Mind & Mood Archive

Articles

Healing yourself after injury, illness, or surgery

A book outlines what you can do to heal as well as possible.

During the year or two after surgery or treatment for a serious medical problem, many people find they need help to feel better emotionally and physically but don't know where to turn. In You Can Heal Yourself (St. Martin's Paperbacks, 2012), Dr. Julie Silver, assistant professor of physical medicine and rehabilitation at Harvard Medical School and chief editor of books at Harvard Health Publications (which publishes Harvard Women's Health Watch), details practical steps you can take for optimal healing. Her recommendations are based on research and, says Dr. Silver, "years of listening to my patients tell me what helps them and what doesn't." We talked to her about some of the ideas behind You Can Heal Yourself.

Depression and cardiovascular risk in women

Evidence suggests that depression is a treatable risk factor for heart disease and stroke.

Harvard Women's Health Watch readers probably know that the leading cause of death in women is cardiovascular disease (CVD) — that is, heart disease and stroke. Nearly 43 million women in the United States have some form of CVD, and every year, nearly 422,000 die of it — that's more than succumb annually to all forms of cancer combined. Heart disease and stroke are also major causes of life-altering disabilities.

When keeping stuff gets out of hand

You may think the home just needs an extreme makeover, but hoarding is a mental health problem that can be complex and hard to treat.

It's good to keep essentials on hand for the future. But some people take this to an extreme, acquiring and accumulating objects of dubious value (to others) in such large and disorderly quantities that their living space is filled and normal use of the home becomes dangerous or impossible. The problem is known as compulsive hoarding.

Sleep apnea increases dementia risk in older women

More than half of adults ages 65 and over have sleep apnea, a disorder characterized by abnormal pauses in breathing during sleep. Chronic sleep apnea is associated with many health risks, including high blood pressure, heart disease, and stroke. It's also been linked to deficiencies in memory and attention in children and middle-aged adults, but studies of older adults have produced conflicting results. Now, a well-designed study has concluded that older women with sleep apnea are more likely to develop cognitive problems and dementia. The findings were published in The Journal of the American Medical Association (Aug. 10, 2011).

The study. At the start of the study, 298 healthy women, average age 82, completed tests of cognitive function and underwent overnight sleep testing that monitored changes in respiration, heart rate, blood oxygen levels, brain activity, and other measures. Sleep apnea was defined as 15 or more "sleep-disordered breathing events" — pauses in breathing or shallow breathing — per hour. Five years later, the women were given further cognitive tests.

Mild cognitive impairment: More than the usual forgetfulness

Some difficulty with remembering things (like names) and forgetting where you put things (like keys) is so typical that it's considered a normal part of aging.

But some people experience a middle ground of cognitive impairment that's worse than normal age-related problems but not as bad as dementia from Alzheimer's disease or other brain diseases. Researchers labeled this intermediate state "mild cognitive impairment" in the 1980s, and the name stuck.

Preventing delirium in the hospital

Clocks and calendars may help patients stay oriented.

Being a hospital patient can be a disorienting and somewhat frightening experience. Being a hospital patient in the throes of delirium is a lot worse.

Delirium, which usually comes on suddenly, is a confused and scrambled state of mind. Memory and other types of thinking become disorganized. Hallucinations may occur. Symptoms fluctuate unpredictably, and the uneven course can make the experience even more bewildering. Classically, delirium has been associated with agitation and restlessness, but there's growing recognition that it can also put people into a hypoactive state that makes them withdrawn and seemingly drowsy.

Regular exercise may ward off cognitive decline in women with vascular disease

A study provides one more reason to carve out time every day for a brisk walk or similar exercise, especially if you have vascular disease or are at risk for developing it. Vascular disease, including heart disease and other conditions that affect blood vessels, increases the risk of age-related problems with memory and thinking, known as cognitive decline. Many studies indicate that exercise has a protective effect on cognitive function, but most have focused on generally healthy populations. The study suggests that a 72-year-old woman with vascular problems (or vascular risk factors) who exercises at least 30 minutes a day may be, on average, as cognitively sharp as a 65-year-old woman. Results were published in the Archives of Internal Medicine (July 25, 2011).

The study. The investigation involved 2,809 women ages 65 years and over who were part of a larger study, the Women's Antioxidant Cardiovascular Study. All of them had vascular disease or at least three risk factors for heart disease, such as diabetes, high blood pressure, or a body mass index (BMI) of 30 or higher. Researchers periodically asked the women about their exercise habits, including activities such as swimming, biking, and aerobic dance, as well as walking and stair climbing. They also conducted telephone interviews to assess participants' cognitive function using five tests, including memory tests of 10 words and a "category fluency" test that asked participants to name as many animals as possible in one minute. Most of the women (81%) completed at least three assessments at two-year intervals. The researchers classified the women into five groups, or quintiles, based on their reported activity levels an average of 3.5 years before their initial cognitive assessment.

More than the usual forgetfulness

Mild cognitive impairment often stays mild, but it can "progress" to Alzheimer's disease.

Some difficulty with remembering things (like names) and forgetting where you put things (like keys) is so typical that it's considered a normal part of aging. Just as hair thins and joints become less flexible, the brain processes information more slowly in our later years.

Napping boosts sleep and cognitive function in healthy older adults

With age come changes in the structure and quality of our sleep. After about age 60, we have less deep (slow-wave) sleep and more rapid sleep cycles, we awaken more often, and we sleep an average of two hours less at night than we did as young adults. It was once thought that older people didn’t need as much sleep as younger ones, but experts now agree that’s not the case. Regardless of age, we typically need seven-and-a-half to eight hours of sleep to function at our best. So if you’re not getting enough sleep at night, what about daytime naps? Or does napping disrupt the sleep cycle, ultimately yielding less sleep and more daytime drowsiness?

These questions were addressed in a study by researchers at the Weill Cornell Medical College in White Plains, N.Y., and published in the Journal of the American Geriatrics Society (February 2011). The authors concluded that napping not only increases older individuals’ total sleep time — without producing daytime drowsiness — but also provides measurable cognitive benefits.

Psychotherapy at midlife

It's never too late to benefit from talk therapy.

By midlife, you've probably spent years thinking of yourself as a certain kind of person — outgoing or introverted, high-strung or easygoing, optimistic or pessimistic. You may have become accustomed to certain roles and styles of communication in your relationships and certain ways of coping with stress. Even if you're dissatisfied with those roles and your patterns of coping aren't working so well anymore, you may think it's too late or too bothersome to question your perceptions or seek changes in important relationships.

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