Online Care Expands Access to Veterans' Mental Health Services

As the seasons start to shift, many of us may feel a change in our sleep patterns — and our mood. With shorter days and longer nights, it can be tough to maintain a consistent sleep routine. While many believe sleep is crucial for our health and well-being, it often ends up on the back burner when life gets busy. This time of year, filled with hectic schedules and added stress, can make it even harder to prioritize getting enough rest. But understanding the science behind our sleep-wake cycle can help us appreciate why sleep matters so much, even when life feels demanding. In this article, we’ll dive into how our sleep-wake cycle impacts our mood and share some practical tips to help you enjoy more restful sleep at night. What is the sleep-wake cycle? The sleep-wake cycle, also known as the circadian rhythm, is your body’s natural clock. It regulates our daily rhythms of alertness and sleep over each 24-hour period. The circadian rhythm also plays a role in things like appetite, digestion, and hormone release. Humans aren’t the only species to have a circadian rhythm — almost every living thing has some sort of circadian rhythm, including plants, animals, and even microorganisms. Your sleep-wake cycle responds to environmental cues like light and temperature, which help you feel more alert during the day and ready for rest at night. It’s managed by a small part of the brain called the suprachiasmatic nucleus (SCN), located in the hypothalamus. The sleep-wake cycle depends on a complex balance of hormones, especially melatonin and cortisol. As evening approaches and light fades, melatonin levels rise to prepare the body for sleep. Cortisol levels peak in the morning to promote wakefulness and energy. Keeping this natural rhythm steady supports not just physical health but also mood and mental clarity. When this rhythm falls out of sync — whether it’s from shift work, travel across time zones, or just an irregular sleep schedule — it can disrupt this natural balance. These disruptions can make it harder to focus, impact judgment, and increase emotional sensitivity.  Research shows that ongoing disturbances to the circadian rhythm are linked to mental health disorders, including depression and anxiety. For example, studies suggest that shift workers — who tend to have inconsistent sleep schedules — often report higher stress levels and worse mood. Can sleep affect our mood? Getting quality sleep each night is an essential part of maintaining good mental health. Scientists are still learning more, but there are brain functions that can only happen while you’re sleeping. When you get enough quality sleep at night, you help your brain work well while you’re awake. On the flip side, being sleep-deprived may lead to irritability, stress, and even contribute to mood disorders like depression and anxiety. The connection between sleep and your mental health Sleep profoundly influences our mental health through a combination of physiological and psychological mechanisms. Scientists are still trying to understand why, exactly, we need to sleep. But they do know that sleep facilitates crucial processes that restore the brain and regulate emotions, many of which only happen while we’re asleep. There are two broad categories of sleep: REM (Rapid Eye Movement) and non-REM sleep. They both play distinct roles in emotional regulation. During REM sleep, your brain sorts through emotional experiences and memories, which reduces emotional distress and builds resilience. This stage is important for managing complex feelings and keeping emotional reactions in check. On the other hand, non-REM sleep, especially the deeper stages, is essential for recharging your body and mind. It restores physical energy, supports your mood, and strengthens your ability to think clearly, which promotes balance and focus throughout the day. Quality sleep is also important to help your brain to: Strengthen working memory Repair and maintain neural connections Process and regulate emotions Clear out “brain waste” by removing unimportant information Consolidate new learning and insights Support immune response and stress management Sleep and mood disorders Sleep problems and mood disorders, like bipolar disorder, share a complex and often intertwined relationship, which means that each may affect the other.  Being sleep-deprived can make mood disorders worse and can even trigger manic episodes. Additionally, living with a mood disorder can make it much more difficult to get quality sleep.  In depression, for example, individuals often experience insomnia or early morning awakenings, which can intensify feelings of fatigue, despair, and hopelessness during the day. Other people with depression can experience hypersomnia, or sleeping too much — which can lead to increased lethargy and disinterest in daily activities.  People in manic episodes experience a decreased need for sleep, which if prolonged is formally recognized as one in a group of symptoms of bipolar disorder. Not sleeping for days may heighten impacts of mania, after which some people may experience a crash into the opposite mood – a depressive episode involving days of increased sleep. Sleep disturbances are the most commonly reported symptom of depression, and research has found that up to 90% of people with depression get poor quality sleep. Sleep problems have also been linked to more severe depression symptoms and a higher risk of suicide. How the seasons affect sleep-wake cycles Seasonal changes can have a big impact on your sleep-wake cycle, especially if you live in an area (like Northern states) with more drastic changes in daylight hours throughout the year.  Our bodies rely on natural light to keep our circadian rhythms in sync with the 24-hour day. With fewer hours of sunlight in the winter, the circadian rhythm can get out of sync — which makes waking up and going to sleep at regular times harder and leaves many people feeling tired, foggy, or just “off.”  For some people, this shift in light can even contribute to Seasonal Affective Disorder (SAD), a mental health condition where you experience depression or mania in response to seasonal changes. Melatonin, the hormone that makes us feel ready for sleep, depends on light cues, and are released during darkness. When there’s less light in winter, melatonin levels may stay higher in the morning, which can cause daytime drowsiness, or rise early in the evening, which can make people feel sluggish.  Light exposure also influences serotonin—a neurotransmitter tied to happiness and energy. Less sunlight in winter may lower serotonin levels, which often reduces energy and makes people feel emotionally sensitive. Tips for getting quality sleep Getting a good night's sleep can make a big difference in how you feel each day, and there are simple steps you can take to improve your sleep quality.  Here are some tips to help you achieve restful sleep: Get sunlight during the day: Exposure to natural light during the day helps regulate your circadian rhythm and can lead to better sleep at night. Try to spend at least 20 to 30 minutes outdoors, especially in the morning. Even sitting by a window with natural light can have positive effects. If you live somewhere with very dark winters, try a light therapy box. Regular exercise: Engaging in physical activity can help you sleep better and for longer. Aim for at least 30 minutes of moderate exercise most days — but it's best to avoid vigorous workouts close to bedtime, as they can energize your body and make it harder to wind down afterwards. Gentle activities like yoga or stretching in the evening can also help relax your muscles and prepare your body for rest. Be mindful of caffeine consumption: Consuming caffeine in the afternoon or evening can disrupt your ability to fall asleep. Try to limit your intake to morning hours and consider switching to decaffeinated beverages in the afternoon. Remember that caffeine can linger in your system for several hours. Reduce irregular or long naps: While napping can help replenish energy, taking long or irregular naps during the day can interfere with nighttime sleep. If you feel the need to nap, aim for short naps of 20 to 30 minutes in the early afternoon. This approach can boost your mood and alertness during the day without disrupting your nighttime rest. Refrain from using electronics before bed: The blue light emitted by phones and computers can inhibit the production of melatonin, the hormone that facilitates sleep. Try to power down electronic devices at least an hour before bedtime. Instead, engage in relaxing activities that don’t involve screens, such as reading a physical book, journaling, or practicing deep breathing exercises. Set up a night routine: Establish a calming pre-sleep routine to signal to your body that it’s time to wind down. This could include activities like reading, meditating, or taking a warm bath. Consider dimming the lights in your home during this time to further signal your brain that bedtime is approaching. Creating a consistent routine helps your body recognize when it's time to sleep, and makes it easier to relax and transition into a restful state.  Seek professional support If you’ve tried improving your sleep habits but still struggle with sleep issues or feel like your sleep-wake cycle is out-of-sync, reaching out to a professional can provide valuable guidance. A mental health expert can offer insights into your symptoms and provide helpful, evidence-backed support. Rule out a sleep disorder If you’re struggling with sleep issues even after practicing good sleep hygiene, it’s essential to consult with a healthcare provider to identify any underlying sleep disorders. Conditions like sleep apnea or insomnia can disrupt your sleep patterns and have a significant impact on your mental health.  A professional can assess your symptoms and discuss tests or evaluations to pinpoint any specific concerns. Difficulties may persist or worsen if these underlying disorders are not identified and addressed. How mental health treatment can help Fortunately, when it comes to improving sleep, there are several therapeutic approaches and medications that you and a mental health professional can explore: Cognitive-Behavioral Therapy for Insomnia (CBT-I) targets the thoughts and behaviors that interfere with your sleep. This structured program can help you develop healthier sleep patterns and identify, and change, the unhelpful thinking patterns that make both insomnia and depression worse. Mindfulness-based therapies focus on relaxation techniques that promote better sleep by reducing anxiety and stress. Other therapeutic approaches, such as acceptance and commitment therapy (ACT), can also help address sleep-related issues. Medications may offer short-term relief for sleep disturbances. Antidepressant medication can also treat any depression symptoms that could be making your sleep troubles worse. Get mental health support with Cerebral! Image by jcomp on Freepik

When things feel out of control  No matter who we are, life will inevitably throw challenges our way. Problem-solving is an important skill to figure out strategies for how to improve your situation. But what happens when there is no way to improve the situation — when it’s completely out of your control? Try as we might, there will always be things in life that we are powerless to control. When you pay close attention, you may realize that the things in life you can’t control occupy a great deal of your mental space. You might find yourself becoming anxious or frustrated by things like poor weather, the traffic, or other people’s opinions. While it’s understandable to be upset by these things, spending too much time ruminating on them can have negative consequences for your mental health. It’s easier said than done to simply stop thinking about things outside of your control. But there are ways to cope with the stress they cause and protect your mental well-being. Here, we’ll give you 6 actionable tips on how to cope with things you can’t control. {MiniWidget:Anxiety} Recognizing what’s out of your control It can help to first differentiate between the things that are within your control and the things that aren’t. You may realize that many of the things that cause you to feel anxious are things that are outside of your control. What other people think As much as many of us might want to be liked by everyone or have everyone agree with us, unfortunately, one of the main things in life outside of our control is what other people think. No matter how hard you try, you can’t control others’ thoughts. You may be able to influence them and make a good impression – but, at the end of the day, what people think of you, or any other topic, is out of your control. This can be difficult to deal with for many people, especially if you live with a mental health condition like social anxiety disorder. It’s understandable to want others to think highly of you or to agree with you, especially if they’re important to you. But people choose to form their own opinions regardless of how we may feel about them. And it may not be worth sacrificing your mental health to attempt to control their thoughts. The past  Regrets about past decisions and mistakes can make you feel desperate to be able to go back and change past events. You might be plagued with questions about how things could have turned out if you’d made different choices. This regret can be especially overwhelming if you feel like you’ve hurt people in the past.  Although it’s important to balance self-compassion and accountability for your past mistakes, it’s also important to understand that the past is outside of your control. There is nothing you can do to change what happened in the past — but you can control what you do now. The future and “what if” scenarios The future, on the other hand, is — to some extent – within our control. The choices you make today can influence what happens tomorrow. But believing that you’re 100% in control of the future may lead to disappointment, because there are so many factors that are unpredictable and can’t be controlled. So many of us get caught up in the “what ifs” of the future: What if I never meet the right person for me? What if I get sick? What if I get laid off from my job? While these may be understandable and normal worries to have, they’re largely outside of our control. You can work toward doing what you can today to build a happy future, but there’s nothing we can do to guarantee it. Environmental and outside factors  Lastly, we often can’t control outside factors in the environment around us. For example, we can’t control the weather. We can’t control traffic. We can’t control delayed flights, technology mishaps, or a million other frustrating annoyances that happen in everyday life. These events can be upsetting, especially if they get in the way of our plans. But it’s important to recognize that these are factors that are completely outside of our control. It’s okay to be frustrated by them, but dwelling on them may do more harm than good. Tips for coping It’s normal to get upset about these things, even if you know they’re outside of your control. But allowing them to affect your mood or anxiety levels can be detrimental to your overall mental health.  It’s important to practice self-compassion for becoming upset by things outside of your control — it happens to everyone. At the same time, you can use these helpful strategies to cope when you’re feeling frustrated. 1. Recognize your feelings It’s rarely, if ever, helpful to punish yourself for feeling frustrated or trying to push these uncomfortable feelings away. Instead, simply try to recognize your feelings. Notice that you’re feeling frustrated and overwhelmed by these scenarios outside of your control. You don’t need to react to the feelings; simply notice them. It can sometimes be helpful to name the emotions as well. You might be experiencing multiple coexisting emotions. For example, you might feel frustrated, and at the same time feel a sense of peace, acceptance, or even silliness that you’re feeling so frustrated about something out of your control. You might feel a mix of excitement and fear about the unknown future. Recognizing your feelings is the first step to emotional awareness and self-regulation, which are essential components to social-emotional well-being. 2. Journaling Writing in a journal can be an effective way to express your feelings about a situation when you know there’s nothing you can do to change it. Journaling has many mental health benefits. Getting your thoughts out on paper can help you avoid rumination, or thinking about the uncontrollable event over and over again. Journaling can also help you process past stressful and traumatic events, even if you can’t go back and change them. Try to remember to use journaling to combat rumination rather than simply brooding about the situation on paper. Try finding new perspectives as you write. For example, shift the focus of your journal to the things that are in your control, or write to help yourself identify your emotions about what happened without getting stuck on ruminating about it.  You can even try positive rumination journaling, or writing specifically about more positive aspects. For example, you could write about the best thing to come out of the upsetting situation, or simply write about one frustrating and one happy event each day. One study found that positive rumination journaling was helpful for reducing maladaptive rumination. 3. Practice mindfulness  Mindfulness originated in ancient Eastern spiritual traditions, but is now used in mainstream Western medicine to combat a wide variety of health concerns — including anxiety. Mindfulness is still highly misunderstood, but in essence, it’s a way to train your brain to stay focused on each present moment, regardless of how painful it may be.  Mindfulness plays an important role in acceptance and commitment therapy (ACT) and dialectical behavior therapy (DBT), two evidence-based therapy techniques that may help you tolerate uncomfortable emotions over things you can’t control. 4. Get quality sleep A big part of coping with things outside of your control is being resilient, or having the ability to bounce back from challenges and stress. The research on what promotes resilience is ongoing, but one important factor is getting quality sleep. When you get enough restful sleep each night, you’re better-equipped to be able to cope with the inevitable challenges of life, including frustrating situations that are outside of your control. Sleep-deprivation, on the other hand, can make you feel more stressed and heighten your risk for mental health conditions like anxiety and depression. Experts say that healthy adults need between 7 to 9 hours of sleep each night. If you’re consistently falling short, use research-backed sleep hygiene tips. A cognitive-behavioral therapist may also help you identify what might be keeping you awake at night and work toward addressing it.  5. Deep breathing Breathing strategies have been used for millennia to help people reduce stress and have more control over their emotions. One effective breathing technique is deep breathing, also known as belly breathing or diaphragmatic breathing. It works by activating your body’s relaxation response. Start your deep breathing practice by relaxing your body and closing your eyes if you wish. It can help to place one hand on your stomach, right underneath your belly button, and the other on your chest. Breathe deeply, through your nose and into your belly. Try to imagine filling your body with air, starting with the bottom of your stomach. The hand on your belly, not the one on your chest, should rise. Hold your breath for a few seconds. Then, slowly and steadily release the air through your mouth. You may make a “whoosh” sound as the air leaves your belly. The hand on your belly should lower. Repeat this as many times as necessary until you begin to feel calmer. 6. Shift your mindset to what you can control Lastly, try to shift your focus to what you can control. Real life can be messy, and you’ll likely find that, in most situations, there are aspects of it that you can control as well as aspects you can’t control.  For example, you may not be able to control what happens in the future 100%. But you can make good decisions today that will set you up for success in the future. On the flip side, making impulsive choices today may have consequences for the future. In many cases, the aspects that are within your control relate to your own feelings and reactions. You can’t control that your flight is delayed, but you can control how you act toward the airline attendant or demonstrate compassion and try to make the experience as least frustrating as possible for yourself. You can’t change the traumatic event that you went through, but you can be kind to yourself today. Of course, this is easier said than done, and we can’t be positive about everything all the time. But, as much as possible, try to notice when you’re spending a lot of time worrying about things outside of your control, and reframe your focus to the things that you can do something about. How professional therapy can support your mental health If you are constantly facing excessive worries about things that aren’t out of your control, and if these worries are affecting your day-to-day functioning, then it could be a sign of an underlying anxiety disorder. Anxiety can be difficult to deal with, but there are effective treatment methods available that can help.  A therapist can help you become more aware of when you’re feeling anxious about something outside of your control, and why these things hold so much power. They can teach you new skills and strategies you can use to cope with these uncomfortable feelings, and reframe your thoughts so that you’re no longer focusing on things outside of your control. With Cerebral, you can connect with a mental health provider who can work with you on a personalized action plan to help you stop overthinking and equip yourself with strategies to use when you’re feeling like life is out of control. 72% of Cerebral clients reported feeling less anxiety after just 3 months of treatment.* Join Cerebral today! *Based on Cerebral clients with moderate to severe anxiety and/or depression from 2020-2023. Image by freepik

You may have encountered the idea of affirmations when reading about ways to improve mental health, piquing both your interest and skepticism. Can a few well-chosen words really change your emotional and mental state, after all? Without a doubt, the answer is "Yes!"  A proven method for enhancing mental health, affirmations have a psychological effect that has been scientifically demonstrated. Let’s explore how affirmations can change the way your brain functions so you can experience healthier mental and emotional well-being. {MiniWidget:Generic} What are affirmations? Affirmations are succinct, upbeat comments you say to yourself to upset negative thought patterns and promote positivity. Repeating these "cheerleader" words aloud or even silently can cause them to stick in your mind. In doing so, you forge neural pathways that strengthen your sense of self and emotional stability. What is the science behind affirmations? The idea of positive thinking isn’t new as academics have been studying the science behind it for some time. Research indicates that repeating affirmations causes specific parts of the brain to activate. These include the ventromedial prefrontal cortex and areas associated with reward and reflection. This brain region also controls emotions and helps in maintaining your sense of self-worth. Repeating positive affirmations retrains the brain to focus on possibilities and positive ideas. Shifting mental patterns in this way reduces stress and negative self-talk so you enjoy a more balanced emotional state Can affirmations help with anxiety or depression? Affirmations are not a replacement for professional therapy or medication, but they can be an effective complementary tool in managing anxiety and depression. Positive messaging replaces a never-ending stream of negative thoughts, breaking down self-doubt and rumination. This interruption provides you with a break from the stresses of the situation and encourages you to be more optimistic. Benefits of affirmations Affirmations offer a range of mental health benefits, making them a simple yet effective practice. These include: Reduces negative self-talk A critical inner voice is something many will deal with at some point. Affirmations help combat that negativity, reinforcing your strengths and potential. As positive statements become part of your mental routine, the constant flow of doubt becomes quieter, leading to a more compassionate self-view. Promotes healthy behaviors Affirmations possess the power to drive change. Whether kicking a bad habit, adopting a healthier lifestyle, or overcoming procrastination, they solidify your commitment to personal growth. Affirming “I am disciplined and focused” can redirect energy toward completing tasks and staying motivated. Decreases stress Focusing on calming and empowering thoughts during affirmations activates the body’s relaxation response, reducing stress. Redirecting mental energy away from worries promotes a sense of inner peace and balance. How to make affirmations more effective To fully unlock the benefits of affirmations, follow these practices: Commit to a routine Consistency plays a key role in making affirmations effective. Incorporating them into a daily practice, such as during your morning routine or right before bed, strengthens their impact. The more frequently they are practiced, the deeper they become embedded in your subconscious, reshaping mental patterns for long-term change. Set them in the present Affirmations are most powerful when framed in the present tense. Speaking to yourself as if the positive change is already happening makes the statements feel more tangible. Instead of saying, "I will be confident," say "I am confident." This approach strengthens the connection between thought and reality. Make them personal to you Affirmations that speak directly to your unique needs and challenges resonate more deeply. Crafting statements that feel authentic boosts their emotional impact, which makes the practice feel more genuine and effective. Avoid toxic positivity Affirmations should be realistic and grounded in compassion, not a denial of real challenges. Balancing positivity with authenticity keeps affirmations from feeling forced or disingenuous. Instead of glossing over difficulties, focus on affirmations that offer hope while acknowledging real feelings. Focus on what’s achievable Starting with small, manageable goals ensures that affirmations feel achievable rather than overwhelming. Building confidence from these small successes creates momentum, allowing for larger goals over time. This approach keeps the practice grounded and effective. Pair your affirmations with action Affirmations become even more powerful when they are followed by concrete actions. They should act as a catalyst for positive change, not a substitute for it. After repeating your affirmation, take tangible steps toward your goals, and celebrate each achievement along the way. 5 affirmations to start your practice Here are a few affirmations that can serve as starting points for building a healthier mindset: I am a strong, capable person This statement reinforces self-confidence and serves as a reminder of your inner strength, especially in moments of doubt. I am loved and accepted Affirming that you are worthy of love cultivates a deep sense of belonging, even in the face of external challenges. I am doing my best and that is enough Emphasizing self-compassion, this affirmation encourages acceptance of imperfections and honors the effort being put in. I can handle whatever comes my way This promotes a sense of resilience, reminding you that challenges can be met with strength and adaptability. I trust in my ability to navigate uncertainty Strengthening trust in your ability to handle unknowns builds confidence in managing life’s uncertainties with grace. When positive affirmations don’t work, try speaking with a mental health professional While affirmations can support mental health, not everyone finds success using them and some require  professional therapy, especially  when feelings of depression, anxiety, or hopelessness persist for an extended period.  A qualified therapist can offer personalized guidance and support based on your unique issues. If you would like expert help in taking better care of yourself, join Cerebral and work with someone who has experience caring for persons exactly like you. Positive mental effects from affirmations are possible. If they are used frequently, conveyed openly, and combined with constructive action, they may effect long-lasting change. Try powering up your thoughts to inner strength and positivity if you begin employing affirmations right away.