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• Step-by-Step: Managing Stress When You Have Bipolar Disorder
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If you or a loved one struggles with bipolar disorder, you already know severe mood swings are only one of the many signs and symptoms. Energy levels, concentration and appetite can all be affected. Bipolar disorder has also been linked to insomnia, fatigue and health problems such as diabetes, heart disease and high blood pressure. These conditions can make the disorder harder to manage.
Bipolar disorder is commonly treated with medications and therapy. But research is showing that attention to diet and exercise can also be vital parts of any treatment plan. Healthy lifestyle habits may improve many of the common side effects of treatment, such as weight gain. Plus it can help regulate mood and sleep patterns.
Health at risk
One well-designed study showed that when compared to people with no history of mental illness, people with bipolar disorder were more likely to report:
• Poor exercise habits, including infrequent walking or strength exercises
• Poor eating habits, including having fewer than two daily meals
• Difficulty getting or cooking food
• Weight gain (at least 10 pounds in the past 6 months)
How diet and exercise can help
It’s common knowledge that a healthy diet and regular exercise are critical for maintaining a healthy weight and warding off chronic diseases. In addition:
The food you eat (and what you drink) can also have an effect on blood sugar as well as brain chemicals, both which affect the way you feel. Sugar, processed foods, caffeine and alcohol are more likely to contribute to mood disturbance. Foods such as vegetables, fruits, oil-rich fish, beans and whole grains may be more likely to help stabilize mood.
Exercise can also help to restore regular sleep and eating patterns. It can increase strength, reduce stress and help control weight. It is thought that exercise may also help with depression by generating more endorphins and boosting serotonin levels. These are two brain chemicals that have been linked with helping regulate moods.
Helpful guidelines
The following eating and exercise guidelines can get you started on the right track:
Eat regular meals and snacks.The goal here is to keep your blood sugar from rising or falling dramatically.
• Don’t skip meals. Regular meals help make for a stable routine and fewer mood changes.
• Avoid fad diets or crash dieting. These can have negative effects on your mood and overall health.
• Eat regularly (and don’t overeat, especially before bedtime). Heavy meals at bedtime may interfere with restful sleep.
Limit simple carbohydrates. Sugars and simple carbohydrates may make you feel better in the short term, but they are often followed by a drop in blood sugar. This can cause your mood to take a downswing.
Limit sugar-sweetened beverages (iced tea, lemonade, soda), cakes, pastries, cookies, white flour breads, cereals, crackers and pastas.
Increase complex carbohydrates. Vegetables, fruits, whole grains and beans contain complex carbohydrates that enter your system slowly. This works to help prevent extreme swings in your blood sugar levels.
These nourishing foods also provide a host of important vitamins and minerals. Notably, they are rich in the B vitamin folic acid. Folic acid deficiencies have been linked to depression in clinical studies.
Include healthy fats, specifically omega-3. Though there is no conclusive evidence that omega-3 can help with mood, some experts do suggest omega-3 as an add-on to medication.
• Omega-3 fatty acids may be found in fatty fish and fish oils and to a lesser degree in flaxseed, flaxseed oil and walnuts.
• It can be hard to get enough omega-3 in the diet, so some experts suggest supplements, typically from fish oil.
• Talk to your doctor before you try omega-3 fatty acids or add any other supplement to your diet.
Avoid or strictly limit caffeine and alcohol. Watch what you drink.
• Too much caffeine can contribute to anxiety, nervousness and mood swings.
• Alcohol can worsen depression, interfere with sleep and make treatment less effective.
Talk to your doctor about an exercise program. Whether you choose walking, biking, hiking or dancing, try to include regularly scheduled activities that get your body moving.
• Start slowly, and talk to your doctor first.
• Ask about including strength training in your program. This can help build muscle tissue and is helpful for weight control and bone health.
• Make it a regular part of your routine. Regular daily activity may help stabilize your moods.

http://www.myoptumhealth.com/portal/Sponsored+Content/Sponsored+Content+for+Bipolar+Disorder

http://www.express.co.uk/posts/view/199595/Acupuncture-Chinese-needles-do-give-us-a-lift-

Q: Tell me about family members of yours — what have they struggled with?

A: My sister has bipolar disorder. She was first diagnosed with just depression about a decade ago and medicated for that, which really exacerbated the manic side of bipolar until she was properly diagnosed. She also had substance abuse, which made it even harder to diagnose and treat. Calen, my nephew, her son, was diagnosed with schizoaffective disorder around the same time.

Q: Have they bonded over their experiences?

A: Who wants a bond like that?

Q: And you also had a grandmother with depression?

A: I don’t think she was ever diagnosed. But it looms very large in my childhood memory. I also had an uncle who committed suicide. But we had no vocabulary for it. It wasn’t a time … The kind of culture my parents came from … it was considered a dumb thing to go to a psychiatrist, even though my dad was a medical doctor, a surgeon.

Q: Have you ever struggled with mental-health problems yourself?

A: Absolutely. There are times when I have sought help, when I’ve been on antidepressants. But I’m not a seriously depressed person. There are times when it helps you get through.

Q: You’ve been doing advocacy work to try to erase the stigma of mental illness.

A: There’s still a huge stigma. We need to get over the fear of saying it out loud — get rid of the shame.

A lot of people have approached me. They frequently say, “I’ve had mental illness in my family, too.” And I say, “What do you have?”

Close does advocacy work with bringchange2mind.org

http://www.usatoday.com/yourlife/health/medical/mentalhealth/2010-11-10-glenn-close-depression_N.htm

Visits for mental health concerns, like anxiety and acting out at school, were the only kind to increase during deployment; complaints for all physical problems declined, the study found.

Researchers have long known that deployment puts a strain on families, particularly spouses. Experts said the new study, being published in the journal Pediatrics and including more than half a million children, significantly fills out the picture of the entire family as multiple deployments have become a norm.

“This study gives us an excellent beginning to understand what’s happening” in military households, said Benjamin Karney, a psychologist at the University of California, Los Angeles. “It’s pretty amazing that they were able to look at essentially the entire military population and strongly document something we suspected was happening but didn’t know for sure.”

In the study, a research team led by Dr. Gregory H. Gorman of the Uniformed Services University of the Health Sciences analyzed the health records of 642,397 children ages 3 to 8 with parents in the military. It compared the frequency of health visits from 2006 to 2007 when a parent was deployed with those when the parent was home.

The researchers found that the children saw a doctor or other health professional about six times a year and about once every two years for a mental health reason. During deployment of a parent, however, the visit rate dropped by about 11 percent for physical problems but rose by 11 percent for psychological complaints. Stress, anxiety and attention-deficit problems were among the more common diagnoses, and mothers were far more likely than fathers to take a child to a doctor.

“It’s not clear yet whether kids are in fact suffering more mental problems when a parent is deployed, or that mothers are more attendant to any shift in behavior,” Dr. Karney said. “That’s the next question we have to ask.”

The rates were highest for 7- and 8-year-olds in two-parent families. This may be because when single parents deploy, children are left with caregivers who are less sensitive to changes in behavior and therefore less likely to seek treatment, the study’s authors suggested.

“These findings are especially important for nonmilitary pediatricians, who provide almost two-thirds of outpatient care for the children of military parents,” they concluded.

Despite the strain of duty, military marriages tend to be relatively stable, research suggests. In a recent study, Dr. Karney and John S. Crown of the RAND Corporation found time deployed was associated with a lower risk of divorce for most of the military, at least from 2002 to 2005.

By Benedict Carey

http://www.nytimes.com/2010/11/08/us/08child.html?_r=1&nl=todaysheadlines&emc=tha22

The Eugene resident was diagnosed with post traumatic stress disorder a few years ago. “I’m a survivor of sexual assault, that’s where the PTSD comes from,” Macdonald said.

Triggers like loud noises and crowds can cause Macdonald to have panic attacks and anxiety on a daily basis.

That’s where Daphne steps in.

“She helps me focus when I’m stressed out in public,” she said.

Daphne is a psychiatric service animal, traveling with Macdonald to the store and on public transportation.

But a month ago, Macdonald said, she was refused service by employees at a Eugene Dari Mart. The employee also questioned the dog’s service standing – and the owner’s disability – by saying, ‘”‘Oh, what is she gonna do? Go get that candy bar for you?” Macdonald recalled.

Local dog trainer Harold Hansen tells us that shouldn’t have happened. He said federal law prohibits businesses from asking why someone needs a service animal.

“The people in the store or the hotel or the restaurant can’t ask what’s your disability; that’s still illegal,” Hansen said. “But they can ask, ‘What job does your dog do?’”

Hansen says the dog must also do a job, meaning it has to assist the owner in some way. And that “way” can be anything from pulling a wheelchair to helping PTSD survivors through their day.

Macdonald said she hopes her experience will help educate others.

“I’m not blind, I’m not in a wheelchair, I don’t have an apparent physical disability,” she said. “I just feel like people need to know that there are lots of other things service animals do.”

A spokeswoman for Dari Mart told KATU’s Eugene sister station, KVAL, that its stores follow all state and national guidelines. The spokeswoman also said Dari Mart has signs clearly posted in all of its stores welcoming service animals.

http://www.katu.com/news/local/105605608.html

Excessive, ongoing worry and tension
An unrealistic view of problems
Restlessness or a feeling of being “edgy”
Irritability
Muscle tension
Headaches
Sweating
Difficulty concentrating
Nausea
The need to go to the bathroom frequently
Tiredness
Trouble falling or staying asleep
Trembling
Being easily startled
In addition, people with GAD often have other anxiety disorders (such as panic disorder, obsessive-compulsive disorder, and phobias), suffer from depression, and/or abuse drugs or alcohol.

What Causes GAD?
The exact cause of GAD is not fully known, but a number of factors — including genetics, brain chemistry, and environmental stresses — appear to contribute to its development.

Genetics: Some research suggests that family history plays a part in increasing the likelihood that a person will develop GAD. This means that the tendency to develop GAD may be passed on in families.
Brain chemistry: GAD has been associated with abnormal levels of certain neurotransmitters in the brain. Neurotransmitters are special chemical messengers that help move information from nerve cell to nerve cell. If the neurotransmitters are out of balance, messages cannot get through the brain properly. This can alter the way the brain reacts in certain situations, leading to anxiety.
Environmental factors: Trauma and stressful events, such as abuse, the death of a loved one, divorce, changing jobs or schools, may lead to GAD. GAD also may become worse during periods of stress. The use of and withdrawal from addictive substances, including alcohol, caffeine, and nicotine, can also worsen anxiety.
How Common Is GAD?
About 4 million adult Americans suffer from GAD during the course of a year. It most often begins in childhood or adolescence, but can begin in adulthood. It is more common in women than in men.

How Is GAD Diagnosed?
If symptoms of GAD are present, the doctor will begin an evaluation by asking questions about your medical history and performing a physical examination. Although there are no laboratory tests to specifically diagnose anxiety disorders, the doctor may use various tests to look for physical illness as the cause of the symptoms.

The doctor bases his or her diagnosis of GAD on reports of the intensity and duration of symptoms — including any problems with functioning caused by the symptoms. The doctor then determines if the symptoms and degree of dysfunction indicate a specific anxiety disorder. GAD is diagnosed if symptoms are present for more days than not during a period of at least six months. The symptoms also must interfere with daily living, such as causing you to miss work or school.

ow Is GAD Treated?
If no physical illness is found, you may be referred to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses like GAD. Treatment for GAD most often includes a combination of medication and cognitive-behavioral therapy.

Medication: Drugs are available to treat GAD and may be especially helpful for people whose anxiety is interfering with daily functioning. The medications most often used to treat GAD in the short-term are from a class of drugs called benzodiazepines. These medications are sometimes referred to as “tranquilizers,” because they leave you feeling calm and relaxed. They work by decreasing the physical symptoms of GAD, such as muscle tension and restlessness. Common benzodiazepines include Xanax, Librium, Valium and Ativan. Antidepressants, such as Paxil, Effexor, Prozac, Lexapro, and Zoloft, are also being used to treat GAD. These antidepressants may take a few weeks to start working but they’re more appropriate for long-term treatment of GAD.
Cognitive-behavioral therapy: People suffering from anxiety disorders often participate in this type of therapy, in which you learn to recognize and change thought patterns and behaviors that lead to anxious feelings. This type of therapy helps limit distorted thinking by looking at worries more realistically.
In addition, relaxation techniques, such as deep breathing and biofeedback, may help to control the muscle tension that often accompanies GAD.

Are There Side Effects of GAD Treatment?
Dependency on anti-anxiety medications (benzodiazepines) is a potential complication of treatment. Side effects of antidepressants vary by specific drug and the person taking them. Common side effects can include sleepiness, weight gain, and sexual problems.

What Is the Outlook for People With GAD?
Although many people with GAD cannot be cured and symptoms can return from time to time, most people gain substantial relief from their symptoms with proper treatment.

Can GAD Be Prevented?
Anxiety disorders like GAD cannot be prevented. However, there are some things that you can do to control or lessen symptoms, including:

Stop or reduce your consumption of products that contain caffeine, such as coffee, tea, cola, and chocolate.
Ask your doctor or pharmacist before taking any over-the-counter medicines or herbal remedies. Many contain chemicals that can increase anxiety symptoms.
Exercise daily and eat a healthy, balanced diet.
Seek counseling and support after a traumatic or disturbing experience.
Practice stress management techniques like yoga or meditation.

Taken from:

http://www.webmd.com/anxiety-panic/guide/generalized-anxiety-disorder

The study, which involved 1,013 children ages 10-11, found that those who spent more than two hours in front of a screen, whether watching TV, using a computer, or a combination, also were more likely to say they had trouble relating to friends and peer groups and to report feelings of unhappiness.

The children were told to wear accelerometers, devices attached to their waists that recorded their activities every 10 seconds during waking hours for seven straight days.

Working on a computerized questionnaire, the children then were asked about how much time daily they usually spent watching TV or using a computer for reasons other than doing homework. They also were asked questions such as whether they often felt unhappy, down-hearted, tearful, or lonely.

Scores were based on a “Strengths and Difficulties Questionnaire,” a well-known inventory designed to provide insights into the psychological well-being of young people.

The answers “combined to produce an overall score that indicates whether the child/young person is likely to have a significant problem,” study researcher Angie S. Page, PhD, of the University of Bristol in England, tells WebMD in an email. “It has five sections that cover details of emotional difficulties — conduct problems, hyperactivity or inattention,” and trouble relating to friends and peers.

The questionnaire “is only a screening tool that will provide predictions about how likely it is that a child or young person has significant mental health problems.”

Role of Physical Activity
Page tells WebMD that the study found “no evidence that sedentary time — time spent not moving or [engaging in] minimal movement — is related to negative psychological well-being. It seems more like what you are doing in that sedentary time that is important, [for example] if you choose to spend large numbers of hours screen viewing for entertainment then this is associated with negative mental well-being.”

Page tells WebMD that while low levels of screen viewing may “not be problematic, we cannot rely on physical activity to ‘compensate’ for long hours of screen viewing.”

She says “watching TV or playing computer games for more than two hours a day is related to greater psychological difficulties, irrespective of how active children are.”

Parents, she says, should encourage physical activity for their children and take steps to reduce their time in front of a screen.

What’s seems clear from the study, she tells WebMD, is that children who spend longer than two hours in front of a computer or TV screen may suffer detrimental consequences, physically and mentally.

Children who engaged in more moderate physical activity fared better in certain measures of psychological health, she says.

The study is online in advance of publication in the November edition of the journal Pediatrics.

http://children.webmd.com/news/20101011/kids-screen-time-linked-to-psychological

As anyone who has ever sought help for addiction, depression or any other mental illness knows, insurance coverage is often skimpier than for a physical malady. Plans typically limit the number of therapy visits they’ll pay for, and they may also impose a separate deductible for mental health and substance abuse services and require higher out-of-pocket contributions from patients.

Two federal laws that provide better insurance coverage for more people with mental health and substance abuse problems are just beginning to take effect, …

Under the Mental Health Parity and Addiction Treatment Act, which took effect this year, the mental health and substance abuse benefits that a health plan provides have to be just as generous as its coverage for medical and surgical treatments. The law does away with different co-payments, deductibles and visit restrictions.
“These financial equalizers will be very helpful to families that have not been able to access care before,” says Katherine Nordal, executive director for professional practice at the American Psychological Association.

Coverage isn’t mandated
Plans are not required to provide mental health or substance abuse coverage, however, and they can also determine that they will not cover specific disorders.
Some companies made the changes starting last January, but the regulations on parity went into effect July 1, so in most plans the changes become effective when they renew their coverage after that date, said Elaine Alfano, deputy policy director at the Bazelon Center for Mental Health Law in Washington.
The parity law — which was championed by former Sen. Pete Domenici, R-N.M., and the late Sen. Paul Wellstone, D-Minn. — doesn’t apply to plans at companies with 50 or fewer employees or to individual health insurance policies. The new health-care overhaul law, however, will eventually pick up the slack. Under the law, health plans sold through the state-based insurance exchanges that will begin offering coverage in 2014 must include mental health and addiction benefits, and the benefits must be on a par with a plan’s medical benefits. The exchanges will be open to individuals and to small businesses with 50 or fewer employees.

Advocates say they are pleased on the whole with the new laws. But they are watching closely to see whether plans try to erect roadblocks to treatment by claiming it’s not medically necessary, for example, or requiring that someone get preapproved before receiving services, says Andrew Sperling, director of legislative advocacy for the National Alliance on Mental Illness.

Texas family sees new help
For the Bryan family of San Antonio, the new laws are already making a difference. Kevin Bryan, 17, has had bipolar disorder since he was a child. But as he went through adolescence, Kevin became increasingly paranoid and out of touch with reality, says his mother, Chris. About three years ago clinicians determined he suffered from schizoaffective disorder, a diagnosis that led to a change in his medication and a doubling of his outpatient therapy visits to twice a week.
Unfortunately, the health plan covered only 52 outpatient therapy sessions annually, so by August or September of each year, the Bryans were paying $60 out-of-pocket each time Kevin had an appointment, or roughly $3,000 a year. “I kept making the point to the insurer that it was cheaper to cover his visits than to have him wind up in the hospital,” says Chris Bryan, but nothing changed.
Under the new parity provisions, and the annual cap on visits was lifted. Now, when Kevin visits his therapist, his parents are responsible only for a $15 co-payment. He is responding well to treatment and considering going to college next year.

Looking down the road, Chris Bryan says the family may also benefit from the provision in the health-care overhaul that allows adult children
to stay on their parents’ insurance plan until age 26. “We were starting to worry about how to get him coverage as an adult,” she says.
Mental health advocates are particularly pleased that the health-care overhaul will also beef up coverage of preventive services, including screening for depression and alcohol misuse.
In September, the Department of Health and Human Services announced nearly $100 million in grants under the new Prevention and Public Health Fund. They include more than $20 million to help local behavioral health agencies integrate primary care into the mental health care they already provide, and another $5 million to establish a national resource center dedicated to the integration of physical and mental health care.
Integrated care is vital
Integrated care is critical, say experts. The life expectancy for someone with serious mental illness is 25 percent lower than that of the average person, according to Nordal, in part because of metabolic problems resulting from the long-term use of powerful psychotropic drugs. With ongoing integrated care, the severity of chronic mental illness can be reduced and lives saved, as doctors, therapists and other health care practitioners work together sharing information to make sure their patients’ ongoing physical and mental health needs are addressed.
Of course, dealing with problems before they become chronic can be even more effective. According to the National Institute of Mental Health, half of the people with a mental illness have it by the time they’re 14. But on average, people don’t receive formal treatment for their illness until they’re 24, says David Shern, president and CEO of Mental Health America, an advocacy group.

Early intervention — for example, teaching kids how to manage their emotions or educating grade school teachers about effective behavior management — can be effective strategies for keeping children from developing more severe, long-term emotional problems later on, say experts. “That’s why routine screening and treatment is so important,” says Shern.