Your Diet and Your Mood: Vitamin D and Omega-3s

Diet is important to health and, of course, to mood management. Making wise changes to your diet is something you can easily implement. Following is a collection of some of the more verified nutrition elements which are related to improvements in mood.

Low vitamin D levels are associated with greater risk for depression. Though vitamin D is not a stand-alone treatment for depression, it is good to make sure you are getting enough. The main source is from exposure to sunlight, but this has its own risks. Taking a supplement of 1,000 -2,000 IUs is an option.

Vitamin D and Depression article

Our brain and nervous system need fats. Nerves are sheathed in nodules of fat and nerve signals move quickly by jumping along the fatty covering. A particular kind of fats found in fish, Omega-3s, have been found to ward off depression and even improve it. You can get Omega-3s by eating fish several times per week. Or you can take a supplement which contains the EPA and DHA variants. Supplements come as fish oil but also can be krill oil. (This might make a difference in taste.)

Harvard Article on Omega-3 and Depression

It is always better if you can get your nutrients from the foods you eat. Anti-oxidants are in fruits, Omega-3s are in fish, protein is in meat and nuts and beans, healthy carbohydrates are in whole grains.

WebMD Diet and Depression article

You may have heard that chocolate helps mood. So if you are a chocolate fan, this is good news! Dark chocolate is better than milk chocolate for this purpose. And limit it to only 1 oz. per day.

Chocolate and Mood

These are some of the main diet approaches to mood management which are encouraged by the medical field. There are many healthy options including drinking enough water. Be sure to research anything that interests you. And with supplements, keep in mind that there isn't oversight by the FDA, so what you are getting in the caplet isn't verified.

Three Ways to Improve Falling and Staying Asleep

Sleep is one of the most important components of being healthy. It is during sleep that we rest and rejuvenate. During sleep, our mind sorts and categorizes the day’s experiences and solidifies memories. Our muscles and tissues heal. Lack of sleep has been shown to contribute to hallucinations and mood disturbance. So poor sleep can mess up your mood, but a mood disorder can mess up your sleep. At least poor sleep accompanies most mood disorders. Getting sleep under control can be a significant aspect of getting mood under control.


Make a habit: Our brains are creatures of habit and association. You want to create habits which indicate to the brain that it is time for sleep. First, have a schedule of going to bed and waking up at the same time every day. This means weekends, too, if you have sleep difficulties. Have a wind-down routine to get ready for bed: change into sleep wear, brush your teeth, read or do something relaxing, do a sleep meditation. Some activities are best done earlier in the day. Exercise helps one to get a better night’s sleep if done earlier in the day, but can make sleeping difficult if done too close to bedtime. Also, use of electronics and viewing screens should be stopped about an hour before bed. They have been found to inhibit the production of melatonin by the brain.


Break an association: When you go to bed, if you find yourself lying there thinking and not able to fall asleep longer than half an hour, get up out of bed. As I said, our brains make associations. If every night you lie in bed thinking, your brain decides the bed is your thinking place! So, get up and move to another part of the room. Go into another room if you can. Do not turn on the TV or get onto your computer! If you are doing those things in the middle of the night, again, your brain thinks that is the time to do those things instead of sleep. Keep lights dim and do something quiet or relaxing even boring until you get drowsy, then go back to bed and try to sleep again.


Fix the environment: The sleep environment is important. The room should be dark and a little cooler than during the day. It should be quiet. If there is someone in your vicinity who snores and you have poor sleep along with a mood disorder, it is a matter of health to get away from the snoring party. Some people like “white noise” or some background noise like a fan. But again, because of association, you could find that you cannot fall asleep without the background noise, and when traveling, have to take your noise source with you. Others might not be able to sleep around you! It is best to not have any electronics emitting light in the room, especially blue light which research has shown disrupts sleep. Get the devices out of the room or cover them or put them away where the light cannot be seen. Also, turn off electronics or put them away somewhere so that you are not receiving texts or alerts during the night.


A lot of people do not like to make the changes needed for better sleep, especially stopping the use of electronics. If you are diagnosed with and seeking treatment for a significant sleep or mood disorder, however, it is important that you do everything you can to help improve your sleep.

A Blank Mind

This is a time with our economy shut down when people are feeling a lot of uncertainty and fear. In thinking about how to cope in this situation, I thought about years ago when I agreed to do a first jump with a parachute out of an airplane. Just the fact that I agreed to that means the average person doesn’t think like me! But if you can, my thought process which allowed me to do the jump could be helpful during times of uncertainty.


I had three days of in-class instruction and then the day came. Before even going up in the plane, my mind basically went blank. I talked with people and did things I needed to do, but I wasn’t thinking much. I remember someone walked by while I ate a sandwich and wondered how I could eat before a first jump. I just wasn’t thinking much, was kind of numb, and so I still had an appetite! Once in the airplane and flying, I waited as a couple of other people went before me. I think it was all so out of my experience that I was in a kind of shock or amazement. I did the jump and that is quite a fun story! 

But coping with uncertainty and fear is what this is about. Over the years, I had a few people show interest in doing a jump if I would go with them. I turned them down. During this time, I worked as a therapist with clients experiencing severe chronic pain. They were not living the life they wanted. In the group of people that I jumped with, someone broke their tailbone, someone broke several bones in his foot, and someone got whiplash. I did, too, and I still have residual issues in my neck. When people wanted me to go again, my thinking had changed. I now knew too much about the sequence of experiences involved in the jump process. I now thought about how my life could be damaged if I had a back injury, for instance. If I went again, I would be more afraid because it was no longer an ‘out-of-this world’ experience. I wouldn’t be in shocked amazement; I would think enough to be scared!

I always remember that now in times of high stress when I don’t know how things will turn out. I try not to think about it! 

I still do things to stay on track and set myself up well, but I also do a lot of distraction to get through. I stay busy, but I also go into that blank-mind mode if I can. Thinking about how badly it could go wrong is not helpful. There are times when a person just needs to keep moving forward. So as Scarlet O’Hara said in Gone with the Wind, “I can’t think about that today. I’ll just go crazy if I do! I’ll think about that tomorrow.”

Thinking Matters

Did you know that your thoughts lead to your emotional reaction which then leads to how you act?


Here is an example that I like to give:


If we were sitting in a group of people, and a rabbit was released into the middle of the group:


One person might think, “Oh, what a cute little bunny! Rabbits are so soft and sweet. I love rabbits! I want to pick it up!” As a result, that person could feel happy, warm, loving and might move to go pet the rabbit or to pick it up.


Another person might think, “I hate rabbits! They scratch and bite. Rabbits are just awful rodents. Get it away from me! Get it out of here!” As a result, this person could feel fear, anxiety, anger, disgust and might move to chase the rabbit out of the room or the person might leave the room.


These different reactions come from the way the person thinks (and past experience which shapes thinking.)

This is why, if you struggle with emotions which overwhelm you or moods which hinder you, it helps to look at your thinking. Changing your thinking can help you manage your emotional reactions.


About now in my explanation is when people jump to the injunction to “think positive!”

Now, thinking positively does have its usefulness, but it has been used so often and it just doesn’t always fit some situations. Many people feel annoyed when they hear “Think positive!” posed as a solution.


The reality is that much of our thinking which leads to unpleasant emotions is extreme. It jumps to the worst outcome. It eliminates a variety of possibilities.


Managing your emotions can be helped by changing your thinking to be more moderate and reasonable. Instead of jumping to the worst conclusion, look at the situation as it is and think of how to handle it at that time.


The next time you are in the middle of a strong emotion or are distressed in some way, slow down and ask yourself, “Am I making this worse by how I am thinking? How can I handle what is happening right now?” 

Then you can choose an action to take such as doing something distracting or getting some exercise. You can look at what is in your control and make decisions about that. 


Change your thinking to manage your emotions.

Five Steps to Find Your Motivation

I frequently hear from my clients that they are not motivated. They don’t feel like doing anything. Yet many do not like any amount of downtime. I think in some way they are not in touch with themselves or they do not like their own company. (Some have trauma and are avoiding painful, intrusive thoughts. That is another more complicated issue.) Some people stay busy with activities, often driven by shoulds and have-tos, trying to please others. Some people want to have another person interacting with them. Some people need a constant distraction such as TV, You Tube, games or social media. Society also imposes expectations that, over time, can put a person on auto-pilot meeting responsibilities, but not engaging in fulfilling activities. It is this sense of fulfillment, inherent interest or curiosity, or simply enjoying the experience that would naturally lead to a feeling of motivation.


During this time when the whole country is being encouraged to stay home, this could bring uncomfortable feelings to the forefront for many. Staying home could be a miserable experience. I think this would be a good time for people to get more in touch with themselves and more comfortable with their own company. In order to feel motivated, a person needs to look forward to something. (People can also be motivated by fear or by a threat, but this is not the kind of motivation people are seeking.) In order to look forward to something, it helps to know what you like, what you enjoy. Some people have become so out of touch that they don’t know what they like. They don’t have an opinion anymore. They don’t care. 


In order to feel more, to have a care, to want to do something, a person needs to get in touch with his/her own experience of likes and dislikes. The person needs to know his/her own opinion.


I recommend five steps to reconnect and find motivation. 

First, believe that you have the right to have an opinion. It is not selfish or bad. 

Next, stop to notice your own reactions. Start with small things such as what color do you prefer; do you actually like the food you are eating; do you feel physically comfortable; what temperature do you like the room to be? Instead of thoughtlessly going along with what others want, ask yourself if it is what you want. 

Third, voice your opinion. You don’t have to do this in a demanding or rude manner. You do not have to press for others to change in any way. Just speak up for yourself. Much of the time, one’s preferences do not even affect others. 

Fourth, take action. Purposely with intention, do things you like. Set aside time for enjoyment. 

Finally, learn to advocate for yourself in an assertive manner. Make a conscious decision about either going along with others’ desires or advocating for what you want. Assess the pros and cons.


Identify your authentic likes and dislikes and you might find your motivation.

Take Back Some Control While At Home

Exactly two weeks after my blog post saying I would be making the most of spring and summer, my state is under stay-at-home orders to control the spread of the COVID19 virus. Due to my compromised immune system, I was sent home from work even though the acute psychiatric unit is open as an essential service. Now, the weather has turned cooler than average and it is raining for several days in a row. My job still exists, so I am not in the dire straits as are many others.


These conditions - staying home, being more isolated, not productively working, uncertainty about the future – can take a toll on people’s mental and emotional wellbeing. Anxiety and depression increase. There are truly significant stressors and we do not want to deny that. However, we can do certain things to help us tolerate the situation and persevere. 


Of course, I always talk about managing one’s thoughts. I am a cognitive-behavioral therapist after all. Try not be judgmental of yourself. I am talking about the thoughts that you are worthless and lazy if you are not working and you are a failure if you can’t support yourself or your family. The appearance of the corona virus was completely out of our control. Government is closing down the places of employment. And I know it is easier said than done, but try not to think too much about the future. At least, don’t let your mind go to the extreme catastrophe. Consciously each day take some time to just be. Accept the current moment and do with it what you can. Take care of your home. Spend some time on the hobby you never have time for. Listen when/if someone wants to talk with you.


Give yourself a semblance of a schedule. At first, lounging on the couch binge watching a favorite series on Netflix and taking naps, seems wonderful. It doesn’t take long, though, until you start feeling sluggish and bored. Decide on one or two things you want to attend to that day. Block out some stretches of time to dedicate to those activities. They could be practical things that you have neglected or more self-fulfilling things. But decide how you will spend your time. You don’t have to schedule every hour, just give yourself a time period such as in the morning and in the afternoon. Identify a start time. And do take a shower somewhere in there. It will help you feel better.


Take care of yourself. You know all of the healthy advice. In particular, do try to go outside to breathe fresh air and hopefully get some sunlight shining on you even if you have to stay on your porch. At least it is spring and better weather is coming. My point is, be aware that certain conditions exist which tend to encourage depression and anxiety in particular. With that awareness, make choices to counter those effects.

A Therapist Facing Challenges Which Test Emotional Endurance

I have joined the clan of chronic illness. Don’t worry. I am not going to go on complaining about my miserable symptoms. Instead, I think it is very interesting how a therapist who has taught about cognitive distortions for over 20 years responded to some significant medical occurrences.


First, six years ago, I suddenly had a foot fracture. I had run a 10k two months before! As I was winding down from that, I took up Pilates. One day, I got into a plank position which caused pain in my toes. Then my foot swelled and it hurt to walk. It didn’t go away. The doctor said it was just the final straw on an overstressed fragile bone. The flawed structure of my foot shifted the pressure to a smaller bone when my foot landed during running. Well, that meant I really shouldn’t keep running. I was unhappy. Becoming a runner in my 40s had improved my self-image. Now, this just placed me back into the physically weak, uncoordinated, rejected role I had lived most of my life.

I healed from the foot fracture and stayed active with walking, hiking, swimming, and paddle boarding. While growing up, I was not athletic nor was I comfortable in or around water. These activities I took up independently out of my own interest and curiosity. This again contributed to improving my self-image. 

Then, I developed a chronic cough. I had learned to wait things out and they usually went away. Plus, whenever I was out on the water, I could exert myself and not start coughing. Seemed like asthma to me. But the cough got worse, louder and more forceful. I was certain I was scaring everyone around me. Over more than a year passed as my doctor tried to eliminate possible causes. Then a CT scan of my lungs produced a very alarming picture. I was rushed in to see a lung specialist the next day. Soon I met with a lung surgeon and I was admitted to the hospital for a surgical lung biopsy. 


The two nights in the hospital following the surgery were quite painful. This is where my own thinking became interesting. The pain was severe. I thought, “I can’t stand this! I can’t go all night hurting like this!” But it got worse. The pain medication caused me to vomit. “Do I take it for the pain? What if it makes me sick again? But this pain is too much!” I was hurting and could not get comfortable. The night was very long. I had the sense of despair. But I caught my own thinking and reminded myself that I was the one who taught others that your way of thinking can make the experience of pain worse. Time to take the medicine I handed out to others. I told myself I wasn’t going to die from the pain. It wouldn’t be forever. Others got through this sort of thing. I can handle it. Luckily, the pain was less the second night.


I was diagnosed with an autoimmune disorder and began treatment. I was positive and had faith in the recommended treatment. The process to get cleared up and into remission took almost a year. But I was triumphant! I engaged in healthy activity and decided I would walk a 5k at the end of May. But as I increased my distance and pace, my foot began hurting down the side. I backed off a little and hoped the pain would go away. One day, I went for a little trail hike and knew I had to keep to a flat path and take it slow and careful. I knew this wasn’t good.

I ended up in a walking boot again with a stress fracture in a different spot. I was so upset that simply walking would cause a fracture! I was upset that I wasn’t capable of doing a 3.1-mile fun walk. This was going to be my marker of recovery from my lung issue. Nope.

I was still in the boot when it was time for a camping trip I had planned. I went camping and made the best of it. In years past, I wouldn’t have gone. Still, I was highly frustrated at my bad luck. I wasn’t experiencing the full joy of camping. Plus, a bone scan showed that I had osteoporosis years before I should. After about a decade of running which I was sure was building my bones up and protecting me, it turned out the treatment for my lung disorder may have contributed to bone weakening and loss! How could this be after all of my hard work and persistence? Why me?! I felt very discouraged and vulnerable. Then my cough returned! A CT scan again produced an awful picture. I went back on medication. Now I was knowingly taking something that harms bones in order to save my lungs. I felt trapped.


I am currently tapering down off of that. My foot has healed. Spring is around the corner. Shall I try it again? How much walking can I do? At what pace? Should I try to increase? What about hiking? Is it safe for me to go on mild natural trails? What if I mis-step? I am at risk for a hip fracture not just a foot fracture. But it seems I have some natural optimism (or the ability to distance myself from reality). I have plans to be active and to get as much enjoyment out of spring and summer as I can. My kayak and my paddle board are waiting!