Saturday, November 8, 2008
Diet and Exercise
Be glad of life, because it gives you the chance to love, and to work, and to play, and to look up at the stars. ~Henry Van Dyke
Currently, life expectancy in the United States, according to the CDC, is 77.8 years. That breaks down to 75.2 years for men and 80.4 years for women. Interestingly, life expectancy in the year 1900 was only 47.3 years. There is no definitive data on life expectancy for gay populations. However, many of the major health concerns for heterosexuals are the same for homosexuals. Two of the best methods anyone can utilize to live a long, healthy life are regular exercise and healthful eating habits.
Exercise: Physical activity should be as integral a part of your daily routine as showering, eating, or brushing your teeth. No medication your doctor can prescribe, or vitamin you can take, or “energy drink” you can buy, will make you feel as good or benefit your health as much as regular exercise. The benefits of exercise are numerous, including:
-Improved energy, mood, and self-esteem. Regular exercise helps reduce feelings of depression and anxiety.
-Decreased risk of chronic disease. Exercise lowers blood pressure and improves cholesterol levels, two of the main contributors to heart disease, which is still the #1 cause of death in the United States. Exercise also reduces the risk of osteoporosis, diabetes, and certain types of cancer.
-Improved sleep patterns. Exercise helps you fall asleep faster and promotes deeper sleep.
-Improved sexual performance. Men who exercise regularly are less likely to have problems with erectile dysfunction.
The American College of Sports Medicine recommends doing cardiovascular exercise (such as walking, jogging, or swimming) for 30 minutes, five days per week, as well as strength training two times per week. This may seem like a lot. If you’re currently not exercising at all, start slow, and build your way up. Considering the benefits, there are few activities in your day that should have a higher priority than exercise. So, turn off the TV, log off the computer, and get moving. Try exercising first thing in the morning. You get it out of the way, and it’s a great way to start your day.
I like Matthew McConaughey’s advice: “Just break a sweat, somehow, every day.”
Eating: We live in a culture that surrounds us with food. Food is cheap, easily available, and for the most part, is laden with empty calories and void of nutritional value. You can’t swing a gym sock over your head without hitting a fast food store, a convenience store, or a vending machine. Up to 25% of Americans eat some type of fast food every day. It’s no wonder, then, that two-thirds of Americans are either overweight or obese. Managing your food intake is a challenging process, and requires commitment, effort, and planning. Some of the principles that I have found most useful include:
-Always make sure you have food with you. Pack a lunch, as well as healthy snacks, every time you leave the house. Fruit, nuts, or (my favorite) low-carb tortillas with peanut butter, are much more healthful choices than most of the sugary junk laying around workplaces. Carrying your own food empowers you, because you’re not at the mercy of eating junk when you get hungry. You’ll also save money.
-Avoid fast food. If you must eat “on the run,” get a (6 –inch) sub sandwich on wheat bread and load it up with vegetables. And skip the chips.
-Drink water. Don’t drink soda. What is soda anyway? Colored, liquid fizz with chemicals. Is this really what you want to put into your body? Water is pure liquid refreshment. It helps with digestion, detoxifies the liver and kidneys, and works as a natural appetite suppressant. It also prevents dehydration, which can contribute to the formation of kidney stones.
-Avoid processed or pre-packaged foods. In other words, try to avoid eating anything out of a box, a can, a vending machine, or a convenience store. This type of “food” is loaded with calories and chemicals, and has very little nutritional value. It reeks havoc on your digestive system, as well as your cholesterol and blood sugar levels.
-Eat five or more servings of fruits and vegetables a day. Try eating fruit in the morning with breakfast, and raw vegetables with your sandwich instead of chips or fries.
-Watch your portion sizes. A “portion” is about the size of your fist. Bigger is not always better. Contrary to what our parents taught us, it’s OK to leave food on your plate. Eat enough so that you don’t feel hungry, but try not to stuff yourself.
-Be “mindful” of your eating. Before you go shoveling something into your mouth, ask yourself: “Am I really hungry? Or am I bored? Or stressed out? Or depressed?” Be aware if something other than hunger is prompting you to eat.
If you want more information on exercise and eating healthy, visit www.cdc.gov/healthyliving.com. It’s always advisable to visit your physician before starting a new exercise or diet program.
Currently, life expectancy in the United States, according to the CDC, is 77.8 years. That breaks down to 75.2 years for men and 80.4 years for women. Interestingly, life expectancy in the year 1900 was only 47.3 years. There is no definitive data on life expectancy for gay populations. However, many of the major health concerns for heterosexuals are the same for homosexuals. Two of the best methods anyone can utilize to live a long, healthy life are regular exercise and healthful eating habits.
Exercise: Physical activity should be as integral a part of your daily routine as showering, eating, or brushing your teeth. No medication your doctor can prescribe, or vitamin you can take, or “energy drink” you can buy, will make you feel as good or benefit your health as much as regular exercise. The benefits of exercise are numerous, including:
-Improved energy, mood, and self-esteem. Regular exercise helps reduce feelings of depression and anxiety.
-Decreased risk of chronic disease. Exercise lowers blood pressure and improves cholesterol levels, two of the main contributors to heart disease, which is still the #1 cause of death in the United States. Exercise also reduces the risk of osteoporosis, diabetes, and certain types of cancer.
-Improved sleep patterns. Exercise helps you fall asleep faster and promotes deeper sleep.
-Improved sexual performance. Men who exercise regularly are less likely to have problems with erectile dysfunction.
The American College of Sports Medicine recommends doing cardiovascular exercise (such as walking, jogging, or swimming) for 30 minutes, five days per week, as well as strength training two times per week. This may seem like a lot. If you’re currently not exercising at all, start slow, and build your way up. Considering the benefits, there are few activities in your day that should have a higher priority than exercise. So, turn off the TV, log off the computer, and get moving. Try exercising first thing in the morning. You get it out of the way, and it’s a great way to start your day.
I like Matthew McConaughey’s advice: “Just break a sweat, somehow, every day.”
Eating: We live in a culture that surrounds us with food. Food is cheap, easily available, and for the most part, is laden with empty calories and void of nutritional value. You can’t swing a gym sock over your head without hitting a fast food store, a convenience store, or a vending machine. Up to 25% of Americans eat some type of fast food every day. It’s no wonder, then, that two-thirds of Americans are either overweight or obese. Managing your food intake is a challenging process, and requires commitment, effort, and planning. Some of the principles that I have found most useful include:
-Always make sure you have food with you. Pack a lunch, as well as healthy snacks, every time you leave the house. Fruit, nuts, or (my favorite) low-carb tortillas with peanut butter, are much more healthful choices than most of the sugary junk laying around workplaces. Carrying your own food empowers you, because you’re not at the mercy of eating junk when you get hungry. You’ll also save money.
-Avoid fast food. If you must eat “on the run,” get a (6 –inch) sub sandwich on wheat bread and load it up with vegetables. And skip the chips.
-Drink water. Don’t drink soda. What is soda anyway? Colored, liquid fizz with chemicals. Is this really what you want to put into your body? Water is pure liquid refreshment. It helps with digestion, detoxifies the liver and kidneys, and works as a natural appetite suppressant. It also prevents dehydration, which can contribute to the formation of kidney stones.
-Avoid processed or pre-packaged foods. In other words, try to avoid eating anything out of a box, a can, a vending machine, or a convenience store. This type of “food” is loaded with calories and chemicals, and has very little nutritional value. It reeks havoc on your digestive system, as well as your cholesterol and blood sugar levels.
-Eat five or more servings of fruits and vegetables a day. Try eating fruit in the morning with breakfast, and raw vegetables with your sandwich instead of chips or fries.
-Watch your portion sizes. A “portion” is about the size of your fist. Bigger is not always better. Contrary to what our parents taught us, it’s OK to leave food on your plate. Eat enough so that you don’t feel hungry, but try not to stuff yourself.
-Be “mindful” of your eating. Before you go shoveling something into your mouth, ask yourself: “Am I really hungry? Or am I bored? Or stressed out? Or depressed?” Be aware if something other than hunger is prompting you to eat.
If you want more information on exercise and eating healthy, visit www.cdc.gov/healthyliving.com. It’s always advisable to visit your physician before starting a new exercise or diet program.
Test Your STD IQ with Dr. Wayne's STD Quiz!
“There is hardly anyone whose sexual life, if it were broadcast, would not fill the world at large with surprise and horror.” --William Somerset Maugham
According to the CDC, rates of sexually transmitted diseases (STDs) among gay men have been increasing in recent years. While some STDs are curable (such as gonorrhea, chlamydia, and syphilis), others are not (such as herpes and HIV). Having any STD, even one that is curable, makes you much more likely to acquire HIV if you’re exposed.
Here are some questions to help you assess your knowledge of STDs. Remember, knowledge is power, and prevention is the best strategy.
Q: True of False? Washing or showering after sex is a good way to protect yourself against STDs.
A: False. According to the CDC, washing the genitals, urinating after sex, or douching will not prevent any STD. Abstinence from sex, or monogamy with an uninfected partner, are the surest ways to prevent STDs. Condoms can greatly reduce the risk of STDs if used correctly, and consistently.
Q: True of False? It burns when I urinate. I must have a urinary tract infection.
A: Maybe. But you might have gonorrhea or chlamydia. Urinary tract infections can be common in some women, but they are rare in men. Anyone having “genital” symptoms such as discharge or burning with urination should see a doctor for testing. Untreated infection with gonorrhea or chlamydia can lead to serious complications, such as pelvic inflammatory disease and ectopic pregnancy in women, or epididymitis (swollen, infected testicles) in men. Both men and women are at risk for infertility if not treated.
The symptoms of gonorrhea or chlamydia usually appear within a week of being infected, but may take as long as 4 weeks. Many infected people have no symptoms. Testing involves a simple urine test, and infections can be cured with antibiotics.
Q: True or False? Gonorrhea and chlamydia are not spread by oral sex.
A: False. Gonorrhea and chlamydia can be spread by oral, vaginal, or anal sex. They are bacterial infections, and the bacteria can grow not only in the genitals and reproductive organs, but also in the mouth, throat, eyes, and rectum. They can also be passed from an infected mother to her baby during childbirth. Ejaculation does not have to occur during sex for these infections to be spread. Symptoms of a throat infection include – a sore throat. Rectal infection can cause anal itching, discharge, bleeding, or painful bowel movements. Again, there often are no symptoms.
Q: True of False? Lesbians don’t get STDs, so they don’t need to get pap smears.
A: False. While STD rates among lesbians are low, lesbian sex is not without risk. HPV (human papilloma virus), the virus that causes genital warts and cervical cancer, is spread through genital contact, including lesbian sex. There are over 40 strains of the HPV virus, classified as either “low risk” or “high risk.” A person with a healthy immune system can usually clear the virus within 2 years. In some people, “low risk” strains can cause genital warts, which appear within a few weeks of exposure, but may not appear for several months. They can be anywhere in the genital area or around the rectum, or even in the groin and inner thighs. They can be treated with topical medication, or frozen or surgically removed by a physician. They do not progress to cancer. “High risk” strains of HPV can cause cervical cancer in women or anal cancer in men. These cancers do not have symptoms until they are advanced, so it is important for all women, including lesbians, to get pap tests every year. Pap tests look for early cell changes, which can be treated before they progress to cancer. Anal pap tests are also being used to detect early cancer in gay men, particularly those infected with HIV. There is an HPV vaccine that is approved for women, and it is currently being studied for use in men.
Q: I had a sore on my penis, but it didn’t hurt, and it healed up after 2 weeks. It must have been nothing, and I’m OK now, right?
A: Wrong. What you described sounds like syphilis. Syphilis is a bacterial infection spread by oral, vaginal, or anal sex. Syphilis occurs in stages. The first stage is a painless ulcer that appears at the area of contact (the genitals, rectum, or mouth, but it can be anywhere on the body), usually within a few weeks from the time of exposure. The ulcer heals on its own, but the bacteria remain in the blood. Within a month or two, the second stage occurs, which can include fever, headache, swollen lymph nodes, or a rash in the mouth or on the palms of the hands and soles of the feet. These resolve within a few weeks, and the infection then enters a latent stage, which may last for years. During the latent stage, the infection begins to slowly and steadily damage the internal organs (heart, brain, and liver, and also the eyes, joints, and blood vessels), causing blindness, dementia, and even death. Several famous people throughout history are alleged to have contracted syphilis, including Vincent Van Gogh, Friedrich Nietzsche, Adolf Hitler, and Karen Blixen (aka Isak Dinesen, the author of Out of Africa).
Rates of syphilis have increased substantially in recent years. According to the CDC, men who have sex with men account for 64% of syphilis cases in the United States. Additionally, Phoenix and Maricopa County have one of the highest rates of syphilis in the nation. Syphilis is diagnosed with a blood test, and if it’s detected in the early stages, is easily cured with antibiotics.
Q: True of false? People with genital herpes aren’t contagious unless they’re having an outbreak.
A: False. Herpes is a viral infection transmitted by oral or genital contact, and can be transmitted even if the infected person has no visible sores. Herpes causes painful, fluid-filled blisters that occur within a few weeks of exposure. The blisters heal, but can recur. There is no cure for herpes, and there is no vaccination. Medication is available that, if taken daily, can decrease not only the frequency and severity of outbreaks, but also the risk of transmitting the infection to others. Consistent condom use can also reduce the risk of spreading the infection.
Having any STD infection makes you up to five times more likely to become infected with HIV if you’re exposed to the virus. The CDC recommends getting tested for STDs every 6 months if you’ve had new or multiple sexual partners and have engaged in unprotected sex.
So, how did you score? If you’d like more information about STDs, talk with your doctor, or visit the CDC website at www.cdc.gov/std.
According to the CDC, rates of sexually transmitted diseases (STDs) among gay men have been increasing in recent years. While some STDs are curable (such as gonorrhea, chlamydia, and syphilis), others are not (such as herpes and HIV). Having any STD, even one that is curable, makes you much more likely to acquire HIV if you’re exposed.
Here are some questions to help you assess your knowledge of STDs. Remember, knowledge is power, and prevention is the best strategy.
Q: True of False? Washing or showering after sex is a good way to protect yourself against STDs.
A: False. According to the CDC, washing the genitals, urinating after sex, or douching will not prevent any STD. Abstinence from sex, or monogamy with an uninfected partner, are the surest ways to prevent STDs. Condoms can greatly reduce the risk of STDs if used correctly, and consistently.
Q: True of False? It burns when I urinate. I must have a urinary tract infection.
A: Maybe. But you might have gonorrhea or chlamydia. Urinary tract infections can be common in some women, but they are rare in men. Anyone having “genital” symptoms such as discharge or burning with urination should see a doctor for testing. Untreated infection with gonorrhea or chlamydia can lead to serious complications, such as pelvic inflammatory disease and ectopic pregnancy in women, or epididymitis (swollen, infected testicles) in men. Both men and women are at risk for infertility if not treated.
The symptoms of gonorrhea or chlamydia usually appear within a week of being infected, but may take as long as 4 weeks. Many infected people have no symptoms. Testing involves a simple urine test, and infections can be cured with antibiotics.
Q: True or False? Gonorrhea and chlamydia are not spread by oral sex.
A: False. Gonorrhea and chlamydia can be spread by oral, vaginal, or anal sex. They are bacterial infections, and the bacteria can grow not only in the genitals and reproductive organs, but also in the mouth, throat, eyes, and rectum. They can also be passed from an infected mother to her baby during childbirth. Ejaculation does not have to occur during sex for these infections to be spread. Symptoms of a throat infection include – a sore throat. Rectal infection can cause anal itching, discharge, bleeding, or painful bowel movements. Again, there often are no symptoms.
Q: True of False? Lesbians don’t get STDs, so they don’t need to get pap smears.
A: False. While STD rates among lesbians are low, lesbian sex is not without risk. HPV (human papilloma virus), the virus that causes genital warts and cervical cancer, is spread through genital contact, including lesbian sex. There are over 40 strains of the HPV virus, classified as either “low risk” or “high risk.” A person with a healthy immune system can usually clear the virus within 2 years. In some people, “low risk” strains can cause genital warts, which appear within a few weeks of exposure, but may not appear for several months. They can be anywhere in the genital area or around the rectum, or even in the groin and inner thighs. They can be treated with topical medication, or frozen or surgically removed by a physician. They do not progress to cancer. “High risk” strains of HPV can cause cervical cancer in women or anal cancer in men. These cancers do not have symptoms until they are advanced, so it is important for all women, including lesbians, to get pap tests every year. Pap tests look for early cell changes, which can be treated before they progress to cancer. Anal pap tests are also being used to detect early cancer in gay men, particularly those infected with HIV. There is an HPV vaccine that is approved for women, and it is currently being studied for use in men.
Q: I had a sore on my penis, but it didn’t hurt, and it healed up after 2 weeks. It must have been nothing, and I’m OK now, right?
A: Wrong. What you described sounds like syphilis. Syphilis is a bacterial infection spread by oral, vaginal, or anal sex. Syphilis occurs in stages. The first stage is a painless ulcer that appears at the area of contact (the genitals, rectum, or mouth, but it can be anywhere on the body), usually within a few weeks from the time of exposure. The ulcer heals on its own, but the bacteria remain in the blood. Within a month or two, the second stage occurs, which can include fever, headache, swollen lymph nodes, or a rash in the mouth or on the palms of the hands and soles of the feet. These resolve within a few weeks, and the infection then enters a latent stage, which may last for years. During the latent stage, the infection begins to slowly and steadily damage the internal organs (heart, brain, and liver, and also the eyes, joints, and blood vessels), causing blindness, dementia, and even death. Several famous people throughout history are alleged to have contracted syphilis, including Vincent Van Gogh, Friedrich Nietzsche, Adolf Hitler, and Karen Blixen (aka Isak Dinesen, the author of Out of Africa).
Rates of syphilis have increased substantially in recent years. According to the CDC, men who have sex with men account for 64% of syphilis cases in the United States. Additionally, Phoenix and Maricopa County have one of the highest rates of syphilis in the nation. Syphilis is diagnosed with a blood test, and if it’s detected in the early stages, is easily cured with antibiotics.
Q: True of false? People with genital herpes aren’t contagious unless they’re having an outbreak.
A: False. Herpes is a viral infection transmitted by oral or genital contact, and can be transmitted even if the infected person has no visible sores. Herpes causes painful, fluid-filled blisters that occur within a few weeks of exposure. The blisters heal, but can recur. There is no cure for herpes, and there is no vaccination. Medication is available that, if taken daily, can decrease not only the frequency and severity of outbreaks, but also the risk of transmitting the infection to others. Consistent condom use can also reduce the risk of spreading the infection.
Having any STD infection makes you up to five times more likely to become infected with HIV if you’re exposed to the virus. The CDC recommends getting tested for STDs every 6 months if you’ve had new or multiple sexual partners and have engaged in unprotected sex.
So, how did you score? If you’d like more information about STDs, talk with your doctor, or visit the CDC website at www.cdc.gov/std.
The Unholy Ghost: Depression
“My melancholy – she is the most faithful mistress I have ever known” --Soren Kierkegaard
Andrew Solomon, author of “The Noonday Demon: An Atlas of Depression,” describes depression as “the aloneness within us made manifest. It destroys not only your connection to others, but also the ability to be peacefully alone with yourself.” Depression is among the most burdensome diseases in the world. The annual economic consequences of depression are estimated at 83 billion dollars in the US. Up to 20% of the adult population experiences a major depressive episode at some time in their lives. Depression rates in the gay population are thought to be significantly higher, and as high as 40% in patients with HIV.
Depression has been an area of intensive clinical study in recent years, both in defining what it is, what causes it, and in formulating effective treatments. According to the DSM-IV, depression is defined by the following:
-Feelings of sadness or hopelessness
-Loss of interest in pleasurable activities
-Changes in sleep patterns, like sleeping too much, or not being able to sleep well. The classic complaint is waking up in the early morning and not being able to go back to sleep.
-Changes in appetite, such as eating too much, or not eating enough
-Loss of energy
-Trouble concentrating
-Thoughts of worthlessness or guilt
-Thoughts about death or suicide
A major depressive episode includes at least five of the above symptoms, which are present most of the day, nearly every day, for at least 2 weeks, and cause significant distress or dysfunction. A minor episode includes two of the symptoms, at least one of which is feelings of hopelessness or loss of interest in pleasurable activities. In addition to emotional symptoms, depression can also manifest in physical symptoms, such as headaches, muscle aches, or abdominal pain.
Most cases of major depression occur between ages 30-40, but can occur at any point from childhood to old age. Episodes usually last from several months to a year. Many people with major depression have recurrent episodes throughout their lives. Genetic factors can predispose some people to depression, especially when combined with environmental influences. Life stressors, such as chronic illness or the death of a loved one, can be triggers for depression. Use of cocaine and crystal meth can affect brain chemistry and contribute to the onset of depression. Some depressive episodes occur without any obvious trigger.
Depression has become one of the most important factors in the HIV/AIDS epidemic. Major depression increases the risk of becoming infected with HIV. People with untreated depression may attempt to “self-medicate” with alcohol and other drugs, and have more self-destructive behavior patterns, such as using crystal meth and engaging in unprotected sex with multiple partners. Concurrently, people infected with HIV are at higher risk for developing depression. This is thought to be due to several factors, including the direct effects of the virus on the brain and central nervous system, low testosterone levels (common in HIV infection), and also from the social isolation, guilt, and stress that often accompany a diagnosis of HIV. People with depression who are HIV positive are less likely to take their HIV medications, and are at increased risk for progression of their HIV disease.
Fortunately, depression is treatable. The first step in treatment is to visit your doctor for a thorough physical examination. He or she may perform lab tests to see if your symptoms have an “organic” cause (thyroid disease, diabetes, etc). When a diagnosis of depression has been established, you can discuss with your doctor what treatment option is best for you.
Aerobic exercise, when performed regularly (three times per week), can help with depression. Psychotherapy and antidepressant medications are the main ways depression is treated clinically. Cognitive behavior therapy (CBT) works to change negative thinking and behavior patterns. Interpersonal therapy (IPT) focuses more on working through troubled relationships which can contribute to depression. The most common antidepressant medications are the SSRIs (selective serotonin reuptake inhibitors) such as Prozac and Zoloft, which work to normalize neurotransmitters in the brain and improve mood. Once the medication is started, it takes about four weeks to get the full benefit, and most patients need to take the drugs for at least six months in order to minimize the risk of relapse. They are popular drugs and have helped many people with depression, but they can have serious side effects, and should be used only under close medical supervision.
For more information on depression, visit the National Institute of Mental Health website at www.nimh.nih.gov/health/publications/depression
Andrew Solomon, author of “The Noonday Demon: An Atlas of Depression,” describes depression as “the aloneness within us made manifest. It destroys not only your connection to others, but also the ability to be peacefully alone with yourself.” Depression is among the most burdensome diseases in the world. The annual economic consequences of depression are estimated at 83 billion dollars in the US. Up to 20% of the adult population experiences a major depressive episode at some time in their lives. Depression rates in the gay population are thought to be significantly higher, and as high as 40% in patients with HIV.
Depression has been an area of intensive clinical study in recent years, both in defining what it is, what causes it, and in formulating effective treatments. According to the DSM-IV, depression is defined by the following:
-Feelings of sadness or hopelessness
-Loss of interest in pleasurable activities
-Changes in sleep patterns, like sleeping too much, or not being able to sleep well. The classic complaint is waking up in the early morning and not being able to go back to sleep.
-Changes in appetite, such as eating too much, or not eating enough
-Loss of energy
-Trouble concentrating
-Thoughts of worthlessness or guilt
-Thoughts about death or suicide
A major depressive episode includes at least five of the above symptoms, which are present most of the day, nearly every day, for at least 2 weeks, and cause significant distress or dysfunction. A minor episode includes two of the symptoms, at least one of which is feelings of hopelessness or loss of interest in pleasurable activities. In addition to emotional symptoms, depression can also manifest in physical symptoms, such as headaches, muscle aches, or abdominal pain.
Most cases of major depression occur between ages 30-40, but can occur at any point from childhood to old age. Episodes usually last from several months to a year. Many people with major depression have recurrent episodes throughout their lives. Genetic factors can predispose some people to depression, especially when combined with environmental influences. Life stressors, such as chronic illness or the death of a loved one, can be triggers for depression. Use of cocaine and crystal meth can affect brain chemistry and contribute to the onset of depression. Some depressive episodes occur without any obvious trigger.
Depression has become one of the most important factors in the HIV/AIDS epidemic. Major depression increases the risk of becoming infected with HIV. People with untreated depression may attempt to “self-medicate” with alcohol and other drugs, and have more self-destructive behavior patterns, such as using crystal meth and engaging in unprotected sex with multiple partners. Concurrently, people infected with HIV are at higher risk for developing depression. This is thought to be due to several factors, including the direct effects of the virus on the brain and central nervous system, low testosterone levels (common in HIV infection), and also from the social isolation, guilt, and stress that often accompany a diagnosis of HIV. People with depression who are HIV positive are less likely to take their HIV medications, and are at increased risk for progression of their HIV disease.
Fortunately, depression is treatable. The first step in treatment is to visit your doctor for a thorough physical examination. He or she may perform lab tests to see if your symptoms have an “organic” cause (thyroid disease, diabetes, etc). When a diagnosis of depression has been established, you can discuss with your doctor what treatment option is best for you.
Aerobic exercise, when performed regularly (three times per week), can help with depression. Psychotherapy and antidepressant medications are the main ways depression is treated clinically. Cognitive behavior therapy (CBT) works to change negative thinking and behavior patterns. Interpersonal therapy (IPT) focuses more on working through troubled relationships which can contribute to depression. The most common antidepressant medications are the SSRIs (selective serotonin reuptake inhibitors) such as Prozac and Zoloft, which work to normalize neurotransmitters in the brain and improve mood. Once the medication is started, it takes about four weeks to get the full benefit, and most patients need to take the drugs for at least six months in order to minimize the risk of relapse. They are popular drugs and have helped many people with depression, but they can have serious side effects, and should be used only under close medical supervision.
For more information on depression, visit the National Institute of Mental Health website at www.nimh.nih.gov/health/publications/depression
Alcohol
“I drank to drown my sorrows, but the darned things learned how to swim.” --Frida Kahlo
Two-thirds of Americans drink alcohol. Many people use alcohol responsibly. However, an estimated 10% of the general population, and up to 20% of gay people, abuse alcohol. The consequences of alcohol abuse range from poor quality of life (feeling tired and hung over), to social and family disruption, to devastating legal, professional, and medical problems.
The terms “alcohol abuse,” “alcohol dependence,” “moderate drinking,” and “heavy drinking” can seem vague and confusing.
According to the DSM-IV, alcohol abuse is defined as a harmful pattern of alcohol use that includes one or more of the following:
-Interference with work, school, or social obligations
-Using alcohol in physically dangerous situations (such as driving)
-Legal problems related to alcohol use
- Physiologic manifestations, such as blackouts, sleep disturbances, or memory lapses
-Continuing to use alcohol despite social or relationship problems
Alcohol dependence, or alcoholism, is an even more harmful pattern of use, and includes three or more of the following:
-Tolerance, meaning you need to drink more and more in order to feel “buzzed”
-Withdrawl symptoms, such as nausea, sweating, anxiety, and shakiness occur when you’ve stopped drinking
-Drinking more than you intended to, or not being able to stop drinking once you’ve started
-Feeling like you should cut down your drinking
-Spending a lot of time thinking about, using, and recovering from alcohol
-Continuing to use despite alcohol-related health problems
So, how much is too much? According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), certain groups, such as pregnant women, recovering alcoholics, people who plan to drive, and people with certain medical conditions, should not drink at all.
Moderate drinking, meaning that a person is at low risk for alcohol problems, is defined as follows:
For men: two drinks per day
For women: one drink per day
Differences in body composition and muscle mass between men and women make alcohol more concentrated in a woman’s body, which is why drinking limits are lower for women than for men.
Heavy drinking, which suggests the person is at risk for adverse consequences, is defined as follows:
For men: greater than 14 drinks per week, or more than 4 drinks on one occasion
For women: greater than 7 drinks per week, or more than 3 drinks on one occasion
Binge drinking is defined as 5 drinks in a row for men, or 4 drinks for women.
A standard “drink” contains 12 grams of alcohol, and is equivalent to a 12-ounce beer, a 5-ounce glass of wine, or a cocktail containing 1.5 ounces of hard liquor.
Some studies have suggested that moderate drinking may help protect against heart disease. Paradoxically, however, even moderate alcohol intake has been shown to increase the risk of other diseases, including breast and gastrointestinal cancers. Heavy drinking has been linked to numerous health problems, including high blood pressure, heart failure, and liver disease. Additionally, more than half of all traffic fatalities, drownings, suicide attempts, and domestic violence cases are related to alcohol use. Because of all the potentially harmful consequences of alcohol use, the American Heart Association does not recommend drinking alcohol solely to reduce the risk of heart disease.
Can you imaging alcohol being illegal? In 1920, all states, except for Rhode Island and Connecticut, voted in favor of the Prohibition Amendment, which outlawed the manufacture, sale, and transportation of alcoholic beverages. It quickly became an unpopular law, and was difficult (and very expensive) to enforce. The need for jobs, the looming economic depression, and the growth of organized crime, helped prompt the repeal of the amendment 13 years later. It is the only amendment to the U.S. Constitution that has ever been repealed.
For more information on alcohol, including suggestions on how to cut down your drinking, visit the National Institute on Alcohol Abuse and Alcoholism website at http://www.niaaa.hih.gov/
Two-thirds of Americans drink alcohol. Many people use alcohol responsibly. However, an estimated 10% of the general population, and up to 20% of gay people, abuse alcohol. The consequences of alcohol abuse range from poor quality of life (feeling tired and hung over), to social and family disruption, to devastating legal, professional, and medical problems.
The terms “alcohol abuse,” “alcohol dependence,” “moderate drinking,” and “heavy drinking” can seem vague and confusing.
According to the DSM-IV, alcohol abuse is defined as a harmful pattern of alcohol use that includes one or more of the following:
-Interference with work, school, or social obligations
-Using alcohol in physically dangerous situations (such as driving)
-Legal problems related to alcohol use
- Physiologic manifestations, such as blackouts, sleep disturbances, or memory lapses
-Continuing to use alcohol despite social or relationship problems
Alcohol dependence, or alcoholism, is an even more harmful pattern of use, and includes three or more of the following:
-Tolerance, meaning you need to drink more and more in order to feel “buzzed”
-Withdrawl symptoms, such as nausea, sweating, anxiety, and shakiness occur when you’ve stopped drinking
-Drinking more than you intended to, or not being able to stop drinking once you’ve started
-Feeling like you should cut down your drinking
-Spending a lot of time thinking about, using, and recovering from alcohol
-Continuing to use despite alcohol-related health problems
So, how much is too much? According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), certain groups, such as pregnant women, recovering alcoholics, people who plan to drive, and people with certain medical conditions, should not drink at all.
Moderate drinking, meaning that a person is at low risk for alcohol problems, is defined as follows:
For men: two drinks per day
For women: one drink per day
Differences in body composition and muscle mass between men and women make alcohol more concentrated in a woman’s body, which is why drinking limits are lower for women than for men.
Heavy drinking, which suggests the person is at risk for adverse consequences, is defined as follows:
For men: greater than 14 drinks per week, or more than 4 drinks on one occasion
For women: greater than 7 drinks per week, or more than 3 drinks on one occasion
Binge drinking is defined as 5 drinks in a row for men, or 4 drinks for women.
A standard “drink” contains 12 grams of alcohol, and is equivalent to a 12-ounce beer, a 5-ounce glass of wine, or a cocktail containing 1.5 ounces of hard liquor.
Some studies have suggested that moderate drinking may help protect against heart disease. Paradoxically, however, even moderate alcohol intake has been shown to increase the risk of other diseases, including breast and gastrointestinal cancers. Heavy drinking has been linked to numerous health problems, including high blood pressure, heart failure, and liver disease. Additionally, more than half of all traffic fatalities, drownings, suicide attempts, and domestic violence cases are related to alcohol use. Because of all the potentially harmful consequences of alcohol use, the American Heart Association does not recommend drinking alcohol solely to reduce the risk of heart disease.
Can you imaging alcohol being illegal? In 1920, all states, except for Rhode Island and Connecticut, voted in favor of the Prohibition Amendment, which outlawed the manufacture, sale, and transportation of alcoholic beverages. It quickly became an unpopular law, and was difficult (and very expensive) to enforce. The need for jobs, the looming economic depression, and the growth of organized crime, helped prompt the repeal of the amendment 13 years later. It is the only amendment to the U.S. Constitution that has ever been repealed.
For more information on alcohol, including suggestions on how to cut down your drinking, visit the National Institute on Alcohol Abuse and Alcoholism website at http://www.niaaa.hih.gov/
Gay Health Issues
“The first wealth is HEALTH.” --Ralph Waldo Emerson
According to the Surgeon General, gay people are one of the most underserved groups in the U.S. when it comes to health care. Many doctors are not experienced in providing care to gays and lesbians. Concurrently, many gay people are reluctant to disclose their sexual orientation to their medical providers. They may avoid routine exams and even delay seeking treatment when a problem occurs. This is unfortunate, because many medical problems can be treated most effectively when detected early.
Much of general health care maintenance for heterosexual people is the same for homosexuals. However, several issues are of particular concern for gay men and lesbians, and should have additional emphasis. These include:
1. Substance Abuse: Alcoholism, smoking, and use of drugs such as crystal meth, are more prevalent in the gay community. The adverse effects of smoking and alcohol abuse are well documented (cancer, heart disease, lung and liver disease, among others). Perhaps even more alarming is the link between crystal meth use and HIV infection. The euphoria from crystal meth can lead to disinhibition and high-risk sexual behavior. To put it simply, when you’re high on drugs (or alcohol) you’re less likely to protect yourself. Crystal meth use has become an epidemic, and is one of the most serious health care crises facing the gay community.
2. Sexually Transmitted Diseases (STDs): Men who have sex with men (MSM) have one of the highest rates of STDs of any group in the U.S. Rates for lesbians are considerably lower, but lesbian sex is not without risk. Risk factors for getting an STD include:
· Having a new sexual partner
· Having multiple sexual partners
· Being previously infected with an STD
· Using illicit drugs
· Contact with sex workers
Identifying and treating STDs is important, because STD infections, particularly ones that cause open sores or breaks in the skin (such as herpes), can increase the risk of HIV transmission. Undetected infection can also cause infertility, and put pregnant women at risk for spontaneous abortion and other complications. Some STDs are curable (such as syphilis, gonorrhea, and chlamydia) while others are not (HIV, herpes). The CDC recommends that MSM get vaccinated against Hepatitis A and B, as these can be transmitted sexually. Besides abstinence, monogamy with an uninfected partner is the most effective way to protect yourself against STDs. Condom use can also prevent infection, and is recommended by both the CDC and the World Health Organization.
3. Cancer: Some studies suggest that lesbians have a higher risk of breast cancer. The hormonal changes that occur when a woman is pregnant or breastfeeding are thought to offer some measure of protection against gynecological cancers, and many lesbians do not bear children. Annual mammograms are effective in detecting early cancers, which can often be successfully cured with treatment. The American Cancer Society recommends annual mammograms for all women, starting at age 40, and even earlier if there are other risk factors, such as family history.
Human Papilloma Virus (HPV), the virus that causes genital warts and cervical cancer, is spread through sexual activity, including lesbian sex. Yearly pap smears can detect early cell changes, which can be treated before they progress to cancer. The HPV vaccine, which protects against cervical cancer, is approved for women up to age 26.
HPV is also thought to be the cause of anal cancer, which is increasing among gay men, particularly those infected with HIV. Anal pap tests are now being used to detect these early cancers. Condoms can protect against the spread of HPV. Use of the HPV vaccine in gay men is currently being studied.
4. HIV: The number of HIV cases in the U.S. has stabilized, but there have been increases in certain populations of gay men. This is thought to be due to the epidemic of crystal meth use. HIV is most commonly transmitted during vaginal or anal intercourse, or from sharing needles during IV drug use. Oral sex can also be risky, particularly if a man infected with HIV ejaculates into the mouth of someone with open mouth sores. Again, abstinence, monogamy, and condom use are effective in stopping the spread of HIV. In the event of an unsafe sexual encounter (such as if a condom breaks), it is crucial to seek medical treatment within a few hours for post-exposure prophylaxis, which is a “drug cocktail” that can decrease the risk of becoming infected.
Knowing your status is important. The CDC recommends HIV testing twice yearly in gay men who engage in unprotected sex. Early diagnosis can facilitate more effective treatment. There is still no cure for HIV, and no vaccine is yet available.
5. Depression: Gay men and lesbians, according to some studies, have higher rates of depression and anxiety disorders than the general population. Several factors may contribute to this. Many gay persons struggle with low self-esteem, isolation, or face discrimination, or are rejected by friends and family members. Some feel they need to keep their sexuality “hidden” from employers or from their families. Some have even been victims of violence and hate crimes. The coming-out process can be traumatic, and can leave emotional scars that last for years. Depression left untreated can lead to serious impairment and functional disability. Early detection can facilitate treatment, either with lifestyle changes (exercise, diet changes), counseling, or medications.
Finding a doctor you feel comfortable with is an important part of staying healthy. You can contact the Gay and Lesbian Medical Association for health care referrals. They can be reached by email at www.glma.org/programs/prp/index.shtml, or by phone at (415)255-4547.
According to the Surgeon General, gay people are one of the most underserved groups in the U.S. when it comes to health care. Many doctors are not experienced in providing care to gays and lesbians. Concurrently, many gay people are reluctant to disclose their sexual orientation to their medical providers. They may avoid routine exams and even delay seeking treatment when a problem occurs. This is unfortunate, because many medical problems can be treated most effectively when detected early.
Much of general health care maintenance for heterosexual people is the same for homosexuals. However, several issues are of particular concern for gay men and lesbians, and should have additional emphasis. These include:
1. Substance Abuse: Alcoholism, smoking, and use of drugs such as crystal meth, are more prevalent in the gay community. The adverse effects of smoking and alcohol abuse are well documented (cancer, heart disease, lung and liver disease, among others). Perhaps even more alarming is the link between crystal meth use and HIV infection. The euphoria from crystal meth can lead to disinhibition and high-risk sexual behavior. To put it simply, when you’re high on drugs (or alcohol) you’re less likely to protect yourself. Crystal meth use has become an epidemic, and is one of the most serious health care crises facing the gay community.
2. Sexually Transmitted Diseases (STDs): Men who have sex with men (MSM) have one of the highest rates of STDs of any group in the U.S. Rates for lesbians are considerably lower, but lesbian sex is not without risk. Risk factors for getting an STD include:
· Having a new sexual partner
· Having multiple sexual partners
· Being previously infected with an STD
· Using illicit drugs
· Contact with sex workers
Identifying and treating STDs is important, because STD infections, particularly ones that cause open sores or breaks in the skin (such as herpes), can increase the risk of HIV transmission. Undetected infection can also cause infertility, and put pregnant women at risk for spontaneous abortion and other complications. Some STDs are curable (such as syphilis, gonorrhea, and chlamydia) while others are not (HIV, herpes). The CDC recommends that MSM get vaccinated against Hepatitis A and B, as these can be transmitted sexually. Besides abstinence, monogamy with an uninfected partner is the most effective way to protect yourself against STDs. Condom use can also prevent infection, and is recommended by both the CDC and the World Health Organization.
3. Cancer: Some studies suggest that lesbians have a higher risk of breast cancer. The hormonal changes that occur when a woman is pregnant or breastfeeding are thought to offer some measure of protection against gynecological cancers, and many lesbians do not bear children. Annual mammograms are effective in detecting early cancers, which can often be successfully cured with treatment. The American Cancer Society recommends annual mammograms for all women, starting at age 40, and even earlier if there are other risk factors, such as family history.
Human Papilloma Virus (HPV), the virus that causes genital warts and cervical cancer, is spread through sexual activity, including lesbian sex. Yearly pap smears can detect early cell changes, which can be treated before they progress to cancer. The HPV vaccine, which protects against cervical cancer, is approved for women up to age 26.
HPV is also thought to be the cause of anal cancer, which is increasing among gay men, particularly those infected with HIV. Anal pap tests are now being used to detect these early cancers. Condoms can protect against the spread of HPV. Use of the HPV vaccine in gay men is currently being studied.
4. HIV: The number of HIV cases in the U.S. has stabilized, but there have been increases in certain populations of gay men. This is thought to be due to the epidemic of crystal meth use. HIV is most commonly transmitted during vaginal or anal intercourse, or from sharing needles during IV drug use. Oral sex can also be risky, particularly if a man infected with HIV ejaculates into the mouth of someone with open mouth sores. Again, abstinence, monogamy, and condom use are effective in stopping the spread of HIV. In the event of an unsafe sexual encounter (such as if a condom breaks), it is crucial to seek medical treatment within a few hours for post-exposure prophylaxis, which is a “drug cocktail” that can decrease the risk of becoming infected.
Knowing your status is important. The CDC recommends HIV testing twice yearly in gay men who engage in unprotected sex. Early diagnosis can facilitate more effective treatment. There is still no cure for HIV, and no vaccine is yet available.
5. Depression: Gay men and lesbians, according to some studies, have higher rates of depression and anxiety disorders than the general population. Several factors may contribute to this. Many gay persons struggle with low self-esteem, isolation, or face discrimination, or are rejected by friends and family members. Some feel they need to keep their sexuality “hidden” from employers or from their families. Some have even been victims of violence and hate crimes. The coming-out process can be traumatic, and can leave emotional scars that last for years. Depression left untreated can lead to serious impairment and functional disability. Early detection can facilitate treatment, either with lifestyle changes (exercise, diet changes), counseling, or medications.
Finding a doctor you feel comfortable with is an important part of staying healthy. You can contact the Gay and Lesbian Medical Association for health care referrals. They can be reached by email at www.glma.org/programs/prp/index.shtml, or by phone at (415)255-4547.
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