Keeping Your New Year's Resolution with Mindfulness

By Brandon Cornejo M.D., Ph.D.

How many of you are trying to get yourselves back into a regular gym and exercise routine for your New Year's resolution? When it comes to exercise, one of the biggest challenges is staying motivated and consistent. I hope I can help you with this two-part blog post on "Mindfulness."

What is Mindfulness?

• Mindfulness is a nonjudgmental, present-centered awareness in which each thought, feeling, or sensation that arises is acknowledged and accepted.

Mindfulness as a Therapeutic Approach

• Mindfulness based stress reduction means to focus your attention on the "now."

• People practicing mindfulness work on not judging or evaluating the present moment but focus on simply “being” present.

• People in a formal mindfulness class engage in daily meditation along with skill-building homework that ties them to the “here and now.” 

 How Does Mindfulness Work?

• Mindfulness allows a person to pause calmly and reflectively before reacting to things.

• Mindfulness may prevent relapse of clinical depression by allowing a person to have some “space” between who they are and their emotions.

• Mindfulness based cognitive therapy (MBCT), a form of therapy that combines elements of mindfulness with cognitive based approaches to treatment, can be an effective approach for the treatment of anxiety or depressive disorders.

• Mindfulness may enhance mood as well as help eliminate negative thoughts associated with depressive states.

So why is "mindfulness" important to keeping that New Year's resolution of daily exercise? Next week, I will post part two with my tips for staying in the present moment while exercising. Happy New Year's!

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How to "Bully-Proof" Kids

By Gariane Phillips Gunter, M.D. 

Do you think October's national anti-bullying campaign was successful in stopping bullies? The Washington Post recently blogged about our country having a hard time defining bullying among kids. So, what can we, as parents, do to protect our children and teens? Here are some tips for "bully-proofing" your kids:

Distinguish between events and feelings - It is important to teach your children the difference in their interpretations of life situations. This helps kids learn to understand and relate to the feelings of others. They will be able to determine if someone is treating them appropriately - or if they are, in fact, being bullied.

Develop a sense of self - Another great way to bully-proof your child is to help them develop a sense of self. Encourage them to learn about and understand who they "are" because children who struggle to identify self-awareness or constantly strive to be their "hero" are never going to be able to live up to those expectations. This can be detrimental for their self-esteem - making them a direct target for bullying. Kids with low self-esteem are less likely to stick up for who they are which makes them prime targets for those looking to pick on someone (bullies often bully due to their own low self-esteem).

Monitor their online lives - Parents or caregivers should have access to online accounts and cell phones to ensure their teens' safety over the Internet. Cyberbullying continues to be a nationwide epidemic.  

Positive activities - It is also important to encourage your kids to explore activities that make them feel good about themselves. Find something that they are really good at because it will help increase their overall self-esteem and feeling of self-worth. Encouraging courageous behavior is another great way to guide children. You can teach them to stand up for themselves and for their peers and other friends. When groups of kids or teens stand together to put an end to a bullying situation, the bully is more likely to back off and won't mess with your child again.

Following these tips when your kids are young is the best way to show them how to establish early on that they will not tolerate bullying. 

Sources: http://www.makebeatsnotbeatdowns.org/, http://www.olweus.org/
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Female Athlete Triad: Sport Gone Bad

By Claudia L. Reardon, M.D.

Psychiatrists encourage nearly everyone to participate in sports and exercise. Sports not only improve physical health but also can greatly improve mental well-being. However, if girls and women take involvement in sports too far, they can suffer a well-described triad of symptoms. The so-called female athlete triad consists of the following three inter-linked health problems:

1. Insufficient caloric intake/disordered eating
2. Menstrual problems
3. Weak bones

Girls and women who participate in “leanness sports” that emphasize thinness (running, ballet, gymnastics, figure skating, and others) are particularly at risk. If they receive the message that being thinner could result in greater athletic success, they may try to cut down on their caloric intake to levels too low to support their levels of physical activity. This can result in full-blown eating disorders, irregular menstrual cycles, and weak bones (including osteoporosis at young ages).

Some common myths about the female athlete triad include the following:

• If an athlete’s performance has not started suffering, then she must not have a problem. FACT:  Even if an athlete’s performance has not started suffering, it eventually will.  Not taking in enough calories to match activity level is not sustainable in the long-run.
• It is normal for female athletes to stop menstruating. FACT:  It is never normal for a female athlete to stop menstruating. There are serious health risks, especially bone loss, to not menstruating. Studies show that after three years of not menstruating, bone loss is likely to be permanent. Loss of future reproductive function could also occur.
• If an athlete is not eating enough to match activity level, she is aware of what she's doing. FACT: Denial is powerful. Athletes will very often feel that they are being as healthy as possible, and that meticulous attention to diet is a sign of dedication to sport. Coaches, parents, and professionals will need to help the athlete see the problems with the behaviors.
• An athlete who eats “healthy," is a top performer on the team, and excels in class is unlikely to have an eating disorder. FACT: Traits that are desirable in an athlete can make them more at risk of developing an eating disorder. Mental toughness, pursuit of excellence, performance despite pain, commitment to training, and being a team player are very similar to excessive exercise, perfectionism, denial of discomfort, and being self-less.

What can you do if someone you know might be suffering from the female athlete triad?

1. Share your concerns with the athlete.
2. Talk with the coach, athletic trainer, or school counselor.
3. Encourage the athlete to see a physician and dietitian. Not all health care professionals are familiar with the details of the female athlete triad; to help them out, you can send along this brochure with the athlete to the appointment.

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Should your Doctor be your Friend?

By Jeffrey Borenstein, M.D.

Last Friday, October 14th, I was asked to be a guest on the Dr. Drew show to address the important issue of the doctor-patient relationship. Our discussion centered on the friendship between Dr. Conrad Murray and Michael Jackson and the inappropriate crossing of boundaries.

First and foremost, the doctor-patient relationship is special, centered on trust, caring, and helping. But it is not a friendship – friendships are two way streets. The therapeutic alliance in the doctor-patient relationship is a one-way street – the doctor’s role is to help the patient. 

Another issue we discussed was “doctor shopping." When a person who has a diagnosis of chemical dependency gets prescriptions from various doctors in order to misuse medications, typically pain meds or anti-anxiety meds (benzodiazepines), it's called "doctor shopping." When a physician is aware of this behavior or even suspects "doctor shopping," it's the doctor's duty to take action and stop filling prescriptions rather than enable such destructive behavior.

If you have a friend or family member misusing medication in this way, don’t sit by quietly. Taking appropriate action could save a life. Encourage your loved one to seek appropriate treatment. On the Healthy Minds Public Television series, we have two episodes which focus on chemical dependency, episodes #111 and #112 which can be seen at www.wliw.org/healthyminds. 

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The Significance of a Sleeping Brain

By Sara Coffey, D.O.

As a mother of a newborn, "sleep" is an increasingly interesting and important topic in our household.  Not only for my baby, but for my husband and myself - which brings me to the book Healthy Sleep Habits, Happy Child by Dr. Weissbluth.  Since I'm a psychiatry resident as well as a mom, I'm especially drawn to Dr. Weissbluth's discussion on studies showing sleep linked to temperament and attention in children.

Children need sleep in order to develop.  A sleeping brain is more than just a resting brain; it is a brain that's able to restore, process, and complete essential tasks that an active awake brain is unable to do.  Dr. Weissbluth explains that for young infants, daytime sleeping or naps can help to enhance the brain’s capacity to think.  When we become adults, our busy schedules cause us to forget the importance of these daytime respites and restorations.  Our hectic grown-up days may not always allow naptime, but naps are essential to raising healthy infants and kids.  

The significance of sleep doesn't only apply to young children.  Did you know that teenagers need more sleep than pre-teens?  So, to all parents who are noticing behavior problems, irritability, decreased concentration, or other changes in your children's moods, focus on their sleeping habits.  HealthyMinds.org blogger Dr. Gariane Gunter shares how many hours of sleep a child needs according to his or her age in this post.  I've included some of her tips below:

• Birth-6 Months: Children need 16-20 hours
• 6-12 Months: Children need 14-15 hours
• Ages 1-3: Children need 10-13 hours
• Ages 3-10: Children need 10-12 hours
• Ages 11-12: Children need 9-12 hours
• Teenagers need 10-12 hours of sleep per night

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Live Longer by Making Mental Wellness Your Mission

By Felicia Wong, M.D.

September is National Recovery Month and SAMHSA's National Wellness Week (Sept. 17-23), a time to remind us why "wellness" is so important to our overall health. Did you know, people with mental and substance use disorders die decades earlier than the general population, mostly due to preventable medical conditions?

Each day, we face all sorts of demands and drama which can lead to insomnia, lack of concentration, problems in our relationships, and other mental health issues. In a past blog post, I identified coping tools for dealing with stress and boosting your overall well-being. Here are "Top 8 Tips for Mental Wellness." I hope you will take another look and share with your loved ones this week. 

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

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

3) Stay Positive. Positive emotions can boost your ability to bounce back from stress.

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

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

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

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

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

Which tips on this list are missing in your life? Today is the perfect time to take action! Your wellness matters. 

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Helping Others Helps Your Mental Health: Why Volunteering Makes Us Happier

By Roberto Blanco, M.D.



I had just sat down for Dr. Norden’s Neuroanatomy class when one of my classmates, who had just walked into lecture late, announced he heard on the radio that a plane had crashed into one of the World Trade Center Towers.  As was her way, Dr. Norden showed immediate concern, and before I knew it, we were watching another plane fly into the second tower live on CNN in the front of the lecture hall.  It was a surreal scene in Light Hall on Vanderbilt’s Medical campus; one that I did not expect to experience.  The rest of the day was a blur of events and emotions – people in a state of shock, tears shed, classmates comforting each other, and Dr. Norden attempting to put things in perspective.  Class was dismissed for the day, and the rush to call loved ones in New York City and Washington, D.C. began.  My thoughts immediately turned to family members who lived in New York and worry when I was unable to reach them.

10 years ago, the world of every American changed.  In response, the country and the world came together in support of the victims of the terrible tragedy.  People from far and wide drove, some for thousands of miles, to reach New York City and care for complete strangers.  People sacrificed their time, sweat, and a good portion of their lives and livelihoods to help those in need.  Donations flooded in to support the victims’ families.  A rush of prayers, love, and aid from across the globe also streamed in for those affected.  It seemed that the world was one in giving to those who had lost.

I recently wrote a blog post here on happiness, human fulfillment, and flourishing.  In that posting, I discuss human fulfillment and flourishing as the real definition of happiness and the final aim of all of what we do.  A great way to help yourself and your own mental health is to help others.  Feeling useful and needed is a wonderful way to work towards human fulfillment and recognize all you have for which to be grateful.  Serving others is a sign of individual and community emotional health.  Volunteering your time and talents also leads you to finding the love within yourself that you didn’t know you had.  When faced with those who have lost and are truly in need, just like on September 11th, the true beauty of mankind comes out.  

For Sunday's 10th Anniversary of September 11th, President Obama is calling for a national day of giving in memory of those who passed during the attacks.  His goal is to have over 1 million Americans engaged in volunteer work on September 11th.  The American Psychiatric Association has joined "Give an Hour" in aid of military members, veterans of Iraq and Afghanistan, and their families as part of the “I will” campaign to encourage that same spirit of service that was felt in the days following the attacks.  So, think about joining us in giving by helping build a house for a needy family through an organization like Habitat for Humanity.  Volunteer to distribute food or give to your local food bank.  Help a friend move.  Donate time or resources to a homeless shelter, spend time with the elderly, or serve at a local hospital.  This September 11th, let’s honor those who died by helping a member of your community in need.
In photo: Dr. Blanco and another volunteer work together to build a home through Habitat for Humanity
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Mental Illness or Muse? Amy Winehouse and Historic Artists with Bipolar Disorder

By Mohammad Alsuwaidan, MD 

We have no doubt lost a profound musical talent in the tragic death of Amy Winehouse this week.  Her public struggle with substance abuse and bipolar disorder (commonly known as manic depression) has reignited curiosity about possible links between creativity and mental illness. In such unfortunate circumstances, it serves well to draw upon the lessons of history in making meaning out of sorrow.

A little more than 120 years ago, a misfortune befell another budding talent. A young painter entered a psychiatric hospital in Saint-Rémy-de-Provence, Southern France. Known by his neighbors in town as “fou roux" (the crazy redhead), he had been troubled with mental illness throughout his life. A few months prior, he had reached a crisis point and during his breakdown, he rushed to a brothel to see his friend - a prostitute named Rachel. He handed her a small wrapping of newspaper - telling her to “keep this object carefully” and ran off. Unwrapping it, she was shocked to find the freshly cut and still bloody lower portion of his left ear!

Vincent van Gogh holds legendary status in Art and his influence has crossed cultures and eras. To gaze onto the vivid colors and hypnotic swirls in his work is to be transported into another world - a morphed view of reality that can only be seen through his eyes. There is a tendency to romanticize van Gogh’s mental illness – which most respected psycho-biographers believe to have been bipolar disorder.

The notion that there is a fine line between creative genius and “craziness” is not new and has existed since ancient times. Most of this interest has focused on bipolar disorder; many famous figures have been speculated to have suffered from this mental illness: Beethoven, Edgar Allan Poe, Emily Dickinson, Victor Hugo, Charles Dickens, Edvard Munch, and many more. We continue to see this pattern in the modern day among celebrated actors, poets, painters, and musicians like Ms. Winehouse. Yet, despite our modern methods, illuminating the “line” or “link” between mental illness and creativity remains elusive.  Studies show that a certain level of melancholy or mixed emotions may be needed to access the creative spring. Unfortunately this negative emotion may also underlie some of the symptoms seen in bipolar disorder. 

Herein lies the eternal dilemma in the field of medicine – balancing benefits of treatments against their risks. Could some bipolar treatments dampen the creative drive? The evidence, both anecdotal and empirical, says yes.

Yet research also reveals that when individuals with bipolar disorder receive treatment, their overall productivity, focus, and organization improve. We know that the poet Robert Lowell produced the largest portion of his work after receiving lithium treatment for his bipolar disorder. And though some critics argue that his “pre-lithium” work is more striking in its poetic beauty, they admit that had it not been for the stabilizing effects of his treatment leading to many more – still beautiful – poems, we may have never known Lowell and his artistic mastery at all.

The message to mental health professionals is clear in my mind; we should attempt to treat highly-creative individuals with mood disorders with all the latest advancements including medications. BUT we should listen carefully and work with our patients to understand what effect treatment is having on their creative drive. Perhaps some individuals need some degree of discontent to “kindle the creative fire,” and we should step up to the challenge of helping them achieve a tolerable and productive balance.

At the young age of 37, after a manic episode of creating many paintings, Vincent van Gogh walked into an empty field outside his home, aimed a loaded revolver into his chest, and pulled the trigger. His famous last words, as he lay dying in his brother Theo’s arms, were "La tristesse durera toujours" (the sadness will last forever).

Perhaps had he not suffered some degree of sadness, you and I would have never heard of van Gogh. Perhaps had he lived longer, his influence would have been even greater. Perhaps the next van Gogh or Poe or Winehouse will walk into a mental health clinic next week suffocated by their sadness, yet possessed by creative inspiration. The questions are complex scientifically, ethically, and philosophically. But I believe that a balance can and should be reached (or at least approached) and that tragic endings can be re-written. 

Dr. Mohammad Alsuwaidan is a psychiatrist with expertise in Mood Disorders at the University of Toronto and a Master of Public Health candidate at Johns Hopkins University. Learn more: http://www.mohammadalsuwaidan.com/


References:
KR Jamison, Touched with Fire: Manic Depressive Illness and the Artistic Temparment, Free Press Paperbacks (New York 1993). p.85
AW Flaherty, Frontotemporal and Dopaminergic Control of Idea Generation and Creative Drive. Journal of Comp. Neurology 493:147-153 (2005).
Santosa C.M. et al. Enhanced creativity in bipolar disorder patients: A controlled study. J. Affect. Disord. (2006), doi:10.1016/j.jad.2006.10.013
Flaherty, A. (2011). Brain illness and creativity: mechanisms and treatment risks. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 56(3), 132.


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Can My Child Have Bipolar Disorder? Pediatric Bipolar Disorder: Fact or Fiction

By Molly McVoy, M.D.   

Can children really have bipolar disorder?  Or, is it a parenting issue?  Is this mental illness overly-diagnosed?

Many of these questions have been raised in the media with increased frequency over the last several months.  What's most concerning is, that instead of focusing on diagnosis and treatment for children with serious mental illness, the debate has focused on who is to blame: is it parents, psychiatrists, drug companies, schools?  The bottom line is that children are suffering, and parents are struggling to keep their children safe, healthy, and happy.  More attention should be paid to actually helping these children, not to pointing fingers of blame.

Pediatric bipolar disorder is a rare but very real illness.  The most recent statistics indicate the mental illness affects approximately 1.5% of children.  Contrary to popular reports, the most recent studies also indicate the rates of pediatric bipolar disorder are not increasing over time, and the rates do not vary between US and non-US populations.¹

When pediatric bipolar disorder occurs, it can be very impairing.  Affected children have extreme mood swings – not for minutes at a time but for days.  Children can become suicidal, violent, and often feel quite out of control.  When properly diagnosed and treated, the lives of these children and their families can improve dramatically.  Treatment often involves a combination of mood stabilizing medication and intensive psychotherapy.  But when missed or misdiagnosed, these children may go on to suffer for a lifetime.

Stigma continues to be associated with a mental health diagnosis, and nowhere is that truer than in pediatric mental illness.  Perhaps, in the future, efforts will focus on how to help, not who to blame.

Links:

http://www.aacap.org/

http://www.bpkids.org/

References:

1. VanMeter, AR, Moreira, AL, Youngstrom, EA. Meta-analysis of epidemiologic studies of pediatric bipolar disorder. J Clin Psychiatry. 2011, May 31.

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Family Game Night Can Make You Smarter

By Scott Benson, M.D. 

My daughter brought two treats when she came home for college break.  A new game, Bananagrams, and a new book by Richard Restak, M.D. and puzzle master Scott Kim called The Playful Brain: the surprising science of how puzzles improve your mind. 

In this collaboration, Kim shares some of his favorite puzzle formats, and Dr. Restak explains the science behind the games.  Together they cover a wide variety of puzzles that have been shown to keep us alert, thinking, and youthful in mind and spirit.  fMRI data (which shows electrical activity in different parts of your brain) helps to tease out which areas of the brain are activated as people solve different types of puzzles.  

Scientists have not been able to prove a direct link between these forms of brain exercise and prevention of various forms of dementia.  But the puzzles, and games like Bananagrams, provide a focus for interpersonal interaction – playing with your family, talking with your neighbors – which does have a powerful effect on mood and our sense of well-being. 

Summer is the perfect time to bond with your kids in a board game challenge.  How do you get your family to put down their cell phones and turn off the TV to play a game?  Please share suggestions!

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Seeing Stars is a Serious Deal - Sports-Related Concussions

By Claudia L. Reardon, M.D.

Concussions in athletes have received increased media attention recently.  More and more evidence shows that there can be serious short- and long-term consequences of concussions if athletes return to physical activity too soon.  A concussion is a brain injury and must be treated very seriously. 

How do you know if someone has sustained a concussion?  Signs and symptoms of a concussion after an athlete hits his/her head include:

• Headache
• Nausea/vomiting
• Dizziness
• Vision changes
• Sensitivity to light and sound
• Feeling confused or groggy
• Concentration difficulties
• Inability to remember events before or after the hit
• Mood, behavior, or personality changes

Importantly, most athletes with concussions won’t experience all of these signs and symptoms.  Some of them might not appear for hours or even days.  If you, a coach, a game official, or medical provider suspect a concussion, take the following steps:

• Remove the athlete from the game/practice immediately.
• Seek medical attention.
• Do not return to physical activity until cleared by a physician.  Returning to activity too soon can cause long-term physical and psychiatric problems and even death.
• When returning to play, do so gradually, under the guidance of your health care provider.

Sports participation has many positive physical and mental health benefits for children and adults alike.  In the spirit of competition, athletes and coaches often want to do everything they can to win.  However, if a concussion is suspected, it is not worth it to risk long-term brain damage to stay in the game to help the team.   
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What does Archbishop Desmond Tutu say about Mental Illness Stigma?

Watch exclusive interviews with Archbishop Desmond Tutu and actress Lorraine Bracco who attended this year's APA Annual Meeting in May.  Also included, video posts from HealthyMinds.org bloggers Dr. Claudia Reardon, Dr. Gariane Gunter, and Dr. Molly McVoy.  Have a mental health issue on your mind? Our Healthy Minds bloggers will anwser right here! Let us know what you want to know
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Towards A Healthier View of Happiness: Human Fulfillment

By Roberto A. Blanco, M.D. 

I believe that mistaking what one would call pleasure or joy with happiness is causing people a lot of unnecessary pain.  In popular culture and the media, “happiness” is the feeling when you open a brand new bottle of soda, when you have a party with your friends, or when you get a new car.  Consumer culture has subtle but noticeable effects on people’s beliefs to the point where most people buy into these images or ideals consciously or unconsciously to some extent.  

But, this is not the meaning of happiness for which we should be striving.  This is because pleasure, while it may be fun, is superficial and impossible to sustain.  Even for people who live a “charmed life," it is impossible to find pleasure or joy in all events in life.  In fact, unless there is some larger or longer-lasting definition of happiness such as human satisfaction that fills our lives, it is likely that we won’t be able to find joy in anything.  Events that should provide joy will lose their effect eventually without some deeper meaning.

This may be why many people become depressed.  A lot of us put pressure on ourselves to be “happy” all of the time.  Because we confuse pleasure for happiness at times, the fact that we are not “happy” all of the time can lead to more dissatisfaction with life or lack of fulfillment.  If happiness equates with pleasure or joy, how can we be happy and happy with ourselves when we are going through difficult but worthwhile transitions?  What about during periods of grief? 

It is often very difficult to sustain superficial happiness especially when the inevitable thoughts of ‘why am I feeling bad?’ or ‘why am I not happy?’ creep into the mind.  These thoughts often cause people to feel guilt and then as if they are failures.  To be joyful and smiling all of the time is just an unrealistic goal and we should not feel bad about ourselves if we happen to be in a difficult stage of life.  We need to keep in mind that it is all part of a larger plan or goal of development, human fulfillment or self-actualization.

The search for a good definition of happiness is not a new idea and certainly not one that I thought of.  Over 300 years before Christ and in his book entitled NicomacheanEthics, Aristotle proposed his definition of happiness to the ancient Greek people and laid out his arguments for the meaning of happiness.  He argued that having true happiness is the best and final aim for human activity.  Aristotle called true happiness “eudaimonia” which was a type of long-lasting happiness more consistent with human fulfillment or satisfaction.  Aristotle also believed that happiness should be human fulfillment and not confused with joy or pleasure when he wrote:

For one swallow does not make a spring, nor does one sunny day;
similarly, one day or a short time does not make a man blessed and happy.

I agree that human fulfillment is a loftier goal than joy because when someone is having a difficult time or fallen on hard times, they can still be working towards human fulfillment. During these formative or growing experiences, we can still feel as we are fulfilled or fulfilling our own self-actualization even if we aren’t joyous.  When we take into consideration human fulfillment, we no longer need to feel guilty or as failures during difficult times, transitional periods, or episodes of grief.  We begin to see life from the wide angle of human fulfillment rather than from the small picture of pleasure.

Kahlil Gibran, the famous Christian mystic poet from the early 20th century, also believed in eudomainia.  When Almustafa, the all-knowing visitor in the poem The Prophet, answers a woman’s question on pain, he exemplifies this belief in the beauty of human fulfillment and long-lasting satisfaction despite these painful episodes:

And could you keep your heart in wonder at the daily miracles of your life, your pain would not seem less wondrous than your joy;
And you would accept the seasons of your heart, even as you have always accepted the seasons that pass over your fields.
And you would watch with serenity through the winters of your grief.

As people living in a society where mental illness is so common, we must seek to understand happiness and human fulfillment.  In the hopes of making happiness something more meaningful and sustainable, what we should be striving for is an eternal, longer-lasting form of happiness which is known as human fulfillment or as the Greeks called it eudaimonia.  This is because human fulfillment rather than joy or pleasure allows for the different stages of our lives and growth without having to feel guilt or as if something is wrong.  If we make human fulfillment the goal, we will live happier and more satisfying lives.  Now the obvious question becomes, how do we achieve it?

1.  Aristotle (1999).  Nicomachean Ethics. (Martin Ostwald Trans.)  Upper Saddle River, New Jersey: Prentice Hall, Inc.
2. Gibran, Kahlil (1964).  The Prophet .  New York: Alfred A. Knopf.
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Make Mental Health Your Priority Every Month

By Felicia Wong, M.D

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

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

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

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

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

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

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

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

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

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

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

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

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

So now you know the tools. . . Today is the perfect time to start incorporating this list into your day-to-day routine.  For more information, go to http://www.liveyourlifewell.org/ . 
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Yes, Food Addiction is Real. Do You Know Someone Suffering?

By Sarah Johnson, M.D.
The obesity epidemic is a huge problem (no pun intended) due to associated medical problems and their burden on the healthcare system. In 2009, an estimated 25% of Americans met criteria for obesity. This figure has steadily increased since the 1970’s.

Obesity leads to heart disease, strokes, high blood pressure, diabetes, and may be associated with increased risk for depression. It has been suggested that over-eating and other eating behaviors associated with obesity may share features with drug and alcohol addiction. This would certainly explain why this epidemic is so difficult to combat.  

The DSM IV-TR defines substance dependence as three or more of the following symptoms occurring within one year: tolerance, withdrawal symptoms, substance taken in larger amounts or for a longer duration than intended, attempts to cut back, excessive time spent pursuing, using, or recovering from use, reduction or discontinuation of important activities because of use, and continued use despite adverse consequences. 

Food cravings associated with binge eating can trigger the same area of the brain that is activated in drug craving. Although research is preliminary and limited at this time, specific foods such as carbohydrates may actually have a direct effect on mood in those who crave them.

Certain eating behaviors, such as restriction combined with overeating or binge-purge cycles may emulate addictive behaviors. Personality traits such as impulsivity have been found in samples of addicts and obese individuals. Children with behavior disorders such as ADHD and Conduct Disorder may be at increased risk for both addictions and obesity.  

Prevention is the best way to reduce the impact of behaviors associated with obesity. While eating may have similarities with addiction, we live in a toxic food environment, and awareness is key in prevention. Family members can seek help from medical professionals for loved ones who may be exhibiting pathological eating behaviors. 

For more information: Corsica JA, Pelchat ML. Food addiction: true or false? Curr Opin Gastroenterol. 2010 Mar;26(2):165-9.
Wilson GT. Eating disorders, obesity, and addiction. Eur Eat Disord Rev. 2010 Sep-Oct; 18(5):341-51.

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