"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.

Coffee: The New Health Food?

Plenty of health benefits are brewing in America's beloved beverage.

By Sid Kirchheimer
WebMD Feature

Reviewed by Michael W. Smith, MD

Want a drug that could lower your risk of diabetes, Parkinson's disease, and colon cancer? That could lift your mood and treat headaches? That could lower your risk of cavities?

If it sounds too good to be true, think again.

Coffee, the much maligned but undoubtedly beloved beverage, just made headlines for possibly cutting the risk of the latest disease epidemic, type 2 diabetes. And the real news seems to be that the more you drink, the better.

Reducing Disease Risk

After analyzing data on 126,000 people for as long as 18 years, Harvard researchers calculate that compared with not partaking in America's favorite morning drink, downing one to three cups of caffeinated coffee daily can reduce diabetes risk by single digits. But having six cups or more each day slashed men's risk by 54% and women's by 30% over java avoiders.

Though the scientists give the customary "more research is needed" before they recommend you do overtime at Starbuck's to specifically prevent diabetes, their findings are very similar to those in a less-publicized Dutch study. And perhaps more importantly, it's the latest of hundreds of studies suggesting that coffee may be something of a health food -- especially in higher amounts.

In recent decades, some 19,000 studies have been done examining coffee's impact on health. And for the most part, their results are as pleasing as a gulp of freshly brewed Breakfast Blend for the 108 million Americans who routinely enjoy this traditionally morning -- and increasingly daylong -- ritual. In practical terms, regular coffee drinkers include the majority of U.S. adults and a growing number of children.

"Overall, the research shows that coffee is far more healthful than it is harmful," says Tomas DePaulis, PhD, research scientist at Vanderbilt University's Institute for Coffee Studies, which conducts its own medical research and tracks coffee studies from around the world. "For most people, very little bad comes from drinking it, but a lot of good."

Consider this: At least six studies indicate that people who drink coffee on a regular basis are up to 80% less likely to develop Parkinson's, with three showing the more they drink, the lower the risk. Other research shows that compared to not drinking coffee, at least two cups daily can translate to a 25% reduced risk of colon cancer, an 80% drop in liver cirrhosis risk, and nearly half the risk of gallstones.

Coffee even offsets some of the damage caused by other vices, some research indicates. "People who smoke and are heavy drinkers have less heart disease and liver damage when they regularly consume large amounts of coffee compared to those who don't," says DePaulis.

There's also some evidence that coffee may help manage asthma and even control attacks when medication is unavailable, stop a headache, boost mood, and even prevent cavities.

Is it the caffeine? The oodles of antioxidants in coffee beans, some of which become especially potent during the roasting process? Even other mysterious properties that warrant this intensive study?

Actually, yes.

Some of coffee's reported benefits are a direct result of its higher caffeine content: An eight ounce cup of drip-brewed coffee contains about 85 mg -- about three and a half times more than the same serving of tea or cola or one ounce of chocolate.

"The evidence is very strong that regular coffee consumption reduces risk of Parkinson's disease and for that, it's directly related to caffeine," DePaulis tells WebMD. "In fact, Parkinson's drugs are now being developed that contain a derivative of caffeine based on this evidence."

Caffeine is also what helps in treating asthma and headaches. Though not widely publicized, a single dose of pain reliever such as Anacin or Excedrin contains up to 120 milligrams -- what's in a hefty mug o' Joe.

Boost to Athleticism

It's also caffeine -- and not coffee, per se -- that makes java a powerful aid in enhancing athletic endurance and performance, says physiologist and longtime coffee researcher Terry Graham, PhD, of the University of Guelph in Canada. So powerful, in fact, that until recently, caffeine in coffee or other forms was deemed a "controlled" substance by the Olympic Games Committee, meaning that it could be consumed only in small, designated amounts by competing athletes.

"What caffeine likely does is stimulate the brain and nervous system to do things differently," he tells WebMD. "That may include signaling you to ignore fatigue or recruit extra units of muscle for intense athletic performance. Caffeine may even have a direct effect on muscles themselves, causing them to produce a stronger contraction. But what's amazing about it is that unlike some performance-enhancing manipulation some athletes do that are specific for strength or sprinting or endurance, studies show that caffeine positively enhances all of these things."

How does this brew affect growing minds and bodies? Very nicely, it seems, says DePaulis. Coffee, as you probably know, makes you more alert, which can boost concentration. But claims that it improves a child's academic performance can be exaggerated. Coffee-drinking kids may do better on school tests because they're more awake, but most task-to-task lab studies suggest that coffee doesn't really improve mental performance, says DePaulis.

But it helps kids' minds in another way. "There recently was a study from Brazil finding that children who drink coffee with milk each day are less likely to have depression than other children," he tells WebMD. "In fact, no studies show that coffee in reasonable amounts is in any way harmful to children."

On the flip side, it's clear that coffee isn't for everyone. Its legendary jolt in excess doses -- that is, more than whatever your individual body can tolerate -- can increase nervousness, hand trembling, and cause rapid heartbeat. Coffee may also raise cholesterol levels in some people and may contribute to artery clogging. But most recent large studies show no significant adverse effects on most healthy people, although pregnant women, heart patients, and those at risk for osteoporosis may still be advised to limit or avoid coffee.

The bottom line: "People who already drink a lot of coffee don't have to feel 'guilty' as long as coffee does not affect their daily life," says Hu. "They may actually benefit from coffee habits in the long run."

In other words, consume enough caffeine -- whether it's from coffee or another source -- and you will likely run faster, last longer and be stronger. What's enough? As little as one cup can offer some benefit, but the real impact comes from at least two mugs, says Graham. By comparison, it'd take at least eight glasses of cola to get the same effect, which isn't exactly conducive for running a marathon.

But the harder you exercise, the more benefit you may get from coffee. "Unfortunately, where you see the enhancing effects from caffeine is in hard-working athletes, who are able to work longer and somewhat harder," says Graham, who has studied the effects of caffeine and coffee for nearly two decades. "If you a recreational athlete who is working out to reduce weight or just feel better, you're not pushing yourself hard enough to get an athletic benefit from coffee or other caffeinated products."

But you can get other benefits from coffee that have nothing to do with caffeine. "Coffee is loaded with antioxidants, including a group of compounds called quinines that when administered to lab rats, increases their insulin sensitivity" he tells WebMD. This increased sensitivity improves the body's response to insulin.

That may explain why in that new Harvard study, those drinking decaf coffee but not tea beverages also showed a reduced diabetes risk, though it was half as much as those drinking caffeinated coffee.

"We don't know exactly why coffee is beneficial for diabetes," lead researcher Frank Hu, MD, tells WebMD. "It is possible that both caffeine and other compounds play important roles. Coffee has large amounts of antioxidants such as chlorogenic acid and tocopherols, and minerals such as magnesium. All these components have been shown to improve insulin sensitivity and glucose metabolism."

Meanwhile, Italian researchers credit another compound called trigonelline, which gives coffee its aroma and bitter taste, for having both antibacterial and anti-adhesive properties to help prevent dental cavities from forming. There are other theories for other conditions.

Drinking May Raise Breast Cancer Risk

By Amanda Gardner
HealthDay Reporter 1 hour, 12 minutes ago

SUNDAY, April 13 (HealthDay News) -- Alcohol, consumed even in small amounts, increases the risk of breast cancer and particularly estrogen-receptor and progesterone-receptor positive breast cancer, a new study shows.

The findings, expected to be presented Sunday at the annual meeting of the American Association for Cancer Research, in San Diego, are followed by a second study that found an association between breast cancer risk and two genes involved in alcohol metabolism.

Previous data has suggested that consuming alcohol ups the risk of breast cancer, although the precise mechanisms have not been clarified.

In some forms of breast cancer, malignant cells have receptors that render them sensitive to hormones such as estrogen. The first study aimed to see if the hormone receptor status of the tumor influenced the relationship between alcohol consumption and breast cancer risk.

In the study, a team led by Dr. Jasmine Lew of the U.S. National Cancer Institute followed more than 184,000 postmenopausal women for an average of seven years.

Those who had less than one drink a day had a 7 percent increased risk of breast cancer compared to teetotalers, the team reported. Women who drank one to two drinks a day had a 32 percent increased risk, and those who had three or more glasses of alcohol a day had up to a 51 percent increased risk.

But the risk was seen mostly in those 70 percent of tumors classified as estrogen receptor- and progesterone receptor-positive. Researchers suspect that alcohol may have an effect on breast cancer via an effect on estrogen.

The risk was similar whether women consumed primarily beer, wine or spirits, the NCI team noted.

The second study dug deeper into other possible mechanism by which alcohol consumption increases breast cancer risk.

"For years, we've known that there's an association between alcohol drinking and breast cancer risk, but nobody knows yet what the underlying biological mechanisms are," said Dr. Catalin Marian, lead author of the study and a research instructor in oncology at the Lombardi Comprehensive Cancer Center at Georgetown University in Washington, D.C. "The logical step was to begin analyzing the alcohol metabolizing genes."

And indeed, two of these genes -- ADH1B and ADH1C -- were associated with a two-fold increase in breast cancer risk.

But the study does not prove a definite cause-and-effect link. "This is an association," Marian said. "This type of study is good for generating hypotheses. It's not a definite conclusion. It needs to be replicated by other studies to say for sure that what we found is there."

Another researcher urged caution in interpreting the results of both studies.

"These studies are too early for use in a clinical setting or to advance a public health message," said Dr. Peter Shields, co-author of the genetics study and deputy director of the Lombardi Comprehensive Cancer Center.

However, he added that the findings "really do advance science, and, with proper replication in other studies, then they may be highly clinically significant."

Belly Up to the Salad Bar

WebMD Feature from "Men's Fitness" Magazine

By Elizabeth M. Ward, M.S., R.D.

RAW

Fresh spinach has nearly nine times the bone-building vitamin K of iceberg lettuce. Use at least 2 cups and you’ll get some hefty doses of zeaxanthin and lutein to protect your vision as well.

BRIGHTEN UP

Brightly colored produce generally serves up the most nutrients. For example, carrots and broccoli contribute beta-carotene (which the body can convert to vitamin A to bolster immunity, eyesight, and skin health) and anticancer compounds. The best salads include a variety of vegetables, such as artichoke hearts, beets, corn, red and green bell peppers, peas, plus lots of tomatoes (an excellent source of vitamin C).

PILE ON FREEBIES

They’re not nutritional superstars, but you can’t go wrong with cucumbers, mushrooms, celery, or zucchini. They’re low cal, and their exceptional water content helps to fill you up.

SKIP SPROUTS

They may look healthy, but raw alfalfa and mung sprouts have been linked to nearly 40% of recent food-related illnesses.

SKIRT THE CREAMY STUFF

Steer clear of all mayo-based concoctions. Just ½ cup of pasta salad runs about 115 calories and 5 grams of fat; potato salad costs you around 180 calories and 10 fat grams. If you must have them, skip the dressing on your green salad.

POUND PROTEIN

Aim for at least 25 grams of high-quality protein, which will help keep you fuller longer. The best salad bar sources include whole egg (7 grams); cottage cheese (7 grams per ¼ cup); tofu (6 grams per 1.4 ounces); chopped chicken or turkey (11 grams per ¹/³ cup); or plain tuna (23 grams per 3 ounces). Avoid using shredded cheese. A cup supplies 28 grams but has more fat than a Big Mac.

FILL UP ON FIBER

Although most vegetables are decent fiber sources, beans are the best. Include ½ cup of chickpeas (garbanzos) for 5 fiber grams, or get 8 grams with black beans. Three-bean salad is another worthy option.

GO NAKED

Toppings like bacon bits, fried chow mein noodles, and croutons are a tease, with few nutrients and lots of calories. Sunflower seeds are the one exception. Two tablespoons (100 calories) provide nearly half your daily quota for vitamin E, necessary for fighting off many forms of cell damage. At 61 calories per 2 tablespoons, raisins are another OK choice—if you can spare the calories.

CHANGE YOUR OIL

If you have to add some flavor to your vegetables, at least pick the right one. Prepared dressings are loaded with sodium, calories, and fat. Instead, top your salad with one tablespoon of heart-healthy olive oil plus as much red wine or balsamic vinegar as you want.

GET SOME ON THE SIDE

Man does not live by salad alone, and neither should you. For balance, choose 1 ounce of whole-grain bread to accompany your (now) healthy platter.

Originally published on February 1, 2008

A License to Parent?

A License to Parent?

Recently I was discussing a few well publicized parenting outrages with a colleague. "I'm sick of kids being neglected and mistreated!" he said passionately and angrily. "I've decided we should make all parents earn a license before they are allowed to become parents. After all, everyone thinks it's OK for the state to mandate basic requirements before it allows us to drive a car."

"Why not then," he continued, "for the most important job of all to get right - that of being a parent? Then we could provide child development and child rearing classes to everyone before they actually had kids to raise. I'm convinced we can diminish the amount of child abuse and neglect in this country through this measure."


My colleague cited a book he had just read on the subject. I don't think I can really represent the position fairly, so if you'd like to read a more detailed rationale for the granting of parenting licenses, read the author's own words: THE RATIONALE FOR LICENSING PARENTS by Jack C. Westman, M.D.

Sounds like a good idea, right?

**********

I hope not. To be honest, the idea horrifies me, although I must admit I agree with the sentiment behind his modest proposal and that prospective parents should learn about child development and what constitutes basic parenting skills. Frankly I don't understand why these aren't part of the basic curriculum taught in all schools to all kids. And, alas, it is true (albeit rarely) that some parents just shouldn't keep having kids (as with a patient of mine whose first five kids are in foster care due to neglect and now she just had her sixth.)

**********

But even if we wanted to, could we really weed out those who will become rotten parents? I have been surprised so often I highly doubt it. Take Millie who was a stone cold neglectful cocaine addict when her child was an infant and who, against all odds, turned her life around and got clean and has been a great mom to her four kids since. Or Sally who, after doing OK with her first, had a second child who somehow sent her into a tailspin that turned her into an impossibly neglectful, depressed mom.

Secondly, can adequate parenting skills be taught? Or more importantly, can inadequate parenting skills be overcome by a simple course in child development? I wouldn't bet on it. Can we teach someone not to abuse their kids? Would that it was so simple! Can we teach parents to love their kids? Just what would taking a course for the license ensure anyway? Just what would it teach?

Thirdly, who gets to decide who shall bear children and who shall not? And just where would you draw the line between acceptable and unacceptable future parenting skills? I would bet the bias against poor and minority families would especially play out here, as we denied them the right to parent in far greater numbers than we would economically advantaged parents.

Finally, just how would we as a society enforce the lack of a parenting license? The ways to do it seem to me to be too intrusive and horrible to contemplate (forced adoption? jail time?).

**********

Some human rights seem more untouchable to me than others, and the right to procreate without government interference has to be close to the top, even if you are unlikely to be a candidate for mother-of-the-year.

Extreme cases tend to lead to bad ideas and a license to parent is another one of them. Far better to devote enough resources to help families in trouble: high quality early child care and public school, universal health care for children, opportunities for economic self-sufficiency, more programs to help hopelessly inadequate parents, and more safeguards for kids who are exposed to such parents.

But "No" to authoritarian government intrusion into the lives and reproductive biologies of all families.

To Vaccinate or Not--That is the Question!

My parents never thought twice about my vaccinations. It was required by the schools way back then (I'm 51) and for the most part still is. I know my folks' generation saw this scientific advancement as another way to protect their children.

But there are different schools of thought now on this subject and recent articles, as well as an Op-Ed in The New York Times brought the subject to light again.

And whenever the subject turns to prevention, we turn to our expert, Dr. Carl Baum of The Center for Children's Environmental Toxicology--Yale-New Haven Children's Hospital. He took a brief stroll down memory lane and what he remembered might startle you.

Here is what Dr. Baum had to say:

In 1990, a large measles outbreak produced over 27,000 cases and 89 deaths in the United States. In Philadelphia, where I was training in pediatrics, there were over 1400 cases, almost one-third of which occurred among members of 2 church groups in Philadelphia. By the following spring, 6 people had died.

This was a disaster that highlighted the global importance of prevention. As in many other disasters, a natural process can accelerate because effective preventive strategies fail or are circumvented. In the 1990 measles outbreak, the disease spread rapidly, predominantly among preschool-age children. It turns out that the Philadelphia church groups claimed religious exemption and refused vaccinations for their members.

Why dredge up this memory? Because it is also the future: there will be more "exemptions" (read: failures) to vaccinate children against preventable disease, and therefore more disasters. In the recent case of Hannah Poling, the 9-year-old autistic girl with mitochondrial disease, a federal vaccine claims court ruled--contrary to the medical literature--that vaccines had worsened her condition. As Dr. Paul Offit, one of the great teachers from my residency, recently wrote in an Op-Ed column in The New York Times ..."the system worked fine until a few years ago, when vaccine court judges turned their back on science...."

The irony is that many of the parents who exempt their children from vaccines believe they are doing their best to protect them. In fact, when abandoning effective preventive strategies, they are doing just the opposite.

Do you agree with Dr. Baum? Have you vaccinated your children? Or do you opt out? Let us know...this is an important issue and we want to hear what you have to say.

(c) Leah-Anne Thompson. Image from BigStockPhoto.com

Urinary symptoms often affect women's sex life

By Jill Stein Mon Mar 31, 3:53 PM ET

MILAN (Reuters Health) - Women with lower urinary tract symptoms, or LUTS, are more likely to have sexual problems than women without LUTS, researchers reported here at the annual meeting of the European Association of Urology.

Dr. Con Kelleher, at Guy's and St. Thomas' Hospital Trusts in London, and colleagues examined the impact of LUTS on women's sexual functioning using a database that contains records from 333 general practices.

The study included 1,377,000 women 18 years of age or older who had been seen at one of the practices from 2000 through 2006.

The rate of sexual dysfunction among women with LUTS was twice that of women with no LUTS, researchers found.

The data also showed that women between 30 and 60 years of age were significantly more likely to report sexual dysfunction than women outside this age range.

Overall, the occurrence of overactive bladder, incontinence, and voiding problems, as well as sexual difficulties, increased markedly during the study period.

"The data suggest that the relationship between sexual dysfunction and LUTS (including overactive bladder) should be considered in women when diagnosing and treating these conditions," Kelleher said.

Sex therapists: A few minutes is best

By MEGAN K. SCOTT, Associated Press Writer Thu Apr 3, 11:39 AM ET

NEW YORK - Maybe men had it right all along: It doesn't take long to satisfy a woman in bed. A survey of sex therapists concluded the optimal amount of time for sexual intercourse was 3 to 13 minutes. The findings, to be published in the May issue of the Journal of Sexual Medicine, strike at the notion that endurance is the key to a great sex life.

If that sounds like good news to you, don't cheer too loudly. The time does not count foreplay, and the therapists did rate sexual intercourse that lasts from 1 to 2 minutes as "too short."

Researcher Eric Corty said he hoped to ease the minds of those who believe that "more of something good is better, and if you really want to satisfy your partner, you should last forever."

The questions were not gender-specific, said Corty (who, it must be noted, is male). But he said prior research has shown that both men and women want foreplay and sexual intercourse to last longer.

Dr. Irwin Goldstein, editor of the Journal of Sexual Medicine, cited a four-week study of 1,500 couples in 2005 that found the median time for sexual intercourse was 7.3 minutes. (Women were armed with stopwatches.)

It's difficult for both older men and young men to make sexual intercourse last much longer, said Marianne Brandon, a clinical psychologist and director of Wellminds Wellbodies in Annapolis, Md.

"There are so many myths in our culture of what other people are doing sexually," Brandon said. "Most people's sex lives are not as exciting as other people think they are."

Fifty members of the Society for Sex Therapy and Research in the U.S. and Canada were surveyed by Corty, an associate professor of psychology at Penn State Erie, The Behrend College, and student Jenay Guardiani. Thirty-four members, or 68 percent, responded, although some said the optimal time depended on the couple.

Corty said he hoped to give an idea of what therapists find to be normal and satisfactory among the couples they see.

"People who read this will say, 'I last five minutes or my partner lasts 8 minutes,' and say, 'That's OK,'" he said. "They will relax a little bit."

Yoga Program May Help Prevent Falls in Elderly

Fri Apr 4, 11:47 PM ET

FRIDAY, April 4 (HealthDay News) -- A specific type of yoga may help improve stability and balance in women over age 65, possibly helping them to avoid falls, a preliminary study reports.

After nine weeks of participating in an Iyengar yoga program designed for senior citizens, 24 elderly females had a faster stride, an increased flexibility in the lower extremities, an improved single-leg stance and increased confidence in walking and balance, according to the findings of researchers at Temple University's Gait Study Center.

The researchers, scheduled to present their findings Friday at the Gait and Clinical Movement Analysis Society's annual meeting in Richmond, Va., suggested that improving balance and stability through yoga could help reduce the risk of falling.

"We were very impressed at the progress our participants made by the end of the program," principal investigator Dr. Jinsup Song, director of the Gait Study Center, said in a prepared statement. "Subjects demonstrated improved muscle strength in lower extremities, which helps with stability.

There was also a pronounced difference in how pressure was distributed on the bottom of the foot, which helps to maintain balance."

The U.S. Centers for Disease Control and Prevention has said that falls are the leading cause of nonfatal injuries and hospital admissions for trauma among people aged 65 and older. Almost a third of older adults suffer some type of fall each year, the CDC reported.

The program was crafted specifically for elderly people who have had little or no yoga experience. The Iyengar technique, which is known for the use of props such as belts and blocks, was chosen to help participants gradually master the poses while building their confidence.

"In the past, similar studies have been done that look at gait and balance improvement in elderly females using a more aggressive form of yoga," Song said. "For this study, we worked to create a very basic regimen that taught participants proper ways to breathe, stand and pose."

Researchers also found that some participants who had unrelated back and knee pain were pain-free by the end of the study.

Song said he hoped the work will pave the way for a larger study on how Iyengar yoga affects the function of the foot to improve balance and stability and prevent falls.

7 Relationship Problems and How to Solve Them

How to resolve the most common relationship problems and get your love life back on track.

By Carol Sorgen
WebMD Feature

Reviewed by Amal Chakraburtty, MD

It’s a rare couple that doesn’t run into at least a few relationship problems -- even when their love life is generally happy. It helps, experts say, to know what the most common problems in a relationship or marriage are. That way you’ll have a better chance of getting through them if they occur in yours. Scott Haltzman, MD, is a clinical assistant professor of psychology at Brown University in Providence, R.I. “Knowing what to expect from relationships -- the good, the bad, and the ugly -- is the best way to make sure you're not looking for something that will never be there,” Haltzman says.

Ideally, basic topics such as money, sex, and kids should be discussed before a couple decide to share their life together, says Margaret A. Cochran, PhD. Cochran is a San Francisco Bay area psychotherapist who coaches couples on resolving marriage problems and building romantic intimacy. But agreeing on these things, she says, doesn’t guarantee that a marriage or long-term relationship is going to be trouble free.

Marriage and family therapist Terri Orbuch, PhD, director of the NIH-funded Early Years of Marriage project at the University of Michigan in Ann Arbor, has identified seven common relationship problems and ways to address them. Her suggestions can help you get a wobbly relationship back on track.

Relationship problem #1: Lack of trust

Trust is an essential part of a relationship, Orbuch tells WebMD. “Trust becomes an issue when one partner doesn’t feel the other is being honest, or doesn’t have his or her best interests at heart,” she says. It can become a major issue if one of you feels the other has a roving eye — or worse, sees signs of a cheating spouse.

Orbuch‘s solution is a “trust talk.” You and your partner need to ask one another about your feelings about and experience with dependability and commitment. What are the behaviors that are causing you to lose trust in your partner or to doubt his or her commitment? Finally -- and Orbuch says you need to think about this carefully -- do you have unresolved issues of your own that hinder your ability to trust others? “You have to have a trustworthy partner,” Orbuch says, “but you also have to have the ability to trust.”

Mary Jo Fay, RN, MSN, author of When Your “Perfect Partner” Goes Perfectly Wrong, offers these tips to help you and your partner develop trust in each other.

• Be consistent.
• Be on time. When you have to be late, call and say you’ll be late.
• Do what you say you will do, and call when you say you will call.
• Don’t lie — not even little white lies — to your partner or to others.
• Be fair, even in an argument.
• Be sensitive to the other’s feelings. You can still disagree, but don’t discount how your partner feels.
• Carry your fair share of chores.
• Respect your partner’s boundaries.
• Be a good listener.
• Try not to overreact when things go wrong.
• Don’t dig up old wounds. Remember that once you say things, you can’t take them back.
• Don't be jealous.

Relationship problem #2: Issues with sex

Even partners who love each other can have problems in their sexual relationship, says Orbuch. Pointing to the thorny issues of frequency, satisfaction, types of sexual activity, and the role of physical intimacy in the rest of the relationship, Orbuch tells WebMD that the nature of sex can change over the course of a relationship. “The passage of time,” she says, “affects sexuality. Most couples don’t retain that urgent longing they first felt.”

Talking about your sexual relationship not only gets the issue out in the open, but can also be arousing, says Orbuch. “Talk about your fantasies, how often you’d like to have sex, what things you might like to try,” she says. For many women, talk leads to intimacy, though that’s not always true for men. Passion can also be fueled by “newness.” “Do something new and exciting with your partner," Orbuch says, "whether that’s taking a cooking class together or arranging a mystery date.”

Relationship problem #3: Not enough communication

“Many couples assume that handling daily tasks is communicating,” Orbuch says. “But true communication means sharing your goals and thoughts and dreams — not just talking about whose turn it is to pick up the kids.”

Orbuch tells WebMD it’s important to spend at least five minutes a day talking about topics other than work, your schedules, and your kids. “This can be in person, on the phone, or even in email,” she says. “Or make a point of gathering at the dinner table each night to talk. This is important even if you’re a couple without kids.” Childless couples can get stuck in communication ruts, too.

Communicating with each other can go a long way toward resolving your relationship problems. But don’t be hesitant to seek help from a professional counselor. “Whether you’re a new couple, in the middle of your relationship, or long-established partners," says Orbuch, "a third party can help you if you get stuck."

Relationship problem #4: Money issues

Money issues are a sore spot for many couples. Addressing them involves many questions, says Orbuch, from how much money you each think you should save to who earns more and who makes the financial decisions. “Money is an especially sensitive subject,” says Orbuch. “People just don’t like to talk about it."

Every three months, Orbuch says, you should schedule a “money talk.” Make a list of short- and long-term financial goals, and plan for how much you're spending and how much you're saving. “It’s not unusual for one partner to play a more primary role in money matters,” says Orbuch, “but the other partner should be involved and aware. One person shouldn't be making big financial decisions alone.”

Relationship problem #5: Dividing chores

“Who does what at home can be a source of conflict between couples,” says Orbuch. “Women like to feel that they’re part of a team. It doesn’t have to be 50-50, but it does have to be fair.”

Orbuch says you should choose a time when you’re not frustrated or angry and you're both feeling relaxed. Then discuss each of your expectations. Do you expect your husband to take out the trash? Does he expect you to cook dinner? If reality doesn’t meet your expectations, instead of being frustrated, look for solutions together that may work better for each of you.

Relationship problem #6: Managing conflict

Most couples argue from time to time. “It’s not the amount of conflict, but how you handle it,” says Orbuch. “Destructive behavior, such as yelling, shouting, or withdrawing, is not appropriate. You need to develop a constructive conflict style.”

Start by bringing up your concerns in a timely way, Orbuch says, but find the right time to talk. That’s not when the kids are clamoring for your attention, or when your partner has just walked in from work at the end of a long day. Remain as calm as possible, and use “I statements" to explain how you think and feel. For example: “I feel neglected when you don’t call if you’re going to be late,” instead of: “You’re so thoughtless you can’t even pick up a phone.” And, Orbuch says, make sure you’re really listening to what your partner is saying, not thinking about your response while he or she is talking. Keep lines of communication open — remember, disagreement doesn't necessarily mean disrespect.

Relationship problem #7: Maintaining compatibility

Compatibility doesn’t always mean having similar hobbies and interests, says Orbuch. Rather, it has more to do with having similar attitudes and values. “Couples who feel the same way about issues such as children, religion, and lifestyle are more likely to stay together,” Orbuch says.

The solution again is to talk, says Orbuch. “You don’t need to be compatible on all issues,” she says, “but you should think alike on at least some of the major issues in your relationship.” For the topics you don’t agree on, Orbuch tells WebMD, you should discuss whether there's room for compromise or negotiation, and how this might affect your relationship. For instance, Orbuch says, “If one of you really wants children and the other really doesn’t, you need to honestly evaluate whether you can maintain your relationship."

While you're resolving a relationship problem

If you're working on one of these relationship problems, says Karen Sherman, PhD, there are things you can do that will help you appreciate each other while you resolve them. Sherman, a New York psychologist and co-author of Marriage Magic! Find It, Keep It, Make It Last, says you should keep the following in mind.

. Respect each other. Speak and behave respectfully toward one another. Don't humiliate or put your partner down, especially in public. When you speak with each other, speak as you did when you first started dating.

2. Show appreciation of one another. Say "thank you," and "I appreciate that you . . . ." It lets your partner know that he or she matters.

3. Be realistic. Thinking your mate will meet all your needs — and will be able to figure them out without your asking — is a Hollywood fantasy. “Ask for what you need directly,” says Sherman.

4. Recognize that the two of you are different, come from different families, and have been raised differently. Rather than getting annoyed or assuming that your partner doesn't care, open up and be receptive to learn about your partner's different way of doing things.

5. Use humor. Learn to let things go, and enjoy one another more. Have fun!

Relaxation skills help some skip hypertension meds

Tue Apr 1, 4:41 PM ET

NEW YORK (Reuters Health) - Learning stress management techniques could help people with a type of high blood pressure common among the elderly to eliminate their need for antihypertensive drugs, a new study shows.

Individuals with the condition, known as isolated systolic hypertension, who participated in relaxation training had a better chance of being able to drop at least one of their blood pressure drugs than individuals in a control group who did not participate in relaxation training, Dr. Jeffery A. Dusek of Massachusetts General Hospital in Boston and colleagues found.

If the findings are confirmed in patients with other types of hypertension, Dusek and colleagues conclude, the benefits in preventing stroke, heart attack, kidney failure and other ill effects of high blood pressure -- as well as reducing spending on drugs -- would be "incalculable."

As people age, their systolic blood pressure -- the top number in the blood pressure reading -- tends to rise, while their diastolic blood pressure, or the bottom number, often drops, Dusek and his team explain in the Journal of Alternative and Complementary Medicine.

Up to three-quarters of elderly people with hypertension have isolated systolic hypertension, which is a "therapeutic challenge" to treat effectively, given the risk of lowering diastolic blood pressure too much, as well as the fact that many elderly people take multiple medications, they note.

To determine whether learning stress management techniques could help people manage systolic hypertension without drugs, the researchers randomized 122 hypertensive men and women aged 55 and older to 8 weeks of relaxation response training or a control group. All were taking at least two antihypertensive drugs at the study's outset.

Individuals in the relaxation response group participated in weekly sessions that included 15 minutes of instruction in how to produce the response (such as mindfulness meditation and deep breathing), along with a guided 20-minute relaxation response session. They were instructed to listen to a 20-minute relaxation response tape every day.

Patients in the control group listened to a series of 20-minute tapes of instructions on lifestyle modification techniques.

At the end of 8 weeks, 44 people in the relaxation response group and 36 control group participants had reduced their blood pressure to target levels and were eligible for an additional 8 weeks of training that included supervised antihypertensive medication elimination.

Thirty-two percent of the study participants in the relaxation group were able to keep their blood pressure at the recommended level while eliminating one or more of their anti-hypertensive drugs, compared to 14 percent of those in the control group.

After the researchers controlled for various characteristics of people in each group, they found that being in the relaxation response group increased a person's chances of being able to drop at least one medication more than four-fold.

SOURCE: The Journal of Alternative and Complementary Medicine, March 2008.

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.

Comprehensive sex ed may cut teen pregnancies

By Amy Norton Mon Mar 24, 4:08 PM ET

NEW YORK (Reuters Health) - Comprehensive sex education that includes discussion of birth control may help reduce teen pregnancies, while abstinence-only programs seem to fall short, the results of a U.S. survey suggest.

Using data from a 2002 national survey, researchers found that among more than 1,700 unmarried, heterosexual teens between 15 and 19 years old, those who'd received comprehensive sex ed in school were 60 percent less likely to have been pregnant or gotten someone pregnant than teens who'd had no formal sex education.

Meanwhile, there was no clear benefit from abstinence-only education in preventing pregnancy or delaying sexual intercourse, the researchers report in the Journal of Adolescent Health.

The study found that teens who'd been through abstinence-only programs were less likely than those who'd received no sex ed to have been pregnant. However, the difference was not significant in statistical terms, which means the finding could have been due to chance.

In addition, there was no evidence that comprehensive sex education increased the likelihood of teen sex or boosted rates of sexually transmitted diseases (STDs) -- a concern of people who oppose teaching birth control in schools.

While comprehensive sex ed did not clearly reduce the STD risk, there was a modest, but statistically insignificant reduced risk of engaging in sex. The abstinence-only approach had no effect on either factor, the researchers found.

"The bottom line is that there is strong evidence that comprehensive sex education is more effective than abstinence-only education at preventing teen pregnancies," said lead researcher Pamela K. Kohler, of the Center for AIDS and STD at the University of Washington in Seattle.

She told Reuters Health the study "also solidly debunks the myth that teens who learn about birth control are more likely to have sex."

Currently, the federal government champions the abstinence-only approach, giving around $170 million each year to states and community groups to teach kids to say no to sex. This funding precludes mention of birth control and condoms, unless it is to emphasize their failure rates.

Critics have long pointed out that studies have failed to show that abstinence-only education delays sex or lowers rates of teen pregnancy.

The current study is the first to compare the effects of comprehensive sex ed and abstinence-only education in a national survey, Kohler noted.

Of the teens in the study, two thirds said they had received comprehensive sex education, while about one quarter had had abstinence-only courses. Just under 10 percent said they'd received no formal sex education.

There is now a body of evidence showing that the comprehensive approach may cut the odds of teen pregnancy, without increasing the likelihood of teens having sex, according to Kohler.

However, she added, "there seems to be a gap between scientific evidence and policy change."

SOURCE: Journal of Adolescent Health, April 2008.

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.