Archive for the ‘Disorders and Conditions’ Category

Sleep States

November 7th, 2009

Sleep, Sleep Disorders, Lack of Sleep

If you want to catch up on sleep, don’t plan a vacation to West Virginia. People there are more sleep-deprived than anywhere else in the US. You’d be better off going to, say, Hawaii, where the scent of plumeria must lull citizens into REM, since more people there report sleeping through the night compared to every other state.

According to a poll of more than 400,000 people just completed by the Centers for Disease Control, the percentage of people reporting disturbed and inadequate sleep really does vary wildly from one state to the next. In West Virginia, over 19 percent of the respondents reported bad sleep during the previous 30 days. But people in chilly North Dakota had far lower numbers, with only 7.4 percent having lost sleep. In general, the Southern states performed poorly, although none were nearly as sorry as West Virginia. Florida respondents, for instance, reported 13.5 percent poor sleep, and Alabama 13.2.

But while the geography factor certainly sparked interest among researchers, so did the finding that overall, the respondents, regardless of which state they lived in, were overwhelmingly short on sleep. Only three out of every 10 respondents claimed excellent sleep for the previous month, meaning that a full 70 percent hadn’t slept well at least some of the month A full 38 percent hadn’t had adequate sleep for more than seven nights in the previous 30 days, and more than one in ten claimed they hadn’t enjoyed a single good night’s rest.

The study also found that adults now get considerably less sleep than they did a mere decade ago, and that sleep levels continue to decline. Experts say that adults need between seven and eight hours of rest every night in order to maintain health. But in this latest poll, 20 percent of the respondents reported sleeping less than six hours a night, far short of the minimum, compared to only 13 percent in 2001. And remember, quality of sleep counts even more than quantity — six restless hours adds up to nowhere near enough restorative rest.

The statistics skew not only by geography, but also by gender, economic status, and educational level. Having a college degree, for instance, may open the door to employment, but apparently, it shuts the door on good shut-eye. In fact, high school dropouts fare much better in the sleep department (38 percent report excellent sleep) than do college graduates (28 percent). The data show that men sleep better than women, the elderly sleep better than young adults, and Caucasians sleep better than Blacks or Hispanics.

The sleeplessness epidemic has an impact beyond making people dull at work or school. In fact, the researchers say that not sleeping the minimum seven hours night after night adds up to a chronic sleep disorder, and that’s what between 50 million to 70 million Americans suffer from. Lack of sleep correlates with psychological problems such as anxiety and depression, as well as with physical issues including increased risk for obesity, hypertension, diabetes, and high cholesterol — not mention, higher mortality rates. Plus, poor sleep links to higher levels of smoking, substance abuse, and drinking, more risk of car accidents, compromised attention span and greater likelihood of obesity.

On the other hand, some evidence indicates that oversleeping (more than eight hours a night) also correlates to major health issues and increased risk of early death. You can’t sleep too much or too little. But many experts argue that the factors that lead people to oversleep — typically depression or preexisting heath issues — cause the spike in morbidity and mortality, not sleeping in. In any event, nobody is arguing with the reality that sleep deprivation causes an array of serious psychological and physical health problems.

So what is causing all the restless nights? And why do rates of sleeplessness just keep increasing?

The CDC report says, "The major causes of sleep loss are overlapping and include lifestyle and occupational factors that reflect broad societal factors (e.g., work hours and access to technology), and specific sleep disorders." In other words, people work into the night or work so many hours that their schedule cuts into sleep. Or, they stay up at night enjoying "technology," including the Internet and television.

According to researcher Lela McKnight Eily, who led a previous CDC sleep study, "At night, we’re doing everything except for sleeping — we’re on the Internet, we may be watching TV. With these new lifestyles, we have kind of taken sleep for granted as something that we can do when we have time or we can catch up on it on the weekends. We don’t realize that sleep is a vital part of overall health and that chronic sleep loss is related to both physical and mental health issues. It’s getting worse."

The researchers don’t mention a few other factors that might cause tossing and turning. First, diet contributes to insomnia. Drinking caffeine-laden sodas and coffees, eating sweets, and eating a poorly balanced diet all create sleeplessness. So do many pharmaceuticals. Not getting enough exercise also throws the metabolism off and makes sleep difficult. Compared to a few decades ago, we eat more, we eat worse, and we exercise less and then to compensate for the toll on our bodies, we take more pharmaceuticals. No wonder we have disturbed sleep. And, of course, we haven’t even mentioned the epidemic of obesity, which can be a major contributing factor to sleep apnea. Add to that the factors the CDC named — the late night internet cruising and work schedules that spill over into the night, and you have the perfect recipe for insomnia.

The CDC recommends that health care providers address the problem by "evaluating patients who report chronic insufficient rest or sleep and advise them of effective behavioral strategies including keeping a regular sleep schedule; avoiding stimulating activities within 2 hours of bedtime; avoiding caffeine, nicotine, and alcohol in the evening; sleeping in a dark, quiet, well-ventilated space; and avoiding going to bed hungry." I was with them until that last recommendation, the "avoid going to bed hungry" They don’t mention that the pre-bedtime snack should not be milk and cookies, nor should it be a large meal, which surely will wake you in a few hours as your body tries to digest. Instead, the report says, "pharmacologic intervention might be warranted."

If you can’t sleep, you might take a good look at your lifestyle and physical condition, and if there’s no way to get it under control in the short run, at least try some natural solutions before resorting to Ambien.

:hc

Non-Drinkers Virtuous, but Depressed

October 20th, 2009

Drinking, Alcohol, Teetotalers, Depression, Anxiety, Norwegian University of Science and Technology

To drink, or not to drink: that is the question that the experts keep batting around, and the jury still is out. One week the news announces that red wine keeps the doctor away; the next it announces that drinking alcohol leads to cancer. For those on the love-to-drink side of the fence, a new study gives you something to toast.

The study, led by the Norwegian University of Science and Technology and the University of Bergen, analyzed data collected on 38,000 Norwegians. The researchers looked at drinking habits and mental health of the subjects, considering how much alcohol they had consumed in the two previous weeks and reviewing results of standardized tests that measure anxiety and depression levels. While it was indeed those who drank the most who turned up the most anxious, the surprise was that those who didn’t drink at all had an elevated incidence of anxiety compared to moderate drinkers. Even more surprising, though, was the fact that those who drank the least registered as most depressed. Those who hadn’t had a drink in the past two weeks were more depressed (and more anxious) than the moderate drinkers; those who abstained from alcohol completely were the most depressed of all.

It seems counter-intuitive that abstinence would bring on the blues since alcohol is a depressant, but in fact, the data showed that the happiest people consumed a few glasses of wine a week, or a bottle of beer, or a shot of hard liquor. To repeat, too much alcohol correlated with increasing depression, but again, not as much as complete abstinence. As the abstract for the study, published in the journal Addiction, concludes, "The risk of case-level anxiety and depression is elevated in individuals with low alcohol consumption compared to those with moderate consumption. Individuals who label themselves as abstainers are at particularly increased risk."

But teetotalers need not despair. There is a silver lining in this study for them — sort of.

The reason for the increased depression, say the experts, probably has nothing to do with the effects of alcohol on the system, and everything to do with the context in which drinking occurs. According to study director Dr. Eystein Stordal, non-drinkers tend to be social misfits. "We see that this group is less socially well-adjusted than other groups. Generally when people are with friends, it is more acceptable in Western societies to drink than not to drink. While the questionnaire recorded non-drinkers’ subjective perception of the situation, a number of other studies also confirm that teetotalers experience some level of social exclusion."

For those who don’t cop to the "if you can’t beat them, join them" mentality at cocktail hour, here’s some more unsettling analysis from the pros. Time Magazine says non-drinkers "have fewer close friends than drinkers, even though they tend to participate more often in organized social activities," and "have a harder time making strong friendship bonds." And a UPI article says, "…abstinence may be associated with being socially marginalized, or with particular personality traits that may also be associated with mental illness."

The experts do also note that non-drinkers may have made the choice to abstain not because they’re lunatics, but because they have health issues that prevent them from drinking, and those health issues may have an independent effect on mood. And in fact, according to Dr. Stordal, "We found on average that there were more people with physical complaints among the non-drinkers than in the other groups. These individuals are more likely to use medicines that mean they shouldn’t drink. But it may also be true that having such an illness increases a person’s tendency to be anxious or depressed."

In other words, if you don’t drink because you have cancer, it may be the cancer that makes you depressed and not the lack of merlot. Or, it could be the medications you take to battle the disease are triggering your depression. On the other hand, if you had a drinking problem in the past, as did 14 percent of the subjects now on the wagon, you might still be facing the internal and external issues that led you to drink in the first place, and now you have no substance with which to soothe yourself, which would lead, of course, to depression.

If you do choose to risk being a pariah and refuse to drink, you can take comfort in knowing that a study several years ago found that after seven days of abstinence from alcohol, brain cell proliferation doubled, and after four to five weeks, new neurons formed in the hippocampus. You can interpret those findings several ways. Perhaps they indicate that ignorance really is bliss — the more brain cells you have, the more miserable you get. On the other hand, maybe the analysts need to go on the wagon for a month or two themselves so they might notice that many non-drinkers don’t have a personality flaw, a physical ailment, a mental illness, or a history of substance abuse — they simply want to be conscious, clear, and happily depressed without the use of intoxicants.

:hc

Another Reason Not to Buy a Convertible

October 17th, 2009

Convertible Cars

Most dogs love to drive with their heads hanging out the window, the wind whipping the saliva out of their open mouths. Likewise, many humans believe that every dog should have his day and that driving a convertible is one of life’s drool inducing pleasures. But the open-air fun and glamour that convertibles evoke may come at a cost beyond the price-tag, because new research shows that convertible riders have an elevated risk of losing their hearing.

The study, funded by Worcestershire Royal Hospital in the UK, found that the typical noise generated by a moving convertible registers considerably higher than the threshold usually associated with hearing loss. Dr. Philip Michael, the study director, said, "If you are exposed for long periods above 85 decibels [of sound], you have the potential for hearing loss. The maximum noise [of cars tested] was at 70 miles per hour and that was 89 decibels. It has the potential for causing long-term hearing loss.”

The researchers tried out a variety of vehicles just to make sure the noise level stayed loud from one car to the next. In the name of medicine, they drove a Toyota MR2, a Mazda Miata MX5, the Audi A4 Cabriolet, a Morgan plus 4 Roadster, a Porsche 997 Carrera, an Aston Martin V-8 Vantage, and a Bentley convertible — all at 50, 60, and 70 miles per hour.

Dr. Michael found that paying a lot for a car doesn’t mean it becomes exempt from wind resistance. The expensive cars were as noisy as the cheapest once the tops went down. Also, going slower made only a minimal difference in noise level when driving on the highway. Oh, and cranking up your car’s stereo to override the wind noise doesn’t actually help.

But in the world of ear-popping noise, all is relative. While normal conversation registers at about 60 decibels, you could drive with the top down to a Rolling Stones concert and back again and get a whole lot less noise exposure than if you actually went into the concert, where the noise-level would be at about 115 decibels.

And that brings up a simultaneous study of 5,000 people in the US, which found that men have three times the risk of hearing loss related to noise compared to women. While driving a convertible may up the ante for potential deafness, so do many other activities — and apparently, men indulge in more of those activities. For instance, operating heavy equipment or machinery like chain saws or lawnmowers without ear protection can damage hearing. Men are more likely to shoot guns, to drive motorcycles, and to listen to head-banging music — in other words, to have jobs or hobbies that require noise exposure.

It’s something that most people don’t think about in the course of normal life — that turning the stereo up too high can degrade hearing over time, even if it’s Mozart on the sound waves. In fact, a significant percentage of adults do suffer from noise-induced hearing loss, including 13 percent of the subjects in the sample. According to Dr. Douglas Mattox, professor of otolaryngology at Emory University School of Medicine, "Noise-induced hearing loss is the number one preventable kind of hearing loss. We’re all born with 20,000 inner hair cells on each side of the head, and those are a non-renewable resource, and they never come back every time one is lost."

How can you lessen your chances of damaging your hearing while still having fun? First, wear earplugs or noise-canceling headphones when operating noisy machinery, playing the drums, taking off in the airplane, and when driving your convertible (assuming it’s legal to do so in your state). Next, lower your frequency of exposure. As Allison Grimes, head of the audiology department at the UCLA Medical Center says, "…if you drive eight hours a day, seven days a week you have a much greater concern than if you drive two hours on a Sunday afternoon." If you have a convertible, roll up the windows to slash the noise level, and use a wind guard. Also, eat your vegetables and fruits: another simultaneous study found that men over the age of 60 can decrease their risk of hearing loss by a full 20 percent just by consuming plenty of folates, which are found in leafy green vegetables, fruits, and beans.

Oh, I almost forgot to mention: men can also possibly preserve their hearing by remaining single. The data shows that married men suffer far more noise-induced hearing loss than single men, a fact that puzzles the researchers. Some media sources have been having fun with this fact, blaming nagging wives for the phenomenon. A more politically correct analysis might theorize that with a wife’s second income, men can afford to buy more of the toys and tools they crave — the power saws, CDs, and motorbikes. If so, perhaps they can begin diverting some of the excess funds to a folate supplement and a pair of good noise-cancelling headphones.

:hc

Baby Stroke: Health Blog

October 8th, 2009

Pediatric Strokes

In childhood, when the time horizon seems to stretch endlessly into the future, few worry about diseases usually associated with old age such as diabetes, clogged arteries, and stroke. But stunningly, these conditions increasingly afflict the very young — including not only children, but also babies. In fact, strokes in utero can occur, even before birth. Now, a new study shows that children have strokes far more frequently than previously thought, with the youngest children the most frequent victims.

According to Stroke: Journal of the American Heart Association, pediatric strokes occur two to four times more frequently than previously thought. Dr. Nidhi Agrawal, who headed a research team out of the University of California, San Francisco, says that hospitals have been underreporting the incidence of strokes among children in part because record-keeping systems lack the proper diagnostic codes. Since childhood stroke was thought to be so rare — afflicting only about 2.4 out of every 100,000 children — insurance and hospital charts have no corresponding category to check off on the intake forms. With that in mind, the researchers carefully combed through 2.3 million children’s records in the Kaiser Permanente database, looking for symptoms corresponding to stroke. After analyzing the radiology records, they found many cases of stroke that had been classified otherwise.

In fact, several earlier studies found even higher pediatric stroke rates of up to 7.9 per 100,000, including strokes occurring before or immediately after birth. According to the website Kids_Have_Strokes.org, one out of every 4000 infants will suffer from a stroke before reaching age one, and strokes strike six out of every 100,000 children from age one to 18. Those kids who do suffer strokes often end up with lifelong disabilities. Five to 10 percent of childhood stroke victims die from the event, and over half will have serious long-term physiological and neurological difficulties.

While scientists have conducted substantial research on how to treat and rehabilitate adult victims of stroke, there’s been very little progress in developing treatment approaches to benefit young stroke sufferers over the past decades or in understanding what triggers stroke in children. This probably is because the problem has been considered more uncommon than it actually is, and so, it’s received very little attention and very little research funding. It’s also led to misdiagnosis on a large scale. As study co-author Dr. Heather Fullerton says, “These data have unfortunate implications on pediatric stroke research, which has depended largely on retrospective observational studies. The findings “support recent calls for the field to move toward prospective multicenter studies of pediatric stroke.”

Dr. Ian Butler, MD, of the University of Texas Medical School, also hopes this new data will draw attention and research dollars to the issue. He says, “The number of times someone has said to me, ‘We didn’t think it was a stroke because it was a child,’ is legend. All of the residents here have it hammered into them to include stroke.”

Certainly, it’s disturbing in a larger sense that physicians and hospitals have been missing the medical reality simply because they don’t have an appropriate check-box on their intake forms, and because they don’t expect to see the presenting condition. Here’s another example of how the medical model, as often practiced, focuses so myopically on symptoms and diagnoses that it fails to consider possibilities outside the box, or to notice what the patient actually is experiencing beyond the presenting symptoms. In the case of pediatric stroke, it seems that medical professionals have allowed diagnostic codes to trump thoughtful observation and even careful review of the radiology report, and that approach has been completely misguided.

Which brings up the “what else?” question: What else do hospitals miss? What other conditions frequently get the wrong diagnosis slapped on them because no appropriate check box exists on the presenting form? You can bet where there’s frequent misdiagnosis, there’s also corresponding mistreatment. And all that wrong treatment adds up to the fact that medical errors — wrong prescriptions, wrong therapies, surgeries on wrong body parts on so on — kill up to 98,000 Americans each year.

At least in the case of pediatric stroke, the misdiagnosis issue has come to light, and where there’s light, there’s hope — as long as physicians read about this study when it shows up in their inbox, and as long as research organizations respond by committing some funds to study treatment alternatives. Then again, the example of hormone replacement therapy is enough to quash any such hope. Even though the evidence of its ability to induce cancer is now pretty much incontrovertible, its use as a therapy has only dropped by half. That means that half the doctors out there have either not read those studies or have decided to ignore them.

In the end, perhaps the best advice I can offer is that you should treat all exchanges you have with a doctor or hospital as business transactions — or as the saying goes, “Caveat emptor.”

:hc

Smart Sperm – Revenge of the Nerds: Health Blog

October 3rd, 2009

Healthy Sperm Concentration

There’s an old joke in which a young boy being bathed by his mother points to his privates and asks, “Are these my brains mom?”  “Not yet,” she replies.  The element of truth behind the joke may surprise you.  According to a study by researchers at the University of New Mexico, intelligence correlates to healthy sperm. 

The study, led by Dr. Geoffrey Miller, found that men who scored highest on intelligence tests also had the highest numbers of healthy sperm. Men who scored lower on the intelligence tests had fewer sperm and the quality of those sperm was lower. According to Dr. Miller, this is not because the same genes affect intelligence and sperm quality. Instead, said Miller, “…the two traits could be linked through a tangled web of biological and environmental interactions that has evolved to help women pick a mate.”

The 2009 study analyzes data collected in 1985 research involving 4,402 Vietnam war veterans, 425 of whom provided usable sperm samples.  The researchers studied these samples for sperm concentration, sperm count, and sperm motility.  They also subjected the 425 vets to a battery of intelligence tests.  The new research analyzed the connection between the scores on the intelligence tests and the three measures of sperm quality, while controlling for variables that could throw off the results, such as tobacco and alcohol use, drug use, age, length of service in Vietnam, days of sexual abstinence and so on. The researchers found significant correlation between intelligence and all three of the sperm-quality measures.

Does healthy sperm lead to more success in finding mates? If so, forget the idea that women just want macho cavemen with fat wallets. They also want the brains behind that wallet (perhaps because of some unconscious belief that brains will keep the wallet fat). According to Miller, “Traits such as language, humour, and intelligence evolved in both sexes because they were sexually attractive to both sexes.”  In other words, in the evolutionary battle for mates, men projected their fitness for procreation not merely through physical strength, but through traits such as intelligence, humor, and language. For lack of a better term, you can call it the “nerd” effect.

According to the authors of the study, men and women may have selected intelligence as a sign of underlying genetic fitness because, over millennia, it was such a reliable indicator. The smart caveman could predict where dinner was roaming and perhaps invent novel ways of snagging it; the smart modern man ostensibly can write computer software and become a billionaire. But here’s the proviso: to be really attractive to women, the brains do have to translate to money, at least according to research. Maybe the term “nerd effect” doesn’t cover it. Perhaps we need to call it the “Microsoft/Google effect.”

Which brings up the unfortunate truth for the nerds out there who think that merely being able to complete the Times crossword is sexy enough to attract females. Though women may want brainy boys, studies show they also want the accoutrements of wealth and macho in the men they pursue. Research consistently shows that women rate the ability to provide as the number one consideration when choosing a mate. A recent study out of the University of Wales found that women really do prefer men who drive flashy cars. Then again, we need there is a proviso here. Although women may prefer wealthy nerds for mates, their cavewoman predecessors, they are still sexually attracted to brawn. A 2007 study out of UCLA found that women preferred muscular men for sex partners, while study after study affirms that women prefer tall men.

So brains, brawn, and money all count, and brains can lead to money, closing that circle. But even if intelligence signals healthier sperm, modern lifestyle choices can reverse any evolutionary gains.  For example, smoking has been shown to harm sperm and male fertility — aside from the fact that smoking may indicate dubious intelligence to begin with. A 2005 study (sponsored by, of all organizations, Phillip Morris) showed that a smoker’s sperm was less likely to bind to an egg, a key step in fertilization.  Similarly, a Danish study that ran from 1992 to 1995 showed that men who drink caffeine decrease their fertility. (Whoops! That may rule out the Microsoft/Google effect as programmers often live on caffeine and sugar.) I wonder if from a Darwinian perspective, it may only be a matter of time until these habits are selected out of existence.

:hc

Scientists “Discover” Low Self-Esteem Leads to Weight Gain: Health Blog

September 29th, 2009

Weight Gain

It seems so very Monty Python-esque: a new British study involving 6500 people has come to the conclusion that low-self esteem and emotional problems lead people to get fat. One can almost hear the director of that study, Dr. David Collier of King’s College, echoing Ms. Anne Elk in the Flying Circus, “This is my theory, it is mine, and it belongs to me, and I own it, and what it is, too.” Like Anne Elk’s theory that the brontosaurus is thin on top, fat in the middle, and thin at the other end — this latest study points to the obvious.

 

Dr. Collier and his research team tested his theory that emotional problems and weight are linked by collecting data on 6500 participants in the British Birth Cohort Study, which began back in 1970. At age 10, the participants were measured for height and weight, and they also completed self-esteem assessments. The scientists tracked the participants over the next 20 years, and sure enough, those with low self-esteem and emotional issues put on more weight over the next two decades than those who were emotionally stable. The researchers noted that subjects who felt less in control of their lives and who worried more were among the biggest weight gainers, with the correlation being stronger for women than men. But, Dr. Collier says, “This is not about people with deep psychological problems, all the anxiety and low self-esteem were within the normal range.”

The most surprising fact about the research is that anyone found the results surprising. But it seems that the research team did, in fact, believe they had stumbled upon something new — something thin on the ends and fat in the middle, dare I say. “What’s novel about this study is that obesity has been regarded as a medical metabolic disorder – what we’ve found is that emotional problems are a risk factor for obesity,” said Dr. Collier.

Perhaps Dr. Collier and his cohorts have been stuck in the lab for the past few decades while overwhelming numbers of overweight citizens bought books about emotional eating and tuned into talk shows on the subject. A quick trip to Amazon.com shows that typing in “Emotional Eating” brings up 2,803 titles. Type “emotional eating” into a Google search and you’ll pull up 2,970,000 references. Clearly, it’s hardly news that difficult emotions can lead to overeating, and it’s a no-brainer that overeating leads to weight gain.

At least the researchers gave a nod to the other factors that correlate with weight gain. “While we cannot say that childhood emotional problems cause obesity in later life, we can certainly say they play a role, along with factors such as parental BMI [body mass index], diet and exercise,” said co-director of the study Andrew Ternouth. Plus, Dr. Ternouth had advice to offer: “Strategies to promote social and emotional aspects of learning, including the promotion of self-esteem, are central to a number of recent policy initiatives. Our findings suggest that approaches of this kind may carry positive benefits for physical health as well as for other aspects of children’s development.”

Well, it may seem naïve and the money spent on the study may seem wasteful, but those preventative recommendations sure beat the pants of pharmaceutical and surgical approaches. On the other hand, promoting self-esteem doesn’t guarantee svelte waistlines, either. We’ve all known chubby bullies who feel terrific about themselves. In fact, experts on emotional eating, such as Dr. Roger Gould, author of Shrink Yourself, suggest that it isn’t the emotional problem, per se, that makes the person overeat — it’s that the person learns to use food to “stuff down” emotional difficulties, and that is learned behavior, at least in part.

The child observes the parent deal with problems by eating junk. The parent gives the child treats as rewards, or to shut the child up. The child watches commercials for junk food on television, seeing the actors smiling as they devour treats. The child discovers that by eating junk, he gets a temporary soothing sensation, using food as a drug. But the thing is, as the child keeps eating to stuff emotions, he suffers from the physiological and psychological effects of eating junk food. These effects can include emotional imbalance from the effects of sugar, low-self-esteem as weight piles on, mental fog, lack of energy and withdrawal from exercise. In other words, it’s a catch-22 — emotional problems lead to overeating, and overeating leads to emotional problems.

To interrupt the cycle, kids need emotional balance and nurturing, yes; but they also need to learn that overeating isn’t the answer. They need healthier foods, healthier coping mechanisms, and healthier routines, including getting enough exercise. After all, emotional problems and low self-esteem are hardly new phenomena. People in the 1950s had emotional problems, but most didn’t get fat.  Now two-thirds of adults in the US are overweight — so clearly something has changed and you can bet it isn’t plummeting self-esteem. In fact, new studies show that kids today suffer from too much self-esteem — that the self-esteem movement in education that started in the 1980s led parents and teachers to overindulge kids, making them lazy and narcissistic. They think they’re great as they are.

The experts are right about one thing — early intervention is key. But they miss the mark in thinking more hugs and praise will help Johnny eschew the brownie when he feels blue. Johnny needs to learn other ways to deal with episodes of normal sadness (also known as life). Johnny needs to understand that when it comes to his body and his life, “They are his, and they belong to him, and he owns them, and what they are, too.”

:hc

Too Depressed to Enjoy Music: Health Blog

August 27th, 2009

Music, Depression

In the category of “studies we may not need that confirm the obvious,” new research has uncovered the fact that depressed people enjoy things less than happy people do. No really! That was actually the subject of a study that someone paid for. The researchers involved in this study elevated their observations into the realm of science by observing brain activity in 31 subjects using magnetic resonance imaging (MRI). Each subject listened to their favorite musical compositions for three minutes while their brains were scanned, with the researchers observing the brain’s response. Sure enough, the pleasure centers in the brains of happy people showed far more activity in response to the music than the dulled-out brains of the depressed people.

“Our results revealed significant responses within the areas of the brain that are associated with reward processing in healthy individuals. They also showed significant deficits in these neuro-physiological responses in recently depressed subjects compared to the healthy subjects,” said study director Dr. Elizabeth Osuch of the Lawson Health Research Institute in Ontario.

Now to be fair, the study did yield interesting data revealing exactly which parts of the brain respond to pleasure and which parts stop responding when depression descends. Armed with this information, scientists can now look for ways to stimulate those non-responsive brain centers without involving the entire brain. “If we can target these areas of the brain through treatment, we have the potential to treat depression earlier, right at the source,” Dr. Osuch says.

It’s unclear what type of treatment Dr. Osuch has in mind, but it sounds like she might be referring to some form of targeted electro-stimulation, which certainly would be an improvement over the once disfavored but now increasingly popular practice of electro-shock therapy, which attempts to…well, actually no one really knows what it does or how it works. In shock treatment, also called electro-convulsive therapy (ECT), electrodes stimulate the brain until the body goes into convulsion. After a few such treatments, the lucky patient loses some of the gloom; the unlucky patient experiences major memory loss. Though some consider this treatment to be a form of medieval torture, others say it’s the best way to go when antidepressants don’t work (and as I’ve written before, they usually don’t work). Incidentally, the concept for ECT came from an Italian psychiatrist, Ugo Cerletti, in 1938. For some reason, he was observing the barbaric act of slaughterhouses using electrocution to shock pigs into unconsciousness so that the slaughterhouse workers could slit the pigs’ throats more readily. It occurred to him that the same concept could be applied to the treatment of mental illnesses in human beings (without the slitting of throats I assume). And three quarters of a century later, no one has any idea how it works — which, of course, has never stopped it from being used. (And the medical establishment complains about alternative medicine!!!)

“[Shock therapy is] the definitive treatment for depression,” says Dr. Kenneth Melman, a psychiatrist at Swedish Medical Center in Seattle. “There aren’t any other treatments for depression that have been found to be superior to ECT.” Now that’s a scary thought — a thought that makes it seem urgent for scientists to figure out pronto how to stimulate those targeted spots only while leaving the rest of the brain alone. But then again, and thankfully, many physicians don’t belong to Dr. Melman’s electro-happy club. In fact, some practice another method of brain modification that has virtually no dangerous side effects.

Instead of going for pharmaceuticals or destructive procedures, patients can opt for neurofeedback, a process in which results from an EEG are broadcast visually and in sound, as patients watch and listen. In other words, patients see their own brain wave patterns dance across a screen while listening to corresponding sounds. Normal scans show a particular pattern, and so do scans of depressed people. Depressed people learn how to alter their brain wave patterns to match the patterns of more chipper people through techniques akin to meditation. So far, clinical evidence looks quite positive — especially when patients try neurofeedback in conjunction with psychotherapy. And since neurofeedback patients actually change brain-wave patterns, they don’t need to worry about slipping back into depression when they go off the treatment, as do those on drugs.

But in the case of most mild to moderate depression, machines and drugs are probably superfluous. Good nutrition and the proper use of supplements can alleviate many cases of depression, especially when sufficient exercise is thrown into the mix. Interestingly, a new study shows that weight loss by itself can lift depression, perhaps as a result of altered blood-sugar metabolism and improved hormonal balance as weight declines. I’ve written before about numerous supplements that can ease mood problems, and about magnets, which outperformed antidepressants in recent clinical trials.

But what about the impaired lack of music appreciation among the glum found by the researchers in the recent study? Well, as Hamlet, the world’s most famous depressive, might say, “Ay, there’s the rub.”  Numerous studies have found that music works well as an antidepressant. In fact, music has a better track record in clinical studies than drugs do. In other words, if patients in the study that we cited at the top of the blog had been allowed to listen to their favorite compositions for longer periods of time, with clinical help, instead of for the three minutes allowed in the study, they might actually have experienced a lift in mood. While they might not have enjoyed the music as much as the already-happy subjects did at the outset, by the end of the session, all indications are they too might have been whistling a happier tune.

:hc

Swine Flu Soirees: Health Blog

July 4th, 2009

Swine Flu Parties, H1N1, Tamiflu

When Mike Meyers and Dana Carvey sang the Wayne’s World theme song, "Party time….excellent," they probably didn’t have swine flu parties in mind. Who could even imagine such a thing? But sure enough, that’s the newest craze sweeping the world, with Mom’s across the globe discussing the benefits of bringing their kids to just such a shindig. And why? Because they hope that exposing their children to the bug will build immunity against future exposures, when more virulent strains might possibly appear.

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Depression Gene Has Mental Breakdown: Health Blog

June 27th, 2009

Depression

Back in 2003, depressed people had something other than bad parenting to blame for their mental malaise. At that time, a well-publicized study announced that a link had been found between a gene called 5-HTTLPR and depressive illness. The research postulated that people with a variant of that gene didn’t carry serotonin to their brain cells effectively. Since serotonin seems to allay depression, the scientists suspected that those with the gene variant would get depressed when life became difficult. And sure enough, the study found that those subjects who had the gene did get more profoundly depressed after traumatic life events than the subjects lacking the gene.

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Brain Functions Even After Death: Health Blog

May 28th, 2009

Near Death Experience, Pam Reynold

According to the American Medical Association and the American Bar Association, death is legally defined as the "irreversible cessation of all functions of the entire brain, including the brain stem." So how, then, do we explain the fact that up to 20 percent of those who die and then are brought back to life report that they retained consciousness even during the near-death experience? How do we explain the common phenomenon of seeing the black tunnel with the light at the end and the gathered dead relatives? Is consciousness a function of the seemingly inert brain, or does it reside somewhere outside of the "vital functions of the organism"?

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