tame overwhelm with guided meditation

When I have too much work and not enough time, I find myself going into a state of manic overdrive in order to get everything done. While I'm in it, it feel like this state of frenzy helps me get things accomplished, but in actuality it leads me to get distracted, burned out, make mistakes, or simply give up.

So this week I'm trying something new, and when I feel overwhelmed I am trying to take a moment to slow down. I'm on day two of this strategy, and I must admit its still a bit uncomfortable (how can I take 5 minutes to sit quietly and breathe with all these deadlines looming?), but I really think if I stick with it this strategy will save me time in the long run.

Since sitting still on my own volition seems impossible, I've been doing these guided meditations available from the Meditation Room. They range from 3-10 minutes in length, and there's even one specifically for taking a workplace break.

Support H.R. 1424: Call your state representative today!

Tomorrow the house will be voting on bill H.R. 1424, the Paul Wellstone Mental Health and Addiction Equity Act of 2007. This bill, if enacted, would fight insurance discrimination against the mentally ill by requiring mental health parity. Insurance plans that currently cover mental health would have provide the same benefits and same limits for mental health services as for physical health services. While this bill (sponsored by Rep. Patrick Kennedy (D-RI)) would not cure all of the inequities surrounding mental health care, it would be a positive step forward for health care reform.

Stigma surrounding mental illness and misunderstanding of its prevalence, manifestations, and treatment options allow insurance companies to shortchange customers on mental health coverage. While there is data to dispute the misconceptions about mental health, much of that information never makes it to the general public.

One common misconception is that covering mental health care would be too much of a financial drain. In testimony to the house opposing H.R. 1424, the National Retail Federation states the bill would increase cost of coverage for retailer and employee alike. However, untreated mental illness is a great drain on the economy. The Wall Street Journal estimates the cost of untreated mental illness at over $90 billion a year, including lost productivity and resulting medical expenditures. Untreated mental illness causes increased absenteeism and lower productivity. Another damaging misconception is that mental illness occurs infrequently, so it doesn't need to be a priority. As discussed in a previous post, mental health issues are very common in the US. According to the Surgeon General, fifty-four million Americans, about 1 in 5 people, are affected by mental illness each year, regardless of ethnicity, sex or socioeconomic class.

The most damaging misconception about mental illness, particularly substance abuse, is that the illness is not real. The pervasive fallacy that one can control one's mental illness but simply chooses not to allows people to believe that someone seeking psychiatric treatment does not deserve the same medical attention as someone seeking physical treatment. This notion is ridiculous. Perhaps my psych degree and employment at a drug and alcohol center makes me more attuned to this issue than the average person, but it seems ludicrous to me that anyone with the option to thrive would choose to suffer. Mental illness is very real, and without proper treatment its consequences cause a great burden on the sufferer and anyone in their orbit. However, even if this were a valid argument for limiting treatment of mental illness, then shouldn't coverage be limited for people with type 2 diabetes who choose a poor diet, or people with high blood pressure who choose to lead sedentary lives? Nobody would ever dream of enforcing those types of limitations on physical problems (well...maybe the insurance companies dream it, but they couldn't get away with it), yet this double standard is tolerated for mental health issues.

So call your representative today! H.R. 1424 will not only expand coverage, but it will help to challenge outmoded beliefs, fight discrimination, normalize mental illness, and allow people to get the treatment they deserve.

UPDATE 3/6/08
It passed!

FDA approves laughter for treatment of malaise

Perhaps I should have listened to my own advice, but as usual my winter-induced ennui convinced me to spend the last two months in hibernation. While I haven't really felt like doing anything, I have been able to stave off the sadness of SAD with a daily dose of laughter. While the FDA hasn't actually validated the ol' adage, there is plenty of data to prove that laughter can reduce pain, improve oxygen flow to the brain, and generally lift spirits.

So if winter is trampling your mood, try renting Super Troopers, reading some Sedaris, joining a laughter yoga group, or just yucking it up at my new favorite joke:

Bush and Cheney are at a restaurant for lunch. The waitress comes over and asks what they will be having.

Bush says, "I'll have a quickie."

The waitress steps back in disgust and says, "Mr. President, I thought that kind of piggish behavior went out with the last administration!"

She storms off and Dubya looks confused. Cheney shakes his head at the president and says, "George, it's pronounced QUICHE."

SAD: Winter's silent bummer

I notice it first around the end of daylight savings time; a mere week of walking home from work in the dark triggers sleepiness, lethargy, and general ennui. It typically peaks in February, (although the start of March is often terrible) at which point I dedicate myself to sleeping until the crocuses start to bud.

Many people slow down in the winter; increased eating and sleeping during the cold, dark months becomes a form of human hibernation. However, some experiences of winter that move past rest to a period of prolonged distress, sadness, and anxiety could be attributed to seasonal affective disorder (SAD). If you suffer from internet-induced hypochondria, keep in mind that the rates of SAD are relativity low; only about 1 in 20 people are thought to have SAD. However, one of the simplest and least obtrusive treatments for SAD is a walk during lunchtime, and that would be a healthy lifestyle addition for anyone, the depressed and the hypochondriac alike.

SAD is caused by limited exposure to light during the darker months, and standard treatment for SAD is light therapy. Light-boxes are typical, but one study demonstrated that walking for an hour a day in winter sunlight can be as effective as 2.5 hours of light therapy. Its important that the sun be absorbed through the retina, so avoid wearing sunglasses while outside. Since daily exercise improves overall health, this treatment can have numerous health benefits.

In more severe cases of SAD (or if its too cold and miserable to go outside), light therapy shows efficacy in numerous clinical trials. 30 minutes a day in front of a 10,000 lux lamp improved symptoms in 3/4 of research participants in trials at Columbia University.

And of course, if you're feeling hopeless, worthless or suicidal, talk to someone and seek professional help.

How sad is your state?

The nonprofit agency Mental Health America released a report that ranks depression for each state. The organization developed a composite measure of depression levels based on data from SAMSHA's National Household Survey on Drug Use and Health and the CDC's Behavioral Risk Factor Surveillance System (two of my favorite data sets!).

Hawaii, Illinois, Maryland, and New Jersey were found to be the mentally healthiest states, while Idaho, Nevada, Utah, West Virginia, and Wyoming were found to have the poorest mental health.

Available resources, affordable treatment, insurance coverage, and utilization of available services were all factors associated with better mental health. So basically, the more people who can and do use mental health services in a state, the lower the suicide and depression rates. States with more generous mental health coverage tended to be the states where more people accessed treatment, resulting in lower suicide rates.

Who paid for this research, you ask? Why, the kind folks at Wyeth Pharmaceuticals. How nice of them! I'm sure they weren't thinking at all about their meds down the pipeline, like Pristiq, an anti-depressant undergoing regulatory review right now, or vabicaserin, an anti-depressant currently in phase 3 research. I'd love to see a marketing map of target advertising audiences when Pristiq is approved. Oh wait, I already posted it above, silly me. However, while I am suspicious, I don't classify this kind of industry support as "bad", just saddening. Data like this informs the psych health policy debate while helping to destigmatize mental health treatment, so studies like this need to get done. Unfortunetly, as it often seems when it comes to mental health, only ones willing to foot the bill are those with potential for financial gain.