We just got back from teaching in Santa Barbara California. The temperatures were in the upper 60’s to lower 70’s and the sun was shining every day. It was a nice break from the cold weather we’d been experiencing in New Mexico.

While away, I was asked to spend a week answering questions about seasonal affective disorder on a web site called cafemom (www.cafemom.com). Cafemom is a community of mothers who chat, share information, and support each other. I agreed, thinking that there would be very few questions. I was wrong. The interest in SAD appears to be rather huge, especially at the end of January.

Driving down the freeway yesterday we were startled by a sudden loud siren. Plowing down the shoulder of the road was a large black vehicle that looked like a combination tank and space ship. The traffic slowed and moved to the right while a long line of police cars sped by. A few minutes later, we heard the first news bulletins on the radio. A man was shooting employees at a local business. The big black vehicle contained a swat team.

Workplace violence has become all too familiar. The incident yesterday, like many, was an explosion of violence related to a domestic dispute. The children involved in this incident will be haunted by what happened forever. Following these events inevitably many stories will appear about how to recognize and prevent these tragedies from happening. Unfortunately domestic violence is a common occurrence that has a dark history sometimes supported by cultural norms.

Dementia is a general term referring to various types of declines in memory, concentration and judgment. Dementia has a variety of causes, but strokes, toxins, head injuries, Parkinson’s, Huntington’s and Alzheimer’s are among the most common.

Early signs of dementia include apathy, withdrawal, confusion, short term memory loss, problems following or maintaining conversations, disorientation (especially in unfamiliar areas), difficulty planning ahead, struggles with daily tasks such as balancing checkbooks, loss of initiative and motivation, loss of interests and a diminished ability to learn new skills.

As improved healthcare and nutrition allow people to live longer, the downside has been a soaring frequency of dementia. In fact, as many as half of those aged 80 and above may suffer from some form of dementia.

We have written extensively in this blog and in our books about the strong scientific evidence that supports cognitive behavioral therapy (CBT) as one of the most effective treatments for both anxiety and depression. CBT is so well studied and validated that frankly, we can’t imagine why it shouldn’t be the foundation of most treatment plans.

At the same time, we’ve regularly recommended mindfulness techniques such as meditation, yoga, and mindful acceptance to our clients (and we practice what we preach). Mindfulness oversimplified involves focusing on and accepting the present moment. Throughout the years we’ve attended numerous continuing education classes to learn more about mindfulness techniques. Mindfulness is a part of Dialectical Behavior Therapy (DBT), Mindfulness Based Cognitive Therapy (MBCT), Acceptance and Commitment Therapy (ACT) and Mindfulness Based Stress Reduction (MBST). Wow, that’s a bunch of initials.

A few years ago, Chuck and I were asked to write Seasonal Affective Disorder For Dummies. SAD is thought to be a biologically caused type of depression related to the lack of sunlight in the winter. We had a great time researching and writing the material—including a trip to Alaska to interview people who live months without seeing sun and one to Merida Mexico, an area close to the equator which gets pretty steady sunlight times all year long.

Here in New Mexico, we enjoy more sunny days than most locations; however, our days get shorter like most other regions. I can recall growing up in Michigan and feeling pretty weary in February. I wasn’t diagnosed (everyone I knew felt the same), but the dirty snow piled on the streets, the continued cold, and darkness of February were pretty depressing.

A recent, small study published in Behavior Research and Therapy by G. Haeffel (and passed along to us by Kenneth Pope, Ph.D.) questions the general use and even the effectiveness of self-help books as “traditionally operationalized and sold in stores.” The author states, “This also raises concerns about the benefits of self-help books (e.g., CBT for Dummies), an industry that generated an estimated $9 billion in 2004.” Parenthetically, although we’ve written books in the For Dummies series, we did not write that particular one.

Since an overwhelming number of other studies support the efficacy of self-help books for the treatment of various disorders, including depression and anxiety, this one study initially came as a bit of a surprise. However, what we found more disturbing was the sweeping generalizations made about the implied ineffectiveness of self-help books in general. Mind you, most self-help books are not even especially intended to standalone as a complete intervention strategy and most authors strongly recommend that they be used as a compliment or adjunct to traditional psychotherapy. Furthermore, if attempts are made to use such books as a standalone approach, most ethical authors repeatedly warn readers to obtain additional professional assistance if symptoms don’t improve promptly.

When I meet new people, they often tell me about someone they know that has some sort of emotional problem. Many people give me a synopsis of symptoms and ask whether or not a person has obsessive compulsive disorder, anxiety, attention deficit disorder, depression, or borderline personality disorder. I’m pretty quick to say that I don’t ever make a diagnosis without seeing a person, but can talk about some qualities that might suggest this or that. I almost always point out that emotional problems are different than physical ailments; they tend to be more dimensional and less categorical. At this point, most people are stifling a yawn and moving on to the next topic (or in your case blog).

But our blog readers tend to be persistent, so let me continue. In the medical model, which psychology too often tries to emulate, a person has a disease and that disease can, in most cases, be verified by a medical test. For example, your biopsy reveals cancerous tissue or your blood test suggests that you have been invaded by parasites. Or the sore throat, fever, and a positive culture are consistent with a diagnosis of strep throat. Good medical diagnosis then hopefully leads to specific, specialized treatment.

The diagnosis of mental disorders is not so black and white. You don’t catch depression. And the symptoms of depression can look very different among people. Some with depression sleep too much or eat too much. Some toss and turn all night and lose their appetite. Some weep; others rage. There’s no blood test or MRI for assessing a diagnosis of depression. And unlike pregnancy, you can be just a little anxious or depressed.

The same diagnostic issue is even truer for what are known as the personality disorders. For example, the diagnosis of Obsessive Compulsive Personality Disorder (which is different than the more commonly known, Obsessive Compulsive Disorder) requires a person to demonstrate four of the following eight symptoms (according to the DSM IV TR):

• Preoccupation with details, rules, and lists
• Perfectionism that interferes with finishing projects
• Unable to throw away worthless objects
• Unable to delegate tasks
• Miserly spending
• Inflexible, scrupulous over conscientiousness
• Devotion to work to the …
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We love the wealth of information available to us from the internet. Because of our various interests, Chuck and I both have “Google Alerts” for articles or blogs about subjects we write about. (If you don’t know what Google Alerts are, Google it!) Many days, the shear number of suggested links and articles gets a bit overwhelming; both of us spend hours digging into the topics presented to us on these alerts. Frankly, lots of the topics are thinly veiled advertisements for various products and we quickly delete them. However, some alerts send us to fascinating research or poignant news articles.

One such article today detailed the suicide of a 21 year old woman in the UK who had battled Obsessive Compulsive Disorder and depression. The article chronicled a life that for this woman seemed unbearable. She apparently used 10 bottles of hand wash every day, and like many people with contamination fears had infected and blistered hands. She was afraid to get treatment because she feared that she might get contaminated from the facility. So, she dressed in her best clothes and jumped from the 10th story of a parking lot.

The saddest part of this story is that OCD left untreated often leads to depression. The vast majority of people with OCD or depression do not commit suicide, but the risk is certainly greater for them than others without these disorders. Sorry to bring this up during the season to be jolly, but people with OCD and depression don’t usually get better because of the brightness of the holidays. We have a few messages:

• There are effective treatments for both OCD and depression. These treatments should include some type of cognitive behavioral therapy. Medication can also be considered but is not always necessary. Many people don’t realize that empirically supported psychotherapies are at least as effective as medication for these problems and usually do a better job of preventing reoccurrences.
• There are many products, cures, and solutions offered on the internet. Some of these treatments are cleverly packaged with pseudo-scientific authenticity claims. Please be careful about buying something that offers a quick fix.
• If you or …
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You’re going to see lots of blogs on this topic in the next few weeks. However, we recommend getting a jump on these issues early.

Do you suffer from depression, anxiety, or obsessive compulsive disorder? If so, the holidays may cause you to crash. You could find that panic attacks that had been dormant, reemerge. Or compulsions to clean, count, or arrange things uptick to the point you barely have time to do anything else. Sadness may deepen and you’re not sure why. For that matter, even if you don’t have some type of depression or anxiety disorder, the holidays sometimes create considerable stress and anxiety. Why? Consider these possibilities:

• The stress of choosing gifts for people who are impossible to buy for
• The stress of deciding how much to spend in an seriously impaired economic climate
• The stress of seeing family that bring up painful issues from childhood (one of our favorite cartoons depicts a banner stretching across a huge ballroom declaring something like “Conference of Functional Families” with a single person standing alone in the room reading the sign)/li>

• The stress of attempting to prepare a fancy holiday feast, wanting everything to be “perfect”
• The stress of being around overly critical family members
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My wife, Dr. Smith, and I are big fans of mindfulness approaches to therapy and we’ve included discussions of mindfulness in most of our self help books within the For Dummies series (including Borderline Personality Disorder For Dummies). In brief, Mindfulness is typically described as involving focused attention on experiences in the present moment as well as acceptance and openness to whatever the present entails. Experiences are observed and noticed rather than evaluated and judged.

A real advantage of taking a Mindful approach to experience is that relatively few present moment experiences are truly “awful” or intolerable. In fact, the vast majority of things that gravely upset people have to do with imagined, future catastrophes or guilt, shame, and self loathing over past actions.

One of our favorite discussions was about me learning the value of mindfulness in our earlier book, Depression For Dummies and it goes as follows:

Charles never feels as grounded and at peace as when he takes our dogs on a long jog three or four times each week. He heads out the door and in just a few minutes makes it to the West Mesa overlooking Albuquerque. You can see the entire city laid out at the footstep of a majestic mountain range. The view is stunning and you can see many miles out to the horizon.

The mesa is laced with dirt roads and gullies created by occasional downpours that blow through the otherwise parched land. Rabbits routinely dart across the running path. And once in a while, you can spot a coyote in the distance. Charles connects with the experience by noticing the rhythm of his running, the obvious joy the dogs exhibit, the quiet, and the (usually) gentle breezes.

Because he runs a long way, sometimes predicting a sudden downpour is impossible. The first few times rain started to drizzle, Charles cursed his fate and picked up the pace to return home as quickly as possible. But frequently Charles got soaked before he arrived home, and he felt distressed at his soaked condition. After all, everyone knows it’s awful to get drenched in the rain.

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