Thursday, 29 March 2012

"Counting to Ten"

Do you ever get so mad that all you want to do is yell or throw something? Ever feel like you can't possibly fight back tears for a second longer? We all have those days sometimes, right? Some of us are pretty good about letting "it" go. Some of us like to hold on, ruminate, and just generally feel lousy longer.

I have days when not much really bothers me. Then I have those days when every little thing is about to send me over the edge of some emotional roller coaster. Those are the days when I have a difficult time clearing my head of what "it" is - an interaction with a friend or colleague that went awry or a mistake made. It's a super fun cycle, actually. First the "it" happens, then you ruminate, then you start to feel the physical effects of the negative thoughts (butterflies in the tummy, tension in your neck, shoulders and head), and then trouble sleeping because you can't clear your mind.

Emotions are a funny thing - all in your head, right? Well, yes. In your brain actually. Ever heard of the cingulate system? No, me neither. Turns out it's kind of a big deal.

Here's a description of the cingulate system from Change Your Brain, Change Your Life by Daniel G Amen M.D., "The cingulate system is the part of the brain that allows you to shift your attention from one thing to another, to move from idea to idea, to see the options in life. In my experience, the term that best relates to this part of the brain is cognitive flexibility."

This part of the brain allows us to do some very cool things like planning, goal setting, and adapting to change. However, there is always a flip side. When the cingulate system is abnormal "we have a tendency to get stuck on things, locked into things, and to rethink the same thought over and over." Ever obsess on the same thought or find yourself on a negative path? You can thank your cingulate system for that.

The good news is that like many wellness issues we have the opportunity to turn things around and break those thought patterns that are causing us harm. Here are some of my favourite suggestions from Dr Amen:

Notice When You Are Stuck: Distract yourself and then come back to the problem later. Some great ways to distract yourself are going for a walk, listening to relaxing or uplifting music, meditating, or singing a song (OK, maybe don't do that in your cubicle at work).
* Write Out Options & Solutions: Seeing a thought on paper can make it easier to deal with in a rational way. After you write down the thought that's "stuck", write down a list of possible solutions.
* Seek The Counsel of Others: Do you have a trusted friend or mentor? Often it helps to talk about something that you can't let go of and talking it through can open up new options.
* Cingulate System Nutrition: Good news for carb lovers: foods high in carbohydrates (pasta, potatoes, bread, pretzels, and popcorn) increase L-tryptophan levels in the blood, resulting in more L-tryptophan being available to enter the brain, where it is converted to serotonin. Per Dr.Amen, many people on low carb diets often trigger cognitive inflexibility or mood problems. So go ahead and indulge in that plate of mashed potatoes - it's good for your cingulate system!
* Exercise: OK, let's be real - exercise isn't really one of my favourite things but there is no denying that it works. If I have had a rough day at work, I almost always feel better if I make the 25 minute trip home by foot.

Here's my favourite idea of all. We all know the Serenity Prayer, right? "God, grant me the serenity to accept the things I cannot change,..." It's a comforting reminder that we have limits in life, that we need to respect those limits, and that we are all just human. But reciting it also takes us away from whatever we are stuck on. I like the idea of making room only for something positive in my head, pushing the negative thoughts out and away. But what if, instead of the Serenity Prayer or counting to ten, we took a moment for something silly? How about this from The Rules of Life by Richard Templar:

"I must go down to the sea again, to the lonely sea and the sky. I left my pants and socks there and I wonder if they are dry." ~ Spike Milligan

I feel better already.

KB xo

Sunday, 25 March 2012

"Manic Monday"

"Tell me why? I don't like Mondays. Tell my why? I don't like Mondays. I want to shoo-oo-oo-oot the whole day down." ~ #1 hit for The Boomtown Rats in 1979

Ah, Bob Geldof. Always with his finger on the pulse of society. Granted, his work with LiveAID and the starving in Africa was probably a bit more impactful overall (just a bit) but one can't overlook his popular ode to what is arguably the least popular day of the week.

Tuesday is OK. Wednesday is "hump day", when you know that by the end of it you are in the home stretch. Thursday is exciting because Friday is just around the corner - you are losing steam but you know you can hold on for one more day. Friday is bliss because the weekend is so close that you can almost touch it. Saturday is all about decadence - you can sleep in, play with your kids, party all night, and your time is yours. Sunday is bittersweet - there is a laid back energy in the morning but by late afternoon you start to realize that your precious freedom is slipping through your fingers. Before you know it it's here, that dreaded of all days: MONDAY!

So how did this happen? How did poor, little, old Monday get such a bad rap? Well, 66% of North Americans start their work week on a Monday for one. Is it a sign that we aren't happy with our jobs? I actually really like my job and the company that I work for. It's clearly not the job in my case.

Maybe it's me and not Monday itself. Nothing bad has ever happened to me on a Monday so there is really no reason that I should discriminate against it. It's not like that time when I was in fourth grade and got food poisoning after eating a meal that included Rice-a-Roni which subsequently resulted in a life long aversion to the "San Francisco treat".

There is an anonymous quote in the book Practically Radical by William Taylor that really speaks to me, "If all you ever do is all you have ever done, then all you'll ever get is all you ever got." OK, anonymous person, I hear what you are saying and I am going to take up your challenge. So here's a revolutionary idea, why don't I change how I approach Mondays?

Here's another statistic from the April 2012 issue of Chatelaine magazine, "74% of people view Mondays as the best day to start acting healthy; moreover, it's the day new habits are most likely to stick and become permanent lifestyle changes."

I feel that an apology is in order...

Dear Monday,
I am sorry that I have not showed you enough gratitude and have not given you your due respect. Beginning tomorrow I promise to embrace you and the world of opportunity that you represent, 52 times each year. It won't always be easy but I promise to give it 100%.
Sincerely,
me

Clean slate. Fresh start. Bring on Monday.

KB xo

P.S. want to embrace Monday, too? Check out this great, inspiring website with ideas about how to make healthy, positive changes each and every Monday of your life: www.mondaycampaigns.org

Tuesday, 20 March 2012

"Take it Easy"

"Standing on the corner in Winslow, Arizona. Such a fine sight to see. It's a girl, my lord, in a flatbed Ford slowin' down to take a look at me. Take it ea-easy. Take it ea-easy." ~ The Eagles

Those, my friends, are the opening lines of what may be my favourite song of all time, Take It Easy by the Eagles.

I listen to music a large part of my day, every day. If I am at work I usually have my headphones in and listening to classical music or Chris Botti. It helps me tune out the world of cubicles around me and focus on what I need to focus on. If I am home I always have music on. And it can be almost anything depending on my mood. I am never without it.

I was raised on music by my mom. From an early age I was schooled in a diverse musical catalogue - everything from classic Rod Stewart, The Eagles, Tom Jones and Gino Vanelli (yes, Gino Vanelli - it was the 70's, people!) to Joe Cocker, Kenny Rogers, John Mayer, and K.D. Lang. Some of the lessons "took" - I have seen Rod Stewart and Tom Jones in concert MANY times, each time as good as the time before. When I went with girlfriends to see Tom Jones in Las Vegas, a friend who couldn't make it embroidered our initials in leopard print panties for us to throw (we didn't throw them - they were too cute!). Other lessons didn't - sorry Kenny!

Music triggers many happy memories in me. I clearly remember the summer that Grease was released. Every time I heard "You're The One That I Want" signalling the beginning of the commercial for the movie, I would race to the TV - the song just made me so happy and want to dance. To this day whenever I hear any of the Grease songs I think of that summer and going to the movie with my friend Laura. Then I just think about Laura and smile. Simple times when small things made a kid happy.

In my recent quest to bring peace and balance to my life I have stumbled upon a new love: Reggae. I dare you - try and be sad, cranky, mad or irritable while listening to reggae. It's scientifically impossible. OK, I haven't actually conducted scientific research but based on my experience (control group: one adult woman), I feel nothing but happy & relaxed when I listen to it. In fact, it inspired this post.

I have heard about the positive impact of music on learning and concentration but what about chronic pain and mental health issues. According to a report in ScienceDaily in May 2006, music can reduce pain and depression in people by up to 25%. That's substantial when you are desperate for relief, relief of any sort. In a controlled clinical trial in the United States, 60 people were divided into three groups - two listened to different types of music and the third was a control group with no music. The groups who listened to music (the type proved unimportant) for an hour every day for a week reported improved physical and psychological symptoms while the control group saw no improvement.

Music can promote relaxation, communication, creative self-expression, insight, and emotional processing. And you don't need a prescription. Oh, and 45 minutes of soft music before bed can help you sleep better.

My musical tastes have changed over time but one thing remains constant - my diverse taste. Yes, I worship at the altar of Jon Bon Jovi but I also love Tony Bennett, vintage Spice Girls, Sergio Mendes, Faith Hill, Hedley, Beyonce, and I'll even admit to the odd Britney Spears tune. The other consistent thread - the music either invokes happy thoughts and memories or just makes me feel happy in the moment. And isn't that really the point? Being happy in the moment.

One of my happiest musical memories includes "Take It Easy." Years ago, my mom, my brother, and I were driving along the Coquihalla Highway in my mom's jeep. The stereo was cranked and the three of us were singing along with Glen Frey and the boys at the top of our lungs, word for word. It was one of those moments in time that was pure bliss and utterly priceless. I can't think of that time or hear that song without smiling. Simple times & happy moments? Yes.

KB xo

For information about music therapy in British Columbia check out the Music Therapy Association of BC: www.mtabc.com




Sunday, 18 March 2012

"Sshhhhhhhh"

I have a love/hate relationship with sleep. I adore a good sleep, when I am nestled under my duvet with crisp, clean sheets, my room is the perfect temperature and there is no noise or light to bother me. Tearing myself out of my blissful state in the morning is almost always painful and I admit that I have never been a morning person. But what's to hate? Not being able to fall asleep.

I have never been quick to fall asleep and last night is the perfect example of this. Although I was tired, I tossed and turned. My neck and shoulders ached and regardless of how many variations of pillow arrangements that I tried, I couldn't get comfortable. And then it started. The dreaded thoughts in my head. These are the thoughts that always come up in the dead quiet of night. Was I rude to that person when I said that thing? Did I look like an idiot to that client that day? What about my relationship with that friend - do they still like me? I didn't do a good enough job of that report. And on and on and on.

But I had an epiphany! What if I create more quiet time in my daily life? Will this help me sleep better?

OK, it wasn't really my epiphany, per say. It's actually Brene Brown's concept. Brene Brown, PhD, is the author of The Gifts of Imperfection. I recently read an article in the April 2012 issue of HEALTH magazine about positivity. In the article Brown talks about how to have happier thoughts at 3a.m., "What happens at night is the stillness is so uncomfortable that our mind starts racing and we can't shut down." She suggests creating more physical stillness in our days so that our mind doesn't race at night when it gets some quiet time. Examples of this are going for a walk by yourself without any gadgets (that's right - no Blackberry or I phone!) or eating lunch by yourself in a sunny spot. Brown states that once you start cultivating stillness you will feel less anxiety.

Hmmm. Interesting idea, I thought. Kind of makes sense to me. And then I remembered my recent experience on the first day of my two week vacation. Home, sick in bed with the cold that I had been fighting for a week while keeping up a frenetic pace at work, I felt BORED. Bored?! I was sick and it was only day one of my vacation. Yikes! It was a big "aha moment" for me. In the last couple of weeks that I have been back at work, when I get home at night I have been feeling a bit, yes, bored. There it is again. Could it be that I don't know how slow things down? Have I forgotten how to relax, really relax? Yup - pretty much.

For awhile now I have been hearing about the merits of meditation. I have tried it on and off but it has never really stuck. And yet, there are those benefits that I keep hearing about everywhere. A study by Japan's National Institute of Industrial Health of 600 workers who had been taught to mediate found that they had improved emotional stability, showed less anxiety and neurosis, and fewer nagging physical ailments. OK, worth another shot!

So today I tried it. I set my kitchen timer for five minutes and turned on some instrumental music. I sat comfortably, closed my eyes and focused on the music. Yes, it was hard to keep those wandering thoughts from my head but I consciously pushed them away and refocused on the guitar and then on the piano. Wait, what's that sound? Five minutes are up? I'll be frank, I wasn't sure I could sit quietly without doing anything for 5 minutes but I did it.

So my new promise to myself is to create more stillness in my life - each and every day. Goodbye anxiety and hello sweet dreams? I'll let you know.

KB xo

Sunday, 4 March 2012

"Keith Richards and Me"

Years ago I watched a comedian on TV speaking about child birth. She couldn't imagine a drug-free birth - she was all about reducing the pain as much as she could. To illustrate her point she said, "I want drugs. And get Keith Richards to bring them so that I know they are good!"

Mental health issues are riddled with stigmas. A big one has to do with medication. Some people think that drugs are the answer. Others refuse to even consider medication. So let's talk about drugs.

When I was first diagnosed with depression twenty years ago my doctor prescribed an antidepressant. I didn't question or doubt it because my doctor is not one to quickly hand out a prescription for anything - he has always been a big proponent of a healthy lifestyle, including a balanced diet and regular exercise. For both of us the medication was just a piece of the overall care plan to treat my illness, a care plan that we discussed together. Fairly soon after starting the medication I began to see positive changes. I went from high highs and low lows to a much more even keel. I still felt emotions, just not in such an extreme way. Getting my emotions under control to a large extent then allowed me to work on the other aspects of getting well - it allowed me to catch my breath.

For many years the meds, coupled with a fairly healthy lifestyle, were enough to keep me well. In 2003 when I suffered my first major depressive episode, my doctor and I adjusted my medication dosages and added a psychologist into the mix for a brief period of time. After about a year of putting one foot in front of the other on a daily basis, I was mostly well again. Life carried on and it wasn't until 2010 that I fell into another deep depression. This time I felt different. This time I felt like nothing was helping. I felt almost hopeless. Could it be that the drugs that had helped me through years of difficult times weren't working anymore? That's what I thought.

So I sought alternatives. My doctor and I spoke about working with the University of British Columbia Mood Disorder Clinic. A respected and prominent psychiatrist there (let's call him Dr. Smith) was working on a study of the impact of light therapy and negative ION therapy on patients with severe depression. Here was an opportunity to help others with this illness and perhaps find an alternative treatment. The catch? I had to stop taking my medication in order to participate. The meds weren't working anyway, right? Sign me up! What did I have to lose? Turns out, a lot.

I began visiting UBC on a weekly basis. I worked mostly with Dr. Smith's research assistant who was lovely - she repeatedly assessed the state of my depression as I slowly reduced my medication and she added a compassionate touch to what was a fairly clinical research project. Here's a brief time line that perhaps best illustrates my experience withdrawing from medication:

May 27: After a gradual reduction of dosage and under medical supervision, I am no longer taking medication.
May 29: I am starting to experience withdrawal side effects: extreme irritability, restlessness, hysteria, anger, vomiting, headaches. I am also experiencing what I can only describe as "brain zaps" - continual, irritating short circuits in my brain.
June 1: Dr. Smith prescribes an anti-anxiety medication to help with the extreme irritability that I have been experiencing. The pills make me very foggy so I only take them in extreme situations (see below).
June 5: I suffer a panic attack in a store - I am so irritated by a woman playing with a child's tambourine (she thinks she's amusing her grandchild but she has no idea that she may soon be wearing her ass for a hat) that I have to leave the store and wait for my mom and niece outside. Once outside I breathe deeply and try to regain some sense of calm.
June 7: Withdrawal symptoms seem to be dissipating - I have only experienced a slight headache, tears, and body aches.
June 9: Extreme sadness and constant tears but none of the withdrawal symptoms. Even the ever present "brain zaps" are gone.
June 14: Surprise! Dr. Smith says that I no longer qualify to participate in the study - I am not depressed enough. Seems that I have shifted from major depression to moderate. Woo-hoo!
June 21: Turns out that the surprise is on Dr. Smith, after all. I am so depressed by this date that I am having suicidal thoughts again. Immediately I am back in my psychiatrist's office and we resume my course of medication, this time adding a supplemental antidepressant, coupled with continued cognitive behavioural therapy (CBT).

So here's what I learnt on my great adventure: you don't need to go to an amusement park to ride a roller coaster. OK, I learnt a lot more than that. I also learnt to have a healthy respect for drugs.

In retrospect, my decision to participate in the UBC study might not have been the best. But it's hard to regret it - I was open to trying new things to become well and I was working with a team of doctors. I will be hesitant in the future, however, to mess with my medication. I have first hand experience as to the strength of antidepressant medication. And you could argue that having something so strong in your body isn't healthy. That may be true - 20 or 40 years from now we may discover that these medications are harmful. But my experience has been that they have kept me alive and for that I am grateful.

It's very important to me that I stress a few things. First of all, any decisions to start or stop medication should be discussed with your doctor. And if you don't feel comfortable with medical advice that you have been given, seek alternative opinions and educate yourself. Every person is different and what works for one person might not work for another. It is generally accepted, however, that medication works best when combined with CBT. I feel strongly that the cognitive behavioural therapy is what gave me the edge in getting well. Today, I am still on medication but my dosage is lower and at a steady level. I balance this with a generally healthy, balanced lifestyle.

If you are suffering from depression, whether you choose medication or not, here are some suggestions from Christiane Northrup, MD to support your treatment:

* Stop Drinking: alcohol is a depressant and can make depression itself particularly persistent.
* Engage in Regular Exercise: exercise changes brain chemistry and exercising 20-30 minutes a day four to five days per week can have a significant positive impact on your mood.
* Get Outside in the Natural Light: This raises serotonin levels in your brain. In the winter you may want to consider a light box or full-spectrum light bulbs to get enough light.
* Take a Multivitamin and Make an Effort to Eat Well: Avoid refined carbohydrates, eat protein at least three times a day, and be sure to include a source of omega-3 fat in your diet regularly.

Finally, if you do decide to take an antidepressant, allow time for it to work. Per Dr. Northrup, "half of those who stop their medication within three months of starting get depressed again."

Did I forget to mention that I also experienced a hallucination while withdrawing from my meds? Yup - I giant hummingbird in my bedroom one night. I know that I wasn't sleeping because I said to myself, "Oh, that's a giant hummingbird and I am not dreaming." A drug-induced hallucination - so that's probably one thing that Keith Richards and I have in common.

KB xo

She Seemed Happy

She seemed happy. He was so successful. He had it all - love, money and fame. The last time that I spoke to her she was making plans. The...