Social Isolation…or Hibernation?

hibernationI’m hibernating…yes, it’s Winter in Australia. I don’t want to leave the house (not even to step outside to get the mail) and I just want to sit quietly, alone, on my couch.

Avoiding social contact is a common pattern you might notice when falling into depression. Some people skip activities they normally enjoy and isolate themselves from the world. Others turn to alcohol or junk food to mask their pain and unhappiness. I do both.

I’m doing it all at the moment…BUT I don’t feel depressed (I think!) I just want to stop for a little bit – I don’t want to fight at the moment, I don’t want to search for answers at the moment.

So, maybe I am depressed? I just can’t tell anymore.

Depression traps vary from person to person, but what they have in common is that they can serve to worsen your mood:

Trap #1: Social Withdrawal

isolationSocial withdrawal is the most common tell-tale sign of depression.

“When we’re clinically depressed, there’s a very strong urge to pull away from others and to shut down,” says Stephen Ilardi, PhD, author of books including The Depression Cure and associate professor of psychology at the University of Kansas. “It turns out to be the exact opposite of what we need.”

“In depression, social isolation typically serves to worsen the illness and how we feel,” Ilardi says. “Social withdrawal amplifies the brain’s stress response. Social contact helps put the brakes on it.”

The Fix: Gradually counter-act social withdrawal by reaching out to your friends and family. Make a list of the people in your life you want to reconnect with and start by scheduling an activity.

Trap #2: Rumination

A major component of depression is rumination, which involves dwelling and brooding about themes like loss and failure that cause you to feel worse about yourself.

Rumination is a toxic process that leads to negative self-talk such as, “It’s my own fault. Who would ever want me a friend?”

“There’s a saying, ‘When you’re in your own mind, you’re in enemy territory,'” says Mark Goulston, MD, psychiatrist and author of Get Out of Your Own Way. “You leave yourself open to those thoughts and the danger is believing them.”

“When people are clinically depressed, they will typically spend a lot of time and energy rehearsing negative thoughts, often for long stretches of time,” Ilardi says.

The Fix: Redirect your attention to a more absorbing activity, like a social engagement or reading a book.

Trap #3: Self-Medicating With Alcohol

cocktailsTurning to alcohol or drugs to escape your woes is a pattern that can accompany depression, and it usually causes your depression to get worse.

Alcohol can sometimes relieve a little anxiety, especially social anxiety, but it has a depressing effect on the central nervous system, Goulston says. Plus, it can screw up your sleep.

“It’s like a lot of things that we do to cope with feeling bad,” he says. “They often make us feel better momentary, but in the long run, they hurt us.”

The Fix: Talk to your doctor if you notice that your drinking habits are making you feel worse. Alcohol can interfere with antidepressants and anxiety medications.

Trap #4: Skipping Exercise

If you’re the type of person who likes to go the gym regularly, dropping a series of workouts could signal that something’s amiss in your life. The same goes for passing on activities – such as swimming, yoga, or hydrotherapy – that you once enjoyed.

When you’re depressed, it’s unlikely that you’ll keep up with a regular exercise program, even though that may be just what the doctor ordered.

Exercise can be enormously therapeutic and beneficial, Ilardi says. Exercise has a powerful antidepressant effect because it boosts levels of serotonin and dopamine, two brain chemicals that often ebb when you’re depressed.

“It’s a paradoxical situation,” Ilardi says. “Your body is capable of physical activity. The problem is your brain is not capable of initiating and getting you to do it.”

The Fix: Ilardi recommends finding someone you can trust to help you initiate exercise — a personal trainer, coach, or even a loved one. “It has to be someone who gets it, who is not going to nag you, but actually give you that prompting and encouragement and accountability,” Ilardi says.

Trap #5: Seeking Sugar Highs

When you’re feeling down, you may find yourself craving sweets or junk food high in carbs and sugar.

Sugar does have mild mood-elevating properties, says Ilardi, but it’s only temporary. Within two hours, blood glucose levels crash, which has a mood-depressing effect.

The Fix: Avoid sugar highs and the inevitable post-sugar crash. It’s always wise to eat healthfully, but now more than ever, your mood can’t afford to take the hit.

Trap #6: Negative Thinking

NTWhen you’re depressed, you’re prone to negative thinking and talking yourself out of trying new things.

You might say to yourself, “Well, even if I did A, B, and C, it probably wouldn’t make me feel any better and it would be a real hassle, so why bother trying at all?”

“That’s a huge trap,” says Goulston. “If you race ahead and anticipate a negative result, which then causes you to stop trying at all, that is something that will rapidly accelerate your depression and deepen it.”

The Fix: Don’t get too attached to grim expectations. “You have more control over doing and not doing, than you have over what the result of actions will be,” Goulston says. “But there is a much greater chance that if you do, then those results will be positive.”

 

It’s Delightful, It’s Delicious, It’s D-Ribose


I started taking D-Ribose 2 weeks ago. (I wasn’t able to find it anywhere near me so I buy it online from iHerb.com.) My capsules have 4 250mg of D-Ribose so I thought I should be feeling fabulous.

In a study by Dr Jacob Teitelbaum, D-Ribose treatment led to improvements in all categories:

  • 61.3-percent increase in energy
  • 37-percent increase in overall well-being
  • 29.3-percent improvement in sleep
  • 30-percent improvement in mental clarity
  • 15.6-percent decrease in pain

Improvement began in the first week of treatment, and continued to increase at the end of the three weeks of treatment.

Additionally, in her book, Food That Helps Win the Battle Against Fibromyalgia, naturopathic doctor Deirdre Rawlings states that d-ribose supplements can help FM by improving energy transfer to your muscles.

So where was all my great improvement? I had written a post previously so I knew that I only needed 5mg three times a day (and I was taking heaps more!).

But guess what? I messed up (I’m blaming fibro fog, and it’s fixed now) – it was supposed to read 5 grams three times a day!

So, starting today, I am taking one capsule three times a day – it is a bit short of the 5 grams (just 750mg) so I’m still looking forward to some positive effects.

D-ribose is a type of simple sugar (a 5-carbon sugar; unlike 6-carbon glucose sugar)  that plays a role in energy metabolism and specifically in the formation of ATP, or adenosine triphosphate, the fuel that every cell in your body uses for its energy production. In fact, the ATP energy molecule is made of ribose. Ribose is found in limited amounts in meat and vegetables, though your body usually manufactures enough ribose from glucose to meet its daily needs. However, researchers believe that people with FM may have a deficit in ATP production, which accounts for the lack of energy and feelings of fatigue.

No side effects are associated with the use of ribose supplements, according to Tufts Medical Center; however, no long-term safety studies have yet been conducted. The only significant (bad) side effect seen, so far, is feeling hyper/over-energised (oh! wouldn’t that be nice!) in which case you should lower the dose or take it with food.

As with any nutritional supplement, inform your doctor if you plan to use D-Ribose.

I’ll let you know when (I’m being positive) I start feeling fantastic!

If you’d like to see iHerb’s selection of D-Ribose products, click here. Use Coupon Code LHJ194 to get $10 off any first time order over $40 or $5 off any first time order under $40.

The (Coffee) Spoon Theory

We all know that I have some really bad addictions: smoking and sugar. One habit I have never gotten into (mainly because I hate hot drinks) is caffeine. And new research, presented at the recent annual meeting of the American Pain Society, has found a link between caffeine consumption and the severity of FM pain.

Luckily (for some of you), low to moderate intake showed little to no association with pain severity, BUT the news is not as good for those individuals who live at their local Starbucks.

“There is a weak but significant relationship between caffeine consumption and pain severity in fibromyalgia patients,” said lead investigator Steven E. Harte, PhD, a research investigator in the Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Health System, in Ann Arbor. “According to our data, there is almost no association between pain and low to moderate caffeine consumption.”

Very few previous studies have looked at high levels of caffeine and chronic pain severity.

This study included 252 patients who met the American College of Rheumatology’s criteria for fibromyalgia. Low caffeine consumption was considered to be 0.25-1.5 cups per day; moderate equalled 2-3.5 cups per day; and high consumption was more than 4 cups per day.  FM patients in the high caffeine-intake group reporting significantly greater pain levels than individuals in the low caffeine-intake group. No difference was seen between low and moderate caffeine consumption.

“This association appears to be driven primarily by those patients drinking eight or more cups of caffeinated beverages a day,” said Dr. Harte. “Thus, like most things, moderation is key when it comes to caffeine consumption.”

However, he also noted that it is possible that patients with worse FM pain and related symptoms (e.g., fatigue and cognitive deficits) “may consume more caffeine … to reduce these symptoms.”

There was no reference to how much sugar each person added to their coffee!

 

Diet of Desperation

I always have fish and chips on a Monday, except I don’t eat fish so it’s either a hamburger or souvlaki. Sometime during the week, I have a pepperoni pizza; and another day, it’s a cheese pizza. Chinese take-out is on Thursday. In there, as well, is a hell of a lot of Cadbury’s, and maybe some ice-cream.

Yes, my diet sucks. But I’m too scared to change it!

I suffer from depression and I take 100mg of sertraline (anti-depressant) daily. It took 3 years of experimentation and dark, scary days to reach a place where, despite everything, I’m pretty good. Antidepressants are also called serotonin re-uptake inhibitors, preventing the supply of serotonin in the brain from going down. However, antidepressants are not the only way to elevate serotonin levels. Many ordinary people self-medicate when they are feeling depressed by eating lots of carbohydrates.

R.I.P Davy Jones

I don’t question this theory – in fact, I am a total believer.

Here is how ingesting sugar – or some carbohydrate that is broken down into sugar after digestion – can alter our mood for the better. When we digest carbohydrates, our blood sugar levels rise, and then insulin is secreted, lowering the blood levels of most amino acids with the exception of tryptophan, which is a precursor to serotonin. When there is more tryptophan than other amino acids, it enters the brain at a higher rate,[1] potentially alleviating a functional deficiency in brain serotonin and thus serving as self-medication.[2]  The brain then produces more serotonin. Studies focused on this link appear to back this up: high carbohydrate meals raise serotonin,[3] while fatty or protein rich meals tend to lower it. The type of carbohydrate chosen seems to be based upon its glycemic index, or how high it causes blood sugar levels to peak. The higher glycemic index carbohydrates like sugar have a greater effect on serotonin than starchy, lower glycemic index foods like potatoes.[4]

And it’s not just sugar that we crave: certain alkaloids have been isolated in chocolate that may raise brain serotonin levels.[5] Scientists now speculate that chocolate addiction may actually have a real biological basis with a serotonin deficiency being one factor.[6] Another basis that has been proposed for why chocolate has such a powerful influence on mood is that chocolate has ‘drug-like’ ingredients including anandamines, caffeine, and phenylethylamine.[7]

Expert tips to avoid the cravings include:

  • Be honest with yourself about how deep your problems with food go – I figure I can’t really be more honest than this!
  • Distract yourself by doing something else – oh yeah! because that works for the 61.5% of the Australian adult population considered overweight or obese! (Sorry – couldn’t find up to date figures on ALL the other countries!)
  • Exercise! Exercise stimulates the feel-better chemicals called endorphins and improves your mood. But it’s awfully hard to exercise when you can’t get yourself out of bed…
  • Drink a glass of water. Really? (need I say more?)
  • Be mindful of what you are consuming rather than grazing all day. A food journal can be very helpful – if you want to keep track of what you will need from the supermarket!

So, when doctors, websites, other bloggers, family and friends tell me that perhaps I need to alter my diet to help with my FM, all I can think of is the return of the Big Black Dog.

 

P.S. I love footnotes!


[1] Gendall & Joyce, 2000; Sayegh et al., 1995; Velasquez-Mieyer et al., 2003; Wurtman & Wurtman, 1995

[2] Pijl et al, 1993; Spring, Chiodo & Bowen, 1987; Wurtman, 1990; Wurtman & Wurtman, 1995

[3] Rouch C, Nicolaidis S, Orosco M. ‘Determination Using Microdialysis, of Hypothalamic Serotonin Variations in Response to Different Macronutrients’ Physiological Behaviour 1999 Jan 1-15;65(4-5):653-7.

[4] Lyons PM, Truswell AS. ‘Serotonin Precursor Influenced by Type of Carbohydrate Meal in Healthy Adults. American Journal of Clinical Nutrition 1988 Mar;47(3):433-9.

[5] Herraiz T. ‘Tetrahydro-beta-carbolines, Potential Neuroactive Alkaloids, in Chocolate and Cocoa’ Journal of  Agriculture, Food and Chemicals 2000 Oct;48(10):4900-4

[6] Bruinsma K, Taren DL. ‘Chocolate: Food or Drug?’ Journal of American Diet Association 1999 Oct;99(10):1249-56

[7] Benton D, Donohoe RT. ‘The Effects of Nutrients on Mood’ Public Health Nutrition 1999 Sep;2(3A):403-9