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Feb 29

Friends are a matter of life and death


We are such a cynical lot. When a Downing Street advisor points out that loneliness is probably more dangerous to our health in retirement than smoking, there are plenty who immediately assume that the advice is part of some dastardly statist plot to get pensioners out of their one-bed flats to sweat their final years away on a factory production line – see below for one example.

But might it be true? And if it is, should we take isolation as seriously as we do obesity or smoking in our health strategies?

The findings which inspired David Cameron’s nudge unit come from a meta-analysis (analysing lots of different pieces of existing research) of 148 studies into the effects of social isolation on mortality in the US. The researchers were able to look at the lives of almost 309,000 people for an average of 7.5 years. (That is a seriously big sample.)

What emerged was that those with stronger social relationships had a 50% increased likelihood of survival than those who lived more solitary lives. (And that is a seriously powerful finding.)

The effect was consistent across a number of factors:

  • age
  • sex
  • health status
  • follow-up period
  • cause of death

This isn’t research showing that pensioners are better off having friends – it suggests that we are all likely to enjoy health benefits if we have busy social lives.

The ‘dastardly statist plot’ view
Political blogger Anna Raccoon writes: “It’s official. There is a peril more likely to carry you off to your maker in the wee small hours of the morn than smoking. It must be so, the government says it is so.No, it’s not eating more than three pomegranates a week, nor taking a bath with less than five people. Give up?

It’s enjoying a peaceful retirement. Quit yer laughing, they’re deadly (sic) serious. They are forming government policy round this notion as we speak.”

No-one is suggesting it is wrong to live alone or enjoy one’s own company. But human beings are social creatures and starved of contact we can, quite literally, die.

The conclusion to the US research makes the point that “many decades ago high mortality rates were observed among infants in custodial care (ie, orphanages), even when controlling for pre-existing health conditions and medical treatment”.

It was then noticed that lack of human contact predicted mortality. “The medical profession was stunned to learn that infants would die without social interaction. This single finding, so simplistic in hindsight, was responsible for changes in practice and policy that markedly decreased mortality rates in custodial care settings.”

Loneliness is bad for our health. Seriously bad. Doctors have known this for decades. Friendship can make the heart grow stronger

An article in Science magazine in 1988 noted that “social relationships, or the relative lack thereof, constitute a major risk factor for health – rivalling the effect of well-established health risk factors such as cigarette smoking, blood pressure, blood lipids, obesity and physical activity”.

The more recent research concludes that, if the impact of isolation is potentially so great on our health, we should do more to prevent it. “Medical care could recommend if not outright promote enhanced social connections; hospitals and clinics could involve patient support networks in implementing and monitoring treatment regimens and compliance, etc.”

Feb 29

Perfectionism and depression have been shown to be closely related, with perfectionism being a predictor of depressive symptoms. In a romantic relationship, expectations of perfectionism can lead to hostility, criticism, and resentment. These emotions cause harm to the intimacy and closeness needed to maintain a healthy union and often result in conflict. A healthy intimate relationship provides many psychological and physical benefits, and is vital to one’s well-being. The cycle of perfectionism and conflict diminishes the resources needed to maintain this balance and can cause partners to withdraw and experience depressive symptoms. Additionally, individuals who suffer with depression may be seen as imperfect to their mates, setting the stage for future conflict, which eventually leads to further depressive symptoms. Identifying the role that each of these behaviors and emotions plays in the cycle is important to more effectively treat partners experiencing difficulty within their relationships.

To address this dilemma, Sean P. MacKinnon of the Department of Psychology at Dalhousie University in Halifax tested the level of social disconnect in over 200 heterosexual couples. He looked specifically at perfectionism, conflict, and measures of depression in a 28-day period. MacKinnon found that perfectionist expectations led to depression by way of conflict. In other words, when perfectionism was not met, couples fought, and each felt more depressed after. MacKinnon also discovered that depression was a cause and an effect of conflict. The behaviors of depressed individuals; irritability, withdrawal, isolation, and fatigue, increased the hostility within the relationships and caused more fights, which in turn led to more depressive symptoms.

Individuals with high perfectionist ideals were more likely to engage in conflicts with their partners, which led to a greater breakdown of respect and intimacy, two factors necessary to conflict resolution in relationships. Although the results of this study clearly demonstrate a vicious cycle, MacKinnon believes that there is hope for partners struggling with perfectionism. He added, “By better understanding how perfectionistic concerns confer vulnerability to depressive symptoms, we can develop greater understanding—and ultimately, better assessment and treatment options—for people suffering from depressive symptoms.”

Feb 29

New safety warnings on statins like Zocor, above, cite increased risks of memory loss and diabetes.

The Food and Drug Administration (FDA) added new safety warnings to cholesterol-reducing statin drugs on Wednesday, noting increased risks of Type 2 diabetes and memory loss for patients who take the medications.

The changes to the prescribing information apply to the class of statins, including many popularly prescribed drugs such as Lipitor (atorvastatin), Crestor (rosuvastatin), Zocor (simvastatin) and Vytorin (simvastatin/ezetimibe). The new warnings are based on results from the latest clinical trials and reports of adverse events from patients, physicians and drugmakers.

The FDA said that statins may increase users’ risk of brain-related effects like memory loss and confusion. The reports have generally not been serious, however, and the symptoms go away once the drug is stopped, the agency said.

Statins’ labels will now also warn patients and doctors that the drugs may cause a small increase in blood sugar levels and Type 2 diabetes — an effect that has been shown previously in studies. Type 2 diabetes can further increase the risk of heart disease.

In addition, the FDA made a label change specific to Mevacor (lovastatin). Mevacor can interact with other drugs, increasing the risk for muscle pain and weakness, another side effect that has previously been associated with high-dose statin use. Other drugs may raise such risks by increasing the amount of statins in the blood, and the FDA warned that Mevacor should not be taken with protease inhibitors, which are used to treat HIV, certain antibiotics and some anti-fungal medications.

At the same time, the statins’ labeling will no longer require the routine monitoring of patients’ liver enzymes, which was originally intended to alert doctors if the medications were becoming toxic and starting to damage the liver. The FDA concluded that such serious damage is rare, and regular testing for all users isn’t necessary. The agency now recommends that liver enzyme tests be performed before starting statin therapy, and as clinically indicated thereafter.

MORE: Who Should Take Statins? The Debate Continues

Despite the new safety warnings, the agency said patients should not be scared off statins. “The value of statins in preventing heart disease has been clearly established,” said Dr. Amy G. Egan, deputy director for safety in the FDA’s division of metabolism and endocrinology products, in an agency statement. “Their benefit is indisputable, but they need to be taken with care and knowledge of their side effects.”

But some experts worried that the labeling changes would result in unnecessarily alarming patients and causing some who may benefit to shy away. “I do not believe there is enough hard evidence to justify information and warnings about memory loss and confusion or increase in blood sugar,” Dr. Scott Grundy of the University of Texas Southwestern Medical Center told MedPage Today. “I also think that these warnings will cause some people who need statins to stop taking them. That would be unfortunate.”

In general, however, experts tended to support the FDA’s action, noting that while the potential diabetes and cognitive side effects were rare, they should still be highlighted to doctors and patients. “These are reasonable and prudent recommendations,” Dr. Steven Nissen of the Cleveland Clinic also told MedPage Today. “I am pleased that FDA did not overstate the diabetes and cognitive function risks. Both problems are uncommon and don’t diminish the importance of statins in cardiovascular protection. For the vast majority of patients, the benefits far outweigh the risks.”

Dr. Gordon Tomaselli, president of the American Heart Association noted people concerned about their cholesterol levels should always focus on prevention through lifestyle changes first, trying drug treatment only if their physicians recommend it. “As with all therapies, the decision to use statins for primary or secondary prevention must include careful consideration of the risks and benefits, side effects and cost,” Tomaselli said in a statement. “The FDA’s announcement on the label changes does not question the benefit of statins to lowering cholesterol, but it does provide patients and healthcare providers the most current information about the safe use of statins.”

Feb 29

Stress Changes How People Make Decisions


ScienceDaily (Feb. 28, 2012) — Trying to make a big decision while you’re also preparing for a scary presentation? You might want to hold off on that. Feeling stressed changes how people weigh risk and reward. A new article published in Current Directions in Psychological Science, a journal of the Association for Psychological Science, reviews how, under stress, people pay more attention to the upside of a possible outcome.

It’s a bit surprising that stress makes people focus on the way things could go right, says Mara Mather of the University of Southern California, who cowrote the new review paper with Nichole R. Lighthall. “This is sort of not what people would think right off the bat,” Mather says. “Stress is usually associated with negative experiences, so you’d think, maybe I’m going to be more focused on the negative outcomes.”

But researchers have found that when people are put under stress — by being told to hold their hand in ice water for a few minutes, for example, or give a speech — they start paying more attention to positive information and discounting negative information. “Stress seems to help people learn from positive feedback and impairs their learning from negative feedback,” Mather says.

This means when people under stress are making a difficult decision, they may pay more attention to the upsides of the alternatives they’re considering and less to the downsides. So someone who’s deciding whether to take a new job and is feeling stressed by the decision might weigh the increase in salary more heavily than the worse commute.
The increased focus on the positive also helps explain why stress plays a role in addictions, and people under stress have a harder time controlling their urges. “The compulsion to get that reward comes stronger and they’re less able to resist it,” Mather says. So a person who’s under stress might think only about the good feelings they’ll get from a drug, while the downsides shrink into the distance.
Stress also increases the differences in how men and women think about risk. When men are under stress, they become even more willing to take risks; when women are stressed, they get more conservative about risk. Mather links this to other research that finds, at difficult times, men are inclined toward fight-or-flight responses, while women try to bond more and improve their relationships.
“We make all sorts of decisions under stress,” Mather says. “If your kid has an accident and ends up in the hospital, that’s a very stressful situation and decisions need to be made quickly.” And, of course, big decisions can be sources of stress all by themselves and just make the situation worse. “It seems likely that how much stress you’re experiencing will affect the way you’re making the decision.”

Feb 29

Be A Better Dad



Any father can learn to be a better dad. But it takes a commitment — and desire — to focus on one of the more important areas in your life. An involved dad is a better dad — one a child will appreciate not only as a kid, but in fond memories as they progress into adulthood. Children with involved fathers will grow up to be happier, better able to cope with life’s troubles, and healthier than children who have absent or uninvolved dads.

Being a better dad doesn’t mean you have to change who you are, though. It simply means paying attention to the important moments in your child’s life, and being there for both them and the family when needed.

Whether you’re married, divorced, or never married, it’s important to realize that children need both parents involved in their lives. Fathers who spend time with their children increase the chances that their children will succeed in school, have fewer behavior problems, and experience better self-esteem and well-being.

Click through to read the tips to improve your standing as a dad in your children’s life.

1. Spend time with your children.

Yes, it’s important to be there for your children for important events in their lives. But it’s even more important to be there for everyday things — such as dinner every night, and the weekends, and every moment in-between. Quality time is more important than sharing TV time, but any time is better than very little.

Somebody once said that showing up is 80 percent of life. It’s probably just as true for parenting. If you’re there and spending time with them, they’ll remember and appreciate it. If, on the other hand, you always seem too busy for your children, they will feel neglected no matter what you say.

2. Be a role model.

Fathers are role models whether they realize it or not. A girl with a loving father grows up knowing she deserves to be treated with respect. Fathers can teach sons what is important in life by demonstrating honesty, humility, and responsibility.

3. Eat or cook together as a family.

Sharing a meal together has been an important part of healthy family life since the beginning of time. It remains an important idea even in this modern, technological age. Why? It gives children the chance to talk about what they are doing in their lives and in school, making it an excellent time for fathers to listen and give advice.

In this day and age, moms aren’t the only ones doing the cooking. Fathers can take to the kitchen and share cooking time with their children, just as moms have done for centuries.

4. Don’t be afraid to show affection.

Sometimes dads learn from their own upbringing that showing affection isn’t a part of being a man. That’s both sad and wrong.

Yet sometimes a man still has difficulty showing outward affection to their loved ones — even to their children. Children need the security that comes from knowing they are wanted, accepted, and loved by their family. Showing affection every day — even a quick hug, pat on the back, or kiss on the cheek — is the best way to let your children know that you love them.

5. Respect your children’s mother.

Regardless of whether you have a relationship with the child’s mother, it’s important to show them the same kind of respect you should any other adult. Children pick up on far more than we think about relationships — especially between their parents.

When children see their parents respecting each other, they are more likely to feel that they are also accepted and respected. Your relationship with their mother is the model for all future romantic relationships for the child. It doesn’t have to be perfect, but it does have to be respectful.

6. Set fair rules, and discipline with love and restraint.

One fault of modern parenting is the lack of clear boundaries between many parents and their children, along with an accompanying set of clear rules, and timely, fair discipline. Children are not simply miniature adults who can be reasoned with in a rational manner. That’s why they (and you) will appreciate clear rules and fair discipline.

All children need guidance and discipline, not as punishment, but to set reasonable limits and help children learn from natural or logical consequences. Fathers who discipline in a calm, fair, and nonviolent manner show their love.

7. Be a kind, patient teacher.

Children need good teachers and nobody is a better teacher than you. Teaching comes in all forms — not just helping your child with their homework. Begin talking with your kids when they are very young and talk to them about all kinds of things. Listen to their ideas and problems.

A father who teaches his children about right and wrong and encourages them to do their best will see his children make good choices. Involved fathers use everyday examples to teach the basic lessons of life.

8. Read to your children.

Children thrive on their imaginations, and nothing reaches their imagination more than a book. Begin reading to your children when they are very young. Instilling a love for reading is one of the best ways to ensure they will have a lifetime of interest in their imagination, leading to increased personal and career growth.

* * *

These tips are just the start of becoming a better father. It requires a simple, but ongoing commitment on your part — a commitment that lasts their entire childhood. Even as they age into young adults, a dad’s work is never really done. Even after children are grown and leave home, they will still look to their fathers for wisdom and advice.

Fatherhood really does last their lifetime. That’s why it’s important to make it count early on.

Feb 28

Young? Female? Stressed.


by Nursetopia on February 25, 2012

Younger Americans – those between the ages of 18 to 34 – are more stressed than any other age group, according to a new Polaris Marketing Research study. In addition, a new American Psychological Association study, Stress in America, explains women are stressed more than their male counterparts and are more likely to exhibit psychosomatic symptoms of stress such as headaches, upset stomach, or crying.

What intrigues me most about these two studies is the level of stress young women normally have – without any illness or chronic disease. The adolescent and young adult population, or those between the ages of 15 to 39, are the largest uninsured population in the U.S., and when a life-threatening illness, such as cancer, impacts them, it can be biopsychosocially devastating. Distress related to illness can only compound the normal stress of this population. Nurses and other healthcare professionals need to be aware of this and take actions, such as education, ongoing encouragement, and connection to resources, to reduce stress and distress in their younger, specifically female, patients.

Feb 28

Stress Changes How People Make Decisions


Trying to make a big decision while you’re also preparing for a scary presentation? You might want to hold off on that. Feeling stressed changes how people weigh risk and reward. A new article published in Current Directions in Psychological Science, a journal of the Association for Psychological Science, reviews how, under stress, people pay more attention to the upside of a possible outcome.

It’s a bit surprising that stress makes people focus on the way things could go right, says Mara Mather of the University of Southern California, who cowrote the new review paper with Nichole R. Lighthall. “This is sort of not what people would think right off the bat,” Mather says. “Stress is usually associated with negative experiences, so you’d think, maybe I’m going to be more focused on the negative outcomes.”

But researchers have found that when people are put under stress—by being told to hold their hand in ice water for a few minutes, for example, or give a speech—they start paying more attention to positive information and discounting negative information. “Stress seems to help people learn from positive feedback and impairs their learning from negative feedback,” Mather says.

This means when people under stress are making a difficult decision, they may pay more attention to the upsides of the alternatives they’re considering and less to the downsides. So someone who’s deciding whether to take a new job and is feeling stressed by the decision might weigh the increase in salary more heavily than the worse commute.

The increased focus on the positive also helps explain why stress plays a role in addictions, and people under stress have a harder time controlling their urges. “The compulsion to get that reward comes stronger and they’re less able to resist it,” Mather says. So a person who’s under stress might think only about the good feelings they’ll get from a drug, while the downsides shrink into the distance.

Stress also increases the differences in how men and women think about risk. When men are under stress, they become even more willing to take risks; when women are stressed, they get more conservative about risk. Mather links this to other research that finds, at difficult times, men are inclined toward fight-or-flight responses, while women try to bond more and improve their relationships.

“We make all sorts of decisions under stress,” Mather says. “If your kid has an accident and ends up in the hospital, that’s a very stressful situation and decisions need to be made quickly.” And, of course, big decisions can be sources of stress all by themselves and just make the situation worse. “It seems likely that how much stress you’re experiencing will affect the way you’re making the decision.”

Feb 28

Omega-3s helps depression


By Christine Stapleton

According to Dr. Freeman’s presentation, meta-analysis of Omega-3 fatty acids, studied as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA but not the plant source alpha-linolenic acid) show benefit over placebo for unipolar and bipolar depression. Meta-analysis pools together the results of all available clinical trials because the size of individual clinical trials is too small to reliably draw a conclusion.

What does this mean? It means that Omega-3 fatty acids are important to neurocognitive development. It means that adults should consume fish, which is high in Omega-3 fatty acids at least twice a week. Dr. Freeman also recommends that patients with mood, impulse-control or psychotic disorders should consume 1 g of EPA + DHA daily. In addition, supplements may be useful in patients with mood disorders between 1-9 g per day but doses greater than 3 g per day should be monitored by a physician.

And now, a word about B vitamins and Omega-3 fatty acids. Vitamin B6 negates the effects of Omega-3s, Dr. Freeman said, who also recommended against taking B vitamins 3, 6 and 9.

As for the other complementary and alternative medicines:

  • Studies of St. John’s Wort have not been positive, Dr. Freeman said. However, there have been some favorable results in randomized controlled trials of major-depressive disorders, especially in mild to moderate major-depressive disorder. A major concern with St. John’s Wort is that it can have significant and potentially dangerous interactions with other drugs, Dr. Freeman said.
  • People with treatment resistant major depression saw significant benefits from SAMe and the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services has found enough evidence to support further research.
  • Folate has been shown to boost the response of SSRIs, such as Prozac, especially in women
  • Bright light therapy has shown significant benefit in treating Seasonal Affective Disorder but can also “rev-up the risk of mania,” Dr. Freeman said.
  • Systematic reviews and meta-analysis of acupuncture have “failed to demonstrate consistently positive results over control conditions.” While the pool of evidence is limited because of flawed methodology, there is “very inconclusive evidence at this time for efficacy,” Dr. Freeman said.
  • Finally, my favorite, exercise: “Epidemiological studies support benefits for decreased risk of depression.” In other words, just do it.
Feb 28

Irregular Heart Rhythm Linked to Memory Problems


Some People With Atrial Fibrillation May Be at Risk for Memory Problems, Dementia
By Denise Mann
WebMD Health News Reviewed by Laura J. Martin, MD

Feb. 27, 2012 — Atrial fibrillation (AF), an irregular heart rhythm, is known to increase a person’s risk of stroke. Now, new findings suggest that some people with AF who also have other heart disease risks may be more likely to develop memory problems that may make daily living more difficult.

The findings appear in the Canadian Medical Association Journal.

About 2.2 million adults in the United States have AF, according to the Heart Rhythm Society. When a person has AF, blood is not pumped efficiently through the heart and may pool and clot. If a clot dislodges and travels toward the brain, a stroke may occur.

Treatment for AF may include blood-thinning medication to decrease stroke risk.

The new findings do not apply to everyone with AF. “This study was done in a high-risk group of older people with heart attack, stroke, or diabetes,” says researcher Koon Teo, MBBCH, PhD. He is chief of the cardiology service at McMaster University Medical Centre in Hamilton, Ontario, Canada. “We don’t want people in their 30s or 40s with AF to panic.”

But “if you have AF and other risk factors, you should be aware that you may be more likely to develop [mental] problems and have difficulty taking care of yourself and performing activities associated with living independently.”

Researchers analyzed data from two studies that included more than 31,000 people from 733 centers in 40 countries. Participants were aged 55 years or older with heart disease or diabetes. Of these, 1,106 had AF when the study began. An additional 2,052 developed AF during the course of the study.

More people with AF than without showed signs of mental decline and had problems performing activities of daily living, such as showering, dressing, and feeding themselves. They were also at greater risk for being diagnosed with dementia than their AF-free counterparts.

More Research Needed

Sumeet Chugh, MD, says the new findings are intriguing, but it is too early to draw any firm conclusions about AF and risk for mental problems. He is an associate director of the Cedars-Sinai Heart Institute in Los Angeles. “This is merely an association and can’t show cause and effect,” he says.

Exactly what could cause memory problems among people with AF is not fully understood, but people with AF may have a series of tiny, undetectable strokes that could result in the mental impairment.

“It is also too early to say that treating AF can lower risk for [mental] decline among those who may be predisposed. It is possible, but we can say that for sure,” Chugh says.

Robert J. Myerburg, MD, says the new study asks many more questions than it answers. He is a cardiology professor at the University of Miami Miller School of Medicine. “The best that we can say is that there is an association, but whether AF is the cause is unclear.”

It could be the high blood pressure causing the mental decline, not the AF, for example.

The bottom line for people with AF remains the same. “Treat this condition aggressively to lower your risk for stroke,” he says.

Feb 27

Sleeping Pills Linked to Raised Risk of Death


MONDAY, Feb. 27 (HealthDay News) — Prescription sleeping pills may help you get some much needed rest at night, but using them routinely might also make it more likely that you will die or develop certain types of cancer, research suggests.

A new study suggests that those who take these medications are four times more likely to die than people who don’t take them. What’s more, the research shows that sleeping pills is also associated with a raised risk for certain cancers. The findings appear online Feb. 27 in the journal BMJ Open.

Sleeping pills linked to these risks included benzodiazepines such as temazepam; non-benzodiazepines such as Ambien (zolpidem), Lunesta (eszopiclone) and Sonata (zaleplon); barbiturates; and sedative antihistamines.

The new study only shows an association between the sleeping aids and death risk, not cause-and-effect, and many experts are urging caution in jumping to any conclusions from the findings.

The study author, however, was less reticent.

“Popular sleeping pills are associated with a shocking excess of deaths and a horrible increase in new cancers,” said Dr. Daniel Kripke, of the Scripps Clinic Viterbi Family Sleep Center, in La Jolla, Calif.

Many Americans use sleeping pills. During 2010, between one in 20 and one in 10 adults took a sleeping pill in the United States.

In the new study, Kripke’s team tracked more than 10,500 people averaging 54 years of age. These patients had a range of underlying health conditions and were prescribed sleeping pills for an average of about 2.5 years between 2002 and 2007. The researchers compared these patients’ risks for death and cancer against those of people who did not take sleeping pills.

Those who were prescribed up to 18 doses a year were 3.6 times more likely to die than their counterparts who were prescribed none, while those prescribed between 18 and 132 doses were more than four times as likely to die, the study showed. Those taking more than 132 doses a year had five times the risk of dying compared to those prescribed none. This was true regardless of age, but risks were highest among those individuals aged 18 to 55.

Specifically, there were 265 deaths among 4,336 people taking Ambien, compared with 295 deaths among the 23,671 people who had not taken sedatives or sleeping pills.

Those taking the highest doses were also at greater risk of developing several types of cancer, including esophagus, lymphoma, lung, colon and prostate cancers. Interestingly, the risks of leukemia, breast cancer, uterine cancer, bladder cancer, leukemia and melanoma were not elevated. This association was not explained away by preexisting health problems, the researchers added.

There are many known mechanisms that may explain these increased risks, Kripke stressed. For example, esophageal regurgitation may lead to esophageal cancer. These medications may also make sleep apnea worse, and they may make people more susceptible to falls and automobile crashes.

“For the particular sleeping pills studied, I do not see any time I would prescribe them,” Kripke said.

However, other experts weren’t ringing alarm bells.

Dr. Victor Fornari, director of child and adolescent psychiatry at the Zucker Hillside Hospital of the North Shore-Long Island Jewish Health System in Manhasset, N.Y., said that people who take sleeping pills should not panic. There could be many reasons for this increased risk of death that have little to do with the pills and more to do with the reasons why people take them, he explained.

“Sleep is the first thing affected when someone is under distress due to medical illness or psychological problems,” he pointed out. “These are safe and effective medications when prescribed by a physician as part of a comprehensive treatment plan.”

“Don’t stop taking these medications if you feel that you need them and are taking them with a doctor’s prescription, but be mindful that they shouldn’t be taken frivolously and there are alternatives such as avoiding napping, getting proper exercise, eliminating caffeine and doing other the kinds of things that improve sleep hygiene,” Fornari said.

But Dr. Bryan Bruno, acting chairman of the department of psychiatry at Lenox Hill Hospital in New York City, cautioned against the chronic use of sleeping pills.

“They can be dangerous and are ideally used on a temporary or short-term basis,” he said. “Chronic use should be avoided if possible, particularly because there are risks involved, including dependence. They are not benign or without risk, and should be used cautiously.”

More information

Learn more about good sleep hygiene at the National Sleep Foundation.

Feb 26

Impulsive children with attention problems tend to play more video games, while kids in general who spend lots of time video gaming may also develop impulsivity and attention difficulties, according to new research published by the American Psychological Association.

“This is an important finding because most research on attention problems has focused on biological and genetic factors rather than on environmental factors,” said Douglas A. Gentile, PhD, of Iowa State University and lead author of the study published this week in the debut issue of APA’s journal Psychology and Popular Media Culture.

Although the findings indicated that playing violent video games also can be linked to impulsivity and attention problems, the overall amount of time spent playing any type of video game proved to be a greater factor, according to the article. This was the case regardless of a child’s gender, race or socioeconomic status.

Researchers collected data from 3,034 children, ages 8 to 17 years old, over three years at 12 schools in Singapore. The children provided information about their video game playing habits by completing questionnaires in their classrooms at three intervals, each a year apart starting in grades three, four, seven and eight. They also completed psychological tests commonly used to measure attention and impulsiveness. Regarding attention, the children answered questions such as how often they “fail to give close attention to details or make careless mistakes” in their work or “blurt out answers before questions have been completed.” For the impulsivity test, they selected points they felt described themselves, such as “I often make things worse because I act without thinking” or “I concentrate easily.”

The study described attention problems as having a difficult time engaging in or sustaining behavior to reach a goal, particularly when the subject is difficult or boring. Yet previous research has found that playing video games can improve visual attention for rapid and accurate recognition of information from the environment, the authors noted.

“It is possible that electronic media use can impair attention necessary for concentration even as it enhances the ability to notice and process visual information,” Gentile said.   Understanding some of the environmental influences that video gaming may have on attention and impulsivity can help develop more effective solutions for children and parents, the authors said.

Feb 25

Ritalin Increases the Awareness of Mistakes


By TRACI PEDERSEN Associate News Editor

Individuals who take Ritalin are significantly more aware of their mistakes, according to research at the University of Melbourne.

The study, led by Dr. Rob Hester from the Department of Psychological Sciences along with colleagues at the Queensland Brain Institute, evaluated how the brain monitors performance errors – specifically those of impulse control.

Researchers discovered that a single dose of methylphenidate (Ritalin) led to much stronger activity in the brain’s error monitoring network and intensified individuals’ awareness of their own mistakes.  The drug works by increasing the levels of catecholamines in the brain.

The research shows that activity in parts of the brain that play a role in human error, including the dorsal anterior cingulate (dACC) and inferior parietal lobule (IPL), differs depending on whether a person is aware of his or her performance errors.

Researchers used functional magnetic resonance imaging (fMRI) to show that methylphenidate promoted the conscious awareness of performance errors by strengthening activation differences within the dACC and IPL for both conscious and unconscious mistakes, compared to placebo and other comparison drugs.

The results show the potential of the drug in addressing problems of awareness and insight evident in a variety of neurologic and psychiatric conditions. A weakened awareness of mistakes has been linked to loss of insight in several clinical syndromes.

“For example, in conditions such as schizophrenia and Alzheimer’s disease, poor error awareness has been associated with delusions, paranoia and has been the cause of considerable distress to patients,” said Hester.

“Failing to recognize your own error at the time can account for the difference between your recollection and the reality that confronts you. Understanding the brain mechanisms that underlie how we become conscious of our mistakes is an important first step in improving error awareness, and potentially reducing these symptoms.”

Source:  The University of Melbourne


Feb 25

3 Big Benefits of Coffee


If you like coffee and it likes you (i.e., it doesn’t give you migraines, jitters, an upset stomach, or irregular heartbeats), enjoy. Here’s why:

  1. Coffee wards off Alzheimer’s disease. Something in coffee releases a substance called GCSF that helps sweep beta-amyloid deposits (the plaque buildups seen in Alzheimer’s) out of your brain. Cut your risk of Alzheimer’s disease in half.
  2. Coffee fends off Parkinson’s. The reason isn’t clear, but the finding is consistent, and more coffee equals more protection. Protect your coffee’s antioxidants with this serving style.
  3. Coffee fights diabetes. As coffee consumption goes up, diabetes risk goes down. Specifically, risk drops about 7 percent with each daily cup. Learn how coffee helps prevent diabetes.

No time to brew a fresh pot? No worries. Instant coffee holds its own because it starts out as brewed coffee and retains some of the healthy substances. Here’s another bonus: Instant has two-thirds more fiber. Yep, believe it or not, a 12-ounce cup of instant coffee contains about 3 grams of fiber, versus about 1.8 grams in brewed.(Coffee doesn’t just come in a cup. Check out these scrumptious coffee recipes fromEatingWell.)

Don’t like coffee? Here’s how to get its benefits without touching the stuff.

Feb 24

Teen Depression and Resources To Help


By Erika Krull, MS, LMHP
This is a follow-up to the previous post about bullying and suicide risk in teens.  When highlighting that specific area of concern about our teen population, I thought it made sense for you to have some more detailed information and some solid resources.

Normal Moodiness and Support for Depression

Since teenage boys and girls are famous for their moodiness, it should come as no surprise that nearly 20% of teens will develop depression before they reach adulthood.   Doesn’t it make sense, though?  They’re exploring the many joys and hazards of romantic relationships (plus those unruly hormones), are trying to find their way between childhood and adulthood, while going through massive changes in their brain.

While general moodiness and emotional swings are considered fairly normal for these kids, clinical depression is not.  It’s a problem that needs effective treatment.  You may not be able to remove all the hurdles in your teen’s life, but you can help them get through the rough times when they need you most.  And they do need you, even if they believe you are somehow part of their problem (rightfully or not).  When you show that you are there for them in an open unwavering sort of way, they’ll be more likely to accept your suggestions for help.

Depression Risks

Some of the risks of teen depression are self-harm (cutting, burning), suicide, poor nutrition, poor sleep, declining grades, and increased family conflict.  Even though your teen may be the one displaying the most obvious symptoms, consider the bigger family picture and how it might play into their situation.

If grandpa died recently, siblings are growing up or moving away, new family members being introduced (blended family, new baby), or family conflict has risen, be aware that your teen’s depression may be strongly linked.  This may not be the case, but it’s still a good idea to see the bigger picture.  You may start to understand ways the whole family can be more helpful and supportive, even if the family situation isn’t the main problem.

I found a few useful online resources for you and your teen (or someone else you know with a depressed teen).

General resource about teen depression –

A quiz you can take to help you know if your teen is depressed –

A forum for teens with depression issues-

Feb 24

Poor Sleep Affects Everything Else


By Dr. Marie Hartwell-Walker

Q. Where do I start? Well First of all I’ve had sleeping problems ever since i was in year 5 which was when I felt completely crazy and had no idea why but never told anyone. Due to not being able to sleep, I stress out more and get tired way too quickly. I never have dreams and I don’t know why I can’t sleep since it’s been going on for this long there has got to be a real reason behind this.

The other thing is, I’m really lonely … I’ve been dating my boyfriend for 1 year and 3 months now. If you asked him about me he’d tell you I’m absolutely nuts due to the fact that I get crazy mood swings and get mad about nothing way too much even sometimes at my friends. Due to all this, I keep it all bottled up inside me so no one can get hurt because I don’t want to my problem some one else’s burden.

I feel so sick of being alone, I can’t even talk to my boyfriend about problems. He think’s every time I have a problem it’s stupid which makes me feel stupid and like all I do is annoy him. He never even listens to me and does whatever he wants. I cry occasionally because of him and my other social problems. Holiday’s are the worst time of year since even though i have someone, it feels like he’s not even there for me when I really need him. I always feel so lonely and tired but I never sleep so I can’t just sleep on it and forget about.

At night all I do is think and think about the past and all the things I’ve done wrong. All the problems keep me hurting inside but I can’t tell anybody because it’s useless. No one really cares, even if they did listen they would have no answer. What makes me feel worse about my boyfriend is that even though we’ve been together this long he’s never been able to support me when I’m emotional especially if I cry he just get’s mad and doesn’t bother trying to help me.

I have friends but I can’t even talk about them because I don’t feel like I can trust them. All my ex-best friend’s would usually tell their other best friend or their girlfriend or something and then everyone would know. Some people even think I’m a slut just because I’ve had a relationship for this long. I wish I had someone to talk to without them thinking I’m stupid. All through out primary and a little bit now – people have always thought that I was stupid, i try and try but nothing is ever good enough. Not even to my parents … I’ll never be good enough.

Help me, I don’t know what to do about myself and especially my relationship

A: Where you start is with the sleep disorder. When people don’t sleep, they are vulnerable to depression, mood swings, irrational crying and irritability. Please go to your doctor and ask for help with sleep. You might be referred for a “sleep study” to help figure out why you’ve never been able to establish a regular sleep pattern.  It could be that you suffer from sleep apnea or some other medical disorder that is making it impossible to get a good night’s sleep. The good news is that it’s possible that a good diagnosis will lead to good treatment — which will lead to good sleep.

As for the relationship: You’re expecting a lot from a 15-year-old boy. You guys got together when you were only a little more than 13. That’s really young to find someone who will also grow into the kind of person who can be a forever love. You are changing. He is changing. It’s part of growing  through adolescence. I’m impressed you two have been able to hold a relationship together in spite of your ups and downs and his inability to cope with them. He sounds like a good friend.

I doubt you are stupid. I think never getting enough sleep may make you look like you are. It’s hard to do your best academically or in life if you are tired all the time.  For that reason, the priority has to be getting your sleep in order.

Feb 24

Why Music Listening Makes Us Feel Good


The Chemical Link Between Music and Emotion

Published on January 20, 2011 by Kimberly Sena Moore in Your Musical Self
It can be argued that music is a core function in our brain. Our brains are wired from the beginning to process and understand music. Yet music has always been sort of a mystery, especially since it’s not typically considered “necessary” for survival. That is reserved for the trifecta of food, sex, and sleep.

A study came out this month that adds another important piece of information as we continue to figure out how our brain processes music. When we satisfy our desire to eat, to sleep, or reproduce, our brain releases dopamine–the “feel good” neurochemical involved when we experience pleasure and reward.

A study was conducted by researchers at McGill University in Canada. An initial 217 participants were narrowed down to 8 who consistently responded the same way when listening to music regardless of the listening environment.

For the study, the researchers used a combination of PET (positron emission tomography) and fMRI (functional magnetic resonance imagining) techniques to scan the brains of the 8 participants as they listened to music over the course of three session. In addition, the participants completed a questionnaire in which they rated how pleasurable they found the music.

This is where it gets a little more technical–the PET scan showed the researchers that dopamine was released in the striatum during peak moments of emotional arousal when listening to the music. The fMRI scan helped show a distinct difference in timing and structures involved–the caudate was active when anticipating the peak emotional arousal and the nucleus accumbens was more involved when actually experiencing the peak emotion.

In layperson’s terms? When we 1) anticipate and then 2) actually experience a pleasurable response while listening to music, our brain reacts in distinct and specific ways to release the “feel good” chemical dopamine.
What Does This Mean?
From an academic standpoint, this is a fascinating study. According to the researchers, this may be the first study to show that an abstract reward such as listening to music–as opposed to a tangible reward such as eating and sleeping–releases dopamine. We’ve traditionally considered abstract rewards to be processed on a more cognitive level, but this study shows that our ancient reward circuits can be involved.

Additionally, it points to a shared neural network involving tangible and abstract rewards. We already know that skills such as speech production use shared neural networks to those used to sing. This study shows a similar relationship, demontrating shared neural circuitry involving how our reward circuits process tangile and abstract rewards.

From a practical standpoint, this will not affect your average day-to-day listening. Just know that, when you experience an emotion while listening to music, ancient reward circuits are flooding your brain with a chemical designed to make you feel good.

Researchers have found that parents who anger easily and over-react are more likely to have toddlers who act out and become upset easily.

The research is an important step in understanding the complex link between genetics and home environment. In the study, researchers from Oregon State University, Oregon Social Learning Center, and other institutions collected data in 10 states from 361 families linked through adoption – and obtained genetic data from birth parents as well as the children.

They followed the children at nine, 18 and 27 months of age, and found that adoptive parents who had a tendency to over-react, for example, were quick to anger when children tested age-appropriate limits or made mistakes. These over-reactive parents had a significant effect on their children, who exhibited “negative emotionality,” or acting out and having more temper tantrums than normal for their age.

Genetics also played a role, particularly in the case of children who were at genetic risk of negative emotionality from their birth mothers, but were raised in a low-stress or less-reactive environment.  The study was published in the latest edition of the journal Development and Psychopathology.

“This is an age where children are prone to test limits and boundaries,” said lead author Shannon Lipscomb, an assistant professor of human development and family sciences at OSU-Cascades. “However, research consistently shows that children with elevated levels of negative emotionality during these early years have more difficulties with emotion regulation and tend to exhibit more problem behavior when they are of school age.”

Researchers also found that children who exhibited the most increases in negative emotionality as they developed from infants to toddlers (from nine to 27 months of age) also had the highest levels of problem behaviors at age two, suggesting that negative emotions can have their own development process that has implications for children’s later behaviors.

“This really sets our study apart,” Lipscomb said. “Researchers have looked at this aspect of emotionality as something fairly stable, but we have been able to show that although most kids test limits and increase in negative emotionality as they approach toddler age, the amount they increase can affect how many problem behaviors they exhibit as 2-year-olds.”

Lipscomb said the take-away message for parents of young children and infants is that the way they adapt to toddlerhood – a challenging time marked by a child’s increasing mobility and independence – can have an impact on how their child will develop.

“Parents’ ability to regulate themselves and to remain firm, confident and not over-react is a key way they can help their children to modify their behavior,” she said. “You set the example as a parent in your own emotions and reactions.”

Feb 23

By Lori Wright, Media Relations

Authoritarian  parents whose child-rearing style can be summed up as “it’s my way or the  highway” are more likely to raise disrespectful, delinquent children who do not  see them as legitimate authority figures than authoritative parents who listen  to their children and gain their respect and trust, according to new research  from UNH.

“When  children consider their parents to be legitimate authority figures, they trust  the parent and feel they have an obligation to do what their parents tell them  to do. This is an important attribute for any authority figure to possess, as  the parent does not have to rely on a system of rewards and punishments to  control behavior, and the child is more likely to follow the rules when the  parent is not physically present,” said Rick Trinkner, a doctoral candidate at  UNH and the lead researcher.

This is the first study to look at whether  parenting styles influence adolescents’ beliefs about the legitimacy of parent  authority and if those perceptions affect delinquent behavior. The results are  presented in the February issue of the Journal of Adolescence in the article  “Don’t trust anyone over 30: Parental legitimacy as a mediator between  parenting style and changes in delinquent behavior over time.”

The  research was conducted by UNH researchers Trinkner; Ellen Cohn, professor of  psychology; Cesar Rebellon, associate professor of sociology; and Karen Van  Gundy, associate professor of sociology. The researchers relied on data from the New  Hampshire Youth Study, an ongoing, longitudinal survey of middle school and  high school students examining the psychological, sociological, developmental,  and legal factors that influence adolescent delinquency. Analyses reported are  based on data collected over an 18-month period beginning in the fall of 2007.

“While it is generally agreed  that authoritative parenting is more effective than authoritarian and  permissive styles, little is known about why some parenting styles are more  efficient than others. Our  results showed that parental legitimacy was an important mechanism by which  parenting styles affected adolescent behavior,” Trinkner said.  The  researchers evaluated three parenting styles: authoritative, authoritarian, and  permissive.

Authoritative parents are both demanding  and controlling, but they are also warm and receptive to their children’s  needs. They are receptive to bidirectional communication in that they explain  to their children why they have established rules and also listen to their  children’s opinions about those rules. Children of authoritative parents tend  to be self-reliant, self-controlled, and content.

On the other hand, authoritarian parents  are demanding and highly controlling, but detached and unreceptive to their  children’s needs. These parents support unilateral communication where they  establish rules without explanation and expect them to be obeyed without complaint   or question. Authoritarian parenting produces children who are discontent,  withdrawn, and distrustful.

Finally, in contrast to authoritarian  parenting, permissive parents are nondemanding and noncontrolling. They tend to  be warm and receptive to their children’s needs, but place few boundaries on  their children. If they do establish rules, they rarely enforce them to any  great extent. These parents tend to produce children who are the least  self-reliant, explorative, and self-controlled out of all the parenting styles.

“The style that parents used to rear their  children had a direct influence on whether those children perceived their  parents as legitimate authority figures. Adolescents who perceived parents as  legitimate were then less likely to engage in delinquent behavior. Thus,   authoritative parenting may be more effective than the other styles because this  style makes adolescents more willing to accept their parents’ attempts to  socialize them and subsequently follow their rules,” Trinkner said.

“Conversely, authoritarian parents have the  opposite effect in that they actually reduce the likelihood of their children  perceiving their authority as legitimate. Adolescents from authoritarian  parents are more likely to resist their parents’ attempts at socialization,” he  said.

While the children of permissive parents  were less likely to respect their parents as authority figures, the researchers  found they were no more or no less likely to engage in delinquent behavior.

According to the researchers, the results  show that fostering and creating parental legitimacy is one technique for  parents to exert control over their children. Additionally, parents are more  likely to be viewed as legitimate authorities if they utilize authoritative  parenting practices rather than authoritarian or permissive practices, which  tend to undermine parental authority.

“Our data offer further evidence that  authoritative parenting is an effective way for parents to successfully  socialize their children and that its influence works largely through its  effect on youth perceptions of parental legitimacy,” Trinkner said.

Feb 23

Migraines linked to depression in women


Women who have had migraine headaches are more likely than other women to develop depression, according to a new finding based on 14 years of health data.

The findings are to be presented Feb. 22 in New Orleans at the annual meeting of the American Academy of Neurology.  “This study confirms it: Having migraines increases your risk of depression, which we’ve suspected for many years,” said Dr. Timothy A. Collins, a Duke University Medical Center neurologist who was not involved with the research. Collins specializes in headache treatment.

Researchers looked at more than 36,000 women enrolled in the Women’s Health Study, and found that after 14 years, depression had developed among those who suffered from migraines at a higher rate than among those who didn’t get the throbbing headaches.

Study researcher Dr. Tobias Kurth, an epidemiologist at Brigham and Women’s Hospital in Boston, said women who have migraines shouldn’t assume they’ll develop depression, but should be aware of the link to the increased risk.

A predominantly women’s affliction

Migraines can last four to 72 hours and are often accompanied by pulsating pain, nausea, vomiting and sensitivity to light and sound.

One in 10 Americans has migraines, according to the National Institute of Neurological Disorders and Stroke, but they affect women three times more often than men.  One previous study found that women with more than 15 chronic headaches a month are four times more likely to have depression than women who have fewer than 15.

Collins noted a 2011 Canadian study that found people with migraines were more likely than others to have depression, but people with depression were no likelier than people without the condition to have migraines.  Although some antidepressants have been shown to reduce a high frequency of migraines, there is no evidence that shows that treating migraines will help with depression, Kurth said.

Women with any history of migraine are at risk

Kurth and fellow researchers looked at 36,154 women without depression who were enrolled in the Women’s Health Study, an ongoing investigation conducted by Brigham and Women’s Hospital and Harvard Medical School. Nearly 6,500 of the women reported having migraines, or suffering them in the past.

After 14 years, 3,971 of the women in the study had developed depression. Researchers found that women with any history of migraine had 1.3 times the risk of developing depression than women who’d never had a migraine.

“There are no good theories” to explain the link between depression and migraines, Collins said, though some have suggested hormones play a role. The drop in estrogen levels that occurs prior to menstruation is a trigger for headaches in many of his patients, he said.  Collins recommends that women talk with their doctors about how frequently they have their headaches.

“There’s medication that can alleviate the pain as well as prevent them from happening so often,” he said.  “Before this study, I didn’t ask my patients if they had depression,” Collins added. “But now I will.”

Feb 23

Laughter has serious benefits


“We don’t laugh because we’re happy, we’re happy because we laugh” – William James
Do we laugh enough or should we learn to laugh more? Joyful, good-natured, ‘mirthful’ laughter is a tonic for our body, mind, emotions, and spirit. Whether we use it as a distraction, to cheer ourselves up, or as a practice to energise and enthuse us, laughing impacts every part of us. In many ways it is the ultimate drug, with no harmful side-effects.

On a physical level, laughter stimulates our cardiovascular and pulmonary systems by giving our hearts and lungs a vigorous workout. It stimulates blood flow, oxygenates our blood and energises our whole physical system even if we’re hospitalised. The US doctor Patch Adams has been using it professionally for years.

Its endorphin-triggering effect makes laughter a strong painkiller for emotional and mental pain, as well as physical. It has been proven that higher levels of pain can be readily tolerated and the healing process is speeded up. Both the Norman Cousins experience, described in his classic best seller ‘Anatomy of an Illness’, and the current RX Laughter project with children in UCLA hospital in Los Angeles provide the evidence.

Psychologically, laughter is the antithesis of depression. If we’re feeling any anxiety, it is an excellent antidote. In fact, in 2002 in Austria Dr Koutek started using the sound of spontaneous group laughter as part of his treatment for patients with depression. In our Bristol laughter club there are countless examples of people whose lives have benefitted from the ‘lightness’ that laughter induces. People’s faces change, their body language and posture become more open and relaxed, their communication becomes more playful and spontaneous. Even the simple smiling exercise based on the 1988 F. Strack, L.L. Martin and S. Stepper’s pencil exercise produces lasting results. All you need do is smile genuinely three times a day for at least 10-15 seconds and some people find it transforms their lives.

Laughter and playfulness, in turn, unlock our natural creativity. “You can learn more about a person in an hour of play than a year of conversation” said Plato. Creativity is an essential part of a fun-filled life and helps neuroplasticity, our brain’s learning ability, by strengthening mental flexibility and resilience. Because of this – as we see in Martin Seligman’s Positive Psychology – optimism, positivity and happiness become learnable skills. In short, we learn to become happier.

On the self-development path, the practice of laughter is the practice of joyfulness. Ancient traditions as well as new ones encourage us to practice laughing – with a sense of willingness. What ancient traditions intuited and experienced, and neuroplasticity shows, is a practice is learning new skills until they become second nature. Current thinking is that it might be only 21 days, as in the Chopra 21-day meditation challenge. The key ingredients are single-mindedness, perseverance and tenacity to keep going until you become aware of the differences in your life. There are numerous recent psychological studies which show the beneficial impact of smiling especially when this is the genuine ‘Duchenne’ smile which uses the involuntary orbicularis oculi muscles. This genuine smile encourages an empathetic response and consequently stimulates sociability.

Top tips to laugh more:

  1. Look for laughter and laughter will find you. Look for as many opportunities to smile and laugh in your day, and importantly, communicate them. Not only will you feel better, you will also be encouraging a positive ripple in others too.
  2. If it will be funny later, it’s funny now. Often we look back and laugh at things. Can we laugh at them now instead?
  3. Start your day with a laugh. This is both a Zen and a Hawaiian practice. No matter what yesterday delivered, start today with a chuckle, a kinaesthetic version of a positive affirmation. Why? We get the endorphins. We may then feel more upbeat and better equipped for your day ahead. Its worth remembering, when we’re feeling really rough, that’s the time we need our endorphins most.
  4. Fake it till you make it. Feeling grumpy? Sluggish? Irritable? When you’re ready to change your mood, smile and laugh, even if you don’t yet feel like it. Your system will release endorphins anyway because it can’t tell the difference between the real joyful laugh and a fake one. The key is your willingness.

Joe Hoare is an expert in laughter and runs Laughter Retreats and Laughter Facilitation courses.

Feb 22

Combatting Asperger’s: A Losing Proposition


Despite the immediate sense of relief that seems to accompany such newfound self-awareness, it did not take me very long to start thinking about ways that I could learn to manage my so-called disorder. For, it seemed the most glaring evidence of my condition lay in all the negative stuff—the socially unacceptable behaviors, the difficulty relating to people, the complete inability to (Heaven help me) operate on someone else’s timeframe—rather than in the myriad positive aspects of my uniqueness. I sometimes regarded Asperger’s as something that needed to be combatted and conquered.  When I realized, for instance, that my marriage was in trouble largely because of my behaviors and detachment from my wife, Kristen, I immediately blamed Asperger’s. (I don’t pay attention to her needs? Asperger’s! I don’t help with the housework? Also Asperger’s! It takes me three hours to make my breakfast yet I can’t find time to help the kids get ready for school? Yep, that would be the Asperger’s, too…I’m sure of it.) I thought the only way to save our marriage would be to somehow conquer my disorder. After all, erasing my neurological condition would automatically make me a better husband. Wouldn’t it?  I thought I was really onto something, but when I told Kristen that I was on a mission to defeat my own brain, she did what she always does when I lose sight of the big picture: She smiled, knowingly, and then showed me a different way.  “We don’t need to fix you, Dave. We need to fix our relationship, and that’s something we can do together. Let’s focus on that.”  I hadn’t thought of it that way, but she sure made a lot of sense. Asperger syndrome, in and of itself, isn’t something to combat. Rather, it’s something that makes us who we are, and like any other personal attribute, having Asperger’s—being Aspergian, as my friend John Elder Robison would say—means that, like anyone, we were born with certain assets and certain liabilities. How we manage those assets and liabilities is completely up to us, as individuals.  Notably, the nature of Asperger’s is such that many of us who fit within the parameters of the condition can learn to manage certain behaviors that, in some ways, might hold us at a disadvantage—be it in the workplace, in school, or in our relationships with people we love. Living successfully on the spectrum is not about saying no to the disorder. It’s about saying yes to your best possible life. If we are so inclined, of course—and inclined I was.

With this profound insight from Kristen, I set out not to defeat my syndrome, but rather to be the husband I wanted to be—a far more worthwhile proposition. When Kristen and I were having trouble communicating, for example, I took notes on how I might express myself more openly, or listen more empathically. When I realized we no longer had common ground on which to rebuild, I learned to love the television shows she typically watches, my usual television habits be damned, just so we’d have something fun to talk about. When it became clear that Kristen needed a husband who would, every now and then, load a dishwasher or fold a basket of laundry without being asked, I committed (though admittedly reluctantly) to start taking initiative with the housework. I did these things as a means to a worthy end: being a better husband.

Of course, the responsibility of marital reconstruction wasn’t entirely on my shoulders. Kristen maintained her end of the bargain as well. She worked every day towards the marriage she wanted to have, a relationship that suited both of us. Mindful of my neurological composition, she learned new ways to engage with me, which enabled better communication and brought us closer together.

Had I focused on combatting myself and my neurological makeup, Kristen and I would have gotten nowhere, and our marriage would have suffered further as a result. But I listened to her guidance, had faith in her vision, and cast my focus strictly on building a better relationship, using knowledge of my condition as a roadmap. And along the way, I couldn’t help but learn how self-acceptance balanced with a desire to adapt can radically change the course of one’s life.

So, if you don’t mind my prying, I have to wonder: have you ever felt as though you were at odds with your autistic mind? Or have you always accepted yourself for who you are?

Feb 21

Couples seek therapy to achieve better communication, increase trust, and enhance intimacy, among other reasons. Surprisingly, almost half of couples who enter relationship therapy do so with the goal of determining if the relationship is viable enough to continue. Although there is much research examining how therapy goals influence outcome, little attention has been given to the relationship between viability goals and outcome in couple’s therapy. To this end, Jesse Owen of the Department of Educational and Counseling Psychology at the University of Louisville led a study that looked specifically at how treatment goals expressed at the beginning of therapy affected eventual outcome with regards to maintaining the relationship.

Using data collected from 249 couples treated by various therapists, Owen looked at goals of improving the relationship compared to goals of clarifying the relationship’s viability. Owen examined intake paperwork to determine goals and discovered that the partners who had a goal of improvement had better outcomes than those who sought clarification. Specifically, couples who entered therapy to find ways to improve their existing relationship were nearly 80% more likely to be together 6 months after treatment than the couples who entered therapy wanting to know if they should separate or not. More than half of the couples who wanted clarification at the beginning of therapy had split up 6 months later.

Owen believes that these results underscore the impact of goal assessment, both for the couple and individual, at the beginning of treatment. Additionally, Owen emphasizes that the clinician has a significant influence on outcome, noting that even when a couple’s primary goal is clarification, they may consider other options as a result of the clinician’s hope and encouragement. The re-evaluation of goals throughout treatment is essential to achieve a positive outcome, even if that outcome is dissolution of the relationship. “The complex intersection of varied hopes, goals, and expectations, occurring often within an emotionally charged atmosphere, requires that clinicians ‘dance’ simultaneously with different partners.” Owen added, “Determining and tracking goals from the outset appears likely to help ensure that the therapist does not step on too many feet too often.”

Reference: Owen, J., Duncan, B., Anker, M., Sparks, J. (2012, February 13). Initial Relationship Goal and Couple Therapy Outcomes at Post and Six-Month Follow-Up. Journal of Family Psychology. Advance online publication. doi: 10.1037/a0026998

Feb 21

By Douglas Eby

“What would be truly surprising would be to find that sound could not suggest colour, that colours could not evoke the idea of a melody, and that sound and colour were unsuitable for the translation of ideas, seeing that things have always found their expression through a system of reciprocal analogy.” Charles Baudelaire

A simple definition of synesthesia is that it is a “crosstalking” or overlapping of sensory experiences that for most people remain separate. Researchers find a higher proportion of creative people are synesthetes.

The image is from the book “The Hidden Sense: Synesthesia in Art and Science.”

The publisher explains that synesthesia occurs “when two or more senses cooperate in perception. Once dismissed as imagination or delusion, metaphor or drug-induced hallucination, the experience of synesthesia has now been documented by scans of synesthetes’ brains…”  The author “reports that some studies define synesthesia as a brain impairment, a short circuit between two different areas. But synesthetes cannot imagine perceiving in any other way; many claim that synesthesia helps them in daily life.”

From MIT Press page for the book “The Hidden Sense: Synesthesia in Art and Science” by Cretien van Campen.  The quote by French poet Charles Baudelaire (1821-1867) comes from the article “Art and Synesthesia: in search of the synesthetic experience” by Dr. Hugo Heyrman, a lecture presented at the First International Conference on Art and Synesthesia in 2005, Universidad de Almería, Spain.

Dr. Heyrman writes, “My starting point is the hypothesis that ‘synesthesia-phenomena’ are at the roots of all artistic practice.”  He also quotes neuroscientist Dr. Vilayanur S. Ramachandran (from ‘Hearing Colors, Tasting Shapes’, Scientific American, May 2003): “Synesthesia is seven times more common among artists, novelists and poets, and creative people in general. Artists often have the ability to link unconnected domains, have the power of metaphor and the capability of blending realities.”

A summary of the book “Wednesday Is Indigo Blue: Discovering the Brain of Synesthesia” by Richard E. Cytowic notes, “Synesthetes rarely talk about their peculiar sensory gift – believing either that everyone else senses the world exactly as they do, or that no one else does. Yet synesthesia occurs in one in twenty people, and is even more common among artists. One famous synesthete was novelist Vladimir Nabokov, who insisted as a toddler that the colors on his wooden alphabet blocks were ‘all wrong.’ His mother understood exactly what he meant because she, too, had synesthesia.”

Magenta Tuesdays

In her Psych Central article “3 Fascinating Facts About Our Brilliant Brains,” Margarita Tartakovsky, M.S. quotes neuroscientist David Eagleman from his book Incognito: The Secret Lives of the Brain: “For some people, there are magenta Tuesdays, tastes that have shapes and wavy green symphonies.”

Eagleman gives more examples in his book: “…the feel of sandpaper might evoke an F-sharp, the taste of chicken might be accompanied by a feeling of pinpoints on the fingertips, or a symphony might be experienced in blues and golds.”

People with “spatial sequence synesthesia” have locations for time and other numbers. For instance, “They can point to the spot where the number 32 is, where December floats or where the year 1966 lies.”

More common with artists

In her article “Are You a Synesthete?,” Darya L. Zabelina, M. S., says “Four percent of the population, when seeing number 5, also see color red. Or hear a C-sharp when seeing blue. Or even associate orange with Tuesdays. And among artists, the number goes to 20-25%!”

She explains, “The primary perspective of the cause of synesthesia is a mutation that causes defective pruning between areas of the brain that are ordinarily connected only sparsely. Therefore areas that are disconnected within a human brain retain certain connections in synesthetes, which causes unusual associations.”

More associations

In “First person: One singular sensation,” Lily Dayton (Special to the Los Angeles Times February 20, 2012) writes about her experience “when someone’s telling you a story and you get that amazing tingly feeling in your scalp, like their words are massaging your brain.”

She also writes about having a conversation with her father, who shares these kinds of experiences, about “the thrilling roar of the vacuum and the way the song ‘Ave Maria’ could feel like wing beats grazing our foreheads.”  In her longer article “The blended senses of synesthesia” she writes about even more connections: “If you ask Emma Anders about the number five, she’ll tell you that it’s red. She’ll also tell you that five is a mischievous, self-centered brat — like a kid throwing a temper tantrum at a party.

“Two is yellow, three is purple, four is an intense sky blue,” says the 21-year old student at UC San Diego. “An eight is very noble and kind of held together, almost like a parent figure to five. Nine is a brown-haired guy, and he’s pretty calm — but he’s really into seven.”  She says Anders also “ascribes colors to flavors and smells. (Vaseline, for instance, smells burgundy, and a green apple tastes yellowish-orange.)”

A cognitive advantage

Dayton notes that David Brang, a UC San Diego neuroscientist says “nature provides a strong hint that the brains of synesthetes may have some kind of cognitive advantage.  “The genes for synesthesia appear to be dominant, and family trees depict the trait marching through the bloodline. This high degree of heritability suggests the genetic mutation that causes synesthesia provides some significant evolutionary benefit.”  She adds, “Brang’s hypothesis is that the benefit is related to creativity, enhanced perception and overall smarts.  “So far, studies have found that so-called colored sequence synesthetes (who experience color when they see numbers or letters) have a heightened ability to discriminate between similar colors, while mirror-touch synesthetes (who experience touch sensations when watching another person touch themselves) are more sensitive to touch in general.”

What about you? Do you experience any kind of synesthesia?

Feb 20

Dehydration Influences Mood, Cognition


By Rick Nauert PhD Senior News Editor

Dehydration Influences Our Mood While most understand that dehydration can have medical complications, a new study shows that even mild dehydration can influence mood, energy levels and the ability to think clearly.

Regrettably, we often use thirst as an indicator for when we need to drink — a response that experts say is too late to avoid many of the detrimental effects of dehydration.

In two recent studies, researchers at the University of Connecticut’s Human Performance Laboratory discovered the mental, mood and cognitive downside of even mild dehydration. Investigators determined that it didn’t matter if a person had just walked for 40 minutes on a treadmill or was sitting at rest – the adverse effects from mild dehydration were the same.

Mild dehydration is defined as an approximately 1.5 percent loss in normal water volume in the body. The take home message is that individuals need to stay hydrated at all times, not just during exercise, extreme heat or exertion.

“Our thirst sensation doesn’t really appear until we are 1 [percent] or 2 percent dehydrated. By then dehydration is already setting in and starting to impact how our mind and body perform,” says Lawrence E. Armstrong, one of the studies’ lead scientists and an international expert on hydration. The importance for everyone to stay hydrated is a message that needs to be promoted.

“Dehydration affects all people, and staying properly hydrated is just as important for those who work all day at a computer as it is for marathon runners, who can lose up to 8 percent of their body weight as water when they compete.”

In the study, separate groups of young women and men were tested. Twenty-five women with an average age of 23 took part in one study. The men’s group consisted of 26 men with an average age of 20. All of the participants were healthy, active individuals, who were neither high-performance athletes nor sedentary — typically exercising for 30 to 60 minutes per day. Each participant took part in three evaluations that were separated by 28 days. All of the participants walked on a treadmill to induce dehydration, and all of the subjects were hydrated the evening before the evaluations commenced. As part of the evaluation, the subjects were put through a battery of cognitive tests that measured vigilance, concentration, reaction time, learning, memory, and reasoning. The results were compared against a separate series of tests when the individuals were not dehydrated.

The young women experienced mild dehydration which caused headaches, fatigue, and difficulty concentrating. They also perceived tasks as more difficult when slightly dehydrated, although there was no substantive reduction in their cognitive abilities. The research findings are published in The Journal of Nutrition. In the tests involving the young men, mild dehydration caused some difficulty with mental tasks, particularly in the areas of vigilance and working memory, according to the results of the second UConn study. While the young men also experienced fatigue, tension, and anxiety when mildly dehydrated, adverse changes in mood and symptoms were “substantially greater in females than in males, both at rest and during exercise,” according to the study. The men’s study was published in the British Journal of Nutrition.

“Even mild dehydration that can occur during the course of our ordinary daily activities can degrade how we are feeling – especially for women, who appear to be more susceptible to the adverse effects of low levels of dehydration than men,” says Harris Lieberman, one of the studies’ co-authors. “In both sexes these adverse mood changes may limit the motivation required to engage in even moderate aerobic exercise. Mild dehydration may also interfere with other daily activities, even when there is no physical demand component present.” Investigators are uncertain why women and men are so adversely affected by mild dehydration. One possibility is that neurons in the brain detect dehydration. These neurons may then signal parts of the brain regulating mood. This process could be part of an ancient warning system protecting humans from more dire consequences, and alerting them to the need for water to survive.

In order to stay properly hydrated, experts like Armstrong recommend that individuals drink eight, 8-ounce glasses of water a day, which is approximately equivalent to about 2 liters of water. People can check their hydration status by monitoring the color of their urine. Urine should be a very pale yellow in individuals who are properly hydrated. Urine that is dark yellow or tan in color indicates greater dehydration. Proper hydration is particularly important for high-risk groups, such as the elderly, people with diabetes, and children.

Source: University of Connecticut

Feb 20

By Traci Pedersen Associate News Editor

Treating Depression with the Love HormoneWhen a person hugs or affectionately touches another, the brain chemical oxytocin is released, helping to strengthen social bonds, among other actions. This “hormone of love” might provide hope for those suffering with depression, according to researchers who are currently conducting a clinical trial.

“In humans, oxytocin is released when they hug or experience other pleasant physical touch, and it plays a part in the human sexual response cycle,” said Dr. Kai MacDonald, assistant clinical professor of psychiatry at UC San Diego School of Medicine. Oxytocin seems to change the brain signals responsible for social recognition through facial expressions, says MacDonald, perhaps by changing the firing of the amygdala, the area of the brain that plays a major role in the processing of important emotional stimuli. Therefore, oxytocin in the brain may be a very strong mediator of human social behavior. “That’s why oxytocin is sometimes called ‘the love hormone,’” said MacDonald. “It’s said that the eyes are the window to the soul… they certainly are the window to the emotional brain. We know that the eye-to-eye communication, which is affected by oxytocin, is critical to intimate emotional communication for all kind of emotions — love, fear, trust, anxiety.”

Previously, UC San Diego researchers discovered that oxytocin could help those with schizophrenia, and MacDonald and colleague David Feifel, M.D., Ph.D., professor of psychiatry, are now enrolling participants to study its role in clinical depression. “Studies of blood levels and genetic factors in depressed patients point to the possibility that this natural hormone might play a part in helping clinical depression,” said MacDonald. “Previously, studies of healthy individuals have shown that intranasal doses of oxytocin reduce activation of brain circuits involved in fear, increase levels of eye contact, and increase both trust and generosity,” MacDonald said. “Interestingly, people given oxytocin don’t report feeling any different, but they act differently.”

Early clinical data also indicates oxytocin may help women with anxiety disorders. “A hug or a touch that causes a release of this hormone might somehow change brain signals,” MacDonald said. “We want to see if we can harness this response to help patients who suffer from depression.”

Source: University of California

Feb 19

I am The Human WakeUp Call. My story reminds people that life is a gift and every day counts. It’s time to wake up to the fact that none of us have endless tomorrows, even though we might be living as if we do. Contrary to the frequent fear-driven messages we hear, this is a lesson of finding the possibility for change, then pursuing it. It’s the small, consistent changes we make that lead to big differences.

I wasn’t always on this WakeUp call mission however. Like so many others, during my career I never played a very active role in where I headed. The promotions and job changes were spaced out well enough to give me the illusion of progress, but in reality I simply ‘floated down the river’ letting life take me from one place to another. None of it truly felt like it was my ‘right’ work. I was not really happy, but moderately comfortable.

Then, one day when I was in my thirties, the ‘river’ I was floating in took me to another Fortune 500 company and I found myself in yet another meaningless job. I had just moved to Connecticut from New York City and the new office was all the way in downtown Manhattan, increasing my commute from 25 minutes to more than two hours each way! Each morning my wife would drive me to the station with our one-year-old daughter sleeping in back, tucked sweetly into her car seat. I would come home each night and my little girl would be exactly as I left her, asleep in the backseat as my wife waited in the parking lot for my train to arrive. Days would go by where I wouldn’t see her awake at all. Children look peaceful while sleeping, but seeing her mostly in that state started to remind me that this was not the kind of parent I wanted to be, absent from her waking world.

I soon found myself wishing away my weekdays, hoping for each one to finish sooner than the clock would allow, in favor of the weekend and time – awake! – with my family. I realized that my work felt unimportant to me yet AGAIN, I felt out of place AGAIN, and I didn’t know what to do about it. My wife was taking care of our daughter and upkeep on our new home so I was the sole financial provider. However, I didn’t know what would fulfill me and had no direction. So I did what many people in that situation do – nothing. After all, life was just fine… wasn’t it?

Then, one Monday afternoon, I was sitting outside my office having lunch. It was a beautiful late summer day in New York where the sky was a stunning cerulean blue with not a cloud in sight. As I sat there enjoying the warmth of the sun on my face, I felt more grounded than I had in a long while. I looked up at my office building and was overcome by the sense that somehow it controlled my life. I realized at that moment that I HAD to make a change… even if it was a small change. A new intention was born.

This time had to be different! I had to take action. So I decided that the next morning, instead of rushing to catch the early train in keeping with my new morning ritual, I would take a later train so I could have a nice relaxing breakfast with my wife and (awake) daughter. I remember smiling at the thought thinking this was a good first step. Not a big step, but at least a new beginning. One of the most important lessons I realized from that small decision was that nothing would change until I changed it. It was clear that I would never FIND the time. I had to CREATE it!

The next morning my wife, surprised to see that I was already dressed and ready to go, asked quizzically, “I thought you were taking the later train today?” She asked me whether we were still having breakfast together or if she should drive me to the station so I could make my normal train. Little did I know, at that moment, I was standing at the crossroads of my life and my answer to that innocent question would determine my fate.

The chatter in my head started: “Do I just take the early train and have breakfast together another day? Will my daughter even be aware that we’re having breakfast? Do I risk going in late? Will I get in trouble at work? I’ve only been there a few months, can I even do this?” But then I had a moment of truth and my true values came forth to guide me, stirring something inside me and stopping my hesitation. “No,” I said to her. “The whole point of the morning was to have breakfast together, so let’s have breakfast together. I’ll catch the next train.” It was a simple declaration; as innocent a decision as if made on any other day of my life.

So we spent some wonderful time together having breakfast in our small dining room. It was another beautiful morning and I looked at my family and just smiled. I had known my wife since we met on a Junior High School trip to Quebec in 9th grade and I knew the moment I saw her that she was the “one”. Here we were 18 years later and I was living the reality of my dreams. Life was good!

She dropped me off and I took the train into New York City, smiling the whole way. I’m sure I looked out of place among the cranky faces of so many other commuters who were beaten down by the many hours they had spent getting in and out of the city at such a cost. But nothing could bother me that day – I felt I had some control of my life! It felt great!

I got on the subway, and instead of being in my office, I was underground at 8:45am when the first plane slammed into the North Tower of the World Trade Center, into my floor, hitting my desk. Most of the members of my group were up there when it happened, including my boss and team. The morning I had breakfast with my family just happened to be September 11, 2001.

So now you see why I feel compelled to share my story with you and why I recreated my career to serve as a WakeUp Call for others – so you don’t have to experience a tragedy or a near miss to wake up to the possibility of your life. So you stop drifting downstream looking back at your life asking ‘why?’ and instead turn around to look forward and say, ‘What now? Where do I want to go?’ So you and the many thousands of people I now work with can stop ‘losing’ precious days.

In many ways my life began anew the day before that memorable day in September, but not for the reason that you may think. Most people believe that it was my close brush with death that changed my outlook on life. Yet my feeling of being alive and having control over my life spread a smile over my face long before I arrived to see my office engulfed in flames. It wasn’t the fact that I didn’t die on September 11, but instead the reality that I had already begun living on September 10.

In the simple act of choosing a small step toward my larger goal, I had turned myself around to face downstream and take responsibility for the direction in my life. Sometimes we give in to the illusion that we have no control over our lives. Yet small decisions can make big differences in your life. Do you realize that life is a gift and every single day counts? You don’t have endless tomorrows and the ‘some day’ you are waiting for may never come.

I gave up my comfortable corporate life and chose what for me is a harder road. Today I am a business and personal leadership coach, sharing my message and empowering others through individual and team coaching, mentoring, workshops, seminars and keynote speaking. I have been blessed to have touched people across the US, in Canada, Europe and even as far away as Nigeria in Africa. I love my family and my life as much as ever (including my son who has since been born.) Now, I even love my work! How can you live any other way?

If you feel that you have no control over your life, it’s time to find one small thing you can do to move your life in a better direction. You may have continued down uninspired paths because you were simply stuck or afraid or uncertain of how to break this powerful spell. But if you can find one thing to change, one thing that makes you feel more alive, then you must do it.

September 10th was a day that looked just like any other day. Is today your September 10th? What are you waiting for?

Mike Jaffe, President and Founder, MBA, CC, CLPC (413) 854-2401.

Feb 18

ADHD and Obesity


If you have ADHD, are you more likely to be overweight?
Published on February 17, 2012 by Emily Deans, M.D. in Evolutionary Psychiatry

If you were to guess, would you think that people with ADHD are more likely to be obese or skinny?
I would have thought skinny, just on first hunch.  Calories in = calories out, right?  And a lot of folks with ADHD are very fidgety!  Never sit still. In fact I seem to remember some press a few years back about how fit people tend to fidget and burn more calories than sedentary people, and how it might be the key to staying lean. One of the most telling sights on an adolescent inpatient psychiatric unit where there are girls struggling with anorexia is the amount of fidgeting during groups. These young ladies do not sit still, not for a moment, as they try every possible method to burn calories.

Well, when it comes to ADHD, the fidgeting does not seem to be enough to fight the fat.  In fact there are actually a number of studies linking ADHD to childhood and adulthood obesity.  One of the largest studies came out in late 2010 in the International Journal of Obesity.  About 12,000 people were followed over a decade or so from adolescence into adulthood, and records were kept of ADHD hyperactive and inattentive symptoms, along with waist circumference, BMI, blood pressure, physical activity, smoking, and alcohol use.  One weakness of the study is that no one tracked any measure of diet, but the results were telling nevertheless.

Folks with ADHD symptoms in childhood were 41 percent likely to be obese as adults, whereas kids without ADHD symptoms were only 34 percent likely to be obese (still an appalling number—these are young adults, after all, with a mean age at the last wave of the study of 28.9 years), and the more ADHD symptoms you had, the more likely you were to be obese—those with three or more inattentive or hyperactive symptoms were 50 percent more likely to be obese as adults.

The discussion of the paper is interesting.  Quite a while back in my personal blog, I had a post on antidepressants and weight gain or loss. The take-home point is that medicines that seem to increase the dopamine response make you skinnier over time. Well, one of the theorized problems in a brain with ADHD is that dopamine isn’t handled well or efficiently. As we know, dopamine is a neurotransmitter that helps us focus, plan ahead, and stay motivated. Here’s a pertinent quote from the study:

“Genetic association studies have found that ADHD and obesity are both associated with genes regulating dopamine availability. Furthermore, in two separate studies using Positron emission tomography with [11C]…have shown that individuals with ADHD and those who are obese both show lower than normal dopamine (D2) receptor availability. This lower dopamine receptor availability could reflect the common dispositions in both ADHD and obesity.”

The lack of self-restraint and impulsivity characteristic of ADHD could theoretically make it harder to restrain one’s eating habits and leave one vulnerable to obesity.

There is a rather large Australian study showing a link between a processed foods “Western Diet” and the risk of ADHD in young people.  Twinkies aside, it’s pretty clear that highly processed food diets are associated with more obesity in the long term.  (In the short term, most of us can severely cut calories any which way and lose weight. High carb, low carb, Twinkies, Slim-Fast TM, South Beach TM—they all work in the short term but typically have a 95 percent failure rate in the longer term. The key is what works to keep weight off for more than five years, which is the holy grail of obesity research at the moment.)

And then, of course, there is the fact that having ADHD is stressful, and one might end up with depression or anxiety, and then be more vulnerable to obesity via the inflammation pathway. Yikes! So many ways to get in trouble. How do we stay healthy and happy?

The answer is always the same. Practice stress reduction, sensible exercise, restorative sleep, and eat wholesome, nutrient-rich food because the causes all boil down to the same thing.  Eat what you are designed to eat, exercise, and chill out when you get the chance.  Enjoy family and friends. When things are already deranged it may not be a cure, but in most cases it will help. And unlike so many other Western medicine interventions that seem like good ideas at the time, real food and good sleep are unlikely to cause harm.

Feb 17

Partner’s Depression Treatment Not Working?



If your partner has been taking medication and going to therapy, yet is still struggling with severe depression, there is hope. Sometimes, therapy and medication for depression is not enough. Treatment-resistant depression does not have to be the life sentence it sounds like, however: there are other options that are safe and effective.

Recently, The Dr. Oz Show did an episode on electroconvulsive therapy (ECT) for depression. My department chair at Duke, Dr. Sarah Lisanby, was one of the panel experts. Besides being an expert on ECT, she is also a leading researcher on another alternative treatment for depression, called transcranial magnetic stimulation, or TMS. A third option is vagus nerve stimulator therapy, or VNS. If your partner is not getting relief, one of these three other options might be worth considering.

Electroconvulsive therapy (ECT)

Many of us have visions of One Flew Over the Cuckoo’s Nest or A Beautiful Mind when we think of electroconvulsive therapy treatment. Today’s treatment reality has come a long way from the depictions of those treatments in those movies, though. Someone undergoing ECT usually has six to twelve treatments given three times a week. The patient is given general anesthesia and a muscle relaxant, so they are asleep while the treatment is occurring. The patient’s brain is then stimulated by brief, controlled series of pulses given through electrodes placed at precise locations on their head. The result is that the patient has a seizure, which lasts about a minute, but since the patient is asleep and has been given muscle relaxants, they feel no pain and there is no muscle spasm. The patient wakes up approximately 10 minutes after the procedure is complete.

The pros of this procedure are that, according to the American Psychiatric Association, ECT produces a substantial improvement in at least 80 percent of patients. It also helps patients who suffer with most forms of mania, some forms of schizophrenia, bipolar disorder, Parkinson’s disease and other disorders. The biggest drawback to ECT is memory loss that often accompanies the treatment. For some, the memory loss is short-term; for others, it is long-term and can be permanent.

Transcranial magnetic stimulation (TMS)

TMS is a newer treatment for depression that is non-invasive. Like ECT, it does use electrical pulses to stimulate precise areas of the brain, but these pulses come from a wand that is held over the patient’s head by a technician. The pulses are thought to stimulate neurons that release serotonin, dopamine, and norepinephrine, which are all mood-boosting chemicals. Patients remain awake during the procedure, and do not require any type of anesthesia, as there is no pain. A typical treatment course for TMS is about 30 minutes, five to six times a week, for six to eight weeks.

The pros of TMS are that results generally occur quickly, if a patient is going to respond to treatment. Unlike medication, which may take six to eight weeks to start working, improvement from TMS is usually evident within a few treatments. The cons of TMS are that it can be expensive, and possibly not available nearby, depending on where you live. Also, the time commitment for treatment can be challenging. Side effects including minor face twitching, a headache, or tingling in the scalp, all of which resolve quickly.

Vagus nerve stimulation (VNS)

This treatment came into being after patients with epilepsy who were treated with vagus nerve stimulation reported improvements in mood as well. Subsequent clinical trials proved this to be true. VNS  has been controversial as a treatment, however, and is only recommended after four medication and/or ECT trials have failed to relieve the patient’s depression. A pulse generator–similar to a pacemaker–is implanted into the patient’s vagus nerve, where it sends out precisely timed mild electrical pulses to the left vagus nerve, which then go to the brain.

The cons of VNS include that it is not meant to be an exclusive treatment for depression, as it should also be accompanied by medication and possibly ECT treatment. It can also take several months for the patient to notice any mood changes, and some studies have shown its effectiveness to be low. The U.S. FDA reports that patients receiving VNS therapy may experience various side effects including hoarse voice, cough, shortness or breath, difficulty swallowing, and neck pain, some of which may persist as long as the device is active.

Feb 16

Autism Signs Appear in Brains of 6-Month Old Infants


The findings suggest that there is a potential to disrupt autism during a child’s first year before the disorder becomes entrenched.
By Karen Rowan and MyHealthNewsDaily  | February 18, 2012 | 14

The early signs of autism are visible in the brains of 6-month-old infants, a new study finds, suggesting that future treatments could be given at this time, to lessen the impact of the disorder on children.

Researchers looked at how the brain develops in early life, and found that tracts of white matter that connect different regions of the brain didn’t form as quickly in children who later developed autism, compared with kids who didn’t develop the disorder. “The way the wiring was changing was dampened” in the children with autism, said study researcher Jason Wolff, who studies developmental disabilities at the University of North Carolina, Chapel Hill. “It was a more blunted change over time, in how the brain was being wired,”

In contrast, in the brains of infants who did not later develop autism, white matter tracts were swiftly forming, Wolff said. “Their brains were organizing themselves in a pretty rapid fashion.” The findings suggest that during a child’s first year, “there is a potential to intervene, to disrupt autism before it becomes entrenched,” Wolff said. “There are a lot of possibilities to improve outcomes for these children.”

The study is published today (Feb. 17) in the American Journal of Psychiatry.

A crucial time

The first year of life is an important time in brain development, and is also when the first symptoms of autism start to appear, Wolff said.

In the study, the researchers looked at the brains of 92 infants, when they were 6 months, 1 year and 2 years old. All of the children had a sibling with autism; research shows such children have a higher risk of developing the disorder themselves.  The researchers used a brain scan called diffusion tensor imaging, a type of MRI scan which allowed them to see changes in the brain’s organization over time.

When the kids were 2 years old, 28 had developed autism, while 64 had not. The researchers looked back at the early brain scans, to see if there were differences between the groups.  “We looked at pathways that connect brain regions to each other, and 12 out of 15 were different in kids with autism,” Wolff said.

Previous studies had found differences in brain volume in infants of this age, and other researchers had looked at white matter tracts in older children with autism, and adults, but the structures had not been examined before in infants so young, Wolff said.  The fact that so many of the tracts were affected shows that autism is a “whole-brain phenomenon,” Wolff said. “There are widespread differences” in the brains of people with the disorder, he said.

What’s causing the brain differences?

As to what might be causing these brain differences, it’s too early to say, Wolff said. But the findings are consistent with what researchers suspect about what triggers autism’s development, he said, “there’s a complex interaction between genes, and a child’s experiences with the world.”  And while the brain scans of the two groups of children certainly revealed their differences, those scans are not at the point where they could be used to diagnose the disorder in a 6-month-old, Wolff emphasized.

Feb 15

5 Steps to Change Feelings of Anger


By Christy Matta, MA

Have you ever been so angry and stuck in spiteful or resentful thoughts that it seemed to take over your life?

Painful feelings such as anger, are often associated with worries about negative consequences — perhaps that an important goal will be blocked or that you will fail, be criticized, hurt or abandoned.  The intensity of your feelings and worries can leave you stuck in a cycle of angry feelings, with resentment and rage fueled by worry, spiteful thoughts and memories of hurtful experiences.

Emotions, even those that are painful, serve an important purpose in our lives. Anger can motivate us to fight for an important cause or overcome obstacles.

But sometimes we can get stuck.  We become annoyed and remember every past irritation.  Or we feel resentful and begin to think only of how we’ve been wronged.  When angry, we’re more likely to lash out, have a short fuse or act in other ways that perpetuate hostile and tense interactions.  Once the cycle begins, anger can stick around, damage our relationships and keep us from positive life experiences.

Sometimes the only way to change painful emotions is by changing how you act.  The key word here is sometimes.  In the case of anger, it is not important whether you have a legitimate reason to feel angry.  Anger often is justified, but not helpful.  When angry, ask yourself “is the anger doing me any good?”  If it is helping you, say by motivating you to stand up for yourself or causing you to right a wrong, than acting differently will not decrease your anger.  But if anger is damaging relationships or making problems worse, changing your actions can have an impact on how you feel.

Changing how you act will only change how you feel if you change both your actions and your thoughts.  Acting kindly towards someone with whom you are angry, instead of lashing out, will not reduce your angry feelings if you are thinking “what a hypocrite” or “I can’t stand this person” during the encounter.  You have to change your thinking, as well as your behavior.  This could mean “I can understand why this person acts as they do, even if I don’t agree with it.”

Steps to Change Angry Feelings

  • Figure out your emotion. Emotions can be complicated and confusing.  Figuring out what you are feeling, for example anger, annoyance or frustration, is an important first step.  Are underlying feelings of guilt or fear influencing your anger?
  • Ask yourself what action goes with that emotion. Aggression usually goes with anger.  Aggression can be physical, verbal or indirect and passive.
  • Ask yourself ‘do I want to reduce my anger?’  It only makes sense to try to change those feelings you want to change.
  • Figure out what the opposite action is.  The opposite of aggression is kindness or at the very least, decency.  Putting yourself in someone else’s shoes and imaging their perspective is an effective way to change angry and aggressive thoughts into something kind or at least understanding.
  • Do the opposite action all the way.  Throw yourself in to acting differently in both your actions and your thoughts.  Acting differently, without thinking differently won’t work.  You have to do both.

The ability to solve life’s problems and live the life you want to live sometimes means acting in opposition to your feelings.  You may need to gently leave a situation that makes you angry or be fair-minded in thoughts about someone who has hurt you.  Doing so can release you from anger that has become destructive in your life.

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