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.
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.
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:
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:
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.”
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.
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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.
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.
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!
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.
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.
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:
Guillain-Barré syndrome is not contagious — it cannot spread from one person to another.
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.
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:
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It's unclear what causes binge eating disorder.
Like other eating disorders, BED is probably caused by a combination of genetic, psychological, and social factors.
Some risk factors for binge eating disorder include:
People with binge eating disorder have frequent bingeing episodes, typically at least once a week over the course of three months or more.
Binge eating episodes are associated with three or more of the following:
Some people also display behavioral, emotional, or physical characteristics, such as:
There are several treatments available for BED. Treatment options may include:
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.
“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.
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.
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.
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.
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.”
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.
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.
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.”
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.
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.”
Statistically speaking, ovarian cancer is relatively rare: It represents just 1.3 percent of all new cancer cases in the United States each year, according to the National Cancer Institute (NCI). But although its numbers are small, the fear factor for many women may be disproportionately large.
We spoke to two leading ovarian cancer experts: Robert J. Morgan, Jr., MD, professor, and Mihaela C. Cristea, MD, associate clinical professor, of the medical oncology and therapeutics research department at City of Hope, an NCI-Designated Comprehensive Cancer Center in Duarte, California.
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Here are 10 essential facts about ovarian cancer that you should know:
1. About 20,000 women in the United States are diagnosed with ovarian cancer each year. As a comparison, nearly 250,000 women will be diagnosed with breast cancer this year, according to the American Cancer Society. Of the women diagnosed with ovarian cancer, 90 percent will be older than 40; most ovarian cancers occur in women 60 or older, according to the CDC.
2. You should see your doctor if you experience any of these ovarian cancer symptoms:
It’s important to pay attention to your body and know what’s normal for you. If you have abnormal vaginal bleeding or have any of the other symptoms for two weeks or longer, see your doctor right away.
These symptoms can be caused by many different problems, but it’s best to have them evaluated, suggests the University of Texas MD Anderson Cancer Center.
3. It’s tricky to pinpoint early, milder symptoms of ovarian cancer. However, the findings of a study published in Cancer in 2007 point to a cluster of vague symptoms that may suggest the need for ovarian cancer testing, says Dr. Morgan. In the study, researchers linked these symptoms to the possibility of ovarian cancer:
If a woman experiences these symptoms on more than 12 days a month for less than one year, she should insist that her doctor perform a thorough ovarian evaluation, says Morgan. This might include the CA-125 blood test or atransvaginal ultrasound exam.
4. Early detection can mean a better prognosis. When detected early enough, ovarian cancer can be cured. “Stage 1 and stage 2 ovarian cancer is curable about 75 to 95 percent of the time, depending on the tumor grade and cell type,” says Morgan. But because this cancer occurs deep inside the body’s pelvic region, it is often diagnosed in later stages, he says. The cure rate for stage 3 ovarian cancer is about 25 to 30 percent, and for stage 4 it's less than 5 percent, he adds.
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5. Ovarian cancer has several key risk factors. These include:
6. Ovarian cancer is not a single disease. In reality, it’s a diverse group of cancers that respond to different treatments based on their molecular characteristics, says Dr. Cristea. Treatment will also depend on other health conditions, such as diabetes or heart problems, that a woman might have.
7. Ovarian cancer treatments are evolving and improving all the time.“Immunotherapy is emerging as a new treatment option for many malignancies, including ovarian cancer,” says Cristea. In another recent development, the firstPARP inhibitor, a DNA-repair drug, has been approved for women with BRCA-mutated ovarian cancer when chemotherapy hasn’t worked. “Women should also ask their doctors about clinical trials that are evaluating immunotherapy as well as other new treatments,” she adds.
8. Surgery may prevent ovarian cancer in women at very high risk. For women who carry the BRCA or other genes that predispose them to ovarian cancer, doctors often recommend surgery to remove the ovaries and fallopian tubes.Angelina Jolie, the actor and human rights activist, decided to have this surgery in March 2015. “Removing the ovaries can decrease the risk of developing the disease by 98 percent, and can substantially decrease the risk of developing breast cancer,” notes Morgan. Women in this very high-risk group should opt for this surgery after they’ve completed childbearing at around age 35, he notes.
9. Even after remission, ovarian cancer can still respond to treatment. “About 80 to 90 percent of ovarian cancer patients will achieve remission after chemotherapy treatment,” says Morgan. However, many of those women will later experience a recurrence of the cancer. The longer the remission, notes Morgan, the better the chances are for achieving a second remission.
10. It’s best to see an ovarian cancer specialist. When you’ve been diagnosed with ovarian cancer, getting a referral to an ovarian cancer specialist is a wise move, says Cristea. If you’re having surgery, it’s best to have a gynecologic oncologist perform the operation instead of a gynecologist, she adds. And to make sure you’re getting state-of-the-art treatment, consider seeking a second opinion at a NCI-Designated Cancer Center.
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.
There are three basic types of hearing loss:
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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:
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.
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:
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.
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.
Strawberries, lemons, blueberries, and onions – sounds like your average grocery list, right? Just as they are nutritious and important for a well-balanced diet, these ingredients can give your skin and hair a major boost, too.
Strawberries, lemons, blueberries, and onions – sounds like your average grocery list, right? Just as they are nutritious and important for a well-balanced diet, these ingredients can give your skin and hair a major boost, too.
Read on to learn these six expert-recommended at-home treatments that can help combat your biggest beauty woes.
Strawberries, lemons, blueberries, and onions – sounds like your average grocery list, right? Just as they are nutritious and important for a well-balanced diet, these ingredients can give your skin and hair a major boost, too.
Read on to learn these six expert-recommended at-home treatments that can help combat your biggest beauty woes.
Some prescription drugs can cause or contribute to the development of depression and other mood disorders.
What do certain asthma, acne, malaria, and smoking-cessation prescription drugs have in common? Answer: Their possible side effects include depression or other mood disorders.
Depression as a side effect of prescription drugs is widespread and increasingly gaining attention. The medications that contribute to drug-induced depression might surprise you. For example, an asthma medication, Singulair (montelukast), is prescribed to help people breathe more easily, but its side effects may include depression, anxiety, and suicidal thinking, according to a research review published in Pharmacology in 2014.
“In 2009, Merck added psychiatric side effects as possible outcomes with Singulair, including tremor, depression, suicidality — suicidal thinking and behavior — and anxiousness,” says J. Douglas Bremner, MD, researcher and professor of psychiatry and radiology at Emory University School of Medicine in Atlanta.
Drugs With Depression as a Side Effect
Dr. Bremner has published studies on the possible relationship between the use of retinoic acid acne treatments and the development of depression. One of the drugs within this category is Accutane (isotretinoin), the oral treatment for severe acne that has been associated with psychiatric problems, including depression.
“The original brand-name version of isotretinoin, Accutane, was taken off the market in 2009, although it continues to be marketed as Roaccutane in the U.K., Australia, and other countries," Bremner notes. "In the U.S. there are three generic versions available that have also been associated with reports of depression and suicide, Sotret, Claravis, and Amnesteem."
RELATED: Are You Getting Hooked on Anxiety Medications?
The full list of drugs that could cause depression is a long one. British researchers found 110 different medications between 1998 and 2011 that were associated with increased depression risk, according to a report published in BMC Pharmacology and Toxicology in September 2014.
Besides isotretinoin and montelukast, drugs that can cause or contribute to the development of depression or other mood symptoms include:
Lariam (mefloquine), used to treat malaria. Depression, anxiety, and psychosis are among the side effects of this medication, according to an article in Medical Science Monitor in 2013 that explored the chemical cascade behind mood changes.
Chantix (varenicline), used to stop smoking. The Food and Drug Administration (FDA) lists hostility, anxiety, depression, and suicidal thoughts as possible side effects of this medication.
Inderal (propranolol hydrochloride) and other drugs in the beta-blocker class, used to treat high blood pressure. Research on beta-blockers and depression suggests that some, but not all, of the medications in this class can contribute to depression, according to a report in the February 2011 issue of the Journal of Clinical Psychopharmacology.
Contraceptives. Contraceptives including those delivered by vaginal ring or patch could lead to depression in some people, according to research published in the Cochrane Database of Systematic Reviews in 2010.
Corticosteroids. Some people who take corticosteroids experience side effects such as depression, anxiety, and panic attacks, among other symptoms, according to a review of research published in Rheumatology International in 2013.
Interferon-alpha. As many as 40 percent of people using this immunologic medication may experience depression, according to a 2009 report in Dialogues in Clinical Neuroscience.
Interferon-beta. The link between this immunologic medication and depression is debated, but researchers reporting in Therapeutic Advances in Neurologic Disorders in 2011 note that depression is a concern for those who take it, in part because of their underlying conditions.
Nonnucleoside reverse transcriptase inhibitors. These HIV medications may increase the risk for depression, according to research published in the September 2014 issue of HIV Medicine. Arimidex (anastrozole) and aromasin (exemestane). Both of these long-term breast cancer therapies may contribute to depression, according to the FDA.
Vigabatrin. This anticonvulsant may cause depression, irritability, and psychosis, notes a review of studies in Acta Neurologica Scandinavica in 2011.
The FDA investigates drugs that have many reports of depression symptoms as a side effect. It requires what are called black-box warnings to be clearly printed on medications, like isotretinoin, that have been linked to depression and suicidal behavior, among other serious health threats. Make sure you read the information pamphlets that come with your prescription medications (and ask your pharmacist if you don’t understand what they say). You can stay on top of any news about their side effects by setting up a news alert on Google.
You can get the latest drug safety information on the FDA website.
Also, pay attention to how you feel. Though you may be taking medications that seem unrelated to mood, let your doctor know if you have symptoms such as sadness, difficulty sleeping, hopelessness, sleep changes, or thoughts of suicide.
“If you suspect your medication may be causing depression or similar problems, talk with your doctor and, if necessary, consult with a psychiatrist,” Bremner advises. The good news is that drug-induced depression usually clears up once you stop taking the medication.
Are Your Drugs Causing Depression?
It can be challenging to figure out whether your depression is related to taking a prescription drug, but here are some indicators:
Timeline. Drug-induced depression is defined as depression that appears within a month of starting or stopping a medication, according to the American Society of Health-System Pharmacists (ASHP). The society also advises that other conditions that might cause depression have to be considered in figuring out whether medication is the contributing factor. Bremner found in his research that the timeline varies from weeks to a month or two.
Dose-response relationship. With some drugs, depression symptoms may get better as the dose is reduced or worse as it is increased. This is usually a clear indicator of a relationship.
If you are uncertain about whether your changes in mood or energy are drug symptoms, talk with your doctor. Screening tools and questionnaires can reliably identify depression. You can also send information about your experiences to the FDA.
Prescription Drug-Induced Depression Treatment
In severe cases, people taking prescription drugs have developed depression leading to suicidal behavior. Because of this risk, don’t ignore or try to wait out feelings of depression, even if you believe they are only a prescription drug side effect. Talk with your doctor about these options to correct the situation:
Switching to an alternative treatment. If an equally effective medication that does not have depression as a side effect exists, the easiest option is to switch prescription drugs.
Getting a psychiatric evaluation. This may be recommended in any case to make sure you do not have an underlying psychiatric condition that has gone undiagnosed. People with a history of depression may have a worse response to some medications. An antidepressant might be prescribed in order to help manage depression symptoms.
Talk therapy will not work in this case, says Bremner, because the problem is chemically based. You will need prescription medication to address the depression if you cannot stop taking the drugs that are causing it.
If you think your depression symptoms are linked to a prescription drug you’re taking, talk with your doctor right away, get screened for depression, and find a better way to manage both your health issues and your mood.
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.
Do you have difficulty hearing conversations held in a noisy room? Do you have a harder time picking up women’s voices than men’s? Do you constantly ask others to repeat what they just said? If you answered ‘yes’ to these questions, you may be experiencing hearing loss — especially if you are 65 or older.
About 8.5 percent of adults between the ages of 55 and 64 suffer from hearing loss, according to the National Institute on Deafness and Other Communication Disorders. That number jumps to 25 percent for those 65 to 74, and it doubles to 50 percent for ages 75 and older. After high blood pressure and arthritis, hearing loss is the most common chronic condition affecting senior health.
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As you age, you are at risk for two types of hearing loss. The most common type of hearing loss in seniors is presbycusis, or age-related hearing loss. A gradual loss of hearing that affects both ears, presbycusis occurs when tiny hairs in the ear, which are necessary for converting sound waves to sound, become damaged or die. Hearing loss from presbycusis is permanent because once these hairs are damaged or die, they are not replaced with new growth.
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The other type of hearing loss that seniors experience is tinnitus, or ringing in the ears. Tinnitus can be either permanent or temporary.
A lifetime of exposure to loud noises such as music, motorcycles, or firecrackers can cause hearing loss in seniors. Noise-related hearing loss often results in tinnitus. Other causes of and risk factors for hearing loss experienced by seniors include:
Your genes may also play a role in presbycusis, as it tends to run in families. Environmental factors like loud music and smoking make it difficult to determine the effect of genetics on age-related hearing loss; however, according to American Family Physician, an estimated 50 percent of age-related hearing loss is inherited.
Men are also more likely than women to develop hearing loss, and they’re more likely to develop it at an earlier age, says American Family Physician.
Losing hearing can have a significant effect on other aspects of your wellbeing. Researchers in a 2014 survey of 18,300 adults found that about 12 percent of participants with hearing loss had moderate to severe depression compared with about 5 percent of those with excellent hearing. The survey, which was published in JAMA Otolaryngology Head and Neck Surgery, also noted that women were particularly susceptible to depression related to hearing loss.
Hearing loss also appears to worsen cognitive functioning, according to a study published in the February 2013 issue of JAMA Internal Medicine. Among the nearly 2,000 seniors studied, hearing loss lowered cognitive functioning on some assessments as much as 41 percent more than it did among those without hearing loss.
Though you can’t always fully prevent hearing loss, you can take steps to minimize or overcome it. Age-related hearing loss may be prevented or at least lessened by avoiding loud noises.
Because there is no known cure for age-related hearing loss, treatment is generally focused on improving your ability to function day to day. Your doctor may treat you or refer you to a hearing specialist such an otolaryngologist (or ENT, a medical doctor who specializes in the ear, nose, and throat) or an audiologist (a licensed professional who diagnoses and helps manage hearing problems). The cause and extent of your hearing loss will determine the course of treatment.
A hearing aid may be one recommendation from your doctor or audiologist. Hearing aids can be beneficial for many, but according to the National Institute on Deafness and Other Communication Disorders, fewer than 30 percent of adults older than 70 who could benefit from a hearing aid have one. Hearing aids have come a long way over the years and are available in a variety of styles. A hearing aid and its battery will either fit behind the ear, on the ear, just inside the ear, or in the ear canal.
Types of hearing aids include:
Using assistive listening devices also can help compensate for hearing loss. These products either amplify sound, such as sound from telephones, televisions, and radio listening systems, or alert the user visually, such as with smoke detectors or alarm clocks.
Surgery may be another consideration. Cochlear implants are electronic devices with one part surgically implanted in the skin and the other part worn behind or in the ear. Used only for severe hearing loss, implants will not restore normal hearing, but they can make sounds louder. Because of the nature of the implants, they are not without risks — they pose the potential for infection, damage to the facial nerve, and tinnitus.
Speech or lip reading and sign language may be an answer for some seniors with hearing loss. Both of these techniques require training and practice and are generally recommended for those with severe hearing loss.
See your doctor as soon as you think you have a hearing problem. The loss of hearing could be a symptom of another medical condition. Seniors with untreated hearing loss are also more likely to suffer emotionally and socially when they areunable to interact with friends and family members. Left untreated, hearing loss could lead to deafness, and seniors who do not address their hearing loss put their lives at risk if they are unable to hear emergency warnings such as car horns or smoke alarms.
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!
Influenza, commonly known as "the flu," is a viral infection of the respiratory tract that affects the nose, throat, and sometimes lungs.
tend to happen annually, at about the same time every year. This period is commonly referred .
However, each outbreak may be caused by a different subtype or strain of the virus, so a different flu vaccine is needed to prevent the flu each year.
For most people, a bout of flu is an unpleasant but short-lived illness.
For others, however, flu can pose serious health risks, particularly if complications such as pneumonia develop.
Every year, thousands of Americans die from the flu. According to the Centers for Disease Control and Prevention (CDC), the number of deaths caused annually by flu in the United States ranged from 3,000 to 49,000 between 1976 and 2006, with an annual average of 23,607 flu-related deaths.
The best way to avoid getting the flu is to get an annual flu vaccination, encourage the people you live and work with to do likewise, stay away from people who are sick, and wash your hands frequently.
All U.S. adults, including pregnant and postpartum women, should be screened for depression by their family doctor, the nation's leading preventive medicine panel recommends.
Further, doctors need to follow through and get treatment for anyone who tests positive for depression, the U.S. Preventive Services Task Force concluded in an update of its depression screening guidelines.
This is the first time the panel has specifically advocated depression screening in pregnancy and shortly after giving birth. It cited a U.S. study that found that 9 percent of pregnant women and more than 10 percent of postpartum women exhibited signs of major depression.
The American College of Obstetricians and Gynecologists (ACOG) applauded the recommendation.
"Because fewer than 20 percent of women in whom perinatal depression is diagnosed self-report their symptoms, routine screening by physicians is important for ensuring appropriate follow-up and treatment," said ACOG president Dr. Mark DeFrancesco in a statement.
Depression can harm both the child and mother, interfering with their interactions and affecting social relationships and school performance, the panel noted. Risk factors during pregnancy and after delivery include poor self-esteem, child-care stress, prenatal anxiety and decreased social support, the report said.
The new report -- published Jan. 26 in the Journal of the American Medical Association -- updates a similar recommendation the panel issued in 2009 that called for routine screening of adults.
In general, primary care physicians should be able to treat most cases of uncomplicated depression, and refer more complex cases to a psychiatrist, said Dr. Michael Pignone, a member of the task force and director of the University of North Carolina's Institute for Healthcare Quality Improvement.
"That's part of our job," Pignone said.
Options for treatment include therapy with a psychologist or licensed clinical social worker or antidepressant medications.
The task force is an independent, volunteer panel of national experts in preventive medicine. It issues recommendations, and revisits them on a regular basis to make sure that medical evidence still supports the guidelines.
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Depression is among the leading causes of disability in persons 15 years and older, the panel noted.
Millions of adults suffer from depression and don't know it, said Dr. Michael Thase, a professor of psychiatry at the University of Pennsylvania Perelman School of Medicine.
At any given time, between 5 percent and 10 percent of U.S. adults suffer from a depressive disorder, but half receive no treatment for their depression, Thase said.
The task force's depression guidelines are aimed at detecting and helping those adults who unknowingly have depression, Pignone said.
"This is about screening, not about diagnosing people who come to a doctor's office saying, 'I feel depressed.' The potential value of screening is in those people who would not be found as part of regular clinical care," he said.
Some people may not want to acknowledge they are depressed because there is a stigma around mental illness, Pignone said. Others might just think they are feeling blue, and will get over it.
"In some people, their symptoms may seem more physical to them," he added. For example, depression might cause stomach pain, headaches or sleeping problems.
The task force did not recommend any particular questionnaire for depression screening, because "there are many good tools and there's no single tool that should be recommended above others," Pignone said.
The most common screening tool, the Patient Health Questionnaire, consists of 10 simple questions that can be answered in minutes, according to the U.S. Department of Health and Human Services.
The task force also could not recommend how regularly people should be screened, because not enough research has been done in that area, Pignone said.
"The task force recommendation is that people should be screened at least once," he said. "For the meantime, clinicians should use their judgment about the risk of depression in their patients, in deciding how often to screen."
However, the task force did emphasize the need to follow up a positive screening with treatment.
Dr. Michelle Riba, a former president of the American Psychiatric Association, agreed that primary care doctors should be able to treat most patients with depression.
However, Riba added that doctors should develop a relationship with a psychiatrist they can consult on cases of depression. The psychiatrist could talk with the practitioner on the phone, review patient charts, and help decide the best course of action.
Doctors also should be open to other forms of treatment for depression, such as cognitive-behavioral therapy or light therapy, said Elizabeth Saenger, a psychologist in private practice in New York City.
Light therapy affects the body's production of the hormone serotonin, and studies have shown it can help alleviate depression symptoms, Saenger said.
It makes sense for primary care doctors to lead the way on depression screening because they see patients most often, said Dr. Alan Manevitz, a psychiatrist with Lenox Hill Hospital in New York City.
Treating depression can help patients face other health problems with which they are struggling. "As depression gets worse, so many other chronic illnesses also get worse," Manevitz said. "People don't take care of their health as well when they are depressed."
People who live with constant road noise may face a higher risk of developing depression, researchers say.
The risk was about 25 percent higher for people living in areas with a lot of traffic, compared to those living in areas with little road noise. However, the risk was largely confined to those who were poor, unemployed, had limited education, smoked or had insomnia, the German study authors found.
"Although we can't say for sure, it has been thought that noise causes stress and annoyance," said lead researcher Ester Orban, of the Center for Urban Epidemiology at University Hospital Essen.
"If this noise persists over a long time and is constant and loud, it may contribute to depression," she said.
Orban cautioned that these findings only show that road noise is associated with depression, not that it causes depression. "Road noise seems to play a role, but I wouldn't talk about causality," she explained.
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Orban said there are some simple things people can do to reduce their exposure to traffic noise, short of moving.
"If you feel annoyed by traffic noise you can use earplugs, and if traffic noise is disturbing your sleep, choose a bedroom away from the busy road," she suggested.
The report was published online Nov. 25 in the journal Environmental Health Perspectives.
For the study, Orban and her colleagues collected data on more than 3,000 people, aged 45 to 75, who took part in the Heinz Nixdorf Recall study. The study participants were followed for an average of five years.
Depressive symptoms include feeling lonely, sad, depressed, having trouble concentrating or feeling like a failure.
Simon Rego, director of psychology training at Montefiore Medical Center/Albert Einstein College of Medicine in New York City, said this study adds to existing evidence that traffic noise is linked to an increased risk of depressive symptoms.
"This is not surprising, as we already have extensive evidence that noise is associated with both stress and heart disease," he said.
Given that depression is common worldwide and can have a negative effect on individuals and society, and given that its cause is complex, it's important to examine everything that may play a role, including environment and how it interacts with psychological, social and biological factors, Rego said.
Those with a low socioeconomic status and sleep disturbances may be particularly vulnerable to noise effects, he added.
"This suggests that, along with targeting biological factors with medications and psychological factors with treatments such as cognitive behavioral therapy, interventions may also be aimed at targeting environmental factors," Rego said.
Targeting environmental factors includes both individual and societal approaches, he added.
On an individual level, helping patients get a good night's sleep with better sleep practices may help lower the odds of depression, Rego said.
"On a larger scale, communities can work on improving urban planning to address traffic noise in order to help treat depression or perhaps even prevent it," he added.
By the time David Clark was in his early thirties, he owned a chain of 13 retail stores that reported $8 million a year in sales, and he was married with three children. “I should be happy,” he recalls thinking. But he wasn’t.
He was depressed. “I couldn’t find simple joy in anything, and had thoughts of stepping in front of a bus to end it,” he says. The depression caused him to eat massive amounts of fast food and drink recklessly, he says, and that led to obesity. At his heaviest, the nearly 6-foot-tall Clark, from Lafayette, Colorado, weighed 320 pounds.
Clark was not alone in suffering from depression and obesity. Nearly half of all adults who live with depression — 43 percent — are obese, and adults with depression are more likely to be obese than adults who aren’t depressed, according to the Centers for Disease Control and Prevention.
Whether depression or obesity comes first can vary from person to person, says Kim Gudzune, MD, MPH, assistant professor of medicine at Johns Hopkins Medicine in Baltimore. “But if you have one condition, you’re more likely to have the other,” she says.
Depression and obesity are often linked because of the stigma of obesity. Some who are obese have a poor body image and can become depressed as a result, Dr. Gudzune says, and others eat to drown their sorrows.
In addition, “there may be shared neural pathways between obesity and depression that may place individuals at risk for both,” says Leslie Heinberg, PhD, director of behavioral services for the Bariatric and Metabolic Institute at the Cleveland Clinic in Ohio.
How Clark Turned His Life Around
After his weight gain, Clark was at risk for high blood pressure and was borderline diabetic.
He says he overcame both of his health conditions essentially on his own. One morning, when he was 34, Clark says he woke up and realized how close to death he was. He knew that if he didn’t change, his children would be fatherless.
“I didn’t want my kids to see their father drink himself to death,” he says, so he joined Alcoholics Anonymous and followed the group's 12 steps to stop drinking. “I went on a spiritual journey to make peace with my path,” says Clark, who grew up poor and homeless. As a kid, he and his dad had roamed the country in the back of a pickup truck, he says.
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He also began running. And running. Some years earlier, he'd seen the New York City Marathon on television and always had it in the back of his mind that that was something he might do. Eventually, Clark became an ultra-marathon runner. Now 44, he runs at least 80 to 100 miles a week and competes in some of the most challenging endurance races on the planet, including across Death Valley in California.
At first, it was painful to run, but he says the pain was also motivating. “I knew the stakes had to be pretty high to make such a dramatic change in my life," he says.
Running: A Low Cost Mood Booster
After Clark revamped his diet to be plant-based, stopped drinking alcohol, and began running regularly, his weight began to drop. It took him 18 months, but he got down to a healthy 180 pounds. When he switched to competitive running, he lost another 20 pounds and has stayed at 160 for years now, he says.
The running also improved his mood, says Clark, who chronicles his journey in the book Out There: A Story of Ultra Recovery. Exercise releases endorphins — hormones that reduce your perception of pain and improve your mood, according to Harvard Medical School in Boston.
Clark advises others who struggle with obesity and depression to do like he did and “draw a line in the sand” to say, “I’m not going to live this way anymore — I’m going to move on to a better place.”
What You Can Do
Though Clark lost weight on his own, not everyone can. So if you're struggling, consider working with a nutritionist or your doctor to find a weight-loss program. The key is to make low-calorie, healthy choices and exercise more so that you burn more calories than you consume, according to the National Institutes of Health. If you're extremely overweight, your doctor might suggest medication to curb your appetite, or weight-loss surgery.
Exercise and eating well may also help treat your depression. You can work with a therapist who can help you find the right treatment plan. That could include individual or group therapy, stress-reduction techniques, medication, or some combination of these.
Treatment can be difficult, because a side effect of some depression medications is weight gain, Gudzune says. But treating depression and weight issues simultaneously, Heinberg says, can be beneficial because if people who are depressed are able to lose weight, that could benefit their depression.
As a physician anesthesiologist, I know how challenging it can be to treat patients who are in pain. For most people, pain is temporary. But for more than 100 million Americans, there is no end to pain.
Chronic pain can be broad or focused, dull or sharp, distracting or excruciating, and in many cases, debilitating.
Your likelihood of experiencing chronic pain increases with age. Gender can also influence how much pain you have. In general, women report having more pain than men.
The Serious Effects of Pain
Living with chronic pain can affect your life in many ways:
Mental health changes. According to a 2006 survey from the American Academy of Pain Medicine, almost two-thirds of people living with chronic pain have reported a decrease in overall happiness and 77 percent reported feeling depressed.
Increased fatigue. Pain can affect your daily functioning, resulting in decreased concentration, diminished energy levels, and difficulty falling or staying asleep.
Decreased job performance. Chronic pain costs the U.S. more than cancer, heart disease, and diabetes. Health economists estimate that the cost of chronic pain may be as high as $635 billion a year, according to a report published in the Journal of Pain. We can only guess how many people have been limited in their professional advancement because of pain.
Which Doctor Is Best at Treating Pain?
If you are experiencing pain, your first stop should be to visit your primary care physician. A 2010 analysis of a national medical database found that 13 percent of all doctors visits were to discuss pain. Of these visits, 45 percent were at a primary care physician's office. Less than 1 percent of those surveyed sought help from a specialized pain physician.
Specialized pain physicians are underused by patients, probably because the specialty is relatively new and people don't know about it. These physicians are trained to treat difficult pain conditions using the most advanced treatments.
I like to compare pain physicians to football players. The goal of all of these doctors is the same — to relieve pain — but the role they play varies:
Anesthesiologists spend four years of their training managing anesthesia and pain control in surgical patients. Most pain specialists are anesthesiologists, and they can offer a full array of pain treatments.
Neurologists focus on targeting the neural, or nerve, aspects of pain. Treatments include medications and procedures to treat nerve-related pain.
Physical medicine and rehabilitation physicians focus on relieving pain and improving their patients' day-to-day functioning via physical therapy and physical reconditioning.
The Future of Pain Treatment
Recently, the American Society of Anesthesiologists analyzed dozens of peer-reviewed medical journals from the past year to create its first Women’s Pain Update. Highlights from the report include:
Success with alternative pain-relief methods such as music, yoga, and rose oil.
Breast cancer research that found the type of anesthesia used during breast cancer surgery can affect how quickly and comfortably you recover.
New research has also led to the development of medications that can decrease nerve irritation and depression caused by pain. Similarly, there are several new procedures that can treat pain.
For example, pain specialists can use X-ray or ultrasound imaging guidance to provide relief through steroid injections that target specific nerves and areas of the spinal cord. The procedure is fairly low risk when administered by a physician specifically trained in interventional pain treatments. All three major pain societies, the American Pain Society, the American Society of Interventional Pain Physicians, and the American Academy of Neurology, state that epidural steroid injections are best suited for those with a pinched or inflamed nerve root (also called radiculopathy).
However, we still have a lot to learn about steroid procedures. Studies have shown that any type of epidural injection — including saline — can relieve pain. In fact, such injections provide twice the pain relief of intramuscular steroid injections, without the associated risks.
Don't resign yourself to a life in pain. If you are one of the millions of people lacking an effective remedy for your pain, a trained pain medicine physician may be able to help you achieve your pain management goals.
Getting a correct diagnosis of multiple sclerosis (MS) can be a challenge.
No single test can determine a diagnosis conclusively, and not everyone has all of the common symptoms of MS, such as numbness, tingling, pain, fatigue, and heat sensitivity. And to complicate matters, the symptoms you do have may resemble those of some other condition.
To figure out what’s causing possible MS symptoms, doctors look at your medical history, the results of a neurological exam, and an MRI — and sometimes do a spinal tap (also called a lumbar puncture), says Jack Burks, MD, a neurologist and chief medical officer for the Multiple Sclerosis Association of America. "The diagnosis can also require eliminating the possible MS mimicker diseases," he says. That leads to an MS diagnosis by exclusion.
Here are some of the conditions that are sometimes mistaken for multiple sclerosis:
Lyme disease is a bacterial infection transmitted through a tick bite. Early symptoms include fatigue, fever, headaches, and muscle and joint aches. Later symptoms can include numbness and tingling in the hands and feet, as well as cognitive problems such as short-term memory loss and speech issues. If you live in an area that’s known to have Lyme disease or have recently traveled to one, your doctor will want to rule out the possibility, Dr. Burks says.
A migraine is a type of headache that can cause intense pain; throbbing; sensitivity to light, sounds, or smells; nausea and vomiting; blurred vision; and lightheadedness and fainting. A study published online in Neurology in August 2016 found that a migraine was the most common correct diagnosis in study subjects who had definitely or probably been misdiagnosed with MS, occurring in 22 percent of them. That said, headaches — and migraines in particular — do commonly occur with MS, shows a study published in Neurological Sciences in April 2011. And according to a study published in the Journal of Headache Pain in October 2010, they are also significantly associated with other types of pain, as well as with depression.
Migraines can be difficult to diagnose, and doctors use some of the same tools to diagnose the headaches as they do for MS, including taking a medical history and performing a thorough neurological examination.
Conversion and psychogenic disorders are conditions in which psychological stress is converted into a physical problem — such as blindness or paralysis — for which no medical cause can be found. In the Neurology study on MS misdiagnosis, 11 percent of subjects definitely or probably misdiagnosed with MS actually had a conversion or psychogenic disorder.
Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disease that, like multiple sclerosis, attacks the myelin sheaths — the protective covering of the nerve fibers — of the optic nerves and spinal cord. But unlike MS, it usually spares the brain in its early stages. Symptoms of NMOSD — which include sudden vision loss or pain in one or both eyes, numbness or loss of sensation in the arms and legs, difficulty controlling the bladder and bowels, and uncontrollable vomiting and hiccups — tend to be more severe than symptoms of MS. Treatments for MS are ineffective for and can even worsen NMOSD, so getting an accurate diagnosis is extremely important. A blood test known as the NMO IgG antibody test can help to differentiate between MS and NMOSD.
Lupus is a chronic, autoimmune disorder that, like MS, affects more women than men. It can cause muscle pain, joint swelling, fatigue, and headaches. The hallmark symptom of lupus is a butterfly-shaped rash covering the cheeks and bridge of the nose, but only about half of people with lupus develop this rash. There is no single diagnostic test for lupus, and because its symptoms are similar to those of many other conditions, it is sometimes called “the great imitator.”
Rheumatologists (physicians specializing in diseases of the muscles and joints) typically diagnose lupus based on a number of laboratory tests and the number of symptoms characteristic of lupus that a person has.
A stroke occurs when a portion of the brain stops receiving a steady supply of blood, and consequently doesn't get the oxygen and nutrients it needs to survive. Symptoms of a stroke include loss of vision; loss of feeling in the limbs, usually on one side of the body; difficulty walking; and difficulty speaking — all of which can also be signs of an MS flare. The age of the person experiencing the symptoms may help to pin down the correct diagnosis. "While MS can occur in 70-year-olds, if the person is older, you tend to think of stroke, not MS," Burks says. A stroke requires immediate attention; if you think you’re experiencing a stroke, call 911.
Fibromyalgia and MS have some similar symptoms, including headaches, joint and muscle pain, numbness and tingling of extremities, memory problems, and fatigue. Like MS, fibromyalgia is more common in women than in men. But unlike MS, fibromyalgia does not show up as brain lesions on an MRI.
Sjögren’s syndrome is another autoimmune disorder, and the symptoms of many autoimmune disorders overlap, Burks says. Sjögren’s causes fatigue and musculoskeletal pain and is more common in women than in men. But the telltale signs are dry eyes and dry mouth, which are not associated with MS.
RELATED: The Complex Process of Diagnosing MS
Vasculitis is an inflammation of the blood vessels that can mimic MS, says Kathleen Costello, an adult nurse practitioner and at The Johns Hopkins MS Center in Baltimore and vice president of healthcare access at the National Multiple Sclerosis Society. Depending on the type of vasculitis, symptoms can include joint pain, blurred vision, and numbness, tingling, and weakness in the limbs.
Myasthenia gravis is a chronic autoimmune disease that causes muscle weakness that typically comes and goes, but tends to progress over time. The weakness is caused by a defect in the transmission of nerve impulses to muscles. In many people, the first signs of myasthenia gravis are drooping eyelids and double vision. Like MS, it can also cause difficulty with walking, speaking, chewing, and swallowing. If a doctor suspects myasthenia gravis, a number of tests can help to confirm or rule out the diagnosis.
Sarcoidosis is another inflammatory autoimmune disease that shares some symptoms with MS, including fatigue and decreased vision. But sarcoidosis most commonly affects the lungs, lymph nodes, and skin, causing a cough or wheezing, swollen lymph nodes, and lumps, sores, or areas of discoloration on the skin.
Vitamin B12 deficiency can cause MS-like symptoms such as fatigue, mental confusion, and numbness and tingling in the hands and feet. That's because vitamin B12 plays a role in the metabolism of fatty acids needed to maintain the myelin sheath. Vitamin B12 deficiency can be identified with a simple blood test.
Acute disseminated encephalomyelitis (ADEM) is a severe inflammatory attack affecting the brain and spinal cord. Symptoms include fever, fatigue, headache, nausea, vomiting, vision loss, and difficulty walking. A very rare condition, ADEM typically comes on rapidly, often after a viral or bacterial infection. Children are more likely to have ADEM, while MS is more likely to occur in adults.
Consuming more meals from the sea linked to lower risk, study suggests, but cause-and-effect not proven.
Can eating a lot of fish boost your mood? Maybe, say Chinese researchers.
Overall, the researchers found that people who consumed the most fish lowered their risk of depression by 17 percent compared to those who ate the least.
"Studies we reviewed indicated that high fish consumption can reduce the incidence of depression, which may indicate a potential causal relationship between fish consumption and depression," said lead researcher Fang Li, of the department of epidemiology and health statistics at the Medical College of Qingdao University in China.
But this association was only statistically significant for studies done in Europe, the researchers said. They didn't find the same benefit when they looked at studies done in North America, Asia, Australia or South America. The researchers don't know why the association was only significant for fish consumption in Europe.
The study was also only able to show an association between eating fish and the risk for depression, not that eating fish causes a lower risk for depression, Li said.
Still, Li thinks there may be reasons why fish may have an effect on depression.
"Fish is rich in multiple beneficial nutrients, including omega-3 fatty acids, high-quality protein, vitamins and minerals, which were associated with decreased risk of depression from our study," Li said.
The researchers pointed out that it's possible that the omega-3 fatty acids in fish may change the structure of brain membranes, or these acids may alter the way certain neurotransmitters work. Neurotransmitters are the brain's chemical messengers, sending information from brain cell to brain cell. Some neurotransmitters, such as dopamine and serotonin, are thought to be involved in depression, the researchers said.
RELATED: 10 Foods I Eat Every Day to Beat Depression
The report was published Sept. 10 online in the Journal of Epidemiology & Community Health.
Depression affects 350 million people around the globe, according to background information in the study. The mood disorder is the leading cause of disability worldwide, according to the World Health Organization.
Past research has suggested that dietary factors may play a role in depression, the researchers said.
To look at the possible connection between eating fish and depression, Li and colleagues reviewed 26 studies published between 2001 and 2014. The studies included more than 150,000 people. Ten of the studies were done in Europe.
This process, called a meta-analysis, attempts to find consistent patterns across multiple studies.
In addition to an overall benefit from fish in curbing depression, Li's team found a difference between men and women. Specifically, the researchers found a slightly stronger association between eating a lot of fish and lowered depression risk in men by 20 percent. Among women, reduction in risk was 16 percent, the researchers said.
Simon Rego, director of psychology training at Montefiore Medical Center/Albert Einstein College of Medicine in New York City, said it's "impossible to draw any definitive conclusions about direct cause and effect" due to the study's design.
But, he added, "While the exact way fish may prevent depression is unknown, it's promising to learn that depression may be preventable for some people by making simple modifications to their lifestyle, such as by eating more fish."
Rego said it's especially important to look for novel treatments because depression can have a significant impact on people's lives, and many people don't respond fully to first-line depression treatments.
Future research needs to look into whether the effects of fish on depression vary by the type of fish eaten. In addition, this review didn't look at whether or not fish oil supplements could have the same effect.
1 / 13 Seasonal Depression: Common But Treatable
If shorter days and shifts in weather zap your energy and make you feel blue, you’ve got classic symptoms of a seasonal mood disorder. Seasonal affective disorder (SAD) is a form of seasonal depression triggered by the change in seasons that occurs primarily in winter. Why do some people get SAD? Experts aren’t certain, but some think that seasonal changes disrupt the circadian rhythm: the 24-hour clock that regulates how we function during sleeping and waking hours, causing us to feel energized and alert sometimes and drowsy at other times.
Another theory is that the changing seasons disrupt hormones such as serotonin and melatonin, which regulate sleep, mood, and feelings of well-being. About 4 to 6 percent of U.S. residents suffer from SAD, according to the American Academy of Family Physicians, and as many as 20 percent may have a mild form of it that starts when days get shorter and colder. Women and young people are more likely to experience SAD, as are those who live farther away from the equator. People with a family history or diagnosis of depression or bipolar disorder may be particularly susceptible.
"It is important to treat SAD, because all forms of depression limit people's ability to live their lives to the fullest, to enjoy their families, and to function well at work," says Deborah Pierce, MD, MPH, clinical associate professor of family medicine at the University of Rochester School of Medicine and Dentistry in Rochester, New York. Here are a few SAD treatment options you might want to consider.
Cognitive therapy was aimed at 'getting people out of hibernation mode.'
Individuals with seasonal affective disorder (SAD) who participated in 6 weeks of daily cognitive-behavioral therapy (CBT) saw more improvement than those who used light therapy, with the advantage for CBT becoming apparent two winters post-intervention, researchers reported in AJP In Advance.
Two winters after receiving either CBT or light therapy, researchers found that those who received CBT experienced a smaller proportion of recurrence as measured the SIGH-SAD, a primary measure of SAD symptoms, as compared with those who received the light therapy (27.3 percent versus 45.6 percent, respectively), and larger proportion of remissions from SAD as defined by a score of less then 8 on the Beck Depression Inventory-II (68.3 percent versus 44.5 percent, respectively), according to Kelly Rohan, PhD, and colleagues from the University of Vermont.
For the study, Rohan and colleagues randomized 177 patients to receive either light therapy on a daily basis for 30 minutes upon waking or to receive CBT-SAD, a type of intervention that delivered psychoeducation, behavioral activation, and cognitive restructuring specifically targeting winter depression symptoms in group therapy sessions twice per week for 6 weeks.
Rohan told MedPage Today that CBT-SAD therapy involved "getting people out of hibernation mode so they approach rather than avoid winter... the activities do not necessarily need to be outdoors or involve communing with snow. They involve anything the person finds enjoyable that can be done in the winter to experience pleasure, rather than withdrawing and socially isolating oneself, which breeds depression." This could involve staying active in one's routines, such as going to the gym, maintaining hobbies, or developing new hobbies to take the place of summer-specific hobbies, or seeing people socially, for instance.
The following winter, researchers contacted study participants in both groups, asking them to resume the treatment they received during the previous winter under their own volition.
Those who received light therapy the previous winter received a letter asking them to resume the daily light therapy upon the onset of the first depressive symptom and those who received CBT-SAD were encouraged to use the skills taught to them the previous winter. Researchers instructed participants in both groups that if recommended strategies were insufficient to relieve symptoms of depression, they should pursue formal treatment, and included contact information for local mental health centers.
RELATED: How to Survive Daylight Saving Time and Shorter Days
Researchers conducted in-person visits in January or February of the first winter following the initial intervention as well as the second winter.
Responses to CBT the first winter after the intervention strongly predicted its effectiveness the following winter. Those who were depression-free the first winter following the intervention were markedly more likely to be depression-free during the second winter compared with those had still shown depression symptoms during the first winter.
In contrast, those who received light therapy who remained depression-free the winter following the intervention were only twice as likely to avoid recurrence during the second winter compared with those without a substantial initial response.
Light therapy has long been used as a treatment for SAD, but one major obstacle to success in treatment includes lack of compliance. In the study, only about a third of subjects reported continuing light therapy at each follow-up, which may have been in part due to study design, according to the authors.
Said Rohan, "In practice, these data indicate that there are options for treating SAD. If someone is willing not only to use light therapy to alleviate current symptoms, but also to keep using daily light therapy until spring and resume using it each fall/winter season, that is a viable option -- however, if someone is willing to work on their thoughts and behaviors in CBT-SAD over 12 sessions in a winter, that is also an option. Better yet, CBT-SAD is a treatment that might have longer-lasting benefits than light therapy in terms of lower risk for SAD recurrence and less severe symptoms two winters later."
Rohan said she hopes to get rates of depression recurrence even lower following SAD treatment in her next study. "This may involve early fall booster sessions to reinforce use of CBT-SAD skills as the seasons change," she noted, or for those who receive light therapy, a conversation regarding increasing compliance with the daily regimen to offset depression recurrence.
More Americans are surviving cancer than ever before, but as the population ages, even more will develop the disease.
That's the good and bad news from the 2017 Cancer Progress Report from the American Association for Cancer Research, released Wednesday.
According to the report, the cancer death rate dropped 35 percent among children and 25 percent among adults from 1991 to 2014. That translates to slightly more than 2 million fewer cancer deaths.
On the flip side, new cancer diagnoses are predicted to rise from nearly 1.7 million this year to 2.3 million in 2030, said the association's president, Dr. Michael Caligiuri.
And this year alone, more than 600,000 Americans are predicted to die from cancer, according to the report.
Caligiuri said the increase in cancer cases is simply a consequence of more people living longer. As the report noted, 53 percent of U.S. cancer diagnoses occur among those aged 65 and older, and that population segment is expected to grow from about 49 million in 2016 to just over 74 million in 2030.
"The longer people live, the higher the incidences of cancer are going to be," Caligiuri said.
"The longer you live, the more likely are the chances for serious genetic mutations that cause cancer, and the weaker your system is in repairing your DNA when you do have those genetic changes," he explained.
Dr. Anthony D'Amico is a professor of radiation oncology at Harvard Medical School in Boston. He said, "The most likely explanation for the progress in cancer survival is a combination of advances in cancer treatment coupled with early detection through screening."
The AACR report noted that death rates for many of the most commonly diagnosed cancers in the United States -- including breast, colorectal, lung and prostate cancer -- have been declining for more than a decade. But deaths from other forms of cancer -- brain, liver and uterine cancer -- have been increasing.
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And progress has not benefited every American equally, the researchers noted. Disparities in cancer care continue between whites and blacks, the insured and uninsured, the poor and the elderly.
But there is progress in treatment. Between August 2016 and July 2017, nine new anticancer drugs were approved by the U.S. Food and Drug Administration, the report said. In addition, the FDA approved the use of eight existing drugs for fighting new cancers.
Two of the new drugs are immunotherapeutics, called checkpoint inhibitors. These treatments increase survival and improve the quality of life for patients with many types of cancer.
Progress was also seen in drugs that target specific cancer molecules. In fact, seven of the new drugs do just that, the researchers said.
The FDA also approved a new optical imaging agent to help doctors see brain tumors and more accurately guide their removal.
The keys to more progress in preventing and curing cancer include basic science to understand the biology of cancers, Caligiuri said, then making those findings relevant to cancer treatment through animal and early human trials. Next comes testing on many people to see how safe and effective these new treatments are, he added.
In addition, more studies are needed to better understand the risks for cancer and to develop ways to lower those risks. These include lifestyle changes -- such as not smoking, eating a healthy diet and exercising -- and screening to detect cancer early.
On the cancer prevention side, cigarette smoking declined by nearly 39 percent from 2000 to 2015, which should mean fewer cases of lung cancer in the future, the report said.
The researchers also said that, in the future, nearly all cases of cervical cancer and many cases of oral and anal cancer could be prevented if girls and boys received the human papillomavirus (HPV) vaccine.
Yet, only 63 percent of girls and fewer than 50 percent of boys had received at least one dose of HPV vaccine in 2015, the study reported.
According to D'Amico, "There is still a lot more to do, but we are going in the right direction in terms of discovery, screening and biology."
Cancer is not an inexpensive disease. Direct medical costs in 2014 were nearly $88 billion, the report said. This does not include the indirect costs, such as lost productivity from cancer-related care and death.
Yet the U.S. National Institutes of Health (NIH) received only $30 billion in funding for 2014, Caligiuri said. And of that total, only about $5 billion went to the U.S. National Cancer Institute.
Not surprisingly, Caligiuri believes that both the NIH and the FDA need more money to spend on cancer research and treatment if further progress in the fight against cancer is going to happen.
"The limiting step for more progress against this beast called cancer is funding," Caligiuri said. "The data clearly show that when we have the funding, we can make phenomenal progress."
The keys to successful psoriasis management are working with your doctor to find a treatment plan that’s right for you and then sticking to that plan. But your role in treatment doesn’t stop with medication. Making certain lifestyle changes is important, too.
From the foods you eat to the support you seek, making healthy choices every day can help you ease the discomfort of flaky, red itchy skin, avoid flares, and start living life to the fullest. Follow these 10 steps.
1. Eat an anti-inflammatory diet. Despite extensive research, there’s no evidence supporting a specific “psoriasis diet,” says Caitríona Ryan, MD, a dermatologist at Texas Dermatology Associates in Dallas and vice chair of the dermatology residency program at Baylor University Medical Center. However, many people with psoriasis report feeling better when they avoid foods that have been shown to cause or increase inflammation (such as fatty red meats, processed foods, refined sugar, and nightshade vegetables) and embrace foods that are known to reduce inflammation. Inflammation-fighting foods include those rich in omega-3s, such as salmon, albacore tuna, flaxseeds, and walnuts, and colorful fruits and vegetables, such as spinach, carrots, and blueberries, according to the National Psoriasis Foundation (NPF).
2. Maintain a healthy weight. People who are overweight tend to have more severe psoriasis, according to a study published in November 2012 in Clinical & Experimental Dermatology Research. “We know that adipose tissue (fat) produces inflammatory cytokines like tumor necrosis factor (TNF),” Dr. Ryan says. Overproduction of TNF, a cell signaling protein, can trigger psoriasis. In addition, systemic and biologic agents for treating psoriasis tend to work better in patients who aren’t overweight, she says.
3. Aim for 30 minutes of exercise most days. Physical activity goes along when it comes to maintaining a healthy weight and lowering your risk for comorbid conditions — such as your risk for heart disease and type 2 diabetes, which increase when you have psoriasis. Try to get at least 30 minutes of aerobic exercise five times a week, and add in some strength training. Although a study published in 2012 in the Archives of Dermatology showed that women who exercised vigorously lowered their risk of developing psoriasis, any level of exercise is better than none, says the NPF. That may mean simply taking the stairs at work instead of the elevator or parking farther away in parking lots.
4. Quit smoking and drinking too much. Neither of these habits is good for anyone, says Mark Lebwohl, MD, a professor and chairman of the department of dermatology at Icahn School of Medicine at Mount Sinai in New York. But they may be even worse for people with psoriasis, he says. The chemicals in tobacco may trigger inflammation that can both cause psoriasis and make flares more severe, according to the NPF. In addition, excessive alcohol consumption may interfere with your response to psoriasis treatment and make it less effective. If you need help quitting smoking or drinking excessively, talk to your doctor.
5. Arm yourself with moisturizer to fight dry skin. “The skin of people with psoriasis is very dry,” Dr. Lebwohl says. “Moisturizing makes it feel better.” Apply moisturizer after showering and after washing your hands. The thicker the moisturizer the better — creams and ointments lock more moisture in your skin.
6. Avoid illness. “Infections worsen psoriasis — even mild colds or urinary tract infections,” Ryan says. “So keeping healthy is rather important.” To stay healthy, eat well, wash your hands frequently, get quality sleep, and be sure your immunizations are up to date. Also be sure to get a flu shot before the start of the flu season.
7. Avoid injuries, too. Some people can develop lesions in new areas if their skin is cut, bruised, or burned, according to The Psoriasis and Psoriatic Arthritis Alliance (PAPAA). Try not to scratch, Ryan says. Be sure to protect your hands and skin when doing activities that could lead to injury such as household chores in the kitchen or pruning bushes in the garden.
8. Cut back on stress. Stressed out? Like most inflammatory conditions, too much tension can cause psoriasis to flare or can exacerbate lesions, according to the NPF. If you’re feeling overextended, look for ways to reduce stress in your life — be it meditation, exercise, or talking to a therapist.
9. Reach out for support. “There are a lot of benefits to support groups,” Lebwohl says. Whether the groups meet online or in person, people with psoriasis often share tips that work well for them and that can help others in their group, Lebwohl says. And sometimes, it helps just having someone listen to you who understands what you’re going through.
10. Stick to your treatment plan—even when you feel good. “Many patients think they’re better off minimizing treatment,” Lebwohl says. They stop taking their medication or go longer than they should between injections. But if you want to avoid flares, you need to stick to the plan. Says the NPF: Using your treatments as prescribed makes a big difference in how well they work.