Mind & Mood
Your mood and your mental health affect every aspect of your life, from how you feel about yourself to your relationships with others and your physical health. There's a strong link between good mental health and good physical health, and vice versa. In the other direction, depression and other mental health issues can contribute to digestive disorders, trouble sleeping, lack of energy, heart disease, and other health issues.
There are many ways to keep your mind and mood in optimal shape. Exercise, healthy eating, and stress reduction techniques like meditation or mindfulness can keep your brain — and your body — in tip-top shape.
When mood and mental health slip, doing something about it as early as possible can keep the change from getting worse or becoming permanent. Treating conditions like depression and anxiety improve quality of life. Learning to manage stress makes for more satisfying and productive days.
Mind & Mood Articles
If your determination to become more physically active has started to flag, the findings of several studies may help renew your commitment. Research has already documented that higher levels of physical activity can help prevent or ameliorate many conditions that reduce function and hamper independence as we get older, including heart disease, stroke, cancer, diabetes, osteoporosis, and depression. Various types of exercise have also been linked with a reduced risk for dementia and Alzheimer's disease.
Now four studies, including two randomized trials, add further evidence that regular exercise may be the best thing we can do to stay not only physically healthy but also cognitively sharp into old age.
Three of the studies appeared in the Jan. 25, 2010, issue of Archives of Internal Medicine. In the first study, Harvard researchers analyzed health data from more than 13,000 women participating in the long-running Nurses' Health Study. They found that the women who reported getting the most exercise at age 60 were almost twice as likely to become successful survivors, compared with the most sedentary women. (A "successful survivor" was defined as living beyond age 70 without developing cognitive, physical, or mental health limitations or any of 10 major chronic conditions, including cancer and cardiovascular disease.) Successful survival was associated with a level of exercise equivalent to walking briskly five to six hours per week.
Obsessive-compulsive disorder (OCD), which affects 2% to 3% of people worldwide, often causes suffering for years before it is treated correctly — both because of delays in diagnosis and because patients may be reluctant to seek help.Although OCD tends to be a chronic condition, with symptoms that flare up and subside over a patient's lifetime, effective help is available. Only about 10% of patients recover completely, but 50% improve with treatment.
As the name implies, OCD is characterized by two hallmark symptoms. Obsessions are recurring and disturbing thoughts, impulses, or images that cause significant anxiety or distress. Compulsions are feelings of being driven to repeat behaviors, usually following rigid rules (such as washing hands multiple times after each meal). When these symptoms interfere with work, social activities, and personal relationships, it is time to consider treatment.
For initial treatment of OCD, the APA recommends cognitive behavioral therapy, drug therapy with selective serotonin reuptake inhibitors (SSRIs), or a combination of the two.
As people grow older, their vision, hearing, reflexes, strength, flexibility, and coordination tend to deteriorate. These physical changes can undermine driving skills, such as being able to see and hear other vehicles, stop suddenly, navigate an intersection safely, or maintain control of a car. Alzheimer's disease only compounds age-related challenges by impairing memory, insight, and reasoning.
As Alzheimer's progresses, for instance, a patient may have trouble remembering how to get somewhere, or may become confused (such as stopping at a green light or stepping on the gas pedal instead of the brake).
Although most experts agree that anyone with moderate to severe Alzheimer's or another dementia should stop driving, no consensus exists about patients at earlier stages of cognitive decline. The American Academy of Neurology and the American Association for Geriatric Psychiatry both recommend that patients with mild dementia stop driving. The Alzheimer's Association, however, believes that the determination should be based on driving ability rather than a medical diagnosis.
According to the National Comorbidity Survey Replication, only about 40% of people with major depression receive adequate conventional treatment, so it's important to get a better understanding of the other measures depressed patients are taking. A survey of American women indicates that a high proportion of them use alternative and complementary medicines for depression.
Researchers analyzed a national telephone survey of more than 3,000 women, with Mexican Americans, Chinese Americans, and African Americans somewhat over-represented in order to get a picture of ethnic differences. Of these women, 220 said they had been medically diagnosed with depression in the previous year, and 54% of them had used alternative medicine to treat the symptoms. The authors point out that the percentage would have been even higher if they had been able to include depressed women who never received a medical diagnosis.
The most popular alternatives were manual therapies, including chiropractic, massage, and acupressure, used by 26%; medicinal herbs and teas, used by 20%; and vitamins and nutritional supplements, used by 16%. Other unconventional remedies were yoga, meditation, tai chi, Chinese medicine, Ayurveda, and Native American healing.
Every brain changes with age, and mental function changes along with it. Mental decline is common, and it's one of the most feared consequences of aging. But cognitive impairment is not inevitable. Here are 12 ways you can help maintain brain function.
Through research with mice and humans, scientists have found that brainy activities stimulate new connections between nerve cells and may even help the brain generate new cells, developing neurological "plasticity" and building up a functional reserve that provides a hedge against future cell loss.
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NaltrexoneA different kind of drug treatment for opiate addicts is the long-acting opiate antagonist naltrexone, taken three times a week after detoxification. It neutralizes or reverses the effects of opiates, and triggers a withdrawal reaction in anyone who is physically dependent on opiates. An addict who takes naltrexone faithfully will never relapse, but most addicts simply stop using it, or refuse to take it in the first place. But even if most addicts will not continue to take the drug, some may — especially patients who are highly motivated to get free of the opiate because they have so much to lose from a persistent addiction. An injectable, slow-release version of naltrexone is under development, but this product is not yet available and has not received FDA approval.
Behavioral treatmentBehavioral therapists regard opiate addiction as the effect of learned associations and patterns of reward and punishment. Patients learn to identify and remember moods, thoughts, and situations that tempt them to use opiates. The therapist helps them avoid these temptations, consider the consequences of relapse, and find other ways to achieve a feeling of pleasure or accomplishment. Training in stress management, relaxation, and general problem-solving may also help. Cognitive therapists try to help addicts recognize and dismiss self-defeating attitudes that make life seem unbearable without the drug.
PsychotherapyIndividual psychotherapy is never recommended as the main treatment for opiate addiction; it rarely succeeds because addicts are reluctant participants at best. Addiction must be addressed directly. But opiate addicts often have psychiatric symptoms and psychiatric disorders, and some of these dually diagnosed patients can make good use of psychotherapy — psychodynamic, interpersonal, or supportive — as long as the addiction is treated at the same time.
In the aftermath of a life-threatening trauma, most people recover with the support of family and friends. But some develop post-traumatic stress disorder (PTSD), an anxiety disorder that may last a lifetime if appropriate help is not available. Many unwelcome and unanticipated life events, such as a spouse's betrayal or the loss of a job, can cause distressing emotional reactions, but most such events don't lead to Post Traumatic Stress Disorder (PTSD). Under the current official definition, PTSD is diagnosed only if you have been exposed to actual or threatened death or serious injury and responded with fear, helplessness, or horror.
However, the definition of PTSD is broadening, as mental health professionals gain more experience with the disorder. Individual traits and circumstances help determine how an event is perceived and how emotionally overwhelming it is. In making a diagnosis of PTSD, a mental health professional considers both the type of trauma and the individual's reaction. The point in a person's life when a trauma occurs may also predict her likelihood of developing the disorder.
First described in male war veterans, PTSD is now known to occur in children and women as well, following a range of experiences. Motor vehicle accidents are a leading cause of PTSD in both men and women. In women, rape frequently results in PTSD, and some women develop PTSD after a traumatic childbirth. Child abuse, including sexual abuse, can lead to chronic PTSD even if force was not involved. PTSD may also occur following a heart attack or diagnosis of cancer. Health care workers confronted with the aftermath of violence or natural disaster can also develop PTSD.
Dozens of opiates and related drugs (sometimes called opioids) have been extracted from the seeds of the opium poppy or synthesized in laboratories. The poppy seed contains morphine and codeine, among other drugs. Synthetic derivatives include hydrocodone (Vicodin), oxycodone (Percodan, OxyContin), hydromorphone (Dilaudid), and heroin (diacetylmorphine). Some synthetic opiates or opioids with a different chemical structure but similar effects on the body and brain are propoxyphene (Darvon), meperidine (Demerol), and methadone. Physicians use many of these drugs to treat pain.
Opiates suppress pain, reduce anxiety, and at sufficiently high doses produce euphoria. Most can be taken by mouth, smoked, or snorted, although addicts often prefer intravenous injection, which gives the strongest, quickest pleasure. The use of intravenous needles can lead to infectious disease, and an overdose, especially taken intravenously, often causes respiratory arrest and death.
Addicts take more than they intend, repeatedly try to cut down or stop, spend much time obtaining the drug and recovering from its effects, give up other pursuits for the sake of the drug, and continue to use it despite serious physical or psychological harm. Some cannot hold jobs and turn to crime to pay for illegal drugs. Heroin has long been the favorite of street addicts because it is several times more potent than morphine and reaches the brain especially fast, producing a euphoric rush when injected intravenously. But prescription opiate analgesics, especially oxycodone and hydrocodone, have also become a problem.
Think smoking marijuana is harmless? Think again. Chronic users of the drug often find themselves lacking motivation. Some even seem depressed or have other signs of mental illness. But does chronic marijuana use lead to psychiatric problems? Or do people suffering from mental illness use marijuana to self-medicate? While this drug was becoming increasingly popular with young people in the 1990s, researchers were busy trying to figure out if marijuana was a cause or an effect of psychiatric problems. And their work seems to have paid off. Research now indicates that marijuana use increases the risk of depression, as well as schizophrenia. But at the same time, depressed people do not use marijuana more often than their non-depressed counterparts.
In an Australian study, researchers interviewed 1,600 14- and 15-year-olds, then again seven years later. Participants filled out a questionnaire, reporting on their use of marijuana and symptoms of depression or anxiety. A surprising 60% of the participants had used marijuana by the time they were 20. The researchers found that the young women who had used marijuana weekly as teenagers were twice as likely to have depression as a young adult than women who did not use the drug. Daily use as a teenager was associated with four times the risk of depression for young women.
Also, among the young adults, women who used marijuana daily were five times more likely to experience depression and anxiety than those who did not use the drug. However, the researchers found no relationship between teenage depression and anxiety and later use of marijuana. This refutes the idea that youths suffering from depression turn to marijuana as a way of self-medicating.