I wrote this blog back in June, but I think it time to repeat it. The holidays are over and all that good cheer and those good ideas for New Year’s resolutions have worn off. The regular day to day stresses are wearing many thin. So, I think this will be a good reminder to take a deep breath and think about what is important.

Have you ever had one of those weeks where every step you take, something or someone is making you angry? I was having one of those weeks until I heard a quote on a daytime talk show taken from St. Augustine: “Resentment and anger is like taking poison and expecting the other person to die”. First, this wisdom immediately deflated my anger and then it led me to question the point of anger in the first place.

Anger has been with us since the beginning of mankind. The emotion of anger has intrinsically been an impetus for change. It may cause discomfort, however when dealt with constructively, it moves us to act and improve the circumstance causing the discomfort. When dealt with destructively, anger can cause violence, self-loathing and depression.

As a physician, I see the physical effects of this on a daily basis. Depression, heart disease, and obesity (that can cause diabetes, high blood pressure and certain cancers) can often result from prolonged anger, resentment and hostility. Many patients I see heal and improve when we address the underlying anger and resentment in their lives.

With all that is going on in the world right now, it seems there is anger at every turn. The media is busy reporting various feuds; politicians are angry with one another, and the opposing parties. Doctors are angry with insurance companies, and patients are angry because they are not getting what they want from their doctors.

I think if we all stopped for a moment when we become angry and truly thought about what was going on internally, we could make great changes in ourselves and in the world. If we find that anger is consuming us, it is time to get help before it destroys us.

“The best work of the world is done in the tension between anger and control.” ~ G. Stanley Hall

If it seems that almost everyone you know is on antidepressants, your perceptions would be correct. Major depressive disorder affects up to 12% of men and 25% of women. Antidepressants can be effective in treating this disorder but only result in a remission in 30% of those treated. The response rate to medication (meaning there is some improvement) can be up to 70%.

The most popular antidepressants of choice are the selective serotonin reuptake inhibitors like Prozac and Zoloft. These medications block the reuptake of serotonin by the brain keeping up levels available to the central nervous system.

New research has found that there may be something out there that can augment and perhaps treat depression alone. It gets to the very core of the problem and believe it or not it is not a medication. It is a vitamin. I know this sounds too good to be true, but it is not. Let me explain.

Folic acid is an essential B vitamin. It is found in green leafy vegetables, eggs, cereals and fortified foods (to name a few). When you take in folic acid in your diet it is absorbed by the small intestine where it is converted by a series of enzymes and ultimately into L-methylfolate. This metabolite is used to make serotonin, norepinephrine and dopamine, which are all important for mood regulation.

Scientists have identified 40 mutations on the gene responsible for making the enzyme that converts folic acid into L-methylfolate. The most common genotype is known as C677T. If there is one mutation on this gene your ability to convert folic acid is reduced by 34%. If you have two mutations, it is reduced by 71%. Now you probably are seeing where I am going with this.

If you have a defective enzyme then you cannot convert folic acid to L-methylfolate properly and you will have lower serotonin, norepinephrine and dopamine levels. These gene mutations are extremely common. The treatment is simple. It is a prescription of L-methylfolate. This is a vitamin that is considered medicinal food. If given in the proper amounts (7.5 to 15 mgs) it can improve depression relatively quickly. In a study of elderly depressed patients, the response rate at 6 weeks was 81%. Results are often seen in just two weeks.

It is well tolerated with no more side effects than placebo. It does not interact with other medications. If an antidepressant has produced a positive response but the patient is still somewhat depressed L-methylfolate can help.

If you are depressed and/or on medication for depression, I recommend you ask your doctor to see if you have the genetic abnormality that I mentioned. The test is MTHFR. When I treat my depressed patients with this vitamin, I have seen amazing results. It just makes sense. If serotonin levels are genetically low then why not find a healthy way to boost them?

I give a lot of medical advice. Sometimes I feel like a broken record by repeatedly relaying the message that the secret of health is to maintain a healthy lifestyle. However, there is another more important secret that goes beyond the day-to-day choices that include food and exercise. It addresses personal power and what drives us. What I am talking about is having a sense of purpose.

I know to some this may sound like psychobabble. However, let me tell you about the nun study. Since 1986, a group of researchers has been studying nuns while they are alive and examining their brains after they die. They have been able to identify some of the risk factors for Alzheimer’s disease. They have found that those with a positive outlook who were continually exercising their brains were less likely to develop the disease.

The most interesting finding was that there were some nuns who died and then Alzheimer’s disease was found on autopsy, but they showed no signs of the disease in life. Those women had a positive attitude and a sense of purpose. That seemed to be enough to keep them healthy and functional.

A study of 155 senior citizens done in Chicago found that those seniors with a sense of purpose were 2.4% more likely to remain mentally sharp than those who did not. Those who were outgoing and self-satisfied were 50% less likely to develop Alzheimer’s. This attitude may boost the immune system and protect blood vessels.

There are so many things that we do not know. But, I am convinced that we all possess an amazing power. That is the power of our minds. It could be what is behind the placebo effect or perhaps it is just what overall wellness is about. Regardless, if you want to find the path to healing or maximum health, it is important to find your passion and you own personal path in life and then follow it!

It is a new year and you have decided this is the year you are going to get into good shape. You have it all figured out. You find a gym, a class, and you even have a cute workout outfit picked out. That is wonderful. What you need to know is that most people are motivated at the beginning of a fitness program but they tend to fall off the wagon after several weeks. The key is to stay motivated and adopt simple techniques that will serve you throughout the year and your life. Here are a few:

1. If you are mindful, you will begin to notice how much better you feel by eating healthy, moving and losing weight. That in and of itself will be motivating.

2. Set small, reachable goals. The best example of this was an interview I heard on the Today show. A woman who had lost 100 pounds said that she looked at her weight loss as losing ten pounds ten times. She basically set out to lose 10 pounds at a time. If she had looked at losing 100 pounds it would have felt impossible.

3. Reward yourself when you reach your goal with something other than food! It could be something small such as a CD or a new purse or briefcase. It could be big such as a vacation or money that you reward yourself with.

4. Don’t do it alone. It helps to have the motivation of your friends and family. Just as being overweight can be contagious so can improving attitudes towards food and lifestyle changes. Including a family member or friend in your program can increase your chance of success.

5. If you can’t find a friend or family member to join your program, consider using a trainer or nutritionist. Even if you only meet with them once a month, you will have someone to support you and to be accountable to. It can really help.

Good luck with your workout routine. Following these few small tips can make a big difference in how you feel and help you to succeed.

It is inevitable that as the New Year approaches most morning talk shows, magazine articles and radio shows are urging us to make our New Year’s resolutions. My lists were quite extensive in the past. As I have gotten older and wiser (I think) my lists have gotten shorter and much more realistic. It is a good idea to look back on the previous year and find ways to improve. I worry, however, that most of us set ourselves up for failure. So, here is my advice:

*If weight loss is your goal estimate the possibility of losing one pound a week. Thinking you can lose a tremendous amount of weight over a short period of time is unrealistic. Try for five to ten pounds at a time.

*For exercise, if you have been sedentary, start slow. Walk one block a day and add blocks from there. Get your doctor to help with an exercise program.

*If you are looking to become healthier, find a doctor or provider who can help you come up with a reasonable plan. Going to the vitamin counter of the local health food store without guidance is not a good idea. Natural is not necessarily safe.

*Plan out your health care goals by mapping out the preventive studies that you need and get them scheduled. Eye exams, blood pressure checks, BMI calculations, vaccines, and pap smears and mammograms for women, PSA’s and digital rectal exams for men, cholesterol profiles and fasting blood sugars are a good start.

*For fun: smile and laugh more, love more, give more of yourself by paying it forward, and eat chocolate on occasion in moderation of course!

The key is to put yourself first on the list. If you do not take care of yourself then you cannot take care of anyone else. Keep your list short, sweet and something that you can follow and achieve in 2012. Happy Healthy New Year!

Do you ever wonder if the new modern technologies are rotting your brain? Are you dependent on your car or cellphone GPS to get you where you want to go? You may want to re-think that.

Scientists have found that when you use your brain to navigate your route in your car or on foot that you use a map in your head or you find your way on autopilot. Either way you are using the hippocampus area of your brain. If you depend on the GPS you are not.

When scientists have examined the brains of taxi cab drivers in London where they are always looking for shortcuts, they found that their hippocampus was larger than those of non-taxi cab drivers. Older adults who do not use GPS and use maps to navigate have more grey matter than those who don’t.

It is possible by activating this part of the brain that we may be able to prevent dementia. This is one instance where it might make sense to do things the old fashioned way. If you need to find a new route to work or go to a place you have not been to in awhile, use a map and navigate on your own.

Another thing that can help is to start calling people the old-fashioned way. Remember their numbers and call them. Do not rely on your smart phone for directions or phone numbers. It can make you stupid!

We are living in tumultuous times. We have so many things that tend to pop up and cause worry. Finances, health, emotional and family problems are all common issues. Many people start to get a sense of helplessness and hopelessness. This impacts their health causing pain, disease, fatigue and depression. I care for many patients where this is the case.

In trying to help them, I have found something that works. That thing is becoming a helper. It costs no money and it improves their health by boosting the immune system and improving brain function. Doing something for others is the key to feeling better.

Studies have found that those who give of themselves experience joy and happiness. It can be something as simple as volunteering for the SMART program and reading to children or working at a food bank. The hospitals and many clinics welcome volunteers. For those who want to donate money there are infinite worthy causes.

People who help others have been studied. Researchers have found that they experience a surge in their endorphins similar to the high that runners experience. Giving to others in need decreases the intensity and awareness of pain, relieves stress, and activates positive emotions. All these things help to improve health. The results of a study done in 2700 men in Michigan found that those men who worked as regular volunteers had a two and a half times lower death rate than those who did not.

Amazing things happen when one goes from being the one who is helped to being the helper. It is nothing short of a miracle. Over and over I see people heal and feel good about themselves and what they are doing. It is easy to get wrapped up in our lives and ourselves, but stepping out of it and realizing that we each have something valuable to give can be good for us as well as others.

When I was growing up, my grandmother had a huge, heavy handbag. The reason I know this is because I was the designated shlepper of that handbag. Since that time, handbags have become purses and have gone through many size changes. We have seen the tiny purses; the medium purses, the backpack purses and we are now all lugging around the huge, heavy purses or handbags (which are really shoulder bags!) again. The more things change, the more things stay the same.

Designers are combining purses with computer bags, which can weigh up to ten pounds. As a result, doctors have been diagnosing women with shoulder strain because they are schlepping these bags. This can cause permanent shoulder damage and chronic pain. If women can keep their posture aligned while carrying their heavy bags, they have fewer problems. Those that do have shoulder pain may find relief with the use of anti-inflammatory medication, massage and physical therapy.

If you are a busy woman who keeps her closet, computer, and spare shoes in her purse, the best way to prevent this problem is to change things up. Keep your purse light and change the weight and size of the purse frequently. Be sensible and prevent “shlepper shoulder” today!

We are heading towards the big three holidays: Thanksgiving, Christmas/Hanukkah, and New Years. We have all seen the movies. You know the ones. The ones with scenes where there are mild, funny conflicts and then everyone makes up and there is a happy holiday ending. Wouldn’t it be great if life worked that way? I am not saying that holidays cannot be fun and happy. However, when families’ get together there is usually some element of drama and it can be stressful.

When expectations of a wonderful holiday are not fulfilled many of us are tempted to self medicate with food, alcohol and even drugs. That is why it is so important to learn productive ways to deal with holiday stress. Eating a healthy diet, exercise and deep breathing and meditation techniques help. Finding a funny movie as a diversion might take the edge off as well.

Life is rarely as bright and fun-filled as it seems in the movies or on television. We all have our “stuff“ regardless of how it looks from the outside looking in. That is something I have learned as a physician and the keeper of people’s secrets. Even those who look like they have everything, have issues.

Many people look to the holidays as the time when those issues may be resolved or at least put aside. If that does not happen and you find yourself upset, rather than reaching for the cookies when you feel family pressures go for a walk around the block. A quick trick is the 4-7-8 breathing method. Inhale for a count of 4 hold your breath for a count of 7 and then let it out for a count of 8. Do it for a cycle of three 4-7-8’s and you will find yourself calming down.

Stay healthy over the holidays by making positive choices when faced with stress. You will feel better and develop some good coping mechanisms to handle difficult situations now and in the future.

There are many foods we hear about that are considered junk food and often on the “forbidden” list, but they really aren’t bad for you. Here are a few that may surprise you - just in time for the holidays!

Sour Cream

It is true that sour cream is 90% fat. However, it is usually only eaten in small quantities. A serving of sour cream is two tablespoons and is only 52 calories. This is less saturated fat than is in a 12-ounce glass of 2% milk.

Coconut

Coconut is packed with saturated fat. However half the fat is lauric acid. A recent review has found that lauric acid can increase the LDL or “bad” cholesterol levels, but it boosts the HDL or “good” cholesterol more. The rest of the fat is made up of medium chain fatty acids, which are neutral. A pinch of unsweetened shredded coconut can make a nice snack, or at least can add some flavor to another snack. Just don’t overdo it as it is high in calories.

Chocolate

Chocolate has been given a bad rap in the past. However, dark chocolate is rich in flavonoids. These compounds (also found in green tea and red wine) have been found to reduce inflammation and relax blood vessels, improve blood flow, and even improve your mood. Three ounces a day can decrease blood pressure. Once again, moderation is the key when it comes to eating chocolate. The recommended amount is the equivalent of 2 Hershey kisses a day.

Pork Rinds

Pork rinds are made from fried pigskin. Sounds fatty?! However, a one-ounce serving contains 9 grams of fat, 17 grams of protein and NO carbohydrates. Almost half the fat is unsaturated and in the form of oleic acid (the same healthy fat found in olive oil); the rest is saturated fat that is in the form of stearic acid and considered harmless. The key, if you like these, is not to go overboard.

Beef Jerky

Beef jerky is often thought to be high in preservatives and not particularly healthy. However, it doesn’t have to be unhealthy if you get the right brands. It is a great high protein snack that won’t raise your insulin levels. The key is to find it with all natural ingredients (without MSG, sodium nitrate and chemicals). For variety and omega-3 fatty acids, make sure to get grass-fed beef or give salmon jerky a try!