It has been many moons since my last post, and things are still headed in a good direction.  I am in school getting my Community Health degree and my dual focus has been mental health and nutrition.  I hope to open a consulting business specializing in eating disorders and how good nutrition can impact your mental health.

Through the process of school, I have taken many wellness courses that have been quite insightful for me and my process.  I would like to share with you some of these essays in the next few posts.

I will start with my self-care plan:

It was very difficult for me to choose just one health focus. I began my journey towards wellness and the pursuit of studying it two years ago.  That’s the point where I lost everything. I lost my job, my identity, and lastly my emotional and physical health. I became disabled.

Physically, I have many problems: I am “grossly” obese (although, I hate that term; I find it very condescending), I have chronic back pain due to arthritis, bulging disks, sciatica, and knee problems.  I was just diagnosed with pre-diabetes and borderline high cholesterol.  I’m a mess.  Emotionally, I suffer from Dysthymic and Major Depressive and Anxiety Disorder-these I have suffered since a child.  Having said all of this, I am on a path to change things.  I am motivated to change things; I have to or I will die young.

I initially wanted to focus on my physical health, in particular my issues with chronic pain. You suggested that I perhaps may want to focus on stress and my anxiety issues. My initial research did support this. One article asked the question whether lower back pain pre-cedes some psychiatric disorder such as depression or anxiety, or vice-versa, they found that as much as 77 percent of individuals with lower back pain suffered from some form of life-time psychiatric disorder.  Moreover, “…. of these patients with a positive lifetime history for psychiatric syndromes, 54% of those with depression…., and 95% of those with anxiety disorders had experienced these syndromes before the onset of their back pain….  Such findings substantially add to our understanding of causality and predisposition in the relationship between psychiatric disorders and chronic low-back pain.” (“Psychiatric illness and chronic low-back pain. The mind and the spine–which goes first?” Polatin PB1, Kinney RK, Gatchel RJ, Lillo E, Mayer TG. University of Texas, Department of Psychology. Spine Vol 18 Issue 1. 1993, January).  In my case, my depression and anxiety came first. In retrospect, I imagine it was my anxiety and need for perfection in my job that contributed to my negligence in the original injury (I attempted to lift a keg of beer by myself, in order to change it).  As the years passed, my anxiety and depressive episodes contributed to recurring injury to my back; the chronic pain inhibited my mobility which contributed to my weight gain, which contributed to my depression and loss of self-efface.  It was a continuing negative cycle.



  1. Self-care Plan
  2. Spirituality and Energy Therapies
  3. Meditation, Mindfulness and Prayer.

I have always considered myself to be a spiritual person.  As a child I had a child’s version of the bible, and read and re-read it.  I was most taken in by the story of Ruth.  I loved how devoted, and strong she was. Reading how she reaped the wheat to feed her sickly mother-in-law, and how determined she was resonated with me.

As I grew into my teenage years, I began to explore other religions other than the one I was brought up in.  Being a Beatles fan I explored Hinduism and Meditation.  Later I began reading about other religions and philosophies.  I explored the eastern religions, such as Taoism and Buddhism.  I also began to read books on Jesus.  I have collected many books on religion and enjoy the scholarly approach to it. I am, as a friend once said, slightly obsessed by the concept.


Religious and spiritual interventions in mental health care: a systematic review and meta-analysis of randomized controlled clinical trials

  1. P. B. Gonçalves, G. Lucchetti,  P. R. Menezes, and H. Vallada

The scope of this meta- analysis is beyond the needs of this assignment, but it does attempt to prove a correlation with wellness and the practice of spiritual and religious activity in life. It is important to note that spirituality and religiosity are not one in the same. Although religiosity has components of spirituality in it, one may be spiritual without subscribing to a religious domination or have a belief in God.  The article attempts to define spirituality by relating definitions by several authors.  However, in reading the definitions included, it is obvious that there are two common elements in all the definitions: (1) a link between the “self” and an intangible or tangible element greater than the” self”; (2) a belief structure that allows transcendence to a higher power, whether it is found within the “self” or in separate entity.

The results found that there was significant reduction of anxiety using meditation and psychotherapy but very little evidence or difference in other intervention types as it relates to depression. There was shown to be positive and neutral evidence for religiosity and prayer.




  1. Art Therapy and CBT

I have found that tapping into my creative side allows me that “flow” or energy connection one may have when experiencing a spiritual connection. All time stops for me when I am in that state, and it feels as if I am tapping into the collective consciousness of the universe as well as getting a glimpse of the beginning of existence. According to my research art therapy can be used to lessen stress and anxiety. This article used CBT (Cognitive Behavior Therapy) along with art to see if the combination could treat anxiety. I have use CBT in the past and it gave me my identity back. Through CBT I recognized my behaviors needed to change, and then I took steps to do just that.  I explored my artistic side and realized that I have the ability to paint.  I also began writing on a regular basis either in journal form or through creative stories.  My self-esteem increased to a healthy level for the first time in my life.

I know now that I need to be creative on a daily basis to maintain my wellness.


 Should art be integrated into cognitive behavioral therapy for anxiety disorders?” Morris, Frances J. The Arts in Psychotherapy, 2014, Vol 4 (4),

used the seven stages of CBT treatment, breathing retraining, cognitive restructuring, interceptive exposure, imaginal exposure, in vivo exposure, and relapse prevention. (Morris, 2014 The researchers used CBT also but were encouraged to relate their emotions and experiences in reference to the stage with drawings.  The mediums used were simple and basic: paper, markers, pastels both oil and chalk, colored pencils, and pen. The individual who suffered from PDA showed a decrease in frequency of panic attacks and her agoraphobic tendencies, but however, it did not affect depression.

  1. Botanicals and Nutrition
  2. Healthy Eating Habits

Last spring semester, I took Basics of Nutrition.  We had to keep a two- week record of what we consumed on a daily basis.  We used this data to determine our nutrient consumption.  It was an eye opener for me.  I thought I ate healthy, but the data told me differently.  I consumed about 2000 calories a day and it was very heavy in starchy carbohydrates and protein.  I also consumed far too much sodium, and the fat I consumed was high in saturated fats.

I eat a great amount of cheese; that’s where my high protein counts and saturated fat levels came from.

This fall, I had to choose a behavior goal was to increase the amount of fruits and vegetables in my diet and to use the website as a food and nutrition tracker. I did increase my intake, but I also de erased my intake of refined and processed foods and cheese. I also have begun The Mediterranean Diet”.

Making sure I have enough magnesium, Vitamins A, B, and K, as well as complete proteins will assist with my overall health and thus my stress and anxiety





Nutrients and Botanicals for Treatment of Stress: Adrenal Fatigue, Neurotransmitter Imbalance, Anxiety, and Restless Sleep Kathleen A. Head, ND, and Gregory S. Kelly, ND                  Amino Acids and Vitamins: As Neurotransmitter Cofactors and other Supportive Mechanism

These include the B vitamins such as Thiamin and Pantethine; amino acids L-Tryptophan and L-Tyrosine and other neuro-mechanisms such as Melatonin. Many studies showed these supplements to inhibit cortisol levels and induce sleep, and several are essential for neuro-transmitter formation (serotonin, dopamine)

The article concluded that these supplements, along with lifestyle can help reduce certain stress related conditions. It pointed out that botanicals can support adrenals, normalize cortisol levels, help sleep disorders, reduce anxiety, balance neurotransmitters with amino acid precursors and provide specific nutrient co-factors. I have also started a regiment of wheatgrass as research for another class pointed out its benefits for wellness.

  1. Mind body manipulation and therapies

I have longed desired to try the ancient forms of qi gong and Tai-Chi.  In my research I discovered that Qi-Gong would be a more holistic form of exercise for me and its focus is on maintain balance.  I have used yoga in the past, but with my mobility issues I have not used it for quite some time.  Now that I discovered a yoga form more suitable for me, I can start very soon.

  1. Qi-Gong: …Managing stress and anxiety through qigong exercise in healthy adults: a 2systematic review and meta-analysis of randomized controlled trials

According to the article,” Qigong exercise is an ancient form of martial arts that was developed in China and has been used in China for thousands of years to improve physical fitness and stamina [6]. The basic components of qigong exercise include concentration, relaxation, meditation, breathing regulation, body posture, and movement [6]. According to the philosophy of traditional Chinese medicine, qigong exercise aims to achieve a harmonious flow of vital energy (qi)and regulate the functional activities of the body through regulated breathing, mindful

concentration, and gentle movements. With regular practice and rehearsal of the structured movements, as well as concentration on mind and breath, practitioners can experience mood stabilization and improved strength and fitness. Qigong is an easily adaptable form of mind body exercise that can be practiced any place and any time, without any special equipment. Itis widely practiced not just to improve physical health, but also to manage stress…” Managing stress and anxiety through qigong exercise in healthy adults: a systematic review and meta-analysis of randomized controlled trials BMC Complementary and Alternative Medicine 2014, 14:8 doi:10.1186/1472-6882-14-8)

2.The Psychological Benefits of Yoga Practice for Older Adults: Evidence and Guidelines Kimberlee Bethany Bonura, PhD, RYT INTERNATIONAL JOURNAL OF YOGA THERAPY – No. 21 (2011).  

The article stresses that the yoga practices that concentrate on all eight of the limbs, provide the greatest impact on the psychological health of the individual.  Mostly, this can be seen through the emphasis on breathing techniques, mindfulness and concentration that yoga emphasizes. The article relates the benefits of yoga such as decrease in stress and anxiety by lowering cortisol levels, decreased levels in depression and pain, the ability for self-reflection, increase feelings of self-esteem and self-efficacy, and increased levels of self-control and self-actualization.

There are several tables featured in the article, specifically guidelines for yoga instructors, research materials and examining the different types of yoga, which includes Chair Yoga, but the one table I found most beneficial is as follows:

“Recommendations for Specific Yoga Practices

  • Meditation practice supports internal focus, increased self-control, and mindful acceptance. For instance, learning to focus on the breath may provide a simple exercise that supports learning to cultivate attentional focus.
  • Relaxation exercises that provide strategies for stress management and stress reduction are an integral part of a yoga practice for older adults.  Table 2. Recommendations for “Yoga Professionals: Guidelines for Teaching Yoga to Older Adults Recommendations for Specific Yoga Practices (continued)
  •         Breathing practice increases lung capacity and oxygenation, which supports increased energy and alertness. For example, learning to take deep breaths by relaxing the abdominal muscles provides a strategy for stress management, especially in contrast to the shallow breathing that may occur under stress. However, all breathing exercises should be carefully considered, especially those which involve rapid breathing or holding the breath, because these exercises may be contraindicated for older adults or individuals with chronic health conditions.
  •         Standing poses (supported by a chair, if needed) increase leg and torso strength, to improve the individual’s ability to complete activities of daily living and reduce the likelihood of falling. Also, standing poses support maintenance of thigh strength, which facilitates ongoing ability for walking and mobility.  Balance poses (supported by a chair, if needed) support muscle control, to reduce the likelihood of falling. This further increases the ability to perform activities of daily living.
  •         Squats (supported by a chair, if needed) support pelvic, thigh, and buttock strength.



A randomized(sic) study of the effects of massage therapy compared to guided relaxation on well-being and stress perception among older adults

The conclusions of the study showed that both techniques are effective in reducing stress, depression, and anxiety in both the control group and the research group.  Guided relaxation used mindfulness techniques as well as aromatherapy, soothing music, and breathing exercises. The massage used a Swedish massage technique as well as soothing music.




“Low Back Pain Fact Sheet” National Institute of Neurological Disorders and Stroke.  

“Psychiatric illness and chronic low-back pain: The mind and the spine-which goes first?’. Palatino P, Kinney R, Gatchel R, Mayer T, Lillo E. Spine [serial online]. January 1, 1993;18(1):66-71. Available from: Scopus®, Ipswich, MA. Accessed October 29, 2016.


Chong-Wen W, Chan C, Ho R, Chan J, Siu-Man N, Chan C. Managing stress and anxiety through qigong exercise in healthy adults: a systematic review and meta-analysis of randomized controlled trials. BMC Complementary & Alternative Medicine [serial online]. January 2014;14(1):8-23. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed November 26, 2016.

Bonura K. The Psychological Benefits of Yoga Practice for Older Adults: Evidence and Guidelines. International Journal Of Yoga Therapy [serial online]. September 2, 2011;21:129-142. Available from: Alt HealthWatch, Ipswich, MA. Accessed November 26, 2016.

Lakhan S, Vieira K. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutrition Journal [serial online]. January 2010;9:42-55. Available from: Academic Search Complete, Ipswich, MA. Accessed November 5, 2016.

Head K, Kelly G. Nutrients and Botanicals for Treatment of Stress: Adrenal Fatigue, Neurotransmitter Imbalance, Anxiety, and Restless Sleep. Alternative Medicine Review [serial online]. June 2009;14(2):114-140. Available from: Academic Search Complete, Ipswich, MA. Accessed November 6, 2016.

MORRIS, FJ. Should art be integrated into cognitive behavioral therapy for anxiety disorders?. The Arts in Psychotherapy. 41, 343-352, Sept. 1, 2014. ISSN: 0197-4556.

Sharpe, P., Williams, H., Granner, M., & Hussey, J. (2007). A randomised study of the effects of massage therapy compared to guided relaxation on well-being and stress perception among older adults. Complementary Therapies In Medicine, 15(3), 157-163.








3. Self care plan :Pat Spinello




Mind: write in journal; work on cookbook; organize daytimer for classes

Body: chair yoga; continue physical therapy; med diet

Spirit: mindfulness 15 minutes each day; find art classes on line through Make time to go to wellness center. Meditate 15 minutes every day by listening to nature sounds

Make sure to leave one day a week free of all school and work to recharge


Mind: continue with journal; schedule reasonable study times

Body: chair yoga, med diet, water yoga at YMCA

Spirit: mediate and mindfulness; wellness center; painting

Make sure to leave one day a week free of all school and work to recharge



Mind: continue with journal; schedule reasonable study times

Body: chair yoga, med diet, water yoga at YMCA

Spirit: mediate and mindfulness; wellness center; painting listen to music while studying

This month will be important to keep stress down. Book a massage. Call around to massage schools to see if they provide a discount for practices.

Make sure to leave one day a week free of all school and work to recharge


Mind: continue with journal; schedule reasonable study times

Body: chair yoga, med diet, water yoga at YMCA; qi-gong at the ymca. This will give you a three day workout schedule with only an hour a day.

Spirit: mediate and mindfulness; wellness center; painting, listen to music while studying; take one day off to re-charge







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