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.

Mindfulness Therapy May Help Ease Recurrent Depression

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

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

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

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

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

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

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

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

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

RELATED: 6 Depression Symptoms You Shouldn’t Ignore

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

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

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

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

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

Eating Carbs and Fats Before a Workout? Read This

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

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

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

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

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

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

Carbohydrates: Your Diet's Fuel

Before you feast on chicken and boycott carbs, take a closer look at the U.S. Food Pyramid.

Carbohydrates are highlighted as an important part of ahealthy diet, and not banned by any means. Your body needs a wide variety of foods to function and stay healthy.

"Carbohydrate is one of the macronutrients that we need, primarily for energy," says Sandra Meyerowitz, MPH, RD, a nutritionist, online nutrition coach, and owner of Nutrition Works in Louisville, Ky.

While fats and protein are also necessary for energy, they're more of a long-term fuel source, while carbohydrates fulfill the body's most immediate energy needs. "It's your body's first source of energy — that's what it likes to use," adds Meyerowitz.

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+

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.

Obesity Linked to 13 Types of Cancer

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

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

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

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

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

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

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

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

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

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

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

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

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

Key findings include:

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

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

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

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

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

6 Easy and Amazing Oatmeal Recipes to Try This Week

Ask anyone what their favorite breakfast is, and you’ll likely get answers ranging from veggie omelets to sugary cinnamon buns. But how many people can say their favorite morning meal is oatmeal? Well, that’s all about to change. Not only is oatmeal super healthy (it’s packed with belly-filling fiber), but it’s also incredibly versatile. Whether you prefer the grains sweet or savory — or packed with protein or healthy fats — we have the right recipe for you. And remember that no matter which flavor combination you choose, one thing is guaranteed: You’ll never look at oatmeal the same way again.

Tomato Basil Oatmeal
Sweet oatmeal recipes are easy enough to find, but savory ones? Those are a little harder to pull off. With its tomato puree, pine nuts, fresh herbs, and Parmesan cheese, Oatgasm’s tomato and basil oatmeal reminds us of a lower-carb bowl of pasta — one that you’ll want to eat for breakfast, lunch, and dinner. Mangia!

Slow Cooker Overnight Oatmeal
Don’t have time to cook breakfast in the morning? No problem. Just toss 2 cups of oats into a slow cooker, top with some dried berries, and add water. Wait 90 minutes, and voila! With just 193 calories, this slow cooker overnight oatmeal will be your new favorite breakfast.

Blueberry Muffin Overnight Oats
Our love of overnight oats continues with this mouthwatering blueberry version from Eat Yourself Skinny. (Seriously, how gorgeous is this?) The Greek yogurt and chia seeds add an extra shot of protein (13.4 grams in one jar!) and a chewy, flavorful texture. And did we mention it only takes a few minutes to make?

Date-Sweetened Apple Pie Oatmeal
This gluten-free apple pie oatmeal from the Minimalist Baker is sweetened with dates, apple slices, and a dash of honey. It’s part crispy, part thick and creamy, and all parts totally delicious. Plus, it’s easy to mix and match this base recipe with other toppings — think: toasted nuts and flaxseed.

5-Minute Oatmeal Power Bowl
Who says comfort food can’t be healthy, too? This oatmeal power bowl from Oh She Glows is not only delicious, but it also lives up to its belly-filling promise: laden with chia seeds, almonds, and cinnamon, it’s an instant, energizing way to start your day.

Raspberry-Almond Overnight Oatmeal
Breakfast doesn’t get much easier than this raspberry almond oatmeal. Simply combine oats, milk, yogurt, almonds, chia seeds, and a dash of almond extract in a pint-sized mason jar, then shake, stir, and refrigerate. It’s packed with healthy ingredients, and served up in a perfect portion size, too!

8 Ways to Maximize Your Depression Treatment

Tailor Your Depression Treatment

Although depression can make you feel like you’re alone, the truth is that you’re not: Major depression affects nearly 15 million adults in the United States every year, according to the Depression and Bipolar Support Alliance (DBSA). However, depression treatment can be different for everyone. "Depression is unique to the individual," says Steve Koh, MD, MPH, chair of the American Psychiatric Association Scientific Committee and an assistant clinical professor of psychiatry at the University of California, San Diego. That’s why it’s important to work with your doctor to find the right depression treatment plan. Although medication is a mainstay of treating and managing depression, it’s not the only answer — and it can take time to find just the right treatment for you. "Medication can have different effects, good and bad, so you should have good communication with your doctor to ensure that it’s not only working well, but that it’s also not causing any side effects," Dr. Koh says. Consider these tips to help increase your chances of successful depression treatment.

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.”

8 Things You Can Start Doing Now to Look Younger

2 / 9   Use the Right Skin Care Products

When shopping for skin care products, there are three powerful ingredients you should look for to maintain youthful-looking skin, says Robinson. One, check the label for a serum containing antioxidants like vitamin C (Robinson likes Elizabeth Arden Prevage Anti-Aging Daily Serum), which will help brighten your skin; two, add retinoids, which increase cell turnover and stimulate collagen renewal, to your routine; and three, start using an alpha hydroxy acid exfoliator to remove the top layer of dead skin cells (Robinson is a fan of Peter Thomas Roth Un-Wrinkle Peel Pads, which are gentle enough to be used daily). 

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.

6 Depression Symptoms You Shouldn’t Ignore

Major depression isn’t always so easy to spot in yourself or someone you love. Use these clues to determine when treatment is needed.

Everyone feels a little down in the dumps now and then. But sadness and withdrawal can become crippling, putting you at risk for a number of serious conditions and consequences, including suicide.

Depression symptoms aren't always as obvious as frequent crying and overwhelming despair. “Oftentimes the changes are subtle, and the person may not notice, but their friends and loved ones may,” says Boadie W. Dunlop, MD, director of the mood and anxiety disorders program in the psychiatry department at Emory University School of Medicine in Atlanta.

There's no one pattern. Depression symptoms may gradually progress from the mild, such as choosing to stay home to watch TV instead of going out with friends, to the more severe, such as thoughts of suicide. Or someone may go from seeming perfectly happy to being totally depressed in a matter of days or weeks. The progression varies from person to person.

“Depression symptoms are particularly troubling if someone displays more than one, or if they persist for more than two weeks,” says Simon Rego, PsyD, associate professor of clinical psychiatry and behavioral sciences at Albert Einstein School of Medicine and director of psychology training at Montefiore Medical Center in the Bronx, New York.

RELATED: 10 Drug-Free Therapies for Depression

To help you recognize depression that warrants concern, whether in yourself or a loved one, here are six depression symptoms — some of which you might even find surprising — that you shouldn’t ignore:

1. Trouble Sleeping Despite being slower in demeanor and motivation, depressed people often lie awake at night, unable to sleep, says Sarah Altman, PhD, a clinical psychologist in the department of psychiatry and behavioral health at The Ohio State University Wexner Medical Center in Columbus. On the other hand, some depressed people may find it difficult to get out of bed and may sleep for long periods during the day.

2. Loss of Interest in Favorite Activities Some people turn to hobbies they enjoy when they feel blue, but people with major depression tend to avoid them. “So if a person who loved spending time with her grandchildren suddenly doesn’t want to see them, or a guy who loves to fish suddenly hangs up his rods, it’s a red flag,” says Tina Walch, MD, psychiatrist and medical director of Northwell Health's South Oaks Hospital in Amityville, New York.

3. Increase in Energy Ironically, when depressed people have made a decision to do something drastic, such as killing themselves, they may go from lackadaisical and slowed to more energetic. That's because they feel a sense of relief in having come to a resolution, Dr. Walch says, "so if you notice a drastic switch like this, you should be very concerned."

4. Change in Appetite Some people overeat when they're depressed or anxious, but in people with severe depression, the opposite is usually true. “A depressed person may stop eating because he or she is no longer concerned with physical well-being,” says John Whyte, MD, MPH, a board-certified internist in Washington, DC and author of Is This Normal?: The Essential Guide to Middle Age and Beyond. “Disregard for personal hygiene is also cause for concern,” Dr. Whyte adds.

5. Touchiness “In some people, depression manifests as more irritability and impatience than feeling down,” Dr. Dunlop says.

6. An Emerging Dark Side “A person who is severely depressed may become preoccupied with death and other morose topics,” Walch says. For example, he or she may talk about what things will be like “after I am gone,” and may also become more likely to take uncalculated risks.

The Next Step: Getting Help

If you notice any of these serious depression symptoms in yourself or someone you love, reach out and get help. “In most people, depression, even major depression, is a very treatable disorder," Walch says. "There is a wide range of medications and therapies that have been proven to work." Specifically, here's what you should do:

Assess the severity. If you or a loved one is considering harming himself or herself, or is having other dark thoughts, immediate treatment is critical. “Go to the nearest emergency room or contact your local or a private mental health provider,” Walch says. Or contact the National Suicide Prevention Lifeline at 800-273-8255 (TALK).
Create a safe environment. “If the person expresses suicidal thoughts, remove any potentially lethal items from the home, such as guns,” Dunlop says.
See a mental health professional. “It doesn’t have to be a psychiatrist — it can also be a psychologist or therapist,” Whyte says.
Be kind. “Blaming or chastising depressed people for feeling low or unmotivated is not helpful and typically serves to reinforce negative feelings they already have,” Dunlop says. “Instead, open the discussion in a nonjudgmental way and encourage the person to seek help.”
Ignore the stigma. “The recent story of the [suicidal] German copilot [Andreas Lubitz] has not been helpful in terms of the stigma surrounding depression,” Walch says. “Depressed people who are suicidal are not murderers. Suicidal thinking can be a depression symptom, but homicidal thinking is not.”
Look to resources. “There are many organizations that have online resources about depression,” Dr. Altman says. They include the National Institute of Mental Health, the National Alliance on Mental Illness, and the American Psychological Association.

5 Cooking Tips to Spice Up Your Heart-Healthy Diet

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

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

Beauty

Beauty

 

18 Ways to Make This Your Healthiest Summer Ever

I don’t know about you, but I’m tired of summer always being linked to the dread of bathing suit season when there are so many healthy aspects to celebrate this time of year. Fresh produce is abundant, beautiful, and more affordable. The weather (at least in most parts of the country) is perfect for outdoor walking, biking, hiking, and swimming, and the days are longer so you have more time to fit in physical activity. Vacations allow you time to relax, de-stress, and get active with friends and family, and your schedule may be more flexible, allowing you more time to focus on healthy habits.

With summer upon us, it’s the perfect time to set some health goals and embrace new opportunities to eat smart and get fit. Here are 18 ideas to motivate and inspire you throughout the sunny months ahead:

Head to the Farmer’s Market

Loading up on summer’s best and freshest produce, including leafy greens, tomatoes, corn, zucchini, green beans, berries, and stone fruits will make it easier to gobble up more vegetable and fruit servings.

Make salad your main course a few times a week. Take advantage of farm-fresh lettuce and the bounty of seasonal produce to concoct creative salad bowls. For a quintessential summer meal, top your greens with sweet corn, diced tomato, avocado, and crumbled feta.
Swap sugary desserts for delicious seasonal fruits. Instead of reaching for cookies, pastries, or chocolate after dinner, dig into a bowl of naturally sweet, ripe fruit. Best bets include berries, watermelon, cantaloupe, apricots, peaches, and plums.
Lay out a healthy, no-cook summer spread. If it’s too hot to cook, throw together a picnic-style meal of sliced raw veggies (carrots, cherry tomatoes, zucchini, cucumber, etc.) with hummus, sliced whole-grain bread or crackers, cheeses, olives, fruit, nuts, hard-boiled eggs, and other tasty nibbles.
Get grilling. It’s a terrific way to infuse flavor into lean proteins like skinless chicken breasts and thighs, turkey burgers, fish, shrimp, and pork tenderloin, especially if you start with a tasty spice rub or marinade. If you cook extra, you’ll have ready-to-eat proteins to add to leafy green or grain-based salads for simple meals later in the week.
And don’t forget the grilled veggies. Whenever you fire up the grill, toss on some sliced zucchini, summer squash, eggplant, bell peppers, and/or mushrooms. Chop them up and toss with pasta or cooked whole grains like brown rice, farro, and quinoa for a simple meal. Or, layer grilled vegetables on whole-grain bread spread with goat cheese or hummus for a tasty vegetarian sandwich.
Cool down with fruit smoothies. Blend your favorite summer fruits — and veggies like carrots, spinach, and beets — with yogurt and your milk of a choice for a hydrating breakfast or snack. The fruit will add plenty of sweetness, so you can skip added sugars like maple syrup and honey. Make extra and pour into ice pop molds or small paper cups with popsicle sticks for a fun frozen dessert.
Start your day with a hearty, refreshing breakfast. Overnight oats are a great choice this time of year (they’re the more seasonally appropriate counterpart to a hearty bowl of hot oatmeal). Or, top fresh fruit with a dollop of protein-rich yogurt or part-skim ricotta cheese and optional chopped nuts. I can’t wait to dig into my first bowl of fresh cherries, peaches, or nectarines with ricotta!
Go skinny-dipping. Whip up a tasty new dip each week to enjoy with all of the deliciously dunkable summer produce. Try Greek yogurt with mixed fresh herbs, artichoke pesto (you have to try this recipe!), or any number of unique hummus variations, including roasted red pepper, beet, edamame, and carrot-based blends.
Start spiralizing. I don’t endorse a lot of single-use kitchen gadgets, but I’m pretty fond of the vegetable spiral slicers that are all the rage right now. The price is right at about $15 to $25 per machine, and you can use it to make low-cal veggie pastas and salads out of all of the inexpensive summer bumper crops like zucchini, summer squash, cucumbers, carrots, and even beets. Check out this recipe for zesty Carrot Noodle Stir Fry from the blog Inspiralized.
Sip on iced tea. To help you stay hydrated in the hot weather, I suggest keeping a pitcher or two of unsweetened iced tea in the fridge at all times. Switching up the flavor from week to week will prevent you from getting bored in the beverage department. Mint green tea is a classic summertime brew, but I also love fruity combos like pomegranate and raspberry.
Plant something … anything! Never grown anything edible before? Don’t let that stop you; starting a simple garden in pots or other containers is actually really easy. Go to the nearest hardware store and pick up a large planter, a bag of potting soil, and a small potted plant, like any fresh herb or one of the vegetables listed here. Consider starting with basil or a cherry tomato varietal; they’re both easy to grow and versatile in the kitchen.
Go on a pick-your-own adventure! Don’t wait for apple picking in the fall. Make a date with family or friends to harvest summer produce at a local orchard or farm (visit pickyourown.org to find a site near you). If you’re willing to put in the labor, you can buy buckets of berries, stone fruit, and other seasonal items at a great price.
Sit down and enjoy meals outdoors. So many people I know own lovely patio sets but rarely use them. Make a plan to sit down to a family meal in your backyard once a week. You’ll likely eat more slowly and mindfully when you’re dining al fresco. If you don’t have access to an outdoor eating space, plan a fun picnic at a local park.
Master a few healthy recipes for summer cookouts. Finding lighter fare at barbecues can be a challenge, but if you volunteer to bring a healthy dish, you know you’ll have at least one good option to pile onto your plate and dilute some of the heavier entrees and sides. To keep things simple, bring a big bowl of fruit salad or pick up a crudite platter from the grocery store. If you don’t mind doing a bit more prep, I recommend throwing together a pasta salad with lots of veggies, like this colorful soba noodle salad with edamame, red pepper, and purple cabbage.
Go for a daily walk. Now that the days are longer, it’s easier to squeeze in a short walk at the start or end of your day. Aim for at least 30 minutes most days of the week (but if you can only commit to 15 or 20, that’s still well worth the effort). When things start to heat up, schedule an early morning or late evening walk when temps are cooler.
Hit the trail. For a change of scenery, seek out some local walking and hiking trails in your area using sites like alltrails.com and traillink.com. Pack a healthy lunch or snacks and make a day of it!
Take a hiatus from TV. With all the network hit shows on summer break, it’s the perfect time to reduce your screen time. Cut down on evening television viewing and spend that time outdoors walking, biking, doing yardwork, or playing with the kids or grandkids.

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.

Can a Gluten-Free Diet Ease Your Depression?

The gluten-free movement has been a major dietary trend in recent years, with many Americans opting to cut out gluten completely.

A protein found in wheat, barley, and rye, gluten is especially harmful to some people: For those with celiac disease, eating it can cause inflammation and damage the small intestines.

But some say that even if you don’t have celiac disease, going gluten-free can help relieve symptoms of depression.

So can it? Well, the scientific evidence is sparse, and experts haven’t yet reached a consensus. Here’s what you should know before going gluten free to relieve depression symptoms.

Does a Gluten-Free Diet Treat Depression?

Skeptical experts are hesitant to endorse the gluten-free diet as a mood booster. “There is little to no good evidence for this concept,” says Sheila Crowe, MD, a professor of medicine at the University of California, San Diego, and the vice president of the American Gastroenterological Association.

Her opinion isn’t unique: Alan Manevitz, MD, a psychiatrist at Lenox Hill Hospital who treats patients with mood disorders, also cites the lack of evidence that a gluten-free diet can alleviate depression.

Instead of cutting out gluten, these experts say that you should focus on eating a healthy diet in general. “My go-to diet for patients without specific disease is a healthy Mediterranean diet,” says Dr. Crowe. This meal plan includes plenty of fruit and vegetables, lean protein, nuts, legumes, and some wine.

RELATED: For Our Family, Gluten-Free Isn’t a Fad, It’s a Lifesaver

Omega-3 fatty acids, which are found in many staples of the Mediterranean diet, can have a calming effect, says Dr. Manevitz. One April 2015 study in the journal Mental Illness found that when people over 65 took omega-3 supplements, they saw a reduction in their major depression symptoms after 12 weeks.

Can Going Gluten-Free Still Help?

Perhaps. Experts in the gluten-free camp — like David Johnson, MD, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk — say that there’s some evidence that gluten may cause depression in patients with non-celiac gluten sensitivity. (For the record, experts also debate whether non-celiac gluten sensitivity exists, says Emily Deans, MD, a psychiatrist and clinical instructor of psychiatry at Harvard Medical School.)

But some research suggests that the bacteria in the gut can affect both mood and behavior, Dr. Johnson says. ''Eating gluten may change the bacteria in the gut," and that, in turn, could potentially change behavior, he says.

In a May 2014 study in Alimentary Pharmacology & Therapeutics, people with irritable bowel syndrome reported better moods when they weren’t eating gluten, despite their continuing gastrointestinal symptoms.

Studies like this one are rare, but there’s also anecdotal evidence. Dr. Deans allows her depression patients to go gluten-free — assuming they’re taking any medications they’ve been prescribed and are participating in therapy, if needed. She believes that “gluten seems to irritate the immune system in some people,” even in those without celiac disease.

But there’s one thing all these experts would agree on: the need for a healthy diet. Simply eliminating gluten is not enough, says Deans. “I don’t think a gluten-free muffin is any healthier than a regular muffin,” she says.

Instead, if you’re depressed you should focus on eating “clean, whole food,” which has been linked to depression relief, Deans says.

How to Cut Out Gluten

Talk to your doctor first about the best approach. Eating gluten-free means including plenty of fruits and vegetables and some meat and eggs in your diet, says Deans. She notes that you may not want to suddenly switch out all of your gluten-containing rice and pasta for the gluten-free kinds.

And keep in mind that eliminating gluten may not help right away. Some patients see a difference in their mood around the two- to four-week mark, while others may not notice a change until after at least 30 days, she says.

Another point on which experts agree: If you suspect that eating gluten affects either your mood or GI tract, talk to your doctor about being tested for celiac disease.

Fighting Off Fatigue

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

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

Chronic Fatigue: A Better Health Plan

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

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

 

 

Chronic Fatigue: What Can Cause Exhaustion

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

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

Chronic Fatigue: When It’s Chronic Fatigue Syndrome

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

 

 

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

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

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

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

Chronic Fatigue Syndrome: Possible Causes

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

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

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

Expert Panel Recommends Questionnaire to Help Spot Depression

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

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

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

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

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

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

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

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

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

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

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

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

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

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

RELATED: 10 Drug-Free Therapies for Depression

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

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

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

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

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

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

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

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

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