Women’s Sleep Habits Linked to Mood

When mom doesn’t get enough sleep, the whole family suffers. In women, there’s a definite connection between sleep and mood. Worry, stress and anxiety can interfere with sleep, and sleep problems can increase depression and anxiety symptoms. According to a 2007 National Sleep Foundation study on women’s sleep habits, the relationship between sleep and mood is bi-directional. More than half of the women surveyed in the NSF poll said they had felt unhappy, sad or depressed in the past month, and one-third (36%) had felt hopeless about the future. Most reported problems sleeping, and 40% had been diagnosed with a sleep disorder.

Biology affects a woman’s sleep habits. The NSF study analyzed sleep patterns at each stage of a woman’s life:

• Menstruation. Menstruating women slept longest, averaging 7 hours, 32 minutes of shut-eye; however, 67% reported insomnia several nights a week. One-third experienced sleep problems during their cycle.
• Pregnancy. Women got more sleep during pregnancy than at any other time — approximately 8 hours, 14 minutes per night — although 84% complained of insomnia several nights a week and 30% said they never got a good night’s sleep.
• Post Partum. Women slept least — an average 7 hours, 46 minutes — after childbirth. Nearly half (47%) reported never getting a good night’s sleep, and 84% experienced chronic insomnia, 90% related to child care. Two in every 10 women experienced post partum blues or depression.
• Perimenopausal. During menopausal transition, women got the least amount of sleep (7 hours, 12 minutes). More than half (59%) reported insomnia a few nights each week; and 43% experienced a sleep disorder, hot flashes or night sweats that interfered with sleep.
• Postmenopausal. Postmenopausal women slept an average 7 hours, 19 minutes but had the highest incidence of sleep disorders (50%) and insomnia (61%). Forty-one percent used a sleep aid several nights a week.

Because of the link between sleep and mood, psychiatric treatment that addresses both issues through cognitive-behavioral therapy and psychodynamic therapy can be most effective. A board-certified psychiatrist like Dr. Tracey Marks with considerable experience treating sleep disorders can help you find workable and lasting solutions to sleep better and enjoy life more.

Routine Depression Screening Advised for Teens

With more than two million U.S. teens affected by depression, an influential medical panel is urging physicians to routinely screen their teen patients for depression. According to the U.S. Preventive Services Task Force, a government-appointed blue-ribbon group of medical experts that sets health guidelines for doctors on a wide range of health issues, most depressed teens struggle with their condition undiagnosed and untreated. The task force’s recommendations, which exceed teen depression screening guidelines suggested by the American Academy of Pediatrics’, were published in the April issue of the journal Pediatrics.

Evidence suggests that teen depression can be accurately diagnosed in primary-care settings with the aid of simple but detailed questionnaires. Because routine school/sports physicals, illness and injury send most teens to their primary-care doctor several times a year, the task force believes that increased screening by primary-care physicians has the greatest potential to dramatically increase the number of teens receiving help for depression. An estimated 6 percent of U.S. teens suffer from clinical depression that requires psychotherapy and, in some cases, medication.

Teen depression can lead to social isolation, persistent sadness, school problems, and even suicide. Screening for early detection and treatment is crucial to improving symptoms and helping teens cope, the panel said. While other medical groups have recommended screening high risk teens, the panel experts recommend screening all teens at least once a year. “You will miss a lot if you only screen high-risk groups,” Dr. Ned Calonge, task force chairman and chief medical officer for Colorado’s Department of Public Health and Environment told the Associated Press.

The teen years are a time of volatile emotions, individualization, separation from family, and boomeranging self-confidence that can quickly spiral down into depression. With families always on the go, teens’ natural emphasis on spending more time with their friends, and the normal teen desire for privacy, parents can often miss early signs of depression. Teens, too, can be adept at hiding depressive feelings and suicidal thoughts from their families and friends. However, simple questionnaires that focus on depression indicators — mood, anxiety, appetite, drinking, substance abuse — have proven remarkably accurate in helping physicians diagnose teen depression.

In light of highly publicized links between antidepressants and teen suicide, Calonge stressed that the panel is not promoting drug treatment alone. The panel specifically recommends routine depression only when psychotherapy is readily available to immediately help teen patients.

Psychotherapy Can Achieve Positive, Lasting Change

“The changes we practice become our nature.” That sentiment is at the core of the problem-oriented approach to psychotherapy used by Atlanta psychiatrist Dr. Tracey Marks to help her patients find workable and lasting solutions to life’s challenges. Emphasizing Cognitive-Behavioral Therapy and Psychodynamic Therapy, Dr. Marks provides her patients with the support they need to tackle their toughest challenges while guiding them on their journey to discover and learn the skills necessary to make positive and lasting changes in their lives.

“Cognitive-Behavioral Therapy replaces non-productive habits of thought and behavior with new ways of perceiving situations, thinking about them, and acting within them to achieve more satisfying outcomes,” Dr. Marks explains. “It’s based on the realization that you can choose your thoughts.”

Using Cognitive-Behavioral Therapy, Dr. Marks assists her patients in recognizing non-productive thinking patterns that result in negative, distorted behavior. She teaches her patients to replace those negative patterns with positive, affirming thoughts that motivate the desired behavior. “Changing your thinking pattern can change your outlook, your behavior, and your life,” asserts Dr. Marks. She guides her patients in recognizing and embracing positive, productive thought and behavior processes that will change their lives for the better.

Dr. Marks uses Psychodynamic Therapy, or insight-oriented therapy, to help patients discover the motivating source that explains their behavior. By gaining insight into the relationships and events that drive attitude and behavior, patients are better able to understand harmful behaviors and work to replace them with positive, productive thoughts and actions.

“Sometimes just realizing where we acquired an irrational fear, belief, or habit is enough by itself to free us from it,” explains Dr. Marks. “Other times it provides us the conviction or the understanding to work on changing an attitude or a reaction that we know is harmful.”

As a medical doctor, Dr. Marks has the knowledge and experience to correctly assess the source of your symptoms and personal challenges. She has the expertise to identify the proper treatment and the skill to guide you in learning to face your challenges with success. Understanding the unique individuality of each patient, Dr. Marks works closely with each patient to develop a personal treatment plan that is best suited to their individual needs and goals.

Rage, Revenge Spur Mass Murder

Today marks the 10-year anniversary of the Columbine High School tragedy in Littleton, Colorado during which 12 students and one teacher lost their lives at the hands of two disturbed students who killed themselves at the end of their rampage. The tragic event ended the open-door policy most schools had practiced, changed society’s view of childhood bullying, changed the way SWAT teams respond to such events, and shattered our personal sense of safety. If such horror could happen in a quiet, little town like Littleton, Columbine made us realize that catastrophic violence could touch our own lives.

While mass murder is nothing new, its increasing occurrence — seven in the past month — has shocked and troubled psychiatric experts. While there does not appear to be any common trigger that sends a mass murderer on a killing spree, experts have identified two common characteristics: a cataclysmic event that triggers a suicidal rage and a thirst for revenge.

“It’s the constellation or coming together, the perfect storm of someone’s last shot at something,” retired FBI senior profiler Mark Safarik told the Associated Press. “For them, there’s just no other way out. Or if there’s another way out, they don’t choose it, because they’re going to punish somebody.”

Safarik doesn’t think there’s any way to predict who will leap over the edge of reason. There is scant similarity in motivations, personality types, individual experiences or even choice of targets to guide behavior analysts in their efforts to predict and thereby prevent mass murders. For example, Jiverly Wong who opened fire in a Binghamton, New York immigration center had recently been laid off, but investigators do not understand why he went to the center instead of his former workplace to exact his grim revenge.

What behaviorists have discovered is that intense media coverage seems to encourage more mass murders. “I think that people that are on the edge, that are contemplating such tragic events, sometimes all it takes is that being highlighted in the media for them to go, ‘You know, I could do something like that, I’m that angry,’” Safarik said. “It’s in their face on the television, and now it’s in their thinking patterns. It becomes an option that, perhaps earlier on, wasn’t an option for them.”

When Does Parental Involvement Become Meddling?

Parents today pride themselves on how tuned in they are to their children. They coach their soccer teams, drive them to karate and gymnastics classes, chaperone field trips, and work the pancake breakfast. They enjoy spending time with their children and their friends. But many parents have trouble finding the right balance between being involved in their children’s lives and meddling. They friend their children’s friends on Facebook. They “help” their children with school projects. They pick up job applications and some have even attended job interviews with their children.

Such over-involvement is problematic, psychologists say. Stepping over the line from monitoring your child’s activities to active participation blurs the necessary demarcation between parent and child. Friending your child on Facebook allows you to appropriately monitor his online activities, but friending your child’s friends interferes with his ability to develop independence. Parents who assume too much responsibility for their children’s lives rob them of the experiences necessary to learn life skills and opportunities to practice responsibility.

“The responsibility of being a parent has diminished,” elementary school teacher Linda Graves told reporter Martin Rozenman of The Columbus (OH) Dispatch in an April 16, 2009 article. “I think, because of their limited time, parents want to be the good guy — the friend rather than the disciplinarian.”

The problem is exacerbated when parents try to relive the glories of their own youth — whether real or unattained — through their children. Even when children have an interest in these activities, parental pressure to succeed can create anxiety that overpowers any pleasure the child might experience.

“It’s one thing to enjoy the success of your kids, but, when parents’ self-esteem is based on their kids’ success, it’s horribly self-destructive. Kids crumble under that pressure or succeed and are really unhappy,” California psychologist Jim Taylor, author of two books on parenting, told The Dispatch’s Rozenman.

There are healthy ways for parents to be involved in their children’s lives. Eating dinner as a family, turning off the TV and playing a board game once a week, and vacationing together will bring you closer to your children without crowding their space.

Is Lack of Sleep Making Us Crazy?

“Economic insomnia” is one more complication of America’s financial meltdown, and psychiatric experts warn that it could be making us crazy. People are losing sleep worrying about job loss, foreclosure and bankruptcy. The longer the recession continues, the greater the chance that the financial boogeyman will creep out of the closet and steal away our ability to provide basic necessities for our families. Nearly everyone knows someone who has lost their job to economic demons, and most of us have had to make lifestyle changes. Worry is making for a lot of restless nights. Researchers warn that lack 0f sleep increases the risk of depression and other serious psychiatric conditions.

“When you are tired, when you’re worn out, then everything becomes more of a challenge for you,” Dr. Adam Moscovitch, medical director of the Canadian Sleep Institute in Toronto, told Calgary Herald reporter Sharon Kirkey in an April 12, 2009 online article. ”Your confidence is affected, your ability to trust yourself. So there is a higher likelihood you’ll be ruminating about, are you doing things right? It significantly affects, from the psychologic standpoint, the [risk] of mental illness developing.”

Researchers have proven that lack of sleep has a negative impact on physical and mental health. People who get six hours of sleep or less per night increase their risk of high blood pressure, heart attack and stroke. Chronic sleeplessness weakens the immune system, causes changes in appetite, interferes with sexual interest, decreases the ability to concentrate, and negatively affects function and judgment. Growing evidence indicates that not getting enough sleep can also trigger mental illness, particularly depression, anxiety and mood disorders.

In a 20-year study of 591 young adults published in 2008 in the journal Sleep, Dr. Daniel Buysse of the University of Pittsburgh found that insomnia lasting two weeks or longer often triggered depression. The link between sleep and mental health appears to reside in the amygdala, the brain area that governs emotions. Harvard Medical School and the University of California-Berkeley researchers found that sleeplessness stimulates the amygdala, causing increased brain activity associated with depression, anxiety and other mental illnesses. 

Because of the risk to mental and physical health, chronic insomnia that persists for weeks or months at a time should never be ignored. If worry is regularly interfering with your sleep, talk to your health professional today.

Not All Mood Swings are Bipolar Disorder

I sometimes hear people ask “one minute I feel down, the next minute I’m really happy, am I manic depressive?”

Bipolar disorder or manic depression is a mood disorder whereby a person has discreet episodes of depression or mania. The index episode is a term used to define the first episode. If a person’s index episode is depression, they may not be diagnosed with bipolar disorder until they have a manic episode. That is, this person may be diagnosed as having depression for years until they have a manic episode at which time their diagnosis will change to bipolar disorder. The person who has mania as their index episode will start with a diagnosis of bipolar disorder.

Everyone is different, but a typical course of the illness is such that a person may have 1-2 episodes of mania and/or depression in a year or every few years. Rapid cycling bipolar disorder is defined by having four or more episodes in a year.

So back to the question – people with bipolar disorder don’t switch between depression and mania within the course of a day. In fact, depression requires symptoms lasting two weeks to be considered a depressive episode. The situation of extreme moods that flip back and forth over the course of a day would be considered emotional lability or emotional volatility that may be present in a person with anxiety or a mood disorder (such as depression or bipolar disorder). But it can also be a part of someone’s personality. For example, people with histrionic personality traits can have dramatic or “over the top” responses that are intense reactions to life issues that are not necessarily a mental disorder that requires medication treatment.

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