Make Mental Health Your Priority Every Month

By Felicia Wong, M.D



As the month of May comes to an end, make a promise to yourself that personal mental wellness will remain a daily priority.  Mental Health America has been working for 100 years to promote well-being for all Americans and recently developed a resource called 10 Tools to Live Your Life Well based on extensive scientific evidence.

Each day, we face all sorts of demands and drama which can lead to insomnia, lack of concentration, problems in our relationships, and other mental health issues. 

These "10 Tools" provide proven, healthy ways to cope with stress and boost your overall well-being.  Make a commitment to follow this list and feel more relaxed, fulfilled, and focused long after Mental Heath Month is over. . .  

1) Connect with Others. People who feel connected are happier and healthier--and may even live longer.

2) Stay Positive. People who regularly focus on the positive in their lives are less upset by painful memories.

3) Get Physically Active. Exercise can help relieve insomnia and reduce depression.

4) Help Others. People who consistently help others experience less depression, greater calm, and fewer pains.

5) Get Enough Sleep. Not getting enough rest increases risks of weight gain, accidents, reduced memory, and heart problems.

6) Create Joy and Satisfaction. Positive emotions can boost your ability to bounce back from stress.

7) Eat Well. Eating healthy food and regular meals can increase your energy, lower the risk of developing certain diseases, and influence your mood.

8) Take Care of Your Spirit. People who have strong spiritual lives may be healthier and live longer. Spirituality seems to cut the stress that can contribute to disease.

9) Deal Better with Hard Times. People who can tackle problems or get support in a tough situation tend to feel less depressed.

10) Get Professional Help if You Need It. More than 80 percent of people who are treated for depression improve.

So now you know the tools. . . Today is the perfect time to start incorporating this list into your day-to-day routine.  For more information, go to http://www.liveyourlifewell.org/ . 

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Yoga Helps Heal Heart & Emotional Scars of Cancer

By Felicia Wong, M.D.

“Cancer is a very alienating and existential disease. I know of no other common disease that immediately causes so much fear, anxiety, depression, confusion, and a sense of impending disaster in a patient or his/her significant others when they hear the word “cancer” for the first time.” --- Murray Krelstein, MD, a psychiatrist and cancer survivor.

Although oncologists, family members, and friends can provide significant sources of support, adding a mental health professional to a cancer patient’s treatment team is often helpful. Talking about the emotions and worries associated with cancer can be difficult, and it is important to have a therapist who is familiar with these situations. Additionally, cancer patients and survivors often suffer from sleep disorders, depression, anxiety, fatigue, and other mood changes.

Researchers at the University of Rochester Medical Center found that among patients receiving chemotherapy, over three-quarters suffer from insomnia. Those who suffer from insomnia are, in turn, more likely to suffer from fatigue and depression. For 65% of cancer survivors, insomnia continues even after the completion of chemotherapy.

Cancer is a diagnosis that affects both body and mind. So, it makes sense that cancer patients and survivors practice yoga to improve their quality of life.

While research on the use of yoga for cancer is relatively new, there have been recent studies confirming yoga’s mental health benefits. A Harvard Health Publication highlights the benefits of yoga for stress, depression, and anxiety:

- By reducing perceived anxiety, yoga appears to adjust stress response systems. This, in turn, reduces heart rate, lowers blood pressure, and can make breathing easier.

- There is evidence that yoga practices helps increase heart rate variability, an indicator of the body's ability to respond to stress more flexibly.

Optimizing wellness after a cancer diagnosis and beyond involves a complex integration of interventions that address both the mind and the body. Ideally, a psychiatrist is part of the cancer treatment team. However, if this is not available, please ask your doctor for referrals.

For additional resources on coping with cancer:

http://www.cancersupportivecare.com/live.html

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Coping with Stress in America

By Adair Parr, M.D.

A survey by the American Psychological Association highlighted the negative impact that stress can have on families and children. This is an extremely important topic that affects many family caregivers, who are under a great deal of stress taking care of loved ones. More and more Americans are affected by stress. The survey indicates that many Americans feel that they are experiencing unhealthy amounts of stress. The economy is one of the main reasons. Fewer are satisfied with the ways that their employer helps employees balance work and non-work demands and many are concerned about job stability.

In addition, stress impacts the entire family. Children recognize when their parents are stressed and that could make them feel sad and worried. Nevertheless, parents frequently underestimate the impact that their own stress has on their children.



Stress affects both our mental and physical health. Some people manage stress by smoking, drinking or over-eating. That can lead to bigger problems. The study shows that Americans understand the importance of healthy behaviors like getting enough sleep, exercising and eating healthy. However, lack of time and motivation gets in the way of following through on these goals. Willpower was identified as a barrier to many healthy behaviors, even when they are recommended by a health care provider.

Managing your stress is extremely important. Stress does affect the family members you care for. There are healthy ways to manage your stress. Some suggestions are: exercising or playing sports; listening to music; spending time with friends and family; going to religious services; journaling; and practicing yoga / meditation. 





If you find that you are overwhelmed or suffering physical symptoms from stress like headache, poor appetite and insomnia, or if you are feeling depressed or suffering from chronic irritability and crying spells, you may need to see a mental health provider. The Healthy Minds website has brochures about dozens of mental health issues including early warning signs of mental illness.

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Anger: A Complicated Emotion

Anger is a normal emotion that can be useful in coping with the world. But anger expressed in excess or suppressed can cause problems. Healthy Minds blogger Molly McVoy, M.D., talks about anger, how to recognize inappropriate anger and what to do about it.

Mental Health Checkup: Tension, Anxiety and Tuning In

By Gina Duncan, M.D.



Continuing my Mental Health Checkup series, here are some additional factors to consider as you evaluate your mental health:

Tension and Anxiety — Are you feeling tense and wound up all the time? How about nervous and anxious? Is it hard for you to unwind at the end of the day? We live in a fast-paced society and stress has become a common part of our everyday lives. If, however, you are finding that you’re unable to take mental breaks during the day where you can feel totally relaxed and worry-free even for a few moments, then that could indicate that your stress is approaching dangerous levels. Relaxation is a skill that many of us have to learn and practice. There have been some great previous posts with relaxation tips as well as ways to cope with anxiety and stress.

Writing in ajournal is one way

to stay "in touch" with yourself.

Tuned In — In general, how “in touch” do you feel with yourself? Do you feel like you’re experiencing emotions and you don’t know why, like being angry or crying “for no reason”? It’s not uncommon to get so busy that you don’t have time to process everything that is happening on an emotional level in real time. However, taking some time to write in a journal or talk to a friend can be critically important to good mental and emotional health, particularly when you find yourself in periods of great transition or change. The danger of being out of touch with yourself emotionally is that you may respond to difficult situations in ways that you later regret (such as impulsively sending off an angry email to your boss, or taking out your frustration on your kids). It is also difficult to advocate for yourself and your needs when you don’t know what those needs are. Being able to take a moment and identify that “I feel angry because _____.” or “I am hurt because _____.” can take you a long way in staying in touch with yourself.



Tomorrow I will write about avoidance and eating habits.

Getting Help Gets a Good Customer Review

By Molly McVoy, M.D.



A recent survey published in Consumer Reports, found that respondents reported the highest satisfaction for the combination of medication and talk therapy, when compared to talk therapy or medication alone.



The survey reported on over 1500 people treated for anxiety, depression or both. They also found that readers reported a higher satisfaction with treatment by a psychiatrist than by other mental health professionals (psychologists, social workers, and licensed professional counselors).

 

This is good news for psychiatrists and the mental health community in general. This is one indicator that the public feels treatment works and that psychiatrists help.





In addition, this consumer report supports the scientific evidence we already have – depression and anxiety treatment does work! In study after study, approximately 2/3 of patients respond to treatment for depression with an even higher percentage responding to treatment for anxiety disorders.



The bottom line is, treatment works and, it appears, most of the public knows it!

On learning to worry

By R. Scott Benson, M.D.



Mardi Gras is a big celebration in my town and after the parades and the parties everyone picks up the idea of Lent and sacrifice. The best one I heard was a friend who decided to give up worrying for Lent. A good choice.



Psychiatrists have long recognized the toxic effects of excessive worry but too often pick up the mantra – “don’t worry”. Good advice, but usually it’s not enough. Research in cognitive behavioral therapy (CBT) for obsessive compulsive disorder sent me in a different direction. Engage your worries! Give them the attention they demand! With a little discipline.







I instruct my patients –



1. Make a list of your worries. Watch for duplicates. Worries are like that. They change a little to try and sneak back into your thinking.



2. Set aside time twice a day to get out your “worry list” and read through it. Try for once in the morning, and again in the late afternoon. Think English tea time. Give each worry the time it deserves. Pay special attention to any that you can do something about today.



3. If a new worry comes up you can add it to the list. This is especially useful for those late night worries that make it hard to fall asleep.



4. If worries try to get on your mind outside of your “worry time” gently remind that worry that you already have worried about it, and it will have to wait until the next worry time.



Worriers believe that they worry about everything, all of the time. Putting order to their worries helps them reframe the problem and put it in a correct perspective.

RELAX: Feel the stress melt away

By Felicia K. Wong, M.D.



The winter snow may still be months away from melting, but now that the hubbub of the holiday season has passed, it’s time to rest, relax and de-stress!



Easier said than done right? For many of us, finishing one project just means we can start the next. We live in a fast-paced society where there is a lot of pressure (both external and internal) to “go-go-go”. In other words, we live in a world that is full of stressors and stress.



Our body responds to stress by producing stress hormones. These hormones help you respond to “fight or flight” situations and historically helped our ancestors run to safety from lions. However, these days there are (usually) no lions to run from and instead, when the body is chronically stressed, these hormones can take a toll on physical and mental health. People who are under a lot of stress are often emotional – anxious, irritable and depressed.



Ideally, you can try to change the situation that is causing your stress. But if the situation is fixed, there are relaxation methods that can be useful strategies to cope with stress.



Relaxation is a skill. It is something that we are not necessarily born knowing how to do. Good news! Relaxing techniques can be learned and practiced.



I’d like to share with you a relaxation technique called Progressive Muscle Relaxation (PMR). This is a great way to reduce overall body tension. Here is a video to introduce the practice and help you get started:





Each person will find for themselves unique ways to relax – be it through exercise, yoga, music or meditation. PMR is just one strategy. There is no right or wrong way to relax, and no one technique that will work for everyone. So, find out which ones work the best for you and get started!



Before practicing PMR, consult with your physician if you have a history of serious injuries, muscle spasms, or back problems, because the deliberate muscle tensing of the PMR procedure could exacerbate these pre-existing conditions.

Am I Alone?

by Gariane Phillips Gunter, M.D.

















Am I Alone? by Megan Hance



I get a funny feeling, it comes from deep inside.



I get all mad and angry, wanting to go and hide.



My doctor calls it depression, my dad says it's just me.



But the thoughts and feelings, no one will ever be able to see.



Some say I'm psycho, some say I'm just weird.



It's like I'm a different person, and the old me just disappeared.



I get really edgy, I want to commit suicide real bad.



Then I get a headache, followed by feeling sad.



I wish I could get help, I wish it would go away.



Maybe if I keep praying real hard, it will some day.





I came across this poem and think that the author does a beautiful job of describing the stigma often experienced by those with mental illnesses. The holiday season can be a particularly difficult time as symptoms of depression and anxiety may flare, and feelings of hopelessness creep in.



If you feel yourself slipping away, please contact your doctor or a friend and get help right away. Receive the gift of treatment that everyone deserves. I wish you all a safe and Merry Christmas.

Too busy to relax?

By Gina Newsome Duncan, M.D.



For most of us, stress is a part of everyday life—at home, at work, during our commute. Even going on vacation can be stressful. Stress not only has a psychological effect. It also has a physiological effect. That is, it affects us physically, leading to direct changes in our heart rate and blood pressure, and over time, our risk for certain illnesses such as heart attacks and strokes.







Stress also plays a significant role in anxiety, depression and other mental illnesses. This is detailed in the book The Relaxation Response, by Dr. Herbert Benson, a Harvard physician and expert in Mind/Body medicine.



Relaxation, the antidote to stress, can often seem like a luxury. How many of us picture a hot bubble bath complete with scented candles and soothing music, or a long walk on a sun-soaked beach as the perfect way to relax? The problem is that most of us don’t have time to do these things on a regular basis. When you’re in the midst of a crisis, or have a deadline looming at work, it’s not always possible to take an extended break.



The good news is that there are steps we can take psychologically to improve how we feel physically. With practice, you can learn how to relax anywhere and in any situation.



Some of the most common relaxation techniques are:

1. Deep breathing

2. Progressive muscle tension and relaxation

3. Guided Imagery/Visualization

4. Mindfulness



If you have a moment, try this simple exercise right now:



Sit in a comfortable position, either reclining slightly or laying down.

Take a deep breath in while slowly counting “one-thousand-one, one-thousand-two”. Then exhale, while counting “one-thousand-one, one-thousand-two, one-thousand-three, one-thousand-four”. Repeat this for several minutes.



Next, while maintaining a slow, regular pace of breathing, move on to progressive muscle tension and relaxation. This means tensing and relaxing the different muscle groups of your body one at a time. For example, start with your feet, curling your toes under… holding…and then relaxing. Then move on to your legs, stomach, etc, until you have worked your way up to your head.



How did that feel? Don’t worry if you couldn’t relax right away. It takes practice!



Most major bookstores and entertainment stores carry relaxation CDs that incorporate the breathing and muscle relaxation techniques described above. Combined with guided imagery and soothing music, these CDs can be a great way to learn the relaxation response if you don’t feel confident doing it on your own. A quick Google search can also pull up many websites with different types of relaxation exercises, suggestions, and even video.



The best thing is that this can take as little as 5 minutes and can be done anywhere—at your desk or while parked in your car—anytime you need to recharge.



Taking time to relax is not a luxury, it’s a necessity!

Holiday Anxiety

By Jeffrey Borenstein, M.D.



As we begin the holiday season, people have hopes and perhaps expectations of an ideal holiday. Time with family and friends, time off from work or school, plans to travel – but the preparation and anticipation is often stressful. While some people may experience feelings of sadness this time of year, often people experience anxiety.





Family gatherings – both large and small may bring up memories and emotions which have been on the back burner but which now result in a higher level of emotions. The holiday season is also a busy time, juggling usual work/school/household activities with holiday preparations. With time off from work and school our usual routines are interrupted, which is an additional stressor. All this can result in feelings of anxiety. What should you do?



Most importantly – step back and realize what emotions you are feeling. If you are experiencing heightened anxiety, there are steps you can take. Take a look at the Healthy Minds information about anxiety. I am also providing a link to an article in the New York Times in which I was interviewed entitled, “Easing Anxiety in All It’s Forms.”



Excessive drinking during the holidays is also a problem for many people. Some use alcohol to help with their stress and anxiety and those with alcohol problems are particularly vulnerable. Instead of helping, drinking can do the opposite and make you feel worse. HealthyMinds.org has some tips on safe alcohol consumption.



To help you cope during the holidays, make sure you get adequate sleep, make sure you exercise (and walking counts) and share your feelings with friends or family. If you begin to feel overwhelmed and have difficulty functioning, you should seek professional assistance. Most importantly – realize that you are not alone. Many people experience holiday anxiety. Accept support from family, friends and if need be professionals.

Does “The Most Wonderful Time of the Year” leave you with the blues? Thoughts on how to make this holiday season less stressful and more enjoyable.

By Gina Newsome Duncan, M.D. 

The holiday season can, indeed, be a wonderful and exciting time of year, but for some, it can also be stressful and overwhelming. Many of us tend to overextend ourselves during the holidays, both with our time and our finances. This can take a huge toll, leaving some of us physically exhausted and financially spent come January.

With the current economy, some people may feel pressured to make up for the cutbacks they’ve had to make in recent months by spending above their means. Others may be more realistic about what they can afford, but worry that they won’t be able to have a good holiday on a budget. We tend to think of the holiday season as a time for family, however, bringing everyone together can also be stressful if there are unresolved tensions within the family.

If you’re worried about being able to afford gifts this holiday season, talk with your loved ones about the real meaning of the holidays for your family. Do things that are consistent with your religious and cultural traditions.

The season may be bittersweet for some adults. If reminded of losses such as the loss of a loved one, find a way to incorporate old traditions and honor your loved ones during this season.

Here are some tips to help you cope with the holiday blues:

Don’t focus on having the “perfect” holiday. Focus instead on having an enjoyable holiday, and that includes time for relaxation.

Examine and then lower expectations—both those that you have of yourself and those that others have of you. Do you expect that you have to create the perfect holiday and give the perfect gift? Do you expect others to give you the perfect gift? Do you expect your children or relatives to be on their best behavior at all times? If so, you will likely be disappointed. Things are rarely (if ever!) perfect. Having this mindset will make it more likely that you will run yourself ragged and end the season feeling exhausted and inadequate.

Avoid overspending, as this will only cause increased post-holiday stress when you get your bank statement. Where possible, consider giving homemade gifts. Baked goods make delicious presents and are a lot less expensive than individual store-bought gifts. They also allow you to give something of yourself in a tangible way.



Do something nice for yourself. Take a break from your shopping and make time for a bubble bath or a nice walk.



Don’t be afraid to say no. Setting limits can be difficult. But overextending yourself can leave you feeling underappreciated and resentful. It’s hard to have the “holiday spirit” when you feel that way!



If worried about not having enough, try giving to the less fortunate. This can often produce a change in our perspective.



Shop online if the mall is too stressful.



For some, the holiday season itself is always enjoyable, but the months that follow can be difficult. The winter season in some areas of the country may not end until late March or early April. Some find that their moods go down predictably during this time of year. Read Dr. Felicia K. Wong’s recent post on Seasonal Affective Disorder for tips on coping with this common form of depression.