U N I V E R S I T Y
O F
M I C H I G A N
DEPRESSION CENTER
THE MICHIGAN DIFFERENCE®
U-M Depression Center
Rachel Upjohn Building
4250 Plymouth Road
Ann Arbor, MI 48109-2700
800-475-6424
www.depressioncenter.org
WHAT’S INSIDE
A Message from Our
Director
~
Workshops and Support
Groups
~
Mindfulness Strategies
for Managing
Depression
~
Nutrition Tips for
Boosting Mood
~
New Titles from the
UMDC Reading Corner
~
Bipolar Gene Repository
Grows
update
From the Nation’s First Comprehensive Depression Center
WINTER
SPRING 2011
2009
Empowering Patients Through
Depression Education
New series of educational videos offers individuals and families
practical information on depression self-management
The Depression Center has just released a series of six short videos developed
from the same body of evidence-based research supporting the online Depression
Toolkit. These video shorts feature Depression Center faculty discussing various
themes in their areas of expertise,
emphasizing the importance of adhering
to treatment plans and stressing the
effectiveness of self-care techniques
on treatment outcomes.
The series includes videos on sleep
(Todd Arnedt, PhD), psychotherapy
(Heather Flynn, PhD), nutrition (Simon Evans, PhD), medication (Gregory Dalack,
MD), treatment-resistant depression (Stephan Taylor, MD), and exercise (Richard
Dopp, MD).
All videos can be viewed on the Depression Center’s toolkit website (www.
depressiontoolkit.org), and they are also available on YouTube. The videos were
produced through the support of a grant from the Patient Education Advisory
Committee of the FRIENDS of the University of Michigan Hospitals and Health
Centers.
The goal of the videos is to empower
patients and their families in learning
treatment adherence and self-care
strategies to create an informed patient
population that is engaged in their own
treatment, and to reduce the stigma associated with seeking treatment for
depression, bipolar and related mood disorders.
DEPRESSION CENTER UPDATE | WINTER 2011
Family – and Patient-Focused
In keeping with the increased
emphasis on providing family- and
patient-centered care throughout
the U-M Health System,
Depression Center and Department
of Psychiatry support groups
and workshops offer additional
therapy options for families and
individuals with bipolar disorder
and depression. These various
groups offer patients and their
families a chance to develop a
support network and learn about
depression and bipolar disorder,
including discussions about risk
factors, treatments, coping,
healthy communication methods,
and stigma.
Group offerings include:
♦ Family Education Workshops
♦ Support Groups for:
• Adults with Depression and
Bipolar Illness
• Adolescents and College
Aged Persons with
Depression and Bipolar Illness
• Family Members of Persons
with Depression and Bipolar
Illness
These groups are led by Kathy
Schoof, LMSW, and Laura
Nitzberg, LMSW, in collaboration
with post-graduate fellows who
have a master’s in social work.
An additional support group for
survivors of suicide is held at the
Women’s Center of Southeastern
Michigan, in Ann Arbor.
Evidence shows that the groups
are effective in helping patients
and families understand depressive
illness and how to manage it.
Data from the Family Education
Workshops demonstrate that
group participants increased their
knowledge about depression and
bipolar illness, coping strategies,
and the importance of medication.
TIPS
for cultivating mindfulness
Mindfulness:
A Strategy for Depression
Management
At its core, mindfulness is about focusing
our awareness on the present moment
and paying attention to our immediate
experiences without judgment. Mindfulness
can empower individuals to help alleviate
stress, anxiety, and even prevent repeated
bouts of depression. Since we all experience
periods of stress and difficulty, even those
who do not struggle with depression can
benefit from a mindfulness approach to
wellness.
Mindfulness is intended to heighten
self-awareness and acceptance of our
thoughts and feelings, shift patterns of
negative thinking, and help develop broader
perceptions and approaches to the things that
challenge us in our lives.
Mindfulness works to help us focus more on
the present moment, to be aware of what we
are experiencing through our senses and our
minds without trying to change anything or
getting caught up in worries about the past or
the future. We’re less likely to have unhelpful,
conditioned reactions to stress when we’ve
cultivated mindfulness.
A number of mindfulness-based techniques
can be used to manage depression and
related illnesses. There are many ways to
incorporate mindfulness practices into daily
life. These include yoga, meditation, creative
expression, or spending time outdoors.
Mindfulness-based Cognitive Behavioral
Therapy is a specific type of psychotherapy
which has been found to prevent relapse and
recurrence in people who have experienced
multiple depressive episodes, and can in
some cases be as effective as maintenance
medication. You may also learn mindfulness
through classes or audio recordings of guided
mindfulness meditations.
You have the ability within you to
develop mindfulness. Some ideas for
things you can do every day to make
mindfulness a habit:
• Pay attention to input from all
five senses. Observe what is
happening around you without
getting too caught up in your
thoughts about your experience,
or reacting automatically to
situations. Allow yourself to
simply acknowledge thoughts
and feelings, which in turn will
make it easier to accept them
without judgment.
• Practice noticing your breathing
when you have a few free
moments to help you focus on
the present moment, noticing
any thoughts and feelings that
might also arise. You can also try
breathing exercises or meditating
for longer periods to develop your
focus even further.
• Do one thing at a time, and give
that one thing your complete
attention. Resist giving into
competing distractions.
d Therapy
These groups are one example of
the Depression Center’s focus on
empowering individuals and their
families with the tools that allow
them to take greater control over
depression and bipolar illness.
All of the groups are free of
charge; visit our website for
registration information and
group schedules: http://www.
depressioncenter.org/Workshops_
and_Groups/
A Message From Our Director
Effectively managing depression and maintaining wellness:
these are achievable, but rarely simple. They characteristically
involve approaches that integrate therapy, medication, exercise,
stress-reduction, healthy sleep, avoidance of substance
misuse, spirituality, and others. A dedicated team of healthcare
professionals is perhaps essential in creating the roadmap to
wellness. To be most successful, however, every depressionfighting strategy requires the active participation of
one critical person – the person seeking wellness.
Learning to be an “educated patient or consumer,”
a champion for one’s own wellness, an expert in
knowing where and when to turn for answersthese are vital steps toward feeling better and
staying better.
By providing patients – and their families – with
information they can use to better understand
their illness and their treatment options, we can
greatly enhance recovery and patient outcomes.
This principle is known as “self-management.”
The term is a bit misleading. It is simply a strategy
for achieving personal wellness that has been
effectively used for people with depression as well as those
living with other chronic illnesses, such as diabetes and asthma.
Self-management is an empowering philosophy on which
much of the Depression Center’s work is built. We have just
produced a series of short patient education videos that provide
information to help individuals with depression take greater
control of their recovery. These compelling videos feature six of
our Center experts speaking on a variety of topics, from exercise
to neuromodulation treatments to sleep. Please check out
these videos (linked on our www.depressiontoolkit.org website),
which we hope will be a great resource for anyone struggling
with depression. In this issue of Update, we also discuss the
power of participation in support groups – many of which are
offered through the Depression Center and Department of
Psychiatry – for individuals and their families to monitor and
manage their symptoms in a way that aids their recovery and
improves their quality of life.
I also invite you to explore our online
Depression Toolkit for a wealth of additional
self-management and wellness resources.
The Toolkit, supported by a magnanimous
gift from the Ravitz Foundation, is continually
growing and improving. It includes the
feature “Your Self Care Portfolio,” a collection
of tools to help individuals take on their
depression with greater autonomy.
Self-management does not and should never
mean that anyone is in the fight against
depression alone. Nor does it ever imply that
anyone with depression should decide to
‘tough it out.’ It does mean that with improved
self-awareness and renewed attention to
daily details of treatment adherence, nutrition, sleep, exercise,
and monitoring, individuals can take renewed charge of their
recovery and maintenance. Knowledge is power. Knowledge
heals. And knowledge plus action can produce the remarkable
result of wellness.
Merci,
John Greden, M.D.
Junk Food and Depression – Is There a Relationship?
Studies have found evidence
that consuming certain nutrients
known for the benefits they
provide for physical health, such
as omega-3s and B vitamins, can
also help prevent depression.
This begs the question of
whether a diet heavy in more
processed types of foods could
actually increase the likelihood
that someone might develop
depression. What does the
latest science tell us?
One recent major study from
the University College of London
examined data on the social,
work, lifestyle, and health
factors of more than 10,000
people. When they compared
the people who ate a diet
of primarily “whole foods”
(focused on fruits, vegetables,
whole grains and fish) to those
who ate mainly less healthy
foods (lots of processed meats
and grains, fried foods, and highfat dairy products), they found
that the people with the more
processed diets were more
likely to develop depression than
those who followed healthier
diets.
This study is particularly
meaningful because it showed
the benefits of carefully
choosing a “menu” of healthy
foods for brain health, not just
the particular advantages of
one or two vitamins or minerals.
The more we understand
all of the factors that may
contribute to depression and
related disorders, the more we
can do to prevent and treat
these conditions effectively.
Understanding that eating
more processed foods might
increase the odds of developing
depression can help us make
more informed decisions every
day about the foods we eat,
knowing that those individual
choices, however small, can add
up to a lifestyle that will promote
both brain and bodily fitness.
The take-away message:
nutrition affects the way we feel,
and the foods we choose can
have an enormous impact on the
way our brain functions. Eat well
– your brain will thank you!
Depression Center
member Simon
Evans, PhD, a
research professor
in the department
of psychiatry,
investigates the relationships
between mind and body
wellness.
The Mood and Food Connection
Most of us have days when we feel great:
energetic, enthusiastic, clear-headed,
content, and well-balanced. We also have
those other days when we feel down:
sluggish, unmotivated, forgetful, irritable,
helpless, and hopeless.
Compelling scientific evidence shows
that mental health and physical health
are absolutely intertwined, and we now
understand that the link between mood and
nutrition is much stronger than previously
thought. The prevention and management
of many diseases rely on our genetic
individuality, our environment, stress
management, and healthy lifestyle habits
– and nutrition is the foundation of a
healthy body and mind.
Healthy eating habits can be
challenging to maintain with
our modern lifestyle, which can
generate feelings of stress that can
disrupt our good intentions, which
in turn can affect our mood. Here
are a few tips that will hopefully
help you feel happier and healthier:
• Don’t skip breakfast, and eat three
well-balanced meals. Simply skipping
breakfast is associated with lower fluency
and problem-solving ability, along with
lack of energy and motivation.
• Eat good sources of protein. These
include eggs, nuts, fish, whole grain
quinoa, yogurt or cheese. Protein consists
of amino acids, the building blocks of
neurotransmitters. Protein also helps
stabilize blood sugar, which can interfere
with concentration and mood when
elevated (hyperglycemia).
• Avoid high-sugar foods or refined
carbohydrates, such as bagels,
doughnuts, and other refined grain
products, and make sure cereals are truly
whole grain (preferably organic), like
oatmeal. Generally, try to eat whole fruit
rather than drink fruit juice, as the fiber in
the fruit will help slow down absorption
of sugars in the fruit as well as be more
filling.
•
Eat at least 6 servings of
vegetables and 2 servings of fruit
every day. Try to get all of the colors
of the rainbow. One serving = ½ cup.
See the website ewg.org to see the
produce with the highest and lowest
pesticide content to make the
best choices.
•
Mind your dietary fats:
Found in both plant and animal
foods, these play a significant
role in brain function. Omega-3
fats from foods such as fish, flax seeds,
walnuts, some eggs, and grass-fed beef
have been shown to improve cognitive
function and lower depression by
reducing inflammation.
Excessively low-fat diets, as well as diets
high in processed foods, are linked to
mood changes.
• Choose beverages wisely: Drink plenty
of filtered water to improve blood flow
and keep your brain well-hydrated.
Avoid sugary drinks or those with
artificial sweeteners, colors, flavors, or
preservatives. Limit or avoid alcohol, and
limit coffee intake. Green tea has been
shown to reduce anxiety and sharpen
mental focus while relaxing the mind.
• Vitamins are key: Take a high quality,
natural vitamin and mineral supplement
daily. Many of the B vitamins such as B1
(thiamin), B2 (riboflavin), B6 (pyridoxine),
folate, and B12 (methylcobalamin) have
been shown to reduce the incidence
of depression. Low levels of Vitamin D3
increase one’s risk of major depression.
Also, low levels of magnesium, selenium,
and zinc are linked to mood changes.
• Snack well: Pack healthy snacks such as
nuts, fresh or dried fruit, and veggies to
keep your blood sugar stable and give you
energy.
Katherine Briggs Goldberg,
M.S., R.D., is a dietitian and
culinary arts specialist with
U-M’s MHealthy Health
and Well-Being Services
in Nutrition Education,
as well as a member of
the Depression Center
Community Volunteer
Committee.
Depression Center Events
UMDC
READING
CORNER
Listed below are recommended books
on the topics of wellness and selfmanagement. You can find these books,
media and many other resources at
the FRIENDS Depression Education
Resource Center, located in the east
atrium of the Depression Center
building.
Feeling Good: The New Mood Therapy
Revised and Updated
by David Burns
The Relaxation & Stress Reduction
Workbook
by Martha Davis
Brainfit for Life: A User’s Guide to LifeLong Brain Health and Fitness
by Simon J. Evans
Full Catastrophe Living: Using the
Wisdom of Your Body and Mind to Face
Stress, Pain, and Illness
by Jon Kabat-Zinn
Happiness Is a Choice: Symptoms,
Causes, and Cures of Depression
by Frank Minirth
We hope you will join us for the ninth annual University of Michigan Depression on College
Campuses Conference to learn about new research findings and innovative strategies to help
college campuses identify and treat depression earlier, and more effectively.
To register, or for more information or the conference agenda, please visit www.depressioncenter.org/docc or contact Trish Meyer at [email protected]
The conference is presented by the U-M Depression Center, in partnership with schools and
colleges of the University of Michigan.
March Bright
Nights Forum
Learning and Depression:
What’s the Connection?
Tuesday, March 8th from
7:00 - 8:30 p.m.
Downtown Ann Arbor Library
Presenter: Cindy EwellFoster, PhD, Clinical Lecturer,
U-M Department of
Psychiatry
Quiet Mind, Healthy Body: The Art of
Low Stress Living
by Nancy Tan
The University of Michigan Health
4-hour shifts available, Monday-Friday.
4-hour shifts available, Monday-Friday.
Choose
own schedule.
Choose
youryour
own schedule.
10 Simple Solutions to Stress: How to
Tame Tension and Start Enjoying Your
Life
by Claire Michaels Wheeler
www.depressioncenter.org/
ResourceCenter
For more information about Friends
visit www.med.umich.edu/friends
The University
of Michigan
System
gift shops,
run byHealth
the non-profit
System gift shops, run by the non-profit
group “Friends,” is currently seeking to
group “Friends,” is currently seeking to fill
fill
several
volunteer
several
volunteer
positions.positions.
Beginning Mindfulness: Learning the
Way of Awareness
by Andrew Weiss
FOR MORE
INFORMATION
about featured book selections
This newsletter is funded
through the support of the
FRIENDS of the University of
Michigan Hospitals and Health
Centers.
VOLUNTEERS NEEDED
FOR THE U-M
HOSPITAL
GIFT SHOPS!
We welcome your involvement in helping
To learn
more, of
contact
thepatient
Friends
to further
our mission
supporting
[email protected]
or
education and treatment.
[email protected] or
734.615.6147, or visit us online at
www.med.umich.edu/friends/
at
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UPDATE
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BIPOLAR RESEARCH EFFORT GROWS IN STRENGTH
Although no single gene “causes” bipolar disorder, the disease has its roots in genetic vulnerabilities
that run in families. The manic “highs” and deep depressed “lows” pose an immense challenge to the 5.7
million American adults who live with bipolar disorder, and these individuals also live with the possibility
that their loved ones, especially their children, are at risk of developing the disease. Part of the mission
of the Heinz C. Prechter Bipolar Research Fund’s Genetics Repository’s important research is to find the
information necessary to help treat bipolar illness more effectively and move closer to a cure.
The U-M Depression Center is pleased to announce that Pennsylvania State University has joined the
team of academic institutions collaborating in the Prechter Bipolar Genetics Repository, starting with the
addition of 300 genetic samples to the collection.
The Prechter Repository is the first independently funded repository of its kind in the nation. The Repository
is collecting DNA samples from people diagnosed with bipolar disorder as well as from healthy individuals.
Unique characteristics of the Genes Project include emphasis on those with early onset of the disease
as well as ongoing, long-term evaluations of research participants at regular intervals. It is also the first
“translational” bipolar project to integrate genetic, longitudinal biomedical and clinical outcome measures.
The Prechter Repository now houses 1,453 genetic samples from studies at U-M along with its
collaborating sites Johns Hopkins, Stanford, Weill Cornell, and now Penn State University. In addition to
sharing knowledge between these institutions, confidential, coded DNA repository samples and clinical
information will be made available to scientists worldwide to accelerate and share clinical breakthroughs
in evaluating and treating bipolar disorder.
To learn more about the Genes Project: 1-877 UM-GENES
http://www.prechterfund.org/research/repository.asp
Executive Officers of the University of Michigan Health System
Ora Hirsch Pescovitz, Executive Vice President for Medical Affairs; Robert P. Kelch,
Executive Vice President for Medical Affairs (Emeritus); James O. Woolliscroft,
Dean, U-M Medical School; Douglas Strong, Chief Executive Officer,
U-M Hospitals and Health Centers; Kathleen Potempa, Dean, School of Nursing.
The Regents of the University of Michigan
Julia Donovan Darlow, Laurence B. Deitch, Denise Ilitch, Olivia P. Maynard,
Andrea Fischer Newman, Andrew C. Richner, S. Martin Taylor, Katherine E. White,
Mary Sue Coleman (ex-officio)
The University of Michigan, is an equal opportunity/affirmative action employer. © 2011 The Regents of the University of Michigan, Ann Arbor, Michigan, 48109
Published 4x/yr by the University of Michigan Depression Center.