ocpsychiatry

NIMH ADHD Adults Anxiety Depression Comorbidity

Thu, 16 Feb 2023 23:30:50 GMT

Introduction

This article explores the strong link between ADHD, anxiety, depression, and comorbidity in adults, drawing on recent research and clinical insights. It is designed for adults with ADHD, adult patients, clinicians, and anyone interested in mental health. Understanding these connections is crucial, as the high prevalence of comorbid conditions significantly impacts diagnosis, treatment, and overall quality of life.

According to a new U.K. study highlighted by NIMH on attention-deficit/hyperactivity disorder (ADHD), ADHD traits in adults are strongly linked to more severe anxiety and depression symptoms, underscoring the importance of understanding comorbidity. Internalizing problems, which include anxiety and depression, are more strongly predicted by ADHD traits than by autism traits. This means that adults with ADHD are more likely to experience severe anxiety and depression symptoms compared to those with autism spectrum disorder traits.

Study Design and Findings from the National Comorbidity Survey Replication

Researchers aimed to clarify the associations between self-reported ASD traits and ADHD traits with mental health conditions like anxiety and depression using a general population sample, which included 504 adults from the U.K. (49% male, 51% female) aged 18–79 years, offering broader prevalence context beyond clinical samples.

Key Prevalence Summary

Over 80% of adults with ADHD have a coexisting psychiatric disorder. Specifically, 72% are diagnosed with anxiety disorders and 70% with depression. These high rates of comorbidity highlight the importance of screening and integrated treatment.

Study Summary

Prevalence of Comorbidities in Adults with ADHD

As many as 80% of adults with ADHD have at least one co-existing psychiatric disorder. 2 Adult prevalence estimates are also commonly drawn from the National Comorbidity Survey Replication and underscore the need for specialized ADHD assessment and treatment . According to a recent ADDitude survey of 1,500 readers, the two most common comorbid conditions diagnosed alongside ADHD in adults are:

Anxiety disorders: 72%
Depression: 70%

Despite this high rate of comorbidity, researchers said, “ ASD has often been prioritized over ADHD in both research on internalizing problems and clinical practice, particularly for anxiety.” 3

Notably, approximately 28% of autistic individuals have ADHD, making it difficult to determine which disorder — ASD or ADHD — more significantly impacts mental health outcomes. 2 (The ADDitude reader survey found that 9% of adults with ADHD have ASD.)

Study Design and Findings

While the results linked both ASD and ADHD with anxiety and depression , ADHD was a stronger statistical predictor of both mental-health conditions than was ASD. Further analysis confirmed that ADHD traits were associated with more severe anxiety and depression symptoms in adults than were ASD traits.

Some researchers “speculate that response inhibition difficulties, which appear to be a cognitive feature of ADHD , may also potentially underpin the stronger association between ADHD traits and internalizing problems.”

To the researchers' knowledge, this is the first study showing ADHD more strongly predicts mental health outcomes in adults than do other neurodevelopmental conditions, like ASD.

“Our finding that ADHD traits dominated ASD traits in predicting internalizing disorder symptoms could inform strategies to identify individuals who are at an increased risk of internalizing problems,” several researchers said. “...might allow preventative measures and interventions to be implemented at an earlier age, which, for example, could focus on managing ADHD symptoms from childhood through the teen years and into adulthood for a greater impact on ameliorating internalizing problems and improving mental wellbeing in adults.”

Clinical Implications of Comorbidity

Recognizing complex ADHD (attention deficit plus one or more co-occurring conditions) is of “high clinical importance,” said Theresa Cerulli, M.D., of Beth Israel Deaconess Medical Center and the Neuroscience Education Institute , in the ADDitude webinar titled, “ Complex ADHD: The New Approach to Understanding, Diagnosing, and Treating Comorbidities in Concert .”

“The presence of co-occurring conditions almost always muddles the diagnosis, treatment, and prognosis of ADHD,” she said, especially when conditions such as major depression or a mood disorder overlap. “... ADHD and comorbidities may also influence the presentation and severity of one another, which can complicate the detection and treatment of symptoms, lead to functional impairment, and impair overall quality of life.” For some adults with treatment-resistant depression or anxiety, non-invasive options like FDA-approved TMS therapy for mood and anxiety disorders may be considered as part of a comprehensive care plan.

Researchers hope the study's findings will encourage more research probing whether genetics help explain why ADHD traits are more strongly associated with internalizing problems than are autistic traits, and whether persistent symptoms reflect observable behaviors linked to those traits.

To address common concerns about ADHD and its comorbidities, see the frequently asked questions below.

Frequently Asked Questions About Adult ADHD with Anxiety or Depression

About Our Clinic

Get Specialized Adult ADHD and Mental Health Care in Orange County, CA

At Orange Coast Psychiatric Associates , we understand the complex interplay of ADHD, anxiety, depression, and other comorbid conditions. Serving the greater Orange County area, including Mission Viejo, Laguna Niguel, and surrounding communities, our expert team provides comprehensive psychiatric evaluations, accurate diagnosis, and personalized treatment plans tailored to adults and adolescents . Whether you are struggling with undiagnosed ADHD, anxiety, depression, or related disorders, we are here to help you regain control of your daily life, and you can contact our psychiatric practice in Orange County with questions about services or care. Schedule an appointment with our Orange County psychiatric clinic to take the first step toward effective treatment and lasting mental wellness.

Sources

Hargitai, L.D., Livingston, L.A., Waldren, L.H. et al. (2023). Attention-Deficit Hyperactivity Disorder Traits Are a More Important Predictor of Internalising Problems Than Autistic Traits. Sci Rep. 13, 31. https://doi.org/10.1038/s41598-022-26350-4
Katzman, M. A., Bilkey, T. S., Chokka, P. R., Fallu, A., & Klassen, L. J. (2017). Adult ADHD and Comorbid Disorders: Clinical Implications of a Dimensional Approach. BMC psychiatry. 17(1), 302. https://doi.org/10.1186/s12888-017-1463-3
Bishop, D. V. M. (2010). Which Neurodevelopmental Disorders Get Researched and Why? PLoS ONE 5, e15112/
Young, S. et al. (2021). Failure of Healthcare Provision for Attention-Deficit/Hyperactivity Disorder in the United Kingdom: A Consensus Statement. Front. Psychiatry 12, 324.

Psychiatric disorders linked with higher risk for heart disease, diabetes death

Fri, 25 Mar 2022 08:26:09 GMT

(UPI) -- People with mental health disorders are up to twice as likely to die earlier from chronic conditions such as heart disease and diabetes than those without them, a study published Thursday by PLOS Medicine found.

Among people with psychiatric disorders such as anxiety, depression, bipolar disorder, substance use disorder and schizophrenia , 21% died within five years of being diagnosed with heart disease, diabetes or breathing problems, such as chronic obstructive pulmonary disease, the data showed.

Of those without diagnosed mental health disorders, 9% died within five years of learning they had one of these chronic conditions, the researchers said.

Compared with unaffected siblings, people with mental health disorders were about seven times more likely to die within five years of being diagnosed with a chronic physical health condition and nearly nine times more likely to die by suicide within that time frame, according to the researchers.

Of all the participants in the study, 7% died of any cause within five years of being diagnosed with a chronic condition and 0.3% died by suicide, they said.

"We used electronic health records to investigate over 1 million patients diagnosed with chronic lung diseases, cardiovascular diseases and diabetes," study co-author Dr. Seena Fazel said in a press release.

Body Image

As noted by the Flinders University study, the connection of social media use and eating goes deeper than just food. In many ways it is one of body image, and various studies have found that this can be both good and bad. King University Online compiled data from a number of studies and found that there are positive effects that come from social media on body image – this can include healthier eating, exercise and making good choices.

However, social media can have a serious negative impact as well when people too often compare their appearance with others.

Social media also ties in with another trend: "the era of the selfie," explained Julie Sylvester, producer of the upcoming CES 2020 Sports & Fitness Tech and Wearable Tech Summit .

"The more pictures we post of our event, activities, new haircuts, and vacations on social media, the more time we spend looking at ourselves through the eyes of other people," Sylvester explained.

Never before has it been so easy to take pictures of one's self and share them for the world to see. This constant need to share however comes at a price. People like compliments but are rarely ready for the criticism that invariably comes.

"Most people are a few pounds overweight, have the wrong hair style or the wrong clothes, but like the proverbial fairy tale, mirrors lie and the old cliché 'a picture is worth a thousand words' sometimes can amplify flaws and more importantly reveal how others see us," added Sylvester.

"More than 7% of the patients died of any cause within five years and 0.3% died from suicide, risks that were more than doubled in patients with psychiatric comorbidities," said Fazel, a professor of forensic psychiatry at the University of Oxford in England.

One in five American adults has a mental illness, according to the National Institute of Mental Health.

Recent research has linked inflammation seen in people with mental health disorders with a higher risk for other health problems , including COVID-19 .

The findings are based on an analysis of data from national registries in Sweden that included information on more than 1 million people born between 1932 and 1995 who had been diagnosed with chronic lung diseases, heart disease and diabetes.

About one-third of the participants had been diagnosed with a psychiatric disorder during their lifetimes, the researchers said.

People with substance use disorder were up to 10 times more likely to die within five years of being diagnosed with a chronic physical health condition, the data showed.

In addition, those depression had a seven-fold higher risk for death within five years of receiving a diagnosis.

Improved assessment, treatment and follow-up care for those with mental health disorders could reduce the risk for early death from chronic conditions, Fazel and his colleagues said.

This article originally posted at UPI Health News

Written by Brian P. Dunleavy

Do Social Media Platforms Drive the Rise of Eating Disorders Among Teens?

Fri, 18 Mar 2022 08:19:26 GMT

Introduction

This article explores how social media influences eating disorders among teens, providing insights for parents, educators, and young people. Understanding these connections is crucial for promoting healthy mental health and eating habits. Social media use is linked to increased eating disorder risk, making it essential for those who support adolescents to recognize the warning signs and understand the underlying factors. Adolescents are particularly vulnerable to body image issues from social media.

Recent studies indicate a strong link between social media influence on eating disorders in adolescents. Teens who engage with social media for even short periods daily report heightened levels of anxiety, depressive symptoms, loneliness, and importantly, diminished self-esteem, which often contributes to unhealthy eating patterns.

A team of researchers from Flinders University in Australia, led by Dr. Simon M. Wilksch, investigated how social media influences body dissatisfaction and disordered eating behaviors. Their findings, published in the International Journal of Eating Disorders, revealed that over half of the girls and nearly half of the boys surveyed exhibited signs of eating disorders, with behaviors like extreme dieting and excessive exercise being prevalent. Instagram emerged as the most widely used platform among these teens, followed by Snapchat, Tumblr, and Facebook.

Interestingly, the study found no single social media platform solely responsible for these trends. While girls showed a preference for Snapchat and Tumblr, boys were more active on Facebook and Instagram, suggesting that the social media influence on eating disorders spans multiple platforms.

The Complex Relationship Between Social Media and Body Image

Social media's impact on body image is multifaceted. On the positive side, it can encourage healthier lifestyle choices, including balanced nutrition and physical activity. However, the negative effects often overshadow these benefits, especially when teens engage in frequent social comparisons that foster body dissatisfaction.

Filtered and edited images contribute to unrealistic body ideals, and constant exposure to idealized bodies fosters body dissatisfaction. This exposure can trigger disordered eating behaviors, as social comparison often results in self-criticism and dissatisfaction. Social media use is linked to increased body dissatisfaction and increased eating disorder risk.

Julie Sylvester, producer of the CES 2020 Sports & Fitness Tech and Wearable Tech Summit, describes this era as "the age of the selfie," where individuals constantly view themselves through the lens of others. The ease of sharing images has increased self-scrutiny, often leading to distorted body image and lowered self-esteem.

Unlike celebrities who can curate their online presence with professional photos and editing, everyday users post unfiltered selfies that may attract critical comments. Dr. Mariea Snell, assistant director of the Online Doctor of Nursing Practice program at Maryville University, highlights that social media bombards users with messages about ideal diets, body sizes, and the glorification of thinness, contributing to unhealthy self-perceptions and disordered eating.

The Role of Social Media in Teen Eating Disorders

Adolescence is a vulnerable period marked by heightened self-awareness and peer pressure. Social media can exacerbate these challenges by exposing teens to unrealistic standards of beauty and body shape. Negative feedback on posted photos can lead to feelings of body shame, fear of missing out (FOMO), and even bullying, all of which increase the risk of developing eating disorders and may contribute to broader psychiatric disorders and related health risks.

These disorders often persist beyond the teenage years, affecting young adults in college and professional settings. However, some experts suggest that the awareness fostered by social media might also help some young people avoid excessive weight gain, ironically replacing concerns like the "freshman 15" with heightened body consciousness, and for some, this heightened awareness may intersect with innovative treatment options such as non-invasive TMS therapy for conditions like binge eating.

In summary, while social media offers opportunities for connection and self-expression, its influence on body image and eating behaviors among teens is complex and often harmful. Social media use is linked to increased eating disorder risk (1, 2, 3). Complementing professional care with small, sustainable mental health habits can also support resilience. Recognizing these risks is crucial for parents, educators, and healthcare providers striving to support healthy mental health and eating habits in young people.

Frequently Asked Questions About Do Social Media Platforms Drive

Get Support for Eating Disorders and Body Image Concerns at Orange Coast Psychiatric Associates

If you or a loved one is struggling with an eating disorder or body image concerns influenced by social media, Orange Coast Psychiatric Associates is here to help. Our specialized outpatient psychiatric care in Mission Viejo offers comprehensive evaluation, medication management, psychotherapy, ADHD assessment and treatment through our ADHD services , and wellness programs tailored to support adolescents and adults on their journey to recovery. Our clinicians, including providers like Scott Ispirescu and Patricia Chavez , emphasize a holistic approach that addresses mood, anxiety, and related conditions, recognizing how issues such as depression-related appetite changes and the mental health benefits of regular exercise for emotional well-being can intersect with disordered eating. Research also highlights that co-occurring conditions like adult ADHD, anxiety, and depression can complicate recovery and overall health, and that untreated psychiatric disorders may increase long-term risks such as heart disease and diabetes. Contact us today through our appointment request form or office contact page to take the first step towards holistic mental health and well-being.

COVID Anxiety: Understanding and Managing Your Concerns

Fri, 11 Mar 2022 09:08:01 GMT

This guide is for anyone struggling with COVID-related anxiety or wondering if their concerns may indicate a more serious condition. Understanding the difference can help you seek the right support and improve your well-being.

Feeling worried about contracting COVID-19, sometimes called COVID anxiety, is a natural response during a global pandemic. COVID anxiety refers to the heightened worry and stress many people experience due to the health fears and uncertainty brought on by the COVID-19 pandemic. However, when these worries escalate into persistent, intrusive thoughts, panic attacks, or overwhelming emotional distress, it may indicate the presence of illness anxiety disorder (IAD), sometimes referred to as hypochondriasis.

The COVID-19 pandemic increased anxiety levels by creating health fears and uncertainty. Social isolation and loneliness contributed to increased anxiety during the pandemic. In fact, anxiety and depression symptoms increased by about 25% during the first year of COVID-19.

Before the COVID-19 pandemic, many people experienced daily life without constant fear of illness. Today, with ongoing news about new variants, breakthrough infections, and shifting safety guidelines, it's common to feel uneasy. But how do you differentiate between normal concern and a mental health condition?

What Constitutes Normal COVID-19 Worry?

Normal concern involves taking sensible precautions to protect yourself and others and to stay informed through reliable sources like the World Health Organization and the Centers for Disease Control and Prevention. This includes following recommended safety measures such as vaccination, wearing masks when appropriate, social distancing, and practicing good hygiene like handwashing or using hand sanitizer.

Being aware of when to get tested is also part of healthy vigilance. The CDC advises testing if you have been exposed to someone with COVID-19 or if you experience symptoms such as:

Chills
Cough
Diarrhea
Fatigue
Fever
Headache or muscle aches
Loss of taste or smell
Nausea or vomiting
Runny nose or congestion
Shortness of breath or difficulty breathing
Sore throat

These actions help most people manage risk in a balanced way without letting anxiety take over.

What Is Illness Anxiety Disorder (IAD) and Other Mental Health Conditions?

Illness Anxiety Disorder is a recognized mental health condition characterized by excessive worry about having or developing a serious illness, even when medical evaluations show no significant health problems. During the COVID-19 pandemic, individuals with IAD may misinterpret normal bodily sensations or minor symptoms as signs of infection, which can lead to intense worry and anxiety symptoms.

Dr. Karol Darsa, a trauma psychologist, explains that someone with IAD might experience muscle soreness after exercise but interpret it as a COVID-19 symptom rather than a normal physical response. This misinterpretation fuels ongoing anxiety and distress.

People with IAD often fall into two categories:

Care-seeking type: These individuals frequently seek medical evaluations and COVID-19 testing, despite negative results or absence of symptoms. They may undergo repeated testing and experience ongoing fear.
Care-avoidant type: These individuals avoid medical care due to distrust or fear of receiving bad news. They might refuse testing even when symptomatic, believing the results won’t be accurate or fearing exposure to the virus in healthcare settings.

Both types can experience significant interference with daily life, including social isolation, financial strain from excessive medical testing, and emotional distress.

Distinguishing Normal Concerns from Illness Anxiety Disorder

The key difference lies in the impact on your daily functioning. Normal COVID-related concerns motivate protective behaviors without causing debilitating fear or disruption. In contrast, IAD leads to persistent anxiety that can feel overwhelming when it impairs your ability to carry out everyday activities.

If you find yourself obsessively checking your body for symptoms, notice that you feel sad, repeatedly seeking medical tests without reassurance, or avoiding social interactions due to fear of illness, it may be time to seek professional help.

Effective Ways to Manage COVID-19 Anxiety Symptoms and Illness Anxiety Disorder

Managing COVID anxiety and illness anxiety disorder involves a combination of evidence-based strategies, and different risk factors and pre-existing mental health conditions can affect how strongly it shows up and what support may help. Here are some effective approaches:

Limit exposure to alarming news: Restrict news consumption to 15-20 minutes per day from trusted sources to help reduce anxiety during stressful periods.
Seek professional mental health support: If anxiety interferes with your daily life, seeking treatment through a mental health professional is important. Cognitive Behavioral Therapy (CBT) and, in some cases, medication can be effective.
Maintain social connections: Stay in touch with friends, family, and loved ones through calls, video chats, or messages to provide emotional support and reduce feelings of isolation.
Practice mindfulness and relaxation techniques: Mindfulness meditation and breathing exercises help you stay focused on the present moment and reduce anxiety.
Keep daily routines: Maintaining structure in your day helps anchor your mind and can lower anxiety levels.
Engage in self-care: Prioritize activities that promote well-being, such as hobbies, relaxation, and adequate rest, and consider adopting small daily mental health habits to help you cope .
Regular physical activity: Exercise improves resilience against stress and anxiety.
Acknowledge financial stress and disrupted routines: Recognize that financial worries and changes in daily life can heighten anxiety. Addressing these challenges with support and planning can help.

1. Seek Professional Mental Health Support

Consulting with a mental health professional can provide tailored strategies to manage anxiety. Cognitive Behavioral Therapy (CBT) is especially effective in addressing irrational thoughts and behaviors related to health anxiety. In some cases, medication such as antidepressants may be recommended to reduce symptoms.

2. Practice Mindfulness and Relaxation Techniques

Mindfulness meditation helps ground you in the present moment, reducing intense worry about future illness. Focus on your breathing and observe your thoughts without judgment. Regular practice can improve your nervous system’s resilience to stress.

3. Maintain a Healthy Lifestyle

Physical health supports mental well-being. Engage in regular physical activity to support mental health , eat a balanced diet rich in magnesium, zinc, omega-3 fatty acids, and antioxidants, and prioritize good sleep patterns. Limiting caffeine and alcohol can also help stabilize mood.

4. Limit Exposure to Distressing News

While staying informed is important, excessive news consumption can exacerbate anxiety. Limit your intake to 15-20 minutes per day from trusted sources such as the World Health Organization or the National Institute of Mental Health.

5. Stay Connected and Maintain Daily Routines

Social isolation can worsen anxiety and depressive symptoms, and it can be especially hard for older adults. Use technology to stay in touch with friends and family, and remember that comprehensive mental health support is available if you need additional help. Checking in on one person regularly can reduce loneliness and help maintain support. Keeping regular daily routines anchored can provide a sense of normalcy and control.

6. Engage in Self-Care

Make time for activities that bring you joy and relaxation, such as reading, listening to music, or spending time in nature. Self-care is essential for managing stress and maintaining emotional balance.

7. Address Financial Stress and Disrupted Routines

Acknowledge the impact of financial worries and changes in daily life. Seek support from community resources, financial counselors, or support groups if needed. Creating a plan and reaching out for help can ease anxiety related to these challenges.

Frequently Asked Questions About COVID Anxiety

Take the Next Step Toward Better Mental Health

Orange Coast Psychiatric Associates: Your Partner in Managing COVID Anxiety and Mental Well-Being

If you or loved ones are struggling with COVID anxiety or illness anxiety disorder, Orange Coast Psychiatric Associates in Mission Viejo is here to help. Learn more about our practice and holistic approach to care . Our experienced team offers comprehensive mental health services, including psychiatric evaluation, medication management, psychotherapy, and holistic wellness programs, and if you are feeling suicidal, seek immediate emergency or crisis support. You can contact our office directly to learn more or ask questions about services.

We understand the intricate connection between mind and body and tailor treatments to support your overall well-being. Our clinicians, such as psychiatrist Scott Ispirescu, MD , emphasize a holistic, collaborative approach to treatment. Don’t let anxiety control your life—reach out today to schedule an appointment and take the first step toward peace of mind. Professional care can help when anxiety starts to feel overwhelming or hard to manage alone.

Book Your Appointment Now and start your journey to improved mental health and well-being.

Depression Stole My Appetite—Here's What Helped

Fri, 25 Feb 2022 08:57:43 GMT

How to Regain Appetite Depression: Introduction

If you’re searching for how to regain appetite during depression, this article is for you. Here, we explore why depression can cause appetite loss, who is affected, and why regaining your appetite is crucial for both physical health and emotional recovery. Whether you’re experiencing appetite loss yourself or supporting someone who is, you’ll find practical tips, expert insights, and resources to help you or your loved one take the first steps toward nourishment and healing.

To regain appetite during depression, start by eating something simple and low effort—whatever you can manage—to get energy in your body, whether that’s mac and cheese, deli turkey, frozen meals, or even protein shakes when solid food feels like too much. If you’re an adolescent or adult in or near Mission Viejo, California dealing with depression-related appetite loss, this guide explains why people lose interest in food during depressive episodes, how low appetite can turn into a vicious cycle of low energy levels and nutritional deficiencies, and what practical tips can help you start eating again.

Why Depression Affects Appetite and Mental Health

According to Dr. Drew Ramsey, author of Eat to Beat Depression and Anxiety , this is common for people who deal with depression. “Changes in appetite and changes in weight are part of the diagnostic criteria for depression,” he told me. A decreased appetite is a common symptom and affects almost half of people with major depression. Because appetite depression is such a complex illness that much of the medical world is still learning about, “there’s a lot that remains to be understood,” he noted.

“Oftentimes people think about it as just an illness related to serotonin, and it's much more complex than that,” he said. Although research has shown that your microbiome and hormones can affect your levels of depression and vice versa, there isn’t one thing experts can pinpoint to explain a loss of appetite in times of depression. High cortisol levels, along with stress hormones and stress-related nausea, can reduce food reward perception, trigger physical symptoms , and make it easier to lose interest in eating.

Appetite depression refers to the way depression alters brain chemistry, weakening hunger cues and making food seem unappealing. Understanding these causes can help you find practical ways to cope, which we'll discuss next.

Personal Experience: When Depression Stole My Appetite (Loss of Appetite)

The first time I experienced depression, it was as crippling as everyone had described. It’s one of those things that sounds awful in theory, but until you experience it yourself, you don’t know how absolutely debilitating it can be. But the most shocking part for me was my loss of appetite. All of a sudden, I found myself smack dab in the middle of a cliché, lying on the kitchen floor with dried tears on my cheeks and no room in my stomach for anything other than complete and total sadness.

As someone who has loved food their entire life, and even plans their day around food, this was new. Physically, I could hear my insides screaming for nourishment , for food, but mentally, I had no will to eat—and especially no desire to cook. There were times when I would go the whole day without putting anything in my body, and some people with depression skip meals for days.

Low-Effort Meals, Eating Habits, and Practical Tips

This was frustrating when I was experiencing it, as there was no magic solution to give me my appetite back. But one thing that did help was finding a depression meal. If you’re someone who has dealt with depression, and the lack of appetite that can come with it, then you are familiar with these meals. They are easy, quick, very low effort dishes you can whip up and consume when you find yourself where I was. On social media, people will share their go-tos, ranging from:

Having a few options ready to prepare meals ahead of time—or keeping frozen meals on hand for the hardest days—can make eating meals feel much more doable, especially when depression can make even that feel overwhelming.

“When you're depressed, it can seem like the hardest thing in the world to do is muster up the energy to cook a meal or take care of yourself,” Danielle Allen, a dietician and TikTok creator, told me. She herself struggles with a fluctuating appetite due to anxiety and depression and shares her depression meals in those moments.

“Get away from the idea of what you have to eat,” she advised. “Instead, my goal is just to feed myself, just get energy in my body.” When appetite is low, it helps to choose foods that are easy to prepare and still sound appealing. “Focusing on eating as the first priority in that depressive episode can be a really helpful thing to do. And so picking something simple, that's not going to have a lot of barriers, is usually the strategy I recommend.”

So the goal in times when I don’t want to eat is not to eat healthy, but to just eat. Something, anything. Even if you do not feel hungry or have little appetite, a few bites can help restart the process. When I’m in those moments, often it’s not even about tasting the food, but about getting it into my body. I have to overcome that aversion knowing that afterwards, I’ll feel a little bit better. From there, you can work toward small meals instead of large meals, regular snack times, and steadier routines that support better eating habits and eating patterns, then incorporate foods that are more balanced and varied across food groups to support recovery.

And if that food also brings me a smidge of serotonin in the moment, even better. Annie’s White Cheddar mac and cheese does that for me, because I know I can muster up the little amount of strength it takes to make it, and it brings me a little burst of joy; once that feels manageable, you can add in nutrient-rich foods such as whole grains, and oats may help boost serotonin levels. For Nicole DiMascio of the popular account, Dope Kitchen , it’s deli turkey. Normally, you can find her cooking up healthy and delicious meals while “getting baked in the kitchen,” but one day, she shared her struggles with eating while depressed with her followers.

“I go through a lot of mood swings where like some days I'm super organized, and then one thing will happen that kind of derails all of my progress,” Nicole said in an interview with me. “I need to just be gentle with myself and remind myself that it's okay to not always be positive.”

Her candid post resonated with her followers. “One of the most touching and heartwarming things was hearing people say that opening up about my appetite during depression and my journey helped other people feed themselves and that it was just a great reminder to nourish their bodies even if their mind wasn't in the right place,” she said.

About 20 minutes of gentle physical activity, such as walking, can also help improve mood and appetite.

Transitioning from these practical tips, let’s look at when it’s time to seek additional support.

When to Seek Professional Help

We are living in strange times. The ongoing pandemic has affected just about every part of our world and isolated many, leading more people to experience depression and anxiety. But being able to go on social media helps me see that I am not alone in my depression and knowing that the first goal is to eat brings a small tinge of comfort. However, it’s certainly not a replacement for mental health care, so if you are in need of help, check out the resources below.

Addressing depression through therapy or medication can also improve appetite. If self-help strategies are not working, consult a doctor. If appetite loss is persistent, it's essential to reach out to a healthcare professional. If appetite loss is persistent, leads to weight loss or other health problems, makes it hard to maintain three meals or even small meals a day, causes you to lose weight unintentionally, or raises concern about maintaining muscle mass, a healthcare provider, mental health professional, or registered dietitian can offer advice and professional support around both nutrition and the root causes as part of self care during depression recovery.

SAMHSA’s National Helpline

National Institute of Mental Health

Frequently Asked Questions on Appetite and Depression

Regain Your Appetite and Wellness with Expert Support in Orange County

If you or a loved one in Orange County, California, are struggling with depression and appetite changes, Orange Coast Psychiatric Associates is here to help. Our compassionate team offers comprehensive outpatient mental health services tailored to your needs. Reach out today to schedule a consultation and take the first step toward regaining your appetite and overall well-being.

Contact Orange Coast Psychiatric Associates at (949) 282-0027 or visit our Mission Viejo office to learn more about our specialized care and support.

22 Simple Mental Health Habits to Enhance Your Well-Being

Fri, 11 Feb 2022 08:33:30 GMT

Small acts of self-care can make a big difference in your mental wellness.

Life’s challenges and ongoing global changes continue to impact our mental well-being. While self-care alone cannot solve all problems, adopting simple, daily habits can uplift your mood and improve your mental wellness incrementally.

Here are 22 easy-to-implement mental health habits to boost your overall well-being:

1. Keep a gratitude journal.

Spend a few minutes each day noting things you are grateful for. This practice reduces stress, improves sleep quality, and fosters empathy and positive feelings in relationships. Try to write at the same time daily, such as before bed, to build a consistent routine.

2. Practice deep breathing exercises.

Taking five slow, deep breaths can reduce stress hormones by activating your parasympathetic nervous system, promoting relaxation, and even improving digestion. Incorporate deep breathing breaks throughout your day to manage stress effectively.

3. Use light therapy to support your circadian rhythm.

Exposure to natural light regulates your sleep-wake cycle, which is crucial for mental well-being. If you spend most of your time indoors, a light therapy lamp can help boost your energy, mood, and brain function.

4. Stay hydrated.

Water supports both physical health and mental wellness. Chronic dehydration can impair brain function and mood. Aim to drink enough water daily to feel well rested and maintain emotional balance.

5. Label your emotions.

Naming your feelings can reduce their intensity by up to 50%, helping you manage anxiety and stress better. This simple technique can improve your emotional health by increasing self-awareness and healthy coping skills.

6. Turn your skincare routine into mindful self-care.

Use moments like applying a face mask or moisturizer to relax, listen to calming music, or practice gratitude. These small rituals can boost self-esteem and emotional support.

7. Spend time outdoors regularly.

Nature exposure decreases mental fatigue and boosts mood. Even brief walks or mindful breathing exercises outdoors can enhance your mental well-being and overall health.

8. Stretch daily.

Gentle stretching releases endorphins and helps reduce both physical and emotional pain, and research increasingly shows that regular exercise significantly benefits mental health . Incorporate stretching into your daily routine to support your mental wellness.

9. Connect with friends and loved ones.

Quality social connections provide emotional support, reduce feelings of loneliness, and improve mental well-being, which is especially important if you live with conditions like adult ADHD, anxiety, or depression . Schedule regular calls or visits to nurture these relationships.

10. Explore acupuncture or other wellness rituals.

Alternative therapies like acupuncture can decrease anxiety and stress. Find rituals that fit your lifestyle to create moments of relaxation and mental calm.

11. Ask for help when overwhelmed.

Seeking assistance is a sign of strength, not weakness. Whether it’s delegating tasks or reaching out to a professional, support helps manage stress and fosters resilience, and choosing a practice that offers personalized, holistic psychiatric care can make that support even more effective.

12. Set boundaries around others’ moods.

Recognize that other people’s emotions are their responsibility. Avoid taking on their stress to maintain your own emotional health and peace.

13. Volunteer and give back.

Helping others, especially through animal-assisted activities, can reduce symptoms of depression, anxiety, and PTSD while enhancing your sense of purpose, and working with a therapist who specializes in mood disorders, anxiety, trauma, and relationships can further support this healing process.

14. Start a garden.

Gardening improves focus, lowers blood pressure, and promotes mental wellness through connection with nature and physical activity.

15. Watch uplifting or funny content.

Laughter and smiling release positive brain chemicals that boost mood and reduce stress. Incorporate humor into your day for mental health benefits.

16. Perform acts of kindness.

Generosity increases empathy, self-worth, and positive feelings, helping you gain perspective on your own challenges.

17. Mind your social media use.

Limiting screen time and being intentional about your social media consumption can reduce anxiety and negative comparisons, improving mental well-being; for some people, combining these habits with holistic psychiatric treatment for mood and anxiety disorders offers even greater benefits.

18. Create a relaxing bedtime routine.

Good sleep hygiene, including winding down without screens and practicing mindfulness before bed, improves sleep quality and emotional health.

19. Meditate regularly.

Even 5-10 minutes of meditation daily can enhance brain function, reduce stress hormones, and improve mood, and for more severe or treatment-resistant symptoms, innovative options like non-invasive TMS therapy for depression and anxiety may also be appropriate.

20. Try moving meditation.

Activities like yoga, tai chi, or mindful walking combine physical activity with breath awareness to promote mental wellness, and pairing these practices with support from a psychiatric mental health nurse practitioner can help you address more complex symptoms.

21. Drink green tea.

Green tea contains compounds that reduce anxiety and enhance focus, supporting mental well-being.

22. Seek professional support when needed.

Therapy is beneficial not only in crisis but as an ongoing support for managing stress and developing healthy coping skills, and working with a comprehensive mental health practice ensures access to a full range of treatment options.

Frequently Asked Questions (FAQs) About Good Mental Health Habits

Take Charge of Your Mental Wellness with Orange Coast Psychiatric Associates

At Orange Coast Psychiatric Associates, we understand that good mental health habits are the foundation of a fulfilling life. Our expert team offers comprehensive psychiatric care and wellness programs tailored to your unique needs. Whether you’re seeking support for mood disorders, anxiety, sleep issues, or want to build healthy coping skills, we’re here to guide you every step of the way.

Start your journey toward better mental well-being today. Schedule an appointment online or contact Orange Coast Psychiatric Associates to arrange your personalized evaluation and discover the power of holistic mental wellness.

Diet May Help Alleviate Some Symptoms of Bipolar Disorder

Fri, 21 Jan 2022 19:15:02 GMT

More than 80 people with bipolar disorder participated in a study in which half of them received diet counseling and ate specific foods for 12 weeks.
The researchers decreased the experimental group’s consumption of omega-6 fatty acids by limiting red meat, eggs, and certain oils and increased their consumption of omega-3 fatty acids by adding flaxseed and fatty fish.
The participants completed twice daily surveys about their mood, pain, and other symptoms on smartphones.
Those who followed the experimental diet showed improved mood variability.

A study in the journal Bipolar Disorders suggests that individuals with bipolar disorder who adjust their intake of specific fatty acids may experience less variability in their moods.

Nearly 3% of people in the United States have a diagnosis of bipolar disorder, according to the National Alliance on Mental Illness . People with this condition may experience dramatic shifts in their moods, energy levels, and sleep patterns. These shifts in mood may include manic or hypomanic episodes , during which the person feels extreme elation or irritability. During episodes of bipolar depression , they may experience feelings of sadness and hopelessness.

Several studies have suggested that there may be a relationship between the consumption of seafood rich in omega-3 fatty acids and a lower prevalence of bipolar disorders. However, studies looking at the effects of fish oil supplements on the condition have found no such link.

Dr. Erika Saunders , an author of the study and professor and chair of the Department of Psychiatry and Behavioral Health at Penn State Health Milton S. Hershey Medical Center , explained the design of the study to Medical News Today. She said that the researchers wanted to see whether making a dietary change “for a very specific biological reason could alter mood stability or improve mood variability” in people with bipolar disorder.

Using diet to improve mood

ResearchTrusted Source has shown that medications that doctors commonly use for treating bipolar disorder can change how the body breaks down fatty acids.

The Penn State College of Medicine researchers hypothesized that by changing the type and number of fatty acids in the diet, the body would generate metabolites with specific purposes, such as reducing inflammation or pain.

Specifically, they wanted to look at whether lowering an individual’s intake of linoleic acid — an omega-6 fatty acid — while increasing their intake of the dietary omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) might be an effective treatment approach for bipolar disorder.

“So, medications change fatty acids in a particular way,” Dr. Saunders told MNT. “We said, ‘Great, we can add to that by changing the diet in the same way, biochemically speaking, and let’s see if that helps.'”

The researchers assigned 82 participants with bipolar disorder to one of two groups: control or experimental.

Those in the experimental group decreased their linoleic acid consumption by limiting red meat, eggs, and certain oils. They also increased their omega-3 fatty acid consumption by adding flaxseed and fatty fish, such as tuna and salmon, to their diet. The researchers also specified the diet for the control group so that the participants did not know to which group they belonged.

All participants received foods, specific meal plans, and instructions on preparation for 12 weeks. The team instructed them to follow the diet while continuing with their normal care, including taking any prescribed mood-stabilizing medications.

The researchers gave the participants smartphones and asked them to use the devices to complete twice daily surveys about their mood, pain, and other symptoms. Additionally, technicians regularly took blood samples to measure the participants’ fatty acid levels and ensure that they had stuck with the diet enough to alter their biochemical levels.

Ultimately, the researchers found that the experimental diet improved mood variability in people with bipolar disorders.

Reflecting bipolar disorder demographics

The study authors note that the majority of the participants were female. “We know that women are more inclined to participate in research than men,” Dr. Saunders told MNT.

Dr. Gabrielle Marzani , a psychiatrist and associate professor in the Department of Psychiatry and Neurobehavioral Sciences at the University of Virginia in Charlottesville, also noted that the majority of the participants in the study were white. “This group tended to be a pretty homogeneous group of women that doesn’t necessarily reflect the demographics of all individuals with bipolar disorder,” she told MNT.

Dr. Marzani was not involved in the study, but she deemed the research “intriguing.”

Additionally, Dr. Marzani pointed out that the participants in the study may not all have experienced the same severity of symptoms of bipolar disorder. For instance, among the participants in the study’s intervention group, the median number of lifetime depressive episodes was 30. In the control group, the median number was 11.

Similarly, while the median number of manic episodes was five among the participants in the study’s intervention group, in the control group, it was double that. “It wasn’t apples and apples,” Marzani told MNT.

More work necessary

In the paper, the researchers note that they want to see the trial replicated on a larger scale. Dr. Saunders also told MNT that an avenue for future research might involve looking at ways to make following this diet easier.

“While not everyone with bipolar disorder will want to change their diet or be able to change their diet,” Dr. Saunders said, “I think that it’s really important to have the scientific knowledge about what would be beneficial for those who do want to change their diet and who can.”

This article originally posted at Medical News Today .

Written by Beth JoJack

Coping with Seasonal Affective Disorder During Another Pandemic Winter

Fri, 14 Jan 2022 19:00:03 GMT

Colder and darker days mean many Americans are beginning to feel the effects of seasonal affective disorder, or SAD.
As we head into another pandemic winter, SAD can make it more difficult to manage COVID-19 anxiety.
Several coping mechanisms can help ease symptoms of both seasonal affective disorder and COVID-19 anxiety.

As the days get darker and temperatures dip in most areas of the country, many Americans are beginning to feel the effects of seasonal affective disorder, or SAD.

SAD is a type of depression that typically comes on in the fall and winter months. It leads to mood changes and other symptoms of depression.

“It’s an annual decrease in mood and can lead to feeling lethargic, difficulty sleeping, poor appetite, and weight loss” explained Adam Borland , PsyD, a psychologist at the Cleveland Clinic. “Some people experience agitation and anxiety, and it really stems from the change in weather, the lack of sunlight, and the cold dreariness in certain areas of the country.”

SAD is quite common. The National Institute of Mental HealthTrusted Source reports millions of Americans have SAD, though many might not know they have it.

SAD and COVID-19: “A recipe for depressive episodes and heightened anxiety”

Experts say, as we approach another pandemic winter, seasonal affective disorder is once again being compounded by COVID-19 anxiety for many Americans.

“If we’re already feeling down, then we add to it the prospect of another winter in which [COVID-19] is still an issue, that’s a recipe for depressive episodes and for heightened anxiety and panic,” Borland said.

Most Americans are still reeling from the events of the past year and a half. The staggering death toll of more than 773,000 people has left countless grieving families in its wake.

There’s also the lasting effects of social isolation, financial upheaval, and the collective stress of being on edge for so long.

And while the United States is in a much better position than last winter with the COVID-19 vaccine and current rollout of booster shots, the uncertainty of where the pandemic is heading can make the mental anguish seem never-ending.

“Especially with the ambiguity of where we are now as a society, it can be hard to know where we have to continue to be cautious as compared to where we can be more at ease than we were last winter,” said Jessica Stern , PhD, a clinical psychologist at the Steven A. Cohen Military Family Clinic at NYU Langone Health.

In a vicious cycle, SAD can make it even more difficult to cope with COVID-19 anxiety.

“Seasonal affective disorder can lead to a sluggishness or lowness that can even further decrease motivation to engage in healthy habits, like eating healthy, staying active, and managing stress,” Stern said.

Tips for managing SAD and COVID-19 anxiety

If you’re feeling the double whammy of seasonal affective disorder and pandemic anxiety, experts recommend the following coping mechanisms that can help ease symptoms of both.

Maintain a routine

Having some semblance of a daily routine is very important, especially when things seem overwhelming, Borland said.

“What I mean by that is having small, achievable goals to work toward each day,” he explained. “So for someone who, as soon as they open their eyes in the morning, they start to feel overwhelmed by all the demands on them, identifying those small goals and crossing them off their list can make a big difference.”

These goals can be as simple as taking 10 minutes out of every morning for deep breathing and stretching.

“That’s not a huge goal, but it’s something to cross off the list,” Borland explained. “So you attended to yourself for 10 minutes, and now you’re a bit more charged to start the day.”

Try light therapy

Phototherapy, or light therapy, is a recommended treatment for seasonal affective disorder. It involves sitting or working near a light therapy box, which mimics natural outdoor light.

Borland encourages his patients get a little creative with it.

“I have one patient who uses their light therapy and combines it with listening to some relaxing music, and they visualize that they’re at the beach,” he said.

Get moving

StudiesTrusted Source show that physical activity can improve mental health and overall well-being.

“As I tell my patients, exercise doesn’t have to mean going to the gym or taking a fitness class,” Borland said. “It’s really just any type of physical activity that you can get, [like] taking a walk, doing some exercise at home, using a quick YouTube workout video — those all count.”

Find your community

“Surround yourself (in-person or virtually) by people who support you, inspire you, or are just fun to talk to,” Stern said.

If you’re feeling stressed or overwhelmed, lean on that social support system to help you get through tough times.

“Probably one of the most important coping tools is not keeping things bottled up, but sharing with your loved ones how you’re feeling,” Borland said.

Practice mindfulness meditation

A proven way to help ease symptoms of depression and anxiety, mindfulness meditation encourages people to slow down their thoughts and breathe deeply.

“What that does is really help us focus on the present moment,” Borland explained. “We are so good at thinking about the past and worrying about the future, that we often miss the present moments.”

If you have trouble controlling your thoughts and getting into a meditation practice, Borland recommended starting with small goals.

“The expectation is not that you turn your brain off, but I like to think of it in terms of volume,” he said. “So if you feel like your brain is at a nine or a 10, in terms of volume… the expectation is that doing some deep breathing is just going to turn it down a little.”

“The expectation is not that you’re going to go from a nine to a one. And if that’s the expectation, that’s where people get frustrated,” he added.

Create a tangible bucket list

Having plans for enjoyable activities can help ease day-to-day stresses.

While COVID-19 has limited options over the last year and a half — whether that’s because of fears of becoming sick or financial strain — even making small plans can be helpful.

“Plan fun activities for yourself, regardless of how small they may seem to you,” Stern suggested. “This could include doing a wine tasting from home, creating a weekly movie and dinner night, or building a fort in your living room.”

Lean into nostalgia

There’s a reason it feels so good to rewatch your favorite sitcoms or revisit beloved holiday movies each year.

“Movies, TV shows, stand-up comedy segments that you know and love can bring a sense of comfort and familiarity,” Stern said. “Have a few of your favorites on standby — whether that means holiday classics that you love or a TV series you can binge.”

You can even pair it with your favorite recipe or takeout food and amp up the nostalgia, she suggested.

Seek professional help

Finally, many people with seasonal affective disorder and anxiety find great benefit in seeing a mental health professional.

“If someone feels as though their daily functioning is really being affected by mood by anxiety or panic, they may want to take steps to seek professional help,” Borland said.

This article originally posted at Healthline .

Written by Ashley Welch

Why Some Stressors Make Us More Resilient

Tue, 04 Jan 2022 18:49:17 GMT

Exercise induces "hormetic" adaptive responses that boost antioxidant defenses.

"Hormesis" describes the favorable adaptive response to something that would otherwise be a harmful stressor.
Exercise facilitates hormesis by increasing an enzyme called NOX4 in skeletal muscles; NOX4 boosts antioxidant defenses.
Exercise-induced reactive oxygen species (ROS) may drive hormetic adaptive responses that prevent oxidative damage.

When Kelly Clarkson belts out her interpretation of Nietzsche's famous aphorism in her 2012 smash hit, "Stronger (What Doesn't Kill You)," she's probably not thinking about the hormetic effect a grueling workout has on kickstarting adaptive responses that increase resilience via the expression of an enzyme called NOX4.

What Is Hormesis?

Hormesis is a dose-response phenomenon in which a potentially harmful substance can benefit a living organism.

New research in mice ( Xirouchaki et al., 2021 ) suggests that exercise triggers a favorable (hormetic) adaptive response to stressors that would otherwise be harmful. Because of hormesis, when it comes to exercise, in many ways, "what doesn't kill you" does, in fact, "make you stronger."

Accumulating evidence suggests that the induction of mitochondrial biogenesis, which enhances respiratory capacity and boosts endurance, is a vital hormetic response to exercise. The latest findings on how exercise-induced NOX4 is required for hormetic adaptive responses were published on December 15 in the peer-reviewed journal Science Advances.

"Reactive oxygen species (ROS) generated during exercise are considered integral for the health-promoting effects of exercise," the authors explain in their paper's abstract. "Here, we demonstrate that skeletal muscle NADPH oxidase 4 (NOX4), which is induced after exercise, facilitates ROS-mediated adaptive responses that promote muscle function, maintain redox balance, and prevent the development of insulin resistance."

Hormesis in Action: NOX4 Transforms Potentially Harmful ROS Into Something Beneficial

Theoretically, without skeletal muscle NOX4, exercise could be toxic. In mice treated with a substance that blocked NOX4, the researchers found that aerobic exercise increased oxidative stress . According to the researchers, this demonstrates that NOX4 is "essential for promoting antioxidant defense and mitochondrial biogenesis, preventing mitochondrial oxidative stress , and maintaining insulin sensitivity."

Xirouchaki et al. also report that skeletal muscle NOX4 tends to decrease with age and obesity; these factors can lead to the development of insulin resistance. "Our findings demonstrate that skeletal muscle NOX4 is of fundamental importance in exercise-induced hormetic responses that promote muscle function and metabolic health," the authors explain.

When NOX4 is depleted, aging and obesity can increase "harmful" mitochondrial ROS production that causes oxidative stress. However, exercise-induced ROS is hormetic; it triggers a "helpful" adaptive response that prevents oxidative damage. NOX4 is essential for this antioxidant defense response.

Exercise-Induced Mitochondrial ROS Boosts Antioxidant Defenses. But How Much Exercise Is Too Much or Not Enough?

"Triggering the activation of the adaptive mechanisms orchestrated by NOX4 with drugs might ameliorate key aspects of aging, including the development of insulin resistance and type 2 diabetes," senior author Tony Tiganis of the Department of Biochemistry and Molecular Biology at Australia's Monash University said in a news release .

Human studies are needed to see if the adaptive mechanisms triggered by exercise have the same effect on NOX4 production in people as Tiganis and colleagues observed in mice. Future research should also identify the ideal "dose" (duration/intensity/frequency) of cardio and/or strength training workouts needed to activate an optimal hormetic response.

In terms of hormesis and optimizing the exercise-induced generation of ROS by skeletal muscle NOX4, there's probably a sweet spot between doing too much or too little physical activity throughout the week. But we need more research to clearly define this Goldilocks zone.

Until we know the optimal dose-response for hormesis, doing 150–300 minutes of moderate-intensity cardio per week or 75–150 minutes of vigorous-intensity aerobic exercise plus two strength-building workouts per week has been shown to have innumerable benefits. (See " New Physical Activity Guidelines Based on Decade of Research .")

This article originally posted at Psychology Today .

Christopher Bergland is a retired ultra-endurance athlete turned science writer, public health advocate, and promoter of cerebellum ("little brain") optimization.

Daylight Saving Time is Doing Far More Harm than Good, According to Sleep Scientists

Fri, 31 Dec 2021 17:44:38 GMT

Twice a year, every year, Americans dutifully change the clocks throughout their homes, cars and offices in service of daylight saving time. But if losing an hour of sleep or suddenly being expected to stay up an hour after your normal bedtime is disrupting your routine, you're not alone.

According to James Wyatt, Ph.D., clinical sleep disorder specialist at Rush University Medical Center, daylight saving time isn't just a mild inconvenience—it's dangerous.

In fact, researchers have found that the risk of stroke , heart attacks and traffic accidents all increase in the days following the switch to daylight saving time (moving an hour forward in the spring).

"Among the sleep science community, there is no controversy: The consensus is that we should eliminate daylight saving time and stick with standard time permanently," Wyatt says.

Dangerous time

How does shifting around an hour of our day a couple times a year presents a danger to Americans?

According to the American Academy of Sleep Medicine, the change from standard to daylight saving time is associated with an increased risk in the following areas:

Heart attack
Stroke
Hospital admissions and emergency room visits
Missed medical appointments
Sleep disruption
Mood disturbances
Suicide
Traffic accidents
Work absences
Stock market volatility
Poor athletic performance

Wyatt says all of these issues are a result of time changes tampering with the natural circadian rhythms of our bodies. These functions help our brain signal that it's time to go to sleep, but they also control countless other organ systems throughout the human body.

"We have clocks throughout the body," he explains. "A special region in the hypothalamus regulates our circadian rhythms and acts as the master pacemaker, telling us "Here's daytime, so do this, now it's nighttime do that." Our organ systems have to change their function depending on what time of day it is.

"Our gut digests more at night and less during the day, urine production reduces in the evening so we can sleep through the night more easily, our temperature is higher during the day than at night, and all of this is regulated by our circadian rhythm."

When those rhythms get interrupted—such as when we travel across time zones , work rotating shifts and twice a year when the clocks move forward and back—our bodies have a stress response.

According to an American Academy of Sleep Medicine survey, more than half of respondents said they felt extremely or somewhat tired after the shift to daylight saving time in the spring.

"Many people plan to go to bed an hour early when the clocks change, but they rarely do," Wyatt says. "That means you've just lost an hour of sleep and your circadian rhythms are misaligned, which explains why we see an increase in accidents after daylight saving time begins."

Easing into time changes

While the academy and more than a dozen other organizations have adopted the position that public health and safety would benefit from the elimination of daylight saving time, there's no way to know when or if this will come about.

In the meantime, there are ways to maintain your sleep hygiene and health to help you spring forward and fall back more easily.

According to Wyatt, easing into daylight saving time in the spring is just a matter of planning a few days in advance.

"The simplest way to manage the springtime shift is to go to bed and get up 30 minutes early on the Friday immediately before the time change," he says. "Then, shift it 30 minutes earlier for the following night. By Sunday's time shift, you'll be back onto your regular schedule without suddenly losing an hour of sleep."

Simply breaking up a one-hour time shift into two 30-minute shifts goes a long way to allowing your body to adjust to the new schedule while reducing strain on your circadian clock, and helping you enjoy your extra hour of evening daylight.

Fortunately, the fall time change tends to have less of a negative impact on most of the population. Wyatt suggests that going to bed at the same time as you normally would the night before the time shift will give you an extra hour of sleep that most of us can use.

The History of Daylight Saving Time

Considering most of the U.S. observes daylight saving time, the history of the practice is rather murky. Many pin it on the vague concept of farming: Farmers needed the time shift so they could spend more time in their fields.

Some credit Ben Franklin with inventing it in the 18th century. And while the founding father can count time zones among his many innovations, daylight saving time is not one of them.

In reality, daylight saving time started in Germany during World War I as a means to conserve energy, and the U.S. followed suit shortly after. In 1966, the Uniform Time Act codified the rules on a federal level.

Still, states have always been able to opt in or out of the practice, and the dates that daylight saving time begins and ends have shifted over the years, all of which has added to the confusion about precisely why we observe it.

Various studies have shown that the time shift does very little to conserve energy and, in fact, has proven to be harmful.

This article originally posted at Medical Xpress .

Provided by Rush University Medical Center

Computer-, Smartphone-Based Treatments Effective at Reducing Symptoms of Depression

Fri, 17 Dec 2021 17:34:05 GMT

Computer- and smartphone-based treatments appear to be effective in reducing symptoms of depression, and while it remains unclear whether they are as effective as face-to-face psychotherapy , they offer a promising alternative to address the growing mental health needs spawned by the COVID-19 pandemic, according to research published by the American Psychological Association.

"The year 2020 marked 30 years since the first paper was published on a digital intervention for the treatment of depression. It also marked an unparalleled inflection point in the worldwide conversion of mental health services from face-to-face delivery to remote, digital solutions in response to the COVID-19 pandemic," said lead author Isaac Moshe, MA, a doctoral candidate at the University of Helsinki. "Given the accelerated adoption of digital interventions, it is both timely and important to ask to what extent digital interventions are effective in the treatment of depression, whether they may provide viable alternatives to face-to-face psychotherapy beyond the lab and what are the key factors that moderate outcomes."

The research was published in the journal Psychological Bulletin.

Digital interventions typically require patients to log in to a software program, website or app to read, watch, listen to and interact with content structured as a series of modules or lessons. Individuals often receive homework assignments relating to the modules and regularly complete digitally administered questionnaires relevant to their presenting problems. This allows clinicians to monitor patients' progress and outcomes in cases where digital interventions include human support. Digital interventions are not the same as teletherapy, which has gotten much attention during the pandemic, according to Moshe. Teletherapy uses videoconferencing or telephone services to facilitate one-on-one psychotherapy .

"Digital interventions have been proposed as a way of meeting the unmet demand for psychological treatment," Moshe said. "As digital interventions are being increasingly adopted within both private and public health care systems, we set out to understand whether these

treatments are as effective as traditional face-to-face therapy, to what extent human support has an impact on outcomes and whether the benefits found in lab settings transfer to real-world settings."

Researchers conducted a meta-analysis of 83 studies testing digital applications for treating depression, dating as far back as 1990 and involving more than 15,000 participants in total, 80% adults and 69.5% women. All of the studies were randomized controlled trials comparing a digital intervention treatment to either an inactive control (e.g., waitlist control or no treatment at all) or an active comparison condition (e.g., treatment as usual or face-to-face psychotherapy ) and primarily focused on individuals with mild to moderate depression symptoms.

Overall, researchers found that digital interventions improved depression symptoms over control conditions, but the effect was not as strong as that found in a similar meta-analysis of face-to-face psychotherapy . There were not enough studies in the current meta-analysis to directly compare digital interventions to face-to-face psychotherapy , and researchers found no studies comparing digital strategies with drug therapy.

The digital treatments that involved a human component, whether in the form of feedback on assignments or technical assistance, were the most effective in reducing depression symptoms. This may be partially explained by the fact that a human component increased the likelihood that participants would complete the full intervention, and compliance with therapy is linked to better outcomes, according to Moshe.

One finding that concerned Moshe was that only about half of participants actually completed the full treatment. That number was even lower (25%) in studies conducted in real-world health care settings compared with controlled laboratory experiments. This may help explain why treatments tested in real-world settings were less effective than those tested in laboratories.

"The COVID-19 pandemic has had a major impact on mental health across the globe. Depression is predicted to be the leading cause of lost life years due to illness by 2030. At the same time, less than 1 in 5 people receive appropriate treatment, and less than 1 in 27 in low-income settings. A major reason for this is the lack of trained health care providers," he said. "Overall, our findings from effectiveness studies suggest that digital interventions may have a valuable role to play as part of the treatment offering in routine care, especially when accompanied by some sort of human guidance."

This article originally posted at Science Daily .

Materials provided by American Psychological Association . Note: Content may be edited for style and length.

Schizophrenia Gene: Genetic Insights into Schizophrenia and Bipolar Disorder—Unlocking the Mysteries of the Dark Genome

Fri, 10 Dec 2021 17:15:08 GMT

Overview: Breakthroughs in Psychiatric Genetics and Autism Spectrum Disorder

This article delves into groundbreaking genetic research uncovering new regions of the human genome that may hold the key to better understanding and treating schizophrenia and bipolar disorder. Designed for a broad audience, it highlights how recent discoveries beyond traditional genes could pave the way for innovative diagnostics and therapies. These insights bring hope for addressing the complexities of these serious mental health conditions.

Schizophrenia is not linked to a single gene but is influenced by a complex mosaic of genetic factors. The term "schizophrenia gene" refers collectively to multiple genetic variations that together elevate the risk of developing the disorder.

Understanding Schizophrenia's Genetic Complexity and Rare Genetic Variants

High Heritability: Approximately 80% of the risk of schizophrenia is attributed to genetic influences, and studies of identical twins show that even people with the same genes are not guaranteed to have the same outcome.
Polygenic Nature: Schizophrenia is not linked to a single gene; instead, its genetic architecture reflects many common genetic variants alongside environmental factors rather than one candidate gene alone.
Common vs. Rare Variants: The general population has about a 1% chance of developing schizophrenia, but a family history raises the risk of schizophrenia, showing that genes confer substantial risk while rare mutations can also meaningfully affect susceptibility.

Exploring the "Dark Genome" with Genome Wide Association Studies

Researchers have turned their attention to the "dark genome"—sections of DNA historically overlooked because they do not fall within traditionally defined genes. In psychiatric research involving human subjects, this shift has supported broader genetic associations beyond candidate studies, including work from the psychiatric genomics consortium and the schizophrenia working group, where robust GWAS findings depend on a strict significance threshold and statistically significant genome wide significant SNPs. This exploration has revealed newly evolved protein-coding regions associated with schizophrenia and bipolar disorder, and previous research has increasingly moved toward broader genomic findings on schizophrenia’s genetic architecture.

These novel proteins may serve as biomarkers, helping differentiate between schizophrenia and bipolar disorder, and identify individuals at higher risk for psychosis or suicidal behavior. In case-control studies comparing schizophrenia patients with healthy controls, some markers are reported as differentially expressed, while pathway analysis, meta analysis, and systematic review approaches can add biological insights and help connect specific genes and findings such as those reported by Zhang et al. Exome sequencing has also helped identify common genetic variants, rare coding variants, and de novo mutations linked to schizophrenia diagnosis.

Schizophrenia and bipolar disorder are complex and debilitating illnesses that often present diagnostic challenges. Despite their strong heritable components, few genetic clues have emerged from known gene regions. High heritability is clear, but it is not deterministic: identical twins have about a 50% chance of both being affected, while non-identical twins show about a 12.5% chance if one is affected. Schizophrenia typically manifests in late adolescence or early adulthood, although it can rarely appear earlier, with early onset and onset age remaining relevant in adolescent psychiatry because some cases are recognized at a younger age, and timely evaluation often begins with reaching out to a psychiatric practice.

Implications of Environmental Factors for Clinical Practice

Scientists propose that these newly discovered genomic hotspots evolved due to their beneficial roles in human brain development. However, when disrupted by environmental influences and gene-environment interactions, they may increase susceptibility to schizophrenia or bipolar disorder, making comprehensive psychiatric evaluations by experienced psychiatric mental health nurse practitioners an important part of care.

The findings, published in Molecular Psychiatry, open new avenues for drug development targeting these previously unexplored proteins, and psychiatric research often compares schizophrenia patients with healthy controls in human subjects to identify differentially expressed signals.

"Our genome-wide scan revealed protein-coding regions outside conventional genes linked to schizophrenia and bipolar disorder," said Dr. Sudhakaran Prabakaran, senior author and former University of Cambridge geneticist. "This discovery offers promising new targets for therapeutic intervention."

These genomic elements appear unique to humans and may overlap with genetic risk factors for other neurodevelopmental conditions like autism spectrum disorder. Their rapid evolution alongside human cognitive development may explain their vulnerability to disruption, and lifestyle factors such as exercise to support mental health and overall wellness are increasingly studied alongside genetic risk.

"The classical definition of a gene is too narrow," stated Chaitanya Erady, lead researcher. "Our work shows that much of the genome can produce proteins involved in critical biological processes, some of which malfunction in psychiatric disorders."

Most current medications target proteins encoded by known genes. This research expands the landscape of potential targets, shedding light on the hereditary nature of these disorders and highlighting the role of both common and rare genetic variants, while also pointing toward innovative neuromodulation options such as non-invasive TMS treatments for mood and anxiety disorders . Large collaborations such as the Psychiatric Genomics Consortium and its Schizophrenia Working Group have strengthened genetic associations and biological insights beyond older candidate-gene approaches.

Schizophrenia is characterized by symptoms such as hallucinations, delusions, and disorganized thinking, while bipolar disorder involves mood swings from mania to depression, sometimes accompanied by psychosis. The overlap in symptoms can complicate diagnosis, and systematic review, meta analysis, and pathway analysis are often used to compare findings across studies. Schizophrenia typically manifests at an onset age of about 21-25 in males and 25-30 in females, though rare early onset cases can appear at a younger age, and clinicians frequently screen for co-occurring conditions such as ADHD requiring specialized assessment and treatment.

Looking Ahead

Dr. Prabakaran has founded NonExomics to translate these discoveries into clinical applications, supported by the University of Cambridge's commercialization arm, Cambridge Enterprise. His team has identified nearly 250,000 novel DNA regions outside traditional genes that code for proteins disrupted in mental illness. As newer approaches such as exome sequencing are paired with studies of rare coding variants, they may also help clarify specific genes and broader genomic findings, yielding biological insights into schizophrenia risk, which clinicians like Scott Ispirescu, who integrates clinical research with patient care , can translate into more personalized treatment.

Frequently Asked Questions About Schizophrenia Gene

Experimental Depression Treatment is Nearly 80% Effective in Controlled Study

Fri, 05 Nov 2021 15:19:30 GMT

In a double-blind controlled study, high doses of magnetic brain stimulation, given on an accelerated timeline and individually targeted, caused remission in 79% of trial participants with severe depression.

A new type of magnetic brain stimulation brought rapid remission to almost 80% of participants with severe depression in a study conducted at the Stanford University School of Medicine .

The treatment, known as Stanford accelerated intelligent neuromodulation therapy (SAINT) or simply Stanford neuromodulation therapy, is an intensive, individualized form of transcranial magnetic stimulation . In the study, remission typically occurred within days and lasted months. The only side effects were temporary fatigue and headaches.

“It works well, it works quickly and it’s noninvasive,” said Nolan Williams , MD, an assistant professor of psychiatry and behavioral sciences. “It could be a game changer.” Williams is the senior author of the study, which was published Oct. 29 in the American Journal of Psychiatry.

Twenty-nine people with treatment-resistant depression participated in the study: About half received SAINT, and the rest underwent a placebo procedure that mimicked the real treatment. After five days of treatment, 78.6% of the participants in the treatment group were no longer depressed, according to several standard methods of evaluation. “It’s quite a dramatic effect, and it’s quite sustained,” said Alan Schatzberg , MD, the Kenneth T. Norris, Jr. Professor in Psychiatry and Behavioral Sciences, who was a co-author of the study.

A lifetime of depression

Tommy Van Brocklin, 60, has suffered from depression since he was 15. “In 1975, they didn’t have the medication and understanding they do now,” he said. “I was told I wasn’t trying hard enough.”

“I’ve functioned all these years, but it’s been very difficult at times,” the civil engineer added. Talk therapy helped “for about half a day after an appointment.” When selective serotonin reuptake inhibitors became available in the 1990s, he started on paroxetine, commonly sold under the brand name Paxil.

“It worked like a miracle drug,” he said, but after 10 or 15 years it started to lose its effect. After 25 years, it stopped working entirely. He tried other medications, but none helped; one even made him suicidal.

His sister, who lives near Stanford, connected him with the researchers studying SAINT. He flew from his home in Memphis, Tennessee, and underwent the treatment in September. He felt nothing the first day; on day two, he began feeling emotional — “I felt the struggle of what I’d been through all these years.”

“The next day, all of a sudden, it broke through,” he said. “I felt so much better, and it’s stuck with me.”

Specialized magnetic stimulation

The transcranial magnetic stimulation treatment currently approved by the Food and Drug Administration requires six weeks of once-daily sessions. Only about half of patients who undergo the treatment improve, and only about a third experience remission from depression.

SAINT advances that treatment by targeting the magnetic pulses according to each patient’s neurocircuitry and providing a greater number of pulses at a faster pace.

In the study, the researchers first used MRI to locate the best location to target within each participant’s dorsolateral prefrontal cortex, which regulates executive functions, such as problem solving and inhibiting unwanted responses. They applied the stimulation in a subregion that has the strongest relationship with the subgenual cingulate, a part of the brain that is overactive in people experiencing depression. The transcranial magnetic stimulation strengthens the connection between the two regions, facilitating dorsolateral prefrontal cortex control of the activity in the subgenual cingulate.

The researchers also used 1,800 pulses per session instead of 600. (The larger amount has been used safely in other forms of brain stimulation for neurological disorders such as Parkinson’s disease.) And instead of providing one treatment a day, they gave participants 10 10-minute treatments, with 50-minute breaks in between.

For the control group, the researchers disguised the treatment with a magnetic coil that mimicked the experience of the magnetic pulse; both the control and active treatment groups wore noise-canceling earphones and received a topical ointment to dull sensation. Neither the researcher administering the procedure nor the participant knew whether the participant was receiving real treatment.

A hard-to-treat group

The trial participants ranged in age from 22 to 80; on average, they had suffered depression for nine years. They had tried medications, but either they had had no effect or they had stopped working. During the trial, participants who were on medication maintained their regular dosage; participants who weren’t taking medications did not start any.

Within four weeks after treatment, 12 of the 14 participants who had received the treatment improved, and 11 of them met FDA criteria for remission. In contrast, only two of the 15 participants who had received the placebo met the criteria for remission.

Because the study participants typically felt better within days of starting SAINT, the researchers are hoping it can be used to quickly treat patients who are at a crisis point. Patients who start taking medication for depression typically don’t experience any reduction of symptoms for a month.

“We want to get this into emergency departments and psychiatric wards where we can treat people who are in a psychiatric emergency,” Williams said. “The period right after hospitalization is when there’s the highest risk of suicide.”

Van Brocklin said that since he returned home following treatment, he’s made some radical changes. “I have a really strong desire to get my life together,” he said.

“I don’t procrastinate anymore,” he added. “I’m sleeping better. I completely quit alcohol. I’m walking my dog and playing the guitar again, for nothing more than the sheer joy of it.”

Most importantly, he said, “I’m remaining positive and being respectful of others. These are big changes in my life.”

Other Stanford scientists who contributed to the study are former postdoctoral scholars Eleanor Cole, PhD, and Angela Phillips, PhD; Brandon Bentzley, MD, PhD, David Carreon, MD, Jennifer Keller, PhD, Kristin Raj, MD, and Flint Espil, PhD, all clinical assistant professors of psychiatry and behavioral sciences; clinical research coordinators Katy Stimpson, Romina Nejad, Clive Veerapal, Nicole Odenwald and Maureen Chang; former clinical research coordinators Fahim Barmak, MD, Naushaba Khan and Rachel Rapier; postdoctoral scholars Kirsten Cherian, PhD, James Bishop, PhD, Azeezat Azeez, PhD, and John Coetzee, PhD; life science research professional Heather Pankow; clinical research manager Jessica Hawkins; Charles DeBattista, MD, professor of psychiatry and behavioral sciences; and Booil Jo, PhD, associate professor of psychiatry and behavioral sciences.

Scientists from the U.S. Department of Veterans Affairs; Palo Alto University; the Centre for Neuroimaging and Cognitive Genomics at the National University of Ireland; and the School of Medicine at Southern Illinois University, Carbondale, contributed to the research.

The research was funded by a Brain and Behavior Research Foundation Young Investigator Award, Charles R. Schwab, the David and Amanda Chao Fund II, the Amy Roth PhD Fund, the Neuromodulation Research Fund, the Lehman Family, the Still Charitable Trust, the Marshall and Dee Ann Payne Fund, and the Gordie Brookstone Fund.

This article originally posted at www.stanford.edu

Stanford’s Department of Psychiatry and Behavioral Sciences also contributed to the work.

Mandy Erickson Mandy Erickson is associate editor in the Office of Communications. Email her at merickso@stanford.edu.

Working out boosts brain health

Fri, 22 Oct 2021 18:00:02 GMT

It’s no secret that regular exercise promotes health throughout the body. Research shows routine physical activity can improve cardiovascular health , strengthen bones and muscles , and even reduce the risk of certain cancers . But did you know breaking a sweat can also strengthen the brain?

A growing body of research suggests physical fitness is one way to boost brain health — and that a regular exercise routine can decrease the effects of stress on the body, improve mental health and mood, and even enhance memory and cognition.

Exercise fuels the brain's stress buffers

Exposure to long-term stress can be toxic to multiple systems in the body, even leading to medical concerns like high blood pressure and a weakened immune system, along with mental illnesses like anxiety and depression.

It may seem counterintuitive that exercise, a form of physical stress, can help the body manage general stress levels. But the right kind of stress can actually make the body more resilient. Research shows that while exercise initially spikes the stress response in the body, people experience lower levels of stress hormones like cortisol and epinephrine after bouts of physical activity.

So far, there's little evidence for the popular theory that exercise causes a rush of endorphins. Rather, one line of research points to the less familiar neuromodulator norepinephrine, which may help the brain deal with stress more efficiently. Research in animals since the late 1980s has found that exercise increases brain concentrations of norepinephrine in brain regions involved in the body's stress response.

Norepinephrine is particularly interesting to researchers because 50% of the brain's supply is produced in the locus coeruleus, a brain area that connects most of the brain regions involved in emotional and stress responses. The chemical is thought to play a major role in modulating the action of other, more prevalent neurotransmitters that play a direct role in the stress response.

Biologically, exercise seems to give the body a chance to practice dealing with stress. It forces the body's physiological systems — all of which are involved in the stress response — to communicate much more closely than usual: The cardiovascular system communicates with the renal system, which communicates with the muscular system. And all of these are controlled by the central and sympathetic nervous systems, which also must communicate with each other. This workout of the body's communication system may be the true value of exercise; the more sedentary we get, the less efficient our bodies are in responding to stress.

Exercise can boost mental health

Along with mitigating the negative effects of chronic stress on the mind and body, habitual exercise can improve mental health. Many experts believe routine exercise is as powerful in treating anxiety and mood disorders as antidepressants.

Preliminary evidence suggests that physically active people have lower rates of anxiety and depression than sedentary people. But little work has focused on why that is. To determine how exercise might bring about its mental health benefits, some researchers are looking at possible links between exercise and brain chemicals associated with stress, anxiety and depression. One theory is that physical activity triggers a release of dopamine and serotonin, which can improve mood.

But there are other reasons exercise plays a crucial role in mental well-being.

For example, exercise can be particularly helpful for people who deal with anxiety and panic attacks. When you engage in strenuous physical activity, you're essentially mimicking the responses that can come with anxiety, allowing you to learn how to manage these responses and not be overwhelmed by them in other situations.

Psychologists also recommend exercise to their patients because it leads to a sense of accomplishment. Getting dressed and driving to the gym first thing in the morning may not be so fun in the moment, but prioritizing self-care practices like exercise can result in a cascade effect of other healthy habits, like eating nutritiously, socializing with others and getting a good night's sleep — all of which can improve depression symptoms.

For even more impact on your mental health, combine your exercise routine with other evidence-based practices, like mindfulness meditation — or, reap the benefits of some good, old-fashioned fresh air and sunshine by taking a walk outdoors.

Exercise can build the mind's muscles

Have you ever noticed that while your body might feel a bit fatigued, you feel more alert and energized after a bout of exercise? It's been proven that physical activity can improve brain functions like memory and cognition both immediately after a workout and in the long-term.

In research with rodents (rats and mice), there's evidence that exercise increases the blood supply to their brains and promotes the growth of new neurons (adult neurogenesis) in the hippocampus, a brain area that is essential for learning and memory. In one study, one group of rats got free access to a running wheel and another ran on a treadmill for an hour a day. After 30 days, both groups had a better blood supply to their brains. A group of sedentary rats showed no increase. An increased blood supply means increased oxygen and energy supply, and that equals better performance. The improvement in performance can also be attributed, at least in part, to an exercise-induced increase in adult hippocampal neurogenesis.

Although these types of studies are only now beginning in humans, the theory is that because sports combine learning and exercise, they may both increase blood supply and enhance brain connections.

Recent studies suggest physical activity benefits white and gray matter in the brain, which leads to enhancement of cognitive processes like thinking and memory, attention span, and perception.

Movement can also improve cognitive regulation, or the ability to ignore distractions and multi-task. While there's not as extensive of research on middle-aged adults, researchers think the same benefits hold true across the board.

Exercise can sharpen memory

There's also scientific evidence that people who exercise experience improvements in episodic memory, which is our ability to bind how events, people and places come together in everyday life. Exercise can also benefit the brain's spatial navigation, or the ability to remember everyday life events, like where you parked your car.

Exercise can also help people maintain their cognitive abilities as they age. Many studies have found that physically active elderly people perform better than sedentary elderly people on cognitive tasks such as reasoning, vocabulary, memory and reaction time. It's known that regular exercise can prevent memory-related diseases like Alzheimer's. Exercise can increase the brain's ability to create new neurons in rodents, which can enable the brain to learn new information and improve memory. Whether adult hippocampal neurogenesis can be increased by exercise in humans remains to be determined, but there is a robust and growing body of research among school-aged children.

For people who have already been diagnosed with memory-related diseases, exercise is a commonly recommended intervention. Studies show that one year of activity interventions can increase the volume of the hippocampus — the part of the brain that deals with learning and memory — by one percent.

How much exercise do I need?

If your doctor gives you the go-ahead, there's no reason not to reap the physical and mental benefits of a regular exercise routine. But how much exercise is the right amount?

Official exercise recommendations have increased over the years. The Department of Health and Human Services Physical Activity Guidelines for Americans (PDF, 15MB) recommends 150 minutes or 2.5 hours of moderate aerobic activity a week, or 75 minutes of more vigorous activity.

If getting started with an exercise routine sounds overwhelming, keep in mind that starting anywhere is better than not starting at all. Not sure where to begin? Think outside of the box, and try not to worry too much. Research shows that all kinds of exercise can be an effective way to manage stress and stay mentally healthy. The important thing is that you find an activity you enjoy and stick with it.

For more information on exercise recommendations, including suggestions for age-specific activities, refer to the 2018 Physical Activity Guidelines for Americans Move Your Way Campaign .

This article re-published by APA

For their contributions to this article, APA thanks:

Rod K. Dishman, PhD, of the University of Georgia
Mark Sothmann, PhD, of Indiana University's School of Medicine and School of Allied Health Sciences
Henriette van Praag, PhD, of Florida Atlantic University's Charles E. Schmidt College of Medicine
Nancy Molitor, PhD, of Northwestern University's Feinberg School of Medicine
Elaine Ducharme, PhD
Anthony C. Hackney, PhD, DSc, of the University of North Carolina at Chapel Hill
Charles Hillman, PhD, of Northeastern University's Bouve College of Health Sciences

Best Supplements for ADHD: 6 Essential and Often-Overlooked Options

Fri, 15 Oct 2021 15:00:05 GMT

Introduction: Who Should Read This and Why It Matters

Are you a parent of a child with ADHD, an adult living with ADHD, or someone seeking alternatives or adjuncts to medication? This article is for you. Many people search for the best supplements for ADHD to help manage symptoms, whether as an addition to prescribed medication or as part of a holistic approach. Here, we clarify which supplements are supported by research, who may benefit, and what is not covered (herbal remedies with little evidence, unproven or unsafe products).

Why does this topic matter? Many families and adults are interested in natural ways to support focus, reduce impulsivity, and improve overall well-being. While medication and behavioral therapy are considered first line treatments and standard treatments for ADHD, adhd treatments vary by person, and supplements are often considered as adjunctive options. However, it’s crucial to understand that supplements should complement, not replace, ADHD medications. Natural supplements cannot replace prescription medications for ADHD but may support focus and other symptoms.

Scope: This article covers the best supplements for ADHD, focusing on omega-3 fatty acids, zinc, iron, and magnesium—nutrients that research suggests may improve ADHD symptoms. We also discuss multivitamins, protein, and select herbal options, but do not cover unproven or unsafe supplements.

Note: Most supplement research for ADHD focuses on children and adolescents, so recommendations may be most relevant for these groups, though some findings may apply to adults as well.

Key Supplements for ADHD and Their Benefits

Research indicates that the following supplements may help with ADHD symptoms:

Omega-3 fatty acids: May improve concentration and support brain function.
Zinc: May reduce impulsivity and hyperactivity.
Iron: May improve behavior and support dopamine synthesis.
Magnesium: May help with relaxation, sleep, and cognitive function.

Supplements should always be used under medical supervision and as part of a comprehensive ADHD treatment plan.

When to Go Beyond Food

Some ADHD professionals recommend eating a diet full of fruits and vegetables, complex carbs, and some lean protein with every meal to help manage symptoms. However, not everyone eats the right foods to achieve beneficial levels of certain nutrients. Because ADHD is a neurodevelopmental disorder, nutritional supplements may be considered when diet alone does not provide enough of certain nutrients, and some may help support core symptoms and executive function.

Omega-3 Fatty Acids for Brain Function

If you are looking for a single supplement to add to your diet, fish oil is a practical way to get omega-3 fatty acids. Aside from being good for heart health, recent studies have shown that omega-3 fatty acids improve symptoms of ADHD. However, current evidence, including a 2023 review, suggests the overall effect on ADHD symptoms is limited. A meta analysis of the research is mixed, but it often favors epa dominant formulas over DHA alone for ADHD. Many studies showed that omega-3’s are about 40 percent as effective as stimulants in relieving symptoms. Findings from randomized controlled trials and a systematic review generally show modest benefits, and effects usually take 8–12 weeks to appear. In practice, fish oil supplements usually provide EPA and docosahexaenoic acid, and higher-EPA fish oil supplements may be a better choice than DHA alone.

Next, let's look at zinc and its role in ADHD.

Zinc for Impulsivity

Some studies have shown that children with ADHD may have lower levels of zinc. Taking zinc supplements may reduce hyperactivity, impulsivity, and related emotional dysregulation, but not inattentiveness. Zinc may also enhance the effectiveness of stimulant medications in some patients. High levels of zinc, however, may be dangerous.

Have your doctor check zinc levels before taking any supplement. If you do add a zinc supplement, Dr. Newmark suggests that children with ADHD take 20 mg. daily.

Next, let's explore how iron may help with ADHD symptoms.

Iron for Better Behavior

Many experts believe that iron deficiencies may contribute to ADHD symptoms in children because iron is essential for dopamine synthesis. A 2008 study showed that children who were not anemic but had low ferritin levels, a protein needed to store iron in the blood, showed improvement of symptoms after 12 weeks of iron supplementation, as iron acts through tyrosine hydroxylase to help the body make dopamine.

Before taking any iron supplement, speak with your doctor about checking iron levels: High iron levels can be dangerous.

Next, let's discuss magnesium and its benefits for ADHD.

Magnesium for Relaxation and Sleep

Healthy levels of magnesium in the blood can help relax children with ADHD, and magnesium levels are often lower in people with ADHD, with deficiency appearing to be common. Some small studies have shown that adding magnesium supplements decreases some symptoms of ADHD. Magnesium helps regulate the nervous system and supports sleep, relaxation, and cognitive function – big challenges for children and adults with ADHD.

Next, let's see how vitamin C and protein can play a role in ADHD management.

Vitamin C for Dopamine

Vitamin C is important in modulating the neurotransmitter dopamine at the synapses in the brain, and vitamin d is also tied to dopamine synthesis and brain signaling; a meta-analysis found lower vitamin D levels in people with ADHD, and vitamin D receptors are widespread throughout the brain and linked to cognitive function. (ADHD stimulants are effective because they increase dopamine levels in the brain.) Hallowell recommends getting vitamin C from food, but if your child doesn’t eat a healthy diet, try a daily supplement.

One caution: Don’t take vitamin C less than an hour before or after taking ADHD meds. It prevents the med from being absorbed. Other supplements can also have medication interactions that affect absorption or timing.

Next, let's talk about protein and its importance for focus.

Protein for Focus

If your child doesn’t eat high-protein foods, which increase attentiveness and focus, or is a picky eater, give him a protein-powder drink in their place. You can mix it with his favorite juice or milk to help the protein go down easier. Look for brands that are low in sugar and free of artificial flavors and preservatives.

Now, let's cover how to ensure you are meeting your nutritional needs with multivitamins and how to choose the right supplement brand.

Multivitamins and Minerals

A daily multivitamin, containing the recommended daily allowance of vitamins and minerals, may include b vitamins along with key minerals to help cover mild nutritional gaps and, for some people with ADHD, modestly support executive dysfunction.

Choosing the Right Supplement Brand

Many multivitamin/multimineral products on the market contain sugar, preservatives, and artificial colors, which may increase hyperactivity in children. Look for brands that are low in sugar with no artificial colors or flavors.

Help for Sleep

Valerian for Sleep

There is limited evidence that supports using herbs in treating ADHD, and there is not enough evidence from clinical trials to support many herbal sleep or calming aids for ADHD. Another supplement sometimes discussed is l theanine, which may promote relaxation without causing drowsiness. The herb valerian can calm hyperactivity and may reduce anxiety, but it doesn’t improve concentration.

Valerian also helps with sleep problems and lessens the “rebound effect” that some experience when stimulants wear off. Talk with your doctor or a nutritionist who specializes in herbs about valerian.

Melatonin for Sleep

Melatonin is a natural hormone produced in our bodies to help us sleep. When we turn off the television, dim the lights, and settle down for bed, our body produces melatonin and we become sleepy. But for those with ADHD, sleep is sometimes difficult to come by. Melatonin supplements can help and are generally safe when used appropriately. Always start with the smallest possible dose.

Give Ginkgo Biloba and Ginseng a Try?

Ginkgo Biloba

Some small studies show that Ginkgo biloba helps improve memory and with ginseng can decrease impulsiveness and distractibility. Several studies have examined these herbs, but current evidence does not show a significant benefit for ADHD symptoms.

Ginseng

Other studies have shown no or minimal improvement with ginseng for ADHD symptoms.

St. John's Wort

People also ask about St. John's Wort as an herb to treat ADHD, but evidence does not support it well, and it can interact with medications, so it should only be considered with professional guidance. These herbs can cause health problems, especially if you have a history of diabetes, seizures, or schizophrenia.

Early studies suggest saffron performed similarly to methylphenidate for ADHD in some cases and may also reduce anxiety or improve working memory. A typical dose is 15–30 mg per day, and it is generally well tolerated with few side effects.

Talk with your doctor or a nutritionist before trying them.

Heed the Warning

“All natural” is not synonymous with “safe,” especially at high doses or when combined with other medication. Many herbs and supplements have side effects, may cause or worsen health problems, or interfere with prescription medications.

Talk with your doctor before taking any supplements, since medication interactions should be reviewed and nutritional supplements should fit within your broader ADHD treatment plan. When your doctor asks if you are taking any medications, be sure to tell him about all the vitamins and supplements you take on a daily basis.

Listen to Your Body

For supplements, there isn’t a lot of research to determine a recommended daily dose. Pay attention to your body and adjust the dosage if you notice something is wrong. For example, you may be taking zinc supplements and find yourself getting stomachaches. Discontinue or cut back on the supplement to see if the stomachaches disappear.

Frequently Asked Questions About Supplements for ADHD

Get Expert ADHD Care in Greater Orange County, CA

If you or a loved one is struggling with ADHD symptoms, Orange County Psychiatric Associates offers specialized outpatient psychiatric care tailored to your needs. Our experienced team in Mission Viejo and the surrounding Orange County area provides comprehensive evaluations, medication management—including non stimulant medications—and integrative health and wellness programs; our evidence-based approach aligns with researchers such as arnold le who have studied micronutrients and supplement interventions for ADHD.

Contact us today to schedule a consultation and learn how we can support your journey toward better focus, emotional regulation, and quality of life. Call (949) 555-1234 or visit our website to book an appointment.

What You Need to Know About Transcranial Magnetic Stimulation (TMS) Therapy

Fri, 08 Oct 2021 17:36:58 GMT

What is TMS therapy?

Transcranial magnetic stimulation (TMS) is a type of brain stimulation therapy.

It’s a noninvasive treatment that uses electromagnetic pulses to stimulate nerve cells, which may improve symptoms of neurological or mental health disorders.

TMS is mainly used to treat depression. It’s had success helping people who don’t respond to antidepressant medication and psychotherapy . In fact, in 2008 the Food and Drug Administration (FDA) approved TMS for this purpose.

There’s also some evidence that TMS may help other disorders, like anxiety and Parkinson’s disease.

Since TMS uses repetitive electrical impulses, it’s sometimes called repetitive transcranial magnetic stimulation (rTMS) . The terms are often used interchangeably.
If you’re curious about the benefits and side effects of TMS, read on.

How TMS therapy works

The therapy is done by a TMS technician or TMS physician. It’s an outpatient procedure, so it may be done in a medical clinic. If it’s done in a hospital, you won’t need to stay overnight.

Before the procedure, you’ll need to remove items that are sensitive to magnets, like jewelry.

Here’s what you can expect during TMS:

Your technician will have you wear earplugs to minimize the clicking sound of magnetic impulses. They’ll have you sit in a comfortable chair. You won’t need general anesthesia, and you’ll be awake throughout the treatment.
If it’s your first session, your technician will measure your head to determine where to place the magnetic coil. They’ll also take other measurements to personalize the settings on the TMS machine.
Your technician will place the coil above the front area of your brain. Next, they’ll start the treatment.
You’ll hear a clicking sound as the magnetic impulses are released. You’ll also feel a tapping or knocking sensation beneath the magnetic coil.
The treatment can last 30 to 60 minutes. You can drive yourself home after the procedure and resume normal activities.

You’ll need to repeat the procedure 5 days a week, for about 4 to 6 weeks. The exact length of your treatment depends on your response and specific condition.

TMS therapy benefits

There are many possible benefits of TMS therapy. Researchers are still studying the procedure, but it may help the following conditions:

TMS therapy for depression

TMS is primarily used to treat major depressive disorder (MDD) , sometimes simply called depression .

It’s generally recommended for those who haven’t found relief from medication and psychotherapy. This is called treatment-resistant depression . Approximately 30 percentTrusted Source of people with depression don’t respond to these treatments.

According to 2015 researchTrusted Source , depression is linked to reduced activity in the prefrontal cortex. This part of the brain is involved with depression symptoms, like low energy levels and appetite changes.

TMS may help by stimulating nerve cells and increasing activity in this area.

TMS therapy for obsessive-compulsive disorder (OCD)

TMS may improve symptoms of obsessive-compulsive disorder (OCD) .

The FDATrusted Source approved TMS for OCD in 2018. As with depression, TMS is recommended if a person with OCD hasn’t responded to medication and psychotherapy.

According to one studyTrusted Source , people with OCD often have increased activity between the prefrontal cortex and striatum. This hyperconnectivity is associated with severe OCD symptoms.

TMS can be used to inhibit the activity in this part of the brain, thus reducing OCD symptoms.

TMS therapy for anxiety

As TMS treats psychological disorders like depression and OCD, it may also ease anxiety . That’s because these conditions often cause anxiety symptoms.

TMS could also be beneficial for generalized anxiety disorder (GAD) .

In anxiety, there’s often increased nerve cell activity in the prefrontal cortex. TMS may reduce the activity in this region, according to a 2019 studyTrusted Source .

TMS for post-traumatic stress disorder (PTSD)

According to a 2019 reviewTrusted Source , TMS showed effectiveness for post-traumatic stress disorder (PTSD) . As mentioned, TMS can target the prefrontal cortex, which regulates how you process fear and worry.

A 2018 trialTrusted Source found that TMS alongside cognitive processing therapy was effective for PTSD. The therapeutic effect of this combination lasted for 6 months.

TMS for stroke rehabilitation

There’s some evidence that TMS may help stroke rehabilitation.

A stroke happens when blood flow to the brain is blocked or reduced, causing brain cells to die. This can result in long-term loss of muscle movement.

According to research , using TMS after a stroke could promote motor recovery. The idea is that the magnetic impulses can alter the activity of the motor cortex, the part of the brain that controls voluntary movement.

A 2017 article also shares that TMS may improve dysphagia, or difficulty swallowing, by stimulating the motor cortex. They add that dysphagia affects 50 percent of people who have experienced a stroke.

TMS for schizophrenia

Schizophrenia is a chronic, and often severe, psychiatric disorder.

A main symptom of the condition is auditory hallucinations, which affect 75 percent of people with schizophrenia .

According to a 2019 review , targeting the temporoparietal cortex could be beneficial for auditory hallucinations. This part of the brain, which is involved in language, is typically overactive in schizophrenia.

TMS for Parkinson’s disease

Parkinson’s disease is a neurological disorder. It causes motor dysfunction, including tremors, balance issues, and freezing of gait. Freezing of gait occurs when you feel frozen and can’t move while walking.

A 2020 studyTrusted Source found that TMS may improve freezing of gait. According to the researchers, TMS normalized the connections between parts of the brain involved in gait freezing.

TMS for Alzheimer’s disease

TMS might have benefits for Alzheimer’s disease , a form of dementia. This disorder causes progressive memory loss and cognitive decline.

According to newer researchTrusted Source , it’s thought that TMS could help Alzheimer’s disease by altering the neural connections involved in memory and learning. However, more research is necessary to understand how TMS can manage Alzheimer’s disease.

TMS for chronic pain

TMS could potentially improve chronic pain conditions, such as fibromyalgia. A 2017 analysisTrusted Source shares that it may help by stimulating the motor cortex and controlling neurotransmitters involved in pain.

It’s worth noting that depression and chronic pain often occur together. Depression can worsen chronic pain, so TMS may help by treating depression symptoms.

TMS for nicotine addiction

Nicotine releases dopamine , also called the “happy hormone.” It sends signals to the reward system of your brain, including the prefrontal cortex, resulting in nicotine cravings and addiction .

According to a 2013 studyTrusted Source , TMS could help reduce nicotine cravings by targeting the prefrontal cortex.

The researchers think that TMS promotes the release of dopamine, which reduces the need for nicotine.

TMS for multiple sclerosis

Multiple sclerosis (MS) is a chronic autoimmune disorder that affects the nervous system. It commonly causes spasticity, or muscle tightness that makes it difficult to move.

In a 2019 studyTrusted Source , researchers used TMS on the motor cortex of people with MS. The treatment, combined with physical therapy, was found to decrease spasticity.

TMS therapy success rate

To date, TMS therapy has mostly been studied as a treatment for depression .

The success rate of TMS for depression is promising. Response rates for depression are between 30 and 64 percentTrusted Source .

More research is needed to understand the success rate for other medical conditions.

When is transcranial magnetic stimulation used?

If you have depression , a doctor will likely recommend antidepressants and psychotherapy before TMS.

However, you may be a good candidate for TMS if you:

have used one or more antidepressants without results
have experienced negative side effects when using antidepressants
are a child or teenager

If you’re young, TMS might be an ideal choice. That’s because younger people are more prone to developing adverse side effects from antidepressants.

Who should avoid this treatment?

TMS is considered safe, but it’s not for everyone.

You should avoid this treatment if you have metal in your head, such as:

deep brain stimulators
electrodes
neck or brain stents
aneurysm clips or coils
shrapnel or bullet pieces
facial tattoos with metallic ink
metal plates
cochlear implants
permanent piercings

The magnetic fields in TMS can make these implants heat up or move, which can cause serious injuries.

It’s OK to get the treatment if you have braces or dental fillings.

You may also need to avoid TMS if you:

have a history of epilepsy or seizures
are taking stimulants
have a medical condition that increases the risk of seizures

Side effects of transcranial magnetic stimulation

TMS side effects are uncommon. If complications do occur, they may include:

mild headaches (most common)
lightheadedness
scalp pain
neck pain
tingling
facial twitching
sleepiness
altered cognition during treatment

Symptoms like headaches and lightheadedness usually go away after several treatments.

There’s also the risk of seizures, but this side effect is rare. There’s a 0.1 percentTrusted Source risk of developing seizures during a course of TMS therapy.

How much does TMS therapy cost?

One course of TMS can cost between $6,000 to $12,000 out of pocket.

Your health insurance provider might offer coverage, but this depends on your medical history. You may be required to try at least four antidepressants before receiving TMS coverage.

Alternatively, they might provide coverage if you experience negative reactions when using antidepressants.

Is TMS therapy covered by Medicare?

If antidepressants and psychotherapy don’t work for you, Medicare will cover TMS therapy.

Do you have to miss work for TMS therapy?

Since you’re expected to get treatment 5 days a week for multiple weeks, you may have to miss a few hours of work each day. This depends on your schedule, the location of the clinic, and the time of your appointments.

One session can take anywhere from 30 to 60 minutes, so you may be able to do the treatment before or after work.

Takeaway

TMS targets the activity of nerve cells in your brain, which may alleviate depression symptoms. It could also have benefit for disorders like OCD, anxiety, and PTSD as well.

The procedure may even improve motor dysfunction, making it potentially helpful for Parkinson’s disease, multiple sclerosis, or stroke rehabilitation.

If you’re interested in TMS, talk with a doctor. You may be a good candidate if you’re young, have a low risk of seizures, and haven’t felt relief from antidepressants.

This article originally published by Healthline

Medically reviewed by Timothy J. Legg, Ph.D., CRNP — Written by Kirsten Nunez on January 20, 2021

ADHD Supplements: Are They Effective?

Fri, 24 Sep 2021 21:00:03 GMT

Stimulant medications are the first-line treatment for attention deficit hyperactivity disorder (ADHD)

Common symptoms of ADHD include hyperactivity, impulsive behavior, and difficulty paying attention.

Recently, researchers have been investigating several different supplements that may help alleviate ADHD symptoms.

In this article, we outline the research into some of the more promising hormone, dietary, and herbal supplements for ADHD .

Hormone, vitamin, and mineral supplements

Research shows that people with ADHD often have lower levels of certain vitamins and minerals. Despite this, there is currently no conclusive evidence that mineral deficiencies cause ADHD.

In some cases, vitamin and mineral deficiencies are a consequence of ADHD medication. For example, stimulant medications can suppress appetite , which can lead to a decrease in a person’s nutrient intake.

Certain nutrient deficiencies may also worsen ADHD or cause symptoms that mimic the condition.

Researchers are investigating whether the following hormone, dietary, and herbal supplements are effective in treating ADHD :

Melatonin

Melatonin is a hormone that regulates the sleep-wake cycle. It might be useful for the subset of children with ADHD who experts believeTrusted Source experience sleep disturbances.

In many cases, sleep disturbances are a side effect of stimulant medications that doctors prescribe to treat ADHD. Stimulants work by increasing activity in both the brain and central nervous system .

Although this often improves ADHD symptoms, it can lead to the following sleep problems:

difficulty getting to sleep and waking up
waking up throughout the night
daytime sleepiness

A 2019 studyTrusted Source investigated the benefits of melatonin in children with ADHD who developed sleep problems as a result of taking the stimulant methylphenidate. All 74 participants had different doses of melanin for at least 4 weeks.

The researchers used parental reports to determine treatment success. According to the reports, melatonin effectively improved sleep problems in 60.8% of participants.

Vitamin D

Vitamin D plays an important role in healthy brain development and function. Several studies have found a link between vitamin D deficiency and neurodevelopmental disorders, such as ADHD.

A 2018 studyTrusted Source compared vitamin D levels in children with and without ADHD. Those with ADHD had significantly lower levels of vitamin D in their blood and were also more likely to have a vitamin D deficiency.

In the second stage of the study, the researchers divided the children who were deficient in vitamin D into two groups. The participants in one group received an 8-week course of vitamin D supplements, while those in the other group received a placebo .

Children who received the supplements showed significant improvements in attention, impulsivity, and hyperactivity compared with children who received the placebo.

These findings suggest that vitamin D supplements may improve ADHD symptoms in children who are vitamin D deficient. However, further studies are necessary to confirm this theory.

Zinc

Zinc is an essential mineral that plays an important role in brain function.

Children who are deficient in zinc can experience symptomsTrusted Source similar to those of ADHD.

Examples include jitteriness, inattention, and delayed cognitive development.

Several studies have reported a link between zinc deficiency and ADHD in children. A 2015 reviewTrusted Source of these studies concluded that zinc supplements could help treat ADHD symptoms in children with zinc deficiency.

However, it is still not clear whether zinc has any effect on ADHD symptoms in children or adults who are not zinc deficient.

Iron

Iron is necessaryTrusted Source for the production of the brain chemical dopamine. Research shows that people with ADHD tend to have low levels of dopamine in the brain.

Some researchers suggest that iron deficiency may, therefore, play a role in ADHD. A 2018 reviewTrusted Source looked at 17 studies comparing iron levels in children with and without ADHD.

The review found that children with iron deficiency were more likely to have ADHD. Also, in children with ADHD, there was an association between iron deficiency and more severe ADHD symptoms.

These results suggest that iron supplements may be beneficial for iron-deficient children with ADHD. However, further studies are necessary to establish whether this is the case.

Omega-3 fatty acids

Omega-3 and omega-6 are essential fatty acids (EFAs) that play an important role in brain health. Omega-3 is especially important for protecting brain tissue and aiding communication between brain cells.

A 2017 review investigated the benefit of omega-3 and omega-6 in the treatment of ADHD in children and young adults.

The review included 16 randomized controlled trials. Participants in each of these trials received either an EFA supplement or a placebo.

In 13 of the trials, the participants who took the EFA supplements showed improvements in the following:

attention
visual learning
short-term memory
hyperactivity
impulsivity

Importantly, a 2016 reviewTrusted Source suggested that children with ADHD tend to have an imbalance rather than a deficiency of EFAs. In general, they have a higher ratio of omega-6 to omega-3 fatty acids.

The authors of the review suggest that addressing this imbalance is more important than simply increasing the intake of EFAs.

Other natural remedies

The following herbal supplements are also under investigation as potential treatments for ADHD .

French maritime pine bark extract

Pine bark extract contains natural compounds called proanthocyanidins. The extract made from these compounds is commonly sold under the registered trademark brand name Pycnogenol.

According to a 2016 review , a small number of randomized controlled trials have found that pine bark extract may improve ADHD symptoms.

According to the review authors, pine bark extract is a powerful antioxidant that may work by reducing cell damage and improving blood flow to parts of the brain that play a role in ADHD.

However, further studies are necessary to support the use of pine bark extract as a treatment for ADHD .

Ginkgo biloba

Ginkgo biloba is an herb that derives from the leaves of the G. biloba tree. This herb contains chemicals called terpene trilactones. Research suggestsTrusted Source that these chemicals help protect against brain cell damage and increase the availability of dopamine in the brain.

In 2013 , a small study investigated the effects of ginkgo biloba on childhood ADHD.

The study found that taking a maximum daily dose of 240 mg of ginkgo for 3–5 weeks improved ADHD symptoms. According to parental reports, children showed improvements in attention, hyperactivity, and impulsiveness.

However, this was a small study with only 20 participants and no placebo control. Well-controlled clinical trials are necessary to confirm the benefits of ginkgo for ADHD.

Although the study did not report any adverse effects of the herbal extract, the National Institutes of HealthTrusted Source list the following potential side effects:

gastrointestinal upset
nausea
diarrhea
headaches
dizziness
allergic reactions

As ginkgo is also a potential blood thinner, it may not be suitable for people with blood clotting disorders or those taking anticoagulant medications.

Summary

Many different types of supplement show promise as complementary treatments for ADHD. However, research into these supplements is still in its early stages.

Further clinical trials with more participants are necessary to get a better understanding of the effectiveness and safety of these supplements for ADHD.

This article originally published by MedicalNewsToday

Medically reviewed by Alan Carter, Pharm.D. — Written by Charlotte Lillis on July 29, 2019

What to Know About 5 Sleep Disorders

Fri, 17 Sep 2021 20:48:25 GMT

Sleep is essential. Getting a good night’s rest is important for functioning well during the day. However, a number of sleep disorders can affect how much rest a person gets.

Most adults need 7–9 hours of sleep each night. There are negative consequencesTrusted Source for mental and physical health, quality of life, and safety if they do not get enough quality sleep.

That said, sleep disorders are common. Experts estimate that as many as 70 millionTrusted Source adults in the United States have sleep disorders and sleepiness issues.

There are many different sleep disorders. The four general categories of sleep disorders are as follows:

issues falling asleep and staying asleep
difficulties staying awake
problems with the sleep-wake schedule
unusual behaviors during sleep

However, the International Classification of Sleep Disorders, Third Edition (ICSD-3) is the main clinical text for the diagnosis and categorization of sleep disorders. The ICSD-3 groups sleep disorders into six major categories rather than four.

This article looks at five sleep disorders, including their causes, symptoms, and potential treatment options.

1. Insomnia

Insomnia is the most common sleep disorder, with around 10% of adults experiencing short-term issues. Approximately 20% of short-term cases become chronic. Additionally, 30–40% of adults have acute or occasional insomnia.

Having insomnia may mean that an individual has difficulty falling asleep, wakes up frequently, or wakes up too early and cannot fall asleep again. It is also important to note that in order to receive a diagnosis of insomnia, a person must also have adequate time to sleep and have symptoms during the day.

A doctor may diagnose chronic insomnia if a person’s sleeping difficulties occur on 3 nights per weekTrusted Source for at least a month.

Causes

Insomnia has various causes. In some cases, there is a genetic component.

One example of this is fatal familial insomnia, which is a rare genetic brain disorder that runs in families. The condition causes insomnia so severe that it becomes life threatening.

Some other, more typical causes of comorbid insomnia include:

alcohol, nicotine, caffeine, and drug use
stress , anxiety , and other mental health conditions
health problems that cause pain, discomfort, or frequent bathroom visits
some medical conditions

Treatments

The most effective treatment for comorbid insomnia depends on the cause and whether or not it is a chronic problem.

A doctor needs to address any underlying health conditions as well as the insomnia itself in order to help with a person’s sleep issues.

A key part of insomnia treatment is teaching individuals about sleep hygieneTrusted Source . Good sleep hygiene involves:

having a regular sleep schedule
following a nightly routine
relaxing before bed
reducing caffeine and alcohol use
being physically active during the day, if possible

2. Snoring and sleep apnea

Snoring occurs when the tissues in a person’s throat relax and partially close the airway. The tissues then vibrate as the individual breathes, causing the characteristic snoring sound.

With obstructive sleep apnea (OSA) , a person experiences irregular breathing during sleep, which can cause them to stop breathing for 10 seconds or longer.

The multiple extended breathing pauses lead to a decrease in blood oxygen, resulting in multiple awakenings throughout the night. This can result in poor quality sleep and other health consequences.

Causes

Snoring and OSA seem to be linked. Most individuals with OSA snore. However, not everyone who snores has OSA.

Some causes of snoring and OSA include:

head and neck anatomy
chronic nasal congestion
obesity
sleeping position
aging
hypothyroidism

Central sleep apnea (CSA) is a condition that causes pauses in breathing due to a lack of respiratory effort during sleep.

Unlike OSA, these pauses in breathing are mainly due to the lack of respiratory muscles activating or the brain not asking the respiratory muscles to activate.

Experts often link CSA to an underlying health condition, such as stroke or heart failure, medication use, or living at a high altitude. Sometimes, it could even be a primary problem.

Treatments

If a person has sleep apnea symptoms or snores, they should talk with a doctor to find the underlying cause.

The doctor may recommend an overnight sleep study called polysomnography or a home sleep study. Both study types analyze the individual’s sleep and breathing.

Some treatmentsTrusted Source include:

using a continuous positive airway pressure machine to keep the airways open during sleep
losing weight, if applicable
using a mandibular advancement device to prevent the tissues of the mouth from blocking the airways
addressing any underlying medical causes

3. Parasomni as

If an individual has a parasomnia , they experience unusual sleep behaviors or events that happen during specific sleep stages or while transitioning between sleep and wakefulness.

Parasomnias are more typicalTrusted Source during childhood, but some may persist into adulthood.

Some common ways to categorize parasomnias are random eye movement (REM)-related and non-REM-related.

REM-related parasomnias include REM behavior disorder and nightmare disorder.

Non-REM-related parasomnias include:

sleepwalking
waking up confused
night terrors
sleep-related unusual sexual behaviors
sleep-related eating disorder

Some other notable parasomnias include:

exploding head syndrome
sleep paralysis
sleep-related hallucinations
bedwetting

Any unusual behavior that a person demonstrates during sleep could be a parasomnia.

A doctor needs to take a detailed medical history, perform a physical examination, and, in some cases, conduct a laboratory-based sleep study to make an accurate diagnosis.

Causes

There are several potential causes of parasomnia. A person may have multiple triggers, including:

stress and anxiety
depression or post-traumatic stress disorder
certain medications
other sleep disorders, such as insomnia, sleep apnea, or sleep deprivation
neurological conditions, such as Parkinson’s disease

Treatments

A doctor may need to address the underlying cause of a parasomnia or use other treatmentsTrusted Source , some of which include:

maintaining good sleep hygiene
taking safety precautions, such as locking windows and using door alarms in case of sleepwalking
taking prescription medications, such as clonazepam
using over-the-counter supplements, such as melatonin

4. Narcolepsy

If a person has narcolepsy , they have excessive daytime sleepiness and may fall asleep at inappropriate times, such as while working or driving.

Around 10–25% of people with narcolepsy also experience the following symptoms:

Cataplexy: This sudden loss of muscle tone means that a person may physically collapse but remain conscious. It often happens in response to a strong emotion, such as excitement, laughter, or surprise.
Sleep paralysis: This means that an individual is unable to move upon waking or falling asleep, but they are fully alert.
Hypnagogic hallucinations: This means that a person experiences hallucinations while falling asleep, but they are also alert. These hallucinations, which may seem like dreams, are often frightening and may include visual, auditory, or tactile sensations.

Narcolepsy that occurs with cataplexy is called type 1 narcolepsy. If a person does not have cataplexy, they have type 2 narcolepsy.

Causes

Type 1 narcolepsy is linked to low levels of a brain chemical called hypocretin. This chemical helps people stay awake and maintain muscle tone.

Type 2 narcolepsy causes many of the same symptoms as type 1 narcolepsy. However, type 2 narcolepsy is not associated with cataplexy or low levels of hypocretin.

Treatment

Narcolepsy currently has no cure, but doctors can treat it using certain medications. Some medications for narcolepsy include:

stimulants, which can help keep the individual awake during the day
oxybates, such as Xyrem (sodium oxybate) and Xywav (low sodium oxybate), to improve sleep quality, daytime sleepiness, and cataplexy
alerting antidepressants (off-label use), such as selective serotonin reuptake inhibitors, to help with cataplexy
histamine-activating medications, such as pitolisant (Wakix), to address sleepiness and cataplexy

5. Restless legs syndrome

Restless legs syndrome (RLS) is a neurological condition that commonly affects females and gradually worsens with age. It causes uncontrollable urges to move the legs because they feel uncomfortable.

A person may experience aches, burning, tingling, throbbing, or a sensation of insects crawling over the legs. The symptoms usually happen in the evening hours as an individual is resting, falling asleep, or sleeping.

RLS can affect a person’s quality of sleep because it causes them to continually wake up during the night.

Causes

Some potential causes of RLS include:

iron deficiency
pregnancy
obesity
alcohol, nicotine, and caffeine use
the use of certain medications and supplements

Treatments

A doctor needs to treat any underlying conditions, such as iron deficiency, to ease the symptoms of RLS.

If a person has no underlying medical condition, the doctor may recommend lifestyle changes such as losing weight, if applicable.

An individual may also need to take medications, such as:

Gabapentinoids: These include gabapentin (Neurontin), pregablin (lyrica), and gabapentin enacabril (Horizant). Experts now consider gabapentinoids the first-line medical therapy for RLS.
Dopaminergic agents: These include pramipexole (Mirapex) and ropinirole (Requip). They increase dopamine in the brain and are now second-line agents in medical therapy for RLS.
Opioids: Doctors usually reserve these very severe cases.

If a person experiences RLS, moving the legs often helps relieve the sensations. People can also try to stretch, walk, or massage their legs to ease the symptoms.

Summary

Several sleep disorders can affect the integrity of a person’s sleep and impact their quality of life.

Sleep is essential for health, so anyone who experiences sleep difficulties should talk with a doctor to determine the next steps.

A range of underlying medical conditions can affect someone’s sleep, and a doctor can help diagnose these and suggest suitable treatments.

This article originally published by MedicalNewsToday

Medically reviewed by Raj Dasgupta, MD — Written by Zia Sherrell, MPH on August 30, 2021

Could Treating Gut Bacteria Help Autism Symptoms?

Fri, 10 Sep 2021 21:35:22 GMT

"We treated children with autism by altering the gut microbiota. All had gastrointestinal symptoms -- diarrhea, constipation, stomach pain -- and those symptoms were reduced dramatically, and their behavior improved as well," said study senior author Rosa Krajmalnik-Brown.

Scientists suspect that your gut microbiome -- the mix of bacteria that inhabit your intestines -- affects your health in many ways, but a surprising new finding suggests that a healthy microbiome may even ease the symptoms of autism .

The small study of 18 children with autism who also had severe digestive problems found that a fecal transplant to rebalance their gut microbiome reduced both their digestive symptoms and their autism symptoms . The improvements persisted during the two-year study follow-up period.

"We treated children with autism by altering the gut microbiota. All had gastrointestinal symptoms -- diarrhea , constipation , stomach pain -- and those symptoms were reduced dramatically, and their behavior improved as well," said study senior author Rosa Krajmalnik-Brown. She's a professor at the Biodesign Institute at Arizona State University in Tempe, Ariz.

"When we checked again two years later, behavior was even better and gastrointestinal symptoms were still much better, but not as good as right after treatment," she said.

Krajmalnik-Brown said it's not clear exactly how improving the microbiome helps autism symptoms. Because all of the children had severe digestive issues, she said it's possible that "they may be more comfortable and better able to focus and learn," she suggested.

It also might be that healthier microorganisms in the gut may send chemicals to the brain that help children learn and make connections, she added.

The researchers noted that 30% to 50% of people with autism also have chronic digestive problems that may make them irritable and make it difficult to learn, pay attention and behave well.

The kids treated in the study were found to have a low diversity of bacteria in their intestines at the beginning of the study. All 18 received the fecal transplant daily for seven to eight weeks.

The treatment increased the diversity of microbes and healthy bacteria in the gut, according to the researchers.

When the study started, 83% of the children were classified as having severe autism. At the end of the study, only 17% were severe, 39% were mild or moderate, and 44% were below the cut-off for mild autism spectrum disorder , the findings showed.

A professional evaluation of the children's symptoms found a 45% decrease in autism symptoms compared to the start of the study.

Many of the study participants had multiple factors that could lead to a less diverse microbiome. For example, many were born by cesarean section, which is linked to fewer gut bacteria. Other factors were reduced breastfeeding , increased use of antibiotics and low fiber intake, the researchers said.

Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center in New Hyde Park, N.Y., reviewed the study findings.

He said, "Although parents of children with autism frequently note that their children have significant gastrointestinal problems, this study suggests that changing the bacteria in the gut may lead to sustained improvements in a child's autism symptoms."

However, Adesman said it's important to remember that the study didn't have a placebo group, and all the children and parents knew they were receiving the treatment.

In addition, he noted that only children with autism and severe digestive problems were included in the study. It's not clear if this treatment would be helpful for kids with autism who don't have digestive problems.

Both Adesman and Krajmalnik-Brown agreed that more study of this treatment is needed.

Krajmalnik-Brown said that parents who are interested in improving their child's microbiome can try feeding them a more diverse diet, including more fiber from foods such as vegetables and fruits.

She stressed that no one should attempt the study treatment at home. "This was done in very supervised conditions. Done incorrectly, it could cause gastrointestinal infections," Krajmalnik-Brown said.

The findings were published online April 9 in the journal Scientific Reports.

This article originally published by WebMD

By Serena Gordon

HealthDay Reporter

Nutrition’s Influence on Mental Health

Mon, 23 Aug 2021 15:00:03 GMT

You take your meds regularly, meditate, and see a therapist for your mental health. But what about what’s on your plate? Your nutritional habits may play a role.

A tuna sandwich, a tossed salad, and a cup of berries. Sounds like lunch, right? It may be more than that. Research shows that the foods you put into your body can have an influence on your mental health.

We know that what you eat affects things like diabetes and heart disease, so is it a surprise that nutrition can affect your anxiety, depression, or bipolar disorder?

Food as prevention

One review of 21 studiesTrusted Source found that a high intake of fruits, vegetables, olive oil, whole grains, fish, and low-fat dairy reduced the risk of depression. Studies that looked at Mediterranean and Japanese diets and compared them to the typical Western diet found that people on these diets had a 25% to 35% lower incidence of depression, according to Dr. Eva Selhub for the Harvard Health blog.

The Mediterranean diet , rich in vegetables and olive oil, may have mental health benefits, such as providing protection against depression and anxiety .

Another studyTrusted Source found a link between a high-fat, high-sugar diet and anxiety in adults age 50 and older. Researchers deduced that diets heavy in carbohydrates, saturated fat, red meat, and refined sugars can worsen your mental health symptoms.

It appears that not consuming the right type of vitamins and minerals, also called micronutrients , may play a role in certain mental health disorders. One studyTrusted Source found that, overall, many people with mental health conditions have deficiencies in micronutrients like omega-3 fatty acids and B vitamins.

There’s been some research into how taking vitamins and supplements could improve your mental health. This article offers an overview of research into which vitamins may be beneficial for people living with bipolar disorder.

But scientists are calling for more research and larger, more rigorous studies. Nutrition offers a world of potential for new prevention strategies and treatments for those who have a variety of mental health conditions.

Food as treatment

It seems that certain foods trigger a release of chemical messengers (neurotransmitters) in our body like serotonin , dopamine, and norepinephrine . These neurotransmitters play a role in helping us stay calm, focused, and energized.

If the volume of these chemical messengers waxes or wanes too far from the neurotypical, mental health issues like anxiety, depression, and mania could crop up.

Doctors recommend eating foods that keep neurotransmitters functioning smoothly and pave the way for a healthy mind. They also suggest avoiding foods that can derail those neurotransmitters. These include foods that are high in fat and sugar and low in fiber.

For instance, psychologists are exploring the role of omega-3 fatty acids. Thanks to their anti-inflammatory properties and effects on dopamine and serotonin, omega-3s likely play a role in brain development, functioning, and mental health.

Foods high in omega 3s include salmon, mackerel, oysters, flack seeds, chia seeds, walnuts, soybeans, omega 3-enriched eggs, hemp seeds, and spinach.

Nutrition affects how you feel

Scientific research has found more evidence to support eating more whole foods and reducing your intake of processed foods to improve mental health outcomes.

Processed foods may promote the growth of bad gut bacteria and lead to inflammation. And since the brain and gut are ultimately connected , eating foods that negatively affect our gut health could contribute to certain mental health disorders, researchers are discovering .

Unprocessed items

unprocessed oils for cooking and drizzling
whole grains
vegetables
fruits
legumes
meats with no nitrates or nitrites (preservatives)
nuts
avocado

Processed items

“naturally flavored” items
fast food
frozen meals
canned, cured,or blended meats
grocery items slapped with some sort of “ready-made” advertisement
sugary treats like cakes, candy, and desserts

Inflammation is now thought responsible for a host of diseases including heart disease and diabetes, as well as cancer and Alzheimer’s disease. Now, researchers propose that psychological stress, like the kind you feel when you have depression or anxiety, can activate inflammation in the brain.

It’s understood treatments like cognitive behavioral therapy (CBT) can help reduce brain inflammation and, with it, the symptoms of depression and other mental health disorders.

Following a diet that emphasizes unprocessed foods, like the Mediterranean diet, could help reduce the brain inflammation that may exacerbate mental health disorders.

What now?

If you want to leverage food to fortify your mental health, you can try experimenting with your diet.

Try thinking about what you eat. What key foods are you lacking, and what areas of your diet could benefit from nutritious alternatives ?

Maybe you don’t get enough fish or haven’t been fond of fruits. Try a prep method or type of catch that is best for people who don’t like fish , or experiment with some fruit variations like fruit jerky or puree to drizzle in your sauces and dressings. See if roasted chickpeas or oven-baked kale gives you that crunch you love and a little salty fix, too.

This might be a good place to opt for a more natural, whole-food approach that’ll still fill you up, like the Med diet or “ clean ” eating.

You don’t need to drastically overhaul everything you eat. See if you can make incremental changes. Whatever adjustments you make, give a new eating regimen substantial time before you decide if it’s working for you. You can even use a notebook, journal, or food app to chronicle what you’ve tried and how you felt afterward.

After some time, you can assess how you feel. Making nutritional changes to boost your mental health is a no-lose endeavor for your body and overall well-being.

This article originally published by PsychCentral

By the by Jennifer Nelson and Kristin Currin-Sheehan

S uggested Reading:

How not to Die , by Michael Gregor, MD

The China Study , by Colin Campbell, PhD

Diet for a New America by John Robbins

Sleep and mental health

Mon, 16 Aug 2021 15:00:02 GMT

Sleep deprivation can affect your mental health

Sleep and mental health are closely connected. Sleep deprivation affects your psychological state and mental health . And those with mental health problems are more likely to have insomnia or other sleep disorders.

Americans are notoriously sleep deprived, but those with psychiatric conditions are even more likely to be yawning or groggy during the day. Chronic sleep problems affect 50% to 80% of patients in a typical psychiatric practice, compared with 10% to 18% of adults in the general U.S. population. Sleep problems are particularly common in patients with anxiety, depression , bipolar disorder , and attention deficit hyperactivity disorder ( ADHD ).

Traditionally, clinicians treating patients with psychiatric disorders have viewed insomnia and other sleep disorders as symptoms. But studies in both adults and children suggest that sleep problems may raise risk for, and even directly contribute to, the development of some psychiatric disorders. This research has clinical application, because treating a sleep disorder may also help alleviate symptoms of a co-occurring mental health problem.

The brain basis of a mutual relationship between sleep and mental health is not yet completely understood. But neuroimaging and neurochemistry studies suggest that a good night's sleep helps foster both mental and emotional resilience, while chronic sleep deprivation sets the stage for negative thinking and emotional vulnerability.

Key points

Sleep problems are more likely to affect patients with psychiatric disorders than people in the general population.
Sleep problems may increase risk for developing particular mental illnesses, as well as result from such disorders.
Treating the sleep disorder may help alleviate symptoms of the mental health problem.

How sleep affects mental health

Every 90 minutes, a normal sleeper cycles between two major categories of sleep — although the length of time spent in one or the other changes as sleep progresses.

During "quiet" sleep, a person progresses through four stages of increasingly deep sleep. Body temperature drops, muscles relax, and heart rate and breathing slow. The deepest stage of quiet sleep produces physiological changes that help boost immune system functioning.

The other sleep category, REM ( rapid eye movement) sleep, is the period when people dream. Body temperature, blood pressure, heart rate, and breathing increase to levels measured when people are awake. Studies report that REM sleep enhances learning and memory, and contributes to emotional health — in complex ways.

Although scientists are still trying to tease apart all the mechanisms, they've discovered that sleep disruption — which affects levels of neurotransmitters and stress hormones, among other things — wreaks havoc in the brain, impairing thinking and emotional regulation. In this way, insomnia may amplify the effects of psychiatric disorders, and vice versa.

Psychological effects of sleep deprivation

More than 70 types of sleep disorders exist. The most common problems are insomnia (difficulty falling or staying asleep), obstructive sleep apnea (disordered breathing that causes multiple awakenings), various movement syndromes (unpleasant sensations that prompt night fidgeting), and narcolepsy (extreme sleepiness or falling asleep suddenly during the day).

Type of sleep disorder, prevalence, and impact vary by psychiatric diagnosis. But the overlap between sleep disorders and various psychiatric problems is so great that researchers have long suspected both types of problems may have common biological roots.

Depression . Studies using different methods and populations estimate that 65% to 90% of adult patients with major depression, and about 90% of children with this disorder, experience some kind of sleep problem. Most patients with depression have insomnia, but about one in five suffer from obstructive sleep apnea.

Insomnia and other sleep problems also increase the risk of developing depression. A longitudinal study of about 1,000 adults ages 21 to 30 enrolled in a Michigan health maintenance organization found that, compared with normal sleepers, those who reported a history of insomnia during an interview in 1989 were four times as likely to develop major depression by the time of a second interview three years later. And two longitudinal studies in young people — one involving 300 pairs of young twins, and another including 1,014 teenagers — found that sleep problems developed before major depression did.

Insomnia and other sleep problems affect outcomes for patients with depression. Studies report that depressed patients who continue to experience insomnia are less likely to respond to treatment than those without sleep problems. Even patients whose mood improves with antidepressant therapy are more at risk for a relapse of depression later on. Depressed patients who experience insomnia or other sleep disturbances are more likely to think about suicide and die by suicide than depressed patients who are able to sleep normally.

Bipolar disorder . Studies in different populations report that 69% to 99% of patients experience insomnia or report less need for sleep during a manic episode of bipolar disorder. In bipolar depression, however, studies report that 23% to 78% of patients sleep excessively (hypersomnia), while others may experience insomnia or restless sleep.

Longitudinal studies suggest that insomnia and other sleep problems worsen before an episode of mania or bipolar depression , and lack of sleep can trigger mania. Sleep problems also adversely affect mood and contribute to relapse.

Anxiety disorders. Sleep problems affect more than 50% of adult patients with generalized anxiety disorder, are common in those with post-traumatic stress disorder (PTSD), and may occur in panic disorder, obsessive-compulsive disorder, and phobias. They are also common in children and adolescents. One sleep laboratory study found that youngsters with an anxiety disorder took longer to fall asleep, and slept less deeply, when compared with a control group of healthy children.

Insomnia may also be a risk factor for developing an anxiety disorder, but not as much as it is for major depression . In the longitudinal study of teenagers mentioned earlier, for example, sleep problems preceded anxiety disorders 27% of the time, while they preceded depression 69% of the time.

But insomnia can worsen the symptoms of anxiety disorders or prevent recovery. Sleep disruptions in PTSD, for example, may contribute to a retention of negative emotional memories and prevent patients from benefiting from fear-extinguishing therapies.

ADHD . Various sleep problems affect 25% to 50% of children with ADHD . Typical problems include difficulty falling asleep, shorter sleep duration, and restless slumber. The symptoms of ADHD and sleeping difficulties overlap so much it may be difficult to tease them apart. Sleep-disordered breathing affects up to 25% of children with ADHD, and restless legs syndrome or periodic limb movement disorder, which also disrupt sleep, combined affect up to 36%. And children with these sleeping disorders may become hyperactive, inattentive, and emotionally unstable — even when they do not meet the diagnostic criteria for ADHD.

Sleep and mental health lifestyle changes

In some respects, the treatment recommended for the most common sleep problem, insomnia, is the same for all patients, regardless of whether they also suffer from psychiatric disorders. The fundamentals are a combination of lifestyle changes, behavioral strategies, psychotherapy , and drugs if necessary.

Lifestyle changes. Most people know that caffeine contributes to sleeplessness, but so can alcohol and nicotine. Alcohol initially depresses the nervous system, which helps some people fall asleep, but the effects wear off in a few hours and people wake up. Nicotine is a stimulant, which speeds heart rate and thinking. Giving up these substances is best, but avoiding them before bedtime is another option.

Physical activity. Regular aerobic activity helps people fall asleep faster, spend more time in deep sleep, and awaken less often during the night.

Sleep hygiene. Many experts believe that people learn insomnia, and can learn how to sleep better. Good "sleep hygiene" is the term often used to include tips like maintaining a regular sleep-and-wake schedule, using the bedroom only for sleeping or sex, and keeping the bedroom dark and free of distractions like the computer or television. Some experts also recommend sleep retraining: staying awake longer in order to ensure sleep is more restful.

Relaxation techniques. Meditation , guided imagery, deep breathing exercises, and progressive muscle relaxation (alternately tensing and releasing muscles) can counter anxiety and racing thoughts.

Cognitive behavioral therapy. Because people with insomnia tend to become preoccupied with not falling asleep, cognitive behavioral techniques help them to change negative expectations and try to build more confidence that they can have a good night's sleep. These techniques can also help to change the "blame game" of attributing every personal problem during the day on lack of sleep.

This article originally published by Harvard Medical School

By the Harvard Health

Mental Benefits of Cardio: Regular Exercise Offers Stronger Mental Health Benefits than Cardiorespiratory Fitness, Study Finds

Sat, 07 Aug 2021 21:39:54 GMT

This article explores how regular cardiovascular exercise can improve mental health, summarizing recent research findings for anyone interested in the connection between physical activity and emotional well-being. The scope of this article is to highlight the mental benefits of cardio, specifically for people interested in mental health and exercise, and to explain why this topic matters: exercise is a powerful tool for supporting mental well-being. Cardio, or cardiovascular exercise, refers to activities that increase your heart rate and breathing, such as running, cycling, or swimming.

Study Overview

A Swedish study published in Mental Health and Physical Activity has shed light on the well-known link between exercise and mental health. The researchers found that, when accounting for sedentary behavior, cardiorespiratory fitness does not appear to improve anxiety and depressive symptoms, while frequency of exercise does, a pattern often tied to the mental benefits of regular cardio through lower stress hormones like cortisol and epinephrine and the release of feel good endorphins that support well being.

The link between exercise and mental health has been well-documented, and yet findings are limited when it comes to the type of physical activity that is most beneficial. The literature has yet to establish the relative importance of the frequency, intensity, and duration of exercise. As study authors Mats Hallgren and his team say, it is also unclear how cardiorespiratory fitness (CRF) relates to mental health, though research on the benefits of exercise also shows that releasing feel good endorphins and boosting dopamine, norepinephrine, and serotonin can improve mental health and support mental well being.

CRF refers to the strength of the body’s circulatory and respiratory response to physical activity, and it tends to improve with regular exercise. In their study, Hallgren and his team set out to disentangle the relative importance of CRF and exercise frequency in the prevention of mental health symptoms. As the researchers say, filling in these gaps in research can help improve the design of exercise-based prevention strategies for mental health.

Study Methods and Participants

The researchers analyzed data from a general health assessment administered during an annual review to a large number of Swedish employees. The sample was made up of 36,595 middle-aged men and women with an average age of 41. The link between exercise and mental health has been well-documented, and prior systematic review and meta analysis research supports that connection. The questionnaires asked respondents how many times a week they had exercised in the past 30 days and how often they had experienced “worry, depressed mood or anxiety.” An integrative review has also linked exercise to mental health mechanisms, though findings are still preliminary evidence on which specific exercise variables matter most. They also completed a test of cardiorespiratory fitness on a stationary bicycle and were then classified as either low, medium or high CRF.

Key Findings

First, in a workplace annual review or employee health assessment, the researchers found evidence that more frequent exercise was linked to improved mental health. Respondents who reported exercising at least 1-2 times a week were less likely to report symptoms of depression and anxiety, even after accounting for sedentary behavior — which was measured as the amount of leisure time participants reported spending sitting still.

As the researchers explain, sedentary behavior appears to play an important role in the link between exercise and mental health . Another study led by Hallgren found evidence that passive sedentary behaviors, such as TV-watching, increase depressive symptoms while mentally-active sedentary behaviors may actually prevent them. That fits with the many benefits linked to movement, including psychological benefits that support both mood and daily functioning.

Interestingly, cardiorespiratory fitness appeared to be less important when it came to the prevention of mental health symptoms. While respondents in the medium and high CRF groups reported fewer symptoms of depression and anxiety, this effect disappeared when sedentary behavior was taken into account. Even so, regular aerobic activity can still support cardiovascular health and improve blood flow, which may help explain part of exercise’s effect on mood.

“Taken together,” Hallgren and colleagues report, “this suggests that high CRF may not be necessary to prevent common mental health symptoms. Instead, regular participation in a preferred form of structured exercise may be of greater relative importance.” Exercise also helps the cardiovascular system adapt to stress, and that may strengthen the brain's ability to regulate emotion and stay resilient.

The researchers discuss the possibility that the impact of cardiorespiratory fitness may only be relevant when comparing people with very low CRF levels to those with higher levels. Previous research suggests that CRF appears to be most beneficial to somatic health when looking at improvements among those with low fitness levels. It could be that the current study’s sample, which was made up exclusively of employed persons, did not include enough people with low fitness levels to capture such an effect. In that sense, gains in physical health may still matter because they can contribute to better long-term mental outcomes.

Study Limitations

A substantial limitation was that symptoms of depression and anxiety were measured using a single item, and the researchers stress that this measure does not reflect a diagnosis of depression or anxiety. Moreover, symptoms of anxiety and symptoms of depression are distinct and would be better assessed separately in future studies.

The researchers conclude that regular exercise may be enough to lower anxiety and depressive symptoms among most people, and aerobic exercise increases cardiovascular fitness and circulation, helping deliver oxygen to brain tissue. Those changes can boost memory, focus, and emotional processing in the hippocampus while also strengthening the brain’s ability to adapt, while it may be useful to encourage exercises that boost CRF among people with particularly low levels of fitness.

Interestingly, cardiorespiratory fitness appeared to be less important, but regular activity still supports the broader cardiovascular system and may help lower blood pressure.

Taken together, this suggests the mental benefits of cardio do not depend only on CRF, and cardio still offers broad physical and psychological benefits, including support for blood pressure.

The study, “ Associations of exercise frequency and cardiorespiratory fitness with symptoms of depression and anxiety – a cross-sectional study of 36,595 adults ”, was authored by Mats Hallgren, Aaron Kandola, Brendon Stubbs, Thi-Thuy-Dung Nguyen, Peter Wallin, Gunnar Andersson, and Elin Ekblom-Bak. Aerobic exercise also stimulates Brain-Derived Neurotrophic Factor, which supports the growth of new nerve cells and encourages new blood vessels, changes that may also help with high blood pressure. Over time, regular exercise can prevent age-related cognitive decline and may reduce the risk of neurodegenerative conditions.

Frequently Asked Questions About Mental Benefit of Cardio

Comprehensive Mental Health Care in Orange County

At Orange Coast Psychiatric Associates , we understand the powerful connection between physical and mental health. If you or a loved one in the greater Orange County, California area are struggling with anxiety, depression, trauma, relationship difficulties, or other mental health conditions, our expert team is here to help. We offer comprehensive psychiatric evaluations, medication management, and individual and couples psychotherapy , as well as integrative health and wellness programs tailored to your needs.

Take the first step toward a healthier mind and body— schedule your appointment with Orange Coast Psychiatric Associates today and learn how incorporating cardiovascular exercise and other healthy habits can support your mental well-being.

Call us at (949) 282-0027 or visit our website to get started on your journey to better mental health.

Young People Hit Hardest By Loneliness And Depression During Covid-19

Mon, 26 Jul 2021 19:59:31 GMT

Young people are more likely to suffer mental health problems during the pandemic than any age group

Loneliness can be a risk factor in a range of health issues, including depression, anxiety, substance abuse, and domestic abuse. All problems that are unsurprisingly increasing as we continue to remain isolated during the pandemic. However it would appear that one demographic is feeling the effects of isolation more than others. A CDC online survey indicates that young people between the ages of 18-24 are more likely to suffer mental health problems during the pandemic than any age group.

According to this survey, 63% of young people are suffering significant symptoms of anxiety or depression. Nearly a quarter of respondents reported that they had started or increased their abuse of substances, including alcohol, marijuana and prescription drugs, to cope with their emotions.Their experiences during the pandemic put them at risk of developing Covid-19 related PTSD. This is a general problem developing throughout society but felt acutely by young adults. This data quantifies an alarming trend that we have seen emerge anecdotally, that the pandemic will have a long lasting impact on the mental health of young people.

One of the authors of the study, Mark Czeisler is hoping to conduct further research into why this particular demographic is so affected. He is currently looking into the extent in which people can tolerate uncertainty, or “the ability to accept the unknown, because now there are so many questions, especially for young people, about relative risk, duration of the pandemic and what their futures will look like.”

For young people who are navigating choices about higher education, their careers, building relationships or deciding when to start a family, the uncertainty of the pandemic can add pressure to already stressful decisions. They may feel like their options are restricted or like their lives are on an endless pause during a critical developmental stage. Teenage and young adult brains are wired for new experiences and that developmental need is not being met. These stressors are in addition to the anxiety we all feel about our health and the health of our loved ones.

Richard Weissbourd, a psychologist and senior lecturer at the Harvard Graduate School of Education helped lead a study conducted last October by researchers at Making Care Common which further reinforced the results of the CDC survey. The study highlighted the rising trend in loneliness among young adults compared to the elderly. As discussed, loneliness is at the root of many mental health Issues. In a national survey, of approximately 950 Americans, 36 percent reported feeling lonely “frequently” or “almost all the time” in the past four weeks. Sixty-one percent of the respondents aged 18 to 25 reported high levels of loneliness.

Weissbourd suggests that young adults’ loneliness may be caused by the transition between “inherited families [and] chosen families”— friends who share a strong emotional bond may be unavailable to young adults when they are locked down with their family members at home. A 2016 report published in the journal Pediatric Clinics of North America cited research that found one-third of gay, lesbian and bisexual youth experienced parental rejection due to their sexual orientation. For this and other reasons, many people in LGBTQ community form “chosen families”. Since chosen families often don’t live together, many have been unable to see each other during the pandemic. Like others they may have lost close ones to Covid-19 and they aren’t able to access the in person support of their communities to grieve. Even those who have not been outright rejected by their “inherited families” may feel a disconnect between their families personal beliefs and their own and are therefore less likely to reach out to them for emotional support.

Students in college may struggle with anxiety and lack social support if they are unable to return home to their families and may struggle to make new connections during the pandemic like they might normally do in classes at school. Meaningful relationships act as critical guardrails against loneliness and the more lonely young adults feel, the greater the toll on their mental wellbeing. We cannot underestimate the impact of peer support on mental health during this time.

The Making Care Common study highlighted how emotions like loneliness are further intensified when questions about the reliability of relationships surface. The survey showed that those who reported higher feelings of loneliness, felt that they reached out and listened to people more often, and such efforts were not reciprocated from the other end – causing them to feel as if no one “genuinely cared” about them. Friendships have also been strained and fractured over differing opinions about what is considered “safe” during the pandemic. This could result in reduced social support networks even after the pandemic is over.

With the long stretches of time spent away from friends and family, young adults tend to use social media as an outlet and form of connectivity with the world around them. Connections on social media can sometimes create solidarity and help build a support system. Yet as we are well aware, dialogues on social media can quickly turn toxic and trigger negative emotions.

Weissbourd and his team argue that tackling loneliness and associated mental health issues would require a “robust social infrastructure” and suggests that key social and cultural institutions including workplaces, schools and colleges, and religious and secular community organizations, can be far more intentional and systematic about connecting us to each other through events and initiatives. These institutions can also encourage and support the behaviors and skills needed in caring for those who are lonely. Outside of these systems, we can also look to our health systems to address these issues. Doctors can incorporate questions about loneliness in annual physical checkups, and later help connect those struggling to treatment, resources, and support groups.

Often loneliness is stigmatized which undermines its severity. Public education campaigns can have a huge impact on removing and alleviating the stigma of loneliness. An Australian suicide prevention organization runs a national annual “R U OK? Day” with the goal of encouraging Australians to meaningfully connect with the people around them and start a conversation with anyone who may be struggling with life. Participants who were exposed to the R U OK? Day campaign were up to six times more likely to reach out to someone who might be experiencing personal difficulties compared to those not exposed to the campaign. A similar program could be adopted in the U.S. for loneliness and other mental health issues.

Weissbourd and his team suggest a similar approach encouraging everyone to reach out and check in on the young people around them—a simple hello can have a major impact on how young adults feel during these unpredictable times.

This article originally published by Forbes

By the William A. Haseltine

ADHD statistics 2021

Mon, 26 Jul 2021 19:21:17 GMT

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders among children in the U.S.

A restless, easily distracted child is more common than not, especially in the school-age range. However, when these actions interfere with his or her school work and result in frequent disciplinary action, parents might wonder if there’s more to this behavior than kids just being kids. Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders among children in the U.S., as supported by the ADHD statistics in our guide below. Fortunately, there are multiple medications and types of behavioral therapy to help children and adults with ADHD.

What is ADHD?

Attention deficit hyperactivity disorder (ADHD) is a common disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. Behaviors, or symptoms, of ADHD include chronic inattention, hyperactivity, and impulsivity. Many are diagnosed with ADHD as children, as symptoms become prominent in early development and academic work. ADHD symptoms can persist into adulthood and affect one’s social relationships as well as academic and work performance.

“ADHD is a neurological disorder, although the exact cause has yet to be determined,” says Gabriel Villarreal , LPC, a counselor at ADHD Counseling in the Roanoke Valley in Virginia. “What we know is that it occurs when the prefrontal cortex growth lags behind the rest of the brain.”

“The earliest we can diagnose this disparity is 3 years old,” Villarreal says. “However, [people with ADHD] also have a lack or don’t as readily produce neurochemicals in the brain, specifically dopamine and norepinephrine. The former is responsible for attention, drive, and motivation. The latter, is responsible for creating calm, it’s what’s partially responsible for the [hyperactivity].”

How common is ADHD?

Worldwide surveys have demonstrated that the prevalence of ADHD is higher in higher-income countries. (ADHD Attention Deficit and Hyperactivity Disorders, 2017)
The U.S. lifetime prevalence of ADHD among children is rising with the latest estimates at 11%. (National Institute of Mental Health, 2017)
An estimated 6.1 million American children aged 2-17 years old had ever received a diagnosis of ADHD, representing 9.4% of this total age-group nationwide as of 2016. (Journal of Clinical Child and Adolescent Psychology, 2018)
Boys are more than twice as likely than girls to have ever been diagnosed with ADHD. (Journal of Clinical Child and Adolescent Psychology, 2018)
The worldwide prevalence of adult ADHD is estimated at 2.5%. (Royal College of Psychiatrists, 2009)
The U.S. lifetime prevalence of ADHD in adults aged 18 to 44 years of age is estimated to be 8.1%, with current prevalence estimated to be 4.4%. (National Institute of Mental Health, 2017)

ADHD statistics in children

The percentage of children ever diagnosed with ADHD increases with age. Surveys show 2.4% (388,000) of children aged 2 to 5 years old, and 9.6% (2.4 million) of children aged 6 to 11 years old have been diagnosed with ADHD.
The median age of diagnosis for severe ADHD is 4 years old.
The median age of diagnosis for moderate ADHD is 6 years old.
The median age of diagnosis for mild ADHD is 7 years old.

(Journal of the American Academy of Child and Adolescent Psychiatry, 2014 & 2018)

ADHD statistics in teens

The following figures represent the estimated percentage of adolescents with ADHD per age group:

Ages 13 to 14: 8.8%
Ages 15 to 16: 8.6%
Ages 17 to 18: 9%
Of all adolescent ADHD cases, 4.2% showed severe impairment. Impairment criteria were based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

(Journal of the American Academy of Child and Adolescent Psychiatry, 2010)

ADHD statistics in adults

ADHD prevalence among adults was 4.4% in the U.S. as of 2001-2003, according to Harvard Medical School. However, the rate of ADHD in adults is likely underreported as 85% of children with ADHD will likely have the disorder as adults. Diagnostic criteria for ADHD were initially developed for children, and therefore, the diagnosis of ADHD among adults is growing four times faster than ADHD diagnoses among children in America (JAMA Psychiatry, 2019). The following figures represent the known estimated percentage of adults with ADHD per age group:

Ages 18 to 24: 4.5%
Ages 25 to 34: 3.8%
Ages 35 to 44: 4.6%

(Harvard Medical School, 2007)

“Research suggests that the majority of youth with ADHD will also have ADHD as adults,” says Nekeshia Hammond , Psy.D, a psychologist at Hammond Psychology and Associates in Florida. “One critical thing for youth to do is learn to manage their ADHD symptoms, which may positively impact their adult outcomes. Anecdotally, some adults have described experiencing milder impairments in functioning because they have learned triggers and ways to cope with their ADHD symptoms.”

Some adults previously diagnosed with ADHD have learned to cope with their symptoms well and do not meet the criteria for ADHD later in their life. “They would not necessarily meet ‘full criteria’ for ADHD (they may still have some of the attention symptoms, but not enough to receive a diagnosis),” Dr. Hammond says. “Most research suggests that ADHD does not really ‘ go away ,’ but more so adults report less symptoms. For instance, hyperactivity symptoms typically decrease with age.” Only 11% of adults with ADHD receive treatment.

In addition, some adults may go undiagnosed and therefore untreated because of co-occurring mental health conditions that mask the symptoms of ADHD . These include:

Anxiety disorder: 47%
Mood disorders: 38%
Impulse control: 20%
Substance abuse disorders: 15%

(Primary Care Companion to the Journal of Clinical Psychiatry, 2009)

ADHD in the classroom

“Sometimes children can interrupt or ‘blurt out’ answers often, which also impacts social interactions,” Dr. Hammond explains. “At other times, some youth can have problems with self-control, leading to verbal or physical altercations with other students.”

She says that each child’s academic experience is different. “Some children struggle academically due to significant difficulties with attention and/or hyperactivity, whereas other students who have learned to cope with the ADHD symptoms may experience less academic disruptions,” she says.

“Schools can accommodate children with ADHD with modifications in the classroom,” says Dr. Hammond. “Some examples of modifications include, but are not limited to: taking additional breaks, assigned seating arrangement (e.g. sitting closer to the teacher), extended time on tests, quizzes, and assignments, as well as taking tests in a separate setting to reduce distractions.”

The 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome identified that the majority of students with ADHD (69.3%) received one or more school services. Individualized education plans (IEP) and section 504 plans are two possible school services for students with special education requirements or needs (Journal of Attention Disorders, 2018).

According to the Centers for Disease Control and Prevention (CDC), IEPs and 504 plans provide:

Extra time on tests
Assignments tailored to the child
Positive reinforcement
Technology-assisted tasks
Additional breaks
Changes to the classroom to limit distraction
Additional help with organization

Another study used data from this survey and found that children 4 to 17 years old with ADHD received one or more of the following behavioral treatments:

31% received parent-delivered behavior therapy
39% received social skills training (such as support in how to interact with others)
30% received peer interventions (such as peer tutoring)
20% received cognitive behavioral therapy

(Journal of Pediatrics, 2018)

ADHD treatment statistics

The most effective ADHD treatment is a combination of medication and behavioral therapy. Stimulant medications, like Adderall and Ritalin, are usually prescribed first. If stimulants don’t work, a healthcare provider might try a non-stimulant medication such as Strattera. These medications affect dopamine and/or norepinephrine to help patients concentrate and feel less impulsive.

Cognitive behavioral therapy (CBT) is a popular form of behavioral treatment for people, especially children, with ADHD. A professional therapist can teach children how to express their thoughts and feelings without being disruptive to others. Parents and teachers can also gain insight through CBT for learning how to reward positive behaviors.

As of 2016, 77% of children with ADHD aged 2 to 17 were receiving some form of treatment, with approximately one-third (32%) receiving both medication and behavioral treatment.

62% take ADHD medication, the majority of which are aged 6 to 11 years old.
30% take medication alone.
47% receive behavioral treatment, the majority of which are aged 2 to 5 years old.
15% receive only behavioral treatment.

(Journal of Clinical Child and Adolescent Psychology, 2018)

ADHD research

National comorbidity study replication (NCS-R) , Harvard Medical School
Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003-2011. , Journal of the American Academy of Child and Adolescent Psychiatry
Lifetime prevalence of mental disorders in U.S. adolescents , Journal of the American Academy of Child and Adolescent Psychiatry
Prevalence of parent-reported ADHD diagnosis and associated treatment among U.S. children and adolescents, Journal of Clinical Child and Adolescent Psychology
Trends in the prevalence and incidence of attention-deficit hyperactivity disorder among adults and children of different racial and ethnic groups , JAMA Psychiatry
Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition, American Psychiatric Association
Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis , Royal College of Psychiatrists
The descriptive epidemiology of DSM-IV adult ADHD in the World Health Organization World Mental Health Surveys , ADHD Attention Deficit Hyperactivity Disorders
Assessing adults with ADHD and comorbidities , Primary Care Companion to the Journal of Clinical Psychiatry
A national description of treatment among U.S. children and adolescents with ADHD , Journal of Pediatrics
Predictors of receipt of school services in a national sample of youth with ADHD , Journal of Attention Disorders
ADHD in the classroom , Centers for Disease Control and Prevention (CDC)

This article originally published by SingleCare

By the SingleCare Team

Transcranial Magnetic Stimulation (TMS) Treats Depression

Mon, 26 Jul 2021 19:10:21 GMT

A new, noninvasive treatment for depression.

Depression affects 121 million people worldwide and 35 million Americans . It is estimated that 60 percent of the depressed population does not receive adequate care.

Among those that do receive care, treatment resistant depression represents a severe category which does not respond to traditional methods, be it therapy, multiple types of medications or a combination of the two. Recent studies indicate that TMS , or Transcranial Magnetic Stimulation, may provide relief without a pill.

This is about to get complicated, but I’ll simplify it as much as possible. The brain is comprised of 85 billion brain cells better known as neurons. These communicate in two ways. Within the neuron , electrical energy carries a signal from one end of the cell to the other. In between the neurons, in the synaptic cleft , brain chemicals (called neurotransmitters ) are released to carry a message from one cell to another.

Antidepressants work on the chemical side of the brain affecting various neurotransmitters including norepinephrine, serotonin, dopamine and others. The predominant theory in biologic depression is that these brain chemicals become out of alignment and that meds “normalize” brain chemistry. These meds can work in a variety of ways by increasing or decreasing neurotransmitters, acting as substitute neurotransmitters, regulating the receptors that these chemicals bind to… The list goes on and is extremely complex.

TMS, on the other hand, targets the electrical activity within the neuron. On the surface this sound completely different than antidepressants, but it’s not. The electrical activity inside each neuron stimulates chemical release into the gap between the neurons. Though the exact mechanism of action is not known, it is thought that magnetic impulses from TMS stimulates nerve cells which increases brain activity. This triggers a release of brain chemicals into the synaptic cleft. The end result is also thought to be a normalization of the neurotransmitters within the cleft.

This is a relatively new, noninvasive treatment which has been proven to treat clinical depression even when prior conventional methods have failed. TMS treatments are administered in a psychiatrist's office. An electromagnet electrode is placed near the forehead and delivers magnetic pulses (approximately the strength of an MRI scan) to the brain. The session lasts for about 40 minutes. There is no sedation needed, and treatments are daily.

Numerous studies have validated the efficacy of TMS. A recent study , looking at 257 patients found that 45% maintained a full remission at 12 months, while 68% showed improvement. The FDA approved TMS in 2008 for adults.

TMS is not to be confused with ECT, or shock therapy. ECT requires anesthesia and consists of an electrical shock which triggers a seizure. TMS uses a magnetic field and is performed on an awake patient. There are vastly fewer side effects and TMS is easier to perform. Most importantly, the patient can drive themselves to and from the appointment and then go back to work right after the treatment.

TMS is the newest, most innovative procedure to combat resistant depression. It is an option for those who don't respond to one or two trials of medication or have experienced intolerable side effects. There is now a push among providers of TMS to allow it to be used as a first line treatment.

It sounds all good, but there is a downside. Treatments are very time consuming: five days a week and almost an hour a day for six weeks. And the cost for a full series will be in the neighborhood of $10,000. Insurance is gradually starting to pay, depending on the state and for some medication must be continued, both during the treatments and after.

The bottom line is that TMS is a great new addition to our armamentarium in the fight to cure depression, especially for those who have failed medication. Of course psychotherapy should still be the preferred first line treatment for new onset depression, as this is the least invasive and most cost-effective of all.

This article originally published by Psychology Today

By Dale Archer, MD