You already know that you feel better after you exercise, and you know there's ample evidence demonstrating that exercise helps your mental health. But how do you get started?
Most common mistake people make is starting out too hard.
Guidelines for getting started
NTY: How Exercise Makes You Less Anxious
How to get started:
Start with an easy walk 20 minutes 3x week. Set your timer for 10 minutes. Goal is to walk 10 minutes out, and 10 minutes back for a total of 20 minutes.
A particularly effective technique to to incorporate the breathwalk technique. Basically this involves mentally repeating a mantra and tapping your fingers to the rhythm of your steps. For more detailed information, check out the breathwalk website.
Recommend breathwalk technique.
Also recommend ChiWalk technique with a metronome.
Gradually increase to goal of walking vigorously for 30 minutes 6x/week.
Find that metronome is helpful for keeping pace.
For strength training I recommend circuit training with kettlebells
breaks the boredom of regular weight lifting routines. Doesn't require a lot of equipment.
Kettlebell circuits. Good place to get started at Mike Mahler's aggressive strenght training website
Sample circuit:
KB front squat 30 seconds
Rest 30 seconds
KB swings 30 seconds
Rest 30 seconds
KB R/L overhead press 30 seconds
15-20 minutes 3x/week.
By combining a light cardio program with a circuit training program, you'll get the hormonal benefits of both cardio and strength training.
Wednesday, November 25, 2009
Tuesday, November 24, 2009
What Every Patient Needs to Know About Dietary Supplements
Have you considered taking supplements such as 5-HTP, SAM-e, or St. John's Wort to treat symptoms of depression or anxiety? If you have, you're not alone. In fact, studies suggest that as many as 60% of patients have tried supplements to treat their symptoms BEFORE seeking professional help.
Before taking any supplements, it's important educate yourself about potential risks and, if you're already taking prescribed medication, to consult with your doctor first. Remember, just because a supplement advertises itself as "natural" doesn't mean that it's "safe". Here are two reliable sources for information about supplements you may be considering:
This government-run site provides up-to-date information on supplements and other forms of alternative therapies such as yoga and accupunture. Check out the report "Using Dietary Supplements Wisely" for an excellent overview of safety considerations.
This subscription website provides independent testing of vitamins, supplements and nutrition products. If you've ever wondered about whether a supplement actually contains the ingredients listed on the label, this is the place to go.
Before taking any supplements, it's important educate yourself about potential risks and, if you're already taking prescribed medication, to consult with your doctor first. Remember, just because a supplement advertises itself as "natural" doesn't mean that it's "safe". Here are two reliable sources for information about supplements you may be considering:
This government-run site provides up-to-date information on supplements and other forms of alternative therapies such as yoga and accupunture. Check out the report "Using Dietary Supplements Wisely" for an excellent overview of safety considerations.
This subscription website provides independent testing of vitamins, supplements and nutrition products. If you've ever wondered about whether a supplement actually contains the ingredients listed on the label, this is the place to go.
Monday, November 23, 2009
Top 5 Reasons Why Your Medication Isn't Working--And What To Do About It
Are you frustrated by your psychiatric medications? Do you find that you continue to take your medications for day, months, or even weeks, and still haven't found relief from your symptoms? Do you often find yourself wondering if you're even on the right medications, or wondering if your doctor has misdiagnosed you?
Before you give up, it's worth keeping in mind that psychiatric medications don't work for everyone. For example, many studies report that only about 60-70% of patients will respond to antidepressant therapy.
However, this doesn't mean you should give up hope if your medications aren't working as expected. Consider the following common medication errors:
1) Changing the time you take the medication each day.
As harmless as it may seem, taking your medications at different times of the day can have a tremendous impact on outcome. Some medications, for example, should only be taken in the morning as they are more likely to cause insomnia if taken closer to bedtime. Other variables, such as whether or not medication is taken with meals, can also impact absorption rates and, ultimately, outcomes. To avoid this error, be sure to take your medication at the same time every day, and ask your doctor if food impacts the absorption of your medication.
2) Taking your medication only when needed.
Some medications have a fast onset of action and are intended to be taken only as needed when symptoms arise. But the majority of medications prescribed for anxiety and depression have a delayed onset of action. Many patients assume that if they are feeling better there is no need to take medications consistently. Be sure you understand which medications should be taken as needed and which should be taken on a regular schedule.
3) Combining medications with over-the-counter medications to "boost" the effect.
Patients sometimes assume that combining prescription medication with over the counter supplements such as St. John's Wort or SAM-e is a harmless practice. It's not. Cases of serotonin syndrome, a serious and potentially life threatening drug reaction, have been reported in patients who combined their antidepressants such as Prozac (fluoxetine) with St. John's Wort. Don't assume that because a medication or supplement is available without a prescription, it's safe to take with your prescription medication. Ask your doctor.
4) Continuing to use alcohol, even in moderation.
Let's not forget that alcohol is a central nervous system depressant. If your taking an antidepressant and continuing to drink, even in moderation, you may be setting yourself up for failure. Alcohol, moreover, is known to intensify the side effects of many antidepressant and anti-anxiety medications. If your medication seems to have stalled and you're still drinking, consider abstaining until you're back on track.
5) Not defining specific target symptoms or treatment goals.
Perhaps the single most important reason why medications don't work is the failure to identify treatment goals. It's simply not enough identify "depression" or "anxiety" as target symptoms. Major depressive disorder and generalized anxiety disorder are conditions characterized by a constellation of symptoms, including: fatigue, difficulty concentrating, sleep disturbances, and restlessness. I ask patients to identify at least three target symptoms. Together, we track the outcome of these symptoms with each follow-up visit. Doing so gives us a better idea of treatment outcomes instead of relying on subjective reports of a single symptom.
While medications for treating depression and anxiety are far from perfect, you improve your chances of having a favorable outcome by avoiding the pitfalls listed above.
Before you give up, it's worth keeping in mind that psychiatric medications don't work for everyone. For example, many studies report that only about 60-70% of patients will respond to antidepressant therapy.
However, this doesn't mean you should give up hope if your medications aren't working as expected. Consider the following common medication errors:
1) Changing the time you take the medication each day.
As harmless as it may seem, taking your medications at different times of the day can have a tremendous impact on outcome. Some medications, for example, should only be taken in the morning as they are more likely to cause insomnia if taken closer to bedtime. Other variables, such as whether or not medication is taken with meals, can also impact absorption rates and, ultimately, outcomes. To avoid this error, be sure to take your medication at the same time every day, and ask your doctor if food impacts the absorption of your medication.
2) Taking your medication only when needed.
Some medications have a fast onset of action and are intended to be taken only as needed when symptoms arise. But the majority of medications prescribed for anxiety and depression have a delayed onset of action. Many patients assume that if they are feeling better there is no need to take medications consistently. Be sure you understand which medications should be taken as needed and which should be taken on a regular schedule.
3) Combining medications with over-the-counter medications to "boost" the effect.
Patients sometimes assume that combining prescription medication with over the counter supplements such as St. John's Wort or SAM-e is a harmless practice. It's not. Cases of serotonin syndrome, a serious and potentially life threatening drug reaction, have been reported in patients who combined their antidepressants such as Prozac (fluoxetine) with St. John's Wort. Don't assume that because a medication or supplement is available without a prescription, it's safe to take with your prescription medication. Ask your doctor.
4) Continuing to use alcohol, even in moderation.
Let's not forget that alcohol is a central nervous system depressant. If your taking an antidepressant and continuing to drink, even in moderation, you may be setting yourself up for failure. Alcohol, moreover, is known to intensify the side effects of many antidepressant and anti-anxiety medications. If your medication seems to have stalled and you're still drinking, consider abstaining until you're back on track.
5) Not defining specific target symptoms or treatment goals.
Perhaps the single most important reason why medications don't work is the failure to identify treatment goals. It's simply not enough identify "depression" or "anxiety" as target symptoms. Major depressive disorder and generalized anxiety disorder are conditions characterized by a constellation of symptoms, including: fatigue, difficulty concentrating, sleep disturbances, and restlessness. I ask patients to identify at least three target symptoms. Together, we track the outcome of these symptoms with each follow-up visit. Doing so gives us a better idea of treatment outcomes instead of relying on subjective reports of a single symptom.
While medications for treating depression and anxiety are far from perfect, you improve your chances of having a favorable outcome by avoiding the pitfalls listed above.
