Tag: Exercise

  • A psychiatrist’s reflections on grief

    A psychiatrist’s reflections on grief

    In the spring of 2014, I lost my “memere” (the French Canadian term for grandmother). While I had lost grandparents before and have since, my memere’s passing was particularly painful for me. From my earliest memories, she was a constant source of love, support, and joy. She was like a second mother, from taking care of me when I was home from school for a couple weeks with the Chicken Pox, to helping me navigate the choppy social waters of adolescence, to the countless times her quick wit made me laugh. As painful as her death was, it also somehow felt “normal.” She lived to her late seventies, and while I would have wanted her to live longer, I had the sense that she lived a long, rich life. Because she had found out she was dying of pancreatic cancer while still feeling relatively well, I had the opportunity to say goodbye. And I spent the days following her passing with family, celebrating her life and cherishing her memory.

    Five months later, my father died suddenly of a heart attack at sixty-one years old. Only catastrophic metaphors seem to work here: it was like being hit by a Mack truck of grief. For all we knew before he died, he was perfectly healthy, with a stellar visit with his primary care physician only weeks prior and very few risk factors for heart disease (e.g., he wasn’t a smoker, obese, or diabetic). His relatively young age and seemingly good health made his sudden death stunning and tragic. I immediately thought about everything he would never get the chance to experience (retirement with my mother, his grandson’s birth, a new home on the coast of Maine). To make matters even worse, he died on his thirty-fifth wedding anniversary. My mother found an un-signed card. (I could go on, but I won’t . . . )

    I still wince remembering the details of that day (a psychiatrist would call this a traumatic memory), and the following days and weeks were a blur of blinding shock and grief, during which I sometimes felt like I was underwater emotionally, desperate to catch a breath but unable to surface. It was nothing less than a physical experience, and a deeply alienating one that no one could understand or ease. I hurt for my father, thinking about all the life he was so abruptly deprived. I hurt for myself, in a desperate state of disbelief about the reality that I would never see him again. Most of all, I hurt for my dear mother, who had lost her mother and her life companion in the span of five months. Seeing her in her own place of anguish and wrenching grief, where I could neither reach nor comfort her, was the worst part.

    How does one get through this? While grief is a universal human experience, every individual’s suffering is unique and in certain ways incomparable. However, I feel that my own experience five years ago, combined with my training as a psychiatrist, might benefit others. Take it one day at a time; recovering from grief is not a race. Realize that life will never go back to “the way it was before” your loss, so your goal should be to – slowly and carefully – find a “new normal.” You will never stop missing your loved one or hurting over their loss, but trust (even when you can’t imagine it) that your day-to-day experience will get easier. I still think of my father every day, but memories of him are no longer always accompanied by pangs of sadness that take my breath away. And while I don’t believe that trauma makes anyone stronger, healing is possible, and you may even find that you grow in ways that you never would have otherwise.

    Take care of yourself, by doing all the things that you don’t want to do. Eat even though you have no appetite. Go to bed early or sleep in. Exercise even if you have no energy. Avoid turning to alcohol or drugs to temporarily numb the pain (they will likely make you feel worse). Do things that you enjoy and find meaningful, even if nothing brings you pleasure and everything seems meaningless. Even though you can’t concentrate, read books about other people’s grief, or books that have nothing to do with loss whatsoever. Interact with friends and family even though you feel like isolating. Let people know how they can help you (otherwise, you will drown in floral arrangements and baked ziti). For instance, you may need help with funeral arrangements, more time off or a lighter load at work for a while, or a few shoulders to cry on. Ask for what you need.

    Finally, reach out for more formal help if you’re struggling to feel better and move forward after a month or two. Grief counseling could help, either in a group or one-on-one. And if your grief prevents you from functioning for what feels like a long time or is accompanied by serious symptoms like thoughts of suicide or crippling anxiety, be sure to let your health care provider know. These are signs that you might need mental health treatment to cope with your loss, and the sooner you start it, the better.

    Grief is part of the human experience. Everyone who experiences the joy of loving will experience the pain of losing. But even when you’re suffering so much that you can’t imagine going on, it is important to remember that healing is possible, and that you can and will move forward without your loved one, but with their memory and legacy. After all, wouldn’t they want it that way, and isn’t this one of the reasons you loved them so much?

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  • To stay healthy, exercise, and sit less

    To stay healthy, exercise, and sit less

    To stay healthy, exercise appears necessary, but not sufficient.  We also should sit less, according to a new study published in Nature: Scientific Reports. Sitting too much may jeopardize your health.

    Two and a half hours a week of physical activity is important for a longer life and to deter all kinds of chronic conditions.  You should spend at least 20 minutes a day increasing your heart rate. That benefits your heart, your mind, your muscle, your skin and more.

    But, if you exercise for 20-30 minutes a day and then spend the rest of the day sitting, you may still jeopardize your health.  Sitting can increase your likelihood of heart disease, diabetes, and obesity. It can lead to high blood pressure, high blood sugar, and extra body fat around the waist. And, it can hurt your cholesterol.

    The Mayo Clinic reports that, if you sit too much, it increases your risk of death from cancer and heart disease. A meta-analysis of 13 studies found that if you sit for eight hours a day straight, without any exercise, your risk of dying is analogous to the risks of dying from obesity and smoking.

    The New York Times reports that a 2019 study published in the Journal of Applied Physiology found a link between inactivity and fewer health benefits from exercise. It suggests that sitting for long periods could actually change our bodies. Researchers from the University of Texas at Austin studied a small group of healthy young people who sat four days in a row for at least 13 hours a day.

    The people in the study drank a fatty sugary ice cream shake on the fifth day. Not surprisingly, their bodies struggled to process the shake. More interestingly, even when the study participants exercised intensively for an hour at the end of the fourth day, their bodies struggled to process the shake on the fifth day. The metabolic results were similar, high blood sugar and triglyceride levels.

    What’s the solution? Take a break from sitting periodically, and walk around a little.

    The Nature: Scientific Reports researchers studied 64 men and women sitting for longer and shorter periods of time over four-day sessions. Those who sat more appeared to hurt their heart health. Those who stood more had better insulin and cholesterol levels, likely from increasing their blood flow and muscular contractions over the day.

    The more you use your muscles, the more blood sugar you burn. That, in turn, steadies your insulin levels and causes chemical activity that helps to lessen bad cholesterol.

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  • Keeping mentally and physically healthy and engaged may prevent dementia

    Keeping mentally and physically healthy and engaged may prevent dementia

    A 2017 study by a worldwide team of dementia experts, published in Lancet, lays out the latest research findings on dementia, and the news is better than you might expect. There are a range of proven ways, particularly through mental and physical stimulation, to prevent or delay dementia.

    Dementia literally translates from the Latin to mean “out of mind.” It is a brain disorder that affects memory and the ability of people to process information. In 2015, 47 million people around the world, mostly people over 65, were living with dementia at a cost of $818 billion. By 2050, there are expected to be almost 150 million people living with dementia. Today, one in three older people die with dementia.

    Though there is no cure for dementia, people’s daily activities may delay or prevent its onset. And, for people diagnosed with dementia, there are ways to slow down the course of the disease and improve quality of life. The data suggest that people who are better educated, as well as more mentally and physically active and socially engaged, are less likely to be diagnosed with dementia.

    Not surprisingly, social isolation, not having friends or family to talk to and spend time with, and poor education, increases the risk of dementia. In addition, people with hearing loss who are not managing that condition are prone to getting dementia.

    Here are a few ways that have been found to delay or prevent dementia:

    • Treatment for hypertension or high blood pressure is important since high blood pressure has been found to cause dementia.
    • It is possible that more than one in three cases of dementia can be delayed or prevented through exercise, having a social network, and engaging your mind.
    • Smoking less.
    • Managing hearing loss,
    • Keeping your blood sugar level under control if you have diabetes.
    • Maintaining a healthy weightand,
    • Treating depression.

    Getting a diagnosis of dementia in its early stages can allow for treatment interventions that maximize memory and cognition, and reduce stress and depression. There are many people living with dementia who are able to drive and function independently. You can learn more about the living with dementia movement, here.

    Here are ways to help people living with dementia remain independent. And, here are best practices for communicating with a person with dementia.

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  • Seven tips for getting a good night’s sleep

    Seven tips for getting a good night’s sleep

    According to the Centers for Disease Control, sleep matters–not getting a good night’s sleep is a public health problem. Insufficient sleep leads to poor health outcomes and greater risk of early death. Yet, one third of adults in the U.S. do not get enough sleep on a regular basis. We need between seven and nine hours a night.
    Here are seven tips for a good night’s sleep from the National Institutes of Health:
    1. Develop a sleep routine: Set a daily bedtime and wake-up time and stick to it. If you have an iphone or ipad, the clock app has a helpful bedtime setting. In addition to tracking your sleep, it turns off all the sounds on the device during bedtime hours.
    2. Exercise daily:  Even 20 to 30 minutes a day of exercise can help you sleep soundly.
    3. Avoid alcohol, cigarettes and caffeine, especially directly before you go to sleep.
    4. Relax before bedtime: Do something quiet and calming–take a bath, listen to classical music, read a book.
    5. Let the sun wake you up. Bright sunlight has been shown to reset your biological clock.
    6. Only go to sleep when you’re ready to fall asleep. It can be anxiety-producing and cause insomnia to lay in bed awake trying to sleep if you don’t feel tired.
    7. See a doctor if you continue to struggle to fall asleep or stay asleep at night.  There are effective cures. Here are five proven interventions for sleeplessness or insomnia.

    Keep in mind that if you are often tired during the day, you could have sleep apnea.

    A recent Rand study also recommends limited use of electronics before sleep. The Rand study finds that people who sleep on average fewer than six hours a night have a 10 percent higher risk of mortality than people who sleep between seven and nine hours a night. And, people who sleep on average between six and seven hours a night have a four percent higher mortality risk.

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  • Exercise can slow down the aging of your heart and muscles substantially

    Exercise can slow down the aging of your heart and muscles substantially

    Aging is part of life. But you may be able to slow down the aging process biologically if you exercise regularly. While it is hard to control the aging of your skin, it appears that you may be able to slow down the aging of your muscles and heart substantially. The New York Times reports on a recent study in the Journal of Applied Physiology.

    The researchers found that active older men and women in their 70’s, who have exercised regularly throughout their adult lives, have muscles that are hard to differentiate from 25 year olds who are in good health. Younger and older adults who exercise regularly have the same number of enzymes and capillaries.

    Active older adults in their 70’s also are better able to engage in aerobic exercises than most other people in their 70’s. While they did not have the same aerobic capacity as people in their 20’s, it was 40 percent better than people their age who were not active. And, it was about the same as people in their 40’s.

    This study looked at 28 people who exercise recreationally. And, it was an observational study, so it does not prove that exercise caused these health improvements or whether other factors, such as genes and diet, played a material role. Moreover, it does not tell us the extent to which taking up serious exercise in later life is associated with “younger” muscles and hearts. Other studies show that people who exercise seriously, not recreationally, into old age tend to have healthier muscles, brains, immune systems and hearts than people who are not active.

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  • Genes have little to do with how long you live

    Genes have little to do with how long you live

    If you’re thinking that you’re likely to live a long life because your mom and dad lived to a ripe old age, think again. Stat News reports on a study of more than 400 million people, revealing that genes have little to do with how long you live. You have a lot more control over your longevity than you might think.

    Based on ancestry.com data, scientists found that your genes are responsible for less than 7 percent of how long you will live. Environmental factors contribute far more heavily to how long you live. For this reason, spouses have more similar lifespans than siblings. Spouses live in the same place, so they are exposed to similar social networks, chemicals in the air, crime rates, and other external forces, all of which affect their lifespans. Spouses also tend to lead similar lifestyles, they often have similar diets and views about exercise, along with what it means to live a healthy life.

    Scientists believe that high or low income levels could also explain life spans. Other factors that contribute to how long you live include education, access to health care, smoking, and societal influences.

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  • Do you need a bone scan?

    Do you need a bone scan?

    I want to talk today about bone scans . Here’s my basic advice: for the 40 million people with osteoporosis, this test is critical to diagnose and start treatment. It is good to develop a bone density baseline, but there is generally no reason to do it until you’re at least 65. It’s recommended for women over 65 and those under 65 only if they have a fracture or arthritis or family history or other indications that demonstrate a need for a scan. Men over 70 should consider the test if there is an indication such as, steroids or low testosterone, for it. (Medicare covers a bone scan every two years for people at risk of osteoporosis with a referral from your doctor.)

    Unless the test shows evidence of osteoporosis or serious bone loss or you have other indications, you should be able to avoid scans in the future. You shouldn’t get your bone density tested repeatedly if there’s no evidence you need it. If test results show minimal bone loss, also called osteopenia, you might want to forgo repeated scans.

    As you age, it’s natural to suffer some bone loss. Osteopenia has a much lower risk of fractures than osteoporosis and since bone density does not change rapidly, you probably can wait to get scanned again. Similarly, medication generally should not be taken to treat osteopenia. These drugs can carry some risks (as does any medication) and, the clinical benefit for those with osteopenia appears minor at best.  Moreover, medications can be costly and lengthy.

    So, if you are diagnosed with osteopenia and your doctor recommends regular bone scans or medications, you should ask your doctor whether you can avoid them. Medications alone could cost you between $38 and $148 each month, depending upon whether you take the generic or brand-name drug.

    Instead of undergoing extra tests and getting another prescription, focus on how you can influence your health and reduce your chance of these and other tests. Make sure your diet is balanced and contains Calcium and Vitamin D. Avoid excessive drinking and smoking and medications that promote bone loss. Perform weight-bearing exercises. Finally, make your house and work safe by removing fall hazards.

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  • People who engage in social sports found to live longer

    People who engage in social sports found to live longer

    Mounds of evidence show that being socially engaged is good for your health. And, there is as much or more data that demonstrate the value of exercise. The New York Times reports on the latest evidence, which shows that people who engage in social sports live longer than people who engage in solo sports.

    Of course, you cannot know how many more years you will live or whether you will in fact live longer because you play tennis rather than jog, much less hang out on the sofa. But a new observational study, published in Mayo Clinic Proceedings, of 8,600 Danish men and women, finds that people who engage in social sports, such as tennis and soccer, live longer than people who jog and bike ride. And, it should go without saying that those who exercise lived longer than those who are sedentary.

    So how many more years of life are we talking for people who exercise? The researchers found that bikers live 3.7 years longer and joggers live 3.2 years longer than people who don’t exercise.

    People who play tennis live 9.7 years longer than people who are sedentary; people who play badminton live 6.2 years longer, and people who play soccer live 5 years longer.

    Another recent study of 80,306 British men and women also found that people who engage in racket sports live longer than people who jog, a solitary sport.

    Bottom line. We have no definitive evidence as to why people who play social sports tend to live longer than others who exercise. But, it is easy to conjecture that social sports reduce stress more than solitary sports.  And, stress reduction generally brings with it psychological and physiological benefits. We do know that social engagement is great for your health and wellness, as is exercise, and that social isolation can cause premature death. Combining social interactions with exercise may give your health an extra big boost.

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  • This is your brain on exercise

    This is your brain on exercise

    To support brain health, we know many things that people should not do, such as smoke, drink alcohol heavily, use most recreational drugs, and engage in activities associated with frequent head trauma. But other than getting adequate sleep, there isn’t much that we know people should do to promote brain health, sharp cognition, and good mental health. Of course, we recommend eating a healthy, well-balanced diet, but very few individual foods or nutritional supplements have been proven to be good for the brain. The same goes for “brain teaser” activities and “cognitive skills training” programs. Contrary to logic, they haven’t been shown to produce sustained benefits. However, time and again, one activity has been connected to robust improvements in brain health and prevention of brain diseases and mental health problems: exercise. And the encouraging results keep rolling in.

    Regular aerobic exercise has been linked to reduced risk of developing dementia, such as Alzheimer’s disease. This type of exercise has also been repeatedly shown to prevent depression, and has even been proven to be an effective treatment for depressive and anxiety disorders, with effect sizes roughly equivalent to medications. These benefits have been consistently demonstrated in both human studies and in studies examining animal models of mental illness. More recently, non-aerobic weight training has also been definitively associated with positive effects on brain and mental health outcomes.

    As if this news wasn’t good enough, the amount or “dose” of exercise that people need to promote brain health is not as high as you may think. Minimal amounts of exercise such as 20-30 minutes of walking or gardening a day – not even enough to lose weight – may be enough to boost cognitive functioning and lower the risk of mental health problems. So, it should be possible to fit into all but the very busiest schedules.

    Exactly how exercise helps the brain is unclear, and there are many theories, multiple of which may be simultaneously true. Exercise may increase blood flow and oxygen supply to the brain. It may also increase the production and activity of “neurotrophic” (literally “brain feeding”) factors, such as brain-derived neurotrophic factor (BDNF) []. BDNF in critical brain areas such as a memory center called the hippocampus promotes brain health and mental resilience through stimulating the growth of new neurons and connections between them. Exercise causes chemicals to be released from muscles and bones that may be essential to sustaining proper brain functioning. In addition, physical activity causes the release of several “feel good” substances, such as endorphins and endocannabinoids, which have been implicated in the feeling of general well-being and relaxation after a workout often referred to as a “runner’s high.” Finally, exercise may benefit your brain for the same reasons that it is good for the rest of your body – it lowers blood pressure and inflammation levels and enhances proper blood flow and heart functioning.

    Regardless of the exact reasons why it’s so healthy, we know that exercise is a relatively easy-to-do, inexpensive, and fun way to improve brain health and reduce the risk of mental illness and cognitive decline. So, do your brain a favor and grab those running shoes or that bicycle and head outside!

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  • Five ways to feel at your best

    Five ways to feel at your best

    If you focus on birthdays, we are all getting older.  But, many of us who may be “getting up there” in age find ways to stay young at heart–fit, mentally active, and purposeful.  Here are five ways to feel at your best:

    1. Be active: Walk, run, jump rope. Get your heart rate up.  Countless studies show the value of aerobic exercise for your gut, your memory, your immune system, your cardiovascular health, your strength, your stress level, your mood, your cholesterol levels. It may be the best medicine for your body and brain. Also, do balancing exercises and use weights to strengthen your muscles. That is key to good health, including bone health, lowering risk of stroke and even spousal health
    2. Eat well and keep a healthy weight: Sense of smell and taste can change as you age; it’s still important to eat healthy foods. Eat lots of fruits, vegetables, beans, nuts, seeds, lean meats and fish. Avoid, fats, pasta and sugared drinks. And if you need help losing weight or eating better, talk to your doctor; in some cases, Medicare covers weight-loss counseling and nutrition counseling.
    3. Get the sleep you need. Here are seven tips for getting a good night’s sleep.
    4. Keep in touch with family and friends you enjoy. And make one of them your health care buddy, someone to go with you to the doctor, take notes and be a second set of eyes and ears.
    5. And, perhaps, take up bowling: Watch this video from the Atlantic on how one older adult has stayed young and met his life partner bowling.

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    If you’d like to learn more about what you can do to feel at your best, click here for the National Institutes of Health booklet, Young at Heart.