This post has been written to assist the reader in observing signs of depression in a friend or loved one.

How to Tell if  Somone is Depressed: A Quick Story

A young couple I have treated for some time came into my office recently. Lisa was angry with Justin because he had been (in her opinion) distant and unloving towards her in recent weeks. No matter how hard she tried to please him, nothing seemed to work, and she began to wonder whether he had lost interest in her. After I asked Justin certain key questions, it became clear that he had gradually become depressed and, in doing so, had lost interest in pretty much everything that had previously given him pleasure – including Lisa. Once Justin’s depression was adequately treated, he became the warm, loving and attentive man with whom Lisa had fallen in love and chosen to spend her life with.

There are some important lessons to this story.

First, depression is not always obvious. It can masquerade as something else (in this case, lack of interest in your partner).

Second, it is valuable for friends or loved ones to learn the tell-tale signs of depression so that they can offer help as early in the process as possible because depression is a painful condition, both for the person suffering from it and his or her loved ones.

So, here are seven tell-tale signs of depression that will help you determine if your friend or loved-one is developing depression:

1. Loss of interest in things that were previously pleasurable

Sometimes this loss of pleasure – also known as anhedonia – may not be complete. So your loved one may gravitate only to those things that are easily enjoyed and require the least amount of effort, such as playing video-games, sitting in front of the TV or surfing the Web. This readily leads to thoughts or comments such as “You have plenty of time and interest in surfing the Web, but not when it comes to spending quality time with me.” Engaging with another person and meeting that person’s needs require more effort than surfing the Web and therefore may be an early sign of depression.

2. Sleep difficulties

This may take the form of trouble falling asleep or waking up during the night or the early hours of the morning. You may find your loved one in another room, trying to while away the time. This may disrupt your own sleep and may feel like abandonment, leading you to say things like, “Not only isn’t he/she available for me during the day but even at night.” Again, it’s important not to take the symptom personally, but recognize it for what it is.

3. Eating changes

Too little or too much eating–with corresponding weight changes in the expected direction. A husband (for example) can readily become angry with his wife and blame her for eating too much and gaining weight, misinterpreting the symptom as a sign that she no longer cares as much about their intimate life and is therefore “letting herself go.”

4. Anger and irritability

A depressed person struggles to get through the day. Ordinary obstacles and challenges become more difficult and can lead to frustration and the feelings that go along with that. This is another tell-tale sign of depression that is easy to take personally.

5. Expressing negative thoughts

You might feel enthusiastic about something and your friend or loved one might come back with a “downer” of a response, such as “I don’t think that will amount to anything,” or “What does it matter? It makes no difference.” Such negative thoughts are a cardinal symptom of depression, yet sometimes they feel almost calculated to throw a dampener on things. The depressed person is not trying to make life difficult for others even though that is often the effect of depressive thoughts and utterances.

6. Suicidal ideas

These may take a passive form such as, “I don’t care if I live or die” or a more active form, such as “Sometimes I feel like driving the car off the road.” Always take such statements very seriously. There is a common myth that if a person is really suicidal, they don’t tell others about it; they do it. By this erroneous logic, if the person is telling you about it, you might mistakenly conclude that they won’t actually do it. Nothing could be further from the truth. Not only are such statements key elements of depression (which warrants treatment in its own right), but they suggest that such treatment is urgent.

7. Loss of confidence in oneself

Loss of confidence in oneself is a sign of depression. Depressed people feel poorly about themselves and their future. If your friend or loved one is usually more self-confident and optimistic and this then changes suspect depression.

What to do if someone I know is depressed?

Now that you have found out how to tell if someone is depressed, I wanted to offer some things you can do.

If you detect one or more of these signs in a friend or loved one, you may want to look up a more comprehensive list of symptoms for major depression in the standard manual for psychiatric conditions, the DSM-IV.

Once you suspect depression, do encourage your friend or loved one to seek consultation and treatment with a qualified person, not only for his or her sake but for yours. Sometimes it can also be helpful and comforting for you to offer to accompany the person to the consultation.

Wishing you Light and Transcendence,

Norman

I thought it might be helpful to include this 8-minute video, 11 Tips for Greater Happiness.

If you enjoyed this blog post you may wish to read:

• 9 Simple Tips to Help You Manage Your Emotions
• How to Stop Your Emotions from Controlling You?
• How to Become an Emotional Detective: Methods Used to Uncover Basic Emotions

The post Seven Tell-Tale Signs of Depression in a Friend or Loved One appeared first on Norman E. Rosenthal, MD.

As a psychiatrist, I have given a lot of thought to how to lead a healthier life by managing your emotions. Here are some of my thoughts, which I expressed in my book, “The Emotional Revolution.”

Here are my 9 Steps to Help You Learn How to Manage Your Emotions:

1. Use your emotions and bodily responses to recognize when you are under stress. A racing pulse, dry mouth, aching stomach, tight muscles, or muscle pain may all indicate that something is amiss in your emotional world.

2. Write down your thoughts and feelings about what is stressing you. Take a daily inventory of your emotions. By writing down what you feel and when you may be able to identify patterns of emotional ups and downs. It is also important to write down the thoughts that go with your feelings.

3. Control whatever aspect of the stress that you can. Life presents many situations every day, and you should not view them in black and white terms- those you can control versus those you cannot. Look for the shades of grey- the elements you can control. When you know what’s going to happen in a situation, your nervous system can gear up to handle it.

4. Don’t make mountains out of molehills. When difficult situations arise, it is important to assess how bad they really are before going into panic mode. If you want to live a low-stress life, don’t get all worked up over trivial matters.

Illustrated by Karen Lauria – www.imagekind.com

5. Redefine the Problem. Your attitude to stress can affect your health more than the stress itself can. If the problem is out of your control, recognize that and redefine the problem to determine which parts you can avoid or handle.

6. Develop behaviors that distract you from stress. Anything you do that distracts you from your stress for a while is good. For example, you could get out in nature and take a walk, work in the garden or perhaps learn to fly fish.

7. Reach out to a friend or a family member. Social relationships are good for your health, and reaching out to someone about your stress can improve your outlook. If you are lacking social networks, you may find it easiest to meet others during a shared activity.

8. Exercise Regularly. Regular exercise is good for your physical and emotional health. Even moderate exercise can help reduce stress.

9. Meditate and Relax. Meditation has a wide variety of health benefits, and stress reduction is one of the big ones.

There is no single way to instantly reduce stress or manage your emotions. By using a variety of tools and methods, you will be able to calm your mind and regain your emotional health.

Thank you for reading these 9 simple tips. If you found this post useful please share it with your colleagues and/or friends.

Wishing you Light and Transcendence,

Norman

If you found this article helpful you might also like, Seven Signs of Depression in a Friend or Loved One.

Additional Information:

1. University of Arizona – Manage Your Emotions (Click Here)
2. Transcendental Meditation and Stress
   

The post 9 Simple Tips to Help You Manage Your Emotions appeared first on Norman E. Rosenthal, MD.

The tendency to experience seasonal changes and difficulties exist on a spectrum. People who experience these changes to a milder degree are said to suffer from the winter blues. The distinction between SAD and the winter blues is not hard and fast. A person might easily experience SAD during one winter and the winter blues during another, depending on where they live, the severity of the winter, what treatment they may be receiving, and many other factors. Fortunately, it is often unnecessary to distinguish between whether somebody has SAD or the winter blues.

The following is a summary of the most commonly used treatments for seasonal affective disorder. If you wish to learn more about each type of treatment you can find further details elsewhere on this website, as well as in my latest book Defeating SAD: A Guide to Health and Happiness Through All Seasons.

1) Light Therapy

The observation that the symptoms of SAD develop as the days get short and dark and remit in the spring and summer was a powerful clue that the symptoms of SAD might be caused by the changing length and strength of environmental light across the seasons. If that were the case, we reasoned, perhaps giving people more light during the dark days would reverse their symptoms. This turned out to be true. Through a series of experiments, our team at the National Institute of Mental Health in Bethesda, Maryland, and other groups throughout the northern hemisphere, found that light therapy, as it came to be known, was indeed an effective treatment for SAD. Important elements involved in successful light therapy included:

• The brightness of the light

Environmental light is measured in lux. Indoor light levels. in the absence of direct sunlight, often fall between 300 to 500 lux. To get a therapeutic effect, we and other researchers found that much higher environmental light levels are necessary.  Although light levels were initially found to be effective at 2500 lux, increasing levels further to  10,000 lux was found to be preferable.

• Obtaining a light box

Practically speaking, this level of light is best achieved by obtaining a special light fixture, which commonly goes by two opposite-sounding names – a SAD lamp or happy light. In order to administer the light properly, the box needs to be placed at a certain distance from the recipient and used for a certain amount of time, preferably in the morning. More details about the best box to use and how to use it can be found elsewhere on this website.

• Light from other sources

Remember, not all therapeutic light has to come from a box.  Even though the months of winter are dark, you’d be surprised how much light you can get by walking outdoors on a winter day and glancing up periodically at the sky. Outdoor sports, such as skiing, will expose you to even more light.

2) Cognitive Behavior Therapy (CBT)

Often the down feelings of SAD or the winter blues can be aggravated by certain dysfunctional behaviors and distorted thought patterns that are amenable to being modified by systematically inspecting them and, where necessary, changing them. Kelly Rohan, professor of psychology at the University of Vermont, has conducted most of the research in this important area.

Therapeutic behavioral interventions include helping people to exercise, socialize, and commit to potentially enjoyable activities, which easily fall by the wayside when you have SAD. Cognitive corrections are geared towards improving the distorted thinking that commonly occurs in people when they feel depressed. The depressed person is taught to identify certain types of specific distortions which are given names such as “fortune telling.” For example, depressed people who experience a rejection may conclude that nobody will ever accept them. The term “fortune telling” highlights the unwarranted nature of this assumption. Instead, patients are encouraged to think of possible reasons for the rejection that don’t reflect poorly on their worth.

Rohan and colleagues have found that a CBT approach is not only helpful in reversing the symptoms of SAD but also in preventing them from occurring in subsequent winters.

3) Attention to foundational habits

Certain healthy habits, when practiced regularly, can boost and maintain your good spirits through the wintertime. Such habits include:

• Exercise, both aerobic and resistance training
• Making sure you get enough good sleep – but not too much
• Managing your diet. Even though people with SAD crave sweets and starches, the energy boost these foods may give you is short-lived and you are likely to be going back for more before long. Shift your food group intake towards proteins, complex carbohydrates (such as legumes, grains and green vegetables)
• Meditation, such as Transcendental Meditation and Mindfulness practices can be helpful in providing stress release helping you stay grounded.

4) Minimize stress.

Recognize that this is a season when people with SAD or the winter blues have trouble with stress and can be greatly helped by relieving stress. Often it is worth paying for prepared food or services if you can afford to do so. Sometimes people with SAD feel ashamed to ask for help and thereby compound the problem by taking on more stress.

When should you consider getting medical help? 

If the above self-help methods do not seem to be having their desired effect after a week or two and you are still suffering from SAD or the milder version, the winter blues, consider consulting a mental health professional. You may benefit from antidepressant medications and other professional services and I certainly recommend you access these opportunities if you are still having trouble. There is no need to suffer when help is available.

If your functioning is severely disturbed and your symptoms are jeopardizing your personal life or your work, that should spur you on to seek medical help sooner rather than later.

If you feel as though life is not worth living and have any thoughts of harming yourself, please do not delay in seeking out professional help.

How long should treatment continue?

There is no fixed rule to measure how long to continue treatment. The best guide is to use your “internal sad meter.” What I mean by that is evaluate how you are feeling, asking yourself questions such as:

1. Is my energy level lower than normal?
2. Am I sleeping too much?
3. Am I eating too much, especially sweets and starches?
4. Am I having trouble getting things done?
5. Am I having trouble socializing and is this causing me problems with friends and family?
6. Have I lost all interest in sex?

Depending on how you answer these questions you will have a very good sense as to whether you are suffering from the winter blues or SAD – and how you are managing with the condition. Once you have made this assessment you can decide whether you need more treatment or not.

When should I stop treatment? 

This varies from person to person. Once again I suggest that you consult your “internal sad meter.” If you are feeling well again in those aspects of your functioning that are important to you, it may be time to taper some of your treatments such as additional light. Other self-care, such as maintaining your foundational habits or checking your thought processes and behaviors will serve you well throughout the year. When spring comes and you choose to pack away your lights, or your lightbox, don’t put it too far away as spring weather is often erratic and a snap of cloudy weather may call for bringing out the lightbox for a week or two.

Related reading:

• Defeating SAD: A Guide to Health and Happiness Through All Seasons.
• Seasonal Affective Disorder Symptoms (Top 9)
• Summer Seasonal Affective Disorder | Symptoms & Treatment
• What college students should know about Seasonal Affective Disorder
• Feeling Depressed? Look on the Bright Side

The post Beating the Winter Blues: Effective Strategies for Treating SAD appeared first on Norman E. Rosenthal, MD.

What is Seasonal Affective Disorder (SAD)?

Timing of SAD Symptoms

Typically, symptoms of seasonal affective disorder (SAD) occur as the days get shorter and darker. As you can imagine, the timing of when that happens differs according to where you live. Even a difference of two or three degrees of latitude can make a difference to when SAD is likely to strike. In Maryland, for example, where I have lived for several decades, I would typically feel my own SAD symptoms starting in mid-October and going on till March. When I would visit my sister in the Boston area, however, my symptoms would extend from September through April. Since Boston is at about 42 degrees latitude and Bethesda, Maryland at 39 degrees latitude, I can personally attest that a small difference in latitude can extend or contract the duration of symptoms by a month on either end.

I’m referring of course to a time before we knew what SAD was and how to treat it. Now the timing of symptoms can very much be altered for the better thanks to all the SAD-defeating treatments discussed elsewhere on this webpage.

As far as the timing of symptoms is concerned, be careful not to be fooled by darkness that arrives at unexpected times, such as during the springtime when cloudy weather is not uncommon and may last for a week or two. SAD symptoms may also emerge unexpectedly, for example, when you happen to find yourself in dark environments for any reason – for example in basement apartments or rooms with windows that are either small or obstructed. I have seen people whose symptoms arise because of heavy foliage outside their windows or another building too close to theirs.

In many people with SAD the symptoms, if left unchecked, progress in a predictable way, starting with physical symptoms, such as changes in sleeping, energy and eating. Such symptoms are often followed by psychological symptoms, such as difficulty concentrating and thinking clearly, and withdrawal from friends and family. As you can imagine, all these symptoms have consequences. The resulting depression is often a late emerging symptom, which is one of the reasons why the diagnosis of SAD can get missed. Many of the physical symptoms can seem nonspecific and resemble other conditions.

Ask yourself: How do I feel when the days get shorter and darker, and around the Christmas holidays? How do I feel when spring arrives and the days get longer and brighter? Such simple questions can be the first step towards diagnosis and a happy outcome.

In order to defeat SAD, be sure to catch the symptoms early before you or those you care about get depressed. Remember the old cliche – prevention is better than cure and catch the symptoms of SAD early.

Not sure if you have SAD? Take the seasonal affective disorder quiz

Seasonal Affective Disorder Symptoms

Lack of energy, feeling sluggish
Increase need for sleep and difficulty waking in the morning
Increased appetite, especially for sweets and starches
Weight gain
Difficulty concentrating
Less interested in engaging with others
Difficulty completing tasks and getting things done
Decreased creativity
Depressed mood, sadness

As you can imagine, the symptoms mentioned above lead to difficulties in different ways.

What you soon realize is that everything requires energy. Without your usual quota of energy, things you may take for granted in other seasons can become all but impossible.

Increased appetite and craving for sweets and starches inexorably lead to weight gain, especially since your lack of energy means fewer calories get burned from exercise.

Difficulty waking up in the morning results in difficulty starting work on time. Difficulty concentrating and getting things done means that the quality of your work is often not your best. Sometimes people feel like they are actually failing at their job or in their homes, where chores mount, bills are unpaid and all sorts of problems may ensue.

As though you don’t already have enough problems, withdrawal from friends and family typically causes people to avoid you. On the one hand you may feel a sense of relief at being left alone. Loneliness, however, may compound your sense of misery and feelings of abandonment.

Finally, all the problems resulting from all the symptoms mentioned above contribute to feeling clinically depressed, which can be severe in some people with SAD, especially if you don’t know what’s causing it.

The good news about SAD is that there is so much you can do to overcome it, as I elaborate elsewhere on this website and in my book, Defeating SAD: A Guide to Health and Happiness Through All Seasons.

Looking For More Info? Explore Dr. Rosenthal’s Landmark Book Defeating SAD!

The Course of SAD Symptoms

We can think about the course of SAD symptoms across the seasons or across a person’s lifetime.

As I mentioned above, SAD symptoms begin and end at different times of the year depending on where you live, which in turn affects the length of the day and the amount of light to which you are exposed.

People in the same location may experience their symptoms at different times of the year, however. For example, the symptoms of one of my patients with winter SAD began in August, whereas others are fine until after the holiday season and may experience symptoms for the first time as late as January or February.

The course of symptoms can fortunately be radically changed by treatment and in many people, can be entirely eliminated.

Bottom Line

Knowledge of the symptoms can lead almost all who suffer from SAD to be successfully treated.

Related reading:

• Seasonal Affective Disorder | Overview + Infographic
• Summer Seasonal Affective Disorder | Symptoms & Treatment
• Seasonal Affective Disorder Quiz
• Defeating SAD (Seasonal Affective Disorder): A Guide To Health & Happiness Through All Seasons

The post Seasonal Affective Disorder Symptoms (Top 9) appeared first on Norman E. Rosenthal, MD.

Of natures, some are well- or ill-adapted for summer, and some for winter.

—Hippocrates

What is Summer SAD?

While Seasonal Affective Disorder (SAD) is commonly associated with the fall and winter months, some individuals experience a similar pattern of depressive symptoms during the summertime. This condition is known as reverse seasonal affective disorder, summertime seasonal affective disorder, or summer-onset SAD.

How My Colleagues and I Discovered Summer SAD

We have known about summer seasonal affective disorder (Summer SAD) for almost as long as its more common winter counterpart.

After my colleagues and I at the National Institute of Mental Health (NIMH) first encountered a few people who reported having regular winter depressions (separated by non-depressed periods in spring and summer), I approached a journalist Sandy Rovner at the Washington Post, who was intrigued by the idea of seasonal depression.  Her resulting article, aptly titled, “Seasons of the Psyche” was deemed so novel that it was syndicated all over the country.  Thousands of readers responded, the majority endorsing the regular winter pattern of depression featured in the article. But a significant minority complained that they felt worst in the spring and summer, year after year. So we realized, there was indeed a summer version of seasonal affective disorder, which we called “Summer SAD” or “Reverse SAD” because its timing was the opposite of winter SAD.

My colleague Thomas Wehr and I were eager to explore the features of what we called Summer SAD.

We compared 30 people with recurrent summer depression (summer SAD) to 30 sex-matched people with recurrent winter depression (winter SAD).

Here’s what we found.

Similarities and Differences Between People with Summer and Winter SAD

Seasonal depression symptoms in people with summertime seasonal affective disorder

Although people with both types of SAD reported feeling worst in their seasons of risk, those with the reverse seasonal affective disorder were more likely to report the following:

• Sleeping less
• Feeling overactivated and agitated
• Having decreased appetite
• Having more suicidal ideas
• Being bothered by heat and/or light

Seasonal depression symptoms in people with winter seasonal affective disorder

Those with winter seasonal affective disorder were more likely to report the following:

• Sleeping more
• Feeling slowed down
• Feeling lethargic
• Having increased appetite and carbohydrate craving
• Gaining weight
• Having fewer suicidal ideas
• Being bothered by darkness

Not sure if you have SAD? Take the seasonal affective disorder quiz

People with winter SAD seemed more like one another than those with summer SAD, whose symptoms differed to a greater extent from person to person.

Both groups in our study were predominantly women (90%), having a greater preponderance than we usually find in people with winter SAD in whom the female to male ratio was closer to about 3 or 4 to 1.

As you might expect, those with Summer-SAD were more likely to attribute their symptoms to heat or light, whereas those with winter SAD typically blamed the short dark days.

Since the world is getting warmer and more people, at least in the US, are moving south, summer SAD may become increasingly common and important from a public health perspective.

Treatment of Summer Depression

1. Keep cool

We had learned from Winter SAD the value of reversing the seasonal changes that seemed instrumental in causing symptoms: Hence the development of light therapy. By analogy, some sort of “cold therapy” seemed logical for people with Summer SAD.

Of course, with regard to light therapy, we were at an advantage as a result of basic studies, which suggested that bright light would be especially helpful. Specifically, Alfred J. Lewy and colleagues in our group had shown that exposing people to bright light was capable of suppressing the nighttime secretion of melatonin – a hormone known to be responsible for orchestrating seasonal rhythms in animals.

Even though we had no analogous biological finding to guide us in the treatment of summer depression, we followed a basic principle in medicine: Replace what is missing – in the case of summer SAD, cool temperatures.  Although there have been no systematic studies of this treatment. Several patients endorse the value of staying cool.

Here is an example.

Elaine: Bathing in cool waters

Elaine was a woman in her mid-fifties, who had suffered from regular summer depressions for several years – until she and her family went on a visit to the Finger Lakes in northern New York State during the summer. There she developed the habit of bathing in the cold lake waters every day, which had a profoundly positive effect on her mood.  She believed that it broke the worst part of her summer depression, shortening it and making it less severe.

Over time, Elaine began to seek out cool spaces, much as people with winter SAD gravitate to the light.

Just as traveling south during winter may help people with winter SAD, so traveling north during the summer may be helpful for people with summer SAD.

Other ways to stay cool during the hot summer days

Although we haven’t yet developed an effective “cold therapy” for people with summer-SAD, analogous to the treatment of winter SAD, here are some things you can do to stay cool during the summer, which may greatly help people with summer SAD.

• Take regular cold showers or baths
• Turn down the thermostat on your air conditioning
• Keep curtains drawn (If you also have winter-SAD, make sure that doesn’t cause another set of problems by reducing your ambient light levels too much.)

As yet untested both for effectiveness and safety are the relatively new cryotherapy chambers, in which a person climbs into a chamber filled with very cold air for brief periods. It would certainly be something worth testing in people with summer-SAD under proper experimental circumstances.

Looking For More Info? Explore Dr. Rosenthal’s Landmark Book Defeating SAD!

2. Consider starting or altering your dose of antidepressant medications

Of course, when it comes to receiving antidepressant medications, an appropriate medical professional needs to be involved.

One special consideration in treating summer SAD with medications is to anticipate the coming depression based on past history. For example, if you happen to get depressed even in July (not an uncommon pattern of summer SAD), it might be helpful to start antidepressants (or increase the dosage of current antidepressants) a few months earlier — for example in April or May. That way the higher dose of medicine will be in place when it is needed most.

Since summer depressions often have mixed features – overactivity and agitation combined with low mood – it may be useful to combine antidepressants with mood stabilizers, such as lithium carbonate, Lamictal (lamotrigine) and neuroleptics, such as Abilify (aripiperazole). As you can imagine, it is important to find someone with appropriate expertise to help you manage the shifting mood fluctuations of this tricky form of SAD.

3. Light manipulations

Even though heat is usually an important component of the problem of summer SAD, light may also play a role.

Too much light may agitate people, creating an uncomfortable mix of depression and irritability.  For some people, decreasing environmental light may settle down the irritable component of the problem, which can help calm people down.  People can decrease their ambient light by staying in darkened rooms or wearing blue-blocking goggles, which can be less inconvenient. Such goggles can readily be obtained online.

Paradoxically, some people may benefit from extra light, strategically administered at certain times of the day. One colleague of mine with summer SAD, for example, found that being exposed to a short burst of sunlight early in the morning did wonders for reversing the symptoms of her summer SAD.

Conclusion:

Summer SAD certainly exists and can be both severe and dangerous since the mix of depression and agitation may go along with suicidal ideas and behavior.  The pattern of agitation, loss of appetite, insomnia, and negative responses to heat and/or light is opposite to that usually found in people with winter SAD.  Although people with summer SAD often do not respond as well as those with winter SAD, there are still several ways to alleviate symptoms, as outlined above.

Related reading:

• What college students should know about Seasonal Affective Disorder
• 11 Tips for Greater Happiness
• Seasonal Affective Disorder—Beating the Winter Blues
• 4 Articles: Seasonal Affective Disorder & Winter Blues

The post Summer Seasonal Affective Disorder | Symptoms & Treatment appeared first on Norman E. Rosenthal, MD.

Although many things are unpredictable, one thing is certain: No life is entirely free of adversity. No matter how hard you try to prevent misfortune, loss, mistakes, and accidents, setbacks are bound to occur. That is the bad news. The good news is that you can often do a lot to soften the blow of adversity or even turn it around to your advantage.

Here’s how:

1. Accept that adversity has occurred.

This advice might sound simplistic or even ridiculous. How could you possibly miss the fact that something bad has happened? You’d be surprised. Denial is a powerful force. Often people just don’t want to accept bad news. That recent breakup? Well, he or she is bound to come back. Not necessarily. The same goes for those risky shares you bought that then went through the floor. Oh, they’re sure to bounce back, you might think. Maybe, maybe not. If you recognize that a setback may be irreversible, you have taken a step in the right direction.

2. Analyze the situation, including your contribution to it.

Whether you’re dealing with work or your personal life, analyzing a situation correctly is crucial to proper decision making. For example, if you did something to cause a breakup, an apology may make all the difference. On the other hand, if conflicts are irreconcilable, move on.

3. Respond in proportion to the nature of the adversity

Don’t shoot a mouse with a gun. A mouse trap is likely to be more effective and will certainly cause less damage.

Click Here to Get the Book!

4. Regulate your emotions and stabilize your physiology

Adversity destabilizes us emotionally and physically. We may feel sad, angry, or even hopeless. We may feel like to staying in bed with the covers over our head, eat too little or too much, and sleep and wake at all hours. Perhaps we’re evening punishing ourselves for whatever has gone wrong when in fact the very opposite behavior will likely be much more helpful. So, get plenty of sleep and light, and eat good food.

5. Cultivate good habits

When you do things regularly, they become habits – and good habits make it easier for us to take care of ourselves. So, maintain your regular schedule – waking, sleeping and eating at regular hours. This will strengthen your circadian (daily) rhythms, and make it easier for you to fall asleep at night and wake up in the morning. Other good habits may include exercise, meditation, and yoga. Avoid bad habits – like using addictive substances to boost your energy or settle yourself down. Bottom line: When things go wrong, you need to take better care of yourself than ever.

6. Reach out for help

Sometimes when adversity hits, you may want to avoid others, perhaps out of embarrassment or a wish not to seem like a “loser.” Instead, seek out the help of friends and family, who may be able to offer valuable advice, support, comfort and concrete assistance. Obviously, it makes sense to choose carefully whom you approach for help so that you are more likely to get the response you need rather than criticism or rejection.

7. Tell a story

Research by psychologist James Pennebaker has shown that writing down one’s deepest thoughts and feelings in just four sessions of 20 minutes spread over 7 to 10 days can have lasting benefits both physically and psychologically.

Norman E. Rosenthal, M.D.

Clinical Professor of Psychiatry at Georgetown University School of Medicine and the author of The Gift of Adversity, Tarcher Perigree, 2013

Additional:

• The Gift of Adversity | The Huffington Post
• The Gift of Adversity: An Interview with Dr. Norman Rosenthal | World …
• Signs of Infidelity: 10 Clues That Your Partner May Be Cheating
• 11 Tips for Greater Happiness

The post Seven Ways to Handle Adversity appeared first on Norman E. Rosenthal, MD.

I was delighted to see the Time Magazine article, featuring the research on Botox for depression that my friend and colleague Eric Finzi and I conducted.  I think that the approach holds out real promise for many people who struggle with that difficult condition.

TIME MAGAZINE: BOTOX ARTICLE
Or click on any image below

THIS IS ONLY AN IMAGE, Click to Read

THIS IS ONLY AN IMAGE, Click to Read

The post Botox For Depression Featured in TIME Magazine appeared first on Norman E. Rosenthal, MD.

Here we are again at the New Year, like Janus, that two-faced god of ancient Greece, one face cast back to the old year and the other looking forward to the future – steadily or tentatively, with anticipation, trepidation or both.

It is time once again for our New Year’s resolutions. But before we resolve to do anything, let’s take stock. After all, if you wanted to fix up your house, you would first inspect it thoroughly, decide what needed fixing, and then make plans to do so. In the same vein, I encourage you to ask, “How has the last year been for me? What am I pleased about and what might I like to change?” Consider those areas of your life that most people regard as important so that you can tackle them one by one.

Here they are:

• Physical health
• Emotional well-being
• Relationships with friends and family
• Spiritual life
• Engagement with the world around you

Physical health

First, do you have any physical illness that needs ongoing maintenance or care? This is one area where attentiveness or neglect can make a huge difference to the quality of your life. As a doctor, I encounter all too often people who skip necessary medications, dietary advice or exercise. One patient of mine, for example, a highly intelligent woman with diabetes, often forgets her daily insulin with unfortunate consequences.

Now is an excellent time to take inventory of your health, identify problems or vulnerabilities and review your plan for how to take care of them in the New Year.

But even for those of us without specific ailments, we are becoming increasingly aware of the value of preventive measures in creating a healthy and happy life. Review your diet and exercise program and make just a few small changes that can have big payoffs. For example, cut out or minimize pure sugar in your diet. Take a 20-minute walk once a day. You are more likely to stick to such simple measures than to complicated plans.

Emotional well-being

Ask yourself how you are doing emotionally, which is something many of us don’t do. Instead, we might focus on the emotion of the moment, as in “I am happy or sad, angry or lonely.” But take the opportunity to question more broadly how you are doing overall in your emotional life – a first step to any change that is needed. For every emotional problem there is a potential remedy. Sadness can be lifted, rage pacified, anxiety relieved. At the same time, satisfaction can be expanded and happiness attained. For each of these goals many solutions have been offered. They can easily be researched online, in books or by speaking with a counselor. But the first step is to ask the question, diagnose what is needed and then set out to make a plan to address it.

Relationships with friends and family

It is well known that happiness depends to a large degree on relationships with friends and family. Now is a good time to take stock of these and ask yourself about the health of your relationships. Often we find ourselves complaining that others misunderstand us, do too little for us or don’t appreciate us enough. But let’s not forget also to look inwards and ask ourselves whether we are doing enough for them. Let me quote here from the famous prayer of St. Francis

Grant that I may not so much seek

To be consoled as to console

To be understood as to understand

To be loved as to love

For it is in giving that we receive

As it has often been pointed out, we cannot control the behavior of others, only our own behavior. Being creative in how you relate to others and help them can be key to improving your relationships.

Spiritual life

Consider those practices that uplift you and make you feel better about yourself as a person. Often these very same practices also help others, in that they involve charity and kindness.  In helping others, we lift our own spirits. Spiritual practices may or may not involve a specific religion. Think about what practices are right for you and put them on your list.

Engagement with the world around you

On the macro level, we all share the same home – the earth – and we realize, now more than ever, that its resources are finite. The earth is getting more crowded and hotter. At the same time it is a more interconnected world. Be mindful of the health of our planet and develop some investment in the importance in our interconnectedness.

On the local level, we can support our communities in many ways, from buying local produce to helping local charities and simply being a good citizen. I think of the Dalai Lama’s famous saying, “Be kind whenever possible, and it is always possible.” This kindness should start with yourself. Your body is your dwelling place. Look after it. Your brain runs all your life’s activities. Nurture and respect it. The better you take care of yourself, the more you will be able to reach out to others in the New Year and take care of them.

With these thoughts, I wish you all a healthy and happy New Year, and hope that you manage to accomplish at least some of your resolutions in the New Year.

Additional Articles:

• New Year’s Resolutions: Keep It Simple
• Preventing Winter Weight Gain: Breakfast and The Carbohydrate Connection
• What college students should know about Seasonal Affective Disorder

The post New Year’s Resolutions appeared first on Norman E. Rosenthal, MD.

I was very pleased when a colleague who heads up the department of psychology at American University in Washington, DC, invited me to talk to his students about seasonal affective disorder (SAD) and the Winter Blues. Having researched the condition, which I described and named back in 1984, and treated hundreds of SAD patients since then, I have become increasingly impressed at the risk it poses to college students.

As most of you probably know by now, Seasonal Affective Disorder is a type of depression that typically arises during the dark days of the year. What is less well known, however, is that people with SAD generally experience other symptoms before they become depressed.

These include:

• Difficulty waking
• Decreased energy
• Difficulty concentrating
• Increased appetite especially for sweets and starches
• Weight gain
• Anxiety
• Decreased interest in socializing

[Video 3:33] What College Students Need to Know About Seasonal Affective Disorder

As you can imagine, having these symptoms can interfere with functioning both in your personal and professional life. They are enough to make anybody feel depressed, which is what often follows. The Winter Blues is a lesser variant of the condition that interferes with creativity, productivity and the joy of living, but is not disabling.

In a study of schoolchildren in Maryland, my colleagues and I found that by the time the students reached their senior year of high school, 1 in 20 had full-fledged SAD and 2 or 3 times that number had the Winter Blues. Although college students have not been studied systematically, my guess is that they probably suffer in higher numbers.

Here’s why:

1. Disturbed biological rhythms

Most high school students get some help from their parents in regulating their daily (circadian) rhythms. Parents often help their children get going in the morning and encourage them (with more or less success) to get to bed at reasonable hours of the night. With college comes the freedom to stay up late and sleep in the next morning. In doing so, students are deprived of sleep and light – especially the important light of early morning. Their daily (circadian) rhythms shift later (delayed), which compounds the problem.

2. Workload increases over the course of the semester

To some extent increased workload is a function of the syllabus, as many schools ease students into their studies. But as vulnerable students begin to experience fall-winter difficulties, their work piles up and they fall increasingly behind, thereby compounding the problem. Once again, the corrective input that good parents can provide is usually missing. Students often feel ashamed that they are not managing as well as they would like to – or think they ought to – and delay reaching out for help, which only makes the problem harder to reverse when they finally do so.

Advice to students who think you (or a friend) may have SAD or the Winter Blues.

1. Recognize the problem. Remember that the early symptoms often involve changes in energy, sleep, appetite, weight, concentration and engagement with others. These symptoms often occur before feelings of depression.

2. Take SAD seriously. Act sooner rather than later. Get help when needed.

3. Bring more light into your home, which can mean more regular lamps or light fixtures specially designed to deliver light levels found to be therapeutic in research studies. Light therapy is usually most potent in the morning – and the earlier the better.

4. Put your bedside lamp on a timer that turns the light on half an hour before you wake up in the morning – or invest in a dawn simulator.

5. Exercise, preferably combined with light – such as walking outside on a bright winter day or working out indoors in front of a light box.

6. Stay active socially, and schedule activities that you enjoy with friends and family members who cheer you up.

7. If you find that despite all your best efforts, you are falling behind in your work, or that your health is suffering physically or emotionally, seek out professional help. Antidepressants and other strategies can be very helpful. You don’t have to do it all yourself.

Further reading:

For more information on SAD and the Winter Blues check out additional articles by looking through this blog and my book Winter Blues (Guilford 2013)

Social Media:

In order to maximize awareness about SAD in students, please post pictures and information about this on your social media and use the hastag #BeatSAD. My details are below—my team and I will do our best to find your posts and respond.

Facebook – https://www.facebook.com/normanrosenthal/
Twitter – https://twitter.com/DoctorNorman
Instagram – https://www.instagram.com/doctornorm/

Additional Resources:

11 Tips for Greater Happiness

Seasonal Affective Disorder: Beating the Winter Blues

How to Stop Your Emotions from Controlling You

The post What college students should know about Seasonal Affective Disorder appeared first on Norman E. Rosenthal, MD.

Nobody wants to find out that his or her partner is cheating, but unfortunately infidelity happens all too often. If cheating is happening, you may as well know about it so that you can decide what steps to take.

Here are some signs of infidelity—ten clues to help you determine whether your partner may be cheating.

1. You have a suspicion that something is going wrong. Ask yourself whether you have always been a suspicious person or whether it started at a certain point—like after he or she came back from a business convention. This question helps you sort out whether there is reason to be concerned about infidelity. Remember, your emotions provide you with crucial information about your world—including how solid your relationship is.

2. Behavioral patterns change. He or she may start “working” later, extending “work trips” or “needing” to go out of town more frequently.

3. Behavior regarding mobile devices changes. For example, there may be an increase in texting, often done surreptitiously so as to suggest that the texter doesn’t want you to see what is being texted. Or the cell phone is never left unattended, but is carefully guarded as though it contains the nuclear codes.

4. Likewise, unexplained emails may raise suspicions. Or, after you become suspicious, your partner refuses to give you access to his or her personal email password, or to see the emails.

5. Your partner shows a decrease in sexual interest—at least in you. This may take the form of a partner begging off (not tonight, I have a headache) or showing less enthusiasm while making love.

6. It’s harder to reach your partner than before. Although everybody is unavailable at times, this often escalates when a partner is cheating.

7. When you question your partner about why you’ve been having a hard time reaching him or her, the response is often defensive. Sometimes you are blamed for being paranoid, which may make you feel guilty about your suspicions—until the next round of suspicious behavior.

8. You “smell a rat.” Fragrances are often giveaways—such as a novel soap, cologne or mouthwash. Or the absence of a smell may be suspicious—such as a partner freshly showered at an unusual time of day, like when they are supposedly just coming home from work.

9. Evidence that a friend or colleague at work is taking up an increasing amount of real estate in your partner’s head. Suggestions of infidelity may take the form of a territorial secretary or a colleague who enters the conversation a bit too often.

10. Subtle changes in the environment for which there is no good explanation—like a change in the positioning of the seat on the passenger’s side of the car.

What do you do if you find an increasing number of suggestive clues that your partner is cheating? That is an important question and a topic for another blog.

Related Reading:

11 Tips for Greater Happiness

Seven Tell-Tale Signs of Depression in a Friend or Loved One

Infidelity: Mending your marriage after an affair

The post Signs of Infidelity: 10 Clues That Your Partner May Be Cheating appeared first on Norman E. Rosenthal, MD.

A picture of the night sky in Essex

I arrived back last Thursday from a week in the United Kingdom, during which I delivered three different talks, geared towards different audiences, in London, Colchester, and other towns in Essex. My host Barry Spivack was an excellent guide, connecting me with first-rate organizations and fascinating people.

In speaking to groups of physicians and therapists, I chose “Transcendence: Healing and Transformation Through Transcendental Meditation,” the name of my 2011 NY Times bestseller. Transcendence talks about my own rediscovery of Transcendental Meditation at the urging of a young man with bipolar disorder whom I had been treating. He told me that although my medications had helped to stabilize his moods, what was making him “really happy 90% of the time” was Transcendental Meditation. Our exchanges on the subject sent me back to refresh my technique (I had learned TM decades before), to meditate regularly, to research the effects of TM in people with bipolar disorder and ultimately to write about the subject. Transcendence was all about what meditation can do for people who are stressed or suffering from a multitude of stress-related conditions. As such, I thought this talk would be ideal for practitioners so that they could recommend it to their patients.

[Video 2:10] #1 Washington Post Best-Seller Super Mind

As I continued to meditate, I realized that TM can do much more than simply relieve stress. It can help expand consciousness and grow our mental capacity, boosting performance and helping us lead richer lives. That discovery in myself, my patients and in the literature led me to write Super Mind. In a second talk, “From Transcendence to Super Mind,” I chronicled this progression of consciousness in those who meditate, and offered the talk to both meditators and members of the general public. It was especially memorable for me to talk with both experienced meditators and novices in Rendlesham, where a beautiful new Peace Palace has just been built. I was also delighted to return to Alternatives in London, a group devoted to self-improvement and spiritual growth, which I had first visited five years ago. I was deeply moved to find people I had met on my first visit were back again to join me a second time. Several came up to me to describe their lives and spiritual journeys in the interim.

Finally, I prepared a more academic talk called “The Quest for Innovation in Psychiatry: A Personal Perspective,” which I presented at the University of Essex, the Institute of Psychiatry in London, and Cambridge University.

Wherever I traveled, I met friendly and open-hearted people, eager to hear about the expansion of consciousness and new discoveries in brain science and how they can help all of us lead happier and more productive lives.  I reconnected with old friends and made new ones, walked through parks beneath the wide skies of Essex – their soft and magical light trans-illuminating the clouds – and came away once again in awe of that magnificent country and its people.

Wishing you light and transcendence,

Dr. Norm

Media From the UK Super Mind Tour:

Doctor behind seasonal affective disorder brings meditation mission to Britain

Pioneer of Seasonal Affective Disorder (SAD) to give free public talk

Doctor behind Seasonal Affective Disorder is coming to Cambridge

The post My Super Mind Tour of the United Kingdom appeared first on Norman E. Rosenthal, MD.

Dr. Norman E. Rosenthal will be in the UK giving talks from Thursday 13th October through Thursday 20th October. Please have a look at the following information for specific details.

Open to the public:

– Monday 17th October 7.30 p.m. at Maharishi Peace Palace, Gardenia Close, Rendlesham, IP12 2GX – all welcome – entry £12.00.
To book visit: Super Mind Rendlesham

– Wednesday 19th October 1.00 p.m. at Firstsite Auditorium , Lewis Gardens, High Street, Colchester, CO1 1JH – all welcome – entrance free.
To book visit: Super Mind Colchester

Wednesday 19th October 7.00 p.m. at Alternatives at Columbia Hotel, Lancaster Gate, W2 3NS London – all welcome – – entry £15.00, concessions £10.00.
To book visit: Super Mind London

[Video 2:44] Dr. Rosenthal Introduces “Super Mind”

Transcendence: Healing and Transformation Through Transcendental Meditation (Special Presentations for the Medical Profession)

Dr. Rosenthal will describe the technique of Transcendental Meditation and summarize the research supporting its physical and psychological benefits, based on hundreds of research articles. He will discuss the potential benefits of TM for cardiovascular health and psychological well-being. Beyond that, he will also explore the technique’s potential for promoting personal growth and transformation. Rosenthal has chronicled these ideas in his New York Times best seller Transcendence.

If you are interested in attending one of the talks below please send an email to Barry Spivack (barryspivack@yahoo.co.uk)

Thursday 13th October
– Colchester Hospital 1.00 p.m. – lunchtime talk to hospital doctors
– Ipswich Hospital  3.00 p.m. – talk to doctors
– Colchester Hospital 7.45 p.m. – evening talk to Essex GPs

Tuesday 18th October
– Broomfield Hospital, Chelmsford – 7. 45 p.m. evening talk to hospital doctors and GPs

The Quest for Innovation in Psychiatry: A Personal Perspective
(Special Presentations for the Medical Profession)

Drawing on almost four decades of psychiatric research experience Dr Rosenthal will discuss the elements required for innovation including the value of “taking a flyer,” a bold, high-risk, high-yield step that can significantly advance a field. He will refer specifically to his work with seasonal affective disorder and light therapy, Transcendental Meditation for post-traumatic stress disorder, and Botox for depression.

Monday 17th October
– Department of Health and Human Sciences Essex University 2.00 p.m.– afternoon talk to faculty and students

Tuesday 18th October
– Institute of Psychiatry, Kings College London – afternoon talk

Thursday 20th October

– Department of Psychiatry, Cambridge University – lunchtime talk to faculty

Short Bio:

Dr Norman Rosenthal is a Clinical Professor of Psychiatry at Georgetown University Medical School in Washington D.C. A highly cited researcher, he has published more than 200 scholarly papers. He was the first physician to describe and name Seasonal Affective Disorder (SAD) and pioneered the use of light therapy as a treatment. More recently he has researched the use of Botox for Depression and Transcendental Meditation for Post Traumatic Stress Disorder. He has authored or co-authored 9 popular books, including several best sellers. His most recent book, Super Mind, reached number one in the Washington Post best sellers list.

Additional Information:
– Find out more about the book, Super Mind
– Super Mind: Boost Performance with Transcendental Meditation (Infographic)

The post From Transcendence to Super Mind: Accessing Higher States of Consciousness Through Meditation appeared first on Norman E. Rosenthal, MD.