Depression and Substance Abuse

Depression often feeds a substance abuse problem, but the opposite may also be true. Find out just how intertwined these two conditions are.

Mood disorders, like depression, and substance abuse go together so frequently that doctors have coined a term for it: dual diagnosis. The link between these conditions is a two-way street. They feed each other. One problem will often make the other worse, according to the Anxiety and Depression Association of America (ADAA).

About 20 percent of Americans with an anxiety or mood disorder, such as depression, also have a substance abuse disorder, and about 20 percent of those with a substance abuse problem also have an anxiety or mood disorder, the ADAA reports.

Compared with the general population, people addicted to drugs are roughly twice as likely to have mood and anxiety disorders, and vice versa, according to the National Institute on Drug Abuse (NIDA).

The Shared Triggers of Depression and Substance Abuse

When it comes to substance abuse and depression, it isn't always clear which one came first, although depression may help predict first-time alcohol dependence, according to a study published in 2013 in the Journal of Clinical Psychiatry.

The conditions share certain triggers. Possible connections between depression and substance abuse include:

The brain. Similar parts of the brain are affected by both substance abuse and depression. For example, substance abuse affects brain areas that handle stress responses, and those same areas are affected by some mental disorders.
Genetics. Your DNA can make you more likely to develop a mental disorder or addiction, according to research published in 2012 in Disease Markers. Genetic factors also make it more likely that one condition will occur once the other has appeared, NIDA reports.
Developmental problems. Early drug use is known to harm brain development and make later mental illness more likely. The reverse also is true: Early mental health problems can increase the chances of later drug or alcohol abuse.
The Role of Environment

Environmental factors such as stress or trauma are known to prompt both depression and substance abuse.

Family history is another factor. A study published in the Journal of Affective Disorders in 2014 found that a family history of substance abuse is a significant risk factor for attempted suicide among people with depression and substance abuse.

These types of dual diagnosis may also be traced back to a time in early life when children are in a constant process of discovery and in search of gratification, according to David MacIsaac, PhD, a licensed psychologist in New York and New Jersey and president of the New York Institute for Psychoanalytic Self Psychology.

RELATED: 6 Depression Symptoms You Shouldn’t Ignore

Any interruption or denial of this natural discovery process can manifest clinically and lead people to believe that everything they feel and think is wrong, he explains.

This idea, which Dr. MacIsaac says is based on the work of Crayton Rowe, author of the book Empathic Attunement: The 'Technique' of Psychoanalytic Self Psychology, challenges the idea that people dealing with depression try to self-medicate using drugs or alcohol. In fact, people with a dual diagnosis may be doing just the opposite, MacIsaac suggests.

"Individuals who are severely depressed drink to feed this negativity," he explains. "Initially it's soothing, but only for about 15 minutes. After that individuals sink deeper and deeper and feel worse than they did before."

For these people, MacIsaac points out, negativity is "where they get their oxygen." Any inclination that treatment is working will trigger a need to go back into the black hole of negative discovery, and alcohol will intensify their depression, he adds.

Why Simultaneous Treatment Is Important

Successful recovery involves treatment for both depression and substance abuse. If people are treated for only one condition, they are less likely to get well until they follow up with treatment for the other.

If they are told they need to abruptly stop drinking, however, depressed people with a substance abuse problem may be reluctant to undergo treatment, MacIsaac cautions. "They cling to drinking because they are terrified of losing that negativity," he says.

People with dual diagnoses must understand the root of their issues on a profound level, MacIsaac says. Once they understand, he says, they may have the ability to change. Treatment for depression and substance abuse could involve therapy, antidepressants, and interaction with a support group.

If you think you need treatment but are unsure where to start, the American Psychological Association provides the following suggestions:

Ask close friends and relatives whether they have recommendations for qualified psychologists, psychiatrists, or other mental health counselors.
Find out whether your state psychological association has a referral service for licensed mental health professionals.

Prescription Drugs That Cause Depression

Some prescription drugs can cause or contribute to the development of depression and other mood disorders.

What do certain asthma, acne, malaria, and smoking-cessation prescription drugs have in common? Answer: Their possible side effects include depression or other mood disorders.

Depression as a side effect of prescription drugs is widespread and increasingly gaining attention. The medications that contribute to drug-induced depression might surprise you. For example, an asthma medication, Singulair (montelukast), is prescribed to help people breathe more easily, but its side effects may include depression, anxiety, and suicidal thinking, according to a research review published in Pharmacology in 2014.

“In 2009, Merck added psychiatric side effects as possible outcomes with Singulair, including tremor, depression, suicidality — suicidal thinking and behavior — and anxiousness,” says J. Douglas Bremner, MD, researcher and professor of psychiatry and radiology at Emory University School of Medicine in Atlanta.

Drugs With Depression as a Side Effect

Dr. Bremner has published studies on the possible relationship between the use of retinoic acid acne treatments and the development of depression. One of the drugs within this category is Accutane (isotretinoin), the oral treatment for severe acne that has been associated with psychiatric problems, including depression.

“The original brand-name version of isotretinoin, Accutane, was taken off the market in 2009, although it continues to be marketed as Roaccutane in the U.K., Australia, and other countries," Bremner notes. "In the U.S. there are three generic versions available that have also been associated with reports of depression and suicide, Sotret, Claravis, and Amnesteem."

RELATED: Are You Getting Hooked on Anxiety Medications?

The full list of drugs that could cause depression is a long one. British researchers found 110 different medications between 1998 and 2011 that were associated with increased depression risk, according to a report published in BMC Pharmacology and Toxicology in September 2014.

Besides isotretinoin and montelukast, drugs that can cause or contribute to the development of depression or other mood symptoms include:

Lariam (mefloquine), used to treat malaria. Depression, anxiety, and psychosis are among the side effects of this medication, according to an article in Medical Science Monitor in 2013 that explored the chemical cascade behind mood changes.
Chantix (varenicline), used to stop smoking. The Food and Drug Administration (FDA) lists hostility, anxiety, depression, and suicidal thoughts as possible side effects of this medication.
Inderal (propranolol hydrochloride) and other drugs in the beta-blocker class, used to treat high blood pressure. Research on beta-blockers and depression suggests that some, but not all, of the medications in this class can contribute to depression, according to a report in the February 2011 issue of the Journal of Clinical Psychopharmacology.
Contraceptives. Contraceptives including those delivered by vaginal ring or patch could lead to depression in some people, according to research published in the Cochrane Database of Systematic Reviews in 2010.
Corticosteroids. Some people who take corticosteroids experience side effects such as depression, anxiety, and panic attacks, among other symptoms, according to a review of research published in Rheumatology International in 2013.
Interferon-alpha. As many as 40 percent of people using this immunologic medication may experience depression, according to a 2009 report in Dialogues in Clinical Neuroscience.
Interferon-beta. The link between this immunologic medication and depression is debated, but researchers reporting in Therapeutic Advances in Neurologic Disorders in 2011 note that depression is a concern for those who take it, in part because of their underlying conditions.
Nonnucleoside reverse transcriptase inhibitors. These HIV medications may increase the risk for depression, according to research published in the September 2014 issue of HIV Medicine. Arimidex (anastrozole) and aromasin (exemestane). Both of these long-term breast cancer therapies may contribute to depression, according to the FDA.
Vigabatrin. This anticonvulsant may cause depression, irritability, and psychosis, notes a review of studies in Acta Neurologica Scandinavica in 2011.
The FDA investigates drugs that have many reports of depression symptoms as a side effect. It requires what are called black-box warnings to be clearly printed on medications, like isotretinoin, that have been linked to depression and suicidal behavior, among other serious health threats. Make sure you read the information pamphlets that come with your prescription medications (and ask your pharmacist if you don’t understand what they say). You can stay on top of any news about their side effects by setting up a news alert on Google.

You can get the latest drug safety information on the FDA website.

Also, pay attention to how you feel. Though you may be taking medications that seem unrelated to mood, let your doctor know if you have symptoms such as sadness, difficulty sleeping, hopelessness, sleep changes, or thoughts of suicide.

“If you suspect your medication may be causing depression or similar problems, talk with your doctor and, if necessary, consult with a psychiatrist,” Bremner advises. The good news is that drug-induced depression usually clears up once you stop taking the medication.

Are Your Drugs Causing Depression?

It can be challenging to figure out whether your depression is related to taking a prescription drug, but here are some indicators:

Timeline. Drug-induced depression is defined as depression that appears within a month of starting or stopping a medication, according to the American Society of Health-System Pharmacists (ASHP). The society also advises that other conditions that might cause depression have to be considered in figuring out whether medication is the contributing factor. Bremner found in his research that the timeline varies from weeks to a month or two.
Dose-response relationship. With some drugs, depression symptoms may get better as the dose is reduced or worse as it is increased. This is usually a clear indicator of a relationship.
If you are uncertain about whether your changes in mood or energy are drug symptoms, talk with your doctor. Screening tools and questionnaires can reliably identify depression. You can also send information about your experiences to the FDA.

Prescription Drug-Induced Depression Treatment

In severe cases, people taking prescription drugs have developed depression leading to suicidal behavior. Because of this risk, don’t ignore or try to wait out feelings of depression, even if you believe they are only a prescription drug side effect. Talk with your doctor about these options to correct the situation:

Switching to an alternative treatment. If an equally effective medication that does not have depression as a side effect exists, the easiest option is to switch prescription drugs.
Getting a psychiatric evaluation. This may be recommended in any case to make sure you do not have an underlying psychiatric condition that has gone undiagnosed. People with a history of depression may have a worse response to some medications. An antidepressant might be prescribed in order to help manage depression symptoms.
Talk therapy will not work in this case, says Bremner, because the problem is chemically based. You will need prescription medication to address the depression if you cannot stop taking the drugs that are causing it.

If you think your depression symptoms are linked to a prescription drug you’re taking, talk with your doctor right away, get screened for depression, and find a better way to manage both your health issues and your mood.

The Calming Power of Nature

Spending time in nature eases depression, and could be a good supplement to medicine and therapy.

Remedies for depression abound, from medications to psychotherapy, or talk therapy. Having a range of treatment options is a good idea because no single treatment works equally well for each of the millions of U.S. adults with depression. Now researchers say a new therapy, proven to relieve depression, should be added to the mix as a supplement to established treatments. It's called nature.

Interacting with nature can have replenishing effects for those with depression, says Ethan Kross, PhD, associate professor of psychology at the University of Michigan and one of many experts who has studied the nature-depression link.

A little dose of nature helps us all recharge, but it may have special benefit for those who are depressed. "It seems that, from our work, the restorative effect of nature seems to be stronger for individuals diagnosed with depression," says Marc Berman, PhD, assistant professor of psychology at the University of Chicago. That might be because they feel mentally fatigued, and being in nature re-energizes them. However, Dr. Berman has a strong caveat: "We're not arguing that interacting with nature should replace clinically proven therapies for depression," he says. Nor should those with clinical depression try to treat themselves.

RELATED: How to Create a Depression Treatment Plan

However, Berman and others say, interactions with nature could serve as a very effective supplemental treatment.

What Nature-Depression Research Shows

Among the studies finding nature helps with depression:

Adults with depression who took a 50-minute walk in a natural setting for one research session and then a 50-minute walk in an urban setting for another research session were less depressed and had better memory skills after they took the nature walk.
Adults who moved to greener urban areas, compared to less green, had better mental health during follow-up three years after the move.
Those who took group nature walks reported less depression, less stress, and a better sense of well-being than those who didn't take nature walks, according to a study that looked at more than 1,500 people in a walking program.
Being outdoors and in nature boosts vitality, which experts define as having physical and mental energy. Those with depression often report fatigue and decreased energy. Researchers found the energy-boosting effect of nature was independent of the physical activity or social interaction experienced while outdoors.
How Nature Works Its Magic

The phenomenon of how nature helps improve depression is still being analyzed fully, Dr. Kross says.

One possibility, Berman says, is that interacting with nature helps due to the attention-restoration theory. "We have two kinds of attention," he says. "One is top-down (also called directed), the kind we use at work." Directed attention can be depleted fairly quickly, as you can only focus and concentrate for so long.

Another type of attention is bottom-up, or involuntary. "That's the kind automatically captured by things in the environment, such as lights or music." Involuntary attention is less susceptible to depletion. "You don't often hear people say, 'I can't look at this waterfall any longer,'" Berman says.

Why does nature hold this special effect? In a natural environment, we can choose to think or not, Berman says, and this choice is believed to help us rest our brains. You can then pay attention later, when you need to. "It is giving people more ability to concentrate, which is a big problem for those with depression," Berman says. Nature provides an effective setting for resting our brains, unlike urban settings. Even in the most peaceful urban environment, you have to pay attention to such things as traffic and stoplights.

Nature's replenishing effect is fairly instantaneous, Berman says. So if you're depressed and having an especially bad day, a quick dose of nature might help.

However, Berman cautions that anyone with clinical depression needs to be under a doctor's care, with supervision of all their treatments.

Essential Facts About Antidepressants

Newer antidepressants target brain chemicals involved in regulating mood, but they're not magic bullets. Here are the risks and benefits of these commonly prescribed drugs.

Although mild forms of depression are often treated without medication, those with more severe symptoms may benefit from taking antidepressant drugs. These medications, which target brain chemicals involved in mood, may help people with severe depression who do not respond to talk therapy or healthy lifestyle changes alone, according to the National Alliance on Mental Illness (NAMI).

The Use of Antidepressants Is on the Rise

Roughly 67 percent of people living with depression use medication as their primary form of treatment, NAMI reports. Antidepressants are the second most commonly prescribed drugs in the United States, according to a study published in 2013 in the American Journal of Clinical Hypnosis. Overall, use of antidepressants increased from 6.5 percent in 2000 to 10.4 percent by 2010, a study published in 2014 in the Journal of Clinical Psychiatry reveals.

How Antidepressants May Help

There are many theories about what causes depression, according to the National Institute of Mental Health (NIMH). Brain imaging technology shows that parts of the brain involved in mood, thinking, sleep, and behavior look different in people with depression than in those who are not depressed. Genetics, stress, and grief could also trigger depression, according to NIMH.

RELATED: 6 Need-to-Know Antidepressant Facts

Because specific chemicals called neurotransmitters, particularly serotonin and norepinephrine, are involved in regulating mood, medications that target these chemicals are often used to treat depression. Antidepressants work by increasing concentrations of these chemicals. These drugs include:

Selective serotonin reuptake inhibitors (SSRIs): SSRIs work by making more of the neurotransmitter serotonin available to your brain. Some of the drug names you may be familiar with are Prozac (fluoxetine), Paxil (paroxetine), and Celexa (citalopram).

The most common side effects associated with these medications include sexual problems, headache, nausea, dry mouth, and difficulty sleeping. These symptoms often fade over time, NAMI notes.

Atypical antidepressants: This class of drugs includes serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Effexor (venlafaxine) and Cymbalta (duloxetine). In addition to serotonin, these antidepressants may target other brain chemicals such as dopamine or norepinephrine.

Side effects of SNRIs are similar to those associated with SSRI drugs. You may also experience, fatigue, weight gain, or blurred vision.

The antidepressant Wellbutrin (bupropion) affects only the levels of norepinephrine and dopamine. This drug, known as a norepinephrine and dopamine reuptake inhibitor (NDRI), has similar side effects as SSRIs and SNRIs, but it is less likely to cause sexual problems. Rarely, seizures may occur.

Tricyclic antidepressants: Tricyclics also affect levels of brain chemicals, but they are no longer commonly used because they have more side effects, including fatigue, dry mouth, blurred vision, urination difficulties, and constipation. If you have glaucoma, you should not take any tricyclic antidepressant. Some tricyclics antidepressants include amitriptyline, amoxapine, and Norpramin (desipramine).

Monoamine oxidase inhibitors (MAOIs): Like tricyclics, MAOIs are now prescribed less often because of their risk for serious side effects. These drugs work by blocking an enzyme called monoamine oxidase, which breaks down the brain chemicals serotonin and norepinephrine. People taking MAOIs can experience dangerous reactions if they eat certain foods, drink alcohol, or take over-the-counter cold medicines.

In 2006, the U.S. Food and Drug Administration (FDA) approved Emsam (selegiline), the first skin patch for treating major depression. At its lowest dose, this once-a-day patch can be used without the dietary restrictions associated with oral MAOIs. Some other MAOIs include Marplan (isocarboxazid) and Nardil (phenelzine).

Depression Medications and Government Warnings

In 2005, the FDA warned that the risk of suicidal thoughts or behavior could be higher in children and adolescents taking depression drugs. In 2007, the warning was expanded to include anyone under age 25 taking antidepressants.

However, to balance the risks and benefits of antidepressants, the FDA’s so-called black box warning also states that depression itself is associated with a greater risk for suicide, notes a 2014 study published in the New England Journal of Medicine. Nevertheless, if you are taking an antidepressant, especially if you are under 25, let your doctor know if your depression seems to be getting worse or if you have any thoughts of hurting yourself.

Antidepressants Are Not Magic Bullets

It's important to remember that simply taking a pill will not cure depression. It may take up to 12 weeks before these drugs have their full effect. Some people need to take various doses or combinations of different medications before they find the treatment strategy that works best for them, according to NAMI.

It’s also important to take antidepressants as prescribed and to follow up with your mental health professional on a regular basis. Some depression drugs must be stopped gradually — if you suddenly stop taking your medication, you could experience withdrawal symptoms or a relapse of your depression.

Often the most effective treatment for depression involves some form of talk therapy, notes NAMI. Discuss with your doctor how exercise and limiting alcohol can also help ease your symptoms.

The Link Between Depression and Debt

Too often, depression and debt are connected — and together, they can spiral out of control. Try these strategies to regain your footing.

Mental problems and money problems often go hand in hand. For one, debt is an increasingly common stressor that can trigger depression. Indeed, people who live with debt are more likely than their peers to be depressed and even contemplate suicide, according to a report on the health effects of debt published in 2014 in BMC Public Health. They're also less likely to take good care of their health. On the other hand, the researchers found that debt management programs can help stave off depression. Here's what else you need to know.

How Debt Leads to Emotional Distress

Debt can make you feel helpless, hopeless, and low on self-esteem — and these are all symptoms and risk factors for depression, says Nadine Kaslow, PhD, professor in the department of psychiatry and behavioral sciences at Emory University School of Medicine in Atlanta.

Credit card debt, mortgage foreclosure, student loan debt, medical debt, and job loss can all contribute to depression, agree the authors of the BMC Public Health article, adding that you might also experience anger and anxiety. Other factors, such as being the sole breadwinner with dependent children, being elderly and not having much saved for retirement, or having very high interest debts, seem to increase depression risk.

When Depression Leads to Debt

It’s easy to understand how the stress of debt can trigger or worsen depression, but you may not realize that depression can also lead to debt problems.

Symptoms of depression can lead some people to accumulate growing piles of debt, Dr. Kaslow says. "Someone with depression may exhibit behaviors that can lead them into a debt crisis."

"Some people may try to relieve feelings of depression by compulsive shopping. Depression is often associated with destructive and addictive behaviors that can result in overwhelming debt. This type of debt can lead to extreme despair and even to suicide," Kaslow warns.

RELATED: 5 Ways to Ease Unemployment Blues

Compulsive buying, which can lead to debt, is indeed linked to depression, anxiety, and other mood disorders, researchers reported in the American Journal of Addiction in 2013. The researchers note that in addition to depression treatment, support groups using cognitive behavioral strategies can help control compulsive buying.

How to Find Debt and Depression Help

If you find you are dealing with debt and depression, it is important to address both, Kaslow says. Many types of help are available. "If a person is feeling trapped, desperate, and hopeless, they may need help for depression and help getting out of debt," she adds.

Depression is a very treatable disorder. The first step is to recognize the problem and ask your doctor for depression help. Once depression is diagnosed, your doctor might recommend a range of treatment strategies, including talk therapy, medications, and support groups.

For someone with addictive spending behaviors, Debtors Anonymous (DA) is an organization that can be very helpful, says Kaslow. DA has meetings all over the country where people share their experiences with compulsive debt and debt management. There are also online meetings. For help with compulsive debt, check out DA's website.

A good source of advice for getting help with a debt problem can be found via the Federal Trade Commission, which recommends the following strategies:

Develop and closely follow a budget.
Contact your creditors instead of avoiding them.
Know your rights when dealing with debt collectors.
Use a credit counseling or debt management agency.
Seek protection through bankruptcy laws.
Learn about the steps you need to take to repair your credit.
Beware of debt management scams promising an easy fix.

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.

Antidepressant, Painkiller Combo May Raise Risk of Brain Bleed

Taking both an antidepressant and a painkiller such as ibuprofen or naproxen may increase risk of a brain hemorrhage, a new study suggests.

Korean researchers found that of more than 4 million people prescribed a first-time antidepressant, those who also used nonsteroidal anti-inflammatory drugs (NSAIDs) had a higher risk of intracranial hemorrhage within the next month.

Intracranial hemorrhage refers to bleeding under the skull that can lead to permanent brain damage or death.

The findings, published online July 14 in BMJ, add to a week of bad news on NSAIDs, which include over-the-counter pain relievers such as aspirin, ibuprofen (Motrin, Advil) and naproxen (Aleve).

Last Thursday, the U.S. Food and Drug Administration strengthened the warning labels on some NSAIDs, emphasizing that the drugs can raise the risk of heart attack and stroke.

As far as the new link to brain bleeding in antidepressant users, experts stressed that many questions remain unanswered.

And even if the drug combination does elevate the odds, the risk to any one person appears low.

"The incidence of intracranial hemorrhage in people taking antidepressants and NSAIDs was only 5.7 per 1,000 in a year. So about 0.5 percent of people taking these drugs will develop a (hemorrhage) over one year," said Dr. Jill Morrison, a professor of general practice at the University of Glasgow in Scotland.

Still, she said, it's wise for people on antidepressants to be careful about using NSAIDs.

Both types of drug are widely used, and about two-thirds of people with major depression complain of chronic pain, the researchers pointed out.

Make sure an NSAID is the appropriate remedy for what ails you, said Morrison, co-author of an editorial published with the study.

It's known that NSAIDs can cause gastrointestinal bleeding in some people, and studies have suggested the same is true of SSRI antidepressants -- which include widely prescribed drugs such as Paxil, Prozac and Zoloft.

But neither drug class has been clearly linked to intracranial hemorrhage, said Dr. Byung-Joo Park, the senior researcher on the new study.

So Park's team looked at whether the two drug types, used together, might boost the risk.

RELATED: Some Antidepressants Linked to Bleeding Risk With Surgery

The investigators used records from Korea's national health insurance program to find more than 4 million people given a new prescription for an antidepressant between 2009 and 2013. Half were also using an NSAID.

Park's team found that NSAID users were 60 percent more likely to suffer an intracranial hemorrhage within 30 days of starting their antidepressant -- even with age and chronic medical conditions taken into account.

There was no indication that any particular type of antidepressant carried a greater risk than others, said Park, a professor of preventive medicine at Seoul National University College of Medicine.

He agreed that antidepressant users should consult their doctor before taking NSAIDs on their own.

Park also pointed out that the study looked at the risk of brain bleeding within 30 days. So the findings may not apply to people who've been using an antidepressant and an NSAID for a longer period with no problem.

That's an important unanswered question, said Morrison, noting it's possible that the risk of brain bleeding is actually higher for people who used NSAIDs for a prolonged period.

Why would antidepressants have an effect on bleeding? According to Park's team, the drugs can hinder blood cells called platelets from doing their job, which is to promote normal clotting.

Since NSAIDs can also inhibit platelets, combining the two drugs may raise the odds of bleeding, the researchers said.

It's not clear whether there is a safer pain reliever for people on antidepressants, Morrison said. But it's possible that acetaminophen (Tylenol) could fit the bill.

"Acetaminophen does not have the same propensity to cause bleeding problems as NSAIDs do," Morrison said. "So theoretically, this would be safer."

And since this study was conducted in Korea, she added, it's not clear whether the risks would be the same in other racial and ethnic groups. More studies, following people over a longer period, are still needed, Morrison said.

Loneliness May Fuel Mental Decline in Old Age

Slower deterioration seen in people with more satisfying relationships, researchers say.

Loneliness and depression are linked to an increased risk of mental decline in the elderly, a new study suggests.

Researchers analyzed data from more than 8,300 American adults aged 65 and older who were assessed every two years between 1998 and 2010. Seventeen percent reported loneliness at the beginning of the study, and half of those who were lonely had depression.

Over the course of the study, mental decline was 20 percent faster among the loneliest people than among those who weren't lonely. People who were depressed at the start of the study also had faster mental decline.

However, lower mental function did not lead to worsening loneliness, according to the study scheduled for presentation Monday at the Alzheimer's Association International Conference in Washington, D.C. Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

RELATED: The Health Risks of Loneliness 

"Our study suggests that even one or two depressive symptoms -- particularly loneliness -- is associated with an increased rate of cognitive decline over 12 years," study author Dr. Nancy Donovan said in an association news release. She is a geriatric psychiatrist at Brigham and Women's Hospital in Boston and an instructor in psychiatry at Harvard Medical School.

"We found that lonely people decline cognitively at a faster rate than people who report more satisfying social networks and connections. Although loneliness and depression appear closely linked, loneliness may, by itself, have effects on cognitive decline," she explained.

This is important to know for the development of treatments to enhance mental health and quality of life for older adults, she added.

The new study suggested a link between loneliness, depression and heightened risk of mental decline, but it did not prove cause-and-effect.

Serotonin Syndrome: 7 Things You Need to Know

1 / 8   Serotonin Syndrome
Serotonin is a neurotransmitter (a naturally occurring brain chemical) that helps regulate mood and behavior, and increasing serotonin is one way of treating depression.

But if you're taking antidepressant medication that increases serotonin too much, you could be at risk for a dangerous drug reaction called serotonin syndrome.

"Serotonin syndrome usually happens when a doctor prescribes a drug that increases serotonin to a patient already on an antidepressant," said Mark Su, MD, assistant professor of emergency medicine at Hofstra University and director of the Toxicology Fellowship at North Shore University Hospital in Manhasset, N.Y.

Expert Panel Recommends Questionnaire to Help Spot Depression

Part of your next visit to your family doctor's office should be spent filling out a questionnaire to assess whether you're suffering from depression, an influential panel of preventive medicine experts recommends.

What's more, people concerned that they might be depressed could download an appropriate questionnaire online, fill it out ahead of time and hand it over to their doctor for evaluation, the panel added.

In an updated recommendation released Monday, the U.S. Preventive Services Task Force urged that family doctors regularly screen patients for depression, using standardized questionnaires that detect warning signs of the mental disorder.

If a patient shows signs of depression, they would be referred to a specialist for a full-fledged diagnosis and treatment using medication, therapy or a combination of the two, according to the recommendation.

These questionnaires can be self-administered in a matter of minutes, with doctors reviewing the results after patients fill out the forms, said Dr. Kirsten Bibbins-Domingo, vice chair of the task force.

"This could be a checklist that patients fill out in the waiting room, or at home prior to the visit," she said. "The good thing is we have many instruments, measures that have been studied for screening for depression."

About 7 percent of adults in the United States currently suffer from depression, but only half have been diagnosed with the condition, said Bibbins-Domingo, who is a professor of medicine, epidemiology and biostatistics at the University of California, San Francisco.

"We know that depression itself is a source of poor health," she said. "It leads people to miss work, to not function as fully as they might, and we know it is linked and associated with other types of chronic diseases."

It makes sense that family doctors perform front-line screening for depression, since they are more likely than a mental health professional to come across a person with undetected symptoms, said Michael Yapko, a clinical psychologist and internationally recognized depression expert based in Fallbrook, Calif.

"Only about 25 percent of depression sufferers seek out professional help, but more than 90 percent will see a physician and present symptoms and signs that could be diagnosed," said Yapko, who is not on the task force.

The panel has recommended regular depression screening for adults since 2002, but their guidelines currently urge doctors to ask two specific questions that provide a quick evaluation of a person's mood. The questions are, "Over the past two weeks, have you felt down, depressed, or hopeless?" and "Over the past two weeks, have you felt little interest or pleasure in doing things?"

The updated recommendation expands doctors' options for depression screening, adding commonly used questionnaires like the Patient Health Questionnaire, or PHQ-9.

The PHQ-9 is a list of 10 questions that focus on problems that a person might have experienced during the past two weeks, including poor appetite, low energy, sleep problems and a lack of interest in doing things.

"These are not instruments that diagnose depression," Bibbins-Domingo noted. "They give clinicians the first indication of something that should be followed up on."

RELATED: 10 Drug-Free Therapies for Depression

Yapko said that someone who wanted to could lie on the questionnaires and avoid having their symptoms detected, but he added that in his experience it's not a very likely scenario.

"When you have people who are suffering who genuinely want help, they're happy to give you as accurate a portrayal as they can give you," he said. "Generally speaking, the people seeking help want help and they want to do their best in filling these things out. That's what makes the test worthwhile."

The task force is an independent, volunteer panel of national experts that has been issuing recommendations on preventive medicine since 1984.

Yapko and Bibbins-Domingo said depression screening shouldn't eat into a doctor's time, since patients can fill out and score the questionnaires on their own.

Instead of wasting time reading magazines in the waiting room, patients "could be filling out an inventory that is self-administered, self-scored and wouldn't take any physician time at all," Yapko said.

Patients also could download and fill out a depression questionnaire at home and hand it in when they go to the doctor, but Yapko said patients should make sure they're using the form their doctor prefers.

"Which of the many inventories and questionnaires a doctor might wish to use is a matter of personal and professional judgment," he said. "So, a doctor would need to specify which form to obtain online and the patient would then need to remember to bring it in, not always easy when depression negatively affects your memory. Easier to have the form in the office and have them fill it out in the waiting room."

Yapko added that it's important that doctors who screen for depression follow up by referring patients to a mental health professional, rather than trying to diagnose and treat depression themselves.

"When physicians get a diagnosis of depression, their most immediate thing to do is prescribe an antidepressant," Yapko said, noting that more than 70 percent of antidepressants are prescribed by non-psychiatrists. "Only a minority of people walk out of a doctor's office with a referral to a mental health professional, a fact which drives me a little crazy."

Herbal remedy isn't regulated, and can have side effects and serious drug interactions.

Herbal remedy isn't regulated, and can have side effects and serious drug interactions.

St. John's wort is a popular herbal therapy for depression, but a new Australian study highlights the fact that "natural" does not always equal "safe."

Using reports filed with Australia's drug safety agency, the researchers found that adverse reactions to St. John's wort were similar to those reported for the antidepressant fluoxetine -- better known by the brand name Prozac.

Those side effects included anxiety, panic attacks, dizziness, nausea and spikes in blood pressure, the researchers reported in the July issue of Clinical and Experimental Pharmacology and Physiology.

"It's concerning to see such severe adverse reactions in our population, when people believe they are doing something proactive for their health with little risk," lead researcher Claire Hoban, of the University of Adelaide, said in a university news release.

Research has shown that St. John's wort can help ease mild to moderate depression. But the fact that it works also means there is a risk of side effects, said Dr. Samar McCutcheon, a psychiatrist at Ohio State University Wexner Medical Center in Columbus.

"Even if the bottle says 'natural' or 'herbal,' it still has ingredients that are active in your body," said McCutcheon, who was not involved in the study.

It has long been recognized that St. John's wort can have significant side effects and interact with certain medications, McCutcheon pointed out.

But many consumers may not know that, she noted, largely because dietary supplements are not regulated in the way that drugs are.

"I definitely think this [lack of awareness] is still an issue," McCutcheon said. "People think St. John's wort is safe because they can buy it at a health food store."

In the United States, dietary supplements do not have to be studied for safety and effectiveness before they reach the market.

"Plus," McCutcheon said, "you're relying on companies to make sure these products include the ingredients they're supposed to, and keep out ingredients that they shouldn't."

The situation is similar in Australia, and many consumers there are unaware that supplements are largely unregulated, according to Hoban's team.

RELATED: 7 Supplement Risks Every Woman Should Know About

The researchers based their findings on doctors' reports to Australia's national agency on drug safety. Between 2000 and 2013, there were 84 reports of adverse reactions to St. John's wort, and 447 reports on Prozac.

But since those are voluntary reports, they do not reflect the actual rate of side effects from either therapy, according to the researchers. And, Hoban said, bad reactions to St. John's wort are particularly likely to go unreported, since the herb is often not even considered a drug.

According to McCutcheon, it's important for people with depression symptoms to see a health professional before self-medicating with St. John's wort. "That will help ensure you have the right diagnosis," she said.

If your symptoms are actually part of a different disorder, St. John's wort may be ineffective -- or possibly even risky. For example, McCutcheon said that in people with bipolar disorder, the herb might fuel a manic episode.

But possibly the biggest concern, she said, is the potential for St. John's wort to interact with commonly used medications.

The herb can dampen the effectiveness of birth control pills, blood thinners and heart disease drugs, along with some HIV and cancer drugs, according to the U.S. National Center for Complementary and Integrative Health.

What's more, it can interact with antidepressants. It's not clear exactly how St. John's wort works, McCutcheon said, but it's thought to boost levels of the brain chemical serotonin -- which is how the most commonly used antidepressants work.

"If you use the two together, you run the risk of having too much serotonin," she said. And that raises the risk of a potentially fatal condition called serotonin syndrome, whose symptoms include confusion, tremors, diarrhea and a drop in body temperature.

Some side effects of St. John's wort are caused by the herb itself, such as skin rash that's worsened by sunlight, said Dr. John Reed, director of inpatient services at the University of Maryland's Center for Integrative Medicine in Baltimore.

But the main concern is still its potential for interacting with other medications, he said. "Compared with other herbs, St. John's has more drug interactions," Reed explained. "So if you're using it, don't take other medications unless it's under medical supervision."

He added that anyone on any medication should do some homework before starting an herbal product. "Go online and do a search for drug interactions. Ask your pharmacist or doctor," Reed advised.

"Unfortunately," he said, "this type of information [on drug interactions] doesn't have to be printed on product labels."

The bottom line, according to McCutcheon, is that people with depression should talk to their providers about any supplements they take, or want to take. And those providers, she said, should be willing to have nonjudgmental discussions.

"I want all my patients to be comfortable enough to bring up anything with me," McCutcheon said.

Why Depression Is Underreported in Men

Women are more likely than men to seek treatment for depression. Why do men try to manage the condition on their own?

Women are 70 percent more likely than men to have depression. It is this feminine predisposition to depression that may contribute to its being underreported among men, says Amit Anand, MD, a professor of medicine at the Cleveland Clinic's Lerner College of Medicine and vice-chair of research for its Center for Behavioral Health.

More than 6 million U.S. men struggle with the condition each year, according to the National Institute of Mental Health (NIMH). And it maybe their reluctance to discuss their depression, as well as several other obstacles, that prevent many of them from seeking treatment, Dr. Anand says. These barriers not only affect how men with depression are diagnosed, he says, but also how they are treated.

Why Depression Is Underreported

Several factors contribute to depression often being unreported and undiagnosed in men. For starters, men who are depressed may not recognize their symptoms. “Women are far more likely to acknowledge that they have depression and seek help,” Anand says.

Also, symptoms of depression vary from person to person, and symptoms may not always be obvious, according to NIMH. Complicating matters is that men who are depressed often suppress their feelings rather than showing sadness and crying,reports the National Alliance on Mental Illness (NAMI).

Men and women also have different risk factors for depression that could affect whether they seek treatment, according to a study published in 2014 in the American Journal of Psychiatry. The factors most directly linked to depression among women are divorce, lack of parental or social support, and marriage troubles. For men, depression is more closely linked to drug abuse as well as financial, legal, and work-related stress, the researchers say. Their research suggests that men are less likely to seek medical attention if they attribute depression to career disappointment or failures. Rather than seek help, Anand says, men with depression are more likely to try to tough it out.

"Men may be more likely to suffer in silence or try to self-medicate with alcohol or drugs," says Dean F. MacKinnon, MD, an associate professor of psychiatry and behavioral sciences at the Johns Hopkins School of Medicine in Baltimore.

RELATED: 6 Depression Symptoms You Shouldn’t Ignore

Men may see their symptoms as a sign of weakness, he explains, likening the situation to the idea that men don't like asking for directions. “Men don't ask for direction because it makes them seem weak, but also they are afraid they won't get the right information,” Dr. MacKinnon says.

Men might also be worried about the social stigma associated with a diagnosis of depression, according to research published in Qualitative Health Research in 2014.

In addition, depression affects men differently than women, according to a 2013 study published in JAMA Psychiatry. Though women usually have traditional symptoms, such as feelings of sadness and worthlessness, the study found that men with depression were more likely to experience anger and irritability, and to engage in risky behaviors. This suggests that if men are using traditional criteria to assess their symptoms, their depression could go unreported.

Why Treatment Is Critical

What sets men and women with depression apart can also make the condition more difficult to treat, Anand says. Men with untreated depression can experience issues like anger, aggression, and substance abuse. Using drugs and alcohol to self-medicate, he says, can complicate treatment for depression.

Untreated depression among men can also have tragic consequences. “Women may talk about suicide more, but men may be more likely to complete suicide,” Anand says. “They may also use much more violent means of trying to commit suicide, like guns or hanging.” In fact, according to NAMI, men are four times more likely to die of suicide than women.

Most adults with depression improve with treatment, usually a combination of talk therapy and medication, Anand says. He notes, however, that it can be difficult to convince some men to try talk therapy.

Medication used to treat depression may also work differently in men and women. For instance, today the most commonly prescribed antidepressants, according to NIMH, are SSRIs — selective serotonin reuptake inhibitors. Tricyclics, which are older antidepressants, are not used as often today because they come with more serious side effects, like drowsiness, dizziness, and weight gain. However, some research suggests that women respond better to SSRIs — like Prozac (fluoxetine) and Zoloft (sertraline) — and that tricyclics, like imipramine, may be more effective for men, Anand says.

SSRIs may also cause more sexual side effects, which tend to bother men more often than women, and could result in fewer men following through on treatment, Anand says.

If your doctor does recommend an SSRI, adjusting the dosage or switching from one SSRI to another can help alleviate unwanted side effects, according to NIMH.

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.

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.

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.

Resting Heart Rate for MEN Or WOMEN

Resting Heart Rate for MEN

Age 18-25 26-35 36-45 46-55 56-65 65+
Athlete 49-55 49-54 50-56 50-57 51-56 50-55
Excellent 56-61 55-61 57-62 58-63 57-61 56-61
Good 62-65 62-65 63-66 64-67 62-67 62-65
Above Average 66-69 66-70 67-70 68-71 68-71 66-69
Average 70-73 71-74 71-75 72-76 72-75 70-73
Below Average 74-81 75-81 76-82 77-83 76-81 74-79
Poor 82+ 82+ 83+ 84+ 82+ 80+

Resting Heart Rate for WOMEN

Age 18-25 26-35 36-45 46-55 56-65 65+
Athlete 54-60 54-59 54-59 54-60 54-59 54-59
Excellent 61-65 60-64 60-64 61-65 60-64 60-64
Good 66-69 65-68 65-69 66-69 65-68 65-68
Above Average 70-73 69-72 70-73 70-73 69-73 69-72
Average 74-78 73-76 74-78 74-77 74-77 73-76
Below Average 79-84 77-82 79-84 78-83 78-83 77-84
Poor 85+ 83+ 85+ 84+ 84+ 84+

Why Drinking Tea May Help Prevent and Manage Type 2 Diabetes

Drinking Tea for Diabetes: Green Tea or Black Tea?

When it comes to drinking tea for diabetes, Steinbaum says benefits are tied to all teas, but that green tea is the clear winner. "For one, when you drink green tea for diabetes, you will get a higher level of polyphenols than you would get in black,” she explains. It’s the polyphenols in fruits and vegetables that give them their bright colors. So, having more color means that green tea is richer in polyphenols. “Of the black teas, the more orange the color, the higher the polyphenols,” she adds.

    "Green tea is good for people with diabetes because it helps the metabolic system function better."

Suzanne Steinbaum, DO

Besides its color, green tea also contains higher polyphenol levels because it's prepared from unfermented leaves, "so it is really pure,” Steinbaum says. Black tea, on the other hand, is made from leaves that are fully fermented, which robs it of some nutrients. “Plus, some black tea varieties can have two to three times more caffeine than green, which isn’t good in excess,” she says.

Polyphenols: Beyond Drinking Tea for Diabetes

The benefits of tea are clear. But besides tea, a number of foods high in polyphenols also can help prevent and manage type 2 diabetes. “The fruits highest in polyphenols are berries, grapes, apples, and pomegranates — because of their rich color,” Steinbaum says. Broccoli, onions, garlic, tomatoes, eggplant, and spinach are also good sources, as are cranberries, blood oranges, blackberries, blueberries, raspberries, strawberries, rhubarb, lemons, limes, and kiwis. “We know red wine contains resveratrol, which is a polyphenol — the highest concentration is in Bordeaux,” Steinbaum says.

Vitamin D

 

 

TB

Tuber Culosis

to know go to doctor

hellow

6 Ways To Tone Your Entire Bod Using Just A Resistance Band

Not only are resistance bands a great toning tool, but you can take them anywhere because they're light and super compact. They're also a smart transition to using weights.

For this workout, try to do 10-12 repetitions of each move using a band that challenges you. (Try this Adjustable Resistance Tube, $8, ) Bands usually come with a light, medium, and heavy option, so choose the best match for your fitness level (and switch to a heavier one as you get stronger). Try to flow from one exercise to the next without taking a break.

(The Slim, Sexy, Strong Workout DVD is the fast, flexible workout you've been waiting for!)​

To start, step on the center of the band with one leg and then step forward with your other leg. Lean your torso forward and keep reaching out through the top of your head all the way down to your tailbone. Try not to hunch over, and make sure to keep tension on your band the whole time. This will be your base posture throughout all six of these moves:

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.

Bullied Teens at Risk for Later Depression

Getting picked on at age 13 tied to raised odds of poor mental health at 18, U.K. researchers report.

Young teens who are bullied appear to be at higher risk of depression when they reach early adulthood, according to new research.

"We found that teenagers who reported being frequently bullied were twice as likely to be clinically depressed at 18 years," said Lucy Bowes, a researcher at the University of Oxford in England, who led the research.

The researchers found an association, not a definitive cause-and-effect relationship, Bowes said. "In our type of study, we can never be certain that bullying causes depression," she explained. "However, our evidence suggests that this is the case."

To explore the possible link, the investigators used data on nearly 4,000 teens in the Avon Longitudinal Study of Parents and Children, a community-based group born in the United Kingdom. At age 13, all completed a questionnaire about bullying. At 18, they were assessed for depression.

The study found that nearly 700 teens said they had been bullied "often" -- more than once a week -- at age 13. Of those, nearly 15 percent were depressed at age 18. More than 1,440 other teens reported some bullying -- one to three times over a six-month period -- at age 13. Of these, 7 percent were depressed at age 18. In comparison, only 5.5 percent of teens who weren't bullied were depressed at age 18.

RELATED: Living With the Scars of Bullying

Bowes also found the often-bullied teens tended to stay depressed longer than others. For 10 percent of those often-bullied who became depressed, the depression lasted more than two years. By comparison, only 4 percent of the never-bullied group had long-lasting depression.

Among the bullying tactics, name calling was the most common type, experienced by more than one-third of the teens. About one of four had their belongings taken. About 10 percent were hit or beaten up. Most never told a teacher and up to half didn't tell a parent. But up to three-quarters did tell an adult if the bullying was physical, according to the study published in the June 2 online edition of the BMJ.

Bowes noted that other studies have found the same bullying-depression link. If it does prove to be a causative factor, she added, bullying may account for 30 percent of those who develop depression in early adulthood.

In addition, the link held even when factors such as mental and behavioral problems and stressful live events were taken into account, Bowes said.

The research did not look at why bullying might increase the risk of depression or why some teens appear more vulnerable.

The study findings ring true in practice, said Gilda Moreno, a clinical psychologist at Nicklaus Children's Hospital and Baptist Hospital in Miami, who reviewed the findings.

Children who are bullied over time may develop a ''learned helplessness," she said. "It's not having the skills to stand up to the bullying. That's what may lead to the depression."

Because bullied children often don't tell their parents or teachers, Bowes said that parents need to be aware of potential signs. If a child is reluctant to go to school, parents should talk about why and ask about their relationships with friends, she suggested.

Bowes said parents should also believe their child if he or she complains about bullying, and follow up with the school administrators.

Loners are more likely than others to get picked on, Moreno added. Parents can encourage their kids to develop friendships, she said, to foster a kind of core support group.

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.

The 1-Hour Workout That Gets Ciara THIS Bod

The singer — who gave birth to a son in May — recently appeared on MTV’s House of Style and continues to work with Degree Women for the brand’s Do More campaign. Users can search for fitness classes and view behind-the-scenes rehearsal footage on Degree’s web site

“As a hardworking woman, I’m always trying to figure out how I can get better and improve at everything I do," explains Ciara. "I really love being able to share this message with other women and encourage them to keep pursuing their dreams.”

 

 

 

 

At a Degree Women press event, Ciara gave Everyday Health the scoop on how she stays fit, healthy, and gorgeous while trying to juggle a packed schedule. 

On her fitness regimen: “I work out an hour a day. That’s all you need — the rest of it’s all about how you eat,” says Ciara. “When I train with Gunnar [Peterson], we do a mix of plyometric moving and weight training because you want a good balance of cardio, while still maintaining your muscle.”

 

 

 

On eating right: “For breakfast, I love an egg white omelet with spinach and turkey. I’ll also have a side of fruit and wheat toast,” she says. If she gets a late-night craving, Ciara satiates herself with chocolate Ensure protein shakes. “Sometimes I get hungry before I go to bed — I’ll drink one of these and it holds me over until the morning.” 

On how she motivates herself before a performance: “I think about what it is that I want to do onstage and how great I want the show to be,” she says. “I pray, stretch, jump, and move around to get my body warmed up.”

On maintaining her glow: “When I wake up, I wash my face with my dermatologist’s [Dr. Sabena Toor] foaming cleanser, which is made with organic ingredients,” says Ciara. “Then I put vitamin C and Revisions tinted moisturizer all over my face. I do that twice a day.”

The Link Between Diet and Eye Disease

Eye disease is one of the most common causes of permanent disability in the United States. More than 20 million Americans age 40 and older have cataracts, and 10 million Americans age 60 and over have age-related macular degeneration (AMD). These eye diseases occur as we grow older, and proper nutrition may have some affect on both of them.

Cataracts develop on the lens of the eye when the proteins in the lens are damaged. These proteins are responsible for keeping the lens clear. When they become damaged, the lens becomes cloudy or opaque, and your vision may become blurry. You may also have poor night vision or double vision with cataracts. Cataract surgery is often necessary to remove and replace the damaged lens with an artificial lens.

AMD occurs when cells in the macula of the eye die. The macula is located in the center of the retina in the back of the eye, and is responsible for your sharp, central vision, which you need for reading and other tasks that require good eyesight. Once the macula is damaged, your vision is no longer clear, and you cannot make out fine details of objects. There is no cure for AMD, but proper nutrition may help prevent it from worsening.

Diet and Eye Disease: What Is a “Healthy Eyes” Diet?

According to Nelson, the nutrients associated with eye health are vitamins C and E; carotenoids, beta carotene, lutein, and zeaxanthin; omega-3 fatty acids; zinc; and vitamins B6, B9 (folic acid or folate), and B12.

“Antioxidants, especially lutein, help deter build-up of waste products in the retina, which in turn helps reduce your risk for AMD,” says Jennifer K. Nelson, MS, RD, director of clinical dietetics and associate professor of nutrition at the Mayo School of Health Sciences in Rochester, Minn. “Folate and vitamin B6 decrease the presence of the blood chemical homocysteine, which lowers your risk for AMD. Antioxidants also help prevent the cross linking of proteins in the lens which can cause cataracts.”


Here's a list of foods containing eye-healthy nutrients:

  • Fruits and vegetables (good sources of vitamins C and E)
  • Dark green vegetables such as kale and spinach (lutein, vitamin E)
  • Yellow and orange fruits and vegetables (beta carotene and zeaxanthin)
  • Anchovies, herring, mackerel, salmon, sardines, trout, tuna, and white fish (omega-3 fatty acids)
  • Beef, eggs, lamb, milk, peanuts, pork, and whole grains (zinc)
  • Bananas, chicken, dried beans, fish, liver, pork, and potatoes (vitamin B6)
  • Citrus fruits, fortified cereals, dried beans, green leafy vegetables, liver, mushrooms, nuts, and peas (folic acid)
  • Dairy products, eggs, meat, poultry, and shellfish (vitamin B12)

A diet high in refined carbohydrates, such as white rice, white bread, and pasta, may actually increase your risk of developing AMD. These foods have a high glycemic index, which means they are broken down rapidly into blood glucose or sugar. Choose breads and pasta made from whole grains and brown rice for your complex carbohydrates.

Diet and Eye Disease: Nutrition Supplements for Eye Health

 

In 2001, the National Eye Institute’s Age-Related Eye Disease Study (AREDS) found that taking a specific supplement of high doses of vitamin E, beta carotene, zinc, and copper may prevent intermediate AMD from progressing to the advanced stage. AREDS found no evidence that the supplement benefited anyone who showed no signs of AMD or those with early stage AMD. The AREDS-2 clinical trials are currently being conducted to look at the addition of lutein, zeaxanthin, and omega-3 fatty acids to the original AREDS formula.

For those with intermediate AMD who want to try the supplement formula, a discussion with your doctor is a must. “Because the AREDS-recommended supplement contains relatively high doses of antioxidants and zinc, you and your health care provider need to determine if the AREDS supplement is right for you,” cautions Nelson. “It is important that you do not self-medicate any supplements higher than the daily recommended intakes."

“We also need to look at the long-term effects of taking the AREDS supplement,” says Nelson. “For example, the AREDS formula has a very high level of beta carotene, which may increase the risk for lung cancer in smokers.” Nelson adds that eating a diet with plenty of green leafy vegetables, fish, and fortified cereals should make taking supplements for eye health unnecessary for most people.

“We’re only just beginning to look at nutrition and eye health, and it’s an exciting time because we have found such a link,” says Nelson. “A healthy diet is the foundation for healthy eyes.”

Why Some Seniors Lose Their Hearing

Do you have difficulty hearing conversations held in a noisy room? Do you have a harder time picking up women’s voices than men’s? Do you constantly ask others to repeat what they just said? If you answered ‘yes’ to these questions, you may be experiencing hearing loss — especially if you are 65 or older.

About 8.5 percent of adults between the ages of 55 and 64 suffer from hearing loss, according to the National Institute on Deafness and Other Communication Disorders. That number jumps to 25 percent for those 65 to 74, and it doubles to 50 percent for ages 75 and older. After high blood pressure and arthritis, hearing loss is the most common chronic condition affecting senior health.

Psoriatic Arthritis Types

www.PsoriaticInfo.com

Learn About The Different Types

of Psoriatic Arthritis Today.

 

 

 

What Causes Hearing Loss?

As you age, you are at risk for two types of hearing loss. The most common type of hearing loss in seniors is presbycusis, or age-related hearing loss. A gradual loss of hearing that affects both ears, presbycusis occurs when tiny hairs in the ear, which are necessary for converting sound waves to sound, become damaged or die. Hearing loss from presbycusis is permanent because once these hairs are damaged or die, they are not replaced with new growth.

Related: 11 Early Signs of Dementia

The other type of hearing loss that seniors experience is tinnitus, or ringing in the ears. Tinnitus can be either permanent or temporary.

Risk Factors Related to Hearing Loss

A lifetime of exposure to loud noises such as music, motorcycles, or firecrackers can cause hearing loss in seniors. Noise-related hearing loss often results in tinnitus. Other causes of and risk factors for hearing loss experienced by seniors include:

  • Smoking
  • Allergies, high blood pressure, tumors, or stroke
  • Medications
  • A punctured eardrum
  • Viruses or bacteria
  • Earwax buildup

Your genes may also play a role in presbycusis, as it tends to run in families. Environmental factors like loud music and smoking make it difficult to determine the effect of genetics on age-related hearing loss; however, according to American Family Physician, an estimated 50 percent of age-related hearing loss is inherited.

Men are also more likely than women to develop hearing loss, and they’re more likely to develop it at an earlier age, says American Family Physician.

The Consequences of Hearing Loss

Losing hearing can have a significant effect on other aspects of your wellbeing. Researchers in a 2014 survey of 18,300 adults found that about 12 percent of participants with hearing loss had moderate to severe depression compared with about 5 percent of those with excellent hearing. The survey, which was published in JAMA Otolaryngology Head and Neck Surgery, also noted that women were particularly susceptible to depression related to hearing loss.

Hearing loss also appears to worsen cognitive functioning, according to a study published in the February 2013 issue of JAMA Internal Medicine. Among the nearly 2,000 seniors studied, hearing loss lowered cognitive functioning on some assessments as much as 41 percent more than it did among those without hearing loss.

Hearing Aids and Other Treatment Options

Though you can’t always fully prevent hearing loss, you can take steps to minimize or overcome it. Age-related hearing loss may be prevented or at least lessened by avoiding loud noises.

Because there is no known cure for age-related hearing loss, treatment is generally focused on improving your ability to function day to day. Your doctor may treat you or refer you to a hearing specialist such an otolaryngologist (or ENT, a medical doctor who specializes in the ear, nose, and throat) or an audiologist (a licensed professional who diagnoses and helps manage hearing problems). The cause and extent of your hearing loss will determine the course of treatment.

hearing aid may be one recommendation from your doctor or audiologist. Hearing aids can be beneficial for many, but according to the National Institute on Deafness and Other Communication Disorders, fewer than 30 percent of adults older than 70 who could benefit from a hearing aid have one. Hearing aids have come a long way over the years and are available in a variety of styles. A hearing aid and its battery will either fit behind the ear, on the ear, just inside the ear, or in the ear canal.

Types of hearing aids include:

  • Analog hearing aids that increase the volume of some sounds while lowering the volume of others
  • Digital hearing aids that allow you to determine which sounds to make louder or lower

Using assistive listening devices also can help compensate for hearing loss. These products either amplify sound, such as sound from telephones, televisions, and radio listening systems, or alert the user visually, such as with smoke detectors or alarm clocks.

 

 

Surgery may be another consideration. Cochlear implants are electronic devices with one part surgically implanted in the skin and the other part worn behind or in the ear. Used only for severe hearing loss, implants will not restore normal hearing, but they can make sounds louder. Because of the nature of the implants, they are not without risks — they pose the potential for infection, damage to the facial nerve, and tinnitus.

Speech or lip reading and sign language may be an answer for some seniors with hearing loss. Both of these techniques require training and practice and are generally recommended for those with severe hearing loss.

See your doctor as soon as you think you have a hearing problem. The loss of hearing could be a symptom of another medical condition. Seniors with untreated hearing loss are also more likely to suffer emotionally and socially when they areunable to interact with friends and family members. Left untreated, hearing loss could lead to deafness, and seniors who do not address their hearing loss put their lives at risk if they are unable to hear emergency warnings such as car horns or smoke alarms.

All Diet and Nutrition Articles

All Diet and Nutrition Articles

 

5 Reasons Why Skin Cancer Surgery Isn’t So Scary

Get the inside scoop on Mohs surgery, the most popular treatment option for basal and squamous cell carcinomas.

Veva Vesper has dealt with more than her fair share of Skin Cancer in the last 25 years. The 69-year-old Ohio resident has had more than 500 squamous cell carcinomas removed since the late 1980s, when the immunosuppressant medication she was taking for a kidney transplant caused her to develop them all over her body — everywhere from the corner of her eye to her legs.

While Vesper’s story is unusual, skin cancer is the most common cancer in the United States. In fact, it’s currently estimated.

Mike Davis, a 65-year-old retired cop, and like Vesper, a patient at The Skin Cancer Center in Cincinnati, Ohio, has a more familiar story. Earlier this year, he had a basal cell carcinoma removed from his left ear — the side of his face most exposed to UV damage when driving on patrol.

Energy Drinks Tied to Inattention, Hyper Behavior in Middle Schoolers

Yale University researchers looked at more than 1,600 students at middle schools in one urban school district in Connecticut. Their average age was around 12 years.

Boys were more likely to consume energy drinks than girls. The researchers also found that among boys, black and Hispanic students were more likely to drink the beverages than white students.

Children who consumed energy drinks were 66 percent more likely to be at risk for hyperactivity and inattention symptoms, according to the study in the current issue of the journal Academic Pediatrics.

RELATED: Energy Drinks Pack a Deadly Punch

Energy drinks have high levels of sugar and also often contain caffeine, the researchers noted. For the study, the investigators took into account the number and type of other sugar-sweetened drinks consumed by the students.

"As the total number of sugar-sweetened beverages increased, so too did risk for hyperactivity and inattention symptoms among our middle-school students. Importantly, it appears that energy drinks are driving this association," study leader Jeannette Ickovics, a professor in the School of Public Health, said in a Yale news release.

"Our results support the American Academy of Pediatrics recommendation that parents should limit consumption of sweetened beverages and that children should not consume any energy drinks," she added.

The students in this study drank an average of two sugary drinks a day. The number of daily sugary drinks ranged from none to as many as seven or more such drinks. Some sugar-sweetened beverages and energy drinks contain up to 40 grams of sugar each. Depending on how old they are, children should only have about 21 to 33 grams of sugar a day, according to the researchers.

Along with causing problems such as hyperactivity and inattention, sugary drinks increase children's risk of obesity, Ickovics noted. About one-third of American children are overweight or obese, according to the latest estimates from the U.S. Centers for Disease Control and Prevention.

Efforts by HealthDay to reach out to the beverage industry for comment were unsuccessful.

diabetes type 2

There is a problem about diabetes type 2

 

 

many topic

 

bad habit or not nutration food is a cause of diabetes

 

   
   

 

 

6 Detoxifying Vegetable Soup Recipes for the New Year

Bone broth was the hipster darling of 2015 food trends, but if healthy eating is one of your resolutions, just sipping on broth isn’t going to cut it. It’s a new year, and 2016 is all about doubling down on fruits and veggies in the most delicious way possible. Sure, salads pack in a lot of produce, but broth-based soups may be the most satisfying — and warming! — route to healthy eating this winter. If you’ve been mainlining gingerbread and peppermint bark for the past two weeks, a detoxifying veggie soup is the perfect way to usher in a healthier new year, one satisfying slurp at a time. Here are five recipes that’ll give your resolutions staying power all month long:

Many-Veggie Vegetable Soup

Many-Veggie Vegetable Soup 

We like to think of this dish from Love & Lemons as the “everything but the kitchen sink” of all soup recipes. Here at Everyday Health, we have a strict “no produce left behind” policy, and this is the perfect way to use up all of those death-row veggies in the fridge. Satiating sweet potatoes and carrots pair with lighter veggies like zucchini, tomatoes, and kale to create a hearty, stew-like dish that makes a delicious winter lunch or light supper.

Spiralized Vegan Ramen Soup With Zucchini Noodles

Spiralized Vegan Ramen Soup With Zucchini Noodles

Happiness is when two of your food obsessions (ramen and spiralizing) come together to create a healthy, guilt-free dish. Our friend Ali over at Inspiralized created the ultimate healthy substitute for when you’re jonesing for ramen. This recipe, which swaps noodles for zucchini ribbons, clocks in at 117 calories per serving, which makes it the perfect starter. Or you can make a vegan-friendly meal by adding protein-rich tofu or quinoa — or vegetarian (and a little more authentic!) by serving it with a perfect soft-boiled egg.

 

Spinach Soup With Rosemary Crouton

Spinach Soup With Rosemary Croutons

Here’s another “easy button” recipe that requires just a few essential ingredients that can be swapped in and out depending on what you have in the fridge. Here, cooked spinach, onion, and potatoes are blended with rosemary to create a vegetable-rich savory slurp, but you could use any green you have on hand (think: kale, arugula, mustard greens) and a variety of herbs (thyme, basil, and tarragon would all do the trick!). Eschewing bread this month? Just skip the croutons.

Carrot Apple Ginger Soup

Carrot Apple Ginger Soup

If you haven’t hit the supermarket for your annual “New Year, New You” shopping spree, check the crisper for these holiday holdovers: carrots, onions, apples, and ginger. This bright, sweet, and spicy soup from Joy the Baker keeps in the fridge for up to four days and freezes like a dream. Your first week of January lunch problem? Solved!

Amazon Bean Soup

Amazon Bean Soup With Winter Squash and Greens

If you’re looking for a vegetarian soup that even the most persnickety carnivore will love, look no further. The United Nations has declared 2016 the “International Year of Pulses” (pulses being beans and legumes to me and you), and for good reason: Beans are cheap, healthy, and environmentally-friendly sources of protein that are packed with fiber and nutrients. We love this wintry mix of beans, carrots, squash, and greens, finished with a squirt of lime. You can easily make this a vegan dish by swapping the butter for heart-healthy olive oil and the chicken stock for a veggie version.

No-Bone Broth

No-Bone Broth

Now that you’ve got five delicious soup ideas, you’ll need some broth. Matt Weingarten, culinary director for Dig Inn, created this No-Bone Broth recipe from kitchen scraps, like apple cores, vegetable peels, and the tops and tails of celery, to create a nutrient-rich, vegan stock that’s a perfect base for any soup recipe.

DIY Beauty Treatments for Every Skin Problem

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.

5 Reasons Why Skin Cancer Surgery Isn’t So Scary

Veva Vesper has dealt with more than her fair share of skin cancer in the last 25 years. The 69-year-old Ohio resident has had more than 500 squamous cell carcinomas removed since the late 1980s, when the immunosuppressant medication she was taking for a kidney transplant caused her to develop them all over her body — everywhere from the corner of her eye to her legs. 

While Vesper’s story is unusual, skin cancer is the most common cancer in the United States. In fact, it’s currently estimated that one in five Americans will get skin cancer in his or her lifetime.  

Mike Davis, a 65-year-old retired cop, and like Vesper, a patient at The Skin Cancer Center in Cincinnati, Ohio, has a more familiar story. Earlier this year, he had a basal cell carcinoma removed from his left ear — the side of his face most exposed to UV damage when driving on patrol. 

The buildup of sun exposure over your lifetime puts you at greater risk for developing basal and squamous cell skin carcinomas as you age. Both Vesper and Davis had Mohs surgery, the most effective and precise way to remove the two most common types of skin cancer. 

How to Protect Your Child From an Allergic Reaction While You're Away

You may feel in complete control of your child's allergies — at least when he or she is under your watchful eye. But you can't be with him or her 24/7, and you want her to live as normal a life as possible. What's the balance between letting your child enjoy life and managing your stress in the face of severe childhood allergies? You’ll need to explain to other parents, teachers, and caregivers all they need to know to try to avoid the allergens, recognize allergy symptoms, and treat an allergic reaction so they’ll be as knowledgeable and vigilant as you are. There are steps you can take to clearly convey this potentially life-saving information about your child’s allergies.

Create an Allergy Action Plan

Before a child with severe allergies goes to school, day care, or a babysitter (even a close relative), put an allergy action plan in place to ensure your child’s safety. First, meet with your child’s doctor and ask for a letter that outlines the following:

  • What your child is allergic to as confirmed by allergy testing
  • How to avoid exposure to the allergens, including reducing the risk of cross-contamination in food preparation for food allergies
  • What medications and treatment are needed in case of an allergic reaction, whether mild or severe

This letter is the basis of your written allergy action plan at home, school, and anywhere else your child goes. Send a copy of this letter along with your instructions wherever your child is being watched by others.

Share Your Child’s Allergy Action Plan

Whenever a child with severe allergies is under the care of anyone other than a parent, whether it’s a relative or a babysitter, make sure the caregiver is familiar with your child’s allergy action plan.

However, it's not enough to just hand a written emergency plan to another caregiver, says Scott H. Sicherer, MD, an Elliot and Roslyn Jaffe professor of pediatrics, allergy, and immunology and the chief of the division of allergy and immunology in the department of pediatrics at Mount Sinai Hospital in New York City and author of Food Allergies: A Complete Guide for Eating When Your Life Depends on It. “You should still educate them about avoiding, recognizing, and managing an allergic reaction,” Dr. Sicherer says.

Manage Severe Childhood Allergies at School

Make an appointment to talk with the principal and school nurse before the school year starts, or as soon as you learn of your child's allergy, to discuss the situation and the school’s allergy policy. Take the letter from your child’s doctor along and use the information to work with the school nurse to develop an at-school allergy action plan that meets your child’s specific needs.

Also meet with your child’s teacher and discuss what measures will be taken to prevent an allergic reaction in the classroom, such as regular hand washing, safe foods allowed in the classroom, and allergy-free celebration treats.

"Most schools have allergy policies in place and have had children with allergies before,” Sicherer says. “They may have a variety of approaches for keeping children safe and being ready to recognize and treat reactions." For example, some schools may have special tables in the lunchroom for children with food allergies or offer closer supervision while they’re eating.

Here are three questions to ask about a school’s allergy policy:

  • Where is allergy medication stored?
  • Who is authorized to give allergy medications?
  • What is the allergy emergency plan for field trips and other extracurricular activities?

“Allergy medications at school must be immediately available with clear instructions, and they should not be locked up,” says Robert Wood, MD, a professor of pediatrics and the chief of pediatric allergy and immunology at Johns Hopkins Children’s Center in Baltimore, Md. “Medication needs to be within five minutes of where the child is.”

In October 2013, the Centers for Disease Control and Prevention released its first voluntary guidelines for managing food allergies at school, but there are no mandatory national standards. Some states have their own allergy guidelines in place for schools, which can help you and your school design your own allergy action plan.

Share Information With Your Child About Allergies

How you educate your child to protect him or herself from allergic reactions will depend on his or her age. Preschool and early elementary school kids can’t be expected to speak up for themselves about their allergies and should have close supervision. In the case of a food allergy, there should be very explicit instructions about what they’re allowed to eat, Dr. Wood says.

Young children with severe food allergies may learn that they can’t share food with another child, Sicherer says, or that there are specific people, like Mom, Dad, and their teacher, who know what they're allergic to and what's safe to eat — and that no one else can give them food. But as they get older, they can learn more and take more responsibility for themselves. "They may learn to speak up in restaurants and read food labels to begin to decide what’s safe under supervision," Sicherer says.

Teens and E-cigarettes

In Figure 2 Teen e-cig users are more likely to start smoking.
30.7 percent of e-cig users started smoking within 6 months while 8.1 percent of non users started smoking. Smoking includes combustible tobacco products (cigarettes, cigars, and hookahs).

Getting an IBS Diagnosis

Diagnosing irritable bowel syndrome isn’t like diagnosing other diseases. Your doctor can’t take a swab or a vial of blood and test it to determine the problem. There is no single test that can point to IBS as the cause of your symptoms.

Instead, when you go to your doctor about IBS symptoms like diarrhea, constipation, abdominal pain, and stomach cramps, he has to rule out other conditions and then pay careful attention to your symptoms before giving you a diagnosis.

Diagnosing IBS “For years, anyone who had gastrointestinal symptoms that couldn’t be explained was told they had IBS,” says Steven Field, MD, a gastroenterologist and clinical assistant professor of medicine at New York University School of Medicine in New York City. But now doctors use the "Rome criteria," which are a specific set of symptoms that have to be present in order to give a diagnosis. In addition, the criteria designate red-flag symptoms that don’t point to IBS, he says.

 

 

Giving your doctor detailed information about your symptoms and when you experience them will go a long way toward getting an accurate diagnosis. Here’s what your doctor considers before he makes a diagnosis:

Laboratory tests to rule out other conditions. To make sure something other than IBS isn’t causing your symptoms, your doctor may run blood tests, test your stool sample, order an X-ray, or perform a colonoscopy (a procedure in which your doctor uses a small flexible camera to look inside your colon).

Your symptoms. Under the Rome criteria, a diagnosis of IBS can be made if you have had abdominal pain during at least 12 weeks during a 12-month period, even if those 12 weeks aren’t consecutive, and if you experience two of these three things:

  • A bowel movement that causes the abdominal pain to go away
  • A change in the frequency of your bowel movements
  • A change in your stool’s appearance (it becomes hard and lumpy or loose and watery

Other signs of IBS include mucus in your stool, a swollen abdomen, an urgency to have a bowel movement, having trouble passing stool, or a feeling that your bowel isn’t empty after going to the bathroom.

If you have red flag symptoms. Your doctor will also be looking for red-flag symptoms that aren’t associated with IBS, Dr. Field says. Those include: 

  • Blood in your stool
  • Fever
  • Unexplained weight loss
  • Pain or diarrhea that’s so intense it wakes you up when you’re asleep
  • What triggers your symptoms. The factors that bring on your symptoms are another clue as to whether or not you have IBS. Eating such items as fried and greasy foods, caffeine, dairy products, chocolate, alcohol, and carbonated drinks often trigger symptoms, but the exact food triggers are different for everyone. Large meals may also trigger IBS symptoms.

 

 

Stress — which can result from major life changes such as getting married or getting a new job — is also a major trigger for IBS symptoms, Field says. And for women, symptoms are usually more severe during their menstrual period, possibly because of the effect of hormones on IBS.

The bottom line: Giving your doctor detailed information about your symptoms and knowing what triggers them will help with your diagnosis. Many doctors recommend keeping a food diary to determine exactly what brings on your symptoms and sharing that information with your doctor to make a better diagnosis and get you the right treatment.

By Marie Suszynski | Medically reviewed by Cynthia Haines, MD

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.

8 Healthy Game Day Snacks for Football Season

1 / 9   Skip the Takeout and Whip Up These 8 Winning Snacks

Even if you're not a football fanatic, game day is always an excuse to watch a good matchup, spend time with family and friends, and especially to eat your favorite foods. Nachos, chili, cheese dips — your upcoming game-day gathering will probably boast some of the best non-holiday spreads of the year. Game on! This year, it’s not about what foods you should avoid; instead, we scoured our favorite blogs for healthier game day dishes that score major points for flavor, originality, and nutrition. One look at these winning recipes and you won’t want to order out.

5 Cooking Tips to Spice Up Your Heart-Healthy Diet

Add Flavor, Texture, and Zest with Heart-Healthy Ingredients

If you have high cholesterol and blood pressure, your doctor has probably advised you to start following a healthy diet as part of your treatment plan. The good news is that delighting your taste buds while sticking to a heart-healthy meal plan is easy — and many of the foods you enjoy most likely aren’t off limits. Healthy herbs and spices lend robust and savory flavor, hearty nuts add texture and a buttery taste, and teas infuse a bright flavor and antioxidants. Michael Fenster, MD (also known as Dr. Mike), a board-certified interventional cardiologist and gourmet chef, shares his cooking tips for preparing delicious meals that will boost your heart health. These choices are part of a healthy lifestyle that may reduce your risk for heart conditions like high blood pressure, heart attack, or stroke down the road.

emphysema and chronic bronchitis

emphysema and chronic bronchitisemphysema and chronic bronchitisemphysema and chronic bronchitisemphysema and chronic bronchitis emphysema and chronic bronchitis emphysema and chronic bronchitis emphysema and chronic bronchitis

A Diet for Better Energy

Complex carbs are key for sustained energy throughout the day, while too many sugary snacks can lead to energy crashes. Find out which foods you need for round-the-clock energy.

 

Juggling the responsibilities of work, life, and family can cause too little sleep, too much stress, and too little time.

Yet even when you're at your busiest, you should never cut corners when it comes to maintaining a healthy diet. Your body needs food to function at its best and to fight the daily stress and fatigue of life.

Energy and Diet: How The Body Turns Food Into Fuel

Our energy comes from the foods we eat and the liquids we drink. The three main nutrients used for energy are carbohydrates, protein, and fats, with carbohydrates being the most important source.

Your body can also use protein and fats for energy when carbs have been depleted. When you eat, your body breaks down nutrients into smaller components and absorbs them to use as fuel. This process is known as metabolism.

Carbohydrates come in two types, simple and complex, and both are converted to sugar (glucose). “The body breaks the sugar down in the blood and the blood cells use the glucose to provide energy,” says Melissa Rifkin, RD, a registered dietitian at the Montefiore Medical Center in the Bronx, N.Y.

Energy and Diet: Best Foods for Sustained Energy

Complex carbohydrates such as high-fiber cereals, whole-grain breads and pastas, dried beans, and starchy vegetables are the best type of foods for prolonged energy because they are digested at a slow, consistent rate. “Complex carbohydrates contain fiber, which takes a longer time to digest in the body as it is absorbed slowly," says Rifkin. Complex carbs also stabilize your body’s sugar level, which in turn causes the pancreas to produce less insulin. This gives you a feeling of satiety and you are less hungry.”

Also important in a healthy, energy-producing diet is protein (preferably chicken, turkey, pork tenderloin, and fish), legumes (lentils and beans), and a moderate amount of healthy monounsaturated and polyunsaturated fats (avocados, seeds, nuts, and certain oils).

“Adequate fluids are also essential for sustaining energy,” says Suzanne Lugerner, RN, director of clinical nutrition at the Washington Hospital Center in Washington, D.C. “Water is necessary for digestion, absorption, and the transport of nutrients for energy. Dehydration can cause a lack of energy. The average person needs to drink six to eight 8-ounce glasses of water each day.”

Energy and Diet: Foods to Avoid

 

Simple carbohydrates, on the other hand, should be limited. Ranging from candy and cookies to sugary beverages and juices, simple carbs are broken down and absorbed quickly by the body. They provide an initial burst of energy for 30 to 60 minutes, but are digested so quickly they can result in a slump afterward.

You should also avoid alcohol and caffeine. Alcohol is a depressant and can reduce your energy levels, while caffeine usually provides an initial two-hour energy burst, followed by a crash.

Energy and Diet: Scheduling Meals for Sustained Energy

 

“I always recommend three meals and three snacks a day and to never go over three to four hours without eating something,” says Tara Harwood, RD, a registered dietitian at the Cleveland Clinic in Ohio. “If you become too hungry, this can cause you to overeat.”

Also, try to include something from each food group at every meal, remembering that foods high in fiber, protein, and fat take a longer time to digest.

Even if life is hectic, it’s important to make wise food choices that provide energy throughout the day. Your body will thank you.

 

Eating Carbs and Fats Before a Workout? Read This

The New York Times published an article “Should Athletes Eat Fat or Carbs?” last week which was based on a study that shows a diet comprised of 85 percent fat can help improve overall performance for ultra-endurance athletes more than the traditional high-carbohydrate diet considered best for athletes. And by fat, they mean good fats that come from foods like nuts, avocados, and extra-virgin olive oil — not your cheeseburgers and French fries. But before you throw all your healthy eating rules out the window, it’s important to note that this recommendation is not for most of us — these recommendations for real athletes. We’re talking about people who exercise for a living — think NBA players, Olympic swimmers, or professional marathoners.

Let’s be honest: Most of us don’t run more than two marathons a week or work out at all hours of the day, so this way of eating is not recommended, even for high school and college players and people who exercise regularly. However, this information certainly brings into question traditional thinking and, as so often with these studies, leaves us wondering if this type of eating could benefit other types of athletes or moderately active people. We’ll need to continue to watch the research for more answers.

It’s important to remember that carbohydrates are an essential part of a healthy, well-balanced diet and provide fuel for your workouts in the form of glycogen, which is stored in the liver and muscles. Fat, however, must be broken down into fatty acids before it can be used as fuel, and only endurance athletes who vigorously exercise throughout the day are able to use up all their glycogen stores before their bodies start using fat. A ketogenic diet, like the ones the article reviews with 85 percent of the diet from fat, forces your body to use fat more readily as an energy source. This is referred to as a ‘ketoadaption’ and takes several weeks to achieve.

Still, it’s not a good idea to overdo it on carbohydrates or fat for all your meals. Fats should only comprise 20 to 30 percent of your total daily calorie intake per meal (think two slices of avocado). Carbohydrates should make up 40 to 50 percent of your meal, and sources of good carbohydrates include vegetables, fruits, legumes, and whole grains. Government experts have offered suggestions for the 2015 Dietary Guidelines, (due to be published in the fall) which encourage Americans to cut down on meat, added sugars, and starchy, high-carb foods and include more fruits, vegetables, whole grains, and healthy fats into their diets.

“The move toward reducing the amount of carbohydrates recommended for the general public is because most of us are not active. We sit too much! When we don’t move, or if we move for only an hour a day, we’re not utilizing all the carbohydrates we are eating, and therefore we continue to gain weight and increase our risk for chronic diseases. For the most part, we are moving too little and eating too much and especially carbohydrates because they are easy, available, and taste good,” says Maureen Namkoong, MS, RD nutrition and fitness director at Everyday Health.

There’s a place for good carbohydrates and fats in a balanced diet. Good carbohydrates and fats give you energy, may help you lose weight, and promote cardiovascular health. But too much of a good thing can be bad — and this is true for fats and carbs, too.

When’s The Best Time to Exercise?

Ask the Fitness Expert,  Jennifer Bayliss

Q: What’s the best time of day to exercise?

A: The best time of day to exercise is the time that works best for you. Studies go back and forth on this topic and there are benefits in exercising in the morning and later in the day. Ultimately, it comes down to personal preference and lifestyle. Choose a time that helps you make exercise a regular and consistent part of your routine. Here’s why:

It’s all about finding your rhythm.
Ever wonder why some of us are morning people while others are not? This has quite a bit to do with your body’s internal clock, or your circadian rhythms. Circadian rhythms are a daily cycle of sleep and wake cycles. It’s this cycle that regulates physical, mental, and behavioral changes within a 24-hour period. Body temperature, blood pressure, and metabolism are some of the physiological processes that can be affected by your body’s internal clock. These rhythms respond to changes in the environment and can be set and reset. The changes in the environment that can have an effect on circadian rhythms include lightness and darkness, temperatures within the environment, artificial light, the use of an alarm clock to wake, timing of meals, and time of day you exercise. Your personal clock can affect what time of day you prefer to exercise. So, are you a morning person or a night owl?

If you’re a morning person…
It’s a no brainer: You should workout in the AM. Research suggests that those who exercise in the morning tend to be more consistent with their exercise routine. The idea is you’ll get your workout in before any other events or distractions of the day interfere, thus setting yourself up for success. People who exercise earlier in the day generally find they can manage their time better and they feel more energized throughout the day. If you do exercise in the morning, make sure to give yourself a little extra warm-up time to get your body temperature elevated and your muscles warm. Some people have trouble exercising in the morning because of dizziness, fatigue, or lightheadedness experienced when working out on an empty stomach. If that happens to you, try having a small snack, such as a banana or a serving of low-fat yogurt, prior to exercise.

If you’re a night owl…
Afternoon or evening exercise can be the perfect way to unwind. Some people find that afternoon or evening workouts are more productive and help relieve some of the stresses of the day. For others, exercise in the morning doesn’t feel good because, when you wake up, your muscles may feel tight and your blood sugars may be low. Afternoon or evening workouts may just seem that much better because you are more alert, your body temperature is naturally elevated, and your muscles are warm and flexible. You also have the added benefit of having had the opportunity to get some food in your system which can help you feel more energized during your workout.

Whether you exercise for weight loss, stress relief, or one of the many other health benefits, it is important to be consistent. Schedule that time for exercise based on what works best for you — morning, noon, or afternoon. Your body’s internal clock will reset itself and your sleep habits and changes to meal times will either fall into place or can be adjusted based on when you decide to work up a sweat!

Do you have a fitness question for us? Leave a comment below!

Jennifer Bayliss is a fitness expert and coach at Everyday Health. She is a certified strength and conditioning specialist through the National Strength and Conditioning Association, a AFAAcertified personal trainer, and holds both an undergraduate and a graduate degree in exercise science.

topics topics

yes right