Diabetes and Diet

Controlling diabetes does not mean that you are advised to starve. You have specific foods to eat and specific food to avoid so that your blood sugar level is maintained. You can go ahead with your food habits, but your position is like that of a horse. Gallop forward, but well controlled by the jeans.

You will be put on restrictions with regard to certain types of foods, but you will begin to taste some of the items, which you have not hitherto been fortunate enough to taste. This change in food pattern will be for the better, diabetes or no diabetes.

When you study the recipes for diabetes, you will realize the importance of diet in your life. Hitherto, what you have been doing? Dump into the stomach anything that appeals to your eyes, anytime. Since you need to control your diabetes, don't be emotional in your food habits. Be factual and realistic.

For treating diabetes, you can not say with certainty that this one is good for you and that one is not good for you. It is a trial and error method. You will have to view the food from its medicinal content point of view.

As a rule, you know that when you are out to control diabetes, you avoid heavy meals, instead you take food in small quantities, several times in a day. Several times, does not mean that you go on eating at the interval of every two hours.

It is better if you draw a time table for your eating, and what you should take for the breakfast, lunch and dinner. This disciplined approach to the food itself would be part of the recovery process.
Diabetes is not a time bound disease as such; it's all about controlling. Diabetes is such a widespread malady that in every County, there exists a diabetic association which will give you the latest about this disease.

The underlying point about any system or procedure that you follow with regard to the intake of food, is that you need to control the insulin level within your body.
So, your emphasis should be on citrus fruits and fruits and vegetables in which the fiber content is more. Some foods release the insulin in to the blood slowly. This is Nature's way to control the sugar level within your body.

There is an ancient, trusted method to make your food items tasty and good from the point of view of controlling the diabetes. Along with every meal, take some fresh curry leaves. This item, taken regularly over a period of 6 months, has the capacity to cure even the hereditary diabetes.

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I'm Blue, Soooo Blue (Depression, part 4)

Depression is certainly treatable. There is definitely hope! One of the main things for depression treatment is for you to decide that you want treatment. Often this one step goes a long way to alleviating depressive symptoms.

As psychotherapists will tell you, sometimes it is a mystery to them, why they have so many people who only come in for one appointment. When following up with those clients, the therapists discover that they are notably happier and less depressed. It seems that just the fact of "doing something" to get better is in fact a step toward getting better. However, this is NOT the standard treatment. Everyone reacts differently. They point is that saying to yourself, "I need to take care of myself. I need to get some help" is a HUGE step forward. Following through is the next best thing.

The most common treatment for depression, particularly mild to moderate depression, is a combination of medication and psychotherapy. Listed below are some common medication types, as well as common psychotherapies.

Medication Treatment for Depression -

Antidepressant medications are often the first treatment option prescribed by health professionals. Antidepressants relieve the symptoms of depression, which makes it easier to face your problems and take appropriate action

Tricyclic drugs - tricyclic antidepressants (TCAs) are a commonly used class of antidepressant drugs. They prevent neurotransmitters such as norepinephrine and serotonin from being absorbed back into the nerves of the brain, thereby making these important neurotransmitters more available for the brain to use. The more norepinephrine and serotonin available to the brain, the less likely symptoms of depression will occur. Some common prescription names of TCAs: Elavil, Pamelor, Sinequan.

MAOI (Monoamine oxidase inhibitors) - monoamine oxidase (MAO) inhibitors block the enzymes depelete the brain of norepinephrine and serotonin. However, they're commonly prescribed for patients with atypical depression (for example, depression marked by an increased appetite and need for sleep, rather than anorexia and insomnia) and for some patients who fail to respond to TCAs. MAO inhibitors are associated with serious side effects so people treated with one of these drugs must be able to comply with the necessary dietary restrictions to prevent toxicity or overdose. Some common MOAIs: Parnate, Nardil, Marplan.

SSRIs antidepressant medication (Selective serotonin reuptake inhibitors) - SSRIs are one of the drugs of choice for treating depression. They're effective and produce fewer adverse effects than TCAs. They work by targeting specifically serotonin levels in the brain. Even so, they're associated with sleep and stomach problems and alterations in sexual desire and function. Some common drugs in this class: fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft)

Serotonin and norepinephrine reuptake inhibitors (SNRIs) are another newer form of antidepressant medicine. They treat depression by increasing availability of the brain chemicals serotonin and norepinephrine. Medications in this class are Duloxetine (Cymbalta)
Venlafaxine (Effexor, Effexor XR), Desvenlafaxine (Pristiq)

Other Antidepressant medications - drugs like maprotiline, trazodone (Desyrel), and bupropion (Wellbutrin) aren't chemically related to the other antidepressants listed above but they can be effective in treating depression by blocking the reuptake of norepinephrine, serotonin, dopamine and epinephrine. However, the reason they aren't used as commonly as the other compounds is because of increased adverse effects.



Depression Therapies

Psychotherapy or Talk Therapy for Depression

Electroconvulsive Therapy (ECT)

Depression Light Therapy
Light therapy (phototherapy) is exposure to light that is brighter than indoor light but not as bright as direct sunlight. It may help with depression and may help reset your "biological clock" which controls sleeping and waking cycles. Typically, you sit in front of a high-intensity fluorescent lamp for 30 minutes to 2 hours each morning. The main use is in Seaonal Affective Disorder (SAD), which is a type of depression related to shorter days and reduced sunlight exposure during the fall and winter months. Most people with SAD feel better after they use light therapy. This may be because the light therapy replaces the lost sunlight exposure.


Vagus Nerve Stimulation (VNS Therapy)
VNS involves electrical stimulation of the vagus nerve in the neck that goes up into the lower part of the brain. Research suggests that approximately one-third of patients with severe depression which has failed treatment with four or more medications may respond to VNS. VNS involves surgical implantation of a small electronic stimulator under the collar bone. An electric lead is then attached to the vagus nerve. The stimulator “fires” small electrical impulses to the nerve on a regular cycle 24 hours a day. Some patients can take as long as nine to twelve months before responding to this treatment.


rTMS
Transcranial Magnetic Stimulation
Herbal treatment for Depression - The herbal treatment of depression had fewer side effects and as the researchers concluded, it showed promise for the long-term treatment of mild to moderate depression.


St. John Wort (Hypericum perforatum)

Hyperforin

5HTP (5-hydroxytryptophan)

Ginkgo Biloba

Natural treatment for Depression - Aa variety of natural treatment of depression can be used to help alleviate depression including exercise, yoga, meditation, etc.

Exercise or Yoga

Meditation


Alternative treatment for Depression - There are many alternative treatments available for depression. Each of these alternative treatment of depression addresses human suffering in different ways, but generally they seek to re-establish a balance or harmony within the body and in the lifestyle of the person being treated.

Aromatherapy

Vitamins

Diet

Depression Treatment through Self Help- I found that the best way to cope with such intense discomfort was to live my life one day at a time.

Of course, you should understand that some of these treatments are controversial and may or may not have research backing the effectiveness or safety of the treatments. ALWAYS, ALWAYS, ALWAYS check with your physician before trying any new treatment or procedure.

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I'm Blue, Soooo Blue (Depression, part 3)

Remember, everyone gets depressed at some time, but not everyone gets depression. Depression comes in many forms. Yesterday we talked about degrees of reactions to change. The same occurs in all symptoms of depression. The sympoms tend to run on a continuum: eating too much to not eating at all, or somewhere inbetween.

The Diagnositic and Statiscitcal Manual (DSM-IV-TR), which is the "bible" of diagnostic symptoms for mental health professionals, lists the symptoms of depression. According to the different levels, intensities, and symptoms, there are over 200 different combinations for depression.

The symptoms of major depression can be divided into three categories:

1. 
   Disturbances of emotion and mood.
2. 
   Changes in the "housekeeping" functions of the brain - those that regulate sleep, appetite, energy and sexual function.
3. 
   Disturbances of thinking and concentration.

Some of the most common symptoms of clinical depression include:

• loss of interest or pleasure in ordinary pleasurable activities, including sex.
• chronically sad or empty mood.
• irritability or excessive crying.
• social withdrawal or isolation.
• changes in energy levels, fatigue, feeling slowed down, slowed movements.
• agitated actions (pacing, hand-wringing, etc.)
• sleep disturbances (insomnia, early morning waking, or sleeping too much).
• changes in eating habits (loss of appetite, significant weight loss or weight gain).
• difficulty with focus or concentration, impaired memory, difficulty in making decisions.
• feelings of guilt, worthlessness or helplessness.
• feelings of hopelessness and despair.
• increase in addictive behavior.
• thoughts and/or talk of death and suicide.
• suicide attempts.
• chronic aches and pains that don't respond to treatment.

If some of these seem to apply to you, then think about them in terms of these three words - number, duration and intensity.

1) Number. The symptoms of depression are "additive" - that is, the greater the number of symptoms you have, the more likely you are to be clinically depressed. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), five or more of these symptoms should be present for a person or someone close to that person to consider him or herself "clinically depressed."

2) Duration. The longer you have been down in the dumps, the more likely it is that you are clinically depressed. According to the DSM IV, the five or more symptoms must exist for at least two weeks for a diagnosis of major depression to be made.

3) Intensity. Many of us can feel emotional pain and still cope with our daily existence. Some experiences of depression are within the normal course of living. The pain of major depression can be so great, however, that its intensity (along with the number and duration of symptoms) can significantly impair one's ability to cope.

If you feel like you are clinically depressed, GREAT! You know what you can do, talk to your primary physician or make an appointment with a mental health professional (psychiatrist, counselor, psychologist) to get started on a treatment plan. You can also go to one of these sites to assess your level of depression and share this information with your physician or MHP:
Zung Self Rated Depression Scale
Mayo Clinic Depression Screening
Psych Central Depression Quiz

Keep in mind these are SCREENING tools only and NOT a substitution for a thorough examination by your physician and/or MHP.


Remember, there is HELP and there is HOPE!


Next up: Treatment options.

I'm Blue, Soooo Blue (Depression, part 2)

So what causes depression? There are many factors that lead to depession. Often, more than one, and usually a combination of many factors combine to lead to depression.

Simply put, when one of the following factors occurs, it changes our brain chemistry in some way. Of course, the factors themselves can vary in intensity; so a job change can vary from moving to a new cube, getting a new boss, being transferred to new department, being transferred to a new city, getting a demotion, getting fired, getting arrested for imbezzlement, etc. So when you say job change, that can mean many different things.

Add to that, the way we react to that change. For some people, getting a new boss is a huge deal, others, its no biggie. It doesnt meant the former person is weaker or inferior than the latter, it just means that the person reacted differently.

So, a job change occurs and our brain chemistry changes somewhat depending upon the type of change and our reaction to it. If multiple things happen our chemistry can change to the point where we are getting low in them which is a common cause of depression.

Let's look at some of these factors:

Genetics and biology.
Like other medical conditions, for example heart disease, cholesterol, and cancer, depression tends to run in families. People can be born with a certain predisposition to depression or have lower levels of chemical neurotransmitters to begin with.

Childhood trauma and other psychological factors.
As we discussed, changes in our psychology (reactions to trauma, personal loss, rejection) can also alter the biochemistry of the brain and nervous system - sometimes permanently. How we adjust to traumas, or how we are taught to adjust, can have a huge impact on the likelihood of develping clinical depression.

Environmental factors.
Poor nutrition, hormonal imbalances, toxins in the environment, brain injuries, stress, substance abuse, and can lead to depressive states. Good nutrition, decreasing stress, healthy lifestyles are keys to minimizing depressive symptoms. Alcohol depresses the nervous system, thus drinking too much, too often can lead to depressive states. Thus, moderation in drinking alcohol is essential.

Prescription medications
Many people do not realize that many common prescription drugs have side effects that can induce depression. These include cardiac drugs and hypertensives, sedatives, steroids, stimulants, antibiotics, antifungal drugs and analgesics.

Sociological factors.
Many changes in modern society, such as the breakdown of traditional communities (people don't stay in one spot for very long any more), the dissolution of extended families (with mobility in the world, often families are spread throughout the country or world), the widening gap between rich and poor, and our increased isolation due to technology (we text/email people instead of calling or visiting), may play a part in the rising rates of depression worldwide.

Spiritual crises.
People can suffer from an existential depression when life loses its meaning and purpose. Any significant transition, especially a change of roles in family or work, can trigger this crisis in meaning. Connection to a "Higher Power"has been shown to increase mood and levels of neurochemicals.

Next, we'll look at symptoms of clinical depression...

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I'm Blue, Soooo Blue

Depression is a word we hear bandied about often. People say "I'm so depressed", but are they really? What's the difference between "the blues", "feeling down", being depressed, and having depression?

I'm glad you asked.

Starting next week, we'll look at depression and depressive disorders and hopefully answer a few of those questions as well as talk about what you can do if you feel like you have depression.

If you feel like you are going to harm yourself, harm others, or are concerned about people being aggressive toward you, please go to you local emergency room or call 911 for assistance.

Fight or Flight

A friend of mine, who is a medical professional, is in a dilemma. She discovered a practice that many of her coworkers were doing, with the blessing of some supervisors, was bordering on illegal. A misdemeanor, but still legally damaging to the medical licenses and certainly a potential liability for the company. None of it was done maliciously, there was just misunderstanding of how situations should be reported. Some people thought one way, others a different way. One way was correct, one was not.

My friend certainly didn't see herself as a whistle blower, she simply (or so she thought) brought the situation to the supervisor on duty. This supervisor was one who thought incorrectly about the policy. My friend suggested that the supervisors "get on the same page", so that practitioners, like herself, could be consistent in applying the practice and be in compliance with the law.

The situation my friend was discussing with the supervisor had many dimensions to it, so it ended up being a bigger deal than expected. However, something unexpected happened. My friend's supervisor had a sit down with her and told her she should "watch how you interact" with other people and you shouldn't "tell the supervisors they need to get their act together". Her supervisor went so far as to hint that if she were wanting to advance in the company, she would need the backing of said supervisors, they have great influence with the hiring manager, so she needs to be aware of "your impact on others".

She felt this to be a veiled threat...shape up, go along with us...if you don't behave, we will not promote you (or discourage your advancement)....even when potential illegal activity occurs.

So what to do? Fight the system? The practice she brought to light is being changed to comply with the law, so that's good. Does she have anything to apologize for? Should she confront her supervisor about the veiled threat. What she seems most concerned about is that her supervisor is generally very good and this seems out of character for her.

Does she "comply" and mold to their expectations in order to advance within the company or does she stand up and say this is wrong. In whistle blower situations this is what happens...the whistle blowers are told to keep quiet, don't make a stir, just go along with the wrong situation. Brave people who stand up to the corporations at times have saved lives and have actually saved the company money in potential lawsuits, yet, they are threatened with loss of job, loss of advancement, or worse.

There comes a point where you have to say, "this is wrong" and let the chips land where the may. Its wrong to implement this practice illegally, it is wrong to threaten someone with loss of advancement if he/she doesn't tone it down.

How do you respond?

Healing Forgiveness

I have a scar on the thumb of my left hand. It is a small triangular white patch of scar tissue just at the beginning of my knuckle. I can still remember getting how I got the wound. I was probably 5 or 6 and I had gotten up one night for midnight snack. My snacks were usually carrots. So there I was, late at night, peeling a carrot over the trash can. I sliced into my thumb fairly deep, such that it took quite some time for most of the bleeding to stop, then, since it was near the knuckle, kept getting opened up again. Every once in awhile the scar hurts and it reminds me of the wound.

I've been a big fan of the Twelve Steps and Twelve Traditions of Alcoholic Anonymous (AA) for many years. I've never attended an AA meeting, but having worked with people with serious addictions (to many different things, not just alcohol), I've picked up some of the wisdom the Twelve Steps offer.

One of the most powerful and often most difficult is Step 9, known as making amends. This step is often implemented after a long process of healing self, self-awareness, and understanding of the wrongs the have occurred due to the addictions. Making amends is more than saying "I'm sorry". Anyone can say that. Most people say it as an automatic reaction, but do they feel sorrowful for their actions? In most cases not, it is a polite statement given in such situations.

Amending means changing. Think of the great efforts we must take to amend the Constitution of the United States. Think of what that means to amend the Constitution. We are literally changing the way we govern our life, liberty and pursuit of happiness. Thus, the framers of the Constitution made it very difficult, considered it such a serious task, that it requires two-thirds approval of either the Senate or House just to propose an amendment, and the 75% of the States (legislatures) have approve it. Amending is a huge task.

Such is the same with Step 9. By following through with this step, you are actually changing a relationship. In most, but not all, you are repairing the brokenness that the addiction caused. The pain of the brokenness is replaced by the pain of healing. It does not have to be the other person, the person you hurt, who changes. The act of amending changes you. Thus, since you are no longer the same person you were at the beginning of the relationship, the relationship must change. How it changes depends on you and the other person. There are times where all you can do is amend and move on, mourning the loss of that relationship; other times you dance with joy in healing tunes.

My scar on my left thumb is a bold reminder of the wound. It is not the same wound I had when I was young. My skin amended and changed...but left me wiser for the relationship.