Wednesday Bubble: chase the midlife blues away with a cup of java?
Coffee. The morning elixir that oh, so many of us rely on. Did you know that caffeine is the world’s most frequently ingested psychoactive substance?!
We’ve heard a lot about the blues and depression during midlife and menopause, with some experts saying that the two are connected and others, that they are not. However, regardless of whether or not menopause increases the risk for depression, it is clear that depression affects twice as many women as men, and at least 20% of all US women at some point during their lifetime. Hence, if there is an easy way to boost the success of antidepressants or behavioral or other strategies, I’m all for it. And it appears that coffee may be the part of the solution.
Coffee? Really?
In a newly published study in the esteemed Archives of Internal Medicine, researchers say that they followed over 50,000 women and examined their food intake including how often they drank caffeinated and decaffeinated coffee, tea and soft drinks and and ate chocolate. During the 10 years of the study, researchers identified slightly over 2,000 cases of depression. However, it appeared that drinking two to three cups of coffee daily reduced the risk of developing depression by 15% compared to drinking one cup a day or less. Women who drank four or more cups a day had a decreased risk of 20%. And decaffeinated beverages? No dice.
In so far as this study goes, it’s not conclusive and it could be possible that mildly depressed women drink less coffee. And keep in mind that too much of a good thing is well, too much. Studies have shown that long-term consumption of caffeine can lead to tolerance, meaning that you need greater amounts to achieve the effects that many of us crave. Nevertheless, so far, the results show that coffee may very well be mildly protective against depression.
English playwright and theatre director John Van Druten once said, “I think if I were a woman I’d wear coffee as a perfume.” I think I’d rather just drink it than wear it!
Read MoreTalk health to me, baby…on ePatient Conference, Seduce Health and menopause
When was the last time talking health was considered sexy? Or creative? Or passionate? Well, if you are a long time reader of Flashfree, you know that I don’t mince words and I don’t attempt to turn menopause or aging into a steamy soap opera (unless we’re talking steamy as in night sweats and hot flashes). However, I do try to approach the ‘what you need to know’ with humor, integrity and candor and stay away from fear mongering. That’s why I was excited to meet a lot of people last week who not only shared my passion for healthcare but more importantly, for conversing about it.
If you have not heard of ePatient Conference, you may want to check it out next year. It’s two solid days of engagement, exchange and networking. But if you take away the buzzwords, you are left with an opportunity to put creativity back into the way that healthcare is approached, managed and talked about.
Among the many incredible experiences — from hearing Seth Godin’s keynote to witnessing the VGo Robot take photos of the audience — none were quite as inspiring as meeting Google’s Chief Health Strategist, Roni Zeiger. And while Roni is undoubtedly doing some very cool things with Search and Trends over at the Google Headquarters, I was most impressed when he started telling me about Seduce Health. Along with co-founder Alexandra Drane, Roni started the site “to get a public conversation started about how we can reframe how we ask people to change their behavior, to live healthier and therefore happier lives. To move from fear and lecturing to passion and dreams, hope and beauty.”
It’s not a bad goal. But is it achievable?
It’s fairly clear that health messaging often falls on deaf ears and that sometimes, the individuals, experts and organizations leading the charge are the ones who are also misleading the very public they seek to educate. Take overweight and obesity for example, problems affecting an estimated two out of three American adults and at least 17% of all children. Obesity is the elephant in the room, acknowledged but rarely discussed without fear or lecturing, under- or misestimated and frequently inadequately addressed. Menopause is also a good example, a natural transition in a woman’s life that has been turned into the disease of the 21st century, medicalized by many health practitioners, manufacturers and the media, and mongered to the point where we have a burgeoning Menopause Industrial Complex based on greed, profit, fear and self-loathing rather than empathy and education.
When it comes to women’s health, I do believe that can be sensuous and passionate, not dry and stale. Along these lines, I recently wrote that:
taking control doesn’t have to mean that the aging process is denied, stopped or obliterated, medicalized or industrialized. Rather, it means taking charge to feel better, more vibrant, healthier so that you/we/I can live the best life I can live while we are alive. For me personally, that doesn’t mean hormone replacement or botox or lipo; it means trying to make more healthier decisions, control or address my symptoms with evidence-based alternatives and accept the transition as a natural part of my journey. I consider this time an opportunity for shifting priorities and interests that open all sorts of possibilities. And, I want to take the experience out of the closet and foster discussion and sharing. Ultimately, I’d like the see a more natural course driven by women themselves, as opposed to societal expectations and stigmatization of the aging process and as opposed to the Menopause Industrial Complex.
I’ve said it before and I’ll say it again. Let’s crowdsource menopause. Let’s make it a goal to seduce our peers and practitioners into talking about it, embracing it and not trying to change it into something its not: a four letter word. Aging can be a hopeful, positive experience.
What do you say? You in?
p.s. If you are curious about ePatient Conference, organizer Keven Kruse has graciously posted presenter slides here.
Read MoreMenopause: the symptom? Or, the disease?
A few years ago, I ran across the following story on the BBC:
“Woman’s Death Blamed on Menopause.”
“A woman who refused to take hormone replacement therapy died while suffering a menopausal episode, an inquest had heard. Margaret Drew…was killed when she walked out of her family home on to a nearby railway line and was hit by a train…There is no trigger to this at all, except hormones making her do things that she normally wouldn’t do, Dr. Carlyon [Cornwall Coroner) concluded…”
Menopause. The silent killer. Oh really? Drew’s husband claims that his wife was “delightful, lovely and friendly” 99% of the time; the other 1% she’d become “totally irrational.” Yet, she refused to try HRT, he says. On the day of her suicide, he said that his wife was “clearly angry about something.”
Something.
Obviously, the conclusion is that that the “something” is hormones. This reminds me of vintage advertising copy that conveys the simple message that a pill a day can cure all that ails, wipe away the tears, mood swings and instability so that women can “transition without tears” (or better yet, without killing themselves).
Notably, a search in the National Library of Medicine’s PubMed database turned up only one recent study specifically dealing with suicide ideation across reproductive stages. In it, researchers compared data in 8,794 women, and found an increased risk of thinking about suicide among women during perimenopause, not before or after entering menopause. These findings remained after controlling for risk factors such as anxiety and mood disorders. HOWEVER, the researchers noted that the study design did not allow them to form any definitive conclusions about the specific reasons for thinking about suicide.
Another search yielded information that the risk for a major depression increases during perimenopause, primarily as the direct result of vasomotor symptoms. The same does not hold true for women before menopause begins or once they enter menopause. Note that while major depression is a risk factor for suicide, not everyone who is depressed will actually kill themselves.
So, are hormonal fluctuations the sole cause of such deep unhappiness that women want to kill themselves?
Interestingly, just a week after the menopause/train suicide story hit the interwebz, a rather controversial set of data also emerged: since 1972, women’s overall level of happiness has dropped. These findings held true regardless of child status, marital status and age. Researcher Marcus Buckingham, writing in the Huffington Post, said that women are not more unhappy than men because of gender stereotyping and related attitudes, due to working longer hours or because of the inequality of housework/responsibilities at home, but rather, the hormonal fluctuations of menopause may be to blame. What’s more, he leaves us hanging so we’ll tune in for part two of the piece to learn the true cause of our declining happiness or better yet, read his book (which evidently guides women through the process of finding the true role that they were meant to play in life).
Importantly, reactions to this study (and various pundits’ assessment of it) have been mixed. One of the most poignant comments I’ve read asks the question “how is happiness measured? What does it mean?”
I have no idea what caused Mrs. Drew to walk into a train and kill herself. Perhaps she was depressed. Clearly she was suicidal.
I have no idea why research shows that women are less happier than they were three decades ago.
However, is menopause the cause? Aren’t these conclusions an example of how the Menopause Industrial Complex perpetuates societal myths that menopause is a disease that requires treatment? That as women, our attitudes, belief systems and actions are hormonally-based and driven? That we are hysterical beings who need guidance on how to find our way and fulfill our dreams, realize our paths, but only if we calm down?
Feeling angry? Blame it on menopause. Unhappy? Blame it on menopause. Not realizing your dreams? Blame it on menopause. Overworked, overstressed, undervalued? Blame it on menopause.
Blame it on menopause.
I don’t know about you but I’m tired, tired of hearing that menopause is not the symptom but the disease. Isn’t it time we start fighting back?
Read MoreWednesday Bubble: Got symptoms? Got milk? An udder disaster…
Got milk?!
Milk is being touted as the next best thing, that is, when it comes to hormonal symptoms. In fact, a new campaign sponsored by the California Milk Processor Board centers around the claim that milk can help reduce the symptoms of PMS. EverythingIdoiswrong.com offers global gauges of PMS symptoms, packaged apologies for men who feel victimized by PMS and even analyzes or verifies their mistakes so that they can avoid them during the next cycle. In a piece about the marketing effort in the Washington Post, Executive Director of the California Milk Processor Board, Steve James, is quoted as saying that the strategy is to “disarm the situation surrounding PMS and its effects,” both for women and individuals around them who are suffering from their mood swings and other symptoms.
Say what?!!!
Is this advertising for milk or a drug claim?
According to the website, the claims about milk are derived from a review that appeared in the year 2000 in the Journal of the American College of Nutrition. In the review, the authors discuss the potential links between altered calcium balance and affective disorders, such as depression and anxiety. Because women with PMS reportedly have calcium fluctuations that interfere with hormonal balance, some researchers have hypothesized that this imbalance can lead to both mood and other features of PMS. In these studies, however, participants obtained their calcium through supplements and not through dietary means; this enabled the researchers to control and standardize intakes (which averaged as much as 1300 mg calcium daily). Translated into daily milk consumption, this means that a person would have to drink more than 4, 8 oz glasses of milk daily to achieve the level of calcium used in clinical studies.
Honestly, do you know anyone over the age of “tween” who consumes that much milk?
Regardless of the studies cited, the claims about milk are exaggerated and inconclusive. Many of the studies were poorly designed or relied upon recall. However, one has to wonder if the milk-PMS claims will set off a cascade of others that stretch to the other end of the hormonal spectrum –menopause — where too much calcium is believed to be too much of a good thing: although calcium may offer protection against osteoporosis, it may also increase the risk for heart disease in some women.
Let’s get away from the hard science for a moment and take a closer look at the campaign. The inference:
- Women: your PMS causes undue suffering to people around you, especially your male partners
- Men: humor the woman in your life. If you want to save your relationship, friendship, partnership, etc, create a photo with puppy eyes, film a video apology or better yet, make fun of her. Oh, and have her drink milk.
Don’t know about you but this one is so absurd it may not even be bubble-worthy. Hey California Milk Processor Board – you may want to add a few women to your marketing team. This one’s an udder disaster.
Hat tip to Reuters Health Executive Editor, Ivan Oransky for the campaign heads up. (I tried to milk it Ivan – how’d I do?!!)
Read MoreCancer…it’s still personal
Two years ago, I wrote a post about breast cancer and the fact that it was personal. Very personal. I want to share a portion of that post today and also add a few thoughts. The reason? It’s personal. Again.
Location: Department Store dressing room stall. Circa: late 1960s, early 1970s.
The characters: Me and my mom.
Scene: She is covering herself as she removes her shirt. I notice the scars. Lots of scars….to the side of one breast. I meet her eyes and she meets mine. Then I learn what the term ‘ breast cancer’ means.
My mother was diagnosed with breast cancer when she was 30. Thirty. Even today, less than half of women under the age of 40 are likely to develop breast cancer and the majority of cases are diagnosed after the age of 50. So, imagine the shock. What’s more, imagine the time. 1960… when breast cancer awareness wasn’t at the fore and people didn’t discuss it, when breasts and surrounding muscle were literally hacked off rather than carefully removing the tumor with clean margins, when many men left their wives after they became disfigured.
My dad didn’t leave. And my brother learned about it through a ‘friend’ in school who was teasing him.
I’ve spoken to my mother about her cancer, about the fear of it returning, and about how she feels about not being able to wear sleeveless tops or strengthen/firm those muscles even though she has exercised regularly her entire life. How she felt when my brother came home from school and asked her about it. How she feels now when a friend is diagnosed with cancer. Her answer is always pretty much the same.
But cancer can return. And even though this time it’s not in her breast, it looks like she’s may go down that road…again. And my heart is breaking. Because the fear in the tone of her voice says more than any words can.
She is afraid.
I don’t blame her. I would be afraid too.
Only this time? She’s 80, not 30 and although she’s tough as nails and very, very active, cancer has an insidious nature, sometimes too insidious. And even though in my heart of hearts I believe that she will be fine, I still feel awful about it.
In the past two years, I’ve had two friends who’ve been diagnosed with breast cancer, not for the first but second time. Recently, another close friend developed a very rare form of cancer and despite its severity, emerged in one piece and better than ever. Others in my life are four-, five-time survivors. Hell, even my dad has had bladder cancer since the early 90s. People survive. People move on with their lives. And yet sometimes, we lose people that we love.
Although it may be too early for a Mother’s Day post, it’s never too late to let someone know how you feel about them.
So Mom?
Thank you. The relationship has been a difficult one for most of our lives, threatened by personality and character and actions and words. Often, this road has not been an easy one. But you brought me into this life and I want you to know that despite all, the forks we’ve taken to get to this place have converged and our road is paved with mutual love and respect. I. Love. You. That is all.
And the cancer, I am not certain of the outcome this time. But I am certain of one thing: a mother’s love, and my mother’s love, is one of the most important gifts.
This one’s close to the bone. It’s close to my heart. It’s personal.
Read MoreWednesday Bubble: botox those emotions right out of your life
Still thinking about botox for your aging skin? Well, you may take years off of y0ur face but it appears that you may also put up a barrier to one of the most important communication tools humans possess: the ability to accurately make emotional judgements based on expressions. Ultimately, this implies that botoxing not only smooths signs of aging but also numbs social interactions.
Bubble-worthy? You bet! This week we’re bursting the aging bubble wide open and challenging the societal push and pull towards the elusive Fountain of Youth.
So, what have researchers learned?
First, a bit of background and psychobabble. It is believed that facial expressions are powerful clues into inner thoughts and emotions, and that humans subconsciously mimic this expression in order to decode, or perceive it. Less clear, however, is whether or not we can use these clues to make better judgements about one another.
To find this out, researchers conducted two experiments:
- In the first, a small group of women received either Botox injections (which paralyze facial muscles) or Restylane filler (which plumps wrinkles) for the purpose of smoothing facial wrinkles that are most often associated with expression, i.e., frown lines, forehead and crows feet in the Botox group and frown and laugh lines in the Restylane group. They were then shown images used to convey emotional states through the eyes and surrounding areas only and asked to select the emotion that best demonstrated the respective expression.
- In the second, the researchers applied a restrictive gel to the lower forehead, brow and area surrounding the eyes that when dried, would tighten facial muscle contractions in half the group, and then applied the gel to the inner arm in the other half. They then conducted a test in which the participants were asked to judge emotions in brief audio clips and then took a quiz that would measure how much brain power was used to evaluate emotional cues.
The findings?
Although botox didn’t completely block out women’s ability to discern emotional cues, perception was significantly lowered compared to women who had had Restylane. Interesting enough is that the researchers allude to a previous study that shows a similar dulling of reactions to emotional stimuli, implying that botox appears to interfere with emotional processing. What’s more, while the women who had restrictive gel applied to their face appeared to be better able to judge emotional expression but only the type that they would normally mimic themselves. However, the ability to judge audio emotions were the same whether the gel was applied to the face or inner arm. This suggests that facial muscle mimicry is essential.
So what do these findings really mean? Researchers say that it is possible that prolonged use of Botox could lead to changes in the way that our central nervous systems process emotions and even diminish the feedback we get from other people’s expressions. This may also effect social interactions and close relationships.
Is it an absolute? No. However, this information does suggestion that short-term gains in appearance might have longer term ramifications, such as interfering with important emotion cues and even the way the brain processes them.
I’m not sure that that’s worth the price of a smoother face. What do you think?
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