WHAT IS DEPRESSION? REALLY!

It’s normal to experience sadness. (Who didn’t cry when Simba couldn’t wake up Mufasa?) But unlike typical sadness or grief, time can’t and won’t heal Major Depressive Disorder (MDD), the term for clinical depression, which most people just call “depression.” It’s a common mental health condition that shows up like an unwanted houseguest and refuses to leave. This extended period of sadness or emptiness comes with a constellation of other symptoms, like exhaustion, sleep trouble, a shrinking appetite, overeating, sudden crying spells, and sometimes thoughts of suicide. Symptoms range in severity and must last for two weeks or more to receive an MDD diagnosis, though it’s rare than an episode would only last for that short time. Most people have symptoms for six months to a year, and sometimes, they can last for years.

Without treatment, depression won’t fade away on its own. Even if you do white-knuckle it through your first episode of depression, your chance of another recurrence is more than 50 percent. If you’ve had two episodes, that chance shoots up to 80 percent. Meaning, you’re going to want to deal with this sooner rather than later.

One hallmark of depression is an inability to experience pleasure, which is literally no fun. Losing interest in things you once enjoyed often means that your capacity to function at work and home takes a dive. In fact, depression is one of the leading causes of disability in the U.S., as 7.2% of Americans—17.7 million people—experience Major Depressive Disorder, each year.

Other Types of Depression

We talked about MDD (a.k.a. depression) but there are other types of depression. They include:

• Persistent Depressive Disorder. This is a chronic form of depression, formerly known as dysthymia. Sometimes people call it “high functioning” or “smiling” depression. While symptoms aren’t as severe as MDD, they last for two years or longer. People with PDD might feel like they’ve always been depressed. (In cases of “double depression,” people experience severe episodes of MDD within their usual state of chronic depression.)
• Seasonal Affective Disorder (SAD). Depression symptoms start and end seasonally, around the same times every year. Most people get depressed in cold, dark winter, but some people’s mood plummets in summer.
• Premenstrual Dysphoric Disorder (PMDD). Here, depression symptoms are tied to the luteal phase of the menstrual cycle, starting about one week before your period and ending just after your period. Though many of the symptoms mirror PMS—irritability, high anxiety, frequent crying—they’re much more severe. They interrupt your ability to work, destroy personal relationships, and can lead to thoughts of self-harm and suicide. This condition was added in 2013 as a form of depression to the DSM-5, the official guide of mental disorders.
• Peripartum Depression. New mothers with this disorder typically develop symptoms of depression and even psychosis within a few weeks of giving birth. It used to be called postpartum depression and many people still use the term interchangeably. (In some cases, symptoms start during pregnancy; other times, when the baby is several months old—hence the name change.)
• Perimenopausal Depression. In midlife (specifically, the years leading up to menopause), people experiencing this disorder have typical depressive symptoms plus perimenopause symptoms like hot flashes and night sweats.
• Substance/Medication-Induced Depressive Disorder. Substance abuse (alcohol, opiates, sedatives, amphetamines, cocaine, hallucinogens, etc.) or taking some medications, like corticosteroids or statins, can trigger the symptoms of depression. If substance use (or withdrawal from using) is causing your symptoms, you may have this version of depression.
• Disruptive Mood Regulation Disorder. A child with this juvenile disorder is grumpy and bad-tempered most of the time. They have severe, explosive outbursts with parents, teachers, and peers several times a week. Their overreactions are extreme and inconsistent with their developmental level.

Depression strikes people at a median age of 32, but it’s important to remember that depression can happen to anyone, at any age, of any race, gender, or political affiliation. One out of every six adults will experience depression at some time in their life. Fortunately, depression is treatable. That’s why, at the first hint of symptoms, it’s important to make an appointment with a mental health professional who can help determine whether you have depression, and if so, which type—and most importantly, which treatment is appropriate for you.

What Causes Depression?

You’re not going to like this answer, but no one knows for sure. That said, for the past few decades, the prevailing theory is that depressed people have an imbalance in their brain chemistry—more specifically, low levels of neurotransmitters like norepinephrine, epinephrine, and dopamine, which help regulate mood, sleep, and metabolism. We now know it’s a little more complicated than that.

Certain circumstances put people at a higher risk of depression, including childhood trauma, other types of mental illness and chronic pain conditions, or a family history of depression, but anyone can get depressed.

Scientists informed by decades of research believe that the following factors also up your risk of becoming depressed, but they can’t prove causality. Still, they can play heavily in the development of depression, so it’s important to be aware of them:

• Genetics. Research shows that having a first-degree relative with depression (a parent, sibling, or child) makes you two-to-three times more likely to have depression tendencies.
• Traumatic life events from childhood, such as abuse or neglect.
• Environmental stressors, like a loved one’s death, a messy divorce, or financial problems.
• Some medical conditions (e.g., underactive thyroid, chronic pain). Per science, the relationship between these physical conditions and depression is bidirectional, so there’s a chicken-or-egg thing going on because they feed each other.
• Certain medications, including some sedatives and blood pressure pills.
• Hormonal changes, like those that come with childbirth and menopause.
• Gut bacteria. There has been a link established between the microbiome and the gut-brain axis, but it’s only just starting to be studied.

Learn More About Depression Causes

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Do I Have the Symptoms of Depression?

Wondering whether your feelings qualify for clinical depression? Those with MDD experience five or more of the below symptoms during the same two-week period, and at least one must be depressed mood or loss of pleasure. The symptoms would be distressing or affect daily functioning.

1. You feel down most of the time.
2. The things you liked doing no longer give you joy.
3. Significant weight loss (without dieting) or weight gain or feeling consistently much less hungry or hungrier than usual.
4. Having a hard time getting to sleep and staying asleep or oversleeping.
5. A molasses-like slowdown of thought, becoming a couch potato, or spending days in bed. (This should be noticeable to others, not just subjective feelings of restlessness or slothiness.)
6. So. So. Tired. You’re so exhausted you can’t even.
7. Feeling worthless a lot of the time, even if you haven’t done anything wrong.
8. Being super distracted, indecisive, and unable to concentrate.
9. Recurrent thoughts of death or suicide(with or without a specific plan to actually do it). If you need help for yourself or someone else, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

How Do Doctors Diagnose Depression?

When you’re having a depressive episode, it might feel like you’re destined to feel terrible forever. That’s not true. It’s just what your depressed brain wants you to think. The hardest step is ignoring that feeling and making an appointment with a doctor and/or mental health professional, such as a psychologist or psychiatrist. A mental health professional is the only expert that can help you figure out if you are depressed.

Unfortunately, there’s no easy blood test that can determine if you have depression, though that would make diagnosis a lot easier. (Get on it, science!) The DSM-5 helps clinicians make that call with a targeted list of common symptoms. To be diagnosed with MDD, patients must experience five or more of the above symptoms (see “Do I Have the Symptoms of Depression?”)—one must be depressed mood or loss of pleasure—during a two-week period.

Even if your symptoms match up to MDD, though, your doctor should rule out any underlying medical causes first. Some conditions, such as thyroid disease and vitamin deficiency, can mimic symptoms of depression. Next, consider any medications you’re currently taking.
If this sounds like you or someone you know, make an appointment with a mental health professional. Now. Don’t wait! What’s the worst thing that can happen? If you feel better by the time the appointment rolls around, you can always cancel it. If you don’t, you’ve saved yourself precious time (and unnecessary pain) by taking steps to managing your mental health.

Go Deeper into Signs and Symptoms of Depression

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What Are the Best Treatments for Depression?

Regardless of why you’re depressed, it’s important to get treatment before the condition starts to erode your quality of life. Studies and surveys show that most adults in the U.S. who screen positive for depression remain untreated. Don’t be one of them.

As scientists continue to hash out theories about the root causes of depression, research shows that the most effective treatment is a mix of psychotherapy, medication, and lifestyle changes. It might take a (frustratingly long) while to find the right recipe —antidepressants work differently in different people so finding the right fit often takes some trial and error. Plus, the mental health professional you’re working with will be by your side. They won’t give up and neither should you. Some of the treatment options available are:

Psychotherapy

This doesn’t mean you’ll find yourself reclined on a couch, complaining about your relationship with your mother (though it might). A psychiatrist, psychologist, therapist, or licensed clinical social worker might use a variety of techniques to help change the negative thinking, beliefs, or behaviors that exacerbate your depression and make your world seem hopeless. Types of therapy include psychodynamic therapy, Cognitive Behavioral Therapy (CBT), and interpersonal therapy.

Medication

*WARNING – TRY EVERYTHING BEFORE YOU TRY MEDICATION.  YOU COULD LOOSE YOUR JOB, AND MAKE IT MORE DIFFICULT TO GET ANOTHER ONE.  ALSO, YOU WILL HAVE TO TURN IN ALL YOUR GUNS, YOU CAN NOT WORK WITH CHILDREN AND MANY OTHER RESTRICTIONS NOW APPLE.

Your depression might require more than coaching. Doctors may prescribe medication including antidepressants, mood stabilizers, and/or antipsychotic pills in order to decrease the symptoms of depression. These include:

• SSRIs (selective serotonin reuptake inhibitors) like Prozac (fluoxetine), Paxil (paroxetine), and Zoloft (sertraline) and SNRIs (serotonin and norepinephrine reuptake inhibitors) like Cymbalta (duloxetine) and Effexor XR (venlafaxine) make neuro-transmitters serotonin and norepinephrine already existing in the brain more available.
• TCAs (tricyclic antidepressants) like Tofranil (imipramine) and Norpramin (desipramine) and MAOIs (monoamine oxidase inhibitors) like Emsam (selegiline) and Marplan (isocarboxazid) are first-generation antidepressants that work similarly on neuro-transmitters, but they’re used less often because of unpleasant side effects.
• Doctors may also use atypical antidepressants like Zyban or Wellbutrin (bupropion) or Remeron (mirtazapine) that affect serotonin, norepinephrine, and dopamine levels in ways unique from other anti-depression drugs. Or they may add atypical antipsychotics, a.k.a. second-generation antipsychotics like Seroquel (quetiapine) or Abilify (aripiprazole). They’re “atypical” in that they affect dopamine and other neurotransmitters without the physical side effects, such as tics and tremors, that first-generation antipsychotics can cause.

Brain Stimulation

For treatment-resistant depression that doesn’t get better after exhausting psychotherapy and more than two classes of antidepressants (such SSRIs and TCAs), there are more hardcore options. Severe depression may warrant electroconvulsive therapy (ECT), which you might remember from One Flew Over the Cuckoo’s Nest. Fear not—modern ECT is safe, performed under anesthesia, and much less aggressive than you see in the movies.

There is also repetitive transcranial magnetic stimulation (rTMS) which some docs refer to as “ECT Lite”. For severe depression, some people receive vagus nerve stimulation (VNS), a surgical implant that works kind of like a pacemaker, sending electric pulses to the brain.

Other Treatment Approaches

These may include:

• For severe, treatment-resistant depression, the FDA recently approved esketamine, a nasal spray based on the party drug/anesthetic ketamine. Experts say it works by kicking up production of glutamate, a neurotransmitter that helps prompt the brain to form new neural connections.
• Sadness during seasonal depression (SAD) can be alleviated with melatonin-regulating light therapy.
• Postpartum depression may be treated with Brexanolone (Zulresso), an IV version of the body’s own neurosteroid allopregnanolone.
• Research shows that lifestyle changes like incorporating exercise and mindfulness can amplify results of medication and therapy. Even if they aren’t foolproof mood-lifters, it never hurts to build a health-supportive routine.

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Where Can I Find Depression-Related Communities?

The thing about depression is that it makes you want to roll yourself into a blanket burrito and never come out. But shutting out the world can make an already-bad situation worse by giving you free reign to neglect your needs, ruminate over your perceived flaws, and destroy any chance of forward momentum. Along with therapy and medication, finding supportive people—and connecting with them online and in real life—is a key part of taking care of yourself. Here’s where to start.

Top Depression Instagrammers and Bloggers

• Tonya Ingram, @tonyainstagram, tonyaingram.com

Follow because: She has one hell of a way with words—after all, she is a poet and author. She also battles some pretty heavy stuff like depression, lives as a “lupus legend” (her words—we love) and is currently waiting on the sidelines for a kidney transplant. She takes it all day by day and shares how she gets out of bed, looks herself in the mirror, and figures out how to simply… survive.

• Scott Ste Marie, @depressiontoexpression, depressiontoexpression.com

Follow because: Immediately, he sounds like someone you want to be friends with, someone whose vibe you want to channel. A former Twitter employee and now public speaker, Scott isn’t going to guide you on some path to a complete cure—nor is he going to sugarcoat the realities of living with depression. In order to overcome your demons, Scott believes you have to come to terms with the fact that sometimes life sucks, and that’s okay.

• Kevin Hines, @kevinhinesstory, kevinhinesstory.com

Follow because: You know the saying “What doesn’t kill you only makes you stronger”? Kevin Hines is living proof. He is the only person ever to survive a suicide attempt from the Golden Gate Bridge. After a sea lion kept him afloat, he was reborn as someone who now devotes his life to making sure you’re here tomorrow—which is why he regularly uses the hashtag #beheretomorrow.

• Lola, Gina, and Nora Tash, and Nicole Argiris, @mytherapistsays, mytherapistsays.ca

Follow because: Sometimes the only way to come out of a deep dark hole is with the universal language of laughter. These girls (mostly family or like family) create endless hilarious memes that represent the real trials and tribulations of living in today’s social media-infested world. The point of it all? So you know that, as they put it, “you’re never alone and never as batshit as you think.”

• Sad Girls Club, @sadgirlsclub

Follow because: It’s not your typical reel of inspirational quotes and nod-worthy memes — though, those are sprinkled in, too. Mostly, this feed—run by women of color (including founder @elyse.fox)—gives you actual advice on how to cope with depression, especially in modern-day situations, like discussing mental health at work (hashtag awkward). This feed gives you the ammo you need to shut down stigma.

• Kate Allan, @thelatestkate

Follow because: Animals make everything better — especially when they’re paired with a quirky drawing and an all-too-familiar feeling. A wolf that speaks to your soul; a fox that gives you all the feels; and a bird who tells it like it is. Run by artist, author, and anxious human Kate, this page (and the cute animals that live there) is a feel-good must-follow.

• The Sad Ghost Club, @theofficialsadghostclub, thesadghostclub.com

Follow because: Nathan, Lize, and Helen are besties—or, ghosties, as they refer to themselves—who came together to share life with mental illness from behind the computer screen. These ghosts don’t sugarcoat things, but they’re also not gloom and doom. You’ll be hooked on their graphics and positive (but not overly earnest) messages.

Top Depression-Related Podcasts

• The Hilarious World of Depression. Stand-up comedy meets a psych appointment when actors and comedians struggling with depression tell their (surprisingly funny) mental health stories to “professionally depressed” host John Moe.
• Terrible, Thanks for Asking. Author Nora McInerny, who has dealt with depression, isn’t afraid to ask the awkward questions, as real listeners share their own tales of coping with grief, despair, and anxiety.
• Jen Gotch is OK…Sometimes. Ladyboss CEO and ban.do founder Jen Gotch gets vulnerable and real every week, sharing her struggles with mental health.
• Happier with Gretchen Rubin. It’s no surprise that the author of The New York Times bestseller The Happiness Project has tons of suggestions to help you emerge from your sad cave, build positive habits, and create a happier outlook. Her slightly skeptical sister Elizabeth Craft keeps all that sunshine in check.
• Anthologies of Hope. You’re here, and you’re reading this, so that in itself proves that you haven’t given up hope. But it’s not just that you are here—it’s why you’re here. This podcast dives even deeper into that “why” and tries to bring that to the forefront of your mind instead of the other garbage trying to pull you down. Host Rick Osowski, who has battled depression, brings a variety of guests into the fold to talk about their why.

Top Depression Support Groups and Non-Profits

• Anxiety and Depression Association of America (ADAA). This nonprofit is dedicated to the prevention, treatment, and cure of anxiety, depression, OCD, PTSD, and co-occurring disorders. Come here for new research, monthly webinars from mental health experts, educational infographics and stats, and a Find-a-Therapist database you can search by disorder. You can always find (free) support on the ADAA Online Peer-to-Peer Support Group or support group iOS app for iPhone.
• National Alliance on Mental Illness (NAMI). This nonprofit mental health advocacy group offering free education and support programs such as NAMI Peer-to-Peer (eight free sessions for adults with specific mental health conditions). You can also connect with other folks who have depression on this org’s online message boards and via NAMI Connection (use the site to find a weekly or monthly recovery group near you).
• Reddit, r/depression. Reddit is the hideously under-designed social website for anonymous users with a bad rep for attracting “incels” and “neckbeards.” The self-proclaimed “Front Page of the Internet” has memes, conspiracy theories, and thousands of communities called subreddits—and some of them are quite lovely. For example, the r/depression subreddit is over a decade old with more than half a million subscribers. In here, the vibe is all about empathy, support, and helpful feedback. (A recent study even found that visiting the subreddit caused a “positive emotion change” in users.)
• Talkspace. More like “safe space.” It’s online, it’s private, and it’s “open” 24/7. Over 1 million people use Talkspace to get matched up with one of their 5,000+ licensed therapists and then message them…as much and as often as they’d like. There are different packages depending on your needs, but the instant feedback and comfort is pretty much priceless.
• Sad Girls Club. This is a nonprofit, an online community, and an Instagram handle (see above) focused on the millennial and Gen Z experience of mental illness (depression, anxiety, or something undiagnosed all count). They host meetups IRL where you can connect with similar people and try a cool twist on art therapy like a poetry slam or embroidery class.
• To Write Love on Her Arms (TWLOHA). It’s not just a nonprofit — it’s a movement. Online, at in-person events, through social media and blogs, TWLOHA creates a place for hope and healing through depression, addiction, self-injury, and suicide. People who attend their events and join this community have said they’ve felt transformed. Worth a try, yea?

• We are in this Together!

  -People Start to Heal The Moment They Are Heard-

  Health and Wellness Associates

  EHS Telehealth

  DR MARK WILLIAMS MD  BC-PSYCH

  

COVID 19 PANDEMIC IS HARMING KIDS MENTAL HEALTH

Since last April, hospital emergency rooms across the United States have seen a sustained surge in visits related to the mental health of school-aged kids, a new report reveals.

The findings suggest the COVID-19 pandemic is taking a toll on children because of disruptions to their everyday life, anxiety about illness and social isolation. That conclusion comes from a U.S. Centers for Disease Control and Prevention review of data on hospitals in 47 states. Those hospitals account for nearly three-quarters of emergency department visits nationwide.

The study tracked emergency visits involving children under age 18 who sought care for a mental health issue between Jan. 1 and Oct. 17, 2020.

“Our study looked at a composite group of mental health concerns that included conditions that are likely to increase during and after a public health emergency, such as stress, anxiety, acute post-traumatic stress disorder and panic,” said lead author Rebecca Leeb, a health scientist at the CDC in Atlanta who is part of its COVID-19 Response Team.

“We found that from March through October, the proportion of mental health-related emergency department visits increased 24% for children aged 5 to 11, and 31% among teenagers aged 12 to 17 years, compared to 2019,” Leeb said.

Pediatric mental health visits actually dropped off dramatically from mid-March to mid-April, when stay-at-home orders were in effect in much of the country. Since then, however, such visits have steadily increased, according to the report.

But Leeb said interpreting the numbers is not straightforward.

On the one hand, she said even the large jumps seen in the report likely underestimate the total number of pediatric mental health emergencies. “Many mental health care encounters occur outside of emergency departments,” Leeb explained.

But additional research indicates emergency department visits as a whole dropped significantly between January and October. And that, Leeb said, might mean that “the relative proportion of emergency department visits for children’s mental health-related concerns may be inflated.”

Regardless, Leeb said the findings show that many kids’ mental health was sufficiently concerning to prompt ER visits at a time when the public was being discouraged from using emergency departments for anything but the most critical care.

As such, the findings “highlight the importance of continuing to monitor children’s mental health during the pandemic to ensure access to mental health services during public health crises,” Leeb said.

The study did not set out to identify specific reasons for emergency visits and Leeb said figuring that out requires more study.

But past research shows that the lost sense of safety and disruption to daily living that often accompanies disasters is a common trigger for stress. And that stress, in turn, can lead to isolation and trigger mental health emergencies, Leeb said.

This is not surprising, according to psychologist Lynn Bufka, senior director for practice, research and policy at the American Psychological Association.

“These are stressful times for many and stress can exacerbate mental health concerns,” Bufka noted. “Previous research indicates that a portion of children do have adverse outcomes from traumatic events, and this pandemic is no different.”

Bufka pointed to the wholesale uprooting of kids’ routines and structure, both in terms of school and socializing.

“Children’s play is one way children explore and understand their world, so not being able to play with friends gives them fewer outlets for fun, but also just fewer general opportunities to cope and explore,” she explained.

Kids may also pick up on parents’ stress, which can magnify their own fears.

“All of this has an impact on children and how they understand their world and interpret the events around them,” Bufka said. Some kids adapt more easily; others will struggle. For youngsters with existing mental health problems, the current stresses will add to them.

But parents and other adults can do a lot to support kids and help those who are struggling.

On that front, Leeb advised parents to foster a supportive environment and learn about behavior that signals kids are under mounting stress. The CDC has a number of helpful resources, she said, including an online primer on talking with your child about the coronavirus.

Leeb and her colleagues published their findings in the Nov. 13 issue of the CDC’s Morbidity and Mortality Weekly Report.

 

We are in this Together!

-People Start to Heal The Moment They Are Heard-

Health and Wellness Associates

EHS Telehealth

DR MARK WILLIAMS – PSYCHIATRIST

REVIEWED BY  DR ANNE SULLIVAN

 

 

 

 

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HWA – DEPRESSION

How are you feeling today? If you’ve found yourself reading this, probably pretty crappy. Maybe you’ve been feeling listless and down for a lot longer than you expected, and it’s making you worry that you might have depression. Maybe you’ve just received a diagnosis of clinical depression and you’re looking for answers. We get it.  But we won’t let depression swallow you up. 

What Is Depression, Really?

It’s normal to experience sadness. (Who didn’t cry when Simba couldn’t wake up Mufasa?) But unlike typical sadness or grief, time can’t and won’t heal Major Depressive Disorder (MDD), the term for clinical depression, which most people just call “depression.” It’s a common mental health condition that shows up like an unwanted houseguest and refuses to leave. This extended period of sadness or emptiness comes with a constellation of other symptoms, like exhaustion, sleep trouble, a shrinking appetite, overeating, sudden crying spells, and sometimes thoughts of suicide. Symptoms range in severity and must last for two weeks or more to receive an MDD diagnosis, though it’s rare than an episode would only last for that short time. Most people have symptoms for six months to a year, and sometimes, they can last for years.

Without treatment, depression won’t fade away on its own. Even if you do white-knuckle it through your first episode of depression, your chance of another recurrence is more than 50 percent. If you’ve had two episodes, that chance shoots up to 80 percent. Meaning, you’re going to want to deal with this sooner rather than later.

One hallmark of depression is an inability to experience pleasure, which is literally no fun. Losing interest in things you once enjoyed often means that your capacity to function at work and home takes a dive. In fact, depression is one of the leading causes of disability in the U.S., as 7.2% of Americans—17.7 million people—experience Major Depressive Disorder, each year.

Other Types of Depression

We talked about MDD (a.k.a. depression) but there are other types of depression. They include:

• Persistent Depressive Disorder. This is a chronic form of depression, formerly known as dysthymia. Sometimes people call it “high functioning” or “smiling” depression. While symptoms aren’t as severe as MDD, they last for two years or longer. People with PDD might feel like they’ve always been depressed. (In cases of “double depression,” people experience severe episodes of MDD within their usual state of chronic depression.)
• Seasonal Affective Disorder (SAD). Depression symptoms start and end seasonally, around the same times every year. Most people get depressed in cold, dark winter, but some people’s mood plummets in summer.
• Premenstrual Dysphoric Disorder (PMDD). Here, depression symptoms are tied to the luteal phase of the menstrual cycle, starting about one week before your period and ending just after your period. Though many of the symptoms mirror PMS—irritability, high anxiety, frequent crying—they’re much more severe. They interrupt your ability to work, destroy personal relationships, and can lead to thoughts of self-harm and suicide. This condition was added in 2013 as a form of depression to the DSM-5, the official guide of mental disorders.
• Peripartum Depression. New mothers with this disorder typically develop symptoms of depression and even psychosis within a few weeks of giving birth. It used to be called postpartum depression and many people still use the term interchangeably. (In some cases, symptoms start during pregnancy; other times, when the baby is several months old—hence the name change.)
• Perimenopausal Depression. In midlife (specifically, the years leading up to menopause), people experiencing this disorder have typical depressive symptoms plus perimenopause symptoms like hot flashes and night sweats.
• Substance/Medication-Induced Depressive Disorder. Substance abuse (alcohol, opiates, sedatives, amphetamines, cocaine, hallucinogens, etc.) or taking some medications, like corticosteroids or statins, can trigger the symptoms of depression. If substance use (or withdrawal from using) is causing your symptoms, you may have this version of depression.
• Disruptive Mood Regulation Disorder. A child with this juvenile disorder is grumpy and bad-tempered most of the time. They have severe, explosive outbursts with parents, teachers, and peers several times a week. Their overreactions are extreme and inconsistent with their developmental level.

Depression strikes people at a median age of 32, but it’s important to remember that depression can happen to anyone, at any age, of any race, gender, or political affiliation. One out of every six adults will experience depression at some time in their life. Fortunately, depression is treatable. That’s why, at the first hint of symptoms, it’s important to make an appointment with a mental health professional who can help determine whether you have depression, and if so, which type—and most importantly, which treatment is appropriate for you.

What Causes Depression?

You’re not going to like this answer, but no one knows for sure. That said, for the past few decades, the prevailing theory is that depressed people have an imbalance in their brain chemistry—more specifically, low levels of neurotransmitters like norepinephrine, epinephrine, and dopamine, which help regulate mood, sleep, and metabolism. We now know it’s a little more complicated than that.

Certain circumstances put people at a higher risk of depression, including childhood trauma, other types of mental illness and chronic pain conditions, or a family history of depression, but anyone can get depressed.

Scientists informed by decades of research believe that the following factors also up your risk of becoming depressed, but they can’t prove causality. Still, they can play heavily in the development of depression, so it’s important to be aware of them:

• Genetics. Research shows that having a first-degree relative with depression (a parent, sibling, or child) makes you two-to-three times more likely to have depression tendencies.
• Traumatic life events from childhood, such as abuse or neglect.
• Environmental stressors, like a loved one’s death, a messy divorce, or financial problems.
• Some medical conditions (e.g., underactive thyroid, chronic pain). Per science, the relationship between these physical conditions and depression is bidirectional, so there’s a chicken-or-egg thing going on because they feed each other.
• Certain medications, including some sedatives and blood pressure pills.
• Hormonal changes, like those that come with childbirth and menopause.
• Gut bacteria. There has been a link established between the microbiome and the gut-brain axis, but it’s only just starting to be studied.

Do I Have the Symptoms of Depression?

Wondering whether your feelings qualify for clinical depression? Those with MDD experience five or more of the below symptoms during the same two-week period, and at least one must be depressed mood or loss of pleasure. The symptoms would be distressing or affect daily functioning.

1. You feel down most of the time.
2. The things you liked doing no longer give you joy.
3. Significant weight loss (without dieting) or weight gain or feeling consistently much less hungry or hungrier than usual.
4. Having a hard time getting to sleep and staying asleep or oversleeping.
5. A molasses-like slowdown of thought, becoming a couch potato, or spending days in bed. (This should be noticeable to others, not just subjective feelings of restlessness or slothiness.)
6. So. So. Tired. You’re so exhausted you can’t even.
7. Feeling worthless a lot of the time, even if you haven’t done anything wrong.
8. Being super distracted, indecisive, and unable to concentrate.
9. Recurrent thoughts of death or suicide(with or without a specific plan to actually do it). If you need help for yourself or someone else, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

• We are in this Together!-

  -People Start to Heal The Moment They Are Heard-

  Health and Wellness Associates

  EHS Telehealth

  REVIEWED BY DR M WILLIAMS

• 

HWA-WHAT IS COVID 19 LOCKDOWN DOING TO OUR MENTAL HEALTH

What Is the COVID-19 Lockdown Doing to Our Mental Health?

 

In the time of COVID-19, things move fast—and that goes for research, too. In fact, researchers out of the University of Sydney and the University of Adelaide in Australia have already conducted and published a study about the wellbeing of adults going through lockdown due to the virus.

Researchers wanted to know: How does all this time cooped up under such stressful circumstances affect people’s health? Well, the COVID-19 pandemic has affected people mentally, as well as physically, says a study published in Psychiatry Research. Sure, it may seem like a no-brainer. But now we have evidence to prove it.

The main findings of the preliminary study include:

• Adults in locations more affected by the virus experienced distress, lower physical and mental health, and reduced life satisfaction.
• Adults who had existing chronic health conditions were at increased risk of lowered mental and physical health during lockdown.
• Adults who had stopped working during lockdown were also at higher risk of harm to their mental and physical health.

To gather this data, researchers spoke to 369 adults living in 64 Chinese cities after they have been living in isolation due to measures to slow the spread of COVID-19 for one full month (in February of 2020).

 

“As many parts of the world are only just beginning to go into lockdown, we examined the impact of the one-month long lockdown on people’s health, distress and life satisfaction,” said study author Stephen Zhang, Ph.D., associate professor of entrepreneurship and innovation at the University of Adelaide, in a news release. He says the study may act like a “crystal ball” for what’s ahead for people in other countries where lockdown measures are approaching that one-month mark, like Australia and the United States.

The study suggests that adults with chronic medical issues reported lower life satisfaction during the outbreak—notable, considering the Centers for Disease Control and Prevention states that those certain chronic health conditions like diabetes and heart disease are at an increased risk of severe complications should they get ill with COVID-19.

Employment situations played a major role, too: Of those surveyed, more than one-fourth continued to go to work in an office setting. Thirty-eight percent worked from home, and 25 percent stopped work completely during the outbreak.

“We weren’t surprised that adults who stopped working reported worse mental and physical health conditions as well as distress,” study co-author Andreas Rauch, a professor at the University of Sydney, said in the news release. “Work can provide people with a sense of purpose and routine, which is particularly important during this global pandemic.”

Another interesting finding in this study? Those who exercised more than 2.5 hours per day during lockdown reported lower life satisfaction, and those who exercised for half an hour or less reported positive life satisfaction. The study authors found these results surprising.

“It’s possible adults who exercised less could better justify or rationalize their inactive lifestyles in more severely affected cities,” said Dr. Zhang. “More research is needed but these early findings suggest we need to pay attention to more physically active individuals, who might be more frustrated by the restrictions.” While physical health is a major concern during this time, don’t let your mental health fall by the wayside. The CDC reports that it’s normal to feel extra stressed, anxious, or afraid during the COVID-19 pandemic—so it’s all the more important to take proactive steps to support your mental health during these unprecedented times. That may mean seeking the support of a therapist via telehealth, practicing self-care and relaxation techniques, and focusing on what you can control, experts say.

Other ways to cope with stress during this time include the following, per the CDC:

• Listen to your body’s needs. During this stressful time, making your body a priority can be helpful. That may look like taking deep breaths, eating healthy meals, getting enough sleep, and staying active.
• Take breaks from the news. When you turn on the TV or scroll through social media, it’s all pandemic talk, all the time. Taking a time-out from consuming news on the virus can be good for your mental health.
• Make time for connection. We may be social distancing right now, but there are still ways to connect with others. Schedule video calls with friends and family to stay in touch and find support.

 

We are in this Together!

-People Start to Heal The Moment They Are Heard-

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Schizophrenia: Symptoms, Types, Causes, Treatment

 

 

Schizophrenia is a chronic, severe, debilitating mental illness characterized by disordered thoughts, abnormal behaviors, and anti-social behaviors. It is a psychotic disorder, meaning the person with schizophrenia does not identify with reality at times.

Who is Affected

• Schizophrenia affects about 1.1% of the world’s population
• 3.5 million Americans have schizophrenia
• Schizophrenia is most commonly diagnosed between the ages of 16 to 25
• Schizophrenia can be hereditary (runs in families)
• It affects men 1.5 times more commonly than women
• Schizophrenia and its treatment has an enormous effect on the economy, costing between $32.5-$65 billion each year

How Common Is Schizophrenia in Children?

 

Schizophrenia in young children is rare. The National Institute of Mental Health (NIMH) estimates only 1 in 40,000 children experience the onset of schizophrenia symptoms before the age of 13.

Types of Schizophrenia

There are five types of schizophrenia (discussed in the following slides). They are categorized by the types of symptoms the person exhibits when they are assessed:

• Paranoid schizophrenia
• Disorganized schizophrenia
• Catatonic schizophrenia
• Undifferentiated schizophrenia
• Residual schizophrenia

Paranoid Schizophrenia

Paranoid-type schizophrenia is distinguished by paranoid behavior, including delusions and auditory hallucinations. Paranoid behavior is exhibited by feelings of persecution, of being watched, or sometimes this behavior is associated with a famous or noteworthy person a celebrity or politician, or an entity such as a corporation. People with paranoid-type schizophrenia may display anger, anxiety, and hostility. The person usually has relatively normal intellectual functioning and expression of affect.

Disorganized Schizophrenia

A person with disorganized-type schizophrenia will exhibit behaviors that are disorganized or speech that may be bizarre or difficult to understand. They may display inappropriate emotions or reactions that do not relate to the situation at-hand. Daily activities such as hygiene, eating, and working may be disrupted or neglected by their disorganized thought patterns.

Catatonic Schizophrenia

Disturbances of movement mark catatonic-type schizophrenia. People with this type of schizophrenia may vary between extremes: they may remain immobile or may move all over the place. They may say nothing for hours, or they may repeat everything you say or do. These behaviors put these people with catatonic-type schizophrenia at high risk because they are often unable to take care of themselves or complete daily activities.

Undifferentiated Schizophrenia

Undifferentiated-type schizophrenia is a classification used when a person exhibits behaviors which fit into two or more of the other types of schizophrenia, including symptoms such as delusions, hallucinations, disorganized speech or behavior, catatonic behavior.

Residual Schizophrenia

When a person has a past history of at least one episode of schizophrenia, but the currently has no symptoms (delusions, hallucinations, disorganized speech or behavior) they are considered to have residual-type schizophrenia. The person may be in complete remission, or may at some point resume symptoms.

What Are Causes of Schizophrenia?

Schizophrenia has multiple, intermingled causes which may differ from person to person, including:

• Genetics (runs in families)
• Environment
• Brain chemistry
• History of abuse or neglect

Is Schizophrenia Hereditary?

Schizophrenia has a genetic component. While schizophrenia occurs in only 1% of the general population, it occurs in 10% of people with a first-degree relative (parent, sibling) with the disorder. The risk is highest if an identical twin has schizophrenia. It is also more common in people with a second-degree relative (aunts, uncles, cousins, grandparents) with the disorder.

Schizophrenia Symptoms

Many people with schizophrenia do not appear ill. However, many behavioral changes will cause the person to seem ‘off’ as the disease progresses. Symptoms include:

• Social withdrawal
• Anxiety
• Delusions
• Hallucinations
• Paranoid feelings or feelings of persecution
• Loss of appetite or neglecting to eat
• Loss of hygiene

Symptoms may also be grouped into categories, discussed in the following slides.

Positive (More Overtly Psychotic) Symptoms

The “positive,” or overtly psychotic, symptoms are symptoms not seen in healthy people, include:

• Delusions
• Hallucinations
• Disorganized speech or behavior
• Dysfunctional thinking
• Catatonia or other movement disorders

Negative (Deficit) Symptoms

“Negative” symptoms disrupt normal emotions and behaviors and include:

• Social withdrawal
• “Flat affect,” dull or monotonous speech, and lack of facial expression
• Difficulty expressing emotions
• Lack of self-care
• Inability to feel pleasure (anhedonia)

Cognitive Symptoms

Cognitive symptoms may be most difficult to detect and these include:

• Inability to process information and make decisions
• Difficulty focusing or paying attention
• Problems with memory or learning new tasks

Affective (or Mood) Symptoms

Affective symptoms refer to those which affect mood. Patients with schizophrenia often have overlapping depression and may have suicidal thoughts or behaviors.

How Is Schizophrenia Diagnosed?

The diagnosis of schizophrenia is made both by ruling out other medical disorders that can cause the behavioral symptoms (exclusion), and by observation of the presence of characteristic symptoms of the disorder. The doctor will look for the presence of delusions, hallucinations, disorganized speech or behavior, and/or negative symptoms, along with social withdrawal and/or dysfunction at work or in daily activities for at least six months.

The doctor may use physical examination, psychological evaluation, laboratory testing of blood, and imaging scans to produce a complete picture of the patient’s condition.

How Is Schizophrenia Diagnosed?

Mental health screening and evaluation is an important part of the diagnosis process for schizophrenia. Many other mental illnesses such as bipolar disorder, schizoaffective disorder, anxiety disorders, severe depression, and substance abuse may mimic symptoms of schizophrenia. A doctor will perform an assessment to rule out these other conditions.

Schizophrenia Treatment – Medications

Antipsychotic medications are the first-line treatment for many patients with schizophrenia. Medications are often used in combination with other types of drugs to decrease or control the symptoms associated with schizophrenia. Some antipsychotic medications include:

• olanzapine (Zyprexa)
• risperidone (Risperdal)
• quetiapine (Seroquel)
• ziprasidone (Geodon)
• aripiprazole (Abilify)
• paliperidone (Invega)

Schizophrenia Treatment – Medications (Continued)

Mood swings and depression are common in patients with schizophrenia. In addition to antipsychotics, other types of medications are used.

Mood stabilizers include:

• lithium (Lithobid)
• divalproex (Depakote)
• carbamazepine (Tegretol)
• lamotrigine (Lamictal)

Antidepressants include:

• fluoxetine (Prozac)
• sertraline (Zoloft)
• paroxetine (Paxil)
• citalopram (Celexa)
• escitalopram (Lexapro)
• venlafaxine (Effexor)
• desvenlafaxine (Pristiq)
• duloxetine (Cymbalta)
• bupropion (Wellbutrin)

Schizophrenia Treatment – Psychosocial Interventions

Family psycho-education: It is important to include psychosocial interventions in the treatment of schizophrenia. Including family members to support patients decreases the relapse rate of psychotic episodes and improves the person’s outcomes. Family relationships are improved when everyone knows how to support their loved one dealing with schizophrenia.

Schizophrenia Treatment – Psychosocial Interventions (Continued)

Assertive community treatment (ACT): Another form of psychosocial intervention includes use of out-patient support groups. Support teams including psychiatrists, nurses, case managers, and other counselors, meet regularly with the schizophrenic patient to help reduce the need for hospitalization or a decline in their mental status.

Schizophrenia Treatment – Psychosocial Interventions (Continued)

Substance abuse treatment: Many people with schizophrenia (up to 50%) also have substance abuse issues. These substance abuse issues worsen the behavioral symptoms of schizophrenia and need to be addressed for better outcomes.

Schizophrenia Treatment – Psychosocial Interventions (Continued)

Social skills training: Patients with schizophrenia may need to re-learn how to appropriately interact in social situations. This kind of psychosocial intervention involves rehearsing or role-playing real-life situations so the person is prepared when they occur. This type of training can reduce drug use, and improve relationships.

Schizophrenia Treatment – Psychosocial Interventions (Continued)

Supported employment: Many people with schizophrenia have difficulty entering or re-entering the work force due to their condition. This type of psychosocial intervention helps people with schizophrenia to construct resumes, interview for jobs, and even connects them with employers willing to hire people with mental illness.

Schizophrenia Treatment – Psychosocial Interventions (Continued)

Cognitive behavioral therapy (CBT): This type of intervention can help patients with schizophrenia change disruptive or destructive thought patterns, and enable them to function more optimally. It can help patients “test” the reality of their thoughts to identify hallucinations or “voices” and ignore them. This type of therapy may not work in actively psychotic patients, but it can help others who may have residual symptoms that medication does not alleviate.

Schizophrenia Treatment – Psychosocial Interventions (Continued)

Weight management: Many anti-psychotic and psychiatric drugs cause weight gain as a side effect. Maintaining a healthy weight, eating a well-balanced diet, and exercising regularly helps prevent or alleviate other medical issues.

What Is the Prognosis for Schizophrenia?

The prognosis for people with schizophrenia can vary depending on the amount of support and treatment the patients receives. Many people with schizophrenia are able to function well and lead normal lives. However, people with schizophrenia have a higher death rate and higher incidence of substance abuse. When medications are taken regularly and the family is supportive, patients can have better outcomes.

 

-People Start to Heal The Moment They Are Heard- 

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Poor Diet = Poor Mental Health

Researchers at Loma Linda University in California have found that adults in the state whose diets are poor are more likely to have poor mental health regardless of their gender, age, education, marital status or income level than those with healthy diets. The team reported that increased consumption of sugar was associated with bipolar disorder and that fried foods, or those that contain a lot of sugar and processed grains, were linked with depression.

To reach these conclusions the researchers reviewed data from more than 240,000 telephone surveys conducted with California residents over a 10-year period. The team found that nearly 17 percent of adults were likely to suffer from mental illness – 13.2 percent with “moderate psychological distress and 3.7 percent with severe psychological distress. Those whose diets were poor (they ate more French fries, fast food, soda and sugar) were more likely to be among those with mental illness than people whose diets were deemed healthy Study leader Jim E. Banta, Ph.D., M.P.H., said the results are similar to those from earlier studies conducted in other countries that found links between mental illness and unhealthy diets. While the new findings don’t prove that unhealthy diets contribute to mental illness, Dr. Banta said evidence seems to be pointing in that direction.

May take? These findings are disheartening but not surprising. The evidence from previous investigations conducted in Europe that Dr. Banta referred to suggests that the trans-fats and saturated fats in some junk foods increase the risk of depression. In 2010 researchers from Spain who followed the diet and lifestyle of more than 12,000 men and women for 6 years reported that at the outset, none of the participants had been diagnosed with depression, but at the study’s end, 657 were found to be depressed. They noted that the risk of depression increased among participants who consumed junk foods. In 2009, British researchers reported that among nearly 3,500 midlife men and women participating in a 5-year study those whose diets were high in processed meat, chocolates, sweet desserts, fried foods, refined cereals and high-fat dairy products were 58 percent more likely to be depressed that those whose diets were composed mainly of fruit, vegetables and fish.Contact us and we can get you started on the right track.

 

-People Start to Heal The Moment They Are Heard- 

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Are You Taking Buspirone : Buspar or Vanspar

Buspirone (Oral Route)

 

US Brand Name

1. Buspar
2. Buspar Dividose
3. Vanspar

Descriptions

 

Buspirone is used to treat certain anxiety disorders or to relieve the symptoms of anxiety. However, buspirone usually is not used for anxiety or tension caused by the stress of everyday life.

It is not known exactly how buspirone works to relieve the symptoms of anxiety. Buspirone is thought to work by decreasing the amount and actions of a chemical known as serotonin in certain parts of the brain.

This medicine is available only with your doctor’s prescription.

 

Before Using

The Following Information was prepared by the Mayo Clinic, Rochester MN.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

IBS, Celiac Disease, Hodgkins Lymphoma, Crohns Disease, Gastric ByPass Patients, and other digested conditions, taking it in tablet form my increase your symptoms.

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies on the relationship of age to the effects of buspirone have not been performed in the pediatric population. However, no pediatric-specific problems have been documented to date.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of buspirone in the elderly.

Pregnancy

Information about this buspirone-oral-route

	Pregnancy Category	Explanation
All Trimesters	B	Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Do not eat grapefruit or drink grapefruit juice, orange juice, tomato juice, or other heavily citric juices while you are taking this medicine.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Isocarboxazid
• Linezolid
• Phenelzine
• Tranylcypromine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alfentanil
• Almotriptan
• Amitriptyline
• Amoxapine
• Amphetamine
• Benzhydrocodone
• Benzphetamine
• Bromazepam
• Bromopride
• Buprenorphine
• Butorphanol
• Carbinoxamine
• Ceritinib
• Clorgyline
• Clozapine
• Cobicistat
• Codeine
• Conivaptan
• Desvenlafaxine
• Dextroamphetamine
• Dihydrocodeine
• Dolasetron
• Doxylamine
• Duvelisib
• Escitalopram
• Esketamine
• Fentanyl
• Flibanserin
• Fosnetupitant
• Granisetron
• Hydrocodone
• Hydromorphone
• Hydroxytryptophan
• Idelalisib
• Iproniazid
• Ivosidenib
• Larotrectinib
• Levomilnacipran
• Levorphanol
• Lisdexamfetamine
• Lithium
• Lofexidine
• Lorcaserin
• Lorlatinib
• Loxapine
• Lumacaftor
• Meclizine
• Meperidine
• Metaxalone
• Methadone
• Methamphetamine
• Methylene Blue
• Metoclopramide
• Midazolam
• Mirtazapine
• Moclobemide
• Morphine
• Morphine Sulfate Liposome
• Nalbuphine
• Netupitant
• Nialamide
• Oxycodone
• Oxymorphone
• Palonosetron
• Pargyline
• Pentazocine
• Periciazine
• Procarbazine
• Remifentanil
• Scopolamine
• Selegiline
• Sertraline
• Sodium Oxybate
• Sufentanil
• Tapentadol
• Toloxatone
• Tramadol
• Trazodone
• Vilazodone
• Vortioxetine
• Ziprasidone
• Zolpidem

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Diltiazem
• Erythromycin
• Fluoxetine
• Ginkgo
• Haloperidol
• Itraconazole
• Nefazodone
• Rifampin
• St John’s Wort
• Verapamil

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Grapefruit Juice

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Kidney disease or
• Liver disease—Effects may be increased because of slower removal of the medicine from the body.

Proper Use

Drug information provided by: IBM Micromedex

Take buspirone only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of unwanted effects.

This medicine comes with a patient information insert. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

You may take this medicine with or without food, but take it the same way each time.

Do not eat grapefruit or drink grapefruit juice, orange juice, tomato juice, or other heavily citric juices while you are taking this medicine.

After you begin taking buspirone, 1 to 2 weeks may pass before you begin to feel the effects of this medicine.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For anxiety:
    • Adults—At first, 7.5 mg two times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 60 mg a day.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.   ( We always recommend calling the local Veterinarian Office to see if he can use it)

 

Precautions

Drug information provided by: IBM Micromedex

If you will be using buspirone regularly for a long time, your doctor should check your progress at regular visits to make sure the medicine is working properly and does not cause unwanted effects.

Do not take buspirone if you are also taking a drug with monoamine oxidase (MAO) inhibitor activity (e.g., isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]). If you do, you may develop extremely high blood pressure.

This medicine will add to the effects of alcohol, ( so no alcohol ) and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your medical doctor or dentist before taking any of the above while you are taking this medicine.

Buspirone may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.

Avoid drinking alcoholic beverages while you are using this medicine.

Do not suddenly stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. This is to decrease the chance of having withdrawal symptoms such as increased anxiety; burning or tingling feelings; confusion; dizziness; headache; irritability; nausea; nervousness; muscle cramps; sweating; trouble with sleeping; or unusual tiredness or weakness.

If you think you or someone else may have taken an overdose of buspirone, get emergency help at once. Symptoms of an overdose are dizziness or light headedness; severe drowsiness or loss of consciousness; stomach upset, including nausea or vomiting; or very small pupils of the eyes.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Drug information provided by: IBM Micromedex

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

1. Chest pain
2. confusion
3. fast or pounding heartbeat
4. fever
5. incoordination
6. mental depression
7. muscle weakness
8. numbness, tingling, pain, or weakness in the hands or feet
9. skin rash or hives
10. sore throat
11. stiffness of the arms or legs
12. uncontrolled movements of the body

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

1. Dizziness or light headedness especially when getting up from a sitting or lying position suddenly
2. drowsiness (severe)
3. loss of consciousness
4. nausea or vomiting
5. stomach upset
6. very small pupils of the eyes

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

1. Restlessness, nervousness, or unusual excitement

Less common or rare

1. Blurred vision
2. clamminess or sweating
3. decreased concentration
4. diarrhea
5. drowsiness
6. dryness of the mouth
7. muscle pain, spasms, cramps, or stiffness
8. ringing in the ears
9. trouble with sleeping, nightmares, or vivid dreams
10. unusual tiredness or weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

 

 

People Start to Heal, The Moment They Feel They are Heard

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Weighted Blankets for Mental Health

Weighted Blanks for Mental Health

 

 

A weighted blanket is a blanket filled with hypoallergenic, non-toxic polypropylene pellets. The pellets are sewn into self-contained small pockets that are evenly distributed throughout the blanket. These pellets give the blanket its weight, which should generally be around 10 percent of the user’s body weight, give or take a few pounds depending on the individual’s needs and preferences.

Created to mimic the benefits of deep touch pressure therapy, weighted blankets have been shown to help ease anxiety, increase oxytocin in the brain and help individuals with sensory processing disorders feel more relaxed. DTP, as shown in the Journal of Medical and Biological Engineering, is about gently applying pressure to the body, which releases a calming chemical in the brain called serotonin to relax the nervous system.

Weighted blankets are perhaps most closely associated with sensory processing disorder and related conditions like autism, anxiety and attention-deficit hyperactivity disorder (ADHD). However, weighted blankets may help with a wide variety of other health issues.

One study found that 63% of patients reported lower anxiety after use and 78% preferred the weighted blanket as a calming modality. A study from the Journal of Sleep Medicine and Disorders found it easier to settle with increased sleep duration, decreased movements and more “refreshed” feeling afterwards.

Researchers at Temple University found that 95 percent of participants with ADHD in a study improved when they received sensory intervention. The interventions offered included deep pressure touch therapy and a variety of strenuous exercise. As one researcher stated, “We found significant improvement in sensory avoiding behaviours, tactile sensitivity, and visual auditory sensitivity in the group that received treatment.”

Myofascial release, which involves the application of firm but gentle pressure over the fibromyalgia pain points can help sufferers find some relief from their pain. Weighted blankets can mimic this pressure, which may help fibromyalgia sufferers experience a reduction in symptoms.

 

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How to Cope with Loneliness During the Holiday Season

Health and Wellness Associates

How to Cope with Loneliness During the Holiday Season

Tips to make your holidays brighter when you feel alone

Christmas evokes images of green and red for many. But for those suffering from loneliness, the holiday blues are also a very real thing.

Loneliness is common during the holidays. When we feel there is an expectation is to experience extreme joy or happiness, feelings of sadness and loneliness can strike even harder.

Whether you’re feeling alone or you want to be there for those around you, understanding what causes loneliness, as well as how to minimize it, can make your holidays much more joyful.

Understanding loneliness

Feeling lonely doesn’t mean you don’t have friends, family or loved ones who care. In fact, it’s very possible to feel lonely while having a loving support system in tow.

Some studies have called loneliness a disease, and others have called it a “hidden killer” of the elderly. While there are many studies on loneliness, there is no exact definition.

Loneliness is a subjective feeling. It can refer to a state of solitude, as well as the perception of feeling alone. While loneliness is a universal human emotion, it amplifies is different ways. Lonely people often dread the holidays, because of the perception that everyone around them is experiencing human connection in a way that they are not.

Examples of groups that tend to experience this more than others include those who are recently single, divorced or widowed, those who live far from family, and those who stay emotionally distant from others. Studies have shown that adults under age 30 tend to experience significantly higher levels of loneliness than other age groups, though those ages 80 and older can experience high levels as well.

How to beat loneliness during the holidays

One thing that is agreed upon is that there are ways to overcome loneliness. However, because these ways tend to involve emotional risk, many are slow to adopt them. Whether you’re feeling alone or you are in solitude, here are some tips to use this holiday season:

Tips to overcome loneliness when you feel alone

• Practice self-care. While you may be thinking about giving gifts to others this season, don’t hesitate to give yourself the gift of a spa treatment, invest in a hobby, or other activities that will get you to socialize and enjoy the season. Taking your focus off feeling alone can help curb the feeling.
• Choose the right people to surround yourself with. When you’re lonely, it may be tempting to call up your friend who loves to co-commiserate. But because loneliness is contagious, you won’t be doing yourself any favors. Choose to surround yourself with positive people.
• Pursue gratitude. Whether you prefer journaling, meditation or prayer, taking the time to write or say what you’re thankful for can shift your attention away from what you don’t have, and spotlight what you do have. Always remember that thankfulness is a choice.

Tips to overcome loneliness when you are alone

• Be vulnerable. If you’re waiting for your neighbor to be the first to say hello, take the risk and say hi first. Call a friend you haven’t spoken with in a while, or learn more about that person you always take a fitness class next to. Remembering that we’re all seeking human connection can take the pressure off the situation.
• Give back. Helping others who have less than we do often reminds us of all we have to be thankful for. Bonus: you may meet some volunteers who have similar interests to you, and are open to helping others.
• Release your expectations. In the age of social media, it’s easy to think the holidays are supposed to look as perfect as a Christmas card. Rethinking your expectations can stop you from playing the comparison game, at which point you may realize you have plenty to be thankful for.

 

Stepping out of your comfort zone is never convenient or easy, but it may be just the thing you need this holiday season.

Health and Wellness Associates

Dr Mark Williams

healthwellnessassociates@gmail.com

 

 

10 Proven Ways to Overcome Jealousy

Health and Wellness Associates

 

 

Jealousy has struck all of us at some point in our lives. In fact, we might have been under the spell of jealousy even before our very first memories. Jealous behaviors can be observed in human beings as early as infancy, but it’s one of those things that we likely won’t outgrow. Jealousy can intensify with age because the only thing worse than jealousy is romantic jealousy.

Think you’re too old or too “experienced” in relationships to be swept away by romantic jealousy? That’s unlikely. It can happen to anyone at any age. Jealousy usually has an interesting way of afflicting even the most (self-proclaimed) super-confident, “non-jealous” types.

The funny thing about romantic jealousy is that a) It’s never funny to the afflicted person, and b) People act like admitting to being jealous is like confessing to a crime. This could occur for various reasons, but it’s likely that the jealous person is already humiliated enough to discover that they can’t hide their jealousy (resulting in someone noticing it and pointing it out), therefore admitting to being jealous is only intensifying those uneasy feelings.

Like most things in life, romantic jealousy is okay in moderation. But what if you’re romantic jealousy goes overboard or even becomes obsessive in nature? This can not only affect your relationship, but also rob you of your happiness (and your sanity).

Below are 10 ways that are more than just band-aid solutions for overcoming romantic jealousy. Jealous feelings flare up for a reason and it’s important to look at yourself a little deeper and think about why you’re having these feelings. Romantic jealousy might begin a process of self-discovery and allow you to make some positive changes to not only better your relationship, but increase your overall happiness and wellbeing.

1. Don’t compare yourself

This tip is number one for a reason because if there is one thing that jealous people have in common it’s comparing themselves to others. The point of comparison is typically the individual that we believe our romantic partner is interested in or “likes” better than us.^[1] The danger with engaging in this downward-spiral habit: It feeds into negative things like low self-esteem, bitterness, cynicism, envy…you name it.

What to do: We all give in and compare ourselves to others once in a while, but it’s important to combat this by acknowledging our positive traits and qualities. If you find yourself looking to another person and comparing your life to theirs, this could mean that you need to take some time to celebrate your own accomplishments and recognize your own uniqueness.

2. Focus on your relationship

Romantic jealousy not only takes up a lot of your mental space, but also physical space between you and your partner. When your conversations with your partner are characterized by arguments related to jealousy, you’re taking up time and energy that you can be spending and enjoying together.

 

What to do: One of the mysteries behind romantic jealousy is that the core fear of the jealous person is losing their partner, but the very acts that accompany jealousy can make that possibility come true. In other words, your biggest fear is losing your partner, but by letting jealousy interfere with your relationship, you might be pushing your partner away from you. Give your relationship priority over your jealousy.

 

3. How do you see yourself?

Self-esteem issues are an important root cause of romantic jealousy. Working on increasing self-esteem can be a lifelong process for some, but you can start by thinking about how your jealousy is influenced by your beliefs about yourself. If you feel you are not “enough” for your partner (i.e., smart enough, good looking enough, funny enough, rich enough, etc.) then you are prone to suffering from romantic jealousy.

What to do: One of the most effective ways to work on increasing your self-esteem is by participating in one (or more) activities or hobbies that you enjoy that provides you with a sense of meaning and accomplishment. This is not as complicated as it sounds. This hobby or activity can be anything you enjoy (e.g., cooking, singing, drawing, swimming, dancing). The point is that you’re doing something that makes you feel good about yourself, something that reminds you that there is more to you than the list of “enough’s”. You have many positive qualities and abilities that make you a special person. Practice acknowledging and celebrating this fact.

 

4. Forgive and forget

Romantic jealousy is often ridden with not just jealousy about things going on in the present, but things in your partners past as well. These “things” can be anything from baggage from a past relationship to an ex that is still somehow in your partner’s life. Forgetting the past is not an easy task, but it is critical if you want to enjoy a positive and lasting relationship with your partner.

What to do: There is a prerequisite, though, in your quest to forget your partners past: You must accept your partner for who they are. Neither you nor your partner can change what happened in the past. If you are accepting to be in a relationship with your partner, you should also agree to accept and respect the “life baggage” that they carry.

 

5. It might be you, not them

Oftentimes, people who are jealous fail to accept their own role in the problem and feel that it’s their partner who is triggering the jealous feelings and actions. In your pursuit to overcome romantic jealousy, consider that these feelings might actually have nothing to do with your partner.^[5]

What to do: In many cases, jealousy is a personal, internal state of insecurity and self-doubt. You could be trying to ease the burden on yourself by blaming your partner for “making” you jealous. Taking responsibility is key in order to begin addressing the problem.

 

6. Talk to your partner

Discussions between couples about romantic jealousy often appear more like an interrogation than an actual dialogue. Your partner will likely become defensive, tune you out, label you “jealous,” and dismiss anything you have to say.

What to do: If after you have thoroughly thought about your role and responsibility for your jealous behaviors you continue to feel like your partner is partly to blame, then it’s time to talk about it. This conversation should occur at a “neutral” time (i.e., not during or shortly after an argument or disagreement) and should consist of the following:

• Express your feelings to your partner. This is not the time to pretend that you’re not jealous. Your partner already knows you are, so leave the pride aside.
• Be specific about what bothers you. Don’t make general or arbitrary statements that leave your partner guessing or confused.
• Try to arrive at a solution together. Talking about a problem without participating in offering a solution comes off like you’re just complaining. Tell your partner how you would like to resolve your concerns and let your partner come up with solutions too.

7. Who you surround yourself with

A couple went for marriage counseling for issues unrelated to jealousy. After a few months of counseling, the wife suddenly began to bring up issues related to romantic jealousy. It was later revealed that the couple had recently rekindled an old friendship with another couple. The wife in the other relationship was extremely jealous towards her husband and would vent all of her jealous suspicions to her friend.

What to do: We all know the importance of surrounding ourselves with positive people, but we really understand this when we notice someone else’s issues or negative qualities rubbing off on us. If you are struggling with romantic jealousy, having a group of friends who either egg you on or speak negatively about relationships in general will only bring you down. Strive to surround yourself with other people that you would like to emulate.

8. Stop stalking…

People struggling with romantic jealousy often spend hours trying to dig up information on their partner. They search emails, social media sites, personal belongings, cell phones, or even try to secretly follow their partner. Finding no evidence to substantiate their jealousy theories does not discourage them. It only seems to make them search longer and harder. Stalking feeds into the obsession aspect of romantic jealousy. It is time consuming and distressing for the jealous partner. When the other partner finds out about the stalking behaviors, they might feel angered at the mistrust and the violation of privacy.

What to do: Think about how you are investing your time, the way it makes you feel when you are stalking your partner, and what else you can be doing with your time instead. This can help put things in perspective. If you ask someone who has overcome romantic jealousy, they will likely tell you that they took a “let the chips fall where they may” approach to their relationship: If their partner is doing something wrong, sooner or later the truth will be revealed. They refuse, though, to let negative behaviors rob their happiness and well being.

9. …so you can stop and smell the roses

Imagine yourself enjoying your relationship without putting in all the energy that jealousy takes from you. Once you free yourself from some of the negative thoughts and behaviors that accompany romantic jealousy, you will be amazed to rediscover all of things you’ve been missing. You will also find that you are enjoying your partner and your relationship so much more.

 

What to do: Visualize what your ideal relationship with your partner would look like. Write your ideas down if needed. Once you set the intention to work on yourself you will be more likely to actively put effort towards your goals.

 

10. Confidence is key

When we want to make personal changes, sometimes there is an inevitable focus on the negative: Your issues, your problems, and your negative traits. Change can also successfully take place by focusing on and building upon something positive that will counter or outweigh the negative behavior that you want to change. Confidence is the direct opposite of jealousy. When you build self-confidence, feelings like jealousy, doubt, and insecurity don’t have room to grow. Those feelings will always be present to a certain extent because we’re human, but your confidence and belief in yourself will prevail.

What to do: Developing and increasing your self-confidence works in much the same way as the other tips on this article. You must acknowledge and accept your own uniqueness and dedicate your time to activities that make you feel good about yourself and give you a sense of purpose. If your self-confidence is based on what others think or say about you or what you think your partner expects from you, then your beliefs about yourself will likely be unstable and ever changing. When your self-confidence is based on what you feel and know about yourself, then you alone are in charge of your own happiness.

Health and Wellness Associates

Preventative and Restorative Medicine

healthwellnessassociates@gmail.com