Anxiety -- Don't just rely on medications.
This article is a technical one, but the summary is easy to read -- it shows that meditation may be as effective as escitalopram (Cipralex brand name in Canada) for
controlling anxiety. Many of the patients I see have significant anxiety so it is not always reasonable to stop medication, but don't just rely on the medication -- exercise, meditation,
psychotherapy, among others, all help. Also, this study used escitalopram, but many of my patients are on different medications because escitalopram may not be the right medication for you (e.g., its
interactions with other medications can be dangerous). Again, don't stop medication without speaking to me (or your physician for other patients) (studies like this one are always overly optimistic
-- in the real world the results from meditation may not be as powerful) but consider meditation and other techniques to help with anxiety in addition to the medication.
https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2798510
Boost mood and resiliency during the winter months
Depression rates in 2021 rose to 32.8% of all USA adults according to this link, which of course depends on how a depression is defined. However, more people are struggling with depression now. Below are some useful tips from this easy to read article:
1. Experiment with small goals -- what is appropriate for you
(calling a friend, doing work on a certain aspect of one of your projects, going for a walk...)
2. Try to get a full night of sleep
3. Don't stay isolated -- interact with others
4. Exercise day after day -- do whatever is appropriate for you
5. Do things that you like, that make you happy, every so often
https://www.futurity.org/winter-covid-19-mood-depression-2687952-2/
Useful book I use with patients for CBT-I (Cognitive Therapy for Insomnia).
"The Insomnia Answer" -- This book is a bit dated and a bit lengthy to read but it was written for the non-medical reader. The authors are PhD's, i.e., non-drug treatment of insomnia, and experts in the area of sleep science. The paperback version is reasonably priced, plus you can find it at many community libraries.
Link at amazon.ca (note: available at other sources, including for free in libraries):
Schizophrenia -- More evidence to keep your mind active -- Cognitive Remediation
"Cognitive Remediation Therapy" is different than "CBT / Cognitive Therapy/ Cognitive Behavioral Therapy".
If you have been doing cognitive remediation exercises -- keeping your mind active -- whether to help with the long term effects of schizophrenia or bipolar disorder or another disorder -- there is more evidence that these therapies can help. The link to the article below is a bit technical, but it gives more evidence that these techniques work, and it gives a bit more information about them. (Again, "Cognitive Remediation Therapy" is not the same thing as the popular "Cognitive Therapy/CBT.") I will try to post a good link to Cognitive Remediation Therapy for the non-medical reader in the future.
https://www.bcss.org/education/treatments-for-sz/cognitiveremediation/
https://pubmed.ncbi.nlm.nih.gov/31699627/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058696/
2022 -- Schizophrenia -- Cognitive Remediation Therapy works over the long term
Dr Buonocore and colleagues in Milano, Italy, looked at a group of patients diagnosed with schizophrenia ten years after they had received Cognitive Remediation Therapy. They found that 10 years later the cognitive and functional improvements that the therapy initially gave the patients was still preserved.
https://www.sciencedirect.com/science/article/pii/S2215001322000166
Anxiety and Depression -- Significant Reduction in the Risk of Anxiety and Depression is Associated with Cardiorespiratory Fitness
This association study looked at the baseline cardiorespiratory fitness (calculated, i.e., estimated) in over 30,000 people in Norway and the use (estimated from purchase records) of anxiolytics or antidepressants over the next ten years. (These people were part of another large Norwegian health study.) The more fit someone was, the less likely they ended up using these medications, thus suggesting a lower risk of an anxiety disorder or a depressive disorder. (This association did not hold for people in the study over 65 years old.) While not proving cause and effect, this study is more evidence suggesting that physical fitness may protect against more serious anxiety or depression.
https://www.sciencedirect.com/science/article/pii/S0165032723008637?via%3Dihub
A good quality review/meta-analysis Feb 2024 showed the same results, concluding that " Exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense. "
https://www.bmj.com/content/384/bmj-2023-075847
Hitting Rock Bottom and Recovering
This YouTube video (ignore the slang in the video title) has been praised recently as helping many people.
While the video will not magically turn around everybody's life, some of the advice it offers may be helpful to some aspects of all of us.
(Note: YouTube videos can be updated, i.e., changed. I viewed the video at the end of June 2024. About 7 minutes long. No sponsorship, although an iOS app was offered.
At this time video creator has two other videos listed, no dangerous/political/commerical content superficially obvious.)
Staying Physically Healthy: Life's Essential 8
The American Heart Association's "Life's Essential 8" has been found to reduce the risk of more serious medical illnesses. (There is also a
large psychiatric literature supporting improved mental health by staying physically healthy, and vice-versa also.) If you look at the figure above these are:
1. Stop/reduce smoking.
2. Get adequate sleep.
3. Healthy eating (limit sodium, sugar; increase healthy foods)
4. Stay physically active (150+ min/wk moderate intensity or 75+ min/wk vigorous)
5. Normal/controlled blood glucose (fasting glucose not above 5.6 mmol/l)
6. Body Mass Index (BMI), i.e., weight, within guidelines
7. Normal/controlled lipid (cholesterol) levels
8. Normal/controlled blood pressure
Note: These are generalized recommendations from the AHA and derived publications. Individual recommendations for you may be different and should collaboratively be discussed with your health-care provider.
Recent scientific article considering the Life's Essential 8: BMC Public Health 2024:
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-19189-z
Oct 2024 Molecular Psychiatry article: Cannabis Causes Brain Changes which may cause or worsen psychiatric diseases
There has been lots of controversy about cannabis (marijuana) over the last few decades with many
patients feeling it helps them to feel better. However, from the viewpoint of the doctor we often see our patients worsening over the long-term with its use. This article published in October 2024
shows how there are ("epigenetic") changes to the DNA of users -- these changes affected cellular energy production which is thought to affect functioning of neurons. We know that cannabis use is
associated with people who develop psychosis -- this article gives some of the mechanisms why this may be occurring, and even if psychosis does not develop, it may be harmful to many people at risk
of other psychiatric disorders. Careful research takes a long time, but it is occurring.
https://www.nature.com/articles/s41380-024-02689-0