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Herbs for Depression: St. John’s Wort (Hypericum)

Hypericum is an herbaceous perennial weed used since the time of ancient Greece for its many medicinal properties (NIMH 1997; Bombardelli and Morazzoni 1994; Salzman 1998). The plant contains several chemical compounds thought to elevate mood; among them, hyperforin is regarded as the most likely source of this antidepressant action. It is believed that the herb achieves its effect by increasing levels of serotonin, an up (or excitatory) neurotransmitter, in the brain. Hypericum also may inhibit secretion of cortisol, a stress hormone (Wong et al, 1998; Chatterjee et al 1998). Data from clinical trials suggest that hypericum and prescription antidepressants may be equally effective in the treatment of mild-to-moderate depression (Linde et al 1996; Wheatley 1997; Hippius 1998). Moreover, the herb appears to be well tolerated (Hippius 1998), causing fewer side effects than those observed with conventional antidepressants (NIMH 1997; Wheatley 1997).

Only 2% to 3% of people who use hypericum experience side effects. The most common side effects are gastrointestinal problems, allergic reactions, fatigue, delayed hypersensitivity, dizziness, dry mouth, constipation, restlessness, and confusion. Because of these potential side effects, use of hypericum is not advised during pregnancy or lactation. In addition, users should avoid exposure to strong sunlight. Hypericum may interact with several important classes of antidepressant medications such as monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs). It is therefore important for depression sufferers to inform their physicians of all medications, herbs, and vitamin, mineral, and other nutritional supplements used so as to avoid harmful drug interactions.

What to Expect as You Overcome Major Depression

Learn what to expect as you go through treatment and recover from major depression.

After a bout of major depression, it’s a relief when you start to feel like your old self again. Overall, you’re improving as you go through treatment for major depression, “but it’s often two steps forward and one step back,” says Shoshana Bennett, PhD, a clinical psychologist. “It’s rarely a straight line up.” Just knowing to expect some bad days with the good can help you be more patient with yourself. “These are dips, not relapses,” Dr. Bennett says.

A risky time during depression recovery is when you start having several good days in a row. It’s easy to think that — since you’re not having symptoms — you don’t need treatment for depression anymore, but going off medication or quitting therapy for depression too soon can lead to symptoms coming back.

American Psychiatric Association guidelines recommend that people with depression who have been successfully treated with antidepressants keep taking them for at least four to nine months, and sometimes longer. Similarly, people with depression who have fewer symptoms with talk therapy should talk with their therapist about how long to continue treatment.

Keeping Depression Symptoms Away Besides sticking with your depression treatment, you can take steps to keep symptoms under control. Connecting with friends and family, thinking positively, staying active, eating well, and getting enough sleep all help, but there’s a catch, says Jon Allen, PhD, senior staff psychologist at the Menninger Clinic in Houston: “The nature of depression makes it difficult to do those things.”

Don’t be surprised if these healthy steps feel unnatural at first. Depression fosters hopeless thinking, so you may have trouble believing that they’ll ever get easier. “They will,” Dr. Allen notes, “as you pull out of depression.”

Friends and family might see a change in your depression symptoms and depressed behavior before you do. “It’s remarkably common,” Allen says. “People will say, ‘Gosh, you look better,’ or ‘You sound better,’ and the depressed person is thinking, ‘Well, I still feel terrible.'” It can be very frustrating for the depressed person, who ends up feeling that other people don’t understand how tough things really are.

Building a Depression Support Network A support group is one place to find other people who know what you’re going through because they’ve had depression themselves. To locate in-person and online depression support groups, call the Depression and Bipolar Support Alliance (800-826-3632).

If you pulled away from friends and family while depressed, now is the time to start rebuilding those bonds. Allen suggests making concrete plans; for example, to meet a friend for coffee. “By making that commitment to someone else, you may feel obligated to show up,” he says. It’s added motivation to get out and rejoin the world. Friends and family can also be a source of encouragement on days when depression symptoms or worries about symptoms get you down. Gradually, you’ll start to feel more hopeful, too.

Exercise and Major Depression

Learn how exercise and physical activity can change your brain chemistry and support your major depression treatment plan.

Exercise is prescribed for a wide variety of health conditions — from heart disease to diabetes. Science shows being active can improve your physical and mental health, and make positive changes in your brain chemistry. But if you’re battling major depression, the thought of working out may seem unthinkable. Here’s some information about the benefits of exercise that may change your mind.

Exercise and Nerve Growth    Early brain chemistry research found that mice living in an exercise-friendly environment stopped acting depressed after a stressful social experience — while mice who didn’t exercise stayed depressed. Scientists attribute the mice’s recovery to the growth of new brain nerves caused by exercise.  This and other research has led scientists to understand how brain nerve growth works in humans, too. Adults affect their brain chemistry through experiences — such as physical activities — and how they respond to them. The proteins largely responsible for the brain’s ability to adapt and change are called neurotrophins. Antidepressants affect neurotrophins in the brain — and so does exercise.

Benefits of Exercise Therapy for Depression In addition to stimulating new nerve growth and improving your ability to think, remember, and learn, exercise boosts serotonin, dopamine, norepinephrine, and endorphins in your brain. These neurotransmitters help you calm down and focus. In studies, exercise therapy has also shown an antidepressant effect.

One Duke University researcher, James Blumenthal, PhD, has been studying exercise and MDD for over a decade. “Based on the best available evidence to date,” Dr. Blumenthal believes that “exercise may be generally comparable to medication in the treatment of MDD.” Similar studies continue to find at least modest clinical benefit for exercise and better mental health. But don’t self-treat your depression symptoms or try to get through your recovery with exercise alone. Talk to your doctor about treatment and self-care options — including exercise — that are right for you.

Adding Exercise to Your Treatment Plan Once you start exercising, you’re likely to notice some changes in your symptoms right away. “Simply moving more and sitting less will make a difference in how you feel,” says exercise physiologist and dietitian Amy Ogle, MS, RD. “And if you typically exercise alone, consider working out with a group or partner because the social connection helps lessen depressive symptoms.”

Shoot for at least 2 1/2 hours of exercise in a week. Strength training counts toward that time, too. Just remember to check with your doctor first, especially if you have another medical condition.

“Sticking to a plan and following your progress,” Ms. Ogle adds, “will renew your sense of self-mastery and control.”  You can progress to the following routine:

  • 5-10 min warm-up, gently moving upper and lower body in full range of motion
  • 30 min aerobic exercise, such as walking, light jogging, swimming, biking or a group exercise class. You should be able to talk, but not comfortably sing.
  • 5 min cool-down and stretching

Boost Your Energy Level in 11 Steps

Learn how to recharge your batteries so you can keep on going like the Energizer bunny.

Tired of Having No Energy?

Everyone feels tired now and then, but are your energy stores totally depleted? Think of it this way: If you blow a fuse in your house, you can’t expect to get power back by lighting a few candles and searching for food with a flashlight. You’ve got to find the bad fuse, replace it, and reset the system. Same goes for your energy. Before you reach for the big Cs to snap out of your sluggishness (you know . . . cookies, candy, carbs, and caffeine concoctions), we’ve got an 11-step plan to pep you up.

Consider Your Sleep Habits

It’s pretty basic, but you need to get your ZZZs. Sleep loss is a major energy drain. Our bodies and brains need 6 to 9 hours of sleep to restore good brain-cell functioning (i.e., the ability to perform physically as well as mentally, since both coordination and thinking require those brain cells to work well). Getting on a regular bedtime schedule will help set your internal clock so your body knows when to sleep and when to wake. Find out what’s causing any sleep issues you may have.

Train Your Brain

Tell your body you want to watch Glee reruns all night and — thanks to mechanisms called feedback loops — you downshift energy production. This explains why you can feel too tired to move even though you’ve been sitting around all day. Tell your body to move and it responds by giving you the energy to get moving. Your body teaches your brain. That’s how healthy behaviors become automatic habits. This may be tough the first few times you try, but it gets easier.

Stay Hydrated

Getting to the point where you’re just starting to feel thirsty (a mere 2.6% drop in hydration levels) is one of the quickest ways to take the spring out of your step. In fact, being even just a little dehydrated can lead to unpleasant feelings, such as fatigue, crankiness, and foggy thinking. When you feel yourself dragging, grab a tall glass of water. Another plus of H20: people who drink water throughout the day consume a whopping 9 percent fewer daily calories.

Cut Back on Sugar

A sugar-filled diet gives you about a birthday candle’s worth of energy, while a healthy diet is more like an eternal flame. Work on limiting simple sugars (they end in –ose, such as glucose, sucrose, maltose, and dextrose — ribose is OK), syrups, and any grain that’s not 100% whole. Ribose is the exception because it’s a special sugar made in your body. It doesn’t come from food, but does come in supplement form and can help build the energy factories of your body. It’s not for everyone, so talk to your doctor first.

Trade TV Time for Exercise

No time to exercise, but plenty of time to watch TV? Exercise can do a world of good to boost your energy, so even on days when you don’t feel up to it, try to do some kind of physical activity, such as walking, strength training or cardio to kick your feel-good endorphins into high gear. Still uninspired? Try the 10-minute rule. Make a deal with yourself to get moving for at least 10 minutes. Chances are, once you start, you’ll feel so much better that you’ll keep going.

Spend Time in the Sun

Short days can causes seasonal affective disorder (SAD) — neurochemical changes in your brain due to lack of sunlight. From late fall until spring, people with SAD become depressed, sleep too much, withdraw from friends, and battle low energy and relentless carb cravings. To prevent SAD and get energized, try to spend some time in the sunshine. If there isn’t any, ask your doctor about light therapy, which involves sitting in front of a special box that shines ultrabright lights.

Sip Tea

Black, green, and white teas all contain the energizing amino acid L-theanine, which isn’t found in coffee. Green tea contains free-radical-fighting compounds that help you stay younger and avoid the aging and decrease in energy that accompany chronic disease. Although green tea has one-third the caffeine of black tea, it’s been shown to yield the same level of energy and attentiveness.

Get a Daily Dose of Magnesium

For a little extra get-through-the-day energy, top your veggies with toasted sesame seeds. They’re loaded with magnesium — a mineral that cells need in order to convert food to energy. Other magnesium-rich foods include: whole grains, dark leafy greens, pumpkin seeds, and cashews. Magnesium not only boosts your energy, it also helps strengthen your bones and keep your heart, nerves, muscles, and immune system functioning well.

Take a Power Nap

Close your office door or slip out to your car for a quick snooze. Power naps, or “cat naps,” can boost your mood, memory, and productivity. They also increase your alertness and energy while lowering your blood pressure. To get the most out of your siesta, keep it short (10 to 30 minutes), aim for midafternoon, and get comfy (kick of your shoes, loosen tight clothing and darken the room). Can’t take a nap? Opt for an afternoon walk or office-gym workout.

Eat More Mini-Meals

To stay energized all day, you have to eat often. That means shifting away from three big meals toward five to six balanced mini meals. To maintain steady energy levels, pair complex carbs that are high in fiber (e.g., beans, peas, and whole grains) with unsaturated fats (e.g., avocado, walnuts, or mixed greens with olive oil). Add protein, such as lean meat, nuts, fish, and edamame, as an accent rather than as a main dish.

Still Tired? Talk to Your Doctor

If you’ve tried everything under the sun to boost your energy but still feel tired, it’s probably time to make an appointment with your doctor. Share how you’ve been feeling, when your fatigue began, and what factors may be causing it. Don’t be afraid to ask questions and to find out what treatment options may be available to you.

Top Ways to Get Your Energy Back — Now

February 21, 2010 12:00 AM by Mehmet C. Oz, MD, and Michael F. Roizen, MD

You’re grumpy at the groundhog (who needed extra weeks of winter?) and a little short with your spouse, and you have been spending more time with the mac-and-cheese casserole than the treadmill. Winter can do that. But it doesn’t have to. Use these strategies to cuff the classic energy thieves that are still hanging around this time of year, and get your mojo back before spring hits:

Energy thief #1: Short, dark days.
What happens: Short days can cause seasonal affective disorder (SAD) — neurochemical changes in your brain due to lack of sunlight. This results in depression in up to 6% of Americans (the further north you go, the more likely you are to be a SAD sufferer). From late fall until spring, people with SAD become depressed, sleep too much, withdraw from friends, and battle low energy and relentless carb cravings.
Turn it around: Light therapy — sitting in front of a special box that shines ultra bright lights — has long been considered to be the best way to combat SAD. But a new University of Vermont study reveals that cognitive-behavioral therapy (CBT) may be even better. CBT is a type of psychotherapy that helps people outsmart depression by teaching them to change their negative ways of thinking. In fact, in this study, CBT alone was able to stomp out SAD with a success rate of 81% (compared with 49% for CBT plus light therapy and 32% for light therapy alone). Why wouldn’t more therapies be better? Researchers surmise that trying to balance two therapies was just too confusing, but CBT alone allowed people to focus on the coping skills they needed to banish their winter blues.

Energy thief #2: You can’t get enough comfort.
What happens: When the mercury heads south, we crave calories, carbs (they help our brains make the calming neurotransmitter serotonin), and fat. In fact, a 2006 University of Massachusetts Medical School study found that once the days become shorter, we pack away an average of 86 extra calories a day and weigh more than at any other time of year. We also snarf down more total and artery-clogging saturated fat.
Turn it around: Just cozy up to good-for-you carbs and healthy omega-3 and omega-9 fats that will satisfy your biology and your brain without packing on a gratuitous layer of blubber.

Trade meatloaf and pot roast for hearty whole grains like whole-wheat pasta and brown rice, or try polenta, a veggie burger, or salmon. Or warm up with a satisfying bean-based vegetable chili or Tuscan white bean soup. Since beans and whole grains are digested slowly, they’ll keep you full longer, so you’ll eat less overall. And if it seems like there are slim pickings in the produce department, now is actually the prime time to load up on nutrient-packed starches, including sweet potatoes and winter squash (roast or bake them with a drizzle of olive oil). Finish your feast with seasonal winter fruit (think apples, pears, oranges, grapefruit, and tangerines, or even frozen berries) topped with a sprinkle of heart-healthy walnuts or almonds and you’ll get all the carbs and fats your body craves — but you’ll do it the healthy way.

Energy thief #3: You stay in. On the couch.
What happens: Your workout plan bites the dust. We log less exercise in winter than any other time of year, with a paltry 45% of Americans and 36% of Canadians keeping active. Pretty ironic, since exercise can lift you out of the winter doldrums by boosting energy, improving mood, and helping you sleep better.
Turn it around: Start with your schedule. Make regular exercise appointments on your calendar the same way you’d ink in any other non-negotiable activity. But give yourself a bit of a break: Don’t think exercise needs to be a hard-core trip to the gym. Taking the dog for an extra-long walk or doing crunches and lifting weights in front of the TV count, too. Still uninspired? Try the 10-minute rule. Make a deal with yourself to get moving for at least 10 minutes. Chances are, once you start, you’ll feel so much better that you’ll keep going.

A “Bad” Habit That Helps You Live Longer?

Some of us just can’t live without our morning coffee fix. And some of us may be feeling a little guilty about that.

Not to worry. Your morning cup of joe could actually be helping you live longer. A recent study has linked coffee drinking to a reduced risk of death, regardless of the cause.

Healthy or Not, Here I Come!
Over the years, research has produced mixed results on the health benefits of coffee. But a recent study was a win for the earthy brew. Heavy java drinkers (2 or more cups per day) experienced a modest decrease in all-cause mortality, including death from heart disease. We can probably credit the antioxidant-rich beans used to brew the stuff. In fact, Americans drink so much coffee that it’s one of our top sources of antioxidants. 

Reality Check
So what are the caveats for coffee drinking? There are only a few. If you are sensitive to caffeine, you don’t need to be told not to be a java junkie. And unfiltered coffee can raise blood fats, so use paper filters and ditch the French press. Although it remains to be seen if coffee has a long-term impact on blood pressure, we know it can cause a temporary spike, so go easy if you have high blood pressure. And — as always — do everything in moderation. A pot-a-day habit probably doesn’t do anyone any favors.