sunrise. This light gently tells the body it is time to awaken – even if it is still dark outside. Avery explains, “We think the light signal through the eyelids connects to the hypothalamus in the brain and in essence resets the body’s clock.”

Dr. Rosenthal suggests, “It is best to start light therapy as soon as the first symptoms of winter depression appear, before they progress to a full-blown picture of SAD.” Use of a SAD light must be consistent. Once the symptoms of depression have diminished, regular use of the lamp will likely be needed until springtime when sunlight increases.

SAD lights are available from several companies online, including the following (Please note that this is not an endorsement, but meant simply to assist the search for SAD resources):  www.alaskanorthernlights.com  / www.naturebright.com / www.northernlighttechnologies.com / www.sadlight.com / www.sunbox.com / www.verilux.com.

What Else Can You Do? There may be a number of things that help.

• Go outdoors and walk briskly if we do have a sunny day. Remember – don’t wear sunglasses. Or work out in a brightly lit gym. Exercising increases the body’s endorphins (“natural morphine”) and fights depression. Look forward to an outdoor activity such as ice skating, skiing or sledding.
• Open blinds and curtains and turn on lamps during the day in your home or office.
• Eat foods high in Omega-3 fatty acids. Examples are wild salmon, flaxseed oil, walnuts, oysters, sardines, beans, olive oil, soy products and halibut. Fish oil supplements are inexpensive and easy to take.
• Avery emphasizes good sleep habits. Try to go to bed and arise on a regular schedule. Make the bedroom completely dark and cool. Dim the lights in the evening, signaling the brain the day is winding down.
• Start a gratitude list. Even simple things that can be appreciated – a good cup of coffee, a call from a friend, a new experience, the love for your pet. Focusing on the positive gives a perspective that reduces depression.
• Do something for someone else. Give an anonymous gift. Give your time to a good cause.
• Don’t go into hibernation mode. Continue making and accepting social connections. Schedule fun activities.
• Schedule a winter vacation to a sunny place.
• Increase your Vitamin D intake. Recent studies show that vitamin D protects against depression, osteoporosis, heart disease, multiple sclerosis, rheumatoid arthritis, infections and cancers. Good sources of vitamin D are fortified milk, salmon, tuna and eggs. A lab test can measure vitamin D levels and then the proper dosage can be prescribed.
• Talk to a mental health provider. Psychologists have found that the use of good therapy, particularly Cognitive Behavioral Therapy (CBT) can be very helpful for depression.
• If depression isn’t alleviated with these suggestions, visit with a medical professional to discuss medication. The FDA recommendation for SAD is Buproprion XL or one of the drugs in the SSRI class such as Prozac or Zoloft.

Once a person recognizes the pattern of SAD, it can be a relief to know there is help. Checking with a medical practitioner prior to beginning the above treatments can be important. And if symptoms become intolerable, don’t wait to call for help.

Sleep Tips Expand

Need Some Help Falling Asleep?

These suggestions are just that, suggestions. They are not dogma. For example, caffeine might not keep you awake at night. But if you are having trouble falling asleep, try avoiding caffeinated drinks after lunch and see if you fall asleep easier. Use what works for you and makes sense for your lifestyle.

• Try to develop a routine. Go to bed and wake up at the same time every day. It will help you fall asleep quicker and wake up easier as your internal clock starts to change.

• Eat healthy and exercise regularly, but avoid large meals or rigorous exercise three hours prior to bedtime.

• Avoid caffeine in the evening. Caffeine has a long half-life and can still be affecting your body five to seven hours after consuming.

• Develop a bedtime ritual, such as a hot bath or reading a book for pleasure, that allows you to relax and prepares your body and mind for sleep. Going directly to bed after a busy stressful day can result in lying in bed with your mind racing. Watching TV or surfing the net can also interfere with developing a quiet mind for sleep.

• Listen to music with a slow rhythm and a deep pitch. It will help slow your metabolism and release chemicals in your body similar to tranquilizers.

• Make sure the temperature is comfortable for you. Do you need to feel warm and cozy to fall asleep or do you prefer to sleep cool?

• Make your bed the most comfortable place in the world for you, with the right mattress, pillows, sheets, and blankets or quilts.

• Avoid bright light prior to going to bed. Light is a signal to our body to wake up.

• Find what works for you and do it. If it stops working, be flexible and try something else.

Enjoy sleeping. It does not mean you are lazy or irresponsible. Nor does it mean you are missing out on fun. Sleep is what allows you to take a responsible attitude in life, complete tasks to the best of your ability, and to feel alive and energetic during your waking hours.

Tips for Relaxing Expand

Learning to relax is like learning any new skill: It takes practice to become good at it.

We have prepared three kinds of relaxation exercises: Active , Progressive , and Visualization. Choose one and see if it works for you. Everyone is different and different techniques work for different people (several stress and relaxation CD’s are available for checkout or for use in the Counseling Center’s Chill Room).

Find a quiet time to practice. It is best to find a comfortable position, either lying down or sitting with your spine straight and arms and legs uncrossed.

One approach is to read a relaxation exercise into a tape recorder to make an audiotape. Play the tape back to yourself so you can follow the instructions while listening.

Once you practice sufficiently at home, you will be able to use these exercises anywhere without anyone knowing you are doing them. For example, you can use them just before an exam or a presentation.

One way to test how well your practice with relaxation is progressing is to rate your level of tension before and after the exercise: Initially, on a scale from 0 to 100, rate your tension level with 0 being totally relaxed and 100 being totally tense. Then, when you finish the relaxation exercise, rate your level of tension again. If you are able to lower your tension level by even 1 point, you are being successful.

Have patience with yourself, and remember this is a skill you are learning (a skill you can keep and use throughout your life).

Reducing Test Anxiety Expand

Things to do before an exam:

1. Don’t Cram.  Cramming is probably better than not studying at all, but the best way to reduce test anxiety is to prepare for an exam well in advance.
2. Know Your Limitations.  Don’t be embarrassed about asking for help if you can’t solve a problem on your own.
3. Develop a Magic Word.  Get in the habit of doing something relaxing each week. While you are doing this activity, say to yourself “relax” (or some other calming word) and notice how you body feels when it is relaxed. Practice saying your magic word in different situations, and try to recapture the bodily feeling of relaxation. With continued association, you can use your ‘magic word’ if you discover yourself becoming anxious during a test.
4. Relax.  Do something that is relaxing for you before you go to an exam.
5. Be Punctual.  Don’t show up for an exam early or late. If you come early, you can ‘catch’ other people’s anxiety. If you show up late, you start out under pressure.
6. No Last Minute Review.  Don’t go over your test material immediately before an exam. You can always find something you don’t know, no matter how well you have prepared.
7. Eat.  Skipping meals before an exam makes one more anxious.
8. Sleep.  Plenty of rest will allow your body to more effectively manage the added stress of the examination. Sleep tends to clear the mind as well.

Things to do during an exam:

1. Calm Yourself.  Identify several calming phrases (e.g., “regardless of how I do on this test, I’m going to be okay…I’ll just do my best”). Try to become aware of when you are thinking negatively and stop. Substitute positive thoughts.
2. Snack.  You may want to take a small snack with you to the exam (make certain your professor is comfortable with this). If you find yourself getting anxious, put aside your test materials and take a minute to eat your snack. Eating the snack helps to temporarily remove you from the stressful situation, and also serves to increase your energy.
3. Build Your Self-Confidence.  Scan the whole exam and pick out the questions you know the answers to. Answer these questions first, even if they are only worth a couple of points.
4. Keep Your Mind on the Task.  Try not to compare yourself to other people during the examination.

Things to do after an exam:

1. Have a Good Time.  Regardless of how you think you did, reward yourself for surviving the experience.
2. Identify Your Strengths and Weaknesses.  Try to figure out what you did well, and what you could improve upon, during the exam. Look for information you can use as you prepare for your next exam.
3. Analyze Your Performance.  Try to identify reasons why you performed the way you did on the exam (e.g., “I studied the right material”). Be careful not to draw false conclusions about the class or yourself (e.g., “I am incapable of passing this course”). Remember, we all have the potential to do just about anything we want. We succeed or fail mainly on the basis of whether we worked ‘with’ ourselves or ‘against’ ourselves.

Exam Preparation Expand

I. Prepare your schedule.

Good time management is imperative. Take a seminar or workshop on time management or read, and utilize, a time management book or tape. Begin to incorporate good time management skills into your life. Begin to study for that test on the evening of the first day of class.

II. Prepare your materials.

Go to every class! Take careful notes. Rewrite your notes after each class and review them all at least once a week (daily, for more difficult classes). Keep your notes in an organized notebook and do additional research on concepts that aren’t clear to you (keep this additional information in your notebook as well). Read all written materials thoroughly and take careful notes or highlight all important facts or concepts. Review these at least weekly. Create flashcards for more difficult concepts or facts, and review them weekly. Discuss questions and problem areas with your professor or T.A. on a regular basis. Participate in class-you’ll remember more if you’re involved in the process of learning. Take advantage of or create study groups for more difficult classes. Work through every homework assignment carefully.

III. Prepare your body.

Be rested, fed, and fit! Eat three meals a day of reasonably nutritious food and avoid excessive caffeine or sugar. Exercise regularly.

IV. Prepare your mind.

Watch out for negative or critical self-talk before a test (or at any other time). Dispute it! Argue with it! Out-talk it! Go to a counselor for help with this, if necessary, because critical self-talk can affect performance tremendously! Watch out for catastrophic thinking-“If I fail this test, get a C, etc., I’ll be a failure, have no future, end up on the streets, and so forth.” This sort of thinking is self-defeating, and really can impair your performance. It also isn’t realistic. Change the usual way that you think about tests and studying. Put grades and tests in perspective. Even an ‘F’ on a test is not really the end of the world.

To help clear you mind and find necessary balance within yourself and your life, do a relaxation or meditation exercise daily (don’t knock it until you’ve tried it!). You might try doing some relaxation exercises before tests. A counselor can help you with learning relaxation strategies or guided imagery to enhance test-taking.

Avoid procrastination and ‘just do it!’ Don’t wait to be in the mood, or clean your apartment first. Break your tasks up into small pieces, reward yourself after each bit, and get to it. Develop your goals-for the semester, the year, the next five years. Make goals realistic, definable, and related to your studies. Make sure they’re your goals-not mom’s, dad’s, or your friend’s. And don’t forget to re-evaluate your study plan regularly. Throw out what doesn’t work for you, and keep looking for solutions to problems areas. Reward yourself for a job well done.

In summary, careful preparation of your schedule, study materials, your body and your mind is imperative for achieving good results on tests and in your studies. A counselor from EWU Counseling and Psychological Services may be able to assist you through major obstacles such as anxiety, depression, procrastination, and lack of appropriate goal-setting. The Academic Support Center (509-359-2487) on campus is another resource available to students struggling with study skills, test anxiety, etc. Disability Support Services (509-359-6871) is available to assist those with disabilities impacting their participation in education and learning.

Tips for Managing Stress Expand

What is Stress? Stress is an everyday fact of life. We cannot avoid it. Stress is any change we must adjust to. We often think of stressful events as negative…a big exam, a flat tire…however, positive events can create stress as well. For example, that ‘A’ on the exam can create performance stress in that you may feel the need to maintain the same level of achievement. Falling in love may be as stressful, for some, as breaking off a relationship.

Thus, the goal is not to eliminate all stress. Life would be dull without both joyful stressors for which we have to adjust, and distressors requiring a response. In fact, stress and anxiety often motivate individual’s toward peak performance. The Chinese apparently have two spellings for stress, one meaning ‘danger,’ the other ‘opportunity.’ Thus, what we want to do is limit the harmful effects of stress, while maintaining life’s quality and vitality.

Note that experienced stress is actually the interaction of a stressor and an individual’s stress reactivity. A stressor only has the ‘potential’ to elicit a stress response. Therein lies some personal control, and possibilities for more effective management of the stressors in your life. Stressors come in many packages that vary with each of us as individuals. They may present as external events, such as relationship conflicts, or be more internal, such as personal expectations or life crises.

Stress begins with a life situation that knocks you out of balance. We all know that the same situation presented to different people may result in very different reactions. Different people will interpret the situation differently. Therefore, a life situation to which you must adapt is a necessary but not sufficient component of stress. What is also necessary is your interpretation of the life situation as stressful.
What occurs next is an emotional and physiological reaction to the distressing life event, such as anger, fear, helplessness and concomitant physiological arousal. Over time, increased physiological arousal (i.e., the ‘fight or flight’ response) can lead to health consequences. Some experts estimate that as much as 50-80% of all physical illness is stress-related. Consequences may be seen interpersonally as well, as when someone lashes out angrily at another due to stress. Schematically, this may be presented in this way:

A. Life Situation→B. Perception as Stressful→C. Emotional Arousal

→Physiological Arousal

→Consequences

 

Stress management entails setting up roadblocks at various points along the stress pathway (above). Change can be made in an individual’s life situation, and in the way s/he perceives and responds emotionally and physiologically to the stressor. You are in much greater control over yourself than you ever realized, and managing stress is simply exercising that control. Since stress results from the interaction of a stressor and an individual’s stress reactivity, stress interventions aim to reduce stress reactivity, thereby enabling you to cope more successfully with the array of stressors that impinge upon you. Remember-“A pearl is the result of an oyster’s victory over an irritation.” (author unknown)

Self-care involves taking steps to manage stress and maintain wellness. Self-care takes place at each level of the stress model. For example, early in the model, it involves getting sleep and good nutrition. Next (at level B), it involves thinking realistically and positively, and checking our perceptions. Later in the model, we are encouraged to take care of ourselves emotionally and physically-to nurture our friendships, to express ourselves, and to exercise our bodies and minds.

Lifestyle Changes for Effective Stress Management

Stressor Interventions

1. Learn to Plan. Don’t procrastinate and let things pile up. If you must take on more than one project at a time, prioritize work to be done and space deadlines far enough apart to control the buildup of stress. Learn time management skills.
2. Recognize and Accept Limits. Set realistic expectations. Nobody can be perfect so try not to be hard on yourself if you don’t meet some of your goals.
3. Have Fun. Give yourself a break. You need to occasionally escape from the pressures of life and have fun. Find pastimes which are absorbing and enjoyable to you, no matter what your level of ability. Identify activities both physical and mental that you find enjoyable and helpful in dealing with stress.
4. Be a Positive Person. Avoid criticizing others. Learn to praise the things you like in others. Focus upon the good qualities those around you possess. Learn to do this for yourself also. Notice and reward yourself for your good qualities and for even small improvements.
5. Learn to Tolerate and Forgive. Intolerance of others leads to frustration and anger. An attempt to really understand the way other people feel can make you more accepting of them. It is important to become aware and accepting of your own feelings as well.
6. Avoid Unnecessary Competition. There are many competitive situations in life that we cannot avoid. Too much concern with winning in too many areas of life can create excessive tension and anxiety and make one unnecessarily aggressive.

Perception of Threat Interventions

1. Try to maintain a reasonable perspective. To a large degree, your perceptions determine what is stressful to you. Blowing a job interview or task isn’t as catastrophic as it may feel when it happens. Take time to sit back and think about it. Failing does not mean you are a failure!
2. Imagine doing what stresses you and having it come out well.
3. Avoid cognitive distortions that may skew your perception.
4. Recognize that you’ve been through many stressful, and perhaps similar, experiences before, and you lived to tell about it.

Psychological Effects Interventions

1. Share your feelings with someone to prevent a build-up of pressure, frustration, and emotions. This could be a friend, relative, or counselor.
2. Become more aware of your thoughts. Avoid excessive worry and negative self-talk. Replace these with positive self-talk, task relevant thinking, and a more positive attitude.
3. Talk out your troubles. Find a friend, member of the clergy, counselor, or psychotherapist you can be open with. Expressing your bottled-up tension to a sympathetic ear can be incredibly helpful.

Physical Effects Interventions

1. Make sure you get enough sleep and nutritious food. Your body must be in good shape for your thinking to be at its best.
2. Get regular exercise to keep your body healthy and to get rid of some physical tension.
3. Take time out to rest and relax using methods already comfortable and effective for you, such as reading a novel, listening to music, playing an instrument, going to a movie.
4. Learn a systematic, drug-free method of relaxation such as meditation, yoga, or progressive muscle relaxation.

*Managing stress effectively is a skill that you learn. Like all skills, it takes time and active participation for it to work effectively. Chronic conditions should be evaluated by a competent medical professional to exclude physical causes. 15 Styles of Distorted Thinking Expand

1. Filtering: You take the negative details and magnify them, while filtering out all positive aspects of a situation. A single detail may be picked out, and the whole event becomes colored by this detail. When you pull negative things out of context, isolated from all the good experiences around you, you make them larger and more awful than they really are.
2. Polarized Thinking: The hallmark of this distortion is an insistence on dichotomous choices. Things are black or white, good or bad. You tend to perceive everything at the extremes, with very little room for a middle ground. The greatest danger in polarized thinking is its impact on how you judge yourself. For example-You have to be perfect or you’re a failure.
3. Overgeneralization: You come to a general conclusion based on a single incident or piece of evidence. If something bad happens once, you expect it to happen over and over again. ‘Always’ and ‘never’ are cues that this style of thinking is being utilized. This distortion can lead to a restricted life, as you avoid future failures based on the single incident or event.
4. Mind Reading: Without their saying so, you know what people are feeling and why they act the way they do. In particular, you are able to divine how people are feeling toward you. Mind reading depends on a process called projection. You imagine that people feel the same way you do and react to things the same way you do. Therefore, you don’t watch or listen carefully enough to notice that they are actually different. Mind readers jump to conclusions that are true for them, without checking whether they are true for the other person.
5. Catastrophizing: You expect disaster. You notice or hear about a problem and start “what if’s.” What if that happens to me? What if tragedy strikes? There are no limits to a really fertile catastrophic imagination. An underlying catalyst for this style of thinking is that you do not trust in yourself and your capacity to adapt to change.
6. Personalization: This is the tendency to relate everything around you to yourself. For example, thinking that everything people do or say is some kind of reaction to you. You also compare yourself to others, trying to determine who’s smarter, better looking, etc. The underlying assumption is that your worth is in question. You are therefore continually forced to test your value as a person by measuring yourself against others. If you come out better, you get a moment’s relief. If you come up short, you feel diminished. The basic thinking error is that you interpret each experience, each conversation, each look as a clue to your worth and value.
7. Control Fallacies: There are two ways you can distort your sense of power and control. If you feel externally controlled, you see yourself as helpless, a victim of fate. The fallacy of internal control has you responsible for the pain and happiness of everyone around you. Feeling externally controlled keeps you stuck. You don’t believe you can really affect the basic shape of your life, let alone make any difference in the world. The truth of the matter is that we are constantly making decisions, and that every decision affects our lives. On the other hand, the fallacy of internal control leaves you exhausted as you attempt to fill the needs of everyone around you, and feel responsible in doing so (and guilty when you cannot).
8. Fallacy of Fairness: You feel resentful because you think you know what’s fair, but other people won’t agree with you. Fairness is so conveniently defined, so temptingly self-serving, that each person gets locked into his or her own point of view. It is tempting to make assumptions about how things would change if people were only fair or really valued you. But the other person hardly ever sees it that way, and you end up causing yourself a lot of pain and an ever-growing resentment.
9. Blaming: You hold other people responsible for your pain, or take the other tack and blame yourself for every problem. Blaming often involves making someone else responsible for choices and decisions that are actually our own responsibility. In blame systems, you deny your right (and responsibility) to assert your needs, say no, or go elsewhere for what you want.
10. Shoulds: You have a list of ironclad rules about how you and other people should act. People who break the rules anger you, and you feel guilty if you violate the rules. The rules are right and indisputable and, as a result, you are often in the position of judging and finding fault (in yourself and in others). Cue words indicating the presence of this distortion are should, ought, and must.
11. Emotional Reasoning: You believe that what you feel must be true-automatically. If you feel stupid or boring, then you must be stupid and boring. If you feel guilty, then you must have done something wrong. The problem with emotional reasoning is that our emotions interact and correlate with our thinking process. Therefore, if you have distorted thoughts and beliefs, your emotions will reflect these distortions.
12. Fallacy of Change: You expect that other people will change to suit you if you just pressure or cajole them enough. You need to change people because your hopes for happiness seem to depend entirely on them. The truth is the only person you can really control or have much hope of changing is yourself. The underlying assumption of this thinking style is that your happiness depends on the actions of others. Your happiness actually depends on the thousands of large and small choices you make in your life.
13. Global Labeling: You generalize one or two qualities (in yourself or others) into a negative global judgment. Global labeling ignores all contrary evidence, creating a view of the world that can be stereotyped and one-dimensional. Labeling yourself can have a negative and insidious impact upon your self-esteem; while labeling others can lead to snap-judgments, relationship problems, and prejudice.
14. Being Right: You feel continually on trial to prove that your opinions and actions are correct. Being wrong is unthinkable and you will go to any length to demonstrate your rightness. Having to be ‘right’ often makes you hard of hearing. You aren’t interested in the possible veracity of a differing opinion, only in defending your own. Being right becomes more important than an honest and caring relationship.
15. Heaven’s Reward Fallacy: You expect all your sacrifice and self-denial to pay off, as if there were someone keeping score. You fell bitter when the reward doesn’t come as expected. The problem is that while you are always doing the ‘right thing,’ if your heart really isn’t in it, you are physically and emotionally depleting yourself.

*From Thoughts & Feelings by McKay, Davis, & Fanning. New Harbinger, 1981. These styles of thinking (or cognitive distortions) were gleaned from the work of several authors, including Albert Ellis, Aaron Beck, and David Burns, among others.