Manage Your Moods
By Marnell Jameson
Lately, when I talk about life's ups and downs with friends,
I'm surprised to find how many are on anti-depressants. They
swear by them. Indeed, the TV ads for these medications make
them seem like a miracle drug, which for many they are.
But I wonder, are doctors prescribing and people taking
these mood-lifting pills too readily? Isn't it OK to have a
bad day anymore? I'm not down most days. But some days I am.
Like when I'm behind in my work, I feel stressed. When I
hear news of wars and kidnappings, I feel sad. When my kids
are fighting instead of doing homework, I feel irritable.
When money gets tight, or one of my parents gets sick, I
feel anxious. When it's that time of the month, I feel all
of the above. Is that a problem?
What is a normal mood cycle, anyway? What triggers bad moods
and, most important, how can we manage moods -- short of
medication -- so they don't manage us?
What's Normal?
My questions
lead me to some of the nation's leading mood experts. First
I discover there's no such thing as normal. We all come into
the world with a set point for mood that we inherit, says
Martin Seligman, Ph.D., a clinical psychologist at the
University of Pennsylvania and founder of the Positive
Psychology movement, which studies what makes people
mentally healthy as opposed to mentally ill.
Much like our weight
set point, Seligman believes our mood set point means that
while our moods will go up and down, they'll stay within a
set range. Even happy people's moods go up and down all d ay.
Though our genes mostly dictate whether we're generally
sunny or sullen, external factors also play a huge role in
whether we feel more blue than pink. Stress, travel, poor
sleep, medications, light, hormones, pain, illness, caffeine
and alcohol are all common mood disrupters. Any one of those
can cause chemical messengers, or neurotransmitters, to be
released in the brain, which can affect people differently
depending on their genes, says psychiatrist John F. Greden,
M.D., chairman of the department of psychiatry and executive
director of the Depression Center at the University of
Michigan in Ann Arbor.
Thus, depending on your brain chemistry, you could buoyantly
shoulder a load of stress, or crumble at the smallest
mishap.
Individual brain chemistry also makes certain people
more susceptible to bouts of depression. In certain
cases, the best relief does indeed come from
antidepressants, most often the much-advertised SSRIs
(selective seratonin reuptake inhibitors) sold under names
like Paxil, Prozac and Zoloft.
"For some people it simply rights the ship," says Greden.
"For others it may be life saving."
However, they're not for
everyone. According to a study reported in the New England
Journal of Medicine in 2000, SSRIs didn't help one-third of
those people suffering mild to moderate depression, and
weren't effective for half of those suffering chronic
depression.
Furthermore, the side effects can include loss of sex drive,
weight gain, insomnia and headaches. So before you fill a
prescription, you might first consider other ways to get a
handle on moodiness, especially if it's mild.
Get a Handle on
Hormones
All through
their life cycle, women have points when they're more
vulnerable to low moods, says Nanette Santoro, M.D.,
professor and director of reproductive medicine and
endocrinology at Albert Einstein College of Medicine and
Montefiore Medical Center in New York City.
Reaching menarche, having a baby, the changes of middle age,
menopause -- all these come with hormonal changes that can
play havoc with disposition. Most women who feel their mood
plummet for no obvious reason know to look at the calendar.
Shifting hormones cause most women to experience some
moodiness around their menstrual cycle. Usually women
experience the physical symptoms of PMS first: malaise,
headache, fatigue and breast tenderness. The emotional
fallout comes a day or two later, says Jean Endicott, Ph.D.,
a professor of clinical psychology at Columbia University
Medical School in New York City.
"In terms of a woman's monthly cycle, considering the first
day of the woman's period Day 1, the best days of the month
are Days 6 through 10," she says. "That's when most women
can count on feeling their best."
Take advantage of those days, and plan for the worst ones,
usually days 21 through 28. While most women can tolerate
their PMS symptoms, 3 percent of women have what doctors
call PMDD (Premenstrual Dysphoric Disorder), which is like
PMS squared.
"These women experience severe mood and behavior swings
before their period. They have great difficulty functioning
at work and getting along with their family," says Endicott,
a specialist in treating the disorder. "They come to dread
those days." SSRIs often work well in the treatment of PMDD,
she says.
Moods can get a little worse during the peri-menopausal
years, which on average hits American women between the ages
of 47 and 51. But here's the good news: After menopause,
women get a "post-menopausal zest," says Santoro. On the
whole, post-menopausal women have better mental health than
men of all ages and younger women. "It's the opposite of
what most people think."
Know Your Triggers
Hormones, however, are a small part of the picture, notes
Stephanie Ross, Ph.D., clinical psychologist and assistant
clinical professor at Northwestern University Feinberg
School of Medicine and co-director of Women's Mental Health
at Evanston Northwestern Healthcare in Illinois.
"Men suffer from low mood, too," she says. "So you need to
consider other factors like medication, age, underlying
emotional problems and stresses. Moods are a mix of biology
and every day life."
Greden agrees. "People don't do enough to link mood to their
environment. People need to look at their lives and ask,
'How do the things I do affect and change the way I feel?'
To really learn to manage your moods, he says, you need to
be your own scientists.
Start by looking at your family, because you'll have some of
those genetic tendencies. Ask close blood relatives what
makes them feel up or down. Then document what sets off a
bad mood in you.
Endicott tells patients with mood disorders to chart their
moods in a journal. List the two or three most troubling
symptoms: Low energy, irritability, tension, teariness,
whatever. Then rank on a scale of 1 to 5 how each was that
day. Note what day of your cycle it is, how much alcohol or
coffee you consumed, whether you exercised, how you slept,
and any medication you took.
After a couple months, you'll start to see a pattern. "For
many the awareness is all they need," she says. "Once you
can pin down when your low spells are coming and why, you
feel more in control, and the moods don't take you by
storm." During times you know will be difficult, get more
exercise, decrease your caffeine consumption, get more rest,
and don't schedule that big presentation for work, or your
daughter's slumber party.
Marnell Jameson is a free-lance writer who frequently
writes about health issues. She lives in Southern
California.
(c) 2003, Marnell Jameson. Distributed by Tribune Media
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