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About Samar Hafeez

A Clinical psychologist and a counsellor, Samar Hafeez is driven by her passion for a healthy lifestyle and to motivate others to achieve the same. Armed with a Masters in clinical psychology, she is also specialized in women’s health and hygiene and has gained 6 years’ experience in this field. Samar is an optimist and firmly believes that anyone with a willingness to change his/her lifestyle can do it. She helps people using cognitive and behaviour healing methods –simple as changing disruptive thoughts & behaviour into favouring thoughts and behaviours.

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Link between Vitamin D Deficiency & Depression

Vitamin-D- deficiency

Depression has been called the world’s number one public health problem. The American psychological association states that it is the most commonly occurring mental disorder. In India statistics show a shocking rise in the number of depression cases every single year and it affects almost every age group irrespective of gender.

Most of us know depression is a heterogeneous illness and has many different triggers. Let’s try to identify if VITAMIN D deficiency is one among them.

Vitamin D also was known as the “Sunshine” vitamin is a steroid hormone precursor. It was originally thought to play a role in mineralization of bones for keeping them strong and healthy, but over time research has linked low levels of Vitamin D levels to obesity, heart disease, diabetes, cancer, anxiety and DEPRESSION!

Limited sun exposure, darker skin tone, higher altitudes, poor diet, liver and kidney diseases, age etc., are few risk factors for Vitamin D deficiency.

Diagnosis:  The most accurate way to measure how much Vitamin D is in your body is the 25- hydroxylated blood test (25(OH)D). In my practice, I have observed not many have enough or optimal Vitamin D levels which should be over 35 ng/ml

I personally feel that it’s the most underrated and undervalued vitamin of all

Symptomology:  If you have a Vit D deficiency you may experience following physical symptoms

  • Aching bones, joint pains
  • Poor muscle endurance
  • Muscle cramps and weakness
  • Fatigue and generalized weakness
  • DIFFICULTY LOSING WEIGHT
  • Low immunity
  • Decreased stamina and endurance

You may also experience symptoms of Depression that include:

  • Overwhelming sadness, hopelessness, feeling empty
  • Diminished interest or pleasure in activities
  • Loss of appetite
  • Significant weight loss(when not on diet) or weight gain
  • Insomnia or Hypersomnia(excessive sleep) nearly every day
  • Lethargy
  • Problems concentrating
  • Headaches, back and neck pains
  • Psychomotor agitation/retardation(restlessness or sluggishness)
  • Recurrent suicidal ideations.

A link between Vitamin D deficiency and Depression

Many research studies have concluded that Vitamin D receptors have been found in the areas of brain that are linked to the onset of depression, It has also been found that Vitamin D affects the number of chemicals called Monoamines such as serotonin, dopamine (also known as ‘happy hormones’) and how they work in brain. Many anti-depressants medications work by increasing the number of monoamines in the brain.

A review of an international research shows Over 31,000 people participated in 13 studies that efficiently studied this area and the results showed a significant relationship between low levels of Vitamin D and depression.

According to a study in the Netherlands involving 1,702 people found that significant low levels of Vitamin D cause the developing of depressive symptoms in individuals. A 2 year follow up suggested that Vitamin D could be a cost-effective part of prevention and treatment interventions for depression.

One type of depression that appears to be even more strongly associated with Vitamin D is Seasonal Affective Disorder (SAD), a mood disorder characterized by depressive symptoms during times of year when there is relatively less sunshine. It occurs majorly during winter seasons. Symptoms of SAD coincide with a reduction in Vitamin D which in turn effects serotonin levels in the brain, thereby causing depressive symptoms.

Food sources of Vitamin D:

  • Fatty fish like tuna, mackerel, salmon, sardines and herring
  • Cod liver oil contains 450 IU of Vitamin D per teaspoon(5ml)
  • Oysters, shrimp
  • Egg yolks
  • Mushrooms: Like humans, mushrooms synthesize D when exposed to UV light
  • Vitamin D fortified cereals, milk, orange juice or soy milk.

Other helpful options are to get enough sun (at the least for around 15 mints daily) around midday which can be between 11 am to 1 pm. At this time sunlight is at its highest point and your body may manufacture it more efficiently in less time.

Also, get Vitamin D supplements if your D levels are at extremely low levels, recommended daily allowance (RDA) would be of 600 IU daily, plus a 60,000 IU Vitamin D sachet in milk/curd once every month for 4-6 months(see your physician for more information)

Of course, Vitamin D supplementation is only a part of a comprehensive treatment plan. A plan whether based on pharmaceuticals or natural methods should include psychotherapy. However, low levels of Vitamin D can impair and prolong recovery from depression. Hence, it’s always best to treat a problem holistically!

NOTE:

  • Healing properties of natural sunlight cannot penetrate glass, you cannot sit inside your home or car and reap its benefits
  • If you have darker skin, you will need about 25 times more exposure than a light-skinned individual to produce the same amount of D
  • You are looking at months of sunlight/supplements before levels return to normal
  • Kidneys and liver activates Vitamin D, having a kidney disease or damaged liver will hinder the activation of Vitamin D
  • SUNSCREENS- From strongest to weakest prohibit the body from making vitamin D by 95%. Your body needs sunlight without sunscreens to produce vitamin D. Even SPF 8 creams can prevent the production of vitamin D

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Reduce Anxiety, Sleep Sound

anxiety1

Anxiety and Fear are a part of life. You may feel anxious before you take a test or walk a dark street. This kind of anxiety is useful as it can make you more alert, careful and productive, however, it usually ends soon after you are out of the situation that caused it. But, for millions of people, the anxiety does not go away and gets worse over time. This can make one, more restless, clumsy and unproductive thereby causing dysfunction in daily activities, and ultimately begins to take over lives.

Anxiety has plagued millions around the world from time immemorial. Anxiety is defined as a feeling of excessive worry, nervousness or unease about something. In this people are always preoccupied with ‘what- if’ thinking, what if something bad, dangerous or threatening could happen, what if anything bad happens to someone I love etc.

Symptoms of Anxiety:

Physical symptoms include:

  • Muscle tension, Muscle Twitching
  • Chronic indigestion, constipation, Diarrhoea
  • Increased or heavy breathing
  • Hyperventilation/Palpitations
  • Nausea
  • Cold chills, Hot flash, Frequent urination, sudden weight loss, headaches

Emotional symptoms include:

  • Feeling of dread, feeling tense and jumpy
  • Irritability
  • Restlessness
  • Sleep problems
  • Panicky most of the time

Cognitive symptoms:

  • Poor concentration Negative thoughts and Apprehension
  • Confusion
  • Poor communication, attention and memory skills

Now let’s move on to discuss how Anxiety may cause sleep problems

Many of us toss and turn and watch the clock when we can’t sleep for a night or two. But for some, a restless night is routine.

The growing cases of sleep disorders due to anxiety are not to be ignored. Indian women outnumber men when it comes to disturbed sleep due to anxiety.

Anxiety and sleep have a bidirectional relationship, meaning high amounts of anxiety tends to disrupt sleep and disruptions in sleep tend to increase anxiety.

In case of Anxiety, it begins in anticipation of an event. When you reflect on a stressful event at night, the emotional centres of brain namely Amygdala and Insular cortex get activated. This stimulates a chain of events that raise both your adrenaline and blood sugar levels. This sudden source of energy then keeps you alert, tense and restless. Ultimately disrupting your sleep.

Sleep on other hand is an integral part of emotional regulation. A lack of it leaves your emotions unstable and in disarray. You are more prone to falling sick often, show irritability and lack of patience and discontent often.

What your Anxiety at night may look like

An individual usually experiences either racing or stagnant/fixed anxious thoughts. These thoughts build on each other or spiral around making it harder and harder to fall asleep.

Some people describe this feeling as being stuck in their head.

Due to the consistent rise in adrenaline and cortisol (stress hormone) levels more and more physical symptoms may result.

Reduce Anxiety

  1. Melt Anxiety with mindfulness meditation: Focusing on your breath and physical sensations can help you stay in the present moment. This can help you recognize what your thoughts may be, allowing them to pass without reaction or judgement.
  2. Rationalize and not Awfulize: Accept the what if thinking as a projection that connects horrifying thoughts and images to anxiety. Think that a what if disaster does not validate or guarantee a disaster, Awfulizing things real or imagined situations as horrible, Awful or terrible will only make symptoms worse
  3. The shift from passive to active perspective: Talk to yourself in a realistic self- assuring way
  4. Relax your body Relax your mind: Practice Diaphragmatic breathing these exercises are simple to learn and can have relatively quick effects. This technique involves breathing in a way that your belly expands as you breathe in and contracts as you breathe out. Psychologist Jon Carlson describes belly breathing as a technique that can send calming signals to the brain and promote a feeling of relaxation and improved attention and awareness.
  5. Imagination and Relaxation: Rolodex of anxiety thoughts can be controlled by using Guided imagery, Guided imagery serves to redirect people’s attention away from what is stressing them and towards an alternative focus, this includes only visualizing pleasant and relaxing image like on a beach or on a serene hill or whatever may soothe a person. This practice is extremely portable, as it relies on nothing but one’s imagination and concentration abilities.
  6. Exercise: Regular exercise provides an outlet for frustrations and releases mood-enhancing endorphins/hormones
  7. Play music: Soft calming music can lower blood pressure and muscle agitation, usually found symptoms in people who get anxious often
  8. Direct anxiety elsewhere: Lend a hand to relative or neighbour or volunteer in your community services. Helping others will take your mind off your own anxieties and will help you count your blessings.

Sleep More Soundly

  1. Make good sleep a priority: Block out 7 hours for a full uninterrupted sleep
  2. Maintain regularity: Try to sleep and wake up on same time daily even on weekends, this helps circadian rhythm your ‘biological clock’ to tick properly.
  3. Avoid stimulants: Say no-no to alcohol, coffee, chocolate or nicotine post sunset
  4. Keep it cool: sleep in a dark room which is slightly cold, this helps the temperature in the brain to fall and help fall asleep quicker, the cool room takes your brain and body in the right temperature direction to get good sleep.
  5. Dark- deprived society: We need darkness in the evening to allow the release of a hormone called Melatonin(sleep hormone) It helps the healthy time of our sleep. In this modern era, we are severely deprived of darkness. So try to dim lights down in your home an hour before bed. Stay away from LED screens as they emit blue light that actually puts break on melatonin and fools brain into thinking it’s still daytime, even though night time.
  6. Do not stay in bed awake: If you haven’t fallen asleep within 30 mins of getting into bed or have woken up and finding difficult to fall back asleep, the advise is to get up go to another room and in dim light just read a book, no screens, no email checking, NO FOOD. And only when you feel sleepy should you return to bed and that way your brain can actually re-learn the association between bed being a place of sleep, rather than a place to stay awake.
  7. Avoid big meals before bedtime and avoid working out 2 hours before bedtime.
  8. Try magnesium-rich foods/supplements like fish or fish oil, almonds, bananas, pumpkin seeds, warm milk, cherries, mushrooms and dark green leafy veggies in dinner. Magnesium relaxes muscles and easesanxiety1 anxiety which contributes to insomnia
  9. Chamomile magic: Try having a cup of chamomile tea 30 mints before bed chamomile is regarded as a mild tranquillizer and sleep inducer, It relaxes nerves and muscles and help fall sleep quicker.

The power of sleep has always been known to be significant but now there’s more and more evidence demonstrating just how important it is for those who experience anxiety. By using above mentioned techniques you can hope for relief from anxiety and eventually will sleep your anxiety away!

 

 

 

 

 

 

 

 

 

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Know all about ‘Eating Disorders’

eating problms

DO YOU look in the mirror and pick yourself apart? Do you constantly worry about what and how you look?

Ask yourself, “What percentage of your time in a day you are preoccupied with thoughts regarding food, weight, and body image?”

If your answer is that you spend so much time with these concerns that it interferes with your happiness and daily functioning, then let me tell you that you may be having an Eating Disorder.!

What Is an Eating Disorder?

Eating Disorders are illnesses that cause serious disturbances in a person’s everyday diet. They are characterized by irregular eating habits which include inadequate or excessive food intake which can damage individual’s well-being.

In addition to abnormal eating patterns, there are severe distress or concern about body weight and shape. An Eating Disorder also includes your beliefs about food and how they impact your body.

Who Suffers From Eating Disorder?

Eating disorders can develop during any stage in life but typically it appears during teen years or young adulthood but, may also develop in childhood. It can affect both men and women, however, it’s more common in women.

Eating disorder when manifested at a young age can cause severe impairment in growth development, and overall mental and social well- being.

Let’s move on to knowing three most common types of Eating Disorders

ANOREXIA NERVOSA

The Term Anorexia Nervosa literally means “Lack of Appetite induced by Nervousness”

This is perhaps the best- known eating disorder. It causes its sufferers to excessively fear to be overweight and restrict their eating habits in an unhealthy, dangerous way which leads to a significantly low body weight.

Male and female suffering from Anorexia show following hallmarks

  • Extremely limited food intake
  • Obsessive intense fear of weight gain
  • Problems with body image (Unrealistic perception of the body) and a low self-esteem
  • Denial of low body weight

Overtime, the following symptoms may develop as the body goes into starvation

Physical symptoms

  • Menstrual cessation
  • Osteopenia or osteoporosis(Thinning of bones)
  • Anaemia
  • Fatigue
  • Brittle nail and hair
  • Skin dries and can take on a yellowish cast
  • Severe constipation, Low BP

Emotional and behavioural symptoms

  • Excessive/Compulsive exercising
  • Frequently skipping a meal or refusing to eat
  • Denial of hunger
  • Frequent checking in the mirror for ‘perceived’ flaws
  • Flat mood(Lack of emotion)
  • Low self-esteem
  • Irritability
  • Low sex drive

BULIMIA NERVOSA

The Greek word for Bulimia is BOULIMIA which means extreme hunger. Patients with bulimia nervosa eat frequently in a discrete period of time (example within any 2 hour period) they also have a sense of lack of control over eating during the episode.

They often consume thousands of calories that are high in sugars, carbohydrates and fats. They can eat rapidly, sometimes gulping food without even tasting it.

After a binge, they PURGE their bodies of food and calories they FEAR by using laxatives, enemas, diuretics, vomiting or by excessive exercise. People with Bulimia can be underweight, overweight or even obese.

Many people don’t know when a family member or friend has Bulimia nervosa because they almost always hide their binges but Bulimia nervosa does have symptoms that should raise red flags:-

Physical Symptoms

  • Chronically inflamed or a sore throat
  • Salivary glands in the neck and below jaw bone swollen; cheeks and face often become puffy
  • Tooth enamel wears off and begins to decay from exposure to stomach acids
  • Constant vomiting causes GERD (Gastro oesophagal reflux disease)
  • Laxative and Diuretic abuse cause kidney and intestinal problems
  • Frequent Severe dehydration from purging of fluids

Emotional and Behavioural symptoms

  • Negative/distorted self- image
  • Hoarding or hiding food
  • Social withdrawal
  • Extreme guilt and sadness
  • Excessive worry about body weight and shape

binge eating

BINGE EATING DISORDER

It is a form of compulsive OVEREATING. Sufferers feel a compulsion to eat large amounts of food and as though they cannot stop and UNLIKE PEOPLE WITH BULIMIA, THEY DO NOT TRY TO PURGE OR GET RID OF FOOD BY INDUCING VOMITING AND BY USING OTHER UNSAFE PRACTICES.

Symptoms are more or less similar to Bulimia nervosa except for purging and laxative abuse.

Binge eaters eat a large amount of food when not feeling physically hungry, binge eating episodes typically take place in private and can last for hours or a whole day. It is common for sufferers to feel distressed or guilty about their lack of control, it is this shame and guilt that can prevent a person from talking and seeking help.

CAUSES

Eating disorders are complex thus are influenced by a facet of factors. Though the exact cause is unknown, it is generally believed that a combination of biological, psychological, and/or environmental abnormalities contribute to the development.

Certain psychological, biological/genetic, and personality traits may predispose people to develop eating disorders.

However specific traits are linked to each of the disorders. People with Anorexia tend to be perfectionists and with bulimia and binge eating disorder impulsive nature is common. Hormonal irregularities and nutritional deficiencies can be among causes. As discussed earlier in this blog, negative body image, dissatisfaction with one’s body and low self-esteem can help build tendency towards abnormal eating patterns.

Among Socio-cultural factors, the media has the largest influence on people especially teens and young adults. The media pushes body image, clothes, fast food and weight loss with unrealistic results, the combination of all these lead teens and young adults down the road to eating disorders and a confusing self- image.

And on another side of continuum popular social media pages and videos with a variety of recipes and restaurants tempt people to eat more and more.

Other causes include disruptive thinking patterns and an inability to understand the healthy relationship between food and hunger, family dysfunctions and major life stressors/changes, negative emotions or traumas such as rape, childhood sexual abuse or death of loved ones can also trigger eating disorders.

Even a happy event, such as giving birth can lead to an eating disorder because of the stressful impact of the event on an individual’s new role and body image.

IMPORTANCE OF TREATMENT

Eating disorder untreated can have serious consequences like Malnutrition, stunted growth, osteoporosis, reduced metabolic rate, critically low blood pressure, serious heart, kidney and liver damages, obesity, diabetes (TYPE 1 AND 2), depression, anxiety, obsessive-compulsive disorder and substance abuse, cardiac arrests and even death!

Remember, the sooner the treatment starts, the better it is. The longer abnormal eating patterns continue the more deeply ingrained they become and more difficult to treat.

EFFECTIVE TREATMENT METHODS

  • PSYCHOTHERAPY
    • Cognitive Behaviour Therapy is a therapy focussing on the beliefs, values, maladaptive cognitive processes and negative emotions which are associated with meaning of weight, shape and appearance, it aims at reducing destructive eating patterns and restoring a healthy relationship with food. Psychologists identify important issues associated with causes of destructive eating habits and develop CBT plan respectively.
    • Dialectical Behavioural Therapy is a form of psychotherapy that helps to cope with painful emotions. The focus is on individuals who react to emotional circumstances with extreme behaviours. Weekly sessions help a person with Eating disorder practice mindful eating, distress tolerance and emotional regulation which focus on identifying barriers to changing emotions to constructive ones and to increase positive emotional events.
    • Incorporating Family, Group and Marital Therapy: This can be helpful in addressing the underlying causes of eating disorders and help prevent relapses by resolving interpersonal issues which are related to eating disorders.
  • Nutritional Counselling: This would involve a nutritionist’s guiding plan through weight restoration and stabilization, guidance for normal eating by keeping a food journal which includes type of food, amount, benefits, feelings thoughts associated with intake of food and drink, it also includes which binge foods are to be avoided. The inclusion of individualized meal plans for specific patients to improve nutritional intake is created.
  • Medication: Some patients with Bulimia Nervosa benefit from placebo or anti- depressants. But, medication should always be paired with psychotherapy and nutritional counselling.

A holistic approach involving all above methods/ways with an experienced team of caregivers and healthcare professionals can help patients suffering from eating disorder regain control of their eating behaviour and their lives!

Good Health is more than just being free from disease or injury. A healthy lifestyle helps you feel good, have a vibrant energy and maintain a positive outlook on life thereby contributing to your physical, mental, social well- being. Your mental health is as important as physical health and work hand-and-hand. Letting go of your eating disorder is one of many ways to move towards good health!

 

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