Marshmallow root, Althaea officinalis, has a long history of use in traditional medicine, especially for coughs and digestive issues. In this article, we look at both the evidence behind the health benefits of marshmallow root and its possible side effects.
Tuesday, April 2, 2019
Medical News Today: Gut microbes can spur immune system to attack cancer
An international study has identified gut bacteria that activate the immune system to slow melanoma growth in mice and highlights a key signaling pathway.
Medical News Today: Mental health can impact memory decades later
A new longitudinal cohort study has confirmed a link between experiencing mental health problems throughout adulthood and having poorer memory in midlife.
Medical News Today: Breast cancer: Estrogen byproducts may predict outlook
New research finds an association between the ratio of two estrogen metabolites and the risk of all-cause mortality among women with breast cancer.
Infertility: Other people’s pregnancies
When you are having difficulty becoming or staying pregnant, it often seems as if everyone around you –– friends, family, colleagues –– is pregnant. How can you navigate your world and maintain your relationships while coping with the pain and isolation infertility so often brings?
Support for navigating other people’s pregnancies
In my experience, solid relationships survive infertility. It can be excruciatingly painful when you learn that a friend is pregnant. But if your relationship is based on mutual respect and caring, you will get through it. Trust this, while considering the suggestions below to help you take care of yourself.
- Mean thoughts do not make you a bad person. Most of us consider ourselves good people who care about our friends and share in their happiness. So it’s jolting to encounter mean thoughts that so often accompany infertility. Please don’t be harsh to yourself if you envy your friend or wish her pregnancy would vanish. Thoughts like these are common. I have often seen great relief on the faces of clients when I say, “It’s okay. You’d be happy for your friend if she won the lottery or got a great new house or job. But how can you be happy for her when you long for pregnancy and you have just learned she is pregnant?”
- It gets easier. Learning that your friend is pregnant is often the most difficult time in your experience of her pregnancy. It can help a lot if your friend is sensitive to how and when she tells you. Ideally, this would happen early on. You’d be alone together and she’d use words that acknowledge how hard it is for you. But there is no good way to get this news. I think you will find the sting will subside as her pregnancy progresses and you are no longer feeling bewildered by how she has become pregnant while you have not.
- Navigate baby showers with care. Baby showers are the worst place to be if you are trying to avoid painful reminders that your friend is pregnant and you are not. After all, showers celebrate pregnancy. Lots of oohing and ahhing about cute little baby clothes and baby paraphernalia is likely.
“But can I skip my friend’s shower?” you ask. My answer is a resounding yes. Assuming your friend is aware of your pain, she will understand. She will accept and support your decision if you are straight with her and acknowledge that being at the shower would be really difficult for you. I suggest that you offer to take her to lunch or create some other enjoyable time together. You can give her a shower gift then, offer abundant good wishes, but not have to do so among pregnancy chatter. - Choose two, rather than a group. Generally, steer clear of group settings. When it’s just the two of you, you have some control of the conversation. You can focus on things other than pregnancy or, if you choose, talk about her pregnancy in ways that feel okay enough to you. In a group, control vanishes. Without warning, women prattle about past pregnancies, or worse still, complain about pregnancy symptoms they are having now.
Handling news of a birth
The news that a friend has given birth is as challenging as learning she is pregnant. Again, my best advice is to look for one-on-one opportunities. Plan a time when you can bring dinner to her and her family. Or plan to have a meal together, since others are unlikely to be visiting at the same time. And remember that you have all sorts of plausible reasons for staying only a short time — you know she is sleep deprived, you know they are being flooded by visitors, you know that she will be much more up for visiting in a month or so.
A few words on mutual support
Your ability to maintain important relationships when friends are pregnant is not one-sided. It relies also on your friend’s ability to support you in the ways you want and need to be supported during infertility. This is a complex subject, best explored in a future blog, but I’ll share a few parting thoughts on mutuality. Your friend can’t support you if she doesn’t know the basics of what you are going through. That said, if she has conceived and carried with ease, she is unlikely to really “get it.” You will probably do best if you resolve to accept that she doesn’t get it. She may be struggling to know what to say and how to say it. In many ways, knowing this — that she really cares and is trying — may be what matters most to sustain the friendship.
The post Infertility: Other people’s pregnancies appeared first on Harvard Health Blog.
Discontinuation syndrome and antidepressants
Discontinuation and change are part of life. We all start and stop various activities. Jobs change, relationships change. So, too, may medical treatments, such as antidepressants that help many people navigate depression and anxiety. Planning changes in advance tends to make things easier and smoother. You may start a medication for treatment and discover that it’s not helping your particular medical issue. Or perhaps you’re having side effects. Or maybe your condition has improved, and you no longer need the drug. If so, working with your doctor to change or stop taking an antidepressant slowly may help you avoid uncomfortable symptoms known as discontinuation syndrome.
What is discontinuation syndrome?
Discontinuation syndrome can be a consequence of stopping certain types of antidepressants: selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). You may have heard about this from a friend or on the news, or perhaps read a recent New York Times article on this topic. If you are taking an antidepressant, you may be concerned about your own response to stopping the medication.
Let’s clarify what the term means. Discontinuation syndrome describes a range of symptoms that may occur in patients taking SSRIs or SNRIs after stopping quickly. These can include:
- nausea
- feelings of vertigo
- trouble sleeping
- odd sensory symptoms, such as “pinging” feelings in the skin, or what some people describe as a “zapping” sensation in the brain
- feeling anxious.
As many as one in five people who stop an antidepressant quickly may experience at least a mild version of these symptoms. Usually discontinuation syndrome occurs when a person has been taking medication for at least six weeks or longer. And it’s more likely to happen if you have been taking medication for a long time.
When people stop taking medication, some antidepressants leave the body quickly (short half-life), while others leave the body more slowly (long half-life). Discontinuation symptoms may occur in either case, especially if a drug is stopped abruptly.
Symptoms usually start two to four days after stopping the medicine. They usually go away after four to six weeks. In rare cases, they may last as long as a year.
What are SSRIs and SNRIs?
An SSRI is a type of antidepressant. Examples include fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). These drugs make a neurotransmitter called serotonin more available in the brain. Experts believe this helps reduce symptoms of depression and anxiety and regulate mood.
SNRIs are another type of antidepressant. Examples include duloxetine (Cymbalta) and venlafaxine (Effexor). These drugs work on two neurotransmitters: serotonin and norepinephrine.
These two classes of antidepressants are groundbreaking. Older antidepressants had many hard-to-tolerate side effects, including severe fatigue, dry mouth and eyes, and difficulty urinating. In contrast, SSRIs and SNRIs are generally well tolerated. Like all drugs, though, they do have side effects, including effects on sexual function, which can be difficult to talk about, but are important to tell your physician. Each drug is a little different, and an experienced psychiatrist can help people choose the best option for them.
We encourage patients to think broadly about treating depression. Treating depression with medicine can be very effective. Talk therapy, including cognitive behavioral therapy, also has been shown to be very helpful, as have exercise and social activities. Think about treatment for depression like a menu at a restaurant where you can choose foods from more than one column. Often, a combination of medicine and nondrug treatment maximizes the benefit of both.
What if you’re ready to stop taking an antidepressant?
Let’s suppose you have been on an SSRI like paroxetine for several years and having been working with a psychologist whom you really trust. Your depression is better and you feel ready to stop your medicine. To help you avoid discontinuation syndrome, work closely with the doctor who prescribes your medicine.
While some drugs can either be stopped or very quickly tapered, almost all SSRIs and SNRIs need to be slowly decreased. You may be instructed to drop the dose by small amounts each week, or perhaps every two weeks, or even every month. If you’ve been on a higher dose of medication, a taper may take as long as six months. It’s not worth rushing it because you don’t want to develop discontinuation symptoms. However, if you do, your doctor can increase the dose and then after a little while, you can try the taper again.
We have had patients tell us that physicians don’t want to start these antidepressants for fear of triggering discontinuation syndrome when it’s time to stop taking the medicine. But these are useful and safe medications for most people, and it’s worth exploring their potential carefully. Depression is a serious and common affliction that should be actively treated by all effective methods.
Christopher Bullock, MD, MFA, 1947–2018, was a psychiatrist, psychoanalyst, and writer. He loved Gary Snyder’s poetry; “all the junk that goes with being human” was a quote that inspired his life, his work, and his illness.
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Medical News Today: Is sugar the key to treating lung problems?
Research in mouse models has revealed a surprising link between the activity of immune cells in the lungs and their ability to process simple sugars.
