Scenario 3: You got comfortable, you fell asleep, you stayed asleep — mission accomplished. Your morning alarm goes off and now you just don’t feel rested. You’ve slept all night, but you’re still sleepy.

The above scenarios are common. But how well we sleep at night determines how well we feel and function the following day. It is vital not only to get a healthy amount of sleep, but to sleep well. With good sleep habits, we may be able to prevent some mental fogginess or the need for that morning pick-me-up, as well as avoid the mid-afternoon crash.

The first key to getting good sleep is finding out what works for you. This may require some experimenting on your part. There is no cure-all. We are all designed differently; therefore we all require different things.

It is equally important to find out how much sleep your body requires. Most research shows that the average adult needs 8 hours of sleep, but you may be able to function well with only six, while others may require 10.

Personally, even with some medically-based reasons for poor sleep, I have been able to improve matters by using some of the following tips and techniques:

1. Eating a healthy diet.

   Some of you may be wondering what eating well has to do with sleeping well. Well, as the saying goes, “you are what you eat.” Remember too that “what you eat may affect your sleep.” Avoid eating foods that may upset your stomach. No one likes stumbling to the bathroom in the dark; surely no one enjoys trying to sprint in the middle of the night, either. Avoid foods that may cause acid reflux or heartburn. Cut back on your liquids before bedtime to avoid these bathroom sprints as well.

   While you may enjoy a nice glass of wine with dinner, you may want to make that your last glass for the night. Alcohol may make you fall asleep quickly, but it also causes sleep disturbances and may have you looking at the clock in frustration mid-morning. If you’re hungry or must have a bedtime snack, choose something high in protein and low in sugar. Resist the urge for the midnight chocolate cake and go for a healthier choice such as peanut butter, a protein bar, or a glass of milk.

2. Creating a relaxing environment.

   Remember, this is specific to you and may take some experimenting. I have learned that creating a relaxing environment starts long before I get into bed. It is important to wind down before making your way to the bedroom.

   Find something stress-free and relaxing to do and try to make it your nightly routine. Your brain will soon pick up on this habit and start telling your body it’s time to go to bed.Next, find your comfort noise level. Some people enjoy background noise, while others prefer quiet. Then, find a comfortable temperature. There is nothing worse than waking up because you are too hot or too cold. Lastly, get comfortable.

3. Leaving your stress, worries, and wonderings at the door.

   If you’re like me, you may suffer from the “I can’t seem to turn my brain off” syndrome. I lay down and think I’m going to relax and find myself thinking of things I didn’t get done, making a to-do list for the next day, or wondering why certain colors don’t seem to match, or how animals got their names.

   I have found that this is where guided meditation and relaxation works for me. I have been fortunate enough to download a few on my phone and they seem to work. If you can’t download apps to your phone or another device, look for meditation CD’s. I have found some pretty good ones at the local library and those are always free. Even on the nights where I can’t quite meditate I may start to wonder “why does this guy’s voice sound so strange” and it still takes my mind off other things. Soon, I’m asleep.

If you wake up, don’t think about going back to sleep. I’m sure it sounds weird, but it works. I went through a period where I woke up every morning at 2:33 a.m. I would wake up and not even have to look at the clock because I already knew the time. This was later determined to be due to some hormonal issues, but it was frustrating nonetheless. I found myself looking at the clock and thinking “I have to go back to sleep.” I didn’t realize I was actually creating more anxiety for myself and making it more difficult to go back to sleep.

I’ve learned to go back to my guided meditations or to just lay and be aware of how my body is feeling. If I find that I absolutely cannot go back to sleep after 10-15 minutes I get up. Avoid stimulating activities or bright lights if possible. On nights like this I try to enjoy some warm tea, a light snack, then get back and bed and try to relax again.

Sleep disturbances can be caused by a variety of issues. If you try various techniques and still have frequent or persistent problems falling asleep or staying asleep you should seek medical attention. Sleep disturbances can be a symptom of an underlying medical condition.

Interruptions in sleep caused by loud snoring or pauses in breathing can be symptoms of sleep apnea. Sleep apnea is a treatable condition, but can be fatal. Falling asleep at inappropriate times could be a sign of narcolepsy or other disorder. You may also wish to contact your physician if you continue to wake up and do not feel rested, have strange body sensations or movements while lying down, experience sleep paralysis, frequent vivid dreams or sleep walking.

Again, there are no quick fixes for sleep issues. It takes some time and work to figure out what works best for you, but once you find a routine that works, stick with it. If you find that after some time it no longer works, change it up. Our bodies and their needs change, so we have to be ready to adapt. Here’s to happy sleeping!

This month we had the pleasure of talking to Christina Hibbert, PsyD, a clinical psychologist and expert in women’s emotional health across the lifespan; pregnancy and postpartum mental health; grief and loss; and parenting.

Hibbert is the founder of the Arizona Postpartum Wellness Coalition and author of the upcoming memoir This is How We Grow. A frequent speaker, she’s been called “The Singing Psychologist,” and often shares an original song or two when she speaks.

Hibbert is the mother of six energetic kids and has a private practice in Flagstaff, AZ. Get to know Christina Hibbert by visiting her website at www.drchristinahibbert.com.

1. What’s surprised you the most about being a therapist?
How similar we all are on the inside, despite how we appear on the outside. Deep down, we all just want acceptance and love.

2. What’s the latest and greatest book you’ve read related to mental health, psychology or psychotherapy?
My all-time favorite “greatest” book is Bonds That Make Us Free: Healing Our Relationships, Coming to Ourselves, by C. Terry Warner (I’ve read it 3 times!). Warner shows us how we “betray ourselves” in relationships by failing to act on impulses to do the “right” thing. Then, we end up fighting to protect our self-betrayal and this blocks out love.

For instance, if a dad hears his newborn cry and thinks “I should feed him so my wife can sleep,” but then falls asleep instead, he has betrayed himself. He then has to tell her all the “reasons why” he didn’t wake up (“I work all day, you know!”); she feels hurt, so does he, and the love has vanished. Understanding these principles has changed my world, and now it helps me change others’ worlds too!

3. What’s the biggest myth about therapy?
That the therapist is going to “fix” you. That’s not it at all. Therapy is a partnership, and when both parties do their part, change is the result. The therapist offers insights, suggestions, and tools, and the client implements them in his or her life. That’s what therapy is all about.

4. What seems to be the biggest obstacle for clients in therapy?
Implementing the insight gained from therapy into real life. One of the most common questions I get as a psychologist is: “What stops us (human beings) from making the change we know we need to make?”

And all I can say to that is that making change is tough business. But it’s also simpler than we think. It can take just an instant to choose to change — just an instant to make up your mind and do it.

Instead, we are our own worst enemies, standing in the way of the change we desire. My job is to not only help clients see and understand the need for change, but to help them “get out of their own way,” and let change happen.

5. What’s the most challenging part about being a therapist?
The emotional drain. It’s lovely to get to know clients on such a deep level — to be there with them in their most intimate moments. But it can take a lot out of you if you’re not careful.

I have to consciously choose to leave it all behind when I go home, and I have to set limits on how much I can give to clients so I still have enough to give to my family and myself. (For instance, at this time I only see clients one day a week. I spend the other days being a “stay-at-home-mom” while also blogging for my website and working on my upcoming book!)

6. What do you love about being a therapist?
The deep connection with clients. There’s nothing like feeling someone’s heart and helping them heal it. It bonds you for life. I also love being a psychologist for the opportunities it provides for other types of connections; through speaking, teaching, and writing I also connect with people. It’s wonderful to have a career with so many options.

7. What’s the best advice you can offer to readers on leading a meaningful life?
Make “space” to check in with yourself each day. Even 5-10 minutes to be still, meditate, ponder, or pray will make a huge difference in creating a meaningful life, for it will allow you to “unplug” and instead “tune in” to what really matters.

Ask yourself, “What matters most to me?” Then listen, and write it down. Compare everything you do each day to your list of “what matters most.” Pay attention to the things that do matter, and get rid of all that doesn’t. Repeat this process often, and your life will be full of love, joy, and meaning.

(Hibbert has written more on these topics in her posts “What Matters Most,” and “Joy is in the Moments: 3 Tips for Discovering & Appreciating the Joy in Life.”)

8. If you had your schooling and career choice to do all over again, would you choose the same professional path? If not, what would you do differently and why?
I would absolutely choose the same path. I love what I do. The only thing I might do differently is add a minor in music and songwriting. It’s a favorite hobby of mine I often incorporate into my talks and seminars, and I’d love to have more expertise in that area!

9. If there’s one thing you wished your clients or patients knew about treatment or mental illness, what would it be?
That’s there’s so much more to life than just “feeling better.” Many of us are simply hoping to overcome mental illness—to just “feel better.” But we’re shooting far too low. That’s why my tagline is “Overcoming, Becoming, Flourishing.”

I want everyone to know that life isn’t just about overcoming challenges—it’s about becoming who we’re meant to be and even living a life that’s flourishing!

Don’t settle for just “being better.” Keep with it until you’re “better than better”!

10. What do you do to cope with stress in your life?
I put myself to bed early as often as I can so I can be up early and feel rested the next day. I take an “hour of power” each morning, including exercise, meditation, prayer, and scripture study before getting the kids ready and out the door. This gets me centered and focused on what really matters for my day. I strive to give my family my full attention when I’m with them, so I’m very careful about taking on new projects that can’t be done in the few hours when everyone’s at school.

I take a little time each afternoon to rest, read, nap or relax before my kids get home and my “night shift” begins. I also know I need time alone to de-stress and I love to travel, so I try to get away for a night or two as often as I can (with six kids, leaving the house is often the only chance I get to just “be me”!).

I also take baths, walks, talk with my husband, and get a massage at least once a month. And music is a great stress-reliever! If I’m really needing help, I’ll sit down at the piano or guitar and write a new song or sing!

Yes, it’s September. Your children are back in school and it is time for my annual article urging parents to work toward creating a healthier and better-rounded education for their children.

In a recent three-week period, there were three newspaper articles underscoring how schools have increasingly become pressure cookers that may be harmful to your children. A few years ago, in the Boston Globe, there was an article about some local high schools trying to develop ways of reducing teen stress. I have reported in past columns about the epidemic of anxiety, depression, and eating disorders among high school students. Parents and high school staff, especially in affluent suburbs, have become obsessed with building resumes in order to get into the best possible colleges, even though the evidence continues to say that the college you go to is not a significant predictor of life success.

The Globe article described groups of parents and staff who are recognizing this and even report that college admissions offices are accepting some responsibility for this trend. The admissions staff are concerned about a rise in the number of new students who are arriving on campuses in poor physical and mental health. (Again, I have reported before about the epidemic of mental health problems among college students that are simply overwhelming the inadequately staffed college counseling centers.)

Small steps being taken by some schools include eliminating homework over vacations, eliminating mid-year exams, and adding yoga to phys ed. (Of course phys ed is disappearing from our schools!) I love the idea of yoga classes in high schools. There is an abundance of evidence that teaching some form of stress management is essential for reducing the negative impact of excessive stress. In turn, learning to manage stress is a critical component in developing problem-solving skills and boosting self-confidence.

Of course, some administrators see this as psychobabble and talk about asking more of their students rather than less. I think these administrators are more concerned with the ranking of their high schools than the needs of their students. In our country’s obsession with getting results now, we are turning high schools into junior colleges with an ever-increasing focus on having students taking honors and advanced placement courses. Meanwhile, high schools continue to ignore the plea by physicians that our teens are suffering from sleep deprivation, noting that high school schedules (early morning starts) ignore the changing sleep patterns of teens. Research has shown that students learn more when they have had a good night’s sleep and have eaten a reasonable breakfast and lunch. Such obvious needs are being ignored. And we trust our children’s welfare to these people?

On August 6th, a Boston Globe article reported that elementary school lunches are shrinking. In just the past two years, lunch periods, on average, have been reduced from 30 minutes to 24 minutes. That’s the lunch period. Subtract the time it takes to get to the cafeteria, assuming the students leave class exactly on time (which, reportedly is often not the case), and children generally have less than 20 minutes to eat. Much too rushed.

It’s not only about having time to eat. Lunch period is an important socializing time as well as a break from the rigors of the classroom. When you add to this, reports of shrinking recess as well, there is a clear pattern of schools increasing anxiety about statewide test scores and trying to cram more academics into the school day. The school day unfortunately has become increasingly focused on teaching to the tests and less on teachers being able to introduce creative curriculum.

If there really isn’t enough time in the school day to address all these needs, why not lengthen the school day? When did six hours become the golden rule? The best of our schools, highly rated private day schools, keep children all day and add mandatory participation in sports as well as providing increased access to teachers and smaller classes so education can be more individualized. No reason public schools can’t do this. Except for unions. Private school teachers do this for less pay and benefits. It shouldn’t be about the money. Most teachers spend hours at home correcting papers and planning classes. If they had a longer day at work, time could be made available for their “homework” to be done at school.

The distorted expectations just keep creeping downward. The pressure to achieve academically is increasingly dominating our model of education, ignoring the old saying about teaching the total child – cognitive, social and emotional aspects need to be balanced for a healthy life. Schools are failing our children by ignoring the social and emotional needs and parents have unfortunately become their accomplices in this process. In fact, parents are often the driving force.

Challenge: Uncontrollability

“Bipolar disorder can feel uncontrollable,” according to Sheri L. Johnson, Ph.D., professor of psychology at the University of California-Berkeley and director of the Cal Mania (CALM) Program. Symptoms, such as mood changes, can seem to appear suddenly and without provocation. And they can diminish daily functioning and ruin relationships, said Sheri Van Dijk, MSW, a psychotherapist and author of The DBT Skills Workbook for Bipolar Disorder.

Strategies: While bipolar disorder can seem unpredictable, there are often patterns and triggers you can watch out for. And even if you can’t prevent symptoms, you can minimize and manage them.

One way to monitor changes is to keep a mood chart, Van Dijk said. Depending on which chart you use, you can record everything from your mood to the number of hours you slept, your anxiety level, medication compliance and menstrual cycle, she said. (This is a good chart, she said.) For instance, you can anticipate a potential depressive episode if you see that your mood has been progressively sinking in the last few days, Van Dijk said.

Practicing healthy habits is an effective way to lessen the hold emotions have on you. Make it a priority to get enough sleep, going to bed at the same time and waking up at the same time, Van Dijk said. Create a calm bedtime routine, avoid substances such as alcohol – which disrupts sleep – and don’t exercise in the evenings, said Johnson, also co-author of Bipolar Disorder: A Guide for the Newly Diagnosed.

Sleep deprivation can trigger mania, and “it makes you more susceptible to being controlled by your emotions, such as irritability,” Van Dijk said. On the other hand, sleeping too much can cause lethargy and also reduce your ability to manage emotions, she said.

Exercise helps to reduce depressive symptoms. Eliminating caffeine can reduce irritability and anxiety and improve sleep, Van Dijk said. She suggested cutting out caffeine for two weeks and paying attention to any changes. Some people also find that certain foods exacerbate their mood swings. You can check by cutting out specific foods from your diet, and watching the results, she said.

You also can use a variety of strategies to stave off the negative consequences from your symptoms. For instance, if impulsive spending is a problem, gain control by having a low limit on your credit cards, Johnson said. When you’re experiencing early signs of mania, have someone else hold onto your checks and cards, Johnson said. If you do overspend, return your purchases, she said. You can even ask a friend to go with you, she added.

Challenge: Medication

“There is no ‘one size fits all’ medication that helps everyone with bipolar disorder,” Johnson said. Lithium is typically the first line of treatment. But for some people the side effects are especially troublesome, she said. Finding the right medication (or combination of medications) can seem like a daunting process.

Strategies: Learn as much as you can about mood-stabilizing medications, Johnson said, including their potential side effects. “Find a doctor who will work with you to make adjustments based on your experiences with the different medications,” she said. Expect that it might take several tries to figure out the best medications for you.

Many of the side effects dissipate after the first two weeks, Johnson said. Changing the dose schedule helps to minimize side effects. For instance, if you feel groggy, your doctor might suggest taking your medication in the evening, she said.

Support groups are another valuable tool, Johnson said. (She suggested looking at the Depression and Bipolar Support Alliance website for a group.) For instance, individuals in these groups are usually familiar with compassionate doctors in the area, she said.

Challenge: Relationships

Bipolar disorder is hard on relationships. The very symptoms – swinging moods, risky behaviors – often leave loved ones feeling confused, exhausted and like they’re walking on eggshells, Van Dijk said.

She also sees loved ones have difficulty distinguishing between the illness and the person. They might invalidate the person’s feelings and either blame everything on the illness or believe the person is making conscious choices when it is the illness.

Strategies: Bipolar disorder is difficult to understand, Van Dijk said. “Different affective episodes, [such as] depression versus hypomania, result in different symptoms, and one episode of depression or hypomania can be different from the next within the same person,” she said.

So it’s incredibly important for loved ones to get educated about the illness and how it functions. Individual therapy, family therapy and support groups can help. Refer loved ones to self-help resources and biographies or memoirs of people with bipolar disorder, Johnson said.

Getting a handle on your emotions also improves relationships, she said. Working on assertiveness is key, too, she said. Individuals with bipolar disorder tend to have a tough time being assertive. Therapy is a good place to learn assertiveness skills. But if you’d like to practice on your own, Van Dijk suggested using “I statements”: “ I feel _____ when you ______.” She gave the following example: “I feel scared and hurt when you threaten to leave me.”

Challenge: Anxiety

According to Johnson, about two-thirds of people with bipolar disorder also have a diagnosable anxiety disorder.

Strategies: Johnson stressed the importance of using relaxation techniques and not using avoidance behaviors. As Van Dijk explained, “the more you avoid things because of your anxiety, the more your anxiety will actually increase, because you never allow your brain to learn that there’s nothing to be anxious about.”

Psychotherapy is tremendously helpful for managing bipolar disorder and the above challenges. If you’ve been prescribed medication, never stop taking it abruptly – this boosts the risk for relapse – and communicate regularly with your doctor.

Below, Moss explains why understanding our dreams is so important, how we can explore our dreams, what to do if we don’t dream and much more.

Moss is the author of Dreaming the Soul Back Home, Active Dreaming, The Secret History of Dreaming, and numerous other books about dreaming, shamanism, and imagination. His fascination with the dream world began in his childhood in Australia.

During that time, he had three near-death experiences and first learned the ways of a traditional dreaming people through his friendship with Aborigines. Visit him online at www.mossdreams.com.

Q: How do you define a “dream”?

A: A dream is a wake-up call. It takes us beyond what we already know. Dreams are the language of the soul, and they are experiences of the soul.

There are “big” dreams and “little” dreams, of course. In big dreams, we go traveling and we may receive visitations. We travel across time – into the future and the past – and we travel to other dimensions of reality. This is reflected in the words for “dream” that are used by indigenous people who have retained strong dreaming traditions and respect for dreamers.

Among the Makiritare, a shamanic dreaming people of Venezuela, for example, the word for dream is “adekato,” which means “a journey of the soul.”

Q: On your website, you write “Dreaming isn’t just what happens during sleep; dreaming is waking up to sources of guidance, healing, and creativity beyond the reach of the everyday mind.” What do you mean by that?

A: Too often we go about in waking life in the condition of sleepwalkers, following schedules, trying to fit in with other people’s expectations and deadlines, out of touch with the deeper meaning of our lives.

Dreaming, we find our inner compass and the larger story of our lives, from which we can draw courage and clarity to make better choices when confronted with everyday challenges.

The wake-up call may come in a sleep dream. It may come in that liminal state of hypnagogia when we are drifting between sleep and waking; this is a marvelous space for creative discovery, when we can make connections that escape the ordinary mind, as I explain in my Secret History of Dreaming.

We may receive the wake-up call in the midst of everyday life, through the play of meaningful coincidence or a pop-up symbol from the world about us; navigating by synchronicity is the dreamer’s way of operating 24/7.

We can learn to travel into the dream world wide awake and conscious, in the way of the ancient shamans, as I teach people to do in my Active Dreaming approach. In this way, we can journey to places of healing and guidance in nonordinary reality and bring back gifts.

In my new book, Dreaming the Soul Back Home, I explain how we can develop the skills of lucid dream travel to find and bring home parts of our vital energy and identity that may have gone missing in life, so we can be whole and strong.

Q: Why is it important to analyze our dreams?

A: For starters:

• We solve problems in our sleep
• Dreams coach us for future challenges and opportunities
• Dreams show us what the body needs to stay well – and get well
• Dreams hold up a “magic mirror” to our current actions and attitudes, helping us to take an objective look at ourselves and make wiser choices
• Dreams are a creative studio where we develop new ideas – as inventors, scientists, writers and world-changers have always done.

Beyond all the above, dreams put us in touch with our BIGGER story and our larger purpose.

Q: What are the best ways that readers can start analyzing their dreams?

A: First, consider your feelings on waking. Those feelings will be your first and best guidance on the nature and meaning of the dream – whether it is negative or positive, literal or symbolic, urgent or important or trivial.

Then, do a reality check: Compare the contents of the dream with your waking life and compare the situation and behavior of your dream self with that or your everyday self. If you are running away from something in your dream, where may you be running away from something in regular life?

Ask, of any dream: Is it possible that any part of this could manifest in the future? Dreams are constantly rehearsing us for challenges and opportunities that lie ahead. If you feel that a dream may portend an unpleasant future event, you may be able to work with that dream to avoid that unwanted possible future.

A good game to play is to ask “What part of me?” is each of the characters and elements in a dream. However, we also want to remember that dreams are transpersonal as well as personal, so that your deceased grandmother in your dream (for example) may not only be a part of you that is like Grandma or carries her attitudes – but your actual grandmother making a visitation, which is the kind of thing that goes on very frequently in dreams.

Learn how to share dreams with a friend in a mutually helpful way. I have invented a simple four-step technique for doing this that I call the Lightning Dreamwork. We start by learning to tell our stories to each other simply and clearly. We ask each other a few essential questions (“Feelings?” “Could any of this happen in the future?”); then we offer mutually empowering feedback by saying, “If it were my dream, I would think about such-and-such.”

Finally, we encourage each other to take action to bring guidance and energy from the dream into regular life. I explain this technique in my book The Three “Only” Things.

Q: Is there such a thing as a right and wrong interpretation of one’s dreams?

A: What is always wrong is to tell anyone else what their dreams (or their lives) mean, or to let them do that to you. We must become authors of meaning for our dreams and our lives. In our efforts to understand our dreams we often get it “wrong” because the dream reflects a situation that hasn’t developed yet, and we fail to look carefully enough at how the dream may reflect something that is developing in our world but is not yet manifest.

We may also get it “wrong” by failing to discern whether a dream is literal, symbolic, or an experience of a separate reality.

Q: Many people say that they don’t dream, which probably means that they simply can’t remember their dreams. What can readers do to remember their dreams?

A: Before you go to bed, write down an intention for the night. Make sure your intention has some juice. Don’t make dream recall one more chore to fit in with all the others.

Ask to meet your dream lover, or go to Hawaii without paying for the plane ticket, or to have fun in the night and remember. Keep pen and paper (or a recorder) next to your bed so you are ready to record something when you wake up.

Record something whenever you wake up, even if it’s at 3 a.m. If you don’t remember a dream when you first wake up, laze in bed for a few minutes and see if something comes back. If you still don’t have a dream, write something down anyway: whatever is in your awareness, including feelings and physical sensations.

You are catching the residue of a dream even if the dream itself is gone. And as you do this, you are saying to the source of your dreams, “I’m listening. Talk to me.”

Don’t give up on fragments from your night dreams. The wispiest trace of a dream can be exciting to play with, and as you play with it you may find you are pulling back more of the previously forgotten dream.

Q: Anything else you’d like readers to know about analyzing their dreams?

A: Dreams require action. If we do not do something with our dreams, we will not dream well. The action might be as simple as Googling a funny word, as I did while doing this interview (see my blog post).

We might decide to wear the color red because we were flaunting it in the dream, or to get in touch with an old friend who showed up, or to avoid that road accident in a possible future previewed by a dream.

As we grow our practice as active dreamers, we may want to reenter a dream to resolve nightmare terrors, talk to a dream guide, go on with an adventure, or access sources of healing and guidance or reclaim a child self or a connection with the Greater Self.

Cyclothymia affects up to 1 percent of the population. However, at a hospital’s psychiatric department, it’s anywhere from 3 to 5 percent, according to Dr. Stephen B. Stokl, MD, Chief of Psychiatry at Southlake Regional Health Centre in Ontario.

Cyclothymia is marked by bouts of low-grade depression and hypomania, which includes elevated or irritable mood, decreased need for sleep and racing thoughts for at least four days. Adults are diagnosed after symptoms persist for two years. (Kids and teens are diagnosed after one year.) “Cyclothymia has an insidious onset that starts in late adolescence or early adulthood, and has a chronic nature,” Stokl said. It’s milder than bipolar I and bipolar II.

Most people never get treatment, according to John Preston, PsyD, professor at Alliant International University and author of three books on bipolar disorder, including Taking Charge of Bipolar Disorder. That’s because the depressions typically aren’t incapacitating, and people do feel OK for periods of time, he said. (But these periods don’t last longer than two months, which DSM-IV stipulates for the diagnosis.)

In other words, because symptoms tend to be less debilitating, people just don’t realize they have an illness, said Sheri Van Dijk, MSW, a psychotherapist and author of The DBT Skills Workbook for Bipolar Disorder. It’s usually loved ones who notice a problem, finding it hard to live with someone who has unstable moods, Preston said.

In fact, the toll on relationships can be dramatic. “Cyclothymia usually comes with a high morbidity in terms of breakdown in relationships both personal and at work,” Stokl said.

Also, if untreated, cyclothymia can get worse. “At least half of the people with cyclothymia, over a period of time, will start developing increasingly severe mood episodes,” and will be diagnosed with bipolar disorder, Preston said.

Diagnosing Cyclothymia

Diagnosing cyclothymia can be tricky. It may be misdiagnosed as bipolar NOS, bipolar II or borderline personality disorder, Van Dijk said. But individuals with bipolar II tend to struggle with more severe depression.

As Preston explained, there also are important differences between cyclothymia and borderline personality disorder. A person with borderline personality disorder may appear to be experiencing a hypomanic episode by acting upbeat and animated. But their elevated mood doesn’t last long and it always happens after becoming infatuated with someone new, he said. (Once the infatuation fades, they’re back to feeling dejected.)

The hallmark sign of hypomania is a decreased need for sleep, Preston said. People with hypomania only sleep for four or five hours. But they feel no fatigue, while those with borderline personality disorder become exhausted, he said.

Also, “People with borderline personality disorder are exquisitely sensitive to feeling rejected and abandoned,” he added.

The best way to diagnose cyclothymia – and bipolar disorders in general – is to get a comprehensive history of the person’s mood, which requires talking to both the person and a loved one who knows them very well, Preston said. Loved ones are usually better able to spot the mood changes, he said.

One of the perceived disadvantages is that the breastfeeding mother will get less sleep at night. This is an important and real concern. Sleep disruption is known to have a major impact on the mother’s ability to function during the daytime and is a risk factor for postpartum depression.

Postpartum women need to consider strategies — with their family and support partners — for ways to maximize their consolidated sleep. However, few scientific studies have addressed whether feeding methods really do affect the mother’s sleep. There are a handful of studies (mostly based on mother’s subjective report) that suggest that breastfed infants sleep longer and awaken less frequently during the night. But this does not tell us whether the mother’s sleep also differs.

Therefore, our goal with this study was to determine whether mothers’ sleep or daytime functioning differed based on whether she was exclusively breastfeeding, formula feeding, or using a combination of the two.

To accomplish this goal, my collaborators Dr. Heather Clawges (a pediatrician and lactation consultant), Ms. Eleanor Santy (an undergraduate research assistant) and I asked mothers to volunteer to wear a wristwatch-type device called an actigraph. The actigraph recorded the mothers’ movements, and told us when each mother was awake and asleep.

Every morning, within a short time after awakening, the mothers used a hand-held computer to tell us her perceptions of her sleep: how often she had awakened that night, how much total time she was awake during the night, and her sleep-quality score. During the day, whenever she fed her baby, the mother also used her hand-held computer to report her current level of sleepiness and fatigue.

The 80 women who participated in the study contributed this information for 15 continuous weeks, starting when their babies were one week old. A researcher visited the mother each week to give her a new wrist monitor and hand-held computer, but did not give her any sleep advice. It is also important to note that each woman was screened before the study started and was not eligible for the study if she had symptoms or a history of depression.

The results of this study were very straightforward: We did not find differences between women who had exclusively breastfed, exclusively formula fed, or used a combination of the two methods on any measure. In other words, feeding method made no difference in terms of objectively measured total sleep time, sleep efficiency (the ratio of sleep to wake during the night), or sleep fragmentation (the amount of sleep interruption during the night) as recorded by the wrist monitor. Nor were there any differences based on the mothers’ subjective reports of their number of nocturnal awakenings, total nocturnal wake time, or sleep quality. Finally, there were also no differences between groups on daytime levels of sleepiness or fatigue.

One sidenote is that we also asked the mothers who gave the nighttime feedings at each week. We were surprised to learn that not one single mother had help giving nighttime feedings, even if she was exclusively formula feeding! The contrast between our findings of no differences based on feeding methods and the previous studies showing that breastfed infants awaken more often at night is intriguing. Common sense would declare that if the infants awaken more often, then their mothers should, too. It is possible that despite their self reports, breastfeeding mothers awaken more often during the night to feed their infants but that they return to sleep more quickly or sleep during feedings, and consequently do not remember these awakenings. We cannot test this unequivocally because the wrist monitor is not sensitive enough to identify discrete awakenings.

Our speculation is that if breastfeeding mothers awaken more often at night, then breastfeeding itself may provide a form of compensation. In other words, breastfeeding mothers may return to sleep more quickly and not remember awakening. This could be because they are not exposed to as much ambient light or physical activity as would be required to prepare formula. It is also possible that breastfeeding mothers are sleeping during feedings. Researchers Qillin and Lee have previously reported that breastfeeding mothers who cosleep sleep more than both those who do not co-sleep and those that formula feed. The major limitation of our work was that we did not collect data about co-sleeping, which is very common in our society despite professional recommendations against doing so.

Breastfeeding may also have a soporific effect. Sanchez and colleagues have shown that nucleotides present in breast milk have both strong maternal circadian rhythms and appear to facilitate a “hypnotic action” in the infant. In addition, differences in circulating prolactin are suspected to have a primary role in sleep architecture differences between breast and formula feeding mothers. Prolactin shows a nocturnal peak, which is vital for milk production, and is usually associated with facilitation of sleep onset and the delta wave brain activity important for restorative sleep.

In sum, our study shows that choosing to formula feed does not equate to improved sleep for the mother. The risks of not breastfeeding should be weighed against the cumulative lack of evidence that breastfeeding has a negative impact on the mother’s sleep.

Breastfeeding photo available from Shutterstock

Q: Our 14-month-old son constantly awakens during the night and won’t stop crying unless we hold him for long periods of time. We have tried “following the book” and ignoring his cries but he just doesn’t stop and after 30-45 minutes plus, we just can’t take it anymore. It is affecting everyone’s sleep and the whole family is becoming irritable. Why does this happen? Any suggestions on how to stop it?

A: Infant Sleep Disturbance is so common that it has come to have its own official name and corresponding acronym (ISD). Most of the information I’m about to share with you came from a major research review article published late last year. Probably 20 to 30 percent of all infants will experience this problem of waking up after being asleep. Actually nearly all infants (through the first two years of life) wake up during the night. Infant sleep is apparently very different from that of older children and adults in that it has a high proportion of what is referred to as REM (rapid eye movement) sleep and this presents in short cycles. Infants frequently awaken at the end of the cycle, fuss a bit, and fall asleep again. Obviously, a significant number of infants fuss a whole lot more and don’t fall back to sleep within a reasonable period of time.

Many of these infants arrive with a temperament that predicts an increased likelihood of ISD. This seems to be especially true for high-activity infants as well as infants who are hypersensitive to sound or touch, highly irritable or moody, or seem poorly self-regulated (don’t easily establish eating and sleeping schedules). In many cultures, such fussy infants would simply be kept in the parents’ bed or bedroom until they became more settled. Our culture, with its fear of dependency and stress on autonomy, urges parents to push for the separation. If your infant is in this category, you may simply choose to ignore the advice of Western pediatrics and just share a bed with your baby. However, there are alternatives.

You tried “extinction,” i.e., ignoring the crying infant, which is the primary technique. It often works after just a few nights of simply letting the baby cry and not intervening. Three problems arise with this approach. One, some infants are incredibly resistant to being ignored, the crying intensifies and may go on for exceptionally long periods of time; two, some infants, after appearing to have resolved the problem, demonstrate something called “the post-extinction response burst,” i.e., the problem returns and is actually worse; third, many parents are just too uncomfortable with this approach and can’t carry it out effectively. By the way, research on the effects of using extinction has shown no negative outcomes; contrary to the fears of many parents, the children show improved demeanor and security.

In response to parental resistance to using extinction, researchers have come up with some alternatives that appear to be effective. Mostly they are just modifications of the basic approach. One is to re-enter the infant’s room every five minutes during the sleep disturbance, simply restore his/her sleeping position, say”goodnight,” and leave. Research demonstrated this to be effective in ending the ISD. Another study had a parent sleep in the infant’s room for a week but not interacting with the infant when the latter is crying. This also proved effective. Both of these studies were based on a belief that the ISD was symptomatic of the infant’s separation anxiety. These techniques are designed to increase the parent’s presence without creating extra attention that might prolong the problem.

A third form of modified extinction is to ignore the infant until you feel uncomfortable (even if it’s just 10-15 minutes in the beginning) and then, every second night, wait five minutes longer. When you go in to the infant’s room, once again the recommendation is a brief interaction, no more than 30 seconds, place the infant in the sleeping position, and leave. The emphasis in all these techniques is to try to avoid getting drawn into elaborate rituals of extended periods of physical contact and attention.

Naturally, if your infant has developed a sleep disturbance, you should always consult with your pediatrician before trying any of these techniques to make sure there is nothing medically wrong. Some physicians, especially with very severe cases, may recommend using a sedative, typically an antihistamine. The research shows very limited effectiveness of this approach with infants. In some cases there was short-term relief and then the problem returned. In others, it was successful; often it didn’t help very much, if at all.

The key points here are that sleep disturbances in infants are quite common, there are several techniques that can work, and just keep reminding yourself that this too shall pass!

Whether it’s your first or fourth child, your relationship still sees a jolt. As Marter said, “The first child most often brings about the greatest life and relationship change, but each subsequent child affects a couple almost exponentially, widening the scope of responsibilities and compounding family and relationship dynamics.”

Having children can bring couples closer. But it also can chip away at a relationship if you’re unprepared for the potential pitfalls. Take this surprising statistic: Within three years of their child’s birth, about 70 percent of couples experience a significant slump in their relationship quality, according to the Gottman Relationship Institute.

The key in keeping a relationship happy and fulfilling is knowing what these pitfalls are, having realistic expectations and staying committed to each other. Below are three of the most common pitfalls and pointers to help.

Pitfall 1: Sleep deprivation

Everyone knows that having kids is exhausting. But you might not fully appreciate the fatigue. According to Marter, “the chronic and cumulative nature of sleep deprivation during the newborn phase is perhaps one of the most commonly underestimated challenges of new parenthood.”

Sleep deprivation sinks your mood, makes it harder to cope effectively with stress and exacerbates mood swings and anxiety. And that’s just what it does to each person.

Lack of sleep strains the relationship in various ways: Couples may fight about who’s doing more and sleeping less. Because couples are extra agitated and stressed, they might squabble more in general. And the primary caregiver may feel unsupported and alone and eventually resent their spouse, Marter said.

Pointers: Sleep when your baby sleeps, Marter said. “This may mean letting the laundry or scrapbooks wait and forcing yourself to nap. It might mean going to bed at 8 p.m., so that you can sleep during your baby’s longest stretch.”

What if your baby isn’t really sleeping? Marter suggested working with your pediatrician and reading other resources such as Healthy Sleep Habits, Healthy Child by Dr. Marc Weissbluth. If feedings are the reason your family isn’t getting much sleep, she also suggested checking out the La Leche League, and figuring out a feeding schedule that works best.

Ask loved ones for support and, if it’s financially feasible, hire help for household chores, a babysitter so you can take daytime naps or a night nanny, Marter said.

And work as a team. For instance, moms who are breastfeeding can pump so their partners or loved ones take turns doing the feedings.

Pitfall 2: Lack of intimacy

Sexual intimacy declines after having a baby, and not surprisingly, this can negatively affect your relationship. “Because sexuality is intensely personal and sexual connection is a major component of romantic relationships, sexual dysfunction or disconnection can become a significant problem for many couples,” Marter said.

The decline happens for many reasons. Physicians typically suggest that women abstain from intercourse for 4 to 6 weeks after childbirth. Even after that time, “women may experience or fear pain from intercourse due to the effects of delivery, an episiotomy, perineal tearing, and/or vaginal dryness due to hormone fluctuations,” Marter said. Couples also experience a decline in desire because of busy schedules, body image issues, fatigue and other concerns.

Pointers: Expect that intimacy will decline after childbirth. This is normal considering the sleep deprivation, new responsibilities and need for the woman’s body to heal, Marter said. Avoid viewing lack of sex as rejection or a sign of trouble in your relationship.

Be close and intimate in other ways, such as kissing, touching, snuggling or spooning, Marter said. Make time to physically connect with each other. Staying home and watching a movie is one way, she said.

“Good sex requires good communication.” Marter suggested talking openly about your needs, preferences and fantasies with your partner. These are some questions she suggested raising: “What is good about [your sex life]? When was it the best and why? What do you each desire? What schedule seems to work best for you? What gets in the way of having more sex?”

Also, work on your emotional connection. For instance, “Create at least 20 minutes per day to connect and talk about things other than the responsibilities with household and baby,” Marter said.

Pitfall 3: Responsibilities

In Marter’s practice, the most prevalent problem for couples is division of labor. Resentments inevitably peak when one partner feels like they’re tackling more tasks and working harder. “They may compare and become competitive or defensive about their responsibilities, schedules or the pros and cons of their work or role,” she said.

They also might glorify each other’s positions, Marter said. A stay-at-home dad might think his wife’s day at work is filled with swanky business lunches, interesting projects and a quiet commute, while he’s dealing with temper tantrums and dirty diapers. His wife might imagine him playing, cuddling and connecting with their child, while she deals with a difficult boss, endless deadlines and concerns over job security. “Then, when an issue like who is going to do the laundry comes up, the misunderstandings have created an environment ripe for conflict,” she said.

One of the problems is that couples usually don’t have a plan for how they’re going to divvy up responsibilities. Marter finds that many couples make assumptions about who’ll do what — often based on how their parents did things — which typically leads to confusion and conflict.

Pointers: Map out what your routine and responsibilities will look like, Marter said. And make sure it’s fair to both partners. Again, couples get into trouble when responsibilities are vague. One of Marter’s clients wanted her husband to help out in the mornings, but the couple ended up bickering instead. “By sitting down and reviewing the mornings tasks, the husband was able to select several items that his wife agreed would be helpful for him to manage,” she said.

When you’re figuring out fairness, remember that a relationship requires give and take. “For example, the husband of a client who is a teacher really steps it up during her grading periods and she picks up the slack when he travels for work,” Marter said.

Also, lower your standards, and let some things go. Another client of Marter’s, who was super stressed and worn out, used to iron all her baby’s clothes. Of course, getting enough sleep supersedes ironing. “Focus on the big things and let the small stuff go,” Marter said.

“The transition to family is simultaneously joyous, miraculous and wondrous and one of the most challenging life experiences and opportunities for growth,” Marter said. It helps for couples to have realistic expectations about parenthood and their relationship and to remain committed to working as a team.

The book is divided into an introduction and four chapters, but there is no table of contents—likely, in my opinion, because Butler wants his reader to follow him through his story, step by step.  The introduction sets the stage for how the book operates overall: weaving seamlessly between intimate experience and observations of the larger human network. He gives us the encyclopedic definition of sleep as well as some insight into his own issues with sleep, beginning as a child suffering from sleep terrors.  Perhaps the most creative section of the book, though Butler’s creativity shines throughout, he mimics the way the mind falls asleep to end his introduction.  He meticulously takes us through a list of outside influences (lights and noises) as well as inside processes that loop through our mind as we begin to sleep.  He beautifully captures and intertwines both his large philosophical thoughts and trivial matter.

Butler then leads the reader on a path of the history, science and culture (if you will) of sleeplessness that only a true sufferer could shed light on. In the first chapter (his title chapter), he maintains his balance of personal, reflective thought and scientific fact. He explains the types of insomnia and most notably points out primary and secondary insomnia.  (Primary insomnia is caused by mental disorders or a medical condition and secondary insomnia is related to more extrinsic factors.)  He balances these facts with a personal twist and writes his own discovery that sleeplessness “seems a hypersensitivity to the condition of being alive.” This shows his acute attention to detail and his intimate knowledge of the life of an insomniac.

The second half of this chapter echoes and explains the way the brain “clings” to ideas as tiredness sets in—he calls this section “Uncontrollable Reflection” and comically includes footnotes throughout that allude to different tangents his mind took while writing the section. 

The second chapter gives a deep history of insomnia and theories on sleep in general.  He includes quotes and ideas from a range of people across history; almost everyone from Aristotle to Edison and beyond.  Again, he draws a parallel between history and his own personal experience,  explaining a recurring ‘dream’ he would have when he was awake for multiple nights and struggling with his insomnia.

Chapter three begins to get more desperate—similar to how a person may become more desperate for sleep as they watch the hours of the night pass by.  He explains here that he began eating large amounts of food in order to help himself fall asleep.  Unfortunately, he began gaining weight and realized that there was a large amount of scientific data to support the fact that as you increase your BMI, the quality of your sleep declines.  He describes his dreams again here and the pain and anger begin to surface in them. 

Then, in the last chapter, he falls into the inevitable feeling of acceptance, tinged with defeat and resignation.  He delves into both the scientific issues as well as his personal issues he has had with sleeping pills.  To conclude the book, he writes a type of dialogue with himself and seems to find that the solution (for him) is writing.  While he is not the type to preach, I believe this is a message he is sending to his fellow insomniacs.  Certainly, it is not a cure, but perhaps it can be a comfort and a way of coping.

I enjoyed the book overall, but was especially drawn to Butler’s writing. This book is covered with praise for another book of his, There Is No Year, and I plan on reading that soon because of how much I liked his voice.  Butler has an extremely creative mind and his descriptions are gorgeous.  He is also able to condense and explain research and historical fact in a way that is approachable and intriguing.  I do not suffer from insomnia, but do have a particular interest in sleep and dreams and so I found this book very satisfying.  I would encourage you to read the book entirely, as it will make his experimental and creative sections more approachable.  He often likes to lead his readers down a dream-like path, so don’t get startled if things begin to feel unreal; that is, I believe, his intention.  He seems to be playing with the state of insomnia itself, still very much awake, but constantly on the verge of dreams.

Nothing: A Portrait of Insomnia
By Blake Butler
Harper Perennial: October 11, 2011
Paperback, 336 pages
$14.99

Unlike most dream books and interpretations, here is a personalized look based not solely on science or esoteric belief systems but an integral whole of all available resources. This may sound like a daunting undertaking for the reader to embark upon and the beginning of the book does deal a lot with the various beginnings of dream interpretation, from Roberto Assagioli (1888-1974), the first Italian psychoanalyst, through Maslow, Freud and the psychic Edgar Cayce. But there is a purpose for laying the groundwork: The author borrows Maslow’s hierarchy of needs to give the reader a starting point.

After having defined what dreams may be (there are several ideas put forth) and their messages, Hudson advises reader to add their own interpretations to the ones she will offer. She provides various ways to “catch” them, decipher what they are telling you and work with these messages to enhance your life experience.

This is where the book diverges from a cookie-cutter version of dream interpretation and becomes a powerful tool for personal change. At first it would seem frightening to imagine being pushed out of the nest like this: after all, if you knew what your dreams meant, you wouldn’t need the book; right? But that is not really what Hudson is trying to accomplish here. She is, at once, giving you some direction and allowing you, who know more about your life than anyone does, to utilize your specific life experiences in the interpretation.

Hudson gives ample examples of other people’s dreams and many from the experts she discusses in the beginning of the book, which offers the reader a kind of map for their own dream deciphering. She cautions that dreams are seldom literal, as in the case of the man who awoke from a dream of his wife cheating on him, and then shot her dead. The woman was, indeed, faithful and the tragedy would have been averted without a literal translation. She postulates that “if the man who killed his wife thought of her as a personification of loyalty, then his dream might have been calling his own loyalty into question.” Dreams are about us, the people, places and things are most likely projections of our inner sub-personalities (Assagioli), personifications of our inner selves or deal in metaphor, etc. which is specific to each of our singular experiences.

This process is lengthy but thorough. At the end of each chapter, there are simple exercises to help put what you have learned into practice. One could start interpreting their dreams immediately. There are also those dreams that one wakes from with the meaning completely clear. This “immediate insight” often happens when “you still have a foot in dreamland.” I found this helpful, as I used to think that when I was in that half-waking/half-sleeping stage that I was manipulating the meaning that seemed so strong to me. It was simply a very clear thought that I should trust, as Hudson writes. The author also states that the “editing” that we sometimes do in that state is also valid: we are trying to change things, and that is what dreams often there for; to give us a road out of a stifling or dangerous situation, for example.

Later chapters go into more complex information retrieval and how to access it. As Hudson states “Dreams may be about a range of needs.” They also may be very simple. “Eat more spinach” would indicate that one should look at diet and health. Many of Edgar Cayce’s dream interpretations for others dealt with this issue. Some are even predictive of a future health problem. These “prodromal” dreams (ones that serve as precursors to later events) are trying to take care of you in this case.

The back of the book contains a comprehensive list of the possible components of dreams. You can also go through this list and add your own interpretation of “Father,” for instance. Each person will have a different experience of archetypes. If you had a loving parent and someone else had an abusive one, those associations will determine the dream’s message. I would say that you might want to do this in pencil — associations can change over time as we grow. Still, archetypal players and settings will have a firm standing in many cases.

Do not worry if you cannot find a suitable listing for, say, laundry attendant. You could use maid instead, if that resonates with you, or you can pick another that seems to hit close to your feeling about the person, place or thing.

Another strength of the book is that you can always flip back to a particular chapter and deepen your understanding of the material, thereby making a worthy tool even more helpful. The book is well indexed for your exploration. If you want to go further into the minds of the people who began it all and other dream interpretation offerings, there is a useful “Further Reading” section, as well.

In conclusion, our dreams can help us change our lives and grow. By following a few simple rules like “be sure to always look at both the literal and figurative meaning of definitions and suggestions” and to remember that everything in the dream is about some aspect of yourself, the reader can learn not only to interpret their dreams, but to direct them with the exercises and increased awareness won by repetition.

Into Your Dreams: Decipher Your Unique Dream Symbology To Transform Your Waking Life
By Janece O. Hudson, EdD
Adams Media: July 18, 2011
Paperback, 304 pages
$12.95

One of the first questions clinical psychologist Elvira Aletta, Ph.D, asks her depressed clients is about their appetite, sleep and movement. All three are “fundamental to our ability to function [normally]” and affect our energy levels, which directly affects our mood, said Dr. Aletta, the founder of Explore What’s Next, a comprehensive psychotherapy practice.

Some people unwittingly search in all the wrong places to perk up their energy. For instance, they might drink a whole lot of coffee, which increases energy temporarily but then causes a crash. Or they might attribute their fatigue to lack of sleep. But getting more sleep can backfire. According to Dr. Aletta, this notion is “a real trap, because you can end up sleeping 16 hours a day.” Below, she shares five effective ways readers can lift their energy levels.

1. Take it one step at a time.

Making changes when you’re in the depths of depression can seem overwhelming (and impossible), which only worsens your mood. This is why Dr. Aletta stressed the importance of taking small steps and creating feasible goals at your current state. Before creating any goals with her clients, she asks: “Where are you now?” and “What can we do to stretch that out so it’s achievable?”

If someone is so depressed that they stay in bed all day, a good goal for them is to get up and take a shower. For another person who’s also depressed but makes it to work, their goal might be to engage in one pleasurable activity per day. (An example is spending 10 minutes dancing while blasting favorite tunes.)

Also, remember that making a small stretch, as Dr. Aletta calls it, is a step in the right direction to overcoming depression. Some people berate themselves because taking a shower is a seemingly trivial target. But remember that it leads to another step, which leads to another step. All these steps are simply the building blocks to getting better.

2. Practice good sleep hygiene.

Sleep is essential for high energy levels, and getting too much or too little can dramatically affect how you feel. One of Dr. Aletta’s clients had terribly low energy and slept 12 hours a night. To top it off, she worked from 3 p.m. to 11 p.m., and went to bed at 2 a.m. To figure out an optimal sleep schedule, Dr. Aletta and her client counted back from the time she needed to be at work. They talked about a reasonable number of hours for her to have before and after work. This included sleeping from 2 a.m. to 9 a.m. The first week, not surprisingly, she felt groggy. But in the long run, this schedule improved her energy.

For more on sleep hygiene, check out these articles:

• 14 Strategies for Sleeping Better
• 12 Ways to Shut Off Your Brain Before Bedtime
• The First Line of Treatment for Insomnia That’ll Surprise You

3. Eat energy-rich foods.

Certain food groups help to sustain energy, while others, such as simple carbohydrates (think candy) create swift spikes in blood sugar and subsequently crash. “Our goal is to keep blood sugar going up and down in a gentle way,” Dr. Aletta said.

Foods that keep your energy up are complex carbs, including fruits, vegetables and whole grains, and proteins, the building blocks of cells. Dr. Aletta suggested thinking of protein as hardware and complex carbs as the fuel that propels this hardware.

Listening to your body and anticipating the signs of low blood sugar also helps. Dr. Aletta worked with a nurse whose hectic schedule gave her little time to sit down and eat a full meal. She experienced dramatic dips in her energy whenever she let hours go by without eating. She’d become irritable, be hard on herself and have trouble focusing. She learned to tune into her body and notice the early signs of her dips. She also started keeping snacks like granola bars in her locker to boost her blood sugar.

Dr. Aletta underscored that everyone is different and has different food preferences. For instance, one of her clients hated vegetables. So Dr. Aletta didn’t force the issue, and instead recommended that he take certain vitamins.

4. Move your body.

Many of Dr. Aletta’s clients say that they don’t have the energy to go to the gym. And she says to them: “No problem.” Movement isn’t about going to the gym. You don’t have to lift weights or run on the treadmill to gain the benefits of moving your body — unless that’s what you like.

Movement is any physical activity that you enjoy, such as walking your dog, dancing, swimming or playing tennis. Dr. Aletta helps her clients connect to those activities that bring them the most pleasure. One of her clients was so depressed that he forgot how much he loved riding his bike. He couldn’t even remember where he left it. He bought a new bike and began riding it in the park. At the end of their sessions, he was participating in long-distance races.

Movement isn’t only vital to get our hearts pumping and energy soaring, it’s also “a real gift we give to ourselves,” she said.

5. Identify and reduce other energy-zappers.

There are many other factors that can affect your energy levels, Dr. Aletta said. Medication is one culprit. Sometimes taking too many prescription drugs or a dose that’s too high for you can reduce your energy. Don’t hesitate to bring this up to your doctor. Technology also depletes energy. So limit the time you spend watching TV or using your computer or other devices.

And finally, try not to get hung up on the end result. Therese Borchard, author of the blog Beyond Blue and the book Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes, reminds herself and her readers to “’dance in the rain,’ because you can’t wait for the storm to be over to be productive, or else you may not be productive for a long time.” Instead, the key, she said, is to keep moving.

For most of us, dreams are a mystery. They make little sense — if we can recall them in the first place. Heck, some of us don’t even think we dream (hint: we do).

Here, psychotherapist Jeffrey Sumber, who studied global dream mythology at Harvard University and Jungian dream interpretation at the Jung Institute in Zurich, provides insight into some of the most common questions about dreams.

Does everyone dream?

A: While it is biologically the case that we all dream at some point in our sleep, there are those who adamantly claim they do not and have never before dreamed. It is true that there are those who have great difficulty remembering their dreams; however, this has more to do with other factors than simply “not” dreaming.

Some folks have resistance to facing the growth content offered by our unconscious through our dreams. Others simply do the work on a trickledown basis and prefer to grow at a much more subtle, drip, drip, drip basis. I believe that humans must dream as it is one of our body’s natural responses to stress, anxiety and fear.

Why do people have recurring dreams?

A: I believe we all have unique lessons to learn in our life and sometimes these lessons are lifelong. Recurring dreams tend to build upon a particular theme and typically change subtly as we grow into a different understanding of ourselves as well as the obstacles we face.

Careful scrutiny of the dream content tends to reveal tiny changes to the narrative we would at times like to believe is “exactly the same.” Recurring dreams can be a useful barometer for our own growth and development.

Pay attention to the nuances of your recurring dreams as these small changes can offer the greatest lessons.

What do nightmares mean?

A: Nightmares tend to suggest that we are needing to deal with something that generates fear in our self. They can also be a way to release these fears depending on how we respond to the dream itself.

If I have a terrible nightmare and I try to forget it as soon as I wake up because it was so traumatic, it is likely it will recur because I am not using the dream material to learn and grow. Nightmares are rarely prescriptive, meaning they are not signs that something bad will happen.

On the other hand, nightmares exist to shake us up so that we spring into action by confronting the root fear, addressing the anxiety, or finding a good therapist. ☺

Why do we have nightmares?

A: As I suggested, nightmares are a natural response to fear and anxiety and while they don’t feel very good in the moment, they are releasing pressure for our psyche to operate with less anxiety.

Nightmares are a call to action. Ask yourself: “What am I afraid of?” “What does this dream suggest about me right now?” “What can I do to learn more about the root fear that this nightmare reveals?”

Why is that our dreams rarely follow a logical pattern (e.g., familiar people take on different faces)?

A: Most of us do not think in linear patterns. If I did, then A+B will always = C, right? So, by that measure, if I am overweight and I can reduce excess body fat through diet and exercise, then I will automatically assume a rigorous detail of diet and exercise, correct? Not often the case!

This is largely due to the fact that the vast majority of humans think in abstract ways through nonlinear cycles. We like to believe we are logical beings; however, we spend most of our waking hours moving in illogical patterns.

Therefore, our dreams are a reflection of this unconscious splatter of thoughts and actions. If we were truly logical beings, we would move through life like robots and outside science fiction, robots don’t dream.

Can people control their dreams?

A: If you can control everything you do, say and think during your waking life then you have a great shot at controlling your dreams. There are, however, a number of people who have the ability to influence their dreams.

I can focus my thoughts and intentions surrounding my sleep to inject my consciousness with particular thoughts and ideas and therefore imprint my unconscious mind.

We can typically return to a favorable or curious dream from the past by lying in bed before sleep and replaying as much of the old dream as we remember. The key in this process, however, is to identify oneself with the feeling of the former dream and fall into a similar place before falling into sleep.

How often do we dream?

A: Most of us dream every night and most of us dream throughout our various sleep cycles; however, researchers have suggested that the most vivid and memorable dreams occur during the REM cycle.

What are common myths about dreaming?

A: The most common myth about dreaming is that some of us don’t dream. The next most common myth is that if I die in my sleep that I’ll never wake up. This death dream is more about our overall anxiety and confusion about death and less to do with any reality about dreaming.

When analyzing dreams, what should we pay attention to?

A: Always pay attention to how you are feeling before, during and after a significant dream. Also, take careful note of who are the main figures in a dream and ask yourself what your relationship with these figures are in the dream and outside of the dream.

Be careful when relying on dream books to interpret your own dreams as there are many misconceptions to be had with regard to the collective unconscious. Just because a dream book says that if you dream about a snake then you must be dealing with change or transformation it doesn’t necessarily mean that is exactly the reason you are dreaming about it tonight.

We have very personal associations and understandings with symbols in life and there are also some universal understandings to be had; however, they don’t always mesh.

For more on dream analysis, check out this article, where Sumber offers additional insight.

Sleep Problems in Children

“There are many sleep problems that are typical in children,” Dr. Silberman said, such as sleep talking or walking; confusional arousal (child is confused and disoriented); and sleep terrors (characterized by a blood-curdling scream and terrifying images).

The most important actions you can take are to “keep the bedroom very safe and free of sharp or harmful objects [and to] lock the windows and doors to the outside.” Also helpful is playing soft music or putting in a night-light, because this makes your child more aware of his or her surroundings. Sleep deprivation increases the risk for these problems, so make sure your child is getting enough sleep each night. This helps to decrease or prevent such problems.

To help with sleep terrors, in addition to ensuring your child isn’t sleep-deprived, “calmly bring them into their room.”

Signs Your Child Is Sleep-Deprived

Parents have to be very conscious of the cues that kids are giving them,” Silberman said, since they’re unable to verbalize that they’re sleepy.

Interestingly, the signs that kids are sleep-deprived are completely different from adults. Adults get sleepy, but kids “tend to be more hyper, inattentive, irritated and annoyed.” In fact, Silberman said that a lot has been written about sleep deprivation being mistaken for ADHD.

Also, pay attention to changes in your child. Are your kids participating in school and other activities as usual? Are they dragging?

If your child is showing these symptoms, consider what’s possibly causing it. For instance, “Does it happen on the weekend when they stay up late with you watching a movie?” Silberman said. Also, if these symptoms occur in combination with sleep apnea, see a specialist. The same goes for snoring, since kids shouldn’t snore.

Sleep-Promoting Suggestions for Children

1. Create a bedtime routine.

As with adults, setting up a bedtime routine helps get kids into sleep mode, Silberman said. This includes eliminating arousing activities from the routine and adopting relaxing ones. Make sure kids don’t participate in physical activities too close to bedtime or eat sugary foods. Calming activities include reading, taking a bath, drinking milk and giving hugs and kisses. “Our bodies need those types of signals [when] winding down time.” If your child is old enough, ask them what sleep-promoting activities they prefer.

As much as possible, try to keep the same activities as part of your routine every night, since again, this lets your little one know that it’s time for bed. Going to dinner or on vacation? Silberman emphasized that there’s no need for parents to stress about this. If you can, try to work around outings. For instance, if you’re at someone’s house for dinner, bring your child’s pjs with you and put them on there. Once they get home, they know it’s close to bedtime.

2. Keep a consistent sleep schedule.

For good sleep hygiene, a consistent sleep and wake cycle is important. As parents know, kids thrive on routines. (Adults do, too.) For instance, going to see a movie together? If you have the option, see an earlier showing.

3. Stick with it.

Kids tend to stall before bedtime. They want you to read them just one more book, give them one more hug and kiss and get them another glass of water, Silberman said. They’ll try to press to get their way.

For working parents, it can be especially hard to enforce bedtime. “They haven’t seen their kids during the day and just have a few hours at night [with them].” Many can feel a bit of guilt. But you “shouldn’t feel guilty about emphasizing good sleep habits in kids.” Children “who sleep better do better in school and have a better mood.”

So don’t allow stall tactics to become their own routine. Set limits with your kids in a “kind and calming way.”

4. Get everyone involved in the routine.

Have everyone in the house get ready for bed together, especially if you have young children, she said. You can dim the lights, get into your pjs and brush your teeth together. One of the reasons why kids like to stay up is because they “feel like they’re going to miss something.” “Show them it’s dark outside, there’s nothing to do now” and everyone is sleeping.

5. Don’t use sleep as a punishment.

Parents never want to create an association between a child’s bad behavior and bedtime (e.g., “If you don’t do this, you’re going to bed”). Instead, sleep should be viewed as a positive priority.

For instance, Silberman suggested saying: “Everybody needs sleep; it’s how we grow big and strong; you’ll have a fun day tomorrow because you’ll feel rested; sleep is important for your brain to work.”

6. Don’t get in bed with your child.

Some parents have a tendency to lie down in bed with their kids to help them fall asleep. But this is “teaching your child that they need you [and] can’t fall asleep without you.” She added, “What happens when you’re not there?”

7. Teach your kids to self-soothe.

It’s important for kids to learn to fall asleep on their own. For instance, parents should put a child to bed when they’re calm and seem “sleepy and happy, instead of waiting until they fall asleep on you. You can sing to them while they’re in their crib, and then gradually leave the room.”

8. Give them a transitional object.

What also helps kids self-soothe is to have a transitional object, such as a stuffed animal or blanket. This can be any object that’s comforting to your child. This way, again, parents don’t have to be there in order for their kids to fall asleep.

To learn more about sleep specialist and clinical psychologist Stephanie Silberman, Ph.D, and her work, please visit her website.

Below, Stephanie Silberman, Ph.D, clinical psychologist, sleep specialist and author of The Insomnia Workbook: A Comprehensive Guide to Getting the Sleep You Need, offers her tips.

1. Be aware that teens naturally experience a shift in their circadian rhythms.

Because of this natural shift, Dr. Silberman said, teens don’t get sleepy until much later at night. This sets off a cycle: Teens go to bed late and sleep in later the next day.

2. Help them create a bedtime routine.

Just as a calming bedtime routine is essential for adults, it’s also vital for teens. Not only does the shift in circadian rhythms leave teens sleep-deprived but their habits also can sabotage sleep.

Technology is a big culprit. TV, computers and even cell phones emit bright light, which stimulates their brains. So this combined with the natural shift in circadian rhythms leads to sleep deprivation. As such, have your teen limit their technology use.

Also, help them select relaxing activities that they enjoy as part of their routine. (Good options are reading, taking a bath or a warm shower or meditating or praying.) This will become a signal to their brain that it’s time for bed.

Other sleep-stealers include exercising too close to bedtime and consuming caffeine-filled foods or drinks.

3. Wear sunglasses.

Again, bright light is activating. “If your teen has difficulty winding down at night, have them wear sunglasses” in the afternoon and into the evening, Silberman said. Alternately, your teen can use light to help them wake up in the morning (such as opening the shades right away).

4. Get them out of their rooms.

Teens “tend to hibernate in their rooms,” Silberman said. But this can hinder slumber, because one’s bed should only be used for sleep. This helps create the association between your bed and sleep. If a teen is playing video games, studying, eating and doing anything else on their bed, this confuses this connection.

5. Avoid sleeping in on weekends.

This one might be tough to implement but the later your teen wakes up on the weekend, the later they’ll fall asleep at night — which throws their during-the-week schedule out of whack. Encourage them to keep a consistent sleep and wake cycle every day. Consistency is key for good sleep.

6. Talk to them about sleep.

Have a conversation with your child about the natural shift in their rhythm, Silberman said. Also, talk about why sleep is important and should be a priority, she added.

Numerous studies have shown that not getting enough sleep can negatively affect school performance and impair cognitive function. Sleep deprivation can even be potentially dangerous if your teen drives to school in the morning, she said.

7. Assess their sleeping.

While teens need more sleep, there’s no magic number. As with adults, teens vary in the number of hours they need compared with their peers.

One simple way to assess this is to see what time they naturally go to bed and wake up during the weekend, Silberman said. Then calculate the number of hours they slept. For instance, if they fell asleep at midnight and naturally woke up at 10 a.m., that means they need 10 hours of sleep and should aim for that number every night.

The National Foundation of Sleep has more pointers for parents to help their teens sleep well.

To learn more about sleep specialist and clinical psychologist Stephanie Silberman, Ph.D, and her work, please visit her website.