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Depression and Weight Gain: a Heavy Burden

Depression and Weight Gain: a Heavy BurdenI often hear weight gain among the list of troubles of patients who are depressed.  Sometimes it’s just a few pounds, sometimes it is more.  Often, it is too many.  It makes sense that depression could lead to weight gain; being depressed makes it more difficult to get out of bed and be active.  Being depressed can make it harder to pay attention to what you are eating.  People who are depressed often turn to food to make them feel good or for more energy.  On top of this, gaining weight can lead to poor body image and self-esteem, which can leave people feeling more depressed.  

Research shows: Depressed people tend to gain more weight than those who aren’t depressed. Over 5,000 young people were followed for 20 years. Everyone-whether depressed or not – put on at least a few pounds.  BUT those who were depressed gained the most weight (particularly around the waistline). The study also showed that being overweight, does not necessarily lead to depression.*   

Weight gain and depression are complicated and can be influenced by a number of factors: 

Sleep Disturbances: Depression often causes a disruption of sleep and insufficient sleep can lead to depressive symptoms.  When tired, people turn to food for energy or can take in calories from late-night snacking. Insufficient sleep causes the excretion of ghrelin and leptin, which disrupt the sensations of hunger and feeling full so people might tend to eat more, and feel less full.  Not getting enough sleep also can cause increased fat storage. 

Stress: Stress moves us forward and helps cope with life's demands, but it also affects our mood and emotions.  When under stress our bodies store fuel, slow down metabolism and excrete cortisol and other hormones which are more likely to cause     obesity in the abdominal region.  Elevated cortisol levels also   increase appetite to help the body refuel after stressful times, so people with depression may eat more food – particularly high carbohydrate foods.  

Antidepressants: Unfortunately, weight gain is a side-effect of some anti-depressants; 25% of those on antidepressants gain weight.  Some people report they gain weight on anti-depressants because they start to eat and enjoy food more.  If a medication is effective but causes weight gain, the pressing need to getting depression under control may take precedence. There are antidepressants that are less likely to affect weight.  A conversation with your health care provider is recommended before you make any medication changes and to determine the best course of care.  Carbohydrate control can be a key component in weight control for those using psychotropic (i.e., mood altering) medications.   

Getting help:  

Losing weight is hard, and depression can make everything feel harder. Fighting depression while trying to lose weight can seem insurmountable.  Starting and making change is especially hard when depressed and therapy can be helpful with this.  If you are overweight, depressed or both, you can get help now.  Getting exercise is a prescription for depression and can allow you to sleep better.  A 20-minute walk not only helps to reduce levels of the “stress hormone” and lift the spirits, it burns extra calories. Guided imagery, hypnosis, acupuncture, and EMDR can all be helpful too.

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Concerned about your child’s moods: Feeling Sad or Being Depressed: What’s the difference?

It can be difficult to tell the difference between sadness and depression in children and adolescents because they share many common features. For example, a loss of interest in usual activities, sleep problems, body aches and pains, and problems in school or with peers are some of the more typical problems seen in children and adolescents who are either sad or depressed. However, feeling sad is a normal reaction to a loss or an unexpected stressor, such as the death of a grandparent or an impending transition (e.g., moving or changing schools).

For children who are sad, behavioral symptoms are usually time-limited because children typically have the internal resources to manage their feelings and to move beyond their sadness. On the contrary, for children and adolescents who are depressed, these symptoms may last two or more weeks. In other words, they don’t just ‘get over it’.  It is difficult for them to see the light at the end of the tunnel. This is also true for children and teens who live with chronic or life threatening illnesses, or those who have experienced significant trauma in their lives.

As a child and adolescent therapist, part of my job is help parents and their children to distinguish between sadness and depression. One critical distinction between the two is the presence of suicidal thoughts and plans. It is also important to determine how long the child has been experiencing these emotional and behavioral symptoms. This is why I place an emphasis on partnering with parents because they often provide useful information. Their observations are critical to understanding a child’s or adolescent’s mood and how the  family functions. After all, children live in families!

Three Effective Treatment Strategies

In my practice, I integrate three effective strategies that help children and adolescents to cope with their depression.

  1. Self-hypnosis—a tool used to help children create a shift in their thinking and to manage negative moods
  2. Biofeedback—can show children how their bodies react to negative thoughts.
  3. Creative Expressive Therapies—depending on the child’s interests, I like to integrate drawing, play, and expressive writing into the therapeutic process

The Treatment Benefits

Helping children and adolescents learn new ways of coping has many positive and lasting effects:

• less family conflict
• increased school attendance
• better academic performance
• more positive social interactions
• alleviation of aches and pains
• improved coping strategies

If you are having a difficult time determining if your child is sad or depressed, make an appointment to partner with me to help your child address their concerns.  Call me at 763-546-5797.

By Harriet Kohen, MSW, LICSW

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Depression and the Challenges of Infertility

Depression and the Challenges of InfertilityIt is not surprising that many women and some men suffer from depression and anxiety when faced with fertility challenges.  The ups and downs of infertility and its treatment drain the spirit right out of people.   I hear daily the intensity of the experience, “This is personal.  I feel invisible in the world.  This is physical.  I hate my body.  I am demoralized and afraid.  This is expensive.  I have no control and I feel out of control.  This has taken over my life.  I’m so worried about my relationship.” 

Some women have mood consequences from using birth  control pills and ovarian stimulation medication, on top of the fear of not having a child.  For many of the people I see, the following “formula” captures their experience: 

Uncertain Outcome of Procedures + Uncertain Length of Time + Internal/External Pressure + Medications + Fear = DEPRESSION and ANXIETY. 

It is important to distinguish between depression and grief when dealing with fertility challenges.  Grief hurts but it does not lead the thinking process toward self-hatred and negative thinking.  Depression is a heaviness all its own. 

Help is Available at Partners in Healing

Dr. Deborah Simmons, PhD, LMFT provides specialized counseling for individuals and couples who are suffering from fertility challenges. She provides clinical hypnosis, cognitive behavioral therapy, EMDR (Eye Movement Desensitization and Reprocessing), and energy work.  She works with fertility clinics in the Twin Cities and around the country preparing people for inseminations (IUIs), IVF, donor eggs, donor sperm, donor embryos, and surrogacy. 

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Positive Change with the Brain in Mind

Positive Change with the Brain in MindWe now know that key areas of the brain show significant changes when people are in states of depression.  The affected brain areas regulate working memory, decision-making, information processing, mood regulation and energy management (i.e., metabolism) in the body. We also know that those brain circuits and brain chemicals are highly sensitive to social interactions. For example, research shows that the same areas of the brain that are active when someone is experiencing intense physical pain are active when a person has been rejected or cut off from a major social relationship.  In other words, our social experiences change the structure of the brain.  In turn, those structural and chemical changes in the brain enable new perceptions, new thoughts and new behaviors to emerge.  At PIH, we offer a variety of mind-body therapies (e.g., psychological therapies,  alternative therapies, and nutrition-based  therapies) through which your brain-behavior  connections can be changed to help put you back in charge of your life.  We also collaborate with medical professionals outside of PIH who are part of your care team. Our primary goal is to help you make positive change “with your brain in mind.”

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Is Depression in Your Head?

What is Depression?

depression“Depression” is often described in terms of colors. In its milder form, depression involves a temporary period of feeling “blue.” In its more severe form, it has been associated with blackness, a dark state of mind and body that  people describe as falling into an abyss from which it feels there will be no escape.  Depression’s darkness was recognized 2000 years ago when “melancholy” was used to describe it, a word referring to an excess of a black substance in the body believed to be responsible for the gloominess of depression. No matter the particular form of depression you experience, Partners in Healing (PIH) is here to help you discover an approach or combination of treatment approaches that can help you move through the darkness of depression and back into a brighter light with a more positive outlook on your  future. 

Depression Treatment at PIH

This issue provides a number of perspectives on depression and offers ideas about steps you can take to get back in charge of your life.  At Partners in Healing of Minneapolis, we believe that depression arises from a combination of factors (i.e., genetic, biochemical, psychological, social and nutritional factors), which is why it remains so important to approach each person’s personal struggle with it in an individualized way.  Just as there is no single common cause of depression, there is no single common solution to its effective treatment.  However, at PIH we take the time to generate a plan of care that is specific to your particular needs.