Stress Archive

The tragic story of copilot Andreas Lubitz, the man who apparently crashed Germanwings flight 9525 into the Alps in an act of suicide and murder, demonstrates the opaqueness of mental illness. It is difficult to know when a person is struggling with private psychological and emotional pain that might lead to dangerous or destructive behavior. All of us tend to keep our thoughts, especially our most disturbing ones, to ourselves. Even when encouraged to speak those thoughts aloud — to a mental health professional, for example — it is very difficult to do so. This tragedy will likely spark calls for increased scrutiny of pilots. That’s not necessarily a bad thing, but it could lead to the unintended and undesirable consequence that pilots will become even more wary of seeking help. To honor the lives lost will require policies that protect the public while not being punitive to pilots.

Is brain damage an inevitable consequence of American football, an avoidable risk of it, or neither? An editorial published yesterday in the medical journal BMJ poses those provocative questions. Chad Asplund, director of sports medicine at Georgia Regents University, and Thomas Best, professor and chair of sports medicine at Ohio State University, offer an overview of the unresolved connection between playing football and chronic traumatic encephalopathy, a type of gradually worsening brain damage caused by repeated mild brain injuries or concussions. The big question is whether playing football causes chronic traumatic encephalopathy or whether some people who play football already at higher risk for developing it. The Football Players Health Study at Harvard University hopes to provide a solid answer to that and other health issues that affect professional football players.

You can't see your blood pressure or feel it, so you may wonder why this simple reading is so important. The answer is that when blood pressure is high, your heart is working overtime to pump blood through your body. This extra work can result in a weaker heart muscle and potential organ damage down the road. Your arteries also suffer when your blood pressure is high. The relentless pounding of the blood against the arterial walls causes them to become hard and narrow, potentially setting you up for stroke, kidney failure, and cardiovascular disease.

A healthy lifestyle — not smoking, losing excess weight, eating nutritious foods, and exercising regularly — is the cornerstone for preventing and treating hypertension.

Men need to be challenged to be healthy in mind and body.

It might seem like retirement is a time to take it easy and devote yourself to gardening, golfing, and napping. But don't take it too easy, say Harvard experts. An absence of challenges can have the same effect as too much stress, compromising your physical and mental health. For optimal well-being, you need to stay engaged—with your own interests as well as with other people.

The best-quality evidence available does not prove that taking a statin can cause memory loss or other changes in mental functioning, according to a review in the Journal of General Internal Medicine. Since 2012, the FDA has required that statin manufacturers include a warning on drug packaging that statins could impair mental functioning, but this has been controversial. Researchers took a look at the published evidence for possible mental side effects of statins.

The new review covered randomized clinical trials involving nearly 47,000 people. Such trials are the gold standard in medical research. These included 23 trials in which researchers explicitly measured mental functioning, as well as trials that kept track of mental changes reported by participants.

Job strain—defined as having a demanding job in which you have little control—may slightly increase the risk of a stroke. The findings, in the February 2015 Stroke, echo earlier results that show a similar link between heart disease and job strain.

Researchers gleaned the results from 14 different studies that included more than 190,000 men and women from six European countries. Their average age was 42, and the follow-up lasted just over nine years, on average. Job strain was associated with a roughly 20% higher risk of ischemic stroke (the type that occurs when a clot blocks a blood vessel supplying the brain).

Anticholinergics, a group of medications that includes many over-the-counter and prescription drugs, are well known for causing confusion in older adults. Common medications with anticholinergic properties include medications to treat overactive bladder, such as oxybutynin (Ditropan); medications to treat allergies and sleeping problems, such as diphenhydramine (Benadryl, Sominex, Unisom); and medications used to treat depression, such as amitriptyline (Elavil). It's generally believed that confusion that may develop from anticholinergics clears up when someone stops taking the drugs. But now it appears that the medications are associated with a more permanent effect. A study published online Jan. 26, 2015, in JAMA Internal Medicine linked daily anticholinergic use among older adults for three or more years to an increased risk for developing dementia and Alzheimer's disease.

The study didn't prove that anticholinergics cause dementia; it only found an association between people who take the medications and people who develop dementia. Nevertheless, the researchers suggest that doctors avoid prescribing anticholinergics when possible, or at least limiting the medications to the lowest doses possible. If you're taking an anticholinergic, talk to your doctor about the risks the medication poses, including the risk of falls as a result of confusion.

At middle age, the brain begins to draw on more of its capacity for improved judgment and decision making.

If you forget a name or two, take longer to finish the crossword, or find it hard to manage two tasks at once, you're not on the road to dementia. What you're experiencing is your brain changing the way it works as you get older. And in many ways it's actually working better. Studies have shown that older people have better judgment, are better at making rational decisions, and are better able to screen out negativity than their juniors are.

Medications called anticholinergics are used to treat a host of conditions—overactive bladder, depression, allergies, and Parkinson's disease. They usually aren't recommended for older adults because one of the most common side effects is confusion and difficulty reasoning. Early studies have also indicated that long-term anticholinergic use is associated with an increased risk of dementia, and a recent study by researchers at the University of Washington adds more evidence to support that connection. The results were published online Jan. 26, 2015, by JAMA Internal Medicine.

The researchers tracked almost 3,500 men and women ages 65 and older who were free of dementia. When they matched prescription data for the previous 10 years with the participants' health outcomes, they determined that using anticholinergics was associated with an increased risk of developing dementia. Moreover, dementia risk increased with the dosage of the drugs and the length of time they were used. While people who had taken these drugs daily for the equivalent of three months had no increase in risk, those who had used them for over three years had a 54% greater risk than nonusers.

By Dr. Anne Fabiny, Editor in Chief, Harvard Women's Health Watch