Medicine, Therapy, or Both?

Twice yesterday clients asked good questions about medication, therapy, and how they relate to each other.

A new client, "Mr. X"*,  was prescribed an anti-depressant by his doctor for ongoing depression due to his wife's death several years ago.  He asked my opinion about anti-depressants. He was reluctant to take an anti-depressant, feeling that he should be able to "get over it" on his own.  Like many wise individuals, my client is concerned about his health, and does not want to ingest anything that could harm him. Although like all medications, anti-depressants can cause side-effects, for most people the benefits far outweigh the side effects. Furthermore, we live in an era when there are a number of effective medications for depression, and if the first medication you try leaves you with undesirable side effects, there is a good chance that the next one your doctor prescribes will not.

What I have observed is that for some clients, anti-depressants are a temporary bridge between depression and a return to being "yourself".  Many people who are depressed are bothered by cloudy thinking and/or circular, repetitive thoughts. In such a state, clients are not always able to use therapy to it's full potential. However, anti-depressants help many people return to their normal, logical thought process. When clients can think clearly, they are able to use techniques that they learn in therapy and apply them to their outside life. Once a client feels that they are functioning and feeling better, it is often possible to gradually discontinue anti-depressants. Contrary to what some believe, anti-depressants are not addictive, but discontinuation absolutely needs to be monitored by a qualified physician.

"Bridge the Gap" between medicine and therapy

At this point you may be wondering if I am in the back pocket of a pharmaceutical firm. Absolutely not. I cannot prescribe medication. In fact, I always work with a client on natural stress reducing and mood boosting techniques before making a referral for a medication evaluation.  However, in some situations, the ongoing stress of a death, job loss, or family problems can wear people down to the point where their brain chemistry needs stronger support- ie-medication.

Many well-done independent studies have been done to research what the best treatment is for depression. The results are consistent: many people get better from therapy, many people get better from anti-depressants, but the most effective, quickest way to feel better is through a COMBINATION of medication and therapy. 

Regardless of what "Mr. X" decides regarding medication, I look forward to working with him to help him find his unique path to healing.

Be well,

Laura

 *Details changed to protect client's anonymity.

Not Feeling Festive? Get Your Zzzzzzzzzzzs

You have probably read many articles about the importance of a good night sleep. Good sleep is not only important to your physical health, it is also key to a good mood. Getting plenty of sleep during this busy season is difficult, for sure.  However, it is essential. The holidays put extra emotional and physical demands on us, and sleep helps us bounce back, maintain perspective, and stay healthy.

Not only is the quantity of your sleep important, the quality of your sleep is, too. Sleep quality can be enhanced in many ways: a cool but not cold room temperature, a very dark bedroom, a comfortable bed without pets or children hogging the bed. Those of us who have reached - ahem - "middle age" have biological factors that make our sleep less sound than it used to be, and may need to take extra steps to insure a good night's sleep.

The first suggestions I make to clients who are frustrated by poor sleep are:

• eliminate afternoon caffeine
• limit alcohol to one (women) or two  (men) drinks
• try deep breathing or alternate nostril breathing* when you can't sleep
• turn off all electronics, including the TV, an hour before bed
• keep a small journal or pad near your bed, and write down any thoughts or chores that are nagging at you
• no vigorous exercise closer than three hours to bed time

If you have made these changes and are still having problems falling asleep or staying asleep, or usually feel grouchy or tired in the morning, it is probably time to get some help. I find clients often hesitate to see an internist or psychiatrist to discuss medical interventions for insomnia. However, I urge them to do so, as I have witnessed tremendous improvement in mood and stamina in those who have sought treatment.

Sleep can make the difference between a good day and a bad one

There are natural sleep remedies that are effective for many people. There are also several sleep medications that have been developed in the last decade that at the right dose do not leave people feeling groggy or "hungover".  I  prefer environmental and natural sleep interventions. However, the effect of sleep on quality of life is so profound that medication should be considered if other interventions fail to help.

If the shopping and wrapping are feeling more like torture than fun, crawl into bed early tonight and take a long winter's nap.

Wishing you more "ho ho ho's" and less stress;  good health, and peace this holiday season.

Be well,

Laura

For more information on alternate nostril breathing, go to: http://www.holisticonline.com/yoga/hol_yoga_breathing-ex-nadisodh.htm

Beating the Winter Blues

With three times the normal amount of snowfall already recorded for January, many of us are feeling desperate for warmth and sunshine. Unless you have the good fortune to be able to flee to a tropical hideaway, it's a good idea to shake up your routine. 

• Humor is healing. Seek out a funny friend or a favorite comedy.
• If you have children, remember that you are not responsible for entertaining them. Challenge them to come up with new games and to entertain themselves. A great book full of old school, inexpensive activities is "The Orange Mama Laid", by Kirsten Denny. (Available on Amazon)
• Get outside on sunny days. Even better, leave your sunscreen off for 15 minutes to maximize absorption of Vitamin D.
• If you exercise, try a new sport or class to create some novelty for your body and brain.
• Plan your real or imagined spring garden. Consider starting seedlings indoors in March. Visualizing a bountiful garden and planning for fresh food will lift your spirits.
• Do a good deed. Even small acts like offering a smile to a cranky neighbor or letting someone into traffic have been scientifically proven to reduce stress and create a feeling of well-being.
• Check your caffeine intake. We often unconsciously increase our caffeine consumption during the Winter to keep the cold at bay. If this is the case for you, gradually bring it back down to no more than two to three cups a day. More than that can cause irritability and interfere with sleep.
• More hours indoors can lead to more hot Toddys and wine by the fire. If you are prone to the blues, limit your alcohol intake as much as possible- it's a depressant, and it interferes with sleep. 
• Low folic acid levels are associated with depression. A good source of folic acid is found in leafy green veggies. If they aren't your top food choice, chop them and add them to soups and stews for the last five to ten minutes of cooking. This works well with swiss chard and spinach.
• You've heard it before, but I would be remiss if I did not mention Omega 3 fatty acids, which play a crucial role in overall health. However, Omega 3's are found in greater concentrations in the brain than in other parts of the body, and have been shown to alleviate depression. Omega-3s can be found in fatty fish like wild salmon, sardines, Atlantic mackerel, and in lower quantities in ground flaxseeds, walnuts and omega-3 fortified eggs. Ground flaxseeds can be substituted for small portions of flour or pancake mix without sacrificing taste.

Making all these changes would be daunting. Try choosing a few that appeal to you, and monitor your mood, health and overall level of functioning for the next four to six weeks. Hopefully you will see some positive results. And if you happen to have that tropical hideaway, count me in.