CFS is a complex disorder that can be caused by many things including viruses, stress, sleeping disorders, pregnancy, or hormonal problems.  People with CFS feel very tired, even after a full night of sleep.  It is especially common in women in their 40s and 50s (menopause related) though anyone can experience it.  The main symptom is fatigue that lasts six months or more and four or more of the following:

• Feeling worse the day after exercise

• Muscle Pain

• Memory Problems

• Headache

• Pain in Joints

• Sleeping Problems

• Sore Throat

• Tender Lymph Nodes

What Can I Do?

Talk to Your Doctor

Let your doctor know about the symptoms you are experiencing and how they are affecting your life.  This is an important first step to creating a plan of attack with your healthcare team. 

Sleep

It is difficult for people with CFS to sleep soundly, but there are some things you can do to help achieve a better sleep.  Limiting your screen time before bed can be helpful to allow your mind time to slow down.  Getting sunlight in the first hour of your day can help to trigger the production of melatonin before bed.  Herbal supplements like valerian, passionflower, and L-theanine.  Before starting any supplement, check with your doctor to be sure it’s right for you.

Food

No diet is right for everyone so you should eat in a way that provides you with the most sustainable energy (no sugar or caffeine crashes).  Try to avoid sugar, alcohol, and caffeine.  Some people with CFS find that simple carbohydrates (like those found in white bread) can make symptoms worse.

Anti-Inflammatory Diet

This is an easy place to start if you think your diet might be affecting your CFS symptoms negatively.  Chronic inflammation in the body has been linked to many diseases—cancer, heart disease, arthritis, and even Alzheimer’s.  This diet focuses on fresh fruits and vegetables and avoids processed foods and added sugars.  A simple place to start is to eliminate soda, french fries, white bread, and red meat.  Then add more tomatoes, olive oil, green leafy vegetables, fatty fish, nuts, and fruits like strawberries, blueberries, cherries, and oranges.

Elimination Diet

If you know that you feel worse after eating certain foods, eliminate them from your diet.  If you are having trouble recognizing which foods might be affecting you, try keeping a food journal.  Write down what you ate for each meal (and any snacks) as well as the relative time (sometimes eating too late can have negative affects as well) and then keep track of how you feel the next day.  Over time, you will start to see connections between specific foods and increased negative symptoms.

Gentle Exercise

Getting exercise can help promote a better sleep, but for people with CFS, strenuous exercise can make symptoms worse.  Instead, try doing mind-body exercises like Tai Chi or yoga which promote flexibility, strength, and balance while also helping to reduce stress through meditative movements.

There are so many different things that can trigger anxiety that it can be difficult to pin-point exactly which things may affect you.  For some, money worries are the biggest trigger.  Others might worry about health concerns.  Still others might worry about events that happened in the past or things that haven’t happened yet.  Unfortunately, sometimes thinking about what causes anxiety can actually trigger you to feel more anxiety.

So what should you do?

First- Talk to someone

Exercise

Eat Healthy

Omega-3 Fatty Acids

Vitamin D

Botanicals

Acupuncture

Quit Smoking

Cut out caffeine

Cute out Alcohol

Relaxation Techniques

I think almost all of us have experienced back pain at some point in our lives.  It can be caused by a multitude of reasons, many of which can be happening at the same time: accidents, injuries, sore muscles, weight gain, lack of exercise, and simply getting older.  Certain cancers, infections, and diseases in other organs can cause back pain and stress can make the pain feel worse and/or last longer.

A contributing factor to many of these causes is our lifestyle.  We, as humans, are more sedentary than ever.  Our jobs often require us to sit for extended periods of time, especially when employers require overtime.  Many of us take work home with us and continue to sit at a computer long after we have clocked out for the day.  This change is a major factor in the increase in back pain we are experiencing as a society.

Back pain can last for different amounts of time for different people, which makes it very difficult to say how long you, in particular, will have to deal with it.  When it last for a few days or maybe a few weeks, it is considered acute pain and is usually caused by an injury or overwork - perhaps overdoing it at the gym or doing something like shoveling snow after the first snowfall of the year.  Back pain that lasts longer than three months is considered chronic back pain. 

Symptoms:

• Aches/Pain along the spine, from the base of the neck down to the tail bone

• Sharp, localized pain in the neck, upper back or lower back

• Chronic ache especially after standing or sitting for a long period of time

• Pain that goes from the buttocks down the leg

What should you do about your back pain?

Talk to your doctor

Back pain can be a complicated issue involving lifestyle, injuries, age, and more.  Because of this, having a conversation with your doctor is an important first step.  They can work with you to create a health plan that includes actionable steps for long-term prevention of back pain as well as more immediate steps to help alleviate the pain you are experiencing now.  Medications like NSAIDs can offer some immediate relief, but should not be taken long term as they can have serious side effects.  Opioids and narcotics for back pain can be especially dangerous. 

Body Therapies

Acupuncture: This is a traditional Chinese medicine that involves inserting tiny needles into the skin.  It can help to reduce pain and improve function.  It works especially well when combined with the other body therapies we discuss below.

Spinal Manipulation: Chiropractors and osteopathic physicians can help with back pain.  Chiropractors strongly focus treatment on the spine.  Osteopathic physicians work with the spine as well but generally have a broader focus.  Both use their hands to help improve the motion in your joints as well as the alignment of your body.

Physical Therapy: Physical therapists help you to regain movement, flexibility, and strength.  They use a combination of hands-on techniques as well as exercises to achieve your health goals.

Massage Therapy: Massage therapists manipulate the soft tissues of the body to help regain movement and alleviate pain.  This therapy has similar results to exercise for the treatment of chronic back pain.  One type of massage therapy that works particularly well for back pain is acupressure.

Mind Body Connection

The mind and body are not separate entities.  Pain can affect your mental state and your mental state can affect your pain.  To see optimal progress, both aspects should be addressed in your health care plan.

Yoga: This exercise can not only help improve back pain but can help prevent it from returning.  Because of its focus on breathing, posture, and balance, yoga can also have a positive impact on your mood.  There are many different types of yoga, so it may be particularly helpful to seek out a yoga instructor who specializes in a yoga practice that targets back pain.

Mindfulness Meditation: This type of meditation focuses on the present moment.  It has been shown to reduce pain and is a great long-term practice that you can do from home to manage back pain.  Starting off with an instructor to learn the proper techniques is best.

Cognitive Behavioral Therapy: This type of talk therapy focuses on how you think, including how you think about pain.  The therapist will help you to feel better and act better in all sorts of situations.  This type of therapy has been shown to improve chronic pain.

Choosing a Healthy Lifestyle

One of the best ways to deal with back pain is to avoid it as much as possible.  There are several changes you can implement in your life to help reduce the chance of experiencing back pain or developing chronic back pain.  Most of these changes can be started immediately and will have long term benefits to multiple aspects of your life.

Exercise: Movement is key to so many aspects of our health.  Making sure to engage in regular aerobic and weight-bearing exercises are vital to a healthy life.  Make simple changes first.  Park farther away from the front doors when you go shopping.  Set a timer while working at a computer to remind you to take regular breaks.  Get up, stretch, walk around for a few minutes if possible.  Choose exercises that are sustainable—don’t make a goal to run for five miles every day if you hate running.  Do something that you enjoy—dance, take a class, go biking with a friend, walk your dog. 

Eat Healthy: Diet is not a bad word—it simply means the collection of food choices you make while eating.  Each of us is on a diet of our own making, but unfortunately many of us aren’t making good choices.  That extra weight isn’t just bad for your heart, it adds a significantly high amount of stress to your back which can cause chronic back pain.  Exercise is great for the body’s strength, but our food choices have the largest impact on our weight.  Start by eliminating as many processed foods as possible—stay out of the middle area of the grocery store as much as you can.  Choose fresh cuts of lean meat over highly processed sausages, salamis, or even deli meats.  Increase the amount of fiber in your diet!  A healthy bowel is important for the absorption of nutrients as well as managing weight.  Fiber can be found in almost every fruit and vegetable, so add more into your daily meals, and make sure to add a variety as there are hundreds of different types of fiber split into two groups (soluble and insoluble), all of which are important.  Things like lentils, chickpeas, and beans are other great sources of fiber (and protein).

Lift Properly: Bend your knees and keep your back straight.  This allows most of the work to be done by your thighs, which boast some significantly strong muscles, and less to be done by the smaller back muscles.

Strengthen and Stretch: Stretching helps to keep the muscles primed and ready to do work, making it far less likely that they will be hurt during routine exercise and daily tasks.  One aspect that few people realize is that back pain isn’t always caused by weak back muscles.  Make sure you are doing exercises that strengthen your core abdominal muscles as well.  Pain on one side of the body can oftentimes be caused by weakness on the other, like when you overcompensate for a hurt leg for a day or two and then develop aches and pains in the leg that wasn’t hurt because it was doing more work.

Check Your Mattress: Sleep is important to all aspects of life, which means where you sleep is very important.  If you wake up with back pain regularly, it might be time to get a new mattress.  There are many different types and styles, each of which has different pros and cons.  Some companies now offer trial periods where you can sleep on the mattress for a few weeks to see if it is a good fit for your sleeping style.

Eczema can happen anywhere on the body though most people have it happen on their face, scalp, the inside of elbows and knees, ankles, and on hands.  The skin can feel very itchy and can become quite dry and rough.  Sometimes the skin can form blisters and can become quite red. 

What can I do?

Avoid Triggers

Certain things can make your eczema worse.  Trying to avoid these triggers can help reduce flare-ups.  Some common triggers include:

• Frequent showers or baths

• Heat

• Dry Air

• Stress

• Certain Detergents or Soaps

• Foods you are sensitive to

Try a Probiotic

Probiotics are bacteria that are necessary and good for your health.  They are found naturally in your body but certain things (illness, medicine, diet) can affect their numbers.  Adding more probiotic foods to your diet (like yogurt) or taking a supplement can help boost the numbers of these good bacteria.  Taking probiotics can help to prevent and treat eczema, especially in children.  Breastfeeding mothers can take probiotics to help with eczema symptoms in their nursing baby.

Fish Oil Supplements

Eating fish (e.g. sardines, herring, or canned salmon) 2 - 4 times a week or taking a fish oil supplement can help some people with their eczema.

Mind Body Medicine

Stress, especially long term stress, can have a huge impact on your body.  If you find that your symptoms are worse during times of high stress, consider utilizing mind-body exercises or techniques to help reduce levels of stress.  Consider doing yoga, taking a meditation class, hypnosis, or psychotherapy.

Keep Skin Moist

Try oily skin creams (called ointments) as they work best for keeping skin moist.  Certain lotions can also help.  When choosing a lotion or ointment, look for ones that are labeled “hypoallergenic” and do not have any added fragrance or scents.  Use the ointment or lotion at least twice a day, especially after a bath or shower.

Prescription Creams

Your doctor may prescribe a cream/ointment to help with your eczema.  Steroid creams come in different strengths so make sure to follow your doctor’s instructions when using them.  Topical calcineurin inhibitors are usually only used after regular ointments and steroid creams have been found to be ineffective.

Take a Vitamin D Supplement

Vitamin D supplements can help with eczema, especially if your systems get worse in the winter months.

Diet

Some people find that changing their diet can help with eczema symptoms.  If you find that certain foods make your symptoms worse, avoiding or completely eliminating those foods can be useful.  Make sure that you avoid any foods that you know you are allergic to.  Try to include as many fruits, vegetables, and other fresh foods as possible.  Before making any drastic changes to your diet, talk to your doctor to create a safe, healthy plan for your dietary needs.

Traditional Chinese Medicine

Traditional Chinese herbal medicine can sometimes help with eczema.  If you are interested, try to find a traditional Chinese medicine doctor.  Before taking any supplements, however, be sure to talk about them with your regular primary care doctor as some herbal supplements can interfere with regular medications.  Acupuncture can also help with eczema in some individuals.

You are not alone! Depression is one of the most common mood disorders/medical illnesses in the United States. Millions of people are living with depression.

Depression looks different for everyone.  Some experience periods of sadness or anger and some might feel hopeless, lost, or empty.  In many cases, individuals might feel like they have no energy or might stop doing things that they used to love.  Sometimes those symptoms last for a few days or weeks and sometimes those symptoms can last for years.  Depression can be triggered by events in life, illness, by the changing seasons, or even by hormonal changes in the body. 

Being sad or experiencing grief is not the same as depression.  It is normal to experience sadness or grief after the loss of a loved-one, for instance.  Grief will often come in waves with happy memories/moments interspersed with sad ones.  Grief also doesn’t affect feelings of self-worth.  In grief, you may experience moments of wanting to die as a means to rejoin the loved one you lost—in depression, those suicidal thoughts are often tied to self-loathing or worthlessness, being undeserving of living, or being unable to cope with the pain of depression.

Some Symptoms of Depression:

• Feelings of sadness, tearfulness, emptiness, and hopelessness

• Angry outbursts, irritability, or frustration even over small things

• Loss of interest in pleasurable or normal activities

• Sleep changes (trouble sleeping or sleeping too much)

• Tiredness and lack of energy

• Reduced appetite (with weight loss) or increased cravings for food (and weight gain)

• Anxiety, agitation, and restlessness

• Slowed thinking, speaking, or body movements

• Feelings of worthlessness or guilt (thinking about past failures/mistakes or blaming oneself)

• Trouble concentrating, making decisions, or remembering things

• Sudden impulsive behaviors that are out of the norm for an individual

• Increase in alcohol consumption or taking drugs

• Feeling misunderstood or being extremely sensitive

• Self-harm

• Avoiding social interactions

• Personality changes

• Inability to sit still, hand-wringing, or other purposeless physical activities

• Suicidal thoughts or recurrent thinking about death

• Unexplained physical problems

What can I do?

Talk to someone

Take care of your physical health

lighten your mental load

write in a journal

create a safety plan

• warning signs

• internal coping strategies

• social coping strategies

• trusted family/friends

• local/national resources

Make your environment safe

My loved one is depressed, what can i do?

Listen

The first step is simply to listen.  Don’t try to help, don’t offer advice, don’t tell them what to do or share your own similar experiences—JUST LISTEN.  For many people, feeling heard can be one of the best ways to lessen feelings of depression and increase feelings of self-worth and connection.  Having someone care enough to sit and listen can be an important reminder that they matter, they are loved, and they are wanted.  If someone comes to you and says they are in crisis, they are depressed, or they are feeling lost, listen to what they have to say.  After listening, validate their emotions.  Let them know that you understand how miserable they are and remind them that it isn’t their fault.

Educate Yourself

If you know a loved one suffers from depression or has experienced depression in the past, educate yourself on the signs and symptoms so that you can learn to recognize it when it happens (because sometimes they might not see it in themselves).  Understanding that depression is a medical condition can also help you to understand that this person isn’t doing this on purpose, it isn’t because they are lazy or unmotivated—they need help.  Knowing when to step in and say something can mean a world of difference to the person who is suffering.

Urge Them to Seek Professional Help

Depression is not a weakness or a lack of something—it is a legitimate medical condition that seldom gets better without treatment.  If a loved one comes to you and explains that they are depressed, take them seriously and remind them that it is a medical condition and that it is important to seek help.  Ask them if they have a safety/crisis plan and see if they already have a doctor or therapist they are working with.  If they don’t, offer to help them find one or call their primary care doctor (a great place to start as they often have contacts and resources in other fields).  Offer to make appointments or even transport them to the appointment to make sure they attend.  If they don’t approach you about it but you suspect that they are depressed (you’ve seen several symptoms show up that have lasted a few weeks), talk to them about it.  Let them know that you’ve noticed these changes and are concerned.  Remind them how important they are to you and that you are here to help. 

Help With Daily Tasks

For someone with depression, maintaining any sort or routine or basic care can be difficult.  Help by cooking healthy meals, scheduling regular walks together, or even stopping by to do loads of laundry can help make their day more manageable.  Encourage them to do the task with you and be sure to listen if they feel like talking.  Ask if there are any urgent tasks that need to be done and see if you can help in some small way.

Practice Self-Care

It is very easy to completely ignore our own needs while we are caring for someone else.  In fact, it can feel selfish to take time away from them to engage in something that feels frivolous or luxurious.  Your own health (physical and mental) needs are just as important.  Besides, you can’t help someone if you are struggling yourself.  Make sure to take time to de-stress, make sure you are eating healthy and sleeping well, and don’t be afraid to ask for help if you need it.  Just because you are helping someone else doesn’t mean you can’t ask for help too.

Take Suicide Seriously

Depression can stay relatively stable for some individuals, but for others it can quickly become a downward spiral that may result in suicide.  If a depressed person has a sudden change in mood, starts giving things away unexpectedly, starts buying up guns or hoarding medications, engages in dangerous or risky behaviors, says goodbye in a way that suggests forever, or talks a lot about death or dying, DO NOT IGNORE IT.  These are some of the ways that a depressed person might signal they are thinking about suicide.  Tell the person that you are worried and ask if they are thinking about suicide or have a plan.  If they have a plan, it is far more likely that they will attempt suicide.  Make sure the person is safe.  Do not leave them alone if you know there are guns, drugs, or other means of harm nearby.  Call their health care provider or therapist.  Encourage them to call or text 988 (Suicide and Crisis Lifeline, Veterans can call or text 988 and then press “1” for the Veterans Crisis Line or text 838255).  If they won’t call and you suspect that they are going to harm themselves (they have a plan to commit suicide and their depression is severe), do not leave them alone for any reason and call 911.

What is Menopause?

Menopause is only a day, a single day, marked 12 full months after your last period.  Unfortunately, the changes leading up to that day can have a huge impact on your body.  This time period, lasting anywhere from 7 to 10 years before menopause hits, is called perimenopause and while every woman may have slightly different symptoms, they are all caused by the same changes within the body.

Perimenopause begins when the production of hormones declines, which eventually leads to a woman no longer being fertile.  As these hormone amounts start to decline, your body will start to react in new and sometimes uncomfortable ways.  This transition typically starts in a woman’s 40s, but some women start to experience perimenopause in their mid-30s or later, in their early 50s.

Symptoms

• Irregular Periods

• Vaginal Dryness

• Mood Disruption or changes

• Disruption of sleep

• hot flashes

• hair loss

• skin dryness

• weight gain

• bone density loss

• mental fog

• constipation

• painful intercourse

What can I do about my perimenopause and menopause symptoms?

Talk to Someone

Whether it’s your partner, a trusted friend, or a family member, talking to someone about your experience with menopause can make a world of difference.  It helps to know that you aren’t the only one experiencing such drastic changes and can ease stress and anxiety about what else is to come.  If you’ve already experienced menopause, talk about it with the other women in your lives who have yet to reach it.  Trying to hide the symptoms or how much they affect your life will only make things worse and can increase feelings of depression, anxiety, and even shame. 

Be sure to talk to the men in your life as well.  They will never experience menopause and often have no understanding of what it is let alone what extreme changes are happening in your body.  Tell them about the symptoms you are experiencing and how they make you feel.  Help them to better understand what you are going through so they don’t fall back onto stereotypical understandings that only make you feel worse about what is happening.

Be Patient/Gentle With Yourself

These changes are not something you can control and neither are the symptoms.  If you find yourself forgetting things that only a year ago would have come to you in a second, don’t berate yourself or try to make jokes at your expense.  Give yourself grace and be patient.  You are adjusting to these changes and are trying to navigate a new way of existing in this world.  That takes time.

Exercise

This is important on many levels.  Ensure that you are getting 150 minutes of exercise a week (a little over 20 minutes per day) of both aerobic and weight-bearing exercise.  Aerobic exercise can help strengthen your heart and  boost your mood.  It can also help you to have a better night’s sleep.  Weight-bearing exercise can help reduce the risk of osteoporosis.  Remember to start small with attainable goals and work your way up.  Find some friends or join a class to help with accountability and to make the experience more enjoyable.

Eat Healthy

This should be an important part of everyone’s life, but it becomes especially important as you approach menopause.  Eating healthy foods that are low in saturated fats can help with heart health as well as help to maintain a healthy body weight.  You should focus on fruits, vegetables, lean proteins, and healthy fats.  For those experiencing bowel changes (like constipation), increasing the amount of fiber in your diet in combination with a probiotic can help keep your bowel healthy.

Quit Smoking

Smoking can trigger menopausal symptoms to start sooner and can make them more severe.  In general, smoking increases your risk of heart disease, osteoporosis, cancer and other diseases.  Talk to your doctor about quitting to find out which options might work best for you.

Reduce Stress

This is something we could all benefit from, I’m sure, but it is especially helpful for those going through menopause.  Reducing stress can help lessen the severity of symptoms like anxiety, depression, and various sleep problems.  While most people can’t eliminate all the stress from their life, they can often benefit from taking a very close look at the things in their life causing them the most stress.  Sometimes, these stressful aspects can be eliminated or reduced.  If they can’t, asking someone else to step in and help share some of the burden can help reduce the load (for instance, asking your partner to contribute more by cooking a few meals a week or taking on another household chore).

There are plenty of activities that are shown to help reduce the effects of stress on our bodies like mind-body exercises (yoga or Tai Chi for instance), meditation, and being in nature.  Mind-body exercises, like Tai Chi, are low-impact exercises that focus on the mind body connection.  They improve flexibility, strength, and balance and can have a positive impact on mood, self-esteem, and stress.

Protect Your Sleep

Getting a full night’s sleep is vital.  There are countless studies that show how important sleep is not only for our physical health, but for our mental health as well.  One of the best ways to improve our sleep, is to protect our sleep.  By that we mean doing everything you can to reduce or eliminate distractions that might cut into sleep time while increasing activities that encourage a good sleep.

Set aside your phone before bed.  While it is tempting to scroll through social media or stream the next five episodes of your favorite show, don’t do it.  Set the phone down in another room if necessary and go back to a basic alarm clock to reduce temptation.  Screen exposure before bedtime can not only increase the time it takes to fall asleep but can reduce the quality of sleep as well. 

Don’t make late night plans.  If your friends want to get together, suggest an earlier time or make it clear that you need to get home before it gets too late.  While an occasional late-night adventure isn’t the end of the world, making a habit of it means getting less and less sleep over time, which will have negative impacts on your symptoms and your health.

Dealing with Hot Flashes

Many hot flashes are triggered by things—hot drinks and food, caffeine, alcohol, and stress.  Keep track of what you were doing when you experienced a hot flash to better learn some of the triggers that you can avoid.  Being prepared for hot flashes can help ease the discomfort as well.  Be sure to dress in layers, especially when out of the home.  Sleep in a cooler place with light, airy sheets to reduce the severity of night sweats.  Have a cool beverage ready in case you feel a hot flash starting.

Some foods have shown to help with hot flashes: tofu, soybeans, soy milk, and flax seed 20-40 mg twice a day and Black Cohosh (an herbal supplement) 20-40 mg twice a day.  Be sure to talk to your doctor before starting a new supplement to be sure it is right for you.