Postpartum Depression (PPD) is a mood disorder that affects nearly 1 million women in the U.S. each year. Symptoms of PPD can begin during a woman's pregnancy through the first year following childbirth. PPD is beyond baby blues, which is a normal adjustment period that happens during the first 2 weeks of birth affecting 80% of new moms.
Many people have heard of PPD, but did you know symptoms of PPD can expand beyond depression symptoms and include anxiety, OCD, as well as other psychiatric symptoms? Postpartum depression, anxiety, and OCD symptoms can impact a mother's daily functioning, potentially interfering with her ability to take care of herself or her family. Symptoms of Postpartum Depression may include:
Symptoms of Postpartum Anxiety & OCD may include:
Any woman who is pregnant or has had a baby in the last year can be at risk for PPD. However, factors like history of mental illness, being a first time mom, ambivalence about the pregnancy, lack of support system, partner problems, infertility, complications during childbirth, and recent stressors can all increase of woman's chances of developing PPD. A woman's health care provider can help her choose the best course of treatment. Treating PPD can include individual counseling, medication, and postpartum support groups.
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The Brain Injury Association of America (BIAA) defines traumatic brain injury (TBI) as “an alteration in brain function, or other evidence of brain pathology, caused by an external force.” Every year there are approximately 2.5 million ER visits, hospitalizations, or deaths associated with TBI in the United States. The leading cause of TBIs between 2006-2010 was falls. There are an estimated 1.6 to 3.8 million sports-related TBIs annually, however, only 300,000 result in loss of consciousness.
Traumatic brain injuries can occur without the loss of consciousness. Due to this fact, as well as lingering mental health stigmas, people do not always seek treatment. Symptoms of a TBI may not appear for several days following the injury. Post-concussion syndrome (PCS) occurs 7 to 10 days after a TBI and can last for weeks, months, a year or even longer in some individuals. The severity of the injury does not correlate to the duration of PCS or type of symptoms experienced. The TBI symptoms fall into four categories: physical, cognitive, sleep, and emotional. 1. Physical Symptoms:
2. Cognitive Symptoms:
3. Sleep Disturbance:
4. Neuropsychiatric Conditions Associated with TBI:
Personality changes include:
The mental health of patients with TBI may be greatly impacted. Neuroimaging techniques, biological markers, and neurological/cognitive screening could result in earlier detection and treatment of TBI, improving the outcome for these patients in the future. If you’re new to therapy, or even if you already have an established relationship with a therapist, the following suggestions can help you to ensure the success of your time in therapy.
[1] Find the right fit: A trusting, clinical relationship with your therapist is one of the key factors that leads to improvement. Find someone with whom you have a good connection. Specifically, look for these traits - respectful, friendly, compassionate, and honest. Equally important, make sure to find a therapist who uses an Evidence-Based treatment modality. [2] Make clear therapy goals, and check in on them regularly: Goals are the road map to therapy success. The best goals are SMART: Specific, Measurable, Attainable, Realistic, and Time-Specific. [3] Give it time: Lasting change takes time. Be patient with yourself and the process. Keep an open mind and connect with the experience. It will be worth it! [4] Speak up: Talk about therapy - what you love, like, dislike, agree with, disagree with, the interaction between you and your therapist, etc. Your feedback is essential to the therapy process. If you found a new skill to be helpful, say so! If you have a question or a concern about the therapy process, please ask! Therapy should be collaborative process between you and your therapist. [5] Do the work: Therapy is more than the time you spend in the therapy office. Practicing skills and implementing plans discussed in therapy is what solidifies new insights and solutions. Make it a priority and attend regularly. Make a commitment to prioritize this part of your schedule. The more frequently you attend therapy, the more quickly you should begin to experience positive change, healing, and balance in your life.
L-methylfolate is a medical food similar to a vitamin that is often used as an adjunctive treatment to antidepressant medications for people who suffer from treatment-resistant depression. L-methylfolate enhances the production of serotonin, dopamine and norepinephrine. Research shows that L-methylfolate supplementation is helpful for people with reduced ability to convert folic acid into L-methylfolate.
Reasons why folic acid conversion to L-methylfolate is reduced: 1. Genetic predisposition. For people who are able to obtain genetic testing, the specific deficiency is produced by the methylenetetrahydrofolate reductase (MTHFR C677T) polymorphism. Research shows that up to 70% of depressed people lack the ability to convert folic acid into L-methylfolate and therefore lack the ability to produce enough serotonin, norepinephrine and dopamine to alleviate depression. 2. Poor diet. An unhealthy diet can lead to problems with folic acid conversion. Research shows that L-methylfolate supplementation has been effective in depressed patients with a BMI of 30 or more. 3. Anticonvulsants. Some medications can interfere with absorption and inhibit the enzyme involved L-methylfolate production Deplin (brand name L-methylfolate) has been FDA approved as a medicinal food for antidepressant augmentation. Ask your provider if you would be a good candidate for L-methylfolate supplementation. Compliance with recommended treatment, or treatment adherence, is a very important clinical issue. In fact, nonadherence to medications poses one of the greatest challenges in the treatment of patients with psychiatric illnesses.
According to some studies, more than 50% of psychiatric patients do not comply with their medication regimens. Nonadherence with prescribed medications can be intentional or unintentional. Intentional nonadherence may be the result of fear of side effects, concerns regarding the stigma of mental illness, inconvenience of dosing medications, or the cost of medications. Unintentional nonadherence, on the other hand, is more likely to be the result of forgetfulness or lack of insight as to the importance of treatment compliance. Nonadherence to recommended psychiatric medication regimens is linked to poorer outcomes, including increased hospital admission and disease relapse or exacerbation. Talk to your provider if you have concerns that may lead to medication nonadherence. At PFHL, we believe in working with our patients to develop the most effective treatment strategies. And treatment is never effective with poor medication adherence. Here are some tips to increase medication adherence: [1] Understand your medication. Talk to your provider about what medications you are taking and why. When you understand the benefit the medication provides, you are more likely to be adherent to your medication regimen. [2] Talk to your provider about any concerns you may have. There may be ways we can help alleviate side effects or mitigate the cost of medications. [3] Use a pill reminder app or set an alarm or calendar alert on your phone to remind you to take your medication. [4] Tie your medication doses to a daily activity. For example, keeping your medication with your toothbrush ensures that you see the medication daily (or hopefully, twice daily), which will serve as a visual reminder to take your pill. Pretty soon, taking your medication will be as routine as, well, brushing your teeth. Enlist support from family and friends. Bring a trusted friend or family member to your appointments or to the pharmacy if you feel you may need help understanding or remembering medication instructions. “When we judge people we have no time to love them.” - Mother Teresa
As the weather improves, there will likely be opportunities and obligations to spend time with family. We may look forward to being with some and may hold a reluctance to being with others. Here is an opportunity to work with that reluctance. Instead of holding onto it, redirect it to a curiosity about the other. You may find you do not know much about that other. Formulate some questions you may wonder about and find an opportunity to ask those. Be aware of a possible new connection. If you stay in your reluctance, the opportunity to connect may be lost. Recently I was in a situation with someone with whom I had always felt uncomfortable. I judged him to be surly and not interested in others. He was sitting by himself and I got curious about him. I approached him and asked if he was still living in his same home town. He opened up and I learned so much more about him. He was not surly and was actually interested in me as well. We were able to connect and the discomfort was gone. One meaning of the word, Namaste is, “The light in me sees and honors the light in you.” I look forward to finding that light in others. When we feel our own light, it makes it easier to want to connect with another’s. Let’s connect with our own light and be curious about another’s. May you make bright connections throughout the whole new year. Valerian root, or Valeriana officinalis, is an over-the-counter, herbal supplement that can be helpful for the treatment of insomnia, or difficulty sleeping. The use of this soothing herb for the treatment of insomnia dates back to the 2nd century.
The root of this plant is used to make an extract, which is then made into a tincture (liquid), capsule (pill) or herbal tea, all of which are forms that can be taken orally. Valerian root is a perennial plant native to Europe, Asia and naturalized in North America and is known for its savory or musky scent. Studies have shown that valerian root, taken within 1 to 3 hours of sleep, has been helpful for both the initiation and maintenance of sleep. Valerian root is usually well tolerated and is less likely to cause morning drowsiness that is often associated with prescription medications used for the treatment of insomnia. Numerous pharmacological effects of Valeriana officinalis are mediated via modulation of the GABA system. GABA is a neurotransmitter in the brain which helps to decrease anxiety and relax, or slow down, brain activity in some areas of the brain. Valerian root extract is classified as "generally regarded as safe" (GRAS) by the U.S. Food and Drug Administration and is approved as an effective, mild sedative by Germany's Commission E. However, as with any new supplement or medication, talk with your prescribing clinician before adding something new to your medication regimen. Raising Children in a Media Saturated Society: A Balanced Approach by Jessica Kenimer, LPCC-S4/11/2018 TV, computers, phones, tablets, video games – social media, digital media, interactive media. . . Media is everywhere. A quick internet search provides a vast array of warnings about the risks of children using media along with guidelines specifying everything from when, where, and how to use media. Trying to sift through the ever increasing amount of data and opinions about what is “right” regarding media use for kids can leave parents feeling confused and overwhelmed.
While recommendations and guidelines for parents on how to use media responsibly have changed vastly over time, the overarching goals of parenting have remained the same – to provide for your child's physical and emotional needs while instilling and nurturing character and values to promote independence. The American Academy of Pediatrics suggests making mindful decisions about media use by taking research and guidelines into account while asking yourself what the purpose of using media is for you and your child. Examples of common questions parents may find themselves asking regarding media use for their child include: Will handing my toddler a phone to watch a short video while I pay for groceries permanently stunt his/her development? Mindful considerations: Research indicates that media use in young children may play a factor in delayed language skills; however, this is not likely to happen in the short time it takes to pay for groceries. If you find that you can't go to the grocery store without your toddler having a phone for the entire duration of the trip, it may be time to reconsider and create alternative solutions for your grocery shopping that would be more beneficial to nurturing a child's physical and emotional needs. Is putting a TV in my child's room going to cause problems? Mindful considerations: When purchasing a new TV, consider where the TV will be set up. Placing the TV in a common room and using it as a source of shared family entertainment can be beneficial in creating connectedness. However, placing a TV in a child's room is more likely to be detrimental to the child's sleep patterns. This also creates increased opportunity for isolation and is more difficult to monitor whether or not the child is choosing appropriate programming to watch. Is allowing my child or teenager to use social media okay? Mindful considerations: If social media is primarily used as a way to post funny pictures or easily plan group outings with friends, it can be beneficial to use. If using social media becomes a way to keep track of who said what about whom at school or becomes a source of comparison that results in your child having negative thoughts or feelings about him/herself, it is time to reconsider social media use. As is true for most things, the use of media can be beneficial or harmful depending on how it is used. Parents can take this opportunity to educate and guide their children in ways that will promote healthy physical, emotional, and moral development. Have conversations with your kids about not talking to strangers in public or online, and teach your children to be honest and kind in their interactions with their peers in person and on social media. Finally, DO feel empowered to set structure and rules for media use as well as consequences for misuse of media – just as you would about school attendance and homework, safety, and sleep. Limited exposure to sunlight is not only helpful for people's mental health, but also for their body's physical health
What is Vitamin D? Vitamin D is often called the “sunshine vitamin.” You can get Vitamin D from food or supplements, but exposure to the sun stimulates Vitamin D production in the skin. Why is Vitamin D important? Vitamin D serves several important functions in the body including: promoting calcium absorption, promoting bone health, and reducing inflammation. We also know that serotonin rises with exposure to bright light and falls with decreased sun exposure. Researchers estimate that 50 percent of the general population is at risk of Vitamin D deficiency. This percentage rises in higher-risk populations such as the elderly and those with darker skin. How do you know if your Vitamin D level is in the right range? We recommend testing every six months, as people vary widely in their response to UV exposure or oral Vitamin D supplementation. It is ideal to test in August (highest point) and again in February (lowest point). How to supplement? Recommended supplementation for Vitamin D is individualized. If one is unable to obtain limited exposure to sunlight, a vitamin supplement is helpful. A daily supplement of 2000 U daily may be enough for one person, while another may need to take up to 50,000 U per week to restore his/her level to normal. |
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