Alternative therapies for Depression

ALWAYS CONSULT WITH A TRAINED EXPERIENCED PROFESSIONAL. Many supplements are interactive or similar, consult with a recognized authority before combining supplements and/or prescription medications. Take a list of supplements, herbal remedies and prescriptions to every MD appointment - even if you think that it is already recorded in your chart.

In any given year, nearly 20 million adults in the United States are depressed.

Most people with depression do not seek treatment, although the majority can be helped with treatment. The first step is to talk with your doctor, because depression is a serious illness that shouldn't be self-treated.

Depression can also be a symptom of another condition, such as hypothyroidism or anemia. If you are currently taking medication for depression, do not stop without consulting your doctor.

Natural Remedies for Depression

Here are nine natural remedies that are used for depression.

1) St. John's Wort

The herb St. John's wort (Hypericum perforatum) has long been used in folk medicine for sadness, worry, nervousness, and poor sleep.

Today, the results of over 20 clinical trials suggest that St.John's wort works better than a placebo and is as effective as antidepressants for mild to moderate depression, with fewer side effects. Studies suggest that St. John's wort is not effective for major depression.

Researchers have discovered that this herb works like an SSRI (a class of antidepressant medication) and a weak MAO inhibitor. Numerous studies have confirmed that St. John's Wort does possess antidepressive effects in cases of mild to moderate depression.
It's available at health food stores, drug stores, and online in the form of capsules, tablets, liquid extracts, or tea.

St. John's wort may take 4 to 6 weeks to notice the full effects. Side effects may include dizziness, dry mouth, indigestion, and fatigue. St. John's wort increases photosensitivity, so extra caution should be taken to protect skin and eyes from sunlight.

Although St. John's wort appears to be reasonably safe when taken alone, it can interfere with the effectiveness of prescription and over-the-counter drugs, such as antidepressants, drugs to treat HIV infections and AIDs, drugs to prevent organ rejection for transplant patients, and oral contraceptives.

St. John's wort is not recommended for pregnant or nursing women, children, or people with bipolar disorder, liver or kidney disease.

• Kava Kava: Has soothing and stress relieving qualities; studies have shown its effectiveness in treating anxiety and depression.
  
  
• Ginko Biloba: Improves blood flow through the brain, accounting for its use as an aid in mental acuity. Appears to normalize neurotransmitter levels; a potent antioxidant that protects nervous system cells and regulates blood platelet stickiness. Studies have shown that ginkgo biloba may be used to improve mood and may be useful in conjunction withy standard antidepressants to enhance effectiveness in patients who are resistant to standard drug therapies. Another study showed ginkgo's effectiveness in decreasing sexual dysfunction problems caused by antidepressant drugs.
  

2) Omega-3 fatty acids

Omega-3 fatty acids are a type of good fat needed for normal brain function. Our bodies can't make omega-3s on their own, so we must obtain them through our diet.

Studies have linked depression with low dietary intake of omega-3 fatty acids. In countries with higher fish consumption, such as Japan and Taiwan, the depression rate is 10 times lower than in North American. Postpartum depression is also less common.

Studies suggest that omega-3's together with antidepressants may be more effective than antidepressants alone.

Cold water fish such as salmon, sardines, and anchovies are the richest food source of omega-3 fatty acids. But instead of eating more fish which contain mercury, PCBs, and other chemicals, fish oil capsules are considered a cleaner source of omega-3 fatty acids. Many companies filter their fish oil so that these chemicals are removed.

Fish oil capsules are sold in health food stores, drug stores, and online. Most brands should be stored in the fridge to prevent the oil from going rancid. When comparing brands, the key active components for depression are EPA and DHA.

Fish oil capsules may interact with blood-thinning drugs such as warfarin and aspirin. Side effects may include indigestion and bleeding. Fish oil should not be taken 2 weeks before or after surgery. Fish oil can also cause a fishy aftertaste. To prevent this, try taking the fish oil just before meals.

3) SAM-e

SAM-e, pronounced "sammy", is short for S-adenosyl-L-methionine. It's a chemical that's found naturally in the human body and is believed to increase levels of neurotransmitters serotonin and dopamine. A chemical compound found in all living cells; SAM-e can be found in more than 40 biomedical processes in the body. Supplementing the diet with SAM-e in depressed patients can result in increased levels of serotonin, dopamine and phosphatides, improve binding of neurotransmitters to receptor sites and increase serotonin and dopamine activity. The key to SAM-e's effectiveness is its ability to make brain cells more responsive to neurotransmitters such as serotonin and dopamine.

Several studies have found SAM-e is more effective than placebo.

In North America, SAM-e is available as an over-the-counter supplement in health food stores, drug stores, and online. It should be enteric-coated for maximum absorption. Although it's one of the more expensive supplements, it remains popular as a remedy for depression and osteoarthritis.

Side effects can include nausea and constipation. For more information, read the SAM-e and Depression.

4) Folic Acid

Folic acid, also called folate, is a B vitamin that is often deficient in people who are depressed.

Folate is found in green leafy vegetables, other vegetables, fruit, beans, and fortified grains. It's one of the most common vitamin deficiencies because of poor diet but also because chronic conditions and various medications such as aspirin and birth control pills can also lead to deficiency.

Besides food, folic acid is also available as a supplement or as part of a B-complex vitamin.

Researchers at Harvard University have found that depressed people with low folate levels don't respond as well to antidepressents, and taking folic acid in supplement form can improve the effectiveness of antidepressants. For more information, read Low Folate and Vitamin B12 Linked to Depression.

5) 5-HTP

5-HTP is short for 5-hydroxytryptophan. It's produced naturally in the body and is used to make the neurotransmitter serotonin. Although taking 5-HTP in supplement form may theoretically boost the body's serotonin levels, many experts feel there is not enough evidence to determine the safety of 5-HTP. It should not be combined with antidepressants.

• 5-HTP Fact Sheet
• 5-HTP Potential Drug Interactions

6) Diet

· Reduce your intake of sweets
Sweets temporarily make you feel good as blood sugar levels soar, but may worsen mood later on when they plummet.

· Avoid caffeine and alcohol
Caffeine and alcohol both dampen mood. Alcohol temporarily relaxes us and caffeine boosts energy, but the effects of both are short-lived. Both can worsen mood swings, anxiety, depression, and insomnia.

· Vitamin B6
Vitamin B6 is needed to produce the mood-enhancing neurotransmitters serotonin and dopamine. Although deficiency of vitamin B6 is rare, a borderline deficiency may occur in people taking oral contraceptives, hormone replacement therapy, and drugs for tuberculosis.

· Magnesium
Most people do not get enough magnesium in their diets. Good sources of magnesium are legumes, nuts, whole grains and green vegetables. Like vitamin B6, magnesium is needed for serotonin production. Stress depletes magnesium.

*L-Theanine helps the brain switch to an alpha brain wave pattern. Alpha waves signify an awake, alert and relaxed physical and mental state of being without drowsiness. In addition, accessing an alpha state helps to improve learning and concentration, strengthens the immune system and nourishes stress-induced hormonal balance
This amino acid, a derivative of one of the brain’s neurotransmitters, is best known for promoting a sense of relaxation in times of stress. It is so effective that the Japanese have added L-theanine to more than 50 products, including beverages, ice cream, jelly candy and gum.

• L-tyrosine: A precursor to norepinephrine; may be valuable to the people who do not respond to most antidepressant drugs except amphetamines.
• L-tryptophan: a natural relaxant helping alleviate insomnis by inducing normal sleep. Reduces anxiety and depression and anxiety. Reduces tensance to migraine headaches, works with lysine in reducing cholesterol levels.
• L-phenylalanine: Converted to tyrosine (a naturally occuring form of phenylalanine); D-phenylalanine (which does not normally occur in the body or in food) is metabolized to phenylethylamine (PEA), an amphetamine-like compound that occurs normally in the human brain and has been shown to have mood elevating effects. Studies have shown that depressed people commonly have low levels of phenylethylamine.

Homeopathic Remedies

7) Exercise

Regular exercise is one of the most effective and inexpensive ways to improve mood.

Exercise, particularly aerobic exercise, releases mood-elevating chemicals in the brain and can decrease stress hormones.

One of the best options to bust the blues is taking a brisk walk outside each morning for at least 30 minutes five days a week.

But what's important is that you choose something you enjoy and will stick with, whether it's going to the gym, signing up for dance classes, playing tennis, or gardening.

8) Light Therapy

Getting enough sunlight has been shown to be effective for seasonal mood changes that happen in the darker winter months.

Exposure to light in the morning helps the body's sleep/wake cycle work properly.

Production of serotonin, a brain chemical that key in influencing our mood, is turned on in the morning upon exposure to light. During the winter when there is less sunlight, serotonin levels can drop, making us feel tired and prone to seasonal affective disorder (SAD).

One of the most simple ways to increase your exposure to light is to walk outdoors in the morning. Just be sure to use sunscreen to protect your skin from ultraviolet light.

Another option is to use special lights that simulate natural daylight. Studies have found they are effective.

These lights can be found online. There are different types available, from light boxes to visors, that are typically used for 20-30 minutes a day. Look for lights with a minimum of 3,000 lux. many experts suggest 10,000 lux.

Although they are rather expensive ranging from $150 to $500, they may be covered by insurance.

9) Relora

• A patented magnolia and phellodendron extract
  
  
• Addresses weight gain triggered by stress
  
  
• Takes will-power and metabolism out of the equation
  

An important breakthrough for anyone struggling to lose weight! Now there's an all natural diet formula that breaks the weight/stress connection to help you meet your fitness goals and feel great while you do it. Introducing Relora, the revolutionary magnolia and phellodendron extract blend that addresses one of the most difficult aspects of successful weight mangagement: stress. High stress levels trigger the release of hormones that can not only increase appetite, but can also affect how the body stores and metabolizes fat. By working with the body's natural chemistry to reestablish a normal balance of these hormones, Relora takes will power and metabolism out of the diet equation, breaking the stress cycle that so often derails even the most well-designed fitness plans. It is similar to 5-HTP ---- so please, consult with a recognized authority before combining with any other supplement or prescription medication.

Glycemic index ?

Glycemic index (also glycaemic index, GI) is a ranking system for carbohydrates based on their effect on blood glucose levels. It compares available carbohydrates gram for gram in individual foods, providing a numerical, evidence-based index of postprandial (post-meal) glycemia. The concept was invented by Dr. David J. Jenkins and colleagues in 1981 at the University of Toronto.

Carbohydrates that break down rapidly during digestion have the highest glycemic indices. Carbohydrates that break down slowly, releasing glucose gradually into the blood stream, have a low glycemic index. A lower glycemic index suggests slower rates of digestion and absorption of the sugars and starches in the foods and may also indicate greater extraction from the liver and periphery of the products of carbohydrate digestion. A lower glycemic response is often thought to equate to a lower insulin demand, better long-term blood glucose control and a reduction in blood lipids. But in fact, some foods having a low glycemic index or having very little carbohydrate cause a high insulin response or raise blood lipids.

Glycemic index of foods

GI values can be interpreted intuitively as percentages on an absolute scale and are commonly interpreted as follows:

Classification	GI range	Examples
Low GI	55 or less	most fruit and vegetables (excepting root vegetables), oats, buckwheat, whole barley, All-bran,
Medium GI	56 - 69	sucrose, candy bar, croissant, brown rice
High GI	70 or more	corn flakes, baked potato, Jasmine rice, white bread, white rice

A low GI food will release glucose more slowly and steadily. A high GI food causes a more rapid rise in blood glucose levels and is suitable for energy recovery after endurance exercise or for a person with diabetes experiencing hypoglycemia.

The glycemic effect of foods depends on a number of factors such as the type of starch (amylose vs. amylopectin), physical entrapment of the starch molecules within the food, fat and protein content of the food and organic acids or their salts in the meal — adding vinegar for example, will lower the GI. The presence of fat or soluble dietary fibre can slower gastric emptying rate thus lowering the GI. Unrefined breads with higher amounts of fibre generally have a lower GI value than white breads. Many brown breads, however, are treated with enzymes to soften the crust, which makes the starch more accessible. This raises the GI, with some brown breads even having GI values over 100.

Weight control

Recent animal research provides compelling evidence that high GI carbohydrate is associated with increased risk of obesity. In human trials, it is typically difficult to separate the effects from GI and other potentially confounding factors such as fibre content, palatability, and compliance. In the study (Pawlak et al, 2004), male rats were split into high and low GI groups over 18 weeks while mean bodyweight was maintained. Rats fed the high GI diet were 71% fatter and had 8% less lean body mass than the low GI group. Postmeal glycemia and insulin levels were significantly higher and plasma triglycerides were three-fold greater in the high GI fed rats. Furthermore, pancreatic islet cells suffered "severely disorganized architecture and extensive fibrosis". The evidence in this study showed that continued consumption of high glycemic index carbohydrates would likely have led to the development of severe metabolic abnormalities.

While adding butter or oil will lower the GI of meal, the GI ranking does not change. That is, with or without additions, there is still a higher blood glucose curve after white bread than after low GI bread such as pumpernickel. List of foods with low index rating.

1. Vegetables (at least 5 portions a day)
2. Gross bread, grain, pasta, and other low glycemic, amyloid food (3–6 portions daily)
3. Fruit (2–3 times a day)
4. Nuts, seeds and shell fruits (eat 1–3 times a day), and oils pressed from these (1–2 times a day)
5. Pure proteins like meat, fish, poultry, eggs (up to 2 portions daily — red meat not more than 1–2 times a day)
6. Dairy products (1–2 portions daily, preferably low-fat products)
7. White bread, rice, potatoes, sweets (cookies and cakes) — eat rarely

MEMORY

What is memory?

Simply put, memory is the mental activity of recalling information that you have learned or experienced. That simple definition, though, covers a complex process that involves many different parts of the brain and serves us in disparate ways.
Memory can be short-term or long-term. In short-term memory, your mind stores information for a few seconds or a few minutes: the time it takes you to dial a phone number you just looked up or to compare the prices of several items in a store. Such memory is fragile, and it’s meant to be; your brain would soon read “disk full” if you retained every phone number you called, every dish you ordered in a restaurant, and the subject of every ad you watched on TV. It’s also meant to hold an average of seven items, which is why you can usually remember a new phone number for a few minutes but need your credit card in front of you when you’re buying something online.
Long-term memory involves the information you make an effort (conscious or unconscious) to retain, because it’s personally meaningful to you (for example, data about family and friends), or you need it (such as job procedures or material you’re studying for a test), or it made an emotional impression (a movie that had you riveted, the first time you ever caught a fish, the day your uncle died). Some information that you store in long-term memory requires a conscious effort to recall: personal memories about experiences you’ve had at specific times (episodic memory) and factual data not bound to time or place (semantic memory), which can be everything from the names of the planets to the color of your child’s hair. Another type of long-term memory is procedural memory, which involves skills and routines you perform so often that they don’t require conscious recall.
These areas of the brain are especially important in the formation and retention of memory:

• The hippocampus, a primitive structure deep in the brain, plays the single largest role in processing information as memory.
• The amygdala, an almond-shaped area near the hippocampus, processes emotion and helps imprint memories that involve emotion.
• The cerebral cortex, the outer layer of the brain, stores most long-term memory in different zones, depending on what kind of processing the information involves: language, sensory input, problem-solving, and so forth.

In addition, memory involves communication among the brain’s network of neurons, millions of cells activated by brain chemicals called neurotransmitters.

Stages of Memory Formation and Maintenance
Acquisition	New information enters your brain along pathways between neurons in the appropriate area of the brain. The key to encoding information into your memory is concentration; unless you focus on information intently, it goes “in one ear and out the other.” This is why teachers are always nagging students to pay attention!
Consolidation	If you’ve concentrated well enough to encode new information in your brain, the hippocampus sends a signal to store the information as long-term memory. This happens more easily if it’s related to something you already know, or if it stimulates an emotional response.
Retrieval	When you need to recall information, your brain has to activate the same pattern of nerve cells it used to store it. The more frequently you need the information, the easier it is to retrieve it along healthy nerve cell connections.

How can I improve my memory?

If you think you have a poor memory, you may just have some less-than-effective habits when it comes to taking in and processing information. Barring disease, disorder, or injury, you can improve your ability to learn and retain information.

General Guidelines for Improving Memory
Pay attention.	You can’t remember something if you never learned it, and you can’t learn something — that is, encode it into your brain — if you don’t pay enough attention to it. It takes about eight seconds of intent focus to process a piece of information through your hippocampus and into the appropriate memory center. So no multitasking when you need to concentrate. If you distract easily, try to receive information in a quiet place where you won’t be interrupted.
Tailor information acquisition to your learning style.	Most people are visual learners; they learn best by reading or otherwise seeing what it is they have to know. But some are auditory learners who learn better by listening. They might benefit by recording information they need and listening to it until they remember it.
Involve as many senses as possible.	Even if you’re a visual learner, read out loud what you want to remember. If you can recite it rhythmically, even better. Try to relate information to colors, textures, smells and tastes. The physical act of rewriting information can help imprint it onto your brain.
Relate information to what you already know.	Connect new data to information you already remember, whether it’s new material that builds on previous knowledge or an address of someone who lives on a street where you already know someone.
Organize information.	Write things down in address books and datebooks and on calendars; take notes on more complex material and reorganize the notes into categories later. Use both words and pictures in learning information.
Understand and be able to interpret complex material.	For more complex material, focus on understanding basic ideas rather than memorizing isolated details. Be able to explain it to someone else in your own words.
Rehearse information frequently and “overlearn.”	Review what you’ve learned the same day you learn it, and review it at intervals thereafter. What researchers call “spaced rehearsal” is more effective than “cramming.” If you’re able to “overlearn” information so that recalling it becomes second nature, so much the better.
Be motivated and keep a positive attitude.	Tell yourself that you want to learn what you need to remember and you can learn and remember it. Telling yourself you have a bad memory actually hampers the ability of your brain to remember, while positive mental feedback sets up an expectation of success.

Mnemonic devices

Mnemonics (the initial “m” is silent) are clues of any kind that help us remember something, usually by causing us to associate the information we want to remember with a visual image, a sentence, or a word.

Common types of mnemonic devices include:

• Visual images: a microphone to remember the name “Mike,” a rose for “Rosie.” Use positive, pleasant images, because the brain often blocks out unpleasant ones, and make them vivid, colorful, and three-dimensional — they’ll be easier to remember.
• Sentences in which the first letter of each word is part of or represents the initial of what you want to remember. Millions of musicians, for example, first memorized the lines of the treble staff with the sentence “Every good boy does fine” (or “deserves favor”), representing the notes E, G, B, D, and F. Medical students often learn groups of nerves, bones, and other anatomical features using nonsense sentences.
• Acronyms, which are initials that creates pronounceable words. The spaces between the lines on the treble staff, for example, are F, A, C, and E: FACE.
• Rhymes and alliteration: remember learning “30 days hath September, April, June, and November”? A hefty guy named Robert can be remembered as “Big Bob” and a smiley co-worker as “Perky Pat” (though it might be best to keep such names to yourself).
• Jokes or even off-color associations using facts, figures, and names you need to recall, because funny or peculiar things are easier to remember than mundane images.
• “Chunking” information; that is, arranging a long list in smaller units or categories that are easier to remember. If you can reel off your Social Security number without looking at it, that’s probably because it’s arranged in groups of 3, 2, and 4 digits, not a string of 9.
• “Method of loci”: This is an ancient and effective way of remembering a lot of material, such as a speech. You associate each part of what you have to remember with a landmark in a route you know well, such as your commute to work.

Brain exercise

Memory, like muscular strength, is a “use it or lose it” proposition. The more you work out your brain, the better you’ll be able to process and remember information.

Novelty and sensory stimulation are the foundation of brain exercise. If you break your routine in a challenging way, you’re using brain pathways you weren’t using before. This can involve something as simple as brushing your teeth with your nondominant hand, which activates little-used connections on the nondominant side of your brain. Or try a “neurobic” exercise that forces you to use your faculties in unusual ways, like showering and getting dressed with your eyes closed. Take a course in a subject you don’t know much about, learn a new game of strategy, cook up some recipes in an unfamiliar cuisine. That’s the most effective way to keep your synapses firing.

How can healthy habits help my memory?

Treating your body well can enhance your ability to process and recall information.

Regular exercise	Increases oxygen to your brain. Reduces the risk for disorders that lead to memory loss, such as diabetes and cardiovascular disease. May enhance the effects of helpful brain chemicals and protect brain cells.
Managing stress	Cortisol, the stress hormone, can damage the hippocampus if the stress is unrelieved. Stress makes it difficult to concentrate.
Good sleep habits	Sleep is necessary for memory consolidation. Sleep disorders like insomnia and sleep apnea leave you tired and unable to concentrate during the day.
Not smoking	Smoking heightens the risk of vascular disorders that can cause stroke and constrict arteries that deliver oxygen to the brain.

You probably know already that a diet based on fruits, vegetables, whole grains, and “healthy” fats will provide lots of health benefits, but such a diet can also improve memory. Research indicates that the following nutrients nurture and stimulate brain function:

B vitamins, especially B6, B12, and folic acid	B vitamins protects neurons by breaking down homocysteine, an amino acid that is toxic to nerve cells. They’re also involved in making red blood cells, which carry oxygen. Best sources: spinach and other dark leafy greens, broccoli, asparagus, strawberries, melons, black beans and other legumes, citrus fruits, soybeans
Antioxidants: Vitamins C and E, beta carotene	Antioxidants fight free radicals, which are atoms formed when oxygen interacts with certain molecules. Free radicals are highly reactive and can damage cells, but antioxidants can interact with them safely and neutralize them. Antioxidants also improve the flow of oxygen through the body and brain. Best sources: blueberries and other berries, sweet potatoes, red tomatoes, spinach, broccoli, green tea, nuts and seeds, citrus fruits, liver
Omega-3 fatty acids	Omega-3 fatty acids are concentrated in the brain and are associated with cognitive function. They count as “healthy” fats, as opposed to saturated fats and trans fats, protecting against inflammation and high cholesterol. Best sources: cold-water fish such as salmon, herring, tuna, halibut, and mackerel; walnuts and walnut oil; flaxseed and flaxseed oil

Because older adults are more prone to B12 and folic acid deficiencies, a supplement may be a good idea for seniors; ditto an omega-3 supplement (at any age) if you don’t like eating fish. But nutrients work best when they’re consumed in foods, so try your best to eat a broad spectrum of colorful plant foods and choose fats that will help clear, not clog, your arteries. Your brain will thank you!

Does memory naturally decline with age? If so, why?

Several factors cause aging brains to experience changes in the ability to retain and retrieve memories:

• The hippocampus is especially vulnerable to age-related deterioration, and that can affect how well you retain information.
• There’s a relative loss of neurons with age, which can affect the activity of brain chemicals called neurotransmitters and their receptors.
• An older person often experiences decreased blood flow to the brain and processes nutrients that enhance brain activity less efficiently than a younger person.

However, in healthy older adults, these changes represent more of a slowing in the ability to absorb, store, and retrieve new information, not a loss. The factual information you’ve accumulated over the years remains largely intact, as does procedural memory. You can make and recall new long-term memories; the process just takes a little longer.
Of course, some older adults do develop more significant problems with memory that are the result of diseases such as Alzheimer’s or stroke; injury; poor nutrition; other physiological issues; or emotional problems.

Compensating for memory loss

Even if you are experiencing a troublesome level of memory loss, there are many things you can do to learn new information and retain it.

Keeping track of dates, schedules, tasks, phone numbers	Write it down! Leave yourself notes or make checklists. Put appointments and important dates on calendars and in a day planner or electronic organizer. Ditto for phone numbers and other contact information. If you have trouble remembering how to do something, write down the steps.
Remembering where you put things	Put the things you use regularly (keys, glasses, purse, watch) in the same spot when you’re not using them. If you have to put something down in a different place, look at the place when you put down the object and say the location out loud. If necessary, write down where things are.
Staying on top of times and places	Set an alarm clock or timer to remind you when to leave for an appointment or do something in your home. Use a map to help you get from one place to another. Enlist friends and relatives to remind you of where you need to be and things you’re supposed to do.
Learning new information	Work on your ability to focus your attention and screen out distractions: Listen closely when someone talks to you. Repeat back the information. Try to talk with people in quiet places. Focus on one thing at a time.

Preventing memory loss

The same practices that contribute to healthy aging also contribute to healthy memory.

Regular exercise	It gets more oxygen to your brain. It reduces the risk for disorders that lead to memory loss, such as diabetes and cardiovascular disease. It may enhance the effects of helpful brain chemicals and protect brain cells.
Healthy diet featuring fruits, vegetables, whole grains, and “healthy” fats	Antioxidants literally keep your brain cells from “rusting.” B vitamins protect neurons and help reduce risk of cardiovascular diseases. Avoiding saturated fats and trans fats helps cholesterol levels and reduces risk of stroke.
Managing stress	Cortisol, the stress hormone, can damage the hippocampus if stress is unrelieved. Stress makes it difficult to concentrate.
Good sleep and enough of it	Sleep is necessary for memory consolidation. Sleep disorders like insomnia and sleep apnea leave you tired and unable to concentrate during the day.
Not smoking	Smoking heightens the risk of vascular disorders that can cause stroke and constrict arteries that deliver oxygen to the brain.

In addition, two other lifestyle factors are crucial for maintaining healthy memory throughout life:

Lifelong learning and exercise of the brain

When it comes to memory, it’s “use it or lose it.” Just as physical exercise can make and keep your body stronger, mental exercise can make your brain work better and lower the risk of mental decline. Here are some ideas for brain exercise, from light workouts to heavy lifting:

• Play games that involve strategy, like chess or bridge, and word games like Scrabble.
• Work crossword and other word puzzles, or number puzzles such as Sudoku.
• Read newspapers, magazines, and books that challenge you.
• Get in the habit of learning new things: games, recipes, driving routes.
• Take a course in an unfamiliar subject.
• Take on a project that involves design and planning: a new garden, a quilt, a koi pond.

Strategies for the Aging Brain

1. Concentration on daily tasks thus retaining valued independence
2. Relaxation thereby reducing anxiety which is a common feature
3. Motivation, which helps to avoid depressive states
4. Undertaking daily activities and keeping active
5. Short term memory retention
6. Memory for significant life events
7. Socialisation, thereby avoiding the tendency for self-isolation and depression.

If you feel you might have Alzheimer's

You will want to remain as independent as you can for as long as possible. Although you will gradually need an increasing amount of help it is important to make sure that other people don’t take over your life when you can still manage it. Make sure, too, that you are consulted on matters which concern you. You should have the opportunity to make your own choices for as long as you can. It is essential that you retain your confidence and self-esteem.

Talking things over

You will need to discuss plans for the future with those who are closest to you and with certain professionals.

• If your family and friends do not already know about your diagnosis, try to tell them as soon as possible. They may not believe you at first because they are so upset by the news. Try to discuss matters in a calm way.
• It helps if you can talk about your own wishes for the future. But try not to ask people to make promises now that may be difficult to keep in the future.
• It may help if you can talk to someone you trust outside the family about your feelings.

Putting your affairs in order

Now is the time to make sure that any important documents such as details of your mortgage or tenancy agreement, insurance policies, bank statements or building society books are in order and can easily be found. Go through all the details with a member of your family, partner or trusted friend.

• Sort out any recent bills, guarantees and regular payments. It might be a good idea to arrange to pay your regular household bills by direct debit if you are not already doing so. Details of how to do this are given on each bill.
• Look again at your will and make sure that it expresses your wishes, or consult a solicitor about making a new will.
• Make an Enduring Power of Attorney, if you have not already done so. This enables you to appoint one or two people to manage your affairs in your best interests if it becomes necessary.

Work

If you are still at work you are probably finding it stressful. There may be an opportunity to switch to a less demanding job or to reduce your hours. Whatever the situation you will probably need to think about leaving work fairly soon.

• You will need expert advice on your pension rights if an occupational pension is due to you. It may be possible to negotiate a lump sum.
• Before leaving work, check on benefits that you or your family may be entitled to. If necessary, your personnel department or manager should be able to help you make enquiries.

Services

Look at what services are available. Even if you don’t need them now they may be useful in the future. Those closest to you should not take on all the responsibility for helping you.

• Contact your local social services department for details of services that they can arrange. Find out about a community care assessment. Social services departments are listed in the phone book under the name of the county council or metropolitan authority.
• Find out what services are arranged through your GP or your consultant.
• Find out what kinds of services and support are provided by local voluntary organisations such as the Alzheimer’s Society. Social services or your local citizens advice bureau can advise about this.

Health

It is important to take good care of your health. Having dementia should not mean that you feel ill. So always check with your doctor if you feel unwell. This is important because any illness can make you feel more confused and forgetful.

• Try to eat balanced meals.
• Try to take regular exercise.
• Enjoy the odd drink if you wish but avoid too much alcohol as it will make you more disoriented.
• If you are on medication ask your GP to check whether it is essential. Drugs can sometimes increase confusion.
• Poor vision and poor hearing can make you more confused. It is important to have regular eye and hearing checks.
• Painful teeth, gums or dentures can also make life more difficult. Make sure that you have regular dental check-ups.

Driving

If you drive you may have to give up doing so either now or in the near future.

Anyone who drives and has a diagnosis of dementia must inform the Driver and Vehicle Licensing Authority (DVLC) at Swansea who will treat every case individually.

You should always check with your insurance company to see whether you are still covered.

Memory

• Don't be afraid to ask questions.
• Don't be afraid to say that you have not understood.
• Don’t be afraid to say that you have forgotten what has been said.
• It is not your fault if you can’t remember as well as you used to. Look for ways to aid your memory.
• Place helpful telephone numbers by the phone where you can see them.
• Put labels on cupboards or drawers to remind you where things are.
• Write reminders to yourself to lock the door at night or put out the rubbish on a certain day, for example.
• Put things you use all the time, such as your keys or glasses, in an obvious place – such as a large bowl in the sitting room.

Routine

Try to take things at a slower pace. Doing things at the same time each day or each week can also be reassuring. But do try to keep on making the occasional visit or trip.

Enjoying life

Some of your previous interests may seem too stressful or demanding. But there will be many activities that will still give you pleasure.

• Try to find things which you still enjoy such as listening to music, knitting, playing dominoes, talking to a friend.
• Caring for a pet can be very satisfying and reassuring. Taking a dog for a walk is a good way of getting regular exercise.
• Conversation between lots of people can be hard to follow. You may prefer friends or family to visit one or two at a time.
• Try to concentrate on those things that you can still do rather than worrying about those that you can’t.

Alzheimer’s Disease Description

Early-Stage Alzheimer’s

• Trouble remembering recent events and conversations
• Difficulty remembering the month or day of the week
• Loss of ability to manage finances
• Withdrawal from social situations and general apathy
• Cooking and shopping become more difficult
• Poor judgment – difficulty making wise decisions
• Tendency to lose things
• May become disoriented in familiar surroundings

Middle-Stage Alzheimer’s

• Difficult behaviors emerge
• Anger, suspiciousness, overreacting and paranoia (e.g., believing that family members are stealing money or spouse is having an affair)
• Wandering
• Repeating questions or statements
• Sundowning (i.e., restlessness or agitation in the evenings)
• Fear of bathing
• Hallucinations
• Eating problems
• Incontinence
• Hoarding belongings
• Inappropriate sexual behavior
• Violent behavior
• Will go from needing help choosing clothes and remembering to change clothes to needing help getting dressed.
• Will progress from needing reminders regarding personal care to needing help bathing, taking medication, brushing teeth, toileting, etc.
• Increased difficulty in verbal expression and comprehension
• Spatial problems (e.g., having trouble setting the table)
• Loss of reading, writing and arithmetic abilities
• Loss of coordination
• Will need care or supervision 24 hours a day, seven days a week
• May not recognize family and friends at times

Late-Stage

• Inability to communicate
• Inability to recognize people, places and objects
• Cannot participate in any personal care activities
• Loses ability to walk
• Loses ability to smile
• Muscles may become contracted
• May lose ability to swallow
• Seizures may occur
• Weight loss
• Majority of time spent sleeping
• May exhibit a need to suck on items
• Incontinence

Natural Hormone Replacement Therapies

NATURAL ALTERNATIVES TO HORMONE REPLACEMENT THERAPIES:

Menopause is the stage in a woman's life cycle when her periods stop completely. The average age for menopause is 50, although it can affect women as early as 35 and as late as 60.

For around 10% of women periods just suddenly stop, and that's it. But for most women, there are disturbances in their monthly cycle and other symptoms often for years before periods actually stop.

There are huge varieties of experience at menopause: some women sail through it with very few problems, while others can suffer badly. Symptoms and side effects of menopause include: hot flushes, night sweats, insomnia, fatigue, mood swings, vaginal dryness, lack of libido, incontinence, reduced self esteem and increased risk of osteoporosis.

Most natural remedies for the menopause focus on foods, exercise and supplements that are designed to help balance hormones in the body naturally.

One of the most effective dietary 'treatments' for menopause symptoms is to eat foods containing isoflavones, which are largely found in soya products, and which appear to mimic the effect of oestrogen in the body. Aim for around 50-100mgs a day in the form of soya milk, yoghurt or tofu . Eating small, regular amounts throughout the day may keep hormone levels steady and prevent hot flushes which are caused by hormone 'surges'.

Vitamins
In other dietary approaches, nutritional therapists often recommend supplements of vitamin C and E, but supporting evidence is not spectacular. In a 1998 American study, daily 800 iu doses of vitamin E reduced the number of hot flushes, but only by one a day. The subjects barely noticed the difference. Supplements or foods rich in calcium (oily fish and dairy products), boron (which protects against calcium loss) magnesium and vitamin K (involved in bone production) are usually advised to prevent osteoporosis.

Herbalists rely on hormone-balancing herbs such as black cohosh, agnus castus, hops and wild yam in treating menopause problems. In scientific trials of a standardised extract of black cohosh, marketed as Remifemin, German researchers found it relieved hot flushes and believe the herb may inhibit sudden hormonal surges.

Individually tailored remedies prepared by herbalists can contain as many as ten herbs. As well as wild yam and black cohosh, medical herbalist Anne McIntyre says she often includes motherwort as a relaxant, lemon balm and ginseng to lift the spirits and rose petals to cool the system. St John's wort is traditionally used if depression is a problem, and sage is a favourite to relieve hot flushes. A recent small Scottish trial of Menosan, a standardised tincture of fresh sage, found that it reduced the frequency and severity of hot flushes by over half (56 per cent). Sage, a mild phytoestrogen, is thought to have a rebalancing effect on the hypothalamus, a part of the brain that regulates sweating.

• Sprinkle a tablespoon of linseeds onto breakfast cereals or salads or into stews and casseroles. These act in a similar way to soya to mimic oestrogen, and have the added bonus of maintaining good digestive health. Always drink a large glass of water with linseeds.
• If you hate soya or can't eat enough of it to make a difference, ask at your local health store for a red clover supplement - red clover is a plant which is rich in isoflavones
• Red clover: Not only has red clover shown great promise in relieving hot flashes, but an Australian study also found that women who were given a daily dose of red-clover--derived isoflavones (estrogenlike compounds) may have lowered their risk of cardiovascular disease. Pregnant or breast-feeding women should avoid red clover, as should people taking anticoagulant drugs..
• Soy: In a study conducted in Italy, phytoestrogens (plant compounds similar in structure to a woman's own estrogen) and protein in soy (available as tofu, soy milk or edamame) were shown to reduce hot flashes. The researchers found that 60 grams of soy protein a day reduced flashes by 45 percent. Soy has also been found to lower cholesterol and may help decrease the risk of breast cancer and osteoporosis.
• Some women also find that supplementing with Vitamin E is helpful in reducing hot flushes.
• Black cohosh: A review of eight studies in the Journal of Women's Health and Gender Based Medicine in 1999 found that using black cohosh was a safe and effective way to diminish hot flashes. Research also shows it may help stabilize mood swings. There do not appear to be serious side effects associated with short-term use. The NIH recommends that pregnant women or those who are breast-feeding avoid using this herb. Large amounts (more than several grams daily) may cause abdominal pain, nausea, headaches and dizziness.
• Ginkgo: Years of research have shown that this herb, which is a staple of traditional Chinese medicine, may improve memory, concentration and blood flow to the brain. In addition, doing word games like crossword puzzles and taking classes to learn new skills can help keep your mind sharp.
• Ideally, you laid down good calcium stores when you were younger, but it's important to maintain bone health at this stage of life. A diet naturally rich in calcium (dairy products and oily fish) is recommended, and you should consult your doctor or nutritional therapist about possibly supplementing with boron, magnesium and Vitamin K, all of which help protect against calcium loss and build stronger bones.
• Vitamin D is also essential for bone health, and is gained mainly through exposure to sunlight. If you sit outside for 15-20 minutes daily through Spring and Summer, you should store up enough Vitamin D to last through the winter.
• There are several herbs which are widely known to help with menopause symptoms, including black cohosh, dong quai, hops and wild yam. But if you seriously want to get through the menopause 'naturally' it's well worth while consulting a properly trained medical herbalist to have an individually tailored herbal 'prescription' drawn up. Taken in the right quantity and mix, this can be a very powerful way to treat menopause symptoms of all kinds.
• Homeopathy can also be helpful. Standard remedies include Natrum Mur for tiredness, mood swings and vaginal dryness and Sulphur for hot flushes, but again, a personal consultation with a good homeopath is recommended - see our archived feature on Homeopathy for more information.
• Exercise can also help to maintain bone density and muscle mass and help with insomnia and mood swings. Three to four weekly sessions of aerobic exercise (walking, cycling, swimming) should be combined with a couple of sessions of weight bearing exercise (walking, weight training in the gym).
• Lack of libido and vaginal dryness can cause havoc with sexuality. As well as all of the above, ask your GP for a water-soluble lubricating gel. And remember those pelvic floor exercises? Now's a good time to start practising them again, as these help keep the vaginal walls strong and healthy and also help control urine flow and mild incontinence problems.
• In some ways, menopause can be compared to adolescence: it's a time of enormous changes and a passage into the next stage of your life. A positive outlook, and a review of your diet and exercise regime can make an enormous difference, whether you decide to take HRT or not. It's important to be kind to yourself: aromatherapists often recommend adding rose or lavender oils to your bath to help you relax, lift your mood and alleviate hot flushes.

RELAX ....

Remember, do some simple stretches several times a day. If you have time, say when watching TV, breathe in to the count of five while tensing muscles from fingers and toes up to shoulders - hold your breath for one second - then exhale, release breath, and let muscles relax for count of five. Let your shoulders slump forward. Slowly uncurl and notice how your body feels.

An easy quick exercise program - under twenty minutes a session at home with no equipment, 5BX. Adapt the more elaborate stretches to do under the massaging water of a shower. Start with hot water - stretch - and then gradually cool the temperature to a refreshing level.

DEEP MUSCLE RELAXATION:

1) Extend your arms in front of you and clench your fists. For this and each successive muscle group, tense the indicated muscle group for about 7–10 seconds and then completely relax those muscles (let them go completely limp) for 20–30 seconds before moving on to the next muscle group.

2) Extend your arms in front of you and point your fingers toward the ceiling as though you were pushing a wall.

3) Touch your fingers to your shoulders to tense your biceps.

4) Shut your eyes tightly so that you tense the muscles around your eyes, in your forehead, and your temples (skip this exercise if you are wearing contact lenses).

5) Push your tongue against the roof of your mouth, clinch your molar teeth, and pull the corners of your lips around as though trying to touch your ears. (This will look like a bad grimace.)

6) Pull your chin down one inch from your sternum (breastbone) and at the same time try to pull your chin further toward the sternum and backwards toward your back. This sets up antagonistic muscle reaction and can cause your head to tremor.

7) Take a deep breath and hunch your shoulders up towards your ears.

8) Pull your shoulders back as though trying to touch them together in the back.

9) Suck your stomach in as though trying to touch your backbone.

10) Push your buttocks into chair to tense your buttock muscles.

11) Extend your legs in front of you and lift your heels six inches off floor to tense your thigh muscles.

12) With your legs extended and heels resting on floor, point your toes toward your knees to tense your calf muscles.

13) With your legs extended and heels resting on floor, curl your toes under toward the arches (tense for 5 seconds only as these muscles easily experience cramps).

Staying completely relaxed, review the condition of each of these muscle groups.

Notice the relaxed feeling you should now be enjoying. During the exercises, you may notice that your palms become warmer, that your upper torso becomes heavier and heavier. Concentrate on these effects since they are evidences of deep relaxation.

Sit quietly for several minutes. You might wish to use this experience for implanting more firmly in your mind that you can control the pain. Enjoy the feeling of relaxation and a lessening of your pain or tension.

As you end the exercise session, gradually begin to move your feet, hands, head, and torso. Do not make any sudden movements; just gradually enter your normal routine, enjoying your relaxed state.

Try to practice this exercise twice a day — morning and evening are best for most people. Practicing in the morning often helps in beginning the day more centered, less feverishly. Practicing in the evening helps to wash out the cumulative stress of the day.