Mental Health Archive

Ask the doctor

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Q. I know that some viruses live permanently inside us, but only make trouble now and then. I even heard recently that they might be a cause of Alzheimer's disease. Why do they sometimes cause disease, and can we keep that from happening?

A. We live all of our lives with various microorganisms on us and inside us. One example is the herpes family of viruses. Out of more than a hundred herpesviruses, there are nine that infect humans. Once we get infected with these viruses — usually early in life — they remain with us, "asleep" inside some of our cells. But periodically, they "wake up" (reactivate), start producing multiple copies of themselves, and infect other cells. That's what's happening when a cold sore suddenly forms on your lip.

News briefs

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We're learning more about the link between weight gain and several major classes of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), like sertraline (Zoloft), and tricyclic antidepressants, such as amitriptyline (Elavil). Research has shown that putting on pounds is a possible short-term side effect of the medications. But a study published May 23, 2018, in The BMJ suggests that antidepressants are also associated with sustained weight gain. Researchers analyzed the health information of more than 300,000 people in the United Kingdom (average age 51) who'd had their weight and body mass index measured at doctor appointments between 2004 and 2014. About 18% had been prescribed antidepressants. During the study period, people who took antidepressants had a 21% higher risk for a 5% or greater weight gain, compared with people who didn't take antidepressants. The risk peaked in the second and third years. There was no evidence of weight gain after seven years. The study was observational and didn't prove that antidepressants cause weight gain. But researchers hope the findings will encourage people to talk to their doctors about weight gain as a possible side effect of antidepressants, and plan for potential and even delayed weight gain if they're using the medications.

Every day, carve out a little time to release your worries and relax your mind. It may counteract the heart-damaging effects of stress.

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Stress is an inevitable part of life. People often fret over day-to-day hassles such as traffic jams and unpaid bills, not to mention the relentless news about natural disasters and political crises. Many are also coping with the added anguish of divorce, illness, or death within their families.

All of these so-called psychosocial stresses first take hold in your mind. But the effects spread throughout your brain and body. Sometimes, you can even feel it: your heart pounds, you breathe faster, and your muscles tense. However, chronic stress also has more insidious physical effects that can harm your heart (see "Stress and your cardiovascular system").

Performing resistance exercises could help ease symptoms of depression.

Pumping iron might inflate not only your muscles, but also your mood, says a study in published in the June issue of JAMA Psychiatry.

The study's authors came to this conclusion after examining the results of 33 randomized clinical trials involving more than 1,800 people. They found that people with mild to moderate depression who performed resistance training two or more days a week saw "significant" reductions in their symptoms, compared with people who did not. The findings also suggested that resistance exercises may be even more beneficial for those with more severe depressive symptoms.

Research we're watching

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Aggressively treating high blood pressure might help ward off cognitive changes, according to findings presented at the Alzheimer's Association International Conference in July. Researchers from the Systolic Blood Pressure Intervention Trial compared two strategies to manage high blood pressure in more than 9,300 older adults (average age about 68). One strategy aims to achieve the standard treatment level for high systolic blood pressure (the first number in a blood pressure reading), keeping it under 140 mm Hg. The more aggressive strategy sets a goal of less than 120 mm Hg. The aggressive strategy reduced not only heart risks, but seemed to protect the brain.

People in the more aggressively controlled blood pressure group were 19% less likely than those in the standard treatment group to develop new cases of mild cognitive impairment (often a forerunner to dementia). They were also 15% less likely to develop any form of dementia or mild cognitive impairment. This study provides another reason to work with your doctor to reduce high blood pressure.

Being more social is linked with greater health benefits, but what if you're not comfortable in the company of others?

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Research continues to stress the relationship between social connection and long-term health. Interacting regularly with other people appears to lower your risk for heart disease, depression, and early death.

But what if being social is not who you are? People who are introverts — that is, they prefer time alone over group outings — are often at a disadvantage when it comes to social engagement.

In the journals

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More reasons to take good care of your eyes: it may protect against cognitive decline and keep you safe behind the wheel, according to two studies published online June 28, 2018, by JAMA Ophthalmology.

In the first study, researchers looked at almost 560,000 adults ages 65 and older and found they had 9% fewer serious car crashes in the year following cataract surgery. Besides causing blurry vision, cataracts can intensify the glare from headlights and sunlight, which can make driving dangerous, according to the researchers.

When depression strikes, doctors usually probe what's going on in the mind and brain first. But it's also important to check what's going on in the body, since certain medical problems are linked to mood disturbances. In fact, medical illnesses — and medication side effects — may be behind nearly 10% to 15% of all cases of depression.

It's not uncommon for a physical illness to trigger depression. Up to half of heart attack survivors and those with cancer report feeling blue, and many are diagnosed with depression. Many people who have diabetes, Parkinson's, or other chronic conditions become depressed.

The adjustment from summer vacation back to the structure and demands of the school year affects many students, but some experience so much anxiety that they avoid going to school. Understanding the reasons for school refusal can help parents identify problems and act quickly.

Because social connections are vital to human development and health, and writing is a way to form or strengthen a sense of connection to others, the creative expression of writing has been found to improve health and boost healthy emotions.