A short essay on not taking anything for granted and counting our blessings on Thanksgiving and every day.

"The world's most unsatisfied hunger is the hunger for appreciation."

- Mary Crisorio

Life Letters

Last weekend, while visiting with my sister and her children, my seven-year old nephew, Mikey, informed me that he was building a bomb shelter to save his toys when the end of the world comes on New Years Day. I asked him why he thought the world would end on New Years Day, and he told me that he'd heard about it at school from his friends.

"Grown ups don't tell us kids stuff like that, they try and keep it a secret," he informed me matter-of-factly. I confessed that while I might have been guilty of keeping a few secretes of my own from him, I promised that I knew nothing about the world coming to an end at any point in the near future, and that I wondered if his friends might have been misinformed. He gazed at me sympathetically for a few moments, and then told me that he didn't want to make me sad, but it was true.

I responded that there were a number of rumors spawned by Y2K that I didn't believe for a moment, and that there were a whole lot of scientists who didn't believe them either. Mikey was generally impressed with the opinions of scientists, as he planned on being one when he grew up. I was counting on his faith in them to give me some leverage, but Mikey wasn't buying.

"Well, auntie, I think the President told them to keep this a secret," he replied apologetically, apparently hating to disillusion me.

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I continued to attempt to persuade him that while there might be some minor inconveniences at the beginning of the New Year, we were perfectly safe. While he eventually made significant concessions, it was clear that I hadn't completely convinced him. Finally, he suggested that while the kids at school could have gotten it wrong, we might want to do our best to make this coming Thanksgiving "extra special," since it might very well be our last.

Later, the same night, while my daughter and I were preparing to make a Thanksgiving tape for my grandmother, I asked if she'd heard at school that the world would be ending soon. She told me that she'd heard a little about it but didn't believe it would happen. I breathed a sigh of relief, but then she added, "people just seem to keep getting worse mom." I asked her what she meant, and she wouldn't (or couldn't) answer, no matter how I rephrased my questions. Once again, all of my years of training to be a psychotherapist were rendered useless in the face of a child's silence.

As the last Thanksgiving of the century approaches, and plans are made all over the world to commemorate the dawning of the new millennium, we're confronted with at least as many gloom and doom stories it seems, as we are offered reasons to experience a genuine sense of optimism, gratitude and celebration. I'm painfully aware that there are a number of economic, social, and environmental challenges that we confront today that appear to only grow more daunting, and on a bad day, I'm willing to admit that the future looks pretty grim.

So many of us reminisce about the good old days, a time when we had no conception of aids, the war on drugs, nuclear bombs, school shootings, managed care, dead beat dads, day-care scandals, holes in the ozone, and acid rain. Those days when the pace was slower, families stayed together, foods weren't poisoned with pesticides, and people communed on front porches or around kitchen tables, instead of sitting silently in front of television sets, have come to represent our lost golden years to so many Americans.

The Greek philosopher, Epicurus, once advised that we shouldn't diminish what we have by longing for what we don't have, but instead we need to recognize that so much that we now take for granted were once among the things we only hoped for.

Not so long ago Aids was unheard of, and yet it was entirely possible for entire communities to be wiped out by smallpox or the measles. There was a time that parents never even imagined that while their children were in school, some crazy kid might walk into their classroom and start shooting. Instead, in the not so distant past, funerals for toddlers and mothers who never left their birthing beds alive were all too commonplace. Back then, parents didn't need to concern themselves with the massive amounts of junk food consumed by their offspring, and weren't engaged in a daily and often futile struggle to get their children to eat their vegetables. But, these were also the days when if the crops should happen to fail, entire communities were confronted with starvation.

And while families for the most part stayed together, a three-hour road trip today to visit friends and relatives would have been a three-day and often arduous journey rarely undertaken in the early years of the last century.

Yes, it's true that our ancestors seldom if ever considered divorce as an option when those small and inevitable disagreements evolved into bitter battles. Still, I suspect that "till death do us part," meant something entirely different to a generation whose life expectancy didn't come close to approaching the ancient age of seventy. And the rising cost of health care wasn't much of a concern to a world where emergency rooms, neighborhood health clinics, immunizations, CAT scans, burn units, and blood tests hadn't even been conceived of.

As I begin to prepare for the last Thanksgiving that I'm likely to speak with a grandmother who now lies in bed on a hospice unit, I'm trying very hard to count my blessings. And while I attempt to stay focused on them, I still find my vision obstructed every now and then by anticipatory tears of grief. I'm grieving for a woman who enchanted me with stories as she gently braided my hair, who played cards with me for hours while teaching me some of the finer points of winning and losing, who took me on wonderful and even sometimes outrageous adventures, and who offered up a seemingly endless supply of time and love for me.

Abraham Herscel wrote, "we teach our children how to measure, how to weigh. We fail to teach them how to revere, how to sense wonder and awe." As I approach this last Thanksgiving of the century with more than a little ambivalence, there are so many gifts that continue to delight and sometimes even astound me. And I want to do my best to inspire the children in my life to celebrate the magic and mystery of our troubled but still beautiful world.

Albert Einstein wrote, "There are two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle." On the one hand, I'm a born skeptic, and on the other, I'm an absolute believer in miracles, how can I not be, when miracles can be found everywhere I look, if I'm only willing to see them?

This weekend, if Mikey still insists on building his bomb shelter, I'll help him. And then I'm going to ask him if he'll assist me in making plans for next year, an event that the United Nations has proclaimed as the "International Year of Thanksgiving." I'm thinking that we might want to start by making a list of everything we're grateful for, and I have a feeling, knowing Mikey, that our list will contain a whole lot of miracles.

next: Life Letters: Honoring Both Traditions and New Beginnings

A short essay on the importance of family rituals in the lives of children and adults.

Life Letters

Rituals are as old as the earliest civilization. They can mark occasions by utilizing a special event to represent a far grander scheme, help to create meaning, and foster lasting memories. They can solidify, celebrate, commemorate, validate, and comfort.

For the past several years, my husband and I have joined friends and family around a magnificent campfire to acknowledge the close of the old year and the beginning of the new. It's always a festive affair complete with feasting, music, laughter and celebration. While this has been a family tradition for some time now, there have been other, quieter rituals that I have engaged in during the month of January which have offered important chances to reflect upon lessons learned during the previous year and to contemplate and prepare for the opportunities ahead.

One weekend in January, my husband, daughter and I followed Susannah Seton's advice in "Simple Pleasures for the Holidays: A Treasury of Stories and Suggestions for Creating Meaningful Celebrations." We had a special dinner, made a fire and gathered pillows around the fireplace, lit a candle, turned out the lights, and took turns talking about the past year - our favorite memories, challenges, humorous moments and lessons we'd learned. Next, we each wrote down something that we wanted to let go of and watched our papers disappear among the flames in the fireplace. Finally, we blew out our candle and camped out in the living room.

On another winter afternoon, I joined a small group of women to create what Barbara Biziou in "The Joy of Ritual" calls a vision collage. First we filled the room with beautiful music and gathered together magazines, poster board, scissors and glue. Next, we each asked ourselves silently, "what brings me joy?" and then began thumbing through the magazines, pausing to cut out anything that we saw that we wanted to manifest more of during the coming year. Once we each had a sizeable stack of pictures and word phrases, we arranged and pasted them on poster boards to serve as reminders during the year of what we valued most. The afternoon concluded with a wisdom circle followed by a potluck. It was a very special experience, and I still treasure the collage that I made that day.

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From the time my daughter was a small child, until she was sixteen, we made baked goods and chocolates together for friends and neighbors during the Holidays. Tucking her into bed used to involve a rather lengthy and specific ritual; there was a story, a witch chasing ceremony, a little back rub, and always a glass of apple juice placed at her beside in the event that she got thirsty in the night. A Syracuse University study published in the American Psychological Association's Journal of Family Psychology found that family rituals are associated with marital satisfaction, children's health, academic achievement, a sense of personal identity in adolescence, and closer family bonds. In this uncertain and unpredictable world, children need rituals to help them feel safe, contained, and cared for. They don't have to be complicated, and yet those few moments we invest may provide our children with gifts to carry with them for a lifetime.

next:Life Letters: Home Words

• About Change
• About Shame
• Analyzing Your Dreams
• Boundaries
• Can You Make Someone Change?
• Clear Communication: #1
• Clear Communication: #2
• Clients and Success in Therapy
• Couples: Passive & Controlling Partners
• Depression: The Problem
  
• Depression: What To Do About It
• False Memories and Responsibility
• Fantasy And Reality: #1
• Fantasy And Reality: #2
• Finding Purpose
• Growing Up Emotionally
• Healing From Sexual Abuse: A Strategy
• How Much Change Is Possible?
• How To Have A Lousy Sex Life
• How To Talk About Feelings
• Life's Craziest Beliefs
• Mistakes Every Good Parent Makes
• Motivation
• Natural Anger
• Perfectionism
• Powerful Ideas: #1
• Problem Solving #1: Roadblocks
• Problem Solving #2: Defining The Problem
• Problem Solving #3: The Six Aspects of The Problem (#1)
• Problem Solving #4: The Six Aspects of The Problem (#2)
• Problems With Anger
• Quitting Addictions
• Self Love
• Self-help Quiz #1
• Self-help Quiz #2

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• Sexual Abuse In Childhood
• Shame: What You Can Do About It
• Should We Blame Our Parents?
• Stages of Therapy
• Stop Making Comparisons!
• Subconscious Life Scripts
• Success
• Teenagers
• Were You Loved As A Child?
• What Is A Therapist's Job?
• What To Tell A Therapist
• Who Is A Therapist?
• Why Are You Treated The Way You Are?
• Why Do We Work So Hard?

next: Self-help Quiz #1

Chapter 12 of the book Self-Help Stuff That Works

by Adam Khan

WHAT'S THE FIRST THING you do when you get a flat tire or when you burn your dinner or when one of your kids gets an F? When something goes wrong, you say something - to yourself or to someone else. If you're upset, you think or say emotionally loaded expressions, and those expressions intensify your upsetting feelings.

When you find yourself thinking or saying a thought like "This is terrible," you can change it to a less emotional description - for example, "This is inconvenient." Notice how different the two statements are, emotionally speaking. Try saying each statement to yourself and check how different they feel.

It seems like a simple change to make, and it is. But it can change a setback from a catastrophe to just annoying, at least in your experience.

The emotionally loaded comment doesn't help you. It may even hinder you from dealing with the situation rationally. The emotionally neutral statement "This is inconvenient," leads to an emotionally neutral response - in other words, a reasonable, practical response.

Try to become emotionally neutral when an emotionally charged response is counterproductive. Notice what you're thinking and try to make the same comment as a bland, computerlike description of the situation rather than a comment charged with emotion.

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NEUTRALIZE THE NEGATIVE. It's a simple technique, but with practice it can level out some of the downturns in this roller-coaster ride we call life without in any way interfering with the upturns.

Describe upsetting situations to yourself in emotionally neutral words.

Self-Help Stuff That Works makes an excellent gift. It is a classy hardbound with a sewn binding. You can now order it from any of twelve online bookstores. These are the most popular:

• http://www.amazon.com

• http://www.barnesandnoble.com

• http://www.borders.com

You can give other people good advice, and it really is good. If they would heed your advice, they would be better off. Find out how to benefit from your own advice.
A Wiser Adviser

If worry is a problem for you, or even if you would like to simply worry less even though you don't worry that much, you might like to read this:
The Ocelot Blues

Learn how to prevent yourself from falling into the common traps we are all prone to because of the structure of the human brain:
Thoughtical Illusions

next: Stress Control

Chapter 19 of the book Self-Help Stuff That Works

by Adam Khan

THE ATTITUDE OF TAOISM and the Buddhist concept of nonattachment and the basic principle of cognitive therapy can be reduced to a single technique that creates calm, contentment, and peace of mind. The technique is to let go of an idea you're clinging to. Remind yourself it is only an idea and stop clinging to it as if the idea were meaningful and weighty.

For example, Judy is a thirty-eight-year-old woman who lives in the same town as her alcoholic mother. Judy was upset about this. It bothered her that her mother drank so much every day. One day she discovered the prime source of her stress: The idea that it was her duty to save her mom.

So she gave up the idea. It was just an idea, after all, it was not The Law. And the idea caused her needless suffering. So every time she felt upset because of her mother's drinking, she said to herself: The only one who can stop Mom's drinking is Mom. She became happier, more relaxed, and probably healthier.

She let go of a fixed notion that she should save her mom. Giving up an attachment to an idea is known by Buddhists and Taoists as nonattachment. It is known by cognitive therapists as arguing against statements. And in Rational-Emotive Therapy, they call it giving up musturbation. Clinging to an idea is the source of the bulk of human suffering.

Here's the technique:

You will relax and feel happier every time you let go of an idea that has been causing you unnecessary stress.

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Let go of an idea that causes you needless stress.

Why aren't we more positive naturally? Why does it seems our minds and the minds of those around us gravitate toward the negative? It's not anyone's fault. It is merely the product of our evolution. Read about how it came about and what you can do to improve your general positivity:
Unnatural Acts

Would you like to learn more about the fine art of positive thinking? Would you like to behold the power of positive thinking? How about the power of anti-negative thinking? Check this out:
Positive Thinking: The Next Generation

How can you take the insights from cognitive science and make your life have less negative emotion in it? Here's another article on the same subject but with a different angle:
Argue With Yourself and Win

next: Pillar of Strength

Self-Therapy For People Who ENJOY Learning About Themselves

• Should We Blame Our Parents?
• Discipline
• Mistakes Every Good Parent Makes
• Teenagers

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next: Should We Blame Our Parents?

A thorough discussion of alternative treatments for depression and bipolar disorder including lifestyle changes, EMDR, neurofeedback, and amino acid supplements.

Over the past 50 years, psychiatric drugs have become the major tools for treating mental illness. The first tranquilizers, introduced in 1952, have been followed nearly every decade since by a new class of drugs, the latest being antidepressants. While drugs were a godsend compared to the standard (and now seemingly barbaric) therapies of the 1930s—induced insulin coma, electroshock, and lobotomy—their shortcomings and dangers have become increasingly clear.

Fifty percent of depressed and bipolar patients experience no improvement with antidepressants. Of those who find relief, half go off their "meds" because of the unbearable side effects: Psychiatric drugs often cause a 30- to 60-pound weight gain, 58 percent report some level of sexual dysfunction, 40 percent develop tics or muscle spasms from major tranquilizers, and significant numbers report increased agitation, depression, mania, or suicidal urges. Other unadvertised, potential dangers include increased risk of non-Hodgkin's lymphoma, invasive ovarian cancer, and lung and bladder cancers; doubled risk of heart attack; elevated risk for developing Type 2 diabetes; and, in children, increased mania, suicide, and stunted or delayed growth.

And yet in the face of this prescription onslaught, mounting evidence indicates that depression, bipolar, and other mood disorders are caused by a combination of genetic, environmental, and lifestyle factors. While there's not much anyone can do to alter the genes they've inherited, holistic approaches to the other two factors can lead to safer ways of managing these conditions.

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Rule out Underlying Causes

Finding relief from the symptoms associated with mood disorders is a process that starts with addressing various physical issues. The biggest step many of us can take toward mental health involves getting our bodies into the best shape possible. This requires skilled sleuthing by the patient and experienced practitioners. The goal? To identify and eliminate common underlying causes of mental illness, such as environmental toxins, medications, diseases, low or imbalanced hormones, food allergies, parasites, and candida yeast.

• Get a complete physical, and ask your healthcare provider to review all your prescriptions and any illnesses you may have for mood disorder side effects. Order some or all of the tests below, using the knowledge of your history and symptoms to gauge which of them will most likely identify potential culprits.
• Make sure you're taking the basics. These include high potency vitamin, mineral, and amino acid supplements (see below) and fish oils to ensure the brain has adequate supplies of the raw materials it needs to function properly and override genetic errors or digestive flaws.
• Avoid unhealthy foods and lifestyle choices. Start by eliminating the "bad" fats. Fried foods, hydrogenated oils, and trans fats clog up the body's intricate systems and contribute to systemic inflammation. Replace these bad actors with the "good" fats required for health, such as fish, olive, vegetable, nut, and seed oils.
• Cut out any and all substances that affect your mind. This may sound like a no-brainer, but stop using street drugs, alcohol, and tobacco, and either cut way back or eliminate caffeine, refined sugar, chocolate, artificial sweeteners, and monosodium glutamate.

Some mood disorders, those triggered by emotional trauma or produced by abnormal brain-wave patterns, remain immune to biological remedies. However, two nondrug therapies, Eye Movement Desensitization & Reprocessing (EMDR) and neurofeedback have shown remarkable rates of success.

The Eyes Have It

Traumatic experiences, such as rape, sexual or physical abuse, war experiences, or being the victim of a violent crime or terrifying accident may cause post-traumatic stress disorder (PTSD). Symptoms may include depression, anxiety attacks, rage or aggressive behavior, suicidal tendencies, substance abuse, terrifying nightmares, and visual flashbacks in which the person re-experiences some of the emotions and sensations from the original trauma.

Francine Shapiro, PhD, a senior research fellow at the Mental Research Institute in Palo Alto, California, developed EMDR after she noticed her own stress reactions diminish when her eyes swept back and forth while walking through a park. During treatment, a therapist asks patients to identify a vivid visual image related to the incident, along with related emotions and body sensations. While focusing on the image, negative thoughts, or sensations, patients simultaneously move their eyes back and forth, following the therapist's fingers across their field of vision, for 20 to 30 seconds.

Patients are next told to "let their mind go," observing whatever thought, feeling, image, memory, or sensation surfaces. The therapist helps them "process the association"—and deal with any distress the images may cause—before moving on to the next focus. The primary objective is to "reprogram" the emotional brain so it stops continuing to react based on past experiences.

In 2002, The Journal of Clinical Psychology reported that 70 percent of EMDR participants achieved results in three active treatment sessions. It is one of four therapies given the highest recommendation by the US Department of Veterans Affairs guidelines for PTSD.

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Retraining Brain Waves

D. Corydon Hammond, PhD, professor and psychologist at the University of Utah School of Medicine, says neuroscientists have discovered a brain-wave pattern that identifies people with a "biological predisposition for developing depression." An excess of slow alpha brain-wave activity in the left frontal area of the brain signals this predisposition. According to Hammond, research has found that antidepressants have only an 18 percent effect over and above a placebo and appear "to still leave intact the biological predisposition for becoming more easily depressed." By retraining the brain, it is possible to produce an enduring change.

Using electroencephalograms (EEGs) to measure brain-wave activity, neurofeedback teaches patients how to alter the flow of electrical impulses in their brains. The patient sits in front of a computer screen that's connected to a very small EEG recorder, which registers brain-wave patterns via electrodes pasted to the patient's scalp. The therapist uses computer readings to assess "normal" or "abnormal" levels of brain waves at any frequency and sets up a program that rewards desirable frequencies and discourages damaging ones with sounds and visuals.

Learning to control the mind and giving the body a clean bill of health can help people with mood disorders avoid an often life-long reliance on psychiatric drugs—and save them from the damage those pharmaceutical can wreak havoc on mind and body alike.

Amino Acid Supplements

Check with your practitioner (or therapist) about taking the following between meals (without food):

• Tryptophan (sold as 5-Http), 50 to 150 mg for depression, stress, and to curb carbohydrate cravings.
• Tyrosine or Phenylalanine (or a combo, since tyrosine is made from phenylalanine), 500 mg two or three times a day (too much can trigger mania) to lift depression, aid in stress management, promote memory, and suppress appetite.
• GABA, 500 mg as needed to calm down or for sleep (sometimes blended with taurine and glycine for calming).
• Glutamine, 1,000 mg three times a day to make more GABA and to promote intelligence or memory while healing leaky gut and reducing alcohol or sugar cravings.
• Methionine, 500 mg twice a day to lower blood histamine, which, when elevated, contributes to mania and anxiety.

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• Cysteine and cystine, methionine, and glutamic acid, all of which are sulfur-containing amino acids that aid in detoxification.
• Taurine, methionine, and glutamine to improve fat digestion and absorption of fat-soluble vitamins.
• Balanced amino acids. If you are a vegan, vegetarian, or do not like or digest protein well, try taking a balanced amino acid formulation.

Making Mental Waves

The four types of brain waves linked to mood disorders—beta, SMR (sensorimotor rhythm), alpha, and theta—correspond to different problems and conditions.

1. Beta waves (15-18 Hz) occur when fully awake, with eyes open and our concentration fixed on something. Considered a measure of arousal, higher frequencies (21-30 Hz) indicate anxiety and obsessions. Therapists often reward beta-wave activity to relieve depression or to improve concentration in individuals with ADHD.

2. SMR waves (12-15 Hz) indicate calm attention with physical inactivity. Hyperactive children learn to calm down by increasing their ability to generate SMR waves.

3. Alpha waves (8-12 Hz), when recorded with eyes closed, are an indicator of relaxed wakefulness and meditative states. Excessive alpha activity on the left side of the brain may indicate depression. Treatment focuses on reducing left frontal alpha wave activity while increasing left frontal beta wave activity.

4. Theta waves (4-7 Hz) are associated with light, healthy sleep. Although the normal adult produces no theta rhythm while awake, these frequencies are important in infancy, childhood, and young adults, and they indicate pleasure. Children with concentration problems often have excessive theta activity in the front of their brains. They appear awake in class, trying to concentrate, but their brain is literally half-asleep. Neurofeedback corrects this by teaching the child how to reduce theta waves.

Emotional Transformation Therapy (ETT) is a new accelerated form of psychotherapy developed by Steven Vazquez, PhD, a practicing therapist for 25 years. It combines the use of colored lights, eye movement and stimulation, and brain-wave entrainment with psychotherapy for rapid relief of depression, anxiety, PTSD, and physical pain. Relatively new, the best source of information on ETT is www.lightworkassociates.com.

About the author: Gracelyn Guyol is the author of Healing Depression & Bipolar Disorder Without Drugs. The book features Gracelyn's own story and those of thirteen other people around the country who have cured their depression and bipolar disorder using only natural therapies. In-depth research and the expertise of alternative health-care professionals are included in this landmark guide for patients and caregivers seeking responsible, safe alternatives to psychiatric drugs.

Source: Alternative Medicine

back to: Complimentary and Alternative Medicine

Recommendations for self-care during the holidays.

Life Letters

It's no secret that the holidays can be a particularly challenging time for many of us. Both the time honored traditions, and the more superficial trappings of the season that bring joy to many Americans, are often painful reminders to those of us who are hurting of what we have lost or never found. During a particularly difficult period in my own life as I attempted to make it through holidays that offered me no comfort, no joy, and no sense of celebration, I struggled to find some sense of meaning that might sustain me. How could I appreciate the Christmas trees, music, parties, and countless other signs of Christmas that both surrounded and seemed to mock me? In an attempt to muster the energy to at least pretend that I wasn't resenting it all, I decided to focus on the deeper meanings of these rituals and to explore how they might serve to nurture my wounded spirit.

In an article entitled, "The Meaning of Christmas: Look Deeper," Peter Kreeft points out that the shepherds at the Nativity scene represent the peasant soul in each of us - the long silenced child who heard Santa on the rooftop, left carrots for the reindeers, and who believed in magic and mystery and awe. This soul, like the shepherd guarding his sheep, stays awake in the darkness faithfully keeping watch over our bodies, and witnesses our untold stories and our secret dreams.

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The shepherds remind us each year to honor our souls and to pause and ask ourselves the following question during the frenetic holy days, "what is it that my soul needs?"

The Wise Men, suggests Kreeft, represents the wisdom that exists within each of us; that part of our selves that searches and leaves behind the comfort and security of the known in order to find our own answers - our own 'Bethlehem'. The wise men, without a map, and with no guarantees that they would reach their destination, bravely traveled onward, fueled by their hope and their faith.

As you prepare for the holidays, you may want to ask yourself what it is that you have faith in, what might assist you in getting through the difficult periods of the season? What are your hopes and expectations for this time of year? Are they realistic? Are they based on your own personal needs or on the desires of others? Which holiday activities are likely to be particularly stressful for you? Which of these are actually optional rather than truly necessary? What might you simply say "no" to if you gave yourself permission?

Mistletoe, which lacks roots of its own and lives off the tree it attaches itself to, was thought to be magical by ancient Europeans and a symbol of peace to the Druids and Romans. It has been written that when battling soldiers found themselves under the mistletoe, they immediately laid down their arms and declared peace for the day.

When the stresses of the season threaten to overwhelm us, it can be helpful to allow the mistletoe to remind us of our need to reground and center ourselves. What offers you a sense of calm? What can you hold onto? Is there an issue that you are currently struggling with that you can let go of for the time being, an unnecessary battle you are waging that you can choose to walk away from for the time being and lay down your arms? If you have learned such practices as deep breathing, progressive relaxation, mindfulness, and meditation, now is the time to use them. If you haven't yet acquired these important skills, now is a good time to explore them.

Because they stayed green and alive when other trees appeared to be dead and bare, evergreen trees have been a part of mid-winter festivals for thousands of years, symbolizing immortality, resiliency and rebirth.

The Pine trees that we bring into our homes during the holidays have held fast, remained rooted, and reached towards the heavens even as they confronted the harsh winds, long nights, and bitter cold of winter. Their strength in the face of adversity can be a faithful reminder to those of us who have both been both broken and yet gained strength as we've attempted to cope with our suffering to stand tall and hold on to all that is essential within us, just as the sacred pine has held on. What strengths do you possess that you can share with those around you during the holidays?

Throughout the centuries candles have offered both light and heat during the frigid days of winter. It's been said that the tradition of placing candles in windows during the Christmas season originated in Victorian England where candle lit windows were a sign to passersby that they would be welcomed in and offered shelter during the holidays. The candle represents our humanness and our mortal bodies; while the candle's flame symbolizes our spiritual nature, our life force, and the light we shine out into the world.

How might you utilize your creativity and sensitivity during this time of year, how might you shine your own unique light into the world?

We are surrounded by two primary colors at Christmas, red and green. Red has been associated with anger, danger, and the blood of our wounds. At the same time, it has come to represent royalty, passion, fire, creativity, and love. Green signifies growth, wealth, fertility, nature, good luck, youth, and hope. And yet, green has also been linked with sickness, envy, inexperience, decay, and death.

As we are greeted with the colors of the season, we are reminded of the complexities of our nature and the inevitable mix of good and bad, health and sickness, gains and loss, the darkness and light that make up each and every life. The colors of Christmas have also come to represent to me how each of our lives is a work of art and that we are the artists ultimately charged with creating our own masterpieces. What might you consider beginning to add right now to the canvas of your life?

Aldous Huxley wrote, "After silence, that which comes closest to expressing the inexpressible is music." The holidays are filled with music and while certain Christmas carols may stir up painful memories, others can serve to nourish our souls. When I'm feeling tired and need to get energized, listening to songs such as "Rudolph the Red Nosed Reindeer" and "The Ten Days of Christmas" often inspires me to get active. On the other hand, listening to the more soothing melodies of Christmas are particularly helpful when I'm feeling stressed and need to let go and relax.

What holiday music inspires and energizes you? What music soothes and restores you? Try matching holiday music to your mood, and arranging it to best fit your needs and see what happens.

Everywhere we look during the holiday season there will be both sacred images and superficial symbols. It has been said that, "beauty lies in the eye of the beholder." I encourage you to screen out as much as possible that which brings you no comfort or joy, and focus instead on the magic, mystery, and meaning of the season.

Many Blessings...

next:Life Letters: The Last Thanksgiving

St. John's Wort is an alternative mental health herbal treatment for mild to moderate depression. Learn about the usage, dosage, side-effects of St. John's Wort.

Botanical Name:Piper methysticum
Common Names:Awa, Kava

• Overview 
• Plant Description
• What's It Made Of?
• Available Forms
• How to Take It
• Precautions
• Possible Interactions
• References

Overview

St. John's wort (Hypericum perforatum), once thought to rid the body of evil spirits, has a history of medicinal use dating back to ancient Greece, where it was used to treat a range of illnesses, including various 'nervous conditions.' St. John's wort also has antibacterial and antiviral properties and, because of its anti-inflammatory properties, has been used to help heal wounds and burns.

In recent years, there has been renewed interest in St. John's wort as a treatment for depression and there has been a great deal of scientific research on this topic. St. John's wort is one of the most commonly purchased herbal products in the United States. Because St. John's wort interacts with a wide variety of medications, it is important to take it only under the guidance of a healthcare provider who is knowledgeable about herbal medicines.

Alternative Herbal Treatment for Depression (Herbal Antidepressant)

In numerous studies, St. John's wort has been effective in reducing depressive symptoms in those with mild to moderate but not severe (called major) depression. When compared with tricyclic anti-depressants (medication frequently prescribed for this condition) such as imipramine, amitriptyline, doxepin, desipramine, and nortriptyline, St. John's wort is equally effective, and has fewer side effects. This also appears to be true for another well known class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) including fluoxetine and sertraline.

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Other

St. John's wort has also shown promise in treating the following conditions, a few of which are related to depression.

• Alcoholism: In animal studies, St. John's wort substantially reduced the craving for and intake of alcohol. It is hypothesized that alcohol abuse may be a form of self-medication and that, by relieving depressive symptoms, St. John's wort may reduce the perceived need for alcohol.

• Bacterial infections: In laboratory studies, St. John's wort has demonstrated the ability to fight certain infections, including some bacteria that are resistant to the effects of antibiotics. More research is needed in this area to understand if these test tube findings will prove useful for people.

• HIV infection and AIDS: While laboratory research suggests that St. John's wort may kill or inhibit the growth of human immunodeficiency virus (HIV; the virus that causes AIDS), St. John's wort has serious interactions with medications used to treat people with the virus. In the case of the protease inhibitor indinavir, for example, concurrent use of St. John's wort may cause the medication to lose its effectiveness. In addition, participants in a study of St. John's wort for people with HIV dropped out of the study prematurely because of intolerable side effects from the herb.

• Premenstrual syndrome (PMS): An early study suggests that St. John's wort may be useful in relieving both physical and emotional symptoms of PMS including cramps, irritability, food cravings, and breast tenderness.

• Seasonal affective disorder (SAD): Used alone, St. John's wort has improved mood in those suffering from SAD (a form of depression that occurs during the winter months because of lack of sunlight). This condition is often treated with photo (light) therapy. Effects may prove to be even greater when the herb is used in combination with light therapy.

• Viral encephalitis: Herbal specialists may recommend use of a tincture containing a combination of ginkgo, St. John's wort, and rosemary to relieve symptoms associated with recovery from brain inflammation (viral encephalitis) such as cognitive impairment, visual and speech disturbances, and difficulty performing routine functions.

• Wounds, minor burns, hemorrhoids: Topical St. John's wort is, at times, recommended by herbal specialists to reduce pain and inflammation and to promote healing by applying the agent directly to the skin. Preliminary laboratory tests are suggesting that this traditional use may have scientific merit.

• Ear painfrom an ear infection: In a study of over 100 children between ages 6 and 18 with ear pain from an ear infection (called otitis media), a combination herbal ear drop, including St. John's wort, garlic, calendula, and mullein flower, alleviated pain as much as a standard pain killing ear drop.

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Plant Description

St. John's wort is a shrubby plant with clusters of yellow flowers that have oval, elongate petals. The plant gets its name because it is often in full bloom around June 24, the day traditionally celebrated as the birthday of John the Baptist. Both the flowers and leaves are used for medicinal purposes.

What's It Made Of?

The best-studied active components are hypericin and pseudohypericin, found in both the leaves and flowers. There has been recent research to suggest, though, that these best-studied components may not be the most active in the plant, which also contains essential oils and flavonoids.

Available Forms

St. John's wort can be obtained in many forms: capsules, tablets, tinctures, teas, and oil-based skin lotions. Chopped or powdered forms of the dried herb are also available. St. John's wort products should be standardized to contain 0.3% hypericin.

How to Take It

The bulk of scientific research on St. John's wort has been conducted in adults. However, one large study (over 100 children under age 12) found St. John's wort to be a safe and effective way of treating mild to moderate symptoms of depression in children. Dosage should be directed by a qualified practitioner and will likely be adjusted according to the weight of the child. Children being treated with St. John's wort should be carefully monitored for side effects such as allergic reactions or digestive upset.

Adult

• Dry herb (in capsules or tablets): The usual dose for mild depression and mood disorders is 300 to 500 mg (standardized to 0.3% hypericin extract), three times per day, with meals.
• Liquid extract (1:1): 40 to 60 drops, two times per day.
• Tea: Pour one cup of boiling water over 1 to 2 tsp of dried St. John's wort and steep for 10 minutes. Drink up to 2 cups per day for four to six weeks.
• Oil or cream: To treat inflammation, as in wounds, burns or hemorrhoids, an oil-based preparation of St. John's wort can be applied topically.

Internal dosages generally require at least eight weeks to get the full therapeutic effect.

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Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a practitioner knowledgeable in the field of botanical medicine.

Many people take St. John's wort for depression. It is important to bear in mind that depression can be a serious condition and may be accompanied by thoughts of suicide or homicide, both of which warrant immediate medical attention. Evaluation by a healthcare professional should always be sought before using St. John's wort.

Potential side effects from St. John's wort are generally mild. They include stomach upset, hives or other skin rash, fatigue, restlessness, headache, dry mouth, and feelings of dizziness or mental confusion. Although not common, St. John's wort can also make the skin overly sensitive to sunlight (called photodermatitis). Those with light skin who are taking St. John's wort in large doses or over a long period of time should be particularly careful about sun exposure. The use of sunscreen with a skin protection factor (SPF) of at least 15, and the avoidance of sunlamps, tanning booths, or tanning beds is recommended while taking St. John's wort.

Because of the potential for serious interaction with medications used during surgery, patients should discontinue the use of St. John's wort at least 5 days prior to surgery and should avoid taking it post surgery. See Possible Interactions for more information about mixing St. John's wort and medications.

St. John's wort should not be taken by women who are pregnant, trying to become pregnant, or breastfeeding.

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Possible Interactions

St. John's wort interacts with a range of medications. In most cases, this interactions leads to reduced the effectiveness of the medication in question; in other cases, however, St. John's wort may increase the effects of a medication.

If you are currently being treated with any of the following medications, you should not use St. John's wort without first talking to your healthcare provider:

Antidepressants
St. John's wort may interact with a such as ntidepressant medications that are used to treat depression or other mood disorders, including tricyclics, SSRIs (see earlier discussion), and monoamine oxidase inhibitors (MAOIs)phenelzine. How St. John's wort works is not entirely clear, but is believed to be similar to how SSRIs work. Therefore, using St. John's wort with this class of antidepressants in particular can lead to exacerbation of side effects including headache, dizziness, nausea, agitation, anxiety, lethargy, and lack of coherence.

Digoxin
St. John's wort should not be taken by those on digoxin because the herb may decrease levels of the medication and reduce its effectiveness.

Immunosuppressive medications
St. John's wort should not be taken by those on immunosuppressive medications such as cyclosporine because it may reduce the effectiveness of these medications. In fact, there have been many reports of cyclosporin blood levels dropping in those with a heart or kidney transplant, even leading to rejection of the transplanted organ.

Indinavir and other protease inhibitors
The Food and Drug Administration (FDA) issued a public health advisory in February 2000 concerning the probable interaction between indinavir and St. John's wort that resulted in significantly decreased blood levels of this protease inhibitor, a class of medications used to treat HIV or AIDS. The FDA recommends that St. John's wort not be used with any type of antiretroviral medication used to treat HIV or AIDS.

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Loperamide
There has been a report of a possible interaction between St. John's wort and the antidiarrheal medication, loperamide leading to delirium in an otherwise healthy woman.

Oral contraceptives
There have been reports of breakthough bleeding in women on birth control pills who were also taking St. John's wort.

Reserpine
Based on animal studies, St. John's wort may interfere with the intended action of this medication used to treat high blood pressure.

Theophylline
St. John's wort can reduce levels of this medication in the blood leading. Theophylline is used to open the airways in those suffering from asthma, emphysema, or chronic bronchitis.

Warfarin
St. John's wort interferes with the anticoagulant medication, warfarin, by reducing blood levels as well as the effectiveness. This leads to the need to for adjustments in doses of this medication.

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The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

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Detailed overview of medications used to treat childhood bipolar disorder plus their side-effects plus the important role of therapy.

Few controlled studies have been done on the use of psychiatric medications in children. The U.S. Food and Drug Administration (FDA) has approved only a handful for pediatric use. Psychiatrists must adapt what they know about treating adults to children and adolescents.

Medications used to treat adults are often helpful in stabilizing mood in children. Most doctors start medication immediately upon diagnosis if both parents agree. If one parent disagrees, a short period of watchful waiting and charting of symptoms can be helpful. Treatment should not be postponed for long, however, because of the risk of suicide and school failure.

A symptomatic child should never be left unsupervised. If parental disagreement makes treatment impossible, as may happen in families undergoing divorce, a court order regarding treatment may be necessary.

Other treatments, such as psychotherapy, may not be effective until mood stabilization occurs. In fact, stimulants and antidepressants given without a mood stabilizer (often the result of misdiagnosis) can cause havoc in bipolar children, potentially inducing mania, more frequent cycling, and increases in aggressive outbursts.

No one bipolar medication works in all children. The family should expect a trial-and-error process lasting weeks, months, or longer as doctors try several medications alone and in combination before they find the best treatment for your child. It is important not to become discouraged during the initial treatment phase. Two or more mood stabilizers, plus additional medications for symptoms that remain, are often necessary to achieve and maintain stability.

Parents often find it hard to accept that their child has a chronic condition that may require treatment with several medications. It is important to remember that untreated bipolar disorder has a fatality rate of 18 percent or more (from suicide), equal to or greater than that for many serious physical illnesses. The untreated disorder carries the risk of drug and alcohol addiction, damaged relationships, school failure, and difficulty finding and holding jobs. The risks of not treating are substantial and must be measured against the unknown risks of using medications whose safety and efficacy have been established in adults, but not yet in children.

The following is a brief overview of medications used to treat childhood bipolar disorder. More information about specific medications is available in the Drug Database.

This brief overview is not intended to replace the evaluation and treatment of any child by a physician. Be sure to consult with a doctor who knows your child before starting, stopping, or changing any medication.

Mood Stablizers

• Lithium (Eskalith, Lithobid, lithium carbonate) - A salt that occurs naturally in the earth, lithium has been used successfully for decades to calm mania and prevent mood cycling. Lithium has a proven anti-suicidal effect. An estimated 70 to 80 percent of adult bipolar patients respond positively to lithium treatment. Some children do well on lithium, but others do better on other mood stabilizers. Lithium is often used in combination with another mood stabilizer.
• Divalproex sodium or valproic acid (Depakote) - Doctors frequently prescribe this anti-convulsant for children who have rapid cycling between mania and depression.
• Carbamazepine (Tegretol) - Doctors prescribe this anti-convulsant because of its anti-manic and anti-aggressive properties. It is useful in treating frequent rage attacks.
• Gabapentin (Neurontin) - This is a newer anti-convulsant drug that seems to have fewer side effects than other mood stabilizers. However, doctors do not know how effective this drug is, and some parents report activation of manic symptoms in young children.
• Lamotrigine (Lamictal) - This newer anti-convulsant medicine can be effective in controlling rapid cycling. It seems to work well in the depressive, as well as the manic, phase of bipolar disorder. Any appearance of rash must be immediately reported to the doctor, as a rare but severe side-effect may occur (for this reason Lamictal is not used in children under l6).
• Topiramate (Topamax) -This newer anti-convulsant drug may control rapid-cycling and mixed bipolar states in patients who have not responded well to divalproex sodium or carbamazepine. Unlike other mood stabilizers, it does not have weight gain as a side effect, but its efficacy in children has not been established.
• Tiagabine (Gabitril) - This newer anti-convulsant drug has FDA approval for use in adolescents and is now being used in children as well.

Valproate (Depakote) Use Warning - National Institute of Mental Health

According to studies conducted in Finland in patients with epilepsy, valproate may increase testosterone levels in teenage girls and produce polycystic ovary syndrome in women who began taking the medication before age 20. Increased testosterone can lead to polycystic ovary syndrome with irregular or absent menses, obesity, and abnormal growth of hair. Therefore, young female patients taking valproate should be monitored carefully by a physician.

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Other Medications for Treating Bipolar Disorder

Doctors may prescribe antipsychotic medications (Risperdal, Zyprexa, Abilify, Seroquel) for use during manic states, particularly when children experience delusions or hallucinations and when rapid control of mania is needed. Some of the newer antipsychotic medications are very effective in controlling rages and aggression. Weight gain is often a side effect of anti-psychotic medications.

Calcium channel blockers (verapamil, nimodipine, isradipine) have recently received attention as potential mood stabilizers for treating acute mania, ultra-ultra-rapid cycling, and recurrent depression.

Anti-anxiety medications (Klonopin, Xanax, Buspar, and Ativan) decrease anxiety by diminishing activity in brain arousal systems. They reduce agitation and over-activity, and help promote standard sleep. Doctors commonly use these medications as add-ons to mood stabilizers and antipsychotic drugs in acute mania.

A Cautionary Note on Antidepressants and Stimulants from the National Institute of Mental Health

Effective treatment depends on appropriate diagnosis of bipolar disorder in children and adolescents. There is some evidence that using antidepressant medication to treat depression in a person who has bipolar disorder may induce manic symptoms if it is taken without a mood stabilizer. In addition, using stimulant medications to treat attention deficit hyperactivity disorder (ADHD) or ADHD-like symptoms in a child with bipolar disorder may worsen manic symptoms. While it can be hard to determine which young patients will become manic, there is a greater likelihood among children and adolescents who have a family history of bipolar disorder. If manic symptoms develop or markedly worsen during antidepressant or stimulant use, a physician should be consulted immediately, and diagnosis and treatment for bipolar disorder should be considered.

Side-Effects of Bipolar Medications

Side effects that are particularly troublesome and that are worse in children include the following: Atypical neuroleptics (except aripiprazloe) are associated with marked weight gain in many children. One day we hope to have specific genetic tests that will tell us beforehand which people will gain weight on these medications. But right now, it is trial and error. The dangers of this weight gain include glucose problems that may include the onset of diabetes and increased blood lipids that may worsen heart and stroke problems later in life. In addition, these drugs can cause an illness called tardive dyskinesia, which is irreversible, unsightly, repeated movements of the tongue in and out of the mouth or cheek and some other movement abnormalities. Depakote may also be associated with increased weight and possibly with a disease called polycystic ovarian syndrome (POS). In some cases POS is associated with infertility later in life. Lithium has been the market the longest and is the only medication that has been shown to be effective against future episodes of mania and of depression and of completed suicides. Some people who take lithium over a long time will need a thyroid supplement and in rare cases may develop serious kidney disease.

It is very important that children on these bipolar medications be monitored for the development of serious side effects. These side effects need to be weighed against the dangers of the manic-depressive illness itself, which can rob children of their childhood.

Psychotherapy

In addition to seeing a child psychiatrist, the treatment plan for a child with bipolar disorder usually includes regular therapy sessions with a licensed clinical social worker, a licensed psychologist, or a psychiatrist who provides psychotherapy. Cognitive behavioral therapy, interpersonal therapy, and multi-family support groups are an essential part of treatment for children and adolescents with bipolar disorder. A support group for the child or adolescent with the disorder can also be beneficial, although few exist.

Therapeutic Parenting™

Parents of children with bipolar disorder have discovered numerous techniques that the Child and Adolescent Bipolar Foundation refers to as therapeutic parenting. These techniques help calm their children when they are symptomatic and can help prevent and contain relapses. Such techniques include:

• practicing and teaching their child relaxation techniques
• using firm restraint holds to contain rages
• prioritizing battles and letting go of less important matters
• reducing stress in the home, including learning and using good listening and communication skills
• using music and sound, lighting, water, and massage to assist the child with waking, falling asleep, and relaxation
• becoming an advocate for stress reduction and other accommodations at school
• helping the child anticipate and avoid, or prepare for stressful situations by developing coping strategies beforehand
• engaging the child's creativity through activities that express and channel their gifts and strengths
• providing routine structure and a great deal of freedom within limits
• removing objects from the home (or locking them in a safe place) that could be used to harm self or others during a rage, especially guns; keeping medications in a locked cabinet or box.

Sources:

• NIMH, Child and Adolescent Bipolar Disorder: An Update from the National Institute of Mental Health (last reviewed June 2008)
• Papolos DF, Papolos J: The Bipolar Child: The Definitive and Reassuring Guide to Childhood's Most Misunderstood Disorder, 3rd ed. New York, NY, Broadway Books, 2006.
• Child and Adolescent Bipolar Foundation website
• NAMI website, Facts About Child and Adolescent Bipolar Disorder (last reviewed Jan. 2004).

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