Books Podcast: What Really Causes Depression?

Podcast about an interesting (and controversial) new book written by Johann Hari.  Entitled Lost Connections: Uncovering the Real Causes of Depression- and the Unexpected Solutions, Mr. Hari’s book offers a different, and sometimes critical, perspective when in reaction to more main stream opinions concerning mental illness.  Read more here.

Leveraging Smartphones in Patient Care

Interesting article published by two doctors considering the potential impact of smartphones to help monitor information relevant to mental illness.  Smart phones have become ubiquitous in Western society and are increasingly penetrating developing spaces so there is a lot of potential to exploit the extensive reach of this technology.  Read the article here.

10 Tips for Dealing with Depression During the Holidays

While most of us are so busy with doing that, we have little time for being, the days surrounding major holidays can feel especially overwhelming. Most of us seem to lose touch with our connection to the natural world until we experience a life-changing event that locks that moment down into the month or the season. “The Holiday Season,” with capital letters, is one of those markers that is meant to provide a space for reflection, wonder, and deep joy. Advertisers capitalize on our sentiment through advertisers using images of families or neighbors coming together to cheer up individuals who are portrayed as alone and lonely, if not downright abandoned.

Unfortunately, many lonely people do not have a cheering group of neighbors, friends, or families eager to surprise them with holiday lights, tins of cookies, or invitations to join them for a holiday meal. Loneliness and hopelessness can increase while images of altruistic concern and heartwarming moments seem to be the bar against which all holiday experiences should be measured.

Once the first day of winter arrives, the shortened days and decreased exposure to sunlight generate unexpected feelings of depression for many along with lethargy that comes from the resultant vitamin D production in the body. If you have experienced loss, heartache, or depression, the change in season can send you spiraling deep into a very dark place. Putting on a brave face for others can be especially difficult when the world is blasting us with images of group hugs and the memory of your final hug with someone you love is all that you can think about.

No matter what the cause of your holiday lows might be, here are ten tips that might help you cope during this season:

Don’t completely isolate yourself from other people. Social connection has great healing power – attend a faith-based service, even if you are not committed to a particular religion, just to experience the positive feelings of being surrounded by others.

Allow yourself space to acknowledge any losses, despair, or hurt you are feeling, but do not let yourself use the loss as an excuse to escape through alcohol or other addictive substances.

If a particular ritual is just too painful to try and continue this year, accept that there are limits to what you are capable of doing and forgive yourself for that.

Don’t allow yourself to use any holiday-related time off from work as an excuse to hide from the world – stick to as regular a schedule as you can.

Don’t binge eat or binge drink – while these may offer a sense of temporary escape, they are not healthy coping methods.

If you’re recovering from a broken relationship, it’s especially important not to dwell on the past, an imagined future, or thoughts of revenge. Make sure that your ex’s contact information is wiped from your phone to help you avoid any temptation to make any desperate attempts at reaching out.

If you’re recovering from grief at the loss of a loved one, create a special new ritual that honors the person who is no longer there. Light a special candle and offer a silent or spoken tribute to this person. Add a special decoration to your collection and display it in this person’s honor. Choose a special recipe that was always a favorite and prepare it each year – saying a special prayer in their honor before consuming it.

Reflect on what has brought the most joy to you during this season in past, happier years. Force yourself to engage in this aspect of the holiday with as much energy and commitment that you can muster. If it was the lights of the season, throw your heart into decorating your home with the lights that always brought a smile! If it was the cookies, bake your heart out – even if you aren’t the most talented chef, enjoy doing something that your loved one would have enjoyed seeing happen. If it was the carols and songs of the season, let the CDs, Sirius, or Pandora serenade the silence with the songs this person loved.

Remind yourself that at this time of year, the shortest day falls on the last day of autumn. Winter may bring the coldest weather, the deepest hibernation of animal life, the barren trees may stand out starkly against the winter sky, but remind yourself that once the first day of winter has arrived, the days are once again growing in length and the nights are beginning to shorten. This is a magic time when we can feel the change in the natural world on a very deep level. The feelings of depression or deep grief you feel may ebb and flow like a tide, but remind yourself that there is a natural rhythm in life and it truly is always darkest before the dawn.

Honor your feelings, but don’t allow yourself to get so wrapped up in despair or hopelessness that you retreat fully from the world around you. When we let ourselves get sucked into a place of abject despair and darkness, we are sacrificing the potential for joy that others might bring you – or that you, yourself, could bring others.

If your holiday season is a time of depression, grief, or hurt, know that you are not alone. Others also are suffering as the world blares entreaties to be “merry and bright,” but sadness and heartache are filling your heart. Keep active over this period, show up in life, and remind yourself that each day that you do, it’s one less day you’ve given depression the power to take from your life.

By Suzanne Degges-White, Ph.D., LPC, LMHC, NCC. Susan is professor and chair of the Counseling, Adult and Higher Education department at Northern Illinois University. She is a licensed counselor whose focus includes working with individuals and families facing transitions. Her academic research explores development over the lifespan with a strong focus on women’s relationships and women’s developmental transitions. She is currently president of the Association for Adult Development and Aging, a division of the American Counseling Association.

 

 

 

 

Dual Diagnosis: Why Substance Abuse Worsens Your Mental Health

Blog posted by experts from the Cleveland Clinic briefs the different factors that lead to high rates of ‘co-occurrence’, ie instances of both mental illness and substance abuse.  It also clearly points out that though the problems associated with both can be overwhelming due to their overlapping, interwoven and mutually reinforcing tendencies, there are plenty of options to help treat the illness.  Read the blog here.

Emotion Rules When There is Depression

Stuck in a negative network, changing thoughts or actions is just plain hard.

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“I cannot do what you suggest – I know it won’t work.”

That was Jon’s mantra as he sat in my office and said that he can never be happy. The one thing he wants – a wife and family – will never happen because fate has determined he is not going to achieve that goal. Yet most opportunities he gets to meet someone new, he believes will not work.

Why is he resisting meeting new people when someday one might be interested in him? His inability to move from one idea to another to create a change in thinking or in attitude is typical for depression. And, as in Jon’s case, it seems like it’s intentional. Or at least that’s what family and friends see when they tell their depressed loved ones to “Just do it!” It is easy to judge from the outside, but it is hard to see on the inside of a person with depression.

That stuckness is a feature of underlying neurobiology. All of us think in networks: when we start to think about a topic, we enter a network of related concepts that allows thinking to be efficient and helpful. Ideas are linked and things we need to know are easier to access when we enter a network of similar ideas, experiences, or emotions. That is why when people are trying to develop a creative solution to a problem, they brainstorm. That is, they utter or write every idea that pops into their minds about solving a problem – no matter how ridiculous it sounds on the surface – and do not assess the idea until they have a long list of options. Brainstorming is valuable because it helps us remove ourselves from the already framed network and helps create a new one.

That same efficient brain that networks and categorizes also causes a problem when depression hits. Entering a negative network that connects similar thoughts, experiences and emotions result in a depressed person linking negative networks. It promotes the discouraged outlook that is typical of depression. And, unfortunately, in depression, the ability to move to another more positive network is impaired. The weakened activity of the neurotransmitters causes “stuckness” in the pathway in the brain that allows shifting of thought and emotion.

That pathway includes a part of the brain called the anterior cingulate cortex (ACC) that should allow for rapid shifting between emotion and thinking and should aid in developing creative problem-solving. But when people suffer depression, this pathway of the brain is impaired. It may be overactive – spinning in place without creating movement. Or it may be sluggish and unable pass along cognitive decisions like, “I will try something new,” to the emotional part of the brain that generates the discouraged, “I never have good results.”

Emotion rules when there is depression. The negative “It won’t work for me,” style of thinking seems to have more power than the optimistic, “Just give it a try,” method of thinking.

Sitting with Jon, I want to say, “Just do what I am suggesting!” I want him to borrow my ability to generate a new idea, but some things have to change before he can try something new. He cannot respond to “just do it” while his negative networking is making him believe that his case is different. His notions about how to act are the ones in the network of what he has typically done, which is a very negative network.

How can he get out of this?

He needs a MAP.

When you use a map – even your navigator – you have to know where you are starting and where you are going. Jon needs to know he is currently stuck and that another way just might be possible. But where is he going? He needs to believe in a reasonable solution. In our conversations, Jon is beginning to believe that his depressed thinking is a problem.

Medication might help him be less negative – it can correct the neurotransmitter problems that cause the sluggish or overactive pathway to prevent new ideas. (Supplements and nutrition and sunlight can also help!) Next, he needs to redefine his goal. If marriage to exactly the right person is the only thing that will make him happy, then I cannot help him. He needs a matchmaker and a lot of money for that. If he wants to redefine what a happy life looks like to him, therapy can guide him. But once he can see the need for help to navigate his goal of a happy life, he needs to find a map. This map will need to take him toward feeling better and developing a more flexible, creative way of thinking. If he can get out of the negative network he will be more able to generate new actions and take charge of his discouraged mood.
MAP – Move, Ask, Play

M – (You may want to consider medication as the first M and then go to this one)

Jon needs to move. Literally, move his body. The stuck brain finds it easier to shift gears when the physical body is moving. Walking, swimming, bike riding can all be good. Try movement without earbuds pumping music. The creative brain will take over and just might jump the tracks of negativity while you move. And vigorous exercise has a way of pumping up energy that lightens depression.

A – Ask for input. When we brainstorm it works better if we have more than one person adding ideas. We spur each other into different networks. Jon might benefit if he shares his challenge of being stuck with a friend or three. And it will be good for him to ask people what gives them happiness or satisfaction. He might hear that there are many ways to be content.

P – Play around with different options. Jon does not have to commit to an idea of what is fun or pleasurable or satisfying. He would benefit from playing with the children in his life whose joy is infectious. Play sports or games. Playing stimulates different networks and may result in some changes in his mood or thoughts that may help him be less depressed.

There is a saying that life is a journey, not a destination. I do not know Jon’s ultimate destination, nor does he. The outcome of this MAP will help him find a better, more creative, and less depressed way of living his life.

By Margaret Wehrenberg, Psy.D. Margaret is the author of 5 books published by W.W. Norton, includingThe 10 Best Ever Anxiety ManagementTechniques, The 10 Best Ever Depression Management Techniques and her most recent 10 Best Anxiety Busters, an ideal book for the general public. She earned her M.A. studying psychodrama and bioenergetics, and had years of experience as a certified drug and alcoholism counselor, before earning her Psy.D. She now specializes in treating anxiety and depression and has a private practice in Naperville, IL. She is a frequent contributor of articles to The Psychotherapy Networker magazine, has contributed a chapter to Clinical Pearls of Wisdom (Ed. M. Kerman), and has produced CD for breathing, muscle relaxation and imagery for anxiety management.

This article originally appeared in Psychology Today magazine.

 

How To Deal With Stigmatizing Remarks About Mental Illness

In the wake of the massacre in Texas, this pertinent article looks into how President Trump’s characterization of the shooting as resulting from a “mental health problem” is part of a broader tendency to demonize mental illness in the wake of tragedies.  The article lays out why such an approach is both misleading and unhelpful, while also providing some helpful advice for combatting stigmatization.  Read it here.

Seasonal Affective Disorder: What You Need to Know

We set our clocks back an hour in early November, resulting in shorter days, and darker skies before most of us leave work each afternoon.

It is important to understand the effect that light has on us. If you find yourself falling into the doldrums at this time of year as the number of daylight hours dwindle, seasonal affective disorder (SAD), sometimes called seasonal depression, may be to blame. Most SAD sufferers experience symptoms during the winter months, causing researchers to conclude that inadequate sunlight may play a role. But you don’t have to spend the winter months feeling depressed and unmotivated. Here’s what you need to know about SAD and how to alleviate it.

What Causes Seasonal Affective Disorder?

Most researchers believe decreased access to sunlight plays a role in seasonal affective disorder. Light affects our circadian rhythms, and UV rays can also change how the body processes vital minerals and other nutrients. For example, inadequate sunlight exposure is linked to low Vitamin D, which, in turn, has been linked to depression and other physical and mental health woes. So, the effects of darkness on the body—not just darkness itself—might be partially to blame.

A recent study, published in the Journal of Affective Disorders, bolstered the connection between SAD and inadequate sunlight. It found that weather and climate—including rain and pollution levels—don’t appear to alter mood. But access to sunlight is a major predictor of mental health. In the study, people who lived in regions with shorter, darker days were more likely to experience poor mental health.

While light almost certainly plays a role, not all cases of SAD occur during the short, dark days of winter. A small fraction of cases occur on a seasonal basis during the spring or summer, which suggests that no single factor can fully explain SAD. Other potential risk factors include:

  • Seasonal lifestyle changes. If you only work during a portion of the year, have less to do during a specific time period, or face annual stress, you may experience seasonal depression.
  • Seasonal associations with previous trauma and grief. Our minds form strong connections between the sights and sounds of seasonal shifts and memories of the past. You may find yourself growing depressed each year around the time you suffered a trauma or loss.
  • Cultural norms and traditions. The high of the holiday season followed by the low of the new year can spur depression in some people.
  • Certain health issues are more likely to manifest at specific times of the year. For example, if you have severe allergies, you may get depressed in the spring, while chronic bronchitis can make the winter months depressing.

Each of these factors alone is unlikely to trigger depression, but in conjunction with other risk factors—including a family history of any form of mental illness—they can lead to SAD.

Symptoms of Seasonal Affective Disorder

Cyclical depression that occurs around the same time each year or that relents when the season changes, is the hallmark of SAD. If symptoms are not cyclical, you might be diagnosed with another disorder, such as major depressive disorder or dysthymia.

People with SAD often experience depressive symptoms which are less severe than those associated with major depressive disorders. Though suicidal thoughts can and do occur—particularly if SAD is left untreated—these thoughts are less common. Some common symptoms include:

  1. Low energy, feelings of grogginess, or excessive sleep. People with summer SAD may experience insomnia.
  2. Changes in appetite. People with SAD are vulnerable to weight gain. SAD sometimes causes carbohydrate cravings, because carbs offer a temporary energy boost.
  3. Irritability and anger.
  4. Changes in your relationships with others: People with SAD often feel lonely and rejected.
  5. Loss of interest in previously enjoyed activities.
  6. Feelings of guilt.
  7. Dread or uncertainty about the future.
  8. Loss of motivation.
  9. Feelings of sadness.

Treatment for Seasonal Affective Disorder

People with winter SAD often respond well to light therapy, which involves sitting under a UV lamp for a short period of time each day. If you have access to daylight and can spend time outdoors, you might also find your symptoms improving if you receive 20-40 minutes of daily direct sun each day.

Treatment for major depression can also prove effective at treating SAD. Those treatment options include:

  • Psychotherapy to help you talk through your feelings, identify problematic thought patterns, and more effectively cope with your depression. If causes relationship problems, therapy may also help improve your relationships. Your therapist can also talk to you about lifestyle changes—diet, exercise, activities—that may complement your treatment and help to alleviate your depression.
  • Antidepressants: Depression alters chemicals in your brain. Sometimes lifestyle remedies are inadequate to get things back on track. Antidepressants can be effective and often need only to be taken for a short period.

Is It Possible to Prevent Seasonal Affective Disorder?

Research on the prevention of SAD is mixed. However, there is some evidence that light therapy can help prevent SAD in people with a previous history of the condition. If you’re worried that you might develop SAD this winter, talk to your doctor about preventative strategies. Also, maintain a healthy lifestyle—overeating during the holidays, excessive spending, and low motivation can all make SAD worse.

If you experience SAD, you don’t have to suffer through months of misery. SAD is one of the most treatable forms of depression, and with the right care, you can feel better in weeks, or even days.

This article originally appeared in Psychology Today magazine

Joel L. Young, M.D., is the Medical Director of the Rochester Center for Behavioral Medicine outside of Detroit and teaches Psychiatry at Wayne State University School of Medicine. Trained at the University of Michigan, Dr. Young is certified by the American Board of Psychiatry and Neurology and holds added qualifications in geriatric and forensic psychiatry. In addition, he is a diplomate of the American Board of Adolescent Psychiatry.

Dr. Young and his clinic have been primary investigators in a number of clinical trials involving antidepressant, AD/HD, and bipolar medications. He has authored three books and more than 70 textbooks and articles. His most recent book, When Your Adult Child Breaks Your Heart: Coping with Mental Illness, Substance Abuse, and the Problems That Tear Families Apart, was published by Lyons Press in December 2013.

 

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