Appendix B

WHERE DO YOU NEED HELP TO FEEL BETTER FAST? A QUICK MENTAL HEALTH CHECKUP

Out of suffering have emerged the strongest souls; the most massive characters are seared with scars.

KHALIL GIBRAN

There are common reasons why people struggle with how they feel. Issues such as anxiety, depression, bipolar disorder, attention deficit hyperactivity disorder, addictions, posttraumatic stress disorder, and chronic stress are widespread among the population. According to the Centers for Disease Control and Prevention, almost 50 percent of the US population will suffer from a mental health issue at some point in their lives.[413] It is almost more normal to have a problem than not to have a problem. If you picked up this book, odds are that you (or someone you love) have struggled at some point with how you felt. Knowing your specific vulnerabilities is critical to getting the right help.

Only about one-third of people with depression or other mental health issues ever seek help. Asians, Hispanics, and African Americans are 30 percent less likely than whites to try to find assistance, and people age 60 and older are half as likely to seek treatment as those under 44.[414] This means that most people who suffer with mental health challenges never get the help they need and suffer unnecessarily when help is available.

On pages 302–304 are several questionnaires that will help you pinpoint where you might be struggling, followed by some simple suggestions to help you feel better fast. Please rate yourself on each of the symptoms listed below using the following 0–4 scale. If possible, have another person who knows you well (such as a spouse or parent) rate you too; this will give you the most complete picture. Having two or more symptoms with a score of 3 or 4 on any questionnaire may indicate a problem that needs to be taken seriously.

Anxiety Issues

  1. ___ 1. Anxious, tense, or nervous
  2. ___ 2. Panic attacks, which are periods of intense, unexpected fear or emotional discomfort
  3. ___ 3. Excessive tension, physical stress symptoms
  4. ___ 4. Fear of going crazy or doing something out of control
  5. ___ 5. Predict the worst
  6. ___ 6. Avoid conflict
  7. ___ 7. Freeze in anxious or upsetting situations
  8. ___ 8. Bite your fingernails or pick at your skin
  9. ___ 9. Need a lot of reassurance
  10. ___ 10. Avoid everyday places 1) for fear of having a panic attack, or 2) needing to go with other people in order to feel comfortable
  11. ___ 11. Cold or sweaty palms

Depression Issues

  1. ___ 1. Depressed or sad mood
  2. ___ 2. Decreased interest in things that are usually fun, including sex
  3. ___ 3. Significant weight gain or loss without trying, or appetite changes
  4. ___ 4. Recurrent thoughts of death or suicide
  5. ___ 5. Sleep changes, including lack of sleep or marked increase in sleep
  6. ___ 6. Physically agitated or “slowed down”
  7. ___ 7. Low energy or feelings of tiredness
  8. ___ 8. Feelings of worthlessness, helplessness, hopelessness, or guilt
  9. ___ 9. Decreased concentration or memory

Bipolar Disorder: Includes periods of depression (questions above) that tend to cycle with the manic symptoms below.

  1. ___ 1. Periods of an elevated, high, or irritable mood
  2. ___ 2. Periods of very high self-esteem or grandiose thinking
  3. ___ 3. Periods of decreased need for sleep without feeling tired
  4. ___ 4. More talkative than usual or feel pressure to keep talking
  5. ___ 5. Racing thoughts or frequent jumping from one subject to another
  6. ___ 6. Easily distracted by irrelevant things
  7. ___ 7. Marked increase in activity level
  8. ___ 8. Excessive involvement in pleasurable activities with painful consequences (affairs, gambling, etc.)

ADHD

  1. ___ 1. Trouble sustaining attention; easily distracted
  2. ___ 2. Difficulty completing projects
  3. ___ 3. Feeling overwhelmed by the tasks of everyday living
  4. ___ 4. Trouble maintaining an organized work or living area
  5. ___ 5. Inconsistent work performance
  6. ___ 6. Lack attention to detail
  7. ___ 7. Make decisions impulsively
  8. ___ 8. Have difficulty delaying what you want; must have your needs met immediately
  9. ___ 9. Restless, fidgety
  10. ___ 10. Make comments to others without considering their impact
  11. ___ 11. Impatient, easily frustrated
  12. ___ 12. Frequent traffic violations or near accidents

Addiction Issues

  1. ___ 1. Excessive use of substances (alcohol, drugs, food) or behaviors (gambling, sex, shopping, Internet, video games)
  2. ___ 2. Loss of control over substance use or behaviors
  3. ___ 3. Experienced negative consequences (relationships, money, health, law) because of substance use or behaviors, yet they did not cause you to stop
  4. ___ 4. Require more of a substance or behavior to make you feel good
  5. ___ 5. Experience withdrawal symptoms when you stop the substance use or behaviors
  6. ___ 6. Other people in your life complain about your substance use or repetitive behaviors
  7. ___ 7. Your substance use or repetitive behaviors distract you from your goals
  8. ___ 8. Feel guilty about your substance use or repetitive behaviors

Posttraumatic Stress Disorder (PTSD)

  1. ___ 1. Recurrent thoughts of a past traumatic event (e.g., sexual abuse, accident, fire)
  2. ___ 2. Recurrent distressing dreams of a past upsetting event
  3. ___ 3. A sense of reliving a past upsetting event
  4. ___ 4. A sense of panic or fear of events that resemble a past upsetting event
  5. ___ 5. Effort spent avoiding thoughts or feelings associated with a past trauma
  6. ___ 6. Persistent avoidance of activities/situations that cause remembrance of an upsetting event
  7. ___ 7. Inability to recall an important aspect of a past upsetting event
  8. ___ 8. Feeling detached or distant from others
  9. ___ 9. Feeling numb or restricted in your feelings
  10. ___ 10. Marked physical response to events that remind you of a past upsetting event, e.g., sweating when getting in a car if you have been in a car accident

Chronic Stress

  1. ___ 1. Family stress
  2. ___ 2. Work stress
  3. ___ 3. Health stress
  4. ___ 4. Financial stress
  5. ___ 5. Headaches
  6. ___ 6. Tension
  7. ___ 7. Irritability
  8. ___ 8. Insomnia
  9. ___ 9. Low frustration tolerance
  10. ___ 10. Trouble coping

ONCE YOU’VE IDENTIFIED YOUR MENTAL HEALTH ISSUES

  1. Get help. Early treatment is essential to stave off the ravages of mental health issues. Treatment does not necessarily mean psychiatric medicines. At Amen Clinics, we prefer natural treatments whenever possible, such as those discussed throughout the book, including a healthy diet, exercise, omega-3 fatty acids EPA and DHA and other supplements, meditation, and cognitive behavioral therapy. All have a strong research basis showing they are effective. But if these strategies don’t work, or faster results are needed, medications are important to consider. Here are research-based strategies to boost your mental health if you are struggling with
    • Anxiety
      • Brain-healthy habits (see chapter 2)
      • Exercise[415] (see chapter 4)
      • Hypnosis (see chapter 1)
      • Diaphragmatic breathing (see chapter 1)
      • Hand warming (see chapter 1)
      • Meditation (see chapter 1)
      • Calming music (see chapter 1)
      • ANT therapy (cognitive behavioral therapy, or CBT; see chapter 5)
      • Supplements to boost GABA, such as GABA itself,[416] magnesium, and theanine from green tea[417] (see chapter 10)
    • Depression and Negativity —See my book Healing Anxiety and Depression for more detailed information on the seven types of anxiety/depression
      • Brain-healthy habits (see chapter 2)
      • Exercise[418] (see chapter 4)
      • Antioxidant-[419] and tomato-rich diet[420] (see chapter 9)
      • Omega-3 fatty acids —higher in EPA than DHA[421] (see chapter 10)
      • SAMe (s-adenosyl methionine) for depression,[422] especially in males[423] (see chapter 10)
      • Saffron[424] (see chapter 9)
      • Optimize vitamin D levels[425] (see chapter 10)
      • ANT therapy (cognitive behavioral therapy, or CBT; see chapter 5)[426]
      • Acupuncture[427]
      • Medication, if necessary
      • Methylfolate (as an add-on treatment to antidepressant medication)[428]
    • Bipolar Disorder
      • Brain-healthy habits (see chapter 2)
      • Exercise[429] (see chapter 4)
      • Omega-3 fatty acids EPA and DHA[430] (see chapter 10)
      • Medication, if necessary
    • ADHD —See my book Healing ADD for more detailed information on the seven types of ADD/ADHD, and take our free online test at www.ADDTypeTest.com.
      • Brain-healthy habits (see chapter 2)
      • Exercise[431] (see chapter 4)
      • Omega-3 fatty acids —higher in EPA than DHA[432] (see chapter 10)
      • Zinc[433]
      • Magnesium[434]
      • Iron (if ferritin levels are low)[435]
      • Phosphatidylserine[436]
      • Work with an ADHD coach
      • Medication, if necessary
    • PTSD
      • Brain-healthy habits (see chapter 2)
      • EMDR (eye movement desensitization and reprocessing;[437] visit www.emdria.org) (see chapter 7)
      • Loving-Kindness Meditation[438] (see chapter 1)
    • Stress Management
      • Brain-healthy habits (see chapter 2)
      • Exercise[439] (see chapter 4)
      • Prayer[440] and mindfulness meditation[441] (see chapter 1)
      • If you struggle with worry, consider supplements to raise the neurotransmitter serotonin, such as 5-hydroxytryptophan (5-HTP) or saffron[442]
  2. Try these research-proven tips. Use them to lower stress and boost your level of happiness and overall mental health.
    • Start every day with the words “Today is going to be a great day.” Your mind makes happen what it visualizes. When you start the day by saying these words, your brain will find the reasons it will be a great day.
    • Write down three things you are grateful for every day. Researchers found that people who did this significantly increased their sense of happiness in just three weeks.[443]
    • Every day, write down the name of one person you appreciate. Then tell him or her. Appreciation is gratitude expressed outwardly, and it builds positive bridges between people.
    • Limit screen time. Studies report a higher level of depression and obesity with increased time spent with technology.
    • Exercise —it is the fastest way to feel better. Go for a walk or a run.
    • Enjoy some dark chocolate. It can boost blood flow to your brain,[444] help improve your mood, and decrease anxiety. In one study, seniors who ate more of it had a lower incidence of dementia than those who ate less.
    • Listen to music. Just 25 minutes of Mozart or Strauss has been shown to lower blood pressure and stress. Listening to ABBA has also been shown to lower stress hormones —Mamma Mia![445]
    • Choose experiences that give you a sense of awe, such as looking at a sunset or something else beautiful in nature.[446]
    • Drink green tea, which contains L-theanine, an ingredient that helps you feel happier, more relaxed, and more focused.[447]
    • Read an inspiring, powerful novel.[448]
    • Take a walk in nature,[449] which is also associated with reducing worry.[450]
    • Go barefoot outside. It decreases anxiety and depression by 62 percent, according to one study.[451]
    • Listen to a sad song. Really. It was found to increase positive emotion.[452] Listening to lullabies and soothing music also decreased stress and improved sleep.[453]
    • Stop complaining! It rewires your brain to see the negative in way too many places.[454]
    • Spend time with positive people if you want to feel happy.[455] People’s moods are contagious. (If you want to feel depressed, hang out with gloomy people.)
    • Do something you love that brings you joy. For me, it is playing table tennis or spending time with my wife, kids, or grandkids.
    • Write down your five happiest experiences, and then imagine reliving them.
    • Engage in activities that make you feel competent.[456]
    • Be patient. People tend to be happier with age, especially if they take care of their brains.[457]
    • Learn to forgive; it can help reduce negative feelings.[458]
    • Help someone else or volunteer; people in one study who did felt happier.[459] And make time for friends.[460]
    • Get intimate with your spouse. Making love with a partner increased overall happiness and decreased stress hormones. In mice, it helped boost the hippocampus.[461]
    • Journal your feelings. It helps to get them out of your head and allows you to gain perspective.[462]
    • Learn to kill the ANTs (automatic negative thoughts). Whenever you feel sad, mad, nervous, or out of control, write down your negative thoughts. Next, ask yourself if they are really true or if they are a bit distorted, making you feel worse. Focusing your mind on positive, rational thoughts will help you feel much better.