http://www.lulu.com/shop/wajahat-fatima/ruins-speak/paperback/product-23268503.html

This is the link to my aunt's amazing, poetic, autobiographical book in Urdu, called "Ruins Speak". I'm working on translating it into English.

According to John Leddy, the director of the University at Buffalo’s Concussion Management Clinic, controlled cardio exercise is good for recovering from concussions.

http://www.athleticbusiness.com/high-school/can-cardio-exercise-aid-in-concussion-recovery.html

Long considered a forbidden activity for individuals with concussions, cardiovascular exercise is slowly becoming recognized as a recovery tool.

For that, you can thank physician John Leddy. As the director of the University at Buffalo’s Concussion Management Clinic, where he also is an associate professor of orthopedics, family medicine and rehabilitation sciences, Leddy for the past five years has conducted research suggesting that supervised workouts on treadmills, stationary bikes, ellipticals or stair-steppers – performed for as little as 10 minutes at 80 percent of a patient’s target heart rate – can help in the recovery process. He also claims a cardio workout provides a clearer indication than cognitive testing of when an athlete is ready to return to play.

“Everybody thought that doing something like this would make people worse, not better,” says Leddy. “But it does make them better, because it’s controlled. Fifty years ago, when doctors started doing stress tests on people with cardiac disease, people thought that would give them heart attacks. But the fact is, stress tests don’t do that. And now those tests are done as a matter of routine.”

If Leddy has his way, his exercise protocol for concussion patients will become routine, too, and he points to rehab clinics around the country that have already adopted some of his ideas. “It’s okay, at some point, for people with concussions to begin exercising again, as long as they’ve seen a doctor and had testing done under medical supervision,” he says. “As this catches on, you might see people in health clubs or fitness facilities who are actually doing this program and trying to recover from concussion symptoms.”

For now, though, UB appears to be the only facility undertaking outcome-based studies in this area. That’s why, in September, the university was among the 15 organizations to receive a sports-related medical research grant from NFL Charities to take the next step. Using the $100,000 grant, Leddy and Barry Willer, a UB professor of psychiatry and rehabilitation services, will spend this year assessing the fitness levels of student-athletes from several area colleges, plus members of the Buffalo Bills and the Buffalo Sabres, within hours of being diagnosed with a concussion.

“We haven’t done early assessments like that yet,” Leddy says. “But we think the physiology is different right after a concussion versus when someone is recovered. We want to see if the treadmill test is a good way to find out if there is a change in cerebral blood flow when they are symptomatic during exercise versus when they are not.”

The 18-month study began in earnest in January and will include as many as 30 injured athletes and 30 healthy control subjects. The results, as Bills’ executive vice president for strategic planning Mary Owens told UB Reporter, the University at Buffalo’s online staff newspaper, “will benefit athletes at all levels.”

“Replacing the conventional wisdom of long-term rest with a graduated exercise program may improve recovery in those with lingering concussion problems,” acknowledges Stanley Herring, a member of the NFL Head, Neck and Spine Committee and a team physician with the Seattle Seahawks and the MLB’s Seattle Mariners. “A study like this is important because it explores a potential treatment for athletes with persistent concussion symptoms.”

Persistent concussion symptoms are those that linger for more than two or three weeks. Though they affect only a small percentage of concussed athletes, they are what got Leddy (also a doctor for UB athletic teams) thinking differently in the first place. “Why should these athletes be sitting around doing nothing? Why can’t they do something, something that’s controlled and safe?” he asks. “Physical rest beyond three weeks is detrimental.”

So he asked student-athletes with lasting concussion symptoms to hop on a treadmill while he monitored such vitals as blood pressure and heart rate. Patients would exercise to the point where their symptoms – such as dizziness and headaches – increased, and Leddy would then stop the machine and establish 80 percent of whatever the patient’s heart rate was at that moment as the new target heart rate for daily 20-minute workouts. After all, he reasoned, the individual had already proved he or she could exercise at that level without becoming symptomatic. For high-performance athletes, the target heart rate can be increased to 90 percent, while deconditioned individuals who suffer a concussion from an accident or other non-athletic incident may be prescribed a maximum of 10 or 15 minutes of exercise at 80 percent.

Leddy and Willer, who chose 80 percent arbitrarily, based their early research on similar studies (involving concussed rats) conducted at UCLA in the early 2000s. “What those studies told us was that maybe exercise isn’t so bad; it’s the timing that is important,” Leddy says. “It’s not just telling people to go out and do whatever they want. It’s quantifying what they can do and building a rehab program around that information. Now, we tell patients to go to a gym and use a piece of equipment they like that doesn’t involve a lot of bouncing and movement of the head. We want them to get an aerobic workout.”

Leddy and his research colleagues also want to ensure their athletes are ready – really ready – to return to play. Cognitive baseline testing, they say, might not be the answer.

“Most people view concussion as a cognitive problem,” Leddy says. “We view it as a physiological problem that has cognitive consequences. Therefore, what the NFL study may show is that doing a physiological stress, like exercise, is actually a better way to determine if someone has recovered than the cognitive testing that all sports teams use. We wanted something that is more representative of what athletes do on the field, and that is get their heart rate and blood pressure up. The real test for football players is to see if they suffer from any symptoms when they go back to hitting.”

To that end, an obstacle course could be designed in a clinical setting involving participants running in a figure-eight pattern and then colliding with a heavy punching bag, as well as participating in a cardio test. “What I’m hoping is that someday, instead of using a computer test to determine if Michael Vick has recovered from a concussion, they’ll put him on a treadmill. Or maybe they’ll do both,” Leddy says.

Still, some skeptics will need more convincing. Isn’t it risky, they might ask, to take concussed patients to the brink of dangerous symptoms? “We’ve thought about that, for sure,” Leddy concedes. “Do that to people, and they will get worse temporarily – for several minutes or several hours – but it doesn’t last. At least with this, they’re doing something active, and what happens right away is their reactive depression goes away. So if they can exercise and they have a goal, they automatically feel better. They make progress. They see an end point. The exercise is doing something physiologically, but also psychologically, to help them.”

This is an interesting article! Bipolar disorder has always been thought to be a genetic disorder, that is due to mutations in genes. One of the reasons bring it is inherited and runs in families. However, here the authors make a case for it not being genetic but physiological in nature. I’ve put the most important passage in the article in quotes below. If you’d love to read the whole article, there’s, as always, a link below too. CRMP2 is a protein that is involved in neural networking, i.e in arranging neurons from soma to axon and making networks between neurons. In bipolar disorder, the activity of this protein is low. When Lithium is given to Lithium responsive neurons, the activity of CRMP2 is brought back up to normal, thereby correcting the underlying cause of the disorder. That’s what the authors say. Just have to wait and see if this is truly the underlying cause of bipolar disorder. 
https://m.medicalxpress.com/news/2017-05-underlying-molecular-mechanism-bipolar-disorder.html

“In hiPS cells created from lithium-responsive and non-responsive patients, researchers observed a physiological difference in the regulation of CRMP2, which rendered the protein to be in a much more inactive state in responsive patients. However, the research showed that when lithium was administered to these cells, their regulatory mechanisms were corrected, restoring normal activity of CRMP2 and correcting the underlying cause of their disorder. Thus, the study demonstrated that bipolar disorder can be rooted in physiological—not necessarily genetic—mechanisms. The insights derived from the hiPS cells were validated in actual brain specimens from patients with bipolar disorder (on and off lithium), in animal models, and in the actions of living neurons.”

Tomorrow I go home Tomorrow I start worrying again. Tomorrow anxiety will hijack my brain again. 

It will take me through twisted, tortuous roads, it will show me in sickening, horrifying detail what can go wrong and convince me that it all will go wrong. 

It will hijack my brain and my mind for half the day. Yes half the day. For the rest, it will grant me respite. I will be free to be me for the second half of the day. I will make the most of it. I will make plans of how to defeat anxiety tomorrow. “Get up, don’t listen to your thoughts, get out and go for a brisk walk. Set your coffee out on your bedside table and drink it the moment you open your eyes, watch something funny on YouTube, etc. etc…” 

I won’t let it beat me. It’s not real. And then the thought sneaks in: Isn’t it real? Aren’t all those things possible? God if anyone is a master at playing mind games, head games, it is anxiety. And I hate it that it’s using my head as the playing field. 

Tomorrow I will go home and I will be the unwilling star player in this god awful, sick, twisted game. All the while, I’d rather be dancing. 💃🏻💃🏻💃🏻💃🏻

Sometimes I just want to break down and cry

At the exquisite beauty of life

At the hideousness of it

At the warmth and tenderness

At the frigid, iciness

At the loving arms enveloping me

At the cruel feet kicking the life out of me

At my terrifying, heartbreaking love for my precious child

At the fear and terror that everything will go wrong

At the family gatherings with love, care, and compassion. Loving togetherness

And the aching goodbyes, the pangs of missing each other, “Oh we were all together just yesterday!”

Feel and feel and feel too much

My heart cries out at your tender touch

Time to up the Lithium? Yes, if it gets any deeper than this.

Beauty and feelings mean nothing to me if I’m in the hospital in a freaking manic phase.

Wow! Sometimes you do something only in the spirit of helping someone, and it totally comes back to bite you in your derrière. You don’t have to do this thing, you are under no obligation to do it. But for some reason you feel someone is asking for your help without using the exact words, so you actually try to help. My advice was actually to read “The Power of Now” by Eckhart Tolle. Also it was about the effects of L-Dopa when people first start taking it for early onset Parkinson’s disease. How that advice could be taken wrongly and twisted to make me feel like I’d done something wrong is quite puzzling and quite beyond me. 

Do I stop helping people? If someone reaches out to me either in words or actions, do I just ignore them to avoid the backlash? Yes. For a bit. Until I understand how trying to help someone is wrong. I’m going to stop. For self preservation. For my own peace of mind and for the peace in my life. I’m going to put myself first. And not go out on a limb to help anyone else. 

I have always been helpful and selfless. But this incident is teaching me how to be more selfish and less selfless, so that I cannot be turned into the scapegoat into which I have frequently been turned. My entire life. I think I needed that lesson. 

Pretty great article for anyone struggling to accept they have a mental illness. So many reasons not to accept that we have these wretched illnesses. Dr. Susman offers alternative ways of looking at things, more helpful and constructive ways. Would be a great read for relatives of those struggling with mental illness as well.

Me, after my first depression, at which point I had no idea what the hell happened to me, but after that, I realized and accepted that I suffered from a mental illness. My first manic phase when I was Alice in Wonderland, and what a wonderland it was, well it was quite difficult to disavow my illness. After that first manic phase, I of course had to accept that I had bipolar 1. And though I’ve lost my baby brother to this illness, 31 years after my diagnosis, I’m still here.

As per the author’s request, I am removing the text of the article here, please just click on the link to read it 🙂

http://davidsusman.com/2017/06/01/overcoming-the-8-reasons-why-people-dont-get-treatment-for-mental-illness/?utm_content=buffer575a8&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

My baby brother, the most loving, the sweetest, most caring, most handsome, most missed, most beloved. Bipolar disorder took him from our lives but never, never from our hearts. I love you Farooq, I always have and I always will. 

The reason I did a search on allergies and anxiety is that recently I went on a family vacation to Lake George NY.  While I was there, my Ohio river valley allergies absolutely vanished! And lo and behold so did the massive amounts of anxiety I had been experiencing! Now I admit, my son was with us on this vacation, so part of the reason my anxiety disappeared was that I knew he was with me and safe and sound. But I feel it was more than that, I thought perhaps my allergies were making me anxious. Allergies happen because our immune system reacts against something otherwise benign like pollen. If our immune system didn’t think pollen or mold or other environmental substances  were pathogens and if our immune system didn’t mount a full on attack against these things, we would not have allergies! Simple. 

Since I also knew the immune system is implicated in the development and perpetuation of mental illness, well it only made sense that allergies and anxiety may well be related! 

After I came back home to Louisville, my allergies returned with a vengeance and so did my anxiety! 

So I did a search about it and found many publications relating the two. One such article is below. I’ve bolded what was most important to me. 

I have also made an appointment with my allergist, I intend to get injections of my allergens in minute doses in an attempt to rid my self of these annoying and perhaps anxiety producing allergies. 

I will report back on my anxiety levels when I have completed the injections. 

http://www.ei-resource.org/articles/mental-and-emotional-problem-articles/the-links-between-allergies-and-anxiety/
The Links Between Allergies and Anxiety
Last Updated on Monday, 09 May 2016 02:04

by Ryan Rivera

October 2011
Beyond starting with the letter “A,” most people do not equate allergies with anxiety when looking at the causes of both disorders. Allergies are an environmental health problem, caused by an immune system that reacts poorly to the environment. Anxiety is a mental health problem, caused by inadequate coping strategies, stress, and genetics. But these two disorders have a fairly strong link, both directly and indirectly, and those that suffer from both may need to address each of those issues if they hope to successfully treat it.
Indirect Ways That Allergies Contribute to Anxiety
Many of the ways that allergies affect anxiety are indirect – meaning that the allergies are not physically causing the anxiety, but are contributing to it considerably. These include:
Fear of Allergic Reaction – Those that experience severe allergic reactions to things like peanut butter or bee stings may experience stress and anxiety every day, concerned over whether or not they’ll be able to stay safe in the environment. Life threatening allergies can be a frightening thing, and if you are already suffering from any mild anxiety, that fear can easily make your anxiety much worse.
Sleep Problems – When your allergies keep you awake at night, getting a full night’s sleep can be difficult. Unfortunately, experiencing the symptoms of anxiety is very common when you are struggling to get a full night’s rest. Over time this can become a vicious cycle, since anxiety can then cause sleep issues, and sleep issues can cause your allergies to worsen.

Oversensitivity to Body Changes – While panic attacks are a mental health problem, they are often triggered by concerns over physical health. Those that suffer from panic attacks become oversensitive to their own body’s physical reactions, causing them to experience panic. When you have allergies, you experience physical symptoms often, and those that are prone to panic attacks may easily respond negatively to those changes.

Even indirectly, it’s clear that allergies and anxiety are linked. Research has also found that anxiety itself can have a direct effect on allergies.

How Anxiety May Affect Allergies
Research at Ohio State University has shown that anxiety is also a factor in experiencing allergy symptoms. Several studies have shown that even a small amount of stress can not only increase the intensity of an allergy attack, but also cause the allergy attack itself to last longer and fade less quickly.
The reason for this is that stress and anxiety can affect the status of your immune system. Since allergies themselves are already caused by an inadequate immune system response, the additional stress on your immune system only makes it work less efficiently, resulting in more serious allergy symptoms than if you did not have stress.
How Allergies May Affect Anxiety
The physical effects are not necessarily one sided either. While you already read the ways that allergies can indirectly affect anxiety symptoms, early research is showing that allergies themselves may actually trigger an increase in anxiety.
Research in the British Journal of Dermatology found that patients that suffered from skin allergies experienced greater levels of anxiety. Studies have also shown that a compromised immune system can cause physical stress, and research has indicated in the past that experiencing physical anxiety symptoms may increase the likelihood of experiencing stress and worry – both of which are mental health symptoms, rather than physical symptoms.
While research in both of these areas is fairly new and still subjected to intense medical scrutiny, there is early evidence that anxiety can cause allergies to worsen, and vice versa.
What Does This Mean For Future Research and Treatment?
The next steps in research are going to need to focus on direct causes – looking at how the immune system interacts with anxiety and vice versa in order to discover where or what the direct link is that causes the two diseases to essentially feed off each other, assuming such a link exists.
Nevertheless, the early evidence does indicate that there is a medical link between both disorders, and beyond that there are several indirect links that cause anxiety to fuel allergies and vice versa, so that in the event that research finds them to be independent, each can still exacerbate the symptoms of the other, causing those that experience both to live with the vicious cycle.

One thing is clear, however. For those that experience both anxiety and allergies, treating only one may not be adequate enough to reduce the symptoms. Allergy treatments are going to be less effective for those whose symptoms are exacerbated by anxiety, and anxiety treatments are going to struggle to work if the individual is simultaneously dealing with the physical and mental effects of allergies. Both need to be addressed if one is to be free of either, which means that research needs to continue to discover the links so that each can be treated successfully.