Cooking Up a Cure

As you can imagine, the topic of food comes up a lot in client sessions. Over or under indulgence in food are extremes that many of us use to cope when we are stressed or unhappy. Unfortunately, over time this strategy results in health problems, sometimes life-threatening ones. Although challenging, especially in our “super-size-me culture”, it is important to find balance and peace of mind in our relationship with food.

If you were hoping to read about how to eat for optimal physical and mental health, you can check out my post The Power of the Gut-Brain Connection . There you will find plenty of ways to improve your physical and mental health through food.

Today, I want to share my thoughts about food and mood from a different perspective. It is a cold February Sunday in Connecticut, and I was inspired by the many references made to pork shoulder in an engaging and thought-provoking novel I finished recently, Kitchens of the Great Midwest  (J. Ryan Stradal). I wanted to try pork shoulder because it is especially suited to how I like to cook on Winter Sundays- I get a stew or soup going by mid-day and enjoy the smell and anticipation of the meal to come.

If you are familiar with pork shoulder you know it is NOT a low-fat meat and likely has never been used in the same sentence with the word “healthy”.  Cooking an indulgence like this is where “balance” comes in. Healthy eating most days and meals of the week leaves room for most us for an occasional treat.

This kind of pleasure is incredibly worthwhile on many levels. First, food fully engages our senses. Good smells, tastes, textures and new flavor combinations are fantastic for our mood and can even reduce anxiety. Food is often visually appealing, and taking in the color and shapes of a beautiful dish is wonderfully calming for our busy brains.

Cooking for ourselves and others is a healing act of self-care and love.

I can still remember the sweet smell of vanilla-laced sugar cookies baking as I worked side by side with my grandmother, who thrilled me as an eight-year-old when she gave me an apron “like hers”. I loved it even more when she had me roll out the dough or sprinkle colored sugar on the cookies. This nurturing childhood memory has become a lovely piece of my decades long narrative around family and food.

I try to continue the tradition of sharing love by enjoying conversation with family and friends by preparing and sharing a fragrant, tasty meal whenever possible. It’s a fantastic respite that slows the passage of time and restores me from the demands of busy work days.   

If you don’t have good memories connecting food and love, I enthusiastically encourage you to take some baby steps towards creating some. The abundance of online recipes, complete with video demonstrations, make it easy to learn how to cook or, for accomplished cooks, to learn new skills and recipes. If you live alone or your family migrates to their own corners to eat, or eats at different times, shake things up and invite someone to join you. Try meals from different cultures and you may discover a love of a spice or an herb that is new to you and a recipe to add to your regular rotation.  

Here’s to finding more satisfaction and connection through food. Now if you don’t mind, I am going to excuse myself to join my husband to break bread and try Peruvian Pork Stew with Chilies, Lime and Apples.

Be well,

Laura

photo by Joanie Simon, food blogger

Healing after Tragedy

The unspeakable horror experienced by Las Vegas concert goers on Sunday was more than unnerving, it was debilitating and gut-wrenching. The effects of this traumatic tragedy will be felt for a very long time. For me, it was the “last straw” in a string of horrific recent world events. I was and still am struggling to make sense of the suffering that is taking place in Puerto Rico and other Caribbean Islands, in Houston and in Florida post Hurricanes; and in Mexico post-Earthquakes. The political divisiveness and inefficiency in the US and its ripple effects throughout the world is certainly not helping matters and has felt life-altering since the election.

In session, many of my clients have been sharing the strong feelings these events bring up for them: fear, anger, outrage, fury, disbelief, helplessness, hopelessness, confusion, curiosity, empathy and compassion. My job as a trauma therapist is to help clients regain some sense of safety, experience their feelings in a safe, nonjudgmental space and heal from their personal and collective traumas.

Plenty of research shows that people can regain an improved sense of well-being by taking action to help others who are suffering, including survivors of mass disasters and traumas researchgate.net, psychologytoday.com. Although many of us feel that we have little to nothing to offer, this is never truly the case.

Although I have fantasies of making like Pitbull and flying my (imaginary) private plane to Puerto Rico cnn.com to help, for me that is not realistic. I can however, send a donation to relief organizations and offer a spot at no charge for a local individual in need of trauma therapy.

Consider making a donation, no matter how small, to a well-regarded relief or political organization whose mission you embrace. Check them out first: charitywatch or charitynavigator. Send thank you letters to first responders or call a Dunkin Donuts in Las Vegas and buy coffee and donuts to be delivered to the ER in one of the hospitals or first responder organizations. If a story you read about one of the victims and their families moves you, see if you can locate their address and send a condolence letter. Whether you are religious or not, prayer is very healing.  The benefits of prayers are magnified if done in a live, virtual or energetic community. 

Courtesy of Las Vegas Review Journal

Small, local acts of kindness are also healing. Check on a neighbor who lives alone, wave someone in to long line of traffic, thank a teacher or other “giver” who is in your life. Tell them how much they mean to you.

Make a call or send an email to your local legislators to voice your opinion about gun control, climate control, or insurance coverage. Consider joining a political organization that stands for the change you want to see in the world. Try hard to stay involved- change takes time and persistence. For more on how to heal through action, you may want to check out the post I wrote after the Sandy Hook tragedy: self-helpsage.blogspot.

In addition to taking action and helping others, it’s incredibly important to take extra good care of yourself in challenging times. Don’t forget to be extra kind to yourself and your family and get adequate sleep; and regular, healthy meals and exercise. If outdoor exercise is possible for you, do it! It is even better for mood than an indoor workout.

Check out Sunnyskyz, a "good news" website. Be wary of reading or watching extensive news coverage.  This makes most of us feel worse, not better. Think about watching a favorite movie or show, reading an uplifting book, listening to music, or reaching out by phone to a beloved friend or relative. If overwhelming feelings persist, try meditating, journaling or writing a list of people or things you are grateful for. If you start to worry that you are a loved one are really struggling with mood or behavior, don’t hesitate to reach out for professional help. We are living in challenging times and positive, human connection is powerful.  

Sending peace and healing,

Laura

Not Feeling Festive? Get Your Zzzzzzzzzzzs

I am re-posting a timely blog in hopes it may help you if you missed it 5 years ago...

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

UNDERSTANDING THE REAL COSTS OF DELAYING MENTAL HEALTH TREATMENT

One of the many reasons I love my work is that I have the honor and pleasure of seeing most of my clients get better. Do I have special skills that other mental health clinicians do not? No, my work simply mirrors the statistics on the efficacy of mental health treatment. Research shows that therapy is effective at least 80 percent of the time.

Since therapy usually helps, and no one wants to suffer, why are we our own worst enemies when it comes to getting help? Our tough inner critic tells us "you should be able to snap yourself out of this", or "you don't have it so bad, think about what Mary next door has been through", or "you need to help the kids, you're not as important." My wish for folks suffering from mental health challenges or family struggles is that they view mental health treatment as a tool that can help them move towards their future, not as a failure and a last resort.

Recently I have noticed an increase in the length of time clients are waiting to get themselves or their kids to treatment. My colleagues have shared the same observation with me. There are good reasons: financial challenges, increasingly spartan or absent insurance coverage, busy family schedules, and the still present stigma in our culture towards mental health treatment. The problem with delayed treatment is that it increases the likelihood of the development of a second mental health challenge, a substance abuse problem, and physical illness.

Not only does the client get worse if not getting help, but family members and co-workers are also sorely tested by caring for or working with a depressed, highly anxious, bi-polar or substance-involved individual. Many times the people that end up in my office have anxiety or depression that has been triggered by living or working with someone who has not sought help for their own challenges. Delays in getting help often leads to multiple family members in crisis. Jobs are lost, marriages fail, and academic careers stall.

The decision to see a therapist does not bind you to a never-ending series of weekly appointments. One of the important roles a trained therapist plays for you or your child is "assessment".  We evaluate a client's functioning in their environment: home, school, work, relationships, and community. We work with clients to collect data by interview, observation, surveys and test (psychologists) instruments. Thanks to the assessment process, clients can decide whether to enter the "therapy or treatment" phase of mental health treatment after gaining an understanding of their diagnosis and treatment options. After the assessment, I may recommend that a client meet with a psychiatrist, nutritionist, career counselor or life coach. Sometimes I work with parents to help them sort through parenting challenges without ever seeing the child.

The bottom line is that there may be much to gain by investing in a few visits. Unfortunately, waiting until you or your child are too sad to get out of bed in the morning, or your daily glass of wine has turned into a daily bottle, will likely cost more time and more money, and more importantly, needless suffering.

THE POWER of the GUT-BRAIN CONNECTION, by Laura van Riper, LCSW

In recent decades health care providers in the U.S. have embraced the Mind-Body connection with varying degrees of enthusiasm. Although a long-term believer in the power of the Mind-Body connection, I have been cautious about delving too much into physical health with my psychotherapy clients. However, the more I learn about the molecular similarities and relationship between our digestive tracts and our brains, the more strongly I feel that it would be remiss of me to fail to ask clients about their eating habits and their digestive health:  research increasingly shows that they have a very strong impact on mood and mental health.

We have known for decades that an upset brain sends messages to our "guts",  but now we know that our guts send messages to our brain. We have a complete, separate (enteric) nervous system in our digestive tracts that can communicate and remember independently from, and can influence, the brain. Some scientist are starting to advocate for the view that the gut and the brain are one system, not two.


French Drs. Fetissov and Dechelotte suggest that eating disorders, major depression, and even narcolepsy might not originate in the brain but from a dysfunction of the gut, specifically the immune system.                                                              
Research has shown that 95 percent of serotonin, a key "feel good" chemical, is made and/or found in the gut, as are a large percentage of dopamine and GABA, two other important chemicals involved in mood and sleep regulation. In fact, docs are improving treatment of chronic and often debilitating gastrointestinal (GI) problems such as constipation, diarrhea and irritable bowel syndrome with medications that allow more serotonin to circulate in the body- the exact same medications that psychiatrists prescribe for depression and anxiety.

So what goes wrong for the many Americans who suffer from depression, anxiety, insomnia,  eating disorders, GI problems, or both? Their immune systems- about 80 percent of which are found in the GI tracts-  are compromised by bad bacteria due to some combination of low-fiber, highly processed, chemically-spiked food;  stress;  sleep deprivation;  and over use of antibiotics.  These factors lower the amount of good bacteria in the gut and reduce levels of serotonin, dopamine or GABA.  A lack of good bacteria in the gut also adversely affects nutritional health, making it more difficult for our bodies to synthesize B vitamins, vitamin K and to absorb calcium, magnesium and iron. The resulting deficiencies of vitamins, minerals and neurotransmitters create susceptibility to many diseases, including depression and anxiety, eating disorders, and a plethora of GI tract problems and autoimmune diseases.

Here's the take-away: Supporting the health of the digestive tract can reap great emotional, cognitive and physical rewards.

Supporting the health of  body and brain
  1.  Make simple, inexpensive dietary changes

• Reduce consumption of processed, chemically preserved or colored foods, and genetically modified foods
• Increase consumption of Prebiotic Foods: artichokes, bananas, barley, beets, chicory, flax, garlic, leeks, oats, onions, soybeans, wheat
• Increase natural sources of Omega-3 fatty acids: wild caught salmon, halibut, scallops, tuna, flax seed* (ground 20 minutes or less before you consume it), walnuts, pasture raised meats and dairy products, black beans, kidney beans, winter squashes, olive oil
• Increase sources of soluble and insoluble fiber: dried figs, garbanzo beans, large Lima beans, red kidney beans, corn grits
• Increase foods high in insoluble fiber: wheat bran, dried coconut, pistachios, almonds, lentils
• Add fermented foods: add small amounts of plain yogurt, pickles, sauerkraut, miso soup, kimchi, kefir, buttermilk, creme fraiche to several meals a day. These foods are natural probiotics that help maintain a healthy bacterial balance in the GI tract/immune system
• Get adequate vitamin D, especially in Winter. Most Americans in the northern U.S. require supplementation if not outside for at least 15 minutes a day in Winter.     

 2.  Increase exercise: Aim for 3 or more days a week, 20 minutes or more, but most important, choose exercise you enjoy.

 3.  Develop good sleep habits. Turn off screens 30-60 minutes before lights out, and aim for a minimum of 7 hours, preferably 8 or more.

 4.  Decrease stress: Find five minutes a day to deep breathe, stretch, journal, use aromatherapy, or try guided meditation; and just say "no" to optional commitments that don't excite you.

The science of the gut-brain connection may intrigue or bore you, yet there is no denying that it warrants attention.  A healthy digestive tract lays a strong foundation for physical and emotional vitality. With a few simple tweaks, you can improve yours.

Be well,
Laura

*Although freshly ground flax seed it a nutritional powerhouse, it can interfere with the absorption of medication. Ideally, leave a 3-4 hour window before or after taking medication before consuming. 

For more information on strengthening your brain and body through food, check out http://www.whfoods.com/ , a non-profit foundation with no commercial interests.

For more information on reducing stress, check some of my other blog posts.

Let the Sunshine In

As a clinical social worker, I have observed firsthand the effects that vitamin D levels can have on mood.  The shorter days of Winter are tough on many people. Vitamin D- which our bodies make when exposed to the sun, is crucial for making hundreds of enzymes and protein and interacting with more than 2,000 genes vital for health and fighting disease- is in limited supply.  Vitamin D deficiency has been linked to chronic modern diseases such as heart disease, diabetes, cancer, osteoporosis, and depression. 

Several studies suggests that Vitamin D deficiency and depression are linked, and that increasing Vitamin D levels can help. We do not know whether low levels of vitamin D cause depression, worsen it, or are a symptom of the underlying depression. One study included  adult women with depression, all of whom were taking antidepressants. The women were also being treated for Type 2 Diabetes or an underactive thyroid gland. All were deficient in vitamin D, with levels under 21 ng/mL. Levels below 21 ng/mL are considered vitamin D deficient.  The women received vitamin D therapy for eight to 12 weeks. After treatment, their levels increased to 32 to 38 ng/mL. The women also reported improvements in symptoms of depression following vitamin D therapy. One woman's depression score changed from indicating a major depression to mild depression.  

I believe that many doctors and mental health professionals have had similar experiences with patients. I have had three clients who presented with major depression, tested below 10ng/ml in vitamin D, and after 10 weeks of receiving vitamin D supplements and weekly therapy, experienced a remission in their depression. Of course we can't measure how much improvement was caused by the increase in Vitamin D, and how much was caused by therapy.  My stance regarding treatment is to  use every helpful, healthy tool available to combat depression.

In addition to the clients who have suffered from major depression and had their Vitamin D levels tested, I have had many clients who have described and exhibited increased symptoms of depression in the late Fall and Winter. Seasonal Affective Disorder (SAD) is real, can be debilitating, and is prevalent when vitamin D stores are low.  In one study, eight subjects with SAD received 100,000 I.U. of vitamin D daily and all experienced a significant lessening of their depression as measured by the Hamilton Depression Inventory. Vitamin D blood levels improved by 74% in all eight subjects.  Vitamin D may be an important treatment for SAD. More, larger studies will be necessary to confirm these findings.

Vitamin D is called the sunshine vitamin because our bodies produce it when exposed to sunlight. Sunlight is an excellent source of vitamin D.  A person sitting outside in a bathing suit in New York City gets more vitamin D in 20 minutes than from drinking 200 glasses of milk.  Many experts suggest getting 10 to 15 minutes of sunshine sans sunscreen three times weekly.  Talk to your doctor about the pros and cons of sun exposure for you. 

Vitamin D is also added to milk and other foods, and is available in small amounts in fatty fish like tuna, salmon, and mackerel; beef liver, cheese, and egg yolks. It can be hard to get as much as we need from our diets, which is why supplements are often needed. Many, but not all, doctors include Vitamin D levels in their standard battery of blood tests when patients come in for a physical. Make sure you check with your doc if you are depressed, and request a blood test for Vitamin D levels. Your health depends on it.

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