Episode #96
Living With POTS
ft. Sam Bregman
POTS - Postural Orthostatic Tachycardia Syndrome - can be a challenging and life-changing diagnosis.
If you or a loved one has been diagnosed with POTS, how can you cope?
How did the Mayo Clinic use Cognitive Behavioral Therapy (CBT) to help one sufferer?
Join me, Dr Julie Osborn, in this fascinating interview with my cousin, Sam, as we share with you how cognitive behavioral therapy can help you live with POTS.
Click to listen now!
Reference Guides:
Full Episode Transcript
Dr Julie
Hi! It's Dr. Julie. Welcome to My CBT Podcast. I have my Doctorate in Psychology and I'm a licensed clinical social worker specializing in Cognitive Behavioral Therapy. I'm here to help you bring the power of CBT into your own life.
So I'm first going to start off with an email - because you guys know I love doing that and I appreciate you reaching out to me. I always want to hear your questions or how the podcast is helping you. And for confidentiality, I'm going to keep the email person's name out, but I thought it'd be a really good email to share and my response back to her.
So it says,
“Hello, Dr. Julie.” (She's from Portugal, but she was in Austria, which is a long way as a way, so I love hearing from her! She's 38 years old and has a three and a half year old son. So one week after the birth of her child, she was diagnosed with breast cancer.)
She says,
“I did the whole shebang: chemo, operation, radiation. Now I'm all good and I'm doing the hormonal therapy. So I have induced menopause. My anxiety levels are off the roof. I sleep really bad. I don't know if it's the hormones or I'm afraid that the monster comes back.
“I've heard all of your episodes and it really helps me, but in the day, I kind of forget everything and the fear takes over. I need to be very self conscious about every thought I have, but it helps me at the end of the day. In your experience, do you think the fear gets better with time or worse?
“Thank you so much for the time you put in, trying to help others really are appreciated on the other side of the planet, so thank you for that!”
I'm just going to read back to you guys my response, just to kind of keep it simple and be able to answer a question.
So I said,
“Thanks for being a listener and I'm grateful to know you are cancer-free. It is a lot, and menopause can be so difficult.
If it's available to you, seeing an acupuncturist helps me tremendously. My answer to you is if it gets better or worse… I'd say it's better as long as you use your CBT tools, good self care and being present.
Time doesn't heal us - it's what we do with our time. And don't let cancer take another moment from you or your son.”
She found that helpful. So, again, thank you for reaching out. You guys can always send questions and comments and I will always respond.
So today I'm very excited. I'm going to be interviewing one of my favorite cousins named Sam, and I'm actually in Arizona with him together, and he has a really great story to share that I thought all of you would really benefit from. And he's going to share with us how CBT has helped him as well with his journey. So thanks for being here. Sam.
Sam
My pleasure. Thank you for having me on.
Dr Julie
You're welcome. So I'm going to let you get started and kind of share where you started and how things have helped. And then I'll kind of interrupt and ask questions along the way, keeping it kind of CBT focused and hopefully answering some questions for some people. Okay. Is that okay?
Sam
That's good.
Dr Julie
Yeah. Okay. Yeah.
Sam
So, basically, six years ago, I developed a chronic illness called POTS, which stands for Postural Orthostatic Tachycardia Syndrome, which is a fancy way to say that my autonomic nervous system doesn't work properly. So, for those of you who don't know what that means, it's essentially things like my blood pressure, my heart rate, and other similar functions are out of whack sometimes. So I've been an athlete my whole life. I was playing club soccer, doing well in school, playing some other sports, and from about twelve to 16 years old, my health was pretty normal. I was living for the most part of normal life. I was doing fine. And the summer of 2020 so it was the summer following my sophomore year of high school, my health really started to go downhill. I don't know what caused it, and I don't think I ever will know, but basically by November of 2020, I got to the point where I could hardly walk. I was bedridden for a month, and every moment felt like just pure agony. There's a period of about six to nine months, starting at the summer of 2020, where I only had, I think, about 15 minutes where I felt healthy and normal.
The rest of the time that I was awake, I always felt like something was off or there was other various symptoms that I experienced.
Dr Julie
That's intense.
Sam
Yeah, it was tough. And so my mom's a social worker, and so obviously she had some experience in medical space, so we thought I'll start going to some doctors and figure this out. I had been going to a cardiologist. He was helpful, but he didn't give me a ton of clarification of the push I needed to adopt certain practices. And so after going from specialist to specialist, every answer I got was basically, Sam, you're fine, or we don't know how to help.
Dr Julie
Wow.
Sam
And obviously I knew I wasn't fine. And although all the doctors had good intent, those weren't the answers I was looking for. Eventually, through one of my mom's high school friends, we found out that Mayo might be able to help out. So we popped up a couple of Zoom calls with them, and this is in early 2021, and they thought that I had this condition called Pots. So they sent me to the Scottsdale campus. I did something called a tilt table test. We were basically strapped down like Frankenstein. And so you're doing some testing with your breath, and I don't remember what else we did. They basically launched you up to a 70 degree incline for ten minutes, and then they bring you back down to be in parallel with the ground. And so they measure differences in heart rate and blood pressure, and if you exceed certain levels, you have this condition called Puff.
Dr Julie
Okay?
Sam
So although we finally had a name for this condition, because before we had no idea what it was, I still didn't feel very good. So I'm like, well, I still need some more help. So fortunately, the doctors at Mayo told me about this program that they have in Minnesota. So I flew out at the end of March and 2021 to do a week of testing there, flew back to Chandler, and then flew back for all of May to participate in a month long intensive outpatient program. And while I was there, they basically completely changed my life. They taught me what my condition is, how to manage it, and how to thrive again. Because at that point, from basically summer of 2020 until spring of 2021, my whole life felt and taken for me. I couldn't do the things I loved. Like, I couldn't go play sports. I couldn't hang out with friends. I was essentially confined to my house and for some time, my bed in my couch, and it's a little exciting at first. I got to watch some TV and some Netflix series. They get old real quick. Basically when I was at, we took a flight out to the Mayo Clinic for the outpatient program.
And from what I had heard from previous patients, if you put in the effort, this program can completely transform your life. And so at that time, I'm like, well, there's no other option, so I have to go 110% and make sure this thing is worth it because it's also very expensive. For example, if you didn't have insurance, it was going to cost $50,000 just for the program alone. And you also to COVID a month of activities, hotels, food, because one parent.
Dr Julie
Went with you, right?
Sam
Yeah, my dad came with me for the second trip out. Tomo and my mom came with me for the first.
Dr Julie
Right.
Sam
So while I was there, there was a couple of main things that we focus on, and one of the first ones was we don't talk about the condition. So you don't talk about if you're feeling bad. You don't talk about your different symptoms. You basically don't even mention the word pots. Like, I almost forgot about certain things that I experienced for certain words that I learned about this journey because it was almost like they were blacklisted. Like, I can't mention those in order to get healthy, I have to just.
Dr Julie
And what did when you first went there, when they said that, what did you think?
Sam
It was a shock, because every day prior to that point, that's all I talked about, because it's what consumed my mind in my life for so many months. And so it was weird. And it was really hard at first, and then eventually I'm like, oh, I like this. I'm starting to act and think and feel a little bit more normal. And so the emphasis on that, just while I was there, they also basically taught us about these different ways to manage our condition and potentially beat it. And so there was, I think, five or six main things, and those were exercise, hydration, a high sodium diet, a very strict sleep routine to improve our circadian rhythms, and stress management. So to get some more emphasis, stress management means diaphragmatic breathing at least once a day.
Dr Julie
Okay.
Sam
I train five days a week. So cardio and strength training, because as myself and other patients improved our strength, it helps with the circulation as the muscles get stronger to pump the blood better.
Dr Julie
Okay.
Sam
Sleep. To be honest, I don't know exactly how that impacts biological functions, but from experience, it helps a ton. So I try to be in bed by ten or 1015, wake up at seven. Being a college student is a little tough sometimes, so still working on that, but it's getting better. And then I have like a gallon Jaguar carry around. I have some salt supplements that I use.
Dr Julie
Okay.
Sam
And yeah, they've been really helpful. Another thing while I was there is they focused a lot on CBT.
Dr Julie
Yes, that's why he's here.
Sam
And to benefit. Prior to this, I didn't really have much knowledge about CBT, and as they started to tell us about the triangle, everything kind of started to click. I understood why they were teaching us these things and also how these new learnings were really helping me.
Dr Julie
So tell listeners, what was the triangle for you when you were there, when you said the triangle?
Sam
So I think it was the cycle of thoughts impact your actions, and your actions impact your behaviors or emotions.
Dr Julie
Yeah. So what I talk about, I have a little bigger than a triangle, but it's your thoughts create your moods which affects your behaviors and your physical reactions, and then your environment is a big factor. Right. And I just wanted just to back up a little bit, I wanted to share with you listeners. When Sam told me actually his dad was given a letter from Mayo Clinic to send out to Sam's loved ones saying, this is what's going on and don't ask him about it. And I thought, that is so interesting. And my brain is going with my CBT, like, yeah, when we focus on the negative, it just gets bigger and bigger and bigger. And I thought, that is so great, and it's such a shift versus like, oh, let's talk about it. How do you feel about it? How is it affecting you? They're like, no, we're going to focus on getting well and not to ask you. So I was always first, I was mindful because you just want to say, oh, my God, how are you doing? How are you feeling? And you're like, that's not what's best. Right? So I thought it was, like, spot on when they sent out that letter for all of us to be educated.
Dr Julie
Yeah, right. Because in a loving way, we want to let you know that we care and we're thinking about you. So how does that normally happen? We ask, right. Instead of just like, oh, how are you doing? Right? But that's what was best for you. So I just wanted to really share that because I think physical issues, mental issues, people just hyper focus on them, and they get more depressed and more anxious and more overwhelmed instead of saying, okay, what tools am I going to do on a daily basis that I can get better? So I just wanted to really emphasize that with all of you guys that whether it's your health issues or mental health or both, that focusing on that and telling everybody about it doesn't actually benefit you in a loving way. I know people think that's kind of cold, but it really isn't if you understand the whole concept.
Sam
Yeah, well, it is interesting too, because the doctors there sure that we couldn't talk about our physical symptoms, but family and friends were allowed to ask about our emotional states.
Dr Julie
Okay.
Sam
And so that was really big, especially with myself and many of the other people there dealing with anxiety, depression, potential PTSD, and list of many other things. In addition. So being able to share the emotional side was helpful because at times it could feel like, I'm going through all this stuff and like, nobody knows or understands or is allowed to even hear about it. But then having that channel that we could kind of tap into of the emotional side allowed, I guess, part of the journey to feel more heard and understood.
Dr Julie
Okay, so who would you share your emotional power with? Like, just certain people or what?
Sam
So mainly my mom and dad. Mayo did have a rule that once I left, I had to meet with a CBT therapist once a week.
Dr Julie
Yay.
Sam
So I've been doing that from May of 2021 up till the present moment.
Dr Julie
Okay.
Sam
And then some stuff with friends, but mainly my therapist and parents.
Dr Julie
So let me ask you, if somebody says, oh, how things with your pots? Do you set that boundary and say, I'm fine, thank you, but I'm not going to talk more about it than that, or does that come up for you or how do you handle it?
Sam
Yeah, so the main thing that comes up is initially sharing it with people. People, whether it's friends, family, connections, professionally, I usually have to give a brief explanation of the backstory and kind of share like, this is what's going on. This is what's happened. I'm much better now. I can't really talk about the past a ton here's. Kind of like where I am right now. And then future goals. So it seems to be once I provide the backstory and then share, like, that's the most I can provide right now. People are pretty understanding. I kind of just move on from there.
Dr Julie
Okay. And you say that that's about as much as I can share right now.
Sam
Yeah.
Dr Julie
Good. Okay. Yeah. So having those healthy boundaries and not feeling like I have to explain into everybody because it's what's best for me not to. Okay. And then so share with me maybe some of the CBT tools you found most helpful or also I wanted to interview Sam too, because his resiliency and also your structure and how you've really been driven to stick to this. Because I know I've shared with other podcasts, in my other podcasts, I've done that. A lot of people come to therapy and two things either get well enough and then they stop because they don't want to really go deep, or they do get well and they stop and they put the book away and then they're like, okay, I don't have to do any of this anymore. And they don't understand. Like, it's a lifestyle change. Right. It's psycho education. And it's not just, I'm going to learn, say with me, I do file records with people. What are your hot thoughts? And this is going to be what you're going to do the rest of your life. And I practice everything I preach. So what do you think for you has allowed you to stay driven and focused and committed, I guess, to the things you learned?
Sam
Yeah, so I think there's a couple of things. Being in the Mayo program and experiencing this massive shift in physical and mental health just basically made me think like, okay, whatever they say works and I'm going to trust it completely. That was one of the big things. I think the biggest thing was getting to a point of such miserable mental and physical health where I basically told myself, like, I will never go back to this place again because it was just so horrible for me and those around me where that's not even an option.
Dr Julie
Okay.
Sam
Yeah. I think it was just that promise. And then also the hope of knowing, like, my health can improve, I can get better, and starting to get glimpses of improvements, whether it's with symptoms or my body being able to push a little bit more. Maybe it's through exercise or traveling or a little bit of a variation in the sleep schedule and still feeling okay. Those have been huge. And at times I've made mistakes. I haven't been perfect. I found that complacency is a killer of progress. It's easy to get to a point that you're happy ish with and then you kind of settle for that and eventually before you know it, you're back to the place where you're at before. Yeah. For example, there's been times throughout this health journey where I'll be really good with my routine and then my health starts to get good. I slack up on the sleep routine a little bit. A couple of days later I start feeling some not so fun consequences of that. And I'm like, okay, Sam can't keep doing that because the way my condition works is there's a chance I could outgrow my earlier mid twenties.
And that is one of my biggest goals in life, is to beat this. And so I think it's the vision of potentially beating that not wanting to go back to the place where I was and understanding that if I keep doing what I'm doing, my health will feel will be better and better and better. And as a result, my mental health will be better. And then everybody I interact with and the projects I'm working on and just everything else in my life will significantly improve.
Dr Julie
Right, and you're living the life that you were hoping for.
Sam
Yeah.
Dr Julie
Right. So when they taught you that triangle, you're saying about your thoughts with your moods, your behaviors, all that, how do you use that today? Would you say like, are you more mindful of your thoughts?
Sam
Yes. Something I try to do is I journal a ton.
Dr Julie
Okay.
Sam
And that helps me become more aware of what I'm thinking of because I feel like throughout the day my mind is going from one thing to another. The meditation, that's helped quite a ton. But there's still a lot of my mind journaling and just kind of reviewing that, thinking like, what am I thinking of right now? Something I'll do in the morning, I'll journal with just no filter. So whatever I'm thinking of, whatever I'm nervous about, everything in my mind gets put onto paper. Yes, that helps a ton. And just trying to I think talking slower because I used to talk really fast has helped a lot because it allows me to think about what I'm going to say before I actually say it. And so because of that and then also some help from mentors, I've learned to be very intentional with what I say. And as a result I've realized I have to no, I have to I get to try to curate my thoughts in a way that are best for myself. So meditation is super helpful. There's not many times in my day where I'm still in quiet and just have time to process my thoughts.
And when I meditate, it seems to be some only of the times when I can do that. And so in that I realized, okay, I'm thinking a ton about that quiz or that pitch, or this interview or this conversation and yeah, I find that solitude allows me to become aware of my thoughts and then understand, like, okay, is this healthy me? Is it not? Should I kind of let that blend drift away? Should I pay more attention to that?
Dr Julie
Yes. I love when you say like when you corrected yourself, right? You said, oh, I have to. And they're like, no, I get to to slow down and think more instead of like, oh, I have to do this. I have to do my cognitive therapy homework. I get to do this. Right? I get to learn and change, and I can see the progress and that it actually works. Right. So that self care, I think, self love, self compassion that all of us need more of to give ourselves permission, that I need to take care of this, and I need to come first sometimes. I know, Sam well, you're very loving and giving person. You're always thinking of others, but this also is like but I also have to take care of myself first so that I can be there for everybody else, right?
Sam
Yeah. It's been interesting because even now, at times, I'll stay up a little bit too late working on the business or some school assignments, and in that moment, I'm thinking, I'm doing what I need to do. It's for other people. In some cases, it's worth kind of this, I guess, step back for my health. But every time, I keep coming back to this idea of in order to serve other people in the most effective and best way possible, I have to be my best self. And in order for me to do that, I have to prioritize my health physically and mentally and also spiritually. It doesn't have to be from a religious perspective, but meditation for me is a pretty spiritual practice. And so with me, a lot of the work I do, I try to make it bigger than myself. And again, coming back to this idea of, like, I have to take care of myself to serve others well.
Dr Julie
Yes. Which is my goal, right. I want to serve others and be there and whatever, but I have to take care of myself. And I think a lot of people haven't learned that. So many people just give give or make have no boundaries or let other people, like, take control of their lives, and they're not happy. Right. And then they think I've always said, like, the word selfish gets a bad rap. They say, oh, that's selfish. Yeah. I need to be selfish. Like I say, for myself, for me to be there for my clients every day, it can be a lot. And I want to be like everyone to feel like they have my full attention. I'm fully engaged, so I need to take time off. I start my day late so I can work out in the morning. So all of those things end up helping everybody else. And that's what you'll have to find, that balance. I know me and you were talking earlier about progress, not perfection. So especially with what you went through, it's kind of rigid, like, you need to do this, this, and this. And recently, I was sharing with Sam too.
I only need one other person with POTS before him, and now I'm just meeting more and more people. And I know it's hard to get diagnosed and all that stuff, so more people are getting a little educated. But you need to find that balance. Right. Some things you need to keep really on track, and some things I think you're learning. Like, I need, as I always say, that the shade of gray to find that balance. So you're not getting upset with yourself if you didn't do it just right.
Sam
Yeah.
Dr Julie
Right?
Sam
Yeah, for sure. Because I found, like, my sleep schedule impacts me quite a bit. And when I don't do all of that, I tend to beat myself up and kind of tell myself, like, oh, because you're slacking up on this, you're not going to outgrow the condition. And that's not a super enjoyable thought loop to be in.
Dr Julie
That's what I would call a hot thought, which is a thought that's not 100% true. That just because I do this, I'm never going to outgrow.
Sam
Yeah.
Dr Julie
I can just get back on track tonight instead. Right?
Sam
Yeah.
Dr Julie
Yes. So that's what, you know, my big thing is we have you know, I tell everybody we have 80 to 90,000 thoughts a day. That's a lot, every human. So we're lucky if we know 100. And I'm probably being generous, right? So our thoughts are either facts or 100%, or they're hot thoughts. And the hot thoughts are the ones that create our negative moods even more. So that's perfect. Like, if you don't get enough sleep, you think, oh, I'm never going to outgrow this now, hot thought. But then that just flares anxiety and worry and maybe blaming or being upset with you, some sense saying, no, there's some truth. If I continue this, I probably won't outgrow it, but I can get back on track tonight, and I can keep going towards that goal. And that's where we want everyone to learn what are my hot thoughts? Because they're not 100% true. Because I think something doesn't mean it's true.
Sam
Yeah, that's a very good point, because I think for myself and other people, we have these thoughts and just interpret them as like, this is reality and this is completely true, and they get set like this, and there's no other options or ways to look at it. And CBT has definitely helped me realize our thoughts are just thoughts sometimes. And that's it.
Dr Julie
That's it. And we don't get attached to them.
Sam
Yeah, right.
Dr Julie
Like when you said earlier, I can just let that one go. That's not getting attached. Right. So when we get attached to our thoughts, it's not good because most of them aren't even because most of them aren't 100% true. Right. Most of them are hot. So all of that understanding, all of that and these things that you've learned are going to be for your life, even if you outgrow the pots, right? You still want to do everything you're doing. Is that right?
Sam
Yeah. So Mayo basically encouraged me to completely recreate my life, or at least my lifestyle, and therefore my life. And I found that all the practices that I've adopted are good for people, whether they're dealing with a chronic illness or they're just completely healthy and normal. And I've seen so much improvement and benefit from doing these things that, yeah, I'm 100% sure whether I have this or not, I'll continue doing this until the day I die.
Dr Julie
Exactly. And that's important to learn. So I wanted to share Sam's story with you guys because I know when it comes to health stuff, like, you guys know I went through my cancer last year, that I really use my CBT tools to get through that, and then I'll let the fear take over. Like, I'm sure you probably had fear like, oh my God, am I going to be like this my whole life? What does that even look like? Nothing good. Or me being stuck, like, which I shared the earlier email. I'm not stuck in this fear of if my cancer is going to come back. If it does, I'll deal with it, but in the meantime, I do things to stay healthy and well. Right. So it goes back to what can we control? Right? And that's what I'm going to focus on. And you focus on what do I have control over? And the rest I kind of have to let go and just pray things will work out well, but I have more benefit or more probability that will happen because I'm controlling what I can't control.
Sam
Yeah, I think it's a really good point. It's funny, I feel like once you kind of surrender a little bit and kind of just trust that things are going to work out in your favor, different things in your life start to work out in pretty magical ways, like you say, like controlling what you can. So maybe it's going to the gym a couple of days a week or being in bed by a certain time, spending time with a certain friend or family member and the other things that you were stressing about but aren't really up to you if you kind of just understand, like, that's not up to me. I'm just going to trust it's going to work out in my favor or the way that's best, even if it doesn't seem like that right now. Anxiety, at least for me personally, the levels of anxiety drops so much, and it's easy. Like, I know for times of my life, especially with the health, I felt like I was living in anxiety and fear, like, every day and going from that state to more of just a calm, loving state feels so good for us.
Dr Julie
And anxiety is all about not having control over something, right? So it just feeds it like, I'm guessing maybe not everybody that goes to the. Mayo Clinic follows things as well as you do, and it just feeds, and they don't get well. It's like a paper cut. You focus on it, and it hurts even more because you're so focused on it. And I'm sure you've had some experience with some people that didn't follow it as well, and they didn't get to where you I mean, let me tell you, it sounds like the poster child for Mayo Clinic, which is great. I want to just share just a little side note for some people that are going through this or want to figure out if you relate to what's it's there to share that I know the one back east, Mayo Clinic is for, like, teens, but the one out here in Arizona actually helps adults with Pops, correct?
Sam
I believe so. In Minnesota, they have a pediatric version, which is what I attended.
Dr Julie
Yeah.
Sam
And they also have a version for adults, so I think there's different locations you can go to. Highly recommended.
Dr Julie
Yeah. So just a side note. When you guys are like, oh, my God, I have these symptoms. I didn't know what they were, or I thought it was something else. I just want to give you a little direction. Reach out to Mayo Clinic, period, and they can give you some great direction. But I hope what you guys have taken today is that things can get pretty scary, right? And we can get wrapped up in our health, and oh, my God, what's going to happen? But we have to kind of stop and say, okay, what's the next step to take? And trust people that know what they're talking about, and you have nothing to lose to try. That's the other thing. Like, follow the sleep schedule, be hydrated, work out. Like, let me see. Right? And then you're able to prove to yourself, like, they know what they're talking about, and I'm benefiting from it, so I'm going to stick with it. Right? And that's what's important, to make that commitment to yourself that this is what I'm going to do, regardless of what anybody else thinks or says or, oh, don't worry if you only get 8 hours tonight when you're like, no, I need my nine and a half, and that's what I'm going to stick with.
Dr Julie
Right? Like, you have to continue to, again, honor yourself and listen and be mindful of what you're thinking so you can follow through and do everything else that comes with it 100%. Okay.
Sam
And one more thing I want to add a point, too, is initially can be kind of a weird shift if people aren't used to some of these new habits or practices that you're implementing into your life, after some time, people will just get used to it. They're like, oh, Sam has to be in bed by ten.
Dr Julie
All right.
Sam
He's going to head out at eight or 830.
Dr Julie
Right.
Sam
And it just becomes the norm. And so I think that makes it much easier because if there's sort of a conflict within social groups of you wanting to do one thing and then the people around you don't necessarily understand or agree with you, it can be hard to stay on track. And so having other people just understand and get used to your new norm definitely helps a ton.
Dr Julie
I love that. And when you're consistent, that's when people, I think, started respecting the choices you're making. Because I'm like, oh yeah, he left last night. Oh. But he's staying tonight, so I don't really know what he's doing. But it's like, oh, yeah, he goes at this time. And then they really want the best for you too. Right? I think they can support that 100%. Very good. Okay, so I know we talked about a lot. Is there anything else that you want to share you think be helpful?
Sam
Yeah, I would say no matter where you are, whether things are really tough right now or life is feeling like it's going pretty good, just remember that the bad will go away and in some cases, the good will too. And so it doesn't mean that one is better than the other. Obviously the good is more enjoyable, but having both allows the better times to be so much more enjoyable and cherished. And so just remember, even if the times right now are tough, they're going to make the good times so much better. So just keep trying to do everything you can. Stay hopeful. And remember, if you pursue things that are bigger than yourself, it's even easier to stay on track because you have an obligation not only to yourself, but to people around you.
Dr Julie
Oh, beautiful. I love that. Yes. And everything progress, not perfection. One day at a time. Sometimes one moment at a time for you right back in the day. Let me just do this one thing.
Sam
Sometimes it was just trying to get up and walk down the hallway and hope that I wasn't going to pass down and have my head at the floor. So, yeah, it's just taking each moment at a time.
Dr Julie
And then you just build on that, right? Yeah. And trusting that it's going to continue to get better and again. Trust me. I know you guys can't see us, but Sam looks fabulous. He's changed just how he looks by working out, and you're accomplishing so many great things. He's in college now and we always say in our family, sam is going to be a big famous person today. So you heard him here first. So let me share before we finish up. If somebody wants to follow you just to kind of see he promotes what he does, he practices what he preaches. What's the way that they can follow you with the social media that you have?
Sam
Yeah. So my instagram is bregman underscore Sam. And bregman is B-R-E-G-M-A-N. My TikTok is SamBregman. Those are the two main places that I post. You can also check me out at my website, if you like, at www.samuelbregman.com.
Dr Julie
Beautiful. Okay, and you guys know you can find me…my website MyCognitiveBehavioralTherapy.com
I'm also on TikTok Now, which is under MyCBTPodcast; MyCBT podcast on Instagram - the same. And then Dr. Julie Osborn on Facebook.
So please keep sharing your thoughts, your concerns, your questions. I'd love to hear your feedback about this episode. I'm sure some of you will find it helpful and always pass it along to others in your life that you think will benefit as well.
And as always, remember to make decisions based on what's best for you, not how you feel.