Heart disease and depression link

Being diagnosed with coronary heart disease can be frightening and stressful, however optimistic the prognosis. It can be a time to revaluate lifestyle, relationships and work and can place enormous pressure on the individual and their family, affecting all aspects of life – including mental health. Now, the American Heart Association has recommended that coronary patients should also be screened early and regularly for depression. They have spoken out because of the growing body of evidence that shows a link between depression in cardiac patients and a poorer long-term outlook.

Many studies have now shown that major depression is associated with worse prognosis in patients with coronary disease. What has also now been confirmed is that more severe depression is associated with the patient having earlier and more severe cardiac events.

In many cases, depression can often be treated with exercise, counselling, good nutrition and cognitive-behavioural therapy. American Psychiatric Association suggests that two questions can identify patients who may need further follow up and treatment. The doctor should ask: ‘Over the past two weeks, how often have you been bothered by the following two symptoms?

1. Little interest or pleasure in doing things

2. Feeling down, depressed, or hopeless

If the answer to either question is yes, they have been bothered by those symptoms then the follow up questions are: ‘how often have you been bothered in the past two weeks by:

1. Trouble falling asleep, staying asleep, or sleeping too much

2. Feeling tired or having little energy

3. Poor appetite or overeating

4. Feeling bad about yourself, that you are a failure, or that you have let yourself or your family down

5. Trouble concentrating on things such as reading the newspaper or watching television

6. Moving or speaking so slowly that other people could have noticed or being so fidgety or restless that you have been moving around a lot more than usual

7. Thinking that you would be better off dead or that you want to hurt yourself in some way.

This is not a definitive way to define depression, but it is a useful tool to evaluate how someone is coping after having a coronary and can help you decide whether or not help is needed.

Often used strategies for patients who have coronary disease and depression are antidepressant drugs, cognitive behavioural therapy, and physical activity, such as aerobic exercise. Diet can also play a part, and most nutritionists would recommend a diet that excluded sugar, caffeine and alcohol.

Aspartame – The sweet deception

I know I have mentioned aspartame before – probably too often – but I can’t emphasise strongly enough that sweeteners do you no favour, especially if you are trying to lose weight. Your body does not recognise a sweetener as sugar, and so you unconsciously seek it out in other ways. Many experts now believe that Aspartame is one of the most dangerous substances ever added to food, not only because it has been proven to make you fatter, but because of its links to serious health problems such as cancer and neurological diseases.

Why am I mentioning it now? Because many people just don’t think it’s true, or that I am a scaremongering killjoy (only on Halloween and never when it concerns your health!) Can I just point out that Aspartame has brought more complaints to the Food and Drug Agency in the USA than any other additive-ever. It’s responsible for a staggering 75% of the complaints they receive and from 10,000 consumer complaints, the FDA compiled a list of 92 symptoms, including death.

Now I think death is a pretty serious symptom – so if you are addicted to diet drinks and sweeteners, could you at least cut down and stop me worrying about you?

Another good reason for women to be happy

As I cast a damper on women’s consumption of orange juice recently, I thought I would redress the balance by promoting the real health benefits of optimism for women who want to avoid breast cancer.

A study at Ben-Gurion University of the Negev in Israel has found that women who are happy and optimistic appear to be less likely to get breast cancer than their gloomier counterparts. Also, women who had experienced more than one major tragedy in their lives, such as the death of a close family member or a serious illness, were significantly more likely to have the disease.

The researchers were able to conclude that experiencing more than one meaningful life event (severe and/or mild to moderate) is a risk factor for breast cancer among young women and that general feelings of happiness and optimism can play a protective role against the disease.

This points up yet again the importance of the relationship between happiness and health for all of us. Indeed, some previous studies have suggested a link between stressful life events, psychological distress, and cancer. It is believed by many therapists that psychological stress may contribute to an increase in cancer by modifying cell responses to environmental factors, but it is still unproven.

We already know that an optimistic outlook can actually increase your lifespan, and now it seems it can protect you against one of our most feared diseases.

Alert – The placebo effect and antidepressants

Five centuries ago, the Swiss alchemist and physician Paracelsus (1493-1541) wrote: “You must know that the will is a powerful adjuvant of medicine.” In a nutshell that sums up the effect that placebos can have on our bodies: they can effect change without containing any active chemical ingredients that could medically make a difference to the state of our health, and yet they often can provoke therapeutic effects – both positively and negatively – when administered to patients.

Researchers now believe that belief in the placebo as being part of a curative treatment seems to stimulate the body’s own healing mechanism – if we believe it is doing us good, then it is. Our belief stimulates certain bio-chemical responses and reactions and increases our ability to initiate our own healing process.

The term placebo literally means “I shall please” and was used in mediaeval prayer in the context of the phrase Placebo Domino (“I shall please the Lord”). Much later, during the 18th century, the term was adopted by medicine and was used to imply preparations of no therapeutic value that were administered to patients as “decoy drugs.” Over time it became recognised as having an important role in the therapeutic treatment of patients and in more recent studies, the placebo effect was estimated at 60% of the overall therapeutic outcome. In a recent review of 39 studies regarding the effectiveness of antidepressant drugs, psychologist Guy Sapirstein concluded that 50 per cent of the therapeutic benefits came from the placebo effect, with a poor percentage of 27% attributed to drug intervention. Now an even more startling study by the FDA has revealed that the new generation of SSRI anti-depressant drugs are even less effective than Sapristein’s study showed.

I have a vested interest in the subject as I have been treated for depression since my teens and now 50 years on have tried many drugs, therapies and natural alternatives and finally discovered that I just have to learn to recognise it and live with it as for me nothing has proved effective over the long term and the side effects of antidepressants have seriously affected both my creativity and natural personality. Depression is a serious medical illness caused by imbalances in the brain chemicals that regulate mood. I am certainly not alone with my experience of depression as it affects one in six people at some time during their life, making them feel hopeless, worthless, unmotivated, even suicidal.

Doctors measure the severity of depression using the “Hamilton Rating Scale of Depression” (HRSD), a 17-21 item questionnaire. The answers to each question are given a score and a total score for the questionnaire of more than 18 indicates severe depression.

Mild depression is often treated with psychotherapy or cognitive-behavioural therapy to help people to change negative ways of thinking and behaving. For more severe depression, current treatment is usually a combination of psychotherapy and an antidepressant drug, which is used to normalize the brain chemicals that affect mood.

Antidepressants include “tricyclics,” “monoamine oxidases,” and “selective serotonin reuptake inhibitors” (SSRIs). SSRIs are the newest class of antidepressants and the FDA (Food and Drug Administration) in the USA has reported on both published and unpublished trials on SSRIs submitted to them during their licensing process. The findings have rocked the medical world as it has indicated that these drugs have only a marginal clinical benefit. On average, the SSRIs improved the HRSD score of patients by just 1.8 points more than the placebo. The most effective clinical rating for SSRI’s was for severely depressed patients and the FDA again reported that this reflected a decreased responsiveness to placebo rather than an increased responsiveness to antidepressants. I am not saying don’t take antidepressants, I have done so myself, but I am saying think before you go down the drug intervention route.

That ‘will’ that Paracelsus referred to that certainly has a powerful role to play, particularly in the area of whether we regard our treatment positively or negatively, regardless of what it contains. Positive or negative thinking seems to be a decisive risk factor for every treatment, perhaps even more important than medical intervention, so looking at our attitude to life could be the first place to start. Research clearly indicates that positive thinkers live on average 6 years longer than those who always respond negatively to life – it’s not about being a ‘Pollyanna’ and forever looking on the bright side but it is about taking those lemons life hands out and making some lemonade, or in my case lemon curd, rather than leaving them in the bowl to rot and decay.

Mobile phones and Autism Link

Do you know a child who doesn’t have, or want, their own mobile phone? There are good practical reasons for giving children a way of being in touch when away from home, but there is now new research that links mobile phone use and autism. Rates of autism, a disabling neurodevelopmental disorder, have increased nearly 60-fold since the late 1970s, with the most significant increases occurring in the past decade. The cause of autism is unknown, although theories include such potential causes as:

* Genetic predisposition

* Inability to clear heavy metals

* Increased vulnerability to oxidative stress

* Environmental exposures including mercury preservatives in vaccines

* Trans-generational accumulation of toxic heavy metals

Now a groundbreaking new theory has been suggested by a study published in the Journal of the Australasian College of Nutritional & Environmental Medicine. They believe that it is electromagnetic radiation (EMR) from cell phones, cell towers, Wi-Fi devices and other similar wireless technologies that are an accelerating factor in autism.

The study involved over five years of research on children with autism and it found that EMR negatively affects cell membranes, and allows heavy metal toxins, which are associated with autism, to build up in the body. The researchers pointed out that autism rates have increased concurrently along with the proliferation of cell phones and wireless use. EMR from wireless devices (such as laptops, bluetooth etc) works in conjunction with environmental and genetic factors to cause autism.

EMR, the researchers say, could impact autism by facilitating early onset of symptoms or by trapping heavy metals inside of nerve cells, which could accelerate the onset of symptoms of heavy metal toxicity and hinder therapeutic clearance of the toxins.

What’s the solution? At present there doesn’t seem to be one. Research on the potential health effects from mobile phone technology is evaluated periodically by the Government’s Health Protection Agency s Radiation Protection Division after the Stewart Report in 2000 recommended further research as part of an overall precautionary approach to the use of mobile phone technology. The independently managed Mobile Telecommunications and Health Research (MTHR) programme, jointly funded by Government and industry, was set up in 2001 in response to the Stewart Report recommendations. It is currently supporting a number of studies into the possible health effects but there is no definitive answer as yet. My suggestion? Seriously limit mobile phone use – especially for children – and my feeling is that being available 24/7 by phone is hugely stressful and is a health hazard in itself so switch it off unless it is an essential call! My mobile is off until I need to check my messages or call ahead about a delayed appointment.

In fact my mobile message is very specific it says ‘I do not leave this mobile switched on so do not leave a message unless you are prepared for it not to be picked for several days. Leave a message on my home phone instead’. Worth a try?

Blood Test for Alzheimer’s diagnosis?

18 million people worldwide are affected by Alzheimer’s, but it has been hard for doctors to make an accurate diagnosis until the disease is well progressed. Now, researchers have developed a simple blood test that may be able to predict whether mild lapses of memory could be an early sign of Alzheimer’s disease. In a study published in the journal Nature Medicine, an international team of researchers describe 18 cell-signalling, or communication, proteins found in blood that predicted with 90 percent accuracy whether a person would develop Alzheimer’s disease.

Currently, doctors diagnose Alzheimer’s disease by excluding other potential causes of memory loss, such as stroke, tumours and heavy drinking. They can also administer simple paper-and-pencil tests, and sometimes use brain scans, but this blood test could be used to detect changes in these proteins and because they occur early on in the disease process they could be used to predict the disease two to six years ahead of its onset.

Killer diet for rheumatoid arthritis?

Diet is important with rheumatoid arthritis

First on the hit list are tomatoes, maybe not killers exactly but if you suffer from arthritis they are certainly to be avoided. They are among a group of foods that trigger inflammation and general discomfort because they contain solanine, an alkaloid that is known for its toxicity. Other foods that are high in solanine are potatoes, aubergines and peppers, all of which you might know better as the nightshade plant family. The solanine is found in their leaves and roots and its purpose is to provide natural protection against insects for the plant. When we eat those foods the solanine is neutralized in the intestine, but because of their ability to trigger joint pain, some researchers believe that arthritis patients may not be able to adequately process the solanine and so it is still toxic in their system.

If you suffer from arthritis then you know that dietary solutions can be very helpful for some people, so that taking all the nightshade family out of the equation can be beneficial. Unfortunately this does not make any difference at all to other people with arthritis and that it is another factor entirely that causes the most problems. An excellent book by Patrick Holford called Say No to Arthritis  made this point many years ago, and pointed out that certain foods can increase the severity of rheumatoid arthritis symptoms and these include milk, pork, red meat, cod, eggs and cereal. This is now confirmed by research done in Norway and Sweden, which has shown that certain people may be predisposed to develop rheumatoid arthritis when their diet includes plenty of high-protein foods. If you do suffer from this painful condition then an investigation into what foods affect you might well be very beneficial, and the book I just mentioned is a good place to start with that.

ADHD drugs and risk of heart disease

The number of children on anti depressants and other behaviour altering drugs has quadrupled in the last ten years. In 2005 GP’s wrote more than 631,000 prescriptions for drugs such as Prozac to under 16′s as against 146,00 in the mid 1990′s. This disturbing trend sees drugs being the first line in the situation instead of other options such as counselling which might be more appropriate. In line with the fact that the use of Ritalin to control stress and aggressive behaviour in children has also increased tenfold in the same period, there is a timely study being undertaken in the USA to look at the potential heart risks from medicines used to treat attention deficit hyperactivity disorder (ADHD).

The U.S. Food and Drug Administration, in collaboration with the Agency for Healthcare Research and Quality, will examine clinical data of about 500,000 children and adults who have taken ADHD drugs, including Ritalin. The analysis is expected to take about two years and will include all drugs currently marketed for treating ADHD. There are millions of people taking these medicines worldwide and it is known they can increase heart rate and blood pressure, and this has raised concerns they may therefore raise the risk of heart attacks, strokes or other cardiovascular problems. There have been cases reported of heart problems in both adults and children who receive drug treatment for ADHD, but these patients have had known underlying risk factors. What is not known is whether or not these events are directly related to the drug treatment and the study hopes to get further information to protect from potential risks from heart disease.

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