Do I have Major Depression?

Image from Slideshare.net.

Sometimes it’s hard to tell if you have major depression, especially when you’re living with it.   

For some people, depression is a pervasive feeling of sadness or hopelessness. For some, depression means feelings of anger or extreme irritability. People with depression may swing from high levels of activity to lethargy, or they may report not feeling emotion at all.

Then there is depression that may encompass any or all of these symptoms. This is called “Major Depressive Disorder (MDD) with mixed features,” and has been most commonly misdiagnosed as bipolar disorder.

Here’s a good explanation from the neuroscience branch of Cambridge University Press:

“For the first time in 20 years, the American Psychiatric Association (APA) updated the psychiatric diagnostic system for mood disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Perhaps one of the most notable changes in the DSM-5 was…a structural bridge between bipolar and major depression disorders, [which] formally recognizes the possibility of a mix of hypomania and depressive symptoms in someone who has never experienced discrete episodes of hypomania or mania.”

If you suspect you may have MDD with mixed features, it is important to be diagnosed and treated by a professional. In fact, an article on the Psychiatric Times website described Major depression with mixed features as “a diagnostic chameleon.”

“Mixed features…are caused by the overlap of depressive and manic symptoms, but it’s hard to understand them by reading separate descriptions of these two states. It would be like trying to imagine green by studying yellow and blue…

“Mixed features can look like anxiety, ADHD, borderline personality disorder, or depression with an agitated edge.”

If you suspect you or someone you love may have MDD with mixed features, it is important to be properly diagnosed to receive the proper medication (such as a mood stabilizer in cases of persistent anxiety or anger). Come and see me and let’s get you on the road to emotional stability.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Sunlight Helps Fight Depression

Image from SmithDebnamLaw.com.

I’ve written about this before: exposure to sunlight can help fight depression. Coupled with mild to moderate exercise, being out in the daylight can help fight carbohydrate cravings, weight gain, social avoidance, even fatigue!

A 2014 study of office workers compared the mental health of those who had windows in their office, and those who didn’t. The workers with access to more natural light during the day reported more positive changes than those who didn’t.

“There is increasing evidence that exposure to light, during the day — particularly in the morning — is beneficial to your health via its effects on mood, alertness, and metabolism,” said Phyllis Zee, M.D., a Northwestern Medicine neurologist and sleep specialist who worked on the study.

Think about this for a minute: by going out into the morning sunlight, you can improve your mood, boost your productivity and concentration, and even help you metabolize more effectively. More exposure to light during the day (and less exposure to light at night) helps your body and mind fall into a natural circadian rhythm (another name for your internal clock, according to the National Sleep Foundation).

So what do you do when sunlight is scarce?

Plan daily walks outside. Remember, as little as eight minutes a day of vigorous exercise can positively affect the rest of your work day. If you go outside during your lunch break, you have the greatest chance of enjoying some good, strong daylight.

Get your vitamin D. A good vitamin D3 supplement is an inexpensive alternative to sunshine. You can also eat foods rich in vitamin D, such as egg yolks, fatty fish (such as salmon or tuna), milk and cheese.

Therapy and medication. If you find it difficult to manage your depression no matter the season, please contact me. In addition to traditional therapy, I also offer one on one “Talk and Walk” sessions on the Greenbelt. Let me help you start off 2019 with better mental and physical health.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Police Arrest Fewer Mentally Ill People with New Program

Image from WSJ.com.

In Gainesville, Florida, officer Shelly Postle teamed up with Makenzie Boyer, a mental health professional to handle calls regarding people with mental health issues.

Postle and Boyer handled 434 calls in eight months, making a co-responder team that halted 92 percent of potential arrests of mentally ill people. Boyer said she and Postle do a general assessment of behavior to check whether the person is a threat to themselves or others, and see if they are on their medications.

“Law enforcement can show up and if someone is experiencing a mental health crisis, they only have a couple of options,” Boyer said in a local news article.

Seventy-five percent of those people contacted by the co-responder team were diverted to mental health outpatient treatment, or they agreed to be submitted into inpatient treatment instead of being evaluated after being taken into custody.

The officer and mental health worker then followed up with individuals who frequently contact the public safety system.

Shockingly, by not arresting mentally ill people, the team actually saved the city and county over $200,000 dollars in eight months.

I think this is such a wonderful program. Our officers are such valuable public servants, and with the help of mental health professionals they could have more time and resources to devote to safety in our communities.

Beat the Post-Christmas Blues

Image from Vivanti.ca

The post-Christmas season can be a real emotional low point. Maybe there’s a backlog at work. Maybe your kids’ schedule is thrown off by late nights and holiday excess. Maybe you had a blowup at a family member during Christmas.

Whatever may be dragging you down, here are a few suggestions to lift your mood.

  • High-impact eating. This time of year there are a lot of sweets around for easy snacking. But these are low-impact foods: yes, they’re delicious and high-calorie, but they don’t actually make you feel full or satisfied. If you focus on eating meals that make you feel full and satisfied, you can enjoy those treats in small doses throughout the day (instead of having fudge for breakfast).
  • Exercise. I’ve written about this before: even as little as eight minutes of vigorous exercise can go a long way toward fighting anxiety and depression. Eight minutes a day! Make it something you love to do, and try it out for yourself.
  • Breathe deeply. Try this today: sit down in a quiet room, alone, and set a timer for 10 minutes. Shut your eyes and focus on your breath coming in and going out. Take deep, slow breaths and when the timer goes off, you’re done. This type of mindfulness exercise can help reset your mind and calm you down.
  • Try to forgive yourself and others. When you look back at the previous year, what were your triumphs? Your failures? Give yourself congratulations for the good, and forgive yourself for the bad. (I’ve written more about forgiveness in this post.) You can decide what practices do you want to carry forward, and what things you want to leave behind.

Above all, if you are carrying heavy emotional burdens you can’t seem to shift, contact me. I want to help in any way I can.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

How charitable giving benefits your mental health

Image from EverydayHealth.com

This title from Time Magazine really does say it all: “Being Generous Really Does Make You Happier.”

Researchers from the Unviersity of Zurich in Switzerland told 50 participants that they’d be receiving about $100 in a few weeks. Twenty-five people promised to spend that money on themselves, and twenty-five people committed to spend the money on someone they knew who needed it.

Next, researchers asked all the participants to think about a friend they’d like to give a gift to, and how much money that person would possibly spend. Each participant had an MRI of their brains, especially noting the parts of the brain that deal in social behavior, generosity, happiness and decision-making.

The people who had agreed to spend their money on other people had more activity in the regions of their brain associated with altruism and happiness, even reporting higher levels of happiness after the experiment ended.

There is other research that points to the connection between generosity and better health. How about this 2005 study where elderly participants who gave and received social support were associated with lower morbidity? Or this 2017 study by the Women’s Philanthropy Institute about how the more people give the better they feel?

Simply put, it improves your health to give, whether that means financial donations or with acts of service to people in need. Charitable giving can improve your quality of life by simply changing your outlook to recognize your privileges, and how you can help the less fortunate. The more you give, the more you serve, the more it becomes second nature.

So get out there and serve someone today!

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Four Ways to Beat Holiday Stress

Image from Psychology Today

The Christmas season can be overwhelming. Managing traditions, a heavy end-of-year workload, financial stress, even time spent with extended family can contribute to poor mental health. Here are ways you can manage your stress during “The Most Wonderful Time of the Year”: 

Set boundaries. 

This is the most important (and probably the most difficult) part of combating holiday stress. The more you run up against holiday traditions and expectations from friends and family, the more potential there is to disappoint people. And that’s okay! It’s hard, but this is exactly the time you need to take careful inventory of yourself. Ask yourself these questions: 

  1. What are the most important things to me right now?
  2. What do I need to let go of?
  3. Who can I ask for help?

Exercise. 

According to Science Daily, the holidays is exactly the time you should be getting physical activity. Here’s what exercise physiologist Erica Christ has to say about it: 

“When times get crazy, the thing people give up is exercise, and that’s the key thing a person needs….the burst of energy that you get from exercise can help burn the adrenaline off and calm you down.”

Physical activity can stimulate dopamine production in your brain, which can improve your mood. Even if it’s just for half an hour, a little exercise can go a long way. 

Alone time. 

I’ve written about this before: taking time to be alone benefits your mental health during the holidays. Simply making the choice to be alone and do something you like to do can calm you down and even nurture your creative side! 

Self care. 

In an excellent article aimed at helping nurses de-stress during the holidays, Jennifer Lelwica Buttaccio writes: 

As natural-born caregivers, it’s almost standard practice to put other people’s needs before your own. But if you want to beat burnout, it’s essential you incorporate a variety of strategies to help you unwind, relax, and rest each day…If need be, mark it on your calendar, and make these self-care activities non-negotiable.

In short: relax. Breathe deeply. And call me if you need someone to talk to. 

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

 

Singing Through Parkinson’s Disease

A group of Parkinson’s patients singing in a research study for Iowa State University.

Patients with advanced Parkinson’s are singing their way to better mental health, says Elizabeth Stegemöller, assistant professor of kinesiology at Iowa State University. (Click here to see a video of Stegemöller leading her singing group in 2017.)

Stegemöller saw patients’ moods improve and their stress decrease, and their motor symptoms fell as well.

“Some of the symptoms that are improving, such as finger tapping and the gait, don’t always readily respond to medication, but with singing they’re improving,” Stegemöller said in ScienceDaily.com.

The data is still new, but Stegemöller says the singing patients showed improvements that were similar to taking medication. Singing is also beneficial in helping Parkinson’s patient improve their respiratory and swallow control.

Stegemöller and her team measured heart rate, blood pressure and cortisol levels for the singing participants, who also reported any feelings of happiness, sadness, anger and anxiety. The same data was recorded after the one-hour singing session ended.

This is one of the first studies to look at how singing affects heart rate, blood pressure and cortisol in people with Parkinson’s disease, according to ScienceDaily. While reported levels of happiness and anger stayed about the same, patients reported they were feeling less anxious and sad.

Researchers are taking it one step further: analyzing blood samples to measure oxytocin levels, indicators of inflammation and neuroplasticity to see if these factors are also affected by singing.

Isn’t it incredible how our minds can affect our physical health? Chronic health conditions can take such a toll on your emotional health. If you feel like you’re under a cloud, call me. We can sing our way through this together.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

The Effects of Gratitude on Heart and Brain

Image from NIH.gov.

I’ve written about the ways gratitude can improve your life.

Gratitude can improve your romantic relationships, help you sleep better, decreases depression, even decreases suicidal thoughts.

A 2017 study conducted at the University of Seoul, South Korea, focused on the effects of gratitude on neural network functional connectivity, and how gratitude affects your heart and brain at the same time. 

The study observed 32 healthy volunteers–17 women, 15 men–and had them go through two 5-minute exercises called the gratitude and resentment interventions. The participants followed instructions written and spoken on a screen while they were in an MRI scanner. The first minute of both the gratitude and resentment exercises participants focused on slow, deep breathing, relaxing and calming themselves.

During the gratitude exercise, the participant was asked to focus on a mental image of their mother for four minutes and to tell their mothers in their mind how much they loved and appreciated her.

During the resentment  exercise, the participant focused for four minutes on a moment or person who had made them angry.

During the gratitude intervention, scientists observed lower heart rates than in the resentment intervention. The scientists wrote:

Given that [heart rate] is decreased among people with high self-esteem, and increased among people with high stress and anxiety, our results suggest that gratitude intervention modulates heart rhythms in a way that enhances mental health.

Scientists also found that there was a connection between expressing gratitude and higher activity in the anterior cingulate cortex (ACC), a part of the brain that is involved in decision making, ethics and emotion (among other things). Higher ACC activity means lower rates of anxiety and depression. Lower ACC activity means “emotional disorders, such as social anxiety disorder and major depressive disorder.”

“Our gratitude intervention could play a pivotal role in reducing anxiety,” they wrote. “This evidence is consistent with the idea that ACC activity is facilitated by meditation.”

While we all know gratitude is a wonderful, healing emotion, I wondered: why exactly did the scientists ask participants to use a mental image of their mother for the gratitude test?

I found this sentence in the study fascinating: “Gratitude towards a parent has been associated with resilience and low levels of aggression as well as high levels of happiness and low levels of depressive symptoms. Although expressing gratitude toward one’s mother is a powerful positive experience that can lead to a happier life, putting this theory into practice is difficult in many cases.”

Family relationships can be difficult, and I know that Thanksgiving can sometimes be a stressful or upsetting experience. Take these Korean scientists’ advice and spend a few minutes in gratitude meditation before meeting with family. And if Thanksgiving leaves you feeling raw and upset, give me a call. I want to help you have the healthiest family relationships you can.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Book Review: The Choice by Dr. Edith Eva Eger

Image from Amazon.com.

The Choice by Dr. Edith Eva Eger is an incredibly empowering book on trauma recovery, written by a woman who has sometimes been nicknamed “the Anne Frank who didn’t die.

The pain of Dr. Eger’s story is hard to fathom. Nearly her entire family, all Hungarian Jews, died in Auschwitz when she was 16 years old. Dr. Eger was an accomplished ballerina and was once made to dance before Josef Mengele, the SS doctor who was nicknamed “Angel of Death” for torturing Auschwitz inmates in the name of scientific observation. He gave her a loaf of rye bread after she finished dancing, which she tore up and shared with her bunkmates.

The Nazis transferred prisoners from Auschwitz to Gunskirchen near the end of the war. Dr. Eger remembers being made to ride on top of the train cars full of ammunition as a kind of human shield. By the time she and Magda were marched into Gunskirchen, she weighed about seventy pounds.

The girls were rescued when an American GI pulled her from a pile of corpses, feeding her M&Ms one at a time. Her sister Magda also survived and they eventually made their way back to their home where, miraculously, their sister Klara had survived the war. The reunion is as painful and beautiful as you would imagine. (A blue-eyed blonde woman, she had passed as a gentile, living part of the time as a novice in a convent.)

What sets Dr. Eger’s book apart from other Holocaust memoirs is best summed up in the forward, written by her colleague and friend Philip Zimbardo, PhD.

“…[H]er book is so much more than another Shoah memoir, as important as such stories are for remembering the past. Her goal is nothing less than to help each of us to escape the prisons of our own minds….it is Edie’s mission to help us realize that just as we can act as our own jailers, we can also be our own liberators.”

The book is divided into four sections: Prison, Escape, Freedom, and Healing. The last two sections describe how Dr. Eger eventually stops running from her past and embraces it. She is given a copy of “Man’s Search for Meaning” by Victor Frankl in her undergraduate studies and through him, she eventually finds the permission and the words to speak her truth. Frankl became a mentor and friend to Dr. Eger until he died in 1997.

Dr. Eger becomes a psychologist and begins to practice, finding pieces of her own trauma in her patients. To the spouses in crisis, to the girl with eating disorders, to the Vietnam veteran with PTSD. And as she gives them permission to heal, she gives permission to herself as well.

In the final section of the book, Dr. Eger delivers an address in Berghopf, Hitler’s private palace. She tells the crowd: 

“Every beating, bombing, and selection line, every death, every column of smoke pushing skyward, every moment of terror when I thought it was the end–these live on in me, in my memories and my nightmares…The past isn’t gone…it lives on in me. But so does the perspective it has afforded me: that I lived to see liberation because I kept hope alive in my heart. That I lived to see freedom because I learned to forgive.”

As Dr. Eger writes, “Maybe to heal isn’t to erase the scar, or even to make the scar. To heal is to cherish the wound.” This book is singular because of how Dr. Eger doesn’t once diminish the experiences of those who haven’t suffered as she suffered. She finds the commonality in all our pain, and gives people tools to own their part in their healing.

Read this book. And if you see pieces of yourself in Dr. Eger’s journey, give me a call. Post traumatic stress disorder (PTSD) is a common problem with trauma and can be a serious interruption of your life.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

How Stress Alters Your Brain

Image from APA.org.

If you are in your 40s and suspect your memory is already slipping, stress could be the culprit.

A new study found that forty-somethings who had high levels of cortisol (a stress hormone) in their bodies also had reduced brain volumes and lower cognitive performance.

This study–unlike many prior studies of cortisol’s effect on the brain–specifically targeted middle-aged men and women. Participants did cognitive testing, a brain MRI, and a fasting morning blood sample.

Those with the highest levels of cortisol had the worst performance on visual perception, executive function and attention tasks. They also had a more difficult time retaining information.

The study also found that women tended to have higher cortisol levels than their male counterparts.

I know that stress is pervasive and unavoidable. Things like personal conflict, work responsibilities and financial uncertainty are part of the human experience.

So what can you do about it?

Over the long term, women’s stress levels tend to naturally decrease with age. However, here are a few suggestions how to proactively manage your stress today:

  • Therapy. Feelings of stress can be closely linked to anxiety, depression, and other mental illnesses.  If you have a difficult time unwinding, or you don’t understand why exactly you are feeling stress, you may need extra help or medication to manage your mental health.
  • Get outside. I believe strongly in getting out into nature to improve your mental health. I wrote here about Japanese “shinrin-yoku” or “forest bathing,” which is simply taking in a forest atmosphere, which has been shown to lower cortisol levels. I actually offer walking therapy sessions on the Greenbelt for this reason.
  • Chew gum. I know this may sound silly, but there is a surprising amount of research about chewing gum and stress. This 2015 study drew a strong link between mastication (chewing) and lower levels of salivary cortisol, higher level of alertness, and lower self-reported levels of anxiety and stress.
  • Write it out.  Getting your anxieties and worries out on paper is so helpful: which things can you control? Which things aren’t your responsibility? What can you do about it? Simply writing out your feelings can help with anxiety and depression, as well as help you plan how to manage current stresses.

There are so many ways to help yourself lower your stress levels. Do it for your peace of mind, and for your future brain function.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958 or email her at satu214@gmail.com. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.