No matter how brilliant the person may be, I have never met anyone with depressive illness who could acknowledge and accept their brilliance. Mental illness is an equal opportunity disorder that crosses all races and socioeconomic classes and affects the self esteem of those with the disorder. The ability of the disease to manipulate self doubt leaves many insecure in their talents and abilities. Worries and doubts about being a good parent can limit instinctual maternal abilities. Insecurities about parenting capabilities can be magnified by active symptoms of depressive illness which may also limit the ability to remain consistently emotionally available.

In my opinion, adults who have had the experience of limited and conditional love and attention as children have less self confidence and more insecurity. My message, therefore, is to make it your personal goal to achieve your best emotional stability. If you cannot be emotionally available when ill, plan to find a warm, loving and emotionally available person to help you co-parent. It may be your partner, a grandmother, a neighbor or your best friend. Just find someone who can be readily supportive of your child when your symptoms of illness make you become emotionally unavailable. In this way, you can limit the potential impact of your poor self esteem and avoid repeating the legacy of emotional distance from your child.

I have frequently been accused of making my patients obese. Reports of patients eating almost no calories yet gaining or maintaining weight while on my medications is a daily event. In my defense, clinical practice has required keeping my knowledge of nutrition current since my college days at Cornell. So what has been my observation about weight loss? It appears that emotional eating is alive and well in my practice.

When quizzed, my patients often reveal that they have quirky diets or they eat too much and do not exercise. Consider my favorite question, “What did you have for breakfast yesterday?” Most often I am told that my patient does not believe in eating breakfast or had consumed coffee and a carbohydrate such as a bagel or toasted bread with butter. The bread selection was white, which has minimal nutritional value. Meanwhile, that same patient will complain of a lack of energy. Many of my patients are befuddled by the knowledge that the brain needs nutrition in order to function in the morning. Caffeine alone will not provide the carbohydrates, fats, and proteins required for optimum performance.

So what is the latest information in the weight loss world? The answer seems simple but may be very hard to do: write down the calories you consume during the day. A Kaiser Permanente study published in the American Journal of Preventive Medicine reports that participants who wrote down their daily food intake lost the most weight. Weight Watchers has been aware of this simple well known fact since their inception, requiring members to write down their intake for optimal results.

The Kaiser study included an ethnically diverse racial population of 1,685 people who were designated as obese or overweight at age 25 or older. It discovered that the most powerful predictor of weight loss was how many days per week diary entries were recorded. The author, Stevens, concluded that visualization of food intake allows for accountability and awareness of said intake.

What does this mean for you? Writing down everything you eat in a disciplined fashion requires determination as well as identification of a method that works for you. I have heard that some patients use colorful index cards placed in their pockets. Others have identified online sites for recording on the internet. Still others use pocket composition notebooks found at local office supply stores. Whatever method you use, just use it consistently in order to have the best weight loss success story.


http://www.mypyramidtracer.gov/

Differences in parenting styles can be a major problem. Two individuals with different backgrounds come together to raise a child. The ability to parent gets very complicated when a parent has emotional issues and can't be consistent with their message to their children. In my opinion, that can be a recipe for disaster. Children are smart, period. They quickly figure out how to get their needs and desires met. Problems in parenting occur when both parents can't agree on the messages about the rules for their child.

Limit setting is an area that can be very tricky. One parent may be unable to set limits for a variety of reasons. In my world of psychiatry, if you are depressed, it is very hard to stay consistent with the parenting message. The other parent should agree and not be erratic in supporting the depressed parent in their established kid rules. So when one parent says no but is too overwhelmed to stay consistent, the kid often seeks out the parent who will grant them permission. For example, the kid gets to play on the computer although one parent said no. Later the parent with depressive illness feels better, but the kid learned a lesson about parental differences. Ask parent X for permission when parent Y says no. The child learns from the parenting differences not to listen to the "mean" parent who sets limits.

This Mindsupport message is to settle your parental differences in adult privacy. Kids learn life lessons when both parents agree on the issues.

Motherhood often provides numerous lessons in flexibility, starting with the breast feeding choice. A few years ago, Jennifer Lopez made the cover of People Magazine after the birth of her twins. I appreciated her frankness concerning her decision to opt out of breast feeding. It appears she has bonded with her babies but decided it would be okay not to breast feed. She was quoted in the article as saying, "My mom didn't breast feed and I think that was the thing for me. You read and figure out what is the best for them."

Many of my patients feel that they must breast feed their babies. I have witnessed many patients struggling with their illness, attempting to breast feed, staying up all night, working the next day and not accepting treatment for their illness out of fear of an adverse effect on their baby. These women have great responsibilities as they balance newborns, families, and careers, often without extended families to help them. Yet they feel in order to be a good mother, breast feeding is their only option.

If you want to breast feed and it works for you, great! If not, and bottle feeding your baby is the best option, that's fine too. We have made mothers feel guilty about the bottle feeding choice. I have met many moms as they struggle with both severe emotional illness and trying to breast feed. Their inability to obtain restorative sleep and appropriate treatment magnifies their illness and inability to enjoy the early days of mothehood.

Hearing the message from Jennifer Lopez is gentle reminder that females have the ability to choose whether or not to breast feed.

Love should not hurt. Domestic violence is a real problem. It is not acceptable under any circumstances for your child to witness someone beating you or cursing at you. Kids deserve better childhood memories. If untreated, those children are then at increased risk of repeating the cycle themselves. Their real family dramas can last a lifetime in their child's mind. Kids who experience this negative, violent world can believe they are worthless adults and repeat the same cycle of negative life experiences. In my job as a psychiatrist, I often see patients who are locked in their past with painfully horrible childhood memories. This daily pain can be magnified by untreated emotional illness which allows them to develop a higher tolerance for painful life situations. My favorite example to tell patients is that it takes them longer to tell someone to stop when their bare feet are being stepped on.

So if you are planning to get pregnant and you have painful issues that impact your daily life, get treatment first. Children thrive in loving and nurturing emotional environment.

Personal experience is often required for some individuals to acknowledge a different life path. An old Washington Post newspaper article reported that England's Prince William stepped out of his privileged life one Christmas Eve and fed the homeless at a British youth center. He is quoted as stating, "I can't, after one night, even begin to imagine what it must be like to sleep on the London streets night after night." As a psychiatrist, it is common to hear the struggle for unconditional acceptance of a mental illness.

Why are the symptoms of mental illness so hard to accept? Ignorance about the illness and fear of the unknown quickly come to mind. People ask how mental illness can be in their family. The answer is easy. It is a reality that mental illness is an equal opportunity illness. The disease crosses all levels of social, economic and racial barriers. Could mental illness be a family curse or punishment for a legacy of misdeeds? Despite the scientific data, many still believe mental illness is just bad behavior and poor moral values. A segment of our society assumes that the symptoms of mental illness are just manipulative games played in order to avoid responsibilities.

Our society's limited acceptance of mental illness can pose barriers to individuals developing their necessary support networks. This process of identifying an emotional support system can be painful. The person or groups identified for emotional support should accept your illness unconditionally. Those you can guarantee will trigger your self doubt and insecurities about your emotional well being should probably not a have a number on your cell phone speed dial.

If you had a heart attack and needed a support system, who would you ask for help? This is the same concept of support needed for your brain disease. What is good for your heart is good for your brain!

As a psychiatrist who treats adults, I have repeatedly noted that food habits are tough to change, but not impossible. Starting any plan to change your food relationship requires mood stability. The complexity of food and mood, in my opinion, requires emotional stability for successful negotiation with changing food patterns. If emotions are out of control with life stress, there are too many triggers for mindless eating.

Why is food so tricky? The happy hormone of serotonin, known for its calming effect, can be released by eating carbohydrates. So saying “no” to a quick emotional pick me up requires emotional will power. Also, the tongue can be sensitive to texture as well as content. At times, a desire for a crunch needs to be satisfied. So what does this mean for weight control? Reading the FDA’s nutrition facts label on every package is a good starting place.

First, portion size can be a problem. If you wait until you are starving when you eat, managing your portion size will be more difficult. With starvation status, the brain will signal your body to store fat. In storage mode, your body will hold onto your weight as a secure energy source. An easy way to learn portion size is to start by buying a couple of frozen low fat and low calorie entrees from the supermarket. Eat a couple to determine a portion size and then use the container as a guide for your home prepared meals.

Second, start to read the nutritional label on every food item. Look at the serving size on packaged food. Many times you might assume the package contains one serving when it is actually two. For instance, one bottle of soda may be two servings of food. You have to decide if 300 calories is worth it to you for one drink, especially if your total per meal is 500 calories.

Third, once you have determined your correct portion size, then check your low cost calorie fillers. Watch for food with added sugars such as sucrose, glucose, high fructose corn syrup and maple syrup. These all can provide added calories without nutritional content. Water is always the best thirst quencher, but if you would like something else like fruit juice or soda, be sure to read the label and decide if it is worth the calories. Also, certain salad dressings can add a lot of unnecessary calories when drenched on a salad.

Fourth, be careful of mindless eating. A Kaiser research study highlighted the importance of writing down daily food consumption and how keeping this written record increases the likelihood of sustaining weight loss. The Food and Drug Administration has created an interactive and multimedia website that has a variety of tools for weight management. A meal planner, tip for the day, and podcasts are some of the resources found on www.mypyramid.gov.

Fifth, input equals output. The President’s Council on Physical Fitness, http://www.fitness.gov/, provides guidance and exercise tools for all ages. Additional exercise tools can be found in the following two websites: www.health.gov/paguidelines/adultguide/default.aspy andhttp://www.presidentschallenge.org/. Eating, eating, and more eating without doing any exercise can promote weight gain. I have observed patients who are prescribed my psychiatric medication successfully lose weight. Common stories of weight lost after sustaining the mood stability required to negotiate emotional eating, portion control, sensible food selection, and physical activity is a frequent observation. Therefore there is hope! Patients can lose weight while taking prescribed psychiatric medication often known for weight gain. It appears that a common thread among these weight loss patients is mood stability and a willingness to change their relationship with food. This is America and anything is possible.