Mind & Mood Archive

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.

No one is "perfect." Yet many people struggle to be a perfectionist , which can trigger a cascade of anxieties. Striving to be a perfectionist may be a strong suit or a stumbling block, depending on how it's channeled, as clinical psychologist Jeff Szymanski explains. Dr. Szymanski is an associate instructor of psychology at Harvard Medical School and executive director of the International OCD Foundation.

"The core of all perfectionism is the intention to do something well," says Dr. Szymanski. "If you can keep your eye on intention and desired outcome, adjusting your strategy when needed, you're fine.... But when you can't tolerate making a mistake, when your strategy is to make no mistakes, that's when perfectionism starts veering off in the wrong direction." In its most severe form, perfectionism can leave you unable to complete any task for fear of making a mistake.

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.

A negative attitude about aging appears to be associated with a higher likelihood of Alzheimer's disease.

A study in the journal Psychology and Aging examined healthy, dementia-free subjects from the Baltimore Longitudinal Study of Aging, the nation's longest-running scientific study of aging.

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.

This ancient practice can transform the way you think about food and set the stage for a lifetime of healthy eating.

Like most of us, you've probably eaten something in the past few hours. And, like many of us, you may not be able to recall everything you ate, let alone the sensation of eating it. According to a 2011 report from the U.S. Department of Agriculture, the average American spends two-and-a-half hours a day eating, but more than half the time, we're doing something else, too. Because we're working, driving, reading, watching television, or fiddling with an electronic device, we're not fully aware of what we're eating. And this mindless eating—a lack of awareness of the food we're consuming—may be contributing to the national obesity epidemic and other health issues, says Dr. Lilian Cheung, a nutritionist and lecturer at Harvard T.H. Chan School of Public Health.

Ask the doctor

Q. My daughter had a miscarriage a few months ago and since then she has been depressed and withdrawn. Do you know anything I can do to help?

A. Miscarriage can involve a difficult emotional recovery, and many women and their partners are surprised at the intensity of their feelings. Many women who have experienced a miscarriage feel that they have done something wrong. They may worry that the miscarriage resulted from stress or lifestyle choices they made during pregnancy. In fact, most miscarriages are the result of chromosomal abnormalities, structural abnormalities of the uterus, or maternal endocrine or autoimmune disorders.

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Research we're watching

Light therapy has been the treatment of choice for seasonal affective disorder (SAD)—the gloom that descends on some people as the days grow short. The therapy typically involves spending about 30 minutes a day—usually immediately after waking—in front of a box that emits bright fluorescent light. A study published online Nov. 18, 2015, by JAMA Psychiatry demonstrates that light therapy can also alleviate major depressive disorder.

Researchers randomly assigned 122 women and men with major depression to four groups—31 received fluoxetine (Prozac) and light therapy, 32 received light therapy and a placebo pill, 31 took fluoxetine and underwent a sham (placebo) treatment using an ion generator in place of the light box, and 30 took a placebo and underwent sham therapy. At the end of the eight-week treatment period, depression was alleviated in 17 of those who had both light therapy and fluoxetine, 14 of those who had light therapy and took placebo pills, six who took fluoxetene and had sham light therapy, and nine who had only placebo treatments.

Image: Thinkstock

Four steps—following a healthy diet, getting regular exercise, socializing, and challenging your brain—can improve your mental skills, even as you age.

Observational studies over the past few years seem to be repeating the same message: regular physical activity, a good diet, taking on new mental challenges, and maintaining strong social connections may each help you hang on to your mind. The latest and most impressive study goes a step further by suggesting that if you follow all four practices, you may even reverse lost mental capacity. The results of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) indicated that doing so not only kept cognitive skills from declining, it also improved reasoning skills and speed in performing mental tasks.