Addiction Archive

Last year, the Alzheimer’s Association predicted that rates of dementia would continue to rise. However, a report recently published in the New England Journal of Medicine found that rates of dementia have actually dropped steadily over the past three decades. Whether the drop in rates applies to everyone, and whether it will continue, remain to be seen. But the evidence also confirms that there’s quite a lot you can do to lower your dementia risk.

New findings link cardiovascular fitness to better thinking skills and memory in older people.

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Exercise that speeds up your heart rate and breathing keeps your heart and blood better cardiovascular fitness to a sharper brain is providing new clues about this heart-mind connection.

"It's not just about delivering more oxygen to the brain, although that's part of it," says Dr. John Ratey, associate clinical professor of psychiatry at Harvard Medical School and author of Spark: The Revolutionary New Science of Exercise and the Brain. Having a fit, healthy cardiovascular system also protects against vascular dementia, which happens when blood vessels feeding the brain are blocked or narrowed, leading to memory problems and other cognitive trouble.

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A heart attack or unstable angina (sudden chest pain that happens at rest) usually requires a hospital stay. After such events—which doctors call acute coronary syndromes—about one in five people ends up back in the hospital with heart disease or dies in the following year. But there's a bright side: new research suggests that survivors with an optimistic attitude are less likely to be readmitted to the hospital with heart problems.

The study, published in the January 2016 Circulation: Cardiovascular Quality and Outcomes, included 164 people, mostly men, who were hospitalized for acute coronary syndromes. Two weeks after the event, they filled out questionnaires designed to measure their sense of optimism and gratitude.

Ask the doctors

Q: I went for my usual check-up, and in addition to taking my blood pressure, the medical assistant handed me a form to fill out with nine questions related to my mental health. I've never had this happen before. Is this new?

A: Yes, it is new for most people. The U.S. Preventive Services Task Force (USPSTF) has just released an important depression screening recommendation. The USPSTF recommends regular depression screening for all adults, which is a modification from advice originally given in 2009, in which screening was recommended only for clinics or doctors who had adequate support systems to provide mental health care for those who were identified with depression. Since that time, multiple studies have found that mental health care from primary care clinicians works very well, and probably just as well as specialist care from psychiatrists. That isn't to say we don't need care from psychiatrists, but rather that not everyone needs a psychiatrist, especially those with mild to moderate depression.

The U.S. Preventive Services Task Force has recently updated their guidelines on depression screening to include pregnant and postpartum women, which will be a great help to the many new moms who experience mood changes that go beyond the “baby blues.” The updated guidelines offer other benefits, too, that help improve everyone’s access to mental health care — especially those who can’t currently afford it.

Thorough risk assessment and family assistance may help you take them more safely.

Prescription pain pills such as oxycodone (Oxycontin) and hydrocodone (Vicodin) are in a class of drugs known as opioids. They're typically used to treat severe pain after surgery, and sometimes to treat chronic pain. But these drugs come with many risks, including addiction. Does that put you at risk if you take opioids? "You have to look at it on a case-by-case basis," says Dr. Hilary Connery, an addiction psychiatrist at Harvard-affiliated McLean Hospital.

Risks and benefits

Opioids are powerful painkillers that block messages of pain to the brain and decrease the body's perception of discomfort. They may also create a feeling of euphoria. Opioids are especially useful in the short term, such as the initial weeks following joint replacement. Common side effects include nausea, itching, drowsiness, or constipation.

Learning to deal with stress can lower your risk for anxiety, depression, and cardiovascular disease.

The more we learn about women's hearts, the more we realize that they are different from men's. One of the most dramatic differences is a rare heart condition called takotsubo cardiomyopathy, or broken-heart syndrome, that is nine times more common in women than in men. It has been cited as evidence that sudden emotional stress can actually cause death in some women.

Like a heart attack, takotsubo cardiomyopathy strikes suddenly with symptoms such as chest pain and shortness of breath; however, it does not involve clogged arteries. Takotsubo cardiomyopathy is brought on by a surge of stress hormones that literally bend the heart out of shape. As a result, when the main pumping chamber of the heart (the left ventricle) contracts, it balloons out, so it can't eject blood into the arteries effectively.

Music therapy can calm anxiety, ease pain, and provide a pleasant diversion during chemotherapy or a hospital stay.

It's almost impossible to find someone who doesn't feel a strong connection to music. Even if you can't carry a tune or play an instrument, you can probably reel off a list of songs that evoke happy memories and raise your spirits. Surgeons have long played their favorite music to relieve stress in the operating room, and extending music to patients has been linked to improved surgical outcomes. In the past few decades, music therapy has played an increasing role in all facets of healing.

What is music therapy?

Music therapy is a burgeoning field. People who become certified music therapists are usually accomplished musicians who have deep knowledge of how music can evoke emotional responses to relax or stimulate people or help them heal. They combine this knowledge with their familiarity with a wide variety of musical styles to find the specific kind that can get you through a challenging physical rehab session or guide you into meditation. And they can find that music in your favorite genre, be it electropop or grand opera.

Although poor health can lead to unhappiness and a shorter life, unhappiness alone is not associated with a shorter life span, according to a recent report from the Million Woman Study. That investigation has followed hundreds of thousands of women throughout the United Kingdom beginning in 1996 and has tracked deaths among the participants.

In the third year of the study, the women were asked to rate their health, happiness, stress, feelings of control, and whether they felt relaxed. When the researchers looked at data from 720,000 women with a median age of 59, they found that 83% reported being generally happy and 17% said they were unhappy. During 10 years of follow-up, 4% of participants died. When the researchers factored out poor health, which was strongly associated with unhappiness, they found that the risk of dying was essentially the same for happy and unhappy women. The study was published online Dec. 6, 2015, by The Lancet.