Overly Controlling Moms Lose Out, Study Says

Helicopter parents, take note: A mother has a better relationship with her child if she respects the youngster's need for independence at a young age, a new study suggests.

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Mothers who allowed children more freedom at age 2 were viewed more positively by their children later in childhood, according to the University of Missouri study.

The study included more than 2,000 mothers and their children. The researchers observed how much the mothers controlled the children's play at age 2 and then interviewed the children at fifth grade to assess how they felt about their mothers.

"When mothers are highly controlling of small children's play, those children are less likely to want to engage with them," Jean Ispa, co-chair of the department of human development and family studies, said in a university news release.

 

 

Respect for independence is important both for children's growth and for creating positive parent-child relationships, she said. "We found that mothers who supported their children's autonomy were regarded more positively by their children than mothers who were highly directive," she said.

RELATED: Being a Good Parent Without Judging Other Parents

"Mothers who are very directive when their children are toddlers often tend to still be controlling when their children enter adolescence," Ispa noted.

Mothers with small children mostly use physical controls, she said, but when children are older these directives become more verbal and psychological -- not allowing kids to speak their mind, for instance. "It's not surprising that their children begin to view them in a negative light," Ispa said.

The findings, published online recently in the journal Social Development, don't mean that parents should not establish and enforce rules or offer advice, Ispa said. She noted that behavioral rules -- such as teaching children to check for cars before crossing the street -- did not have a negative impact on mother-child relationships.

It was psychological control -- such as inducing guilt or telling children what to think and feel, or to play in certain ways -- that damaged mother-child relationships, the study found.

 

 

"Many times, parents think that employing these controlling behaviors is the 'right way' to raise children, but our research shows that really does not work," Ispa said.

"Allowing children age-appropriate levels of autonomy to make safe decisions is very good for kids, and they usually will make wise decisions when they have been taught about safe choices as well as consequences," she added.

"A good place for parents to start would be to have open discussions and allow their children to express their own points of view," she suggested. "When giving children instructions, explain reasons for decisions rather than simply saying, 'Because I said so.' "

Fighting Off Fatigue

You might write off a feeling of fatigue to doing too much. You work, run a home, raise kids, volunteer in your community — all of these activities can leave you feeling overtired, you tell yourself as you collapse on the sofa.

But there’s fatigue, and then there’s chronic fatigue, a feeling of exhaustion that probably signals a medical condition and needs a doctor’s evaluation to help you start feeling like your old self again.

Chronic Fatigue: A Better Health Plan

If you experience a level of fatigue that leaves you exhausted at the end of the day, but is not so severe that it’s keeping you from living your normal life, making a few healthy lifestyle changes may help. Try taking these steps:

  • "Pick a stress-relieving habit," says Donna Jackson Nakazawa, author of The Autoimmune Epidemic, "Try daily meditation, a brisk morning walk, yoga, or all three. Stress suppresses the immune system.”
  • Avoid processed foods full of chemicals, preservatives, and additives.
  • Avoid heavy meals, alcohol, and caffeine in the evening, which can keep you from getting a good night’s sleep. Sleep disturbances are common in people with chronic fatigue.
  • Follow a regular exercise program, which has been shown to relieve symptoms of fatigue.
  • Get help for depression. Cognitive therapy, a non-medical way of treating depression, has also been shown to be effective in treating chronic fatigue.
  • If you're still menstruating, to avoid anemia eat foods high in iron, such as liver, lentils and beans, and green leafy vegetables, . Remember that vitamin C helps your body absorb iron, so be sure to include fruits and vegetables high in vitamin C in your diet.

 

 

Chronic Fatigue: What Can Cause Exhaustion

If your fatigue is more than garden-variety tiredness, a visit to your doctor can help pinpoint a cause. About 40 percent of people who have symptoms of chronic fatigue turn out to have a treatable, underlying medical condition, such as:

  • Anemia. Anemia occurs when you don't have enough red blood cells or when your red blood cells are not carrying enough oxygen. Some common causes are loss of excessive amounts of blood during menstruationautoimmune diseases, dietary iron deficiency, and vitamin B-12 and folate (another B vitamin) deficiencies. The most common symptoms of anemia are fatigue and weakness; other symptoms are dizziness, headache, and low body temperature.
  • Depression. Studies consistently show that depression is twice as common in women as in men, and tends to last longer and be more serious. About 10 percent of women experience depression during pregnancy, and 10 to 15 percent in the postpartum period. A very common symptom of depression is constant fatigue; other symptoms include sadness and difficulty concentrating.
  • Stress. Stress can have serious effects on your health. Short-term stress and long-term stress have both been shown to cause trouble sleeping, lack of energy, and lack of concentration.
  • Thyroid disease. An autoimmune disease of the thyroid gland called Hashimoto's thyroiditis is a common cause of fatigue in women. When working correctly, your thyroid gland produces hormones that give you energy. When your thyroid gland is under-functioning because of an autoimmune attack, one of the main symptoms is fatigue; others include depression, low body temperature, dry skin, and weight gain.

Chronic Fatigue: When It’s Chronic Fatigue Syndrome

Fatigue means being too beat to go to the movies or shopping, or to engage in any number of the other normal activities you're used to. With chronic fatigue syndrome (CFS) you might be struggling to get through each day; for some people it can get bad enough that even holding down a job becomes difficult, forcing them to consider going on disability leave.

 

 

The Centers for Disease Control and Prevention says that between 1 and 4 million Americans have chronic fatigue syndrome. It is four times as common in women as men and usually begins in the childbearing years, although in rare cases it may occur in teenagers.

At this time, there are no tests to diagnose chronic fatigue syndrome. Your doctor can only diagnose CFS when other medical conditions known to cause fatigue are ruled out. Doctors call this "a diagnosis of exclusion."

The most debilitating symptom of CFS is severe, unexplained, persistent fatigue, lasting six months or more. It’s a fatigue that doesn’t go away after rest or sleep and keeps you from doing at least half the things you would normally do each day. To make the diagnosis, doctors will also look for four or more of the following symptoms:

  • Poor concentration or memory loss
  • Sore throat
  • Swollen lymph nodes
  • Muscle aches
  • Joint pain
  • Headache
  • Tiredness not relieved by sleep
  • Tiredness lasting more than 24 hours after exertion

Chronic Fatigue Syndrome: Possible Causes

Just what causes chronic fatigue syndrome is still unknown. Originally, scientists thought that being infected with certain viruses, especially the Epstein-Barr virus that causes mononucleosis, might be at the root of CFS, but there have been no conclusive findings. Now researchers are looking at whether inflammation brought on by an abnormal, overactive immune response occurrs in the nervous system of those with chronic fatigue.

Nakazawa believes that shifts in our 21st-century lifestyle, including daily exposure to toxins, pesticides, heavy metals, chemicals in our processed-food diets, and modern stress levels, are partly responsible. "Scientists who study autoimmune disease have called this epidemic 'the global warming of women's health,'" she says.

Advises Nakazawa, "At the same time that you work to lessen exposure to things that might overwhelm your immune system, you also need to relax and find joy in the world every day. How optimistically you perceive the world around you also impacts your stress level and your well-being."

Best Ways to Beat Dry Skin

Dry, itchy skin is no joke. Because skin is the body's largest organ (weighing about nine pounds), the frustration and discomfort that go along with dehydration can affect your daily existence, from your wardrobe to your social life. And if you happen to have a skin condition like eczema, you know from experience that flaky skin is no laughing matter.

However, you can fight flakiness and itchiness with a few important tips. Here, skin experts share their best advice for keeping your skin soft and supple.

Find the Right Exfoliator

Exfoliating can be beneficial for those who have dry skin because it helps the dead surface layers of skin cells to be shed, layers that can prevent moisturizers from being absorbed, says Doris Day, MD, a clinical assistant professor of dermatology at New York University Medical Center.

The key is to find the exfoliator that works best for your skin. Scrubs and alpha-hydroxy and beta-hydroxy acids are best for those who don't have sensitive skin. Those with sensitive skin can exfoliate with a home remedy that consists of a paste made from baking soda and water. “It’s great for your face or for rough patches like your heels, and nobody breaks out from it,” says Mona Gohara, MD, an assistant clinical professor of dermatology at Yale University.

Note that if you have any skin conditions, it’s best to check with a dermatologist before trying anything new. And beware of exfoliating too often because it can cause irritation.

Don’t Wash Too Often

 

 

Like exfoliating too much, washing too often can lead to dryness. “I usually tell people to use soap only where they need it — underarms, groin, hands and feet,” says Rebecca Baxt, MD, a dermatologist in Paramus, New Jersey.

Take a Lukewarm Shower

 

 

“Hot showers can strip the skin of oil and leave skin dry,” says Joshua Zeichner, MD, the director of cosmetic and clinical research in the department of dermatology at Mount Sinai Hospital in New York City. Although hot showers are relaxing, fight the urge to parboil yourself and use lukewarm water instead. Also, limit the length of your showers to 10 minutes or less.

Moisturize Every Day

Using a moisturizer daily is crucial to combating dry, flaky skin. “When the skin is dry, it needs to be hydrated from the outside in — drinking eight glasses of water is not enough,” says Dr. Day.

For the most effective moisturizer, look for ingredients, including ceramides, that help support and replenish lipids in the skin. Hyaluronic acid and glycerin, both humectants, help the skin attract water and hold in moisture. Additionally, Dr. Zeichner recommends that, to help seal in moisture, you apply moisturizer to damp skin after showering.

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U.S. Cancer Death Rate Continues to Fall

More Americans are surviving cancer than ever before, but as the population ages, even more will develop the disease.

That's the good and bad news from the 2017 Cancer Progress Report from the American Association for Cancer Research, released Wednesday.

According to the report, the cancer death rate dropped 35 percent among children and 25 percent among adults from 1991 to 2014. That translates to slightly more than 2 million fewer cancer deaths.

On the flip side, new cancer diagnoses are predicted to rise from nearly 1.7 million this year to 2.3 million in 2030, said the association's president, Dr. Michael Caligiuri.

And this year alone, more than 600,000 Americans are predicted to die from cancer, according to the report.

Caligiuri said the increase in cancer cases is simply a consequence of more people living longer. As the report noted, 53 percent of U.S. cancer diagnoses occur among those aged 65 and older, and that population segment is expected to grow from about 49 million in 2016 to just over 74 million in 2030.

"The longer people live, the higher the incidences of cancer are going to be," Caligiuri said.

"The longer you live, the more likely are the chances for serious genetic mutations that cause cancer, and the weaker your system is in repairing your DNA when you do have those genetic changes," he explained.

Dr. Anthony D'Amico is a professor of radiation oncology at Harvard Medical School in Boston. He said, "The most likely explanation for the progress in cancer survival is a combination of advances in cancer treatment coupled with early detection through screening."

The AACR report noted that death rates for many of the most commonly diagnosed cancers in the United States -- including breast, colorectal, lung and prostate cancer -- have been declining for more than a decade. But deaths from other forms of cancer -- brain, liver and uterine cancer -- have been increasing.

RELATED: 'Cancer Pen' Could Help Surgeons Spot Tumor Cells in Seconds

And progress has not benefited every American equally, the researchers noted. Disparities in cancer care continue between whites and blacks, the insured and uninsured, the poor and the elderly.

But there is progress in treatment. Between August 2016 and July 2017, nine new anticancer drugs were approved by the U.S. Food and Drug Administration, the report said. In addition, the FDA approved the use of eight existing drugs for fighting new cancers.

Two of the new drugs are immunotherapeutics, called checkpoint inhibitors. These treatments increase survival and improve the quality of life for patients with many types of cancer.

Progress was also seen in drugs that target specific cancer molecules. In fact, seven of the new drugs do just that, the researchers said.

The FDA also approved a new optical imaging agent to help doctors see brain tumors and more accurately guide their removal.

The keys to more progress in preventing and curing cancer include basic science to understand the biology of cancers, Caligiuri said, then making those findings relevant to cancer treatment through animal and early human trials. Next comes testing on many people to see how safe and effective these new treatments are, he added.

In addition, more studies are needed to better understand the risks for cancer and to develop ways to lower those risks. These include lifestyle changes -- such as not smoking, eating a healthy diet and exercising -- and screening to detect cancer early.

On the cancer prevention side, cigarette smoking declined by nearly 39 percent from 2000 to 2015, which should mean fewer cases of lung cancer in the future, the report said.

The researchers also said that, in the future, nearly all cases of cervical cancer and many cases of oral and anal cancer could be prevented if girls and boys received the human papillomavirus (HPV) vaccine.

Yet, only 63 percent of girls and fewer than 50 percent of boys had received at least one dose of HPV vaccine in 2015, the study reported.

According to D'Amico, "There is still a lot more to do, but we are going in the right direction in terms of discovery, screening and biology."

Cancer is not an inexpensive disease. Direct medical costs in 2014 were nearly $88 billion, the report said. This does not include the indirect costs, such as lost productivity from cancer-related care and death.

Yet the U.S. National Institutes of Health (NIH) received only $30 billion in funding for 2014, Caligiuri said. And of that total, only about $5 billion went to the U.S. National Cancer Institute.

Not surprisingly, Caligiuri believes that both the NIH and the FDA need more money to spend on cancer research and treatment if further progress in the fight against cancer is going to happen.

"The limiting step for more progress against this beast called cancer is funding," Caligiuri said. "The data clearly show that when we have the funding, we can make phenomenal progress."

Breast Cancer Awareness Month 2017

October is Breast Cancer Awareness Month, an annual campaign to raise awareness of breast cancer risks, the value of screening and early detection, and treatment options available to women and men who are diagnosed with one of the many forms of breast cancer. More than 249,000 people in the United States are diagnosed with invasive breast cancer every year, and nearly 41,000 die from the disease.

Over the years, a loop of pink ribbon has come to symbolize breast cancer awareness, and today the image of a pink ribbon can be found emblazoned on thousands of products, from apparel to dishware to office supplies. But there's more to awareness than just wearing pink.

Obesity Linked to 13 Types of Cancer

There's a link between obesity and 40 percent of all the cancers diagnosed in the United States, health officials reported Tuesday.

That doesn't mean too much weight is causing all these cancer cases, just that there's some kind of still-to-be explained association, according to the U.S. Centers for Disease Control and Prevention.

Still, the study findings suggest that being obese or overweight was associated with cancer cases involving more than 630,000 Americans in 2014, and this includes 13 types of cancer.

"That obesity and overweight are affecting cancers may be surprising to many Americans. The awareness of some cancers being associated with obesity and overweight is not yet widespread," Dr. Anne Schuchat, CDC deputy director, said during a midday media briefing.

The 13 cancers include: brain cancer; multiple myeloma; cancer of the esophagus; postmenopausal breast cancer; cancers of the thyroid, gallbladder, stomach, liver, pancreas, kidney, ovaries, uterus and colon, the researchers said.

Speaking at the news conference, Dr. Lisa Richardson, director of CDC's Division of Cancer Prevention and Control, said early evidence indicates that losing weight can lower the risk for some cancers.

According to the new report from the CDC and the U.S. National Cancer Institute, these 13 obesity-related cancers made up about 40 percent of all cancers diagnosed in the United States in 2014.

RELATED: U.S. Cancer Death Rate Continues to Fall

Although the rate of new cancer cases has decreased since the 1990s, increases in overweight and obesity-related cancers are likely slowing this progress, the researchers said.

Of the 630,000 Americans diagnosed with a cancer associated with overweight or obesity in 2014, about two out of three occurred in adults aged 50 to 74, the researchers found.

Excluding colon cancer, the rate of obesity-related cancer increased by 7 percent between 2005 and 2014. During the same time, rates of non-obesity-related cancers dropped, the findings showed.

In 2013-2014, about two out of three American adults were overweight or obese, according to the report.

For the study, researchers analyzed 2014 cancer data from the United States Cancer Statistics report and data from 2005 to 2014.

Key findings include:

Of all cancers, 55 percent in women and 24 percent in men were associated with overweight and obesity.
Blacks and whites had higher rates of weight-related cancer than other racial or ethnic groups.
Black men and American Indian/Alaska Native men had higher rates of cancer than white men.
Cancers linked to obesity increased 7 percent between 2005 and 2014, but colon cancer decreased 23 percent. Screening for colon cancer is most likely the reason for that cancer's continued decline, Schuchat said.
Cancers not linked to obesity dropped 13 percent.
Except for colon cancer, cancers tied to overweight and obesity increased among those younger than 75.
The new report was published online Oct. 3 in the CDC's Morbidity and Mortality Weekly Report.

Dr. Farhad Islami is strategic director of cancer surveillance research for the American Cancer Society.

He said it's "important to note that only a fraction of the cancers included in the calculation in this report are actually caused by excess body weight."

According to Islami, "many are attributable to other known risk factors, like smoking, while for many others, the cause is unknown. Obesity is more strongly associated with some cancers than others."

The World Cancer Research Fund estimates that "20 percent of all cancers in the United States are caused by a combination of excess body weight, physical inactivity, excess alcohol, and poor nutrition. The American Cancer Society is currently doing its own extensive calculation of the numbers and proportions of cancer cases attributable to excess body weight, the results of which will be published soon," he said.

11 Struggles Every New Runner Understands

I've never been one of those people. You know the kind, the ones who wake up in the morning or lace up in the evening and "go for a run."

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I've always been envious of my roommates, who can sneak in a jog with ease and carry on with their day, as if they had done something casually simple like taking the trash out. So, I made a vow to give running another chance. After all, the exercise has been shown to make you happier, reduce your risk for disease and even increase longevity.

While group classes and long walks will probably always be more my speed, I did find that I was enjoying running more than I ever did in the past. However, that doesn't come without a few hiccups. Below are a handful of struggles all new runners can probably relate to.

Getting winded in the first few minutes.

Probably one of the most discouraging elements of getting into a running routine is realizing that you're not as in shape as you thought you were. I continuously find myself doing more walking or jogging than actual running. But just because you need those intermittent breaks doesn't mean you aren't a runner. In fact, research shows that walking intervals during your run can help you maintain your overall pace.

Two words: Sore. Muscles.

The second-day pain is real. If you're experiencing those achy muscles, try one of these post-run remedies. Just make sure you're checking in with your body as you establish your routine. A little soreness is OK, but if the pain is more intense you may have sustained a running-related injury.

 

 

Feeling overwhelmed by the copious amount of races.

Color runs, beer runs, zombie runs, princess half marathons... the list is seriously endless. However, there are some perks to picking a race. Signing up for one helps you set a goal as you get into a routine, plus there's an opportunity to turn it into a social event by participating with your friends.

If your goal is to become a marathon runner (and props to you!), there are also some benefits there: Research shows consistent long-distance running can improve cardiovascular health and lower the risk for other organ disorders, the Wall Street Journal reported.

The jolting agony of waking up at 6 a.m.

My sleepy brain is constantly telling me my bed feels better than running (and often, the bed wins). If you need a little extra motivation, try one of these hacks to help you jumpstart your morning workout.

The boredom.

Part of the reason I never got into a routine in the first place was because the exercise itself seemed extremely dull to me (the treadmill is my arch-nemesis). Once I discovered more running-path options, I started to have more fun. However, that's not to say that I don't get a little bored sometimes — and that's OK.

Note: If you still just can't get excited by the process most of the time, you may want to try a more entertaining workout option instead. Exercise should be engaging, not mind-numbing.

Trying to find your perfect route.

Finding your favorite place to run is like finding a good apartment: It feels elusive until one day you hit the lottery. Whether you're into lush scenery or a skyline, it's important to find the routes that work for you in order to make the exercise entertaining.

The joy of picking out new workout clothes.

Sleek tanks! Compression pants! Neon shoes!

Running toward (multiple) "finish lines."

If you've ever uttered to yourself just one more pole, you're not alone. In fact, picking out an arbitrary finish line on your run can improve your performance. Research shows those who stare at a target in the distance go faster and feel less exertion than those who don't concentrate on anything, The Atlantic reported.

 

 

Bargaining with yourself on your run.

If you run five more blocks, you can binge-watch Scandal when you get home, I tell myself. Chances are I'd probably do it anyway — but at least it encourages me in the moment.

Creating a playlist that will consistently keep you motivated.

No, a simple music-streaming app won't do when your lungs are on fire and your legs feel weak. You need that one specific song that will inspire you to keep going (shout out to all my Shake It Off comrades). If you're looking for a playlist to spice up your run, check out some of these.

Eating Well As You Age

Looking in the mirror for changes as you age? A healthy diet helps to ensure that you'll like the reflection you see. Good nutrition is linked to healthy aging on many levels: It can keep you energized and active as well as fight against slowing metabolism and digestion and the gradual loss of muscle mass and healthy bone as you age.

Making healthy diet choices can help you prevent or better manage chronic conditions such as high blood pressure, high cholesterol, and diabetes. It's never too late to adopt healthier eating habits.

Strategies for Healthy Eating as You Age

Replace old eating habits with these healthy approaches:

  • Eat every three or four hours. “This keeps energy levels high and keeps appetite hormones in check to avoid overeating,” says Kim Larson, RD, of Total Health in Seattle and a spokesperson for the Academy of Nutrition and Dietetics.
  • Eat protein at each meal. Aim for 20 to 30 grams to help maintain muscle mass. Choose fish at least twice a week as a source of high quality protein. Other good sources of protein include lean meat and poultry, eggs, beans, nuts, and seeds.
  • Choose whole grains. Replace refined flour products with whole grains for more nutrients and fiber.
  • Choose low-fat dairy. Cutting out the saturated fat may help lower your risk for heart disease.
  • Learn about portion sizes. You may need to scale back on the serving sizes of foods to control your weight.
  • Choose nutrient-rich whole foods over empty calories. Whole foods are those closest to their natural state. Empty calories are typically processed foods with added salt, sugar, and fat. For example, snack on whole fruit instead of cookies.
  • Eat a “rainbow” of foods. “Eat five to seven servings of fruits and veggies each day to keep antioxidants like vitamins A, C, and E high,” Larson says. Choosing fruits and vegetables of different colors provides your body with a wide range of nutrients. According to research published in the May 2012 issue of the Journal of the American Geriatric Societyexercise coupled with higher fruit and vegetable intake led to longer lives. Fruits and veggies also fill you up with fiber, which cuts down on snacking and helps control weight, Larson says.
  • Choose healthy cooking techniques. Try steaming, baking, roasting, or sautéing food rather than frying it to cut back on fat.
  • Cut down on salt. If you’re over 51, national recommendations are to eat less than 1,500 milligrams of salt per day. Look for low-sodium foods and season your meals with herbs and spices rather than salt.
  • Stay hydrated. “Dehydration can cause irritability, fatigue, confusion, and urinary tract infections,” Larson says. Be sure to drink plenty of water and other non-caffeinated liquids throughout the day.
  • Ask about supplements. You may have changing nutrient needs as you get older and might benefit from vitamins B12 and D, calcium, and omega-3 fatty acid supplements, Larson says. Ask your doctor or a dietitian for guidance.

Overcoming Challenges to Healthy Eating

Eating a healthy diet can be complicated by changes you may face as you age, such as difficulty eating or a limited budget. There are strategies you can try to solve these common challenges:

  • If you've lost your appetite or sense of taste: Try new recipes and flavors — adding spices, herbs, and lemon juice can make foods more appealing. If you take medication, ask your doctor if appetite or taste changes are side effects and if switching to another drug might help.
  • If you have a hard time swallowing or chewing: Choose foods that are moist and easy to eat, such as nutritious soups made with beans and vegetables, Larson says.
  • If affording groceries is difficult: Shop from a list — careful planning can help you make the healthiest and most cost-effective food choices. Use coupons or shop on days when discounts are offered. Buying fruits and veggies when they’re in season and frozen produce in bulk can also help control expenses.
  • If you have trouble preparing meals: Consider buying healthy prepared or semi-prepared meals or at least pre-cut ingredients to cut down on energy-draining prep time.

Larson believes in the importance of enjoying your food. Make healthy-diet changes step by step and have fun experimenting to find new tastes and cooking styles. Eat slowly and pay attention to the experience. “Create a pleasant eatingenvironment," she says. "Sit by a window and enjoy every bite.”

What You Need to Know About Hyperpigmentation

Even small skin traumas like a pimple or bug bite can leave you with complexion-busting dark spots. “This is one of the most common ailments that patients come to see me about,” explains Jeanine Downie, MD, director of Image Dermatology in Montclair, New Jersey. “It’s an annoying condition that affects all skin types, but the good news is that it’s fairly easy to treat.”

Find out how Dr. Downie helps patients treat and avoid marks on their complexions.

Everyday Health: What causes hyperpigmentation?

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Jeanine Downie: Any trauma or inflammation to the skin — either from acne, pimples, bug bites, or simply a bump, cut, or scratch — disrupts the surface layers where you have melanin, responsible for skin’s color. As the skin heals, it leaves behind residual pigmentation and dark spots.

 

 

 

EH: Is there anything you can do to prevent it?

JD: Unfortunately, if you’re prone to these dark spots, it’s tough to prevent them. Still, picking or scratching at an irritation will further traumatize the area, so hands off! You’ll also want to be vigilant about wearing sunscreen. As your skin gets darker, so will those hyperpigmented areas — it’s not like a tan is going to even out the color. Obviously, daily sunscreen wear is a must anyway, but this is just one more reason to protect your skin from UV rays.

EH: What steps can you take to treat it?

JD: The sooner you start taking care of your wound, the better it’ll look once healed. I recommend keeping the wound covered, especially if the skin is broken, and applying a topical healing ointment.

 

 

For large cysts or cuts, you may even want to see your dermatologist for a treatment plan. Once the pimple or cut has healed, apply 2% hydroquinone cream, which is available over-the-counter, or 4% hydroquinone, available by prescription from your doctor.

If the topical creams don’t quite do the trick, talk to your dermatologist about chemical peels or laser treatments to completely eliminate more stubborn discoloration.

EH: Is hyperpigmentation more common in people with darker complexions?

JD: No matter your skin color, everyone is susceptible to hyperpigmentation. Still, those with darker complexions seem to hold on to those spots for much longer because they have more melanin in their skin. It also means those hyperpigmented areas are going to be darker and more visible as well. Pregnancy and certain medications can increase your body’s production of melanin, and lead to hyperpigmentation as well.

6 Ways to Prep Your Skin for Summer

Scheduling vacation plans and buying a new swimsuit will mentally prepare you for summer, but your skin may need some help getting ready, too. For gorgeous, smooth skin you'll feel ready to bare, you need to take a few simple steps. Try this head-to-toe refresher to take your skin out of hibernation.

1. Reveal Glowing Skin

Regular exfoliation can be a part of a healthy skin regimen no matter the season; as long as your skin is not sensitive, exfoliation can help you achieve smooth, healthy-looking skin that makes you look more glowing and youthful. “But it must be done with care,” says Doris Day, MD, a dermatologist in New York City. “The goal is to lift off the outer layer of skin cells that are ready to be sloughed off without stripping the skin.”

 

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Brushes, polishing cloths, and scrubs offer easy ways to smooth away rough spots. Rotating cleansing brushes work by physically buffing off the dead skin cells. Exfoliating cloths, microdermabrasion kits, and scrubs with granular ingredients also operate the same way. “For the body, look for a scrub that contains coarse particles that dissolve over time, like sugar, so you don’t irritate the skin,” says Dr. Day.

Products that chemically exfoliate the skin contain ingredients such as glycolic, salicylic, or polyhydroxy acids that cause the skin to shed its outer layer and reveal the newer layer.

2. Remove Hair Without Irritation

If your summer forecast calls for sunny days at the beach or poolside, you may be putting some effort into removing unwanted hair. But once you rip off the wax strip, it’s also important to care for the skin that’s newly exposed to the elements.

Give your skin some time to recover before rolling out your beach towel or getting active outdoors. “I advise clients to stay out of the sun or heat for at least 48 hours after any hair-removal process,” says Cindy Barshop, owner of Completely Bare spas. “Follicles are vulnerable to irritation, and skin may be sensitive due to any heat or friction from lasers, waxing, or shaving.”

Since most of us don’t plan our hair removal that far in advance, buffer your tender skin with an oil-free sunscreen, wait for it to dry (about 5 minutes), and dust on some talc-free baby powder, says Barshop. To prevent ingrown hairs, it’s helpful to wear loose-fitting clothing and use an after-waxing product that contains glycolic and salicylic acids, which team up to prevent dead skin cells from causing bothersome bumps.

 

 

3. Fight UV Rays With Food

All the work you put into making your skin look good won’t be worth it unless you guard it from the sun’s damaging rays, which are strongest during the summer. Surprisingly, you can protect yourself from the inside, too. “In addition to usingsunscreen, eat cooked tomatoes every day if you know you’re going to be in the sun,” says Jessica Wu, MD, assistant clinical professor of dermatology at USC Medical School. According to research, cooked tomatoes are rich in lycopene, an antioxidant that helps fight the effects of UV rays such as redness, swelling, and blistering from sunburn. If you plan to spend a lot of time outdoors, you may benefit from consuming tomato sauce, grilled tomatoes, or even Bloody Marys. “This doesn’t replace sunscreen, but the habit could give you additional protection if you can’t reach your back and miss a spot,” Dr. Wu adds.

4. Clear Up Body Breakouts

It’s no better to have acne on your body than on the face, especially in the heat, when hiding and covering up isn’t an option. The approach to treating acne on the back, chest, and elsewhere on the body is the same as treating facial acne: “Exfoliate regularly, don’t pick, and treat with effective ingredients,” says Day.

Washing with products that contain salicylic acid helps slough off the dead skin cells; a treatment product with micronized benzoyl peroxide can also help by penetrating the skin and killing off the bacteria that cause acne.

If your skin is sensitive, investing in an acne-treating blue light tool may be worth the cost. “You simply wave the light wand over skin for five minutes daily and it helps kill bacteria,” says Leslie Baumann, MD, a dermatologist in Miami. If you have severe body acne, see a dermatologist.

5. Erase Cellulite

First, the good news: Some products may be able to smooth out the undesirable dimples and unevenness of cellulite. The bad news: They won’t get rid of cellulite forever. The smoothing and toning effect, like many good things in life, is fleeting. Still, it may be worth slathering on a toning body lotion to make your skin look and feel tighter for a day at the beach or a special event.

“Products that contain caffeine and theophylline temporarily dehydrate fat cells,” says Dr. Baumann. “However, it’s the massage and the application of the cream that does the work.” The best course of action long-term is to exercise regularly, coupled with targeted massage, suggests Baumann.

Another way to hide cellulite is to apply a fake tan. Take advantage of the newest self-tanners, which have come a long way from the strong-smelling streaky creams or sprays of yesteryear. “There has been so much progress in the formulations — the colors are natural, there’s no streaking, and the scent is so much better,” says Day.

6. Treat Your Feet

If you’ve stuffed your feet inside boots all winter, they probably could use a little TLC for sandal weather. Jump-start your program with a salon pedicure, or if you’re short on time, you can heed Day’s DIY tip, which will help soften feet while you sleep. First, remove thicker skin with a foot file. Apply a rich emollient cream or ointment, then cover the feet in plastic wrap and cotton socks. Leave on overnight. Repeat every day until you achieve smooth skin, then once a week to maintain soft skin.

7 Healthy Habits of the 2016 Presidential Candidates

The New Hampshire primary's in full swing, and if there’s one thing all the presidential hopefuls can agree on, it’s that running for office is the ultimate endurance challenge. They’re canvassing across the country with little time to exercise or sleep, and it doesn’t help that at every stop they’re tempted by unhealthy foods like pizza, pork chops, and pies. So how do the presidential candidates stay healthy and keep their energy levels up during the grueling primary season? Read on to find out!

What Is Guillain-Barré Syndrome?

Guillain-Barré syndrome (GBS) is an illness that can result in muscle weakness or loss of muscle function in parts of the body.

In people with Guillain-Barré syndrome (pronounced GHEE-yan ba-RAY), the body's own immune system attacks the peripheral nervous system.

The peripheral nervous system includes the nerves that connect the brain and spinal cord to the limbs. These nerves help control muscle movement.

GBS Prevalence

Guillain-Barré syndrome is a rare disease.

The Centers for Disease Control and Prevention (CDC) estimates that about 1 or 2 out of every 100,000 people develop GBS each year in the United States.

Anyone can get GBS, but the condition is more common in adults than in children, and more men than women are diagnosed with GBS each year.

Causes and Risk Factors

Doctors don't know what causes Guillain-Barré syndrome.

Many people with GBS report a bacterial or viral infection (such as the flu) days or weeks before GBS symptoms start.

Less common triggers for GBS may include:

  • Immunizations
  • Surgery
  • Trauma

Guillain-Barré syndrome is not contagious — it cannot spread from one person to another.

Types of GBS

There are several types of Guillain-Barré syndrome, which are characterized by what part of the nerve cell is damaged.

The most common type of GBS is called acute inflammatory demyelinating polyradiculoneuropathy (AIDP).

In AIDP, the immune system mistakenly attacks the protective nerve covering that helps transmit nerve signals from the brain to other parts of the body.

Guillain-Barré Syndrome Symptoms

The first symptoms of Guillain-Barré syndrome often include feelings of tingling or weakness in the feet and legs. These feelings may spread to the arms and face.

The chest muscles can also be affected. Up to a quarter of people with GBS experience problems breathing.

In very severe cases, people with GBS may lose all muscle function and movement, becoming temporarily paralyzed.

Signs and symptoms of Guillain-Barré syndrome may include:

  • Pricking or tingling "pins and needles" sensations in the fingers, toes, ankles, or wrists
  • Muscle weakness that starts in the legs and spreads to the upper body
  • Unsteady walking
  • Difficulty with eye or facial movements (blinking, chewing, speaking)
  • Difficulty controlling the bowels or bladder
  • Rapid heart rate
  • Difficulty breathing

What Is Binge Eating Disorder?

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It's unclear what causes binge eating disorder.

Like other eating disorders, BED is probably caused by a combination of genetic, psychological, and social factors.

Some risk factors for binge eating disorder include:

  • A history of anxiety or depression
  • A history of dieting (especially in unhealthy ways, such as skipping meals or not eating enough food each day)
  • Painful childhood experiences, such as family problems

Symptoms of Binge Eating Disorder

People with binge eating disorder have frequent bingeing episodes, typically at least once a week over the course of three months or more.

Binge eating episodes are associated with three or more of the following:

  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when you're not feeling hungry
  • Eating alone, because you feel embarrassed about how much you're eating
  • Feeling extremely disgusted, depressed, or guilty after eating

Some people also display behavioral, emotional, or physical characteristics, such as:

  • Secretive food behaviors, including hoarding, hiding, or stealing food
  • Feelings of anger, anxiety, worthlessness, or shame preceding a binge
  • Feeling disgusted with your body size
  • A strong need to be in control, or perfectionist tendencies

Binge Eating Disorder Treatment

If you have binge eating disorder, you should seek help from a specialist in eating disorders, such as a psychiatrist or psychologist.

There are several treatments available for BED. Treatment options may include:

 

10 Varicose Veins Myths

If you have ropy, blue blood vessels in your legs, you may think that they’re unsightly but don't cause any overt symptoms. Yet for some people, varicose veins can cause skin damage and, even worse, lead to dangerous blood clots.

They’re incredibly common: Varicose veins affect about one in four U.S. adults, or about 22 million women and 11 million men between ages 40 and 80.

Psoriatic Arthritis

www.PsoriaticInfo.com

Living With PsA Could Mean Living

With Joint Damage. Learn More Now.

 

Your leg veins face an uphill battle as they carry blood from your toes to your heart. Small flaps, or valves, within these vessels prevent blood from getting backed up on this journey, and the pumping action of your leg muscles helps push the blood along. 

But if these valves weaken, blood can pool — primarily in the veins of your legs — increasing pressure in the veins. As a result of this increased pressure, your body tries to widen the veins to compensate, causing them to bulge and thicken, and leading to the characteristic twisted appearance of varicose veins.

 

 

To help you learn the facts about these enlarged veins, we've set the record straight on 10 sometimes confusing pieces of information, including who gets varicose veins and why, health problems they can cause, and treatment options.

Myth 1: Varicose Veins Are Only a Cosmetic Issue

“A lot of people are told by primary care doctors or others that varicose veins are a cosmetic issue only, when oftentimes they can be much more than that,” saysKathleen D. Gibson, MD, a vascular surgeon practicing in Bellevue, Washington.

“A significant percentage of patients with varicose veins will eventually develop symptoms,” says Pablo Sung Yup Kim, MD, assistant professor of surgery at Mount Sinai's Icahn School of Medicine in New York City. “The most common include dull achiness, heaviness, throbbing, cramping, and swelling of the legs.” Other symptoms include severe dryness and itchiness of the skin near varicose veins. People with varicose veins are also at an increased risk for a dangerous type of blood clot known as deep vein thrombosis.

Other not-so-common signs and symptoms, found in less than 10 percent of patients, include bleeding, skin discoloration, skin thickening, and ulcer formation — all due to varicose veins, says Kim. Unfortunately, once you have skin damage, it’s usually permanent.

“It’s very important to seek medical advice if you have varicose veins and experience symptoms — before changes in the skin are irreversible,” he says.

Myth 2: Varicose Veins Are an Inevitable Sign of Aging

Aging definitely worsens varicose veins, though not everyone gets them. “It's a degenerative process that gets worse and more prominent as we age,” says Dr. Gibson. But young people can get varicose veins, too. While the average age of patients treated in Gibson’s practice is 52, she and her colleagues have treated patients as young as 13.

If you've got varicose veins, it may run in your family. “The cause of varicose veins is primarily genetic,” Gibson explains.

Changes in hormone levels also come into play as a risk factor for varicose veins. “Your risk can be made worse, especially by pregnancy,” she adds.

Myth 3: Varicose Veins Are Strictly a Women’s Issue

While varicose veins are more common in women, men get them, too. About one-quarter of adult women have some visible varicose veins, compared to 10 to 15 percent of men.

Steve Hahn, 51, of Kirkland, Washington, first noticed in his twenties that he had varicose veins in his left leg after he sprained his ankle playing basketball. When he injured his knee about 10 years ago, he noticed that the varicose veins had become more extensive.

“After about five years of thinking about it, I finally had them treated,” he says. “Both of my legs felt very heavy all of the time at this point, as opposed to just after walking a golf course or playing tennis or basketball.”

After treatment, Hahn says, “I feel like I have new legs.” The heaviness is gone, as is the ankle swelling, which he didn't know was related to the varicose veins. And as a side benefit, he adds, he looks better in shorts.

Myth 4: Running Can Cause Varicose Veins

Exercise — including running — is usually a good thing for your veins. “Exercise is always good for the circulation,” Kim says. “Walking or running can lead to more calf-muscle pumping and more blood returning to the heart.”

“Being a runner doesn’t cause varicose veins,” adds Gibson, though there's controversy about whether exercise makes them worse or not.” Compression stockings can help prevent blood from pooling in your lower legs during exercise. “For patients who haven't had their varicose veins treated and are running, I recommend compression. When you’re done running and are cooling off, elevate your legs,” she says.

Myth 5: Varicose Veins Are Always Visible

While the varicose veins you notice are right at the surface of the skin, they occur deeper in the body, too, where you can't see them. “It really depends on the makeup of the leg,” Gibson says. “If you've got a lot of fatty tissue between the muscle and the skin, you may not see them. Sometimes surface veins are the tip of the iceberg and there's a lot going on underneath.”

Myth 6: Standing on the Job Causes Varicose Veins

If you have a job that requires you to be on your feet a lot — as a teacher or flight attendant, for example — you may be more bothered by varicose veins. But the jury's still out on whether prolonged standing actually causes varicose veins. “People tend to notice their varicose vein symptoms more when they’re standing or sitting,” Gibson explains.

RELATED: Steer Clear of These 9 Artery and Vein Diseases

Myth 7: Making Lifestyle Changes Won't Help

Your lifestyle does matter, because obesity can worsen varicose veins, and getting down to a healthy weight can help ease symptoms. Becoming more physically active is also helpful. “Wearing compression stockings, doing calf-strengthening exercises, and elevating your legs can all improve or prevent varicose veins,” saysAndrew F. Alexis, MD, MPH, chairman of the dermatology department at Mount Sinai St. Luke's and Mount Sinai Roosevelt in New York City.

Myth 8: Surgery Is Your Only Treatment Option

The only treatment available for varicose veins used to be a type of surgery called stripping, in which the vein is surgically removed from the body. That’s no longer the case. While this procedure is still the most commonly used varicose vein treatment worldwide, according to Gibson, minimally invasive procedures that don't leave scars have become much more popular in the United States.

Endothermal ablation, for example, involves using a needle to deliver heat to your vein, causing it to close and no longer function. While the procedure doesn't leave a scar, it can be painful, and you may have to undergo sedation before being treated. “You have to have a series of injections along the vein to numb it up; otherwise, you wouldn't be able to tolerate the heat,” Gibson explains. You may need to take a day off from work to recover, as well as a few days off from the gym.

Some medications, called sclerosing agents, close a vein by causing irritation. Others are adhesives that seal a vein shut and don’t require the area to be numbed. Gibson and her colleagues have helped develop some of the new technologies and products used in treating varicose veins, including adhesives.

Milder varicose veins can be treated by dermatologists with non-invasive approaches, such as laser therapy and sclerotherapy, says Dr. Alexis. “For more severe cases where symptoms may be involved, seeing a vascular surgeon for surgical treatment options is advised.”

Although treatment for varicose veins means losing some veins, you have plenty of others in your body that can take up the slack, explains Gibson. “The majority of the blood flow in veins in the leg is not on the surface at all; it's in the deep veins within the muscle,” she says. “Those deep veins … are easily able to take over for any veins that we remove on the surface.”

Myth 9: Recovery After Varicose Vein Treatments Is Difficult

 

 

Newer treatments have quicker recovery times. “These procedures can be performed in an office within 20 to 30 minutes with no recovery time. Patients can usually return to work or daily activities on the same day,” Kim says.

Myth 10: Varicose Veins Can Be Cured

Treatments are effective, but they aren't a cure, Gibson says. Sometimes, varicose veins can make a repeat appearance after treatment. “What I tell my patients is it's kind of like weeding a garden,” she says. “We clear them all out, but that doesn't mean there's never going to be another dandelion popping out.”

Many Under 40 May Not Need Regular Cholesterol Checks: Study

Many adults under 40 may not need to have routine cholesterol screenings, a new study suggests.

To come to this conclusion, the researchers looked at the real world implications of two conflicting sets of guidelines on cholesterol testing.

One, from the American College of Cardiology/American Heart Association (ACC/AHA), says that all adults older than 20 should have a cholesterol screening. They also suggest a repeat test every four to six years.

The other guidelines come from the U.S. Preventive Services Task Force, a government-funded, independent panel of medical experts. They say many adults can go longer before their first cholesterol test -- until age 35 for men, and age 45 for women.

The exception would be people with a major risk factor for heart problems -- such as high blood pressure, smoking or a family history of early heart disease.

Those patients can start cholesterol testing at age 20, the task force adds.

The new findings support the "more targeted" approach the task force uses, according to lead researcher Dr. Krishna Patel, of Saint Luke's Health System in Kansas City, Mo.

Why? The study, Patel explained, tried to estimate the impact of the two different guidelines in the "real world."

To do that, the researchers used data on 9,600 U.S. adults aged 30 to 49 who were part of a government health study.

The study team found that among nonsmokers with normal blood pressure, very few were at heightened risk of suffering a heart attack in the next 10 years. That means very few would be considered candidates for a cholesterol-lowering statin -- even with elevated LDL (so-called "bad" cholesterol) levels.

"So, screening cholesterol early doesn't bring much actionable information," Patel said. "If we're not going to treat, there's no point in doing it."

The study was published May 15 in the Annals of Internal Medicine.

Others disagreed with Patel's point.

The point of screening younger adults is not so doctors can put them all on statins, said Dr. Neil Stone, one of the authors of the ACC/AHA guidelines.

Instead, there are two central reasons, Stone explained.

One is to spot younger adults who may be heading down a path toward heart disease later in life.

Once they know their LDL is high, they and their doctors can have an "all-important discussion" about diet and lifestyle changes, said Stone, who is also professor of medicine at Northwestern University's Feinberg School of Medicine in Chicago.

READ MORE: 9 Things Dietitians Wish You Knew About High Cholesterol

The other reason is to catch cases of familial hypercholesterolemia, a genetic condition that causes very high LDL levels (above 190 mg/dL), he said.

People with the condition have a much higher-than-average risk of heart disease, and often develop it at a young age.

Because of that, the condition should be treated with statins, according to the ACC/AHA.

There is "strong and compelling evidence," Stone said, that catching the condition in younger adults makes a difference.

Dr. Paul Ridker, who wrote an editorial accompanying the study, had a similar view.

"Familial hypercholesterolemia is a common disorder, and it's easy to detect," said Ridker, of Brigham and Women's Hospital in Boston. "Why delay something as simple and inexpensive as a cholesterol test?"

Plus, he said, catching even "run-of-the-mill" high LDL is important.

"Knowing about it early in life can be a good motivator to make lifestyle changes," Ridker said.

What if a young adult has healthy LDL levels? Ridker said he'd be "fine" with that patient forgoing further tests until later in life.

For her part, Patel agreed that a one-time check, to catch familial hypercholesterolemia, is a wise move for young adults. But she questioned the value of repeat testing.

According to Stone, the ACC/AHA guidelines say it's "reasonable" to repeat cholesterol testing every four to six years. "It's not mandatory," he noted.

But people's lives, and heart disease risk factors, change as they move through adulthood, Stone said. So, a periodic cholesterol check can be useful when it's done as part of a "global risk assessment" where doctors look at blood pressure, smoking habits and other major risk factors for heart disease.

Motivating younger adults to get those risk factors under control is critical, according to Stone. "We know it's a big deal if you can have optimal risk factor [control] by age 45 or 50," he said.

In the study, very few people were at elevated risk of heart attack -- as long as they didn't smoke or have high blood pressure. ("Elevated" meant a greater than 5 percent chance of having a heart attack in the next 10 years.)

In the absence of those two risk factors, only 0.09 percent of men younger than 40 were at elevated risk of heart attack. And only 0.04 percent of women younger than 50 were.

But smoking, in particular, changed everything: Among male smokers in their 40s, one-half to three-quarters were at elevated risk of a heart attack.

"Smoking had a huge effect," Patel said. Smokers, she stressed, should "definitely" have their cholesterol tested -- and, more importantly, quit the habit.

Psoriasis Linked to Higher Risk of Depression

People with psoriasis may be twice as likely to experience depression as those without the common skin condition, regardless of its severity, a new study suggests.

"Psoriasis in general is a pretty visible disease," said study author Dr. Roger Ho, an assistant professor of dermatology at New York University School of Medicine in New York City. "Psoriasis patients are fearful of the public's stigmatization of this visible disease and are worried about how people who are unfamiliar with the disease may perceive them or interact with them."

Genetic or biologic factors may also play a role in the link between depression and psoriasis, which requires more research, he said. Either way, the findings mean that all individuals with psoriasis could benefit from screening for depression, Ho said, and their friends and family members should be aware of the connection as well.

The findings were scheduled for presentation Thursday at an American Academy of Dermatology meeting in New York City. They have not yet been published in a peer-reviewed journal and should be considered preliminary.

Most people with psoriasis have red, raised patches of skin covered with silvery-white scales, the researchers noted. These patches usually appear on the scalp, elbows, knees, lower back, hands and feet.

The researchers analyzed the responses of more than 12,000 U.S. adults in the 2009-2012 National Health and Nutrition Examination Survey conducted by the U.S. Centers for Disease Control and Prevention.

Overall, nearly 3 percent of responders reported that they had psoriasis, and about 8 percent had major depression based on their answers to a depression screening assessment. Among those with psoriasis, 16.5 percent had sufficient symptoms for a diagnosis of major depression.

Those with any degree of psoriasis had double the odds of having depression even after taking into account their age, sex, race, weight, physical activity level, alcohol use and history of heart attack, stroke, diabetes and smoking, the researchers said.

Depression is one of several concerns that someone with psoriasis should look out for, said Dr. Delphine Lee, a dermatologist at John Wayne Cancer Institute at Providence Saint John's Health Center in Santa Monica, Calif.

"Patients with psoriasis should be aware that there are several other health issues associated with this condition, including cardiovascular and metabolic diseases, such as diabetes, as well as psychological or psychiatric disorders," Lee said. "To address your health beyond your skin is critical to maximizing a person's quality of life."

Several aspects of dealing with psoriasis may contribute to depression, said Dr. Doris Day, a dermatologist at Lenox Hill Hospital in New York City.

RELATED: 7 Hidden Dangers of Psoriasis

What matters more than its severity is the location of flare-ups, she said. Some of her patients won't wear shorts if it's on their legs or won't go on dates because they're embarrassed about red spots on their skin, she added.

"Also, because it's a chronic illness, you don't know if it's going to get worse and you don't get to take a vacation from it either," Day said. "You're using topical treatments all year long, and as soon as you stop, it comes right back. It's very depressing, and it can affect your self-esteem and your quality of life."

Anxiety about how psoriasis and its treatment may affect your future health might also contribute to depression, Day explained.

"It's unsightly, it can be itchy, people are worried about it spreading to other parts of their body, they worry about the side effects of medication, they worry about psoriatic arthritis, they worry about taking medications when they're pregnant, and they worry about passing it along to their children," she said.

Day recommended that people with psoriasis seek mental health treatment to get to the bottom of their depression.

"It's about that emotional connection and finding out what about this condition is affecting someone in the way that it is," Day explained.

Not seeking help can make matters worse, said Dr. Tien Nguyen, a dermatologist at Orange Coast Memorial Medical Center in Fountain Valley, Calif.

"Psoriasis can cause severe emotional distress," he said, noting some patients may have suicidal thoughts or attempt suicide. "Stress is a known cause of exacerbation of psoriasis, so this will lead to a vicious cycle."

Day added that it's critically important to continue seeing a dermatologist to learn about new medications that become available.

"There are some really amazing new treatments that have a great safety profile that can have excellent clearance with lasting results," Day said.

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10 Ways to Fight Chronic RA Pain

The aches and pains of rheumatoid arthritis can be hard to overcome, but these strategies may help in treating chronic pain.

From fatigue to loss of appetite, rheumatoid arthritis (RA) can impact your life in a number of ways, but the most limiting symptom for many people is pain. Because that pain comes in different forms, you may need more than one strategy to relieve it.

“The primary cause of rheumatoid arthritis pain is inflammation that swells joint capsules," says Yousaf Ali, bachelor of medicine and bachelor of surgery, an associate professor of medicine at the Icahn School of Medicine and chief of the division of rheumatology at Mount Sinai West Hospital in New York City. Joint capsules are thin sacs of fluid that surround a joint, providing lubrication for bone movement. In RA, the body's immune system attacks those capsules.

The first goal of pain relief is the control of inflammation, Dr. Ali explains. “Inflammation can cause acute (short-term) pain or longer-lasting smoldering pain," he says. "Chronic erosion of joint tissues over time is another cause of chronic pain. But there are many options for pain relief.”

Getting RA pain under control may take some work. You may find that you'll need to take several drugs — some to slow the joint damage and some to alleviate joint pain. Alternative therapies, like acupuncture, combined with drugs may help you to feel stronger. It may take some time, too. Try the following strategies — with your doctor's supervision — to discover which are most effective for you:

Treatments and Strategies to Help Relieve Chronic RA Pain

1. Inflammation Medication "In the case of RA, all other pain-relief strategies are secondary to controlling inflammation," Ali says. The No. 1 option in the pain relief arsenal is to control inflammation with disease-modifying anti-rheumatic drugs, called DMARDs. These drugs, which work to suppress the body's overactive immune system response, are also used to prevent joint damage and slow the progression of the disease. DMARDs are often prescribed shortly after a diagnosis in order to prevent as much joint damage as possible.

"The most commonly used is the drug methotrexate," he says. It's administered both orally and through injections. Digestive issues, such as nausea and diarrhea, are the most common side effect of DMARDs, and of methotrexate in particular, if taken by mouth. Hair loss, mouth sores, and drowsiness are other potential side effects. Methotrexate, which is taken once a week, can take about five or six weeks to start working, and it may be three to six months before the full effects of the drug are felt; doctors may also combine it with other drugs, including other DMARDs.

"Steroids may be used to bridge the gap during an acute flare," adds Ali. "If flares continue, we can go to triple-drug therapy, or use newer biologic drugs that are more expensive but also effective.” The most common side effect of biologics are infections that may result from their effect on the immune system.

The next tier of pain relief includes these additional approaches:

2. Pain Medication The best drugs for acute pain, Ali says, are nonsteroidal anti-inflammatory drugs, called NSAIDs. Aspirin and ibuprofen belong to this class of drugs, as does a newer type of NSAID called celecoxib. While NSAIDs treat joint pain, research has shown that they don't prevent joint damage. In addition, NSAIDs may irritate the stomach lining and cause kidney damage when used over a long period of time.

"Stronger pain relievers, calledopioids, may be used for severe pain, but we try to avoid them if possible," says Ali. "These drugs must be used cautiously because of the potential to build up tolerance, which can lead to abuse."

3. Diet Although some diets may be touted to help RA symptoms, they aren’t backed by the medical community. “There is no evidence that any special diet will reduce RA pain," Ali says. But there is some evidence that omega-3 fatty acids can help reduce inflammation — and the joint pain that results from it. Omega-3s can be found in cold-water fish and in fish oil supplements. A study published in November 2015 in the Global Journal of Health Sciences found that people who took fish oil supplements were able to reduce the amount of pain medication they needed.

4. Weight Management Maintaining a healthy weight may help you better manage joint pain. A study published in November 2015 in the journal Arthritis Care & Research suggested that significant weight loss can lower the need for medication in people with RA. Among the study participants, 93 percent were using DMARDs before they underwent bariatric surgery, but that dropped to 59 percent a year after surgery.

5. Massage A massage from a therapist (or even one you give yourself) can be a soothing complementary treatment to help reduce muscle and joint pain. A study published in May 2013 in the journal Complementary Therapies in Clinical Practice involved 42 people with RA in their arms who received either light massage or medium massage from a massage therapist once a week for a month. The participants were also taught to do self-massage at home. After a month of treatment, the moderate-pressure massage group had less pain and greater range of motion than the others.

6. Exercise Although you may not feel like being active when you have RA, and it might seem that being active could put stress on your body, gentle exercises can actually help reduce muscle and joint pain, too. “Non-impact or low-impact exercise is a proven way to reduce pain," Ali says. "We recommend walking, swimming, and cycling.” In fact, one of the best exercises you can do for RA is water aerobics in a warm pool because the water buoys your body.

The Arthritis Foundation also notes that yoga is another option to help reduce RA pain, and traditional yoga poses can be modified to your abilities. Yoga may also help improve the coordination and balance that is sometimes impaired when you have the disease. When it comes to exercise, though, it’s also wise to use caution. Talk with your doctor if any workouts are making your pain worse, and, in general, put any exercise plan on hold during an acute flare.

7. Orthoses These are mechanical aids that can help support and protect your joints. Examples include padded insoles for your shoes and splints or braces that keep your joints in proper alignment. You can even get special gloves for hand and finger RA. A physical therapist can help you determine the best orthoses options for you.

8. Heat and Cold Heat helps to relax muscles, while cold helps to dull the sensation of pain. You might find that applying hot packs or ice packs, or alternating between hot and cold, helps reduce your joint pain. Relaxing in a hot bath can also bring relief, as can exercising in a warm pool.

9. Acupuncture This Eastern medicine practice, which has been around for centuries, is thought to work by stimulating the body's natural painkillers through the use of fine needles gently placed near nerve endings. “I have found acupuncture to be helpful for some patients, but the pain relief is usually not long-lasting,” says Ali.

10. Transcutaneous Electrical Nerve Stimulation (TENS) TENS is a form of therapy that uses low-voltage electric currents to stimulate nerves and interfere with pain pathways. “TENS is usually used for stubborn, chronic pain and not as a first-line treatment for RA,” Ali says. One of the benefits of this treatment is the low occurrence of side effects. If you're interested in trying it for pain relief, talk with your physical therapist.

Remember, you’re not alone — your doctor and specialists can help you find relief from chronic pain. If you’re experiencing more pain than before, or if pain is interfering with your ability to get things done, don’t hesitate to talk to your doctor. Ask your rheumatologist about pain relief options, like exercise, massage, yoga, and acupuncture, but remember that the first priority on your pain relief list should be to get RA inflammation under control.

How Trauma Can Lead to Depression

You don't have to have been personally involved in a traumatic experience to suffer the effects.

Over the last few years, a long string of traumatic events have occurred and been widely covered in the news, including movie theater, school, and workplace shootings, as well as natural disasters such as typhoons and earthquakes. These events can be devastating for those personally involved, yet their impact may also be felt by others not directly involved at all.

Many people can go through or hear about such traumatic events and be fine after some time without additional interventions, says Anthony Ng, MD, chief medical officer at Acadia Hospital and chief of the psychiatry service at Eastern Maine Medical Center in Bangor.

But some people who experience such traumatic events — whether personally or just by hearing about them — can become depressed, according to the Depression and Bipolar Support Alliance. Traumatic life events were found to be the biggest single cause of anxiety and depression in a study by researchers at the University of Liverpool published in 2013 in PLoS One. 

RELATED: The Healing Power of Horse Therapy for PTSD

For some, traumatic events such as the Boston Marathon bombing and Sandy Hook Elementary School shooting challenge their basic assumptions about how life works, says Irina Firstein, a licensed therapist who has lived and practiced in New York City for more than 25 years. They can become so scared that they develop a generalized anxiety or panic disorder, which can lead to depression, she says.

Depression and PTSD: What's the Connection?

People who continue to experience extreme symptoms of stress long after a traumatic event may have post-traumatic stress disorder (PTSD), which can also lead to depression — a continued feeling of intense sadness that interferes with a person's ability to function normally.

Depression and PTSD often coexist, and their symptoms may overlap. A study on Vietnam veterans counducted 40 years after the war, published in 2015 JAMA Psychiatry, found that about a third of those who suffered from PTSD also had major depressive symptoms.

Symptoms of depression include sadness, feelings of loss, disillusionment, loss of appetite, and difficulty sleeping, Firstein says.

Symptoms of PTSD include:

Reliving traumatic events through flashbacks or nightmares
Avoiding experiences that remind you of the trauma
Panic attacks
Physical symptoms such as rapid heartbeat, trembling, shortness of breath, or headaches
Symptoms of PTSD and depression that commonly occur together include:

Trouble concentrating
Avoidance of social contacts
Irritability
Abuse of drugs or alcohol
How to Cope With the Effects of Traumatic Events

"Some of these symptoms are normal after such an event," Firstein notes. "However, if they persist, one should try to get professional help.”

Dr. Ng. says red flags that you're not managing well on your own include:

Missing a significant number of days of work or school
Withdrawing from family members or people around you
Experiencing mood swings, such as being irritable and angry to the point that it’s causing problems at home
Not being able to eat and losing weight
Not being able to sleep at night. “As a result, you feel exhausted and can’t function in the daytime,” Ng says.
Having thoughts of hurting yourself or others
Mental health professionals can help. “Psychotherapy; eye movement desensitization and reprocessing, or EMDR therapy (trauma reprocessing using eye movements); and medication are very effective," Firstein says.

In addition to getting professional help, ways to cope with PTSD and depression include:

Spending more time with friends and family
Learning as much as you can about PTSD and depression
Taking part in activities you enjoy
Getting regular exercise
Learning relaxation techniques
Joining a support group
Avoiding drugs and alcohol
The following resources can help you find ways to cope with trauma and depression, as well as help you find therapists in your area: 

Your family doctor. “Tell your doctor, ‘I’ve experienced these symptoms. What can I do?’ Your doctor might treat you or refer you to a psychiatrist or counselor or therapist,” Ng says.
The National Alliance on Mental Illness HelpLine. This organization's staff and volunteers can help you find treatment. Call 800-950-NAMI (6264) or email info@nami.org.
The National Suicide Prevention Lifeline. If you are having suicidal thoughts, call 800-273-TALK (8255). Counselors are available 24/7, and the service is free and confidential.
The American Psychological Association’s psychologist locator.
The PTSD Alliance.
The National Center for PTSD, part of the U.S. Department of Veterans Affairs.  
The Anxiety and Depression Association of America.
Don’t Ignore Symptoms That Persist

Unexplained and unexpected trauma has always been part of the human experience, and depression and PTSD are common results of these events. The best way to deal with them is to know the symptoms and ask for help.

Additional reporting by Beth W. Orenstein.

DIY Beauty Solutions

Strawberries, lemons, blueberries, and onions – sounds like your average grocery list, right? Just as they are nutritious and important for a well-balanced diet, these ingredients can give your skin and hair a major boost, too.
Strawberries, lemons, blueberries, and onions – sounds like your average grocery list, right? Just as they are nutritious and important for a well-balanced diet, these ingredients can give your skin and hair a major boost, too.

Read on to learn these six expert-recommended at-home treatments that can help combat your biggest beauty woes.

Strawberries, lemons, blueberries, and onions – sounds like your average grocery list, right? Just as they are nutritious and important for a well-balanced diet, these ingredients can give your skin and hair a major boost, too.

Read on to learn these six expert-recommended at-home treatments that can help combat your biggest beauty woes.

10 Essential Facts About Ovarian Cancer

Statistically speaking, ovarian cancer is relatively rare: It represents just 1.3 percent of all new cancer cases in the United States each year, according to the National Cancer Institute (NCI). But although its numbers are small, the fear factor for many women may be disproportionately large.

We spoke to two leading ovarian cancer experts: Robert J. Morgan, Jr., MD, professor, and Mihaela C. Cristea, MD, associate clinical professor, of the medical oncology and therapeutics research department at City of Hope, an NCI-Designated Comprehensive Cancer Center in Duarte, California.

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Here are 10 essential facts about ovarian cancer that you should know:

1. About 20,000 women in the United States are diagnosed with ovarian cancer each year. As a comparison, nearly 250,000 women will be diagnosed with breast cancer this year, according to the American Cancer Society. Of the women diagnosed with ovarian cancer, 90 percent will be older than 40; most ovarian cancers occur in women 60 or older, according to the CDC.

2. You should see your doctor if you experience any of these ovarian cancer symptoms:

  • Vaginal bleeding (especially if you’re past menopause)
  • Abnormal vaginal discharge
  • Pain or pressure in the area below your stomach and between your hip bones
  • Back pain
  • A change in bathroom habits, such as urgently needing to urinate, urinating frequently, or having constipation or diarrhea

It’s important to pay attention to your body and know what’s normal for you. If you have abnormal vaginal bleeding or have any of the other symptoms for two weeks or longer, see your doctor right away.

 

 

These symptoms can be caused by many different problems, but it’s best to have them evaluated, suggests the University of Texas MD Anderson Cancer Center.

3. It’s tricky to pinpoint early, milder symptoms of ovarian cancer. However, the findings of a study published in Cancer in 2007 point to a cluster of vague symptoms that may suggest the need for ovarian cancer testing, says Dr. Morgan. In the study, researchers linked these symptoms to the possibility of ovarian cancer:

  • Pelvic or abdominal pain
  • Strong urge to urinate or frequent urination
  • Bloating or increased abdominal size
  • Difficulty eating or feeling full early

If a woman experiences these symptoms on more than 12 days a month for less than one year, she should insist that her doctor perform a thorough ovarian evaluation, says Morgan. This might include the CA-125 blood test or atransvaginal ultrasound exam.

4. Early detection can mean a better prognosis. When detected early enough, ovarian cancer can be cured. “Stage 1 and stage 2 ovarian cancer is curable about 75 to 95 percent of the time, depending on the tumor grade and cell type,” says Morgan. But because this cancer occurs deep inside the body’s pelvic region, it is often diagnosed in later stages, he says. The cure rate for stage 3 ovarian cancer is about 25 to 30 percent, and for stage 4 it's less than 5 percent, he adds.

RELATED: Overcoming Ovarian Cancer, Twice

5. Ovarian cancer has several key risk factorsThese include:

  • Women with a family history of ovarian cancer may be at higher risk.
  • Women who have never been pregnant and women who have uninterrupted ovulation due to infertility treatments seem to be at higher risk.
  • Early onset of your period, or having a late menopause, seems to increase risk.
  • Using talcum powder in the genital area may increase risk.
  • Smoking is a risk factor for a type of ovarian cancer known as mucinous ovarian cancer. Quitting smoking seems to reverse the risk back to normal, says Morgan.

6. Ovarian cancer is not a single disease. In reality, it’s a diverse group of cancers that respond to different treatments based on their molecular characteristics, says Dr. Cristea. Treatment will also depend on other health conditions, such as diabetes or heart problems, that a woman might have.

7. Ovarian cancer treatments are evolving and improving all the time.Immunotherapy is emerging as a new treatment option for many malignancies, including ovarian cancer,” says Cristea. In another recent development, the firstPARP inhibitor, a DNA-repair drug, has been approved for women with BRCA-mutated ovarian cancer when chemotherapy hasn’t worked. “Women should also ask their doctors about clinical trials that are evaluating immunotherapy as well as other new treatments,” she adds.

 

 

8. Surgery may prevent ovarian cancer in women at very high risk. For women who carry the BRCA or other genes that predispose them to ovarian cancer, doctors often recommend surgery to remove the ovaries and fallopian tubes.Angelina Jolie, the actor and human rights activist, decided to have this surgery in March 2015. “Removing the ovaries can decrease the risk of developing the disease by 98 percent, and can substantially decrease the risk of developing breast cancer,” notes Morgan. Women in this very high-risk group should opt for this surgery after they’ve completed childbearing at around age 35, he notes.

9. Even after remission, ovarian cancer can still respond to treatment. “About 80 to 90 percent of ovarian cancer patients will achieve remission after chemotherapy treatment,” says Morgan. However, many of those women will later experience a recurrence of the cancer. The longer the remission, notes Morgan, the better the chances are for achieving a second remission.

10. It’s best to see an ovarian cancer specialist. When you’ve been diagnosed with ovarian cancer, getting a referral to an ovarian cancer specialist is a wise move, says Cristea. If you’re having surgery, it’s best to have a gynecologic oncologist perform the operation instead of a gynecologist, she adds. And to make sure you’re getting state-of-the-art treatment, consider seeking a second opinion at a NCI-Designated Cancer Center.

Could Eating Fish Help Ward Off Depression?

Consuming more meals from the sea linked to lower risk, study suggests, but cause-and-effect not proven.

Can eating a lot of fish boost your mood? Maybe, say Chinese researchers.

Overall, the researchers found that people who consumed the most fish lowered their risk of depression by 17 percent compared to those who ate the least.

"Studies we reviewed indicated that high fish consumption can reduce the incidence of depression, which may indicate a potential causal relationship between fish consumption and depression," said lead researcher Fang Li, of the department of epidemiology and health statistics at the Medical College of Qingdao University in China.

But this association was only statistically significant for studies done in Europe, the researchers said. They didn't find the same benefit when they looked at studies done in North America, Asia, Australia or South America. The researchers don't know why the association was only significant for fish consumption in Europe.

The study was also only able to show an association between eating fish and the risk for depression, not that eating fish causes a lower risk for depression, Li said.

Still, Li thinks there may be reasons why fish may have an effect on depression.

"Fish is rich in multiple beneficial nutrients, including omega-3 fatty acids, high-quality protein, vitamins and minerals, which were associated with decreased risk of depression from our study," Li said.

The researchers pointed out that it's possible that the omega-3 fatty acids in fish may change the structure of brain membranes, or these acids may alter the way certain neurotransmitters work. Neurotransmitters are the brain's chemical messengers, sending information from brain cell to brain cell. Some neurotransmitters, such as dopamine and serotonin, are thought to be involved in depression, the researchers said.

RELATED: 10 Foods I Eat Every Day to Beat Depression

The report was published Sept. 10 online in the Journal of Epidemiology & Community Health.

Depression affects 350 million people around the globe, according to background information in the study. The mood disorder is the leading cause of disability worldwide, according to the World Health Organization.

Past research has suggested that dietary factors may play a role in depression, the researchers said.

To look at the possible connection between eating fish and depression, Li and colleagues reviewed 26 studies published between 2001 and 2014. The studies included more than 150,000 people. Ten of the studies were done in Europe.

This process, called a meta-analysis, attempts to find consistent patterns across multiple studies.

In addition to an overall benefit from fish in curbing depression, Li's team found a difference between men and women. Specifically, the researchers found a slightly stronger association between eating a lot of fish and lowered depression risk in men by 20 percent. Among women, reduction in risk was 16 percent, the researchers said.

Simon Rego, director of psychology training at Montefiore Medical Center/Albert Einstein College of Medicine in New York City, said it's "impossible to draw any definitive conclusions about direct cause and effect" due to the study's design.

But, he added, "While the exact way fish may prevent depression is unknown, it's promising to learn that depression may be preventable for some people by making simple modifications to their lifestyle, such as by eating more fish."

Rego said it's especially important to look for novel treatments because depression can have a significant impact on people's lives, and many people don't respond fully to first-line depression treatments.

Future research needs to look into whether the effects of fish on depression vary by the type of fish eaten. In addition, this review didn't look at whether or not fish oil supplements could have the same effect.

8 Ways to Squeeze Fitness Into Your Day

While I aim for 20 or 30 minutes of daily exercise, I never miss an opportunity to sneak in extra movement throughout the day. After all, your muscles have no idea if you’re in a fancy gym or in your kitchen — as long as you’re working them, they’ll get toned!

By doing little exercises throughout the day wherever you can — in the kitchen, in your car, while you brush your teeth, or while you're sitting at your computer — you’ll keep the oxygen flowing and stretch and tone your muscles.

 

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You’ll also boost your metabolism: Did you know you can burn up to 500 calories per day just by fidgeting? It’s true! I like to call these little movements "fidget-cizes." They take only one minute or less and they really do work! Fidget-cizes don't replace your regular workouts, but when life gets too hectic, use these moves as a way to squeeze in a little extra fitness all day long. Here are a few of my favorites. Give them a try!

  • Squeeze that butt: Do it in the elevator, as you're walking down the aisles of a grocery store, and while you're waiting in line at the bank. No one will know — and it's so effective!
  • Work those legs: Try doing leg lifts at your desk or squats while you brush your teeth at night.
  • Add some steps to your day: Whenever you can, sneak in extra walking. Park your car far away from the store, take the stairs instead of the elevator at work, or do a few laps of the mall before you shop this weekend. Every step counts!
  • Tuck that tummy: If you're relaxing in the living room in front of the TV, try lying on the floor or on a blanket and doing crunches. Make a deal with yourself that you'll do them throughout each commercial break. Easy!
  • Take a “dip” on the couch: Sit at the edge of the couch and place your palms down on each side of you. Move forward so that your body is off the couch, bend your elbows behind you, and lower your body toward the floor with your knees bent and feet together. Bend and extend your arms multiple times as you watch TV — you’ll lose that arm jiggle in no time!
  • Stretch it out: Tension can build up in the neck and shoulders simply from sitting at your desk, and it gets even worse as the long work day drags on. Stretching encourages those tense muscles to relax and counteracts any tightness from poor posture and tired muscles. Try doing my Shoulder and Chest Relaxer, One-Arm Reach, and Neck and Shoulder Release at your desk — you'll probably start an office trend!
  • Get firm on the phone: If you spend a lot of time on the phone like I do, don't just sit there — make it a workout by "pretending" to sit! Press your back flat against a wall and lower your body by bending your knees to a 45- to 90-degree angle. Hold the position for as long as you can.
  • Get lean while you clean: Did you know that by doing household chores — carrying laundry upstairs, vacuuming, making your bed, dusting — you can burn up to 400 calories an hour? You’ve got to do these tasks anyway, so you might as well turn on some music and think of it as exercise!

Go ahead: Turn idle time into exercise time and look for every opportunity to move your body. All of those little moments will add up to major health benefits — you’ll see!

6 Things I Didn't Know About Depression Until It Happened to Me

If you or a loved one has been diagnosed with depression, these insights from people who are successfully managing their own depression may help you.

Depression can make you feel alone and isolated, but in reality you aren't. Many other people live with depression every day, and you can learn a lot from them. Here, three people diagnosed with depression share insights they’ve gained along the way.

1. It's Not Your Fault

For the longest time, "I felt like something was wrong with me," says Marisa McPeck-Stringham, 37, a social worker in Ogden, Utah, who blogs about her life, including her depression, as Iron Daisy. She first noticed as a teen that she was sometimes down in the dumps, but she wasn't diagnosed until age 20, she says. Before the diagnosis, she would ask herself: What's wrong with me? She knew she had a good family, a good home, and great parents. "I didn't know it was a mental illness," she says. "I didn't know it was a problem with my brain chemistry."

That reaction is a common one, says Michelle B. Riba, MD, associate director of the University of Michigan Comprehensive Depression Center in Ann Arbor and past president of the American Psychiatric Association. Patients often tell her they think they did something to bring on the depression, and that they could have been stronger.

Dr. Riba tells her patients, "It's a medical condition and has to be treated like a medical condition." Anyone diagnosed with depression must be evaluated to see which treatment or combination might work for them, Riba says.

2. Being Depressed Takes a Lot of Energy

Elizabeth Moon, 70, of Austin, who wrote Crown of Renewal and other books, was diagnosed in the early 1980s. She didn't understand until after she got a diagnosis and was treated how exhausted she had been from trying to keep up with her life. "I didn't realize how long I had been depressed," she says.

"I was active, very physically active," says Moon. "I didn't think of myself as depressed; I didn't realize I was sliding into depression."

RELATED: 5 Things Psychologists Wish Their Patients Would Do

“Not everyone fits the stereotype of sitting on the couch," unable to do anything, she says. "If you’re feeling worthless, like you have no future — even if you appear to be healthy and holding down a full-time job, get checked out.”

"People may not pinpoint [depression symptoms] right away," Riba says of those who get depressed. They may think they’re sleep deprived, for instance, or just have some temporary issues balancing responsibilities.

3. Exercise Has Been Proven to Help With Symptoms

Often, the last thing you want to do if you’re depressed is go out and get some exercise. But those who’ve been there understand the value of exercise, and say it often helps. "If I don't get out and exercise, I have to really watch myself and make sure I’m not sliding," Moon says. "I do much better if I’m active. I have much less chance of sliding into another episode."

RELATED: The Real Monthly Cost of Depression

Exercise ''readjusts our brain chemistry," says McPeck-Stringham. She includes exercise as part of her "self-care" routine. Her workouts also become valuable "me" time, she finds.

And there is good evidence that exercise improves your mental health. A study published in 2014 in JAMA Psychiatry found that exercise does lower your chance of becoming depressed. And in people who already have depression, exercise helps lift depressive symptoms.

4. Writing Helps You Sort Out Your Emotions

Keola Birano, 33, of Hilo, Hawaii, is a full-time writer who also works for his wife's clothing business. Diagnosed at age 19, he soon learned the power of writing — not for his livelihood, but for his depression. First, he wrote a letter to his father and ''without giving it to him," burned it. "It released whatever [negative] feeling I may have held onto," he says.

He has continued writing, both for his blog, Keola Birano Reimagined, and for personal growth. "When you write, it opens up parts of your brain you didn't know were there,'' he says. "I try to do 10 minutes a day on autopilot, to let the feelings out."

5. Managing Depression Is an Ongoing Effort

"It takes a lot of significant work to keep yourself strong," Birano says. "You have to keep working on it. Once you start thinking you have it beat, you set yourself up for failure."

Moon agrees. "I can go downhill in 30 seconds,'' she says. "I've learned to have a plan in place when that happens," she says. Part of her plan is to keep tabs on her mental health before that slide downhill. "At least five times a year, I take the Beck Depression Inventory [a tool used by mental health experts] and see where I am. If I’m coming up [on the score], I need to be very careful. If the score doesn't go back down, I may need meds."

RELATED: 10 Foods I Eat Every Day to Beat Depression

For her, the best approach has been to take medications when needed and then taper off them, she says, but she doesn’t claim this is best for everyone. It’s important to remember that decisions to stop or start medications should always be done in conjunction with your physician.

6. Having a Depression Relapse Doesn’t Mean You Failed

"Right now, I’m in between episodes," Moon says. "I know another one may come and it isn't a disaster when it does come. It doesn't mean you’ll end up committing suicide either."

Figuring out what works for you to stay on an even keel is critical, Moon says. The most important thing for anyone who's depressed? "Recognize when you’re falling off the cliff," she says. Then go get the help you need and deserve.

Giving the 'Green Light' to Migraine Relief

A new study sheds light -- literally -- on a potential means of easing migraine pain.

Researchers in Boston exposed 69 migraine patients to different colors of light. They found that while blue light exacerbated headache pain, a narrow spectrum of low-intensity green light significantly reduced light sensitivity.

In some cases, this green light also reduced migraine pain by about 20 percent, the researchers found.

They noted that migraine headache affects nearly 15 percent of people worldwide, and a frequent symptom of migraine is light sensitivity, also known as photophobia.

"Although photophobia is not usually as incapacitating as headache pain itself, the inability to endure light can be disabling," study author Rami Burstein, of Beth Israel Deaconess Medical Center in Boston, said in a medical center news release.

RELATED: Home Remedies for Headache Treatment

"More than 80 percent of migraine attacks are associated with and exacerbated by light sensitivity, leading many migraine sufferers to seek the comfort of darkness and isolate themselves from work, family and everyday activities," he added. Burstein directs the medical center's Comprehensive Headache Center.

Two experts said the treatment may have merit.

"Certainly Dr. Burstein's work suggests that more research should be done, as this is a potentially beneficial new avenue for treatment," said Dr. Noah Rosen, who directs Northwell Health's Headache Center in Great Neck, N.Y.

He pointed out that "light therapy has been used successfully in other conditions such as certain dermatologic issues and seasonal affective disorder [SAD]."

Dr. Gayatri Devi is a neurologist at Lenox Hill Hospital in New York City.

He said the success in some patients with light therapy "implicates the thalamus -- a brain 'relay station' between the sensory organs, including the eyes and the cortex of the brain -- as the area where migraine-related photophobia is amplified."

For his part, Burstein said he's now trying to develop an affordable light bulb that emits narrow-band green light at low intensity, as well as sunglasses that block all but the narrow band of green light.

Rosen stressed, however, that more study may still be needed.

"In general, it seems a safe treatment but one that is limited by cost, access and whether its use on a regular basis would decrease disability," he said.

The findings were published May 17 in the journal Brain.

Teens and E-cigarettes

In picture shows that "Teens are more likely to use e-cigarettes than cigarettes."

Past-month use of cigarettes was 3.6 percent among 8th graders, 6.3 percent among 10th graders, and 11.4 percent among 12th graders. Past-month use of e-cigarettes was 9.5 percent among 8th graders, 14.0 percent among 10th graders, and 16.2 percent among 12 graders.

Two times as many boys use e-cigs as girls.

diabetes type 2

There is a problem about diabetes type 2

 

 

many topic

 

bad habit or not nutration food is a cause of diabetes

 

   
   

 

 

Fewer Diabetes Cases Being Missed

Although the number of people diagnosed with diabetes is still on the rise, the good news is that most people with the disease know they have it, a new study shows.

The research suggests that over the past two and a half decades, the percentage of undiagnosed cases has dropped significantly.

"If you're going to your doctor, you probably don't have to worry about undiagnosed diabetes," said study author Elizabeth Selvin, a professor of epidemiology at Johns Hopkins University's Bloomberg School of Public Health.

Selvin explained that previous estimates suggested that over a quarter to 30 percent of people with diabetes probably didn't know it. But those estimates assumed that doctors were only doing one test for diabetes and not following up with a confirmatory second test, as the American Diabetes Association recommends.

However, "we found that's not consistent with how diabetes is diagnosed in clinical practice. In practice, an abnormal finding is confirmed with a second test for the diagnosis. When you use two tests, we see that we're doing a good job with screening and diagnosing diabetes," Selvin said.

In fact, the two-test method seems to capture about 90 percent of all diabetes cases, the researchers noted.

Selvin and her colleagues used data from U.S. National Health and Nutrition Examination Surveys done from 1988 to 1994 and from 1999 to 2014.

RELATED: 9 Types of Medication That Help Control Type 2 Diabetes

The surveys showed that when the research began in 1988 to 1994, there were about 10 million adults with diabetes and confirmed undiagnosed diabetes (that means people who just had one test and didn't get a follow-up test). By 1999 to 2014, there were 25.5 million adults with diabetes or undiagnosed diabetes.

The new research revealed that the number of undiagnosed cases as a percentage of all diabetes dropped from more than 16 percent to slightly less than 11 percent over 26 years.

People who were undiagnosed were more likely to be overweight or obese, older, or a racial or ethnic minority. They were also less likely to have health insurance or access to health care, the study found.

"What we need to figure out is how to target our screening and prevention efforts to the group that actually is undiagnosed. Some of the people being missed have very high [blood sugar levels] and the efforts should be concentrated on getting those people to the clinic," Selvin said.

The findings were published Oct. 23 in the Annals of Internal Medicine.

Dr. Anne Peters is director of the clinical diabetes program at the University of Southern California Keck School of Medicine in Los Angeles. She wrote an editorial that accompanied the study.

"I think there are fewer undiagnosed cases than we used to think, but there are still a lot of people who are undiagnosed," Peters said.

"People with risk factors need to get tested. But people get afraid of the stigma. They get afraid of the disease. But diabetes doesn't have to be awful. People don't have to give up. We need a lot more public awareness and a lot more prevention," she said.

And that doesn't mean you have to lose 100 pounds. "Losing 15 pounds can make a big difference. Just walking 30 minutes a day, five days a week is incredibly beneficial. Take diabetes on in bite-sized pieces," Peters advised.

"There are so many new ways to treat diabetes. Almost everything has changed in the past 30 years. But the earlier you start treatment, the better. Some things are better to face," she said.

12 Ways to Ease Seasonal Depression

1 / 13   Seasonal Depression: Common But Treatable
If shorter days and shifts in weather zap your energy and make you feel blue, you’ve got classic symptoms of a seasonal mood disorder. Seasonal affective disorder (SAD) is a form of seasonal depression triggered by the change in seasons that occurs primarily in winter. Why do some people get SAD? Experts aren’t certain, but some think that seasonal changes disrupt the circadian rhythm: the 24-hour clock that regulates how we function during sleeping and waking hours, causing us to feel energized and alert sometimes and drowsy at other times.

Another theory is that the changing seasons disrupt hormones such as serotonin and melatonin, which regulate sleep, mood, and feelings of well-being. About 4 to 6 percent of U.S. residents suffer from SAD, according to the American Academy of Family Physicians, and as many as 20 percent may have a mild form of it that starts when days get shorter and colder. Women and young people are more likely to experience SAD, as are those who live farther away from the equator. People with a family history or diagnosis of depression or bipolar disorder may be particularly susceptible.

"It is important to treat SAD, because all forms of depression limit people's ability to live their lives to the fullest, to enjoy their families, and to function well at work," says Deborah Pierce, MD, MPH, clinical associate professor of family medicine at the University of Rochester School of Medicine and Dentistry in Rochester, New York. Here are a few SAD treatment options you might want to consider.

Impulsive, Agitated Behaviors May Be Warning Signs for Suicide

Risky behaviors such as reckless driving or sudden promiscuity, or nervous behaviors such as agitation, hand-wringing or pacing, can be signs that suicide risk may be high in depressed people, researchers report.

Other warning signs may include doing things on impulse with little thought about the consequences. Depressed people with any of these symptoms are at least 50 percent more likely to attempt suicide, the new study found.

"Assessing these symptoms in every depressed patient we see is extremely important, and has immense therapeutical implications," study lead author Dr. Dina Popovic, of the Hospital Clinic de Barcelona, in Spain, said in a news release from the European College of Neuropsychopharmacology (ECNP).

The findings were scheduled for presentation Saturday at the ECNP's annual meeting in Amsterdam.

One expert in the United States concurred with the findings.

"It has long been known that those patients with depression who also experience anxiety and/or agitation are more likely to attempt or complete suicide," said Dr. Donald Malone, chair of psychiatry and psychology at the Cleveland Clinic. "These symptoms can also be a clue that the underlying diagnosis is bipolar depression (manic depressive disorder)," he added.

In the study, Popovic's team looked at more than 2,800 people with depression, including nearly 630 who had attempted suicide. The researchers conducted in-depth interviews with each patient, and especially looked for differences in behaviors between depressed people who had attempted suicide and those who had not. Certain patterns of behavior began to emerge, the study authors said.

"Most of these symptoms will not be spontaneously referred by the patient, [so] the clinician needs to inquire directly," Popovic said.

She and her colleagues also found that "depressive mixed states" often precede suicide attempts.

RELATED: What Suicidal Depression Feels Like

"A depressive mixed state is where a patient is depressed, but also has symptoms of 'excitation,' or mania," Popovic explained. "We found this significantly more in patients who had previously attempted suicide, than those who had not. In fact, 40 percent of all the depressed patients who attempted suicide had a 'mixed episode' rather than just depression. All the patients who suffer from mixed depression are at much higher risk of suicide."

The researchers reported that the standard criteria for diagnosing depression spotted only 12 percent of patients with mixed depression. In contrast, using the new criteria identified 40 percent of these patients, Popovic's team said.

"This means that the standard methods are missing a lot of patients at risk of suicide," she said.

Malone agreed that a "mixed state" can heighten odds for suicide.

"This study appropriately cautions caregivers to pay particular attention to suicide risk when treating patients with mixed states," he said.

"Bipolar patients are at higher risk of suicide in general when compared with non-bipolar depression, even when not in a mixed state," Malone said. Drug treatments for bipolar depression "also can differ significantly from those of unipolar depression," he added. "In fact, antidepressants can worsen the situation with bipolar patients."

According to Malone, all of this means that "accurate diagnosis is essential to deciding on effective treatment."

Dr. Patrice Reives-Bright directs the division of child and adolescent services at South Oaks Hospital in Amityville, N.Y. She said that the "more commonly known risk factors for suicide include hopelessness, history of previous attempts and recent loss or change in one's life."

However, the impulsive and risky behaviors outlined in the new study can "also increase the likelihood of someone who is depressed to act on thoughts to end his or her life," Reives-Bright said.

She agreed with Malone that "identifying these symptoms of a mixed state is important when assessing mood symptoms and selecting treatment options for the patient."

Findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal. However, according to Popovic, one strength of the new study is that "it's not a clinical trial, with ideal patients -- it's a big study, from the real world."

More than 800,000 people worldwide die by suicide every year, and about 20 times that number attempt suicide, according to the World Health Organization. Suicide is one of the leading causes of death in young people.

Scans Suggest Recurrent Depression May Take Toll on the Brain

The area of the brain involved in forming new memories, known as the hippocampus, seems to shrink in people with recurring depression, a new study shows.

Australian researchers say the findings highlight the need to spot and treat depression when it first develops, particularly among young people.

Ian Hickie, who co-directs the Brain and Mind Research Institute at the University of Sydney, led the study. His team looked at the neurology of almost 9,000 people from the United States, Europe and Australia. To do so, they analyzed brain scans and medical data for about 1,700 people with major depression, and almost 7,200 people who didn't suffer from depression.

The researchers noted that 65 percent of the participants with major depression had suffered recurring symptoms.

The study, published June 30 in the journal Molecular Psychiatry, found that people with major depression, particularly recurring forms of the condition, had a smaller hippocampus. This part of the brain was also smaller among participants diagnosed with depression before they reached the age of 21.

Many young people diagnosed with depression go on to develop recurring symptoms, Hickie's team noted.

RELATED: Depression as a Risk Factor for Dementia

Recurrence seemed key: About a third of participants had had only one episode of major depression, and they did not show any reduction in the size of their hippocampus compared to non-depressed people.

According to the researchers, that suggests that it is recurring depression that takes a toll on brain anatomy.

The take-home message: Get depression diagnosed and treated before brain changes can occur, the Australian team said.

"This large study confirms the need to treat first episodes of depression effectively, particularly in teenagers and young adults, to prevent the brain changes that accompany recurrent depression," Hickie said in a university news release.

According to co-researcher Jim Lagopoulos, "these findings shed new light on brain structures and possible mechanisms responsible for depression."

"Despite intensive research aimed at identifying brain structures linked to depression in recent decades, our understanding of what causes depression is still rudimentary," Lagopoulos, who is an associate professor at the institute, said in the news release.

The study couldn't prove cause-and-effect, however, and the study authors say that more research could help explain if the brain changes are the result of chronic stress, or if these changes could help spot people who are more vulnerable to depression.

only am I not alone, but I am connecting in a significant and meaningful way

only am I not alone, but I am connecting in a significant and meaningful way

Type 2 Diabetes Drug Helps Some With Chronic Depression

A new small study is adding evidence to the theory that insulin resistance may play a leading role in some people's depression.

The study found that a medication normally used to boost insulin sensitivity in people with type 2 diabetes appears to help ease the symptoms of chronic depression. And, the effect was strongest in people who were insulin-resistant but didn't have diabetes, the study found.

These findings "add to the neurobiological explanation of what's going on when people are depressed, and it should help de-stigmatize depression. It's a disease of the brain," said the study's lead author, Dr. Natalie Rasgon, a professor of psychiatry and behavioral sciences at Stanford University School of Medicine in California.

"Depression is kind of a catch-all term, like the common cold; it can have more than one cause," Rasgon said. "In this study, we saw two separate effects of the [drug]. In patients with insulin resistance, their insulin resistance improved, and their depression improved."

That may mean that insulin resistance is playing a significant role in the depression of these people, she explained.

But patients who weren't insulin-resistant also saw their depression improve during the trial.

"That speaks to a different mechanism. It could be an anti-inflammatory effect," Rasgon said.

Findings from the study were published Nov. 18 in Psychiatry Research. Funding for the study was provided by the U.S. National Institutes of Health. The researchers received no support from the makers of the drug, pioglitazone (Actos), which has U.S. Food and Drug Administration approval for use as a treatment for type 2 diabetes.

RELATED: Why Sugar Is Poison for Depression

Insulin is a hormone that allows the body and brain to use the sugar from foods as fuel. Someone who is sensitive to insulin uses the hormone effectively. Someone who is insulin-resistant doesn't use insulin well, and sugar is released into the bloodstream instead of being used to power cells in the body and brain. Insulin resistance can be a precursor to type 2 diabetes, the researchers said.

The study included 37 adults -- 29 women and eight men -- recruited at Stanford University. The study volunteers were between 21 and 75 years old. Their weight ranged from underweight to severely obese, the study authors noted. None had diabetes, but some were insulin-resistant or had pre-diabetes, the researchers said.

All of the study volunteers had depression for longer than a year. Despite standard treatments for the mental health disorder, they were still experiencing depression, the study authors said.

Rasgon and her team randomly gave the study volunteers 12 weeks of treatment with pioglitazone or an inactive placebo. People were allowed to stay on their current antidepressant treatment as well. Pioglitazone works by making people more sensitive to insulin, the researchers said.

All of the study participants were tested for depression and insulin resistance at the start of the trial, and again at the end.

People who were insulin-sensitive had improvements in their depression whether they were taking the drug or a placebo. But those who were insulin-resistant only saw improvement in their depression symptoms if they were taking the insulin-sensitizing drug. People who were insulin-resistant who took the placebo didn't get better.

The more insulin-resistant someone was, the better the drug worked on their depression, the study found.

The idea that insulin resistance could cause problems in the brain makes sense, Rasgon said. The brain uses a lot of glucose (sugar), so anything that makes it harder for the brain to get the glucose it needs could affect vital brain functions, such as controlling emotions and thinking, she suggested.

Whether it would be safe for people who don't have type 2 diabetes to take pioglitazone for long periods isn't known. Rasgon pointed out that the study was small and only done for 12 weeks. She hopes to be able to do a longer and larger trial.

"The data in this study is preliminary," said Dr. Eric Hollander, director of the anxiety and depression program at Montefiore Medical Center in New York City. "But it may eventually lead to a new paradigm that could be helpful in reducing the stigma of depression," he added.

"Mood disorders may be part of a systemic illness -- at least in a subgroup of depressed patients," he said.

Hollander suggested that improvements in insulin resistance or decreased inflammation may be what helped ease depressive symptoms.

Both experts said these findings suggest that any of the treatments for type 2 diabetes may also help people with longstanding depression. Treatments include other medications that improve insulin sensitivity, and even lifestyle factors, such as losing weight or exercising. Both of those lifestyle factors increase insulin sensitivity, too.

8 Things Your Dentist Knows About You Just By Looking In Your Mouth

You flossed right before your appointment—and that’s the only time.

Sorry, but you can’t fool your dentist into thinking you floss daily by doing it the night before or morning of your visit. 

“The gums of people who only floss right before a visit are bleeding or look damaged,” says Timothy Stirneman, D.D.S., of All Smiles Dental in Algonquin, Illinois. “Healthy gums are nice and tight and pink.”

Santa Monica-based dentist Kenneth Wong, D.D.S., is on to you, too. “When patients floss right before coming in for a cleaning, I can see the slices where the floss cut at the gum because they were overzealous,” he says. 

Statins May Boost Survival Odds After Cardiac Arrest

The odds of surviving cardiac arrest seem higher for patients who've been taking cholesterol-lowering statins, a new study shows.

Researchers in Taiwan studied the medical records of nearly 138,000 cardiac arrest patients. Those already using statins such as Lipitor (atorvastatin) or Crestor (rosuvastatin) were about 19 percent more likely to survive to hospital admission and 47 percent more likely to be discharged. Also, they were 50 percent more likely to be alive a year later, the study found.

"When considering statin use for patients with high cholesterol, the benefit of surviving sudden cardiac arrest should also be considered, as statin use before cardiac arrest might improve outcomes of those patients," said study author Dr. Ping-Hsun Yu.

Yu is a researcher from the National Taiwan University Hospital and College of Medicine in New Taipei City.

The greatest survival benefit from statins was seen in patients with type 2 diabetes, Yu's team said.

Cardiac arrest is the abrupt loss of heart function. Death often occurs instantly or shortly after symptoms appear, according to the American Heart Association.

"We know that a large proportion of cardiac arrests occur due to coronary plaque rupture," said Dr. Puneet Gandotra, director of the cardiac catheterization laboratories at Northwell Health Southside Hospital in Bay Shore, N.Y.

RELATED: Bystander CPR Doubles Cardiac Arrest Survival Rates

"This rupture leads to a snowball effect in arteries and can cause arteries to get blocked, resulting in a heart attack or cardiac arrest," he explained.

So how might statins help?

"I feel that due to statin therapy, there is significant plaque stability and the effects of rupture are not as significant. Thus, an improvement in survival is noticed with patients on statin therapy who have cardiac arrests," Gandotra said.

Statins are often prescribed for patients after a heart attack or stroke as a way to prevent a second cardiovascular event. However, "this does not mean that everyone should be on statin therapy," Gandotra said.

These drugs can have side effects, such as muscle pain and weakness and higher blood sugar levels. In addition, the value of statins for preventing a first cardiac arrest or stroke is not clear, the researchers added.

Dr. Suzanne Steinbaum, director of Women's Heart Health at Lenox Hill Hospital in New York City, said, "What we learn from studies like this is that [statins] have other benefits.

"A study like this gives me a reason to say, 'There are more reasons for you to take a statin than just to lower your cholesterol,' " Steinbaum said.

For the study, Yu and colleagues divided the medical records of almost 138,000 patients according to whether they had used statins for 90 days within the year before their cardiac arrest. The researchers also accounted for gender, age, other medical problems, number of hospitalizations, post-resuscitation and other variables.

Because more than 95 percent of the patients in the study were Asian, these results might not apply to other groups or ethnic populations, Yu said.

The findings were to be presented on Sunday at the American Heart Association annual meeting, in New Orleans. Data and conclusions presented at medical meetings are usually considered preliminary until published in a peer-reviewed medical journal.

Parent's Depression May Harm Child's Grades, Study Finds

A child's grades in school might suffer if a parent is suffering from depression, according to a new study.

Researchers found that Swedish teens received lower grades during their final year in school if either of their parents had previously been diagnosed with depression.

The difference in grades was noticeable but not huge, said senior author Brian Lee, an associate professor of epidemiology and biostatistics at Drexel University's Dornsife School of Public Health in Philadelphia.

"It's not an entire letter grade drop, but at the same time it might be the difference between a student passing or failing," Lee said.

Parents' depression could affect the children's home lives, causing stress that impacts their academic performance, Lee said.

"Depression is a social disease," he said. "It doesn't just affect you. It affects your relationships as well. If there's strain there, it may affect the child's academic performance."

Since depression can be handed down, it also could be that the children are not doing as well in school because they suffer from undiagnosed mood disorders, he added.

Infants also might receive poorer care during early development if their mothers are depressed -- less breast-feeding or nurturing, for example -- which could have long-term impacts on children's ability to learn and problem-solve, he said.

"There are many different mechanisms to explain what we've found, and those are just a few possibilities," Lee said.

The study, published online Feb. 3 in JAMA Psychiatry, only found an association between parental depression and worse grades, however, not a direct cause-and-effect relationship.

In the study, Lee and his colleagues examined data on more than 1.1 million children born in Sweden between 1984 and 1994.

Compulsory education ends at age 16 in Sweden, and kids leaving school are assigned a final school grade based on how well they did in their last year. The researchers compared the final grades of teens whose mothers and fathers had been diagnosed with depression against those of teens whose parents do not have a mood disorder.

RELATED: Should You Have Kids If You’re Depressed?

They found that maternal and paternal depression affected a teen's performance during that final year in school, even if the depression occurred years earlier.

In general, both maternal and paternal depression in any period of a child's life were associated with worse school performance. Maternal depression was associated with a larger negative effect on school performance for girls compared with boys, according to the results.

The impact of depression is as large as similar effects on grades caused by differences in family income and the level of mom's education, the researchers reported.

Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center in New Hyde Park, N.Y., said, "This study provides strong evidence to suggest that children who have a depressed parent are at increased risk for lower academic performance."

Adesman, who was not involved with the research, found it "striking" that parental depression affects learning "regardless of whether the parental depression occurred early in a child's life or later and regardless of whether it is the mother who is depressed or the father."

The findings show that parents suffering from depression need to get help if they want to protect their kids, said Myrna Weissman, chief of epidemiology at the New York State Psychiatric Institute and a professor at Columbia University in New York City.

"We must make sure there's good available treatment for the parent so they stay asymptomatic. That would help a great deal," said Weissman, who wrote an editorial accompanying the study. "We have great data now showing if you treat the parent, the children function better."

Friends of a parent with depression should urge them to seek help, Weissman said.

Schools can offer programs to help children of depressed parents, but Weissman thinks it would be better to get treatment for the adult.

"Depression is highly treatable," she said. "I would certainly begin there."

How to Find the Right Therapist for Your Depression

The right therapist can make all the difference in getting the best treatment for depression, but do some homework before you choose one.


If you're depressed, a therapist can teach you how to deal with your feelings, change the way you think, and change the way you behave to help ease your symptoms.

Finding a therapist you are comfortable with is essential. You will need to talk openly and honestly with your therapist about your thoughts and feelings, so it's important to find the right specialist for you, says Ryan Howes, PhD, a clinical psychologist and a clinical professor at the Fuller School of Psychology in Pasadena, California.

The first step is to look at yourself and determine what it is you need, Dr. Howes says. “Ask yourself, Am I the sort of person who benefits from someone who tells me what to do? Or do I need someone with a good ability to listen and who will talk through things with me?" he advises. Your answer will tell you whether you need someone who will provide directive or non-directive therapy.

Also consider whom you might feel most comfortable with: a man or a woman; someone about your age, or someone younger or older; someone with lots of experience, or someone who is relatively new with fresh ideas. “Once you narrow it down, you can start looking for people who meet your criteria,” Howes says.

Different Types of Therapists and Their Credentials

Several types of mental health professionals can serve as a therapist for people with depression. Being aware of the training differences might help you narrow your search.

Psychiatrists are medical doctors (MD or DO degree) who have completed specialized training in mental and emotional disorders. They can diagnose, treat, and prescribe medications for depression. Psychiatrists may also provide individual or group therapy. Philip R. Muskin, MD, professor of psychiatry and chief of consultation-liaison psychiatry at the Columbia University Medical Center in New York City, advises starting with a physician if you’re severely depressed.

Psychologists have a doctoral degree (PhD or PsyD) in psychology. They are skilled in the diagnosis of emotional disorders and spend most of their time providing individual or group psychotherapy, but do not prescribe medication.

Social workers usually have a master’s degree in social work (MSW) and have training in providing individual or group therapy.

Licensed professional counselors have a master’s degree in psychology (or a related area) and are trained to diagnose and counsel individuals or groups.

Psychiatric nurses are registered nurses (RNs) with training in psychiatric nursing.

Sources of Referrals

How do you go about finding the right therapist for you?

You might want to start by talking with your family doctor. If your doctor feels you need a mental health specialist, he or she should be able to give you referrals, Dr. Muskin says. Or you might be the one to tell your regular doctor, "I need to see a psychiatrist, and this is why,” he adds.

RELATED: 5 Things Psychologists Wish Their Patients Would Do

You could also ask around to see if your friends or family members know of a good therapist who has experience in treating depression. “Personal references can be very good, particularly if they come from someone who knows you well and what you like,” Muskin says.

Here are other resources to help you find a therapist for depression treatment: 

The National Alliance on Mental Illness (NAMI) runs a helpline that can help you locate support. Call 800-950-NAMI or email info@NAMI.org.
The American Psychological Association has a therapist locator on its website.
The Anxiety and Depression Association of America can also help you locate a therapist near where you live. 
Your health insurance company likely has a dropdown menu item, such as “find a provider,” for names of professionals in its network.
Schools and universities often have counseling services that can offer referrals if they can’t help you directly. You may have access if you’re an alum or faculty.
The clergy Faith leaders often know of mental health professionals who can help. And if they know you, they can recommend someone who fits your personality and needs. 
Employee Assistance Programs If offered by your employer, they’re part of your benefits package.  
How to Interview Potential Therapists

Once you have a list of at least two or three potential therapists, it's time to figure out which one is best for you. Call each therapist to get some key information before making an appointment.

Questions to ask include:

Are you taking new patients?
What experience do you have treating patients who have depression?
Where do the therapy sessions take place? Some psychiatrists have more than one office where they see patients, Muskin says. Their location and when they hold appointments can matter to you, he adds.
How much does the therapy cost? Do you take my insurance?
Can I meet with you before committing to a therapy session?
RELATED: 6 Questions Everyone Should Ask Their Therapist

If you're able to make a consultation appointment before a therapy session, ask the therapist more specific preliminary questions, such as:

What type of therapy would you recommend for my depression symptoms?
What will this type of therapy involve?
What are the benefits and the primary goals of my depression treatment?
Are you willing to work with other members of my medical team to coordinate my depression treatment? This is especially important if you have a non-MD therapist who will rely on your primary care doctor to prescribe medications.
How often would I need therapy sessions?
After meeting with a potential therapist, take some time to decide whether you are comfortable with them. If you aren’t, keep looking until you find one you like and trust.

Some people will improve with psychotherapy alone; others may need both psychotherapy and a prescription antidepressant. Once you start therapy for your depression, be patient. Psychotherapy (sometimes referred to as talk therapy) for depression can sometimes be painful, and you may find yourself doing most of the talking during the first few sessions. Your therapist will partner with you to ease your depression symptoms and improve your life.

Light Box Might Help Nonseasonal Depression, Too

Light therapy, a treatment for a kind of depression known as seasonal affective disorder (SAD), may also benefit nonseasonal depression, a new study indicates.

"The combination of light and an antidepressant seems to work very well for treating nonseasonal depression," said study leader Dr. Raymond Lam, a professor and head of the Mood and Anxiety Disorders Program at the University of British Columbia in Canada.

Depression, a leading cause of disability worldwide, affects one in 20 people, according to background information with the study. Current treatments include psychotherapy and antidepressant medication, but recurrent episodes are common.

Since bright light treatment is used for people whose seasonal depression occurs in the darker months, the researchers hypothesized it might also lift depression that isn't brought on by light deprivation.

Lam and his team randomly assigned 122 adults with major depression not related to seasonal affective disorder to one of four groups. One group got 30 minutes of bright light treatment a day and took a placebo pill, while another used a device that was not light therapy and took the antidepressant fluoxetine (Prozac). A third group took a placebo pill and used a placebo device, while a fourth took Prozac and got light therapy.

The researchers followed the men and women for eight weeks, looking to see how many went into remission -- defined as having normal scores on a widely used depression scale.

"About 60 percent of the patients who got the combination [Prozac plus light] treatment went into remission with their symptoms compared to about 40 percent on light therapy alone," Lam said.

RESEARCH: 12 Ways to Treat Seasonal Depression

The antidepressant alone was not superior to placebo medication. Only about 30 percent of those on placebo medication and sham light treatment had remission, as did just 20 percent of those on Prozac with sham light treatment.

Light therapy alone was better than placebo, but not from a statistically significant point of view, Lam said.

Experts can't say for sure why light therapy works, but for seasonal affective disorder they think it may help correct disturbances in the body's circadian rhythms, or internal clock.

The same may be true for nonseasonal depression, Lam said. "Another theory is that light affects neurotransmitters in the brain such as serotonin [which affects mood]," he said. Or both could play a role, he added.

One limitation of the study, published online Nov. 18 in JAMA Psychiatry, is that patients' natural light exposure was not measured, the researchers said.

Simon Rego is director of psychology training at Montefiore Medical Center and an associate professor at Albert Einstein College of Medicine in New York City. He said the study is the first well-designed comparison of light therapy and the combination of light therapy and antidepressant medications in adults with nonseasonal major depressive disorder.

"In this case, the authors found that the light treatment, whether delivered alone or particularly when delivered in combination with an antidepressant medication, was efficacious in the treatment of nonseasonal [depression] and, just as important, the treatments were well-tolerated by the subjects," Rego said.

"It appears that light therapy, which is already seen as an effective treatment for seasonal affective disorder, may also be appropriate for nonseasonal [depression]," he added.

However, questions remain, Lam said, such as how long the combination treatment should continue.

Light boxes are sold at drugstores and other locations, Lam said, for less than $100 to $300. Some insurance plans cover them, he said.

Recommended treatment involves sitting in front of the fluorescent light box for a half hour daily as soon as possible after waking up. Lam said this can be done while eating breakfast or working on the computer.

The Canadian Institutes of Health Research funded the study. Lam reports serving as a consultant to or receiving honoraria for speaking from various pharmaceutical companies, including Eli Lilly and Co., which makes Prozac.

Influenza, a viral infection, illness that can range from mild to life-threatening

Influenza, commonly known as "the flu," is a viral infection of the respiratory tract that affects the nose, throat, and sometimes lungs.

 tend to happen annually, at about the same time every year. This period is commonly referred .

However, each outbreak may be caused by a different subtype or strain of the virus, so a different flu vaccine is needed to prevent the flu each year.

For most people, a bout of flu is an unpleasant but short-lived illness.

For others, however, flu can pose serious health risks, particularly if complications such as pneumonia develop.

Every year, thousands of Americans die from the flu. According to the Centers for Disease Control and Prevention (CDC), the number of deaths caused annually by flu in the United States ranged from 3,000 to 49,000 between 1976 and 2006, with an annual average of 23,607 flu-related deaths.

The best way to avoid getting the flu is to get an annual flu vaccination, encourage the people you live and work with to do likewise, stay away from people who are sick, and wash your hands frequently.

Conquering Depression and Obesity

By the time David Clark was in his early thirties, he owned a chain of 13 retail stores that reported $8 million a year in sales, and he was married with three children. “I should be happy,” he recalls thinking. But he wasn’t.

He was depressed. “I couldn’t find simple joy in anything, and had thoughts of stepping in front of a bus to end it,” he says. The depression caused him to eat massive amounts of fast food and drink recklessly, he says, and that led to obesity. At his heaviest, the nearly 6-foot-tall Clark, from Lafayette, Colorado, weighed 320 pounds.

Clark was not alone in suffering from depression and obesity. Nearly half of all adults who live with depression — 43 percent — are obese, and adults with depression are more likely to be obese than adults who aren’t depressed, according to the Centers for Disease Control and Prevention.

Whether depression or obesity comes first can vary from person to person, says Kim Gudzune, MD, MPH, assistant professor of medicine at Johns Hopkins Medicine in Baltimore. “But if you have one condition, you’re more likely to have the other,” she says.

Depression and obesity are often linked because of the stigma of obesity. Some who are obese have a poor body image and can become depressed as a result, Dr. Gudzune says, and others eat to drown their sorrows.

In addition, “there may be shared neural pathways between obesity and depression that may place individuals at risk for both,” says Leslie Heinberg, PhD, director of behavioral services for the Bariatric and Metabolic Institute at the Cleveland Clinic in Ohio.

How Clark Turned His Life Around

After his weight gain, Clark was at risk for high blood pressure and was borderline diabetic.

He says he overcame both of his health conditions essentially on his own. One morning, when he was 34, Clark says he woke up and realized how close to death he was. He knew that if he didn’t change, his children would be fatherless.

“I didn’t want my kids to see their father drink himself to death,” he says, so he joined Alcoholics Anonymous and followed the group's 12 steps to stop drinking. “I went on a spiritual journey to make peace with my path,” says Clark, who grew up poor and homeless. As a kid, he and his dad had roamed the country in the back of a pickup truck, he says.

RELATED: 6 Ways to Set Goals You’ll Actually Achieve

He also began running. And running. Some years earlier, he'd seen the New York City Marathon on television and always had it in the back of his mind that that was something he might do. Eventually, Clark became an ultra-marathon runner. Now 44, he runs at least 80 to 100 miles a week and competes in some of the most challenging endurance races on the planet, including across Death Valley in California.

At first, it was painful to run, but he says the pain was also motivating. “I knew the stakes had to be pretty high to make such a dramatic change in my life," he says.

Running: A Low Cost Mood Booster

After Clark revamped his diet to be plant-based, stopped drinking alcohol, and began running regularly, his weight began to drop. It took him 18 months, but he got down to a healthy 180 pounds. When he switched to competitive running, he lost another 20 pounds and has stayed at 160 for years now, he says.

The running also improved his mood, says Clark, who chronicles his journey in the book Out There: A Story of Ultra Recovery. Exercise releases endorphins — hormones that reduce your perception of pain and improve your mood, according to Harvard Medical School in Boston.

Clark advises others who struggle with obesity and depression to do like he did and “draw a line in the sand” to say, “I’m not going to live this way anymore — I’m going to move on to a better place.”

What You Can Do

Though Clark lost weight on his own, not everyone can. So if you're struggling, consider working with a nutritionist or your doctor to find a weight-loss program. The key is to make low-calorie, healthy choices and exercise more so that you burn more calories than you consume, according to the National Institutes of Health. If you're extremely overweight, your doctor might suggest medication to curb your appetite, or weight-loss surgery.

Exercise and eating well may also help treat your depression. You can work with a therapist who can help you find the right treatment plan. That could include individual or group therapy, stress-reduction techniques, medication, or some combination of these.

Treatment can be difficult, because a side effect of some depression medications is weight gain, Gudzune says. But treating depression and weight issues simultaneously, Heinberg says, can be beneficial because if people who are depressed are able to lose weight, that could benefit their depression.

Too Soon to Widely Recommend Ketamine for Depression

The drug ketamine -- known as Special K on the party scene -- shows promise as a depression treatment. But researchers aren't ready to recommend it because its long-term effects remain unknown.

That gap in knowledge must be filled before ketamine can be widely used to treat depression, said Colleen Loo, co-author of a new research review. She's a professor at the University of New South Wales in Australia.

Ketamine, an anesthetic drug, is increasingly being used off-label to treat severe and treatment-resistant depression. And some preliminary findings suggest rapid-acting effectiveness, Loo said.

But "this has not been effectively explored over the long term and after repeated dosing," she added in a university news release.

RELATED: 10 Diseases That Make Depression Feel Worse

Loo and her colleagues examined 60 published studies of ketamine treatment for depression, involving a total of nearly 900 patients. The investigators found few studies reported on the safety of repeated doses or sustained use of the drug.

"As ketamine treatment will likely involve multiple and repeated doses over an extended time period, it is crucial to determine whether the potential side effects outweigh the benefits to ensure it is safe for this purpose," she explained.

Past research has linked longer-term ketamine use to bladder inflammation, liver damage, memory loss and addiction. These potential troubles "may limit the safe use of ketamine as a long-term antidepressant treatment," the review authors wrote.

The review was published July 27 in The Lancet Psychiatry.

10 Ways to Live Better With Psoriasis

The keys to successful psoriasis management are working with your doctor to find a treatment plan that’s right for you and then sticking to that plan. But your role in treatment doesn’t stop with medication. Making certain lifestyle changes is important, too.

From the foods you eat to the support you seek, making healthy choices every day can help you ease the discomfort of flaky, red itchy skin, avoid flares, and start living life to the fullest. Follow these 10 steps.  

1. Eat an anti-inflammatory diet. Despite extensive research, there’s no evidence supporting a specific “psoriasis diet,” says Caitríona Ryan, MD, a dermatologist at Texas Dermatology Associates in Dallas and vice chair of the dermatology residency program at Baylor University Medical Center. However, many people with psoriasis report feeling better when they avoid foods that have been shown to cause or increase inflammation (such as fatty red meats, processed foods, refined sugar, and nightshade vegetables) and embrace foods that are known to reduce inflammation. Inflammation-fighting foods include those rich in omega-3s, such as salmon, albacore tuna, flaxseeds, and walnuts, and colorful fruits and vegetables, such as spinach, carrots, and blueberries, according to the National Psoriasis Foundation (NPF). 

2. Maintain a healthy weight. People who are overweight tend to have more severe psoriasis, according to a study published in November 2012 in Clinical & Experimental Dermatology Research. “We know that adipose tissue (fat) produces inflammatory cytokines like tumor necrosis factor (TNF),” Dr. Ryan says. Overproduction of TNF, a cell signaling protein, can trigger psoriasis. In addition, systemic and biologic agents for treating psoriasis tend to work better in patients who aren’t overweight, she says.

3. Aim for 30 minutes of exercise most days. Physical activity goes along when it comes to maintaining a healthy weight and lowering your risk for comorbid conditions — such as your risk for heart disease and type 2 diabetes, which increase when you have psoriasis. Try to get at least 30 minutes of aerobic exercise five times a week, and add in some strength training. Although a study published in 2012 in the Archives of Dermatology showed that women who exercised vigorously lowered their risk of developing psoriasis, any level of exercise is better than none, says the NPF. That may mean simply taking the stairs at work instead of the elevator or parking farther away in parking lots.

4. Quit smoking and drinking too much. Neither of these habits is good for anyone, says Mark Lebwohl, MD, a professor and chairman of the department of dermatology at Icahn School of Medicine at Mount Sinai in New York. But they may be even worse for people with psoriasis, he says. The chemicals in tobacco may trigger inflammation that can both cause psoriasis and make flares more severe, according to the NPF. In addition, excessive alcohol consumption may interfere with your response to psoriasis treatment and make it less effective. If you need help quitting smoking or drinking excessively, talk to your doctor.

5. Arm yourself with moisturizer to fight dry skin. “The skin of people with psoriasis is very dry,” Dr. Lebwohl says. “Moisturizing makes it feel better.” Apply moisturizer after showering and after washing your hands. The thicker the moisturizer the better — creams and ointments lock more moisture in your skin.

6. Avoid illness. “Infections worsen psoriasis — even mild colds or urinary tract infections,” Ryan says. “So keeping healthy is rather important.” To stay healthy, eat well, wash your hands frequently, get quality sleep, and be sure your immunizations are up to date. Also be sure to get a flu shot before the start of the flu season.

7. Avoid injuries, too. Some people can develop lesions in new areas if their skin is cut, bruised, or burned, according to The Psoriasis and Psoriatic Arthritis Alliance (PAPAA). Try not to scratch, Ryan says. Be sure to protect your hands and skin when doing activities that could lead to injury such as household chores in the kitchen or pruning bushes in the garden.

8. Cut back on stress. Stressed out? Like most inflammatory conditions, too much tension can cause psoriasis to flare or can exacerbate lesions, according to the NPF. If you’re feeling overextended, look for ways to reduce stress in your life — be it meditation, exercise, or talking to a therapist.

9. Reach out for support. “There are a lot of benefits to support groups,” Lebwohl says. Whether the groups meet online or in person, people with psoriasis often share tips that work well for them and that can help others in their group, Lebwohl says. And sometimes, it helps just having someone listen to you who understands what you’re going through.

10. Stick to your treatment plan—even when you feel good. “Many patients think they’re better off minimizing treatment,” Lebwohl says. They stop taking their medication or go longer than they should between injections. But if you want to avoid flares, you need to stick to the plan. Says the NPF: Using your treatments as prescribed makes a big difference in how well they work.

Mindfulness Therapy May Help Ease Recurrent Depression

Review of 9 studies suggests it helps patients better cope with troubling thoughts and emotions.

Mindfulness therapy may help reduce the risk of repeated bouts of depression, researchers report.

One expert not connected to the study explained the mindfulness approach.

"Mindfulness-based cognitive therapy enhances awareness of thoughts and emotions being experienced, and enables development of skills to better cope with them," said Dr. Ami Baxi, a psychiatrist who directs adult inpatient services at Lenox Hill Hospital in New York City.

In the new study, a team led by Willem Kuyken, of the University of Oxford in England, analyzed the findings of nine published studies. The research included a total of almost 1,300 patients with a history of depression. The studies compared the effectiveness of mindfulness therapy against usual depression care and other active treatments, including antidepressants.

After 60 weeks of follow-up, those who received mindfulness therapy were less likely to have undergone a relapse of depression than those who received usual care, and had about the same risk of those who received other active treatments, the team reported.

The study authors also believe that mindfulness therapy may provide greater benefits than other treatments for patients with more severe depression.

The study was published online April 27 in the journal JAMA Psychiatry.

"Mindfulness practices were not originally developed as therapeutic treatments," Richard Davidson, of the University of Wisconsin-Madison, wrote in an accompanying editorial. "They emerged originally in contemplative traditions for the purposes of cultivating well-being and virtue," he explained.

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"The questions of whether and how they might be helpful in alleviating symptoms of depression and other related psychopathologies are quite new, and the evidence base is in its embryonic stage," according to Davidson.

While this review is the most comprehensive analysis of data to date, it "also raises many questions, and the limited nature of the extant evidence underscores the critical need for additional research," Davidson concluded.

However, another psychologist said she is already using mindfulness therapy in her practice.

"I have increasingly incorporated mindfulness based-interventions into my work with children, adolescents and adults, and I've seen how it has improved treatment outcome and overall well-being in my clients," said Jill Emanuele. She is senior clinical psychologist at the Child Mind Institute in New York City.

Emanuele said there is growing evidence that the approach brings patients "increased awareness of emotions and thoughts, and the ability to more effectively regulate and cope with them."