Understanding Depressive Symptoms Part 2 Happiness Isn’t Brain Surgery


welcome to happiness isn’t brain surgery with Doc’s nights this podcast was created to provide you the information and tools doc Snipes gives her clients so that you two can start living happier our website Doc Snipes calm has even more resources videos and handouts and even interactive sessions with Doc Snipes to help you apply what you learn go to doc Snipes comm to learn more hi everybody and welcome to happiness isn’t brain surgery with Doc’s knipes practical tools to improve your mood and quality of life we’re going to continue with our segment on causes of depressive symptoms and ways to address them in the first section we really talked about what depression is what depressive symptoms are and why it’s not a one size fit fits all that we can just give you a pill or suggest some sort of treatment that works for everybody well it just doesn’t work that way in this section we’re going to address one of the symptoms of depression which is fatigue a lot of people with depression have overwhelming fatigue so we’re going to talk about what might be causing that talked about how it contributes to feelings of depression and identify interventions that may help improve energy and motivation now some of these things are very biologically based very medical in nature so I’m going to suggest talking with your doctor about different ways to address it for you for example chronic fatigue syndrome there are a lot of different ways you can address that just like there’s a lot of different ways you can address depression so we’re not going to go into that in depth so some of the medical stuff I will defer to your to your physician but I do want to bring it up and help you understand that it may be causing fatigue and when you feel fatigued for long enough it can cause you to feel hopeless and helpless which can cause you to feel sort of depressed so first cause of fatigue is the obvious poor sleep and I’ve done videos on sleep so you can go back and review some of those I will do another shorter video on sleep in this um set of podcasts but it’s important to understand how sleep affects you not everybody needs as much sleep there are recommended guidelines for how much sleep you’re getting I personally love my sleep and I need sleep in order to feel energetic and all that kind of stuff so I know for me that making sure I’m getting quality sleep and enough quality sleep is imperative to keeping my mood and Happiness where I want it to be one of the things that you can do to monitor your sleep obviously you can go have a sleep study done that can get expensive and it’s only a snapshot in time but if you know you’re having sleep problems that might be something to consider another thing you can do is get one of the fitness trackers and there are a lot of different companies that make Fitness trackers that do track your sleep and tell you the different stages of sleep so when you’re getting deep sleep versus light sleep that can help you kind of track and understand how your body works for example caffeine has like the 12-hour half-life or supposed to but I know that if I’ve had caffeine and from watching how my sleep patterns go throughout throughout the month I know if I’ve had caffeine after about 10:30 in the morning my sleep that the next night is going to be really mucked up and it’s not just until after 10:30 that night my sleep is not going to be quality for quite a while or maybe even all night long we’ll talk more well when you ingest certain chemicals like caffeine caffeine has a six hour half-life which means it takes six hours to get out of your system passed away it takes 12 hours to get completely out of your system now for me you know looking at my sleep chart for whatever reason and you know that’s more than I’m really concerned about right now I know that my sleep is usually messed up even if it’s been 12 hours since I had caffeine know your own tendencies there are a lot of other things that can contribute to poor sleep like I said wait till that segment we’ll go over that if you’re fatigued rule that one out first there are a lot of other things if you’re for example a new mother you may not get quality of sleep because you’re sleeping a lot more lightly so you can hear this new baby when it rolls over in bed I know I didn’t sleep well at all when I had infants in the house and now that they’re older nicely like a rock poor nutrition I said in the last presentation crap in equals crap crap out if you eat junk food you’re probably not getting the proteins and the complex carbohydrates and the kinds of things that your body needs in order to fuel the processes that make the neurotransmitters and help keep everything running in your body it would like be like putting diesel into a gasoline based engine it just doesn’t work it’s important to remember that vitamins are like spark plugs that help your body use the proteins and energy to make things like your neurotransmitters serotonin and your hormone melatonin which is the one that helps you sleep again think about an engine you can have great gas in your lawnmower but if the spark plugs aren’t working no matter how much gas you put in there it ain’t going to turn off so you need to have vitamins which come in like real foods and you also need to have the energy so good nutrition I’m not saying fanatical but good nutrition is really important in order to make sure that your body can use the good food that you’re taking in so if you’re eating donuts and pizza for every male ya might want to check that every once in a while sure you know I’m a big fan of both doughnuts and pizza however that’s not something that you want to live on every day anemia and there are a lot of things that can cause anemia basically you want to look at your nutrition make sure you’re eating iron rich foods your green vegetables your red meats if you’re not against eating red meat if you think you might be anemic have your doctor do a blood test generally they’ll look at that when you go in for your annual physical not enough calories and this kind of goes with not enough quality calories because you can eat 20,000 calories of potato chips and not have the vitamins and stuff you need in order to fuel the processes in your body so that’s that’s one point but not enough calories because there’s a lot of people who are consistently or on and off on diets and then you restrict their calories to the extreme so they’re not getting enough energy to fuel their body you need to make sure your body has enough energy a good nutritionist and some physicians are comfortable consulting with you on that but a good nutritionist can help you figure out what your nutritional plan should be now I want to emphasize here that in most states and every state that I know of but there’s you know I haven’t really researched it super in-depth but I know in most states providing nutritional prescriptions nutritional advice is restricted to licensed or registered dietitians and licensed nutritionists so personal trainers and people who have a certification from somewhere in nutrition well they can provide you education knowing what works for you and making a nutritional prescription really needs to be done by your physician and/or nutritionist I say that because I often hear personal trainers and coaches making meal plans for people and that can be so dangerous especially if people have certain biological needs insulin resistance means your body doesn’t process carbs like it should and again there’s a fair number of reasons for that a lot of that is because we eat highly processed foods but this is something that if you tend to eat lunch and then shortly afterwards feel really crappy you might want to talk the same thing with any meal but you might want to talk to your doctor about whether you’ve become insulin resistant and there’s anything you need to do about that because insulin resistance in some people can be a precursor to diabetes so you want to check in on it sooner rather than later but if your body is not processing carbs which are your instant energy if you will then you’re going to feel fatigue so you need to make sure that if you give your body fuel it can actually use it caffeine overload now I am a huge fan of coffee but I learned the hard way that too much caffeine for too long is not good it causes your body to basically run on air when it’s supposed to be running on energy and you’re artificially causing your body to run hotter or run longer then it’s really supposed to because it’s not and you’re throwing everything out of whack so cut back on caffeine and it’s hard it’s not something that most people are going to do overnight it’s a weaning process again you can get headaches you can get all kinds of side-effects from this but you will probably find that if you’re able to back off on your caffeine in a sensible way that your energy levels are more constant throughout the day instead of being really high and then really low and then really high and then really low so pay attention to that if you think that’s an issue for you something to consider working with your treatment team food allergies some people who have gluten intolerance or other food allergies find that when they eat those foods not only do they get and upset belly but they also feel extreme fatigue partly because a lot of your nutrition is absorbed through your GI tract and if it’s all mucked up because of this food allergy then you’re not getting the Nutri you’re not extracting the nutrition you need to from your foods there can be a lot of food allergies I would say start simple talk to your doctor most doctors will tell you to do what we call an a/b test eliminate one food at a time if you feel better and keep it out of your diet you know that’s going to be you be between you and a nutritionist and and/or your doctor what you feel you can actually eliminate versus what you need to cut down on or modify in some way dehydration you wouldn’t think about it but dehydration actually causes not only fatigue but foggy head 1% dehydration can actually cause you to have difficulty making decisions well you I drink plenty of fluids throughout the day you might be telling me well that’s wonderful but we need to look at those fluids since I haven’t been drinking caffeine I noticed when I go to restaurants for lunch that a lot of restaurants everything they offer besides water often has either high levels of caffeine or high levels of sugar or both in them and caffeine contributes to dehydration so you don’t want to go out and be drinking a bunch of caffeine and say well I’m hydrated actually it’s just the opposite you just reduced your hydration even more when I was little I used to go out on the boat with my father and that’s a misnomer that a lot of people in Florida kind of get wrong when they go to the beach or when they go out on the boat they bring alcohol and you know diet coke or some other caffeinated beverage both of which are directs both of which will reduce your hydration so when you have your normal 64 ounces of water if you’re even getting that much that’s great but if you’ve had caffeine or alcohol you need to drink more in order to reach more water not more caffeine or alcohol you need to drink more water in order to compensate for that some people say a one to one ratio so if you drink eight ounces of a caffeinated beverage you want to drink eight ounces of water to go with it options switch to something decaffeinated look for options that you can bring with you to the beach or wherever you’re going that will help you stay hydrated stress and anxiety also causes fatigue well why partly because it impairs sleep if you’re stressed out you’re probably going to toss and turn and dream and have difficulty getting to sleep and all that kind of stuff so what do you want to do first thing is work on some distress tolerance skills and there are other videos on that so I’m not going to go into it super deeply but basically distress tolerance skills help you take whatever stressing you out and kind of box it up and push it away for now realizing you may not be able to change it right now and helps you put yourself sort of in a different place through guided imagery or even just actually taking a little vacation you know getting out of the office for 15 minutes vulnerability prevention also helps with the sleep don’t drink too much caffeine or alcohol before going to bed make sure you’re getting enough sleep anything that contributes to your stress and anxiety it’s probably going to impair your sleep so that’s a vulnerability you want to look at okay what things caused me to toss and turn or not be able to get to sleep let’s start marking those off if you know that you get on social media or if you go and start reading the news right before bed it gets you all fired up guess what don’t do it set another time during the day to do those things if you feel you have to do them so you aren’t going to get yourself all worked up right before bed stress and anxiety also keeps you idling if you’re stressed out you stay on this higher level of alertness kind of like a car in idle have you ever watched your gas mileage I’m obsessive about my gas mileage but when you go through the city and if you have to sit at stoplights for a long time you can watch your gas mileage goes go down because you’re spending energy and you’re wasting energy by sitting at those stoplights so stress and anxiety are kind of the same way for your own personal energy and remember fatigue means there’s no energy so if you’re using all your energy idling at stoplights to use this sort of analogy then you’re going to feel fatigued and you’re probably not going to have the energy to do the things you want to do which can be depressing what can you do about it be mindful if you find that you’re stressed out throughout the day or even if you don’t know mindfulness means nothing more than checking in with yourself and I tell people to do it at mealtimes because we all eat before your meal check in with yourself and go how am I feeling am i stressed out about anything what can I do about it what do I need right now pretty simple and it’s not brain surgery you don’t even have to write it all down just do a check in with yourself and if you notice that you’re stressed out about something figure out what you can do to either fix it or box it up and put it on the shelf until you can do something about it and purposeful action purposeful action means doing just that taking whatever is bugging you and saying all right I have only this amount of energy how do I want to spend it and is it worth using my energy worrying about this or trying to be up change something that can’t be changed maybe you find out and you know this is just an example find out that your house was built ten feet over the property line well that could really stress you out and you could be all concerned about it not going to be able to move the house at this point no matter how much you push your shoulder into it no matter how many bulldozers you get I mean if you get bulldozers you’re probably going to destroy the house so a purposeful action means figuring out the best way to use your energy to deal with that problem and then doing it and sometimes it’s going to mean putting it on a shelf because there’s nothing you can do about it at the moment and worrying is not going to change the situation if you get up when you have to go into the doctor and they take tests or they do a biopsy on something that’s stressful for anybody no doubt and you can worry about it until those biopsy results come in 24 48 72 hours later but did whirring change the results no did whirring impair your sleep and use up energy that you could have been using to do something fun yeah so understanding how you’re using your energy being mindful of how you’re using your energy and choosing how to use it effectively staying with the energy analogy and fatigue when I Drive like I said I am a freak about gas mileage so being mindful when I’m driving about when I push the accelerator and how hard I push it versus when I can coast because in Tennessee we’ve got a lot of hills you can get some good speed going that’s my purposeful action when I’m driving because I want to maximize my gas mileage stress and anxiety can also just lead to exhaustion and feelings of hopelessness and helplessness which is you know your prime prime symptom of depression you know if you’re exhausted all the time and you don’t have the energy to do the things you want to do and you don’t feel like you ever will that can be pretty depressing some things that you can do to address it radical acceptance you know sometimes like in the example of getting a biopsy things are as they are and you’ve just got to accept that you’re going to have to wait worrying about it’s going to do no good calling the doctor’s office every thirty seconds is not going to do any good so accepting that things are as they are it may suck I’m not saying it doesn’t but there’s nothing you can do to change it at the moment so what can you do to improve the next moment which is where purposeful action comes in if you’re worried sticking with the biopsy example if you sit around your house and you’re not occupied doing other things you may worry about it so choosing how to use that energy instead maybe go to a movie or get up and do something else or use some guided imagery there are a lot of other things that you can do to help distract yourself until you can get the results and then use your energy to figure out how to address them if anything needs to be addressed at all insufficient or excess physical activity a body in motion tends to stay in motion and a body at rest tends to stay at rest that’s one of Newton’s laws but the same thing is true with us like I said earlier when I was on bed rest with my daughter I felt achy all over and it was really it seemed to get harder and harder to get up out of bed and do that kind of stuff you know even just daily activity daily activities of daily living the longer I was on bed rest and part of it was you know stress about you know what was going on but part of it was just the fact that I wasn’t moving and your body naturally kind of stiffens up if you’ve ever had shoulder surgery or something you know that they get you into physical therapy as soon as possible because they don’t want your joints so quote freeze up so they want you working through range of motion well you’ve got a lot of joints you got to move them so if you’re sitting too much if you’re laying in bed too much you may actually get this now if you’ve got physical conditions paint chronic pain anything like that before you start jumping out of bed and trying to exercise or do something obviously check with your doctor but knowing you know looking at what’s reasonable for you if you’ve normally been a couch potato what’s reasonable may be simply getting up and doing some stretching exercises or walking around in your yard not even around the block walking around in your yard a little bit so look at what’s reasonable for you don’t go from zero to fifty overnight in sure enough recovery time especially if life is otherwise stressful so if you’re already working out great but you can actually work out too much I had a personal trainer tell me one time your muscles are as recovered as they’re going to be after 48 hours well that’s true if you’re resting during those 48 hours for me I lift on one day and then I do an endurance run on the next day so my muscles are not completely resting now body builders would like freak the freak out but I’m doing that because it prevents some muscle growth there are a lot of different theories on fitness but you want to make sure that your body has time to rest and repair and I say that because even if you’re just lifting three days a week or exercising three days a week it may take you a little bit longer to recover if life is otherwise stressful if you’ve got things that are keeping you from getting enough sleep if you’ve just got a lot of stuff going on if you’re spending a lot of time cleaning the house you only have so much energy and you know we’re just going to quantify it by whatever I’m holding right here you’ve got to figure out how to use that energy and if you use some of it to work for working out great your body is going to have to use some of that for recovery and if you don’t a lot if you’ve got too much going on and your body can’t a lot energy to recovery it’s going to take a little longer doesn’t mean it’s necessarily a bad thing but you’ve got to listen to your body if you don’t feel like working out one day because you’re still a key or something take it easier or maybe skip that day that’s going to be between you and your health team which takes us to chronic pain some people have chronic pain fibromyalgia they were in a car accident they were injured some other way yes and chronic pain can be frustrating because pain tells your body you are the weak link in the herd and you’re probably the one that’s going to be eaten by the lion you know if you want to go back to primitive times your body hasn’t kind of caught up with the fact that there’s no lions anymore so you tend to have more cortisol you tend to have worse sleep if you are in pain now sometimes you can’t get pain to go away completely but there are things that you can do to address chronic pain with your care team talk with them about starting yoga talk with them about mild exercise or stretching massage or acupressure can be helpful for some people acupuncture can be – that’s a choice that you can look at guided imagery is another one that has been used a lot for people who are recovering from substance abuse issues who do have chronic pain there are also medications out there I obviously intentionally did not put those in here but with the work of your multidisciplinary care team if you’ve got chronic pain you’re probably working with a pain specialist and a physician and maybe a physical therapist it’s important to talk about what your options are to help you feel the best if your chronic pain is something that’s short-term if you will maybe you had shoulder surgery I’ve heard it’s six to eight months before the pain really goes away that’s chronic so you might want to talk to your care team about how can I best manage my pain during the recovery period the other one I want to talk about that causes fatigue is Lyme disease now some people mistakenly get diagnosed with chronic fatigue syndrome when they’ve actually got Lyme disease because you know a lot of times we haven’t talked about that especially if you’re not in an area where there’s a high propensity of Lyme disease and I got this infographic from the CDC where it’s dark up here in the Northeast is where you obviously have a whole lot more Lyme disease and you also have some over here however Lyme disease antics have been moving slowly south and westward so places like Indiana and Illinois and Ohio Tennessee yep Kentucky Virginia are all seeing a lot more cases than they did back in 2010 when this infographic was created so this isn’t seven years later about time for a new infographic if you’ve been bitten by a tick or how to tick on you whatever you want to call it even if you don’t still have that tick which you may not maybe it was four or five years ago do a little research on Lyme disease not everybody gets the bull’s eye rash don’t you love it when there’s just not a definitive way to say whether it’s there or not if you have chronic fatigue type symptoms and you’ve been bitten by a tick you can get a blood test to see if you’re positive for Lyme disease and there may be a different treatment course than you’re currently on if they discover that that’s the case if you do get bitten by a tick now and you don’t have chronic fatigue syndrome do be aware that Lyme disease is out there and it’s increasing in prevalence what we do at our house is we pull it off we put it kill it put it in a little plastic baggie and then keep it on hand and then if the bullseye rash develops or if people start feeling flu-like symptoms we have the tick available because we’re in an area where there’s not a high rate of Lyme disease right now so we don’t necessarily go to the doctor every time we get a tick on us but that’s one thing that you can do hypothyroid can be biologically based you may have died Roy disease you may have something else going on this is an easy thing for docs to test for from blood work and be able to work with you on there are some nutritional cases of people not getting enough iodine because most places have gone to non-iodized salt they’ve switched over to sea salt a lot of people are using sea salt and they don’t eat shellfish and other food that’s high in iodine as I always say don’t supplement until you’ve talked to your doctor because a lot time’s the supplements way overdue how much you need and that might not even be the issue so talk to your physician ahead of time make sure he or she knows if you’re not using iodized salt and they can make a more educated judgment call from there but iodine is needed to support the thyroid so if you’re not getting enough then you may start experiencing thyroid issues hormone changes especially related to estrogen and testosterone anyone who’s had PMS can tell you what hormone changes can do to your energy levels you know I’m not a guy so I don’t know what loti feels like but low tea is also associated with fatigue easy to do a blood test to measure those kinds of levels figure out what’s going on now low low estrogen or low testosterone could also be symptoms of something else so figuring out what’s causing those that condition in you is going to be important diabetes now doctors don’t exactly know why diabetes causes extreme fatigue and some people but it does so if you are from a family if you have a high risk of developing diabetes if you already have diabetes or you have hypoglycemia it’s important to be aware of how that’s affecting your energy levels and make steps nutritionally or medically to take care of yourself as best as possible heart disease is another thing that causes fatigue your blood your heart pumps your blood your blood delivers oxygenated oxygen through oxygenated cells throughout your body if the ticker ain’t working if the pump ain’t pumping enough you may not be getting enough oxygen throughout your body and you may be feeling fatigued this is one of the kind of least common causes of fatigue especially in younger people but it’s one to be aware of if you’ve got a family history of heart disease if you are personally having a lot of risk factors for heart disease it may contribute to fatigue another thing that contributes to fatigue is just plain obesity if you are carrying a lot of weight it can be exhausting so there’s something to be said not only for heart disease and diabetes prevention but also just to increase your energy levels so you can use that energy to do other things for you know reducing your your body fat percentage to something that’s in the healthy range poor sleep almost always causes fatigue but fatigue is not always caused by poor sleep regularly feeling fatigue can cause feelings of hopelessness and helplessness which a lot of people call depression if you’re feeling fatigued not on your a-game you may your body may perceive this as a threat and raise your cortisol levels because it doesn’t want you to be that you know weak link in the group that gets eaten by the lion as your cortisol levels go up you probably will feel more irritable burn more energy constantly stay on a moderate alert state which causes you to feel fatigued over time chronic stress can cause fatigue if you’re under stress all the time you’re probably idling almost constantly it’s important to understand that what would that do to your gas mileage if you just left your car idling all day and all night yeah it would go into the toilet when a chronic stressor cannot be stopped sometimes your body’s just going to cut its losses and go you know what we’re not going to be able to fix this so it pulls back and there’s a whole webinar that I did on the HPA axis and how the body responds to chronic stress but basically the short version is if you’ve got a chronic stressor eventually your body may just say you know what can’t win this and pull back all your fight-or-flight energy and save it for another occasion which can cause you to feel depressed addressing fatigue means looking at your whole body and your lifestyle to identify what can be causing your fatigue so do an assessment for yourself and then take it to your doc take it to your treatment team and go this is what I’ve got going on this is what I think might be contributing to it let them look at it because they were trained in it in their own specialties and they may have ideas on things you can do to reduce your fatigue improve your mood and improve your motivation there are some resources that you can look at to get more information about some of the things we talked about today if you like this podcast please subscribe on your favorite podcast app join our Facebook group at Doc’s nice calm / Facebook or join our community and access additional resources at Doc Snipes calm thanks for tuning in to happiness isn’t brain surgery with Doc’s naipes our mission is to make practical tools for living the happiest life affordable and accessible to everyone we record the podcast during a Facebook live broadcast each week join us free at Doc’s 9.com / Facebook or subscribe to the podcast on your favorite podcast player and remember Doc Snipes calm has even more resources Members Only videos handouts and workbooks to help you apply what you learn if you like this 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