P: What can I do if I suffer from “Jet Lag” while traveling abroad?

R: If traveling west to the USA, for example, you will arrive say in New York at 1:00pm while your internal clock tells you it’s 7:00pm. You are facing a long day ahead and may feel like going to bed before the people in New York usually go to bed. You need what’s called a phase delay! What can you do?
During the flight:

• Drink liquids frequently (especially water, avoid alcohol), because dehydration increases some of the symptoms of jet lag.
• Take a short nap if you’re feeling tired. You can program it according to the necessity of alertness at your arrival (immediately after waking from nap there is a transient period of up to an hour when performance is diminished).
• Don’t eat too much; have little snacks (especially at the end of the trip in case you have to be alert). Small snacks won’t cause that post-meal excess of sleepiness.

• Get exposed to bright, natural light.
• Take a short nap at a time that would be nighttime in Madrid (two hours before dinner, for example).
• If you have to stay alert during the afternoon and cannot afford to rest, do some intense exercise (better outside), or at least exercise for 45 minutes to an hour. This will delay the release of melatonin and increases body temperature.
• Delay dinnertime, but eat 1 to 2 hours earlier than New Yorkers.
• Eat a meal rich in proteins, which activate arousal, but will also help you stay asleep. Avoid meals high in carbohydrates.
• Go to bed 1 or 2 hours earlier than you would if you were following the local schedule.
• Taking melatonin at 8pm local time on arrival day could help with the phase advance. It should be taken an hour later each day after arrival. The last day will be the day you take it at 6:00am.
• If you have problems sleeping, take your usual dose and type of sleeping pill or, if you have never taken one, consult your doctor.

• Stay awake, try not to take a nap. To help you do this, drink a caffeinated beverage before you get on the plane. Walk frequently up and down the aisle once you‘re aboard, and avoid copious meals and alcoholic drinks.
• Drink liquids frequently; dehydration could make things worse.
• During the second half of the trip, if the light on the plane is strong, put your sunglasses on so that your retinas receive less intensity.
• Take melatonin at 8pm local time.

• Continue wearing your sunglasses if you’re going to be exposed to bright light or, if possible, avoid exposure to bright light altogether.
• An hour or more before going to bed, eat a meal rich in carbohydrates or drink some warm whole milk.
• Avoid any activity or substance than could make you more alert.
• Take a sleeping pill to help you fall asleep (consult your doctor).
• If possible, delay the time that you wake up by one hour or more so that you’ll get closer to a normal amount of rest.
• Get exposure to bright light in the afternoon local time (12:00pm-6:00pm); it will advance the internal clock.
• Avoid natural light between 7:00am-11:00am local time; it could cause a phase delay.
• Melatonin should be taken an hour earlier each day after arrival. The last day will be the day you take it at 3:00pm.

Q. Some days I feel I can’t control my anxiety about things that are happening in my life. Do I have an anxiety disorder?

 A. A certain level of anxiety is a necessary part of most days. This anxiety is considered normal because while it is still experienced as “stress”, it is manageable.  However, if your anxiety gets to be too intense, persistent, or begins to interfere with your normal daily activities, you may want to consult a professional to learn anxiety management.

Q. I’m feeling down; how can I tell if my sadness is normal or if it’s a depressive disorder?

A. All of us have days when we feel down. Usually, it doesn't last, and the following day we're feeling better. Even when it’s been a bad day, we can still find enjoyment in things. These bad days are part of life and not considered “depression”. Remember, in order to give a diagnosis of depression, you must have at least 5 of the following symptoms every day, or almost every day, for a period of two weeks: Depressed mood- feeling “sad” or “empty” (can be irritability in children), a decrease in interest or pleasure experienced in daily activities, weight changes, sleep disturbances (sleeping too much or too little), feelings of worthlessness or guilt, fatigue, a decrease in ability to concentrate, problem solve and make decisions, and thoughts of death or suicide. These symptoms will be intense enough to interfere with your ability to function on a daily basis.

Sometimes the sadness may be the result of an event such as a break-up or death of a loved-one. While you may have some of these symptoms of depression, you most likely don’t have major depression, but you may still want to seek professional help to minimize the duration of these symptoms.

FREQUENTLY ASKED QUESTIONS ABOUT ADDICTION

Q. Is recovery possible?

A. Studies done on the treatment of addictions show that there are different degrees of effectiveness depending on the type of addiction in question (a substance or an activity). In general, a person's motivation for quitting an addictive substance (alcohol, tabacco, cocaine...) or an addictive behavior (gambling, sex, Internet...) is a key factor that the probabilty of recovering will depend on. In therapy, at times it's necessary to begin working on generating motivation when it's observed that it is lacking.

Furthermore, in some cases relapse can be a normal part of the recovery process, meaning that those that relapse can still recover, it will simply take longer.

Q. Is it an addiction or a disease?

A. An addiction is something that usually has a negative social stigma. Howver, addictive substances (alcohol, tabacco, cocaine...) have addictive components that a person becomes dependent on and that they need in their system in order to eliminate symptoms of withdrawal (which differ depending on the substance). Those that are addicted to an activity such as gambling, etc., have simialr behavioral patterns to those that are addicted to substances especially when it comes to loss of control over their behavior.

All addictions are considered psychological problems and there are psychological and medical treatments available to help with recovery.

Q. Am I not quitting because I don't want to or because I can't?

A. While it's true that there are some people with an addiction that do not have the motivation necessary at a given moment to quit (whether it's a substance or an activity), it's also true that even when a person is highly motivated, recovery is not an easy process and usually requires the guidance of a professional. The probability for recovery increases when the person has high motivation and seeks the help of a professional.