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In This Issue: } 10 Ways to Simplify Your Life and Dial

Down Stress Levels

} Who Can I Talk to About Mental Health Issues?

} Can Exercise Keep You Mentally Sharp?

} Treating Depression

It seems like everyone is stressed out these days - from your co-workers, to your friends, to the person standing next to you in line.

Stress, by itself, isn’t necessarily bad. Low or even moderate amounts of stress can be good for us, provided we manage it in healthy ways. But poorly managed stress can take a toll. Heart disease, fatigue, and obesity are just a few of the potential consequences.

If stress is bothering you, consider the following 10 ways to regain control:

1. Recognize your symptoms. Your signs of stress may be different from someone else’s. Some people get angry. Others have trouble concentrating or making decisions. Some feel worried or depressed. For some, stress leads to physical symptoms such as headache, back pain, upset stomach, or trouble sleeping.

Mental Health

10 Ways to Simplify Your Life and Dial Down Stress LevelsStress may be inevitable. But how you deal with it is largely up to you. Here are some tools to help you manage the stress in your life.time. Even quick workouts can benefit your heart.

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Mental Health

2. Identify the sources. What situations trigger your stress? Among other things, your stress may be linked to your family, health, work, or personal relationships. Keep in mind that stress is often caused by a change in your life, negative or positive. Marriage, divorce, job loss, or a promotion may all increase stress.

3. Evaluate your coping strategies. Examine the ways in which you deal with situations that cause you stress. Responses like smoking, drinking alcohol, or eating too much may feel good in the short run, but they can cause long-term harm.

4. Learn to say ‘no.’ Sometimes the best way to deal with unnecessary stress is to avoid it. Know your limits, and refuse to take on more responsibilities than you can handle.

5. Plan ahead. Don’t let your to-do list get out of control. Think about your day, and decide which tasks are the most important. Do those items first. Let other tasks drop to the bottom of - or even off - your list.

6. Create time to relax. It’s not always easy, but it’s important to make time for yourself. Take vacations or other breaks. Make time to read a good book, listen to music, watch a comedy, or just have a warm cup of tea. Some people find deep breathing exercises helpful for relieving stress.

7. Exercise regularly. A brisk walk, a bike ride, and a trip to the gym are just some of the physical activities that can help prevent or reduce stress. Aim to get 2 hours and 30 minutes of exercise each week. Talk to your doctor before increasing your activity level.

8. Eat healthfully. Eating balanced, nutritious meals throughout the day will help you cope with stress by keeping you energized and focused. Also, cut back on caffeine. You’ll feel more relaxed and will likely sleep better.

9. Talk to family and friends. Simply talking with supportive people can often bring stress relief, even if the stressful situation doesn’t change. By the same token, limit the time you spend with people who only add to your stress.

10. Get help. If stress seems overwhelming, consider talking to a mental-health professional. He or she can offer healthy stress-busting techniques.

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PsychiatristsA psychiatrist is a medical or osteopathic doctor with special training in the diagnosis and treatment of mental and emotional illnesses. Like other doctors, psychiatrists can prescribe medication. A psychiatrist should have a state medical license and be board-eligible or board-certified by the American Board of Psychiatry and Neurology.

PsychologistsA psychologist has an advanced degree from an accredited graduate program in psychology and two or more years of supervised work experience. Most states require a doctoral degree and a state license for psychologists. Psychologists can make diagnoses, do psychological testing, and provide therapy.

Clinical social workersSocial workers have a master’s degree in social work from an accredited graduate program. They are trained to make diagnoses and provide individual and group therapy. Their qualifications should include a state license and membership in the Academy of Certified Social Workers.

Licensed professional counselorsA licensed professional counselor has a master’s degree in psychology, counseling or a related field. Licensed counselors are trained to diagnose and treat mental and emotional disorders. They are required to have a state license.

Marriage and family therapistsA marriage and family therapist (MFT) has at least a master’s degree and two years of supervised clinical experience. They are trained to diagnose and treat mental health and substance abuse problems from a family perspective. They can provide individual, couples, family and group therapy.

Certified mental health counselorsThese professionals have a master’s degree and several years of supervised clinical work experience in mental health. They can diagnose and provide treatment for many emotional and mental health issues. They are certified by the National Academy of Certified Clinical Mental Health Counselors.

Certified alcohol and drug abuse counselorsCertified alcohol and drug abuse counselors have specific clinical training in alcohol and drug abuse. They can diagnose substance abuse issues and provide individual and group counseling. They must carry a state license.

Mental Health

Who Can I Talk to About Mental Health Issues?Many different types of professionals offer talk therapy. Learn more about their training and how to choose a therapist.If you are struggling with an emotional problem, a mental health professional can help. Psychotherapy offered by a trained and licensed therapist can often successfully treat relationship problems and many mental health conditions, including depression and anxiety.

Many different types of professionals offer psychotherapy (talk therapy). Some of them can also prescribe medication if needed.

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Can Exercise Keep You Mentally Sharp?Exercise helps both body and mind.Exercise maintains your body by keeping it fit and strong. Physical activity also helps ward off serious conditions like heart disease, diabetes and cancer. But exercise doesn’t just work wonders for your body. These effects apply to your brain, too. Physical activity sustains brain function and wards off declines in mental ability, too.

Experts say that exercise can help prevent mental decline as we age. Regular exercise may enhance memory and mood, and may improve our ability to juggle multiple mental tasks.

The aging brainSevere memory loss or other serious mental impairments are most often caused by disease. But age-related mental declines may be the result of decreased brain activity and stimulation. Both mental and physical exercise can help keep your brain sharp.

Your brain with exerciseSo how does physical activity boost brain power? It helps you:

} Think more clearly. Getting your heart rate up pumps blood to the brain. This helps your brain perform better. Low-impact exercises like walking may be best for “clearing your head” because muscles don’t work hard enough to use up extra oxygen and glucose.

Mental Health

Psychiatric nursesThese are registered nurses (RNs) with a master’s degree in psychiatric and mental health nursing. They may also be called advanced practice registered nurses, psychiatric nurse practitioners or psychiatric clinical nurse specialists. They can diagnose and treat people with mental health disorders, and in most states they can prescribe medication. They are certified by the American Nurses Credentialing Center and must have a state license.

Pastoral counselorsPastoral counselors are clergy with a degree in mental health and extensive supervised clinical practice. As a result, they approach emotional issues from both a psychological and a spiritual perspective. They are required to have certification from the American Association of Pastoral Counselors.

Choosing a therapistPicking a therapist is a very personal matter. It’s fine to get a name from a friend or family member. But a therapist may work well with someone you know and yet not be a good match for you.

To choose a therapist, first talk with him or her on the phone or in person. Find out about licensing and level of training, approach to psychotherapy, fees and any specialty area. Some therapists focus on one area, such as treating depression, traumatic stress, substance abuse or grief.

If you feel the therapist is a good fit for you, the next step is to make an appointment. But if you are not satisfied after meeting in person, keep looking. The type of training or license a therapist has is not the most important factor. What matters most is how well you connect with the therapist. You should be able to talk openly and feel heard and understood.

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} Improve your memory. Experts say that exercise brings on the growth of nerve cells in the hippo campus, the region of your brain involved in memory. Studies show that seniors who walk regularly have better memories than inactive older adults. And the more you exercise, the better your memory gets.

} Better your ability to do complex tasks. One study found that aerobic exercise helped people with mild cognitive problems to organize information, pay attention and multi-task better. This may be because exercise helps the body move glucose to the brain, which improves its function.

} Possibly ward off Alzheimer’s disease. There is growing research that suggests regular exercise is linked with a lower risk of Alzheimer’s. Brain activity has been shown to increase with physical fitness. One study found that adults who exercised three times a week had a much lower chance of getting Alzheimer’s than those who didn’t.

} Ease depression and anxiety. Exercise increases the level of serotonin (a chemical that affects mood) in the brain. Low levels of serotonin are linked with clinical depression. Some studies show that exercise can work just as well as medication in treating mild depression in some people.

} Reduce stress. Physical activity helps lower the release of cortisol in your body. Cortisol is a hormone linked with stress.

} Help keep your blood pressure in check. High blood pressure can harm blood vessels in your brain and reduce your brain’s oxygen supply. This damages nerve cells that are used for decision-making and memory.

Time to get movingCheck with your doctor first before starting an exercise program. Then use these tips to get moving:

} Pick an activity you enjoy. Try walking, swimming or playing tennis. You’ll be more likely to stick with exercising if you enjoy doing it.

} Start slowly. Work your way up to at least 30 minutes of exercise most days of the week.

} Get a workout buddy. Exercise can help build friendships. It may be easier to stick to a fitness schedule if you have someone counting on you to show up.

Even if you’ve lived an inactive lifestyle up until now, regular activity will help keep your body - and brain - in shape.

Treating DepressionDepression is an illness, and it can be treated successfully. Learn about medications, talk therapy and other treatments that may be used.A first step in escaping from the fog of depression is recognizing that it is not part of who you are. Depression is an illness like high blood pressure, asthma and other medical problems, and it can be treated successfully. With proper treatment and support, you could feel better in a matter of weeks.

For treatment to work, you need help from an experienced doctor, one who can recommend treatments that are likely to work for your form of depression. A doctor may prescribe medications and/or refer you for psychotherapy or other treatments.

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Antidepressant medicationsThere are many medications that are used to treat depression. Experts think they work by altering the levels of brain chemicals that affect mood. Antidepressants include:

} Selective serotonin reuptake inhibitors (SSRIs). These are the most commonly prescribed antidepressants. They include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil) and citalopram (Celexa). Common side effects include nausea, insomnia, restlessness, dry mouth and decreased sex drive. SSRI side effects are usually mild, and most of them will go away within a few weeks.

} Other antidepressants such as bupropion (Wellbutrin), venlafaxine (Effexor) and duloxetine (Cymbalta).The side effects of these drugs vary. They may include nausea, fatigue, weight gain, nervousness, dry mouth and blurred vision.

} Tricyclic antidepressants such as amitriptyline or desipramine. Tricyclics are an older class of drugs, and they are more likely than SSRIs to cause side effects such as drowsiness, dry mouth and constipation. They may be tried if other antidepressants don’t work.

} Monoamine oxidase inhibitors (MAOIs). These older medications are rarely prescribed because of the risk of serious interactions with other drugs and certain foods.

Important things to keep in mind: } Antidepressants need time to work. It may be

as long as 12 weeks after you start taking an antidepressant before you feel better.

} People respond differently to antidepressants. Don’t be discouraged if one medication doesn’t work for you. Your doctor can change the dose or prescribe a different medication.

} Antidepressants often work best when combined with psychotherapy. Therapy can sometimes get to the root of the problems that contributed to your depression.

} Do not suddenly stop taking an antidepressant. This can cause unpleasant symptoms, including a return of depression. When you are ready to quit, your doctor can work with you to slowly taper the dose.

NOTE: Anyone being treated with antidepressants, especially people being treated for depression, should be watched closely for worsening depression and for suicidal thinking or behavior. Close watching may be especially important early in treatment or when the dose is changed (either increased or decreased). Discuss any concerns with your doctor. Call 9-1-1 right away if you or anyone is having thoughts of suicide or death.

NOTE: SSRI antidepressants, such as sertraline, citalopram and paroxetine, may slightly raise the risk of congenital heart defects if taken during the first trimester of pregnancy. Discuss the benefits and risks of antidepressants with your doctor if you are pregnant or plan to get pregnant. Do not stop taking these medications without first talking to your doctor.

PsychotherapyPsychotherapy involves talking with a mental health professional. It could be a psychiatrist, social worker, psychologist or counselor. Therapists can help depressed people gain insights about themselves and make positive changes in their behavior and feelings.

There are many types of psychotherapy to choose from. Two that are commonly used to treat depression are cognitive-behavioral therapy and interpersonal therapy.

} Cognitive-behavioral therapy can help identify and correct negative thought patterns. This can improve a person’s outlook and sense of self-worth.

} Interpersonal therapy looks at the relationships that may be at the root of depression.

Psychotherapy can often help relieve symptoms of depression. In general, people with severe depression respond best to a combination of psychotherapy and medication.

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Transcranial magnetic stimulation (TMS)Transcranial magnetic stimulation is a treatment that stimulates the brain by delivering strong, focused magnetic pulses. It was approved in 2008 to treat major depression in adults who have not responded to standard treatments. TMS has fewer side effects than most other treatments for depression. Scalp pain and headache are the most common.

Electroconvulsive therapy (ECT)During ECT, a mild electric shock is applied to the brain while the person is asleep under anesthesia. ECT is a highly successful treatment for people with severe depression who can’t take medications. It may also be life-saving for those at high risk for suicide. Side effects may include short-term memory loss and confusion.

Light therapyPeople with severe seasonal affective disorder (SAD) often need bright light treatment (phototherapy). For this treatment, a person sits in front of a special light box each morning for half an hour or longer. The light box emits bright white light that is about 10 times stronger than regular lights. Side effects are uncommon but may include headaches or eyestrain.

Mental Health