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Coping Toolbox 101



Priyanka Upadhyaya, Psy.D.
You can take many steps to take care of yourself when you have PTSD, Anxiety and/or Depres-sion, or even a less serious case of the blues. The first step is to be aware when you are feeling stressed or overwhelmed and might benefit from help.
Research studies have shown that psychotherapy, medications, spiritual practice, and healthy lifestyle changes such as exercise, a healthy diet and improved sleep can help improve your mood and restore health. Additionally reaching out and connecting with positive social supports is key to good mental health.
The following tips can help you take steps towards better mental and physical health. They are not meant to be a to-do list, but a reminder that you can make small changes in your life that might help your mood. They are a starting point.
Learn more about the condition you have: Educate yourself and become your own health advocate
Talk to your WTC Health Program provider if you have symptoms of PTSD, anxiety and/or depression or call Voices of September 9/11 to get more information about how a mental health provider can be of help. Getting treatment is a critical step to reducing your symptoms and promoting recovery.
Move to change your state of mind!
Regular exercise can be powerful medicine. Try walking, swimming, weight training, martial arts, or dancing. Note that even small amounts of movement can help you change your mood.
Eat to nourish
People may turn to poor eating habits when feeling overwhelmed with stress, such as overeat-ing, not eating enough, or making unhealthy food choices.
TUNE in to your hunger: When you think you feel hungry PAUSE and ask yourself: "am I really hungry or am I feeling something else?
Eat a WHOLESOME diet with a variety of nutrient rich foods.
PAUSE when you reach for junk food! Because we tend to crave carbohydrates when we are stressed and depressed. Choose your carbohydrates wisely.
Sleep is crucial for promoting energy, concentration, and resilience. You can address sleep problems in many ways - you can seek medical advice for medications, you can seek psycho-therapy, and an MD or therapist will both be able to help you with good sleep hygiene.
Here are some lifestyle tips that can help promote better sleep:
  • Winding Down: As sleep time approaches try these tips to calm your body and mind for sleep
  • Avoid caffeine, alcohol, or nicotine in the evening.
  • Take a warm shower right before bedtime to increase deep sleep as your body cools.
  • Keep your bedroom at a comfortable temperature and turn off bright lights.
  • Avoid looking at a bright screen prior to bedtime- the bright light from your device or TV suppresses the sleep hormone, melatonin, which tells your brain "its time for bed."
  • Use the bed only for sleeping and sex, not watching TV or working. This way, your bed becomes a cue for sleeping.
  • Wear earplugs and a sleep mask if noise and light bother your sleep.
  • A white noise machine may be helpful for environmental noises.
  • Get regular exercise.
  • Relaxation therapies such as yoga and deep abdominal breathing may be useful in initiating sleep.
  • Meditation and listening to soothing music can also help with sleep issues.
  • Don't lie in bed tossing and turning. Get out of bed and do some calming activity. Go back to bed when you are feeling drowsy.
Develop a self-care routine
Prioritize taking time out to care for yourself.
Breathe to Relax and take a break
Inhale…..Exhale….Repeat. Deep mindful breathing practiced regularly can be a powerful tool to relax the nerves and re-energize the body and mind.
Anyone can do this form of breathing or mindfulness meditation. By becoming aware of your breath in the moment, you begin living less "in your head" and more in the "now."
You can also practice breathing while doing something that helps you unwind or relax can also be effective. For instance try listening to soothing music, watch uplifting movies, get outdoors, engage in a yoga or meditation practice or engage in prayer.
Like a tree makes a solid foundation by building roots, when your emotions overwhelm your capacity to cope, use Grounding skills to re-connect and 'root yourself'.
Concentrate and focus on the present by directing your attention on something specific. For instance, you can touch objects around you and describe them. Run cold water over your hands, and describe aloud how it feels. Say all the different types of fruits you can think of right now.
Be gentle and compassionate with yourself
Check your harsh inner critic. Sometimes you may not even be aware, but you might be putting yourself down and being overly critical.
Think about what you could be angry at and address the root cause
PTSD, Depression and anxiety can also include feelings of anger. Anger is a powerful and primary emotion. When harnessed well, it can have many positive consequences, but it can become harmful when you deny or don't address these feelings.
Label your angry feelings. Accept or discuss them so that you are less likely to feel burdened by them.
Allowing yourself positive experiences and small pleasures is one of the keys to changing a neg-ative mindset about yourself and your life.
Laughter and Humor
Laughter is a powerful antidote to stress, physical pain, and conflict. Laughter relaxes the body, releases the body's natural "feel good" chemicals, and boosts the immune system by decreas-ing stress hormones. Humor and laughter also can improve your health by lightening the load of anger, and negative emotions. Below are some ways to infuse laughter and humor into your life:
  • Smile: Give your phone a break. Look up and smile at people during your morning commute.
  • Count your blessings- Being Grateful: The simple act of considering the good things in your life will help with negative thoughts.
  • When you hear laughter, move toward it. When you hear laughter, seek it out.
  • Spend time with fun, playful people. Positivity is contagious – spend time with people who enjoy fun.
  • Bring humor into conversations.
  • Simulated laughter: Believe it or not, it's possible to laugh without finding something funny—research shows simulated laughter can be just as good for you as the real thing.
Build positive memories
Positive emotions are not just temporary- they have a long lasting impact on the way our brains get wired.
When we build positive memories, over time they help with a better physical health, resilience and optimism. They also counter the effects of painful experiences and increase our problem solving abilities.
Add activities to your life that give you a sense of meaning and purpose.
Feeling a sense of purpose or meaning can alleviate distress related to PTSD, depression or anx-iety symptoms.
Ways to build a sense of purpose and meaning can include:
  • To serve/help others - Volunteering, looking after animals, raising a family, looking after grandchildren are all good examples of helping others.
  • Re-learning through problem solving - being involved in activities that challenge and stretch us seem impossible with depression, but our brains are healthiest when challenged and stretched.
  • Go beyond your struggles: building a spiritual practice & prayer - Engaging in a spiritual practice, prayer or taking up a cause larger than yourself can be very healing.
If you are interested in getting help for your mental health as related to your experience of 9/11, call Voices of September 11th at 203-966-3911 for more information on how an experienced mental health professional can help you.
It's never too late to get help.
Priyanka Upadhyaya, PH.D.


Psychologist/Clinical Instructor
World Trade Center - Environmental Health Center NYU
Langone Medical Center-Bellevue Hospital
Dr. Priyanka Upadhyaya is a clinical psychologist at the World trade center environmental health center at Bellevue hospital which is one of three clinical centers of excellence dedicated to the integrated assessment and treatment of individuals who were present in the New York city disaster area.
Dr. Upadhyaya provides individual, group psychotherapy, mentors and supervises social workers and doctoral psychology students. She presents on various aspects of trauma informed care at case conferences and seminars, conducts community outreach workshops and in house staff training and education workshops. Dr. Upadhyaya is also part of initiatives to transmit health messages across the survivor and responder population through social media and online newsletters and participates in department wide research initiatives. Her interests and areas of expertise include evidenced based treatment of trauma, mindfulness and meditation, reducing barriers to mental healthcare, post traumatic growth and resilience.

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