Are You a Type D Personality?

You’re probably aware of whether you tend toward a type A or type B personality, since those labels are part of our lexicon. What you may not know, however, is that there is a third type — type D — and it’s not a great category to find yourself in. The D stands for distress, and a growing body of research links this personality type with a variety of health risks and even early death — so it may be especially important for these inhibited and gloomy folks to do everything they can to lighten up.

Remember Eeyore — the sad, self-conscious donkey character in Winnie-the-Pooh? To my mind, he is a perfect illustration of the type D personality. He always expected the worst and therefore, that’s what he usually got. Traits associated with this personality type include social inhibition, a negative self-image, depressed mood, hostility, tension, chronic anger and a tendency to overreact to stressful events.

Type D & Death Risk

It’s already known that having this type D personality elevates risk for people who have had heart attacks, cardiac bypass surgery and/or stent implants. In new research from the University of Tilburg in the Netherlands, scientists set out to determine the impact of these characteristics on people with a common condition called peripheral artery disease (PAD), a circulatory problem in which narrowed arteries reduce blood flow to the limbs. People who have PAD have four to five times greater risk for heart attack and stroke.

Researchers asked 184 patients (average age 65) diagnosed with PAD to fill out a 14-item personality questionnaire to assess character traits, such as negativity and social inhibition. They rated statements such as “I would rather keep people at a distance” and “I often find myself worrying about something” as false or true on a scale of zero to four. During the next four years, 16 patients (9%) died — six of cardiovascular disease, seven of cancer and one each from emphysema, pneumonia and acute pancreatitis. After factoring in other variables such as age, gender, diabetes and kidney disease, investigators learned that those with type D personalities were more than three times as likely to have died as those who were Type A or B.

How Distress Raises Risk

There are numerous pathways linking this particular personality type with poor health outcomes, I learned from study coauthor Johan Denollet, PhD, a professor of medical psychology at Tilburg University. Some are physical, other behavioral. For instance, Type D individuals tend to…

• Experience chronic anxiety and negativity. Living in such a state has a variety of physical effects on your body, none beneficial. Chronic stress drives up levels of inflammatory proteins called cytokines, which leads to increased oxidative stress and contributes to disease. The adrenal glands respond to stress by pumping out cortisol, the hormone that helps us meet perceived threats. Having high and prolonged levels of cortisol in the bloodstream causes serious problems, including blood sugar imbalances, reduced immunity, slower wound healing and increased abdominal fat.

• Have poor health habits. Research has shown that people with type D personalities often neglect their health by eating improperly, not having medical checkups and being sedentary.

• Are unlikely to be proactive in seeking medical care. Perhaps because they are unable to express their emotions and are tense, insecure and uncomfortable in social situations, type D individuals are often slow to seek the medical help they need. In one study, type D patients with chronic heart failure experienced more cardiac symptoms and worried more about them than other people but, paradoxically, were less likely to discuss them with health-care professionals. Other research demonstrates that heart failure patients with “inadequate consultation behavior” face a six-fold increased risk for impaired health.

What Can Help

Generally speaking, you can’t change your personality — but if you recognize these traits in yourself or a loved one, there are plenty of things you can do to address the issues and minimize the impact on your health. For example, Dr. Denollet notes that type D personalities are more likely to experience anxiety and depression — and points out that these can be managed to a significant degree with counseling and/or medication. Other strategies include…

• Adopting healthier lifestyle behaviors, such as better diet and regular exercise.

• Participating in programs or counseling to conquer addictions, such as smoking or alcohol abuse, or to improve social skills and learn to relax.

• Using techniques such as guided imagery, breathing exercises, meditation, tai chi and yoga to help manage stress and mood and learn to control anger and hostility.

While you can’t change who you are, if you have a type D personality, you can take these concrete steps to make yourself healthier and, I’llbet, happier.

Source(s):

Johan Denollet, PhD, professor of medical psychology, Tilburg University, Tilburg, The Netherlands.

The Real Scoop on Coffee and Caffeine

Do you worry that coffee could harm your health? Relax. Studies suggest that, when consumed in moderation — meaning two to four eight-ounce servings daily — coffee may in fact be good for you.

It is not clear whether the benefits come from coffee itself or its caffeine. Even decaffeinated coffee may have some caffeine, and there is limited research on other caffeinated beverages, such as tea. Per cup, coffee has about 100 mg of caffeine… black tea has about half as much. Studies show that coffee may…

• Reduce risk for some cancers. An analysis of nine studies found that drinking two cups of coffee daily lowered liver cancer risk by 43%. Coffee also may protect against colorectal cancer.

• Help prevent diabetes. Among 200,000 study participants, those who drank four to six cups of regular or decaffeinated coffee daily were 28% less likely to develop type 2 diabetes than people who drank two cups or less daily.

Possible reason: Chlorogenic acid, an antioxidant in coffee, slows sugar’s release into the bloodstream.

• Protect memory. In a study of 7,000 seniors, women who drank more than three cups of caffeinated coffee or six cups of caffeinated tea daily had less memory loss than women who drank two cups or less.
• Prevent gallstones. In a study of 80,000 female nurses, drinking two or more cups of caffeinated coffee daily cut gallstone risk by about 20%.

Why: Caffeine may aid the digestive fluid bile, reducing formation of cholesterol crystals that become stones… and stimulate gallbladder contractions, flushing away crystals.

• Lower Parkinson’s disease risk. In the nurses’ study, women who drank one to three cups of caffeinated coffee daily were 40% less likely than nondrinkers to develop Parkinson’s, a movement disorder caused by loss of brain cells.

• Improve physical performance. The amount of caffeine in two to five cups of coffee boosts endurance… helps the body burn fat instead of carbohydrates… and eases muscle soreness.

Reassuring: Coffee drinkers are no more likely to have heart attacks or chronic high blood pressure than nondrinkers. Coffee oils can raise cholesterol, but paper filters remove these oils. Coffee doesn’t appear to increase risk for ovarian or breast cancer. Some women say coffee worsens premenstrual syndrome and fibrocystic breast disease (benign breast lumps), but research does not support this.

Cautions: Both regular and decaf coffee can cause digestive upset. Caffeine can trigger migraine or cause insomnia. Animal studies suggest that at high doses, caffeine may weaken bones by blocking calcium absorption. Moderate amounts of caffeine do not impair fertility or cause birth defects, but consuming more than 200 mg daily may double miscarriage risk — so limit caffeine to 100 mg per day while pregnant.

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Bottom Line/Women’s Health interviewed JoAnn E. Manson, MD, DrPH, a professor of medicine and women’s health at Harvard Medical School, and chief of the division of preventive medicine at Brigham and Women’s Hospital, both in Boston. She is one of the lead investigators for two highly influential studies on women’s health — the Harvard Nurses’ Health Study and the Women’s Health Initiative. Dr. Manson is the author, with Shari Bassuk, ScD, of Hot Flashes, Hormones & Your Health (McGraw-Hill).

The Right Place for Stroke Treatment

Hospitals advertise constantly these days and, by and large, the ads don’t say much that you need to pay attention to. But if you notice that a nearby hospital promotes itself as a “stroke center,” do take note — a new study from the University of Toronto reports that being treated at a stroke center vastly reduces your likelihood of suffering serious permanent disability from stroke.

What’s a Stroke Center?

Here in the US, a hospital that wants to be certified as a “primary stroke center” by The Joint Commission must meet very specific criteria, including team training for staff. With stroke, time is everything. At stroke centers, everyone — from the ambulance staff responding to 9-1-1 calls all the way through the doctors and nurses working in the emergency room — expedites diagnosis and treatment to be sure patients who would benefit from the clot-busting drug tissue plasminogen activator (tPA) get it in time to help.

I called Ralph L. Sacco, MD, MS, professor and chairman of neurology at Miller School of Medicine, University of Miami, and now the incoming president of the American Heart Association, and he reiterated how important it is to know in advance how to deal with a stroke emergency. “For every minute we delay treatment and dispensing tPA, millions of brain cells die,” Dr. Sacco said. “The recommended window for successful treatment is four and one-half hours — but within that time and before the drug can be given, the symptoms of stroke have to be recognized, 9-1-1 called, the patient taken to a hospital, and a CT scan performed. That’s not a lot of time to work with.”

How You Can Be Prepared

“Learn which primary hospitals are certified for stroke treatment and which are not,” Dr. Sacco advised, noting that there are stroke centers in most urban areas. Look online, at www.strokecenter.org/strokecenters.html, where you can click on your state to find a list of primary stroke centers accredited by The Joint Commission.

Refresh your memory on the warning signs for stroke, from The American Stroke Association:

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.

• Sudden confusion, trouble speaking or understanding.

• Sudden trouble seeing in one or both eyes.

• Sudden trouble walking, dizziness, loss of balance or coordination.

• Sudden, severe headache with no known cause.

Another quick way to test is to have the person smile. If one side of the face droops, stroke may be suspected.

Finally, remember that it is always best to call 9-1-1 immediately if you suspect stroke in yourself or a companion. Research has shown that people who walk into an emergency room on their own may be treated with less urgency. A trained emergency team responding to a 9-1-1 call not only can get you to the right hospital, but also can start some treatment right away and help speed you through the admission process.

Source(s):

Ralph L. Sacco, MD, is chairman of neurology, Miller Professor of Neurology, Epidemiology, and Human Genetics at the Miller School of Medicine, University of Miami. Dr. Sacco will serve as president of the American Heart Association for the 2010-2011

Zinc — Boosts Libido, Preserves Sight, Defeats Colds

Do you know zilch about zinc? Let’s rectify that, as this essential trace element is vital to your health and well-being. According to some reports, as many as 12% of Americans may have a zinc deficiency, a figure that may rise to as much as 45% in people over age 60. Among the important functions of zinc in our bodies — it boosts the immune response… protects cell membranes from harmful oxidants and structural damage… repairs DNA… and supports nearly 100 different enzymes that regulate the chemistry of cells and organisms.

Regular Daily Health News contributor Mark Stengler, NMD, told me that zinc is also helpful in stabilizing blood glucose… contributes to neurological function… and helps the formation of testosterone, thereby potentially boosting sexual function. (So the reputation of oysters as an aphrodisiac has a scientific basis — they have more zinc than any other food.) And, of particular interest to the older population, says Dr. Stengler, is that zinc helps prevent or reduce the damage of age-related macular degeneration, a leading cause of blindness in adults over age 60.

Why Do We Lack Zinc?

Our ability to absorb zinc may decline with age. On top of that, many older folks take medications known to deplete zinc, in particular thiazide diuretics and ACE inhibitors (used to control blood pressure) and acid-suppressing medications. Additionally, having a digestive disorder that prevents proper nutrient absorption — such as irritable bowel syndrome (IBS) or Crohn’s disease — can contribute to deficiency. And since animal products are a primary source of zinc, eating a vegetarian diet can also mean that you don’t get enough.

With so many people at risk, you’d think there would be good tests to measure zinc levels, but alas, the only ones available are not sensitive enough to be useful — so it is important to be aware of deficiency symptoms. Severe deficiency causes severe problems (such as rashes, chronic diarrhea and night blindness), but that’s rare in developed countries. Lower level deficiency is far more common, but its symptoms can be troublesome, too — including depression, a loss of appetite and libido, and frequent colds and other infections.

Zinc and Colds

When you get a cold or respiratory infection, supplementing with zinc can help relieve your sore throat and shorten your suffering, a benefit that has been demonstrated in many studies. This has made zinc-based cold fighters, including the Zicam Cold Remedy line, quite popular. There was considerable concern last year when the FDA issued a warning about use of Zicam products delivered nasally (its gels and sprays). These are no longer being sold, and according to Dr. Stengler, Zicam lozenges are safe (a daily dose — six lozenges — has 80 mg of elemental zinc). Dr. Stengler likes even better lozenges that contain 15 mg to 25 mg of elemental zinc, and in particular the brands Bluebonnet and LifeExtension. At the first sign of a cold, have one every two hours away from meals, since zinc supplementation may also interfere with the absorption of iron and calcium, and competes with copper for uptake from the gut. Note: Zinc may hinder absorption of antibiotics, so if you’re on them, be sure to use it at least two hours before or after the time you take the drug.

For Health in General

The zinc Recommended Daily Allowance is 11 mg a day for men and 8 mg for women. You can obtain this much from food (see below), but if you have signs of deficiency or are not eating a zinc-rich diet, Dr. Stengler says 15 mg per day is generally a good supplemental dose. The upper limit for a zinc supplement is 40 mg — too much zinc has been associated with prostate cancer. Pregnant and nursing women should not take zinc unless instructed to do so by a doctor.

Zinc-rich foods include…

• Beef
• Crab
• Turkey
• Oysters
• Liver
• Dairy including milk, yogurt and cheddar cheese
• Cashews, almonds, peanuts
• Crimini mushrooms
• Spinach
• Pumpkin seeds

For most people at most times, he says, eating a varied, healthful diet and taking a daily multivitamin with zinc should be sufficient to prevent deficiency.

Source(s):

Mark A. Stengler, NMD, a naturopathic medical doctor and leading authority on the practice of alternative and integrated medicine. He is editor of Bottom Line’s Natural Healing newsletter, author of The Natural Physician’s Healing Therapies (Bottom Line Books), director of the La Jolla Whole Health Clinic in La Jolla, California, and adjunct clinical professor at the National College of Natural Medicine in Portland, Oregon. To learn more about his work, visit www.drstengler.com and www.lajollawholehealth.com.

A New Way to Fight Depression Using Only Your Mind

Zindel Segal, PhD, CPsych
Centre for Addiction and Mental Health

Suffering from depression is very different from being sad. Sadness is a normal part of life. Depression is a constellation of psychological and physical changes that persist, unrelenting, for a minimum of two weeks — and often much longer.

One of every eight women and one of every five men will suffer at least one bout with serious depression at some point in their lives. Genetics seem to predispose some people to depression, though life events can be a factor as well. Seniors who experience losses in physical functioning and social networks can be especially susceptible to bouts of depression.

For those affected, depression often becomes an ongoing issue — those who have faced it once have a 40% chance of experiencing an episode in the future and those who already have had multiple episodes face up to an 80% chance of additional recurrences.

Depression is most commonly treated with medication that regulates the brain’s chemistry and with professional counseling, which helps people take effective action in the face of the low motivation and pessimism that often define depression.

Exciting new tool: In the last decade or so, a new technique has been shown in studies to help sufferers head off depression before it takes hold. The technique is called mindfulness — paying attention to the present moment, without judgment, in order to see things more clearly.

LIFE ON AUTOMATIC PILOT

Mindfulness can prevent depression from taking hold of us because the alternative — our usual state — is that we operate on “automatic pilot.” Our minds are elsewhere as we perform mundane activities. Example: You’re taking a shower, but wondering what’s waiting in your e-mail.

If we let it, this automatic pilot also will select our moods and our emotional responses to events — and the responses it chooses can be problematic. For instance, if you make a minor misstep in some area of your life, your autopilot might select as your emotional response feelings of anger, failure and/or inadequacy, even though the event might have been completely inconsequential.

Because your mind is not paying full attention to the situation, you might not grasp that the negative feelings are greatly out of proportion to what’s really going on. You only know that you feel bad. When these negative feelings persist, they can pull you into the downward spiral of depression.

Example: A friend mentions that one of the stocks in his portfolio has turned a profit. Your investments have not been as successful, and your autopilot selects inadequacy as your primary emotional response. This may sound like an overreaction, but in someone who is prone to depression, these feelings can expand into a full-blown episode.

Mindfulness can be an antidote to automatic pilot. By becoming more aware of the world around us, we experience life directly, not filtered through our minds’ relentless ruminations. We learn to see events for what they are rather than what our autopilot might turn them into. That helps us to derail potential episodes of depression before they have a chance to take hold. It typically takes two weeks or longer for depression to fully sink in, so there is often plenty of time to stop the process.

BECOMING MINDFUL

Learning to be mindful involves more than simply paying attention. You must reorient your senses so that you experience a situation with your whole mind and heart and with all of your senses.

Try it out: Pick up a raisin. Hold it, feel it, examine it as if you had never seen anything like it before. Explore the raisin’s folds and texture. Watch the way light shines off of its skin. Inhale its aroma. Then gently place it on your tongue. Notice how your hand knows exactly where to put it. Explore the raisin in your mouth before biting. Then chew once or twice. Experience the waves of taste and the sensation of chewing. Notice how the taste and texture change as you chew. Once you swallow, try to feel the raisin moving through your digestive system.

Keep it up: Practice the following three steps every day to make mindfulness a regular part of your life — and episodes of depression less likely…

1.Focus on your breath. Focusing your attention on your breath is perhaps the simplest, most effective way to anchor your mind in the moment. You think only of this breath. You can do this anytime, anywhere.

2.Watch your thoughts drift by like clouds. See them, acknowledge them, but do not attempt to reason them away. Some people attempt to use logic to escape depression. They tell themselves, My life is pretty good — I should be happy. This just leads to troubling questions like If my life is good, why am I so unhappy? What’s wrong with me?

It is also tempting to try to push negative thoughts away so that you don’t have to deal with them at all. Unfortunately, the thoughts are still there even if you refuse to acknowledge them.

Better: When you feel bad, reflect on what is bothering you. Try to uncover the original thought or event that set off your bad feelings. Then view it as just a thought, something independent from you even though it has popped into your head. Do not dismiss it, though. Even if the thought or the event that caused it was trivial, the feelings it has prompted are real and significant.

Next, notice any physical sensations that you are experiencing. Does your throat feel tight? Is your mouth dry? Are there butterflies in your stomach? Just as you are learning to watch your feelings float by, watch these physical sensations in a detached way. If you can learn to spot the onset of these sensations, you will be able to identify the early signs of depression sooner — and head off the bad feelings before they take root.

3.Take action. Ask yourself: Does this thought have any merit? Is it connected to negative thoughts that I have had in the past? What can I do to make myself feel better about this issue?

Example: You feel depressed about your work life even though you are doing fine in your job. When you reflect on these negative thoughts, you realize that they began recently, when you learned that your brother received a promotion. You feel left behind because it has been some time since your last promotion.

What actions could you take to allay these negative feelings? Perhaps you could speak with your supervisor about your job performance and your prospects for future promotions… or contact a headhunter to remind yourself that you have other options.

With any problematic thought, identifying it quickly and taking some positive action is often enough to head off depression.

Important: Learning the mindfulness approach can be useful for preventing future bouts of depression — not for combating an episode that is already under way. When people are in the midst of depression, they typically cannot concentrate sufficiently to practice mindfulness. It is better to use the technique between episodes of depression so that it becomes a natural part of your thought process.

WHERE TO FIND HELP AGAINST DEPRESSION

For information about depression and links to local support, contact…

• National Institute of Mental Health, 866-615-6464, www.nimh.nih.gov.

• National Alliance on Mental Illness, 800-950-6264, www.nami.org.

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Bottom Line/Retirement interviewed Zindel Segal, PhD, CPsych, the Morgan Firestone Chair in Psychotherapy at the University of Toronto, and head of the Cognitive Behavioural Therapy Unit at the Centre for Addiction and Mental Health, both in Toronto, Canada. He is a coauthor of The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness (Guilford).

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