Anger: Heart Disease

How Anger Hurts Your Heart?

Yellers, ragers, and door slammers beware -- frequent high levels of anger have now been linked to heart disease.

If you knew that frequent anger might raise your risk of heart disease significantly, would you continue to blow off steam by yelling and smashing things during an argument or getting furious if the office email crashes during a rushed, stressful day?

It's time for hot heads to take heed: Increasingly, the negative, irritable, raging, and intimidating personality type worries heart researchers and doctors alike. "You're talking about people who seem to experience high levels of anger very frequently," says Laura Kubzansky, PhD, MPH, an associate professor at the Harvard School of Public Health in Cambridge, Mass., who has studied the role of stress and emotions on cardiovascular disease.

The key here is "high" levels. Moderate anger may not be the problem, according to Kubzansky. In fact, expressing anger in reasonable ways can be healthy. "Being able to tell people that you're angry can be extremely functional," she says. But explosive people who hurl objects or scream at others may be at greater risk for heart disease, as well as those who harbor suppressed rage, she says. "Either end of the continuum is problematic."

Anger's Physiological Effects on the Heart
So how exactly does anger contribute to heart disease? Scientists don't know for sure, but anger might produce direct physiological effects on the heart and arteries. Emotions such as anger and hostility quickly activate the "fight or flight response," in which stress hormones, including adrenaline and cortisol, speed up your heart rate and breathing and give you a burst of energy. Blood pressure also rises as your blood vessels constrict.

While this stress response mobilizes you for emergencies, it might cause harm if activated repeatedly. "You get high cortisol and high adrenaline levels and that is the cardiotoxic effect of anger expression," says Jerry Kiffer, MA, a heart-brain researcher at the Cleveland Clinic's Psychological Testing Center. "It causes wear and tear on the heart and cardiovascular system." Frequent anger may speed up the process of atherosclerosis, in which fatty plaques build up in arteries, Kiffer says. The heart pumps harder, blood vessels constrict, blood pressure surges, and there are higher levels of glucose in the blood and more fat globules in the blood vessels. All this, scientists believe, can cause damage to artery walls.

And anger might not be the only culprit. In Kubzansky's own research, she found that high levels of anxiety and depression may contribute to heart disease risk, too. "They tend to co-occur," she says. "People who are angry a lot tend to have other chronic negative emotions as well."

Emotions and the Heart
According to an analysis of findings from 44 studies published last year in the Journal of the American College of Cardiology, evidence supports the link between emotions and heart disease. To be specific, anger and hostility are significantly associated with more heart problems in initially healthy people, as well as a worse outcome for patients already diagnosed with heart disease.

The same study also showed that chronically angry or hostile adults with no history of heart trouble might be 19% more likely than their more placid peers to develop heart disease. The researchers found that anger and hostility seemed to do more harm to men's hearts than women's. Among patients already diagnosed with heart disease, those with angry or hostile temperaments were 24% more likely than other heart patients to have a poor prognosis.

In light of such findings, some doctors now consider anger a heart disease risk factor that can be modified, just as people can lower their cholesterol or blood pressure. "We're really good at treating heart attacks, but we're not that good at preventing them," says Holly S. Andersen, MD, cardiologist and director of education and outreach at the Ronald O. Perelman Heart Institute at New York-Presbyterian Hospital/Weill Cornell Medical Center. "Stress is not as easy to measure as your cholesterol level or your blood pressure, which are clearly objective. But it's really important that physicians start taking care of the whole person -- including their moods and their lives -- because it matters." The bottom line: "A change of mind can lead to a change of heart," Kiffer says.

Coping With Anger
Got a hair-trigger temper? Counseling and anger management might help in the long term, but what can you do for a quick fix?

Recognizing signs that you're getting angry and shifting your frame of mind will help, says Wayne Sotile, PhD, author of Thriving With Heart Disease. The next time you feel your anger -- and heart rate -- rising, try these coping statements to get a grip fast:

"I can't accomplish anything by blaming other people, even if they are responsible for the problem. I'll try another angle"

"Will this matter five years from now? (Five hours? Five minutes?)"

"If I'm still angry about this tomorrow, I'll deal with it then. But for now, I'm just going to cool off."

"Acting angry is not the same as showing that I care."

By Katherine KamWebMD the Magazine - Feature
Reviewed by Louise Chang, MD

Our motto: One step ahead, everyday.

Hangover

The alarm goes off, and it feels as if someone is hitting you with a hammer. It is the next morning after a night of drinking, and your head is pounding and your body is aching. Your mouth is dry, and you are thirsty. You try to move to a more comfortable position, and it only hurts more. To make matters worse, when you move, you discover that you are dizzy and nauseated. The room seems as if it is spinning. You put one foot on the floor to make it stop. It doesn't work. You have a hangover.

What Is a Hangover?
The term hangover refers to a constellation of unpleasant and painful symptoms that can develop after drinking too much alcohol. Those symptoms can range from mild discomfort to the more severe symptoms described above.

There is no set amount of alcohol that will cause a hangover, since each individual reacts to alcohol differently, but generally, the more you had to drink, the more severe the hangover symptoms.

The Symptoms of a Hangover
Most of the unpleasant symptoms experienced during a hangover are caused by two factors: the diuretic alcohol effect that causes the drinker to become dehydrated, and the toxic effects of alcohol poisoning of many systems of the body.

Excessive amounts of alcohol can affect the liver, the brain, the gastrointestinal system, the central nervous system and sensory perception. It can disrupt your sleep and other body rhythms, affect your mood and affect your attention and concentration.

The Causes of a Hangover
Most of the symptoms experienced during a hangover are caused by the direct effect of alcohol on the body's systems, as mentioned above, but there are many other factors that can add to the unpleasantness of a hangover that are not direct effects of the alcohol consumed.

Hangover symptoms can also be caused by the withdrawal of alcohol from the body, the effects of metabolites produced when alcohol is consumed, other chemicals found in alcoholic beverages, behaviors associated with drinking and personal characteristics of the drinker.

The Cure for Hangovers
There are many traditional practices that are thought to alleviate hangover symptoms, but some of them are unfounded myths that really don't help much at all. There are some practices that can actually make matters worse.

Left alone, hangover symptoms will go away on their own within eight to 24 hours, but when your head is pounding and the room is spinning, any treatment that can bring relief can sound like a good idea.

Preventing a Hangover
The best cure for a hangover is to never get one in the first place. People who drink nonalcoholic beverages do not get hangovers, and generally speaking, those who drink moderate amounts -- one drink a day for women and no more than two a day for men -- do not experience hangover symptoms.

If you drink any alcohol at all, though, you can experience negative consequences the next morning. Although there is no sure way to eliminate all of the unpleasantness of a hangover, there are steps that you can take to reduce the severity of the symptoms.

The Hangover as a Deterrent
For many people who experience a particularly severe hangover, it can be the motivation to never drink excessively again. It happens every day: someone has a very bad experience after drinking too much and they simply make a decision to quit drinking and they never drink again.

But it is not the case for all the people and that they don't easily decide to quit the drinking habit. For some people (usually psychologically dependents on alcohol), who are motivated to drink a particular day, may experience a prior psychological intoxication. This psychological intoxication may be more intense than the physiological intoxication and there are chances that it could be enough euphoric. It is this more intense psychological intoxication, that they never want to quit the drinking habit. This is because, as once a psychological need is gratified, people have a strong desire for the same need again. (As from the researches of Klub Psychology)

Others, though, continue to drink despite repeated bouts with severe hangover symptoms. Continuing to drink despite negative consequences can be sign of alcoholism or alcohol dependence or, at the very least, alcohol abuse. Heavy drinkers who have sworn to themselves "never again" during a hangover, but return to drinking a short time later, have, by definition, a drinking problem.

People who do not drink alcohol do not get hangovers. People who drink small amounts of alcohol rarely get hangovers. People who drink nonalcoholic beverages or those will very small amounts of alcohol within them rarely get hangovers.

However, people who drink to the point of intoxication usually experience some hangover symptoms. Among those who drink until they are intoxicated, those who drink large amounts of alcohol generally have more hangover symptoms compared with those who drink less.

Therefore, the best cure for a hangover is to prevent it from happening in the first place by not drinking alcohol at all, or by drinking very modest amounts. There are other steps that can help in hangover prevention, but once the symptoms of a hangover begin, there are few options that actually bring relief.

Some of the widely used, traditional hangover "cures" really do little to relieve symptoms and some of them can actually make the situation worse.

What Does Not Work?
There are several myths and urban legends surrounding curing a hangover that have been around for years. Most of them have no scientific basis:

· The Hair of the Dog That Bit You - The practice of having a drink the next morning to ward off the effects of a hangover doesn't really work in the long run, contrary to popular belief. Since the worse hangover symptoms occur when the drinker's blood alcohol content returns to zero, taking a drink the next morning only delays the inevitable. It may lessen the symptoms in the short term, but giving the liver more alcohol to metabolize will only increase the discomfort later. Additionally, a morning-after drink can lead to more drinking and can contribute to eventual alcohol dependence.

· Black Coffee - Coffee may relieve the feeling of fatigue associated with hangover and help alleviate the headache symptoms by restricting blood vessels, but that relief is only temporary and the symptoms will return. More importantly, coffee acts as a diuretic further dehydrating the body and increasing the hangover symptoms. Again, coffee may lessen some symptoms initially, but in the long run may cause more problems.

· Taking Tylenol Before Going to Bed - This treatment seems to make sense, but it fails on two levels. First, the effects of acetaminophen (Tylenol) will usually wear off before the onset of hangover symptoms. It would be better to take it after the symptoms begin. Additionally, when the liver is processing alcohol it cannot process acetaminophen as it usually does, which can cause liver inflammation and possible permanent liver damage.

· Eating Fried or Greasy Foods - If you eat foods with a lot of fat before drinking, the oils can coat your stomach lining and slow down the absorption of alcohol. This can help prevent the severity of a hangover. However, eating greasy food the morning after a drinking bout will probably only add to the gastrointestinal malaise by irritating the stomach and intestines.

· Eating Burnt Toast - Carbon can act like a filter in the body and activated charcoal is used to treat some types of poisonings, but the carbon found on burnt toast is not activated charcoal and it does not work the same in the body. Over-the-counter products sold as hangover cures that contain carbon are intended to be taking before drinking, not after the hangover begins.

What Does Work to Relieve Hangovers?
The only real cure for a hangover is time. If no more alcohol is consumed, hangover symptoms should subside between eight and 24 hours. There are some things that can be done to relieve some of the most severe symptoms.

· Water or Sports Drinks - The dehydration effects of alcohol causes some of the most discomfort associated with hangovers -- headache, dizziness, and lightheadedness. The quickest way to relieve those symptoms is to drink lots of water. Sports drinks, such as Gatorade, will not only relieve dehydration, but also replace needed electrolytes.

· Painkillers - Aspirin and ibuprofen (Advil or Motrin) may reduce hangover headache and muscle pain, but should not be used if you are experiencing abdominal pain or nausea. The medications themselves are gastric irritants and can compound gastrointestinal hangover symptoms. Acetaminophen (Tylenol) should not be taken during a hangover because alcohol metabolism enhances acetaminophen's toxicity. Also, ibuprofen taken when dehydrated can sometimes cause kidney dysfunction especially in persons with poor kidney function.

· Eggs - Because eggs contain cysteine, which breaks down acetaldehyde in the body, eating eggs the morning after a drinking binge could help remove the hangover-causing alcohol metobolite toxin from the body.

· Bananas - Alcohol, like any diuretic, depletes the body of potassium. Eating bananas, or other fruit high in potassium, while having hangover symptoms can replenish the potassium and lost electrolytes. Sports drinks typically are good sources of potassium.

· Bouillon Soup - If you can't handle the idea of eating anything solid while experiencing severe hangover symptoms, try some bouillon soup. It also can help replace salt and potassium lost during a drinking binge.


· Fruit or Fruit Juice - Consuming fruit or fruit juice while hungover can increase energy, replaces vitamins and nutrients and has been shown to speed up the body's process of getting rid of toxins. Fruits and fruit juices therefore can help decrease the intensity of hangover symptoms.

The Bottom Line
Drinking as much water as possible over the course of the evening and before you go to bed will relieve a great deal of the hangover symptoms caused by dehydration. But only time will cure the hangover symptoms caused by the alcohol poisoning effects of excessive drinking.

Sources: http://www.about.com/

Our motto: One step ahead, everyday.

Healthy coping during holiday stress

The holiday season can be a stressful time. With the combined stressors of holiday shopping, financial strain, difficult relatives, travel stress and a busy schedule of demands, many people find themselves more stressed than usual. Women, who often shoulder the bulk of the added holiday burden as far as baking, shopping, coordinating, party-throwing and planning are concerned, are often particularly stressed during this time.

This added stress can come out in many different ways. Some people respond to stress emotionally, either feeling anxiety, depression or anger and frustration. Others respond with a weakened immune system, getting sick more frequently (which is more of a danger during this season anyway, as people crowd indoors and swap germs in airports and malls). Others just power through and find themselves battling burnout by the end of the year.

As people try to cope with all these stressors, relatively few people take the time to learn new stress management practices; most just use their regular coping tactics, but to a greater degree. This is fine for people who normally cope with stress in a healthy way. For many people--people who do use some healthy coping techniques--also cope with stress in unhealthy ways, either with 'comfort food', a glass of wine, a shopping trip or something similar. These behaviors aren't the healthiest coping techniques to begin with, but they aren't generally as harmful as when they're taken to an extreme. Under increased pressure, mildly unhealthy coping becomes emotional overeating, excessive drinking, chain smoking, compulsive buying, and the like. And these responses to stress generally add more stress.

How does one deal?

By replacing unhealthy coping with healthy stress management techniques.

First, finding some healthier ways to reduce stress can make quite a difference here because, when there is less stress to react to, unhealthy responses can diminish. Also, when healthy coping skills are substituted for unhealthy ones, it's easier to let go of unhealthy habits. Finally, after working harder at healthy stress management (which can include ideas mentioned in the resources below), if you still find yourself feeling overwhelmed with stress or coping in a way that causes problems in other areas of your life, it might be a good idea to talk to someone and find resources to help.

Holiday stress can be a bit daunting, but it can also be just the thing you need to cause you to reexamine your lifestyle and your reactions to stress, and create healthier habits for the coming year, and for your future. Here are some resources to help.

Handling Family Conflict

Going to see your family (or your partner's) can be wonderful and stressful, all at once! While it might be really special and fun seeing everyone (or not--some of you know what I mean!), it can also be stressful for a number of reasons. There might be a relative that you love, but can only take in small doses. You may find yourself or your partner acting differently around your families of origin, and not know how to adjust. You may stress about gifts, alliances, roles, events or any number of things. Or you may get homesick because things are just so darn fun when you see your family! Whatever the stress you may face, I think I have a resource or two here that can help you diffuse stress from the situation. Check out the articles below.

Research shows that supportive relationships are good for our mental and physical health. However, dealing with difficult people and maintaining ongoing negative relationships is actually detrimental to our health. It’s a good idea to diminish or eliminate relationships that are filled with conflict. But what do you do if the person in question is a family member, co-worker, or someone you otherwise can’t easily eliminate from your life?

The following are tips for dealing with difficult people who are in your life, for better or for worse:
Difficulty: Average
Time Required: Ongoing

Here's How:Avoid discussing divisive and personal issues, like religion and politics, or other issues that tend to cause conflict. If the other person tries to engage you in a discussion that will probably become an argument, change the subject or leave the room.

In dealing with difficult people, don’t try to change the other person; you will only get into a power struggle, cause defensiveness, invite criticism, or otherwise make things worse. It also makes you a more difficult person to deal with.

Change your response to the other person; this is all you have the power to change. For example, don’t feel you need to accept abusive behavior. You can use assertive communication to draw boundaries when the other person chooses to treat you in an unacceptable way.

Remember that most relationship difficulties are due to a dynamic between two people rather than one person being unilaterally "bad." Here’s a list of things to avoid in dealing with conflict.

Do you do any of them?Try to look for the positive aspects of others, especially when dealing with family, and focus on them. The other person will feel more appreciated, and you will likely enjoy your time together more.

However, don’t pretend the other person’s negative traits don’t exist. Don’t tell your secrets to a gossip, rely on a flake, or look for affection from someone who isn’t able to give it. This is part of accepting them for who they are.

Get your needs met from others who are able to meet your needs. Tell your secrets to a trustworthy friend who's a good listener, or process your feelings through journaling, for example. Rely on people who have proven themselves to be trustworthy and supportive. This will help you and the other person by taking pressure off the relationship and removing a source of conflict.

Know when it’s time to distance yourself, and do so. If the other person can’t be around you without antagonizing you, minimizing contact may be key. If they’re continually abusive, it's best to cut ties and let them know why. Explain what needs to happen if there ever is to be a relationship, and let it go. (If the offending party is a boss or co-worker, you may consider switching jobs.)

Tips:Try not to place blame on yourself or the other person for the negative interactions. It may just be a case of your two personalities fitting poorly.

Remember that you don't have to be close with everyone; just being polite goes a long way toward getting along and appropriately dealing with difficult people.

Work to maintain a sense of humor -- difficulties will roll off your back much more easily. Shows like "The Office" and books like David Sedaris' Naked can help you see the humor in dealing with difficult people.

Be sure to cultivate other more positive relationships in your life to offset the negativity of dealing with difficult people.

Combating holiday overeating

The holiday season is a notoriously bad time for the waistline. In fact, just thinking about December makes some people swear they've put on a pound or two! While this tends to be a time of year that people want to look their best--most people see family and friends galore at holiday parties and gatherings and want to look nice dressed up, or be remembered as looking their best--it's also a time when staying svelte is most difficult. Think about it; in addition to the regular causes of stress-related weight gain, we have these other factors to contend with:
More food. Better Food.Yes, with all the holiday parties and nice dinners with family, people are often presented with more opportunities to gorge themselves with really delicious (and often more fattening) food. More food is served socially this time of year, and there are also generally more sweets being passed around. This makes for more times when we have to 'be good', and we're bound to slip up a little extra.

More Emotional Stress.

The holidays can bring social and emotional stress as we face family gatherings where there might be some unresolved conflict, or attend office functions with people we might not choose to hang out with socially. There's also the stress of buying gifts (often on a tight budget), fitting in all the activities of the season, and other stressors that occur during the holiday season. (Read more about those stressors in this article on holiday stress.) Because stressed people tend to eat more, and gain more weight, this can take a toll.

More Excuses

People who are celebrating often indulge more than they would in their regular lives. When celebrating the holidays, there are several occasions where people might relax their dietary standards a little, in the name of celebration. These celebrations, however, can be rather plentiful during the holiday season, and the indulgences ("Oh, look--the neighbors made us fudge!" "Hey, it's a party! Why not have another piece of pie?" etc.) can add up.

So what's a body-conscious person to do? Obviously, you can't cancel the holidays!

The first step is to be aware of these triggers, and notice them before they catch you off guard again this month. Have a plan for parties (you can eat a little--not a lot--and try to throw in some extra exercise, for example), and watch your holiday stress levels. And follow regular guidelines for combatting emotional eating, of course.

Tools and Guidelines for Combatting Emotional Eating:

Take The Stress and Weight Gain TestStress can contribute to weight gain in several ways. If you're having trouble with your weight and wonder what role stress may be playing, or if you just want information and resources for healthy change, this is the quiz for you! The following 10 questions are each designed to help you assess a different aspect of your lifestyle to determine if you may benefit from some simple changes that can help you keep your weight under control when you're stressed. At the end of the quiz, you'll find resources that pertain to your specific situation.

What Causes Emotional Eating?Even if we know what we're supposed to be eating, there are additional factors that influence how much and what type of food we consume. One of these factors is stress, which is linked to increased emotional eating. Emotional eating has many causes. Learn about the main reasons--besides hunger--that stressed people eat, and find resources to stop emotional eating.

How To Stop Emotional EatingAs anyone who's watching their weight will tell you, hunger is just one of many reasons that people eat. If you're an emotional eater, you may find yourself eating to deal with uncomfortable emotions, using food as a reward when you're happy, and craving sweets or unhealthy snacks when stressed. This article can help you to cut down emotional eating and develop healthier eating habits--even when stressed!

By Elizabeth Scott, M.S., About.com Guide to Stress Management

Our motto: One step ahead, everyday.

Safeguarding your sight:5 common eye myths dispelled

Although aging puts people at greater risk for serious eye disease and other eye problems, loss of sight need not go hand in hand with growing older. Practical, preventive measures can help protect against devastating impairment. An estimated 40% to 50% of all blindness can be avoided or treated, mainly through regular visits to a vision specialist.

Regular eye exams are the cornerstone of visual health as people age. Individuals who have a family history of eye disease or other risk factors should have more frequent exams. Don’t wait until your vision deteriorates to have an eye exam. One eye can often compensate for the other while an eye condition progresses. Frequently, only an exam can detect eye disease in its earliest stages.

What steps can you take?
You can take other steps on your own. First, if you smoke, stop. Smoking increases the risk of several eye disorders, including age-related macular degeneration. Next, take a look at your diet. Maintaining a nutritious diet, with lots of fruits and vegetables and minimal saturated fats and hydrogenated oils, promotes sound health and may boost your resistance to eye disease. Wearing sunglasses and hats is important for people of any age. Taking the time to learn about the aging eye and recognizing risks and symptoms can alert you to the warning signs of vision problems.

Although eyestrain, spending many hours in front of a television or computer screen, or working in poor light do not cause harmful medical conditions, they can tire the eyes and, ultimately, their owner (see below). The eyes are priceless and deserve to be treated with care and respect — and that is as true for the adult of 80 as it is for the teenager of 18.

5 common eye myths dispelled

Myth 1 : Doing eye exercises will delay the need for glasses.Fact: Eye exercises will not improve or preserve vision or reduce the need for glasses. Your vision depends on many factors, including the shape of your eye and the health of the eye tissues, none of which can be significantly altered with eye exercises.

Myth 2: Reading in dim light will worsen your vision.Fact: Although dim lighting will not adversely affect your eyesight, it will tire your eyes out more quickly. The best way to position a reading light is to have it shine directly onto the page, not over your shoulder. A desk lamp with an opaque shade pointing directly at the reading material is the best possible arrangement. A light that shines over your shoulder will cause a glare, making it more difficult to see the reading material.

Myth 3: Eating carrots is good for the eyes.Fact: There is some truth in this one. Carrots, which contain vitamin A, are one of several vegetables that are good for the eyes. But fresh fruits and dark green leafy vegetables, which contain more antioxidant vitamins such as C and E, are even better. Antioxidant vitamins may help protect the eyes against cataract and age-related macular degeneration. But eating any vegetables or supplements containing these vitamins or substances will not prevent or correct basic vision problems such as nearsightedness or farsightedness.

Myth 4: It’s best not to wear glasses all the time. Taking a break from glasses or contact lenses allows your eyes to rest.Fact: If you need glasses for distance or reading, use them. Attempting to read without reading glasses will simply strain your eyes and tire them out. Using your glasses won’t worsen your vision or lead to any eye disease.

Myth 5: Staring at a computer screen all day is bad for the eyes.Fact: Although using a computer will not harm your eyes, staring at a computer screen all day will contribute to eyestrain or tired eyes. Adjust lighting so that it does not create a glare or harsh reflection on the screen. Also, when you’re working on a computer or doing other close work such as reading or needlepoint, it’s a good idea to rest your eyes briefly every hour or so to lessen eye fatigue. Finally, people who stare at a computer screen for long periods tend not to blink as often as usual, which can cause the eyes to feel dry and uncomfortable. Make a conscious effort to blink regularly so that the eyes stay well lubricated and do not dry out.

Source: http://www.health.harvard.edu/

Our motto: One step ahead, everyday.

Positive Psychology

Tough economic times are the perfect setting to begin using positive psychology to your advantage, says a new report from Harvard Medical School. Positive Psychology: Harnessing the power of happiness, personal strength, and mindfulness is a guide to the concepts that have made "Positive Psychology" the most popular course at Harvard University, and teaches how to put positive emotion to work in your life.

Positive emotions have been linked with better health, longer life, and greater well being in numerous scientific studies. On the other hand, chronic anger, worry, and hostility increase the risk of developing heart disease, as people react to these feelings with raised blood pressure and stiffening blood vessels. A Harvard School of Public Health study found that people who are generally hopeful were less likely to develop hypertension, diabetes, or respiratory tract infection than those who were less hopeful.

Using positive psychology can help you in the following aspects:

Using the positivity in your life as a moral strength
Finding and using your inner character strengths
Achieving the “flow” experience
Putting mindfulness to use toward well being
Developing gratitude
Savoring pleasure
Finding the meaningful live

Positive emotions and the brain

Is there a biological dimension to happiness? Why does your heart seem to “jump for joy” or your eyes “light up” when you feel happy? Researchers now agree that there is a biomolecular aspect to happiness and that the brain is command central for the chemical and physiological changes that occur in the body with positive emotions. While many researchers have studied positive emotions by observing human and animal behavior, others are trying to discover what is happening inside the brain at the structural and molecular levels.

Since the middle of the 20th century, neuroscientists have investigated the mechanisms of positive emotion in the brain and body. Before that time, positive emotions were regarded as too subjective for rigorous scientific study. But a better understanding of the brain chemicals known as neurotransmitters and increased ability to use technology to create images of the living brain opened new opportunities for study.

In the 1950s, psychologists identified a “pleasure center or reward area” in an area of the brain known as the nucleus accumbens. They found that laboratory animals would press a lever to deliver an electrical stimulus to their own brain’s “pleasure center” repeatedly until they were exhausted—undeterred by hunger, thirst, or pain. When researchers stimulate the nucleus accumbens of people, they smile, laugh, and report feeling pleasure, happiness, or euphoria. Later, by mapping connected areas, the researchers identified a reward circuit in the brain that involves the prefrontal cortex (the thinking part of the brain) and several underlying areas, including the nucleus accumbens and the amygdala ( the center for emotion, so said).

The chemical basis of these pleasurable sensations also came under investigation. While the interactions are extremely complex and variable, some patterns have been described. Researchers found that the neurotransmitter dopamine activates the reward system and is associated with positive emotions, exuberance, and desire. On the downside, the dopamine reward system may also be associated with addictions, in which people develop uncontrollable urges to repeatedly engage in pleasurable but harmful behaviors, ranging from taking drugs to gambling excessively. Children and adult with more reward neurotransmitter, as endorphin, don't involve in social interactions and to a layman this condition is called Autism.

Another group of chemicals, the internally produced opiate-like chemicals called endorphins, are also associated with pleasurable feelings, such as those created by eating chocolate or a runner’s high. Endorphins released in the brain also increase the release of dopamine.

When people feel happy, they often feel physical sensations—a rush of passion, a flutter of joy—that correspond to brain signals to nerves of the heart, circulatory system, skin, and muscles. These physical sensations are accompanied by chemical changes in the brain and are interpreted as pleasurable.

Scientists have used modern brain imaging methods to help determine exactly which areas of the brain correspond to sensations of pleasure. This approach has revealed distinct patterns in both the cortex and underlying structures when people feel negative and positive emotions. In the 1990s, researchers used positron emission tomography (PET) scans to produce three-dimensional images of people’s working brains. They observed that positive and negative emotions activated different parts of the brain, and that areas activated by happiness were deactivated by sadness and vice versa.

Another technique, electroencephalography, revealed striking, emotionally-based asymmetries in the activity of the prefrontal cortex. In these studies, the brains of generally happy people showed greater activity in the left prefrontal cortex, and this area became more active when people were exposed to amusing video clips. The right side, on the other hand, became more active when people experienced negative emotions.

The development of a new brain imaging technology, functional magnetic resonance imaging (fMRI), spurred a large increase in the number of brain studies, contributing to some confusion about which areas of the brain were associated with happiness and sadness. Results of these many studies suggest that the brain may be even more complex than once imagined by earlier researchers. Nonetheless, many studies support the notion that the left side of the brain is generally associated with positive emotions and the right side with negative emotions. They have also identified the anterior cingulate cortex as active in emotional regulation, and that part of the brain is often called the “affective division” of the cingulate cortex.

Why do humans have these pleasure centers in the brain? Experts theorize that because human survival depends on achieving basic goals such as finding food and procreating, a rush of pleasurable sensations associated with eating or having sex would positively reinforce these behaviors, leading us to repeat them and hence increase the chances that we will survive and reproduce.

Source: Harvard Medical School

http://www.hms.harvard.edu/

Our motto: One step ahead, everyday.

Cognitive Therapy for Depression

Are your thoughts dragging you down?

Almost everyone has dark thoughts when his or her mood is bad. With depression, though, the thoughts can be extremely negative. They can also take over and distort your view of reality.
Cognitive therapy can be an effective way to defuse those thoughts. When used for depression, cognitive therapy provides a mental tool kit that can be used to challenge negative thoughts. Over the long term, cognitive therapy for depression can change the way a depressed person sees the world.

Studies have shown that cognitive therapy works at least as well as antidepressants in helping people with mild to moderate depression. Treatment with medication and/or psychotherapy can shorten depression's course and can help reduce symptoms such as fatigue and poor self-esteem that accompany depression. Read on to see how cognitive therapy or talk therapy might help you start thinking and feeling better if you are depressed.

Cognitive Therapy for Depression: A Thinking Problem

Cognitive therapy was developed in the 1960s as an alternative way to treat depression, says Judith S. Beck, PhD. Beck is director of the Beck Institute for Cognitive Therapy and Research located just outside Philadelphia. She tells WebMD that the principle underlying cognitive therapy is "thoughts influence moods."

According to cognitive therapists, depression is maintained by constant negative thoughts. These thoughts are known as automatic thoughts. That means they occur without a conscious effort. For example, a depressed person might have automatic thoughts like these:

· "I always fail at everything."
· "I'm the world's worst mother."
· "I am doomed to be unhappy."

Beck says automatic thoughts "may have a grain of truth. But," she adds, "the depressed person distorts or exaggerates the reality of the situation." This negative distortion helps fuel the depression.

With cognitive therapy, a person learns to recognize and correct negative automatic thoughts. Over time, the depressed person will be able to discover and correct deeply held but false beliefs that contribute to the depression.

"It's not the power of positive thinking," Beck says. "It's the power of realistic thinking. People find that when they think more realistically, they usually feel better."

Cognitive Therapy for Depression: How It Works

Cognitive therapy posits that most problems have several parts. Those parts include:

· the problem as the person sees it
· the person's thoughts about the problem
· the person's emotions surrounding the problem
· the person's physical feelings at the time
· the person's actions before, during, and after the problem occurs

The way cognitive therapy works is a patient learns to "disassemble" problems into these various parts. Once a person does that, problems that seemed overwhelming become manageable.

During regular cognitive therapy sessions, a trained therapist teaches the tools of cognitive therapy. Then between sessions, the patient often does homework. That homework helps the person learn how to apply the tools to solve specific life problems.

"They make small changes in their thinking and behavior every day," Beck says. "Then over time, these small changes lead to lasting improvement in mood and outlook."

Cognitive Therapy for Depression: Evidence It's Effective

How well does cognitive therapy for depression work? And how well does it stack up when compared to other treatments for depression?

Robert DeRubeis, PhD, is professor of psychology and associate dean for the social sciences at the University of Pennsylvania. He tells WebMD, "The evidence is consistent and convincing that cognitive therapy is an effective treatment for depression. And," he adds, "[that means] not just the milder forms of depression."

Large, well-designed studies that include hundreds of subjects have shown the following:

1. Cognitive therapy works as well as antidepressant medicines alone to improve mild to moderate depression.

"When conducted well, cognitive therapy works as quickly and as thoroughly as antidepressant medications," says DeRubeis, who has led several large studies of cognitive therapy for depression. "Used consistently, cognitive therapy may work better than antidepressants in the long run," he adds.

2. Cognitive therapy works as well as antidepressant medicines at preventing depression relapses.

DeRubeis tells WebMD that when a person continues using the skills he learned with cognitive therapy, those skills help prevent relapses, a common problem with depression. "Cognitive therapy appears to prevent the return of symptoms as well as taking medication," he says. "And it does it without medication."

3. Cognitive therapy reduces residual symptoms of depression.

After a "successful" treatment for depression, many people continue to have mild depressive symptoms. Adding cognitive therapy to the treatment plan helps reduce these residual symptoms.

Cognitive Therapy for Depression: With or Without Antidepressants?

Cognitive therapy has become the standard "talk therapy" used to treat depression. In addition to its high rate of success, it is also cost-effective. The benefits from cognitive therapy often come in weeks rather than months or years, as may be the case with other treatments.
But can cognitive therapy replace antidepressant medications? For some people, says DeRubeis, the answer is yes.

"The data show that, when conducted well, cognitive therapy is a reasonable alternative to medications even for more severe forms of depression," DeRubeis says. This assumes a patient is able to participate in a cognitive therapy program.

But it doesn't have to be an "either-or" decision. In some studies, cognitive therapy for depression worked even better when combined with antidepressants.

Because everyone's situation is unique, the decision about how to use cognitive therapy should always be made by the patient and the mental health provider together.

Cognitive Therapy for Depression: Think Well, Feel Better

Depression demonstrates how closely linked the mind and body are. People who are depressed, frequently feel bad physically, not just sad or "down." Besides helping to improve a person's mood, cognitive therapy can also improve the physical symptoms of depression. It does this by:

· improving a person's overall energy level
· increasing the quality and duration of sleep
· improving appetite and restoring the pleasure of eating
· heightening a person's sex drive

Cognitive therapy can also relieve chronic pain. Many people with chronic pain also have depression. According to Beverly E. Thorn, PhD, cognitive therapy treats both at once." Thorn is professor of psychology at the University of Alabama and author of Cognitive Therapy for Chronic Pain. She says that after a course of cognitive therapy for chronic pain, "patients' symptoms related to depression are reduced as well."

The effects of cognitive therapy are often longer lasting than pain medicines. "Pain medications have all kinds of side effects and can actually add to depression," Thorn says. With cognitive therapy, patients learn coping skills and how to apply them. When they do, there is less need for pain medications.

Cognitive Therapy for Depression: How to Start

If you feel you might be depressed, the first thing to do is call your primary care physician (or email at klubpsychology@gmail.com). He or she can probably refer you to a professional therapist or psychiatrist who is knowledgeable about cognitive therapy.

If not, you can find a cognitive therapist in your area by contacting one of the following professional organizations:

Academy of Cognitive Therapy
http://www.academyofct.org

Association for Behavioral and Cognitive Therapies
http://www.abct.org/

The Beck Institute for Cognitive Therapy and Research
http://www.beckinstitute.org/

Klub Psychology: For Psychosocial Services
www.klubpsychology.blogspot.com

Cognitive Therapy for Depression: 5 Questions to Ask Your Provider

Here are questions to ask your provider if you are considering cognitive therapy for depression:

1. Should I take antidepressants if I'm trying cognitive therapy?
2. How do I find a therapist who practices cognitive therapy?
3. Will my health insurance cover cognitive therapy?
4. When can I expect to start feeling better?
5. How will I know cognitive therapy is working for me?

By Matthew Hoffman, MD
Reviewed By Brunilda Nazario, MD

Our motto: One step ahead, everyday.

Dealing with difficult people

Use the following strategies to end the emotional tug-of-war, once and for all.I like to imagine that I’m a kind, patient person. That I embody calm when confronted with prickly personalities. That their aggravations roll off me like water off a duck’s back. But this delusion is quickly dispelled every time I have a run-in with a difficult person.

Take last week: My friend (let’s call her Liz) and I decided to meet at noon for lunch. She’s often late, so I took my time walking over to the café. But mid-stroll, I became paranoid that Liz would be punctual for once, so I rushed to be there on the dot. She was nowhere to be seen. I breathed deeply, rationalizing that now I had some coveted alone time. That lasted all of four minutes. At 12:08, I called Liz on her cell, convinced I’d given her the wrong address. She never picked up. Ten minutes later, she showed up with a big smile and zero apology.

“Oh, don’t be mad at me. You know I’m always late,” she said. “It’s just part of my personality. Besides, haven’t you enjoyed all the great people watching?" My reaction was less like a duck, more like a rabid dog. The worst part was that my emotional equilibrium had been knocked off-kilter. It took me a good 15 minutes to calm down enough to actually enjoy spending time with my friend.

Trying personalities like Liz’s are everywhere — in your home (possibly sharing your bed), at the office, in your book club. They may even be complete strangers. What makes them difficult may be an undisputed character flaw — they’re sycophantic or self-centered or perpetually gloomy — or simply a quirk that rubs you the wrong way. But inevitably, a brush with them leaves you fuming or at least out of sorts.

Instead of devising elaborate avoidance schemes or barbed comebacks, you can change your dynamic with these sanity stealers. Use the following strategies to end the emotional tug-of-war, once and for all.

Turn the Spotlight on You
“You must change how you react to people before you can change how you interact with them,” says Rick Kirschner, N.D., coauthor of Dealing with People You Can’t Stand. That requires some self-examination.

People who irritate us usually have something to show us about ourselves. “Ask yourself: How is this person holding up the mirror to me?” suggests Sandra Crowe, author of Since Strangling Isn’t an Option. For example, being around my chronically late friend reminds me how quick-tempered and impatient I can be — not my favorite traits. Reminding myself of this may keep me from bouncing off the walls when I find myself waiting for her yet again.

If it’s a good friend or intimate, think, too, about your own behavior in the relationship. Have you contributed to the strain by saying yes instead of no too many times? Did you neglect to signal early on that something was bothering you? “If you don’t look at your own actions, you end up making the other person 100 percent of the problem,” explains Susan Fee, author of Dealing with Difficult People: 83 Ways to Stay Calm, Composed, and in Control. That also puts the solution squarely in her hands — and out of yours.

Delving into the root cause of your frustration can turn up problem-solving insights. Fee provides an example from her own life: “When I first got married, my mother-in-law drove me crazy. She was always hovering and intrusive. But after asking myself again and again why she bothered me so much, I realized what was going on: Her behavior was foreign to me because I never knew what it was like to be mothered — when I was 12, my mom had a debilitating stroke. It became clear that this was just my mother-in-law’s way of showing her love for me. Once I understood that, our relationship improved.”

Switch Perspectives
“Most of the time, difficult people just want something different than we do,” says Ronna Lichtenberg, author of Work Would Be Great If It Weren’t for the People. “Or they handle things differently.”

It’s no surprise, then, that you may be your difficult person’s difficult person. It could be a matter of opposite outlooks: Super-friendly people, for instance, may be at odds with all-business-all-the-time types — and vice versa. The same goes for laid-back folks and workaholics. Understanding those basic differences gives you a glimpse of someone else’s viewpoint, which may help temper your irritation.

If you’re having trouble feeling empathetic toward someone you care about, try analyzing her behavior. This strategy worked for Alicyn Mindel, a mom of two from Providence who struggled for years with her friend “Dina,” who was a terrible listener. “Whenever I started talking about my personal problems, she would turn the conversation around to herself. Then, one day, a different pal was talking about attention-starved people, and I realized Dina fit the description perfectly. From that moment on, every time Dina and I got together, I gave her a big, long hug. The transformation was amazing: She became warmer, more open, and over time, she started asking me about my life — without segueing into her own issues.”

Choose Your Approach
Armed with your insights, you now need to decide whether to confront the perpetrator. As a general rule, you should talk things over only with someone you’re close to, whether that’s your husband or a longtime colleague. It’s probably not worth stirring the pot if you only see him once a month, like an in-law or acquaintance on the PTA board. (For people you don’t know at all — say, the salesclerk who’s more interested in her cell phone chat than in helping you — you’ll need a different strategy.)

You can also skip the conversation if you know it will fall on deaf ears, or if you suspect it will be taken the wrong way. That was the case with Mindel: “I never addressed the issue with Dina because she tends to be defensive. I knew I’d have a better chance of fixing our friendship by changing my actions.” A good litmus test for determining whether or not to start a conversation is first to imagine the worst-case scenario. Then ask yourself, Will our relationship survive? If you’re confident it will, set up a time to talk. If it won’t, try a tactic that’s less confrontational.

Start a Dialogue
Before you say anything, you have to do a little homework. How exactly do you want the behavior to change? In the long term, what are you expecting from this relationship? Until you can answer those questions, you’re not ready to talk to anyone.

If you fear a bad reaction, plan ahead: “Figure out in advance how you’re going to respond,” advises Fee. “Will you walk away? Breathe deeply until he calms down?” This exercise can also help you focus on what might trigger a heated response.

Make sure no one will interrupt the conversation and pick a time when you’re not hungry or tired, so you can give it your full attention.

And Follow These Talking Tips

· Start the conversation with sincere flattery — it’s especially effective if you’re afraid you’re going to hurt someone’s feelings. With loved ones, “explain that the reason you’re having this talk is that you care so much and want to improve the relationship,” suggests Fee.

· Call out the behavior, not the person. “You need to learn how to separate the individual from the act,” Lichtenberg explains. “Confronting someone is not so different from disciplining a kid. You don’t say to your child, ‘You’re bad!’ You say, ‘It’s bad that you drew on the wall"

· Cite specific examples of what’s bothering you. Avoid vague comments like, “You’re such a snob.” Instead say, “Last week, you made three disparaging comments about the clothes I was wearing.”

· Spell out what you want to change. The next time your Freud-wannabe friend tries to be your personal shrink, you can say, “I appreciate your advice, and I know you want to be helpful. But most of the time, I really just want an ear. I’m telling you this because I want to be able to share things with you.”

· Request feedback as soon as possible. If you don’t, it can turn into a lecture. Right away ask, “What do you think about what I’ve said?” Or, “Have you been feeling the same way?”

· Pay attention to more than your words. “Only 7 percent of communication is what you’re actually saying — the rest is your tone of voice, expression, and body language,” says Kimberly Alyn, author of How to Deal with Annoying People.

Take a Less Direct Approach
Sitting down for a heart-to-heart won’t work with everyone. At times it’s better to resolve an issue in a more roundabout way, even with loved ones. For example, humor can be especially effective. If your sister has a habit of psychoanalyzing you every time you chat, Alyn suggests saying, “Wow, I feel like I should be lying on a couch for this. How much do I owe you?” Here, more ways to fix those frustrating interactions:

· Put the difficult person to good use. When Bette Walter, an entrepreneur in Blue Bell, PA, is considering a new business move, she turns to a friend who always shoots down her plans: “I ask her what she thinks before she can tell me what a dumb idea it is. She’s very logical, so it’s helpful.” For know-it-alls, steer the conversation toward a topic you’re interested in, so you can at least learn something until you can make your getaway.

· Remember this rule: If you can predict it, you can plan for it. “If you see an incessantly forlorn coworker walking your way, get up and leave your desk,” says Kirschner. “Or pick up the phone and pretend you’re speaking to someone. If you stop listening to her, she’ll eventually stop coming over.”

· Get the last word. If someone is giving you unsolicited advice, saying “Thanks” will usually put an end to her rant. When you’re around a braggart, just smile, advises Crowe. Then reply, “Wow, that’s really great. I’m so happy for you.”

Plan an exit strategy. When you can’t get a chatty person off the phone, pretend.
My ultimate strategy is to remind myself that every strength is a weakness and every weakness, a strength. Yes, my friend Liz is always late, but her time-isn’t-an-issue attitude also makes her relaxed and carefree — and that’s what I love about her. The next time we meet, I plan to bring a good book. Or maybe I’ll just tell her to meet at 11:40 instead of noon, so that we both show up right on time.

By: Sarah Felix

about.com

Our motto: One step ahead, everyday.