Antidepressants Blog

Answer: Let’s look at several possibilities:A. You may be consuming a food to which you are reacting; i.e., a wheat or dairy product. If you are still eating some grains or dairy products, try to eliminate them totally from your diet for a few days and see if the problem resolves itself. Both are common causes of constipation.B. You may not be drinking enough water. Try increasing your water consumption to eight to ten glasses each day. Make sure you are drinking the water between meals.C. You may not be eating enough fiber. Make sure you are eating at least five to six servings of raw or lightly steamed vegetables per day, in balance with your protein. The menu suggestions include several servings of vegetables each day. If you find that you simply can’t do this, use a sugar-free fiber supplement with an additional eight ounces of water. Take the fiber supplement before you go to bed each night at least three hours after your last meal.D. Certain mineral deficiencies can cause constipation, particularly deficiencies in magnesium and potassium. Use a magnesium supplement (not magnesium oxide) to increase your magnesium intake to about 500 milligrams per day. Take about 99 milligrams of potassium per day. (Avoid potassium chloride. Use both a magnesium and potassium ion bonded to an amino acid combination, or use magnesium glycinate. These mineral forms are typically well absorbed.) And remember that magnesium helps reduce craving for chocolate and sweets.E. After following these suggestions, if you still can’t get things moving again, you may need to resort temporarily to an herbal laxative that contains dandelion root, burdock, ginger, fennel, buckthorn, and small amounts of cascara sagrada. Sometimes it helps to take an herbal fiber supplement with psyllium husks and other fibers. Be sure to drink plenty of water with them!Avoid all herbal laxatives that contain senna or large amounts of cascara sagrada. Most reputable herbal companies have formulated an herbal laxative that will stimulate the bowels without creating dependence on them.*62\319\2*

Work out the Facts — Iron out the Kinks I

Lower-back injury from weight-lifting… tendon strains from Taekwondo… a damaged sternum from piling on too many weight plates at the gym.

Too much exercise — or wrongly-executed moves — can lead to injury, exhaustion or even, over the long haul, a suppressed immune system… which can lead to the worst result of all: having to stop exercising cold turkey.

In women, experts caution, over-exercising carries particular problems — menstrual irregularity, infertility, loss of bone density!

Stay on the healthy side of the injury chasm. It’s not easy, because exercise makes you feel so good and most of us are shameless endorphin junkies. When you hit that aerobic plateau, when those natural opiates wash through your system, you just want to keep going. Like a drug addict, you don’t want the high to end.

Figuring out just how far or how long is too far or too long is the problem. Here are suggestions that can help.

Check it out. Before you begin, see a doctor, especially if you’re over 60, have a disease or disability, are taking medications, are recovering from an illness or surgery.

Also consult a doctor if you’re worried that exercise may affect any other aspect of your health.

If you’re running a cold or temperature or suffering from a sore throat, avoid exercise until you’re feeling better.

And keep a regular check on your blood pressure, especially if you’re over 35.

Build up gradually. It takes time to get fit. Begin slowly, perhaps just introducing more overall activity into your life. Gradually increase your exercise periods to 5 to 10 minutes twice a week, then to 15 to 30 minutes three or four times a week. You’ll lower your risk of sprains, strains and other injuries.

Avoid abrupt starts and stops. Ease in and out of exercise. Abruptly starting or stopping can cause soreness or injury (especially in older people). Stopping suddenly can also sharply reduce blood pressure, causing fainting or even a heart attack. So it’s important to take the time to warm up and cool down sufficiently. Begin and end each workout with 5 to 15 minutes of stretching exercises, slow walking or gentle calisthenics.

Don’t push your heart to the brink. Avoid exercising so strenuously that you exceed 90 per cent of your maximum heart rate. To find out your own maximum, use this rough formula: Subtract your age from 220. For most people, exceeding their upper limit may mean nothing more than approaching utter exhaustion. But those with underlying coronary disease risk a possible heart attack. (To be safe, they should keep their heart rate well below the level where abnormalities appear on an exercise stress test).

Don’t be a weekend warrior. Though regular, sustained exercise reduces the risk of heart disease, occasional bouts of overexertion will achieve just the opposite — weekend warriors are at war with their hearts! If you save all your exercise or all your heavy chores for the weekend, you are one of those weekend warriors and you could be setting the stage for a heart attack if you’re unfit. Recent studies have shown a powerful link between heavy physical exertion and an increased risk of heart attack in people who are out of condition. According to one study reported in Circulation, a sudden bout of exertion activates blood platelets in sedentary people, but not in those who are physically active. Activated platelets clump together and can form clots, which may cut off blood flow to the heart.

Preferably, avoid high-impact aerobics. This is the kind of aerobic exercise marked by high jumps and percussive bounces which are hard on your body. (In contrast, in low-impact aerobics one foot is always on the ground).

Be kind to your body. If you’re doing aerobic dance, or even if you’re skipping rope, the surface you’re working out on should be sufficiently padded. Especially avoid bare cement floors — you might pay with severe shin splints and other injuries.

Also, never do aerobic dance bare-footed. It’s important that you cushion the jolt of your foot hitting the floor, with proper shoes.

The right shoes are also important if your exercise of choice is walking or jogging — they should be well-padded, with good arches and ankle supports.

Don’t neglect strength-training. All sports emphasize a limited number of muscle groups. This can cause injury to the overworked muscles. Strength-training, by compensating for these muscle imbalances, may prevent the damage (such as tendinitis, if you’re a tennis player) that could otherwise result. Work out with light weights to help strengthen the rotator cuff (muscles and tendons in your shoulder).

Use correct technique. If you do sit-ups with straight legs instead of knees bent, for instance, you can hurt your back. If you walk with your toes pointed outward, you can expect knee pain, arthritis, bunions and lower-back pain. In general, perform your exercises slowly avoid jerky, fast movements.

Listen to your body. If you’re exercising with faulty technique, or if you’re exercising in excess of what you should, your mind will often send messages to your body to stop. Pain is one of the most direct messages you’ll get. If you ignore the command, soreness and muscle injury can result. Stay alert to symptoms such as chest pain, shortness of breath, aching joints or muscle cramps. Get to medical attention if any of them occurs, especially if you’re elderly or suffer from a chronic ailment.

Protect your lungs. Polluted air — a cocktail of noxious gases and particulate matter — is a particular hazard for exercisers. Because exercise makes you breathe faster and more deeply, it can dramatically increase the adverse effects of pollutants on your lungs and heart. Add to this the fact that joggers, runners and cyclists often breathe through the mouth (thus bypassing the nasal passages which help filter out some pollutants).

Several studies have found that those who exercise strenuously outdoors run much higher risks of pollution-related symptoms: coughing, throat irritation, headaches, shortness of breath and tightness in the chest. For people with coronary disease, exercise in highly polluted air can lead to irregular heart rhythm or angina.

You can’t avoid air pollution completely, especially in the urban jungle, but you can minimize your risks while exercising:

Schedule your outdoor workouts for times when there’s less car exhaust and the sun is not to strong. (Ozone, one of the more dangerous components of urban smog, forms when sunlight acts on car and industrial emissions).

Protect your lungs. Something as simple as not smoking, and taking deep breaths several times a day, can minimize lung damage so that by age 70 you’ll still have the lungs of a 45-year-old.

If you exercise during rush hour, choose areas with little traffic. Open, windy areas are preferable since air currents can disperse pollutants.

While exercising outdoors, breathe through your nose, not your mouth. This should reduce the amount of pollutants reaching your lungs.

The so-called anti-oxidant nutrients (such as Vitamin C and E and beta-carotene) help fight the damaging "free radicals" created by pollution and thus may ward off or repair long-term lung and cellular damage. Boost your intake of these nutrients.

Stay away from second-hand cigarette smoke — a known source of hazardous pollutants — especially before and after strenuous exercise.

And if you have asthma or any other lung condition, consult your doctor about your exercise options.

The essence of cognitive therapy is to change these unhealthy beliefs into more flexible and realistic attitudes. Of course, patients may resist changing, since doing so may challenge the basic structure of their lives. One cause of resistance is known as symptomatic self-reinforcement.” In other words, if starving yourself makes you feel good about yourself, then that behavior may be hard to give up. Or the patient may resist because she doesn’t want to surrender the “guidelines for living” that she has established for herself. She must confront an onslaught of new feelings and experiences, but she lacks the “rulebook” that in the past told her how to respond.

Naturally, during this time the patient feels confused, frustrated, and frightened. Or she may shut down emotionally. Many patients who reach this phase of therapy tell me, “I just feel empty,” or, “I feel nothing at all.” Sometimes, as treatment takes effect, she encounters emotions she hasn’t felt in ages. She may want to interpret her sadness, anger, or depression as evidence that she is weak. In the past, she knew that such weakness would lead to a dietary catastrophe. In therapy, she learns that such emotions are part of daily life, and that she can learn how to handle them without falling back on her symptoms.

One way to change distorted thinking is through de-centering. In this strategy, I encourage the patient to think about the problem from another perspective, to remove herself from the center of the issue and try to evaluate things more objectively.

Here’s an example. A patient named Liz told me, “Everyone always watches me when I eat.” I asked her, “Do you always notice what other people eat?” “Of course not,” Liz answered, “Why should I?” By exploring this topic further, the patient eventually realized that, just like herself, other people are probably too wrapped up in their own concerns to spend much time noticing her. Liz learned that she was not the center of someone else’s universe-and found she was much happier with that thought.

Another way to counteract distorted thinking is through decatastrophizing. Let me explain. A patient might say, “If I don’t get that promotion at work, then my life won’t be worth living.” I might challenge this by exploring it further, saying, “What’s the worst that can happen?” or, “What can you do to make this situation better?” My goal is to help the patient take a more realistic view of the event, and to help her discover some of the alternatives open to her. When you are feeling depressed, it generally helps to be active rather than to sit passively and helplessly.

A similar approach works to counteract the “tyranny of the ‘Shoulds.’ “If the patient says she “should” do something-study harder, eat less-I will urge her to explore what would happen if she didn’t. Often, she begins to see that the dire consequences she had predicted would actually fail to materialize.

Through reattribution, the patient learns to interpret her experience more accurately. For example, an anorexic might feel that her excess energy is a sign of vitality and health, a vindication of her decision to starve herself. I will work to show her that extreme anxiety may result when the body is threatened with emaciation and that this can result in the need to be constantly active.

Another technique, developed by Christopher Fairburn, focuses on problem solving. In this strategy, the patient learns how to tackle problems in new and creative ways without resorting to bingeing.

First she must identify the problem precisely and come up with as many alternative solutions as possible. Say, for example, that her boyfriend breaks their date for Saturday night. Normally such a catastrophe would prompt her to binge. In therapy, though, we look at the other actions she might take: calling another friend, running errands she has been putting off, finishing a project, and so on. She then looks at each of these alternatives and decides which is the most practical and effective. After rehearsing the solution in her head, she carries it out. Later that day or the next, she reviews her decision and decides how well it worked, perhaps giving herself a grade on a scale of one to ten.

I ask patients to use their food-monitoring sheets to note these problems and how they came up with their solution. We can then review the process in therapy sessions. Doing so lessens the impact of problems. What’s more, it reduces the frequency with which problems occur.

I’ve mentioned just a few of the strategies of cognitive therapy. Regardless of the approach, the goal is to help the patient express her thoughts and to examine those thoughts from many different angles. We challenge her overly constricted ways of thinking and feeling. In the process, we help bring about a fundamental change in the way she perceives and interprets the world.

When we reach that goal, the patient finds herself equipped with a magnificent tool for fixing disordered eating: her mind.

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As a personal trainer and motivational speaker, Barbara Press is devoting her life to helping others meet their health-and-fitness goals. To look at this dynamic young woman now, you’d never guess that she once weighed 250 pounds.

“I turned my life around, and I tell everyone who asks me that they can, too,” says the Oxnard, California, resident. “But I also tell them that if they’re not willing to give 100 percent, they shouldn’t even bother getting started.”

It was her own willingness to give 100 percent that transformed Barbara from an overweight, out-of-shape 20-year-old into the fit and trim 33-year-old that she is today. Her 115-pound weight loss was spurred by a man whom she barely knew.

“We were on our first—and last—date when, for reasons that I still can’t explain, he started telling me that I was too fat,” she recalls. “At the time, I was hurt and angry. But his insults persuaded me to turn my life around. If I were to run into that guy today, I’d thank him from the bottom of my heart.”

Once Barbara made up her mind to slim down, she went at it with gusto. “I worked harder at that than at anything that I ever had before,” she says.

She read as much as she could on all aspects of weight loss, then began making changes in her diet. She concentrated on controlling her portion sizes and making healthy food choices. Within 1 year, she lost 60 pounds.

Inspired by her progress, Barbara added exercise to her weight-loss program. She walked regularly, working her way up to 5 miles every day. “I got addicted to it,” she says. “My day just wasn’t complete without a good workout.”

After taking off those first 60 pounds, Barbara set a more modest goal: to lose just 10 pounds a year. She consistently surpassed that goal, and by age 26, she had dropped to 135 pounds.

One year later, after losing her job in the insurance industry, Barbara enlisted in the navy at her brother’s urging. She served as a physical fitness coordinator for 6 years. “If I hadn’t lost all of that weight, I never would have been gotten into the military,” she says. “Slimming down definitely changed my life.”

During her stint in the navy, Barbara allowed her weight to bounce back to a more comfortable 155 pounds, where she is still holding steady. These days, she’s a full-time student, pursuing a bachelor’s degree in health education. She works as a personal trainer at a local gym and has her own health-and-fitness business on the side. And she’s often invited to speak about weight loss and health to various groups in her community.

When new clients visit Barbara for the first time, she asks them to spend a day or two thinking about whether they’re ready to commit 100 percent to a fitness program. “I want them to understand that getting healthy isn’t something that they can work at for a couple of days and then forget about for a while,” she says. “Anybody can do a fitness program and feel great. But you have to be ready to give what it takes.”

WINNING ACTION

Contemplate your ability to commit. Take Barbara’s advice: Spend a day or two carefully considering whether you’re really ready to commit to eating better and exercising more. You may realize that now is not the time or that slimming down isn’t a high priority for you or that you’re doing it for the wrong reasons. As the first of the

Ten Commandments of Weight Loss says, you have to believe in yourself and make yourself a top priority in order for weight loss to happen. When you’re really ready, that’s the time to get started. Then nothing will stop you.

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