Multifocal Motor Neuropathy

Multifocal Motor Neuropathy, commonly referred to as MMN, is a neurological disorder that primarily affects the motor nerves responsible for controlling your muscles. The hallmark of MMN is the impediment in transmitting electrical signals within your body, resulting in a weakening of the hands and arms, accompanied by muscle twitches and cramps. While MMN is a chronic condition, it is not life-threatening, and most cases can be effectively managed with appropriate treatment. In this comprehensive exploration of MMN, we will delve into its causes, symptoms, diagnosis, and treatment options, shedding light on this condition to enhance understanding and awareness. Causes of Multifocal Motor Neuropathy The exact cause of MMN remains elusive. What is known, however, is that MMN is an autoimmune disease, characterized by an aberration in the immune system where it mistakenly attacks the body’s own nerve cells, perceiving them as foreign invaders. Ongoing research endeavors are dedicated to unraveling the precise triggers and mechanisms that underlie this autoimmune response. Uncovering these triggers is vital for developing more targeted and effective treatment strategies for MMN. Symptoms of Multifocal Motor Neuropathy The initial signs of MMN typically manifest in the hands and lower arms. Individuals with MMN may experience weakness, uncontrolled muscle cramping, and persistent twitching. This weakness and discomfort often commence in specific regions, such as the wrist or fingers, and tend to be more pronounced on one side of the body. Over time, MMN may progress to affect the legs. It is noteworthy that MMN is not associated with pain, and sensory functions of the hands and arms remain intact. Nevertheless, the symptoms of MMN tend to worsen gradually as individuals age. Getting a Diagnosis Diagnosing MMN is a meticulous process, as it shares symptomatic similarities with other neurological conditions, particularly Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease. To ascertain an accurate diagnosis, individuals exhibiting symptoms suggestive of MMN will typically be referred to a neurologist, a specialist in nervous system disorders. The diagnostic process involves a combination of clinical evaluation and specific tests. The neurologist will conduct a thorough physical examination and inquire about the nature and duration of the symptoms. Key questions may include: Furthermore, the diagnostic process may encompass the following tests: Treatment Options for Multifocal Motor Neuropathy The treatment of MMN is tailored to the severity of the symptoms and their impact on an individual’s daily life. In cases of mild symptoms, treatment may not be immediately necessary. However, for those who require intervention, there are several treatment options available, with the primary goal of enhancing muscle strength and minimizing the progression of the condition. Taking Care of Yourself with MMN Early diagnosis and treatment are pivotal in managing MMN and reducing the severity of symptoms. Adherence to the recommended treatment plan and open communication with your healthcare provider are essential components of managing the condition. Additionally, occupational and physical therapy may be beneficial for individuals experiencing difficulties with daily activities. These therapies can help maintain muscle strength and provide strategies for accomplishing routine tasks with greater ease. What to Expect Living with MMN The impact of MMN on an individual’s life can vary widely depending on the specific muscles affected and the severity of the condition. Many individuals with MMN are capable of maintaining most, if not all, of their normal activities. However, for some, the disease may progress to the point where daily tasks become challenging. The specific challenges faced by individuals with MMN correlate with the muscles impacted. Weakness in hand muscles can hinder activities such as eating, typing, writing, and buttoning clothes, while weakness in leg muscles may result in difficulties with walking. For those with severe MMN, these limitations can affect various aspects of daily life. In conclusion, Multifocal Motor Neuropathy is a complex neurological condition that primarily affects the motor nerves controlling muscle movements. While the exact cause remains unclear, ongoing research is shedding light on the autoimmune nature of the disease. Early diagnosis and appropriate treatment, such as IVIg, can significantly improve the quality of life for individuals living with MMN. By understanding the causes, symptoms, and available treatments, individuals and their healthcare providers can collaborate to effectively manage this condition and maintain a fulfilling and active lifestyle.

Acquired Lipodystrophy

Lipodystrophy is a complex and multifaceted disorder that profoundly impacts the way the body utilizes and stores fat, often resulting in significant changes in both one’s physical appearance and overall health. When lipodystrophy is acquired, it means that an individual was not born with this condition but developed it at some point in their life. This condition primarily affects the fat deposits located just beneath the skin, leading to alterations in body contours and, in many cases, causing a range of additional changes throughout the body. One distinct form of acquired lipodystrophy is associated with individuals living with HIV, referred to as LD-HIV. The development of lipodystrophy in these cases may be linked to the antiretroviral medications used in the treatment of HIV or, in some instances, the virus itself. Acquired lipodystrophy encompasses various subtypes, including: 1. Acquired Generalized Lipodystrophy (AGL), also known as Lawrence syndrome: This form of lipodystrophy tends to manifest in children, although adults can be affected as well. AGL is more prevalent in girls, occurring three times more frequently than in boys. It is characterized by the widespread loss of subcutaneous fat from various parts of the body, including the face, arms, legs, palms, and sometimes the soles of the feet. This extensive fat loss can result in a muscular appearance and visible veins under the skin. People with AGL may experience increased hunger and rapid growth. In adults, hormonal imbalances can lead to features such as enlarged hands and feet, an enlarged jawbone, and larger-than-average sex organs. 2. Acquired Partial Lipodystrophy (APL), also known as Progressive Lipodystrophy or Barraquer-Simons syndrome: APL typically emerges around ages 8-10, and like AGL, it predominantly affects girls. This type of lipodystrophy primarily targets the upper body, starting with the face and then progressing to the neck, arms, and chest. 3. Localized Lipodystrophy: Unlike the generalized forms, localized lipodystrophy can develop in individuals of any age. It often appears as small dimples in the skin, which may seem unusual but are generally not associated with significant health issues. The loss of fat due to lipodystrophy is not merely a cosmetic concern; it can also have far-reaching consequences on an individual’s health. Fat tissue plays a critical role in producing the hormone leptin, which regulates appetite and influences insulin production. When there is extensive fat loss, as seen in AGL and APL, individuals may not have adequate leptin levels, potentially leading to issues with appetite regulation and insulin production. Additionally, fat can accumulate in atypical locations, such as the bloodstream, heart, liver, and kidneys, contributing to conditions like diabetes, high cholesterol, high triglycerides, liver disease, and kidney failure. Managing the complications associated with lipodystrophy typically involves medical intervention, lifestyle modifications, and, in certain cases, cosmetic procedures. Doctors can offer guidance on addressing these health concerns, and surgical options may be considered to address cosmetic concerns. The precise causes of acquired lipodystrophy often remain unknown, but several potential triggers have been identified, including infections (measles, pneumonia, infectious mononucleosis, or hepatitis), autoimmune diseases, repeated injections or pressure on the same area of the body, and injuries. For example, individuals with diabetes who regularly administer insulin injections may develop localized lipodystrophy at the injection sites. To mitigate this risk, it’s recommended to vary injection sites regularly. Symptoms of acquired lipodystrophy can vary widely from person to person, depending on the specific type and extent of the condition. The subtype of lipodystrophy an individual has will dictate where fat loss occurs, the degree of fat loss, and the associated effects on their body. AGL leads to widespread fat loss from various body parts, while APL predominantly affects the upper body, and localized lipodystrophy typically results in small, skin dimples or dents. Additionally, due to the disruption in fat tissue, individuals may experience difficulties in sugar metabolism, blood sugar control, and may develop associated health issues, including an enlarged liver or spleen. Diagnosing acquired lipodystrophy necessitates a thorough medical examination and evaluation of the patient’s health history. Doctors will inquire about observed symptoms, their onset, the extent of fat loss, and any additional issues such as panniculitis (swollen bumps under the skin) or skin rashes. Blood tests to measure sugar, cholesterol, triglyceride levels, liver enzymes, and uric acid can help identify any metabolic abnormalities. For individuals suspected of having APL, doctors may also look for specific markers related to the autoimmune attack on fat cells. When considering treatment options, since the lost body fat cannot be fully replaced, the primary focus is on preventing or managing complications associated with the condition. A healthy lifestyle plays a crucial role in managing acquired lipodystrophy. This involves maintaining a low-fat diet, especially for adults, while ensuring children receive sufficient calories and proper nutrition to support growth. Regular exercise is encouraged to help regulate blood sugar and prevent the dangerous buildup of fat. In cases of AGL, individuals may receive metreleptin injections to replace the missing leptin and mitigate the risk of other associated diseases. Medications such as statins and omega-3 fatty acids can be utilized to control high cholesterol and triglycerides. Diabetes management may involve insulin or other medications to regulate blood sugar. Notably, women with AGL should exercise caution when considering oral birth control or hormone replacement therapy, as these interventions can potentially worsen certain fat-related issues. For those who experience cosmetic concerns, various surgical and non-surgical options are available. Plastic surgery techniques, such as skin grafts from the thighs, belly, or scalp, implants, and filler injections, can help restore facial features and reduce the appearance of fat loss. Liposuction can be considered for the removal of excess fat deposits, although fat may reaccumulate over time. Caring for individuals with lipodystrophy goes beyond medical treatment; it requires compassion and understanding. Family and friends should provide emotional support and encouragement to help those affected maintain a positive self-image. It’s important to foster friendships, prepare individuals for potential unkind comments, and consider professional counseling to navigate the emotional challenges associated with the condition. While the outlook for people with

Achalasia: What You Should Know

Achalasia is a rare medical condition that affects the normal functioning of the esophagus, making it challenging for food and liquids to pass from the mouth to the stomach. In this comprehensive exploration, we will delve into the intricate details of achalasia, including its causes, symptoms, diagnosis, and various treatment options. Achalasia: An Overview Achalasia is a disorder characterized by the disruption of crucial processes that facilitate the passage of food into the stomach. Under normal circumstances, two essential actions take place following the act of swallowing: the esophagus, a muscular tube responsible for transporting food to the stomach, contracts and relaxes to propel food downwards, while a small muscle flap or valve located at the bottom of the esophagus opens to permit the contents to empty into the stomach. However, individuals afflicted with achalasia experience significant impairments in these fundamental processes. The esophagus becomes inefficient at pushing food downward, and the lower esophageal valve fails to open completely. Consequently, food becomes trapped at the base of the esophagus, analogous to a clogged sink, occasionally leading to regurgitation into the mouth. Achalasia: Causes and Risk Factors While the precise etiology of achalasia remains a subject of ongoing research, experts have identified several potential factors that may contribute to its development: 1. Genetics: In some cases, achalasia appears to have a hereditary component, suggesting a genetic predisposition. 2. Autoimmune Problems: Dysregulation of the immune system may contribute to the onset of achalasia, although the exact mechanisms remain under investigation. 3. Viral Infection: Some researchers have posited that viral infections could play a role in triggering achalasia, although no definitive viral cause has been established. 4. Neurodegenerative Factors: Achalasia may be linked to the loss of nerve function, particularly within the esophagus, although more research is needed to confirm this hypothesis. It is crucial to note that individuals of all racial backgrounds can develop achalasia, and it is observed with near-equivalence in both men and women. While it is most commonly diagnosed in individuals aged 30 to 60, there have been cases reported in children. Furthermore, achalasia has occasionally been identified in individuals with Down syndrome. Symptoms of Achalasia The primary symptom of achalasia is difficulty in swallowing, affecting both liquids and solid foods. However, individuals with achalasia may also experience various associated symptoms, including: 1. Chest Pain: Often occurring after eating, chest pain can be a distressing symptom of achalasia. 2. Regurgitation: Food and liquids coming back up into the throat can lead to discomfort and distress. 3. Heartburn and Belching: Achalasia may result in symptoms commonly associated with gastroesophageal reflux, such as heartburn and belching. 4. Weight Loss: As a consequence of reduced food intake and difficulty swallowing, individuals with achalasia may experience unintended weight loss. 5. Nighttime Coughing: Coughing, particularly at night, can be a result of regurgitated material entering the airway. 6. Vomiting: The inability to effectively empty the esophagus can lead to vomiting episodes. 7. Pneumonia: In severe cases, aspiration of food or liquid into the lungs can lead to pneumonia. Symptoms of achalasia may be exacerbated by certain dietary habits, such as consuming food within four hours of bedtime. Additionally, specific foods, particularly those requiring increased esophageal peristalsis, such as meat and bread, may exacerbate the condition. Diagnosing Achalasia Achalasia’s symptoms often overlap with those of heartburn and other esophageal disorders, making diagnosis a complex process. Healthcare providers may initially treat patients for heartburn, reserving further evaluation if the condition does not improve. Suggested diagnostic procedures include: 1. Endoscopy: Utilizing a specialized tool known as an endoscope, equipped with a tiny camera, physicians examine the esophagus to identify abnormalities. 2. Barium Swallow Test: This test involves the patient ingesting a barium solution, allowing healthcare providers to visualize the esophagus and assess its functionality. 3. Manometry: A test that involves the insertion of a thin tube into the throat to measure the strength of esophageal muscles and evaluate the performance of the lower esophageal valve. Achalasia: Treatment Options Effective management of achalasia is essential to improve the quality of life for those affected by this condition. Treatment options include: Surgery: Surgery is often the most successful approach for addressing achalasia, providing long-term symptom relief. The most common surgical procedure is the Heller myotomy, typically conducted using minimally invasive techniques. During this procedure, the surgeon creates small incisions in the abdomen and employs surgical instruments to reach the lower esophagus. The primary objective is to enlarge the lower esophagus, enhancing swallowing. Heller myotomy procedures are highly successful and result in significant symptom relief. Another surgical alternative is peroral endoscopic myotomy (POEM), a procedure that eliminates the need for external incisions. In POEM, a specialized endoscope with an integrated camera is inserted through the mouth and down the throat. This endoscope is then used to create a small cut in the inner lining of the esophagus, followed by tunneling to access the inner muscle of the lower esophagus. This approach also aims to facilitate improved swallowing. However, it’s important to note that both surgical procedures may cause acid reflux in some individuals. The choice between these surgical methods is typically made after a thorough consultation with your healthcare provider to determine the most suitable option for your specific case. Other Treatment Options: While surgery is the most successful treatment for achalasia, alternative options exist for individuals who may not require or prefer surgical interventions. These alternatives, although generally less effective, can provide symptom relief and may require multiple procedures. They include: 1. Injections of Muscle-Relaxing Medicine: Botox (botulinum toxin) injections into the tight esophagus muscles can temporarily relax these muscles, allowing for more normal swallowing. 2. Pneumatic Dilation: During this procedure, a balloon is inserted into the valve between the esophagus and the stomach and inflated to stretch the tight muscles. Several repetitions of this procedure may be necessary before significant improvement is observed. 3. Medication: Two classes of drugs, nitrates and calcium channel blockers, can be employed to relax the lower esophageal sphincter. These medications aim to

What Is Vocal Fry?

Vocal fry, also known as creaky voice, is a distinctive voice tone characterized by a raspy and scratchy quality, often most pronounced at the end of sentences. This phenomenon is produced when the larger, relaxed vocal cords vibrate slowly, resulting in a lower pitch. While vocal fry can be a natural vocal register for some individuals, others may intentionally switch to this lower register, either as a learned social habit or due to external influences. Moreover, vocal fry can also serve as a potential indicator of underlying health conditions. Is Vocal Fry Harmful? In most cases, vocal fry itself is not physically harmful. It typically doesn’t lead to severe health issues, but it can be associated with certain health conditions, including voice disorders or other respiratory and neurological issues. Individuals who experience vocal fry not linked to health conditions may occasionally encounter hoarseness or a scratchy sensation in the throat, but it is typically not physically detrimental. Nonetheless, vocal fry can have a significant impact on various aspects of a person’s life. The human voice plays a crucial role in shaping how others perceive an individual’s social status, personality traits, and emotions. Despite some evolving social acceptance of vocal fry, research has shown that it can still carry negative social connotations. For instance, young adult women with vocal fry may be unfairly perceived as less educated, competent, or hirable in workplace settings. Interestingly, men employing vocal fry do not face the same level of negative perception. Therefore, while vocal fry may not pose a direct physical threat, its societal implications highlight the importance of understanding and addressing this vocal quality, especially in contexts where social perception plays a significant role, such as professional and interpersonal relationships. It underscores the need for individuals to be aware of their vocal patterns and, if necessary, seek guidance from professionals to improve their vocal quality and communication effectiveness. Why Do People Exhibit Vocal Fry? in shaping the quality of one’s voice. Vocal fry tends to be more pronounced in individuals with thicker vocal cords that vibrate slowly and do not fully close during speech production. Beyond physiological factors, social and cultural influences also play a role in the prevalence of vocal fry. It’s often adopted as a learned speech habit, influenced by popular culture and societal trends. Interestingly, this speech pattern is notably common in the English language, and bilingual individuals may use it more frequently when speaking English compared to other languages. However, vocal fry isn’t always a conscious choice. It can result from underlying health conditions like vocal fold lesions, leading to irregular vocal cord vibrations. In such cases, vocal fry persists throughout sentences and is often accompanied by symptoms such as vocal fatigue and throat pain. It’s essential to note that vocal fry is not exclusive to any particular gender; individuals of all genders can exhibit this speech pattern. Overall, vocal fry is a multifaceted aspect of speech influenced by a combination of physical, social, and health-related factors. Managing Vocal Fry For individuals experiencing vocal fry not related to medical issues, there may be no need for significant changes in speech patterns. However, overuse and misuse of the voice can have consequences for throat health and speech patterns. To alleviate discomfort associated with vocal fry, individuals can take several at-home measures to protect and strengthen their voice: 1. Stay Hydrated: Drinking ample water helps maintain vocal cord health. 2. Rest Your Voice: Taking breaks and allowing periods of rest for the vocal cords during the day can prevent strain. 3. Avoid Extreme Pitches: Refrain from speaking at unnaturally low or high pitches, as well as from speaking too softly or too loudly. 4. Dietary Considerations: Avoiding triggers for acid reflux, such as spicy or acidic foods, can be beneficial. 5. Medication Use: Limit the use of medications that may dry out the vocal cords, but consult a healthcare provider before making changes. 6. Physical Health: Regular exercise and good posture contribute to voice strength. 7. Stress Management: Managing stress and ensuring adequate rest can mitigate the effects of tension or fatigue on the voice. When vocal fry is suspected to result from an underlying health condition, a healthcare provider may recommend a laryngoscopy—a diagnostic procedure involving the insertion of a small, flexible tube with a camera into the throat to visualize the larynx and vocal cords. This allows for a closer examination of the vocal cords to identify any structural abnormalities, growths, or other issues that may be contributing to the vocal fry. Based on the findings, individuals with vocal cord disorders may benefit from voice therapy sessions with a speech-language pathologist. Voice therapy is a specialized form of therapy that focuses on retraining and adjusting vocal patterns, often including exercises to enhance clarity, vocal strength, and proper breathing techniques. This therapy can be tailored to the specific needs of the individual, addressing the underlying causes of vocal fry and working to improve overall vocal health. In conclusion, vocal fry is a distinct voice quality that can have a range of causes, including natural vocal characteristics, learned habits, and health conditions affecting the vocal cords. While vocal fry itself is not physically harmful in most cases, it can carry negative societal perceptions, especially when associated with young women. Managing vocal fry can involve at-home strategies for throat health, such as staying hydrated and avoiding vocal strain, and, in some cases, professional voice therapy to address underlying issues. Understanding vocal fry as a unique aspect of speech can contribute to more informed conversations about voice quality and its diverse expressions. It is essential to approach the topic with sensitivity and awareness of the potential underlying factors that may contribute to vocal fry in individuals, allowing for better support and management when needed.

4 Things Never to Say to Someone With Vitiligo—Even if You Don’t Mean Any Harm

Take note: All of these comments are unhelpful—and can even be hurtful. Vitiligo is a skin condition that affects millions of people worldwide, causing patches of skin to lose their natural color. The color of our skin is determined by a pigment called melanin, which is produced by melanocytes. When a person has vitiligo, these melanocytes either stop functioning or die, resulting in the loss of melanin production. This condition can affect anyone, regardless of their age or ethnicity, although it may be more noticeable in individuals with darker skin tones. While vitiligo is not life-threatening, it can profoundly impact an individual’s physical appearance and emotional well-being. Living with vitiligo can be challenging, especially when it develops during childhood, a period when children are learning about their bodies and forming their identities. Those with vitiligo often face bullying and insensitive comments, making it essential for us to be mindful of our words and actions when interacting with individuals living with this condition. In this exploration, we will hear from four individuals who have vitiligo and learn about the comments and behaviors that can be hurtful or insensitive when engaging with someone affected by this condition. 1. Avoid Asking if Vitiligo Is Contagious One of the most important things to remember when interacting with someone who has vitiligo is to avoid asking if the condition is contagious. Mariah Perkins, a 22-year-old living with vitiligo, shared her experience of someone asking her this question. Such inquiries can deeply affect individuals with vitiligo, as they imply that their skin is undesirable or even repulsive. For many, vitiligo onset occurs during adolescence, a vulnerable period when individuals may be particularly sensitive about their appearance. Mckyla Crowder, who has lived with vitiligo since the age of 4, echoed this sentiment, emphasizing the importance of treating people with vitiligo with the same respect and consideration as anyone else. She emphasized that individuals with vitiligo are still the same on the inside, and their condition does not define their worth or character. 2. Avoid Recommending Products to “Fix” Their Skin Another insensitive comment is suggesting products that claim to “fix” or conceal vitiligo-affected skin. Marian De Vos shared her experience of being referred to a product that promised to provide full coverage for her skin, similar to a foundation for the entire body. While some people with vitiligo may choose to cover their skin using makeup, it is a deeply personal decision that should not be influenced by unsolicited product recommendations. Mariah Perkins, too, went through a phase of using makeup to conceal her vitiligo, a practice that was both time-consuming and expensive. Eventually, she made the courageous decision to stop using makeup to hide her vitiligo. Similarly, Mckyla Crowder used makeup and layers of clothing to hide her symptoms, especially during high school, when she became acutely aware of her differences. However, she eventually embraced her true self and found a supportive community that helped her come out of her shell. 3. Avoid Labeling Their Skin as “Flawed” or “Imperfect” When interacting with someone with vitiligo, it is vital to refrain from using derogatory terms like “flawed” or “imperfect” to describe their skin. Such comments can have a profoundly negative impact on their self-esteem and body image. As Marian De Vos eloquently put it, referring to individuals with vitiligo as “imperfect” can cause them to doubt themselves and their self-worth. Embracing one’s appearance is challenging enough, and using derogatory language only adds to the burden. Mckyla Crowder emphasized that vitiligo is not a flaw, and it does not cause physical pain. Just as you wouldn’t label someone else’s condition as a “flaw,” it is crucial to extend the same courtesy to individuals with vitiligo. 4. Do Not Comment on New or Changing Spots Vitiligo is a condition that typically progresses slowly over time, with pigment loss spreading to involve more of the skin. Rarely, some individuals may experience repigmentation. It is essential to avoid pointing out changes in someone’s vitiligo-affected skin, as they are acutely aware of these developments. For individuals living with vitiligo, accepting the changing nature of their skin can be a challenging journey. Chelsey Hamilton, a 25-year-old with vitiligo, shared her experience of friends noticing new white patches on her skin. Such comments, even when well-intentioned, can be uncomfortable for individuals with vitiligo, as they are still coming to terms with their changing bodies. 5. Respect Their Privacy and Choices When meeting someone with vitiligo for the first time, it is important to respect their privacy and choices regarding their condition. Not everyone is ready to discuss or acknowledge their vitiligo openly, and making unsolicited comments about their skin can be distressing. Each person’s journey with vitiligo is unique, and some may not be ready to embrace their condition fully. In conclusion, understanding and supporting individuals with vitiligo requires sensitivity, empathy, and respect for their unique experiences and choices. Avoiding hurtful comments and behavior and treating them with kindness and understanding can go a long way in creating a more inclusive and supportive society for those living with vitiligo.

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 the possibility of getting a tattoo with a physician before giving in to peer

How to Go Back to Sleep After Waking up With Anxiety

Experiencing anxiety in the middle of the night can disrupt your sleep and make it challenging to fall back asleep. The connection between anxiety and sleep is significant, as anxiety can exacerbate sleep disorders like insomnia, while insufficient sleep can also worsen anxiety symptoms. When nighttime worries strike, it’s crucial to take proactive measures to manage anxiety and promote better sleep for your overall well-being. Why Would Anxiety Cause Someone to Wake Up in the Middle of the Night Stressful life events and anxiety can lead to a state of heightened mental and emotional arousal called hyperarousal. This can disrupt your body’s natural fight-or-flight response, which is regulated by hormones like noradrenaline (norepinephrine). Normally, in the morning, your brain releases more noradrenaline, which keeps you awake and alert. However, when stress is present during the day, it can disrupt your sleep at night, particularly if your sleep is vulnerable to stress. This can result in an increase in noradrenaline levels during the night, leading to sudden awakenings with feelings of anxiety and difficulty returning to sleep. Various mental disorders associated with anxiety or stress can contribute to sleep difficulties.These include: The Vicious Cycle of Anxiety During Sleep An intricate relationship exists between anxiety and sleep, often leading to a vicious cycle. Waking up with stress, worry, and anxiety can make it challenging to fall back asleep, creating more anxiety as you wonder if you’ll ever get the rest you need. During sleep, different stages, including REM (rapid eye movement) sleep, play a role in processing emotions and adapting to stressful events. REM sleep influences how we remember details and can help reduce emotional responses when recalling stressful experiences over time. It also affects autonomic functions such as breathing and heart rate. For instance, in the early days after the loss of a beloved pet, intense stress and grief may be experienced, resulting in tears and shortness of breath. However, as time passes and sleep aids in the processing of grief, emotions tend to become less intense. Eventually, the emotional response when thinking back on the loss diminishes. Conditions like anxiety disorders, post-traumatic stress disorder (PTSD), or sleep disorders can disrupt sleep patterns, including the amount of REM sleep obtained. This reduction in REM sleep can impede emotional recovery from challenging events, further perpetuating the cycle of lost sleep and heightened anxiety and stress. To break this cycle, it is important to prioritize healthy sleep habits. The Centers for Disease Control and Prevention (CDC) recommends adults aim for at least seven hours of sleep per night. Signs that you may not be getting enough sleep include difficulty staying awake during the day, impaired concentration and focus, emotional instability, slower reaction times, and difficulties with decision-making and problem-solving. How to Avoid Anxiety at Night Managing anxiety effectively can significantly improve your sleep. Here are some strategies to help you reduce anxiety and stress: How to Go Back to Sleep Once You Wake Up If you suspect that anxiety is waking and keeping you up at night, it’s important to be aware of the typical signs and symptoms associated with panic attacks. These can include racing and intrusive thoughts, feelings of fear and loss of control, an elevated heartbeat, sweating, chills or hot flashes, shortness of breath or chest pain, nausea or abdominal pain, dizziness or faintness, and numb or tingling sensations in the body. Experiencing these symptoms during the night can jolt you awake and make it difficult to fall back asleep. Even if you’re not having a full-blown panic attack, anxiety symptoms such as persistent worry, muscle tension, restlessness, and fatigue can still keep you up at night. The racing thoughts and fixations on worries can prevent you from finding calm and relaxation necessary for sleep. To further help you reset and go back to sleep after waking up with anxiety, consider the following techniques: When to See a Healthcare Provider Seeking help from a healthcare provider is essential when experiencing anxiety and sleep difficulties. Here are some reasons to consider reaching out to a healthcare professional: Remember, seeking help is a sign of strength and a proactive step towards better mental health. A healthcare provider can assess your situation, provide an accurate diagnosis, and develop a comprehensive treatment plan to help you manage your anxiety and improve your sleep. Recap Anxiety upon waking up can indeed disrupt sleep and exacerbate worries and fears. Managing anxiety and finding ways to fall back asleep are crucial for maintaining overall health and well-being. It’s important to monitor your sleep patterns and ensure you’re getting sufficient rest. If you suspect you have a mental health disorder or if your anxiety is persistent and significantly impacting your daily life, seeking help from a healthcare professional is important. They can provide a proper diagnosis, offer appropriate treatment options, and support you in managing your anxiety and improving your sleep. Remember that taking care of your mental health is just as important as taking care of your physical health. Seeking professional help is a positive step towards understanding and addressing your anxiety and sleep concerns.

I Finally Had My Trichotillomania Under Control Before the Pandemic—But Now I’m Struggling in Quarantine

Recently, while working from home, I unexpectedly recalled a Zoom meeting. A wig, the first one I could reach from my bed, seemed the most natural, so I put it on before turning on my camera. It was short and dark brown. I sloppily threw on a stocking hat and combed my hair into place, figuring no one would notice anyhow. One of my employees asked me, “Kimi, did you cut your hair?” shortly after the call started. Shit. My typical workplace wig was a different color than I remembered and reached just halfway down my waist. “Uh, I actually got it cut a few weeks ago,” I explained. “Fair enough; I haven’t seen you in person for an entire month, after all,” the coworker said. I hadn’t yet worked up the nerve to inform my coworkers that I suffer from trichotillomania, a disorder that causes me to pull out my hair excessively and is conceptually similar to obsessive-compulsive disorder (OCD). The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) defines trichotillomania, also known as ‘trich’ by those who suffer from it, as an impulse control disorder characterized by compulsive, repetitive hair-pulling despite conscious efforts to stop, resulting in both objectively noticeable hair loss and perceived distress or impairment in daily functioning. Since I was a young adolescent, trich has been a part of my life. I have attempted counseling and medicine to treat it, but ultimately have learned to embrace it as part of who I am. But wow, this confinement is making me crazy. Before the pandemic—and after fourteen years of pulling my hair—I had finally come up with a game plan to get my trichotillomania under control, and it was working. I decided at the beginning of the year to make a concerted effort to lengthen my hair. My hair was at its shortest then, but I was able to use creative styling to cover most of my thinning areas. Eventually, I was able to reduce my hair-pulling practically to nil by covering my hair with a wig whenever I left the house (for work or otherwise). I had made excellent progress, but staying put brought up a totally different set of conditions than I had anticipated. No longer was I required to wear wigs for work, so I stopped using them to avoid damaging my hair. Three months of development were undone in a matter of days due to the stress of working from home and worried about my family’s safety or my friends’ who had lost their employment. You have to understand that trich causes hair-pulling to become an automatic habit. I used to spend hours on daily conference calls while socially isolating and working from home, aimlessly trying to shave off split ends and other “off” patches of hair (such as those that are thicker or coarser than the rest) with my fingers. After a long day, my hair would accumulate on the floor of my bedroom like tumbleweeds, and I’d have to sweep it up. I never went more than fifteen minutes without yanking. A few days into my confinement, I looked in the mirror and saw that one of the bald patches I’ve had for years had spread across my entire scalp. I felt like a failure and was devastated by my own failure. I’m not alone right now—the pandemic may be worsening hair-pulling and skin-picking disorders for many others. An increase in hair-pulling and skin-picking during the pandemic was primarily attributed to extreme fluctuations in sensory or emotional stimulation, according to Fred Penzel, PhD, a psychologist who serves on the scientific advisory board for the International OCD Foundation and the TLC Foundation for Body-Focused Repetitive Behaviors. “I’ve always believed that this is a form of self-regulation; it’s a way of dealing with being overstimulated or under-stimulated,” Penzel said. Although it is too soon to say with data that body-focused repetitive behaviors (BFRBs) are on the rise primarily due to self-isolating, the TLC Foundation recognized an early need for services and quickly rolled out additional programming for support groups and webinars featuring several experts in BFRB research to address the growing number of people affected by this condition. Two of my friends, Rebecca and Jude (who asked that their last names not be used for privacy reasons), also suffer from trich, and they told me that they had an especially hard time avoiding hair-pulling when they were socially isolated. For Rebecca, “the pulling” became increasingly stressful. And Jude could relate: “At the beginning of lockdown, my scalp-pulling was off the charts.” During their time in quarantine, Rebecca and Jude shaved their heads in an extreme measure to combat their impulse to tear out their hair. “Even though I had done it before, the decision to shave my head was very difficult,” recalls Rebecca, who was unable to receive her usual shorter haircut since barber shops were closed. I wasn’t thrilled with it at first, but I’m beginning to like it again. It’s tough to live at a time with so many unknowns, so be kind to yourself, and do what you can to take charge of the things you can. While Rebecca has gone for a complete shave, Jude has opted for something closer to an undercut: “I made the decision to claim my hair,” she explains. “As soon as I did it, I felt completely at peace and wondered why I had waited so long.” Since my previous strategy to reduce hair-pulling wasn’t working in quarantine, I knew I had to come up with a new plan. It’s crucial to remember that there are various causes of hair pulling and that no two people will respond to the same treatments in the same way; therefore, while I knew that shaving my head would help me, I also knew that it would help Rebecca and Jude as well. Psychologist at MGH and TLC Foundation scientific advisory board member Nancy Keuthen, PhD, recommends first learning about the roots of one’s

Stressed About Your Salary, Debt, or Spending Habits? Here’s What to Know About Financial Anxiety

You are not alone if the mere notion of checking your bank balance causes anxiety. Concerns about money are frequent, and after a worldwide epidemic that caused widespread job loss and economic suffering, this is especially true. According to the Congressional Research Service, in April 2020, at the height of the epidemic, unemployment reached a peak of 14.7%. That percentage is higher than the peak unemployment rates during the Great Recession of 2007–2009, making it the highest unemployment rate the United States has seen since the Great Depression. Two years have passed since these jobless highs, but that hasn’t calmed Americans’ nerves much. Soaring inflation has made it harder than ever to pay for necessities like food, petrol, and utilities. One of the reasons why financial worries are so common? We mentally connect it to our basic ability to stay alive. “Money is really a resource that can provide people with a sense of safety and security,” says Chloe Carmichael, PhD, a psychologist based in New York City and quoted in Health. To paraphrase, “when we feel that resources are scarce, it can actually make people feel like their survival is in jeopardy on a very primal level.” There’s no need to panic about money. Matt Lundquist, LCSW, a psychotherapist at Tribeca Therapy in New York City, tells Health that some financial concerns may be a positive incentive. A healthy dose of fear may motivate you to make positive changes, he argues. For instance, if you overspent over the weekend and then realized it, you could reevaluate your spending habits, and if you’re worried about an approaching bill, you might save more money than you need. However, according to Lundquist, money worries become problematic when they take up too much mental space or start to get in the way of daily living. So, how can you keep your financial concerns under control? Expert advice on relieving financial strain is provided here. Create a plan Amy Morin, a licensed psychotherapist and the author of four books on mental strength, has given several presentations on the topic of how one’s financial situation might affect one’s state of mind. According to her research, those who are in debt are three times more likely to experience despair. Suicide ideators also tend to have higher levels of debt, according to Morin. One of the most important strategies to confront these negative emotions and ensure they don’t win? Create a strategy. Morin, who is also the editor-in-chief of Verywell Mind, tells Health that coming up with a concrete strategy might help people feel more in charge of their financial circumstances. Spending cuts and revenue increases may both figure into your plan. As part of this process, you should create a monthly budget and an organized strategy for paying off your debt. It’s important to take into account the sources of emotional strain while you formulate your strategy. Mental health professional Celia Mion-Araoz, who deals with patients at Community Health of South Florida Inc. who are stressed out by financial concern, tells Health. Mion-Araoz recommends making a list of all the invoices, payments, or charges that need to be addressed, and then prioritizing them from most urgent to least urgent. “Prioritization is a crucial first step in order to get your head around a more complex problem, break it down, and thereby gain a sense of control over it,” which will “help you gather momentum for working your way through the financial stress and through the items on your list.” Focus on attainable goals first Create a list of realistic payment targets and a workable strategy for tackling each item on your list, moving from the top down once you have established a hierarchy of financial priorities. Again, as Mion-Araoz puts it, the point is to “begin to break down the financial stressors into smaller parts,” to deal with the most pressing issues first and in order of importance rather than everything at once. As the author puts it, “by achieving these incremental, attainable payment goals or wins, you gain confidence and momentum and reduce the sense of being overwhelmed.” Recognize and talk through your emotions surrounding money Health spoke with Julie Elledge, PhD, founder and CEO of Mentor Agility, to learn more about how money influences every aspect of our life. However, there is no help for people to deal with these emotions, and few socially acceptable methods to communicate about sentiments related to money. One of the first steps in dealing with worry is realizing that it’s okay to talk about money worries. Speaking about one’s financial situation may evoke a wide range of feelings, including guilt, pride, anxiety, envy, power, control, and a sense of worth, as Elledge points out. “By learning to recognize and discuss these feelings, we can lessen the hold that money has on our well-being.” Elledge recommends talking to a life partner (though it may bring up extremely powerful emotions) or a financial wellness coach about how you’re feeling. “A coach who is fluent in financial wellbeing will help you manage emotions, define your goals, plan your opportunities, and help you find the road map to getting back on the right track,” says Elledge. Elledge expands on this idea, saying that this kind of expert may help you reframe your “underachieving narrative” as an inspiring one of triumph. Storytelling methods that aid a client in integrating their varied and powerful feelings into a single narrative thread are frequently employed to achieve this goal. Elledge recommends consulting a financial expert to “help you manage the resources to bring your story to a successful outcome.” Schedule time to worry Many aspects of your life and your finances are beyond your control. Neither the economy nor your chances of getting a pay rise are under your control. Moreover, there is no use in expending mental resources on such concerns. Instead of letting anxiety about these issues consume your whole waking day, consider limiting it to just 15 minutes by making time in

This Is What It’s Like to Be an Adult With Separation Anxiety

Have you ever noticed that when your young child starts crying and holds onto your leg tightly whenever you try to leave for work or run an errand, they may be experiencing separation anxiety? It’s a natural part of their development. However, what many people don’t realize is that adults can also experience separation anxiety. It’s not limited to children. When adults have separation anxiety, they may exhibit various symptoms commonly associated with anxiety. These can include a constant feeling of being on edge, difficulty concentrating or thinking clearly, and physical manifestations such as a dry mouth and headaches. These symptoms can be distressing and interfere with daily life. What Exactly Is Separation Anxiety? Separation anxiety is a condition characterized by feelings of fear or distress when being separated from individuals to whom one is emotionally attached. While it is considered normal and even healthy for young children to experience some degree of nervousness or discomfort when apart from their loved ones between the ages of six months and three years, persistent and excessive separation anxiety in later childhood and adulthood can be classified as an anxiety disorder. The crucial aspect of separation anxiety is that the emotions and behaviors associated with it are disproportionate and not aligned with typical developmental milestones. It becomes a concern when the distress and fear experienced during separations become excessive and are not developmentally appropriate for the individual’s age. Symptoms of Separation Anxiety Elizabeth Zakarin, PhD, an assistant professor of psychology at Columbia University Medical Center, highlights several signs that indicate someone is suffering from separation anxiety. These symptoms may not come as a surprise, but they are important to recognize. One key sign is a constant fear of the possibility of being separated from home or loved ones, even in circumstances beyond their control, such as a house fire or natural disaster. Individuals with separation anxiety disorder struggle with situations that take them away from their loved ones. They may experience extreme distress and anxiety when anticipating overnight business trips that require being away from their child or spouse. They may also have recurrent thoughts related to being separated from their loved ones or display overprotective behavior towards their children. Significant life changes, such as going away to college, moving, or getting married, can be particularly challenging for adults with separation anxiety. Furthermore, those with separation anxiety may obsessively worry that something bad will happen to their loved ones when they are away, such as illness or death. They may be reluctant to spend time away from home, even for school or work. These individuals dislike being alone and may have separation-themed nightmares. Additionally, they may experience physical symptoms like headaches, nausea, or heart palpitations when anticipating or experiencing separation from someone they are close to. These feelings and symptoms can significantly impact relationships and daily life. Separation anxiety disorder can have profound consequences in social and work settings, leading to social isolation, difficulties in maintaining employment or career advancement, challenges in relationships, and overall dissatisfaction with life. Who Gets Separation Anxiety? In the past, separation anxiety disorder was primarily associated with childhood, but the understanding has evolved. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) now recognizes that separation anxiety disorder can occur in both children and adults, categorizing it as an anxiety disorder rather than solely a childhood disorder. It is important to note that underdiagnosis of adult separation anxiety disorder has been observed, and data from a nationally representative survey suggests a lifetime prevalence rate of 6.6 percent for this condition. While individuals who experienced separation anxiety in childhood are at an increased risk of developing adult separation anxiety, it is also possible to develop this anxiety disorder as an adult without a prior history. Certain factors can contribute to the development of adult separation anxiety. Significant life transitions like moving away to college, becoming a parent, or experiencing a life stressor or loss can trigger this anxiety, particularly in individuals who have an underlying anxiety disorder. Additionally, a family history of separation anxiety disorder or other mental health disorders may increase the risk. Treating Separation Anxiety Effective treatments are available for separation anxiety, providing hope for those experiencing its challenges. Evidence-based therapies such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) have shown success in treating separation anxiety. These therapies can help individuals identify and challenge negative thought patterns, develop coping strategies, and gradually expose themselves to anxiety-inducing situations in a controlled manner. Couples or family counseling can also be beneficial, facilitating healthier interactions and communication between the individual and their loved ones. In some cases, medications such as selective serotonin reuptake inhibitors (SSRIs) may be prescribed to help reduce anxiety symptoms. Open and honest communication with loved ones is crucial. Sharing your experience and concerns can foster understanding and support from those close to you. It is important to engage in these conversations so that your loved ones can be there for you during the treatment process. Seeking professional help from a healthcare provider is essential for an accurate diagnosis and to develop a comprehensive treatment plan. With the right support and treatment, individuals with separation anxiety can make significant progress, resolve underlying issues, and lead fulfilling lives. Remember, you don’t have to face separation anxiety alone. Reaching out for support and exploring appropriate treatment options can provide a path towards healing and improved well-being.