Emotional Support Animals vs. Service Animals… It’s important to know the difference…

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The Difference Between an Emotional Support Animal (ESA) and a Service Animal

I’m writing about this topic today because its a question that comes up fairly often. And its very important, and in some circumstances, is a crime, not to know the difference.

A Service Animal and an Emotional Support Animal are two completely different beasts (haha), and as such, they have different rights and privileges.

So what is the difference between an ESA and a Service Animal? A Service Animal has many more rights and privileges than an ESA. They are specifically trained to help an individual with a specific disability.  Service Animals have special and extensive training (in many cases, years worth) specifically to address certain conditions such as epilepsy, sight, etc. These highly trained and specialized animals are certified as support animals and are authorized to go in most public spaces with their human companions, among other things.

Alternately, An ESA can be ANY kind of pet that is used specifically to address an individuals legitimate emotional needs (for example, anxiety or depression). ESA’s help the individual to feel safe and secure, and foster a sense of well-being for the individual. As such, they don’t require special training and are often “just a pet.” An ESA does not have as many rights or privileges as a Service Animal, for example, they don’t have to be allowed in many public spaces such as restaurants or stores, but they can be allowed in housing and modes of travel that usually don’t allow pets (when traveling with your ESA you should call ahead to find out about special requirements).

It is important to know the laws in your specific state and county regarding ESA’s.

In California, in order to call an animal an ESA, you must have a letter of prescription from your doctor. It is illegal to misrepresent your pet as an ESA. I am willing to write letters of prescription for my clients as long as I feel that an ESA will benefit their specific need.  For example, I do find (as does research on the topic) that an ESA can be really effective in the treatment of certain mood disorders.

That being said, it is important to know that it is a serious crime to represent your pet as an ESA or Service animal if it is not. And it is also a serious crime to represent your ESA as a service animal if it has not been trained and certified as such, because it is not.

ESA’s as well as Service Animals are both supported by the American’s with Disabilities Act and the Fair Housing Act. Here are a few useful links if you want to learn more:

 

ADA National Network – Service Animal Handbook

Michigan State University Animal Law – Q & A

Bazelon Center for Mental Health Law – Fair Housing Sheet #6

 

The Importance of Sleep

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Today I’m writing about a topic that is currently near and dear to my heart: the importance of sleep.  I didn’t learn the value of getting a good night’s sleep until I was in graduate school, but since then, I’ve made a point of trying to get my nightly eight.  Unfortunately however, as a mother of a 2.5 month old, it’s pretty much a given that I am at this point, nowhere near that.

The difference is astounding.

The topic of sleep has become more relevant in the recent years, as people are recognizing correlations between sleep deprivation and a number of physical and mental health issues, including (but not limited to); lowered immune system, increased mood disorders such as depression, obesity, hypertension, difficulties with attention and concentration,  and reduced quality of life, among others.

As interest and research on this topic has spiked, so too have the “internet facts.” You know, the little snippets of information, maybe actual fact, maybe based loosely on some obscure research, or maybe entirely made up. At a glance, it’s hard to tell.  For example, you’ve probably heard that “sleep deprivation is like being drunk.” There’s actually truth to that. It has been found that lack of sleep can produce both cognitive and motor impairment very similar to being inebriated.

There’s also truth to the fact that prolonged periods of lack of sleep can lead to hallucinations and even death, along with a variety of other symptoms (you’ve probably heard the saying “without sleep, first we go crazy and then we die”).  This research was based on individuals who were kept awake for a protracted amount of time. For most of us, however, it’s not that clear cut – four hours of sleep here, five hours there…. We’re not going to go crazy, and we’re certainly not going to die. Are we really sleep deprived? Or are we just chronically “tired?”

According to a number of sources, at any given time, between 33% and 40% of American’s are sleep deprived (and as a new mother, I’m currently one of them). The CDC (Center for Disease Control) has even recognized insufficient sleep as a public health problem.

In thinking about this topic today, I recognize that through insufficient sleep, I’ve become my own study of one, which, in a way, has been quite enlightening. Going on 2.5 months (and even longer if you consider the sleep difficulties that come along with pregnancy) of disturbed and insufficient sleep, like mothers everywhere, my sleep deprivation has become a chronic issue.

And I’ve begun to feel it. As a psychologist and a neuropsychological assessment specialist, I have a pretty good understanding of the brain and its cognitive processes, as well as the mind-body connection, so I’ve been able to recognize some symptoms as I see them popping up in myself.  And one of the top ones so far has been problems with word-finding. The word is on the “tip of my tongue,” but my brain just cant seem to access it. In thinking about this, I’m reminded that difficulty with verbal acuity is a symptom in quite a few neurocognitive and emotional issues; dementia, traumatic brain injury, learning difference and depression, to name only a few.

Another symptom I’ve noticed is difficulty with memory. While memory itself is still intact, I find myself “forgetting” more often. It’s not a loss of data, but rather a seeming difficulty with spontaneous retrieval. For example, forgetting that an appointment time has been moved. Once reminded, however, the information is there.  This also ties into a third symptom – cognitive dullness. Basically, just not feeling as sharp as usual… The information is there, it may just take a bit longer to retrieve it than usual. To cope with this short-term issue, writing down everything has become a strategy. And I can’t help but think, that symptoms are also symptoms of other psychological and cognitive-based issues; depression, brain injury, dementia, and so on…

And then there are the emotional symptoms that come along with sleep deprivation. While I’m lucky that I did not experience postpartum depression like many other new mothers, an elevation in moodiness is now not rare, particularly in the evenings (those of you who read my post on jellybeans may understand why time of day makes a difference), and as such, there’s also an elevation in the use of coping tools (such as the need to be excessively organized, which in turn helps with the memory issues). Nerves seem to be tied to a “hair trigger” that can make one more prone to anger and anxiety.  Mood fluctuations like these can give a greater understanding of what it might feel like to have a bipolar disorder, and also inspires more appreciation of the description of feeling of a  “Jekyll and Hyde” moment that I’ve heard about from some of my clients who experience a bipolar episode. In the mornings things are solid, but towards evening, if one is not careful, anxiety and reactivity could become transformative.

But these symptoms, they all make sense. Higher-functioning organisms need sleep to survive. But not just for survival, we also need sleep to function optimally. Sleep is the time when our brain most effectively consolidates information, “takes out the trash,” and makes new neuronal connections (incidentally, it is also the time when the body most efficiently heals itself). This is why sleep is important to babies (and why they do so much of it). Their brains (and bodies) are growing and developing at such a rapid rate.

And for those of you wondering about the connection between sleep and obesity…This makes sense for a number of reasons. I certainly feel less inclined to exercise when tired, and I’m sure I’m not alone in that. But it’s not just the lack of physical energy. When you’re feeling run down your body craves instant energy – sugar/carbs.  To make a long explanation short, carbs increase the release of the neurotransmitter serotonin. Serotonin helps to regulate mood (which is why we want to eat carbs when we are feeling sad or stressed), and it also helps to regulate the sleep/wake cycle. If your body feels deprived of a resource, it will automatically crave that resource – in this case, Serotonin, or… one of the easiest ways to release more of this neurotransmitter, the consumption of carbohydrates. On top of that, when you’re run down, or not operating at peak cognitive efficiency, you tend make poor choices, meaning that you are less likely to choose the healthy food option.  All a recipe for obesity.

Cognitive dullness, compromised immune systems, obesity, memory issues, word-finding struggles, mood-related symptoms, attention and concentration difficulties, among a host of other issues…  Loss of sleep makes us more vulnerable to all of these things.  As an assessor, I am frequently struck by how significantly sleep can impact an individual’s functioning, illustrated in a quantitative manner by test results, but also seen qualitatively by the manner in which these sleep-deprived individuals approach that testing and through the symptoms they report.

One of the first questions I ask my clients is about their sleep habits. I’m curious to know if a chronic lack of sleep may be contributing to, or even causing potential symptoms. This is also particularly relevant in children. Children need more sleep than adults, a fact of which many parents are unaware. Could your child’s emotional dysregulation be due to the fact that they aren’t getting enough sleep?

The National Sleep Foundation has an extensive age-based list of recommendations for required hours of sleep nightly that allows for optimal functioning. The NSF is a great resource as you can also find educational information (for example, this video on what the brain does during sleep, information on sleep hygiene, and resources to help you find sleep professionals.

Sleep deprivation is cumulative, and sleep cannot be “made up.” A chronic lack of sleep can have long-term permanent damaging side-effects on both physical and mental health and well-being. One of the most important things you can do for yourself is to make sure you are getting enough sleep so that you can function as the optimal YOU.

If you are suffering from any of the symptoms mentioned above, its important to consult a health professional such as your primary care provider for assistance and resources.

On Resources and Jellybeans…

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I’ve been seeing a lot of posts and articles claiming that more successful people make less “little choices” throughout their day. For example, an article came up on Facebook recently about the woman who wears the same exact outfit every day for work, effectively eliminating the forced decision of “what do I wear to work today?”  Or the article about the CEO who eats the same exact breakfast and lunch every day, so that he does not have to include these decisions on his list of things to do for that day.

Yes, eliminating these smaller decisions from your day to day reality really does work, but what I don’t see is explanation as to why this works. Yes it’s true that eliminating smaller choices leaves more room for larger choices, but, why does this matter?

So, I talk to people a lot about Jellybeans….

Consider that Jellybeans are a metaphor for the internal resources that you use throughout your day. A person only starts the day with a limited number of resources, or jellybeans, and once they are used up, or once the jar is empty, well… you have no more jellybeans, and therefore, no more resources.

To further flesh out this analogy… consider that every choice or decision you make throughout the day (and no, choice and decision are not the same things, but that’s a different blog for a different day)… as I was saying, every choice or decision that you make throughout the day uses up a jellybean.

So you wake up in the morning, feeing refreshed and ready to start the day. You have a full jar of jelly beans. But as soon as you wake up, you start taking jellybeans from that jar. In some cases even before you get out of bed. You ask yourself…

“Do I have breakfast first, or go to the gym?”  – deduct one jellybean…

“What do I wear?” – deduct one jellybean… “What do I have for breakfast?” – deduct one jellybean…  “When do I have to leave for work to make it there on time?” – deduct one jellybean… “How do I do my hair?” – another jellybean… “What jewelry do I wear?” –of course, another jellybean.

Say you started with a jar full of 100 jellybeans.  But now before you are even out of the house you are down 6 jellybeans…. Not an auspicious way to start your day, but not too shabby either…

Or maybe you’re like a majority of us who DON’T wake up in the morning feeling refreshed…  Perhaps you only got five hours of sleep, or have to finish a big paper before you head off to class (at 9am). Or maybe you have to drop the kids off at the carpool, before dropping your partner off at work, before heading to the bus, and you’re already running 10 minutes late… You get the idea.

As you can probably tell, some of these strains on your resources are a lot greater than just deciding what to wear to work.   And bigger stressors of course take more jellybeans.  It is important to understand that every choice or decision you make throughout the day, no matter how banal, is a potential stress point – which is why all choices and decisions consume resources.

So in the example above, perhaps finishing that paper takes 10 jellybeans, or the daily morning commute with spouse and kids takes 20. Well my friend, you may already be down 20-30 jellybeans, and you haven’t even made it to work!

So what DOES happen to our jellybeans at work?  Well, you know that coworker that won’t stop talking to you so that you can actually get some work done (or maybe you ARE that coworker)? That project that was due yesterday? The endless meetings? Whether to use the elevator or take the stairs? …All of these things take jellybeans.

If you’re one of the lucky ones, at the end of the day you may have some jellybeans left.

Or like many of us, your jellybean jar may be empty.

So what happens when you get home and your jar is completely empty? The kids still want attention, dinner still has to be made, your partner wants some romance…. All things that take jellybeans.

When our jellybean jar is empty, or, as the metaphor implies, we are completely out of resources, we start trying to pull resources from other areas that don’t have them to spare, which in turn, further depletes us. We get moody and grumpy, lash out, and don’t make good decisions. Ever wonder why you or someone you love becomes “a different person” some evenings?

But it doesn’t just happen in the evening – you can run out of jellybeans at any time of day. For example, some people may hit their low in the morning and then rebuild their reserves throughout the day.  Or others may have ups and downs throughout the day (the good news is, you can put those jellybeans back throughout the day! But more about that later…).

First, let’s talk about jellybean deficiency.  We started this analogy assuming that everyone wakes up with a full jar of jellybeans every morning.  This is not always the case. For some, it is never the case.

Ever notice how you feel so much better after a nap? Babies take them, the elderly take them, college students… but for the average adult, a nap is a pipe dream made of unicorns and cool-whip clouds. It just doesn’t happen for the majority of us.

Which is unfortunate, as sleep is one of the most important jellybean replinishers. 7-9 hours usually set us right – but if you are one of the many chronically sleep-deprived humans on this planet who only get about 4-5 hours of sleep on average per night, good luck with adequately replenishing your jellybeans.

Getting enough sleep is one of the most important gifts we can give ourselves. It is during sleep that our bodies and minds repair themselves most efficiently.  Your mind processes information throughout the day, gets rid of what it doesn’t need, consolidates more efficiently what it does, etc…etc… (but again, a different subject for a different day).

The bottom line is if you are getting only 5 hours of sleep a night, you may be waking up with a jelly bean jar that is only half full, if that.  Which means that you are likely going to run out of resources a lot faster than someone else who regularly gets enough sleep, might.

Of course there are many problems that come along with having a chronic jellybean deficit. Mood disorders, depression, anxiety… essentially, having less resources means that you are less resilient, and therefore, more susceptible to a number of stress and health-related issues.

Now, I’ve been talking a lot about the external stressors that consume our jellybeans – work, family, friends, etc. But what about the internal stressors?

Actually, internal stressors are one of our biggest jellybean consumers. For example, let’s talk about negative self-talk for a minute. You know, those ruminative negative thoughts that we  have about ourselves that try to make us believe that we are not as good as others, not as smart, etc… that jerk on our shoulder whose only joy is to make us feel bad about ourselves? No matter how many handfuls of jellybeans you throw at him, he just won’t go away?  Well say goodbye to your jellybeans, because for some people, he may be eating them faster than you can produce them.

Let’s take depression for example. For a depressed individual, these internal stressors are persistent and constant, and as such, are a great consumer of resources.  Now sources say that at any given time, 20% of the population has some form of depression. That’s a huge number of people walking around on any given day in a jellybean crisis.

Now, will having more jellybeans cure depression? For some people perhaps it might help, for others, not so much. But having more resources is only ever a good thing when taking in mental health terms.

So the question is, how do we bring more jellybeans into our lives? We’ve already talked about sleep, which is a big one. Now that we know where our jellybeans go, eliminating the smaller decisions can also be a good idea. Coming back to the woman who wears the same outfit every day to work, well that’s 5 less jellybeans she’s losing a week. And over the course of a year, she’s saving herself 260 jellybeans.  And when we consider matching jewelry and shoe choices, well that number could triple!

I know it’s not practical (or desirable) for everyone to wear the same outfit every day.  I sure wouldn’t want to do it myself. I love my clothes and I’m not giving them up. So what else can we do to preserve our jellybeans?

The first step is trying to figure out where your jellybeans actually go throughout the day. Are there some things in your life that are taking more jellybeans than others? Is there a time or situation in the day where you’re just upending your jar right out the window? Are you pelting your coworkers with handfuls of jellybeans for whatever reason?

Once you’ve determined where your jellybeans are going, it’s time to decide what you can do about it. How can you keep more of your jellybeans in the jar throughout the day? Where can you cut back on needless expenditures? Can you put a “do not disturb” sign on our door to keep out those pesky coworkers? Can you order food in advance to eliminate the last minute decision of where to have lunch every day (because last minute decisions take more jellybeans than preplanned ones)? What else can you do to hold on to your jellybeans?

And also, how can we replenish our jellybean stash? What can we do throughout the day that makes us feel recharged? Brainstorm ideas and start keeping track of the things that actually refill your jellybean jar. Does taking 5 minutes to read a book make you feel recharged? Exercising? Walking up a flight of stairs? Putting your head down on your desk for 10 minutes? Socializing? NOT socializing? Even doing something that recharges you for only a few minutes can make a world of difference. Make a list of these things and try to fit them into your schedule and see how you feel (in a judicious manner, of course – trying to cram in too much might actually have the opposite effect and deplete your jellybeans).

If you do try instituting some of these practices into your life, you may be surprised with the results. Watching your consumption of your own internal resources may also give you further insight into your own daily practices, and knowledge, my friends, is power.

For further help with putting these ideas into practice, I recommend working with your therapist.

Disclaimer: This blog is not therapy and does not constitute a therapeutic arrangement. If you have a medical or mental health condition, please seek treatment from a professional. If you feel suicidal or homicidal please go to your nearest emergency room and seek treatment.