Lifestyle

The happiness enigma

A patient recently came into my practice and pleaded: “I just want to be happy.” I was touched. Afterall, who doesn’t want to be happy? It was such a seemingly small and reasonable request. I felt that I was letting her down by saying that I could not guarantee happiness. That happiness is a state of wellbeing that encompasses living a good life and has to be self-generated. As a psychiatrist, I could help her with her thieves of happiness. Those forces which thwart her attempts to be happy. In this patient, it was the unholy triad of depression, poor boundaries…

Greenspaces: Our brains’ call to the wild

I love it when evidence comes out to support my favourite theories. Patients in my practice often discuss the healing nature of nature. Of how the curved lines and gentle sounds are the perfect antidotes to our jagged plugged-in modern day lives. The poets and writers have always known it. John Burroughs wrote: “I go to nature to be soothed and healed, and to have my senses put in order.” Over the last few years, science has concurred that the healing power of nature is more than just whimsy. Architects and city planners are taking heed, with thought going into…

Inflammation: the brain on fire

A patient came in very upset. She was suffering from headaches and joint pains. She had been to various physicians and had several tests done. She was told that her pain was due to her mood disorder. She felt that she wasn’t being taken seriously, that her doctors wrote it off as “all in her head”. The reality is that mental illnesses can make you physically ill, and physical illnesses can trigger a psychiatric illness. The common pathway is inflammation Inflammation is your body’s response to insult and injury. It is normal and necessary. It’s when a part of your…

Facts on Fasting

Somewhere along the line, we got the message that three meals a day plus snacks is the healthiest. That if we let ourselves get hungry we risk binging to catch up on – and then overshoot – our daily calorie requirements. We know that breakfast is the most important meal of the day and we must not skip it under any circumstance. The idea behind breakfast is that we are hypoglycemic in the mornings, so need breakfast to get our metabolisms going. It seems that we have to once again change how we think about food. Current evidence supports the…

The Exercise Prescription

We all know that we need to get more exercise. In today’s technologically driven world we sit too much and move too little. Being a working mom, I am well aware of how I am always rushing around, but not physically moving very much. It is hard to find the time (and inclination) to exercise with dedication. Doctors have been telling their patients to exercise more since  Hippocrates said: “walking is man’s best medicine”.  A medical prescription is very clear as to the dosage, duration and frequency that is needed. The recommendations on how much and how often to exercise…

The spirit of community

Simon and Garfunkel sang “I am a rock, I am an island” in the 60’s. Concepts like autonomy, self-reliance, winning and individuation have all been useful in carrying mankind forward. “Tall poppies” are no longer cut down, but celebrated. You no longer have to feel bad for being ambitious beyond your circumstance, or for putting yourself first. The pendulum might have swung out a bit far; there has been a cost to this kind of mindset. Loneliness and isolation are on the rise. In a US survey, the number of adults with zero confidants has tripled since the 80’s. Adults, especially…

Going straight for the gut

I am taking a break over the holidays. For the next four weeks, I will be republishing a few of my favourite blogs. We have always known that our mood affects our guts. My anxious patients complain of diarrhoea and my depressed patients of constipation. I could never have imagined how much of a role the gut microbiota plays in communicating with the brain and modulating behavior. I never took “gut feeling” literally! Our gut, the small intestine and the large intestine, is filled with over a kilogram of bacteria, the gut microbiota. That’s almost the weight of an average…

Let’s talk about food

I am taking a break over the holidays. For the next four weeks I will be republishing a few of my favourite blogs. In continuing with thoughts about selfcare, I would like to talk about food. I hosted a dinner party the other night and there was a vegetarian, someone who was Banting-it and a gluten intolerant guest. We generally agreed that Trump was a disaster, wailed about corruption in SA politics and lamented the drought. But when we got to food, the opinions clashed and arguments got heated. I bet that Mrs Cavewoman host did not have these problems.…

The torture of sleep deprivation

A couple came to see me as the last stop before initiating divorce proceedings. Since the birth of their son 18 months before, their home had deteriorated into a war zone. Their baby had colic and was a particularly bad sleeper. Typically, the baby would squawk, and mom would jump up to try to settle him before he woke properly. Inevitably, he did wake and then stayed awake for hours. Mom would become tearful and desperate. Knowing this, dad would also jump up when baby stirred because he wanted to support mom. Both parents were exhausted. Mom was in a…

Why can’t I shake this recurrent depression?

By the time patients come to me for the treatment of their depression, they have often been sick for some time. When we go into the history of the illness, it becomes clear that most have been depressed before.  If you have had two episodes, more than likely, you will have a third one. If you have had three episodes, there’s a 90 percent chance you will have a 4th. It seems that a single episode of depression is more the exception than the rule. The greatest predictor of a relapse of depression is stopping antidepressant treatment. More and more evidence…

Navigate