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 »
The JNMD article reports the results of the longest-term study so far to track people with body dysmorphic disorder (BDD). The study was conducted by researchers at Brown University and Rhode Island Hospital. The good news? The researchers “found high rates of recovery, although recovery can take more than five years.”
This is a small study with only 15 BDD patients who were followed over an eight-year span. An excerpt:
After statistical adjustments, the recovery rate for sufferers in the study over eight years was 76 percent and the recurrence rate was 14 percent. While a few sufferers recovered within two years, only about half had recovered after five years.
The subjects were a small group diagnosed with the disorder out of hundreds of people participating in the Harvard/Brown Anxiety Research Project (HARP). Study co-author Martin Keller, professor of psychiatry and human behavior and principal investigator of the HARP research program which has been ongoing for more than 20 years, said that because the BDD sufferers were identified through this broader anxiety study, rather than being recruited specifically because they had been diagnosed with BDD, they generally had more subtle cases of the disorder than people in other BDD studies. In comparing the HARP study with the prior longitudinal study of BDD, it is possible that the high recovery rate in the HARP study is due to participants having less severe BDD on average.
— In its simplest definition, it is an obsessive preoccupation with a slight, imperceptible, or actually nonexistent anatomic irregularity to the degree that it interferes with normal adjustment within society. Read more »
Did you know that one-third of the country’s physicians are over the age of 65? That’s right, there’s a good chance that your doctor is on Medicare. That’s a concern, because physicians aren’t immune to the ails of aging, and are just as prone as patients to succumb to the effects of Parkinson’s or various types of dementias.
Not comforting if you’re about to undergo an operation, for instance. And absolutely frightening when you consider baby boomers and newly-insured patients will flood our health system in the coming years.
An eye-opening piece from the New York Times highlights the trend. It’s up to doctors and medical societies to report doctors who aren’t able to proficiently perform, but few do. According to the data, the rate of disciplinary action for physicians out of school 40 years was 6.6 percent.
Various tactics to ensure competency have been slow to take off. Requiring all doctors to re-certify, for instance, isn’t working, since the vast majority of doctors practicing are “grandfathered” into not being required to take the test. Read more »
*This blog post was originally published at KevinMD.com*
Dr. Shaf Keshavjee, a thoracic surgeon and director of the Toronto Lung Transplant Program, showed the amazing miracle of modern lung transplantation at TEDMED 2010. Here’s his fascinating talk where an actual living, breathing set of porcine lungs were brought on stage for hands-on inspection by the audience:
Here’s a quick interview we were able to get with Dr. Keshavjee just after the talk: Read more »
*This blog post was originally published at Medgadget*
This is a guest post by Dr. Barbara Okun and Dr. Joseph Nowinski.
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End-Of-Life Planning Makes It Easier To Say Goodbye
Saying goodbye as the end of life approaches can be difficult, even for those with a gift for words. In a moving account in a recent issue of The New Yorker, writer Joyce Carol Oates describes the last week of her 49-year marriage, as her husband was dying from complications of pneumonia. Like A Year of Magical Thinking, Joan Didion’s poignant memoir of her husband’s sudden death and its aftermath, Oates’ essay highlights the need for each of us to think about death and dying — and discuss them with loved ones — long before they become a likelihood.
In our work with individuals and families facing death, we have seen too many people miss the opportunity to say goodbye because they avoid what feels like a scary or taboo topic: What do I want to happen when I die? Beginning this discussion early, preferably while you are in good health, can help pave the way for a “good death.” In our new book, Saying Goodbye: How Families Can Find Renewal Through Loss, we offer a guide to help individuals facing a terminal illness and their families navigate the realities of death and dying. Planning ahead is essential. Here are some suggestions for doing that:
Choose your team. Identify support people and specialists (legal, medical, financial, religious) you can count on to advocate for you and help you make decisions. Designate these people to act for you by signing advance medical directives. Read more »
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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.
