Staying Resilient Through Troubled Times

Every so often, life takes a swing at you, connects, and knocks you flat: Your company hires you a new boss, a guy so young you could be his mom. Instead of finding yourself on a plane to Spain for a long-planned holiday, you’re spending your vacation money paying the bills for an unexpected illness.

When these things happen—and happen they do—it’s hard to imagine ever coming out the other side.

But you can bounce back. (Yes, even if you’re still reeling from, say, discovering that your husband who claimed to be “hiking the Appalachian Trail” was off canoodling with a gorgeous Argentinian woman.)

You don’t need to pen a best-selling tell-all and commune with Oprah to get it out of your system, à la Jenny Sanford, nor do you have to be able to envision a future filled with sunshine and lollipops like the impossibly perky few who seem to be born with the resilience gene. But you can get to a place where you’re enjoying a few good laughs and happier moments—in short order, for that matter.

It’s true that some people are born with easygoing temperaments that make it easier to bounce back from life-shaking events, but even those who are thrown by upheavals can learn how to ratchet up their resilience skills, says Karen Reivich, PhD, a psychologist and co-director of the Penn Resiliency Project at the University of Pennsylvania. “There are many aspects of resilience that can be taught,” she says.

The next time you’re watching your luck circle the drain, try these seven steps to get through it and move on to a new chapter of your life.

1. Get pissed off
Being resilient doesn’t mean you have to smile serenely like a Stepford Wife. “It’s critical to acknowledge to yourself whatever emotions you’re going through, and share them with other people who can support you and help you keep perspective,” says Mary Alvord, PhD, a psychologist in Maryland and a public-education coordinator for the American Psychological Association, who also confirms that holding in emotions is bad for your health. So go ahead and rage and curse until you start to feel better.

2. Quit catastrophizing
After a few days or weeks (depending on the scope of your crisis), that initial wave of emotions will start to feel a little less apocalyptic. That’s the time to take a new look at the situation. “We spend a lot of mental energy making problems much bigger than they really are,” Reivich says. The loss of a job can morph into thoughts of I’m going to live on the streets.

“When you hear that voice in your head, label it as the worst-case scenario,” she says. Then write it down along with the best-possible scenario—I’ll help an old lady across the street, and she’ll leave me her estate in her will. Finally, put down the most-likely scenario—I’ll tighten my belt while I find a new job. “As you write things down, you can feel your anxiety start to lessen,” Reivich says.

3. Assemble your pit crew
You know those friends who love to snipe about how bosses suck and husbands don’t appreciate you? Don’t call them. They will keep you stuck at Step 1. Relationships can only buoy you through bad times if they’re based on positive traits, says David Palmiter, PhD, a professor of clinical psychology at Marywood University. Make a list of the friends who listen without reinforcing negative feelings and who root for you to succeed. Then meet for lunch or a jog so you can soak in their advice.

4. Make your what-I’ve-got list
Though it may be hard to feel thankful right now, there is always something to be grateful for. Studies have shown that keeping a gratitude journal makes you feel more optimistic, the cornerstone of resilience. Grab a notepad and list the good stuff that you have in your life, from the big-picture (your children, your health) to the small (the flowers that bloomed on your terrace this morning, the Thai restaurant that gives you extra spring rolls).

While you’re at it, make a list of your own best qualities, Reivich suggests. Do you have a great sense of humor? Skill in the kitchen? “When you take time to think about what you do best, you can more easily access those strengths when you’re facing a challenge,” she says.

5. Plan your strategy
The key to resiliency is to spend less energy on what you can’t change and more on things you can be proactive about, Alvord says. If your child has been diagnosed with a learning disorder, instead of wondering Why him?, take the skills you listed in Step 4 and work on the things you can control—finding a top-notch tutor, nurturing his talents, and letting him know how much you adore him. “Ruminating over the problem can get you stuck in a holding pattern,” Reivich says, “but focusing on solutions can help you see a way forward.”

6. Make your plan B (and C)
Once you’ve got your immediate situation under control, start thinking ahead. “If you remain flexible, a crisis can open up opportunities,” Alvord points out. Let’s say you get laid off. There may be some tough times ahead, but there will be new possibilities, too: you can spend the summer with your kids, downsize to a less-stressful life, go back to school for that degree.

7. Do good
Spreading positive karma by volunteering or just helping a neighbor will help you conquer any lingering feelings of helplessness. “Not only are you proving to yourself that you have the ability to make a difference in your life, but you are literally making the world a better place,” Palmiter says. In the end, resilience is about knowing that you have the power to adjust your plans and feel secure in your new normal. Once you have that, you’ll feel as good as you did before—if not better.

Article courtesy of Marisa Cohen for Health magazine.

The Link Between PTSD and Dementia

Older veterans with post-traumatic stress disorder may face a greater risk of developing dementia than veterans without PTSD, says a new study released today by doctors at Houston’s Veterans Affairs Medical Center.

The study, which looked at nearly 10,500 veterans age 65 and older, found that those with PTSD had twice the rate of dementia compared with non-PTSD veterans of the same age. The results are similar to a study published in June by doctors with the San Francisco Veterans Affairs Medical Center. That study found that vets 55 and older with PTSD were nearly twice as likely to develop dementia.

The anxiety disorder is caused by exposure to a terrifying or life-threatening event. Symptoms include flashbacks to troubling memories and emotional problems. It occurs in about 7 percent of adult Americans, but the rates are much higher among veterans. About 30 percent of Vietnam War veterans and 12 to 20 percent of Iraq War veterans have been diagnosed with the disorder, according to the VA’s National Center for PTSD.

The question of whether PTSD may be a risk factor for dementia is still unclear, says Salah Qureshi, M.D., a psychiatrist at the Michael E. DeBakey VA Medical Center in Houston and one of the study’s authors.

“We cannot say that PTSD was a cause of dementia. What we are trying to say is that [these] vets are twice as likely to be diagnosed with dementia,” Qureshi says. He would like to see more research done on whether “identifying PTSD earlier and treating it will reduce these rates.”

The study also found a greater rate of dementia among veterans with PTSD who had returned uninjured versus those who had been injured. Of the 36 percent of veterans in the study with PTSD, 11 percent of those uninjured had dementia, compared with 7 percent of those with injuries. Veterans without PTSD had much lower dementia rates—4.5 percent of those uninjured and 5.9 percent injured.

Although there’s still no clear link between the anxiety disorder and dementia, the authors of the Houston study suggest that veterans with PTSD “should be screened more closely for dementia. Because PTSD is so common in veterans, this association has important implications for veteran care.”

The study was published in the September issue of the Journal of the American Geriatrics Society.

Article courtesy of Candy Sagon for AARP Bulletin.

Mental health care is important, especially as we age–would you seek treatment, or encourage a loved one to seek treatment, if you or a loved one experienced symptoms of a mental health disorder?

Can a Tax on Alcohol Reduce Disease?

Alcohol abuse is the third leading cause of preventable death in the U.S., and it contributes to countless diseases, car crashes, injuries, and crimes. How can we solve these thorny problems? Making booze more expensive might be a good start, a new study suggests.

Doubling the current state taxes on alcohol—which would tack on as much as 50 cents to the price of the average six-pack or bottle of wine—could be expected to reduce alcohol-related deaths by 35%, fatal car crashes by 11%, and the rates of sexually transmitted disease by 6%, according to the study. Higher taxes on booze would also lead to 2% less violence and 1.4% less crime, the researchers estimate.

“What is surprising is the consistency of the effect across a broad range of health outcomes that kind of don’t have anything to do with each other,” says Alexander C. Wagenaar, PhD, the lead researcher and a professor of epidemiology and health outcomes at the University of Florida, in Gainesville.

If state alcohol taxes were doubled, the tax on a six-pack or bottle of wine would increase by anywhere from a few pennies to 50 cents, depending on the state, and the tax on a standard bottle of liquor could go up by as much as a few dollars. (If the federal tax were doubled instead, the increase would be about 30 cents for a six-pack and 20 cents for a bottle of wine.)

Though modest, these tax hikes would add up over time and may ultimately curb the heavy drinker who’s seeing his weekly alcohol budget rise, the college student stockpiling booze for a party, and even the social drinker. “Studies show that all these groups respond to price,” Wagenaar says.

Even a slight decrease in drinking could have a large impact on public health. If millions of people living in an area consumed half a drink less per week, on average, the small differences in alcohol intake—and intoxication—could lead to big drops in the area’s overall injury and death rates, Wagenaar says.

There is some evidence that raising taxes can reduce unhealthy behaviors, even for people who are addicts. Increased taxes on cigarettes and other tobacco products have been shown to reduce smoking rates and influence heavy smokers to cut back or quit.

In the new study, which was published in the American Journal of Public Health, Wagenaar and his colleagues re-analyzed data from 50 studies that investigated the link between increases in alcohol taxes and the rates of drinking-related problems including death, diseases, car crashes, STDs, violence, crime, and suicide. Most of the studies, which were conducted between 1955 and 2004, looked at alcohol tax increases in American states.

One of the studies—led by Wagenaar himself—focused on Alaska, one of the few states to have implemented substantial alcohol tax increases. The researchers found that the state’s alcohol-related deaths dipped in 1983 and 2002, immediately following tax increases. The 1983 increase, which upped the tax on a bottle of beer from four to six cents, was associated with 23 fewer deaths—a 29% drop.

Alcohol abuse has been linked to an increased risk of liver disease, heart disease, stroke, depression, and some cancers, in addition to causing the impaired judgment that leads to risky sexual behavior and drunk driving.

Sara Markowitz, PhD, an associate professor of economics at Emory University, says that even small increases in the price of alcohol are likely to result in measurable gains in public health and safety.

Some health problems are likely to respond more than others to a tax increase, depending on how closely linked they are to alcohol abuse. “The proportion of crime and suicide that are alcohol-related would be far smaller than diseases such as liver cirrhosis,” says Markowitz, who has researched alcohol taxes but was not involved in the new study.

Indeed, the only health measure in Wagenaar’s analysis that did not show a significant drop following higher alcohol taxes was suicide.

Higher taxes on alcohol could provide a much-needed source of revenue for state and local governments reeling from budget shortfalls and cost-cutting. But the willingness of elected officials to increase the tax on alcohol is questionable, says David Jernigan, PhD, an associate professor and alcohol policy expert at the Johns Hopkins School of Public Health.

Alcohol tax increases have lagged behind the inflation rate since the 1950s, which Jernigan attributes to the nation’s anti-tax climate. There have been very few federal and state alcohol tax hikes in the past several decades, he says, and states like California and Maryland that have proposed increases have faced opposition from the restaurant and beverage industries.

What’s more, a proposed tax increase during a sluggish economy would almost certainly be unpopular among drinkers, including those who limit their intake to the occasional glass of white wine and those who’d never dream of getting behind the wheel after drinking.

But boosting the tax on alcohol would be a “win-win for government” by increasing revenue and decreasing costs, Jernigan says.

In Maryland, Jernigan has estimated, a 10-cent-per-drink tax increase would save the state $214 million in healthcare costs and generate $249 million in revenues, in addition to reducing alcohol consumption by 5%.

“In terms of the analysis we did, there’s nothing that makes Maryland stand out from other states,” Jernigan says.

Article courtesy of Carina Storr for Health.com.

What do you think? Would you drink less if alcohol became more expensive?

Braised Balsamic Chicken

It’s that time of year again here in the Pacific Northwest–the clouds are gray and nearly constant, the rain mostly drizzles and occasionally drenches, and we retreat to the warmth of our kitchens. Hearty foods, the kind you can make in a loaf pan or a crockpot, are a favorite for fall’s seasonal recipes. Today’s recipe comes to us courtesy of Allrecipes.com, which is a great resource for heart-healthy cooking that’s tasty and simple.

Ingredients

6 skinless, boneless chicken breast halves
ground black pepper to taste
1 teaspoon garlic salt
2 tablespoons olive oil
1 onion, thinly sliced
1/2 cup balsamic vinegar
1 (14.5 ounce) can diced tomatoes
1 teaspoon dried basil
1 teaspoon dried oregano
1 teaspoon dried rosemary
1/2 teaspoon dried thyme

Directions

1. Season chicken breasts with ground black pepper and garlic salt. Heat olive oil in a medium skillet, and brown the onion and seasoned chicken breasts.

2. Pour tomatoes and balsamic vinegar over chicken, and season with basil, oregano, rosemary and thyme. Simmer until chicken is no longer pink and the juices run clear, about 15 minutes.

Get the Best Sleep Ever

You’ve done all the obvious stuff—cut out late-night caffeine, made sure your bedroom is dark and cozy, avoided scary movies or struggling with your to-do list right before bed. So why are you still tossing and turning? “Certain habits you’re unaware of could be sabotaging your sleep,” says Kristen L. Knutson, PhD, assistant professor and sleep specialist at the University of Chicago’s Department of Medicine.

And, as you may know, lack of shut-eye doesn’t just leave you foggy the next day: Chronic, long-term insufficient sleep ups your odds of diabetes, depression, cardiovascular disease, even weight gain. So what to do? Try these unexpected tweaks, and wake up feeling incredibly well-rested.

It’s a no-brainer that drinking coffee or tea right before you hit the sack won’t do you any sleep favors. But you also need to watch your afternoon drinks, says Joan Salge Blake, RD, a clinical associate professor at Boston University. Love your 4 p.m. peach tea? It’s got caffeine, and so do some flavored waters and even orange sodas, Blake warns. Check the labels on your favorite midday drinks—any that boast energy-boosting benefits are likely culprits. Then, if possible, stop sipping them by 2 p.m., so there’s time for their effects to wear off. Naturally, coffee drinks pack a real wallop, so stay away from them after lunch.

Even though a nightcap may help you relax and fall asleep faster, it’ll make the second half of your sleep cycle restless and unsatisfying. Alcohol decreases deep sleep and increases arousals from sleep, says John E. Brown, MD, an assistant professor of medicine at the University of Maryland. If you like a glass of wine in the evening, have it with dinner—around 6 p.m. rather than 11—and drink in moderation, so it’ll wear off by the time you lie down.

Like to unwind in the tub before you snooze? Surprisingly, a hot bath might make it harder for you to drift off: Doing anything that raises your body temperature too close to bedtime may actually hinder you from falling asleep, because your body needs to cool to a certain temperature in order to reach a sound slumber, says J. Todd Arnedt, PhD, director of the University of Michigan Behavioral Sleep Medicine Program. That doesn’t mean you can’t soak after a rough day—when you get home from work, not right before turning in.

Getting in a little gentle, restorative yoga before you hit the sack can help put your mind at ease, steady your breath, and reduce muscle tension without revving up your heart.

Try this restful Reclined Butterfly pose from Tanya Boulton, managing teacher at Pure Yoga East in New York City:

Lie on your back with the soles of your feet together and your knees bent and dropping toward the floor. Place your arms, palms up, by your sides, keeping your shoulders back and your chest open. Close your eyes and inhale through your nose while slowly counting to four, then exhale while counting back down to one. Continue for 10 minutes, or as long as it takes you to feel fully relaxed.

Keeping your room dark while you sleep is a great start, but bringing the lights down before bed is also important. “Bright light too close to bedtime can make it hard to fall asleep,” Arnedt says. That’s because dimness signals the biological clock that it’s time to wind down, while bright light says “daytime!” Swap out überbright bedroom bulbs for low-watt ones, or install a dimmer switch and keep it low. Like to read in bed? Do it in the lowest light that’s still comfortable.

Need to send out one last e-mail before you “officially” turn in? Not so fast. Typing in bed can wind you up, so when you do unplug, it will be harder to fall asleep, Knutson says. “It’s possible that even the vibration of a BlackBerry could disturb sleep if a person is cued to hear or respond to it,” she says.

For tech-free zzz’s, disconnect an hour before bed, turn your smartphone off, and put any gadgets on an out-of-reach dresser or in another room so you won’t be able to grab it if you get the late-night urge. Also, invest in a real alarm clock (using your cell will only give you another excuse to keep it close)—and get ready to wake up feeling so refreshed that you won’t even need to press snooze.

Article courtesy of Leslie Barrie for Health.com. Edited for length.

Working Out With Diabetes

Exercise is safe—and highly recommended—for most people with type 2 diabetes, including those with complications. Along with diet and medication, exercise will help you lower blood sugar and lose weight.

However, the prospect of diving into a workout routine may be intimidating. If you’re like many newly diagnosed type 2 diabetics, you may not have exercised in years.

If that’s the case, don’t worry: It’s fine to start slow and work up. These tips will help you ease back into exercise and find a workout plan that works for you.

Try quick workouts

As long as you’re totaling 30 minutes of exercise each day, several brief workouts are fine, says George Griffing, MD, professor of endocrinology at the Saint Louis University School of Medicine in St. Louis.

“We need people with diabetes up and moving,” Dr. Griffing says. “If you can do your exercise in one 30 minute stretch, fine. But if not, break it up into increments you can manage that add up to at least 30 minutes each day.”

Focus on overall activity

Increase activity in general—such as walking or climbing stairs—rather than a particular type of exercise.

However, don’t rely on housework or other daily activity as your sole exercise. Too often, people overestimate the amount of exercise they get and underestimate the amount of calories they consume. (A step-counting pedometer can help.)

Get a pedometer

Stanford University researchers conducted a review of 26 studies looking at the use of pedometers as motivation for physical activity. Published in 2007, the review found that people who used a pedometer increased their activity by 27%.

Having a goal of 10,000 steps a day (about five miles) was important, even if the goal wasn’t reached. Pedometer users lost more weight, had a greater drop in blood pressure, and walked about 2,500 steps more per day than those who didn’t use a pedometer.

Work out with a friend

Working out with friends can be an important motivator, particularly for people over 60, according to Vicki Conn, PhD, the associate dean for research at the University of Missouri in Columbia, Mo., who has studied diabetes and exercise.

Having a friend call or setting up an exercise “contract” with a buddy may help. “One of the things we found with our meta-analysis is that behavioral strategies work better; that means setting up some sort of stimulus in the environment where you exercise,” says Conn.

Set specific, attainable goals

For example, you might set a goal of walking 10 minutes every Monday, Wednesday, and Saturday.

“That doesn’t sound like a lot, but…setting up very specific goals like that helps people a lot more than telling people, ‘Gee, you’ve got to exercise more,’ ” says Conn.

Write it all down

Write down your goals, be specific, and keep a record every time you do exercise, says Conn.

Record on your calendar every day whether you exercised for 10 or 15 minutes or more.

Join a class

A class is good because there is an exercise leader and someone to call for emergency help, if necessary, says Conn.

“There is a structured experience exercising and they will learn how their body will react and then they will grow more confident to go out and exercise on their own,” she says.

Don’t set goals too high

“It’s much better to set a lower goal and be successful at it,” says Conn. “That increases one’s sense of confidence. Then you can set a slightly higher goal the next time. You are much more likely to be successful if you start with small, easily attainable goals and gradually increase them.”

Look at the big picture

Working up to a moderate amount of exercise quickly isn’t that important in terms of your health.

“What really matters is next year, you are doing it all the time,” says Conn. “Getting there eventually in a way that you are able to stay with it is what is important because it is long-term behavior change that has health consequences.”

Change one behavior at a time

You’re more likely to be successful if you focus on changing one behavior at a time, rather than everything at once (like taking medication, checking your feet, switching your diet, and exercising).

“What we found—and this is across many studies with thousands of people—if the study focuses only on changing one behavior, namely exercise, they get twice as much of an improvement in their hemoglobin A1C,” says Conn.

Article courtesy of Health.com, edited for length.

Statins May Protect Your Joints, Too

Statins, lauded for their ability to lower cholesterol and prevent heart attacks and strokes, may also reduce the risk of developing rheumatoid arthritis, Israeli researchers report.

“We found that statin users who purchased their medication persistently were less likely to develop rheumatoid arthritis over a long follow-up period,” said lead researcher Gabriel Chodick, from Maccabi Healthcare Services in Tel Aviv.

For example, compared with patients who took statins less than 20 percent of the time, patients who took statins for 40 percent to 59 percent of the time had a 23 percent lower risk of developing rheumatoid arthritis, he said.

“Patients who were covered for more than 80 percent of the time, had a 40 percent lower risk of developing rheumatoid arthritis,” Chodick said. “The effect was stronger in younger patients and in patients using more effective statins.”

The report was published online Sept. 7 in PLoS Medicine. For the study, Chodick’s team collected data on 1.8 million patients who got their health care through the Maccabi Healthcare Services, an HMO in Israel.

The researchers looked for connections between statin use and the development of both rheumatoid arthritis and osteoarthritis, a degenerative joint disease that is unlikely to be affected by statins, the researchers noted.

Over nine years of follow-up, 2,578 people developed rheumatoid arthritis and 17,878 developed osteoarthritis.

When Chodick’s group looked at statin use, they found that those not taking statins had a 51 percent higher risk of developing rheumatoid arthritis over about 80 percent of the follow-up period. After looking for other possibilities, those who took statins regularly had a 41 percent lower risk of developing rheumatoid arthritis compared with people who were not taking statins regularly.

Among those taking statins, there was only a small, short-term reduction in risk of development of osteoarthritis.

“Although the study does not have immediate clinical implications, our findings may suggest that patients who were prescribed statins and take it persistently may benefit from the many effects of statins, which go far beyond cholesterol reduction, including the reduction of rheumatoid arthritis risk,” Chodick said.

A previous study on the same group indicated that persistent use of statins was associated with substantially lower all-cause mortality, which could not be explained only by the prevention of cardiovascular disease, he said.

“We believe that a major part of the improved survival among statin users comes from the anti-inflammatory effects demonstrated by lower risk of rheumatoid arthritis. Unfortunately, our previous study indicated that, despite their benefits, many patients on statins discontinue their treatment,” Chodick said. This work received no outside or corporate funding, the researchers noted.

Dr. Robert Myerburg, a professor of medicine and physiology at the University of Miami Miller School of Medicine, stressed that “this is a study looking for an association, and it doesn’t prove that starting statins early in life will prevent or delay the onset of rheumatoid arthritis.”

The only way to prove the connection is with a clinical trial, Myerburg said. “At this point, I would not use a statin for that [prevention of rheumatoid arthritis] indication,” he said.

Article courtesy of Steven Reinberg for HealthyDay.