How to keep your New Year's resolutions on track

It’s a praiseworthy action, creating a list of New Year’s resolutions, but let’s face it, we are human. Realizing our short attention and commitment spans necessitates planning if we are to achieve the goals we have created. The following is a list of ten ideas for keeping your New Year’s resolutions on track:

1. Use a daily goal assessment as a way of checking your progress. Assessing your goals on paper keeps structure in the process of achieving your New Year’s resolutions.

2. Make it a habit. It’s a good idea to associate your assessment and planning time with another predictable continuous activity that you perform on a daily basis, or weekly basis. For instance, you might make your shaving time a moment in which you review that check list plastered to your bathroom mirror.

3. Make sure your goals are attainable. One unattainable goal can crash the rest of your list. If your goals are not attainable, if they are not palatable, then you’re setting yourself up for failure that could translate into feelings of frustration and self-defeat strong enough to make you oust the rest of your list. So keep it simple Simon.

4. Another important point when considering the maintenance of your New Year’s resolutions is to identify stressors. It may well be that the very thing you have resolved to do is becoming irrelevant because of the stress it is causing you. You may need to reframe your goal or the timeline associated with it.

5. Check yourself for excuses about barriers and impediments to progress. What are you doing to deal with those "bumps in the road?” You may just need some motivation. Try giving yourself a pep talk or writing one down on paper that you could read from time to time when you are feeling “an excuse” coming on.

6. Sometimes it’s not the goal you’re having difficulty with but an obstruction preventing you from addressing, or implementing, the goal in the first place. Perhaps your schedule is such that you’re not allowing enough time for implementation or maybe you’re simply allowing random “things” to eat up your time by not creating healthy boundaries. In scenarios like this a minor tweak or two could be the answer.

7. Stay focused on goals that are a priority. Odds are that your list of New Year’s resolutions contains goals that are forthcoming as well as goals that can wait. Don’t frustrate yourself by trying to take on every goal at once.

8. Leave yourself adequate time to balance work, family and personal commitments. You may find that your New Year’s resolutions are eating up time with family, recreation or personal commitments. It may be time to take a step back and see if you have too much on your plate.

9. Avoid engaging in the old, dysfunctional behaviors that derail your progress. This is kind of an “if / then” situation. You may not be planning on dropping the ball but engaging in seemingly unrelated behaviors, or activities, may cause you to. “Sleeping late may eat up your time for, overeating may make you sluggish when,” you get the idea. Avoid derailing your progress with dysfunctional behaviors.

10. Avoid an “all or nothing mentality.” Resolute Ryan, after missing the mark, says, “Well, that’s it. I broke my New Year’s resolution. I guess I can start back up next year.” That kind of thinking will end your progress before it begins. Give yourself room to make a mistake now and then; in fact, expect mistakes.

Keeping on track with your New Year’s resolutions is a process of patience and planning. If you are willing to approach your goals intelligently and with preparation you will increase your likelihood of succeeding. I wish you the “best of planning.”

2:27 PM
posted by Rolf B. Gainer, Ph.D.

Childhood Tantrums: A Predictor of Later Mental Health Problems

Do childhood tantrums predict mental health problems later in life? Andrew Belden, M.D., a post-doctoral fellow of psychiatry at Washington University, School of Medicine has outlined five out-of-the-ordinary types of temper tantrums which may indicate a high risk for depression or other disruptive behavior problems. Dr. Belden's study involved 297 pre-schoolers who were screened by DSM IV standards as either: healthy; depressed; disruptive or depressed and disruptive. The study then examined the frequency of tantrums, the intensity and where the tantrums occurred. Children who consistently hit a parent or caregiver during tantrums and were unable to calm themselves down were found to be at a greater risk for conditions such as attention deficit hyperactivity syndrome. Children at a high risk for disruptive disorders which involve hostile behavior towards authority figures, aggression and violence were likely to experience tantrums at least five times a day on multiple days in school or at home than children who were categorized as developing normally. Tantrums which lasted more than 25 minutes were considered another measure of risk. Also, children who hit himself or herself during a tantrum had a definitive link to depression.

Ross Greene, M.D. of Harvard Medical School and the author of The Explosive Child, looks toward defining the anatomy of temper tantrums as key to understanding a child and their future risk. Dr. Greene focuses on using the tantrum to determine what skills the child is lacking and helping them build a repertoire of social and coping skills. Dr. Greene advocates for using a negotiation with the explosive child rather than to have the parent impose their will. Preparing children for disruptions to favored routines and changes is a better method than crisis response according to Dr. Greene. Spanking may, in fact, accelerate or prolong a tantrum and is not regarded a good response.

Dr. Belden offers parents an understanding that 30-40% of healthy children will exhibit violence towards a parent or caregiver on occasion and that does not mean that the child is headed towards a mental health problem. Tantrums are part of the learning process for children to learn to express and manage anger and practice coping skills. All things, which if learned in childhood, can serve us throughout our lives.

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Wednesday, January 16, 2008 8:00 AM
posted by Aric Thorpe, MHR

Stress link to asthma?

According to a recent study published in the January issue of the American Journal of Respiratory and Critical Care Medicine, children whose mothers are chronically stressed are more likely to have asthma than children whose mothers are not. According to Anita Kozyrskj, Ph.D., Associate Professor at the University of Manitoba, "It is increasingly clear that traditional environmental risk factors do not fully explain the origins of asthma… evidence is emerging that exposure to maternal distress in early life plays a causal role in the development of childhood asthma. In a cohort of children born in 1995, we found that maternal distress which persists beyond the postpartum period is associated with an increased risk of asthma at school-age." The researchers analyzed the medical records of almost 14,000 children native to Manitoba who were registered with Manitoba Health Services from birth in 1995 to 2003 to determine the presence of asthma at age seven. The following is an excerpt of an article from Medical News Today that reviews the study:

Dr. Kozyrskyj and her colleagues analyzed the medical records of nearly 14,000 children born in Manitoba in 1995 who were continuously registered with Manitoba Health Services until 2003. They determined whether the children had current asthma at age seven by analyzing records of doctor visits, hospitalizations and medications in the year of the child's seventh birthday, and related it to maternal distress as defined by doctor visits, hospitalizations and medication for depression and anxiety. Maternal distress was categorized according to onset and duration into four categories: no distress, postpartum distress only, short-term distress and long-term distress.

Click here to read the entire article from Medical News Today

Click here for information on the treatment of stress related problems
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Tuesday, January 15, 2008 8:18 AM
posted by Sarah McGee

Family Mealtime Reduces Eating Disorders in Teens

Taking time out of the day and eating regular meals with the family may reduce the risk of eating disorders in teenagers. After a five year evaluation, teenage girls were 29% less likely to suffer from eating disorders, such as purging, binge eating, or using diuretics, than their peers when they ate most of their meals with family throughout the week. Among teenage boys, family meals seemed to have little effect on the presence or absence of eating disorders.

Health care providers play an important role in reinforcing the importance of family meal time. According to Dr. Neumark-Sztainer, “Without being judgmental, providers can help families set realistic goals and come up with creative ways to increase frequency of meals together.” The following is an excerpt of an article from Medpage Today that reviews the study:

The prospective findings add to a growing body of literature suggesting family meals play an important role in the health and well-being of adolescent girls.
"Health care professionals have an important role to play in reinforcing the benefits of family meals," they said.

Without being judgmental, providers can help families set realistic goals and come up with creative ways to increase frequency of meals together, Dr. Neumark-Sztainer added.

"This may be eating breakfast together if dinner doesn't work," she suggested. "It can be challenging, I just think we have to put it up there with our priorities."

The researchers' Project EAT (Eating Among Teens) study had previously shown that extreme weight control behaviors increased in prevalence from 14.5% to 23.9% as the girls progressed from middle to late adolescence.

These behaviors can cause physical and psychological problems, including weight gain, depressive symptoms, and the onset of eating disorders, they noted.

Click here to read the entire article

Click here for information on the treatment of eating disorders
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Friday, January 11, 2008 8:41 AM
posted by Sarah McGee

Study: Girls’ Self Image May Affect Future Weight

“Where a teenage girl finds herself on the social ladder during her school years” can determine her weight gain proximity in the future. Over 4000 girls, average age of fifteen, were studied over a two year period. Where they saw themselves ranked among their peers was a determinate factor in weight gain. Although all teenage girls in the study naturally gained some weight over a period of years, girls that thought themselves to be less popular among their peers were 69% more likely to increase their body mass index by 2 units (11 excessive/ unnecessary pounds). Conversely, girls who found themselves to rank higher in popularity also gained weight, but only about 6 ½ pounds.

One limitation to the study was that data collected by the researchers was from ‘self-reports” of changes in height and weight, rather than reporting to a physician for documentation. Before collecting data for the study, the researchers took in to account the participant’s weight, BMI, diet, household income, race/ethnicity, and whether or not they had reached puberty.

All the teenagers were asked the same questions; for instance, “Where would you place yourself on the ladder?” The ladder represented a social scale from 1-10, 10 being the highest and associated with the most respect from peers and 1 being the lowest. 4, 264 girls ranked themslves 5 or higher on the ladder, while 182 said they were 4 or below on the ladder.

The study reflected that teenage girls are sensitive and easily affected by their social environments, possibly affecting physical health and or mental health. Adina Lemeshow, who began the study as a Harvard School of Public Health graduate student, stated, “How girls feel about themselves should be part of all obesity- prevention strategies.” Clea McNeely of John Hopkins Bloomberg School of Public Health called the study strong and stated, “Subjective social status is not just an uncomfortable experience you grow out of, but can have important health consequences.” McNeely went on to state that adults are still the most influential role models in the lives of teenage girls.

I believe, as women, it is our job to be examples throughout the lives of these young girls. Respect is not outdated; it is time tested and key to fostering relationships that will increase trust and affect change.

Click here to read an article from CNN that discusses the study

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Thursday, January 10, 2008 8:21 AM
posted by Aric Thorpe, MHR

Increased risk for hypertension, heart attack, and stroke, years after the events of 9/11

Acute stress caused by the 9/11 attacks increased the risk for hypertension, heart attack, and stroke, for years after the event, according to a recent study conducted by Alison Holma, F.N.P., Ph.D., of the University of California at Irvine. The study followed 2,729 adult participants for three years after the attacks in 2001. Participants that reported extreme stress reactions in the days immediately following the attacks were twice as likely to develop hypertension and three times as likely to suffer a heart attack or stroke. The odds ratio for those reporting ongoing worry after the attacks was 4.67 compared to those that did not report ongoing worry.

The study has public health implications, specifically with regards to the way that governmental organizations and news agencies communicate risks of terrorist events. According to Dr. Holma, "The message from this research is that we need to be very clear about the way in which we communicate information about terror attacks to the public." The following is an excerpt of an article from Medpage Today that reviews the study:

The impact of ongoing worry about terror attacks has public health implications "in terms of the way that we communicate risk of events like terror attacks," she said.

Dr. Holman said that in the years since 9/11 there have been a number of times when Homeland Security has raised alert levels, but there has been no research to determine the effect these terror alerts have on the health of the general public. "The message from this research is that we need to be very clear about the way in which we communicate information about terror attacks to the public," she said. Raising the alert level may, she said, have the unwanted side effect of increasing worry and anxiety.

"To our knowledge, this is the first study to demonstrate that acute psychological responses to 9/11 predicted increased incidence in reports of physician-diagnosed cardiovascular ailments for three years in adults, most of whom did not have known existing cardiovascular disease," she wrote.

Acute stress response was measured using a modified Stanford Acute Stress Reaction Questionnaire. Acute stress symptoms, Dr. Holman said, are similar to the symptoms of posttraumatic stress except in the case of acute stress symptoms occurring immediately.

Click here to read the rest of this article from Medpage Today

Click here to learn about treatment options for stress related behavioral conditions

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Tuesday, January 08, 2008 10:14 AM
posted by Aric Thorpe, MHR

Alcohol and depression often go hand in hand

Alcohol and depression often go hand in hand. Although not everyone that abuses alcohol suffers from depression, depression may fuel the need for alcohol in those that do. People who abuse alcohol and have depression may have a more difficult time quitting as a result.

According to a recent study published in the January edition of Alcoholism: Clinical and Experimental Research, after treatment for alcoholism you are less likely to remain abstinent if you have co-occurring depression. The study, which was performed by researchers from Minneapolis VA Medical Center, charted the success of 462 people attempting to quit using both alcohol and cigarettes. According to the study, those who had co-occurring depression were 1.5 times more likely to have reported drinking after follow up six months after treatment.

Treatment for alcohol abuse that does not address depression is only dealing with half of the problem. According to Molly Kodi, lead author of the study, "our study suggests that treating depression may help people recover from alcohol use problems, although more research is needed on this topic." The following is an excerpt of an article from Medical News Today that reviews the study:

At the beginning of the study, participants smoked at least five cigarettes a day and were alcohol dependent. Among the group, typical problematic drinking symptoms included repeatedly imbibing more than planned, difficulty quitting or cutting down, and continuing to drink even though drinking caused problems such as hangovers or sleeping difficulty.

All participants received intensive alcohol and smoking cessation treatment. Up to a year and a half later, researchers surveyed the participants and asked about their alcohol and tobacco habits.

"Among those who were depressed, the odds of drinking, the next time you checked in with them six months later, were 1.5 times greater than the odds of drinking for individuals without significant depressive symptoms," said lead study author Molly Kodl.

Of the people who were depressed, the majority suffered only mild to moderate mood problems.

"With significant depression, people report mood that is down in the dumps, loss of interest in things they used to enjoy, low energy, appetite changes and difficulty concentrating," Kodl said.

While depression seems to lessen the chances of alcohol abstinence, the study did not find a similar association for tobacco dependence.

Click here to read the entire article

Click here for information on treatment of co-occurring depression and alcoholism

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Monday, January 07, 2008 9:11 AM
posted by Aric Thorpe, MHR

Depression in female bipolar patients successfully treated with light therapy

Light therapy has been successfully used to treat Seasonal Affective Disorder (SAD for short). However, there have been limited studies regarding the affects of light therapy on bipolar patients that have depression. According to Dorothy Sitt, M.D., of the University of Pittsburgh, light-box therapy delivered at midday provided complete relief of depressive symptoms in 4 out of 9 female patients in the study, with partial relief being reported in 2 others. Researches reported in the December issue of Bipolar Disorders that therapy worked best between the hours of noon and 2 p.m. According to the researchers, "We found the optimal response was at 7,000 lux midday light for 45 or 60 minutes." The following is an excerpt of an article from Medpage Today that reviews the study:

Among nonresponders to the midday treatment, one had a full response when switched to a morning schedule, they said. Another had partial symptom relief with morning treatment.

Light therapy is used frequently in patients with seasonal affective disorder, and has been shown to be beneficial in some patients with nonseasonal unipolar depression as well. But it has not been well studied in bipolar depression, Dr. Sit said.

Patients were included in the current study if they had a diagnosis of type I or II bipolar disorder without a seasonal pattern and persistent depressive symptoms that had not responded adequately to other treatments. Those with other psychiatric or physical disorders, including recent drug abuse, were excluded. The women took antimanic drugs beginning four weeks before starting light therapy and continuing through the study period.

Treatment response was defined as improvement of at least 50% from baseline in scores on the Structured Interview Guide for the Hamilton Depression Scale with Atypical Depression Supplement.

Click here to read the entire article from Medpage Today

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Thursday, January 03, 2008 3:01 PM
posted by Aric Thorpe, MHR

Is hoarding a personal problem?

This time of year, in light of abundant gifts, gift giving, decorating, and New Year resolutions, people are purposing to get organized. However, there are some people that find that the task of getting organized is much more difficult. According to David F. Tolin, director of the anxiety disorders center at the Institute of Living, reluctance to get organized is sometimes "a personal problem." The fact is that excessive clutter and disorganization can be a sign of something more serious, a health problem. Often time’s people with brain injuries and certain behavioral issues have a more difficult time getting organized. In particular, behavioral issues such as depression, ADD (attention deficit disorder), grieving, and pain issues can cause a lack of desire to become organized.

Taking the idea that disorganization and clutter are symptomatic of health issues a bit further, hoarding, although not yet a recognized diagnosis, is a word used to describe chronic disorganization that interferes with a person's quality of life. People that suffer from hoarding find it impossible and even painful to part with items they possess. The good news is that there is hope for the disorganized and those that suffer from hoarding. A recent study showed that people suffering from hoarding experienced increased quality of life and less clutter after a six month period of cognitive behavioral therapy. The following is an excerpt of an article from the New York Times that discusses the issue of disorganization and health:

After the holidays, many shoppers load up their carts with storage bins, shelving systems and color-coded containers, all in a resolute quest to get organized for the new year.

The country’s collective desire to clean up is evident in the proliferation of organization-oriented businesses like the Container Store and California Closets. Reality shows like “Mission Organization” on HGTV and “How Clean is Your House?” on Lifetime feed a national obsession to declutter. The magazine Real Simple has even created a $13 special issue on cleaning house.

Getting organized is unquestionably good for both mind and body — reducing risks for falls, helping eliminate germs and making it easier to find things like medicine and exercise gear.

“If you can’t find your sneakers, you aren’t taking a walk,” said Dr. Pamela Peeke, assistant clinical professor of medicine at the University of Maryland and the author of “Fit to Live” (Rodale, 2007), which devotes a section to the link between health and organization. “How are you going to shoot a couple of hoops with your son if you can’t even find the basketball?”

But experts say the problem with all this is that many people are going about it in the wrong way. Too often they approach clutter and disorganization as a space problem that can be solved by acquiring bins and organizers.

Measures like these “are based on the concept that this is a house problem,” said David F. Tolin, director of the anxiety disorders center at the Institute of Living in Hartford and an adjunct associate professor of psychiatry at Yale.

“It isn’t a house problem,” he went on. “It’s a person problem. The person needs to fundamentally change their behavior.”

Click here to read the entire article from the New York Times

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Wednesday, January 02, 2008 4:45 PM
posted by Aric Thorpe, MHR

Psychotropic drugs and weight gain

Currently in the United States there is an obesity epidemic. The obesity epidemic is of particular importance to psychiatrists due to the fact that many of the psychotropic drugs they prescribe are associated with weight gain. There are various reasons for this including using particular combinations of drugs and diet, however. One study, focusing on 98 patients with affective psychosis or schizophrenia, found that recipients of atypical-antipsychotic drugs experienced a 7% weight gain in one year. There are several other studies that have explored the relationship between weight-gain and psychotropic drugs. Here is an excerpt of an article from Journal Watch that discusses some of these studies:

Some weight-related research might augur psychiatric pharmacogenomics, allowing clinicians to identify patients who are likely to gain weight when taking certain medications. In an animal study, the binding of antipsychotic drugs to histamine H1 receptors paralleled their likelihood of increasing appetite. Clozapine and olanzapine, both strongly associated with weight gain, increased hypothalamic AMP-kinase, which regulates food intake through H1 receptors. Atypical antipsychotics might increase appetite and therefore weight gain through this mechanism, which could become a target for treatment. Other receptors might be involved in antipsychotic-induced weight gain. Increased waist circumference, a core component of the metabolic syndrome, was associated with three polymorphisms of the serotonin 2C receptor gene.

Eating more, especially foods that pack a lot of calories into a small volume, is undoubtedly one mechanism of medication-associated weight gain. Animals given high-fat foods showed increased expression of striatal FosB, an early gene product involved in reward signaling. After withdrawal of high-fat or high-carbohydrate foods, animals showed stress responses mimicking those seen after withdrawal from substances that cause physical dependence. Animals also endured an aversive environment to obtain high-fat foods. Any strategy to prevent or treat weight gain must involve an appreciation of the potent effect of food on reward mechanisms.

Click here to read the rest of the article from Journal Watch

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