Undiagnosed ADHD could be the reason your antidepressants aren’t working

Dr. Stephen ManloveStephen Manlove, MD is one of the most entrepreneurial psychiatrists in the upper Midwest. Dr. Manlove graduated from the University of Minnesota Medical School and completed residencies in Psychiatry and Internal Medicine through the University of Virginia Medical School. He holds multiple board certifications in psychiatry/neurology, internal medicine and forensic psychiatry. This deep […]

mindfulness, therapy, young woman smelling wild flowers

Finding Inner Peace Through Mindfulness

The beauty of mindfulness is that it can help you uncover greater degrees of inner peace. I use the terms awareness and mindfulness interchangeably though I find awareness to be more descriptive of what we’re looking for as we walk through the introduction of practicing mindfulness below. 

Inner peace is the springboard for many positive emotions – joy, contentment, humor, satisfaction of one’s life, freedom, lightness of being. These all begin at the doorstep of peace. 

Mindfulness is a little like swimming in the ocean. You can go as deep as you want. This article goes ankle deep. It is up to you how far you want to take it from there. 

Our Thoughts vs. Our Selves

If you break down the sentence “I have a thought”, we see that an “I” has a “thought”. We don’t customarily think about the “I” and the “thought” as two separate things. However, if we challenge our mind to look at these separately, we begin to understand that thoughts are something that “I” have. Technically, one could say, I am not my thoughts. 

As a culture, we’ve been taught to associate our identities with the thoughts that we have – the thoughts about ourselves and the stories we tell ourselves. Another way of looking at our identity is our awareness. And, I would suggest that our awareness is actually the deepest part of who we are. 

This is a new way for most of us to see ourselves. Where is it that we attach our identity? Is it in the awareness or is it in the thoughts we have?

That’s where we begin. We could ask, where do thoughts come from? Part of the goal of mindfulness is to become a student of our own thoughts. We consider:

  • How do thoughts serve us? 
  • Do we have to believe all of our thoughts? 
  • What’s the relationship between our awareness and our thoughts? 

Taking a Step Back

When I was a kid, my friends and I liked to go to the movie theater to see scary movies. To cope with our fears during the films, we learned to mentally take a step back from the screen when it got too frightening. If you think about that, that is a very unique, very human ability. Animals to our knowledge can’t do this. 

By taking a step back we can change what our mind focuses on. For example, I can focus on the lights, the reactions of the people around me, the smell of popcorn, the fact that I’m out with my friends to give my mind a break. Then, when I am ready, I can re-immerse myself in the film. This is a really nimble ability that we have to take a step in or out of our situation. 

This same idea of taking a step back is how we begin to practice mindfulness. 

Upsetting Thoughts Destroy Inner Peace

Upsetting thoughts disrupt inner peace. Everyone has upsetting thoughts at times and everyone has their own kind of upsetting thoughts. There are typically two different styles:

  • Anxious/worrisome thoughts
  • Angry/frustrating thoughts

Upsetting thoughts can come out of nowhere. When you have an upsetting thought, whether you realize it or not, you have the choice to pay attention to that thought or to let it pass. 

Thoughts are a lot like clouds. They come somewhere from the west, they’re in front of us, and then they disappear somewhere to the east. They are always in motion.

If we decide to pay attention to an upsetting thought, we pull it into our consciousness. Thoughts have a way of just moving through, but we have to deliberately pull it into our consciousness for us to focus on them. 

When we begin to focus on that upsetting thought, it triggers other anxious/worrisome thoughts, so we let that cloud grow in size. Again, you have the same choice to focus on them or let them pass. It takes effort to bring thoughts into focus. 

When we start having anxious/worrisome thoughts, it creates anxious/worrisome feelings. Once we begin to have anxious/worrisome feelings, it feels more real. Feelings have a greater depth to them which hook us more. That’s what we want to find, what hooks us.

It would be normal to have a generic upsetting thought, followed by an anxious thought, and then a discouraged/depressed thought. At each point in this progression, we have the choice to let it pass or follow it down the path. 

If I choose to follow my upsetting thoughts, I will end up with a completely cloudy sky. No longer aware that I am a thinker having thoughts, I become lost in my thoughts. 

Step 1: Notice Upsetting Thoughts

The first step to being a student of our thoughts is to simply notice when we are having an upsetting thought. 

By simply planting the intention of noticing when you are having upsetting thoughts, you will begin to notice when you are having upsetting thoughts. 

We need to nurture this ability on a daily basis, reminding ourselves to catch ourselves having upsetting thoughts. As you practice, you’ll get faster at identifying them. The more quickly you can identify them, the easier it is to stop them before they get momentum going. 

Step 2: Identify Whether Your Thoughts Are Useful or Useless

Once we get a hang of noticing upsetting thoughts, have some curiosity about your upsetting thoughts. See what they do. See what they create for you. 

Some questions to consider:

  • Is there a connected theme?
  • Are they helpful in some way?
  • How do your thoughts affect your inner peace?

We can’t presume that all thoughts are helpful. We can protect our inner peace by identifying when we are having upsetting thoughts and understanding if they are useful or useless to us. 

Step 2: Catch & Release Upsetting Thoughts 

We all experience events of life. And when we do, we create and react to the commentaries that we use to describe those events and dramas. We are meaning seeking creatures, so we create stories about these events. They may be positive, neutral, negative, and even hostile. 

When we react and create these commentaries, we have a choice. Put strongly, we can become victims of our own emotions and our thoughts about those comments, or we can take a step back and witness these storylines as they develop. As Mark Twain said, “I’m an old man and have known a great many problems, most of them never happened.”

As we take a step back, we allow our thoughts to fade into silence. Again, thoughts are always in motion. Our brains are made for thinking. Our thoughts are valuable tools in the right context. They are here to serve us, but they can lead us astray. 

Our goal is to simply be more aware of our thoughts and which ones are useful and which are useless to us. Not all thoughts are created equal.   

Some thoughts are stickier than others, and no one will be perfect at this. It’s a matter of doing what we can to not be reactive to all of those storylines our minds create. As we do this, we begin to find peace.

Step 3: Focus on the Present

I used to have a Golden Retriever named Max. He could be asleep, but if you threw a stick, he had to go fetch it. I’d suggest that he didn’t have a choice, he was bred for that. People have more freedom than that. We don’t have to fetch every thought that comes into our mind. 

If you observe your mind, you’ll notice that it might dwell in the past or fixate on the future. Our mind has no time to waste. It has to find things that are potential threats or look for problems to solve. This isn’t a bad thing unless it leads us to places we don’t need to go. We want to notice that we are having thoughts and evaluate whether our fixation on the past or future is helping or hurting us.

We can become more aware by focusing on the present. You’ll notice that our mind is easily bored. In stillness, it has a tendency to race about for something to fill it. One way to embrace the stillness is to take a few deep breaths. Breathing is naturally relaxing and allows us to ground ourselves in the present moment. 

The mind can be afraid to be present to now. It’s afraid of what might be perceived as emptiness, but we may find beauty and delight in emptiness. 

The mind is not prone to trust life. It tends to thrash about looking for potential threats. Our mind tends to over prepare, becoming vigilant. The mind is always looking to create meaning out of things so that it doesn’t have to deal with emptiness. It’s amazing the way we flee emptiness. It’s also ironic that it’s the least thing we need to fear. 

Meditations On Now

Something about now is nurturing. It tends to be overlooked. Now is present. It touches stillness, and is often joyful. There’s a lightness of being in now; it does not get lost in the outer circumferences of life, the outside trivias and dramas that don’t amount to much. There’s a serenity to now. Now demands nothing. It simply is. The experience of now is an experience of a deeper reality. Now can lead to an awareness of the connection to a greater whole. I am now. This last one is a little more than ankle deep in the ocean, but it’s worth some reflection. 

Practice Protecting Your Peace Every Day

We find inner peace by valuing inner peace. I protect my peace and sense of wellbeing from upsetting thoughts that aren’t worth engaging in. It’s a choice. It’s a deeply human choice. And, it’s where real freedom exists. 

Mindfulness is all about being nimble with what we choose to think. We don’t have to go to every place that our thoughts take us. We all have these abilities, we just need to be deliberate in using them. We need to remember to take a step back and ask ourselves, is this a thought worth having? 

Join Us for Group Therapy

Manlove Brain + Body Health is now offering group therapy sessions for depression, anxiety, and PTSD. Learn more >

 

marijuana and mental health

How Medical Marijuana Affects Mental Health

Due to its relaxing effects, it is commonly assumed that cannabis is helpful for people with anxiety. While cannabis can induce a temporary reduction in anxiety, once the immediate effects wear off, people typically experience an increase in anxiety. In fact, regular cannabis use may slowly ramp up anxiety between each use. 

Cannabis is a depressant and is known to worsen depression. At Manlove Brain and Body Clinic, we have seen depression decrease and motivation increase for many patients when they stopped using cannabis. Marijuana also worsens many other mental health conditions such as ADHD, bipolar disorder, and any psychotic disorders, including schizophrenia. 

Marijuana and Stimulants

Using marijuana in combination with a stimulant such as Adderall can be dangerous. When you combine marijuana with a stimulant, the effects can cancel each other out and increase the need for both drugs to have the same effect. This can become a dangerous cycle, as marijuana can be mildly addictive. By taking higher doses, you may be at greater risk of developing an addiction. 

How often does marijuana addiction occur? The age at which you begin using marijuana can greatly affect your chances of becoming addicted. 1 in 6 people will become addicted to marijuana if consumption begins before the age of 18, while 1 in 10 people will become addicted if consumption begins as an adult (SAMHSA). 

Use Caution

Anyone who chooses to use marijuana should use caution, as it can have unpredictable consequences, including worsening anxiety, panic attacks, and paranoia.  Effects may vary greatly from person to person and between uses. Marijuana usage is linked to depression, anxiety, suicidal thoughts, and psychotic episodes (SAMHSA). 

Special Considerations for Marijuana Users

If you are currently taking stimulants or have been diagnosed with psychosis, you should refrain from marijuana use altogether. If you have another mental health disorder, it is best to avoid marijuana use. If you do choose to partake, keep consumption to occasional use only because regular use is likely to worsen your mental health condition(s). 

In addition to a heightened potential for addiction, marijuana can have serious long-term effects on the teenage brain. Since the brain does not finish developing until approximately the age of 25, marijuana use can affect normal brain development if used too early. Early marijuana use can lead to permanent problems with memory, learning, and judgment. 

If you or someone you know is struggling with addiction, please reach out to your family physician or a substance abuse specialist as soon as possible. View the South Dakota Department of Human Services’ list of local resources for drug and alcohol addiction. 

Our Practice

For sustained relief for depression, anxiety, PTSD, or other mental illness, your mental health provider will likely recommend terminating all marijuana usage. 

At Manlove Brain and Body Health, our professional standard is not to mix cannabis and certain medicines. Cannabis, even for medical use, can aggravate mental health conditions, such as ADHD, anxiety, and depression (as do alcohol and stimulants). An important part of what we do is manage medications for patients, which means choosing the best combinations for patient wellness. 

Our mental health providers work with you to maximize your whole body health. We work to get to the root of your psychiatric condition by incorporating holistic practices such as lifestyle modifications and vitamin/mineral supplements to ensure that your brain functions optimally. This also includes removing potential triggers and managing medications to ensure that you have an optimal combination that will provide the maximum benefit with the least amount of medications necessary. Covering up symptoms with medications or drugs will only result in a need to increase the amount of medication you are taking over time to have the same therapeutic effect. 

If you or someone you know is struggling with anxiety, depression, ADHD, PTSD, psychosis, or bipolar disorder, we can help. To schedule an introductory appointment or to learn more about how we can help, give us a call: 605-348-8000. 

 

Group therapy

Psychedelic Assisted Psychotherapy at Manlove Brain and Body Health

Manlove Brain and Body Health recently announced that they will be offering group and individual therapy sessions for depression patients. To learn more about this new offering, read the interview below with therapist Gaylen Bendewald, MSW who will be leading these sessions.

Who are these psychotherapy sessions intended for?

Both of the group and individual sessions are specifically designed for depression patients who are undergoing ketamine therapy as part of their treatment plan. Ketamine is a very unique and powerful medication that can help rewire the brain. With these sessions, we will help patients process their ketamine experience and help them find ways to positively restructure the way they think about themselves and the world around them. 

What are you hoping patients will gain from attending these sessions?

I hope that with these sessions, patients will:

  • Develop the emotional state needed to get the most out of ketamine 
  • Process the experiences you have while in ketamine treatment or other treatments for depression 
  • Explore the untapped potential for change through ketamine treatment coupled with mindfulness training 
  • Learn to celebrate life again

In addition, I think group sessions will be especially beneficial for patients to see that they are not alone. Hearing the stories and strategies of other patients who are going through a similar journey can have an incredible impact on patients to find their way through dark times.  

Tell us a little bit about your background.

I am a licensed clinical social worker with 45 years of outpatient experience. I love to incorporate mindfulness and meditation in my counseling practice, and I have led a meditation group alongside my wife, Lois, for 10 years, as well as taught mindfulness for many, many years.

When will sessions be available?

Group therapy will be offered on Tuesdays from 12pm-1:15pm starting in the next several weeks.

Individual therapy sessions will also be available during clinic hours on Tuesdays. These sessions are meant for people who want to become more of “a student of their own thoughts” through mindfulness or awareness training as a means to a more peaceful, joyful life. 

Will therapy sessions be covered by insurance?

We are working with a variety of insurance providers to cover the cost of therapy sessions for our patients. Please check with your insurance provider to confirm that Manlove Brain and Body Health is in network and that your coverage includes psychotherapy. 

How can patients sign up?

To sign up for group or individual therapy sessions, please let our front desk staff or your current Manlove Brain and Body Health provider know that you would like to sign up. You can reach our front desk staff at 605-348-8000 or [email protected].

 

In addition to offering therapy to help you process your ketamine experience, learn how we ensure you have the best ketamine treatment experience.

improving brain health

10 Lifestyle Tips to Improve and Extend the Life of Your Brain

Dr. Stephen ManloveStephen Manlove, MD is one of the most entrepreneurial psychiatrists in the upper Midwest. Dr. Manlove graduated from the University of Minnesota Medical School and completed residencies in Psychiatry and Internal Medicine through the University of Virginia Medical School. He holds multiple board certifications in psychiatry/neurology, internal medicine and forensic psychiatry. This deep […]

Delusions, Delusion-Like Beliefs, and Conspiracy Theories

Delusions, Delusion-Like Beliefs, and Conspiracy Theories

Dr. Stephen ManloveStephen Manlove, MD is one of the most entrepreneurial psychiatrists in the upper Midwest. Dr. Manlove graduated from the University of Minnesota Medical School and completed residencies in Psychiatry and Internal Medicine through the University of Virginia Medical School. He holds multiple board certifications in psychiatry/neurology, internal medicine and forensic psychiatry. This deep […]

How to Combat Seasonal Depression

In a recent blog, we outlined the differences between depression and sadness. For those with seasonal affective disorder (SAD), it can be even more challenging to determine if you have depression or if you are experiencing temporary sadness due to the temporary nature of SAD. Luckily, there are several remedies that can be easily implemented on your own that will help improve your overall health and can even help prevent clinical depression from developing. If you think you might have seasonal depression, give some of these recommendations a try. 

If you need additional support, don’t be afraid to reach out to a psychiatrist for a personalized treatment plan. 

What is Seasonal Depression?

Seasonal depression is depression caused by the changing seasons, typically beginning in late fall and lasting through early spring. SAD can affect anyone, but those who live in the northern regions of the United States may be at a higher risk. 

Symptoms of seasonal depression may include:

  • Lack of energy
  • Loss of interest in usual activities
  • Difficulty sleeping or oversleeping
  • Difficulty concentrating
  • Feeling hopeless
  • Mood swings
  • Weight gain

SAD is more than being sad about the cold weather. If seasonal changes affect your ability to function as you normally would, this is a good indicator that you may have seasonal depression.

What Causes Seasonal Depression?

Seasonal depression is caused by a chemical imbalance in the brain. In many cases, this is triggered by low serotonin levels, which is an important chemical in the brain that regulates your mood. In other cases, it could be caused by an overproduction of melatonin, which helps regulate your sleep cycles and makes you feel tired. Both serotonin and melatonin help maintain your body’s daily patterns that signal when it is day or night. Seasonal changes may cause your body to over or underproduce these chemicals making it difficult to function as you normally would.

How are these chemical imbalances related to seasonal changes? The lack of sunlight during the winter months can lead to vitamin D deficiency which can cause these imbalances in the brain. Vitamin D helps promote serotonin activity and is inversely connected to melatonin levels. When you are deficient in vitamin D, your serotonin levels drop and you may begin to overproduce melatonin. 

Ways to Combat Seasonal Depression


Increase Vitamin D Levels

Since seasonal depression is often triggered by a lack of vitamin D, it’s no surprise that the best way to combat seasonal depression is to address any vitamin D deficiencies you may have. Here are a few ways you can increase your vitamin D levels:

  • Get outside for 10-15 minutes every day. Going for a daily walk outside will have incredible benefits for your overall health and will give you the much-needed sun exposure to help boost your vitamin D. Even if you are bundled up for the weather, getting some sun exposure on your face will have some benefits. 
  • Incorporate vitamin D rich foods into your diet. 
    • Egg yolks
    • Orange juice fortified with vitamin D
    • Cow milk or plant based milk fortified with vitamin D
    • Wild caught salmon
    • Tuna
    • Swordfish
    • Mushrooms
    • Fortified cereal
  • Take Vitamin D supplements. While the best way for your body to absorb vitamin D will be from sun exposure and vitamin D rich foods, your body will likely absorb at least some vitamin D from over the counter supplements.


Light Therapy

If you live in a northern or midwestern region, getting outside everyday is still very important, but you may need more light exposure than what you are able to get naturally. Consider purchasing a lamp for light therapy. You can find some relatively inexpensive lamps online that you can place on your desk, end table, or even set up on your bathroom vanity for when you get ready for your day. It is best to use the lamp for at least 30 minutes each day, ideally getting a minimum of 10 minutes within the first hour of waking. 

Light therapy helps signal to your body that it is day time. This will reduce the production of melatonin and increase your serotonin production.

Some individuals may begin to feel their mood lift within a few days of beginning light therapy and most will begin to feel a reduction in their depression symptoms within two weeks.


Ketamine for Seasonal Depression

Typically used for treatment resistant depression, ketamine therapy can be a good option for those who are severely affected by seasonal affective disorder. Ketamine can be administered as a nasal spray, shot, IV, or oral medication and can be used on an occasional basis which makes it a good option for treating SAD.


Psychotherapy

Psychotherapy, also known as talk therapy or simply “therapy”, is when an individual sits down with a mental health professional to pinpoint potential triggers of their depression and discuss coping strategies. This can be a good option for those with seasonal depression by recognizing unhealthy thought patterns and retraining the brain. This can be done on a seasonal basis for some extra help when you need it. However, for some, it may be best to participate in psychotherapy on an ongoing basis to help you prepare your thought process for the darkest months.


Improve Your Overall Health

At Manlove Brain and Body Health, we encourage our patients to improve their overall health in as many ways as possible. By improving the overall health of our patients, we have been able to improve their response to depression treatment. No matter how severe your seasonal depression is, you can improve your brain’s response to your treatment methods by eating a healthy diet, maintaining healthy social connections, getting at least 7 hours of sleep each night, limiting caffeine, meditating, and exercising for at least 150 minutes each week. 

By improving your overall health, you are improving your brain’s ability to function properly. This can help your brain adapt to seasonal changes and can prevent other brain diseases including clinical depression, anxiety, mood disorders, and dementia. 

If you experience seasonal depression, try increasing your vitamin D levels and consider purchasing a lamp for light therapy. If these home remedies are not enough, see a psychiatrist to explore ketamine, psychotherapy, or other treatment options for your seasonal affective disorder. 

am i depressed?, depression signs, depression symptoms

Am I Depressed? Know the Signs and Symptoms of Depression

The biggest question people want to be answered before going to see a psychiatrist is: Am I depressed? While no one wants to go through the hassle of making a doctor’s appointment for no reason, it’s always best to ask a mental health professional the answer to that question.

However, to help you determine if it’s time to seek help, The Washington Post recently posted a great article that shares How to know if it’s depression or just ‘normal’ sadness. The biggest takeaway is that sadness is usually linked to a specific event like the loss of a loved one, while depression is typically a consistent negative feeling about one’s self such as feeling like a burden to your friends and family.

Here is a list of depression symptoms to watch for:

  • Change in appetite – this may be a loss or increase in your appetite
  • Sleeplessness
  • Feeling anxious
  • Feeling guilty
  • Suicidal thoughts
  • Feeling angry or irritable over small things
  • Tiredness
  • Trouble concentrating
  • Difficulty remembering past events
  • Loss of interest in hobbies or activities

Everyday Sadness Versus Sadness Every Day

While everyone may experience at least some of these symptoms on occasion, individuals with depression often experience multiple, or even all, of these symptoms on a daily basis.

That brings up an important distinction to be made about the article and the author’s use of the phrases ‘everyday sadness and normal sadness’, which could easily be confused with ‘sadness every day.’ Clearly, the author’s intent is to spell out that depression is different from occasional and temporary sadness, so you shouldn’t shrug it off.

Depression typically comes in waves that happen multiple times throughout one’s life. Time doesn’t always heal. So even if the problem seems like something you just need to power through … don’t go it alone.

The critical message here is to get professional advice starting with your primary care doctor, or give us a call: 605-348-8000. If you think you might need to seek help, chances are it would be beneficial for you to see a mental health professional.

anxiety screening, questionnaire

Screening Patients for Anxiety: Then What?

New recommendations from the US Preventive Services Task Force (USPSTF) gives busy primary physicians and their teams one more thing to implement and manage: anxiety screenings. While the recommendation that adults ages 64 and younger should be screened for anxiety is a major step toward improving mental health across the US, for many physicians, the question quickly becomes, ‘OK, screening will identify patients needing help; then what?’

Megan Burgard CNP at Manlove Brain and Body Health

Mental Health Specialist, Megan Burgard – Nurse Practitioner

Introducing Nurse Practitioner, Megan Burgard to the Manlove Brain and Body Health team!