Your treatment includes lifestyle changes in addition to taking your medications daily and working with a counselor. By adhering to the following recommendations you should notice a rapid improvement in your overall mood. EXERCISE: As long as you are medically healthy, you should exercise a minimum of 30 minutes daily. This workout should be vigorous enough to increase your heart rate which will give you an endorphin release that will elevate your mood, energy, and concentration and will decrease anxiety and irritability. To help motivate you to exercise, I recommend that you ask a friend to hold you accountable to your daily workouts. SUPPLEMENTS: It is imperative that you take daily supplements that are essential not only to the overall health of your brain, but also help your mood. Add a multivitamin with Vitamins D, B12, and B6 and an Omega-3 supplement with 1200mg of Omega-3. SLEEP SCHEDULE: Your brain is programmed by a mechanism called the circadian rhythm which is controlled partly by data about light gathered through the optic nerve of your eye. When your brain senses that it is dark it begins to wind down the day and when it senses light your brain prepares to begin the day. The problem is that many people’s sleep schedules vary significantly and cause a major disruption in this natural cycle so their brain does not know when to wind down or wake up. It is very important that you get on a consistent sleep schedule of about 8 hrs of sleep each night and adhere to it strictly (even on the weekends.) You should go to bed within a couple of hours of it getting dark outside and wake up within a couple of hours of when it gets light outside. If you do not sleep well, try your best to not nap during the day. MEDICATION COMPLIANCE: It is very important that you take your medication on a daily basis, unless otherwise directed. Antidepressants and mood stabilizers do not work well if not taken daily. Antidepressants treat both depression and anxiety, but can take up to 6-8 weeks at the right dose to be helpful so it is very important not to miss any doses. COUNSELING: An important part of your treatment is addressing some of the psychological aspects of mood disorders. We recommend that patients work with a counselor or therapist as medication only changes the biological dysfunction of the brain. Your follow up appointments with the doctor, physician assistant, or nurse practioner are 15 minute medication management visits and are tailored to determining how we can best treat the physical and chemical imbalance in the brain with medication. While this can be very helpful it does not address many of the behaviors and life stressors that lead to depression and anxiety. If you were not referred to a specific counselor at your initial evaluation then please contact your insurance company for a referral list and bring this to your next appointment so that we can recommend a counselor. GENERAL HEALTH: Please continue to see your primary care physician for your annual physical and your opthamologist for an annual or biannual eye exam. You should have blood work done once a year to make sure that you are healthy and tolerating the medication well. This blood work should be done by your primary care physician and should include a fasting comprehensive metabolic panel and lipid panel, a CBC with platelets and diff, B12, Fe, Vitamin D, and TSH. EMERGENCY- If you have a psychiatric emergency then you can go to Green Oaks Hospital by ambulance or private transport 24 hours a day. The address is 7808 Clodus Fields Drive Dallas, TX 75251and the telephone number is (972)991-9504.

Below is a list of online resources that can be helpful for you and your members by providing you with information on diseases, their treatments, and supportive resources.

 Anxiety Disorders of America: http://www.adaa.org/  Academy for Eating Disorders: www.aedweb.org/  Alcoholics Anonymous: http://www.aa.org/  Alzheimer’s Support Groups in Dallas: http://www.alz.org/greaterdallas/in_my_community_support.asp  Anxiety Disorders Association of America: http://www.adaa.org/  American Academy of Child and Adolescent Psychiatry: www.aacap.org  American Association for Geriatric Psychiatry: www.aegponline.org/  Autism Society of America : http://www.autism-society.org/site/PageServer  Children and Adults with Attention Deficit/Hyperactivity Disorder: www.chadd.org/  Depression and Bipolar Support Alliance : www.dbsalliance.org  Eating Disorders Anonymous: www.eatingdisordersanonymous.org  Geriatric Mental Health Foundation: www.gmhfonline.org  Mental Health Association of Greater Dallas: www.mhadallas.org  Narcotics Anonymous: www.na.org/  National Alliance on Mental Illness: www.namitexas.org  National Association of Anorexia Nervosa and Associated Disorders: www.anad.org  National Autism Association: www.nationalautismassociation.org  National Center for Learning Disabilities: www.ncld.org  National Center for Post-Traumatic Stress Disorder: www.ncptsd.va.gov/ncmain/index.jsp  National Center on Birth Defects and Developmental Disabilities: www.cdc.gov/ncbddd  National Eating Disorders Association: www.edap.org  National Institute of Mental Health: www.nimh.nih.gov  National Institute on Alcohol Abuse and Alcoholism: www.niaaa.nih.gov  National Institute on Drug Abuse: www.nida.nih.gov  National Mental Health Association: www.nmha.org  Texas Department of Assistive & Rehabilitative Services: www.dars.state.tx.us/  General Support Groups for all mental illnesses: http://www.recovery- inc.org/meetings/meetings-faq.asp

BIBLIOTHERAPY/SELF HELP BOOKS

Depression o Burns, David: The Feeling Good Handbook, Plume/Penguin, New York, New York, 1989 o Burns, David: Feeling Good: The New Mood Therapy, Avon Books, New York, New York, 1999

Anxiety o Bourne, Edmund: The Anxiety and Phobia Workbook, New Harbinger Publications, Inc., Oakland, CA, 1995 o When Panic Attacks by Dr. David Burns

Relationship Difficulties o The 5 Languages by Dr. Gary Chapman o How to Win Friends and Influence People by Dale Carnegie

Bipolar Depression o An Unquiet Mind by Kay Redfield Jamison

Schizophrenia o Adamec, Christine, & Jaffe, DJ: How to Live With a Mentally Ill Person: A Handbook of Day-to- Day Strategies, John Wiley & Sons, 1996 o Mueser, Kim Tornval: Coping With Schizophrenia: A Guide for , New Harbinger, 1994

Caregiver Stress o National Family Caregivers Association: The Resourceful Caregiver: Helping Family Caregivers Help Themselves, Mosby Lifeline, 1996 o MacE, Nancy L, Rabins, Peter V, & McHugh, Paul R: The 36-Hour day: A Family Guide to Caring for Persons With Alzheimer Disease, related Dementing Illnesses, and Memory Loss in Later Life, third Edition, Johns Hopkins University Press, 1999.

Chronic Illness o Donoghue, Paul J & Siegel, Mary Elizabeth: Sick and Tired of Feeling Sick and Tired: Living With Invisible Chronic Illness, WW Norton, 1994

ADHD o Organizing from the Right Side of the Brain: A Creative Approach to Getting Organized - by Lee Silber o What Does Everybody Else Know That I Don't?: Social Skills Help for Adults With Attention Deficit/Hyperactivity Disorder (Ad/Hd) a Reader-Friendly Guide by Michele Novotni o Time Management for the Creative Person: Right-Brain Strategies for Stopping Procrastination, Getting Control of the Clock and Calendar, and Freeing Up Your Time and Your Life by Lee Silber o Learning Outside The Lines : Two Ivy League Students With Learning Disabilities And Adhd Give You The Tools by -Jonathan Mooney o Making the System Work for Your Child with ADHD (Making the System Work for Your Child) by Peter S. Jensen o Mastering Your Adult ADHD: A Cognitive-Behavioral Treatment Program o Taking Charge of ADHD by Russell Barkley o Driven to Distraction by Edward Hallowell (for adults with ADHD) Abuse o The Courage to Heal by Ellen Bass and Laura Davis o Victims No Longer by Michael Lew (men’s recovery from sexual abuse) o Allies in Healing By Laura Davis (partners of adult survivors) o The Battered Woman by Lenore Davis (spousal abuse)

Addiction A Time to Heal by Timmen Cermak (adult children of alcoholics) Codependent No More by Melodie Beattie My Name is Bill W (movie)

Anger o The Dance of Anger: A Women’s Guide to Changing the Patterns of Intimate Relationships by Harriet Lerner. o Anger: The Misunderstood Emotion by Carol Travis o How to Control Your Anger Before It Controls You by o A Volcano in My Tummy by Eliane Whitehouse and Warwick Pudney (for children)

Anxiety Disorders o The Anxiety and Phobia Workbook by Edmund Bourne o Mastery of Your Anxiety and Panic II by David Barlow and Michelle Craske o S.T.O.P. Obsessing: How to Overcome Your Obsessions and Compulsions by Edna Foa and Reid Wilson

Assertiveness o Your Perfect Right by Robert Alberti and Michael Emmons o The Assertive Woman by Stanlee Phelps and Nancy Austin

Child Development and o Between and Child by Haim Ginott o Parent Effectiveness Training by Thomas Gordon o How to Talk so Kids Will Listen and How to Listen so Kids Will Talk by Faber and Mazlish o Raising Black Children by James Comer and Alvin Poussaint

Communication and People Skills o You Just Don’t Understand: Women and Men in Conversation by Deborah Tannen o Boundaries: When to Say Yes, When to Say No to Take Control of Your Life by Henry Cloud and John Townsend

Death and Grieving o How to Survive the Loss of A Love by Melba Colgrove o How to Go On Living When Someone You Love Dies by Therese Rando o A Grief Observed by C.S. Lewis o On Children and Death by Elizabeth Kubler-Ross o The Grief Recovery Handbook by John James and Frank Cherry

Dementia and Alzheimer’s o The 36 Hour Day: A Family Guide to Caring For Persons with Alzheimer’s Disease, Related Dementing Illness and Memory Loss in Later Life by Nancy Mace and Peter Rabins

Divorce o Dinosaurs Divorce by Laurene Brown and Marc Brown (for children) o The Boys and Girls Book about Divorce by Richard Gardner

Eating Disorders Dying to Be Thin by Ira Sacker and Marc Zimmer

Love and Intimacy o Love is Never Enough by Aaron Beck o Why Succeed or Fail by John Gottman

Depression o Feeling Good: The New Mood Therapy by David Burns o Control Your Depression by Peter Lewinsohn and Ricardo Munoz o Mind Over Mood: Change How You Feel by Changing the Way You Think By Dennis Greenberger and Christine Padesky

Schizophrenia o Surviving Schizophrenia by E. Fuller Torrey

Stress Management o The Relaxation and Stress Reduction Workbook by Martha Davis, Elizabeth Eschelman, Matthew McKay o Wherever You Go, There You Are by John Kabat-Zinn o The Stress and Relaxation Handbook: A Practical Guide to Self-Help Techniques by James Madders

Teens and Parenting o Between Parent and Teenager by Haim Ginott o All Grown Up and No Place to Go: Teenagers in Crisis by