At Partners in Healing (PIH), we approach reproductive loss and bereavement comprehensively.  Reproductive loss includes a number of difficult experiences, including infertility, miscarriage, stillbirth, premature delivery, and unexpected fetal anomaly, among others.  

Some losses result in death.  Other losses feel like a death.  Some losses are symbolic.  For example, when a woman is told that she will need infertility treatment, or that her baby has an anomaly, she is experiencing profound loss.   Often people experience more than one type of loss in their reproductive lives.  This can also include complications in pregnancy or trauma during labor and delivery. 

People do not “get over” a reproductive loss, but they can integrate the experience into what is hopefully and long and happy life.  Telling the reproductive story is a must for healing.  Too often people are afraid to tell their story for fear of burdening others or because others minimize or deny the physical and emotional pain caused by reproductive losses.  This can lead to isolation, resentment, and depression.  At PIH, we actively elicit the story and provide hope for healing and transformation.  

It is insufficient to say that loss is difficult, as each person and each couple experiences loss differently.  

We explore:

• Gender issues
• Psychological make-up
• Childhood trauma
• Medical trauma history
• Family history and dynamics
• Belief systems
• Social environment
• Spiritual beliefs
• Resilience factors 

Our PIH team, including Dr. Deborah Simmons, PhD, LMFT, Dr. Nate and Dr. Nita Champion, ND, and Diane Tanning, RN, MS, L.Ac. provide clinical hypnosis, EMDR (Eye Movement Desensitization and Reprocessing), acupuncture, individual and couples therapy, and naturopathic medicine to those who have experienced reproductive loss.  We listen to our patients’ unique situations and partner with them in developing the most appropriate treatment plan.  Many of our patients have found healing and new purpose. 

We collaborate actively with physicians, nurses, acupuncturists, naturopathic doctors, and other health care professionals across the Twin Cities to ensure that healing is complete and that hope can spring anew for family building in the future.  Dr. Simmons is available for professional consultation, as well.  Compassion and clinical know-how ensure good outcomes at PIH.  To schedule, call us at 763-546-5797.

Have you ever wanted to do a detox or cleanse but weren’t sure which one you should do? Consider our science-based, physician-supervised detox program: DETOX WITH YOUR DOCTOR, a comprehensive detoxification system that addresses both phase I and phase II detoxification.  Dr. Nate Champion, ND and Dr. Nita Champion, ND are offering this group detox event in order to provide patients with additional support, including daily encouragement emails, and a kick-off presentation on April 16th, 6:30pm-7:30pm.  Space is limited.  Sign up soon to reserve your spot!  Please click on the picture below for more details!

Clinical Neuropsychology is the field that studies the relationship between brain functioning and behavior.  It uses standardized testing protocols developed in psychology to explore changes to one's thinking that can result from various neurological conditions or from other circumstances (i.e. the influence of medications used to treat other conditions, use of mood altering chemicals, or psychiatric conditions).

At the Institute for Brain-Behavior Integration (IBBI) at Partners in Healing, neuropsychology can be applied in a wide range of situations, including:

•    Attention-deficit/hyperactivity disorder
•    Disorders related to aging (e.g. Alzheimer's disease)
•    Brain injuries
•    Developmental conditions (e.g. learning disabilities, Autistic Spectrum Disorders)
•    Neurodegenerative disorders (e.g. Parkinson's disease and Multiple Sclerosis
•    Strokes
•    AIDS Dementia Complex
•    Thyroid Disorders
•    Renal Disease
•    SAT/ACT/GRE accommodations

The decision to seek a Neuropsychological Evaluation can be a sensitive issue.  Sometimes, the patient is the one to raise a concern about mental functioning, while at other times it is family members, health professionals, or teachers who raise the initial concern.  The results of a Neuropsychological Evaluation often are necessary to provide solid evidence of what has changed, identify the reason the change has occurred, describe what can be done to potentially reverse or minimize the change, and begin to guide people in their decision-making efforts to better manage their future.

Call Dr. David Alter and Dr. Nancy Foster at the Institute for Brain-Behavior Integration at 763-546-5797 to schedule a Neuropsychological Evaluation.

Paying Attention to the Problem of Attention

Without a doubt, there has been an increase in the prevalence of concerns related to attention management in pediatric patients. Distinguishing ADD/ADHD from attention problems that are related to learning issues, anxiety, depression, or conflict with peers or family is not easy, and often requires more than one set of eyes and ears to make an accurate diagnosis. Obtaining a comprehensive neuropsychological evaluation is often a critical step to arrive at a clear diagnosis and generate an appropriate treatment plan.

A Synopsis of ADD/ADHD Facts

• There has been a 20-fold increase in the prescription of stimulant medication in the past 30 years
• Stimulant medication clearly produces short-term benefits in the ability to focus attention
• A diagnosis of ADD/ADHD needs to be based upon multiple sources of information about other causes of attention management difficulties
• There is strong evidence that use of stimulant medications alone is limited in its ability to effectively address co-morbid problems with anxiety, depression or the effects of intra-familial conflict or distress

A Clear Diagnosis Supports Positive Outcomes

Disruption of attention is one of the most common features of numerous cognitive and psychological conditions. While detection of inattention is important, it does not provide a complete picture to provide an accurate diagnosis of the underlying cause of the inattention.

At the Institute for Brain-Behavior Integration (IBBI), our comprehensive neuropsychological evaluation process generates a detailed picture of:

• Attention management skills
• Learning and information processing abilities
• Behavioral and emotional self-regulation skills
• Family history and current family functioning factors
• Relevant medical concerns, including dietary factors

The information derived from the evaluation is designed to diagnose the specific factors that activate, maintain and/or exacerbate each child’s or teen’s attention difficulties. These can include primary learning or psychological challenges, as well as ADD/ADHD. We will provide the referring physician with thorough evaluation results within 1-2 weeks after the evaluation is conducted.

Collaborative Responses to Multiple Challenges

The problems that go along with attention difficulties include academic performance concerns, family and peer relationship strife, sleep disturbances, and mental health concerns related to anxiety and depression. The co-morbidity of attention problems and learning disabilities is also quite high. Therefore, the biggest challenge lies in how to respond to the concerns regarding attention and behavior when the concerns are brought up with the child’s or teen’s health care provider.

A Multi-disciplinary Health Care Team Can Help—

At Partners in Healing of Minneapolis and the Institute for Brain-Behavior Integration, our integrated health care team consists of professionals trained in:

• Neuropsychology
• Health Psychology
• Clinical Psychology
• Child and Family Therapy
• Nutritional Medicine

Our experienced team of professionals actively collaborates with the pediatric team and the family to discuss the diagnosis, and then develop and implement the treatment plan that works best for each child or teen. Beginning with the diagnosis of causes of inattention through treatment of the child’s or teen’s needs, our collaboration with the pediatric medical team allows us to serve as true Partners in Healing. We look forward to working with you.

• Change is inevitable, but overcoming depression requires learning how to notice it and how to utilize the opportunities for positive change when they arise
• Symptoms often represent people’s best attempted solutions based on the absence of acceptable and available alternatives, but symptoms can resolve when better alternatives are discovered
• Clients almost always possess the internal and personal resources for positive change but need help developing them in carefully built up and gradual steps
• People’s most important resources often exist outside of our their immediate awareness: effective therapy involves helping people gain access to the resources they don’t know they already have
• People learn best when they encounter new experiences that naturally challenge them to expand their range of skills and put new problem-solving tools in their personal life skills “toolkits”
• The primary job of an effective therapist is to know how to access and utilize the naturally occurring  personal resources within each client and guide him or her on the path toward positive change

Applying our Therapeutic Approach with our Clients:

Sam’s* decision to seek therapy, he said, was primarily because of his physical pain caused by the car accident in which he was involved several years earlier.  He saw the pain as the basis for a slew of problems he now faced.  He was not able to participate in his life the way he did before the accident.  His marriage relationship was strained and he was more irritable and less patient with his children.  The intimacy that he and his wife used to enjoy was just a distant memory.  He had no energy or interest for those activities in which he used to find pleasure.  He had been demoted at work, which put additional financial pressures on him and on the family.  His weight had increased by more than 35 lbs, negatively impacting his self-image and lowering his already  injured self-esteem.  Sleep was erratic and non-refreshing.  Most worrisome to him was the expectation that his future held little chance of offering anything   except “more of the same.”   

Partners in Healing’s Whole-Person Approach to the Treatment of Depression

Treating Sam involved four therapeutic components that highlight the individually tailored approach that Partners in Healing (PIH) uses in the treatment of depression.  Of course, we recognize that other approaches to treatment can and do play an important role in the overall plan of care of patients.  That is why PIH clinicians strive to partner with health care professionals from other disciplines (e.g., physician colleagues) whenever possible.  We seek to provide effective, collaborative and integrative treatment experiences for our clients. 

• Psychotherapies: Treating depression typically requires identifying and learning to change the negatively biased thinking and emotional “habits” of  depression that serve to maintain a person’s limited self-view and reduces their chances of making  positive change.  By helping Sam to change the thought patterns supporting his negative self-fulfilling prophecy, he was able to open the door to positive change in his life. It also opened the door to pain management.
• Natural medicine therapies: Many people believe that treating depression requires altering brain chemistry.  This is one reason people seek prescribed medication in depression treatment.  We agree that at some level, every mood, thought and action involves a chemical aspect.  It is widely recognized that over-reliance on prescribed medication is not the most effective method of treating depression.  Moreover, there are many ways to impact the body’s chemistry without over-relying on prescription medications.  Sam met with our Naturopathic physicians and learned about natural therapies that supported healthier digestive and metabolic functioning of the body.  This nutritional and natural medicine support gave his body the nutrients it needed to support healthy brain functioning. With a brain that was metabolically healthier, he was able to put into practice some of the suggestions and skills he learned in his psychotherapy work.
• Self-regulation therapies: The ability to regulate one’s thoughts, emotions and behaviors is essential to healthy mental and emotional functioning.  Without self-regulation skills, we are at the mercy of our environment, reacting to whatever happens in our lives rather than actively shaping our life paths.  Learning to utilize self-regulation skills (e.g., hypnosis, biofeedback and meditation) was an important part of Sam’s overall depression treatment plan.  It also helped impact the psychological and physiological aspects of his pain disorder.
• Behavioral activation: We live in the world and not in our heads.  Therefore, an essential part of the Partners in Healing approach to depression treatment involves learning to weave the skills learned in therapy into the fabric of one’s life.  That was a critical part of Sam’s treatment process.  All three components of his therapy (i.e., psycho-therapy, self-regulation training and natural medicines) led to changes in how he conducted his life. The fourth element, the behavioral application of his skills, finally helped Sam to make a positive impact on his sleep cycle, his response to pain sensations, and his capacity to interact with his spouse and children in more satisfying ways. 

For more information on how Partners in Healing can help you with mood related conditions, please contact us at  763-546-5797.

By David Alter, PhD

*”Sam” represents a composite of several clients written so as to protect the privacy and confidentiality of the individual people the character “Sam” represents.

I often hear weight gain among the list of troubles of patients who are depressed.  Sometimes it’s just a few pounds, sometimes it is more.  Often, it is too many.  It makes sense that depression could lead to weight gain; being depressed makes it more difficult to get out of bed and be active.  Being depressed can make it harder to pay attention to what you are eating.  People who are depressed often turn to food to make them feel good or for more energy.  On top of this, gaining weight can lead to poor body image and self-esteem, which can leave people feeling more depressed.  

Research shows: Depressed people tend to gain more weight than those who aren’t depressed. Over 5,000 young people were followed for 20 years. Everyone-whether depressed or not – put on at least a few pounds.  BUT those who were depressed gained the most weight (particularly around the waistline). The study also showed that being overweight, does not necessarily lead to depression.*   

Weight gain and depression are complicated and can be influenced by a number of factors: 

Sleep Disturbances: Depression often causes a disruption of sleep and insufficient sleep can lead to depressive symptoms.  When tired, people turn to food for energy or can take in calories from late-night snacking. Insufficient sleep causes the excretion of ghrelin and leptin, which disrupt the sensations of hunger and feeling full so people might tend to eat more, and feel less full.  Not getting enough sleep also can cause increased fat storage. 

Stress: Stress moves us forward and helps cope with life's demands, but it also affects our mood and emotions.  When under stress our bodies store fuel, slow down metabolism and excrete cortisol and other hormones which are more likely to cause     obesity in the abdominal region.  Elevated cortisol levels also   increase appetite to help the body refuel after stressful times, so people with depression may eat more food – particularly high carbohydrate foods.  

Antidepressants: Unfortunately, weight gain is a side-effect of some anti-depressants; 25% of those on antidepressants gain weight.  Some people report they gain weight on anti-depressants because they start to eat and enjoy food more.  If a medication is effective but causes weight gain, the pressing need to getting depression under control may take precedence. There are antidepressants that are less likely to affect weight.  A conversation with your health care provider is recommended before you make any medication changes and to determine the best course of care.  Carbohydrate control can be a key component in weight control for those using psychotropic (i.e., mood altering) medications.   

Getting help:  

Losing weight is hard, and depression can make everything feel harder. Fighting depression while trying to lose weight can seem insurmountable.  Starting and making change is especially hard when depressed and therapy can be helpful with this.  If you are overweight, depressed or both, you can get help now.  Getting exercise is a prescription for depression and can allow you to sleep better.  A 20-minute walk not only helps to reduce levels of the “stress hormone” and lift the spirits, it burns extra calories. Bodywork, guided imagery, naturopathic work and hypnosis can all be helpful too.

In my practice at Partners in Healing, I incorporate psychological, behavioral and experiential tools and therapies into my work to address the complex interplay between depression and weight management challenges. 

By Alana Riss Fine, PhD

Did you know that children’s and adolescent’s behaviors can talk? 

• “I hate school!”

• “I forgot my homework—again.”

• “My stomach hurts; do I have to go to school?”

At the Institute for Brain Behavior Integration (IBBI) we believe that children and adolescents often use their behaviors to tell us that something is not quite right. Our brains are made up of a series of interacting modules:

• auditory and visual processing
• attention and memory
• complex problem solving
• reading and language
• motor skills

Learning requires these modules to work in concert in order to produce a written, oral, or behavioral response.  A breakdown in one of these areas can interfere with your child’s ability to learn and achieve academic success.  And, since children and many adolescents are not aware of how their brains work, they use their behaviors to communicate with their parents. Most often, defiance and noncompliance regarding homework can be ‘tip-off’s’ that they have an undiagnosed learning disability that can give rise to depression if not recognized.

How Can You Tell if Your Child or Adolescent May have a Learning Disability

Here are some simple clues:

• Poor Handwriting
• Tends to be clumsy
• Meltdowns while doing homework
• Reads in a slow and choppy manner
• Difficulty sounding out and spelling words
• Delays in fine and gross motor skills
• Family history of learning disabilities
• Speaks and/or writes in short, choppy sentences
• Homework is returned with many comments from the teacher

Substance Abuse, Depression & Learning

It is well documented that learning disabilities and substance abuse go hand-in-hand. Adolescents with an undiagnosed learning disability tend to personalize their academic underachievement rather than attribute it to how their brain processes information. They may develop depression-generating thoughts such as:

What’s wrong with ME? How could I be so stupid? I am such a loser.

When thoughts such as these go unchecked, they begin to take on a life of their own and can negatively shape a child’s self-perception. By adolescence, negative thoughts and habits may have become ingrained, affecting friend choices as well as their relationship with their parents. Adolescents with undiagnosed learning disabilities not only have higher rates of depression, their rate of substance abuse is also much higher than that of their peers.

How a Neuropsychological Evaluation Can Help

An evaluation at the Institute for Brain-Behavior Integration can be an important step in putting your child or adolescent back on a path to success.  IBBI evaluations focus on the pathways between brain functioning and daily behavioral functioning. We work to identify resources that help clients improve day-to-day functioning by improving the integrative functions of the brain through various therapy tools we utilize. This can result in positive changes to school performance, relationship health in families and with peers, and benefit social relating skills. 

By Nancy Foster, PhD

It can be difficult to tell the difference between sadness and depression in children and adolescents because they share many common features. For example, a loss of interest in usual activities, sleep problems, body aches and pains, and problems in school or with peers are some of the more typical problems seen in children and adolescents who are either sad or depressed. However, feeling sad is a normal reaction to a loss or an unexpected stressor, such as the death of a grandparent or an impending transition (e.g., moving or changing schools).

For children who are sad, behavioral symptoms are usually time-limited because children typically have the internal resources to manage their feelings and to move beyond their sadness. On the contrary, for children and adolescents who are depressed, these symptoms may last two or more weeks. In other words, they don’t just ‘get over it’.  It is difficult for them to see the light at the end of the tunnel. This is also true for children and teens who live with chronic or life threatening illnesses, or those who have experienced significant trauma in their lives.

As a child and adolescent therapist, part of my job is help parents and their children to distinguish between sadness and depression. One critical distinction between the two is the presence of suicidal thoughts and plans. It is also important to determine how long the child has been experiencing these emotional and behavioral symptoms. This is why I place an emphasis on partnering with parents because they often provide useful information. Their observations are critical to understanding a child’s or adolescent’s mood and how the  family functions. After all, children live in families!

Three Effective Treatment Strategies

In my practice, I integrate three effective strategies that help children and adolescents to cope with their depression.

1. Self-hypnosis—a tool used to help children create a shift in their thinking and to manage negative moods
2. Biofeedback—can show children how their bodies react to negative thoughts.
3. Creative Expressive Therapies—depending on the child’s interests, I like to integrate drawing, play, and expressive writing into the therapeutic process

The Treatment Benefits

Helping children and adolescents learn new ways of coping has many positive and lasting effects:

• less family conflict
• increased school attendance
• better academic performance
• more positive social interactions
• alleviation of aches and pains
• improved coping strategies

If you are having a difficult time determining if your child is sad or depressed, make an appointment to partner with me to help your child address their concerns.  Call me at 763-546-5797.

By Harriet Kohen, MSW, LICSW

It is not surprising that many women and some men suffer from depression and anxiety when faced with fertility challenges.  The ups and downs of infertility and its treatment drain the spirit right out of people.   I hear daily the intensity of the experience, “This is personal.  I feel invisible in the world.  This is physical.  I hate my body.  I am demoralized and afraid.  This is expensive.  I have no control and I feel out of control.  This has taken over my life.  I’m so worried about my relationship.” 

Some women have mood consequences from using birth  control pills and ovarian stimulation medication, on top of the fear of not having a child.  For many of the people I see, the following “formula” captures their experience: 

Uncertain Outcome of Procedures + Uncertain Length of Time + Internal/External Pressure + Medications + Fear = DEPRESSION and ANXIETY. 

It is important to distinguish between depression and grief when dealing with fertility challenges.  Grief hurts but it does not lead the thinking process toward self-hatred and negative thinking.  Depression is a heaviness all its own. 

Help is Available at Partners in Healing

Our integrated fertility team at Partner in Healing can help.  We provide:

1. Specialized counseling for individuals and couples who are suffering from fertility challenges, that includes hypnosis, cognitive behavioral therapy, and EMDR (Eye Movement Desensitization and Reprocessing); 
2. Acupuncture and Chinese medicine;
3. Naturopathic medicine and nutritional counseling; and
4. Medical massage aimed at reclaiming your body from the rigors of treatment.  We collaborate with national and local leaders specializing in fertility treatment. Let us help you regain your sense of wholeness and rebuild hope as you build your family. 
   

By Deborah Simmons, PhD, LMFT

There are many nutrients that can help to improve overall mood and depressive symptoms. A recent study published by the American Journal of Clinical Nutrition looked at vitamin D intake from foods and supplements in 81,189 postmenopausal women from the Women’s Health Initiative. It found that women with higher amounts of vitamin D in their diet may lower their risk of having depressive symptoms by as much as 20%.   Vitamin D is thought to affect the function of dopamine and norepinephrine neurotransmitters involved in depression. They conclude that “improvement of vitamin D status holds promise for the prevention of depression, the treatment of depression, or both.”

Taking a deeper look at vitamin D, we know that it is a fat-soluble vitamin known as the “sunshine vitamin.”  Our bodies can produce vitamin D when our skin is exposed to ultraviolet sunlight. Vitamin D can also be obtained from our foods and is primarily found in oily fish such as salmon, mackerel, tuna and sardines and other animal sources such as liver, beef, veal, and eggs. Other food options for vitamin D sources include foods that have been fortified with vitamin D such as cereals, yogurt, milk, and orange juice.

Dietary intake of vitamin D may not be enough to maintain a healthy level of vitamin D in the body and therefore regular   supplementation may be needed to support adequate levels. In addition, it is important to have your serum vitamin D levels monitored as vitamin D can accumulate in the liver and fat cells. Groups of people that are more at risk for vitamin D deficiency include breastfed infants, older adults, people with limited sun exposure (such as Minnesotans in the winter), people with dark skin, obese people, gastric bypass patients, and people with medical conditions that cause fat malabsorption, such as those with liver disease, Crohn’s disease, and cystic fibrosis.

There are a variety of effective natural therapies for the treatment of depression and vitamin D may play an essential role. Call Partners in Healing at 763-546-5797 and make an appointment with your Naturopathic Doctor (Dr. Nate or Dr. Nita   Champion) to have your vitamin D levels checked to ensure healthy levels for disease prevention and to optimize the health of your mind, body, and overall mood!

By Nate Champion, ND & Nita Champion, ND