Discovery Behavioral Health, Inc., an expanding network of evidence-based mental health, substance use and eating disorder treatment centers, has acquired Awakenings KC Clinical Neuroscience Institute in Prairie Village, Kansas, outside of Kansas City.

Awakenings offers adult outpatient mental health programs for a wide range of disorders, including anxiety, depression, panic disorder, bipolar disorder, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), thought disorders, co-occurring disorders, attention deficit hyperactivity disorder (ADHD)and eating disorders. The center offers group therapy, cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT), which can be integrated with medication management by a psychiatrist.

In addition, Awakenings offers cutting-edge treatments for major depressive disorder (MDD), including TMS therapy and ketamine infusion therapy for clinical depression. According to a 2021 study by Mental Health America, the states of Missouri and Kansas rank 31 and 43, respectively, in the nation in the rate of clinical depression, a condition which is estimated to affect nearly three million adult Americans. (The higher the ranking, the higher prevalence of mental illness and lower rates of access to care.)

Awakenings is headed by Maria Cristina Davila, M.D., who is double board-certified in psychiatry and neurology. Born in Argentina, she completed her medical school training in Buenos Aires before moving to Kansas City where she completed her psychiatric residency training at University of Missouri, Kansas City Medical School.

She has been practicing in the community since 1998 and has served in many positions in local universities and hospitals. Currently, she serves as president of the Midwest chapter of the American Society of Addiction Medicine.

“Awakenings offers hope to patients who might have tried other treatment programs without success. We’re particularly proud of our ketamine infusion therapies. Because of its rapidness and effectiveness, it can potentially improve symptoms even in patients with treatment-resistant depression and other mental health conditions,” says Dr. Davila.

Ketamine infusion therapy can have an immediate and lasting impact on clinical depression with minimal disruption to the patient’s daily routine. Ketamine is a manmade pharmaceutical first synthesized in 1962 and approved for use in the United States in 1970. It works by stimulating the development of new receptors and synapses in the brain. In 2019, the FDA made a groundbreaking decision to approve a form of ketamine as a clinical treatment for treatment-resistant depression.

Discovery Behavioral Health President & CEO John Peloquin notes, “We’re on the cusp of seeing a wave of breakthrough treatments in behavioral health that combine evidenced-based medications with personalized counseling. Dr. Davila and her team are at the vanguard of introducing these innovations, and we’re thrilled to welcome Awakenings to our growing nationwide network of behavioral health centers.”

For the full story, CLICK HERE

Ketamine – that’s an anesthesia, isn’t it? Correct.

But did you know that in sub-anesthetic doses it is also a promising treatment option for pain and depression?

Let’s start at the beginning.

What is Ketamine and how does it work?

Ketamine is a medication primarily used for anesthesia. It is an antagonist of the NMDA receptors in the brain which are responsible for the anesthetic, analgesic and psychotomimetic effects. Although it’s not entirely clear how ketamine works in the treatment of depression, here’s what the scientists think. The binding of the NMDA receptors increase the neurotransmitter glutamate. This then activates the AMPA receptor. Together, the blockade of NMDA receptors and activation of AMPA receptors leads to the release of other molecules that allow neurons to communicate better. This process is called synaptogenesis and synaptic potentiation, and is the process that is thought to affect mood, thought patterns and cognition.

What is Ketamine being used for in psychiatry?

Ketamine is being used for the management of treatment-resistant depression, bipolar disorder, obsessive compulsive disorder, and post-traumatic stress disorder.

How is Ketamine administered?

At this time, Ketamine is available in multiple formulations, although the intranasal (esketamine) and intravenous routes have the most compelling evidence for the treatment of depression. Whether intranasal or intravenous, repeated dosing is necessary to maintain a therapeutic benefit.

If you’re wondering which is better, there are no current head-to-head studies comparing the two.

Can Ketamine be used alone?

Multiple studies have demonstrated compelling evidence of Ketamine’s effect in treatment-resistant depression. Intranasal esketamine is typically co-administered with an antidepressive medication. Intravenous Ketamine can be administered as monotherapy or adjunctively with a psychotropic regimen.

How is Ketamine tolerated?

Overall, Ketamine is well-tolerated. It has a rapid onset (within 1-2 days) and has been shown to have a rapid reduction in suicidal ideation and depressive symptoms.

The most common side-effect noted with Ketamine administration is dissociation. Individuals describe it as a perceptual disturbance or “abnormal sensation”, but studies have shown no deficits in cognitive function with Ketamine use. For the most part, any changes in perception or dissociation are most noticeable during the first infusion and improve quickly afterward.

Other side effects include high blood pressure, nausea and vomiting.

At this time, the long-term effects of Ketamine are unknown.

In Conclusion…

Ketamine and esketamine represent novel treatment avenues for treatment-resistant depression and other psychiatric disorders. Although the long-term effects are still unknown, multiple studies have demonstrated the efficacy of sub-anesthetic doses of Ketamine in the treatment of psychiatric disorders.

Still have questions? Visit the Ketamine section of our website for more information.

If you are battling treatment-resistant depression and want to know if Ketamine is a treatment option for you, call (913) 381-8555 and make an appointment.

References:

McIntyre RS, et al. Synthesizing the evidence of ketamine and esketamine in treatment-resistant depression: an international expert opinion on the available evidence and implementation. Am J Psychiatry 2021;178:383-399.

Moda-Sava RN, et al. Sustained rescue of prefrontal circuit dysfunction by antidepressant-induced spine formation. Science 2019;Vol 364, Issue 6436

If you’re in need of a same day appointment for your mental health and/or substance abuse concerns, the team at Awakenings KC is here to help.

Call us at 913-381-8555 to schedule.

We hope that everyone had a wonderful (and safe!) Labor Day Weekend. As some aspects of everyday life are getting back to normal, or at least the “new normal”, we’d like to discuss social anxiety, specifically in today’s unique circumstances.

You have an upcoming BBQ you’ve been invited to, or a rescheduled wedding, or you just want to venture out to the grocery store to get a few items for dinner. You want to believe that leaving home is safe again, but as you grab your mask and head out the door, you’re still feeling nervous. Is this normal? The short answer, yes.

Even if you didn’t suffer from overwhelming social anxiety prior to COVID, we’re all experiencing some degree of it now. As we try to cope with the uneasy feelings that come with the country reopening after lockdown, we’d like to discuss a few strategies that may help.

1 – Accept that having some degree of anxiety is normal.

Our current circumstances are unlike anything we’ve ever lived through before. There is no better time than now to practice self-compassion and tolerance.

2 – Think about setting boundaries for socializing. Follow the rules that make sense and that are recommended by reputable sources.

As different parts of the country continue to open at their own speed, it’s ok to also take time to gauge what your own comfort level is with re-socializing. It’s important to have a social support system and communication during these times is going to be key.

It’s counterproductive to go out and run errands or socialize with friends if this is going to send your anxiety through the roof. Consider setting boundaries right now, and let these be known to your family and/or friends ahead of time. It’s also ok for these boundaries to evolve and change. This is a process for everyone.

3 – Practice mindfulness.

Be mindful of how you consume the news. Engage in healthy routines of exercise and reducing/eliminating alcohol and drug use which can worsen your mental health and physical well-being.

Maintain a routine, stay in touch with our community, and try to find small moments of love and joy each day.

4 – Try to manage your emotional response to uncertainty.

Accept that there is no certainty right now, and practicing self-compassion and compassion for those around us is critical at this time. Know that your feelings and anxieties are valid. Even if it seems that no one else is scared or as scared about re-entering the world following lockdown, its ok to have uncertainties and doubts. If you are feeling overwhelmed, try pausing and practicing relaxed breathing or meditation. Try to name the emotion causing such an overwhelming feeling. This can help you recover your sense of control.

5 – If you need more support, do not hesitate to reach out.

If you are having difficulty coping, know that there are resources to help.

We are always here and willing to help at AwakeningsKC. Feel free to call to make an appointment for a consultation in person or by TeleHealth.

For AwakeningsKC Contact information, click here.

Crisis Text Line: Text CRISIS to 741741 for free, confidential crisis counseling.

National Suicide Prevention Lifeline: 1-800-273-8255

As we try to get a sense of what is “safe” and begin socializing again, we must understand that every outing comes with a real amount of risk. It forces the question: How much risk are we willing to tolerate? And it’s something that we must ask ourselves.

The CDC has a dedicated page with helpful tips when considering different social scenarios (such as outdoor versus indoor gatherings), and how to keep yourself and your family as protected as possible. You can visit that page here.

Again, there is no better time than now to practice compassion toward ourselves and others. Things will continue to change and evolve, and although there is a lot of uncertainty regarding the future, we should approach each day, one step at a time, and not hesitate to seek help when needed.

Healthcare workers (HCW’s), including doctors, nurses, nursing assistants, and more, have been on the frontline of the COVID-19 pandemic since it’s onset. You can imagine that this has had a significant impact on their mental health, but to what extent?

Several studies have recently been published describing the increased levels of anxiety, depression, and post-traumatic stress of those directly facing the COVID-19 pandemic. In both China and Italy, around 1300 frontline workers in each country were surveyed. The results were similar in both groups. Increased anxiety was reported by 25-44%, 25-50% reported depression, 10-30% reported insomnia, and 50-70% reported post-traumatic stress symptoms and distress. Younger age and female sex were associated with higher levels of stress in both studies. This could be a confounding factor in both studies, as more nurses, and mostly female nurses, were surveyed, however, it could also be related to the fact that nurses spend more time in direct contact with their patients. Overall, it’s not surprising that the mental health of HCWs has been affected by working on the frontlines of the pandemic.

Following the 2003 SARS outbreak, studies demonstrated an adverse psychological effect among healthcare workers as well. It is clear that pandemics like SARS and COVID-19 can create stress among all populations, but healthcare workers also are tasked with managing this stress while continuing to care for their patients, the increased risk of infecting themselves, and potentially their loved ones. If you or someone you know is experiencing increased anxiety, stress, and/or depression related to the pandemic, do not hesitate to reach out. The CDC has a specific page related to coping with mental health issues during this time, as well as numerous resources listed that you can access here.

References:

Lai J, Ma S, Wang Y. Factors associated with mental health outcomes among health care workers exposed to Coronavirus disease 2019. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2763229
Rossi R, Socci V, Pacitti F, et al. Mental health outcomes among frontline and second-line health care workers during the Coronavirus disease 2019 (COVID-19) pandemic in Italy. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2766378
Pappa S, Vasiliki N, Katsaounou P, et al. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206431/#__ffn_sectitle

Alcohol use disorder (AUD), or alcoholism, affects more than 14 million individuals over the age of 18 in the United States alone.¹ AUD is described as a chronic brain disease that is characterized by compulsive drinking, loss of control over the consumption of alcohol, and experiencing negative emotions when not using alcohol.²

The treatment of AUD typically starts with detox. For individuals with a physiological dependence to alcohol, the abrupt cessation of drinking could result in serious complications, such as alcohol withdrawal seizures. A supervised medical detox, whether inpatient or outpatient, is always recommended.³

So I’ve completed detox, what’s next?

Treatment programs, like Awakenings KC, will employ various modalities to assist in continued abstinence from alcohol. These include, but are not limited to, behavioral therapy, family therapy, and/or the treatment of co-occurring disorders.

An additional treatment for alcohol addiction offered by Dr. Davila at Awakenings KC is ketamine infusion therapy.

What is ketamine?

Ketamine is an anesthetic medication that acts on the central nervous system through antagonism of the N-Methyl-D-Aspartate (NMDA) receptor.^4-6Ketamine is different than other anesthetics in that it has a good safety profile and lacks the major drawback of respiratory depression.⁵

Over the past decade, it has been increasingly used in the treatment of depression and addiction. How does it work? Well, scientists are not 100% sure, but several mechanisms have been proposed and substantiated with research. Several animal and human models have demonstrated that ketamine can rewrite maladaptive reward memories, enhance neuroplasticity and neurogenesis, and enhance psychological therapy efficacy.^4-6

Ketamine in the treatment of addiction.

Ketamine has shown promising results in the treatment of addiction.^4-6 Studies have shown that ketamine infusion can promote abstinence from alcohol and reduce cravings. In recently detoxified alcoholics, abstinence rates increased from 24% to 66% in the ketamine group.⁷

Although ketamine itself has been utilized as a drug of abuse, in sub-anesthetic doses, it is not “rewarding”. In multiple studies, there were no patients that went on to abuse ketamine following their infusion treatments.⁶

In summary…

Ketamine has been shown to increase synaptogenesis and neuroplasticity.⁶ What does this mean? It helps restructure and reorganize the brain at a cellular level, helping to reverse the changes that are associated with depression and addiction.

Ketamine is safe, effective, and shows promising results in the treatment of depression and addiction.

If you’re interested in more information about ketamine infusions, check out the Awakenings KC website here or call for a consultation – (913) 381-8555.

References:

Alcohol facts and statistics – NIH
Alcohol abuse and addiction – NIH
Alcoholism treatment: what is alcohol abuse and how to treat alcoholism – American Addiction Centers
Das RK, Grace G, Walsh K, et al. Ketamine can reduce harmful drinking by pharmacologically rewriting drinking memories. Nature communications. 2019;10:5187.
Ezquerra-Romano I, Lawn W, Krupitsky E, et al. Ketamine for the treatment of addiction: evidence and potential mechanisms. Neuropharmacology. 2018;142:72-82.
McAndrew A, Lawn W, Stevens T, et al. A proof-of-concept investigation into ketamine as a pharmacological treatment for alcohol dependence: study protocol for a randomized controlled trial. Trials. 2017;18:159.
Krupitsky EM, Burakov AM, Romanova TN, et al. Attenuation of ketamine effects by nimodipine pretreatment in recovering ethanol dependent men: psychopharmacologic implications of the interaction of NMDA and L-type calcium channel antagonists. Neuropsychopharmacology. 2001;6:936-47.

As the first few months of the New Year progressed, we watched in shock and fear as the coronavirus pandemic swept China, Italy, and other countries across the globe. Over the last couple months, we have come face-to-face with this same invisible, life-threatening enemy in our own backyard. City, state, and national government officials have implemented social distancing and lock-down regulations, and for each of us, it is safe to say that life has changed in a dramatic fashion.

COVID-19 has caused widespread anxiety throughout the United States, even becoming a compounded issue for those with pre-existing mental health diagnoses. Adding to the fear of the disease itself, we have been forced to distance ourselves from those around us, isolate at home, and only seek medical care if emergent. The silver lining can be found in applications such as FaceTime, Skype, and Zoom, which allow us to continue to connect with colleagues, friends, and loved ones. Physicians are also turning to Telemedicine to ensure that communication with patients is still available in a manner that decreases unnecessary exposure to the medical setting, but is also HIPAA-safe. Despite these unprecedented times that we find ourselves in, it is beneficial to know that we have still have the ability to connect, albeit virtually, with others.

We are currently a few weeks into the pandemic here in the Midwest, and the largest anxiety-provoking question remains, how long will life continue this way? There is a great fear in the unknown that currently surrounds us all. So what are we to do to help us manage the stress, anxiety, depression, and overwhelming feelings? We’ll discuss a few tips and practices that can help you cope with our current circumstances.

First and foremost, take care of yourself so that you can take care of your family and community.
- Begin each day with gratitude. Each morning think of something, no matter how small, that you are grateful for. This practice can also be done with your kids! The current situation that we’re living in is heavy, but thinking of things that make us thankful can help start the day with a more positive outlook.
- Exercise, stretch, meditate.
- Eat regular, well-balanced meals.
- Avoid drugs and alcohol.
Practice a routine.
- Create daily goals for yourself, your kids, and your family. Most individuals, including children, are used to their day being organized and structured, so it can help to continue this while at home.
Take breaks from the 24/7 media coverage.
- Hearing about the pandemic constantly can be upsetting. Try to limit your exposure and select specific news outlets that you find to be the most useful. It is good to be informed, but shouldn’t be overwhelming.
- Obtain accurate information and know the facts about the disease. Try not to fall victim to over-sensationalized headlines and news reports. It’s easier said than done, but obtaining evidence-based, accurate information can help reduce stress surrounding the pandemic. Knowing the facts about the disease can help keep you, your family and your community safe.
Connect with others.
- Physical distancing does not mean that we cannot still reach out to those we love, whether it be by text, telephone or video call. Stay in touch with friends, family members and colleagues. Everyone is feeling anxious to some degree, and it is ok to discuss these anxieties.
Last, but certainly not least, if stress is getting in the way of your daily activities for multiple days in a row, or you are having thoughts of hurting yourself or hurting others, immediately call a healthcare provider or proceed to your nearest emergency room.
- Most doctor’s offices are providing telemedicine services and/or seeing patients that need urgent help. Don’t hesitate to reach out.
- Awakenings KC is still open and offering Telemedicine visits, as well as in-office TMS and Ketamine infusions. Please call the office if you would like more information.

Resources:

Through this difficult time, it is of utmost importance to stay connected. Reach out to friends and/or loved ones that you know might be having a hard time. Offer the above resources if you think that they will help. If you have any additional tips or tricks on how you’re coping with the increased stress and anxiety, please share with us in the comments. We would love to hear from you. We wish everyone the best, and remember, we will get through this.

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The historical foundation that produced the concepts of mind and body can be traced back to the ancient Greek frameworks of Aristotle and Plato. Plato believed the body and soul are two separate entities and mastered the understanding of the soul. On the contrary, Aristotle believed that the two entities are intertwined and belong together in which one cannot exist optimally without the other ^[1], and focused his understanding mainly in the mind. Although these two are separate and contradicting theories, they both agree that the mind is the connection between the body and the soul.

A seventeenth-century French philosopher figure Rene Descartes theorized the distinction between the mind and the body, where it was not unusual to view the “mind” separately from the “body.” The differentiation was that the mind was seen as the concern of organized religion, while the body was seen as the concern of physicians^[1]. This served the preeminent principle in a separation between the so-called “mental” and “physical” health. With advancement in technology, the twentieth century has recognized remarkable development in the understanding of mental disorders and the brains. There is a growing realization of the centrality of mental health to overall health and well-being.

The mind and the body not only influence each other, they are each other.

As Socrates says in the Lesser Hippias, “You will do me much greater benefit if you were to cure my soul of ignorance, than you would if you were to cure my body of disease^[1].”

Fundamental Connection

Before we begin to explore further, it is important to understand the term “health.” The World Health Organization (WHO) defines health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity^[2].

Everything that evolved around you –the beliefs you hold of yourself, your emotions, memories, environment, and habits—can have an influence on your mental and physical health. The connections between what is going on in your mind and what is happening in your body form the psycho-emotional roots of health and illness.

The mind-body connection appears on both physical and chemical levels. The brain is the headquarter that allows you to experience mental states that are labeled as “mind”.

The concept of the mind comprises of mental states of thoughts, beliefs, attitudes, and emotions.
Depending on different mental states, they can have positive or negative effect on the biological functioning of the body.
This happens since the nervous, endocrine, and immune systems share a common chemical language, which allows constant communication between the mind and body through messengers like hormones and neurotransmitters^[3].

As an example, neurological pathways connect parts of the brain that process emotions with the spinal cord, muscles, cardiovascular system, and digestive tract^[3]. Any major life events, stressors, or emotions are able to trigger physical symptoms via these pathways.
You may have experienced this aspect of the mind-body connection when you are nervous and get the butterflies feeling in your stomach, or during intense stress moment where you feel as if your heart is pounding out of your chest.

Physical & Mental

Mind and body are certainly connected. How? Well, think about what happens when you become ill, and for this instance you came down with a flu. You run a high fever and feel as if your whole body is breaking in half, not only your body, but your mind doesn’t seem to work as well. When having a flu, it’s advised to rest as much as possible, increase fluid intake and consume light food in order to feel better.

Now, think about going to work or school or doing any activities when you are in this state. You would be lucky if you did not pass out, but others around you would not be as lucky as you as their chances of catching the flu have increased. Besides, you could have ended up in the hospital for extended care when you have exerted too much of your body when it needs extra rest, not extra work.

This is very similar to mental health problems, for example you are diagnosed with depression. The only thing you would want to do is to rest and not physically do anything. But that’s not the right way to self-care. Self-care in this case would be to see a licensed therapist, take your prescribed medication, and follow the treatment plan or engage in physical activity.

A well-balanced lifestyle helps eliminate unnecessary mental and health problems. Taking care of oneself by allowing yourself to get a good night sleep, eat healthy meals, exercise regularly, follow treatment plans (if any) and take medications as told will help you be ready to tackle life, and stay both physically and mentally healthy.
You can think of it as if you are working out in the gym. If you only focus on one of your muscles, let’s say your bicep. Yes, you would have strong biceps, but what about your other muscles? If you only work on one muscle, you would only have one strong muscle. At the same time, you could focus on all your muscles equally and have a stronger body instead of just one stronger muscle.

Did you know…?

When dealing with any psychiatric or medical disorders, exercise is most definitely the last thing on your to-do list. Interesting enough, exercise should be one of the things that belong on top of your to-do list. There are many benefits from engaging in physical activities. But before we go into the good stuff, allow me to explain why you should squeeze in exercising time in your busy schedule.

Everyone knows regular exercise is beneficial to the body and it helps trim that waistline, cut down the extra pounds, and build that abs that you have always dreamt of. BUT, did you know that exercise is also one of the most effective methods to improve mental health? And no, exercising does not mean only to go to the gym and run on treadmill or lift heavy weights. Any physical activities such as gardening, walking around the block with your lovely pets, using stairs instead of elevator or simply engaging in other less intense activities are considered exercise. All in all, pretty much anything that gets you off the couch. Impact of exercise on mental health is underrated, but benefits of physical activity on mental health are quite extensive.

Regular exercise can have a profoundly positive impact on mental disorders including depression, anxiety, ADHD etc^[4]. It can relieve stress, improves memory, helps with sleep, and boosts overall mood. Exercise is not always about the muscle size and aerobic capacity. It gives an enormous sense of well-being and healthy living.

Stress relief

Stress relief

When you are under stress, your body begins to give a different feel from when you are in normal state. Your muscles become tense, especially in the face, neck and shoulders areas, leading to back or neck pain and painful headaches. You may also feel a tightness in your chest, a pounding pulse, or muscle cramps. With stress, it is possible to experience insomnia, heartburn, stomachache, diarrhea and such. The discomforts and worries can eventually lead to chronic depression and the continual of the cycle.^[4]
Exercise is a great natural stress relief and an effective way to break this vicious cycle. During exercise, your body releases a chemical called endorphins. Endorphins interact with the receptors in your brain that reduce your perception of pain and stress^[4]. They also trigger a positive feeling in the body.
In a study done by James Blumenthal, PhD, a clinical psychologist at Duke University, Blumenthal and his colleagues assigned sedentary adults with major depressive disorder to one of the four groups: supervised exercise, home-based exercise, antidepressant therapy, and a placebo pill.
- After four months of treatment, Blumenthal found that patients in the exercise and antidepressant groups had higher rates of remission than did the patients on the placebo.
  - He concluded that exercise was generally comparable to antidepressants for patients with major depressive disorder.
  - Blumenthal followed up with the patients one year later. The type of treatment they received during the four-month trial didn’t predict remission a year later.
  - However, subjects who reported regular exercise at the one-year follow-up had lower depression scores than did their less active counterparts. In which he said, “Exercise seems not only important for treating depression, but also in preventing relapse.”^[4]

Boost your happiness and lower anxiety

Boost your happiness and lower anxiety

As well as reducing the perception of pain and stress, endorphins create feelings of happiness and euphoria. Following a run or workout, many often described the feeling as “euphoric.” This feeling is known as a “runner’s high,” because they are accompanied by a positive and energizing outlook on life^[5]. With that being said, exercise can alleviate symptoms of depression or anxiety. Instead of depending on medication, exercise can be your effective (and natural) antidepressant pills.
When we are spooked or threatened, our nervous system jumps into action, setting off a cascade of reactions such as sweating, dizziness, and a racing heart. People with heightened sensitivity to anxiety respond to those sensations with fear^[5]. They are also more likely to develop panic disorder down the road, according to Jasper Smits, PhD, Co-Director of the Anxiety Research and Treatment Program at Southern Methodist University.
Smits suggested that regular workouts might help people prone to anxiety become less likely to panic when they experience those fight-or-flight sensations.
- After all, the body produces many of the same physical reactions in response to exercise.
  - They tested their theory among 60 volunteers with heightened sensitivity to anxiety.
    - Subjects who participated in a two-week exercise program showed significant improvements in anxiety sensitivity compared with a control group.
    - People learn to associate the symptoms with safety instead of danger.
    - The findings suggest that physical exercise could help to ward off panic attacks^[5].

Reduce ADHD

Reduce ADHD

Studies have shown that regular exercise improve concentration, motivation, memory, and mood.
Exercising boosts the brain released of dopamine, norepinephrine, and serotonin levels –in all of which affect focus and attention.
More specifically, getting sweaty increases production of cells in hippocampus responsible for memory and learning^[6].
Because of this, exercise can be a replacement of Ritalin and Adderall medications.

Prevent cognitive decline — Dementia and Alzheimer’s

Prevent cognitive decline — Dementia and Alzheimer’s

Truth hurts, but as we get older, our brains get a little fuzzy. As aging and degenerative diseases like Alzheimer’s kill of brain cells, the noggin actually shrinks, losing many important brain functions in the process^[7]. While exercise cannot cure the disease, it can help the brain slow down the cognitive decline.
Levels of the essential nutrient, choline, rise with an increased loss of nerve cells – a marker of Alzheimer’s disease.
Last year, researchers at Goethe University Frankfurt had senior volunteers (aged 65-85) ride a stationary bicycle three times a week for thirty minutes over a twelve-week period; the control group did not exercise.
- The exercising group experienced stabilized choline levels, while the control saw an increase in this metabolite^[7].
Another study from 2013 stresses the importance of cardiovascular exercise. Art Kramer, a neuroscientist who directs the University of Illinois’s Beckman Institute for Advanced Science and Technology, directed one group of older adults to exercise moderately for 45 mins, three times a week.
- The control group ended up losing 1.5 percent of brain volume, while the exercising group increased brain volume by 2 percent^[7]. This increased volume resulted in better memory scores.

Build self-confidence

Build self-confidence

Physical activity can boost self-esteem and improve positive self-image.
Regardless of weight, size, gender, or age, exercise can quickly elevate a person’s perception of his or her attractiveness, that is, self-worth^[8].

Lastly, the most obvious reason: better sleep!

Lastly, the most obvious reason: better sleep!

After running 30 minutes on treadmill or a session of any kind of exercising, your body feels relaxed.
A moderate workout can be the equivalent of a sleeping pill, ever for people with insomnia^[5].
Physical activity raises the body’s core temperature. When the body temperature drops back to normal, it signals the body that it’s time to sleep!
Exercise promotes better sleep.

References
References 2

[1] Burton, N., M.D. (2010, March). Plato and Aristotle on health and disease. Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/hide-and-seek/201203/plato-and-aristotle-health-and-disease

[2] Connection Between Mental and Physical Health. (n.d.). Retrieved from http://ontario.cmha.ca/documents/connection-between-mental-and-physical-health/)

[3] Weinberg, J., M.D. (2018, Feb). Mind-Body Connection: Understanding the Psycho-Emotional Roots of Disease. Retrieved from https://chopra.com/articles/mind-body-connection-understanding-the-psycho-emotional-roots-of-disease

[4] Bhandari, S., MD. (2018, February 21). Exercise and Depression. Retrieved from https://www.webmd.com/depression/exercise-depression

[5] Breene, S. (2013, October 7). 13 Unexpected Benefits of Exercise. Retrieved from https://greatist.com/fitness/13-awesome-mental-health-benefits-exercise

[6] Robinson, L., Segal, J., Ph.D, & Smith, M. (2018, March). The Mental Health Benefits of Exercise. Retrieved from https://www.helpguide.org/articles/healthy-living/the-mental-health-benefits-of-exercise.htm

[7] Beres, D. (2018, February 27). Can exercise prevent dementia? Retrieved from http://bigthink.com/21st-century-spirituality/does-lack-of-exercise-lead-to-dementia

[8] Weir, K. (2011, December). The Exercise Effect. American Psychological Association. Retrieved from http://www.apa.org/monitor/2011/12/exercise.aspx

When was the last time you got 8 hours of sleep? Needed an extra cup of coffee this morning? Learn about the importance of sleep to our mental health and ways to improve your quality of sleep.

Living in the fast-paced 21st century, where busy schedules and endless to-do lists are typical, we tend to deprioritize sleep. We do not realize that we are making one of the biggest mistakes that potentially result in long-term health problems. Without sleep, our bodies cannot function in proper manners and contributes to mental health disorders and memory & learning impairment.

So, what is “sleep?”

Sleep allows you to physically be unconscious while your brain is mentally active. During sleep, our brains are working to process and restore the information that we retrieve from the time we were awake^[1]. After a good night sleep, we are able to retain information and dramatically perform better on the next day. Sleep is taken for granted because many of us overestimate our abilities to fulfill daily duties. We are not aware that sleep is fundamental for a healthy mind, body, and soul.

[Photo courtesy University of Rochester Medical Center]

You may be wondering…what happens to our brain and body during sleep?

Neurotransmitters are chemical messengers which communicate between neurons throughout your brain and body. By acting on different groups of neurons in the brain, neurotransmitters regulate whether we are asleep or awake. They can “switch off” cells that signal the activation of arousal or relaxation.

The arousal signals are sent to the cerebral cortex when the alerting areas of the brain are most active, resulting in wakefulness.[2]
Areas of the brain that promotes wakefulness is inhibited when the sleep-promoting areas of the brain are most active, resulting in sleepiness.^[2]

The Sleep Cycle

Sleep is not just one “snoozed off” action, but it occurs in stages and it is quite complicated. During sleep, the brain and body go through five stages; the non-rapid eye movement (non-REM) phrase includes the first four stages and the rapid eye movement (REM) phrase is the fifth stage.

Stages 1 – 2

Stages 1 – 2

As we shut our eyes to sleep, we enter stage 1 of the sleep cycle.

It is known as light sleep linking between being awake and falling asleep where eyes movements and muscle activity become weak and begin to move slow.
During this stage it is normal to experience hypnic myoclonia or hypnic jerks where the muscle contractions happen suddenly and gives a sensation of falling ^[3].
This stage typically lasts about 5 to 10 minutes.

When there are very minimal to no eyes movements, we’ve made it to stage 2.

This stage marks the actual onset of sleep when you become disengaged from the environment ^[3].
The body temperature continues to decrease, but heart rate and blood pressure are regular.

Stages 3 – 4

Stages 3 – 4

We then continue to stages 3 and 4 or as known as the deep non-REM.

These are the most difficult stages to wake someone up as the body begins the restorative process where blood pressure begins to drop, breathing becomes even slower and muscles are relaxed.
During these deep stages, blood supply to the muscles is increased, energy is restored, tissue growth and repair occur and important hormones are released for growth and development ^[3].

Stage 5

Stage 5

We enter REM sleep when breathing and heart rate become irregular, muscles are shut down becoming paralyzed, and eyes movements are rapid.

This is the stage where the brain is active and dreams come into play.
It is important to get enough REM sleep because it plays an important role in learning and memory function
It is the time for your brain to consolidate and process information from the day before in order to stored it in the long-term memory ^[3].

[Photo courtesy Luke Mastin]

Approximately, we experience three to four sleep cycles. The sleep cycle repeats itself every 60- 90 minute ^[6] in that appropriate 8 hours that we are supposed to get. During the first 2-3 cycles, we spend more time in the deep non-REM sleep, stages 3-4. REM sleep occurs more frequently in the last 2-3 cycles^[4].

Now, what happens when you’re in sleep debt?

Sleep is not a luxury, but a crucial component of our daily lives. We spend one third of our lives asleep. Yet, many of us cannot get 8 hours of quality sleep for various reasons, putting ourselves in sleep debt.

When in sleep debt, parts of your brain become inactive which induces drowsiness. One to four percent of all highway accidents are caused by sleepiness; that’s about 100,000 crashes, 71,000 injuries and 1,550 deaths each year in the USA ^[1].

[Photo courtesy Wheaton AG, Chapman DP, Presley-Cantrell LR, Croft JB, Roehler DR.]

Lack of sleep causes the body to respond as if you were under stress. When under stress, Dr. Malcolm von Schantz explains that the body automatically activate inflammatory genes preparing for injury to occur ^[8]. In the case of sleep-deprivation, there is no actual injury. Genes in the body’s cells function improperly when one is sleep-deprived which produce negative health problems including:

high blood pressure
diabetes
heart diseases
depression
lower sex drive

According to Dr. Kushida, director of the Standford University Center for Human Sleep Research,

loss of sleep ultimately leads to memory and learning impairment due to the disturbances in brain function when adequate sleep is not met ^[9]. Furthermore, sleep-deprived physically makes you look bad by giving you the premature wrinkling and dark circles under your eyes. Without sleep, stress hormone cortisol is produced, and it can eventually break down collagen and causes skin problems ^[8]. They called it “beauty sleep” for a reason.

Tips & Tricks for Better Sleep

Keep Track of Your Sleep
Exercise Daily
Naps are a big NO NO!
Avoid Drinking Coffee, Smoking, and Heavy Meals Before Bed
Eliminate Electronic Devices
Evaluate Your Bedroom
When in Doubt, Meditate!
Seek Professional Help

Keep Track of Your Sleep

Try sticking to the same bedtime and wake-up time throughout the week (even on weekend!).
Keeping track of your sleep schedule in a notebook could be helpful.
Dr. Matthew Ebben, a psychologist and specialist in sleep medicine, suggests that sleep diary is a wealth of information that includes not just when you sleep and wake up, but intake of caffeine, medications, alcohol, nap, exercise, and mood.
It is a useful tool to help many realize what they are doing that encourage them to deprioritize sleep^[10].

Exercise Daily

Find time in your busy schedule to fit in a minimum of 15-30 mins of exercise.
Even if it’s just light exercise, it is still better than nothing.
Exercise reduces stress by producing endorphins or as known as natural painkillers which in turn improve the ability to sleep^[11].
Get moving!

Naps are a big NO NO!

Napping is great for quick energy, but if you are having trouble falling asleep at night, you should definitely avoid any nap times during the day.
Long naps interfere with your body clock and nighttime sleep.

Avoid Drinking Coffee, Smoking, and Heavy Meals Before Bed

These behaviors can disrupt sleep because of the caffeine, nicotine and the discomfort feeling.
It is wisely suggested that you should have your last meal two to three hours before your bedtime ^[12].
Limiting caffeine intake throughout the day can dramatically improve your sleep.
Caffeine is a stimulant that we take to feel and remain alert during the day but it delays the timing of your body clock that will make it hard to fall asleep when the time comes.

Eliminate Electronic Devices

Not only do electronic devices distract you from your sleep, but the light exposure can interfere with melatonin.
You can still use your phone or tablet to read or do anything, but dim the light down to minimum and hold them at least 14 inches away from you ^[13]

Evaluate Your Bedroom

Many find that having a comfortable setting can help them fall asleep easier and getting more quality sleep.
Bedroom should not be too hot or too cold, it should be around 60-67 degrees ^[14].
Make sure the room is kept dark and noise-free for a comfortable nighttime.
Using comfortable mattress and pillows play a great part in your sleep, too.
Replace the mattress when they are 7 years or older because it will not be supportive anymore and replace pillows once a year to properly support your neck and spine.
Lastly, keep your bedroom nice and neat and only use it for sleep.

When in Doubt, Meditate!

Mindfulness meditation is a mind-calming practice that focuses on breathing and awareness of the present moment.
According to Dr. Herbert Benson, the director emeritus of the Harvard affiliated Benson-Henry Institute for Mind Body Medicine, mindfulness meditation is a method that evoke relaxation response in the body that help ease many stress-related ailments such as depression, pain, and high blood pressure ^[15].
Ideally, practicing mindfulness meditation 20 minutes during the day is enough.

Seek Professional Help

If you have tried everything and still having difficulties falling asleep, you should seek professional help. Your problems may be the surface to more serious problems like insomnia, narcolepsy, obstructive sleep apnea, depression and etc.

References 1
References 2
References 3

[1] Why Sleep is Important. (n.d.). Retrieved from https://www.apa.org/topics/sleep/why.aspx

[2] Brain Basics: Understanding Sleep. (2017, May 22). Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Understanding-Sleep

[3] Thompson, Jill. (2017, Sep 26). Hypnic (Hypnagogic) jerking explained. The Sleep Advisor. Retrieved from https://www.sleepadvisor.org/hypnic-jerking/

[4] Understanding sleep cycles. National Sleep Foundation. (n.d.). Retrieved from https://sleep.org/articles/what-happens-during-sleep/

[5] Gordon, A. M., Ph.D. (2013, Jul 26). Your sleep cycle revealed. Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/between-you-and-me/201307/your-sleep-cycle-revealed

[6] Field, A. (n.d.). Why is sleep so important. Harvard Business Review. Retrieved from https://hbr.org/2009/01/why-sleep-is-so-important.html

[7] How much sleep do we really need? National Sleep Foundation. (n.d.) Retrieved from https://sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need/page/0/1

[8] Ghosh, P. (2015, May 15). Why do we sleep? BBC News Science and Environment. Retrieved from http://www.bbc.com/news/science-environment-32606341

[9] Kushida, C. A., Ph.D. (n.d.). College students: getting enough sleep is vital to academic success. American Academy of Sleep Medicine. Retrieved from https://aasm.org/college-students-getting-enough-sleep-is-vital-to-academic-success/

[10] DiGiulio, S. (2018, Mar 15). How to use a sleep diary to figure out what’s keeping you up at night. NBC News. Retrieved from https://www.nbcnews.com/better/health/how-keep-sleep-diary-actually-improve-your-sleep-ncna805281

[11] How Exercise Affects Sleep. National Sleep Foundation. (n.d.). Retrieved from https://sleep.org/articles/exercise-affects-sleep/

[12] Caffeine and Sleep. National Sleep Foundation. (n.d.). Retrieved from https://sleepfoundation.org/sleep-topics/caffeine-and-sleep

[13] Mayo Clinic. (2013, June 3). Are smartphones disrupting your sleep? ScienceDaily. Retrieved from www.sciencedaily.com/releases/2013/06/130603163610.htm

[14] Gregoire, C. (2015, May 25). 7 big things we’ve learned about sleep in the past decade. Huffington Post. Retrieved from https://www.huffingtonpost.com/2015/05/25/sleep-research-health_n_7215662.html

[15] Corliss, J. (2015, Feb 18). Mindfulness meditation helps fight insomnia, improves sleep. Harvard Health Publishing Harvard Medical School. Retriever from https://www.health.harvard.edu/blog/mindfulness-meditation-helps-fight-insomnia-improves-sleep-201502187726

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