“I’m worried that I’m not going to be able to get everything done”…
“It’s so stressful having to do this alone!”…
“I haven’t had a good night’s sleep in weeks”
Even though caregiving can have many rewards, the stress of caring for a loved one can strain even the most resilient person. The emotional and physical demands of caregiving can really take a toll on your health, relationships, and state of mind eventually leading to caregiver burnout.
If you are experiencing caregiver fatigue, there are many ways to manage your stress. Start with these tips that will help you be a caregiver to yourself as well as others.
Caregiver Risk: Feeling lonely and isolated
Solution: Stay connected!
Don’t hesitate to pick up the phone, go for a walk, and talk to a friend about things outside the realm of your caregiving roles.
Caregiver Risk: Physical and emotional burnout
Solution: Take time out from the demands of caregiving
Be realistic about what you can and cannot do and reach out to those in your family and community for support.
Caregiver Risk: Self Neglect
Solution: Pencil in “me time”
Many caregivers are so consumed by their roles as a caretaker that they forget to take care of themselves. Be sure to take care of your
mental and physical health by maintaining a healthy diet, getting adequate sleep, and taking a break every once in a while.
Regain your energy and optimism by making yourself a priority. If you’re struggling to find the perfect balance of support, compassion, and understanding, come see us! At Surya Psychiatric Clinic, we’re committed to providing you and your loved ones with exceptional care in a compassionate, confidential, and friendly atmosphere.
Thousands of students from across the nation will soon be packing up and heading off to their first year of college. Armed with the latest dorm-room supplies, new course books, and career ambitions, they’ll enter a new stage of life.
As exciting as the transition to college can be, it’s important to have a plan for support. When you think about it, college students are separated from their traditional support systems overnight.
On top of that, they’ll also face many new challenges socially, academically, and mentally. It’s no surprise that anxiety often spikes during this time of transition. Luckily, there are some ways both students and parents can prepare for this season of change during the summer months.
Work On Time Management
For the majority of first-year students, college brings a new sense of independence. The household rules of high school are quickly replaced with Greek Life, clubs, socialization, and, of course, studying. With the immense pressure to get the full college “experience”, it’s more important than ever to develop good time management skills. Work on prioritizing your schedule and commitments. Be sure to block off a time for classes, sleep, and other obligations. Deciding how to prioritize and organize your time is an individual skill. Make sure to include time for self-care and relaxation!
Put A Support System In Place
Preparation is an essential part of a healthy transition. Make sure your family has a great support system in place. Create a safe, judgment-free zone that’s both uplifting and encouraging. This type of system is vital for facing the ups and downs of campus life.
Learn Stress-Management Skills
According to the Anxiety and Depression Association of America, a shocking 85% of college students reported they had felt overwhelmed by everything they had to do at some point within the past year. Mental health among college-age students continues to be a rising
concern. Work together as a family to discuss healthy outlets for stress than can help manage the tension of everyday life. Everything from sports, exercise, and meditation are great ways to manage stress. Don’t be afraid to ask for help from your support system both on and off-campus.
Understand The Importance of Sleep
It might be tempting to burn the midnight oil to finish a project, but remember that sleep is not optional…it’s essential! Sleep deprivation can affect the way you handle everyday stressors. Also, insufficient sleep can put you at his for health conditions like obesity and depression. Make your health a priority!
Healthy boundaries are an important part of all relationships. Before heading to college, have a family conversation about your plan for communication. It’s important for parents to give their teens room for personal growth even when it’s hard. Try setting a time to talk that works for everyone’s schedule to connect.
Above all, start an open conversation about drugs, alcohol, and other pressures associated with the college years. Families who build a strong foundation and have good communication will take on college with excitement and pride.
As discussed in a previous blog post, nutrition has been proven to play a key role in managing depression. Although a causal relationship has yet to be established, there is strong enough correlative data to suggest that blood nutrient levels are lower in actively depressed individuals than the population at large. These nutrients include zinc; vitamins D, B12, and B9; omega-3 fatty acids; and tryptophan. Modifying one’s diet to include these nutrients can be an effective step in taking charge of managing depression outside of a clinical setting. The following are examples of recipes that adhere to the Mediterranean Diet discussed in our previous blog post.
BREAKFAST: Microwave Egg Caprese Breakfast Cups
- 2 slices thinly sliced ham
- Shredded mozzarella or provolone or a mix of the two
- 2 eggs
- Basil pesto sauce
- Cherry tomatoes cut in half
- Kosher salt and freshly ground black pepper
- Fresh basil leaves if desired
- Layer the slices of ham on the bottom and up the sides of a ramekin or small bowl pressing into the creases and ruffling the edges then sprinkle the cheese.
- Crack the eggs into the ramekins and add a dollop of pesto over the eggs with a few cherry tomato halves and season with kosher salt and freshly ground black pepper.
- Place in the microwave and cover with a microwave plate cover and cook on high for 1 minute and 30 seconds or until the whites are set, adding additional 20 second bursts if needed. All microwaves will cook differently so play around with the amount of time. If cooking more than one set of eggs at a time. Allow for more cooking time as well. Garnish with fresh basil leaves and more kosher salt and black pepper if desired.
LUNCH: Citrus Shrimp and Avocado Salad
- 1 pound medium Pan-Seared Citrus Shrimp 31/40
- 8 cups greens such as arugula spinach, or spring mix
- Fruity or lemon-flavored extra virgin olive oil
- Juice of 1/2 lemon or 1/2 orange
- 1 avocado sliced or diced
- 1 shallot minced
- 4 ounces toasted sliced almonds
- Kosher salt and freshly ground black pepper
- Prepare the recipe for the Pan-Seared Citrus Shrimp, or gently warm the leftover shrimp. Or, if you prefer, serve the shrimp chilled.
- Toss the shrimp with the salad greens in a large bowl. Lightly drizzle with olive oil, and if desired, some of the sauce remaining from the shrimp with a generous squeeze of citrus, and toss lightly to coat. Add the avocado, shallots and sliced almonds and then season with kosher salt and freshly ground black pepper and serve.
DINNER: Mediterranean Chicken Quinoa Bowl with Broccoli and Tomato
- For the Chicken
- 1 6- ounce skinless, boneless chicken breast
- 1/4 cup olive oil plus 2 tablespoons
- 1 lemon juiced and zested
- 2 cloves garlic pressed or minced
- 2 teaspoons dried oregano
- 1/2 teaspoon kosher salt
- 1/4 teaspoon freshly ground black pepper
- 1 cup Easy Roasted Broccoli and Feta
- 1/2 cup Easy Roasted Tomatoes
- For the Quinoa
- 1 cup dried quinoa
- 1 teaspoon kosher salt
- Crumbled feta cheese
- Slice the chicken breast into 1-inch chunks and add to a gallon freezer bag. In a small bowl, whisk the olive oil, lemon juice and zest, garlic, oregano and salt and pepper then add to the bag, seal, and marinade for at least 30 minutes up to overnight.
- Heat the remaining 2 tablespoons of olive oil in a nonstick skillet over medium high heat. Add the chicken to the skillet and cook until browned on all sides and cooked through, about 10-12 minutes.
- Reduce the heat to medium and add the broccoli and tomatoes to the pan with more olive oil if needed, and warm through.
- Meanwhile, cook the quinoa. Rinse it in a fine mesh strainer under cold water first. Bring a saucepan of water to a boil over high heat, then add 1 teaspoon of kosher salt and quinoa. Boil it like pasta until al dente, stirring occasionally, about 8 to 10 minutes. Drain, fluff with a fork, and return the quinoa to pot, cover with a kitchen towel, then a lid and let sit for 5-10 minutes.
- To assemble the bowls, divide the quinoa between the bowls and top each with half of the chicken and vegetable mixture. Season with more kosher salt and freshly ground black pepper to taste and drizzle with more olive oil if you’d like. Sprinkle with feta cheese crumbles and serve.
 H. (2019, February 20). 50 Favorite Mediterranean Diet Recipes: Foodiecrush .com. Retrieved July 12, 2019, from https://www.foodiecrush.com/50-mediterranean-diet-recipes/
 H. (2018, August 30). Microwave Egg Caprese Breakfast Cups. Retrieved July 12, 2019, from https://www.foodiecrush.com/microwave-egg-caprese-breakfast-cups/
 H. (2018, August 30). Citrus Shrimp and Avocado Salad. Retrieved July 12, 2019, from https://www.foodiecrush.com/citrus-shrimp-avocado-salad/
 H. (2018, August 30). Mediterranean Chicken Quinoa Bowl with Broccoli & Tomato. Retrieved July 12, 2019, from https://www.foodiecrush.com/mediterranean-chicken-quinoa-bowl-broccoli-tomato/
MDD, or Major Depressive Disorder, is one of the most common mental health concerns in the United States, affecting 19% of the population. This disorder is characterized by persistent feelings of sadness, emptiness, and hopelessness accompanied by a loss of interest in once enjoyable activities. MDD greatly interferes in an individual’s ability to socialize as well as perform academically and professionally; additionally, MDD costs the United States an annual $44 billion in lost productivity, disability, mortality, and morbidity. In fact, the World Health Organization estimates that by 2020, MDD will be the second largest cause of morbidity (or disability) on a global scale.
Unfortunately, only about ¼ of diagnosed individuals will have access to specialized treatment including psychotherapy and psychiatric medication. Further, it has been shown that only 60% of individuals with access to these kinds of treatment benefit from clinical improvement. This is likely due to the pervasive nature of this disorder: MDD carries a very high risk of relapse and is normally seen as a recurrent disorder rather than a mood disturbance that only occurs once in a lifetime.
Due to the low percentage of individuals who are able to obtain specialized professional help, coupled with the relatively low success rate of clinical intervention, science has recently delved into the relationship between MDD and nutrition. This research, while unable to determine a causal relationship, has demonstrated that there are several nutritional habits that appear to decrease both the likeliness of developing MDD as well as decrease symptoms in individuals with this disorder. Conversely, science has also demonstrated that certain food groups and eating habits increase both the likeliness and severity of symptoms.
Amino acids, minerals, omega 3 fatty acids, and the B vitamins are among several of the most important nutrients to include when designing a diet to combat depression. These are often found in recipes adhering to the “Mediterranean Diet”, a nutritional regime characterized by consumption of fresh fruit, whole grains, nuts, seafood, and legumes. The following table delineates which nutrients are associated with which foods.
What Nutrients Can Be Found in Your Food?
Omega 3 Fatty Acids
YES: Coldwater Fish
YES: Organ Meat [i.e. liver]
YES: Brazil Nuts
YES: Salmon, Tuna, Mackerel
Vitamins B12/B9 [folate]
Why and how do these nutrients impact the symptoms associated with depression? Let’s start with omega-3 fatty acids: it is quite possible you’ve heard of these as they’ve been at the center of a relatively recent health trend, and have been heavily advertised in various mediums and locations. Firstly, studies have demonstrated that these levels are significantly lower in patients with active depression. Additionally, two omega 3 acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been found to have antidepressant effects; it is believed that this is due to the biological conversion of EPA to DHA, which also produces neurotransmitters such as prostaglandins, thromboxanes, and leukotrienes. Further, the brain has one of the highest levels of lipids in the body; gray matter contains 50% polyunsaturated fatty acids consisting of 33% omega 3 fatty acids. As these are essential fatty acids, they cannot be produced by the body independently and therefore must be consumed through diet. Similar studies have also demonstrated depleted levels of the nutrient selenium in clinically depressed patients.
Vitamins have also been determined to play an important role in depression relief- specifically Vitamin D and Vitamins B12 and B9/folate. Low levels of vitamin D and B12 are associated with decreased mood and increased likeliness of depression; similarly, patients with depression typically exhibit blood folate levels that are 25% below the “healthy” level. Low folate levels are also linked to decreased efficacy and outcomes in patients utilizing antidepressant medication, further highlighting the importance of vitamin B9 when seeking to achieve symptom relief or remission.
Zinc is a nutrient that has similar implications as those of vitamin B in that depressed patients tend to have lower than average blood zinc levels. Interestingly, patients taking zinc supplements and eating foods rich in this nutrient have experienced higher than average rates of success when taking antidepressants; scientists, therefore, believe that zinc enhances the clinical benefit afforded by these medications .
Now, you may have heard of tryptophan; you might even have discussed it at Thanksgiving when one of the younger tablemates wonders aloud why turkey makes them so tired. Tryptophan is vital to the production of serotonin (which is a biological precursor to melatonin, or one of the naturally produced chemicals that induce tiredness). This is important in the treatment of depression; although we’re uncertain of the exact mechanisms by which serotonin impacts MDD, it has been shown to have a significant impact on relieving symptoms. Further, individuals with depression may struggle to sleep due to intrusive thoughts or restlessness; the production of serotonin, and subsequently melatonin, may help them to get a good night’s rest (adequate sleep has also been linked to improvements in depression). Lastly, St. John’s Wort, or hypericum, has been linked to managing symptoms of MDD; although most individual studies are on too small of a scale to be considered significant, a meta-analysis of 27 studies demonstrated that hypericum managed depression as well as commonly prescribed SSRI medication (selective serotonin reuptake inhibitors include Prozac, Paxil, and Zoloft).
On a final note, it is just as important to address what not to eat when managing MDD. Just as the Mediterranean Diet has been linked to the decreased likeliness of MDD and increased symptom relief, a traditional “Western Diet” has been demonstrated to do the opposite. Western diets are high in saturated fat and trans fat; a European study of 12,000 volunteers demonstrated a 48% increased risk of depression in participants with high trans fat intake. Processed and refined oils contain high levels of omega 6 acids; these have the opposite effect of omega 3s in that they promote inflammation of the brain, and that inflammation may increase depression. Further, foods with large amounts of refined sugars and carbohydrates cause a “sugar rush”, resulting in a subsequent energy crash that also lowers mood and disrupts emotional homeostasis.
Caffeine is viewed as a staple of daily American life; unfortunately, this may be problematic for individuals with MDD, particularly if it is related to anxiety. Due to being a stimulant, caffeine can disrupt sleep patterns and increase anxious tendencies (as previously noted, getting consistent, quality sleep is imperative in successfully managing MDD). Alcohol is viewed as a socially acceptable method of decreasing worry and “taking the load off”; in fact, many people have experienced encouragement from those around them to have a drink to calm down or feel better. Although the initial effects may be calming, alcohol is a depressant and as such may increase present depressive symptoms. Additionally, those with MDD have a higher likeliness of developing alcohol use disorder than the general public; the immediate disinhibiting impact of the substance can become habitual and subsequently problematic.
Depression is a complex condition that often requires a multifaceted approach to achieve symptom relief, and ultimately, remission. Although many of these steps and treatment approaches require clinical direction and supervision, lifestyle choices are at the discretion of the individual. As discussed throughout this post, nutrition is one such choice that has been proven to have a significant impact on those suffering from depression. In an upcoming blog post, we will provide examples of recipes that include many of the nutrients discussed above. In the meantime, there is no shortage of creative, tasty combinations that contain these essential ingredients. From simple snacks to gourmet dinners, changing your diet can be an important step in changing, and navigating, your experience with depression.
 Popa, T. A., & Ladea, M. (2012, December 15). Nutrition and depression at the forefront of progress. Retrieved July 12, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3539842/
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Another day, another pill, and no relief.
Imagine what it’s like for the one-third of adults who battle symptoms of Major Depressive Disorder. Those who suffer from persistent feelings of sadness, low energy, sleep disturbances, and, in the very worst cases, thoughts of death or self-harm.
This is what it’s like to have Treatment-Resistant Depression.
Every day, patients around the Tucson area are experiencing relief and new hope through TMS Therapy at Surya Psychiatric Clinic. We’re thankful for continual developments and emerging research that helps provide relief for those who suffer from Treatment-Resistant Depression. But, despite the high success rates of interventional treatments like TMS Therapy, we’re still working to completely crack the depression code. Here are a few things we know about Treatment-Resistant Depression in 2019…
There’s Hope For Relief
The term “Treatment-Resistant” doesn’t mean “hopeless”. It’s generally defined by a patient who isn’t helped by adequate doses of two different antidepressants. When these cases arise, we turn to interventional methods of treatment like TMS Therapy. This noninvasive, FDA-cleared treatment continues to provide relief, hope, and renewed life in those who suffer from Treatment-Resistant Depression.
Age and Gender Might Play A Role
Even though there’s no way to predict for sure who with depression will be unresponsive to treatment, research tells us that there are biological and psychological factors that make certain populations are more vulnerable than others. For example, studies show that women and the elderly are more prone to treatment-resistant cases of depression.
There’s a Link Between Depression and Inflammation
Emerging research draws a connection between Major Depressive Disorder, the immune system, and our inflammatory response as a potential cause of depression. Patients with depression have also been shown to have higher rates of “comorbid inflammatory conditions, including coronary heart disease and rheumatoid arthritis” in some studies.
TMS Therapy is a life-changing treatment choice for people who don’t receive relief from traditional mediations for depression. New innovations like TMS Therapy can address the unmet need of those with Treatment-Resistant Depression.