Light therapy, a treatment for a kind of depression known as seasonal affective disorder (SAD), may also benefit nonseasonal depression, a new study indicates.

"The combination of light and an antidepressant seems to work very well for treating nonseasonal depression," said study leader Dr. Raymond Lam, a professor and head of the Mood and Anxiety Disorders Program at the University of British Columbia in Canada.

Depression, a leading cause of disability worldwide, affects one in 20 people, according to background information with the study. Current treatments include psychotherapy and antidepressant medication, but recurrent episodes are common.

Since bright light treatment is used for people whose seasonal depression occurs in the darker months, the researchers hypothesized it might also lift depression that isn't brought on by light deprivation.

Lam and his team randomly assigned 122 adults with major depression not related to seasonal affective disorder to one of four groups. One group got 30 minutes of bright light treatment a day and took a placebo pill, while another used a device that was not light therapy and took the antidepressant fluoxetine (Prozac). A third group took a placebo pill and used a placebo device, while a fourth took Prozac and got light therapy.

The researchers followed the men and women for eight weeks, looking to see how many went into remission -- defined as having normal scores on a widely used depression scale.

"About 60 percent of the patients who got the combination [Prozac plus light] treatment went into remission with their symptoms compared to about 40 percent on light therapy alone," Lam said.

RESEARCH: 12 Ways to Treat Seasonal Depression

The antidepressant alone was not superior to placebo medication. Only about 30 percent of those on placebo medication and sham light treatment had remission, as did just 20 percent of those on Prozac with sham light treatment.

Light therapy alone was better than placebo, but not from a statistically significant point of view, Lam said.

Experts can't say for sure why light therapy works, but for seasonal affective disorder they think it may help correct disturbances in the body's circadian rhythms, or internal clock.

The same may be true for nonseasonal depression, Lam said. "Another theory is that light affects neurotransmitters in the brain such as serotonin [which affects mood]," he said. Or both could play a role, he added.

One limitation of the study, published online Nov. 18 in JAMA Psychiatry, is that patients' natural light exposure was not measured, the researchers said.

Simon Rego is director of psychology training at Montefiore Medical Center and an associate professor at Albert Einstein College of Medicine in New York City. He said the study is the first well-designed comparison of light therapy and the combination of light therapy and antidepressant medications in adults with nonseasonal major depressive disorder.

"In this case, the authors found that the light treatment, whether delivered alone or particularly when delivered in combination with an antidepressant medication, was efficacious in the treatment of nonseasonal [depression] and, just as important, the treatments were well-tolerated by the subjects," Rego said.

"It appears that light therapy, which is already seen as an effective treatment for seasonal affective disorder, may also be appropriate for nonseasonal [depression]," he added.

However, questions remain, Lam said, such as how long the combination treatment should continue.

Light boxes are sold at drugstores and other locations, Lam said, for less than $100 to $300. Some insurance plans cover them, he said.

Recommended treatment involves sitting in front of the fluorescent light box for a half hour daily as soon as possible after waking up. Lam said this can be done while eating breakfast or working on the computer.

The Canadian Institutes of Health Research funded the study. Lam reports serving as a consultant to or receiving honoraria for speaking from various pharmaceutical companies, including Eli Lilly and Co., which makes Prozac.

• 1 / 7   DIY Beauty Solutions

  Strawberries, lemons, blueberries, and onions – sounds like your average grocery list, right? Just as they are nutritious and important for a well-balanced diet, these ingredients can give your skin and hair a major boost, too.
  
  Read on to learn these six expert-recommended at-home treatments that can help combat your biggest beauty woes.

• 

  2 / 7   Problem: Hyperpigmentation and dark spots

  Solution: Fresh lemon juice and a red onion

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

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

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

  Solution: Almond milk and coffee grounds

  
  For a smoothing hand and foot scrub, Lin suggests combining almond milk with leftover coffee grounds from your morning roast. Almond milk is rich in antioxidants and vitamin E, which helps protect skin from free radicals that can damage cells and break down collagen. Coffee grounds, on the other hand, offer exfoliating benefits that help reveal radiant skin. “Using a caffeine scrub helps to stimulate cells and elastin, and temporarily firm the skin,” says Lin. 
  
  Combine 2 cups of almond milk and the coffee grounds in a bowl, then scrub the formula in circular motions on your hands and feet.

• 4 / 7   Problem: Dull skin

  Solution: Peppermint tea

  
  Using topical treatments isn’t the only way to achieve gorgeous, glowing skin. In fact, radiant skin can be attained from the inside out by drinking a generous cup of peppermint tea. Dallas-based celebrity aesthetician Renee Rouleau advises her celebrity clients to drink a cup of the minty stuff before red carpet events.  
  
  “Peppermint tea is known to boost blood circulation, giving skin a vibrant glow,” says Rouleau, adding that peppermint can also help decrease stress. 

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

  Solution: Strawberries and honey

  
  Strawberries in particular are jam-packed with vitamin C and are a natural source of salicylic acid, which is often found in anti-acne treatments to help clear skin and keep flare-ups at bay. When paired with honey, which has anti-bacterial benefits, they create a powerful at-home alternative to a store-bought mask. 
  
  Mash together three strawberries and 1 Tbsp. honey and apply the mixture. Wash off the mask with warm water after 15 minutes.

• 6 / 7   Problem: Dry, frizzy hair

  Solution: Coconut oil

  
  As the weather gets warmer, your hair can become dry, frizzy, and completely unmanageable. Because of its moisturizing benefits, coconut oil is highly effective when it comes to nourishing hair and battling frizz. 
  
  For a hydrating hair treatment, New York City stylist Nunzio Saviano, owner of Nunzio Saviano Salon in New York City, recommends working a tablespoon of liquefied coconut oil through your hair post-shampoo. Leave the oil in for five to 10 minutes and rinse it out with chilly water, which will also help close the hair cuticle and seal in moisture, fighting frizz.

• 

  7 / 7   Problem: Product buildup

  Solution: Apple cider vinegar

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

  “Apple cider vinegar is an effective clarifying

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

All Diet and Nutrition Articles

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

Thursday, April 03, 2014

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

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

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

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

Life-Saving Tips in the Event of a Mass Shooting

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

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

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

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

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

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

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

Irwin Redlener, MDTWEET

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

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

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

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

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

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

Disaster Preparedness With Children 

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

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

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

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

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Study finds weekly sessions, plus deep breathing, helped ease cases when medications failed.

The calming poses and meditation of yoga may be just what the doctor ordered when it comes to beating depression, new research suggests.

Researchers found that weekly sessions of yoga and deep breathing exercises helped ease symptoms of the common condition. They believe the practice may be an alternative or complementary therapy for tough-to-treat cases of depression.

The intervention seemed helpful for "people who are not on antidepressants and in those who have been on a stable dose of antidepressants [but] have not achieved a resolution of their symptoms," study lead author Dr. Chris Streeter said in a news release from Boston Medical Center. He's a psychiatrist at the hospital and an associate professor of psychiatry and neurology at Boston University.

Major depression is common and often persistent and disabling, Streeters' team noted. Up to 40 percent of people taking medication for this form of depression won't see their depression go away, according to the researchers.

RELATED: Depression May Hasten Death in Years After Heart Diagnosis

However, prior studies have shown that the ancient practice of yoga may be of help.

"The mechanism of action is similar to other exercise techniques that activate the release of 'feel good' brain chemicals," explained Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City, who reviewed the new findings.

He added that exercise, especially yoga, may also "reduce immune system chemicals that can worsen depression."

Then there's yoga's meditative quality, as well, Manevitz said.

"It has been demonstrated that 'mindful' movement -- conscious awareness -- has a much more beneficial impact on the central nervous system," he said.

But would this bear out in a rigorous study? To find out, Streeter's team tracked outcomes for 30 people with major depressive disorder. All were randomly assigned to partake in either a "high-dose" or "low-dose" yoga intervention. The high-dose group had three 90-minute yoga classes each week along with home practice, while the low-dose group engaged in two 90-minute yoga sessions each week in addition to home practice.

The participants practiced Ilyengar yoga, a method that focuses on detail, precision and alignment in posture and breath control.

The study found that both groups had significant reductions in their depression symptoms. Those who took three weekly yoga classes had fewer depressive symptoms than those in the "low-dose" group, but Streeter's team said even two classes a week was still very effective in improving people's mood.

Streeter noted that this intervention targets a different neurochemical pathway in the body than mood-altering medications, suggesting that yoga may provide a new, side effect-free avenue for treatment.

For his part, Manevitz called the study "practical and well-designed." He believes the findings support yoga as a treatment "that can help the millions of people suffering from major depressive disorders around the world."

Dr. Victor Fornari is a psychiatrist at Zucker Hillside Hospital in Glen Oaks, N.Y. He agreed that the new study "supports the use of yoga for the treatment of depression... Yoga, like regular exercise, is good for most people for health maintenance as well as to treat what ails them."

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.

This week marks the second anniversary of my writing this blog.  It’s a good chance to remember why I write the blog, what it has meant to me, and to think about what’s ahead.  I originally wanted to write because the original site, HealthTalk.com, helped me immensely with their psoriasis web content.  I especially enjoyed the various topics presented in the monthly webcast.   By writing I believed I could bring my own story and perspective to the discussion of how to live with and treat psoriasis.  At that time I also felt down about many aspects of my life, including psoriasis.  With no end in sight managing this disease I wondered if anything good could be redeemed from the experience.  If I could help one other person feel like they are not alone in battling psoriasis, if anyone could benefit from my trial and errors with medications, or if caregivers could understand the different dimensions of living with psoriasis then writing would be worth it.  Finally, I wanted a community I could share the struggles with and how better to find one than to help create one?

People with psoriasis may be twice as likely to experience depression as those without the common skin condition, regardless of its severity, a new study suggests.

"Psoriasis in general is a pretty visible disease," said study author Dr. Roger Ho, an assistant professor of dermatology at New York University School of Medicine in New York City. "Psoriasis patients are fearful of the public's stigmatization of this visible disease and are worried about how people who are unfamiliar with the disease may perceive them or interact with them."

Genetic or biologic factors may also play a role in the link between depression and psoriasis, which requires more research, he said. Either way, the findings mean that all individuals with psoriasis could benefit from screening for depression, Ho said, and their friends and family members should be aware of the connection as well.

The findings were scheduled for presentation Thursday at an American Academy of Dermatology meeting in New York City. They have not yet been published in a peer-reviewed journal and should be considered preliminary.

Most people with psoriasis have red, raised patches of skin covered with silvery-white scales, the researchers noted. These patches usually appear on the scalp, elbows, knees, lower back, hands and feet.

The researchers analyzed the responses of more than 12,000 U.S. adults in the 2009-2012 National Health and Nutrition Examination Survey conducted by the U.S. Centers for Disease Control and Prevention.

Overall, nearly 3 percent of responders reported that they had psoriasis, and about 8 percent had major depression based on their answers to a depression screening assessment. Among those with psoriasis, 16.5 percent had sufficient symptoms for a diagnosis of major depression.

Those with any degree of psoriasis had double the odds of having depression even after taking into account their age, sex, race, weight, physical activity level, alcohol use and history of heart attack, stroke, diabetes and smoking, the researchers said.

Depression is one of several concerns that someone with psoriasis should look out for, said Dr. Delphine Lee, a dermatologist at John Wayne Cancer Institute at Providence Saint John's Health Center in Santa Monica, Calif.

"Patients with psoriasis should be aware that there are several other health issues associated with this condition, including cardiovascular and metabolic diseases, such as diabetes, as well as psychological or psychiatric disorders," Lee said. "To address your health beyond your skin is critical to maximizing a person's quality of life."

Several aspects of dealing with psoriasis may contribute to depression, said Dr. Doris Day, a dermatologist at Lenox Hill Hospital in New York City.

RELATED: 7 Hidden Dangers of Psoriasis

What matters more than its severity is the location of flare-ups, she said. Some of her patients won't wear shorts if it's on their legs or won't go on dates because they're embarrassed about red spots on their skin, she added.

"Also, because it's a chronic illness, you don't know if it's going to get worse and you don't get to take a vacation from it either," Day said. "You're using topical treatments all year long, and as soon as you stop, it comes right back. It's very depressing, and it can affect your self-esteem and your quality of life."

Anxiety about how psoriasis and its treatment may affect your future health might also contribute to depression, Day explained.

"It's unsightly, it can be itchy, people are worried about it spreading to other parts of their body, they worry about the side effects of medication, they worry about psoriatic arthritis, they worry about taking medications when they're pregnant, and they worry about passing it along to their children," she said.

Day recommended that people with psoriasis seek mental health treatment to get to the bottom of their depression.

"It's about that emotional connection and finding out what about this condition is affecting someone in the way that it is," Day explained.

Not seeking help can make matters worse, said Dr. Tien Nguyen, a dermatologist at Orange Coast Memorial Medical Center in Fountain Valley, Calif.

"Psoriasis can cause severe emotional distress," he said, noting some patients may have suicidal thoughts or attempt suicide. "Stress is a known cause of exacerbation of psoriasis, so this will lead to a vicious cycle."

Day added that it's critically important to continue seeing a dermatologist to learn about new medications that become available.

"There are some really amazing new treatments that have a great safety profile that can have excellent clearance with lasting results," Day said.

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It's unclear what causes binge eating disorder.

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

Some risk factors for binge eating disorder include:

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

Symptoms of Binge Eating Disorder

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

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

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

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

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

Binge Eating Disorder Treatment

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

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

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.

A small study found that the drug worked quickly in people with major depression.

Low doses of the anesthetic ketamine may quickly reduce suicidal thoughts in people with long-standing depression, a small study suggests.

By the end of three weeks of therapy, most of the 14 study volunteers had a decrease in suicidal thoughts and seven ended up not having any such thoughts, the researchers found.

To get into the study, patients had to have had suicidal thoughts for at least three months, plus persistent depression. "So, the fact that they experienced any reduction in suicidal thinking, let alone remission, is very exciting," said lead researcher Dr. Dawn Ionescu, an instructor in psychiatry at Harvard Medical School in Boston.

Despite these results, many mysteries still remain about the drug, Ionescu said. For example, "we don't know yet how the drug works," she said. "In addition, we do not know if the doses of ketamine being used for depression and suicide will lead to addiction -- more research is needed in this area."

The study used only intravenous ketamine, but oral and intranasal doses may also work, she added.

Whether ketamine might ever become a standard therapy for depression and suicidal thoughts is also up in the air. "That is something we need to investigate," Ionescu said.

All of the study volunteers were being treated for major depressive disorder on an outpatient basis. They had all been experiencing suicidal thoughts for three months or more, and were resistant to other treatments, the researchers said. Eleven of the 14 volunteers were female, and their mean age was 50 years.

Ketamine, which is primarily an anesthetic, had been shown in other studies to quickly relieve symptoms of depression, Ionescu said.

For the study, two weekly intravenous infusions of ketamine were given over three weeks. The first three doses of ketamine were five times lower than typically given when the drug is used as an anesthetic. After initial treatment, the dose was increased.

RELATED: How to Create a Depression Treatment Plan

Patients were checked before, during and after treatment, and every other week during three months of follow-up. Assessments included measurement of suicidal thinking, in which patients were asked how frequent and how intense their suicidal thoughts were, the study authors said.

Of the seven patients who stopped having suicidal thoughts, two continued to be free of both thoughts of suicide and symptoms of depression during the three-month follow-up, the findings showed.

No serious side effects from the drug were seen, the researchers said.

"The most common side effects are an increase in heart rate and blood pressure, and changes in the way people perceive their environment. For example, some people will dissociate and feel like their environment looks different or that parts of their body look different. Generally, the side effects are mild and only last for one to two hours," Ionescu said.

Two patients dropped out of the study. One dropped out because of the drug's side effects, and the other had a scheduling conflict, the researchers said.

All of the patients knew they were getting ketamine. The researchers are now finishing up a study in which some patients received the drug and others got a placebo.

Drugs currently used to treat suicidal thinking include lithium and clozapine, but these drugs can have serious side effects requiring careful monitoring of blood levels. Electroconvulsive therapy can also reduce suicidal thoughts, but its availability is limited and it can have serious side effects, such as memory loss, the researchers explained.

Cognitive behavioral therapy, a type of "talk" therapy, can also be an effective treatment for suicidal thinking, but may take weeks to months to be effective, the study authors pointed out.

Dr. Ami Baxi is director of adult inpatient services in the department of psychiatry at Lenox Hill Hospital in New York City. She said, "Ketamine, often used as an anesthetic in medicine, has been recently shown to cause a rapid antidepressant effect and reduce suicidal thoughts in patients with treatment-resistant depression."

However, this study has many limitations, she added. First, it was a very small study and "only two of the 14 patients were able to maintain this reduction three months after the infusion," Baxi said.

Second, patients knew they were receiving ketamine, "leaving them exposed to a possible placebo effect," she explained.

Baxi agreed this is a promising study, but it's too early to know the effects of ketamine on suicidal thinking. "Additional studies remain essential to enhance our knowledge on the psychiatric benefits of ketamine," she said.

The report was published in the May 10 online edition of the Journal of Clinical Psychiatry.

Exposure therapy isn’t just a treatment for post-traumatic stress disorder. It’s also used to treat anxiety, depression, phobias, and more.

If you’ve experienced a traumatic, life-altering event, you might be surprised to learn that one treatment for such trauma — exposure therapy — involves repeatedly reliving the terrible event.

Sounds more harmful than helpful, right? But people who experience their fears over and over again — with the help of a therapist in exposure therapy — can actually learn to control those fears.

The technique is used to treat a growing list of health conditions that include anxiety, phobias, obsessive compulsive behaviors, long-standing grief, and even depression.

How Exposure Therapy Works

Exposure therapy can seem similar to desensitization. People with PTSD, including combat veterans and rape and assault survivors, may experience nightmares and flashbacks that bring the traumatic event back.

They may also avoid situations that can trigger similar memories and may become upset, tense, or have problems sleeping after the trauma.

Edna B. Foa, PhD, director of the Center for the Treatment and Study of Anxiety at the University of Pennsylvania in Philadelphia, explains exposure therapy for PTSD to her patients this way: "We are going to help you talk about the trauma so that you can process and digest it, and make it finished business."

While you won't forget about the trauma entirely, she tells them, ''It’s not going to haunt you all the time."

Dr. Foa reassures her patients that they won't be exposed to dangerous situations. She also tells them, "You are going to find out that you are stronger than you think."

Although exposure therapy is considered a short-term treatment — 8 to 12 sessions is common — people with more severe conditions (and those with obsessive-compulsive behaviors) may need more time.

Exposure Therapy Works for Many Conditions

For PTSD, says Matthew Friedman, MD, PhD, senior adviser for the Department of Veterans Affairs' National Center for PTSD, and professor of psychiatry, pharmacology, and toxicology at Dartmouth College's Geisel School of Medicine in Hanover, New Hampshire, "It’s one of the best treatments we have.” A 2007 report from the Institute of Medicine also found the technique to be effective for PTSD.

Foa published a study in the Journal of Consulting and Clinical Psychology that showed a reduction in depression and PTSD symptoms in female survivors of assault after 9 to 12 sessions.

And a 2014 study in JAMA Psychiatry found that adding exposure therapy to cognitive behavioral therapy (CBT) was more effective at relieving long-standing grief than CBT plus supportive counseling.

Effective, But Different, as a Depression Treatment

While research is still ongoing, some experts believe exposure therapy can be helpful for serious depression, too. Depression and PTSD share common features, like flashbacks and memory flooding, says Adele Hayes, PhD, professor of psychology at the University of Delaware in Newark. But there are some important differences, too.

“With depression, it's not necessarily a trauma, but a whole store of memories associated with being a failure, worthless, and defective," she says. A depressed person’s encounter with a rude clerk at a store may trigger thoughts that seem to back up their fears: that no one likes them, that they are worthless, and so on.

RELATED: 6 Life-Changing Tips From People Living with Depression

In 20 to 24 sessions of exposure therapy, Hayes persuades her patients with depression to reexamine the events that trigger their ''worthless'' messages. Then she asks them to see if they can reinterpret them in a more positive light. Next, she helps them build up what she calls the ''positive emotion system."

But some people with depression may be fearful of having positive emotions, she says. Paradoxically, if they start to have hope, they may begin to fear that things may fall apart again and get more depressed.

Getting Started With Exposure Therapy

"The first few sessions are distressing," says Foa, but the distress of exposure therapy usually lasts for only three or four weeks. Plus, patients usually work their way up to scarier situations by first tackling challenges that are somewhat less scary. For instance, someone with a social phobia or fear of public places may be advised to go to a supermarket during a time when it’s not busy. After that, they may visit the store when it’s more crowded. At first, it's natural to feel upset, Foa says. But "if you stay long enough, the anxiety will go down," she says. "In the beginning, you’re afraid you won't be able to tolerate it, but in the end, you’re a winner."

Homework is an important part of exposure therapy, so you’ll also do exercises outside of your sessions, Dr. Friedman says. This could include listening to a recording of your account of the trauma or performing a task that could trigger memories of the event. At your next visit, you’d talk through your experiences with your therapist.

Before you begin exposure therapy, make sure to get a clear explanation of what to expect from the therapist you’re working with.

To find an exposure therapy specialist, start by asking your family doctor for a referral, or contact organizations like the American Psychological Association or the Association for Behavioral and Cognitive Therapies that can help you locate one. Veterans can contact their local VA clinic for more information.

Diabetis

The list price of these newer drugs is upwards of $14,000 a year per patient.Getty Images
Are new medicines for people with out-of-control cholesterol wildly overpriced? It's a question that's sparking debate among consumers and providers of care.

Now, researchers at the University of California, San Francisco (UCSF) report that the price of these drugs -- called PCSK9 inhibitors -- would have to be slashed by a whopping 71 percent to be deemed cost-effective.

PCSK9 inhibitors are a relatively new class of medicines for treating patients whose LDL (bad) cholesterol isn't well-controlled on statins or who cannot tolerate statins. Lipitor (atorvastatin) and Crestor (rosuvastatin) are examples of first-line statins doctors typically prescribe to patients with high cholesterol.

The UCSF team didn't question whether these new medicines are effective in reducing heart attacks and strokes.

"These are super awesome drugs, they really work," said study co-author Dr. Kirsten Bibbins-Domingo.

But the price is "far in excess" of what would be considered a reasonable cost for the clinical benefit they provide, added Bibbins-Domingo, a UCSF professor of medicine, epidemiology and biostatistics.

The list price of these newer PCSK9 drugs is upwards of $14,000 a year per patient.

Dr. Kim Allan Williams, who was not involved in the study, is past president of the American College of Cardiology. He said some doctors have a difficult time with such studies because they compare patients' lives and "events" — such as heart attack and stroke — versus dollars spent on these medicines.

The new study doesn't change his view of the value of the PCSK9 inhibitor class.

"No one's giving those drugs unless the patient is incapable of getting to the target [level of LDL cholesterol]," said Williams, who is chief of cardiology at Rush University Medical Center in Chicago. "You're only going to use it for a situation where you have no choice."

RELATED: 8 Foods That Can Cause High Cholesterol

Because the study is based on list prices, not what patients actually pay, it's also "difficult to analyze the cost-effectiveness when [you] don't know exactly what the cost is," Williams added.

He said he's had patients with copays of $380 a month and others who had zero copays because the cost was completely covered by insurance. He worries, though, that poor patients may not be offered the same access to these medicines.

The CSF researchers designed the study to find out how much bang for the buck these drugs actually provide.

Their study updates a prior cost-effectiveness analysis using current list prices as well as results of a recent clinical trial. That trial demonstrated the clinical effectiveness of Repatha (evolocumab), one of two PCSK9 inhibitors approved by the U.S. Food and Drug Administration, in reducing the risk of heart attack and stroke.

Based on a simulation involving 8.9 million adults who would meet trial criteria, adding PCSK9 inhibitors to statins would prevent 2.9 million more heart attacks and strokes compared with adding Zetia (ezetimibe), another type of medication that blocks the production of cholesterol by the liver.

But the PCSK9 inhibitor class is not cost-effective based on a threshold of $100,000 for each life year gained, the study authors contend. They found that you would have to spend $450,000 per year to get one extra year of life per year.

"The price would have to be between $4,000 and $5,000 [per year] for it to be cost-effective," said Bibbins-Domingo. "If you look in other countries, in Europe, for example, that is in fact where this drug is priced."

Dr. Josh Ofman, senior vice president of global value, access and policy at Amgen Inc., the maker of Repatha, took issue with the findings. "We think that their model is deeply flawed," he said.

The study was based a 3 percent per-year rate of heart attacks and strokes, while other studies use much higher rates — more than three times higher — based on "real-world" data, Ofman said. The study is modeling a population that's not having many heart attacks and strokes, he said.

Ofman also questioned the threshold for determining cost-effectiveness that the UCSF researchers used. He said other organizations use a minimum of $150,000 per quality-adjusted life-year saved.

As for the price differential between the United States and Europe, Ofman cited many factors, from government price controls to how those countries price these drugs.

Amgen isn't alone in its criticism of how these medicines are valued. Earlier this month, several national provider and payer groups raised concerns about how the PCSK9 inhibitors are valued in a letter to the nonprofit Institute for Clinical and Economic Review, which assesses the value of new medicines.

More than a dozen organizations, including the National Forum for Heart Disease & Stroke Prevention, the American Pharmacists Association Foundation and the American Society for Preventive Cardiology, signed the letter citing concerns ranging from the types of patients that could benefit from these drugs to the importance of preventing heart attacks and strokes — not just deaths.

"The big controversy about all these types of analyses is what we're willing to value a patient's year of life at," Ofman said.

The new study was published in the Aug. 22/29 issue of the Journal of the American Medical Association.

The active ingredient in "magic mushrooms" may help patients with tough-to-treat depression, a new study suggests.

Twenty patients received psilocybin -- the psychoactive compound in a group of mushrooms that cause hallucinations. Nineteen who completed the study showed improvement in their depression symptoms for up to five weeks after treatment, according to the researchers at Imperial College London.

None had responded to traditional depression treatment, they noted.

"We have shown for the first time clear changes in brain activity in depressed people treated with psilocybin after failing to respond to conventional treatments," said study leader Robin Carhart-Harris, head of psychedelic research at Imperial.

However, his team emphasized that patients with depression should not try to self-medicate with magic mushrooms. While these results are promising, the study was small and did not include a comparison group of patients who did not receive psilocybin, they noted.

Still, brain scans before and after treatment suggest psilocybin may reset the activity of brain circuits that play a role in depression.

"Several of our patients described feeling 'reset' after the treatment and often used computer analogies," Carhart-Harris reported in a college news release. One said he felt like his brain had been "defragged" like a computer hard drive, and another said he felt "rebooted," the researcher added.

RELATED: Depression May Hasten Death in Years After Heart Diagnosis

"Psilocybin may be giving these individuals the temporary 'kick-start' they need to break out of their depressive states, and these imaging results do tentatively support a 'reset' analogy. Similar brain effects to these have been seen with electroconvulsive therapy," Carhart-Harris said.

Larger studies are needed to see if this positive effect can be reproduced in more patients, said study senior author David Nutt.

"But these initial findings are exciting and provide another treatment avenue to explore," said Nutt, director of neuropsychopharmacology in the division of brain sciences.

He added that a trial scheduled to start early in 2018 will test the psychedelic drug against a leading antidepressant.

For this latest study, patients received two different doses of psilocybin, one week apart.

In recent years, promising results have emerged from a number of clinical trials testing the safety and effectiveness of psychedelics in patients with conditions such as depression and addiction.

"Psilocybin can be a promising agent for depression," said Dr. Scott Krakower, assistant unit chief of psychiatry at Zucker Hillside Hospital, in Glen Oaks, N.Y. "For decades, there has been suspected benefit of psychedelic agents for the treatment of psychiatric and neurological disorders."

However, he said, the clinical trials to date have been very small, and without a placebo arm for comparison. He agreed that replication in larger studies is warranted.

The study was published Oct. 13 in the journal Scientific Reports.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

RELATED: Why Depression Is Underreported in Men

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

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

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

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

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

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

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

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

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

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

Everyday Health: What causes hyperpigmentation?

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

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

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

EH: What steps can you take to treat it?

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

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

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

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

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

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