Mind & Mood Archive

A good workout makes you feel better, and regular exercise not only enhances physical health but can lift mood, reduce stress, and heighten self-esteem by improving appearance and physical strength. But how useful is exercise for people with severe depression or anxiety or chronic mental illness? Hundreds of studies now show that it can help — but there are qualifications.

Many reviews and meta-analyses show that regular physical activity is correlated with improvement in clinical depression and anxiety, mild to moderate depressive symptoms, insomnia, and resilience under stress. People who become or remain physically fit or active are less likely to develop clinical depression.

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Q. Does the acne drug, isotretinoin (Accutane), cause depression and suicide, or are psychiatric risks from the Accutane side effects exaggerated?

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.

Women with heart disease or who've had a past heart attack may be at greater risk for memory and thinking problems as they age.

Q. Most of what I read about herbs and supplements to prevent memory loss is negative. Do any supplements help even a little?

A. There's no magic pill to protect the brain from aging and disease. Many vitamins and herbal medicines have been tested to see if they preserve memory or prevent the onset of dementia, but none have passed the test. For example, several well-designed studies have checked to see if the popular herbal supplement ginkgo biloba prevents dementia, but found no strong evidence. However, large doses of Vitamin E may slow the progression of Alzheimer's disease once it takes hold.

Adding vitamin E to standard Alzheimer's drugs modestly slows the decline in daily functioning caused by dementia, according to a study in The Journal of the American Medical Association.

The study involved over 600 adults, almost all of them men. Their average age was 79, and all had been diagnosed with mild or moderate Alzheimer's disease. They were already taking one of the standard Alzheimer's medications, such as donepezil (Aricept).

When people don't get enough sleep, their attention and concentration abilities decline. Their reaction time lengthens, they're inattentive, and they don't respond as well to environmental signals.

A special form of PET scanning offers a more certain diagnosis for some, but at a steep out-of-pocket cost.

A new kind of brain scan can detect beta amyloid, an abnormal protein associated with Alzheimer's disease. It can be helpful when, based on symptoms and a careful assessment, your doctor suspects Alzheimer's dementia but remains unsure of the final diagnosis. "If your doctor suspects that the underlying cause of your cognitive deficits is Alzheimer's disease, then a scan like this can help corroborate that," says Dr. Gad Marshall, an assistant professor of neurology at Harvard Medical School. "It can help with the hard-to-call cases."

There is no strong evidence that widespread, routine testing for dementia in people 65 and older is helpful in the long run, according to a draft recommendation by the U.S. Preventive Services Task Force
(USPSTF). The USPSTF makes recommendations to primary care doctors.

Doctors can screen people for dementia by administering simple tests to look for subtle changes in memory and mental skills—even in people who still behave and function at a normal level for their age. The tests may catch the earliest signs of dementia, before really noticeable symptoms show up.

Dear Readers,

Last winter, my sister sent me an email asking whether I wanted to run the Chicago Marathon with her in October 2013. My initial response was, "Oh my gosh, no." I am a committed exerciser and runner, but the thought of tackling such an ambitious goal made me feel anxious and insecure. I hesitated for a long time, but after much deliberation decided that I would register for the race. 

I am 53 years old and I want to keep myself as mentally and physically flexible as I can be, for as long as I can. Training for a marathon would certainly serve that purpose! I wondered whether I could set three goals for myself: train without injury, run the Chicago Marathon in under four hours, and qualify for the Boston Marathon.