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There’s only so much you can take—a global pandemic, an economic shutdown, sheltering at home, social injustice, societal unrest—it’s enough to make your anxiety go through the roof. But how can you tell if it’s just heightened stress or if your anxiety is a real problem?

Here are 7 signs that your anxiety is out of control and 7 strategies to soothe it.

1. Your sleep is disrupted.

Having trouble falling asleep or tossing and turning throughout the night is a common red flag of anxiety disorders. And it’s a 2-way street. Anxiety can lead to sleep issues, and a lack of adequate rest can ramp up nervousness and stress. In addition, when you sleep for 7 hours, it turns on 700 beneficial genes, but without 7 solid hours of shuteye, you lose out on this important process.

Soothing Strategy: Make sleep a priority. Create a calming nighttime routine and consider natural supplements that promote relaxation, such as magnesium, melatonin, GABA, 5-HTP, l-theanine, and vitamin B6.

2. You have trouble catching your breath.

If you feel like you can’t take a deep breath, you may be worried it’s a sign of COVID-19 or a garden-variety cold or flu. But feeling like you can’t catch your breath is a common indicator of anxiety. The tree branches in the lungs are wrapped with smooth muscle, and when you’re anxious, those muscles clamp down.

Soothing Strategy: Learning diaphragmatic breathing can help loosen those muscles in the lungs so you can breathe freely again. Here’s a very simple yet powerful breathing technique. Breathe in for 3 seconds, hold it for 1 second, breathe out for 6 seconds, hold it for 1 second. Do this 10 times, and you’ll start to feel more relaxed almost immediately.

3. You have an ANT infestation.

ANTs are the automatic negative thoughts that infest your brain and ruin your day. If you’ve got an army of ANTs swirling in your head, they can drive anxiety.

Soothing Strategy: Be careful what you listen to. Don’t subject yourself to hours of TV news, which is constantly spewing out frightening stats and ghastly projections. And understand that you don’t have to believe every stupid thought in your head. You can challenge your thoughts. Whenever you feel sad, mad, nervous, or out of control, ask yourself if what you’re thinking is true. During these difficult times, mental hygiene is just as important as washing your hands. You need to disinfect your thoughts, so they won’t steal your mind or ramp up your anxiety.

4. You’re trying to calm your stress with sugar.

During the pandemic, a lot of people have put on the “Quarantine 15.” If you’re stress eating with cookies, cakes, and candy or other foods that quickly turn to sugar—think pasta, bread, potatoes, and rice—it’s a sign of anxiety. Be aware that sugar may provide short-term relief, but it adds to anxious feelings in the long-term. And packing on the pounds doesn’t help either. Research on 35,000 brain scans shows that as your weight goes up, the physical size and function of your brain goes down.

Soothing Strategy: If you’re struggling with sugar cravings, try intermittent fasting, which has many brain benefits and can diminish cravings. Wait 14 to 16 hours after eating dinner before having breakfast. For example, if you finish dinner at 7 p.m., don’t have breakfast until 9 a.m. or 11 a.m.

5. You’ve stopped caring about taking care of yourself.

If you’ve lost the will to work out or go for a walk even though you know you’ll feel better afterward, it can be a red flag that anxiety has taken control. You may feel so worn out by the chronic bombardment of stress that you don’t want to do anything.

Soothing Strategy: Do something! Even if you just take a 5-minute walk outside or you change up your routine in some small way, it can help get you out of a funk and reset your frame of mind. To get inspired, combine physical activity with things you love, such as listening to an audiobook or a podcast while you go for a walk.

6. You’re more irritable.

If you’re uncharacteristically snapping at your family, your neighbors, or the grocery store checker, it could be due to relentless anxiety. In a 2017 study in The Journal of Nervous and Mental Disease, over 90% of people with generalized anxiety disorder said they felt very irritable during periods of especially high anxiety.

Soothing Strategy: Before you snap at someone, ask yourself this question: Does it fit? Will saying something nasty to your spouse, coworker, or friend help you get you what you want in life? To help you get irritability under control, figure out what you want out of life, and write it down. Then every time you’re about to snap, take a moment and ask, “Does it fit?” If your behavior isn’t going to help you get what you want in terms of the big picture, don’t do it.

7. You’re experiencing repetitive negative thoughts (RNTs).

If you’re ruminating on negative thoughts—repeatedly worrying about the future or fretting about something that happened in the past—it’s time to get serious about your anxiety. RNTs are really nasty thoughts. They’re like ANTs that link to other ANTs, then stack together and attack your mind. A 2020 study in Alzheimer’s & Dementia shows that RNTs are associated with an increased risk of dementia, so it’s critical to change your thinking patterns.

Soothing Strategy: If you’re mired in repetitive negative thinking during these uncertain times, try a little TLC. Researchers have found in extremely stressful situations, people who struggle tend to think that things are permanent (this will never change!), global (it’s everywhere!), and out of control (I’m powerless to do anything!). People who are able to thrive in challenging times think differently, telling themselves that the situation is Temporary (this will pass), Local (it isn’t happening everywhere), and Control (I have control over my own behavior). Try the TLC approach to help calm anxiety.

Anxiety, panic attacks, post-traumatic stress disorder (PTSD), depression, and other mental health issues can’t wait. During these uncertain times, your mental well-being is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time.

At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.

 

By Shane Creado, MD

The COVID-19 pandemic has ravaged the sports world. Now, professional, collegiate, high school, and recreational teams, as well as individual athletes, need to prepare for twin tsunamis on the horizon: the mental health and insomnia pandemics. Studies estimate the prevalence of sleep disturbances in athletes ranges from 13% to 70%, but these rates could rise sharply as a result of the pandemic. As a sports psychiatrist and sleep medicine doctor who specializes in sleep optimization in elite athletes, I have already begun to witness this first-hand. The hope is that we meet the approaching tsunamis with a game plan, so as to ride out the wave and come out even stronger on the other side.

In this article, I will discuss the links between sleep, mental health, and sports performance and will provide recommendations for sleep optimization.

THE IMPACT OF MENTAL HEALTH PROBLEMS ON SLEEP

Stress and mental health disorders worsen sleep quality and quantity.

  1. Anxiety: When your brain is in danger mode, or fight or flight mode—such as during a pandemic—it will not ‘fall’ asleep. Insomnia is not the lack of sleep, but instead, excessive wakefulness of the brain.  The anxiety we live out while we are awake is the anxiety our brain will experience at night. This helps explain why people are experiencing more intense and scary dreams during the pandemic.
  2. ADHD (Attention Deficit Hyperactivity Disorder): Distractibility and a racing mind will not let your brain get into the focused state of relaxation that you need, in order to fall asleep.
  3. Depressive disorders: Sleep difficulties are very common among patients with depression. Individuals with co-occurring depression and insomnia tend to have a more serious disability, greater depression severity, and poorer depression outcomes than those without insomnia.
  4. PTSD: In people who have been traumatized, we see a much higher frequency of insomnia. This may be attributable to a number of reasons: avoiding sleep, fear of loss of vigilance (sleeping is the most vulnerable thing we do!), or therapies like prolonged exposure therapy that temporarily disrupt sleep.
  5. Concussions and sleep problems: In a meta-analysis of 1,706 survivors of TBI across 21 studies, the most common sleep disturbances were: insomnia (50%), difficulty maintaining sleep (50%), poor sleep efficiency (49%), early morning awakenings (38%), nightmares (27%), sleep apnea (23% to 36%), restless leg syndrome (13%), excessive daytime sleepiness (hypersomnia or narcolepsy) (50 to 80%), circadian rhythm disturbances (36%), and abnormal behaviors during sleep. 
  6. Substance use: When it comes to licit and illicit substances, we must think about short-term use (the intoxicating and withdrawal symptoms), and also long-term use.
    Alcohol: Alcohol may initially help you fall asleep, but it can cause you to wake up in the middle of the night. People with combined insomnia and alcohol dependence seem to have more depression, anxiety, hostility, and problems with concentration than others. In addition, long-term alcohol use increases the risk of sleep apnea and leg movements (when asleep). Medications like valium have similar effects on sleep.
    Stimulants can directly affect your ability to fall asleep when you are high, and when you withdraw from a stimulant, the opposite effect is likely.
    Marijuana can disrupt sleep rhythms, as it can lower motivation and make you tired and sleepy. This may result in naps during the day, dozing in bed, or using the bed for activities other than sleep, thereby sabotaging your sleep rhythms.
    Hallucinogens: Party drugs such as ‘Ecstasy’ or ‘Molly’ (MDMA) can affect your sleep directly (which is because MDMA acts as a combination of stimulants and hallucinogens like mescaline).
  7. Bipolar disorder: Bipolar disorder can disrupt sleep, regardless of your mood state. Hypomanic/manic states result in less sleep, which can perpetuate the mood state. Depressive states can be associated with excessive sleep or staying in bed, which can further disrupt sleep-wake cycles. Even patients in normal (euthymic) mood states report sleep disturbances.
  8. Psychiatric medications: Several psychotropic medications are known to contribute to sleep disruptions. They can cause or contribute to insomnia, restless leg syndrome (most anti-depressants), sleep apnea (weight gain with certain medications or muscle relaxation with benzodiazepines), dream enactment, and more.

THE IMPACT OF SLEEP PROBLEMS ON MENTAL HEALTH

Poor sleep worsens the severity of mental health disorders and negative mood states.

  1. Anxiety: Poor sleep adversely affects your frontal lobes (responsible for concentration, executive functioning, rational thoughts) and your temporal lobes (which are important for emotional stability, psychological resilience, memory). Poor sleep also causes you to be more irritable and frustrated (think jet lag).
  2. ADHD (Attention Deficit Hyperactivity Disorder): Distractibility and a racing mind (issues are seen in the frontal lobes of the brain) could be due to poor sleep.
  3. Depressive disorders: Researchers have estimated that 90% of patients with depression complain about sleep quality. Poor sleep is also a major risk factor for suicide. Sleep apnea is a major contributor to depression (20% overlap).
  4. PTSD: In people who have sleep problems like insomnia and sleep apnea, treating these conditions will help the patient heal the areas of the brain needed to engage in therapies to help treat PTSD. If you are sleep deprived, it will be extremely difficult for you to engage in treatments, as well as commit the new things learned to memory.
  5. Concussions and sleep problems: Sleep deprivation can reduce reaction times and increase the risk of TBI, and it can result in more severe symptoms following a concussion as well as a delayed recovery from the concussion. Thus, adequate sleep is critical, not just to reduce the risk of TBI, but also to help heal the brain after a TBI. 
  6. Substance use: Inadequate sleep can contribute to less willpower, more cravings, and more emotional instability, thereby increasing the risk of licit or illicit substance use. “Uppers” can cause or contribute to insomnia, seizures, and sleep fragmentation. “Downers” like alcohol, opiates, and others can worsen sleep apnea and cause your natural sleep rhythms to be disrupted, perpetuating a sleep problem.
  7. Bipolar disorder: Sleep loss or sleep deprivation due to any cause (medications, anxiety, pain) can trigger a manic episode or can delay recovery from a mood state.
  8. Jerusalem Syndrome: This psychotic condition, is thought to be directly attributable to sleep loss.
  9. Sleep medications: Several sleep medications can worsen or contribute to anxiety, depression, concentration problems, parasomnias (abnormal sleep behaviors), and more.

THE IMPACT OF SLEEP PROBLEMS ON GENERAL HEALTH

Poor sleep is associated with a wide range of physical health issues, including hormonal imbalances (in males, smaller testicles and testosterone levels drop by 10%-15%), increased inflammation, premature aging (shortened telomeres), negative effects on gene activity, and lower immunity. In addition, it increases the risk of cancer, obesity (adults with short sleep duration are 55% more likely to become obese), heart disease (in the spring, when we lose one hour of sleep, we see a subsequent 24% increase in heart attacks the following day), diabetes, and dementia. Ultimately, a lack of quality sleep is linked with shorter life spans.

THE IMPACT OF SLEEP PROBLEMS ON ATHLETIC PERFORMANCE

Independent studies have confirmed that sleep disruptions result in higher perceived training loads, decreased maximal jump performance, increased joint coordination variability, reduced reaction times, increase injury risk, performance variations of up to 26% (depending on time of performance and your biological clock— whether you’re a night owl or a morning bird), slower 40-yard dash times, poor team dynamics (people to react more emotionally to negative stimuli because the amygdala overreacts), worse mental resilience.

THE IMPACT OF SLEEP PROBLEMS ON THE BRAIN AND SPORTS PERFORMANCE

A lack of quality sleep negatively impacts the brain—and subsequently, performance—in the following ways:

RECOMMENDATIONS FOR BETTER SLEEP, MENTAL HEALTH, AND PERFORMANCE

“If you told an athlete you had a treatment that would reduce the chemicals associated with stress, that would naturally increase human growth hormone, that enhances recovery rate, that improves performance, they would all do it. Sleep does all of those things.” —Casey Smith, Head Athletic Trainer, Dallas Mavericks

For peak performance, athletes with mental health issues (including substance use disorders) and/or sleep problems need specialized treatment. It is now accepted that sleep and mental health disorders need to be treated concurrently, rather than serially. To enhance sleep and performance, follow these recommendations:

Professional and collegiate sports organizations—as well as high school and recreational teams and any individual athlete—would be wise to use these evidence-based concepts to create sport-specific sleep guidelines and to plan playing schedules based on them. This will allow players to have healthier and longer careers, break world records and have them come as close to athletic perfection as possible, enthralling fans and shareholders for years to come.

About the Author: Shane Creado, MD, Amen Clinics Chicago

Dr. Shane Creado is a board-certified sports psychiatrist and sleep specialist at Amen Clinics. He is the author of Peak Sleep Performance: The Cutting-Edge Sleep Science That Will Guarantee A Competitive Advantage. He is an outspoken advocate for mental health and sleep, the creator of a sleep improvement video series called “Overcoming Insomnia” for Amen University, helped design a high-quality sleep supplement for BrainMD, and is based in Chicago, IL.

 

 

With the pandemic upon us and anxiety through the roof, who can sleep? An increasing number of people are having a tough time dealing with anxious, racing thoughts that keep us from getting the quality sleep we so desperately need. It’s causing hordes of people to turn to prescription pills for relief.

According to an April 2020 report, there has been a 34% increase in the number of prescriptions filled for antianxiety medications during the pandemic. New prescriptions filled for the most popular anti-anxiety drugs—Xanax, Valium, and Ativan—jumped 38% during stay-at-home orders. At the same time, the number of prescriptions filled for sleep disorders rose by 15%.

“This is a disaster waiting to happen,” says Dr. Shane Creado, a psychiatrist and sleep medicine physician at Amen Clinics in Chicago and the author of Peak Sleep Performance for Athletes. Here’s why.

THE TROUBLE WITH SLEEP AND ANXIETY MEDS

Anti-anxiety medications (such as Valium, Xanax, Ativan, and Klonopin) are benzodiazepines that are quick-acting and can be beneficial on a very short-term basis for acute anxiety. However, they have several drawbacks. Brain SPECT imaging studies show that “benzos” reduce overall blood flow and activity in the brain and are harmful to brain function. “They can cause memory problems, daytime drowsiness, confusion, addiction, and severe withdrawal syndrome if they are abruptly discontinued,” says Dr. Creado, who does sleep consults and who is the creator and host of an online course called “Overcoming Insomnia.”

Trying to go off these drugs can increase anxiety to higher levels than before you started taking the medication. Benzos are also dangerous when combined with alcohol or other sedating drugs. From 1999 to 2013, overdose deaths quadrupled, according to research in the American Journal of Public Health.

Sleep drugs, such as Ambien and Lunesta, have similar risks. To understand how they work, it’s important to know that “insomnia is not the lack of sleep, but instead, excessive wakefulness of the brain,” according to Dr. Creado. These drugs are effective because they calm an overactive mind and causing you to become unconscious, but they also have many downsides.

“They may limit REM sleep and that can lead to morning grogginess, which is also known as the ‘hangover effect,’ as well as brain fog and memory problems,” says Dr. Creado. In addition, some people experience episodes of sleepwalking, sleep-driving, sleep-eating, and other behaviors while taking these drugs and have no memory of their actions the following day. Stopping the pills can cause rebound insomnia, making it even harder to get the rest you need.

In addition, benzodiazepines and these sleep drugs carry a black box warning, the FDA’s most stringent warning given to medications with the most serious side effects. This all adds up to a growing number of people who are going to need help to stop their prescription drug habit and to learn how to overcome insomnia and anxiety without these medications.

THE IMPENDING SLEEP DISRUPTION TSUNAMI

Although many experts have been pointing to a post-pandemic mental health crisis, “there hasn’t been enough focus on the sleep disruption epidemic that is headed our way,” says Dr. Creado. This will have dire consequences on mental health, physical health (such as inflammation, heart attacks, strokes, lowered immunity), work productivity, relationships, and more. To avoid becoming a sleep-deprived victim of the second wave of the pandemic, you need to take action now.

Here are some tips to improve sleep quality.

Sleep disorders, anxiety, panic attacks, depression, and other mental health issues can’t wait. During these uncertain times, your mental well-being is more important than ever and waiting to get treatment until the pandemic is over is likely to make your symptoms worsen over time.

At Amen Clinics, we’re here for you. We offer mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples, as well as in-clinic brain scanning and functional medicine evaluations to help our patients. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.

 

 

“I was in Ireland & had been invited to open up, solo, for U2. It was the day of the show… I spent the whole day getting more & more anxious that I didn’t have anything to wear. Instead of going to the arena where the show was being held, I went to a huge shopping mall… I started to get a string of texts from U2’s tour manager asking where the hell I was & why I was skipping soundcheck… Then I got a final text from U2’s tour manager: ‘Don’t bother coming. Show has been canceled. Bono has just died suddenly and unexpectedly from COVID-19…’”

This is an excerpt from one of the many submissions to “I Dream of COVID,” a website where people are documenting the weird and wild dreams they’re having during the global coronavirus pandemic. People are also posting their nightly subconscious escapades on Twitter using #pandemicdreams, including this one:

“I had a dream last night that I went food shopping and people kept intentionally touching me, circling me and intentionally coughing on me. Apparently my subconscious along with the rest of me is pretty damn terrified. #pandemic dreams”

Apparently, the coronavirus isn’t just attacking people’s health and mental well-being, it’s also messing with our minds as we sleep.

What’s Causing Pandemic Dreams?

“Our dreams are being influenced by our heightened stress and anxiety, changes in sleep patterns, isolation, and more,” says Dr. Shane Creado, a psychiatrist and sleep medicine physician at Amen Clinics in Chicago and the author of Peak Sleep Performance for Athletes.

Dr. Creado says he’s been hearing from many patients that not only are they having dreams that are extremely vivid and strange, but they also seem to be remembering more of their dreams. They’re not alone. French scientists from the Lyon Neuroscience Research Center have found a 35% increase in dream recall due to the global pandemic.

Dr. Creado, who does sleep consults and who hosts an online course on Overcoming Insomnia, explains that this may be because the anxiety we’re experiencing during our waking hours is impacting the quality of our sleep. According to Dr. Creado, the fears and stress surrounding the coronavirus pandemic are causing more awakenings, or what is known as sleep fragmentation. This means that when you’re anxious, you lose sleep.

More importantly, to make up for sleep loss, your brain may quickly take a dive into rapid-eye-movement (REM) sleep, which is when our most vivid dreams typically occur. “Thus, worry can not only trigger nightmares,” says the sleep specialist, “but the sleep loss associated with them can increase their frequency.”

Why Nightmares Aren’t All Bad

As many as 85% of adults occasionally experience nightmares, according to the American Academy of Sleep Medicine. What are the most common nightmare themes? A 2016 study found that the top 10 nightmares involve:

  1. Falling
  2. Being chased
  3. Death
  4. Feeling lost
  5. Feeling trapped
  6. Being attacked
  7. Missing an important event
  8. Waking up late
  9. Loved one passing
  10. Sustaining an injury

Other common nightmares include your teeth falling out, being paralyzed, or bugs crawling on you.

But nightmares aren’t all bad. Dream experts believe they may serve a purpose. “In some ways, nightmares may help us better navigate stressful situations in our waking lives,” says Dr. Creado, who trained in sleep analysis from a psychoanalyst from Harvard, and who helps his patients in dream analysis sessions.

A 2019 study in Human Brain Mapping suggests that nightmares help decrease anxiety by acting like a sort of rehearsal for how to deal with daytime stressors.

Having nightmares during this global pandemic is understandable. But having repetitive nightmares can be very troubling and can prevent people from even wanting to go to sleep.  They are common in people who have been traumatized. And we are all currently being traumatized by the fear of COVID-19. Dr. Creado says, “It’s very likely that after things go back to ‘normal,’ we’ll be seeing rising numbers of people suffering from recurring nightmares and sleep disturbances.”

How to Reduce Nightmares Even During a Pandemic

To minimize nightmares, you need to get restful sleep. The following simple strategies can help you get better quality sleep to reduce the sleep fragmentation that can increase vivid dreams and nightmares.

If you’re struggling with sleep disturbances, anxiety, panic attacks, depression, or other mental health issues, you aren’t alone—45% of Americans say the coronavirus pandemic has impacted their mental health. Just because you’re sheltering at home doesn’t mean you have to wait for the pandemic to be over before seeking help. In fact, during these uncertain times, your mental well-being is more important than ever, and waiting to get treatment is likely to make your symptoms worsen over time.

At Amen Clinics, we’re here for you. We offer mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples, as well as in-clinic brain scanning to help our patients. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.

 

Advanced age, obesity, smoking—these are some of the biggest risk factors that make you more likely to develop a severe illness or to die from COVID-19, according to emerging research. They are also many of the same risk factors that attack brain health and contribute to mental illness and memory problems. BRIGHT MINDS is a mnemonic for the 11 major risk factors that steal your mind, and as researchers are discovering, they may also raise the risk for more severe illness or death from the coronavirus.

Know how many of these risk factors you have and follow the tips to minimize your risk.

B is for Blood flow.

The World Health Organization reports that people with high blood pressure or cardiovascular disease are among those at highest risk for severe illness and death from COVID-19. Statistics compiled by the state of New York show that hypertension, coronary artery disease, and high cholesterol are among the top 10 co-morbidities among patients who died from COVID-19.

BRIGHT MINDS Tip: Even though you may be sheltering at home, it’s still critical to exercise to get your blood pumping.

R is for Retirement/Aging.

Research in Clinical Infectious Diseases shows that people of old age are at the greatest risk for poor outcomes from COVID-19. Having dementia, which is typically seen in older people, was listed as one of the top 10 co-existing conditions in people who died from COVID-19, according to statistics from the state of New York.

BRIGHT MINDS Tip: New learning keeps your brain young. When quarantined or self-isolating, keep your mind active.

I is for Inflammation.

A study in Clinical Infectious Diseases found that people with high levels of C-reactive protein—a marker for inflammation—are more likely to have severe coronavirus illness.

BRIGHT MINDS Tip: Avoid pro-inflammatory foods, such as sugar and refined carbohydrates, that drive inflammation.

G is for Genetics.

Researchers suggest the reason why some younger people with no underlying health conditions become seriously ill from COVID-19 may have to do with their genes.

BRIGHT MINDS Tip: Know your genetic risks and be proactive about minimizing them.

H is for Head Trauma.

Although research has yet to show a direct connection between head trauma and coronavirus outcomes, having a head injury increases the likelihood of mental health issues, such as depression, which has been linked to inflammation and immune system dysfunction. In addition, people who have had a traumatic brain injury (TBI) are also more likely to suffer from addictions to toxic substances that may impact pulmonary health. (See T is for Toxins below.)

BRIGHT MINDS Tip: Protect your brain—wear a helmet while biking, avoid climbing ladders, hold the handrail when you walk down stairs.

T is for Toxins.

Smoking anything—cigarettes, marijuana, or methamphetamine—poses a greater risk for severe COVID-19 illness. According to a release from the National Institute on Drug Abuse (NIDA), “Because it attacks the lungs, the coronavirus that causes COVID-19 could be an especially serious threat to those who smoke tobacco or marijuana or who vape.” NIDA also suggests that people with addictions who abuse opioids or methamphetamine may also be at increased risk because these substances negatively affect respiratory and pulmonary health. In addition, kidney disease ranked among the top 10 co-occurring conditions in people who died from COVID-19 in New York state. The kidneys are one of the body’s 4 organs of detoxification—the other 3 are the skin, gut, and liver. Environmental toxins can harm these organs. This damage reduces your detoxification system’s ability to do its job, creating an even greater buildup of toxins.

BRIGHT MINDS Tip: During highly stressful times like during a pandemic, eliminate alcohol and drugs and support your 4 organs of detoxification—liver, kidneys, gut, and skin—by minimizing your exposure to environmental toxins.

M is for Mental Health.

Having depression, anxiety, or other mental health conditions can interfere with immune system function and make you more susceptible to viral infections.

BRIGHT MINDS Tip: Seek treatment for mental health issues but be sure to see a healthcare provider who looks at the brain and treats the root causes of mental illness, rather than just treating symptoms.

I is for Immunity and Infections.

Having a chronic infection, such as Lyme disease, may increase vulnerability to COVID-19 and may worsen outcomes, according to Mark Filidei, D.O., the director of integrative and functional medicine at Amen Clinics in Costa Mesa, California.

BRIGHT MINDS Tip: Shore up immunity with vitamin D, zinc, therapeutic mushrooms, and garlic.

N is for Neurohormones.

A recent report in The New York Times shows that men are dying from COVID-19 at nearly twice the rate as women. Science suggests it may be due, in part, to hormones. Research shows the female sex hormone estrogen stimulates the immune system, giving women more robust immunity, while the male sex hormone testosterone inhibits the immune system.

BRIGHT MINDS Tip: As a general rule, it’s a good idea to check your hormone levels regularly and optimize them if necessary.

D is for Diabesity.

The word “diabesity” combine diabetes and obesity, both of which are associated with poorer outcomes from COVID-19. Obesity is one of the biggest risk factors for hospitalization and critical illness, according to a pre-print study (which means it is not yet peer-reviewed) of over 4,000 people in New York who had tested positive for COVID-19. Having diabetes doesn’t increase the risk of becoming ill from COVID-19, but an analysis in the Journal of Endocrinological Investigation reports that people with diabetes could be up to twice as likely to die from coronavirus.

BRIGHT MINDS Tip: Eat healthy foods—lean protein, colorful vegetables and fruits, and smart carbs (ones that don’t spike your blood sugar)—not just what’s left on the store shelves during the pandemic.

S is for Sleep.

Even though sleep has not been directly associated with worse outcomes from coronavirus, it is tightly linked to immunity. Research on identical twins in the journal Sleep shows that chronic sleep deprivation lowers immune system function.

BRIGHT MINDS Tip: Sleep is often the most affected during a crisis, but you need to make sleep a priority. Aim for 7 hours a night.

If you’re struggling with anxiety, panic attacks, depression, or other mental health issues, you aren’t alone—45% of Americans say the coronavirus pandemic has impacted their mental health. Just because you’re sheltering at home doesn’t mean you have to wait for the pandemic to be over before seeking help. In fact, during these uncertain times, your mental well-being is more important than ever, and waiting to get treatment is likely to make your symptoms worsen over time.

At Amen Clinics, we’re here for you. We offer mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples, as well as in-clinic brain scanning to help our patients. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.

Sleep difficulties are very common in people with depression, and both issues can wreak havoc on your ability to perform at your best—whether it’s on the field, in the boardroom, or in the classroom. Did you know that about 75% of depressed people also struggle with symptoms of insomnia? Many aspects of sleep are linked to depression. How many of the following sleep issues do you have?

7 Sleep Issues Related to Depression

1. Going to bed early and getting out of bed late

Many people who are depressed want to sleep more, as it is considered an escape from their suffering. Many find it difficult to get out of bed in the morning due to reduced motivation and lack of energy, resulting in more time spent in bed trying to sleep. This worsens insomnia because the bed becomes associated with wakefulness and negative thoughts.

2. Waking up earlier than desired

Although early morning awakenings are more common in depressed people, they may also be due to simply being an “early bird” or “lark.” To know the difference, think about whether you were an early riser prior to the depression setting in.

3. Challenges faced by depressed people with strong “eveningness” tendencies

People who have a delayed sleep schedule (“eveningness” tendencies), in which they go to bed later at night, are more likely to have a lower mood in the morning and a better mood in the evening. So, they tend to delay their bedtime because they finally feel better in the evening, and they tend to postpone getting out of bed because they have a lower mood in the morning.

4. More negative thinking (dysfunctional beliefs)

This often means higher alertness in bed, which can lead to an increased effort to go to sleep, which leads to more wakefulness of the mind, which perpetuates the cycle of insomnia.

5. Obstructive sleep apnea (OSA)

Sleep apnea—which is characterized by snorting, gasping, or temporarily stopping breathing while sleeping—may be more prevalent among patients with insomnia and depression. One possibility for the connection may be because of depression-associated inactivity and weight gain, as excess weight and obesity are the most common causes of sleep apnea.

6. Problems quieting the mind at night

When repeated thoughts (ruminations) occur in bed at night, they will interfere with your sleep.

7. Failure to get out of bed when unable to sleep

When you can’t sleep, it’s a good idea to get up so you don’t associate the bed with sleeplessness. However, depressed people often fail to do this because they may have low energy and less motivation, and they already use the bed for negative thinking and as an escape from “the depressing real world” (the wish for sleep to provide an escape from emotional suffering).

When Depression Treatment Doesn’t Help Your Sleep

Surprisingly, many of these sleep problems do not resolve with psychotherapy or antidepressant medication. In fact, several antidepressants are known to contribute to sleep disruptions. Medications like bupropion and venlafaxine can be activating and keep you up at night. Common side effects of most antidepressants include a number of digestive problems, which could also affect sleep. Medications such as mirtazapine can cause weight gain and potentially worsen conditions like sleep apnea. Most antidepressants worsen or contribute to Restless Leg Syndrome, a condition that causes your legs to move involuntarily, making it difficult to get restful sleep. And most antidepressants that work on the neurotransmitter serotonin can worsen or contribute to dream enactment (REM sleep behavior disorder), thereby disrupting sleep.

In addition, when stimulants are used off-label for motivation and energy in depressed patients, they can cause insomnia. When bipolar depression is treated with medications, such as olanzapine and quetiapine, they can cause weight gain and worsen sleep apnea, which in turn causes sleep disruption.

Treat the Depression AND the Insomnia

In general, individuals with co-occurring depression and insomnia tend to have a more serious disability, greater severity of depression, and poorer depression outcomes than those without insomnia. Depressed people with disturbed sleep are also at increased risk for suicide and are more vulnerable to a recurrence of depression. This is why it’s so important to address both issues. If you’re struggling with both depression and sleep deprivation, be sure to have your insomnia diagnosed and treated in addition to treating the depression.

You can find many more common sleep saboteurs that compromise performance, in addition to solutions to optimize sleep, in Dr. Shane Creado’s book, Peak Sleep Performance for Athletes: The Cutting-edge Sleep Science That Will Guarantee a Competitive Advantage.

In “Peak Sleep Performance for Athletes: The Cutting-edge Sleep Science That Will Guarantee a Competitive Advantage” author Dr. Shane Creado, who is board-certified in both psychiatry and sleep medicine and is on the Board of Directors for the International Society for Sports Psychiatry, shares his unique sleep optimization program for athletes that he uses with his patients at Amen Clinics. Order your copy here.

If you or a loved one is looking for that competitive edge or is struggling with sleep problems or depression, Amen Clinics can help. Speak to a specialist today at 888-288-9834 or schedule a visit online.

You probably know that persistent sadness, feelings of hopelessness, and withdrawal from social connections are common symptoms of major depressive disorder. But there are many other signs that you may not know are associated with the condition. At Amen Clinics, we see patients every day who complain about symptoms that they don’t realize are associated with the disorder. Based on our experience with tens of thousands of patients, here are 10 signs of depression that often go unrecognized. Do you have any of these?

1. Unexplained aches and pains.

Many of the patients we see complain of back pain, muscle soreness, headaches, or chest pain that isn’t related to a specific injury or activity and that doesn’t go away with treatment. In most cases, it never occurred to them that it might be related to depression. But research in CNS Drugsshows that approximately two-thirds of people with depression report unexplained physical pain. Our brain imaging work using SPECT technology shows that people who experience chronic pain tend to have high activity in a part of the brain called the limbic system. When there is too much activity in this area of the brain, it is also associated with depression.

2. Getting a lot of colds.

One of the things we notice in our depressed patients is that they tend to catch every cold or flu bug that’s going around. They are usually surprised to learn that depression may negatively impact your immune system, making you more susceptible to viruses and infections. It can also make it harder for you to fight off infections, which means it may take you longer to get over that cold.

3. Trouble concentrating.

When negative thoughts keep swirling in your head, it’s hard to stay focused on the task at hand. A 2014 study in Plos One found that aside from sad moods, concentration problems were one of the most common and debilitating symptoms among depressed people. In our clinics, we see many people who think their problems with focus are a sign of ADD/ADHD, but their brain scans show that it’s actually depression.

4. Feeling irritable.

Do you find yourself getting irritated at the smallest things your family, coworkers, or friends do? Are you feeling angry at the world? Research in the Asian Journal of Psychiatry shows there is a close relationship between anger and major depressive disorder. In our experience, people often don’t make the link between irritability and depression. That’s what happened with Chad. He came to see us because his wife said he needed to get anger management, or she would divorce him. She was tired of Chad getting mad at her and their kids for really insignificant things. When we scanned his brain, however, it was consistent with one of the 7 patterns of depression we have identified. Treating his depression helped him feel less annoyed and more accepting.

5. Being forgetful.

At Amen Clinics, many of the people we see who have memory issues are unaware that it may be related to depression. A growing body of scientific evidence shows that untreated depression significantly raises the risk of developing memory problems and cognitive impairment. For example, a 2015 study concluded that depression is associated with short-term memory loss. Other research has found that people who are depressed have a harder time recalling the intricate details of their lives, meaning you may remember general events but have trouble with the specifics.

6. You’re constipated.

At Amen Clinics, we know that physical health is tied to mental health, so we delve into our patients’ overall wellbeing as part of our evaluations. People are often stunned to learn that having constipation is linked to depression. According to a 2011 report, 22% of constipated people studied showed symptoms of severe depression and 13% had borderline depression levels.

7. Feeling numb.

Some people we see don’t think they’re depressed because they don’t feel sad or weepy. One woman, Sarah, said she didn’t feel much of anything at all and was basically devoid of any emotion. She wasn’t even sad about her child’s high school graduation. “It’s just the next step in life,” she said flatly. She mistook her lack of emotion as a sign of strength. When you don’t feel anything no matter what happens in your life, it can be a sign of depression.

8. Feeling tired all the time.

These days, it seems like everybody’s perpetually tired. The majority of our depressed patients say they feel exhausted, but they often blame it on something else like not getting enough sleep. When you’re depressed, it takes so much extra effort just to get through your day, it can leave you feeling wiped out.

9. Feeling restless.

For some people with depression, the idea of relaxing or having nothing on your calendar can induce stress and anxiety. Our patients often say that downtime is just that—a time when the ANTs (automatic negative thoughts) infest their brains and make them feel down. For example, Shailene thought she was just a type-A go-getter who liked to feel productive at all times and didn’t realize that her need to fill up her time was really just a way to avoid the negativity that would creep in when she wasn’t busy.

10. Feeling like you’re “faking it.”

Some of our patients say they feel like they’re wearing a mask during the day, trying to appear cheerful and motivated. This can be a sign of “smiling depression,” in which people look like the picture of success on the outside, but they feel empty inside. 

If you’re experiencing any of these issues, it’s a good idea to investigate if it might be a sign of depression.

At Amen Clinics, we take a unique brain-body approach to diagnosis and treatment that includes brain SPECT imaging, as well as laboratory testing to check physical health, and other important factors that could be contributing to symptoms. By getting to the root cause of your symptoms, we can create a more effective, personalized treatment plan for you.

If you want to join the tens of thousands of people who have already enhanced their brain health, overcome their symptoms, and improved their quality of life at Amen Clinics, speak to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.

On March 31, Dr. Daniel Amen was featured on the Dr. Phil show to talk about how to do a mental health checkup during the coronavirus pandemic. In this special feature, the two doctors provide the tools you need to boost your brain function and your psychological health to help you cope better with the current global health crisis. Here are some of the highlights of what they share.

1. Practice mental hygiene.

With people experiencing high levels of anxiety, fear, stress, and depression, it’s more important than ever to think about our mental well-being. “We have to pay attention to what we say to ourselves,” says Dr. Phil.

According to Dr. Amen, “Mental hygiene is just as important as washing your hands…literally we have to disinfect our thoughts.”

On the show, Dr. Amen offers several solutions to help viewers learn how to practice mental hygiene and to go from being filled with anxious and fearful thoughts to more positive and empowering thoughts that can help boost brain function as well as immune system function.

2. Don’t let your amygdala hijack your brain.

As Dr. Amen explains on the show, the amygdala is considered the fear center of the brain. When activity in this region goes up, activity in your frontal lobes goes down. The frontal lobes are involved in planning, judgment, and decision-making. This disconnect drives panic and fear and interferes with good decision-making. To keep your amygdala from hijacking your brain, avoid anything that lowers activity in the frontal lobes.

On the show, Dr. Amen shares 4 common things you may be doing that could be decreasing activity in your frontal lobes. And he offers a simple breathing technique that can calm your amygdala to help you feel better fast.

3. Remember, some anxiety is a good thing.

Too much stress and anxiety can attack areas of the brain involved in mood and memory and can suppress the immune system, however, some anxiety is beneficial. According to Dr. Amen, it’s what drives you to do the right things, like social distancing. Dr. Phil, a pilot since he was a teenager, says it’s a good thing “to recognize true danger.” Achieving a healthy level of anxiety is the key, and Dr. Amen offers a number of suggestions to help you mitigate rampant anxiety and replace it with appropriate concern.

4. Changing tiny habits can make a big difference.

On the show, Dr. Amen discusses the simple lifestyle changes and foods that can improve brain function, boost moods, and support the immune system.

5. Make sleep a priority.

The #1 thing you can do to keep your immune system operating at peak capacity is to get adequate sleep. In this feature of Dr. Phil, the pair of doctors offer simple strategies to help you sleep better.

Watch the Episodes here:

Self-Isolating? ‘Mental Hygiene Is Just As Important As Washing Your Hands,’ Says Psychiatrist

Psychiatrist Says Writing Down Negative Thoughts Helps To Get Them Out Of Your Head

Brain Specialist Offers Breathing Exercise To Help Relieve Anxiety During COVID-19 Pandemic

If you’re struggling with anxiety, panic attacks, depression, or other mental health issues, you aren’t alone—45% of Americans say the coronavirus pandemic has impacted their mental health. Just because you’re sheltering at home doesn’t mean you have to wait for the pandemic to be over before seeking help. In fact, during these uncertain times, your mental well-being is more important than ever and waiting to get treatment is likely to make your symptoms worsen over time. 

At Amen Clinics, we’re here for you. We offer mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples, as well as in-clinic brain scanning to help our patients. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk. 

 

Athletes who want to reach their potential are more than willing to devote 110% to their training efforts. They hit the weight room with scientifically backed programs designed to ramp up strength, power, or explosiveness. They monitor what they eat thanks to nutritionists who tailor diets specifically for their goals. They even turn to psychologists and mindfulness experts to boost their mental fitness. But there’s one critical piece missing from their regimen, and it’s something that can have a powerful impact on their performance, decision-making, motivation, accuracy, reaction times, and risk of injury.

What is this missing piece? Sleep.

Poor Sleep is Common Among Athletes

A wealth of studies shows that most athletes aren’t getting the sleep they need. In fact, research estimates that the prevalence of sleep disturbances among athletes ranges from 13% to as high as 70%. And sleep problems are seen in nearly all sports.

In recent years, contact sports have gotten the bulk of the media attention when it comes to head injuries and sleep problems, such as sleep apnea, associated with them. However, sleep disorders are also extremely prevalent in aesthetic sports, which are sports in which leanness is highly encouraged—think gymnastics, dance, cheerleading, and figure skating. An estimated 33% of athletes in these sports suffer from sleep issues.

In a study of 107 professional ice hockey players, 1 in 4 players was found to have a significant sleep disorder. Likewise, 25% of Canadian National Team athletes were identified as having clinically relevant sleep disturbances that required further clinical sleep assessment. In a 2019 survey of Qatar Stars League (QSL) soccer players, 68.5% reported poor sleep quality and 22.5% experienced daytime sleepiness. And the list goes on.

Basically, what these studies highlight is that there is a very high prevalence of sleep problems and sleepiness among athletes across all nations, ethnicities, and sports. And this is bad news for their performance.

Poor Sleep = Poor Performance

A growing body of evidence on a variety of sports show that sleep deprivation affects almost every aspect of athletic ability, including the following:

Optimal Sleep = Peak Performance

Conversely, getting adequate sleep on a regular basis can be just as impactful on performance in a positive way. For example, studies have shown that:

Elite athletes have devoted a lifetime to hard work and discipline, and sleep is the final frontier in performance optimization.

The first step is educating athletes that sleep is really a secret weapon to not only optimize individual performance, but also to improve overall health, enhance relationships with teammates and coaches, boost memory and learning, stave off aging and dementia, and improve immunity and the lifespan.

The next step is learning exactly how to develop a sleep training program for peak performance. You can find the specific steps you need to take in Peak Sleep Performance for Athletes.

In Peak Sleep Performance for Athletes author Dr. Shane Creado, who is board-certified in both psychiatry and sleep medicine and is on the Board of Directors for the International Society for Sports Psychiatry, shares his unique sleep optimization program for athletes that he uses with his patients at Amen Clinics. Order your copy here.

If you or a loved one is looking for that competitive edge or is struggling with sleep problems, Amen Clinics can help. Speak to a specialist today at 888-288-9834 or schedule a visit online.

 

 

By Shane Creado, MD

Everybody knows that a night of tossing and turning can leave you feeling groggy, crabby, and listless. But did you know that chronic sleep deprivation, or even a single restless night, can also negatively impact systemic inflammation and the immune system? Here’s what we know about the link between sleep and these key areas of health and wellness.

How Sleep Affects Inflammation

A wealth of research has shown that sleep loss activates mediators and markers of inflammation and cell damage. Poor sleep has been strongly linked to inflammation throughout the body—including the digestive tract—in inflammatory bowel disease. One study found that sleep-deprived patients with Crohn’s disease were twice as likely to relapse compared with patients who slept well.

Based on the growing scientific evidence, researchers have begun recommending sleep evaluations to help predict outcomes in sufferers of long-term inflammatory issues.

A Surprising Experiment

I recently met with a cricket player named Ashwin, who suffered from “golfer’s elbow” and wrist tendinitis flare-ups every year. This frustrated him because he was diligent about physical therapy, had been screened for chronic inflammatory and autoimmune disorders, and was an otherwise healthy guy.

In blood tests, his levels of the inflammatory markers erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were consistently elevated. In general, this can be related to a number of reasons, such as a poor diet, a chronic skin condition, hard training, or competitive sport.

I heard about this frustrating pattern of injury from his teammate and, as a sleep specialist, I was naturally curious about Ashwin’s sleep patterns. We decided to undertake a little experiment.

This was great news for Ashwin. It did not mean that his golfer’s elbow and wrist tendinitis would never recur, but perhaps they would recur less frequently and with less severity.

Ashwin is a good example of how improving sleep may help calm chronic inflammation. Research shows that getting good sleep turns off the pro-inflammatory processes that occur in people with poor sleep and insomnia. Because of this, I would recommend that every person with a long-term inflammatory condition needs to be educated about sleep optimization. And clinicians should make sleep education part of the treatment toolbox they use with patients or clients who suffer from inflammatory issues.

How Poor Sleep Can Sabotage the Immune System

Skimping on sleep or suffering from insomnia can weaken the immune system. A study showed conclusively that in healthy adults who were limited to 6 hours of sleep a night for one week, there was a change in their gene activity profile relative to when those same individuals were getting a full 8 hours of sleep a night. A total of 711 genes were distorted in their activity, caused by a lack of sleep. About half of those genes were actually increased in their activity, while the other half were decreased.

The genes that were switched off by a lack of sleep were genes associated with the immune system (which indicated an increased risk of infection). In contrast, those genes whose activity levels were increased by way of a lack of sleep were genes associated with the promotion of tumors, long-term inflammation, stress, and—as a result—cardiovascular disease, atherosclerosis, stroke, dementia, and other conditions directly associated with inflammation.

Even a small loss of sleep has been shown to impair immune function. One large 2-week study monitored the development of the common cold after giving people nasal drops with the virus that causes colds. (I think that was rather sadistic!) They found that those who slept less than 7 hours were almost 3 times more likely to develop a cold than those who slept 8 hours or more.

In a study where participants were restricted to four hours of sleep for a single night, there was a 70% drop in natural killer cell activity. These cells play a critical role in immunity, especially in fighting tumor cells and virally infected cells.

For all of these reasons and especially with the current coronavirus outbreak, it’s more important than ever to encourage patients and clients to make sleep a priority.

About the Author: Shane Creado, MD, Amen Clinics Chicago 

Dr. Shane Creado is a board-certified sleep specialist, who works not only on the treatment of sleep disorders but also on perfecting and optimizing sleep. He is the host of the Overcoming Insomnia course, which teaches the best evidence-based strategies to improve sleep. Dr. Creado is also the author of Peak Sleep Performance: The Cutting-Edge Sleep Science That Will Guarantee A Competitive Advantage, available on Amazon.

This book is primarily geared toward coaches, trainers, and elite athletes, but this step-by-step guide to sleep optimization can also be beneficial for anybody who wants to boost their brain health and productivity. For updates about the book, free sleep tips, as well as special offers, follow @peaksleepperformance on Instagram.