Researchers looked at the frequency of serious bleeding among hundreds of thousands of stroke survivors who took different types of SSRI and/or SNRI antidepressants.
DALLAS — Most stroke survivors were able to safely take two types of common antidepressants, according to a preliminary study to be presented at the American Stroke Association’s International Stroke Conference 2024. The meeting will be held in Phoenix, Feb. 7-9, and is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.
Among people with ischemic (clot-caused) stroke, those who began taking an antidepressant known as an SSRI (selective serotonin reuptake inhibitor) and/or an SNRI (serotonin and norepinephrine reuptake inhibitor) for the common conditions of post-stroke depression and anxiety, did not have an increased risk of hemorrhagic (bleeds) stroke or other serious bleeding. This included people taking anticoagulation medications. There was, however, an increased risk of hemorrhagic stroke among stroke patients taking two anti-platelet medications, also called dual anti-platelet therapy or DAPT.
“Mental health conditions, such as depression and anxiety, are very common yet treatable conditions that may develop after a stroke. Our results should reassure clinicians that for most stroke survivors, it is safe to prescribe SSRI and/or SNRI antidepressants early after stroke to treat post-stroke depression and anxiety, which may help optimize their patients’ recovery,” said study lead author Kent P. Simmonds, D.O., Ph.D., a third-year physical medicine and rehabilitation resident at the University of Texas Southwestern Medical Center in Dallas. “However, caution is needed when considering the risk-benefit profile for stroke patients receiving dual anti-platelet therapy because we did find an increased risk of bleeding among this group.”
According to the American Heart Association’s Heart Disease and Stroke Statistics 2024 Update, when considered separately from other cardiovascular diseases, stroke ranks fifth among all causes of death, behind diseases of the heart, cancer, COVID-19 and unintentional injuries/accidents. Approximately one-third of stroke survivors develop poststroke depression. If left untreated, depression may affect quality of life and reduce the chances for optimal poststroke recovery such as returning to their usual daily living activities without assistance.
The most common classes of antidepressants are SSRIs or SNRIs, and they are widely used and effective for treating anxiety and depression. However, they may not be prescribed at all or early enough after a stroke, when the risk of depression or anxiety is particularly high, due to concerns that they may increase the risk of a hemorrhagic stroke or other serious types of bleeding.
Researchers looked at the frequency of serious bleeding among hundreds of thousands of stroke survivors who took different types of SSRI and/or SNRI antidepressants (such as sertraline, fluoxetine, citalopram, venlalfaxine). Serious bleeding was defined as bleeding in the brain, digestive tract; and shock, which occurs when bleeding prevents blood from reaching the body’s tissues.
Researchers also investigated serious bleeding among stroke survivors who took antidepressants combined with different types of blood-thinning medications that are used to prevent future blood clots. These blood-thinning medications may include either anticoagulants or antiplatelet medications. Anticoagulants are prescribed as a single medication and include medications such as warfarin, apixaban and rivaroxaban. Antiplatelet medications may be prescribed as either a single medication (commonly aspirin) or two types of antiplatelet medications can be used in dual antiplatelet therapy. DAPT includes aspirin plus another antiplatelet medication called a P2Y12 inhibitor (such as clopidogrel, prasugrel or ticagrelor).
The study found:
SSRI and SNRIs were generally safe to start during the important early stages of recovery as patients taking these medications were not more likely to develop serious bleeding compared to stroke survivors who did not take an antidepressant. This included ischemic stroke patients who are also taking anti-coagulation therapy.
An increased risk of serious bleeding occurred when SSRIs or SNRIs were taken in combination with DAPT treatments (aspirin and blood thinners). However, the overall risk remained low as serious bleeding events were rare.
Among ischemic stroke patients on antidepressant medications, there was a 15% increase in the risk of serious bleeding when taking medications from classes such as mirtazapine, bupropion and tricyclics compared to SSRI/SNRIs.
“Maximizing rehabilitation early after a stroke is essential because recovery is somewhat time-dependent, and most functional gains occur during the first few months after a stroke,” Simmonds said. “Fortunately, dual antiplatelet therapy is often administered for 14, 30 or 90 days, so, when indicated, clinicians may not need to withhold antidepressant medications for prolonged periods of time. Future research should investigate the risk of bleeding associated with the use of anti-depressant and anxiety medications among patients with hemorrhagic or bleeding stroke.”
According to a 2022 American Heart Association scientific statement, social isolation and loneliness are associated with about a 30% increased risk of heart attack or stroke, or death from either. “Depression may lead to social isolation, and social isolation may increase the likelihood of experiencing depression. The current study helps answer safety issues around the use of antidepressants for treatment of mental health issues that may develop after a stroke,” said Crystal Wiley Cené, M.D., M.P.H., FAHA, chair of the writing group for the Association’s scientific statement, and a professor of clinical medicine and chief administrative officer for health equity, diversity and inclusion at the University of California San Diego Health. Dr. Cené was not involved in this study.
CHICAGO - A new baby should bring a time of happiness for a family but what is frequently dismissed as the "baby blues" is a mental health condition called postpartum depression.
Uncontrollable crying, an inability to complete daily tasks, insomnia, oversleeping and low energy are common symptoms mothers experience and can last for weeks. In severe cases, thoughts of harming themselves, other people or their newborn may occur.
Dr. Robin Drake OB/GYN at Rush University Medical Center in Chicago, said a strong support system can help but in some cases, it is ineffective.
"Asking for people to maybe help care for the baby so they have more time for a little bit of self-care," Drake recommended. "Having more time for rest, even showering, just getting a good meal in afterwards, are things that can be really helpful for mood but for many people, that's just not enough."
Drake suggested reaching out to a health care provider or psychotherapist for an assessment to rule out the existence of any other major health conditions or undiagnosed mental health concerns such as bipolar disorder. In 2019, House Bill 3511 was enacted to require the Illinois Department of Public Health to partner with the state's American Academy of Pediatrics to urge physicians to conduct postpartum mental health screenings at well-baby visits.
Extreme cases of postpartum depression lasting for weeks or even months may need medication to alleviate the symptoms. In 2019, the first medicines were formed but one drawback was a required brief hospital stay to help the treatment take effect.
Dr. Donna O'Shea, OB/GYN and chief medical officer for population health at UnitedHealthcare, described one drug which has produced better results in less time.
"This year, Xerove is an option that is in pill form that's taken daily for two weeks and can make a difference in three days," O'Shea explained. "There are many available treatments and paths a woman can go, depending on the severity of her symptoms."
O'Shea added most employers, with guidance from their health care providers, have an employee assistance program, which permits a worker to speak privately with a trained health professional at no cost. Other options include virtual behavioral health coaching or joining a women's postpartum discussion group.
The Illinois Department of Public Health reported in 2019, one in 10 women reported feelings of depression before, during and after her pregnancy.
The National Maternal Mental Health Hotline is available 24/7 at 1-833-TLC-MAMA (1-833-652-6262).
Keywords: Postpartum depression symptoms, Postpartum mental health treatment, Postpartum depression support resources
Illinois postpartum depression screenings, Xerove postpartum depression medication, National Maternal Mental Health Hotline
You’re a doctor. You have fifteen minutes with your patient, who cries as she ticks off a laundry list of vague symptoms. Depression is very common, you think, and it could explain all of those symptoms. Do you diagnose the patient with depression, noting it in her medical record, or do you begin an expensive, time-consuming investigation?
Now, replay the scenario from the patient’s perspective. You’re Elke Martinez, a veterinary technician, and you’ve developed muscle and joint pain, headaches, fatigue, and gastrointestinal problems. You go to your primary care doctor, part of the Kaiser Permanente healthcare system, and he attributes your symptoms to depression and anxiety. You know that’s not right, since you’re already being treated for those issues, and the treatment works. What do you do?
What Martinez did was humor her doctor. She attended Kaiser’s group cognitive behavioral therapy classes. The classes didn’t improve any of her symptoms, but they did consume a lot of her time and energy. Meanwhile, she saw more doctors to try to figure out what was actually wrong, but every Kaiser-affiliated doctor asked her about the psychiatric diagnosis already in her chart. “You can see on their face that they’re already checked out,” she says. These experiences undermined not only her trust in her doctors, but also in herself: “You get told this enough and you start to believe it and doubt yourself.”
Your odds of having an experience similar to Martinez’s are shockingly high. A 2017 meta-analysis published in The Lancet showed that for every 100 patients seen in primary care, 15 of them will receive a misdiagnosis of depression.
The problem takes a particular toll on patients who are chronically ill. A 2014 survey by the Autoimmune Association found that 51 percent of patients with autoimmune disease report that they had been told that “their disease was imagined or they were overly concerned.” And a 2019 survey of 4,835 patients with postural orthostatic tachycardia syndrome found that before getting a correct diagnosis, 77 percent of them had a physician suggest their symptoms were psychological or psychiatric.
Incorrect psychiatric diagnoses in medical records can cause long-lasting havoc.
In our culture, aspersions against patients with poorly understood chronic illness still run deep. Just a few months ago in OpenMind, we covered longstanding efforts to label as head cases and confabulators individuals with fibromyalgia, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), persistent symptoms of Lyme disease, and long covid. You can read it here.
Patients affected by rare disorders (those with fewer than 200,000 sufferers in the United States) also suffer enormously from this type of dismissal. According to the National Organization for Rare Diseases, if you initially receive a false psychiatric diagnosis, it takes you 2.5 to 14 times as long to get diagnosed compared to those who were never misdiagnosed, and between 1.25 and 7 times as long as those who received a false non-psychiatric diagnosis.
Even when a patient is in fact depressed or anxious, that might not be the correct explanation for their physical symptoms. The causation may go in the other direction: The patient might have a physical illness that’s causing their psychological distress. Lyme disease patients, for example, are often misdiagnosed
as having depression, bipolar disorder, and more. Yet as a
2021 study pointed out, these patients are often depressed precisely because they are ill. Systemic, whole-body or brain infection can cause impaired sleep, attention, memory, and performance, all of which contribute to depression. Targeting those psychological symptoms without effectively treating the underlying infection will never work.
Psychological diagnoses are often the easiest ones for doctors to make, and the hardest ones for patients to shake. Once a psychological diagnosis is entered into a patient’s medical records, it becomes the starting place for every subsequent doctor who reads it. Patients may not even know the diagnosis is there, since they often don’t see their records (although they have a right to — see Tools for Readers, below).
Martinez realized that the only way she was going to get a proper diagnosis of her physical symptoms was by leaving the Kaiser system, so that she could go to a new set of doctors who couldn’t see the psychiatric misdiagnosis in her chart. Thirteen years after her symptoms started, she finally got an explanation: She has Ehlers-Danlos Syndrome, a disorder of the connective tissue that can cause devastating symptoms throughout the body. By the time she received a proper diagnosis, she was disabled and had to give up the career she loved in veterinary work. And she was luckier than many. On average, with a psychiatric misdiagnosis, it typically takes patients 22 years to get diagnosed with Ehlers-Danlos syndrome.
Photo: SHVETS Production/PEXELS
Incorrect psychiatric diagnoses in medical records can cause long-lasting havoc. When one U.S.-based patient I interviewed, who requested anonymity, was erroneously diagnosed with Munchausen’s syndrome — meaning that she was accused of fabricating her illness — she became unable to get medication for her severe pain for several months, while her therapist worked to persuade the psychologist who diagnosed her to remove it from her chart. In the meantime, she resorted to taking large doses of Ibuprofen, which resulted in a stomach ulcer.
Another patient that I interviewed, also in the U.S., told me that her exhaustion led to a diagnosis of depression while she was a medical resident, even though her low energy was sufficiently explained by her autoimmune disease. When she received her medical license, it came with conditions. Due to her diagnosis of mental illness, she was required to receive a high level of supervision, making it impossible for her to practice.
Yet another patient I spoke with lost the ability to digest food, weighing in at 85 pounds at 5’7”, but the local hospital wouldn’t admit her to the emergency room because her medical records diagnosed her problem as psychiatric. Since she lives in a remote area and is too ill to travel, she hasn’t been able to access medical care at all; last I heard, she had not gotten to the bottom of her digestive woes.
Even today, doctors routinely use the term “medically unexplained symptom” to imply a psychological origin for a patient’s physiological reports.
The problem of misdiagnosing physiological illness as psychological is particularly pernicious because it evokes the loaded and sexist aura of the old, discarded term "hysteria." Sigmund Freud claimed, without evidence, that unconscious traumatic memories can be converted into symbolically relevant physical symptoms. In so doing, he gave doctors permission to think of literally any symptom as having a psychological origin, even in the absence of psychological symptoms. This led to the term “conversion disorder,” which has multiplied into endless euphemisms designed to cover over its sexist origins, including somatization disorder, functional disorder, and bodily distress disorder. Specialists sometimes argue over fine distinctions between the terms, but fundamentally, they all imply that looking for physical causes for your symptoms will be fruitless and that you should instead address them psycho-behaviorally.
Even today, doctors routinely use the term “medically unexplained symptom” to imply a psychological origin for a patient’s physiological reports. In UpToDate, a highly respected online guide for evidence-based treatment, a search for “medically unexplained symptoms” reroutes to an entry on somatization in psychiatry. Both the language and the culture of modern medicine systematically nudge some doctors toward the assumption that ambiguous symptoms are psychosomatic; it is a culture we need to change. “As a matter of peculiar professional fact, there is no term that names diagnostic uncertainty without also naming psychological diagnosis,” bioethicist Diane O’Leary and health psychologist Keith Geraghty state in the Oxford Handbook of Psychotherapy Ethics.
Writing in The American Journal of Bioethics, philosopher Abraham Schwab at Clarkson University notes that psychological diagnoses may be incorrect either because the doctor doesn’t have the knowledge to come to the proper biomedical diagnosis or because the patient has a biological condition that is not yet understood by medical science. “As a result,” he says, “psychogenic diagnoses should carry with them low levels of confidence.”
In practice, though, a psychological diagnosis tends to override other interpretations, making it difficult for doctors to discover a medical explanation for the patient’s symptoms. That’s partly by design: Investigating undiagnosed medical conditions is expensive, and it often doesn’t lead to treatment that relieves the patient's symptoms. The widely used MacLeod’s Clinical Investigation Handbook cautions that “if [patients with medically unexplained symptoms] are not managed effectively, fruitless investigations and harm from unnecessary drugs and procedures may result.” Furthermore, a patient’s very determination to find a medical explanation can be dismissed as “doctor-shopping” and viewed as an indication of somatization.
Mental health professionals have historically resisted making records available to their patients.
Patients with erroneous psychological records face enormous obstacles since their doctors are discouraged from seeking out the physiological cause of their suffering and further complaints may be met with further suspicion. But there are ways to push back against these challenges, and the place to start is by accessing medical records — and then pushing to get errors fixed.
Mental health professionals have historically resisted making records available to their patients. Common justifications are that patients suffering delusions will become hostile if told in records that their beliefs aren’t correct, or that clinicians will hold back in their note-taking because they’re worried about the reaction of the patient. But some other professionals have argued for encouraging patients to review records, writing in the Journal of the American Medical Association: “The clinician who actively solicits open and ongoing dialogue, including a patient’s opinion about a note’s accuracy, may enhance both clinical precision and the treatment relationship.”
Since 1996 the Health Insurance Portability and Accountability Act (HIPAA) has given patients a legal right to access their medical records. Starting in October of 2022, the 21st
Century Cures Act made it easier to do so. In particular, the Act requires that healthcare providers provide patients access to all the health information in their electronic medical records without delay and without charge. This rule does not include notes from psychotherapy sessions that are not contained within the regular medical record, but it does include any diagnoses made. If a patient believes anything in that record is wrong — such as an incorrect psychiatric diagnosis — they can request that it be changed. See the “Tools” section below for specific guidance on how to purgi falsehoods from your medical record.
Fully fixing the problem of incorrect psychiatric diagnoses, and the array of challenges that result from them, will take a major shift in mindset in the medical profession. It will require a much more nuanced understanding of the complexities of how our mental and physical states affect one another bidirectionally. It will require an acceptance that psychological treatment is an adjunct for physical treatment, rather than a way of getting rid of responsibility for a problematic patient. And it will require a transformation in our healthcare system so that doctors have the time they need to investigate complex patients.
Such changes are beyond what any individual patient can accomplish. But in the meantime, patients can at least ensure that their medical records aren’t making their quest for accurate diagnosis and effective treatment more difficult.
DANVILLE - Lavender Zarraga, APRN, a behavioral health provider at OSF HealthCare, says it’s not uncommon for her patients to ask for a medication that isn’t the right fit.
The culprit? She says symptoms of common mental health issues like depression, attention deficit hyperactivity disorder (ADHD) and bipolar disorder can overlap. So, it’s important to stay in contact with your provider to make sure you’re on the best treatment plan.
On depression mimicking ADHD: “You have changed executive functioning. You can’t decide. You feel dull. You can’t concentrate,” Zarraga says. “You have a hard time learning new things. You can’t remember things or forget things easily. Attention and concentration are low. You think ‘Why am I processing everything so slow?.’”
Lavender Zarraga, APRN
Zarraga adds that she’s seen people with depression take prescribed medicine and feel better, but then residual symptoms that mimic ADHD creep in. And, she says, ADHD can seem like bipolar disorder.
“If you start somebody on an antidepressant and they have an underlying bipolar disorder that they have not been diagnosed with, that can trigger mood symptoms. It could potentially trigger mania [a high energy period where high-risk behaviors can occur],” Zarraga says.
It’s a lot to sort out, and it may make the person feel like they have a whole new set of problems.
“Talk to a provider. See what’s going on,” Zarraga says to people in that situation, noting that kids should not have to carry these issues into adulthood.
“There’s a lot of talking involved,” she adds. “Let’s start from the beginning. Let’s go back to your childhood. How were you doing then? And we relate that to how you are now.”
From there, Zarraga says treatment could include more counseling or different medication. She says medicine for children is more straightforward. But for adults, a provider will make sure the pill isn’t impacting the rest of the person’s body.
There are also science-backed written tests that can help diagnose someone with ADHD. Questions along the lines of: Can you sit still in class? Does your mind wander all the time?
And a word for caregivers, friends and family members: watch for symptoms of these disorders in your loved ones and have a conversation, if needed. Don’t ignore things, Zarraga says.
“There’s nothing wrong with just talking about it. It’s not going to hurt anybody to discuss it,” she says, noting that society is now more accepting of mental health issues.
Signs to watch for in your close companion: irritability, aggression, anxiety and trouble sleeping. If you or someone you know needs to talk to a professional quickly, the national suicide and crisis lifeline is 9-8-8.
NAPSI -- Eye disease affects more than your ability to see the world clearly. People with impaired vision face an increased risk of falls, fractures, injuries, depression, anxiety, cognitive deficits and social isolation. One of the best ways to protect yourself against vision loss from eye disease is to get regular eye exams.
Ophthalmologists—physicians who specialize in medical and surgical eye care—have more tools than ever before to diagnose eye diseases earlier, and to treat them better. But these advances cannot help people whose disease is undiagnosed, or who are unaware of the seriousness of their disease.
That’s why the American Academy of Ophthalmology recommends all adults receive a comprehensive eye exam by age 40, and every year or two after age 65.
Here’s how low vision can affect nearly every aspect of your life:
1. Depression and social isolation. Being unable to drive, read, enjoy hobbies or see loved ones’ faces is frightening and can lead some people to withdraw from life, leaving them feeling helpless or lonely. One study found that after being diagnosed with a vision-threatening eye disease, a person’s chance of experiencing depression triples.
2. Dementia. Several studies suggest a connection between eye disease and dementia. While the cause is unclear, it’s possible some eye diseases interfere with the brain’s sensory pathways. Early diagnosis and treatment are the best way to prevent vision loss.
3. Injuries from falls. People with decreased vision are more likely to misstep and fall. Every year, about 3 million older Americans are treated for injuries from falls, according to the Centers for Disease Control and Prevention. Many of these falls are caused by low vision. Luckily there are some changes around the house people can make, such as grouping furniture together and increasing lighting. Seeing an ophthalmologist regularly and making sure your glasses are updated with your latest prescription are important safety precautions as well.
Can’t Afford an Eye Exam? EyeCare America® Can Help.
For individuals age 65 or older who are concerned about their risk of eye disease and/or the cost of an eye exam, you may be eligible for a medical eye exam, often at no out-of-pocket cost, through the American Academy of Ophthalmology’s EyeCare America® program. This public service program matches volunteer ophthalmologists with eligible patients in need of eye care across the United States. To see if you or a loved one qualifies, visit www.aao.org/eyecare-america to determine your eligibility.
The five components of a healthy workplace include: protection from harm, connection and community, work-life harmony, mattering at work and opportunity for growth.
A new year brings about many possible changes – promises to eat better, exercise more, stop smoking, save money, and so on. Another priority for some is to improve their work situation.
If that’s you, there may be no better time than the present, especially after the U.S. Surgeon General Vivek Murthy released a report that links a toxic workplace culture to health issues such as heart disease, depression and anxiety.
"A toxic workplace is basically any work setting where you're dealing with any sort of psychological stress, where you're feeling nervous, you have some fear, anxiety, sadness, depression – things like that," says Victor Mendoza, a behavioral health provider with OSF HealthCare. "If you start noticing those things in your own workplace, that can be something we would call a toxic environment."
According to the U.S. Surgeon General, the five components of a healthy workplace include: protection from harm, connection and community, work-life harmony, mattering at work and opportunity for growth.
Mendoza says now is the time for organizations to assess their relationship with employees – to create a sense of connection among workers, show them they are important, and support their professional needs.
"First of all, if they haven't added these five components, they should probably try to because I think that's a good foundation to what a healthy work environment should be like," says Mendoza. "You want to have a workplace where you feel comfortable, you feel heard, you feel like there is upward mobility, and that that people care for you. That you're not just a number to them but that you actually are a human, and they understand and are willing to be empathic to your situation. And if there is a concern, they're open to listen to you."
There are many ways feeling stressed or miserable can manifest in an unhealthy work environment such as increasing the risk for cardiovascular disease, increasing the chance of high blood pressure, weakening immune systems, causing headaches and increasing anxiety and stress. Mendoza says physical symptoms can include stomach aches, nausea, vomiting, diarrhea and racing heartbeat.
The report comes during an uncertain time in workplace culture due to the COVID pandemic, when employees are seeking more flexible opportunities including working remotely or a hybrid schedule. Mendoza adds that the pandemic also affected our routines, and when routines are changed it can impact our mental health.
"It's been really tough for a lot of people," says Mendoza. "When all this started with the pandemic, a lot of people were having anxiety about what was going to happen. People feared losing their jobs, and a lot of people did lose their jobs, sadly, and that was very hard for them. They had to switch careers. A lot of them were lucky they were able to keep their jobs, but they had to work from home and that that created some stress as well even though we do have good technology."
There are things, however, you can do to cope with your workplace stress. Mendoza suggests keeping track of the stressors in your job, developing healthy responses such as exercise, getting enough sleep and learning how to relax and take time to recharge by unplugging from work, and making sure to use your vacation days.
Mendoza says it’s easy for some people to feel guilty about work-related issues. The most important take home message is to first take care of yourself, and not let a stressful environment affect your health.
"Sometimes you can only do so much and you have to advocate for yourself, and you have be aware when this happens," he adds. "So set up good boundaries with your workplace, make sure that you're taking some time off work for self-care, whatever that looks like for you, and do something you enjoy. Make sure you do some basic things like exercise, you’re eating well and you're sleeping well. That's a really good foundation to deal with a toxic work environment."
Libby Allison OSF HealthcareBLOOMINGTON - Now that Labor Day has come and gone, so have the days of summer sun into the evening hours. While this is a typical sign of changing seasons, it can also come with a change in mood for those who suffer from seasonal affective disorder, or SAD.
It’s estimated that SAD affects 5-million to 8-million people a year in the United States, particularly in late fall and colder, winter months when days are shorter and nights are longer.
It is thought to be related to the lack of available sunlight, leading to a deficiency of Vitamin D. This can disrupt a person’s natural sleep cycle, and the effect on the brain can cause a person to function differently.
"People in the winter time, particularly in northern, far northern latitudes or far southern latitudes, farther away from the equator will tend to get kind of sluggish and maybe depressed, they start to have carbohydrate cravings, and it may be enough that it’s really a significant problem for them," explains Dr. Scott Hamilton, a psychiatrist with OSF HealthCare Behavioral Health in Bloomington.
As a behavioral health psychiatrist, Dr. Hamilton works with people suffering from Seasonal Affective Disorder. He says there’s a difference between SAD and a case of the occasional winter blahs. If you find your mind and mood are impacting your relationships, ability to work, or social activities, it’s something that needs to be addressed.
There are a number of treatment opportunities for Seasonal Affective Disorder. Dr. Hamilton says one of the most effective is bright light therapy.
"These have a UV shield, full spectrum light, 30 minutes in the morning is how most studies were done with pretty good results. Pretty uniformly positive results in people that have wintertime depression, and people that don’t have winter depression, they do sometimes still help, but they’re not as likely to be helpful."
Dr. Hamilton says these light boxes are available online, often for less than $50. He also says that simple behavior modification can help with SAD symptoms. He says eating well and exercise can have a tremendous effect on depression symptoms, but if a person is having a tough time functioning on a day-to-day basis, he or she might want to see a therapist for professional help.
"I think trying that and getting more exercise and doing some healthy things first does make sense," said Dr. Hamilton. "If they get to the point where they can’t function or they get suicidal thoughts, things like that, then they ought to talk to somebody. Those would be the real red flags."
Learn more about Seasonal Affective Disorder here. To connect with an OSF HealthCare Behavioral Health specialist, talk to your primary care physician for a referral. To for more information about OSF HealthCare Behavioral Health.
BRANDPOINT - Did you know that the first 12 weeks after giving birth are known as the fourth trimester? While you may have just given birth, your body will continue to change just like it did during your three trimesters of pregnancy.
The fourth trimester can have many surprises for first-time mothers. They might experience many physical, mental and emotional changes as their bodies heal and adjust to motherhood. While they may expect certain changes like stretch marks, hair loss and weight fluctuations, many other postpartum adjustments aren't discussed as much.
First Response™ wants to bring awareness to the changes mothers should expect during the fourth trimester. By learning about these changes and how to manage them, women can embrace and accept them with self-compassion and feel empowered to ask for support during their postpartum journey.
1. Postpartum bleeding
If you're a first-time or soon-to-be first-time mom, you may not know you'll experience bleeding after birth. While it may seem scary, this is a very normal part of the postpartum healing process.
According to the Cleveland Clinic, this vaginal discharge is known as lochia and contains a mix of blood, mucus and uterine tissue. It's similar to menstrual blood and can last several weeks, though the heaviness of the discharge should subside over time.
During the first six weeks after giving birth, use sanitary maxi pads (not tampons) to deal with the bleeding. For the first week, expect to go through several pads throughout the day. Most importantly, remember to take it easy and give your body time to heal.
2. Breast engorgement
During the fourth trimester, you may experience breast engorgement until your milk supply regulates. Your breasts may feel swollen, tight and tender, and you may even leak breast milk until symptoms subside, usually within a few days as you begin to regularly breastfeed. Use a cold compress to relieve swelling and pain. If you choose to breastfeed, you can wear a well-fitting bra to provide support and reduce soreness, according to La Leche League International.
If you don't plan to breastfeed, it can take up to several weeks for breast engorgement to subside. During this time, do not pump so your body gets the signal that it doesn't need to produce milk. A cold compress, supportive bra and over-the-counter pain meds can help you manage pain and discomfort until you stop producing milk.
3. Poor sleep
Babies don't have the same sleep schedules as adults. According to the Sleep Foundation, while newborns sleep up to 18 hours a day, they don't sleep in one solid block of time like adults do. Until your baby begins to sleep through the night, you will likely be up several times a night to attend to your baby.
To combat sleep deprivation during the fourth trimester, nap during the day when your baby sleeps. If a partner or family member is helping you, trade off middle-of-the-night feedings. Also, ask friends and family for help with house chores or child care so you can get some well-deserved rest.
4. Postpartum depression
You may have heard of the baby blues when mothers feel overwhelmed, irritable and stressed the first couple of weeks after giving birth. This is your body's natural response to the drop in hormone levels postpartum. However, some women may feel these symptoms more intensely and for long periods, indicating a more serious form of depression.
According to the National Institutes of Health, one in seven women can develop postpartum depression (PPD) within the first six weeks of giving birth. Some symptoms of PPD include:
Depressed mood
Loss of interest or pleasure
Insomnia
Loss of energy or fatigue
Feelings of worthlessness or guilt
Because of the societal expectations of motherhood, it can be difficult for women to admit they need help. That's why it's incredibly important for new mothers to have a support system of friends, family and other mothers to help them overcome the stigma of PPD and get the care they need.
If you're experiencing PPD, reach out for help and contact your doctor. While PPD is serious, it is treatable.
Get connected
These are just four ways your life may change after giving birth. While these changes may sound overwhelming, you can manage them with a little help and understanding. That's why First Response has launched the Pregnancy Hub by First Response.
This online community aims to connect, inspire and provide resources to those navigating trying to conceive (TTC), pregnancy and motherhood. By joining, you'll have free access to resources and advice, the opportunity to engage in meaningful conversations with other members, share personal experiences, and more. To learn more and get connected, visit FirstResponsePregnancyHub.SocialMediaLink.com.
**The content provided on this health blog is intended for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.**
Shorter days throughout them are thought to be linked to a chemical change in the brain and may be part of the cause of seasonal affective disorder or more commonly known as SAD. Exposure to artificial UV light have shown effectiveness in limiting the changes brought less sunlight.
Photo: Yuris Alhumaydy/Unsplash
by Shelli Dankoff OSF Healthcare
BLOOMINGTON - Now that Labor Day has come and gone, so have the days of summer sun into the evening hours. While this is a typical sign of changing seasons, it can also come with a change in mood for those who suffer from seasonal affective disorder, or SAD.
It’s estimated that SAD affects 5-million to 8-million people a year in the United States, particularly in late fall and colder, winter months when days are shorter and nights are longer.
It is thought to be related to the lack of available sunlight, leading to a deficiency of Vitamin D. This can disrupt a person’s natural sleep cycle, and the effect on the brain can cause a person to function differently.
“People in the winter time, particularly in northern, far northern latitudes or far southern latitudes, farther away from the equator will tend to get kind of sluggish and maybe depressed, they start to have carbohydrate cravings, and it may be enough that it’s really a significant problem for them,” explains Dr. Scott Hamilton, a psychiatrist with OSF HealthCare Behavioral Health in Bloomington.
As a behavioral health psychiatrist, Dr. Hamilton works with people suffering from Seasonal Affective Disorder. He says there’s a difference between SAD and a case of the occasional winter blahs. If you find your mind and mood are impacting your relationships, ability to work, or social activities, it’s something that needs to be addressed.
There are a number of treatment opportunities for Seasonal Affective Disorder. Dr. Hamilton says one of the most effective is bright light therapy.
“These have a UV shield, full spectrum light, 30 minutes in the morning is how most studies were done with pretty good results. Pretty uniformly positive results in people that have wintertime depression, and people that don’t have winter depression, they do sometimes still help, but they’re not as likely to be helpful.”
Dr. Hamilton says these light boxes are available online, often for less than $50. He also says that simple behavior modification can help with SAD symptoms. He says eating well and exercise can have a tremendous effect on depression symptoms, but if a person is having a tough time functioning on a day-to-day basis, he or she might want to see a therapist for professional help.
“I think trying that and getting more exercise and doing some healthy things first does make sense,” said Dr. Hamilton. “If they get to the point where they can’t function or they get suicidal thoughts, things like that, then they ought to talk to somebody. Those would be the real red flags.”
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Family Features - Even before COVID-19 limited social contact with friends, family and colleagues, many adults experienced loneliness and depression due to limited contact with others. A national survey in 2018 by Cigna discovered loneliness levels have reached an all-time high, with nearly half of 20,000 U.S. adults reported they sometimes or always felt alone.
With shelter-in-place mandates in place around the country, the pandemic forced many more people into even greater levels of isolation. Between stay-at-home orders or wanting to avoid coming down with COVID, Americans over the age of 50 spent a lot more time alone. And that isn't a good thing.
Despite the physical implications of a global pandemic, research shows the mental health stakes are high, too.
Wikipedia says, "Social isolation is a state of complete or near-complete lack of contact between an individual and society. It differs from loneliness, which reflects temporary and involuntary lack of contact with other humans in the world."
In another nationwide survey, commissioned by Barclays, it found that half of Americans over the age of 50 said the isolation from their friends and family has been more challenging than concerns over health risks they may face.
Social isolation has provided plenty of time for Americans to reflect on their priorities. The majority of Americans surveyed (90%) have re-evaluated their post age-50 goals and put spending more time with family at the top of their lists. In fact, the most common first thing 50-plus Americans will do once COVID-19 is over is to see and spend time with their families (41%).
"While restrictions are beginning to ease, many older adults are still isolated from friends and family, and that takes a toll on their mental well-being" said Lisa Marsh Ryerson, president of the AARP Foundation. "We must do all we can to help older adults, who have suffered greatly during COVID-19, strengthen the social connections that are so essential to their ability to lead longer, healthier lives."
For example, AARP Foundation's Connect2Affect platform equips older adults with the tools they need to stay physically and mentally healthy and connected to their communities. The AARP Essential Rewards Mastercard from Barclays is helping fund the foundation's work to increase social connection with donations based on new accounts and eligible purchases, up to $1 million annually.
A little creativity and a commitment to filling time productively can help reduce the strain of being alone until it's safer to resume social activities.
Use technology to connect with loved ones. Video chats and traditional phone calls can help you feel connected even when you can't be together in person. While a drop-in call can be fun, consider arranging regular visits with kids and grandkids. If you schedule calls throughout the week, you'll have something regular to look forward to and can benefit from a check-in that affirms everyone is healthy and safe.
Make time for physical activity. Staying closer to home may mean you're not getting the exercise you once did, but it's important for your health to stay active. Regularly using your muscles helps keep your body strong, and even light physical activity a few times each week can help keep your cardiovascular system fit for better heart health. Regular exercise can also provide a range of positive mental health outcomes, including reduced stress, anxiety and depression, and improved memory.
Volunteer in your community or consider virtual volunteering. Helping others is a way to release feel-good endorphins for yourself. While your limited social calendar may afford you some extra time, inquire with local nonprofits about how you can contribute to their causes. Especially as funding for charitable organizations has dropped, volunteers are still essential to most nonprofit organizations, whether the help comes in person or virtually. Even from a distance, you may be able to help with tasks like making calls to donors, assisting with mailings or planning fundraising campaigns.
Learn a new hobby or skill. Another way to fill your free time, and reap some positive energy, is to explore a new hobby or skill. The personal satisfaction of learning and focusing your mental energy on something that interests you can help offset the disappointment of being away from those you love.
Find more resources that support older adults at connect2affect.org.
ROCKFORD - The holidays are typically a time for joy and celebration with loved ones. But for some survivors of violent crime, the holidays can also be filled with stress, anxiety and memories of not-so happy times.
“For other folks it can be the holidays that triggers something because maybe you’ve lost a loved one to gun violence or you witnessed losing that person and you’re going into the holidays and yes, it happened 20 years ago; that doesn’t mean you’re not going to have the symptoms and side effects of that loss,” says Therasa Yehling, manager for the OSF Strive Trauma Recovery Center at OSF HealthCare Saint Anthony Medical Center in Rockford.
Therasa Yehling
Yehling says those side effects include anxiety, depression or post-traumatic stress disorder (PTSD) after a trauma such as gun violence, assaults, domestic violence, human trafficking and armed violence or robbery in which they are the victim or witness.
The events causing the trauma could have occurred two weeks ago or 10 years ago. There is no expiration date on the grief that happens as a result of violent crime, Yehling adds.
“When we talk to people we actually try to get a full picture of the trauma in their lifetime," says Yehling. "We’re finding that some people have had a lot of trauma starting in their childhood all the way up. Really then, a new traumatic event can stir up all the old stuff that maybe we’ve never dealt with and the symptoms of trauma have rendered that person almost catatonic and they can’t function.”
Yehling offers several basic tips for violent crime survivors during the holidays.
Trust your grief and your healing
Experience the grief and don’t run from it
Say no to things that make you uncomfortable and form healthy boundaries
Create new traditions
Make a list of things you’re grateful for this year
Do something kind for someone else
If none of those things seem to help or if these feelings are interrupting daily activities Yehling says it’s time to seek professional help as soon as possible. She does warn that seeking support will also mean doing a deep dive into what’s causing your feelings.
“I think people have to understand that if someone is going to talk about something very traumatic, such as sexual assault, domestic violence, human trafficking – it is important that they talk to someone who can help them through that process, therapeutically," says Yehling. "Otherwise you’re helping them to relive it and that’s about it.”
Yehling adds that our expectations of having the perfect time with family during the holiday season are often unrealistic. While that can be stressful enough, it becomes worse when you add the complexities of being a survivor of violent crime. Yehling encourages family and friends to go slowly and give their loved one the time and space they need to get through the holidays.
“I just think whether you have trauma or not everyone needs to be gentle and kind and supportive,” Yehling says.
For more information on help for survivors of violent crimes, visit OSF HealthCare.
Key Takeaways:
The holidays can trigger emotions for survivors of violent crime.
Violent crime includes gun violence, assaults, domestic violence or robbery.
Side effects include anxiety, depression or post-traumatic disorder.
Ways to cope include saying no to things that make you uncomfortable, create new traditions or do something nice for someone else.
If nothing else helps, seek professional help as soon as possible.
Study says depression and anxiety caused by chronic pain may contribute to a poor quality of life and reduce life expectancy.
Photo: Vladislav Muslakov/Unsplash
by Terri Dee Indiana News Service
INDIANAPOLIS, IN - April is National Stress Awareness Month. Stress is the body's way of processing work, personal, and family pressures, or other triggers.
A new study in the Journal of the American Medical Association has found a link between stress and chronic pain, which is defined as pain that persists for three months or more and lasts beyond the normal healing time of an injury or illness.
Former chiropractor Dr. Sean Pastuch is CEO of Active Life, a personal coaching company focusing on chronic pain-management options.
He suggested that biological, psychological and social interventions could be effective forms of treatment.
What is viewed as pleasurable to some may feel painful to others.
"The connection between all of those three things -- the physical, the mental, and the emotional -- is that when we think about pain, no one's defining what the word means," said Pastuch. "So, if we evaluate what the word 'pain' means, then we come to find that in order for there to be pain, there needs to be a negative emotional component to it."
He said that if you feel something, you have to decide if you like the way it feels or not. And what is viewed as pleasurable to some may feel painful to others.
The study also says depression and anxiety caused by chronic pain may contribute to a poor quality of life and reduce life expectancy.
A 2022 Indiana Chronic Care Policy Alliance report shows almost 8% of adults have chronic pain, with arthritis as the leading disorder.
Patsuch said patients face obstacles in finding a physician who can identify their pain, which means fewer or no opportunities to receive treatment.
"The reason why doctors struggle to help people with chronic pain, and why the confidence level among doctors is low," said Pastuch, "is because of all the medical schools, fewer than 15 actually have dedicated curriculum to supporting a patient with chronic pain."
Of the medical schools that offer a pain-management curriculum, he said the majority focus on students in the anesthetics department.
Patsuch suggested that when a patient is with their doctor, to use words other than "it just hurts." They need to be able to describe what hurts and ask, "How do I want to resolve it?"
This spring, high school senior Nathan Kassis will play baseball in the shadow of covid-19 — wearing a neck gaiter under his catcher’s mask, sitting 6 feet from teammates in the dugout and trading elbow bumps for hugs after wins.
"We’re looking forward to having a season," said the 18-year-old catcher for Dublin Coffman High School, outside Columbus, Ohio. "This game is something we really love."
Kassis, whose team has started practices, is one of the millions of young people getting back onto ballfields, tennis courts and golf courses amid a decline in covid cases as spring approaches. But pandemic precautions portend a very different season this year, and some school districts still are delaying play — spurring spats among parents, coaches and public health experts across the nation.
Since fall, many parents have rallied for their kids to be allowed to play sports and objected to some safety policies, such as limits on spectators. Doctors, meanwhile, haven’t reached a consensus on whether contact sports are safe enough, especially indoors. While children are less likely than adults to become seriously ill from covid, they can still spread it, and those under 16 can’t be vaccinated yet.
Less was known about the virus early in the pandemic, so high school sports basically stopped last spring, starting up again in fits and spurts over the fall and winter in some places. Some kids turned to recreational leagues when their school teams weren’t an option.
But now, according to the National Federation of State High School Associations, public high school sports are underway in every state, though not every district. Schedules in many places are being changed and condensed to allow as many sports as possible, including those not usually played in the spring, to make up for earlier cancellations.
Coaches and doctors agree that playing sports during a pandemic requires balancing the risk of covid with benefits such as improved cardiovascular fitness, strength and mental health. School sports can lead to college scholarships for the most elite student athletes, but even for those who end competitive athletics with high school, the rewards of playing can be extensive. Decisions about resuming sports, however, involve weighing the importance of academics against athletics, since adding covid risks from sports could jeopardize in-person learning during the pandemic.
Tim Saunders, executive director of the National High School Baseball Coaches Association and coach at Dublin Coffman, said the pandemic has taken a significant mental and social toll on players. In a May survey of more than 3,000 teen athletes in Wisconsin, University of Wisconsin researchers found that about two-thirds reported symptoms of anxiety and the same portion reported symptoms of depression. Other studies have shown similar problems for students generally.
"You have to look at the kids and their depression," Saunders said. "They need to be outside. They need to be with their friends."
Before letting kids play sports, though, the Centers for Disease Control and Prevention said, coaches and school administrators should consider things like students’ underlying health conditions, the physical closeness of players in the specific sport and how widely covid is spreading locally.
Karissa Niehoff, executive director of the high school federation, has argued that spring sports should be available to all students after last year’s cancellations. She said covid spread among student athletes — and the adults who live and work with them — is correlated to transmission rates in the community.
"Sports themselves are not spreaders when proper precautions are in place," she said.
Still, outbreaks have occurred. A January report by CDC researchers pointed to a high school wrestling tournament in Florida after which 38 of 130 participants were diagnosed with covid. (Fewer than half were tested.) The report’s authors said outbreaks linked to youth sports suggest that close contact during practices, competitions and related social gatherings all raise the risk of the disease and “could jeopardize the safe operation of in-person education.”
Dr. Kevin Kavanagh, an infection control expert in Kentucky who runs the national patient safety group Health Watch USA, said contact sports are "very problematic," especially those played indoors. He said heavy breathing during exertion could raise the risk of covid even if students wear cloth masks. Ideally, he said, indoor contact sports should not be played until after the pandemic.
"These are not professional athletes," Kavanagh said. "They’re children."
A study released in January by University of Wisconsin researchers, who surveyed high school athletic directors representing more than 150,000 athletes nationally, bolsters the idea that indoor contact sports carry greater risks, finding a lower incidence of covid among athletes playing outdoor, non-contact sports such as golf and tennis.
Overall, "there’s not much evidence of transmission between players outdoors," said Dr. Andrew Watson, lead author of the study, which he is submitting for peer-reviewed publication.
Students, for their part, have quickly adjusted to pandemic requirements, including rules about masks, distancing and locker rooms.
~ Matt Troha
Dr. Jason Newland, a pediatrics professor at Washington University in St. Louis, said all sorts of youth sports, including indoor contact sports such as basketball, can be safe with the right prevention measures. He supported his daughter playing basketball while wearing a mask at her Kirkwood, Missouri, high school.
Doctors also pointed to other safety measures, such as forgoing locker rooms, keeping kids 6 feet apart when they’re not playing and requiring kids to bring their own water to games.
"The reality is, from a safety standpoint, sports can be played," Newland said. "It’s the team dinner, the sleepover with the team — that’s where the issue shows up. It’s not the actual games."
In Nevada’s Clark County School District, administrators said they’d restart sports only after students in grades 6-12 trickle back for in-person instruction as part of a hybrid model starting in late March. Cases in the county have dropped precipitously in recent weeks, from a seven-day average of 1,924 cases a day on Jan. 10 to about 64 on March 3.
In early April, practices for spring sports such as track, swimming, golf and volleyball are scheduled to begin, with intramural fall sports held in April and May. No spectators will be allowed.
Parents who wanted sports to start much earlier created Let Them Play Nevada, one of many groups that popped up to protest the suspension of youth athletics. The Nevada group rallied late last month outside the Clark County school district’s offices shortly before the superintendent announced the reopening of schools to in-person learning.
Let Them Play Nevada organizer Dennis Goughnour said his son, Trey, a senior football player who also runs track, was "very, very distraught" this fall and winter about not playing.
With the reopening, he said, Trey will be able to run track, but the intramural football that will soon be allowed is "a joke," essentially just practice with a scrimmage game.
"Basically, his senior year of football is a done deal. We are fighting for maybe one game, like a bowl game for the varsity squad at least," he said. "They have done something, but too little, too late."
Goughnour said Let Them Play is also fighting to have spectators at games. Limits on the numbers of spectators have riled parents across the nation, provoking "a ton of pushback," said Niehoff, of the high school federation.
Parents have also objected to travel restrictions, quarantine rules and differing mask requirements. In Orange County, Florida, hundreds of parents signed a petition last fall against mandatory covid testing for football players.
Students, for their part, have quickly adjusted to pandemic requirements, including rules about masks, distancing and locker rooms, said Matt Troha, assistant executive director of the Illinois High School Association.
Kassis, the Ohio baseball player, said doing what’s required to stay safe is a small price to pay to get back in the game.
"We didn’t get to play at all last spring. I didn’t touch a baseball this summer," he said. "It’s my senior year. I want to have a season and I’ll be devastated if we don’t."
Many so-called night people feel that, when it comes to society’s expectations about when the workday should start, they drew the short straw.
Research shows that “night owls” are hard-wired to sleep later, yet 9-to-5 work schedules force them to battle their physiology and wake up early. Research also has shown that conventional timetables leave them vulnerable to physical and mental health issues.
“It is harder for night owls to function in the world because they’re out of sync with the conventional schedule,” said Kelly Baron, an associate professor at the University of Utah who studies sleep health and clinically treats patients who have insomnia. She noted that poor sleep is also a driver of worker absenteeism and use of sick days. “We would get better performance out of employees if they were allowed to work at their best working time.”
Her research has found that keeping late evening hours can cause even healthy night owls to be prone to bad habits like eating fast food, not exercising, and socializing less.
But the covid-19 pandemic, which forced many people to telework, allowed more flexibility in work schedules, prompting sleep scientists to rethink assumptions about sleep and how to assess patients.
The pandemic “was an international experiment to understand how sleep changes when work hours and work environments change,” said Baron.
Researchers in Italy are among those tapping into this question. In a recent study, they found that many Italians who don’t typically fit into a traditional daylight timetable thrived and their health improved when the pandemic’s remote working conditions allowed them to work later hours.
Federico Salfi, a doctoral student at the University of L’Aquila and self-professed night owl, joined with colleagues late in 2020 to examine how the work-from-home trend influenced Italian sleep habits. Through social media, they identified 875 people who represented in-office and remote workers. They then used web-based questionnaires to discover the impacts of remote working on sleep health. The findings: The pandemic’s work-from-home flexibility helped the participants better align their work and sleep schedules — many of them for the first time.
More specifically, the researchers found evidence that evening-type people slept longer and better while working from home, with a corresponding decrease in symptoms of depression and insomnia.
They also pointed out an important theme that echoes other studies — that people who fall into the night-owl category regularly sleep less than early risers. On his podcast, Matthew Walker, a professor of neuroscience and psychology at the University of California-Berkeley and author of “Why We Sleep,” said it was the difference of 6.6 hours a night versus more than 7 hours a night, leading night owls to accumulate a chronic sleep debt. (The study is available as a preprint and has not yet been peer-reviewed.)
So why don’t such people just go to bed earlier? The answer is complicated.
To feel sleepy requires a biochemical cascade of events to kick into action, and that timing is determined by a person’s chronotype. A chronotype is an internal “body clock” that determines when people feel awake or tired during a 24-hour period. The cycles are genetically set, with about half of people falling into the midrange — meaning they neither wake at dawn nor fall asleep past midnight — and the others evenly split as morning larks or night owls.
In prehistoric times, a mix of mismatched bedtimes served an evolutionary purpose. Evening types would watch over morning types while they slept, and vice versa. Modern society, however, rewards early risers while stigmatizing those burning the midnight oil, said Brant Hasler, associate professor at the University of Pittsburgh and part of the university’s Center for Sleep and Circadian Science. “We are catering to one portion of our population at the expense of another.”
Walker has outlined specific health consequences on his podcast. Late-night types are 30% more likely than early birds to develop hypertension, which can lead to strokes or heart attacks, and 1.6 times as likely to have Type 2 diabetes since sleep affects blood sugar regulation. They are also two to three times as likely to be diagnosed with depression and twice as likely to use antidepressants.
A study published in February also found that evening people who slept more during the pandemic still had remarkably poorer mental health compared with morning larks.
Neither Walker nor Hasler was involved in the Italian study.
Still, some experts noted that the Italian study had limitations.
“I couldn’t find clearly included in the study: Were people always on those schedules? [Or did they change after the pandemic?] Because that is something that really matters,” said Stijn Massar, a senior research fellow at the National University of Singapore. Plus, since covid has drastically affected almost all aspects of life, pandemic-era sleep data can get muddied by the many lifestyle changes people have had to endure.
Moreover, sleep scientists are still wondering if it is always healthier for someone to sleep in sync with their chronotype.
It’s a question of prioritizing individual schedules versus community schedules. But “sleep is one of the great mysteries of life,” said Massar. “This is all somewhat speculative,” with each new study providing glimpses of the bigger picture.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
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I’ve always known my Arab culture is worth celebrating.
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Among people with ischemic (clot-caused) stroke, those who began taking an antidepressant known as an SSRI (selective serotonin reuptake inhibitor) and/or an SNRI (serotonin and norepinephrine reuptake inhibitor) for the common conditions of post-stroke depression and anxiety, did not have an increased risk of hemorrhagic (bleeds) stroke or other serious bleeding. This included people taking anticoagulation medications. There was, however, an increased risk of hemorrhagic stroke among stroke patients taking two anti-platelet medications, also called dual anti-platelet therapy or DAPT.
“Mental health conditions, such as depression and anxiety, are very common yet treatable conditions that may develop after a stroke. Our results should reassure clinicians that for most stroke survivors, it is safe to prescribe SSRI and/or SNRI antidepressants early after stroke to treat post-stroke depression and anxiety, which may help optimize their patients’ recovery,” said study lead author Kent P. Simmonds, D.O., Ph.D., a third-year physical medicine and rehabilitation resident at the University of Texas Southwestern Medical Center in Dallas. “However, caution is needed when considering the risk-benefit profile for stroke patients receiving dual anti-platelet therapy because we did find an increased risk of bleeding among this group.”
"People in the winter time, particularly in northern, far northern latitudes or far southern latitudes, farther away from the equator will tend to get kind of sluggish and maybe depressed, they start to have carbohydrate cravings, and it may be enough that it’s really a significant problem for them," explains Dr. Scott Hamilton, a psychiatrist with OSF HealthCare Behavioral Health in Bloomington.
As a behavioral health psychiatrist, Dr. Hamilton works with people suffering from Seasonal Affective Disorder. He says there’s a difference between SAD and a case of the occasional winter blahs. If you find your mind and mood are impacting your relationships, ability to work, or social activities, it’s something that needs to be addressed.
There are a number of treatment opportunities for Seasonal Affective Disorder. Dr. Hamilton says one of the most effective is bright light therapy.
"These have a UV shield, full spectrum light, 30 minutes in the morning is how most studies were done with pretty good results. Pretty uniformly positive results in people that have wintertime depression, and people that don’t have winter depression, they do sometimes still help, but they’re not as likely to be helpful."
Dr. Hamilton says these light boxes are available online, often for less than $50. He also says that simple behavior modification can help with SAD symptoms. He says eating well and exercise can have a tremendous effect on depression symptoms, but if a person is having a tough time functioning on a day-to-day basis, he or she might want to see a therapist for professional help.
"I think trying that and getting more exercise and doing some healthy things first does make sense," said Dr. Hamilton. "If they get to the point where they can’t function or they get suicidal thoughts, things like that, then they ought to talk to somebody. Those would be the real red flags."
Learn more about Seasonal Affective Disorder 
