Surprising Physical Signs of Heart Disease

Many people associate heart disease with obvious symptoms, like chest pain. But there are some not-so-obvious connections, like swollen feet or bleeding gums, that should also merit a heart check from your doctor.

The classic red flags for a heart attack are familiar to anyone who has watched medical dramas on television. The patient, usually an older man, starts wheezing and gasping for breath. Then he clutches his chest, staggers, and eventually falls over. In real life, the signs and symptoms of heart disease are much more varied and subtle.

Signs Versus Symptoms of Heart Disease
First, some definitions. Heart disease symptoms are indications that you feel or experience, while a sign of heart disease is something your doctor can see or find. Obvious heart disease symptoms include shortness of breath and chest pain. But your doctor will also look for common heart disease signs during an examination or in a patient interview.

Knowing the signs of heart disease is important because you may have them before you have any of the common heart disease symptoms. Letting your doctor know about these warning signs could help you get early treatment for heart disease.

"Signs like ankle swelling or weight gain do not necessarily mean you have heart disease, but taken together with other symptoms of heart disease, laboratory studies, and family history, they are an important part of making a diagnosis of heart disease or heart failure," says Carl E. Orringer, MD, associate professor of medicine and director of the Preventive Cardiovascular Medicine and LDL Apheresis Programs at the University of Miami Miller School of Medicine.

Swelling of the Feet and Lower Legs
Retention of fluid in the feet and legs is known as peripheral edema. Edema may appear as "sock marks" on your legs and ankles at the end of the day, especially if you wear tight socks or hose. Mild peripheral edema is common. Your doctor may check for this sign by pressing a finger against your ankle or shin bone to see if a depression or dent is left behind. This is called "pitting edema” and it could indicate congestive heart failure.

Edema may be a sign of heart failure because when your heart is not pumping well, fluid from inside your blood vessels tends to leak out into surrounding tissues. The legs and ankles are common areas for edema because of the effects of gravity.

"Peripheral edema may be caused by a host of issues,” says Dr. Orringer. “The bottom line is that most people with peripheral edema do not have heart disease, but it could be an important sign if there are other signs and symptoms of heart failure."

Male Pattern Baldness
"If you watched any of the royal wedding, you might have noticed that Prince William is balding on the top of his head. This type of balding of the crown of the head in young men may be a sign of an increased risk for heart disease," says Orringer.

Several large studies have confirmed the link between baldness and heart disease. Compared with men with a full head of hair, men with crown loss have an increased risk of heart disease of about 23 percent. Men with complete loss of hair on the top of their head have an increased risk of 36 percent.

The combination of hair loss, high blood pressure, and high cholesterol pushes the risk even higher. This link may be due to too much of the male hormone testosterone, which interferes with hair growth on the head and causes hardening of the arteries. That doesn't mean you are doomed to heart disease if you are bald, but it does suggest you should be screened more carefully for other signs and symptoms of heart disease.

Yellow Bumps on the Skin
Xanthomas are deposits of fat that build up under the skin. They may appear as small yellow bumps or as flat, wide plaques on your elbows, knees, hands, feet, or buttocks. A type of xanthoma called xanthelasma palpebrarum appears on the eyelids. These yellow, fat deposits can potentially be signs of heart disease because they may indicate high levels of fats in the blood.

"Xanthomas may be a sign of a rare, inherited type of blood disorder in which high levels of triglycerides accumulate in the blood. Xanthomas may also be a sign of increased cholesterol, and they may disappear once cholesterol levels are under control," says Orringer.

Gum Disease
Swollen, sore, or bleeding gums are usually a sign of poor oral hygiene, but may also be an important sign of heart disease. "The association between gum disease and heart disease is the real deal," says Orringer. "There is plenty of research available now that backs up this connection."

Gum disease and heart disease may be linked because they are both signs of poor circulation, or there could be common bacteria that are involved in both gum disease and plaque buildup inside coronary arteries. The link may also have something to do with the body's response to prolonged inflammation. In any case, taking better care of your teeth and gums may be a good way to cut down your risk for heart disease.

Emotional Stress
Weakening of the heart muscle accompanied by extreme emotional stress, grief, or loss, especially in women, is called takotsubo cardiomyopathy, or broken heart syndrome. When this occurs, surging stress hormones, especially adrenaline, trigger cardiac pain that feels a lot like a heart attack, often with heart palpitations, shortness of breath, and flushing. But unlike during a real heart attack, the arteries are not blocked. This potentially serious and often overlooked condition is more common in women than in men; in fact, men make up for only 10 percent of diagnosed cases.

Signs of Heart Failure
Heart failure means the heart is not functioning as well as it should. It doesn't mean the heart has failed. Another term for heart failure is congestive heart failure, or CHF. Heart failure gradually gets worse over time. Some early warning signs may include:

Weight Gain If your heart starts to fail and fluid starts to build up in your tissue, causing edema, you might see a sudden weight gain.

Frequent Urination Heart failure may cause decreased blood flow to the kidneys, which causes you to retain more fluid. One of the signs of this fluid may be frequent urination.

Cataracts Although the exact cause of the relationship between cataracts and heart disease is not known, studies show that people who have cataracts are at higher risk for heart disease, high blood pressure, and high cholesterol. "This link is probably more of an association than a sign of heart disease," says Orringer.

Nighttime Cough "One of the signs of heart failure may be the buildup of fluid in the chest and heart when lying flat at night. This increased fluid can cause a nighttime cough," explains Orringer.

Remember that all these heart disease signs may have many different causes. They do not mean you have or will get heart disease. But combined with other heart disease signs and symptoms, your blood tests, and your family history, they give your doctor the best chance to find heart disease early and keep you in good health.

Resting Heart Rate for MEN Or WOMEN

Resting Heart Rate for MEN

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

Resting Heart Rate for WOMEN

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

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11 Struggles Every New Runner Understands

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

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

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

Getting winded in the first few minutes.

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

Two words: Sore. Muscles.

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

 

 

Feeling overwhelmed by the copious amount of races.

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

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

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

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

The boredom.

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

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

Trying to find your perfect route.

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

The joy of picking out new workout clothes.

Sleek tanks! Compression pants! Neon shoes!

Running toward (multiple) "finish lines."

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

 

 

Bargaining with yourself on your run.

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

Creating a playlist that will consistently keep you motivated.

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

Eating Well As You Age

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

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

Strategies for Healthy Eating as You Age

Replace old eating habits with these healthy approaches:

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

Overcoming Challenges to Healthy Eating

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

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

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

What You Need to Know About Hyperpigmentation

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

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

Everyday Health: What causes hyperpigmentation?

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

 

 

 

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

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

EH: What steps can you take to treat it?

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

 

 

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

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

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

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

6 Ways to Prep Your Skin for Summer

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

1. Reveal Glowing Skin

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

 

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

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

2. Remove Hair Without Irritation

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

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

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

 

 

3. Fight UV Rays With Food

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

4. Clear Up Body Breakouts

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

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

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

5. Erase Cellulite

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

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

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

6. Treat Your Feet

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

7 Healthy Habits of the 2016 Presidential Candidates

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

What Is Guillain-Barré Syndrome?

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

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

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

GBS Prevalence

Guillain-Barré syndrome is a rare disease.

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

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

Causes and Risk Factors

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

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

Less common triggers for GBS may include:

  • Immunizations
  • Surgery
  • Trauma

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

Types of GBS

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

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

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

Guillain-Barré Syndrome Symptoms

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

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

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

Signs and symptoms of Guillain-Barré syndrome may include:

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

What Is Binge Eating Disorder?

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It's unclear what causes binge eating disorder.

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

Some risk factors for binge eating disorder include:

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

Symptoms of Binge Eating Disorder

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

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

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

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

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

Binge Eating Disorder Treatment

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

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

 

10 Varicose Veins Myths

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

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

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

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

 

 

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

Myth 1: Varicose Veins Are Only a Cosmetic Issue

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

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

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

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

Myth 2: Varicose Veins Are an Inevitable Sign of Aging

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

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

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

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

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

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

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

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

Myth 4: Running Can Cause Varicose Veins

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

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

Myth 5: Varicose Veins Are Always Visible

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

Myth 6: Standing on the Job Causes Varicose Veins

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

RELATED: Steer Clear of These 9 Artery and Vein Diseases

Myth 7: Making Lifestyle Changes Won't Help

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

Myth 8: Surgery Is Your Only Treatment Option

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

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

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

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

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

Myth 9: Recovery After Varicose Vein Treatments Is Difficult

 

 

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

Myth 10: Varicose Veins Can Be Cured

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

10 Essential Facts About Ovarian Cancer

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

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

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

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

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

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

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

 

 

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

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

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

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

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

RELATED: Overcoming Ovarian Cancer, Twice

5. Ovarian cancer has several key risk factorsThese include:

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

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

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

 

 

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

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

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

How to Prevent Hearing Loss

Do you have trouble following a conversation in a noisy room? Do other people complain that you have the television turned up too loud? If the answer to either of those questions is yes, you may already have some degree of hearing loss.

Hearing loss can start at any age. According to the National Academy on Aging and Society, the number of affected Americans between the ages of 45 and 64 has increased significantly since 1971. But it’s much more common in seniors: Some 40 percent of the 20 million Americans who have hearing loss are 65 or older.

Contrary to popular belief, however, hearing loss is not an inevitable part of aging. Some causes of hearing loss can be prevented, and most types of hearing loss can be helped.

Types and Causes of Hearing Loss

There are three basic types of hearing loss:

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  • Sensorineural hearing loss is caused by damage to the inner ear nerves or the nerves that carry sound to the hearing area of the brain. Once you have this type of nerve damage, the only treatment is a hearing aid. Causes of sensorineural hearing loss include injuries, tumors, infection, certain medications, and excessive noise exposure.
  • Conductive hearing loss is caused by a condition that blocks sound waves from being transferred to the nerves involved in the hearing process. Whereas sensorineural hearing loss usually affects both ears, conductive hearing loss may only affect one ear. Common causes include ear infections, ear wax, ear trauma such as a punctured eardrum, and other diseases that affect the ear canal, the eardrum, or the tiny bones in the middle ear. Unlike sensorineural hearing loss, this type of hearing loss can often be corrected and restored.
  • Mixed hearing loss occurs when someone who has nerve type hearing loss from aging or noise trauma then gets an ear infection or develops a wax impaction, causing their hearing to suddenly get much worse. It’s a combination of sensorineural hearing loss and conductive hearing loss.

Hearing Loss Evaluation

If you are having trouble hearing or develop sudden deafness, you need to get your hearing checked as soon as possible. Sudden deafness is a serious symptom and should be treated as a medical emergency. For many people, though, hearing loss may be gradual and not obvious. Here are seven warning signs to watch out for:

  • You have trouble hearing while on the telephone.
  • You can’t seem to follow a conversation if there is background noise.
  • You struggle to understand women’s or children's voices.
  • People complain that you turn up the TV volume too high.
  • You constantly ask people to repeat themselves.
  • You have a long history of working around loud noises.
  • You notice a ringing, hissing, or roaring sound in your ears.

 

 

If you think you have any kind of hearing loss, the place to start is with your doctor. Whether your hearing loss is gradual or sudden, your doctor may refer you to an audiologist (a medical specialist in hearing loss) or an otolaryngologist (a medical doctor specializing in disorders of the ear).

 

 

Depending on the cause and type of your hearing loss, treatment may be as simple as removing ear wax or as complicated as reconstructive ear surgery. Sensorineural hearing loss can't be corrected or reversed, but hearing aids and assistive devices can enhance most people’s hearing. For those with profound hearing loss approaching deafness, an electronic hearing device, called a cochlear implant, can even be implanted in the ear.

Tips for Hearing Loss Prevention

One type of hearing loss is 100 percent preventable: that due to noise exposure. Noise is measured in units called decibels: Normal conversation is about 45 decibels, heavy traffic may be about 85 decibels, and a firecracker may be about 120 decibels. Loud noise — anything at or above 85 decibels — can cause damage to the cells in the inner ear that convert sound into signals to the brain. Here are some tips for avoiding noise-induced hearing loss:

  • Minimize your exposure to loud noises that are persistent.
  • Never listen to music through headphones or ear buds with the volume all the way up.
  • Wear ear plugs or protective earmuffs during any activity that exposes you to noise at or above 85 decibels.
  • See your doctor about a baseline hearing test, called an audiogram, to find out if you already have some early hearing loss.

You should also see your doctor if you have any symptoms of ear pain, fullness, or ringing, or if you experience any sudden change in your hearing. These symptoms could be early warnings of preventable hearing loss.

Hearing loss or deafness can have a serious effect on social well-being. It can cut you off from the world around you. Know the causes of hearing loss, and practice hearing loss prevention to preserve the hearing you still have.

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What to Expect Before and After Bariatric Surgery

Bariatric surgery isn't a spur-of-the-moment operation. In fact, preparing for the procedure may begin a year or more before your surgery date, and lifestyle changes continue well after the surgery has been performed. Be prepared by knowing what will be asked of you every step of the process.

The Year Before Surgery

Leading up to the procedure, your surgical team will likely recommend becoming more informed about diet and exercise.The amount of time you spend in this stage depends on several factors, including your insurance and your team’s recommendations, says bariatric surgeon Ann Rogers, MD, director of the Penn State Hershey Surgical Weight Loss Program in Hershey, Pennsylvania.

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“There’s always some component of nutritional education and some expectation that patients will lose some weight in that program,” explains Dr. Rogers. The dietitians and others who work with you during this stage will send reports on your progress to your surgical team before you schedule your surgery date.

In this phase, you may need to make additional lifestyle changes as well depending on the program. Rogers’ program, for instance, requires smoking cessation, though other weight-loss surgery clinics do not.

The Week Before Surgery

The final days before your surgery can be extremely emotional, filled with excitement, nervousness, and anxiety. Taking these steps as you prepare for your surgery will ease tension and ensure that everything goes smoothly the day of your procedure:

• Read the materials from your clinic.

• Eat and drink as directed. “We have a preoperative diet for eight days, which consists of bariatric-friendly protein shakes,” Rogers says. “They are high in protein, and they do not have sugar.” Most programs have a preoperative diet, although the duration varies, she says. Make sure you understand how long that diet lasts and exactly what you can eat.

• Adjust medications as needed. Discuss how to manage any other conditions you might have, such as diabetes, with your weight-loss surgery team and your primary care physician.

 Meet with the anesthesiologist. Once your surgery date is scheduled, you'll also meet with the anesthesiologist, who will ask about your health history. Although patients will have lots of tests done and medical information detailed during the months before surgery, the anesthesiologist might ask for more tests, advises Rogers.

 Take a blood thinner. Clotting is a risk associated with surgery, says Rogers. Your doctor might recommend taking a blood-thinning medication before and after the surgery.

What to Pack

Rogers suggests taking the following items with you to the hospital:

 Instructions. Bring the manual or other instructions you’ve been given, as well as any preoperative paperwork.

• Identification. You’ll need it to check in.

• CPAP (continuous positive airway pressure) machine. If you've been using one for sleep, take it with you.

• Laptop and cellphone.

• Pajamas and toiletries.

• Pillow and blanket.  

The Day of the Surgery

What your weight-loss surgery will entail varies depending on the specific type of surgery you'll be having.

• Roux-en-Y: This procedure is also known as “gastric bypass.” Your stomach will be divided into a small top pouch and a larger lower pouch. Your small intestine will also be divided and the lower part raised up to attach to your new, smaller stomach. This procedure reduces the quantity of food you can eat at any given time.

• Sleeve gastrectomy: In this procedure, the majority of your stomach will be removed, creating a banana-shaped stomach.

• Biliopancreatic diversion with duodenal switch: In this procedure, a portion of your stomach is removed. The remaining portion is then attached to a lower segment of your small intestine.

 Banding: In this procedure, an inflatable band is wrapped around the upper part of your stomach, creating a small stomach pouch. The band can be adjusted as needed. 

9 Things You’ll Have to Do After Surgery

• Have a ride home in place. Expect to spend at least one night in the hospital, Rogers says. When you're discharged, you'll need to have someone drive you home.

• Prevent blood clots. You will need to adhere to strategies to prevent blood clots from developing. These include taking blood thinners and getting up and walking around while in the hospital and at home.

• Take pain medication. You'll probably get a prescription for pain medication. Laparoscopic surgery reduces pain and hospital stays, but you still may need prescription pain medication for a day or two after discharge, Rogers says.

• Anticipate constipation, as it's a byproduct of the pain medications and the surgery itself. Be sure to talk with your doctor or nurse about how to prevent constipation.

• Eat a restricted diet. Your diet will be restricted to liquid protein shakes for a week or so after the procedure, and then soft foods following that period. Most people can transition to eating food with texture after their one-month follow-up appointment. By three months you should be able to eat fruits and vegetables, Rogers says. The ASMBS recommends cutting down on carbohydrates and increasing protein.

• Drink lots of fluids. The ASMBS recommends at least 64 ounces, or 8 cups, of fluids daily.

• You may need to take supplements. Calcium, vitamin D, and B vitamins are among those your doctor might recommend.

 Exercise – but nothing too strenuous. Walking daily, starting the day you get home, is good for you, says Rogers. However, skip the gym until you have your doctor’s permission. You should be able to lift small weights, she says, but avoid heavy items.

• Plan on missing work for a while. People with desk jobs usually can go back to work in about three weeks, Rogers says. Those with physical jobs or jobs that require extended periods of sitting, such as driving trucks, will have to wait a longer period of time.

Regis Philbin Takes on High Cholesterol

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.”

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How to Protect Yourself During a Mass Shooting

No one thinks they could be in this situation, but here's advice from safety experts if it happens.

Thursday, April 03, 2014

The headlines appear with unnerving frequency about mass shootings somewhere in the United States -- at a movie theater, a shopping mall, a school, a sporting event. Yesterday, a shooting tragedy took place at the Fort Hood military base in Texas, the second at this site since November 2009.

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Precisely how often mass shootings have occurred depends somewhat on interpretation. The Congressional Research Service, which defines a mass shooting as one that takes place in a relatively public place and results in four or more deaths, not including the shooter, identified 78 such shootings in the United States from 1983 to early 2013. A report by researchers at Texas State University, done after the killings at Sandy Hook Elementary School in Connecticut, used different parameters and identified 84 mass shootings from 2000 to 2010 by people whose main motive appears to have been mass murder.

Though the precise number of mass casualty shootings may be hard to determine, there's no disagreement that people today need to think about their safety whenever they go out in public, said Dennis Krebs, a retired captain and paramedic with the Baltimore County Fire Department and author of "When Violence Erupts, A Survival Guide for Emergency Responders" and the "Special Operations Mission Planning Field Guide." 

“If you at least think about what you would do if you were confronted with such a situation, it gives you an edge,” Krebs said. 

Life-Saving Tips in the Event of a Mass Shooting

Irwin Redlener, MD, director of the National Center for Disaster Preparedness at Columbia University, said that people don’t need to panic or even fear going to public places to avoid mass casualty shootings. He does agree with Krebs though: In 2014, it’s worth giving some thought to how to protect yourself during a mass shooting. 

 

 

What you can do if faced with a mass shooting depends greatly on the situation and your physique and physical capabilities, Dr. Redlener noted. “If you’re small and alone or with your 1-year-old or your 14-year-old, it’s going to be different,” he said. “Everything about survival guidelines is dependent on the details of the particular situation.” 

However, experts in public safety do have advice on how to protect yourself and your loved ones in the event of a mass shooting.

Pay attention to your surroundings. No matter where you go, "be aware of your environment," Redlener said. "If you see something that looks suspicious or out of place, or you notice an unusual gathering of people, you can begin taking action prior to the event occurring." By being aware, you may be able to avoid the scene and not walk into trouble. “Situational awareness is something that police officers and the military are taught and trained to do,” he said. When you go to a mall or a movie, know where the nearest exits are. 

RELATED: Media Exposure to Traumatic Events Can Be More Stressful Than Being There

Flee if you can. If you’re caught in a mass shooting, “you want to get outside of the building as quickly as you possibly can," Krebs said. A lot of people freeze, but "that's the last thing you want to do,” he said. Urge any people you're with to come with you, but don’t waste precious time trying to persuade them to get out while you can. 

 

"If you see something... suspicious or out of place...you can begin taking action prior to the event."

Irwin Redlener, MDTWEET

 

David Reiss, MD, a San Diego psychiatrist, said that some training in the martial arts can help prepare you to deal with your body’s natural fight-or-flight response and not be paralyzed when faced with traumatic events from which you should flee. “To be aware of that response and have some training in dealing with it can be useful without going overboard,” he said. 

Leave your belongings behind. Drop whatever stuff you have with you -- packages, luggage, purse, or backpack. It will make your exit easier. Nothing is more important than your life, Krebs said. Video of the mass shooting at the Los Angeles airport in November 2013 showed people fleeing with their suitcases, but, as Krebs said, "there's nothing in that piece of Samsonite that’s worth your life." 

If you can’t run, hide. “You want to be in an area that allows you to be protected from the gunman or further mischief by the armed perpetrator,” said Stephen Hargarten, MD, MPH, professor and chairman of emergency medicine and director of the Injury Research Center at the Medical College of Wisconsin. Lock and barricade the doors to your hiding place. In one recent mass shooting at a mall, a store clerk was able to protect some shoppers by hitting the button for a gate in front of the store, sealing everyone inside, Krebs said. 

Once in hiding, be quiet. Shut off your cellphone. Instinct may tell you to keep it on and try to call for help, but a ringing phone could be dangerous if it attracts the shooter's attention, Krebs said. Call 911 for help only if and when it’s safe to do so. 

 

 

Try to avoid confronting the shooter. According to the U.S. Department of Homeland Security, taking any action against the shooter should be a last resort -- something you do only if your life is in imminent danger. But, if there's no other option, yell, act aggressively, or look around for something that might work as a weapon. 

Afterwards, exit carefully. Once the shooting has stopped and you are able to leave the building, go out with your hands up. Drop whatever you are carrying. “Police may not have a description of the suspect they’re after," Krebs said, "and if you come running out the door with something in your hand, you could end up getting hurt." 

Disaster Preparedness With Children 

Parents with young children should follow the same advice that flight attendants give passengers: Take care of yourself first because, if you don’t, you won’t be able to help your children, Dr. Hargarten said.

Before you're faced with a traumatic event, talk with your children about the best ways to handle such situations. What you say will depend on their age, but whatever you say, try not to frighten them unnecessarily. Emphasize that in an emergency situation like that, they would need to follow your directions, no questions asked. If you have to scream at your children, it could attract the attention of the shooter. 

As part of your family's disaster preparedness plan, decide where to meet if you get separated in an emergency -- even if it's a place you've been many times before. 

Dr. Reiss said you can’t anticipate mass casualty shootings and should not spend your days fretting over what you would do if you were caught up in one. “If you expect emergencies every moment of your day, it will ruin your life,” he said. It’s best to give it some thought but not let it overwhelm you

10 Winter Foods for Depression

1 / 11   Boost Your Mood With Seasonal Bounty
It’s winter, and depending on where you live, it could be very cold and gray, with sunshine in short supply. The winter doldrums plus holiday high anxiety make this season especially stressful and depressing for many people. But you might be able to eat your way to a better mood. Load your plate with these winter foods for depression to lift your spirits.

A Diet for Better Energy

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

 

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

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

Energy and Diet: How The Body Turns Food Into Fuel

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

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

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

Energy and Diet: Best Foods for Sustained Energy

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

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

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

Energy and Diet: Foods to Avoid

 

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

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

Energy and Diet: Scheduling Meals for Sustained Energy

 

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

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

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

 

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Talk Therapy May Help Depressed Teens Who Shun Antidepressants

Cognitive behavioral therapy can help boost mood without drugs.

Depressed teens who refuse antidepressants may benefit from counseling, a new study suggests.

The study included more than 200 teens who were unwilling to take medication to treat their depression. The researchers found that those who tried a type of short-term "talk therapy" -- known as cognitive behavioral therapy (CBT) -- were more likely to recover than those who didn't.

"High numbers of adolescents experience depression, as many as 10 to 15 percent each year -- and up to one in five by age 18," said lead researcher Greg Clarke. He is a depression investigator at the Kaiser Permanente Center for Health Research in Portland, Ore.

"Unfortunately, most of these depressed teens are not treated. As few as 30 percent get specific depression care," he said.

In many cases, depressed teens refuse to take antidepressants, "often because of side effect concerns," Clarke said. These include warnings going back to 2004 about suicidal thoughts and behavior related to antidepressant use, the researchers said. Other common side effects from antidepressants include weight gain and fatigue.

"Offering brief cognitive behavioral therapy is an effective alternative," Clarke said. The small to moderate benefits found in this trial may be tied to reduced need for psychiatric hospitalization, the researchers noted.

The report was published online April 20 in the journal Pediatrics.

Simon Rego is director of psychology training at Montefiore Medical Center/Albert Einstein College of Medicine in New York City. He said that depressed teens can benefit from talk therapy offered by pediatric and family practices.

Teen depression is usually identified in primary care and is increasingly treated there, he said. But as many as 50 percent of teens with depression turn down medications, and of those who start antidepressants, as many as 50 percent fail to keep taking them, Rego said.

"Integrating cognitive behavioral therapy into primary care would present adolescents with depression with a non-medication treatment that would be easily accessible, brief and cost-effective," Rego explained.

According to the Anxiety and Depression Association of America, cognitive behavioral therapy can cost $100 or more per hour. "Some therapists or clinics offer therapy on a sliding scale, which means that charges fluctuate based on income," the association says. Not all insurance plans cover cognitive behavioral therapy.

RELATED: 7 Antidepressant Side Effects

For the study, Clarke and his colleagues conducted a five- to nine-week program in which counselors used cognitive behavioral therapy techniques to help teens identify unhelpful or depressive thinking and replace those ideas with more realistic, positive thoughts.

The program also helped patients create a plan to increase pleasant activities, especially social activities, Clarke said.

Between 2006 and 2012, the researchers randomly assigned 212 teens with major depression to receive either the weekly cognitive behavioral therapy or other care for depression, which could have included school counseling or outside therapy. All the teens, who were aged 12 to 18, had either refused antidepressants or stopped taking them, the study authors said.

On average, teens who tried cognitive behavioral therapy recovered seven weeks faster (22.6 weeks versus 30 weeks) than teens who didn't, the investigators found. In addition, the teens who used cognitive behavioral therapy were less likely to require psychiatric hospitalization, the findings showed.

Recovery was defined as having no or minimal symptoms of depression for eight weeks or more. Symptoms included feelings of hopelessness, loss of interest in friends and activities, changes in sleep and appetite, trouble concentrating and feelings of worthlessness or excessive guilt.

After six months, 70 percent of teens in the cognitive behavioral therapy program had recovered, compared with 43 percent of teens not in the program, the researchers reported.

Some benefits were still associated with cognitive behavioral therapy after one year, although the gap between the two groups of teens had tightened, Clarke said.

Prescription Drugs That Cause Depression

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

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

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

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

Drugs With Depression as a Side Effect

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

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

RELATED: Are You Getting Hooked on Anxiety Medications?

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

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

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

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

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

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

Are Your Drugs Causing Depression?

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

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

Prescription Drug-Induced Depression Treatment

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

RELATED: 7 Supplement Risks Every Woman Should Know About

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What You Need to Know About Hyperpigmentation

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

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

Everyday Health: What causes hyperpigmentation?

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

 

 

 

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

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

EH: What steps can you take to treat it?

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

 

 

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

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

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

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

Best Ways to Beat Dry Skin

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

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

Find the Right Exfoliator

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

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

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

Don’t Wash Too Often

 

 

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

Take a Lukewarm Shower

 

 

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

Moisturize Every Day

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

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

Depression Among Doctors: A Growing Problem

Long shifts of on-the-job training, and caring for patients in life-or-death situations, is enough to wear a person down. And it does.

Close to one-third of medical residents (doctors out of medical school and in training) experience depression, according to a new study published online in JAMA. The risk starts on the first day of residency training, when the probability that a doctor will become depressed more than quadruples compared to those not in residency.

“This is remarkable considering how patients often don’t report their depression because of the social stigma that’s attached to it,” says study author Douglas A. Mata, MD, MPH, a resident physician himself at Brigham and Women’s Hospital and a clinical fellow at Harvard Medical School in Boston.

“We also found that the number of depressed residents might be going up — that is, the prevalence of physician depression might be getting worse with time,” adds Dr. Mata. “It’s certainly not getting any better, so we’ve got a public health crisis on our hands that isn’t being talked about enough.”

Depression among doctors in training has been studied extensively over the years, so this study looked at what the research shows as a whole. Mata and his colleagues searched four databases of medical research for all relevant studies from 1963 through September 2015.

They found 31 studies that assessed depression at one point in time, and 23 long-term studies. Together, the studies involved more than 17,500 doctors and showed that 29 percent of them had depression or symptoms of depression. Most of the studies relied on self-reporting, but their methods also differed significantly.

In studies using a nine-question survey to assess depression symptoms, about one in five medical residents (21 percent) had depression. Studies that used another depression measure doubled that, to 43 percent of doctors experiencing depression at some point in their residency.

How Stressful Work Conditions Boost Depression Risk

“Doctor training has a deluge of risk factors for depression,” Mata says. “Many residents spend all their waking hours working like crazy, so their relationships with friends and family go on the back burner, making them feel isolated. Also, constant lack of sleep, combined with ‘time zone changes’ take a toll on the mind and body.”

What Mata means by time zone changes is the effect of being on overnight call every third or fourth night, which is much like taking transatlantic flights twice a week and dealing with the resultant jet lag. Worse, residents must often relocate to new cities each year, where they may lack essential support systems, he says.

“They may have tens of thousands of dollars of debt hanging over their heads as well, since the United States places the financial risks and burdens of training on the students themselves, not on the public health system they’re training to serve,” adds Mata. “To top it all off, they’re responsible for the care of ill patients, and they’re exposed to some mentally traumatic scenarios in the process.”

Is Patient Safety at Risk?

Depression among MDs appears strongly linked to the start of residency training, when the percent of doctors with depression jumped 16 points in the study, putting them at 4.5 times greater risk of depression once residency has begun.

“As clinicians, we’re used to treating others, but we’re often bad at taking care of ourselves,” Mata says. “Doctors need to pay more attention to their own mental well-being, and to that of their colleagues.”

Not doing so could have serious ramifications for patients, points out Victor Fornari, MD, chief of the division of child and adolescent psychiatry at Long Island Jewish Medical Center in Manhasset, New York.

RELATED: 5 Things Psychologists Wish Their Patients Would Do

“Depressive symptoms and depression may interfere with attention and focus,” says Dr. Fornari, who was not involved in the study. “Depression in resident physicians may also interfere with the development of the doctor-patient relationship. Patients may experience their depressed resident physicians as less engaged or less interested in their care.”

And attempting to counteract that impression could potentially make the situation worse, suggests Mata. “The doctors who care the most may overextend themselves to give their patients more empathy, which puts them at a higher risk for depression,” he says.

At the same time, sleep deprivation during residency contributes to depression and possible medical mistakes, he says.

“Sleep deprivation has been linked to a high risk of needle-stick injuries and exposure to bloodborne pathogens,” Mata says. “Depression has also been linked to more medical errors. Depressed doctors report more anxiety about making mistakes, whether or not they actually do.”

How Thanking Your Doctor May Help

While patients should not necessarily worry about their doctors’ health and safety, Mata says, they can help in small ways.

“Just tell your doctors ‘thank you’ and make sure they understand what they mean to you,” he says. “That goes a long way.”

But such kindnesses will not solve a problem that appears to be worsening. The study found that prevalence of depression among residents increased by half a percent each year, though the authors note the rise could relate to increased awareness of depression among docs.

Recognizing the problem is the first step. Residents also need support and mentoring, and modified work hours, which is already occurring in many institutions, Fornari says.

“Part of medical training is encouraging the resident physician to regulate their own self-care in an effort to learn how to manage their stress and ask for assistance with depression,” Fornari says.

Mata would like to see a proactive model rather than the current reactive one, which relies on residents to identify their own depression and seek help. Year-long resilience-based programs that teach coping skills from the first day of residency would be an important measure, he says.

“Widespread depression among doctors will inevitably cause good docs to work fewer hours and even leave the field,” Mata says, adding that the situation may even dissuade people from entering the medical field. “This has broad social implications for the health of our population as a whole.”

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DIY Beauty Treatments for Every Skin Problem

  • 1 / 7   DIY Beauty Solutions

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

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

  • 2 / 7   Problem: Hyperpigmentation and dark spots

    Solution: Fresh lemon juice and a red onion


    Lemon juice and red onions are naturally acidic, and when combined together, they create a gentle-yet-effective at-home alternative to dark spot and hyperpigmentation treatments that are often formulated with harsh chemicals.

    For best results, Michael Lin, MD, a board-certified dermatologist in Beverly Hills, California, suggests blending ¼ of a red onion with freshly squeezed lemon  juice before applying it to the desired area with a Q-tip. After 10 to15 minutes, wash off the homemade treatment with a mild cleanser.

  • 3 / 7   Problem: Dry, calloused hands and feet

    Solution: Almond milk and coffee grounds


    For a smoothing hand and foot scrub, Lin suggests combining almond milk with leftover coffee grounds from your morning roast. Almond milk is rich in antioxidants and vitamin E, which helps protect skin from free radicals that can damage cells and break down collagen. Coffee grounds, on the other hand, offer exfoliating benefits that help reveal radiant skin. “Using a caffeine scrub helps to stimulate cells and elastin, and temporarily firm the skin,” says Lin. 

    Combine 2 cups of almond milk and the coffee grounds in a bowl, then scrub the formula in circular motions on your hands and feet.

  • 4 / 7   Problem: Dull skin

    Solution: Peppermint tea


    Using topical treatments isn’t the only way to achieve gorgeous, glowing skin. In fact, radiant skin can be attained from the inside out by drinking a generous cup of peppermint tea. Dallas-based celebrity aesthetician Renee Rouleau advises her celebrity clients to drink a cup of the minty stuff before red carpet events.  

    “Peppermint tea is known to boost blood circulation, giving skin a vibrant glow,” says Rouleau, adding that peppermint can also help decrease stress. 

  • 5 / 7   Problem: Uneven skin tone and UV damage

    Solution: Strawberries and honey


    Strawberries in particular are jam-packed with vitamin C and are a natural source of salicylic acid, which is often found in anti-acne treatments to help clear skin and keep flare-ups at bay. When paired with honey, which has anti-bacterial benefits, they create a powerful at-home alternative to a store-bought mask. 

    Mash together three strawberries and 1 Tbsp. honey and apply the mixture. Wash off the mask with warm water after 15 minutes.

  • 6 / 7   Problem: Dry, frizzy hair

    Solution: Coconut oil


    As the weather gets warmer, your hair can become dry, frizzy, and completely unmanageable. Because of its moisturizing benefits, coconut oil is highly effective when it comes to nourishing hair and battling frizz. 

    For a hydrating hair treatment, New York City stylist Nunzio Saviano, owner of Nunzio Saviano Salon in New York City, recommends working a tablespoon of liquefied coconut oil through your hair post-shampoo. Leave the oil in for five to 10 minutes and rinse it out with chilly water, which will also help close the hair cuticle and seal in moisture, fighting frizz.

  • 7 / 7   Problem: Product buildup

    Solution: Apple cider vinegar

    Product buildup (sometimes confused for dandruff) is residue left behind on your hair and scalp by shampoo, mousse, hairspray, and other styling products. Additionally, dirt, natural oils, and hard water mineral deposits can build up on your hair shaft, leaving locks dull and weighed down. For a quick at-home fix, celebrity colorist Kyle White recommends a five-minute apple cider vinegar treatment.

    “Apple cider vinegar is an effective clarifying

Getting an IBS Diagnosis

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

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

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

 

 

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

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

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

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

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

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

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

 

 

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

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

By Marie Suszynski | Medically reviewed by Cynthia Haines, MD

Welcome to HealthTalk Blog

For those of you who’ve been with HealthTalk for some time, my name is probably familiar. I’m the founder of this health education company that creates and publishes free audio programming on the latest treatments and quality of life innovations for chronic illnesses such as multiple sclerosis, psoriasis, asthma and various types of cancer.

And also, more recently, I’m a patient treated successfully for chronic lymphocytic leukemia.

Quite frankly, I stumbled into the healthcare arena by accident some 20-plus years ago. And I’m glad I did, because I’ve become fascinated with the improvements to treatment and patient care over the years.

And it may have saved my life.

When I was diagnosed with CLL in 1996, I had been doing this for more than a decade. I carefully researched my options and found a doctor at the M. D. Anderson Cancer Center who recommended what was then an experimental treatment (today, it’s the standard of care). Now I’m in molecular remission.

At HealthTalk, I’m responsible for partnering with advocacy groups and major hospitals (including M. D. Anderson) and I still host many programs, including the upcoming Crohn’s webcast on November 10.

Getting back to my broadcasting roots, I also just launched a radio program called This blog will feature my perspective on the news of the day and other interesting nuggets of useful knowledge that I come across in my work exploring the world of patient empowerment.

This is a very exciting time in medicine. I hope you’ll join me as we travel down the path toward better care together.

Depression Screening Should Include All Pregnant, Postpartum Women

All U.S. adults, including pregnant and postpartum women, should be screened for depression by their family doctor, the nation's leading preventive medicine panel recommends.

Further, doctors need to follow through and get treatment for anyone who tests positive for depression, the U.S. Preventive Services Task Force concluded in an update of its depression screening guidelines.

This is the first time the panel has specifically advocated depression screening in pregnancy and shortly after giving birth. It cited a U.S. study that found that 9 percent of pregnant women and more than 10 percent of postpartum women exhibited signs of major depression.

The American College of Obstetricians and Gynecologists (ACOG) applauded the recommendation.

"Because fewer than 20 percent of women in whom perinatal depression is diagnosed self-report their symptoms, routine screening by physicians is important for ensuring appropriate follow-up and treatment," said ACOG president Dr. Mark DeFrancesco in a statement.

Depression can harm both the child and mother, interfering with their interactions and affecting social relationships and school performance, the panel noted. Risk factors during pregnancy and after delivery include poor self-esteem, child-care stress, prenatal anxiety and decreased social support, the report said.

The new report -- published Jan. 26 in the Journal of the American Medical Association -- updates a similar recommendation the panel issued in 2009 that called for routine screening of adults.

In general, primary care physicians should be able to treat most cases of uncomplicated depression, and refer more complex cases to a psychiatrist, said Dr. Michael Pignone, a member of the task force and director of the University of North Carolina's Institute for Healthcare Quality Improvement.

"That's part of our job," Pignone said.

Options for treatment include therapy with a psychologist or licensed clinical social worker or antidepressant medications.

The task force is an independent, volunteer panel of national experts in preventive medicine. It issues recommendations, and revisits them on a regular basis to make sure that medical evidence still supports the guidelines.

RELATED: 9 Depression Types to Know

Depression is among the leading causes of disability in persons 15 years and older, the panel noted.

Millions of adults suffer from depression and don't know it, said Dr. Michael Thase, a professor of psychiatry at the University of Pennsylvania Perelman School of Medicine.

At any given time, between 5 percent and 10 percent of U.S. adults suffer from a depressive disorder, but half receive no treatment for their depression, Thase said.

The task force's depression guidelines are aimed at detecting and helping those adults who unknowingly have depression, Pignone said.

"This is about screening, not about diagnosing people who come to a doctor's office saying, 'I feel depressed.' The potential value of screening is in those people who would not be found as part of regular clinical care," he said.

Some people may not want to acknowledge they are depressed because there is a stigma around mental illness, Pignone said. Others might just think they are feeling blue, and will get over it.

"In some people, their symptoms may seem more physical to them," he added. For example, depression might cause stomach pain, headaches or sleeping problems.

The task force did not recommend any particular questionnaire for depression screening, because "there are many good tools and there's no single tool that should be recommended above others," Pignone said.

The most common screening tool, the Patient Health Questionnaire, consists of 10 simple questions that can be answered in minutes, according to the U.S. Department of Health and Human Services.

The task force also could not recommend how regularly people should be screened, because not enough research has been done in that area, Pignone said.

"The task force recommendation is that people should be screened at least once," he said. "For the meantime, clinicians should use their judgment about the risk of depression in their patients, in deciding how often to screen."

However, the task force did emphasize the need to follow up a positive screening with treatment.

Dr. Michelle Riba, a former president of the American Psychiatric Association, agreed that primary care doctors should be able to treat most patients with depression.

However, Riba added that doctors should develop a relationship with a psychiatrist they can consult on cases of depression. The psychiatrist could talk with the practitioner on the phone, review patient charts, and help decide the best course of action.

Doctors also should be open to other forms of treatment for depression, such as cognitive-behavioral therapy or light therapy, said Elizabeth Saenger, a psychologist in private practice in New York City.

Light therapy affects the body's production of the hormone serotonin, and studies have shown it can help alleviate depression symptoms, Saenger said.

It makes sense for primary care doctors to lead the way on depression screening because they see patients most often, said Dr. Alan Manevitz, a psychiatrist with Lenox Hill Hospital in New York City.

Treating depression can help patients face other health problems with which they are struggling. "As depression gets worse, so many other chronic illnesses also get worse," Manevitz said. "People don't take care of their health as well when they are depressed."

8 Healthy Game Day Snacks for Football Season

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

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

10 Ways to Live Better With Psoriasis

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

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

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

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

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

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

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

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

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

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

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

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

Essential Facts About Antidepressants

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

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

The Use of Antidepressants Is on the Rise

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

How Antidepressants May Help

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

RELATED: 6 Need-to-Know Antidepressant Facts

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

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

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

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

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

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

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

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

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

Depression Medications and Government Warnings

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

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

Antidepressants Are Not Magic Bullets

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

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

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

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Study Finds No Proof of 'Seasonal' Depression

A new study cast doubts on the existence of seasonal depression -- a mood disorder linked to reduced sunlight in the winter months.

This form of depression -- known as seasonal affective disorder (SAD) and recognized by the mental health community for nearly 30 years -- "is not supported by objective data," the new study claims.

Depression comes and goes, said study lead researcher Steven LoBello. If someone experiences depression in the fall and winter, "it doesn't mean that seasonal changes have caused the depression," added LoBello, a professor of psychology at Auburn University at Montgomery, Ala.

For the study, LoBello and colleagues used data from a telephone survey of more than 34,000 U.S. adults asked about depression and then gathered information on time of year, latitude and more when measuring depression.

LoBello noted the study found no evidence that symptoms of depression were season-related and said, "If this seasonal pattern of depression occurs at all, it may be fairly rare."

Dr. Matthew Lorber, acting director of child and adolescent psychiatry at Lenox Hill Hospital in New York City, also said that seasonal affective disorder may not be a "legitimate diagnosis."

Big drug companies, Lorber said, pushed to have SAD recognized as a standard diagnosis. "It then allowed them to market to a new population to use their medications. That was a motivating factor in creating this disorder," said Lorber, who wasn't involved in the new study.

LoBello thinks the seasons have no place in the diagnosis of depression, and he would like to see these criteria discontinued.

His reasoning? Assuming a cause that isn't accurate may lead patients to pursue treatments that won't deliver relief, LoBello said.

According to the new report, published Jan. 20 in Clinical Psychological Science, seasonal affective disorder was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM) -- the bible of psychological diagnosis -- in 1987.

RELATED: Why Depression Is Underreported in Men

LoBello isn't the first to explore the validity of this diagnosis.

Kelly Rohan, an associate professor of psychology at the University of Vermont, has done her own research on seasonal depression and found "no season differences in reports of depressive symptoms."

"I certainly did not argue that this means SAD does not exist," she said. "However, only a minority of depression cases are actually SAD."

So, how come other research has found that a significant percentage of the public suffers from this condition? (The American Academy of Family Physicians says up to 6 percent of U.S. adults have winter depression, and as many as one in five have mild SAD symptoms).

It all depends on how the studies are done and how the questions are asked, Rohan said. "Also, SAD depressive symptoms tend to be less severe than in nonseasonal major depression and mood tends to be back to normal in the spring and summer," she said. "So when you take all the depressed people in this sample -- including the minority that claims to be SAD -- and look at seasonal differences in their depression scores, I am not surprised that it is a wash."

For the study, LoBello and colleagues used the 2006 Behavioral Risk Factor Surveillance System. The 34,000-plus respondents had been asked about the number of days they felt depressed in the past two weeks. The researchers matched these responses with the location of each person and the day, month, latitude and amount of sun exposure when interviewed.

People who responded to the survey in the winter months, when sunlight exposure was low, had no greater levels of depressive symptoms than those who responded to the survey at other times, the researchers said.

In addition, the researchers found no evidence for seasonal differences in mood when they zeroed in on more than 1,700 participants with clinical depression.

An Expert's Guide to Sneezin' Season

Allergy sufferers should prepare for a particularly 'nasty' spring, New York sinus specialist says.

This could be a bad spring allergy season and people with allergies need to be prepared, an expert warns.

Psoriatic Arthritis

www.PsoriaticInfo.com

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With Joint Damage. Learn More Now.

 

"With the crazy up and down weather, some parts of the country could see worse allergy-provoking conditions. There is likely to be a pollen superburst this season, so sufferers should get ready," Dr. Jordan Josephson, a sinus specialist at Lenox Hill Hospital in New York City, said in a hospital news release.

"It promises to be a nasty spring," he added.

It's crucial to deal with allergy symptoms immediately, according to Josephson.

"Allergies left untreated can cause sinus swelling leading to chronic sinusitis. Allergies can also affect your digestive tract. Gastroesophageal reflux disease (GERD) can be a direct response of the allergic response. So allergies can seriously affect your quality of life. Just ask any allergy or sinus sufferer," he said.

 

 

Dr. Punita Ponda is assistant chief in the division of allergy and immunology at Northwell Health in Great Neck, N.Y. She suggested that if you know you have spring allergies, start taking allergy medication at least one to two weeks before the start of allergy season. Then continue taking it throughout the season, she noted in the news release.

RELATED: 9 Seasonal Allergy Signs You May Be Overlooking

 

 

Josephson outlined a number of other ways to keep your allergy symptoms under control, including: staying indoors as much as possible between 10 a.m. and 4 p.m., when pollen counts are highest; using your air conditioner, which cleans and dries the air; keeping doors and windows closed; and using an air purifier.

After being outdoors, remove your clothes and wash them immediately. Keep pollen-exposed clothes separate from clean clothes. You should also take a shower after being outside in order to remove pollen from your skin and hair, he suggested.

In addition, irrigate your sinuses daily to flush out pollen. And take antihistamines, but try to avoid decongestants.