Category: Insight

Oct 13

Does Getting Wet From Rain Make You Sick?

Rainy weather has long been associated with the common belief that it can make you sick, particularly by causing colds or the flu. However, it’s essential to clarify that the rain itself doesn’t harbor the power to transmit viruses that lead to these illnesses. Instead, it’s the consequences of being caught in the rain, such as prolonged exposure to cold and wet conditions, that can weaken your immune system and potentially increase the risk of catching a cold or flu virus. How You Get Sick First and foremost, it’s crucial to understand how colds and the flu are typically transmitted. These illnesses are caused by viruses that spread through an infected person’s bodily fluids. This means that close contact with individuals who are already sick or touching surfaces contaminated with virus-containing fluids—such as nasal discharge or saliva—and subsequently bringing your contaminated hands to your eyes, mouth, or nose can lead to infection. Research has shown that a higher prevalence of cold and flu cases occurs during cold and rainy seasons. However, this increase in illnesses is not directly attributable to rain itself. Instead, it is often a result of people spending more time indoors during inclement weather. In indoor environments, close contact with infected individuals and contaminated surfaces is more likely, creating favorable conditions for the transmission of these viruses. Why You Get Sick After Being in the Rain While being exposed to rainwater doesn’t directly cause illness, it can lead to physical discomfort and a lowered body temperature. When you become wet and remain in cold and damp conditions for an extended period, your body may struggle to regulate its temperature effectively. This is because the continuous evaporation of moisture from your wet skin leads to heat loss. Research has demonstrated that drops in body temperature can diminish the effectiveness of your immune response, which plays a vital role in defending your body against viruses. Consequently, if you feel chilled during or after being in the rain, your susceptibility to catching a virus may increase. Recent studies have shed light on how cold temperatures can specifically affect your nasal immunity. When you’re exposed to cold conditions, your nasal blood vessels constrict, potentially impeding the delivery of white blood cells to the nasal mucous membrane—a critical line of defense against germs. This reduced immune response in the nasal area can compromise your ability to fend off viruses. Why Rain Showers Are Different It’s important to distinguish between rain showers and other forms of moisture exposure, such as taking a shower. Unlike rain showers, taking a shower won’t make you sick. There are several reasons for this: 1. Temperature Control: After a shower, individuals typically dry off and put on dry clothes in a temperature-controlled environment. This prevents significant heat loss due to the continuous evaporation of water on the skin. 2. Limited Exposure: Showers are typically of short duration, minimizing the time spent in wet conditions. Prolonged exposure to wet and cold conditions is more likely to impact body temperature and immune response. 3. Hygiene: Proper personal hygiene practices, such as using clean towels and dry clothing after a shower, reduce the risk of becoming chilled or experiencing prolonged exposure to moisture. In summary, while rainy weather itself doesn’t transmit cold or flu viruses, getting soaked in the rain and subsequently feeling chilled can indirectly affect your immune system and increase your susceptibility to illness. This phenomenon underscores the importance of staying warm and dry when exposed to wet conditions to protect your health. Can Rain Cause Hypothermia? Besides the potential for illness, another significant concern when exposed to cold and rainy conditions is the risk of hypothermia. Hypothermia occurs when your body loses heat faster than it can produce it, leading to a dangerously low body temperature. Even in temperatures above 40°F (4.4°C), extended exposure to rain or sweat while feeling chilled can result in hypothermia. For reference, the average human body temperature is around 98.6°F (37°C), while hypothermia sets in when body temperature drops below 95°F (35°C). Symptoms of hypothermia can include shivering, exhaustion, confusion, loss of coordination, memory impairment, slurred speech, and drowsiness. However, it’s crucial to note that hypothermia can impair cognitive function, leading affected individuals to underestimate the severity of their condition. If someone exhibits symptoms of hypothermia after being exposed to rain, immediate medical attention is necessary to prevent potentially life-threatening consequences. Tips for Staying Healthy Outdoors in Rainy Weather Given the potential risks associated with getting wet and chilled in the rain, it’s essential to take precautions to protect your health when spending time outdoors during inclement weather. Here are seven valuable tips to help you stay healthy while hiking, walking, or running in the rain: 1. Check the Weather: Before heading out, be sure to check the weather forecast to anticipate the conditions you’ll encounter. Knowing the expected temperature and rainfall can help you dress appropriately and prepare for the elements. 2. Wear Breathable, Waterproof Outerwear: Invest in a waterproof rain jacket or a specialized running jacket designed to keep you dry. Look for outerwear with a durable water-repellent (DWR) coating that repels moisture while allowing your body to breathe. Avoid rain jackets that do not offer breathability, as they can trap heat and cause excessive sweating. 3. Avoid Cotton Clothing: Cotton has the tendency to absorb water and retain it against your skin, leading to a sensation of wetness and cold. It’s advisable to avoid wearing cotton layers, especially those in direct contact with your skin, as they can contribute to heat loss. 4. Wear Moisture-Wicking Base Layers: Under your rain jacket, opt for clothing made from moisture-wicking materials such as wool, nylon, and polyester. Moisture-wicking fabrics help prevent sweat and rain from saturating your skin, reducing the risk of heat loss and chills. 5. Cover Your Head: Wearing a waterproof hat or using the hood of your rain jacket can help shield your hair and face from rainwater. Not only does this improve visibility in heavy rain, but it

Oct 13

7 Breakthrough COVID Cases Have Hit the New York Yankees—What Does This Term Mean?

Only one team member has symptoms, and all were diagnosed via routine testing. In a recent and unexpected turn of events, seven members of the New York Yankees, including three coaches and four non-coach support staff members, have tested positive for COVID-19, despite all of them having been fully vaccinated against the virus. This development has raised questions about the nature of “breakthrough cases” and their implications, shedding light on the complex dynamics of the ongoing battle against the pandemic. The announcement of these breakthrough cases came to the fore during a press conference held by the team on March 11. The Yankees disclosed that all seven individuals who tested positive had received the Johnson & Johnson vaccine, and remarkably, only one of them experienced “some symptoms” of COVID-19. The positive cases were detected through routine testing, emphasizing the importance of regular monitoring and surveillance in preventing the spread of the virus. Team manager Aaron Boone conveyed the team’s adaptability in the face of this unexpected situation, stating, “We’re learning as we go. We’re getting informed on what we need to do exactly, and just trying to do the best we can to be able to make quick adjustments on the fly and pivot.” This underscores the challenges and uncertainties that continue to surround COVID-19, even in the presence of vaccination efforts. As a precautionary measure, every member of the Yankees traveling party has undergone at least three COVID-19 tests, including PCR nasal swabs and saliva tests, to ensure the virus is properly monitored and contained. During the press conference, it became evident that several players and coaches had resumed wearing masks in the dugout during games, highlighting the team’s commitment to minimizing the virus’s impact. Manager Aaron Boone emphasized the silver lining of vaccination, noting, “One of the good things about being vaccinated is that we are blunting the effects of this virus. I feel like, in a lot of ways, because we’re vaccinated, we’re good and we’re able to deal with this.” The term “breakthrough cases” took center stage during the press conference, prompting questions about what precisely constitutes a breakthrough case and why such occurrences happen. A breakthrough case, as defined by the Centers for Disease Control and Prevention (CDC), occurs when an individual who has been fully vaccinated against a particular illness, such as COVID-19, subsequently develops that illness. For COVID-19, a minimum of two weeks must have passed since the person’s last vaccine dose for the case to be classified as a breakthrough. In essence, these individuals are considered fully vaccinated against the virus. It is essential to recognize that breakthrough cases are not unique to COVID-19; they can occur with other illnesses as well, such as the flu. Dr. William Schaffner, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, underscores this point, emphasizing that no vaccine, regardless of its efficacy, is perfect. “Even at their best, these vaccines are 95% effective—not 100%,” Dr. Schaffner explains. The anticipation of breakthrough cases was built into vaccine development and distribution plans. The effectiveness of COVID-19 vaccines varies among different vaccines. Based on clinical trial data, the Pfizer-BioNTech vaccine boasts a 95% effectiveness rate in preventing symptomatic COVID-19 infections, the Moderna vaccine stands at 94.1%, and the Johnson & Johnson vaccine at 66%. However, direct comparisons between these vaccines may not be entirely accurate, as they were not studied simultaneously, under the same conditions, or against identical variants. The CDC acknowledges that individuals can still contract COVID-19 shortly before or after vaccination, leaving them vulnerable to infection. Additionally, certain COVID-19 variants may lead to illness in fully vaccinated individuals. As of April 26, the CDC reported a total of 9,245 breakthrough cases of COVID-19 in the United States, occurring after more than 95 million Americans had been fully vaccinated. Among these cases, 27% were asymptomatic, meaning the individuals showed no symptoms. Furthermore, 9% of those with breakthrough infections required hospitalization, and sadly, 132 individuals (approximately 1% of total cases) succumbed to the virus. The CDC has announced plans to transition its reporting to focus solely on breakthrough cases that result in hospitalization or death, beginning on May 14. This shift aims to enhance the quality of data collection, prioritizing cases of greater clinical and public health significance. Regarding the treatment of breakthrough cases, many individuals do not require any medical intervention. Dr. Schaffner points out that a significant portion of these cases is either asymptomatic or presents with mild symptoms, highlighting the vaccine’s success in mitigating the severity of the disease. In cases where individuals experience more severe symptoms, they receive the same treatment as those who have not been vaccinated, emphasizing the importance of prompt medical attention when necessary. Despite the occurrence of breakthrough cases, health experts continue to emphasize the critical importance of COVID-19 vaccination. The primary objectives of the vaccines remain steadfast: to prevent severe illness, hospitalizations, and deaths. Dr. Amesh Adalja, an infectious disease expert and senior scholar at the Johns Hopkins Center for Health Security, underscores the vaccines’ remarkable success in achieving these objectives. While the information presented here is accurate as of the time of publication, the fluid nature of the COVID-19 situation warrants ongoing vigilance and adaptation to evolving circumstances. Readers are encouraged to stay informed by referring to trusted sources such as the CDC, WHO, and their local public health departments for the latest information and guidance pertaining to COVID-19. In summary, the emergence of breakthrough cases among the New York Yankees serves as a stark reminder of the complexities surrounding COVID-19, even in the presence of vaccination efforts. These cases highlight the need for continued vigilance, regular testing, and adherence to public health measures. While breakthrough cases do occur, vaccines remain a potent tool in reducing the severity of the disease and preventing hospitalizations and deaths. The battle against COVID-19 is ongoing, and a collective commitment to vaccination and public health measures remains crucial in overcoming the challenges posed by the virus.

Sep 05

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: 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 financial penalties associated with hyperactivity disorder. However, people with ADHD face challenges in other, more subtle ways. According to Tuckman, people with ADHD

Sep 05

Is Adderall in Short Supply? Challenges: What You Need to Know Taking the ADD Drugs

The FDA reported a shortage of Adderall, a medicine used to treat attention-deficit/hyperactivity disorder (ADHD). The announcement follows weeks of complaints from customers and pharmacists about difficulties obtaining the medication. This is the second time in recent years that the government agency has recognized a scarcity of Adderall, also known as amphetamine mixed salts pills. The FDA detected a shortage in September of 2019, but by May of 2022, the problem had been remedied. Aurobindo Pharma, Lannett Company, Milan Pharmaceuticals, Sandoz, and Teva Pharmaceuticals were the five drug manufacturers hit by the Adderall shortage. Teva, one of these pharmaceutical firms, is suffering manufacturing delays that are generating the current shortage, as was indicated in the FDA’s press statement reinstating the formal shortage. In September, an FDA spokeswoman assured Health that the agency still anticipated having sufficient supply to fulfill demand, despite the difficulties that Teva would be experiencing over the following months. The agency, however, now claims that rival producers are falling behind. The FDA noted in a news statement that while “other manufacturers continue to produce amphetamine mixed salts,” their output is insufficient to fulfill the current demand in the United States. Teva, the leading U.S. supplier of both original and generic Adderall, acknowledged delays of the medicine in September and stated that they should be temporary. A representative for Teva, Kelly Dougherty, told Health that while certain customers “may encounter a backorder (intermittently) based on timing and demand,” such delays are usually short-lived. “We are actively shipping both branded and generic Adderall to customers,” the company said, adding that “we expect full recovery for all inventory and orders in the coming weeks, at which point we expect no disruption at the pharmacy level.” Before the announcement on Wednesday, doctors and patients have been sounding the alarm in interviews with media sites including BuzzFeed News, Bloomberg, and NBC News about the difficulty of maintaining enough supplies of Adderall. Sixty-four percent of community pharmacists surveyed by the National Community Pharmacists Association in August said they had trouble getting Adderall in for their patients. The FDA has verified the accounts of patients and clinicians, yet many still have trouble getting their hands on life-changing medications. What you need to know about buying Adderall and what to do if you run across problems doing so are detailed below. Increased demand complicates already challenging supply conditions. Limited availability of the medicine was reportedly caused by a manpower shortfall at Teva, as reported by Bloomberg. Dougherty stated that there is “no product shortage on our end,” and that “any noted delays are the downstream effect of a past labor shortage on the packaging line which has since been resolved.” More people using Adderall at the same time has led to shortages in recent years. The use of amphetamines like Adderall was already on the rise before to the COVID-19 epidemic, with consumption tripling between 2006 and 2016; nevertheless, the pandemic accelerated the trend. Iqvia Holdings found that prescriptions for Adderall climbed by more than 10% between 2020 and 2021 as a result of lockdowns, and that the number of telemedicine visits, especially those dealing with mental health difficulties, increased. The New York Times noted that several of the start-up businesses that began offering telemedicine mental health services during the epidemic, such as Cerebral Inc. and Done Global Inc., have come under fire for potentially overprescribing the ADHD medicines. In May, Cerebral announced that they will “indefinitely” discontinue dispensing restricted medications including Adderall, Ritalin, and others. The Wall Street Journal states that the U.S. Drug Enforcement Administration (DEA) is also looking into the prescription procedures of Done. If Your Pharmacy Is Out of Your Medications, What to Do The best way to avoid having to go without Adderall is to get your prescription refilled as soon as possible. “That way you have time to find another pharmacy that stocks your medication if your usual pharmacy is out-of-stock,” Farah Khorassani, PharmD, associate clinical professor at the University of California, Irvine School of drugstore & Pharmaceutical Sciences told Health. If your pharmacy is out of Adderall, Khorassani suggests calling around to other pharmacies in the area, or having your pharmacist do so on your behalf. Alex Dimitriu, MD, founder of Menlo Park Psychiatry & Sleep Medicine and BrainfoodMD, advised checking into mobile or mail-order pharmacies if your regular drugstore was out of stock. According to Sonia Gaur, MD, a psychiatrist at Stanford Health Care, you may wish to urge your healthcare physician to phone your prescription into a new pharmacy. If the drug becomes increasingly difficult to obtain due to the shortage, you and your doctor may want to consider switching to a different type of stimulant prescription. As part of its shortage statement, the FDA suggested that patients who were unable to obtain Adderall consult with their doctors about using other forms of medication, such as extended-release forms of amphetamine mixed salts. However, because withdrawal symptoms from stopping Adderall or any other medicine can be severe, it’s not a good idea to do so without first consulting a doctor. According to Guar, “the risk profile is based on multiple factors,” including “comorbid diagnoses,” “length of taking medications,” and “medication dose.” In addition to affecting your energy and mood, abruptly changing your drug regimen may cause you to feel more exhausted and hungry than normal. Dr. Dimitriu says that fortunately, you should only have these symptoms for approximately a week. If you forget to refill your prescription in time and run out of medicine, Dr. Dimitriu advises starting with a lesser dosage and gradually building back up. If you have tried everything and can’t find your medication, talk to your doctor about other possibilities and make getting enough sleep a top priority. “Sleep is essential to ADHD and our attention, focus, and impulse control,” Dr. Dimitriu stated, “so make sure you keep sleeping well (over seven hours) whether on meds or off.”

Sep 05

14 Signs You Could Be Having a Panic Attack

A panic attack is not a typical occurrence of fleeting worry that we all experience from time to time. It can be best described as an explosive manifestation of anxiety, striking suddenly and forcefully. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a panic attack is characterized by a sudden surge of intense fear or discomfort, accompanied by a chaotic mix of unpleasant sensations.¹ These episodes can be highly distressing, leading some individuals to keep their experiences hidden. Concerns about the social stigma associated with psychiatric diagnoses often cause people to delay seeking treatment, as highlighted in a 2020 review published in Neuroendocrinology Letters.² Furthermore, even after receiving a diagnosis, some individuals continue to visit the emergency room repeatedly, mistakenly attributing their symptoms to heart disease, as noted in a 2022 review in the Journal of Family Medicine and Primary Care.³ It’s important to understand that during a panic attack, you are not in any immediate physical danger. As Russell Hunter, PsyD, a clinical psychologist specializing in anxiety disorders and the author of Attacking Panic: The Power To Be Calm, explains, a panic attack is essentially a “false alarm.” To help you identify when you might be experiencing a panic attack, consider the following indicators: A Panic Attack Comes on Quickly The transition from feeling perfectly fine to being engulfed in a state of intense panic can be startling. This sudden shift is attributed to the activation of your body’s fight-or-flight response, as explained by the American Psychological Association. This response triggers the release of hormones, accelerates your breathing, and causes a spike in blood sugar levels, as stated by Russell Hunter in an interview with Health. Interestingly, certain individuals may even experience what are known as nocturnal panic attacks, which abruptly awaken them from sleep, as documented in a 2013 study published in the Journal of Clinical Sleep Medicine. There May Be No Obvious Trigger A panic attack occurs as a response to a perceived threat, although the specific trigger may not be immediately evident. The National Institute of Mental Health suggests that in some cases, an individual’s survival instincts are overly sensitive, leading to excessive panic responses. According to the DSM-5, panic attacks are a symptom associated with panic disorder. While the exact reasons why certain individuals experience panic attacks remain unclear, it is believed that a combination of factors, such as a family history of panic attacks, stressful life events, and environmental influences, may contribute to their occurrence. Typically, panic attacks tend to emerge during a person’s teenage years or before the age of 25. However, it’s important to note that panic attacks can also affect children and adults in their 30s. It’s Short-Lived The duration of a panic attack can vary from person to person, but on average, the peak intensity of symptoms tends to last for a few minutes. As the minutes pass, you may start to recognize that the perceived threat or danger is not real, as Russell Hunter pointed out. This realization often occurs as the body’s stress response begins to diminish. It is important to remember that although the peak intensity subsides relatively quickly, some residual symptoms or feelings of unease may linger for a bit longer. However, with time and a deeper understanding of panic attacks, individuals can gain the confidence to navigate through these episodes more effectively. You May Think You’re Having a Heart Attack A rapid or pounding heartbeat is a frequently observed symptom during a panic attack, often accompanied by chest pain or discomfort. This similarity to heart attack symptoms is what causes many individuals experiencing a panic attack to believe they are having a heart attack. However, once they arrive at the hospital, they often begin to feel better because they start to realize that the perceived danger is subsiding, as described by Russell Hunter. It Can Be Hard to Catch Your Breath Shortness of breath and hyperventilation are common indications that you may be experiencing a panic attack. According to Lily Brown, PhD, an assistant professor of psychology and director at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania’s Perelman School of Medicine, breathing difficulties are among the most prevalent symptoms associated with panic attacks. You Think You Might Faint Many individuals experiencing a panic attack frequently report feelings of dizziness or lightheadedness, which can lead to a fear of fainting. As a response, people often adopt a seated position with their head between their legs. According to Lily Brown, PhD, it is important to note that the sensation of fainting during a panic attack is rare. However, individuals often don’t have the chance to discover that if they allow themselves to endure that feeling, it will eventually diminish. There’s a Feeling of Doom During a panic attack, it is common to experience a sense of losing control or even a fear of death. These distressing sensations can be prevalent during such episodes. In specific social situations, individuals with social anxiety disorder may also encounter similar feelings, such as fear and trembling. However, a small study conducted by Lily Brown and her colleagues in 2016, published in Psychiatry Research, revealed notable differences in the occurrence of panic attacks between panic disorder and social anxiety disorder. The study indicated that the intense and distressing sensations associated with panic attacks are more frequently observed in individuals with panic disorder compared to those with social anxiety disorder. Your Hands Get Tingly According to the American Academy of Family Physicians, panic attacks can manifest as a sensation of pins and needles or numbness in the extremities.¹¹ In rare cases, more severe symptoms such as pseudoseizures can occur, as noted by Russell Hunter. Hunter explains that during pseudoseizures, individuals may collapse to the ground and experience convulsions. However, it’s important to understand that these symptoms are not a result of abnormal brain functioning but rather induced by severe psychological distress, which can occur during a panic attack. It’s Like

Sep 05

What is Cerebellar Agenesis?

Causes and symptomsEpidemiologyCase reportDiagnosis and treatmentReferencesFurther reading Cerebellar agenesis is a condition in which the normal formation of the hindbrain is disrupted. Patients with this disorder have very few pieces of cerebellar tissue – frequently the remains of lower cerebellar peduncles, anterior vermal lobules, and flocculi. Cerebellar agenesis is a condition in which the normal formation of the hindbrain is disrupted. Image Credit: Peter Porrini/Shutterstock.com Both genetically mediated and disruptive causes can cause cerebellar agenesis (CA). Cerebellar agenesis can manifest itself in various ways, with symptoms ranging from mild to severe. Cerebellar agenesis affects not only physical abilities but also cognitive abilities, linguistic impairments, and affective issues. Causes and symptoms Cerebellar agenesis is caused by a variety of factors (heterogeneous). Cerebellar damage caused by bleeding, lack of or decreased blood flow (ischemia), or other conditions are acquired (prenatal/perinatal) causes. Cerebellar agenesis (CA) can be caused by both genetically mediated and disruptive causes. CA can be caused by a genetically mediated pathomechanism (e.g., mutations in the pancreatic transcription factor 1 gene, PTF1) or a disruption (e.g., intrauterine/neonatal damage with the disappearance of the developing cerebellum). Sener used the phrase “vanishing cerebellum” to describe cerebellar disruptive lesions in children with Chiari II malformation. Prenatal hindbrain herniation through the foramen magnum can induce parenchymal injury, resulting in the resolution of a portion of the cerebellum (usually asymmetric). The cerebellum vanishes totally in disruptive CA due to direct or indirect damage. Cerebellar agenesis can manifest itself in various ways, depending on the person. According to the medical literature, some people with cerebellar agenesis have only modest symptoms. It has been suggested that motor performance may be nearly normal in some cases, possibly due to partial compensation from other brain areas. Individuals with cerebellar agenesis whose mental capacities were undamaged and who did not exhibit any symptoms of cerebellar agenesis have also been reported (asymptomatic cases). Cerebellar agenesis most likely represents a spectrum of diseases ranging from severe disability to milder manifestations of the disorder. Earliness, localization, and degree of cerebellar agenesis appear to be linked to the severity and range of motor, cognitive, and psychiatric deficits. Patients with congenital anomalies have more severe and less specific impairments than those who develop cerebellar lesions later in life. Patients with phylogenetically more ancient structures involved (complete or partial cerebellar vermis agenesis) have a more severe clinical picture. This includes severe, pervasive impairments in social and communication skills (autism or autism-like behavior), behavior modulation (self-injury and aggressiveness), and a marked delay in language acquisition, especially in language comprehension. Related Stories When lesions are limited to phylogenetically more recent structures, such as the cerebellar hemispheres, the clinical picture is marked by minor cognitive impairment or borderline IQ, adequate social functioning, context adjustment abilities, and a better prognosis. Epidemiology Cerebellar agenesis is extremely uncommon, with only a few documented cases. CA appears to afflict both men and women in about equal percentages. The disorder’s exact frequency and prevalence in the general population are unknown. The occurrence of congenital solitary cerebellar agenesis is extremely unusual. Case report In 2020, Dennison et al. described a case of cerebellar agenesis recently encountered and diagnosed in Orlando, Florida, United States. At 37 weeks and two days, a 25-year-old mother gave birth to a 5 lb 11 oz, somewhat preterm child via C-section. Polyhydramniosis and a positive chlamydia test during early pregnancy affected the pregnancy, which later tested negative after therapy. The fetus was breech at birth, necessitating a cesarean section. The amniotic fluid was stained with meconium, and the umbilical cord was found to be short. The infant was microcephalic, hypertonic, and spastic at birth and was in significant respiratory distress with irregular breathing. At one and five minutes after birth, the APGAR scores were 5/10 and 7/10, respectively. The infant’s breathing problems persisted, necessitating an emergency transfer to the newborn intensive care unit (NICU), where they were put on continuous positive airway pressure (CPAP). The infant was hypertonic and had excessive deep tendon reflexes, according to a medical assessment performed in the NICU. All primitive reflexes were missing, including Moro, rooting, and sucking. A systolic cardiac murmur of grade I to II was also present in the baby. Bilaterally, coarse breath sounds were heard. The infant had twitching and spastic motions during their time in the NICU. The infant had echocardiography on day one of life, which revealed a massive, bidirectional patent ductus arteriosus. A patent foramen ovale with left-to-right shunting was also present. Because of the aberrant neurological test, a brain computed tomography was performed, which revealed that the cerebellum was almost completely absent, with only traces of the cerebellar hemispheres and vermis remaining. There was also partial corpus callosum agenesis and extensive cerebral and brain stem atrophy. Brain magnetic resonance imaging (MRI) verified these results, prompting additional neurological testing. During waking and sleep, continuous electroencephalography indicated significantly aberrant background activity with burst suppression and extended clusters of infantile spasms, consistent with early infantile epileptic encephalopathy (also known as Ohtahara syndrome). Topiramate was prescribed for the infant’s epileptic activity, considerably reducing symptoms. The infant had a tracheostomy and a gastrostomy tube before being discharged. The infant’s spasms persisted despite a visit to the neurology department, although they showed modest improvement following a course of high-dose steroids. To date, follow-up electroencephalography has revealed that epileptiform discharges have persisted. The infant’s spastic quadriplegia remained severe, necessitating a ventilator and g-tube. The infant experienced sudden cardiac arrest at six months of age and was brought to a hospital after multiple rounds of cardiopulmonary resuscitation and recovery of spontaneous circulation. The infant was eventually declared brain dead, and life support was turned off. Diagnosis and treatment Diagnosis is largely based on the neuroimaging findings of MRI. Regarding diagnosis, prognosis, and genetic counseling, it is also critical to distinguish cerebellar disturbances from cerebellar abnormalities. The treatment for cerebellar agenesis focuses on the specific symptoms that each person experiences. Collaboration with a group of professionals might be necessary for treatment. Pediatricians, neurologists, speech pathologists, and other

Sep 05

How to Cope With Coronavirus Anxiety and Panic

The COVID-19 pandemic has brought numerous uncertainties and unknowns, leading to a sense of fear and anxiety. The fear of the unknown can be overwhelming because it reminds us that we have limited control over the situation, which triggers the fight-or-flight response. This heightened state of awareness and stress can lead to panic and anxiety as we grapple with the uncertainty of what may happen. According to experts, this feeling of powerlessness can result in different responses. Some individuals may adopt a defeatist attitude, feeling that they have no control over their lives, which can contribute to anxiety or depression. Others may feel compelled to take action to regain a sense of control, even if the actions are not necessarily productive or helpful in the given situation. Engaging in activities or behaviors to regain control may provide temporary relief or a sense of empowerment, but it may not necessarily address the underlying anxiety or resolve the uncertainty. In some cases, it may even exacerbate the anxiety. It is important to be mindful of the actions we take and evaluate whether they are truly beneficial or if they are driven by a need to regain control in a situation where control is limited. During times of uncertainty, it is crucial to prioritize self-care, maintain healthy coping mechanisms, and seek support from loved ones or mental health professionals. Accepting that there are certain aspects beyond our control and focusing on what we can manage can help alleviate anxiety and provide a sense of stability in uncertain times. Panic is caused by anxiety or a need for control The experience of panic is driven by the need to regain control, which can be intensified by social contagion and external influences. When faced with uncertain situations like the COVID-19 pandemic, panic can be triggered by the collective behavior of others and the constant stream of negative information in the media. This panic response is often characterized by a lack of clear thinking and irrational behavior, as exemplified by the rush to stock up on toilet paper, which is not actually in short supply. For individuals who already have anxiety, COVID-19 can serve as a significant trigger. Seeking concrete answers in the midst of uncertainty can amplify anxiety, and even minor triggers such as a sneeze or hearing about job losses can contribute to heightened worry and anxiety. It’s important to recognize that anxiety is a common experience for many people during these challenging times. The definition of clinical anxiety involves excessive anxiety and worry occurring on a regular basis for an extended period. Given the current circumstances, it is likely that a significant portion of the population meets this criteria. However, it’s crucial to understand that excessive worrying does not effectively alleviate fear or uncertainty. Trying to constantly control or seek reassurance about feared outcomes is unlikely to provide genuine relief. Instead, it’s important to cultivate acceptance of uncertainty and learn to be comfortable with not knowing all the answers. Here are some suggestions to help cope with the unknown and foster a more positive outlook: Slow down your thoughts by organizing them Anxiety often leads to racing thoughts and impulsive actions, but worrying is not an effective solution when faced with uncertainty. Dr. Brewer emphasizes the importance of slowing down the body and mind. With the rapidly changing circumstances, it becomes crucial to create space for clear thinking and planning. Dr. Yeager suggests practicing deep breathing to calm the mind and slow down thoughts. Engaging in the act of writing, whether it’s making to-do lists or jotting down thoughts in a notebook or document, can help shift focus to concrete tasks and regain a sense of control. By breaking down responsibilities into manageable steps, anxiety can be mitigated, and a logical approach can be adopted. To alleviate uncertainty, Dr. Ivankovich suggests contemplating various scenarios and considering possible responses. Although we cannot fully predict or prepare for the unknown, we can take proactive steps and implement measures within our control to the best of our abilities. It’s essential to acknowledge what actions can be taken in the present and let go of concerns that are beyond our influence. By focusing on one task at a time, prioritizing logical actions, and accepting the limits of control, individuals can reduce anxiety and navigate uncertain situations more effectively. It’s important to cultivate a mindset that embraces adaptability and resilience, allowing us to respond thoughtfully to each situation as it arises. Reach out to others for help and other perspectives If you’re struggling with anxiety, reaching out to a therapist can be beneficial. Many therapists are currently offering short-term assistance for free, and there are text-based tools and therapy apps available that can be accessed during the COVID-19 crisis. Talking to friends or a partner about your anxieties can also provide a helpful reality check. They may offer a different perspective or help you reframe your thinking. Dr. Yeager emphasizes that uncertainty is a shared experience for everyone at this time. Coping with uncertainty involves using lists, processes, and seeking support from others. It’s akin to playing chess, where you can only plan a few moves ahead because circumstances can change rapidly. Being willing to control what you can and adapt when necessary is essential in managing uncertainty effectively. Stop checking the news so much Constantly exposing yourself to the 24/7 news cycle can contribute to increased anxiety. Dr. Brewer explains that the brain treats the news like a casino, where the uncertainty of when the next big story or update will come creates a dopamine-driven anticipation. This intermittent reinforcement schedule can be addictive. To manage anxiety, it’s recommended to limit checking the news to two or three times a day to receive updates that are similar in scale. If negative headlines continue to trigger anxiety, it may be helpful to disconnect from live updates. Dr. Brewer suggests relying on credible sources such as the World Health Organization (WHO) or the Centers for Disease Control and Prevention