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Note from Carole Carson: The guidelines below were provided by Dr. Maxine Barish-Wreden.  Dr. Max provides this advice to her patients who find themselves dealing with stress, anxiety and depression.

Mind-Body Practices

• Decide you are going to get better.  Create a positive intention for yourself every morning about how your day is going to go.
• Focus on what you want to create in your life, on what inspires you, instead of focusing on what you are trying to get rid of. Make a Treasure Map (collage or picture) of your intended outcome for yourself.
• Tell the truth. Clean up whatever messes you need to clean up in your life. Say NO when you mean it and YES when you are inspired (and, this takes courage)!

“Be willing to say ‘No’ to anything that is not a resounding ‘Yes!’”     David Whyte

• Re-frame your difficult experiences. Create more positive self-talk.
• Meditate, pray or do something else to create quiet time every day. Engage in 3-5 minutes of deep slow breathing 3 times daily.
• Write in a journal every day.  Write out what has been difficult for you with the intent of clearing it from your body . Consider also writing a story about yourself from the 3^rd person, as if you are the hero of your own story. Include what have you learned about yourself from this experience, what strengths or gifts have you discovered, etc.
• When you notice yourself judging yourself or anyone else in your life, stop, breathe and choose a positive thought instead. What we do to others, including judging them, is what we do to ourselves.
• Do something you love, something that brings you joy, every single day.
• Every night, write down at least 3 things that went well for you that day or 3 things you are grateful for. Notice all of the things that contributed to those 3.  For an added bonus, share this with at least one other person every day.
• Practice gratitude, forgiveness and compassion for yourself and others.

Exercise

• Just do it! Daily exercise is one of the MOST important things that you can do to lift your mood.  Aim for a minimum of 30 minutes of aerobic exercise every day (on the average for the week). The goal of 45-60 minutes of daily exercise is even better.

Nutrition/Supplements

• Breakfast:
  • Eat breakfast every day that includes:
    • 1 serving of protein (about 20 grams)
    • 1-3 servings of high fiber grains
    • 1-2 servings of fruit or vegetables
• Lunch:
  • Eat a low-fat, low calorie (approx 500 cal) lunch with healthy carbs and protein and 2 fruits or veggies.
• Dinner:
  • Healthy carbs, proteins, and fats; more protein if you need to be alert in the evening.
  • High fat dinner will interfere with your REM sleep
• Snacks
  • Fruit or veggie at every snack
  • 30 gms carbs in afternoon and at bedtime if needed

• Eat a healthy, whole foods. Minimize your intake of animal food.
• Increase your intake of fiber. Aim for 50 grams of dietary fiber per day.
• Dump junk food!  This includes sugar, sodas, white flour/pasta/rice, etc, and fast food. Consider reducing your intake of gluten.
• Minimize your intake of alcohol to no more than 1 drink a day and no alcohol for at least 4 hours before you go to bed. If you are using recreational drugs, stop it!
• Drink 4-8 glasses of fluids per day, preferably water or green tea
• Take a B-50 or B-100 complex tablet every day, along with a multivitamin.
• Take vitamin D3 every day, 1,000-2,000 units/day; get your vitamin D blood level checked and be sure it is at 40-60 ng/ml.
• Be sure you are getting enough iron. Get your blood levels checked.
• Take fish oil every day. Be sure you are getting at least 200 mg of DHA per day. Take vitamin E with this, 200-400 units/day
• Avoid caffeine, especially if you are tired or not sleeping well. This includes caffeine in coffee, tea, soft drinks with caffeine, and chocolate. Herbal tea and coffee substitutes are acceptable.
• Other supplements that may help (talk to your doctor first!):
  • St. John’s Wort, 600 mg in am, 300 mg in pm (do NOT take if you are taking prescription anti-depressants)
  • 5-HTP, 50-400 mg/day (Do NOT take if you are taking prescription anti-depressants!)
  • SAMe, 200-800 mg twice daily
  • Inositol, 1-4 gms twice daily (comes as a powder; mix in any liquid)
  • Thyroid med or probiotics after you talk to your doctor.

Sleep and Rest

• Get enough sleep and rest, whatever that is for you.
• Talk to your doctor if you have chronic insomnia.

Light Therapy

• Get a least 30 min of sun exposure every day
• If sunlight is unavailable to you, consider purchasing a 10,000 lux light box and getting 30 min of exposure to this light every morning

Humor

• Watch a funny movie or video everyday, and learn to laugh at yourself and your

Relationships

• Hang out with people that you love, people who bring out the best in you.
• Tell at least one person every day what you appreciate about them; do the same for yourself.
• Get a pet to love.

Work/Outside Activities

• Create work that you love. If you are not doing what you love, take some action toward what would feel fulfilling to you.
• Do volunteer work. When we are helping others, we focus less on our own troubles.
• Take up a hobby that you love.
• Join a club or service organization.
• Go back to church/temple, etc. if the experience is meaningful to you.
• Spend time in nature.

About Maxine Barish-Wreden, MD

Dr. Maxine Barish-Wreden, co-medical director of the Sutter Downtown Integrative Medicine Program, writes a biweekly column on integrative medicine for the Sacramento Bee with her medical partner. Maxine holds a bachelor’s degree in nutrition from the University of Maryland and graduated from the University of Chicago Pritzker School of Medicine. She has a long-term interest in complementary medicine, particularly the mind-body-spirit connection, and she strongly believes in the capacity of the human body, psyche and spirit to heal, given the appropriate environment. She will guide the community on the positive effects of lifestyle, including nutrition and exercise, on health and wellness.