Category Archives: Mental Health

Why Smokers Do and Don’t Quit Smoking

My father-in-law is in his 70s and still smokes every day. He’s tried to quit before, but in the recent years has decided that he was old enough to live his life however he wanted, and that included smoking. Nevermind the fact that he has had a quadruple bypass operation for his clogged arteries (and other coronary operations), is on polypharmacy, leads a sedentary lifestyle, and has been nagged by his doctors and us about quitting smoking for years.

I know that many doctors – especially internists and general practitioners/family doctors – often encourage their smoking patients to quit smoking, citing the harms of smoking and the benefits of not smoking relative to the patient’s capacity to heal. Even those of us who do not practice medicine but work in the healthcare field know that smoking wreaks havoc on a variety of bodily functions right down to the molecular level.

Earlier this year, three Greek researchers published a study on why smokers quit or don’t quit smoking in Harm Reduction Journal (source: Harm Reduction Journal, March 29, 2006, 3:13 doi:10.1186/1477-7517-3-13). What they found may give some insight not just to medical doctors with an interest to helping their patients quit smoking, but for those of us with a personal interest to help either our loved ones or ourselves to quit smoking.

A popular assumption many doctors have about smokers quitting smoking is to introduce cognitive dissonance – an emotional state of mind where two beliefs are in conflict with each other. A person experiencing cognitive dissonance will move to resolve that conflict of belief. If a smoker believes that smoking is harmful to one’s health yet continues to smoke, the smoker experiences this contradiction and would move to resolve that contradiction. One would assume that the smoker would then stop smoking – right?

I doubt that smokers would deny the harmful effects of smoking. We can see from what’s happening in society that this is not the case – people still smoke even when they’ve been exposed to anti-smoking campaigns, nagging from friends and loved ones (I admit, I am one of those annoying people who remind their friends that smoking is bad for them), and shock-and-awe pictures of lungs blackened by chronic smoking.

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How Work-Life Imbalance Makes You Sick

Dr. Sheldon Cohen‘s keynote presentation at the 8th International Congress of Behavioral Medicine was published in International Journal of Behavioral Medicine (2005 Vol 12 No 3, 123-131).

Cohen summarized 20 years of research on psychosocial influences on infection susceptibility.

Cohen also debunks these pervasive myths of stress and disease:

  • Myth: Infectious disease-causing agents is wholly responsible for causing infectious disease.
  • Myth: Stress suppresses the immune system, which makes us susceptible to infections and disease.
  • Myth: Stress overstimulates cortisol production, which leads to susceptibility to disease.

According to Cohen’s article, infectious disease-causing agents are not sufficient causative agents for disease. Our immune system’s modulating responses against viruses in our body determine whether we become infected.

We would also assume that health-related behaviors like smoking, alcohol consumption, sleep, exercise, and diet contributed to disease susceptibility. Cohen has observed that these behaviors were independent of susceptibility to the common cold across five different strains of viruses (including 3 rhinovirus types).

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Truth is More Than Just One Side of the Story

This morning two newsfeeds came to my attention. One came from an open letter from Mental Health America, a non-profit organization. Mental Health America stated its agreement with the FDA not the extend the black box warning label of suicidal ideation risk across all age groups (not just children and teens) to antidepressants after recognizing that antidepressant use may actually lower suicide ideation in elderly adults.

Mental Health America then stated its disappointment with the FDA for extending the black box warning label of suicidal ideation risk of antidepressant use to age 25. The organization’s position is that 90% of suicides occur from untreated or undertreated depression. This extended warning label may discourage treatment in individuals suffering from depression and mental illnesses who may benefit from antidepressants. Continue reading

Interview on Self-Injury

Dr. Jane Chin: What are the biggest misconceptions or “myths” people have about self-injury?

Dr. Deborah Serani: I’d have to say that the biggest misconception about self-injury is that most people think that those who cut or self-injure are suicidal. Though any behavior that puts a person in harm’s way requires clinical evaluation, the basic reason individuals cut or self-harm comes from the wish “to control” or to “numb away feelings.”

Dr. Chin: Why is cutting or self injury such a difficult subject for people to talk about?

Dr. Serani: There is a lot of shame associated with this behavior. Seeing the scars or scabs serves as reminder to the person that they cannot find a better way to move through pent up feelings. They feel like they have failed or are flawed in some way, which exacerbates there negative feelings even more. Continue reading

Public Access to Articles on Antidepressant Safety

Journal of Child and Adolescent Psychopharmacology is a peer-reviewed journal published by Mary Ann Liebert, Inc. The February/April issue (Volume 16, 2006) explored the controversial topic of using selective serotonin reuptake inhibitors, or SSRIs to treat depression in children and teens.

Peer Review: Peer review of a scientific publication is considered a rigorous process that makes a published scientific study a credible source of information. A panel of the researcher’s “peers” assess the submitted publication for scientific merit and objectivity.

This topic has been controversial because of the debate around safety and effectiveness of this class of drugs for what is considered a vulnerable population. Based on the potential impact of this controversy, the publisher has made this double issue free for viewing.

View: http://www.liebertonline.com/toc/cap/16/1-2

pills.gif The association between treating teens and children with SSRI drugs and an increased risk of suicide has made this a highly public controversy – including a past episode of Law & Order on television.

This journal is clearly aimed for healthcare professionals, researchers, and industry consultants. The publisher of the journal is a privately held media company that also publishes other magazines in biomedical research and biotechnology.

If readers are particularly interested in a specific article, I will be happy to help decipher it for you.