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Improved Mental Health Tied to Quitting Smoking

In a new study from Washington University, researchers find that quitting smoking does more than improve physical health as stopping the habit also improves mental health.

Typically, health professionals who treat people with psychiatric problems often overlook their patients’ smoking habits, assuming it’s best to tackle depression, anxiety, or substance abuse problems first.

However, the new study shows that people who struggle with mood problems, or addiction can safely quit smoking and that kicking the habit is associated with improved mental health.

The study is published online in the journal Psychological Medicine.

“Clinicians tend to treat the depression, alcohol dependence or drug problem first and allow patients to ‘self-medicate’ with cigarettes if necessary,” said lead investigator Patricia A. Cavazos-Rehg, Ph.D.

“The assumption is that psychiatric problems are more challenging to treat and that quitting smoking may interfere with treatment.”

In the study, Cavazos-Rehg discovered that quitting, or significantly cutting back on cigarette smoking was linked to improved mental health outcomes.

Specifically, quitting altogether or reducing by half the number of cigarettes smoked daily was associated with lower risk for mood disorders like depression, as well as a lower likelihood of alcohol and drug problems.

“We don’t know if their mental health improves first and then they are more motivated to quit smoking or if quitting smoking leads to an improvement in mental health,” Cavazos-Rehg said.

“But either way, our findings show a strong link between quitting and a better psychiatric outlook.”

Naturally, the serious health risks associated with smoking make it important for doctors to work with their patients to quit, regardless of other psychiatric problems.

“About half of all smokers die from emphysema, cancer, or other problems related to smoking, so we need to remember that as complicated as it can be to treat mental health issues, smoking cigarettes also causes very serious illnesses that can lead to death,” she said.

Researchers analyzed questionnaires gathered as part of the National Epidemiologic Study on Alcohol and Related Conditions.

This survey was administered in the early 2000’s and just under 35,000 people were surveyed. As part of the study, participants answered questions about drinking, smoking, and mental health in two interviews conducted three years apart.

The researchers focused on data from 4,800 daily smokers. Those who had an addiction or other psychiatric problems at the time of the first survey were less likely to have those same problems three years later if they had quit smoking.

And those who hadn’t had psychiatric problems at the initial survey were less likely to develop those problems later if they already had quit.

At the time of the first interview, about 40 percent of daily smokers suffered mood or anxiety disorders or had a history of these problems. In addition, about 50 percent of daily smokers had alcohol problems, and some 24 percent had drug problems.

Forty-two percent of those who had continued smoking during the years between the two surveys suffered mood disorders, compared with 29 percent of those who quit smoking.

Alcohol problems affected 18 percent of those who had quit smoking versus 28 percent who had continued smoking.

And drug abuse problems affected only 5 percent of those who had quit smoking compared with 16 percent of those who had continued smoking.

“We really need to spread the word and encourage doctors and patients to tackle these problems,” Cavazos-Rehg said.

“When a patient is ready to focus on other mental health issues, it may be an ideal time to address smoking cessation, too.”

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Study Finds Cigarettes ‘Trick’ Smokers’ Brains

New research shows that smokers are more susceptible to positive images of smoking, while more biased to negative images of smoking, including the health risks.
Researchers at the Institut Universitaire en santé mentale de Montréal and Université de Montréal found that chronic smokers have altered emotional reactions when they are exposed to images — both negative and positive — associated with tobacco.“We observed a bias depending on how smoking is portrayed,” said Le-Anh Dinh-Williams, a student at the Centre de recherche de l’Institut Universitaire en santé mentale de Montréal and the study’s first author.

“For example, the brains of the smokers in our study were more aroused by images that showed smoking in a positive light than by images that encouraged them to stop. They were also more affected by aversive non-smoking related images than by images of the specific negative consequences of smoking.”

In Canada and the U.S., approximately 20 percent of adults smoke cigarettes despite knowing its adverse effects, according to the researchers.

“We wanted to understand why knowing about the negative health impacts of tobacco does not prevent smokers from lighting up,” she said.

Using neuroimaging techniques, the researchers compared the emotional reactions of 30 smokers as they looked at aversive smoking-related images, such as lung cancer, compared to other aversive images — like an old man on his deathbed. They also had the smokers view positive smoking-related images, such as a smoker satisfying the urge to smoke.

The study helps explain why 70 to 95 percent of smokers who quit will, despite their best efforts, start smoking again within one year, according to the researchers.

“Many factors make it difficult for people to quit. Part of the explanation could certainly be because cigarettes ‘trick’ the brains of smokers,” said Stéphane Potvin, Ph.D., a co-author of the study and researcher at the Institut Universitaire en santé mentale de Montréal and assistant professor in the Department of Psychiatry at Université de Montréal.

“Specifically, we discovered that the brain regions associated with motivation are more active in smokers when they see pleasurable images associated with cigarettes and less active when smokers are confronted with the negative effects of smoking.”

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Dumped? How To Heal The Health Effects Of A Broken Heart?

Romantic rejection can manifest in various forms of physical anguish, researchers find.

Got a stomach ache? A headache? Insomnia? Your health issues may be related to your recent romantic rejection.

When 23-year old Emmie Scott, a direct marketer in Richmond, Va., and her boyfriend/co-worker broke up and still had to endure seeing each other daily, Scott suffered a broken heart—literally. “The most uncomfortable symptom I experienced is the sensation that someone was sitting on my chest—a combination of both pain and pressure that’s left more than one of my friends commenting that my heart must actually be broken.”

Researchers now understand that romantic rejection triggers change in our brains that affect our health. Edward Smith, a Columbia University psychologist, and a team of colleagues found that intense emotional pain can activate the same neural pathways as physical pain. Seems being jilted can hurt in a primitive physical way as if you’ve been sucker-punched by a welterweight.

What’s more, that physical pain can manifest in surprising ways. Aside from chest pain, you may get hit with a kick-butt cold or flu, develop insomnia, or a range of gastro symptoms from loss of appetite to diarrhea. The precise health wallop you suffer may have to do with how your body manifests stress. Asthmatic? You could have an asthma attack. Suffer from a skin condition like eczema or psoriasis? Your skin will likely flare up. Have irritable bowel syndrome? Prepare to hit the restroom.

“While in college I found out my boyfriend (and high school sweetheart) was cheating on me. Although only 110 pounds, I dropped almost 15 and broke out with a case of shingles, which required a week of prednisone to calm,” says Christina Stoever Young, 40, producer of a historic haunted walking tour in Truckee, Calif.

Here, the top health complaints stemming from heartache:

• Complaint: Heart pressure or pain, palpitations, abnormal heart rhythms.

Why: When the stress response is triggered by a breakup or divorce, the body sends out a massive flooding of the hormones cortisol and adrenaline. “Anytime your adrenaline levels are higher, you’re more vulnerable to faster heart rate, palpitations, and certain arrhythmias, or abnormal heart rhythms, as well as skipped beats, lightheadedness, feeling your chest pounding, and a fluttering feeling in your neck,” says Dr. John M. Kennedy, a Marina Del Ray cardiologist and co-author of “The 15 Minute Heart Cure: The Natural Way to Release Stress and Heal Your Heart in Just Minutes a Day.”

Women heart patients facing severe stress from marriage difficulties were found to have three times the risk of heart attack as women without such stress. Worse, there’s a syndrome that mimics heart attack called Takotsuba syndrome, or broken heart syndrome, in which an EKG, chest X-ray, and blood work all indicate a heart attack. But when a cardiologist goes inside the heart searching for the culprit blocked artery, the arteries are wide open. The stress response simulates heart attack symptoms. “A broken heart syndrome is an extreme form of what heartache can do to our bodies,” says Kennedy. While it can be lethal, the heart muscle usually recovers within six months.

What helps: Anything that relieves stress helps prevent these heart problems during relationship troubles: exercise, yoga, meditation, relaxing through breathing or visualization, even short term anti-anxiety medication.

• Complaint: Cold or flu.

Why: These same stress hormones torch your immune system leaving you vulnerable to rogue bacteria and viruses. “Normally when you’re confronted with bacteria or virus, your body will mount a defense,” says Dr. Valerie Scott, a board certified family doctor in Mt. Pleasant, S.C. Post break up, however, your immune system is weakened and those defenses aren’t unable to ward off illness.

What helps: Managing your stress improves your immune system. Exercise, eat well, take a multi-vitamin, especially the B-complex vitamins, which boost immunity, rest enough and decompress with music, comedy or friends to counteract the flood of stress hormones.

• Complaint: Gastro upset (stomach pain, loss of appetite, diarrhea,).

Why: The excess cortisol shooting into your system during your break up diverts blood away from your digestive track, leaving you with GI unpleasantness–that ‘can’t eat for weeks, sour stomach, run to the bathroom feeling you get when your relationship tanks.

What helps: Try over-the-counter meds for your queasy stomach. In one study, researchers simulated rejection in the lab and found that aspirin alleviates the painful feelings triggered by being rebuffed. While it seems skeptical, it’s worth a try, as is curbing your desire to veg on the couch. Exercise prompts your brain to release uplifting endorphins that will settle your stomach. What’s more, misery loves company. “You want to surround yourself with family and friends and supportive people because it’s easy to get depressed,” says Kennedy, which may worsen symptoms. Camaraderie can stimulate a much-needed dose of missing oxytocin, a feel-contented hormone.

• Complaint: Insomnia.

Why: Sleeping patterns, not unlike eating patterns, become skewed during relationship demise. Some people want to stay in bed all day — while others can’t seem to sleep at all. Science really doesn’t understand why it happens, but it’s likely due to racing thoughts, the ‘he-said, she-said’ reenactment of the break up plays out mentally while at rest. Plus, stress hormones, still at their peak, may wreck your circadian rhythms and internal clock.

What helps: Stay active enough so your body will reach the reparative deep levels of sleep it needs, but don’t push yourself to exhaustion, which backfires. Exercise, but avoid it after 9 pm, since it could cause insomnia. Skip caffeine after 3 in the afternoon for the same reason. Turn off TV, computer and cell phone at least an hour before bed and embrace a relaxing sleep routine: low lighting, candles, and a warm bath. “Once you calm that stress response, all of these medical things resolve and get better,” says Scott.

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Depression: Recognizing The Physical Symptoms

Most of us know about the emotional symptoms of depression. But you may not know that depression can be associated with many physical symptoms, too.

In fact, many people with depression suffer from chronic pain or other physical symptoms. These include:

• Headaches.
These are fairly common in people with depression. If you already had migraine headaches, they may seem worse if you’re depressed.

• Back pain.
If you already suffer with back pain, it may be worse if you become depressed.

• Muscle aches and joint pain.
Depression can make any kind of chronic pain worse.

• Chest pain.
Obviously, it’s very important to get chest pain checked out by an expert right away. It can be a sign of serious heart problems. But depression can contribute to the discomfort associated with chest pain.

• Digestive problems.
You might feel queasy or nauseous. You might have diarrhea or become chronically constipated.

• Exhaustion and fatigue.
No matter how much you sleep, you may still feel tired or worn out. Getting out of the bed in the morning may seem very hard, even impossible.

• Sleeping problems.
Many people with depression can’t sleep well anymore. They wake up too early or can’t fall asleep when they go to bed. Others sleep much more than normal.

• Change in appetite or weight.
Some people with depression lose their appetite and lose weight. Others find they crave certain foods — like carbohydrates — and weigh more.

• Dizziness or lightheadedness.

Because these symptoms occur with many conditions, many depressed people never get help, because they don’t know that their physical symptoms might be caused by depression. A lot of doctors miss the symptoms, too.

These physical symptoms aren’t “all in your head.” Depression can cause real changes in your body. For instance, it can slow down your digestion, which can result in stomach problems.

Depression seems to be related to an imbalance of certain chemicals in your brain. Some of these same chemicals play an important role in how you feel pain. So many experts think that depression can make you feel pain differently than other people.

Treating Physical Symptoms:

In some cases, treating your depression — with therapy or medicine or both — will resolve your physical symptoms.

But make sure to tell your health care provider about any physical symptoms. Don’t assume they’ll go away on their own. They may need additional treatment. For instance, your doctor may suggest an antianxiety medicine if you have insomnia. Those drugs help you relax and may allow you to sleep better.

Since pain and depression can sometimes go together, easing your pain may help with your depression.

Other treatments can also help with painful symptoms. Certain types of focused therapy — like cognitive behavioral — can teach you ways to cope better with the pain.

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