Tai Chi Aids Seniors in Fighting Depression


With more than 2 million people age 65 and older suffering from depression in the U.S., including half of those living in nursing homes, effectively treating the elderly is a growing problem – especially as the numbers of seniors rise.

Researchers at UCLA found that an ancient martial art can help significantly.

When a gentle, Westernized version of tai chi chih was combined with a standard drug treatment for a group of depressed elderly adults, researchers found greater improvement in the level of depression — along with improved quality of life, better memory and cognition, and more overall energy — than among a different group in which the standard treatment was paired with a weekly health education class.

“This is the first study to demonstrate the benefits of tai chi in the management of late-life depression, and we were encouraged by the results,” said first author Dr. Helen Lavretsky, a UCLA professor-in-residence of psychiatry.

“We know that nearly two-thirds of elderly patients who seek treatment for their depression fail to achieve relief with a prescribed medication.”

In the study, 112 adults age 60 or older with major depression were treated with the drug escitalopram (brand name Lexapro), a standard antidepressant, for approximately four weeks. From among those participants, 73 who showed only partial improvement continued to receive the medication daily but were also randomly assigned to 10 weeks of either a tai chi class for two hours per week or a health education class for two hours per week.

All the participants were evaluated for their levels of depression, anxiety, resilience, health-related quality of life, cognition and immune system inflammation at the beginning of the study and again four months later.

The level of depression among each participant was assessed using a common diagnostic tool known as the Hamilton Rating Scale for Depression, which involves interviewing the individual. The questions are designed to gauge the severity of depression. A cut-off score of 10/11 is generally regarded as appropriate for the diagnosis of depression.

The researchers found that among the tai chi participants, 94 percent achieved a score of less than 10, with 65 percent achieving remission (a score of 6 or less). By comparison, among participants who received health education, 77 percent achieved scores of 10 or less, with 51 percent achieving remission.

While both groups showed improvement in the severity of depression, greater reductions were seen among those taking escitalopram and participating in tai chi.

“Depression can lead to serious consequences, including greater morbidity, disability, mortality and increased cost of care,” Lavretsky said. “This study shows that adding a mind-body exercise like tai chi that is widely available in the community can improve the outcomes of treating depression in older adults, who may also have other, co-existing medical conditions, or cognitive impairment.

“With tai chi,” she said, “we may be able to treat these conditions without exposing them to additional medications.”

The results of the study appear in the current online edition of the American Journal of Geriatric Psychiatry.

Source Psych Central

Having a Bad Job Can Be Worse Than None At All


Although in the current economy being unemployed feels like the worst thing in the world, researchers have found something even worse — being stuck in a bad job.

Australian National University researchers have found that, from a mental health perspective, you may be better off being unemployed rather than being in a bad job.

The work was undertaken by researchers from the Centre for Mental Health Research, led by Liana Leach, Ph.D.

Using data from the 20-year Personality and Total Health (PATH) Through Life Project, the team looked at the mental health effects of being in a “bad job” – a job with low security, high stress and little control. The results, Leach said, were significant.

“Our research had two main findings. First, we found that those in poor quality jobs had poorer mental health than those in good quality work. People who were in a bad job were five times more likely to be categorized as depressed and twice as likely to be categorized as anxious than those in good quality work.

“Second, over time, those who moved from being unemployed into poor quality work actually experienced a greater decline in their mental health than those who remained unemployed,” she said.

The study examined the effect of several adverse work conditions on an individual’s mental health, rather than looking at the effect of specific roles or occupations.

The researchers examined results from a national household survey conducted over seven years of more than 7,000 people living in Australia.

Job quality was graded based on four factors: stress and level of demand, amount of control employees said they had over their work, job security (or potential for a future) and whether or not the pay was fair.

Participants also filled out a mental health questionnaire that assessed symptoms of depression and anxiety as well as positive emotions, such as feelings of happiness and calm.

After taking into account possibly confounding factors that could influence the findings, such as an individual’s age, gender, marital status and level of education, the mental health of unemployed individuals was on par with, or better than, the mental health of those with poor-quality jobs.

Those with the poorest-quality jobs showed a greater drop in mental health over time compared with those who were unemployed.

“In our study, a bad job, or poor quality job, was one where people perceived their job was insecure, perhaps because they were on a short-term contract or casual work, they had high job demands or a heavy workload, and they didn’t have much control over how they managed that workload. They also felt that it would be difficult to gain another similar job, suggesting they felt trapped in their current workplace,” said Leach.

The results indicate that, for employers, one of the keys to happy and mentally healthy employees is to keep an eye on these negative factors and work with staff to find solutions.

Leach said the study suggests it would be best for employers to be open to negotiation with employees about their work conditions – making sure employees have reasonable workloads and some control over how they manage this workload is likely to produce employees with better mental health.

“For their part, employees might like to negotiate with employers to see if they can make their workplace one that benefits their wellbeing and mental health.

“Everybody has moments in their jobs where it’s difficult and you’re not enjoying what you’re doing, but we hope this study helps to improve people’s workplace environments so that we can improve their mental health too,” said Leach.

Source Psych Central

Serotonin Seems to Skew View of Others’ Intimacy


A new finding suggests our view of the intimacy of other couples’ relationships is influenced by the brain chemical serotonin.

University of Oxford scientists studied healthy adult volunteers and discovered that when the activity of serotonin, a neurotransmitter associated with mood, is low then the adult rated couples in photos as being less “intimate” and less “romantic’” than those with normal serotonin activity.

The results raise the possibility that lower serotonin activity in people with depression and other psychiatric conditions could contribute to changes in the way they perceive personal relationships.

The Medical Research Council-funded study is published in the journal Biological Psychiatry.

“Serotonin is important in social behavior, and also plays a significant role in psychological disorders such as depression,” said Professor Robert Rogers of the Department of Psychiatry at Oxford University, who led the research.

“We wanted to see whether serotonin activity influences the judgments we make about peoples’ close personal relationships.”

Problems with social relationships, and a feeling of social isolation, are a feature of depression in some people. It is possible that alterations in brain systems — such as serotonin — contribute to these difficulties by changing the way people think about relationships with partners.

Such understanding is important as supportive close relationships are known to protect against the development of mental illnesses and to promote recovery in those affected by psychiatric conditions.

The opposite is also true: dysfunctional relationships can be triggers for those at risk of these conditions.

The team from Oxford University, along with colleagues from the University of Liverpool and King’s College London, manipulated the serotonin activity in healthy adult volunteers, and then asked them to make judgments about sets of photographs of couples.

The approach involved giving amino acid drinks to two groups of volunteers. One group received drinks that contained tryptophan, the amino acid from which serotonin is made in the brain.

The other group received drinks that did not contain tryptophan. Differences in the judgments made by the two groups reflected changes in serotonin activity.

The 22 volunteers who received the drink without tryptophan consistently rated the couples in the photos as being less “intimate” and “romantic” than the 19 participants who received the control drink.

“Although this is only a small study, the same patterns may well extend to the way we perceive our own relationships,” Rogers said. “Serotonin activity may affect people’s ability in depression to maintain positive or intimate personal relationships.”

Source Psych Central

Facebook: Three Minutes To Improving Your Self-Esteem?

By Tamara Hicks, Psy.D., and Brett P. Kennedy, Psy.D.

Since its launch in 2004, Facebook has become a household word.  It has over 500 million active users who have an average of 130 friends. People spend over 700 billion minutes per month on it and and it is the subject of an Oscar winning movie, The Social Network. Clearly Facebook is a part of us, but what impact is it having on our lives?

In a study, published in the journal Cyber psychology, Behavior, and Social Networking, In their study, Mirror, Mirror on my Facebook Wall: Effects of Exposure to Facebook on Self-Esteem, two Cornell researchers, Amy Gonzalez and Jeffery Hancock, posit that Facebook boosts self-esteem. The study separated sixty-three students into three groups to examine “people’s attitudes about themselves after exploring different internet sites.” Two groups were “offline” and either sat in front of a mirror or just remained in the room looking at a blank computer screen.  The “online” group was permitted to engage their Facebook profile pages for three minutes.

A survey completed after the test showed that those who were on Facebook scored higher on the Rosenburg Self-Esteem scale than the “offline” participants.  The researches also noted that the Facebook users who spent the three minutes exclusively viewing their own profiles vs. viewing the profiles of others scored higher as well and those who changed their profile (updated) vs. those who did not,  also scored higher.   The researchers suggest that the process of “selective self presentation”  was responsible for influencing their self-esteem.  In other words,  the process of  engaging your own profile and making changes to it that makes you feel better about your self.

My colleague Guy Winch, who writes the popular Psychology Today blog, The Squeaky Wheel and author of the book, The Squeaky WheelComplaining the Right Way To–Get Results, Improve Relationships, Enhance Self-Esteem,  has a bit of a complaint of his own about this study. “The study did not prove that viewing Facebook enhances self-esteem but rather that viewing Facebook makes us feel slightly better about ourselves while we’re viewing our profiles. Subjects completed the questionnaires as soon as they finished viewing Facebook, not hours or days afterward. Therefore, the study did not demonstrate that Facebook has any lasting impact on self-esteem whatsoever. I imagine the same impact could be gained by looking at our family photo albums. In addition, self-esteem is still a poorly understood construct and certainly one too complex to be captured in any accuracy by a simple ten-item questionnaire.”

Dr. Winch makes a great point–just as self-esteem is complex, so is the Facebook experience. Typically, this experience is about interaction.  Focused,  “selective self-presentation” is only a small part of that process.  Facebook is about checking out profiles, engaging others, playing games and processing a lot of data.   Participants who participated in those behaviors scored lower on the self-esteem scale.

What is self-esteem anyway?  it is such a common buzzword,  but how is it understood and defined?   The Merriam Webster dictionary defines it as a “confidence and satisfaction in oneself.” Experts in the field of self-esteem conceptualize it as:

  • Confidence in our ability to think, to cope with the basic challenges of life and confidence in our right to be successful and happy. —Nathaniel Branden
  • Having a positive image of self. — Don Simmermacher 
  • An evaluation of the emotional, intellectual, and behavioral aspects of the self-concept. — Diane Frey & Jesse Carlock
  • A state of mind. It is the way you feel and think about yourself and others, and is measured by the way you act. —- Connie Paladino

Abraham Maslow who founded humanistic psychology and developed Maslow’s “hierarchy of needs”Maslow's Hierarchy of Needs addresses  as a  the normal human need to be accepted and valued by others.  George Boeree, Ph.D. wrote,  “Maslow noted two versions of esteem needs, a lower one and a higher one.  The lower one is the need for the respect of others, the need for status, fame, glory, recognition, attention, reputation, appreciation, dignity, even dominance.  The higher form involves the need for self-respect, including such feelings as confidence, competence, achievement, mastery, independence, and freedom.” Maslow’s theory on the need of esteem highlights how self-esteem is nurtured and impacted by our relationships with others.    

Since Facebook is fast becoming a vital necessity of modern-day socializing. The average person spends over seven hours a month on the site, a number that has nearly doubled in just a year’s time. It is clear that Facebook is an experience that embodies much more than three minutes of pure “me” time.   In therapy, where people tend to spend fifty minutes focusing on themselves, Facebook frequently makes an appearance in the narratives clients share in session.  Clients discuss Facebook as an inevitable part of life that they have  a love /hate relationship with. The latter seems to come up more in sessions and the adjectives people use to describe themselves or their behaviors do not always convey confidence and satisfaction with oneself.  

I frequently hear clients label their voyeuristic behaviors on Facebook, as “time wasting”.  They describe “stalking” and “obsessing” about past, present, and future lovers.   People say they feel “overwhelmed” by the number of posts and updates from their Facebook friends and “pressured” to post on their own experiences and observations.   They can describe the Facebook experience as  “competitive”  and admit to being “envious” when comparing themselves to others.  Many label themselves as “lonely” and  “pathetic” and  feeling “left out” as they observe the lives and activities of others.   Many  regularly report being “angry” about something they have seen or discovered while Facebooking.   In fairness, clients tend to bring their conflicts and struggle to therapy, so it is probably not a surprise that they tend to share the hate more than the love, but these negative experiences are likely to be a hit on esteem according to Maslow.   Conversely, all of the joy, successes, connection, sharing, and validation that Facebook facilitates presumably would counter those hits. 

It would seem then, the bigger question about Facebook is not whether it is good or bad for our self-esteem but how can we best manage the positive and the negative contributions that undoubtedly will accumulate over countless Facebook moments that shape who we are.  Our self-esteem can become  fixed at times and is clearly  impacted by circumstances but it seems to be an ever evolving relationship we experience within ourselves and how we project that to the world, our   “social network”.  A home base for our Digital Self where  past, present, and potentially future relationships converge in many degrees of depth or context, exponentially and ten-fold.   We now observe, ingest, and share  so much more than humanly possible before Facebook and we are only in the infancy of becoming acquainted with socializing in this way.   We can now passively take an active interest in so many lives and must determine how actively we  want to share ourselves with others.    All this information, sharing, and interacting all, according to Maslow, contributes to our overall sense of self.  Perhaps because so much of it is spent engaging with others, three minutes of “me” time does carry some weight.

Facebook will likely have an  impact on our self-esteem because it is the conduit for our Digital Self to express itself and connect online.   But will that prove to be exclusively a positive or negative one?   Probably not.   While  Gonzalez’s and Hancock’s study tries to isolate a particular Facebook activity, it is  limited in the information it provides us with respect to self-esteem as a whole, but may prove valuable in determining what kinds of activities contribute to that complex equation.  Facebook is an experience made up of many parts, as is our self-esteem, and only time will tell how Facebook shapes that and how we shape ourselves on Facebook.

Source Psychology Today

Mid-Life Crisis-Myth or Reality? Turning Crisis into Wisdom

By Ilene Serlin, Ph.D

Mid-Life Crisis-Myth or Reality?

Turning Crisis into Wisdom

Growing up in the 60s and as a student of Jean-Paul Sartre and Simone de Beauvoir, I was sure that I-and each human being-was unique. I resisted theories of developmental psychology or any suggestion that my issues were “age-related.”

Many years later, I look back upon my 30s, my 50s, and even now my 60s, and cannot escape the patterns. Yes, I’m unique-but my issues also live in the context of their times and across others of my age. At this point in time, the rich complexity of uniqueness/commonality is comforting and feels like a doorway into wisdom. At each decade I ask myself-and those with whom I work-“How am I unique, and how do I correspond to the developmental issues of others my own age?”

The following excerpt is from a client, Jeff Weinberger, who had just confronted turning 50. His reflection below is a good example of one man’s understanding of his uniqueness and of his commonality with all others. Jeff has given permission to include his identity in this blog so that his story may serve as a model to help others begin their own journeys toward midlife self-acceptance:

I am not 30.

No matter what my friends (or your friends) say, 50 is not the new 30 (or 40, or even 49). 50 is 50. Period. It’s not like 30 or 40. Those decades had their own unique challenges and opportunities, as does this one.

I turned 50 a few weeks ago, and as I relaxed at home after a weekend of celebration, I realized I had suddenly arrived on something like a new plateau.

This is not a mid-life crisis. In fact I don’t think (at least I hope) that I ever will have one of those:  http://posterous.jeffweinberger.com/mid-life-without-the-crisis]). It’s turning out to be a new perspective on my life and the world that surrounds me.

It is a new so-called life-stage. And I’m just starting the journey of learning a few things about being a 50-something (besides that I’m now eligible for AARP membership).

  • I know more about how to get where I want to go. I don’t know everything – I hope not! – but I do know more than I did, and more than at any prior age (obviously!), about how the proverbial game is played, and how I can tilt the outcome more in my favor. I may not win (as one of my favorite t-shirts ever read: “He who dies with the most toys, wins”), but I can certainly do a better job with the tools now available to me of ending up where I want to be.
  • I am turning into Popeye (“I am what I am”). Or at least I’m becoming more secure in who I am, who I’ve become in the past 50 years and how I want to become a better me (notice, not become something else) for the next 10-20-30-more years. This has also led to far less conflict in my life – I’m so much more comfortable ceding ground to others that I never wanted anyway. I just needed to learn that I never wanted it.
  • There are more younger people in my life. Of course, but it may not seem obvious that the overall average age of the people in the room (business, social, whatever room you’re in) hasn’t changed – you’ve just gotten older. I’ve noticed that more of my new friends and associates are younger than I, where there used to be a more even division of age. I’m now the older, more-experienced guy. That’s nice in and of itself, but the other benefit is that all these new young associates and friends challenge me, teach me and keep me on my toes.
  • I’m learning to live with new realities. I am – thankfully – suffering no serious physical challenges, but I do find that I don’t have some of the physical capacity I once did. I can’t always improve every statistic of my workout. I can’t always be faster or stronger than anyone else I choose to compare myself to. It’s starting to give me a longer-term, more balanced perspective on my own capability. I have started to think in terms of what performing well means, and how to keep challenging myself through variety rather than through linear progress. I think it’s going to keep the physical condition aspects of my life quite interesting.
  • I’ve given myself permission to be honest. In my teens, 20s and 30s, I was always trying to prove that I had it all under control and built a facade to help make others believe that and be impressed. But it was a fraud. I knew I had hard, deep, challenging questions. When I started opening up and telling people about my challenges and questions, I found out not only was I not alone, but that I gained more respect for honesty than I ever did for the facade. Plus I’ve developed deeper, better relationships as a result, and the people around me value me for the real, not perceived, me. Living and loving life comes with hard questions; being honest about it makes it easier – whether I deal with them or not.

I’m new to this. I’ve only been 50 for a few weeks, but it’s crystal clear to me that there’s a new life-stage starting, with a set of new perspectives, better tools and knowledge and, I hope, a lot more fun, growth and learning ahead.

I don’t know where it will take me (maybe I should write down now what I plan to say when I turn 60?), but it promises to be the best decade I’ve had yet – and I don’t think I could ask for more than that.

Source Psychology Today