Have a headache? Don’t take a pill

Today is Tuesday – that means the New York Times Science Section.  I always find a lot of interesting items in this section.  But, unfortunately, I don’t have time to write about them all.

So, since I have had acupuncture, I thought I’d start there and then write about one more item of interest.

Headache and Acupuncture

Sinced 1998, when the National Institutes of Health (NIH), accepted acupuncture as a “useful alternative” for the treatment of headache, 25 randomized controlled studies have looked at this ancient treatment.  Four of these studies compared acupuncture to massage, 16 studies compared acupuncture to acupppuncture-like placebo and seven compared acupuncture to medication. 

The sample sizes in the massage studies were too small to demonstrate significant results in either direction.  Acupuncture relieved headache for the majority of the individuals in both the placebo and the medication studies.  Furthermore, the individuals  in the medication studies preferred acupuncture because of fear of side effects from medication.

From my own experience (for a shoulder injury, not for headache), acupuncture was painless and gave me a legitmate reason to put my feet up and rest during the day.  The acupuncture results were good and lasted as long as the steroid injection.  However, when my symptoms returned once again, I chose physical therapy and REALLY worked at it.  That gave me the longest lasting results.

Depression and Heart Disease

Is there a connection?  Yes.  But is it causative – does depression cause heart disease?  Perhaps.  Three large studies (each with well over 1,000 participants) demonstrated a link but not a cause.  In the words of Dr. Mark Hamer of University College, London, “It’s really quite difficult to understand.”

Some depressed people become less active, some smoke more, some do both.  Smoking is a serious risk factor for heart disease.  Lack of exercise is another serious risk factor.  Being over-weight is another.  So, does depression exert a behavioral/secondary effect on the cardiovascular system (depression -> behavioral change -> risk factors -> heart disease) or is something else going on?

There is a well know link between depression/anxiety and an increase in the stress hormone, cortisol.  Depressed individuals have greater than normal circulating cortisol.  Excessive cortisol causes weight gain.  If this is the case, then depression has more than a behavioral/secondary effect on the cardiovascular system (depression -> increased cortisol -> weight gain risk factor -> heart disease).  This would account for the indiviuals who have heart attacks and some weight gain but no behavioral changes.

So, there is a connection between depression and heart disease.  However, it must be remembered that a connection (or correlation) does not mean a cause. 

Bottomline: do not smoke, do exercise, keep your weight within normal limits and, if you are prone to depression, get it treated.

And keep your eye out for more studies.  Heart disease is the number one cause of death in this country.

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Mary Lou Bernardo, PhD, MSN

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