Prescriptions for Life

Don't Worry, Be Happy! The Surprising Benefits of Optimism

Susan Biali, M.D. — Thu, 12 Nov 2009 00:21:40 +0000

How do you view the difficult events that show up in your life, or happen in the world around you? I'm open about the fact that I was very depressed during my residency, and even before that, it often seemed that life's events were relentlessly unfair. Yet something has happened to me over the last few years, perhaps as a result of the extraordinarily positive experience of finding my right place in the world. Somehow, I've become an incurable optimist.

Living in Mexico for several years played a big role in this. It's a very spiritual and optimistic place, despite the hardships faced by so many. I constantly heard the phrase: "por algo pasan las cosas" - "everything happens for a reason". Good or bad, it's all good. They see all life events as divinely ordained, no matter how difficult or painful they may appear on the surface.

I recently read an interview (on www.eqtoday.com, unfortunately it no longer seems to be available) with the father of positive psychology, Martin Seligman, which made me feel very happy about having switched teams to join the optimists. When Seligman, a staggeringly prolific researcher, was asked to describe the one piece of information that he'd like every person to know, this is what he said:

"If you are a pessimist in the sense that when bad things happen you think they are going to last forever and undermine everything you do, then you are about eight times as likely to get depressed, you are less likely to succeed at work, your personal relationships are more likely to break up, and you are likely to have a shorter and more illness-filled life. That's the main discovery I associate with my lifetime."

This would be awful news if there was no way out of being pessimistic, but Seligman himself claims that he's a "born pessimist". Much of his work focuses on learned optimism, and the first thing his optimism programs teach is to recognize the catastrophic things that we say to ourselves when things go wrong.

Pessimists think that they (or their usual bad luck) are responsible for the bad things that happen to them. They think that one bad thing happening means that more are on the way. Optimists, in contrast, see negative events as being external and unrelated to them, isolated negative incidents that have no relationship to other aspects of their lives, or things that might happen in the future. I choose to see negative events as surprise circumstances that always, in retrospect, arrive with a gift hidden inside.

You can decide which attitude to have - who would you rather be?

Today, I thoroughly enjoy living with the attitude that "things will always work out". Whenever something challenging comes along, that's what I say. And if I forget, my Mexican husband reminds me. I may feel sorry for myself for a little while, but eventually I pull up my socks and start to look for the gift in the experience. I do what I need to deal with the situation, but trust that as a rule, things will work out well. And they always do, in some way - if I remember to look for it.

How optimistic are you when you talk to other people about their lives? There's a fine line between optimism and false hope, but based on the research that I've seen, I think we'd do well to encourage everyone around us to be optimistic, too. Especially when people are sick: research has shown that optimistic breast cancer patients have better outcomes than pessimistic patients, and a longitudinal study in Harvard students found that optimists were significantly healthier than pessimists throughout life.

Focus on your strengths, focus on your successes, and focus on all that's good about life. Even if you never have before, you can start right now. We have so much to be optimistic about - regardless of what's going on in the world right now, if you have access to the internet you have a better standard of living than millions of others out there. Be grateful for what you have, and know that all things work together for good, if you choose to see life's events from that perspective. It really is a choice.

Healthy Success: Create a Successful Life Without Killing Yourself

Susan Biali, M.D. — Wed, 04 Nov 2009 21:23:25 +0000

From the first time I met Maria, she awed me with her careless beauty, impeccable style, and spontaneous hilarity. I secretly hoped that when I reached my 50's, I'd manage to be a little bit like her. It wasn't until she became a client that she told me a secret that few others know: Maria has multiple sclerosis. Before you start feeling sorry for her, you need to know one more thing: she got diagnosed almost thirty years ago.

In her early 30's when the disease hit, she had a high-level corporate job, a business on the side, and was raising four kids in her spare time. She wanted it all and was determined to get it, until MS suddenly knocked her flat. For two years she battled it with one medical therapy after another, without any improvement.

"It was so depressing," she told me, "and I couldn't understand it. Then one day, I realized that I had to change my life. If I wasn't going to live much longer, I decided that I might as well spend my life doing what I want." She reprioritized her life: she made more time for her husband, family, and friends, moved to a small town she loved, and got steadily better. Today, she only gets the slightest hint of symptoms, on days when she hasn't had enough sleep.

Maria radically changed her definition of success and possibly saved her life. Of course, though multiple studies have identified stress as a trigger for MS episodes, it's a complex auto-immune disorder and might not be so easily "cured" in every case. Still, her story fits a pattern I've seen countless times in my patients, many of whom developed serious medical illnesses during very stressful or unbalanced times in their lives.

How do you define success? If you believe society, it's about money, cars, fashion, and fame. How many of your choices have been driven by this all-consuming myth? Studies have shown repeatedly that money and material success aren't statistically associated with long term health and happiness.

I frequently fall into this success trap. When the media calls and when high-powered invitations and tempting offers come one after the other, I find myself sacrificing more and more free time, sleep, and even my relationships.

It's a cycle that that repeats itself in my life: I get things into balance and then a series of events suddenly takes over my schedule. I get incredibly stressed out, and more often than not it's some kind of major physical warning sign that forces me to take my life back.

Most recently, I developed stress-related low back pain that made it hard for me to walk, much less dance. Knowing the importance of listening to my body, I heeded the signs and grabbed a quick, much-needed vacation. Before that, frequent chiropractic visits had helped, but the problem didn't truly go away until the first day of my vacation, when I found myself standing on a beach with no to-do list or Blackberry in sight.

On that vacation, I also started studying yoga. Now I do yoga every morning (at home, using online videos from www.yogajournal.com) and my life and body feel so much better. Even better than before I got stressed in the first place!

What would a successful life look like to you? Would you be exhausted, sleep-deprived and stressed, prematurely aging, catching every cold around, and spending most of your time alone at a desk? I doubt it. So why do so many of us live this way in the name of "success"?

Create a definition of true success for yourself, one that the media and society have nothing to do with. Financial success is a worthwhile goal, but for my life to be truly successful I have to include lots of fun and laughter, fabulous relationships, enough time for me, radiant health, and passionate, meaningful work. I'm about three quarters there. How close are you?

Research and repeated surveys demonstrate that, in spite of our relentless pursuit of the dollar, our relationships and social contacts are the greatest predictor of health and happiness. Unfortunately, as we go for the golden ring our friends and family are usually among the first and hardest hit casualties.

If you had lots of money, fame, and achievements, but didn't have good health or good relationships, how would you feel about that? Is there a possibility, right now, that you're setting yourself up for business success and health and life failure?

Anyone who's briefly lost their health due to an illness or accident knows how desperately important their health suddenly seems. What can you do, starting now, to ensure that when you reach the top in your career, your body won't just keel over, and feebly raise a white flag?

Define real, healthy success for yourself and keep this definition in your mind every day. Remind yourself when you're tempted to pull an all-nighter, or consider canceling a night out with your friends to put in more work on that project, or think you might be able to make it through the day without lunch.

As author Annie Dillard wrote: "How we spend our days is, of course, how we spend our lives."

Spend your precious life currency on the things that really count. That's real success.

Is Depression Contagious? How I Caught It, and Cured It

Susan Biali, M.D. — Wed, 28 Oct 2009 19:39:05 +0000

I took a copy of the October 2009 issue of Psychology Today with me on a recent much-needed vacation, and found myself fascinated by psychologist and fellow PT Blogger Michael Yapko 's article, "Secondhand Blues", about the contagious nature of depression.

I dedicate a significant portion of my professional work (including my book, Live a Life You Love: 7 Steps to a Healthier, Happier, More Passionate You) to sharing my own story about depression, detailing how I went from being a suicidally depressed Emergency Medicine resident to deeply enjoying my new life as a wellness expert/speaker/life coach and professional flamenco dancer.

I typically credit my recovery to key elements of my personal reinvention: rediscovery of dance and creative expression; following long-suppressed dreams; honoring and celebrating my authentic self; eating and sleeping well; having as much fun as possible; deep spiritual work; and revolutionizing old destructive patterns in relationships.

After reading Yapko's article, I realized that I'm also free of depression today because I've "de-infected" myself from depressive tendencies I'd "caught" while growing up. Below are some excerpts from Yapko's article, with my comments:

"Anything that victimizes someone holds the potential to depress that person...what victimizes us the most is telling ourselves what we can't do, what we're inept at, what we're not good enough to do - all those things by which we limit and even devalue ourselves."

That victimizing voice in our head is frequently an echo of adult voices we heard growing up. Though I loved art as a child, I wasn't as talented as my younger sister, who already demonstrated genius-level artistic talent as a toddler. Since I excelled at school and sciences, I was "the smart one" and she was "the artistic one". I continually got the message that I wasn't artistic and that I shouldn't bother even trying to create things, since that was my sister's arena.

Though I was good at science, I didn't love it. I loved to dance and to write. However, since these aptitudes were essentially ignored, I began to ignore them too. My natural exuberant expression turned sober and quiet, and my depression deepened over the years - almost twenty bleak, art-free years, until I rediscovered my creative self in my late 20's. I decided to pursue my dancing and writing dreams, no matter what anyone else said (and they said a lot!). It was then that my depression began to lift.

"A child who is diagnosably anxious at age 8 or 9 is at high risk for becoming a depressed adult...the child has a negative interpretive style."

I lived amidst fear and worry in the recession of the early 1980's, and remember my parents going on about this terrible thing called "the mortgage". I realized recently that this is probably why I have never bought my own house! The "sky is falling" atmosphere made me feel anxious, and I began having anxiety attacks whenever my mother was late picking me up from my "Pioneer Girls" meetings. I was frequently the only kid left, standing alone in the dark outside the church. That fear and insecurity about life and a world full of evil mortgages fueled a sense of helplessness that grew as I got older.

Today, my personal faith and spiritual practice give me a worldview grounded in the meaning, support and gifts to be found in all circumstances, challenges and disappointments. When I shed the need to constantly worry about life, depression fell away as well.

"A family environment of perfectionism reflecting unrealistically high standards is another factor that greatly increases vulnerability to depression."

Having a father who met the president of his country of origin - because he was the top student in the entire country - is a pretty tough measure to live up to. I consistently achieved straight A's and even received 100% scores in some subjects in high school and university; however, this was always treated as being normal by my parents. They were proud in a way that calmly recognized my having lived up to expectations, rather than celebrating my achievements.

I learned that the only worthwhile place was at the top - preventing me from trying out riskier activities, such as arts courses. Today, I let myself try anything I think might be fun! I still overachieve, as you can tell, but now it's in areas of life that I love.

"Another important element...is whether emotions can be expressed or not, what kinds of emotions can be expressed, and to what degree."

Growing up, I felt like it wasn't safe to express my (justified) anger, and was judged or punished if I did so. Today I have a husband who accepts me just as I am, and sticks by my side despite my volatile range of emotions. I've discovered that if I express how I feel, the emotion typically passes like a cloud over the sun, and I find myself free and unencumbered after. People who repress their anger have actually been shown to die younger; I have finally freed myself of this particular death sentence.

Yapko has recently published a book on this: Depression is Contagious. I agree with him that the growing rates of depression in the modern world are largely due to societal and social influences, not just biochemical changes in the brain. If you suffer from depression it's important to tell your physician, and you may need pharmocological help to pull you out of the darkness. However, in my experience you can ultimately heal depression and keep it at bay by changing the way you look at and live your life.

Revolutionize Your Life By Thinking Big

Susan Biali, M.D. — Sun, 27 Sep 2009 22:59:36 +0000

I just got home from a meeting with a friend who's a fellow medical doctor and speaker. We happily brainstormed ideas for an event that we're putting together, until suddenly everything shifted.

This shift began when I said "We have to give them an experience that will be memorable."

"That's it!" my friend exclaimed. "We have to give them an experience that's guaranteed to change their lives forever."

Now we were excited. Now we had a vision. Now - we were finally thinking big. Our focus and energy shifted from conceiving something good to creating something great. When you have that kind of energy behind a project, idea, or dream, it changes everything, exploding your possibilities and dramatically increasing your probability of success.

I recently spoke at a conference and received Michael Port's book, The Think Big Manifesto(www.thinkbigrevolution.com), as a thank you gift. I finished it in one day. I was so impressed that I asked Michael if I could share some excerpts with you.

He said yes, so here are my thoughts on some favorite lines from his book:

"You will succeed at a level you didn't think was possible when you know what you stand for and you live it. You will be bold and extraordinary, just being you." (p.84)

What do you stand for? What might you be known for, already? (warning: it might not be a good thing!) Some example of things worth standing for (from Michael's book)include love, freedom, respect, green living, possibility or happiness.

I stand for hope. I used to be suicidally depressed, until I learned to think big and discovered that by being true to myself and pursuing my dreams, I could create a life that felt joyous and meaningful to me. Today I live to give people hope for a better experience of life, by teaching them how to improve their physical and mental health, supporting them in living their dreams, and so on. I try to encourage and uplift people, everywhere I turn, everywhere I stand, every time I open my mouth.

What would you love to stand for? How can you change your behavior and choices based on that, now?

"People who play small think they have to do it all themselves. What about you? Are you ready to play bigger by truly collaborating with others? Or are you shut up in ‘silo thinking'? ‘Only I can get this right. I can't rely on anyone else.'" (p.99)

Chip Wilson, founder of Lululemon, a billion-dollar company that makes gorgeous yoga-inspired active wear, spoke at the same conference that I did (and was probably also given Michael's book!). He failed at his first attempt at building a great company because his "winning formula" was "Don't trust - Don't Delegate." When he built Lululemon, he recognized that if he wanted to attain greatness, he would have to follow a new formula: "Delegate and Trust."

I'm a loner and a perfectionist, and find it hard to let go of control. Yet I'm learning quickly that if I want to do great things on a big scale, I need the collaboration and support of great people. Great ideas can't be executed alone, at least not to their full potential.

"As much as we influence others, so are we at risk of catching others' values and actions, of coming under their influence. If we surround ourselves with small thinkers, we will think small...to let a sad thought or a bad one get into your mind is as dangerous as letting a scarlet fever germ get into your body." (p.139)

Be careful who you share your big ideas or dreams with, and be careful who you allow to share their advice or opinions with you. Almost every great idea that has been conceived on this earth seemed outrageous or outright impossible at first. Seek the company, counsel and writings of those who have achieved big things and you will begin to see possibilities everywhere you turn.

"To work hard, which we'll need to do when we're thinking big, we must cultivate the warrior within us... we must train ourselves to be psychologically, intellectually and physically capable to withstand the hard work we'll need to do and yet still be able to relax into life, to find the levity, the fun, and stay foolish." (p.149)

To do what you were meant to do here on this earth and live to your greatest potential - which for me means developing your talents and serving others while living absolutely on purpose - you need to be in the best shape possible. Nurture and jealously protect your physical, emotional, and spiritual health, as well as your happiness.

I know a successful management consultant and inspirational leader who asks herself before she does anything, including putting a bite of food in her mouth: "Will this serve the empire?" She doesn't mean "empire" from a wealth/power perspective - she's referring to the tangible good that she intends to do on a global scale.

Whether your "empire" is your family home, or a sphere of influence that reaches to the ends of the earth, thinking big, standing for something meaningful, and taking exceptionally good care of yourself and your life will give you a sense of wellness and fulfillment far richer than any material riches this world can offer.

Three Secrets for Creating Happier, More Meaningful Relationships

Susan Biali, M.D. — Tue, 08 Sep 2009 17:40:56 +0000

I frequently talk about relationships as one of the most important contributors to your health and happiness. And it's not just your closest relationships - the number of social contacts you have in your daily life, period (including the bank teller and your neighbor down the street) are directly associated with your well-being.

I'm an introvert and could happily spend long stretches of time working and hanging out at home, without interacting with anyone other than my husband and our dog. Though I love people and deeply appreciate my friends, I don't have a strong drive to regularly reach out to others. I'm terrible about calling people, and can easily let long stretches of time go by without connecting. This hasn't got anything to do with whether or not I like them, I'm just not very socially oriented. That said, I'm increasingly aware that given the health and happiness benefits of time with other people, it's in my best interest to override my anti-social tendencies and spend more time with others.

Last week at church, the sermon was about three elements that are required to create a better relationship with the divine. Listening, I realized it was good advice about creating a better relationship with anyone who is important to you.

Here are the three points, with my take on them:

1) Notice and act on your desire to connect with others

Whenever you think of someone, or spend time with someone, and feel a desire to spend more time with them in the future, make note of it. You might meet someone new who you really like, or hear a song on the radio that's your uncle's favorite, or maybe you run into an old friend on the street. In that moment, you may be struck by how much you enjoy that person and feel a desire to see them again soon. What do you do when that happens? Like me, do you file it away in your mind, forget and then after five years pass by, ask yourself: "Has it really been five years since I last saw Jenny??"

When you feel that desire to spend more time with someone, act on it. Make a date for lunch, even if the next possible opportunity is a couple of months or a year away. Pick up the phone and call them when you think of them, just to say hello. Send a quick Facebook message to let them know you were thinking of them.

2) Spend "real" time together

Speaking of Facebook, I heard someone comment the other day that though it's so easy to "keep in touch" with people these days through social media comments, emails or text messages, it's not the same as real time. Don't let the fact that you've had regular brief contact with someone online replace face-to-face or voice-to-voice time. If you find it hard to find time, get a Bluetooth headset or speaker for your cell phone and make calls to friends from your car while you're driving to and from work. Take it from me - you'll wonder why you ever spent so many hours listening to that rush hour radio program!

3) Make a special effort that demonstrates your commitment and caring

Life moves so quickly these days and though we may network or socialize with many people, we don't necessarily get to know them on a deeper level. As our pastor said in his sermon: "Relationships don't develop automatically and don't deepen on their own - it takes effort". Be conscious of this in your relationships, and think about what efforts you can make to deepen your connection with people who matter to you. What kind of effort would be most significant to each individual? Some people don't care about birthdays (or actually hate being reminded of them), while others feel slighted if they don't get a phone call or an e-card. Pay close attention to what other people value, and make the effort to connect with them on that level.

Make time for people in your life, especially the ones that you love the most and the ones that make you laugh the most. If a hermit like me can do it, you certainly can. In fact, last night after a long day of work and flamenco dance rehearsals, I dragged myself all the way back into town to go to a friend's birthday party because I know that her birthday is important to her. A group of us had dinner, ate heaps of rich flourless chocolate cake, and then went out dancing. I had the time of my life. In retrospect it's quite funny that I thought I was making the effort just to please my friend. When we're good to our friends and family, we're really taking care of ourselves.

Get A Good Night's Sleep: Surprising Ways Sleep Can Improve Your Health and Life

Susan Biali, M.D. — Tue, 25 Aug 2009 00:22:11 +0000

How much sleep did you get last night? According to "Healthy Sleep", a publication by the U.S. National Institutes of Health (NIH), in the early 1900's people used to average 9 hours of sleep a night. Today, the average adult sleeps less than 7 hours, and more than a third of adults experience significant daytime sleepiness that affects their work and social functioning. Most of us need an average of 7-8 hours sleep, and some might need more (like me!).

In these days of packed schedules, internet, and late-night television, it can require immense discipline to get to bed on time. I battle with it constantly - I run my business from home, and with 24 hour email and web access there's always one more thing I can do before I go to bed.

When I first started practicing medicine, a colleague introduced me to the work of sleep expert William Dement, founder of the Sleep Research Centre at Stanford. In a publication for physicians, Sleep Made Super Simple, Dement notes that: "Lacking its rightful place and emphasis in life and health, the dimension of sleepiness and alertness remains poorly understood and widely ignored...as a result, almost no one makes an effort to manage their schedules and commitments in a way that takes into account the crucial need for healthy and adequate sleep". Later, he comments that "many people, in fact, live their days in a kind of ‘twilight zone' of impaired alertness which they rarely recognize, and as a consequence, they fail or only partially succeed in work, study, and human relationships."

Do you know how big your sleep debt is? If you think that your body has long forgotten that all-nighter you pulled last week, you're wrong. According to the NIH report, our body produces a compound called adenosine that accumulates in our blood when we're awake, and eventually triggers drowsiness. When we sleep, our body breaks the adenosine down. If you don't get enough sleep, your adenosine levels remain high, and you'll continue to feel drowsy (and be under-productive, and likely grumpy) the following day. If you fall asleep the instant your head hits the pillow, or any time you slow down during the day, you probably have a significant sleep debt.

If you're trying to improve your health, before you sign up for that expensive program or empty your wallet buying supplements, first take a good look at your sleep habits. If you'd like to lose weight, make sure that you're getting at least 7 hours every night - any less, and your body produces less leptin hormones than it normally should. As a result, your appetite increases, and you're significantly more likely to be obese. The same goes for women who are having trouble getting pregnant: good quality sleep promotes healthy levels of sex hormones, and women who are sleep-deprived are less likely to conceive, and more likely to miscarry.

When we sleep, our bodies produce other hormones called cytokines, which help our immune system fight infections. Studies have shown that if you get the flu vaccine while sleep-deprived, you'll produce half as many antibodies (and therefore have only half the benefit), compared to people who get vaccinated after a good night's sleep.

Our body experiences inadequate sleep as stress, which increases levels of health-damaging stress hormones. Regularly scrimping on sleep may also put you at higher risk for developing mood disorders like depression, and diseases such as heart disease and diabetes. Sleep might well be our long-sought fountain of youth - if you get enough, your body has more time to regenerate your cells, and even repairs UV skin damage.

To improve your work performance, and possibly even increase your income, get to bed on time. Lack of sleep significantly slows your thinking processes, and makes it harder to focus on a task, and pay attention. According to the NIH report, if you don't get enough sleep you'll be more likely to make poor decisions, and you'll take more risks.

Get to bed earlier, and try to stay there for eight hours . Avoid caffeine, alcohol, nicotine, large meals and strenuous exercise for several hours before bedtime. Take naps to improve daytime functioning and reduce your sleep debt, but don't nap for more than an hour, or after 3 pm (that may make it harder to fall asleep at night). Make your bedroom a place dedicated to sleep and relaxation - remove the TV, and anything remotely work-related. I'll do it, too. How about committing, right now, to getting eight hours of sleep, every night, for the next month? Prepare to be shocked by how well you'll perform, look, and feel.

How Food Can Improve Your Mood: Delicious Ways to Prevent Depression

Susan Biali, M.D. — Wed, 29 Jul 2009 20:08:31 +0000

I have a history of depression, though thankfully I haven't had an episode in almost ten years. I turned my mood around by making major changes in my personal and professional life, and will tell you more about that in another post.

I'm a practicing medical doctor (GP) with a degree in Dietetics, and am fascinated by the potential for certain foods and simple wellness practices to prevent and treat major medical conditions or diseases. I've written for years about the ability of food to protect and boost your mood, though in some cases of depression anti-depressant medications might still be necessary. That said, understanding the relationship between food and mood can help increase the effectiveness of anti-depressant medications, and may also help prevent relapse.

I protect myself from recurrent depression and deliberately "feed" my daily mood by following the following dietary rules for a good mood:

1) Eat Breakfast & Eat Regularly

Have you ever been in a terrible mood, only to realize that you haven't eaten in hours? If I skip a meal (which occasionally happens, if I'm really busy or really focused on a task), I'll get really irritable and even weepy, and wonder what's wrong with me - until I realize that I haven't eaten! As soon as I sit down and eat something solid, the bad mood disappears. Eating a balanced breakfast and making a point to eat regularly (don't ever let yourself get too hungry), will keep your blood sugar and mood stable.

2) Eat Enough Protein

I love carbs and would easily eat them all day if I could. Eating protein with every meal (think fish, chicken, eggs, nuts, yogurt, milk, soy, chickpeas, etc.) helps the food last longer in your stomach and bloodstream, prevents blood sugar crashes, and also keeps you "up" and alert for two to three hours afterwards. It's a good idea to eat a healthy, low-glycemic carbohydrate source with the protein (as opposed to following a stringent low carb diet) as a diet too high in protein and too low in carbs will make most people feel moody.

3) Avoid Simple Sugars

Carbohydrates are the classic feel-good food. Carbohydrate-rich foods enable the mood-enhancing amino acid tryptophan to enter the brain, where it's used to produce the neurotransmitter serotonin. However, if you eat carbohydrates that produce a short surge of glucose in your bloodstream (think carb foods made from white sugar, white flour, white rice, etc.) you'll get a short-lived sugar high and then get hit with a mood-wrecking crash. For a consistent positive mood, choose whole grain, high fiber carbohydrate sources with lasting power.

4) Eat Fish Three Times a Week

I try to eat fish as often as I can. I'll often treat myself after a long day at the clinic by calling to order wild salmon sushi takeout as I head out the office door. Fish such as salmon (especially wild) and tuna are rich in mood-protecting omega-3 fatty acids. Research has found that people who eat fish less than once a week have almost a third higher incidence of mild to moderate depression when compared to people who eat fish more frequently. Note: don't eat too much fresh tuna, as it's high in mercury.

5) Get Enough Folic Acid (hint: eat more leafy greens!)

Most of us are familiar with folic acid and have heard that this B vitamin should be taken as a supplement by all women of child-bearing age to prevent neural tube defects. In my office I've noticed that the only women of child-bearing age who seem to take this are the ones who are actively trying to bear children! That aside, research has found that many people who are depressed have low folic acid levels. In addition, antidepressant medications don't seem to be as effective if your folic acid levels are low. Consider taking a supplement, and make sure you eat lots of leafy greens such as spinach and kale. Other folic acid sources include lentils, asparagus, and peas.

6) Limit Your Alcohol Intake

Though having a drink will give you an initial relaxed happy buzz, alcohol is actually a significant depressant. If you have troubles with your mood, it's best to stay away from it. It also negatively impacts the quality of your sleep, which can make your mood even worse the next day.

If you follow these "rules", you'll find that you not only protect your mood - you'll protect your overall health, too. Now that's my kind of side effect.

America's Got Talent: How To Discover and Develop Yours

Susan Biali, M.D. — Wed, 22 Jul 2009 21:51:38 +0000

In the last few months I've found myself riveted by talent shows like American Idol and America's Got Talent. And like the rest of the world, I found myself thrilled and overcome to tears by Susan Boyle's incredible performance and story on Britain's Got Talent. Last night, we spent another evening glued to the couch and the screen alternately howling with laughter and giddy with goosebumps as we watched one "talent" act after another on America's Got Talent.

As a big part of my mission in life is helping as many people as humanly possible to connect with and finally pursue deeply buried talents and dreams, I find these shows professionally as well as personally fascinating. I'm evangelical about the subject because I myself didn't experience true fulfillment in life until I re-awakened my childhood fascination with dance in my late 20's - that led to a totally new career as a flamenco-dancing wellness expert/author/speaker.

Watching last night's contestants, I observed five key truths that can help you discover and develop your own unique talent(s) - no matter how old you are, no matter how silly you think your dreams are, and no matter how convinced you are that it's "too late".

1) ENTHUSIASM: more important than extreme talent

Though I've had the surprising privilege of performing for and even teaching high-profile clients and celebrities, I always point out that I'm not even close to being a "great" dancer. I'm not even the best flamenco dancer in my hometown. Yet I've been told that the reason I've gotten the opportunities that I have is because of the passion and love for the art that comes out of me when I perform.

Ishaara, last night's Bollywood group, is a perfect example of that. They don't appear to be professional dancers, though perhaps some of them have taken classes. Almost anyone with coordination could learn the simple but very effective dance routine they put together. What brought the house down, and the crowd to their feet, was the energy and passion that poured from them as they danced. They love what they do, so much, that they make you love what they do, too. Put love and passion into your talents, however they may be expressed, and you will be amazed by how far it will take you.

Watch Ishaara dance

2) YOUR TIME IS NOW: It's never too late

I collect stories of people who finally developed and expressed a talent late in life, and enjoyed much success and joy despite their unconventional timing (I'm one of those stories).

One AGT "never too late" hero is 43 year old Kari Callin, who has been singing since she was 3 years old and has dreamed of being a professional singer her entire life. Her obstacle? Callin was born with birth defects, a cleft lift and palate, and has surgical scars and facial features that mark her as different from more typically glamorous singing superstars. She told the audience how once, she'd gathered the courage to audition for a cruise ship job, and they didn't even give her the chance to sing.

To quote AGT judge Sharon Osbourne: "Forget the cruise ship, they'll never be able to afford you now!"

Watch Kari Callin bring the house down

3) EXPECT THE UNEXPECTED - and enjoy it!

I've observed that life creates the most fortuitous circumstances for us and our god-given talents, often right under our noses. I never imagined that meeting my Mexican husband would cause me to move to Mexico, and that there I would finally live out my dancing dreams. On America's Got Talent, two randomly matched, introverted college roommates spent months living together without even really talking to each other. When they finally did, they found they both shared a passion for music and dance.They look like two average guys, but watch what happened when these two finally connected and collaborated. It's just spectacular!

Watch Anthony & Matt

4) PERSIST: It will pay off.

When I heard that 16 year old contestant Mia Boostrum had come back again after failing to win the show last year, I prepared myself to be bored by the "comeback", and the judges were equally skeptical. In the end, Mia proved that she really had dedicated herself to phenomenal improvement over the year that had passed. She was so good that it made me ask myself: when I look back over the last year, have I worked as hard as I could to develop my talents? What about you? For me, the answer is a clear no.

Mia's performance

5) DON'T LET THE BUZZER BLOCK YOU.

My pet peeve on America's Got Talent is those annoying buzzers that trigger a giant red X. I agree that some acts are difficult to endure in their entirety, but just because a person gets a buzzer, or the crowd yells them off the stage (awful!), doesn't mean they should give up on their dreams or talent. A lackluster singer might just need some guidance and vocal training. A scarily-dressed entertainer might just need an image consultant. A "bad" dancer might just need to take some classes or practice a bit more.

I take great joy in proving people wrong - people who have criticized me, or insulted me, or who have gleefully predicted that I would fail. If you dream of doing something special, even if you're not obviously talented at it, I still maintain that there is a reason you have that dream, and the only way that you will experience the wonderful experiences that await you along that path is to walk it. Ignore anyone who tries to "buzz" you by telling you you can't.

What's the next step for you, to explore and develop your unique talent?

Take it - right now!

Was Michael Jackson a Highly Sensitive Person(HSP)? Are You?

Susan Biali, M.D. — Wed, 08 Jul 2009 22:31:37 +0000

Watching the events over the last week, and observing so many details of Michael Jackson's life has made me reflect a lot about myself and my own life. I imagine the coverage may have had the same effect on you.

I'm struck over and over by the primary message of self-actualization - the importance of expressing your God-given gifts to the fullest in your lifetime - and the impact that each of us might have on the world if we actually did that.

That's fodder for another post, but at this moment I'd also like to reflect on the frequently discussed contrast between Jackson's shy, reclusive personality (documented since he was a young child), and his outrageously impressive and even flamboyant ability to perform on and dominate the world stage.

I can relate, though on a smaller scale. I too am a professional performer - I'm a flamenco dancer, speak for large audiences, and work with the media as a wellness expert. I've loved being on stage, in the spotlight, since I can remember. Most people are terrified of speaking or performing in front of people, while I have the opposite problem: it can be hard to get me to get off the stage, or to make me share it with others! The similarity to Jackson is that while I may appear very extroverted on stage or on camera, I'm actually an extremely private person who needs a huge amount of alone time.

By definition, an extrovert is a person who gets energized by being around others. That certainly applies to me (and seems to apply to Jackson): I love being on stage in front of a crowd, or at a great event, or laughing and talking with really interesting, high energy people. But I still need to spend more time alone than I do with other people, in order to feel balanced and comfortable in my own skin.

People often won't understand this. I seem so outgoing, with a "big" personality in stage, but in my personal life I often get accused of being anti-social. I prefer to spend large amounts of time alone, and like to spend the balance of my time with a small group of very close friends and family. I also have a number of other unusual traits (such as being extremely susceptible to noise, and almost obsessed with the luxury of total silence in my living and working space), which made me wonder for years if I was just some kind of weirdo.

One night, when I was feeling particularly frustrated by my "sensitivity", I actually did an Internet search to try to find some explanation for my personality. I can't recall which search terms I used, but I found a website about "The Highly Sensitive Person." It changed my life and the way I saw and understood myself, forever.

The website (http://www.hsperson.com ) is based on the work of psychologist Dr. Elaine Aron, who has written several books on this subject. Apparently "HSPs" make up 15-20% of the population, "too many to be a disorder, but not enough to be well understood by the majority of those around you". I'll say!

According to Aron's website, if you're a Highly Sensitive Person:

- You're more aware than others of subtleties. Our brains processes information and reflects on it more deeply. You notice more things than others do.
- You're more easily overwhelmed, and get naturally overstimulated when things are too intense, chaotic or new.
- You're easily affected by other people's moods
- During busy days, you may need to withdraw into a darkened room or quiet place to get some privacy and relief from over-stimulation
- You get overwhelmed by bright lights, strong odors , loud noises, crowds and any other strong sensory input
- You're deeply creative and moved by arts and music

A more detailed Self Test can be found on Aron's website here .

Reading the complete list of HSP traits was a huge relief to me - it meant I was essentially normal, part of a large group of people who largely go unrecognized by science or society. Now I could explain to my husband why I am the way I am. I can't comfortably live in a housing situation where there are shared walls (e.g. a condo or duplex), as I find uncontrollable noise from other people to be very disruptive and stressful. When I travel it's best that I not share a room with others (other than my husband, who's used to me), as I find I get stressed and overwhelmed if I don't have a private space to decompress on my own between activities.

Now that I understand why I am the way I am, and that it's a real neurophysiological condition, I can look after myself properly and explain myself to others without being embarrassed or seeming "strange".

It's hard to know if MJ had the same combination of traits, though there's no doubt that from a young age he was labeled as "shy", as many HSPs are, and was extraordinarily gifted and extroverted within the arts. Thirty percent of HSPs are extroverts, which is an interesting and logical explanation for my personality (as described above). I'm naturally outgoing when I want to be, but need lots of down-time alone to balance busy times that involve lots of socializing or stimulation.

What I do know is if that you're an HSP like me, this knowledge might help you finally be able to understand, celebrate and honor your unique package, instead of feeling ashamed or frustrated by who you are. Now go make yourself a soothing cup of tea, find a cozy quiet place to relax, and enjoy!

Can't Find Your Life's "Purpose"?

Susan Biali, M.D. — Wed, 24 Jun 2009 00:34:48 +0000

Over the course of several years, not too long ago, I devoured a steady stream of books that focused on "finding your purpose". As I read a particularly inspiring passage or story, I'd feel a momentary injection of hope, which would then quickly flip into frustration and despair. As much as I longed to find my elusive "purpose", I worried that I was a rare and unfortunate exception, a "purpose"- less human being.

Yesterday, I had a coaching session with a new client. She told me that she had tried all kinds of different courses, activities, and therapy, and still "couldn't find" her life's passion and purpose. She envied an acquaintance who had become a world-renowned fly-fishing expert. He had started out drawing pictures of fish as a young child, and had steadfastly and happily followed a razor-focused life path ever since. She, by comparison, felt like she'd been chasing different dead-end routes all her life, without getting anywhere.

Most people who know me would find it hard to believe that I ever worried about my "purpose". I'm living that purpose so passionately now, but rather than having encountered a single purpose-defining moment (which would divide my existence into "life before the moment I found my purpose", and "life after I found it"), the discovery of that purpose has been more of a winding, baffling, nonsensical yet brilliantly perfect journey.

In my life I started out determined to become a Solid Gold Dancer, but later abandoned that dream and followed a largely unplanned and very windy path: I became a (rather inept) gymnast and gymnastics coach, studied physics, studied kinesiology/human mechanics, modeled (rather unsuccessfully) for a while, got a degree in Dietetics, became a medical doctor, got into an Emergency Medicine residency, quit that residency and became a GP, became a salsa dancer, became a flamenco dancer, started a photography business, almost completed my first novel, became a travel writer, became a health writer, became an inspirational writer, planned to move to Italy, moved to Mexico, began working as a life coach, became a professional speaker, became a non-fiction self-help book author...and that's just a brief summary, missing lots of details and other equally improbable tangents.

When you look at everything I've sampled in life, you can imagine why I often thought I was hopelessly lost. Yet when I look back now, it's all perfect. Each sudden change in direction made an important contribution to the person I am today, by providing me with a unique skill, knowledge or experience that I now use today to help myself and others. The twists and turns in my life set the stage for the contribution that I'm now making to the world, a contribution and a role that I now appreciate as being uniquely mine.

If you're blessed with tons of different ideas or talents, celebrate them rather than bending to pressure to "just pick one". If you've got lots of different interests, and almost as many diplomas or degrees, embrace all the different things you know. As you give each unique aspect of you room to be, to breathe and to express itself, you'll find that some naturally fall away, while others stick and become an essential part of you and your path. Each of us is unique: don't compare yourself to others, unless there's something about a person or their life that resonates with and inspires you.

I've found that living my way into my passion and purpose has been a process and a journey, not a single "aha" moment. I do have those, but I usually think that a certain "aha" is going to take me to a certain destination, and I end up in another place entirely. There's one thing I can always bet on, though: that unexpected destination turns out to be far better for me than the original one I might have planned. It may not always come in an appealing package, but it's always good for my development and my life.

No matter what turns your road takes, remember to watch for the gifts that await you at each intersection, bend and look-out. Enjoy your journey!