take pride in even small achievements

9 Hobbies Proven to Help Anxiety & Depression

By: Diana Vilibert    April 27, 2016    Follow Diana at @dianavilibert

When it comes to addressing your depression and anxiety, working with your doctor on a treatment plan is wholly recommended—but that doesn’t mean your treatment plan should be comprised entirely of a traditional combo of therapy and medication.

Mental health professionals and researchers are increasingly recommending alternative therapies in conjunction with therapy and medication as treatment for depression and anxiety—and some of the activities proven to help may surprise you.

Playing Video Games

Gamer and author Jane McGonigal has called gaming “the neurological opposite of depression”—that’s because playing games activates parts of the brain that don’t usually get activated when you’re depressed—the ones associated with motivation, learning and goal orientation. And you don’t have to be a gamer to reap the benefits—if long, complex games aren’t your thing, think simple. Casual video games that are fun and easy to play in short increments have been shown to improve mood and decrease stress. McGonigal even created a game specifically to help increase your ability to stay strong, motivated and optimistic.

Volunteering

You can help yourself by helping others, studies suggest. Not only does volunteer work improve physical health, research shows it can also counter depression and anxiety, especially in older adults.

Dancing

Bust a move. Whether you can dance circles around anyone on Dancing With the Stars or your talent is mostly confined to the Macarena and the Electric Slide, working up a sweat on the dance floor (or in your living room) has its perks. Research suggests that dance beneficially modulates concentrations of serotonin and dopamine, improving mood in those with mild depression.

Gardening

Got a green thumb? Use it to boost your mental health.Research shows that over time, gardening can decrease the severity of depression and reduce rumination, the tendency to repetitively think about upsetting things. Even keeping plants and flowers around can lower anxiety, increase relaxation, reduce perceived stress levels and reduce your chances of suffering from stress-related depression.

Playing An Instrument

You’ve probably noticed what a huge effect listening to music can have on your mood. Playing an instrument makes a major impact, too. A study of older adults taking piano lessons found that reading music and playing a music instrument decreased depression, induced a positive mood and improved psychological and physical quality of life.

Going to Art Museums

Art therapy dates back to the 1940s, but you don’t need to be handy with a paintbrush to get the benefits. Making art has been shown to boost mood, but so does viewing it. In fact, studies have shown such a direct link between the content of artwork and the brain’s response to pain, stress and anxiety that hospitals are starting to choose artwork that specifically promotes a sense of optimism and energy.

Hiking

If your version of hiking is just walking somewhat close to a tree, that’s fine, too. Numerous studies have found that just being out and about in nature has a ton of mental health benefits. Forest environments promote lower concentrations of cortisol, lower pulse rate, lower blood pressure, greater parasympathetic nerve activity and lower sympathetic nerve activity, according to experiments done in 24 forests across Japan. You don’t need to go that far, either—grab a friend and take a walk in a nearby park to lower perceived stress, lower depression and reduce obsessive, negative thoughts.

Exercise

Don’t worry, we won’t tell you to start training for a marathon—researchers say that anything from a 10-minute walk to a 45-minute walk can elevate a depressed mood, providing several hours of relief. Some research even suggests that regular exercise can be just as effective as medication for reducing symptoms of anxiety and depression in some people.

Partnering Up

Whether you’re drawing, dancing or hiking, amplify the effects of your favorite anxiety-reducing activity by inviting a friend to join you. Research shows that the presence of social support suppresses cortisol levels in response to stress, increasing calmness and decreasing anxiety.

source: www.care2.com

clinical depression

wellness

black dog

rough night ... rough day

bad dreams last night left me shaken to the core
in a fog today
barely functioning
weak and worn

tomorrow is another day 

a chance for a fresh start

we humans

We are remarkable beings.
Humans adapt ... yet, we are creatures of habit.
When conditions are rough, we get used to it.
When things become dirty, we become accustomed to it.
If we stay home on the couch a lot, we get comfortable there.

Humans adapt very well ... that can be good at times, and not so good at times.
I have forced myself back into the productive routines us North Americans do ... the rat race.
I am a cog in the machine of society and I have my place.

We owe it to ourselves to not let depression beat us. We owe it to ourselves to fight and work and crawl back to a life we deserve. We cannot just lay down and let the black dog win.

During my depression I reminded myself that the darkness was temporary, and it was.
It may return next year, or perhaps the year after ... and I hope I will be again strong enough to win that battle as well, but for now I am proud to be back on my feet, back in the game and living again.

7 Things That Are Making Your Depression Worse

By VIVIAN MANNING-SCHAFFEL APRIL 15, 2016

Nobody chooses to have depression. But that doesn't mean you have zero control over this serious and sometimes debilitating health disorder that affects some 350 million people. Just as you can help to improve the condition—with exercise, cognitive therapy, medication, addressing any underlying conditions (like a thyroid disorder), and other therapies—you can also make it worse. Read on to learn about the everyday habits that can keep the black cloud from lifting.

1. What you eat
You know the expression, you are what you eat, of course. We might also say: You feel what you eat. In a study in the American Journal of Psychiatry, researchers in Australia linked a typical Western diet—of processed or fried foods, refined grains, sugary products, and beer—to greater depression and anxiety in women compared to a diet of vegetables, fruit, meat, fish, and whole grains. The researchers, from the Deakin University School of Medicine in Australia, believe that it's the composition of our microbiome, that community of microorganisms living in our digestive system, that exert an influence on mental health. In continuing research, they're exploring how improving the diet can help ease psychological symptoms. They're also looking into the connection between depression and "leaky gut," a condition in which a weakened stomach lining allows the contents of the gut to leak into the body and trigger an immune response that, in turn, contributes to depression. Until scientists can pinpoint the exact dietary culprits behind psychological distress, it can't hurt to cut back on the sugary, carby crap—like white bread, white pasta, and pastries—and eat more whole, fresh foods that you recognize from nature.

2. How you sleep (or don't)
It's no surprise that lack of shut-eye plays a major role in mental health. "Sleep disturbance is a significant depression symptom, and changes in sleep patterns, such as insomnia, can signal, or even trigger, a depressive episode," says Jean Kim, MD, clinical assistant professor of psychiatry at George Washington University. Insomnia is common in people with depression, she adds, as is early morning awakening. To help people with depression sleep better, Kim advises some good old fashioned sleep hygiene: keeping bedtime and wake-times consistent and shutting off screens a few hours before bedtime to limit blue light, which can throw off melatonin cycles.

3. Your social media habits
Social media is not always a happy pastime. Not only have researchers identified a phenomenon called "Facebook depression"—the result of not getting the likes one hopes for in relation to their number of friends—but there's now plenty of evidence linking depression with excessive digital activity, like texting, watching video clips, video gaming, chatting, emailing, and other media use. Kim suspects it may be related to feelings of isolation and can exacerbate social anxiety among those who might be prone to it. On the flip side, she says, Facebook can ease symptoms of depression in some cases of those who feel isolated, because it aids socialization. If Facebook bums you out more than it makes you happy, take long social media breaks and remember that most people are only posting about the good stuff in their lives—not the parking tickets, bad haircuts, and dishes piled in the sink.

4. Your stress management style
Stressful situations can sink depressives into a deeper funk. But they don't affect everyone equally. A study in the journal Science that explored why stressful experiences lead to depression in some people, but not in others, found the likely culprit to be a gene that regulates serotonin levels in the brain. Of course you can't swap out your genes, but you can take steps to keep stress levels in check. A study in the journal JAMA Internal Medicine found that mindful meditation—the practice of contemplating the present moment and breathing deeply—can be effective in easing psychological stress. Stop, Breathe and Think is an easy-to-use app that can help you learn to practice mindful meditation.

5. The weather
While a recent study conducted at the Auburn University at Montgomery questioned the validity of Seasonal Affective Disorder, anecdotal evidence suggests that some people do tend to get low in the winter when there's less daylight. Kim agrees that some correlation with seasonal changes have been noted with respect to depression and daylight-hour length. Since sunlight requires no prescription, it doesn't hurt to get plenty if it improves your mood. One study found early morning exposure to light to be more effective than midday or late afternoon light exposure.

6. Whether you light up
Everyone knows that smoking is bad for you, but if you suffer from depression, smoking can worsen your symptoms. According to a study in the BMJ, smokers who quit felt less depressed and had a more positive mood and quality of life compared to those who kept lighting up. Kim attributes the difference to the up-and-down mood swings caused by nicotine addiction. "Nicotine has some calming and focusing effects, but withdrawal may cause irritability and anxiety," she says.

7. How much you drink
It's well established that heavy drinking can spur temporary episodes of depression, also called substance-induced depression, but it can be a bit of a chicken-egg scenario. (Here are 6 sneaky signs you drink too much.) "It might be a form of self-medication for underlying depression, but alcohol usually makes depression worse because it has depressant effects," Kim says. Stick to moderate consumption—one glass per day for women, two for men—to make sure booze isn't worsening your blues.

source: www.prevention.com

breathe

hang in there

it's like

everything is temporary

Going Off Antidepressants

Harvard Women’s Health Watch    Updated: October 27, 2015

If not handled carefully, coming off your antidepressant medication can cause disturbing symptoms and set you up for a relapse of depression.

About 10% of women ages 18 and over take antidepressants. As many of us know, these medications can be a godsend when depression has robbed life of its joy and made it hard to muster the energy and concentration to complete everyday tasks. But as you begin to feel better and want to move on, how long should you keep taking the pills?

If you’re doing well on antidepressants and not complaining of too many side effects, many physicians will renew the prescription indefinitely — figuring that it offers a hedge against a relapse of depression. But side effects that you may have been willing to put up with initially — sexual side effects (decreased desire and difficulty having an orgasm), headache, insomnia, drowsiness, vivid dreaming, or just not feeling like yourself — can become less acceptable over time, especially if you think you no longer need the pills.

The decision to go off antidepressants should be considered thoughtfully and made with the support of your physician or therapist to make sure you’re not stopping prematurely, risking a recurrence of depression. Once you decide to quit, you and your physician should take steps to minimize or avoid the discontinuation symptoms that can occur if such medications are withdrawn too quickly.

Why discontinuation symptoms?

Antidepressants work by altering the levels of neurotransmitters — chemical messengers that attach to receptors on neurons (nerve cells) throughout the body and influence their activity. Neurons eventually adapt to the current level of neurotransmitters, and symptoms that range from mild to distressing may arise if the level changes too much too fast — for example, because you’ve suddenly stopped taking your antidepressant. They’re generally not medically dangerous but may be uncomfortable.

Among the newer antidepressants, those that influence the serotonin system — selective serotonin reuptake inhibitors (SSRIs, now commonly known as SRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) — are associated with a number of withdrawal symptoms, often called antidepressant or SRI discontinuation syndrome. Stopping antidepressants such as bupropion (Wellbutrin) that do not affect serotonin systems — dopamine and norepinephrine reuptake inhibitors — seems less troublesome over all, although some patients develop extreme irritability.

Having discontinuation symptoms doesn’t mean you’re addicted to your antidepressant. A person who is addicted craves the drug and often needs increasingly higher doses. Few people who take antidepressants develop a craving or feel a need to increase the dose. (Sometimes an SRI will stop working — a phenomenon called “Prozac poop-out” — which may necessitate increasing the dose or adding another drug.)

Discontinuation symptoms can look like depression

Discontinuation symptoms can include anxiety and depression. Since these may be the reason you were prescribed antidepressants in the first place, their reappearance may suggest that you’re having a relapse and need ongoing treatment. Here’s how to distinguish discontinuation symptoms from relapse:

• Discontinuation symptoms emerge within days to weeks of stopping the medication or lowering the dose, whereas relapse symptoms develop later and more gradually.
• Discontinuation symptoms often include physical complaints that aren’t commonly found in depression, such as dizziness, flulike symptoms, and abnormal sensations.
• Discontinuation symptoms disappear quickly if you take a dose of the antidepressant, while drug treatment of depression itself takes weeks to work.
• Discontinuation symptoms resolve as the body readjusts, while recurrent depression continues and may get worse.

If symptoms last more than a month and are worsening, it’s worth considering whether you’re having a relapse of depression.

A range of symptoms

Neurotransmitters act throughout the body, and you may experience physical as well as mental effects when you stop taking antidepressants or lower the dose too fast. Common complaints include the following:

Digestive. You may have nausea, vomiting, cramps, diarrhea, or loss of appetite.

Blood vessel control. You may sweat excessively, flush, or find hot weather difficult to tolerate.

Sleep changes. You may have trouble sleeping and unusual dreams or nightmares.

Balance. You may become dizzy or lightheaded or feel like you don’t quite have your “sea legs” when walking.

Control of movements. You may experience tremors, restless legs, uneven gait, and difficulty coordinating speech and chewing movements.

Unwanted feelings. You may have mood swings or feel agitated, anxious, manic, depressed, irritable, or confused — even paranoid or suicidal.

Strange sensations. You may have pain or numbness; you may become hypersensitive to sound or sense a ringing in your ears; you may experience “brain-zaps” — a feeling that resembles an electric shock to your head — or a sensation that some people describe as “brain shivers.”

As dire as some of these symptoms may sound, you shouldn’t let them discourage you if you want to go off your antidepressant. Many of the symptoms of SRI discontinuation syndrome can be minimized or prevented by gradually lowering, or tapering, the dose over weeks to months, sometimes substituting longer-acting drugs such as fluoxetine (Prozac) for shorter-acting medications. The antidepressants most likely to cause troublesome symptoms are those that have a short half-life — that is, they break down and leave the body quickly. (See the chart “Antidepressant drugs and their half-lives.”) Examples include venlafaxine (Effexor), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa). Extended-release versions of these drugs enter the body more slowly but leave it just as fast. Antidepressants with a longer half-life, chiefly fluoxetine, cause fewer problems on discontinuation.

Besides easing the transition, tapering the dose decreases the risk that depression will recur. In a Harvard Medical School study, nearly 400 patients (two-thirds of them women) were followed for more than a year after they stopped taking antidepressants prescribed for mood and anxiety disorders. Participants who discontinued rapidly (over one to seven days) were more likely to relapse within a few months than those who reduced the dose gradually over two or more weeks.

Antidepressant drugs and their half-lives*

Drug	Half out of body in	99% out of body in
Serotonin reuptake inhibitors
paroxetine (Paxil)	24 hours	4.4 days
sertraline (Zoloft)	26 hours	5.4 days
escitalopram (Lexapro)	27 to 32 hours	6.1 days
citalopram (Celexa)	36 hours	7.3 days
fluoxetine (Prozac)	Four to six days	25 days
Serotonin and norepinephrine reuptake inhibitors
venlafaxine (Effexor)	5 hours	1 day
duloxetine (Cymbalta)	12 hours	2.5 days
desvenlafaxine (Pristiq)	12 hours	2.5 days
Dopamine and norepinephrine reuptake inhibitor
bupropion (Wellbutrin)	21 hours	4.4 days

*Discontinuation symptoms typically start when 90% or more of the drug has left your system.

Source: Adapted from Joseph Glenmullen, M.D., The Antidepressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and “Addiction” (Free Press, 2006).

Slow and steady

If you’re thinking about stopping antidepressants, you should go step-by-step, and consider the following:

Take your time. You may be tempted to stop taking antidepressants as soon as your symptoms ease, but depression can return if you quit too soon. Clinicians generally recommend staying on the medication for six to nine months before considering going off it. If you’ve had three or more recurrences of depression, make that at least two years.

Talk to your clinician about the benefits and risks of antidepressants in your particular situation, and work with her or him in deciding whether (and when) to stop using them. Before discontinuing, you should feel confident that you’re functioning well, that your life circumstances are stable, and that you can cope with any negative thoughts that might emerge. Don’t try to quit while you’re under stress or undergoing a significant change in your life, such as a new job or an illness.

Make a plan. Going off an antidepressant usually involves reducing your dose in increments, allowing two to six weeks between dose reductions. Your clinician can instruct you in tapering your dose and prescribe the appropriate dosage pills for making the change. The schedule will depend on which antidepressant you’re taking, how long you’ve been on it, your current dose, and any symptoms you had during previous medication changes. It’s also a good idea to keep a “mood calendar” on which you record your mood (on a scale of one to 10) on a daily basis.

Consider psychotherapy. Fewer than 20% of people on antidepressants undergo psychotherapy, although it’s often important in recovering from depression and avoiding recurrence. In a meta-analysis of controlled studies, investigators at Harvard Medical School and other universities found that people who undergo psychotherapy while discontinuing an antidepressant are less likely to have a relapse.

Stay active. Bolster your internal resources with good nutrition, stress-reduction techniques, regular sleep — and especially physical activity. Exercise has a powerful antidepressant effect. It’s been shown that people are far less likely to relapse after recovering from depression if they exercise three times a week or more. Exercise makes serotonin more available for binding to receptor sites on nerve cells, so it can compensate for changes in serotonin levels as you taper off SRIs and other medications that target the serotonin system.

Seek support. Stay in touch with your clinician as you go through the process. Let her or him know about any physical or emotional symptoms that could be related to discontinuation. If the symptoms are mild, you’ll probably be reassured that they’re just temporary, the result of the medication clearing your system. (A short course of a non-antidepressant medication such as an antihistamine, anti-anxiety medication, or sleeping aid can sometimes ease these symptoms.) If symptoms are severe, you might need to go back to a previous dose and reduce the levels more slowly. If you’re taking an SRI with a short half-life, switching to a longer-acting drug like fluoxetine may help.

You may want to involve a relative or close friend in your planning. If people around you realize that you’re discontinuing antidepressants and may occasionally be irritable or tearful, they’ll be less likely to take it personally. A close friend or family member may also be able to recognize signs of recurring depression that you might not perceive.

Complete the taper. By the time you stop taking the medication, your dose will be tiny. (You may already have been cutting your pills in half or using a liquid formula to achieve progressively smaller doses.) Some psychiatrists prescribe a single 20-milligram tablet of fluoxetine the day after the last dose of a shorter-acting antidepressant in order to ease its final washout from the body, although this approach hasn’t been tested in a clinical trial.

Check in with your clinician one month after you’ve stopped the medication altogether. At this follow-up appointment, she or he will check to make sure discontinuation symptoms have eased and there are no signs of returning depression. Ongoing monthly check-ins may be advised.

source: www.health.harvard.edu

much better now

An episode of depression is damn ugly.
The struggle to crawl out of the hole is hard and painful.
It's tough to do ... even with the meds
and the family doctor
and the therapist
and the helpline
and the understanding coworkers
and the friend who checks in with you ...
Even with all those supports ... depression is a hard, painful struggle.
I can't imagine how difficult the challenge would be without those supports.

I am back at work, playing volleyball, and functioning again.
I can still feel the poison of depression within me,
but I have picked myself up, dusted myself off and rejoined the human race.
When a coworker asks how I am, the answer is "OK" ...
and that's better than I was 2 or  3 weeks ago.
Everyday, I am a little stronger and am starting to feel hopeful again
that within a couple of weeks I might be able to put this darkness behind me.

hmmm

today was ok

Today I felt like my old self for a few hours.

It was nice.

Almost 5 weeks in, it's been a long haul ... a dark and ugly voyage ...
but today I wasn't unhappy and had energy, and kinda felt ok.

I suspect being in a better place today may have a lot today with sleep.
I got home late last night, but slept in late this morning.
I am pretty sure sleep makes a big difference in recovery.

I will make every effort to get to bed early tonight
because tomorrow, my alarm will go off at 5:20 am,
and I need to rise to the challenges of work and life,
and the rat race we all run in.

Sleep and Depression

If you've been diagnosed with clinical depression, you may be having trouble getting to sleep or staying asleep. There's a reason for that. There is a definite link between lack of sleep and depression. In fact, one of the common signs of depression is insomnia or an inability to fall and stay asleep.

That's not to say insomnia or other sleep problems are caused only by depression. Insomnia is the most common sleep disorder in the U.S., affecting nearly one out of every three adults at some point in life. More women suffer from insomnia than men, and as people get older, insomnia becomes more prevalent.

Most experts agree that adults need seven to nine hours of sleep a night. But even without depression, according to the National Sleep Foundation, the average American only gets about 6.9 hours. When you add depression to the mix, the problems with sleep are compounded.

What's the Link Between Sleep Disorders and Depression?
An inability to sleep is one of the key signs of clinical depression. Another sign of clinical depression is sleeping too much or oversleeping.

Having a sleep disorder does not in itself cause depression, but lack of sleep does play a role. Lack of sleep caused by another medical illness or by personal problems can make depression worse. An inability to sleep that lasts over a long period of time is also an important clue that someone may be depressed.

What Is Clinical Depression?
Clinical depression is a mood disorder. It causes you to feel sad, hopeless, worthless, and helpless. Sure, we all feel sad or blue from time to time. But when you feel sad for long periods and the feelings become intense, the depressed mood and its associated physical symptoms can keep you from living a normal life.

Why Is Sleep So Important?
Normal sleep is a restorative state. However, when sleep is disrupted or inadequate, it can lead to increased tension, vigilance, and irritability.

Physical or emotional trauma and metabolic or other medical problems can trigger sleep disturbances. Poor sleep can lead to fatigue. With fatigue, you exercise less and that leads to a decline in your fitness level. Eventually, you find yourself in a vicious cycle of inactivity and disturbed sleep, which causes both physical and mood-related symptoms.

What Is Insomnia?
Insomnia is difficulty initiating or maintaining normal sleep. It can result in nonrestorative sleep and interfere with or impair the way you function during the day. Insomnia is often a characteristic of depression and other mental health disorders. With insomnia, you may sleep too little, have difficulty falling asleep, awaken frequently throughout the night, or be unable to get back to sleep.

With untreated depression, you may have overwhelming feelings of sadness, hopelessness, worthlessness, or guilt. These feelings can interrupt sleep. Or your mind may be in overdrive, ruminating about situations over which you have no control. With that rumination come high levels of anxiety, fears about poor sleep, low daytime activity levels, and a tendency to misperceive sleep.

How Are Sleep Disorders and Depression Treated?
The treatment for clinical depression depends on how serious the mood disorder is. For instance, psychotherapy (talk therapy or counseling) combined with medications (antidepressants) is highly effective in treating depression. The antidepressants work to decrease symptoms of sadness or hopelessness while the psychotherapy helps improve coping skills and change negative attitudes and beliefs caused by depression. Talk therapy also works on coping skills to help you fall asleep more easily.

Which Medications Help Sleep Disorders and Depression?
Your doctor may treat sleep disorders and depression with an antidepressant such as an SSRI -- a selective serotonin reuptake inhibitor. Additionally, your doctor may prescribe a sedating antidepressant or a hypnotic medication -- a sleeping pill or other medication that helps people sleep.

Which Types of Antidepressants Can Help With Sleep?
Your doctor may prescribe one of the following antidepressants that can also help you sleep:

• An SSRI such as Zoloft, Prozac, Celexa, Lexapro, and Paxil. These medications can perform double duty for people by helping them sleep and elevating their mood. Some people taking these drugs, though, may still have trouble sleeping. Other antidepressant medicines that affect serotonin through multiple serotonin receptors include Viibryd and Brintellix.
• Tricyclic antidepressants (including Pamelor and Elavil)
• SNRIs (serotonin/norepinephrine reuptake inhibitors such as Effexor, Pristiq, Khedezla, Fetzima, or Cymbalta)
• Sedating antidepressants (such as Remeron). The antidepressant trazodone is not widely used to treat depression but because it can cause drowsiness it is often paired as a sleep aid that can be used with other antidepressants.

Which Hypnotics or Sleeping Pills Are Most Effective?
Your doctor may prescribe one of the following hypnotics or sleeping pills to help resolve insomnia:

• Ambien/Ambien CR
• Belsomra
• Lunesta
• Restoril
• Sonata
• Rozerem

Are There Other Sleep Tips That Can Help Depression?
Here are some lifestyle tips that -- in combination with antidepressants and sedative-hypnotics -- may help improve sleep and resolve insomnia:

• Meditation, listening to soft music, or reading a book before bedtime can help increase relaxation while focusing your thoughts on neutral or pleasant topics.
• Clear your head of concerns by writing a list of activities that needs to be completed the next day. Then tell yourself you will think about it tomorrow.
• Get regular exercise -- but no later than a few hours before bedtime. Daily exercise, including stretching and conditioning exercises, can help to facilitate sleep and relieve the associated anxiety many people have about staying asleep.
• Avoid looking at a bright screen (for example, a laptop or television) prior to bedtime because the light emitted from cathode ray tube computer monitors can suppress release of the natural hormone melatonin, which signals the brain to go to sleep.
• High levels of arousal associated with racing thoughts, worries, or rumination may delay sleep onset. Relaxation therapies such as yoga and deep abdominal breathing may be useful in initiating sleep.
• Don't use caffeine, alcohol, or nicotine in the evening. Check the ingredients in any over-the-counter or prescription medications to see if "sleeplessness" is indicated. Some medications such as headache medicines contain caffeine, which can cause poor sleep.
• Don't lie in bed tossing and turning. Get out of bed and do some light activity (such as reading or listening to soft music) in another room when you can't sleep. Go back to bed when you are feeling drowsy.
• Use the bed only for sleeping and sex. Don't lie in bed to watch TV or read. This way, your bed becomes a cue for sleeping, not for lying awake.
• Take a warm shower right before bedtime to increase deep sleep as your body cools.
• Keep your bedroom at a cool temperature.
• Wear earplugs and a sleep mask if noise and light bother your sleep.
• Get blackout shades for your bedroom to keep outside lights from bothering you.
• A white noise machine may also help if you cannot sleep because of household noises.

Article Sources
 National Institute of Mental Health: "What Is Depression?"
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5.
Fieve, R. Bipolar II, Rodale Books, 2006.
CDC: "Sleep and Chronic Disease."
American Academy of Family Physicians: "Depression in Women."
Depression and Bipolar Support Alliance (Sleepless in America): "What's Keeping You Up All Night?"
News release, FDA.

Reviewed by Joseph Goldberg, MD on 1/, 014

source: WebMD

Men, masculine pride and how to cope with depression

September 26, 2014   Jason Spendelow    Clinical Psychologist, University of Surrey

Masculinity plays an important role in dealing with problems such as depression. Men often don’t feel able to reach out for assistance because both the symptoms of depression and the act of seeking help goes against a stereotypical view of how us blokes should or shouldn’t behave.

Of course, traditional masculine characteristics are not necessarily “good” or “bad”. Stereotypical male traits such as self-reliance and independence can be very valuable in life (for both men and women). But when demonstrated through unhealthy and over-used psychological practises, they can spell trouble for well-being and mark seeking help as off-limits.

For example, adherence to “strait-jacket” masculinity, might not only prevent getting treatment but also intensifies tactics such as hiding depressed mood and increasing risk-taking behaviours such as substance use.

So being competitive with your mates on the football pitch, rugby field or golf course, for example, is great in order to secure the win and bragging rights, but “not giving in” to a serious dose of depression by coping in secret is not, and can do more harm in the long run.

So, if the prospect of seeking help makes you twitchy, what can you do about it?

Get out of the strait-jacket

Research has shown that some men re-interpret and expand what it means to be a man in order to subtly un-hook themselves from the strait-jacket variety of masculinity. It may seem subtle to those on the outside but it’s a big personal step. Rather than seeing seeking help as an unacceptable behaviour, some see it as demonstrating an ability to be responsible, proactive, and practical. So rather than a sign of dependence on others, it can be seen as a responsible way of maintaining psychological health and responsibilities, by being an engaged partner, for example.

And in fact, breaking out of the strait-jacket could be seen as more masculine than falling into line with traditional expectations of not seeking help. Some men even see themselves as a “hero” that is “in battle” with depression as a way to preserve a sense of their masculinity while getting help. And when you’re experiencing severe symptoms, such as suicidal thoughts or being unable to work or even get out of bed, it can feel like a fight.

Focus on things you still do

Re-framing the masculine narrative can be supported through men’s relationships with others. The role of caregiver or provider is valued by many men. Seeking help can be seen as part of being able to do this rather than undermining it.

Men with depression can help themselves to retain a sense of self-worth by focusing on valued roles they can still perform – and those supporting them can help them confirm this.

Small steps are still rewarding

Taking on responsibility for tasks previously given up due to depressed mood (usually in a gradual way) is a common approach to treating depression and is another way in which men can re-establish lost self-worth.

When you’re depressed, it’s important not to underestimate the boost you can get from small victories and accomplishments.

Trying to achieve several of these each day, such as going for a 15-minute jog or even cleaning one shelf of a bookcase, can help you fight depression in an effective way. The feeling of achievement and personal control that comes from activities such as physical exercise is believed to be one possible way in which exercise combats depression.

Professionals can help

Professional help should always be sought when depressed mood persists for more than a couple of weeks, is accompanied by significant levels of distress and/or impairment in your ability to carry out day-to-day tasks such as going to work or having a shower. Thoughts of self-harm or suicide are especially important warning signs that require immediate professional attention.

People often say that “talking treatments” are not for them, but when you’re really struggling it is worth a try. And not all help and treatment is the same; there are a variety of therapeutic techniques that approach depression in different ways.

One approach called Cognitive Behaviour Therapy (CBT) emphasises, among other things, developing practical skills. This is one reason why CBT might be particularly suited to men. However, there are other approaches that focus more on other issues, such as understanding the role played by early life experiences. And, of course, medication can be a good option for people in certain circumstances. But whatever course of action is taken, it’s vital men do not suffer in silence.

source: theconversation.com

how r u ?

and on it goes

some days have been not too bad

today was miserable

at times I was on the edge of tears (for no reason at all)

I made it through the day, but the sadness ... the darkness ... was oppressing

home now, I hope that by next week, things will get better

I don't want to miss any more work

I am doing my best to keep going and stay active

at times the misery consumes me