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Teens Who Smoke Pot: At Risk For Mental Illness Later?

Teenagers and young adults who use marijuana may be messing with their heads in ways they don’t intend.

Evidence is mounting that regular marijuana use increases the chance that a teenager will develop psychosis, a pattern of unusual thoughts or perceptions, such as believing the television is transmitting secret messages. It also increases the risk of developing schizophrenia, a disabling brain disorder that not only causes psychosis, but also problems concentrating and loss of emotional expression.

In one recent study that followed nearly 2,000 teenagers as they became young adults, young people who smoked marijuana at least five times were twice as likely to have developed psychosis over the next 10 years as those who didn’t smoke pot.

Another new paper concluded that early marijuana use could actually hasten the onset of psychosis by three years. Those most at risk are youths who already have a mother, father, or sibling with schizophrenia or some other psychotic disorder.

Young people with a parent or sibling affected by psychosis have a roughly one in 10 chance of developing the condition themselves — even if they never smoke pot. Regular marijuana use, however, doubles their risk — to a one in five chance of becoming psychotic.

In comparison, youths in families unaffected by psychosis have a seven in 1,000 chance of developing it. If they smoke pot regularly, the risk doubles to 14 in 1,000. Read more »

*This blog post was originally published at Harvard Health Blog*

Deep Brain Stimulation: Experts Warn About Aggressive Marketing

A paper published in the February issue of Health Affairs — discussed at length in an article in the New York Times — contains the sort of blunt, plain-spoken language you seldom read in academic journals. The authors, who include some of the most prominent neuroscientists and ethicists in the world, warn that manufacturers are misusing the FDA’s humanitarian device exemption to promote deep brain stimulation as a “treatment” for obsessive compulsive disorder (OCD).

In fact, they make clear that deep brain stimulation is very much an experimental procedure. Research is still at an early stage, and the risks to patients are not well defined. When suffering is severe and no other treatment has provided relief, there is value in making available an intervention like deep brain stimulation. But misleading or biased information, no matter where it comes from, certainly undermines patients’ ability to calculate benefits and risks.

To enable deep brain stimulation, a surgeon must first implant electrodes in the brain and connect them to a pair of small electrical generators underneath the collarbone. Deep brain stimulation uses electricity to affect how brain signals are transmitted in particular areas of the brain. The image to the left, from the National Institute of Mental Health, shows how deep brain stimulation depends on the implantation of pulse generators below the collarbone and electrodes in the brain.

Specific concerns are raised by the article in Health Affairs (and in our own article on this topic last year in the Harvard Mental Health Letter). Read more »

*This blog post was originally published at Harvard Health Blog*

When Your Health Hinders Your Love Life

This is the time of year when stores are filled with red hearts and other reminders that Valentine’s Day is approaching. It’s a mood booster, not to mention a nice break from all that winter grey (at least up here in Boston). After all, what would life be like without romance, love — and sex?

Unfortunately, a variety of health problems — as well as some of the treatments for them — can get in the way of sexual desire and functioning. Here’s a quick look at some of the main sources of trouble and suggestions about what to try first. If these initial strategies don’t work, have a heart to heart with your doctor about what to do next. There may not be a quick fix for health-related sexual problems, but there are steps you can take to help ensure that you can still enjoy a love life while taking care of the rest of your health.

Arthritis

Arthritis comes in many guises, but most forms of this disease cause joints to become stiff and painful. The limitations on movement can interfere with sexual intimacy — especially in people with arthritis of the knees, hips, or spine.

One common solution is to try different positions to find a way to make sex physically more comfortable. Another option is to take a painkiller or a warm shower before sex to ease muscle pain and joint stiffness. Or try a waterbed — which will move with you.

You can read more online by viewing this helpful article posted by the American College of Rheumatology.

Cancer

Cancer treatment may have long-term impact on sexual desire and functioning. Surgery or radiation in the pelvic region, for example, can damage nerves, leading to loss of sensation and inability to have an orgasm in women and erectile dysfunction in men. Chemotherapy can lower sex drive in both men and women. Read more »

*This blog post was originally published at Harvard Health Blog*

Avoid Weight Gain By Using Brain Tricks To Master Portion Control

When I was growing up, my parents had a simple rule when it came to food: “Finish everything on your plate.” We had to sit at the table until we did.

They meant well. They wanted us to understand that food should not go to waste. The problem with this advice — and I’m sure I’m not the only American who grew up with it — is that we learned early on to eat everything put in front of us when we sat down to meals. Then the size of the plates grew — and so did the amount of food we consumed.

Portion inflationIt’s called portion inflation. Take a look at the illustration at left. It’s based on an analysis published in the Journal of the American Dietetic Association which found that typical restaurant portion sizes today are two to eight times as large as those in 1955. Back then, people who consumed a typical American meal (a hamburger, French fries, and a soda) had only one portion size to pick from. Today we can choose from multiple portion sizes: reasonable, big, bigger, and ridiculous (as I’ve come to think of the sizes listed in that last column).

Portion size matters. The bigger the portion, the more calories you can consume. An example using a table of calorie information available online in the nutrition section at McDonald’s: By choosing the largest size in each category, you’ll end up consuming nearly triple the number of calories in a meal as you would if you chose the smallest portions.

Food Smallest size/calories Largest size/calories
Hamburger 3.5 oz/250 calories 11.1 oz/750 calories
French fries 2.5 oz/230 calories 5.4 oz/500 calories
Coca Cola 12 oz/110 calories 32 oz/310 calories
Total calories 590 calories 1,560 calories

Partly as a result of portion inflation, we’re eating more. Dietary surveys indicate that, on a per capita basis, Americans consumed 200 calories more per day in the 1990s than they did in the 1970s. That may not sound like a lot, but over time extra calories translate into extra pounds. Some experts calculate that people who add 150 calories a day to their diets, without increasing physical activity to burn those calories off, will gain as many as 15 pounds in a year. Read more »

*This blog post was originally published at Harvard Health Blog*

Feeling SAD? Maybe It’s Seasonal Affective Disorder

This picture shows the view from my office window in Boston: Dull, dreary, and depressing — at least on overcast days like today. Lack of light is one of the reasons that people feel mentally foggy.

One of the bloggers I follow, Rachel Zimmerman of WBUR’s CommonHealth blog, recently wrote that she’s been drinking three times as much coffee as usual. In addition to imbibing more caffeine, I’ve been trying to boost my spirits and alertness with mid-day runs to the snack machine (not the best strategy, in case you’re wondering).

At this time of year, many people aren’t just foggy and sad — they’ve got SAD, or seasonal affective disorder. About half a million Americans — women more often than men — are diagnosed with seasonal affective disorder each year. Many others experience at least some of the symptoms, which include loss of pleasure and energy, inability to concentrate, feelings of worthlessness, and an uncontrollable urge to eat sugar and high-carbohydrate foods (in my case, chocolate chip cookies).

Bright white light therapy remains a mainstay of treatment for seasonal affective disorder. That’s because the light acts on cells in the retina, the tissue located at the back of the eye that sends visual information to the brain. The hypothalamus, which helps control the sleep-wake cycle, is one part of the brain that receives this information. During the winter months, when people tend to stay indoors more, days are shorter,  and the weather becomes overcast, our exposure to natural light diminishes. That disrupts the sleep-wake cycle, as well as other circadian rhythms. The result can be symptoms of seasonal affective disorder. Read more »

*This blog post was originally published at Harvard Health Blog*

Latest Interviews

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

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