Ask Dr. Matt...

What does it feel like to have SAD?: Individuals with SAD often...

Beginning in November/December complaints of fatigue (low energy)

Difficulty waking up in the morning

More of an effort to get things done at home & work

Diminished interest in friends and previously enjoyable activities

Increased irritability, negative thinking, pessimism

Weight gain (more of a draw to eat sweets/carbs)

Feelings of hopelessness and depression

A pattern existing from winter to spring, then back to feeling better

What causes SAD?:  Ongoing research suggests...

a. A lack of adequate morning light to suppress the hormone melatonin

b. Lack of sunlight may disrupt the sleep cycle (circadian rhythms) = over sleeping

c. Negative affect on levels of neuro-chemicals, primarily serotonin that affects mood

Who has SAD?:

An estimated 6% of the population suffers from full-criteria SAD

14% experience sub-clinical levels of SAD (Winter Blues)

Women outnumber men 3 to 1 in reporting the disorder

SAD Treatment Plan:

4 Core Components:

Light

1. Purchase a portable light therapy device. You can get one online, including Amazon.com, Costco.com, or at Apollohealth.com. Use it for 30 to 60 minutes early each morning. Sit in front of it, or to the side, but don’t stare directly into it. You may also want to add another 30 minutes in front of the light box during the late afternoon between 5:00 and 7:00.

2. On sunny days fit in a walk outside for at least 15 minutes.

Thoughts

Cognitive-Behavioral Therapy (CBT): Will hep you identify negative thought patterns and retrain them. The progress you make with the light will be dramatically more affective and last longer with CBT. Visit with a psychologist to start CBT.

Sleep

1. Fix a bedtime and a wake time. This may not be possible for your schedule every day, but I’d recommend having a schedule even if you are only able to stick to it half the time.

2. Avoid napping during the day. This may not be possible because of your schedule, but if you don’t need a nap, avoid it and then go to bed a bit earlier that evening.

3. Avoid alcohol, caffeine, and spicy or sugary foods 4-6 hours before bedtime.

Antidepressants

If you have struggled with SAD for more than 2 years and suffer significant depressive symptoms you may want to consult with your physician about a medication. These medicines can improve the balance of brain chemicals that affect mood.

3 Bonus Components:

Diet

Start with more water throughout the day: 6 to 8 glasses total. Then, watch the numbers of carbs and sugars you are eating.

Exercise

Try to fit in 30 minutes of moderate exercise 3 to 5 times per week, but not within 2 hrs of going to bed.

Music/Movies/Books

Listening to happy and upbeat music (and movies) in conjunction with the other treatment methods can positively improve your mood.

That’s it. You should start to feel better within a week or so after starting this treatment protocol. But you need to stick with it until the season changes. You should also visit with your doctor prior to starting any treatment plan.

1. Expectations

            Make sure they are realistic  (not overly positive or negative)

2. Identify what makes you happy

            Make sure it is part of the holiday – plan it!

3. Identify what makes you feel rested

            Make sue it is part of the holiday – plan it!

4. Be willing to set limits

            On time and activities

5. Something old and something new

            Traditions yes, but also add something new to the season

(To be accurately diagnosed please see a qualified professional)

Symptoms of Depression: 5 in the same 2 weeks & a change from previous functioning

depressed mood most of the day

loss of interest or pleasure

feel sad or empty

     Note: In children and adolescents, can be irritable mood

significant weight loss when not dieting or weight gain

decrease or increase in appetite nearly every day

     Note: In children, consider failure to make expected weight gains.

insomnia or hypersomnia nearly every day

psychomotor agitation or retardation nearly every day (not merely subjective feelings of restlessness or being slowed down)

fatigue or loss of energy nearly every day

feelings of worthlessness or excessive or inappropriate guilt

diminished ability to think or concentrate, or indecisiveness,

recurrent thoughts of death (not just fear of dying),

recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

What creates our mood each day?            The "Mood Triangle"

Our moods fluctuate each day normally, large mood swings on a regular basis, or having regularly low or high moods without fluctuation can indicate a problem.           

Mood is a dynamic combination of:

Patterns of Thinking (Pessimistic, Negative)

     Thoughts lead to Feelings Lead to Behavior

Patterns of Behavior

Biology

Treatment Options:

            Cognitive-Behavioral Therapy to treat depressive patterns of thinking & behavior

            Medication to treat biology

How to get started at home?

            1. Read: “Learned Optimism” – Martin Seligman

            For Parents, read: “The Optimistic Child” – Martin Seligman

            2. Talk with your family doctor

            3. Consult with a psychologist

What is Fear?

An emotional and physical response to a threat

A basic survival mechanism

Occurs in response to an external stimulus (threat of danger)

One of a few basic or innate emotions (joy or sadness)

Fear is related to the behaviors of escape and avoidance

Is fear different than anxiety? Yes, fear is different than anxiety, which is largely internal. Anxiety is the result of threats, which are perceived to be uncontrollable or unavoidable.

Fight or Flight: When a threat is perceived the sympathetic nervous system activates the release of adrenaline and the response.

What Causes Fear?

Learning (fear conditioning) via experience, observation, or cognitive projection.

Evolution (preparedness) for innate fears (heights, snakes, the dark, and death, etc.)

Social & Cultural – things feared by the larger social network (Witches in medieval Europe or polio in the 20^th century America)

Neurobiology – the Amygdala is the brain structure that processes negative emotions.

Common Fears:

spiders, snakes, heights, water, enclosed spaces, tunnels and bridges, social rejection, failure, and public speaking, terrorist attacks, death, being a failure, war, criminal or gang violence, being alone, the future, nuclear war

Why we like to scare ourselves? Emotion of fear is more important to modern humans than instinct.

1. Thrill - Adrenaline rush

We enjoy fear for fear's sake.

Research has found that we entertain thoughts of ghosts and goblins because we crave the stimulation of fear's chemicals (adrenaline).

2. Dealing with Death

Confronting fear is our modern world way of dealing with death. By scaring ourselves in a controlled and fictional manner, we affirm we are still alive.

By scaring ourselves the horror of death has been rendered safe.

The thrill of horror movies and books derives from the fact that we know it is not real.

By experiencing these scary, but obviously unreal forms of entertainment, we are immunizing ourselves against the fear of death and proving that we can control our fear.

We enjoy the fear we create for ourselves because it allows us to choose not to be cowardly.

1. Superstition:
Definition: Superstition is the belief that unknown (often magical or supernatural) connections between events can cause or prevent certain outcomes.
1948: 1st psychology paper on superstition: BF Skinner’s pigeons.
How they develop:
False Associations/Correlations: People associate behavior with an external phenomenon that was not necessarily connected in any way with personal behavior. Correlation without causation.
Highly important situations = more superstitions (Safety, Money, Sports)
Intermittent schedule of reinforcement, like gambling: a big pay-off, but not sure when it will come, this keeps you persistent despite loss or set backs.
Wanting more control is the driving force behind most superstitions. We tend to look for some kind of a rule, or an explanation for why things happen. Sometimes the creation of a false certainty is better than no certainty at all.
Purpose: Keep us safe or lucky = People don’t want to take a chance, so they do it.

FYI: Many superstitions started as a way to control children. Keeping kids in the house at night, out of the forest, etc.

2. Getting rid of superstitions: Self-observation. Record each time the event occurs and the actual event that follows you’re unlikely to maintain your superstitions.

Making good decisions can be a challenge...

1. Common ingredients:

Emotional and Logical decision making:
    Most people recognize these styles
    Decisions are often successful when both come together

Example: Who to marry

2. Missing Ingredient:

One of the main things that determines decision making is something we’re unaware of -- your perspective on time.

Example:
Making the decision to skip work.
    You might think about what happened the last time you skipped work.
    You might think about how it might affect your job in the tomorrow, etc.
    You could focus on how much fun it would be right now
    You might figure you won’t get much done today anyway, so why not?

These four responses are typical of distinct time perspectives:
    past, future, present-hedonistic, and present-fatalistic

Research Shows:
Young people who are high in the present-hedonistic category are more likely to drink, smoke, use drugs, and drive dangerously

The first step to making better decisions is to understand how your own time perspective biases your thinking. Then you can start nudging it a little closer to the ideal:

Feeling positive about the past, planning for the future, and savoring the occasional splash of present hedonism

Time focus can also affect your mood:
    Past w/ regret = depression
    Future w/o control = anxiety
    Present = grounded and in control

Philip Zimbardo, PhD (Stanford Prison Study) developed a test:
Take the test and see how you measure up at www.thetimeparadox.com

Today we’ll talk about:
    1. What PTSD is
    2. Effects on the body
    3. Effective treatment
    4. What friends and family can do
    5. Resources

1. What is PTSD? Post Traumatic Stress Disorder is an anxiety disorder
    *Also called in the past: Shell Shock or Battle Fatigue
    **This is what go General Patton in trouble in WWII for striking a couple soldiers
    ***Descriptions of PTSD date back to the Greeks (battle of Marathon)

2. How does it develop? A person...
    a) experienced or witnessed an event that involved actual or threatened death or serious injury to self or others (combat, assault, natural disasters)
    b) the person’s response involved intense fear for themselves or others

3. What are the main symptoms? The traumatic event is re-experienced by...
    a) intrusive thoughts or memories (flashbacks)
    b) recurrent distressing dreams
    c) acting or feeling as if it is happening again (triggered by events)
    d) physiological and psychological distress
    e) avoidance of things associated with the event (thoughts, places, activities)
    f) memory loss for the event
    g) feeling detached from others or emotionally numb
    h) lasts more than one month

4. Not just an emotional disorder: Neurological changes take place in the brain...
    Biochemical: a norepinephrine - cortisol ratio higher than in non-PTSD individuals
    Neuroanatomy: reduction in the volume of the hippocampus

5. What treatment is effective for the person who has PTSD?
    a) Education about the condition
    b) Cognitive-Behavioral Therapy (retraining patterns of anxious thinking)
    c) Group therapy (reduces isolation and stigma)
    d) Exposure therapy
    e) Medication
*Combination therapy is most common and shows best results - full recovery is possible

6. What can friends and family do to help those who have PTSD?
    1. Become educated on the disorder, all aspects of it - end the stigma
    2. Be involved in and supportive of treatment
    3. Don’t expect or pressure your friend/family member to be just like they were before,  give them time - a full recovery is possible

7. Resources: www.apa.org

What is Worry? Anxious thoughts that are generally tied to specific real-world issues, reasonable and controllable although the person feels stressed

What is OCD? An anxiety disorder characterized by: (Biochemical, not Character)
    Obsessive worries: unwanted recurrent and persistent intrusive thoughts or impulses that cause significant distress and interferes with daily functioning.

    Often recognize that the thoughts are irrational, but can’t control them.

    Compulsive behaviors (can be mental) ritualistic, repetitive, or rigid

    Obsessive thoughts often lead to compulsive behaviors with the purpose of dealing with the anxiety

    examples:     Contamination obsessions = Compulsive washing/cleaning    
            Safety obsessions = Compulsive checking
            Religious obsessions = Compulsive praying/confessing

    How is it different from worry?
        OCD: People often recognize the anxiety is irrational or disproportionate, but feel out of control to stop it

How to deal with daily worries: Can generally handle on your own
    1. Recognize the worries
    2. Challenge the worrisome thoughts “Is this helpful to me?”
    3. Stop procrastinating and take meaningful action

What to do if it’s OCD: Should work with a psychologist in CBT and possibly medication = OCD is a brain disorder that can be treated via CBT retraining
    1. Recognize you’re obsessing
    2. Reattribute the worry: “It’s not me, it’s OCD”
    3. Refocus your thinking: Shift gears and refocus your attention
    4. Revalue the validity of the obsessive worry

Book: “Brain Lock” by Jeffery Schwartz

What we’ll talk about:
    1. Good and bad control
    2. Assess what type you have
    3. How to get the right type

Control” The word control gets a bad wrap when it comes to our personal lives (control freak or out of control). But it is an important part of life.

1. Locus of Control: Belief about what causes the good or bad results in life, either in general or in a specific area. The extent to which individuals believe that they can control events that affect them. (Rotter, 1954)

2.    Two Types: Internal vs. External
Internal locus: Belief that events result primarily from personal behavior and actions.
    Better control of their behavior
    Exhibit more political behaviors
    More likely to attempt to influence other people
    More likely to assume that their efforts will be successful
    More active in seeking information and knowledge concerning their situation
External locus: Believe that powerful others, fate, or chance primarily determine events
    Luck plays a big role in their lives
    If a general state: Higher rates of depression and anxiety, less life success
    If a specific/limited trait: Same applies to this limited arena of life

Your Type?
        Anticipating job interview results...
        Anticipating how your day will be...
        Explaining disappointments...
        Explaining success...

3. How to develop an Internal Locus of Control
    Must recognize your role in the outcomes of life events
    Keep a nightly journal of good things that happen and then analyze your role

What is love? What makes people fall in love? Many different theories – biology & psychology
Biology view: Sexual Attraction and Attachment – chemicals, hormones, pheromones, odor = reproduction of the species
    Psychology view: Emotional intimacy love and Passionate love

Pheromones: Chemical signals that triggers a natural response in another member of the same species. Alarm; Food Trail; Sex – found in insects, some animals and plants. Humans: few good studies, via sweat glands

Western Cultures: Love encompasses the entire relationship – passion & attraction, intimacy and companionship.
    Goodness of fit:

How to improve loving relationships:
    1. Express it: verbally and physically
Verbally: say I love you, also express specifics that you love and like about your partner.
Physically: physical touch, pleasant smells and deeds
    2. Time together pays dividends: creative and new activities = novelty
3. Have the same idea of what love is: Love Story or analogy
4. Like your partner: Get to know them, also you should continue to be interesting
    5. Learn to problem solve not ignore, small problems will grow into big ones

How to make someone fall in love with you:
    1. Love yourself – develop yourself, be interesting
    2. Be attractive: physically and interpersonally
    3. Smell good

Freud: What do women want?
1.    Men think women find a man with resources highly attractive
2.     Women think men find a woman who's stereotypically feminine attractive.
3.    The truth is men and women both list physical appearance as the quality that's most
sexually attractive.
But for romantic attraction. Both men and women list qualities of kindness, warmth, a sense of humor, sociability, trustworthiness and a stable personality as attributes sought in a romantic partner.

This week the Dow dropped (and stayed) below 7,000; Every day new gloomy news crosses the airwaves; You have friends and family who are talking about their financial worries; How's a person supposed to stay sane during these gloomy economic times?

Truth is… it can be tough. Money equals security in our culture and worries about money create very real worries about how we will survive. Psychologically, what a person thinks about influences how he or she feels, and how we feel influences what we do, in other words:

Thoughts = Feelings = Behaviors

However, in stead of allowing ourselves to helplessly focus on negative thoughts, which will invariably lead to negative feelings and consequently negative/depressive behaviors (See equation above) there are things one can do to make real changes that will make our thoughts more positive, elevate our moods, and increase the likelihood that our behaviors will be productive.

If you are in the middle of serious economic problems already then it is likely that this solution may seem a bit too naive, but truthfully, this is the pattern, in some form or another, that others who have been in similar bad straits have followed on their road back to success, whether they knew it or not.

How To Do It?

Here are 5 steps that will help you make the (Thoughts = Feelings = Behaviors) equation work for you.

1. Be A Proactive Planner: I like to say, "Nothing cures stress and anxiety quite as well as a good plan." But you must be proactive in at least two important ways:

a. Have a Financial Plan for your current finances and make them stretch. A little extra in the bank, and fewer debts, will help you ride this out.

b. Make a Career Plan B. This may seem hard to do, but it’s not. especially if you’re not in your dream job. Think back to past successes, or re-contemplate things you’ve wanted to do. Now is a great time to get new training or re-specialize. At the very least, beef-up your resume and make yourself needed.

2. Focus on Your Skills and Achievements: Remember, what you think about will influence, almost immediately how you feel and what you do. Think about when you’ve been successful before and write down what you did to be that way and apply those principles again in your life today. Situations change, but principles of success remain the same.

3. Forget the Doom and Gloom Hype: Pay attention to what you have to, your finances, your investments, but don’t be a bad news junkie. Be realistic. Ask yourself, how is this affecting me and what can I do about it, then get busy doing what you can, but quit just thinking about it.

4. Beware of Increases in Unhealthy Behaviors: When we feel down we naturally want to feel better, unfortunately we can often turn to unhealthy habits that make things worse, like smoking, drinking, over eating, gambling, and yes, even over spending!

5. Increase Healthy Behaviors: Now is the time to be at your best to face the challenges that are coming, so be active, get some exercise, make yourself get better sleep, improve your nutrition, and even spend some time meditating or connecting spiritually with yourself and your family.

Frankly, things may get worse before they get better for our economy, but be proactive, use these steps, and take charge of how things unfold for you. If you feel overwhelmed by this process already and think you can’t do it alone, contact a mental health professional who can help coach you along, I’m happy to help and/or make referrals where needed.

What is Emotional Eating?
1. Food does more than fill us up, it satisfies our feelings. When you respond to those feelings with comfort food that’s emotional eating.
2. Eating/Feeding is our first way of satisfying ourselves beginning infancy. As kids we can be trained to use food to satisfy emotions.
3. Eating can become a habit preventing us from learning skills that will effectively resolve our emotional distress.
*VIMP!: 75% of overeating is caused by emotions.
Emotions vs. Hunger: How to Tell the Difference
1. Emotional hunger comes on suddenly; physical hunger occurs gradually.
2. When eating to fill an emotional void you crave a specific food, such as pizza or ice cream, and only that food will meet your need. When you eat because you are actually hungry, you're open to options.
3. Emotional hunger feels like it needs to be satisfied instantly with the food you crave; physical hunger can wait.
4. Even when you are full, if you're eating to satisfy an emotional need, you're more likely to keep eating. When you're eating because you're hungry, you're more likely to stop when you're full.
5. Emotional eating can leave behind feelings of guilt; eating when you are physically hungry does not.
5 Common Emotional Eating Triggers?
Social. Excessive eating can result from being encouraged by others to eat or eating to fit in.
Emotional. Eating in response to boredom, stress, fatigue, tension, depression, anger, anxiety
or loneliness.
Situational. Eating may be associated with certain activities such as watching TV, going to the
movies or a sporting event, etc.
Thoughts. Eating as a result of negative self-worth or making excuses for eating. For example, scolding oneself for looks or a lack of will power.
Physiological. Eating in response to physical cues. For example, increased hunger due to
skipping meals or eating to cure headaches or other pain.
How to break the habit of emotional eating:
Recognize: Recognize emotional eating triggers
Retrain: Make a list of things to do when you get the urge to eat and you're not hungry: Take a walk, call a friend, play a game, clean, nap, or do something productive
    Develop skills for dealing directly with your emotional problems*
Give-in: When you do get the urge, find a comfort food that's healthy, make a list

The key is moderation, not elimination.

*Depression, boredom, loneliness, chronic anger, anxiety, frustration, stress, problems with interpersonal relationships, poor self-esteem

By identifying what triggers our eating, we can substitute more appropriate techniques to manage our emotional problems.

Number one foods for men and women
Ice cream is number 1 for men and women
Next:
    Women: chocolate and cookies
    Men: pizza, steak, and casserole
Happy People: pizza or steak (32%)
Sad People: ice cream and cookies (39%)
Bored People: Potato chips (36%)

Expert says video games can alter how brain works: January 8th, 2009 @ 6:53am
By Paul Nelson
Some parents may worry that too much computer or video game time could affect their child's brain. In some ways, those parents may be right.

A psychologist from UCLA recently said daily exposure to technology can alter how your brain works. Other psychologists say it's true that every time you play a video game or search online or use your BlackBerry, you are wiring your brain to a certain capacity.

Utah clinical psychologist Dr. Matt Woolley said, "Any time you see, hear, feel, smell and touch anything, your brain has a reaction to that, and so learning takes place. If that happens repeatedly, then you make what they call pathways or neuroconnections."
But the report also says the parts of the brain that work during face-to-face situations can become weaker. Dr. Woolley says the theory is plausible:

"You definitely have a lack of physical interaction the more technology you use to interact with other people. So, people can become truly more distant but even emotionally more distant," he said. Woolley says this is probably more likely in people who are prone to anxiety and not so much among the normal person. Still, if your child seems to be fixated with video games or surfing the Internet, he says you should arrange some play dates.
"With kids that are growing up with a lot of instant messaging [and] texting, it's important for them to learn to socialize face to face," he said.

But Woolley says the theory might not take into account the fact that people have a tendency to want to be around others. "Every person would not be at risk for this," he said.

Avid gamers don't like the assertion that video games make people anti-social. They say gamers are more social than people think. Gamerz Funk owner Michael Winger said, "Research that I've read actually says most gamers are actually more active than your average person. You know, more likely to go out on a date and more likely to go to a social environment like a night club." Winger says even when gamers are fixated on what they're playing, they still get plenty of interaction with other people. "I see some of the people that come in here and play, and I've heard them make comments like, ‘This place is so much more fun than playing at my house,'" he said.
E-mail: pnelson@ksl.com

Take home message: You can manage stress despite the economy!
Lot’s of stressful messages out there. This week’s stressful headlines:
    “Dow plunges 680 points” or “U.S. recession is officially called”
Today let’s talk about:
    How to manage stress about bad economic news
    What to say and not say at home around the kids
    Teaser: Number one stress reducing food
Tips:
1. Don’t believe everything you hear: Remain calm. Pay attention to your economic experience. Don’t get caught up in doom-and-gloom hype.
2. Don’t be a chicken little: Don’t overreact or to become passive.
3. Work it baby: Make yourself more valuable at work. Take stock of your finances/investments and make needed changes. Find healthier ways to deal with stress.
4. Hey genius, don’t make it worse: Don’t turn to smoking, drinking, gambling, emotional eating, over spending.
5. Give more (of your time) this holiday: Financially sound idea. Service helps you feel more positive.
6. Look for the good in things around you: Take off the manure-colored glasses.
7. Spend less, do more with friends and family: This is what brings happiness, costs little.
8. Don’t watch the news all the time: Evaluate your own economy for yourself
9. Get a pro of your own pro: Credit counseling services, financial planners, psychologist
10. Be careful talking about your fears around the kids (Fears about mortgages, college tuition, retirement, and day-to-day expenses): Kids are resilient - However, they are very aware of tension at home, be honest with your kids, but only share information they need to hear, talk at an age-appropriate level. Kids take things literally, don’t say, “We’ll be living on the streets.” Ask them about their thoughts and help correct them. If money is tight, it’s OK to talk with the kids about budgeting, saving, the cost of items. Parents who use healthy stress-relieving behaviors set a good example for children. Taking a family walk or playing a board games
Being proactive about managing your family’s stress and continuing life as usual, despite what’s happening on Wall Street or Main Street, will help make a psychologically healthy home even in a time of economic unrest.

FAQ’S: Money and work are two of the top sources of stress for almost 75 percent of Americans, according to the American Psychological Association’s 2007 Stress in America survey.

Stress Reducing Foods:

#1:
Blueberries:  Packed with antioxidants and vitamin C, which are potent stress busters. Low in calories. Good source of fiber.
Asparagus: High in folic acid, B vitamins, and antioxidants.
#2:

Beef:  Iron, B vitamins and zinc.

Dish:

Sushi: Seaweed has anxiety-fighting properties. Magnesium, which it is filled with, reduces stress, and the benefits of fish are outstanding.