0 Live Longer by Making Mental Wellness Your Mission

By Felicia Wong, M.D.

September is National Recovery Month and SAMHSA's National Wellness Week (Sept. 17-23), a time to remind us why "wellness" is so important to our overall health. Did you know, people with mental and substance use disorders die decades earlier than the general population, mostly due to preventable medical conditions?

Each day, we face all sorts of demands and drama which can lead to insomnia, lack of concentration, problems in our relationships, and other mental health issues. In a past blog post, I identified coping tools for dealing with stress and boosting your overall well-being. Here are "Top 8 Tips for Mental Wellness." I hope you will take another look and share with your loved ones this week. 

1) Help Others. People who consistently help others experience less depression, greater calm, and fewer pains.

2) Take Care of Your Spirit. People who have strong spiritual lives may be healthier and live longer. Spirituality seems to cut the stress that can contribute to disease.

3) Stay Positive. Positive emotions can boost your ability to bounce back from stress.



4) Get Physically Active. Exercise can help relieve insomnia and reduce depression.

5) Get Enough Sleep. Not getting enough rest increases risks of weight gain, accidents, reduced memory, and heart problems.

6) Eat Well. Eating healthy food and regular meals can increase your energy, lower the risk of developing certain diseases, and influence your mood.

7) Deal Better with Hard Times. People who can tackle problems or get support in a tough situation tend to feel less depressed.

8) Get Professional Help if You Need It. More than 80 percent of people who are treated for depression improve.

Which tips on this list are missing in your life? Today is the perfect time to take action! Your wellness matters. 

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0 Helping Others Helps Your Mental Health: Why Volunteering Makes Us Happier

By Roberto Blanco, M.D.





I had just sat down for Dr. Norden’s Neuroanatomy class when one of my classmates, who had just walked into lecture late, announced he heard on the radio that a plane had crashed into one of the World Trade Center Towers.  As was her way, Dr. Norden showed immediate concern, and before I knew it, we were watching another plane fly into the second tower live on CNN in the front of the lecture hall.  It was a surreal scene in Light Hall on Vanderbilt’s Medical campus; one that I did not expect to experience.  The rest of the day was a blur of events and emotions – people in a state of shock, tears shed, classmates comforting each other, and Dr. Norden attempting to put things in perspective.  Class was dismissed for the day, and the rush to call loved ones in New York City and Washington, D.C. began.  My thoughts immediately turned to family members who lived in New York and worry when I was unable to reach them.



10 years ago, the world of every American changed.  In response, the country and the world came together in support of the victims of the terrible tragedy.  People from far and wide drove, some for thousands of miles, to reach New York City and care for complete strangers.  People sacrificed their time, sweat, and a good portion of their lives and livelihoods to help those in need.  Donations flooded in to support the victims’ families.  A rush of prayers, love, and aid from across the globe also streamed in for those affected.  It seemed that the world was one in giving to those who had lost.



I recently wrote a blog post here on happiness, human fulfillment, and flourishing.  In that posting, I discuss human fulfillment and flourishing as the real definition of happiness and the final aim of all of what we do.  A great way to help yourself and your own mental health is to help others.  Feeling useful and needed is a wonderful way to work towards human fulfillment and recognize all you have for which to be grateful.  Serving others is a sign of individual and community emotional health.  Volunteering your time and talents also leads you to finding the love within yourself that you didn’t know you had.  When faced with those who have lost and are truly in need, just like on September 11th, the true beauty of mankind comes out.  



For Sunday's 10th Anniversary of September 11th, President Obama is calling for a national day of giving in memory of those who passed during the attacks.  His goal is to have over 1 million Americans engaged in volunteer work on September 11th.  The American Psychiatric Association has joined "Give an Hour" in aid of military members, veterans of Iraq and Afghanistan, and their families as part of the “I will” campaign to encourage that same spirit of service that was felt in the days following the attacks.  So, think about joining us in giving by helping build a house for a needy family through an organization like Habitat for Humanity.  Volunteer to distribute food or give to your local food bank.  Help a friend move.  Donate time or resources to a homeless shelter, spend time with the elderly, or serve at a local hospital.  This September 11th, let’s honor those who died by helping a member of your community in need.

In photo: Dr. Blanco and another volunteer work together to build a home through Habitat for Humanity

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0 Why Women Must Exercise for Mental Health

By Claudia Reardon, M.D.


Exercise has mental health benefits for men and women of all ages.  However, there are unique factors to consider in thinking about the mental health benefits of exercise for women in particular.  Compared to men, women have a two-fold increased prevalence of major depression throughout their reproductive life cycle.  Exercise can be a very useful treatment for depression in women at any of a number of different times in their lives:   

• During pregnancy and breastfeeding:  Depression is highly prevalent in women of childbearing age.  Medications are often necessary to treat moderate to severe depression.  However, many women wish to avoid treatment with medications during pregnancy and while breastfeeding.  At least one study has shown that women who exercised regularly reported less depression in the first and second trimesters compared with women who did not exercise.  The American College of Obstetricians and Gynecologists has recommended 30 minutes of moderate exercise on most days.

• During the postpartum period:  Exercise can also help to treat and prevent postpartum depression.  One study has shown that postpartum women who exercised three times per week had less depression than postpartum women who did not exercise. 

• During the premenstrual period:  Exercise can be useful to treat physical and emotional premenstrual symptoms.  It is less clear if exercise by itself can treat the most severe of premenstrual syndromes (called “premenstrual dysphoric disorder”), but it is still a first-line treatment strategy that most physicians would recommend. 

• During menopause:  Several studies have shown that aerobic exercise can improve both depression and insomnia occurring during menopause.  Additionally, lower intensity exercise such as yoga has been shown to improve psychological well-being in menopausal women.

Importantly, women may experience barriers to exercise.  Here are some examples of these barriers, and strategies to help address them:

• Childcare issues:  Women are often responsible for childcare, which makes it difficult for them to find opportunities to exercise.  Gyms that offer childcare services can be helpful.  Also, partners can share the workload. 

• Intimidation:  Some women may feel uncomfortable working out in the coed environment of a gym.  Consider taking women-only exercise classes, or walking or doing other exercise with women exercise buddies.

• Self-consciousness about appearance:  If a woman is already uncomfortable about her appearance, then she might worry that she’s drawing even more attention to her body by exercising, especially if wearing skimpy sports clothes.  One strategy is to try walking, which can be done almost anywhere and in almost any type of clothing.

• Guilt:  Women, especially those who are family caretakers, sometimes describe feeling guilty about taking time for themselves to exercise.  Remember, it is not a selfish thing to exercise.  You are taking time to improve your physical and emotional health, which will allow you to more effectively be there for others.  Besides, you deserve to experience the benefits of exercise!   

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0 Yoga Helps Heal Heart & Emotional Scars of Cancer

By Felicia Wong, M.D.

“Cancer is a very alienating and existential disease. I know of no other common disease that immediately causes so much fear, anxiety, depression, confusion, and a sense of impending disaster in a patient or his/her significant others when they hear the word “cancer” for the first time.” --- Murray Krelstein, MD, a psychiatrist and cancer survivor.

Although oncologists, family members, and friends can provide significant sources of support, adding a mental health professional to a cancer patient’s treatment team is often helpful. Talking about the emotions and worries associated with cancer can be difficult, and it is important to have a therapist who is familiar with these situations. Additionally, cancer patients and survivors often suffer from sleep disorders, depression, anxiety, fatigue, and other mood changes.

Researchers at the University of Rochester Medical Center found that among patients receiving chemotherapy, over three-quarters suffer from insomnia. Those who suffer from insomnia are, in turn, more likely to suffer from fatigue and depression. For 65% of cancer survivors, insomnia continues even after the completion of chemotherapy.

Cancer is a diagnosis that affects both body and mind. So, it makes sense that cancer patients and survivors practice yoga to improve their quality of life.

While research on the use of yoga for cancer is relatively new, there have been recent studies confirming yoga’s mental health benefits. A Harvard Health Publication highlights the benefits of yoga for stress, depression, and anxiety:

- By reducing perceived anxiety, yoga appears to adjust stress response systems. This, in turn, reduces heart rate, lowers blood pressure, and can make breathing easier.

- There is evidence that yoga practices helps increase heart rate variability, an indicator of the body's ability to respond to stress more flexibly.

Optimizing wellness after a cancer diagnosis and beyond involves a complex integration of interventions that address both the mind and the body. Ideally, a psychiatrist is part of the cancer treatment team. However, if this is not available, please ask your doctor for referrals.

For additional resources on coping with cancer:

http://www.cancersupportivecare.com/live.html

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0 Depression: Should I Tell the Boss?

By Gina Newsome Duncan, MD

Depression is the leading cause of disability among people ages 15-44, affecting nearly 7 percent of the adult population in a given year. That means that close to one in ten American adults is suffering from depression at any given point in time. A recent CNN Health article highlighted the dilemma one woman with depression faced when considering whether to tell her employer.

It may not be talked about much, but depression is most certainly present in the workplace. What are the effects? People suffering from depression can experience a decrease in concentration, difficulty making decisions, feelings of isolation, feeling slowed down in their thinking and mental processing, and poor sleep, which can lead to daytime fatigue. All of these factors can result in poor job performance. In fact,a decline in job performance is often the wake-up call that someone is experiencing depression and needs to do something.

If you feel that you may be suffering from major depressive disorder and are concerned about the effect on your work, what should you do?

1. A good first step is to talk with a psychiatrist or your primary care physician about your symptoms and explore possible treatment options. Psychiatrists and primary care physicians are familiar with employment issues and should be able to get you started on a plan to address your concerns.


2. Find out about your company’s Employee Assistance Program (EAP). It is in your company’s best interest for you to function at your optimal level, and most large companies offer some type of EAP. In most cases, confidentiality and privacy requirements apply to EAP services, and the employer does not usually know who is or is not using them, except in cases where the employer referred the worker to the EAP. Employee Assistance Programs offer a broad range of services, including psychological assessment, counseling, support and referrals.

Other things to keep in mind:



Depression is real, but it is not as visible as something like a broken leg. Depression can be difficult for others to accept as a true illness or valid reason for being excused from work. As a society, we can be stoic when it comes to issues of emotional distress; “Just suck it up and keep going,” we tell ourselves and others. It can be hard for others to understand or appreciate the effects of a major depressive episode or another mental illness unless they or a loved one have experienced it. Employers are beginning to understand that attending to their employees’ mental health is not just a nice thing to do, it makes good business sense.



Federal laws protect the rights of workers who become medically ill or disabled. This includes workers who are unable to work due to a mental illness such as major depression. However, employer sensitivity toward such employees can vary, particularly if the employee has not taken official medical leave but is frequently calling out sick or requesting time off for regular psychiatrist or therapist appointments during work hours.



Whether or not to disclose your illness to your boss and/or your coworkers is an individual decision that depends on your company’s culture and your own preference. But here are a couple of thoughts to keep in mind: If your symptoms are not affecting your job performance in a visible way and if, with the help of your doctor, you have started a treatment plan that you are finding helpful, then disclosing your illness to your employer may not be necessary. If, on the other hand, your symptoms are severe, causing frequent missed days of work or other job performance issues that threaten your employment, and if you have not yet started treatment, then being proactive and addressing the issue with someone you trust, like a doctor, Employee Assistance Program or a boss, can be an important step.



Have you experienced firsthand the effects of depression in the workplace? If so, how was it addressed? How can we reduce the culture of stigma that surrounds mental illness in the workplace?

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