​Seasonal affective disorder: It’s more than winter blues
 
Julia Haskins
The Nation's Health February/March 2019, 49 (1) 24;
 
Winter can be a difficult season to get through. The days are shorter and colder, and you’re more likely to spend more time indoors. You may not take part in the same activities you would when it’s warm and sunny outside. While plenty of people get down during the darker months, some people go through a more serious form of the winter blues called seasonal affective disorder.
 
Seasonal affective disorder is a type of depression that comes around the same time each year, usually beginning in autumn and ending in spring. Winter is usually the toughest season for people to get through.
 
It’s not so much the cold weather as the lack of light that makes the disorder so hard to deal with, says Jill RachBeisel, MD, vice chair of clinical affairs in the Department of Psychiatry at the University of Maryland School of Medicine. The amount of light we get can affect our waking and sleeping cycles and our mood.
 
“Seasonal affective disorder is not something to just brush off and tough out,” she says.
 
The disorder mostly affects women and young adults and people who live in high latitudes, meaning that they live far from the equator where there is less sunlight. People who have family members with depression or a history of depression themselves are also more likely to have it. But the disorder can affect anyone, regardless of age, gender, location or genes. That’s why when winter rolls around, it’s important to recognize signs and symptoms and get help if you need it. People with seasonal affective disorder may feel tired, sad or irritable. They may lose interest in their favorite activities and withdraw from friends and family. Hunger, weight gain and difficulty sleeping are also typical.
 
Some people also go through the disorder during the summer, although it’s much less common then. People with summertime seasonal affective disorder may feel restless or angry and can also have weight loss, less appetite and problems sleeping.
 
There are three main types of treatment for seasonal affective disorder, RachBeisel says: light therapy, psychotherapy and medication. A mental health professional might recommend one of these treatments or a combination.
 
Light therapy involves a box that gives off a bright light that you sit in front of for about 15 to 30 minutes every day. If you use light therapy early in the fall, you may be able to reduce symptoms of seasonal affective disorder or prevent it altogether, RachBeisel says.
 
Antidepressants and psychotherapy have also shown to be effective treatments for the disorder. A therapist can help you talk through feelings of sadness or hopelessness and can help you find solutions to stay active and connected to the people around you when you’re depressed, RachBeisel says.
 
Even though scientists don’t know exactly what causes seasonal affective disorder, light plays a big role in treatment.
 
“Getting as much exposure as you can during your daily activities is really important,” RachBeisel says.
 
She encourages people with the disorder to go outside as much as possible to take in natural light. Even if it’s cold, a short walk outside during your lunch break can help you feel better. At home, arrange your furniture or position yourself so that you can take in light from the window, she suggests. And for some people, getting natural light is helpful enough that light therapy may not be necessary.

Some signs and symptoms of seasonal affective disorder may just feel like normal parts of going through a rough patch during the winter. But if you’re concerned that you have more than just a case of the winter blues, speak to a mental health professional about what you’re feeling. Some mental health problems can even get worse with seasonal affective disorder, RachBeisel says.
 
Symptoms of the disorder do generally lift when spring comes, but it’s important to take care of yourself in the meantime. Remember that it’s temporary and there are brighter days ahead.
 
Enjoy winter a little more
 
Even with seasonal affective disorder, you can find ways to get through the more difficult months and have fun doing it. Though you may have to adapt some activities for winter weather, you can still enjoy them. To make the season a little more bearable, try these ideas to keep you active, healthy and happy:

• Invite some friends over for a potluck with healthy comfort foods.
• Bundle up and take a brisk walk around your neighborhood with a friend.
• Roll out your yoga mat for some stretching.
• Surround yourself with nice things at home, like bright flowers or cozy blankets.

                  
Copyright The Nation’s Health, American Public Health Association
thenationshealth.aphapublications.org/content/49/1/24

Today is World Mental Health Day!

"There’s no need to suffer in silence - share how you’re feeling, ask how someone is doing and listen for the answer. Be willing to ask for help when you need it and know that we are all in this together." #WMHD

Together we can end the stigma - today and every day.

Today is World Suicide Prevention Day, 2019.  Suicide is a leading cause of death in the United States, and suicide rates have have been on the rise over the past two decades.  Raising awareness, offering support, and knowing what do in if you or somebody you know is having suicidal thoughts is key to preventing suicide.  There is always hope!

The following offers information about how you can help yourself or a loved one in a suicidal crisis:

Are You Feeling Suicidal?
 
How to Deal with Suicidal Thoughts and Feelings and Overcome the Pain
 
You’re not alone; many of us have had suicidal thoughts at some point in our lives. Feeling suicidal is not a character defect, and it doesn’t mean that you are crazy, or weak, or flawed. It only means that you have more pain than you can cope with right now. This pain seems overwhelming and permanent at the moment. But with time and support, you can overcome your problems and the pain and suicidal feelings will pass.
 
I’m having suicidal thoughts, what do I need to know?
 
No matter how much pain you’re experiencing right now, you’re not alone. Some of the finest, most admired, needed, and talented people have been where you are now. Many of us have thought about taking our own lives when we’ve felt overwhelmed by depression and devoid of all hope. But the pain of depression can be treated and hope can be renewed. No matter what your situation, there are people who need you, places where you can make a difference, and experiences that can remind you that life is worth living. It takes real courage to face death and step back from the brink. You can use that courage to face life, to learn coping skills for overcoming depression, and for finding the strength to keep going. Remember:

1. Your emotions are not fixed – they are constantly changing. How you feel today may not be the same as how you felt yesterday or how you’ll feel tomorrow or next week.
2. Your absence would create grief and anguish in the lives of friends and loved ones.
3. There are many things you can still accomplish in your life.
4. There are sights, sounds, and experiences in life that have the ability to delight and lift you – and that you would miss.
5. Your ability to experience pleasurable emotions is equal to your ability to experience distressing emotions.

 
Why do I feel suicidal?
 
Many kinds of emotional pain can lead to thoughts of suicide. The reasons for this pain are unique to each one of us, and the ability to cope with the pain differs from person to person. We are all different. There are, however, some common causes that may lead us to experience suicidal thoughts and feelings.
 
Why suicide can seem like the only option
If you are unable to think of solutions other than suicide, it is not that other solutions don’t exist, but rather that you are currently unable to see them. The intense emotional pain that you’re experiencing right now can distort your thinking so it becomes harder to see possible solutions to problems, or to connect with those who can offer support. Therapists, counselors, friends or loved ones can help you to see solutions that otherwise may not be apparent to you. Give them a chance to help.
 
A suicidal crisis is almost always temporary
Although it might seem as if your pain and unhappiness will never end, it is important to realize that crises are usually temporary. Solutions are often found, feelings change, unexpected positive events occur. Remember: suicide is a permanent solution to a temporary problem. Give yourself the time necessary for things to change and the pain to subside.
 
Even problems that seem hopeless have solutions
Mental health conditions such as depression, schizophrenia, and bipolar disorder are all treatable with changes in lifestyle, therapy, and medication. Most people whoseek help can improve their situation and recover. Even if you have received treatment for a disorder before, or if you’ve already made attempts to solve your problems, know that it’s often necessary to try different approaches before finding the right solution or combination of solutions. When medication is prescribed, for example, finding the right dosage often requires an ongoing process of adjustment. Don’t give up before you’ve found the solution that works for you. Virtually all problems can be treated or resolved.
 
Take these immediate actions
 
Step #1: Promise not to do anything right now
Even though you’re in a lot of pain right now, give yourself some distance between thoughts and action. Make a promise to yourself: “I will wait 24 hours and won’t do anything drastic during that time.” Or, wait a week.
Thoughts and actions are two different things—your suicidal thoughts do not have to become a reality. There is no deadline, no one’s pushing you to act on these thoughts immediately. Wait. Wait and put some distance between your suicidal thoughts and suicidal action.
 
Step #2: Avoid drugs and alcohol
Suicidal thoughts can become even stronger if you have taken drugs or alcohol. It is important to not use nonprescription drugs or alcohol when you feel hopeless or are thinking about suicide.
 
Step #3: Make your home safe
Remove things you could use to hurt yourself, such as pills, knives, razors, or firearms. If you are unable to do so, go to a place where you can feel safe. If you are thinking of taking an overdose, give your medicines to someone who can return them to you one day at a time as you need them.
 
Step #4: Don’t keep these suicidal feelings to yourself
Many of us have found that the first step to coping with suicidal thoughts and feelings is to share them with someone we trust. It may be a family member, friend, therapist, member of the clergy, teacher, family doctor, coach, or an experienced counselor at the end of a helpline. Find someone you trust and let them know how bad things are. Don’t let fear, shame, or embarrassment prevent you from seeking help. And if the first person you reach out to doesn’t seem to understand, try someone else. Just talking about how you got to this point in your life can release a lot of the pressure that’s building up and help you find a way to cope.
 
Step #5: Take hope – people DO get through this
Even people who feel as badly as you are feeling now manage to survive these feelings. Take hope in this. There is a very good chance that you are going to live through these feelings, no matter how much self-loathing, hopelessness, or isolation you are currently experiencing. Just give yourself the time needed and don’t try to go it alone.
 
Reaching out for help
 
Even if it doesn’t feel like it right now, there are many people who want to support you during this difficult time. Reach out to someone. Do it now. If you promised yourself 24 hours or a week in step #1 above, use that time to tell someone what’s going on with you. Talk to someone who won’t try to argue about how you feel, judge you, or tell you to just “snap out of it.” Find someone who will simply listen and be there for you.
It doesn’t matter who it is, as long as it’s someone you trust and who is likely to listen with compassion and acceptance.
 
How to talk to someone about your suicidal thoughts
Even when you’ve decided who you can trust to talk to, admitting your suicidal thoughts to another person can be difficult.

• Tell the person exactly what you are telling yourself. If you have a suicide plan, explain it to them.
• Phrases such as, ‘I can’t take it anymore’ or ‘I’m done’ are vague and do not illustrate how serious things really are. Tell the person you trust that you are thinking about suicide.
• If it is too difficult for you to talk about, try writing it down and handing a note to the person you trust. Or send them an email or text and sit with them while they read it.

 
What if you don’t feel understood?
If the first person you reached out to doesn’t seem to understand, tell someone else or call a suicide crisis helpline. Don’t let a bad experience stop you from finding someone who can help.
 
If you don’t know who to turn to:
In the U.S.– Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or the National Hopeline Network at 1-800-SUICIDE (1-800-784-2433).
In the UK and Ireland– Call the Samaritans at 116 123
In Australia– Call Lifeline Australia at 13 11 14
In other countries– Visit IASP or Suicide.org to find a helpline in your country.
 
How to cope with suicidal thoughts
Remember that while it may seem as if these suicidal thoughts and feelings will never end, this is never a permanent condition. You WILL feel better again. In the meantime, there are some ways to help cope with your suicidal thoughts and feelings.
If You Have Suicidal Thoughts and Feelings

Things to do:

Talk with someone every day, preferably face to face. Though you feel like withdrawing, ask trusted friends and acquaintances to spend time with you. Or continue to call a crisis helpline and talk about your feelings.

Make a safety plan. Develop a set of steps that you can follow during a suicidal crisis. It should include contact numbers for your doctor or therapist, as well as friends and family members who will help in an emergency.

Make a written schedule for yourself every day and stick to it, no matter what. Keep a regular routine as much as possible, even when your feelings seem out of control.

Get out in the sun or into nature for at least 30 minutes a day.

Exercise as vigorously as is safe for you. To get the most benefit, aim for 30 minutes of exercise per day. But you can start small. Three 10-minute bursts of activity can have a positive effect on mood.

Make time for things that bring you joy. Even if very few things bring you pleasure at the moment, force yourself to do the things you used to enjoy.

Remember your personal goals. You may have always wanted to travel to a particular place, read a specific book, own a pet, move to another place, learn a new hobby, volunteer, go back to school, or start a family. Write your personal goals down.

Things to avoid:

Being alone. Solitude can make suicidal thoughts even worse. Visit a friend, or family member, or pick up the phone and call a crisis helpline.

Alcohol and drugs. Drugs and alcohol can increase depression, hamper your problem-solving ability, and can make you act impulsively.

Doing things that make you feel worse. Listening to sad music, looking at certain photographs, reading old letters, or visiting a loved one’s grave can all increase negative feelings.

Thinking about suicide and other negative thoughts. Try not to become preoccupied with suicidal thoughts as this can make them even stronger. Don’t think and rethink negative thoughts. Find a distraction. Giving yourself a break from suicidal thoughts can help, even if it’s for a short time.
 

Recovering from suicidal thoughts
Even if your suicidal thoughts and feelings have subsided, get help for yourself. Experiencing that sort of emotional pain is itself a traumatizing experience. Finding a support group or therapist can be very helpful in decreasing the chances that you will feel suicidal again in the future. You can get help and referrals from your doctor or from the organizations listed in our Recommended reading section.
 
5 steps to recovery

1. Identify triggers or situations that lead to feelings of despair or generate suicidal thoughts, such as an anniversary of a loss, alcohol, or stress from relationships. Find ways to avoid these places, people, or situations.
2. Take care of yourself. Eat right, don’t skip meals, and get plenty of sleep. Exercise is also key: it releases endorphins, relieves stress, and promotes emotional well-being.
3. Build your support network. Surround yourself with positive influences and people who make you feel good about yourself. The more you’re invested in other people and your community, the more you have to lose—which will help you stay positive and on the recovery track.
4. Develop new activities and interests. Find new hobbies, volunteer activities, or work that gives you a sense of meaning and purpose. When you’re doing things you find fulfilling, you’ll feel better about yourself and feelings of despair are less likely to return.
5. Learn to deal with stress in a healthy way. Find healthy ways to keep your stress levels in check, including exercising, meditating, using sensory strategies to relax, practicing simple breathing exercises, and challenging self-defeating thoughts.

 
Suicide crisis lines in the U.S.:
National Suicide Prevention Lifeline at 1-800-273-8255 or IMAlive at 1-800-784-2433.
The Trevor Project offers suicide prevention services for LGBTQ youth at 1-866-488-7386.
SAMHSA’s National Helpline offers referrals for substance abuse and mental health treatment at 1-800-662-4357.
Suicide crisis lines worldwide:
In the UK and Ireland: Call Samaritans UK at 116 123.
In Australia: Call Lifeline Australia at 13 11 14.
In Canada: Call Crisis Services Canada at 1-833-456-4566.
In other countries: Find a helpline near you at Befrienders Worldwide, IASP, or International Suicide Hotlines.
 
Authors: Jaelline Jaffe, Ph.D., Lawrence Robinson, and Jeanne Segal, Ph.D. Last updated: June 2019

From: https://www.helpguide.org/articles/suicide-prevention/are-you-feeling-suicidal.htm

You have probably heard of the brain chemical called Serotonin, often referred to as the "happiness chemical" because it is known to contribute to feelings of happiness and wellbeing. In fact, the most commonly prescribed antidepressants are meant to increase the amount of Serotonin in our brains. While these medications can provide great benefits, did you know there are also proven ways to increase our brain's Serotonin levels without medication? Check out some of these ideas!

Serotonin is a neurotransmitter, or chemical messenger, that’s involved in many processes throughout your body, from regulating your mood to promoting smooth digestion.
 
It’s also known for:
 
-promoting good sleep by helping regulate circadian rhythms
-helping regulate appetite
-promoting learning and memory
-helping promote positive feelings and pro-social behavior
 
If you have low serotonin, you might:
 
-feel anxious, low, or depressed
-feel irritable or aggressive
-have sleep issues or feel fatigued
-feel impulsive
-have a decreased appetite
-experience nausea and digestive issues
-crave sweets and carbohydrate-rich foods
 
Read on to learn about different ways to increase serotonin naturally.

1. Food

 
You can’t directly get serotonin from food, but you can get tryptophan, an amino acid that’s converted to serotonin in your brain. Tryptophan is found primarily in high-protein foods, including turkey and salmon.
But it’s not as simple as eating tryptophan-rich foods, thanks to something called the blood-brain barrier. This is a protective sheath around your brain that controls what goes in and out of your brain.
 
In a nutshell, tryptophan-rich foods are usually even higher in other amino acids. Because they’re more abundant, these other amino acids are more likely than tryptophan to cross the blood-brain barrier.
 
But there may be a way to hack the system. Research suggests that eating carbs along with foods high in tryptophan may help more tryptophan make it into your brain.
 
Try consuming tryptophan-rich food with 25 to 30 grams of carbohydrates.
 
 
Here are some snack ideas to get you started:
 
-whole-wheat bread with turkey or cheese
-oatmeal with a handful of nuts
-salmon with brown rice
-plums or pineapple with your favorite crackers
-pretzel sticks with peanut butter and a glass of milk
 
 
 
     2. Exercise
 
Exercising triggers the release of tryptophan into your blood. It can also decrease the amount of other amino acids. This creates an ideal environment for more tryptophan to reach your brain.
 
Aerobic exercise, at a level you’re comfortable with, seems to have the most effect, so dig out your old roller skates or try a dance class. The goal is to get your heart rate up.
 
Other good aerobic exercises include:
 
swimming
bicycling
brisk walking
jogging
light hiking
 

1. Bright light

 
Research suggests that serotonin tends to be lower after winter and higher in summer and fall. Serotonin’s known impact on mood helps support a link between this finding and the occurrence of seasonal affective disorder and mental health concerns linked to the seasons.
Spending time in the sunshine appears to help increase serotonin levels, and research exploring this idea suggests your skin may be able to synthesize serotonin.
 
To maximize these potential benefits, aim to:
 
-spend at least 10 to 15 minutes outside each day
-take your physical activity outside to help increase the serotonin boost brought on by exercise — just don’t forget to wear sunscreen if you’ll be out for longer than 15 minutes
-If you live in a rainy climate, have a hard time getting outside, or have a high risk for skin cancer, you can still increase serotonin with bright light exposure from a light therapy box. 
If you have bipolar disorder, talk to your therapist before trying a light box. Using one incorrectly or for too long has triggered mania in some people.
 
4. Supplements
 
Some dietary supplements may help to jumpstart the production and release of serotonin by increasing tryptophan.
Before trying a new supplement, check in with your healthcare provider. Make sure to tell them if you also take:
 
-prescription medication
-over-the-counter medication
-vitamins and supplements
-herbal remedies
 
Choose supplements made by a manufacturer that is known and can be researched for reports on their quality and purity of products. Research suggests these supplements could help increase serotonin and reduce symptoms of depression:
 
Pure tryptophan
Tryptophan supplements contain much more tryptophan than food sources, making it possibly more likely to reach your brain. A small 2006 study suggests tryptophan supplements can have an antidepressant effect in women, though more research is needed. 
 
SAMe (S-adenosyl-L-methionine)
SAMe appears to help increase serotonin and may improve depression symptoms, but don’t take it with any other supplements or medications that increase serotonin, including certain antidepressants and antipsychotics.

5-HTP
This supplement can easily enter your brain and produce serotonin. A small 2013 study suggests it worked as effectively as antidepressants for those with early symptoms of depression. But other research on 5-HTP for increasing serotonin and reducing symptoms of depression has yielded mixed results. 
 
 
 
Probiotics
 
Research suggests getting more probiotics in your diet may increase tryptophan in your blood, helping more of it to reach your brain. You can take probiotic supplements, available online, or eat probiotic-rich foods, such as yogurt, and fermented foods, such as kimchi or sauerkraut.
 
Use caution when trying these supplements if you already take medication that increases serotonin. This includes several types of antidepressants.
 
Too much serotonin could cause serotonin syndrome, a serious condition that can be life-threatening without treatment. 
 
If you want to try replacing antidepressants with supplements, work with your healthcare provider to come up with a plan to safely taper off antidepressants for at least two weeks first. Abruptly stopping can have serious consequences.
 
5. Massage
 
Massage therapy helps increase serotonin and dopamine, another mood-related neurotransmitter. It also helps to decrease cortisol, a hormone your body produces when stressed.
While you can see a licensed massage therapist, this might not be necessary. One 2004 study looked at 84 pregnant women with depression. Women who received 20 minutes of massage therapy from a partner twice a week said they felt less anxious and depressed and had higher serotonin levels after 16 weeks.
Try swapping 20 minutes of massage with a partner, family member, or friend.
 
 
6. Mood induction
 
Too little serotonin can negatively impact your mood, but could a good mood could help increase serotonin levels? Some research suggests yes.
Thinking about something that makes you feel good can help increase serotonin in your brain, which can help promote an improved mood in general.
 
Try:
-visualizing a happy moment from your memory
-thinking about a positive experience you had with a loved ones
-looking at photos of things that make you happy, such as your pet, a favorite place, or close friends
 
Keep in mind that moods are complex, and it’s not always that easy to change your mood. But sometimes just engaging in the process of trying to direct your thoughts toward a positive place can help.
 
When to seek help
 
If you’re looking to increase serotonin to improve mood-related symptoms, including those of depression, these methods may not be enough.
Some people simply have lower serotonin levels due to their brain chemistry, and there isn’t much you can do about this on your own. In addition, mood disorders involve a complex mix of brain chemistry, environment, genetics, and other factors.
If you find that your symptoms are starting to impact your day-to-day life, consider reaching out for support from a therapist. 
Depending on your symptoms, you may be prescribed a selective serotonin re-uptake inhibitor (SSRI) or another type of antidepressant. SSRIs help keep your brain from reabsorbing the serotonin that’s released. This leaves more available for use in your brain.
Keep in mind that you may only need to take SSRIs for a few months. For many people, SSRIs can help them get to a place where they can make the most out of treatment and learn how to effectively manage their condition.
The bottom line:
Serotonin is an important neurotransmitter, affecting everything from your mood to your bowel movements. If you’re looking to boost your serotonin, there are a few things you can try on your own. However, don’t hesitate to reach out for help if these tips aren’t cutting it.

Source: 
https://www.healthline.com/health/how-to-increase-serotonin?fbclid=IwAR1mMTwrf3Tr2KOENDyxo55eGdnxJ7vggKjjr00W_h1G85h7IGPRI3d9Irk​

Sleep deprivation can affect your mental health
Harvard Health Publishing
 
Updated: March 18, 2019; Published: July, 2009
 
Sleep and mental health are closely connected. Sleep deprivation affects your psychological state and mental health. And those with mental health problems are more likely to have insomnia or other sleep disorders.
 
Americans are notoriously sleep deprived, but those with psychiatric conditions are even more likely to be yawning or groggy during the day. Chronic sleep problems affect 50% to 80% of patients in a typical psychiatric practice, compared with 10% to 18% of adults in the general U.S. population. Sleep problems are particularly common in patients with anxiety, depression, bipolar disorder, and attention deficit hyperactivity disorder (ADHD).
 
Traditionally, clinicians treating patients with psychiatric disorders have viewed insomnia and other sleep disorders as symptoms. But studies in both adults and children suggest that sleep problems may raise risk for, and even directly contribute to, the development of some psychiatric disorders. This research has clinical application, because treating a sleep disorder may also help alleviate symptoms of a co-occurring mental health problem.
 
The brain basis of a mutual relationship between sleep and mental health is not yet completely understood. But neuroimaging and neurochemistry studies suggest that a good night's sleep helps foster both mental and emotional resilience, while chronic sleep deprivation sets the stage for negative thinking and emotional vulnerability.
 
Key points

• Sleep problems are more likely to affect patients with psychiatric disorders than people in the general population.
• Sleep problems may increase risk for developing particular mental illnesses, as well as result from such disorders.
• Treating the sleep disorder may help alleviate symptoms of the mental health problem. 

How sleep affects mental health
 
Every 90 minutes, a normal sleeper cycles between two major categories of sleep — although the length of time spent in one or the other changes as sleep progresses.
During "quiet" sleep, a person progresses through four stages of increasingly deep sleep. Body temperature drops, muscles relax, and heart rate and breathing slow. The deepest stage of quiet sleep produces physiological changes that help boost immune system functioning.
 
The other sleep category, REM (rapid eye movement) sleep, is the period when people dream. Body temperature, blood pressure, heart rate, and breathing increase to levels measured when people are awake. Studies report that REM sleep enhances learning and memory, and contributes to emotional health — in complex ways.
Although scientists are still trying to tease apart all the mechanisms, they've discovered that sleep disruption — which affects levels of neurotransmitters and stress hormones, among other things — wreaks havoc in the brain, impairing thinking and emotional regulation. In this way, insomnia may amplify the effects of psychiatric disorders, and vice versa.
 
Psychological effects of sleep deprivation
 
More than 70 types of sleep disorders exist. The most common problems are insomnia (difficulty falling or staying asleep), obstructive sleep apnea (disordered breathing that causes multiple awakenings), various movement syndromes (unpleasant sensations that prompt night fidgeting), and narcolepsy (extreme sleepiness or falling asleep suddenly during the day).
 
Type of sleep disorder, prevalence, and impact vary by psychiatric diagnosis. But the overlap between sleep disorders and various psychiatric problems is so great that researchers have long suspected both types of problems may have common biological roots.
 
Depression. Studies using different methods and populations estimate that 65% to 90% of adult patients with major depression, and about 90% of children with this disorder, experience some kind of sleep problem. Most patients with depression have insomnia, but about one in five suffer from obstructive sleep apnea.
 
Insomnia and other sleep problems also increase the risk of developing depression. A longitudinal study of about 1,000 adults ages 21 to 30 enrolled in a Michigan health maintenance organization found that, compared with normal sleepers, those who reported a history of insomnia during an interview in 1989 were four times as likely to develop major depression by the time of a second interview three years later. And two longitudinal studies in young people — one involving 300 pairs of young twins, and another including 1,014 teenagers — found that sleep problems developed before major depression did.
 
Insomnia and other sleep problems affect outcomes for patients with depression. Studies report that depressed patients who continue to experience insomnia are less likely to respond to treatment than those without sleep problems. Even patients whose mood improves with antidepressant therapy are more at risk for a relapse of depression later on. Depressed patients who experience insomnia or other sleep disturbances are more likely to think about suicide and die by suicide than depressed patients who are able to sleep normally.
 
Bipolar disorder. Studies in different populations report that 69% to 99% of patients experience insomnia or report less need for sleep during a manic episode of bipolar disorder. In bipolar depression, however, studies report that 23% to 78% of patients sleep excessively (hypersomnia), while others may experience insomnia or restless sleep.
 
Longitudinal studies suggest that insomnia and other sleep problems worsen before an episode of mania or bipolar depression, and lack of sleep can trigger mania. Sleep problems also adversely affect mood and contribute to relapse.

Anxiety disorders. Sleep problems affect more than 50% of adult patients with generalized anxiety disorder, are common in those with post-traumatic stress disorder (PTSD), and may occur in panic disorder, obsessive-compulsive disorder, and phobias. They are also common in children and adolescents. One sleep laboratory study found that youngsters with an anxiety disorder took longer to fall asleep, and slept less deeply, when compared with a control group of healthy children.
 
Insomnia may also be a risk factor for developing an anxiety disorder, but not as much as it is for major depression. In the longitudinal study of teenagers mentioned earlier, for example, sleep problems preceded anxiety disorders 27% of the time, while they preceded depression 69% of the time.
But insomnia can worsen the symptoms of anxiety disorders or prevent recovery. Sleep disruptions in PTSD, for example, may contribute to a retention of negative emotional memories and prevent patients from benefiting from fear-extinguishing therapies.
 
ADHD. Various sleep problems affect 25% to 50% of children with ADHD. Typical problems include difficulty falling asleep, shorter sleep duration, and restless slumber. The symptoms of ADHD and sleeping difficulties overlap so much it may be difficult to tease them apart. Sleep-disordered breathing affects up to 25% of children with ADHD, and restless legs syndrome or periodic limb movement disorder, which also disrupt sleep, combined affect up to 36%. And children with these sleeping disorders may become hyperactive, inattentive, and emotionally unstable — even when they do not meet the diagnostic criteria for ADHD.
 
Sleep and mental health lifestyle changes
 
In some respects, the treatment recommended for the most common sleep problem, insomnia, is the same for all patients, regardless of whether they also suffer from psychiatric disorders. The fundamentals are a combination of lifestyle changes, behavioral strategies, psychotherapy, and drugs if necessary.
 
Lifestyle changes. Most people know that caffeine contributes to sleeplessness, but so can alcohol and nicotine. Alcohol initially depresses the nervous system, which helps some people fall asleep, but the effects wear off in a few hours and people wake up. Nicotine is a stimulant, which speeds heart rate and thinking. Giving up these substances is best, but avoiding them before bedtime is another option.
 
Physical activity. Regular aerobic activity helps people fall asleep faster, spend more time in deep sleep, and awaken less often during the night.
 
Sleep hygiene. Many experts believe that people learn insomnia, and can learn how to sleep better. Good "sleep hygiene" is the term often used to include tips like maintaining a regular sleep-and-wake schedule, using the bedroom only for sleeping or sex, and keeping the bedroom dark and free of distractions like the computer or television. Some experts also recommend sleep retraining: staying awake longer in order to ensure sleep is more restful.
 
Relaxation techniques. Meditation, guided imagery, deep breathing exercises, and progressive muscle relaxation (alternately tensing and releasing muscles) can counter anxiety and racing thoughts.
 
Cognitive behavioral therapy.Because people with insomnia tend to become preoccupied with not falling asleep, cognitive behavioral techniques help them to change negative expectations and try to build more confidence that they can have a good night's sleep. These techniques can also help to change the "blame game" of attributing every personal problem during the day on lack of sleep.

Elizabeth Wiener and Lisa Brookman
 
A more flexible work schedule, an abundance of social activities and the expectation of being carefree can put a lot of pressure on people with anxiety.
 
So many of us count down the days until the warmth and relaxation of summer arrives. It’s an exciting time filled with long sunny days, new adventures and a less formal routine. But for some, especially those who struggle with anxiety, the summer months can trigger feelings of being overwhelmed and losing control. A more flexible work schedule, an abundance of social activities and the expectation of being carefree can put a lot of pressure on a racing mind.

1) Get Moving
Exercise has long been known as a great way to defuse anxiety. Enjoying the warm weather, soaking up the sunshine and hitting the pavement is a winning combination to calm a racing mind. Get a pool membership, find a great bike trail, go for regular hikes or take part in an outdoor boot camp to get those endorphins pumping while you enjoy a healthy dose of vitamin D.

2) Set a Goal
Try and challenge yourself to train for a raceor take on a new activity. Although daunting, completing it can fuel your sense of adventure, show you that you can overcome your fears and make you feel proud and accomplished. Don’t avoid challenges this summer. Though it can be scary at first, that feeling of stepping outside your comfort zone is ultimately exhilarating.

3) Plan a Getaway
A change of scenery has always been a great way for me to unwind and curb anxious thoughts. Being in a new environment, embarking on adventures and reconnecting with my husband allow me to leave my daily routine and stresses behind and feel refreshed and recharged. Book a getaway with your favourite travel partner, even if it’s just a staycation. An escape from the hustle and bustle of your daily grind can do you a world of good.

4) Get Outside
Exposure to sunlight 
and fresh air has long been known to increase serotonin levels and reduce anxiety. Being outside promotes a sense of calm and well-being. This summer, take up a new outdoor hobby, such as gardening. It will force you to spend time outdoors and give you a sense of accomplishment as you watch the seeds of your labour take root.

5) Practice Mindfulness and Meditation
The art ofmindfulnessis simply being in the here and now. Take a few minutes every day to focus on the sights and sounds of what’s happening around you. Paying attention to the music of nature, smelling freshly cut grass and feeling the heat of the sun on your face will help ground you and put a stop to ruminating thoughts.

6) Make Good Use of Vacation Time
We often use vacation time as a way to accomplish unfinished tasks, attend long overdue appointments and get things done around the house. This summer, use some of your holidays for self-care. Pick up a book you’ve been meaning to read, hang out by the pool or meet an old friend for lunch. Adding some fun and relaxation to your summer can help you reboot and reduce stress.

Elizabeth Wiener is an educator who lives with depression and anxiety. Lisa Brookman is a clinical psychotherapist based in Montreal. Together, 
they form WiseWomenCanada.com. Follow them on Twitter at: @wisewomencanada 

source: ​https://www.besthealthmag.ca/best-looks/mental-health-in-the-summer/

"Self-care" has certainly become a buzz word in recent years, but what is it, really? True self care means taking care of your whole self in a way that works for you. A balanced you mentally, emotionally, and physically means you can be your best you with family, socially, at work, and even when you're alone.

By Raphailia Michael, MA
 
When asked the question: “Do you take care of yourself?” most of us will answer “yes” — we’d even think, “What kind of question is this? Of course, I care about myself.”
When asked, “In what ways do you take care of yourself?” — well, that’s where the tricky part begins.

What is self-care?
Self-care is any activity that we do deliberately in order to take care of our mental, emotional, and physical health. Although it’s a simple concept in theory, it’s something we very often overlook. Good self-care is key to improved mood and reduced anxiety. It’s also key to a good relationship with oneself and others.

What isn’t self-care?
Knowing what self-care is not might be even more important. It is not something that we force ourselves to do, or something we don’t enjoy doing. As Agnes Wainman explained, self-care is “something that refuels us, rather than takes from us.”

Self-care isn’t a selfish act either. It is not only about considering our needs; it is rather about knowing what we need to do in order to take care of ourselves, being subsequently, able to take care of others as well. That is, if I don’t take enough care of myself, I won’t be in the place to give to my loved ones either.

In a few words, self-care is the key to living a balanced life

Where do you start? Well, there are three golden rules:

• Stick to the basics. Over time you will find your own rhythm and routine. You will be able to implement more and identify more particular forms of self-care that work for you.
• Self-care needs to be something you actively plan, rather than something that just happens. It is an active choice and you must treat it as such. Add certain activities to your calendar, announce your plans to others in order to increase your commitment, and actively look for opportunities to practice self-care.
• What I often emphasize to my clients is that keeping a conscious mind is what counts. In other words if you don’t see something as self-care or don’t do something in order to take care of yourself, it won’t work as such. Be aware of what you do, why you do it, how it feels, and what the outcomes are.

Although self-care means different things to different people, there’s a basic checklist that can be followed by all of us:

• Create a “no” list, with things you know you don’t like or you no longer want to do. Examples might include: Not checking emails at night, not attending gatherings you don’t like, not answering your phone during lunch/dinner.
• Promote a nutritious, healthy diet.
• Get enough sleep. Adults usually need 7-8 hours of sleep each night.
• Exercise. In contrast to what many people think, exercise is as good for our emotional health as it is for our physical health. It increases serotonin levels, leading to improved mood and energy. In line with the self-care conditions, what’s important is that you choose a form of exercise that you like!
• Follow-up with medical care. It is not unusual to put off checkups or visits to the doctor.
• Use relaxation exercises and/or practice meditation. You can do these exercises at any time of the day.
• Spend enough time with your loved ones.
• Do at least one relaxing activity every day, whether it’s taking a walk or spending 30 minutes unwinding.
• Do at least one pleasurable activity every day; from going to the cinema, to cooking or meeting with friends.
• Look for opportunities to laugh!

​Set up a 15-day self-care routine and see how you feel before and after. And never forget: As with everything, self-care takes practice!

Exercise is an amazing benefit to both physical and mental health and something anybody is capable of in some way. This article largely discusses the use of exercise in inpatient treatment facilities, but it is equally as beneficial in outpatient treatment. A little movement can go a long way!

Summary: Adding exercise as a treatment for patients in psychiatric care facilities has positive benefits and is proving to be more effective than medications or psychotherapy alone. Exercise helps reduce mental health disorder symptoms such as anxiety, depression, anger and psychomotor agitation. Researchers say exercise also helps to develop a more balanced and integrated sense of self for those with mental health disorders.

Source: University of Vermont

When it comes to inpatient treatment of a range of mental health and mood disorders — from anxiety and depression to schizophrenia, suicidality and acute psychotic episodes — a new study advocates for exercise, rather than psychotropic medications, as the primary prescription and method of intervention. Findings from the study reveal that physical exercise is so effective at alleviating patient symptoms that it could reduce patients’ time admitted to acute facilities and reliance on psychotropic medications.

“The general attitude of medicine is that you treat the primary problem first, and exercise was never considered to be a life or death treatment option. Now that we know it’s so effective, it can become as fundamental as pharmacological intervention,” explains David Tomasi, a lecturer at the University of Vermont, psychotherapist and inpatient psychiatry group therapist at the University of Vermont Medical Center and lead researcher of the study.

Practitioners at inpatient psychiatric facilities — often crowded, acute settings in which patients experience severe distress and discomfort — typically prescribe psychotropic medications first, rather than natural remedies like physical exercise, to alleviate patients’ symptoms such as anger, anxiety and depression. In fact, Tomasi estimates that only a handful of inpatient psychiatric hospitals in the U.S. provide psychotherapist-supported gym facilities exclusively for these patients. Instead, practitioners rely on classical psychotherapeutic and pharmacological frameworks to treat psychiatric symptoms, which they monitor to determine when a patient is ready to be discharged from the facility.

Tomasi, in collaboration with UVMMC’s Sheri Gates and Emily Reyns, built a gym exclusively for roughly 100 patients in the medical center’s inpatient psychiatry unit, and led and introduced 60-minute structured exercise and nutrition education programs into their treatment plans. The psychotherapists surveyed patients on their mood, self-esteem and self-image both before and after the exercise sessions to gauge the effects of exercise on psychiatric symptoms.

Patients reported lower levels of anger, anxiety and depression, higher self-esteem, and overall improved moods. Tomasi, Gates and Reyns found an average of 95 percent of patients reported that their moods improved after doing the structured exercises, while 63 percent of the patients reported being happy or very happy, as opposed to neutral, sad or very sad, after the exercises. An average of 91.8 of patients also reported that they were pleased with the way their bodies felt after doing the structured exercises.

“The fantastic thing about these results is that, if you’re in a psychotic state, you’re sort of limited with what you can do in terms of talk therapy or psychotherapy. It’s hard to receive a message through talk therapy in that state, whereas with exercise, you can use your body and not rely on emotional intelligence alone” explains Tomasi.
​
“The priority is to provide more natural strategies for the treatment of mood disorders, depression and anxiety,” he adds. “In practice, we hope that every psychiatric facility will include integrative therapies — in our case, exercise in particular — as the primary resource for their patients’ psycho-physical wellbeing.”

https://neurosciencenews.com/exercise-mental-health-14069/?fbclid=IwAR1gvz3bSZKF07qkjwB-nk19K0wbnJRLP0haO_Vc3AEWcPVqD1Oj7Q57G1E