Do you have faith in what the Universe is doing for you all day, everyday?

DESCRIPTION:

You don’t attract into your life what you want. You don’t attract what you think about. You don’t attract what you feel. Desires, thoughts, and feelings are all important, but these are more effects than causes.

You attract what you’re signaling.

Think of yourself as a vibrational transmitter. You’re constantly sending out signals that tell the universe who you are in this moment. Those signals will either attract or repel other vibrational beings, events, and experiences.

You naturally attract that which is in harmony with your state of being, and you’ll repel that which is out of sync with your state.

If your energetic self radiates wealth and abundance, your physical reality will reflect wealth and abundance for your physical being.

If your energetic self radiates anger and frustration, your physical reality will reflect that as well.

Since the signals you’re sending out at any given moment tend to be fairly complex, your experience of physical reality will be equally complex.

Once you can accept that your vibrational self attracts compatible patterns, it becomes clear that if you want to experience something different in your life, you must somehow change the signals you’re putting out.

The Art of Dealing With Difficult People

By ‘difficult’ people we mean people with certain personality traits or emotional
characteristics that make it difficult for you to communicate with them. The ability
to effectively cope with such people while maintaining a healthy work environment
is known as the skill of dealing with difficult people.

It is inevitable for you to come across a difficult person in your life that bring about
distress, whether it’s in the form of a neighbor, relative, colleague, employee,
customer, or supplier. However, the intensity of their difficulty may vary depending
upon the kind of difficult person they are; downers, better than(s), passives, or
tanks.
We’ve all been there. Be it work, school or Thanksgiving dinner, we’ve all found
ourselves in situations where we have been forced to interact with people we find
to be “difficult”. For many of us, we’d rather eat glass than have to deal with
challenging people like this but how we survive and, dare I say thrive, in these
situations can separate us from the pack in both business and in life.

Why Is Dealing with Difficult People Important
Whenever we are faced with unreasonably difficult people, our instinct is to react
with frustration and irritation. That, however, is the ticket to destruction. It causes
tension to build in the work environment and can prove a serious threat to the
productivity as well as the overall stability of the work environment.
Therefore, it is important to develop the skills of dealing with difficult people not
only for the sake of your satisfaction but because your long term as well as short
term success depends to a great extent on your ability to smoothly and successfully
interact with such people. To increase the likelihood of your success in life and
career, you must be savvy in dealing with such difficult behaviors.
How to Improve Your Skills of Dealing with Difficult People?
Since it is difficult to avoid crossing paths with difficult people, the best option is to
improve your skills of dealing with difficult people in the following way:

  1. Identify the nature of difficulty. Analyze the specific behavior causing
    distress and identify the kind of difficult person you need to deal with. For
    example, is he a ‘downer’ who is always complaining and criticizing, a
    ‘passive’ who never contributes anything, a ‘better than’ who believes he
    knows everything, or just a bossy ‘tank’. Moreover, you must also analyze
    whether or not the behavior is consistent because sometimes it is possible
    that the person is just having a bad day.
  2. Understand them instead of trying to change them. Mostly when we come
    across someone with a difficult behavior, we tend to advise them to change
    themselves. For instance, we may try to encourage a ‘passive’ to stand up for
    himself or a ‘downer’ to be more positive in his thinking. This, however, only
    causes them to resent us. The best way is to try to understand them, their
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    The Art of Dealing with Difficult People
    Discover How to Identify Different Types of Difficult People and 10 Keys to Handling Them with Ease and Grace
    values, and whatever it is that drives their decisions. This not only helps them
    relax but also encourages them to be more open-minded.
    Identifying Difficult People
    Difficult people can take many forms. “Difficulty” can manifest itself in quite a few
    ways, oftentimes, including people who spread rumors, who find the negative in
    everything, those who rarely cooperate, or who don’t value the input and opinions
    of others. They may find every opportunity to create problems or they may simply
    use passive resistance to waylay your best efforts to move your agenda forward.
    At the end of the day, defining “difficult” is a uniquely personal thing. What is
    challenging to me may be a breeze for you. Understanding your personality,
    preferences, and triggers can help you to recognize the types of people and
    situations that irritate you.
    Several types of difficult people and how their behaviors serve to irritate others like
    a course grade of sandpaper:
    ▪ Perfectionists: If you are looking for quick results, perfectionists can be a
    source of frustration.
    ▪ Control Freaks: When you want to do things your way, overly controlling
    types can be a source of irritation as well.
    ▪ Creative People: They’re essential if generating ideas is the plan but can
    cause frustration when you just want to get to deliver a simple result.
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    The Art of Dealing with Difficult People
    Discover How to Identify Different Types of Difficult People and 10 Keys to Handling Them with Ease and Grace
    ▪ Shapers: Although shapers may seek to take over as and when they see fit,
    they can really help drive action.
    ▪ Aggressive or Defensive People: Assertion can help move a group forward.
    Aggression or defensiveness can have the opposite effect on a group’s
    dynamic.
    ▪ Submissive People: The lack of confidence and fear of failure that many
    submissive types display can be a source of frustration as well.
    Identifying the Issue
    Turning the situation inward and analyzing your triggers and reactions to these
    situations can help you to be prepared and self-aware when they arise. Elizabeth
    B. Brown shares several questions that you may want to reflect on in order to help
    you understand the root issue of why that person at work or in life is making you
    insane:
    ▪ What emotional tornadoes does the difficult person in your life spin off?
    ▪ How do you react to a difficult person in your life?
    ▪ How does your difficult person react to your reactions?
    ▪ If the other person is the problem, are you growing unhealthy actions and
    reactions in response to him or her?
    ▪ Are you the difficult person driving others to reactive behavior?
    ▪ How do others react to your actions and responses?

Feeding into our frustrations when dealing with a difficult person can become a
vicious cycle. We tend to see or hear an interaction and then interpret that action
based, not on fact, but on our assumptions. Then we react. Unfortunately, we
usually don’t have all of the information as to why an individual may be showing up
the way they are and, in the absence of factual information, we tend to fill in the
blanks with our own theories about what might be going on.

The Art of Dealing with Difficult People
Discover How to Identify Different Types of Difficult People and 10 Keys to Handling Them with Ease and Grace
Managing Your Reactions
It is all about breathing. Slow, deep breathing actually triggers something at the
bottom of your spine called the Vegus nerve, which sends neurotransmitters to
brain that actually calm you down.
Then, take a moment to reflect on how you feel. Ask yourself questions about how
you can respond to difficult person, or how you can create a good outcome from
the situation. While this seems like overkill, this is an essential step to getting your
brain out of its instinctual response (things like sharpness, negativity, and
defensiveness). Forcing yourself to think of ways to create a good outcome makes
your brain go into a more positive mode of thinking.

Leveraging Some Self-Control
Know yourself. Having a clear sense of self, what causes you tension and where
your limits are can serve you well when interacting with people that you find to be
difficult. Staying calm and developing your awareness and emotional intelligence
skills can help you to manage your reactions to frustrating situations.
Seek to understand the situation. Gaining some clarity by asking questions while
managing your own reactions can serve to help find a mutually satisfactory
outcome. Reflecting on what you would determine as a satisfactory outcome
before getting into an interaction with a difficult person can help you maintain
focus on what really matters.
Stick to the facts and acknowledge emotions. Using examples and stating facts as
opposed to interpretations can help keep interactions with people you find difficult
in check. Paraphrasing and checking for accurate understanding can also show that
you hear what people are saying and that you are doing your level best to work
effectively with them. Responding and stating your emotions or the impact that the
person is having on you based on their behavior, if delivered correctly, can
sometimes be the nudge that someone needs to realize that they are rubbing you
the wrong way.
Seek the advice of others. You’re not alone in this. You are not the only person who
has ever had to productively interact with a difficult person. Seeking out the advice
of others or finding someone to help coach you through it can be quite beneficial.
Sometimes, talking it out can help you reframe the situation to a place where you
can facilitate a more positive outcome.
Keep records, if necessary. Sometimes, things can be so abrasive that you run the
risk of hitting an end-state that you never intended. If things are to the point where
interactions are toxic, it may be time to start making intentional effort to begin
documenting things. If things go south, at least you have a good record of what led
to that place.

  1. Critics
    Certainly, there is a time and place for criticism. In fact, the best ideas and the most
    effective solutions often come from debate. All points of view are challenged. But
    difficult critics, destructive critics aren’t looking for answers. They aren’t involved
    in the give and take that leads to consensus and team building. They’re just critics.
    Or as I like to say, “Critics are spectators, not players.”
    I’m sure you’ve noticed. The people who won’t lift a finger to help are often the
    first ones to point one. Or as one disgusted husband replied when he was asked
    whether his wife drove, he said, “Only in an advisory capacity.” So yes, critics are
    non-cooperative. And their negative behavior makes it difficult for us to even want
    to cooperate with them.
  1. Liars
    As Kim Hubbard says, “Honesty pays but it doesn’t seem to pay enough for most
    people.” That’s sad, but she’s probably right. Anything less than honesty makes
    cooperation, teamwork, and relationships difficult to build. And cooperation,
    teamwork, and relationships are built on trust, and trust is ALWAYS built on truth.
    Of course, lies come in many forms. It might be the lies that are told to impress a
    prospective customer or the lies that are told to keep a spouse from getting upset.
    Or they may be the lies that are used in job hunting. As one recruiter told me, “The
    closet most people come to perfection is when they fill out a job application.” Or
    as a former Prime Minister of Great Britain said, “There are three kinds of lies: lies,
    darned (I can’t say the real word) lies, and statistics.”
    However liars lie, they are difficult to deal with. They’re like Jason and Melinda out
    shopping for living room furniture. They found a set they liked but told the
    salesperson they couldn’t afford it. The sales person replied, “That’s no problem.
    You make one payment, and you don’t make another payment for a year.” Melinda
    asked, “Who told you about us?”
    The most unfortunate thing about lying is that it’s seldom necessary. And the truth
    — no matter how distasteful — would probably be easier for others to accept than
    the lies used to cover it up. As La Rochefoucauld said so wisely, “Almost all our
    faults are more pardonable than the methods we think up to hide them.”

Lavender Oil for Anxiety coping mechanisms

Lavender Oil for Anxiety and Depression

Review of the literature on the safety and efficacy of lavender

By Jeremy Appleton, NDPrinter Friendly Page

Abstract

Lavender flower and its extracts have been used, both internally and by olfaction, for centuries as a treatment for anxiety and depression. Modern analytical research has identified the main active constituents of the oil; in vitro and animal studies have begun to elucidate mechanisms of action; and controlled clinical trials in humans now document lavender’s efficacy, safety, and dose. This paper reviews these developments, with summary details from selected studies, and provides a preliminary comparison of lavender’s efficacy and safety to its main botanical and pharmaceutical alternatives.

Introduction

Anxiety is a common complaint and may range from every day stress to clinically relevant symptoms requiring medical intervention. Patients with generalized anxiety disorder (GAD) can experience excessive anxiety and worry associated with the stresses of everyday life. Most cases of GAD begin in childhood and can lead—without treatment—to a chronic condition, with fluctuating symptoms, often exacerbated by stressful life events.1 Disturbed sleep has been observed to be among the most frequent accompanying disorders of generalized anxiety.2 Individuals with anxiety disorder not otherwise specified (AD NOS) also present with clinically significant symptoms, but they tend to report less worry, negative affect, depression, and comorbidity than those with GAD.3 The most commonly prescribed agents in the medical treatment of anxiety are benzodiazepines and selective serotonin reuptake inhibitors (SSRIs).4 The well-known side effects of benzodiazepines include drowsiness, fatigue, confusion and disorientation, dizziness, decreased concentration, impaired memory, dry mouth, and blurred vision. Benzodiazepines can impair the ability to drive or operate machinery and may thus interfere with essential activities of daily living. They lower the tolerance to alcohol and are widely reported to cause physical and psychological dependence and withdrawal symptoms.5 SSRIs, on the other hand, may cause sedation and fatigue, gastrointestinal disturbances, agitation or insomnia.6,7The risks and inconveniences associated with available anxiolytic pharmaceutical medications may be one of the reasons anxiety disorder is considered an undertreated condition.8 Herbal preparations have long been a mainstay for treating anxiety and depression. Some botanical agents, most notably kava (Piper methysticum), have demonstrated efficacy for clinically diagnosed anxiety disorders.9-13 Others, such as St. John’s wort (Hypericum perforatum), are clinically efficacious for depression in most,14-25 though not all26,27 clinical studies. Kava, however, has been withdrawn by many manufacturers due to concerns over potential hepatotoxicity,28-32 even though these effects may have been primarily due to drug interactions, misuse, and poor quality extracts of this otherwise well-tolerated phytomedicine; St. John’s wort’s popularity has suffered because it was found to stimulate cytochrome P450 34, an enzyme that metabolizes at least half of the known pharmaceuticals sold today.33 A safe, non-sedating, non–habit forming herbal anxiolytic with proven efficacy for GAD and depression is, therefore, of interest to clinicians. Throughout history, lavender has been cultivated for its flowers and oils and used both cosmetically and medicinally. A member of the Labiatae family, lavender is primarily used either dried or as an essential oil. Historical use includes documented activity as an antibacterial, antifungal, carminative, sedative, and antidepressant.34 Lavandula angustifolia, Mill. is the most common species of lavender utilized for health purposes.35 Lavender is native to the Mediterranean, the Arabian Peninsula, Russia, and Africa. Lavender has a high concentration of volatile oils, which impart its distinctive and pleasing fragrance. The relaxing experience of lavender fragrance led to its deliberate, therapeutic use in aromatherapy to relieve mild anxiety. Lavender has been also used internally for mood imbalances such as anxiety, insomnia, and gastrointestinal distress, including “nervous stomach.”36

Lavender Constituents

Lavender essential oil is obtained from steam distillation processing of the flowering tops of L. angustifolia. Modern analytical methods, such as capillary gas chromatography, have demonstrated that lavender oil contains more than 160 constituents, many of which interact synergistically to contribute to its healing effects. The main active constituents of lavender oil are linalool, linalyl acetate, terpinen-4-ol, and camphor. The quantity of the linalyl acetate is determined by the method of steam distillation as it degrades upon distillation to yield linalool. The highest content of linalyl acetate is obtained when fresh lavender flowers are steam distilled right after harvest. Other constituents found in lavender include: cis-ocimene; terpinen-4-ol, ß-caryophyllene; lavandulyl acetate; 1,8-cineole; and small amounts of limonene, geraniol, lavandulol, ß-pinene, camphene, geranyl acetate, and neryl acetate.37,38 Relative amounts of bioactive constituents can vary significantly from one lavender oil to another. The European Pharmacopoeia includes limits or ranges for the content of the predominant components. Specifically, oils with high concentrations of esters and low concentrations of cineol and other minor components are generally considered to be of higher quality because these parameters indicate that a gentle and careful production process was applied and that high quality raw materials were used. A high quality lavender extract would not only comply with this monograph but would ideally exceed those specifications with a higher content of linalyl acetate (ideally 33–45%) and lavandulyl acetate (≥1.5%), and a lower limit for the content of cineol (≤2 %).39

Mechanisms of action

In vitro and in vivo studies have demonstrated multiple possible mechanisms of action of lavender oil, as well as its individual constituents, which may partly account for its relaxing effects when taken orally. Lavender oil has potentiated expression of GABA-A receptors in cell culture;40 it has shown spasmolytic activity on guinea pig ileum;41 linalool, a main active ingredient of lavender oil, has been shown in animals to inhibit glutamate binding in the brain;42 linalool has also inhibited acetylcholine release and influenced ionic conductance in neurons;43 linalyl acetate is described to exert a relaxing effect.44 Lavender oil has reduced dose-dependently spontaneous motility and caffeine-induced hyperactivity of mice.45Lavender oil aromatherapy has been shown to be effective in the management of anxiety and depression and small and medium-sized controlled and uncontrolled clinical trials.

Clinical Efficacy of Lavender

Lavender Aromatherapy

Much prior research on lavender has focused on the administration of lavender via an olfactory route. The anxiolytic activity of lavender olfaction has been demonstrated in several small and medium-sized clinical trials.46-53 The efficacy of aromatherapy of lavender is thought to be due to the psychological effects of the fragrance combined with physiological effects of volatile oils in the limbic system.54 These calming effects of lavender oil and single constituents may be the origin of the traditional use of lavender. Lavender oil olfaction has been shown to decrease anxiety, as measured by the Hamilton rating scale,51 and can increase mood scores.55The following are selected examples of clinical trials on lavender aromatherapy:

  • Dunn and colleagues demonstrated anxiolytic activity of lavender oil aromatherapy in patients in intensive care units. Subjects received at least 1 session of aromatherapy with 1% lavender essential oil. Significant anxiolytic effects were noted in the 1st treatment, though 2nd and 3rd treatments did not appear to be as effective.47
  • Alaoui-Ismaili and colleagues found that the aroma of lavender is considered by subjects to be very pleasant and is correlated with changes in the autonomic nervous system.56
  • Tysoe and colleagues conducted a study of lavender oil in burner use on staff mood and stress in a hospital setting. A significant number of respondents (85%) believed that lavender aroma improved the work environment following the use of the lavender oil burners.57
  • Diego and colleagues demonstrated that people receiving lavender oil (10%) olfaction for 3 minutes felt significantly more relaxed and had decreased anxiety scores, improved mood and increased scores of alpha power on EEG (an indicator of alertness), and increased speed of mathematical calculations.58
  • Lewith and colleagues investigated the effects of lavender aromatherapy on depressed mood and anxiety in female patients being treated with chronic hemodialysis.59 The effects of aromatherapy were measured using the Hamilton rating scale for depression (HAMD) and the Hamilton rating scale for anxiety (HAMA). Lavender aroma significantly decreased the mean scores of HAMA, suggesting an effective, noninvasive means for the treatment of anxiety in hemodialysis patients.
  • Lavender aromatherapy, with or without massage, may also reduce the perception of pain and the need for conventional analgesics in adults and children, though more rigorously controlled trials are needed.60

Oral Lavender Supplementation: Anxiety

Lavender oil has also been shown to be effective via the oral route. Several clinical studies have demonstrated the benefit of lavender extracts in comparison to reference or placebo in decreasing symptoms of anxiety and depression. Orally administered lavender capsules (100 mL and 200 mL) were tested in 97 healthy subjects in a randomized double-blind, placebo-controlled clinical trial.61 Film clips were used to elicit anxiety. Measures included anxiety, State Trait Anxiety Inventory (STAI), mood, positive and negative affect scale (PANAS), heart rate (HR), galvanic skin response (GSR), and heart rate variation (HRV). After baseline measurements, capsules were administered. Participants viewed a neutral film clip, then an anxiety-provoking and light-hearted recovery film clip. For the 200 mL lavender dose during the neutral film clip, there was a trend toward reduced state anxiety, GSR, and HR and increased HRV. In the anxiety-eliciting film, lavender was mildly beneficial in females but only on HRV measures. In males, sympathetic arousal increased during the anxiety film (GSR). HRV significantly increased at 200 mL during all 3 film clips in females, suggesting decreased anxiety. The authors concluded that lavender has anxiolytic effects in humans under conditions of low anxiety, but they were unable to draw conclusions about high anxiety or clinical anxiety disorders. Kasper and colleagues investigated the efficacy of lavender oil (WS® 1265) for AD NOS in comparison to placebo in a primary care setting.62 This study was the first double-blind, randomized, placebo-controlled trial to document the anxiolytic efficacy of orally administered lavender essential oil for anxiety disorder. In 27 general and psychiatric practices, 221 adults reporting unspecified anxiety were randomized to receive 80 mg per day of lavender oil or placebo for 10 weeks with office visits every 2 weeks. A baseline HAMA total score of ?18 and a total score > 5 for the Pittsburgh Sleep Quality Index (PSQI) were required. The primary outcome measures were HAMA and PSQI total score decrease between baseline and week 10. Secondary efficacy measures included the Clinical Global Impressions scale, the Zung Self-rating Anxiety Scale, and the SF-36 (Quality of Life) Health Survey Questionnaire. Subjects taking WS® 1265 showed a total score decrease by 16.0 ± 8.3 points (mean± SD, 59.3%) for the HAMA and by 5.5 ± 4.4 points (44.7%) for the PSQI compared to 9.5 ± 9.1 (35.4%) and 3.8 ± 4.1 points (30.9%) in the placebo group (P<0.01 one-sided, intention to treat). WS® 1265 was superior to placebo regarding the percentage of responders (76.9 vs. 49.1%, P<0.001) and remitters (60.6 vs. 42.6%, P=0.009). Adverse effects were uncommon and included dyspepsia (4.7% in the treatment group vs 1.8% in the placebo group) and eructation (3.7% in the treatment group and none in the placebo group). Lavender had a significant beneficial influence on quality and duration of sleep and improved general mental and physical health without causing any unwanted sedative or other drug-like effects. Researchers concluded that the lavender oil “is both efficacious and safe” for AD NOS and predicted that it could emerge as “a gentle therapeutic alternative in the treatment of anxiety.” Woelk and Schlaefke conducted a multicenter, double-blind, randomized Phase III study of lavender oil (Silexan, WS® 1265, Dr. Willmar Schwabe, Karlsruhe, Germany) in comparison to low-dose lorazepam for patients with GAD.63 The Hamilton Anxiety Rating Scale (HAMA-total score) was used as the primary objective measurement to monitor changes in the level of tension and relaxation beginning at baseline through week 6 of the trial. Additional data were collected using the Self-rating Anxiety Scale, Penn State Worry Questionnaire, SF-36 Health Survey Questionnaire, and specific sections of the Clinical Global Impressions of severity disorder. A total of 77 female (76.6%) and male (23.4%) subjects 18–65 years of age were randomized into groups. Participants were eligible for the study if they met the inclusion criteria of a HAMA-total score of greater than 18, as well as a score equal to or greater than 2 on both anxious mood and tension items. Secondary objective outcome data were obtained from responder and remission rate comparisons made between the 2 treatment groups. In order for a participant to qualify as having a significant response to treatment they were required to have a reduction of at least 50% in the HAMA-total score during the 6-week trial. Remission was defined as a HAMA-total score of less than 10 points at the end of the 6-week study. The results demonstrated that WS® 1265 was comparable to the conventional approach in its ability to promote relaxation.* The HAMA-total score decreased by 45% in the WS® 1265 group and decreased by 46% in the conventional group. At the conclusion of the 6-week intervention, 40% of the WS® 1265 group and 27% of the conventional treatment group were determined to be in remission. The WS® 1265 group had a response rate of 52.5% compared to only 40.5% taking the conventional option. Adverse effects in the WS® 1265 group were uncommon and included nausea (5.2%), eructation (3.9%), and dyspepsia (2.6%).

Oral Lavender Supplementation: Depression

In a 4-week randomized, double-blind study, researchers compared the efficacy of a tincture of L. angustifolia with imipramine in the treatment of mild to moderate depression.64 Forty-five adult outpatients who met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) for major depression based on the structured clinical interview for DSM-IV participated in the trial. Patients had a baseline Hamilton Rating Scale for Depression (HAMD) score of at least 18. In this study, patients were randomly assigned to receive lavender tincture (1:5 in 50% alcohol ) 60 drops per day plus placebo tablet (Group A), imipramine tablet 100 mg per day plus placebo drops (Group B), or imipramine tablet 100 mg/per day plus lavender tincture 60 drops per day (Group C) for 4 weeks. Lavender tincture at this concentration was found to be less effective than imipramine in the treatment of mild to moderate depression (P=0.001). In the imipramine group, anticholinergic effects such as dry mouth and urinary retention were observed, whereas headache was observed more in the lavender tincture group. The combination of imipramine and lavender tincture was more effective than imipramine alone (P<0.0001). Researchers concluded that lavender tincture may be of therapeutic benefit in the management of mild to moderate depression, but only as adjuvant therapy. In an open-label Phase II trial, Stange and colleagues administered 80 mg per day of lavender oil (Silexan, WS® 1265, Dr. Willmar Schwabe Pharmaceuticals, Karlsruhe, Germany) to 50 patients with neurasthenia, post-traumatic stress disorder, or somatization disorder for 3 months.65 Using the State Trait Anxiety Inventory, von Zerssen’s Depression Scale, and a sleep diary for assessment, researchers found that state and trait anxiety as well as depression were reduced and efficiency of sleep was improved significantly. Controlled clinical trials are needed to confirm whether oral lavender oil is an effective treatment for depression.

Comparison to Kava, Benzodiazepines, and Antidepressants

To date, lavender has been compared to benzodiazepines,66 paroxetine (an SSRI antidepressant), and imipramine (a tricyclic antidepressant). It has also been compared to kava.67 Kava was perhaps the best studied botanical anxiolytic and was the leading product in this category until concerns about liver toxicity prompted many companies to discontinue offering it. In a 6-week study, kava was found to produce a mean reduction of the HAMA score of 10 points, whereas the mean reduction of that score from lavender (WS® 1265) has ranged from 11.3 points (6-week study)63 to 16 points (10-week study),62 suggesting comparable to superior efficacy. Pharmaceutical anxiolytics (primarily benzodiazepines) typically produce HAMA reductions in the range of 11 to 15.3, suggesting comparable to superior efficacy of WS® 1265 without the attendant side effects.62,63,68,69 The Hamilton Anxiety Scale is used in most clinical trials of anxiolytic agents for GAD. In the study by Kasper and colleagues,62 a diagnosis of AD NOS was used instead, but the HAMA scale was still employed and baseline HAMA scores were similar across all trials (ie, > 18). At first glance it might appear that patients with AD NOS responded better to lavender than patients with GAD. However, the study of lavender for GAD was of shorter duration (6 weeks) than the study of lavender for AD NOS. In the longer study, the mean HAMA score change at the 6-week mark was nearly identical to that seen at the end of the 6-week study of patients with GAD. Therefore, the additional month of therapy at the same dose is likely to have had additional effects. In a meta-analysis of 21 double-blind, placebo-controlled trials in patients with GAD, Hidalgo and colleagues determined average effect sizes for HAMA total score change versus baseline of 0.50 for pregabalin, 0.45 for hydroxyzine, 0.42 for venlafaxine XR, 0.38 for benzodiazepines, 0.35 for selective serotonin reuptake inhibitors (SSRIs) and 0.17 for buspirone.70 The effect size of lavender (WS® 1265) was computed to be 0.75 in AD NOS. The significant reduction of anxiety-related symptoms in patients treated with lavender was not only evident in the judgment of the investigators, but was also perceived by the study participants subjectively according to the results of the self-rating questionnaire. The effects of lavender extract (WS® 1265) and other anxiolytic agents on HAMA scores are compared in Table 1 below. They are expressed as a mean HAMA score change. TABLE 1

  DoseLength of
study
DiagnosisHAMA score
at baseline
Mean HAMA
score change
Lavender (WS®
1265)62
80 mg/d10 weeksAD NOS26.8-16
Lavender (WS®
1265)63
80 mg/d6 weeksGAD25-11.3
Lorazepam630.5 mg/d6 weeksGAD25-11.6
Bromazepam713 mg TID6 weeksGAD28.07-13
Oxazepam705 mg TID6 weeksGAD28.24-11
Kava(WS®
1490)70
100 mg (70%
kavalactones) TID
6 weeksGAD28.35-10
Escitalopram7210-20 mg/d24 weeksGAD23.7-15.3
Paroxetine71 20-50 mg/d 24 weeksGAD 23.4-13.3
Duloxetine6860-120 mg/d9-10 weeksGAD -11.1

 Based upon the available data, it appears that therapy with at least some lavender extracts is comparable or superior in efficacy to many commonly prescribed anxiolytics, including benzodiazepines, SSRIs, and kava. The adverse event profile for lavender is the least severe of these options by a wide margin. In particular, benzodiazepines are well-known for their significant habit-forming potential, a drawback not found with lavender preparations.

Adverse Events, Safety and Dosage

The German Commission E Monographs list no contraindications, side effects, or drug interactions for lavender flower. Internal use of the volatile oil of lavender oil has been reported to cause nausea73 and drowsiness after excessive intake.74 This effect may be dose- and/or quality-dependent, as the occurrence of nausea was higher in the placebo group than in the treatment group (WS® 1265) in the largest and longest controlled clinical trial of lavender oil supplementation.62 In a brief report, Henley and colleagues described 3 cases of otherwise healthy boys with prepubertal gynecomastia,75 all of whom had normal serum concentrations of endogenous steroids and none of whom had been exposed to any known exogenous endocrine disruptors. The repeated topical application of 1 or more over-the-counter personal care products that contained lavender oil or lavender oil and tea tree oil was documented for all 3 patients. The authors performed in vitro tests that suggested weak estrogenic and antiandrogenic activities of the oils that may have contributed to an imbalance in estrogen and androgen pathway signaling. The effective dose of lavender oil is suggested to be 20–80 mg per day.36 The best-designed clinical studies with the most robust combination of efficacy and tolerability used 80 mg per day of a well-defined lavender oil. No serious adverse events during either of the published studies on this extract were reported.

Conclusion

Lavender oil aromatherapy has been shown to be effective in the management of anxiety and depression and small and medium-sized controlled and uncontrolled clinical trials. The best validated use of lavender as an anxiolytic agent is oral supplementation of 80 mg per day of a high-quality, well-defined lavender essential oil that has a demonstrated efficacy comparable or superior to benzodiazepines and kava, with a super safety profile.

Conflict of Interest Statement

Jeremy Appleton, ND, is an employee of Schwabe North America, a subsidiary of Dr. Willmar Schwabe GmbH & Co, which manufactures and distributes WS® 1265, discussed in this article.

About the Author

Jeremy Appleton, ND, is a licensed naturopathic physician. He is a graduate of Reed College and the National College of Natural Medicine. He served on faculty at NCNM as the nutrition department chair and has also taught at Bastyr University, where he did his residency. Appleton left his private practice in 1998 to work in the natural products industry. He is the author of several books and hundreds of articles on natural medicine. He currently serves as director of scientific affairs at Integrative Therapeutics.

Eating Disorders Aren’t What You Think: 9 Things You Should Know Experts say eating disorders can affect anyone, so it’s important to dispel any myths surrounding the ailments. Getty Images The Academy of Eating Disorders has released a list of “9 truths” they say people should know about eating disorders. They say the truths dispel myths that people with eating disorders are either overly skinny or noticeably overweight. Among the truths are eating disorders aren’t choices, families aren’t to blame for them, and eating disorders can affect anyone. If you or a loved one had an eating disorder, would you be able to recognize it? While stereotypes might indicate that people with eating disorders are malnourished and skinny, the full spectrum of eating disorders goes far beyond these preconceived notions. The Academy for Eating Disorders is trying to bust the stigma and improve knowledge of this disease. The advocacy group has released a new document titled Nine Truths about Eating Disorders. People can look healthy Many people may think a person with an eating disorder would be someone all “skin and bones” or someone who carries a lot of extra weight. But experts say this doesn’t reflect reality. Dr. Dina Hirsch, a senior psychologist at Syosset Hospital’s Center for Weight Management on Long Island in New York, told Healthline it’s important for physicians to recognize this truth. “Normal weight patients with eating disorders such as atypical anorexia or bulimia nervosa are often commended for their weight loss without discussion of how it was accomplished,” she said. “Both of these illnesses have physical and mental health consequences just as serious as anorexia nervosa but are frequently missed by medical professionals who are overly focused on praising them for weight loss,” she added. Families are not to blame The Academy for Eating Disorders’ document points out that families can be a source of strength for people dealing with an eating disorder. They can also serve as an ally for both the person and doctors alike. According to Dr. Shawna Newman, director of child and adolescent psychiatry at Lenox Hill Hospital in New York, family members may feel overwhelmed when a loved one is dealing with an eating disorder. “It’s really tough when parents are scared,” she told Healthline. “It’s tough to reel in the emotion.” But the same familial closeness that can cause anxiety can also help identify problems, assisting doctors in working toward a solution. “The great thing is that people can go to a doctor and have a relatively nonjudgmental assessment and feedback,” explained Newman. “You can easily accompany a family member to their appointment and speak to the doctor about staying on the right track with nutrition.” An eating disorder is a health crisis To some, an eating disorder may seem like a minor roadblock, one that’s easy to get over. But because these disorders affect a person’s psychological well-being, it isn’t that simple. Dr. S. Bryn Austin, president of the Academy of Eating Disorders, said in a release that the messaging in pop culture and society at large can often spur an eating disorder that can be tough to beat. “In addition, frank discrimination in healthcare against people living in larger bodies takes a direct and sometimes devastating toll on health and well-being regardless of whether or not a person believes the stigmatizing messages,” she said. Eating disorders aren’t choices An eating disorder may start off as someone choosing to starve themselves so they can fit into smaller clothes. But once the disorder has taken hold, it’s no longer a choice. “It’s so challenging when you have an eating disorder because food is necessary. We don’t get away from it. We’ve got to eat to live,” said Newman. Newman said that when a person has gotten themselves to a point where their brain is effectively rewired to think differently about how they look, it’s similar to trauma. Eating disorders can affect anyone “Eating disorders come in more than one flavor. The calorie restriction type in which people seriously restrict their intake is very common in teenage girls. But boys can be affected too,” said Newman. There’s truth to the notion that young women are the highest-risk group for developing eating disorders, but that doesn’t mean that men — or any other demographic group — are immune. According to statistics, about 2 percent of men will deal with a binge eating disorder at some point in their lives. There’s an increased risk for suicide There’s no shortage to the health risks that eating disorders can carry. The Academy of Eating Disorders released notes that the mortality rate for eating disorders is second only to opioid use disorder when it comes to psychiatric illnesses. According to a 2014 studyTrusted Source of 1,436 people with eating disorders, almost 12 percent had attempted suicide at some point while 43 percent had a history of suicidal ideation. Genes and environment play a role Various benchmarks, such as body mass index, give us a rough idea of what we need to do in order to be healthy. But the social and physiological determinants of health are tricky to pin down. “There are many factors that go into it,” said Newman. “Different people have different genetics. Biology isn’t just what you’re consuming, but it’s also that every person in every family has different strengths that can cause different kinds of weight.” “Weight is very much influenced by genetics, but it can also be influenced by cultural factors, as diets are different in different cultures, and there are different kinds of access to food,” she explained. Genes alone can’t predict While the influence of genetics on health and eating disorders can’t be denied, genes are hardly the end-all in terms of prediction. Eating disorders can be spurred by a person’s perception of what their body should look like — often influenced by images on social media or television. Sometimes things can be exacerbated by preconceptions from peers or even doctors, said Hirsch. “It’s imperative that we address weight bias by educating physicians on the nine truths — teaching them that eating disorders affect people of all shapes and sizes, that positive body image promotes health rather than the contrary, and that dietary restriction strategies can increase the risk of developing eating disorders,” she said. “Physicians also need to stop judging and blaming patients for their weight,” she added. Full recovery is possible Anyone who’s tried to change their eating habits knows that it isn’t as simple as just flipping a switch. The same goes for people with eating disorders who are trying to revert to healthier eating habits. “The idea that there’s something wrong about your body is very tough to get past,” said Newman. “It can take a long time. You can change your behaviors and re-train, but to change your core belief is very challenging.” While it may be a challenge for someone to lose their eating disorder, it’s certainly not impossible — particularly when the person, health professionals, and loved ones are all pulling in the right direction. “Weight-related issues should be treated like any other health issue — with compassion, sensitivity, and concern — and not judgment, blame, or oversimplification,” said Hirsch. “Only then will we be able to address one of the nation’s leading health problems — obesity — and decrease the rate of eating disorders.” Written by Dan Gray on January 14, 2020 New.

If you or a loved one had an eating disorder, would you be able to recognize it?

While stereotypes might indicate that people with eating disorders are malnourished and skinny, the full spectrum of eating disorders goes far beyond these preconceived notions.

The Academy for Eating Disorders is trying to bust the stigma and improve knowledge of this disease.

The advocacy group has released a new document titled Nine Truths about Eating Disorders.

People can look healthy

Many people may think a person with an eating disorder would be someone all “skin and bones” or someone who carries a lot of extra weight.

But experts say this doesn’t reflect reality.

Dr. Dina Hirsch, a senior psychologist at Syosset Hospital’s Center for Weight Management on Long Island in New York, told Healthline it’s important for physicians to recognize this truth.

“Normal weight patients with eating disorders such as atypical anorexia or bulimia nervosa are often commended for their weight loss without discussion of how it was accomplished,” she said.

“Both of these illnesses have physical and mental health consequences just as serious as anorexia nervosa but are frequently missed by medical professionals who are overly focused on praising them for weight loss,” she added.

Families are not to blame

The Academy for Eating Disorders’ document points out that families can be a source of strength for people dealing with an eating disorder.

They can also serve as an ally for both the person and doctors alike.

According to Dr. Shawna Newman, director of child and adolescent psychiatry at Lenox Hill Hospital in New York, family members may feel overwhelmed when a loved one is dealing with an eating disorder.

“It’s really tough when parents are scared,” she told Healthline. “It’s tough to reel in the emotion.”

But the same familial closeness that can cause anxiety can also help identify problems, assisting doctors in working toward a solution.

“The great thing is that people can go to a doctor and have a relatively nonjudgmental assessment and feedback,” explained Newman. “You can easily accompany a family member to their appointment and speak to the doctor about staying on the right track with nutrition.”

An eating disorder is a health crisis

To some, an eating disorder may seem like a minor roadblock, one that’s easy to get over.

But because these disorders affect a person’s psychological well-being, it isn’t that simple.

Dr. S. Bryn Austin, president of the Academy of Eating Disorders, said in a release that the messaging in pop culture and society at large can often spur an eating disorder that can be tough to beat.

“In addition, frank discrimination in healthcare against people living in larger bodies takes a direct and sometimes devastating toll on health and well-being regardless of whether or not a person believes the stigmatizing messages,” she said.

Eating disorders aren’t choices

An eating disorder may start off as someone choosing to starve themselves so they can fit into smaller clothes.

But once the disorder has taken hold, it’s no longer a choice.

“It’s so challenging when you have an eating disorder because food is necessary. We don’t get away from it. We’ve got to eat to live,” said Newman.

Newman said that when a person has gotten themselves to a point where their brain is effectively rewired to think differently about how they look, it’s similar to trauma.

Eating disorders can affect anyone

“Eating disorders come in more than one flavor. The calorie restriction type in which people seriously restrict their intake is very common in teenage girls. But boys can be affected too,” said Newman.

There’s truth to the notion that young women are the highest-risk group for developing eating disorders, but that doesn’t mean that men — or any other demographic group — are immune.

According to statistics, about 2 percent of men will deal with a binge eating disorder at some point in their lives.

There’s an increased risk for suicide

There’s no shortage to the health risks that eating disorders can carry.

The Academy of Eating Disorders released notes that the mortality rate for eating disorders is second only to opioid use disorder when it comes to psychiatric illnesses.

According to a 2014 studyTrusted Source of 1,436 people with eating disorders, almost 12 percent had attempted suicide at some point while 43 percent had a history of suicidal ideation.

Genes and environment play a role

Various benchmarks, such as body mass index, give us a rough idea of what we need to do in order to be healthy.

But the social and physiological determinants of health are tricky to pin down.

“There are many factors that go into it,” said Newman. “Different people have different genetics. Biology isn’t just what you’re consuming, but it’s also that every person in every family has different strengths that can cause different kinds of weight.”

“Weight is very much influenced by genetics, but it can also be influenced by cultural factors, as diets are different in different cultures, and there are different kinds of access to food,” she explained.

Genes alone can’t predict

While the influence of genetics on health and eating disorders can’t be denied, genes are hardly the end-all in terms of prediction.

Eating disorders can be spurred by a person’s perception of what their body should look like — often influenced by images on social media or television.

Sometimes things can be exacerbated by preconceptions from peers or even doctors, said Hirsch.

“It’s imperative that we address weight bias by educating physicians on the nine truths — teaching them that eating disorders affect people of all shapes and sizes, that positive body image promotes health rather than the contrary, and that dietary restriction strategies can increase the risk of developing eating disorders,” she said.

“Physicians also need to stop judging and blaming patients for their weight,” she added.

Full recovery is possible

Anyone who’s tried to change their eating habits knows that it isn’t as simple as just flipping a switch.

The same goes for people with eating disorders who are trying to revert to healthier eating habits.

“The idea that there’s something wrong about your body is very tough to get past,” said Newman. “It can take a long time. You can change your behaviors and re-train, but to change your core belief is very challenging.”

While it may be a challenge for someone to lose their eating disorder, it’s certainly not impossible — particularly when the person, health professionals, and loved ones are all pulling in the right direction.

“Weight-related issues should be treated like any other health issue — with compassion, sensitivity, and concern — and not judgment, blame, or oversimplification,” said Hirsch. “Only then will we be able to address one of the nation’s leading health problems — obesity — and decrease the rate of eating disorders.”FEEDBACK:

How to Cope with Anxiety

Do You Live with Anxiety? Here Are 11 Ways to Cope

anxiety

Breathe: There are ways to calm your anxiety

Know that feeling of your heart beating faster in response to a stressful situation? Or perhaps, instead, your palms get sweaty when you’re confronted with an overwhelming task or event.

That’s anxiety — our body’s natural response to stress.

If you haven’t recognized your triggers yet, here are a few common: your first day at a new job, meeting your partner’s family, or giving a presentation in front of a lot of people. Everyone has different triggers, and identifying them is one of the most important steps to coping and managing anxiety attacks.

Identifying your triggers can take some time and self-reflection. In the meantime, there are things you can do to try to help calm or quiet your anxiety from taking over.

5 quick ways to cope with anxiety

If your anxiety is sporadic and getting in the way of your focus or tasks, there are some quick natural remedies that could help you take control of the situation.

If your anxiety is focused around a situation, such as being worried about an upcoming event, you may notice the symptoms are short-lived and usually subside after the anticipated event takes place.

Question your thought pattern

Negative thoughts can take root in your mind and distort the severity of the situation. One way is to challenge your fears, ask if they’re true, and see where you can take back control.

Practice focused, deep breathing

Try breathing in for 4 counts and breathing out for 4 counts for 5 minutes total. By evening out your breath, you’ll slow your heart rate which should help calm you down.

The 4-7-8 technique is also known to help anxiety.

Use aromatherapy

Whether they’re in oil form, incense, or a candle, scents like lavender, chamomile, and sandalwood can be very soothing.

Aromatherapy is thought to help activate certain receptors in your brain, potentially easing anxiety.

Go for a walk or do 15 minutes of yoga

Sometimes, the best way to stop anxious thoughts is to walk away from the situation. Taking some time to focus on your body and not your mind may help relieve your anxiety.

Write down your thoughts

Writing down what’s making you anxious gets it out of your head and can make it less daunting.

These relaxation tricks are particularly helpful for those who experience anxiety sporadically. They may also work well with someone who has generalized anxiety disorder (GAD) when they’re in a bind too!

However, if you suspect you have GAD, quick coping methods shouldn’t be the only kind of treatment you employ. You’ll want to find long-term strategies to help lessen the severity of symptoms and even prevent them from happening.ADVERTISING

6 long-term strategies for coping with anxiety

If anxiety is a regular part of your life, it’s important to find treatment strategies to help you keep it in check. It might be a combination of things, like talk therapy and meditation, or it might just be a matter of cutting out or resolving your anxiety trigger.

If you’re not sure where to start, it’s always helpful to discuss options with a mental health professional who might suggest something you hadn’t thought of before.

Identify and learn to manage your triggers

You can identify triggers on your own or with a therapist. Sometimes they can be obvious, like caffeine, drinking alcohol, or smoking. Other times they can be less obvious.

Long-term problems, such as financial or work-related situations, may take some time to figure out — is it a due date, a person, or the situation? This may take some extra support, through therapy or with friends.

When you do figure out your trigger, you should try to limit your exposure if you can. If you can’t limit it — like if it’s due to a stressful work environment that you can’t currently change — using other coping techniques may help.

Some general triggers:

  • a stressful job or work environment
  • driving or traveling
  • genetics — anxiety could run in your family
  • withdrawal from drugs or certain medications
  • side effects of certain medications
  • trauma
  • phobias, such as agoraphobia (fear of crowded or open spaces) and claustrophobia (fear of small spaces)
  • some chronic illnesses like heart disease, diabetes, or asthma
  • chronic pain
  • having another mental illness such as depression
  • caffeine

Adopt cognitive behavioral therapy (CBT)

CBT helps people learn different ways of thinking about and reacting to anxiety-causing situations. A therapist can help you develop ways to change negative thought patterns and behaviors before they spiral.

Do a daily or routine meditation

While this takes some practice to do successfully, mindful meditation, when done regularly, can eventually help you train your brain to dismiss anxious thoughts when they arise.

If sitting still and concentrating is difficult, try starting with yoga.

Try supplements or change your diet

Changing your diet or taking supplements is definitely a long-term strategy. Research shows certain supplements or nutrients can help anxiety reduction.

These include:

  • lemon balm
  • omega-3 fatty acids
  • ashwagandha
  • green tea
  • valerian root
  • kava kava
  • dark chocolate (in moderation)

However, it can take up to three months before your body is actually running on the nutrition these herbs and foods provide. If you’re taking other medications, make sure to discuss herbal remedies with your doctor.

Keep your body and mind healthy

Exercising regularly, eating balanced meals, getting enough sleep, and staying connected to people who care about you are great ways to stave off anxiety symptoms.

Ask your doctor about medications

If your anxiety is severe enough that your mental health practitioner believes you’d benefit from medication, there are a number of directions to go, depending on your symptoms. Discuss your concerns with your doctor.

When is my anxiety harmful?

Identifying what sort of anxiety you’re dealing with can be somewhat challenging because how one’s body reacts to perceived danger can be entirely different compared to another person.

It’s likely you heard anxiety as a blanket term for that general feeling of worry, nervousness, or unease. It’s often a feeling grown in response to an upcoming event that has an uncertain outcome.

Every person deals with it at one time or another, because it’s part of our brain’s response to a perceived danger — even if that danger isn’t real.

That said, there are times anxiety can get serious and turn into anxiety attacks that initially feel manageable and then gradually build up over a few hours. (This is different from a panic attack, which is out of the blue and subsides.)

Signs of an anxiety attack

These are some of the more common mental and physical symptoms of anxiety:

It’s also possible to experience an anxiety and panic attack simultaneously. The quick coping strategies mentioned above may also help with a panic attack.

Other mindful strategies to cope with panic attacks include focusing on an object, repeating a mantra, closing your eyes, and going to your happy place.

Symptoms of a panic attack

What causes anxiety?

If you notice that quick tips haven’t been working, you may want to consider seeing a professional for help. Especially if you believe you have GAD and its interfering with routine activities and causing physical symptoms.

A mental health professional can help with streamlining the process of identifying your triggers, maintaining long-term strategies through behavioral therapy, medications, and more.

For example, if your anxiety stems from a trauma you experienced in your past, it can be helpful to work through that with a licensed therapist. On the other hand, if you’re brain chemistry predisposes you to chronic anxiety, you may need to go on medication to manage it.

Anxiety may always be a part of your life, but it shouldn’t overtake your day-to-day. Even the most extreme anxiety disorders can be treated so that the symptoms aren’t overwhelming.

Once you find what treatment works best for you, life should be a lot more enjoyable and a lot less daunting.

Taking the next step for your ASMTHA

Everything You Need to Know About High Cholesterol

What is cholesterol?

Cholesterol is a type of lipid. It’s a waxy, fat-like substance that your liver produces naturally. It’s vital for the formation of cell membranes, certain hormones, and vitamin D.

Cholesterol doesn’t dissolve in water, so it can’t travel through your blood on its own. To help transport cholesterol, your liver produces lipoproteins.

Lipoproteins are particles made from fat and protein. They carry cholesterol and triglycerides (another type of lipid) through your bloodstream. The two major forms of lipoprotein are low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

If your blood contains too much LDL cholesterol (cholesterol carried by low-density lipoprotein), it’s known as high cholesterol. When left untreated, high cholesterol can lead to many health problems, including heart attack or stroke.

High cholesterol typically causes no symptoms. That’s why it’s important to get your cholesterol levels checked on a regular basis. Learn what cholesterol levels are recommended for your age.

LDL cholesterol, or “bad cholesterol”

Low-density lipoprotein (LDL) is often called “bad cholesterol.” It carries cholesterol to your arteries. If your levels of LDL cholesterol are too high, it can build up on the walls of your arteries.

The buildup is also known as cholesterol plaque. This plaque can narrow your arteries, limit your blood flow, and raise your risk of blood clots. If a blood clot blocks an artery in your heart or brain, it can cause a heart attack or stroke.

According to the Centers for Disease Control and PreventionTrusted Source, over one-third of American adults have elevated levels of LDL cholesterol. Find out how you can check your LDL cholesterol levels.

HDL cholesterol, or “good cholesterol”

High-density lipoprotein (HDL) is sometimes called “good cholesterol.” It helps return LDL cholesterol to your liver to be removed from your body. This helps prevent cholesterol plaque from building up in your arteries.

When you have healthy levels of HDL cholesterol, it can help lower your risk of blood clots, heart disease, and stroke. Learn more about HDL cholesterol.

Triglycerides, a different type of lipid

Triglycerides are another type of lipid. They’re different from cholesterol. While your body uses cholesterol to build cells and certain hormones, it uses triglycerides as a source of energy.

When you eat more calories than your body can use right away, it converts those calories into triglycerides. It stores triglycerides in your fat cells. It also uses lipoproteins to circulate triglycerides through your bloodstream.

If you regularly eat more calories than your body can use, your triglyceride levels can get high. This may raise your risk of several health problems, including heart disease and stroke.

Your doctor can use a simple blood test to measure your triglyceride level, as well as your cholesterol levels. Learn how to get your triglyceride level tested.powered by Rubicon Project

Getting your cholesterol levels checked

If you’re age 20 years or older, the American Heart Association recommends getting your cholesterol levels checked at least once every four to six years. If you have a history of high cholesterol or other risk factors for cardiovascular disease, your doctor may encourage you get your cholesterol levels tested more often.

Your doctor can use a lipid panel to measure your total cholesterol level, as well your LDL cholesterol, HDL cholesterol, and triglyceride levels. Your total cholesterol level is the overall amount of cholesterol in your blood. It includes LDL and HDL cholesterol.

If your levels of total cholesterol or LDL cholesterol are too high, your doctor will diagnose you with high cholesterol. High cholesterol is especially dangerous when your LDL levels are too high and your HDL levels are too low. Find out more about your recommended cholesterol levels.

Tips

  • Pay attention to the saturated and trans fats on your food labels, as well as added sugars. The less of these you consume, the better. No more than 10 percent of your daily calories should come from either saturated fats or added sugars.
  • Don’t worry about eating enough cholesterol. Your body makes enough whether or not you consume it.
  • Eat more healthy, unsaturated fats. Try replacing butter with extra virgin olive oil in cooking, buy lean cuts of meat, and snack on nuts and seeds instead of french fries or processed snack foods.

Recent guidelines for normal cholesterol levels

Your body needs some cholesterol to function properly, including some LDL. But if your LDL levels are too high, it can raise your risk of serious health problems.

In 2013, the American College of Cardiologists (ACC) and the American Heart Association (AHA) developed new guidelines for the treatment of high cholesterol.

Before this change, doctors would manage cholesterol based on numbers in a cholesterol levels chart. Your doctor would measure your total cholesterol, HDL cholesterol, and LDL cholesterol levels. They would then decide whether to prescribe a cholesterol-lowering medication based on how your numbers compared to the numbers in the chart.

Under the new guidelines, in addition to your cholesterol levels, treatment recommendations consider other risk factors for heart disease. These risk factors include diabetes and the estimated 10-year risk for a cardiac event such as a heart attack or stroke. So what your “normal” cholesterol levels are depends on whether you have other risk factors for heart disease.

These new guidelines recommend that if you don’t have risk factors for heart disease, your doctor should prescribe treatment if your LDL is greater than 189 mg/dL. To find out what your personal cholesterol recommendations are, talk to your doctor.

Cholesterol levels chart

With the changes mentioned above in the treatment guidelines for high cholesterol, cholesterol charts are no longer considered the best way for doctors to gauge the management of cholesterol levels in adults.

However, for the average child and adolescent, the National Heart, Lung, and Blood InstituteTrusted Source classifies cholesterol levels (mg/dL) as follows:

Total cholesterolHDL cholesterolLDL cholesterol
Acceptablelower than 170higher than 45lower than 110
Borderline170–19940–45110–129
High200 or highern/ahigher than 130
Lown/alower than 40n/a

High cholesterol symptoms

In most cases, high cholesterol is a “silent” problem. It typically doesn’t cause any symptoms. Many people don’t even realize they have high cholesterol until they develop serious complications, such as a heart attack or stroke.

That’s why routine cholesterol screening is important. If you’re age 20 years or older, ask your doctor if you should have routine cholesterol screening. Learn how this screening could potentially save your life.

Causes of high cholesterol

Eating too many foods that are high in cholesterol, saturated fats, and trans fats may increase your risk of developing high cholesterol. Other lifestyle factors can also contribute to high cholesterol. These factors include inactivity and smoking.

Your genetics can also affect your chances of developing high cholesterol. Genes are passed down from parents to children. Certain genes instruct your body on how to process cholesterol and fats. If your parents have high cholesterol, you’re at higher risk of having it too.

In rare cases, high cholesterol is caused by familial hypercholesterolemia. This genetic disorder prevents your body from removing LDL. According to the National Human Genome Research Institute, most adults with this condition have total cholesterol levels above 300 mg/dL and LDL levels above 200 mg/dL.

Other health conditions, such as diabetes and hypothyroidism, may also increase your risk of developing high cholesterol and related complications.

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Risk factors for high cholesterol

You may be at a higher risk of developing high cholesterol if you:

  • are overweight or obese
  • eat an unhealthy diet
  • don’t exercise regularly
  • smoke tobacco products
  • have a family history of high cholesterol
  • have diabetes, kidney disease, or hypothyroidism

People of all ages, genders, and ethnicities can have high cholesterol. Explore strategies to lower your risk of high cholesterol and related complications.

Complications of high cholesterol

If left untreated, high cholesterol can cause plaque to build up in your arteries. Over time, this plaque can narrow your arteries. This condition is known as atherosclerosis.

Atherosclerosis is a serious condition. It can limit the flow of blood through your arteries. It also raises your risk of developing dangerous blood clots.

Atherosclerosis can result in many life-threatening complications, such as:

High cholesterol can also create a bile imbalance, raising your risk of gallstonesSee the other ways that high cholesterol can impact your body.

How to diagnose high cholesterol

To measure your cholesterol levels, your doctor will use a simple blood test. It’s known as a lipid panel. They can use it to assess your levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.

To conduct this test, your doctor or other healthcare professional will take a sample of your blood. They will send this sample to a lab for analysis. When your test results become available, they will let you know if your cholesterol or triglyceride levels are too high.

To prepare for this test, your doctor may ask you to avoid eating or drinking anything for at least 12 hours beforehand. Learn more about testing your cholesterol levels.

How to lower cholesterol

If you have high cholesterol, your doctor may recommend lifestyle changes to help lower it. For instance, they may recommend changes to your diet, exercise habits, or other aspects of your daily routine. If you smoke tobacco products, they will likely advise you to quit.

Your doctor may also prescribe medications or other treatments to help lower your cholesterol levels. In some cases, they may refer you to a specialist for more care. See how long it may take for your cholesterol treatment to work.

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Lowering cholesterol through diet

To help you achieve and maintain healthy cholesterol levels, your doctor may recommend changes to your diet.

For example, they may advise you to:

  • limit your intake of foods that are high in cholesterol, saturated fats, and trans fats
  • choose lean sources of protein, such as chicken, fish, and legumes
  • eat a wide variety of high-fiber foods, such as fruits, vegetables, and whole grains
  • opt for baked, broiled, steamed, grilled, and roasted foods instead of fried foods
  • avoid fast food and junk food

Foods that are high in cholesterol, saturated fats, or trans fats include:

  • red meat, organ meats, egg yolks, and high-fat dairy products
  • processed foods made with cocoa butter, palm oil, or coconut oil
  • deep fried foods, such as potato chips, onion rings, and fried chicken
  • certain baked goods, such as some cookies and muffins

Eating fish and other foods that contain omega-3 fatty acids may also help lower your LDL levels. For example, salmon, mackerel, and herring are rich sources of omega-3s. Walnuts, almonds, ground flax seeds, and avocados also contain omega-3s. Discover other foods that may help lower your cholesterol levels.

What high-cholesterol foods to avoid

Dietary cholesterol is found in animal products, such as meat, eggs, and dairy. To help treat high cholesterol, your doctor may encourage you to limit your intake of high-cholesterol foods.

For example, the following products contain high levels of cholesterol:

  • fatty cuts of red meat
  • liver and other organ meats
  • eggs, especially the yolks
  • high-fat dairy products, such as full-fat cheese, milk, ice cream, and butter

Depending on your doctor’s recommendations, you might be able to eat some of these foods in moderation. Learn more about high-cholesterol foods.

Cholesterol medications

In some cases, your doctor might prescribe medications to help lower your cholesterol levels.

Statins are the most commonly prescribed medications for high cholesterol. They block your liver from producing more cholesterol.

Examples of statins include:

Your doctor may also prescribe other medications for high cholesterol, such as:

  • niacin
  • bile acid resins or sequesterants, such as colesevalam (Welchol), colestipol (Colestid), or cholestyramine (Prevalite)
  • cholesterol absorption inhibitors, such as ezetimibe (Zetia)

Some products contain a combination of drugs to help decrease your body’s absorption of cholesterol from foods and reduce your liver’s production of cholesterol. One example is a combination of ezetimibe and simvastatin (Vytorin). Learn more about the drugs used to treat high cholesterol.

How to lower cholesterol naturally

In some cases, you may be able to lower your cholesterol levels without taking medications. For example, it may be enough to eat a nutritious diet, exercise regularly, and avoid smoking tobacco products.

Some people also claim that certain herbal and nutritional supplements may help lower cholesterol levels. For instance, such claims have been made about:

However, the level of evidence supporting these claims varies. Also, the U.S. Food and Drug Administration (FDA) hasn’t approved any of these products for treating high cholesterol. More research is needed to learn if they can help treat this condition.

Always talk to your doctor before taking any herbal or nutritional supplements. In some cases, they might interact with other medications you’re taking. Learn more about natural remedies for high cholesterol.

How to prevent high cholesterol

Genetic risk factors for high cholesterol can’t be controlled. However, lifestyle factors can be managed.

To lower your risk of developing high cholesterol:

  • Eat a nutritious diet that’s low in cholesterol and animal fats, and high in fiber.
  • Avoid excessive alcohol consumption.
  • Maintain a healthy weight.
  • Exercise regularly.
  • Don’t smoke.

You should also follow your doctor’s recommendations for routine cholesterol screening. If you’re at risk of high cholesterol or coronary heart disease, they will likely encourage you to get your cholesterol levels tested on a regular basis. Find out how to get your cholesterol levels checked.

Outlook for high cholesterol

If left untreated, high cholesterol can cause serious health problems and even death. However, treatment can help you manage this condition, and in many cases, it can help you avoid complications.

To learn if you have high cholesterol, ask your doctor to test your cholesterol levels. If they diagnose you with high cholesterol, ask them about your treatment options.

To lower your risk of complications from high cholesterol, practice healthy lifestyle habits and follow your doctor’s recommended treatment plan. Eating a well-balanced diet, exercising regularly, and avoiding tobacco products may help you achieve and maintain healthy cholesterol levels. It could also help lower your risk of complications from high cholesterol.

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Everything you need to know about High Cholesterol

Everything You Need to Know About High Cholesterol

What is cholesterol?

Cholesterol is a type of lipid. It’s a waxy, fat-like substance that your liver produces naturally. It’s vital for the formation of cell membranes, certain hormones, and vitamin D.

Cholesterol doesn’t dissolve in water, so it can’t travel through your blood on its own. To help transport cholesterol, your liver produces lipoproteins.

Lipoproteins are particles made from fat and protein. They carry cholesterol and triglycerides (another type of lipid) through your bloodstream. The two major forms of lipoprotein are low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

If your blood contains too much LDL cholesterol (cholesterol carried by low-density lipoprotein), it’s known as high cholesterol. When left untreated, high cholesterol can lead to many health problems, including heart attack or stroke.

High cholesterol typically causes no symptoms. That’s why it’s important to get your cholesterol levels checked on a regular basis. Learn what cholesterol levels are recommended for your age.

LDL cholesterol, or “bad cholesterol”

Low-density lipoprotein (LDL) is often called “bad cholesterol.” It carries cholesterol to your arteries. If your levels of LDL cholesterol are too high, it can build up on the walls of your arteries.

The buildup is also known as cholesterol plaque. This plaque can narrow your arteries, limit your blood flow, and raise your risk of blood clots. If a blood clot blocks an artery in your heart or brain, it can cause a heart attack or stroke.

According to the Centers for Disease Control and PreventionTrusted Source, over one-third of American adults have elevated levels of LDL cholesterol. Find out how you can check your LDL cholesterol levels.

HDL cholesterol, or “good cholesterol”

High-density lipoprotein (HDL) is sometimes called “good cholesterol.” It helps return LDL cholesterol to your liver to be removed from your body. This helps prevent cholesterol plaque from building up in your arteries.

When you have healthy levels of HDL cholesterol, it can help lower your risk of blood clots, heart disease, and stroke. Learn more about HDL cholesterol.

Triglycerides, a different type of lipid

Triglycerides are another type of lipid. They’re different from cholesterol. While your body uses cholesterol to build cells and certain hormones, it uses triglycerides as a source of energy.

When you eat more calories than your body can use right away, it converts those calories into triglycerides. It stores triglycerides in your fat cells. It also uses lipoproteins to circulate triglycerides through your bloodstream.

If you regularly eat more calories than your body can use, your triglyceride levels can get high. This may raise your risk of several health problems, including heart disease and stroke.

Your doctor can use a simple blood test to measure your triglyceride level, as well as your cholesterol levels. Learn how to get your triglyceride level tested.powered by Rubicon Project

Getting your cholesterol levels checked

If you’re age 20 years or older, the American Heart Association recommends getting your cholesterol levels checked at least once every four to six years. If you have a history of high cholesterol or other risk factors for cardiovascular disease, your doctor may encourage you get your cholesterol levels tested more often.

Your doctor can use a lipid panel to measure your total cholesterol level, as well your LDL cholesterol, HDL cholesterol, and triglyceride levels. Your total cholesterol level is the overall amount of cholesterol in your blood. It includes LDL and HDL cholesterol.

If your levels of total cholesterol or LDL cholesterol are too high, your doctor will diagnose you with high cholesterol. High cholesterol is especially dangerous when your LDL levels are too high and your HDL levels are too low. Find out more about your recommended cholesterol levels.

Tips

  • Pay attention to the saturated and trans fats on your food labels, as well as added sugars. The less of these you consume, the better. No more than 10 percent of your daily calories should come from either saturated fats or added sugars.
  • Don’t worry about eating enough cholesterol. Your body makes enough whether or not you consume it.
  • Eat more healthy, unsaturated fats. Try replacing butter with extra virgin olive oil in cooking, buy lean cuts of meat, and snack on nuts and seeds instead of french fries or processed snack foods.

Recent guidelines for normal cholesterol levels

Your body needs some cholesterol to function properly, including some LDL. But if your LDL levels are too high, it can raise your risk of serious health problems.

In 2013, the American College of Cardiologists (ACC) and the American Heart Association (AHA) developed new guidelines for the treatment of high cholesterol.

Before this change, doctors would manage cholesterol based on numbers in a cholesterol levels chart. Your doctor would measure your total cholesterol, HDL cholesterol, and LDL cholesterol levels. They would then decide whether to prescribe a cholesterol-lowering medication based on how your numbers compared to the numbers in the chart.

Under the new guidelines, in addition to your cholesterol levels, treatment recommendations consider other risk factors for heart disease. These risk factors include diabetes and the estimated 10-year risk for a cardiac event such as a heart attack or stroke. So what your “normal” cholesterol levels are depends on whether you have other risk factors for heart disease.

These new guidelines recommend that if you don’t have risk factors for heart disease, your doctor should prescribe treatment if your LDL is greater than 189 mg/dL. To find out what your personal cholesterol recommendations are, talk to your doctor.

Cholesterol levels chart

With the changes mentioned above in the treatment guidelines for high cholesterol, cholesterol charts are no longer considered the best way for doctors to gauge the management of cholesterol levels in adults.

However, for the average child and adolescent, the National Heart, Lung, and Blood InstituteTrusted Sourceclassifies cholesterol levels (mg/dL) as follows:

Total cholesterolHDL cholesterolLDL cholesterol
Acceptablelower than 170higher than 45lower than 110
Borderline170–19940–45110–129
High200 or highern/ahigher than 130
Lown/alower than 40n/a

High cholesterol symptoms

In most cases, high cholesterol is a “silent” problem. It typically doesn’t cause any symptoms. Many people don’t even realize they have high cholesterol until they develop serious complications, such as a heart attack or stroke.

That’s why routine cholesterol screening is important. If you’re age 20 years or older, ask your doctor if you should have routine cholesterol screening. Learn how this screening could potentially save your life.

Causes of high cholesterol

Eating too many foods that are high in cholesterol, saturated fats, and trans fats may increase your risk of developing high cholesterol. Other lifestyle factors can also contribute to high cholesterol. These factors include inactivity and smoking.

Your genetics can also affect your chances of developing high cholesterol. Genes are passed down from parents to children. Certain genes instruct your body on how to process cholesterol and fats. If your parents have high cholesterol, you’re at higher risk of having it too.

In rare cases, high cholesterol is caused by familial hypercholesterolemia. This genetic disorder prevents your body from removing LDL. According to the National Human Genome Research Institute, most adults with this condition have total cholesterol levels above 300 mg/dL and LDL levels above 200 mg/dL.

Other health conditions, such as diabetes and hypothyroidism, may also increase your risk of developing high cholesterol and related complications.

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Risk factors for high cholesterol

You may be at a higher risk of developing high cholesterol if you:

  • are overweight or obese
  • eat an unhealthy diet
  • don’t exercise regularly
  • smoke tobacco products
  • have a family history of high cholesterol
  • have diabetes, kidney disease, or hypothyroidism

People of all ages, genders, and ethnicities can have high cholesterol. Explore strategies to lower your risk of high cholesterol and related complications.

Complications of high cholesterol

If left untreated, high cholesterol can cause plaque to build up in your arteries. Over time, this plaque can narrow your arteries. This condition is known as atherosclerosis.

Atherosclerosis is a serious condition. It can limit the flow of blood through your arteries. It also raises your risk of developing dangerous blood clots.

Atherosclerosis can result in many life-threatening complications, such as:

High cholesterol can also create a bile imbalance, raising your risk of gallstonesSee the other ways that high cholesterol can impact your body.

How to diagnose high cholesterol

To measure your cholesterol levels, your doctor will use a simple blood test. It’s known as a lipid panel. They can use it to assess your levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.

To conduct this test, your doctor or other healthcare professional will take a sample of your blood. They will send this sample to a lab for analysis. When your test results become available, they will let you know if your cholesterol or triglyceride levels are too high.

To prepare for this test, your doctor may ask you to avoid eating or drinking anything for at least 12 hours beforehand. Learn more about testing your cholesterol levels.

How to lower cholesterol

If you have high cholesterol, your doctor may recommend lifestyle changes to help lower it. For instance, they may recommend changes to your diet, exercise habits, or other aspects of your daily routine. If you smoke tobacco products, they will likely advise you to quit.

Your doctor may also prescribe medications or other treatments to help lower your cholesterol levels. In some cases, they may refer you to a specialist for more care. See how long it may take for your cholesterol treatment to work.

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Lowering cholesterol through diet

To help you achieve and maintain healthy cholesterol levels, your doctor may recommend changes to your diet.

For example, they may advise you to:

  • limit your intake of foods that are high in cholesterol, saturated fats, and trans fats
  • choose lean sources of protein, such as chicken, fish, and legumes
  • eat a wide variety of high-fiber foods, such as fruits, vegetables, and whole grains
  • opt for baked, broiled, steamed, grilled, and roasted foods instead of fried foods
  • avoid fast food and junk food

Foods that are high in cholesterol, saturated fats, or trans fats include:

  • red meat, organ meats, egg yolks, and high-fat dairy products
  • processed foods made with cocoa butter, palm oil, or coconut oil
  • deep fried foods, such as potato chips, onion rings, and fried chicken
  • certain baked goods, such as some cookies and muffins

Eating fish and other foods that contain omega-3 fatty acids may also help lower your LDL levels. For example, salmon, mackerel, and herring are rich sources of omega-3s. Walnuts, almonds, ground flax seeds, and avocados also contain omega-3s. Discover other foods that may help lower your cholesterol levels.

What high-cholesterol foods to avoid

Dietary cholesterol is found in animal products, such as meat, eggs, and dairy. To help treat high cholesterol, your doctor may encourage you to limit your intake of high-cholesterol foods.

For example, the following products contain high levels of cholesterol:

  • fatty cuts of red meat
  • liver and other organ meats
  • eggs, especially the yolks
  • high-fat dairy products, such as full-fat cheese, milk, ice cream, and butter

Depending on your doctor’s recommendations, you might be able to eat some of these foods in moderation. Learn more about high-cholesterol foods.

Cholesterol medications

In some cases, your doctor might prescribe medications to help lower your cholesterol levels.

Statins are the most commonly prescribed medications for high cholesterol. They block your liver from producing more cholesterol.

Examples of statins include:

Your doctor may also prescribe other medications for high cholesterol, such as:

  • niacin
  • bile acid resins or sequesterants, such as colesevalam (Welchol), colestipol (Colestid), or cholestyramine (Prevalite)
  • cholesterol absorption inhibitors, such as ezetimibe (Zetia)

Some products contain a combination of drugs to help decrease your body’s absorption of cholesterol from foods and reduce your liver’s production of cholesterol. One example is a combination of ezetimibe and simvastatin (Vytorin). Learn more about the drugs used to treat high cholesterol.

How to lower cholesterol naturally

In some cases, you may be able to lower your cholesterol levels without taking medications. For example, it may be enough to eat a nutritious diet, exercise regularly, and avoid smoking tobacco products.

Some people also claim that certain herbal and nutritional supplements may help lower cholesterol levels. For instance, such claims have been made about:

However, the level of evidence supporting these claims varies. Also, the U.S. Food and Drug Administration (FDA) hasn’t approved any of these products for treating high cholesterol. More research is needed to learn if they can help treat this condition.

Always talk to your doctor before taking any herbal or nutritional supplements. In some cases, they might interact with other medications you’re taking. Learn more about natural remedies for high cholesterol.

How to prevent high cholesterol

Genetic risk factors for high cholesterol can’t be controlled. However, lifestyle factors can be managed.

To lower your risk of developing high cholesterol:

  • Eat a nutritious diet that’s low in cholesterol and animal fats, and high in fiber.
  • Avoid excessive alcohol consumption.
  • Maintain a healthy weight.
  • Exercise regularly.
  • Don’t smoke.

You should also follow your doctor’s recommendations for routine cholesterol screening. If you’re at risk of high cholesterol or coronary heart disease, they will likely encourage you to get your cholesterol levels tested on a regular basis. Find out how to get your cholesterol levels checked.

Outlook for high cholesterol

If left untreated, high cholesterol can cause serious health problems and even death. However, treatment can help you manage this condition, and in many cases, it can help you avoid complications.

To learn if you have high cholesterol, ask your doctor to test your cholesterol levels. If they diagnose you with high cholesterol, ask them about your treatment options.

To lower your risk of complications from high cholesterol, practice healthy lifestyle habits and follow your doctor’s recommended treatment plan. Eating a well-balanced diet, exercising regularly, and avoiding tobacco products may help you achieve and maintain healthy cholesterol levels. It could also help lower your risk of complications from high cholesterol.

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What causes Chronic Pain?

Everyone experiences occasional aches and pains. In fact, sudden pain is an important reaction of the nervous system that helps alert you to possible injury. When an injury occurs, pain signals travel from the injured area up your spinal cord and to your brain.

Pain will usually become less severe as the injury heals. However, chronic pain is different from typical pain. With chronic pain, your body continues to send pain signals to your brain, even after an injury heals. This can last several weeks to years. Chronic pain can limit your mobility and reduce your flexibility, strength, and endurance. This may make it challenging to get through daily tasks and activities.

Chronic pain is defined as pain that lasts at least 12 weeks. The pain may feel sharp or dull, causing a burning or aching sensation in the affected areas. It may be steady or intermittent, coming and going without any apparent reason. Chronic pain can occur in nearly any part of your body. The pain can feel different in the various affected areas.

Some of the most common types of chronic pain include:

  • headache
  • postsurgical pain
  • post-trauma pain
  • lower back pain
  • cancer pain
  • arthritis pain
  • neurogenic pain (pain caused by nerve damage)
  • psychogenic pain (pain that isn’t caused by disease, injury, or nerve damage)

According to the American Academy of Pain Medicine, more than 1.5 billion people around the world have chronic pain. It’s the most common cause of long-term disability in the United States, affecting about 100 million Americans.

What causes chronic pain?

Chronic pain is usually caused by an initial injury, such as a back sprain or pulled muscle. It’s believed that chronic pain develops after nerves become damaged. The nerve damage makes pain more intense and long lasting. In these cases, treating the underlying injury may not resolve the chronic pain.

In some cases, however, people experience chronic pain without any prior injury. The exact causes of chronic pain without injury aren’t well understood. The pain may sometimes result from an underlying health condition, such as:

Who is at risk for chronic pain?

Chronic pain can affect people of all ages, but it’s most common in older adults. Besides age, other factors that can increase your risk of developing chronic pain include:

  • having an injury
  • having surgery
  • being female
  • being overweight or obese

How is chronic pain treated?

The main goal of treatment is to reduce pain and boost mobility. This helps you return to your daily activities without discomfort.

The severity and frequency of chronic pain can differ among individuals. So doctors create pain management plans that are specific to each person. Your pain management plan will depend on your symptoms and any underlying health conditions. Medical treatments, lifestyle remedies, or a combination of these methods may be used to treat your chronic pain.

Medications for chronic pain

Several types of medications are available that can help treat chronic pain. Here are a few examples:

  • over-the-counter pain relievers, including acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin (Bufferin) or ibuprofen (Advil).
  • opioid pain relievers, including morphine (MS Contin), codeine, and hydrocodone (Tussigon)
  • adjuvant analgesics, such as antidepressants and anticonvulsants

Medical procedures for chronic pain

Certain medical procedures can also provide relief from chronic pain. An example of a few are:

  • electrical stimulation, which reduces pain by sending mild electric shocks into your muscles
  • nerve block, which is an injection that prevents nerves from sending pain signals to your brain
  • acupuncture, which involves lightly pricking your skin with needles to alleviate pain
  • surgery, which corrects injuries that may have healed improperly and that may be contributing to the pain

Lifestyle remedies for chronic pain

Additionally, various lifestyle remedies are available to help ease chronic pain. Examples include:

  • physical therapy
  • tai chi
  • yoga
  • art and music therapy
  • pet therapy
  • psychotherapy
  • massage
  • meditation

Dealing with chronic pain

There isn’t a cure for chronic pain, but the condition can be managed successfully. It’s important to stick to your pain management plan to help relieve symptoms.

Physical pain is related to emotional pain, so chronic pain can increase your stress levels. Building emotional skills can help you cope with any stress related to your condition. Here are some steps you can take to reduce stress:

Take good care of your body: Eating well, getting enough sleep, and exercising regularly can keep your body healthy and reduce feelings of stress.

Continue taking part in your daily activities: You can boost your mood and decrease stress by participating in activities you enjoy and socializing with friends. Chronic pain may make it challenging to perform certain tasks. But isolating yourself can give you a more negative outlook on your condition and increase your sensitivity to pain.

Seek support: Friends, family, and support groups can lend you a helping hand and offer comfort during difficult times. Whether you’re having trouble with daily tasks or you’re simply in need of an emotional boost, a close friend or loved one can provide the support you need.

For more information and resources, visit the American Chronic Pain Association website at theacpa.org.

 

What is Multiple Sclerosis?

What is multiple sclerosis (MS)?

Multiple sclerosis (MS) is a chronic illness involving your central nervous system (CNS). The immune system attacks myelin, which is the protective layer around nerve fibers.

This causes inflammation and scar tissue, or lesions. This can make it hard for your brain to send signals to the rest of your body. See illustrations that show the physiological changes associated with MS.

What are the symptoms of MS?

People with MS experience a wide range of symptoms. Due to the nature of the disease, symptoms can vary widely from person to person. They can also change in severity from year to year, month to month, and even day to day.

Two of the most common symptoms are fatigue and difficulty walking.

Fatigue

Around 80 percent of people with MS report having fatigue. Fatigue that occurs with MS can become debilitating, affecting your ability to work and perform everyday tasks.

Difficulty walking

Difficulty walking can occur with MS for a number of reasons:

Difficulty walking can also lead to injuries due to falling.

Other symptoms

Other fairly common symptoms of MS include:

  • acute or chronic pain
  • tremor
  • cognitive issues involving concentration, memory, and problem-solving skills

The condition can also lead to speech disorders. Learn more about the symptoms of MS.

What are the types of MS?

Types of MS include:

Clinically isolated syndrome (CIS)

Clinically isolated syndrome (CIS) involves one episode of symptoms lasting at least 24 hours. These symptoms are due to demyelination in your CNS.

There are two types of episodes: monofocal and multifocal. A monofocal episode means one lesion causes one symptom. A multifocal episode means you have more than one lesion and more than one symptom.

Although these episodes are characteristic of MS, they aren’t enough to prompt a diagnosis.

If lesions similar to those that occur with MS are present, you’re more likely to receive a diagnosis of relapsing-remitting MS (RRMS). If these lesions aren’t present, you’re less likely to develop MS.

Relapsing-remitting MS (RRMS)

Relapsing-remitting MS (RRMS) involves clear relapses of disease activity followed by remissions. During remission periods, symptoms are mild or absent and there’s no disease progression.

RRMS is the most common form of MS at onset and accounts for about 85 percent of all cases.

Primary progressive MS (PPMS)

If you have primary progressive MS (PPMS), neurological function becomes progressively worse from the onset of your symptoms. However, short periods of stability can occur. The terms “active” and “not active” are used to describe disease activity.

Progressive-relapsing MS (PRMS) was a term previously used to describe progressive MS with clear relapses. This is now categorized as PPMS.

Secondary progressive MS (SPMS)

Secondary progressive MS (SPMS) occurs when RRMS transitions into the progressive form. You may still have noticeable relapses in addition to disability or gradual worsening of function.

The bottom line

Your MS may change and evolve, but you can only have one type of MS at a time. Find out more about the different types of MS.

How is MS treated?

No cure is available for MS, but multiple treatment options exist.

Disease-modifying therapies (DMTs)

Disease-modifying therapies (DMTs) are designed to slow disease progression and lower your relapse rate.

Self-injectable disease-modifying medications for RRMS include glatiramer acetate (Copaxone)and beta interferons, such as:

Oral medications for RRMS include:

Intravenous infusion treatments for RRMS include:

  • alemtuzumab (Lemtrada)
  • natalizumab (Tysabri)
  • mitoxantrone hydrochloride (only available in generic form), which is for severe MS only

In 2017, the Food and Drug Administration (FDA) approved the first DMT for people with PPMS. This injectable drug is called ocrelizumab (Ocrevus), and it can also be used to treat RRMS.

Not all MS drugs will be available to or appropriate for every person. Talk to your doctor about which drugs are currently on the market and the risks and benefits of each one.

Other drugs

Your doctor can prescribe corticosteroids, such as methylprednisolone (Medrol) and prednisone (Prednisone Intensol, Rayos) to treat relapses.

Other treatments may also ease your symptoms and improve your quality of life. Because MS is different for everyone, treatment depends on your specific symptoms. For most, a flexible approach is necessary. Get more information on treatments for MS.

What are the early signs of MS?

MS can develop all at once, or the symptoms can be so mild that you easily dismiss them. Three of the most common early symptoms of MS are:

  • Numbness and tingling that affects the arms, legs, or one side of your face. These sensations are similar to the pins-and-needles feeling you get when your foot falls asleep. However, they occur for no apparent reason.
  • Uneven balance and weak legs. You may find yourself tripping easily while walking or doing some other type of physical activity.
  • Double vision, blurry vision, or partial vision loss. These can be an early indicator of MS. You may also have some eye pain.

It isn’t uncommon for these early symptoms to go away only to return later. You may go weeks, months, or even years between flare-ups.

These symptoms can have many different causes. Even if you have these symptoms, it doesn’t necessarily mean that you have MS. Discover more early signs of MS.

What causes MS?

If you have MS, the protective layer of myelin around your nerve fibers becomes damaged.

It’s thought that the damage is the result of an immune system attack. Researchers think there could be an environmental trigger such as a virus or toxin that sets off the immune system attack.

As your immune system attacks myelin, it causes inflammation. This leads to scar tissue, or lesions. The inflammation and scar tissue disrupt signals between your brain and other parts of your body.

MS isn’t hereditary, but having a parent or sibling with MS raises your risk slightly. Scientists have identified some genes that seem to increase susceptibility to developing MS. Find out more about the possible causes of MS.

How is MS diagnosed?

Your doctor will need to perform a neurological exam, a clinical history, and a series of other tests to determine if you have MS.

Diagnostic testing may include the following:

  • MRI scan. Using a contrast dye with the MRI allows your doctor to detect active and inactive lesions throughout your brain and spinal cord.
  • Visual evoked potentials test. This test requires the stimulation of nerve pathways to analyze electrical activity in your brain. In the past, brainstem auditory and sensory evoked potential tests were also used to diagnose MS.
  • Spinal tap (lumbar puncture). Your doctor may use a spinal tap to find abnormalities in your spinal fluid. It can help rule out infectious diseases.
  • Blood tests. Doctors use blood tests to eliminate other conditions with similar symptoms.

The diagnosis of MS requires evidence of demyelination occurring at different times in more than one area of your brain, spinal cord, or optic nerves.

It also requires ruling out other conditions that have similar symptoms. Lyme diseaselupus, and Sjögren’s syndrome are just a few examples. Learn more about the tests used to diagnose MS.

What’s it like to live with MS?

Most people with MS find ways to manage their symptoms and function well.

Medications

Having MS means you’ll need to see a doctor experienced in treating MS.

If you take one of the DMTs, you’ll have to make sure you adhere to the recommended schedule. Your doctor may prescribe other medications to treat specific symptoms.

Diet and exercise

well-balanced diet, low in empty calories and high in nutrients and fiber, will help you manage your overall health.

Regular exercise is important for physical and mental health, even if you have disabilities. If physical movement is difficult, swimming or exercising in a swimming pool can help. Some yoga classes are designed just for people with MS.

Other complementary therapies

Studies regarding the effectiveness of complementary therapies are scarce, but that doesn’t mean they can’t help in some way.

The following may help you feel less stressed and more relaxed:

The bottom line

MS is a lifelong condition. You’ll face unique challenges that can change over time.

You should focus on communicating concerns with your doctor, learning all you can about MS, and discovering what makes you feel your best.

Many people with MS even choose to share their challenges and coping strategies through in-person or online support groups. See what 11 public figures have to say about navigating life with MS.

You can also try our free MS Buddy app to share advice and support in an open environment. Download for iPhone or Android.

What are the dietary recommendations for people with MS?

Diet hasn’t been shown to have an impact on the nature of the disease, but it can help with some of your challenges. If you’re fatigued, for instance, a diet high in fats and simple carbohydrates won’t help.

What to eat

Your diet should mainly consist of:

The better your diet, the better your overall health. You’ll not only feel better in the short term, but you’ll be laying the foundation for a healthier future. Explore the relationship between diet and MS.

What to limit or avoid

You should limit or avoid:

If you have other medical conditions, ask your doctor if you should follow a special diet or take any dietary supplements. Specialized diets such as the ketopaleo, or Mediterranean diets may help with some of the challenges faced by people with MS.

Read food labels. Foods that are high in calories but low in nutrients won’t help you feel better or maintain a healthy weight. Check out these additional tips for eating an MS-friendly diet.

What are the statistics on MS?

According to the National Multiple Sclerosis Society, there hasn’t been a scientifically sound national study on the prevalence of MS in the United States since 1975. In a 2017 study, however, the Society estimated that around 1 million Americans have MS.

Other things you should know:

  • MS is the most widespreadTrusted Source neurological condition disabling young adults worldwide.
  • Most people are between the ages of 20 and 50 at the time of their diagnosis.
  • Overall, MS is more common in women than men. According to the National Multiple Sclerosis Society, RRMS is two to three times more common in women than men, and PPMS rates in women and men are roughly equal.
  • Rates of MS tend to be lower in places that are closer to the equator. This may have to do with sunlight and vitamin D exposure. People who relocate to a new location before age 15 generally acquire the risk factors associated with the new location.
  • Data from 1999 to 2008 showed that direct and indirect costs of MS were between $8,528 and $54,244 per year. Current DMTs for RRMS can cost up to $60,000 a year. Ocrelizumab (Ocrevus) costs $65,000 a year.

Canadians have the highest rate of MS in the world. Check out more MS facts and statistics here.

What are the effects of MS?

The lesions from MS can appear anywhere in your CNS and affect any part of your body.

Mobility issues

As you age, some disabilities from MS may become more pronounced. If you have mobility issues, falling may put you at an increased risk of bone fractures. Having other conditions such as arthritis and osteoporosis can complicate matters.

Other issues

One of the most common symptoms of MS is fatigue, but it’s not uncommon for people with MS to also have:

  • depression
  • anxiety
  • some degree of cognitive impairment

The bottom line

Mobility issues can lead to a lack of physical activity, which can cause other health problems. Fatigue and mobility issues may also have an impact on sexual function. Discover more effects of MS.

What is the prognosis for people with MS?

It’s almost impossible to predict how MS will progress in any one person.

About 10 to 15 percent of people with MS have only rare attacks and minimal disability ten years after diagnosis. This is sometimes called benign MS.

About half of people with MS use a cane or other form of assistance 15 years after receiving an MS diagnosis. At 20 years, about 60 percent are still ambulatory and less than 15 percent need care for their basic needs.

MS type

Progressive MS generally advances faster than RRMS. People with RRMS can be in remission for many years. A lack of disability after five years is usually a good indicator for the future.

Age and sex

The disease generally progresses faster in men than in women. It may also progress faster in those who receive a diagnosis after age 40 and in those who have a high relapse rate.

The bottom line

Your quality of life will depend on your symptoms and how well you respond to treatment. This rarely fatal but unpredictable disease can change course without warning.

Most people with MS don’t become severely disabled and continue to lead full lives. Take a closer look at the prognosis for people with MS.

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OBAMA CARE aka The Affordable Care Act

The Affordable Care Act

The Affordable Care Act (ACA), also known as Obamacare, was signed into law in 2010.

The act aimed to provide affordable health insurance coverage for all Americans. The ACA was also designed to protect consumers from insurance company tactics that might drive up patient costs or restrict care.

Millions of Americans have benefitted by receiving insurance coverage through the ACA. Many of these people were unemployed or had low-paying jobs. Some couldn’t work because of a disability or family obligations. Others couldn’t get decent health insurance because of a preexisting medical condition, such as a chronic disease.

The ACA has been highly controversial, despite the positive outcomes.

Conservatives objected to the tax increases and higher insurance premiums needed to pay for Obamacare. Some people in the healthcare industry are critical of the additional workload and costs placed on medical providers. They also think it may have negative effects on the quality of care.

As a result, there are frequent calls for the ACA to be repealed or overhauled.

Here’s a look at some of the pros and cons of Obamacare.

Pros

More Americans have health insurance

More than 16 million Americans obtained health insurance coverage within the first five years of the ACA. Young adults make up a large percentage of these newly insured people.

Health insurance is more affordable for many people

Insurance companies must now spend at least 80 percent of insurance premiums on medical care and improvements. The ACA also aims to prevent insurers from making unreasonable rate increases.

Insurance coverage isn’t free by any means, but people now have a wider range of coverage options.

People with preexisting health conditions can no longer be denied coverage

A preexisting condition, such as cancer, made it difficult for many people to get health insurance before the ACA. Most insurance companies wouldn’t cover treatment for these conditions. They said this was because the illness or injury occurred before you were covered by their plans.

Under the ACA, you can’t be denied coverage because of a preexisting health problem.

No time limits exist on care

Before the ACA, some people with chronic health problems ran out of insurance coverage. Insurance companies set limits on the amount of money they would spend on an individual consumer.

Insurance companies can no longer maintain a preset dollar limit on the coverage they provide their customers.

More screenings are covered

The ACA covers many screenings and preventive services. These usually have low copays or deductibles. The hope is that if you’re proactive in your healthcare, you can avoid or delay major health problems later.

Healthier consumers will lead to lower costs over time. For example, a diabetes screening and early treatment may help prevent costly and debilitating treatment later.

“The ACA is going to help all Americans have higher quality and less costly healthcare in the decades to come,” says Dr. Christopher Lillis, an internist in Virginia and a member of Doctors for America.

Prescription drugs cost less

The ACA promised to make prescription drugs more affordable. Many people, particularly senior citizens, are unable to afford all their medications. The number of prescription and generic drugs covered by the ACA is growing every year.

According to a Centers for Medicare and Medicaid Services press release from 2017, Medicare beneficiaries have saved over $26.8 billion on prescription drugs under Obamacare.

Cons

Many people have to pay higher premiums

Insurance companies now provide a wider range of benefits and cover people with preexisting conditions. This has caused premiums to rise for a lot of people who already had health insurance.

You can be fined if you don’t have insurance

The goal of Obamacare is for people to be insured year round. If you’re uninsured and don’t obtain an exemption, you must pay a modest fine. Recent events have changed this fine, and beginning with the tax year 2019 it will be eliminated.

Some people think it’s intrusive for the government to require health insurance. ACA supporters argue that not having insurance passes your healthcare costs on to everyone else.

Taxes are going up as a result of the ACA

Several new taxes were passed into law to help pay for the ACA, including taxes on medical device and pharmaceutical sales. Taxes were also increased for people with high incomes. Funding also comes from savings in Medicare payments.

The wealthy are helping to subsidize insurance for the poor. Some economists, however, predict that in the long term, the ACA will help reduce the deficit and may eventually have a positive impact on the budget.

It’s best to be prepared for enrollment day

The ACA website had a lot of technical problems when it was first launched. This made it difficult for people to enroll and led to delays and lower-than-expected signups.

The website problems were eventually fixed, but many consumers have complained that signing up for the right family or business coverage can be tricky. In recent years, the enrollment period has also been shortened to between November 1 and December 15.

Many hospitals and public health agencies have set up programs to help guide consumers and business owners through the setup process. The ACA website also has sections devoted to explaining the procedures and available options.

Businesses are cutting employee hours to avoid covering employees

Opponents of Obamacare claimed the legislation would destroy jobs. The number of full-time jobs has gone up in recent years, but there are still reports of businesses cutting hours from employee schedules.

Business with 50 or more full-time employees must offer insurance or make payments to cover healthcare expenses for employees. By reducing hours, businesses are able to get by the 30-hour-per-week definition of a full-time employee.

Looking ahead

The ACA is subject to changes every year. The legislation can be amended, and budget decisions can affect how it’s implemented. Changes in the healthcare field, along with changes to the political makeup of future presidential administrations and Congress, make it likely that the ACA will continue to change for years to come.

If you or a loved one have bipolar disorder.. read on.

What is bipolar disorder?

Bipolar disorder is a mental illness marked by extreme shifts in mood. Symptoms can include an extremely elevated mood called mania. They can also include episodes of depression. Bipolar disorder is also known as bipolar disease or manic depression.

People with bipolar disorder may have trouble managing everyday life tasks at school or work, or maintaining relationships. There’s no cure, but there are many treatment options available that can help to manage the symptoms. Learn the signs of bipolar disorder to watch for.

Bipolar disorder facts

Bipolar disorder isn’t a rare brain disorder. In fact, 2.8 percent of U.S. adults — or about 5 million people — have been diagnosed with it. The average age when people with bipolar disorder begin to show symptoms is 25 years old.

Depression caused by bipolar disorder lasts at least two weeks. A high (manic) episode can last for several days or weeks. Some people will experience episodes of changes in mood several times a year, while others may experience them only rarely. Here’s what having bipolar disorder feels like for some people.

Bipolar disorder symptoms

There are three main symptoms that can occur with bipolar disorder: mania, hypomania, and depression.

While experiencing mania, a person with bipolar disorder may feel an emotional high. They can feel excited, impulsive, euphoric, and full of energy. During manic episodes, they may also engage in behavior such as:

Hypomania is generally associated with bipolar II disorder. It’s similar to mania, but it’s not as severe. Unlike mania, hypomania may not result in any trouble at work, school, or in social relationships. However, people with hypomania still notice changes in their mood.

During an episode of depression you may experience:

Although it’s not a rare condition, bipolar disorder can be hard to diagnose because of its varied symptoms. Find out about the symptoms that often occur during high and low periods.

Bipolar disorder symptoms in women

Men and women are diagnosed with bipolar disorder in equal numbers. However, the main symptoms of the disorder may be different between the two genders. In many cases, a woman with bipolar disorder may:

  • be diagnosed later in life, in her 20s or 30s
  • have milder episodes of mania
  • experience more depressive episodes than manic episodes
  • have four or more episodes of mania and depression in a year, which is called rapid cycling
  • experience other conditions at the same time, including thyroid diseaseobesityanxiety disorders, and migraines
  • have a higher lifetime risk of alcohol use disorder

Women with bipolar disorder may also relapse more often. This is believed to be caused by hormonal changes related to menstruation, pregnancy, or menopause. If you’re a woman and think you may have bipolar disorder, it’s important for you to get the facts. Here’s what you need to know about bipolar disorder in women.

Bipolar disorder symptoms in men

Men and women both experience common symptoms of bipolar disorder. However, men may experience symptoms differently than women. Men with bipolar disorder may:

  • be diagnosed earlier in life
  • experience more severe episodes, especially manic episodes
  • have substance abuse issues
  • act out during manic episodes

Men with bipolar disorder are less likely than women to seek medical care on their own. They’re also more likely to die by suicide.

Types of bipolar disorder

There are three main types of bipolar disorder: bipolar I, bipolar II, and cyclothymia.

Bipolar I

Bipolar I is defined by the appearance of at least one manic episode. You may experience hypomanic or major depressive episodes before and after the manic episode. This type of bipolar disorder affects men and women equally.

Bipolar II

People with this type of bipolar disorder experience one major depressive episode that lasts at least two weeks. They also have at least one hypomanic episode that lasts about four days. This type of bipolar disorder is thought to be more common in women.

Cyclothymia

People with cyclothymia have episodes of hypomania and depression. These symptoms are shorter and less severe than the mania and depression caused by bipolar I or bipolar II disorder. Most people with this condition only experience a month or two at a time where their moods are stable.

When discussing your diagnosis, your doctor will be able to tell you what kind of bipolar disorder you have. In the meantime, learn more about the types of bipolar disorder.

Bipolar disorder in children

Diagnosing bipolar disorder in children is controversial. This is largely because children don’t always display the same bipolar disorder symptoms as adults. Their moods and behaviors may also not follow the standards doctors use to diagnose the disorder in adults.

Many bipolar disorder symptoms that occur in children also overlap with symptoms from a range of other disorders that can occur in children, such as attention deficit hyperactivity disorder (ADHD).

However, in the last few decades, doctors and mental health professionals have come to recognize the condition in children. A diagnosis can help children get treatment, but reaching a diagnosis may take many weeks or months. Your child may need to seek special care from a professional trained to treat children with mental health issues.

Like adults, children with bipolar disorder experience episodes of elevated mood. They can appear very happy and show signs of excitable behavior. These periods are then followed by depression. While all children experience mood changes, changes caused by bipolar disorder are very pronounced. They’re also usually more extreme than a child’s typical change in mood.

Manic symptoms in children

Symptoms of a child’s manic episode caused by bipolar disorder can include:

  • acting very silly and feeling overly happy
  • talking fast and rapidly changing subjects
  • having trouble focusing or concentrating
  • doing risky things or experimenting with risky behaviors
  • having a very short temper that leads quickly to outbursts of anger
  • having trouble sleeping and not feeling tired after sleep loss

Depressive symptoms in children

Symptoms of a child’s depressive episode caused by bipolar disorder can include:

  • moping around or acting very sad
  • sleeping too much or too little
  • having little energy for normal activities or showing no signs of interest in anything
  • complaining about not feeling well, including having frequent headaches or stomachaches
  • experiencing feelings of worthlessness or guilt
  • eating too little or too much
  • thinking about death and possibly suicide

Other possible diagnoses

Some of the behavior issues you may witness in your child could be the result of another condition. ADHD and other behavior disorders can occur in children with bipolar disorder. Work with your child’s doctor to document your child’s unusual behaviors, which will help lead to a diagnosis.

Finding the correct diagnosis can help your child’s doctor determine treatments that can help your child live a healthy life. Read more about bipolar disorder in children.

Bipolar disorder in teens

Angst-filled behavior is nothing new to the average parent of a teenager. The shifts in hormones, plus the life changes that come with puberty, can make even the most well-behaved teen seem a little upset or overly emotional from time to time. However, some teenage changes in mood may be the result of a more serious condition, such as bipolar disorder.

A bipolar disorder diagnosis is most common during the late teens and early adult years. For teenagers, the more common symptoms of a manic episode include:

  • being very happy
  • “acting out” or misbehaving
  • taking part in risky behaviors
  • abusing substances
  • thinking about sex more than usual
  • becoming overly sexual or sexually active
  • having trouble sleeping but not showing signs of fatigue or being tired
  • having a very short temper
  • having trouble staying focused, or being easily distracted

For teenagers, the more common symptoms of a depressive episode include:

  • sleeping a lot or too little
  • eating too much or too little
  • feeling very sad and showing little excitability
  • withdrawing from activities and friends
  • thinking about death and suicide

Diagnosing and treating bipolar disorder can help teens live a healthy life. Learn more about bipolar disorder in teenagers and how to treat it.

Bipolar disorder and depression

Bipolar disorder can have two extremes: up and down. To be diagnosed with bipolar, you must experience a period of mania or hypomania. People generally feel “up” in this phase of the disorder. When you’re experiencing an “up” change in mood, you may feel highly energized and be easily excitable.

Some people with bipolar disorder will also experience a major depressive episode, or a “down” mood. When you’re experiencing a “down” change in mood, you may feel lethargic, unmotivated, and sad. However, not all people with bipolar disorder who have this symptom feel “down” enough to be labeled depressed. For instance, for some people, once their mania is treated, a normal mood may feel like depression because they enjoyed the “high” caused by the manic episode.

While bipolar disorder can cause you to feel depressed, it’s not the same as the condition called depression. Bipolar disorder can cause highs and lows, but depression causes moods and emotions that are always “down.” Discover the differences between bipolar disorder and depression.

Causes of bipolar disorder

Bipolar disorder is a common mental health disorder, but it’s a bit of a mystery to doctors and researchers. It’s not yet clear what causes some people to develop the condition and not others.

Possible causes of bipolar disorder include:

Genetics

If your parent or sibling has bipolar disorder, you’re more likely than other people to develop the condition (see below). However, it’s important to keep in mind that most people who have bipolar disorder in their family history don’t develop it.

Your brain

Your brain structure may impact your risk for the disease. Abnormalities in the structure or functions of your brain may increase your risk.

Environmental factors

It’s not just what’s in your body that can make you more likely to develop bipolar disorder. Outside factors may contribute, too. These factors can include:

  • extreme stress
  • traumatic experiences
  • physical illness

Each of these factors may influence who develops bipolar disorder. What’s more likely, however, is that a combination of factors contributes to the development of the disease. Here’s what you need to know about the potential causes of bipolar disorder.

Is bipolar disorder hereditary?

Bipolar disorder can be passed from parent to child. Research has identified a strong genetic link in people with the disorder. If you have a relative with the disorder, your chances of also developing it are four to six times higher than people without a family history of the condition.

However, this doesn’t mean that everyone with relatives who have the disorder will develop it. In addition, not everyone with bipolar disorder has a family history of the disease.

Still, genetics seem to play a considerable role in the incidence of bipolar disorder. If you have a family member with bipolar disorder, find out whether screening might be a good idea for you.

Bipolar disorder diagnosis

A diagnosis of bipolar disorder I involves either one or more manic episodes, or mixed (manic and depressive) episodes. It may also include a major depressive episode, but it may not. A diagnosis of bipolar II involves one or more major depressive episodes and at least one episode of hypomania.

To be diagnosed with a manic episode, you must experience symptoms that last for at least one week or that cause you to be hospitalized. You must experience symptoms almost all day every day during this time. Major depressive episodes, on the other hand, must last for at least two weeks.

Bipolar disorder can be difficult to diagnose because mood swings can vary. It’s even harder to diagnose in children and adolescents. This age group often has greater changes in mood, behavior, and energy levels.

Bipolar disorder often gets worse if it’s left untreated. Episodes may happen more often or become more extreme. But if you receive treatment for your bipolar disorder, it’s possible for you to lead a healthy and productive life. Therefore, diagnosis is very important. See how bipolar disorder is diagnosed.

Bipolar disorder symptoms test

One test result doesn’t make a bipolar disorder diagnosis. Instead, your doctor will use several tests and exams. These may include:

  • Physical exam. Your doctor will do a full physical exam. They may also order blood or urine tests to rule out other possible causes of your symptoms.
  • Mental health evaluation. Your doctor may refer you to a mental health professional such as a psychologist or psychiatrist. These doctors diagnose and treat mental health conditions such as bipolar disorder. During the visit, they will evaluate your mental healthand look for signs of bipolar disorder.
  • Mood journal. If your doctor suspects your behavior changes are the result of a mood disorder like bipolar, they may ask you to chart your moods. The easiest way to do this is to keep a journal of how you’re feeling and how long these feelings last. Your doctor may also suggest that you record your sleeping and eating patterns.
  • Diagnostic criteria. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is an outline of symptoms for various mental health disorders. Doctors can follow this list to confirm a bipolar diagnosis.

Your doctor may use other tools and tests to diagnose bipolar disorder in addition to these. Read about other tests that can help confirm a bipolar disorder diagnosis.

Bipolar disorder treatment

Several treatments are available that can help you manage your bipolar disorder. These include medications, counseling, and lifestyle changes. Some natural remedies may also be helpful.

Medications

Recommended medications may include:

  • mood stabilizers, such as lithium (Lithobid)
  • antipsychotics, such as olanzapine (Zyprexa)
  • antidepressant-antipsychotics, such as fluoxetine-olanzapine (Symbyax)
  • benzodiazepines, a type of anti-anxiety medication such as alprazolam (Xanax) that may be used for short-term treatment

Psychotherapy

Recommended psychotherapy treatments may include:

Cognitive behavioral therapy

Cognitive behavioral therapy is a type of talk therapy. You and a therapist talk about ways to manage your bipolar disorder. They will help you understand your thinking patterns. They can also help you come up with positive coping strategies.

Psychoeducation

Psychoeducation is a kind of counseling that helps you and your loved ones understand the disorder. Knowing more about bipolar disorder will help you and others in your life manage it.

Interpersonal and social rhythm therapy

Interpersonal and social rhythm therapy (IPSRT) focuses on regulating daily habits, such as sleeping, eating, and exercising. Balancing these everyday basics can help you manage your disorder.

Other treatment options

Other treatment options may include:

Lifestyle changes

There are also some simple steps you can take right now to help manage your bipolar disorder:

  • keep a routine for eating and sleeping
  • learn to recognize mood swings
  • ask a friend or relative to support your treatment plans
  • talk to a doctor or licensed healthcare provider

Other lifestyle changes can also help relieve depressive symptoms caused by bipolar disorder. Check out these seven ways to help manage a depressive episode.

Natural remedies for bipolar disorder

Some natural remedies may be helpful for bipolar disorder. However, it’s important not to use these remedies without first talking with your doctor. These treatments could interfere with medications you’re taking.

The following herbs and supplements may help stabilize your mood and relieve symptoms of bipolar disorder:

Several other minerals and vitamins may also reduce symptoms of bipolar disorder. Here’s 10 alternative treatments for bipolar disorder.

Tips for coping and support

If you or someone you know has bipolar disorder, you’re not alone. Bipolar disorder affects about 60 million peopleTrusted Source around the world.

One of the best things you can do is to educate yourself and those around you. There are many resources available. For instance, SAMHSA’s behavioral health treatment services locatorprovides treatment information by ZIP code. You can also find additional resources at the site for the National Institute of Mental Health.

If you think you’re experiencing symptoms of bipolar disorder, make an appointment with your doctor. If you think a friend, relative, or loved one may have bipolar disorder, your support and understanding is crucial. Encourage them to see a doctor about any symptoms they’re having. And read how to help someone living with bipolar disorder.

People who are experiencing a depressive episode may have suicidal thoughts. You should always take any talk of suicide seriously.

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Bipolar disorder and relationships

When it comes to managing a relationship while you live with bipolar disorder, honesty is the best policy. Bipolar disorder can have an impact on any relationship in your life, perhaps especially on a romantic relationship. So, it’s important to be open about your condition.

There’s no right or wrong time to tell someone you have bipolar disorder. Be open and honest as soon as you’re ready. Consider sharing these facts to help your partner better understand the condition:

  • when you were diagnosed
  • what to expect during your depressive phases
  • what to expect during your manic phases
  • how you typically treat your moods
  • how they can be helpful to you

One of the best ways to support and make a relationship successful is to stick with your treatment. Treatment helps you reduce symptoms and scale back the severity of your changes in mood. With these aspects of the disorder under control, you can focus more on your relationship.

Your partner can also learn ways to promote a healthy relationship. Check out this guide to maintaining healthy relationships while coping with bipolar disorder, which has tips for both you and your partner.

Living with bipolar disorder

Bipolar disorder is a chronic mental illness. That means you’ll live and cope with it for the rest of your life. However, that doesn’t mean you can’t live a happy, healthy life.

Treatment can help you manage your changes in mood and cope with your symptoms. To get the most out of treatment, you may want to create a care team to help you. In addition to your primary doctor, you may want to find a psychiatrist and psychologist. Through talk therapy, these doctors can help you cope with symptoms of bipolar disorder that medication can’t help.

You may also want to seek out a supportive community. Finding other people who’re also living with this disorder can give you a group of people you can rely on and turn to for help.

Finding treatments that work for you requires perseverance. Likewise, you need to have patience with yourself as you learn to manage bipolar disorder and anticipate your changes in mood. Together with your care team, you’ll find ways to maintain a normal, happy, healthy life.

While living with bipolar disorder can be a real challenge, it can help to maintain a sense of humor about life. For a chuckle, check out this list of 25 things only someone with bipolar disorder would understand.

Everything You should know about Allergies

Everything You Need to Know About Allergies

Allergies

An allergy is an immune system response to a foreign substance that’s not typically harmful to your body. These foreign substances are called allergens. They can include certain foods, pollen, or pet dander.

Your immune system’s job is to keep you healthy by fighting harmful pathogens. It does this by attacking anything it thinks could put your body in danger. Depending on the allergen, this response may involve inflammation, sneezing, or a host of other symptoms.

Your immune system normally adjusts to your environment. For example, when your body encounters something like pet dander, it should realize it’s harmless. In people with dander allergies, the immune system perceives it as an outside invader threatening the body and attacks it.

Allergies are common. Several treatments can help you avoid your symptoms.

Symptoms of allergies

The symptoms you experience because of allergies are the result of several factors. These include the type of allergy you have and how severe the allergy is.

If you take any medication before an anticipated allergic response, you may still experience some of these symptoms, but they may be reduced.

For food allergies

Food allergies can trigger swelling, hives, nausea, fatigue, and more. It may take a while for a person to realize that they have a food allergy. If you have a serious reaction after a meal and you’re not sure why, see a medical professional immediately. They can find the exact cause of your reaction or refer you to a specialist.

For seasonal allergies

Hay fever symptoms can mimic those of a cold. They include congestion, runny nose, and swollen eyes. Most of the time, you can manage these symptoms at home using over-the-counter treatments. See your doctor if your symptoms become unmanageable.

For severe allergies

Severe allergies can cause anaphylaxis. This is a life-threatening emergency that can lead to breathing difficulties, lightheadedness, and loss of consciousness. If you’re experiencing these symptoms after coming in contact with a possible allergen, seek medical help immediately.

Everyone’s signs and symptoms of an allergic reaction are different. Read more about allergy symptoms and what might cause them.

Allergies on skin

Skin allergies may be a sign or symptom of an allergy. They may also be the direct result of exposure to an allergen.

For example, eating a food you’re allergic to can cause several symptoms. You may experience tingling in your mouth and throat. You may also develop a rash.

Contact dermatitis, however, is the result of your skin coming into direct contact with an allergen. This could happen if you touch something you’re allergic to, such as a cleaning product or plant.

Types of skin allergies include:

  • Rashes. Areas of skin are irritated, red, or swollen, and can be painful or itchy.
  • Eczema. Patches of skin become inflamed and can itch and bleed.
  • Contact dermatitis. Red, itchy patches of skin develop almost immediately after contact with an allergen.
  • Sore throat. Pharynx or throat is irritated or inflamed.
  • Hives. Red, itchy, and raised welts of various sizes and shapes develop on the surface of the skin.
  • Swollen eyes. Eyes may be watery or itchy and look “puffy.”
  • Itching. There’s irritation or inflammation in the skin.
  • Burning. Skin inflammation leads to discomfort and stinging sensations on the skin.

Rashes are one of the most common symptoms of a skin allergy. Find out how to identify rashes and how to treat them.

Causes of allergies

Researchers aren’t exactly sure why the immune system causes an allergic reaction when a normally harmless foreign substance enters the body.

Allergies have a genetic component. This means parents can pass them down to their children. However, only a general susceptibility to allergic reaction is genetic. Specific allergies aren’t passed down. For instance, if your mother is allergic to shellfish, it doesn’t necessarily mean that you’ll be, too.

Common types of allergens include:

  • Animal products. These include pet dander, dust mite waste, and cockroaches.
  • Drugs. Penicillin and sulfa drugs are common triggers.
  • Foods. Wheat, nuts, milk, shellfish, and egg allergies are common.
  • Insect stings. These include bees, wasps, and mosquitoes.
  • Mold. Airborne spores from mold can trigger a reaction.
  • Plants. Pollens from grass, weeds, and trees, as well as resin from plants such as poison ivy and poison oak, are very common plant allergens.
  • Other allergens. Latex, often found in latex gloves and condoms, and metals like nickel are also common allergens.

Seasonal allergies, also known as hay fever, are some of the most common allergies. These are caused by pollen released by plants. They cause:

  • itchy eyes
  • watery eyes
  • runny nose
  • coughing

Food allergies are becoming more common. Find out about the most common types of food allergies and the symptoms they cause.

Allergy treatments

The best way to avoid allergies is to stay away from whatever triggers the reaction. If that’s not possible, there are treatment options available.

Medication

Allergy treatment often includes medications like antihistamines to control symptoms. The medication can be over the counter or prescription. What your doctor recommends depends on the severity of your allergies.

Allergy medications include:

Immunotherapy

Many people opt for immunotherapy. This involves several injections over the course of a few years to help the body get used to your allergy. Successful immunotherapy can prevent allergy symptoms from returning.

Emergency epinephrine

If you have a severe, life-threatening allergy, carry an emergency epinephrine shot. The shot counters allergic reactions until medical help arrives. Common brands of this treatment include EpiPen and Twinject.

Some allergic responses are a medical emergency. Prepare for these emergency situations by knowing allergic reaction first aid.

Natural remedies for allergies

Many natural remedies and supplements are marketed as a treatment and even a way to prevent allergies. Discuss these with your doctor before trying them. Some natural treatments may actually contain other allergens and make your symptoms worse.

For example, some dried teas use flowers and plants that are closely related to plants that might be causing you serious sneezing. The same is true for essential oils. Some people use these oils to relieve common symptoms of allergies, but essential oils still contain ingredients that can cause allergies.

Each type of allergy has a host of natural remedies that may help speed up recovery. There are also natural options for children’s allergies, too.

How allergies are diagnosed

Your doctor can diagnose allergies in several ways.

First, your doctor will ask about your symptoms and perform a physical exam. They’ll ask about anything unusual you may have eaten recently and any substances you may have come in contact with. For example, if you have a rash on your hands, your doctor may ask if you put on latex gloves recently.

Lastly, a blood test and skin test can confirm or diagnose allergens your doctor suspects you have.

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Allergy blood test

Your doctor may order a blood test. Your blood will be tested for the presence of allergy-causing antibodies called immunoglobulin E (IgE). These are cells that react to allergens. Your doctor will use a blood test to confirm a diagnosis if they’re worried about the potential for a severe allergic reaction.

Skin test

Your doctor may also refer you to an allergist for testing and treatment. A skin test is a common type of allergy test carried out by an allergist.

During this test, your skin is pricked or scratched with small needles containing potential allergens. Your skin’s reaction is documented. If you’re allergic to a particular substance, your skin will become red and inflamed.

Different tests may be needed to diagnose all your potential allergies. Start here to get a better understanding of how allergy testing works.

Preventing symptoms

There’s no way to prevent allergies. But there are ways to prevent the symptoms from occurring. The best way to prevent allergy symptoms is to avoid the allergens that trigger them.

Avoidance is the most effective way to prevent food allergy symptoms. An elimination diet can help you determine the cause of your allergies so you know how to avoid them. To help you avoid food allergens, thoroughly read food labels and ask questions while dining out.

Preventing seasonal, contact, and other allergies comes down to knowing where the allergens are located and how to avoid them. If you’re allergic to dust, for example, you can help reduce symptoms by installing proper air filters in your home, getting your air ducts professionally cleaned, and dusting your home regularly.

Proper allergy testing can help you pinpoint your exact triggers, which makes them easier to avoid. These other tips can also help you avoid dangerous allergic reactions.

Complications of allergies

While you may think of allergies as those pesky sniffles and sneezes that come around every new season, some of these allergic reactions can actually be life-threatening.

Anaphylaxis, for example, is a serious reaction to the exposure of allergens. Most people associate anaphylaxis with food, but any allergen can cause the telltale signs:

  • suddenly narrowed airways
  • increased heart rate
  • possible swelling of the tongue and mouth

Allergy symptoms can create many complications. Your doctor can help determine the cause of your symptoms as well as the difference between a sensitivity and a full-blown allergy. Your doctor can also teach you how to manage your allergy symptoms so that you can avoid the worst complications.

Asthma and allergies

Asthma is a common respiratory condition. It makes breathing more difficult and can narrow the air passageways in your lungs.

Asthma is closely related to allergies. Indeed, allergies can make existing asthma worse. It can also trigger asthma in a person who’s never had the condition.

When these conditions occur together, it’s a condition called allergy-induced asthma, or allergic asthma. Allergic asthma affects about 60 percent of people who have asthma in the United States, estimates the Allergy and Asthma Foundation of America.

Many people with allergies may develop asthma. Here’s how to recognize if it happens to you.

Allergies vs. cold

Runny nose, sneezing, and coughing are common symptoms of allergies. They also happen to be common symptoms of a cold and a sinus infection. Indeed, deciphering between the sometimes-generic symptoms can be difficult.

However, additional signs and symptoms of the conditions may help you distinguish between the three. For example, allergies can cause rashes on your skin and itchy eyes. The common cold can lead to body aches, even fever. A sinus infection typically produces thick, yellow discharge from your nose.

Allergies can impact your immune system for prolonged periods of time. When the immune system is compromised, it makes you more likely to pick up viruses you come into contact with. This includes the virus that causes the common cold.

In turn, having allergies actually increases your risk for having more colds. Identify the differences between the two common conditions with this helpful chart.

Allergy cough

Hay fever can produce symptoms that include sneezing, coughing, and a persistent, stubborn cough. It’s the result of your body’s overreaction to allergens. It isn’t contagious, but it can be miserable.

Unlike a chronic cough, a cough caused by allergies and hay fever is temporary. You may only experience the symptoms of this seasonal allergy during specific times of the year, when plants are first blooming.

Additionally, seasonal allergies can trigger asthma, and asthma can cause coughing. When a person with common seasonal allergies is exposed to an allergen, tightening airways can lead to a cough. Shortness of breath and chest tightening may also occur. Find out why hay fever coughs are typically worse at night and what you can do to ease them.

Allergies and bronchitis

Viruses or bacteria can cause bronchitis, or it can be the result of allergies. The first type, acute bronchitis, typically ends after several days or weeks. Chronic bronchitis, however, can linger for months, possibly longer. It may also return frequently.

Exposure to common allergens is the most common cause of chronic bronchitis. These allergens include:

  • cigarette smoke
  • air pollution
  • dust
  • pollen
  • chemical fumes

Unlike seasonal allergies, many of these allergens linger in environments like houses or offices. That can make chronic bronchitis more persistent and more likely to return.

A cough is the only common symptom between chronic and acute bronchitis. Learn the other symptoms of bronchitis so you can understand more clearly what you may have.

Allergies and babies

Skin allergies are more common in younger children today than they were just a few decades ago. However, skin allergies decrease as children grow older. Respiratory and food allergies become more common as children get older.

Common skin allergies on babies include:

  • Eczema. This is an inflammatory skin condition that causes red rashes that itch. These rashes may develop slowly but be persistent.
  • Allergic contact dermatitis. This type of skin allergy appears quickly, often immediately after your baby comes into contact with the irritant. More serious contact dermatitis can develop into painful blisters and cause skin cracking.
  • Hives. Hives are red bumps or raised areas of skin that develop after exposure to an allergen. They don’t become scaly and crack, but itching the hives may make the skin bleed.

Unusual rashes or hives on your baby’s body may alarm you. Understanding the difference in the type of skin allergies babies commonly experience can help you find a better treatment.

Living with allergies

Allergies are common and don’t have life-threatening consequences for most people. People who are at risk of anaphylaxis can learn how to manage their allergies and what to do in an emergency situation.

Most allergies are manageable with avoidance, medications, and lifestyle changes. Working with your doctor or allergist can help reduce any major complications and make life more enjoyable.

Everything You need to know about Acid Reflux and Gerd

What’s acid reflux and GERD?

Acid reflux happens when contents from your stomach move up into your esophagus. It’s also called acid regurgitation or gastroesophageal reflux.

If you have symptoms of acid reflux more than twice a week, you might have a condition known as gastroesophageal reflux disease (GERD).

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), GERD affects about 20 percent of people in the United States. If left untreated, it can sometimes cause serious complications.

GERD symptoms

Acid reflux can cause an uncomfortable burning feeling in your chest, which can radiate up toward your neck. This feeling is often known as heartburn.

If you have acid reflux, you might develop a sour or bitter taste at the back of your mouth. It might also cause you to regurgitate food or liquid from your stomach into your mouth.

In some cases, GERD can cause difficulty swallowing. It can sometimes lead to breathing problems, like a chronic cough or asthma.

GERD causes

The lower esophageal sphincter (LES) is a circular band of muscle at the end of your esophagus. When it’s working properly, it relaxes and opens when you swallow. Then it tightens and closes again afterwards.

Acid reflux happens when your LES doesn’t tighten or close properly. This allows digestive juices and other contents from your stomach to rise up into your esophagus.

GERD treatment options

To prevent and relieve symptoms of GERD, your doctor might encourage you to make changes to your eating habits or other behaviors.

They might also suggest taking over-the-counter medications, like:

In some cases, they might prescribe stronger H2 receptor blockers or PPIs. If GERD is severe and not responding to other treatments, surgery might be recommended.

Some over-the-counter and prescription medications can cause side effects. Find out more about the medications that are available to treat GERD.ADVERTISING

Surgery for GERD

In most cases, lifestyle changes and medications are enough to prevent and relieve symptoms of GERD. But sometimes, surgery is needed.

For example, your doctor might recommend surgery if lifestyle changes and medications alone haven’t stopped your symptoms. They might also suggest surgery if you’ve developed complications of GERD.

There are multiple types of surgery available to treat GERD. Click here to read about the procedures that your doctor might recommend.

Diagnosing GERD

If your doctor suspects you might have GERD, they’ll conduct a physical exam and ask about any symptoms you’ve been experiencing.

They might use one or more of the following procedures to confirm a diagnosis or check for complications of GERD:

  • barium swallow: after drinking a barium solution, X-ray imaging is used to examine your upper digestive tract
  • upper endoscopy: a flexible tube with a tiny camera is threaded into your esophagus to examine it and collect a sample of tissue (biopsy) if needed
  • esophageal manometry: a flexible tube is threaded into your esophagus to measure the strength of your esophageal muscles
  • esophageal pH monitoring: a monitor is inserted into your esophagus to learn if and when stomach acid enters it

GERD in infants

About two-thirds of 4-month-old babies have symptoms of GERD. Up to 10 percent of 1-year-old babies are affected by it.

It’s normal for babies to spit up food and vomit sometimes. But if your baby is spitting up food or vomiting frequently, they might have GERD.

Other potential signs and symptoms of GERD in infants includes:

  • refusal to eat
  • trouble swallowing
  • gagging or choking
  • wet burps or hiccups
  • irritability during or after feeding
  • arching of their back during or after feeding
  • weight loss or poor growth
  • recurring cough or pneumonia
  • difficulty sleeping

Many of these symptoms are also found in babies with tongue-tie, a condition that can make it hard for them to eat.

If you suspect your baby might have GERD or another health condition, make an appointment with their doctor. Learn how to recognize GERD in infants.

Risk factors for GERD

Certain conditions can increase your chances of developing GERD, including:

Some lifestyle behaviors can also raise your risk of GERD, including:

  • smoking
  • eating large meals
  • lying down or going to sleep shortly after eating
  • eating certain types of foods, such as deep fried or spicy foods
  • drinking certain types of beverages, such as soda, coffee, or alcohol
  • using nonsteroidal anti-inflammatory drugs (NSAIDS), such as aspirin or ibuprofen

If you have any of these risk factors, taking steps to modify them may help you prevent or manage GERD. Find out more about what can raise your chances of experiencing it.

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Potential complications of GERD

In most people, GERD doesn’t cause serious complications. But in rare cases, it can lead to serious or even life-threatening health problems.

Potential complications of GERD include:

  • esophagitis, an inflammation of your esophagus
  • esophageal stricture, which happens when your esophagus narrows or tightens
  • Barrett’s esophagus, involving permanent changes to the lining of your esophagus
  • esophageal cancer, which affects a small portion of people with Barrett’s esophagus
  • asthma, chronic cough, or other breathing problems, which may develop if you breath stomach acid into your lungs
  • tooth enamel erosion, gum disease, or other dental problems

To lower your chances of complications, it’s important to take steps to prevent and treat the symptoms of GERD.

Diet and GERD

In some people, certain types of foods and beverages trigger symptoms of GERD. Common dietary triggers include:

  • high-fat foods
  • spicy foods
  • chocolate
  • citrus fruit
  • pineapple
  • tomato
  • onion
  • garlic
  • mint
  • alcohol
  • coffee
  • tea
  • soda

Dietary triggers can vary from one person to another. Find out more about common food triggers and how to avoid making your symptoms worse.

Home remedies for GERD

There are several lifestyle changes and home remedies that may help relieve GERD symptoms.

For example, it might help to:

  • quit smoking
  • lose excess weight
  • eat smaller meals
  • chew gum after eating
  • avoid lying down after eating
  • avoid foods and drinks that trigger your symptoms
  • avoid wearing tight clothing
  • practice relaxation techniques

Some herbal remedies might also provide relief.

Herbs commonly used for GERD include:

  • chamomile
  • licorice root
  • marshmallow root
  • slippery elm

Although more research is needed, some people report experiencing relief from acid reflux after taking supplements, tinctures, or teas that contain these herbs.

But in some cases, herbal remedies can cause side effects or interfere with certain medications. Check out the potential benefits and risks of using herbal remedies to treat GERD.

Anxiety and GERD

According to 2015 researchTrusted Source, anxiety might make some of the symptoms of GERD worse.

If you suspect that anxiety is making your symptoms worse, consider talking to your doctor about strategies to relieve it.

Some things you can do to reduce anxiety include:

  • limit your exposure to experiences, people, and places that make you feel anxious
  • practice relaxation techniques, like meditation or deep breathing exercises
  • adjust your sleep habits, exercise routine, or other lifestyle behaviors

If your doctor suspects you have an anxiety disorder, they might refer you to a mental health specialist for diagnosis and treatment. Treatment for an anxiety disorder might include medication, talk therapy, or a combination of both.

Pregnancy and GERD

Pregnancy can increase your chances of experiencing acid reflux. If you had GERD before getting pregnant, your symptoms might get worse.

Hormonal changes during pregnancy can cause the muscles in your esophagus to relax more frequently. A growing fetus can also place pressure on your stomach. This can increase the risk of stomach acid entering your esophagus.

Many medications that are used to treat acid reflux are safe to take during pregnancy. But in some cases, your doctor might advise you to avoid certain antacids or other treatments. Learn more about the strategies you can use to manage acid reflux in pregnancy.

Asthma and GERD

It’s been reported that more than 75 percent of people with asthma also experience GERD.

More research is needed to understand the exact relationship between asthma and GERD. It’s possible that GERD might make symptoms of asthma worse. But asthma and some asthma medications might raise your risk of experiencing GERD.

If you have asthma and GERD, it’s important to manage both conditions. Read more about the links between these conditions and how you can effectively manage them.

IBS and GERD

Irritable bowel syndrome (IBS) is a condition that can affect your large intestine. Common symptoms include:

  • abdominal pain
  • bloating
  • constipation
  • diarrhea

According to a recent reviewTrusted Source, GERD-related symptoms are more common in people with IBS than the general population.

If you have symptoms of both IBS and GERD, make an appointment with your doctor. They might recommend changes to your diet, medications, or other treatments. Learn more about the link between these conditions and how you can find relief.

Drinking alcohol and GERD

In some people with GERD, certain foods and drinks can make the symptoms worse. Those dietary triggers might include alcoholic beverages.

Depending on your specific triggers, you might be able to drink alcohol in moderation. But for some people, even small amounts of alcohol trigger symptoms of GERD.

If you combine alcohol with fruit juices or other mixers, those mixers might also trigger symptoms. Discover how alcohol and mixers can trigger GERD symptoms.

The difference between GERD and heartburn

Heartburn is a common symptom of acid reflux. Most people experience it from time to time, and in general, occasional heartburn isn’t a cause for concern.

But if you get heartburn more than twice a week, you might have GERD.

GERD is a chronic type of acid reflux that can cause complications if left untreated. Find out the differences and links between heartburn, acid reflux, and GERD.

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What is Fibromyalgia?

Men also get fibromyalgia. Yet, they may remain undiagnosed because this is seen as a woman’s disease. However, current statistics show that as the 2016 diagnostic protocol is more readily applied, more men are being diagnosed.

Men also have severe pain and emotional symptoms from fibromyalgia. The condition affects their quality of life, career, and relationships, according to a 2018 survey published in the American Journal of Public Health.

Part of the stigma and difficulty in getting diagnosed stems from society’s expectation that men who are in pain should “suck it up.”

Men who do venture in to see a doctor can face embarrassment, and the chance that their complaints won’t be taken seriously.

Fibromyalgia trigger points

In the past, people were diagnosed with fibromyalgia if they had widespread pain and tenderness in at least 11 out of 18 specific trigger points around their body. Healthcare providers would check to see how many of these points were painful by pressing firmly on them.

Common trigger points included the:

  • back of the head
  • tops of the shoulders
  • upper chest
  • hips
  • knees
  • outer elbows

For the most part, trigger points are no longer a part of the diagnostic process.

Instead, healthcare providers may diagnose fibromyalgia if you’ve had pain in 4 out of the 5 areas of pain as defined by the 2016 revised diagnostic criteria, and you have no other diagnosable medical condition that could explain the pain.ADVERTISING

Fibromyalgia pain

Pain is the hallmark fibromyalgia symptom. You’ll feel it in various muscles and other soft tissues around your body.

The pain can range from a mild achiness to an intense and almost unbearable discomfort. Its severity could dictate how well you cope day to day.

Fibromyalgia appears to stem from an abnormal nervous system response. Your body overreacts to things that shouldn’t normally be painful. And you may feel the pain in more than one area of your body.

However, available research still doesn’t pinpoint an exact cause for fibromyalgia. Research continues to evolve in better understanding this condition and its origin.

Chest pain

When fibromyalgia pain is in your chest, it can feel frighteningly similar to the pain of a heart attack.

Chest pain in fibromyalgia is actually centered in the cartilage that connects your ribs to your breastbone. The pain may radiate to your shoulders and arms.

Fibromyalgia chest pain may feel:

  • sharp
  • stabbing
  • like a burning sensation

And similar to a heart attack, it can make you struggle to catch your breath.

Back pain

Your back is one of the most common places to feel pain. About 80 percent of Americans have low back pain at some point in their lives. If your back hurts, it may not be clear whether fibromyalgia is to blame, or another condition like arthritis or a pulled muscle.

Other symptoms like brain fog and fatigue can help pinpoint fibromyalgia as the cause. It’s also possible to have a combination of fibromyalgia and arthritis.

The same medications you take to relieve your other fibromyalgia symptoms can also help with back pain. Stretching and strengthening exercises can help provide support to the muscles and other soft tissues of your back.

Leg pain

You can also feel fibromyalgia pain in the muscles and soft tissues of your legs. Leg pain can feel similar to the soreness of a pulled muscle or the stiffness of arthritis. It can be:

  • deep
  • burning
  • throbbing

Sometimes fibromyalgia in the legs feels like numbness or tingling. You may have a creepy crawling sensation. An uncontrollable urge to move your legs is a sign of restless legs syndrome (RLS), which can overlap with fibromyalgia.

Fatigue sometimes manifests in the legs. Your limbs can feel heavy, as if they’re held down by weights.

Fibromyalgia causes

Healthcare providers and researchers don’t know what causes fibromyalgia.

According to the latest research, the cause appears to be a multiple-hit theory that involves genetic disposition (hereditary characteristics) complemented by a trigger, or a set of triggers, such as infection, trauma, and stress.

Let’s take a closer look at these potential factors and several more that may influence why people develop fibromyalgia.

Infections

A past illness could trigger fibromyalgia or make its symptoms worse. The flupneumonia, GI infections, such as those caused by Salmonella and Shigella bacteria, and the Epstein-Barrvirus all have possible links to fibromyalgia.

Genes

Fibromyalgia often runs in families. If you have a family member with this condition, you’re at higher risk for developing it.

Researchers think certain gene mutations may play a role. They’ve identified a few possible genes that affect the transmission of chemical pain signals between nerve cells.

Trauma

People who go through a severe physical or emotional trauma may develop fibromyalgia. The condition has been linkedTrusted Source to post-traumatic stress disorder (PTSD).

Stress

Like trauma, stress can leave long-lasting effects on your body. Stress has been linked to hormonal changes that could contribute to fibromyalgia.

Healthcare providers don’t fully understand what causes the chronic widespread nature of fibromyalgia pain. One theory is that the brain lowers the pain threshold. Sensations that weren’t painful before become very painful over time.

Another theory is that the nerves overreact to pain signals.

They become more sensitive, to the point where they cause unnecessary or exaggerated pain.

Fibromyalgia and autoimmunity

In autoimmune diseases like rheumatoid arthritis (RA) or multiple sclerosis (MS), the body mistakenly targets its own tissues with proteins called autoantibodies. Just like it would normally attack viruses or bacteria, the immune system instead attacks the joints or other healthy tissues.

Fibromyalgia symptoms look very similar to those of autoimmune disorders. These symptom overlaps have led to the theory that fibromyalgia could be an autoimmune condition.

This claim has been hard to prove, in part because fibromyalgia doesn’t cause inflammation, and to-date reproducing autoantibodies haven’t been found.

Yet, it’s possible to have an autoimmune disease and fibromyalgia simultaneously.

Fibromyalgia risk factors

Fibromyalgia flare-ups can be the result of:

  • stress
  • injury
  • an illness, such as the flu

An imbalance in brain chemicals may cause the brain and nervous system to misinterpret or overreact to normal pain signals.

Other factors that increase your risk of developing fibromyalgia include:

  • Gender. Most fibromyalgia cases are currently diagnosed in women, although the reason for this gender disparity isn’t clear.
  • Age. You’re most likely to be diagnosed in middle age, and your risk increases as you get older. However, children can develop fibromyalgia also.
  • Family history. If you have close family members with fibromyalgia, you may be at greater risk for developing it.
  • Disease. Although fibromyalgia isn’t a form of arthritis, having lupus or RA may increase your risk of also having fibromyalgia.

Fibromyalgia diagnosis

Your healthcare provider may diagnose you with fibromyalgia if you’ve had widespread pain for 3 months or longer. “Widespread” means the pain is on both sides of your body, and you feel it above and below your waist.

After a thorough examination, your healthcare provider must conclude that no other condition is causing your pain.

No lab test or imaging scan can detect fibromyalgia. Your healthcare provider may use these tests to help rule out other possible causes of your chronic pain.

Fibromyalgia can be hard for healthcare providers to distinguish from autoimmune diseases because the symptoms often overlap.

Some research has pointed to a link between fibromyalgia and autoimmune diseases like Sjogren’s syndrome.

Fibromyalgia treatment

Currently, there isn’t a cure for fibromyalgia.

Instead, treatment focuses on reducing symptoms and improving quality of life with:

  • medications
  • self-care strategies
  • lifestyle changes

Medications can relieve pain and help you sleep better. Physical and occupational therapy improve your strength and reduce stress on your body. Exercise and stress-reduction techniques can help you feel better, both mentally and physically.

In addition, you may wish to seek out support and guidance. This may involve seeing a therapist or joining a support group.

In a support group, you can get advice from other people who have fibromyalgia to help you through your own journey.

Fibromyalgia medication

The goal of fibromyalgia treatment is to manage pain and improve quality of life. This is often accomplished through a two-pronged approach of self-care and medication.

Common medications for fibromyalgia include:

Pain relievers

Over-the-counter pain relievers such as ibuprofen (Advil) or acetaminophen (Tylenol) can help with mild pain.

Narcotics, such as tramadol (Ultram), which is an opioid, were previously prescribed for pain relief. However, research has shown they’re not effective. Also, the dosage for narcotics is typically increased rapidly, which can pose a health risk for those prescribed these drugs.

Most healthcare providers recommend avoiding narcotics to treat fibromyalgia.

Antidepressants

Antidepressants such as duloxetine (Cymbalta) and milnacipran HCL (Savella) are sometimes used to treat pain and fatigue from fibromyalgia. These medications may also help improve sleep quality and work on rebalancing neurotransmitters.

Antiseizure drugs

Gabapentin (Neurontin) was designed to treat epilepsy, but it may also help reduce symptoms in people with fibromyalgia. Pregabalin (Lyrica), another anti-seizure drug, was the first drug FDA-approved for fibromyalgia. It blocks nerve cells from sending out pain signals.

A few drugs that aren’t FDA-approved to treat fibromyalgia, including antidepressants and sleep aids, can help with symptoms. Muscle relaxants, which were once used, are no longer recommended.

Researchers are also investigating a few experimental treatments that may help people with fibromyalgia in the future.

Fibromyalgia natural remedies

If the medications your healthcare provider prescribes don’t entirely relieve your fibromyalgia symptoms, you can look for alternatives. Many natural treatments focus on lowering stress and reducing pain. You can use them alone or together with traditional medical treatments.

Natural remedies for fibromyalgia include:

Therapy can potentially reduce the stress that triggers fibromyalgia symptoms and depression.

Group therapy may be the most affordable option, and it will give you a chance to meet others who are going through the same issues.

Cognitive behavioral therapy (CBT) is another option that can help you manage stressful situations. Individual therapy is also available if you prefer one-on-one help.

It’s important to note that most alternative treatments for fibromyalgia haven’t been thoroughly studied or proven effective.

Ask your healthcare provider about the benefits and risks before trying any of these treatments.

Fibromyalgia diet recommendations

Some people report that they feel better when they follow a specific diet plan or avoid certain foods. But research hasn’t proven that any one diet improves fibromyalgia symptoms.

If you’ve been diagnosed with fibromyalgia, try to eat a balanced diet overall. Nutrition is important in helping you to keep your body healthy, to prevent symptoms from getting worse, and to provide you with a constant energy supply.

Dietary strategies to keep in mind:

  • Eat fruits and vegetables, along with whole grains, low-fat dairy, and lean protein.
  • Drink plenty of water.
  • Eat more plants than meat.
  • Reduce the amount of sugar in your diet.
  • Exercise as often as you can.
  • Work toward achieving and maintaining your healthy weight.

You may find that certain foods make your symptoms worse, such as gluten or MSG. If that’s the case, keep a food diaryTrusted Source where you track what you eat and how you feel after each meal.

Share this diary with your healthcare provider. They can help you identify any foods that aggravate your symptoms. Avoiding these foods can be beneficial helping you manage your symptoms.

Fibromyalgia can leave you feeling tired and worn out.

A few foods will give you the energy boost you need to get through your day.

Fibromyalgia pain relief

Fibromyalgia pain can be uncomfortable and consistent enough to interfere with your daily routine. Don’t just settle for pain. Talk to your healthcare provider about ways to manage it.

One option is to take pain relievers such as:

  • aspirin
  • ibuprofen
  • naproxen sodium
  • help with discomfort
  • lower pain levels
  • help you better manage your condition

These medications bring down inflammation. Though inflammation is not a primary part of fibromyalgia, it may be present as an overlap with RA or another condition. Pain relievers may help you sleep better.

Please note that NSAIDS do have side effects. Caution is advised if NSAIDS are used for an extended period of time as is usually the case in managing a chronic pain condition.

Talk with your healthcare provider to create a safe treatment plan that works well in helping you manage your condition.

Antidepressants and anti-seizure drugs are two other medication classes your healthcare provider may prescribe to manage your pain.

The most effective pain reliever does not come in a medication bottle.

Practices like yoga, acupuncture, and physical therapy can:

Fibromyalgia fatigue can be just as challenging to manage as pain.

Learn a few strategies to help you sleep better and feel more alert during the day.

Living with fibromyalgia

Your quality of life can be affected when you live with pain, fatigue, and other symptoms on a daily basis. Complicating things are the misunderstandings many people have about fibromyalgia. Because your symptoms are hard to see, it’s easy for those around you to dismiss your pain as imaginary.

Know that your condition is real. Be persistent in your pursuit of a treatment that works for you. You may need to try more than one therapy, or use a few techniques in combination, before you start to feel better.

Lean on people who understand what you’re going through, like:

  • your healthcare provider
  • close friends
  • a therapist

Be gentle on yourself. Try not to overdo it. Most importantly, have faith that you can learn to cope with and manage your condition.

Fibromyalgia facts and statistics

Fibromyalgia is a chronic condition that causes:

  • widespread pain
  • fatigue
  • difficulty sleeping
  • depression

Currently, there’s no cure, and researchers don’t fully understand what causes it. Treatment focuses on medications and lifestyle changes to help ease the symptoms.

About 4 million AmericansTrusted Source ages 18 and over, or about 2 percent of the population, have been diagnosed with fibromyalgia. Most fibromyalgia cases are diagnosed in women, but men and children can also be affected.

Most people get diagnosed in middle age.

Fibromyalgia is a chronic (long-term) condition. However, some people may experience remission-type periods in which their pain and fatigue improve.

What is COPD?

What is COPD?

Chronic obstructive pulmonary disease, commonly referred to as COPD, is a group of progressive lung diseases. The most common are emphysema and chronic bronchitis. Many people with COPD have both of these conditions.

Emphysema slowly destroys air sacs in your lungs, which interferes with outward air flow. Bronchitis causes inflammation and narrowing of the bronchial tubes, which allows mucus to build up.

The top cause of COPD is tobacco smoking. Long-term exposure to chemical irritants can also lead to COPD. It’s a disease that usually takes a long time to develop.

Diagnosis usually involves imaging tests, blood tests, and lung function tests.

There’s no cure for COPD, but treatment can help ease symptoms, lower the chance of complications, and generally improve quality of life. Medications, supplemental oxygen therapy, and surgery are some forms of treatment.

Untreated, COPD can lead to a faster progression of disease, heart problems, and worsening respiratory infections.

It’s estimated that about 30 million people in the United States have COPD. As many as half are unaware that they have it.

What are the symptoms of COPD?

COPD makes it harder to breathe. Symptoms may be mild at first, beginning with intermittent coughing and shortness of breath. As it progresses, symptoms can become more constant to where it can become increasingly difficult to breathe.

You may experience wheezing and tightness in the chest or have excess sputum production. Some people with COPD have acute exacerbations, which are flare-ups of severe symptoms.

At first, symptoms of COPD can be quite mild. You might mistake them for a cold.

Early symptoms include:

  • occasional shortness of breath, especially after exercise
  • mild but recurrent cough
  • needing to clear your throat often, especially first thing in the morning

You might start making subtle changes, such as avoiding stairs and skipping physical activities.

Symptoms can get progressively worse and harder to ignore. As the lungs become more damaged, you may experience:

  • shortness of breath, after even mild exercise such as walking up a flight of stairs
  • wheezing, which is a type of higher pitched noisy breathing, especially during exhalations
  • chest tightness
  • chronic cough, with or without mucus
  • need to clear mucus from your lungs every day
  • frequent colds, flu, or other respiratory infections
  • lack of energy

In later stages of COPD, symptoms may also include:

  • fatigue
  • swelling of the feet, ankles, or legs
  • weight loss

Immediate medical care is needed if:

  • you have bluish or gray fingernails or lips, as this indicates low oxygen levels in your blood
  • you have trouble catching your breath or cannot talk
  • you feel confused, muddled, or faint
  • your heart is racing

Symptoms are likely to be much worse if you currently smoke or are regularly exposed to secondhand smoke.

Learn more about the symptoms of COPD.

What causes COPD?

In developed countries like the United States, the single biggest cause of COPD is cigarette smoking. About 90 percent of people who have COPD are smokers or former smokers.

Among long-time smokers, 20 to 30 percent develop COPD. Many others develop lung conditions or have reduced lung function.

Most people with COPD are at least 40 years old and have at least some history of smoking. The longer and more tobacco products you smoke, the greater your risk of COPD is. In addition to cigarette smoke, cigar smoke, pipe smoke, and secondhand smoke can cause COPD.

Your risk of COPD is even greater if you have asthma and smoke.

You can also develop COPD if you’re exposed to chemicals and fumes in the workplace. Long-term exposure to air pollution and inhaling dust can also cause COPD.

In developing countries, along with tobacco smoke, homes are often poorly ventilated, forcing families to breathe fumes from burning fuel used for cooking and heating.

There may be a genetic predisposition to developing COPD. Up to an estimated 5 percentTrusted Source of people with COPD have a deficiency in a protein called alpha-1-antitrypsin. This deficiency causes the lungs to deteriorate and also can affect the liver. There may be other associated genetic factors at play as well.

COPD isn’t contagious.

Diagnosing COPD

There’s no single test for COPD. Diagnosis is based on symptoms, a physical exam, and diagnostic test results.

When you visit the doctor, be sure to mention all of your symptoms. Tell your doctor if:

  • you’re a smoker or have smoked in the past
  • you’re exposed to lung irritants on the job
  • you’re exposed to a lot of secondhand smoke
  • you have a family history of COPD
  • you have asthma or other respiratory conditions
  • you take over-the-counter or prescription medications

During the physical exam, your doctor will use a stethoscope to listen to your lungs as you breathe. Based on all this information, your doctor may order some of these tests to get a more complete picture:

  • Spirometry is a noninvasive test to assess lung function. During the test, you’ll take a deep breath and then blow into a tube connected to the spirometer.
  • Imaging tests include a chest X-ray or CT scan. These images can provide a detailed look at your lungs, blood vessels, and heart.
  • An arterial blood gas test involves taking a blood sample from an artery to measure your blood oxygen, carbon dioxide, and other important levels.

These tests can help determine if you have COPD or a different condition, such as asthma, a restrictive lung disease, or heart failure.

Learn more about how COPD is diagnosed.

Treatment for COPD

Treatment can ease symptoms, prevent complications, and generally slow disease progression. Your healthcare team may include a lung specialist (pulmonologist) and physical and respiratory therapists.

Medication

Bronchodilators are medications that help relax the muscles of the airways, widening the airways so you can breathe easier. They’re usually taken through an inhaler or a nebulizer. Glucocorticosteroids can be added to reduce inflammation in the airways.

To lower risk of other respiratory infections, ask your doctor if you should get a yearly flu shot, pneumococcal vaccine, and a tetanus booster that includes protection from pertussis (whooping cough).

Oxygen therapy

If your blood oxygen level is too low, you can receive supplemental oxygen through a mask or nasal cannula to help you breathe better. A portable unit can make it easier to get around.

Surgery

Surgery is reserved for severe COPD or when other treatments have failed, which is more likely when you have a form of severe emphysema.

One type of surgery is called bullectomy. During this procedure, surgeons remove large, abnormal air spaces (bullae) from the lungs.

Another is lung volume reduction surgery, which removes damaged upper lung tissue.

Lung transplantation is an option in some cases.

Lifestyle changes

Certain lifestyle changes may also help alleviate your symptoms or provide relief.

  • If you smoke, quit. Your doctor can recommend appropriate products or support services.
  • Whenever possible, avoid secondhand smoke and chemical fumes.
  • Get the nutrition your body needs. Work with your doctor or dietician to create a healthy eating plan.
  • Talk to your doctor about how much exercise is safe for you.

Learn more about the different treatment options for COPD.

Medications for COPD

Medications can reduce symptoms and cut down on flare-ups. It may take some trial and error to find the medication and dosage that works best for you. These are some of your options:

Inhaled bronchodilators

Medicines called bronchodilators help loosen tight muscles of your airways. They’re typically taken through an inhaler or nebulizer.

Short-acting bronchodilators last from four to six hours. You only use them when you need them. For ongoing symptoms, there are long-acting versions you can use every day. They last about 12 hours.

Some bronchodilators are selective beta-2-agonists, and others are anticholinergics. These bronchodilators work by relaxing tightened muscles of the airways, which widens your airways for better air passage. They also help your body clear mucus from the lungs. These two types of bronchodilators can be taken separately or in combination by inhaler or with a nebulizer.

Corticosteroids

Long-acting bronchodilators are commonly combined with inhaled glucocorticosteroids. A glucocorticosteroid can reduce inflammation in the airways and lower mucus production. The long-acting bronchodilator can relax the airway muscle to help the airways stay wider. Corticosteroids are also available in pill form.

Phosphodiesterase-4 inhibitors

This type of medication can be taken in pill form to help reduce inflammation and relax the airways. It’s generally prescribed for severe COPD with chronic bronchitis.

Theophylline

This medication eases chest tightness and shortness of breath. It may also help prevent flare-ups. It’s available in pill form. Theophylline is an older medication that relaxes the muscle of the airways, and it may cause side effects. It’s generally not a first-line treatment for COPD therapy.

Antibiotics and antivirals

Antibiotics or antivirals may be prescribed when you develop certain respiratory infections.

Vaccines

COPD increases your risk of other respiratory problems. For that reason, your doctor might recommend that you get a yearly flu shot, the pneumococcal vaccine, or the whooping cough vaccine.

Learn more about the drugs and medications used to treat COPD.

Diet recommendations for people with COPD

There’s no specific diet for COPD, but a healthy diet is important for maintaining overall health. The stronger you are, the more able you’ll be to prevent complications and other health problems.

Choose a variety of nutritious foods from these groups:

  • vegetables
  • fruits
  • grains
  • protein
  • dairy

Drink plenty of fluids. Drinking at least six to eight 8-ounce glasses of noncaffeinated liquids a day can help keep mucus thinner. This may make the mucus easier to cough out.

Limit caffeinated beverages because they can interfere with medications. If you have heart problems, you may need to drink less, so talk to your doctor.

Go easy on the salt. It causes the body to retain water, which can strain breathing.

Maintaining a healthy weight is important. It takes more energy to breathe when you have COPD, so you might need to take in more calories. But if you’re overweight, your lungs and heart may have to work harder.

If you’re underweight or frail, even basic body maintenance can become difficult. Overall, having COPD weakens your immune system and decreases your ability to fight off infection.

A full stomach makes it harder for your lungs to expand, leaving you short of breath. If that happens, try these remedies:

  • Clear your airways about an hour before a meal.
  • Take smaller bites of food that you chew slowly before swallowing.
  • Swap three meals a day for five or six smaller meals.
  • Save fluids until the end so you feel less full during the meal.

Check out these 5 diet tips for people with COPD.

Living with COPD

COPD requires lifelong disease management. That means following the advice of your healthcare team and maintaining healthy lifestyle habits.

Since your lungs are weakened, you’ll want to avoid anything that might overtax them or cause a flare-up.

Number one on the list of things to avoid is smoking. If you’re having trouble quitting, talk to your doctor about smoking cessation programs. Try to avoid secondhand smoke, chemical fumes, air pollution, and dust.

A little exercise each day can help you stay strong. Talk to your doctor about how much exercise is good for you.

Eat a diet of nutritious foods. Avoid highly processed foods that are loaded with calories and salt but lack nutrients.

If you have other chronic diseases along with COPD, it’s important to manage those as well, particularly diabetes mellitus and heart disease.

Clear the clutter and streamline your home so that it takes less energy to clean and do other household tasks. If you have advanced COPD, get help with daily chores.

Be prepared for flare-ups. Carry your emergency contact information with you and post it on your refrigerator. Include information about what medications you take, as well as the doses. Program emergency numbers into your phone.

It can be a relief to talk to others who understand. Consider joining a support group. The COPD Foundation provides a comprehensive list of organizations and resources for people living with COPD.

What are the stages of COPD?

One measure of COPD is achieved by spirometry grading. There are different grading systems, and one grading system is part of the GOLD classification. The GOLD classification is used for determining COPD severity and helping to form a prognosis and treatment plan.

There are four GOLD grades based on spirometry testing:

  • grade 1: mild
  • grade 2: moderate
  • grade 3: severe
  • grade 4: very severe

This is based on the spirometry test result of your FEV1. This is the amount of air you can breathe out of the lungs in the first one second of a forced expiration. The severity increases as your FEV1 decreases.

The GOLD classification also takes into account your individual symptoms and history of acute exacerbations. Based on this information, your doctor can assign a letter group to you to help define your COPD grade.

As the disease progresses, you’re more susceptible to complications, such as:

  • respiratory infections, including common colds, flu, and pneumonia
  • heart problems
  • high blood pressure in lung arteries (pulmonary hypertension)
  • lung cancer
  • depression and anxiety

Learn more about the different stages of COPD.

Is there a connection between COPD and lung cancer?

COPD and lung cancer are major health problems worldwide. These two diseases are linked in a number of ways.

COPD and lung cancer have several common risk factors. Smoking is the number one risk factor for both diseases. Both are more likely if you breathe secondhand smoke, or are exposed to chemicals or other fumes in the workplace.

There may be a genetic predisposition to developing both diseases. Also, the risk of developing either COPD or lung cancer increases with age.

It was estimated in 2009 that between 40 and 70 percentTrusted Source of people with lung cancer also have COPD. This same 2009 studyTrusted Source concluded that COPD is a risk factor for lung cancer.

2015 studyTrusted Source suggests they may actually be different aspects of the same disease, and that COPD could be a driving factor in lung cancer.

In some cases, people don’t learn they have COPD until they’re diagnosed with lung cancer.

However, having COPD doesn’t necessarily mean you’ll get lung cancer. It does mean that you have a higher risk. That’s another reason why, if you smoke, quitting is a good idea.

Learn more about the possible complications of COPD.

COPD statistics

Worldwide, it’s estimated that about 65 millionTrusted Source people have moderate to severe COPD. About 12 million adults in the United States have a diagnosis of COPD. It’s estimated that 12 millionmore have the disease, but don’t know it yet.

Most people with COPD are 40 years of age or older.

The majority of people with COPD are smokers or former smokers. Smoking is the most important risk factor that can be changed. Between 20 and 30 percent of chronic smokers develop COPD that shows symptoms and signs.

Between 10 and 20 percent of people with COPD have never smoked. In up to 5 percentTrusted Source of people with COPD, the cause is a genetic disorder involving a deficiency of a protein called alpha-1-antitrypsin.

COPD is a leading cause of hospitalizations in industrialized countries. In the United States, COPD is responsible for a large amount of emergency department visits and hospital admissions. In the year 2000, it was noted that there were over 700,000 hospital admissionsTrusted Sourceand approximately 1.5 millionTrusted Source emergency department visits. Among people with lung cancer, between 40 and 70 percentTrusted Source also have COPD.

About 120,000 people die from COPD each year in the United States. It’s the third leadingcause of death in the United States. More women than men die from COPD each year.

It’s projected that the number of patients diagnosed with COPD will increase by more than 150 percent from 2010 to 2030. Much of that can be attributed to an aging population.

Check out more statistics about COPD.

What’s the outlook for people with COPD?

COPD tends to progress slowly. You may not even know you have it during the early stages.

Once you have a diagnosis, you’ll need to start seeing your doctor on a regular basis. You’ll also have to take steps to manage your condition and make the appropriate changes to your daily life.

Early symptoms can usually be managed, and certain lifestyle choices can help you maintain a good quality of life for some time.

As the disease progresses, symptoms can become increasingly limiting.

People with severe stages of COPD may not be able to care for themselves without assistance. They are at increased risk of developing respiratory infections, heart problems, and lung cancer. They may also be at risk of depression and anxiety.

COPD generally reduces life expectancy, though the outlook varies considerably from person to person. People with COPD who never smoked may have a modest reduction in life expectancyTrusted Source, while former and current smokers are likely to have a larger reduction.

Besides smoking, your outlook depends on how well you respond to treatment and whether you can avoid serious complications. Your doctor is in the best position to evaluate your overall health and give you an idea about what to expect.

Learn more about the life expectancy and prognosis for people with COPD.

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Alzheimers Disease ; Everything you need to know.

What is Alzheimer’s disease?
Alzheimer’s disease is a progressive form of dementia. Dementia is a broader term for conditions caused by brain injuries or diseases that negatively affect memory, thinking, and behavior. These changes interfere with daily living.
According to the Alzheimer’s Association, Alzheimer’s disease accounts for 60 to 80 percent of dementia cases. Most people with the disease get a diagnosis after age 65. If it’s diagnosed before then, it’s generally referred to as early onset Alzheimer’s disease.
There’s no cure for Alzheimer’s, but there are treatments that can slow the progression of the disease. Learn more about the basics of Alzheimer’s disease.
Alzheimer’s facts
Although many people have heard of Alzheimer’s disease, some aren’t sure exactly what it is. Here are some facts about this condition:
Alzheimer’s disease is a chronic ongoing condition.
Its symptoms come on gradually and the effects on the brain are degenerative, meaning they cause slow decline.
There’s no cure for Alzheimer’s but treatment can help slow the progression of the disease and may improve quality of life.
Anyone can get Alzheimer’s disease but certain people are at higher risk for it. This includes people over age 65 and those with a family history of the condition.
Alzheimer’s and dementia aren’t the same thing. Alzheimer’s disease is a type of dementia.
There’s no single expected outcome for people with Alzheimer’s. Some people live a long time with mild cognitive damage, while others experience a more rapid onset of symptoms and quicker disease progression.
Each person’s journey with Alzheimer’s disease is different. Find out more details about how Alzheimer’s can affect people.

Dementia vs. Alzheimer’s
The terms “dementia” and “Alzheimer’s” are sometimes used interchangeably. However, these two conditions aren’t the same. Alzheimer’s is a type of dementia.
Dementia is a broader term for conditions with symptoms relating to memory loss such as forgetfulness and confusion. Dementia includes more specific conditions, such as Alzheimer’s disease, Parkinson’s disease, traumatic brain injury, and others, which can cause these symptoms.
Causes, symptoms, and treatments can be different for these diseases. Learn more about how dementia and Alzheimer’s disease differ.



Alzheimer’s disease causes and risk factors
Experts haven’t determined a single cause of Alzheimer’s disease but they have identified certain risk factors, including:
Age. Most people who develop Alzheimer’s disease are 65 years of age or older.
Family history. If you have an immediate family member who has developed the condition, you’re more likely to get it.
Genetics. Certain genes have been linked to Alzheimer’s disease.
Having one or more of these risk factors doesn’t mean that you’ll develop Alzheimer’s disease. It simply raises your risk level.
To learn more about your personal risk of developing the condition, talk with your doctor. Learn about amyloid plaques, neurofibrillary tangles, and other factors that may cause Alzheimer’s disease.

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Alzheimer’s and genetics
While there’s no one identifiable cause of Alzheimer’s, genetics may play a key role. One gene in particular is of interest to researchers. Apolipoprotein E (APOE) is a gene that’s been linked to the onset of Alzheimer’s symptoms in older adults.
Blood tests can determine if you have this gene, which increases your risk of developing Alzheimer’s. Keep in mind that even if someone has this gene, they may not get Alzheimer’s.
The opposite is also true: Someone may still get Alzheimer’s even if they don’t have the gene. There’s no way to tell for sure whether someone will develop Alzheimer’s.
Other genes could also increase risk of Alzheimer’s and early onset Alzheimer’s. Learn more about the link between genes and Alzheimer’s disease.


Symptoms of Alzheimer’s disease
Everyone has episodes of forgetfulness from time to time. But people with Alzheimer’s disease display certain ongoing behaviors and symptoms that worsen over time. These can include:
memory loss affecting daily activities, such as an ability to keep appointments
trouble with familiar tasks, such as using a microwave
difficulties with problem-solving
trouble with speech or writing
becoming disoriented about times or places
decreased judgment
decreased personal hygiene
mood and personality changes
withdrawal from friends, family, and community
Symptoms change according to the stage of the disease. Find out about early indicators of Alzheimer’s and how they progress into more severe symptoms.



Alzheimer’s stages
Alzheimer’s is a progressive disease, which means the symptoms will gradually worsen over time. Alzheimer’s is broken down into seven stages:
Stage 1. There are no symptoms at this stage but there might be an early diagnosis based on family history.
Stage 2. The earliest symptoms appear, such as forgetfulness.
Stage 3. Mild physical and mental impairments appear, such as reduced memory and concentration. These may only be noticeable by someone very close to the person.
Stage 4. Alzheimer’s is often diagnosed at this stage, but it’s still considered mild. Memory loss and the inability to perform everyday tasks is evident.
Stage 5. Moderate to severe symptoms require help from loved ones or caregivers.
Stage 6. At this stage, a person with Alzheimer’s may need help with basic tasks, such as eating and putting on clothes.
Stage 7. This is the most severe and final stage of Alzheimer’s. There may be a loss of speech and facial expressions.
As a person progresses through these stages, they’ll need increasing support from a caregiver. Find out more about how the stages of Alzheimer’s progress and the support needs that are likely for each.

Early onset Alzheimer’s
Alzheimer’s typically affects people ages 65 years and older. However, it can occur in people as early as their 40s or 50s. This is called early onset, or younger onset, Alzheimer’s. This type of Alzheimer’s affects about 5 percent of all people with the condition.
Symptoms of early onset Alzheimer’s can include mild memory loss and trouble concentrating or finishing everyday tasks. It can be hard to find the right words, and you may lose track of time. Mild vision problems, such as trouble telling distances, can also occur.
Certain people are at greater risk of developing this condition. Learn about risk factors and other symptoms of early onset Alzheimer’s.
Diagnosing Alzheimer’s disease
The only definitive way to diagnose someone with Alzheimer’s disease is to examine their brain tissue after death. But your doctor can use other examinations and tests to assess your mental abilities, diagnose dementia, and rule out other conditions.
They’ll likely start by taking a medical history. They may ask about your:
symptoms
family medical history
other current or past health conditions
current or past medications
diet, alcohol intake, or other lifestyle habits
From there, your doctor will likely do several tests to help determine if you have Alzheimer’s disease.
Alzheimer’s tests
There’s no definitive test for Alzheimer’s disease. However, your doctor will likely do several tests to determine your diagnosis. These can be mental, physical, neurological, and imaging tests.
Your doctor may start with a mental status test. This can help them assess your short-term memory, long-term memory, and orientation to place and time. For example, they may ask you:
what day it is
who the president is
to remember and recall a short list of words
Next, they’ll likely conduct a physical exam. For example, they may check your blood pressure, assess your heart rate, and take your temperature. In some cases, they may collect urine or blood samples for testing in a laboratory.
Your doctor may also conduct a neurological exam to rule out other possible diagnoses, such as an acute medical issue, such as infection or stroke. During this exam, they will check your reflexes, muscle tone, and speech.
Your doctor may also order brain-imaging studies. These studies, which will create pictures of your brain, can include:
Magnetic resonance imaging (MRI). MRIs can help pick up key markers, such as inflammation, bleeding, and structural issues.
Computed tomography (CT) scan. CT scans take X-ray images which can help your doctor look for abnormal characteristics in your brain.
Positron emission tomography (PET) scan. PET scan images can help your doctor detect plaque buildup. Plaque is a protein substance related to Alzheimer’s symptoms.
Other tests your doctor may do include blood tests to check for genes that may indicate you have a higher risk of Alzheimer’s disease. Find out more about this test and other ways to test for Alzheimer’s disease.
Alzheimer’s medication
There’s no known cure for Alzheimer’s disease. However, your doctor can recommend medications and other treatments to help ease your symptoms and delay the progression of the disease for as long as possible.
For early to moderate Alzheimer’s, your doctor may prescribe medications such as donepezil (Aricept) or rivastigmine (Exelon). These drugs can help maintain high levels of acetylcholine in your brain. This is a type of neurotransmitter that can help aid your memory.
To treat moderate to severe Alzheimer’s, your doctor may prescribe donepezil (Aricept) or memantine (Namenda). Memantine can help block the effects of excess glutamate. Glutamate is a brain chemical that’s released in higher amounts in Alzheimer’s disease and damages brain cells.
Your doctor may also recommend antidepressants, antianxiety medications, or antipsychotics to help treat symptoms related to Alzheimer’s. These symptoms include:
depression
restlessness
aggression
agitation
hallucinations
Learn more about Alzheimer’s medications available now, and those being developed.

Other Alzheimer’s treatments
In addition to medication, lifestyle changes may help you manage your condition. For example, your doctor might develop strategies to help you or your loved one:
focus on tasks
limit confusion
avoid confrontation
get enough rest every day
stay calm
Some people believe that vitamin E can help prevent decline in mental abilities, but studiesindicate that more research is needed. Be sure to ask your doctor before taking vitamin E or any other supplements. It can interfere with some of the medications used to treat Alzheimer’s disease.
In addition to lifestyle changes, there are several alternative options you can ask your doctor about. Read more about alternative Alzheimer’s treatments.
Preventing Alzheimer’s
Just as there’s no known cure for Alzheimer’s, there are no foolproof preventive measures. However, researchers are focusing on overall healthy lifestyle habits as ways of preventing cognitive decline.
The following measures may help:
Quit smoking.
Exercise regularly.
Try cognitive training exercises.
Eat a plant-based diet.
Consume more antioxidants.
Maintain an active social life.
Be sure to talk with your doctor before making any big changes in your lifestyle. Read more about possible ways to prevent Alzheimer’s.
Alzheimer’s care
If you have a loved one with Alzheimer’s, you may consider becoming a caregiver. This is a full-time job that’s typically not easy but can be very rewarding.
Being a caregiver takes many skills. These include patience perhaps above all, as well as creativity, stamina, and the ability to see joy in the role of helping someone you care about live the most comfortable life they can.
As a caregiver, it’s important to take care of yourself as well as your loved one. With the responsibilities of the role can come an increased risk of stress, poor nutrition, and lack of exercise.
If you choose to assume the role of caregiver, you may need to enlist the help of professional caregivers as well as family members to help. Learn more about what it takes to be an Alzheimer’s caregiver.
Alzheimer’s statistics
The statistics surrounding Alzheimer’s disease are daunting.
According to the Centers for Disease Control and Prevention (CDC), Alzheimer’s is the sixth most common cause of death among U.S. adults. It ranks fifth among causes of death for people 65 years and older.
study found that 4.7 million Americans over the age of 65 years had Alzheimer’s disease in 2010. Those researchers projected that by 2050, there will be 13.8 million Americans with Alzheimer’s.
The CDC estimates that over 90 percentTrusted Source
 of people with Alzheimer’s don’t see any symptoms until they’re over 60 years old.
Alzheimer’s is an expensive disease. According to the CDC, about $259 billionTrusted Source
 was spent on Alzheimer’s and dementia care costs in the United States in 2017.
The takeaway
Alzheimer’s is a complicated disease in which there are many unknowns. What is known is that the condition worsens over time, but treatment can help delay symptoms and improve your quality of life.
If you think you or a loved one may have Alzheimer’s, your first step is to talk with your doctor. They can help make a diagnosis, discuss what you can expect, and help connect you with services and support. If you’re interested, they can also give you information about taking part in clinical trials.

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Medically reviewed byTimothy J. Legg, PhD, PsyDon December 4, 2018 — Written by Jaime Herndon and Kristeen Cherney

Cardiovascular Diseases

Cardiovascular disease (CVD) is a term used to refer to the range of diseases which affect the heart and blood vessels. These include hypertension (high blood pressure); coronary heart disease (heart attack); cerebrovascular disease (stroke); heart failure; and other heart diseases.

Cardiovascular disease is the top cause of death globally.

In the map we see death rates from cardiovascular diseases across the world.

Overall we see a strong East-West divide in CVD death rates. Rates across North America and Western/Northern Europe tend to be significantly lower than those across Eastern Europe, Asia and Africa. Across most of Latin America, these rates are moderate. In France, for example, the age-standardized rate was around 86 per 100,000 in 2017; across Eastern Europe this rate was around 5 times higher at 400-500 per 100,000. At the highest end of the scale, Uzbekistan had a rate of 724 per 100,000.Death rate from cardiovascular disease, 2017

The annual number of deaths from cardiovascular diseases per 100,000 people.

Source: IHME, Global Burden of Disease (GBD)

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

What is Congestive Heart Failure?

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An Overview of Congestive Heart Failure (CHF)

Symptoms, Causes, Diagnosis, Treatment, and Coping

By James Myhre and Dennis Sifris, MD

 Medically reviewed by Richard N. Fogoros, MD Updated on December 02, 2019Heart Failure

In This Article

Congestive heart failure (CHF) is the term used to describe what happens when the heart is unable to pump enough blood to meet the body’s needs. (It should not be confused with cardiac arrest in which the heart stops beating entirely.) CHF is simply the inadequate functioning of the heart muscle. The condition can either be acute, meaning it occurs rapidly, or chronic, which means it occurs over the long term.

Symptoms of CHF may include fatigue, the swelling of the legs, and shortness of breath (especially with exercise).1 CHF can be diagnosed based on a review of your symptoms, blood tests, a cardiac ultrasound, and X-ray. Treatment can vary by the underlying cause and may include diet, exercise, anti-hypertensive medications, blood thinners, and drugs like Entresto designed specifically to treat heart failure.

Severe cases may require an implantable cardiac device to improve the strength or rhythm of the heart. In the worst-case scenario, a heart transplant may be required.

Symptoms

The symptoms of CHF can vary by the location of the heart damage, broadly described as left-sided heart failure, right-sided heart failure, or biventricular failure.

Left-Sided Failure

The left side of the heart is responsible for receiving oxygen-enriched blood from the lungs and pumping it to the rest of the body.

If the heart is failing on the left side (referred to as left ventricular heart failure), it will back up into the lungs, depriving the rest of the body of the oxygen it needs.

Left-sided heart failure is either caused by systolic dysfunction, which is when the heart doesn’t pump out blood the way it should, or diastolic dysfunction, in which the heart doesn’t fill up with blood as it should.2Left-Sided Systolic Heart Failure

Characteristic symptoms of left-sided heart failure include:

  • Fatigue
  • Dizziness
  • Shortness of breath, especially when lying flat or during exertion
  • Dry hacking or wheezing
  • Rales and crackling sounds in the lungs
  • Abnormal “galloping” heart sounds (gallop rhythm)
  • Nighttime breathlessness (paroxysmal nocturnal dyspnea)
  • Cool skin temperature
  • Bluish skin tones due to the lack of oxygen (cyanosis)
  • Confusion

Right-Sided Failure

The right side of the heart is responsible for receiving oxygen-poor blood from the body and pumping it to the lungs to be oxygenated.2

If the right side of the heart is failing (known as right ventricular heart failure), the heart cannot fill with enough blood, causing the blood to back up into the veins.

Right-sided heart failure is often caused by pulmonary heart disease (cor pulmonale) in which the enlargement or failure of the right ventricle leads to circulatory congestion in the lungs as well as the rest of the body.3

Characteristic symptoms of right-sided heart failure include:

  • Fatigue
  • Weakness
  • Shortness of breath, particularly with exercise
  • Accumulation of fluid, usually in the lower legs (peripheral edema) or lower back (sacral edema)
  • A distended jugular vein in the neck
  • Rapid heart rate (tachycardia)
  • Chest pain or pressure
  • Dizziness
  • Chronic coughing
  • Frequent nighttime urination (nocturia)
  • The build-up of fluid of the abdomen (ascites)
  • An enlarged liver
  • Nausea
  • Loss of appetite

Biventricular Failure

Biventricular heart failure involves the failure of both the left and right ventricles of the heart. It is the type most commonly seen in clinical practice and will manifest with symptoms characteristic of both left and right heart failure.4

One of the common features of biventricular heart failure is pleural effusion, the collection of fluid between the lung and chest wall.

While pleural effusion can occur with right-sided heart failure and to a lesser extent with left-sided heart failure, it is far more characteristic when both sides are involved. Symptoms of pleural effusion include:

  • Sharp chest pain
  • Shortness of breath, particularly with activity
  • Chronic dry cough
  • Fever
  • Difficulty breathing when lying down
  • Difficulty taking deep breaths
  • Persistent hiccups

Complications

CHF is a potential complication of many different diseases and disorders. However, the development of CHF can spur further complications, increasing the risk of illness, incapacitation, and death. Characteristic complications of CHF include:

  • Venous thromboembolism, which is a blood clot that forms when blood starts to pool in a vein.5 If the clot breaks off and travels to the lung, it can cause a pulmonary embolism. If it breaks off and lodges in the brain, it can cause a stroke.
  • Kidney failure, which can occur when reduced blood circulation allows waste products to accumulate in the body. If severe, dialysis or a kidney transplant may be required.
  • Liver damage. This commonly occurs with advanced right-sided heart failure when the heart fails to supply the liver with the blood it needs to function, leading to portal hypertension (high blood pressure in the liver), cirrhosis, and liver failure.6
  • Lung damage, including empyema (accumulation of pus), pneumothorax (collapsed lung), and pulmonary fibrosis (lung scarring) which is a common complication of pleural effusion.
  • Heart valve damage, which can occur as your heart works harder to pump blood, causing the valves to enlarge abnormally. Prolonged inflammation and heart damage can lead to severe arrhythmia, cardiac arrest, and sudden death.

Causes

Causes of CHF include coronary artery disease, high blood pressure, heart valve disease, infection, excessive alcohol use, or a previous heart attack.7

Congestive heart failure (often referred to simply as heart failure) affects around 6 million Americans and is the leading cause of hospitalization in people over 65 years old. Over 650,000 new cases are diagnosed each year.

The word “congestive” refers to the build-up of fluid in the veins and tissues of the lungs and other parts of the body. It is this congestion which triggers many of the characteristic symptoms of CHF.

CHF is caused by any number of conditions that damage the heart muscle itself, referred to as cardiomyopathy. Common causes include:7

  • Coronary artery disease (CAD), in which the arteries that supply blood and oxygen to the heart become narrowed or obstructed
  • Myocardial infarction (MI), also known as a heart attack, in which a coronary artery becomes blocked, which starves and kills heart muscle tissues
  • Heart overload (including high-output heart failure), in which the heart is overworked by conditions such as hypertension, kidney disease, diabetes, heart valve disease, a congenital heart defect, Paget’s disease, cirrhosis, or multiple myeloma
  • Infections, which includes viral infections such as German measles (rubella) or coxsackie B virus. Another cause is systemic viral infections, such as HIV, which can cause progressive damage to the heart muscle. Non-viral illnesses like Chagas disease can also cause heart failure.
  • Long-term alcohol or substance abuse, including methamphetamine or cocaine abuse
  • Cancer chemotherapy drugs like daunorubicin, cyclophosphamide, and trastuzumab
  • Amyloidosis, a condition in which amyloid proteins build up in the heart muscle, often in association with chronic inflammatory disorders like lupus, rheumatoid arthritis, and inflammatory bowel disease (IBD)
  • Obstructive sleep apnea, a form of sleep apnea considered an independent risk factor for CHF when accompanied by obesity, hypertension, or diabetes
  • Toxic exposure to lead or cobalt

Acute Decompensated Heart Failure

Chronic heart failure is the stage in which the heart condition is stable. Chronic heart failure can sometimes progress to acute decompensated heart failure (ADHF) in which the symptoms worsen and increase the risk of respiratory failure.8

ADHF if often triggered by an instigating event such as:

  • Heart attack
  • Pneumonia
  • Uncontrolled or worsening hypertension
  • Hyperthyroidism (overactive thyroid gland)
  • Severe anemia
  • Arrhythmia (abnormal heart rhythm)9

Diagnosis

If congestive heart failure is suspected, your doctor will make the diagnosis based on a review of your symptoms, a physical examination, blood tests, imaging tests, and other diagnostics designed to measure heart function. The failure will then be classified by order of severity to direct the appropriate course of treatment.

Physical Examination

After a review of your symptoms and medical history, your doctor will perform a physical exam to identify the symptoms indicative of CHF.10 This will include, among other things, a review of your:

  • Blood pressure
  • Heart rate
  • Heart sounds (to check for abnormal rhythms)
  • Lung sounds (to assess for congestion, rales, or effusion)
  • Lower extremities (to check for signs of edema)
  • Jugular vein in your neck (to check whether it is bulging or distended)

Laboratory Tests

There are a number of blood tests used to diagnose CHF, some of which can identify the underlying cause of the dysfunction. These may include a complete blood count (to check for anemia), a C-reactive protein (to detect signs of infection), and liver function, kidney function, or thyroid function tests (to establish whether other organ systems are involved and why).

Arguably the most important test is the B-type natriuretic peptide (BNP) test which detects a specific hormone secreted by the heart in response to changes in blood pressure. When the heart is stressed and works harder to pump blood, the concentration of BNP in the blood will begin to rise.11

The BNP test is one of the cornerstone diagnostics of heart failure. However, increases in BNP values do not necessarily correspond to the severity of the condition.

In most labs, a BNP of less than 100 picograms per milliliter (pg/mL) can definitively rule out CHF in 98 percent of cases.

High BNP levels are far less conclusive, although levels above 900 pg/mL in adults over 50 years old can accurately diagnose CHF in around 90 percent of cases.12

Imaging Tests

The primary imaging tool for diagnosing CHF is an echocardiogram. An echocardiogram is a form of ultrasound that uses reflected sound waves to create real-time images of the beating heart.10 The echocardiogram is used to determine two diagnostic values:

  • Stroke volume (SV): the amount of blood exiting the heart with each beat
  • End-diastolic volume (EDV): the amount of blood entering the heart as it relaxes

The comparison of the SV to the EDV can then be used to calculate the ejection fraction (EF), the value of which describes the pumping efficiency of the heart.

Normally, the ejection fraction should be between 55 percent and 70 percent. Heart failure can typically be diagnosed when the EF drops below 40 percent.

Another form of imaging, known as angiography, is used to evaluate the vascular structure of the heart. If coronary artery disease is suspected, a narrow catheter would be inserted into a coronary artery to inject contrast dyes for visualization on an X-ray. Angiography is extremely useful in pinpointing blockages that may be damaging the heart muscle.

A chest X-ray on its own can help identify cardiomegaly (enlargement of the heart) and evidence of vascular enlargement in the heart. A chest X-ray and ultrasound can also be used to help diagnose pleural effusion.13

Other Tests

In addition to the BNP and echocardiogram, other tests can be used to either support the diagnosis or characterize the cause of the dysfunction. These include:

  • Electrocardiogram (ECG), used to measure the electrical activity of the heart
  • Cardiac stress test, which measures your heart function when placed under stress (usually while running on a treadmill or pedaling a stationary cycle)

CHF Classification

If congestive heart disease is definitively diagnosed, your cardiologist would classify the failure based on a review of your physical exam, lab findings, and imaging test. The aim of the classification is to direct the appropriate course treatment.

There are several classification systems a doctor may rely upon, including the functional classification system issued by the New York Heart Association (NYHA) or the CHF staging system issued by the American College of Cardiology (ACC) and the American Heart Association (AHA).

The NYHA functional classification is broken down into four classes based on both your physical capacity for activity and the appearance of symptoms.14

  • Class I: no limitation in any activities and no symptoms from ordinary activities
  • Class II: mild limitation of activity and no symptoms with mild exertion
  • Class III: marked limitation of activity and symptoms at all times except rest
  • Class IV: discomfort and symptoms at rest and with activity

The ACC/AHA staging system provides greater insight as to what medical interventions should be implemented at which stages.7

  • Stage A: the “pre-heart failure” stage in which there is no functional or structural heart disorder but a distinct risk of one in the future
  • Stage B: a structural heart disorder but with no symptoms at rest or activity
  • Stage C: stable heart failure that can be managed with medical treatment
  • Stage D: advanced heart failure in need of hospitalization, a heart transplant, or palliative care

The ACC/AHA system is especially useful—each stage corresponds to specific medical recommendations and interventions.

Treatment

The treatment of congestive heart failure is focused on reducing symptoms and preventing the progression of the disease. It also requires treatment for the underlying cause of the failure, whether it be an infection, a heart disorder, or a chronic inflammatory disease.

The treatment will be largely directed by the staging of the CHF and may involve lifestyle changes, medications, implanted devices, and heart surgery.15

Lifestyle Changes

One of the first steps in managing CHF is making changes in your life to improve your diet and physical fitness and to correct the bad habits that contribute to your illness. Depending on the stage of the CHF, the interventions may be relatively easy to implement or may require a serious adjustment of your lifestyle.

Reduce Sodium Intake: This not only includes the salt you add to food, but also the types of food that are high in sodium. The less salt in your diet, the less fluid retention there will be. Most doctors recommend no more than 2,000 milligrams per day from all sources.

Limit Fluid Intake: This can vary depending on the severity of your condition, but generally speaking, you would limit your fluids to no more than 2 liters (8.5 cups) per day.

Achieve and Maintain a Healthy Weight: If you are overweight, you may need to work with a nutritionist to first determine your ideal weight and daily calorie intake, and then to design a safe and sustainable low-sodium diet.

Stop Smoking: There is no safe amount of smoking. Smoking contributes to the development of atherosclerosis (hardening of the arteries), making your heart work much harder than it normally would have to.16

Exercise Regularly: You need to find an exercise plan you can sustain and build upon to get stronger. Try starting with no less than 30 minutes of exercise three times per week, incorporating cardio and strength training. Working with a personal trainer can help ensure the appropriate workout routine, which is one that neither overtaxes you nor leaves you unchallenged.

Reduce Alcohol Intake: While an occasional drink may not do you any harm, moderate alcohol intake can sometimes complicate left-sided heart failure, particularly in people with alcohol-induced cardiomyopathy.17 Speak to your doctor about the appropriate limits based on the nature and severity of your CHF.

Medications

There are a number of medications commonly prescribed to improve the function of your heart. These include:18

  • Diuretics (water pills) to reduce the amount of fluid in your body and, in turn, your blood pressure
  • Angiotensin-converting enzyme (ACE) inhibitors which block an enzyme that regulates blood pressure and salt concentrations in your body
  • Angiotensin receptor blockers (ARBs) that reduce blood pressure by relaxing blood vessels and improving blood flow
  • Entresto (sacubitril/valsartan), which is a combination drug used in place of ARBs and ACE inhibitors in people with a reduced EF (generally under 40 percent)
  • Apresoline (hydralazine) and isosorbide dinitrate, which are sometimes prescribed in combination for people who can’t tolerate ARBs and ACE inhibitors
  • Lanoxin (digoxin), which is sometimes prescribed for people with severe heart failure but is largely avoided due to the high degree of toxicity
  • Vasopressin receptor antagonists like Vaprisol (conivaptan) which may be used for people with ADHF who develop abnormally low sodium levels (hyponatremia)
  • Beta-blockers, which continue to be an integral component in treating CHF

Drugs to Avoid: There a number of drugs that you may need to avoid if you have heart failure, which may either undermine therapy or contribute to cardiac congestion. These drugs include:19

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like Voltaren (diclofenac), Advil (ibuprofen), or Aleve (naproxen) can precipitate fluid retention. Use Tylenol (acetaminophen) instead.
  • Certain anti-arrhythmia drugs (particularly sodium channel-blocking drugs) may increase heart rhythm problems in people with CHF.
  • Calcium channel blockers can also induce arrhythmia, particularly in people with left-sided systolic failure.
  • Salt substitutes typically contain potassium which promotes arrhythmia.
  • Antacids often contain high quantities of sodium and are best avoided.
  • Decongestants like pseudoephedrine can raise blood pressure and should only be used under the direction of your doctor.

Since other drugs (including ketamine, salbutamol, tamsulosin, and thiazolidinediones) can affect heart function, it is important to advise your doctor about any drugs you are taking, including supplements and herbal remedies.

Implantable Devices

Heart failure is described when the EF is 40 percent or less. This means that 40 percent or less of the blood in your left ventricle leaves the heart with each heartbeat.

If your EF falls below 35 percent or you experience severe arrhythmia as a result of CHF, your doctor may recommend an implantable device to reduce the risk of illness or death. Different approaches are used for different conditions.20

  • Automatic implantable cardioverter defibrillators (AICDs), similar to pacemakers, are used to correct arrhythmias as they occur.
  • Cardiac resynchronization therapy (CRT) involves the synchronization of the right and left ventricles so that they work more effectively.
  • Cardiac contractility modulation (CCM), approved in Europe but not in the United States, is used to strengthen the contraction of the left ventricle with synchronized bursts of electrical stimulation.

The implants are typically inserted beneath the skin of the upper left chest. Before the surgery, medication will be given to make you sleepy and comfortable.

The implantation of a device does not require open-heart surgery, and most people go can home within 24 hours.

Surgery

Surgery may be indicated to repair the underlying or contributing causes of heart failure. This may include repairing or replacing leaky heart valves or performing a coronary artery bypass graft (CABG) to redirect the blood flow around one or more blocked arteries.20

If a heart attack has occurred, surgery is often needed to repair the bulging and thinning of the left ventricular, known as a ventricular aneurysm.

Some surgeries are minimally invasive—accessing the heart through a blood vessel or through the chest without opening the ribcage—while others are open-heart.

If the risk of death is high and a donor’s heart is not available, open surgery may be used to implant a ventricular assist device (VAD) into the chest.20 The VAD mechanically pumps blood from the left ventricle to the aorta and is powered by an external battery worn over the shoulder. It is a short-term solution used by doctors when waiting for a donor’s heart.

heart transplant is typically indicated with the EF has dropped below 20 percent and/or the risk of death within one year is high. Around 3,500 heart transplants are performed around the world each year, more than half of which are performed in the United States.21

People who successfully undergo heart transplant surgery can expect to live an additional 15 years on average.

Coping

Being diagnosed with congestive heart failure doesn’t mean that you’re going to die or that your heart will suddenly stop. It simply means that your heart is failing to work as well as it is supposed to.

While there is no cure for CHF, there are steps you can take to maintain or improve your heart function.

Weigh Yourself Daily: Changes in your weight may be a sign that your condition is worsening. Start by knowing your “dry weight” (your weight when there no extra fluids in our body) and keep a daily record. Call your doctor if your weight is either 4 pounds more or 4 pounds less than your dry weight in the span of a week.

Take Your Medications Daily: You need to maintain a steady concentration of medications in your bloodstream to sustain the desired effect. Some drugs used to treat CHF have a short drug half-life (including Entresto with a half-life of 10 hours) and must be taken as prescribed without missing any doses. To avoid missed doses, try programming alarm reminders on your cell phone.

Keep Your Doctor Appointments: People who remain under consistent medical care invariably do better than those who don’t. Making and keeping your appointments allows your doctor to intervene before a medical problem become serious or irreversible.

Check Food Labels: Sodium is hidden in many foods that we eat. Learn how to read product labels and to choose foods low in salt, including lean meats, poultry, fish, fruit, vegetables, eggs, low-fat dairy, rice, pasta, and dry or fresh beans. Avoid canned or packaged foods, and be aware that “reduced-sodium” products may still contain more than you need.

Find Alternative Seasonings: Instead of salt or sodium-rich condiments, season your food with fresh herbs, dried spices, lemon juice, or flavored vinegar.

Plan Ahead When Eating Out: Check the menu online in advance of your reservation, and call ahead to discuss your dietary requirements so that you make the right choices.

Get Help Kicking Bad Habits: Quitting “cold turkey” with cigarettes or alcohol is rarely effective. Speak with your doctor about smoking cessation aids (many of which are fully covered by the Affordable Care Act). If you have a drinking problem, ask your doctor about support groups or alcohol treatment programs.

Try to Relax: Don’t treat your stress with alcohol or sleeping pills. Instead, explore methods of stress relief, including exercise, yoga, or meditation. If you are unable to cope, ask your doctor for a referral to a therapist who can either help you one-on-one or enlist you in group therapy. Heart failure has also been linked to depression, so addressing your feelings with a mental health professional can be helpful.22

A Word From Verywell

Experiencing congestive heart failure usually changes your life in a lot of ways. However, by making healthy changes, you will improve your heart and all other aspects of your health. You can live well with CHF for many years. Find support from family and friends who can help you normalize CHF. The more they understand your condition, the better able they can help you achieve your therapy goals. Try asking your doctor for a referral to a support group in your area or connect with others online through the American Heart Association Support Network.

How Vascular Tone Affects The Heart

Tone, also known as vascular tone, refers to the amount of constriction present in blood vessels. Higher tone means more constriction, which indicates more resistance to blood flow, and thus, means the heart has to work harder to pump blood.

The Vascular tone varies among different organs. The vascular tone of the pulmonary system may be different than that of the coronary vascular system. The vascular tone of blood vessels and arteries determine how hard the heart has to work to pump blood throughout the body. When there is no resistance from blood vessels, the heart is able to pump smoothly, reducing the risk of heart disease. The higher the resistance from blood vessels, the harder the heart has to pump, the higher the risk of heart disease.

Too much resistance pushing against artery walls is known as high blood pressure or hypertension. High blood pressure will, over the course of time, damage the walls of the larger arteries, such as the aorta and carotids, as well as the smaller ones, the cerebral, coronary and renal arteries. High blood pressure makes the heart work harder pumping blood throughout the body.

Blood pressure has two readings, the top number is the systolic and the bottom number is diastolic. The 2017 AHA/ACC guidelines define hypertension as follows

  • Normal: <120 mm Hg and <80mmHg
  • Elevated: 120-129 mm Hg and <80 Hg

Hypertension:

  • Stage 1: 130-139 mm Hg or 80-89 mm Hg
  • Stage 2: 140 mm Hg or higher, or 90 mm Hg or higher

Risks of Hypertension

Uncontrolled hypertension causes arteries to become narrow, stiff and inflexible. As a result, the heart has to work harder to move blood through the body. This can result in stroke, heart attack, and heart failure. Heart failure can also damage kidneys, cause problems with vision, and affect memory.

Treatment

In general, the goal is to bring blood pressure to below 120/80. However, in some cases this goal needs to be individualized, and if you have hypertension you should discuss the goal of treatment with your doctor.

Medications that have been used to reach acceptable blood pressure levels include:

Medication to reduce blood pressure to acceptable levels will be determined by a medical professional.

Lifestyle Modifications

By taking an active role in their care, patients can help to reduce hypertension by making the following modifications:

  • Losing weight
  • Eating more fruits, vegetables
  • Eating low-fat dairy products
  • Lowering the level of sodium intake
  • Exercising regularly
  • Cutting down on alcohol consumption
  • Quitting smoking

Medication needs to be taken regularly and patients should not skip a dose.

When do see a docotor if hypertension persists.

Hypertension does not usually cause any noticeable symptoms. When it does, you might experience dizziness, shortness of breath, headaches, and nosebleeds, which could indicate that your blood pressure is high.1 Complications such as heart disease, stroke, and kidney failure can occur if long-term hypertension is not adequately treated. A hypertensive emergency, which is an uncommon and dangerous event, may cause blurry vision, nausea, chest pain and anxiety.2

hypertension symptoms
© Verywell, 2018

Frequent Symptoms

Overall, the vast majority of people who have hypertension, which is described as chronically high blood pressure (>130 mm Hg or diastolic pressure >80 mm Hg), do not experience any symptoms of the condition. It is usually diagnosed in the doctor’s office with a simple blood pressure measurement using a blood pressure cuff.

Symptoms that do occur, if present, may indicate temporary fluctuations or elevations in blood pressure, and can be related to the timing of medication doses. Generally, the symptoms of hypertension can happen at any time, do not last for long, and may recur. They include:

  • Recurrent headaches: Headaches are fairly common among people with or without hypertension. Some people with hypertension notice changes or worsening of headaches when medications are skipped or when the blood pressure becomes higher than usual. Headaches associated with hypertension can be mild, moderate, or severe3 and can be of a throbbing nature. 
  • Dizziness: People with hypertension may notice dizziness in relation to medication doses and blood pressure fluctuations. 
  • Shortness of breath: Hypertension can cause shortness of breath as a result of the effect on the heart and lung function.4 Shortness of breath is more noticeable with physical exertion or exercise. 
  • Nosebleed: You may be more prone to nosebleeds if you have hypertension, although, in general, nosebleeds are not a classic sign of high blood pressure.

Rare Symptoms 

Extremely high blood pressure that occurs suddenly is more likely to produce noticeable symptoms than chronic hypertension. However, it is important to know that even very high blood pressure may not produce symptoms. 

Severe high blood pressure is defined as systolic pressure of >180 mm Hg or a diastolic pressure of >120 mm Hg. People with severe high blood pressure can develop symptoms quickly, including: 

  • Blurry vision or other vision disturbances: Blurred vision and vision changes are warning signs that you could be at risk of a serious health problem, such as a stroke or a heart attack.5 
  • Headaches: Headaches associated with very high blood pressure tend to be throbbing in nature and can develop rapidly. 
  • Dizziness: The dizziness of very high blood pressure is described as vertigo (a sensation that the room is spinning).6 
  • Nausea, vomiting or loss of appetite: Nausea associated with severe hypertension can develop suddenly and may be associated with dizziness.  

Hypertensive Urgency

A type of high blood pressure without serious symptoms is called hypertensive urgency.

Hypertensive urgency is defined as a systolic blood pressure of >180 mm Hg and a diastolic blood pressure of >120 mm Hg. This blood pressure is considered high enough to put you at serious risk of sudden, life-threatening events.

In situations of hypertensive urgency, there is no organ failure or other immediately critical conditions, but these conditions could quickly develop if the blood pressure isn’t quickly brought under control.7

Complications

Untreated hypertension causes serious complications, including organ damage. Less commonly, a condition called hypertensive emergency, which may also be called hypertensive crisis or malignant hypertension can occur.

Hypertensive Emergency

A hypertensive emergency, unlike the similar sounding hypertensive urgency, is characterized by serious, life-threatening complications. A hypertensive emergency means that the blood pressure is >180 mm Hg or the diastolic pressure is >120 mm Hg, and that end-organ damage is occurring. Signs and symptoms can include shortness of breath, anxiety, chest pain, irregular heart rate, confusion, or fainting.8 

Aneurysm Rupture

An aneurysm, which is a bulge in the wall of an artery, can form due to a number of causes. Aneurysms can occur in the aorta, brain, and kidneys. Hypertension contributes to aneurysm formation, and sudden elevations of blood pressure can increase the risk of an aneurysm rupture—a serious event that can be fatal.9 

Vascular Disease

Hypertension increases the risk of vascular disease, characterized by atherosclerosis (hardening and stiffening of the blood vessels) and narrowing of the arteries. Vascular disease can involve the blood vessels in the legs, heart, brain, kidneys, and eyes, causing a range of disabling or life-threatening symptoms. 

Heart Disease

Hypertension contributes to the development and worsening of coronary artery disease, cardiac arrhythmias, and heart failure.10 

Kidney Failure

Hypertension can affect the kidneys, as their blood vessels become less able to function effectively; permanent damage is possible.

Respiratory Disease

Respiratory disease can develop as a consequence of heart disease, manifesting as shortness of breath with exertion. 

When to See a Doctor

It is important to go to your regular check-ups with your doctor. Hypertension is a common condition and, if caught, can be treated with medication to prevent complications.

However, if you experience any of the symptoms of hypertension, such as frequent headaches, recurrent dizziness, nosebleeds, shortness of breath, nausea or vomiting, don’t wait—speak to your doctor immediately.

Hypertension requires regular visits with your doctor to monitor your progress. If you are already on blood pressure medication and experience any related side effects, contact your doctor to see if your regimen needs to be adjusted.

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When to Go to the Hospital

A hypertensive emergency requires immediate emergency medical care. 

The symptoms of a hypertensive emergency include:

  • Severe headaches
  • Chest pain
  • Palpitations
  • Shortness of breath
  • Severe dizziness or feeling faint
  • Vision changes
  • Weakness, numbness, tingling in the arms, legs, or face on one of both sides
  • Trouble speaking or understanding words
  • Confusion or behavioral changes

Do not attempt to lower extremely elevated blood pressure in yourself or someone else.11 While the goal is to reduce blood pressure before additional complications develop, blood pressure should be reduced over the course of hours to days, depending on severity. It is important not to lower blood pressure too quickly, because rapid blood pressure reductions can cut off the supply of blood to the brain, leading to brain damage or death.

The number one cause of death in young children is actually hypertension and or blood clotting.

Hypertension, which is chronically high blood pressure, is one of the most common medical problems.1 Hypertension does not usually cause any symptoms, and it is not always diagnosed in the early stages. It is a leading cause of heart attackstrokekidney disease, and other serious medical problems.

Because hypertension is so common and consequential, it is important for everyone to have their blood pressure checked periodically. And if you have hypertension, you can work closely with your doctor to find an effective treatment.High pressure impacts arterial wall contraction.

Symptoms

Most people who have hypertension only develop symptoms when their condition progresses enough to cause damage.2

In many instances, the very first sign of hypertension is a sudden heart attack or a stroke. This is why hypertension is often called “the silent killer.”

Hypertension is classified based on how high the blood pressure is. The stages are:3

  • Stage 1 hypertension: Systolic pressure 130 to 139 mmHg or diastolic pressure 80 to 89 mmHg
  • Stage 2 hypertension: Systolic pressure greater than 139 mmHg orpressure diastolic greater than 89 mmHg

Prehypertension describes blood pressure that is higher than the desirable range, but not high enough to be labeled hypertension. In prehypertension, the systolic pressure is 120 to 129 mmHg and the diastolic pressure is less than 80 mmHg.

Symptoms of prehypertension and stage 1 and 2 hypertension rarely occur. If you do experience symptoms, they may include:

  • Headaches
  • Dizziness
  • Nosebleeds
  • Nausea, vomiting
  • Shortness of breath
  • Blurred vision

Malignant Hypertension

In addition to these types of hypertension, there is a rare, severe form called hypertensive emergency, or malignant hypertension. Malignant hypertension is diagnosed when the blood pressure is extremely high and is accompanied by evidence of acute organ damage.

This acute organ damage is caused by extremely low blood supply or rupture of blood vessels when they are suddenly exposed to very high blood pressure. The effects may include bleeding in the eyes, kidney failure, heart rhythm irregularities, heart attack, aneurysm rupture, or stroke.

Symptoms can include:

  • Dizziness
  • Loss of consciousness
  • Chest pain
  • Shortness of breath
  • Vision changes
  • Weakness, numbness or tingling of the face, arms or legs

Malignant hypertension is always a medical emergency and requires aggressive intensive medical care.​This Rare Form of High Blood Pressure Can Be Life-Threatening

Causes and risk factors for hypertension
 Illustration by Cindy Chung, Verywell.

Causes

The pressure generated by the beating heart forces the blood forward and stretches the elastic walls of the arteries. In between heartbeats, as the heart muscle relaxes, the arterial walls snap back to their original shape, moving the blood forward to the body’s tissues. With hypertension, the pressure in the arteries is high enough to eventually produce damage to the blood vessels.

The causes of hypertension are usually divided into two general categories:

  • Primary hypertension of no known cause, also called essential hypertension
  • Secondary hypertension that is caused by an underlying medical problem

The vast majority of people with hypertension have essential hypertension.4

Primary Hypertension

There are some risk factors that can make it more likely for you to develop primary hypertension.5

The most ones include advancing age, male gender, obesity, and elevated cholesterol and triglycerides levels. Women are more likely to develop hypertension after menopause. Hypertension is more common and more severe in African Americans and among people who have a family history of the condition.

Secondary Hypertension

Secondary hypertension can be caused by kidney disease; sleep apnea; coarctation of the aorta; disease of the blood vessels supplying the kidneys; various endocrine gland disorders; the use of oral contraceptives; smoking; alcohol intake of more than two drinks per day; chronic use of non-steroidal anti-inflammatory drugs (NSAIDs); and antidepressant use.6

Excess salt intake is an important factor in developing hypertension for many people.

Diagnosis

Hypertension is diagnosed when your blood pressure at rest is found to be persistently elevated.3

A blood pressure measurement is expressed as two numbers, the systolic and the diastolic blood pressures, and reported as 120 mmHg/80 mmHg, or more simply, 120/80.

The higher number, the systolic pressure, represents the pressure within the artery at the moment the heart is contracting. The lower number, the diastolic pressure, represents the arterial pressure in between heartbeats, while the heart is relaxing.Why Systolic and Diastolic Blood Pressure Are Both Important

Measuring Blood Pressure in the Doctor’s Office

Formal guidelines for measuring blood pressure state that it should be measured in a quiet, warm environment after you have been sitting restfully for at least five minutes. You should not have had coffee or used tobacco for at least 30 minutes. At least two blood pressure measurements should be taken under these conditions at least five minutes apart. This should be repeated until the measurements agree to within 5 mmHg.

If you are anxious or stressed when getting your reading, you may experience what’s called white coat hypertension. In this case, though your measurement is high at the doctor’s office, it is normal just about any other time, so you do not need to be treated.7

In addition to checking your blood pressure, your doctor may take a careful medical history, do a physical examination, and run routine blood work. Further steps to test for a medical condition in addition to hypertension may be necessary if your doctor suspects secondary hypertension.

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Measuring Blood Pressure at Home

Ambulatory blood pressure monitoring can be done by using at-home devices that measure your blood pressure at periodic increments throughout a 24-hour or 48-hour time period.8 This provides your medical team with an average blood pressure reading that is believed to be more accurate than one taken at the doctor’s office. Accumulating evidence supports the reliability of this approach.

People who have fluctuating blood pressure readings may be labeled as having labile hypertension. This could result from the medication wearing off, from white coat hypertension, or from physiological changes that affect blood pressure. Ambulatory blood pressure monitoring can help your medical team sort out that issue as well.The Benefits of Ambulatory Blood Pressure Monitoring

Treatment

Treatment of hypertension is important, despite the fact that it rarely causes noticeable symptoms at the early stages. Hypertension accelerates atherosclerosis, which leads to coronary artery disease, heart attacks, heart failure, strokes, kidney failureperipheral artery disease, and aortic aneurysms. Treating hypertension in the early stages has been shown to prevent these complications.

First Steps

The treatment of hypertension always starts with smoking cessation, diet, exercise, weight management, and sodium restriction. In some cases, these sorts of lifestyle changes are enough, and medical therapy may not be necessary, especially if you have prehypertension or stage 1 hypertension.

However, medication is needed to sufficiently reduce blood pressure for most stage 1 and almost all stage 2 hypertension cases. There are a vast number of prescription medications that have been approved for the treatment of hypertension, and guidelines have been developed to help doctors quickly find an effective and well-tolerated treatment regimen for almost anyone with this concern.9

Medications for hypertension fall into several categories:

  • Diuretics
  • Angiotensin-converting enzyme inhibitors
  • Calcium channel blockers
  • Beta blockers
  • Angiotensin II receptor inhibitors
  • Combination therapies

If you have secondary hypertension, treatment of the cause of your high blood pressure is also necessary.

Coping

When you are first diagnosed with hypertension, you can expect a period of time when you will be seeing your doctor more often than usual. You will need some baseline testing to look for an underlying cause for your hypertension, and you will probably need several medical visits to determine whether lifestyle adjustments or medication will be effective in helping you reach your optimal blood pressure.

A few things that may come up as you adjust to treatment include medication side effects, medication adjustments, and resistant hypertension.

Medication Side Effects

The most common side effects of anti-hypertensive medications include hypotension (low blood pressure) and dizziness. These effects are the result of the excessive lowering of blood pressure, and they can be alleviated if your doctor adjusts your medication dose. Each drug and medication category also has its own unique side effects, which you should familiarize yourself with when you begin taking the medication (check patient information provided by your pharmacy, or ask the pharmacist herself).

Medication Adjustments

If your medication is working, but not quite as well as it should, your doctor may raise the dose or switch you to another medication. Most people need such adjustments when first starting treatment for hypertension and eventually require little, if any, changes.

Resistant Hypertension

Some people have resistant hypertension, which means that it is very difficult to get the blood pressure under control. If this is your situation, your doctor may need to continue to search for causes of secondary hypertension, as well as switch your medication(s) to try to get better blood pressure control.7

A Word From Verywell

Hypertension is a common medical condition that often has severe consequences over the long-term. You generally would not know that you have hypertension unless you have your blood pressure checked. If you have mildly elevated levels, lifestyle adjustments may be enough to lower your blood pressure within ideal ranges. If you need medication, you may need to have some adjustments to get your dose just right, especially early on. Blood pressure management is generally effective, and most people are able to avoid the complications of hypertension with lifestyle modifications and medical management.

The Leading cause of Death in Young Adults

The causes of death among people ages 15 to 24 in the United States are either largely preventable or congenital. Regardless of this, far too many young people die prematurely. These are the top causes of death for people in the ages where they are in high school, college, or entering the workforce. See how each cause may be prevented.1

Accidents

Two cars involved in a car accident
Reza Estakhrian/Getty Images 

Accidents account for 41 percent of deaths among people in the 15 to 24 age group. Motor vehicle accidents alone account almost a quarter of all deaths of these young adults. The good news is that the motor vehicle death rate has been going down in recent years as cars have become safer. To protect yourself, wear your seat belt, drive defensively and avoid risky behaviors that may lead to accidents.2

Suicide

Suicide accounts for 18 percent of deaths among people of this age group. Sadly, most people who commit suicide feel like it is their only way out of a helpless feeling situation.

However, there are many resources for people with suicidal thoughts. If you are experiencing depression or other mental health issues, seek help. With talk therapy and medications, you can find that life is worth living. In fact, most people who attempt suicide say they regret it. Interviews with 29 people who survived a suicide attempt jumping off the Golden Gate Bridge say they regretted the decision the moment they jumped.

If you or someone you know is in crisis, call 1-800-273-TALK (8255) right away. This free hotline is available 24 hours a day.3

Homicide

Sixteen percent of deaths among people age 15 to 24 are due to homicide. In 2015, 87 percent of all homicides against people of all age groups in the U.S. were committed with firearms, and gun violence is more common in urban and poor communities.

Unfortunately, you cannot necessarily control where you live or what other people do. However, you can do your best to protect yourself by avoiding dangerous and confrontational situations and seeking help for domestic violence.4

Drugs and Alcohol

Fifteen percent of the deaths of in this age group were induced by drugs or alcohol. Abusing drugs and alcohol may be a rite of passage into adulthood, but it is risky. In addition to the chance of an overdose, it also greatly increases risky sexual behavior and the odds of contracting HIV and other sexually transmitted diseases. Preventing drug and alcohol abuse is the focus of many programs, both aimed at encouraging parents to discuss these issues with their kids and peers to influence each other.5

Cancer

Cancer deaths account for 5 percent of deaths among the 15 to 24 age group. Unfortunately, there is no proven way to prevent cancer, and this percentage includes many childhood cancers that are not preventable.​6

Heart Disease

Three percent of people who die when they are 15 to 24 die of heart disease. Exercise and a healthy diet can help to prevent and reverse heart disease, however, many young people who die of heart disease were born with it.7

Congenital Conditions

Congenital illnesses, some inherited from parents, such as cystic fibrosis or maternally-transmitted HIV, account for 1.5 percent of deaths among this age group. A healthy pregnancy can help prevent many of these conditions.​8

Chronic Lower Respiratory Disease

Chronic lower respiratory disease accounts for 0.7 percent of deaths in this age group. Reduce your risk by not smoking or quitting smoking.9

Stroke

While most people think of strokes as only occurring in older adults, they can occur in anyone at any age. Stroke is responsible for 0.6 percent of deaths among people ages 15 to 24.​

Exercise, not smoking, and having a healthy diet can help prevent stroke. However, the cause of stroke in this age group is often due to inherited disorders rather than sequelae of chronic vascular disease as in older adults.10

Flu and Pneumonia

You may not think that the flu or pneumonia is very dangerous if you are in your teens or early twenties, but 0.6 percent of deaths in the 15 to 24 age group are attributable to flu and pneumonia—184 deaths in a year. This number can rise dramatically in a year with pandemic flu.

Get a flu vaccine every year and wash your hands regularly. Be sure to talk with your doctor about extra precautions to take if you have a compromised immune system due to illness or other reasons.

Infectious Diseases- A-Z

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How to Spot A Psychopath

How to Spot a Successful Psychopath

2010 study published in the Journal of Research and Personality titled “The Search of the Successful Psychopath” examined what separates psychopaths who become criminals from psychopaths who succeed in business.

Researchers concluded that successful psychopaths share the same core features as other psychopaths. They’re arrogant, dishonest, and callous. They experience little remorse, minimize self-blame, exploit people, and exhibit shallow affect.

What made successful psychopaths different was their level of conscientiousness. Psychopaths who become criminals rank low in this personality trait. Successful psychopaths, however, rank higher in conscientiousness.

Ranking higher in conscientiousness means that successful psychopaths are less impulsive, negligent, and irresponsible than the psychopaths who live a life of crime. That doesn’t mean successful psychopaths are always law-abiding citizens, however. They just might be smart enough not to get caught.

Psychopaths are most often male. But that doesn’t mean you’ll never encounter a female psychopath. Although they’re not as common, they do exist and they can be just as harmful as male psychopaths.

Why Psychopaths Sometimes Succeed in the Workplace

Psychologists estimate 1 percent of the population meets the criteria for psychopathy. Yet about 3 percent of business leaders may be psychopaths. By comparison, an estimated 15 percent of prison inmates are estimated to be psychopaths.

So why would a disproportionate number of business leaders be psychopaths? Researchers suspect their characteristics and behavior may give them some competitive advantages in the workplace.

For example, they’re quite charming. That can come in quite handy when someone is looking to network with powerful people.

They also have a grandiose sense of self. When they say they can skyrocket the company to new heights, they believe it. And they often convince others that they’re capable and competent too.

They’re also good at manipulating people. They know how to use guilt and flattery to get what they want.

How to Deal With a Psychopath

Whether you’re convinced your boss is a psychopath or you’re concerned your colleague is a psychopath, there’s a good chance that you’ve encountered at least one psychopath in the workplace.

Switching teams, changing departments, or finding a new job altogether may not feel like an option. But it’s best to avoid psychopaths whenever possible because working alongside a toxic person will take a toll on your psychological well-being.

If you must deal with a psychopath, try these five strategies:

1. Keep Your Emotions in Check

No matter how frustrated or upset you feel, keep your emotions in check. Losing your cool gives a psychopath more power over you, as he’ll see that he can manipulate your emotions. Present a calm demeanor at all times.  

2. Don’t Show That You’re Intimidated

Psychopaths often use intimidation to control others. A psychopath may make subtle threats, stand over you while you’re talking, or use aggressive language to get you to back down. Stand your ground in an assertive manner, and report incidents of bullying or harassment to human resources.

3. Don’t Buy Into Their Stories

Psychopaths often use long-winded tales to paint themselves as victims. They often blame other people and refuse to take any responsibility for their wrongdoing. Showing sympathy for them plays into their hand, so keep discussions centered on facts only.

4. Turn the Conversation Back on Them

Pointing out a psychopath’s flaws can be the best way to disarm them. So when a psychopath blames someone else, turn the conversation back on them. Say something like, “Are you doing OK today? I saw how you responded in the meeting today and I wonder if you might be stressed out.”

5. Opt for Online Communication Whenever You Can

2016 study published in Personality and Individual Differences found that psychopaths excel at negotiating when they’re communicating face-to-face. Online conversations make it difficult–if not impossible–for them to charm their way into a better deal. So consider requesting all communication occur via email if you can.  

Build Your Mental Strength 

If you can’t escape daily interaction with a psychopath, it’s especially important to work on building your mental muscles. Get proactive about taking care of yourself and managing your stress.

If you’re struggling, consider talking to a mental health professional. It’s difficult to stay mentally strong when you’re working alongside a toxic person. PUBLISHED ON: APR 17, 2018The opinions expressed here by Inc.com columnists are their own, not those of Inc.com.More from Inc.3 Ways to Make Sure Your Business Outperforms Its CompetitorsWhy You Need More Silence in Your MeetingsHow to Actually Stick to This Year’s ResolutionsWhy Generosity is Smart For Making Profits (and the Right Thing to Do)FEATURED VIDEO4 Things Every Founder Must Do Before Choosing an InvestorWhen you decide to sign up and take capital from someone,Volume 0% 

EXIT STRATEGIES

Entrepreneurs Should Consider Doing These 3 Things Before Building a Company With an Exit Strategy

Here’s an alternate path to the Silicon Valley way.

By Marcel SchwantesFounder and Chief Human Officer, Leadership From the Core@MarcelSchwantes

GETTY IMAGES

Almost all startups founded in Silicon Valley are operating under the same imperative: in five to seven years, the company must undergo a liquidity event that returns capital to the original founders, investors, and other stakeholders.

This exit-focused approach to entrepreneurship is showcased in our leading universities and media (think Shark Tank), but not without a cost.

While companies with billion-dollar valuations pop up like weeds, so do stories of criminally inflated numbers — i.e. WeWork — or disappointing IPOs. The result is an exit that enriches a few but leaves a fading company to be acquired by one of the tech giants or dismantled for parts by a private equity firm.

Building a company with an exit strategy in mind can feel like the only option for entrepreneurs — but it isn’t. Richard Seaman, chairman of the Seaman Corporation and author of A Vibrant Vision, says that the exit-focused rhetoric and unicorns that dominate our headlines are not what powers our economy.

In fact, in the United States, privately owned, family-run businesses account for 64 percent of our country’s GDP, or $5.9 trillion, according to research.

So how do you go about building a company that will outlast you? Seaman shared three insights with me. 

1. Make a conscious choice to focus on the long-term.

Avoiding the Silicon Valley exit strategy starts with a conscious choice: What kind of business are you building? Are you going to spend the next five to seven years focused on turning your idea into gold — and then getting out? Or are you in this for the long haul? Seaman says how you answer this question will have a waterfall effect, coloring every choice you make from here on out.

 2. Focus on building all parts of the business, not just hyping a product.

If you are building a business to sell, you will most likely focus on the finance component of your business, shepherding your startup through the “Valley of Death,” which can hinder the long-term profitability of a company. However, creating a multigenerational business requires you to focus on the sustainability of the business from the start — investing in all parts of the business, such as innovation, marketing and sales, products and services, human capital, operational excellence, and finance. “Remember to focus on creating perennial growth, not just launching one initiative,” states Seaman.

3. Assess your liquidity needs and seek out sources of funding that match your objectives.

Many entrepreneurs balk at the idea of creating a business that survives them because they do not personally have the capital to get their idea off the ground. However, there are many methods of funding aside from angel investment or venture capital that do not involve giving away ownership in your business early on. Every business’s capital needs will be different at various stages, but it is important to develop a working relationship with your local banker early on.

While we might glorify the serial entrepreneur, thousands of multimillion-dollar, multigenerational businesses exist that are more innovative, more desirable to work for, and preferred by consumers to the boom-or-bust Silicon Valley startup. This model of entrepreneurship requires serious commitment, but it results in a business that creates and sustains deep and lasting value far beyond the money going into shareholders’ pockets.

CANCER SUCKS

In 2017, 9.6 million people are estimated to have died from the various forms of cancer. Every sixth death in the world is due to cancer, making it the second leading cause of death – second only to cardiovascular diseases.1

Progress against many other causes of deaths and demographic drivers of increasing population sizelife expectancy and — particularly in higher-income countries — aging populations mean that the total number of cancer deaths continues to increase. This is a very personal topic to many: nearly everyone knows or has lost someone dear to them from this collection of diseases.

Summary

Cancers are defined by the National Cancer Institute as a collection of diseases in which abnormal cells can divide and spread to nearby tissue. Cancers can arise in many parts of the body – leading to a range of cancer types, as shown below – and in some cases spread to other parts of the body through the blood and lymph systems. In this entry we provide an overview of all types of cancer.

Cancer is one of the leading causes of death

Almost 10 Million people die from cancer annually

Cancer is one of the world’s largest health problems. The Global Burden of Disease estimates that 9.56 million people died prematurely as a result of cancer in 2017. Every sixth death in the world is due to cancer.2

The Global Burden of Disease is a major global study on the causes and risk factors for death and disease published in the medical journal The Lancet.3

Cancer is a particularly common cause of death in richer countries where people are less likely do die of infectious diseases and causes of deaths that lead to very early deaths for people in poverty.

The chart is shown for the global total, but can be explored for any country or region using the “change country” toggle. Switching to one of the richer countries shows that the share of deaths attributed to cancer is higher.

Because is one of the leading causes of death it is one of the world’s most pressing problems to make progress against this disease.Number of deaths by cause, World, 2017
02 million6 million10 million16 millionCardiovascular diseases17.79 millionCancers9.56 millionRespiratory diseases3.91 millionLower respiratory infections2.56 millionDementia2.51 millionDigestive diseases2.38 millionNeonatal disorders1.78 millionDiarrheal diseases1.57 millionDiabetes1.37 millionLiver diseases1.32 millionRoad injuries1.24 millionKidney disease1.23 millionTuberculosis1.18 millionHIV/AIDS954,492Suicide793,823Malaria619,827Homicide405,346Parkinson disease340,639Drowning295,210Meningitis288,021Nutritional deficiencies269,997Protein-energy malnutrition231,771Maternal disorders193,639Alcohol use disorders184,934Drug use disorders166,613Conflict129,720Hepatitis126,391Fire120,632Poisonings72,371Heat (hot and cold exposure)53,350Terrorism26,445Natural disasters9,603CC BY

Source: IHME, Global Burden of Disease
19902017 Change country

Deaths from cancer

In the chart we see the total number of deaths in 2017 attributed to the range of different cancers.

The group of tracheal, bronchus, and lung cancers claimed the largest number of lives – 1.9 million in 2017. Next follow colon and rectum, stomach and liver cancer, all claiming between 800,000 and 900,000 globally in 2017.

This chart also allows exploring deaths by country (click ‘change country’ at the bottom of the chart).

In exploring patterns across various countries, we see that tracheal, bronchus, and lung cancer is the leading form of cancer deaths across most high and middle-income countries. However, the leading form in lower income countries varies: colon and rectum; liver; cervical; stomach; breast and prostrate all top the list in several countries.Cancer deaths by type, World, 2017

Total annual number of deaths from cancers across all ages and both sexes, broken down by cancer type. 
0200,000600,0001 million1.4 million1.8 millionTracheal, bronchus, and lung cancer1.88 millionColon and rectum cancer896,040Stomach cancer864,989Liver cancer819,435Breast cancer611,625Pancreatic cancer441,083Esophageal cancer435,959Prostate cancer415,910Leukemia347,583Cervical cancer259,671Brain and nervous system cancer247,143Bladder cancer196,546Lip and oral cavity cancer193,696Ovarian cancer175,982Gallbladder and biliary tract cancer173,974Kidney cancer138,526Larynx cancer126,471Other pharynx cancer117,412Multiple myeloma107,114Other cancers102,920Uterine cancer85,239Nasopharynx cancer69,550Non-melanoma skin cancer65,097Malignant skin melanoma61,665Thyroid cancer41,235Hodgkin lymphoma32,560Testicular cancer7,662CC BY

Source: IHME, Global Burden of Disease (GBD)
19902017 Change country

Cancer deaths by age

How are cancer deaths distributed across age groups? And how did this change over time?

In this chart we see the breakdown of total cancer deaths by broad age category, ranging from under-5s to those over 70 years old.

Almost half – 46% in 2017 – of all people who die from cancer are 70 or older. Another 41 percent are between 50 and 69 years old – so that 87% of all cancer victims are older than 50 years.

The distribution of deaths across the age spectrum has changed notably since 1990. The share of deaths which occur in those aged over 70 has increased by 8 percentage points, whilst the share in those aged 50-69 and 15-49 has fallen.

Collectively, children and adolescents under 14 years old account for around one percent of cancer deaths — this equates to around 110,000 children per year.  Deaths from cancer, by age, World

Total annual cancer deaths differentiated by age category across both sexes. Data includes all forms of cancer. 
19901995200020052010201520170%20%40%60%80%100%70+ years old50-69 years old15-49 years old5-14 years oldUnder-5sCC BY

Source: IHME, Global Burden of Disease (GBD)
 Change country Relative

1999
 70+ years old41.97%
 50-69 years old40.23%
 15-49 years old15.74%
 5-14 years old1.18%
 Under-5s0.89%
 Total100%

Cancer prevalence

What is the prevalence of cancers across the world’s population?

The charts here provide data on the share of a given population with any form of cancer. This is first shown collectively across all cancer types, followed by breakdown by cancer type.

The prevalence of cancer around the world

The map shows that we tend to see a higher prevalence of cancer in higher-income countries.

Prevalence of cancer ranges from approximately 5.5 percent of the population in the US down to around 0.4 percent in the countries shown in light yellow.

Globally the share of people with cancer reached 1.3% in 2017.

Related chart – the number of people with cancerThis map shows the total number of people with cancer across all countries of the world.

Share of population with cancer, 2017

Share of total population with any form of cancer, measured as the age-standardized percentage. This share has been
age-standardized assuming a constant age structure to compare prevalence between countries and through time.
No data0%0.5%1%2%3%4%5%6%CC BY

Source: IHME, Global Burden of Disease
19902017

Prevalence of cancer by type

When broken down by type of cancer we see that breast cancer is globally the most prevalent form. Following breast cancer are prostrate and colon & rectum cancer.

When you change this chart to another country you see that across most countries these are the top three cancer forms.

Related chart – the number of people with cancer, by typeThis chart shows the numbers of people with different types of cancer. As we explored above, the prevalence of breast cancer is highest globally; an estimated 17 million had breast cancer in 2017. 10 million had prostate cancer; and 9 million had colon & rectum cancer.

Share of population with cancer, World, 2017
0%0.05%0.1%0.15%0.2%Breast cancer0.21%Prostate cancer0.13%Colon and rectum cancer0.12%Cervical cancer0.05%Tracheal, bronchus, & lung cancer0.04%Uterine cancer0.04%Stomach cancer0.04%Bladder cancer0.03%Non-melanoma skin cancer0.03%Kidney cancer0.03%Thyroid cancer0.03%Brain & nervous system cancer0.02%Lip & oral cancer0.02%Ovarian cancer0.02%Larynx cancer0.01%Esophageal cancer0.01%Liver cancer0.01%Testicular cancer<0.01%Nasopharynx cancer<0.01%Pancreatic cancer<0.01%Gallbladder & biliary tract cancer<0.01%CC BY

Source: IHME, Global Burden of Disease

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017 Change country

Cancer prevalence by age

Age breakdown of people with cancer

We see that globally the majority of cancers occur in older populations. Approximately 70% of cancer cases occur in those aged over 50.

The chart shows that in 2017, 43 percent were aged between 50 and 69 and 27 percent were over 70 years old.

Around five percent of global cancers occur in children and adolescents younger than 15. These are predominantly childhood cancers within the group of leukemia.Prevalence of cancer by age, World
19901995200020052010201520170%20%40%60%80%100%70+ year olds50-69 year olds15-49 year olds5-14 year oldsUnder-5sCC BY

Source: IHME, Global Burden of Disease
 Change country Relative

Prevalence of cancer by age

This bar chart compares the prevalence across ages.

Globally 6% of those over 70 years had cancer in 2017. Of the population younger than 50 the prevalence is well under 1% globally.

In all these charts it is possible to switch to any other country: In the US more than 20% of people older than 70 years are living with cancer according to the estimates of the Global Burden of Disease shown here. In Spain it is 9%.Share of population with cancer by age, World, 2017
0%1%2%3%4%5%6%70+ years olds6.27%50-69 years old3.32%All ages1.36%15-49 years olds0.64%Under-5s0.47%5-14 years old0.2%CC BY

Source: Global Burden of Disease (IHME)
19902017 Change country

The global disease burden from cancer

Death rates only capture the mortality of cancer. However, the impact of cancer on people’s lives is more than that. Many live with cancer for long periods and it is important to also capture the morbidity caused by cancer.

The Disability-Adjusted Life Year (DALY) is a metric that captures the total burden of disease – both from years of life lost due to premature death and from years lived with the disease. One DALY equals one lost year of healthy life.

The map shows DALYs from cancers, measured per 100,000 individuals. This is age-standardized to allow comparisons between countries and over time.This is measured across all cancer types.

Also shown are disease burden rates broken down by cancer types. We see that at a global level, the largest burden results from tracheal, bronchus and lung cancer, followed by liver, stomach, colon & rectum, and breast cancer.

Extending the timeline of this chart shows how the disease burden has changed for each type of cancer.Disease burden rates from cancers, 2017

Disability-Adjusted Life Years (DALYs) per 100,000 individuals from all cancer types. 
DALYs measure the total burden of disease – both from years of life lost due to premature death and years lived with a
disability. One DALY equals one lost year of healthy life.
No data1,0001,5002,0002,5003,0003,5004,0004,500>5,000CC BY

Source: IHME, Global Burden of Disease

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Disease burden rates by cancer types, World, 2017

Disability-Adjusted Life Years (DALYs) per 100,000 individuals from all cancer types.
DALYs measure the total burden of disease – both from years of life lost due to premature death and years lived with a
disability. One DALY equals one lost year of healthy life.
0100200300400500Tracheal, bronchus, and lung cancer503.05Liver cancer253.56Stomach cancer235.94Colon and rectum cancer235.73Breast cancer216.29Esophageal cancer119.91Pancreatic cancer112.25Brain & nervous system cancer111.92Cervical cancer98.18Prostate cancer90.01Lip & oral cancer64.23Ovarian cancer57.11Bladder cancer45.26Gallbladder & biliary tract cancer43.22Kidney cancer41.14Larynx cancer39.89Uterine cancer26.27Nasopharynx cancer25.45Non-melanoma skin cancer16.64Thyroid cancer14.08Testicular cancer4.74CC BY

Source: IHME, Global Burden of Disease

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017 Change country

Is the mortality of cancer on the rise?

With an increase in global cancer deaths from 5.7 to 9.6 million since 1990, and similar trends in the number of absolute deaths across most countries, it may seem reasonable to assume that cancer death rates are on the rise as well. But is this really the case?

Cancer: Comparing absolute deaths, the death rate, and the age-standardized death rate

Whilst a crucial metric of total disease burden and mortality, the absolute number of deaths has two shortcomings: it fails to account for changes in population size and age structure.

As we have explored above, the majority of cancer deaths occur in those aged over 50 years old; this means we should expect the total number of cancer deaths to increase as a population ages. Rising life expectancyaging populations, and population growth compound each other and are the main drivers of the rising absolute number of cancer deaths.

To account for the rise in the total population epidemiologists rely on rates. Typically they report the number of deaths per 100,000 individuals.

To account for the changing age-structure they rely on so called age-standardized death rates. This metric corrects for the effects of a changing age structure by normalizing the death rate to a fixed reference population structure and thereby telling us how the death rate from cancers would have changed if the age structure of the population had not changed.4

The chart shows how each metric of cancer deaths has changed since 1990.

The total number of cancer deaths has increased globally. As we have seen before the total number of cancer deaths has increased more than 50 percent since 1990. This metric however does not correct for the increasing size or the aging of the world population.

The death rate from cancers has also increased globally. This metric corrects for the population size and the comparison with the increase of the absolute number of global cancer deaths shows that much of the total increase of cancer deaths is driven by the increase of the global population. The rate only increase a quarter as much as the absolute number of deaths.

The age-standardized death rate from cancers is falling globally. Corrected in this way for both the increase and the aging of the world population the number of deaths from cancer is falling. This metric shows that the world is slowly making progress against cancer. The age-standardized death rate from cancer has fallen by 15% since 1990.

These changes can be viewed in for all countries in the world by using the “Change country” option.Change in three measures of cancer deaths, World

This chart is comparing cancer deaths, the cancer death rate, and the age-standardized death rate.
199019952000200520102017-10%0%+10%+20%+30%+40%+50%+60%Cancer deathsCancer death rate (notage-standardized)Age-standardized cancer death rateCC BY

Source: OurWorldinData based on IHME, GBD
19902017 Change country Relative change

Age-standardized cancer death rates by country

The age-standardized death rate from all cancer types are shown in this visualization.

The global trend shows what we have seen in the previous section: while the number of cancer deaths is increasing, individual death rates are falling. In 1990, 143 people out of every 100,000 died from cancer globally — by 2017 this had fallen to 121 per 100,000.

It is possible to switch this chart to the map view. This shows that in 2017, most countries have age-standardized death rates of 50 to 150 deaths per 100,000 individuals.Death rate from cancer, 2017

The annual number of deaths from all cancers per 100,000 people.
No data050100125150175200250500CC BY

Source: IHME, Global Burden of Disease (GBD)

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Age-standardized death rates by type of cancer

For the purposes of assessing the total incidence of cancer, in the chart above we grouped all cancer types together to look at overall trends. However, death rates and progress in reducing mortality incidence varies across the many forms of cancer. In the chart we see the individual age-standardized death rates across cancer types. This is again measured as the number of deaths per 100,000 individuals.

As we would expect from the leading cause of cancer deaths, rates in tracheal, bronchus and lung cancer are highest globally at 24 per 100,000. This has fallen slightly from 26 per 100,000 in the early 1990s, with even greater declines in some countries (in the US, rates have fallen from 47 to 34 per 100,000).

The death rate from stomach cancer has fallen substantially – from 19 per 100,000 in 1990 to 11 per 100,000 in 2017 – and contributed to much of the slow global progress against cancer mortality.

In some cases we have seen dramatic declines over the last few decades. For some, such as stomach cancer there has been notable progress — declining from 19 to 11 deaths per 100,000.Cancer death rates by type, World

The number of deaths from different types of cancer per 100,000 individuals.
To allow comparisons between countries and over time this metric is age-standardized.
19901995200020052010201520170510152025Tracheal, bronchus, and lung cancerColon and rectum cancerStomach cancerLiver cancerBreast cancerPancreatic cancerProstate cancerEsophageal cancerCervical cancerBrain and nervous system cancerBladder cancerLip and oral cavity cancerGallbladder and biliary tract cancerOvarian cancerKidney cancerLarynx cancerOther pharynx cancerUterine cancerNasopharynx cancerNon-melanoma skin cancerThyroid cancerTesticular cancerCC BY

Source: IHME, Global Burden of Disease (GBD)
19902017 Change country

Conclusion

The global trends on cancer mortality — as presented in the data above — shows that the world is making progress against cancer once we take into account how the size and age-structure of the world have changed. This represents progress, but this progress is very slow. The age-standardized death rate from cancer has fallen by 15% since 1990.

The number of cancer deaths is increasing as the world population is growing and aging

The number of cancer deaths has increased from around 5.7 million in 1990 to 8.8 million in 2017 as this chart shows.

As we just saw, this is happening for two big reasons: The first one is that the world population is increasing and with it the number of annual deaths. In 1990 49 Million people died and since then the number of total deaths has increased by more than 7 Million – as this chart shows.

The second big reason is that the world made rapid progress against causes of death that once killed people early in life – especially infectious diseases. [See our entry on causes of death for more information.] This means that the world population is aging and more people are dying of causes that kill people at an older age, like cancer.

Because the world is getting richer and fewer are dying an early death we can expect the number of people dying from cancer to increase further.Cancer deaths by type, World

Annual cancer deaths by cancer type, measured as the total number of deaths across all age categories and both
sexes. Smaller categories of cancer types with global deaths <100,000 in 2016 have been grouped into a collective
category ‘Other cancers’. See sources for list of grouped cancers.
19901995200020052010201602 million4 million6 million8 millionLarynx cancerOther pharynxcancerOvarian cancerLip and oral cavitycancerBrain and nervoussystem cancerNon-HodgkinlymphomaLeukemiaOther cancersGallbladder cancerKidney cancerBladder cancerCervical cancerProstate cancerPancreatic cancerEsophageal cancerBreast cancerLiver cancerColon and rectumcancerStomach cancerTracheal,bronchus, and lungcancerCC BY

Source: IHME, Global Burden of Disease (GBD)

Note: All cancer types with less than 100,000 global deaths in 2016 into a collective category ‘Other cancers’.
 Change country Relative

Smoking and lung cancer

Lung cancer and smoking around the world since 1950

This chart shows death rates from lung cancer in men in the US and Spain since 1950. It is possible to add many more countries to this chart.

In many countries we see a significant rise, peak and then decline in lung cancer death rates in the 20th century. In the United States, the death rate peaked in the 1980s in men. In Spain this peak was later, only in the 1990s.

These trends are driven by the trends in smoking. The other chart shows the sales of cigarettes per person. Smoking is the biggest risk factor for lung cancer and we see that the trends in lung cancer follow those in smoking with a lag of around 20 years.

In 2017 7 Million people globally died a premature death because of smoking. The fact that smoking causes lung cancer is the major reason for the high death toll of smoking.

It is possible to add the data to lung cancer in women in the US to this chart. In the US it was once much more common for men to smoke so that the peaks of lung cancer for men are much higher. Smoking became more common for women only later so that lung cancer death rates for women peaked later.Lung cancer death rates

Number of lung cancer deaths per 100,000 people. 
Add country19501960197019801990200201020304050Spain – MaleUnited States – MaleCC BY

Source: WHO, International Agency for Research on Cancer (IARC)
19502002

Sales of cigarettes per adult per day

Figures include manufactured cigarettes, as well as estimated number of hand-rolled cigarettes, per adult (ages 15+)
per day.
Add country19001920194019601980200020140 cigarettes2 cigarettes4 cigarettes6 cigarettes8 cigarettes10 cigarettesSpainUnited StatesCC BY

Source: International Smoking Statistics (2017)
19002014

Share of cancer deaths attributed to smoking

The world map shows the Global Burden of Disease estimates of the share of cancer deaths that can be attributed to smoking.

Globally more than one in five cancer deaths (22% in 2016) are attributed to smoking – switch to the chart tab to see the global estimate.

In most richer countries the share is higher – the average in high income countries is 28% in 2016.

In poor countries, where fewer people were smoking in the past, tobacco is responsible for a much smaller faction of cancer deaths.Share of cancer deaths attributed to tobacco, 2016

Share of total cancer deaths attributed to tobacco smoking (which is inclusive of smoking and secondhand smoke).
This impact is measured across total cancer types.
No data0%5%10%20%30%40%50%60%CC BY

Source: IHME, Global Burden of Disease (GBD)
19902016

Cancer over the long run

Cancer deaths in the US since 1930

This charts provides a long run perspective on cancer death rates, from 1930 in the United States.

In orange we see again the pronounced peaks for lung cancers in men and then later in women.

For many other forms of cancer the age-standardized death rates show a long-term decline:

  • Breast cancer death rates started falling in the early 1990s.
  • The death rate for prostate increased until the mid 90s and then started to decline sharply.
  • Colon and rectum cancers declined over the last decades in both men and women.
  • Pancreas cancer and leukemia increased until the 1970s and then remained at around the same level.
  • Uterus, liver, and stomach cancers declined continuously over this 80 year period.

Cancer death rates in the United States over the long-run

Age-standardized death rates from various forms of cancer in males and females, measured as the number of deaths
per 100,000 individuals. Age-standardization is based on normalisation to the standard US population structure in the
year 2000.
193019401950196019701980199020002011020406080Lung and Bronchus (male)Lung and Bronchus (female)Breast (female)Prostate (male)Colon and Rectum (male)Colon and Rectum (female)Pancreas (male)Liver (male)Pancreas (female)Leukemia (male)Uterus (female)Liver (female)Stomach (male)Stomach (female)CC BY

Source: American Cancer Society
19302011

What can be done about cancer?

Cancer survival rates

Cancer death rates are falling; five-year survival rates are rising

Global cancer deaths are rising: in 1990 5.7 million died from cancer; by 2016 this had increased to 8.9 million. But it’s also true that the world today has more people, and more older people, who are more likely to die from cancer. To understand what is happening we therefore have to correct for the population increase and ask for the rate – the number of deaths per 100,000 people – and we have to adjust for ageing.

When we compare these metrics (shown here) we see that age-standardized cancer death rates are falling globally. Death rates which correct for ageing show a 17 percent decline from 1990 to 2016.

Five-year survival rates have increased

Why are cancer death rates falling? One hypothesis is that cancer prevalence is falling (i.e. less people have cancer). Is this true?

Globally, no. The share of people with cancer (even when corrected for ageing) has been slowly increasing in recent decades. Global cancer prevalence has risen from 0.54 percent to 0.64 percent since 1990 (largely due to smoking). In some countries – the US, for example – the age-corrected prevalence has been fairly constant in recent decades (with the rate of new cases actually falling).

If death rates are falling but prevalence is rising or constant, then it must be the case that people with cancer have better or longer survival rates. We see this clearly in the USA when we look at the change in five-year survival rates across cancer types. This is shown in the chart as the change from 1970-77 to 2007-2013.

Here we see that on aggregate five-year survival rates for all cancers increased from 50.3 to 67 percent. But we also see significant differences not only in start or end survival rates, but the change over time. Prostate cancer has close to 99 percent five-year survival, but has also seen major progress from a rate of 69 percent in the 1970s. In contrast, pancreas has low five-year survival rates at 8.2 percent, up from 2.5 percent.

There are two key factors which could contribute to improved five-year survival rates: earlier detection and/or improved treatment. Defining the exact attribution of each is difficult, and varies depending on cancer type. But there have been some studies which have attempted to do so. Scott Alexander published a very good overview of the relative impact of detection versus treatment here.

One way to test whether survival rates only increased from early diagnosis is to look at how survival has changed for each stage of cancer: if detection was the only improvement then we would see no increase in survival rates in later cancer stages. National cancer statistics published by the US government show increases in survival rate within all stages (from very early to late-stage).5

Other studies focused on specific cancer types show similar results.6

Tumours have gotten smaller in recent decades – the result of earlier detection. Studies have shown that this can account for a significant share of survival improvements: one study attributed early detection as 61 percent and 28 percent of improved survival in localized-stage and regional-stage breast cancer, respectively7 But even when correcting for size and early detection, we have seen improvements. 

This suggests better treatment has played a role too.

In both detection and treatment, we’re seeing progress. This is important because of the large toll of cancer: Globally every sixth death is due to cancer – this makes it the world’s second largest cause of death. Progress here is important for many.

Interactive chart: The same data shown in the chart can be viewed and downloaded in this interactive here. Cancer survival rates in the US by race can be seen here.

Five year cancer survival rates usa v2 01

Cancer survival rates across the world

In this charts, we provide the widest coverage across countries of five-year survival rates by cancer type.

This data was published in the The Lancet in 2015 by Allemani et al.8

You can explore the range of countries using the “Change country” selection in the interactive chart.Five year survival rates by cancer type, United Kingdom, 2009

Share of adults (aged 15-99), and children (aged 0-14) for leukaemia, diagnosed with cancer who survive at least five
years following their diagnosis date. The year provided represents the year of diagnosis.
0%10%20%30%40%50%60%70%80%Prostate83.2%Breast81.1%Cervix60.2%Rectum56.6%Colon53.8%Leukaemia47%Ovary36.9%Stomach18.5%Lung9.6%Liver9.3%CC BY

Source: Allemani et al. (2015)
19992009 Change country

Cancer survival rates across the world by type

The three maps below show how the five-year survival rates for lung, breast and liver cancer vary across the world. This data is again from Allemani et al. 2015 Lancet paper.9

Lung cancer survival rates across the world

In lung cancer Japan has the highest five-year survival rates at approximately 30 percent.

In contrast to this only 7% of lung cancer patients are alive five years after diagnosis in Chile, Bulgaria and Mongolia.Five year survival rates from lung cancer, 2009

Share of adults (aged 15-99) diagnosed with lung cancer who survive at least five years following their diagnosis date.
The year provided represents the year of diagnosis.
No data<5%7.5%10%12.5%15%17.5%20%22.5%>25%CC BY

Source: Allemani et al. (2015)
19992009

Breast cancer survival rates across the world

In breast cancer, higher income countries in particular across North America, Europe and Oceania tend to have five-year survival rates over 80 percent in 2009.

This is almost double that of the lowest nation with available data in 2009 – Jordan – at only 43 percent. A decade earlier the survival rate in Algeria was as low as 17%.Five year survival rates from breast cancer, 2009

Share of adults (aged 15-99) diagnosed with breast cancer who survive at least five years following their diagnosis date.
The year provided represents the year of diagnosis.
No data10%20%30%40%50%60%70%80%90%100%CC BY

Source: Allemani et al. (2015)
19992009

Liver cancer survival rates across the world

Compared to breast cancer the five year survival rates for liver cancer are much lower around he world.

The lowest survival rate in 2009 was in Romania with just 2.3%. In Japan the chance to survive for five years was more than 10-times higher: 27% in 2009.Five year survival rate from liver cancer, 2009

Share of adults (aged 15-99) diagnosed with liver cancer who survive at least five years following their diagnosis date.
The year provided represents the year of diagnosis.
No data0%2.5%5%7.5%10%12.5%15%17.5%>20%CC BY

Source: Allemani et al. (2015)
19992009

Cancer survival rates by income

In these two charts we see that the five-year survival rates – following diagnosis – are lower in poorer countries.

Especially for breast cancer survival rates are lower in poorer countries. In high income countries survival rates are above 80% while in many poor countries it is well below 80% or even 60%.

The relationship between lung cancer survival rate and average is less strong. There is significant variability in five-year survival rates between countries of a similar income, but the lowest survival rates are again reported from the poorest countries.Five-year breast cancer survival rates vs. GDP per capita, 2009

Share of those diagnosed with breast cancer who survive at least five years following diagnosis, versus gross domestic
product (GDP) per capita, measured in 2011 international-$.
GDP per capita, PPP (constant 2011 international $)$10,000$20,000$30,000$40,000$50,000$60,000LINEARFive-year breast cancer survival rate0%20%40%60%80%ChinaIndiaUnited StatesIndonesiaBrazilRussiaJapanGermanyTurkeyThailandUnited KingdomSouth AfricaAlgeriaMalaysiaRomaniaPortugalCzech RepublicTunisiaJordanNorwayMaltaAfricaAsiaEuropeNorth AmericaOceaniaSouth AmericaCC BY

Source: Allemani et al. (2015), World Bank – WDI
19992009 Search Average annual change

Five-year lung cancer survival rate vs. GDP per capita, 2009

Share of those diagnosed with lung cancer who survive at least five years following diagnosis, versus gross domestic
product (GDP) per capita, measured in 2011 international-$.
GDP per capita, PPP (constant 2011 international $)$10,000$20,000$30,000$40,000$50,000$60,000Five-year lung cancer survival rate0%5%10%15%20%25%30%35%ChinaIndiaUnited StatesIndonesiaBrazilRussiaJapanGermanyTurkeyFranceUnited KingdomSouth KoreaColombiaSpainArgentinaPolandAlgeriaAustraliaChileEcuadorPortugalAustriaSwitzerlandIsraelJordanDenmarkSlovakiaFinlandNorwayIrelandLithuaniaMongoliaLatviaSloveniaMauritiusCyprusAfricaAsiaEuropeNorth AmericaOceaniaSouth AmericaCC BY

Source: Allemani et al. (2015), World Bank – WDI
19992009 Search Average annual change

Are cancers caused by genetic or external factors?

Are cancers caused by genetic factors, or determined by external factors such as behavioral, lifestyle and environmental exposure?

The relative contribution of genetic factors (DNA replication and tissue type) versus external exposure has been a dominant topic within cancer research. The outcomes of such studies are highly important — if genetic factors are found to be dominant then early detection and understanding of the relative vulnerability of different DNA and tissue variations arguably present the best opportunity to reduce cancer burden. In contrast, if external and environmental risk factors dominate, then lifestyle choice which reduces risk exposure is crucial for this reduction.

In a 2015 paper Cristian Tomasetti and Bert Vogelstein, published in Science, the authors conclude that only one-third of cancers are attributable to environmental factors or inherited predispositions; the vast majority result from “bad luck” – random mutations which can occur when DNA replicates in normal non-cancerous cells.10

This study therefore argued that, beyond some cancer types which are deterministic (D-tumors) and can be reduced through lifestyle factors or vaccines, the most promising approach to reduction of cancer deaths across most cancers (replicative, R-tumors) is early detection.

This paper has been highly contest within the scientific literature. A number of later publications in Science provided a rebuttal to these conclusions, suggesting analytical flaws in the prior analysis, and epidemiological evidence which suggests otherwise.11

Such studies have argue that the role of ‘chance’ in cancer development was overstated by Tomasetti and Vogelstein, and the role of environmental exposures was understated. Wu et al. (2016) published a study in Naturewhich concluded that intrinsic factors (which relates to the ‘bad luck’ DNA replication) account for less than 10-30 percent of cancer development, with the majority resulting from extrinsic risk factors.12

The Global Burden of Disease (GBD) study attempt — using risk-exposure relationships — to provide attribution of certain risk factors to disease burden and mortality outcomes.13 These risk factors include a wide range, including smoking, diet and nutrition, obesity, alcohol intake, air pollution, & environmental exposures to carcinogens.

In the chart we see IHME estimates of the share of global cancer deaths which are attributed to one of these major risk factors. For example, 84 percent of tracheal, bronchus and lung cancer deaths are attributed to risk factors such as smoking and air pollution. The remaining share of deaths we would therefore assume no attribution to risk factors, and would occur naturally in the absence of such risks (i.e. deaths from lung cancer which would result if no one smoked, zero air pollution etc.).14Share of cancer deaths attributed to risk factors, 2016

Risk factors include known risks such as smoking, diet and nutrition, obesity, lack of physical inactivity, alcohol
consumption, air pollution, and environmental exposures.
The remaining share therefore represents deaths which would be expected to have occurred in the absence of these
known risk factors.
0%20%40%60%80%100%Cervical cancer100%Mesothelioma91.4%Tracheal, bronchus, and lung cancer84.1%Larynx cancer71.8%Esophageal cancer69.8%Lip and oral cavity cancer69.8%Nasopharynx cancer64%Colon and rectum cancer53.2%Liver cancer41.5%Uterine cancer36.5%Kidney cancer32.3%Bladder cancer32%Pancreatic cancer27.5%Breast cancer26.8%Stomach cancer18.4%Gallbladder and biliary tract cancer15%Leukemia14.8%Ovarian cancer12.3%Thyroid cancer9.4%Multiple myeloma6.8%Non-Hodgkin lymphoma5.1%Prostate cancer4.4%Brain and nervous system cancer0%Hodgkin lymphoma0%Malignant skin melanoma0%Non-melanoma skin cancer0%Testicular cancer0%CC BY

Source: IHME, Global Burden of Disease

Cancer by income, poverty and inequality level of the country

Cancer deaths by income

Whilst cancer prevalence shows a positive relationship to income, death rates from cancer incorporate several factors: cancer prevalence, detection and treatment. When we compare cancer death rates across income we see no strong relationship between these measures.

There is also no correlation between the level of income inequality in a country and the cancer death rate.Death rate from cancers vs. GDP per capita, 2016

The death rate (measured as the number of deaths per 100,000 individuals) refers to all forms of cancers and is
standardized for age to allow cross-country comparisons.
GDP per capita, PPP (constant 2011 international $)$1,000$10,000$100,000LOGCancers – age-standardized death rate050100150200250ChinaIndiaUnited StatesIndonesiaBrazilPakistanNigeriaBangladeshRussiaJapanMexicoPhilippinesVietnamEthiopiaIranTurkeyDemocratic Republic of CongoFranceTanzaniaMyanmarPolandAlgeriaUgandaMoroccoNepalPeruSaudi ArabiaMozambiqueAustraliaCameroonAngolaChileMaliNetherlandsMalawiZimbabweHungaryBurundiIsraelSwitzerlandParaguaySingaporeCroatiaCongoUruguayArmeniaKuwaitOmanMongoliaQatarGuinea-BissauGabonGrenadaTongaYemenAfricaAsiaEuropeNorth AmericaOceaniaSouth AmericaCC BY

Source: IHME (2017), World Bank – WDI
19902016 Search Average annual change

Definition of metrics

Number of deaths, death rates, and age-standardized rates

In this entry we define cancer deaths in three fundamental ways:

  • Absolute (total) number of cancer deaths;
  • Cancer death rate: this reports the number of deaths per 100,000 individuals within a given population;
  • Age-standardized death rate: this reports the number of deaths per 100,000 individuals assuming a constant and consistent age-structure of population between countries and across time.

These measures vary in the information they provide. Absolute (total) number of cancer deaths & prevalence figures provide an important indication of the total cancer burden within a given country or society. This is an important metric for a number of reasons, including the need for management and provision of adequate health services (which is dependent on the total societal burden, not just the incidence or risk for a given individual).

However, total number of cancer deaths fails to correct for population size and age. Cancer deaths can therefore rise as a result of higher cancer prevalence and/or poorer treatment, but also due to an increase in total population or an aging population. Cancer death rates correct for changes in population size, age-standardized death rates correct for population size and age structure. Age-standardization therefore gives a more indicative measure of the prevalence and incidence of underlying cancer risk factors between countries and with time without the influence of demographic and population structure changes.

Data Sources

Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease (GBD)
  • Data: Death rates, absolute number of deaths and DALYS across all cancer types
  • Geographical coverage:Global, across all regions and countries
  • Time span:Most metrics available from 1990 onwards
  • Available at: Online here

International Agency for Research on Cancer (IARC)/World Health Organization (WHO)
  • Data: Cancer incidence and mortality of major types of cancer by sex
  • Geographical coverage: Approx. 180 countries
  • Time span: 1950-2002
  • Available at: IARC and WHO’s Globocan 2012 website, and at Gapminder.org
  •  On Gapminder, search for “cancer” in the search box to find the data files.
National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) Program
  • Data: Cancer mortality and incidence for over 30 types of cancers by race/ethnicity, sex and age
  • Geographical coverage: United States
  • Time span: 1975-2010
  • Available at: SEER Cancer Statistics Review website

References

  1. See the relevant data here. This is data from Schutte, A. E. (2017). Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Available online.
  2. The Institute for Health Metrics and Evaluation (IHME) put relatively small error margins around this global figure: the lower and upper estimates extend from 9.2 to 9.7 million. Full data on cancer deaths, including upper and lower estimates can be downloaded at the IHME’s Global Burden of Disease (GBD) Results Tool.
  3. The latest study can be found at the website of the Lancet here: TheLancet.com/GBD The 2017 study was published as GBD 2017 Risk Factor Collaborators – “Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017” and is online here.
  4. The IHME Global Burden of Disease (GBD) define age-standardization as: “A statistical technique used to compare populations with different age structures, in which the characteristics of the populations are statistically transformed to match those of a reference population.”
  5. Jemal, A. et a. (2017). Annual Report to the Nation on the Status of Cancer, 1975–2014, Featuring SurvivalJNCI: Journal of the National Cancer Institute, Volume 109, Issue 9, 1 September 2017.
  6. Rutter, C.M. et al. (2013). Secular Trends in Colon and Rectal Cancer Relative SurvivalJNCI: Journal of the National Cancer Institute, Volume 105, Issue 23, 4 December 2013.
  7. Elkin, E.B. (2005). The effect of changes in tumor size on breast carcinoma survival in the U.S: 1975–1999Cancer. Volume 104, Issue 6.
  8. Allemani, C., Weir, H. K., Carreira, H., Harewood, R., Spika, D., Wang, X. S., … & Marcos-Gragera, R. (2015) – Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2). The Lancet, 385(9972), 977-1010. Online here.
  9. Allemani, C., Weir, H. K., Carreira, H., Harewood, R., Spika, D., Wang, X. S., … & Marcos-Gragera, R. (2015) – Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2). The Lancet, 385(9972), 977-1010. Online here.
  10. Tomasetti, C., & Vogelstein, B. (2015). Variation in cancer risk among tissues can be explained by the number of stem cell divisions. Science347(6217), 78-81. Available online.
  11. Wild, C., Brennan, P., Plummer, M., Bray, F., Straif, K., & Zavadil, J. (2015). Cancer risk: role of chance overstated. Science347(6223), 728-728. Available online.Song, M., & Giovannucci, E. L. (2015). Cancer risk: many factors contribute. Science347(6223), 728-729. Available online.Ashford, N. A. et al. Cancer risk: role of environment. Science 347, 727 (2015). Available online.
  12. Wu, S., Powers, S., Zhu, W., & Hannun, Y. A. (2016). Substantial contribution of extrinsic risk factors to cancer development. Nature529(7584), 43. Available online.
  13. GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 14 Sept 2017: 390;1345-1422. Available online.
  14. Note that IHME risk factors do not account for sun exposure, which is a known risk factor for skin cancer. Attribution for skin cancers in the data are therefore an underestimate.

Citation

Our articles and data visualizations rely on work from many different people and organizations. When citing this entry, please also cite the underlying data sources. This entry can be cited as:

Max Roser and Hannah Ritchie (2020) - "Cancer". Published online at OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/cancer' [Online Resource]

BibTeX citation

@article{owidcancer,
    author = {Max Roser and Hannah Ritchie},
    title = {Cancer},
    journal = {Our World in Data},
    year = {2020},
    note = {https://ourworldindata.org/cancer}
}

Dissociative Disorders

Dementia

Dementia comprises several forms — the most common being Alzheimer’s disease — is an illness which results in a deterioration of cognitive capacity and function beyond what is expect from the normal ageing process. It can occur either in a chronic or progressive form. It affects several cognitive functions including memory, comprehension, judgement, language and learning capacity.

In the map we see death rates from dementia across the world. Note that these rates have been age-standardized which aims to correct for differences in the age structure of a population (which are different between countries and change over time). This therefore allows us to compare the likelihood that any given individual will die from dementia across countries and through time.

Across most countries, the death rate from dementia-related illness is below 55 per 100,000 individuals. Dementia rates in some countries have changed slightly since 1990, but significantly less so than other disease burdens.Death rate from Alzheimer & other dementia, 2017

The annual number of deaths from Alzheimer’s disease and other forms of dementia per 100,000 people.
No data025354045556065708085CC BY

Source: IHME, Global Burden of Disease (GBD)

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Additional information

Diarrheal diseases

Diarrheal diseases are caused primarily by viral and bacterial pathogens. They are particularly dominant at lower incomes where there is poor access to safe sanitationdrinking water and hygiene facilities. Diarrheal diseases are a leading cause of death in children.

In the map we see death rates from diarrheal diseases across the world.Diarrheal diseasesYou can explore global, regional and country-level data on diarrheal diseases in our full article here.Death rate from diarrheal diseases, 2017

The annual number of deaths from diarrheal diseases per 100,000 people.
No data05255075100150200250300CC BY

Source: IHME, Global Burden of Disease (GBD)

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Tuberculosis

Tuberculosis (TB) is an illness caused by the ingestion of bacteria (Mycobacterium tuberculosis) which affects the lungs. The World Health Organization (WHO) estimate that up to one-quarter of the global population has latent TB, meaning they have been infected with the disease but are not ill with the disease (although this does not inhibit it from becoming active in the future).

People with compromised immune systems, such as those suffering from malnutrition, diabetes, or are smokers are more likely to become ill with TB. There is a strong link between HIV/AIDS and TB: those infected with HIV are 20-30 times more likely to develop active tuberculosis.

In the map we see death rates from tuberculosis across the world.

Across most countries, the death rate from TB is below 5 per 100,000. Rates in 2017 across Eastern Europe were slightly higher, between 5-10 per 100,000. Across South Asia, these reach 25-50 per 100,000, with highest rates across Sub-Saharan Africa ranging from 50 to over 250 per 100,000.Death rate from tuberculosis, 2017

The annual number of deaths from tuberculosis per 100,000 people.
No data0510255075100125150200>250CC BY

Source: IHME, Global Burden of Disease (2017)

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Additional information

Malnutrition

Malnutrition arises in various forms, with the broad definition capturing undernourishment, micronutrient deficiencies and obesity. In this case, we refer to ‘protein-energy malnutrition‘ (PEM) which refers to energy or protein deficiency caused by insufficient food intake. Protein-energy deficiency can also be exacerbated by infection or disease, which can have the effect of increasing nutritional needs, and/or reducing the body’s ability to retain energy or nutrients. You can find more information on hunger and undernourishment in our entry.

In the map we see death rates from protein-energy malnutrition across the world.

The highest rates are seen across across Sub-Saharan Africa, which are typically in the range of 10-100 per 100,000 individuals. For most countries, this rate is below 5 per 100,000. In North Korea during its famine period, rates reached over 400 per 100,000.Death rate from malnutrition, 2017

Deaths from protein-energy malnutrition per 100,000 people.
No data05102550100150200300400>450CC BY

Source: IHME, Global Burden of Disease (GBD)

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Additional information

HIV/AIDS

An infection with HIV (human immunodeficiency virus) can lead to AIDS (acquired immunodeficiency syndrome). AIDS results in a gradual and persistent decline and failure of the immune system, resulting in heightened risk of life-threatening infection and cancers.

In the majority of cases, HIV is a sexually-transmitted infection. However, HIV can also be transmitted from a mother to her child, during pregnancy or childbirth, or through breastfeeding. Non-sexual transmission can also occur through the sharing of injection equipment such as needles.

In the map we see death rates from HIV/AIDS across the world.

Most countries have a rate of less than 10 deaths per 100,000 – often much lower, below 5 per 100,000. Across Europe the death rate is less than one per 100,000.

Across Sub-Saharan Africa the rates are much higher. Most countries in the South of the region had rates greater than 100 per 100,000. In South Africa and Mozambique, it was over 200 per 100,000.HIV/AIDSYou can explore global, regional and country-level data on HIV prevalence, deaths, and treatment in our full article here.Death rate from HIV/AIDS, 2017

The annual number of deaths from HIV/AIDS per 100,000 people.
No data0102550100200>250CC BY

Source: IHME, Global Burden of Disease (GBD)

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Malaria

Malaria is a disease that is transmitted from person to person by infected mosquitoes. The bite of an infected Anopheles mosquito transmits a parasite that enters the victim’s blood system and travels into the person’s liver where the parasite reproduces. There the parasite causes a high fever that involves shaking chills and pain. In the worst cases malaria leads to coma and death.

In the map we see death rates from malaria across the world.MalariaYou can explore global, regional and country-level data on malaria prevalence, deaths, and treatments in our full article here.Death rate from malaria, 2017

The annual number of deaths from malaria per 100,000 people.
No data02.551020406080>100CC BY

Source: IHME, Global Burden of Disease (GBD)

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Smoking

Tobacco smoking is not a direct cause of death, but it nonetheless one of the world’s largest health problems.

Smoking is one of the world’s leading risk factors for premature death. Tobacco a risk factor for several of the world’s leading causes of death, including lung and other forms of cancer, heart disease, and respiratory diseases. 

In the map we see death rates from tobacco smoking across the world.SmokingYou can explore global, regional and country-level data on the prevalence of smoking, its health impacts and attributed deaths in our full article here.Death rate from smoking, 2017

The annual number of deaths attributed to smoking per 100,000 people.
No data0255075100150>200CC BY

Source: IHME, Global Burden of Disease (GBD)

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Suicide

Every suicide is a tragedy. With timely, evidence-based interventions, suicides can be prevented.6

In the map we see death rates from suicide across the world.SuicideYou can explore global, regional and country-level data on deaths from suicide in our full article here.Death rate from suicides, 2017

The annual number of deaths from suicide per 100,000 people.
No data051015204050100CC BY

Source: IHME, Global Burden of Disease (GBD)

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Homicides

Intentional homicides are defined as “an unlawful death deliberately inflicted on one person by another person”.7Civilian and military deaths during interstate warscivil wars and genocides are not counted as homicides – but Our World in Data presents the evidence on deaths in the linked articles.

In the map we see homicide rates across the world.HomicidesYou can explore global, regional and country-level data on homicides in our full article here.Homicide rate, 2016

Number of intentional homicide deaths per 100,000 people.
No data012510203050100150CC BY

Source: UN Office on Drugs and Crime’s International Homicide Statistics

Note: Intentional homicides are estimates of unlawful homicides purposely inflicted as a result of domestic disputes, interpersonal violence, violent
conflicts over land resources, intergang violence over turf or control, and predatory violence and killing by armed groups.
19952016

Natural disasters

Natural disasters can occur in many forms – ranging from earthquakes and tsunamis, to extreme weather events, and heatwaves.

The largest disaster events are often infrequent, but high-impact meaning there is significant variability in deaths from year-to-year.

In the the map we see death rates from natural disasters across the world.Natural disastersYou can explore data on the number, costs and deaths from natural disasters in our full article here.Death rate from natural disasters, 2017

The annual number of deaths from all forms of natural disaster per 100,000 people.
No data00.010.050.10.515101001,0002,300CC BY

Source: IHME, Global Burden of Disease

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Road incidents

Road incident deaths include those of drivers – motor vehicles and motorcyclists – in addition to cyclists and pedestrian deaths.

In the map we see death rates from road incidents across the world.

Death rates are typically lowest across Western Europe and Japan, with less than 5 deaths per 100,000 individuals. Across the Americas, rates are typically slightly higher at 5 to 20; most countries in Asia lie between 15 and 30; and rates are typically highest across Sub-Saharan Africa with over 25 per 100,000.Death rate from road accidents, 2017

The annual number of deaths from road accidents per 100,000 people.
Deaths include those from drivers and passengers, motorcyclists, cyclists and pedestrians.
No data051015202530405060>70CC BY

Source: IHME, Global Burden of Disease (GBD)

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Additional information

Drowning

The World Health Organization (WHO) emphasises that drowning is one of the most overlooked, preventable causes of death across the world.8 For every country in the world, drowning is among the top 10 killers for children. In some countries, such as Bangladesh, it is the top mortality cause for children under 15 years old.

In the map we see death rates from drowning across the world.

In 2016, death rates were highest in Papua New Guinea and Seychelles, between 10 to 16 deaths per 100,000. Rates were also high in countries such as Bangladesh, Central African Republic, Vietnam, and Haiti.

If we look at death rates we see a significant decline since 1990 — especially in low to middle-income countries. In Bangladesh and China, for example, rates have fallen by more than two-thirds over this period.Death rate from drowning, 2017

The annual number of deaths from drowning per 100,000 people.
No data012.557.5101520253035CC BY

Source: IHME, Global Burden of Disease (GBD)

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Additional information

Fire

In the map we see death rates from fire across the world.

Most countries across the Americas, Western Europe, East Asia and Oceania average death rates below 2 per 100,000. Rates across other regions are typically higher at 2-6 per 100,000. When viewed through time we see a notable decline in fire death rates, particularly across Sub-Saharan Africa and Eastern Europe. Death rate from fires and burns, 2017

The annual number of deaths due to fire, heat and hot substances per 100,000 people.
No data012468101214CC BY

Source: IHME, Global Burden of Disease (GBD)

Note: To allow comparisons between countries and over time this metric is age-standardized.
19902017

Additional information

Terrorism

Terrorism is defined in the Oxford Dictionary as “the unlawful use of violence and intimidation, especially against civilians, in the pursuit of political aims.” We quickly see that this definition is unspecific and subjective.9 In our full article on Terrorism we look at adopted definitions, and how it’s distinguished from other forms of violence.

In the map we see death rates from terrorism across the world.TerrorismYou can explore data on the number of terrorist attacks and deaths in our full article here.Deaths from terrorism, 2017

Confirmed deaths, including all victims and attackers who died as a result of the incident.
No data02550751002505001,0005,00010,00015,000CC BY

Source: Global Terrorism Database (2018)

Note: The Global Terrorism Database is the most comprehensive dataset on terrorist attacks available and recent data is complete. However, we
expect, based on our analysis, that longer-term data is incomplete (with the exception of the US and Europe). We therefore do not recommend this
dataset for the inference of long-term trends in the prevalence of terrorism globally. 
19702017

Deaths by animal

Mosquitoes are by far the world’s deadliest animal

Around 1.5 million people are killed by animals every year.

More than half a million are killed by other humans – in warhomicides, and terrorism. And close to a million people are killed by other animals in any given year.10 

Mosquitoes are, by far, the world’s deadliest animal for humans: at estimated 780,000 died from the transmission of disease from mosquitoes in 2016. Mosquito deaths are the sum of deaths (in order, highest to lowest) from: Malaria, Dengue fever, Japanese encephalitis, Yellow fever, Zika virus, Chikungunya, West Nile virus, and Lymphatic filariasis, for which it is the vector.

Deadliest animals 01
Estimated number of global human deaths by animal, either from direct contact/attack or transmission of disease.

Does the news reflect what we die from?

One of the primary motivations for our work at Our World in Data is to provide a fact-based overview of the world we live in — a perspective that includes the persistent and long-term changes that run as a backdrop to our daily lives. We aim to provide the complement to the fast-paced reporting we see in the news. The media provides a near-instantaneous snapshot of single events; events that are, in most cases, negative. The persistent, large-scale trends of progress never make the headlines.

But is there evidence that such a disconnect exists between what we see in the news and what is reality for most us?

One study attempted to look at this from the perspective of what we die from: is what we actually die from reflected in the media coverage these topics receive?11

To answer this, Shen and his team compared four key sources of data:

For each source the authors calculated the relative share of deaths, share of Google searches, and share of media coverage. They restricted the considered causes to the top 10 causes of death in the US and additionally included terrorism, homicide, and drug overdoses. This allows for us to compare the relative representation across different sources.12

What we die from; what we Google; what we read in the news

So, what do the results look like? In the chart below I present the comparison.

The first column represents each cause’s share of US deaths; the second the share of Google searches each receives; third, the relative article mentions in the New York Times; and finally article mentions in The Guardian.

The coverage in both newspapers here is strikingly similar. And the discrepancy between what we die actually from and what we get informed of in the media is what stands out:

  • around one-third of the considered causes of deaths resulted from heart disease, yet this cause of death receives only 2-3 percent of Google searches and media coverage;
  • just under one-third of the deaths came from cancer; we actually google cancer a lot (37 percent of searches) and it is a popular entry here on our site; but it receives only 13-14 percent of media coverage;
  • we searched for road incidents more frequently than their share of deaths, however, they receive much less attention in the news;
  • when it comes to deaths from strokes, Google searches and media coverage are surprisingly balanced;
  • the largest discrepancies concern violent forms of death: suicide, homicide and terrorism. All three receive much more relative attention in Google searches and media coverage than their relative share of deaths. When it comes to the media coverage on causes of death, violent deaths account for more than two-thirds of coverage in the New York Times and The Guardian but account for less than 3 percent of the total deaths in the US.

What’s interesting is that Americans search on Google is a much closer reflection of what kills us than what is presented in the media. One way to think about it is that media outlets may produce content that they think readers are most interested in, but this is not necessarily reflected in our preferences when we look for information ourselves.

[Clicking on the visualization will open it in higher resolution; The chart shows the summary for the year 2016, but interactive charts for all available years is available at the end of this blog.13]

Causes of death in usa vs. media coverage

How over- or underrepresented are deaths in the media?

As we can see clearly from the chart above, there is a disconnect between what we die from, and how much coverage these causes get in the media. Another way to summarize this discrepancy is to calculate how over- or underrepresented each cause is in the media. To do this, we simply calculate the ratio between the share of deaths and share of media coverage for each cause.

In the chart below we see how over- or underrepresented each cause is in newspaper coverage.14 Causes shown in red are overrepresented in the media; those in blue are underrepresented. Numbers denote the factor by which they are misrepresented.

The major standout here – I had to break the scale on the y-axis since it’s several orders of magnitude higher than everything else – is terrorism: it is overrepresented in the news by almost a factor of 4000.

Homicides are also very overrepresented in the news, by a factor of 31. The most underrepresented in the media are kidney disease (11-fold), heart disease (10-fold), and, perhaps surprisingly, drug overdoses (7-fold). Stroke and diabetes are the two causes most accurately represented.

[Clicking on the visualization will open it in higher resolution].

Over and underrepresentation of deaths in media

Should media exposure reflect what we die from?

From the comparisons above, it’s clear that the news doesn’t reflect what we die from. But there is another important question: should these be representative?

There are several reasons we would, or should, expect that what we read online, and what is covered in the media wouldn’t correspond with what we actually die from.

The first is that we would expect there to be some preventative aspect to information we access. There’s a strong argument that things we search for and gain information on encourages us to take action which prevents a further death. There are several examples where I can imagine this to be true. People who are concerned about cancer may search online for guidance on symptoms and be convinced to see their doctor. Some people with suicidal thoughts may seek help and support online which later results in an averted death from suicide. We’d therefore expect that both intended or unintended exposure to information on particular topics could prevent deaths from a given cause. Some imbalance in the relative proportions therefore makes sense. But clearly there is some bias in our concerns: most people die from heart disease (hence it should be something that concerns us) yet only a small minority seek [possibly preventative] information online.

Second, this study focused on what people in the USA die from, not what people across the world die from. Is media coverage more representative of global deaths? Not really. In another blog post, ‘What does the world die from?‘, I looked in detail at the ranking of causes of death globally and by country. The relative ranking of deaths in the USA is reflective of the global average: most people die from heart disease and cancers, and terrorism ranks last or second last (alongside natural disasters). Terrorism accounted for 0.06 percent of global deaths in 2016. Whilst we’d expect non-US events to feature in the New York Times, global news shouldn’t substantially affect representative coverage of causes.

The third relates to the very nature of news: it focuses on events and stories. Whilst I am often critical of the messages and narratives portrayed in the media, I have some sympathy for what they choose to cover. Reporting has become increasingly fast-paced. As news consumers, our expectations have quickly shifted from daily, to hourly, down to minute-by-minute updates of what’s happening in the world. Combine this with our attraction to stories and narratives. It’s not surprising that the media focuses on reports of single (inadvertently negative) events: a murder case or a terrorist attack. The most underrepresented cause of death in the media was kidney disease. But with an audience that expects a minute-by-minute feed of coverage, how much can possibly be said about kidney disease? Without conquering our compulsion for the latest unusual story, we cannot expect this representation to be perfectly balanced.

How to combat our bias for single events

Media and its consumers are stuck in a reinforcing cycle. The news reports on breaking events, which are often based around a compelling story. Consumers want to know what’s going on in the world — we are quickly immersed by the latest headline. We come to expect news updates with increasing frequency, and media channels have clear incentives to deliver. This locks us into a cycle of expectation and coverage with a strong bias for outlier events. Most of us are left with a skewed perception of the world; we think the world is much worse than it is.15

The responsibility in breaking this cycle lies with both media producers and consumers. Will we ever stop reporting and reading the latest news? Unlikely. But we can all be more conscious of how we let this news shape our understanding of the world.

And journalists can do much better in providing context of the broader trends: if reporting on a homicide, for example, include context of how homicide rates are changing over time.16

As media consumers we can be much more aware of the fact that relying on the 24/7 news coverage alone is wholly insufficient for understanding the state of the world. This requires us to check our (often unconscious) bias for single narratives and seek out sources that provide a fact-based perspective on the world.

This antidote to the news is what we try to provide at Our World in Data. It should be accessible for everyone, which is why our work is completely open-access. Whether you are a media producer or consumer, feel free to take and use anything you find here.

Laura Zukerman

Owner and Founder at the Goddess Bibles A Memoir By Laura Zukerman

Becoming Your Inner Goddess

Goddess on Fire

HERE IT IS : STATISTICS TO SHOW DEATH.

LEADING CAUSES OF DEATH

Of the 56.9 million deaths worldwide in 2016, more than half (54%) were due to the top 10 causes. Ischaemic heart disease and stroke are the world’s biggest killers, accounting for a combined 15.2 million deaths in 2016. These diseases have remained the leading causes of death globally in the last 15 years.

Chronic obstructive pulmonary disease claimed 3.0 million lives in 2016, while lung cancer (along with trachea and bronchus cancers) caused 1.7 million deaths. Diabetes killed 1.6 million people in 2016, up from less than 1 million in 2000. Deaths due to dementias more than doubled between 2000 and 2016, making it the 5th leading cause of global deaths in 2016 compared to 14th in 2000.

Lower respiratory infections remained the most deadly communicable disease, causing 3.0 million deaths worldwide in 2016. The death rate from diarrhoeal diseases decreased by almost 1 million between 2000 and 2016, but still caused 1.4 million deaths in 2016. Similarly, the number of tuberculosis deaths decreased during the same period, but is still among the top 10 causes with a death toll of 1.3 million. HIV/AIDS is no longer among the world’s top 10 causes of death, having killed 1.0 million people in 2016 compared with 1.5 million in 2000.

Road injuries killed 1.4 million people in 2016, about three-quarters (74%) of whom were men and boys.


Top 10 global causes of deaths 2016

Top 10 global causes of deaths 2000

Leading causes of death by economy income group

More than half of all deaths in low-income countries in 2016 were caused by the so-called “Group I” conditions, which include communicable diseases, maternal causes, conditions arising during pregnancy and childbirth, and nutritional deficiencies. By contrast, less than 7% of deaths in high-income countries were due to such causes. Lower respiratory infections were among the leading causes of death across all income groups.

Noncommunicable diseases (NCDs) caused 71% of deaths globally, ranging from 37% in low-income countries to 88% in high-income countries. All but one of the 10 leading causes of death in high-income countries were NCDs. In terms of absolute number of deaths, however, 78% of global NCD deaths occurred in low- and middle-income countries.

Injuries claimed 4.9 million lives in 2016. More than a quarter (29%) of these deaths were due to road traffic injuries. Low-income countries had the highest mortality rate due to road traffic injuries with 29.4 deaths per 100 000 population – the global rate was 18.8. Road traffic injuries were also among the leading 10 causes of death in low, lower-middle- and upper-middle-income countries.

Source: Global Health Estimates 2016: Deaths by Cause, Age, Sex, by Country and by Region, 2000-2016. Geneva, World Health Organization; 2018.

Top 10 causes of deaths low-income countries 2016

Graph2

Graph3

Graph4

Why do we need to know the reasons people die?

Measuring how many people die each year and why they died is one of the most important means – along with gauging how diseases and injuries are affecting people – for assessing the effectiveness of a country’s health system.

Cause-of-death statistics help health authorities determine the focus of their public health actions. A country in which deaths from heart disease and diabetes rise rapidly over a period of a few years, for example, has a strong interest in starting a vigorous program to encourage lifestyles to help prevent these illnesses. Similarly, if a country recognizes that many children are dying of pneumonia, but only a small portion of the budget is dedicated to providing effective treatment, it can increase spending in this area.

High-income countries have systems in place for collecting information on causes of death. Many low- and middle-income countries do not have such systems, and the numbers of deaths from specific causes have to be estimated from incomplete data. Improvements in producing high quality cause-of-death data are crucial for improving health and reducing preventable deaths in these countries.

Eating Disorders

When you become so preoccupied with food and weight issues that you find it harder and harder to focus on other aspects of your life, it may be an early sign of an eating disorder. Studies suggest that 1 in 20 people will be affected at some point in their lives. Ultimately without treatment, eating disorders can take over a person’s life and lead to serious, potentially fatal medical complications. Although eating disorders are commonly associated with women, men can develop them as well.

Eating disorders are a group of related conditions that cause serious emotional and physical problems. Each condition involves extreme food and weight issues; however, each has unique symptoms that separate it from the others.

Anorexia Nervosa. People with anorexia will deny themselves food to the point of self-starvation as they obsesses about weight loss. With anorexia, a person will deny hunger and refuse to eat, practice binge eating and purging behaviors or exercise to the point of exhaustion as they attempts to limit, eliminate or “burn” calories.

The emotional symptoms of anorexia include irritability, social withdrawal, lack of mood or emotion, not able to understand the seriousness of the situation, fear of eating in public and obsessions with food and exercise. Often food rituals are developed or whole categories of food are eliminated from the person’s diet, out of fear of being “fat”.

Anorexia can take a heavy physical toll. Very low food intake and inadequate nutrition causes a person to become very thin. The body is forced to slow down to conserve energy causing irregularities or loss of menstruation, constipation and abdominal pain, irregular heart rhythms, low blood pressure, dehydration and trouble sleeping. Some people with anorexia might also use binge eating and purge behaviors, while others only restrict eating.

Bulimia Nervosa. People living with bulimia will feel out of control when binging on very large amounts of food during short periods of time, and then desperately try to rid themselves of the extra calories using forced vomiting, abusing laxatives or excessive exercise. This becomes a repeating cycle that controls many aspects of the person’s life and has a very negative effect both emotionally and physically. People living with bulimia are usually normal weight or even a bit overweight.

The emotional symptoms of bulimia include low self-esteem overly linked to body image, feelings of being out of control, feeling guilty or shameful about eating and withdrawal from friends and family.

Like anorexia, bulimia will inflict physical damage. The binging and purging can severely harm the parts of the body involved in eating and digesting food, teeth are damaged by frequent vomiting, and acid reflux is common. Excessive purging can cause dehydration that effect the body’s electrolytes and leads to cardiac arrhythmias, heart failure and even death.

Binge Eating Disorder (BED). A person with BED losses control over their eating and eats a very large amount of food in a short period of time. They may also eat large amounts of food even when he isn’t hungry or after he is uncomfortably full. This causes them to feel embarrassed, disgusted, depressed or guilty about their behavior. A person with BED, after an episode of binge eating, does not attempt to purge or exercise excessively like someone living with anorexia or bulimia would. A person with binge eating disorder may be normal weight, overweight or obese.

Eating disorders are very complex conditions, and scientists are still learning about the causes. Although eating disorders all have food and weight issues in common, most experts now believe that eating disorders are caused by people attempting to cope with overwhelming feelings and painful emotions by controlling food. Unfortunately, this will eventually damage a person’s physical and emotional health, self-esteem and sense of control.

Factors that may be involved in developing an eating disorder include:

  • Genetics. People with first degree relatives, siblings or parents, with an eating disorder appear to be more at risk of developing an eating disorder, too. This suggests a genetic link. Evidence that the brain chemical, serotonin, is involved also points a contributing genetic and biological factors.
  • Environment. Cultural pressures that stress “thinness” as beautiful for women and muscular development and body size for men places undue pressure on people of achieve unrealistic standards. Popular culture and media images often tie being thin to popularity, success, beauty and happiness. This creates a strong desire to very thin.
  • Peer Pressure. With young people, this can be a very powerful force. Pressure can appear in the form of teasing, bullying or ridicule because of size or weight. A history of physical or sexual abuse can also contribute to some people developing an eating disorder.
  • Emotional Health. Perfectionism, impulsive behavior and difficult relationships can all contribute to lowering a person’s self-esteem and make them vulnerable to developing eating disorders.

Eating disorders affect all types of people. However there are certain risk factors that put some people at greater risk for developing an eating disorder.

  • Age. Eating disorders are much more common during teens and early 20s.
  • Gender. Statistically, teenage girls and young women are more likely to have eating disorders, but they are more likely to be noticed/treated for one. Teenage boys and men are less likely seek help, but studies show that 1 out of 10 people diagnosed with eating disorders are male.
  • Family history. Having a parent or sibling with an eating disorder increases the risk.
  • Dieting. Dieting taken too far can become an eating disorder.
  • Changes. Times of change like going to college, starting a new job, or getting divorced may be a stressor towards developing an eating disorder.
  • Vocations and activities. Eating disorders are especially common among gymnasts, runners, wrestlers and dancers.

A person with an eating disorder will have the best recovery outcome if they receive an early diagnosis. If an eating disorder is believed to an issue, a doctor will usually perform a physical examination, conduct an interview and order lab tests. These will help form the diagnosis and check for related medical issues and complications.

In addition, a mental health professional will conduct a psychological evaluation. They may ask questions about eating habits, behaviors and beliefs. There may be questions about a patient’s history of dieting, exercise, bingeing and purging.

Symptoms must meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in order to warrant a diagnosis. Each eating disorder has its own diagnostic criteria that a mental health professional will use to determine which disorder is involved. It is not necessary to have all the criteria for a disorder to benefit from working with a mental health professional on food and eating issues.

Often a person with an eating disorder will have symptoms of another mental health condition that requires treatment. Whenever possible, it is best to identified and address all conditions at the same time. This gives a person comprehensive treatment support that helps insure a lasting recovery.

Each person’s treatment will depend on the type of eating disorder, but generally it will include psychotherapy along with medical monitoring and nutritional counseling. Family-based treatment is especially important for families with children and adolescents because it enlists the families’ help to better insure healthy eating patterns and increases awareness and support.

Many people receive treatment for an eating disorder without needing an intensive treatment setting. However, for some people, an inpatient or residential eating disorder treatment center or partial hospital setting is best when they begin treatment. Others may need hospitalization to treat serious problems caused by poor nutrition or for care if they are very underweight.

Support groups, nutrition counseling and medications are also helpful to some individuals.

Psychotherapy should be provided by a mental health professional with experience in treating eating disorders. Because of the complexity, therapy needs to address both the symptoms and a person’s psychological, interpersonal and cultural influences which contributed to the disorder.

Cognitive behavioral therapy (CBT) is often successfully used in the treatment of eating disorders because it helps people understand the relationship between their thoughts, feelings and behaviors. CBT that is developed for the treatment of bulimia is very effective at changing the binge-purge behaviors and eating attitudes.

Wellness and Nutrition Counseling involves professionals helping a patient return to a normal weight. Dietitians and other health care providers can help change old habits and beliefs about food, dieting and exercise with healthy nutrition and eating information and planning. Sometimes planning and monitoring responsibilities are shared with mental health professionals or family members.

Laura Zukerman

Owner and Founder at The Goddess Bibles A Memoir By Laura Zukerman

Becoming Your Inner Goddess

Goddess on Fire.

Depression

Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It’s a serious mental health condition that requires understanding and medical care. Left untreated, depression can be devastating for those who have it and their families. Fortunately, with early detection, diagnosis and a treatment plan consisting of medication, psychotherapy and healthy lifestyle choices, many people can and do get better.

Some will only experience one depressive episode in a lifetime, but for most, depressive disorder recurs. Without treatment, episodes may last a few months to several years.

An estimated 16 million American adults—almost 7% of the population—had at least one major depressive episode in the past year. People of all ages and all racial, ethnic and socioeconomic backgrounds experience depression, but it does affect some groups more than others.

Is someone you care about dealing with Depression? Or are you? We can help. Click to email our Helpline for more support.

Depression can present different symptoms, depending on the person. But for most people, depressive disorder changes how they function day-to-day, and typically for more than two weeks. Common symptoms include:

  • Changes in sleep
  • Changes in appetite
  • Lack of concentration
  • Loss of energy
  • Lack of interest in activities
  • Hopelessness or guilty thoughts
  • Changes in movement (less activity or agitation)
  • Physical aches and pains
  • Suicidal thoughts

Depression does not have a single cause. It can be triggered by a life crisis, physical illness or something else—but it can also occur spontaneously. Scientists believe several factors can contribute to depression:

  • Trauma. When people experience trauma at an early age, it can cause long-term changes in how their brains respond to fear and stress. These changes may lead to depression.
  • Genetics. Mood disorders, such as depression, tend to run in families.
  • Life circumstances. Marital status, relationship changes, financial standing and where a person lives influence whether a person develops depression.
  • Brain changes. Imaging studies have shown that the frontal lobe of the brain becomes less active when a person is depressed. Depression is also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation.
  • Other medical conditions. People who have a history of sleep disturbances, medical illness, chronic pain, anxiety and attention-deficit hyperactivity disorder (ADHD) are more likely to develop depression. Some medical syndromes (like hypothyroidism) can mimic depressive disorder. Some medications can also cause symptoms of depression.
  • Drug and alcohol abuse. Approximately 30% of people with substance abuse problems also have depression. This requires coordinated treatment for both conditions, as alcohol can worsen symptoms.

To be diagnosed with depressive disorder, a person must have experienced a depressive episode lasting longer than two weeks. The symptoms of a depressive episode include:

  • Loss of interest or loss of pleasure in all activities
  • Change in appetite or weight
  • Sleep disturbances
  • Feeling agitated or feeling slowed down
  • Fatigue
  • Feelings of low self-worth, guilt or shortcomings
  • Difficulty concentrating or making decisions
  • Suicidal thoughts or intentions
  • Many treatment options are available for depression, but how well treatment works depends on the type of depression and its severity.

Laura Zukerman

Owner and Founder at the Goddess Bibles A Memoir By Laura Zukerman

Becoming Your Inner Goddess

Goddess on Fire

Dissociative Disorders

Dissociative disorders are characterized by an involuntary escape from reality characterized by a disconnection between thoughts, identity, consciousness and memory. People from all age groups and racial, ethnic and socioeconomic backgrounds can experience a dissociative disorder.

Its estimated that 2% of people experience dissociative disorders, with women being more likely than men to be diagnosed. Almost half of adults in the United States experience at least one depersonalization/derealization episode in their lives, with only 2% meeting the full criteria for chronic episodes.

The symptoms of a dissociative disorder usually first develop as a response to a traumatic event, such as abuse or military combat, to keep those memories under control. Stressful situations can worsen symptoms and cause problems with functioning in everyday activities. However, the symptoms a person experiences will depend on the type of dissociative disorder that a person has.

Treatment for dissociative disorders often involves psychotherapy and medication. Though finding an effective treatment plan can be difficult, many people are able to live healthy and productive lives.

Is someone you care about dealing with a dissociative disorder? Or are you? We can help. Click to email our Helpline for more support.

Symptoms and signs of dissociative disorders include:

  • Significant memory loss of specific times, people and events
  • Out-of-body experiences, such as feeling as though you are watching a movie of yourself
  • Mental health problems such as depression, anxiety and thoughts of suicide
  • A sense of detachment from your emotions, or emotional numbness
  • A lack of a sense of self-identity

The symptoms of dissociative disorders depend on the type of disorder that has been diagnosed. There are three types of dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM):

  • Dissociative Amnesia. The main symptom is difficulty remembering important information about one’s self. Dissociative amnesia may surround a particular event, such as combat or abuse, or more rarely, information about identity and life history. The onset for an amnesic episode is usually sudden, and an episode can last minutes, hours, days, or, rarely, months or years. There is no average for age onset or percentage, and a person may experience multiple episodes throughout her life.
  • Depersonalization disorder. This disorder involves ongoing feelings of detachment from actions, feelings, thoughts and sensations as if they are watching a movie (depersonalization). Sometimes other people and things may feel like people and things in the world around them are unreal (derealization). A person may experience depersonalization, derealization or both. Symptoms can last just a matter of moments or return at times over the years. The average onset age is 16, although depersonalization episodes can start anywhere from early to mid childhood. Less than 20% of people with this disorder start experiencing episodes after the age of 20.
  • Dissociative identity disorder. Formerly known as multiple personality disorder, this disorder is characterized by alternating between multiple identities. A person may feel like one or more voices are trying to take control in their head. Often these identities may have unique names, characteristics, mannerisms and voices. People with DID will experience gaps in memory of every day events, personal information and trauma. Women are more likely to be diagnosed, as they more frequently present with acute dissociative symptoms. Men are more likely to deny symptoms and trauma histories, and commonly exhibit more violent behavior, rather than amnesia or fugue states. This can lead to elevated false negative diagnosis.

Dissociative disorders usually develop as a way of dealing with trauma. Dissociative disorders most often form in children exposed to long-term physical, sexual or emotional abuse. Natural disasters and combat can also cause dissociative disorders.

Doctors diagnose dissociative disorders based on a review of symptoms and personal history. A doctor may perform tests to rule out physical conditions that can cause symptoms such as memory loss and a sense of unreality (for example, head injury, brain lesions or tumors, sleep deprivation or intoxication). If physical causes are ruled out, a mental health specialist is often consulted to make an evaluation.

Many features of dissociative disorders can be influenced by a person’s cultural background. In the case of dissociative identity disorder and dissociative amnesia, patients may present with unexplained, non-epileptic seizures, paralyses or sensory loss. In settings where possession is part of cultural beliefs, the fragmented identities of a person who has DID may take the form of spirits, deities, demons or animals. Intercultural contact may also influence the characteristics of other identities. For example, a person in India exposed to Western culture may present with an “alter” who only speaks English. In cultures with highly restrictive social conditions, amnesia is frequently triggered by severe psychological stress such as conflict caused by oppression. Finally, voluntarily induced states of depersonalization can be a part of meditative practices prevalent in many religions and cultures, and should not be diagnosed as a disorder.

The goals of treatment for dissociative disorders are to help the patient safely recall and process painful memories, develop coping skills, and, in the case of dissociative identity disorder, to integrate the different identities into one functional person. It is important to note that there is no drug that deals directly with treating dissociation itself. Rather, medications are used to combat additional symptoms that commonly occur with dissociative disorders.

Psychotherapy

Different psychotherapies are used to treat dissociative episodes to decrease symptom frequency and improve coping strategies for the experience of dissociation. Some of the more common therapies include:

  • Cognitive behavioral therapy (CBT) helps change the negative thinking and behavior associated with depression. The goal of this therapy is to recognize negative thoughts and to teach coping strategies.
  • Dialectical behavioral therapy (DBT) focuses on teaching coping skills to combat destructive urges, regulate emotions and improve relationships while adding validation. Involving individual and group work, DBT encourages practicing mindfulness techniques such as meditation, regulated breathing and self-soothing.
  • Eye movement desensitization and reprocessing(EMDR) is designed to alleviate the distress associated with traumatic memories. It combines the CBT techniques of re-learning thought patterns with visual stimulation exercises to access traumatic memories and replace the associated negative beliefs with positive ones.

Laura Zukerman

Owner and Founder At The Goddess Bibles A Memoir By Laura Zukerman

Becoming Your Inner Goddess

Goddess on Fiya..

Obsessive Compulsive Disorder also known as OCD

Obsessive-compulsive disorder (OCD) is characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions). Although people with OCD may know that their thoughts and behavior don’t make sense, they are often unable to stop them.

Symptoms typically begin during childhood, the teenage years or young adulthood, although males often develop them at a younger age than females. More than 2% of the U.S. population (nearly 1 out of 40 people) will be diagnosed with OCD during their lives.

Is someone you care about dealing with Obsessive-Compulsive Disorder? Or are you? We can help. Click to email our Helpline for more support.

Most people have occasional obsessive thoughts or compulsive behaviors. In an obsessive-compulsive disorder, however, these symptoms generally last more than an hour each day and interfere with daily life.

Obsessions are intrusive, irrational thoughts or impulses that repeatedly occur. People with these disorders know these thoughts are irrational but are afraid that somehow they might be true. These thoughts and impulses are upsetting, and people may try to ignore or suppress them.

Examples of obsessions include:

  • Thoughts about harming or having harmed someone
  • Doubts about having done something right, like turning off the stove or locking a door
  • Unpleasant sexual images
  • Fears of saying or shouting inappropriate things in public

Compulsions are repetitive acts that temporarily relieve the stress brought on by an obsession. People with these disorders know that these rituals don’t make sense but feel they must perform them to relieve the anxiety and, in some cases, to prevent something bad from happening. Like obsessions, people may try not to perform compulsive acts but feel forced to do so to relieve anxiety.

Examples of compulsions include:

  • Hand washing due to a fear of germs
  • Counting and recounting money because a person is can’t be sure they added correctly
  • Checking to see if a door is locked or the stove is off
  • “Mental checking” that goes with intrusive thoughts is also a form of compulsion

The exact cause of obsessive-compulsive disorders is unknown, but researchers believe that activity in several portions of the brain is responsible. More specifically, these areas of the brain may not respond normally to serotonin, a chemical that some nerve cells use to communicate with each other. Genetics are thought to be very important. If you, your parent or a sibling, have an obsessive-compulsive disorder, there’s close to a 25% chance that another immediate family member will have it.

A doctor or mental health care professional will make a diagnosis of OCD. A general physical with blood tests is recommended to make sure the symptoms are not caused by illegal drugs, medications, another mental illness, or by a general medical condition. The sudden appearance of symptoms in children or older people merits a thorough medical evaluation to ensure that another illness is not causing of these symptoms.

To be diagnosed with OCD, a person must have must have:

  • Obsessions, compulsions or both
  • Obsessions or compulsions that are upsetting and cause difficulty with work, relationships, other parts of life and typically last for at least an hour each day

For many, a combination of medicine and therapy is superior to either approach alone. While medicine may work directly on the brain, the therapies are believed help to retrain the brain to recognize “false threats.”

Psychotherapy

There are two types of psychotherapies that are helpful for treating OCD:

  • Exposure and response therapy exposes a person to the cause of their anxiety. For example, a person with a fear of germs may be asked by a doctor or therapist to put their hand on something considered dirty, such as a doorknob. Afterwards, they will refrain from washing their hands. The length of time between touching the doorknob and washing hands becomes longer and longer. Ultimately, when the person realizes that not washing right away does not cause a deadly reaction, the compulsion to wash fades.
  • Cognitive behavioral therapy focuses on the thoughts that are causing distress, and changing the negative thinking and behavior associated them. For obsessive-compulsive disorder, the goal of this therapy is to recognize negative thoughts and, with practice, gradually lessen their intensity to the point of harmlessness.

Medication

The most common type of medication used to treat OCD are antidepressants. Treating OCD with antidepressants often takes longer to take effect than treating depression. Also, these medicines must sometimes be given in larger doses and for a longer period of time than for depression.

Complementary Health Approaches

Aerobic exercise is a key complimentary intervention that can work to improve the quality of life for people with OCD. Exercise can work to naturally reduce the baseline level of anxiety a person experiences.

Laura Zukerman

Owner and Founder at The Goddess Bibles A Memoir By Laura Zukerman

Becoming Your Inner Goddess

Goddess on Fire

Early Psychosis and Psychosis

Most people think of psychosis as a break with reality. In a way it is. Psychosis is characterized as disruptions to a person’s thoughts and perceptions that make it difficult for them to recognize what is real and what isn’t. These disruptions are often experienced as seeing, hearing and believing things that aren’t real or having strange, persistent thoughts, behaviors and emotions. While everyone’s experience is different, most people say psychosis is frightening and confusing.

Psychosis is a symptom, not an illness, and it is more common than you may think. In the U.S., approximately 100,000 young people experience psychosis each year. As many as three in 100 people will have an episode at some point in their lives.

Early or first-episode psychosis (FEP) refers to when a person first shows signs of beginning to lose contact with reality. Acting quickly to connect a person with the right treatment during early psychosis or FEP can be life-changing and radically alter that person’s future.

Is someone you care about dealing with psychosis? Or are you? We can help. Click to email our Helpline for more support.

Early Warning Signs Before Psychosis

Early psychosis or FEP rarely comes suddenly. Usually, a person has gradual, non-specific changes in thoughts and perceptions, but doesn’t understand what’s going on. Early warning signs can be difficult to distinguish from typical teen or young adult behavior. While such signs should not be cause for alarm, they may indicate the need to get an assessment from a doctor.

Encouraging people to seek help for early psychosis is important. Families are often the first to see early signs of psychosis and the first to address the issue of seeking treatment. However, a person’s willingness to accept help is often complicated by delusions, fears, stigma and feeling unsettled. In this case, families can find the situation extremely difficult, but there are engagement strategies to help encourage a person to seek help.

It’s important to get help quickly since early treatment provides the best hope of recovery by slowing, stopping and possibly reversing the effects of psychosis. Early warning signs include the following:

  • A worrisome drop in grades or job performance
  • Trouble thinking clearly or concentrating
  • Suspiciousness or uneasiness with others
  • A decline in self-care or personal hygiene
  • Spending a lot more time alone than usual
  • Strong, inappropriate emotions or having no feelings at all

Signs Of Early Or First-Episode Psychosis

Determining exactly when the first episode of psychosis begins can be hard, but these signs and symptoms strongly indicate an episode of psychosis:

  • Hearing, seeing, tasting or believing things that others don’t
  • Persistent, unusual thoughts or beliefs that can’t be set aside regardless of what others believe
  • Strong and inappropriate emotions or no emotions at all
  • Withdrawing from family or friends
  • A sudden decline in self-care
  • Trouble thinking clearly or concentrating

Such warning signs often point to a person’s deteriorating health, and a physical and neurological evaluation can help find the problem. A mental health professional performing a psychological evaluation can determine if a mental health condition is involved and discuss next steps. If the psychosis is a symptom of a mental health condition, early action helps to keep lives on track.

Psychosis

Psychosis includes a range of symptoms but typically involves one of these two major experiences:

Hallucinations are seeing, hearing or feeling things that aren’t there, such as the following:

  • Hearing voices (auditory hallucinations)
  • Strange sensations or unexplainable feelings
  • Seeing glimpses of objects or people that are not there or distortions

Delusions are strong beliefs that are not consistent with the person’s culture, are unlikely to be true and may seem irrational to others, such as the following:

  • Believing external forces are controlling thoughts, feelings and behaviors
  • Believing that trivial remarks, events or objects have personal meaning or significance
  • Thinking you have special powers, are on a special mission or even that you are God.

We are still learning about how and why psychosis develops, but several factors are likely involved. We do know that teenagers and young adults are at increased risk of experiencing an episode of psychosis because of hormonal changes in their brain during puberty.

Several factors that can contribute to psychosis:

  • Genetics. Many genes can contribute to the development of psychosis, but just because a person has a gene doesn’t mean they will experience psychosis. Ongoing studies will help us better understand which genes play a role in psychosis.
  • Trauma. A traumatic event such as a death, war or sexual assault can trigger a psychotic episode. The type of trauma—and a person’s age—affects whether a traumatic event will result in psychosis.
  • Substance use. The use of marijuana, LSD, amphetamines and other substances can increase the risk of psychosis in people who are already vulnerable.
  • Physical illness or injury. Traumatic brain injuries, brain tumors, strokes, HIV and some brain diseases such as Parkinson’s, Alzheimer’s and dementia can sometimes cause psychosis.
  • Mental health conditions. Sometimes psychosis is a symptom of a condition like schizophrenia, schizoaffective disorder, bipolar disorder or depression.

A diagnosis identifies an illness; symptoms are components of an illness. Health care providers draw on information from medical and family history and a physical examination to diagnose someone. If causes such as a brain tumor, infection or epilepsy are ruled out, a mental illness might be the reason.

If the cause is related to a mental health condition, early diagnosis and treatment provide the best hope of recovery. Research shows that the earlier people experiencing psychosis receive treatment, the better their long-term quality of life.

Early Psychosis And Psychosis

The most effective treatment for early psychosis is Coordinated Specialty Care (CSC). The earlier a person experiencing psychosis receives CSC, the better his or her quality of life becomes. CSC’s team-based approach encourages the individual experiencing early psychosis to share in decisions about treatment and recovery goals.

CSC programs have six components:

  • Case management—helping the individual develop problem-solving skills, manage medication and coordinate services
  • Family support and education—giving families information and skills to support a loved one’s treatment and recovery
  • Psychotherapy—learning to focus on resiliency, managing the condition, promoting wellness and developing coping skills
  • Medication management—finding the best medication at the lowest possible dose
  • Supported education and employment—supporting someone to continue or return to school or work
  • Peer support—connecting the person with others who have been through similar experiences

Each component is provided by a team of specially trained healthcare professionals who help individuals get their lives back on track and realize their goals, such as finishing school or returning to work.

Psychosis Treatment

Treatment for psychosis often involves a combination of psychotherapy and medication. Several types of therapy can help individuals learn to manage their condition, while medication targets symptoms and helps to reduce their impact. How well treatment works depends on the cause(s) of the psychosis, its severity and its duration.

Psychotherapy

Therapy is essential in treating psychosis. Common therapies include the following:

  • Cognitive behavioral therapy (CBT)—teaches people to observe and change ineffective patterns of thinking. For psychosis, CBT teaches someone to critically evaluate an experience to determine whether or not the experience is real.
  • Supportive psychotherapy—teaches a person to cope with developing and living with psychosis. The therapist attempts to reinforce a person’s healthy ways of thinking and reduce internal conflict.
  • Cognitive enhancement therapy (CET)—builds brain capacity through the use of computer exercises and group work. Increasing cognitive functions, such as the ability to organize thoughts, is the ultimate goal.
  • Family psychoeducation and support—gives families skills and support to help a loved one reach recovery. NAMI Basics, NAMI Family-To-Family and NAMI Family Support Groups are examples of programs the help people develop skills in collaboration, problem-solving and recovery support.
  • Peer support and support—connects people with others who have been through similar experiences. NAMI Peer-To-Peer and NAMI Connection are examples of peer-led programs that equip individuals with the tools they need to realize recovery while building supportive, caring relationships.

SCHIZOAFFECTIVE DISORDER

Schizoaffective disorder is a chronic mental health condition characterized primarily by symptoms of schizophrenia, such as hallucinations or delusions, and symptoms of a mood disorder, such as mania and depression.

Reading NAMI’s content on schizophrenia and bipolar disorder will offer many overlapping resources for schizoaffective disorder. Because schizoaffective disorder is less well-studied than the other two conditions, many interventions are borrowed from their treatment approaches.

Many people with schizoaffective disorder are often incorrectly diagnosed at first with bipolar disorder or schizophrenia because it shares symptoms of multiple mental health conditions.

Schizoaffective disorder is seen in about 0.3% of the population. Men and women experience schizoaffective disorder at the same rate, but men often develop the illness at an earlier age. Schizoaffective disorder can be managed effectively with medication and therapy. Co-occurring substance use disorders are a serious risk and require integrated treatment.

Is someone you care about dealing with Schizoaffective Disorder? Or are you? We can help. Click to email our Helpline for more support.

The symptoms of schizoaffective disorder can be severe and need to be monitored closely. Depending on the type of mood disorder diagnosed, depression or bipolar disorder, people will experience different symptoms:

  • Hallucinations, which are seeing or hearing things that aren’t there.
  • Delusions, which are false, fixed beliefs that are held regardless of contradictory evidence.
  • Disorganized thinking. A person may switch very quickly from one topic to another or provide answers that are completely unrelated.
  • Depressed mood. If a person has been diagnosed with schizoaffective disorder depressive type they will experience feelings of sadness, emptiness, feelings of worthlessness or other symptoms of depression.
  • Manic behavior. If a person has been diagnosed with schizoaffective disorder: bipolar type they will experience feelings of euphoria, racing thoughts, increased risky behavior and other symptoms of mania.

The exact cause of schizoaffective disorder is unknown. A combination of causes may contribute to the development of schizoaffective disorder.

  • Genetics. Schizoaffective disorder tends to run in families. This does not mean that if a relative has an illness, you will absolutely get it. But it does mean that there is a greater chance of you developing the illness.
  • Brain chemistry and structure. Brain function and structure may be different in ways that science is only beginning to understand. Brain scans are helping to advance research in this area.
  • Stress. Stressful events such as a death in the family, end of a marriage or loss of a job can trigger symptoms or an onset of the illness.
  • Drug use. Psychoactive drugs such as LSD have been linked to the development of schizoaffective disorder.

Schizoaffective disorder can be difficult to diagnose because it has symptoms of both schizophrenia and either depression or bipolar disorder. There are two major types of schizoaffective disorder: bipolar type and depressive type. To be diagnosed with schizoaffective disorder a person must have the following symptoms.

  • A period during which there is a major mood disorder, either depression or mania, that occurs at the same time that symptoms of schizophrenia are present.
  • Delusions or hallucinations for two or more weeks in the absence of a major mood episode.
  • Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the illness.
  • The abuse of drugs or a medication are not responsible for the symptoms.

Medications

Doctors and other mental health professionals will often prescribe medications to relieve symptoms of psychosis, stabilize mood and treat depression. The only medication approved by the FDA to treat schizoaffective disorder is the antipsychotic drug paliperidone (Invega).

However, some medications approved for the treatment of other mental health conditions may be helpful for schizoaffective disorder. These medications include:

  • Antipsychotics. A health care provider will prescribe antipsychotics to relieve symptoms of psychosis, such as delusions and hallucinations.
  • Antidepressants. When schizoaffective disorder is depressive-type antidepressants can alleviate feelings of sadness, despair and trouble concentrating.
  • Mood stabilizers. When bipolar disorder is the underlying mood disorder, mood stabilizers can help stabilize the highs and lows.

Psychotherapy

Family involvement, psychosocial strategies, self-care peer support, psychotherapy and integrated care for co-occurring substance abuse can all be part of an individual support plan.

  • Cognitive behavioral therapy (CBT) helps change the negative thinking and behavior associated with feelings of depression. The goal of this therapy is to recognize negative thoughts and to teach coping strategies. With conditions like schizoaffective disorder that have symptoms of psychosis, additional cognitive therapy is added to basic CBT (CBTp). CBTp helps people develop coping strategies for persistent symptoms that do not respond to medicine.

Alternative Treatment Options

For cases where medication and psychotherapy do not work for a person with schizoaffective disorder, ECT may be worth considering. ECT involves transmitting short electrical impulses into the brain. Although ECT is a highly effective treatment for severe depression, it is not the first choice in treating schizoaffective disorder.

Cultural Considerations

Research has shown that African Americans and Latinos are more likely to be misdiagnosed with schizoaffective disorder, so people who have been diagnosed should make sure that their mental health professional understands their background and shares their expectations for treatment.

Laura Zukerman

Owner and Founder At The Goddess Bibles A Memoir By Laura Zukerman

Becoming Your Inner Goddess

Goddess on Fire

Schizophrenia

Schizophrenia is a serious mental illness that interferes with a person’s ability to think clearly, manage emotions, make decisions and relate to others. It is a complex, long-term medical illness, affecting about 1% of Americans. Although schizophrenia can occur at any age, the average age of onset tends to be in the late teens to the early 20s for men, and the late 20s to early 30s for women. It is uncommon for schizophrenia to be diagnosed in a person younger than 12 or older than 40. It is possible to live well with schizophrenia.

It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a change of friends, a drop in grades, sleep problems, and irritability—common and nonspecific adolescent behavior. Other factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In young people who develop schizophrenia, this stage of the disorder is called the “prodromal” period.

With any condition, it’s essential to get a comprehensive medical evaluation in order to obtain the best diagnosis. For a diagnosis of schizophrenia, some of the following symptoms are present in the context of reduced functioning for a least 6 months:

Hallucinations. These include a person hearing voices, seeing things, or smelling things others can’t perceive. The hallucination is very real to the person experiencing it, and it may be very confusing for a loved one to witness. The voices in the hallucination can be critical or threatening. Voices may involve people that are known or unknown to the person hearing them.

Delusions. These are false beliefs that don’t change even when the person who holds them is presented with new ideas or facts. People who have delusions often also have problems concentrating, confused thinking, or the sense that their thoughts are blocked.

Negative symptoms are ones that diminish a person’s abilities. Negative symptoms often include being emotionally flat or speaking in a dull, disconnected way. People with the negative symptoms may be unable to start or follow through with activities, show little interest in life, or sustain relationships. Negative symptoms are sometimes confused with clinical depression.

Cognitive issues/disorganized thinking. People with the cognitive symptoms of schizophrenia often struggle to remember things, organize their thoughts or complete tasks. Commonly, people with schizophrenia have anosognosiaor “lack of insight.” This means the person is unaware that he has the illness, which can make treating or working with him much more challenging.

Research suggests that schizophrenia may have several possible causes:

  • Genetics. Schizophrenia isn’t caused by just one genetic variation, but a complex interplay of genetics and environmental influences. While schizophrenia occurs in 1% of the general population, having a history of family psychosis greatly increases the risk. Schizophrenia occurs at roughly 10% of people who have a first-degree relative with the disorder, such as a parent or sibling. The highest risk occurs when an identical twin is diagnosed with schizophrenia. The unaffected twin has a roughly 50% chance of developing the disorder.
  • Environment. Exposure to viruses or malnutrition before birth, particularly in the first and second trimesters has been shown to increase the risk of schizophrenia. Inflammation or autoimmune diseases can also lead to increased immune system
  • Brain chemistry. Problems with certain brain chemicals, including neurotransmitters called dopamine and glutamate, may contribute to schizophrenia. Neurotransmitters allow brain cells to communicate with each other. Networks of neurons are likely involved as well.
  • Substance use. Some studies have suggested that taking mind-altering drugs during teen years and young adulthood can increase the risk of schizophrenia. A growing body of evidence indicates that smoking marijuana increases the risk of psychotic incidents and the risk of ongoing psychotic experiences. The younger and more frequent the use, the greater the risk. Another study has found that smoking marijuana led to earlier onset of schizophrenia and often preceded the manifestation of the illness.

Diagnosing schizophrenia is not easy. Sometimes using drugs, such as methamphetamines or LSD, can cause a person to have schizophrenia-like symptoms. The difficulty of diagnosing this illness is compounded by the fact that many people who are diagnosed do not believe they have it. Lack of awareness is a common symptom of people diagnosed with schizophrenia and greatly complicates treatment.

While there is no single physical or lab test that can diagnosis schizophrenia, a health care provider who evaluates the symptoms and the course of a person’s illness over six months can help ensure a correct diagnosis. The health care provider must rule out other factors such as brain tumors, possible medical conditions and other psychiatric diagnoses, such as bipolar disorder.

To be diagnosed with schizophrenia, a person must have two or more of the following symptoms occurring persistently in the context of reduced functioning:

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Disorganized or catatonic behavior
  • Negative symptoms

Delusions or hallucinations alone can often be enough to lead to a diagnosis of schizophrenia. Identifying it as early as possible greatly improves a person’s chances of managing the illness, reducing psychotic episodes, and recovering. People who receive good care during their first psychotic episode are admitted to the hospital less often, and may require less time to control symptoms than those who don’t receive immediate help. The literature on the role of medicines early in treatment is evolving, but we do know that psychotherapy is essential.

People can describe symptoms in a variety of ways. How a person describes symptoms often depends on the cultural lens she is looking through. African Americans and Latinos are more likely to be misdiagnosed, probably due to differing cultural or religious beliefs or language barriers. Any person who has been diagnosed with schizophrenia should try to work with a health care professional that understands his or her cultural background and shares the same expectations for treatment.

With medication, psychosocial rehabilitation, and family support, the symptoms of schizophrenia can be reduced. People with schizophrenia should get treatment as soon as the illness starts showing, because early detection can reduce the severity of their symptoms.

Recovery while living with schizophrenia is often seen over time, and involves a variety of factors including self-learning, peer support, school and work and finding the right supports and treatment.

Medication

Typically, a health care provider will prescribe antipsychotics to relieve symptoms of psychosis, such as delusions and hallucinations. Due to lack of awareness of having an illness and the serious side effects of medication used to treat schizophrenia, people who have been prescribed them are often hesitant to take them.

First Generation (Typical) Antipsychotics

These medications can cause serious movement problems that can be short (dystonia) or long term (called tardive dyskinesia), and also muscle stiffness. Other side effects can also occur.

  • Chlorpromazine (Thorazine)
  • Fluphenazine (Proxlixin)
  • Haloperidol (Haldol)
  • Loxapine (Loxitane)
  • Perphenazine (Trilafon)
  • Thiothixene (Navane)
  • Trifluoperazine (Stelazine)

Second Generation (Atypical) Antipsychotics

These medications are called atypical because they are less likely to block dopamine and cause movement disorders. They do, however, increase the risk of weight gain and diabetes. Changes in nutrition and exercise, and possibly medication intervention, can help address these side effects.

  • Aripiprazole (Abilify)
  • Asenapine (Saphris)
  • Clozapine (Clozaril)
  • Iloperidone (Fanapt)
  • Lurasidone (Latuda)
  • Olanzapine (Zyprexa)
  • Paliperidone (Invega)
  • Risperidone (Risperdal)
  • Quetiapine (Seroquel)
  • Ziprasidone (Geodon)

One unique second generation antipsychotic medication is called clozapine. It is the only FDA approved antipsychotic medication for the treatment of refractory schizophrenia and has been the only one indicated to reduce thoughts of suicide. However, it does have multiple medical risks in addition to these benefits. Read a more complete discussion of these risk and benefits.

Psychotherapy

Cognitive behavioral therapy (CBT) is an effective treatment for some people with affective disorders. With more serious conditions, including those with psychosis, additional cognitive therapy is added to basic CBT (CBTp). CBTp helps people develop coping strategies for persistent symptoms that do not respond to medicine.

Supportive psychotherapy is used to help a person process his experience and to support him in coping while living with schizophrenia. It is not designed to uncover childhood experiences or activate traumatic experiences, but is rather focused on the here and now.

Cognitive Enhancement Therapy (CET) works to promote cognitive functioning and confidence in one’s cognitive ability. CET involves a combination of computer based brain training and group sessions. This is an active area of research in the field at this time.

Psychosocial Treatments

People who engage in therapeutic interventions often see improvement, and experience greater mental stability. Psychosocial treatments enable people to compensate for or eliminate the barriers caused by their schizophrenia and learn to live successfully. If a person participates in psychosocial rehabilitation, she is more likely to continue taking their medication and less likely to relapse. Some of the more common psychosocial treatments include:

  • Assertive Community Treatment (ACT) provides comprehensive treatment for people with serious mental illnesses, such as schizophrenia. Unlike other community-based programs that connect people with mental health or other services, ACT provides highly individualized services directly to people with mental illness. Professionals work with people with schizophrenia and help them meet the challenges of daily life. ACT professionals also address problems proactively, prevent crises, and ensure medications are taken.
  • Peer support groups like NAMI Peer-to-Peer encourage people’s involvement in their recovery by helping them work on social skills with others.

Complementary Health Approaches

Omega-3 fatty acids, commonly found in fish oil, have shown some promise for treating and managing schizophrenia. Some researchers believe that omega-3 may help treat mental illness because of its ability to help replenish neurons and connections in affected areas of the brain.

Additional Concerns

Physical Health. People with schizophrenia are subject to many medical risks, including diabetes and cardiovascular problems, and also smoking and lung disease. For this reason, coordinated and active attention to medical risks is essential.

Substance Abuse. About 25% of people with schizophrenia also abuse substances such as drugs or alcohol. Substance abuse can make the treatments for schizophrenia less effective, make people less likely to follow their treatment plans, and even worsen their symptoms.

Laura Zukerman

Owner and Founder At The Goddess Bibles A Memoir By Laura Zukerman

Becoming Your Inner Goddess

Goddess on Fire

BIPOLAR DISORDER, and how to deal with it when someone you love has it. If you have it, this will help you.

Bipolar disorder

Bipolar disorder is a chronic mental illness that affects about 2.6 percent of Americans each year. It is characterized by episodes of energetic, manic highs and extreme, sometimes depressive lows.

These can affect a person’s energy level and ability to think reasonably. Mood swings caused by bipolar disorder are much more severe than the small ups and downs most people experience on a daily basis.

What are the symptoms?

Bipolar I disorder can cause unpredictable high and low mood swings, also known as manic and depressive episodes.

It’s impossible to predict how long mood episodes may last. You might be severely depressed for a brief or extended period of time before entering into a manic episode. Mania could last anywhere from days to months as well. You may even experience manic and depressive symptoms at the same time, which is known as a mixed episode.

MIXED EPISODES

Mixed episodes occur when lows and highs are experienced at the same time. 


For example, you may be having a mixed episode if you’re: Having trouble concentrating. Having too much energy while feeling very sad. Feeling very up or high. Thinking about death or suicide. Exhausted but overly anxious. Feeling jumpy or wired. Feeling like you can’t enjoy anything. Feeling like your thoughts are coming very fast. Forgetting things a lot. Being talkative while pessimistic. Becoming more active than usual. Having trouble sleeping. Behaving impulsively while feeling exhausted.

What can trigger bipolar I episodes?

Approaches to managing bipolar I

When you have bipolar I, it can seem like your mood episodes are random.

But both depressive and manic episodes are often triggered by something. Being aware of your triggers or warning signs can help you in managing your mood episodes.

Common triggers for bipolar I disorder may include:

  • Sleep deprivation
  • Medications
  • Seasonal changes
  • Substance abuse
  • Stress

Some triggers, such as stress, you can control or manage, while others you may not. Be sure to discuss your triggers with your doctor.

How is it diagnosed?

My journey to a bipolar diagnosis

Bipolar I can go unrecognized for years by not only those who suffer with it, but by family, friends, and even healthcare providers. Manic symptoms are reported less often than depressive ones for most people with bipolar I, so healthcare providers may only see, and therefore treat, symptoms of depression instead of bipolar I disorder.

The first step: If you think you may have bipolar I, talk with a doctor. They can complete a physical exam to rule out other conditions.

Why this matters: People with bipolar disorder often have other health problems including substance abuse, anxiety disorders, thyroid disease, heart disease, and obesity. These conditions can have similar symptoms to bipolar I, which can complicate the diagnosis of bipolar I disorder.

Bipolar I depression is different

Bipolar refers to the opposite ends (the poles) of the emotional spectrum—lows (depression) and the highs (mania).  On top of the deep, unshakeable sadness or emptiness felt by patients with Major Depressive Disorder (MDD), patients with bipolar I also experience manic episodes. Treatments for MDD may not be effective for patients with bipolar I disorder, so it’s important to get the right diagnosis.

How is it treated?

The most effective treatment plan for bipolar I often includes a combination of medication, talk therapy, support groups, and improving overall health and wellness.

However, the cornerstone of every treatment plan is medication and finding the right one for you could take some time. Some people may require more than one medication to experience relief.

Your healthcare provider will start the process by evaluating your symptoms and treatments. So, it’s critical to share all the symptoms you’re experiencing now or have experienced in the past, as well as the medications you’re taking now or have taken in the past.

It’s difficult to be patient when bipolar I affects your life

Maybe you’ve already tried a lot of solutions. You want to get your bipolar I under control, and so does your doctor.

If you are experiencing symptoms like extreme lows and highs of your mood, let your doctor know. Ask if VRAYLAR may help.

Additional Resources


IMPORTANT RISK INFORMATION

What is the most important information I should know about VRAYLAR?

Elderly people with dementia-related psychosis (having lost touch with reality due to confusion and memory loss) taking medicines like VRAYLAR are at an increased risk of death. VRAYLAR is not approved for treating patients with dementia-related psychosis.

Antidepressants may increase suicidal thoughts or actions in some children and young adults within the first few months of treatment and when the dose is changed. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, especially sudden changes in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant is started or when the dose is changed. Report any change in these symptoms immediately to the doctor.

  • Stroke (cerebrovascular problems) in elderly people with dementia-related psychosis that can lead to death
  • Neuroleptic malignant syndrome (NMS): Call your healthcare provider or go to the nearest hospital emergency room right away if you have high fever, stiff muscles, confusion, increased sweating, or changes in breathing, heart rate, and blood pressure. These can be symptoms of a rare but potentially fatal side effect called NMS. VRAYLAR should be stopped if you have NMS
  • Uncontrolled body movements (tardive dyskinesia or TD): VRAYLAR may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop taking VRAYLAR. Tardive dyskinesia may also start after you stop taking VRAYLAR
  • Late-occurring side effects: VRAYLAR stays in your body for a long time. Some side effects may not happen right away and can start a few weeks after starting VRAYLAR, or if your dose increases. Your healthcare provider should monitor you for side effects for several weeks after starting or increasing dose of VRAYLAR
  • Problems with your metabolism, such as:
    • High blood sugar and diabetes: Increases in blood sugar can happen in some people who take VRAYLAR. Extremely high blood sugar can lead to coma or death. Your healthcare provider should check your blood sugar before or soon after starting VRAYLAR and regularly during treatment. Tell your healthcare provider if you have symptoms such as feeling very thirsty, very hungry, or sick to your stomach, urinating more than usual, feeling weak, tired, confused, or your breath smells fruity
    • Increased fat levels (cholesterol and triglycerides) in your blood: Your healthcare provider should check fat levels in your blood before or soon after starting VRAYLAR and during treatment
    • Weight gain: Weight gain has been reported with VRAYLAR. You and your healthcare provider should check your weight before and regularly during treatment
  • Low white blood cell count: Low white blood cell counts have been reported with antipsychotic drugs, including VRAYLAR. This may increase your risk of infection. Very low white blood cell counts, which can be fatal, have been reported with other antipsychotics. Your healthcare provider may do blood tests during the first few months of treatment with VRAYLAR
  • Decreased blood pressure (orthostatic hypotension): You may feel lightheaded or faint when you rise too quickly from a sitting or lying position
  • Falls: VRAYLAR may make you sleepy or dizzy, may cause a decrease in blood pressure when changing position (orthostatic hypotension), and can slow thinking and motor skills, which may lead to falls that can cause fractures or other injuries
  • Seizures (convulsions)
  • Impaired judgment, thinking, and motor skills: Do NOT drive, operate machinery, or do other dangerous activities until you know how VRAYLAR affects you. VRAYLAR may make you drowsy
  • Increased body temperature: Do not become too hot or dehydrated during VRAYLAR treatment. Do not exercise too much. In hot weather, stay inside in a cool place if possible. Stay out of the sun. Do not wear too much clothing or heavy clothing. Drink plenty of water
  • Difficulty swallowing that can cause food or liquid to get into your lungs
  • have or have had heart problems or a stroke
  • have or have had low or high blood pressure
  • have or have had diabetes or high blood sugar in you or your family
  • have or have had high levels of total cholesterol, LDL-cholesterol, or triglycerides; or low levels of HDL-cholesterol
  • have or have had seizures (convulsions)
  • have or have had kidney or liver problems
  • have or have had low white blood cell count
  • are pregnant or plan to become pregnant. VRAYLAR may harm your unborn baby. Talk to your healthcare provider about the risk to your unborn baby if you take VRAYLAR during pregnancy. If you become pregnant or think you are pregnant during treatment, talk to your healthcare provider about registering with the National Pregnancy Registry for Atypical Antipsychotics at 1-866-961-2388 or 
    http://www.womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/
  • are breastfeeding or plan to breastfeed. It is not known if VRAYLAR passes into breast milk. Talk to your healthcare provider about the best way to feed your baby during treatment with VRAYLAR
  • The most common side effects were difficulty moving or slow movements, tremors, uncontrolled body movements, restlessness and feeling like you need to move around, sleepiness, nausea, vomiting, and indigestion.

Persistent depressive disorder

Persistent depressive disorder is a chronic type of depression. It is also known as dysthymia. While dysthymic depression isn’t intense, it can interfere with daily life. People with this condition experience symptoms for at least two years. About 1.5 percent of American adults experience dysthymia each year.

Generalized anxiety disorder

Generalized anxiety disorder (GAD) goes beyond regular everyday anxiety, like being nervous before a presentation. It causes a person to become extremely worried about many things, even when there’s little or no reason to worry.

Those with GAD may feel very nervous about getting through the day. They may think things won’t ever work in their favor. Sometimes worrying can keep people with GAD from accomplishing everyday tasks and chores. GAD affects about 3 percent of Americans every year.

Major depressive disorder

Major depressive disorder (MDD) causes feelings of extreme sadness or hopelessness that lasts for at least two weeks. This condition is also called also called clinical depression.

People with MDD may become so upset about their lives that they think about or try to commit suicide. About 7 percent of Americans experience at least one major depressive episode each year.

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) causes constant and repetitive thoughts, or obsessions. These thoughts happen with unnecessary and unreasonable desires to carry out certain behaviors, or compulsions.

Many people with OCD realize that their thoughts and actions are unreasonable, yet they cannot stop them. More than 2 percent of Americans are diagnosed with OCD at some point in their lifetime.

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental illness that’s triggered after experiencing or witnessing a traumatic event. Experiences that can cause PTSD can range from extreme events, like war and national disasters, to verbal or physical abuse.

Symptoms of PTSD may include flashbacks or being easily startled. It’s estimated that 3.5 percent of American adults experience PTSD.

Schizophrenia

Schizophrenia impairs a person’s perception of reality and the world around them. It interferes with their connection to other people. It’s a serious condition that needs treatment.

They might experience hallucinations, have delusions, and hear voices. These can potentially put them in a dangerous situation if left untreated. It’s estimated that 1 percent of the American population experiences schizophrenia.

Social anxiety disorder

Social anxiety disorder, sometimes called social phobia, causes an extreme fear of social situations. People with social anxiety may become very nervous about being around other people. They may feel like they’re being judged.

This can make it hard to meet new people and attend social gatherings. Approximately 15 million adults in the United States experience social anxiety each year.