Posts Tagged Pain

Migraines Painful — But Don’t Lead to Dementia


Migraines Painful -- But Don't Lead to DementiaResearch from Brigham and Women’s Hospital has shown that migraines are not associated with cognitive decline.

While migraines affect about 20 percent of the female population, there are many unanswered questions surrounding this complex disease, according to the researchers.

Previous studies linked migraines to an increased risk of stroke and structural brain lesions, but until this new study it had been unclear whether migraines had other negative consequences, such as dementia or cognitive decline.

“Previous studies on migraines and cognitive decline were small and unable to identify a link between the two,” said Pamela Rist, a research fellow in the Division of Preventive Medicine at BWH, and lead author on this study. “Our study was large enough to draw the conclusion that migraines, while painful, are not strongly linked to cognitive decline.”

The research team analyzed data from the Women’s Health Study, which included nearly 40,000 women, 45 years and older.

They analyzed data from 6,349 women who provided information about migraine status at baseline and then participated in cognitive testing during followup.

Participants were classified into four groups: No history of migraine, migraine with aura (transient neurology symptoms mostly of the visual field), migraine without aura, and past history of migraine. Cognitive testing was carried out in two-year intervals up to three times.

“Compared with women with no history of migraine, those who experienced migraine with or without aura did not have significantly different rates of cognitive decline,” she said.

“This is an important finding for both physicians and patients. Patients with migraine and their treating doctors should be reassured that migraine may not have long-term consequences on cognitive function.”

There is still a lot that is unknown about migraines, she acknowledged, noting that more research needs to be done to understand the consequences of migraine on the brain and to optimize treatment strategies.

The study was published online by the British Medical Journal.

Source: Brigham and Women’s Hospital

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PTSD Can Affect New Mothers


PTSD Affects One in Three New MothersNatural childbirth is a major cause of post-traumatic stress disorder (PTSD), according to new research.

A Tel Aviv University researcher has discovered that approximately one-third of all postpartum women exhibit some symptoms of PTSD, and a smaller percentage develop full-blown PTSD following labor.

Of the women who developed symptoms, 80 percent opted for natural childbirth without pain relief, reported Professor Rael Strous of TAU’s Sackler Faculty of Medicine.

Other significant factors identified in the study include the woman’s body image, including discomfort about being in an undressed state for a relatively prolonged period of labor and undergoing elective Caesarean sections; fear during labor; and complications in not only this pregnancy, but in earlier ones as well.

Researchers interviewed 89 post-partum women between the ages of 20 and 40, first within five days after delivery and then again one month after delivery.

They discovered that of these women, 25.9 percent displayed symptoms of PTSD, 7.8 percent suffered from partial PTSD, and 3.4 percent exhibited symptoms of full-blown PTSD.

Symptoms included flashbacks of the labor, the avoidance of discussion of the event, physical reactions, such as heart palpitations during such discussions, and a reluctance to consider having another child.

According to Strous, one of the most influential factors was pain management during delivery. Of the women who experienced PTSD symptoms, 80 percent had gone through a natural childbirth, without any form of pain relief.

“The less pain relief there was, the higher the woman’s chances of developing post-partum PTSD,” he said. Of the women who did not develop any PTSD symptoms, only 48 percent experienced a natural childbirth, he added.

A full 80 percent of the PTSD group reported feeling discomfort with being unclothed, and 67 percent had previous pregnancies which they described as traumatic. Fear of the labor itself, both in terms of expected pain levels and danger to themselves and their children, was also influential.

The researchers also discovered that support during labor, in the form of a midwife or doula, had no impact when it came to avoiding PTSD symptoms. Other factors, such as socioeconomic and marital status, level of education, and religion, also had no effect.

Strous suggests doctors become familiar with the profile of women more disposed to suffer from PTSD symptoms, and be on the look-out for warning signs after labor. He also advocates additional research to develop better treatment plans and make more resources available for women.

There are some immediate steps medical professionals can take, Strous added, including better counseling about pain relief and making sure that patients’ bodies are properly covered during delivery.

“Dignity is a factor that should be taken into account,” he said. “It’s an issue of ethics and professionalism, and now we can see that it does have physical and psychological ramifications.”

The study was published in the Israel Medical Association Journal.

Source: American Friends of Tel Aviv University

Pregnant woman on bed photo by shutterstock.

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How to Manage Emotions More Effectively


How to Manage Emotions More Effectively

by Margarita Tartakovsky, M.S.

How to Manage Emotions More EffectivelyFor many people, emotions are a scary thing. Part of the problem is that we just don’t know what to do with them, according to Darlene Mininni, Ph.D, MPH, author of The Emotional Toolkit.

So we turn to the only strategies we do know. If you’re a man, you might distract yourself by playing video games, tinkering with your tools or drinking alcohol, she said. If you’re a woman, you might shop or eat.

Turning to these tools occasionally is OK, Mininni said. Making them part of your regular coping repertoire, however, is problematic.

Emotions are valuable, and offer a bounty of benefits. Once we’re able to process and cope with them effectively, we can learn a lot about ourselves and our needs, Mininni said. Emotions send us important messages and help us connect with others and accomplish great things, she said.

 

Using unhealthy strategies can sabotage our relationships, job and even our health, Mininni said. In fact, people who handle stress effectively have healthier immune systems, don’t get sick as often and age up to 16 years more slowly than people who don’t.1

What is an Emotion?

There’s actually no consensus on what an emotion is, Mininni said. She defines emotions as a “full-body experience,” an interplay between our thoughts and physical sensations.

As an illustration, Mininni created the following simple formula:

Thoughts + Body Sensations = Emotion

For instance, a kind of giddy happiness and anxiety have the same sensations, such as tight muscles and a pounding heart. What determines whether we feel happy or anxious are our thoughts.

Decoding Emotions

Mininni created a valuable step-by-step process to help people identify and manage their emotions. The first step is to figure out what you’re feeling – and you just need to choose from four main emotions.

Mininni said that all emotions fall into these categories: anxiety, sadness, anger and happiness. With anxiety, she said, your mind lights up with “What ifs?” What if I lose my job? What if I don’t meet someone? What if I fail my test?

You have thoughts of the future and everything that can go wrong, she said. Your physical sensations include a racing heart, tight muscles and clenched jaw.

With sadness, you have negative thoughts about the past. You feel tired and heavy; you might cry and have trouble concentrating, she said.

With anger, your thoughts are focused on how you or your values have been attacked, she said. The physical sensations are similar to anxiety, including a racing heart and tightness in the body.

With happiness, your thoughts are focused on what you’ve gained. Maybe you landed a great job, found a nice apartment or received a compliment. Physically, you feel light or calm, and you might laugh and smile, she said.

The next step is to identify the message of your emotion. To do so, ask yourself these questions, according to Mininni:

  • Anxiety: What am I afraid of?
  • Sadness: What have I lost?
  • Anger: How have I or my values been attacked?
  • Happiness: What have I gained?

Coping with Emotions

Once you’ve identified the emotion and its message, the last step is to take action. Ask yourself if there’s anything you can do to solve the situation, Mininni said. If there is, consider what you can do.

For instance, if you’re upset that you can’t find a good job, maybe you can have friends review your resume or hire a professional resume writer. Maybe you can sharpen your interview skills or extend your search a few zip codes.

If there’s nothing you can do, determine how you can cope with the emotion, she said. Mininni suggested meditating, getting social supportwriting, exercising and seeking therapy.

Think of these strategies as an emotional toolkit. You simply reach into your kit, and pick out the healthy tool you need, Mininni said. In fact, you can create an actual tote, and pack it with comforting items such as sneakers, your journal, funny films, favorite books and a list of people you’d like to call when you’re upset.

The strategies that work best will vary with each person, depending on your personality, physiology and other individual factors, Mininni said. For some people, running works wonders in alleviating anxiety. For others, meditation is better.

Emotions may seem confusing and threatening but applying the above practical and clear-cut approach reveals emotions for what they really are: useful, informative and far from murky.

 

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How to Get Over a Breakup


How to Get Over a Breakup

By NATHAN FEILES

Relationship breakups are tough. They are emotionally exhausting, and can be incapacitating at times. For some who begin to dwell in regret and sadness, breakups can even spiral into depression. Even the breakups that make the most logical sense are still emotionally painful. And in fact, it is the emotional — not logical — part of ourselves that causes us to dwell in these relationships that we may logically know are not healthy for us.

While a grieving period is expected after a breakup, as breakups are a form of loss, it can be easy to get caught in an emotionally harmful pattern if we don’t actively push ourselves forward in our lives.

So how do we emotionally get through a breakup and also move forward in an emotionally healthy manner?

7 Tips for Getting Over a Breakup

1. Make plans.

How to Get Over a Breakup

Social interaction is one of the keys to moving forward after a breakup. Isolation often leads to being consumed by emotions and thoughts that exacerbate our sadness and upset. Schedule plans in advance to see friends or family at least a few times during the week and weekends, especially if you live alone, and be sure to follow through with them. If you feel you don’t want to be around anyone, which can be common after a breakup, this is the time to act opposite of the urge. Push yourself to interact with people and prevent a pattern of loneliness and depression.

2. Be aware of the rebound.

Breakups often are a time of intense emotional vulnerability. We are seeking stability. When we feel we can’t internally create it, it is quite possible to engage in unhealthy new relationships that cover up healthy relationship grieving.

While at first the replacement relationship brings a sense of euphoria, the unresolved emotions from the previous relationship often return, creating a more complicated and confusing emotional environment. If you find yourself falling into a new and exciting relationship too soon, you could be experiencing a rebound.

3. Participate in hobbies.

Hobbies are a positive way to keep from dwelling in sadness and forming negative patterns. Whether it’s doing a puzzle, going to museums, gardening, bowling, reading, or whatever it is you enjoy doing, allow yourself to create time and space for them. Be sure to include social hobbies as well as individual ones.

4. Keep up daily self-care routines.

It is also important to remember to take care of your daily needs when dealing with a breakup. Go to the gym, jog, swim, walk, cook, etc. Some may feel less motivated to grocery shop, prepare meals, eat, or shower after a breakup. These may require some extra effort at times, but push yourself to continue your daily routines as before.

5. Don’t overwork.

Some might say that throwing yourself into work is a great distraction from a breakup. However, overworking often is an emotionally avoidant behavior. Overworking may allow us to avoid sadness or loneliness because we are busy; however, it creates an imbalance in our lives as well as a negative pattern that can be tough to break. (Decreasing the work to regain more personal time later becomes difficult.) Work as you would normally work, and reserve those other hours in the day for self-care, hobbies, and social plans that you’ll hopefully be continuing or increasing into your week.

6. Set a daily time limit for grieving.

Each person grieves a loss differently. There is no actual time limit for grieving. However, there is a difference between healthy grieving and dwelling in regret and sorrow. Some could spend months consumed by guilt and sadness if we allow ourselves to.

As we move forward, it is still important to acknowledge our pain and other emotions we may feel as the result of a significant breakup. Set a time each day that you will allow yourself to reflect, feel, and process your relationship loss. Setting a timer is helpful for this. I would recommend no more than 20-30 minutes a day, and have an activity scheduled to immediately follow this time.

7. Seek professional help.

Some people feel ashamed and embarrassed that a breakup is consuming or impacting them, especially when the ex-partner is considered “not worth it.” But breakups are painful! We put time, effort, hope, emotion, and much more into our relationships.

Seeing a therapist to process the residual emotions and thoughts is a healthy way to deal with a breakup, especially if you’re feeling guilt, regret or starting to dwell in sadness.Breakups are rarely going to be easy; however, with healthy tools and motivation, we can heal.

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Response to painkillers may be linked to genetics


Response to painkillers may be linked to genetics

Susan E. Matthews

MyHealthNewsDaily

How the body responds to opiates — the powerful, pain-relieving drugs that carry a high potential for addiction — may be partly determined by genetics, according to a new study.

Researchers studied 121 pairs of twins to look at the role of genetics in people’s reactions to the pain medications. They found that genetic predisposition accounted for 59 percent of the variation between people’s levels of nausea, 36 percent of the differences in how much people disliked the drug and 38 percent of the variation in itchiness in reaction to the drug.

The findings are important because the degree to which people experience unpleasant side effects, and like or dislike the drugs, can be a sign of how effectively the drugs treat their pain, and their potential to develop addiction, the researchers said. Liking a drug increases the susceptibility to addiction, while experiencing negative side effects decreases it.

Genetics matter … people are different, and if we understand why they are different, we can take better care of them,” said study author Dr. Martin Angst, professor of anesthesia at the Stanford University Medical Center.

It’s well-known that the pain relievers cause extremely different reactions in people, but the new study gives researchers a better understanding of how genetics could play a role in those reactions.

“Patients vary dramatically in how much pain relief they get, what extent they suffer from opiates and how much pleasure they get from opiates,” Angst said.

Opiates: reactions and addictions

Nearly 2 million people in the U.S. are addicted to prescription painkillers, a 2009 government survey found, and the problem is growing. Painkiller addiction often begins with a patient taking legitimate prescriptions.

Researchers believe the addiction problem could be curbed if people’s reactions to the drugs were better understood, or could be predicted. Some patients may require 10 times the typical dose for adequate pain relief; others prefer lower doses that cause less extreme side effects, even though it means experiencing more pain.

In the study, participants were randomly assigned to receive either a small amount of a short-acting opiate or a placebo, followed by a heat probe or ice-cold water. Researchers spent 6 hours with each participant, but didn’t know which treatment they’d received. General tolerance to pain was also assessed by applying the heat probe or cold water without any medication.

The study demonstrated that one of the most uncomfortable side effects, nausea, is strongly inherited, as genes account for almost two-thirds of variability between people.

The more severe side effects that come with opiates include slow breathing, which can result in death. Genetics accounted for 30 percent of the variation between people in respiratory depression, and 32 percent of dizziness, the study found.

Opiates represent a “double-edged sword — they’re really important drugs to relieve pain, but they come along with side effects,” Angst said.

More personalized treatment

This line of research could result in a more personalized approach to administering the medications, the researchers said. Someday, people could be screened prior to use so doctors could understand their predispositions, and respond appropriately.

For example, screening could prevent a patient with a low tolerance for opiates from getting a high dose that could bring such euphoric feelings that they predispose the person to seek out the drug in the future, which could be the start of an addiction, said Dr. Doo-Sup Choi, who studies addiction at the Mayo Clinic.

Angst said further research must be done to determine which genes affect tolerance.

The study of 242 participants was large considering the amount of time spent with participants, and it was well-designed and well-performed, Choi said.

The study was published Wednesday in the journal Anesthesiology.

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via Response to painkillers may be linked to genetics – Vitals.

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A Simple Strategy to Let Go of Painful Thoughts and Feelings


English: Managing emotions - Identifying feelings

English: Managing emotions – Identifying feelings (Photo credit: Wikipedia)

No one wants to experience pain.  Whether it’s physical, emotional or mental, once we’ve encountered pain, it’s natural to want it to end.

But, if you pay attention, you will likely find that there are certain emotionally or mentally painful circumstances that you get caught in.  Maybe it’s the angry thoughts about someone who has hurt you or pessimistic thinking about troubles you have faced.

Each of us has a tendency to get caught in certain types of thinking that prolongs painful emotions.  Instead of enjoying a relaxing evening, we might find ourselves ruminating on something hurtful someone said or rather than solving a difficult problem and moving on, you may find you are again and again drawn to thoughts about how unfair your circumstances are.

Sometimes it seems as if the mind just wants to hold on to these painful thoughts and circumstances.  Even as we try to get rid of unpleasant thoughts, we may find ourselves rethinking and reliving painful situations.

Try this:

  • Take a situation that you often find yourself either avoiding and pushing away or painful stuck in.  It may be a situation in which you are ruminating and worried or one that you are fearful of and want to avoid dealing with.
  • When you encounter that situation or thoughts and feelings about that situation, don’t attempt to engage in thinking about it and, at the same time, don’t try to push your thoughts and feelings away.
  • Focus instead on noticing your experience.  You might say to yourself “I’m thinking angry thoughts about that” or “It’s painful to remember my mistake.”  Allow yourself to observe, without judging the situation, your thoughts about the situation or your feelings.

Over time, as you observe your own internal response to this situation, you will find that you no longer need to ruminate about it or push it away.  You will be able to recognize your self-judgments and criticisms of others and let them be.  The pain and the need to attach to it or push it away will pass and you will be able to let it go.

Still having trouble letting go?  In his book, Full Catastrophe LivingJon Kabat-Zinn suggests that when something has a strong hold on your mind, try to direct your attention to what “holding on” feels like.  Become an expert in understanding your own attachment to this worry or problem.  Even when you are struggling to let go, you can become skilled at understanding yourself and the consequences of both holding on and letting go.

You can find more strategies to improve how you feel in my new book, The Stress Response and by clicking here to sign up for more of my tips and here for podcasts using DBT strategies to improve how you feel.

 

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