Archive for November 2016

Depression

Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.

Some forms of depression are slightly different, or they may develop under unique circumstances, such as:

  • Persistent depressive disorder (also called dysthymia) is a depressed mood that lasts for at least two years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder.
  • Perinatal depression is much more serious than the “baby blues” (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth. Women with perinatal depression experience full-blown major depression during pregnancy or after delivery (postpartum depression). The feelings of extreme sadness, anxiety, and exhaustion that accompany perinatal depression may make it difficult for these new mothers to complete daily care activities for themselves and/or for their babies.
  • Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The psychotic symptoms typically have a depressive “theme,” such as delusions of guilt, poverty, or illness.
  • Seasonal affective disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight. This depression generally lifts during spring and summer. Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder.
  • Bipolar disorder is different from depression, but it is included in this list is because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (called “bipolar depression”). But a person with bipolar disorder also experiences extreme high – euphoric or irritable – moods called “mania” or a less severe form called “hypomania.                                                                        www.nimh.nih.gov

Bullying

Bullying is a well-known adversity among school-age children. According to data, approximately 10 percent of US children and adolescents are the victims of frequent bullying by peers. In the aftermath of being bullied, victims may develop a variety of psychological as well as somatic symptoms, some of which may persist into adulthood. Psychological symptoms may include social difficulties, internalizing symptoms, anxiety, depression, suicidal ideation, and eating disorders (i.e., anorexia or bulimia nervosa). Somatic symptoms may include poor appetite, headaches, sleep disturbances, abdominal pain, and fatigue. In both mental health and primary care settings, being aware of these types of psychological and somatic symptoms in vulnerable children and adolescents may expedite the identification and eradication of these abusive experiences.

www.ncbi.nlm.nih.gov

Eating Disorders

Eating disorders are a group of related conditions that cause serious emotional and physical problems. Each condition involves extreme food and weight issues; however, each has unique symptoms that separate it from the others.

Anorexia Nervosa. A person with anorexia will deny themselves food to the point of self-starvation as she obsesses about weight loss. With anorexia, a person will deny hunger and refuse to eat, practice binge eating and purging behaviors or exercise to the point of exhaustion as she attempts to limit, eliminate or “burn” calories. The emotional symptoms of anorexia include irritability, social withdrawal, lack of mood or emotion, not able to understand the seriousness of the situation, fear of eating in public and obsessions with food and exercise. Often food rituals are developed or whole categories of food are eliminated from the person’s diet, out of fear of being “fat”. Anorexia can take a heavy physical toll. Very low food intake and inadequate nutrition causes a person to become very thin. The body is forced to slow down to conserve energy causing irregularities or loss of menstruation, constipation and abdominal pain, irregular heart rhythms, low blood pressure, dehydration and trouble sleeping. Some people with anorexia might also use binge eating and purge behaviors, while others only restrict eating.

Bulimia Nervosa. Someone living with bulimia will feel out of control when binging on very large amounts of food during short periods of time, and then desperately try to rid himself of the extra calories using forced vomiting, abusing laxatives or excessive exercise. This becomes a repeating cycle that controls many aspects of the person’s life and has a very negative effect both emotionally and physically. People living with bulimia are usually normal weight or even a bit overweight. The emotional symptoms of bulimia include low self-esteem overly linked to body image, feelings of being out of control, feeling guilty or shameful about eating and withdrawal from friends and family. Like anorexia, bulimia will inflict physical damage. The binging and purging can severely harm the parts of the body involved in eating and digesting food, teeth are damaged by frequent vomiting, and acid reflux is common. Excessive purging can cause dehydration that effect the body’s electrolytes and leads to cardiac arrhythmias, heart failure and even death.

Binge Eating Disorder (BED). A person with BED losses control over his eating and eats a very large amount of food in a short period of time. He may also eat large amounts of food even when he isn’t hungry or after he is uncomfortably full. This causes him to feel embarrassed, disgusted, depressed or guilty about his behavior. A person with BED, after an episode of binge eating, does not attempt to purge or exercise excessively like someone living with anorexia or bulimia would. A person with binge eating disorder may be normal weight, overweight or obese.

www.nami.org

 

 

 

Stress, Depression and the Holiday Season

When stress is at its peak, it’s hard to stop and regroup. Try to prevent stress and depression in the first place, especially if the holidays have taken an emotional toll on you in the past.

  1. Acknowledge your feelings. If someone close to you has recently died or you can’t be with loved ones, realize that it’s normal to feel sadness and grief. It’s OK to take time to cry or express your feelings. You can’t force yourself to be happy just because it’s the holiday season.
  2. Reach out. If you feel lonely or isolated, seek out community, religious or other social events. They can offer support and companionship. Volunteering your time to help others also is a good way to lift your spirits and broaden your friendships.
  3. Be realistic. The holidays don’t have to be perfect or just like last year. As families change and grow, traditions and rituals often change as well. Choose a few to hold on to, and be open to creating new ones. For example, if your adult children can’t come to your house, find new ways to celebrate together, such as sharing pictures, emails or videos.
  4. Set aside differences. Try to accept family members and friends as they are, even if they don’t live up to all of your expectations. Set aside grievances until a more appropriate time for discussion. And be understanding if others get upset or distressed when something goes awry. Chances are they’re feeling the effects of holiday stress and depression, too.
  5. Stick to a budget. Before you go gift and food shopping, decide how much money you can afford to spend. Then stick to your budget. Don’t try to buy happiness with an avalanche of gifts.

Try these alternatives:

    • Donate to a charity in someone’s name.
    • Give homemade gifts.
    • Start a family gift exchange.
  1. Plan ahead. Set aside specific days for shopping, baking, visiting friends and other activities. Plan your menus and then make your shopping list. That’ll help prevent last-minute scrambling to buy forgotten ingredients. And make sure to line up help for party prep and cleanup.
  2. Learn to say no. Saying yes when you should say no can leave you feeling resentful and overwhelmed. Friends and colleagues will understand if you can’t participate in every project or activity. If it’s not possible to say no when your boss asks you to work overtime, try to remove something else from your agenda to make up for the lost time.
  3. Don’t abandon healthy habits. Don’t let the holidays become a free-for-all. Overindulgence only adds to your stress and guilt.

    Try these suggestions:

    • Have a healthy snack before holiday parties so that you don’t go overboard on sweets, cheese or drinks.
    • Get plenty of sleep.
    • Incorporate regular physical activity into each day.
  4. Take a breather. Make some time for yourself. Spending just 15 minutes alone, without distractions, may refresh you enough to handle everything you need to do. Find something that reduces stress by clearing your mind, slowing your breathing and restoring inner calm.

    Some options may include:

    • Taking a walk at night and stargazing.
    • Listening to soothing music.
    • Getting a massage.
    • Reading a book.
  5. Seek professional help if you need it. Despite your best efforts, you may find yourself feeling persistently sad or anxious, plagued by physical complaints, unable to sleep, irritable and hopeless, and unable to face routine chores. If these feelings last for a while, talk to your doctor or a mental health professional.

Grief

Dealing with grief and loss is something most people have to do sometime in their lives. Grief is a natural response to the loss of someone or something very dear to us. Losses that may lead to grief include the death or separation of a loved one, loss of a job, death or loss of a beloved pet, or any number of other changes in life such as divorce, becoming an “empty nester,” or retirement. Anyone can experience grief and loss, but each person is unique in how he or she copes with these feelings.

Some responses are healthy coping mechanisms, while others may hinder the grieving process. The acknowledgment of grief, time, and support facilitates the grieving process, allowing an opportunity for a person to appropriately mourn a loss and then heal.

Common Reactions to Grief or Loss

The stages of grief reflect a variety of reactions that may surface as an individual tries to make sense of how a loss affects him or her. An important part of the healing process is allowing oneself to experience and accept all feelings that are experienced. The following are the stages of grief:

  • Denial, numbness, and shock: This stage serves to protect the individual from experiencing the intensity of the loss. It may be useful when the grieving person must take action (for example, making funeral arrangements). Numbness is a normal reaction to an immediate loss and should not be confused with “lack of caring.” As the individual slowly acknowledges the impact of the loss, denial and disbelief will diminish.
  • Bargaining: This stage may involve persistent thoughts about what could have been done to prevent the loss. People can become preoccupied about ways that things could have been better. If this stage is not properly resolved, intense feelings of remorse or guilt may interfere with the healing process.
  • Depression: This stage of grief occurs in some people after they realize the true extent of the loss. Signs of depression may include sleep and appetite disturbances, a lack of energy and concentration, and crying spells. A person may feel loneliness, emptiness, isolation, and self-pity.
  • Anger: This reaction usually occurs when an individual feels helpless and powerless. Anger can stem from a feeling of abandonment through a loved one’s death. An individual may be angry at a higher power or toward life in general.
  • Acceptance: In time, an individual may be able to come to terms with various feelings and accept the fact that the loss has occurred. Healing can begin once the loss becomes integrated into the individual’s set of life experiences.

Remember, throughout a person’s lifetime, he or she may return to some of the earlier stages of grief. There is no time limit to the grieving process. Each individual should define his or her own healing process. www.webmd.com

Equine Therapy and our Veterans

Each week, Grimard drives four to six Veterans out to nearby Strongwater Farm, where they get to ride horses for free. Family members of Veterans are also welcome.

“These guys are in the 90-day treatment program at our domiciliary,” said Grimard, a Navy Veteran. “So it’s good for them to get away from the hospital now and then and do something different.

“It’s my job to get these guys back out into the community, doing healthy things,” he added. “They need to know they have alternatives to the lifestyles that landed them in trouble before.”

Just Relax

Grimard said the whole idea is to provide Veterans with relaxing, positive experiences.

“A lot of these guys have anxiety,” he said. “They have traumatic memories, so we want them creating new, pleasant memories to replace the not-so-pleasant ones. This is a peaceful place. When I bring them out here, I don’t tell them I’m taking them to therapy. I just tell them, ‘I’m bringing you out here so you can enjoy life a little.’

“Once they get around a horse, they start to loosen up,” he continued. “You can see them begin to relax. You can see their self-esteem and their confidence building. Gradually you can see them becoming the person they were before all that stuff happened to them.”

Grimard said he’s now seeing an increasing number of younger Veterans — those who served in Iraq and Afghanistan — expressing an interest in visiting the horse farm.

“They’re very physical, very enthusiastic,” he said. “They just jump right on the horse without a second thought. It doesn’t matter whether you’re dealing with posttraumatic stress, addiction or family problems, coming out here is just a fun, cool thing to do.

“Horses, like people, are sentient beings,” Mickelwait noted. “Each one is different; each one has its own personality. The first time we went out to the farm I talked to a horse named Big Red. He was very friendly, but he had no problem invading your body space. He liked to go into your pockets to search for snacks. He was like a hyperactive little kid. He was a handful, but I liked him.”

Mickelwait recently completed her treatment program at the Bedford VA and will soon be working full-time and living in her own apartment in Boston. Recently, she won a scholarship that will enable her to take a writing course at the University of Boston.

The Air Force Veteran said her experience at Strongwater Farm was a memorable step on her road to recovery.

“Riding was the best part for me,” she observed. “I like to ride. I find it relaxing, because I’m focused on my horse. It’s an ‘in-the-moment’ sort of thing. You’re doing nothing but being with that animal.”

“Sometimes I won’t even ride,” said Army Veteran Larry Opitz, another recent graduate of the Bedford VA’s residential treatment program. “Sometimes I just like walking around the barns, or walking through the pastures. It gets you away from everybody. You can do a little soul searching.”

www.va.gov