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Benzodiazepines (and the alternatives)

With the introduction of benzodiazepines such as chlordiazepoxide (Librium) and diazepam (Valium) in the early 1960s, a new era in the treatment of insomnia and anxiety began. The benzodiazepines were more effective and far safer than the older drugs — barbiturates, meprobamate, and glutethimide — that had been prescribed for these purposes. For many years, benzodiazepines continued to be the most popular prescription tranquilizers and sedatives. Since the mid-1980s, new alternatives have been assuming some of these roles, but benzodiazepines are not about to leave the stage.

More than a dozen benzodiazepines are available by prescription. Benzodiazepines have a common basic chemical structure, and they all increase activity at receptors for the neurotransmitter gamma-aminobutyric acid (GABA). This transmitter inhibits the activity of neurons, slowing down the brain and nervous system. Benzodiazepines differ mainly in how quickly they are absorbed, how long their effects last, and how long they take to leave the body.

Overcoming anxiety

The condition tends to strike many older adults, but there are ways to counter its paralyzing effects.



More and more, do you find yourself fighting feelings of worry? Do you feel increasingly anxious and tense? Do you obsess about things that may or may not happen? If so, you may be one of the millions who suffer from anxiety.

Anxiety can develop from many uncontrollable factors, such as genetics, personality, and life events, but the main issue for many older men is that they have too much time on their hands, according to Dr. Cornelia Cremens, a psychiatrist with Harvard-affiliated Massachusetts General Hospital.

Managing the new normal: Actively help your family weather the pandemic

More than six months into the pandemic, it’s clear that we are going to be living with it for some time, and that expectations of life soon returning to normal are not realistic. This is a good time to assess the adjustments we’ve made and see how we can make different choices to get ourselves and our families through the challenge.

Limiting COVID chaos during the school year

As the school year begins, plans for how learning will happen are in flux, and may change rapidly. With so much uncertainty, parents will want to limit confusion and create as much structure as they can for their children in this difficult situation.

Tips to defuse a meltdown

Shifting your thinking and practicing deep breathing can help when you're stuck in an intense emotional moment.

At some point, we've all gotten stuck in a "meltdown" moment — an overwhelming feeling of anger or stress that was difficult to shake off. "Feeling overwhelmed makes it harder to identify ways to get unstuck; the options seem limited, which can create a sense of hopelessness or despair. Additionally, negative memories may come to mind more readily, and we may filter out useful ways of viewing the situation at hand," says Abby Altman, an associate psychologist at Harvard-affiliated Brigham and Women's Hospital.

But there are ways to shift your focus and break out of extremely emotional moments. Take note of the following tips so you can put them to work if a meltdown strikes.

Chronic pain linked to higher risk of heart attack and stroke

Research we're watching

People with chronic pain may be more likely to have a heart attack or stroke than those without chronic pain, according to a study published online May 7, 2020, by the journal Pain Medicine.

From 2001 to 2005, researchers identified 17,614 Taiwanese people who had used pain relievers for at least three months. The most common causes of pain were spinal disorders, arthritis, and headaches; the pain relievers included both over-the-counter drugs and prescription opioids. For the comparison group, researchers used 35,228 people without chronic pain who were matched by age and sex to those in the first group.

Minding your memory

Not all memory issues are cause for concern. Here is how to manage those annoying everyday lapses.

Everyone experiences the occasional "senior moment" as they age. You may misplace everyday items, fail to recall the name of someone you just met, or forget to do something. While these memory slips can be embarrassing and stressful, they usually don't mean that you are on a path to dementia.

"Some degree of memory lapses is a normal part of aging," says Lydia Cho, a neuropsychologist with Harvard-affiliated McLean Hospital. "You can't expect to hold on to all information you've gathered throughout your life, whether it was long ago or recent. It's not realistic or adaptive."

Women's group recommends more screenings for anxiety

Research we're watching

A national coalition of women's health organizations recommends screening all adolescent girls (ages 13 and older) and adult women for anxiety. The goal is to improve detection and treatment for this common condition. The Women's Preventive Services Initiative (WPSI) recommends screening to look for all types of anxiety disorders, such as panic disorder, social anxiety disorder, and generalized anxiety disorder, in addition to depression screenings, which are already recommended for adults, says the WPSI. It would be up to individual clinicians to determine how often to do the screenings and to refer women and girls for follow-up examinations and screening.

Image: fizkes/Getty Images

The mental side of cardiac rehab

If you have experienced a heart attack or undergone a heart procedure, don't neglect your mental health during recovery.

Recovery from a heart attack, heart failure, angioplasty, or heart surgery — what doctors call heart events — can be stressful. Depending on your condition, it may also involve cardiac rehabilitation. This medically supervised program focuses on exercise, diet, and lifestyle changes. While the primary focus is to help you physically, you also need to address your mental and emotional health.

"It's normal to have some anxiety and stress after a heart attack or heart surgery," says Dr. Christopher Celano, assistant professor of psychiatry at Harvard-affiliated Massachusetts General Hospital. "But how long these feelings linger, and whether they are also associated with symptoms of depression, can affect your rehab recovery success and potentially increase your risk of future problems."

Blown up in smoke: Young adults who vape at greater risk of COVID symptoms

While the majority of deaths from COVID-19 have occurred in people 65 or older, younger people who smoke or vape are at much higher risk of becoming infected — twice as likely as those in the same age group who do not use any nicotine-containing substance.

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