Tag Archives: anxiety

Mindfulness: It’s good for your heart

Over the years, I’ve seen mindfulness meditation make a big difference for clients dealing with depression and anxiety. But today I learned that mindfulness is good for the heart not just metaphorically, but physically as well. 

A new study shows that people who are more mindful — in other words, they are better at focusing on “the now” instead of rehashing the past or worrying about the future — have healthier glucose levels. Two things that might help explain this connection, researchers found, are: 1. Mindful people are less likely to be obese, and 2. Mindful people have a stronger sense of control over their lives — they believe they can make important changes.

This is good news for everyone, not just the mindful among us, because mindfulness is a trait that can be learned and developed. Working with a therapist is helpful, but practicing mindful meditation on your own can be, too. You can even find apps for your smartphone that will walk you through various meditations, helping bring your mind back to what is going on inside and around you.

Eventually, we hope, doing these mindfulness exercises will help you cultivate the everyday mindfulness that will change how you behave and how you respond to stressful situations.

So let’s work to be more aware of the world around us! It’s good for our hearts!


Wondering where you fall on the mindfulness spectrum? Here are some questions to consider:

  • Do you find yourself running on autopilot frequently?
  • Do you forget names soon after you hear them?
  • Do you snack without being aware of what you’re eating?
  • Do you break or spill things out of carelessness?

Go here for the full questionnaire researchers use to measure mindfulness. 


Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.

Treating mood swings during perimenopause

When you first start having perimenopausal symptoms, you may not put two and two together; after all, you’re too young to be going through menopause. The changes in your body can confuse you and drive you to distraction. It is not uncommon to be confused and for mood swings to occur. If you are experiencing episodes that you don’t understand such as extreme mood swings, there are treatment options.

Mood swings can have many causes. Sleep patterns may be interrupted by night sweats or hot flashes. Studies show that when a person doesn’t get enough sleep each night, episodes of irritability, lack of focus, and extreme stress may occur. Along with these symptoms, your immune system weakens because the body is not getting the downtime it needs to repair and restore from the day’s activities.

Mood swings can be brought on by difficult or changing situation in your life. A normal interaction with a child who asks for something repeatedly can pluck that last nerve and send you screaming out of the room. A cross word can send you into tears. An extra project at work combined with sleep deprivation can lead to poor work performance and/or missed deadlines.

It can seem like everything has gone to hell in a hand basket in no time at all. This slow descent into the abyss we call stress can lead to depression in many perimenopausal women. Not being able to get a handle on the symptoms leaves you in a vulnerable state without your normal coping mechanisms you’ve relied on during all those “normal” years.

Treatment Options

You are not alone in your despair. There are many options for treating this very common part of perimenopause:

• Support – This can be a group sponsored by your doctor, church, hospital, online group, or simply a group of friends who are also going through the same situation. Talking with others about your symptom can ease the burden. Women experiencing the same things may also be able to suggest ways that may help you cope better.
• Meditation – Taking time out in a quiet place to listen to your inner self can help you prepare for the day with a full suit of armor. Yoga is a type of meditation that also involves body stretches which prove to increase your fitness level and that mind-body connection.
• Exercise – There’s a reason exercise keeps coming up. Exercise is great for a variety of ailments. Physical activity increases oxygen levels in the brain and also releases the body’s natural antidepressants; endorphins. You think more clearly, experience greater mobility, and relieve tension and stress with exercise. That is why exercise is mentioned so often.
• Antidepressants – There are many reasons why antidepressants are prescribed; some reasons are obvious, while others, not so much. There are antidepressants which actually have helpful side effects which benefit perimenopausal symptoms; such as sleeplessness. Your doctor or nurse practitioner may prescribe antidepressants for many different reasons, for instance, to help you cope with mental and physical changes that are causing quality of life problems. You don’t have to stay on antidepressants forever. Your provider will help you wean off the antidepressants when you and your doctor feel you are ready.

Mood swings can be managed during perimenopause even though you might not think so right this minute. You do not have to suffer alone. Ask your doctor or nurse practitioner for information regarding the current research on ways to fight mood swings during this stage in your life.

The role of apathy in the success of weight loss programs

Obesity is sadly at epidemic proportions. Most of us  are very aware of the devastating health consequences of obesity: diabetes and other metabolic syndromes, heart disease, stroke, even Cancer.  So many are trying to fight the battle of the budge whether it be Weight Watchers, Jenny Craig, Nutrisystem, Atkins and others. There is numerous studies identifying the pros and cons of these programs.
This month I read a very interesting article  in the journal of “Diabetes, Obesity and Metabolism” (December)  This article reported a very intriguing study not normally looked at in weight loss studies. The study looked at how different weight loss programs effected weight loss success. There were three groups. (1) standard nutrition counseling; or (2) the Department of Veterans Affairs (VA) weight loss program called “MOVE” ;, or (3) methylphenidate treatment plus the MOVE program together. The intervention was for 6 months (26 weeks). The last group targeted decreasing apathy. They did this by administering a medication that decreased apathy (Methylphenidate. ) The results showed all groups to lose weight but it was observed that those in the group that targeted the symptom of apathy lost the most weight. This is no surprise to me.
In my practice I see many people who present with the symptom of apathy, a state of being where this a lack of interest or caring in the things around them. Often a patient will have no motivation or energy to eat healthy, to exercise, to address a health problem or do those things that will help them feel better or be in a healthier state. Many of these patients are depressed but others have anxiety, psychotic illness or sometimes ADHD. Interestingly, I will notice after treatment which may include Cognitive Behavivoral Therapy, nutritional supplements, goal setting, and for some, the use of medication that has an added effect in decreasing apathy, that many report  they lose weight.  They notice a higher engagement in healthy habits that wasn’t there before. They may notice less binge behavior.

While I don’t advocate the use of medication for everyone,  for some people with diagnosable mental health conditions medication may be quite helpful in losing or preventing weight gain through the mechnism of decreasing apathy.  Psychotherapy, particularly CBT, is also very useful in helping with weight issues. Anything that will help a person be more mentally healthy I believe will contribute to healthy weight.

Now, I know it is the holiday season, but please do not pass the eggnog!

Autistic spectrum disorders: what works?

There is a very interesting study out of the journal of Child Psychiatry and Human Development out this month. It was a study of children with Autism Spectrum Disorders who suffered from anxiety. The purpose of the study was to try out Cognitive Behavioral Therapy (CBT) for 16 weeks with these children to see if anxiety could be reduced. This therapy was also compared with a Social Recreational program.
Results were significant. Children in both groups showed lessened anxiety levels at 6 month follow-up.
This study also made suggestions to make programs successful. Factors such as regular sessions in a structured setting, social exposuire, the use of autism-friendly stategies and consistent therapists were mentioned as components of effective management of anxiety in children and adolescents with ASD.

Stimulants not always the answer for Attentive Deficit Hyperactivity Disorder

In my practice, I’m amazed about how many people come to me and have taken some test online and have self-diagnosed themselves with ADHD or ADD and want me to give them stimulants. It happens every week. I also don’t know how many times I’ve had to tell these same people that stimulants may not be the answer to their problems and can even make their mental health symptoms worse! Let me give you a case in point of when stimulants may have done more harm than good.

Larry, (not his real name) is a 53 year old male who reports that he has taken Adderall or the equivalent for 30 years. He reports it makes him organized. It makes him be able to focus and concentrate and complete tasks. I take careful note but also observe that this same guy is very rigid, angry and irritable during our visit. He has a history of attempted suicide and has been hospitalized several times. He also tries to hide the fact that he lived in a reclusive situation away from civilization for years and has been unable to work for authority figures. He also reports he is estranged from friends and family.

Yes, it is true that stimulants help many people with focus and concentration. It is also the fact that ADHD is not the only condition that makes a person disorganized, unfocused and unable to complete tasks. For instance the guy above ended up being diagnosed with Schizophrenia. Other conditions like Bipolar Disorder, Depression, anxiety disorders and Thyroid Disorders can look like ADHD. Giving the above patient stimulants can bring out his rigidness, his anger and irritability and even psychotic symptoms. If one has tendencies toward obsessive compulsive disorder it would be especially important to avoid taking stimulants. Stimulants can make the OCD worse. A better way to go might be to effectively treat the OCD symptoms and the patient may find that their ADHD like symptoms greatly improve.

Sadly, years of stimulant misuse for the above patient made him so rigid in his expectations that he was psychologically unable to consider other possibilities for his problems. This is why it is so important that when suffering from ADHD like symptoms that a specialist who works regularly with the various mental illnesses be called upon to do the initial evaluation. It can potentially prevent years of problems and help a person become quickly more functional to reach his goals. I wish this guy could have been spared all the pain he went through! Can you imagine the implications for posterity and other family members?

Depression: Should I go herbal or the medication route?

 
I have some patients who come to me for Depression who wonder whether St. John’s Wort is adequate in the treatment of Depression. My answer is it depends on the severity of the Depression. 
 
In mild to moderate cases where the Depression has been experienced for 3-6 months or less I would suggest the possibility of St. John’s Wort as a chemical remedy. There has been some recent promising research showing the effectiveness of St. John’s Wort in these cases. The advantage of using St. John’s Wort is not only in its effectiveness but it has fewer side effects than antidepressants. Antidepressants can have side effects such as weight gain, sexual dysfunction, fatigue and insomnia for some. Usually I see these side effects in the higher doses of antidepressants. There are some antidepressants that are worse than others as far as side effects are concerned.
 
If the Depression has been going on for greater than 3 months and especially for recurrent types of Depression I would suggest trying an antidepressant. Both St. John’s Wort and antidepressants increase Serotonin and other neurotransmitters.
 
This article is not meant to say that other forms of help should not be tried. I am a strong believer of Cognitive Behavioral Therapy (CBT) which seems to have the most promising research out as far as effectiveness. However, in the more severe types of depression the best combination appears to be a therapy like CBT combined with an antidepressant. That appears to be the quickest route to the remission of moderate to severe Depression.  
 
If you are not sure what type of treatment is best for you I would suggest you confer with a mental health specialist who prescribes, either a Psychiatric Mental Health Practitioner (Sometimes called an Advanced Practice Nurse) or a Medical Doctor. In some states Clinical Nurse Specialists (CNS) in mental health can also do the evaluations and prescribe medication.

Anxiety Disorders in Children: a family affair

According to the Surgeon General, anxiety disorders affect approximately 13% of children. Some diagnoses that reflect a problem with anxiety are: Generally Anxiety Disorder, Social Phobia, Avoidant Personality Disorder, and Panic Disorder. All of these show similar symptoms of anxious feelings, sweaty palms, pounding heart, increased respiratory out put, sick or sore stomach, and other symptoms. 

What is the cause of anxiety disorders? It’s not fully understood, but we do know that anxiety disorders tend to run in families—probably a mixture of environmental upbringing and heredity. 

There is also a correlation between anxiety disorders and children that have trouble sleeping. Sometimes it is hard to know what came first, the chicken or the egg. But children that have trouble sleeping tend to have higher levels of stress during the day, which increases stress hormones like Cortisol. Cortisol tends to deplete Serotonin, a feel-good neurotransmitter, which sets them up for problems like anxiety or depression. 

When I see a child for anxiety, I test the parents as well. More than not, I find at least one parent that will also be experiencing anxiety. I will also note that the parent tends to have an “anxious parent” type of parenting style. This is shown by a tendency of over-protectiveness and a tendency towards elevated expressed emotion when stressed. Unfortunately, too often a child learns from this parent how to experience and deal with the world. If the parent has a highly reactive style towards spiders, for example, the child often will also. 

I also would like to note the correlation between anxiety and frequent illness. If you see your child getting sick a lot and missing school you might want to go get your child checked for an anxiety disorder with your Psychiatric Mental Health Nurse Practitioner or Psychiatrist. They are often missed. Thousands of dollars later you may find that your child has an anxiety disorder and not an ulcer!