You will learn to break negative cycles of conflict.  You will learn how to identify and understand your own triggers and those of your partners.

Overthrowing Defensiveness

Often times when we are weakened by emotion whether from depression or anxiety, we are vulnerable to feel that anything a partner does or says is an attack on us.  We tend to interpret any communications or actions in the most negative way possible, when in most cases that was not the intentions from our partners.  When we feel like we are being attacked we automatically become defensive, which in turn we then claim zero responsibility for any of the blame of the problem that is caused.  By saying you aren’t to blame assumes that your partner had hostile intentions.  Refer to the following chart to see how a communication or action can be interpreted negatively and automatic defense response.

The Light at the End of the Tunnel

In order to learn how to stop making negative assumptions and following it up with a defensive response, you need to see how such behaviors pan out in your day to day life.  Use the following chart to track events in which such behaviors show up.  Afterwards, see the alternative to defensive responses.  Follow the directions for the chart.

1.  On the left side, record any communications or actions that you feel are hostile from your partner.
2. In the middle column, record how you interpreted what happened.
3. In the right side, record how you responded

Once you have completed this exercise you should be more aware of your own triggers.  Now it’s time to learn the alternative to the defensive response.  Whenever you feel the urge to be defensive, take a moment and inquire with your partner to find out their true intentions.  To do these follow these steps:

1.  Keep you mouth closed the moment you feel attacked.
2. Take a slow deep breath and exhale very slowly and repeat a couple of times until you feel calmer.
3. Once you are calmer, inquire as to what their intentions were and explain what your own worries are without attacking them.

It’s Not Always About You

It’s very easy to misinterpret how others feel.  When someone you care about is angry, it’s easy to believe it involves you in some way.   When this happens you can easily become distressed and in turn become defensive.  We all have intense emotions about events and beliefs that can be triggered easily.

Learn to identify your partner’s triggers so you can understand the emotion behind the anger.  Understanding your partner in this way, will help you see that all of this anger really isn’t about you, which allows you to feel empathy instead of defensiveness.

Identify your partner’s triggers by reading over the following chart.  Think about how they react to events in life.  Rate them on a scale from 1 to 5 with 1 being almost never and 5 being almost always.

In any spot with a rating of 3 or higher, you have found your partners triggers.  Things in life that happen tie into those triggers are surely to produce strong emotions.  Once you have figured out their triggers observer them in action over the next few weeks and keep track of when you notice them expressing negative emotions.  Record the event and your partner’s overall reactions and then what the trigger is.  By doing this you will learn to let go over your own anger knowing it’s not about you.

Shifting the focus

The language you choose when you are communicating concerns makes a big difference in how the communication goes as well as how heated it will become.  Learn how to communicate without counterattacking your partner.  You will have to clearly state how you feel about an issue and start off with the word “I” rather than “you”.  This will take lots of practice to master.  You should know that this could lead to a negative response by your partner, but your odds are significantly greater as compared to blaming your partner altogether.

Learn how to buffer your communication.  Add a phrase that conveys the possibility that your position may not be entirely correct.  Check out the examples of buffering and unbuffering and see which leads to a useful conversation.  Afterwards, record your own buffered alternatives.

It’s no secret that as human beings we thrive on own social relationships.  Even if we claim we aren’t social at all.  People tend to always have friends and family that they talk things out with, even if it’s as simple talking about a trip to buy groceries.  We function better with support.  Our moods improve and our ability for our bodies to handle stress improves as well.  So it should go without saying that every relationship we encounter affects us in some way, from relative strangers to close friends and family.  Taking the time to improve every relationship will surely improve your mood and create a great sense of well-being.

You will learn how to strengthen just about any relationship and be able to use these strategies more and more.  More importantly, we will take a close look at intimate relationships since these have the most impact on our mental health, as well learning how to cope with the loss of a relationship which often causes anxiety or despair.

How does a relationship connect to your emotion?

When you are anxious or depressed you become preoccupied with everything that concerns you.  Any relationship gets put on the back burner.  All of your attention is focused on your own problems and concerns.  All of this attention and buildup of anxiety leaves you mentally and emotionally drained and to top it off the people who care about you tend to make attempts to help you.  When they aren’t successful they become frustrated and helpless, causing them to pull away from you and the relationship suffers more.

Take a few moments to answer the following questions about an important relationship in your life and see if depression or anxieties have been inflicting harm.

1. Have I pulled away from a relationship? In what ways?
2. Have I become less affectionate?  In what ways?
3. Have I become more critical or irritable?  In what ways?
4. Am I being less empathetic or showing fewer compliments?  In what ways?

As always not everything is always black and white.  There could always be other reasons as to why a relationship isn’t working.  Check with mental health professionals who specialize in couple therapy.

Digging Deeper into your Relationship

Have you ever heard a child make a claim to get a pet for the first time?  They explain how well they will treat the animal.  How well they are capable of feeding it and walking it and cleaning up after it.  So parents indulge in their child’s new found responsibility and go out and get a pet.  The first week is great.  The child does everything just as they said they would.  However, by the end of the third to fourth week, the parents are finding themselves cleaning up more after the pet or feeding it more and having to ask the pet to be walked or taking care of in another way.  The novelty of the pet and enthusiasm involved becomes interrupted by life and complacency sets in.  It’s not that this child went out of their way to become irresponsible, it is just that life took precedence.

Relationships start out in such a similar way.  We become excited to spend time with another person and enjoy so much with them.  We laugh and compliment each other and then one day life interferes and we start forgetting our responsibility to the relationship.  We forget to call or make plans.  The lack of attention causes the relationship to flounder.  By using positive actions and words we nurture our relationships and the strategies you will learn here will help you make almost any relationship better.

Talking it out

Communication it’s the foundation of what relationships are built on.  Positive communication is needed in all of our relationships because it is healthy and it keeps us free from stress.  In order to maintain such a positive environment we introduce a couple of exercises.  First one is called The Daily Bulletin.  This is when you take the time to talk and listen with your partner.  The purpose is to enhance intimacy and should be performed often.

1. Work with your partner to decide on a time when you will sit and talk about the day’s events for 20 minutes.
2. The goal is daily, however 3-4 times will be beneficial as well.
3.  Commit to meeting times and keep them written down where both of you can see them.
4.  Let your partner begin and speak for 10 minutes.
5. Ask questions, nod your head and make brief comments making sure to let them know you understand how they feel.
6.  After they are done speaking, try to summarize what they said in a positive manner.
7. Ask your partner if you are correct in what you understand and if you are not, ask for clarification.
8. Take your time to share about your day and ask your partner to follow the same rules.

Take time to reflect on how you felt before and after and how much better you feel about understanding each other.

The second exercise will remind you of the power of compliments.  When you are anxious or depressed it’s hard to think of others and how much you appreciate them, but not expressing it can make them feel unappreciated as well as causes the relationship to suffer.  Take a moment to write the Top 10 Things I Appreciate About My Partner.

1. First write down all the things you cherish and admire about your partner.  Include items you feel sincerely apply such as talents, intelligence, caring, helping out, etc. and be specific.
2. Compliment you partner at least once a day from the list you created or create a new one.
3. Create a strategy to complete this task every day.  Make a habit handing out compliments to everyone you.

After a couple of weeks of giving out compliments, reflect on any changes in the relationship.

1. If these past two exercises don’t fan out well we recommend you see a couple’s therapist for counseling.  If you can’t think of anything you appreciate about your partner your relationship is in serious trouble.

Attending to a Lost Relationship

Losing a relationship can be devastating.  Life is imperfect and so are people.  Sometimes the loss we suffer is due to death, but other times it’s due other circumstances such as divorce, break ups or a relationship dissolving over happenstance. In any case, dealing with a loss causes stress and sometimes depression.

When you lose a loved one it’s vital that you still take care of yourself.  Making sure you eat and get sleep and stay healthy because grieving take both a mental and physical toll and you’ll need all of your resources to get through it.  Make sure to ask for help.  You can seek helps from friends and family, religious sources, grief support groups and/or mental health professionals. When you are dealing with the loss of a loved one, the better approach is not to hole up in bed or turn to drugs that will only make matters worse, but rather explore your feelings about the person you lost.  Review the relationship and what the person meant to you.  This process causes you to move on.

Take time to look over the following Grief Questionnaire that will help you explore your grief.  Take as much time to answer the questions and don’t rush.  Expect to feel sadness or even cry, but if you feel you can’t handle the exercise at all, please seek professional help.

1. What was life like with this person?
2. What did you cherish about this person?
3. What was difficult about this person?
4. What lessons did I learn from this relationship both positive and negative?
5. What has changed about my life now?
6. What am I grateful for from this relationship?
7. What am I angry about the most?
8. What did I enjoy about this relationship?
9. Compose a letter to the person you lost to provide closure. Express anything that is on your mind.

Becoming Alert

People and the relationships we share with them are irreplaceable.  Having said that, after you experience a loss and take the time to grieve and have recovered, it is important to pick up the pieces and move on and fill your life with meaningful relationships and activities. Take the time to help someone else out.  It will make you feel better and quite normal again.  Talk a little more.  Become social again.  You don’t have to be the life of the party, but simply engaging more and more into conversation with those around you will definitely help you heal.  Go out and do something that makes you happy.  Even if you feel you aren’t ready try doing something that makes you happy.  Allow yourself to enjoy things again.

The current life structure we reside in does not always have our best interests in mind. The constant hustle and bustle of life never seems to slow down. Even when you try to put the brakes on, life still comes at you full speed.

It’s Important To Learn And Relax When Faced With Anxiety And Depression

When you begin to have multiple requirements come up, your body does begin to take a physical approach to solving those opportunities. You will feel your body tense, your breath come faster, your heart beats a bit faster, you start to sweat more, and the digestion of food slows down to allow you muscles to be improved.

These reactions are typical of the instinctive “fight or flight” reflex. These physical manifestations actually cause each of you physical harm that may include high blood pressure, muscle spasms, headaches, and more.

We will help you understand the need for relaxation and to help you find ways to quickly and effectively cool down in an emergency.

Relax

We have already mentioned some of the results of not slowing down and relaxing. If you take the time for yourself and master the ability to relax and lose your daily stress you an improvement in your immune system response, reduced blood pressure, less anger, deeper and better sleep, increased productivity, and in all an overall improved mental and physical state of being.

This is the payoff for just learning to sit down, relax, and enjoy the moment. But how will you know if you are already there? If you take a moment to think about the last week, what were the moments you felt calm? When were you feeling stress or tension? Complete the Relaxation chart to see if you need help relaxing.

You may discover you are one of those few, rare individuals that may feel a sense of panic or loss of control. If this happens to you, do not continue these exercises and immediately seek the help of your primary care physician or mental health professional.

The Breath of Life

If you have not already seen it, depression and anxiety have the ability to steal your motivation, hope, energy, and possibly your soul if you let it. This is a very vicious cycle that can prevent you from making any improvements in your life and that can actually keep you unhappy and depressed if you let them.

We will focus on how get you moving through your life again, and what we need to help you do to generate motivation in general.

Motivation and Myths When You Have Anxiety And Depression

The myth of motivation runs deep into the realm of depression and anxiety. The length of time you may spend trying to get things accomplished may not be fruitful if you cannot get this thing called “motivation” back into your life. If you are not accomplishing what you want, you just make the statement, “I am not motivated”.  Most of us seem to believe that action is the result of motivation.

What you should realize is that this is one large fallacy you cannot afford to believe. The example we can give to you is one of you completing a college degree. You are in the last class you need to take. You just can’t seem to get into the last paper you need to write. It is the only thing between graduating and a nice solid career path. The sun shining and the birds are calling. You just don’t have the motivation to do more than just drink some beer and watch the sky.

How long should you wait for the motivation? The answer is, you should just get up and make yourself get busy. You need to generate your own motivation that in turn creates the action needed for you to begin the process of being excited enough to keep motivation going strong.

Here is a chart we have used in various evolutions. This chart has been modified to create an Activity Log.

While this was the sample log, it does give you the chance to see how you can fulfill this task correctly. Take time to complete your own activity log. List the tasks you have not done and put them in the middle column. Ensure you only use tasks that can be completed and are doable. Then make sure to take the outcome and record it in the right hand column.

The activity log

The SOCCER Goals

The level of emotional distress one can feel appears to be extremely difficult at times. The inclusion of depression or anxiety only seems to increase this difficulty. If you do begin to be overwhelmed, you may have the tendency to start avoiding your responsibilities. We have created an acronym to help you avoid the trap of avoidance.

SOCCER

S: Situation is the true cause or nature of the problem.

O: Options given for this particular problem.

C: Consequences of what can happen with each option.

C: Choosing the option you desire to succeed.

E: Emotional plan for dealing with the level of distress.

R: Running or reviewing your plan is what happens here.

We will continue to work with the SOCCER model in more detail and you will discover the many benefits it can bring to even the new user.

Sizing it up

If you decide to try and bury your head in the sand, don’t. The information you need to gather regarding your problem is you will not be the first person to ever experience this problem. You can learn much if you take the time to talk to people or do some research. Take the time to reflect upon what you have learned.

In this charting situation, the examples give a very solid description of what is happening and the problems that are being faced. This is the time where we can begin to look at finding options.

For you we have the problematic solution chart. Make sure you describe the problem with as much detail as possible. Consider evaluating the problem with the books, articles, or insights you gain from the internet, friends, or other resources. What might be some of the sources of your problems? You must continue to look at those areas. Are there any emotional responses you can include? These can help you to make some proper observations. Finally, let yourself know how important this is to you.

The options collection

Once the problem is given, you can begin to show your creative side. What are the chances you can develop a few interesting and ingenious ways to help solve the problem? You are only limited by your imagination. Make the best of this time to get as many solid potential solutions as possible.

From the sample we gave you we created the following SitOp chart.

Options

These are the simple options. We move to the next step. You should start to prepare your own options checklist.

Options List

The consequences

Once you list the many options available, what are the potential results of each option? This is the stage where you must discover what option may have what actions that will result from performing any specific option. This is not an exact science, therefore you must make a reasonable assumption based upon the known facts of each option. Follow the example situation below.

Use the following chart to complete your personal SITOP and Consequences chart.

Choosing the option

After you begin looking at each available option and have analyzed it for the possible results from that option, it is also important to understand the emotional and psychological factors as they impact you. Taking at look at each of the feelings you develop for each option can help you to narrow down the options you do not wish to pursue.

Once you have made your choice, it may help you to share your choice with close friends. This step may help to cement your actions into reality—the stigma of not fulfilling a commitment can drive you forward to success. Don’t forget—not making a choice IS a choice. This action will lead to result, often more disastrous than your worse expectations.

Again, move forward with your personal example to complete the following charts.

Courage and Emotions

So you made the decision. What do you do now? If you are like many individuals, you do absolutely nothing. While there may be a need to do the actions, what are the physical roadblocks associated with this action? The level of emotional distress with performing an action actually prevents the action from taking place.

Specific strategies to help you overcome the emotional turbulence consists of:

• Talking to yourself-make sure you make positive statements about yourself and the course of action you chose. Reassure yourself you have made a good choice that was difficult to make. It is also the best choice available.
• Perform a simple role-play-if you have already “done the action” in your mind, it becomes easier to actually do in real life.
• Take the time to relax, the action of deep breathes will help remain calm. Take the air deep through your nose, holding your breath for a few seconds, release the air through your mouth, and continue to repeat for at least 8 to 10 times.

Complete your Emotion Chart.

Running with the Plan

The time has come for you to actually make the option an action. What will you do to ensure it is successful? You should be locating the best time and place to put this plan into action, as well as who will be around when you do it. These are all events/components that can help you with success and the subsequent follow up you will need to perform.

Even though this was a sample example, you can see how this strategy can be successful. Don’t be disappointed if the first plan or two you perform don’t work out as easily. Put all of these pieces together and create your own chart.

The total Soccer Plan

If you are able to keep yourself in a positive mood, it should be hard to stay depressed, right? The release of the chemicals called endorphins help keep you energize and establish a good sense of identity and well-being. When you are not feeling so well and those depression feeling set in, the first thing you do is begin to withdraw from any fun activities you may have had. This will help to keep you into that funk of no return.

We will help With Changing Your Behaviors

There are too many pleasurable activities to choose from. If you fail to enjoy the activities of life, you can place yourself into emotional distress. The level of worry or sadness you have can keep you from making the effort to join into any activity that can generate feelings of well-being.

In the following chart, look at some of the various activities. Make sure to check any items you have already done or that may sound appealing. In the second chart, make a list of any activity you think you could do.

Top Pleasures for Me

These lists should help you to make at least a beginning of what you may enjoy. There will be some detail on what can bust up your pleasure later in this section.

Now that you have a list of guilty pleasures, how do you get them into your schedule? This is how you can make the changes necessary to help you keep pushing forward. With the following chart, you should be able to create a calendar of events that will show you pleasure can be planned. This calendar will also help you to understand how you can feel once you start taking time for yourself.

Having the association with pleasurable activities and reducing depression, it becomes quite obvious will are on the right track in eliminating your anxiety and depression.

Pleasures that poison

We need to be clear about a few things. Yes, we want each of you to be able to enjoy yourselves in your daily existence. What we do not want to happen is the excessive reactions to this mission.

If you find yourself engaging into unhealthy lifestyles, we ask that you seek immediate mental health advice. We have listed some of the various items we think are indicative of a problem with pleasure.

• Drug abuse
• Prostitution
• Excess of alcohol
• Too much sleep
• Haning out with undeisrables
• Gambling
• Reckless shopping
• Overeating
• Sexual promiscuity
• Obsessive exercise
• Too much caffeine

Again, we suggest immediate help from a mental health provider or primary care physician if you find yourself in one or more of these activities. These are behaviors that cannot be easily overcome to bring about a reduction to anxiety or depression.

Busting up your pleasure

We hope you were able to locate a few pleasures in our lists. We also hope you were able to place them into your lifestyle easily. We also are realists and understand that this may not be the case.

We keep coming back to distorted thinking. We must keep coming back to this area as distorted thinking will impair your ability to enjoy your pleasurable activities. You do deserve those activities and you are worthy of them. Distorted thinking will keep you from thinking this way.

Decide Fun

There are several areas of depression and anxiety that keep you from pleasure. Some of the thoughts are simplistic and easy. Try to avoid the following thoughts that impair self-esteem.

• I don’t deserve to have fun
• I just don’t think I am good enough
• If I don’t get moving faster, I don’t deserve to have pleasure
• I should be punished
• I let my friends down. I should not have fun

These thoughts are not effective in creating a desire to have any fun. As a matter of fact, they are definitely pleasure killers. If you happen to find yourself at this point, we have another chart for you to use.

We have taken the main ideas of pleasure killers and placed them into a format for you to use. We want you to use this chart as a way to keep your pleasure seeking alive and healthy. If you continue to use the charts as we have in this section, you will be able to keep fun thoughts in your life.

Pleasure Charts

Facts of finding fun

As individuals, we must be able to make the distinction between  too much fun and not enough fun. Many individuals take the stance too much fun is not a good sign. The progression of individuals to only seeking the challenge of intellectual pursuits may not be necessarily wrong, however, thre should be some level of entertainment or relaxation. There are benefits to having some fun.

Those who have fun or exercise on a frequent basis have found:

• Increased immune function
• Less chronic pain
• Decreased heart attack
• Less stress
• Increased life expectancy
• Increased self-awareness and well-being
• Higher productivity
• Better health

What should you do to keep from falling into this type of trap of not seeing the benefit of fun?  The simple answer is just consider how important pleasure is to your life. Take time to complete the self-reflection.

Preventing pleasures?

We have already mentioned many of the thoughts that people say when they are dead set into depression and anxiety. The overall impact those two behaviors have on you is they can help prevent you from moving forward and having some good times.

The thoughts of “I am not going to enjoy myself; that sounds boring; I just look stupid; I am too upset and depressed right now have fun; or I just think I am too anxious.” continuously bring about the wrong behaviors. These are the types of behaviors will help keep you from creating the positive motivation you need to get out and begin to discover the existence of pleasurable activities.

The Pessimism Pleasure Builder chart can help you make the correct decisions on what you should be focusing on to help build a positive relationship with your mind. In this chart, you will find at least five desireabel activities you think might be fun. Make sure to rate the predicted level of fun and THEN compare it to the actual level of fun you had. Again, document your obsevations.

Why is exercise such an important part? Well in order to move past the anxiety and depression, you need to get the natural body chemicals, endorphins, moving through your system. These endorphins are similar to the chemical drug morphine that stimulates the pleasure centers of your brain.

We will help you determine how much exercise you will need in order to keep those chemical flowing while showing you the value of exercise. We will help you learn your top reasons for exercise and help you make a plan to get them to stick.

When It Comes To Anxiety And Depression Enough is enough

Most people do not realize the best time to get into exercise is when you are young. The younger you are the easier it is to keep the habit of exercise going. It also helps to keep your body in a much better shape. If you know you are in a good healthy lifestyle, you should be able to get into exercise. If you are not, we advise seeking the guidance of your primary care physician to begin.

The general guidelines we offer are:

• Children should exercise at least one hour a day of various physically rigorous activities
• Adolescents must follow the same guidelines as children
• Any adult wanting to be healthy must have 30 minutes daily of exercise
• Weight gain from aging processes can be slowed or stopped with 60 minutes of exercise
• Weight loss happens with 60-90 minutes of daily exercise
• Pregnant women should have 30 minutes daily.

Exercise should focus on or  include cardiorespiratory endurance, body composition, flexibility, muscle strength, and muscle endurance. Making sure you body can pump the blood and fluids and oxygen to your organs is essential to good health. If you have too much fat in your body, you will not be fit. Try to keep your body fluid in motion and keep a large range of motion. If you can build muscle strength and perform tasks for longer periods of time, you have a greater chance of keeping healthy and fit.

Why health improvement

So, after all we have talked about we said you might want to avoid the “shoulds” of life.  No we are not trying to make you have guilty feelings. We are just trying to establish the fact you should be concerned with fitness and maintain a healthy lifestyle to improve your mental health. Oh, wait, there will be some many excellent physical elements as well.

In the following chart, mark off anything you may have concerns with. If you have any family traits you are worried about, make a check and go on. Once you have gone through the list, spend a few minutes locating those areas of special concerns. Determine the top reasons why you should exercise.

Why Exercise Chart

•  Make it fun
•  Added energy
•  Lessens heart disease
•  Stress reductions
•  Immune system repair
•  Less depression
•  Reduced blood pressure
•  Lessens diabetes chances
• Increases confidence
• Helps weigh loss
• More flexibility
• More strength
•  Reduces cholesterol and triglycerides
•  Cancer reduction
•  Lessened chance of colon cancer
•  Sleep
•  Mental acuity

These are just some of the many benefits. You should find your own top 10 list and create it below.

Fit it into your life

Okay, we get it. 60-90 minutes a day is a large chunk of time out of your day. We know time doesn’t grow on trees, but where will you find that much time? The good news is you don’t have to have all the exercise at one time. Modern guidelines suggest you can get by with as little as 10 to 15 minutes at a time  for a moderate level of intensity. You will increase your heart rate and breathing just by mowing the lawn, riding a bike, walking or other simple tasks.

Many individuals will see they already have a higher level of exercise just by going to work. If you do not have a physically challenging job, you will need to find a way pump up the volume and get things shaking.

We know everyone is different and they have different lives and habits. The exercise program for you may not work for us. You need to design what will work for you.

In this coming section we would like you to review some potential ideas for exercise for your body. We then want you to determine what may help you get into shape (no—round is not a shape).

•  An early morning walk for at least 15 minutes
•  Use stairs not elevators
•  Walk at lunchtime
•  Golf, tennis, swim, biking, or other exercises
•  Get an exercise video
•  Get a trainer
•  Take some exercise classes such as yoga
•  Buy a treadmill

My reflections

______________________________________________________________________________

Wandering Willpower

When you continue to work though the realm of exercise, you may have found a few items of interest that could fit within your lifestyle. You seem to have what you want, but wait—what about the motivation and the initial excitement. How do you recover when this goes away?

DE-Motivation (no not THE Motivation)

We have discovered the pitfalls of distorted thinking. We need to keep you away from those types of thoughts and keep you moving through action and keeps you from failure. If you have any distorted thoughts, you will not be able to keep your enthusiasm for exercise. Now we need to help you choose a strategy.

Here is one sample de-motivation exercise model.

In this example the individual is a busy mother of two. She is always trying to find the time to do her job every day while  running errands at lunch, and dropping the kids at day care and picking them up. At the end of the day, she is making dinner and is too tired to move. We just told her she needs to exercise. Of course she shook her head and said we were crazy.

Demotivation Exercise Model

Personal Reflections:

My thoughts did cause me to lose focus on my life. If I took time to exercise, I might start feeling better about myself. My sleep might get better if I continue to exercise. If I lose the many bad thoughts, I can start to move forward.

The time has come for you to take the initiative to complete your own de-motivating exercise model.  Just make sure to  read the thought on the left hand column and respond in the right hand column. If you add a thought, make sure it overcomes the de-motivating thought in some way. Make sure to overcome the illogical, irrational, excuses, illegitimate statements, and non-helpful thoughts. Then complete the My reflections checklist at the end.

Demotivation Exercise Model

My reflections

______________________________________________________________________________

Tracking your movements

In order to maintain a high level of effectiveness, you should really look into ways of monitoring your exercise. There are many ways to do this including using a calendar. If you decide that writing down your progress, you will find an additional level of motivation that will keep you paying attention and focused.

This is a sample example of a Calendar list of Exercise

Use the following chart to make all of your exercise observations.

My reflections

______________________________________________________________________________

So you think you have fear? Anxiety? How can we help you say and how does fear relate to depression and anxiety? If you examine fear, it is a smaller component of anxiety that can lead to the appearance of depression.

Whenever you see or feel things that make you uneasy, you may experience fear or anxiety. One thing to remember, if you don’t like enclosed spaces, don’t ride an elevator. The simple solution is to avoid those actions that could lead to your anxiety.

Avoidance however only finds the way to increase the power of the fear and makes the feeling much more intense. If you make the decision to avoid an event, the emotional release of relief feels pretty good, considering the alternative. However, you just gave yourself a bonus for not doing the right thing. You have been able to reward your actions every time you allow this to happen. The next time you are faced with this choice, you will perform the same action again and again.

Here we will examine some common fears and teach you how to climb to the top of your fear. We will also help you to understand OCD (obsessive compulsive disorders), explain how it is treated, and what makes this different/similar to other disorders.

Why worry About Anxiety And Depression?

Most of us do have some items that create panic or worry for us. Having a few small ones is okay; however if you allow your mind to control your body foolishly, there is a problem. This is the time to create an action to overcome this.

Some specific fears

1. Illness/germs
2. Groups of people
3. Planes
4. Spiders
5. Feelings of out of control
6. Outside your house
7. Tall places
8. Enclosed places
9. Mice or rodents
10. Speech making
11. Appliances being on
12. Storms
13. Loneliness
14. Water and drowing
15. Sharks
16. Sexual inadequacies
17. Sickness in public
18. Being rejected
19. Buried alive
20. Getting any disease
21. Chemicals or raditions
22. Cats
23. Dogs
24. Horses
25. No money
26. Telephones
27. Stating stupid things
28. Blood pressure cuffs
29. Needles and injections
30. Doctors
31. Dentists
32. Busy highways
33. Meeting people
34. Travel
35. Trains
36. Jobs interviews
37. Blood
38. Large open areas
39. Eating out side
40. Surgery

If you noticed any fears, don’t worry you are not alone. The best way to overcome those fears is to embrace those fears.

If you can determine the simple fears are not worth the time or trouble, that is okay. The areas you must look at is can you live with those fears. Only you can make the decision if living with those fears is worthwhile.

Your twirling staircase of fear.

If you look at your fears, pick one-the one that you most likely would like to remove from yourself. We will teach you to look at it head on.

We will help you learn the exposure technique to bring your fear to a manageable level through a step process. Don’t take the next step until the entire current process has been commended.

Exposure techniques can benefit all on real or imaginary levels. Keep in mind the real events are not easier to create because you cannot create specific events to correlate with your need to overcome those fears.

In the following exercise, watch our sample individual confront their own Fear Staircase.

The individual is quite shy with women. He can handle the relationships with those of his same sex; he just cannot move past the fact face to face communication with the opposite sex is tough. Our subject wants to move forward in this area.

Emotion and Fear Staircase

1. Where does your fear start? Can you feel the anxiety as well?

I can’t pick up a phone. It scares me and I don’t know why. I just wish I could overcome the problems being out in the open causes.

1. What are you planning to avoid?

This individual obviously has not had a date in a good long time. He even tries to avoid them on the bus, the lunchroom, etc. I find myself using strange excuses to avoid going out.

1. Are there any other events that your fear could influence negatively?

I hate relationships. The people involved right now scare me. What am I supposed to do or say? The last date I had was too many years ago and I was hurt fairly badly.

1. What types of tools or techniques do you use? Any drugs or alcohol? What about the influence of people? Any specific plans or actions planned right now.

When things get to rough for this individual, a prescription drug has been given that allows for some quiet thought. I avoid any group activity for the most part

1. What may be some of the bad situations you may find yourself in as a result of your fears?

When I try to ask someone out, I am fearful I will make a fool of myself and create more embarrassment for myself. I am sure many physical manifestations will happen. I know if someone were to be asked, I would expect to be embarrassed.

This individual, when done with this small exercise takes the information and inputs it into the Fear and Emotions chart.

Staircase of Fear

This is how one should arrange the fears. The higher fears at the top, with the lowers ones at the bottom.

1. Asking for a date face to face (90)
2. Asking for a date face to face (85)
3. Calling for a date by phone (75)
4. Going to the singles club (75)
5. Have a conversation with someone I don’t know. (65)
6. Volunteering a the charity and seeing the large numbers of women? (60)
7. Taking the time to volunteer and going to meetings. (55)
8. You ask someone for a date and are turned down. (45)
9. Eating lunch in the lunch room (35)
10. A female clerk helps me to find something (25)

Here is your opportunity to record your fears.

Emotion and Fear Staircase

1. Where does your fear start? Can you feel the anxiety as well?
2. What are you planning to avoid?
3. Are there any other events that your fear could influence negatively?
4. What types of tools or techniques do you use? Any drugs or alcohol? What about the influence of people? Any specific plans or actions planned right now.
5. What may be some of the bad situations you may find yourself in as a result of your fears?

How to arrange your Staircase Fears

In this segment, you will take six to twenty items you have fears about. Rank each one on a sliding scale of 1-100. If you have items that are large gaps between them, try to fill in the gaps more.

Once you have completed this list of fears, it is time to create your own staircase. Use the following chart to help you complete this. Make sure to evenly space your stairs based upon the ranking you established.

Going up

This is the time to face all the fears you have discovered in your life. Don’t worry, it will be hard, but you can take the time to focus on each one and help to remove these from your life.

Just keep it slow and steady. Don’t push yourself too far or too fast. If you think you are in trouble, make sure to contact a mental health provider.

For this exercise we will use our previous example.

The purpose behind this exercise is to help you take steps and make progress in reducing the fear measure for each area. Try to perform the actions multiple times to reduce the fear and make observations. In our example, see the notes.

TOP EXERCISE

Now that we have done this with our sample individual, make sure to follow the same path and perform your own Top Exercise.

Top Exercise

Take your time to perform this and you will get through this. Avoid any medications or alcohol. Take only those medication necessary to make sure you do not use them as crutches to get you to this point. Taking time to expose your fears takes time. You have all you need.

My reflections

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OCD, Wait did we tell you OCD…..OCD…OCD…OCD….OCD…..

Obsessive compulsive disorder has its own challenges. There are some emotional components that require extreme levels of time and patience if you are a loved one.

The focus on obsessions helps us to understand the various items that run through the mind of an OCD personality: thoughts, pictures, visualizations, etc. There is no rhyme or reason on these items. They may involve fear of these items or needing to constantly check those items. Control seems to be lost by those with OCD. Occasionally, those with OCD may hurt loved ones, exhibit extreme sex behaviors, or violate personal or cultural belief systems.

With the compulsion element added, this person finds themselves needing to repeat specific actions over and over and over again just to try and reduce the personal level of distress. Many individuals exhibit hand washing, rearranging items, consistently checking the same items over and over, and other types of repeating behaviors known as rituals.

You yourself may have some select compulsions. Don’t worry as this is completely natural. What should concern you is if these few areas of concern become an integral part of your lifestyle and begin to create problems with your relationships, job, school, or even within yourself.  If this should happen, seek treatment immediately as it can be dangerous if left unchecked.

How to overcome obsessions

The obsessions you may be experiencing or have are created within your imagination or mind. This is a safe spot for many of the obsessions one may have—you are more than likely unable to act out those obsessions in your mind.

Caution: if you feel like you need to hurt someone or want to act out non-traditional, unacceptable sexual behaviors, contact your mental health provider or primary care physician.

Because obsessions are singularly focused,  you do not need to have the elaborate setup fears require.

Obsession Listing

1. What is your obsession-make sure to explain the distress level and the specific image. _________________________________________________________________________________
2. Rank the level of distress you have from 0 to 100 (low to high). _________
3. Make sure to get a comfortable spot and sit to perform this.
4. Repeat the main thought……and keep repeating it…..and again.
5. Make sure to spend at least 20 to 30 minutes on this—or longer if needed to reduce your level of distress at least 20 to 30 points.
6. Now re-rate your distress._______

This simple process of overcoming obsessions and compulsions is different that what OCD individuals are asked to do. If you try to suppress your OCD type thoughts, you will find they won’t stay subdued. They continue to push forward again and again.  They just keep coming.

Try this: whatever you do—don’t think about a nice juicy steak with fried mushrooms and a fresh baked potato. If you don’t think about this nice juicy steak with steak sauce—we will let you have anything you want…….See if you can keep it from your mind. Did you succeed?

Compulsions—keep them away

Compulsions are similar to fears. If you get them to a specific level of exposure, you can being the process of ridding yourself of them. With compulsions, however, you need to understand you just can’t expose the problems of the activities-YOU MUST LEARN TO STOP DOING THEM. The proper terminology for ceasing those compulsions is: exposure and response prevention. Follow the example below for how this works.

In this example, the individual continuously washes their hands—to such an extent that 3 to 4 hours a day is spent in this activity. Germs are one of the enemies here as well as the fear of being sick. This creates additional hardship by wasted time and physical injury.

Top Exercise

This is an excellent way to try to move through your compulsions and obsessions. Just try to keep a small time delay between your behaviors. We suggest at least 25 to 30 minutes from end to starting the compulsion. Try making minute changes—different shampoos, different arrangements, etc.

My reflections

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Monitor your breathing right now. What is the feeling and sensation you have about this simple task. Slowly breath in and release the air through your mouth and nose. What are you thinking? Just focus on breathing.

Mindfulness is the action of being aware of what happens NOW without any time taken to consider, judge, analyze, or reason about what happens. You should not take any time to think about what exists. This is a process that allows you to be patient and tolerant as you experience the “now” without fighting back. You will learn how to accept your personal thoughts and feelings in this review.

Have you lost your mind?

You are much different than your mind. Would you agree with this? You might consider this to be confusing or think this is just plain stupid. Just go with the flow and examine what we will discuss.

Evaluation versus Observation

As we already did, again sit down and just wait to see what thoughts come to mind. Whatever it is, consider this: besides you, did anyone else see or hear that thought? The distinction in this can be complex. Your mind had the thought, but only you knew the thought. You are different than your mind in this respect.

Here is another exercise for you to consider that will help you make meaningful connections. Here are some basic thoughts about the room we are in right now typing this section.

• There are papers everywhere. I can’t believe the mess.
• Can I stay here and be comfortable? Can I relax here?
• How could I just sit here in one spot and think?
• What am I doing writing this? Is it worthwhile?
• My kids are going to bed. I’m tired too. I have to stay up.
• I want to buy that new computer.
• Where did my coffee cup go?

How many of these thoughts are critical or judgmental. The process of not being critical is difficult, however, it is needed so you can experience the world around you.

This is the sample I should concentrate on:

The gentle swaying of the trees brings out a simple swooshing of leaves. The little chirps of the birds in the yard echo in the stillness of the day, melding with the leaves movement. You can hear faintly a small dog barking in the distance. My kids are laughing in the next room, having fun and enjoying themselves. My desk is cluttered but neat and everything is where I can find it. The computer I have running is quiet and functional. The monitor has a great resolution, and I am getting my work done.

The first exercise did take something out of us. We felt powerless and out of control. If we just listened to the world without judgement, the impact was quite peaceful. There is a three part exercise that can be done to help you make it through this process.

These are the instructions:

1. Sit and look at things around you.
2. Find something negative in what you see.
3. Write down each critical thought you have come to mind.
4. Notice how you feel when you are done and record those feelings.

Critical Mind Exercise

The feelings after writing critical thoughts:

________________________________________________________________________________

________________________________________________________________________________

In this next step, look around one more time without making any critical observations.

1. Just follow your senses and make sure to use your senses. Just describe the experience without format.
2. Notice how you feel. Record this.
3. Reflect on this exercise.

Observations on the state of mind

Observations, sensations, and experiences:

________________________________________________________________________________

________________________________________________________________________________

Feelings after writing observations and experiences:

________________________________________________________________________________

________________________________________________________________________________

My reflections

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The concept of mind clutter: tuning it in and out

With a depressed or anxious mind, your mind will have lots to chatter about. This is usually a set towards judging, evaluating, or creating harsh thoughts about yourself. This can be a very dangerous, if not toxic event. The thoughts that come to mind quickly are:

• I’m not good enough
• I can’t do it
• I make too many mistakes
• She won’t go out with me
• I could cry if it hurts
• I think I’ll get sick
• People will think I am fake
• No one likes me
• I always fail at new things

When you have thoughts like this, you need to learn how to turn them off or tune them out. This can help.

1. Listen to the chatter.
2. In the worksheet below, record the comments that come to mind.
3. Think of a good friend and insert their name into the chatter. If you think people don’t like you, make it People don’t like you John.
4. Can you tell your good friend John the thoughts from step 3? You would not say that to a good friend, would you?

Mind Chatter Tuner

My reflections

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This is an exercise that will help you treat yourself as good as you do your friends. You should be one of your best friends.

Mind Chatter Games

The discussion we had earlier taught us that thoughts and beliefs have an emotional component that can be distorted and twisted against us. If you need to review how to break those thoughts or beliefs, go back to those pages.

The need to battle those thoughts is present. You need to learn how to wage that battle for a successful war. This should be built upon preventing these thoughts from gaining the necessary ammunition to begin the war.

In the example below, you should consider the individual in his position as a corrections officer by day. He attends college at night to try and elevate himself away from a job he doesn’t like. He would prefer the counseling stage instead of the corrections one he finds himself in. Having this type of schedule is difficult, and at times, he becomes challenged.

The Thank you Mind Chart

Thank yous to your mind will help you keep from taking those thought seriously. When you do take them seriously, you have a chance to actually believe them.

To complete this exercise:

1. Record the negative mind chatter you hear.
2. In the left column, record those thoughts.
3. In the right column, record one response that makes light of the thought.

There are other ways to play back. You can sing simple childhood songs or try to change the voices to celebrities or people in your life. Anyway you do it, make it fun. It will be hard to believe something that is a little humorous.

My reflections

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Acceptance Time

Taking the time to go to New Mexico and the Sandia Mountains with an elevation of 10000 feet can help you take advantage of the snow and skiing opportunities available. This particular area has a parking lot that is usually plowed, however, we saw someone who was been stuck in a snow bank. The owner of the car said a few choice words as he revved the tires incessantly.

We were reminded about what we wrote here. Acceptance. If you can accept where you are, you can get to where you want. Gradually we saw the driver of the recognize this and slowly began rock the car and eventually made his way out.

When you are faced with this type of insurmountable obstacle, the best advice we can offer is to slow down, take a moment to regroup, and when things are right, push ahead for success. How does this fit with anxiety and depression? The easiest way to explain this recognition. If you can recognize these feelings as having validity, you will be more prepared to handle these feelings later in your life’s situations.

You should be able to feel good, just not all the time. You need to have variations in moods to appreciate the good things in your life. If you can’t accept worry, how can you understand the word calm?

Examine negative things in your life with a matter of fact approach. Objectively seeking the understanding of your anxiety or depression will help you accept these feelings and as a result, lessen the impact those negative feelings may have upon you.

Review the following example to better see how you can achieve this. In this example test subject is trying to renew his license. He hates crowds and sees there is only one person waiting on the four people in line. When one of the people starts to argue with the attendant, he begins to fear he won’t be able to get lunch before going back to his office.

Accepting with emotions

1. What are your current emotions? Do you have any physical manifestations? Sweating, upset stomache, tightness? Write what you are feeling right now.

What I am feeling is a tension that causes me to move constantly. I am unable to remain still, and the muscles in my neck and shoulders are aching. My blood is moving fast because my heart is pumping fast.

1. What are any of the changes in your feelings? Do they remain the same or do they change? Are there wide variations of highs and lows?

I now can see the level and intensity of these physical elements come and go. They cycle every few minutes. I can see they may be decreasing in intensity with my awareness level.

1. How long will this last? Make a guess.

I think they will go away shortly. Once I leave this place.

1. Can you just observe the thoughts in your mind with feeling them? They seem to disappear if you do not let them act upon you. Wave them goodbye.

Strangely enough, I can seem to see that being late is horrible, and the person arguing is quite silly for doing this, however, in the big picture, there is nothing really to worry about.

1. Predict how long they will stay?

I feel them going away rather quickly now I understand what they are.

If you ever sense you are losing control of any feelings that are not “good”, take the time to relive this exercise and write down all of your reactions and thoughts. If you can’t remember the exact questions, just remember you want to look at things with an objective, not subjective point of view.

This is the worksheet for you to use in the future.

Accepting with emotions

1. What are your current emotions? Do you have any physical manifestations? Sweating, upset stomache, tightness? Write what you are feeling right now. ________________________________________________________________________________
2. What are any of the changes in your feelings? Do they remain the same or do they change? Are there wide variations of highs and lows? ________________________________________________________________________________
3. How long will this last? Make a guess. ________________________________________________________________________________
4. Can you just observe the thoughts in your mind with feeling them? ________________________________________________________________________________
5. Predict how long they will stay? ________________________________________________________________________________

Key points to remember here are to accept your emotions and feelings without making judgements on what they are or how they make you feel. You are looking at this in the fashion Albert Einstein took when he helped to create the first atomic weapon: without passion or emotion.

Once you are able to overcome this obstacle you will no longer have issues with:

• Traffic jams
• Long waits or lines
• Waiting for anyone who is late
• Rejection
• Fear
• Speech making
• Illnesses
• Giving or receiving feedback

Now-This is the time

Should you move away from the past and the future? If you choose to exist in either of these arenas, you may create misery for yourself. If you begin to stagnate your existence in the “what I could have, should have, or would haves” or the “this is what I will do, could do, should do”—all you succeed in doing is validating the guilt of your past or present actions for failing to live up to the extreme ideal of who you SHOULD BE.

We ask that you model yourself after the dog who jumps into the car when the master asks him to go for a ride. The window goes down and the head goes outside enjoying the air, the breeze, and the ride. When you get to the destination, the dog jumps out of the car and begins to walk forward—until the vet’s office appears. By now the dog starts to move back and won’t move forward.

If this was you instead of the dog, the event would be listed on the calendar; the time of the event would be listed; the nature of the appointment would obsess you for days or weeks; finally, you would get to the appointment after creating tension and stress for you.

Take the time to enjoy the experience of the here and now. You need to become more involved with what is happening here, right now. Stop and take five minutes to perform the exercise below. See how you feel and how quickly you can relax.

Present moment Worksheet

1. Get comfortable and sit in your favorite position or piece of furniture. (choose anywhere)
2. In your position, make sure to keep your legs apart-should width should be fine.
3. Place your hands somewhere on your body or torso so you can feel how your breath goes in and out. Keep your breathing shallow and easy paced.
4. If you start to become very comfortable, you may close your eyes and just think about taking your breathes in and out.
5. If you have random thoughts, let them float around. Just breathe and relax.
6. Don’t talk, don’t move. The secret to this exercise is to not make any movement-don’t itch those scratchy parts that just show up. The urge will go away.
7. Keep quiet for a full five minutes. IF any of your muscles tense up, try to feel the intensity and see how it goes away.

Once you complete this, yes, you guessed it—record your observations.

My reflections

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You can overcome the burdens of activities with your mind—provided you eliminate judgments and emotions. Try to locate specific actions during the day when you can relax and enjoy the time. Eating offers one great event you can monitor. The event is not as important as your performing the task.

If you choose to do this at meal time, you can use the following example.

Eating with Purpose

1. What are you going to eat? Can you see the varied shapes and colors? How intense are the colors and can you see the texture?
2. What does this smell like? Sweet, tart, spicy, citrus, what?
3. If you take a small piece and taste it-what is the flavor?
4. Can you take the time to move the food around your mouth with your tongue? What is your mouth doing—salivating, urge to chew?
5. When you do chew, does the flavor get stronger, do the textures change?
6. Allow the food to break apart. Slowly swallow.
7. State the process all over with another piece of food.

My reflections

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When the alarm clock goes off every morning,  how do you wake up and see the world? Do you need to grab your glasses, put in your contacts, or can you see perfectly without those tools?

Your reality can be altered by how you see things. The process of looking at your life and your actions can be distorted by your own personal vision of how things are. Many scholars consider this to be a process called “viewing through life-lenses”. How you are able to incorporate yourself into your world, your friendships or relationships, your career, any events or special circumstances in your life, and how you react or interact with these criteria are all bound within your specific life-lense view.

The roles of perception take many shapes. Some are the eternal optimist with their tinted rose glasses, while other view life through the cracked lenses of pessimism. Through the work  we will help you to determine what shape your lenses are in and how you can view your personal problems to overcome any emotional roadblocks in the way of your life-lenses.

Evaluating the role of Life-lenses

Throughout your day, you will make various assumptions about the world you live in. Whether those assumptions have basis in validity such as the turning of a traffic light from red, to yellow, to green; or whether or not your alarm clock will go off in the morning after you set it, assumptions allow your life to be easier and more efficient.

For the purpose of this article is a life-lens is a specific type of assumption that one does not normally question. Typically these are the assumptions that describe how you feel about yourself, the surroundings you reside, and the many varied things that happen to you. Various terminologies exist to describe your life-lenses including the perfectionist or the vulnerable life-lenses. The first makes the assumption everything you do is perfect, while the second suggests you live in a dangerous world.

The one item to keep in mind regarding life-lenses is the role they play as a broad theme to your existence. The life-lens model influences how you think, feel, and exist, as well as helping to determine your reactions to life events. There is no set pattern that determines what will influence a specific life-lens.

If we take two personalities, Eve and Sandy, we know they are both qualified in their organization as effective leaders? When a position opens in their organization for a senior leadership position, they both apply. However, someone from outside the company is awarded the position. Eve makes statements she should have been given the job, she states she will not work with the new leader, and that the position should have remained an internal position.

Sandy on the other hand begins to approach it by stating she should never have applied, she never should have tried to go above her current position-no matter what her current supervisor said, but she does agree they made a solid decision in whom they chose.

There are two types of life-lenses in action here. The first one is an entitlement lens that suggests the world owes something to the wearer of this lens. By having this lens in place, one makes the assumption whatever the wearer wants, they should get. The second one is an inadequacy lens that prevents an individual from believing they are good enough for anything they perform. This person feels their level of education or knowledge is never sufficient and as a result, they begin to keep themselves from trying to perform.

These two different lenses are applied by these two individuals to most events in their lives. From the simple driving home on the freeway, Eve believes no one else knows how to drive whereas Sandy thinks she is at fault for not leaving earlier.

Try to evaluate the actions in your life and how you may be affecting your life. If you can begin to understand and identify the lenses you are wearing, you can learn how to make changes.

In the following questionnaire, take the time to list and identify what life-lens is present in your life. You should:

• Answer honestly to each question to avoid self-delusion
• Take time to reflect upon various life events and their impact on your—avoid rushing through this
• Make sure to answer the questions on how you feel and react to specific events
• Understand that inconsistencies can happen in this exercise-answer each question honestly
• Answer the questions on how often each lens describes you and your actions.

The following should be the rating scale to use:

1. if the lens never describes you
2. if it occasionally describes you
3. if it sometimes describes you
4. if it usually describes you
5. if it always describes you

Life Lenses Questionairre

If you have given yourself a 3 or higher, those items may give you some difficulty at some point in your life-past, present or future. Don’t lose any sleep if you have many that rate this high. Many find themselves in this position.

Take time to reflect on your questionnaire below.

My reflections

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The inner workings of life-lenses

By now you should begin to see how life-lenses can cause trouble in your life and how they can be considered the root of emotional turbulence in your life. We will discuss some specific examples and show you how life-lenses can impact your personal vision and your emotional state of mind. Keep in mind the broad nature of the life-lense.

For the following exercise imagine three different fathers who react to the same situation of their daughter coming home late one evening. Each will have a different reaction and we examine how each father uses a specific life-lense makes a difference in how the father reacts.

Pete:

Event: It is 11:30 pm and my daughter just got home and her curfew was 11 pm.

John:

Event: It is 11:30 pm and my daughter just got home and her curfew was 11 pm.

Jeff:

Event: It is 11:30 pm and my daughter just got home and her curfew was 11 pm.

Each of the individuals has a unique perspective on this same event. How do you view events? Take time to follow the example and create your own Life-lense Worksheet.

For completing this task, make sure to follow the five simple rules.

1. Write down any event that causes you distressing emotions. It can be an actual event or a thought that comes to mind. Be specific.
2. In the middle column, describe the thoughts you have about this event.
3. The feelings column requires your describe how you feel about this event.
4. Refer back to the Life-Lenses Questionnaire to ensure you know if more than one lens applies to you. Make sure to document all life lenses that apply.
5. Follow up with your self-reflection chart and document your reactions.

Event:

Event:

Event:

My reflections

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Where life-lenses come from

There is no standard thought about where life-lenses came from. Most thoughts consider the childhood you had as the starting point for life-lenses. Through repeated efforts, people begin to make the perspective sweep of being a perfectionist, inadequate, undeserving, etc. Factors that help to create life-lenses are abuse, betrayal, criciticism, loss, rejection, and emotionally charged events.

Having parents who went overboard, no matter how well intentioned, also makes an impact. Overprotective parents create vulnerable children. If you were a single child, your parents made sure you had everything creating a sense of entitilement.

You need to jump to the realization you must understand and change your life-lenses by examining the events in your life that caused those lenses. Once you can find out where they started, you can begin to forgive yourself for thinking yourself weird, crazy, etc.

For an individual who suffers from anxiety, the following chart may apply. The categories of intimacy-avoidant and entitlement apply, as does inadequate and perfectionist. This individual begins to use the Origins of Life Lenses sheet.

Life-lens origins

Example reflections

Everytime I remember my young childhood, I realize my parents and family were distant and cold. I was ridiculed when I was not perfect and treated like a second class citizen. I am anxious and worried if I cannot be the perfect person. I become upset and depressed if I am not able to be perfect in all that I do. Because I felt lonely and unloved as a child, I have a hard time trusting people and keep away from intimate relationships. I still have a hard time not believing possesions and property are more important than people.

It is time for you to perform this same task.

Use the same Origin Life-lens worksheet as above and record any item you had that was a 3 or higher. Make sure to reflect back on your childhood. Make note of any item that may have played a contribution to your answers. Then reflect back onto the results.

My reflections

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Grinding a new prescription for your life lenses

The preceding exercises should have shown you what life-lenses should be targeted as cuasing problems within your life. To help you overcome those challenges, we will share some specific tools to help you make a change to those life-lenses. These life-lenses we are trying to break are not made of the simple breakable glass; they are not able to be shattered by simply throwing them to the ground.

This is a challenging process, one you may not be completely prepared for. The time and energy for this process is more daunting than you realize. The changes you make today could result in falling back to your previous life-lens depending on the type of day you may have had. This is understandable, however, you need to slowly make the change to the new life –lenses on a more permanent basis.

The past, not the present

The emotional responses to events caused some life-lenses to develop. If you recall these events, they do make sense in that background. However, because you have changed through the years, you need to change how you review what happened and look back with the newest prescription of your life lenses with a clear, concise 20/20 vision.

If we revisit our sample information from earlier posts, we see the life-lens of perfectionist again. This individual was criticized when things weren’t done the way the parents thought they should have been done. Having this life-lens allowed for less pain and trauma through the years.  Now as an adult, this life-lens can cause more problems for the wearer that can include stress, anxiety, possibly even depression. This life-lens of perfectionist is more damaging today than when a child. The Then and Now exercise can help determine what triggers emotions and behaviors.

Then and Now exercise

Removed the example of the adam shooting spree

Here is your time to perform you Then and Now exercise. Write down the problem life-lens in the left-hand column. The middle column are the views of your childhood. Make sure to list your current view of events in the right-column. Again, record any observations you have.

Then and Now exercise

My reflections

_______________________________________________________________________________

Current costs or benefits of your existing life-lenses

We know you have some anxiety already that is why you are reading this. We don’t want to cause you anymore anxiety, however, trying to make a change to the life-lenses you currently have will cause some anxiety. These lenses both protect and benefit you from your perspective. Each of us tries to find a way to use our lenses to maintain our view of our emotions, lives, and relationships. This can be a benefit as it protects you from some mistakes you can make.

The true costs of the life-lenses you wear are still to be discovered. We need to help you make that determination in this next section. Review the sample information.

In our sample, we have George a 24 year old college student. He loves to party and have a good time. He believes he has the world under-control and does not set limits in his life or on others. He is fairly comfortable with doing, saying and acting whatever he wants. He has not had trouble, so far…….

The level of partying has taken a drastic turn. Continued drinking until the bars close create opportunities that has him sleeping late and missing classes, experiencing an overabundance of hangovers, and as a result his grades begin to fall. A simple driving excursion turns into a DWI and a letter placing him on academic probation. He finally gains the courage to seek out help at the local mental health clinic (urged by his parents).

The counselor George begins to talk with makes the connection to his life-lenses and asks him to fill out the Cost/Benefit Analysis of this lens.

Cost/Benefit Analysis Sheet

The life-lens under discussion: Under-control. Things can be loose. I can handle anything I put my mind to. If it feels good, do it.

These are the benefits George sees. They are quite easy to discover. He questions the rationale behind this exercise and does not see the negatives. With some careful prodding, George re-evaluates the costs.

This is the time for you to do your own Cost/Benefit Analysis and self-reflection.

The life-lens under discussion:_____________________________________________________

My reflections

_______________________________________________________________________________

Taking Action on your life-lenses

You have made a first step in trying to overcome those life-lenses. The motivation and stage setting were important to help you make the realization you must change. This is the time for you to find out exactly what you need to do by creating a specific plan to overcome your assumptions. Use the following list to help you devise the action you need to take. Don’t let your creativity be thwarted.

Life-Lens Action Steps

Personal Life-lens Action Steps

This is the time to consider all the past events and situations in your life that have led to your life-lens creation. You had some control over these events, however, many instances you did not. Take the responsibility to make the changes necessary to improve your life vision.

My reflections

_______________________________________________________________________________

The views we have about ourselves and the world must be true, right? One always believes their perspective is accurate, however just as a tarnished mirror won’t give an accurate reflection, one’s outlook can be distorted.

We will now help you to take those thoughts and probe them thoroughly, under covering the truth, the whole truth and nothing but the truth. It may not be exactly like ‘NYPD Blue’, but it will be something like a detective case then bringing those twisted thoughts down. Like every criminal mind, a second chance will do it justice. Let’s get rehabilitating those negative patterns that have been landing you in a cyclic spiral of misery.

From Accusing  to Proving Guilty: A Thought Trial

Cognitive Therapy is a technique founded in the 1950’s used by a highly influential psychotherapist, when he discovered that if we can get our thinking to change, we can change the way we feel. Studies indicate that cognitive therapy works well to eliminate negative emotional conditions such as depression and anxiety.

Putting your thoughts on a Thought Trial begins with Thought Tracing. Tracing the thought shows you how a variety of happenings or emotions from your life are all interconnected. I gave you information on peering into moods and emotions, but now we will see how to pin down a detrimental thought by tracking it back to it’s origin.

In a real court trial there are components to Defend, Prosecute, and Judge. You get to play the role of all of these. You will: offer evidence to back up a thought you discover in Thought Tracing and defend this negative thought, use the power of prosecution to charge this thought as guilty of causing anguish, and finally judge this thought, giving it a change to be rehabilitated to a healthy state.

Essentially the goal is to prove the thoughts guilty, and following the exercises and tables will make it almost surely impossible to prove them innocent. However, you may need help from a psychological therapist or professional if you consistently find yourself justifying negative thoughts. A fresh perspective may help further.

We all appreciate stories and visuals more than arduous lecturing. So this next section will demonstrate multiple examples of putting thoughts on trial through Thought Tracing.

Sample case of a Thought Trial

Let’s examine the case of Danny, a handsome 25 year old personal trainer. He is conscious of his health and leads an active lifestyle. He’s recognized by his bright long sleeve shirts he’s always seen wearing. Being an attractive guy, he gets plenty of nods of attention from the ladies.  As good as it may feel, something holds Danny back from ever reciprocating the attention. He’s never had a serious relationship, and there is a reason why. Danny’s dark secret is that he was a burn victim as a small child.  The severe tissue damage has created a map of scars all over his body.  He is confident anyone seeing them will be appalled and disgusted. So instead he chooses to stay isolated from people on a social level.

Finding himself drawn to an attractive young lady he knows from the gym, he realizes his fears are in need of some serious help. The attraction is mutual, but Danny refuses any of her attempts to get to know him. An invitation for lunch sends him reeling in panic, so he blows her off. Spurned by the confusion of his desire to pursue this opportunity and his deep fears to do so, he speaks with his counselor. We can follow his progress below as he uses Thought Tracing, then brings these thoughts to justice in a Thought Trial.

Thought Tracing

After tracing his thoughts, Danny is asked to start pin-pointing his most disturbing thoughts that came up, what can be considered the most detrimental thoughts.

Danny’s most detrimental thoughts:

1.  Cara’s reaction of disgust will devastate me.

2. I feel like a victim of my own circumstance in life.

Now tracing his thoughts, Danny can see what two main thoughts conjure up the most pain. Next he will bring these thoughts to trial in the following table. He will first focus on thought number one. He first writes the thought down, then lists a defense with reasoning and logic. In the next column he will use prosecution to prove it guilty of being a turmoil causing thought.

Thoughts on Trial

Pin-pointed thought: Cara’s reaction of disgust will devastate me.

We can see Danny’s mind is made up, his most detrimental thought so far is in the winning lead. Changing his thinking at this point isn’t a possibility. His counselor encourages him to try Exercise 6-3 where he can do some further Investigating and write down his results in

Investigating Worksheet

1.   Name how this thought may be askew to reality.

2.    Have I changed or exaggerated the scale of the event?

3.   Name a time in life when this thought may not have held true.

4.   If I had a friend that this thought applied to how would I try to help them?

5.   Do I push aside indications that this thought is false?

6.   Is this thought a help or harm to me?

7.   Name a time when this situation happened but I got through it just fine.

8.   What positive changes would happen if I refused to believe this thought were true?

Danny’s Reflections

As hard as it is to ponder this, I think I can see some jumbled thought process here. I would hate to see disgust on Cara’s face, but I’m sure it wouldn’t be the most devastating thing to ever happen to me. So I’m exaggerating there. I have seen a beautiful woman with a handicapped or debilitated man before. It isn’t impossible for a person with a body deformity to have a healthy and loving relationship. I remember my burn support group talked about people finding relationships after their injury. Maybe I could stand to  see if a relationship really could work for me.

Reviewing his Investigation helps Danny to add more evidence to his Thought Trial. He builds his case below.

Danny’s Revision

Pin-pointed thought: Cara’s reaction of disgust will devastate me.

Defense                                                                 Prosecution

We can see how Danny’s thought process is developing in this Thought Trial. He has found these thoughts guilty as charged- they cause pain and anguish in his life and it’s time to change them. Now he and his counselor work on rehabilitating these detrimental thoughts. Even after creating a replacement for his very first thought, he continues to do the same with more, one by one. Again, consistency is key.

Bringing those thoughts to a trial

You know what time it is now, it’s time to take your own thoughts to trial. Don’t be discouraged if you find your initial attempts to be difficult. These things take time and patience. And practice makes perfect! There are more examples listed later for you to refer to if you need some extra help. The first step is to pin-point some thoughts through Thought Tracing. Complete the thought tracing after reading the following instructions:

1. Take note of your body’s responses and write them down whenever you are feeling some discomforting.
2. Use a specific descriptive word that captures your feeling at that moment and record it.
3. Number the intensity of this feeling from 1-100.
4. Think of the surrounding circumstances when your body signaled you and your emotions surfaced.  Sometimes this can be a tangible event or moment in time or it can be a recollection of a time in life. Be specific, though about the thoughts. Use a statement like “At work, I felt this way when….” Instead of “I hate my job.”
5. Use the Translation column to record how the event affected you.
6. Upon reflection of your work, you can pin-point your most detrimental thought and list it accordingly.

Thought Tracing

My most detrimental thoughts:

1.      ­______________________________________________________________________

2.      ______________________________________________________________________

The Thought Tracing sets you up for the Thought Trial. This takes some pondering and patience. Take your first detrimental thought and go over the Investigation. Keep in mind it will take some planning and preparation. Take a malicious thought and consider the Prosecutor’s Investigative Questions.

My reflections

__________________________________________________________________________

The stage is now set to put your detrimental thought on trial. Use the same exercises to place all thoughts on trial one at a time.

1.  In Exercise 6-8, focus on one  of your most detrimental thoughts as the pin-pointed thought  and record it.

2.  On the left, support this thought with all of the logical thought process and apparent evidence you can summon.

3. On the right, counter all of this evidence previously listed in the defense. Also list any assisting points to help the case.

Taking the Thought To Trial

Now you may come to the conclusion, a judgment, if you will, whether your thought is guilty of causing you unnecessary emotional difficulties. Even if you have ruled some truth to some of your thinking process, use your better judgment as to whether these thoughts are a help to your mental state, or harm. If the latter, work to restructure them to become more conducive to your well-being.

More Samples on Thought Trials

More examples will further assist you in your journey to restructure and rehabilitate your thoughts. Remember, the more you change your thinking, the more you change how you feel. We can now look in on some other thoughts that are brought to trial and brought to justice.

Jerry: Destined to be Unhappy?

Jerry,  a 62-year-old retired sports coach, took up the hobbies of a sailor. He enjoyed spending his time on the water, maintaining and restoring his sail boat, planning adventurous travels around the coasts, and in general keeping active. He had been aware of a swelling pain in his knees, but he managed to get by with pain relievers and a firm refusal to address the pain. Soon though, he cannot ignore the pain anymore, and consults with a specialist who delivers the hard-hitting news, Jerry is in dire need of double knee replacements. The idea of this sends Jerry into a state of sadness and gloom.

Below he does some Thought Tracing and is able to pin-point a detrimental thought:  “ My happiness is soon to end.

Connor’s Thought on Trial Worksheet

Pin-Pointed thought: “My happiness is soon to end.”

Reviewing his own evidence, Jerry concludes his thoughts are worthy of a guilty judgment. He can now separate this detrimental thought from reality and change his grim outlook into a positive one.

Tammy: Anxious and Overworked

Tammy  is a 40 year old single mother who works 50+ hours at her corporate job. Balancing the roles of an executive at her job and the role of an involved mother is nothing short of a tiresome struggle. She feels like she isn’t giving full energy to neither her teenage son nor her position at work. Tammy feels anxious and judged constantly. Her desire to perform at a perfect caliber is her motivation to keep going every day. When her son brings home a less than perfect report card, Tammy loses her temper. She ends up in tears, her son ends up not speaking with her, and the result is Tammy in a depressed state. Tammy does some Thought Tracing to track these negative patterns.

Tammy’s Thought on Trial

Pin-pointed thought: I am not fulfilling my role as a mother properly, and because of it my son is becoming a failure.

Creating a Thought Trial is a combative tool to keep negative and accusatory thought patterns in perspective. Reviewing as many examples as possible will continue to solidify this process. Remember to incorporate Investigating examples of distorted thinking. If you do not find progress is likely with these exercises, it is recommended that you seek help from a credentialed mental health professional who is familiar with cognitive therapy.

After the Trial: Restructuring Thoughts for Rehab

The goal at this point is for you to have a good handle on your own collection of detrimental thoughts. Awareness of them will help to place them in their proper perspective, eliminating anxiety, stress, and emotional angst. Now giving these thought processes a chance to be rehabilitated will help a positive outlook to replace a once distorted and miserable one. These thoughts will be replaced and restructured.

Highlighted in this section are a series of four strategies to help sort out the bad thoughts, restructure them, and implement them into your thinking. Realistic replacement thoughts stamp out distorted ones, banishing them to a state of non-existence.

Ask A Friend

The first technique is simple enough. Imagine a good friend of yours is experiencing the same problem that you have. Your friend is also experiencing the same negative thought patterns as you. Imagine your friend is sitting in front of you. You feel their pain and want more than anything to help them through it.

What type of advice do you offer? What type of outlook do you suggest? Looking honestly at your friend’s situation will provide you with the clearest perspective. You wouldn’t say what you think they want to hear by coddling to their thinking, albeit askew to reality or not, would you? You would lovingly provide a healthy and reasonable alternative way to think about their problem.

The simple beauty of this strategy is that the same kind advice you would offer a friend applies to you yourself. This can help you separate your own woes and put them into a realistic objective. It’s like viewing your own situation from a third party point of view.

We see Tammy using the Ask A Friend technique below.

Tammy imagines her best friend Jenna approaching her with the exact same problem. She pin-points her most detrimental thought and works with her to help her turn the thought into a restructured, realistic and healthy thought.

Tammy’s/Jenna’s most detrimental thought:

I am not fulfilling my role as a mother properly, and because of it my son is becoming a failure.

Tammy’s Ask a Friend (Jenna)

Jenna, you are experiencing a small obstacle right now. You are an awesome Mom, and your son’s minor setback is no indication otherwise. It is only a slight drop from his A’s and B’s to some B’s and C’s. You will be able to help him where he needs it by consulting with his teacher. He is also old enough to be responsible for his own success in the classroom. You don’t have to feel like the victim here, it’s really more about him.

Emma reviews her imaginary discussion with Louise.  She sees that her perspective changes when she gives Louise advice rather than listen to the negative automatic dialogue in her own head. Next, she distills this perspective into a single replacement thought.

Tammy’s Restructured Thought

My son is not becoming a failure. He is experiencing a small ‘growing pain’ and all I can do is be here for him and help where I can.

Here is how to get started in restructuring your most detrimental thought:

1.  Write down one of your most detrimental thoughts from your Thought Tracing.

2.  Think of a good friend.

3.  Imagine your friend has the same problem and same thinking about the problem.

4.  Imagine talking with your friend about how to deal with the problem.

5.  Record your advice to your friend.

6.  Restructure the thought.

Ask A Friend

Planning for the future

Certain events that may temporarily distract and disrupt your life will not carry the same weight later in life. For instance, some of the events below may invoke certain emotions initially, but how do you feel it has affected you later in the day? Is it the same intensity?

• A traffic jam
• Feeling shy
• Forgetting your keys
• A rude service person
• A long line

These types of occurrences may create a detrimental thought process, but usually if you think back after some time has passed by, it would be rare to feel the same about the situation. In putting the context into perspective compared to your life, it is reasonable to say it was a trivial moment in time. Let’s consider Tom.

Tom lives in a residence that is managed by a board or committee. He would like to renovate his home inside and out but has to get the board’s approval for some exterior changes he plans to make to his home. The next monthly board meeting is coming up and Tom plans to present his blueprints to the members. When he thinks of doing so, he becomes anxious and feels maybe it’s not worth having to face all of those people. He is afraid he will stutter and stumble and make a fool of himself.

After using Thought Tracing, Tom feels he has pin-pointed his most detrimental thought: “I don’t have enough confidence to not make a fool out of myself.”  Exercise 6-15 shows him evaluating the impact of that event compared to the rest of his life.

Tom’s Planning for the Future

If I stand up to present my plans to the board and I do end up stuttering and stammering, I will feel embarrassed for the moment. On a scale of 1-100 it would probably feel like a 40. At least I would get the information out and be able to move forward with my plans. In the long run that moment won’t matter very much to me, but the outcome of my goals will be met and that will feel great! The overall impact of this on my life would be very low after all.

Tom is ready to restructure that thought into something positive.

Tom’s Restructured Thought

When I present to the board, I may end up looking foolish but it will not affect me afterward. It will not be so bad to do it!

Planning for the Future helped Tom to work his problem out. He also  could have done some Thought Tracing and brought his most detrimental thought to Thought Trial. Point being, there are a variety of tools in your box to face your distress head on.

Here is how to use a thought in Planning for the Future

1.  Write down  one  of your most detrimental thoughts from your Thought  Tracing.

2.  Rate the overall impact  you feel  at the moment (on a scale  of 1 to 100).

3.  Think about  how your thoughts will reflect this moment in about a week from now, in 6 months, in a year?

4.  Rate again how this impact will affect you in the long run.

7.  Write down  a balanced and healthy Restructured Thought.

My most detrimental thought:____________________________________________________

My Planning for the Future

__________________________________________________________________________

Reevaluate your fears

Feeling anxious, worried, sad, or fearful can end up becoming a tangled web of negative emotions that will engulf your thinking. You will then start projecting a negative view in all aspects of life, whether realistic or not. A basic problem may be escalated in your own distorted thinking and then place you out of touch of reality. In short, normal distressing situations are compounded by anxiety and depression.

Rachel’s boss, Kari, takes some time off of work when she undergoes a minor surgical procedure. Rachel fills the responsibility of the position just fine for about a month. Kari’s situation changes and she is no longer able to return to work. Rachel is offered this management position. Although she hadn’t thought twice about performing the role of the job before, Rachel is now experiencing an onslaught of negative thoughts when she imagines herself in this role. Her pin-points a thought: “I am not management material, others won’t respect me.”

Rachel’s Reevaluation

1.  How many times have  I projected this fear in other situations and was it realistic?

There have been much more challenging situations that I have faced in life, and since I am goal oriented, I tend to handle challenges well.

2.  How common of a situation is this? Do I know anyone who it has happened to?

Everyone in a managerial role in this office is respected. A person who would not be fit for the position would not be offered it. I should be honored.

3.  If someone else made this prediction, would I agree?

Not necessarily. I would base my prediction on past performance. I guess mine has been pretty good.

4.  Am I assuming this will happen just because I fear that it will, or is there  a reason- able  chance that it will truly happen?

Of course, there’s a small chance I won’t be able to handle the job. But clearly, I’m making some unwarranted assumptions here. After all, I’ve done the job successfully for a month.

5.  Do I have any experiences from my life that confirm this fear?

For the most part, I accomplish anything I set my mind to.

Rachel can now clearly see from an evaluative stand point her distorted thinking. She is now ready to create a Restructured Thought to replace her initial detrimental thought.

Rachel’s Restructured Thought

Even if I don’t feel confident enough for this position, obviously others feel differently. I could take the opportunity to prove it to myself!

Take one of your most detrimental thoughts and use the Reevaluation to come up with a positive Restructured Thought.

1.  When you find yourself making a negative projection about a situation you are faced with, record your fears.

2.  Take the Change your Predictions Quiz.

3.  Try doing what your fear was to prove the outcome wrong.

4.  Write out a restructured thought  for your original fear and use it in other similar situations.

My Change Your Predictions Quiz

1. 1.       How many times have I projected this outcome in life and how many times did my fear actually manifest? What about for others I know? __________________________________________________________________________
2. If someone else  predicted this negative outcome, would I agree with it? __________________________________________________________________________
3. Is this prediction more of a fear than a reasonable assumption? __________________________________________________________________________

Once you’ve verified to yourself that your negative predictions aren’t realistic, test out that fear by acting on the very same thing that you once feared. Jot your restructured replacement though below.

Find ways to cope in the upcoming section if in fact the outcome will be negative as you feared.

Preparing for the worst

Bad things do happen, and to good people. In this section we imagine what we would do if the worst-case scenario actually did happen. This can be helpful because it will empower you to get through any tough situation.

We see the struggles of Edith, a divorcee of 20 years. Although she has been content being single, she has fallen in love with the man she believes would complete her life. The two of them know they have a special bond and have become inseparable, but something holds Edith back from totally committing. The pangs of betrayal and dejection are still with her from her previous marriage. She completes a Worst-Case Quiz to help her evaluate whether her hesitation to get involved in a relationship is realistic. She will then restructure her thoughts.

Edith’s most detrimental thought: “I cannot commit for fear of being rejected.”

Edith’s Worst-Case Quiz

1.  Does this fear resemble anything from the past?

Yes, my ex-husband hurt me greatly. But after I mended from that, I found happiness again.

2.  What affect will this have on me in a year?

Being hurt again would be painful all over again but I am sure I would find the strength to be happy again just as I did before.  

3.  Do I have sources to turn to for support?

I have reached out and met a wonderful network of friends over the years and I feel confident I would find comfort with them.

5.  What positive outcome could potentially result?

Even if the relationship fails, I have plans to join a garden commission and travel with the projects. I would have a lot of time and energy to put into it.

Edith’s Restructured Thought

This relationship is worth trying. I love him and he loves me, and I will never be truly happy unless I know that I gave it my all- fears and all.

Take one of your  most detrimental thoughts and  use  the  Worst-Case  techniques to combat that thought.

1.  When you find yourself thinking of a bad situation, record your thoughts.

2.  Take the Worst-Case Quiz.

3.  Rehabilitate your detrimental thought  with a restructured thought.

My Worst-Case Quiz

1. Does this fear resemble anything from the past? __________________________________________________________________________

2.  What affect will this have on me in a year? __________________________________________________________________________

3.  Do I have sources to turn to for support? __________________________________________________________________________

4. Is there anyone I know I can ask for help? __________________________________________________________________________

5.  What positive outcome could potentially result? __________________________________________________________________________

Your  reflections

__________________________________________________________________________

The more practice, the better. Familiarize yourself with all of the techniques so that you will be well-equipped to tackle your negative thinking .Review, review, then review some more. This isn’t a competition or a test, it’s rehabilitation in the journey to peace. Take time to reflect on the things you have gleaned about yourself in this post; your weaknesses, strengths, tendencies, favorite techniques, etc.

How you think about an event determines the way you feel.  This is the premise of the principles of cognitive therapy.  We all experience distorted thinking, where you’re thinking doesn’t accurately reflect what is going on.  Distorted thinking can be positive or negative and is a problem when it leads to depression and anxiety.  These distortions are called reality jumblers.  There are three types of reality jumblers.

• The Information Reality Jumblers
• The Self-Judging Reality Jumblers
• The Self-Blame Reality Jumblers

The Information Reality Jumblers

Information Reality Jumblers distort your perceptions of your world.  They affect your thinking.  An example would be someone whom is depressed receiving an average review from their boss.  They are likely to dramatize this event until they feel utterly worthless as a person.  The Information Reality Jumbler is called dramatizing.  Without the jumbler, the reality is that his performance was average even though they would have preferred a much higher rating.

The following exercise exemplifies various way that Information Reality Jumblers can affect your thinking and the way you feel.  Read the descriptions and examples of each type of Information Reality Jumbler.  Think about when your own thoughts might have been influenced by the Jumbler.   Reflect and record any specific examples that you’ve had that might be distorted by an Information Reality Jumbler.

Information Reality Jumbler Exercise

• Dramatizing: Your mind exaggerates the awfulness of unpleasant events while also minimizing the value and important of anything positive about yourself.  For example, one may think, “It’s horrible that we have to work 4 extra hours tonight.  I just can’t stand this job!”  Truth is, although you may not feel like working an additional 4 hours, it definitely fails in comparison to more straining events like being diagnosed with serious health problems.
• Separating: Your mind searches for frightening information while filtering out more positive information.  For example, you are rated highly in a performance evaluation in several areas but one, which is an average rating.  Your mind focuses exclusively on that rating instead of the several positive ones and concludes that the entire evaluation was mediocre.
• Construed Viewings: Your mind views events in an all or nothing fashion.  Where a single performance out of several indicates failure. Your mind sets you up for disappointment and self-abuse.
• Discarding Evidence: Your mind dismisses evidence that may negate its negative thoughts.  For example, you’re preparing a proposal you have to present before the President of Operations at work have a thought that you will be so scared you won’t be able to speak.  Your mind automatically discards that fact that you’ve given countless presentations before and never been so afraid that you couldn’t talk.
• Over Generalizing: You take a single occurrence that is unpleasant and your mind decides that it represents a general trend.  For example, a teach tells a student in an angry tone that he is always late, but in reality he is only late about 10 percent of the time.
• Over Analyzing: Your mind analyzes every detail of an event in your world no matter how insignificant it maybe.  For example, you walk into a room and everyone stops talking, you automatically think “they were talking about me.  Was it something I said?  Or something I did?”  In reality, three co-workers were talking privately about your birthday plans.
• Emotional Reasoning: You treat your feelings as facts, and heed to them immediately without giving yourself time to go through any motions or inquire within yourself as to why you feel this way.  For example you feel guilty and conclude that you must have done something wrong
• Unreliable Predicting: You presume an outcome will be negative without any real evidence or reasoning.  You get into an argument and become convinced that the relationship will end.

Tracking Information Reality Jumblers on Thought Trackers

Recording your thoughts and checking for distortions in them helps clear your thinking and improves your mood.  Here’s a sample a tracking Information Reality Jumblers in a Thought Tracker.

Now it’s time to see if you can recognize the Information Reality Jumblers in different situations.  Review the feelings, events and thoughts of those events provided and fill in the Information Reality Jumblers that you believe apply.  The answers will be provided afterwards.

Here are the answers to the Thought Tracker above.  The point of this exercise was to learn to observe distortions so don’t worry if your answers don’t match up perfectly.

• Scenario 1: Dramatizing, unreliable predicting, construed viewings,  emotional reasoning
• Scenario 2: Discarding the evidence, over analyzing, separating
• Scenario 3: Dramatizing, over generalizing, unreliable predicting

Track your own thoughts and look for possible Information Reality Jumblers.  Take time to reflect afterwards.

The purpose of this exercise is to invoke a process that will have you question whether or not your thoughts about events are always accurate and the possibility of seeing things differently.  Hopefully, your way of thinking is beginning to shake up and the path to feeling better can already be felt.

The Self Judging Reality Jumblers

The Self Judging Reality Jumblers twist the way you view yourself and behaviors.  Those whom are depressed and anxious tend to be judgmental and self-abusive.  Being judgmental becomes a problem because it is a form of self-sabotage.  Self-criticisms make you feel worse and leave you with less energy for change.  Self Judging Reality Jumblers come in three different forms:

• Shoulds
• Crucial Comparisons
• Offensive Labels

Shoulding Yourself

Shoulding refers to putting yourself down by thinking that you should be or act different.  Shoulding jumbles up self views and turn them into self criticisms.

Identify your own should and take the following quiz:

The Shoulding on yourself Quiz

Shoulding makes you feel bad because of guilt and doesn’t elicit positive behavior.  Substitute shoulding with refusing to engage in harsh self judgment.   Refer to the sample below.  These shoulding statements are an example of how to change them into a healthier alternative.

Learning to see the alternative to shoulding on yourself is definitely key to feeling better.  Fill out the following Should Alternative exercise.  Make sure to you tune into what you tell yourself when you feel upset and listen for the should and shouldn’ts you tell yourself.  Come up with an alternative for each of these.

Make Crucial Comparisons

We are all different, so we all have different strengths and weakness.  Even if you are the best at something, doesn’t make you the best at everything.  However, as imperfect human beings we all tend to compare ourselves to others at times in our lives.  Anxious and depressed people tend to judge themselves much more negatively and place value on those comparisons.

Try to identify your negative personal comparison by completing the following Crucial Comparison Quiz.

Critical Comparison Quiz

❏ Wealth and Financials

❏ Appearances

❏ Being intelligent

❏ Being popular

❏ Having Fame

❏ Guys and gadgets

❏ The House

❏ Cars

❏ Clothing and appearance

❏ Status Quo

❏ Your age

❏ Innate Knowledge

The main thing to keep in mind is to not compare everything in your life. The fewer items you compare, the greater the chance you will be well adapted. You may fail victim to the seductive wiles of the comparisons you make. There is also the truth of the situation that also comes into play. Wherever you go, there will be someone more attractive, richer, or smarter than you. You can’t help make these comparisons. What you can do is prevent yourself from thinking yourself not good enough because someone else may have it better than you.

There are other alternatives than making those terrible comparisons. Lets find ways to create alternative examples to combat those critical comparisons.

Comparison Alternative Exercise

Once you see this sample Alternative Exercise, it is possible to effectively create one of your own. If you look into you’re your emotions, quickly examine your thoughts and try to find times when you begin to critically compare yourself to others. These are the thoughts you list in the left hand column. Once you have those listed, you can then create effective thoughts to overcome those  critical thoughts. You must be able to recognize that you may be average, normal, above average, or even below average at many points within your life. Find those areas where you excel and keep those thoughts at the top of your thought processes. Make sure to prioritize your thoughts and accept your weaknesses.

Losing the labels you give yourself

We hear the children’s’ mantra that “sticks and stones may break your bones”, however, what most people fail to recognize is that what is said can make a more dramatic impact than you know. Most people when faced with anxiety or depression fall into the trap of name calling and self-deprecation. When you begin this process, you begin to make things much worse for you.

Labeling Quiz

Miserable

Misfit

Freakish

Klutzy

Dork

Idiot

Stupid

Dumb

Silly

Imbecile

Fat

Terrible

This type of labeling makes you less than you are. The attempts to create a simple statement about who you are without caring about making simple black versus white comparisons are futile and self-defeating. They cannot help you to move forward and in fact, they lead to additional emotional impact. Use the following label worksheet to battle those labels.

My Label Replacement Exercise

As you begin to move away from name calling, you will begin to move forward into a healthier point of view.  Use the following exercise to help you move away from those labels. When you find yourself in an emotional turmoil, listen for those hurtful names. Record the event that triggered the name calling, list the label, and then find one thought that can combat that label.

When you have completed the exercise, use the self reflection chart to talk about your findings.

Scrambling the Self Blame

If you find yourself in an atmosphere anxiety and depression, you may begin to add find additional stress place upon you by you. Detailing yourself to be totally incapable of action or smart enough to prevent you from making mistakes. If you begin to use the process of self-blame scrambling, you place all the fault onto yourself. This begins to lead down the road to self-loathing.

In the following Responsibility Exercise, you will begin to see that the problems you have are not the fault of yourself completely. You will be able to minimize the  impact of those problems.

In this sample exercise, we will assume the following:

Joyce is distraught her husband left her for another woman just before their divorce. The thoughts she believes are she is not attractive, is not exciting, and not smart enough to know her husband was cheating. These are the results of this exercise.

Rating Responsibility Exercise

I blame myself for: The Recent Divorce

I rate the  blame at: 90%

By assigning nearly all of the blame on yourself for this situation, our sample person has essentially created a downward spiral of depression. Through this exercise, this person should be able to reevaluate things a bit more critically and objectively. By the time everything is through, this person might be able to recognize only 20% may be her responsibility. This eye opening affirmation helps to reduce the guilt and self-blame.

Use the following diagrams to evaluate one area of your life that you may feel responsible for.

Make sure to:

• Name the problem at the top of the worksheet
• Assign a percentage of blame to yourself at the top of the worksheet
• List all potential causes in the left hand column
• List the percentage of blame for each cause in the right hand column
• Rerate your blame at the end of the exercise.

______________________________________________________________________________

I take the blame for :___________________________________________________________

I rate the blame at:_____________________________________________________________

After doing this exercise, I re-rate my responsibility at:__________________________________

What have you done to solve the problem

This is the place where you take action to change the problem. You have already assessed the level of responsibility for your problem and made some ideas about what to do with this problem. Through this process, you have been able to remove the blame from yourself and possibly learned that you can love yourself in the future. Here we will show you how to take the responsibility for taking a portion of the problem and learn what not to do if future events.

The subject above does have some responsibility for the mentioned divorce. What follows is the level of responsibility she has a nd her strategy to overcome those.

What follows is your call to action with the action strategy worksheet.

Make sure to:

• Name the problem at the top
• Use the left hand column to address your contribuions
• Use the right hand column to list the action you can take to overcome the contribution

Now take the time to make any reflections for personal self discovery at this time.

Each one of us is truly unique in our own way.  From how we perceive situations and criticisms to how we react when faced with adverse events.  Some people seem to have been born almost pre-designed to be able to handle the most incredible of circumstances without the blink of an eye, while others are unable to process certain traumas in life and are almost stuck in time.  We are a nation of medication seekers.  When something is hard to deal with we tend to automatically seek medicines to help level us out.  Although there are tremendous breakthrough in how medicines truly help us in all kinds of situations, they shouldn’t be the first choice you turn to for help.  Again, self-help is an excellent tool in overcoming your depression and anxieties.

Decoding what your body is really trying to say

What happens to your body physically and how it responds is a huge indicator that something is going on internally, but we don’t always recognize the signals or we deny them altogether and make justifications for them.  Thinking of these signals as an early warning system set in place to help you identify an internal storm is coming and what you can do to prepare yourself.

Keep a journal to log your responses to events.  Start with the physical aspect.  Record pains, heart rates, sleeping schedule, eating schedule and similar physical reactions.  Once you identify the physical reaction, record when it happened and what specifically you were doing.  This will help you see how the connections of what you do in a day effect your mood.  Once you recognize these connections your journey to feeling better will start.  Once you record a weeks’ worth, take time to reflect and see what you can conclude from your own results. Here’s a look at a sample recording:

Sample reflection: Although I never paid attention before, I realize now that my body does react to what is happening around me.  I can clearly see how I become stressed when I present projects or have to talk to my ex.  I can also see that I have been in denial when it comes to finances.  I really get anxious about my bills.  Now that I have realized this all, I want to better myself.

Feel free to use this tracking sheet to record your findings and reflect on them.  Make sure to record how your body responds in the left column.  Be specific to the reaction you felt in the middle column.  Record when this happened and what exactly was going on in the right column.  Afterwards, record your reflections.

Personal Reflections

Linking the Body with the Mind

Once you have become more attentive to your body’s signals, its time to bridge your physical state with your mental states.  By using a list of emotions known as feeling words, you can link these two states.  For those who have a hard time describing or expressing your feelings, read the list slowly and meditate on them to see if they apply to you.

Record and track your feelings every day for a week using the following Unpleasant Emotions.  Each day circle the feeling words that describe your emotions.  Tally the words at the end of the week to find the words that are dominate.  Afterwards reflect on the results.

Personal Reflections

Frame Feelings and Events

Now that you have learned to recognize your body’s physical reactions to events in your life and you have the ability to use feeling words to describe your mental and physical states, its time to connect them to the events that trigger them.  Again, by taking the time to record these together you will be able to see what is really causing you stress versus what might be just adding to it.

Take a look at this sample of a four day Mood Diary of a woman who is anxious a lot.  She worries daily over her children, but at times does not know where her anxiety stems from.  She recognizes her body’s signals and writes down when she feels unpleasant.  She uses a feeling word that describes her emotion.  She rates her physical responses and feelings using a scale where 1 is almost unrecognizable to 100 maximal.   She also records what was happening while she was stressed:

Sample reflection: Well I thought I only worried over the kids, but I can see how that isn’t usually the case.  I often worry and stress over my job.  I often get stressed out when there are any conflicts and I need to overcome being shy.  I never realized all of these feelings and how often they occur.

Try recording in this Mood Diary.  What you learn over a week or more will give you the knowledge and power to make changes in your life and provoke your way of thinking.  Over the course of a week, listen to your body’s signals and write down whenever you feel something unpleasant.  Use feeling words that describe your emotions from the list of Unpleasant Emotions.  Rate your feelings on a scale from 1 – 100.  Record what was happening when you noticed your signals and be specific.  At the end of the week, see if you can gain any insights from your Mood Diary and reflect on what you have learned.

Personal Reflections

Keeping Track of your Thoughts

Some people go through life unscathed while others feel like they bought season passes to events that are tormenting.  These events linger and fester causing some people to spiral into a state of perplexing thoughts, where the same question usually formulates at the end, how did I get here? Imagine if you will, backing up and hitting a parked car.  How would you respond?  Would you be angry?  Would you start to worry about the repairs?    Or would you be upset with yourself for being careless?    

Anyone is likely to feel upset after banging up their car.  If your thoughts are intense or unrelenting however, they provide clues about your habit of thinking negatively.  Such habits dictate how you interpret events and how you feel about them like this accident.  If you feel terribly worried, it’s probably because you are anxious.  If you are left feeling overly down on yourself, you may be prone to depressive thoughts.

In any case, identifying your thoughts lay it all out for you.  Thought Trackers show you how feelings, thoughts and event all connect together.  Read the following sample Thought Trackers of how three different people respond to the same incident.            ­­­­­­­­­­­­­­­­­­

Three different people all backed up into another and experienced three different reactions.  The first person worried about the consequences and put themselves down.  Because they interpreted the accident this way, this person is at risk for anxiety and depression.  The second person gets mad and dramatizes the accident.  This person tends to have problems with anger and depression.  The third person panics and thinks the worst.  This person struggles frequently with anxiety and panic.

When people feel distressed they often feel like they don’t know what is going on in their heads.  They simply have no idea what they are thinking.  You may experience this problem and if so, ask yourself the questions in the quiz below about an event that caused difficult feelings.

Thought Query Quiz

Thought Trackers are a great tool to utilize on a frequent basis because they give you important information about the way your mind interprets events and how your feeling relate.  After completing a Thought Tracker take some time to reflect.

• Barriers that block change
• Breaking down beliefs
• Discovering self- ruin
• Destroying self-ruin

No one wants to be depressed or anxious. You may feel as if there is no other way. Wanting to do something about your distress is different than knowing what to do about your distress. What is stopping you are the many obstacles located within your own mind.

This will help you uncover assumption or beliefs you have making it hard to overcome your depression or anxiety. Once these barriers are identified, it becomes easier to use tools, one tool specifically, to isolate those barriers. Self-awareness will determine if you are sabotaging your attempts at recovery.

Barriers that Block

You may be one of many people that hang onto beliefs that prevent you from changing. Change can be frightening for many. If you have fallen victim to the blame game don’t worry, you can quite easily overcome the varied obstacles preventing your moving forward. These thoughts keep you from maintaining a motivated spirit that stimulates change.

Look for the quizzes in this section to see if you have any change-blocking barriers in your life. It is hoped you will be able to find some exercises to assist you removing barriers and beliefs that will promote an honest appraisal of yourself.

What stands in your way

Resistance to change results from fear, feelings of inadequacy, and an inability to overcome the emotion of helplessness. It is possible you may not recognize these beliefs and as such find yourself trapped without the potential to change.

Fear Change Quiz

1. If I take a risk, I will fail.
2. If I reach out to others, I will be rejected.
3. Whenever I try something new, I screw it up.
4. When I get my hopes up, I am disappointed.
5. If I work on my problems, I will fail.
6. I would rather not try than fail.
7. I will never be a success.
8. I am too anxious and depressed to achieve.

Undeserving Quiz

1. I do not deserve to be happy.
2. I don’t expect much from my life.
3. I feel less worthy than other people.
4. If I ask for help, I feel guilty so I don’t ask.
5. There is something seriously wrong with me; this is why I am distressed.
6. I do not believe I am as good as other people.
7. I am very uncomfortable if people are nice to me.
8. Other people deserve more than I do.

Unjust Quiz

1. I can easily dwell on how unfair life has been to me.
2. I feel very helpless when I deal with my plight.
3. I can’t stop thinking about how I have been mistreated.
4. I am angry about all the bad things that happen to me.
5. No one can understand how difficult life has been for me.
6. Anyone who had my life would complain.
7. No one could appreciate how much I have suffered.
8. If I make changes to my problems,  the value of the trauma of my life is meaningless.

To grade these quizzes use the following scale:

If more than two items are checked in the Fear Change Quiz, you exhibit fear at the thought of changing. If you checked two or more items from the Underserving Quiz, you can’t believe the good things that could come to you if you change. If you check two or more on the Unjust quiz, you are unable to locate the resources needed to make the changes needed. On the chance you find two or more checks on two or more quizzes, you will need to evaluate your belief system in more detail.

Typically, these types of thought patterns are typically based upon childhood events or traumatic events that happen during your life time. Some of the change-blocking beliefs do have a ring of truth to them:

• Life is unfair
• It is reasonable to sometimes be angry
• You will not always succeed.

Remember people have the right to be happy-this includes you as well. You only have to push the bad things in your life away from you to succeed. Moving away from the traumatic events you may have suffered does not make them any less important or valuable to who you are. Moving past those events can only make you stronger.

 An example:

Jasmine a woman with three children finds herself worrying constantly. She remembers the sexual abuse from one of her babysitters. Today, she is an overprotective parent. Recent events have left her wanting more sleep. Her youngest child has been symptomatic with asthma. Jasmine has been listening to the child at night. If her middle child is late from the school bus, panic sets in. The child who is living as an exchange student does not call as often as she would like, therefore she believes him a victim of kidnapping or other foul play. As a result of all this, Jasmine’s doctor fears for her health. Jasmine decides to try monitoring her blood pressure by focusing on her stressors and anxiety.  Looking through the quizzes from this section, Jasmine discovers some barriers to change. She completes the Changing Beliefs Summary.

Changing Beliefs Summary

1. Whenever I try something different, I always screw up.
2. If I get my hopes up, I am disappointed.
3. If I ask for help, I feel guilty so I don’t.

Jasmine moves toward writing her reflections.

I have many change-blocking barriers. I just thought this was the way my life was. I see my beliefs may get in the way of doing something about correcting my problems. But what should I do?

Next Jasmine moves towards what she could do to correct her problems. First, you should try your own Changing Beliefs Summary worksheet.

My Top Three Change-Blocking Beliefs Summary

1.

2.

3.

The next step you should do is documenting your reflections.

My Reflections

Moving through these exercises should help you create an idea of what beliefs may be impeding your forward movement. If you have tried to change but failed, one of the identified beliefs above may be the reason why. Remember, you just can’t take your beliefs and toss them out the door. You must embrace them and recognize they no longer control your actions.

If you desire to make this step, you must be able to see the limits to change your assumptions create. If you are just now finding these beliefs, you will gradually learn more about how to overcome the negatives and understand how the positives can benefit you.

Our sample person, Jasmine, now takes the time to fill out the Advantages and Disadvantages Form to be able to completely and fully understand your barriers to change. She writes down how her beliefs make her life feel better followed by describing how they detract from her ability to move past her depression and anxiety. Jasmine correlates this information into a summary for each of her top three barriers.

Jasmine’s Advantages and Disadvantages Form

Change-Blocking Belief  #1: If I try new things, I fail.

Change-Blocking Belief  #2: If I ask for help, I feel guilty so I don’t.

Jasmine reflects back on these Advantages and Disadvantages.

I realize even not trying is a failure, therefore this is not positive. Change does take work but right now I am very miserable anyway; I must make the effort. As I help others, I feel better. So why would I begrudge someone the good feeling of helping me? A little help could go a long way. I hate being stuck.

These assumptions cause her to remain in limbo and prevent her from changing. These completed exercises can help her start going forward.

It is time for you to make this list.

My Advantages and Disadvantages Form

Change-Blocking Belief #1:                                                                                                                           

Advantages of This Belief                                       Disadvantages of This Belief

Advantages of This Belief                                       Disadvantages of This Belief

My Reflections

Sabotage yourself

Overcoming anxiety and depression takes much effort and work. People being to fear this change; as a result they resist, avoid, and take their time to work on their problems. You must look for ways that you have prevented yourself from correcting your problems.

Remember you can make change; it is not impossible. Others find ways to procrastinate and not address the underlying issues. Locate the reasons of why you avoid making any changes to your barriers.

Hindering Change

•         My situation is hopeless.
•         I will never be okay as a result of my past.
•         I want to make changes, but the time is not right.
•         If I am going to make a change, I want to guarantee results.
•         I use excuses to not deal with problems.
•         It is hard to stick with something that doesn’t have immediate results.
•         If I try to tackle my problems I find myself getting confused.
•         I need 100% results or I cannot motivate myself to change.
•         I dwell on my past failures and can’t try something new.
•         If I find my depression to be based on biological causes, I can’t do anything about it.

These thoughts prevent you from moving forward. These are self-sabotaging thoughts. If you find them popping up, try to use logic to argue against those thoughts.

Self-Sabotage can be stopped.

Writing down your observations, thoughts, feelings, and beliefs can be an excellent way to fight against your depression and anxiety. A dairy is one tool you can use.

This is the form you should use to make your daily diary.

My Self-Sabotage Diary

If you find yourself in a story book world with you as the main character, you may find yourself stuck in a theme of failure. If this sounds true, rewrite the script that allows you to succeed.

• Biology of the mind
• History and you
• What is happening now
• Fault or no fault

Keep in mind you are probably feeling a bit depressed or anxious. You probably are not aware of where they are coming from (origin outside of a person), but it is important to understand the importance of family, genetics, personal history, lifestyle (including stressors), and biology. Through reading this you will recognize the ultimate source of your problem and remove the self-blame you may feel.

The major causes of depression and anxiety were already mentioned; many people do begin to feel as if are to blame for falling victim to this level of distress. However, when the true nature of their problems comes to light, the overwhelming feelings of guilt slowly disappear.

Connecting your body to depression

What else runs in families besides cowards? Depression and anxiety do. Chances are if your Uncle Chet suffered from depression, you or someone in your family will more than likely have it. The specific body make up of genes can also influence your emotional responses.

One of the easiest things to do is talk to your family members. Usually, most family members will share what they know. Question to ask: were there any family members on either side that suffered from anxiety or depression? Again, just because there is 1 or 10 relatives with these symptoms it does not mean you will have it. However, it does offer a baseline approach to help understand the tendencies you may have for depression or anxiety.

List of members in your family with depression or anxiety:

Keep in mind that besides genetics, there are some biological components that involve the drugs you take, whether legal or illegal, or the influences of physical illness. Many drugs-over the counter, prescription, or illegal-have many side effects. Looking for why you have depression or anxiety may be as easy as looking into your cupboards.

Medications can change your emotions-negatively or positively. Make sure to talk with your pharmacist if you would like to know more about how your medication can affect your mental health. Don’t stop taking your medication without consulting your primary care physician first.

If you mix alcohol with drugs OR consume alcohol by itself, this could increase your chances for suffering depression or anxiety. If you abuse alcohol the chances for influencing your problems are greatly increased.  There could be mild to harmful, even deadly, side effects from mixing alcohol and drugs.

Taking illegal drugs such marijuana, cocaine, heroin, methamphetamine, ecstasy or others only alter your mindset for short periods of time. The problem however, is the reality of the real world enters back all too quickly.

In a perfect world, no one would suffer illnesses. However, the physical afflictions of being ill itself can create an anxious or depressive state. Often just the fact you are worrying about being ill can cause additional stressors in your life. Make sure to keep your primary care physician in the loop.

Tossing out a Lifeline

The past is often a cause for some of your sadness. Keep in mind the old adage you sow what you reap; this is quite true with depression and anxiety as well. Locating your Emotional Origins can help you revisit your past history. This is not an easy process and may involve dredging up highly charged emotions. If you get to a point where you are too uncomfortable, it may be desirable to seek the attention of a mental health expert.

Sample Emotional Origin

Questions about Mother

1. What was your mother’s personality like?
   1. My mother was self-centered and thought very little about what my sister and I needed. As things didn’t go her way, she threw temper tantrums. She was incredibly dominant and uptight. Tragically she was a perfectionist and discussed the “right or wrong way” of doing things. She made herself out to be a martyr.
2. How did my mother discipline me?
   1. She mostly yelled at us. She ground us, however we could talk our way out of it. There was not much trouble for me because she didn’t see me break the rules.
3. Was my mother warm or cold?
   1. Often it felt as if she did care about us; other times it seemed as if she didn’t care at all.
4. Was she overly critical or supportive
   1. Inconsistent actions showed she was both. I was encouraged to do things, but then she would criticize my choices. I didn’t know what to expect.
5. How did she spend time with me?
   1. I don’t recall much time with my mother. She did act as Den mother for my Cub Scout troop. She seemed to spend more time concerned about herself than me.
6. Were there special circumstances in her life?
   1. My mother did have a miscarriage when I was younger. There was some depression shown by her after that for several years.
7. Does anything else important come to mind about her? Negative or positive are important.
   1. She never was happy with her life. She was absolutely furious with my dad quite a few times.

Questions about Father or other caregiver

1. What was your father’s personality like?
   1. Everyone like him. He was extremely funny. I don’t think I knew him well.
2. How did my father discipline me?
   1. Mom was the discipline power in the family. My dad just exploded from time to time.
3. Was my father warm or cold?
   1. I guess he was warm, but now it seems superficial. I don’t remember him saying I love you.
4. Was he overly critical or supportive?
   1. He wasn’t. I didn’t get a lot of attention. It seemed to be my sister who had his attention. I just didn’t seem good enough.
5. How did he spend time with me?
   1. When smaller, I would roughhouse or wrestle. He worked long hours and wasn’t really home.
6. Were there special circumstances in his life?
   1. Nothing I can remember. The outside world thought we were ordinary
7. Does anything else important come to mind about him? Negative or positive are important.
   1. If I could not do something, he would be very angry over nothing.

Earliest Questions about Child Hood

1. What are the earliest memories you have?
   1. I don’t remember much. My grandpa took us horseback riding. This was fun. I also remember my mom and dad fighting about money. I was scared.
2. Did I have sibling or other people in the home who had an influence on me?
   1. I look up to my older sister, but she lost interest in me after junior high. My mom and dad liked her best, at least Dad did. I just couldn’t compete.
3. What do I remember about grade school? Grades, feelings, friends, etc.
   1. I was really shy but thought I did well in school. I didn’t have many friends; I guess we were nerds.
4. What do I remember about middle school or junior high?
   1. I was shyer during these times. It seemed like I was awkward and clumsy. I was not invited anywhere. I wasn’t happy. If I was upset, my mother would do some of my homework, and then make me feel guilty about it.
5. What do I remember about high school?
   1. I had a few more friend as I started dating. If the girl broke up with me, I got pretty depressed. I hid in my room for many hours. I didn’t know how to handle my emotions and I withdraw. I stopped working once I earned Bs. I could have been more successful at school.
6. What are the major events of adulthood including trauma or winning the lottery?
   1. I graduated from college, was married, and had a few kids. I divorced after 14 years but made it through ok.
7. What did this exercise teach me about the origins of my anxiety or depression?
   1. When I look back at my childhood, it was not very happy. My dad didn’t seem to care, my mother cared more but she was an emotional roller coaster. I did seem to shut down and now realize it has happened most of my life. I do it when I am unhappy.  I guess I know I am not responsible for my depression alone. I understand rejection, criticism or someone being angry with me causes me to shut down.

1. What was my mother’s personality like?
2. How did my mother discipline me?
3. Was my mother warm or cold?
4. Was she overly critical or supportive?
5. How did she spend time with me?
6. Were there special circumstances (for example, illness, death,  divorce, military service, etc.)?
7. Does anything else important about her come  to mind, whether positive or negative?

Stress Assessment

To find the causes of your anxiety or depression, look around your world. You must be able to identify and observe your surroundings.  If you can locate items that are aggravating your distress you can keep them from depleting your ability to cope and prevent physical harm to your body.

Complete the following Culprit Analysis.

1. In the past year have I lost anyone I care about as a result of death, divorce, or separation?

2. Have I suffered from any serious physical injury or illness?

Have finances caused me any difficulty recently? Have I made major purchases like a new house or car?

1. Am I having arguments or conflicts with anyone?
2. Are there problems at work such as new responsibilities, longer hours, or bad management?
3. Have I made any major changes in my life such as retirement, a new job, or a new relationship?
4. Do I have major responsibility for the care of a parent or child?
5. Do I have daily hassles such as a long commute, disturbing noises, or poor living conditions?

Even though some of these items are a very positive factor, they still offer varying levels of stress in your life. As such, they must be evaluated for the impact they have on anxiety and depression.

Conclusions

If you are like most people, you never asked for depression or anxiety. If you look at three factors; biology, personal history, and personal life stressors, depression or anxiety is understandable.

Take a moment to summarize the contributors to your anxiety.

1. What are your physical contributors?­­­­­­­­­­­­­­­­­­­­­­­­­­­­
2. List your personal history.
3. List the stressors in your world.

After you review your summary you should begin to establish you are not at fault for suffering with anxiety or depression. You are responsible for doing something about it.

In the introduction we talked about how people will feel the emotions of sadness and anxiety. These types of emotions are a natural part of the life cycle. You cannot avoid the anxiety or emotions associated with bills, children, work, getting older, or your health. Did you shed a tear at Bambi or Old Yeller? That is normal.

If you begin to allow your anxiety to overcome performing your daily activities, this is not a normal reaction. This could be a sign you have a major problem with depression. Depression will change the way you think, interact, feel, or behave with others.  Once you know what depression is you can begin to fight back and make changes.

If you find that your symptoms are too severe or they impact too many areas of your life, seek immediate attention from your primary care physician or a mental health provider. These are the individuals that can diagnose the severity of your problem.

Thoughts that cause you to worry

Someone who is truly depressed will exhibit self-degradation by thinking they are a failure, that they have no future, which things are always getting worse, and their life is full of regrets.

Someone with anxiety manifests thoughts of varying degrees. These thoughts may include fear of speaking or meeting people out of potential embarrassment, unreal fears or phobias, and other random self-critical thoughts.

These thoughts, if left alone, can lead to darker thought processes that can only deepen your potential towards depression or in the case of anxiety lead to further thoughts of being hurt or judged by others. Many of us have anxiety or depression based thoughts daily.

Here is a quiz that will help you see if you suffer from the dark. Check mark any item that you believe is true.

Are you Negative?

Many of these thoughts are felt by people who are depressed or anxious. The even numbers will indicate anxious patterns and the odd numbers will be depressive patterns. This does not show a pass or fail, however, they may indicate reasons of concern, especially if you check more than eight or ten items. This would indicate you should take some action. The catch 22 is if you have too much anxiety or depression you may believe too strongly in the results obtained.

If you believe you would be better off dead or have total feelings of being out of control, seek immediate medical or mental health attention.

Are you wallowing in mud or quicksand?

Any person with anxiety or depression will show behavioral signs of their struggle. The inside struggles shows itself on the outside of that person. Typical signs appear as lethargy, being tired, socially withdrawing from friends and family, or problems speaking.

Review the next quiz to see if you are showing physical signs of depression or anxiety.

Physically Depressed or Anxious Quiz

Just like the last quiz, this also is not a pass or fail. The more you check the greater your potential concern. Odd numbers in this case show depression symptoms and even the anxiety based concerns.

Feeling Off

May people primary feel the physical rather than the mental components of depression or anxiety. Sleep, energy, appetite, and pain are some of the more common symptoms. While they affect your body, people may not observe these symptoms as easily as you would think.

Being Sad and Stressed Quiz

The various symptoms listed in Quiz 3 are the result of physical illnesses, food intake or the drugs you may take daily. Again, see a doctor or mental health professional if any of the symptoms are felt by you. Make sure to have a checkup yearly or more frequently if you see noticeable changes.

For Quiz 3, even numbers are related to anxiety and odd to depressions. The more you check the higher the level of concern.

Your relationships

The longer you are exhibiting signs of depression or anxiety, the more likely your relationships are being affected. Your symptoms leak over to your family, friends, spouse, co-workers, and anyone else you come into contact. The relationship Quiz will show this.

The Relationship Quiz

Don’t bother to grade this. This will only help you to understand whether or not you are facing problems with your relationships. The higher the boxes checked the greater is your potential for damaged relationships. This time the odd numbers are depression based and even are anxiety.

Keep in mind those who are shy or introverted may answer questions more often than those who are not. Just be aware of yourself and know whether or not the feelings you are experiencing are not normal for your shyness.

Personal Profiles

There is a personal profile that will help you generate a very simple overview of what you are experiencing. The profile along with the quizzes will help identify how you will react to anxiety or depression.

A sample profile

Personal Problems Profile

1. I have no energy.  (D)
2. Moving takes more effort lately. (D)
3. Sex is not important. (D)
4. I eat all the time. (D)
5. I have nothing to look forward to. (D)
6. I don’t look forward to much of anything. (D)
7. I can’t make decisions. (D)
8. My health will never improve. (A)
9. I’m shaky. (A)
10. I can’t get out of bed. (D)

The symptoms this personal profile shows is a more depressed profile. Most of them are of a physical manifestation. The process of self-discovery helps you identify what you may not even know. The personal reflections of this sample profile suggest many signs of depression.

You can’t improve in life without some type of work. Exercising daily makes you stronger even if you miss one session of exercise, you will feel better the more you exercise. Taking the time to write down your reflections can only help you move through the process that much easily.

In the following personal profile, make sure to write down any of the items from the quizzes that seem to be more of a concern for you. Indicate whether they are anxiety or depression by marking an A or D behind each answer.

Personal Problems Profile

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Personal Reflections

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

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Challenges you will face

Let’s examine thoughts, feelings and behaviors and how you should choose what you should focus upon. It will be your decision on whether or not to choose those items that present the greatest obstacles in your life or you can go through them in chronological order.

What needs to happen is identifying your personal style. Take the time to complete the personal style questionnaire to help you choose.

Personal Style

Thinkers

❏   I like facts and numbers.

❏   I tend to be a very logical person.

❏ I’m a planner.

❏   I like to think through problems.

❏   I carefully weigh costs and benefits before I act.

Doers

❏   I can’t stand sitting around and thinking.

❏   I like to take action on problems.

❏   I like accomplishing things each day.

❏   I like plowing through obstacles.

❏   I act first and think later.

Feelers

❏ I’m a very sensuous person.

❏   I pay a lot of attention to how I feel.

❏   I love massages and hot baths.

❏ Music and art are very important to me.

❏ I’m very in touch with my feelings.

Relaters

❏ I’m a people person.

❏ I’d rather be with people than anything else.

❏   I care deeply about other people’s feelings.

❏  I’m very empathetic.

❏ Relationships are more important to me than accomplishments.

If you checked more of one area than another, you will find the following sections a better resource for you. Thinkers will use Part II; Doers Part III; Feelers Part IV; and Relaters Part V.

Seeking more help

Self-help tools are a great benefit to many. Using these tools can help overcome some of the simpler, minor problems. However, the more serious symptoms require you to seek professional help.  Use the Symptom Checklist to determine if you need additional help. In this list, one item checked off does require you to immediately to seek a professional consultation.

This list is only a guideline and does not include everything. If you are in doubt, seek professional help.

Serious Symptom

❏ I think about killing myself.

❏ Things are hopeless.

❏ I am sleeping too much or not enough for the last several weeks.

❏ My weight has fluctuated by more than a pound over the last few months.

❏ I’m ignoring things in my life that are major responsibilities including my bills or going to work.

❏ I hear voices.

❏ I see things that are not there.

❏ I use drugs or alcohol to an extent it interferes with my life.

❏ I have racing thoughts that won’t stop or slow down.

❏ I trust and care about someone who said I need help.

❏ There have been too many fights or arguments.

❏ I make really poor decisions such as making outlandish purchases or getting involved in questionable business schemes.

❏ I feel people are out to get me.

❏ I can’t get myself to leave the house except for absolute essentials.

❏ I take risks I shouldn’t.

❏ I feel like I’m a special person who’s capable of extraordinary things.

❏ I find myself performing and repeating specific actions such as hand washing, cleaning, arranging things, and checking/rechecking things.

❏ I have disturbing flashbacks or nightmares about past trauma that I can’t seem to forget about.

Call your primary care physician if you have checked one or more of these items. They can help you eliminate any physical cause and you think you need more help try:

• Call your local and state psychology, counseling, social work, or psychiatric associations
• Call your insurance company for their recommendations
• Talk with your friends and family members for advice
• Contact a local University that has a psychology, social work, counseling or psychiatry department for a referral.

During your first session, make sure you ask about receiving current and valid scientific treatment programs.  You should make sure the treatment provider you find has access and training on the newest scientific studies. They must also be licensed in the state you reside.

Cheese by Any Other Name: Sub for Animal Proteins

Portobello mushrooms taste distinctly like steak, with similar texture and flavor. Tofu is also an excellent substitution as well in stir fried food.

Soy can be a textured vegetable protein (TVP) in small dried chunks. As it cooks quickly, it supplies vegetable protein but no fat. It is an excellent addition to soups or stews. Many supermarkets and natural food stores carry this item.

Consider eggplant and other types of mushrooms. The southern parts of the US uses eggplant choices more often than other geographic areas. Try it stuffed, roasted, marinated, or grilled. Fried eggplant is delicious-but we do not suggest it. Tomatoes and onions with it make an excellent ratatouille.

Beans

Many people believe vegetable proteins cannot help with muscle building or growth. Animal protein they say is the only safe bet for doing this. They are correct with just one exception. The soybean has every building block you need to maintain a healthy system for growth. They also keep the fat out of your system much easier.

The best nonmeat solutions of protein are legumes including dried beans, peas, seeds or nuts. The calories of each of these vary, so choose carefully. Here are some substitutions for animal protein:

• ¼ cup of seeds (sunflower seeds)
• 1/3 cup of nuts (peanuts or pecans)
• ½ cup of cooked dry beans
• ½ cup of baked beans
• ½ cup of tofu

No meat stock

The value of a rice soup stock was discussed earlier. Removing animal protein from the recipe changes the taste and flavor. Vegetable stock is just one option. Here on option for 8 cups of broth:

• 3 heads, small, of garlic peeled and smashed
• 1 tablespoon of olive oil
• Coarse salt to taste
• Fresh ground pepper to taste
• 9 cups water

Substitute wine or water with 1 or 2 tablespoons of soy sauce per cup of liquid. No more meat stock!

Goodbye Cheese

The true vegan way of avoiding dairy means you have to eliminate and replace all cheeses. Here are ideas on how to do this.

• Vegan cheeses exist. See if you can find ones similar to cheddar, mozzarella or Monterey jack at the local grocer.
• Tofu is an easy way to replace cottage or ricotta cheese.
• If you like cream cheese, tofu is available in a creamed consistency.

No more Elsie

We have already seen the benefits of soy. Soy milk easy replaces cow’s milk in your diet. By soaking beans overnight, you can easily puree them. Once the solid remnants are strained out, you have a simple liquid you boil for 10 minutes. Premade soy milk is available everywhere.

Soy milk:

• Contains higher protein and fiber
• Isoflavones are present in soy milk-believed to be cancer, osteoporosis, and heart disease prevention chemicals.
• 2% fat without cholesterol
• Helps reduce complications of menopause especially hot flashes.
• Does not contain calcium-supplements may be needed

Milk Chocolate

Antioxidants are necessary chemicals with cancer preventing qualities. Usually flavonols (an antioxidant) is found in dark chocolate rather than milk chocolate (protein in milk chocolate prevents flavonols from binding in the chocolate). Reducing milk chocolate eliminates caffeine. Cocoa is one of the main ingredients of chocolate. Because it is a bitter tasting product, high calorie fructose or sugars must be used to enhance the flavor to a sweeter quality.

Carob is found in the Mediterranean and Middle East. Without the caffeine, it does add fiber.  it can be a substitute for chocolate once the beans are dried and ground. However, once it is used to make chocolate like products, the calorie count nearly meets that of regular chocolate.

Hold the mayo

This is a product that contains higher fat content. It may not be the bad saturated fat, however at 49 kilocalories per tablespoon, it can easily add many calories to your meal.

Tofu mayonnaise can sub for mayo. Here is a simple recipe:

Use one clove of garlic; 8 ounces of tofu, drained; 2 tablespoons fresh lemon juice; 1 teaspoon Dijon mustard; sea salt. Blend these items together for 25 seconds to a smooth consistency. Yields 1 cup.

Removing eggs

Try using an egg substitute to avoid the fat and cholesterol from standard egg products. They are not used in baking however. Try using:

• 1 ½ teaspoons commercial powdered egg replacer
• 1 mashed small ripe banana
• ¼ cup soft tofu, blended
• ¼ cup prunes, pureed

Try these and see if they taste similar to using eggs.

Sour cream

The flavor profile is slightly sour. Don’t let this fool you. 14 g of butterfat-saturated fat- is in every serving of 4 ounces. Vegetarian diets cannot allow you to use yogurt, however tofu is available in sour cream substitutes. Another simple recipe:

10.5 ounce of light firm tofu; 4 teaspoons lemon juice; 2 teaspoons apple cider vinegar; 1 teaspoon sweetener; 1 teaspoon salt. Blend in processor until smooth and creamy. Look mom-no fat!

Non-dairy ice cream dessert

The internet is your friend in this arena. Type in “vegetarian ice cream” and you will find many excellent recipes. The Vegan Scoop; 150 Recipes for Dairy-Free Ice Cream by Wheeler del Torro is also an phenomenal reference. Options for this category contain:

• Gelato
• Sorbets
• Dairy-free ice cream sandwiches
• Fudge popsicles.

Look for good tasting soy based items.

Normalize your glucose

• Know your level
• Exercise and medication
• Reacting to foot and dental problems
• Positive attitude and the unexpected
• Expert help and new information
• Avoid what doesn’t work

Most literature on diabetes tend to focus on what and how to eat. Diabetes is more than just this. The main premise should be on how to control you blood glucose to more normal levels.

If you can reach a level of 100 mg/dl after fasting 8 to 10 hours, this is a normal level. Once you eat, your glucose level should be 140 mg/dl two hours after eating for normal standards. Not exceeding this number of 140 mg/dl is tight control.

We will offer some tricks to keep your levels near normal limits. Advice from experts is one great way to make a tremendous impact upon your glucose level and your lifestyle.

Knowing your level

Most people would admit they do not exercise. If you have diabetes and are part of this crowd, a major tool in controlling your blood sugar is missing. This part of your lifestyle help manage your mental and physical health as well. A simple study examined patients whose parents suffered from diabetes. 80% of those who added an exercise regimen into their life avoided diabetes.

Exhaustion is not to be the end result of exercise. 60 minutes of walking at a steady pace daily (not just at one time) is a simple task to achieve. If you cannot walk extended periods or distances, simply wave your arms to achieve similar results. Weight loss can happen with 90 minutes of daily exercise.

Medications

Newer drugs have been a more recent occurrence. This is an age more receptive to those with diabetes. Specialists had to struggle to achieve the unique balance of food, medications, and diet to achieve positive results. Today, if you do not take your medication, you cannot expect it to work.

Compliance in taking your medication usually is better at the onset of a diagnosis. Once you become more into your lifestyle, the level of control on your blood sugar can fall if you do not continue to follow the directives of your physician.

As you continue to age, additional components from this aging process begin to work against you. These factors begin to work against you. Often your continued use of your medication is essential for your treatment program.

If you become disoriented in what medications you should be taking daily, we recommend a pill or medication box available at most pharmacies. Taking your pills daily becomes much easier. Two or more medicines would be a great time to start.

Foot problems

Many diabetics struggle with asking for help when they should. Most checkups for diabetes happen every quarter (three months or more between visits). If you notice abnormalities or any unusual skin discolorations, contact your doctor immediately. Simple foot problems accelerate rapidly into major complications. You must avoid amputation of digits or even worse. Call your doctor if in doubt.

Dental issues

Twice a day brushing and flossing at the end of the day will help minimize any problems with your teeth. Even with removal of most sugars from your diet, diabetics tend to develop more cavities than those with normal glucose levels. Keep in mind bacteria thrive in high glucose environments. Tight control will minimize this problem.

If you’re happy and you know it

The challenge: keep your life upbeat and positive. This process will help you to see the potential solutions to managing your blood glucose levels with creativity and proactively. A negative frame of mind will create obstacles to your success. You may begin to see how your daily diligence in a controlled diet is pointless and useless. It does matter what you do each and every day.

A positive attitude will assist you in seeking knowledge that will help you understand how your body works, how diet and exercise maintains your health, and more importantly keeps you from adding depression to your lifestyle.

The unexpected is expected

Surprise! Remember how you felt when you first discovered you had diabetes? There is no way to prepare for events such as this. However, by understanding change can happen at any time you can prepare yourself to become adept at spontaneity.

Food choices can be just one component of surprise in your life. Plan for the unexpected and remain in control of your portion sizes. Carry portable calories and food items that can manage you glucose levels.

Medications may also be a concern. If you travel, your luggage may not arrive with you. If you carry your important medications with you as a carry on, you control the surprise factor of medication issues.

New developments

Research is also evolving. With this evolution comes new knowledge and information. Talk to these individuals whenever possible:

• Your primary care physician responsible for most of your medications
• Specialists in diabetes with knowledge of new treatment programs
• Eye doctors who can manage your vision yearly
• Podiatrists who can help you evaluate potential issues with your feet
• Educators-find someone who teaches diabetics about medications and diet
• Mental health specialists when needed to maintain positive outlooks

What Doesn’t Work

Over 2o million Americans make for an excellent market for different therapies. If there are any wonder cures, the professionals listed above will keep you abreast of those treatments.

The Food Diary

Can you try a simple exercise? Most people when faced with the truth of their diet cannot perform this simple task. Take a piece of paper and a pen and journal what you eat for two days. At the end of the two days, ask yourself what you had to eat over this time frame. Don’t look at your journal and see what you notice. Will the lists be the same? Your memory is not something you can rely upon to manage your diabetes.

With a journal you can record exactly what you eat to help you find ways to reduce your food consumption and what foods you might be able to eliminate from your diet.  Your doctor will appreciate the extra time you are taking and can offer advice on your food choices.

The journal can also help you take advantage of knowing how specific foods made you feel (reactions to specific energy sources or your insulin) and they types of activities you have been involved with. Knowing the correlation between food and your state of mind can be beneficial for your ongoing treatment program. A dietician or your doctor can use this information to create a caloric breakdown of exactly what you are eating.

Why do you eat like this

For many people underlying reasons exist for why we do what we do. What was the role of you in your family and how did food play a part in that role? Was food a punishment or a reward? Did your family take time to socialize during dinner? What emotional factors can surface when you are eating? You may wish to discuss this aspect of eating with your physician.

If you can take the time to determine the why’s of eating, you may be able to downgrade the importance of emotions in daily food consumption. If one of the primary reasons for eating is boredom, you are more able to find other activities to do that could prevent poor food choices from surfacing.

Periodically the need for counseling and psychological evaluations may be necessary, but usually a last resort once all other suggested resources have been attempted.

If you examine the patterns of a successful person, repetition will be one common theme. If you look at the patterns of one less successful, repetition is also present. The only difference is one person was able to create a successful pattern by overcoming and breaking the habits (patterns) that were not working.

Until you can make the determination of why you eat try these simple patterns to help build success.

• Eating while doing other activities should not happen. This includes television.
• Eat only in one location in your home. We suggest the table.
• Smaller plates help with some psychological components of eating.
• Chew slowly and with purpose. Use your utensils properly and place them on the table between bits. Only pick up the next morsel once the first has been completely swallowed.
• Don’t eat from a carton, bag, or container. You cannot track what you have eaten.
• Leave a small portion of food on your table. This can train you to stop when you are full.
• Food should always be in cupboards and hidden, never in plain sight.
• Junk food should not be in your home.
• Three meals and several snacks are much better for you.
• Exercise or other healthy activities should take the place of eating. Involve a loved one or a companion to help you stay focused.
• Reward yourself with non-edible rewards.

We have mentioned changing only one item at a time to gauge the level of success you gain. If you change too many at one time, you do not know which one helped change the behavior.

Every Meal

Type 1 diabetics should not miss meals. The medication, insulin, you take everyday must force you to eat at regular times and intervals to avoid the bad habit of eating sugar treats to compensate for lowered blood sugars (that leads to too high of levels later).

Missing meals is not a viable solution for controlling your weight. Some drugs prescribed cause hyperglycemia and lowered blood glucose levels. Diabetic pregnant women have more reasons than diabetes complications to worry about. Both the baby and the mother could end up burning stored fat for energy jeopardizing the long term health of both.

Portion control and reducing how much you consume are integral parts of tight control of blood glucose levels. Smaller meals and snack between meals maintains proper levels, steady energy supplies, and less reliance upon insulin (natural or medication). For anyone, three meals a day is very difficult to manage to achieve a balanced nutritional plan.

Sitting to eat your meals

When you have dinner by yourself, the tendency to consume your food much faster is present. You also may end up eating higher values of calories, often in food categories unhealthy for you. Having a companion for your dining experiences allows for the opportunity to slow the pace of eating and your body will be able to tell you when it is full. Carbohydrate absorption rates are greatly reduced; as a result, blood glucose does not rise as rapidly.

Additionally, when dining with others, a mechanism of social control takes over. You want to emulate appropriate behaviors and reduce the quantity you consume. You also remain seated and only see what food is in front of you, not all the multitudes of fats, carbs, and calories in your kitchen cupboards. You also find ways to offer balanced dishes that meet the requirements of the food pyramid.

Water is important

Without liquid (water) most of the functions of our bodies would cease. Our body consists of over 70% water. You must keep these levels consistent in your body to avoid fatigue, weakness or lethargy, and the dreaded-constipation.

Water offers no nutritional value; it also offers no added calories for you to burn away with exercise. If you continue drinking water instead of sweet fluids like pops or juices, you eventually become accustomed to only drinking this beverage. You may be surprised to know that soft drinks can be used to treat low blood pressure. Blood glucose levels can stabilize once added sugars are eliminated.

This is one habit you make your own—drinking water whenever you can. If you try to drink too much at bedtime, routine midnight bathroom breaks result. If you follow a steady plan of water consumption you can avoid this pesky annoyance.

Veggies during the day

Why should you limit your vegetable choices to the same few every day? Your local grocer continues to increase the level of offerings to try and be supportive of healthier diet trends. Choose different vegetables as a main course and protein as the garnish. How about a veggie omelet? Vegetable juice instead of orange juice? What is the worst that could happen.

The vegetables you should examine are not the starchy choices of beans, peas, or lentils. We do suggest bok choy, green beans, cabbages (red or green), asparagus, carrots, collard greens, onions, squash, and turnips. These make excellent additions to meals or stand alone as snacks. Remember you can eat them fresh or frozen; this is a choice left for you to make.

Reduction of added fats

Reducing fat by almost 50% is really quite simple. Many recipes in your box have been handed down for generations, mother to daughter and fathers to sons. Do these recipes really require all the added fats they suggest? We recommended to use recipes that avoid these added fats. You can do the same to your family recipes as well.

We have shown you how to reduce the fats in items such as pancakes by eliminating oil or lard in some quantities. Find out what works best for your specific diet plan.

If you can eliminate one cup of oil (8 ounces) or 28.35 grams per ounce (9 kilocalories per ounces) you can eliminate 1000 kilocalories by reducing your oil intake just 50%.

Attached fat removal

Many process meats make it nearly impossible to isolate the inherent fats. Most of these items of sausages and lunch meats are to be avoided. Chicken, steak, roast beef and pork do have high levels of fat on them, however much of this can be removed prior to cooking. Selecting lean portions is also easy to perform.

When you cook these non-processed meats, much of the fat can be burned away, leaving a leaner piece of protein than when you started.

Removing salt

Americans add high levels of salt to their food. Much of what we then taste is salt, salt, and more salt. Try losing the salt when cooking and add smaller portions during eating. Many flavors may come to light you may not have known existed.

Lower salt intake lowers blood pressure. The United Kingdom Prospective Diabetes Study (1998) found reduced blood pressure reduces complications of diabetes.

Taste with herbs and spices

Some of the most inventive recipes include those from various chefs whom have discovered notoriety by combining foods and flavor profiles no one had ever done before. Untraditional combinations have given rise to higher levels of nutrition. These new combination offer twists on old, mundane recipes.

Items thought to be dull and uneventful can be re-energized with the correct mixture of herbs and spices. Try these combinations to bring strangely exotic tastes and smells to your home and your health.

Remember many different condiments exist for you to experiment. Salsas, mustard, hot sauce, and horseradish are fun. If you have the thyme, try basil and rosemary. These are best used added at the end of the cooking process.

B’s of cooking

Best cooking practices best begin with B. Braising, broiling, baking, and barbecuing don’t add fat and have a tendency to help remove the fats within. These types of cooking differ from grying and sautéing that require butter or fat to cook—adding the one item you don’t want to consume. Cooking sprays such as canola reduce the chances of adding fat.

It helps to call ahead, and then make future note of which restaurants will help accomodate and make your dining experience easier. Many chefs help make healthy decisions for the diabetic, and do their best to keep sugar and fats low.

Evaluate each food choice by asking discerning questions of your server. Most often, the energy sources are balanced, but the portion size could be reduced or half taken home for later.

Remember our earlier writing. There is no one food that is better than any other( other than avoid fast food). The type of ethnicity is not important. Choosing one that may require exercise to get to is going to be an exceptional choice. Review any menus on the world wide web. You can research all you need to know without having to call.

If the fish of the day is battered or fried, seek elsewhere. When you do see a menu item you like but fear it is not a healthy choice, don’t be afraid to call and ask about substitutions. Replacing or reducing whole milk, butters, gravies, sauces, and dressings will make a difference. Choose the cooking methods that are healthier for you.

If you have an established restaurant with history, the chances are you will find a seasoned staff more willing to walk you through meal choices. They can also help you order smaller portions. If they have larger portions, make sure to share your meal (or take some home as we just said).

Start at the beginning

We have several helpful tips to make your experience a wonderful one. These simple steps can make this a simple process.

• If you arrive prior to your reservation, don’t sit at the bar.
• Try to have your party seated as quickly (and timely) as possible. This will help you keep from becoming too hungry or hypoglycemic.
• Make sure to avoid as many bread and crackers as you can. Remove those items from your table.
• Choose many raw veggies or crudités for a munch able snack prior to ordering.
• Make sure you know you glucose level so you know what you should be ordering.
• When you know your food delivery time, take your insulin at the right time.

Off the menu

If you did not know, the special of the day or season are there to offer a large meal option. Most U.S. diners have a perception that portions must be huge.  Those living in Europe are amazed at how much food Americans consume off their plates. Steaks, poultry and fish are nearly double the recommended serving size. Could this be why the American population is more obese than before?

Some simple strategies:

Plan on bringing home a large portion of your meal. Again, share with someone else. Let your server know you need to eat soon. If there is a delay in the kitchen, veggie snacks can be brought to your table.

If you want a glass of wine, order one glass at a time. Usually if you order a bottle, you drink until the bottle is gone.

An appetizer can be an excellent dinner option.

Clear soups are always a better choice than one with cream. Soup and salads are always a good choice. Ask for dressings on the side.

Ask for item descriptions. Often you can determine what the ingredients are or how they are prepared.

Fish choices should be more frequent than meat or poultry.   You already know the benefits of eating fish.

Other things to know from the entrée description are clues to how the item is cooked. Baked, blackened, broiled, cooked in juices, grilled and poached are all indicators of low fat. Some specific cues exist to indicate high fat entrees such as battered, buttered (in a butter sauce), creamed, deep-fried, escalloped, fried, golden brown, in a plum sauce, in a cheese sauce, sweet and sour, and with peanuts/cashews.

Some sauces such as blue cheese, creamy Italian, low fat French dressing, and red-wine vinegar all have different kilocalorie values. These are listed in descending order of kilocalories.

Some specific restaurants may offer better meal choices. Be aware of what items may be available at each kind of restaurant.

Breakfast

These should include fresh foods and lots of fiber. Juice and fruits should start your meal. When ordering your cereal use skim milk or 1%. Even if Napoleon Dynamite tells you whole milk won’t make you fat-don’t do it. The cereal choices should include oatmeal or wheat or bran flaked cereals. Egg white omelets are good.

Quiche, bacon, fried potatoes, croissants, pastries, and sugar treats should never be on your menu. Coffee with high calories are definitely a no-no. Too bad for Starbucks!

Appetizers, salad, soups

If you want a healthy item in this category, the fresh veggie option is always good. Raw food is healthier than covering your food with sour cream, butter, or even guacamole. Some salsa are fairly healthy. Just ask about the ingredients.

Olive, nachos, avocados offer fat; nuts, chips, and cheese are not ideal because of higher calorie levels. Many restaurants have a fried onion option-they have fat and so do the dipping sauces they give.

Vegetarian food

Vegetarian has many different meanings to different parts of the population. Vegans avoid any animal products, lacto-vegetarians avoid eggs but include dairy, and lacto-ovo-vegetarians include eggs and diary. Any of these diets can include all the necessary nutrients and vitamins, however some planning is required. Supplements are always a backup option.

Vegetarians usually are less obese and much healthier. With diabetes, a vegetarian diet helps to maintain a tighter control over blood sugars, cancer risks, strokes and heart disease.

Good choices are not always easy. Just maintain the simple rules given to make the light, healthy choices of proteins, grains, and vegetables.

Seafood

If you fry your seafood, the low fat healthy choice has been compromised. Best choices for fish are bass, cod, halibut, swordfish, and tuna (if in water). Many shellfish are as well. Herring and tuna in oil or anything fried is no go.

Chinese Food

All soups in this category are excellent choices and fill your stomach. Fried dishes with meats, tofu (bean curd), rice and noodles are to be avoided. Try to take steamed dishes with lots of veggies. Sweet and sour usually means high fat and high calories.  Too bad-no almond cookies for you.

French Food

The premise of French cuisine follows a history of heavy creams and sauces such as gravy. The new cuisine, for lack of a better word implies a food cooked in its own natural juices. While some chefs have embraced this newer style of cooking, for those locations that have not the obvious choice is to stay away.

Indian Food

There are advantages to aspects of Indian food. With some excellent carb choices such as Rice and pita bread, as well as the various animal proteins prepared tandoori (oven baked), Indian food can be a healthy choice. As you move through the menu, make sure to avoid coconut milk in any form and ghee-a butter product. Some appetizers are fried like samosas that impair proper blood glucose levels. Many chicken dishes contain spices for flavoring and remain low fat.

Italian Food

Depending on the style of Italian food, obvious choices will include tomato based sauces rather than their counterparts that consist of higher cream contents. Vegetable soups include Minestrone has lesser fat content. Many times the pasta is acceptable providing you once again-take it in moderation. Many meats contain higher fat levels; therefore sausage should not be on your menu. We have talked about the various spices earlier. Basil is found in most pesto’s; if the pesto is low fat, go ahead and order it. The obvious bread choice is garlic bread. Unless the main ingredient is roasted garlic minus the butter, steer clear. Cheese ravioli and Caesar salads also have high fat contents.

Mexican Food

It is very difficult to not see Mexican restaurants in your excursion out. These types of restaurants are dangerous for the diabetic. Menu selections of refried items, chips, nachos, and cheese become perilously hard to avoid. If possible try to stick with various rice’s, and chicken and fish (grilled of course). You may think burritos and tortillas may be off limits, however proper portioning of cheese, sour cream, and guacamole make these favorites quite acceptable. Larger portions should be split and half taken home.

Thai Food

We have discussed this option as one of the more healthy choices for you. Moderate the quantity of food you consume. The original uses for spices, fish, and vegetables are not only delicious, but heart healthy.

Enjoy your food

Even though you may have planned your dining experience, one obstacle is actually sticking to your plan. If you want to enjoy your meal, follow some simple suggestions below.

• Drink wine, but count calories.
• Behavior modification practices of slowing your eating time through chewing your food and placing your fork on the table after each bite prolong your meal and allow a feeling of being full to happen.
• Spend more time talking and visiting with your companion(s). This is more of a social occasion instead of an eating occasion.
• Minimize the quantity of sauces by removing skin from poultry and asking for sauces on the side. Let as much of the sauces to drip from your next bite prior to placing it into your mouth.
• It is very tempting, but sampling your companion’s servings may not be beneficial.

Desserts

The end of the meal is the climax of the dining experience. Even diabetics feel the urge to splurge on decadent and delicious dessert items. Chefs often use this part of the meal as an integral part of their atmosphere, to display true creative art.

Because of the high level of sweetness to desserts, it is imperative the diabetic continue to make those wise choices we have been discussing. Asking a few simple questions regarding your dining choices (is this item worth it?) will help you to stay on the straight and narrow. If you find the answer to your questions leads to the knowledge poor food choices will raise your blood sugar levels and possible complications to your body, simply avoid those choices that offer those answers.

Read other questions below to guide you through these choices.

• Is this dessert really necessary? Do I want it?
• How long will I remember I had this dessert?
• Will a simple taste be enough or should I share it?
• What are other, healthier options available?

Keep in mind additional calories take additional exercises to burn those calories. A brownie, apple pie, or fudge sundae are over 30 minutes; cheesecake, ice cream cones, and milkshakes take 40 minutes or more.

The decision is yours to make.

Fast Food

If you travel, fast-food options are some of the simplest ways for dining. With our help, we will help you located some great hot-spots and high popularity. Many times travel guides such as Frommer’s offer other choices as well.

The locations discussed here are not ones we personally endorse; they are just typical locations you will encounter.

The fast food chains are the most prevalent in America. McDonald’s is the most well-known with guest counts in the high 20 million or almost 10% of the population daily. Over 14,000 restaurants are claimed and compares to Arby’s with 3,300, Burger King with 7,600, and Wendy’s with 5,900.

Many of these chains have moved towards healthier eating. It is no longer the case more nutrition could be found eating the packaging then the food itself.

Double anything (you may remember it as super sizing) spells trouble. Bacon and sausage are right there as well.

The practical choice for this class of restaurants stems from the intensive preparation that goes into this food that allows for convenience and spontaneity. If you are rushed, fast-food is for you. Diabetics still should find what is good for you.

One of the values quick service offers is the levels of consistency. A burger from coast to coast is similar within each franchise. You can more accurately plan your meals; more importantly your medication and blood sugar levels. The downside is you may not recognize when you have consumed sufficient calories for you meal. Simply stated-order light and only once.

Studies indicate those who consume higher levels of quick service food gain more weight on average-to the tune of over 10 pounds annually. These individuals had a propensity to develop diabetes and associated complications.

We mentioned the level of trans fats in your diet. If you remember these are fats that reduce good cholesterol (HDL) and increase bad cholesterol (LDL). Hydrogenated oils (or partially hydrogenated oils) have been falling from use in many restaurants. They are present in higher quantities in some items like French fries, battered and fried foods, and chicken wings. In-N-Out Burger, Subway, Taco Bell, Pizza Hut, Popeyes, Little Caesars, and Papa Johns all avoid trans fats. Places that include trans-fat are Jack in the Box, Burger King, White Castle, A&W, and Dairy Queen.

Now we will narrow in on the non-trans fat locations to help you in your nutritional search. While you do not have to skip any of the locations that do contain trans-fat, we just want to help you from being seduced by the wiles of unhealthy food choices.

The internet can help guide you through some of these franchises as well.

New Orleans to Civil War locations

Driving I-10 from New Orleans, head to I-310 at exit 220. Follow the turns to State Route 48 to the Destehan Plantation. Just down I-310 you will find a Popeyes restaurant on US- 90.

If you like spicy chicken, Popeyes can offer this. Usually a wing, leg, thigh, and breast combination are recommended options. Make it skinless and without breading. A typical chicken selection will be 200 kilocalories, 51 grams of protein, 9 grams of fat, and 0 carbohydrates.  Breading and skin kept on jumps up your selection several hundred kilocalories. Note: Mild is available if you think you can’t handle the hot.

Adding corn on the cob is a mere 190 kilocalories and 37 grams of carbohydrates. Cajun rice is also good weighing in at 170 kilocalories and 22 grams of carbohydrates. Water is your preferred beverage. Skip the 34 grams of sugars in the dessert choices.

Run through River Road on both sides of the Mississippi into Garyville. The San Francisco Plantation is right there. Move towards Vacherie just down River Road and spend the night.

The next morning our first stop is Conaldsonville on State Route 3089 and the local McDonalds that has the egg McMuffin at 300 kilocalories, 12 grams of fat, 260 mg of cholesterol, and 30 grams of carbs. Avoid the sausage and bacon combinations, the Big Breakfasts and Deluxe beverages with their 1000 kilocalories or more. Small orange juice only adds 70 kilocalories.

Moving down the State Route move to the Nottoway Plantation to Baton Rouge and St. Francisville where we can find the Magnolia Mound Plantation and the Rosedown Plantation respectively.

The Colorado Excursion

If you begin at Colorado Springs going north on US 24, the Garden of the Gods will wow you with its rock formations. Going on with our journey you will locate Florissant Fossil Beds National Monument and the various plants, insects, and trees have been fossilized. Take State Route 9 off of Hartsel and move towards Breckenridge for almost 10 miles to catch I-70. And Dillion.

There is an Arby’s that offers some better information than its competing Ruby Tuesdays. As we mentioned before, Arby’s nutritional information is more widely known (or shared) than Ruby Tuesdays. Arby’s does have trans fats and higher sodium/salt levels. One choice is the Chooped Turkey Club Salad with 230 kilocalories broken down into 11 g of fat (supplying 95  kc). Watch the sodium as it surpasses 800 mg. You may prefer the Chopped Farmhouse Chicken-Grilled with fewer mg of sodium. Either choice gives you only 9g of carbohydrates. No Dijon honey mustard dressing saves 180 kc (all from fat). Toasted sub options are full of calories and salt making them very poor selections.

Take I-70 to Georgetown and the various mining activities it offers and the Hamill House Museum.  Stay on I-70 to US 40 and go to Golden and see the Coors Brewing Company.  You don’t have to look very hard to see excellent choices for dinner. Head towards US 6 through Denver and find I-25 south to see the Air Force Academy at exit 156 B.

Head to Colorado Springs (where we started) and avoid PF Chang’s with its high transfat content and excessive salt. There is a Taco Bell that has acceptable levels of salt in its tacos, gorditas, or chalupas. Most of these recommended features contain fewer than 300 kilocalories, 600 mg of sodium, 12-18 g of fat, and about 30 g of carbohydrates.

Utah

As we begin our trip at Salt Lake City we decide a trip to Mirror Lake is in order. As we laod up our care, a cup of coffee sounds like a promising start to the trip. The item we really want to try is the Double Chocolaty Chip Frappuccino Blended Greme-Whip at a whopping 510 kilocalores. Realizing this, a standard cup of “today’s blend” at 5 kilocalories sounds pretty good. The other luscious items at Starbucks, namely the sugar treats, do not have nutritional information. We order ½ a toasted bagel with jelly with only 100 kilocalories. Avoid adding cream to the coffee to keep it super simple.

Next stop will be Park City for dinner and a leisurely breakfast. Getting back to the road we head to Wasach-Cache National Forest following Route 248 to Upper Provo River Falls of Route 150. We continue for war through Wasshing Lake and Bald Mount Pass, finally ending at Mirror Lake.

Heading back towards our starting point we decide to exit on i-80 exit 126 for Wendy’s. If we decide to order the Mandarin Chicken Salad with only 180 kilocalories, 2 g of fat and 16 g of carbohydrate we can compare it to the Chicken Caesar with the same benchmarks. Chili is off the menu and along with it-heavy amounts of salt. No shakes or Frostys-just say no to the Baconator and its 830 kilocalories and astronomical high level of sodium at nearly 2000 grams. Choose instead the ¼ Hamburger Patty-no doubles or triples, or cheese for that matter.

The Keys of Florida

The great author Hemingway made the Keys of Florida a tourist attraction. With water on both sides of Key Largo’s roadways, this is a beautiful area to visit. Because of the wonderful beaches and water sports along the way, this will be an extended trip you will want to take. US 1 will lead us along the way.

Key Largo offers many places for swimming and snorkeling. This exercise will lead us to lunch at Subway right off US 1. With substantial nutritional information, it is easy to find the perfect items for lunch with 6 grams or less. However, sodium is one item to watch here.

Sharing a sandwich with a companion offers an excellent way to share tastes but keep the calories and the salt. Stick with 6 inch subs. We try the Sweet Onion Chicken Teriyaki and the Veggie. There are no trans fats and a just 200 kilocalories, 33 g of carbs, 17 g of protein and only 3 g of fat.

On our way to Florida Keys Wild Bird Rehabilitation Center we pass through Tavernier. We begin at boat journey once we arrive at Lignumvitae Key Botanical State park. We find ourselves at Long key for dinner and a hotel stay.

After more snorkeling in the morning, decide to move towards Grassy Key part of the city of Marathon, home of the Dolphin Research Center. Wanting breakfast, we spy an IHOP along US 1. Some of the choices we can select include(choose one, not all) : two buttermilk pancakes, two harvest grain ‘n nut pancakes, 2 buckwheat pancakes, or a waffle. The kilocalories are only 225 with 6 g of fat and 34 g of carbs. Go easy on the pancake syrup to make another 115 kilocalories and 29 g of carbs. Orange juice adds to the experience, but also adds 15 g of carbs.

Bahia Honda State Park offers substantial areas for hiking. Once done with hiking, Big Pine Key sounds great with a nice hotel bed and dinner.

The Hemingway House is in Key West. We can visit the museum there or the Mel fisher Maritime Museum and the many treasures from the Spanish galleon, Atocha. We can watch a beautiful sunset right at Mallory Square.

Maine Street

Campobello Island was a favorite spot for FDR. We catch the northern parts of US 1 in West Gouldsboro, Main—only 1800 miles from Key West. We have to watch our way and work through the many detours.

We first come to Columbia Falls and the Ruggles House with it exquisite architecture. Just north of Columbia Falls, Jonesport is off Route 187 with Great Wass Island for ocean scenery, hiking and wildlife. Take 187 back to US 1 and head to Machias.

Our little trip comes across a Dunkin’ Donuts. It takes some persuading, but the over 500 kilocalorie breakfast items are left behind and instead we try our hand at Oven Roasted Flatbread Sandwiches without cheese. The Southwest Chicken, The Egg White Veggie or the Egg White Turkey are much better options with 300 kilocalories, 9 g of fat, and 38 g of carbs. We save enough kilocalories we go back to Dunkin’ Donuts and split a donut three ways!

Machias was our destination prior to donuts and we spend the night there. Early the next morning we get onto Route 191 following the coast and come right back to US 1. Quoddy Head State Park is the easternmost part of this nation with hiking and awesome scenery. Route 189 takes us to Lubec and the lack of fast food restaurants. Instead Murphy’s Village Restaurant is our lunch time. We would love to share what we had, but instead we want you to come and find out for yourself how wonderful the food, the people and service can be.

One we cross the Franklin Roosevelt Memorial Bridge we go to Campobello and the Visitor Center there. The Roosevelt Cottage is one place of interest with its 34 rooms and FDR history.

Highlights

• Rice and other grains
• Quinoa and diabetes
• Legumes and healthy eating

We can help you include different grains and rice into your food choices. Legumes and pastas will also be used in ways you would consider to be unique and delicious.

Rice and grains

From the earliest of times before man first planted and harvested grain, civilizations were nomadic. The result of planting grains changed the world and help civilizations evolve.

Today, the use of rice is widespread. It has the perception of many as being tasteless and needing different condiments to be palatable.  If you try incorporating rice with lowered flavorings and processing, you can add some simple spices to improve the inherent flavor. Some rice varieties you will find include:

Arborio-an Italian short to medium grained rice. This is the primary ingredient for risotto. As it cooks, starches continue to add creaminess.

Basmati means “queen of fragrance” which is affirmed by the aroma of nuts during cooking. True basmati rice is grown near the Himalayas, while other varieties can be found in the United States named Texmati and Kasmati.

Brown rice is whole grain rice without the husk. It only has a shelf life of 6 months. It does require additional time to cook.

Jasmine is less expensive than basmati and much sought after. Originating from Thailand, it can be a staple for many of your dishes.

Long-grain describes a large category of rice’s with similar elongated shapes and a drier texture. It also has decreased starch that allows it to be separated more easily than shorter grain rice.

Medium-grain is simply shorter than long grain, and longer than short grain.

Short-grain rice appears almost round. The clump factor is present and the starch helps bind the grains together.

Wild rice is a marsh grass. It can be combined with other rice’s and offers a chewy and nut flavor.

Veggies to add

Highlights

• Fresh look, old favorites
• Veggie noodles
• Mushroom dishes
• Special Occasions for vegetables
• Vegetarian entrees

The human body is a complex machine requiring various vitamins, nutrients, phyto-chemicals, and fibers. Vegetables can be used in various ways including raw consumption. Increasing your vegetable intake only increases your health.

This section will help you discover new recipes for your family as well as help you enjoy dishes of a vegetarian style.

Just like George Bush, many people have a fear of one or more vegetables. This could be the result of being forced to eat a vegetable you just couldn’t stomach or your mom’s stuffed peppers. We will show you ways to help you overcome this fear and gain a new understanding of vegetables.

Steaming Vegetables

Cooking something in its own juices gives some of the most delicious flavor profiles. Dry steaming does just this. To perform this process of dry steaming, make sure you do not steam any vegetable without allowing some type of vent for the steam to escape.

Blanching vegetables

If you are looking for a way to keep the nutrients in a vegetable, the process of blanching is one we suggest. In this process you boil water and immerse the vegetables for a short period of time. When you remove the vegetable from the boiling water, place the vegetable immediately into ice cold water. This process of “shocking” (placing into ice cold water) stops any cooking and maintains the crunch factor of the vegetable.

To blanch vegetables one must follow the process below.

1. Use a 2 quart sauce pan to boil salted water.
2. As the water begins to boil, prepare an ice water mixture (ice bath) by filling a mixing bowl (medium size) over ½ with ice and cover with water.
3. Blanch the vegetables by trimming the vegetables and placing into the boiling water. Cook until they are crisp and tender. Keep a constant boil by adding vegetables slowly.
4. Using a spoon to remove the vegetables from the boiling water, place them into the ice water mix. Leave in the water for up to 2 minutes. Try one vegetable for taste-but only once it has cooled to a safe temperature.
5. Reheat the vegetables and eat once they are seasoned to taste.

You can find specific blanching times on the internet or consult with your physician or dietician.

Mushrooms

Many chefs have already discovered the value of the variety of mushrooms that exist. Mushrooms can be used for many vegetarian dishes.

Quinoa is a unique whole grain. It offers a high fiber and protein content with a very high iron content. Other nutrients are present as well including magnesium, potassium and phosphorus. It has greater nutritional value and can be a good substitute for other grains.

You may not find it at your local grocer, however many health food stores carry it. Try to locate the grain and not the quinoa pilaf. The lower the processing, the greater the health benefits.

As with other foods, rinsing this food is essential. If you fail to rinse it, you may not remove the protective outer coating or the dust that remains after processing. This dust may make your food bitter. Rinse, drain some water off, and then stir the grains. Re-rinse the grains to ensure you have removed all dusts and coatings.

Legumes

These delicacies are the staple choice of a vegetarian. This does not require you to not eat animal protein to gain the added benefits of these items. These are a food that is multi-purpose with their high protein, low fat (but good fat), high fiber content, complex carbs, and many vitamins. Legumes store well with a shelf life of a year.

Even with the complex carbohydrates legumes offer, a diabetic must still watch consumption levels. Even this shortcoming is compensated by the fiber and protein content they possess instead of the choices of breads, pasta, or other grains.

Spice it up with Seafood

Highlights

• Health benefits of seafood
• Different fish prep methods
• Shellfish in your diet

We have already discussed the benefits of seafood, especially fish and salmon. Seafood is an exceptional menu prep choice because seafood has a mild flavor. As a result, seafood needs little impetus to change the flavor profile-and give nearly endless selections of tastes.

After reading this, we hope you will see the benefits of seafood and the many recipes we will offer.

Reasons for seafood

Protein, fats, and carbohydrates aside, there are other reasons why seafood should be a choice for your diet.

1. Because the oceans contain high levels of minerals, the life contained within those oceans have those same minerals. Consumption of those energy sources translates to nutrient health for you.
2. Kidney function improves with seafood consumption, especially those with diabetes.
3. Fatty fish contain high levels of vitamin D, B vitamins, niacin, and various fat-soluable vitamin A compounds.
4. Omega-3 fatty acids can help lower cholesterol-LDL while raising the good cholesterol HDL. Many of these omega-3 fatty acids also have anit-inflammatory properties.

Health fish preparation

Deep fried fish may be tasty, however this is very unhealthy. In the process of cooking in fat, two things happen. The fat in the oil is very unhealthy and the process of deep frying creates various toxins. The preferred ways to prepare fish are baking, roasting, and grilling.

Baking is one of the first techniques we learn when cooking. Baking infers cooking with dry heat in a closed environment. However, baking is not boring.

Pan roasting encompasses a two part process. The first part demands you cook a meat in a pan on the stove where you sear then seal the meat through heat. The second part suggests you place the meat back into this pan and places it into the oven to finish cooking. Seafood cooks so fast that pan roasting is not an accurate description.

Grilling

Cooking uses various techniques of heat dispersion. Grilling uses heat beneath a food source while broiling cooks from above. Tuna is one fish that is able to be grilled easily. It takes spices well and does not take long to cook.

Concern regarding the safety of fish has been discussed recently. Higher levels of water pollution may have increased methyl mercury to near toxic levels. Pregnant and nursing women are encouraged to avoid large consumption of seafood and maintain 7 ounces weekly. For any information regarding the safety of seafood visit www.fda.gov.

Shellfish

This seafood category includes all the various shelled varieties. Shrimp, lobster, oysters, clams, mussels, and scallops are all included. Octopus and squid are other members of this family. Most of these foods are sold by weight and size.

Various textures exist with shellfish. Chewy or tender, the texture results from how well you cook them. Overcook them and you may end up eating rubber.

Fowl Play

Highlights

• Poultry basics
• Moist and tasty
• Use it all
• Turkey

Most diabetics believed their life of endless chicken breasts and steamed broccoli had just begun. However, our goal is that after reading this article we to have opened your mind.

A portion of poultry is a mere 3.5 ounces. The simple visualization would be half a breast or a drumstick and a thigh. Make sure you do not include the skin and avoid fat content.

Poultry has high bacteria levels so make sure to maintain high sanitation standards to avoid contamination. Rinse all poultry and pat dry prior to use. This removes latent bacteria. Keep poultry isolated from ready to eat food stuffs. Contamination by bacteria can be removed only by cooking. Warm salad cooked to a temperature of 165° does not taste so good.

We also recommend using a different cutting board to identify the one for raw poultry. Make sure when you use this cutting board and any utensils you properly clean and sanitize them and any food surfaces juices may have contacted.

Balanced Meat Meals

Highlights

• Searing
• Braising
• Roasting

Proteins contain lower carbohydrates and impact blood glucose very little. As you eat, make sure to consume some levels of proteins to keep a tight control over your blood sugar and a steady source of energy.

In order to keep your body tissues healthy and in good repair, proteins are a necessary component because they contain the nine essential amino acids. As with seafood, B vitamins are also present. These are needed to help repair the nervous system.

This next part will help you understand searing, braising, and roasting. Make sure to cook to the proper temperatures.

Searing

Placing meat under high temperatures on a stove top causes the meat to become more delicious and remain lower in fat. Searing one side then the other allows for a carmelization process to keep the juices in the meat. Keep the juice, enjoy the flavor.

Veal is an optimal choice because it is not a meat with high saturated fats and cholesterols. Veal also cooks quickly allowing most juices to remain in the meat.

Snacks

Highlights

• Quick snacks
• Dips and Sauces
• Mini-meals

We won’t go back to portion control. Actually we will. Tight control on your blood glucose relies upon steady consumption of food in the right energy groups. If you plan on working out, a snack prior to or after your exercise can maintain your energy.

Some obvious snack choices:

• One string cheese with 4 whole wheat crackers
• 8 dried apricot halves
• ¾ cup oatmeal
• Handful of roasted soy nuts
• 6 smoked almonds
• ½ cup tuna, light mayo and dill pickle relish
• 6 ounces vegetable juice
• ½ cup cottage cheese

Many of the more convenient snack choices are not the best choices. Instand puddings, toaster pastries, and the like are loaded with sugars, salts, and fat. READ YOUR LABELS.

Healthy snacks are not as easy to reach like potato chips, candy bars, or pop. Most people keeps those around. As a diabetic you must focus on stocking fresh veggies or other healthy options. Sugar free drinks are also a must.

Whole grain snacks are not always an easy choice. If you have 6 saltines or 4 whole-wheat crackers, what would you choose? 6 crackers instead of 4, you might consider the 6. However, the whole-wheat crackers will actually keep your hunger at bay. With the complexity of the whole grains, your body will work longer to digest those 4 crackers. The fiber and nutrition remain in the whole-wheat and not the saltines.

Your freezer should contain some quick grab snacks. Try some of our favorites:

• Flavored ice cubes can contain sugar-free drinks. Freeze them and place them into ziplock bags and keep them until needed.
• Grapes when cleaned and taken from their stems can be placed on a baking tray in your freezer. Place these into a ziplock bag and eat what you need to curb your hunger.
• Sugar-free frozen treats are essentially freezer pops for the diabetic.  Many food companies now use 100% fruit juices or sugar substitutes.

Yogurt tubes can be frozen for an easy, quick frozen treat. Make sure to look for added sugar and read your labels.

Kid friendly snacks should always be handy if you have a child with diabetes. If you can teach  a child to snack right early, you can keep those behaviors present for life. These are some kid friendly favorites: snack bags of microwave popcorn, light variety; whole wheat pretzels, add mustard; a cup of low-fat yogurt; one sugar free gelatin cup; lunchmeat rollup; an apple with a small amount of peanut butter; celery sticks dipped in low-fat ranch dressing; one turkey hotdog; ½ cup cottage cheese; 1 ounce part-skim string cheese; and ¼ cup roasted peanuts.

Adding Dips and Sauces to your snacks

Most often people use specific sauces or dips (condiments) to flavor their food choices. If you are not careful, you may fall victim to want to eat the sauces by themselves because they are so tasty. Most of the recipes we have listed here can be a condiment, a spread for sandwiches, or as sauces for your protein based meals.

Most dips are high in fat and calories. Proper use of dips can help increase your intake of vegetables. If you are not careful you may end up eating a full week’s worth of fat and calories.

Mini-meals

These balanced meals are just perfect to fill in between lunch and dinner (or anytime for that matter). These  can also be an excellent way to maintain your steady food consumption and moderate your glucose levels. Chicken is always an excellent choice because it is a protein that is not easily converted to sugar in your body.

If you prefer, we also recommend seafood for the reasons identified earlier. These tasty tidbits are mostly protein and follow the same guidelines as chicken.

Work and snacks

Sweet treats find their way to the office, almost daily it seems. These treats show up when you least expect them and your defenses may be low. The best way to keep on top of your diet is to ensure you have a handy supply of healthy snack available.  Basic snack drawer items to keep available: microwave light popcorn, snack size; individual size nut packs; canned soups, low fat and sodium; fat-free jello or pudding; low fat protein bars; nutritional supplement drinks such as Ensure or Clucerna; individual size sugar free drink mix; and various vegetable or fruit juice, low sodium and no added sugar. If you buy individual sized portions, you don’t have to do the math.

Pasta

Pasta can be a healthy choice with a little help. Try some flour free options in some of our recipes.

Diabetic Desserts

Highlights

• Using juices
• Agave nectar
• Chocolate as treat

Americans have allowed many foods to get crazy. Portion sizes have been discussed numerous times. But what about sugars? If you begin reading the labels as we have taught you, it will be obvious that food companies find ways to sneak that pesky sugar into almost everything. Of course, they do not call it sugar. Look for malt syrup or high-fructose corn syrups to give away sugar in your food. If you look carefully, you can still enjoy your desserts. Eating reasonable portions and selecting the correct ingredients are the rules you should follow.

It will take some time to move away from the craving of sweet treats made up of non-nutritional white flour and sugar. With our help and recipes, craveable desserts are possible. Many options we explore do contain fruits and sugar-free gelatin. We will offer some twists to these standards.

One way to spice up fruit is to take a banana after freezing it. Place it and almonds or peanut butter into a food processor to enjoy a special ice cream creation. Melon and yogurt blended together some spices (nutmeg and cinnamon) can be a delicious soup. Other combinations of yogurt and sugar substitutes/fruits offer large varieties for you to choose from.

Fruits often are enhanced by spices. Melons and papaya are best with ginger or lemon. If you choose a melon, avoid any melon that is overripe-mushy spots or large discolorations. Papayas are best when they display a rainbow of bright colors.

If you really would like to try something refreshing, a juicer can bring out the strong flavor of your fruit and give you the fiber and all natural sugars within the fruit. Leftover juices can be used to flavor other desserts or meals.

A natural sweetener can be found in some nectars. Agave offers a taste that rivals honey. Taken from the plant tequila is processed from, agave has a low glycemic index and gives solid sweetness without experiencing the rise in blood sugar. Agave syrup is also wonderful and adds the healing benefits of Inulin, a byproduct that reduces cancer risks and improves absorption of nutrients and vitamins.

Chocolate

If you despaired of never having chocolate, think again. Chocolate can still be a steady part of your diet-if you use a sugar substitute instead of regular sugar. The higher quality of cocoa powder, the greater the flavor you taste.

Meringue is a versatile creation. Use it as a mold, a food holder, to cover various foods. The benefits of meringue are low fat goodness and its ability to absorb flavoring.

 
Tight control of your blood sugar relies upon regular eating patterns. The longest time without food intake happens at night. While your mind and body are recuperating, your blood sugar does not. Breakfast for the diabetics must start your day.

Parts of Breakfast

Fruits do contain high levels of natural sugars; however you do not need to take them off your menu. Whole fruits offer a better solution because the fiber and skin help reduce absorption rates and a slower rise to blood sugars. The following fruits have lower glycemic indexes: apples, apricots, blueberries, cherries, grapefruit, kiwis, and strawberries. There are other fruits with higher glycemic indexes: cantaloupe, dates, pineapple, raisins, and watermelon. Ultimately, you can eat any of them-just make sure to plan when and what you will have with it.

Eggs

Other foods are good choices for breakfast proteins. Because of the high level of cholesterol, diabetics should examine other non-traditional choices. Some of these choices might be one turkey hotdog in a whole wheat tortilla; one ounce of boiled shrimp with cocktail sauce; two tablespoons of peanut butter with whole wheat toast; 1 slice turkey wrapped around low-fat string cheese; four ounces of grilled chicken breast; or ¼ cup cottage cheese with grape tomatoes.

Whole Grain options:

It may not be butter drenched waffles drowned in maple syrup, however, low sweet whole grain options exist. Refining grains removes the hull and bran; unfortunately most of the nutritional value goes with it. If you consume whole grains, the protein, fat, and fiber slow absorption rates into the bloodstream and also offer feelings of being full longer than refined grains. Make sure to read the labels for whole grains. Make sure you read the words “whole wheat” to improve your diet.

Egg based dishes

Eggs without the yolks offer diabetics the chance to enjoy eggs without  all of the cholesterol. Mixing whole eggs and egg whites is also an option. Doing this for your egg consumption will allow you to protein push your day with amino acids, B complex vitamins, vitamins A, D, E, as well as selenium and zinc.

Baked egg dishes such as quiche can be frozen once made and served as single portion sizes.

Appetizers

For the normal person, appetizers are used to build suspense as you work towards the main course. The diabetic can use this as an opportunity gain additional nutrition while maintaining control over blood glucose levels.

There are many opportunities available within our recipes to give you party options, dinner for two, or family events. Just choose the correct yields for your event and don’t rush through them.

With casual dining becoming a social activity, entertaining has moved from meals to appetizers. We will show you how to include seafood into your diet.

With seafood offering high levels of omega-3 fatty acids, protein, calcium and other nutrients it is a natural choice for your diet. Seafood is lower in cholesterol with different flavors and textures for everyone.

When buying shellfish, they are typically sold by weight and size. If you see labels such as U10 or 26/30, these indicate fewer than 10 shrimp per pound or 26 to 30 shrimp per pound.

Make sure you purchase from a reputable vendor. Look to see if they have been deveined, that dark vein down the back removed. It is the shrimp’s intestinal track and should be removed prior to cooking. Make sure to wash the shrimp prior to cooking. If you purchase shrimp in the shell, chances are you will need to purchase a deveiner to run across the back of each shrimp to cut the shell off and devein in one move.

Salsas

Most salsas include standard seasonings for your grains or legumes. Rice and bean flavors are enhanced through salsa as well. Try varying portions of cilantro, garlic, lime/lemon juice, onions, various peppers (Serrano, poblano, jalepeno) and tomatoes.  When you use hot peppers, use the knife edge instead of your fingernails to remove the ribs and seeds. Unless you like the feel of pepper oil when you touch your face, nose, eyes or other parts of your body!

Many people enjoy fresh fruit in their salsa. Instead of lime or lemon juice, try squeezing the fruit to break the juice sacs, cut the fruit in half, and use a fork to pulp the fruit and get the juice. Make sure to empty the juice into an empty bowl to catch any seeds that might slip through. Mango and pineapple offer different profiles as well.

Dips

In a pinch, a dip can be whipped up without much preparation.  For these times make sure to keep the following on hand:

See the list of salsa supplies previously mentioned.

Adding pureed beans to your dip adds fiber but minimal fat. Make sure to use a food processor to blend in spices. Bean options include cannellini beans, black beans, pinto beans, black-eyed peas, gar- banzo beans, great Northern beans, navy beans, and kidney beans. Make sure to rinse and wash the beans unless the recipe indicates otherwise.

• Olives offer texture and flavor. Olive juice adds flavors too.
• Fresh herbs such as dill, basil, and cilantro add life to a dip.
• Lowfat sour cream adds body and texture while plain yogurt is well matched with herbs and spices.

Dip Chips

Instead of choosing regular style potato chips, consider some of these healthy alternatives:

• Bagel chips are usually located in a specialty bread area of your store. You can also make your own by slicing whole wheat bagels and baking them.
• Fresh veggies will always be a hit. Make sure to include carrots, celery sticks, zucchini, peppers (red, green, orange, yellow), or other favorites.
• Pita wedges can be made by quartering and baking pita bread.
• Various whole wheat crackers exist. Try to find ones made from multiple grains.
• Yucca root is also a tasty treat.

Soups

There are some standards for making soup. Usually one is required to sauté vegetables to soften while bringing out flavor profiles. There are many traditional combinations that are used that include celery, carrots, onions, and various spices.

The best way to sauté is using a low fat oil spray or butter. Browning meats at this time could also enhance the flavor of the vegetables. The carmelization or the browning of the vegetables helps to create a strong flavor for your soup.

Make sure you add some type of liquid. Options for this include broths, wine, water, or milk. Make sure to add a small amount, ½ cup to help dislodge any vegetables that may have caramelized to the bottom of the pan. These small pieces will be extremely flavorful in your soup.

The final stage is to add all proteins, grains, and vegetables into the low boiling soup and let it cook to taste. Various cooking times are out there. Searching the internet will help you locate one for your needs.

Stocks versus water

Most soups begin with water, but when you want additional depth of flavor you want to use stock-a liquid where small pieces of solid proteins, vegetables and spices are cooked then strained to contain only the liquid. This stock is the final stage of a good broth.

Look at your local grocer to see what stocks they have available for you use. Make sure to watch the salt and sodium levels. Remember you can always add salt to your soup.

Stock alternatives

If you want to avoid the potential problems of high sodium stocks, homemade vegetable stock is easy to make. By mixing together vegetable with high aromatic qualities you can have a simple stock in as little as 20 minutes. Typical ingredients would include onion, celery, and carrots with parsley and bay leaf. These simple ingredients are classified as a mirepoix, the basic beginning of many soups. Usually vegetables are rough chopped and unpeeled, however, when getting them ready to add to the soup, prepare as indicated.

To add additional flavors, one could use broccoli, cauliflower, and asparagus, however these should be used sparingly as they could overpower your soup.

Soup standard supplies

Canned evaporated milk can be used in creamy soup recipes. Because over 60% of all water has been taken from the milk, it is extremely concentrated and add much flavor. It is advised to use regular evaporated milk instead of skim. Skim milk in evaporated states tends to curdle and break.

Canned legumes, beans, and the like offer proteins and fiber. Using dried varieties takes additional time in preparation and cook time. Make sure to rinse and drain any canned items used.

• Canned tomatoes can be used in stewed, crushed, whole, or diced format.
• Dried herbs and spices should include oregano, basis, pepper, salt, dill, and other commonly seen spices.
• Dried mushrooms must be rehydrated prior to use. Place them into hot water for 30 minutes and strain them to remove grit and dirt. Rough chop.
• Garlic in any form is great. Usually whole garlic is best as you can sauté, puree, or roast it.
• Grains offer an opportunity to bulk up the soups. These include rice, barley and pasta.
• Olive oil add flavor to your soup and keep it heart healthy.
• Potatoes add starch and body to your soup. They cook quickly and thicken soups fast.
• Salt free mixes can be extremely helpful if you are trying to watch add salt to control blood pressure.

International flavors

Use the following spices to add exotic flair to your soup:

• Chinese five-spice powder, ginger and sesame oil give a Chinese flair
• Chili powder and cayenne season give a southwestern taste
• Cinnamon makes for Cincinnati-style chili
• Basil, marjoram, oregano, thyme, and rosemary offer Italian tastes
• Thyme, cinnamon, ginger, allspice, cloves, garlic and onions give it a Jamaican Jerk
• Cumin, coriander see and cloves take you to North Africa

Creamy Additions

If you love creamy soups, adding cream will make it delicious. It also makes it full of calories and saturated fats-two things a diabetic should avoid. If you need the flavor and texture of creamy soups, we have good news.

When making your soup, substitute 2% milk for cream in your soup. It offers the creamy experience but eliminates much of the fat and calories.

Salads

With every salad you can make, the large variety of assorted ingredients make this a very unique part of a meal. Many items found in salads are complex carbohydrates that help diabetics manage glucose levels. If you add different food energy sources to a salad, it moves from a snack, an appetizer, a meal, or end to your meal. They are easy transported to go where you do.

Greens

Greens can make any salad stand out. Depending on what you choose to add to your salad will depend on what nutrients you add. The darker the green,  the better it is for your health.

Typical greens include arugula, Boston butter lettuce, endive, escarole, frisee, mizuna, radicchio, red leaf lettuce, romaine, spinach, Swiss chard and watercress. Make sure to keep these in the bin designed for vegetables in your refrigerator. Romaine and radicchio must be stored intact as they protect the inner leaves. Loose lettuce including arugula and spinach must be washed, drain, and stored in a plastic bag. This will keep them fresh for several day.

Bagged salads

Many produce companies are moving towards pre-packaged salad mixes. This is done for convenience and to promote health awareness. Some common blends you might find are:

• American blend of iceberg, carrots, radish and red cabbage.
• European Blend also adds green leaf, romaine, iceberg, curly endive and radicchio. Try it with nuts and cheese but especially blue cheese and goat cheese.
• Italian blend is romaine and radicchio. It is usually used for simple protein based salads.
• Spring mix includes baby greens of spinach, radicchio, and frisee. It can also be used as a bed for many entrees.
• Check your local grocer for what blends are available for you.

Growing greens

Homegrown greens are easy to do. With a shallow root system all you need is a shallow planter, potting soil, seeds and sun. Simply fill a shallow container with potting soil. Make sure you have adequate drainage. Place the seeds into the soil. There is no need to space the seeds because they will be harvested before they mature. Water the seeds and keep them moist. Light, frequent watering is best. Place the pot into a sunny area of your house. Within a few weeks, you will be able to harvest. Trim off what you need/want.

Once you have started harvesting, place additional containers out and mix the seed to create your own unique spring mix blend.

Dressings

Most homemade dressings lacked flavor and appeal. While many newer dressing have appeared that improve flavor they may not be best for your health. Making tasty and healthy dressings is very easy to do.

Take equal parts of oil, acid (vinegar based liquids) and stock and whisk them together. Add in your preferred seasonings and continue to whisk. For more potent flavors, process in a food blender.

Adding more than greens

For fun, try adding other vegetables such as tomatoes, cucumbers, and radishes. Many roast various nuts as well-once they are roasted. Roasting the nuts enhances flavor. The roasting process also gives aroma and fragrance.

The nuts most often used are almonds, cashews, pecans, pine nuts, sunflower seeds and walnuts. If used with our favorite word-moderation-nuts will not be as fattening as many believe. Remember nuts add fiber and monounsaturated fats (good fats). This type of proteins stables blood sugars as a result of its long lasting effects.

If you look farther, you can harvest your herb garden for ways to reduce salts and fats to your meals. You can choose various methods of preparation, mincing and chiffonade, are just two options. Mincing is chopping the herbs into small pieces while chiffonade is rolling the herb and thinly slicing them.  Here is a list of favorites:

• Basil is similar to mint. With a slight pepper flavor it is an excellent choice for most pesto sauces. Mixed flavors such as cinnamon and lemon are available as well.
• Cilantro has very pungent aromas. The best parts of cilantro are the tender stems and leaves. This is an Asian and Latin favorite.
• Dill leaves are also pungent. A series of great pairings with dill are fish, dressings, and citrus.
• Mint is most commonly known as a dessert addition. This could be an excellent addition to dressings, dips, sauces, and beverages.
• Parsley has several options. It is often given the description of “fresh”.

Fruit in salads

Fruit salads are a refreshing experience especially when using fresh seasonal offerings. For the diabetic, having too much of these fruits can be harmful. If you use small amounts of fruits and combine with other foods, you can balance fat, carbohydrates, and proteins.

Entrée salads

Adding seafood to a salad does is easy to do. Using a light marinade and broiling your choice of protein with desired herbs can enhance your salad.

Adding canned legumes (garbanzo beans) offers a cost savings and high protein and fiber. These make year round choices.

Leftover Salads

When marinating or cooking your daily proteins, you might consider increasing your yield for dinners later in the week. If you do have “leftovers” we recommend broiled sirloin steak, grilled chicken breast, cocktail shrimp, roasted turkey breast, pan-seared beef tenderloin, and roasted pork tenderloin

The lure of bad food choices can be challenging. View each shopping trip as an adventure in nutrition as you avoid your primal need to feed on what you shouldn’t.

Learning What To Eat At The Supermarket

The Plan - In order to be successful in your diet, you must take a systematic approach. This process will improve efficiency during your shopping and ensure you only purchase those items most likely to conform to your diet.

If you determine what food items are needed to maintain your diet plan, make sure to follow that plan. There was a list given earlier for the basic staples one should have on hand. We recommend you follow this list and include any fresh seasonal selections of fruit or vegetables, perishables of meat, poultry, fish, and dairy products.

You must go onto the defensive when you shop. Whether you know it or not, a supermarket is designed to make you buy. Impulse items  are often those items that diabetics should avoid; high calorie and expensive. If you continue to move through your supermarket, you will notice all perishable items are usually located on the perimeter. High-caloric foods are kept in the center of the store that force you to take the long way to find your staples and perishables. Failure to create a list and buy only what is on this list leaves you at risk of destroying your diet.

If you are fortunate, your local grocer may have an employee trained on what food choices those with medical conditions should have. If your market has this option, make sure to spend time going through the market with this employee. Often you will be given information that makes your trip quicker and more beneficial.

Other key items to remember:

Try to shop at the same location when you shop. Try to make your trips as infrequent as possible. Try to go at less busy times as it will make it easier to avoid walking every aisle. Free samples are often high calorie designed to get you to shop. If you have children do not take them to the store if they are hungry. Finally, the checkout lane should be just that-checkout and leave. Don’t fall to temptation and buy those high calorie treats.

If you use the food pyramid, you should be able to find the right assortment of grains, fruits, vegetables, dairy and proteins.  The challenge of the supermarket will become easier if you follow this plan.

Don’t be afraid to investigate local farmer’s markets. Depending on your geographic location, you may find them year round. Remember specialty food stores offer items traditional markets do not.

The bakery

The trick to using the bakery section is not to avoid it. What you should do is find a way to create a menu that will allow you to have a sweet treat in your meal. You do not have to avoid these fats and carbohydrates, just moderate your portion.

Bakeries have tried to change with the times. The belief muffins and pastries are high in fat has created a movement where lowfat becomes the key word. Even if these items are low fat, they still contain excessive calories and should be avoided. Fat-free options such as angel cake are good, but you must watch the calories they contain.

High fiber choices such as whole-grain breads and bagels are excellent a diet. Usually these items are larger than one serving size. It is wise to consider only half as your serving size. Again eating all of this item will cost you too many calories.

Produce

The average supermarket carries the traditional apples, bananas, potatoes as they always have. However, larger varieties of fruits and vegetables have now been added. This allows you the opportunity to vary your diet and challenge your taste buds. Many of these items might be great substitutions for other high calorie foods you currently consume.

Different fruits and veggies also impart different vitamins and minerals. Different colored veggies offers different vitamins. Choose a rainbow for your refrigerator.

If you have not considered long term storage, freezing many of these fruits will allow you to use them when they are out of season. Dried fruits should be used infrequently because they have high concentrated carbohydrates. The preference for root vegetables is cool and dry locations, whereas other vegetables can be refrigerated.

The Dairy Case

Diet modifications are most easily done here. If you can locate the lowest fat content in the labels, make sure to also look at the food pyramid and the dairy requirements you need. 1% skim milk is preferred. You can buy regular cheese, just use it sparingly.

The Deli Counter

Every deli counter offers prepared and processed food choices. If you remember earlier sections, we mentioned these food choices are not the healthiest. High salt and fat contents are only part of this rationale. Spit roasted chicken may be the best and only option at this area. The lowfat meats included here, as well as many pickled items, contain high levels of salt.

Salad choices here should contain oil, not cream. If you can determine the ingredient content of each food choice, see if it is available –low fat. These are often not visible because most people prefer fatty foods for their rich taste.

Fresh Meat And Fish

As you move through this area, make sure to buy just enough for one normal person for each family member. If you see a cut of meat larger than your needs, you do not have to purchase all of it. If you know you can portion the cut for several meals, this will add levels of convenience to you. Make sure you have the meat cutter wrap it separately to avoid temptation.

In the study where processed meats were listed as unhealthy, it was also determined meat eaters tended to be heavier and exhibit more diabetes. The best choices for lowfat cuts of meat are sirloins, flank steak, and top round. Usually lean cuts lose flavor but these particular cuts are extremely tasty. If you know how you will cook your animal protein, determine if you need to have a lowered fat content. If you cook your hamburger well done, most fat will be lost in cooking.

Skinless poultry removes much of the fat in chicken. This allows for shorter cooking times and a much juicier dinner.

Fish on your plate should happen at least twice a week to achieve the positive results on blood fats. Salmon is good for you, but the fat content adds calories.

If you see breaded (battered) fish, make sure to see the ingredient list. While the breading makes life easier, your diet will not be. A fishy smell should warn you not to purchase that selection.

Frozen Foods and Diet Foods

We already discussed the value in freezing some food products. If you visit the local farmer’s markets as suggested earlier, you may find the need to freeze your food reduced. Many food stuffs are available year-round.

If you see microwaveable food stuffs, read the label for fat and salt content. Avoid frozen items with cream or cheese sauces.

Frozen diet meals do not contain as much salt or fat therefore they are excellent choices for you diet. These meals are usually fewer than 350 kilo calories and have excellent flavor. Additionally if you need to count carbohydrates, that number is on the packaging.

Usually you have the choice of three main frozen foods: Healthy Choice, Lean Cuisine, and Weight Watchers. Each offers low calories and good taste. One of these is usually on sale each week, which should help you keep the savings in your wallet.

Frozen foods may not be the choice for you if you want to like to stay involved in food preparation processes.  These are usually best for those who do not have time to cook for their dietary needs.

Canned and Bottled foods

Before you start cooking your recipe, make sure to review the recipes and the Nutrition Food Facts label. Often you may find oil as a liquid base instead of water. This oil adds fat content.

Canned veggies and fruits come in low-salt and low-sugar selections. Often these choices are healthier options.

When shopping make sure to look for the lower priced items down low. Many stores keep name brand and more expensive selection at eye level. Choose generic or store brands for additional cost savings.

Bottled juices contain high sugar and low nutrition. Pure fruit juice is often a better selection. Instead of soda or pop, choose water. Water contains no calories and has the same nutritional value as soft drinks. You will find water to be less expensive and much better at quenching your thirst. Citrus fruits such as lemon or lime add flavor to your water.

Snack choices

Eating between meals is often a necessary evil. Failure to choose the right snack can make the difference between weight gain and weight control, normal blood glucose levels and high glucose levels. These are some good choices for snacks.

• Baked Chips contain 110 kc an ounce
• Rice cakes fill you but offer no calories
• Fruit and fig bars will satisfy hunger and set you back few kilocalories
• Granola when low-fat restricts kilocalories to 220 to 250
• Raisins and dried fruits give deduct only 130 kilocalories
• Popcorn when plain is free from salt and fat at 30 kilocalories per cup

The mysterious food label

The Nutrition Facts label is not as mysterious once you understand how to read it. The FDA is the regulating agency for these labels.

Serving size details how much is one serving. Multiple servings are in each package so look for servings per container. When you review the calories, you will see how many kilo calories are in each serving. You will also notice the number of fat calories for each serving.  There will be a section detailing the nutritional value of each nutrient as a daily percent amount. The total fat content will be listed as well as how much fat is saturated. Additionally cholesterol is listed. Any food item that has less than 20 mg or less of cholesterol and 2 grams or less of saturated fat (per serving) is low cholesterol. Sodium will be given in mgs based on a 2000 kilo calories. Total carbohydrates are important to understand as your insulin requirements depend on this. Dietary fiber offers how much is digestible and how much add carbohydrates to blood sugar. Sugars indicate how many grams of carbohydrates some from sugar. Protein does not indicate how many grams of protein you will consume. Therefore someone with diabetes this number has no value. Finally the vitamins and minerals are listed individually. These are not required by the FDA so some labels will offer them while others do not.

Good Choices

You will find different food choices that offer different calories, fat, and nutritional value now that you understand how to read Nutritional Food labels.

• Smart  Balance has  only 60 kcal per  tablespoon while I Can’t Believe  It’s Not Butter has  90 kcal per  tablespoon.
• Uncle Ben’s Fast and  Natural Whole Grain Instant Brown  Rice has  170 kcal per  cup  while Uncle Ben’s Ready  Rice Whole Grain Brown  has  240 kcal per  cup.
• Nature’s Own Double  Fiber Wheat  Bread has  100 kcal per  2 slices while Arnold  Double  Fiber Whole Wheat  Bread has  200 kcal per  2 slices.
• Annie’s Naturals Buttermilk Dressing has  60 kcal in 2 tablespoons while Ken’s Steak House  Thousand Islands Dressing has  140 kcal per 2 tablespoons.
• Campbell’s Healthy Request Condensed Chicken  Noodle  Soup has  60 kcal per  cup  while Campbell’s Condensed Vegetable Soup has  100 kcal per  cup.

Spend some time to review Nutritional Labels and you too will find other choices that are healthier for you and your lifestyle. It just takes time to look for them. As you review these choices, make sure you are comparing similar serving sizes for accuracy.

When you hear the word diet, a negative connotation is associated to it. People normally assume diet means “hungry or sacrifice”. However, moderation is key to eating what you want and desire.

By carefully constructing a menu that follows the breakdown of the three calorie/energy sources of carbohydrates, proteins, and fats you are actually following a nutrition plan, not a diet.

The Eating Plan

We have already found the correlation between the correct number of kilocalories from energy sources and tight control on blood sugar. We have already determined how much of each energy source should be consumed. We will discuss how to take these energy sources and create something superbly delicious while making new and original foods.

Be aware of your eating plan before you begin reviewing your recipes. It does not make sense to begin making dinner with high fat or carbohydrates if you have already consumed your recommended daily amount.

As you begin creating an eating plan, look at what seasonal foods may be available. Typically seasonal food choices are inexpensive and the freshest choices at the grocery store. If you research North American chefs, you will realize the importance that seasonal foods have in recipe knowledge.

Many special diabetic recipes do require time, time you may not have when planning a meal. Take a few minutes to examine what meals will fit within your schedule. The more times you make a recipe, the easier it becomes to prepare. Consider the time taken to plan your meals as an investment in your health and lifestyle.

If you have Type 1 Diabetes, you must plan your meals around your medications. With the advent of rapid-acting insulins such as lispro and glulisine timing has become much easier for meals. Regular insulin users still require 30 minutes after medication to eat.

If you are hungry should you eat? If you have low-calorie snacks such as carrots, low-fat pudding, or fruit do so. We recommend diversionary tactics including exercise, hobbies, reading or a movie.

Three meals a day has been a staple for most diets. Several reasons are cited for this standard. Medication issues and spreading caloric intake throughout the day are two of the more obvious. If you concentrate on making your own meals, especially  breakfast and lunch, you gain control over your diet.

Ethnic cuisine

Just because you are a diabetic, you do not have to eat the same foods and eat foods you do not like. Portion control continues to be a main theme with any food, especially if you are obese. Any person of ethnicity of normal weight follows two standards: portion control and exercise. It is easy to cook ethnic foods vegetarian style as well.

Your physician can help you locate a dietician who has knowledge of your ethnic culture. Using this dietician will help you to modify the foods you enjoy to conform to your dietary restrictions. Again, simple changes to portion size or ingredients may be the only concerns addressed.

African-American food choices

Soul food is often used to reference the style of cooking typically associated with African slaves and the ingredients and fuel where they resided. Typical food choices include lots of vegetables and meats, greens, and fruits and meat combinations in main dishes. Many of these food choices are deep-fried as well. Because of the level of work expected and required of the abused slaves, the high levels of cholesterol, fats, sugars and salts were not a factor in health concerns. As with most of the American population, a more sedentary lifestyle has increased obesity, blood pressure and diabetes.

Additional information regarding soul food should also mention the reference to this population maintaining levels of humanity in an inhumane society. By giving to others less fortunate, soul food symbolized the wealth of the American slave. It was also a contributing factor to defining the female slave’s creative, artistic being.

Even though soul food does contain less healthy components, you do not have to completely give up those favorites. Modern chefs have been able to identify ways to cook with fewer fats, oils, and salts while improving the flavor and nutrition with spices and leaner meats.

We recommend Vegan Soul Kitchen by Bryant Terry (Da Capo Press, 2009) to learn how to cook soul food without animal proteins and dairy products.

As with other American populations, the African-American must realize making the move towards healthy nutrition and food necessitates a conscious decision. Creativity in cooking must become more common as cooks/chefs find ways to use fewer salts, sugars, oils, and fats. Changing the yield of recipes will help alter the perception that too much food is a symbol of wealth and allow the inclusion of fruits and low-fat/carbohydrate snacks as a replacement for sweeter baked goods.

Chinese food

Most people equate Chinese food as mostly rice. However, the nation state of China is immense and rice does not grow in every part of China. Other grains including millet and wheat are commonplace. Vegetables such as soybeans and cucumbers are supplements to rice. Because ginger was so prevalent, it became a traditional favorite for flavoring. Over time, small pieces of chicken and beef were added as well.

China was given various animal stock from different cultures. Western culture brought sheep and cattle while those from Thailand came with chicken. Because of the poverty level most Chinese peasants faced, it became part of the cooking process to fry any animal protein in very small pieces so fuel oil would not be wasted cooking larger pieces of meat. This process is now known as stir-frying.

As in modern times, parts of the Chinese population turned to non-animal protein choices. In 1000 AD, bean curd (tofu) was presented as an option for Buddhists who refused meat. It was during this time wheat and rice was milled to create noodles.

Traditional Chinese food is light in sugar and desserts, focusing more on fruits, vegetables, and seafood. Keep in mind those with diabetes should avoid lots of rice. If you choose Chinese as a meal choice, consider tofu for protein in vegetable dishes. Avoid deep-fried dishes.

French Cuisine

The stereoptype of French food instills the image of well dressed, skilled chefs. The term “haute cuisine” essentially means-by skilled chefs. While this genre of food has its roots in Italy, the French added different techniques and ingredients to accent their foods. Catherine de Medici is credited for bringing this expertise to France.

One of the more common techniques offered by French cuisine would be a meal designed as specific courses. This is contrary to other cultures where huge buffet style menus were presented.

• North cuisine: focuses on forest game and stream caught fish
• Central cuisine: introduces red wines for cooking
• South cuisine: specializes in goose liver, truffles, and Roquefort cheeses; also included are olive oils, tomatoes and garlic

Some of the world’s greatest chefs are French. With a penchant for versatility in using available ingredients, one should not wonder why.

Italian Cuisine

The history of Italian cuisine is similar to French. With a very segmented nation, various regions created different traditions and cooking styles. Some of the more common trends include:

• While beef, chicken and goats are present, Northern Italy uses its wild meat proteins such as deer and rabbit. Unique seasonings include bay leaf, rosemary, onions and garlic.
• With a location more sea bound, Southern Italy includes more seafood. One main food item, the artichoke, was presented here first.  Cheeses include ricotta and pecorino.

Most of us believe pasta originated in Italy; however the Arabs of North Africa were instrumental in bringing to Italy in 800 AD. They also brought melons, dates, rice, and lemons, Without the help of the Spanish, the tomato might not have become one of Italy’s own creations.

As you can see, Italian food was influence by many different cultures. Even Germany had its influence of the dumpling on dishes such as risotto and polenta made from yellow corn. Even today, northern Italian cooking includes these dishes as well as cream and meat sauces.

Towards southern Italy, the prevalence of olives in cooking can be seen. Further south, tomatoes become one of the primary components for cooking. The involvement of the sea is found in nearly every meal with seafood as a staple.

For the diabetic, Italian food is possible. While olive oil has some benefit to heart health, it is a fat; therefore reduction in fat is needed before you consume too many calories. As with African-American food, the change from an agrarian lifestyle and rigorous exercise to sedentary society must follow a change in your diet.

At most restaurants a serving size for pasta is suggested at 3 cups. Our recommendation is nothing more than 1 cup of pasta or 2/3 cup of rice. Make note of these changes.

We refer again to the federal food guidelines for Italian cuisine. The emphasis on fresh fruits and veggies fits well within those guidelines and a diet plan that conforms to fiber and reduction of fat intake. Italian cuisine is easily converted to vegetarian menus.

Italian wine, especially the Chianti, is recommended. Make sure to either split dessert with friends or avoid it completely.

Mexican cuisine

Many of the traditions of Mexican cooking have roots in early Mayan and Aztec cultures. With much of the focus on hunting and fishing, it is no wonder rabbit, turkey and fish were included. Corn and beans were some basic staples. It is the Aztecs who are credited with bringing chili peppers, vanilla, chocolate, and honey to the menu. It was only after the Spanish conquered this nation livestock of cows and pigs were introduced. Cheese and bread making followed after.

Other nations have greatly influenced Mexican food. With contributions from the French and Portuguese and many Caribbean island influences, the complexity of Mexican food is a given. This complexity exhibits itself with the mixture of animal proteins, rice, beans, and salsa in a burrito. Unless you make this food at home, you may take in your full allowance of salt in one meal.

Thai Cuisine

Similar in nature to Chinese food, Thai cooking specializes in stir-frying as well. Animal proteins are cooked in smaller quantities that push taste rather than bulk. Salts and sugars are easily avoided because of strong dipping sauces used to flavor food. Veggies are one of the primary energy sources. High fiber fruits such as guava, mango, pineapple, and papaya provide vitamins and minerals as well. These fruits make for great vegetarian options.

Influences from other cultures help to make Thai food very dynamic. The Chinese brought stir-frying and noodles. A focus on the five Asian flavor profiles of sweet, sour, bitter, hot and salt was the result of Chinese influence.

Curry and coconut milk came from India; however the Thais perfected curries with green chili powder, an item gained from the Western World.

The southern region of Thailand contains much seafood. You may have to ask for less spicy dishes because these are traditionally hot. Rice is usually included in these meals.

Thailand grows much garlic, an item that presents itself in most Thai food. Coconut milk blended from the coconut flesh and “milk” is used in curries and soups. Soy sauce has been replaced by “fish sauce” in a process where shrimp, salt, and water ferment.

If you frequent Thai restaurants you may have heard of pad thai. These Thai-style fried noodles were introduced to the Thais by the Chinese people. High unemployment in Thailand was a result of WWII. To combat this and bring the population back to work, noodle shops and stalls were introduced as a way to generate employment. Thais immigrating to the U.S. introduced this specialty. Diabetics need to be careful because of a high sugar level. Half a serving is recommended.

Thai food has three cautions:

1. Avoid large portions
2. Do not consume too much rice
3. Hot spices!

The World’s Cuisine

Here are some generalizations you can take with you:

• Diabetes will not require you to give up foods you love
• Food is not just nutrition and health-it is social status, emotions and much more
• Fatty, sugary desserts contain empty calories
• Portion size and more portion size
• If you exercise, you can correct dietary damage
• Delicious is not full of fat
• You can lower your blood pressure by lowering salt intake

The right stockpile of ingredients

What follows are some standard ingredients for many recipes. These items should be in every home.

The freezer: chicken breasts, egg substitutes, frozen fruits, fruit juice concentrates, soft margarine

The pantry: canned fruits, tomatoes, tuna; oils (canola, peanut, olive); onions, pasta, pasta sauce, dried fruits, evaporated milk, fresh garlic, fruit spreads, ketchup, mustard, various legumes, non-stick sprays, dry milk, peanut butter, potatoes, cooking wines, reduced sodium broths and soy sauce, reduced calorie mayonnaise, sugar-free cocoa mix, tomato paste, vinegars, Worcestershire sauce

Baking: baking powder and soda, cocoa powder, cornstarch, cream of tartar, dry bread crumbs, extracts (vanilla, lemon, almond), flour (all-purpose, whole-wheat) rolled oats, semi-sweet chocolate, sugar free gelatin, unflavored gelatin

Sweeteners: artificial sweeteners, honey, molasses, sugar, light maple syrup

Seasonings: dried herbs, fresh herbs and spices, pepper, salt

If you need any specialty ingredients seek out a specialty stores.

The Right Tools

The right tools can make the job easier when you are cooking. If you purchase high quality tools at the onset you will save yourself replacement costs down the road. Purchase the best set of pans, knives and cutting board you can. Take care of them so they last longer.

The tools: chopping boards, pots and pans, food processor, salad spinner, knives, scales, measuring cups and spoons, steamer with double boiler, microwave, thermometers (roasts and turkey), mixer with dough hook

Modifications

Some simple modifications can be made when cooking that will reduce calories and the numbers of food you need to watch in your diet. Many of these changes will move you towards vegetarian paths.

• Skim milk instead of whole milk
• Use lowfat meats of beef, pork, and skinless poultry
• Packaged meats are high in fat; avoid these
• Select low sodium and saturated fat foods
• High fiber is always good-whole fruits, vegetables and grains
• Yogurt instead of sour cream
• Use sauces, dressings, and gravies-on the side
• Instead of meat, fish, or poultry substitute lentils and beans
• Instead of butter use olive oil, herbs, spices or lemon juice
• Instead of frying try baking or broiling

Holiday Meals

Tight control of diabetes relies upon portion control. Holidays make eating too easy. Follow these tips to enjoy your holidays.

The buffet table is not an enemy-as long as you make only one trip. Fill your plate with the knowledge you should leave large portions on the plate. Avoid high-fat, high-sugar foods/desserts. Take those foods you should eat.

When invited to a potluck dinner, make an option from our recipe list. It is something that fits your diet but will also be something to match what others are bringing. Try a snack before you leave to avoid feeling hungry.

If you lose focus on get off track, you can always go back and do what you are supposed to do.

When treating diabetes the main components to become aware of include exercise, diet, and medication. Diet can help to reduce your glucose levels between 30 and 50 mg/dl and lessen the chance for complications by a third. Exercise can help maintain a healthy weight. There are many medications that can assist in controlling diabetes, however, the time to detail each one is not feasible. Consult with your primary care physician for additional information.

Caloric Regulation

As you move into the importance of dieting, moderation is your best friend. Those who are obese or substantially overweight can manage blood glucose levels through diet. This would include Type 2 individual as well as many severely insulin dependent Type 1 sufferers who require four daily injections. If you hope to avoid the various complications already discussed, maintain a steady regimen for weight loss that includes caloric reduction.

Caloric intake is one critical component for weight loss. Failure increase calories burned versus calories taken in ultimately leads to weight gain. While this appears to be common sense, it is more difficult than one would imagine. What is not important is what one item you reduce. You do not need to target just proteins (or carbohydrates or fats) in your diet. Recent diet trends seem to indicate any diet that requires low fats, carbs, or proteins will offer similar results over time. More important is to reduce portion sizes and the targeted elimination of empty calories that offer no nutrition value. These empty calories include sugars, alcohol, and fats.

Many individuals have a genetic history for diabetes. Having knowledge indicating your immediate family had diabetes allows one to become proactive in their lifestyle. This knowledge will help you maintain an ideal body weight and continue to eat balanced throughout the day.

Failure to have a simple diet solution becomes a challenge to successful weight loss. Usually the first step in achieving weight loss requires you to halve the portions you eat at each sitting. Initial steps include smaller serving sizes at home, however in most dining out instances half portions are indicated and may not be sufficient to impact weight loss. Using some of the information can help you determine when halving your portions is not enough.

Visual Cues for reducing serving sizes

There is not a rule of thumb for reducing your portions, however, some simple visual cues can be used. These would suggest:

• A deck of cards equates to three ounces of meat
• A baseball size amount is a medium piece of fruit, one cup of fruit, pasta or veggies
• Your computer’s numeric keyboard of 1 to 6 is one ounce of cheese
• An incandescent light bulb might be one cup of broccoli
• One grape is 1 teaspoon of peanut butter
• A ping-pong ball equals 2 tablespoons of mayonnaise, oil, or dip
• A hockey puck is one slice of bread, a medium size bagel, or one half cup of grain or cereal

The main thing to keep in mind about portion sizes is that it does not take much to establish weight gain or loss. Just a small increase or decrease of “kilocalories”-100 extra a day-will cause over 10 pounds of weight gain or loss. Over the past two decades, a trend has emerged where portion sizes have increased dramatically. One example tells us today’s modern chocolate chip cookie is 220 kilocalories more than the standard chocolate chip cooking in 1981. This equates to raking your leaves or garden for almost one hour.

To help establish a comparison for your caloric intake, the standard of measurement is one kilocalorie is 1,000 times more than a calorie. This becomes important when you realize health and diet experts define food as a measurement of energy in your diet plan.

Rest and Exercise

The dynamics of our society have evolved to such a point where most people claim they do not have the time to exercise. But how much time is really required to make a difference in your blood sugar levels? Studies following people whose parents both had diabetes showed that 30 minutes of exercise could prevent the advent of diabetes. The goal was not to establish weight loss but to prove the importance of exercise.

Additional studies indicate 30 minutes a day is not required either. A simple routine dedicated to as little as 7 ½ minutes made a difference in blood glucose levels. Exercise for 30 minutes to move you towards being in shape and reduce your glucose. If you push that to 60 minutes a day you can maintain your weight, however 90 minutes a day will cause weight loss.

Additional insights into exercise that should be considered include the benefits of an exercise buddy to offer an incentive to perform your exercise; smaller segments of exercise can be just as beneficial as one long session; maintaining longer sessions of more strenuous exercise creates greater benefits for your body; even small opportunities for exercise can impact your health; use of tools such as a pedometer help to reinforce your continued commitment to your exercise program; finally, glucose tends to be absorbed more by larger muscles, therefore focus on building strength and endurance is an additional method to maintain control over your diabetes.

In planning your daily activities, make sure to restrict how much time you are not active. Watching television and other sedentary actions only assist in weight gain. At the very least, plan how much time you spend performing those activities.

While this information is current at the time of writing, it is important to realize that knowledge progresses and more information becomes known every day. It is recommended you seek out qualified medical advice from your primary care physician, specialist, or health professional.

The importance of Blood Pressure Control

We have already discussed the implications of macrovascular complications. Failing to maintain a controlled blood pressure may affect the progression of eye, kidney, and nerve disease. Your target measurement should be 130/80. It is recommended you have your pressure checked with every doctor’s visit as well as purchasing a home monitor.

Weight loss, reduction of salt intake, increased vegetable and fruit intake, and exercise can aid in blood pressure control. However, many of those who suffer from high blood pressure are not even aware they have it. As a result, most diabetics are not being treated in such a way that will reduce their blood pressure to optimum levels.

When the methods described above fail to reduce your blood pressure, medication may be prescribed. Although many drugs exist designed for elevated blood pressure, one series of drugs has more profound impact for those with diabetes. Angiotensin converting enzyme inhibitors (ACE inhibitors) offer some protective ability for the kidneys. More importantly, if damage to one’s kidneys is discovered early enough, ACE inhibitors can actually help correct the damage that has already happened. Consult with your primary care physician to see if the benefits of ACE inhibitors are a good fit for you.

Diabetes impact other parts of your lifestyle

While we have been discussing the importance of diet and exercise on diabetes, there are other areas to be examined. Each of these areas can affect your diabetes, however making drastic changes is something to be avoided. Make any changes slowly and gauge the level of success. Once you have made significant progress with one area, decide what to target next.

Alcohol

Drinking alcohol in moderation has been found to lower one’s risk of heart disease/attack. For those with diabetes, food must be taken along with any alcohol to avoid your blood glucose levels from falling. Always eat food when drinking alcohol-this will help counteract any glucose lowering medicine

There are those individuals who should not drink alcohol. These people are pregnant women; children and adolescents; anyone taking medication that interacts with alcohol; or anyone with medical conditions that affect the liver or pancreas.

Some standards apply when drinking. Do not drink more than 8 ounces of wine (men) or 4 ounces (women) per day. Because the way alcohol is metabolized by the sexes is different, women are given a lower tolerance. There are some standard conversions for alcohol. 1 ½ ounces of liquor (rum, vodka, whiskey, or gin) or one 12 ounce beer are the same as 4 ounces of wine.

If you remember we discussed empty calories earlier. Alcohol offers only empty calories so make sure include those calories in your diet plan. If have been drinking and stop, you will experience weight loss.

For someone with diabetes, liver, pancreas, and nerve damage are already potential complications. Why would you add alcohol to your diet when it causes cirrhosis, higher blood pressure and for women, neuropathy?

Other ways to improve your lifestyle include avoiding tobacco or street or illicit drugs. Maintaining positive personal relationships and a sense of humor will also add benefit to your lifestyle.

During the study this method was formulated on, those conducting the study determined there were similar results from those who performed carbohydrate counting when compared with their new technique. The end result aided in lowering hemoglobin Alc to normal results.

To understand this method we assume a fasting blood glucose less than 95 mg/dl, after lunch and dinner a level less than 100 mg/dl, and prior to bed less than 130 mg/dl. By adding the units of insulin taken the day before, an initial daily dose was 50% of that previous day total then adjusted by taking the mean fasting glucose levels. Review the three day fasting glucose levels to determine what adjustment should happen.

If the mean was higher than 180 mg/dl, an increase of 8 units is needed. The range of the mean was between 140 to 180 mg/dl, increase the dose by 6 units. 120 to 139 mg/dl indicated 4 units; 95 to 119 mg/dl meant increase 2 units; and 70 to 94 mg/dl was no change. If the level was below 70 mg/dl, decrease by the same units of the previous increase unit intake up to 10% of the previous dose.

Looking at the rapid-acting insulin glulisine our initial dose totaled the remaining 50% of the pre-study insulin daily needs. It was then established that 50% of the insulin would with the highest carbohydrate meal, one third to the meal eaten in the middle, and the remaining 17% of the insulin taken with the smallest carbohydrate meal.

Micronutrients

We have only discussed carbohydrates, fats, and proteins contained in food. However, there are substantially more components in what you eat-micro nutrients. These are small quantities of essential vitamins and minerals your body needs to maintain your health. Following the pyramid technique mentioned earlier will ensure you do not have to worry about consuming sufficient micro nutrients, with few exceptions.

Calcium is needed by adults and children. Minimum daily levels are 1000 mg for adults and 1500 mg for growing children as well as pregnant women and the elderly. This can be consumed in fat-free yogurts and milks, ready-to-eat cereals and calcium fortified soy beverages.

Iron is essential to menstruating women. Therefore consider taking iron supplements or adding spinach and lowfat meats.

Sodium is one item most people can decrease. Avoid any added salt to lessen your sodium intake the 20 to 40 times the recommended levels you currently consume.

By eating additional leafy green veggies, vine fruits, and root veggies, you can add potassium to your diet and lower your blood pressure.

Timing food and medication

Taking insulin must take into consideration when your blood has the highest level of glucose present. This is when the highest level of insulin should be taken. For this to be successful, you need to know three things regarding our insulin: when it is the most active, how long does your insulin last, and when your insulin no longer active.

Regular insulin: This version of insulin has been commonly used for many decades. The important times to remember about regular insulin are as follows:

• 30 minutes from injection to blood glucose being lowered
• Peaks at three hours
• Disappears between six and eight hours.
• Typically needs to be taken 30 minutes prior to eating to avoid hypoglycemia followed by hyperglycemia once the insulin disappears and glucose is being produced by food

Rapid-acting lispro insulin and insulin glulisine: These are newer insulin version that are considered short-acting. The reduction of glucose begins within five minutes, peaks within 60, and ceases to be active in three hours. The greatest benefit of these newer insulin versions allows an individual to need an injection only when eating. The complications of hypoglycemia and hyperglycemia are eliminated.

Because of the elimination of most complications in the newer versions of insulin, they should become the number one recommendation for Type 1 diabetes and Type 2 who need insulin.

When planning on dining out, a person cannot know when they will be eating. With rapid-acting insulin the process becomes much easier. Test your blood glucose, take your insulin, and eat. It allows greater levels of spontaneity you could not experience before.

Keeping your body circulating insulin is a factor in determining what type of insulin you should take. Most Type 1 and select Type 2 may need to take both types of insulin. For individuals who are taking regular doses of insulin, eating regularly is critical. Some insulin formulas such as glargine and detemir remain available for 24 hours. These formulas will work until substantial glucose is consumed and the need for a more rapid-actin insulin presents itself.

Testing your personal blood glucose levels is always suggested. Failure to perform this task will not help you determine how your body will respond to various insulin formulas.

Where you inject insulin also matters. The most obvious choice for an injection site happens to be the abdomen.  Placing injections in muscles that are usually at rest offers more consistent absorption rates. Using leg or arm muscles will vary the rate of absorption based on the level of exercise you perform. Establish a rotation for injection sites.

You should also be aware of how deep you inject. The deeper the injection, the quicker the response to the insulin. Maintain the same needle size to ensure consistent absorption rates and injection depth.

Because of the tremendous variations regarding insulin injections, the importance of education for diabetics is established. This level of education will reduce the effect of those many variations.

Oral glucose medications such as sulfonylurea drug family are also dependent on time factors.

Managing Your weight and meal plans

Highlights:

• How many calories
• 1200 kilocalories and fast weight drop
• 1500 kilocalories and slow weight drop
• 1800 kilocalories maintains weight
• Other diet strategies

It does not matter if you eat a balanced diet that includes all necessary nutrients, proteins, fat, and carbohydrates if you do not monitor your portion sizes. There should be different consideration of kilocalories to help you establish daily calorie levels. Through the use of these different levels you can maintain your weight, lose weight quickly, or lose weight more slowly.

The slower approach to weight loss is the preferred method. Following this plan will decrease the hunger you feel but allow you to decrease your kilocalorie intake by several hundred a day. This method will also enable you to maintain your target weight over time.

Adding exercise will increase how much weight you lose. You can also choose to increase your food intake, but benefit from some weight loss. The number of kilocalories you can burn through exercise can be substantial. Weight loss will happen without your having to reduce caloric intake. Simply adding 30 minutes of exercise will result in 17 pounds off your body weight.

Many of people become concerned when faced with reducing caloric intake. The fear of being hungry is a great deterrent to losing weight. To best answer this fear, consider how much energy an obese person carries in body fat. Each pound of fat offers almost 3500 kilocalories. 25 pounds of excess body fat equates to 87500 kilocalories of potential energy or enough energy to walk nearly 1100 miles.

How many calories do you need?

Every nutritional plan should include how many calories are needed to maintain a target weight. Proceed from this point to determine how much of a calorie reduction is necessary to help lower your body weight.

Ideal Weight

There are various methods to determine “ideal height or weight”. Because each person has different levels of muscle and frame size, normal becomes established by adding or substracting 10% to the range given as normal. An individual who has a body weight of 180 pounds would be considered to have normal weight at 162 pounds (18 pounds less than 180) or 198 (18 pounds more than 180).

As we have discussed, every person has unique needs and requirements. Therefore approximate figures are the best we can offer when determining how many calories you should consume to maintain your ideal weight. If the number given allows you to gain weight, decrease the intake in 100 kilocalorie increments to determine if you are losing weight.

One measurement used to establish ideal weight can be explained. For a man the base weight for a 5 foot man should be 106 pounds. For every inch taller, add 6 pounds. Women’s ideal weight begins at 100 pounds for one who is 5 feet tall and an additional 5 pounds per inch.

Caloric needs

Once you know your ideal weight, multiply this number by 10. This number equates to how many kilocalories you should consume daily. For a man 5 foot, 6 inches tall, the ideal weight would be 142 pounds or 1400 kilocalories. This does not take into consideration any exercise done. It is known as your basal caloric need. Graduated increase of calorie intake relies upon how much physical activity you plan.

 
If you notice the above chart, the very active portion has added the + to its calculations. These are included because very active may require more than just 40% more than basal requirements. The variation will be established baseupon whether or not the person desires to lose or gain weight.

If your intake of kilocalories exceeds daily needs, weight gain occurs. Every pound of fat you gain equates to 3500 kilocalories. If you desire to lose a pound of fat, you must burn off that same amount. What does not matter is whether you burn gradually amounts over time or do so at one time.

1200 kilocalories

The moderate active male requires 1700 kc (kilocalories) to maintain his weight. Reducing your kc intake by 500 daily gives a deficit of 3500 kc in a week or the equivalent of one pound of body fat.

From earlier reading you will remember that 40% of calories should come from carbohydrates, and 30% each from protein and fats. The breakdown for each of these items therefore becomes 480 kc for carbohydrates and 360 kc for protein and fats. With 4 kc of energy per gram of carbohydrates and protein, you can safely eat 120 grams of carbohydrates and 90 grams of protein. Fat grams consist of 9 kc therefore in this example 40 grams of fat can be consumed.

The simple math for this 1200 kc diet is easy when each main component is broken down for you. It becomes infinitely more difficult when dining in a restaurant. Shopping for groceries is not as difficult because labels can lead you to make the right decisions.

1500  kilocalories

Keep in mind the lower the deficit of calories needed versus what is eaten, the slower the weight loss. Using the same math calculations from the 1200 kc diet, 3500 kc will be lost every 17 days instead of every 7. This equates to 24 pounds annual weight loss or reducing your food intake by one slice of bread and butter each day.

1500 kc meal would assume 600 kc of carbohydrates (150 grams), 450 kc of protein (112 grams), and 450 kc of fat (50 grams).

 
This particular meal choice is substantially lower in carbohydrates and protein while nearly meeting the fat requirements. Some additional snack choices of fruits can help fill in the difference.  Taking choices such as an apple, a serving of banana or cherries will offer 45 grams of carbohydrate; several ounces of ricotta cheese (5 grams fat/ounce) adds fat grams; and a minimal amount of almonds (6) or a tablespoon of cashews will give unsaturated fat.

These types of meals of meal are actually quite small. You may be surprised at what a small four ounce portion of a lean animal protein compares with when dining out or at home. Paying attention to your portion size will be instrumental in controlling your blood glucose as well as creating the difference between gaining/losing weight or maintaining your current weight.

Your healthy lifestyle will not be the only item you save. Reducing your portion sizes when dining out will make an impact on how much money you actually spend!

1800 kilocalories

Once you have achieved your “desired weight” that maintains your blood glucose levels within the range of 80 and 140 mg/dl, maintaining this weight should become a primary focus. An 1800 kc diet( only 300 kc higher from our previous diet) when compared to a 1200 kilocalorie diet may seem like a smorgasbord!

When creating this diet plan, the division of carbohydrates, protein, and fat becomes 180 grams, 135 grams, and 60 grams respectively.

 
Even by increasing the amount of kilocalories, we find a diet that still remains short of recommended carbohydrate and protein requirements. While you do reach the correct level of fat grams, you still can add similar snack choices from the 1500 kc diet to reach the other recommended levels.

Type 2 diabetics will find a balance of calories and energy sources in this type of diet plan that will help determine appropriate insulin needs for each meal.

Other diets

What are some of the other diets that exist? How do you know whether or not a high protein-no carbohydrate diet, or a carbohydrate-no protein, or a buffet style carbohydrate diet is right for you? Someone else argues their citrus fruit diet works for them. What is important to realize is each of these diets, if followed, will allow someone to lose weight. The key concept for these diets is to know whether or not the weight will remain constant once you reach a target weight. Keeping weight off is more difficult than losing it.

Some specific diets will be discussed in the following section. We recommend none of these AND everyone of them. This is contradictory we know, however, find a program that helps you lose weight, eat a balanced diet low in fat and protein but enforces carbohydrate intake that focuses on whole grains/fibers/cereals. Do not be afraid to reduce any of the sources of calories to lose weight effectively. Make sure to add exercise into your diet for success.

Low carbohydrate diets

These types of diets promote the fact consuming large amounts of carbohydrates create hunger. By systematically removing or decreasing your consumption of carbohydrates, hunger pains disappear as much as your weight. Protein based diet programs exist such as the Atkins Diet that allows you to take in any protein-lean or high fat. Some examples of other protein based diets:

• Atkins Diet: Large quantities of any meat, shellfish, eggs or cheeses are encouraged. Fruits, starch veggies, and pasta are frowned upon because they offer high levels of carbohydrates. Later in this diet some of these food items may be included. Exercise is suggested, however do not change eating patterns.
• South Beach Diet: While similar to Atkins, this diet suggests low fat proteins. Carbohydrates are still restricted but are gradually phased into the diet to some level. Eating patterns should remain consistent with increased exercise programs.
• Ultimate Weight Solution: Eating lots of protein in this diet encourages reduction in carbohydrate intake. Adding support groups helps you learn how to modify your eating habits over time. This is intended to be a lifelong commitment to changing eating patterns and increasing exercise.
• Zone Diet: If you follow the kilocalorie diets discussed, this diet will be simple for you. By focusing on exact intake of calorie sources by category you should not have to change eating habits. Just make sure to avoid high fat-high carbohydrate food choices. With regular exercise and a lifelong balance you should maintain weight loss.

Portion Control Groups

These series of diet plans focus not on what you eat but HOW MUCH you eat. Using the federal guidelines, portion control is emphasized.

• DASH DIET: Having a focus on grains, fruits, and veggies while reducing/restricting fat intake helps make changes in eating habits. Animal proteins are consumed in limited amounts. There is not a set program of exercise but it is highly recommended. This should be a lifetime diet.
• Jenny Craig: Jenny Craig offers various food products one is expected to purchase to maintain weight loss. Including a counselor and formal exercise regimen is needed for successful weight loss. The specialized food products balance the three main calorie sources daily.
• Weight Watchers: Specific foods have specific point values. Your diet plan focuses on your personal daily number of points and your successful integration of fat, fiber, and calories. This program indirectly suggests changes to decrease eating high calorie foods to stimulate smaller, healthier food choices throughout the day.

Weight training diets

There are many diet plans suggesting balanced intake of calorie sources. Many of these seek out unrefined carbohydrates and low-fat dairy and meat proteins as primary food choices. The Abs Diet is one of these plans, however, we will target on the “Total Body Strength Training Workout” to help build muscle tone and strength. Changes in eating patterns are not a large component of this diet, however, a lifetime diet and exercise program is mandated.

Extreme Diet Plans

Two major programs suggest high personal involvement levels to achieve successful weight loss. Most people find this to be invasive to their lifestyle choices. The dedication of time and commitment to these programs is immense, however, if you do not stick with the program you will only realize short-term success.

• Dean Ornish Program: This program clearly states no processed foods, caffeine, or alcohol. Additionally you must avoid sugar, salt and oil. Meetings and support groups are an essential part of a lifelong behavioral change program.
• Pritikin Eating Plan: This particular plan does not allow much protein or fat. Critical components for changing your lifestyle include exercise and eating behaviors. This is also a lifetime program.

In the big picture, there is not one strategy proven to be more effective than any other. While each diet offers some evidence of success from those who did well, not much information is present for those who did not achieve a modicum of success.

An increase of obesity has been an ongoing trend in American society. With the definition of obesity defined as a BMI (body mass index) of 30 m2  or larger, it is shocking to see the percentage of Americans who were obese jump almost 2 million people from 2005 to 2007. The number of those individuals with diabetes jumped almost 3 million in the same time frame.

With the complications of blindness, kidney failure, heart disease, and potential amputations, it is obvious to see why the United States must take action to correct this trend. Many people must become aware they may not live through their first heart attack.

If the hemoglobin Alc can be lowered in the human body 1%, there is a corresponding reduction of nearly 33% from many of the complications of diabetes. It becomes important to know what to eat, when to eat, and how much you should eat. Remember to skip through this section-“skip pop, fatty foods, and sugary desserts. Skipping as a form of exercise is recommended however.

How much should you eat? Some basic math can help you determine the number of kilocalories you should be eating and what you have been eating. It is at this point you should also make the breakdown between carbohydrates, protein, and fat.

The Vegetarian Diet

The first step when considering a vegetarian diet is to determine what a vegetarian diet is. Removing all animal meats and products is classified as a vegan diet. The inclusion of all lactose based products including eggs, milks, and milk products is a lacto-ovo vegetarian. Finally, a pesco-vegetarian is essentially the same as a lacto-ovo vegetarian but also includes fish.

One recent study mentioned in Diabetes Care (May, 2009) concluded that the Seventh Day Adventists with its varying levels of vegetarianism exhibited the lowest BMI of any group included in the study. Those Seventh Day Adventists following the vegan diet had a BMI of 23.6, the lacto-ovo vegetarians compared at 25.7, and pesco-vegetarians were at 28.8. The incidence of diabetes in vegans was 2.9% compared to 7.6% in non vegetarians.

The Archives of Internal Medicine (2007) compared almost 325,000 men to 225,000 women who were able to provide detailed information on lifestyle habits that included diet, exercise, alcohol and tobacco use, and  personal demographics (education, weight, family history). After ten years of study, the Archives of Internal Medicine notated nearly 50,000 men and just over 23,000 women had died. Typical animal protein intake consisted of 1 to 4 ounces daily while processed animal protein averaged 1 to 1 ½ ounces once a week. This study then concluded there were significantly higher than average death rates based upon higher meat consumption.

Other facts offered though analysis of this study would suggest 1 million men and 500,000 women would not die if they would lessen their red and processed meats. People should limit their intake of steak to once a week; hamburger a maximum of twice a week; and processed meats less frequently-once every six weeks.

The benefits of producing less meat on the environment was one item the study did not include.

Carbohydrates and glucose

With every meal that you consume, carbohydrates contribute to the production of blood glucose immediately. The largest set of carbohydrates consists of starches such as beans, peas, lentils, breads, starch based veggies, cereals, and grains. The next common carbohydrate contributor would be fruits. These two groups differ from milk products as milks also offer proteins and fats (contingent upon whole, lowfat, or fat-free). Cakes, cookies, candy, sweetened beverages, and desserts also add carbohydrates and various levels of fats.

If you have any questions regarding the breakdown of specific foods, you may research those items from the American Diabetes Association and the American Dietic Association websites and publications including the Official Pocket Guide to Diabetic Exchanges and the Diabetes Carbohydrate an Fat Gram Guide.

How Many Carbohydrates

Most people when talking with their physician would be told the normal intake of carbohydrates should consist of 40 to 60 percent of total daily calories. If you are able to limit your intake below those levels, you increase your chances of controlling your blood sugar and blood fat levels. While some dieticians or physicians may suggest more, the only concern should be the control of blood sugars and triglyceride levels.

Glycemic Index

The glycemic index (GI) is a unit of measurement that compares the ability of specific food versus white bread to raise your blood glucose levels. One should ensure foods with lower GIs be included in a diet plan to prevent an increase in blood glucose. While you cannot measure a specific meal for its glycemic index, you can make some substitutions that may help reduce your GI.

Some simple substitutions would be whole grain breads instead of whole meal or white bread, cakes, or muffins; oats or other natural cereals instead of processed cereals; cookies with dried fruits or whole grains instead of plain cookies;  pasta/legumes instead of pasta; apples/plums instead of bananas; and add low GI rice products.

By including these items in your diet you can be assured you will not add calories or increase blood sugar, however you will increase your fiber that may decrease any risk of coronary heart disorders and diabetes. It will improve your bowel functions, and if you already have diabetes, it will help reduce your current blood sugar levels. One simple substitution you can make is taking fiber grams and reducing your carbohydrate gram intake providing the food item has more than 5 grams of fiber.

There are two types of fibers: soluble and insoluble. As you can probably guess, any soluble fiber can dissolve in water where it can safely enter the blood stream where it can help reduce blood sugars. Insoluble fibers remain in the human intestine to help reduce constipation.

Sugar And Subtitutes

Even if someone has diabetes, they can still add some sugars to their diet. Keep in mind those individuals with weights more in line with “normal” should consider sugar instead of any substitute for sugar. To help prevent obesity one simple solution is to eliminate a minimum of 50 calories daily. This is how artificial sweeteners can be beneficial as they add that level of “sweet” and are not empty calories.

Sweeteners And Kilocalories

Table sugar, also known as sucrose, is different than other several sugars naturally found in food. Primary differences  in these types of sugars include difference in absorption rates and processes, as well as how quickly they raise blood sugar levels and convert themselves into glucose. Many of these natural sugars have adverse physical reactions that may include diarrhea.

There are several kilo-calorie sweeteners that offer greater sweetening capabilities and use smaller amounts. Even though you use these in smaller amounts, the calories from these kilo-calorie sweeteners must be documented in your diet plan. Kilo-calorie sweeteners include:

• Fructose naturally occurs in fruits and berries and is sweeter than table sugar. Fructose has a slower rate of absorption and finds its way to the liver for its production into glucose.
• Xylitol is also sweeter than table sugar. It has the added benefit of few kilocalories per gram. Because it is absorbed slower than sugar, an added benefit it offers for gum chewers is less tooth decay.
• Sorbitol/mannitol manifest as sugar alcohols in many plants. Once ingested they turn to fructose, however unlike fructose they are less sweet than table sugar and ultimately have little impact on blood glucose levels.

Non-caloric Sweeteners

Artificial sweeteners (non-nutritive sweeteners) contain no calories but are many times sweeter than table sugar. While they are sweeter than table sugar, they do have an “off-taste” when compared to other sweeteners. Strevia is one exception because it is a plant derivative.

The following is a list of artificial sweeteners:

• Saccharin: This is a heat stable sweetener easily used in baking and cooking. It is 300-400 times sweeter than sugar. You may know saccharin as Sucaryl, SugarTwin, and Sweet’NLow.
• Aspartame: Even though this tends to be more expensive, it is often a preferred substitute because of its flavor profile. Equal and SweetMate are brand names for this sweetener. When cooking or baking, avoid using this sweetener because it is not heat stable.
• Acesulfame-K: Because it is heat stable and offers 200 times the sweetening power of sugar, it is used in baking and cooking.
• Stevia: A more recent sweetener on the market that received FDA approval in 2008. Most notably used in Coca-Cola under the name Rebiana.
• Sucralose: The food industry is fond of this sweetener labeled as Splenda. It too is heat stable, however there is a need to mix Splenda and a sugar “Pure Magic” to allow any baked item model the baking characteristics of sugar.

You can refer to Appendix C to determine the appropriate levels of substitution of each of these artificial sweeteners instead of using sugar. Use of these artificial sweeteners can help manage your diabetes. There is nothing to indicate cancer is a side effect of artificial sweeteners.

Protein Is Not Just From Meat

In America, most people already consume more protein than recommended amounts. Even though much of these proteins come from meat, fish, poultry, milk and cheese, we have established that beans, peas, and lentils also contain protein (remember-carbohydrates too!). Watch the levels of fat in meat protein (there is no constant fat content between meat sources) and try to keep it as low as possible. Choose items such as skinless white meat chicken or turkey, fat-free cheese, and halibut/flounder.

The basic calorie formula should consist of 40% carbohydrates, fats are 30%, with the remaining 30% protein. Protein causes a rise in blood glucose hours after consumption once the liver has processed the protein. It becomes advisable to consume a high protein bedtime snack to avoid low blood sugar while sleeping.

Fat Focus

Most Americans worry about one type of fat-cholesterol normally found in egg yolks. Unfortunately the most commonly consumed fat exists as a chemical-triglyceride.

Do you know your own cholesterol level? Most people know this level as well as the components of good versus bad cholesterol. You should be more concerned about the HDL (high-density lipoprotein). Consult with your physician if you would like additional details regarding your cholesterol.

There is a reasonable level of good versus bad cholesterol. Using the Framingham Study, based upon an examination of the population of Framinghan, Massachusetts, we can measure a person’s risk for heart attack. This formula takes the total cholesterol divided by the good cholesterol for determination. Those with results lower than 4.5 had a lower risk of heart attack.

LDL-C (low-density lipoprotein cholesterol) has been determined to be a leading factor in heart attacks. Those with high risk of heart attack should try to maintain LDL levels less than 70mg/dl.

The one food with high levels of cholesterol would be eggs. To stay within daily recommended levels of less than 300 milligrams one should try to use egg substitutes. One egg nearly equals the daily recommended level.

Other fats

We discussed triglycerides briefly as a chemical component for fat. There are different forms of triglyceride.

• Saturated fat: Typically this is a fat that orginates from animal sources. Butter, bacon, cream, and some cheeses are other sources. These help create bad cholesterol.
• Trans fats: The food industry has helped to create replacements for “expensive” butters. While these are labeled as partially hydrogenated oil, they may cause more damage than saturated fat in contributing to heart disease. Sources for trans fats include margarine, cake and soup mixes, fast foods, frozen foods, cookies and doughnuts, chips, processed breakfast cereals, candies, and whipped toppings.
• Unsaturated fats: These are located in olive and canola oils. These can be broken down into two types.
• Monounsaturated fats: These typically do not raise cholesterol levels. Olive, canola, nuts, and avocados contain monounsaturated fats.
• Polyunsaturated fats: While these do not raise cholesterol levels, they can reduce the level of good cholesterols. Margarines, corn oils, and mayonnaise are some sources of polyunsaturated fats.

Lower your fat intake

Calories in fat are concentrated calories. Reducing the quantity of fat consumed is a good thing. People living near the Mediterranean Sea basin been known to have lowered heart disease. This may be related to the higher consumption of olive oil.

There are some exceptions to the rule that vegetable oil is better than animal based oils. These exceptions would be palm and coconut oils that are considered saturated fats.

Keep in mind the following terms (per serving):

Fat free less than 0.5 grams of fat

Lowfat is less than 3 grams of fat

Reduced fat should contain 25% less fat of similar items

Lean meat should contain less than 10 grams of less, less than 4 grams of saturated fats, and less than 95 mg of cholesterol

Low saturated fat should contain 1 gram or less of saturated fat and less than 15% of calories from saturate fat

Cholesterol-free should have less than 20 mg of cholesterol and less than 2 grams saturated fat

Reduced Cholesterol has a minimum of 25% less cholesterol when compared to similar foods and 2 grams or less of saturated fat

Recommendations:

As mentioned earlier, only 30% or less of your calories should come from fat and in this amount less than 1/3 should be saturated fats. Use as many vegetables oils as possible, using as much canola and olive oil because of their cholesterol lowering properties. Fish and poultry protein sources should become primary choices because of fewer fat calories and fish contains fatty acids that can also lower cholesterol.

Your diet

Once you have established the balance for the types of food energy you should consume, it is time to determine what specific foods you should eat. There are two standard systems and a newer method you can use to help determine what foods to eat.

The Food Pyramid

This method is characterized by helping you to determine a decent, well balanced diet. Through this method you can determine what food choices and portion sizes could benefit you. Because this has recently been revised, it is recommended you visit www.mypyramid.gov for additional information. You will also find other helpful tools and resources to guide your specific lifestyle.

While this may seem to be an optimum method, it may not work for Type 1 diabetics or a Type 2 with obesity. These individuals must examine every calorie they consume, paying close attention to carbohydrates. We can discuss counting calories in coming segments.

Diabetic Exchanges

Diabetic exchanges were the result of collaborative efforts of the ADA and the U.S. Public Health Service in the 1950’s. Some specific revisions have occurred in subsequent years (1976, 1986, and 1995), however most dieticians do not use this when consulted by diabetics. It is for this reason Diabetic Exchanges should be eliminated from good food practices for diabetics.

Carbohydrate counting

One of the easiest ways people with insulin dependent diabetes (Type 2) and Type 1 diabetics can track carbohydrate intake is by counting their carbohydrates. One should be aware of how many carbohydrates should be consumed daily. One this level has been determined, divide this total by how many meals and snacks during the day and with the assistance of your physician determine the level of insulin needs using your baseline carbohydrates and your blood glucose level before each food intake.

If you determine your needs for breakfast consists of 60 grams of carbohydrates and you know each unit of lispro insulin manages 20 grams of carbohydrates, simple trial and error processes can assist in controlling your insulin needs. Simply stated, this method is helpful in knowing how your carbohydrate intake and how many units of insulin are needed to maintain your blood sugar levels. These levels should be evaluated on an individual level as each person’s metabolism is unique.

The example used here assumes a glucose level at 150 mg/dl which is 50 mg/dl high. By knowing each unit of insulin can reduce his glucose level 50 mg/dl. Doing the math for this calculation tells us he would need to take 3 units of insulin for the carbohydrates with 1 additional unit for his elevated glucose level making his requirement 4 units.

Because of additional activity during his morning, our person finds his blood sugar level has dropped to 60 mg/dl. With 75 grams of carbohydrates pending, he would normally take 4 units of insulin. Because his blood level is lowered, he has reduced the total units needed to 3.

Dinner for our person shows him consuming 45 grams of carbohydrates and a measured level of 115 mg/dl. The intake of carbohydrates requires 2 units. The blood sugar level does not need attention, therefore only 2 units are taken.

Successful carbohydrate counting requires succinct knowledge of how many grams of carbohydrates you will consume as well as how much insulin your body needs to overcome your carbohydrate intake. This also requires you to know how your body will react to each unit of insulin and knowledge of how to measure your glucose level.

Use of constant carbohydrates can make this job much easier if you maintain carbohydrate choices consistently through each snack or meal. Using this technique allows you to become more familiar with how much insulin your body will need based upon your blood sugar.

Things to Consider if You Have Diabetes

What you should discover are the various common ingredients we have substituted for many “specialty or hard to find” components. Our recipes will be everyday ingredients you can find at your local grocer. We are not suggesting you do not seek out specialty stores; we have only sought to make these recipes as simple as possible, including definitions for items that may not be well known.

There will be some specific nutritional information that will conform to your nutrition plan (if you have one). The nutritional information does not include any ingredients deemed to be of your choosing or suggested as “to taste”. Salts will be shown in the recipes and is part of the nutritional information. The yields or serving sizes should be based upon the recipe ÷ the desired number of servings.

The order for this information will follow the following format:

• Kcalories
• Kcalories (fat)
• Fat content (grams)
• Saturated fats (grams)
• Cholesterol (milligrams)
• Sodium (milligrams)
• Carbohydrates (grams)
• Fiber (grams)
• Proteins (grams)

The following conventions should also be addressed:

• You should avoid margarine as it tends to impact flavor and nutritional information. Butter is a natural ingredient and is unsalted.
• Flour is all-purpose.
• Lowfat milk will be used unless otherwise specified
• Use large eggs
• Onions used will be yellow unless specified differently
• Use ground black pepper and standard table salt unless a substitute is offered
• Splenda will refer to the standard sugar substitute unless mentioned otherwise
• Use level amounts of any dry ingredients by using a flat object to scrape across any measuring tool
• Temperatures will never be Celsius but Fahrenheit although Appendix D can help you convert to Celius
• Recipes from other books will be listed as “classics”

If you need additional understanding of your diabetes, please consult your physician. You may also seek out information from the American Diabetes Association.

Remember:

These segments contain more specific and interesting information. If you choose, skip those segments. You will not be judged on whether you know these sections.

We will assume you have some basic understanding of cooking, pots and pans, and how to use kitchen tools including knives, cutting boards, measuring cups and the like. If you need additional help understanding more specific terminology, please refer to Appendix C in the back.

While this purpose of this post is to help individuals learn to cook and care for someone with diabetes, it offers great potential for anyone to lead a healthy lifestyle. This post will help you move through the kitchen and your local grocery store to narrow in on those items helpful to you (or your loved one’s) diet as one way to help improve health by reducing the complications from diabetes.

How to begin

What do you need today? Find the that best suits you current needs and go from there. Specific recipes towards the middle for breakfast, lunch and dinner would help if it is meal time, whereas the information needed to manage caloric intake and your glucose.  Remember you control your diet and the impact on your health. Good luck and great eating!

We focus on food and its importance on your lifestyle and health. We already mentioned you (or a one you care for) can have an excellent diet. We will show you what to cook and where to find the items you should be cooking.

What does living with diabetes mean?

Highlights

• Controlling caloric intake
• Watching your blood pressure
• Changes you should make
• Tight control over your lifestyle

In recent years the value of a strict vegan diet has been identified. Prior focus on has been on animal proteins; we will show the value of a vegetarian diet, its impact on the prevention and treatment for diabetes, and why someone should follow this type of diet. We also include various recipes that offer some excellent vegan choices.

What is diabetes

Many fallacies exist regarding the nature of diabetes. People suggest it should common place, however, it is not just that simple. The only way someone can know they have is by having their glucose level (blood sugar) tested.

Numbers and diabetes

Diabetes has various implications when compared to your glucose levels and blood sugar. There are three areas one should examine.

A normal blood sugar has a range of 70 to 139 milligrams per deciliter (mg/dl). Any blood sugar level that equals or exceeds 200 mg/dl at any time during the day along with the symptoms of frequent urination and thirst, becoming easily tired, excessive urinary infections, cuts and bruises that heal slowly, and, in women, genital itching are indications of diabetes.

Another way to determine diabetes is through a fasting blood test. A result higher than is 126 mg/dl  after fasting eight hours is abnormal. The typical results for normal are less than 100 mg/dl.

The final indicator of diabetes would measure 200 mg/dl  two hours after 75 grams of glucose has been given.

While these tests are fairly standard, there is a requirement for at least two separate tests that show these irregular levels. One should not modify their lifestyle on just one positive response.

Other numbers to evaluate may indicate the predisposition for diabetes and can offer opportunities that can either slow the progression of diabetes and many of its symptoms. The range one should become aware of would be 100 to 125 mg/dl while fasting or a casual (normal) range of 140 to 199 mg/l.  These results indicate a stage aptly called prediabetes.  Bear in mind that most individuals who exhibit these variances usually develop diabetes. There is no established time frame, however, 10 years may be typical. Those who suffer from prediabetes usually avoid the smaller blood vessel incidences of eye and nerve damages, they become more susceptible to strokes and heart attacks. The ADA website indicates at least 79 million Americans may have prediabetes.

Three types of diabetes

There are three distinct types of diabetes. These are:

Type 1 Diabetes: This is  also known as  juvenile or insulin dependent diabetes.  Typically Type 1 begins in young children. One common factor for most Type 1 diabetics is the degradation of the pancreas, the organ that promotes the creation and dispersal of insulin, a hormone that instructs the body to absorb glucose at a cellular level. Almost 10 percent of the American population or 25 million people have Type 1 diabetes.

Type 2 Diabetes:  Classified as adult-onset diabetes, this is no longer an apt description. As children exercise less, they gain more weight. This weight gain does not cause one to lose the ability to manufacture insulin; rather the ability of the body to absorb insulin is the problem (insulin resistance).

Gestational Diabetes: While similar to Type 2, gestational diabetes occurs when various hormones or chemicals in pregnant women conflict with each other. While the incidence of this type of diabetes is low (approximately 4% of all pregnancies), there is considerable concern for both mother and child. If left untreated, excessive glucose can be transmitted to the baby that may result in a larger fetus that may be more difficult to deliver. Additionally, when delivered this child is no longer being exposed to the higher glucose levels of the mother that may result in a severe glucose drop for the child. Typically those mothers who are older than 25 are at risk.

Variations of Diabetes:  Most individuals will suffer from one of the three main varieties of diabetes, there are distinct variations that exist.

• Latent autoimmune diabetes occurs in adults (LADA) which models both Type 1 and Type 2
• Beta Cell (the cell that makes insulin) genetic defects
• Medication contraindications from medicines that include cortisol or prednisone
• Pancreatitis or cystic fibrosis
• Other genetic factors

Complications of Diabetes

Not maintaining tight control on your diabetes within the normal range of 70 to 139 mg/dl after eating and under 100mg/dl fasting may affect your body with three phases of complications. These may be categorized by:  irritations, short-term complications, and long-long complications.

Irritations

While irritations are not life threatening, they do offer challenges to daily life. Even those these are minor occurrences they do need to be classified

• Fatigue
• Frequent Urination and thirst
• Blurred vision
• Genital itching
• Gum and urinary infections
• Cuts and bruises  are slow to heal

Short term complications

These complications are more serious events and may become life-threatening. Usually individuals with blood sugar levels in excess of 400 mg/dl show these symptoms:

Ketoacidosis: A Type 1 affliction associated with high blood acid levels resulting from the breakdown of fatty acids. With insufficient production of insulin, the body is unable to slow this process. Failure to treat ketoacidosis causes the patient sickness leading to death. Once fluid and insulin levels stabilize normalcy returns.

Hyperosmolar syndrome: Usually this is associated with elderly individuals. When the kidneys become unable to reduce glucose levels, dehydration can occur causing the blood to thicken. Often the blood takes on characteristics of syrup. Little insulin is needed to return the body to a normal state.

Hypoglycemia (low blood sugar): If an individual is insulin dependent (injection or pill) and fails to consume sufficient food or performs too much physical activity, glucose levels fall to under 70 mg/dl. These individuals manifest symptoms that may include excessive sweating, increased heart rate and pulse, hunger, loss of mental acuity, nervousness or anxiety, or possibly coma. If treated quickly enough through injection or oral glucose, usually permanent damage can be prevented.

Long term implications

If an individual fails to keep tight control over their diabetes and symptoms, long term complications may result. The time frame for these to develop is usually 10 years or more of failed interventions. Additionally, prediabetes and diabetes may present macro vascular complications prior to this time frame. Long term complications greatly reduce one’s quality of life. If left unchecked, the symptomology is hard to overcome. It therefore becomes important to watch for these potential symptoms after five years of your diabetes diagnosis.

These complications are classified as:

Micro vascular

• Diabetic retinopathy that leads to blindness if not corrected.
• Diabetic nephropathy leading to kidney failure if not corrected.
• Diabetic neuropathy that results in nerve damage that includes tingling and numbness in extremities. Loss of nerve sensitivity can lead to injuries that can be infected and may require amputation if not treated.

Macro vascular

• Arteriosclerotic heart disease is a blockage of blood vessels as a precursor to heart attack.
• Arteriosclerotic cerebrovascular disease creates blockages in the brain leading to strokes.
• Arteriosclerotic peripheral vascular disease typically affects the blood vessels of the legs and feet. This complication may lead to amputation of those extremeties.

It is important to understand these long-term complications result ONLY if you fail to maintain tight control of your glucose levels. It is recommended one should monitor both blood pressure, cholesterol and tri-glyceride levels.

You Should Take Prostate Cancer Seriously

Prostate cancer is cancer inside this small gland and is quite common. This cancer is treatable when caught early and is usually found during routine screening. Despite the excellent cure rate, men are particularly frightened of prostate cancer because they see it as a huge threat to their manhood. Many already feel uncomfortable with the screening procedure and are really reluctant to have biopsies and possible surgery.

Male hormones (androgens) can cause the prostate to grow, and many men develop benign enlargement of the prostate as they age. An enlarged prostate squeezes the urethra, vessels, and nerves and can cause symptoms similar to the symptoms of prostate cancer. Enlargement is a very common condition, but don’t assume prostate symptoms are just age-related prostate enlargement. The symptoms are so similar to prostate cancer that you should see your doctor to rule out cancer.

Understanding your risk

Prostate cancer is the most commonly diagnosed cancer, other than skin cancers, and the second leading cause of cancer death in American men. The good news, though, is that 90 percent of prostate cancers are diagnosed early, while still in the prostate (or close by) and carries a five-year survival rate for these men of nearly 100 percent.

While the exact cause of prostate cancer isn’t known, there are certain identifiable risks:

1. Age: Some clinicians feel that every male would develop prostate cancer if they lived long enough, but most men die of a different cause before this happens. It’s an interesting thought. Although many men are now being diagnosed as early as their 40s, the majority, about 65 percent, of diagnoses are made in men over age 65. Here’s the age breakdown:

• Under age 40: You have a 1 in 10,000 chance
• Ages 40 to 59: You have a 1 in 39 chance
• Ages 60 to 69: You have a 1 in 14 chance

1. Ethnicity: African-American men are nearly 60 percent more likely to develop prostate cancer than Caucasian men. They are also two and a half times more likely to die from the disease and are ranked with the highest percentage of prostate cancer cases in the world. Researchers haven’t been able to explain these racial differences.
2. Family history: Men with a single first-degree relative (think father, brother, or son) diagnosed with prostate cancer have a greater risk of developing prostate cancer. A man with a family history of two or more relatives with prostate cancer is four times more likely to develop the disease himself. The risk is highest in men whose family members were diagnosed before age 65.
3. Western-Hemisphere lifestyle: A diet high in calories from unhealthy fat, refined carbohydrates, and animal protein, coupled with low physical activity contributes to a variety of diseases, including cancer. The WHO specifically attributes the development of prostate cancer to this “Western lifestyle.”

Playing your part in prevention

In order to diagnose prostate cancer early, you need to do take an active part in your healthcare. Just as women should perform monthly self breast exams and receive mammograms starting at age 40, men need to start having these annual screening exams at age 40:

• Digital rectal exam (DRE): This rectal exam is administered by a doctor. The doctor inserts a lubricated, gloved finger into the rectum to check the prostate for lumps, nodules, or masses. The prostate should be smooth, uniform in shape, and symmetrical.
• Prostate-specific antigen (PSA): This test measures the level of PSA in the blood. PSA is an enzyme produced mostly by the prostate to liquefy semen and normally enters the bloodstream in small amounts.

When the two tests are done in conjunction with each other cancer detection is improved. Doing these tests singularly may increase the chances of a missed diagnosis in a cancer that already doesn’t produce many symptoms.

Recognizing the symptoms

The symptoms of prostate cancer are easily misinterpreted as other problems, so here are some of the most common signs and symptoms of prostate cancer:

• Rectal pressure or pain in the space between the anus and the scrotum
• Frequent or painful urination
• Frequent urination at night (nocturia)
• Difficulty getting the urine stream started
• Blood in the urine or ejaculate
• Painful ejaculation
• Loss of appetite and weight
• Bone pain caused from local cancer spread into the bones

Treating prostate cancer and considering the prospects

Your prostate cancer treatment options may involve surgery, radiation therapy, or hormone therapy. Discuss your best course of action with your doctor. Your doctor monitors your health closely for any changes in your symptoms, if you develop new symptoms, or if any worsen.

The survival stats for men with the cancer without having metastasized to other organs or tissues are as follows:

• 99 percent survive at least 5 years
• 92 percent survive at least 10 years
• 61 percent survive at least 15 years

Colorectal cancer

Colorectal cancer is located in the colon or in the rectum but is more commonly referred to as simply colon cancer. The colon is the first 4 to 5 feet of the large intestine while the rectum, the connector between the colon and the anus, is the last 5 to 6 inches. The areas are both extensions of each other and cancers in these areas are handled similarly. Colorectal cancer is the third most-common type of cancer in the world with 940,000 new cases diagnosed annually. In the U.S., colon cancer has the second highest mortality rate of all cancers, but many deaths can be prevented with proper screening and risk reduction.

Understanding your risk

There’s no single known risk factor for developing colon cancer, but rather a group of risk factors:

Polyps: Polyps are small, fleshy bumps or nodules attached to the wall of the colon or rectum, and they’re the biggest risk factor of colorectal cancer. Almost all cases of colorectal cancer develop from polyps. These bumps that aren’t removed may grow abnormally and eventually becoming malignant.

The process of going from a benign polyp to a malignant tumor can take several years. Many colon polyps are benign, but all polyps have the potential to become cancerous, some more aggressively than others. When cancer grows within a polyp, in time it can infiltrate the wall of the colon, spreading into blood vessels or lymph nodes. After metastasis has occurred the cure rate drops significantly, which is why detection and removal of polyps before they become cancerous are important.

Age: Over 90 percent of cases are diagnosed in people over the age of 50 with the average age at diagnosis around 70. Your chance of being diagnosed with colorectal cancer is 50 times higher if you’re age 60 to 79 than if you’re younger than age 40.

Family history: Colorectal cancer is more likely to occur among people with a first-degree relative (mother, father, sister, son) diagnosed with colorectal cancer, especially if the cancer was diagnosed at a young age. Between 2 and 5 percent of people with colorectal cancer inherit abnormal genes: One is called familial adenomatous polyposis (FAP) and the other hereditary nonpolyposis colorectal cancer (HNPCC). If you have one or more relatives diagnosed with colorectal cancer before the age of 50, consider having a blood test to determine if you have the gene mutation and then take the appropriate preventative measures.

• Chronic inflammatory bowel disease: People who suffer from Crohn’s disease  inflammatory condition of the gastrointestinal tract) or ulcerative colitis (inflammatory bowel disease) for at least eight to ten years have a higher risk of colorectal cancer. Constant inflammation of the colon can cause cell turnover and can also speed up the growth of polyps. Your doctor may suggest doing more frequent colonoscopies.

Playing your part in prevention

The incidence of colon cancer has gone down in the last 15 years due to the fact that, in many cases, colorectal cancer can be prevented by removing precancerous polyps. Early detection with regular exams after age 50 is the biggest factor in early detection and treatment of colorectal disease, but less than 50 percent of eligible people have been screened for colorectal cancer.

There are a few types of screenings you can have done to test for colorectal cancer

Digital rectal examination (DRE): This exam begins at age 40 (some doctors start at age 50) and continues annually. During a rectal exam, your doctor may be able to detect polyps in the rectum. If older than 50, at no time does this test replace the need for a colonoscopy.

Fecal occult blood test (FOBT): This screening starts at age 50 and continues annually. FOBT tests for hidden blood in three consecutive stool samples. As a doctor, Brent likes to have people start at age 40 because the test is simple, non-invasive, and helpful. This test is also helpful for people that are suspicious of blood in the stool but aren’t sure.

Double-contrast barium enema: This test consists of a series of X-rays of the colon and rectum after being given an enema containing barium dye and an injection of air into the bowel. This test isn’t done as frequently as colonoscopy because the barium enema isn’t as effective as the colonoscopy at detecting polyps smaller than a half an inch. But the barium enema is still an acceptable, low-cost alternative when a colonoscopy can’t be performed.

• Colonoscopy: A colonoscopy is an internal examination of the colon using a flexible lighted instrument called a colonoscope.