Exercise - An effective treatment for mild to moderate depression

By Felicia K. Wong

We’ve all heard it before - “Exercise is good for you”. As holiday eating can lead to unwanted pounds, “Getting more exercise” will be a common New Year’s resolution. However, did you know that exercise has the potential to do wonders for your mental health?

Studies have found that regular exercise can be just as important as medication and therapy for the treatment of mild to moderate depression.

Exercise causes the body to release endorphins, natural chemicals that can reduce your perception of pain. Endorphins can trigger positive feelings and improve your mood quickly.

Regular exercise has been shown to relieve the symptoms of depression by:

- reducing stress

- increasing your energy level

- improving your sleep

- improving your physical fitness, which can improve your self esteem

- providing a distraction from anxiety and feelings of depression

- increasing your sense of mastery and control over your life

It can be difficult to motivate yourself to start moving when you’re feeling down. The goal is to exercise at least 20-30 minutes, three times a week to reap the maximum benefits of exercise for depression. But even a few minutes a day can help boost your mood! Here are some tips to help you get started:

Keep it simple! Set simple and realistic goals. You can start by getting outside and walking around the block. Increase the duration of exercise a little bit each day.

Choose an activity that you enjoy. Walking, biking, yoga – find something that appeals to you.

Keep it interesting. Vary the exercise so you don’t get bored.

Keep it cheap. Unless you plan to use them regularly, avoid buying a health club memberships or expensive equipment. Go outside, get active and enjoy the fresh air!

Make it social. Find friends to exercise with - talking to people will keep it fun and help you stay motivated.

Stick with it! If you exercise regularly, it will become part of your lifestyle and help reduce your depression.

Seeing your doctor is an important step in dealing with depression, and you should discuss treatment options including medication and therapy. However, exercise can be an important additional tool that can provide you with immediate and long-term relief from depression.

This one is for my mother

By Gariane Phillips Gunter, M.D.

During my year as Mrs. United States and daily as a psychiatrist I am fighting to eliminate the negative stigma of mental illness. The presence of mental illness has been very real to me since I was a child. After many years or suffering without a clear cause, my mother was diagnosed with Bipolar disorder when I was in elementary school. Frequent hospitalizations, medication adjustments, ECT were part of a typical day in our household. Nevertheless, my mom is my mom, not “crazy”, “psycho” or a “freak”.

As an adult and now as a psychiatrist, the presence of stigma toward those suffering from a mental illness has become very evident to me. I believe that the source of much of this misperception is from a lack of understanding not a lack of compassion. Many people still do not know that mental illnesses are true biological illness similar to diabetes or hypertension.

They don’t understand that they are brain diseases, not character flaws. Having a mental illness does not mean that you are stupid, lazy, worthless or incompetent. You don’t develop a mental illness because you did something wrong or because you are a “bad” person. It is not your fault.

For you that are struggling with a mental illness, or have a family member who is, you are likely all too familiar with the devastating effects of stigma in your own life. Let us all work together to teach the truth about mental illnesses, as education is our most powerful weapon in the fight against stigma.

……………Be The Change You Hope To See In This World







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Might limiting our exposure to TV make us happier?

By Roberto Blanco, M.D.

Do you ever find yourself feeling hopeless during the evening news? According to a recently published study by University of Maryland Sociologists Robinson and Martin, it appears that it is not just the evening news that is contributing to our unhappiness.

The study, conducted over the last 30 years, showed that self-reported unhappiness was closely linked to the amount of time spent watching TV. The people who reported to be the happiest spent more time reading and socializing instead of sitting in front of the TV.

These results suggest that even when we can “escape” the news to lighter programming, we are still receiving negative messages: that we are not attractive enough, that we should own more things, or that we should have the unattainable lives that are being portrayed. The programs are often entertaining, but the benefits are short-lived. And in the long run, they may be doing more harm than good. The results of the University of Maryland study indicate that limiting our exposure to TV may help us live happier lives.

In the hopes of making you and your family happier, here are a few things you can do to limit TV watching:

Limit the number of hours per night that you spend in front of the television. Pick alternative activities such as reading or exercising to do after work.

Limit the number of hours that your children can spend in front of the television. Set a timer and be consistent. Encourage exercise and outdoor play as much as completing homework , chores and other responsibilities.

Plan family time or an outing for your family that does not involve the TV. Go for a walk, to a park, or to the local public library.

Be an active TV watcher. Pick out the programs you want to watch during the week in advance and stick to your choices. Pick TV programs that are educational, positive, or contribute in some way to your experience of the world. Purchase a recorder for TV programs that you would like to watch and make TV fit your schedule and not the other way around.

Carefully monitor the shows your young children are watching. Studies show that the younger children are, the more they will be affected by scary or violent programming.

If all else fails, get rid of the cable box or Satellite dish. At a cost of $60 per month, getting rid of cable or the dish can save us over $700 per year. This will not only improve your mental health, but your financial health as well.





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

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

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

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

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

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

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

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

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

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

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

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

Shop online if the mall is too stressful.

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

Knowledge is Power

By Jeffrey Borenstein, M.D.

When it comes to mental health, knowledge is power. As host of the Healthy Minds public television series, my goal is to provide people with information about psychiatric conditions and treatment. I interview experts who provide cutting edge information and more importantly, I speak with people who have sought treatment for a mental health issue.

One of the most moving interviews was with Jennifer Crane, a veteran who served in Afghanistan. She spoke about her experiences with post-traumatic stress disorder (PTSD) and how treatment is helping her recover. She has received treatment through the Give an Hour program, which is sponsored by the American Psychiatric Foundation.

The combination of medical and scientific information with the real life experiences of individuals and their families provides our audience with new knowledge and insights about mental health. I hope the show will open up conversations in families and inspire people to seek help. In addition to PTSD, topics include autism, chemical dependency, depression, bipolar disorder, eating disorders and suicide prevention.

As we plan for future episodes of Healthy Minds, I would very much appreciate your comments, ideas and questions. And, remember, when it comes to mental health, knowledge is power.

Maintaining Health in Stressful Jobs

By Bill Callahan, M.D.

I have been asked frequently in the past 10 days how psychiatrists deal with their own reactions to what they hear every day and what its impact is on them.



When I became a psychiatrist after five years as a flight surgeon in the military, I was struck by how much of the four years it takes after medical school to become a psychiatrist was spent on making sure that we dealt with our emotions, knew our own warning signs for stress, and would set limits on a reasonable work load. We are also trained to know when to ask for a consultation with a colleague, or to get additional training for ourselves. Our educational requirements are life-long and part of our commitment to do our best for you.

A big part of my role is to be the “personal trainer for emotions.” At the end of each day, after spending eight hours immersed in the emotions and struggles of other people, I spend some time experiencing the different emotions that work caused in me. That will mean being able to cry to relieve sadness that is created, feeling the full impact of anger, as well as the affection I feel for the people I work with. This process lowers anxiety and stress and prevents a toxic buildup of emotion every day.

In future posts I will talk about how to feel healthy anger, since I find this is the most misunderstood emotion, and the fear of feeling it is a major source of stress for many.

I already had the fundamentals of a healthy life from my military flight surgeon experiences. Daily exercise for at least 45 minutes, combining aerobic and weight training, sleeping from 7 to 9 hours a day, moderate alcohol use and avoiding it all together when under increased stress or emotional strain, and making sure I took time to have fun with family and friends are things we can all do as well.

Please leave your own tips for what you do to relieve stress in the comment section.

Eight Questions Parents Should Ask About Psychiatric Medications

By R. Scott Benson, M.D.

As a child and adolescent psychiatrist I talk to many parents about treatment options for their children. Whether it be talk therapy or medication, any recommendation for treatment should be based on a thoughtful evaluation.

If medication is recommended, parents find the following questions help in navigating this process. This dialogue with your child's doctor is a first step in forming a team effort for your child's treatment.

1. How will the medication help my child? How long before I see improvement?
2. What are the side effects which commonly occur with this medication?
3. Is this medication addictive? Can it be abused?
4. Are there any tests which need to be done before my child begins taking the medication? Will any tests need to be done while my child is taking the medication?
5. How will my child's response to medication be monitored? How often?
6. Are there any other medications or foods to avoid?
7. How long will my child need to take this medication?
8. What do I do if a problem develops (e.g. if my child becomes ill, doses are missed, or side effects develop)?

Are Gray Skies and Short Days Making You S.A.D.? 10 ways to help you manage your symptoms of Seasonal Affective Disorder

By Dr. Felicia K. Wong

Autumn in the North is a magical time of year. The colorful leaves fall with the mercury. The air is cool, crisp, and clean. But for many people, there is a certain reluctance that comes with packing away the summer whites and taking out the winter woolens. Summer has come and gone. Winter is on its way.

Seasonal Affective Disorder (SAD) is a common affliction for those who live in northern climates. SAD symptoms mirror those of clinical depression. However, SAD follows a seasonal pattern, whereas general depression is not affected by the calendar. SAD sufferers may feel depressed, irritable, and tired. They may find it more difficult to concentrate or pay attention. They may want to stay in bed longer and eat more. In severe cases, SAD can lead to problems including suicidal thoughts or behavior, social withdrawal, relationship difficulties, school or work problems, and substance abuse.

Seasonal mood variations are related mostly to daylight, not temperature. For this reason, SAD is common even in places with mild winters such as the Pacific Northwest. Long periods of overcast weather can also exacerbate SAD. Warning signs of SAD usually appear in late fall and end in the spring.

One way to prevent Seasonal Affective Disorder is to live in a warm, southern, climate. But what about those of us who live in the north? Following these suggestions can help alleviate some of the symptoms of SAD:

1. Go outside and walk briskly for thirty minutes during your lunch break, when sunlight is at its peak.

2. If you can’t exercise outdoors, try exercising next to a window.

3. Get more natural sunlight by doing outdoor chores (raking the leaves, shoveling the snow).

4. Keep your windows and blinds open in the home and office.

5. Sit near a window, preferably in sunlight, whenever possible.

6. Join a support group with other SAD sufferers. Join a walking or activity group!

7. Try phototherapy. You can replace the light bulbs in your home with brighter full (broad) spectrum light bulbs. While more expensive then regular light bulbs, these provide light more similar to natural sunlight.

8. Maintain your schedule. Try to keep a regular pattern of sleep. It may be helpful to have a bedside light on timer to turn on half an hour before you wake to help you wake at a regular time even when it is dark outside.

9. Keep things in perspective. Remember that spring is only about 6 months away and that these sad feelings are only temporary and will go away.

10. If you can, go south for vacation!

If none of these strategies improve your depressive symptoms, consider consulting your primary care physician or mental health professional. SAD is a form of depression and can be readily treated with medications or psychotherapy when other self-help methods aren't effective.






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Are Depression Symptoms the Same Across Cultures?

By Gabriella Corá , M.D., MBA

Although, as psychiatrists, we make a diagnosis of depression given a specific set of signs and symptoms, the way in which depression manifests may be different across cultures.

In addition to stigma, many Latinos struggle with acculturation issues, lack of insurance coverage and difficulty communicating with healthcare professionals who are not culturally proficient.

Barriers to care also affect African American communities. The diversity of the Latino, African American as well as the Asian communities is often minimized. Many believe that because someone has the same skin color or speaks the same language they have a similar set of needs. In fact, Spanish-speaking African Americans need tailored interventions to address Latino as well as African American cultural needs in order to effectively treat depression or other mental health disorders.

What to do?

1. Learn about depression: look for good sources of information.

2. Seek for help: Tell your doctor you or your loved one may be experiencing depression. If you don’t have a doctor, go to a community mental health clinic and let staff know you need help.

3. Become familiar with cultural differences in the diagnosis and treatment of depression: ask your doctor if his/her office has culturally-competent or culturally-proficient staff to help you. Cultural proficiency goes beyond speaking the language.

4. Be open to staff: Although the doctor’s office may not have culturally-competent staff, healthcare professionals may be very familiar with working across cultures. The “I can only be treated by someone who looks or talks like me” is a myth. Although this may help in the beginning, we know caring and empathic staff will be able to help you beyond gender, color, ethnicity or language.