Friday, July 10, 2020

Behavioral Health Topic: SUICIDE

S.U.I.C.I.D.E. - a word that, at times, is forbidden and foreboding. A word that, because of fear or shame, many people are uncomfortable talking about or admitting that they think about in a passing manner. Yet an action that is attempted and completed quite often in our society. Suicide is one of the Top 1f0 overall causes of deaths in the US. It is the second leading cause of death in people between the ages of 10 and 34 years and the fourth leading cause of death among individuals between the ages of 34 and 54. Suicide rates are even higher for people over the age of 54 years.

Behavioral Health Topic: SUICIDEContrary to myth, talking about suicide does not increase the likelihood that someone will commit suicide. Talking to someone about their struggles and identifying thoughts of self-harm, may actually help the person decide against self-harm and help them connect to resources for assistance. 

So, let's talk about it.

Never take any threat of suicide lightly.
Suicide is a permanent action to life's temporary problem. At times, you might feel helpless, hopeless, or overwhelmed. Suicidal ideas may briefly come to your mind. These thoughts can be vague and without intention. You might have mixed feelings about these ideas. Suicidal thoughts are common. Most people do not talk about these thoughts, so we really do not know how common they are. Thoughts pass. Feelings pass. But these may be signs to change some things in your life – not end your life. 

Warning signs of suicide may be similar to signs of depression. Sometimes, a person who is not depressed will attempt suicide. Additionally, someone who is depressed, will often not have thoughts of suicide. However, both individuals can benefit from professional treatment and the compassionate support of those around them. Suicide attempts can happen in people with mental health issues like anxiety disorder, drug abuse, bipolar disorder, and post traumatic syndrome disorder (PTSD). People with chronic pain or with terminal physical illnesses may also have thoughts of suicide. These are some warning signs to watch for:
  • Talking about wanting to die
  • Making a plan to kill oneself
  • Sleeping too much or too little
  • Exhibiting extreme mood swings
  • Withdrawing from others and things that have been important
  • Increasing the use of drugs or alcohol
  • Feeling hopeless, trapped, or having no purpose
  • Giving away items of importance 
 If you struggle with suicidal thoughts, create a "Safety Plan." 
  • Put together a small emergency "go" bag with meaningful items that you can access quickly to help you feel more connected with positive and important things in life.  Examples of things to put in your "go" bag are: a change of clothes, pictures of loved ones, your favorite book, a puzzle, writing tablet and pen. 
  • Who will I call? Seek professional help, contact a trusted clergy member, or contact a trusted family member or friend. 
    • Make a list with names and phone numbers of two or three people who will support you through this crisis. Include the National Suicide Prevention Hotline at 1-800-273-8255 or TEXT 838255
  • What will I do? Make a list of safe places to go and safe things to do. Download to your mobile device the Virtual Hope Box app, created by the Defense Health Agency for a collection of resources to use. Remove (or have a loved one take) items that you might use to attempt suicide (firearms, pills, etc.). Do activities that will help you to relax and refocus your thoughts.  Here are a few self-soothing activities: 
    • Focus on your breath – take a few minutes to pull all of your attention and focus on your breathing. Take slow, deep "belly" breaths in through your nose and out of your mouth. 
    • Take a refreshing or relaxing shower or bath
    • Sing or hum a song that inspires or calms you
    • Cook a meal that smells and tastes good – it could be your favorite comfort food
    • Speak positive words aloud. Be kind to yourself by saying good things to you about you and hear yourself say them.
  • Where will I go? Seek safe shelter – an emergency department, or a family member's or friend's home, a special place in the park that puts you around others, or a support group meeting. Go where you will have the care and support of others.
Each person who attempts suicide, has family, friends, or co-workers who are left to cope with the tragic event. Their struggle to understand and recover from the excessive grief is difficult and even traumatic. In many cultures and religious faiths, suicide is a stigma – a mark of disgrace. These survivors may feel shame or guilt and be reluctant to talk about their loved one's battle. They may also feel angry, abandoned, or rejected. They may wonder and ask themselves "What did I do to cause this?" or "What could I have done to stop it?" 

As the survivor, you may not have caused the loved one's battle. You may not have had the power to stop it. However, there are things you can do for your emotional health.
  • Talk to a trusted friend, openly and honestly
  • Seek professional counseling
  • Practice self-soothing activities
  • Consult your physician if you feel you are becoming depressed
  • Always encourage anyone with suicidal ideas, even if such thoughts are vague, to seek professional help
Resources:

American Foundation for Suicide Prevention (AFSP) https://afsp.org/

Suicide Rising Across the US. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/vitalsigns/suicide/index.html

Suicide Facts. Suicide Awareness Voices of Education (SAVE)  https://save.org/about-suicide/suicide-facts/

National Suicide Prevention Hotline: 1-800-273-8255 or TEXT 838255

National Strategy for Suicide Prevention (2012). Action Alliance. 
https://theactionalliance.org/

Self-Soothing Strategies: 8 Ways to Calm Anxiety and Stress. (2018). https://www.psychologytoday.com/us/blog/the-empaths-survival-guide/201810/self-soothing-strategies-8-ways-calm-anxiety-and-stress

Veterans Crisis Line (veteranscrisisline.net)  Dial 800-273-8255 and press 1.

Virtual Hope Box app (Defense Health Agency)

What is Depression? (2017). American Psychiatric Association (APA)  https://www.psychiatry.org/patients-families/depression/what-is-depression

If you have any questions about suicide, please log into your account and send us your question. We are here to help.

Dr. Joe Banken PhD - Health Tip Content Editor

Friday, June 19, 2020

The Mediterranean Diet

Maybe you've heard of the Mediterranean Diet and you want to know more?  In the 1960s, researchers noticed that there were significantly fewer deaths from heart disease in Mediterranean countries than in the U.S. and northern Europe.  One of the more likely causes for this inequality is the difference in our dietary habits.
 
The Mediterranean DietWhat exactly is the Mediterranean Diet?
 
While there is no single definition for this diet, studies began to find that eating primarily vegetables, fruits, whole grains, and healthy fats each day along with fish, poultry, beans, and eggs each week is associated with a reduced risk of cardiovascular disease.  In addition, the traditional diet of this region includes moderate portions of dairy products and limited intake of red meat. 
 
Meals are built around plant-based foods and use healthy fats like olive oil, a monounsaturated fat, instead of saturated or trans-fats which contribute to heart disease.  
 
The Mediterranean diet typically includes fatty fish such as mackerel, herring, sardines, albacore tuna, salmon and lake trout. These fish are rich in omega-3 fatty acids.  These polyunsaturated fats may reduce inflammation in the body.  They also decrease triglycerides, reduce blood clotting, and decrease the risk of stroke and heart failure.
 
Fruit is often served as a dessert, rather than desserts with high levels of refined sugar and other highly refined carbohydrates.
 
Other components of the Mediterranean Diet
 
People in this region also tend to share meals with family and friends.  When you are socializing during meals, you tend to eat more slowly, and recognize that you are full earlier in the meal.  
 
People in this region also tend to be more physically active than people in the U.S. and northern Europe.  
 
They often have a glass or two of red wine with meals.  While alcohol has been associated with a reduced risk of heart disease in some studies, the Dietary Guidelines for Americans caution against starting to drink if you don't already. They also recommend not increasing how much alcohol you drink now.  
 
What do health organizations say about this eating plan?  
  • The Dietary Guidelines for Americans recommends the Mediterranean Diet as a healthy eating plan to promote health and prevent chronic disease.  
  • The World Health Organization considers it a healthy and sustainable dietary pattern. 
  • U. S. News and World Report lists it as one of the best diets year after year in their annual ranking by experts of popular diets.  This is based on how healthy the diets are and how easy they are to follow.  
  • The American Heart Association says that a Mediterranean-style diet can help you achieve their recommendations for a healthy dietary pattern.  They note, too, that this diet is low in sodium, highly processed foods, refined carbohydrates, saturated fats and fatty and processed meats so the risk of stroke, heart disease, obesity, diabetes, high cholesterol and high blood pressure is reduced.  It is also low in added sugar.  
How do you get started on the Mediterranean Diet?
 
Some people are ready to jump right in to protect their health by following this style of eating.  But it is okay to start slowly.  Take a look at what you are eating - and drinking - and find one or two changes you can make.  Maybe cut out, or at least cut down, on sugary drinks.  Just don't substitute juice, which can have more calories than soda.  Water is the best choice.  
 
Choose whole fruits instead of drinking juice.  Whole fruit has fiber, which most juice doesnt, so it helps to keep your blood sugar in check and keeps you full longer, among other health benefits.  One thing you might try is eating an orange with breakfast, rather than drinking orange juice.
 
Find recipes to try using beans, lentils or other legumes.  Search the American Heart Association website, the DASH diet, or the Bean Institute website, but there are many other good sites, too.  

If you have any questions about The Mediterranean Diet, please log into your account and send us your question. We are here to help.

Saturday, June 13, 2020

Adverse Health Effects of Heavy Alcohol Use

Last time we talked about the guidelines regarding alcohol consumption.  This week we'll focus on the adverse health consequences of excessive alcohol use.  Remember that moderate alcohol consumption is considered one drink a day for women and two drinks a day for men.
 
Adverse Health Effects of Heavy Alcohol UseLight to moderate alcohol consumption is considered safe for most people, although there are some people who should not drink alcohol at all.  We talked about this briefly last week, and we'll touch on it again today.
 
Drinking too much alcohol can cause both physical and mental harm to your body in a number of ways.   Let's go through it by body system.
 
Liver:  Heavy drinking can certainly take a toll on the liver.  The metabolism of alcohol creates a toxic compound call acetaldehyde.  This toxin contributes to inflammation in the liver and other organ systems.  Your liver functions to remove toxins from the body, so it has to work overtime when you drink alcohol.   If you drink heavily, either too many drinks in one sitting, or too many drinks over a long period of time, your liver can't keep up.  This excess alcohol can damage your liver in different ways.
  • Fatty liver – Fat builds up in the liver, leading to poor function.
  • Cirrhosis – Liver cells are killed, leading to scarring and fibrosis.  This damage, referred to as cirrhosis, significantly damages the ability of the liver to function properly.  
  • Alcoholic hepatitis – Often caused by binge drinking or heavy drinking over short periods of time, this is an acute inflammation of the liver that can lead to loss of liver function and death.

Pancreas:  Alcohol can cause inflammation in the pancreas, called pancreatitis, which can be acute or chronic.  It can be a very serious condition that causes significant pain and digestive problems.
 
Heart and Cardiovascular System:  Damage to the heart can be caused by excessive alcohol consumption on a single occasion or heavy drinking over a long time.  Heart problems that can be caused by alcohol include:
  • Cardiomyopathy - The heart muscle becomes stretched thin and the heart becomes enlarged and cannot pump adequately.
  • Arrhythmias - Several abnormal heart rhythms can be associated with alcohol use, some fatal.
  • High blood pressure - Increases your risk for cardiovascular death from heart attack and stroke.
  • Brain and Neurologic system:
  • Stroke - Stroke risk is increased by heavy alcohol use, which can lead to significant disability or death.
  • Memory - Alcohol interferes with the pathways in the brain.  Intoxication, especially heavy intoxication prevents your brain from moving short term memories into long term storage, so you may remember what happened when you were drunk for a few days, but you will not be able to remember weeks or years later, even really important things that happened.
  • Encephalopathy - Usually caused by chronic heavy drinking.  This is an inflammation within the brain, which causes confusion, loss of motor coordination, short-term memory loss, involuntary eye movements, and other symptoms.
  • Neuropathy - Also caused by chronic heavy drinking, neuropathy causes damage to sensory nerves, causing tingling, numbness, and pain in the feet and hands.  It can also cause poor function of motor nerves, leading to foot drop, abnormal gait, and frequent falls.

Immune System:  Drinking too much can weaken your immune system.  This is true for chronic excessive drinking, which increases your risk for several infections.  Drinking a lot on a single occasion weakens your immune function for up to 24 hours after getting drunk.  This is certainly not something you want to happen right now!
 
Cancer:  There has been extensive research on the effects of alcohol on cancer risk.  There is strong scientific evidence of an association between alcohol consumption and several types of cancer.  Alcohol is actually listed as a known human carcinogen by the National Toxicology Program of the US Department of Health and Human Services.  The more alcohol a person drinks over time, the higher the risk of developing an alcohol-related cancer.  
 
Here are the types of cancers that have a clear association with alcohol:
  • Head and neck cancer – People who drink 3.5 drinks per day or more have at least a two to three times greater risk of developing head and neck cancers than non-drinkers.  This includes cancers of the tongue, tonsils, larynx and others.  This risk is substantially higher among heavy drinkers who also use tobacco products.
  • Liver cancer – Alcohol consumption is an independent risk factor for liver cancer.
  • Esophageal cancer – Alcohol consumption is a major risk factor for certain types of cancer in the esophagus.
  • Breast cancer – There have been more than 100 studies that looked at the association between the risk of breast cancer and the consumption of alcohol.  These studies have consistently found an increased risk of breast cancer associated with increasing alcohol intake.
  • Colorectal cancer – There is a modestly increased risk of cancers of the colon and rectum associated with alcohol consumption.

For most people, moderate alcohol consumption is not associated with significant health risks.  However, this may not be true for everyone.  Here are just a couple of examples.  If you have a strong family history of breast cancer, you might want to avoid alcohol use, or reserve alcohol for rare special occasions.  If you have high blood pressure that is hard to control, eliminating alcohol consumption might allow you to take fewer medications. 
 
If you have questions about your own alcohol consumption, be sure to talk with your family doctor about your risk.  If you have any questions about the effects of alcohol use, please log into your account and send us your question. We are here to help.  

Dr. Anita Bennett MD - Health Tip Content Editor