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.
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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.
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."
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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.
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.
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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.
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.
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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.
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.
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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.
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.
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.
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.
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"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.
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.
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."
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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.
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.
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.
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.
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.
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.
1 / 8 Healthy Treats to Celebrate the Season
Fall means beautiful foliage, back-to-school time, and, you guessed it, pumpkin spice everything. From lattes to hummus (yes, you read that right), there’s no shortage of pumpkin spice-flavored products on the market. The problem is that many of these foods are laden with fat and sugar. A grande pumpkin spice latte with whipped cream at Starbucks, for example, contains a whopping 50 grams (g) of sugar and 380 calories — enough for a whole meal! Then there’s the pumpkin muffin from Dunkin’ Donuts, which weighs in at 550 calories and 24 g of fat.
The good news is you don’t have to steer clear of foods with pumpkin: They contain even more potassium than bananas, which means they can help lower blood pressure and decrease the risk of stroke and heart disease. Plus, a study published in February 2014 in the International Journal of Clinical Oncology found that consuming foods rich in beta-carotene — like pumpkins — is associated with a decreased risk of colon cancer, and a study published in 2004 showed that it may also reduce risk of prostate cancer.
To help you get into the spirit of the season — without widening your waistline — try these dietitian-approved pumpkin spice treats!
Ask anyone what their favorite breakfast is, and you’ll likely get answers ranging from veggie omelets to sugary cinnamon buns. But how many people can say their favorite morning meal is oatmeal? Well, that’s all about to change. Not only is oatmeal super healthy (it’s packed with belly-filling fiber), but it’s also incredibly versatile. Whether you prefer the grains sweet or savory — or packed with protein or healthy fats — we have the right recipe for you. And remember that no matter which flavor combination you choose, one thing is guaranteed: You’ll never look at oatmeal the same way again.
Tomato Basil Oatmeal
Sweet oatmeal recipes are easy enough to find, but savory ones? Those are a little harder to pull off. With its tomato puree, pine nuts, fresh herbs, and Parmesan cheese, Oatgasm’s tomato and basil oatmeal reminds us of a lower-carb bowl of pasta — one that you’ll want to eat for breakfast, lunch, and dinner. Mangia!
Slow Cooker Overnight Oatmeal
Don’t have time to cook breakfast in the morning? No problem. Just toss 2 cups of oats into a slow cooker, top with some dried berries, and add water. Wait 90 minutes, and voila! With just 193 calories, this slow cooker overnight oatmeal will be your new favorite breakfast.
Blueberry Muffin Overnight Oats
Our love of overnight oats continues with this mouthwatering blueberry version from Eat Yourself Skinny. (Seriously, how gorgeous is this?) The Greek yogurt and chia seeds add an extra shot of protein (13.4 grams in one jar!) and a chewy, flavorful texture. And did we mention it only takes a few minutes to make?
Date-Sweetened Apple Pie Oatmeal
This gluten-free apple pie oatmeal from the Minimalist Baker is sweetened with dates, apple slices, and a dash of honey. It’s part crispy, part thick and creamy, and all parts totally delicious. Plus, it’s easy to mix and match this base recipe with other toppings — think: toasted nuts and flaxseed.
5-Minute Oatmeal Power Bowl
Who says comfort food can’t be healthy, too? This oatmeal power bowl from Oh She Glows is not only delicious, but it also lives up to its belly-filling promise: laden with chia seeds, almonds, and cinnamon, it’s an instant, energizing way to start your day.
Raspberry-Almond Overnight Oatmeal
Breakfast doesn’t get much easier than this raspberry almond oatmeal. Simply combine oats, milk, yogurt, almonds, chia seeds, and a dash of almond extract in a pint-sized mason jar, then shake, stir, and refrigerate. It’s packed with healthy ingredients, and served up in a perfect portion size, too!
You’d be hard-pressed to find someone who doesn’t hit snooze or experience the midafternoon slump every once in a while, but if you constantly feel like you’re dragging it may be time to take a closer look at your routine. If you don’t have a related health condition and are getting enough shuteye each night, you may be to blame for the constant fatigue. Here are 8 energy-zapping habits that you can change today.
1. You’re eating too much sugar. While the candy jar is an obvious culprit, refined carbohydrates like white bread and rice, chips, and cereal are a major source of sugar,too. This type of simple sugar is digested quickly by the body, leading to a dip in blood sugar levels that leaves you feeling fatigued. Be sure to replace refined carbs with whole grain varieties for a lasting energy boost.
Psoriatic Arthritis Types
Learn About The Different Types
of Psoriatic Arthritis Today.
2. You aren’t exercising enough. It may seem counterintuitive that exerting energy will actually increase it, but adding a workout to your daily routine will give you a short-term energy boost. Plus, regular exercise improves sleep quality, which will ultimately leave you feeling more well rested.
3. You’re skipping breakfast. "Skipping breakfast can definitely contribute to low energy in the morning," says Johannah Sakimura, MS and Everyday Health blogger. "It's important to give your body good fuel to start the day after an extended period of fasting." Without this fuel, your body is running on empty – leaving you famished by lunchtime and more likely to make unhealthy choices that will cause that midafternoon dip in blood sugar. "Try to combine healthy carbohydrates, like fruit, veggies, and whole grains, with a protein source, such as eggs, nuts, or dairy. The carbs give you an initial boost, and the protein helps sustain you until your next meal," says Sakimura.
4. You’re sitting too much. Not only is sitting for prolonged periods of time harmful to your health (just one hour of sitting affects your heart!), but it’s a major energy zapper as well. Standing up and moving for even a few minutes helps get your blood circulating through your body and increases the oxygen in your blood, ultimately sending more oxygen to your brain which increases alertness. If you work a desk job, try this move more plan to keep your blood pumping.
5. You’re drinking too much caffeine. Whether it’s a can of soda or constant refills of your coffee mug, many of the beverages we reach for when we feel tired are packed with caffeine – a stimulant that will give you a quick jolt, but can also leave you crashing soon after if you ingest too much. Plus, if you’re drinking caffeinated beverages into the afternoon, they may start to have an effect on your sleep quality. If you’re a coffee drinker, switch to water late-morning and replace soda with seltzer for a bubbly afternoon pick-me-up without the crash.
6. You’re dehydrated. We all know the importance of drinking enough water – and even mild dehydration can have adverse effects on your energy level, mood, and concentration. Aim for at least one glass of water per hour while sitting at your desk, and be sure to fill your bottle up even more if you’re doing strenuous activity or are outdoors in high temperatures.
7. You have poor posture. A study found that slouched walking decreased energy levels while exacerbating symptoms of depression. The good news: Simply altering body posture to a more upright position instantly boosted mood and energy, while enabling participants to more easily come up with positive thoughts. So sit up straight! Set reminders on your phone or calendar throughout the day to remind yourself to check in with your posture and straighten up.
8. You’re not snacking smart. If you’re running to the vending machine for a quick afternoon snack, your selection – most likely high in simple carbs and sugar – will take your energy levels in the wrong direction. Instead choose a snack that has a combo of protein and complex carbs for an energy boost that will last throughout the afternoon. Think trail mix, veggies and hummus, or peanut butter on whole wheat toast.
The keys to successful psoriasis management are working with your doctor to find a treatment plan that’s right for you and then sticking to that plan. But your role in treatment doesn’t stop with medication. Making certain lifestyle changes is important, too.
From the foods you eat to the support you seek, making healthy choices every day can help you ease the discomfort of flaky, red itchy skin, avoid flares, and start living life to the fullest. Follow these 10 steps.
1. Eat an anti-inflammatory diet. Despite extensive research, there’s no evidence supporting a specific “psoriasis diet,” says Caitríona Ryan, MD, a dermatologist at Texas Dermatology Associates in Dallas and vice chair of the dermatology residency program at Baylor University Medical Center. However, many people with psoriasis report feeling better when they avoid foods that have been shown to cause or increase inflammation (such as fatty red meats, processed foods, refined sugar, and nightshade vegetables) and embrace foods that are known to reduce inflammation. Inflammation-fighting foods include those rich in omega-3s, such as salmon, albacore tuna, flaxseeds, and walnuts, and colorful fruits and vegetables, such as spinach, carrots, and blueberries, according to the National Psoriasis Foundation (NPF).
2. Maintain a healthy weight. People who are overweight tend to have more severe psoriasis, according to a study published in November 2012 in Clinical & Experimental Dermatology Research. “We know that adipose tissue (fat) produces inflammatory cytokines like tumor necrosis factor (TNF),” Dr. Ryan says. Overproduction of TNF, a cell signaling protein, can trigger psoriasis. In addition, systemic and biologic agents for treating psoriasis tend to work better in patients who aren’t overweight, she says.
3. Aim for 30 minutes of exercise most days. Physical activity goes along when it comes to maintaining a healthy weight and lowering your risk for comorbid conditions — such as your risk for heart disease and type 2 diabetes, which increase when you have psoriasis. Try to get at least 30 minutes of aerobic exercise five times a week, and add in some strength training. Although a study published in 2012 in the Archives of Dermatology showed that women who exercised vigorously lowered their risk of developing psoriasis, any level of exercise is better than none, says the NPF. That may mean simply taking the stairs at work instead of the elevator or parking farther away in parking lots.
4. Quit smoking and drinking too much. Neither of these habits is good for anyone, says Mark Lebwohl, MD, a professor and chairman of the department of dermatology at Icahn School of Medicine at Mount Sinai in New York. But they may be even worse for people with psoriasis, he says. The chemicals in tobacco may trigger inflammation that can both cause psoriasis and make flares more severe, according to the NPF. In addition, excessive alcohol consumption may interfere with your response to psoriasis treatment and make it less effective. If you need help quitting smoking or drinking excessively, talk to your doctor.
5. Arm yourself with moisturizer to fight dry skin. “The skin of people with psoriasis is very dry,” Dr. Lebwohl says. “Moisturizing makes it feel better.” Apply moisturizer after showering and after washing your hands. The thicker the moisturizer the better — creams and ointments lock more moisture in your skin.
6. Avoid illness. “Infections worsen psoriasis — even mild colds or urinary tract infections,” Ryan says. “So keeping healthy is rather important.” To stay healthy, eat well, wash your hands frequently, get quality sleep, and be sure your immunizations are up to date. Also be sure to get a flu shot before the start of the flu season.
7. Avoid injuries, too. Some people can develop lesions in new areas if their skin is cut, bruised, or burned, according to The Psoriasis and Psoriatic Arthritis Alliance (PAPAA). Try not to scratch, Ryan says. Be sure to protect your hands and skin when doing activities that could lead to injury such as household chores in the kitchen or pruning bushes in the garden.
8. Cut back on stress. Stressed out? Like most inflammatory conditions, too much tension can cause psoriasis to flare or can exacerbate lesions, according to the NPF. If you’re feeling overextended, look for ways to reduce stress in your life — be it meditation, exercise, or talking to a therapist.
9. Reach out for support. “There are a lot of benefits to support groups,” Lebwohl says. Whether the groups meet online or in person, people with psoriasis often share tips that work well for them and that can help others in their group, Lebwohl says. And sometimes, it helps just having someone listen to you who understands what you’re going through.
10. Stick to your treatment plan—even when you feel good. “Many patients think they’re better off minimizing treatment,” Lebwohl says. They stop taking their medication or go longer than they should between injections. But if you want to avoid flares, you need to stick to the plan. Says the NPF: Using your treatments as prescribed makes a big difference in how well they work.
Treatment and recovery from an addiction to drugs or alcohol are steps in a lifelong journey. Unfortunately, 40 to 60 percent of drug addicts and almost half of all alcoholics will eventually go through a substance abuse relapse.
If someone dear to you has been in addiction treatment, it is important for you to be able to recognize if that person is relapsing as early as possible. This way, the problem can be addressed before it spirals out of control. Just because your loved one relapses does not mean that their addiction treatment has failed, however; it just means that the current treatment regimen probably needs to be reevaluated.
Addiction Relapse: Obvious Signs
"Most of the time the signs are so obvious," says Thomas Kosten, MD, Jay H. Waggoner chair and founder of the division of substance abuse at Baylor College of Medicine in Houston.
According to Dr. Kosten, the following are common indicators of a drug or alcohol addiction relapse:
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Addiction Relapse: Early Indicators
There are also signals from the addict that a relapse is just around the corner, when steps can be taken to prevent the relapse or at least address it in its earliest stages. Your loved one may exhibit the following emotions and behaviors:
Addiction Relapse: Stepping in
When you suspect that your loved one has relapsed, Kosten says the best thing to do is tackle the issue head-on. He suggests that you start the conversation in the following way:
If your loved one is showing signs of an impending relapse but hasn’t yet relapsed, Kosten says that it is important to confront him first. Otherwise it is very unlikely that you are going to be able to convince him to get back into addiction treatment. Then you should encourage him to continue with treatment, talk to an addiction counselor or sponsor, and practice good self-care — that is, get enough sleep, eat well, and take steps to relieve stress.
If the addict refuses to talk with a professional or you feel that you need anaddiction expert to help you learn how to confront him, contact your local Council for Alcoholism and Drug Abuse. Or if you have access to the person’s doctor, addiction counselor, or sponsor, speak to that person about how you might deal with the situation.
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.
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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.
“Hepatitis” means inflammation of the liver. Toxins, certain drugs, some diseases, heavy alcohol use, and bacterial and viral infections can all cause hepatitis. Hepatitis is also the name of a family of viral infections that affect the liver; the most common types are Hepatitis A, Hepatitis B, and Hepatitis C.
Hepatitis A, Hepatitis B, and Hepatitis C are diseases caused by three different viruses. Although each can cause similar symptoms, they have different modes of transmission and can affect the liver differently. Hepatitis A appears only as an acute or newly occurring infection and does not become chronic. People with Hepatitis A usually improve without treatment. Hepatitis B and Hepatitis C can also begin as acute infections, but in some people, the virus remains in the body, resulting in chronic disease and long-term liver problems. There are vaccines to prevent Hepatitis A and B; however, there is not one for Hepatitis C. If a person has had one type of viral hepatitis in the past, it is still possible to get the other types.
Hepatitis C is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness that attacks the liver. It results from infection with the Hepatitis C virus (HCV), which is spread primarily through contact with the blood of an infected person. Hepatitis C can be either “acute” or “chronic.”
Acute Hepatitis C virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis C virus. For most people, acute infection leads to chronic infection.
Chronic Hepatitis C virus infection is a long-term illness that occurs when the Hepatitis C virus remains in a person’s body. Hepatitis C virus infection can last a lifetime and lead to serious liver problems, including cirrhosis (scarring of the liver) or liver cancer.
In 2014, there were an estimated 30,500 cases of acute hepatitis C virus infections reported in the United States.
An estimated 2.7-3.9 million people in the United States have chronic hepatitis C.
Approximately 75%–85% of people who become infected with Hepatitis C virus develop chronic infection.
Hepatitis C is usually spread when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the Hepatitis C virus by sharing needles or other equipment to inject drugs. Before 1992, when widespread screening of the blood supply began in the United States, Hepatitis C was also commonly spread through blood transfusions and organ transplants.
People can become infected with the Hepatitis C virus during such activities as
Less commonly, a person can also get Hepatitis C virus infection through
Yes, but the risk of transmission from sexual contact is believed to be low. The risk increases for those who have multiple sex partners, have a sexually transmitted disease, engage in rough sex, or are infected with HIV. More research is needed to better understand how and when Hepatitis C can be spread through sexual contact.
A few major research studies have not shown Hepatitis C to be spread through licensed, commercial tattooing facilities. However, transmission of Hepatitis C (and other infectious diseases) is possible when poor infection-control practices are used during tattooing or piercing. Body art is becoming increasingly popular in the United States, and unregulated tattooing and piercing are known to occur in prisons and other informal or unregulated settings. Further research is needed to determine if these types of settings and exposures are responsible for Hepatitis C virus transmission.
Yes, but this does not occur very often. If Hepatitis C virus is spread within a household, it is most likely a result of direct, through-the-skin exposure to the blood of an infected household member.
Any blood spills — including dried blood, which can still be infectious — should be cleaned using a dilution of one part household bleach to 10 parts water. Gloves should be worn when cleaning up blood spills.
The Hepatitis C virus can survive outside the body at room temperature, on environmental surfaces, for up to 3 weeks.
Hepatitis C virus is not spread by sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing. It is also not spread through food or water.
Some people are at increased risk for Hepatitis C, including:
Less common risks include:
Hepatitis C is rarely passed from a pregnant woman to her baby. About 6 of every 100 infants born to mothers with Hepatitis C become infected with the virus. However, the risk becomes greater if the mother has both HIV infection and Hepatitis C.
Hepatitis C virus has not been shown to be transmitted by mosquitoes or other insects.
No, if you ever tested positive for the Hepatitis C virus (or Hepatitis B virus), experts recommend never donating blood, organs, or semen because this can spread the infection to the recipient.
Approximately 70%–80% of people with acute Hepatitis C do not have any symptoms. Some people, however, can have mild to severe symptoms soon after being infected, including:
If symptoms occur, the average time is 6–7 weeks after exposure, but this can range from 2 weeks to 6 months. However, many people infected with the Hepatitis C virus do not develop symptoms.
Yes, even if a person with Hepatitis C has no symptoms, he or she can still spread the virus to others.
Yes, many people who are infected with the Hepatitis C virus do not know they are infected because they do not look or feel sick.
Most people with chronic Hepatitis C do not have any symptoms. However, if a person has been infected for many years, his or her liver may be damaged. In many cases, there are no symptoms of the disease until liver problems have developed. In persons without symptoms, Hepatitis C is often detected during routine blood tests to measure liver function and liver enzyme (protein produced by the liver) level.
Chronic Hepatitis C is a serious disease that can result in long-term health problems, including liver damage, liver failure, liver cancer, or even death. It is the leading cause of cirrhosis and liver cancer and the most common reason for liver transplantation in the United States. Approximately 19,000 people die every year from Hepatitis C related liver disease.
Of every 100 people infected with the Hepatitis C virus, about
Yes. It is common for persons with chronic Hepatitis C to have a liver enzyme level that goes up and down, with periodic returns to normal or near normal. Some infected persons have liver enzyme levels that are normal for over a year even though they have chronic liver disease. If the liver enzyme level is normal, persons should have their enzyme level re-checked several times over a 6–12 month period. If the liver enzyme level remains normal, the doctor may check it less frequently, such as once a year.
Talk to your doctor about being tested for Hepatitis C if any of the following are true:
No, getting tested for Hepatitis C is not part of routine prenatal care. However, if a pregnant woman has risk factors for Hepatitis C virus infection, she should speak with her doctor about getting tested.
Several different blood tests are used to test for Hepatitis C. A doctor may order just one or a combination of these tests. Typically, a person will first get a screening test that will show whether he or she has developed antibodies to the Hepatitis C virus. (An antibody is a substance found in the blood that the body produces in response to a virus.) Having a positive antibody test means that a person was exposed to the virus at some time in his or her life. If the antibody test is positive, a doctor will most likely order a second test to confirm whether the virus is still present in the person's bloodstream.
Yes, acute hepatitis C can be treated. Acute infection can clear on its own without treatment in about 25% of people. If acute hepatitis C is diagnosed, treatment does reduce the risk that acute hepatitis C will become a chronic infection. Acute hepatitis C is treated with the same medications used to treat chronic Hepatitis C. However, the optimal treatment and when it should be started remains uncertain.
Yes. There are several medications available to treat chronic Hepatitis C, including new treatments that appear to be more effective and have fewer side effects than previous options. The Food and Drug Administration (FDA) maintains a complete list of approved treatments for Hepatitis C.
Yes, approximately 15%–25% of people who get Hepatitis C will clear the virus from their bodies without treatment and will not develop chronic infection. Experts do not fully understand why this happens for some people.
People with chronic Hepatitis C should be monitored regularly by an experienced doctor. They should avoid alcohol because it can cause additional liver damage. They also should check with a health professional before taking any prescription pills, supplements, or over-the-counter medications, as these can potentially damage the liver. If liver damage is present, a person should check with his or her doctor about getting vaccinated against Hepatitis A and Hepatitis B.
Not yet. Vaccines are available only for Hepatitis A and Hepatitis B. Research into the development of a vaccine is under way.
CDC's recommendations for prevention and control of the Hepatitis C virus infection state that people should not be excluded from work, school, play, child care, or other settings because they have Hepatitis C. There is no evidence that people can get Hepatitis C from food handlers, teachers, or other service providers without blood-to-blood contact.
HIV and Hepatitis C virus coinfection refers to being infected with both HIV and the Hepatitis C virus. Coinfection is more common in persons who inject drugs. In fact, 50%–90% of HIV-infected persons who use injection drugs are also infected with the Hepatitis C virus. To learn more about coinfection, visithttp://www.cdc.gov/hiv/resources/factsheets/hepatitis.htm.
This week marks the second anniversary of my writing this blog. It’s a good chance to remember why I write the blog, what it has meant to me, and to think about what’s ahead. I originally wanted to write because the original site, HealthTalk.com, helped me immensely with their psoriasis web content. I especially enjoyed the various topics presented in the monthly webcast. By writing I believed I could bring my own story and perspective to the discussion of how to live with and treat psoriasis. At that time I also felt down about many aspects of my life, including psoriasis. With no end in sight managing this disease I wondered if anything good could be redeemed from the experience. If I could help one other person feel like they are not alone in battling psoriasis, if anyone could benefit from my trial and errors with medications, or if caregivers could understand the different dimensions of living with psoriasis then writing would be worth it. Finally, I wanted a community I could share the struggles with and how better to find one than to help create one?
1 / 10 Not All Milks Are Alike
The milk aisle is changing, and has a growing number of options for what to pour on your cereal or drink down as a late-night snack. But what do the newer types of milk mean for your heart health if you have high cholesterol? Old-fashioned cow’s milk, for example, is loaded with calcium and vitamins A and D, which are all good for your heart and overall health. But the saturated fat in whole milk — and even in 2 percent milk — may counteract those health benefits. When you're trying to get to healthy cholesterol levels, you'll want to limit the amount of saturated fat in your diet.
Alternative milks can provide similar nutritional benefits if you're lactose intolerant, allergic to certain proteins in cow’s milk, vegan, or simply prefer something other than cow's milk. “People choose a milk based on tolerability and taste — in addition to health beliefs,” says Deborah Krivitsky, RD, director of nutrition at the Cardiovascular Disease Prevention Center at Massachusetts General Hospital in Boston. “Each milk will provide different pluses and minuses.”
As a physician anesthesiologist, I know how challenging it can be to treat patients who are in pain. For most people, pain is temporary. But for more than 100 million Americans, there is no end to pain.
Chronic pain can be broad or focused, dull or sharp, distracting or excruciating, and in many cases, debilitating.
Your likelihood of experiencing chronic pain increases with age. Gender can also influence how much pain you have. In general, women report having more pain than men.
The Serious Effects of Pain
Living with chronic pain can affect your life in many ways:
Mental health changes. According to a 2006 survey from the American Academy of Pain Medicine, almost two-thirds of people living with chronic pain have reported a decrease in overall happiness and 77 percent reported feeling depressed.
Increased fatigue. Pain can affect your daily functioning, resulting in decreased concentration, diminished energy levels, and difficulty falling or staying asleep.
Decreased job performance. Chronic pain costs the U.S. more than cancer, heart disease, and diabetes. Health economists estimate that the cost of chronic pain may be as high as $635 billion a year, according to a report published in the Journal of Pain. We can only guess how many people have been limited in their professional advancement because of pain.
Which Doctor Is Best at Treating Pain?
If you are experiencing pain, your first stop should be to visit your primary care physician. A 2010 analysis of a national medical database found that 13 percent of all doctors visits were to discuss pain. Of these visits, 45 percent were at a primary care physician's office. Less than 1 percent of those surveyed sought help from a specialized pain physician.
Specialized pain physicians are underused by patients, probably because the specialty is relatively new and people don't know about it. These physicians are trained to treat difficult pain conditions using the most advanced treatments.
I like to compare pain physicians to football players. The goal of all of these doctors is the same — to relieve pain — but the role they play varies:
Anesthesiologists spend four years of their training managing anesthesia and pain control in surgical patients. Most pain specialists are anesthesiologists, and they can offer a full array of pain treatments.
Neurologists focus on targeting the neural, or nerve, aspects of pain. Treatments include medications and procedures to treat nerve-related pain.
Physical medicine and rehabilitation physicians focus on relieving pain and improving their patients' day-to-day functioning via physical therapy and physical reconditioning.
The Future of Pain Treatment
Recently, the American Society of Anesthesiologists analyzed dozens of peer-reviewed medical journals from the past year to create its first Women’s Pain Update. Highlights from the report include:
Success with alternative pain-relief methods such as music, yoga, and rose oil.
Breast cancer research that found the type of anesthesia used during breast cancer surgery can affect how quickly and comfortably you recover.
New research has also led to the development of medications that can decrease nerve irritation and depression caused by pain. Similarly, there are several new procedures that can treat pain.
For example, pain specialists can use X-ray or ultrasound imaging guidance to provide relief through steroid injections that target specific nerves and areas of the spinal cord. The procedure is fairly low risk when administered by a physician specifically trained in interventional pain treatments. All three major pain societies, the American Pain Society, the American Society of Interventional Pain Physicians, and the American Academy of Neurology, state that epidural steroid injections are best suited for those with a pinched or inflamed nerve root (also called radiculopathy).
However, we still have a lot to learn about steroid procedures. Studies have shown that any type of epidural injection — including saline — can relieve pain. In fact, such injections provide twice the pain relief of intramuscular steroid injections, without the associated risks.
Don't resign yourself to a life in pain. If you are one of the millions of people lacking an effective remedy for your pain, a trained pain medicine physician may be able to help you achieve your pain management goals.
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You flossed right before your appointment—and that’s the only time.
Sorry, but you can’t fool your dentist into thinking you floss daily by doing it the night before or morning of your visit.
“The gums of people who only floss right before a visit are bleeding or look damaged,” says Timothy Stirneman, D.D.S., of All Smiles Dental in Algonquin, Illinois. “Healthy gums are nice and tight and pink.”
Santa Monica-based dentist Kenneth Wong, D.D.S., is on to you, too. “When patients floss right before coming in for a cleaning, I can see the slices where the floss cut at the gum because they were overzealous,” he says.
Statistically speaking, ovarian cancer is relatively rare: It represents just 1.3 percent of all new cancer cases in the United States each year, according to the National Cancer Institute (NCI). But although its numbers are small, the fear factor for many women may be disproportionately large.
We spoke to two leading ovarian cancer experts: Robert J. Morgan, Jr., MD, professor, and Mihaela C. Cristea, MD, associate clinical professor, of the medical oncology and therapeutics research department at City of Hope, an NCI-Designated Comprehensive Cancer Center in Duarte, California.
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Here are 10 essential facts about ovarian cancer that you should know:
1. About 20,000 women in the United States are diagnosed with ovarian cancer each year. As a comparison, nearly 250,000 women will be diagnosed with breast cancer this year, according to the American Cancer Society. Of the women diagnosed with ovarian cancer, 90 percent will be older than 40; most ovarian cancers occur in women 60 or older, according to the CDC.
2. You should see your doctor if you experience any of these ovarian cancer symptoms:
It’s important to pay attention to your body and know what’s normal for you. If you have abnormal vaginal bleeding or have any of the other symptoms for two weeks or longer, see your doctor right away.
These symptoms can be caused by many different problems, but it’s best to have them evaluated, suggests the University of Texas MD Anderson Cancer Center.
3. It’s tricky to pinpoint early, milder symptoms of ovarian cancer. However, the findings of a study published in Cancer in 2007 point to a cluster of vague symptoms that may suggest the need for ovarian cancer testing, says Dr. Morgan. In the study, researchers linked these symptoms to the possibility of ovarian cancer:
If a woman experiences these symptoms on more than 12 days a month for less than one year, she should insist that her doctor perform a thorough ovarian evaluation, says Morgan. This might include the CA-125 blood test or atransvaginal ultrasound exam.
4. Early detection can mean a better prognosis. When detected early enough, ovarian cancer can be cured. “Stage 1 and stage 2 ovarian cancer is curable about 75 to 95 percent of the time, depending on the tumor grade and cell type,” says Morgan. But because this cancer occurs deep inside the body’s pelvic region, it is often diagnosed in later stages, he says. The cure rate for stage 3 ovarian cancer is about 25 to 30 percent, and for stage 4 it's less than 5 percent, he adds.
RELATED: Overcoming Ovarian Cancer, Twice
5. Ovarian cancer has several key risk factors. These include:
6. Ovarian cancer is not a single disease. In reality, it’s a diverse group of cancers that respond to different treatments based on their molecular characteristics, says Dr. Cristea. Treatment will also depend on other health conditions, such as diabetes or heart problems, that a woman might have.
7. Ovarian cancer treatments are evolving and improving all the time.“Immunotherapy is emerging as a new treatment option for many malignancies, including ovarian cancer,” says Cristea. In another recent development, the firstPARP inhibitor, a DNA-repair drug, has been approved for women with BRCA-mutated ovarian cancer when chemotherapy hasn’t worked. “Women should also ask their doctors about clinical trials that are evaluating immunotherapy as well as other new treatments,” she adds.
8. Surgery may prevent ovarian cancer in women at very high risk. For women who carry the BRCA or other genes that predispose them to ovarian cancer, doctors often recommend surgery to remove the ovaries and fallopian tubes.Angelina Jolie, the actor and human rights activist, decided to have this surgery in March 2015. “Removing the ovaries can decrease the risk of developing the disease by 98 percent, and can substantially decrease the risk of developing breast cancer,” notes Morgan. Women in this very high-risk group should opt for this surgery after they’ve completed childbearing at around age 35, he notes.
9. Even after remission, ovarian cancer can still respond to treatment. “About 80 to 90 percent of ovarian cancer patients will achieve remission after chemotherapy treatment,” says Morgan. However, many of those women will later experience a recurrence of the cancer. The longer the remission, notes Morgan, the better the chances are for achieving a second remission.
10. It’s best to see an ovarian cancer specialist. When you’ve been diagnosed with ovarian cancer, getting a referral to an ovarian cancer specialist is a wise move, says Cristea. If you’re having surgery, it’s best to have a gynecologic oncologist perform the operation instead of a gynecologist, she adds. And to make sure you’re getting state-of-the-art treatment, consider seeking a second opinion at a NCI-Designated Cancer Center.
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.
One look at the billion dollar anti-aging industry and it's no surprise we find youth beautiful above all else. But skin isn't the only indicator of it — the size of your eyes is, too. "Women with baby-like features such as large, widely-spaced eyes are typically judged to be most attractive," says Viren Swami, PhD, author of The Psychology of Physical Attraction,who cites cross-cultural study data from African-American, Asian, Hispanic, and Taiwanese participants.
The quickest and easiest way to maximize your eyes is to sketch a line on the top lash line using a smoky shade, and then smudge the shadow with a brush or your fingertip to soften and blend, says Tina Turnbow, a celebrity makeup aritst.
You might write off a feeling of fatigue to doing too much. You work, run a home, raise kids, volunteer in your community — all of these activities can leave you feeling overtired, you tell yourself as you collapse on the sofa.
But there’s fatigue, and then there’s chronic fatigue, a feeling of exhaustion that probably signals a medical condition and needs a doctor’s evaluation to help you start feeling like your old self again.
If you experience a level of fatigue that leaves you exhausted at the end of the day, but is not so severe that it’s keeping you from living your normal life, making a few healthy lifestyle changes may help. Try taking these steps:
If your fatigue is more than garden-variety tiredness, a visit to your doctor can help pinpoint a cause. About 40 percent of people who have symptoms of chronic fatigue turn out to have a treatable, underlying medical condition, such as:
Fatigue means being too beat to go to the movies or shopping, or to engage in any number of the other normal activities you're used to. With chronic fatigue syndrome (CFS) you might be struggling to get through each day; for some people it can get bad enough that even holding down a job becomes difficult, forcing them to consider going on disability leave.
The Centers for Disease Control and Prevention says that between 1 and 4 million Americans have chronic fatigue syndrome. It is four times as common in women as men and usually begins in the childbearing years, although in rare cases it may occur in teenagers.
At this time, there are no tests to diagnose chronic fatigue syndrome. Your doctor can only diagnose CFS when other medical conditions known to cause fatigue are ruled out. Doctors call this "a diagnosis of exclusion."
The most debilitating symptom of CFS is severe, unexplained, persistent fatigue, lasting six months or more. It’s a fatigue that doesn’t go away after rest or sleep and keeps you from doing at least half the things you would normally do each day. To make the diagnosis, doctors will also look for four or more of the following symptoms:
Just what causes chronic fatigue syndrome is still unknown. Originally, scientists thought that being infected with certain viruses, especially the Epstein-Barr virus that causes mononucleosis, might be at the root of CFS, but there have been no conclusive findings. Now researchers are looking at whether inflammation brought on by an abnormal, overactive immune response occurrs in the nervous system of those with chronic fatigue.
Nakazawa believes that shifts in our 21st-century lifestyle, including daily exposure to toxins, pesticides, heavy metals, chemicals in our processed-food diets, and modern stress levels, are partly responsible. "Scientists who study autoimmune disease have called this epidemic 'the global warming of women's health,'" she says.
Advises Nakazawa, "At the same time that you work to lessen exposure to things that might overwhelm your immune system, you also need to relax and find joy in the world every day. How optimistically you perceive the world around you also impacts your stress level and your well-being."
There's a link between obesity and 40 percent of all the cancers diagnosed in the United States, health officials reported Tuesday.
That doesn't mean too much weight is causing all these cancer cases, just that there's some kind of still-to-be explained association, according to the U.S. Centers for Disease Control and Prevention.
Still, the study findings suggest that being obese or overweight was associated with cancer cases involving more than 630,000 Americans in 2014, and this includes 13 types of cancer.
"That obesity and overweight are affecting cancers may be surprising to many Americans. The awareness of some cancers being associated with obesity and overweight is not yet widespread," Dr. Anne Schuchat, CDC deputy director, said during a midday media briefing.
The 13 cancers include: brain cancer; multiple myeloma; cancer of the esophagus; postmenopausal breast cancer; cancers of the thyroid, gallbladder, stomach, liver, pancreas, kidney, ovaries, uterus and colon, the researchers said.
Speaking at the news conference, Dr. Lisa Richardson, director of CDC's Division of Cancer Prevention and Control, said early evidence indicates that losing weight can lower the risk for some cancers.
According to the new report from the CDC and the U.S. National Cancer Institute, these 13 obesity-related cancers made up about 40 percent of all cancers diagnosed in the United States in 2014.
RELATED: U.S. Cancer Death Rate Continues to Fall
Although the rate of new cancer cases has decreased since the 1990s, increases in overweight and obesity-related cancers are likely slowing this progress, the researchers said.
Of the 630,000 Americans diagnosed with a cancer associated with overweight or obesity in 2014, about two out of three occurred in adults aged 50 to 74, the researchers found.
Excluding colon cancer, the rate of obesity-related cancer increased by 7 percent between 2005 and 2014. During the same time, rates of non-obesity-related cancers dropped, the findings showed.
In 2013-2014, about two out of three American adults were overweight or obese, according to the report.
For the study, researchers analyzed 2014 cancer data from the United States Cancer Statistics report and data from 2005 to 2014.
Key findings include:
Of all cancers, 55 percent in women and 24 percent in men were associated with overweight and obesity.
Blacks and whites had higher rates of weight-related cancer than other racial or ethnic groups.
Black men and American Indian/Alaska Native men had higher rates of cancer than white men.
Cancers linked to obesity increased 7 percent between 2005 and 2014, but colon cancer decreased 23 percent. Screening for colon cancer is most likely the reason for that cancer's continued decline, Schuchat said.
Cancers not linked to obesity dropped 13 percent.
Except for colon cancer, cancers tied to overweight and obesity increased among those younger than 75.
The new report was published online Oct. 3 in the CDC's Morbidity and Mortality Weekly Report.
Dr. Farhad Islami is strategic director of cancer surveillance research for the American Cancer Society.
He said it's "important to note that only a fraction of the cancers included in the calculation in this report are actually caused by excess body weight."
According to Islami, "many are attributable to other known risk factors, like smoking, while for many others, the cause is unknown. Obesity is more strongly associated with some cancers than others."
The World Cancer Research Fund estimates that "20 percent of all cancers in the United States are caused by a combination of excess body weight, physical inactivity, excess alcohol, and poor nutrition. The American Cancer Society is currently doing its own extensive calculation of the numbers and proportions of cancer cases attributable to excess body weight, the results of which will be published soon," he said.
More Americans are surviving cancer than ever before, but as the population ages, even more will develop the disease.
That's the good and bad news from the 2017 Cancer Progress Report from the American Association for Cancer Research, released Wednesday.
According to the report, the cancer death rate dropped 35 percent among children and 25 percent among adults from 1991 to 2014. That translates to slightly more than 2 million fewer cancer deaths.
On the flip side, new cancer diagnoses are predicted to rise from nearly 1.7 million this year to 2.3 million in 2030, said the association's president, Dr. Michael Caligiuri.
And this year alone, more than 600,000 Americans are predicted to die from cancer, according to the report.
Caligiuri said the increase in cancer cases is simply a consequence of more people living longer. As the report noted, 53 percent of U.S. cancer diagnoses occur among those aged 65 and older, and that population segment is expected to grow from about 49 million in 2016 to just over 74 million in 2030.
"The longer people live, the higher the incidences of cancer are going to be," Caligiuri said.
"The longer you live, the more likely are the chances for serious genetic mutations that cause cancer, and the weaker your system is in repairing your DNA when you do have those genetic changes," he explained.
Dr. Anthony D'Amico is a professor of radiation oncology at Harvard Medical School in Boston. He said, "The most likely explanation for the progress in cancer survival is a combination of advances in cancer treatment coupled with early detection through screening."
The AACR report noted that death rates for many of the most commonly diagnosed cancers in the United States -- including breast, colorectal, lung and prostate cancer -- have been declining for more than a decade. But deaths from other forms of cancer -- brain, liver and uterine cancer -- have been increasing.
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And progress has not benefited every American equally, the researchers noted. Disparities in cancer care continue between whites and blacks, the insured and uninsured, the poor and the elderly.
But there is progress in treatment. Between August 2016 and July 2017, nine new anticancer drugs were approved by the U.S. Food and Drug Administration, the report said. In addition, the FDA approved the use of eight existing drugs for fighting new cancers.
Two of the new drugs are immunotherapeutics, called checkpoint inhibitors. These treatments increase survival and improve the quality of life for patients with many types of cancer.
Progress was also seen in drugs that target specific cancer molecules. In fact, seven of the new drugs do just that, the researchers said.
The FDA also approved a new optical imaging agent to help doctors see brain tumors and more accurately guide their removal.
The keys to more progress in preventing and curing cancer include basic science to understand the biology of cancers, Caligiuri said, then making those findings relevant to cancer treatment through animal and early human trials. Next comes testing on many people to see how safe and effective these new treatments are, he added.
In addition, more studies are needed to better understand the risks for cancer and to develop ways to lower those risks. These include lifestyle changes -- such as not smoking, eating a healthy diet and exercising -- and screening to detect cancer early.
On the cancer prevention side, cigarette smoking declined by nearly 39 percent from 2000 to 2015, which should mean fewer cases of lung cancer in the future, the report said.
The researchers also said that, in the future, nearly all cases of cervical cancer and many cases of oral and anal cancer could be prevented if girls and boys received the human papillomavirus (HPV) vaccine.
Yet, only 63 percent of girls and fewer than 50 percent of boys had received at least one dose of HPV vaccine in 2015, the study reported.
According to D'Amico, "There is still a lot more to do, but we are going in the right direction in terms of discovery, screening and biology."
Cancer is not an inexpensive disease. Direct medical costs in 2014 were nearly $88 billion, the report said. This does not include the indirect costs, such as lost productivity from cancer-related care and death.
Yet the U.S. National Institutes of Health (NIH) received only $30 billion in funding for 2014, Caligiuri said. And of that total, only about $5 billion went to the U.S. National Cancer Institute.
Not surprisingly, Caligiuri believes that both the NIH and the FDA need more money to spend on cancer research and treatment if further progress in the fight against cancer is going to happen.
"The limiting step for more progress against this beast called cancer is funding," Caligiuri said. "The data clearly show that when we have the funding, we can make phenomenal progress."
Although the number of people diagnosed with diabetes is still on the rise, the good news is that most people with the disease know they have it, a new study shows.
The research suggests that over the past two and a half decades, the percentage of undiagnosed cases has dropped significantly.
"If you're going to your doctor, you probably don't have to worry about undiagnosed diabetes," said study author Elizabeth Selvin, a professor of epidemiology at Johns Hopkins University's Bloomberg School of Public Health.
Selvin explained that previous estimates suggested that over a quarter to 30 percent of people with diabetes probably didn't know it. But those estimates assumed that doctors were only doing one test for diabetes and not following up with a confirmatory second test, as the American Diabetes Association recommends.
However, "we found that's not consistent with how diabetes is diagnosed in clinical practice. In practice, an abnormal finding is confirmed with a second test for the diagnosis. When you use two tests, we see that we're doing a good job with screening and diagnosing diabetes," Selvin said.
In fact, the two-test method seems to capture about 90 percent of all diabetes cases, the researchers noted.
Selvin and her colleagues used data from U.S. National Health and Nutrition Examination Surveys done from 1988 to 1994 and from 1999 to 2014.
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The surveys showed that when the research began in 1988 to 1994, there were about 10 million adults with diabetes and confirmed undiagnosed diabetes (that means people who just had one test and didn't get a follow-up test). By 1999 to 2014, there were 25.5 million adults with diabetes or undiagnosed diabetes.
The new research revealed that the number of undiagnosed cases as a percentage of all diabetes dropped from more than 16 percent to slightly less than 11 percent over 26 years.
People who were undiagnosed were more likely to be overweight or obese, older, or a racial or ethnic minority. They were also less likely to have health insurance or access to health care, the study found.
"What we need to figure out is how to target our screening and prevention efforts to the group that actually is undiagnosed. Some of the people being missed have very high [blood sugar levels] and the efforts should be concentrated on getting those people to the clinic," Selvin said.
The findings were published Oct. 23 in the Annals of Internal Medicine.
Dr. Anne Peters is director of the clinical diabetes program at the University of Southern California Keck School of Medicine in Los Angeles. She wrote an editorial that accompanied the study.
"I think there are fewer undiagnosed cases than we used to think, but there are still a lot of people who are undiagnosed," Peters said.
"People with risk factors need to get tested. But people get afraid of the stigma. They get afraid of the disease. But diabetes doesn't have to be awful. People don't have to give up. We need a lot more public awareness and a lot more prevention," she said.
And that doesn't mean you have to lose 100 pounds. "Losing 15 pounds can make a big difference. Just walking 30 minutes a day, five days a week is incredibly beneficial. Take diabetes on in bite-sized pieces," Peters advised.
"There are so many new ways to treat diabetes. Almost everything has changed in the past 30 years. But the earlier you start treatment, the better. Some things are better to face," she said.
Helicopter parents, take note: A mother has a better relationship with her child if she respects the youngster's need for independence at a young age, a new study suggests.
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Mothers who allowed children more freedom at age 2 were viewed more positively by their children later in childhood, according to the University of Missouri study.
The study included more than 2,000 mothers and their children. The researchers observed how much the mothers controlled the children's play at age 2 and then interviewed the children at fifth grade to assess how they felt about their mothers.
"When mothers are highly controlling of small children's play, those children are less likely to want to engage with them," Jean Ispa, co-chair of the department of human development and family studies, said in a university news release.
Respect for independence is important both for children's growth and for creating positive parent-child relationships, she said. "We found that mothers who supported their children's autonomy were regarded more positively by their children than mothers who were highly directive," she said.
"Mothers who are very directive when their children are toddlers often tend to still be controlling when their children enter adolescence," Ispa noted.
Mothers with small children mostly use physical controls, she said, but when children are older these directives become more verbal and psychological -- not allowing kids to speak their mind, for instance. "It's not surprising that their children begin to view them in a negative light," Ispa said.
The findings, published online recently in the journal Social Development, don't mean that parents should not establish and enforce rules or offer advice, Ispa said. She noted that behavioral rules -- such as teaching children to check for cars before crossing the street -- did not have a negative impact on mother-child relationships.
It was psychological control -- such as inducing guilt or telling children what to think and feel, or to play in certain ways -- that damaged mother-child relationships, the study found.
"Many times, parents think that employing these controlling behaviors is the 'right way' to raise children, but our research shows that really does not work," Ispa said.
"Allowing children age-appropriate levels of autonomy to make safe decisions is very good for kids, and they usually will make wise decisions when they have been taught about safe choices as well as consequences," she added.
"A good place for parents to start would be to have open discussions and allow their children to express their own points of view," she suggested. "When giving children instructions, explain reasons for decisions rather than simply saying, 'Because I said so.' "
For a hypoallergenic beauty product to plump up your lashes, Van Dyke suggests Almay Thickening Mascara. It's affordable, available at mass-market stores, and a great beauty product to avoid skin allergy reactions. Almay products go through rigorous testing to avoid allergens and irritants and maintain the brand's reputation for hypoallergenic beauty products, says Van Dyke. "It is hard to beat Almay for dermatologist-approved makeup, particularly around the eye," she adds.
You may know Nigel Barker as the encouraging yet truthful judge on America's Next Top Model, or as a famed fashion photographer who has shot pictures for GQ, Lucky, and Town & Country, among others — or as the author of a book about connecting with your best self, Beauty Equation.
He's fit and trim and confident, but under that chiseled frame, the now 44-year-old Barker learned a few years ago that he wasn't nearly as healthy as he'd assumed. And he never would have found out — and had the chance to turn his health around — if it weren't for a routine conversation with his insurance company.
In 2011, when Barker asked for an increase in the amount of coverage on his life insurance policy, what he thought would be a no-brainer (pay more to get more) turned out to be a rude awakening.
The company denied the additional coverage because Barker's cholesterol levels were too high.
Food, Family, and High Cholesterol
Barker was shocked: He'd been following a strict low-carb, high-protein diet for the previous two years and had toned his body in the process, which he thought would be good for his heart and health. But his high-protein diet also included saturated fat-heavy red meat, cheese, and butter, which probably contributed to his total cholesterol level of 253 milligrams per deciliter (mg/dL) and an LDL ("bad") cholesterol level of 155 mg/dL.
"I looked great on the outside," says Barker. But inside, potentially dangerous levels of cholesterol were putting him at risk for heart problems.
The optimal level of total cholesterol is less than 200 mg/dL, and LDL should be less than 100 mg/dL, according to the Cleveland Clinic. Barker's total cholesterol level put him at risk for heart disease. On the plus side, Barker's "good" HDL cholesterol was fine, at 63; anything above 60 is considered cardio-protective. Though it's important to aim for these numbers, the American Heart Association (AHA) advocates looking at a person's overall health and lifestyle as risk factors in addition to cholesterol counts.
What you eat is one of these factors, and — bonus! — the perks of a healthy meal plan can extend beyond your heart. A study published in July 2015 in JAMA Internal Medicine found that people who followed a Mediterranean diet rich in heart-healthy foods like whole grains, olive oil, legumes, fish, and fruits and vegetables had better memories and cognition as they aged.
For Barker, even more concerning than just the numbers was his family history of heart disease: His father had his first of several heart attacks at age 45. Having a parent who had a heart attack predicts your heart disease risk more than any other single factor, according to a study published in February 2011 in the Journal of the American College of Cardiology.
"The combination of Nigel's high LDL levels and family history was really scary," says Barker's cardiologist, Suzanne Steinbaum, MD, director of women's heart health at Lenox Hill Hospital in New York City. "When you have a family history of heart disease, you really have to pay attention to your own health."
Because high cholesterol has no symptoms, it can go undiagnosed for years. And people who have a high risk of heart attack due to family history often have no signs or symptoms until they have a heart attack.
While Dr. Steinbaum encourages everyone to have their levels checked regularly, it's especially important if heart disease runs in your family.
The United Stated Preventive Services Task Force recommends getting your cholesterol levels screened at age 35 for men and 45 for women, although if you have increased risk (such as with Barker), you should be screened as early as age 20.
The AHA recommends a more aggressive screening every five years beginning at age 20, but if you have high cholesterol or other heart disease risk factors, your doctor may recommend more frequent testing.
The main priority is to understand your risk and discuss it with your doctor to determine when cholesterol testing is appropriate for you.
How Barker Lowered His Cholesterol Naturally
Steinbaum recommended that Barker first change his diet instead of immediately turn to cholesterol-lowering drugs to lower his total and LDL cholesterol levels.
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So Barker traded his low-carb, high-protein eating plan for a Mediterranean-style diet. "Before, Nigel was eating exactly what he shouldn't have been eating for his heart health," Steinbaum says. "But he made the decision to change, and stuck with it."
Within a year, Barker's total cholesterol reading dropped to a much healthier 165, and his LDL was about 100.
"He did it on his own by making healthy choices every day," says Steinbaum.
And Barker remains committed to those heart-healthy habits. "Sometimes you need the drugs," he says, "but we decided to try a little bit of common sense and discipline first."
A new study sheds light -- literally -- on a potential means of easing migraine pain.
Researchers in Boston exposed 69 migraine patients to different colors of light. They found that while blue light exacerbated headache pain, a narrow spectrum of low-intensity green light significantly reduced light sensitivity.
In some cases, this green light also reduced migraine pain by about 20 percent, the researchers found.
They noted that migraine headache affects nearly 15 percent of people worldwide, and a frequent symptom of migraine is light sensitivity, also known as photophobia.
"Although photophobia is not usually as incapacitating as headache pain itself, the inability to endure light can be disabling," study author Rami Burstein, of Beth Israel Deaconess Medical Center in Boston, said in a medical center news release.
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"More than 80 percent of migraine attacks are associated with and exacerbated by light sensitivity, leading many migraine sufferers to seek the comfort of darkness and isolate themselves from work, family and everyday activities," he added. Burstein directs the medical center's Comprehensive Headache Center.
Two experts said the treatment may have merit.
"Certainly Dr. Burstein's work suggests that more research should be done, as this is a potentially beneficial new avenue for treatment," said Dr. Noah Rosen, who directs Northwell Health's Headache Center in Great Neck, N.Y.
He pointed out that "light therapy has been used successfully in other conditions such as certain dermatologic issues and seasonal affective disorder [SAD]."
Dr. Gayatri Devi is a neurologist at Lenox Hill Hospital in New York City.
He said the success in some patients with light therapy "implicates the thalamus -- a brain 'relay station' between the sensory organs, including the eyes and the cortex of the brain -- as the area where migraine-related photophobia is amplified."
For his part, Burstein said he's now trying to develop an affordable light bulb that emits narrow-band green light at low intensity, as well as sunglasses that block all but the narrow band of green light.
Rosen stressed, however, that more study may still be needed.
"In general, it seems a safe treatment but one that is limited by cost, access and whether its use on a regular basis would decrease disability," he said.
The findings were published May 17 in the journal Brain.
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.”
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:
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.”
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It's unclear what causes binge eating disorder.
Like other eating disorders, BED is probably caused by a combination of genetic, psychological, and social factors.
Some risk factors for binge eating disorder include:
People with binge eating disorder have frequent bingeing episodes, typically at least once a week over the course of three months or more.
Binge eating episodes are associated with three or more of the following:
Some people also display behavioral, emotional, or physical characteristics, such as:
There are several treatments available for BED. Treatment options may include:
The legendary talk-show host is helping raise awareness about heart health and the importance of staying on drug treatment.
Regis Philbin has been entertaining us for more than 50 years — from his legendary morning show with Kathie Lee Gifford and Kelly Ripa to . With his carefree personality and love of the sharp, off-the-cuff one-liner, at age 86 he remains one of America’s favorite television personalities. Seemingly forever young, he got a wake-up call in 1992, when he faced a major health scare that spurred him to lead a more .
Philbin was away from the TV studio and on a trip in Florida when he started to experience sharp chest pains.
“My heart was driving me crazy, I couldn’t believe it, I had these chest pains,” Philbin says. “We did an down there in Florida and my doctor told me my cholesterol levels were at 300. Are you kidding me? Three hundred!”
High blood cholesterol is one of the major markers of heart disease. According to the , a healthy total cholesterol level is less than 200 milligrams per deciliter (mg/dL). Any levels at 240 mg/dL or above — like the levels Philbin had — would be considered significantly high.
Once Philbin was back in New York, his doctor put him on his first , and Philbin, with his wife, Joy, by his side, decided that he would make significant to fight off the progression of his heart disease.
“I think things changed in a hurry,” Philbin says about his approach to his health.
“It shook us both up, it was a wake-up call,” Joy recalls of her husband’s health scare. “Quite frankly, I didn’t give cholesterol a thought myself. I mean, Regis didn’t have the best diet, but I never thought it was that bad. It kind of set him on a new regimen. You really start to feel your mortality. He was only 61 when he had his first event.”
This wouldn’t be his only heart health scare. Philbin had triple bypass surgery in 2007 because of a buildup of .
The ‘Take the Cholesterol to Heart’ Campaign
Right now, the Philbins are raising awareness about heart health through the “” campaign, which they launched in October 2017 in cooperation with Kowa Pharmaceuticals and the American Academy of Family Physicians Foundation. The campaign aims to encourage people to remain on a heart-healthy routine while also seeking out better information and asking questions before considering stopping their . Philbin, who has shared almost everything about his life over decades of being on air, has always been very open about his experiences with and was approached by the campaign to be its public face.
Joy says that what was most stunning to her about being part of the campaign was learning that 50 percent of people who are on statins stop taking the drugs after one year of use. She adds this shocked her because of how helpful the drugs were for her husband’s health.
Statins are drugs that lower blood cholesterol levels by blocking an enzyme that produces cholesterol in the liver. Getting people to maintain their drug regimen is one of the big challenges of treating high cholesterol, says , the president of the Utah Lipid Center and a fellow at the American Heart Association and the National Lipid Association.
“The big question is, why do these people stop taking their statins? One issue is you don’t necessarily feel better or worse when you take a statin; you have to go through testing to know your cholesterol is lower, so you don’t necessarily have a daily reminder every morning telling you you’re getting better,” Brinton says. “Another thing is that some patients will experience , like muscle pain or weakness. They might have stomach pain or a skin rash.
"There’s also a lot of negative and sometimes factually inaccurate information on the web. However, reputable medical sites cite evidence that highlight the positive health benefits of statins and show that these side effects do not occur in anywhere near the high numbers some of these other sites might lead you to believe.”
Reasons to Stay on Your Statins
A looked into the effectiveness of both statin and non-statin therapies for lowering cholesterol. The study reviewed 49 trials from 1966 to 2016 that involved 312,175 people in total. The report’s authors assert that statins should remain at the front of the line in treating cholesterol, but alternative therapies could be just as helpful if a person can’t tolerate statins or is looking for a different source of treatment. These could involve bile acid sequestrants or even a simple .
“I’ll say this up front, . They prevent heart attack and can prevent stroke. But a statin can’t work if you don’t take it,” Brinton stresses.
Brinton says there are a few things people should keep in mind when looking to lower their cholesterol with statin treatment:
Stay informed. To help counter some potentially inaccurate information out there, Brinton says the first person to turn to is your doctor. Beyond that, he says there’s useful information at places like the , the American Heart Association, and the National Lipid Association website, .
Know your options. Brinton says that people who are discouraged by one drug should know that there are multiple statin drugs out there. “A lot of people who stop their statin for whatever reason didn’t talk to or consult their doctor, who then doesn’t have a chance of helping them decide what to do,” he adds. “There are several statins out there, and people need to realize that there are other options if what they try first doesn’t work out.”
Be vigilant. If you’re having a bad experience, your statin medication could be reacting with other medications you are taking. Brinton says it is important that people tell their doctor about other medications or supplements they're on. They could then be prescribed a different statin.
How Regis Stays Healthy in Retirement
This all rings true for the Philbins. After his scare in the early '90s, Philbin started seeing a cardiologist, , and became even more of a “fitness freak,” Joy says.
“When you’re in your thirties, for example, you aren’t running to a doctor. But when you hit your sixties, you become a little more proactive about your health,” Joy says. “If your diet is wrong, you start looking into it. You become more aware.”
Echoing Brinton, Joy says that communication between you and your doctor is key in maintaining the best possible heart health.
“Some people avoid going to the doctor; they’re afraid of bad news,” she adds. “It’s important to maintain that [relationship]. You get closer to your doctor as you age, it’s one of the things you do. That’s crucial. It was so important for Regis.”
For his part, Philbin is doing everything he can to stay healthy in retirement. The talk-show host with the gift of gab is more than happy to share his heart health journey.
“I’ve been dealing with this for 25 years. It’s been a long time,” Philbin says. “I'm always more than happy to talk about this. For me, it’s everything.”