Karuna Counseling’s Newsletter Articles

May 17, 2012

Growing Gratitude

by Micky O’Leary, Ph.D.

Let me begin by acknowledging that Gratitude and I got off to a rocky start. As a child, gratitude often meant being reminded how lucky I was to have a loving family, a roof over my head, an education, etc. I was taught to be polite, to say “thank you” for gifts, whether I liked them or not, to express appreciation for whatever was done for me or given to me.

I remember one Saturday evening in particular. I was about 11 years old and my mother prepared chicken livers for dinner. As we gathered around the table, I expressed my dislike (perhaps, even contempt) for the main dish, to which my father replied that I should be grateful for this nutritious food and be glad that I was not one of the starving children in  (you are free to select an appropriate third world country of the 1950s). After we said Grace, he went on to inform me that I would have plenty of opportunities to learn gratitude for this delicious meal because it would be served every Saturday night from then on.

Fortunately (and for this I was truly grateful), his threat was short-lived and it was only a few weeks before we returned to more appetizing meals like meatloaf. Not surprisingly, I never did develop a liking  for chicken livers, despite my parents’ best efforts. What I do have now, some 50 years later, is a deep and loving appreciation for the childhood meals we shared in our family kitchen, my mother’s commitment to providing us wonderful home-cooked meals, and my parents’ desire that I learn to value what was given to me, even if I didn’t always like it.

Developing gratitude has been a life long journey, with an experience of it that has grown deeper over time. I am often reminded of the Joni Mitchell song “Big Yellow Taxi.” Its refrain is “Don’t it always seem to go that we don’t know what we’ve got til it’s gone….” For many of us, gratitude grows from an awareness of what we’ve lost, or what we stand to lose. For example, how much easier is it to appreciate good health after recovering from a serious accident or illness? Or to value electricity after a lengthy power outage? Or to feel gratitude for our remaining friends and family after one of them dies?

Loss is not always a precursor to gratitude. It is possible to appreciate life’s gifts without it. For instance, think of how children squeal with glee when experiencing a winter snowfall (and the subsequent day off from school). Perhaps you can remember a trip to the beach and seeing the sunset across the water. Or you may be able to recall the excitement and anticipation of a new romance.

However, learning gratitude through loss is an opportunity to deepen our understanding and appreciation of life from a new perspective. Shakti Gawain notes that it is difficult to get in touch with our gratitude when life is hard and we are going through a difficult time. However, with patience and perspective, these “healing crises” can provide meaning and purpose in our life’s journey. For instance, the sudden loss of someone dear to us can show us how “life turns on a dime” and remind us of the fragility and beauty of each moment we have. The unexpected loss of employment can force us to re-evaluate our career goals and options, perhaps leading us to a more rewarding or fulfilling work. Or a reduced level of income may force us to alter our lifestyle, finding a way to live more simply. We can, in the most difficult of times, learn to recognize – and appreciate — our greatest gifts and assets, as well as our “growing edges” – the lessons that we are be challenged to learn. In short, we can take these painful experiences and let them soften and expand our hearts, or harden and contract them.

According to Julie Keene, minister and author, gratitude is closely connected to trust. “In order to be thankful for everyone and everything in my life, I need to trust that the Universe makes sense, that everything my soul has chosen to experience this lifetime has been for my ultimate Highest Good.” Once we are able to appreciate whatever life brings us, it is easier for us to then begin living in a place of contentment and gratitude. Our heart is able to find and dwell in a place of joy.

As I consider what I have written so far, I must admit it looks deceptively simple, a bit like “A Guide to Enlightenment in three short paragraphs.” Finding and living in a place of gratitude is not instantaneous nor without some effort. But be assured, it brings immense rewards.

Benefits of Gratitude as a Practice

There are more than a few reasons to incorporate more gratitude into our lives. Having an “attitude of gratitude” causes us to interact with others from a place of fullness. They are attracted by our energy and feel our appreciation. On the other hand, when our glass is “half empty,” we emit a negativity that tends to repel others and we experience less support.

James Eubanks, an author, columnist and astrologer, notes that it is impossible to feel worry, anger, depression, or any negative emotion in the presence of genuine gratitude:  “The practice of gratitude saves us from our painful human storyline, for it requires us to look deeper into our lives and the people around us. The surface rarely holds depth; rather, it obscures it. Gratitude enriches and deepens the colorful fabric of our lives by allowing us to see more.”

Cultivating gratitude has been linked to better health, sounder sleep, less anxiety and depression, higher long-term satisfaction with life and kinder behavior toward others. In a recent experiment at the University of Kentucky, students who turned in an essay were either praised for it or given harsh criticism. Then each student was allowed to play a computer game with the person who gave them the evaluation. The winner could administer a blast of white noise to the loser. Those who had received criticism about their essay retaliated against their opponent by giving an especially loud blast – much louder than those given by students receiving positive feedback.

However, an interesting exception occurred among students who had been instructed to write their essays about gratitude. Even if their feedback was negative, they didn’t feel compelled to blast their opponents at a higher volume. The researchers viewed the results as an indication that gratitude also reduces aggressive behavior.

 

Suggestions for Practice

Gratitude grows best when it is cultivated. John Kralik, a California attorney and judge, has written about his experience of gratitude in a touching book, A Simple Act of Gratitude: How Learning to Say Thank You Changed My Life. He had reached a point in his life when he felt as if he had lost almost everything that mattered to him. His business was failing, his second marriage was ending, his living conditions were undesirable and he felt distance between himself and his two older children. He was angry and despairing and out of shape. On New Year’s Day he was struck by the thought that his life could be better if he could find a way to focus on the things he had, rather than those he had lost. He made a commitment to himself to write 365 thank you notes over the next year. The resulting story is an endearing and encouraging account of the personal changes he experienced in that process.

Another way to begin a practice of gratitude is with what Robert Emmons of the University of California calls “gratitude lite.” It involves keeping a journal listing five things for which you feel grateful. The list is brief – only one sentence per item – and is done only once a week. The research he did with Michael McCullough of the University of Miami showed that after two months, there were significant changes among the journal keepers, compared with a control group. They felt more optimistic and happier. They reported fewer physical problems and spent more time working out.

One suggestion for bringing more gratitude into your life is planning a “gratitude visit.” Psychologist Martin Seligman recommends writing a 300 word letter to someone who changed your life for the better. Be specific about what the person did and how it affected you. Then deliver it in person without telling the person in advance what the visit is about. When you get there, read the whole letter slowly and out loud to the other person. According to Seligman, if you do this, within a month you will feel happier.

Other possibilities include keeping a gratitude calendar which emphasizes different blessings in each month; performing a service or volunteering to help someone; saying “thank you” often and with sincerity.

One especially lovely practice is the “Hugging Meditation” described by Buddhist monk Thich Nhat Hanh:

  1. Hug someone three times, breathing in and out with awareness;
  2. On the first breath in and out, both of you think about how, at sometime, you don’t know when, you will no longer be here;
  3. The second time, focus on how, at sometime, the other person will no longer be here;
  4. The third time, truly take in that you are both here now, together in this precious moment.

Finally, if you should find your gratitude aptitude getting especially challenged, remember what Buddha wrote:

“Let us rise up and be thankful,
for if we didn’t learn a lot today, at least we learned a little,
and if we didn’t learn a little, at least we didn’t get sick,
and if we got sick, at least we didn’t die;
so, let us all be thankful.”

Suggested Reading

Kralik, John.  A Simple Act of Gratitude: How Learning to Say Thank You Changed My Life. New York: Hyperion, 2011.

Hay, Louise L.  Gratitude: A Way of Life. New York: Hay House, 1996.

Ryan, M.J.  Attitudes of Gratitude: How to Give and Receive Joy Every Day of Your Life. San Francisco: Conari Press, 1999.

April 2, 2012

Acceptance and Commitment Therapy (ACT)

Open window
by Darby Christopher, LMSW
A new wave of well researched and effective therapies has emerged in recent years. Examples include Eye Movement Desensitization Reprocessing (EMDR), Emotional Freedom Technique (EFT), Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and others. This article will focus on the process and benefits of ACT, which primarily provides tools that can be applied to everyday life, with or without the help of an ACT therapist.
Overview
The primary goal of Acceptance and Commitment Therapy, according to Dr. Russell Harris, is the attainment of “psychological flexibility.” This refers to an ability to be open to the present moment, a perhaps deceptively simple yet powerful concept. When we are psychologically flexible, we are able to feel and to observe what shows up in our lives, without clinging to it too tightly.
If much our suffering results from how we respond to sadness, a depressed mood, anxiety or anger, then ACT provides the tools necessary to not worsen the situation by reacting to it or fighting with it. The result is greater self acceptance, less time focused on negative possibilities, and more time invested in valued action.
ACT often uses metaphors to convey its ideas, and a metaphor is helpful here. Suppose  that a certain set of circumstances triggers a depressed reaction in me, and let’s say that this depressed reaction is like a branch that is floating down a stream. Any of the ways that I fight with this depression – whether by feeling badly about it, denying it or trying to avoid it by destructive means – are ways that I am damning up the stream that will not allow the branch to flow through. ACT provides the tools that will help keep me from doing this, so that I will be more able to watch the branch come, flow through and float by.
Acceptance and Commitment Therapy falls under the broad category of Cognitive-Behavioral Therapy (CBT). However, it also follows a current trend in CBT to avoid counteracting symptoms, and to instead embrace the stance and practice of mindfulness.
ACT Tools
What are these tools? Acceptance and Commitment Therapy focuses on 6 core processes that work together. Each one requires effort, and will probably not be mastered over the course of a life time. The goal is to get better at them and experience more freedom, rather than perfection. Let’s look at each one individually.
  • Defusion. This refers to an ability to watch and observe our thoughts and emotions, and to create a little distance between our selves and the thought or feeling. This step is not easy because we often tend not to be aware of our thoughts. With defusion, we slow down and observe ourselves having thoughts and feelings. Next, if appropriate and helpful, a step can be taken to see the thought as perhaps a part of me, but not attached to my deepest identity, and therefore capable of change. 
  • Acceptance. This refers to how I relate to the thoughts and feelings that show up in me. Am I mad at them? Do I hate them and wish they would go away? Do I treat them like unwanted guests? Or, conversely, do I welcome even the painful thoughts and feelings that show up in me, knowing they could have some useful information for me? Do I love these parts and treat them with compassion? Loving what shows up in us leads to relaxation and an ability to listen to ourselves.
  • Contact With The Present Moment. To make contact with the present moment is to experience some sense of vitality right now. The requirements for this may shift as our moments shift. When we engage our observing self, we may pay attention to our sense of sight, smell, hearing, sound or touch, we may look inward and pay attention to our inner sensations, and we might do both of these at once. If we are dealing with a painful experience from our past, we will pay attention to our bodies and feeling experience, rather than ruminating over the facts of the past. Staying focused on the feeling sensations in our bodies allows us to be informed by them, as opposed to diverting our attention and missing out on the message they may offer us. Contact with the present moment often involves slowing down to be present with others, nature, and our own selves.
  • Self-As-Context. This refers to an ability to be in touch with the deeper part of me that is doing all of this observing. When we build our “self-as-context” muscle, we are able to know that there is a part of us that endures and stays steady through the day to day and even moment to moment changes in our lives. Why is this important? Knowing ourselves in this way facilitates the goal of psychological flexibility. If I know that I am so much more than my thoughts and feelings, then I won’t get too attached to them. (However I will still know and honor them as important, and give them their proper place in my life.)
  • Values. This refers to an ability to know what is important to me, and to allow myself to be guided and instructed by this knowledge. We are all given a certain amount of time on this earth to live in this life time. How do I want to spend it? What matters to me? What do I wish to leave behind? Getting in touch with my values both gives me a compass and a sense of deeper meaning.
  • Committed Action. Once I know what my values are, what do I want to do to act on them? What possibilities am I willing to try out? How could my life take on more vitality by my action(s)? 
Conclusion
Acceptance and Commitment Therapy provides useful tools to stay open and present to the moment. There are times when using these tools may seem difficult, if not impossible. With practice, however, they can be useful in even the most difficult situations. ACT does not take the place of other types of important work that also help us be more present to our lives, such as grief work, trauma work, and understanding how our past experiences affect us. ACT can stand on its own as a useful and healing therapy, and can be used in powerful ways in conjunction with other types of therapies.
Resources
The Happiness Trap: How To Stop Struggling And Start Living, by Russ Harris, 2008
Act Made Simple, by Russ Harris, 2009 (Note: This book is written primarily for therapists, though anyone may benefit from reading it.)

April 29, 2011

Book Review: “Taking Antidepressants: Your Comprehensive Guide to Starting, Staying On, and Safely Quitting” by Michael D. Banov, MD

Filed under: 2011 Articles,Depression,Molly's Articles — karunacounseling @ 7:13 pm
Tags: , ,

A Book Review by Molly Keeton Parnell, Ph.D.

I am pleased to have found a book that I can recommend to clients, family, and friends who are dealing with depression and wanting to better understand their treatment options. While the title of the book indicates the subject matter is that of antidepressants, Dr. Banov does a thorough job of discussing various alternatives to traditional medication therapy, including psychotherapy, supplements, exercise, healthy eating, light exposure, yoga, meditation, and more. The fact that the discussion is not limited only to antidepressant medication makes this book much more worthwhile, in my opinion.

Over the years of providing therapy, I have talked with many clients about antidepressant medication. I have found that it is very, very rare that clients feel immediately open to this option. Many come around and try antidepressants and many do not. I am always amazed by what strong opinions exist about medication therapy. People feel that it is “not natural” (neither is cataracts surgery, but most don’t object to this), that they “shouldn’t need it,” or that they should somehow be able to overcome a chemical imbalance through sheer will. It is not the fact that a person has a negative reaction that bothers me – perhaps we should all be more cautious about our medical care. It is this strange phenomenon that average people suddenly seem to fancy themselves a medical expert when it comes to mental health medications. For example, when I was pregnant, I had to be on blood thinner medication. This involved giving myself injections once or twice a day for the entirety of my pregnancies. I certainly received many reactions from people who knew about this (mostly sympathy and some shock at the thought of taking shots everyday), but I never once had someone tell me that I probably didn’t need the medication, that my doctors didn’t know what they were talking about, that blood clotting disorders don’t really exist, or that I could fix my clotting issue by adjusting my attitude. People almost never question treatment or medication for heart disease, Alzheimer’s, or high blood pressure, but when it comes to mental health issues everyone is suddenly an expert. And most likely they haven’t read the first word about depression or its various treatments.

Mental health disorders and their treatment still carry an enormous stigma in our society, despite the fact that an “estimated one quarter of the population will suffer from depression at some point in their lives” (p. 10) and antidepressants are “the most commonly prescribed class of medications” (p. 7). Because of this stigma, depression is more often hidden and dealt with privately. The downside of this is that many, many people do not comprehend the realness of depression, how it differs from the regular sadness and stress we all face in life, and the serious consequences that can result.

When I think about depression, a funny story comes to mind about my sister. She was living in Oregon with some mountain biking enthusiasts who invited her to join an on-road trek one day. Although she had not done much biking, she was a lover of exercise who was in great health and very good physical condition. She figured she was up for the challenge. From almost the very beginning she had great trouble keeping up. She felt discouraged with herself, first frustrated by her poor performance and then questioning if she had been crazy to think she could do this. She felt embarrassed for others to see her struggling and felt badly for slowing them down. She began doubting everything she knew to be true of her fitness, wondering if maybe she wasn’t in great shape, if her daily runs were not really all that impressive, if she wasn’t a real athlete at all. Finally, one friend who knew she could do better took a quick look at her bike. Guess what they found? Her tires were not properly inflated. She was literally doing twice the work to get half as far. Imagine her relief to discover this – not only was she not the utter failure she was beginning to feel like, but also the rest of the day was sure to go much better. As she set out again, looking forward to the ride ahead, she found that she was still struggling to keep up. The same feelings of embarrassment, self-doubt and inadequacy followed. After more time and more struggle and more slowing down of the other bikers, someone took a second look at her bike. This time they discovered that her brakes were functioning improperly and were actually partially applied. For every push of her pedals, the brakes were working against her by trying to stop her in her tracks. Once this problem was resolved, the day went much more as she had envisioned. She was not at the head of the pack, but she was certainly capable of an afternoon ride with some friends.

I promise that this story is true, and although I am sorry that my sister had to suffer through it, I am so grateful to have this excellent analogy of how depression can feel. It is not necessarily that a person with depression can’t function, that they lay on the sofa all day crying or feeling like dying, that they don’t leave the house, feed the cat, go to work, etc. Though depression can look this way at its extremes, many people with depression can continue to function in their lives to the point that others may not even know they are suffering. It is just that the effort it takes to get through normal daily tasks can feel overwhelming. For many, depression comes on quite gradually so that they might not fully notice its presence in their lives. Like my sister on her mountain bike, they may simply think they are lazy, unmotivated, and incapable of achieving their goals. They may chastise themselves for not being able to get their lives together, get things done, or function as well as other people seem to. Not recognizing that depression plays a part can have devastating consequences. Their goals, dreams, relationships, productivity may be slipping away while all the while self-loathing and hopelessness is growing. Depression leads to a great deal of suffering, and not recognizing and getting help for depression leads to worsened depression and therefore greater suffering. It affects not only the person who has it, but their loved ones as well.

Dr. Banov points out that the “emotion of depression” must be distinguished from “the illness of depression” (p. 38). While we all have feelings of sadness or despair at times, the illness of depression (sometimes referred to as a chemical or clinical depression) is a medical condition that causes changes in the physical body and brain. Brain scans of people with depression have shown decreased activity and even atrophy in the hippocampus (plays a role in mood and memory), prefrontal cortex (responsible for planning and attention), the amygdala (generates emotional response during emotionally charged events), and the thalamus (serves as the “communication hub” between our thinking and feeling areas in the brain) (p. 76-77). Depression also can cause or exacerbate other health problems, by affecting insulin levels and blood sugar, compromising the immune system, and leading to elevated blood pressure as well as reduced muscle tissue and bone thickness (p. 79).

Dr. Banov’s book is so packed full of information, any attempt to summarize would be futile. He covers the types of depression, the brain mechanisms that are involved, the various medications used to treat depression, how these medications are believed to work, research studies that both support and do not support their use, typical side effects and how to manage them, generics versus brand names, what to do if your anti-depressant begins to lose effectiveness or causes a numbing of your emotion (not its intended effect), if antidepressants are addictive (they are not), the when and how of discontinuing an antidepressant, and how to deal with special circumstances such as drug interactions, travel, surgery, or pregnancy. Dr. Banov also covers in depth the importance of having a check up for your physical health and the many physical disorders with symptoms that can mimic depression (i.e. thyroid disorders or diabetes).

If you suspect that you or someone you care about is dealing with depression, I highly recommend this book. It contains so much useful information, it could actually be overwhelming for a person with depression to try to decipher all at once. My personal recommendation would be to read the first few chapters to determine if you might be experiencing depression and what your treatment options are. If you do decide to take antidepressant medication, I would suggest that you wait until that time to read more about side effects or long term use. Having read the book myself in just a few days, I can honestly say it is a lot to absorb. Some topics are covered in incredible detail, such as the functioning of neurotransmitters in the brain, and other topics could have used slightly more attention, such as the types of psychotherapy and how alcohol and illicit drug use can worsen depression. To his credit, I appreciate Dr. Banov providing an incredibly comprehensive look at all issues relevant to the topic of depression, even if the reader may want more information on the few areas of special interest to them.

In reading this article and possibly reading this book, I hope that the first message you will take away is that depression is real, and it is serious. It is also quite treatable. Antidepressant medication has been in use since the 1950’s and is improving every year. While most people do not like the idea of taking medication, I can tell you that the vast majority of clients I have known who have taken it have found it to be effective and quite easy to tolerate. While they might initially worry that it is not natural or will change their personality in some way, I have heard many a client say “I finally feel like myself” again once the medication kicked in.

As I stated in my introductory paragraph, one of the best things about this book is its emphasis on treatment strategies other than antidepressant medication. If you want a truly unbiased look at the pro and cons, research support and lack of support, you will find it all in this book. If you want tips on how changing your diet can help and specific foods or supplements that might alleviate depression, you will find that information. I think the best piece of wisdom in the entire book is Dr. Banov’s early recommendation to assess your “depression and antidepressant attitude” (p. 15). Take a moment to evaluate any automatic thoughts or assumptions you have about depression and its treatment. Know that this is your bias and that you are likely to be influenced by it now and in the future.  Be on the lookout for when this bias starts to creep in and do your homework to get a fair and balanced perspective.

Here is my bias: I believe that Western medicine has many drawbacks, including a quick-fix mentality and too often a focus on symptoms rather than the cause. When I think about what we ask our bodies to do, given what we put into them nutritionally, I am sometimes surprised that we function at all. I know that my car runs on gasoline, and I never attempt to make it run on water, sugar, sand, or olive oil. Yet, because we can get by eating a diet of processed foods, we often do. I do not know what percentage of depression might be caused by our diets, lack of exercise, spiritual disconnect, etc., but I am guessing a certain number of people could improve their depression by focusing on these aspects of their lives. Some people, however, will also need medication plus these other things to make their lives rich and fulfilling.

I do not suggest that all of my clients consider antidepressants – not by a long shot. I have seen some clients for years before this type of discussion has ever come up. With other clients, it might be mentioned in our first session. It all depends on how much a person is suffering. In many cases, I think it makes sense to try other things first – healthier foods, sunshine, exercise, yoga, social contact, etc. But if your life feels like it is unraveling and the damage is starting to mount up, an antidepressant may very well be the best choice. There is no rule that you can’t do all those other things too. Most importantly, do something to treat your depression. You deserve to feel better.

August 3, 2010

Managing Anxiety and Depression Using Diet, Nutritional Supplements and SAM-e

by Darby Christopher, LMSW

Please note: This article should not be taken as advice for how to treat any particular condition. Individuals should always consult with their doctor before making any lifestyle or dietary changes, as some natural substances are harmful to specific medical conditions. Never stop taking any prescription medication without the advice and care of your doctor.

 

Introduction

The decision of whether or not to take prescription medication for anxiety or depression is a personal choice an individual makes based on many factors. This choice is made in conjunction with a doctor and often with the help of a therapist. For many individuals, prescription medication is not only a good fit, but the best fit for their particular constellation of life experiences, genetics and environment.

This article is written for individuals who, with the help and consultation of their doctor and therapist, would like to try to use diet and dietary supplements to manage their issues with anxiety and depression without, or in conjunction with, prescription medication. It is also intended to provide information for individuals to explore more fully on their own and with their doctor and therapist.

There are many factors that can affect a person’s mood and energy level, such as diet, proper rest, psychotherapy, exercise, spiritual practices, environment and relationships. This article will focus on diet and biochemistry, while acknowledging that each of these areas are interconnected and equally important.

Why Nutrition Matters

Our bodies need well functioning neurotransmitters, such as serotonin and dopamine, to experience enjoyment, relaxation, focus and motivation. From a holistic perspective, many factors aside from nutrition can affect how well our bodies are able to produce these chemicals. Yet, inadequate nutrition will result in a diminished ability to produce the chemicals we need to feel good. (Inadequate nutrition may result from a tainted food supply, lack of affordable healthy food, absorption problems in the body, and misinformation or inattention to diet.)

What our Bodies Need Nutritionally to Make Feel Good Chemicals

According to Dr. Charles Gant, author of End Your Addiction Now: The Proven Nutritional Supplement Program That Can Set You Free, there are four primary groups of neurotransmitters that are responsible for feelings of well being, relaxation and focus. They include endorphins and enkaphalins, serotonin, GABA, and dopamine and norepinephrine. (Serotonin also contributes to an ability to sleep well.) What our bodies need is to ingest the nutrients necessary to manufacture these items. So, what are these nutrients?

Let’s start with serotonin. Specific cells in our bodies manufacture serotonin using the amino acid tryptophan, working in conjunction with vitamin b6, vitamin c, folic acid and magnesium. Some foods that contain tryptophan include cheese, soy products, seafood, meat, poultry, whole grains, eggs, beans, peanuts and sunflower seeds. Some foods that contain vitamin b6 include tuna, bananas and a variety of green vegetables.

GABA, a neurotransmitter that promotes relaxation, is produced from the amino acid glutamine, working with vitamin b6, vitamin c and magnesium, among others. Foods that contain glutamine include chicken, fish, eggs, beef, beets, dairy, beans and cabbage. A wide variety of fruits and vegetables contain vitamin c, and magnesium is found in specific beans, seeds, fish and green vegetables.

Tyrosine is an important amino acid that contributes to the production of dopamine. Food sources of tyrosine include fish, chicken, pork, whole grains, dairy, beans, nuts and seeds.

The reader may have already noticed that the common admonition to eat a wide variety of fruits, vegetables, whole grains and proteins applies to managing anxiety and depression. As the intention of this article is to provide a broad overview, the above examples are illustrative. The reader is encouraged to research and explore more of the specific proteins, vitamins and minerals that manufacture the various neurotransmitters and which foods support their production.

The Benefit of Whole Foods

Because many of the nutrients that our bodies need to manufacture neurotransmitters now come for sale in a bottle at our neighborhood stores, a word about eating whole foods is in order. In their book Paradox & Healing, Dr. Michael Greenwood and Dr. Peter Nunn discuss the Chinese Traditional Medicine (CTM) concept of “Qi,” or, energy, that is a part of whole foods. They contend, “ …it is the “whole” herb or food which has the Qi and its strengthening properties, not any isolated extract which is called for. In other words, the difference between taking vitamin C in capsules and eating fruit which contains the vitamin is profound.” Recent research into the benefits of phytonutrients found in whole fruits and vegetables corroborates the concept of Qi.

Likewise, in his book Food Rules, Michael Pollan says that, “Foods are more than the sum of their nutrient parts, and those nutrients work together in ways that are still only dimly understood.”  Pollan is a reporter who set out to investigate all of the competing dietary claims in the media. He discovered a very simple truth, which is that the Western diet, with all of its processed foods that he calls “edible foodlike substances,” makes people sick, and traditional diets, no matter what whole, natural foods they consist of, promote wellness. Pollan sums up his discovery of what we should eat in what he calls seven simple words: “Eat food. Not too much. Mostly plants.”

Supplements

Having made a case for the benefit of whole foods, our attention will now turn to the possible benefits of nutritional supplements that come in bottles. Just as in some cases prescription medicine is indicated, there are cases also where nutritional supplements, under a doctor’s supervision, are beneficial. These situations might include cases of nutritional deficiency, attempting to overcome an addiction, as advocated by Dr. Gant, or as a personal preference to combat the effects of anxiety and depression.

Many studies have shown and proven the efficacy of treating various conditions with nutritional supplements. Conversely, concern for supplement use may include the body subsequently under producing the item being supplemented, or other imbalances. (Always consult a doctor when considering nutritional supplements, as they can be harmful or even fatal in excess amounts or when combined with certain conditions.)

Of the many supplements on the market today, a few examples will suffice here. If increased serotonin is desired, a product called 5 HTP may be indicated. The amino acid tryptophan turns into 5HTP in the body along the way to making serotonin. GABA can be purchased directly, as can the amino acid tyrosine, which the body uses to make norepenephrine and dopamine. Fish oil aids in overall brain health, and multivitamins enable the chemicals in our body to do their work.

Inositol is another nutrient for sale that contributes to brain health and helps the body metabolize nutrients. Dr. Fred Penzel reports success in his studies with inositol and trichotillomania (hair pulling), to cite one example.

Herbs, such as St. John’s Wort and hormones, such as estrogen, testosterone and thyroid, are also sometimes indicated in the treatment of depression. As with any supplement, careful attention must be paid to combining herbs and hormones with other treatments, and should take place only under a doctor’s supervision.

SAM-e and Methylation

A popular and increasingly well known product on the market today is SAM-e, which is a naturally occurring substance in the body whose function is to act as a catalyst promoting the chemical reactions that allow the body to produce desired substances. These chemical reactions are known as methylation pathways. SAM-e’s benefit is in taking the raw materials available in the body and producing the desired result, including the regulation of neurotransmitters. Many studies have shown the benefit of SAM-e to alleviate depression.

Conclusion

Individuals who are seeking ways to address their anxiety and depression without or in conjunction with prescription medication may find that a well balanced regime of exercise, meditation, proper rest, social support, work with a therapist, and attention to diet may give them the help and relief they are looking for. For the diet portion of this plan, whole foods are essential. Supplements can be added under a doctor’s care and may be beneficial, but do not take the place of whole foods. Informed consultation with a doctor or therapist may help determine an individual’s best course of action, and some trial and error may be expected along the way to discovering what combination of elements will work best.

Bibliography and Recommended Reading:

Food Rules, by Michael Pollan

End Your Addiction Now: The Proven Nutritional Supplement Program That Can Set You Free, by Dr. Charles Gant and Dr. Greg Lewis

Paradox and Healing: Medicine, Mythology & Transformation, by Dr. Michael Greenwood & Dr. Peter Nunn

Web site, The World’s Healthiest Foods, http://www.whfoods.com/

Web site, The Podell Medical Practice: Merging Traditional Medical Practice and Alternative Therapies, http://www.drpodell.org

August 5, 2007

Is It Sadness or Depression?

Filed under: 2007 and earlier,Depression,Former Karuna therapist — karunacounseling @ 4:44 pm
Tags: , ,

Andrea J Schrage, MA, LPC, CMT

Why is it that most people feel familiar with Depression? Why is it that if you start talking about taking anti-depressants that people come out of the woodwork to tell you about their experience on meds? One of the pieces in the puzzle is that people do not know how to distinguish sadness from “feeling depressed”

To give you a generalized idea of the succession from sadness to depression, it can often look like this:

  1. You have an emotion
  2. You do not know how to attend to it or choose to not attend to it
  3. The feelings get stuffed down via ignoring it or covering it in a addictive pattern
  4. You feel depressed

This is a simplification to help you see all the steps that happen before the depression sets in. Often what happens in this process is that there is a lot of grief that is not getting tended to. When this happens the world can feel unsafe and people tend to start protecting by shutting down their emotions. The blessing and curse in how our bodies work is that when you shut down one emotion, they all tend to get shut down. The curse is that if you don’t want to feel sad then you limit your ability to feel joy. The blessing is that if you don’t feel joy, it may cause you to look for the problem and then heal it.

To help clarify more we can look at “symptoms” of sadness and of depression.

Sadness can come in the form of:

  • Tears
  • A feeling in the throat, heart, or chest
  • It may come in waves that peak and then lessen
  • It is temporary
  • It is usually related to an event, even if it is an old event

Depression can come in the form of:

  • Feeling tired all the time
  • Not finding joy in things that you used to find joy in
  • A negative outlook on most things
  • On-going sadness without an obvious cause
  • Changes in eating patterns
  • Disconnecting from others
  • Difficulty getting up and going in the morning
  • A lack of emotions
  • A change in sleep patterns
  • Hopelessness

Most of us did not learn to properly attend to emotions, we are taught to analyze, ignore, and cover up any emotions that we have. What is surprising for most of us is that we are just as scared to feel real joy and success as we are of feeling sadness and pain. This fact is usually left unnoticed, but it anchors in our system of wanting to avoid emotions. If you can start separating your feelings out, you can tend to them, which will allow you more power and consciousness about the choices that you make in your life.

Ways to start dealing with emotions are through writing, mindfulness, releasing them through the physical body, or through therapy. As you do this practice over time, you retrain your system to not fall into habitual depressive patterns. You will also learn to tolerate feelings and you will begin to pick up on the early cues that you are heading towards a depressive episode. If feelings are overwhelming for you or if you have a history of trauma, then please seek support through professional help.

For more questions about this process you can reach me at: 404-818-6114 or email me at AndreaSchrage@KarunaCounseling.com

http://www.KarunaCounseling.com

February 10, 2005

Preventing The Recurrence of Depression and Anxiety

Filed under: 2007 and earlier,Anxiety,Depression,Former Karuna therapist — karunacounseling @ 4:41 pm
Tags: , ,

by Andrea Schrage, MA, LAPC, CMT

The chronic, recurrent nature of depression and anxiety presents an enormous challenge to sufferers and treatment providers. Combining the use of mindfulness and cognitive behavioral therapy allows for individuals to learn skills that will work more holistically to include mind and body in their growth. Participants can learn to play an active role in preventing the return of depression and anxiety as they watch other areas of their life positively impacted during the process. Through learning these techniques, one will notice a change in how they are able to participate more fully in their life in a conscious and often more peaceful way.

Conscious Choices is a 4-session class designed to teach its members how to combine these two modalities and to give them skills to help them prevent the spiral into reactive moods.

  • Learning to meditate for those who think they can’t.
  • Learning to identify the ongoing flow of critical voices in our heads.
  • Learning to sit with painful emotions and body pains.
  • Learning how to see anxiety and depression coming and make choices to prevent them.
  • Learning to recognize joy and happiness in everyday life.

Effects of this class may include:

  • Increased relaxation.
  • Reduced fear and anxiety.
  • Discontinuation or lessening of depression cycles.
  • Increased happiness and appreciation of life.
  • Feelings of empowerment.
  • Ability to make clearer choices about life.
  • Increased connection with others and self.

by Andrea Schrage, MA, LAPC, CMT

Blog at WordPress.com.