Mother Nature is giving me a migraine

If you suffer from migraines you may have noticed that the frequency of attacks has increased this past year. But before you run to your neurologist in panic let me remind you that weather-related phenomena can cause a throbbing headache.Rapid changes in barometric pressure can change the charge concentration in the air and in turn flood the brain with serotonin which can cause head pain. The lightning from a thunderstorm may also cause a migraine. Actually it is 28% more likely that you will suffer a migraine during lighting.I think we can all agree that Mother Nature is having an angry fit this year across the Glob and those of us who suffer from migraines are keenly aware of her moods.

Other triggers for migraines include:
Emotional stress (good or bad stress)
Changes in schedule (weekends is often the time for an attack)
Traveling (especially airplanes)
Hormonal changes
Certain groups of food
Hunger (don't skip meals)
Strong smells like certain perfumes
Flashing lights
Noise and loud sounds

Depression makes us Bitter

No, really I mean it literally. A study published In May in the Annals of Family Medicine showed that in people with diabetes depression increases the risk of serious hypoglycemia by 40%. Hypoglycemia (dramatic drop in blood sugar) is a serious condition that sends a lot of people to the ER and can be fatal.

It is also the case that Depression is often (not always) accompanying diabetes. People with diabetes often take drugs that at this point work very well, sometimes too well in that they drop sugar levels too low. This being the case, depression can lower these levels even more sending the patient into a hypoglycemic episode. The lead researcher of the study, psychiatrist Wayne Katon, cautions people with diabetes to pay attention to symptoms of depression and seek treatment for it.   

Of course it is my strong opinion that there is no physical condition that if not caused by depression is not exacerbated by it. As I said in a previous blog, the tears the eyes will not shed the body will weep.

A Real Life Faust

The world was my oyster she said. I started from the inner city slums and reached and touched the stars..

In her early 80s she was still a stunning woman with gorgeous blew eyes and a smile more brilliant than the huge stone on her finger.

I am dying she said. One moment I am traveling the world the next I am diagnosed with a rare and fatal illness. I am not ready to die especially not on this illness terms. I always got what I wanted but still there is an emptiness inside that power and money never filled. I want to feel whole before I die.

Her words carefully articulated and perfectly syntaxed painted a picture in my mind of a beautiful and powerful goddess issuing proclamations and receiving adulation from her throne set high up on a pedestal. I shared this image with her along with my feeling of how lonely and scary this throne can be at times. Her blew eyes pierced into mine searching for criticism or condemnation. What she saw instead brought a mist in her eyes which she quickly blinked away. There is no room for vulnerability in my world, she protested.

But vulnerability was exactly what this doctor had in mind for her healing. She had to come down from her icy throne and talk about her fear, ask for help from the people in her life, especially her loving husband whom she had always kept at an arm's length, most of all she had to find her own feelings of affection and get the courage to express them.

Reluctantly she started opening up, first to me about her fears of loosing her independence, of becoming a cripple, of putting her pride away and asking for help and finally of her dying. Then she started opening up to her husband and to her astonishment she felt closer to him than ever before and he became more loving. 

Months into the treatment she started for the first time in her life listening to the people in her family and friends and truly connecting with their problems and pains. The tears of joy in her niece's eyes when she paid her college tuition reawakened a feeling in her heart so intense that shook her very foundation. And just like that she discovered Faust's redemption : That her joy, her purpose, her wholeness, her very redemption was inextricably connected with that of those around her. Her tears were melting her icy pedestal and for the first time in a very long time she was feeling free and light, like a kid.

I don't know how long I have, she said to me one day, and there is plenty of work left for me before I die. You have opened my eyes to a world I had not believed existed for me and for that I am immensely grateful . There is one more thing you can do for me: Tell my story. There are other ice queens out there waiting to be saved, maybe my story will help.

 Yes, I believe it would and I am grateful and deeply touched for entrusting it to me.

The organs weep the tears that the eyes refuse to shed

Psychologist have for years now accepted the connection between depression and susceptibility to infections and gastrointestinal inflammation. Two recent studies at the University of Michigan found that depression and the use of certain antidepressants are both associated with increased risk for Clostridium difficile infection, C. diff, which causes diarrhea and in some cases death.

More specific the researchers found that the risk of C. diff infection among people with a history of depression or depressive symptoms was 36 to 47 percent greater than among people without depression.  Very interesting was also the finding that bereavement and living alone was also found to lower the ability to fight infections in older adults.  

A second study, involving patients, average age 58, found a similar relationship between infection and depression. The same study found an association of specific antidepressants — Remeron, Prozac and trazodone — with C. diff infection. There was no association with other antidepressants.

 

Although the connection between these antidepressants and the infection was not clear and more research is needed, it seems that at the very least patients on these meds that come down with serious infections should be talking to their doctors about the possibility of switching to different antidepressants.  

 

The ancient proverb comes to mind: "The organs weep the tears that the eyes refuse to shed"

Whether ongoing depression or the pain of bereavement sadness needs to be experienced and processed appropriately before the body suffers too.   

 

 

The best Antidepressant/Anxiolitic

I have often told my anxious and depressed patients that one of the most effective medication is exercise.  Their response is often " but I don't have the desire to do it, it will not work".

 

It turns out that  a new U.S. study finds that exercise can help reduce anxiety and depression, even when you don't feel like working out.

Researchers at the University of Colorado Boulder found that being forced to exercise -- for instance by a doctor or gym instructor -- helps reduce stress, anxiety and depression just as well as exercising voluntarily does.

Ok then, here is what I suggest for all of you skeptics who struggle with anxiety and/or depression:  come on in, we will go for a nice bike ride on our newly reconstructed boardwalk!

 

 

More about Stress and Healing

For those of you who found the pervious tips for stress reduction helpful here are some more:

1. Learn some yoga It improves flexibility, it also helps you cope with stress and lower inflammation. Inflammation is an immune response that can be beneficial, such as when your body is fighting off infection, but chronically high levels of inflammation have been tied to health problems such as cardiovascular disease, asthma.

2. Make sure you get enough sleep. Getting adequate sleep doesn't just make you look better, it also improves your health and helps you stress less, according to the Centers for Disease Control and Prevention (CDC). Unfortunately, poor sleep and stress can be a vicious cycle: feeling stressed out during the day can cause you to toss and turn at night, then feel tired and even more stressed the follow morning. If you suffer from insomnia talk to your MD or to a psychologist.

3. Learn some Meditation. Numerous studies have shown the positive benefits of meditation, which include soothing stress, decreasing blood pressure, easing feelings of pain and even preventing relapses in patients with depression. For example, a 2008 study from Emory University in Atlanta showed that Zen meditation, which encourages mental awareness and control of one's thoughts while focusing on breathing, could treat disorders marked by distracting thoughts, such as attention deficit and hyperactivity disorder. There are many different meditation techniques, so don't think that you're required to sit cross-legged and hum a mantra to de-stress. Some meditation styles focus on clearing one's mind, while others encourage visualizing healing or calming imagery or thinking kind thoughts towards oneself and others. Those with physical limitations can also meditate while sitting in a chair or even lying.

4. Venting has its limits. Complaining about what's stressing you out may seem like a good idea, but a study published in July showed that unloading about your problems to a friend may not always be helpful. The study, which was conducted by researchers from the University of Kent in England, found that when people with traits of perfectionism faced daily setbacks, venting made them feel worse . These study participants felt less satisfied with their circumstances than before they talked to a friend about what was stressing them out.

5. Instead Keep a journal. Keeping a journal can lessen stress in several ways, according to the National Institutes of Health (NIH). When you're feeling frazzled, writing down your feelings makes you feel more in control, and may help you better analyze the situation. It can even give you a new perceptive or ways to address the problem. And by looking over past journal entries, you may begin to see a pattern of what stresses you out, according to the NIH. You can then decide what needs to change to prevent those stress triggers from affecting you in the future.

6. Even better: Talk to a psychologist. It is more than venting. It is healing and enlightening.

Healing the Trauma

For the survivors of the Boston massacre and all of us surviving the blows of life.
I hope the words of the Poet are as soothing to you as they are to me.

A Psalm of Life

Tell me not in mournful numbers,
Life is but an empty dream!
For the soul is dead that slumbers,
And things are not what they seem.

Life is real! Life is earnest!
And the grave is not its goal;
Dust thou are, to dust thou returnest,
Was not spoken of the soul.

Not enjoyment, and not sorrow,
Is our destined end or way;
But to act, that each tomorrow
Find us farther than today.

Art is long, and Time is fleeting,
And our hearts, though stout and brave,
Still, like muffled drums, are beating
Funeral marches to the grave.

In the world's broad field of battle,
In the bivouac of Life,
Be not like dumb, driven cattle!
Be a hero in the strife!

Trust no Future, howe'er pleasant!
Let the dead Past bury its dead!
Act, - act in the living Present!
Heart within, and God o'erhead!

Lives of great men all remind us
We can make our lives sublime,
And, departing, leave behind us
Footprints on the sand of time;

Footprints, that perhaps another,
Sailing o'er life's solenm main,
A forlorn and shipwrecked brother,
Seeing, shall take heart again.

Let us then be up and doing,
With a heart for any fate;
Still achieving, still pursuing,
Learn to labor and to wait.
Henry Wadsworth Longfellow