Tuesday, December 18, 2007
1 1/3 cups Flour
1/2 cup Sugar
2 tsp Baking Powder
1/2 tsp Baking Soda
1/2 tsp Cinnamon
1/4 tsp Nutmeg
Pinch of Ground Cloves
Pinch of Salt
1/4 cup Canola Oil
1 cup Sour Cream
1 large Granny Smith Apple (peeled, cored, and finely chopped)
1/2 cup Walnuts (finely chopped)- optional
1/2 cup Sweetened Dried Cranberries
Heat the oven to 400 degrees. Grease the bottoms only of 12 standard muffin cups. In large bowl, whisk together the flour, sugar, baking powder, baking soda, cinnamon, nutmeg, cloves and salt. In a medium bowl, whisk the eggs, oil, and sour cream until well blended. Add the egg mixture, apples, walnuts and dried cranberries to the dry ingredients. Stir just until the batter is blended, then divide it among the muffin cups. Bake for 15 minutes or until a toothpick inserted into the center of one comes out clean. Let the muffins cool in the pan on a wire rack for 5-10 minutes before removing them. Makes 1 dozen.
2 Tbsp Olive Oil
3 Cloves Garlic (finely chopped)
1 (14.5 oz) can Diced Tomatoes (not drained)
1/4 tsp Crushed Red Pepper
10 Kalamata Olives (pitted and chopped)
1 1/2 lb Medium Shrimp (peeled, deveined and rinsed)
3 oz. Feta Cheese Crumbles
1 tsp. Dried Oregano
Warm oil in large skillet over medium heat. Add garlic and cook until fragrant, about 1 minute. Stir in tomatoes, crushed red pepper and olives, and simmer until mixture is thickened, about 10 minutes. Add shrimp and cook, stirring until shrimp are pink and firm, 4 to 5 minutes. Divide shrimp into 4 servings and sprinkle each with feta cheese and oregano. Serve hot.
2 1/2 lb. Beef Chuck (trim fat and cut into 1-inch cubes)
Salt and Pepper
4 Tbsp All-Purpose Flour
3 Tbsp Vegetable Oil
2 Onions (cut into wedges)
6 Carrots (cut into 1-inch pieces)
8 Cloves Garlic (finely chopped)
1 Tbsp Red Wine Vinegar
1 1/2 cups Dry Red Wine
1/2 tsp Dried Thyme
1 Bay Leaf
* consider serving with a side of No-Yolk Egg Noodles
Place meat in bowl; season with salt and pepper and coat with flour. Warm 2 tbsp oil in skillet over med-high heat. Fry half of the meat until brown all over, about 4 minutes, and place cubes in slow cooker. Warm remaining 1 tbsp oil in skillet and fry remaining meat and place in slow cooker. Add onions and carrots to skillet and cook, stirring often, for 2 minutes. Add garlic; cook for one minute longer. Add onion mixture to slow cooker. Pour vinegar and wine into skillet, bring to a boil and then add mixture to slowcooker. Season mixture with salt, pepper and thyme; add bay leaf. Cover and cook on low heat until meat is tender, about 5-6 hours. Remove bay leaf and serve hot.
Wednesday, November 21, 2007
The following news story came from research that was done by Assistant Professor Mike Powers of the University of Florida while studying at the University of Virginia.
UF Researcher Unlocks Secrets of Popular Supplement Creatine
March 23, 2000
GAINESVILLE, Fla. --- A new study by a University of Florida professor finally helps explain some of the side effects associated with the popular muscle enhancer creatine.
Muscle cramping, heat illness and even kidney problems have long been rumored to be associated with taking the supplement, but previous studies couldn't explain these problems.
Now, in a study funded by one of the largest grants ever awarded by the National Athletic Trainers Association Research and Education Foundation, Michael Powers, an assistant professor in UF's department of exercise and sport sciences, shows for the first time that creatine increases both the body's overall water content and its ratio between intracellular and extracellular water.
The finding is important because it explains how the body's natural balance is thrown off by creatine consumption....
To continue with this story, click on the website below: http://www.sciencedaily.com/releases/2000/03/000322150513.htm
Reference: Science Daily, Writer- Kristin Harmel, March 2000
Friday, November 9, 2007
Under regulations from the Food and Drug Administration of the Department of Health and Human Services and the Food Safety and Inspection Service of the U.S. Department of Agriculture, the food label offers more complete, useful and accurate nutrition information than ever before.
With today's food labels, consumers get:
- Nutrition information about almost every food in the grocery store distinctive, easy-to-read formats that enable consumers to more quickly find the information they need to make healthful food choices
- Information on the amount per serving of saturated fat, cholesterol, dietary fiber, and other nutrients of major health concern
- Nutrient reference values, expressed as % Daily Values, that help consumers see how a food fits into an overall daily diet
- Uniform definitions for terms that describe a food's nutrient content--such as "light," "low-fat," and "high-fiber"--to ensure that such terms mean the same for any product on which they appear
- Claims about the relationship between a nutrient or food and a disease or health-related condition, such as calcium and osteoporosis, and fat and cancer. These are helpful for people who are concerned about eating foods that may help keep them healthier longer.
- Standardized serving sizes that make nutritional comparisons of similar products easier
- Declaration of total percentage of juice in juice drinks. This enables consumers to know exactly how much juice is in a product.
- Free. This term means that a product contains no amount of, or only trivial or "physiologically inconsequential" amounts of, one or more of these components: fat, saturated fat, cholesterol, sodium, sugars, and calories. For example, "calorie-free" means fewer than 5 calories per serving, and "sugar-free" and "fat-free" both mean less than 0.5 g per serving. Synonyms for "free" include "without," "no" and "zero." A synonym for fat-free milk is "skim".
- Low. This term can be used on foods that can be eaten frequently without exceeding dietary guidelines for one or more of these components: fat, saturated fat, cholesterol, sodium, and calories. Thus, descriptors are defined as follows:
Low-fat: 3 g or less per serving
Low-saturated fat: 1 g or less per serving
Low-sodium: 140 mg or less per serving
Very low sodium: 35 mg or less per serving
Low-cholesterol: 20 mg or less and 2 g or less of saturated fat per serving
Low-calorie: 40 calories or less per serving.
Synonyms for low include "little," "few," "low source of," and "contains a small amount of."
Lean and extra lean. These terms can be used to describe the fat content of meat, poultry, seafood, and game meats.
- Lean: less than 10 g fat, 4.5 g or less saturated fat, and less than 95 mg cholesterol per serving and per 100 g.
- Extra lean: less than 5 g fat, less than 2 g saturated fat, and less than 95 mg cholesterol per serving and per 100 g.
- High. This term can be used if the food contains 20 percent or more of the Daily Value for a particular nutrient in a serving.
- Good source. This term means that one serving of a food contains 10 to 19 percent of the Daily Value for a particular nutrient.
- Reduced. This term means that a nutritionally altered product contains at least 25 percent less of a nutrient or of calories than the regular, or reference, product. However, a reduced claim can't be made on a product if its reference food already meets the requirement for a "low" claim.
- Less. This term means that a food, whether altered or not, contains 25 percent less of a nutrient or of calories than the reference food. For example, pretzels that have 25 percent less fat than potato chips could carry a "less" claim. "Fewer" is an acceptable synonym.
- Light. This descriptor can mean two things: First, that a nutritionally altered product contains one-third fewer calories or half the fat of the reference food. If the food derives 50 percent or more of its calories from fat, the reduction must be 50 percent of the fat.
Second, that the sodium content of a low-calorie, low-fat food has been reduced by 50 percent. In addition, "light in sodium" may be used on food in which the sodium content has been reduced by at least 50 percent. The term "light" still can be used to describe such properties as texture and color, as long as the label explains the intent--for example, "light brown sugar" and "light and fluffy."
A more complete list of the regulations that pertain to food labeling can be found at the following address: http://www.fda.gov/opacom/backgrounders/foodlabel/newlabel.html
Thursday, November 1, 2007
The nutrition label always lists a serving size, which is an amount of food, such as 1 cup of cereal, two cookies, or five pretzels. The nutrition label tells you how many nutrients are in that amount of food. Serving sizes also help people understand how much they're eating. If you ate 10 pretzels, that would be two servings.
Servings per Container or Package
The label also tells you how many servings are contained in that package of food. If there are 15 servings in a box of cookies and each serving is 2 cookies, then you have enough for all 30 kids in your class to have one cookie each. Math comes in handy with food labels!
Calories and Calories From Fat
The number of calories in a single serving of the food is listed on the left of the label. This number tells you the amount of energy in the food. People pay attention to calories because if you eat more calories than your body uses, you might gain weight.
Another important part of the label is the number of calories that come from fat. People check this because it's good to limit fat intake. The calories in a food can come from fat, protein, or carbohydrate.
Percent Daily Value
You'll see percentages on food labels that are based on recommended daily allowances - meaning the amount of something a person should get each day. For instance, there's a recommended daily allowance for fat, so the food label might say that one serving of this food meets 10% of the daily value. The daily values are based on an adult's needs, not a kids' needs. These are often similar, but kids need may need more or less of certain nutrients, depending on their age and size. Some percent daily values are based on the amount of calories and energy a person needs. These include carbohydrates, proteins, and fat. Other percent daily values - like those for sodium, potassium, vitamins, and minerals - stay the same no matter how many calories a person eats.
The total fat is the number of fat grams contained in one serving of the food. Fat is an important nutrient that your body uses for growth and development, but you don't want to eat too much. The different kinds of fat, such as saturated, unsaturated, and trans fat, will be listed separately on the label.
Cholesterol and Sodium
These numbers tell you how much cholesterol and sodium (salt) are in a single serving of the food. They are included on the label because some people need to limit cholesterol or salt in their diets. Cholesterol and sodium are usually measured in milligrams.
This number tells you how many carbohydrate grams are in one serving of food. Carbohydrates are your body's primary source of energy. This total is broken down into grams of sugar and grams of dietary fiber.
This number tells you how much protein you get from a single serving of the food. Your body needs protein to build and repair essential parts of the body, such as muscles, blood, and organs. Protein is often measured in grams.
Vitamin A and Vitamin C
These list the amounts of vitamin A and vitamin C, two especially important vitamins, in a serving of the food. Each amount is given as a percent daily value. If a food provides 20% of the RDA for vitamin A, that one serving of food gives an adult one fifth of the vitamin A needed for the day.
Calcium and Iron
These list the percentages of calcium and iron, two especially important minerals, that are in a serving of the food. Again, each amount is given as a percent daily value. If a food has 4% of iron, you're getting 4% of the iron you need for the whole day from that serving.
Sunday, October 21, 2007
8 Boneless, Skinless Chicken Breast- cut into 1 inch pieces
2 cans Garbanzo Beans- drained
2 cans Navy Beans- drained
2 cans Low Sodium Chicken Broth
1 cup Water
2 cans White Corn
3 (4 oz) cans Diced Green Chilis
1 White Onion- thinly sliced
2 Cloves Garlic- minced
1 tsp Louisiana Hot Sauce
1 tsp White Pepper
1 tsp Cumin
1 tbsp Olive Oil
Preheat oven to 350F. Saute onion, garlic and cumin in olive oil until onions are translucent. Combine chicken, beans, corn, chilis, pepper, Louisiana hot sauce, water and chicken broth in Dutch oven. Add onion mixture to it. Stir well. Cover and cook for 50 minutes. Top with fresh grated parmesean.
3 Zucchini- quartered and sliced
6 small Yellow Squash- halved and sliced
1 lb Whole Mushrooms- cleaned and halved
1 Red Onion- thinly sliced
2 cans Tomato Sauce
2 cans Whole Peeled Tomatoes
1/2 tsp Garlic- minced
1 tsp Marjoram
1 tsp Oregano
Thin Sliced Low-Moisture, Part-Skim Mozzarella Cheese
Brown or White Rice- Cook as directed and serve with Ratatouille
Combine all ingredients in a large soup pot and cook on med-high for about 25 minutes or until vegetables are soft, stirring occasionally. Take off heat and layer the top with cheese slices. Allow cheese to melt and serve over brown or white rice.
2 lbs Small or Medium Shrimp- uncooked, peeled, deveined
2 (14 oz) cans Diced Tomatoes
1 Red Onion- chopped
4 Stalks Celery- chopped
1 Green Bell Pepper- chopped
2 Cloves Garlic- minced
1 can Sweet Yellow Corn
1 can Cream Corn
1 can Green Chilis- diced
1 bunch Scallions- chopped
2 cans Low Sodium Chicken Broth
1/4 tsp Ground Red Pepper
1 tbsp Worcestershire
1 cup Water
1/4 tsp Black Pepper
Combine all ingredients in a crock pot and cook 4-6 hours.
1 box Frozen Chopped Spinach
1 carton Fat-Free Sour Cream
1 can Waterchestnuts- peeled and sliced
1 envelope Good Seasons Ranch Mix
Thaw spinach and squeeze out excess moisture. Add to sour cream and mix. Stir in ranch dip mix. Chop waterchestnuts and add to sour cream mixture. Refrigerate for at least 1 hour.
Friday, October 19, 2007
2 tbsp Warm Water
1 1/3 cups Warm Water
1 package Dry Yeast
1/3 cup Brown Sugar
5 cups Flour (3c Wheat/2c White)
1/2 cup Baking Soda
Preheat oven to 475F. Mix 2 tbsp water with dry yeast to dissolve. Stir in the rest of the warm water and brown sugar. Mix in flour until it forms a ball. Knead until smooth. Use cooking spray to coat 2 cookie sheets. Bring large pot of water and baking soda to a boil. Using about a golf ball size of dough, roll and form into the shape you choose. Carefully drop the shaped dough into the water for 30 seconds or until they rise to the top. Put on the cookie sheets and sprinkle with salt. Bake 8-10 minutes until golden brown.
2 cups Unbleached Flour
1 cup Brown Sugar- packed
1 tbsp Baking Powder
2 tsp Cinnamon
1/2 tsp Nutmeg
1/4 tsp Baking Soda
1/4 tsp Ginger
1/4 tsp Cloves
1 (15oz) canned Pumpkin
1/2 cup Skim Milk
2 Eggs Whites- whipped
1/3 cup Fat-Free Sour Cream
Preheat oven to 350F. Prepare bundt pan or loaf pan with cooking spray and set aside. Combine flour, brown sugar, baking powder, baking soda, cinnamon, nutmeg, ginger and cloves in large mixing bowl. In medium mixing bowl, combine pumpkin, skim milk, egg whites and sour cream. Spoon the pumpkin mixture into the flour mixture and mix just until moistened. Pour batter into prepared pan. Bake 60 minutes.
Thursday, October 18, 2007
While these children often see an improvement with the addition of medications, little emphasis is ever put on the value of a sound diet. There is some evidence that there could nutrients missings from one's diet that could help with some of the side effects of ADD/ADHD. Some research has even shown that certain foods may even be triggers for some symptoms.
The following article written by Susan Kundrat discusses some of the research being done that draws a link between the cause and effect of nutrition on this disorder.
From the website: http://www.nutritiononthemove.net
"Susan Kundrat, MS, RD, LDN , CSSD, is the President and founder of Nutrition on the Move, Inc. A Licensed, Registered Dietitian, Susan has a passion for helping clients learn to eat to enhance overall health and wellness. Susan is a member of the Gatorade Sports Nutrition Board."
NUTRITION and ADD/ADHD
"Medication can control many symptoms, but doesn’t address the underlying causes and may result in side effects. Therefore, many parents and health practitioners are looking for diet-based alternatives..."
To continue reading this article, click on the website below:
An area that is sometimes overlooked by coaches is the importance of fueling their athletes. What if they have not eaten a sound pre-game meal? What happens if the athlete has not prepared for the event by increasing their fluid intake? Evidence that shows what an athlete eats and drinks before and after an athletic event can have a major impact on their performance.
This article by Susan Kundrat outlines the importance of the following topics:
- Foods for High Energy
- Quick Snack Ideas
- Foods to Have On-Hand
From the website: http://www.nutritiononthemove.net "Susan Kundrat, MS, RD, LDN , CSSD, is the President and founder of Nutrition on the Move, Inc. A Licensed, Registered Dietitian, Susan has a passion for helping clients learn to eat to enhance overall health and wellness. Susan is a member of the Gatorade Sports Nutrition Board."
FOODS AND FLUIDS FOR FITNESS
"People who are involved in an exercise program for fitness and health can learn to maximize their training efforts and get more out of a workout by learning to fuel their bodies with the right foods and fluids...."
To continue reading this article, click on the website below:
Wednesday, October 17, 2007
1 lb Tomatoes- peeled if desired, seeded and chopped
1 small Onion- minced
1 Jalapeno Chili- seeded and minced
1 tbsp Lime Juice
2 tbsp chopped coriander (if desired)
In a bowl, toss the tomatoes, onion, chili pepper, lime juice, coriander and salt (to taste) and let salsa stand for at least 30 minutes. Serve.
1 (9 oz) pack Three-Cheese Tortellini
2 tsp Olive Oil
2 tsp Minced Garlic
1/2 to 3/4 tsp Crushed Red Pepper
2 cups Cherry Tomatoes- halved
1/4 cup Fat-Free, Low-Sodium Chicken Broth
1 tbsp Fresh Basil- chopped
1/4 tsp Salt
1 (6 oz) package Fresh Baby Spinach
Cook tortellini according to package directions. While tortellini cooks, heat oil in large non-stick skillet over medium-high heat. Add garlic and red pepper; saute 30 seconds. Add tomatoes, broth, basil, salt, and baby spinach to pan. Cook 2 minutes or until baby spinach wilts. Stir in tortellini and cook 1 additional minute.
Tuesday, October 16, 2007
1 (16 oz) package Fresh or Frozen Uncooked Cheese Tortellini
2 tbsp Olive Oil
1/2 cup Onion- chopped
3 Garlic Cloves- chopped
1 (9 oz) package Frozen Chopped Spinach- thawed
1 Large Tomato- cubed
1/4 cup Fresh Basil
1/2 tsp Salt
1/2 tsp Pepper
1 cup Reduced Fat Whipping Cream
1/4 cup Freshly Grated Parmesean Cheese
Cook tortellini according to package directions; drain and return to pan to keep warm. In large pan over medium heat, heat olive oil. Add onion and garlic; saute 4 minutes or until light brown. Stir in spinach, tomato, basil, salt and pepper; cook another 5 minutes, stirring occasionally. Stir in whipping bream and parmesean cheese. Cook until mixture comes to a boil. Reduce heat to low and mix in tortellini and cook another 4 minutes until thoroughly heated. Remove from heat and transfer to individual serving plates and top with additional parmesean cheese.
3 tbsp butter (can use Smart Balance)
1 (10.5 oz) bag Miniature Marshmallows
1 (15 oz) box Multi-Grain Cluster Cereal (can use Kashi GoLean Crunch)
1 1/4 cups Dried Cranberries- divided
Vegetable Cooking Spray
Melt butter in large saucepan over low heat. Add marshmallows, and cook, stirring constantly, 4 to 5 minutes or until melted and smooth. Remove from heat. Stir in cereal and 1 cup of cranberries until well coated. Press mixture into a 13 x 9 inch baking dish coated with cooking spray. Chop remaining 1/4 cup cranberries, and sprinkle on top. Let stand 10 to 15 minutes or until firm.
2 cups Frozen Shelled Edamame
1 1/2 cup Fresh Corn Kernels
1 1/2 cup Mango Cubes (1 med)
1 cup Chopped Tomato (1 lg)
1/2 cup Red Onion- chopped
2 tbsp Fresh Cilantro- chopped
1 tbsp Extra Virgin Olive Oil
1 tbsp Lime Juice
3/4 tsp Salt
1/4 tsp Ground Black Pepper
Prepare edamame per package directions. Drain and rinse under cold water. Trandfer to large bowl. Stir in corn, mango, tomato, onion, cilantro, oil, lime juice, salt and pepper. Toss well.
Thursday, October 11, 2007
8 (10-inch) Flour or Wheat Tortillas
1/2 cup Barbecue Sauce
8 ounces (2 cups) Monterey Jack Cheese- shredded
1 1/2 cups Diced Cooked Chicken (can use Rotisseire Chicken)
Wednesday, October 10, 2007
Eggs, dark green and yellow vegetables and fruits, lowfat dairy products, liver
Growth and repair of body tissue, immune functions, night vision
Wheat germ, pork, whole and enriched grains, dried beans, seafood
Carbohydrate metabolism, appetite maintenance, nerve function, growth and muscle tone
Lowfat milk products, green leafy vegetables, whole and enriched grains, beef, lamb, eggs
Carbohydrate, protein and fat metabolism, needed for cell respiration, mucous membranes
Fish, poultry, lean meat, whole grain, potatoes
Carbohydrate and protein metabolism, formation of antibodies, red blood cells, nerve function
Lean beef, fish, poultry, eggs, lowfat and nonfat milk
Carbohydrate, fat and protein metabolism, maintains nervous system, blood cell formation
Egg yolk, meat, lowfat and nonfat milk, dark green vegetables; also made by microorganisms in intestinal tract
Carbohydrate, protein and fat metabolism, formation of fatty acids, utilization of B vitamins
Green leafy vegetables, dried beans, poultry, fortified cereals, oranges, nuts
Red blood cell formation, protein metabolism, growth and cell division
Poultry, fish, whole and enriched grains, dried beans and peas
Carbohydrate, protein and fat metabolism, health and digestive system, blood circulation, nerve function, appetite
Most plant and animal foods, especially leans meats, whole grains, legumes
Converts nutrients into energy, vitamin utilization, nerve function
Citrus fruits, tomatoes, melons, berries, green and red peppers, broccoli
Wound healing, strengthens blood vessels, collagen maintenance, resistance to infection, healthy gums
Egg yolk, fatty fish, fortified milk, also made in skin exposed to light
Calcium and phosphorus metabolism (bone and teeth formation)
Vegetable oil, wheat germ, nuts, dark green vegetables, whole grains, beans
Protects cell membranes and red blood cells from oxidation, may be active in immune function
Green leafy vegetables, cereal, egg yolk
Formation of blood clotting agents and bone
Lowfat or nonfat milk products, calcium fortified orange juice and bread, salmon with bones
Support of bone, teeth, muscle tissue, regulates heart beat, muscle action, nerve functions, blood clotting
Cheese, whole grains, meats, peas, beans
Needed glucose for metabolism (energy), increases effectiveness of insulin, muscle function
Nuts, dried beans, oysters, cocoa powder
Formation of red blood cells, pigment, needed for bone health
Seafood, iodized salt
Function of thyroid gland, which controls metabolism
Meat, fish, poultry, organ meats, beans, whole and enriched grains, green leafy vegetables
Formation of hemoglobin in blood and myoglobin in muscle, which supply oxygen to cells
Nuts, green vegetables, whole grains, beans
Enzyme activation, nerve and muscle function, bone growth
Meat, poultry, fish, eggs, lowfat milk products, beans, whole grains
Bone development, carbohydrate, protein and fat utilization
Vegetables, fruits, beans, bran cereal, lowfat milk products
Fluid balance, controls activity of heart muscle, nervous system
Seafood, lean meat, grains, eggs, chicken, garlic
Fights cell damage from oxidation
Lean meat, eggs, seafood, whole grains, lowfat milk products
Taste and smell sensitivity, regulation of metabolism, aids in healing
The most common side effects of tricyclic antidepressants, and ways to deal with them, are:
- Dry mouth- It is helpful to drink sips of water; chew sugarless gum; clean teeth daily.
- Constipation- Bran cereals, prunes, fruit, and vegetables should be in the diet.
- Bladder problems- Emptying the bladder may be troublesome, and the urine stream may not be as strong as usual; the doctor should be notified if there is marked difficulty or pain.
- Sexual problems- Sexual functioning may change; if worrisome, it should be discussed with the doctor. There is a solution.
- Blurred Vision- This will pass soon and will not usually necessitate new glasses.
- Dizziness- Rising from the bed or chair slowly is helpful.
- Drowsiness- As a daytime problem this usually passes soon. A person feeling drowsy or sedated should not drive or operate heavy equipment. The more sedating antidepressants are generally taken at bedtime to help sleep and minimize daytime drowsiness.
The newer antidepressants have different types of side effects:
- Headache- This will usually go away.
- Nausea- This is also temporary, but even when it occurs, it is transient after each dose.
- Nervousness and insomnia (trouble falling asleep or waking often during the night)- These may occur during the first few weeks; dosage reductions or time will usually resolve them.
- Agitation (feeling jittery)- If this happens for the first time after the drug is taken and is more than transient, the doctor should be notified.
- Sexual problems- The doctor should be consulted if the problem is persistent or worrisome.
Patients often are tempted to stop medication too soon. They may feel better and think they no longer need the medication. Or they may think the medication isn’t helping at all. It is important to keep taking medication until it has a chance to work, though side effects may appear before antidepressant activity does. Once the individual is feeling better, it is important to continue the medication for at least 4 to 9 months to prevent a recurrence of the depression. Some medications must be stopped gradually to give the body time to adjust. Never stop taking an antidepressant without consulting the doctor for instructions on how to safely discontinue the medication. For individuals with bipolar disorder or chronic major depression, medication may have to be maintained indefinitely.
Antidepressant drugs are not habit-forming. However, as is the case with any type of medication prescribed for more than a few days, antidepressants have to be carefully monitored to see if the correct dosage is being given. The doctor will check the dosage and its effectiveness regularly.
A good diagnostic evaluation will include a complete history of symptoms, i.e., when they started, how long they have lasted, how severe they are, whether the patient had them before and, if so, whether the symptoms were treated and what treatment was given. The doctor should ask about alcohol and drug use, and if the patient has thoughts about death or suicide. Further, a history should include questions about whether other family members have had a depressive illness and, if treated, what treatments they may have received and which were effective.
Last, a diagnostic evaluation should include a mental status examination to determine if speech or thought patterns or memory have been affected, as sometimes happens in the case of a depressive or manic-depressive illness.
Treatment choice will depend on the outcome of the evaluation. There are a variety of antidepressant medications and psychotherapies that can be used to treat depressive disorders. Some people with milder forms may do well with psychotherapy alone. People with moderate to severe depression most often benefit from antidepressants. Most do best with combined treatment: medication to gain relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life’s problems, including depression. Depending on the patient’s diagnosis and severity of symptoms, the therapist may prescribe medication and/or one of the several forms of psychotherapy that have proven effective for depression.
Depression can also affect the physical health in men differently from women. A new study shows that, although depression is associated with an increased risk of coronary heart disease in both men and women, only men suffer a high death rate.
Men’s depression is often masked by alcohol or drugs, or by the socially acceptable habit of working excessively long hours. Depression typically shows up in men not as feeling hopeless and helpless, but as being irritable, angry, and discouraged; hence, depression may be difficult to recognize as such in men. Even if a man realizes that he is depressed, he may be less willing than a woman to seek help. Encouragement and support from concerned family members can make a difference. In the workplace, employee assistance professionals or worksite mental health programs can be of assistance in helping men understand and accept depression as a real illness that needs treatment.
A recent NIMH study showed that in the case of severe premenstrual syndrome (PMS), women with a preexisting vulnerability to PMS experienced relief from mood and physical symptoms when their sex hormones were suppressed. Shortly after the hormones were re-introduced, they again developed symptoms of PMS. Women without a history of PMS reported no effects of the hormonal manipulation.
Many women are also particularly vulnerable after the birth of a baby. The hormonal and physical changes, as well as the added responsibility of a new life, can be factors that lead to postpartum depression in some women. While transient “blues” are common in new mothers, a full-blown depressive episode is not a normal occurrence and requires active intervention.
Treatment by a sympathetic physician and the family’s emotional support for the new mother are prime considerations in aiding her to recover her physical and mental well-being and her ability to care for and enjoy the infant.
Some types of depression run in families, suggesting that a biological vulnerability can be inherited. This seems to be the case with bipolar disorder. Studies of families in which members of each generation develop bipolar disorder found that those with the illness have a somewhat different genetic makeup than those who do not get ill. However, the reverse is not true: Not everybody with the genetic makeup that causes vulnerability to bipolar disorder will have the illness. Apparently additional factors, possibly stresses at home, work, or school, are involved in its onset.
In some families, major depression also seems to occur generation after generation. However, it can also occur in people who have no family history of depression. Whether inherited or not, major depressive disorder is often associated with changes in brain structures or brain function.
People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression. Whether this represents a psychological predisposition or an early form of the illness is not clear.
In recent years, researchers have shown that physical changes in the body can be accompanied by mental changes as well. Medical illnesses such as stroke, a heart attack, cancer, Parkinson’s disease, and hormonal disorders can cause depressive illness, making the sick person apathetic and unwilling to care for his or her physical needs, thus prolonging the recovery period. Also, a serious loss, difficult relationship, financial problem, or any stressful (unwelcome or even desired) change in life patterns can trigger a depressive episode. Very often, a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive disorder. Later episodes of illness typically are precipitated by only mild stresses, or none at all.
Signs & Symptoms may include:
- Persistent sad, anxious, or “empty” mood
- Feelings of hopelessness, pessimism
- Feelings of guilt, worthlessness, helplessness
- Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
- Decreased energy, fatigue, being “slowed down”
- Difficulty concentrating, remembering, making decisions
- Insomnia, early-morning awakening, or oversleeping
- Appetite and/or weight loss or overeating and weight gain
- Thoughts of death or suicide; suicide attempts
- Restlessness, irritability
- Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
- Major depression is manifested by a combination of symptoms that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.
- A less severe type of depression, dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.
- Another type of depression is bipolar disorder, also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. Mania, left untreated, may worsen to a psychotic state.