Tag Archives: mental-health

Straight, No Chaser: Healthy, Sustainable Weight Loss – Let’s Get Started

February 3, 2016Diet and Nutrition, General Health and Wellness844-SMA-TALK, Behind the Curtain, BMI, Body mass index, health, heart health, mental-health, Mexico, Obesity, Overweight, overweight and obesity, physical attractiveness, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Weight ManagementJeffrey Sterling, MD

How to Lose Weight, and What is Healthy Weight Loss (AKA, How Much, How Soon and How)?
Let’s start with the How. Commercial voice: “You should contact your physician before starting any weight loss routine”. We ended things on the last post talking about the caloric balance equation, which (simplified) means you need to get off your derriere, and close your mouth. Without getting too technical, to lose weight, 1 pound equals 3,500 calories, so your net caloric intake must be cut by at least 500 calories per day to lose a pound a week. Here are some Quick Tips to cut calories (and I will not be discussing any of the popular diets or medical remedies (with one exception in the next post); you can see your physician or nutritionist about those. Besides, guess what? Most of you don’t need a fad diet. Keep it simple. And…more importantly, you should be more concerned with healthy regimens that help you keep the weight off, not drastic efforts that have proven to have quick short-term but unsustainable long-term outcomes).

1) Work out: If you can sprint, do so. If you can’t, jog. If you can’t jog, walk. I like working out while watching sports, because my heart’s pumping anyway. Weight training at the same time is even better. Once you hit a good exercise regimen, your metabolism will improve, making weight loss that much easier. By the way, the next post is on metabolism; stay tuned.
2) Hungry? Start counting calories. Use this standard to determine what your daily calorie intake should be. Meal plan so you don’t exceed that level. Remember the caloric equation to lose weight: Amount expended minus the amount eaten should be 500 calories a day. In the next post, I’ll give you a Quick Tip for an extra 400 calories a day you can lose.

3) Still hungry? Try brushing your teeth. Don’t laugh. It actually works. And it gives you nice teeth. Otherwise try drinking water or chewing calorie-free gum. All these are nice, simple inexpensive appetite suppressants.
How Soon? It’s natural for anyone trying to lose weight to want to lose it very quickly. But evidence shows that people who lose weight gradually and steadily (about 1-2 pounds per week) are more successful at keeping weight off. Healthy weight loss isn’t just about a “diet” or “program”. It’s about an ongoing lifestyle that includes long-term changes in daily eating and exercise habits. Think health instead of weight, and the weight will improve.

How Much? If you were my patient (but you’re not!), I’d tell you to forget about ideal body weight and BMI – for now. Focus on a modest weight loss, like 5-10% of your current weight. Even this success will improve your blood pressure, cholesterol and blood sugar levels. Once you accomplish that goal, do it again. So even if the overall goal seems large, see it as a journey rather than just a final destination. Seek to learn new eating and physical activity habits that will help you live a healthier lifestyle. These habits may help you maintain your weight loss over time. To that end, I love healthy challenges. Try a 30-day water instead of pop (soda)/coffee, etc. challenge, or even better, give yourself a 30-day ‘fruit for dessert challenge’ or ‘salad of your choice for lunch’ challenge. When that’s done, immediately do it again. Learn to integrate healthy habits into your quest to lose weight, and you’ll increase the odds of having sustainable weight lost. At the end of the day, it’s been well established that those who maintained a significant weight loss report improvements in not only their physical health, but also their energy levels, physical mobility, general mood, and self-confidence. Good luck, and check back for the next post on how to fine-tune your metabolism!

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: The Adverse Health Effects of Obesity and Why You Gain Weight

February 1, 2016General Health and Wellness, Health Prevention844-SMA-TALK, Behind the Curtain, BMI, Body mass index, health, heart health, mental-health, Mexico, Obesity, Overweight, overweight and obesity, physical attractiveness, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Weight ManagementJeffrey Sterling, MD

Earlier, we identified the differences between a ‘normal’ weight and being overweight and/or obese. Today’s goal is to help you understand specific risks of carrying extra weight. We’ll also set the table for losing weight by discussing why weight gain occurs. It bears repeating that none of this has anything to do with the perception of one’s physical attractiveness.
Let’s focus on three considerations.
1. What are the health risks?

As body weight increases, so does the risk for several different medical conditions and illnesses, including the following:
• Arthritis
• Cancers (breast, endometrial, and colon)
• Diabetes
• Gynecological problems (abnormal periods, infertility)
• Heart disease (heart attacks, heart failure, hardening of the arteries)
• High cholesterol
• Liver and gallbladder disease (gallstones)
• Sleep apnea and other respiratory problems
• Stroke
In the event that these risks are just words on a page, learning a little bit about some of them might provide the motivation needed to avoid them.
2. What is a realistic goal for weight loss? What’s the balance between family predisposition and the foods I eat?

No matter what I tell you today, it’s unlikely to turn you into a supermodel. The goal (independent of your consultation with your own health care provider) is to get you to optimize your situation based on the things you can control. Yes, genetic factors do play a role in obesity, but beyond that you are more than able to close your mouth and get off your…couch. You are able to limit your fat and caloric intake and put down the salt shaker. Yes, genetics count, but behavior and environmental (culture, socioeconomic status) consideration play at least as much of a role. These latter considerations can even jumpstart your metabolism beyond your genetic predisposition.
3. Why do I gain weight if I’m still active?

The most simple way to answer this is that weight gain occurs from an energy imbalance. You’re taking in too many calories, and/or you’re not engaging in enough physical activity. It’s an equation, and the weight gain occurs when you’re on the wrong side of the equation. It’s not much more complicated than this. Either do less of the eating, more of the activity, or both. I mentioned in a previous post on caloric counting that you must have an excess of 500 more calories expended than you ingest daily every day for a week just to lose one pound. It takes work. This is the simple answer as to why fad diets don’t work long-term. You can’t cheat the equation. The moment you stop being diligent, you’re headed in the wrong direction. Your weight loss plan must include lifestyle changes for the long-term.
In the next post, we’ll identify some very simple methods to combat obesity based on the information provided to this point. Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight No Chaser: Examining Obesity – Is It Really a Choice Between Health and Happiness

Obesity in the United States places many at a crossroad between self-esteem and health. Often, larger frames are celebrated as more desirable. Other times, they are celebrated because we must learn to ‘love ourselves’, which is seemingly easier than laboring to diet and exercise. Of course, our culture embraces and contributes to obesity. Consider the ramifications of “As American as Apple Pie” or “Coke Adds Life” or the size of our favorite athletes in our most popular sport. Tomorrow we’ll discuss the calorie counts of soft drinks and desserts and their contributions to obesity. At the end of the day, we now have a culture that views what’s physiologically most healthy for our hearts as visually less desirable and a culture where one can ‘reasonably’ (i.e. based on evolved cultural norms) make the decision that having a permissive attitude toward obesity is a more desirable state of being than the pursuit of health.
Odds are, you’re overweight. It was a both a joke and a cause for celebration that Mexico just overtook the US as this hemisphere’s fattest country, but it did bring attention to the fact that more than one-third of U.S. adults (35.7%) are obese, and nearly two-thirds are overweight. Over the next three days, we’ll review various components of obesity that affect your health. To be clear, this is not about your perceived physical attractiveness (and while we’re at it, just because you’re slim, that doesn’t mean you’re anorexic). It’s about your health. If you’re sensitive about your size or have made an educated decision to ‘love yourself as you are’, you don’t have to read through this. If you’re at all interested in how your body is affected by weight, and if you can handle a little truth, proceed. As always, the goal is to educate and stimulate thought, discussion and action.
Let’s start today with making it clear what obesity is and who’s obese. Be reminded the heart is only a pump meant to move blood around the body, carrying oxygen and nutrients to cells in different parts of the body. The heavier you are, the more work your heart has to do and the more likely it becomes that this pump will not function ideally and will functionally ‘give out’ over time. It is this functional failure that produces many diseases.

Let’s start with Ideal Body Weight (IBW). For humans (not ‘Northerners’ or the ‘Small-Boned’ or the ‘Non-Athlete’ or ‘Women Who Haven’t Had Children’), the formula for calculating IBW is as follows:

Women: 100 lbs for the first 5 feet, then 5 lbs. for each additional inch.
Men: 100 lbs for the first 5 feet, then 6 lbs. for each additional inch.

Ideal body weight refers to health, especially heart health, not ‘grown and sexy’ or any other concocted notion of what looks good. So as an example, if you’re a 6 ft tall male, your IBW is 172 lbs. If you’re a female and 5’5”, your IBW is 125. Now before those of you ‘in the know’ tell me there are limitations to IBW and BMI considerations, I’ll stipulate the point and note that doesn’t change the point of this conversation one bit.

‘Overweight’ and ‘Obesity’ are about your risks for disease. We’ll talk about those risks tomorrow, but here are the definitions of each.

Being Overweight is defined as a body mass index (BMI) of 25 or higher; Obesity is defined as a BMI of 30 or higher. BMI gives you an indication if you’re over/underweight or at a healthy weight for your height.
If you’re interested in your BMI, use the following calculator:
http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm
Let’s talk about it. This is important for your health and longevity.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Suicide Data – Understand the Threat

November 30, 2015Mental Health, Public Health844-SMA-TALK, Behind the Curtain, Bipolar disorder, Death, Disorders, Gia Allemand, health, List of causes of death by rate, Major depressive disorder, mental-health, Molecular Psychiatry, Religion, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Suicidal ideation, Suicide, Suicide preventionJeffrey Sterling, MD

There are amazing, shocking and saddening facts about suicide. It is equally amazing that we aren’t discussing this as an epidemic. Consider the following information provided by the Centers for Disease Control and Prevention:
There were an average of 105 suicides a day in the U.S. (over 38,000 for 2010).
An estimated 8.3 million adults reported having suicidal thoughts in the past year.
Suicide is the third leading cause of death among those aged 15-24, the second among those aged 25-34, the fourth among those aged 35-54, and the eighth among persons aged 55-64.
For those committing suicide:

33.3% tested positive for alcohol.
23% tested positive for antidepressants.
20.8% tested positive for opiates (such as heroin and prescription pain killers).
There is one suicide for every 25 attempts.

Females are more likely than males to have had suicidal thoughts, but suicide among males is four times higher than among females (in other words, females think about it and try more often, but males complete the act more often.).
Among Native Americans aged 15-34, suicide is the second leading cause of death, fully 2.5 times higher than the national average.

There are some topics that aren’t amenable to Blogs. Depression and suicide are among them. They can’t be done justice. What I can try to do is break components of the conversation into bite size pieces and give you information to work with. I’ll do this in three parts. Above, I’ve shown you the magnitude of suicide. In the next post, I will help you understand what clinical depression looks like, then finally, I’ll review some Quick Tips to help you prevent falling into the deepest levels of depression and to help you know when immediate attention is required. Just remember: this isn’t the type of depression that involves having a bad day. I’m talking about when your downward mood interferes with your activities of daily living. I’m describing depression that introduces suicide and homicide as an option. If you don’t read these for yourself, read them for knowledge. Someone you know may be affected.
I welcome any questions, comments or thoughts.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Straight, No Chaser In The News: Murders in Virginia, Depression and Violence

August 27, 2015Mental Health, Trauma844-SMA-TALK, Behind the Curtain, Depression, mental-health, murder, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, SuicideJeffrey Sterling, MD

In the news are the horrific live, on-air murders of a television personality and a cameraman. This brings up the relationship between mental health, depression, violent crimes and suicide. Let’s review a few facts on the topic.

The number of clinically depressed individuals involved in a violent crime is actually small (3.7% of men and 0.5% of women in a recently published study).
That said, the number of clinically depressed individuals involved in a violent crime is above average. Studies have found that the depressed are up to three times more likely to be convicted of a violent crime (1.2% of men and 0.2% of women in the general population).

How can these findings be explained? There are two pretty important considerations.

Depression itself is associated with apathy, guilt, hopelessness and sadness. These are human conditions that can lead one to take actions that would normally not be done and also to do them in a way that wouldn’t normally be done (e.g. more recklessly). Violence certainly is included in the scope of actions such individuals consider under these circumstances.
The percentages noted above relate to associations and are not meant to imply that depression causes violence. There is a difference between rates of performing crimes, getting caught performing crimes and getting convicted performing crimes. There are multiple associations found in those more likely to be diagnosed as clinically depressed (e.g. poverty and other components of a lower socioeconomic status) that independently render one less likely to perform well in the criminal justice system.

So what is the relevance of these facts in the current setting?
Let’s stop pretending it’s not the case that certain conditions exist that amount to a powder keg. Feelings of hopelessness and helplessness in the setting of either mental illness or other conditions (e.g. extreme poverty) explain many actions and societal ills. The better course of action (other than heartfelt mourning) is to be proactive and address conditions that produce these outcomes. It is not sufficient to explain away these conditions by ascribing them to poor mental health. Our societies must better appreciate that in many instances, “poor mental health” is a result of our environment and life circumstances, and are not simply a genetically imposed state of being. Let’s provide better support to those easily identified as being in need, and let’s better combat societal ills that have clearly been identified as risk enhancers for depression, other mental illness and violent crimes.
We offer condolences to all affected in this and many other similar tragedies.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Suicide and Suicide Risks in College Students

July 28, 2015General Health and Wellness844-SMA-TALK, Behind the Curtain, Bipolar disorder, Death, Disorders, Gia Allemand, health, List of causes of death by rate, Major depressive disorder, mental-health, Molecular Psychiatry, Religion, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Suicidal ideation, Suicide, Suicide preventionJeffrey Sterling, MD

I just had the privilege of spending time at my alma mater addressing issues on behalf of students and mental health services. Among many other things discussed, I was shocked by the extent to which college suicides have become present on college campuses. I wonder when things changed. Isn’t college supposed to be the “best four years of your life?” It really doesn’t take much though to appreciate how this becomes the case.

Suicide is the second leading cause of death among college-age students in the United States and the third leading cause among those aged 15-24. There are approximately 1,100 deaths by suicide occurring in this age group each year. A recent study from Johns Hopkins and the University of Maryland went in-depth in surveying and analyzing why students may have thoughts on suicide. Here is a summary of some of the study’s findings:

12% of those studied admitted that they had thought of committing suicide.
Of this group of 12%, approximately 25% of them said they had those thoughts repeatedly.
Depression and lack of social support appeared to be major factors contributing to thoughts of suicide.

If you actually think about it, college brings together a lot of risks for suicide.

Late adolescence and early adulthood represents the period of highest risk of developing a major psychiatric disorder.
The academic environment can be a stress-producing inferno for some, who may find themselves overwhelmed and feeling lost and as if they have nowhere to turn.
For many, the college experience represents the first time many are away from home and/or completely detached from the family and friends they’ve had their entire lives. Unless and until a sufficient new social network is established, levels of isolation can be overwhelming.
Even among those with social networks, the academic failure and any social rejection that may occur could be perceived by students as having life-long consequences, so much so that hopelessness and thoughts of suicide could set into a young adult’s mind.

Practically, how might you consider the risk in any one individual? The presence of any of these risk factors should prompt implementation of a support system to counter feelings of suicide.

It shouldn’t be difficult to appreciate how the lack of social support is one of the most powerful predictors of persistent suicidal thoughts. Someone who expresses or has feelings of being unappreciated, unloved and uninvolved with family and friends should be considered at risk – even in the absence of any other risk factors.
A history of clinically diagnosed depression or other psychiatric diagnoses
The exposure to domestic violence (either witnessing or having been abused) in childhood
Having a mother with a history of clinical depression

There are many Straight, No Chaser posts that address suicide prevention, diagnosis and treatment. Feel free to use the search box on the right for additional information.If you are a college student or a family member of a college student, you would do well to review your college’s support system and learn about services and support available for those in need of mental/behavioral health services. College should represent the beginning of one’s adult life, not the place where it ends.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Straight, No Chaser: Mass Trauma, Community Stress and Post-Traumatic Stress Disorder

May 7, 2015General Health and WellnessCognitive behavioral therapy, health, mental-health, Post-Traumatic Stress Disorder, Posttraumatic stress disorder, PTSD, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Symptom, TraumaJeffrey Sterling, MD

If you’ve been following the Straight, No Chaser series on post-traumatic stress disorder, it may have occurred to you that episodes that some might be able to handle when taken in isolation can have dramatically different psychological effects on others. It gives one pause and a cause to reflect on recent episodes in the news locally and abroad through a different prism.
This is the fourth in a series on Post-Traumatic Stress Disorder (PTSD).

For an introduction to PTSD, including signs, symptoms and those at risk, click here.
For a discussion of the diagnosis and treatment of PTSD, click here.
For a discussion of the effects of PTSD in children, click here.

When entire communities are affected by a mass trauma such as a natural disaster, a terrorist attack, the effects of war or even a seemingly senseless death within the community, many can develop signs of post-traumatic stress disorder (PTSD). In these instances, symptoms tend to develop in the first few weeks after the episode. This is a normal, expected and shared community response to serious trauma. Fortunately, when communities suffer trauma, resources are more likely to become readily available, which allows many to experience a lessening of symptoms over time.
In the immediate timeframe of the event, vital measures for physical and mental wellbeing should include the following.

Getting medically evaluated and to a safe place
Securing food and water
Contacting loved ones or friends
Learning what is being done to help and either provide or receive help as needed

Unfortunately, some individuals just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid.” This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
At the end of it all, disasters are just that. It would be a good thing for you and your family to be aware of the types of community disasters you may be exposed to and prepare before you ever need help. Having emergency numbers and other resources on your person at all times can be the difference between life and death when seconds count. Here’s hoping you either never need such assistance or you’re prepared enough during a disaster to make it through ok.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC

Straight, No Chaser: The Effects of PTSD on Children

May 6, 2015Mental Health, Pediatrics/Kids HealthFacebook, health, mental-health, Posttraumatic stress disorder, Psychological trauma, PTSD, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Twitter, WordPressJeffrey Sterling, MD

This is part of a series on post-traumatic stress disorder (PTSD).

For a review of PTSD signs, symptoms and those at risk, click here.
For a review of PTSD diagnosis and treatment, click here.

Children are exposed to the same stimuli that creates post-traumatic stress disorder (PTSD), including physical abuse, sexual assault and the effects of war, but they may have different responses and symptoms than adults. Symptoms unique to children typically involve developmental regression and may include the following:

Clinginess
Bedwetting
Cessation of speech
Acting out the scary event

Teens may become disruptive, disrespectful, or destructive, and they may express guilt or engage in revenge.
Think about these things when your children have been victims of bullying, abandonment or assault. You have to think about PTSD in order to recognize help may be needed. It is very important to get counseling for children that have experienced a traumatic event. The effects may be subtle but could be devastating and long-lasting.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC

Straight, No Chaser: When Eating Goes Wrong, Part I – Anorexia

February 27, 2015Diet and Nutrition, Mental HealthAnorexia nervosa, Diet, Disease, Disorders, Eating, Eating disorder, health, mental-health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Simply put, our society doesn’t do the job it should in promoting a normal image of health at either end of the spectrum. The typically promoted American ideal of beauty sets standards that lead many to pursue unrealistic means of meeting that ideal. In the setting of an actual American population that is disproportionately obese by medical standards, this becomes even more of a problem, as individuals give up on realistic goals and settle into unhealthy eating habits that lead to disease due to obesity.
Most people are aware of two eating disorders (on the low side that is; obesity is another conversation): anorexia and bulimia. It is important to note that eating disorders are real medical and mental diseases. It is equally important to understand that they can be treated. It is vitally important to understand that when left untreated these disorders lead to a much higher incidence of death than in those without these conditions. These diseases cause severe disturbances in one’s diet, so much so that individuals spiral out of control toward severe disease and death in many instances. Sufferers of eating disorders often have a distorted self-image and ongoing concerns about weight and appearance. (This is as true for those pathologically overweight and in denial as it is for those pathologically underweight.)

Today’s Straight, No Chaser discusses anorexia. Anorexia nervosa is an eating disorder with nearly a 20 times greater likelihood of death that those in the general population of a similar age. Why, you ask? Simply put, anorexics are suffering the consequences of starving themselves. Anorexics have a maniacal and relentless pursuit of thinness, even in the face of being extremely thin. They couple an unwillingness to maintain a healthy weight with an intense fear of gaining weight. They possess a distorted view of their bodies and severely restrict their eating in response. They are obsessed.
Other symptoms and habits of anorexics include a lack of menstruation (among females, though men suffer from anorexia, too), binge-eating followed by extreme dieting and excessive exercise, misuse of diuretics, laxatives, enema and diet medications. The medical manifestations of anorexia are serious and can include osteoporosis or osteopenia (bone thinning), anemia, brittle hair and nails, dry skin, infertility, chronically low blood pressure, lethargy and fatigue, and heart and brain damage. It’s worth noting again that people die from anorexia. It is a disorder to be taken seriously.
The key components of treating eating disorders in general are stopping the behavior, reducing excessive exercise and maintaining or establishing adequate nutrition. The pursuit of adequate nutrition is vital enough that when patients develop dehydration and chemical imbalances (i.e., electrolyte abnormalities), they need hospitalization to correct deficiencies.
Specific management of anorexia involves addressing the psychological issues related to the eating disorder, obtaining a healthy weight, and consuming sufficient nutrition. This may involve various forms of behavioral therapy and medication. Regarding medication use, although some (such as antipsychotics or antidepressants) have been effective in addressing issues related to anorexia such as depression and anxiety, no medication has been proven effective in reversing weight loss and promoting weight gain back to a healthy/normal level. Similarly, behavioral therapy has been shown to assist in addressing the roots causes of anorexia but insufficient in addressing the medical issues that the disease contributed to or caused. Ultimately, it appears that a combination of medications, other medical interventions and behavioral therapy is the most effective course. As is the case with most illnesses, the earlier treatment is initiated, the better the outcome tends to be.
Please maintain a sufficient sensitivity toward those with anorexia. It’s a life-threatening condition, not the punch line of a joke about someone’s appearance.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Let's Boost Your Metabolism

February 19, 2015Diet and Nutrition, General Health and WellnessBMI, Body mass index, health, heart health, mental-health, Mexico, Obesity, Overweight, overweight and obesity, physical attractiveness, United States, Weight Management, WordPressJeffrey Sterling, MD

It would be improper for me to have dragged you through the mud for three days and depressed you into thinking you can’t improve your situation. Hopefully, you’re not feeling that way. You should now have a better understanding of how the body works, how to count calories and how to compare yourself to a baseline for health. What left is giving your body a leg up on your efforts. Yep, I’m talking about boosting your metabolism. Any of you that have been with me for a while know that means I’m not promoting something you’ll find in a bottle, although there are many good supplements that can assist in that effort. I’ll refer you to your (or my) favorite personal trainer for those considerations. As always, I want to offer you the tools to be self-empowered. To that end, here’s five Quick Tips to boost your metabolism. Why five? Because five is easier to implement than six. Once you get these five down, let me know, and we can get a bit more intricate.

1. Eat smaller meals, and eat more frequently. It’s true. More meals more often is better, but only if they’re smaller. Calorie counting is still a major part of the equation. The point of more frequent meals is preventing the body from going into starvation mode, which slows your metabolism as the body attempts to conserve energy. If you do this, you’ll discover those meals are smaller and you will get closer to eat more appropriate portions than we typically do. Also, make those in-between meals healthy choices like a handful of fruits or nuts.
2. Prime your pump. Remember, it’s all about your heart’s ability to efficiently move blood around the body anyway. The healthier your heart is, the better your metabolism will be. You need aerobic exercise that increases your heart rate for 20-30 minutes at a time. Learn your target heart rate for your age, and exercise to get into that range. Your metabolism will better approximate that of a fine tuned machine rather than a sputtering old car.
3. Weight train. This is very simple. The more muscular you are, the more calories you will burn, especially relative to someone of the same weight who is obese. Not only will you become a finer calorie-burning machine, in this case you actually will look better! Add weight training to your exercise regimen.
4. Choose the fish (and not the fried variety). Fish oil contains substances called omega-3 fatty acids (EPA, DHA) which increases levels of fat-burning enzymes and decreases levels of fat storing enzymes. Daily ingestion has been shown to help by approximately 400 calories a day.
5. Enlist a personal trainer. Everyone needs help and motivation. Some of us need a lot of help and a lot of motivation. We also need expertise. There’s nothing more frustrating than working hard yet not seeing any results because you’re working incorrectly. A good trainer can put you on the path, supervise your regimen, and hold your hand through the process. The minutia of age, sex and body habitus considerations that also play a role in this can be managed by a good trainer. Your ideal trainer will have knowledge of nutrition, wellness and supplements that are tailored to your specific considerations. This will get your metabolism revved up!
By the way, if you’re into green tea, caffeine or spicy/hot peppers, enjoy them for their other benefits, but don’t expect them to contribute significantly to your efforts to improve your metabolism. At least that’s what the consensus in the medical literature points out.

Finally: yes, it’s true that metabolism naturally slows with age (starting as early as age 25); everyone has heard that fact. However, here’s what you don’t usually hear: that’s not inevitable and is more a result of your becoming less physically active than just aging. That demonstrates the need for you to be even more diligent in your efforts. Good luck, and I welcome your questions and comments.

Straight, No Chaser: Healthy, Sustainable Weight Loss – Let's Get Started

February 18, 2015Diet and Nutrition, General Health and WellnessBMI, Body mass index, health, heart health, mental-health, Mexico, Obesity, Overweight, overweight and obesity, physical attractiveness, United States, Weight Management, WordPressJeffrey Sterling, MD

Straight, No Chaser: The Adverse Health Effects of Obesity and Why You Gain Weight

February 17, 2015General Health and Wellness, Health PreventionBMI, Body mass index, health, heart health, mental-health, Mexico, Obesity, Overweight, overweight and obesity, physical attractiveness, United States, Weight Management, WordPressJeffrey Sterling, MD

The most simple way to answer this is that weight gain occurs from an energy imbalance. You’re taking in too many calories, and/or you’re not engaging in enough physical activity. It’s an equation, and the weight gain occurs when you’re on the wrong side of the equation. It’s not much more complicated than this. Either do less of the eating, more of the activity, or both. I mentioned in a previous post on caloric counts that you must have an excess of 500 more calories expended than you ingest daily every day for a week just to lose one pound. It takes work. This is the simple answer as to why fad diets don’t work long-term. You can’t cheat the equation. The moment you stop being diligent, you’re headed in the wrong direction. Your weight loss plan must include lifestyle changes for the long-term.
In the next post, we’ll identify some very simple methods to combat obesity based on the information provided to this point. Feel free to ask any questions or submit any comments you have.
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Straight No Chaser: Examining Obesity – Is It Really a Choice Between Health and Happiness

February 13, 2015General Health and WellnessBMI, Body mass index, health, heart health, mental-health, Mexico, Obesity, Overweight, overweight and obesity, physical attractiveness, United States, Weight Management, WordPressJeffrey Sterling, MD

Obesity in the United States places many at a crossroad between self-esteem and health. Often, larger frames are celebrated as more desirable. Other times, they are celebrated because we must learn to ‘love ourselves’, which is seemingly easier than laboring to diet and exercise. Of course, our culture embraces and contributes to obesity. Consider the ramifications of “As American as Apple Pie” or “Coke Adds Life” or the size of our favorite athletes in our most popular sport. I’ve previously discussed the calorie counts of soft drinks and desserts and their contributions to obesity. At the end of the day, we now have a culture that views what’s physiologically most healthy for our hearts as visually less desirable and a culture where one can ‘reasonably’ (i.e. based on evolved cultural norms) make the decision that having a permissive attitude toward obesity is a more desirable state of being than the pursuit of health.
Odds are, you’re overweight. It was a both a joke and a cause for celebration that Mexico just overtook the US as this hemisphere’s fattest country, but it did bring attention to the fact that more than one-third of U.S. adults (35.7%) are obese, and nearly two-thirds are overweight. Over the next three days, we’ll review various components of obesity that affect your health. To be clear, this is not about your perceived physical attractiveness (and while we’re at it, just because you’re slim, that doesn’t mean you’re anorexic). It’s about your health. If you’re sensitive about your size or have made an educated decision to ‘love yourself as you are’, you don’t have to read through this. If you’re at all interested in how your body is affected by weight, and if you can handle a little truth, proceed. As always, the goal is to educate and stimulate thought, discussion and action.
Let’s start today with making it clear what obesity is and who’s obese. Be reminded the heart is only a pump meant to move blood around the body, carrying oxygen and nutrients to cells in different parts of the body. The heavier you are, the more work your heart has to do and the more likely it becomes that this pump will not function ideally and will functionally ‘give out’ over time. It is this functional failure that produces many diseases.
Let’s start with Ideal Body Weight (IBW). For humans (not ‘Northerners’ or the ‘Small-Boned’ or the ‘Non-Athlete’ or ‘Women Who Haven’t Had Children’), the formula for calculating IBW is as follows:

Women: 100 lbs for the first 5 feet, then 5 lbs. for each additional inch.
Men: 100 lbs for the first 5 feet, then 6 lbs. for each additional inch.

‘Overweight’ and ‘Obesity’ are about your risks for disease. We’ll talk about those risks tomorrow, but here are the definitions of each.
Being Overweight is defined as a body mass index (BMI) of 25 or higher; Obesity is defined as a BMI of 30 or higher. BMI gives you an indication if you’re over/underweight or at a healthy weight for your height.
If you’re interested in your BMI, use the following calculator:
http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm
Let’s talk about it. This is important for your health and longevity.
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Straight, No Chaser: Sexual Deviances and Perversions (Paraphilias)

July 15, 2014Mental Health844-SMA-TALK, Conditions and Diseases, cross dressing, exhibitionism, fetishism, frotteurism, masochism, mental-health, paraphilia, pedophilia, sadism, sexual perversion, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, transvestism, voyeurismJeffrey Sterling, MD

This is a serious conversation that I won’t sensationalize or joke about. The mental health disorders known as paraphilias (commonly referred to as sexual deviancies or perversions) represent a disturbing level of dysfunction that has devastating consequences for victims. This Straight, No Chaser will provide an overview of these disorders as categorized by the Diagnostic and Statistical Manual of Mental Disorders (DSM).
First, here’s a working definition from the DSM: paraphilias involving recurrent fantasies, urges or behaviors of a sexual nature that center on children, non-humans (animals, objects or materials), or harming others or one’s self. That definition isn’t especially difficult to understand, but what is more difficult to appreciate is these deviants (and often predators) suffer from mental illness and aren’t just “bad people.” What’s especially difficult for society to reconcile is when and if treatment is more appropriate than punishment.
Here’s a list of recognized sexual deviancy disorders, which will be individually discussed in future posts. It is important to note that some of these behaviors occur in the general population in certain circumstances (e.g., between consenting adults) and only are defined as mental disorders when the activity becomes a compulsion, interfering with normal function and/or behavior.

Exhibitionism: the compulsion to display one’s sexual organs to strangers. This compulsion increases until relieved by the act of exposure.

Fetishism: the habit of having sexual energies fixated on an object. Typical objects include garments such as shoes or underwear or may involve materials such as leather or rubber. The objects of fetishes often are required to achieve orgasm.

Frotteurism: the compulsion to rub ones self against strangers others in a sexual manner. This compulsion increases until relieved by the act.

Pedophilia: the act of a sexually mature adult fantasizing about or engaging in sexual behavior with children who haven’t achieved puberty.

Sadism and Masochism: the habit of engaging in sexual encounters where the focus is on causing (sadism) or receiving (masochism) physical and emotional pain, embarrassment and humiliation.

Transvestism: (aka cross-dressing) the habit of an otherwise “normal” heterosexual male having fantasies about and/or dressing in woman’s clothing, which is usually sexually arousing.

Voyeurism: the compulsion to fantasize about and/or actually spy on an unsuspecting person in the act of undressing (aka being a “peeping tom”) as part of a person’s sexual routine.
The DSM also includes a Not-Otherwise-Specified category of paraphilias, including such actions as a chronic preoccupation with making obscene telephone calls, relating sexually to only a part of another’s body, dead people, animals, feces and urine.
Sexual perversions generate many different emotions in victims and the general public. Perhaps Job One is to be conscious of your surroundings and the situations in which you place yourself. Although in most instances you can’t control the inclinations or prevent the actions of others, you can control the choices you make that increase or decrease your risk of becoming a victim of a sexual deviant.
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Straight, No Chaser: Personality Disorder Screening Quiz – Now It's Your Turn!

It’s been an interesting week of responses from you on the series of personality disorders. The most common comment was a request for an ability to test oneself. I’ll provide that information to you, but beforehand, here are the links to the other Straight No Chaser posts on personality disorders.

Introduction: Understanding Personality Disorders
Cluster A: Paranoid, Schizoid and Schizotypal Personality Disorders
Cluster B: Narcissistic, Histrionic, Antisocial and Borderline Personality Disorders
Cluster C: Obsessive-Compulsive, Avoidant and Dependent Personality Disorders

We need a disclaimer here. The link to this personality quiz states pretty clearly that it’s for entertainment purposes only. The results will provide you with a trend, not a diagnosis. It’s a good way to reinforce the information from the previous posts and to learn a little bit more about yourself. In case you were wondering, I scored Doctor Personality Disorder.

Here’s the link to the quiz:

http://www.helloquizzy.com/tests/the-personality-disorder-test-5

I welcome any feedback or questions you have about the topic or the quiz. I think it’s safe to say that most of you should have fun with this quiz.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: The Intersection of Health and Happiness, aka Merry Christmas!

December 25, 2013Mental HealthChristmas, Facebook, Hanukkah, Happiness, Harvard School of Public Health, health, mental-health, Merry Christmas, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, WordPressJeffrey Sterling, MD

Today is Christmas, and we want to celebrate the best parts of you! Even better, do that for yourself and allow that to translate into better health. We have previously discussed your bad habits and how they negatively impact your health. Click here for that discussion. The literature on negative energy and health is well documented and robust. In short, avoid negativity and those that bring it to you! That said, we’re following our own advice and going positive today. That’s the other half of the “health and emotions” equation:

STATE OF MIND = STATE OF BODY.

So here we go.

Research from the Harvard School of Public Health (Go, Crimson!) led by Laura Kubzansky, Associate Profession of Society, Human Development and Health, identified personal attributes that actually do translate into better health. Specifically these personality traits have been shown to help avoid or healthfully manage depression, diabetes, heart attacks, strokes and other diseases.
Her landmark 2007 study followed over 6,000 men and women for over 20 years, discovering that a sense of enthusiasm, hopefulness, engagement in life and the ability to face life’s stresses with emotional balance appears to reduce the risk of coronary heart disease. Her studies have also demonstrated that children with a positive outlook and ability to focus on a task at age seven are in better health with fewer illnesses 30 years later. An additional finding of hers is that optimism cuts the risk of coronary heart disease in half.
This isn’t that hard. It just requires a rewiring of some of our outlook on life. Make a change today. Become a more positive person; become a healthier person! Incorporate these mental lifestyle changes and reap the benefits.

Emotional vitality: a sense of enthusiasm, hopefulness, engagement
Optimism: the perspective that good things will happen and that one’s actions account for the good things that occur in life
Supportive networks of family and friends
Good “self-regulation,” i.e., bouncing back from stressful challenges and knowing that things will eventually look up again
Healthy behaviors such as physical activity and eating well
Avoidance of risky behaviors such as unsafe sex, drinking alcohol to excess, and regular overeating

Speaking of Christmas, the Straight, No Chaser team greatly appreciates your readership, support and feedback. In a matter of a few months, over 3,000 of you both follow us and like us on Facebook. We’ve had readers in over 105 countries around the world. Most of all you’ve helped us successfully launch www.SterlingMedicalAdvice.com (SMA). We’ll continue to give you information to make a difference in your lives. Please continue to share your stories. It is very fulfilling and fascinating to hear how these efforts have made a difference in your lives. Feel free to continue to send us topic requests. We generally find a way to work them into the schedule.

Thank you so much, Merry Christmas, Happy Hanukkah, Happy Kwanzaa, peace and blessings throughout the holiday season.

Feel free to ask your SMA expert consultant if you have any questions on this post.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Mass Trauma, Community Stress and Post-Traumatic Stress Disorder

December 9, 2013Mental Health, TraumaCognitive behavioral therapy, health, mental-health, Post-Traumatic Stress Disorder, Posttraumatic stress disorder, PTSD, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Symptom, TraumaJeffrey Sterling, MD

This is the fourth in a series on Post-Traumatic Stress Disorder (PTSD).

For an introduction to PTSD, including signs, symptoms and those at risk, click here.
For a discussion of the diagnosis and treatment of PTSD, click here.
For a discussion of the effects of PTSD in children, click here.

When entire communities are affected by a mass trauma such as a natural disaster, a terrorist attack or the effects of war, many can develop signs of post-traumatic stress disorder (PTSD). In these instances, symptoms tend to develop in the first few weeks after the episode. This is a normal, expected and shared community response to serious trauma. Fortunately, when communities suffer trauma, resources are more likely to become readily available, which allows many to experience a lessening of symptoms over time.
In the immediate timeframe of the event, vital measures should include the following.

Getting medically evaluated and to a safe place
Securing food and water
Contacting loved ones or friends
Learning what is being done to help and either provide or receive help as needed

Unfortunately, some just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid”. This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
At the end of it all, disasters are just that. It would be a good thing for you and your family to be aware of the types of community disasters you may be exposed to and prepare before you ever need help. Having emergency numbers and other resources on your person at all times can be the difference between life and death when seconds count. Click here for a related Straight, No Chaser on Mass Trauma, and here’s hoping you either never need such assistance or you’re prepared enough during a disaster to make it through ok.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Do medications work differently in older people?

December 7, 2013Geriatrics/Elderly CareDrug, Drug interaction, Drugs and Medications, health, mental-health, Old age, Pharmaceutical drug, Pharmacy, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

The elderly are living longer and more productively. Part of being able to do so is by maintaining an understanding of how your actions affect you. One common action of many of the elderly is taking medications. You should be aware that medications have changing effects with aging, and there are many different reasons for that fact.
First of all, changes in our physiology due to aging make the effects of drugs less predictable and consistent than in younger people. A slower metabolism, increases in body fat and alterations in the function of the kidney and liver (major mechanisms for drug elimination) have important ramifications for what ingested substances will do. Thus, the elderly require more stringent monitoring of drug levels and effects, and you may find that your physician needs to adjust medication doses. This same consideration explains why side effects are more common among the elderly.
Be reminded the presence of other diseases brings additional effects and challenges. Just as with one’s own relatively diminished function, disease imposes the same type of changes onto the body. This can speed the presence of side effects and toxicity as well as adjust the effective dose of a medication.
Have you ever seen the individual with a small ‘army’ of medications? Think about it. The more medications one takes, the more likely drug interactions will ensue and changes in effectiveness in any single medication may occur. This effect incrementally increases with each additional drug one takes. Similarly, the more medications one is taking, the most likely one is to make a mistake in taking the correct medication at the right time. Now consider your independently living parents or grandparents. The elderly often are more prone to make these types of errors.
What can you do about this? Get organized, and get help! Those daily medication containers are good solutions to incorrectly dosing medications. If you’re especially organized, a log is great—not necessarily for you, but for the physician that will be trying to figure out why you’re dizzy or have an altered mental status if and when that occurs.
Talk with each doctor you see or a pharmacist about what to expect from the combination of medications you take; it can make your lives a lot less complicated.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: The Effects of PTSD on Children

December 6, 2013Mental Health, Pediatrics/Kids Health, Public HealthFacebook, health, mental-health, Posttraumatic stress disorder, Psychological trauma, PTSD, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Twitter, WordPressJeffrey Sterling, MD

This is part of a series on post-traumatic stress disorder (PTSD).

For a review of PTSD signs, symptoms and those at risk, click here.
For a review of PTSD diagnosis and treatment, click here.

Clinginess
Bedwetting
Cessation of speech
Acting out the scary event

Teens may become disruptive, disrespectful, or destructive, and they may express guilt or engage in revenge.
It is very important to get counseling for children that have experienced a traumatic event. The effects may be subtle but could be devastating and long-lasting.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Post-Traumatic Stress Disorder Diagnosis and Treatment

December 5, 2013Mental HealthAnxiety, health, mental-health, Posttraumatic stress disorder, Psychological trauma, PTSD, Substance abuse, SymptomJeffrey Sterling, MD

For a review of PTSD signs, symptoms and those at risk, click here.
Not every traumatized person develops post-traumatic stress disorder (PTSD). In those that do, symptoms typically begin within three months of the incident but may present years afterward. The severity of symptoms is such that they must last more than a month to be considered PTSD. There is significant variation in outcome in those with PTSD; some recover within six months, and in some the condition becomes chronic.
To be diagnosed with PTSD, a person must have the following symptom complex for at least one month:

At least one re-experiencing symptom (including flashbacks, scary thoughts or nightmares)
At least three avoidance symptoms (a pathologic response to stay away from or forget the episode)
At least two hyperarousal symptoms (a constant state of being on edge, sensitive and prone to overreact)

Additionally, PTSD is often accompanied by depression, substance abuse, or other anxiety disorders.
PTSD is typically treated with either psychotherapy (“talk” therapy), medications, or both. Mental health professionals will review and discuss all treatment options with you prior to initiating therapy, because some people will need to try more than one variety to discover what works for their symptoms.
If someone with PTSD is going through ongoing trauma, such as an abusive relationship, both the PTSD and the current problems need to be treated. Other ongoing problems can include panic disorder, depression, substance abuse, and suicidal feelings.
The U.S. Food and Drug Administration (FDA) has approved two medications for treating adults with PTSD, sertraline (Zoloft), and paroxetine (Paxil). Both of these medications are also used to treat depression. In PTSD, they help control symptoms such as sadness, worry, anger, and the feeling of numbness inside. Taking these medications often make it easier to go through psychotherapy.
Sometimes people taking these medications have side effects at the beginning of therapy, but they usually go away. Any side effects or unusual reactions should be reported to a doctor immediately. Sometimes the medication dose needs to be reduced or the time of day it is taken needs to be adjusted to help lessen these side effects. The most common side effects of antidepressants like sertraline and paroxetine are the following:

Headache
Nausea (feeling sick to your stomach)
Sleeplessness or drowsiness
Agitation (feeling jittery)
Sexual problems (occurs in both sexes), including reduced sex drive and problems having and enjoying sex.

Doctors may also prescribe other types of medications, such as benzodiazepines (commonly used for relaxation and as a sleep aid), antipsychotics and other antidepressants. There is little information on how well these work for people with PTSD.
If you believe you suffer from PTSD, it’s very simple. Please get evaluated and get the help you need.
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