Sleep Tips

Sleep…that often, elusive rejuvenating sweet respite. Sleep has been proven to consolidate memories, encourages hormonal balance, restores the immune system, decreases the effects of the days’ stressors, and rebuilds muscle. The consequences of decreased sleep or sleep disorders include cognitive impairment, behavioral and emotional deterioration, hormonal imbalance leading to increased risk of disease including cardiovascular disorders and diabetes. In addition, sleep deprivation causes disruption in the hormones that control appetite, increased levels of cortisol, and other stress hormones which have been established to cause retention of body fat, particularly belly fat. Here are some suggestions for a good night’s sleep: 1. Start early. One mistake that people make is staying up too late. Our bodies and brains begin to wind down naturally around 10pm. 2. Develop a routine. Take a shower, read a book, meditate or pray before bed. These proven stress reducers could help you to have a restful night. 3. Engage in quiet relaxing activities at bedtime. Put aside the electronics. Focusing on phones, computers, television, etc. can disrupt the body’s natural inclination to relax. 4. Comfort is key. Create a comfortable, restful environment. Fo example, if laundry piled to the ceiling stresses you out and you have to see that while going to sleep, it might be helpful to get the laundry put away so you can relax. 5. Cut back on liquids after 8pm to prevent late night trips to the bathroom that is disruptive to sleep. 6. If you have trouble falling asleep, get up. It tends to quickly become an unproductive battle to try to will yourself to sleep. Get up, do something relaxing. 7. Take notice of sleep disruptors in your environment. Does a spouse steal the covers? Is your pet a bed hog? Take steps to minimize these environmental factors. 8. Figure out your optimum sleep temperature. A room that is too cool or too warm may interfere with sleep. 9. Stay away from sleep disruptive substances such as caffeine, nicotine, chocolate, soda, energy drinks, etc. 10. Wake up at the same time everyday. Consistent sleeping and waking times train your brain and your body to gear up or down for the day.

Pet Owners and Mental Health

There is significant research that keeping pets can improve your physical health, but did you also know that caring for pets also improves mental health? A study published by the APA, American Psychological Association, found that pet owners rated themselves as happier, healthier, and better adjusted than non-pet owners. The key element that made the difference was the perception on the part of pet owners that their pets gave them a sense that their social needs were met, a sense of belonging, and higher reported self-esteem. Pets decrease our sense of loneliness or isolation. Also, pets require individuals to step out of their own thoughts and feelings to consider the needs of another being, thus encouraging engagement in the world around you. McConnell, et. al. Journal of Personality and Social Psychology 2011, Vol. 101, No. 6, 1239-1252.

Mark Myers Expert Answer to:I'm extremely depressed and angry about being unemployed for some time. How do I go on without having a mental breakdown?

In today's economy, I am sure you are not alone. There are many people who share your plight. The fear you face is understandable. Individuals could experience the following feelings: worry, unproductive, boredom, self defeated, and pessimistic, to name a few emotions. It is important that you take steps to try to take control over areas of your life that you can. Click for more

Mark Myers Expert Answer to: "I'm overwhelmed and tired these days, and never seem to have time to take care of myself. I'm also low on social contact, as my responsibilities are intense. Can anyone offer ideas on how to break out of this box?"

"My situation includes being (temporarily) a single mother to two mentally ill children, a financial crisis, a husband in rehab and a lack of relatives to help with the above. Eeek."
There appears to be more demands on you then resources. Lets start with your children. Depending on the ages of your children and the mental health issues they are experiencing, getting support in this area is extremely important.

For kids with OCD, adding therapy to drugs helps

Children plagued by the repetitive behaviors, irrational fears and intrusive thoughts of

Obsessive-Compulsive Disorder often get some relief from widely prescribed antidepressants. But when they also get a form of psychotherapy that teaches them different ways to think about and respond to their fears and compulsions, they get much better, a new study finds.

In-School Screening Picks Up Mental Health Issues

School-based mental health screening identifies troubled kids and helps get them into care, researchers found

Depression linked to stroke, vitamin D may help both

By David Liu, Ph.D.

Saturday, Aug 13, 2011 (foodconsumer.org) -- Being chronically depressed may be a sign of higher risk of stroke, according to a study in Stroke: Journal of the American Heart

Association.

The study led by Kathryn Rexrode, M.D.at Brigham and Women's Hospital in Boston, Mass found women who had a history of depression was at 29 percent higher risk of total stroke.

The study also found women who used anti-depressant medications particularly selective serotonin reuptake inhibitors were associated with a 39 percent increased risk of stroke. Anti-depressant drugs included Prozac, Celexa and Zoloft.

But the researchers speculated that it is not the medications that cause a higher risk of stroke. Instead use of the drugs only indicates that depression in the patients was more severe.

The study involved in 80,574 women ages 54 to 79 years in the Nurses' Health Study. Participants had no history of stroke at baseline. During the six-year follow-up, prevalence of depression at baseline was 22 percent in the participants and 1,033 strokes were identified.

Depressed women were often those who were single, smoking, and less physically active, according to the study. They were also more likely to have a higher body mass index, and diseases like heart disease, diabetes and high blood pressure, compared to women without a history depression.

A healthy observer said the study suggests what increases the risk of depression may also increase the risk of stroke and vitamin D can be the missing link between the two.

One study in the American Journal of Clinical Nutrition found men who had intake of 600 IU or more of vitamin D per day were 28 percent less likely to suffer stroke and heart attack, compared with those who had an intake of only 100 IU or less per day. In women, the risk reduction was 16 percent.

The study was conduced by Qi Sun of the Harvard School of public Health in Boston MA.

Another study published in 2008 in the journal Circulation linked low serum vitamin D levels with 60 percent higher risk for heart attack, stroke and heart failure, compared with those who had high levels of vitamin D.

Dr. Thomas Wang of Harvard Medical School in Boston, Massachusetts and colleagues who conducted the study also reported that the association was even stronger among those with high blood pressure.

For the study, Wang et al. followed up 1,739 people at an average age of 59 in the Framingham Heart Study for five years.

Now low serum vitamin D is also associated with high risk of depression.

Nanri A and colleagues from International Medical center of Japan in Shinjuku-ku, Tokyo, Japan reported on Aug 19, 2009 in the European Journal of Clinical Nutrition that people who had highest levels of vitamin D were 49 percent less likely to feel depressed.

In winter, high levels of vitamin D were found associated with lower risk of depression, particularly severe depression.

Many other studies also suggest that vitamin D can be the cause for depression.

Violence Against Woman Impacts

Violence against women often leads to more mental illnesses
By AMERICAN MEDICAL ASSOCIATION
08/09/2011 10:55

New study shows that women who experience gender-based violence have higher incidence of anxiety and substance use disorders.
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Women who reported experiencing gender-based violence, such as rape, sexual assault, intimate partner violence and stalking, had an associated higher lifetime prevalence of mental health disorders, dysfunction and disability, according to a study in the August 3 issue of JAMA, a theme issue on violence and human rights.

Violence against women is a major public health concern, contributing to high levels of illness and death worldwide, according to background information in the article. "In the United States, 17 percent of women report rape or attempted rape and more than one-fifth of women report intimate partner violence (IPV), stalking, or both. There is mounting evidence that each of these forms of gender-based violence (GBV) is associated with mental disorder among women, although methodological shortcomings of existing studies constrain the inferences that can be drawn," the authors write.

Susan Rees, Ph.D., of the University of New South Wales, Sydney, New South Wales, Australia, and colleagues assessed the association of a composite index of GBV (rape, sexual abuse, IPV, and stalking) with a range of lifetime mental disorders, including indices of severity and co-existing illnesses. The researchers analyzed data from the Australian National Mental Health and Well-being Survey of 2007, which included 4,451 women (65 percent response rate), ages 16 to 85 years. Diagnostic criteria from the World Health Organization's World Mental Health Survey Initiative was used to assess lifetime prevalence of any mental disorder, anxiety, mood disorder, substance use disorder, and posttraumatic stress disorder (PTSD).

The researchers found that the lifetime prevalence for any mental disorder was 37.8 percent. A total of 1,218 women (27.4 percent) reported experiencing at least 1 of the types of GBV assessed in this study. The lifetime prevalence rates were 14.7 percent for sexual assault, 10 percent for stalking, 8.1 percent for rape, and 7.8 percent for IPV. Women who had been exposed to 1 form of GBV reported a high rate of lifetime mood disorder (weighted, 30.7 percent), lifetime anxiety disorder (38.5 percent), lifetime substance use disorder (23.0 percent), lifetime PTSD (15.2 percent), and any lifetime mental disorder (57.3 percent).

"The association was particularly strong for exposure to 3 to 4 types of GBV (lifetime anxiety disorders: weighted, 77.3 percent; lifetime mood disorder: 52.5 percent; lifetime substance use disorder: 47.1 percent; lifetime PTSD: 56.2 percent; and any lifetime mental disorder: 89.4 percent). Women exposed to a single GBV reported increased rates of suicide attempts (weighted, 6.6 percent), with the highest rate of suicide attempts for those who reported exposure to 3 to 4 types of GBV (34.7 percent)" the authors write.

The researchers also found that gender-based violence was associated with more severe current mental disorder, higher rates of 3 or more lifetime disorders, physical disability, mental disability, impaired quality of life, an increase in disability days, and overall disability.

"Our data underline the observation that mental health disorder in women who have experienced GBV tends to be more severe and associated with comorbidity, characteristics that require expert and comprehensive approaches to treatment. Therefore, there is a need to ensure that expert mental health care is a central component of GBV programs. Similarly, psychiatric services need to be better equipped to assist women with mental health disorders who have experienced GBV," the authors write.

"In general, renewed impetus is needed to develop an evidence base for prevention and clinical interventions that reflect a comprehensive view of GBV and its association with wide-ranging mental and psychosocial disabilities among women."

This article was originally published by the American Medical Association.

Mark Myers Expert Answer to "How Do I help a friend who suffers from Anxiety Disorder?

My answer on @Quora to: How do you help your friend who suffers from anxiety? more

American's Use of Anti Depressants on the Rise.

Americans are popping more antidepressants than ever before to deal with everyday stress, and non-psychiatrists are increasingly willing to prescribe the drugs to patients with no mental health diagnosis, a new study finds. more

Self Medication can lead to Anxiety Disorder

Researchers in a study have reported that the people who drink or consume drugs to calm their anxious nerves could develop abuse disorders in the near future. The Canadian researchers have tested and questioned about 35,000 people and they have found out that the people suffering from anxiety disorder have self medicated them with alcohol and 13% have developed alcoholism as compared to only 5 % of respondents who did not self-medicate.  more

The Two Way Street: Medical Conditions and Mental Health

Studies have shown that a strong relationship between medical conditions/problems and

mental health exists. It is estimated that up to one-third of individuals with a serious medical

condition experience symptoms of depression. Chronic illness can trigger or exacerbate

depressive (feelings of helplessness or despair) or anxiety symptoms (concern about the

future), not to mention both the mental and physical stress of coping with a prolonged illness.

The limitations of the medical condition significantly alter a person’s life, which could create

huge and seemingly overwhelming situations. Self image, independence (or lack of), and social

interactions are obstacles that are put to limits. Lastly, emotional problems could slow down or

prevent full recovery from medical conditions.

The severity of a medical condition typically varies with each person and that person’s

subjective ability in addressing the challenges a chronic or prolonged illness can bring up.

Medical challenges are not limited to the aging population, as hearing loss, vision impairment,

endocrine disorders, gastric issues, surgery, as well as autoimmune diseases could happen to all

age groups. Any one of these could create feelings of loss (loss of mobility, social interaction,

resources, finances, and one’s own mortality). 

The rate for depression occurring with other medical illnesses is quite high:

 Heart attack: 40%-65%

 Coronary artery disease (without heart attack): 18%-20%

 Parkinson’s disease: 40%

 Multiple sclerosis: 40%

 Stroke: 10%-27%

 Cancer: 25%

 Diabetes: 25%

Cleveland Clinic: Copyright 1995-2009, The Cleveland Clinic Foundation

The relationship between medical issues and mental health is a two-way street. Mental health

challenges like anxiety, depression, and substance abuse have a strong link to physical ailments.

Sleep and fatigue due to mental health problems affect and stress us, and if we are not given

enough time to replenish our body we become more susceptible to illness. When we are

experiencing symptoms of anxiety and panic attacks our body experience what is referred to as

flight or fight syndrome, which is just one clear example of the stress these mental health issues

have on our body. This would also make our body more prone to illness and breakdowns.

Another factor to consider in addressing medical conditions and mental health is medication.

Some medications have side effects that could amplify emotions such as anxiety or depression.

If a person has substance abuse problems, the risk of abusing prescriptions is greatly increased.

Energy level or lack thereof, creates less ability to socialize and increase feeling of isolation, and

medications can amplify these feelings as well. Also, some medications may have other side

effects such as a change in sexual desire, which could affect self confidence and relationship

issues.

It is important to understand that medical challenges could have a huge impact on a person’s

psyche. Identify emotional issues that may surface or are surfacing, and have a dialogue with

your support group to educate them on what you are currently feeling and what you may

experience later on. Try to develop regular sleep patterns and resist the urge to isolate. Your

doctor can educate you and your loved ones on medications and side effects. Inviting a loved

one or significant other in on such a discussion will only serve to educate them better on what

you are feeling and how best to cope with it. There are some exercise programs out there such

as water aerobics that may be possible for some with doctor approval. Monitoring your diet is

another way to stay both physically and mentally healthy. Lastly, seek out a therapist who has

experience working with individuals with medical conditions to get the best help for your

situation.

Sleep Better!

The need for sleep is a vital part of our ability to function.  We spend one third of our lives asleep.  Without the proper rest  we could experience problems in the following areas: difficulties in making decisions, lost productivity, concentration, underachievement, being more accident prone, depression, anxiety, sexual performance, and fatigue.  Our enjoyment of life is hampered if we are not able to get the proper rest we need. It is difficult to determine what impact sleep deprivation may have on your presenting problem.  Often times, it is difficult to know if it’s your problem that is causing sleep difficulties or the sleep difficulties causing problems.

About how many hours did you sleep last night? On the average, eight hours of good sleep is  recommended. This could vary from individual to individual. Some of us need more and some less. Our age is one factor in determining the amount of sleep we need. The older we get, the less sleep we may require.
Included are some tips on better sleep habits.  By using these suggestions, you may find yourself with more energy to address other concerns in your life.

Diet
1.  Cut down or eliminate alcohol consumption.
2. Avoid heavy meals before bedtime.  Also avoid acid producing foods such as spices, onions, and peppers.
3.  Cut down or eliminate caffeine . This would include chocolate, tea, and soda pops.
4. A glass of warm milk 15 minutes before going to bed will soothe your nervous system. Milk contains calcium, which aids in relaxation.
5. Try a cup of hot chamomile, catnip, anise or fennel tea. All contain natural ingredients which may help you sleep. Some blends of herb tea are designed to soothe you and help you get to sleep.
6.  A small, low protein, high carbohydrate bedtime snack, such as juice and cookies, eaten about an hour before bedtime, can help you fall asleep sooner.
7. Studies indicate that foods with large amounts of the amino acid L-tryptophan help us sleep better. These include warm or hot milk (but not cold milk), eggs, cottage cheese, chicken, turkey and cashews.


Environmental Factors
1.  Evaluate your sleep environment. Is there too much noise or light?  You may find it helpful to get some ear plugs or sound machines. There may be new noises introduced into your environment that could be making it more difficult to sleep.
2. Try to keep your room as dark as possible. Night time eye shades  could  be helpful. Also consider your alarm clock.  If it is a particularly luminous one, this can be extremely annoying if you're having a hard time getting to sleep.
3. Fresh air and a cool room temperature  will provide best sleeping conditions. Adjust the temperature inside the bed --with more or fewer blankets.
4. Listen to Music. Music should be soft and soothing. There are cassettes and records designed for that very purpose. Other sounds to try to lull you to sleep could be sounds of waves, wind, or other relaxing sounds.
5. A firm bed will give your entire body the support it needs to really relax. It's better for your spine, too. Sleep on your back. This allows for better passage of air and facilitates easier breathing.  


Sleep Friendly Behaviors
1.  Try to keep your sleep and wake times consistent, even on weekends. If you have had a difficult  time sleeping one night, don’t try to catch up with it by sleeping twice as much.  Your body likes regular routines, even if you don’t.
2.  Avoid day time naps.  This will only further throw off your sleep cycle.
3.  Keep a sleep log.  Look for patterns. If you are having success on one night, find out what you did differently and try to repeat it.
4.  Spend your normal sleep time (i.e. 6,7,8, hours) in bed.  If you are used to sleeping eight  hours a night, spending twelve hours to get that amount of sleep will only frustrate you.
5.  Decrease your activities as you approach your desired sleep time.  The more active you are the  more time it will take to settle down to sleep. Individuals with jobs that require a lot of thinking throughout the day, have far more trouble sleeping than individuals who work in more physical settings.  For these individuals, wind down time is especially important.
6. Regular exercise is helpful. Exercise allows for better oxygen and blood flow which helps you relax more and sleep better. Too much exercise or doing it too close to bedtime would be counterproductive.
7. A warm bath is a great way to relax your body. You could also use ingredients to add to the bath...bath salts, Epsom salts,   baking soda, or bath oils. These will relax you and also help remove toxins from your body.
9. Massages could also aid in the transition to sleep. Have your spouse (or whoever) give you a massage just before going to sleep. Items such as foot or back massagers could be bought from most stores.
If your sleep difficulties persist, let your therapist know. You and your therapist may want to explore this with a more focused approach.