Bipolar Support Groups.com blog

http://www.bipolar4lifesupport.co on line support group

I just started working the night shift, and I’m having trouble sleeping during the day. Do you have any sleep tips for shift workers?
Answers from Timothy Morgenthaler, M.D.

Humans are naturally wired to be awake during the day and to sleep at night. Good daytime sleep is possible, though, if shift work is a necessary part of your work life.

To promote better sleep during the day:
•Avoid stimulants, such as caffeine and nicotine, before bedtime. If you’re working nights and need to sleep from morning until afternoon, you might try to avoid caffeine after midnight.
•Create a restful environment. To promote uninterrupted sleep, turn off or unplug your phone and hang room-darkening shades on the windows. You might also turn down the thermostat, wear an eye mask and post a “Do not disturb” sign on your bedroom door — and possibly your front door as well. Schedule appointments and other activities outside of your sleep period, and train your family and friends to leave you alone while you sleep.
•Take a short nap before your shift. Napping for up to 30 minutes just before work or on a break may increase alertness and enhance your performance, including quicker reaction time, better memory, less confusion, and fewer accidents and mistakes — especially if your daytime sleep period was cut short. Keep it short, though. The longer you nap, the more likely you are to feel groggy afterward.
•Stick to the routine. Going to sleep and waking up at the same time every day helps promote good sleep. Be as consistent as possible, even on weekends and days off.
•Make healthy lifestyle choices. Eat a healthy diet and include physical activity in your daily routine. If exercise seems to energize you, plan to work out after you wake up rather than before you go to sleep. Resist the temptation to use junk food or nicotine to stay awake or alcohol to get to sleep.

If these tips don’t seem to help, consult your doctor or a sleep specialist. Sometimes an underlying sleep disorder or other issues need to be addressed.

With

Timothy Morgenthaler, M.D.

http://www.bipolar4lifesupport.co on line support group

Will a bedtime snack help me sleep better?
Answers from Timothy Morgenthaler, M.D.

Eating a small snack a few hours before bedtime may help. There are no specific foods that help you sleep. But, it’s a good idea to avoid certain foods late in the day. Here are a few things to keep in mind:
•Don’t go to bed hungry. A light snack before bedtime can keep hunger pangs from waking you up. For example, have a bowl of oatmeal, cereal with low-fat milk or yogurt with granola. If you have diabetes, discuss nighttime snacks with your doctor.
•Avoid large, high-fat meals late in the day. Also avoid garlic-flavored and highly spiced foods. These foods can make you uncomfortable or cause heartburn.
•Avoid alcohol and caffeine. Both can interfere with sleep. Keep in mind, it can take up to eight hours for the stimulating effects of caffeine wear off.
•Don’t drink too much liquid. Drinking lots of fluids before bed can cause you to wake up repeatedly to use the bathroom.

Everyone has trouble sleeping from time to time. But if you frequently have insomnia, see your doctor to find out what steps you can take to improve your sleep.

With

Timothy Morgenthaler, M.D.

http://www.bipolar4lifesupport.co on line support group

Skip booze for better sleep
By Mayo Clinic Staff

Alcohol depresses the central nervous system and acts as a sedative. It may help you fall asleep, but it prevents deeper stages of sleep and often causes you to wake up in the middle of the night. If you have trouble falling or staying asleep, say no thanks to the after-dinner drinks.

http://www.bipolar4lifesupport.co online support group

Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills

Insomnia is a serious disorder, and effective treatment can be crucial to getting the sleep you need. Explore safe, effective, nondrug insomnia treatments.
By Mayo Clinic Staff

Insomnia is a common problem characterized by trouble falling asleep, staying asleep or getting restful sleep, despite the opportunity for adequate sleep. Cognitive behavioral therapy for insomnia, often called CBT-I, is an effective insomnia treatment for chronic sleep problems.

Cognitive behavioral therapy for insomnia is a structured program that helps you identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep. Unlike sleeping pills, CBT-I helps you overcome the underlying causes of your sleep problems.

To make effective changes, it’s important to understand sleep cycles and learn how beliefs, behaviors and outside factors can affect your sleep. To help decide how to best treat your insomnia, your sleep therapist may have you keep a detailed sleep diary for one to two weeks.

How does cognitive behavioral therapy for insomnia work?

Cognitive behavioral therapy for insomnia aims to improve sleep habits and behaviors. The cognitive part of CBT-I teaches you to recognize and change beliefs that affect your ability to sleep. For instance, this may include learning how to control or eliminate negative thoughts and worries that keep you awake. The behavioral part of CBT-I helps you develop good sleep habits and avoid behaviors that keep you from sleeping well.

Depending on your needs, your sleep therapist may recommend some of these CBT-I techniques:
•Stimulus control therapy. This method helps remove factors that condition the mind to resist sleep. For example, you might be coached to set a consistent bedtime and wake time and avoid naps, use the bed only for sleep and sex, and leave the bedroom if you can’t go to sleep within 20 minutes, only returning when you’re sleepy.
•Sleep restriction. Lying in bed when you’re awake can become a habit that leads to poor sleep. This treatment decreases the time you spend in bed, causing partial sleep deprivation, which makes you more tired the next night. Once your sleep has improved, your time in bed is gradually increased.
•Sleep hygiene. This method of therapy involves changing basic lifestyle habits that influence sleep, such as smoking or drinking too much caffeine late in the day, drinking too much alcohol, or not getting regular exercise. It also includes tips that help you sleep better, such as ways to wind down an hour or two before bedtime.
•Sleep environment improvement. This offers ways that you can create a comfortable sleep environment, such as keeping your bedroom quiet, dark and cool, not having a TV in the bedroom, and hiding the clock from view.
•Relaxation training. This method helps you calm your mind and body. Approaches include meditation, imagery, muscle relaxation and others.
•Remaining passively awake. Also called paradoxical intention, this involves avoiding any effort to fall asleep. Paradoxically, worrying that you can’t sleep can actually keep you awake. Letting go of this worry can help you relax and make it easier to fall asleep.
•Biofeedback. This method allows you to observe biological signs such as heart rate and muscle tension and shows you how to adjust them. Your sleep specialist may have you take a biofeedback device home to record your daily patterns. This information can help identify patterns that affect sleep.

The most effective treatment approach may combine several of these methods.

Cognitive behavioral therapy vs. pills

Sleep medications can be an effective short-term treatment — for example, they can provide immediate relief during a period of high stress or grief. Some newer sleeping medications have been approved for long-term use. But they may not be the best long-term insomnia treatment.

Cognitive behavioral therapy for insomnia may be a good treatment choice if you have long-term sleep problems. You may want to try it if you’re worried about becoming dependent on sleep medications, if medications aren’t effective or if they cause bothersome side effects.

Unlike pills, CBT-I addresses the underlying causes of insomnia rather than just relieving symptoms. But it takes time — and effort — to make it work. In some cases, a combination of sleep medication and CBT-I may be the best approach.

http://www.bipolar4lifesupport.co on line support group

Regular exercise reduces stress and anxiety, and generally improves sleep. But for some people, exercising within five hours of bedtime may cause problems getting to sleep.

Keep in mind, everyone’s different. For some people, late-day exercise isn’t a problem. It may require some trial and error to see how working out affects the quality of your sleep. Without making any other changes that are likely to affect your sleep, take notes on how well you sleep after working out at different times. This can help you determine the time of day that’s best for your workout and the least disruptive to your sleep.

With

Timothy Morgenthaler, M.D.

No matter what your scale says, being comfortable in your own skin is up to you. It can be tough, in a society that prizes unrealistic images. But it’s possible, and it starts with what you say when you look in the mirror.

One of the first rules of achieving a healthy and happy body image is to stop allowing “put-downs” in front of the mirror, says Lori Osachy, body image expert and lead therapist at The Body Image Counseling Center in Jacksonville, Fla.

“Even if in the beginning that means you have to jump in front of the mirror and shout, ‘You’re awesome,’ and then immediately jump back out, that’s OK,” she says. “The goal is to retrain your brain how to think positively about your reflection and your body.”

Over time, telling yourself that you’re beautiful, even if you don’t believe it at first, will improve your confidence, she says. The psychology behind this technique is called “cognitive behavioral therapy,” a method that psychologists and therapists use to stop negative thoughts and replace them with positive ones instead.

Robyn Silverman, PhD, body image expert and author, agrees that “faking” confidence will eventually turn bad body thoughts into good ones, though it takes time.

To speed up the process, Silverman suggests posting notes with positive messages on your mirror to remind yourself of your good qualities. Those notes don’t always have to be about your looks. Jotting down things about your character will help you develop a more positive attitude toward your reflection.

Be Your Own Body Image Advocate

You would never tell your friend she looks fat in a bathing suit, or tell your coworker his arms are scrawny, so why would you tell yourself that?

“Treat yourself as you would treat others, and you’ll find negative thoughts will lessen over time,” says Leslie Goldman, MPH, body image expert and author of Locker Room Diaries.

Ditch the things in your life that make you feel inferior, whether that is body-bashing friends, fashion magazines with supermodels, or TV shows that portray men and women in an unrealistic, sexist way, Silverman says. If a family member or roommate makes you feel bad about the way you look, talk to them directly and establish a “fat-talk-free policy,” she says.

If an advertisement or TV commercial makes you feel bad about yourself, examine it closer and look for the ways it’s trying to sell you something. “Remember, if we didn’t feel inferior to the models in the ads, we wouldn’t want to buy the product,” Silverman says.

Look Beyond the Scale

All too often, people get hung up on the number on the scale, rather than paying attention to how they feel, Silverman says. People of all sizes do that, and it doesn’t help.

If you have treatment-resistant depression, you might have already picked up some of the antidepressant drug lingo — you know your SSRIs, your SNRIs and your MAOIs. But do you really know how these drugs help?

If you don’t, you’re not alone. The truth is that even experts aren’t really sure how antidepressants work. There’s just a lot we don’t know about how the brain functions.

Recommended Related to Depression

St. John’s Wort for Treating Depression

Is it possible to use St. John’s wort, an herbal remedy, to treat depression? Millions of people around the world actually do. They see St. John’s wort as an alternative or natural treatment for depression.

Read the St. John’s Wort for Treating Depression article > >

The most important thing you need to know when you’re living with treatment-resistant depression is that antidepressants often can help. To help you understand all your medication options, here are the facts about different types of antidepressants — along with some tips on how to use them most effectively.

Understanding Antidepressants: Basic Brain Chemistry

If you’ve read up on antidepressants — in newspapers and magazines, or on the Web — you might see depression explained simply as a “chemical imbalance” or a “serotonin deficiency.” Unfortunately, it’s not that simple. We really don’t know what causes depression or how it affects the brain. We don’t exactly know how antidepressants improve the symptoms.

That said, many researchers believe that the benefits of antidepressants stem from how they affect certain brain circuits and the chemicals (called neurotransmitters) that pass along signals from one nerve cell to another in the brain. These chemicals include serotonin, dopamine, and norepinephrine. In various ways, different antidepressants seem to affect how these neurotransmitters behave. Here’s a rundown of the main types of antidepressants.

Continue reading below…

Reuptake Inhibitors: SSRIs, SNRIs, and NDRIs

Some of the most commonly prescribed antidepressants are called reuptake inhibitors. What’s reuptake? It’s the process in which neurotransmitters are naturally absorbed back into nerve cells in the brain. A reuptake inhibitor prevents this from happening. Instead of getting reabsorbed, the neurotransmitter stays — at least temporarily — in the gap between the nerves, called the synapse.

What’s the benefit? The basic theory goes like this: keeping levels of the neurotransmitters higher could improve communication between the nerve cells — and that can strengthen circuits in the brain which regulate mood.

Different kinds of reuptake inhibitors target different neurotransmitters. There are three types:
Selective serotonin reuptake inhibitors (SSRIs) are some of the most commonly prescribed antidepressants available. They include Celexa, Lexapro, Luvox, Paxil, Prozac, and Zoloft. Another drug, Symbyax, is approved by the FDA specifically for treatment-resistant depression. It’s a combination of the SSRI antidepressant fluoxetine (Prozac) and another drug approved for bipolar disorder and schizophrenia called olanzapine (Zyprexa). Abilify and Seroquel have been FDA approved as add-on therapy to antidepressants for treatment-resistant depression. Plus, doctors often use other drugs in combination for treatment-resistant depression. Also, the drug Viibryd was approved in early 2011. It’s an SSRI but affects serotonin in two ways to relieve major depression.
Serotonin and norepinephrine reuptake inhibitors (SNRIs) are among the newer types of antidepressant. As the name implies, they block the reuptake of both serotonin and norepinephrine. They include Cymbalta, Effexor, Khedezla, Fetzima, and Pristiq.
Norepinephrine and dopamine reuptake inhibitors (NDRIs) are another class of reuptake inhibitors, but they’re represented by only one drug: Wellbutrin. It affects the reuptake of norepinephrine and dopamine.

Reflexology is the application of pressure to areas on the feet, hands and ears. Reflexology is generally relaxing and may be an effective way to alleviate stress.

The theory behind reflexology is that these areas correspond to organs and systems of the body. Proponents believe that pressure applied to these areas affects the organs and benefits the person’s health.

Reflexologists use foot charts to guide them as they apply pressure to specific areas. Sometimes these practitioners use items, such as rubber balls, rubber bands and sticks of wood, to assist in their work. Practitioners of reflexology include chiropractors, physical therapists and massage therapists, among others.

Several studies funded by the National Cancer Institute and the National Institutes of Health indicate that reflexology may reduce pain and psychological symptoms, such as anxiety and depression, and enhance relaxation and sleep. Studies also show that reflexology may have benefits in palliative care of people with cancer.

Reflexologists claim that reflexology also can treat a wide variety of medical conditions, such as asthma, diabetes and cancer. However, scientific evidence is lacking to support these claims.

Reflexology is generally considered safe, although very vigorous pressure may cause discomfort for some people.

http://www.bipolar4lifesupport.co on line support group