• Is Your Shopping Out of Control?
• Does Autumn Make You SAD?
  Coping with Seasonal Affective Disorder
• 20 Meal Planning Tips to Prevent Binge Eating
• Commemorating Rosa Parks
• Dear Dr. B.: What is the real cause of my depression?

For many of us north of the equator, fall is officially upon us: the leaves are changing, a chill is in the air, the days are getting shorter and shorter. Once the initial excitement of the change of seasons wears off and the cold, dreary days outnumber the ones filled with sunshine, hundreds of thousands of people will experience a type of winter depression known as Seasonal Affective Disorder (SAD).

Read on..

How you plan and prepare your meals plays a big part in how much you eat, and greatly influences whether or not you will binge. Try some of these useful tips for healthy eating.

1. Only cook enough food to fill plates once with an appropriate portion. Do not plan on leftovers.

2. Schedule your meals and snacks. Stick to the times routinely as often as possible.

3. Do not delay your meals. Eating on a regular schedule will prevent you from becoming overly hungry and wanting to binge.

4. Be sure to snack in between meals. This will help prevent you from becoming too hungry and from bingeing.

Learn all 20 tips...

Paul Warner /AP Photo

We salute the life and memory of Rosa Parks, who passed away on October 24 at the age of 92. Her simple act of defiance changed the course of history in the United States. In 1955, Rosa Parks was riding home from work on a bus in Montgomery, Alabama, when she refused to give up her seat to a white person. Her arrest led to the Montgomery bus boycott, the first of the major civil rights protests that challenged the institution of segregation.

Rosa Parks continued to work for the betterment of her community throughout the rest of her long and productive life. She richly deserved the title of "mother of the civil rights movement". Her life demonstrates that all of us have opportunities to show heroism and courage, and that one individual can truly make a difference. Thank you, Rosa Parks.

Dear Dr. B.,
I am getting mixed signals about what is causing my depression. My family doctor tells me it is caused by a chemical imbalance. He put me on medication to correct the problem. I also have been seeing a counselor that my pastor recommended. She says that the depression stems from being spanked and beaten so much when I was growing up. My family doctor does not put down my being in therapy, but I can tell that he does not think it can help me. I get a similar feeling from my counselor, who seems to think that only therapy will help me solve my problems. This is all making me pretty confused. What do you think?

- Jay P.

Read on...

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For many of us north of the equator, fall is officially upon us: the leaves are changing, a chill is in the air, the days are getting shorter and shorter. Once the initial excitement of the change of seasons wears off and the cold, dreary days outnumber the ones filled with sunshine, hundreds of thousands of people will experience a type of winter depression known as Seasonal Affective Disorder (SAD).

What Causes SAD?

SAD is caused by a biochemical imbalance in the hypothalamus of the brain. Due to the shortening of the daytime hours and the lack of sunlight, SAD sufferers produce increased levels of the sleep hormone melatonin. The severity of symptoms of SAD can vary drastically from person to person. Some people experience only mild discomfort (commonly called the “winter blues”) while others become completely debilitated.

Symptoms

Development and reoccurrence of symptoms below, beginning between September and November and lasting until March or April:

• Sleep problems including increased fatigue, difficulty staying awake, and unrefreshing sleep
• Lethargy
• Carbohydrate cravings, sometimes with associated weight gain
• Decreased libido
• Anxiety
• Social withdrawal
• Depression
• Mood changes

Treatments

Light Therapy: Many people with SAD find relief from light therapy alone. While going out in the sun might help those with the winter blues, a high-intensity light box designed specifically to treat SAD is usually required. These boxes contain bulbs that are at least ten times more intense than ordinary lights. Light therapy should be done on a daily basis from the time the first symptoms appear until the time they go away. Consult with your doctor about the proper intensity, and shop around to find the appropriate light box for you.

Antidepressants: Although many types of antidepressants have not proven effective in treating SAD, non-sedative SSRIs have been effective. Antidepressants should be used in conjunction with light therapy because, while they help treat the depressive symptoms, they do not address the increase in melatonin.

Psychotherapy: Psychotherapy is useful when combined with either or both light therapy and antidepressants because it can help sufferers to cope with their illness.
Exposure to Natural Sunlight: On sunny days, try to get outside and soak in some rays.

What to Do If You Suspect You Have SAD

Contact your primary care physician to discuss treatment options. Research has shown light therapy treatment to be effective within three to four days, so the sooner you address your symptoms, the sooner you can start getting some relief!

By Lauren Bedrosian

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How you plan and prepare your meals plays a big part in how much you eat, and greatly influences whether or not you will binge. Try some of these useful tips for healthy eating.

1. Only cook enough food to fill plates once with an appropriate portion. Do not plan on leftovers.

2. Schedule your meals and snacks. Stick to the times routinely as often as possible.

3. Do not delay your meals. Eating on a regular schedule will prevent you from becoming overly hungry and wanting to binge.

4. Be sure to snack in between meals. This will help prevent you from becoming too hungry and from bingeing.

5. Plan a balanced meal with adequate calories that contains the following: protein, grains, dairy, vegetable, and fruit groups.

6. Carry “portable snacks” with you, in your purse or briefcase, or in your car.

7. Always eat breakfast. If time is a problem, prepare it the night before, or make something you can take with you when you leave the house.

8. Make yourself a healthy lunch to take to work and bring along healthy snacks for coffee breaks.

9. Be creative in preparing your food, so that your snacks and meals are more fun. For example, add chopped nuts to hot cereal or to salads.

10. Always use utensils whenever you eat, including during a binge.

11. Resist the urge to clean your plate; this is particularly important when you do not choose your portions (such as when you eat out).

12. Serve yourself one portion at a time. Remove the serving dishes from the table after you have dished out the portion.

13. Slow down your eating. Put your utensils down while chewing your food, or pause and take a few deep breaths during the meal.

14. Leave the table after eating.

15. Put away leftovers as soon as possible.

16. Do not store your leftovers in transparent containers. If you use opaque containers, you will not immediately know what is in them.

17. Make it a rule to put only one food in your mouth at a time, even when you are bingeing.

18. Instead of cutting fat from your diet, consider substituting food with more beneficial fats for those with animal fat (for example, use olive oil instead of butter).

19. Freeze orange juice, other fruit juice, or grapes for when you crave something sweet.

20. Put something sour in your mouth - such as a slice of lemon or lime, or a pickle – when feeling a binge coming on. This helps eliminate your craving for sweets.

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I am getting mixed signals about what is causing my depression. My family doctor tells me it is caused by a chemical imbalance. He put me on medication to correct the problem. I also have been seeing a counselor that my pastor recommended. She says that the depression stems from being spanked and beaten so much when I was growing up. My family doctor does not put down my being in therapy, but I can tell that he does not think it can help me. I get a similar feeling from my counselor, who seems to think that only therapy will help me solve my problems. This is all making me pretty confused. What do you think?

- Jay P.

Dear Jay,

It sounds as if you are doing all you can to help yourself. Consequently, it pains me to see someone so motivated getting caught between two healthcare professionals who have different opinions. This kind of situation only increases the pressure on you. Moreover, when one really examines the facts, it is completely unnecessary.

Depression is a complicated disorder. Dr. Hagop Akiskal of the University of California at San Diego has described depression as a “final common pathway”, the end result of many different contributing elements. All the research has indicated that both physical and psychological factors play a role in causing depression.

My supervisor and mentor, Dr. Aaron T. Beck, used to compare depression to a powerful river. As a river flows, many different streams pour into it, each one contributing to what becomes a stronger and stronger current. While some people seem to have a genetic predisposition for depression, experiences like physical abuse in childhood lead people to develop a style of thinking that also increases the risk for such symptoms. Moreover, life stresses, such as separation, divorce, or living with an alcoholic spouse also increase the chance that someone will become depressed. Likewise, behaviors such as substance abuse can trigger depression or make it substantially worse.

Most people whom I have treated had two or more of these risk factors prior to becoming depressed. In most cases, one could never be sure what actually caused the depression. During treatment we tried to address in some way all of the risk factors that we could identify, so that we could maximize our chances of being successful.

Finally, there is absolutely no reason why someone cannot be treated with both medication and psychotherapy. Both have been shown to be effective overall in treating depression. Each form of treatment has advantages and disadvantages, but they are not incompatible with each other. Your family doctor ought to be supportive of your psychotherapy, and your therapist ought to be supportive of you taking medication. If they are not, then perhaps they need to learn more about depression.

Dr. Richard Bedrosian is a clinical psychologist, president and founder of MySelfHelp.com, Associate in Psychiatry at the University of Massachusetts Medical School, and author of “Treating Family of Origin Problems: A Cognitive Approach”.

Send your questions for Dr. B. to info@myselfhelp.com. You will remain anonymous if your question is printed in an upcoming newsletter.

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