Health & Blackness

Depression is the most common mental health disorder in the U.S.  We all experience depression at one point or another.  Situational depression may be in relation to unemployment, loss of a loved one, prolonged illness, etc.  But chronic prolonged depression is a serious mental health issue that may require therapy and/or medication management.

Definition.  Depression is an emotional regulation disorder characterized by depressed mood and loss of interest in pleasurable activities.  Severe depression may impair one’s ability to preform regular daily activities.

Subtypes.  There are several different forms of depression, such as:

• Persistent depressive disorder – a chronic form of depression that lasts for at least 2 years
• Postpartum depression – major depression experienced after childbirth
• Psychotic depression – occurs when symptoms of psychosis (delusions or hallucinations) accompany feelings of depression
• Seasonal affective disorder (SAD) – depression that coincides with the winter months, when there is decreased natural sunlight

Cause.  Depression is believed to be caused by an imbalance of serotonin and epinephrine, two of the neurotransmitters in the brain.

Symptoms.  Depression may be associated with feelings of anxiety, irritability, guilt, and hopelessness.  Physical manifestations of depression may include changes in sleep habits or appetite, decreased energy level, inability to focus, and loss of self-esteem.  In the worst cases, depression may be associated with thoughts of suicide.

Diagnosis. Psychological testing is the primary means of diagnosing depression.

Management.  If feeling depressed, practice self-care techniques such as exercising regularly, eating healthy, and getting plenty of sleep.  Make time for relaxing activities such as listening to music, reading a book, or taking a long walk.  Identify a hobby that you enjoy, and find ways to incorporate it into your schedule.  Also avoid isolation by spending time with loved ones.

People who suffer from depression often find psychotherapy with a psychologist or clinical social worker beneficial.  These mental health professionals can teach you skills to help manage negative thoughts and behaviors.  Other support systems to consider are support groups, close friends & family, and/or a spiritual adviser.

Medications. If still struggling with depression despite putting these skills into practice, your doctor may suggest trying a medication to help.  Antidepressants are the medication of choice.  There are several different types of antidepressants available, and a doctor can help determine which one may be best to treat your symptoms.  If started on an antidepressant, it is important to remember that it may take up to 6 weeks to start experiencing any improvement in your mood.  Additionally, if you decide to stop taking your antidepressant, it is important to discuss your concerns with your doctor so that they can help you safely wean off it over time.

Depression may be caused by a combination of genetic, biological, environmental, and psychological factors.  There is no shame in having depression or any other mental illness.  It does not mean that you are weak or that something is “wrong” with you.  If experiencing any of the symptoms above, I encourage you to seek help so that you can manage your symptoms and be your best self.

If ever experiencing thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

Stress.  It’s something all of us experience to varying degrees at one time or another.  And while low levels of stress are normal, persistent and/or high levels of stress can impact both our physical and mental health.

Definition: In the simplest terms, stress is “physical, mental, or emotional strain or tension.”  Stressors are the things in our life that cause stress.  Common stressors include financial strain, family problems, work/school responsibilities, battling illness, and dealing with loss or death.

Effects: Possible physical effects of stress include physical pain (i.e. headache, muscle cramps), GI upset, increased blood pressure, chest pain, weakened immune system, nervous habits (nail biting, pacing, nervous twitches), decreased sex drive, and even certain types of cancers.  Emotionally, you may experience irritability, anxiety, depression, difficulty concentrating, lack of sleep.  Additionally, stress may also lead to behavioral changes such as increased or decreased appetite, increased drug/alcohol use, frequent crying, and social withdrawal.

Coping:  Studies have shown that it is not the stress itself that leads to declines in health, but rather it is our response to stress.  A persistently negative or unhealthy response to stress will ultimately lead to a negative effects on your health.  Positive ways to management your stress include:

• Exercise – regular exercise helps to improve both our physical and mental health.  Strive for 150 minutes each week.
• Assertiveness – learn to say “no” when people try to put too much on you.  Additionally, begin to practice establishing boundaries with people who contribute to your stress.
• Diet – improving your diet can help to improve your mood.  Try to increase your intake of fruits & vegetables, high-quality protein, and healthy fats (i.e. omega-3-fatty acids).
• Time – learn to set aside time for yourself each day, even if only for a few minutes.  Use that time to relax, do one of your hobbies, listen to your favorite song, or treat yourself with your favorite snack.
• Breathing – practicing deep breathing helps you to relax and also slows your heart rate.
• Rest – try to get some quality sleep.
• Socialize – talk to close friends and family about what you’re going through.  If you don’t feel comfortable talking to any of them, consider seeking out a therapist or spiritual adviser.
• Relax – find a relaxation technique that you enjoy.  Options include listening to music, reading a book, taking a hike or walk on the beach, massage therapy, reflexology, and aromatherapy.
• Medication – if you’ve tried all of the tools above, and are still having difficulty, your doctor may try a medication if (s)he suspects an underlying disease such as depression or anxiety.

Remember, before you can be any good to anyone else, you must first be good to yourself.  Identify your stressors, and then do what you can to eliminate them.  Take time for yourself to relax and don’t hesitate to ask for help if you need it.

Otitis media, more commonly known as an ear infection, may or may not require antibiotics, depending on the source of the apparent “infection.”  Otitis media with effusion (OME) occurs when there is a buildup of fluid in the middle ear without signs of infection such as pain, redness, pus, or fever.  The most common causes of that fluid buildup include allergies, irritants such as certain chemicals or cigarette smoke, and changes in air pressure due to airplane travel.

Acute otitis media on the other hand is a true infection and may be caused by either a bacteria or virus.

Risk Factors.  Children under the age of 2 and exposure to air pollution or cigarette smoke are the greatest risk factors for an ear infection.

Symptoms.  Particularly with children, the most common symptoms of an ear infection include pulling at the ears; excessive crying; fluid draining from the ears; sleep disturbances; fever; headache; temporary hearing loss; irritability; and difficulty with balance.

When to seek Medical Care.  Visit your doctor or local urgent care clinic if you experience a temperature >100 degrees, blood or pus in the ears, or symptoms that have not improved within a few days.

Treatment.  Most ear infections will heal on their own.  Tylenol and other OTC pain relievers can be used to treat  associated pain and fever.  Antibiotics such as amoxicillin will be needed for those infections truly caused by bacteria.

A urinary tract infection (UTI) occurs when bacteria infects the urinary tract.  In the worst cases, the infection can spread to the kidneys, requiring hospitalization for treatment.

Risk Factors.  Females are at a higher risk of getting a UTI due to our anatomy.  Other potential risk factors include a previous UTI, being sexually active, pregnancy, increased age, decreased mobility, urinary incontinence, and a history of kidney stones.

Symptoms.  Pain/burning while urinating, frequent urination, low fever (<101 degrees), cloudy/bloody urine, and cramping are common symptoms of a UTI.  Kidney infections may causes more serious symptoms such as low back pain, high fever, nausea/vomiting, mental status changes, chills, and night sweats.

When to Seek Medical Care.  You should seek medical care if you experience any of the symptoms listed above.

Treatment.  As UTIs are usually caused by bacteria, antibiotics are usually needed.  If you are prescribed an antibiotic, you should take it as directed and be sure to finish the full course of therapy even if you start to feel better.  Also be sure to stay well-hydrated and urinate frequently to help flush the bacteria out of your system.  Avoid douching, and using sprays, deodorants, powders, etc in the vagina as these may actually worsen your infection.

A sinus infection occurs when the fluid becomes trapped in the sinus cavity causing increased pressure or pain.  A majority of the time (90%) a sinus infection is caused a virus, and therefore an antibiotic is not needed for treatment.

Risk Factors.  A previous respiratory tract infection, a weakened immune system, and a history of allergies or nasal polyps may all increase your risk of getting a sinus infection.

Symptoms.  The most common symptoms of a sinus infection are headache, stuffy or runny nose, loss of the ability to smell, facial pain or pressure, postnasal drip, sore throat, fever, cough, and fatigue.

When to Seek Medical Care.  Be sure to visit your doctor or local urgent care clinic if you experience a temperature >100 degrees; symptoms that have not improved within 10 days; or multiple sinus infections within the past year.

Treatment.  In the rare occasion that your sinus infection is caused by a bacteria, antibiotics may be prescribed.  Otherwise, rest, OTC medications, and self-care should help provide symptom relief while the virus runs its course. Warm compresses to the nose or forehead, or breathing in steam from a bowl of hot water or shower should help to relieve sinus pressure.  Decongestants and nasal sprays may also help with nasal congestion if needed.

Influenza, more commonly known as the flu, is a viral infection that affects the lungs, nose, and throat.  The flu is spread from one person to another through respiratory droplets (expelled by a cough or sneeze), skin-to-skin contact, saliva (kissing or eating/drinking behind someone), or by touching a contaminated surface (doorknob, bathroom faucet, public telephone, etc.)

Symptoms.  Common flu symptoms include fever, cough, sore throat, runny/stuffy nose, body aches, headache, chills, and fatigue.

Treatment.  As the flu is caused by a virus, antibiotics are not needed.  Generally, if you catch the flu, you should get plenty of rest, and manage your symptoms with OTC cold/flu medications.  Also try to avoid close contact with others to avoid spreading the infection.

OTC treatment focuses on management of symptoms:

• Headache/body ache & fever – available therapies include Tylenol, aspirin, and nonsteroidal anti-inflammatory (NSAID) medications such as Motrin and Aleve.  Tylenol is generally well-tolerated, but should be used with caution if you have any type of liver disease. Aspirin should not be used in children  due to the risk of Reye’s Syndrome.  NSAIDs should be avoided in patients with hypertension, or those who have a history of GI bleeding or ulcers.
• Nasal congestion (stuffy nose) – decongestants are the medication of choice for congestion.  Oxymetazoline is a topical decongestant found in nasal sprays such as Afrin.  Pseudoephedrine (Sudafed) and phenylephrine are available oral decongestants.  DEA regulations require that pseudoephrine be stored behind the pharmacy counter, and you must show ID to purchase it.
• Sneezing/runny nose – Antihistamines are the treatment of choice for sneezing and runny nose.  Older antihistamines, such as diphenhydramine (Benadryl), are usually inexpensive, but commonly cause drowsiness and have to be taken up to 4 times per day.  Newer antihistamines such as fexofenadine (Allergra), loratadine (Claritin), and cetirizine (Zyrtec) are generally well-tolerated without causing daytime drowsiness.  Additionally they can be taken only once daily.
• Cough – When trying to treat cough, the primary question to ask yourself is if your cough is wet (are you coughing up mucus?) or dry (no mucus).  If your cough is wet, guaifenesin (Mucinex) is the treatment of choice.  If your cough is dry, dextromethorphan (Delsym) would be preferred.  If you are a diabetic, try to choose a sugar-free cough syrup in an effort to avoid increasing your blood glucose.
• Sore throat- Lozenges, which generally contain topical anesthetics such as benzocaine and menthol are a good treatment option for sore throat.  Sipping warm liquids such as tea or salt water can also be soothing.

In some instances, your provider may prescribe an antiviral medication such as Tamiflu, Relenza, and Rapivab.  These medications can lesson the symptoms, shorten the duration of the infection, and also prevent complications such as pneumonia.

 

Definition.  Bronchitis occurs when the airways in the lungs become inflamed (swollen) and produce mucus, which causes you to cough.

Causes.  Acute bronchitis, also known as a chest cold, is usually caused by a viral infection.

Symptoms.  Common symptoms of bronchitis include mucus production, chest soreness, fatigue, mild headache/body aches, low-grade fever, watery eyes, and/or sore throat.  Most symptoms last up to 2 weeks, though the cough may linger as long as 8 weeks.

When to Seek Medical Care.  You should schedule an appointment with your doctor or visit the local urgent care clinic if you experience a temperature >100.4 degrees; bloody mucus; shortness of breath; symptoms lasting longer than 3 weeks; or repeated episodes of bronchitis.

Treatment.  Since bronchitis is usually caused by a virus, symptoms almost always improve on their own and antibiotics are not needed.  If, however, your healthcare provider decided that you do have a more serious infection such as pneumonia or whooping cough, antibiotics will likely be prescribed.

Having a cold is considered so “common” because each year the average adult experiences 2-3 of them.  Children may experience them more frequently.  The rhinovirus is the most common virus to cause cold symptoms, but more than 200 different viruses have been linked to cold symptoms.  Infection spreads from one person to another through the air and close personal contact.

Risk Factors.  Exposure to someone else with a cold, being a young-aged child, and having a weakened immune system may increase your risk of catching a cold.

Symptoms.  The most common cold symptoms include sneezing, stuffy nose, sore throat, coughing, and post-nasal drip (mucus dripping from your nose and into your throat).  Symptoms may last for up to 2 weeks.

When to Seek Medical Care.  Consider visiting your doctor or local urgent care clinic if you experience temperature  >100.4 degrees, bloody mucus or cough, or symptoms that last longer than 10 days without improvement.

Treatment.  As the cold is caused by a virus, antibiotics are not needed.  OTC treatment focuses on management of symptoms:

• Headache/body ache & fever – available therapies include Tylenol, aspirin, and nonsteroidal anti-inflammatory (NSAID) medications such as Motrin and Aleve.  Tylenol is generally well-tolerated, but should be used with caution if you have any type of liver disease.  Aspirin should not be used in children due to the risk of Reye’s Syndrome.  NSAIDs should be avoided in patients with hypertension, or those who have a history of GI bleeding or ulcers.
• Nasal congestion (stuffy nose) – decongestants are the medication of choice for management of congestion.  Oxymetazoline is a topical decongestant found in nasal sprays such as Afrin.  Pseudoephedrine (Sudafed) and phenylephrine (Neo-Synephrine) are available oral decongestants.  DEA regulations require that pseudoephrine be stored behind the pharmacy counter, and you must show ID to purchase it.  Some states require a prescription.
• Sneezing/runny nose- Antihistamines are the treatment of choice for sneezing and runny nose.  Older antihistamines, such as diphenhydramine (Benadryl), are usually inexpensive, but commonly cause drowsiness and have to be taken up to 4 times per day.  Newer antihistamines such as fexofenadine (Allergra), loratadine (Claritin), and cetirizine (Zyrtec) are generally well-tolerated without causing daytime drowsiness.  Additionally they can be taken only once daily.
• Cough – When trying to treat cough, the primary question to ask yourself is if your cough is wet (are you coughing up mucus?) or dry (no mucus).  If your cough is wet, guaifenesin (Mucinex) is the treatment of choice.  If your cough is dry, dextromethorphan (Delsym) would be preferred.  If you are a diabetic, try to choose a sugar-free cough syrup in an effort to avoid increasing your blood glucose.
• Sore throat- Lozenges, which generally contain topical anesthetics such as benzocaine and menthol, are a good treatment options for sore throat.  Sipping warm liquids such as tea can also be soothing.

Prevention.  The best way to prevent catching the cold is to prevent spreading the cold virus.  If you are experiencing symptoms, try to minimize close contact with others.  If you must be around other people, wash your hands frequently.  Consider wearing a mask;  if you don’t, make an effort to cough/sneeze into your elbow (not your hand!) to avoid spreading your germs into the air.  If you are living or working near someone who is experiencing cold symptoms, practice good hand washing and try to minimize close contact with him/her.

What are bacteria and viruses?

Bacteria and viruses are microscopic organisms that can cause a variety of infections such as upper respiratory infections, urinary tract infections, ear infections, sinus infections, sore throat, etc.

What are antibiotics?

Antibiotics are medications that specifically fight infections caused by bacteria (not viruses!!).  Antibiotics work by either killing the bacteria or making it difficult for the bacteria to grow.

Which infections are caused by viruses (and therefore should not be treated with antibiotics)?

The common cold, influenza (the flu), most sore throats and coughs, and many sinus and ear infections are generally viral infections.  Therefore antibiotics are likely not appropriate treatment options for these types of acute illnesses.

I just want to feel better…does using an antibiotic hurt anything?

Overuse and misuse of antibiotics leads to antibiotic resistance, which is the ability of the bacteria to resist the effects of an antibiotic.  Every time someone takes antibiotics, sensitive bacteria dies, but resistant bacteria are able to continue to grow and multiply.  Antibiotic resistance can make infections that were typically easy to treat become more dangerous infections because they are now more difficult and expensive to kill.

What can I do to protect myself from antibiotic resistance?

• Ask your doctor about available vaccinations that may help you prevent catching certain infections, such as the flu.
• If you see your doctor for an illness, and they do not prescribe an antibiotic, don’t insist on one.  Based on your symptoms, your doctor may have decided that your infection is viral, and therefore an antibiotic is not needed.  Taking an antibiotic for a viral infection will not help you feel better, and only increases your risk of antibiotic resistance in the future.
• If you are prescribed an antibiotic, take the medication as directed, and make sure to finish it all (even if you start to feel better).  If you don’t complete the full antibiotic course, the bacteria will continue to grow, and may actually become stronger because it now knows how to combat the antibiotic you were receiving.

Why Should I Consider Getting Vaccinated?

Influenza (the flu) is a viral infection that can lead to hospitalization and even death in severe cases.  Flu season can last anywhere from October to May.  During these months, the flu viruses circulate at especially high levels.  Getting an annual flu vaccination is the best way to protect yourself from contracting the flu and sharing it with others.

How does the vaccination work?

About two weeks after receiving your flu vaccine, your body will develop antibodies, which provide protection against infection from the viruses present in the vaccine.  Each year, the seasonal flu vaccine is manufactured to specifically protect against those strains of the virus that that research indicates will be most common during the upcoming flu season.

What types of flu vaccines are available?

Generally the flu vaccine can be administered through an injection or a nasal spray.  Unfortunately though, for the 2016-2017 flu season, the CDC does not recommend use of the nasal spray.

Who should receive the flu vaccine?

Anyone over the age of 6 months should receive the flu vaccine each year.  The flu vaccine is especially important for those at a high risk of complications such as children under the age of 5; adults aged 65 and older; pregnant women; and nursing home residents.  Anyone with a chronic disease such as lung or heart disease and/or a weakened immune system should also strongly consider being vaccinated.

Is there anyone who shouldn’t receive the flu vaccine?

Children younger than 6 months, and those with severe, life-threatening allergies to the flu vaccine or any ingredients within the vaccine should not receive the flu shot.

When should I get vaccinated?

Ideally, you should get vaccinated by October, before the flu season begins.  If you aren’t able to have it done by then though, getting vaccinated anytime within flu season will still offer some protection.

Where can I get vaccinated?

Generally you can get vaccinated at doctor’s offices, health departments, and community pharmacies, and sometimes through your job’s employee health office.

Why is it important to get the flu vaccine every year?

The strains of virus circulating are constantly changing, so the formulation of the flu virus is frequently updated to provide optimal protection.  Additionally, your body’s immune response from the vaccine declines over time, so it’s important to protect yourself each year.

Is it possible to get the flu even if I get vaccinated?

Unfortunately, the effectiveness of the flu vaccine cannot be guaranteed, so it is possible to get the flu even if you’ve been vaccinated.  But healthcare providers will generally continue to encourage vaccination because even if you do get the flu, your symptoms will likely not be as severe as they would be if you had not gotten vaccinated.

Can the flu vaccine give me the flu?

No, the flu vaccine will not give you the flu.  Some people do experience side effects such as soreness, redness, and swelling at the injection site; low-grade fever; and body aches.  While these side effects may mimic flu symptoms, they generally only last a few hours, and are not indicative of an active flu infection.