Some people wear their emotions on their sleeve. Others manifest it in the nest: The state of their homes reflects their state of mind. When depression sets in, the clutter can pile up.

Charles Miles can relate. He owns a three-bedroom Colonial-style home in Bogota, New Jersey, but when he’s feeling blue, routine maintenance is hard to keep up. “There are dishes in the sink. Newspapers on the floor. Instead of putting things away, I leave them where they are. I think, ‘What’s the point?’ I’m just not motivated. It’s the demon I fight all the time.”

Healthcare professionals know all too well the connection between clutter and depression. The abilities you need to keep a home clean and in relative order go by the wayside with depression. People who lose their drive find it hard to handle basic housekeeping and organizational tasks. “A systematic pattern of home neglect is really a form of self-neglect,” says Dr. Holly Parker, a practicing psychologist and faculty member of Harvard University. “People with depression often have low energy, almost like taking gas out of the tank of a car. They lose the motivation to do things they used to love to do. If they give up hobbies, they definitely won’t do housework.”

Clutter is difficult to contain under the best of circumstances. Every Felix Unger has a bit of Oscar Madison in him. For most, it’s a matter of having too much stuff and not enough places to store it. Some have called it an epidemic of affluenza. As a nation of affluence, we buy without thinking what we’re going to do with it, how we’re going to use it, and where we’re going to put it. And because we’re busier than ever, we have less time to figure it all out.

The fact is that previous generations simply didn’t have all the stuff we have today. They were never tempted by 24-hour shopping channels, blasted with emails about last-chance sales, or bombarded with catalogs and junk mail. Generations from baby boomers to millennials may have it all within reach, but most haven’t learned how to keep it in balance. Homes continue to grow fuller, despite our households growing smaller.

It’s not the whole problem, though. Clutter isn’t just about bringing new stuff into the home but the inability to purge the old. Some adhere to the waste not, want not school of housekeeping. Obsolete electronics? Clothes that haven’t fit in years? Broken tools? Folks with a Depression-era mindset hate to throw anything away. And then there are the objects with sentimental value, the biggest clutter culprits because they’re the hardest to part with of all. It’s little wonder why in the U.S. alone, the self-storage industry is a $22 billion business annually.

Living in clutter is more than just a matter of aesthetics. Clutter is an energy sapper that takes its emotional toll and steals domestic joy. If home is where the heap is, it’s a good bet family members are more stressed and less productive. It can create tension in personal relationships. It can cause people to be chronically behind schedule because they can’t find their car keys or they’re unable to sift through their closets for a complete outfit in the morning. And children can suffer as well. Some youngsters experience problems at school because they’re routinely late for class or under prepared for assignments.

Clutter comes in degrees, from mild to severe, from annoying to debilitating. While it can cause anxiety and depression, it can conversely be a symptom of a problem. Professional organizer MaryJo Monroe, owner of reSPACEd, a residential organization and design firm in Portland, Oregon, says one of the first things she notices working with a client who might be depressed is low energy output. “They don’t have stamina. Instead of working two to four hours at a stretch, they’ll start to poop out after an hour.” Another red flag is difficulty making decisions. When the ability to concentrate wanes, figuring out whether to keep, toss, or relocate things becomes impossible.

Self-esteem issues can be at the root. The attitude? I’m just not worth the effort. And it spirals downward from there. When it becomes hard to muster the motivation to turn things around, it can create a negative cycle that feeds on itself. People often become more stressed and more depressed because of the mess. And the inability to dig oneself out brings on feelings of hopelessness.

Losing his job of 14 years started a downward spiral for “John” who was living outside Seattle, Washington. He defaulted on his mortgage and lost his home. The stress caused the dissolution of his marriage and alcohol took over his life. “I started letting things go. Dishes piled up in the sink, garbage was almost never taken out. After all, what was the use? I knew I could pull myself out of it. But not today. Today I didn’t feel like it. I felt like sleeping.” Through the help of a friend, John went into a detox program and got help for his depression. He moved to a new state, got a new job and apartment. “As for how I feel when I come home, the difference is amazing. Coming home to a neat place, and knowing that everything in it—including the cleanliness—was earned by me, makes everything I do there, from waking up in the morning to watching the Late Show before I go to bed, that much sweeter.”

And that message of hope is exactly the one professionals strive to communicate.

Spring is an ideal time to start getting clutter under control. For many, seasons can have a powerful affect on their moods. In the spring, the days are longer, flowers start blooming, people are out and about. Those who struggle during the short, dark days of winter perk up in the spring. “It’s an uplifting time,” Parker says. “You can capitalize on that time of year by getting more things done and capitalize on that boost of mood that comes with longer days.”

Solving clutter problems is a two-step process that takes planning. The first part is getting to the root of the problem, and a number of treatments can help such as therapy, medication, and doing regular exercise.

The second part is putting a system in place. (See “Seven Steps to Clutter Control.”) Enlisting a friend or family member in the organizational process can give the chronically disorganized the cheerleading morale they need to keep going. A home that looks good helps us feel good. And New Jersey homeowner Charles Miles can relate to that, too. When his outlook brightens, tackling the clutter is job number one. His reward for a home organizational makeover is a sense of accomplishment and renewed self-confidence. “I feel great,” says Miles. “I’m like, ‘Let’s invite the neighbors over for dinner!’”

Illustration by Gwenda Kaczor.

End Clutter Now! The Saturday Evening Post

Martha Rhodes manages depression with TMS, not drugs.

Depression that resists drugs and counseling takes a heavy toll on relationships and wages. But the message from mother, wife, and former NYC advertising executive Martha Rhodes, who has struggled with depression for decades, is loud and clear: “Don’t give up! There are alternatives that can help.” For Rhodes, a non-drug therapy called transcranial magnetic stimulation (TMS) made all the difference.

TMS, the newest science-backed approach for stubborn cases of depression, invites patients to recline in comfy spa chairs for a series of magnetic taps to their foreheads. The procedure delivers energy from outside the body to release mood-lifting chemicals in the brain.

Neurostar TMS Therapy is FDA-cleared for treating major depressive disorder in adults who have failed one or more antidepressants.

“Neurostar’s electrical current travels only about one inch, but fortunately that’s enough to reach the target area—the brain’s left front side that often shows low function on imaging scans of people with depression,” says psychiatrist Scott Aaronson, Medical Director of TMS Services at Sheppard Pratt Health System in Baltimore, who has treated about 125 patients who failed multiple drug therapies in his clinic.

TMS is not electroconvulsive shock therapy à la One-Flew-Over-the-Cuckoo’s-Nest. Besides the spa chairs, patients are awake during the 45-minute treatments, and able to resume normal activities immediately afterward.

“I’m delighted to have another tool in my bag to help those with hard-to-treat depression. TMS is approved for stand-alone therapy, and we also see about a 62 percent improvement rate (30 percent for remission) when adding daily TMS for six weeks on top of medication,” says Dr. Aaronson.

Rhodes tried drugs and psychotherapy for years before seeing an ad for TMS in a local magazine. She recounts: “Depression ambushed me. I assumed medications and counseling were doing their job and that I was at fault for still wanting to jump off a bridge. I had never heard the term ‘treatment resistant’ and it nearly cost my life. TMS takes commitment, trust, and patience: I was about halfway through my treatments when I woke up one day and noticed that I felt lighter. No angels, no marching band, but the subtle sense that I can manage this day. Then I started answering phone calls and going out to dinner and I thought: Oh my gosh, I must be getting better. TMS is safe. I absolutely recommend that people with depression consider this treatment.”

TMS is covered by many insurance plans and included in the American Psychiatric Association’s Practice Guidelines for Major Depressive Disorder, a compilation of evidenced-based recommendations for assessing and treating the disorder. In coming years, Aaronson and others believe the non-invasive, non-drug approach may lead to new therapies for bipolar disorder, psychotic diseases, and neurological problems such as tinnitus and headache.

Magnet Therapy Boosts Feel-Good Brain Chemicals The Saturday Evening Post

For two years Cami, an out-of-work creative director, struggled with the symptoms of MS. It was difficult to walk, work, or take pleasure in the simple comforts of home and family. To dull the pain and fight fatigue and insomnia Cami began popping prescription drugs for pain and anxiety—so many that they had to be tracked with a spreadsheet. She began to slip into a fog of depression and self-pity.

Then something happened that changed her life.

Cami had a very good friend whom she looked up to. During a phone call her mentor told her frankly that she was in a bad place. She said Cami needed to stop dwelling on herself if she was ever going to heal. Her prescription for Cami was to give 29 gifts in 29 days and to write about the experience.

Cami not only rose to her friend’s giving challenge, but she also started a self-help movement that has mobilized tens of thousands of individuals across the globe. Motivated by her own positive experiences, Cami founded 29gifts.org, a Facebook-like website in which people share personal stories of giving and receiving while making new friends. Members join together to raise money for individuals in need as well as to contribute to organizations ranging from the National Multiple Sclerosis Society to Charity Water (a group that provides clean water to villages in Africa).

Cami’s foray into philanthropy began inauspiciously. At first she dismissed her friend’s suggestion as “silly.” “I didn’t understand how giving to others was going to help me,” she says. “Most days, I could not get out of bed and felt I had nothing to offer the world.”

But as her friend explained, making the conscious and daily choice to give things away was all about shifting Cami’s focus away from herself. That would create a void into which, perhaps, something positive might enter.

What kinds of gifts? She asked.

Not to worry, her friend answered. Gifts didn’t have to be material things. A smile, warm handshake, or praise would do. The key was to be mindful about it—which is to say, not to do what sales clerks do when they say blankly, “Have a nice day!” For good things to happen, Cami would have to really mean it.

Cami’s first gift was a supportive phone call to a friend who also was struggling with MS. That might have been the hardest because it meant reopening the hardened scab of her own pain so she could be sensitive to the sufferings of others.

After that she was on a roll. For the next 28 days Cami handed out flowers to people on the street, stuffed quarters into a friend’s parking meter, and shared chocolate cake with her husband. She even (gasp!) gave up control of the TV remote for an entire evening. And as her spiritual advisor suggested, Cami chronicled every gift in her journal.

Good things started to happen to Cami very quickly. She could feel her energy coming back. The symptoms of MS were still there, but she was better able to cope. After just two weeks Cami was less reliant on the cane she’d been using. She was taking fewer pain pills. And brain scans showed that the disease had at least temporarily stopped getting worse.

Then, out of the blue, a philanthropic agency in San Francisco hired her to do some consulting work. She rejoiced in being busy again. “I started to wake up each morning feeling positive and excited, wondering what opportunities to give might come my way instead of wondering where I would hurt or what might go wrong,” says Cami. “That was a huge change.”

As she got more fluent with giving she found that receiving gifts from others became easier. She was able to accept even simple things such as a ride to and from the doctor’s office with gratitude instead of guilt or shame. “I now try to give and receive more consciously,” she says.

Halfway through the 29 days Cami began to post her giving stories online, which is how her website got started. She invited others to join her challenge to give. Within weeks more than 200 friends and acquaintances signed up and agreed to the challenge. Today more than 16,000 people in 43 countries have joined the site. Membership is free, but new members must pledge to give 29 gifts in 29 days and to write, share artwork, or blog about the experience on the site. Cami hopes to inspire 29,000 people to sign up.

Cami turned her story into a book, 29 Gifts: How a Month of Giving Can Change Your Life, which has sold more than 60,000 copies and earned her appearances on The Today Show and other places. Today she’s busy writing her second book, a collection of stories from the website. She travels often, speaking to groups about 29 Gifts and the lessons she’s learned.

Through it all the MS symptoms are there in the background. When they flared up recently, Cami needed to be hospitalized for a brief period. It’s not easy, she says, “but being of service to others brings me a sense of balance and peace in the world, no matter what’s going on in my life.”

To learn more about 29 Gifts, visit 29gifts.org.

The Best Gift Ever The Saturday Evening Post

So, it comes as a surpise to find a cluster of new studies that seem to conclude caregiving is good for you. That’s right, instead of wearing you down, making you demented or depressed, good for you!

And, the good it does you is more than just the psychological kind. We’re talking benefits in strength, longevity, brainpower and more.

As it turns out, the author of the studies, Lisa Fredman, a professor of epidemiology at Boston University, was just as surprised when the results first started to come in: “It was a shocker,” she says, adding, “My first thought was, ‘This can’t be right!’ Like many before me, I subscribed to the idea that caregiving is bad for your health. But over time I kept finding essentially the same patterns.”

Fredman’s first study, conducted over eight years, showed that caregivers had lower mortality rates than non-caregivers. The next one focused on physical ability, and found that high-intensity caregivers demonstrated better walking pace, grip strength and speed of rising from a chair than lower intensity caregivers or non-caregivers. A third study was on memory and brain function. Once again, the caregivers performed well, demonstrating brain skills equivalent to those of people ten years younger.

Following is a conversation I had with Fredman about her work and its implications:

Q: You’ve said you were surprised by the results of your research. What was your original hypothesis going into this work?

A: My hypothesis was that caregivers were going to have poorer health outcomes then noncaregivers. And that remained my hypothesis for the first three grants that I wrote over eight or nine years. So I was pretty wedded to that.

Q: What changed your mind?

A: My initial results were that caregivers had lower rates of mortality than the noncaregivers. While they were much more stressed than the noncaregivers, they seemed to be doing better physically. The differences were dramatic. Mortality rates were 25 percent lower for caregivers. Functional decline such as walking speed, grip strength and chair-stand speed was lower for caregivers. Caregivers also maintained higher cognitive ability.

Q: What did the caregivers experience that might have contributed to these positive effects?

A: The physical activity probably has salutary effects. And there are psychological benefits as well. A lot of caregivers report they feel a great deal of gratification that they are able to care for their relatives and keep them out of a long term care facility.

Q: So, why do you think other studies have found such different outcomes?

A: Well, there is a key difference. We used an independent measure of stress, which previous studies had neglected to do. And so we are able to separate out the health effects of stress from the health effects of caregiving. We found that it is primarily the stressed caregivers who are experiencing negative health effects. So now I actually really believe in this hypothesis.

Q: What about the question of selection bias? Obviously you weren’t able to assign some individuals to caregiving roles and then assign others to be free of this responsibility and then compare the two groups. You had to pick those who had chosen to be caregivers and compare them to those who had chosen not to. Does that muddle the data at all?

A: I don’t think it’s a question of whether you have a choice. If you are healthy enough to take care of an older relative who needs assistance you become the caregiver. I wouldn’t consider it a selection bias, but there is a selection of healthier older people assuming the caregiving role.

Q: What about the political risk—or repercussion—of studies showing that caregiving may be healthy? To put it bluntly, is there a chance policy-makers will read too much into this and, say use your results to defund agencies that are helping the caregiver?

A: That is always our concern globally. The message here is that caregiving can be very stressful and stress can have very deleterious effect, not just on a person’s emotional well-being but their physical health as well. And what our studies seem to show is that it is really stress—not being a caregiver—which does a person harm. If anything, my studies support the call to fund more research.

Q: Stress is something that you can reduce by intentional effort. Based on your studies, would you tell someone who is a caregiver to more actively pursue stress-relieving activities?

A: I’m very interested in the effects that stress-relieving activities such as yoga have on caregivers and people in general. I’m excited that we now have the ability to look at physiological and brain effects of these stress reduction programs. Caregivers should try to find ways that work for them to reduce stress such as support groups, talking with a friend, yoga, swimming, running, reading etc. But it is not always realistic to simply advise a caregiver to pursue something like this.

Q: Why not?

A: Caregivers often have trouble finding free time. It can be very difficult for people in this role to stop and concentrate on themselves because they are often fully consumed with the wellbeing of the person that they are caring for.

Q: So how can caregivers find personal time to lower their own stress?

A: It really is important for others to offer respite to caregivers by taking on some of their responsibilities. For example, my sister is the main caregiver for my father. When I pitch in, I seem to spend the entire day doing errands—errands that can seem minor and not very helpful. But my sister assures me that it really helps her because it saves her a substantial amount of time. So it’s exactly those kinds of things—things that don’t seem like such a big deal—but really are, because they give the caregiver the gift of some free time.

(Steven Slon is editorial director for The Saturday Evening Post. This column was first published by Beclose.com)

Is Caregiving Good for You? The Saturday Evening Post

When asked to broach the veteran journalist’s long-standing battle with depression, I was initially intimidated, uncertain how best to broach a very personal conversation.

I took a tip from the best. Mirroring the intrepid journalist’s own trademark style, I jumped in.

And with good humor and characteristic candor, Wallace took a deep breath, leaned back in his chair, asked if it was okay to unpeel an orange for lunch at his desk, then slowly shared his long-standing struggle with what Winston Churchill dubbed the “black dog” of depression. For years, Wallace suffered from the disease in silence, leaning on his wife for support. Later, Wallace turned to the counsel of good friends Art Buchwald and William Styron—who also battled depression; the trio dubbed themselves “The Blues Brothers.”

Despite the on-camera bravado and self-confidence, Wallace was humbled by depression—engulfed by a darkness that at one point in his life led him to attempt suicide. Going public to help others was a brave move for the respected anchorman who to the unsuspecting audience appeared untouched by uncertainty or self-doubt. But he was. And he survived. And he wanted others to know that they could survive as well.

Thank you, Mike, for sharing “60 minutes” with the Post.

MIKE WALLACE: SPEAKING OUT ON DEPRESSION

By Patrick Perry from Sept/Oct 2006

Tough, hard-hitting, and respected, news correspondent Mike Wallace has made his living tackling complex problems. For years, the popular 60 Minutes anchor confronted corruption and fraud, interviewed the famous and infamous, and survived the loss of a son and numerous life challenges. But in his mid-60′s, he began to suffer from what Winston Churchill called the “black dog” of an overwhelming depression that spiraled out of control, carrying Wallace to the brink of suicide.

“My colleagues and I at CBS were on trial for defamation,” Wallace told the Post. ‘We aired a piece about General [William] Westmoreland, and he decided that he was going to sue CBS for Sl20 million. It went through deposition and finally, after a couple of years, wound up in court. It was—to put it mildly—harrowing.”

For five grueling months, Wallace became a central figure in the courtroom drama, with his most precious professional credential—his credibility—on trial. Little by little. Wallace began to experience psychosomatic pain. “I couldn’t sleep, couldn’t think straight, was losing weight, and my self-esteem was disappearing,” he admits.

Initially, he suffered in silence. “At first, I simply didn’t believe that I was depressed. My wife, Mary, did, but I didn’t.” he says. “I eventually reached out to friends who had been through depression. And I talked to my general practitioner, who said, Mike, you don’t want to let the word get out that you are depressed. That’s bad for your image.’ But finally, I had to face up to it.”

During a recent 60 Minutes special retrospective on his career, Wallace publicly acknowledged for the first time that he tried to commit suicide, alluding to taking an excess of pills.

With no traceable family history of mental illness, Wallace found himself in unknown territory. Fortunately, with the support of his wife and family, as well as the guidance and humor of good friends (Art Buchwald and novelist Bill Styron, to name just two), he survived. Wallace admits that “Anyone who says that they don’t have suicidal thoughts, if clinically depressed, is a liar.” says the candid correspondent. “Of course you do.”

Wallace, in a 1957 Post photograph.

The journey back from the brink was at times bumpy and included use of antidepressant therapy. “The medication kicked in after about three or four weeks.” Wallace recalls. “But as soon as the general
withdrew the lawsuit, in effect acknowledging what was said was accurate, I thought, I am fine. I’m going to play tennis. A couple of months later, however, I busted my wrist playing tennis with Art Buchwald.
And I was back in depression as deep as the first time.”

Fortunately, new therapies had emerged, and his physician prescribed one of the newer SSRIs, which slowly began to lift the black mood.

“When depressed, a day seems like a month,” he candidly states. “I am not kidding. I was told that it could take several weeks to take hold. I thought to myself, I don’t know what in the hell to do.”

Ever the professional, Wallace went to Beirut to cover a story.

“I was in a hotel looking down on the old city of Beirut, and I woke up one morning and wondered, ‘Is it possible that the medication has finally taken hold?’ I didn’t believe it, but in fact, it had,” Wallace recalls, “From that day to this. I haven’t had a tremor of depression.”

Wallace remains on medication. By sharing his courageous journey with others, he hopes to counter the stigma associated with the disease. “There’s nothing—repeat, nothing—to be ashamed of when you’re going
through a depression.” he said during a recent CBS Cares interview. “If you get help, the chances of your licking it are really good. But, you have to get yourself onto a safe path.”

For Wallace, the path to recovery included the company of two good friends—whom he calls his “blues brothers.”

“Art Buchwald and Bill Styron helped me tremendously.” he told the Post. “Artie Buchwald stayed in touch with me every night—no matter where I was in the world, but particularly in this country—to listen to my complaints and talk me through it. He did the same thing with Styron. He had to listen to the same bullshit over and over—and over—again and never complained. He was the best friend a man could have.”

Wallace also knows that suicide is all too common among seniors suffering from depression. After all, he almost became a statistic. By stepping forward, he also hopes to educate others about the disease. “You get the feeling that by now everybody knows about depression,” he stresses. “But the fact of the matter is, that is not true. Get to a psychiatrist who has the capacity to prescribe medication. Follow the suggestions of the doctor and stay on the meds! Depression can be treated. It is proven. It has been proven to me. The last 20 years have been the best of my life.”

The 88-year-old may be retiring from full-time correspondent duties, but don’t be too surprised if you see the tenacious interviewer on air. Retirement doesn’t appear to be an operative word in his vast vocabulary.

“I keep talking about it, but I keep taking on chores,” he admits. “I would just as soon die with my boots on.”

From Our Archives: One-on-One with Mike Wallace The Saturday Evening Post

Post: Is CFS a “real” disease?

Vernon: There are more than 4,500 papers in the medical literature that describe disturbed or altered biology in people with CFS, so, yes, the disease is very real. The U.S. Centers for Disease Control & Prevention estimates that at least one million American men, women, and children have CFS. But its devastating effects are sometimes hard to see; people with CFS can look relatively well, especially to those who see them only on a relatively “good” day. Confusion also stems from the possibility that the disease may have several causes, and the fact that it has been described by different names at different times, such as post-viral fatigue syndrome, myalgic encephalomyelitis (ME), chronic fatigue and immune dysfunction syndrome (CFIDS), and ME/CFS.

Post: Is there a specific test or symptom that signals CFS?

Vernon: None have yet been identified, and CFS remains a diagnosis of exclusion. This means doctors diagnose CFS by ruling out other medical and psychiatric diseases that could explain a patient’s symptoms. The medical definition of CFS crafted in the late 1980s is woefully nonspecific. Today, we are addressing the need for better diagnostics and treatment through strategically guided research based on knowledge gained over the past 25 years of CFS research and from other areas of science and medicine.

Post: Are researchers making strides in finding the cause or causes of the disease?

Vernon: There is a great deal of published evidence that acute infection with a variety of different pathogens can lead to CFS in about 10 percent of the cases. So, infection is a plausible cause, possibly in combination with an underlying immune system vulnerability. Understanding who is at greatest risk for severe infection, detecting these infections early, and learning more about the immune response are important approaches to preventing CFS in the future.

Keep in mind that we don’t know the cause of most chronic diseases, yet progress is possible. For example, the “War on Cancer” signed into law by President Richard Nixon in 1971 was aimed at improving cancer treatment and finding cures by increasing research. Indeed, there has been important progress, especially in cancer screening and treatment, even though we still don’t know the cause of most cancers.

Likewise, important findings from more than two decades of CFS research gives me hope that effective treatments will be identified. Currently the handful of physicians in the U.S. who have dedicated their medical careers to caring for CFS patients use a combination of treatment strategies to help patients improve function and quality of life. It requires a partnership and a trial-and-error approach that can be time-consuming and frustrating to both patient and physician. In the future, chemical biomarkers identified by CFIDS Association-funded researchers could help guide treatment using more objective and targeted approaches.

Post: What are biomarkers?

Vernon: Biomarkers can be thought of as indicators not only of disease, but also of response to treatment or even good health. Think of cholesterol, for example. Cholesterol is vital for life, but high levels of bad cholesterol are a biomarker indicating increased risk of cardiovascular illnesses. Biomarker research has found certain molecules on blood cells that occur at different levels in CFS patients compared to healthy people and people with other diagnoses. Other studies on CFS biomarkers may help identify characteristics of people who do not recover from an acute infection and why that might happen.  In addition, we are finding that differences between CFS patients and other groups often show up more clearly when the subjects are studied after a short exercise challenge. Post-exertional relapse is one of the hallmarks of CFS, and it seems to provoke a different biological response than testing patients at rest.

Post: What do people struggling with CFS need to know?

Vernon: There is hope. Right now, awareness about and interest in CFS are at an all-time high and there is tremendous urgency within the scientific community to address the need for better diagnostics and treatment through strategically guided research based on knowledge gained over the past 25 years of CFS research and from other areas of science and medicine.  While some research is not panning out, other areas are heating up. There are new technologies such as genomics, proteomics, and imaging that give us new tools to understand biological abnormalities at the molecular, cellular, and clinical level. The CFIDS Association is laser-focused on making CFS widely understood, diagnosable, treatable, and preventable, and we are making faster progress than ever before.

Quick Guide to Chronic Fatigue Syndrome (CFS)

* People of every age have CFS, but the illness is most common in those ages 40 to 59.

* More than 80 percent of CFS patients in the U.S. don’t know they have it.

* CFS includes four or more of the following characteristics (in addition to fatigue): symptoms that relapse after physical or mental exertion; unrefreshing sleep; substantial memory or concentration problems; muscle pain; pain in multiple joints; headaches of a new type, pattern, or severity; sore throat; and tender neck or armpit lymph nodes.

* CFS is not caused by depression, although the two illnesses often coexist. Many patients with CFS don’t have any psychiatric disorder.

–CFIDS Association of America

RESOURCES: www.cfids.org

www.research1st.com

Fast-Track Research on Conquering Chronic Fatigue The Saturday Evening Post

Recent research published in Innovations in Clinical Neuroscience suggests that boosting patients’ levels of the B vitamin folic acid called L-methylfolate—via tablets of the prescription medical food Deplin—helps regulate brain chemicals affecting mood.

Study data reported by Lawrence Ginsberg, MD, show that patients taking Deplin in addition to an antidepressant improved 2.5 times more often than those taking an antidepressant alone. Patients on the combined therapy also achieved results more quickly.

Depression, a chronic, recurrent disease, is one of the nation’s most common ailments, affecting more than 18 million people in the United States.

And new treatment options are desperately needed. Nearly 70 percent of patients with major depression won’t improve with initial monotherapy, according to the landmark Sequenced Treatment Alternatives to Relieve Depression study.

Scientists have long suspected a link between a deficiency of bioactive folate and depression. L-methylfolate was chosen for the study because of its ability to cross the blood-brain barrier, its bioavailability, and its safety benefits compared to folic acid and other synthetic folates.

Have you tried Deplin? Did it work? Let us know!

B Vitamin Fights Depression The Saturday Evening Post

So, what activities can ward off depression as we get older?

Researchers at UCLA turned to a gentle “Westernized” version of tai chi, the 2,000-year-old Chinese martial art. When a group of adults over age 60 and on antidepressant drug therapy attended a weekly tai chi exercise class, standard rating scales showed greater improvement in their level of depression—along with improved quality of life, better memory and cognition, and more overall energy—when compared to study participants taking the same medicine but going to a weekly health education class.

Results of the study appear in the online edition of the American Journal of Geriatric Psychiatry.

“This is the first study to demonstrate the benefits of tai chi in the management of late-life depression, and we were encouraged by the results,” said first author Dr. Helen Lavretsky, a UCLA professor-in-residence of psychiatry. “We know that nearly two-thirds of elderly patients who seek treatment for their depression fail to achieve relief with a prescribed medication.”

In the study, 112 adults age 60 or older with major depression were treated with the prescription antidepressant escitalopram (brand name: Lexapro) for approximately four weeks. From among those participants, 73 who showed only partial improvement continued to receive the daily medication but were also randomly assigned to 10 weeks of either a tai chi class or a health education class for two hours per week.

Both groups showed improvement in the severity of depression, said Lavretsky, who directs the UCLA Late-Life Depression, Stress and Wellness Research Program, but greater benefits were noted among those participating in tai chi.

“This study shows that adding a mind-body exercise like tai chi that is widely available in the community can improve the outcomes of treating depression in older adults. With tai chi, we may be able to treat other, coexisting medical conditions without exposing them to additional medications.”

If it’s good enough for grandma, it’s good enough for me.

Finding a gentle tai chi class, however, can take some detective work. Contact your health care provider, YMCA, and community wellness centers. Check with friends too—the best referral is always based on firsthand experience. DVDs and online videos are available, but a supervised program seems best.

Know a good facility or instructor offering a low-key form of tai chi? Post it here!

Dealing With Depression The Saturday Evening Post

“Many of us wish that family gatherings were more like what we remember from our childhoods or see on television,” explains Zimmerman. “But dreams of a perfect holiday season can quickly become nightmares—and sometimes lead to bouts of depression.”

To treat yourself this holiday season, Zimmerman offers these five tips:

• Avoid or reduce alcohol consumption. Liquor is a depressant that can deepen existing emotional problems.
• Include exercise in your daily routine. A walk in the sunlight will add energy and help counteract seasonal affective disorder (SAD).
• Maintain close friendships and confide in those you trust. Talking about your feelings helps reduce or eliminate the blues.
• Read one of the dozens of books on the market to discover stress-busting tips.
• Face the facts. No holiday gathering is perfect.

Those who have feelings of depression lasting more than two weeks to seek professional advice, adds Zimmerman. Symptoms of depression may include sleeplessness or sleeping too much, a lack of appetite, inability to concentrate and feeling hopeless.

Stress Less About the Holidays The Saturday Evening Post

For nearly 40 years, as a medical and nutritional writer concentrating on the predicament of aging, I have closely followed the research findings on Alzheimer’s and age-related memory loss.

Yes, we may face an epidemic as baby boomers age, and yes, there may also be a cure in our future. But the fact is our susceptibility to Alzheimer’s, like heart disease, cancer, and diabetes, though somewhat at the mercy of genes, is also partly influenced by factors within our control.

We all can do some things to help our brains negotiate the hazards of advancing age:

Overcome Depression

It is a risk factor for Alzheimer’s, not a symptom.

So you are feeling depressed, and your cognitive functioning is not what it used to be. Is this something to worry about? Yes, say experts. They know that depression is common among older people with mild cognitive impairment and Alzheimer’s.  But does depression bring on the disorder or is depression a subtle early sign of the underlying pathology of Alzheimer’s? Is it cause or consequence?

For ages, doctors thought depression emerged as a symptom after the disease had taken hold. Now, research suggests that the opposite is true—that depression is actually a risk factor that makes you more prone to develop Alzheimer’s in the first place. In short, warding off or treating depression may save you from impending brain disaster.

For example, UCLA researchers found that depressed people with mild memory problems were more likely to end up with Alzheimer’s than nondepressed people. The deeper the depression, the greater the probability.

In a French study, older women with mildly impaired mental agility who were also depressed were twice as likely to progress to Alzheimer’s. Moreover, if you are depressed, you are likely to develop Alzheimer’s at an earlier age, according to new University of Miami findings.

Robert S. Wilson, PhD, a neuropsychologist at the Rush Alzheimer’s Disease Center in Chicago, theorizes that being depressed weakens the brain’s “neural reserve,” its ability to tolerate the pathology that comes with Alzheimer’s. In short, he says, depression changes the brain in distinctive ways that undermine its normal resistance to the disease.

The clear message: If you’re depressed, you are more apt to develop Alzheimer’s, and at an earlier age, especially if you already have age-related memory problems.

What to do? Do not let depression go untreated, especially if you already notice memory problems. Drugs, including antidepressants, and other therapies, such as exercise, can make a difference. UCLA investigators also found that Aricept (donepezil), an Alzheimer’s drug, significantly delayed the progression from mild memory problems to Alzheimer’s in depressed persons.

Find Good Information

The Alzheimer’s Association is a national nonprofit organization with local chapters and a website offering extensive information on the disease. Be sure to check out its excellent interactive tour of the brain, which shows how the brain works and how Alzheimer’s destroys it.  For the brain tour, click on “Alzheimer’s Disease,” then “Brain Tour.” It’s available in several different languages.

The Alzheimer Research Forum is a very lively and well-written website that post comments from both leading authorities on Alzheimer’s and the general public. It reports that the latest research, carries discussions among experts, and gives full exposure to innovate, controversial, and offbeat theories and ideas. It’s the place to go to find out the complete range of what top researchers in the field are thinking and doing.

Excerpted from the book 100 Simple Things You Can Do to Prevent Alzheimer’s and Age-Related Memory Loss by Jean Carper. Copyright © 2010 by Jean Carper. Reprinted with permission of Little, Brown and Company.

Outsmarting Alzheimer’s The Saturday Evening Post

Get out and about. Travel with family and friends to parties and events or invite family and friends to your home. Looking for a fun craft for families with children? Try making a handprint Christmas tree by tracing the hands of each guest on green paper, cutting them out, and gluing them together with fingertips facing down. Add a brown rectangle trunk and decorate.

Volunteer. Helping others is a great mood lifter. Contact schools, shelters, and places of worship for volunteer opportunities in your neighborhood.

Limit the eggnog. Too much alcohol can lower your spirits. Try hot apple or spiced peach cider, or add crushed peppermint to hot chocolate.

Accept and express your feelings. There’s nothing “wrong” with feeling less than jolly. Talk about your feelings to help understand why you feel the way you do.

If an older loved one has the blues or seems depressed:

Lend a hand. Offer help with shopping, transportation, and preparations for get-togethers in their homes.

Be a good listener. Encourage your loved one to talk about how he or she is feeling. Acknowledge “difficult” feelings, including the sense of loss when family or friends die or move away. Suggest lighting a candle or creating an online tribute in honor of the loved one.

Know the signs of depression: Holiday blues are usually mild and temporary. Depression is more serious. Look for sadness that won’t lift; loss of interest or pleasure; changes in appetite, weight, or sleeping habits; frequent crying; feeling restless or tired all the time; feeling worthless, helpless, or guilty; slowed thinking; and thoughts of death or suicide.

Many older people don’t realize when they’re depressed. If you suspect depression, encourage him or her to talk with a health care provider. Depression is a medical illness that can be treated and managed.

Click here for more on depression in older adults from the American Geriatrics Society’s Foundation for Health in Aging.

Beating the Holiday Blues The Saturday Evening Post

My cousin is in her mid-20s and takes Depakote to treat bipolar disorder. She would like to have children, but she is concerned about the effect Depakote would have on her pregnancy. Unfortunately, she is allergic to lithium. Do you know of any research regarding this issue?

Treating Bipolar During Pregnancy The Saturday Evening Post

The picture is entirely different if you compare the 1939 economy to 1932. If you also include the additional 8 or 9 million more people your article mentioned, it becomes more of a compliment than a criticism.

Your article then could, and should read, by 1939 the economy had risen to where it was only one-sixth less than it was in 1928. Roosevelt promised jobs, and from everything I have heard, he delivered. There were an awful lot of people who were glad he was in office.

Herman
Oakfield, Wisconsin

Wrong About Roosevelt The Saturday Evening Post

Dean Ornish, author of several bestsellers—Love and Survival and Reversing Heart Disease—and I walk past the sweets table and play with the fruit. In this magical environment, we both lament that everyone we know could not enjoy the moment we were experiencing. The occasion seemed ideal to ask Dean to expand on a comment he made at a seminar earlier that week as he poetically described his personal battle with depression.

“When you are depressed, for the first time in your life you think you have seen the world with absolute clarity,” said Ornish. “And the reality is painfully depressing. No good can come of this existence, and your personal contribution is worthless. Until then all the times you thought you were happy, you were just deluding yourself.”

Our session highlighted the growing knowledge of the connection of depression with disease. At a first cut, approximately 18 percent of the lost workdays are attributed to depression. But what about more organic ailments that most of us think occur without any involvement from the brain? For example after a heart attack, the second most important predictor of death is depression. Patients who are depressed are more likely to have complications after heart surgery, including infection—perhaps a result of the reduced immunologic function associated with depression. They also get readmitted to the hospital more often and die more frequently after heart surgery.

The converse is also true. Patients who have someone or thing that they love at home survive major illness better than those who do not. This is true even if the loved entity is a pet. They also do better if they belong to an organization that can provide them social support, which is perhaps why churchgoers often seem to survive more often than expected.

Dean reached his lowest point of depression while in college in Texas. All the precipitating factors appeared stacked against him—a lonely dorm room with a brilliant roommate who made him feel inadequate, as well as a high-pressure, pre-med existence in an unfriendly environment far from home. He contemplated suicide by several means and had worked out the details meticulously.

Mental illness afflicts 20 percent of adults and is the largest cause of work loss in the country. As a society we have historically ignored the problem and felt the disease to be a weakness of those suffering. Yet depression is caused by biochemical changes in the mind that are related to genetic as well as environmental factors. And they are responsive to aggressive pharmacologic and environmental treatments.

Numerous herbal remedies have been shown to help patients with mild to moderate depression. More conventional approaches with cognitive-behavioral therapy and selective serotonin reuptake inhibitors (SSRIs), such as Prozac and Zoloft, may also be useful. Dean’s dedicated parents saved his life by rescuing him at school and supporting him through recovery. For Ornish, life changed.

“Depression, like any form of suffering, can be a doorway for transforming our lives for the better,” Ornish says. “I was profoundly depressed in college years ago. Having survived it, I became interested in understanding what caused me to feel that way, and found that the different parts of what became my lifestyle program were enormously helpful in my life. Unfortunately, most physicians are not trained to help people use the experience of suffering as a doorway for change.”

The social stigmata associated with this organic ailment should not stop others from seeking and gaining a full recovery.

Dean Ornish’s Battle With Depression The Saturday Evening Post