What Every Woman Should Know - Cultural Considerations

Major depression and dysthymia affect twice as many women as men. This two-to-one ratio exists regardless of racial and ethnic background or economic status. The same ratio has been reported in ten other countries all over the world. Men and women have about the same rate of bipolar disorder (manic-depression), though its course in women typically has more depressive and fewer manic episodes. Also, a greater number of women have the rapid cycling form of bipolar disorder, which may be more resistant to standard treatments.
A variety of factors unique to women's lives are suspected to play a role in developing depression. Research is focused on understanding these, including: reproductive, hormonal, genetic or other biological factors; abuse and oppression; interpersonal factors; and certain psychological and personality characteristics. And yet, the specific causes of depression in women remain unclear; many women exposed to these factors do not develop depression. What is clear is that regardless of the contributing factors, depression is a highly treatable illness.

The Many Dimensions of Depression in Women

Investigators are focusing on the following areas in their study of depression in women:

The Issues of Adolescence

Before adolescence, there is little difference in the rate of depression in boys and girls. But between the ages of 11 and 13 there is a precipitous rise in depression rates for girls. By the age of 15, females are twice as likely to have experienced a major depressive episode as males. This comes at a time in adolescence when roles and expectations change dramatically. The stresses of adolescence include forming an identity, emerging sexuality, separating from parents, and making decisions for the first time, along with other physical, intellectual, and hormonal changes. These stresses are generally different for boys and girls, and may be associated more often with depression in females. Studies show that female high school students have significantly higher rates of depression, anxiety disorders, eating disorders, and adjustment disorders than male students, who have higher rates of disruptive behavior disorders.

Adulthood: Relationships and Work Roles

Stress in general can contribute to depression in persons biologically vulnerable to the illness. Some have theorized that higher incidence of depression in women is not due to greater vulnerability, but to the particular stresses that many women face. These stresses include major responsibilities at home and work, single parenthood, and caring for children and aging parents. How these factors may uniquely affect women is not yet fully understood.
For both women and men, rates of major depression are highest among the separated and divorced, and lowest among the married, while remaining always higher for women than for men. The quality of a marriage, however, may contribute significantly to depression. Lack of an intimate, confiding relationship, as well as overt marital disputes, have been shown to be related to depression in women. In fact, rates of depression were shown to be highest among unhappily married women.

Reproductive Events

Women's reproductive events include the menstrual cycle, pregnancy, the postpregnancy period, infertility, menopause, and sometimes, the decision not to have children. These events bring fluctuations in mood that for some women include depression. Researchers have confirmed that hormones have an effect on the brain chemistry that controls emotions and mood; a specific biological mechanism explaining hormonal involvement is not known, however.
Many women experience certain behavioral and physical changes associated with phases of their menstrual cycles. In some women, these changes are severe, occur regularly, and include depressed feelings, irritability, and other emotional and physical changes. Called premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), the changes typically begin after ovulation and become gradually worse until menstruation starts. Scientists are exploring how the cyclical rise and fall of estrogen and other hormones may affect the brain chemistry that is associated with depressive illness.
Postpartum mood changes can range from transient "baby blues" immediately following childbirth to an episode of major depression to severe, incapacitating, psychotic depression. Studies suggest that women who experience major depression after childbirth very often have had prior depressive episodes even though they may not have been diagnosed and treated.
Pregnancy (if it is desired) seldom contributes to depression, and having an abortion does not appear to lead to a higher incidence of depression. Women with infertility problems may be subject to extreme anxiety or sadness, though it is unclear if this contributes to a higher rate of depressive illness. In addition, motherhood may be a time of heightened risk for depression because of the stress and demands it imposes.
Menopause, in general, is not asssociated with an increased risk of depression. In fact, while once considered a unique disorder, research has shown that depressive illness at menopause is no different than at other ages. The women more vulnerable to change-of-life depression are those with a history of past depressive episodes.

Specific Cultural Considerations

As for depression in general, the prevalence rate of depression in African American and Hispanic women remains about twice that of men. There is some indication, however, that major depression and dysthymia may be diagnosed less frequently in African American and slightly more frequently in Hispanic than in Caucasian women. Prevalence information for other racial and ethnic groups is not definitive.
Possible differences in symptom presentation may affect the way depression is recognized and diagnosed among minorities. For example, African Americans are more likely to report somatic symptoms, such as appetite change and body aches and pains. In addition, people from various cultural backgrounds may view depressive symptoms in different ways. Such factors should be considered when working with women from special populations.

Victimization

Studies show that women molested as children are more likely to have clinical depression at some time in their lives than those with no such history. In addition, several studies show a higher incidence of depression among women who have been raped as adolescents or adults. Since far more women than men were sexually abused as children, these findings are relevant. Women who experience other commonly occurring forms of abuse, such as physical abuse and sexual harassment on the job, also may experience higher rates of depression. Abuse may lead to depression by fostering low self-esteem, a sense of helplessness, self-blame, and social isolation. There may be biological and environmental risk factors for depression resulting from growing up in a dysfunctional family. At present, more research is needed to understand whether victimization is connected specifically to depression.

Poverty

Women and children represent seventy-five percent of the U.S. population considered poor. Low economic status brings with it many stresses, including isolation, uncertainty, frequent negative events, and poor access to helpful resources. Sadness and low morale are more common among persons with low incomes and those lacking social supports. But research has not yet established whether depressive illnesses are more prevalent among those facing environmental stressors such as these.

Depression in Later Adulthood

At one time, it was commonly thought that women were particularly vulnerable to depression when their children left home and they were confronted with "empty nest syndrome" and experienced a profound loss of purpose and identity. However, studies show no increase in depressive illness among women at this stage of life.
As with younger age groups, more elderly women than men suffer from depressive illness. Similarly, for all age groups, being unmarried (which includes widowhood) is also a risk factor for depression. Most important, depression should not be dismissed as a normal consequence of the physical, social, and economic problems of later life. In fact, studies show that most older people feel satisfied with their lives.
About 800,000 persons are widowed each year. Most of them are older, female, and experience varying degrees of depressive symptomatology. Most do not need formal treatment, but those who are moderately or severely sad appear to benefit from self-help groups or various psychosocial treatments. However, a third of widows/widowers do meet criteria for major depressive episode in the first month after the death, and half of these remain clinically depressed 1 year later. These depressions respond to standard antidepressant treatments, although research on when to start treatment or how medications should be combined with psychosocial treatments is still in its early stages.













Even severe depression can be highly responsive to treatment. Indeed, believing one's condition is "incurable" is often part of the hopelessness that accompanies serious depression. Such individuals should be provided with the information about the effectiveness of modern treatments for depression in a way that acknowledges their likely skepticism about whether treatment will work for them. As with many illnesses, the earlier treatment begins, the more effective and the greater the likelihood of preventing serious recurrences. Of course, treatment will not eliminate life's inevitable stresses and ups and downs. But it can greatly enhance the ability to manage such challenges and lead to greater enjoyment of life.
The first step in treatment for depression should be a thorough examination to rule out any physical illnesses that may cause depressive symptoms. Since certain medications can cause the same symptoms as depression, the examining physician should be made aware of any medications being used. If a physical cause for the depression is not found, a psychological evaluation should be conducted by the physician or a referral made to a mental health professional.

Types of Treatment for Depression

The most commonly used treatments for depression are antidepressant medication, psychotherapy, or a combination of the two. Which of these is the right treatment for any one individual depends on the nature and severity of the depression and, to some extent, on individual preference. In mild or moderate depression, one or both of these treatments may be useful, while in severe or incapacitating depression, medication is generally recommended as a first step in the treatment.³ In combined treatment, medication can relieve physical symptoms quickly, while psychotherapy allows the opportunity to learn more effective ways of handling problems.

Antidepressant Medications

There are several types of antidepressant medications used to treat depressive disorders. These include newer medications-chiefly the selective serotonin reuptake inhibitors (SSRIs)-and the tricyclics and monoamine oxidase inhibitors (MAOIs). The SSRIs-and other newer medications that affect neurotransmitters such as dopamine or norepinephrine-generally have fewer side effects than tricyclics. Each acts on different chemical pathways of the human brain related to moods. Antidepressant medications are not habit-forming. Although some individuals notice improvement in the first couple of weeks, usually antidepressant medications must be taken regularly for at least 4 weeks and, in some cases, as many as 8 weeks, before the full therapeutic effect occurs. To be effective and to prevent a relapse of the depression, medications must be taken for about 6 to 12 months, carefully following the doctor's instructions. Medications must be monitored to ensure the most effective dosage and to minimize side effects. For those who have had several bouts of depression, long-term treatment with medication is the most effective means of preventing recurring episodes.
The prescribing doctor will provide information about possible side effects and, in the case of MAOIs, dietary and medication restrictions. In addition, other prescribed and over-the-counter medications or dietary supplements being used should be reviewed because some can interact negatively with antidepressant medication. There may be restrictions during pregnancy.
For bipolar disorder, the treatment of choice for many years has been Lithium, as it can be effective in smoothing out the mood swings common to this disorder. Its use must be carefully monitored, as the range between an effective dose and a toxic one can be relatively small. However, lithium may not be recommended if a person has pre-existing thyroid, kidney, or heart disorders or epilepsy. Fortunately, other medications have been found helpful in controlling mood swings. Among these are two mood-stabilizing anticonvulsants, carbamazepine (Tegretol^®) and valproate (Depakene^®). Both of these medications have gained wide acceptance in clinical practice, and valproate has been approved by the Food and Drug Administration for first-line treatment of acute mania. Studies conducted in Finland in patients with epilepsy indicate that valproate may increase testosterone levels in teenage girls and produce polycystic ovary syndrome in women who began taking the medication before age 20. ¹¹ Therefore, young female patients should be monitored carefully by a physician. Other anticonvulsants that are being used now include lamotrigine (Lamictal^®) and gabapentin (Neurontin^®); their role in the treatment hierarchy of bipolar disorder remains under study.
Most people who have bipolar disorder take more than one medication. Along with lithium and/or an anticonvulsant, they often take a medication for accompanying agitation, anxiety, insomnia, or depression. Some research indicates that an antidepressant, when taken without a mood stabilizing medication, can increase the risk of switching into mania or hypomania, or of developing rapid cycling, in people with bipolar disorder. Finding the best possible combination of these medications is of utmost importance to the patient and requires close monitoring by the physician.

Herbal Therapy

In the past few years, much interest has risen in the use of herbs in the treatment of both depression and anxiety. St. John's wort (Hypericum perforatum), an herb used extensively in the treatment of mild to moderate depression in Europe, has recently aroused interest in the United States. St. John's wort, an attractive bushy, low-growing plant covered with yellow flowers in summer, has been used for centuries in many folk and herbal remedies. Today in Germany, Hypericum is used in the treatment of depression more than any other antidepressant. However, the scientific studies that have been conducted on its use have been short-term and have used several different doses.
To address increasing American interests in St. John's wort, the National Institutes of Health conducted a clinical trial to determine the effectiveness of the herb in treating adults who have major depression. Involving 340 patients diagnosed with major depression, the eight-week trial randomly assigned one-third of them to a uniform dose of St. John's wort, one-third to a commonly prescribed SSRI, and one-third to a placebo. The trial found that St. John's wort was no more effective than the placebo in treating major depression.¹³ Another study is looking at the effectiveness of St. John's wort for treating mild or minor depression.
Other research has shown that St. John's wort can interact unfavorably with other medications, including those used to control HIV infection. On February 10, 2000, the FDA issued a Public Health Advisory letter stating that the herb appears to interfere with certain medications used to treat heart disease, depression, seizures, certain cancers, and organ transplant rejection. The herb also may interfere with the effectiveness of oral contraceptives. Because of these potential interactions, patients should always consult with their doctors before taking any herbal supplement.

Psychotherapy for Depression

Several types of psychotherapy-or "talk therapy"-can help people with depression.
In mild to moderate cases of depression, psychotherapy is also a treatment option. Some short-term (10 to 20 week) therapies have been very effective in several types of depression. "Talking" therapies help patients gain insight into and resolve their problems through verbal give-and-take with the therapist. "Behavioral" therapies help patients learn new behaviors that lead to more satisfaction in life and "unlearn" counter-productive behaviors. Research has shown that two short-term psychotherapies, interpersonal and cognitive-behavioral, are helpful for some forms of depression. Interpersonal therapy works to change interpersonal relationships that cause or exacerbate depression. Cognitive-behavioral therapy helps change negative styles of thinking and behaving that may contribute to the depression.

Electroconvulsive Therapy

For individuals whose depression is severe or life threatening or for those who cannot take antidepressant medication, electroconvulsive therapy (ECT) is useful.³ This is particularly true for those with extreme suicide risk, severe agitation, psychotic thinking, severe weight loss or physical debilitation as a result of physical illness. Over the years, ECT has been much improved. A muscle relaxant is given before treatment, which is done under brief anesthesia. Electrodes are placed at precise locations on the head to deliver electrical impulses. The stimulation causes a brief (about 30 seconds) seizure within the brain. The person receiving ECT does not consciously experience the electrical stimulus. At least several sessions of ECT, usually given at the rate of three per week, are required for full therapeutic benefit.

Treating Recurrent Depression

Even when treatment is successful, depression may recur. Studies indicate that certain treatment strategies are very useful in this instance. Continuation of antidepressant medication at the same dose that successfully treated the acute episode can often prevent recurrence. Monthly interpersonal psychotherapy can lengthen the time between episodes in patients not taking medication.

The Path to Healing

Reaping the benefits of treatment begins by recognizing the signs of depression. The next step is to be evaluated by a qualified professional. Although depression can be diagnosed and treated by primary care physicians, often the physician will refer the patient to a psychiatrist, psychologist, clinical social worker, or other mental health professional. Treatment is a partnership between the patient and the health care provider. An informed consumer knows her treatment options and discusses concerns with her provider as they arise.
If there are no positive results after 2 to 3 months of treatment, or if symptoms worsen, discuss another treatment approach with the provider. Getting a second opinion from another health or mental health professional may also be in order.
Here, again, are the steps to healing:

• Check your symptoms against this list.
• Talk to a health or mental health professional.
• Choose a treatment professional and a treatment approach with which you feel comfortable.
• Consider yourself a partner in treatment and be an informed consumer.
• If you are not comfortable or satisfied after 2 to 3 months, discuss this with your provider. Different or additional treatment may be recommended.
• If you experience a recurrence, remember what you know about coping with depression and don't shy away from seeking help again. In fact, the sooner a recurrence is treated, the shorter its duration will be.

Depressive illnesses make you feel exhausted, worthless, helpless, and hopeless. Such feelings make some people want to give up. It is important to realize that these negative feelings are part of the depression and will fade as treatment begins to take effect.

Self-Help for Treatment of Depression

Along with professional treatment, there are other things you can do to help yourself get better. If you have depression, it may be extremely difficult to take any action to help yourself. But it is important to realize that feelings of helplessness and hopelessness are part of the depression and do not accurately reflect actual circumstances. As you begin to recognize your depression and begin treatment, negative thinking will fade.
To help yourself:

• Engage in mild activity or exercise. Go to a movie, a ballgame, or another event or activity that you once enjoyed. Participate in religious, social or other activities.
• Set realistic goals for yourself.
• Break up large tasks into small ones, set some priorities and do what you can as you can.
• Try to spend time with other people and confide in a trusted friend or relative. Try not to isolate yourself, and let others help you.
• Expect your mood to improve gradually, not immediately. Do not expect to suddenly "snap out of" your depression. Often during treatment for depression, sleep and appetite will begin to improve before your depressed mood lifts.
• Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
• Remember that positive thinking will replace negative thoughts as your depression responds to treatment.

 

Contentment over Happiness

Sure, we all want to feel happy.  But seeking contentment is a better goal.  Happiness is a mood state, inevitably fleeting, while contentment is more sustainable.  Here are some thoughts on how to find it.

I define contentment as being able to be in the moment BECAUSE you have a sense of the larger picture–you’re able to appreciate momentary pleasure and shrug off stress and annoyances by virtue of knowing that you are where you want to be on a grander scale (or you can envision yourself getting to where you want to be.)

I know, it sounds deceptively simple.  Sometimes the simplest things are the hardest to do. 

 Like when people tell you “Be in the moment” or “Be spontaneous”–you become all the more self-conscious.

But they also get easier with practice.  Mindfulness and appreciation can be learned skills.  They come more naturally to some than others, but if you stick with it, you will improve.

1)  When your mind wanders, gently bring it back to the present.

I say “gently” because frustration is an enemy of being in the moment.  And contentment involves some degree of present-focus.  So if you’re on, say, a family outing and you’re thinking about all the laundry you have to do, remind yourself to be where you are.  You’ll probably have to remind yourself of this multiple times, and that’s okay.  It’s all practice.

2)  Realize that  happiness–like frustration or irritation or anger–is fleeting.

The reason this is actually a positive realization is that we have a tendency to forget that all emotions pass, given time.  So when we’re in a negative space, we need to pause, breathe deeply, and let it go by.  When we’re happy, we need to embrace it because it’s finite.

3)  Contentment lasts.

That’s because there’s a cognitive component to contentment.  Taking stock of where you are and deciding what you love, what you can change, and what you need to accept is key to contentment.

If you make lists and re-read them, it will help ground you overall.  That will make numbers 1 and 2 on this list easier to practice.  You’ll have something to draw on in that larger scheme.

Self-compassion and the recognition that life is a process, not an outcome, will also be helpful.  Contentment is about cultivating a mindset that promotes happiness.  Then you don’t need to chase it, or to run away from negative emotions, either.

Not the Panacea

Almost 19 million Americans have periods where they feel a lack of pleasure or interest in what was once pleasurable and interesting. They feel tired and heavy, potentially overly emotional or numb, and experience an onslaught of negative and self defeating thoughts that can keep  invading the mind over and over again. The more periods of this depressed mood we have in life, the more likely we are to fall back into them again. Why does this relapse occur and how can mindfulness offer hope?

Falling into a depression feels traumatic and just like getting bit by a dog causes us to be fearful of and oversensitive to dogs, our minds and bodies become oversensitive to associations with the depression causing our brains to flinch at any sign of a relapse.

Feeling low mood is normal for everyone, but if we’ve experienced depression in the past, this may be a trigger for a relapse. If we feel tired or if we notice sadness, the mind pops up with the worry “uh oh, that is how I felt when I was depressed, maybe I’m getting depressed”. Our minds begin to go in overdrive with negative self judgments, “I am a failure” or “I am weak” or “I am worthless”. It then tries to solve the mystery as to why we are becoming depressed again and the more it tries to solve this puzzle, the deeper it sinks into depression. Think of a worried, judging person coming at you trying to solve your problems when you’re already not feeling well. Probably not what you’re looking for. You see, it’s not the low mood that’s the problem here, it’s the way we get stuck in habitually relating to it that pours kerosene on the fire, with our minds continuing to fan the flame rolling us into a full blown depression.

The practice of mindfulness teaches us a different way to relate to our thoughts, feelings, and emotions as they arise. It is about learning to approach and acknowledge whatever is happening in the present moment, setting aside our lenses of judgment and just being with whatever is there, rather than avoiding it or needing to fix it. It’s the mind’s attempt to avoid and fix things in this moment that fuels the negative mood.

With Uncomfortable Emotions

If sadness is there, instead of trying to fix it or figure it out, we might just acknowledge the sadness, let it be and get a better understanding of what we need in the moment.

With Self-Judgments

If self-judgments arise (e.g., I am weak, I am a loser) out of past sensitivities to having been depressed before, we can acknowledge that they are associations from the past, let them be, and then gently bring ourselves back to whatever we were doing. In doing this, we’re stopping the ruminative cycle that might occur between our thoughts, feelings, physical sensations and behaviors that can play off one another leading into another relapse (I call this “The Depression Loop” in the upcoming book Uncovering Happiness).

Now, this is easier said than done and it takes practice.

Confidence with Rumination Practice:

Let’s get our hands (or minds) into it. One way to practice mindfulness is to use the breath as an object of awareness. You can place attention at the tip of the nose or the belly and as you breathe in, just acknowledge the breath coming in and as you breathe out just acknowledge the breath going out. As if you were greeting and saying goodbye to an old friend. When the mind wanders, as it will always do, just say to yourself “wandering” and then gently bring your attention back to the breath just noticing it coming in and going out. Most of us catch the mind wandering and gently bring it back billions of times, so know that it is normal for the mind to wander often. You can do this for as little as 1 minute or as much as 30 minutes or more.

Practice this when you’re feeling well and you’ll be better able to recognize when your mind wanders off to ruminations and self judgments when you’re not feeling well.

What does this have to do with gaining confidence over rumination?

Like learning an instrument, you can develop more skill as you practice. When you’re not feeling well and the mind begins to ruminate, as you practiced with the breath, just label it as “ruminating” and then gently bring your attention back to whatever you were doing. Being more present may also give you the ability see the space between stimulus and response and see the “choice point” to  be more flexible and call a friend or do something that then gives you pleasure or connection with others.  This is what I’ve referred to as The Now Effect. 

Know that practicing is an act of self care and helps stop the cycle of rumination and cultivates more patience, compassion, and peace.  

Mindfulness is not a panacea for depression, but it’s a good foundation for preventing relapse.

As always, please write below with any comments, questions, thoughts, or additions that arise after reading this. Your comments below help provide a living wisdom for us all to share and benefit from.

I Miss You - I love You !

 

There are enough of us that have lost loved ones over the years where we can shed tears at a

 

moments notice of good memory reoccurring. Along with that things you needed now with that loved one help to make that assignment run smoother.

 

 

This is our way of providing a honor to our loved ones that have gone before us on this joureny towards a Life of being with God and all who have helped paved the way to our success in life.

Mother's Day

I know Mother's Day is hard for many of my friends. Know that I love you and you are in my prayers with many healing hugs of care and concern for as ll at this most sensitive moment in history.

For a Total Healing of  heart, mind, and soul. 

When to Refer for Medical Treatment

When Grief develops into clinical depression one (1) and family does not know to pinpoint
the Symptoms accurately. For this reason the symptoms and the psychological aspects have been out lined for your education and understanding for this diagnose.

Signs and Symptoms:

Early morning awaking

Serious Weight Loss

Anhedonia:

"The loss of joy," is defined as a lack of the feelings of enjoyment or accomplishment that typically accompany pleasurable events such as socializing with friends, eating a good meal and sex. An individual who is experiencing Anhedonia may no longer feel a desire to go to work, attend classes, manage their health, interact with other people, or engage in hobbies or entertainment. Anhedonia is a common symptom of mood disorders such as major depressive disorder or dysthymic disorder, but it can also be experienced independent from a diagnosed mental health condition. -

Agitation: The Causes

Agitation can come on suddenly or over time. It can last for just a few minutes, or for weeks or even months. Pain, stress, and fever can all increase agitation.
Agitation by itself may not be a sign of a health problem. However, if other symptoms occur, it can be a sign of disease.  Agitation  with a change in alertness (altered consciousness) can be a sign of delirium. Delirium has a medical cause and should be checked by a health care provider right away.
 
Causes

There are many causes of agitation, some of which include:

• Alcohol intoxication or withdrawal
• Allergic reaction
• Caffeine intoxication
• Certain forms of heart, lung, liver, or kidney disease
• Intoxication or withdrawal from drugs of abuse (such as cocaine, marijuana, hallucinogens, PCP, or opiates)
• Hospitalization (older adults often have delirium while in the hospital)
• Hyperthyroidism (overactive thyroid gland)
• Infection (especially in elderly people)
• Nicotine withdrawal
• Poisoning (for example, carbon monoxide poisoning)
• Theophylline, amphetamines, steroids, and certain other medicines
• Trauma
• Vitamin B6 deficiency

Agitation can occur with brain and mental health disorders, such as:

• Anxiety
• Dementia (such as Alzheimer's disease)
• Depression
• Mania
• Schizophrenia

5 Easy Ways to Combat Overthinking

Do you ever become trapped in an overanalyzing rut?
I tend to think a lot in general, but sometimes, I find myself looking at a subject way too closely and way too much, and the ruminating takes on a life of its own. (It might even revolve around an abstract concept as opposed to an actual event that’s occurring.)
When introspection becomes stressful, there are antidotes. Here are some of my personal suggestions…

1. Adopt a hobby.

Maybe if your spare time is filled with an activity that you love, overthinking spells will be pushed to the curb. I’ve started to re-immerse myself in the French language since I’m a total Francophile. Weekend hours are set aside for verb conjugations and charming vocabulary. Oui, oui, oui.

2. Write it down.

I have journaled to lighten my mental load, where I can flesh out thoughts and feelings. (I find that the physical act of writing into a notebook is a more effective cathartic release than an online diary, but to each his or her own.) For someone who isn’t interested in writing, journaling may be viewed as a burden, so it certainly comes down to individual preference.

3. Keep your hands occupied.

According to this article, the psychological theory proposes that when we’re stressed, we absorb information through two channels. “One is the basic, primal sensory channel: the sights, sounds, sensations, and smells of the situation. The other is an intellectual channel: our brains are trying to make sense of what’s going on, and put it into words and a context that we can talk about.”
Researchers explain that if the sensory channel is occupied, the intellectual channel is muted; therefore, stress relief techniques that incorporate the hands “will use up more ‘brain cycles’ and pull processing power away from intellectual activities.” A stress ball may do the trick, along with drawing or knitting. (I’ve experimented with colorful rugs via latch hook!)
The article also presents another theory, which states that large muscle groups contract in preparation for flight when we’re consumed with stress. Muscle fibers in your arms relax and reduce tension when squeezing stress balls or keeping your hands busy with objects of a similar nature.

4. Move around.

I revel in long walks around the neighborhood – preferably in beautiful weather – and have found that walking unleashes mental chatter and induces clarity. Exercise, rolling blade, or any other movement can help as well.

5. Talk to someone.

Sometimes, being honest and vulnerable with someone you’re comfortable with will clear your mind. After exposing your overanalysis to others, it suddenly doesn’t appear as daunting. And who knows, maybe they can relay insight about the topic at hand, which could provide further guidance. With this further guidance contact Dr. Losito 24/7 to receive the reassurance of what is on your mind.

Overthinking can be unpleasant, draining and debilitating, but hopefully, the tips noted above can disrupt these incessant cycles.

When to seek Dr. Losito's help for grief ?

If you recognize any of the above symptoms of complicated grief or clinical depression, talk to a mental health professional right away. Left untreated, complicated grief and depression can lead to significant emotional damage, life-threatening health problems, and even suicide. But treatment can help you get better.

Contact a grief counselor, Dr. Losito, if you:

• Feel like life isn’t worth living
• Wish you had died with your loved one
• Blame yourself for the loss or for failing to prevent it
• Feel numb and disconnected from others for more than a few weeks
• Are having difficulty trusting others since your loss
• Are unable to perform your normal daily activities

Pre - Bereavement Care and Thoughts

It’s tragically common for patients to ignore warnings of other types of cancer, adds Dale Shepard, MD, PhD, a cancer specialist in the department of solid tumor oncology at the Cleveland Clinic. “Cancer can almost always be cured if it’s caught early, but all too often, people wait so long to see a doctor that the disease has spread to the point that it’s no longer curable.”

If you notice any of the following unexplained warning signs, don’t delay—make the time to consult a doctor promptly.

• Unexplained weight loss. While most people would be happy to drop pounds without dieting, unexplained weight loss (of 10 or more pounds) or sudden loss of appetite are among the most common warning signs of cancer, says Dr. Shepard. This symptom is most likely to occur with cancers of the pancreas, stomach, esophagus or lung, reports the American Cancer Society (ACS). It may turn out not to be cancer—there are a number of other serious health conditions that may cause this symptom, including an overactive thyroid, diabetes, liver disease, and depression.

• Persistent low-grade fever. This can be the first symptom of certain cancers, particularly leukemia, Hodgkin’s disease or non-Hodgkin’s lymphoma. Low-grade fever—meaning a temperature between 99.8 and 100.8—can also be caused by a wide range of infections. 

• Worsening fatigue. “If you suddenly can’t get through the day without taking a 3-or 4-four nap, when you never need one before, that can be suggestive of cancer,” says Dr. Shepard. According to the ACS report, this symptom is particularly likely to occur with leukemia, as well as cancers that cause blood loss, such as colon cancer or stomach cancer. Other medical conditions that cause profound exhaustion include anemia, sleep disorders, heart problems, diabetes, fibromyalgia, and arthritis.

• A sore that doesn’t heal or skin changes. You probably know that moles that are asymmetrical (one half doesn’t match the other), have irregular borders, contain a variety of colors, or are larger than a pencil eraser can bewarning signs of melanoma, the deadliest form of skin cancer. What’s not well known, however, is that skin sores or changes (including a persistent rash) can also herald other forms of cancer. Dr. Shepard had a patient whose first symptom of colon cancer was a sore on his scalp that didn’t heal. He has also had patients with lung cancer and lymphoma whose symptoms included persistent rashes.

What Does Skin Cancer Look Like?

• Trouble swallowing or chronic hoarseness. These symptoms, along with lip sores that don’t heal, unusual bleeding, pain or numbness in the mouth, and chronic sore throat, can herald oral cancer. Other reasons for chronic hoarseness can include gastroesophageal reflux disease (GERD), allergies, cancer of the throat or laryngx, smoking, and underactive thyroid, reports the National Institute of Health. A wide range of esophageal disorders can impair swallowing.

• White patches in your mouth. Also known as leukoplakia, these thickened whitish or gray patches on the gums, inside of the cheeks, or the tongue are often mistaken for thrush (an infection that causes white patches). Unlike thrush, which can be scraped away, leukoplakia cannot be removed in this manner. While the condition isn’t always harmful, oral cancer often occurs near leukoplakia patches, the Mayo Clinic reports, and the patches themselves can develop cancerous changes.

• Blood in the toilet. This symptom is frequently dismissed by patients, says Dr. Shepard. “People are quick to think that the problem is a urinary tract infection even if they’ve never had one before. However, blood in the urine can also be a sign of bladder cancer and needs to be investigated by a urologist. Oftentimes, bladder cancer isn’t diagnosed until it reaches an incurable stage because people wait so long to see a doctor.” Similarly, it can be a dangerous mistake to dismiss blood in the stool as being triggered by a hemorrhoid, since it could also be a warning sign of colon cancer, as is any change in your normal bowel habits.

• Unexplained pain. This can be an early symptom of testicular or bone cancer. A headache that doesn’t get better with treatment, such as taking an over-the-counter pain reliever, may signal a brain tumor, while back pain can mark colon or ovarian cancer, the ACS reports. “Unexplained pain is one of the more common symptoms of cancer and always warrants a consultation with your doctor,” says Dr. Shepard.

• A lump or thickening. Several types of cancer, including those of the breast, testicles, and lymph nodes can be felt through the skin. A lump or thickening can either be an early or late sign of cancer, ACS reports. Also be aware that in some cases, breast cancer can cause red or thickened skin, rather than the expected lump, so any change in how your breast looks or feels needs to be checked out. 

• Any persistent, unexplained or troubling symptom. “If something doesn’t seem right, don’t assume it’s nothing,” says Dr. Shepard. ”Listening to your body and getting this symptom checked out sooner rather than later could save your life if the problem turns out to be cancer.”

5 Regrets of Dying

I’ve always been interested in the wisdom of our elders and often do a practice with students and clients when they’ve seemed to veer off the path of what truly matters in their lives. I ask them to project themselves forward many years from now looking back onto this very moment right now, what do they wish they would’ve done? Bonnie Ware is an Australian Nurse who spent many years working in palliative care caring for those who were dying. She eventually published a book called  The Top Five Regrets of the Dying.
Regrets can be seen as something that’s good if they give us insight into what we can change today for the better. Here are the Top 5. Use them as north star to help guide your actions in the days that follow toward an even more fulfilling life. Although we can veer off the path, when we notice the star, we can always come back to it.
Top 5 Regrets of the Dying:

1. I wish I’d had the courage to live a life true to myself, not the life others expected of me. From the time we’re born we’re looking to our parents to teach us the rules of this world and to guide our expectations about how we should or shouldn’t act. Looking to our culture or other people to guide how we should dress, speak, act, and even what kind of profession we should be in is common. What would it look like to get in touch with what seems right to you and live an authentic life?
2. I wish I hadn’t worked so hard.  As the saying goes, no one ever kicked themselves on their deathbeds for missing a day of work. Sometimes we work too much out of routine, other times from other people’s expectations and sometimes as an addictive behavior to avoid discomfort. Are there things that may be more valuable to pay attention to where we can loosen up on working so hard and pay attention to things that nourish us more?
3. I wish I’d had the courage to express my feelings.  Whether it’s at work, in a friendship or a partnership we make the snap judgment to bite our tongue rather than being assertive. Standing in an authentic life means becoming aware of and expressing our feelings. This may be a missed opportunity to let others know we love them that can create deeper connections or maybe it’s a time when someone hurts us and we stay silent out of fear. Learning how to become more aware of our emotions and express them in a skillful way can help us feel more connected, self-reliant and happy.
4. I wish I had stayed in touch with my friends.  There’s no question. At the crux of feeling happy and fulfilled in life is having nurturing relationships. There are so many ways to stay connected nowadays through text, chat, email, social media, the phone and of course face to face. How might you make it a priority to make relationships an integral part of your day to day life?
5. I wish that I had let myself be happier.  Bronnie Ware said that many people didn’t notice until the end of life that happiness is a choice. With awareness we can make conscious choices about what nourishes us and what depletes us. What beliefs we want to invest in and which ones we don’t. We may get hooked into states of high stress, anxiety, depression and even trauma reactions, but at some point we get to choose how we want to relate to them and this may help us ride them with more grace. Maybe it’s time to play a little more, what makes you happy?

Take a moment to look back once again at these five regrets people have had and see where you can begin integrating these more into your life starting today.
As always, please share your thoughts, stories and questions below. Your interaction creates a living wisdom for us all to benefit from.

Treat YourSelf Right !

Still Keep Your Head Up

The Best Person.

The difficulties started when… conversations became texting, feelings became subliminal, the word ‘love’ fell out of context, trust faded as honesty waned, insecurities became a way of living, jealously became a habit, being hurt started to feel natural, and running away from it all became our solution. Stop running! Face these issues, fix the problems, communicate, appreciate, forgive and LOVE the people in your life who deserve it.

Martyr of the Faith.

I pray for the Soto family for their loss of Victoria a daughter, sister, Tia, and Trusting woman martyr of Faith, Trust, Protector of her students, friends, and the holy innocents.

Never Give Up !