7 Steps to Becoming a Happier Person

By Tom Valeo
WebMD Feature

Reviewed by Cynthia Dennison Haines, MD

A popular greeting card attributes this quote to Henry David Thoreau: “Happiness is like a butterfly: the more you chase it, the more it will elude you, but if you turn your attention to other things, it will come and sit softly on your shoulder.”

With all due respect to the author of Walden, that just isn’t so, according to a growing number of psychologists. You can choose to be happy, they say. You can chase down that elusive butterfly and get it to sit on your shoulder. How? In part, by simply making the effort to monitor the workings of your mind.

Research has shown that your talent for happiness is, to a large degree, determined by your genes. Psychology professor David T. Lykken, author of Happiness: Its Nature and Nurture, says that “trying to be happier is like trying to be taller.” We each have a “happiness set point,” he argues, and move away from it only slightly.

And yet, psychologists who study happiness -- including Lykken -- believe we can pursue happiness. We can do this by thwarting negative emotions such as pessimism, resentment, and anger. And we can foster positive emotions, such as empathy, serenity, and especially gratitude.

Happiness Strategy # 1: Don't Worry, Choose Happy

The first step, however, is to make a conscious choice to boost your happiness. In his book, The Conquest of Happiness, published in 1930, the philosopher Bertrand Russell had this to say: “Happiness is not, except in very rare cases, something that drops into the mouth, like a ripe fruit. … Happiness must be, for most men and women, an achievement rather than a gift of the gods, and in this achievement, effort, both inward and outward, must play a great part.”

Today, psychologists who study happiness heartily agree. The intention to be happy is the first of The 9 Choices of Happy People listed by authors Rick Foster and Greg Hicks in their book of the same name.

“Intention is the active desire and commitment to be happy,” they write. “It’s the decision to consciously choose attitudes and behaviors that lead to happiness over unhappiness.”

Tom G. Stevens, PhD, titled his book with the bold assertion, You Can Choose to Be Happy. “Choose to make happiness a top goal,” Stevens tells WebMD. “Choose to take advantage of opportunities to learn how to be happy. For example, reprogram your beliefs and values. Learn good self-management skills, good interpersonal skills, and good career-related skills. Choose to be in environments and around people that increase your probability of happiness. The persons who become the happiest and grow the most are those who also make truth and their own personal growth primary values.”

In short, we may be born with a happiness “set point,” as Lykken calls it, but we are not stuck there. Happiness also depends on how we manage our emotions and our relationships with others.

Jon Haidt, author of The Happiness Hypothesis, teaches positive psychology. He actually assigns his students to make themselves happier during the semester.

“They have to say exactly what technique they will use,” says Haidt, a professor at the University of Virginia, in Charlottesville. “They may choose to be more forgiving or more grateful. They may learn to identify negative thoughts so they can challenge them. For example, when someone crosses you, in your mind you build a case against that person, but that’s very damaging to relationships. So they may learn to shut up their inner lawyer and stop building these cases against people.”

Once you’ve decided to be happier, you can choose strategies for achieving happiness. Psychologists who study happiness tend to agree on ones like these.

Happiness Strategy #2: Cultivate Gratitude

In his book, Authentic Happiness, University of Pennsylvania psychologist Martin Seligman encourages readers to perform a daily “gratitude exercise.” It involves listing a few things that make them grateful. This shifts people away from bitterness and despair, he says, and promotes happiness.

Happiness Strategy #3: Foster Forgiveness

Holding a grudge and nursing grievances can affect physical as well as mental health, according to a rapidly growing body of research. One way to curtail these kinds of feelings is to foster forgiveness. This reduces the power of bad events to create bitterness and resentment, say Michael McCullough and Robert Emmons, happiness researchers who edited The Psychology of Happiness.

In his book, Five Steps to Forgiveness, clinical psychologist Everett Worthington Jr. offers a 5-step process he calls REACH. First, recall the hurt. Then empathize and try to understand the act from the perpetrator’s point of view. Be altruistic by recalling a time in your life when you were forgiven. Commit to putting your forgiveness into words. You can do this either in a letter to the person you’re forgiving or in your journal. Finally, try to hold on to the forgiveness. Don’t dwell on your anger, hurt, and desire for vengeance.

The alternative to forgiveness is mulling over a transgression. This is a form of chronic stress, says Worthington.

“Rumination is the mental health bad boy,” Worthington tells WebMD. “It’s associated with almost everything bad in the mental health field -- obsessive-compulsive disorder, depression, anxiety -- probably hives, too.”

Happiness Strategy #4: Counteract Negative Thoughts and Feelings

As Jon Haidt puts it, improve your mental hygiene. In The Happiness Hypothesis, Haidt compares the mind to a man riding an elephant. The elephant represents the powerful thoughts and feelings -- mostly unconscious -- that drive your behavior. The man, although much weaker, can exert control over the elephant, just as you can exert control over negative thoughts and feelings.

“The key is a commitment to doing the things necessary to retrain the elephant,” Haidt says. “And the evidence suggests there’s a lot you can do. It just takes work.”

For example, you can practice meditation, rhythmic breathing, yoga, or relaxation techniques to quell anxiety and promote serenity. You can learn to recognize and challenge thoughts you have about being inadequate and helpless.

“If you learn techniques for identifying negative thoughts, then it’s easier to challenge them,” Haidt said. “Sometimes just reading David Burns’ book, Feeling Good, can have a positive effect.”

Happiness Strategy #5: Remember, Money Can’t Buy Happiness

Research shows that once income climbs above the poverty level, more money brings very little extra happiness. Yet, “we keep assuming that because things aren’t bringing us happiness, they’re the wrong things, rather than recognizing that the pursuit itself is futile,” writes Daniel Gilbert in his book, Stumbling on Happiness. “Regardless of what we achieve in the pursuit of stuff, it’s never going to bring about an enduring state of happiness.”

Happiness Strategy #6: Foster Friendship

There are few better antidotes to unhappiness than close friendships with people who care about you, says David G. Myers, author of The Pursuit of Happiness. One Australian study found that people over 70 who had the strongest network of friends lived much longer.

“Sadly, our increasingly individualistic society suffers from impoverished social connections, which some psychologists believe is a cause of today’s epidemic levels of depression,” Myers writes. “The social ties that bind also provide support in difficult times.”

Happiness Strategy #7: Engage in Meaningful Activities

People are seldom happier, says psychologist Mihaly Csikszentmihalyi, than when they’re in the “flow.” This is a state in which your mind becomes thoroughly absorbed in a meaningful task that challenges your abilities. Yet, he has found that the most common leisure time activity -- watching TV -- produces some of the lowest levels of happiness.

To get more out of life, we need to put more into it, says Csikszentmihalyi. “Active leisure that helps a person grow does not come easily,” he writes in Finding Flow. “Each of the flow-producing activities requires an initial investment of attention before it begins to be enjoyable.”

So it turns out that happiness can be a matter of choice -- not just luck. Some people are lucky enough to possess genes that foster happiness. However, certain thought patterns and interpersonal skills definitely help people become an “epicure of experience,” says David Lykken, whose name, in Norwegian, means “the happiness.”

Happiness May Be in the Genes

Study Shows Inherited Personality Traits Play a Key Role in Happiness

By Salynn Boyles
WebMD Medical News

Reviewed by Louise Chang, MD

March 5, 2008 -- People tend to be hardwired for happiness, and new genetic research may help explain why.

Past studies suggest that while 50% of happiness is due to situational factors like health, relationships, and career, the other 50% is due to genes.

The new research identified largely inherited personality traits that researchers say are responsible for much of the genetic influence on happiness.

Having the right mix of these inherited traits leads to a "reserve" of happiness that can be called on in times of stress, they say.

"Traits like being active, sociable, conscientious, and not being overly anxious are related to happiness -- and these are also traits that are inherited," researcher Timothy Bates, PhD, tells WebMD.

(Are you happy? Do you believe that your genes make you happy or that you determine your own happiness? Talk about it on WebMD's Health Cafe message board.)

Genes and the Pursuit of Happiness

Bates and University of Edinburgh colleagues Alexander Weiss, PhD, and Michelle Luciano, PhD, have studied the science of happiness for the past 15 years.

Their latest study involved more than 900 identical and non-identical twin pairs who completed a standardized questionnaire designed to identify personality traits.

Since identical twins share all the same genes and non-identical twins do not, the researchers say they were able to determine the influence of genes on the personality traits and on happiness.

"Together with life and liberty, the pursuit of happiness is a core human desire," Weiss notes in a news release. "Although happiness is subject to a wide range of external influence, we have found that there is a heritable component of happiness which can be entirely explained by genetic architecture of personality."

The study appears in the March issue of the journal Psychological Science.

Achieving Happiness by Setting Goals

The findings do not mean that people who don't inherit happiness traits are destined to lead miserable lives, Bates says.

Bates, Weiss, and Luciano are studying whether adopting the traits associated with happiness can make people happy. Early findings suggest it can.

Since setting and achieving goals is a common trait in conscientious people, and conscientiousness is linked to happiness, study participants were asked to set five achievable goals that could be accomplished in a week.

"As soon as people started working toward these goals their happiness scores went up," Bates says. "When they were no longer working toward a goal their happiness scores dropped."

So while some people are genetically predisposed to being goal-oriented and others are not, the research suggests that it is the behavior that drives happiness, whether or not it comes naturally.

People who stay physically active and socially connected also tend to be happier, so adopting these traits is important for people who are naturally introverted, Bates says.

Can Money Buy Happiness?

The research builds on work done over 20 years suggesting a clear role for genes in happiness.

Situational factors do matter, Bates says, but they don't tend to affect happiness long term.

Studies consistently show that rich people are not much happier than poor people, and even people with severe physical disabilities tend to find happiness over time, he says.

"This is what led to the thinking that certain people must have some reserve that allows them to remain at a fairly stable level of happiness despite their situation," he adds.

The research also suggests that happiness is tied to a sense of responsibility and achievement.

"The way to pursue happiness is surprisingly virtuous," Bates concludes. "A sense of humility, working for the things you want, counting your blessings, being sociable, and staying active all play a part."

How to get every thing you want in life

Experts and women like you share simple tips for landing whatever your heart desires, whether its comfy shoes or your share of the American pie. But sometimes knowing - really knowing - what you want is the hardest part of all.

A few weeks ago, I went backpacking in the canyons of southern Utah with nine other women. Our ages spanned three decades, 23 to 53, our occupations-lawyer, bookseller, botanist, social worker, yoga instructor (to name only a few)-were as varied as the colors of the desert flowers that were just starting to bloom on all sides of our campsite. We spent our days hiking, cooling our bodies in pools the creek had carved into the canyon floor. We wrote in our journals. We talked long into the warm spring evenings about our lives and the changes we wanted to make in them.

Danika had put her scientific studies on hold to build schools and medical facilities in earthquake-ravaged Pakistan. Sarah was considering giving up a 10-year career guiding troubled teens in the wilderness for something more stable, more lucrative, more relationship-friendly. Amy was about to go to law school, though she wasn't entirely sure why, because no matter how hard she tried she couldn't imagine herself as a lawyer.

Three days after the trip ended I would fly to New Orleans, to accompany the man in my life on a drive back to Colorado, where he would move in with me and my four Irish wolfhounds. We'd been friends for 20 years, long-distance lovers for one, and this next step seemed on the one hand inevitable, and on the other absolutely insane, given the history of relationship disasters we had each left in our separate paths.

Each of us women on the backpacking trip was at some kind of crossroads, and we all kept coming back to the same questions: How do we know when we are truly following our heart's desire? How can we tell the difference between our one true voice, and all the other voices that have taken up residence in our head and constantly compete for our attention, telling us what we should and should not do? How can we tell the difference between what the people who love us want for us, and what we want for ourselves? How do we learn to quiet the nay-saying voices that belong to bad fathers and bad bosses and bad TV shows that tell us all the things we can't have, and get quiet enough, brave enough, to imagine the life we truly want?

My mother wanted desperately for me to be an actress; my father wanted me to be Chris Evert. For the first 12 years of my life I played tennis as though my life depended on it, and I went into Manhattan a couple of times a week with my mother to audition for commercials and soaps. I couldn't seem to stop running around my backhand, though, and I never got the knack of saying I liked the potato chip if I didn't like the potato chip. When I came home from an eighth-grade exchange program in Wales and announced I wanted to be a writer, my parents' suspicions that I was an alien baby were confirmed. I understand now that it was the width of the Atlantic Ocean that afforded me the time and space to begin to separate my parents' dreams from my own. My mother eventually learned to see the writing life as "a kind of acting," but my father's frustration with my choice lasted as long as his life. And though they have both been gone many years, I still feel their desires in my own decision-making, still hear their disappointments echoed in the advice of friends and lovers, still find it so hard not to act on behalf of them, or in spite of them. Where in all of that longing, do I find the voice that speaks more softly than all the others: my own?

What further complicates this process for me and all women, I think, is our capacity for empathy, our penchant for caretaking, the way we can't seem to be truly satisfied unless we are doing something for someone other than ourselves. Our generous nature is the best of things about us, but we run into trouble when generosity turns into martyrdom and resentment, when our good intentions toward those we love deafen us to that quieter call of our own desires.

Over a breakfast of strong coffee, dried apricots, and granola, I asked my hiking companions how they knew when their truest voice was speaking.

Tami, the owner of a marketing agency, has come to the Utah canyons from Sonoma, CA. The energy she feels around a heart's desire is completely different from what she feels about a "should." She feels a genuine pull, the excitement of what if, and also the fear. Following a heart's desire involves risk: starting her own business, falling in love, writing fiction, running a marathon for the first time. She has to try it, and she has to be willing to fail. When she is in the realm of the shoulds, she is 100 percent in her logical brain, and she has total confidence in her abilities-she is doing what her head knows she is good at, rather than what her heart longs to try. And the shoulds can be an important part of the process. "Sometimes," she says, "the confidence you build up from all the shoulds is what allows you to reach for your heart's desire."

I have an extremely competent analytical brain, so I've been told by the standardized testing people, and in many situations it serves me well. I am an excellent chess player, I usually know what is about to happen next in the movie, and I have been able to win most of the arguments with most of the men who have lived with me, without crying or slamming doors. But my overactive (some would say obsessive) analytical brain can be the biggest impediment to listening to my heart's desire. In fact, sometimes I have to trick my logical brain into looking the other way for a minute to give my intuitive brain the floor. I look into the short stories and novels I write to see if my heart's desire is hiding in their plotlines, and into my dreams, and into the most passionate advice I give my friends. I pay attention to what my body is doing when I talk or think about a new life path.

Is my chest open or closed? Am I standing straight or slumping? And most important, am I breathing? And how deeply? If I can't remember the last time I filled my diaphragm with air, I am probably making the wrong decision.

Out in the wilderness of southern Utah, the Red Rock Canyons served as a makeshift Atlantic Ocean, giving me enough space to think about moving in with my old friend Gary. I let the questions come: Was I breathing deeply? Was that happy nervous excitement in my voice, or abject fear? For the life of me, I couldn't be certain.

Barb, a simulation analysis engineer from Minneapolis, says that for her, fear is always part of the equation, but if she is doing something not because of fear, but despite fear, then she is doing what her heart desires. "If I don't hesitate, if I don't start trying to come up with all kinds of logic that will support my decision, it is probably the right one. If I have to talk myself into something, it's usually because I am trying to convince myself to do something that doesn't feel right in my gut."

Gail Harris has written a book called Your Heart Knows The Answer: How To Trust Yourself & Make the Choices That Are Right For You, which outlines strategies and simple practices to help you tune into your truest voice. "The voice of the heart is always positive and loving," she says, "even when it is asking us to change. It is direct and specific, empowering, grounding, centering, and relaxing. It is unwavering. It will keep telling you the same thing over and over, but it won't use your own logic against you. If it is negative and critical, it is not the voice of your heart."

After all the soul-searching and second-guessing and the final banishment of lingering doubt, Harris notes, the execution of our plans can seem like the easy part. Once you let yourself know that what you really want is to start a catering business, you head to Kinko's for business cards and flyers, check the want ads for kitchen space, and call up those rich friends who always rave about your cooking and see how much they would like to invest. If you've always wanted to write a novel, but have three kids under 6, you look into day care, call in a favor from your sister, and set the alarm for 3 a.m.

As the 10 of us heaved our packs on our backs for the final time on that backpacking trip, they felt lighter. (They were lighter, of course, after all the food we'd eaten, but we felt even more deeply unburdened.) The decision-making was behind us. Danika had a grade school to build in Pakistan, Sarah was off to find a new place to live. Tami had her brand new business to attend to in Sonoma. And me? I had to go clear shelves and drawers for Gary, and welcome him with a big, generous, open heart. And if I failed, if any of us failed, we would know we had tried our best to listen to our heart's desire, and moved forward, with honesty and commitment, and enough belief in ourselves to spread some around.

We have the right, the tools, and the capacity to live precisely the lives we want to. We are the gender that lifts cars off of babies, wins the Iditarod, and swims the English Channel, after all, and anyone who gets in the way of our heart's desire once we have really made up our minds better watch out.

1) Get a better credit score (fast!)

Give your credit score a quick boost simply by increasing your line of credit (just call your credit card company and ask). A third of your score is based on your debt-to-credit ratio, so your $2,000 credit card bill looks less risky to banks if it represents half of a $4,000 credit line rather than most of a $2,500 one.

2) Ditch a bad mood in minutes.

Hyla Cass, M.D., assistant professor of psychiatry at UCLA School of Medicine and author of 8 Weeks to Vibrant Health says there's one easy way to get a pick-me-up anytime, anywhere: Get moving. Take a brisk 10-minute walk, or jog up and down stairs for five minutes. Exercise sends a shot of oxygen to your brain, and boosts endorphins in your bloodstream-both of which short-circuit crankiness. So when you're so grouchy that even you're annoyed with you, do yourself (and everyone around you) a favor. Take a hike.

4) Find a reliable auto mechanic

NPR's "Car Talk" and its hosts Click and Clack have long been the go-to source for perplexed drivers dealing with stuck dipsticks, mysterious rattles, and more. So it makes perfect sense that they'd be the holders of that holy grail all car owners seek: the trustworthy mechanic. The "Car Talk" website (cartalk.com/content/mechx) features more than 16,000 mechanics recommended by people who've used them; just enter your zip code to find the garage nearest you.

5) Develop perfect posture

Having good posture makes you look thinner and ooze confidence-it also helps ease back pain and headaches. Here, three steps to posture that would make Mom proud, courtesy of Drew DeMann, M.D., chiropractic orthopedist at Manhattan Spine & Sports Medicine in New York City.

1. Check your alignment. Many women have rounded shoulders and a C-curve in their back from sitting hunched over a desk all day, says DeMann. So ask a friend to take a photo of you from the side (or check yourself out in a double mirror at the department store). Your earlobe should be over your shoulder and hip. If it's forward of them, you need to correct your posture.
2. Learn what good posture feels like. Straighten your spine as if there were a string stretching from the top of your head to the ceiling, pulling you up. This is how you should carry yourself.
3. Practice, practice, practice. Doing the above exercise on a regular basis will train your body to stand and sit up straight. Strengthening your upper back and abdominal muscles will help you maintain good posture; try lat pulldowns in the gym or do the cobra yoga move.

6) Tasty snacks that don't break the calorie bank

These five treats are all under 200 calories:

* 5 whole-grain crackers (such as Wheat Thins) topped with 1 Tbsp natural peanut butter 184 calories
* 1 oz premium dark chocolate, such as Vivani, Feodora, or Lindt 150 calories
* ¼ cup guacamole and 8 blue-corn tortilla chips 190 Calories
* 1 oz (small handful) dark-chocolate covered almonds or peanuts 160 Calories

Fruit and cheese
* 1 sliced green apple served with 2 oz of light cheddar cheese cubes or 1 light Laughing Cow snack cheese. 189 calories

7) Sign a sophisticated signature

A scribbled scrawl might say something about you-but is it saying anything good? Andrea McNichol, author of Handwriting Analysis Putting It To Work For You says no. Try holding your arm and hand away from your body when signing your name. This naturally creates a more generously spaced signature, which is more attractive and memorable.

Other tips: Always end your autograph with a stroke to the right-ending it to the left means you're living in the past. And skip flourishes like excessive underlining, swirls, or oversize letters (don't even think about heart-dotted i's); these things will make you seem attention-hungry, not like the history maker you know you were born to be.

8) Get more foreplay

He opts for fast and furious; you'd like him to loiter. Sex educator and REDBOOK Love Network expert Lou Paget offers these tips on how to get your man to lengthen the passion prelude:

Drive home the message that more foreplay will lead to more sex and your guy will go along with most anything you request. Say, "If you kiss me the way you used to for three more minutes, it will really get me hot." He'll dive in for a make-out session pronto.

Stroke his ego. Think of a move he does well, tell him it drives you crazy, and ask for more of it-he'll cooperate.

Request, rather than demand; he's more likely to respond if he doesn't feel criticized. Better yet, show, don't tell: Take his hand and guide it in the way you like to be touched-the visuals of you getting aroused will be enough to make him pay attention.

9) A tropical vacation that doesn't cost a fortune

Break out your beach bag. Paradise can come cheap-and you don't even have to plan months in advance. Bookmark these websites:

site59.com lets you book up to three hours prior to your flight (five hours for international). By selling off packages that would otherwise go unbooked, the site can save you up to 70 percent!

11thhour.com is also procrastinator-friendly. You can even hold packages for 24 hours before purchasing, which is handy when you're not quite sure if your best friend prefers window or aisle.

If your dates are flexible, sign up at travelzoo.com for their “Top 20” weekly e-mail to learn about new deals as they become available.

10) An on-call tech guy for your home

Tired of tussling with tech support? Meet the Geek Squad. This 24-hour computer-support task force comes to your doorstep for a flat fee (varies with service) and rescues you from e-purgatory: whether it's a crashed computer ($99) or an iPod that just won't connect ($49). Geek Squad also offers computer help via the telephone, at stand-alone stores and at Geek Squad stations inside Best Buy stores. Hey, even the FBI (yep, that's right) has relied on these guys for tech support. Need we say more? geeksquad.com

11) A never-fail-you lipstick

Who wants to wade through the thousands of colors at the cosmetics counter? You need lipstick that looks great and you need it now. According to Ramy Gafni, New York City-based makeup artist, a berry shade with golden flecks works on everyone. What makes this hue so wearable? "It combines the same undertones found in every woman's natural lip color-blue, pink, and yellow," says Gafni. Get it: Ramy 2Lips Kiss and Tell, $21, or Sephora Super Shimmer Lip Gloss in Rosy Glow, $10.

12) The satisfaction of helping others (without becoming a UN Ambassador)

Have an itch to do some good? Go to volunteersolutions.org, type in your zip code, and choose a social issue that interests you. The site will match you up with a local organization dedicated to the same cause you are.

13) Find the cleanest stall in a public bathroom

Choose the first stall when you walk in. When there are three stalls in a row, most people choose the middle one so it's the dirtiest, says Charles Gerba, a microbiologist.

14) Jeans that fit perfectly

It's Goldilocks's worst fashion nightmare: Jeans are always too tight, too long, too short, or just too plain expensive. Land's End to the rescue: Go to landsend.com and fill out a brief profile, including your measurements, fabric choice, and style. Then, for only $54, you'll get custom jeans that are just right...for you!

15) A great-and believable-line to give your husband when he wants to have sex and you don't

"No, no, I'm into it, really. It's cool. Let me go wash up, Dad-I mean, Bob! Oh no, now I've ruined the moment."-Amy Sedaris

16) Find an umbrella that won't break

You were singing in the rain until your umbrella blew inside out and now you're decidedly...soggy. For the third time today. There is a solution: The Gustbuster's two layers of sturdy 190-thread count nylon are designed to prevent tears and allow air to flow through them, and can withstand winds of 55 m.p.h. or more. It's also backed by a lifetime guarantee. $25-45, gustbuster.com.

17) A foolproof hostess gift for under $20

What's a surefire way to be the best guest? Give your hostess flowers that are already arranged in a chic, simple vase-so she doesn't have to put her party on hold to rummage for one. Handmade from recycled paper and coated, PopVases come in a variety of colors. $6, Traffic Works, 323-582-0616.

18) Get a better price on anything

Know what you want and what it's worth. "A seller who's aware that you're guessing or bluffing will be unlikely to give an inch," advises Holden Lewis of Bankrate.com.

Be a little dramatic. Your "shocked" reaction to a price, even a reasonable one, could bring it down.

Enlist your guy for a little good cop/bad cop act. If a price on a big-ticket item (like a house or a car) isn't as low as you'd like, pretend he won't agree until the figure comes down.

Consider buying multiple items or services at once; a seller who won't budge on a single piece might be willing to cut you a break on a larger sale.

When all else fails, be ready to walk away. If a salesperson is willing to go lower, he'll make you another offer; if he's hit bottom, you can use his best price as a benchmark at another store.

19) Get flat abs in a day

We know, we know. We should have been doing 100 crunches a night for the past six months. But, well, um, we didn't. And now the wedding's this Saturday. Is there any hope? For flat abs tomorrow, "stay away from fruits, dairy, processed carbs, and excessive fats. They can make your body retain water and leave your tummy bloated," says trainer David Kirsch, owner of The Madison Square Club in New York City. We can't promise you'll look like Heidi Klum (one of David's clients), but your belly will be noticeably less noticeable.

20) Shoes that are stylish and comfortable

Think chic comfort is an oxymoron when it comes to your tootsies? Not with these brands!

* Geox, geox.com
* Aerosoles, aerosoles.com
* Faryl Robin, farylrobin.com

21) Get unconditional love

"The most likely path to receiving unconditional love is to give it. As some great philosophers-the Beatles-once said, 'The love you take is equal to the love you make.' It's also important to pick the right person. He doesn't have to be perfect, but he does have to have a track record of being present and loyal even during rough times."- REDBOOK Love Network expert David Wexler, Ph.D., executive director of the Relationship Training Institute.

22) Find a last-minute babysitter you can trust.

Your sitter's sick and Mary Poppins isn't likely to drift down anytime soon. These websites are the next best thing. Just type in your zip code and, for a fee (ranging from $40-50 for the first one to three months, $5-10 per month after that), they'll hook you up with reliable child care. Not a bad price to pay for peace of mind; the websites' detailed profiles list things like sitters' certifications (such as CPR), languages spoken, and whether or not they have transportation.

* Sittercity.com
* 4sitters.com
* babysitters.com

Live in an urban area? Parent-tested childcare resources in cities across the country are listed on gocitykids.com. Also, many colleges and universities have babysitting services that pair parents with their students. Check your local schools' websites or call their Office of Human Resources.

Men vs. Women: Whose Memory Is Worse?

Study Shows Older Men More Likely to Have Memory Problems Than Older Women

By Kathleen Doheny
WebMD Medical News

Reviewed by Louise Chang, MD

April 16, 2008 -- Men have a reputation for having a bad memory, forgetting birthdays or anniversaries -- or so the stereotype goes. Now, a new study lends some science to the stereotype, at least for older men.

Men 70-plus are more likely than women in that age range to have memory problems and other cognitive impairments, according to researchers from the Mayo Clinic in Rochester, Minn., who presented the finding this week at the American Academy of Neurology 60th annual conference in Chicago.

The research team evaluated what is known as mild cognitive impairment, a transition stage between normal cognitive functioning and dementia, in 1,969 men and women ages 70 to 89. Having mild cognitive impairment increases the risk of getting Alzheimer's disease over the next few years, but not everyone with mild cognitive impairment gets Alzheimer's.

"We found that the prevalence of mild cognitive impairment was higher in men than in women," says Rosebud Roberts, MD, an associate professor of epidemiology at Mayo Clinic and a study co-investigator.

Men were 1.6 times as likely as women to have the cognitive problems, she says.

Men, Women, and Memory

Previous studies have tried to evaluate which sex has the better memory. But the research looking at sex differences in memory and other cognitive function has yielded mixed results, Roberts tells WebMD.

"Some studies have reported sex differences in mild cognitive impairment," she says, "but the reports have been inconsistent."

Roberts and her colleagues randomly selected residents from Olmsted County, Minn., who were ages 70 to 89 at the start of the study in 2004. The researchers administered cognitive tests, had a physician examine them, and interviewed them.

The researchers also talked to someone who knew each participant well, such as their spouse, to ask about cognitive functioning. Then they classified them as having normal cognition, mild impairment, or dementia.

In all, 16.7% had mild cognitive impairment, Roberts found. Men were 1.6 times more likely than women to have mild cognitive impairment, even after factoring in such variables as age and marital status.

Second Opinion

The study is scientifically sound, according to Sam Gandy, MD, PhD, chairman of the medical and scientific advisory council for the Alzheimer's Association, who reviewed the study for WebMD.

But the increased risk found in the study for men should be put in perspective, he says. For instance, carrying a gene known as the apoE4 allele boosts the risk of getting Alzheimer's, he says. "The gender effects still take a back seat to the genetic effects [of getting dementia] in terms of magnitude," he says.

Both men and women can improve their lifestyles to reduce their risk of dementia, says Gandy. He cites a recent study in which having belly fat as an adult boosted the risk of dementia later.

"As for recommendations [to reduce risk], for now, diet and lifestyle remain the mainstays," he says. The Alzheimer's Association recommends staying active mentally, socially, and physically, as well as adopting a "brain-healthy" diet.

To qualify as brain-healthy, a diet should be low in fat and cholesterol and be rich in dark vegetables and fruits.

Interpreting the Findings

The new findings are at odds with some studies that have concluded women have more dementia than men, Roberts says. She isn't certain how to interpret the findings thoroughly yet. The findings may suggest that men have a delayed progression from mild impairment to dementia or that women stay in the mild-impairment transition phase more briefly, progressing more quickly than men do to dementia, she says.

The risk factors for mild impairment (such as advancing age) may be different for men, she also speculates, or they may occur at different phases of life for men than for women.

"A person with mild cognitive impairment might have problems with memory, making decisions, or problem solving, or problems with language, like finding a [right] word," Roberts says.

These difficulties are "not severe enough to affect social functioning or work," she says. "It's not something you would notice if you didn't live closely with them."

"I Hate Asking for Help"

WebMD Feature from "Good Housekeeping" Magazine

By Cynthia Hanson

It's the four-letter word no woman likes to utter. How to ask for what you need.

It wasn’t until Kathleen Hornstein realized that she couldn’t move her legs that she finally broke down and asked for help. A 34-year-old Pilates instructor and mom of two, Hornstein was pregnant with twins, and despite being overextended and overtired, she had barely slowed down and prided herself on being able to handle anything that came her way. Then, during her second trimester, as she sat on the basement steps one day talking to her husband and her brother while they hung drywall, she suddenly discovered that she couldn’t stand up. “It felt like my hip and thigh had dislocated,” recalls the West Chicago, IL, mom, now 39. “I was shocked — and scared! — and glad people I could count on were there.”

Minutes later, Hornstein was able to support herself again, but the brief experience of dependence was a wake-up call for her: “My body — and my life — were undergoing rapid changes. I realized I’d need to reconsider my attitude about asking for help if I wanted things to run smoothly — especially after we became a family of six.”

Hornstein’s reluctance to reach out is all too common in our culture, where self-reliance is a revered, ingrained habit, says life coach M. Nora Klaver, author of Mayday! Asking for Help in Times of Need. “Being on the receiving end of a helping hand seems harder for women because we’re raised to be caregivers,” she says. “Asking for care ourselves feels like a personal failure.” In a recent survey of 100 former clients, Klaver found that seven out of 10 had wanted help at least once during the previous week but hadn’t been able to bring themselves to make the request.

Like Klaver’s clients, most of us deal with our daily burdens and serious crises on our own, often winding up isolated and overwhelmed. The alternative would be to admit to ourselves — and others — that we’re not perfect. But we’d rather keep up the appearance of being in control, says psychologist Marcia Reynolds, Psy.D., author of Outsmart Your Brain. “Our resistance is about maintaining our own self-concept,” she explains. “It may often take a life-changing event like pregnancy or a medical emergency to teach us that even the most competent women can use a little help sometimes.”

But why wait for a crisis? We’ve culled the top five excuses women make to justify their reluctance to ask for aid — and the experts’ analysis of what’s really going on behind these bogus rationales. Read on, then grasp a helping hand.

Excuse #1 “I Don’t Want to Look Weak”

On his first day of kindergarten, Joy Stewart’s son brought home a raft of paperwork, but only one document gave her pause: the emergency-contact form, on which she had to name someone who could pick Joshua up at school if she or her husband couldn’t be reached. “My family and friends aren’t available during school hours, so I didn’t have many options,” says Stewart, 41, a real estate agent and mom of two in North Wales, PA. “I wanted to ask my neighbor Nancy but we weren’t close — we just smiled and waved across the cul-de-sac. I figured she’d see me as pathetic and think, Why is Joy asking me? Doesn’t she have any friends?”

Turning to others in times of need should not be a source of shame. Rather, it’s a sign of strength and smarts because it means you know what you can and can’t handle and that you’re planning ahead to get everything done regardless. “But asking for help can reveal things about yourself that you may not be proud of or happy with,” Klaver says. “In Joy’s case, she didn’t like admitting that she didn’t have anyone she could call on to help her out.” To avoid falling into a similar trap, remind yourself that asking for help strengthens social bonds. “When you make yourself vulnerable, others open up in return,” Klaver points out.

Stewart agonized for two weeks, and then, finally, the day before the form was due, she mustered the courage to approach Nancy. Not surprisingly, Nancy happily agreed to be her emergency contact. “I wish I’d asked sooner, because it would have spared me a lot of angst,” Stewart says. “I wasted so much energy — and if Nancy had said no, I wouldn’t have had any backup plan.” A bonus to Stewart’s outreach: The two women now are friends and regularly chat together.

Excuse #2 “I Don’t Want to Impose on My Friends”

When Sharon Marcus moved to New York City from San Francisco, her good friend Anita volunteered to come paint her new apartment and do minor repairs. Marcus wanted to learn those skills and knew she would enjoy working with her friend. Still, “it seemed like a terrible imposition to ask her to take time off from her job, fly across the country, and spend a long weekend working on my new place,” says Marcus, 41, an English professor. She fretted for a week about whether or not to take Anita up on the offer.

She needn’t have, says Reynolds. “Ultimately, it’s up to the other person to decide whether your request crosses the line.” Most people like to be helpful, especially if you’ve given them a hand in the past. If you’re not sure, then before you reach out, ask yourself if the friendship could withstand a “no.”

When Marcus finally followed up, Anita gladly agreed to help; as it turned out, she was eager to see her friend. The two enjoyed a whirlwind weekend of painting and reminiscing, transforming Marcus’s apartment. Marcus also learned enough to go it alone with a paintbrush and small tools. “Anita’s help actually made me need less assistance on other projects,” she says.

Whenever you ask for a significant favor, acknowledge that it’s a big deal (“I know I’m asking a lot”) and give the person permission to decline up front (“I understand if it’s too much and you can’t do it”). And of course, give assurances that you’ll return the favor when she needs it.

Excuse #3 “I’ll Look Incompetent”

When she took her job as director of career services at a liberal arts college, Kim Heitzenrater knew there’d be a learning curve. Nonetheless, during her first three months, whenever students asked her questions about applying to graduate programs, she researched the information herself, even though it would have been much faster and easier to check directly with faculty advisors. “I was afraid that if I asked too many questions, the dean would think he’d made a mistake in hiring me,” says Heitzenrater, 40, a mother of two in Sewanee, TN.

While Heitzenrater’s attitude is common, particularly in the workplace, not tapping others’ knowledge is counterproductive, says Karissa Thacker, Psy.D., a New York City management psychologist who specializes in career issues: “Everybody expects you to ask technical questions.” Heitzenrater ultimately reached the same conclusion. “I wasted too much time looking up everything myself,” she admits. “If I’d asked my colleagues for help early on, I would have gotten up to speed on the job faster and developed relationships with them sooner.”

Asking your boss and coworkers for assistance — tips on shortcuts, a deadline extension, even feedback — doesn’t signal incompetence. On the contrary, says Thacker, “You may feel vulnerable, but what you’re really saying is, ‘I want to do the job right, and I understand the value of teamwork and cooperation.’”

To switch your mind-set, first, recognize that today’s workplace is more collaborative than it used to be. Even if you haven’t been formally assigned to a work team, it’s likely that you’ll need an occasional assist from your peers to do your job. Second, practice asking for help (and giving it) every day so that it starts to feel natural, Thacker recommends.

Excuse #4 “It Won’t Get Done Right if I Don’t Do It Myself”

“Some women won’t accept help because it means surrendering control,” Reynolds says. Case in point: Lori Reidel, 52, of Cincinnati, who didn’t trust other parents to drive her son, Logan. She chauffeured him almost everywhere, even though it meant paying for extra gas and losing the time and flexibility that come with carpooling. “But if I’d let Logan ride in someone else’s car and something happened, I wouldn’t have been able to forgive myself,” Reidel explains. “Primal parental fear is understandable,” comments Reynolds, “but that unbending attitude is unrealistic and unhealthy for child and mother.”

Accepting a helping hand requires an active leap of faith that everything will turn out OK. “You must stand up to the fear and mentally take it down,” Reynolds explains. “Tell yourself, ‘This is an irrational fear. I will accept help for one week; if I can’t handle it, then I’ll make a different choice next week.’” Another mental trick: Remember other occasions when you felt anxious about letting go but that turned out fine — the first time you left your child with a babysitter, for instance.

When her son, now 14, started seventh grade, Reidel heard about a new carpool down the street, and she took a deep breath and joined. The result has been win-win: Logan has become pals with the other kids and Reidel has gained more time — and more trust in the other parents.

Relinquishing lesser tasks may be easier, but it also requires an honest evaluation of costs and benefits. Is it better to let your 9-year-old make his bed badly or to take the time to do it yourself? After a party, does it make more sense to let guests help you clean up or to stay up by yourself washing dishes? Finally, Reynolds says, ask yourself this, “Is it the end of the world if my son’s bed looks sloppy or my margarita glasses aren’t perfectly lined up?” Focus on what you stand to gain — a lighter workload; more time for your kids; a chance to bond with your friends.

Excuse #5 “I Was Raised to Be Self-Sufficient”

When her husband went away on a five-day business trip last September, Isadora Fox, 39, of Austin, couldn’t bring herself to call on a neighbor — even just to watch her 4-year-old daughter, Sasha, for 90 minutes while she prepared for two big exams. Fox, who works part-time as a writer while she studies to become a nurse-practitioner, also had three major deadlines and sole responsibility for driving Sasha to preschool, swimming, gymnastics, and a birthday party. To get everything done, she stayed up until 2 every night, even though she was five months pregnant. “I chose to be a mother, go back to school, and work part time,” Fox says, “so I thought I should suck it up and handle everything myself, because this is what I signed up for.” Instead, she collapsed with a nasty sinus infection.

Subduing an independent-to-a-fault streak takes soul-searching. Try to shift your focus from self-reliance to self-care, understanding that doing what’s best for you will give you strength to care for others. Edit your mental self-talk about independence by telling yourself it’s nothing but a self-imposed, self-limiting mantra.

That strategy worked for Fox. “I started thinking about how I do favors for other people,” she says. “I don’t think worse of them for needing some assistance, and I’m sure that none of my friends and neighbors would mind helping me.” A few months later, when her husband was away during her final exams, Fox asked a friend to babysit for three hours one night while she studied. “I still won’t call someone for help because I’m just tired,” Fox says. “But I will in an emergency — and being eight months pregnant and in the throes of finals counts!”

And what of Kathleen Hornstein? Today, she usually doesn’t hesitate to request the assistance she needs either, whether it’s sending her husband grocery shopping, tapping her daughter to fold laundry, or asking a neighbor to babysit her 4-year-old twins. The result: She’s more relaxed and less frazzled. Better yet, Hornstein says, is seeing the positive impact her requests have had. “My kids are learning responsibility and getting a feeling of accomplishment when they do small chores. And from carpooling, I’ve gotten to know other moms and deepened some existing friendships. I had to learn to ask for help, but now, I can’t imagine living my life any other way.”

Stressed? Grab Your Own Slice of Bliss

Stress: Busted!

WebMD Feature from "Women's Health" Magazine

By the Editors of Women’s Health

Sanity-saving strategies you can use right now

1. Work Pressures
Change your schedule.

When most people get in to work, they check their e-mail and voice mail. Save it for later. Spend your first hour, when you're the sharpest, on creative and strategic thinking. While you're at it, break down your day into specific tasks, rather than trying to juggle everything. Studies now show that a 50-minute task takes four times as long if you juggle too many tasks at once. "Are you a starter of all and finisher of none?" asks Julie Morgenstern, author of Making Work Work. If you can, pick one day a week to leave 30 minutes earlier than usual. "It feels like corporate suicide," Morgenstern says, but allowing yourself that early exit will keep you on deadline and make you hyperfocused to complete jobs more efficiently.

2. Personal Pressures
Change the habit, not the world.

Destressing isn't about eliminating all of your stresses; it's about getting control of them, one at a time. To do that, you should make micro-adjustments in your life, not big ones that eventually add more stress, says Stan Goldberg, Ph.D., author of Ready To Learn. "What's important is whatever [changes you make to your routine] need to be small enough so that there is a minimal amount of difference between what you've been doing and what you now do," Dr. Goldberg says. If you're working on being prompt, get to every appointment—not just to work—5 minutes earlier than normal. Successful change is permanent, not dramatic.

3. Self Care
Eat the antistress diet.

When you're in stress mode, your insides produce more chemical reactions than Marie Curie's lab—you experience surges of the hormone cortisol and sugar levels that spike and plummet, which can leave you feeling under pressure and sluggish. Counteract those reactions with the right foods, says Elizabeth Somer, R.D., author of The Food & Mood Cookbook. For breakfast, avoid sugary cereals or breakfast bars and eat whole-grain cereal and a piece of fruit. Then pop a vitamin with at least 500 milligrams (mg) of calcium and 250 mg of magnesium. Magnesium, which is flushed out when stress rushes in, helps regulate those cortisol levels. For a snack, the crunch of veggie sticks or carrots helps release a clenched jaw and the tension headache you can get as a result of stress. Before bed, go with a light carbohydrate-rich snack, like toast and jam, to quicken the release of the feel-good hormone serotonin, which will help you sleep better.

4. Personal Power
Always avoid "always".

One of the biggest booby traps in your life is overgeneralizing—first dates never work out, she always gets promotions before me, he always arrives at least 5 minutes late. Unconsciously, using "always" and "never" steers you away from feeling that you have any control over changing the things that stress or worry you, says Daniel Amen, M.D., author of Change Your Brain, Change Your Life.

5. Emotional Symptoms
Schedule your emotions.

If we let it, stress can eat away at us like a squirrel with a nut. That constantly worried mentality impedes decision-making, says Susan Nolen-Hoeksema, Ph.D., author of Women Who Think Too Much: How to Break Free of Overthinking and Reclaim Your Life. She suggests you write down what you're worried about, then set aside some quiet time (say 30 minutes) to figure out solutions. That way, worrying won't disrupt your work, and you'll be able to think through the answers.

Forgive and Forget

It's not always easy, but the benefits of forgiving -- and 'forgetting' -- can be powerful. Here are some tips.

By Tom Valeo
WebMD Feature

Reviewed by Cynthia Dennison Haines, MD

Many people view forgiveness as an offshoot of love -- a gift given freely to those who have hurt you.

Forgiveness, however, may bring enormous benefits to the person who gives that gift, according to recent research. If you can bring yourself to forgive and forget, you are likely to enjoy lower blood pressure, a stronger immune system, and a drop in the stress hormones circulating in your blood, studies suggest. Back pain, stomach problems, and headaches may disappear. And you’ll reduce the anger, bitterness, resentment, depression, and other negative emotions that accompany the failure to forgive.

Of course, forgiving is notoriously difficult. “Everyone says forgiveness is a lovely idea until they have something to forgive,” said C.S. Lewis.

And forgetting may not be a realistic or desirable goal.

“Despite the familiar cliche, ‘forgive and forget,’ most of us find forgetting nearly impossible,” says Charlotte vanOyen Witvliet, PhD, associate professor of psychology at Hope College. “Forgiveness does not involve a literal forgetting. Forgiveness involves remembering graciously. The forgiver remembers the true though painful parts, but without the embellishment of angry adjectives and adverbs that stir up contempt.”

Forgiving (and Forgetting) Quells Stress

That type of angry “embellishment,” as Witvliet calls it, seems to carry serious consequences. In a 2001 study, she monitored the physiological responses of 71 college students as they either dwelled on injustices done to them, or imagined themselves forgiving the offenders.

“When focused on unforgiving responses, their blood pressure surged, their heart rates increased, brow muscles tensed, and negative feelings escalated,” she says. “By contrast, forgiving responses induced calmer feelings and physical responses. It appears that harboring unforgiveness comes at an emotional and a physiological cost. Cultivating forgiveness may cut these costs.”

But how do we cultivate forgiveness?

Frederic Luskin, PhD, director of the Stanford University Forgiveness Project, readily admits that forgiveness, like love, can’t be forced.

“You can’t just will forgiveness,” says Luskin, author of Forgive For Good: A Proven Prescription for Health and Happiness. “What I teach is that you can create conditions where forgiveness is more likely to occur. There are specific practices we offer that diminish hostility and self-pity, and increase positive emotions, so it becomes more likely that a genuine, heartfelt release of resentment will occur.”

How to Encourage Forgiveness

For example, Luskin encourages the practice of gratitude -- the active effort to acknowledge what’s good in your life.

“Gratitude is simply focusing your attention on the positive things that have happened,” he says. “That creates a biochemical experience that makes it more likely that forgiveness will occur.”

Stress management, whether through meditation, deep breathing, or relaxation exercises, also helps quell the stress of anger and resentment, he says. So does “cognitive reframing,” which fosters acceptance of the facts of your situation..

“You may wish you had a better mother or a better lover,” Luskin says, “but the world is the way it is.”

Finally, Luskin encourages people to change the story they tell themselves so they appear more like survivors who are hopeful about the future rather than victims with a grievance.

“You can change, ‘I hate my mother because she didn’t love me,’ to, ‘life is a real challenge for me because I didn’t feel loved as a child,’” Luskin said. “That makes forgiveness so much more possible.”

Two Types of Forgiveness

Everett L. Worthington Jr., PhD, a professor of psychology at Virginia Commonwealth University and the author of Forgiveness and Reconciliation:

Theory and Applications, divides forgiveness into two types. Decisional forgiveness involves choosing to let go of angry thoughts about the person you feel has wronged you.

“You can tell yourself, ‘I am not going to seek revenge,’ for example, or, ‘I am going to avoid that person,’” Worthington says. “You could choose decisional forgiveness and still have a lot of emotional unforgiveness.”

The ultimate goal, however, is emotional forgiveness, in which negative emotions such as resentment, bitterness, hostility, hatred, anger, and fear are replaced with love, compassion, sympathy, and empathy.

“Emotional forgiveness is where the health action is,” says Worthington. “Emotional unforgiveness causes a chronic stress response, which results in obsessing about the wrong done to you. Rumination is what gets people into trouble. Rumination is the mental health bad boy. It’s associated with almost everything bad in the mental health field -- obsessive-compulsive disorder, anxiety, depression … probably hives too.”

REACH for Forgiveness

To help people achieve emotional forgiveness, Worthington has devised a 5-step program called REACH, with each letter representing one step.

“First you recall the hurt objectively, without blame and self-victimization,” Worthington says. “Then you empathize by trying to imagine the viewpoint of the person who wronged you. The altruistic part involves getting people to think about a time they were forgiven and how that felt.

When it’s time to commit to forgiveness, people usually say, not yet, but when they finally do, they must then hold on to forgiveness.”

All this is not merely theoretical for Worthington. His mother was beaten to death with a crowbar in 1995, and yet, by applying the five steps of REACH, he managed to forgive.

“Within 30 hours I was able to forgive the youths who had committed this horrible crime,” he writes in Forgiveness and Reconciliation.

When Not Forgiving Is OK

But some people cannot forgive, and that’s OK too, according to Jeanne Safer, PhD, a psychotherapist and the author of Forgiving and Not Forgiving. For some of her patients, recognizing that they don’t have to forgive is a huge relief.

“Many don’t have to forgive in order to resolve their feelings,” Safer says. “They say, ‘I can never feel OK about these terrible things, but I’m not going to be vengeful.’”

To help them achieve this resolution, Safer offers a three-step process. The first step involves re-engagement -- a decision to think through what happened. The second step, recognition, means looking at every feeling you may have about the injury. “You ask yourself, ‘why do I want revenge?’” Safer said. “Revenge is based on powerlessness and it’s doomed to failure.”

The final step involves reinterpretation of the injury, including an attempt to understand the person who caused it. “This is where forgivers and nonforgivers divide,” Safer said. “Sometimes you’re not able to reconnect with the person, but if you go through this process, at least you won’t be a victim.”

Forgiveness research proliferated after the publication in 1984 of Forgive and Forget: Healing the Hurts We Don’t Deserve, by Lewis B. Smedes, who claimed that forgiveness produced benefits for the forgiver.

Safer, however, is wary of those who picked up on this idea and started to promote what she calls “promiscuous forgiveness.”

"What’s important is working it through and achieving resolution, whether it leads to forgiveness or not. Forgiveness involves wishing the other well. You’re already there if you don’t wish them ill,” Safer says.

Are You a Workaholic?

You might as well face it -- you’re addicted to work. Could your workaholism be hurting you?

By Neil Osterweil
WebMD Feature

Reviewed by Louise Chang, MD

On the seventh day, even God rested.

But for workaholics, the day of rest never comes. There is always one more email to read, one more phone call to take, one more critically important trip to the office that can't wait until Monday.

Weekends? Holidays? Family? As the uber-workaholic Ebenezer Scrooge put it, "Bah, humbug!"

"It used to be that I never went on vacation without my laptop and a couple of beepers," says George Giokas, who describes himself as a "reformed" workaholic. When he was starting his company, StaffWriters Plus, in the pre-BlackBerry mid-1990s, Giokas spent more than a few late nights and nearly every Saturday at the office, he tells WebMD.

As he confessed to the online edition of Business Week in 1999, "I've struggled with the weekend issue many times, trying to figure out why I absolutely have to work then. It must be ingrained in me to the point of being a kind of addiction -- like going to the health club every day. If I miss one day, I feel awful."

But Giokas has since learned that the problems that pop up when he's away from the office will still be there when he gets back, and that what happens in the office stays in the office.

"I'm not the sort of person to bring home problems," he says, "and I don't dwell on issues. I get a pretty good night's sleep."

Workaholism: A Life Out of Balance

Not every workaholic, however, is able to achieve the balance that Giokas has found.

Justin Blanton, who practices law in California's Silicon Valley, tells WebMD that he is a workaholic and that the problem has only gotten worse in the four years since he wrote the following on his blog:

"Whether I'm reading a Harry Potter book on my PDA while waiting in the deli line, checking email on my phone as soon as my date makes for the ladies room, or heading back to my computer each commercial break (no TiVo… yet) -- I'm always checking something."

"It's gotten worse in the sense that it hasn't let up at all, and I feel more compelled to be busy," Blanton says today.

In a culture that prizes work ethic, overachievement, and financial success -- where gazillionaires such as Warren Buffett and Bill Gates are household names, and Donald Trump has his own television show -- people who are addicted to working are seen by outsiders as smart, ambitious, and entrepreneurial.

"The system is almost built to reinforce workaholics," says Simon A. Rego, PsyD, associate director of psychology training at Montefiore Medical Center in New York City. "Those are the people who end up getting positive job evaluations, get opportunities for promotion, and see themselves getting bonuses or raises. It's almost like the system has a built-in model to give them free hits of what they're addicted to."

Even when out of the office, workaholics can satisfy their cravings with cell phones, PDAs, laptops, and WiFi, which ensure that work need never be out of reach.

But blaming technology for workaholism is like blaming the supermarket for food addiction or the corner liquor store for alcoholism, says Bryan E. Robinson, PhD, author of Chained to the Desk: A Guidebook for Workaholics, Their Partners and Children, and the Clinicians Who Treat Them.

Robinson and other clinicians who treat patients for work-associated stress say that working hard and having easy access to work does not automatically make someone a workaholic.

"It's important to understand the context," says Edmund Neuhaus, PhD, director of the Behavioral Health Partial Hospital Program at McLean Hospital in Belmont, Mass. "If you're working to the exclusion of your family, your marriage, other relationships, and your life is out of balance, or your physical health is out of balance -- when work takes an exclusive priority to everything else, that's the more extreme end of the spectrum where it becomes a problem," Neuhaus tells WebMD.

"The preoccupation with work is really at the core of what workaholism is," says Robinson, professor emeritus at the University of North Carolina, Charlotte, and a psychotherapist in private practice in Asheville, N.C. "I always say that the difference between someone who's a true workaholic and someone who's just a hard worker is that the workaholic is on the ski slopes dreaming about being back at work, and the hard worker is in the office dreaming about being on the ski slope."

Workaholism is remarkably similar to alcoholism in some ways. Just as an alcoholic will hide bottles around the house and drink furtively, for example, workaholics may try to sneak in work when they think no one is looking.

"It's something that I did in the throes of my own work addiction, and when I think about it now it sounds pretty sick," Robinson says. He once hid some work papers in his jeans after his family went through his suitcase looking for his secret stash while packing for a trip to the beach, he tells WebMD.

Other key signs of workaholism are:

• Trouble delegating work (workaholics tend to be control freaks and micro-managers)
• Neglecting other aspects of one's nonworking life (like the dad who never has time to attend Junior's school play)
• Incorporating other aspects of life into work (such as trying to turn a hobby into a new business)

Workaholics: All Work and No Play

A workaholic might seem to be every CEO's dream: an employee who comes in early, stays late, doesn't take vacations, and takes on mountains of work. But those very qualities may make the workaholic a poor candidate for employee of the month because they often have more work than they can handle effectively, don't delegate, aren't team players, and are often more disorganized than their less compulsive colleagues, Robinson says.

In addition, workaholics may refuse to take time off, even when their work performance is affected -- although here cultural expectations and financial realities may come into play.

"People are afraid to take vacations because they're afraid that with all the downsizing and the economy being what it is that they'd be the first to go," Robinson says.

"I train residents at McLean Hospital," Neuhaus says, "and I tell them, 'You have to take vacations. Go away. You're not going to be any good to me if you don't take vacations.'"

Are Workaholics Hurting Their Health?

Like other forms of addiction, workaholism can have significant health consequences, experts say, including significantly higher work-related stress and job burn-out rates, anger, depression, anxiety, and psychosomatic symptoms such as stomachaches and headaches.

Despite the symptoms, workaholics may be in deep denial about their addiction, like a severely emaciated teen with anorexia who looks in the mirror and sees herself as obese.

Montefiore's Rego tells WebMD that workaholics often need prodding from family and friends to seek help when "the seesaw of life is tilted too much toward work."

One highly effective treatment is cognitive behavioral therapy, a form of psychotherapy focused on identifying and modifying negative thoughts and thought patterns.

"The workaholic might have a set of beliefs about the value of work which are misguided," Rego says. "And if you can intervene cognitively -- not to correct or get rid of them, but just make them a little more rational -- you might see a change in the behavior and consequent stress reaction."

Robinson helps workaholics develop a self-care plan examining five aspects of their lives: work, relationships, play, self, and spiritual life.

"This helps them see in black and white where their lives are lacking," Robinson says.

He also helps patients understand that they don't have to go cold turkey or quit their jobs, but find a balance in their lives and identify what's most important to them, whether it's family, friendships, religion, or beliefs.

Workaholics Anonymous, a national support group modeled on Alcoholics Anonymous and other 12-step programs, publishes on its web site a list of questions that can help you determine whether you are a certified workaholic or just unusually diligent. Positive answers to three or more of the questions may signal the need for help. The group hosts meetings around the country where people with similar problems can share ideas anonymously and provide support and solutions that will help them balance their lives.

Balance in Old Age Tied to Brain Changes

TUESDAY, March 18 (HealthDay News) -- The severity of age-related changes to white matter in the brain affects how well older people are able to move around and keep their balance, a new study says.

White matter changes -- called leukoaraiosis -- are common in older people.

The study participants included 639 women and men, ages 65 to 84, who underwent walking and balance tests, along with brains scans. The scans revealed that 284 of the volunteers had mild age-related changes to their brain's white matter, 197 had moderate changes, and 158 had severe changes.

Compared to those with mild changes, people with severe changes were twice as likely to score poorly on the walking and balance tests and twice as likely to have a history of falls. Participants with moderate changes were 1.5 times more likely than those with mild changes to have a history of falls.

The findings of the three-year study were published in the March 18 issue of the journal Neurology.

"Walking difficulties and falls are major symptoms of people with white matter changes and a significant cause of illness and death in the elderly," study author Dr. Hansjoerg Baezner, of the University of Heidelberg in Mannheim, Germany, said in a prepared statement.

"Exercise may have the potential to reduce the risk of these problems, since exercise is associated with improved walking and balance. We'll be testing whether exercise has such as protective effect in our long-term study of this group," said Baezner, who noted that mobility problems in older people often lead to hospitalization and nursing-home placement.

Monitoring white matter changes may assist early identification of walking problems, which have been linked to other health issues.

"Recently, gait abnormalities have been shown to predict non-Alzheimer's disease dementia, so recognition, early diagnosis and treatment of this disabling condition may be possible through early detection of walking and balance problems," Baezner said.

The causes of white matter changes and the reasons why it's worse in some people aren't fully understood. However, researchers have found evidence of a link to insufficiently treated high blood pressure.

Anxiety Helps Elderly Women Live Longer

FRIDAY, March 14 (HealthDay News) -- Higher anxiety levels may help elderly women live longer, but may harm older men, U.S. research shows.

A team at the Cleveland Clinic and Case Western Reserve University followed 1,000 seniors in three Florida retirement communities for up to 15 years.

They found that women with higher levels of anxiety at the start of the study lived longer than others. Year-to-year changes in anxiety levels didn't appear to affect women's survival, either.

In contrast to women, men with higher anxiety levels at the start of the study were more likely to die earlier, the researchers said.

"Our research indicates that anxiety may have a protective effect on women, possibly causing them to seek medical attention more frequently than men," Dr. Jianping Zhang, of the department of psychiatry and psychology at the Cleveland Clinic, said in a prepared statement. "In contrast, increasing anxiety over time is more detrimental to men. Additional research is needed to better understand the mechanisms and effects of anxiety in men and women."

The study is noteworthy due to the large amount of data collected over a long period of time, noted co-researcher Dr. Leo Pozuelo, who is also in the department of psychiatry and psychology at the Cleveland Clinic.

"Baseline higher anxiety could have led the female study participants to be more active and health-conscious," Pozuelo said in a prepared statement. "We are not certain of the absolute connection between anxiety and mortality, but this data set shows there may be a gender difference."

The study was to be presented Thursday at the annual meeting of the American Psychosomatic Society.

Your Brain on Creativity

To Get Your Creative Juices Flowing, Your Inner Critic Must Hush

By Miranda Hitti
WebMD Medical News

Reviewed by Louise Chang, MD

Feb. 29, 2008 -- For creativity to have a chance, the brain needs to get out of its own way and go with the flow.

That's the bottom line from a new study on creativity.

The study included six full-time professional jazz musicians. They got their brains scanned while playing a scale or a memorized jazz piece exactly as written and again when they were free to improvise, riffing off the assigned music.

When they improvised, the brain's dorsolateral prefrontal and lateral orbital regions were far less active -- and another brain area, the medial prefrontal cortex, was more active.

The brain regions that were quiet during improvisation are involved in consciously monitoring, evaluating, and correcting behaviors, write the researchers.

In contrast, the medial prefrontal cortex allows self-expression, in this case in the form of jazz improvisation, according to the study.

But creativity isn't just about self-expression. The brain's sensory regions were more active during improvisation.

"It's almost as if the brain ramps up its sensorimotor processing in order to be in a creative state," researcher Charles Limb, MD, says in a news release.

"One important thing we can conclude from this study is that there is no single creative area of the brain -- no focal activation of a single area," says Allen Braun, MD, in the news release. "You see a strong and consistent pattern of activity throughout the brain that enables creativity."

Limb, who wrote the jazz piece that the musicians memorized, worked on the study while he was a research fellow with the National Institute on Deafness and Other Communication Disorders (NIDCD). He's now an otolaryngologist at the Johns Hopkins University School of Medicine and a faculty member at Johns Hopkins' Peabody Conservatory of Music.

Braun, who worked with Limb on the study, is the chief of the language section in the NIDCD's intramural research division.

Feeling Hormonal?

WebMD Feature from "Redbook" Magazine By Aviva Patz

Hey, we all are. Hormones control just about every aspect of our physical and mental health — and when they go off-kilter, they can trigger anything from acne and insomnia to memory loss and weight gain. It's enough to ruin any woman's day. Here, 6 common side effects of hormonal flux, plus how to balance yours.

Think hormones take over your life once a month — the cramps, cravings, bloat, and mood swings that make so many of us miserable? That's giving these natural chemicals far too little credit. The reality is that our bodies produce dozens of hormones that control virtually everything we do: from how we think, eat, sleep, and cope with stress to how clear our complexions and how fit our figures are. And when levels of just one hormone fluctuate, the shift can have serious consequences for your mental, emotional, and physical health. Here, six signs your hormones may have gone awry, and what you can do to help restore a healthy balance.

Stubborn Acne

Nearly half of women suffer embarrassing breakouts during the week before their period thanks to normal hormone shifts. But if you've got acne all month long — the deep, cystic kind that no over-the-counter cream can conquer — androgens (male hormones such as testosterone) may be to blame. "A lot of people think acne comes only from diet or lack of hygiene, but it's essentially hormonal, and testosterone is always at the root of it," says endocrinologist Geoffrey Redmond, M.D., author of The Hormonally Vulnerable Woman. Testosterone stimulates excess production of sebum, or oil, that gets trapped beneath the skin's surface and mixes with acne-causing bacteria and dead skin cells, Redmond explains. The result: clogged pores and ugly blemishes. And the higher a woman's testosterone levels — or the greater her sensitivity to the hormone — the more severe her breakouts.

To restore balance: If you're not already taking birth control pills, consider starting. "Oral contraceptives lower levels of free testosterone — the type that's floating around in your blood and causing blemishes — by 50 percent," says Redmond. If you're on the Pill and it's not helping your skin, it may be the formulation. Redmond's top complexion-clearing picks: Ortho Tri-Cyclen and Yasmin, both of which have higher levels of estrogen and lower levels of androgen than certain other pills. Also, avoid any made with levonorgestrel, such as Alesse and Levlite. This synthetic form of progesterone mimics testosterone's effects and may cause breakouts.

If you'd rather not take oral contraceptives at all, spironolactone (marketed as Aldactone) may be your best bet. This drug was shown to safely clear up women's skin by blocking testosterone receptors, thus inhibiting the hormone's activity, according to research at the University of Toronto and elsewhere. Spironolactone has been approved by the FDA only for treating hypertension — not for acne — which means you'll need to find a doctor who will prescribe it off-label. (Note: You can't take it during pregnancy.)

Memory Lapses

Can't remember where you just set down your cell phone? Or what time you told your guy you'd meet him for dinner? You're too young to forget all this stuff...aren't you? Not necessarily. If you're under any amount of long-term stress — dealing daily with a micromanaging boss, staying up nights with a colicky infant, taking care of a sick loved one — your body is constantly pumping out stress hormones such as cortisol. And studies suggest that consistently high levels of cortisol can hamper your ability to learn new things and remember them later. In fact, it could permanently damage brain cells, particularly in the hippocampus, where information is tagged for long-term memory.

To restore balance: You'll like this advice. Think of your favorite healthy hobbies — solving Sudoku, walking with your pup, munching on raspberries from your garden — and simply do them more often. In a recent study, people who practiced lifestyle changes like these that were intended to help reduce stress, boost memory skills, and encourage healthy eating and physical fitness had greater powers of recall after just two weeks, possibly due to lower stress hormone levels, says lead author Gary Small, M.D., a psychiatry professor at UCLA and author of The Longevity Bible. More ways to mellow out: Try meditation, yoga, or any moderately intense aerobic exercise; express your spirituality or religious devotion (join a choir, use your rosaries, say a prayer); or simply sleep 20 minutes later in the morning — all of which have been proved to kick down cortisol. Small also recommends taking frequent relaxation breaks during the day: Just close your eyes and focus on breathing slowly and deeply for two to five minutes.

Insomnia

If you struggle to fall or stay asleep, particularly just before your period, it may be due to the sharp drop in the hormone progesterone that immediately precedes menstruation, according to Joyce Walsleben, Ph.D., associate professor in the Sleep Disorders Center at the New York University School of Medicine. Progesterone is a relaxant, so when levels plummet — as they do just before your period or after giving birth — you may feel restless and unable to sleep. (Breast tenderness, bloating, and cramps — also side effects of rapidly shifting hormones — don't help.)

To restore balance: Preventing the monthly seesaw of hormones requires actually banishing your period. Fortunately, that doesn't mean holding out for menopause, thanks to Seasonale, a form of extended-use birth control that reduces period frequency from 13 times a year to just four. If you're looking for a more natural approach, Walsleben offers this multiprong attack for reducing the side effects of hormonal swings: Drink plenty of fluids to minimize bloating, avoid caffeine after noon, and take ibuprofen before going to bed on nights you're likely to have cramps. And an hour or two before you hit the sheets, try sipping a glass of warm milk, or snack on a few slices of turkey or a handful of nuts. These foods are rich in tryptophan, a building block for the brain chemical serotonin, which helps control sleep. If you still find yourself staring at the ceiling, talk to your doctor about a prescription sleep aid. Lunesta, a new drug proved to safely summon the sandman, isn't supposed to be habit-forming — but the jury is still out, so consider taking it for no longer than a few weeks.

Nonstop Hunger

Willpower, schmillpower. Yes, it's important to maintain healthy habits, but a growing body of research is fingering a handful of hormones for the relentless hunger and overeating that makes some people feel that it's impossible to lose weight. A few under investigation: ghrelin, which stimulates appetite, and leptin and oxyntomodulin, which suppress it. In one study, volunteers who were deprived of sleep saw their levels of ghrelin soar — making them ravenous — while their levels of leptin plummeted. This may explain why people who are chronically sleep-deprived (snoozing less than seven hours nightly) tend to be more overweight than those who get plenty of z's. "Leptin normally signals the brain that your fat stores are large enough, so when levels of the hormone are low, the brain assumes you need more fat and triggers cravings for high-calorie food," says sleep and obesity researcher Gregor Hasler, M.D.

To restore balance: Getting seven to nine hours of shut-eye a night instead of scraping by on just six has been shown to lower your risk of overeating and obesity by 23 percent, in part by restoring your leptin levels. Even just one extra hour of slumber can make a difference. You should also avoid fatty foods, and not just because they're chock-full of calories! Though researchers don't yet understand why, they've found that calorie for calorie, carbohydrates and proteins are significantly more effective at suppressing appetite — and tummy rumbles — than fats. So whenever possible, swap high-fat foods for those loaded with protein and complex carbs such as oatmeal, fresh veggies, and whole grains.

Irritable Bowel Syndrome (IBS)

Some of us get headaches during stressful times, or feel just plain cranky and irritable. But if you carry stress in your stomach instead of your head, it could be because many of the same hormones and neurons are at work in both places — a fact that's led some doctors to dub the gut the body's "second brain." Take serotonin, for example. It's best known as the brain chemical that impacts mood. But 95 percent of the serotonin we produce is actually manufactured in the gut, where it plays a role in digestion. Recent studies suggest that abnormal levels of serotonin may be one cause of irritable bowel syndrome, a condition that causes chronic abdominal pain, cramping, and diarrhea and/or constipation for millions of Americans. "And since up to 90 percent of sufferers are women, some whose IBS symptoms get worse around menstruation, the flux of estrogen and progesterone may also play a role," says gastroenterologist George Arnold, M.D., a clinical professor of medicine at the University of Pittsburgh School of Medicine.

To restore balance: Paxil, a drug designed to treat anxiety and depression by upping serotonin levels in the brain, can also help relieve IBS for patients with tough-to-treat symptoms — even when they're not depressed, according to a study of 110 IBS sufferers conducted by Arnold. "Considering the amount of serotonin being produced in the intestine, we think Paxil must be doing something to the nerves in the gastrointestinal tract," he says. More than 60 percent of Paxil-takers in his study had fewer IBS symptoms — and a brighter outlook on life — compared with 26 percent of placebo-takers.

But before you call your doctor for a prescription, try increasing the fiber in your diet. In phase one of Arnold's study, one in four IBS sufferers reduced pain and bloating and felt much better after simply eating 25 grams of fiber a day, which is the USDA-recommended dose. Although fiber may or may not influence the hormones in the gut (no one knows for sure), it does help expand the diameter of the large and small intestines, which eases painful muscle contractions, according to Arnold. Try adding oatmeal and other whole grains, plus raw fruits and vegetables, to your daily diet.

Persistent Fatigue

Sure, we all have those days when we'd give anything for a midday nap — even if it meant crawling under our desks. But if you struggle daily with feeling sluggish and having zero energy — particularly if you've gained 10 to 20 pounds that you just can't shake no matter how little you eat — you could be suffering from a lack of thyroid hormone, a condition called hypothyroidism. Thyroid hormones control the body's metabolism, and when supplies are short, all systems slow down, including heart rate, mental functioning, and digestion. That's why hypothyroidism can leave a person feeling exhausted, drained, mentally foggy, even constipated. It's thought to affect at least 15 million adults nationwide, targeting 10 times more women than men, according to psychiatrist Louann Brizendine, M.D., director of the Women's and Teen Girl's Mood & Hormone Clinic at the University of California, San Francisco. And up to two thirds of cases go undiagnosed for several years because the symptoms are often dismissed as a side effect of stress.

To restore balance: Ask your doctor about getting your thyroid hormone levels checked, and be proactive about getting thyroid hormone replacement therapy if you need it. "There is some disagreement among doctors about treating subclinical hypothyroidism, since in past generations thyroid hormone was overprescribed, and too much of it can aggravate any underlying heart conditions," says Brizendine. "But in my experience, if you have symptoms of fatigue, depression, and anxiety that coincide with abnormal thyroid levels, you should seek treatment." Finding a doctor who will take these (and any other) mysterious symptoms seriously can deliver much-deserved relief