Natural Treatment For Depression – It Is Possible!

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by: Dr. Isaac Schumann

Depression is one of the most common psychological and emotional problems American adults encounter. A study reports that about 13 to 20 percent of American adults have some form of depressive symptoms. Unfortunately, many severe cases of depression can ultimately lead to suicide.

Are there any solutions and treatments available to stem this unfortunate tide? Fortunately, the answer to this is yes. Unfortunately again, many of these treatments involves a soup of medicines that may have some form or side effect. As we discussed previously psychotherapy is another solution that is gaining popularity due to the favorable results they have exhibited.

For some people, the question that remains is if there are any “natural” depression treatments available that do not involve some cocktail of hard-to-spell medications that can be taken as a preventive and beneficial alternative to mainstream treatments. The answer is yes. Although it is recommended that any form of depression should be consulted with a doctor let’s take a look at a list of natural supplements that may help alleviate symptoms of depression.

It Starts with the Diet

Depression can be treated with better nutrition. Studies have shown that such treatment not only has a beneficial effect on the person’s physical health, but also a favorable effect on the person’s mental and emotional health. This nutritional treatment includes modification of diet, vitamins and minerals, and the addition of some amino acid supplements.

The amino acid supplements are essential elements that are precursors to neurotransmitters. The amino acids D, L-pheylalanine and L-tyrosine are a viable alternative to antidepressant drugs.

A deficiency in vitamins and minerals in the body can also cause depression. If this condition is corrected, depression owing to this cause can be alleviated. Even if you are not sure if you lack vitamins and minerals, supplementing your diet with them will often improve symptoms related to depression and will contribute to better overall health.

Some Very Useful Herbs

The herb St. John’s Wort (Hypericum perforatum) in an extracted standardized form is being used in Germany and other European countries to treat depression in its mild and moderate forms. It is also known to alleviate anxiety and sleep disorders.

This herb claims many benefits – among them are its anti-depressive and antiviral properties.

The Ginkgo (Ginkgo Biloba) extract, while not a primary treatment for major cases of depression, is an excellent supplement to any depression-related syndrome. Studies are beginning to show that Ginkgo can be used to treat some forms of depression that are not responsive to antidepressant agents. In cases of resistant depression, Ginkgo Biloba is beginning to appear attractive to the medical world.

Cut Back on Those Soft Drinks

Many practitioners advocate a nutrition oriented approach to treating depression. They believe that the answer to the depression question can be found in the diet of a person. Studies show that a decrease in the intake of sugars and refined carbohydrates can produce relief from symptoms of depression.

This diet will entail cutting out sugary drinks, pasta, white bread, and other processed foods. For your carbohydrate needs, it would be better to stick to grains, whole wheat, and other natural plant based carbohydrates. Also, cutting down on these kinds of food can do wonders for one’s overall health.

This treatment is recommended for those who feel depressed and languid during the late hours of the morning and the afternoon. For these people, eating sugary foods will induce a temporary feeling of alleviation from depression. However, this is only for a few minutes, and the body automatically reverts to languid depression.

Depression is one serious disorder that should not be taken for granted. Some people will equate depression with other natural feelings such as anger, happiness, and sadness. However, depression is much more complicated than that. It is a disorder and an ailment that can be treated by natural or medical means. It would do well to consult your doctor for more information on dealing with depression.

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Wonderful Herbs For Depression

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“A Powerful Depression Diet to Get Your Mood On The Road to Joy”

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Food and Depression – Tips to Change Your Mood

J Am Diet Assoc 1999 Oct;99(10):1249-56. 5. Benton D, Donohoe RT. The effects of nutrients on mood. Is There a Depression Diet I Can Use?
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A Depression Treatment Plan That Worked!

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Light SAD Therapy for depression?

Thanks to Light SAD Therapy research, we know of one more safe, inexpensive, rapid and effective treatment for depression – perhaps even your depression!
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“What’s the secret on depression and exercise?”

Exercise treatment for major depression: Maintenance of therapeutic benefit at 10 months. Psychosomatic Medicine, Vol. 62. pp. 633-638.
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About The Guest Author

Dr. Isaac Schumann brings to you a life time of experience in the mental health field.

http://www.depressionhelpguides.com

Parenting Teenagers – Teens And Depression

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by: Christina Botto

One minute your teenager will be laughing and joking along with you and the next he is in a fit of rage, yelling or crying with no warning or apparent cause. Mood swings are normal with all teenagers, but how do you know when mood swings turn into depression?

Teenagers have so much to deal with in today’s society that depression can come easily. If left untreated, it can become a much more serious issue. With pressure at school, family situations, and the necessity of making serious life choices at a young age, depression may make such a sudden impact even the teenager may not know that he or she is suffering with this disorder.

Depression in teenagers is often overlooked, and is rarely treated or even diagnosed. Many parents tend to view their teenager’s bad mood as just another teenage trait.

Teenage Mood Swings vs. Depression

Most teenagers suffering with depression will almost constantly be upset, not just with their parents, but also with siblings and even friends. Their grades may drop and their social life may cease suddenly and unexpectedly. Your teenager may make excuses to stay in his room and not participate in social activities, and even when forced to participate, may do so with little or no enthusiasm.

Sometimes, this disorder may actually be a chemical imbalance and uncontrollable with just words and care from the parent. Medications and therapy may be required for your teenager to regain their mental health back. Depression is such a serious disorder that can lead up to even more serious situations like school or home violence, self injury, even suicide.

What parents can do

If your teenager seems unhappy or upset for a long period of time, try to have a talk with him. Begin the conversation casually by mentioning that you can see that something is troubling him. Don’t be discouraged by your teen’s likely response that you cannot help or there’s noting you can do. Point out that sometimes just talking about a situation will help to find a solution or to see it from a different perspective.

If your teenager will not talk to you about her problems speak with her school guidance counselor. He or she might be able to give you helpful information about what is troubling your teen. The guidance counselor might also be able to help you assess if it would be beneficial to your teenager to see a professional therapist or to attend a group counseling session.

Should you decide that therapy is necessary, do not force your teen to attend any of these sessions. Instead, ask him to attend if only to see that his particular problem might not be as unique as he thinks. Your teenager might experience great relief in realizing that he is simply going through natural developmental stages and that it is normal to feel overwhelmed by the pressures of school, family and peers.

Instead of breaking under the stress and thinking he is not capable of handling his daily life, your teenager will approach obstacles more open minded and ready to discuss with you or his therapist.

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My Teenage Depression Story

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Causes of Teen Depression: What Are The 3 Most Common?

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Adolescent Identity and Depression: Why and What To Do…

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Effects of Teenage Drug Abuse

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About The Guest Author

Christina Botto has been involved with helping parents and teenagers resolve complicated issues for more than 14 years, observing and developing parenting strategies. Her dedication to helping parents inspired her to write her book, ‘Help Me With My Teenager! A Step-by-step Guide for Parents that Works.’ Christina continues to help parents and their teens through her website http://www.helpwithteenagers.com

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What About Drugs for Anxiety and Depression?

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by: Margaret Paul, Ph.D.

As a counselor, I am often asked, “Can drugs be helpful for anxiety and depression?” The answer I give is “Yes” and “No.”

Yes, drugs may be useful for short-term help. No, drugs are not a good long-term solution.

Anxiety and depression are not caused by a lack of drugs. Drugs do not heal the underlying causes of anxiety and depression. However, when drugs are temporarily used to give a person a window of relief to do the inner work necessary to heal the underlying causes, they can be useful.

Anxiety and depression generally have two major underlying causes - emotional and physical.

THE PHYSICAL CAUSES OF ANXIETY AND DEPRESSION

Our bodies go into imbalance when we do not eat well or have enough healthy exercise. Our bodies are not made to handle the unnatural substances found in processed food. When we overload our bodies with chemicals, pesticides, sugar, and devitalized foods, our bodies become depleted of vital nutrients and go into stress. Anxiety and depression can be the result of this physical depletion and resulting stress.

Our bodies are designed to thrive on the food and water that God gave us – pure, clean, organic, unaltered food and water. If you take drugs for anxiety and depression and do not clean up your diet and get proper exercise, you are just using a Band Aid for a gaping wound.

THE EMOTIONAL CAUSES OF ANXIETY AND DEPRESSION

Emotionally, anxiety is caused by dysfunctional thoughts – thoughts that are not true. For example, if you tell yourself that you are not good enough or you have to be perfect, you will likely feel anxious. Thoughts of not being good enough and having to be perfect are generally focused on our outer qualities of looks and performance, rather than on the inner qualities of kindness, compassion, and gratitude. When we choose to be kind, loving and compassionate with ourselves and others, we feel good about ourselves. When we choose gratitude for what we do have rather than dwell on what we don’t have, we create inner peace. Kindness and gratitude are wonderful antidotes to anxiety!

Anxiety is always a sign that we are telling ourselves a lie. The truth creates peace inside, while lies create fear and anxiety. This is a sure-fire way of knowing what is true and what is not true!

Emotionally, depression is caused by not taking good care of ourselves. If we ignore our needs, don’t speak up for ourselves, judge ourselves, and make others responsible for our feelings, the result may be depression. If you have a child whom you ignore and judge, that child will likely be depressed. The same occurs on the inner level when we ignore and judge our own inner child. Putting yourself last and taking care of everyone else but yourself may cause you to feel unworthy and depressed.

There is little point in taking drugs for anxiety and depression without attending to your dysfunctional thinking and to how you are treating yourself. However, if you take drugs for a short time and give yourself the opportunity to do your inner work, they may be helpful. Many of the people I work with find that as soon as they start taking good care of themselves, they don’t like the effect of the drugs. They don’t like the fact that the drugs take the edge off their feelings. They find that, rather than wanting to be numbed out, they want to feel all of their feelings deeply, both the highs and the lows. The more they learn to take responsibility for their feelings by attending to their thoughts and needs, the more they want to feel all of their feelings. They discover that, while drugs may take the edge off pain, they also take the edge off joy.

Most of the people I work with can avoid drugs completely by learning to take loving care of themselves, both physically and emotionally. Many of the people who practice the Inner Bonding process that we teach find Inner Bonding to be far more powerful in healing anxiety and depression than drugs.

If you are a person who does not want to learn to take personal responsibility for your pain and joy, then drugs may be a way out for you. But if you want to feel true peace and joy, drugs are not the answer.

Related Links:

6 Powerful Steps to Cure Your Depression -

This free Cure Your Depression E-Course may not be intended for you, but so far thousands of people have found in it what they were looking for.
www.cure-your-depression.com/depresion-viplist.html

About The Guest Author

Margaret Paul, Ph.D. is the best-selling author and co-author of eight books, including “Do I Have To Give Up Me To Be Loved By You?” She is the co-creator of the powerful Inner Bonding healing process. Learn Inner Bonding now! Visit her web site for a FREE Inner Bonding course: http://www.innerbonding.com Phone sessions available.

The Fuel of Stress, Anxiety and Depression


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by: Chris Green

In the 21st Century, it is predicted that stress and stress related illnesses such as depression and anxiety will become the biggest killers. Despite significant advances in housing, standards of living, quality of food, and medical science, the pressures all of us have to face in today’s world are as demanding as any pressures experienced by our predecessors.

Why are these illnesses on the rise? And why do some people become so ill through these illnesses, they can find it hard to function?

Well they sure don’t happen overnight! You don’t suddenly wake up one morning and feel stressed or depressed. It’s not like flicking on a light switch! And by the same rule, if you’re suffering, you can’t just wake up one morning, flick off the switch and say “Great, I’m better now.”

Many people who don’t suffer from these illnesses often say to sufferers:

“Come on, snap out of it.”

If only it was so easy! Should anyone say this to you, please forgive them as it’s just a lack of understanding. It’s very hard for people to understand how you’re feeling if they haven’t been there.

The fact that these illnesses don’t suddenly happen means we can draw some parallels with illnesses such as heart diseases, some cancers and strokes.

Because these illnesses don’t just suddenly happen either.

If we look at heart disease, it’s often the result of damaging behaviors practised over many years. Behaviors such as smoking, lack of exercise and a diet high in saturated fat. Strokes are a result of similar behaviors and cancers too, particularly heavy smoking and drinking as you know.

So how do stressful illnesses such as stress, depression and anxiety compare?

Stress is also the product of harmful mental habits and behaviors. These habits and behaviors are developed and practised over years – since childhood in most cases. These are the mental processes that enable us to make sense of our lives and the circumstances we’re faced with. When we reach adulthood, we perform them automatically because we’ve learned these behaviors by repetition.

Think of it like learning to drive a car. Initially, the skills required to control the vehicle needed conscious thought. It seemed really difficult didn’t it? But once we’ve performed them for sufficient periods, we drive on auto-pilot. We’ve mastered the required skills by repetition.

Here’s the key: if we eat healthy food, take regular exercise, cut out harmful behaviors such as smoking and drinking, we improve our health and drastically reduce the risk of heart disease, cancer and strokes. We are repeating good habits, habits that will give our physical well being a huge boost.

It’s exactly the same for stress. What’s important to understand is that not everyone becomes stressed or depressed – even when tragic and traumatic circumstances happen to them. Just like people who lead a healthy lifestyle and avoid harmful habits and behaviors, people don’t become stressed or depressed because they have learned effective habits and behaviors that prevent stress from arising.

This is very good news if you suffer from these illnesses. Because just as we can learn habits and behaviors which cause us to become highly-stressed, depressed or anxious, we can learn the habits and behaviors which stop these terrible illnesses in their tracks. And the more often we make use of them, we’ll soon begin to perform them automatically and our mental health will benefit enormously.

No more feeling stressed out. No more feeling unable to cope. No more anxiety and no more depression. EVER.

I’m living proof of this. For 5 years, a series of traumatic events sent me spiralling into an anxiety-induced depression nightmare. I came out of it by learning the natural skills that starve these illnesses. The more I used them, the less anxious I became. They’re now as natural to me as driving a car, and I’ve completely eradicated anxiety and depression from my life.

You can do it too.

Related Links:

6 Powerful Steps to Cure Your Depression -

This free Cure Your Depression E-Course may not be intended for you, but so far thousands of people have found in it what they were looking for.
www.cure-your-depression.com/depresion-viplist.html

About The Guest Author

Chris Green is the author of the new book “Conquering Stress”, a special program which will show you how to conquer stressful illnesses such as depression, anxiety, panic and worry permanently and without taking powerful drugs. Click here to learn more about this new book and story…

Food, Anxiety and Depression


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by: Margaret Paul, Ph.D.

In our current society, there are many factors that can cause or contribute to anxiety and depression. Certainly money and work problems, relationship and family issues, as well as illness and loss of loved ones are major contributors to anxiety and depression. Also, how we feel about ourselves and treat ourselves contribute greatly to how we feel. Even in the worst of times, if we are treating ourselves with compassion instead of self-judgment, we may be able to manage big challenges without anxiety or depression. In addition, being able to turn to an inner source of spiritual guidance and comfort is vital to weathering the hard times.

Food is another major factor that greatly affects how we feel. Most people don’t really notice that what they put into their bodies affects how they feel. They might know that if they “sugar out” they may crash emotionally, or if they drink too much they will feel hung over, but they are often unaware of how other foods may be creating anxiety and depression.

In the over 35 years that I’ve been a counselor, I have frequently encountered individuals whose anxiety and depression completely cleared up by tuning into how food was affecting them.

For example, Marnie discovered that dairy, wheat and sugar kept her up at night. She would wake up at around 3:00 in the morning with intense anxiety, and would be tired and depressed the next day. By experimenting around and cutting out different foods, she discovered that she slept fine when she stopped eating dairy, wheat and sugar. All her nighttime anxiety vanished and she was no longer tired and depressed.

Joel discovered that his sleeplessness and resulting depression was a direct result of caffeine from coffee, tea, chocolate and soft drinks. He had not realized how much caffeine he was actually consuming until I suggested that he cut out all caffeine and see what happened to his sleep. After a week of headaches from caffeine withdrawal, he was sleeping soundly for the first time in years and no longer felt depressed.

Adrienne discovered that her feelings of anxiety and depression, that had been with her most of her life, disappeared after she started eating only organic foods. Her system was so sensitive to the pesticides and food additives in non-organic food that she could not eat them without feeling anxious and depressed.

Alex, who periodically struggled with depression, inadvertently discovered that drinking raw milk from an organic dairy had a completely different effect on him than pasteurized milk. He was visiting Los Angeles and went into a health food store where he discovered that he could buy raw dairy products (which are outlawed in most other states). He found that the raw milk gave him more energy and elevated his mood. He also found that, while he was lactose intolerant with pasteurized milk, he had no problems with raw milk. Now he has his raw milk, cheese, and butter shipped frozen to Wyoming, and no longer struggles with depression.

Over and over again my clients, who have chosen to tune into how food was affecting them, have discovered how much their feelings were being affected by food. Many of my clients have learned that even a little sugar brings them down. Sugar consumes so many vital nutrients as the body attempts to process it that it can actually be considered a poison. How many people really take “Sugar Blues” seriously?

A hundred years ago, when people naturally ate non-processed and organically grown food, they were getting all the nutrients they needed. Now, most fruits, vegetables and grains are being grown on devitalized soil and over-processed on top of it. Cows and sheep that were once grass fed are being fed pesticide-sprayed grains and given hormones to fatten them up. As a result, much of our food not only contains little nutrients, but has many toxins as well. Without the vitamins, minerals, and many other factors that natural, organic and grass-fed food contains, many people suffer deficiencies that can cause anxiety and depression, as well a many other illnesses.

I recently found out that the fat of raw organic dairy products, especially butter, contains natural anti-inflammatory nutrients. I wonder if the huge rise in arthritis and other inflammatory conditions is related to the pasteurizing of milk. Any inflammatory condition can certainly contribute to anxiety and depression.

Food is certainly a major factor in the rise of anxiety, depression and illness. Only you can do something about this by learning how you are being affected by the foods you eat.

Related Articles:

Food and Depression – Tips to Change Your Mood

“In the over 35 years that I’ve been a counselor, I have frequently encountered individuals whose anxiety and depression completely cleared up by tuning
www.cure-your-depression.com/food-and-depression.html

About The Guest Author

Margaret Paul, Ph.D. is the best-selling author and co-author of eight books, including “Do I Have To Give Up Me To Be Loved By You?” and “Healing Your Aloneness.” She is the co-creator of the powerful Inner Bonding healing process. Learn Inner Bonding now! Visit her web site for a FREE Inner Bonding course: http://www.innerbonding.com Phone Sessions Available.

Self-care Strategies for Managing Depression, Anxiety, and Other Emotions


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by: Janel Ball, MA, RCC, MBACP

Depression, anxiety, and other emotional problems are issues that many people struggle with. Often, these problems interfere with everyday life and general well-being. I have read a statistic saying that 80% of the population in North America will suffer from some degree of depression at some point in their lives.

There are self-care strategies that you can learn to help you get through your days with a bit more ease if you find you are struggling with managing your emotions or find yourself on a bit of a roller-coaster of emotion at times. Even during bouts of low-self-esteem, self-care and emotional management techniques can help.

In this article, I am going to share some information that I teach to my clients in counselling sessions as well as to members of self-care workshops. If you have any questions about something I have included here, please do not hesitate to contact me and ask.

Good grounding tools are very helpful for better daily living. By grounding, I mean the tool(s) used to help calm yourself in an emotionally upset time. Now don’t get me wrong, I believe it is important to process and feel your emotions at times as this is the body’s way of healing emotional upset to be able to set it aside. Sometimes this can be done at home using some of the tools listed here and sometimes people need the help of a professional to heal some deeper wounds or to help you get over a hurdle. However, there will be times when it is not appropriate to feel upsetting or disturbing emotions, and it is then useful to know way to ‘ground’ or set the emotion aside and come back to it later at a more appropriate time.

Fundamentally, all of these strategies are about you being in control of your emotions instead of your emotions being in control of you. It can be helpful to know that our bodies have processes already designed into our nervous systems to take care of emotions. Emotions have a lifespan of about 45 to 50 minutes. They do not last forever.

Please note that not every technique will work for everyone. Every person will have some that work for them and some that don’t. Once you have found techniques that work for you, it can be helpful to write them up, or type them and print them out, and keep them handy to ensure you’ll use them when you need them.

The main concept to understand is that when you are feeling a lot of emotion, you are functioning from the right side of your brain where your negative emotional centre lies. It is commonly noted in psychology that when you are trapped, in a way, on the right side of your brain, your left side is functioning at a lower capacity. The left side of your brain is thought to be the rational or logical side of the brain. It is therefore helpful to get your left side more activated, but sometimes it needs some help during emotionally charged times. There are many ways to do this, but again, find the strategies that work for you.

Strategies:

Shifting your focus away from the emotion and back to your body can be very useful. This can be done by tapping your feet back and forth and really feeling how your feet connect with the floor.

Another way to shift the focus back to the body is to notice how your body feels on the chair you are sitting in. Notice your back on the back of the chair, your arms on the arm of the chair, your legs, and how your hands are placed.

Next, notice your breath. Long deep breaths in through the nose and out through the mouth if you can. Really feel the breath going into the body. Breath is very life sustaining and supportive – it is a very good thing to connect with at times of feeling emotionally upset. This can help ground and soothe the body and shift your focus away from an upsetting emotion.

Now, the counseling modality I use most of in my practice is something called EMDR (which stands for Eye Movement Desensitization and Reprocessing). You can read some information about EMDR if you click on the tap in the menu bar of the website. Some of the grounding strategies I am including here are the tools I use to end sessions with clients so that things are not left open and my clients can get home safely, go back to work, or whatever it that they need to do that day.

The most important of these tools sounds very simple but it is very effective. All you have to do is move your eyes up and down in a vertical line. No need to move your head, just your eyes. Turning your body to face a doorframe or the corner of a room can help. You can think of a metaphorical door in your mind closing your emotional self and centering the body.

Becoming more aware of your physical surroundings can help shift your awareness and activate the left side of the brain. This can be done through naming objects you see in the room around you, naming colours that you see, as well and sounds that you hear.

Another way to get both sides of your brain working if you are feeling a strong emotion is to access them both at the same time. This an be done by looking at a piece of art such as a painting or a sculpture – not a photograph though - and count at the same time. You do not need to analyze the art. Just by looking at it, the right side of your brain is accessed. By counting (1,2,3,4,5,6,7,8,9,10 – as far up as you need to go), you activate the left side of the brain. If you are aware of a feeling and do these two things together, the feeling should dissipate.

Going for a walk, or other physical activity, can help the body feel better and help release the emotion. I strongly believe in the term “walk it off”.

Reading is something that many people do to take their minds off their worries. Some sort of distraction can help shift your focus away from the emotion.

Cooking can be another good, healthy distraction. By the way, eating healthily and getting some exercise are two of the best things you can do for depression.

Journalling, or writing, is very helpful for some to help you handle an emotionally charged situation. It helps give clarity to thoughts and allows for some distance from them by looking at them. Some people find writing very therapeutic. If it is not the right thing for you, that is okay. Keep in mind, you do not always have to go back and read what you wrote. Sometimes its just nice to have a place to get it out in the moment.

Other creative outlets are very helpful as well. Doing some art – which does not have to look like anything – helps get emotion out. This is a similar idea to journalling. What colour would anger be? What would it look like?

If you are able to do some art and give your thoughts or feelings some creative expression, follow-up with some good self-care like a nice bath, a walk, or a warm drink.

The ‘Container’ is a very common therapeutic tool. To some, the concept of the container might not sound very useful, but when practiced and developed, it does wonders for helping set emotions, upsetting thoughts, or memories aside when it is not a good time to be aware of them.

The container is about using imagery, or the power of you imagination (your mind) to help you when you need it. Our minds are pretty powerful so I encourage you to give this one a shot and see how it goes. When I first heard of this exercise, I also did not think it would be helpful. Was I ever wrong. Even last week on the street I had a member of a group I had run come up to me and tell me how helpful the container is and expressed, “Its just great.”

The container is about imagining some sort of container that is big enough, and strong enough, to hold whatever you might ever need to put in it. One stipulation is that it shouldn’t be something that you see all the time in your day as you may be getting a constant reminder of what you are trying to forget (for the time-being). It can be made of any material and can be any colour. It needs some sort of door or lid to keep what ever you put in there safe inside. It may need a lock of some sort. Examples could be a warehouse, a safe or vault, a big box, or plastic container.

To use, or access, your container when you need it, it is helpful to have a really clear picture of it first (drawing it can help). You might picture the items you would like to go into your container individually being placed inside. You might just get a felt sense of it being set aside and placed into the container. Some people like to have some sort of animation to help take the items into the container such as a pack man motion or some sort of suction.

Now, an important idea pertaining to the Container is that you are not trying to make the things you place into it disappear or say that they are not important. It is about setting things aside and coming back to them at a later time when you can better deal with them such as in counselling, talking to a friend, or journalling about it at home.

Sometimes it is helpful to have some sort of nozzle or valve on the container so that you can more easily be in control of what comes out when it is time to take something out.

The Safe Place is another very common therapeutic strategy and is a very useful tool for many. I originally learned of the ‘safe place’ in relation to working with sexual abuse survivors. However, as the years have progressed, I have found that this tool is very useful for anyone. Again, this strategy utilizes our minds by using imagery to help calm the body and the mind. The safe place works by closing your eyes and imagining yourself in a place (which can be real or imaginary). It can be any place at all that you find soothing and comforting. Some people call this place a relaxation place or a happy place. It is helpful if there are not people who are currently a part of your life in your safe place because if that relationship were to ever go sour for a time, it would affect your safe place.

The safe place can be somewhere you have been, a place that you liked when you were a kid, a place you have always dreamed of going, or an imaginary place such as somewhere in outer space. It is helpful to notice all the colours that are there, the sounds, the objects. The clearer the image is for you, it will easier it will be for you to access it and to use it when you need it.

Imagine yourself in this place and notice how it makes you feel. Do you feel calm, more relaxed, at peace? Whatever the feeling is, notice also where you can feel it in your body. Allow yourself to stay there as long as you need to calm yourself.

Anther strategy to help alleviate emotional distress is the Spiral Technique. For this exercise, allow yourself to feel the emotion and close your eyes. Which direction would the spiral be turning? Ok, now change the direction – this will decrease the intensity of the emotion. Try practicing it and see if you can have work for you.

Practicing something referred to as ‘Dual Awareness’ can really help get you through when nothing else seems to be helping. For this concept, it is helpful to note that the emotion is caused from a past experience. However, you are feeling that past experience being triggered in the present. Be aware of these 2 things at the same time: the emotion being connected to a past experience and yourself in your present surroundings. Tell yourself, “I can allow myself to know I am okay right now”. The feeling will eventually pass – your body will take care of it in its own in time. It will not last forever. Sometimes you might feel as if you just need to hang on. Find something to help you connect with your current surroundings.

Design your surroundings so that they reflect calm and relaxation. Your surrounds can greatly affect your mood. Soothing pictures, some spiritual objects, or other calming objects help create an atmosphere of better emotional health.

Spend time talking to friends when you can. Be aware of their boundaries so that you do not go too far with pushing limits. It is important to share with people who will be understanding and supportive.

When dealing with issues of anger, there are healthy ways to process it. Anger has a lot of energy to it and wants to have a physical way to get out of your system. Going to the gym, for a walk, or for a run can help. Screaming into or punching pillows can also help. Stress balls are good as well. Find a healthy way to get the energy out. Anger serves a purpose of letting us know that something needs to be different but, just as it can be done with other emotions, anger too can find a positive outlet.

Rescue Remedy is a homeopathic product that is becoming more and more common as it is helpful to calm your nerves. You might give this a try and carry it around with you if you find it helpful. It can be found at many health food stores.

If spirituality is important to you, you can get in tune with your body at times of feeling emotional upset by visualizing your chakra system and aligning the chakras. Be aware of centering the body along this system. Finding other spiritual beliefs or outlets can help as well.

It is important to remember that practicing these tools will help. Repetition is the best way to learn something new. Also, please keep in mind that this is not a comprehensive list. There are many ways to ground and self-soothe during times of emotional upset.

In closing, I would like to mention that something I try to encourage to all of my clients and to others in my life as well, is to always attempt to have good self-care. Taking care of what you eat, how much sleep you are getting, limiting the amount of caffeine is in your diet, and getting some exercise will go a long way to helping your body take care of you and help support you better during times of emotional upset.

I hope some of the things on this list will help you.

Janel Ball, MA, RCC, MBACP

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About The Guest Author

Janel Ball has a Master’s Degree in Counselling Psychology and is in private practice downtown Vancouver. She sees mainly men who struggle with self-esteem, anxiety, addictions, depression, and trauma.

Janel is a member of the British Columbia Association of Clinical Counsellors and the British Association of Counsellors and Psychotherapists. The techniques she uses are a combination of Person-centred, Cognitive-behavioural, and EMDR. She works with her clients to find the proper approach for each individual’s needs.

For further information, visit Janel’s web site at http://healingsolutions.ca .

©2008 Janel Ball

Healing Solutions Professional Counselling Services
http://healingsolutions.ca
604-809-0351

Depression Series: My Antidepressant Doesn’t Work. What Can My Psychiatrist Do? (Part 2)


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by: Michael G. Rayel, MD

Maria has been increasingly depressed for the past few years. She has tried at least four newer antidepressants but so far, she doesn’t seem to respond. Unable to work, she’s now feeling helpless and hopeless. Likewise, her family is discouraged. Frustrated and baffled by Maria’s lack of progress, the family doctor refers her to a psychiatrist.

What can the psychiatrist do to help Maria?

The psychiatrist has several options in dealing with a treatment-resistant or refractory depression. First, Maria’s psychiatrist can optimize the dose of her antidepressant. Maria has been taking low doses of antidepressants. In spite of her lack of response, the medication dosage has not been increased. To obtain a clinical response, her psychiatrist should increase the dose every two to three weeks. The antidepressant can be adjusted up to the maximum allowable dose if no or only partial response is observed.

Second, her psychiatrist can choose to augment the effect of her antidepressant with another medication such as lithium, triiodothyronine (T3), or buspirone. Among augmenters, lithium and triiodothyronine have the best support from the literature. Despite lithium’s efficacy, some doctors avoid this drug because it requires regular blood monitoring and has unfavorable side effect profile such as acne, tremors, and thyroid and renal dysfunction.

Recently, studies have shown atypical neuroleptics such as olanzapine and risperidone to be good augmenters. In my opinion, further studies are necessary to establish these two drugs as standard augmenter. Indeed, research studies and clinical experience have found augmentation strategy to be effective.

Third, combination strategy is worthwhile to try. Maria’s psychiatrist can add another antidepressant to boost the effect of her current antidepressant. For instance, trazodone can be added to an SSRI (serotonin reuptake inhibitor e.g. citalopram). Literature suggests that combining two drugs with different mechanisms of action and drugs that involve several brain chemicals has resulted in clinical improvement. In this scenario, one antidepressant plus another antidepressant is equal to three, or four or even ten, not two.

Fourth, the psychiatrist can switch from one antidepressant to another. Previous studies have shown that when making a switch, a drug should be replaced by a drug from a different class e.g. from SSRI to SNRI (serotonin and norepinephrine reuptake inhibitor e.g. venlafaxine), or from TCA (tricyclic agent e.g. nortriptyline) to SSRI. But recent studies show that switching drugs within the same class (e.g. SSRI to another SSRI) is just as effective.

Fifth, Maria’s psychiatrist can also treat other ongoing symptoms or drug-related problems that further complicate her depression. If she is anxious and agitated, then her psychiatrist should prescribe antianxiety drug (e.g. lorazepam) or if Maria is psychotic then adding an antipsychotic drug should help. Moreover, medication side effects (such as insomnia, dryness of mouth, constipation, etc.) that negatively affect Maria’s compliance to the drug should be addressed promptly.

Lastly, if despite above measures Maria doesn’t respond to antidepressants, then electroconvulsive therapy should be entertained. Of course, this procedure should be done with her consent.

In summary, Maria’s psychiatrist can optimize the dose, augment or combine treatment, switch the medication, treat side effects and ongoing symptoms, or use electroconvulsive therapy for treatment-resistant or refractory depression.

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“A Helpful Antidepressant Comparison.”

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About The Guest Author

Copyright © 2003. All rights reserved. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader’s Preference Choice Award 2002), speaker, workshop leader, and psychiatrist. Dr. Rayel pioneers the CARE Approach as a first aid for mental health. To receive free newsletter, visit www.drrayel.com. His books are available at major online bookstores.

Depression Series: Why Don’t I Respond to Medications? (Part 1)


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by: Michael G. Rayel, MD

Maria has been feeling depressed for at least two and a half years. About three years ago, her husband of 20 years left her for another woman. Devastated, she became despondent and tearful almost daily.

Eventually, her depression got worse associated with inability to function. Her appetite, energy, concentration, and sleep became impaired. She also felt hopeless and suicidal. Her psychiatrist put her on a starting dose of antidepressant. She responded initially but after a few days, she felt just like before taking the medication.

For the past two years, Maria has tried four types of antidepressants. She has taken the usual adult doses of these drugs. Although she somewhat improves, she has virtually remained the same — depressed and disabled.

Maria seems to be taking the medications regularly. But why is she not responding to her antidepressants?

Maria is just one of the many depressed individuals who don’t feel “normal” despite treatment. Depression is a treatable disease but how come some people don’t do well on medications?

There are many reasons why depressed patients like Maria don’t improve on antidepressants.

First, is the diagnosis correct?

Depression can be caused by many clinical entities. Sometimes, knowing the right diagnosis is a challenge. Medical disorders, medications such as beta-blockers and benzodiazepines (e.g. clonazepam), and various psychiatric disorders can cause depression and they all require different treatment. If your doctor fails to identify and treat the true cause of your depression, you will remain depressed despite the use of antidepressant.

Second, are there co-morbid disorders?

Depression can exist along with other psychiatric disorders such as anxiety disorder, alcohol or drug problems, personality disorder, dementia, and psychosis. Depression will persist if these co-morbid disorders are not treated. For instance, depressive disorder with psychosis cannot be adequately treated just with antidepressant alone. You need an antipsychotic drug added to an antidepressant to treat the illness.

Third, is there an ongoing neurological or medical disorder that precipitates, aggravates, or complicates depression?

Hypothyroidism, hyperthyroidism, vitamin B-12 deficiency, pancreatic cancer, brain tumor, Parkinson’s disease, and stroke can all cause depression. If any of these disorders are present, antidepressants are less likely to help. The goal in these situations is to treat the underlying medical condition. A 65 year-old lady came to see me complaining of severe depression. On evaluation, she disclosed that she had been on three types of antidepressants for the past four years with minimal response. I checked her recent laboratory results which showed an abnormal thyroid! No wonder, she was not responding to the medication.

Fourth, are there ongoing psychosocial issues?

Financial problems, family conflict, work-related stress can all precipitate and complicate depression. Despite adequate medication treatment, some individuals will remain depressed especially if such problems are not addressed by the therapist or psychiatrist. Is there any way you can reduce the stressors? Please do so the earliest you can.

The treatment of depression is frequently straightforward. Occasionally however, various factors complicate it. For antidepressant to be effective, a psychiatrist should ensure that the diagnosis is correct, that co-morbid psychiatric disorders and medical problems are treated, and that psychosocial issues are adequately addressed.

Maria’s doctor should explore further the real problem and provide the most appropriate intervention.

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“A Helpful Antidepressant Comparison.”

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“What’s a good natural source of serotonin to cure depression?”

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About The Guest Author

Copyright © 2003. All rights reserved. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader’s Preference Choice Award 2002), speaker, workshop leader, and psychiatrist. Dr. Rayel helps individuals recognize the early signs of mental illness and provide early intervention. To receive free newsletter, visit www.drrayel.com. His books are available at major online bookstores.

What is the Treatment for Bipolar Disorder?


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by: Michael G. Rayel, MD

How do we treat bipolar disorder? Specifically, how do we treat mania or depression associated with bipolar disorder? The treatment of these two clinical states is not the same.

The treatment of mania is dependent upon its severity and acuity. For mild to moderate mania, mood stabilizers such as lithium and valproic acid (Valproate) are still the standard of treatment and may be sufficient to contain the symptoms. Lithium starts to work after 10 to 14 days while valproic acid, about 7 to 10 days.

Also, recent studies have shown the effectiveness of atypical antipsychotics such as risperidone, olanzapine, and quetiapine even when used alone to treat the acute phase of bipolar disorder.

These drugs are relatively safe but they don’t come without side effects. Nausea, vomiting, tremors, and dizziness during the initial phase of treatment are commonly experienced. The more serious side effects such as renal and thyroid problem from lithium, liver dysfunction and pancreatitis from valproic acid, and increased risk of diabetes and high cholesterol from atypical antipsychotics are uncommon. However, regular blood tests are required to monitor any abnormalities.

For moderate to severe cases, atypical antipsychotics such as risperidone and quetiapine should be added to the mood stabilizers during the acute phase. Once the illness has stabilized and the symptoms have subsided, then the atypical neuroleptics can be gradually tapered off. But the mood stabilizers should continue. Regardless of severity, patients usually do well on a combination of mood stabilizer and atypical antipsychotic during the acute phase.

What is the treatment for bipolar depression? In general, the mood stabilizers’ dosage should be optimized or if the patient is not on any medication yet, a mood stabilizer such as lithium should be started. Physicians should make sure that the medication maintains a “therapeutic level.” If not, the dosage should be adjusted. Moreover, possible precipitants such as stresses at home should be addressed.

If these measures don’t help and the depression is so severe, an antidepressant with the least risk to induce mania such as bupropion should be added to the mood stabilizer. When the depression is resolved, then the antidepressant can be gradually tapered off because its prolonged use even in the presence of mood stabilizer can still induce mania.

When should the medication be discontinued? Bipolar patients have to continue taking the medication for several months even after they become normal. High relapse rate is common if medications are prematurely stopped. Also, for patients with multiple or difficult-to-treat episodes, they may need to take the medication for years or even for life to prevent recurrence.

Patients and their physicians should thoroughly discuss the risk and benefits of any treatment intervention. Knowledge about the drug’s indication, side effects, and prognosis with or without treatment is a must.

Furthermore, it is crucial that bipolar patients should also receive individual psychotherapy to help them deal with the many personal and psychosocial issues they face on a daily basis. As you know, medication alone won’t suffice to address financial problems, marital conflict, work issues, and prior abuse.

In summary, the combination of medication and psychotherapy is the best treatment for bipolar disorder.

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About The Guest Author

Copyright © 2004. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader’s Preference Choice Award 2002) psychiatrist, and inventor of Oikos Game: A Personal Development and Emotional Skills Game. For more information, please visit http://www.oikosgame.com.

Major Depression and Manic-Depression — Any difference?


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Major Depression and Manic-Depression — Any difference?
by: Michael G. Rayel, MD

Countless number of patients and their family members have asked me about manic–depression and major depression. “Is there any difference?” “Are they one and the same?” “Is the treatment the same?” And so on. Each time I encounter a chorus of questions like these, I am enthused to provide answers.

You know why? Because the difference between these two disorders is enormous. The difference does not lie on clinical presentation alone. The treatment of these two disorders is significantly distinct.

Let me begin by describing major depression (officially called major depressive disorder). Major depression is a primary psychiatric disorder characterized by the presence of either a depressed mood or lack of interest to do usual activities occurring on a daily basis for at least two weeks. Just like other disorders, this illness has associated features such as impairment in energy, appetite, sleep, concentration, and desire to have sex.

In addition, patients afflicted with this disorder also suffer from feelings of hopelessness and worthlessness. Tearfulness or crying episodes and irritability are not uncommon. If left untreated, patients get worse. They become socially withdrawn and can’t go to work. Moreover, about 15% of depressed patients become suicidal and occasionally, homicidal. Other patients develop psychosis—hearing voices (hallucinations) or having false beliefs (delusions) that people are out to get them.

What about manic-depression or bipolar disorder?

Manic-depression is a type of primary psychiatric disorder characterized by the presence of major depression (as described above) and episodes of mania that last for at least a week. When mania is present, patients show signs opposite of clinical depression. During the episode, patients show significant euphoria or extreme irritability. In addition, patients become talkative and loud.

Moreover, this type of patients doesn’t need a lot of sleep. At night, they are very busy making phone calls, cleaning the house, and starting new projects. Despite apparent lack of sleep, they are still very energetic in the morning — ready to establish new business endeavors. Because they believe that they have special powers, they involve in unreasonable business deals and unrealistic personal projects.

They also become hypersexual — wanting to have sex several times a day. One–night stands can happen resulting in marital conflict. Like depressed patients, manic patients develop delusions (false beliefs). I know a manic patient who thinks that he is the “Chosen One.” Another patient claims that the President of USA and the Prime Minister of Canada ask for her advice.

So the big difference between the two is the presence of mania. This manic episode has treatment implications. In fact the treatment of these disorders is completely different. While major depression needs antidepressant, manic-depression requires a mood stabilizer such as lithium and valproic acid. Recently, new antipsychotics, for example risperidone, olanzapine, and quetiapine, have been shown to be effective for acute mania.

In general, giving an antidepressant to manic–depressed patients can make their condition worse because this medication can precipitate a switch to manic episode. Although there are some exceptions to the rule (extreme depression, lack of response to mood stabilizers, among others), it is preferable to avoid antidepressants among bipolar patients.

When considering the use of antidepressant in a depressed bipolar patient, clinicians should combine the medication with a mood stabilizer and should use an antidepressant (e.g. bupropion) that has a low tendency to cause a switch to mania.

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About The Guest Author

Copyright © 2004. All rights reserved. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader’s Preference Choice Award 2002), speaker, workshop leader, and psychiatrist. Dr. Rayel pioneers the CARE Approach as first aid for mental health. To receive free newsletter, visit www.drrayel.com. His books are available at major online bookstores.
mike@drrayel.com