Waiting for today...: Surviving the Moods Swings

Surviving the Moods Swings

A list of items that I’ve incorporated and would like to incorporate into my lifestyle to help keep my mood stable.  

Diet: Hydration
In a study at the University of Connecticut, it was found that mild dehydration in women caused headaches, fatigue and difficulty concentrating.  Although the men in this study also experienced symptoms when mildly dehydrated, the adverse changes in mood were significantly greater in women. Experts recommended to drink eight 8 ounce glasses, approximately 2 liters, of water daily to avoid dehydration.  Mild dehydration can occur during normal activities.   
On very busy days, I easily get dehydrated.  I often get carried away in the workflow and  simply take no thought of the fact that my body is losing water. That is  until the fatigue has settled in. By then, rehydration is an uphill struggle.  In the meantime, I become sluggish and eventually begin to feeling inadequate as things pile up.   
When depressed… I do not fill up my Brita pitcher.  But I don’t like the taste of tap water.  So during these times, keeping a stock of 1 liter bottled water at home.  If I only drink 1 bottle per day it would help avoid severe dehydration.
Source: Nauert, R. (2012). Dehydration Influences Mood, Cognition. Psych Central. Retrieved on July 2, 2014, from http://psychcentral.com/news/2012/02/20/dehydration-influences-mood-cognition/35037.html

Diet: Nutrition
According to the National Center on Health, Physical Activity and Disability (NCHPAD), good nutrition is important when it comes to mood and a sense of well-being. Referencing the old adage, “you are what you eat”, the NCHPAD briefly illustrates how the chemicals in food affect our brain and mood.  For instance, many depression sufferers admit to having an irritable mood: thiamine deficiency can lead to irritability. Another common symptom of depression is insomnia: folate deficiency can result in insufficient sleep.  A balanced diet consists of fresh fruit and vegetables, lean proteins and whole grains and limits processed sugars and saturated fats and supports a healthy lifestyle.  The NCHPAD also cites the timing of meals as important as the content of the meal itself.
I have always been inconsistent when it comes to eating good eating habits. Every time I’ve decided to eat better, I start strong and with much enthusiasm. I feel great!  My mood and energy is high as a result and I’ confident in my ability to commit to a lifestyle of healthy eating indefinitely. Then, I get bored. Fast food and comfort foods begin to look good once again and I cave.  I feel stuck in this vicious cycle.   A short time ago I succumbed to fact that I need help balancing my diet.  After gaining 50 lbs. in one year, I called on Jenny Craig to not only help teach and guide me but to also feed me.
When depressed...  I don’t care about a balanced diet much less meal planning.  I want what I want, when I want it and that’s all I want.  Unfortunately that involves Popeye’s, Bojangle’s, Wendy’s and fried chicken wings… from anywhere.  During the low’s I try to make the better choice when I have the strength.  That means choosing Chipotle, Chik-fil-a, Tropical Smoothie or Subway instead.  Also, keeping Ensure, Vitamin Water and vitamin gummies readily available helps to replace some needed nutrients as the choices above are not nutrient dense.
Source: National Center on Health, Physical Activity and Disability. (n.d.). Food and Your Mood: Nutrition and Mental Health.  Retrieved November 25the, 2014 from http://www.nchpad.org/606/2558/Food~and~Your~Mood~~Nutrition~and~Mental~Health

Exercise
No one can deny the physical benefits of exercise.   However, not everyone knows there is also overwhelming evidence that exercise  improves mood.   During exercise the brain releases chemicals that induce feelings of well-being and promote a sense of clarity.   Research shows that as little as 20 minutes of moderate exercise per day is enough to benefit from the release of these chemicals.   Furthermore, with consistency and time the brain is trained to associate exercise with mood-enhancement.
Exercise is yet another area in my life in which I am most inconsistent.  When I think of exercise I think of pain, sweat and labored breathing.  I also think of having to go through the motions of getting dressed, packing a gym bag, warming up, cooling down, stretching, getting enough water, enough electrolytes, enough protein… it’s just too much!  After wasting money on gym memberships, workout DVD’s and active wear I’ve come to the conclusion that I don’t like exercise.   Today, I’m just focused on moving more.   Wearing a pedometer to track how many steps I take per day, taking the stairs instead of the elevator and walking to the store instead of driving are just a few ways I’m incorporating more moving into my day.   I’ve found that even a 10 minute walk makes me feel accomplished, motivated and lively.
When depressed…  I don’t want to leave my apartment.  Therefore “moving more” is out of the question.  But knowing how important fresh air and sunshine is during these times, I aim to put a jacket over my pajamas and walk around the block at least once, a couple times per week.

Source: Whitney, D. (2012). Exercise: Nature’s Mood Enhancer. Psych Central. Retrieved on November 25, 2014, from http://psychcentral.com/blog/archives/2012/10/24/exercise-natures-mood-enhancer/

Faith
There is a correlation between faith, or spirituality, and emotional wellbeing.  In depression, sufferers often feel out of control which in turn makes them feel powerless over their circumstance.  In times like these, the spiritual minded often turn to a Higher Power for help. This help can come in the form of  support from a community with similar beliefs and words of wisdom from sacred scriptures, for example.  All of these help to push the depressed out of painful isolation and away from the thought that they must go it alone.  
I have always felt a presence of something, someone greater than us.  I find my faith in God the Father of Jesus Christ helps me to view life with a more positive mindset.  I feel my strongest when I am filled with scripture and in a prayerful attitude.  I am also rejuvenated by fellowship with other believers.
When depressed… hopelessness becomes my closest but unwanted companion.  Listening to sermons on my tablet or phone helps to increase my faith and restore my hope.
Source: Govan, M. (n.d.). How Having A Little Faith Can Ease Depression [Web log post]. Retrieved on July 2nd, 2014 from http://www.pbs.org/thisemotionallife/blogs/how-having-little-faith-can-ease-your-depression

Journaling
Studies have shown there is improvement in the overall well-being of those who write out their sorrows and difficult experiences.  The flow of writing takes the depressed mind out of the vicious cycle of dreary thoughts.  In specific study, students were asked to write on a particular topic 15 minutes per day for 4 consecutive days.  It was found that the students that chose to write about their emotions had fewer doctor’s visits for the remainder of the school year.
Writing has always helped me to cope with various insults that come with living. Through the distraction, I am able to find enough happiness to get me from here to there.
When depressed…  It can go either way.  So I’ve made journaling a part of my self-care routine.
Source: Perry, S.K. (2014, May 15). Why Writing Is So Good For You [Web log post]. Psychology Today. Retrieved on June 3rd, 2014 from http://www.psychologytoday.com/blog/creating-in-flow/201405/why-writing-is-so-good-you

Laughter
Laughter is considered a powerful antidote for the mind and body.  It helps to relax the body, boost the immune system and trigger the release of happy hormones called “endorphins”.  Because you can’t feel anxious, angry or sad when laughing there is a positive link between laughter and mental health. Laughing also helps to shift perspectives which in turn helps stave off the feeling of being overwhelmed.    
Humor and laughter helps me forget about the troubles of living.  My mood lifts and I’m given a shot of optimism, a boost of energy to continue on.
When depressed…  I keep comic relief favorites in my Netflix queue and bookmarked on Youtube mobile.  
Source:  Smith, M. & Segal, J. (2014, April). Laughter is the Best Medicine The Health Benefits of Humor and Laughter. Helpguide.org. Retrieved July 3rd, 2014 from http://www.helpguide.org/life/humor_laughter_health.htm

Massage
The Chinese believe that touch releases hormones inside us that bind us to the other human being, thereby relieving feelings of alienation.  In massage therapy layers of muscle and tissue are manipulated through touch to enhance function and promote relaxation.  According to Dr. Mason Turner, massage can help relieve the muscle tension associated with depression.  He adds that massage can also help a person connect their mind and body, which can improve overall health and assist with stress management.
Shortly after nursing school and relocating, I recognized the need for a routine stress management regimen to include massage.  However, it wasn’t until two months after my depression lifted did I gave it a second thought.  Massage therapy leaves me relaxed.  My mind is free of worry during that hour and I’m left more relaxed with a lighter mood and a freer spirit.
When depressed…  Its difficult to say.  I would want to increase the frequency of my sessions from twice a month to once per week. However it is not realistic as it is difficult enough for me to accomplish simple self-care tasks.
Source: Krans, B. (n.d.). Massage Therapy. Healthline. Retrieved July 3rd, 2014 from http://www.healthline.com/health/


Medication
Antidepressant
Primarily used for severe depression, antidepressants can also be used to help reduce the symptoms of milder depression.  There are four classes of antidepressants, the most popular being selective serotonin reuptake inhibitors or SSRI’s.  The type of medication prescribed is based on the individual’s symptoms whereas the dose is based on multiple factors including the type of medication and the individual’s body chemistry. The effectiveness and side effects of antidepressants vary among individuals. Antidepressants are prescribed by licensed psychiatrists.
Mood Stabilizer
Mood stabilizers are typically used to treat bipolar disorder, also known as manic-depression.   The oldest mood stabilizer is Lithium.   Today, a few antiseizure medications have been found to be effective in the treatment of one pole of the disorder, mania or depression.   Mood stabilizers are sometimes used in conjunction with antidepressants to augment the effects of the mood stabilizer or to prevent antidepressant induced mania.   However, these medications are also effective when taken alone.  The effectiveness and side effects of mood stabilizers vary among individuals.  Mood stabilizers are prescribed by licensed psychiatrists.  
For years, I was adamant about not taking medication to treat my depression. Finally resting on the belief that God is the creator and sustainer of all things, I decided to call on a type of faith that may be viewed as unconventional.  That faith convinced me that God heals in the manner in which He sees fit and not according to what makes sense to us (Isaiah 55:8-9).  Just as God cleansed Naaman of his leprosy by way of the Jordan River (2 Kings 5:1-14), God would also relieve my depression by way of medication.  
When depressed...  I have the option of seeing my psychiatrist for an adjustment.  That is if my current dosage of medication becomes ineffective.  I would like that to be an absolute last resort, however.  As I grow in grace and learn to take full accountability for my own wellness, I believe I will experience longer and longer periods of normality with or without medication.
Sources: Psych Central. (2006). Antidepressant Medications. Psych Central. Retrieved on July 4, 2014, from http://psychcentral.com/lib/antidepressant-medications/000451
Smith, M. & Segal, J. (n.d.). Types of Antidepressants and Their Side Effects. Helpguide.org. Retrieved July 3rd, 2014 from http://www.helpguide.org/mental/types_of_antidepressants.htm
Aetna. (2011, October 6th). Mood Stabilizers. Intelihealth. Retrieved July 3rd, 2014 from http://www.intelihealth.com/article/mood-stabilizers
Schimelpfening, N. (2011, September 01). What Are Mood Stabilizers. About.com. Retrieved July 3rd, 2011 from http://depression.about.com/od/druginformation/f/moodstabilizer.htm


Mindfulness

While mindfulness is at the core of Buddhist meditation, Westerners have adopted its practice as part of a holistic approach to mental wellness.  In mindfulness focus is placed on the present moment; being aware of it and accepting of it.  When faced with a stressful circumstance, the stress is usually intensified by the person’s emotions. This could be due to negative thinking, ruminating and self-blaming which then narrows their attention to focus only on the bad.  Mindfulness practice helps a person feel the stress and the emotion without intensifying it thereby expanding their awareness to include what is good about situation.  With consistent practice, a person will notice a lessening of anxiety, stress and depression.  Mindfulness also boosts intelligence, creativity and resiliency.       

One of the first student organizations I joined in college was a meditation group. My interest was always piqued and I figured since I was embarking on one of the most difficult journeys in my life it was time to learn the practice.  Sadly, the only thing I learned was power naps are indeed refreshing.  I learned of mindfulness meditation from my therapist.   Because of my college experience, I initially didn’t buy into.  Then something clicked and I purchased Mindfulness for Dummies1 to gain a greater perspective of the practice.   After my first 5 minute practice, my mind was clear, I felt relaxed and I was also sold on the practice.

When depressed...  I did not begin practicing mindfulness until after my acute depression in October 2014.  However, my plan for future acute episodes would be to listen to calm meditation radio for a few minutes a day until I can muster the courage and willpower to do a 3 to 5 minute exercise a couple times per week.

Source: Experts, Y. (2011). Using Mindfulness To Alter Your Mood. Psych Central. Retrieved on November 26, 2014, from
Penman, D. (October, 2011). Mindfulness Meditation Will Make You Tougher Too. PsychologyToday. Retrieved on November 26, 2014 from
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Psychotherapy
Also called “talk therapy”, psychotherapy is a general term for the treatment of mental health problems.   During these sessions, “you learn about your condition and your moods, feelings, thoughts and behaviors.”  A psychotherapist can be a psychiatrist, a psychologist, a licensed social worker or any other professional with mental health training.  Psychotherapy not only treats mental health disorders, but also helps individuals cope with many of life’s stressors that can affect anyone and can be as effective as medications.
I always thought of myself as deeply introspective.  Once I began therapy, however, I realized that there was much I was missing.  With therapy came clarity.  With clarity I was able to finally begin reclaiming the life that I lost prior to depression.  
When depressed…  I can usually get an appointment with my therapist within a day or two, during a crisis.  I would then continue to see my therapist no less than once per week until I am out of crisis.  I am currently seeing my therapist once a month.
Source: Mayo Clinic. (2013, June 5th). Tests and Procedures Psychotherapy.  Retrieved July 3rd, 2014 from http://www.mayoclinic.org/tests-procedures/psychotherapy/basics/definition/prc-20013335

Sleep
Many have experienced firsthand the effects of poor sleep habits, namely sleep deprivation.  Symptoms include irritability, mental exhaustion and stress to name a few. Studies have shown that even partial sleep deprivation will affect mood.   Alternately, research shows that mood and mental states can affect sleep!  Anxiety and stress increases arousal thereby making it difficult to sleep.   In the case of insomnia, long-term effects include the development of depression and/or anxiety.   The average amount of sleep that is typically recommended for adults is no less than 8 hours per night.  However, according to the National Sleep Foundation, needs are based on factors such as age and gender but they are also individual.    For tips on how to improve sleep, see their infographic2.  
I am not a morning person.  If I close my eyes before 12:30 am, that means I am really exhausted.  I may still wake up at 7:30 am.  But after I feed the cat, I'm back off to bed until about 9:00 am.  At that point, I may shower, get myself some breakfast, do some reading or finish some housework.  Then it's a bit of TV before falling asleep again.  On a perfect day, my day actually starts after 12:00 noon.  Needless to say: I love my sleep.  Unfortunately, my job has me out the door between 8:30 and 9:30 am.  Thankfully, I work 12 hour shifts now. That's 3 to 4 days per week I get keep my routine.
When depressed...  It can go either way.  I can have a difficult time sleeping, tossing and turning or finding myself lying awake for hours.  Or I can intentionally oversleep in an effort to sidestep the feelings of sadness, hopelessness and worthlessness.  Insomnia and hypersomnia doesn't exist together, for me, in the same acute episode.  During my October 2014 episode I experienced insomnia for the first time.  My remedy was melatonin, a sleep mask and on occasion, earplugs.   Melatonin is a hormone made by the human body, sold over the counter in synthetic form1.  After trial and error, I found the right dosage for me.  Unfortunately, I don't have a solution for the hypersomnia.
Source: Division of Sleep Medicine at Harvard University. (December, 2008). Sleep and Mood. Retrieved on November 26, 2014 from http://healthysleep.med.harvard.edu/need-sleep/whats-in-it-for-you/mood
National Sleep Foundation. (2014). How Much Sleep Do We Really Need? Retrieved on December 12, 2014 from http://sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need

1 although sold over the counter, consult your primary care doctor prior to use

to be continued…


Do not be conformed to this world, but continuously be transformed by the renewing of your minds so that you may be able to determine what God's will is—what is proper, pleasing, and perfect.~ Romans 12:2 (International Standard Version)