Mental Health Archive

A new study suggests that hormone therapy might help with perimenopausal depression. But is it safe for you?

Hormone therapy has long been a controversial topic, and a new study about the role of hormones in depression is adding some fodder to the debate. A study published in the January 10 issue of JAMA Psychiatry determined that hormone therapy may help ward off symptoms of depression in women. Researchers found that perimenopausal and early postmenopausal women who were treated with hormones were less likely to experience symptoms of depression than women in the study who were given a placebo.

But while the findings of the study are important — particularly considering that a woman's risk of depression doubles or even quadruples during the menopausal transition — that doesn't mean hormone therapy should be widely used for preventing depression in women at this stage of life, says Dr. Hadine Joffe, the Paula A. Johnson Associate Professor of Psychiatry in Women's Health at Harvard Medical School, who wrote an editorial accompanying the study. "It's not a 'never,' but it shouldn't be a standard approach; in general, all of medicine has moved away from using hormones for prevention," she says.

Many people with anxiety disorders have trouble sleeping. That's a problem. Too little sleep affects mood, contributing to irritability and sometimes depression. Vital functions occur during different stages of sleep that leave you feeling rested and energized or help you learn and forge memories. Sleep usually improves when an anxiety disorder is treated. Practicing good "sleep hygiene" helps, too. Here are some steps to take:

• Go to bed and wake up at the same time every day, even on weekends.
• Daylight helps set sleep patterns, so try to be outdoors while it's light out for 30 minutes a day.
• Exercise regularly (but not too close to bedtime). An afternoon workout is ideal.
• Keep naps short — less than an hour — and forgo napping after 3 p.m.
• Avoid caffeine (found in coffee, many teas, chocolate, and many soft drinks), which can take up to eight hours to wear off. You may need to avoid caffeine entirely if you have panic attacks; many people who experience panic attacks are extra-sensitive to caffeine.
• Review your medications with a doctor to see if you are taking any stimulants, which are a common culprit in keeping people up at night. Sometimes it's possible to switch medicines.
• Avoid alcohol, large meals, foods that induce heartburn, and drinking a lot of fluid for several hours before bedtime.
• If you smoke, quit. Smoking causes many health problems, including compromising sleep in a variety of ways.
• Keep your bedroom cool, dark, and quiet, without distractions like TV or a computer. Avoid using an electronic device to read in bed; the light from the screen can trick your brain into thinking it is daytime. If your mattress is uncomfortable, replace it.
• Reading, listening to music, or relaxing before bed with a hot bath or deep breathing can help you get to sleep.
• If you don't fall asleep within 20 minutes of turning in (or if you wake up and can't fall back to sleep in 20 minutes), get out of bed and do something relaxing until you feel sleepy.

For additional tips and strategies for living with anxiety, buy Coping with Anxiety and Stress Disorders, a Special Health Report from Harvard Medical School. 

The pandemic has been difficult for everyone, but particularly for families. Everyone is feeling so much uncertainty and stress, but one thing we can do is look for ways to create small moments of joy every day. Games, activities, creativity, being outdoors — there are simple, fun ways to be together and make memories.

A study conducted by AARP found correlation between a person’s engagement with music and their opinion of their brain health and cognitive ability. While the study did not involve any objective measure of brain health, music has been shown to activate multiple areas of the brain, and keeping brain pathways active helps keep the brain strong in older age.

The COVID-19 pandemic is affecting the mental health of people who have not been sick, and parents are being hit particularly hard. A survey of US parents found that these worsening circumstances also affect children’s behavior.

The pandemic has caused a surge in depression. If someone you care about is struggling with depression or bipolar disorder, or you have reason to think the person may be suicidal, there are ways you can help — and caring for yourself is important, too.

The trials and challenges of this year are weighing heavily on many people, but attempting to employ positive psychology to put personal struggles in context, and accepting the ups and downs life brings, can ultimately increase positive feelings and provide perspective.

Put the focus on food quality and healthy lifestyle practices to attain a healthy weight.

Most people have been taught that losing weight is a matter of simple math. Cut calories — specifically 3,500 calories, and you'll lose a pound. But as it turns out, experts are learning that this decades-old strategy is actually pretty misguided.

"This idea of 'a calorie in and a calorie out' when it comes to weight loss is not only antiquated, it's just wrong," says Dr. Fatima Cody Stanford, an obesity specialist and assistant professor of medicine and pediatrics at Harvard Medical School.

Research we're watching

A recent study found that nearly one in 10 people who received opioid pain relievers following heart surgery continued to take them for three to six months — a time point when no one should still be experiencing pain from the operation.

The study included nearly 36,000 people with private health insurance who had a coronary artery bypass graft (known as CABG or bypass surgery) or a heart valve replacement between 2003 and 2016. People who were prescribed more than 40 5-mg tablets of oxycodone (Oxycontin, Roxicodone, others) or an equivalent amount of a similar drug were at a much higher risk of prolonged opioid use than people who were prescribed lower doses. Other factors that increased a person's odds of taking opioids long-term included having CABG, being female, or having a history of chronic pain or alcoholism.

News briefs

Probiotic supplements containing helpful bacteria and yeast are marketed as a way to maintain a diverse mix of healthy gut microbes. Now, a review published online July 6, 2020, by BMJ Nutrition, Prevention & Health suggests that probiotic supplements may help relieve depression symptoms. Scientists evaluated seven clinical trials from the past 15 years, which tested a total of 12 different strains of helpful bacteria. One trial in the review tested a "prebiotic," a type of plant fiber that provides food for gut bacteria. Scientists concluded that 11 of these probiotics, either alone or combined with prebiotics, were potentially useful for relieving symptoms of depression, perhaps by reducing inflammation that could affect brain function. The studies were small and short-term, but taken together, they suggest a gut-based approach to maintaining emotional well-being is worth pursuing. In the meantime, talk therapy, exercise, and medications remain the most effective approaches to treat depression. To support your gut health without expensive probiotic supplements, enjoy foods that naturally contain probiotics, such as yogurt, kefir, and sauerkraut. The prebiotic powers of whole grains also may support a healthy gut.

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