Day: July 5, 2024

Jul 05

What Is Eco-Anxiety? How Climate Change Is Affecting Our Mental Health

What Is Eco-Anxiety? How Climate Change Is Affecting Our Mental Health The occurrence of natural disasters in 2020, such as typhoons, hurricanes, wildfires, and others, has raised concerns about the impact of climate change. These extreme weather events are becoming more frequent, and scientists are increasingly linking them to the effects of climate change. During late October and early November 2020, the Philippines experienced the devastating effects of two powerful typhoons that caused widespread destruction. Prior to that, Australia faced severe bushfires that resulted in significant loss of forests, homes, and wildlife. In the United States, the summer of 2020 witnessed record-breaking heatwaves, hurricanes, a rare derecho in the central region, and destructive wildfires that painted the skies orange in the western part of the country. The climate crisis we currently face is not only affecting the Earth’s ecosystems but is also causing a growing sense of unease and anxiety among people worldwide. While not a clinical diagnosis with a specific definition, mental health professionals have introduced the term "eco-anxiety" to describe the increasing sentiments associated with these environmental concerns. Eco-Anxiety Definition Eco-anxiety, as described by the American Psychological Association (APA), refers to a chronic fear of environmental devastation. It is a prevalent condition, with a recent APA poll revealing that 68 percent of US adults experience at least some level of eco-anxiety. Among individuals aged 18 to 34, about half report that climate change-related stress impacts their daily lives. What was once considered a niche issue has now become more widespread due to the increasing occurrence of climate-related events. Climate change is no longer seen as a distant concern but as a pressing reality that affects people directly. Eco-anxiety can have both acute effects, triggered by natural disasters, and chronic effects resulting from gradual climate change. These effects can impact mental health in various ways, including trauma, shock, post-traumatic stress disorder (PTSD), compounded stress, strained social relationships, depression, anxiety, suicidal thoughts, substance abuse, aggression, violence, loss of personally important places, loss of control and autonomy, loss of personal and occupational identity, as well as feelings of hopelessness, fear, or fatalism. It is important to recognize and address the mental health implications of climate change, providing support and resources to individuals experiencing eco-anxiety. Who Is Most Vulnerable to Eco-Anxiety Not surprisingly, those experiencing the direct consequences of climate change—wildfires, superstorms, flooding—are especially vulnerable. Scientists have long studied the psychological health effects of environmental disasters to know the mental health impact is very real. After Hurricane Katrina—the 2005 storm claimed over 1,800 lives—one in six survivors showed signs of post-traumatic stress disorder, suicidal ideation, and suicide more than doubled, and 49 percent of those living in an affected area developed an anxiety or mood disorder. Australia’s Black Saturday bushfires in 2009 left 15.6 percent of the affected community with symptoms of PTSD years after the fact. "We’re going to continue to see climate catastrophes and tipping points," says Doherty. "People have become more used to them, but these really super destructive [events] cause a lot of stress and anxiety." The climate crisis also disproportionately impacts communities of color, according to the United Nations, so they too may be at an even greater risk of eco-anxiety. People of color in the US are more concerned about climate change than their white peers, according to a study by George Mason University’s Center for Climate Change Communication. The authors write the heightened worry is because "[people of color] are often more exposed and vulnerable to environmental hazards and extreme weather events." These hazards include but are not limited to, air pollution, flooding, hurricanes, and wildfires. Some of these environmental problems have been constant, multi-generational threats for communities of color. Take air pollution, for example. A 1999 IOM study found people of color are exposed to higher levels of pollution than their peers. More than two decades later, it’s still a harsh, inequitable reality: Studies have repeatedly shown Black and Hispanic communities are more exposed to air pollution than white communities. To further compound the issue, communities of color tend to have fewer resources (e.g. infrastructure, access to healthcare, lower access to aid after climate-related disasters) to mitigate the effects of the climate crisis and deal with the aftermath of an environmental disaster. What Can Help With Eco- and Climate Anxiety? Climate change is a legitimate concern, and it is natural to experience anxiety in response to the threats it poses. Susan Clayton, an expert in climate anxiety, highlights that a certain level of anxiety can be beneficial as it alerts us to the seriousness of the issue. Anxiety serves as a signal that prompts us to pay attention and take action. To alleviate anxiety related to environmental doom, it is important to shift the dialogue and implement policies aimed at mitigating climate change. Creating greater awareness and acceptance of climate change, along with international efforts to address it, can help alleviate anxiety by providing a sense of collective action. During the Trump administration, environmental protection measures were weakened or rolled back, contributing to heightened concerns. However, it is important to recognize that addressing climate anxiety requires more than just government action. Individual approaches to managing anxiety may vary, from seeking more information to reducing exposure to distressing news. Engaging with local activist groups, communicating with local politicians, and taking personal actions can help regain a sense of control and contribute to positive change. Ultimately, it is crucial to remember that the dysfunctional situation lies in the environmental challenges we face, not in the individuals experiencing anxiety. By collectively taking steps to protect our planet, we can make a meaningful impact and work towards a sustainable future.

Jul 05

What Is Alpha-Stim Cranial Electrotherapy Stimulation?

What Is Alpha-Stim Cranial Electrotherapy Stimulation? Commonly used treatments for managing anxiety symptoms include talk therapy, medication, or a combination of both. In addition to these traditional approaches, cranial electrotherapy stimulation (CES) using an Alpha-Stim device is another potential option. The Alpha-Stim device works by interacting with the brain to help alleviate symptoms related to mood and sleep. It offers an alternative method for individuals seeking additional support in managing their anxiety. It is important to consult with a healthcare professional to determine the most suitable treatment approach based on individual needs and circumstances. Cranial Electrotherapy Stimulation and Alpha-Stim CES, or cranial electrotherapy stimulation, involves the application of a pulsed, low-intensity electrical current to stimulate the brain. This is achieved by placing a pair of electrodes on specific areas of the head, such as the earlobes or temples. The notion of using electricity to influence the brain may initially raise concerns for some individuals. However, it’s important to note that CES utilizes a very low level of electrical current, typically ranging from 50 to 500 millionths of an ampere. This amount is considered minuscule and is generally well-tolerated by individuals who undergo CES therapy. CES emerged as a treatment for mental health disorders during the 1970s, and by the 1980s, the Alpha-Stim Anxiety Insomnia and Depression (AID) device had become a widely used CES device. The AID device is a portable, phone-sized device that requires batteries and is equipped with electrodes that can be clipped onto the earlobes. It can be utilized in both home and clinical settings. The Alpha-Stim AID device has received approval from the Food and Drug Administration (FDA) for the treatment of anxiety, depression, and insomnia. Additionally, there is preliminary evidence suggesting that the Alpha-Stim M device can be effective in managing these conditions as well as acute, chronic, or post-traumatic pain. However, further research is needed to fully understand the extent of its therapeutic impact. How Does Alpha-Stim Device Treatment Work? The Alpha-Stim AID device utilizes CES to interact with the nervous system and restore normal functioning of cell signals. The nervous system plays a crucial role in regulating mood, with cells communicating throughout the body and brain through neurotransmitters like serotonin or dopamine. When neurotransmitters are imbalanced and their receptors don’t function properly, it can disrupt the processing and expression of emotions in different parts of the brain. This imbalance can contribute to the development of mood disorders such as depression and anxiety. It’s important to note that the time required to experience benefits from Alpha-Stim devices may vary from person to person. While some individuals may experience immediate relief, others may need to use the device multiple times to achieve the desired effects. It’s recommended to follow the guidance of healthcare professionals and adhere to the prescribed usage protocol for optimal results. What Have Researchers Found? Research suggests that Alpha-Stim can be an effective treatment for anxiety, although it may not be as effective as cognitive behavioral therapy and other established anxiety treatments. The effectiveness of Alpha-Stim compared to sham devices, which do not emit electricity, has yielded mixed results. A study published in 2014 compared the outcomes of individuals using Alpha-Stim to those using a sham treatment. The results showed that the group using Alpha-Stim experienced a significant reduction in anxiety symptoms by more than three times and a reduction in depression symptoms by 12 times. However, another study published in 2023 found no significant difference in symptom reduction between active Alpha-Stim and sham devices in individuals with major depressive disorder (MDD). Overall, Alpha-Stim devices have been deemed safe, with minimal reported side effects. Headaches have been reported in approximately 0.1% of individuals, and skin irritation in around 0.07%. It’s important to consult with healthcare professionals to determine the most appropriate treatment approach based on individual circumstances and consider the available evidence when considering the use of Alpha-Stim devices. What Else To Know About Alpha-Stim Treatment To try Alpha-Stim in the United States, a prescription from a healthcare provider is required. The Alpha-Stim AID device is priced at $840, while the Alpha-Stim M is priced at $1,299. While these devices can be considered expensive, they may still be more affordable compared to other mental health treatments. If you are considering purchasing an Alpha-Stim device, it is recommended to contact your insurance company to inquire about coverage or reimbursement options. Additionally, some providers offer financing or flexible payment options to assist with the cost of the device. Exploring these possibilities can help make the purchase more manageable financially. A Quick Review Alpha-Stim utilizes cranial electrotherapy stimulation, a treatment involving low-current electricity, which is considered safe and effective. The Food and Drug Administration (FDA) has granted clearance for Alpha-Stim devices to be used in the treatment of anxiety, depression, insomnia, and pain symptoms. However, it should be noted that further research is necessary to fully establish the extent of its effectiveness. Preliminary evidence suggests that while Alpha-Stim may be beneficial, it may not be as effective as established anxiety treatments like cognitive behavioral therapy. It is important to highlight that purchasing an Alpha-Stim device requires a prescription from a healthcare provider. Insurance coverage for the device may vary, and it is advisable to consult with your healthcare provider and insurance company to determine coverage options. It is recommended to discuss with a healthcare provider to determine the most suitable treatment approach, whether it involves Alpha-Stim or other mental health treatments.

Jul 05

This Summer, Some People With ADHD Are Going on “Medication Holidays”—But Is That Wise?

This summer, some people with ADHD are going on "medication holidays"—but is that wise? Some TikTok producers are bragging about the positive effects of taking a break from their ADHD medication, which is also known as a "medication holiday," "medication vacation," or "drug holiday." Taking a break from medication over the weekend may provide some persons with ADHD with a welcome change of pace. However, some TikTok parents are advocating for a lengthy break from their child’s ADHD medication throughout the summer months. Anish Ranjan Dube, MD, head of the Council on Children, Adolescents, and Their Families at the American Psychiatric Association, noted that the decision to take such a break from doctor-prescribed medicine is not one-size-fits-all and should not be swayed by individuals on social media platforms. Because of differences in biology, severity of the pathology, and circumstances, "recommendations by individual users or content based on the personal experiences of such users may have social value in that others may relate to them," he told Health. Dr. David Goodman, an adjunct faculty member in the Department of Psychiatry and Behavioral Sciences at Johns Hopkins University, concurs. He pointed out that many of the individuals sharing their personal experiences on social media have had really unusual ones. Goodman, director of the Adult Attention Deficit Disorder Center of Maryland, told Health that "all those lived experiences are very individual and so what one person says has worked or hasn’t worked for them doesn’t necessarily mean that it’s going to work or not work for you." Call your doctor or pharmacist for guidance regularly. Possible Consequences of Abandoning ADHD Medication Many TikTok users with ADHD create the idea in their "medication vacations" that the medicine’s effects would disappear as soon as they stop taking it. According to Goodman, stimulant medicine, the standard treatment for ADHD, fits this description. Stopping the usage of a stimulant drug will have little to no effect on your condition. "In terms of how long it will be in your system, it will be gone from your body after a day following your final dose. "The benefit is recaptured when you use it again," he explained. Goodman, however, cautioned that it takes a few of weeks to detect an impact if you quit using non-stimulants like atomoxetine or viloxazine.1 It takes two weeks for the effects of non-stimulants to become noticeable, and even after discontinuing use, the effects might linger for up to two weeks. This is similar to the mechanism of action of antidepressants. The Case for Taking a Break From Medicating Their Kids There are a number of scenarios in which parents could consider temporarily suspending their child’s ADHD medication treatment. Some parents have taken to TikTok to announce that they are weaning their child off of ADHD medication so that the youngster may be more like their "true self." Goodman suggested that parents’ concerns about their children’s "muted down" emotional reactions and social participation may be what they mean. To combat their focus problems in the classroom, some kids take medication for ADHD.2 Dube speculated that these children would be able to handle a pharmaceutical break throughout the summer without suffering any ill effects. In any case, he emphasized that certain people (particularly teenagers) may have symptoms of ADHD that are debilitating while activities such as driving, causing easy distractibility or carelessness, thus it is necessary for them to continue taking their meds. A pharmaceutical holiday may trigger a return of symptoms and accompanying impairment "if the medication is helping treat a symptom (or symptoms) that severely affect(s) multiple aspects of one’s life," as stated by Dube. According to the article, "in such cases, it may be more beneficial to remain on the medication." Goodman said that stimulants can cause children and teenagers to lose weight and height, which is another reason why parents would want their children to take a break from the medicine.3 The idea is that "the impact on appetite and weight will be less if you decrease the exposure [of medication] over time," he added. Do Adults Benefit from Taking a Break from Their Medications? Goodman stressed the need of maintaining regular dosing for people who have been diagnosed with ADHD and provided medication. Because "ADHD symptoms show up in work, social relationships, and emotional control," he advised taking medication around the clock. "Adults are also not as worried about their size as kids are." However, he did say that there are times when pausing or changing medication is required. Reducing Adverse Reactions to ADHD Drugs According to Goodman, people can experiment with different dosages of ADHD medicine until they discover the optimal one. However, if undesirable symptoms emerge, doctors may reduce the dosage. "Before you change the dose, you have to figure out if the side effects are from the ADHD medication or are a function of additional medication that was added that is now having an interaction with your ADHD medication," he said. Avoiding withdrawal symptoms by suddenly quitting pharmaceutical use is not recommended. Goodman claims that "more than 30 different stimulant preparations are available." As the prognosis goes, "it’s very likely you can find something that you can take that does what it’s supposed to do, that lasts as long as you’d like it to last, and doesn’t cause problems." Preventing Problems with Tolerance Tolerance problems are cited by several TikTokers as the cause for their drug break. Goodman, however, claims that most persons suffer micro-tolerance, meaning that the following day’s dose has a greater impact if the previous day’s dose was missed. According to Goodman, when tolerance becomes a major problem requiring additional review, this is known as macro-tolerance and is related to the gradual increase in dosage over time. That’s physiologic tolerance, where you need a higher dose to get the same effect, which is why you went from 10 mg to 20 mg to 116 mg after five years. That’s a major issue," he remarked. It’s Important to See a Doctor Goodman recommended discussing

Jul 05

The Financial Consequences of Time Blindness, an ADHD Symptom

The financial consequences of time blindness, an ADHD symptom Symptoms of attention deficit hyperactivity disorder (ADHD) include restlessness, impulsive behavior, and difficulty sitting still. The mental condition ADHD has numerous other symptoms, such as time blindness and impulsive spending, that are often disregarded. All of ADHD’s symptoms can have a significant impact on a person’s daily life. Those less common symptoms of time blindness and impulsive spending make it extremely difficult for me to keep track of my money. Inaccurate time perception, or "time blindness," can have serious consequences. ADHD Subtypes First, ADHD exists on a continuum, with two or three distinct types depending on your criteria. Hyperactive-impulsive and apathetic are the two most common categories. It’s unlikely, though, that your symptoms will fall into one of those two groups. A combination type diagnosis is given to a large percentage of the population. Some people with the neurodevelopmental condition may be restless and fidgety, while others may stare blankly out the window or veer erratically between hyperfocus and distraction. There is mounting evidence that persons with ADHD may experience serious difficulties with their perception of time, which can be just as devastating as the disorder’s more well-known manifestations. Underdiagnosis is a possibility. I was diagnosed with ADHD at the age of 35, but I’d known since I was a kid that my brain was wired differently. Among women my age, underdiagnosis of ADHD is rather typical. In reality, studies conducted between 1997 and 1998 indicated that only approximately 3% of females were diagnosed with ADHD. That’s about the time I realized I needed to do something about my restless leg syndrome if I ever wanted to pay attention in class. The same time period saw a threefold increase in the number of male patients diagnosed by medical professionals. There has long been a disparity between the sexes when it comes to ADHD diagnosis, despite the fact that the number of children diagnosed has increased dramatically since then (11.7% for men and 8.8% for girls in 2019). This void persists in the current diagnostic system.There are three places dedicated to preventing disease. Adults might also suffer from attention deficit hyperactivity disorder (ADHD). This mental illness has long-lasting consequences that can compromise an adult’s quality of life and professional prospects.\ Symptoms of Impulsive Behavior Many individuals with ADHD have told researchers that they struggle to maintain employment and frequently face financial difficulties A 2015 research published in the Lancet followed 1.92 million participants over 32 years; among them, 32,061 were diagnosed with ADHD. The study found that persons with ADHD had a greater death rate than those without the disorder. Researchers also attributed the elevated death rate to the following factors: Diverse forms of irrational conduct Disruptive actions Use of Substances Inattention Impulsivity Dangerous actions Depression, anxiety, obesity, and diabetes are among diseases that may worsen in people with untreated ADHD. Adverse health effects from ADHD can be avoided with early diagnosis and treatment. There is mounting evidence that many people are able to convert their symptoms into highly adaptable characteristics that help them lead fulfilling lives.6 Many potentially harmful actions, such as time blindness, stem from an inability to accurately weigh potential benefits and drawbacks. What is “time blindness”? Time blindness is the inability to see beyond the immediate. "ADHD is, at its core, a blindness to time," said Russell Barkley, PhD, an ADHD researcher, at a discussion for the Centre for ADHD Awareness Canada (CADDAC) in 2009. persons with ADHD are like nearsighted persons in that they can only focus on the immediate future. West Chester, Pennsylvania-based psychologist Ari Tuckman, PsyD, concurs with Barkley’s characterization. Tuckman suggested that people with ADHD’s time blindness contributed to our propensity for impulsive attention. According to Tuckman, "good attention regulation is choosing the right thing moment by moment," while "distractibility" is defined as changing your focus when you should have maintained it. "The antithesis of that is hyperfocus. You refuse to move when you should. All of these causes of time blindness can make people with ADHD more likely to rack up debt. They live for the moment and have an attitude of "I’ll spend now and pay later," even when "later" never comes. It seems like a failure to understand the significance of time in a way that leads to effective action. For instance, I know that I need to take a break from writing these lines in order to respond to a few emails. However, I cannot predict when I will stop or how far in advance I should prepare. Leaving the house is another common example. The time it will take me to get ready is impossible to predict. I can only provide a rough estimate at this time. I’m not trying to be difficult, and I can’t train myself to be good at judging time. Similarly, a person who is colorblind would always struggle to tell the difference between red and green. Consequences of Time Ignorance The consequences of failing to recognize the passage of time can be devastating. Meetings are missed by those with ADHD at work or in the classroom. They might be too preoccupied with work to remember to go to the office or retrieve their children from school. If you have trouble keeping track of time, you can forget to do basic grownup things like go grocery shopping, fill up the gas tank, or pay the rent on time. These actions might be interpreted as disrespectful or lazy by others. However, time blindness and other cognitive problems can be explained by reduced activity in the prefrontal brain. The prefrontal cortex is the part of the brain that controls executive functions including attention and decision-making. Time blindness has far-reaching monetary repercussions. Tuckman suggests that persons with ADHD may have poorer credit ratings because they are more likely to miss a bill payment. They may have trouble qualifying for a mortgage, auto loan, or any loan as all. Tuckman coined the term "ADHD tax" to describe the

Jul 05

How Is Alzheimer’s Disease Diagnosed?

How Is Alzheimer’s Disease Diagnosed? Alzheimer’s disease (AD) is a progressive neurological condition that leads to a significant decline in cognitive abilities, including memory, thinking, and judgment. Early detection is crucial for effective symptom management and improved quality of life. AD is most prevalent among individuals aged 65 and older and is distinguishable from normal age-related memory changes. Unlike typical memory changes, AD symptoms disrupt daily life and impair independent functioning. Diagnosing AD involves a comprehensive assessment using multiple tests, as there is no single diagnostic tool available. If you observe changes in your own memory or notice symptoms of AD in a loved one or caregiver, it is advisable to seek medical attention promptly. During the appointment, the healthcare provider will conduct a thorough medical history review, physical examination, psychiatric evaluation, and may order additional tests such as neurological exams, blood tests, and imaging scans. Undergoing testing for AD can be intimidating, and it is normal to feel apprehensive. If you are experiencing memory changes, having a loved one accompany you to the appointment can provide support. Similarly, if you believe a loved one requires testing, gently encouraging them to bring a trusted companion can be beneficial. Having support during the appointment aids in creating a comfortable environment and facilitates the provider’s understanding of recent changes in cognition and behavior reported by others. Medical History Obtaining a comprehensive medical history is an essential part of the evaluation process conducted by healthcare providers. During your initial appointment, your provider may inquire about the following aspects:45 Family history: Any known history of Alzheimer’s disease or dementia among your immediate family members. Head injuries: Any prior instances of head injuries or brain trauma that may have occurred. Other health conditions: A diagnosis of any existing health conditions that you have received. Daily activities: Difficulties encountered while carrying out routine activities of daily living. Behavioral changes: Any observed changes in behavior by yourself or your loved ones. Memory issues: Instances of misplacing items, difficulty remembering names, or trouble with important tasks. Mood swings: Any fluctuations in mood that you have experienced. Lifestyle changes: Any recent modifications made to your lifestyle. Substance use: Consumption of alcohol, smoking habits, or recreational drug use. Medications: Details of current medications being taken. Sleep and eating patterns: Sleep habits and any changes in appetite or eating patterns. During the appointment, healthcare providers may also request to interview a loved one to gather their perspective on any cognitive, behavioral, or psychological changes they have noticed before proceeding with additional tests. Cognitive and Neurological Exams Cognitive and neurological exams are essential in detecting changes in memory, thinking, and behavior. These tests provide valuable insights into an individual’s cognitive abilities and are typically conducted by neurologists, psychiatrists, or psychologists. The exams can be comprehensive and may require multiple sessions or several hours to complete. The primary goal is to assess various brain functions using a range of tests. Some of the functions that may be evaluated include: Memory and learning Problem-solving Attention and concentration Reasoning and logical thinking Numerical abilities Language and communication skills Social functioning Emotional and mood assessment Motor functions To examine these functions, healthcare providers may employ different types of exams, such as: Mini-Mental State Exam (MMSE): Assesses thinking, learning, memory, and communication abilities. Mini-Cog: A three-step test involving word repetition, clock drawing from memory, and word recall. Functional Activities Questionnaire (FAQ): Measures the individual’s capability to perform daily tasks like cooking, bill payment, and dressing. Montreal Cognitive Assessment (MoCA): Screens for Alzheimer’s disease by evaluating attention, memory, language, orientation, and critical thinking skills. 7-Minute Screen: A brief examination focusing on memory, orientation, visual-spatial skills, and verbal fluency. Neuropsychiatric Inventory Questionnaire (NPI-Q): A caregiver or loved one completes this questionnaire to provide information on delusional behavior, hallucinations, depression, apathy, anxiety, and lifestyle habits. Spinal Tap A spinal tap, also known as a lumbar puncture, is a procedure used to collect a small sample of cerebrospinal fluid (CSF) for analysis. CSF is a fluid that surrounds the brain and spinal cord and can provide valuable information about various neurological conditions, including Alzheimer’s disease (AD). During a spinal tap, a healthcare provider inserts a needle into the lower back to access the spinal canal and collect a sample of CSF. In the case of AD, specific proteins in the CSF, known as biomarkers, can indicate the presence or progression of the disease. Abnormal levels of these biomarkers, such as amyloid-beta and tau proteins, can help support an AD diagnosis. However, it’s important to note that CSF biomarker analysis is not a definitive diagnostic test for AD and is often used in combination with other assessments. Ongoing research in the field aims to explore alternative methods for detecting biomarkers associated with AD. One area of focus is the development of blood-based biomarkers, which would be easier and less invasive to obtain than CSF samples. In May 2022, the U.S. Food and Drug Administration (FDA) approved a new CSF test for AD, indicating ongoing advancements in diagnostic techniques. It’s important to be aware that not all hospitals offer spinal tap exams, and the availability and coverage may vary depending on your healthcare insurance. If you and your healthcare provider believe that a spinal tap may be beneficial in your case, it is advisable to discuss the procedure with your provider and insurance company to determine feasibility and coverage options. Brain Imaging There are additional exams and measures that healthcare providers may utilize, each with its own scoring guidelines and criteria. The results of these exams contribute to determining the subsequent steps and appropriate diagnosis or treatment plan for you or your loved one. Brain imaging tests and lab tests play an important role in the diagnostic process for Alzheimer’s disease (AD) by providing additional information and ruling out other conditions. The main types of brain imaging tests include: Computed tomography (CT): This imaging technique creates detailed photos that can help identify signs of stroke, brain bleeding, or tumors. Magnetic resonance imaging

Jul 05

What Is Alzheimer’s Disease?

What Is Alzheimer’s Disease? Deterioration in cognitive capacities including thinking, memory, language, judgment, and learning are hallmarks of Alzheimer’s disease (AD), a degenerative brain disorder. The National Institute on Aging (NIA) reports that there is currently no cure for Alzheimer’s disease, but that certain medicines may help with symptom management. Alzheimer’s disease often strikes adults over the age of 65 (in more than 90% of cases). A research published in Alzheimer’s & Dementia in March 2021 estimated that 6.2% of the 65+ population in the United States were living with Alzheimer’s disease that year. Without a medical breakthrough, the illness might affect 13.8 million Americans by 2060, when the population is expected to have increased further. Knowing the symptoms, causes, and potential dangers of Alzheimer’s disease is crucial. Why Do We Have Alzheimer’s? Alzheimer’s disease is often misdiagnosed as dementia and vice versa. The National Institute on Aging (NIA) defines dementia as "persistent and severe cognitive impairment that causes significant distress or impairment in daily life." This includes difficulties with thinking, remembering, and reasoning. Alzheimer’s disease is the most typical cause of dementia and is associated with permanent brain abnormalities. According to a report published in Nature Reviews Disease Primers in May 2021, 60-90% of patients with dementia have Alzheimer’s disease. Natural cognitive changes are possible as people age. On rare occasions, people may experience memory lapses, misplace items, or struggle to express themselves adequately. Memory, learning, judgment, and personality are all affected in people with Alzheimer’s disease. The March 2021 report states that these symptoms are disruptive to daily life. According to the National Institute on Aging (NIA), persons with Alzheimer’s may experience hallucinations and a loss of ability to care for oneself as the illness develops. Alzheimer’s disease can manifest in either an early or a late onset form. Early-onset Alzheimer’s disease often affects people in their 30s to mid-60s. According to the NIA, this only accounts for around 10% of all instances of Alzheimer’s. The typical onset age for late-onset Alzheimer’s disease is the mid-60s. According to StatPearls, the average lifespan of a person with late-onset Alzheimer’s disease is 4-8 years, however this can be as high as 20 years in certain cases. According to the NIA, the delay between diagnosis and death increases with patient age. Mild cognitive impairment (MCI) is a kind of dementia that can be caused by Alzheimer’s disease but often only impairs one or two cognitive functions (such as memory) and does not cause significant functional impairment. Temporary factors like medicine, alcohol, or a head injury can trigger MCI without causing it to proceed to dementia. According to Alzheimers.gov, there is hope for certain patients. According to the study published in May 2021, Alzheimer’s causes around 50% of instances of MCI. Causes Because it affects the brain’s nerve cells (neurons), Alzheimer’s is classified as a neurodegenerative disorder. The shrinking and inflammation of the brain are brought on by changes in neurons and the loss of connections between them. The March 2021 article indicates that this process can begin long before any symptoms appear. Amyloid plaques and tau tangles were once thought to be the primary biological brain alterations in understanding Alzheimer’s disease. Outside of neurons, amyloid plaques (clumps of poisonous beta-amyloid 42 protein) accumulate. Naturally occurring beta-amyloid 42 is elevated to pathological levels in Alzheimer’s disease. Inside neurons, tau tangles develop when tau molecules clump together in an unnatural way. According to the NIA, neuronal microtubules (structures that give form to and route nutrients through the neuron) are typically stabilized by tau molecules. However, a July 2022 study suggested that the significance of beta-amyloid proteins as a main predictor of Alzheimer’s disease may have been exaggerated due to the use of faked research data. Researchers into Alzheimer’s disease continue to hold that beta-amyloid proteins are crucial to our knowledge of the illness. However, this discovery may prompt researchers to investigate alternative protein models. According to the NIA, the causes and consequences of these metabolic alterations on mental capacity remain unknown. Some genetic, environmental, and behavioral risk factors have been identified, but there is currently no method to predict how they will impact an individual or implement effective preventative measures. Risk Factors Age is the single most important risk factor for developing Alzheimer’s disease, accounting for more than 90% of all cases in those aged 65 and over. According to StatPearls, roughly 10% of persons over 65 and about 40% of those over 85 have Alzheimer’s disease. Additional danger causes can be: Having a family history of Alzheimer’s might put you at a higher risk of developing the disease yourself. According to the NIA, the predominant cause of Alzheimer’s disease in younger adults is genetics. NIA classifies hypertension, coronary heart disease, and stroke as vascular (blood vessel) disorders. The March 2021 research states that the brain consumes 20% of the body’s oxygen supply, making a strong heart crucial to the proper functioning of the brain. Regular exercise and a heart-healthy diet are two ways to lower your chance of developing cardiovascular disease. Risk factors, according to the May 2021 research, include metabolic disorders including diabetes, obesity in middle age, and low HDL cholesterol ("good" cholesterol). In order to convert the nutrients in meals into usable energy, your body uses a process called metabolism. According to a paper published in the journal Lancet Commissions in July 2020, depression can raise the risk of Alzheimer’s. There is some evidence that antidepressant medication lowers risk, although it is inconclusive. Dementia and the first stages of Alzheimer’s disease share several symptoms with depression. The NIA found that illnesses including high blood pressure, heart disease, and depression, as well as social isolation and loneliness, were all associated with an increased chance of developing Alzheimer’s disease. On the other hand, studies suggest that engaging in more group activities might boost brain power. According to research published in the journal Lancet Psychiatry in April 2018, having a history of traumatic brain injury (TBI) increases the likelihood of developing Alzheimer’s

Jul 05

What It’s Like Battling Type 2 Diabetes When You Have an Anxiety Disorder?

What It’s Like Battling Type 2 Diabetes When You Have an Anxiety Disorder Sarah Ellefson, a Minnesota native, grew up familiar with anxiety due to her father’s own battle with it during her childhood. When she turned 18, she also began experiencing anxiety herself. Her first panic attack occurred at her parents’ house, and she found solace and support from her father, who understood firsthand what she was going through. Ellefson is just one of the many individuals who grapple with generalized anxiety disorder (GAD) in the United States. According to the Anxiety and Depression Association of America, over 6.8 million Americans experience GAD in any given year. GAD is characterized by excessive worry about various events or activities, such as work or school. People with GAD struggle to control their worrying, which can have an impact on their ability to function effectively in professional and social settings. Stress Eating and Other Health Issues Ellefson’s experience with anxiety had a profound impact on her physical well-being, leading to stress eating and stomach pain. However, it was her unexpected diagnosis of type 2 diabetes that prompted her to seek healthier ways to manage her anxiety effectively. In January 2012, while at work in health care administration, Ellefson noticed her vision had become blurry, prompting her to contact her doctor immediately. Despite having previously tested negative for diabetes and not experiencing typical symptoms like extreme thirst or hunger, her blood sugar level measured a startling 440. Her doctor described her situation as fortunate, akin to surviving a car crash without a seatbelt. Ellefson was prescribed multiple oral medications and insulin to control her diabetes. However, her anxiety continued to have a significant impact. She experienced frequent panic attacks, pervasive sadness, and a lack of understanding about how to manage her condition, which lasted for nearly a year and a half. During this challenging period, Ellefson’s anxiety contributed to weight gain of over 40 pounds and a neglect of self-care. She began to isolate herself, avoiding social engagements and experiencing a decline in both mental and physical health. Medical professionals even indicated the possibility of early signs of kidney damage and advised against attempting pregnancy. A turning point occurred when Ellefson reached a breaking point at work, experiencing a panic attack that prompted her to seek immediate help. She connected with a psychologist who specialized in anxiety, a step that marked the beginning of her journey towards regaining control and acknowledging her need for assistance. By seeking professional support and guidance, Ellefson took proactive steps to address her mental health and gradually reclaim her life from the grip of anxiety. The Magic of Physical Activity The psychologist played a crucial role in helping Ellefson find calmness and encouraged her to start getting out of the house, even if it was just for short walks. She began by walking to the end of the street and gradually increased her distance, eventually conquering a footpath around a nearby lake. However, she still needed additional support, which came from a persistent coworker. Initially, Ellefson made excuses, believing she couldn’t run due to her weight and concerns about her heart and joints. Despite her reservations, her friend persisted and convinced her to sign up for a gym. Unexpectedly, Ellefson found herself training for a 5K and engaging a personal trainer, a relationship that has continued for six years. As she became more physically active, Ellefson noticed a reduction in her panic attacks and an increased outgoing nature. She emphasizes that her workouts are not solely for calorie burn but serve as a means to calm her mind, even a simple 30-minute walk. While her fitness journey helped alleviate anxiety, Ellefson recognized that managing her type 2 diabetes required a comprehensive approach, including improvements in her diet. This led her to discover the benefits of meal prepping—an approach that allowed her to plan and prepare nutritious meals in advance. The Wonders of Eating Better Sarah Ellefson’s journey towards better mental and physical health involved adopting the practice of meal prepping six years ago. Due to her demanding work hours and exhaustion after workouts, she struggled to find the energy to cook healthy meals and avoid falling back into unhealthy eating patterns. Meal prepping became a valuable tool in setting herself up for success by ensuring she had nutritious meals readily available. When meal prepping, Ellefson focuses on creating colorful and nutrient-dense meals, with half of her plate consisting of vegetables and the other half incorporating a healthy source of lean protein. This approach has helped her stay on track even when traveling. She found that by consuming whole, unprocessed foods, she could reduce cravings—a significant factor given her history of emotional eating. Additionally, she enjoys taking pictures of her meals, further enhancing her commitment to healthy eating. Her dedication to addressing her mental and physical well-being paid off as she successfully lost 90 pounds and eliminated all diabetes medications, including insulin. Ellefson’s transformation empowered her, allowing her to feel proud of the progress she had made after previously feeling as though life was passing her by. A year after discontinuing her medications, she became pregnant with her son, Ben. Throughout the pregnancy, Ellefson maintained her healthy habits under close medical supervision. Although she had to reintroduce insulin midway through the pregnancy, she stayed committed to her overall health. As she experienced improvements in her mental and physical health, Ellefson learned to be kinder to herself. While she still carries some of her baby weight, she has adopted an accepting attitude and avoids perfectionist tendencies associated with her anxiety. Her approach now revolves around doing her best and focusing on progress rather than aiming for unattainable perfection. Being a working mom, Ellefson recognizes the importance of having a strong support system. She has built friendships through the gym and running, and her husband has been a pillar of support. When she faced a setback and had to resume medication, her husband joined her on runs, turning it into

Jul 05

What Is Iron Deficiency Anemia?

What Is Iron Deficiency Anemia? Iron deficiency anemia occurs when there is an inadequate amount of iron in the body to produce sufficient hemoglobin, the protein responsible for carrying oxygen in red blood cells. Insufficient iron levels can result in anemia, leading to symptoms such as headaches, pale skin, fatigue, and others. The causes of iron deficiency anemia can include insufficient dietary intake of iron, blood loss (such as from menstruation or gastrointestinal bleeding), and certain medical conditions that affect iron absorption or utilization. Treatment approaches vary depending on the underlying cause but often involve dietary modifications to increase iron consumption or the use of iron supplements. Iron deficiency anemia is a prevalent condition, affecting approximately 30% of the global population. While it can occur in individuals of any age or gender, it is more commonly observed in women and children. Early detection and appropriate management are key to addressing iron deficiency anemia and restoring optimal health. Iron Deficiency Anemia Symptoms Iron deficiency anemia is often characterized by a gradual onset of symptoms, which worsen as the condition progresses and the body experiences reduced oxygen supply. While some individuals with mild iron deficiency anemia may not experience noticeable symptoms, common manifestations of the condition can include: Fatigue or a persistent lack of energy Shortness of breath or chest pain, particularly during physical activity Dizziness or lightheadedness Headaches Pale or yellowish skin Cold hands and feet Rapid heartbeat or palpitations Unexplained weakness Pica, which involves cravings for non-food items like clay or ice Swollen or sore tongue Hair loss Brittle nails What Causes Iron Deficiency Anemia? Iron deficiency anemia develops when there is an insufficient amount of iron available in the body to produce an adequate amount of hemoglobin. Hemoglobin is the protein in red blood cells that carries oxygen to tissues throughout the body. Low iron levels can occur due to various factors. Inadequate Iron Intake Your body relies on dietary sources of iron to maintain healthy iron levels. Consuming iron-rich foods is crucial to prevent iron deficiency and maintain optimal iron status. The recommended dietary allowance (RDA) for iron varies depending on age, sex, and life stage. Here are the RDAs for different population groups: Infants 0-6 months: 0.27 mg Infants 7-12 months: 11 mg Children 1-3 years: 7 mg Children 4-8 years: 10 mg Children 9-13 years: 8 mg Adolescents 14-18 years: 11 mg for males, 15 mg for females Adults 19-50 years: 8 mg for males, 18 mg for females Adults 51+ years: 8 mg Pregnancy: 27 mg Breastfeeding: 9-10 mg Problems Absorbing Iron Several medical conditions and medications can interfere with iron absorption, leading to iron deficiency anemia. These include: Gastrointestinal conditions: Conditions like Crohn’s disease, celiac disease, ulcerative colitis, or an H. pylori infection can affect the absorption of iron in the gastrointestinal tract. Digestive system surgery: Certain surgeries, such as bariatric (weight loss) surgery, can alter the normal functioning of the digestive system and impact iron absorption. Genetic conditions: Genetic disorders like cystic fibrosis can impair the body’s ability to absorb iron properly. Medications: Certain medications used to treat heartburn, ulcers, and other acid-related conditions, such as proton-pump inhibitors (PPIs), calcium carbonate, and histamine-2 receptor antagonists, can interfere with iron absorption when taken long-term. Blood Loss Blood loss can lead to iron deficiency anemia as the body loses iron during bleeding. The causes of blood loss associated with iron deficiency anemia include: Heavy menstruation: Women with heavy or prolonged menstrual periods may experience significant blood loss, leading to iron deficiency anemia over time. Internal bleeding in the gastrointestinal tract: Conditions such as inflammatory bowel disease (e.g., Crohn’s disease, ulcerative colitis), colon cancer, or other gastrointestinal disorders can cause internal bleeding, resulting in iron loss. Bleeding during childbirth: Women who experience excessive bleeding during childbirth can develop iron deficiency anemia. Regular use of over-the-counter pain relievers: Long-term or excessive use of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can lead to gastrointestinal bleeding, contributing to iron deficiency anemia. Traumatic injury or surgery: Severe injuries or surgical procedures that involve significant blood loss can deplete iron stores and lead to anemia. Urinary tract bleeding: Bleeding in the urinary tract, such as from a urinary tract infection (UTI), can also result in iron loss and contribute to iron deficiency anemia. Risk Factors Iron deficiency anemia is indeed common and can affect individuals of all ages. Certain risk factors can increase the likelihood of developing this condition. These include: Following a vegetarian or vegan diet: Vegetarian and vegan diets may be lower in iron, especially heme iron found in animal-based sources. This can increase the risk of iron deficiency anemia, but it can be managed by ensuring adequate intake of iron-rich plant-based foods or through iron supplementation. Pregnancy, recent childbirth, and breastfeeding: During pregnancy, the demand for iron increases to support the growing fetus and placenta. Blood loss during childbirth can also deplete iron stores. Additionally, breastfeeding can lead to further iron depletion if the mother’s diet does not provide sufficient iron. Children who consume excessive cow’s milk: Consuming more than 16-24 ounces of cow’s milk per day in young children can interfere with iron absorption and contribute to iron deficiency anemia. It is important to limit cow’s milk intake and ensure children have a well-balanced diet that includes iron-rich foods. Having a chronic inflammatory disease: Chronic inflammatory conditions, such as heart failure or obesity, can disrupt iron metabolism and increase the risk of iron deficiency anemia. Inflammation can affect iron absorption, utilization, and storage in the body. Having myelodysplastic syndrome (MDS): Myelodysplastic syndrome is a group of disorders characterized by abnormal production of blood cells in the bone marrow. In MDS, the bone marrow may produce too few healthy red blood cells, leading to anemia, including iron deficiency anemia. Diagnosis To diagnose iron deficiency anemia, healthcare providers typically start with a thorough evaluation, including a physical exam and review of symptoms, medical history, and risk factors. They may then order specific blood tests to confirm

Jul 05

Love in the Time of Sickle Cell Disease, by Krithika Varagur

August 2023 Issue [Letter from Lagos] Love in the Time of Sickle Cell Disease What’s the cost of rolling the genetic dice? by Krithika Varagur , Illustrations by Katherine Lam Subomi Mabogunje fell for Nkechi Egonu within hours of meeting her in 2004, in his hometown of Ijebu- Ode, a trading hub in southwest Nigeria. They worked at a state-run broadcast TV station, thrown together by the National Youth Service Corps. He was speechless on the day Nkechi first walked into work. While Subomi was thin and bespectacled, she was petite and zaftig, with her hair in a ballerina bun, and coldly immune to the stares that trailed her across the office. Her swaggering personality was also the opposite of his reserved one; she was outspoken in the station’s weekly news meeting, and top brass quickly promoted her to program presenter. She was the most exciting person, Subomi felt, who had ever walked into his hometown. He found the courage to speak to Nkechi one weekend when they were assigned to do community service, clearing overgrown grasses near a government building. Subomi went, despite his habitual avoidance of strenuous physical activity. “You’re too good for this kind of work, ehe?” Nkechi teased, furrowing her brows. “Locals’ discount,” he joked, and she laughed. With his hollow cheekbones, frail body, and elongated fingers, he was clearly what some uncharitable onlookers would call a “sickler”— one of up to six million people in Nigeria with sickle cell disease, a group of inherited blood disorders that turn red blood cells from soft discs into rigid crescents, frequently leading to blood clots that can cause pain episodes, called “crises,” and serious complications in most major organs. But Nkechi never shied away from him. A few days later, the office’s radio transmitter stopped working, so Nkechi and Subomi had nothing to do except talk. After work, they made a beeline for a local dive bar housed in a car wash. Within a few weeks, they were inseparable. From the beginning, Nkechi knew that she and Subomi had “no business dating.” His genotype was SS: he had two abnormal S genes for hemoglobin, the oxygen- carrying protein in his blood. Nkechi’s genotype was AS: she had one abnormal S gene and one normal A gene. Like an estimated quarter of all Nigerians, she was a silent carrier. There was a 50 percent chance that any child they had would suffer from sickle cell disease like their father. This was no light prospect. Subomi’s own childhood had been marred by secrecy and shame over his condition. Nkechi, meanwhile, had lost four cousins to the disease. Those deaths might be understood as products of an earlier, benighted time, when the average Nigerian knew far less about genetic testing and disease management. Today, however, there was a growing consensus— particularly in their college- educated, upper- middle- class milieu—when it came to passing on two sickle cell genes: don’t risk it. But how, and when, do you weigh risk against attachment? Nkechi revealed her genotype just days after meeting Subomi, and he didn’t stop loving her. He liked that she held her ground, didn’t worry about the future, and could make even his stolid father laugh. She also had a quick temper, but he preferred her foot- stomping, door- slamming outbursts to his quieter family life, shuttling between two parents who often lived apart. “But why, dude?” Nkechi asked him in those early months, in her broad, Americanized diphthongs. He wasn’t sure, he said. She was something that had happened to him, like a coconut dropping on your head while you’re walking down the street. By the end of her service year, Nkechi had fallen in love with Subomi, too, but she thought it shouldn’t last. In March 2005, she moved back to Lagos alone. Subomi simply followed her. In April 2006, she broke up with him at a fried chicken restaurant, screaming about how stupid, how uneducated, it would be for them to stay together. They reconciled a week later. She broke up with him again in January 2008, sitting in his parked car. That separation lasted a month. Nkechi was just shy of thirty when she initiated their third breakup in late July 2009. She met him on a Friday evening at home and calmly told him that they had to find other people to marry before it was too late. As the oldest of six, she was starting to feel uneasy that neither she nor her siblings had married or started families, unusual for Nigerians of their generation. She had even talked to a genetic counselor at the Sickle Cell Foundation Nigeria (SCFN), in Lagos, who had advised her to end the relationship. (Though a representative from the foundation told me that this is against their policies.) There were too many obstacles. “A marriage is not just between two people,” Nkechi reminded Subomi. They talked and cried for three hours as the sun set, and she kept crying all the way home on the lurching bus. They were tears of grief, but also relief. She had finally, and responsibly, severed this unwieldiest of attachments. Subomi didn’t sleep much that night. Early the next morning, he started driving to his father’s house in Ijebu- Ode. That afternoon, something told Nkechi to call him to make sure he had arrived safely. Subomi’s boss picked up the phone. “Is Subi there?” she asked, confused. “Oh, it’s you, Nkechi. I was actually just about to call you,” Nkechi recalls him saying over a crackling connection. “Subomi’s had an accident.” Less than an hour outside Lagos, Subomi’s sedan had been rear- ended, hit a truck, and flipped over. Paramedics had taken him to the hospital and dialed the last received call on the phone they fished from Subomi’s pocket. Nkechi’s mouth went dry. At dawn, she began a long bus journey to the hospital, where she ran into Subomi’s mother. They found Subomi in the ICU, in a coma. Nkechi held his mother’s hand as the doctor explained Subomi’s prognosis. It could be

Jul 05

TAVR vs. surgery among obese patients: What cardiologists need to know

Al-Asad et al. reviewed data from nearly 38,000 patients who underwent TAVR or surgical aortic valve replacement (SAVR) for severe AS. All patients presented with a BMI of at least 30 kg/m2 and were originally included in one of four studies completed from 2017 to 2022. While 22.2% of patients included in the analysis underwent TAVR, the other 77.8% underwent surgical aortic valve replacement. TAVR patients had a higher mean age (77 years old) than SAVR patients (67 years old) and were more likely to be female (58% vs. 44%). In-hospital mortality, acute kidney injury, postoperative sepsis and blood transfusion rates were all lower among TAVR patients than SAVR patients. However, the authors noted, permanent pacemakers were more needed more frequently after TAVR than SAVR. The researchers also noted that transfemoral TAVR may not be a suitable approach for some obese patients with severe AS. “The transfemoral approach, which has been traditionally utilized for TAVR, could theoretically present a challenge in this patient population and might warrant the use of alternative access including transradial, transcaval, transapical, or transcarotid,” the group wrote. Al-Asad et al. ultimately concluded that, despite these positive findings, additional research is still needed, especially on the long-term impact of treating obese patients with TAVR vs. SAVR. Read the full study here.