The book is published in a workbook-type format, enabling individuals to people write on the pages and develop their own plans for being able to manage depression.

“Depression is a common problem, but there’s a lot that individuals can do about it, and the more one understands about it, and the more tools one gains, the better they are able to combat it.”

To learn more about the book you can view a recently published article in the Louisville Courier by clicking http://cjky.it/v6mYL6

Be Active. If you are feeling blue or depressed, the natural tendency is to do less. Your energy may sag and it may be hard to enjoy things that used to give pleasure. But if you become less active, depression can get worse. A vicious cycle of reduced activity and increased depression can lead you down into a rut that is hard to escape. So, try to do as much as you can to break this pattern. Make a brief list of activities that you might enjoy, and build some of these activities into a plan to be more active.

Watch for Negative Thinking. When moods turn to sadness, the thoughts that go through are minds are often full of negativity. During the holidays, negative, worrisome, or discouraging thoughts might be making things worse. To counter negativity, try to stop and listen to your inner thoughts. Are they too extreme? Are you focusing only on the problems – the things you don’t have, wish you have, or think you never will have? Is your mind full of regret or self-criticism? If so, try to check these thoughts out. How accurate are they? Is your sad mood interfering with your recalling some of more positive or hopeful parts of your life?

Take Good Care of Yourself. Research studies have shown that lifestyle and personal habits can make a big difference in overcoming the blues and even clinical depression. Aerobic exercise (for example, walking, jogging, or riding a bike) about 3 times a week for at least 30 minutes has been found to be an effective method for overcoming depression. And people who eat the Mediterranean Diet have half the risk of depression as those who don’t follow this healthy eating plan. The Mediterranean Diet emphasizes use of olive oil instead of butter and is high in vegetables, fruits, whole grains, and nuts. It is the opposite of a diet that is high in fast foods. Because depression can make people drink too much alcohol or use illegal drugs, an important caution is to avoid the temptation to “party” too hard during the holiday season – or any time of the year.

Reach Out – Connect to People. Depression often makes people withdraw into themselves and to spend less time with others. This isolation usually escalates the problem. Although you may feel like hibernating and not participating in social activities, it usually helps to connect to family, friends, co-workers, and others who you know.

Get Some Light into Your Life. If you notice that your mood drops and you begin to feel depressed when the days grow shorter and there is less natural light, you may have Seasonal Affective Disorder (SAD). This problem can be combatted with a light box (available on the internet) that produces 10,000 Lux (a measure of light intensity). It is usually recommended that people with SAD get exposure to 10,000 Lux of light for about 30 minutes each morning during the season of the year when there is less natural light.

Dr. Wright’s tips were published as Beating the holiday blues, Posted on December 13, 2011 by Darla Carter of the Louisville Courier

http://cjky.it/tsQT3G

San Francisco, CA (PRWEB) September 22, 2011

Empower Interactive, Inc. today announced the launch of the consumer version of Good Days Ahead, the online program for anxiety and depression, on Help for Depression, a site focused on helping consumers cope with depression and anxiety developed by Healthline Networks, the fastest growing provider of intelligent health information services. Good Days Ahead provides access to evidence-based self-help applications for individuals experiencing depression and anxiety.

See full press release: http://www.prweb.com/releases/2011/9/prweb8818746.htm

When most of us feel sick, particularly if we have unfamiliar symptoms, we automatically turn to the Internet to identify what is ailing us.  Even if we know that we will end up in the doctor’s office confirming this self-diagnosis, our desire for information quickly and on our time schedule compels this type of research.

To feed our desire for information, we are starting to see a significant shift in the type of heath related information that is available on the web.  Sources are expansive and generated by numerous stakeholders: providers, payers, pharmaceutical companies, researchers, NGOs, public service entities, doctors, and, perhaps most importantly, by individuals themselves. Yet, is it helping us and are we finding what we seek? Possibly not!

Pew Research uncovered that only 22% of health related queries met the user’s need[i]. Clearly interpreting scientific publications and synthesizing key data from marketing and publisher copy available online can be a challenging and exhaustive. Users are left searching for advice, interpretation, and a means to simplify the vast and often contradicting literature on the web. Individuals across age groups are turning to social media and one another for help, social networking use among those ages 50 and older nearly doubled over the past year to nearly 42% over the past year[ii].

That said, I believe we are embarking on a substantial wave of innovation in healthcare as web applications emerge to address consumers’ needs in new and exciting mediums.  The next era of healthcare moves beyond static content.  Health will be much like other industry verticals on the web as they progressed from static content to interactive content, generating key platforms to provide services ranging from commerce to curation, gaming, and entertainment. Across the behavioral, mental and physical health spectrum of issues, interactive applications are emerging that help support, socialize and educate individuals to improve their health and wellbeing.

New platforms and channels for timely dissemination of health information (Twitter and Facebook are being used to alert people, in real time, of outbreaks, recalls and health tips) are one exciting use of new technology for improved health. Devices like Fitbit are being used to broadcast, manage, and track healthy physical activities while gaming devices like the XBox Kinect are helping to promote physical activity in an otherwise sedentary form of entertainment. Telehealth is a step in the right direction, primarily helping to address the lack of accessibility to those with limited healthcare services within a reasonable proximity to where they reside. I am encouraged to see these green shoots of opportunity beginning to take form in behavioral health and hope to see more of a transition from information gathering to services and tools. I believe that these trends empower individuals as active participants in solutions to their health issues, or at least enable their ability to follow through on their prescribed plan of care.

At Empower, we are pushing to innovate around truly engaging tools that can help empower individuals to, not only, begin to understand some of the health issues that are impacting their daily lives, but to also take action in correcting the negative impacts of these ailments. Future innovations must enable individuals to overcome many of the health challenges they are facing through sustainable behavioral change. We are confident the migration from static content to interactive, social services will help bridge the gap in behavioral change and overcome the stigmas and lack of access that keep individuals from attaining the wellbeing they seek.

http://www.pewinternet.org/Reports/2006/Online-Health-Search-2006/04-A-Typical-Search-for-Health-Information/08-Health-seekers-feel-mostly-reassured-confident-and-comforted-by-what-they-find-online.aspx

[ii] Older Adults and Social Media, Pew Internet & American Life Project

http://www.pewinternet.org/Reports/2010/Older-Adults-and-Social-Media/Report.aspx

What struck me most was how challenging it is to remain neutral and unbiased when presenting health and finance related choices and yet avoid influencing someone else’s decision.  Choice architecture, the way in which decisions are influenced by how the choices are presented, illustrates how influence is unavoidable. Often, choices are deliberately presented so as to “nudge” us towards a specific choice; also frequent is unintended nudging by biased authors.

In Nudge, two examples apply the concept of choice architecture to individual health decisions originating from a social policy perspective, which hopes to “nudge” individuals towards more healthy decisions.

The first illustrates a novel approach towards smoking cessation in the Philippines, where a would-be non-smoker is incented to open up a bank account and deposit the amount of money he otherwise would have spent on cigarettes into the bank account.  After six months, this “non-smoker”  is required to take a urine test to confirm that he has not smoked recently.  If he passes, the money is returned to him.  If he fails, the account is closed and money is donated to charity.  The results surpass many of the leading smoking cessation methods.  Studies show that opening up an account makes those who want to quit 53% more likely to achieve their goal.

The second example explores a health insurance company’s innovative approach to reducing medical bills.  The company introduced a health plan with incentives for people to make healthy choices. Participants earn rewards by engaging in healthy activities such as: working out at a health club, enrolling their child in a soccer league, or completing a blood pressure check with normal results.  The rewards can be redeemed to obtain airline tickets, hotel rooms, magazine subscriptions, or electronics.

Both of these examples show us positive outcomes of “nudges” that help improve the decisions we make about our health, investments, and our overall happiness.  But, could these nudges be perceived as overreaching?   And what other initiatives, advertising, social pressure, or other mechanisms might be suggesting courses of action that might not be as beneficial to the individual reviewing them?   And what if the individual facing such choices lacks the clarity of mind necessary to make a thoughtful decision?

Personal and professionally generated stress and anxiety have been shown to negatively impact our cognitive abilities.  We all have moments where we feel unable to focus or are simply less effective or productive; studies have found this impairment averages around 1.5 hours per week. [i] “Feeling down” or depressed, stressed, or anxious can significantly impact your ability to perform and think reasonably and rationally.  Studies show that on average, employees suffering from depression had difficulty managing their time, mental and interpersonal job demands, and output demands over 20 percent of the time. [ii]

Helping people learn better coping skills to improve resiliency, regain mental clarity, and improve their emotional well-being can only help them make thoughtful decisions.  Choice architecture is here to stay in all aspects of our life, and its existence both calls for forthright architectures that are consciously and expressly in the best interests of individuals, and giving individuals the tools to perceive and evaluate these choices as presented to them.

http://www.psychologytoday.com/articles/200402/the-price-depression

[ii] Psychiatric Services: Unemployment, Job Retention and Productivity Loss Among Employees with Depression, December 2004, Vol. 55 No. 12

http://psychservices.psychiatryonline.org/cgi/content/full/55/12/1371

We found the “Take A Moment To Thank A Veteran” poem particularly appropriate for today.

Additionally, we are also thankful to our future veterans and found Xerox’s “Let’s Say Thanks” program for honoring troops worth sharing. The program is free to users and honors U.S. military personnel and increases community morale by delivering millions of cards to servicemen and women overseas with messages of support from home.  You can write your own note or select from a list of messages at their website.

To our Veterans and servicemen and women – THANK YOU!

Congratulations to Empower co-founder Dr. Jesse Wright, M.D, Ph.D., whose book Cognitive-Behavior Therapy for Severe Mental Illness, won first prize in the mental health category of the 2009 British Medical Association Medical Book Competition.

From the article:

“Cognitive-Behavior Therapy for Severe Mental Illness is a “how to” guide for using cognitive-behavioral therapy (CBT) for some of the most common and difficult-to-treat psychiatric conditions. It is based on the work the authors have carried out together presenting courses and workshops, previous writings on cognitive-behavioral therapy, and the steady outpouring of research that has documented favorable results when CBT is used to treat severe mental illness. By showing CBT in action in the accompanying DVD, the authors give readers a picture of how CBT methods can be used to tackle challenging clinical problems.”

Congratulations Dr. Wright!

PricewaterhouseCoopers (PwC) published an interesting survey[i] comparing cumulative premium increases and cumulative wage increases from 2000 through 2008.  Although increases from 2000-2001 were comparable, the difference widened significantly in later years with cumulative increases of approximately 80% for premiums vs. 30% for wages.  This difference is the best example of an unsustainable trend and a key drive for adoption of behavioral approaches to wellness.

According to the PwC survey, 71% of employers are offering wellness programs.  Among major U.S. employers, only 4% offer depression disease management programs, compared to 84% for heart disease[ii].  This gap is particularly alarming when you consider that mental health conditions are the second leading cause of workplace absenteeism[iii].  Note that in 2000 (the time of the survey), the cost of lost productivity due to mental disorders was $80B in the U.S.![iv].

Findings from a 42 worksite health promotion study illustrates the economic benefit for employers to take a proactive role in preventive care.  Some of the findings include: 28% reduction in sick leave absenteeism, 26% reduction in health costs, 30% reduction in workers’ compensation and disability management claims costs[v].

According to the U.S. Department of Health and Human Services, employers are saving a median amount of $3.14 for each dollar spent on prevention and awareness.   Examples include:

• Johnson & Johnson’s Health and Wellness Program produced average annual health care savings of $224.66 per employee ($70.96 or nearly 1/3 of savings from decreases in mental health visits).
• The Northeast Utilities WellAware Program reduced lifestyle and behavioral claims by $1,400,000 in its first 24 months.  Participants in the program demonstrated a material reduction in health risk factors including a 16% decrease in mental health risk and a 5% decrease in stress[vi].

The potential gains from addressing these behavioral health issues – for the good of all of us – are just beginning.

[i] PriceWaterhouseCoopers Medical Health Research 2010 Medical Costs Trends for 2010

http://pwchealth.com/cgi-local/hregister.cgi?link=reg/Behind_the_numbers_Medical_cost_trends_for_2010.pdf

[ii] Employers Take Lead in Fighting Depression

http://www.managedcaremag.com/DepressionInWorkplace_Spr2006.pdf

[iii] (APF, 2005) http://fccmh.org/images/uploads/EconomicBurdenofMentalIllness.pdf

[iv] (Guinea R. Informe/Debate. World Federation of Mental Health — Dia de la Salud Mental. Psiquiatría Pública 2000;12:153-8). Source: CMAJ. 2001 April 3; 164(7): 1013–1014.  PMCID: PMC80930, Copyright © 2001 Canadian Medical Association or its licensors Mental health and primary care; Julio Arboleda-Flórez and Benedetto Saraceno

http://www.cmaj.ca/cgi/reprint/164/7/1013.pdf

[v] http://www.centervbhm.com/iv/economicvalueofhealthmanagement.html

[vi] U.S. Department of Health and Human Services, Sept 2003, Prevention makes common “cents”

http://aspe.hhs.gov/health/prevention/index.shtml