Integrating Mental Health in Cammeray, New South Wales, Australia | Medical and health

Integrating Mental Health

Locality: Cammeray, New South Wales, Australia

Phone: +61 412 046 930

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25.01.2022 A new study has investigated the links between vitamin D & depression in almost 4000 Irish adults ( aged 50 years +). The study found that Vitamin D deficiency was associated with a 75% increase in the risk of developing depression over a 4 year follow up period (published in The Journal of Post-Acute and Long-Term Care Medicine). The authors suggest that these findings could be due to the potential direct effect of vitamin D on the brain. Vitamin D receptors are widespread t...hroughout the brain and central nervous system. Vitamin D forms in the skin when it is exposed to UVB from sunlight. UV levels vary depending on the time of year, and the amount of sun exposure we need varies accordingly. Some people are at a higher risk of Vitamin D deficiency than others, including - Naturally dark skinned people (the pigment in their skin reduces UV penetration) - People who cover their skin & avoid sun exposure all year - Elderly or chronically ill people who live mostly indoors - People who are obese - Babies and infants of vitamin D deficient mothers - People taking particular medications, or have conditions causing poor absorption of calcium and vitamin D Current guidelines in Australia recommend sun protection when the UV index is 3 or above but it is good to get sun exposure when it drops below 3 (there is a good free app called Sunsmart that has daily updates on UV levels). If you are concerned about your vitamin D levels they can be checked by your GP through a routine blood test.

24.01.2022 A new study & a personal story.. A recently published systematic review pooled the results from 21 studies in relation to anxiety and gut bacteria. Over half of these studies found a positive effect on improving anxiety symptoms by regulating gut bacteria through either diet or supplementation (published in General Psychiatry). As with any health challenge, anxiety needs to be looked at holistically. However in terms of diet, I generally recommend starting with individuali...sed dietary changes specifically to improve the number and diversity of gut bacteria. I would also like to share a personal story .I have recently had a very bad case of the flu. I had all the usual flu symptoms coughing, high temperatures, aches & pains, no appetite & lethargy. From quite early on with the flu I became extremely anxious of even the smallest things. My theory is that the anxiety was due to one or a combination of the following:- - the virus - inflammation (the inflammatory markers in my blood were very high) - low food intake affecting my blood sugar and/or gut bacteria - dehydration (I was drinking water but having very bad night sweats) - poor sleep quality After about 10 days I was also diagnosed with pneumonia but as the factors above improved so too did the anxiety. Anxiety can sometimes be transient and sometimes it can be longer lasting. Anxiety can be extremely complicated and multifactorial but I also believe that we have some useful additional tools, including looking at gut health, inflammation, sleep etc to help & support us along the way.

23.01.2022 To date there have been very few studies that have examined the association of plain water consumption and common mental disorders including anxiety and depression. In a recent study of approximately 3000 adults, those consuming a daily average of less than 2 glasses of water had a greater chance of having depression than those adults consuming a daily average of 5 or more glasses of water (published in World Journal of Psychiatry). Like all studies, this study has its limi...tations and we can’t make conclusions about direct causation but I believe it serves as an important reminder that water is beneficial not only to our physical health but also to our mental health. Over 70 percent of our body is composed of water and every function in the body is dependent on water, including the activities of our brain and nervous system. Our body’s need for water changes throughout the day and also from one day to the next. Stress, physical activity, warmer temperatures & illness will all increase our body’s need for water. The best way to know if you are drinking enough water is to get into the habit of checking every time you go to the toilet that your urine is light yellow (although be aware that some medications and vitamins may temporarily change the colour of your urine).

23.01.2022 A recent study has provided a really good reminder of why mental health & physical health should not be looked at in isolation. We know that people with cardiovascular disease are more likely to have depression and people with depression are at a higher risk of developing cardiovascular disease..but is it possible that these two different conditions that exist in two different organs may have the same underlying biological mechanism? Researchers from the University of Cambri...dge in the UK have examined data on almost 370,000 adults aged 40-69 to investigate the connection between mental health & heart health (published in Molecular Psychiatry). They have identified that inflammation could be a shared mechanism giving rise to both of these conditions. So what are some of the primary risk factors for chronic inflammation in the body? - Prolonged stress ( remember that stress can sometimes be really obvious such as long term unemployment or family issues and sometimes it is hidden such as loneliness or a lack of autonomy at work); - Physical inactivity; - Other lifestyle choices such high intake of processed food & smoking. A blood test can check levels of systemic inflammation in the body (C-reactive protein or CRP test). This can be a really useful motivator for us to make changes in our life. However, irrespective of whether we currently have elevated inflammatory markers or not, implementing stress management techniques & making healthy lifestyle choices are essential for our long term mental & physical health.

22.01.2022 Cardiorespiratory fitness (CRF) refers to the level at which our heart, lungs & muscles work together during sustained physical activity. The higher our CRF, the more efficient our lungs and heart are able to use oxygen. This allows us to exercise for longer periods without getting tired. So what does this have to do with mental health? While there are genetic factors that influence the development of common mental health disorders, there is an increasing recognition of the ...role of environmental and lifestyle risk factors, including our CRF. A new study (published in the Journal of Affective Disorders) has pooled several studies together and found that (compared to high CRF): Low CRF is associated with a 47% greater risk of a mental health disorder (depression, anxiety) Medium CRF is associated with a 23% greater risk of a mental health disorder This may be because exercise and changes in CRF can literally change the brain, reduce inflammation and increase resilience to damage from oxidation stress. There are different ways to check CRF and here is one that we can do ourselves to give us an idea as to where we sit on the spectrum. 1. Firstly know your estimated maximum heart rate. To work this out, subtract your age from 220 (so for example if you are 25 years old your estimated maximum heart rate is 195 beats per minute). 2. During your next intense cardiovascular workout (and with your doctor's consent if you have a medical condition), bring your heart rate to 80% of your maximum heart rate (so in my example that would be 156 beats per minute). 3. Then stop and time how long it takes for your heart rate to drop to 66 beats less than your 80% maximum (so in my example that would be 90 beats per minute). 4. If it manages this in less than 2 minutes then this is a pretty good indicator that you CRF is towards the higher end of the spectrum (in fact generally speaking the faster your heart rate slows down, the fitter and healthier your heart is). Some important things to consider CRF is relevant for all age groups. In fact a substantial decline in the CRF of children has been recorded worldwide which could have significant and widespread health consequences long term. It is possible to change CRF relatively quickly, including in people with common mental health conditions. For example, a study has found that three weekly 45-minute aerobic exercise sessions for three weeks is sufficient to improve CRF by 31% in older people (mean age 68) and 18% in younger people (mean age 23) with further training leading to greater improvements. So we need to consider including regular exercises into our lifestyle that can help improve our CRF. This includes doing any enjoyable & sustained medium high intensity activity such as running, power walking, swimming, bike riding, dancing, basketball, soccerthe list goes on.

20.01.2022 A new study has looked for links between gut bacteria and depression among 2,100 adults (published in Nature Microbiology). The researchers found that levels of two specific groups of gut bacteria (Coprococcus & Dialister) were consistently depleted in people with depression. Meanwhile, people with higher levels of Coprococcus, and another group of bacteria called Faecalibacterium, typically reported a higher quality of life. The study did not prove that any particular bac...teria can cause or protect us from depression and it is too early to talk about probiotic supplements to treat depression. Given the complexity of both the microbiome and depression, it seems unlikely that it will be that simple anyway. The good news is that the most effective way to improve the whole ecosystem within the gut and ensure diversity of bacteria is to eat a diverse amount of unprocessed plant food every day. By doing this, we are literally feeding & growing the number and type of good bacteria within our gut.and these bacteria, in turn, are involved in: - producing anti-inflammatory compounds - producing chemicals that influence the brain - producing vitamins - supporting our immune system So every day we need to eat a largely plant-based & diverse diet different types of vegetables, fruits, seeds, nuts, beans & whole grains. Mix it up!

19.01.2022 A very interesting study conducted over a period of 5 years has the potential to contribute significantly to how we may help to set the foundation for optimal mental health at a young age (published in the Journal of Adolescent Health). The 2 key findings that I think are important to take home from this study are: 1. The longer and more consistent the participation in sport .the better is mental health over time;... 2. It doesn’t matter if the sport is recreational or performance (i.e casual or organised) Kids (& ADULTS) need to find what sport or body movement they love and do it often. In this study the kids were 10-11 when they were first interviewed ( and 15-16 years old at final interview). There is no optimal age to start having fun in casual or organised sport in my opinion. Start young. On the flip side of this it is also never too late to start. Body Movement should be fun- if you love performance sports then do themif you love more casual sports- do them (or do both). There are no rules. Never force yourself or anyone else to do physical activities that do not bring happiness & joy. ..walking..netball. tennissquash skiing running cycling.soccer, tag.. handball play equipment gym classes shooting baskets/hoops in the back yard badminton. table tennistrampoliningskipping.weights.vacuuming (yes people do love to vacuum).. What do you love to do?

19.01.2022 A new study has uncovered an important link between night time sleep and next day anxiety (published in the journal Nature Human Behaviour). In laboratory experiments, the participants who had more night-time deep sleep experienced the lowest levels of anxiety the next day. The researchers also conducted an online study tracking 280 people of all ages over four consecutive days. The results showed that the amount & quality of sleep they had from one night to the next pred...icted how anxious they would feel the next day. Even subtle nightly changes in sleep affected their anxiety levels. Sleep, (especially a type of sleep called deep sleep) restores the mechanism within our brain that regulates our emotions. This means that, the next day, we are not so emotionally and physically reactive and anxiety is less likely to escalate. So valuing sleep and figuring out ways to have better quality sleep could, in itself, serve as a significant treatment for anxiety. Good sleep habits are an essential foundation for a good nights sleep. The Sleep Health Foundation provides various tips and guidelines which may serve as a helpful start in getting regular quality sleep. https://www.sleephealthfoundation.org.au//Good-Sleep-Habit The only thing I would add to these guidelines is that we should also try to incorporate as much body movement into our day (before dinner) as we canit does wonders for our sleep!

17.01.2022 It is really important to keep in mind that when it comes to diet, sleep & exercise they can all, negatively or positively, have a ripple effect upon each other in some way. We often think of these areas of our life in isolation for example sleep and dietary behaviours are generally thought to be two separate unrelated issues. A large-scale Japanese survey which examined the behaviours of over 85,000 adolescents has found that poor sleep and poor dietary behaviours regularly... occur together (published in Sleep and Biological Rhythms). Some of the findings of the study demonstrate that the following behaviours tend to accompany poor sleep quality & insomnia: - Infrequent eating of breakfast - Poorer diet quality - Regularly eating meals alone I think this study is interesting and useful because it suggests that in order to improve one area of our life we might need consider habits & behaviours in other seemingly unrelated areas. As an example: eating late at night can interfere with sleep quality and we wake up not feeling very hungry. So we are more likely to skip breakfast and eat later in the day and this routine continues from day to day. Changing the timing of eating dinner or stopping late night snacking may therefore have enormous knock on effects to our health because of the impact that it has on sleep! This reaffirms the importance of integrating a holistic understanding of health into our lives in order to support our physical & mental wellbeing.

14.01.2022 As I’ve mentioned in earlier posts, in terms of nutrients needed for mental & physical health, traditional whole-food diets, especially Mediterranean-style, are the best. Whilst every component of a whole-foods diet is important, a recent study has found that perhaps the benefits of the Mediterranean diet are largely coming from the non-refined grains component & the vegetables component (published in the European Journal of Nutrition). Further studies are needed however I be...lieve that this study serves as a handy reminder about the benefits of including non-refined grains into our diets. So what are non-refined grains? These grains are either present in their whole form or ground into a flour while retaining all parts of the seed (bran, germ and endosperm)..brown rice, oats, whole wheat, bulghur wheat, buckwheat, millet, rye, barley, quinoa, spelt, kamut There are three main reasons why non-refined grains are so important for our mood & mental health - They contain vitamins & minerals that support mental health such as zinc, B vitamins & magnesium; - They contain fibre which is essential for our gut health & therefore our brain health; - They help to stabilise our blood sugar. What are some easy ways to get more whole grains into our day? Enjoy breakfasts that include whole-grain cereals, such as shredded wheat, oatmeal or whole-wheat bran flakes (check the ingredients because some bran flakes may just have the bran, not the whole grain). Replace white rice with quinoa, brown rice, wild rice, barley or bulghur. Feature wild rice or barley in soups, stews, casseroles and salads. Use rolled oats or crushed whole-wheat bran cereal in recipes instead of dry bread crumbs. Make sandwiches using whole-grain breads or rolls. If you are not used to eating non-refined grains then start small even trying one new whole grain food or recipe that includes a whole grain is a great start.

07.01.2022 It is really important to be aware that some prescription medications list depression as a potential side effect of the medication. This includes some medications in the following categories: hormonal contraceptives, blood pressure and heart medications, antacids, acne medications, painkillers & cholesterol medications. A large study of over 26,000 American adults found that use of prescription medications that have depression as a potential side effect was common. They foun...d that people are often taking more than one of these medications and this was associated with a greater likelihood of concurrent depression (published in the Journal of the American Medical Association). All studies have their limitations but I believe that the take home messages from this study are - If you are taking prescription medicine(s) and notice changes to your mood then it is important to talk to your doctor to see if any of the medicines you are taking are likely causing or contributing to this. - If so, discuss whether a different medication may be a better choice. - Do not stop taking the medicine unless directed to do so by your doctor. In all cases, the risk of side effects must be balanced against the risk and discomfort of not addressing the condition. Whenever we are embarking on anything new, whether it be prescription medication, supplements or any lifestyle change it can be really helpful to jot down any changes (physical or mental; positive or negative) that you notice so you have something concrete to refer to if necessary. It can serve to remind us or identify patterns which can be really useful over time.

07.01.2022 A new study has examined the effects of stress on an over-looked part of physical healththe gums & teeth! This study included forty dental students all under academic stress in their 4th year of studies. Academic stress is emotional stress (fearworryfrustrationangerguilt...apathy). The study revealed that stress can result in inflammation in the mouth, seen as gum & periodontal disease (the students with increased inflammation had not changed any part of their oral hyg...iene over the course of the study). So what happened? - The stress response triggers unhelpful inflammation - This response happens quickly and can show up anywhere in the body (even in our mouth!) So the study concluded that academic stress is a significant risk factor for gum & periodontal inflammation (published in Balkan Journal of Dental Medicine). It is also important to mention that some students had no inflammatory changes in their mouth at all and yet were subjected to the same external stresswhy might this be? (1) They feel similar amounts of stress but the inflammatory response might be occurring elsewhere in their body OR (2) They may not have triggered inflammation because they have protective mechanisms working for them such as high emotional resilience, high social support & effective stress management techniques. I believe that we shouldn’t simply accept that we will feel stressed around exams or any other time of our life. It is possible to feel internal calm even in the midst of external chaos. Some good strategies in times of both stress and in times of calm are.. Be open to support, help & connection with others Do some body movement that you love doing Journal thoughts and feelings to get clarity Enjoy a variety of wholesome food Also remember that if your Dentist mentions gum inflammation or periodontal disease & your dental hygiene has been good, see this as a helpful red flag for your stress levels it is handy that it shows up in the mouth because it can give us a chance to make important changes in our lifestyleI believe that this study has potential insights about our emotional stress way beyond academic stress and way beyond inflammation in the mouth.

05.01.2022 We all experience varying types and degrees of stress in our lives but how often do we unwittingly accept the impact of stress on our body and mind? And could there be a simple, free technique to calm our nervous system when we need it? Identifying evidence-based stress reduction interventions that are low cost, easy to use and can be self-administered is essential to the overall treatment and management of stress. A recent systematic review has examined diaphragmatic breathi...ng techniques in adults 18 years and over & its effectiveness on reducing stress (published in JBI Database of Systematic Reviews & Implementation Reports). Diaphragmatic breathing (DB) sounds difficult but is very simple once you practice it a couple of times. The diaphragm is a large dome-shaped muscle at the base of the lungs and DB includes developing a pattern of slowing the breath and conscious inhalation & exhalation. A common technique is to: Inhale deeply through the NOSE (for about 3 seconds) such that your belly rises (chest should not move), Pause briefly Exhale slowly and completely though the mouth (for about 4 seconds). Tighten your stomach muscles so your belly falls inward So what are some of the benefits that have been found for DB? 1. It slows the heart rate 2. It can lower blood pressure 3. It helps us to feel more relaxed (very quickly) With clear effects on our mental and physical health it is an invaluable tool for the benefit of our overall health. So you should remember: It can be done as soon as you notice you are feeling stressed (and in fact is a great way to breathe whether we feel stressed or not) It requires no equipment and obviously has no financial cost It is easily taught & learned (it is easiest to start practicing whilst lying down until you get the hang of it) DB will start to impact our nervous system within minutes but no study has yet identified an ideal time commitment required for optimal stress management- and I wonder if any study will ever provide this as we all have different histories and natural tendencies and live under different circumstances. In the meantime, it is my opinion that DB should be the first go-to tool for stress management for people of all ages and circumstances. Even a couple of intentional minutes could change the trajectory of a stressful day.

04.01.2022 When it comes to lifestyle factors that may impact upon mood disorders, it is important to prioritise key areas that need addressing and deal with one area at a time. Poor sleep is the most important area to address first. If we are not getting enough sleep or good quality sleep it becomes extremely difficult to make good health choices on a daily basis (e.g. in relation to diet, exercise or stress management). Identifying sleep disturbance is important for everyone and a r...ecent Australian study has found that, from a mental health perspective, this is particularly important for those people who present with a combination of: - Insomnia (difficultly initiating or maintaining sleep, poor subjective sleep quality at least 3 nights per week) and - Short sleep duration (less than 7 hours per night) This study, conducted over two years, found that in relation to sleep, those who experienced a combination of both insomnia and short sleep duration had the greatest risk of mental health symptoms developing. The authors of the study highlighted the importance of addressing BOTH of these aspects of poor sleep. There are many factors that are within our control that can improve our sleep. This is known as our sleep hygiene and some of the most important are discussed here: http://healthysleep.med.harvard.edu//getti/overcoming/tips If your sleep hygiene is good and you continue having sleep disturbance then it is important to seek advice from your GP in the first instance.