Moorestown Cherry Hill Voorhees NJ Psychiatrist ADHD Depression Anxiety Eating Disorders

Past, Present and Future Psychiatric Trends in USA: Lessons for All

2013-01-02T17:42:31Z

From DrDal’s recent Editorial at the “Bulletin of Clinical Psychopharmacology”:
“Globalization, technology, trade and tourism have played significant roles in creating the trend towards open societies from closed or collectivist societies around the world. Cultural, ethnic, and religious pluralism have been parallel trends that have gained more momentum after the end of the cold war. In return, open societies and pluralism have contributed to easier identification and expression of emotional symptoms and seeking treatment, which has gradually increased the reported frequency of psychiatric conditions in many societies. For instance the World Health Organization (WHO) has listed depression as the most debilitating illness for the world population in terms of “years lived with disability” and the fourth according to the “disability adjusted life years” (sum of years of potential life lost due to premature mortality and the years of productive life lost due to disability) and has predicted that it will become the second by the year 2020 in all age groups”

Click here to read the full editorial.

New Perspectives on Sleep

2012-12-06T20:26:24Z

People of the world have varying sleep patterns. Most experts agree on the fact of the usefulness of having eight hours of uninterrupted sleep. However, modern life styles at work, home, and social settings have brought many limits on sleep time and recent technological developments have further decreased sleeping hours. About 41 million Americans representing a third of all working adults get less than the prescribed eight hours of sleep. In fact, in a report from the Centers for Disease Control and Prevention, this portion of the working American population gets six hours or less of sleep per night. The reasons are attributed to a host of factors that prevent them from getting adequate amount of sleep.

A recent article by David K. Randall published at the New York Times (September 22, 2012) highlighted the fact that the eight-hour sleep regimen may not be applicable and there have been other sleeping patterns like taking naps after lunch time as commonly practiced by Chinese workers or a regular lunchtime nap (siesta), which is commonly taken by people in the Middle East, India, and Spain.

Instead of demanding the bodies to conform to the regular eight hours sleeping pattern, what may be more important is getting adequate quality sleep, not just the time spent asleep. Human brain and body might function really well by doing some learning, reflecting, or deep thinking between first and second episodes of sleep, sometime between 12 – 2am. David Randall suggests you do not need to get nervous if you wake up at 1am, and frustrated, because you cannot fall back asleep. He also cites studies confirming better performance lasting for several hours after a 30 – 60-minute nap. He mentions that military is testing this emerging evidence in activities/missions of soldiers; some coaches making arrangements for their players to take naps before games.

People may continue and explore better alternatives to 8 hour one block sleep time, in order to cope with the changing demands of life.

In his book Dreamland, David K. Randall dives into research investigating those dark hours people spend in sleeping. This book shows that sleep isn’t all that simple. The book also offers interesting and practical information about various things that are related to sleep.

You can read the full New York Times article of David K. Randall here.

Generalized Anxiety Disorder (GAD)

2012-12-06T20:29:47Z

People normally worry about life in general – health, finances, family, or work-related problems. However, if the person’s worrying becomes so intense that it limits him or her from functioning properly, the symptoms might meet the criteria for Generalized Anxiety Disorder or GAD.

People with GAD tend to worry endlessly about simple things. And this much more than normal worrying interferes with the person’s daily activities significantly. The GAD minds always find something to worry about.

A person who heard from the news about a bomb scare may experience extreme anxiety for days or even weeks as negative thoughts race through her mind that something bad might happen again. This dread may eventually limit her to the house for fear of her safety. It can even lead to a nervous breakdown.

Generalized anxiety disorder, unlike phobia has no direct association with objects or situations as the cause of anxiety. It’s a general feeling of fear which defines the person’s daily life, with no provocation or reason in most cases. A friend who failed to show up on agreed time may lead a person to think that an accident might have happened which prevented his or her friend from showing up even if there is no indication of that. When a person cannot stop these anxious, worrying thoughts, it is GAD that is ruling his/her life.

Some people may develop GAD early as a child or later as an adult. Some symptoms of panic disorder, obsessive compulsive disorder, and other types of anxiety can be seen in GAD. People with GAD usually experience headaches and fatigue. GAD may be a life-long challenge especially if they occur along with other anxiety or mood disorders.

Symptoms of GAD

GAD symptoms may show in many different ways, including some of the following:

Nerve-wracking worrying about little and simple things
Not having control over constant worrying
Awareness of obsessive worrying
Inability to relax
Inability to focus or concentrate
Being easily distressed or upset
Problem with sleeping or staying asleep
Feeling exhausted easily
Constantly suffering from some pain such as headaches, muscle pains, agitated stomach, and other unexplained discomfort
Difficulty in swallowing
Trembling or twitching
Irritability, excessive sweating
Frequent urination
Shortness of breath

Diagnosis

Doctors and mental health care providers use the Diagnostic and Statistical Manual for Mental Disorder (DSM) criteria, structured interviews, or psychological questionnaires or tests to identify, define, and diagnose a person who thinks he/she may be suffering from anxiety disorder. DSM 5 will be published by the American Psychiatric Association in 2013 and some changes to grouping and criteria listed in DSM-IV are expected to be made.

To be diagnosed with generalized anxiety disorder (GAD), one must meet the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), summarized below:

For a duration of at least six months, the person suffers from excessive worrying about events or activities for most days of the week
Uncontrollable feeling of fear or anxiety
Severe anxiety or worrying that interferes with normal daily functions
Fear or anxiety that is not associated with another mental condition like substance abuse, panic attack, post traumatic stress disorder (PTSD), etc.
At least three of the following symptoms in adults and one in children – fatigue, inability to focus or concentrate, restlessness, sleeping problem, irritability, and muscle tension.

Generalized anxiety disorder usually manifests along with other mental health conditions which makes diagnosis and treatment more challenging for doctors and mental health care providers. Mental health conditions that commonly co-occur with GAD include:

Panic disorder
Phobia
Substance abuse
Depressive disorders
Post traumatic stress disorder
Eating disorders

Treatment

Like other mental illnesses, GAD likely responds to one of the two types of common psychiatric treatment options:

Medications. There are commonly two groups of medication usually prescribed by doctors to help treat the symptoms of GAD – anti-depressant medications and/or benzodiazepines.

Anti-depressant drugs, although mostly used to treat depression, are also helpful in treating anxiety disorders including GAD. Nowadays selective serotonin reuptake inhibitors (SSRIs) or serotonin neuro-epinephrine reuptake inhibitors (SNRI) are the most commonly used ones. These drugs may have to be taken for several weeks before any positive response to the suffering from GAD symptoms may become evident. Antidepressants can cause some side effects like headache, sleeping problems, or nausea, which are more likely in the beginning of treatment of dose adjustments. Hence it is important to see the prescribing doctor regularly to monitor response and potential adverse events

Psychotherapy. Cognitive behavioral therapy or CBT is most commonly recommended type of psychotherapy that works to focus on the thought and behavioral patterns that triggers anxiety. Such negative thoughts and behaviors are eventually altered with positive thoughts and behavior.

While some may respond positively to medication, others may show improvement with psychotherapy. The doctors will discuss and determine the appropriate treatment for each individual based on the level of severity of the disorder. Combination of both modalities might get better response rates especially in complicated, treatment resistant cases, though each modality may work alone, too.

Exercise for Mental Health

2012-08-24T16:29:45Z

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Health and wellness is increasingly getting popular for many people, not just the young and active, but even for the elderly. The surge in health food supplements, healthy diet concoctions, various exercise programs like pilates, aerobics, and most recently zumba fitness are clear indications that more people are into healthy living nowadays.

For a person’s body to be able to work and function properly, regular exercise should be kept as part of one’s daily activities. This is notwithstanding the other healthy lifestyle habits one has to inculcate in one’s self to be able to have a good physical and mental well being. Surely, at some point in time, you have felt better and invigorated after a good exercise regimen or even just a walk around the block. Exercising can take many forms: a workout in the gym, a lap or two at the running tracks, a swim at the pool, an early morning or evening walk around the park or an hour of zumba fitness in the health club. Whatever form it is, exercise helps to keep the body and mind healthy and active.

People used to exercise to keep their body in good shape. These days, some people exercise to have a good emotional and mental well-being, as exercise can help improve depression, anxiety, self-esteem, drive away problems, and give a sense of control.

In general, people who are physically active tend to have less anxiety, depression, and stress than people who are sedentary. Research suggests that exercise can help specific mental health problems. A relapse of depressive symptoms may be prevented if a person keeps a regular exercise regimen.

If we take into account today’s world of household and office or work-related chores being automated, it is clear that there is a greater need to keep regular exercises in the daily routine. There is less and less physical activity because almost everything is on automatic mode. And a sedentary lifestyle may bring about a lot of problems not just in one’s body but also in mind such as depression, low energy, poor motivation, etc.

Effects of No Exercise

People who lead a life with limited physical activity are more likely to develop:

Depression or low morale
Tension
Anxiety
Sleeping problems
Memory problems

Benefits of Exercise

Knowing that exercise has helpful effects on the brain even for the elderly, one should be able to get some exercise even for a short duration few times each week. Exercise is said to have good effects and benefits on one’s mental health; improving brain functions of the older people, and preventing and slowing dementia. There are research studies that show that exercise increases the level of brain-derived neurotrophic factor or BNDF, a substance that is said to improve mood and help brain cells live longer.

The treatment for some mental disorders and illnesses include exercise and keeping a healthy lifestyle. Exercise has been linked to significantly reduced symptoms of two of the common mental conditions, depression and anxiety disorders. Physical activity has been consistent in causing enhanced physical condition, life contentment, cognitive functions, and psychological or emotional state. Because of these findings, doctors have prescribed exercise as the first line of treatment for mild depression and anxiety disorders.

Other forms of exercises like aerobics, jogging, swimming, cycling, dancing, etc., have been proven to reduce anxiety and depression which is caused by the increase in blood circulation to the brain and by an influence of the hypothalamic-pituitary adrenal (HPA) axis on the physiologic reactivity to stress. The HPA axis gives communication signals or messages to the different regions in the brain including the limbic system which is associated with motivation and mood; the amygdale which is associated with generating fear in response to stress, and hippocampus which plays role in memory formation including mood and motivation.

Patients with schizophrenia also benefit from exercise showing improvements on weight control, reduced blood pressure levels, increased energy levels, etc.

Other health benefits derived from regular exercise include:

Improvement in quality and duration of sleep
Enhanced endurance
Relief from stress and worrying
Better mood
Invigorated strength and energy
Reduced fatigue
Improved mental alertness and focus
Decrease in cholesterol levels
Improved cardiovascular condition

Patients suffering from some serious mental illness could benefit from exercise interventions as a helpful treatment along with psycho-pharmacology and psychotherapy.

Helpful Tips to Remember when Exercising

Any form of exercise should be done in moderation for safety reasons. It is a good idea to talk your doctor before starting exercise. Following these simple tips will get you through a good physical activity:

Start slowly. A moderate level of exercise is a good way to start. Increasing the activity should be in stages to allow the body to absorb the physical strain caused by the exercise.
If the activity is causing severe pain, especially chest pain or severe breathing problems, discontinue the exercise. Shift to a lighter activity. If pain symptoms continue to manifest, call or visit your doctor.
Start with simple physical activity like walking, cycling, swimming, or short-distance jogging. You should not push your body in the early stages of the exercise program.
Test your exercise level using the talk-sing test. You are doing okay if you can talk during exercise; if you can sing during exercise, you should increase the activity level; if you are not able to talk, you need to slow down and decrease your activity level.
Allow a 5-minutes cooling down after exercise. Light stretching may be done during the cool-down period.
Drink water, before and after the exercise.
Moderate exercise for a total of 2-1/2 hours in a week should work your body fine

Make daily activities part of your exercise program. You can:

Walk to work or to do errands.
Mowing the lawn, raking leaves or shoveling snow
Sweeping or vacuuming
Taking the dog for a walk or engaging in play activities with children

Remember that exercise is not just for those who want to keep in shape and to be physically fit. It helps with one’s emotional and mental well-being, too. When stressful situations arise, a good 30-minute exercise may help improve your emotions and alleviate your mind of the stress. It is a good way to improve your self-esteem and have an optimistic and better outlook in life in general.

Learning and Improving Self-Confidence

2012-08-24T16:31:44Z

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Self-confidence is important in almost every aspect of a person’s life and yet everybody seems to be struggling to develop it. Without it, success will be elusive. Self-confidence seen in people who have it inspires confidence in others – peers, bosses, customers, and friends. A person can find success when he or she earns the confidence of other people.

There are two main features that contribute to self-confidence: self-efficacy and self-esteem. A sense of self-efficacy is gained when you see yourself attaining goals with mastered skills. This kind of confidence if learned and used properly will get a person to succeed. And it’s this type of confidence that makes people to meet challenges, and overcome when faced with setbacks.

This overlaps with the concept of self-esteem, which is a more general sense of coping with your life and deserving to feel happy. This comes partly from a feeling or sense of approval from people around you – something that you may or may not have control of. It also comes from knowing that your behavior is virtuous, that you have competence at what you do, and that you can succeed if you put your mind to it.

Affirmations and positive attitude can help build up self-confidence. By setting reasonable, attainable goals and working to reach them you are building your competence, and self-confidence comes with competence. Without it, what you will have is a shallow over-confidence along with all of the issues, failures and frustrations that it brings.

Your level of self-confidence can manifest in many ways – your behavior, body language, manner of speaking, what you say, etc. Check the list below and determine the actions or thoughts which you recognize in yourself and the people around you:

Self Confident Behaviors

The ability to do what you believe to be right, even if faced with strong opposition or criticism from other people
The willingness to take risks and go beyond what is expected to achieve better things
The openness to admit mistakes in order to learn from them
Being humble enough to wait for others to congratulate you on your achievements and not bragging about them
The ability to graciously accept compliments without sounding arrogant

Poor Self-Confidence Behaviors

The mentality of doing everything based on what other people think or expect
Practicing self-regulation by avoiding risky undertakings and staying in your comfort zone due to fear of failure
Exerting effort to cover up mistakes and finding means to fix the problems getting noticed by anyone
Pronouncing your own virtues to everyone as much as possible
Returning compliments with arrogance

From this list, one can see that poor self-confidence can be destructive and manifest a level of negativity. On the other hand, people who are self-confident are generally carrying positively inspired attitude – believing in what they are capable of doing and what they are capable of and the need to live their lives to the fullest.

Building Self-Confidence

Fortunately, there are skills that can be learned and practiced in order to improve self-confidence – whether you are doing it for yourself or for other people. The downside is – it cannot happen overnight. It takes time to build self-confidence.

So how do you build this sense of balanced self-confidence? For anyone who has the focus, will, discipline, and commitment to do what’s necessary, building self-confidence is possible. And what’s even better is that the things you’ll do to build self-confidence will also build success – after all, your confidence will grow with real, solid achievements.

Below is a basic three step approach to self-confidence:

Step 1: Preparing for Your Journey. As the first step this involves getting yourself prepared for your journey to self-confidence. You have to pause for a while to assess your present situation, and where you see yourself moving forward. Getting yourself to have the proper mindset for your mission, and making a commitment to that cause, will be a good way to start your journey.

To best prepare for this journey, it is recommended to do the following:

List down your major achievements
List the ten best things you’ve achieved in an “Achievement Log.” An example would be when good grades from projects, tests, and other similar accomplishments
Think about your strengths and what other people see as your strengths and weaknesses.
Take time to check your values, what you want most and what you want to be in the future. By setting your goals you have clear directions on what you need to do to achieve them
Start managing your mind and mood
Commit yourself to success. Promise to yourself and your loved ones that you will do everything in your power to achieve your goals

Step 2: Setting Out. This is where you start moving towards your goal. By doing the right things, and starting with small, easy wins, you’ll put yourself on the path to success – and start building the self-confidence that comes with it.

Determine the knowledge, skills and abilities necessary and start to learn, practice, and improve them
Focus on the basics. Don’t reach for perfection right away. Remember the perfect can be the enemy of “good enough.”
Set small, realistic goals, and get into action to reach them. Don’t set goals which are particularly challenging at this stage.
Hone your stress management skills. Continue positive attitude and thoughts. Learn to handle failure, be open and honest with yourself and people around you. Accepting your mistakes.

Step 3: Accelerating Towards Success. By this stage, you should notice your self-confidence improving. Now, you may start stretching yourself to meet bigger goals and tougher challenges. Commit more and extend the skills you need in order to achieve the new challenges.

Self-confidence is a very important asset for everyone – a clear understanding of what you can achieve and a clear vision of what you can become. Believing in yourself, in what you do and in the ideas and dreams that you have –are among the basics of self-confidence.

Learning and Practicing Self Compassion

2012-08-24T16:32:23Z

Self-compassion is giving yourself the treatment you would normally give to a dear friend. Feeling compassionate about yourself has no difference in feeling compassionate for others. In order to be compassionate, you have to notice that they, the other people, are suffering. Only if you appreciate and take a better look at the difficult situations of other people can you show compassion to that person.

In much the same way, you must recognize your own suffering or difficulty in order to be compassionate to yourself. People who are self-compassionate steer clear of ruthless assessment or un-constructive criticism of themselves, seeing their flaws or deficiencies as a part of the human condition. This does not mean they do not try to correct them and improve themselves.

Compassion involves being affected by other’s suffering in a way that makes your heart feel their pain. When this happens, you are filled with the desire to extend your help to the needy person in some way. Being compassionate also means that we skip harsh judgement when others make mistakes or fail and instead offer understanding and kindness. Feeling compassionate for others includes realizing that imperfection, misery, or disappointments are part of anyone’s life.

Self-compassion is doing all of those compassionate things towards yourself during difficult times, failure, or even when you don’t like something about yourself. Normally, under these circumstances, you ignore your pain alongside giving unkind judgment and criticisms of yourself. By practicing self-compassion, you comfort and care for yourself when under a difficult situation. You extend the same kindness and understanding to yourself when faced with personal failures. It comes with the acceptance that no one is perfect, including yourself. Any changes, you do to become healthier and happier, must be done not because you think you are of no value, but because you care about yourself, first and foremost.

Being compassionate to yourself is accepting and acknowledging that you are a human being, like everybody else. And that in one’s lifetime, things will not happen the way you expect them to; there will be disappointments, failures, and setbacks. By acknowledging this reality, you will be able to open your heart to feel compassion for yourself and others.

The Three Elements of Self-Compassion

Kindness to Yourself. When things go astray, you feel inadequate and a failure. With self-compassion, you are extending the understanding towards yourself just like you would to a friend or family member. Sparing yourself from self-criticism and unforgiving judgment and being kind yourself is showing self-compassion. When you recognize and accept that life comes naturally with imperfections, failures, difficulties, or frustrations, you will learn to be gentle with yourself instead of getting angry or frustrated. Circumstances that fall short of your expectations are frequent and inevitable. Therefore they should not cause unnecessary stress, self-criticism, or disappointment.
Common humanity. Being human means being vulnerable, mortal, and imperfect. With this acceptance, no amount of shortcomings, failures, or disappointments should be enough to make you feel that you are the only person suffering or feeling inadequate. You are experiencing this reality of human life along with other fellow human beings. Being self-compassionate is recognizing the fact that as humans, people do not have full control over their circumstances and even sometimes to a degree over their behavior. External factors like genetics and environment come into play that could have a positive or negative impact on such behavior. If everyone recognizes one’s essential interdependence, failings and life difficulties shouldn’t have to be taken on a personal level, but can be accepted with compassion and understanding.
Mindfulness. Having a balanced attitude on one’s negative emotions, thoughts, or actions will thwart suppressed or exaggerated feelings under difficult situations. That’s having self-compassion. And this attitude is brought about by relating personal experiences to that of the experiences of other people who are also suffering. This puts your own predicament into a larger perspective, helping you to notice the bigger picture and not feel victimized with your own situation. The willingness to open up and feel one’s own negative emotions and thoughts is required to reach mindful awareness. Mindfulness is a non-judgmental and sympathetic state of mind wherein one objectively observes thoughts and feelings without any attempt to suppress or deny those thoughts or feelings. One cannot ignore pain and feel compassionate about it at the same time. Mindfulness also means that one should not over identify or become preoccupied with thoughts or feelings and avoid being swept away by negative reactions.

Self-Compassion is Not –

Self-pity. Having self-pity is being absorbed by one’s own problems and forgetting about other people who may be in similar situations. One misses his interconnections with other people and harbors a feeling of isolation in terms of feeling that they are the only ones in the world subjected into such suffering. Self-pity usually emphasizes self-centeredness, selfishness, or insensitivity so much so that the feeling of personal suffering is almost always exaggerated to unprecedented levels.

Contrary to self- pity, self-compassion allows one to relate his experience to the experience or situations of other people around him. One does not entertain feelings of isolation and disconnection of the world. Self-compassionate people have a more balanced and objective view of situations and are not embroiled in their own emotional crisis.

Self-indulgence. Some people have this notion that being self-compassionate means they are letting themselves get away with anything. Always making excuses of feeling stressed out or overwhelmed, in order to do things like watching TV all day or eating unlimited amounts of comfort foods, is not self-compassion. It is self-indulgence. One should keep in mind that self-compassion should bring happiness, health, and serenity in the long run. With self-indulgence, you are always in the pursuit extreme pleasure, which usually harms your well-being. This could lead to addictions, laziness, and health problems. To be successful one should be able to work hard, postpone gratification, and limit pleasure and sometimes sacrifice from short gains for bigger rewards on the long run.

In general, people can be very hard on themselves especially when they know they need to change something about themselves, but are worried about being ashamed with such actions. This is the self-flagellation approach which can backfire if one is not able to accept difficult truths about oneself for fear of hating yourself. Such weaknesses may remain unacknowledged when one avoids self-observation, -reflection, and -examination.

On the other hand, compassion comes with inherent and natural caring, motivating growth and change. It also provides the safety needed to see oneself with total clarity but without fear of self-condemnation.

The Facts about Stress

2012-08-25T02:43:43Z

Every person experiences stress at some point in time. Some tolerate and manage it well, some cannot. Because people have different thresholds for stress and use different coping mechanisms, the impact of stress on their physical and mental well-being varies.

Everyone’s life is faced with problems, challenges, hassles, and pressures. No one is exempted from that. For some, these experiences help them respond well to stressful situations. Unfortunately, there are those who are not able to respond well to problems or situations that warrant stress or fear or anxiety.

Stress, like fear is a normal human response activated when faced with events or situations that make you upset or threatened. Technically, it is defined as the way the brain responds to any stimulation. If the situation presents some kind of danger or uncertainty, the stress caused by such will let the body and mind respond in a protective way. One becomes alert and focused, ready for any eventuality. In some cases and situations, the stress response could even be lifesaving.

Types of Stress

Stress can be categorized in three groups:

Good stress or Routine Stress – This is when stress is used to rise to the challenges. This kind of stress usually has good outcome and can be helpful in one’s learning and growth. This usually stems from pressures derived from work, family, and other daily responsibilities.

Tolerable stress – This is the person’s response to some bad events like losing a job. Most has the tools to hold up and contain the emotion. Reaching out to one’s support network helps in one’s coping with the bad situation.

Toxic stress – This stress is elicited when something bad happens and some people cannot activate inner resources or reach out to their support network to deal with the situation. These people seem to have vulnerability in coping or controlling their response to stress, which is likely triggered by environmental factors. This may cause major emotional and physical crisis.

Like fear, people respond to stress in different ways. It is important that a person understands the level of stress he can tolerate and cope well, and what level of stress can cause uncontrollable situations and anxiety disorders. Generally, people respond to stress in three ways:

Angry or agitated response. Your emotions are high, restless, disconcerted, tense, and jumpy.
Withdrawn or depressed response. Low energy and no significant reaction or emotion. You shun people and isolate yourself.
A tense and frozen response. It’s a concealed agitated response, showing no violent reaction. You may look paralyzed but underneath is extreme distress.

Symptoms of Stress Overload

There are signs and symptoms which indicate if your stress level is overboard.

Cognitive Signs – The warning signs include failing memory, lack of focus or concentration, poor judgement, racing thoughts, and constant, endless worrying.
Emotional Signs – The warning signs may range from frequent mood swings, irritability, extreme nervousness, overpowering feeling, severe loneliness, feeling of isolation, and depressed mood.
Physical Signs – The warning signs evident are constant bodily pains and aches, upset stomach, bowel movement problems (diarhea or constipation), nausea, vomiting, palpitation or hyperventilation, tightness of chest, loss of sexual desire and frequent bouts of cold.
Behavioral Signs – Stress is manifested by poor eating habits, bad sleeping habits, isolation from other people, forgetting responsibilities, alcohol and drug consumption to relieve stress, constant jittery gestures like nail-biting, cracking of knuckles, etc.

Common Stressors

Factors that contribute to the onset of stress symptoms are called stressors or triggers. These factors may be external or self-generated, such as:

Big life changes
Work, business or profession
Difficulties in relationships (family members, wife, children, friends, associates, etc.)
Financial crisis
Hectic schedule
Pessimistic attitude
Unrealistic projections and expectations
Perfectionism
Passiveness
Negative value on self

Managing and Coping with Stress

If stress is not addressed and resolved, the effects it may have on a person might lead to an uncontrollable emotional outburst. One needs to undertake practical measures to maintain one’s physical and mental health which can reduce or minimize these negative effects. Learn how to:

Maintain a good support group or network of people who can help you talk through the situations
Recognize signals sent out by your body about overwhelming feeling of stress like sleeping problems, increase in alcohol or drug consumption, etc.
Focus on positive thoughts like accomplishments for the day and not dwelling on failures or disappointments
Set priorities according to urgency. Don’t get yourself overwhelmed with numerous tasks
Keep a regular 30-minute exercise regimen to help improve mood and get rid of stress.
Explore and engage in relaxation activities
Get proper care and treatment for existing or new problems
Consult with a professional mental health specialist when feeling overpowered by stress, feeling you are unable to function well and resorting to alcohol and drugs as coping mechanism.
If you are entertaining suicidal thoughts, it’s time to seek professional help. Remember to call crisis/help lines or 911.

When a person feels stressed out, she or he may try the following:

Take deep breaths in longer gaps (do not exhale before counting to ten slowly)
Have a long warm bath
Divert attention to music
Walk around the house, or the park or just taking long walks
Do yoga exercises
Go to a spa for a massage
Drink warm milk or anything that has no alcohol or caffeine content

One’s ability to cope with stress is largely dependent on one’s lifestyle choices. Keeping it to the basics : Healthy and balanced diet, good sleeping habits, regular physical and mental exercise and strong social networking, will help you get the inner strength and resources needed to ward off and manage toxic stress.

Try to get as much sleep as possible
Keep in touch with family and friends for support
Engage in regular physical and mental exercise to help ward off toxic stressful feelings
If one is smoking, try to quit. Just as alcohol and caffeine triggers stress so does nicotine.

Stress Relief

Stress is part of life. Having some stress is normal. However, if one gets too much stress, it can affect one’s quality of life and health. Hence, certain steps should be taken to get relief from stress.

A person should understand the problems causing stress and carry out actions to solve the problem or manage the response. The first step in successfully relieving stress is identifying what are causing the stress and making a decision to implement changes in how one manages such stressors. A simple example would be changing the TV channel if the program is showing news that are too distressing. If there is no way to avoid a stressful situation, one can think of ways to divert the mind from thinking too much about the situation – listening to music on an mp3 player may be a good way to reduce the stress. One can also ask family and friends for help by checking with them their own ways of handling stress. Or maybe one can try some tai chi, meditation techniques, yoga, or other relaxation exercises. As stress is not about to leave one’s life, one might just as well learn to deal and cope with it.

Relaxation Techniques

One important part of managing stress is doing relaxation exercises. Relaxation is essential in keeping a good health and well-being. And it can be achieved quite easily if a person practices the process. The following activities may help to some during stressful situations:

Hands and arms

Make your hand into a tight fist
Bend the hands back at the wrist feeling the tension release
Bend arms at the elbows with hands made into fists and taut biceps.
Shrug shoulders

Head and neck

Make your forehead wrinkle into a deep frown
Give the widest smile possible
Press lips tightly together
Press the head back against the floor
Touch the chin to the chest

Face Blindness or Prosopagnosia (Facial Agnosia)

2012-08-24T16:56:48Z

Face blindness or prosopagnosia impairs a person’s ability to recognize faces. A married man can wake up every day not recognizing his wife who he was sleeping with in the same bed for years. This is not a problem with his memory because if he hears her or his wife’s name is mentioned, he knows her pretty well.

This poorly understood neurological disorder often comes with other types of recognition impairment, say, place, car, facial expression, or emotion. In general though, face blindness is confined more strictly to facial identity.

It is not surprising to know about the social problems and difficulties experienced by persons suffering from the condition – imagine a person having difficulty in recognizing members of his own family, close friends, and in some cases, even themselves.

Symptoms of Prosopagnosia

While everyone normally experiences at some point in time some difficulty in face recognition or in remembering names, face blindness is on a level that is much more severe than usual forgetfulness. The difficulty in face recognition by prosopagnosics extends to people they have been seeing on a regular basis or spending most time with, like spouses or children.

To offset the impairment, people with prosopagnosia rely greatly on other information such as hair, way of walking, built, or clothing which are all non-facial features of a person. And because they have trouble even imagining the facial appearance of people they know, it is hard for them to even keep track of the identity of the famous characters in even the most popular TV shows and movies.

There are tests available online which will help assess your abilities on facial recognition. Harvard University and University College London have developed diagnostic tests for face blindness which are available through a website (http://www.faceblind.org). They use the data collected from such tests to determine and identify hundreds of individuals who are face blind.

Causes of Face Blindness

Documented cases of face blindness showed that the impairment had been an effect of damage in brain suffered from head trauma, degenerative diseases, or stroke. These patients before the trauma or stroke were able to recognize faces without any difficulty. After the trauma or stroke, the facial recognition ability became impaired. Cases of acquired prosopagnosia were made known to the public for two reasons:

The fact that they were able to recognize faces before trauma, they can notice the difficulty they experienced after the trauma.
Their sickness or condition (head trauma, stroke, etc.) made them always in contact with medical doctors who can detect and assess their face recognition abilities. Their assessment will then result to ordering further face recognition tests.

Developmental prosopagnosia is associated with individuals whose face blindness has genetic links (genetic prosopagnosia), or when individuals suffer prenatal brain damage (preexperiential prosopagnosia), or when individuals suffered brain damage or severe visual problems when they were very young (postexperiential prosopagnosia).

Persons with developmental prosopagnosia usually are not aware that they are unable to recognize faces as well as other people. This is because they have never recognized faces normally which makes their impairment not obvious to them. This could be the reason why there were a number of individuals who became aware of their face blindness only when they reached adulthood.

Prosopagnosia is, as mentioned earlier, a poorly understood disorder. Currently, there are very limited understanding of prosopagnosia, and this is primarily due to the few cases of face blindness that have been thoroughly investigated and studied, especially for developmental prosopagnosia.

Treatment

Individuals suffering from face blindness or prosopagnosia are taught to learn other ways to remember faces. Social situations may pose anxiety and awkwardness and may cause severe shyness. We hope researchers will discover or develop new ways to help individuals with prosopagnosia improve their face recognition abilities. You may find more info and watch clips from a 60 Minutes episode about facial blindness: http://www.cbs.com/shows/60_minutes/ .

Sleep Disorders and ADHD

2012-08-25T02:44:20Z

Attention Deficit Hyperactivity Disorder or ADHD in children may manifest symptoms that are similar to sleep disorders. Some of the shared symptoms are : restlessness, over-active behavior and lack of focus or attention. Children apparently have the opposite reaction or response when sleep is disrupted. While adults with sleep problems tend to become less active and weak, children are the opposite. They become hyperactive to an extent.

A mental disorder known as ADHD (Attention Deficit Hyperactivity Disorder) is characterized by hyperactivity, inattention, and inability to control urges or drives. ADHD has proven links to various sleep disorders.

Children who have ADHD may be observed to have disturbed or interrupted sleep. Studies have shown that ADHD children have more severe sleep disorder than other similar illnesses. There are more below on relationship between ADHD and some Sleep disorders:

Snoring and ADHD. Snoring in children is usually caused by large adenoids or tonsils blocking the airway. This blockage may develop into sleep apnea and cause ADHD-like symptoms. Snoring may be a reason for poor sleep quality and this may eventually cause attention problems the following day. Studies have shown that snoring is common among ADHD children. And snoring children are likely to be afflicted with ADHD as well.

Removing the tonsils or adenoids is found to help improve the child’s sleep pattern and better behavior without the need to take medications.

Sleep Apnea and ADHD. Apnea means ‘without breathing’. Sleep apnea is used to describe airflow disruption of at least ten seconds. One of the three kinds of apneas is obstructive apnea – it makes up *65% of all apneas. The absence of airflow from the nose and mouth to the lungs happens during obstructive sleep apnea. There is no airflow because the entrance to the trachea is blocked caused by various collapsed structures in the pharynx. The respiratory muscles continue to make efforts to get air into the lungs even when the trachea entrance had closed.

In general, people with sleep apnea have episodes of stopped breathing. When this happens, they are awakened from their sleep – awakening could happen from early stage of sleeping and even from the time they are already sleeping soundly. Even with the awakening, one will remain absolutely oblivious of the sleep interruption or breathing disruption. The episodes are likely to happen many times during the night.

In the U.S. there are more or less *2% of the children population who manifest some form of disrupted breathing while sleeping. Enlarged tonsils and adenoids are found to be the most noted reason for the children’s having apnea. This sleep problem observed in children may also be caused by obesity and chronic allergies. As with adults, children with sleep apnea will be tired during the day.

There is treatment available for sleep apnea in children. To begin with, your pediatric doctor or a specialist for ear, nose, and throat problems can identify and diagnose if your child’s tonsils are causing the apnea. The size of the child’s tonsils must be significantly larger than normal to cause obstruction in the airway to cause breathing disruption. For the diagnosis of sleep apnea to be confirmed, the child should undergo polysomnogram – a special laboratory-based study of sleep. Some children may have enlarged tonsils or are snoring loudly but do not have sleep apnea.

For children with abnormally large tonsils and adenoids, the treatment option is surgery. There are other treatments available for those having constrained breathing while sleeping due to other health problems.

RLS (restless leg syndrome) and ADHD. Restless leg syndrome is characterized by crawling sensations felt in the legs or arms which are very uncomfortable and annoying. This creates an overwhelming urge to move, thereby causing disruption in sleep and sleepiness during the day. People with RLS are not able to get good sleep. Hence, they will experience inattentiveness, moodiness, or hyperactivity. These are the same symptoms for ADHD. RLS is identified using polysomnogram or sleep study. Both ADHD and RLS may be treated with medications.

These cases show the clear relationship between ADHD and Sleep disorder symptoms. It sometimes happens that because of the overlapping symptoms of ADHD and Sleep disorder, some patients are misdiagnosed for the other disease.

Ways to Help ADHD Children Get the Needed Sleep

Stay away from caffeine or other sleep-disrupting food or beverages. Check the label of the foods being eaten by your ADHD child. They increase nervousness, agitation which results to interrupted and disrupted sleep.
Keep a consistent and regular routine for sleeping, waking up or even eating schedules.
Soundproof your kid’s bedroom to shield from outside noises.
Don’t take sleep medication unless prescribed and recommended by the doctor..
Check for other medical problem or illnesses. Asthma, allergies and other conditions which cause airway narrowing or pain may contribute to disrupted sleeping.
Introduce your children to a light exercise regimen during the day. Exercise should not be done near bedtime.
A hot bath before bedtime can do wonders. A cool-temperature room may be helpful for a child to sleep in after a warm bath.

*Sourced from webMD

Sleep Hygiene

2012-08-25T02:44:36Z

Photo by: CarbonNYC

People have different reasons for not getting enough sleep – stress with school, family problems, or work-related issues. Other times, lack of sleep is caused by a sleep disorder, which breaks and disrupts sleep in many ways. And it has significant negative effects on one’s quality of life and health. Sleep deprivation can also put one at risk for serious medical problems. Identifying the causes of sleeplessness and subsequently implementing lifestyle changes will help protect you from daytime exhaustion and health problems.

A lot of times people experience the after effects of sleep loss such as exhaustion, lack of concentration, forgetfulness, clumsiness, and irritability. A person’s overall functioning and feeling during the day reflect how well a person slept the night before. In the same light, some remedies for sleep problems result from one’s daily lifestyle choices and they can make a huge difference in the quality of sleep.

Sleep Hygiene Practices

The following sleep habits, also named sleep hygiene can help optimize one’s nightly rest in order to be productive, focused, refreshed, emotionally stable, and physically energetic throughout the next day:

No napping during the day as this disturbs the normal sleep pattern (possibly except up to 1 hour siesta after lunch).
No stimulants (caffeine, nicotine, etc.), or alcohol. These should not be taken close to sleeping time.
No heavy meals before bedtime.
Not sleep with an empty stomach.
No heavy exercising before bedtime. Usual energetic exercises should be completed at least 4-6 hours before bedtime.
Remove anything that adds to light and noise in the bedroom at night. Keeping the room dim, quiet, with comfortable room temperature and with relaxing music can set the right mood for sleeping.
Practice relaxation exercises like yoga, meditation, deep breathing, light stretching or a winding down routine before going to sleep.
Avoid stressful activities and conversations before going to bed. The subconscious might pick up on these thoughts and cause sleep disruption.
Keeping a regular bedtime and wake up time every day including weekends and holidays.
Use the bed ONLY for sex and sleep and not for other activities like watching TV, reading, surfing internet, listening to the radio, texting, etc.

Keeping a Sleep Diary

Some sleep specialists also recommend keeping a sleep diary where all sleep habits and patterns will be recorded. The diary should contain the following information:

What time you go to bed?
What time you wake up?
What time you wake up during the night, how many times, how long does it take to fall back asleep?
How much alcohol, caffeine, and cigarette were consumed and at what times?
What time you had your meal, what food you ate and beverages you drank?
Any emotion or stress experienced during the day, and what time?
Any drugs or medicine taken and what time they were taken?

The sleep diary may contain more than the information listed above. Any information that might be associated with having sleep problems should be included. This will help the doctor or the sleep specialist to identify the possible triggers to the sleep problem.

Sleep Hygiene for Travelers

A common problem of frequent travelers is jet lag. The change in time zones causes disruption in the body’s biological clock and the difficulties in adjusting to the new time zone results to sleep disturbance. There are ways to minimize the effects of jet lag on one’s sleeping pattern:

Condition the mind and body to the change in time zone when you make the trip by adjusting your sleeping and waking up schedule according to the time zone of your destination a week or so before the scheduled travel date.
Adjusting your watch to destination time as soon as you board the plane.
If possible, select a flight that arrives in the destination early evening.
Do not take alcohol or caffeine for 3 – 4 hours before bedtime at your destination.
No heavy exercising before bedtime.
Use earplugs and blindfolds to mask outside noise and lighting while sleeping.
Don’t stay indoors most of the time as this worsens the jet lag.
Make arrangements with the hotel for voice mail services and let them handle all your calls.
Request wake-up calls from the hotel staff.
Some people find use of melatonin to induce sleep helpful.

A change in the environment, i.e., time zone, requires the body and mind some time to adjust. By allowing the mind and body to prepare early for such anticipated change, the adjustments will be less when you are actually in the new time zone area.

Sleep Hygiene for Older Adults

As people age, there are normal changes in the sleeping patterns – sleeping and waking up earlier, and feeling rested even with less deep sleep. However, if less sleep becomes disturbing and disruptive to daily functions, it is not any more a normal part of aging. And just as good sleep is important to younger people, so it is as equally important to senior people as it helps maintain good concentration and memory function, refreshes the immune system, and allows the body to recover from the effects of cell damage that happened during the day. The following sleep hygiene tips can help alleviate age-related sleep problems to have better sleep at night:

Limit caffeine intake late in the day. Avoid caffeinated drinks such as coffee, tea, soft drinks and chocolate.
Don’t take alcoholic beverages before sleeping because alcohol disrupts sleep.
Keep stomach satisfied before sleeping. Light snacks like crackers, cereal, and warm milk may help having a good night sleep.
Do not eat big meals or spicy foods before bedtime. Spicy food can cause indigestion and stomach discomfort. The best is eating dinner at least three hours before sleeping.
Reduce intake of liquid before sleeping to minimize middle of night bathroom visits. Drinking liquid should be limited an hour and a half before sleeping.