Feeling SAD?

Darker days making you feel blue? Suffering from unrelenting cabin fever? Are you sleeping more, lacking energy, craving sweets? You may be feeling SAD, or seasonal affective disorder, a type of depression that can seriously impact your daily life. As many as half a million people in the United States may have winter-onset depression and another 10% to 20% may experience mild SAD according to the American Association of Family Physicians.

Research at Loyola University seems to indicate that SAD is first and foremost a physical disorder where reduced exposure to natural light leads to biochemical imbalances in the brain. This may be a sort of genetic leftover; the human equivalent of hibernation. But rather than retreat to the nearest cave (with a bag of Oreos,) try some of these mood lifters:

• Get outside for at least 30 minutes a day, preferably at mid-day. Lunch walk anyone?
• Take a multivitamin that includes magnesium, B-complex and minerals.
• Aerobic exercise. (My favorite.)
• Avoid caffeine. (You've got to be kidding me.)

If you're less than thrilled with these suggestions, you might try light therapy. Light therapy mimics outdoor light and causes a biochemical change in your brain that lifts your mood and relieves symptoms. In light therapy, you sit a few feet from a specialized light therapy box so that you're exposed to very bright light. Light therapy is generally easy to use and has relatively few side effects. However, light therapy hasn't been officially approved as a treatment by the Food and Drug Administration because of a lack of definitive evidence about its effectiveness in clinical trials. Before you purchase a light therapy box or consider light therapy, consult your doctor or mental health provider to make sure it's right for you. (Got my light from Costco...)

Most people experience some days when they feel down. But if you feel down for days at a time and you can't seem to get motivated to do activities you normally enjoy, see your doctor. This is particularly important if you notice that your sleep patterns and appetite have changed — and certainly if you feel hopeless, think about suicide, or find yourself turning to alcohol for comfort or relaxation. More than usual. (Frankly, just thinking about the impending holidays makes me feel hopeless, think about suicide, and turn to alcohol for comfort.) Find more info here.

Talk it out...

For decades, lithium was the front-line treatment for bipolar disorder. The mysterious salt—doctors still don’t know exactly how it works—stabilizes the intense high and low moods that are hallmarks of the illness.

But after its use for nearly 40 years (the U.S. Food and Drug Administration approved lithium for control of manic episodes in 1970), doctors and consumers have come to the realization that lithium—as well as other mood stabilizing medications—are not the cure-alls initially hoped for.

“It took the field about 25 years to notice that outcomes were not always so good,” says Ellen Frank, PhD, a psychologist and a professor of psychiatry and psychology at the University of Pittsburgh School of Medicine, and director of the Depression and Manic Depression Prevention program at Western Psychiatric Institute and Clinic.

“We don’t know why [people] relapsed—whether there was a non-adherence to medication, or if the early results for lithium were overly optimistic or there was a co-morbid use of illicit drugs, or a combination of those things,” Frank says.

Indeed, lithium’s limitations led researchers to reexamine psychotherapy’s role and potential. In the 1950s and 1960s, therapy for bipolar consisted chiefly of psychoanalysis, founded by Freud; and psycho dynamic therapy, which focuses on a patient’s previous experiences to understand current conflicts, according to Gregory Simon, MD, a psychiatrist and researcher at Group Health Cooperative, a consumer-governed, nonprofit health-care system based in Seattle, Washington.

“Then more came out about the inheritability of the illness, which led people to look for [other] treatments,” says Simon, who is also chair of the Scientific Advisory Board of the Depression and Bipolar Support Alliance (DBSA).

Over the past decade or so, researchers have developed several psychotherapies that are specifically designed for the treatment of bipolar disorder. Most of these therapies, including cognitive behavioral therapy (CBT) and interpersonal social rhythm therapy (IPSRT), were retooled from existing therapies for other mental illnesses, such as those for anxiety and depression, according to researchers.

Early results have been promising: Clinical studies indicate that therapies targeted for bipolar—when combined with appropriate medication—result in greater mood stability and medication compliance, reduction or elimination of hospitalizations, a faster recovery from a bipolar depression, and better overall quality of life.

According to Joseph R. Calabrese, MD, bipolar disorders research chair and professor of psychiatry at Case Western Reserve University, “The best treatment for bipolar disorder includes both a mood stabilizer, which is used to prevent future mood episodes; and psychotherapy/counseling, which is used to help people learn how to manage the symptoms of their illness. Either alone does not work as well.”

Excerpt from Psychotherapy retooled from the Fall 2008 issue of bp Magazine

Veteran's Day 2008

Consider these statistics:

• Nearly 33 percent of those who have been deployed to Iraq and Afghanistan will experience mental health issues.

• In 2007, the suicide rate among veterans who served in the US Army was at an all-time high.

• Approximately 40 percent of all homeless veterans live with mental illnesses.

• Nearly 57 percent of this aforementioned group are African American or Hispanic veterans.

•  Approximately 30 percent of veterans treated in the Veterans health system experienced depressive symptoms, two to three times the rate of the general population.

With an historic Election now behind us, Americans turn to Veterans Day on November 11 to honor all those who once served in our Armed Forces. Michelle Obama has said that, " The struggles of America's families aren't new to Barack... He also knows that when our military goes to war, their families go with them. He's a strong advocate for predictable deployments and better healthcare - including mental health - for returning service people." It is with renewed hope that we hear these words. (Read the rest here.)

Stand with NAMI and make a donation in support of better mental health care resources for veterans, active duty service members, and their families. You may even make your gift in tribute to a veteran, active duty service member, or other loved one, and include a message of support for display on the NAMI's Veterans Tribute Honor Roll.

So today let us say thank you to our veterans - including my son, whose bravery in facing the struggles of his daily life is my constant source of inspiration.