OUR America!

Write Down Everything!

Nothing is more stressful than failing to fulfill responsibilities or meet commitments, and conversely, nothing is more gratifying than knowing you are completely reliable. What’s the easiest way to achieve this?

Give your memory a break and keep a calendar on which everything you must accomplish is noted.

Write down appointment times, daily chores and who’s responsible, due dates for library books, assignments and borrowed items. Include social engagements like lunches, parties, weddings and any other get-together you plan. At the beginning of each year write in all the birthdays, anniversaries and special celebrations you want to acknowledge. I even calendar  gardening tasks, reminders to make annual appointments, and notes when it’s time to take the dogs to the vet.

EVERYTHING for which all family members are responsible goes on the calendar; and we each check it every morning and evening in order to know today’s tasks and then to prepare for tomorrow’s.

It’s simple. Organize your time to increase responsibility and relieve stress.

WRITE IT DOWN! And teach your children to do the same.

This is the most recent installment in an ongoing series elaborating on 52 proven stress relievers identified by researchers at Texas Woman’s University.

People with health problems frequently complain that their sleep is compromised; and sleep issues are almost always a factor for those living with brain disorders or mental illnesses. For almost everybody, any given day’s productivity and level of contentment are directly linked to the quality of sleep the preceding night. Because a good night’s sleep is vital to our overall well-being, each of us would be well-advised to follow these simple sleep hygiene guidelines:

1. No Sleeping In

If you failed to get a good night’s sleep, DO NOT oversleep the next morning. This is critical in recalibrating your body’s sleep cycle. Getting up at the same time every day is the best practice for maintaining a good sleep schedule, but it is vital on a morning after you’ve lost sleep. If you sleep late for just two or three days, you might reset your body clock so that you’ll get sleepy later, awaken later, and fail again to get quality sleep.

2. Set Your Body Clock

Light helps to restart your body clock to its active daytime phase. When you get up in the morning, go outside and get at least fifteen minutes of sunlight. If that’s difficult, or not possible due to the time of day or year, turn on all the indoor lights in your and walk around your house for fifteen minutes. Send the message to your brain that it’s time to be up and wake up. Walking around will get your blood circulating and send more oxygen to your brain to jump start the process.

3. Exercise

Participate in at least thirty minutes of  physical activity during the day. This is the minimum amount of exercise recommended for everybody’s  fitness and well-being, but it is especially important the day after a bad night’s sleep. When you sleep less, make every effort to be more active during the day. A less active lifestyle is particularly problematic for an insomniac. Strenuous exercise, like bike riding, brisk walking, swimming, or  jogging, in the late afternoon promotes more restful sleep. Studies have also shown that insomniacs often are inactive the last two hours before bed. Avoid this by doing some gentle exercise during this time. Consider a slow-paced walk, Anusara yoga, or a stretching routine.

4. No Naps!

Do not take any naps the day after you’ve lost sleep. When you feel sleepy, get up and do something. Walk, make the bed, or do your errands. If your work requires long hours at a desk, get out of that chair every 30 minutes or so and walk around the room. Do a quick exercise routine or take a short walk to increase the flow of oxygen to your brain and increase alertness.

5. Set and Stick To a Bedtime

Go to bed at the same time every night. Be regular. Over time your body will develop a sleep schedule not unlike your hunger cycles. You’ll develop a pattern of healthy sleeping.

When you are having trouble sleeping, do what sleep laboratories teach –go to bed later than usual. If you’re only getting five hours of sleep a night during a period of insomnia,  stay up later and go to bed just five hours before your wake-up time. For instance, if you’ve been waking up at 7 a.m., don’t go to bed until 2 a.m. And remember–No Naps! As your time in bed becomes good sleep time, move your bedtime back 15 to 30 minutes a night until you reach a sleep cycle of 7 to 8 hours per night.

Here are some other suggestions to achieve a good night’s sleep:

Make your space comfortable. Clean sheets, a comfortable pillow and a cool, dark, well-ventilated room are musts.

Keep a notebook and pen on your bedside table to jot down thoughts and ideas to avoid worrying.

Avoid alcohol, sleeping pills, caffeine and cigarettes. All disrupt the natural sleep cycle.

Have a light snack an hour before bedtime. Good choices include:

Dairy products
Soy products:
Seafood
Poultry
Whole grains
Hazelnuts, Peanuts
Eggs
Sesame seeds, sunflower seeds

If sleep eludes you stay in bed for no more than half an hour, then get up and do something quiet until you feel sleepy again. Avoid looking at the clock and don’t worry about not sleeping. Stick to the plan and you’ll soon have a new, healthy sleep routine.

We’ve made such progress in medicine, learned so much about treatment, especially in the area of mental illness or disorders of the brain. Unfortunately, our actions aren’t keeping up with our knowledge.

Are we caught a medical crisis?

Or a moral one?

Last week, representatives for the Substance Abuse and Mental Health Services Administration, part of the U.S. Department of Health and Human Services, released a report stating that more that 10% of American adults experienced serious psychological distress in the past year. This means that 24.3 million people ages 18 years or older  dealt with serious issues like chronic depression, bipolar disorder, anxiety and schizophrenia. Even more alarming is the fact that fewer than half of those people — our neighbors, friends and relatives — received treatment.

What does it say about our system, our society, when in the year 2008, nearly 13 million of our citizens suffered, untreated, with serious illness? Illnesses that are treatable?

Something must change.

As our country grapples with economic issues, not the least of which is health care, we would be wise to remember that mental illness affects one in five families. That’s a lot of families who experience not only loss of income, but also other expenses related to illnesses that could be managed with proper medical care.  And that proper care, that treatment, is much less costly than expenses which ultimately come out of taxpayers pockets, expenses like emergency care and legal and judicial costs often associated with untreated mental illness.

In a statement released along with last weeks report, Eric Broderick, SAMHSA acting administrator said, “As we focus on advancing and protecting the nation’s health we must ensure mental health services are part of the solution.”

Hear! Hear!

Other facts included in the report indicated that our youth, our future, are particularly vulnerable. Consider the following:

– The serious psychological distress rate was significantly higher among young adults ages 18 to 25 at 17.9 percent than among those ages 26 to 49 years old at 12.2 percent or those ages 50 years and older at 7 percent.

– Young adults aged 18 to 25 experiencing serious psychological distress were far less likely to receive mental health services than their older counterparts.

Also disturbing were the facts related to minorities:

- -Fewer than 30 percent of African-Americans and Hispanics experiencing these disorders received mental health services, compared to 50.9 percent of whites.

We can do better.

We must.

A recent Dutch study of over 1200 adults indicated that those with clinical depression had 14% less vitamin D in their blood than did their non-depressed counterparts; and additional studies have identified a link between inadequate vitamin D and poor immune function, early onset age-related vision problems and bone loss. With so many health issues at risk, consider the following options to boost your vitamin D levels and increase health and wellness.

Go outdoors! Spending as little as 15 minutes twice a day, preferably in the early morning and late afternoon, will naturally boost your vitamin D levels. Remember to use sunscreen if you plan to stay out longer.

Eat an abundance of whole foods rich in Omega-3 fatty acids and vitamin D. Good choices include salmon,mackerel, tuna and sardines; scallops, eggs, walnuts, flaxseed and vitamin D fortified dairy products.

Take a multivitamin every day. Talk to your pharmacist or doctor about reputable brands that are readily absorbed.

Take an Omega-3 supplement. In addition to balancing moods, Omega-3’s improve the body’s inflammatory responses, memory, recall and reasoning, have a positive effect on cardiovascular health and seem to prevent the development of some cancers. (For more information on the benefits of Omega-3’s check out the Mayo Clinic trial site.)

Prepare For Each Morning The Evening Before

Having always been a busy woman, I personally attest to the stress-relieving power of this simple practice.

As a college student who also worked part-time, I completed a 5-year program in only three by taking lots of units each semester and going to summer school. After graduation and into my twenties I became the mother of three children, worked full time and attended graduate school. I slept, at most, six hours a night and packed a lot of living into each day’s remaining eighteen  hours.

Over the last twenty years–yes! I’m almost 50!–I’ve kept myself just as busy. And so, I’ve always prepared for each morning the night before.

When my children were still young we selected their clothing the night before, reviewed homework and assignments, had evening bath times, and stowed school-ready backpacks near the door they used to head out to the bus. As they got older, they handled more and more of this prep work themselves, and each developed great organizational skills.

Now that they’re grown, my routine is just a bit different. If I’m going to the gym or taking an early morning yoga class, I lay out my clothes and shoes and make sure my bag is packed and ready before I call it a night. If my day requires professional attire, I hang those garments on pegs just inside my closet, with shoes and accessories on a stool below. If I’m going to the post office, the items to be mailed are on the shelf near the door to the garage so they won’t be forgotten. Tea bags are in cups awaiting hot water, and the next night’s dinner ingredients are in the fridge.  Shopping lists are tucked in the side pocket of my handbag, water bottles are in the car. All this is organized the night before.

In the morning, there is no panic, no anxiety, no emergency, no worry. I am ready for my reduced-stress day!

This is the most recent installment in an ongoing series elaborating on 52 proven stress relievers identified by researchers at Texas Woman’s University.

As many of you know, two of my three children have bipolar disorder; and in our extended family a dozen family members have this or a related diagnosis. And we are far from alone.

The fact is, over 100 million people have friends or family members diagnosed with bipolar disorder. Tom and Fran Smith were a part of that group until their daughter Karla ended her own life at age 26, after a seven-year struggle with this serious mental illness.

During those seven years, Tom Smith says “…we received very little guidance…no one attempted to understand or clarify our frustration, concern and fear; we had no manual that suggested ways to cope…”

After grieving the loss of their vibrant young daughter, the Smith’s were compelled to ease the way for other families in similar circumstances. To that end, they founded The Karla Smith Foundation for  parents and loved ones of people with mental illness. Through support groups, peer-to-peer coaching, and educational programs and events, the KSF helps bring balance into lives that are affected by  mental illness or the suicide of a loved one. In addition to that ambitious endeavor, Tom Smith wrote A BALANCED LIFE: 9 Stategies for Coping with the Mental Health Problems of a Loved One (Hazelden, Sept 2008).

Here, in brief, are those strategies Smith believes will make a difference in the lives of others living with a serious mental illness:

1.–Help our loved one find and continue to take the medication needed for a balanced life.

2.–Urge our loved one to maintain a supportive relationship with a therapist, counselor or sponsor.

3.–Learn as much as we can about the mental disorder of our loved one.

4.–Assist our loved one in developing a healthy self-esteem, since it is critical for a balanced emotional live.

5.–Accept mental illness as a fact of life for our loved one, even though mental illness does not encompass all of life.

6.–Take care of ourselves by proper exercise, sleep, diet, relationships, and by monitoring our feelings.

7.–Become a supportive network of family and/or friends who know about the mental illness and who commit to acting in the best interest of our loved one as far as we are able.

8.–Identify the early warning signs that precede a more difficult phase of the mental illness, and help our loved one when these signs emerge.

9.–Acknowledge our dependence on a Higher Power and seek guidance from that Higher Power in whatever way that is comfortable to us.

In A BALANCED LIFE, Smith commits a chapter to each strategy, illuminating his points with real life stories and experiences. In addition, he includes a series of questions that help families or support groups clarify their feelings and understanding of the facts; as well as easy to understand definitions and explanations of  various mental health issues.

If you know or love someone diagnosed with a serious mental illness, or if you belong to a support group related to this topic, this book is a necessity. An excellent resource on so many levels, A BALANCED LIFE helps families achieve just that.

This article, written by Megan Rauscher and reprinted here in it’s entirety, was originally released by Reuters Health on Monday, January 5, 2009 .

NEW YORK (Reuters Health) - Reduced activity in the part of the brain that helps a person exert appropriate self-control may contribute to the binge-purge syndrome bulimia nervosa, research published today suggests.

In the study, researchers found that women with bulimia responded more impulsively during psychological tests than women without the eating disorder, and brain scans showed differences in areas responsible for regulating behavior.

Dr. Rachel Marsh and colleagues at Columbia University and the New York State Psychiatric Institute, New York, report their findings in the Archives of General Psychiatry.

Bulimia nervosa usually begins during adolescence or young adulthood and primarily affects girls and women. The disorder is characterized by recurrent episodes of binge eating followed by self-induced vomiting or use of laxatives to avoid gaining weight. “These episodes of binge eating are associated with a severe sense of loss of control,” Marsh and colleagues explain.

Certain pathways between nerve cells known as “frontostriatal” circuits help individuals control their own voluntary behaviors. Marsh and colleagues tested these functions in 20 adult women with bulimia and 20 healthy controls using a “cognitive control task” in which a person must indicate the direction an arrow is pointing on the screen (left or right), regardless of where it appears on the screen.

The task is easier, Marsh explained, when the arrow direction matches the side of the screen, but more difficult when, for instance, an arrow that points leftward appears on the right side of the screen.

“We found that patients with bulimia performed worse on the task,” she noted in an interview with Reuters Health. The bulimics responded faster and more impulsively on incongruent conflict trials (where the arrow direction and location did not match) and they also made more errors.

“We think this has to do a lot with their general impulsivity,” Marsh said, “not just in terms of their binge eating behaviors but there is also a very high prevalence of shoplifting and drug abuse in this population.”

“At the same time, when we scanned their brains during performance of the task, the women with bulimia did not activate the frontostriatal circuitry as well as the healthy controls,” Marsh noted. This brain circuitry is responsible for regulating behavior.

The researchers speculate that the inability of bulimics to engage these key nerve pathways in the brain contributes to their inability to regulate binge-type eating and other impulsive behaviors.

SOURCE: Archives of General Psychiatry, January 2009.

Excerpted from Nov. ‘08  Health Day News

Structural abnormalities start early, researchers report

A new scanning technology has detected previously unnoticed bone abnormalities in adolescent girls with anorexia.

“Prior studies have shown only decreased bone density. We show abnormalities of bone structure. Our data suggest that tests showing normal values of bone density in these adolescents do not reflect the true status of bone structure,” said lead reporter,Dr. Miriam A. Bredella.

The new study “shows that the quality of bone in women with anorexia is not normal, which is something we have suspected for a while, because they fracture even with normal bones,” said Dr. Michelle Warren, a professor of medicine and obstetrics and gynecology at Columbia University, who has done studies of her own on the subject.

“This CT methodology is new and gives better knowledge about what is going on in the bones, because it gives information about their architecture,” Warren said.

In terms of medical treatment of women with anorexia, “it shows that we really should pay more attention not only to the absolute value of the bones, but also to how much weight an individual has lost,” she said.

Anorexia is characterized by a distorted body image and intense fear of gaining weight that leads to dangerous food deprivation. It occurs primarily in young women, affecting perhaps one of every 100 adolescent girls, according to the U.S. National Women’s Health Information Center.

Bone studies in anorexia typically use X-rays. The newly reported research used a technique called high-resolution, flat-panel volume computer tomography to compare the bones of 10 girls, aged 13 to 18, with mild anorexia with those of 10 age-matched girls without the eating disorder.

“This is a CT scan that makes very thin slices of bone to see bone structure,” said Bredella, who is an assistant professor of radiology at Harvard Medical School and a musculoskeletal radiologist at Massachusetts General Hospital. “It uses a low dose of radiation, about the same as from the background radiation over a three-day period.”

The CT scans showed no significant difference in bone mineral density in the two groups. They did show significant structural differences, indicating that the first bone problems in anorexia begin before changes in bone density can be detected.

“There can be early or mild already abnormal bone structure, while bone density appears normal,” Bredella said.

Early detection of bone problems is desirable, because “deficits in adolescence result in low peak bone mass and increased risk of fracture in adult life,” Bredella said. “It can be done with a modality that evaluates bone structure as well as density.”

Tests to detect changes in bone structure might be done “if an adolescent has the disease for a while, and it is not getting better,” she said. While the flat-panel volume CT scan used by her group is not widely available, other CT scans in wide clinical use can detect bone structure abnormalities, Bredella said.

There are established treatments, such as low-dose testosterone, that can be used to treat bone disorders in anorexia, she said.

Want to know more?

Go to the US Department of Health and Human Services Women’s Health Information site.

The University of Minnesota Medical School recently reported results from study of the shopping budgets of people diagnosed with bulimia. The surprising finding:

Binges Take About One Third of Food Budgets!

People with bulimia spend thousands of dollars a year on the food they eat during binge episodes and on binging aids such as laxatives and diet pills, according to the first-ever study to look at the direct cost of the eating disorder to patients.

Food for binging accounted for one third of bulimic individuals’ total food spending, Dr. Scott J. Crow of the University of Minnesota Medical School in Minneapolis and colleagues found. “The magnitude of these costs may not be fully apparent to individuals with bulimia nervosa, because of the fact that they accrue gradually and might be partly ameliorated by consumption of food bought by others (e.g. family, partners, roommates),” the researchers write.

Studies have frequently addressed the medical costs of treating bulimia, but have never before identified costs to patients themselves, Crow and his team note in the International Journal of Eating Disorders.

Based on the average 2006 annual U.S. income for women 25 to 34 years old, which was just over $30,000, bulimics spend about 5.3 percent of their before-tax income on expenses related to their binging. And those costs are probably underestimated since the study participants were in treatment, and people with eating disorders who record their food intake  monitor their eating behaviors more closely.

Crow and his fellow researchers hope that informing people with bulimia of the actual monetary cost of their illness will prompt them to seek treatment. “Future studies should continue to examine monetary costs of eating disorder symptoms, to provide accurate data to patients as they evaluate the problems associated with their bulimic symptoms, and to better understand the financial burdens of eating disorders,” they conclude.

SOURCE: International Journal of Eating Disorders, January 2009.