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ELC: Primary, Secondary and Tertiary prevention of Depression

Attitude and motivation are really key in maintenance. The NWCR has found the two reasons people relapse are depression and disinhibited eating. I used to be chronically depressed and then after some recovery work for codependency and anxiety I found I was no longer depressed for no good reason. I still had feelings, but they were appropriate to the situation and if I didn’t have good feelings, I could usually find ways to cultivate some better feelings.

In human development class we’ve been talking about safety in the primary, secondary and tertiary prevention levels. Primary means systemic prevention, like the guidelines on playgrounds, which may seem annoying (and mean there are no playgrounds sometimes) but evidently they reduce injury to children. Secondary means targeted preventive intervention for folks with higher risks. Tertiary is having resources in place for when something does go wrong. This may not seem like a level of prevention, unless you consider that the alternative is assuming nothing wrong will ever happen.

Applying this to motivation and attitude, I think some of my primary strategies are limiting the amount of news media and TV commercials I consume. I used to be a compulsive news watcher, and it just increased my stress. TV commercials manipulate us to feel like we need certain products (usually food) to enjoy life. Secondary strategies are things like knowing when I am likely to have PMS or going to a party, and working out ideas for preventing a blowout. Tertiary strategies involve resliency, which I think is so important. You step on the scale and it’s up 2 or 3 pounds, I never take it personal. I figure out why. Maybe it’s salt. Maybe it’s glycogen. I recently learned that PMS hormones directly affect what your body does with sodium, and chocolate can soften the hormone withdrawal, but also keeps it from resolving. It’s crazy. But my point is, when something goes wrong, I figure it out. If I can’t figure it out, I try and be easy on myself. And if I still feel bad, I might try a non fattening “reward” like playing a videogame, just get my mind off things.

Folks talk about running out of motivation and wondering where they can pick some up, but it’s not a commodity, it’s a process.

ELC: Defining Mental Wellness

I went to one session of a class called Social Health and Diversity this week.  Then an online section of a class I actually need as a nursing prerequisite opened up so I switched to that.  But in this class I got introduced to the SPIES of Health.  Social, Physical, Intellectual, Emotional, and Spiritual.  If you google “wellness wheel” you’ll see that the student health sites for many universities promote some version of this, sometimes SPICES (adding Career) or SPECIES (Adding Environment) and there was one that had a grundle of little slices, like a wedding cake or something.  So I am thinking I should try to mold my model of mental wellness into something like this.  I would like it if there were neural structures associated with these things, so I’ll play with that.

Social is found in the mirror neurons of the brain, which not only fire when we see actions as if we were doing them, they also have been argued to code intention and context and may be one of the distributed sites of language processing.

Physical, as it’s expressed in mental health, would be the motor functions of the brain.  We also know that as much as the brain governs motion, motion can help regulate the brain as shown in studies where exercise can be as effective as antidepressants… if you can motivate yourself to do it.

Intellectual.  This is a toughie since we tend to think that this is what the brain does.  I would class it more specifically as the operations of the prefrontal cortex, such as judgment, decision making, and willpower.

Emotional.  People mean a lot of things when they talk about emotion.  One definition that has stayed with me from my first round of college studies is when a mental state produces an effect on the physical body.  Your heart rate quickens.  Your eyes water.  I would consider this the endocrine (hormonal) functions of the brain.

Spiritual – what do we do with this?  For now I’ll say this isn’t part of the mind, but something we as individuals are part of.  As my teacher pointed out, it doesn’t have to mean organized religion.  It can be family, community or a practice like yoga or tai chi.  It encompasses mindfulness.  On the flip side, it encompasses addiction and compulsive behavior.

ELC: Posted to a friend’s blog

“Hopefully you come to understand what the bingeing means and why you’re doing it.  I don’t usually say “fake it till you make it” but when it comes to accepting yourself, I think it’s called hope. ”

Shame and regret cause further compulsive behavior.  After a binge, we may try to compensate by eating restrictively, and then in a few days that inner child breaks out again.  The hunger for feeling cared for comes out in a desire to be filled.

My own solution is to not engage in compensatory restriction.  I move ahead.  If I’m not hungry for second breakfast, I might go till lunch but then I am back on plan, eating just right, not too much nor too little.  I cultivate normalcy.

ELC: Suddenly, Content!

I registered this domain a couple of months ago.  I had submitted a proposal to an agent and she said it was simultaneously too academic (for the public) and too basic (for health care providers).  I joked with my co author that we could to with a title such as “eating like crazy” and found I liked it so much, I wanted to use it.  I have a lot of blogs, but only a few that I have registered the domain for, and this is one of them.

However, I already have one site that is about weight management and mental illness, and another that is about evidenced based weight maintenance strategies.  But on that site I had accumulated some writings that were just the distillation of what I’d learned from my many months pursuing a lifestyle change.  I was reorganizing the evidenced based weight maintenance and realized these writings could come over here, to Eating Like Crazy.  In their prior incarnation, the posts were grouped under “actualizing change” but when I transplanted them here, the moniker “Eating Like Sane” popped into my head.

ELC: Why do you eat?

“Eat less, move more” or “Eat when you’re hungry, stop when you’re full” is great advice, but if it were that simple, don’t you think we’d be doing it already?