Happier With Sex Life: Men or Women?

Happier With Sex Life: Men or Women?
Study Reveals Global Gender Gap in Sexual Well-Being
By Miranda Hitti
WebMD Medical News
Reviewed by Louise Chang, MD

April 19, 2006 -- All over the world, men are more satisfied with their sex lives than women, a new study shows.

The study included 13,882 women and 13,618 men in 29 countries. All participants were
at least 40 years old.

No matter where participants lived, men generally rated their sexual well-being higher than women, write the University of Chicago's Edward Laumann, PhD, and colleagues.

Participants completed surveys on their "sexual well-being," which was defined as the physical and emotional satisfaction of sexual relationships, satisfaction with sexual health or function, and the importance of sex in one's life.

Women rated themselves lower than men in all of those categories, Laumann's team reports in the Archives of Sexual Behavior.

International Sex Survey

Participants were randomly chosen. They were told that their answers would be confidential.

Survey questions included:

• "Generally, how happy have you been with your life as a whole [physical, social, family, work] during the past 12 months?"

• "During the past 12 months, how physically pleasurable did you find your relationship with your partner to be?"

• "During the past 12 months, how emotionally satisfying did you find your relationship with your partner to be?"

• "If you were to spend the rest of your life with your sexual function/sexual health the way it is today, how would you feel about this?"

Participants also rated how strongly they agreed or disagreed with statements including:

• "Older people no longer want sex."

• "A 'real man' is ready for sex at any time."

• "Women have greater control over sexual desires than men."

• "Women have a duty to meet their partner's sexual needs."

World's Views on Sexual Well-Being

The researchers split the countries into three clusters, which included:
• Cluster 1: Western Europe, Mexico, Australia, Canada, New Zealand, South Africa, U.S.

• Cluster 2: Algeria, Egypt, Israel, Italy, Morocco, Turkey, Korea, Malaysia, the Philippines, Brazil.

• Cluster 3: China, Indonesia, Japan, Taiwan, Thailand.
The countries in cluster 1 had the highest ratings of sexual satisfaction, but
cluster 2 attributed more importance to sex than the other groups, the researchers write. Cluster 3 ranked lowest in all categories on the survey.

Cultural differences in sexual attitudes, practices, and sexual well-being between "East" and "West" deserve more study, the researchers write.

Participants who rated their health as being good also gave their sex lives better ratings. Health was a bigger influence than age, the study shows.

As for the gender gap, Laumann's team writes that "true parity remains an ideal even in countries where beliefs about gender equality are more widespread."

Study's Limits

Many potential participants refused to take the survey. No one knows if their views match those noted in the study.

Also, the surveys weren't given the same way worldwide, which could have affected the results, the researchers note. For instance, the surveys were done by telephone in many Western countries, by mail in Japan, door-to-door in the Middle East and South Africa, and in public places in Asian countries except Japan.

People who hadn't been sexually active in the past year weren't included in some of the results, including those related to sex's impact on overall happiness.

The study was funded by the drug company Pfizer. However, the researchers state in the journal that Pfizer had no input on how the researchers analyzed, interpreted, and reported the findings.

Virtual Sex

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5 Ways to Psych Out Sickness

5 Ways to Psych Out Sickness
WebMD Feature from "Men's Health" Magazine

Heal your body with brainpower

You may not know it, but you have a doctor who's always on call--and he's right between your ears. Here are five ways you can harness your mental medicinal powers.

The Ailment: Allergies

The Mental Medicine: Laughter
Queue up the gut busters when allergies strike. Participants in a Japanese study were less affected by allergens after seeing a funny film but sneezed more after viewing a serious one. Laughter revs your parasympathetic nervous system, preventing allergens from taking hold.

Your therapy:

Sidesplitting DVDs out this month include Superbad, The Simpsons Movie, and Hot Fuzz (the Collector's Edition). For a daily dose, check out funnyordie.com, a video-clip site from Will Ferrell and Anchorman director Adam McKay.

The Ailment: Cuts, scrapes, and bruises

The Mental Medicine: Good deeds

A Good Samaritan act can speed your recovery by at least a day. "Healing is delayed an additional day by hostile interactions," says Janice Kiecolt-Glaser, Ph.D., a professor of psychiatry at Ohio State University. "But a positive interaction boosts cytokines--chemicals that recruit cells that are needed for making repairs--in the area around the wound."

Your therapy:

Surprise your mate with dinner, or send a card to your grandma or a check to your favorite charity. Pay it forward and you'll be cured in no time.

The Ailment: Heart Disease

The Mental Medicine: Optimism

Purging pessimism can help your ticker. Men who scored high on an optimism test were 55 percent less likely to die of cardiovascular disease than those with defeatist dispositions, says a study in Archives of Internal Medicine.

Your therapy:

Start by taking a weekly inventory of what you're grateful for--friends, family, anything--and avoid feeling resentful about what you still don't have. Focusing on gratitude increases optimism, according to a recent study in the Journal of Personality and Social Psychology.

The Ailment: Muscle injury

The Mental Medicine: Visualization

Imagine a workout to boost recovery. Just visualizing lifting weights can actually build muscle, speeding healing, say Cleveland Clinic researchers. In their study, men who visualized working out their biceps saw a 13 percent increase in muscle mass-- without lifting a single weight.

Your therapy:

For 15 minutes a day, imagine exercising your injured muscle, clearly visualizing the muscle. Imagine every detail--the pressure, the range of motion, the muscle flexing and stretching, says sports psychologist Trent Petrie, Ph.D.

The Ailment: Fatigue

Mental Medicine: Hearing music

Just like listening to the radio when you're red-eyed on the road, tuning in to music at your desk will help you focus on the task at hand, Japanese researchers found. Music triggers a relaxation response, muffling unproductive temptations and letting you tackle your work, says Larry McCleary, M.D., author of The Brain Trust Program.

Your therapy:

Plug in to your iPod or call up pandora.com when you feel a dip. It doesn't matter what type of music you listen to, as long as it's something you choose, research shows.

Originally published on December 1, 2007

Men's Top 5 Health Concerns

Men die at higher rates than women for all of the top 10 causes of death. Why don't men take better care of their health?
By Dulce Zamora
WebMD Feature
Reviewed by Louise Chang, MD

Dry, cracked skin formed a small crater around exposed flesh at the base of my fiancé Noel's pinkie.

"How long have you had that?" I asked him.

"A few days," he answered, speculating it was probably just an outbreak of eczema.
"That doesn't look good," I replied. "Maybe you should see your doctor."

"OK," he said. I shook my head, knowing it would be a while before he heeded my suggestion. Last year, it took a few months to convince him to go for a physical examination. Before that, it had been five years since he'd been to a doctor.

To Noel's credit, he's just being a guy. According to a 2001 CDC report, women are 33% more likely than men to visit a doctor in general, although the gap narrows with increasing age.

One could accept the statistic as just another difference between men and women, but the stakes are too high to remain complacent.

The Men's Health Network (MHN) reports that men die at higher rates than women from the top 10 causes of death - heart disease, cancer, stroke, chronic obstructive pulmonary disease, accidents, pneumonia and influenza, diabetes, suicide, kidney disease, and chronic liver disease and cirrhosis.

Men also die younger than women. In 1920, women outlived men only by one year. Today, CDC figures show the life expectancy gap has widened: On average, women survive men by over five years.

"Any human being who is not connected to a physician to screen for major health problems is at greater risk (of disease and death)," says Jean Bonhomme, MD, MPH, a board member of the MHN.

The biggest problem that men have is not so much a specific disease, says Bonhomme, but the diseases are the result of lack of health care monitoring earlier in life. He cites the progression of heart disease as an example: "If you don't get your cholesterol checked when it's going high when you're 20, and if don't get your blood pressure checked when it's going high when you're 30, maybe your blood sugar's getting a little high when you're 40, what do you think is going to happen when you're 50?"

Bonhomme places part of the blame on society in general, which expects boys to be tough and ignore pain. As people get older, however, the rules change. A little pain can get worse, or signal something more serious going on in the body.

Many of the top 10 causes of death are preventable, and can be treated, if found early. To help men better their health, WebMD examined the risk factors for five of the biggest killers of men: heart disease, stroke, suicide, prostate cancer, and lung cancer. We asked the experts why men were so vulnerable to these ailments and what they could do to reduce their risk of disease and death.

According to the CDC, one in four men has some form of heart disease. It is the leading cause of death.

Average annual rates of the first heart disease complication rises from seven per 1,000 men at ages 35-44 to 68 per 1,000 at ages 85-94. For women, similar rates occur but they happen about 10 years later in life. The average age of a person having a first heart attack is 65.8 for men and 70.4 for women.

"For men, heart disease begins to manifest itself about 10 years earlier than women," says Gregory Burke, MD, professor and chairman of the department of public health sciences at the Wake Forest University School of Medicine.

This does not mean men have a free pass against heart disease until they're older. Men have a shorter time to prevent the development of the condition so their overall risk is greater.

According to the American Heart Association (AHA), risk factors for heart disease include:

• Increasing age

• Male sex

• Family history and race.Folks with family history of the disease have greater
risk. So do African-Americans, Mexican Americans,

• Native Americans, Native Hawaiians, and some Asian Americans.

• Smoking

• High blood cholesterol

• High blood pressure

• Physical inactivity

• Obesity and overweight

• Diabetes

Some things, such as your age and sex, obviously cannot be controlled, but modifying lifestyle to eat right and exercise can reduce your risk of heart disease, says Burke.

Stroke

Stroke is the third leading killer in the country, after heart disease and all forms of cancer. The incidence rate of stroke is 1.25 times greater in men than in women, although there is really no difference between the sexes as people get older, according to the American Stroke Association.

"We know that a very important risk factor for stroke is hypertension. The control of hypertension is a crucial factor to try to prevent the onset of stroke," says Burke.
Other risk factors include:

• Increasing age

• Race. African-Americans have the greater risk than whites.

• Gender. Stroke is more common in men than in women until age 75.

• Personal history of stroke or a transient ischemic attack (TIA, or ministroke)

• Diabetes

• High cholesterol

• Heart disease

• Smoking, including secondhand smoke

• Physical inactivity

• Obesity

• Alcohol and substance abuse

In many ways, behaviors that can reduce the risk of stroke mirror those that can reduce risk of heart disease. "We need to recognize that a healthy lifestyle -- dietary factors and exercise -- reduces the risk of people getting hypertension at all," says Burke.

"It happens more commonly in the older folks, but it should never be viewed as inevitable, even in people with a family history of the disease," says Burke.
Suicide and Depression

Men are four times more likely to commit suicide compared to women, reports the MHN, which attributes part of the blame on underdiagnosed depression in men.
William Pollack, PhD, assistant clinical professor of psychiatry at Harvard Medical School, agrees: "Men are more prone to suicide because they're less likely to openly show depression and have somebody else recognize it early enough to treat it, or to have themselves recognize that they're in trouble."

According to the National Institute of Mental Health, more than 6 million men have depression each year. Pollack believes the number of males with depression could be even greater since men may show signs of depression in a manner different from many women.

Instead of sadness, Pollack says depression may play out in the following ways in men:

• Anger

• Aggression

• Work "burnout"

• Risk-taking behavior

• Midlife crisis

• Alcohol and substance abuse

"Society around the men and the men themselves see (the male symptoms of depression) as 'just being a guy,' or 'having a hard time,'" says Pollack. "The problem is that if they are signs of depression, and they're getting bad enough, then many of these men are starting to form thoughts that life isn't worth living."

To help men with depression and to reduce the risk of suicide, doctors, loved ones, and men themselves need to recognize that society's model of masculinity -- to ignore pain --can work against men. Looking the other way may trigger depression and thoughts of suicide.

Lung Cancer

Lung cancer is the leading cancer killer of both men and women, claiming more lives than prostate, colon, and breast cancer combined. In men, there are expected to be about 213, 380 new cases of lung cancer and some 160,390 lung cancer deaths this year.

The good news is that rate of new lung cancer cases has been dropping since the 1980s, and deaths from the cancer have fallen since the 1990s. "That is because of the drop in the prevalence of the use of tobacco products by men that followed the Surgeon General's report in 1964," explains Sener.
Besides smoking, the ACS lists the following as risk factors for lung cancer:

• Exposure to secondhand smoke

• Exposure to asbestos or radon

• Personal history

• Air pollution

Tobacco products are responsible for 90% of lung cancer, which puts the weight of prevention efforts on smoking cessation.

If you're thinking about kicking the habit, Sener recommends the following resources:

• American Cancer Society: (800) ACS-2345

• National Cancer Institute Smoking Quitline: (877) 44U-QUIT

According to the National Institute on Aging, as soon as you stop smoking, your chances of getting cancer from smoking begins to shrink, and you can prevent further damage to your lungs.

Prostate Cancer

Prostate cancer is the most common cancer found in men. It is the second leading type of cancer death in men, after lung cancer.

There is not enough known about what causes prostate cancer and how to prevent it. Yet the disease is treatable if found in early stages. This can be a challenge, since prostate cancer can show no symptoms until it has spread to other parts of the body.
This is where a connection to the doctor helps, says Bonhomme. "I personally know people who are alive today because they got (prostate cancer) screening."

The American Cancer Society (ACS) recommends a prostate-specific antigen (PSA) blood
test and digital rectal exam be offered annually for healthy men starting at age 50 or older. Men who are at high risk -- such as those who have family history of prostate cancer or who are black -- should begin testing earlier.

According to the ACS, other risk factors include:

• Increasing age

• Nationality. The cancer is most common in North America and Northwestern
Europe.

• High-fat diet. Men who eat a lot of red meat and high-fat dairy products and
not enough fruits and vegetables may have a higher risk.

Although older age is a risk factor for prostate cancer, younger men should not be complacent. Thirty percent of prostate cancers occur in men under age 65. "The younger a man is, the more aggressive the tumor is," says Stephen F. Sener, MD, ACS president.

Ubersexual: The New Masculine Ideal?

The authors who popularized the term "metrosexual" say a new type of masculinity is taking hold.
By Tom Valeo
WebMD Feature
Reviewed by Louise Chang, MD

The American Dialect Society named "metrosexual" the "word of the year" for 2003 after marketing consultant Marian Salzman helped popularize it.

Now the "ubersexual" is replacing the metrosexual, Salzman writes in The Future of Men, a book she co-authored with Ira Matathia and Ann O'Reilly.

What's the difference between these two types of men?

In a study they wrote in 2003, the three trend spotters wrote that "One of the telltale signs of metrosexuals is their willingness to indulge themselves, whether by springing for a Prada suit or spending a couple of hours at a spa to get a massage and facial."

In contrast, they claim the ubersexual is less concerned with fashion and more inclined to develop his own sense of style.

"Compared with the metrosexual, the ubersexual is more into relationships than self," they say. "He dresses for himself more than for others (choosing a consistent personal style over fashion fads)."

Examples of Ubersexuals

Holding up actor George Clooney as an example, they say the ubersexual's "best friends are male; he doesn't consider the women in his life his 'buddies.'"

And the ubersexual is more concerned with principles and values. Bono, of the rock band U2, represents this, they say, by the way he campaigns to reduce poverty in Africa.

In short, the ubersexual possesses what the authors call "M-ness," a type of masculinity "that combines the best of traditional manliness (strength, honor, character) with positive traits traditionally associated with females (nurturance, communicativeness, cooperation)."

Although The Future of Men is based on interviews with 2,000 men nationwide, it is not an in-depth sociological analysis, as Salzman, a trained sociologist, readily admits.

"I'm in the business of marketing," she told WebMD. "The job of understanding men was undertaken from the perspective of how we can do a better job marketing to them. I have no apologies for that motivation."

Masculinity in Flux

But by arguing that the ubersexual is already succeeding the metrosexual, the authors of The Future of Men underscore an indisputable fact of life in the U.S. -- the concept of masculinity is in flux, leaving many confused about what it means to be a man.

"It was clear that men were questioning the feminization of men," said Salzman, explaining the origins of The Future of Men.

"We wrote the book to focus on the question, 'what is the byproduct of 40 years of increased rights for women?' The instability of the male role model has been a reaction to the rise of equal rights for women."

This is not the first time in American history that notions of masculinity have shifted.

"It seems like every time the country is in a crisis there's concern about masculinity," said Sonya Michel, a history professor at the University of Maryland and the author, with Robyn Muncy, of Engendered America: A Documentary History, 1865 to the Present.

"For example, during industrialization, skilled artisans started losing their jobs and men started to feel they were losing control. Again, during World War II, when it became clear that the U.S. was going to enter the war, people were wondering if American men were up to the task."

E. Anthony Rotundo, an instructor at Phillips Academy Andover, made a similar point in American Manhood: Transformations in Masculinity from the Revolution to the Modern Era. He stresses economic uncertainty as the cause of current confusion about masculinity.

"The great majority of American men can't support a household on their income," he tells WebMD. "Families with a couple of kids need two incomes, and that calls into question the idea that the man is the breadwinner."

The authors of The Future of Men, in contrast, say the feminist movement has posed the greatest challenge to traditional notions of masculinity.

"The women's movement has arguably had at least as big an impact on men as on women," they write.

From 'Nice Guy' to 'Integrated Male'

Robert Glover, PhD, a psychotherapist and marriage counselor, believes many men have responded to feminism by repudiating traditional masculine traits -- such as strength, assertiveness, and independence -- because they fear feminists may find those traits offensive. In an effort to please women, they transform themselves into sensitive, emotionally responsive "nice guys."

"They constantly ask themselves, 'how do I make sure the woman is happy and doesn't get upset with me?'" says Glover, author of No More Mr. Nice Guy.

This "nice guy syndrome," as he calls it, causes men to hide their masculine nature. And this, according to Glover, often repels women.

"The man believes he's doing everything right in terms of trying to make the woman happy, but her complaint is, 'I can't trust him,'" Glover says. "Men like this are not telling the truth about themselves because they don't want to upset women, but women walk away feeling that their men have no integrity, no consistency. They say things like, 'I don't know what he's really thinking.' Women get very frustrated by males who are always seeking to please them."

Glover tries to help men become "integrated" by recognizing their own needs. And his integrated man bears an uncanny resemblance to the ubersexual.

Honest and Direct

"The integrated man is honest," Glover said. "He's clear and direct in expressing his needs, and he makes his needs a priority. By making his needs a priority, a man doesn't need a woman to fill him up and make him happy. He is not an emotional vampire."

All this helps the integrated male develop the passion that is the hallmark of the ubersexual.

"Only when you put your priorities first can you have passion," said Glover.
Ironically, the ubersexual himself bears an uncanny resemblance to the traditional male of decades past - a more talkative Gary Cooper, perhaps, or a more emotionally expressive Humphrey Bogart. It's as though men have moved so far forward that they can afford to go backward to a time when men were distinctly manly.

The authors of The Future of Men agree.

"In many ways, [ubersexuals] mark a return to the positive characteristics of the Real Man of yesteryear (strong, resolute, fair) without having acquired too much of the self-doubt and insecurity that plagues so many of today's men," they write. "Even if they've never heard the term, they are by their very essence believers in their own M-ness."

How To Boost Your Emotional Health

Boost Your Emotional Health
Experts offer 12 steps to emotional wellness.
By Sylvia Davis
WebMD Weight Loss Clinic - Feature
Reviewed by Louise Chang, MD


Collect Friends

Enjoy Solitude

Get Fit

Seek Pleasure

Find a Passion

Plan for Problems

Seek Constructive Criticism

Take Healthy Risks

Manage Success Well

Don't Go It Alone

Write It Down

Protect Yourself from 'Energy Vampires'

You know you need to take care of your physical health, but have you been doing enough to maintain a healthy emotional balance? Here are 12 tips from the experts for reducing stress, managing negative emotions, and improving your emotional wellness.

1. Collect Friends

You need people, lots of them.

"If you look at all the theories of psychotherapy, people who have a lot of social support are happier," says Rebecca Curtis, PhD, a professor of psychology at Adelphi University in Garden City, N.Y., and director of research at the W.A. White Institute of Psychiatry, Psychology and Psychoanalysis in New York City.

The opposite is true, also. "We all need to be checking out our thoughts with other people, and people get weirder and weirder the more they stay alone," Curtis says.

If the friends-of-friends-of-friends chain reaction that had kept your life stocked with new relationships has fizzled out -- for example, if you have moved to a new place where you don't know anyone -- try taking a more active role. But instead of trying to chat up folks at the local watering hole, sign up for a class that involves a lot of social interaction.

"It's easier to meet people if there's some kind of a structured discussion about a certain subject," says Muriel James, PhD, psychologist and author of It's Never Too Late to Be Happy.

2. Enjoy Solitude

This step may seem to contradict the first one, but actually it complements it. Some isolation can be quite healthy.

"The isolation that comes when people have given up on other people is the problem," Curtis says.

Avoid this extreme, but don't be such a social butterfly that you lose yourself completely. Take time to "sit with your feelings," Curtis says, without distractions.
Some call this meditation, but it doesn't have to be done in the lotus position. For example, if you spend an hour alone in the car every day, keep the radio off, and listen to your thoughts instead.

Haven't got an hour alone? Try a three-minute meditation: close your door, turn off the phone, then close your eyes. Take deep breaths, focusing on your breath as it goes in and out. If thoughts come to you, just bring yourself back to your breathing. Then think about a beautiful image, a flower, a child's face; look at every detail. Then, gradually, breathe faster and open your eyes.

3. Get Fit

We're not saying, "Look fabulous in time for swimsuit season." Just get your body moving. Study after study has shown that exercise lifts mood and generally enhances quality of life.

Break any vicious cycles you see happening, which get in the way of adding positive things like exercise to your daily routine. Booze, cigarettes, overeating, junk food, or all these together are an impediment to physical activity, and overindulging leads to more of the same.

It's important for emotional health to maintain your physical health in all the ways you can. So get enough sleep; eat regular, balanced meals; and take time for relaxation as well.

4. Seek Pleasure

This may also seem like a contradiction, but moderation in all things is the message here. Everyone knows that "all work and no play makes Jack a dull boy." Overly rigorous devotion to work drives you batty.

Still, it's easy to become consumed by your responsibilities and to neglect your own enjoyment of life.

In his book, Your Own Worst Enemy: Breaking the Habit of Adult Underachievement, psychologist Kenneth Christian, PhD, directs readers to add something positive and pleasurable to their life, do it every day, and make it permanent.

5. Find a Passion

If you don't know what your purpose in life is, start smaller. "Make a list of things you want to do before you die," Christian says. Don't be shy about writing down wild schemes. If your first list is uninspiring, make another one. Keep making lists and look for any recurring themes.

Identifying an interest and pursuing it can develop into a rich and exciting life that you'd never imagined you'd have. "Not all that helps us reach goals is linear," Christian says. Ask yourself, "What cooks for me?" he says.

6. Plan for Problems

Instead of expecting everything in your life to go smoothly -- some things will, and some definitely won't -- or worrying about what will happen to you if things go wrong, plan for potential problems.

Some problems blindside us, but others are more predictable. Muriel James gives an example: If you think you may have to get up in the middle of the night, will you fret about possibly tripping over things in the dark, or will you turn on a night light?

7. Seek Constructive Criticism

"Often people are doing things to mess themselves up, but they really don't have a clue of what is going wrong," Rebecca Curtis says. For example, "They really may not be aware of how they're acting with people."

You probably are very charming -- but maybe you are rubbing people the wrong way. Too much self-consciousness can paralyze you socially, but don't be oblivious to how others perceive you.

The same goes for your work. Don't be afraid to ask, "Am I doing a good job?"

8. Take Healthy Risks

People need to approach what they feel anxious about," Curtis says. This doesn't mean you should force yourself into terrifying situations needlessly. But if you never leave your comfort zone, your life will be all the poorer for it.

9. Manage Success Well

"If at First You Do Succeed, Try Thinking Like a Woman," is the title of a chapter in Reclaiming the Fire: How Successful People Overcome Burnout, by Steven Berglas, PhD.
"Women hold on to relationships with competitors. Men litter the battlefield with corpses," says Berglas, a psychologist at the John E. Anderson School of Management
at UCLA.

Spreading your success around, rather than jealously guarding it, promotes better emotional health by continuing to build your sense of self-worth. "If success ends your ability to build self-esteem, or if you're not building self-esteem, you're just resting on it, then you start committing crazy acts," Berglas says.

People who get bored with their success, he says, "start looking for ways to dare the devil and beat him." Eventually they lose.

10. Don't Go It Alone

Psychologists would urge just about everyone to get into therapy. None of us make it to adulthood emotionally unscathed, and there are mental health experts waiting to help you.

"It's the 21st century," Curtis says. "Don't be a dinosaur and insist on doing it all by yourself."

11. Write It Down

Identify negative thoughts and don't let them ambush you, says Judith Orloff, MD, assistant professor of clinical psychiatry at UCLA. "Don't beat yourself up for being stressed, but bring your fears into the open on paper. Make a list of your seven worst fears."

Then, she says, make a second list of the things you are grateful for.
Irwin says he did much the same with a family member who was getting down and negative. Parents need to teach children to make a list of positives, too.
Writing the negatives bleeds them of power. They become words on paper.

12. Protect Yourself from 'Energy Vampires'

The Drama Queen, the Sob Sister, the Constant Talker, the Blamer – do you know any of these people? Chances are, you do. And any of them can wear you out
You need to learn to set boundaries," Orloff says. "Listen for awhile, then break off the interchange. People are so afraid to do this. They don't want to seem impolite. You need to be firm, though kind."

The same goes for technology, which can be an overwhelming stressor. "People go into despair when their computer breaks (or they forget their cell phone for a day).
"Don't let your computer hypnotize you. Get outside, at least look outside!"
SOURCES: WebMD Feature: "10 Steps to Emotional Health in 2005." WebMD Feature: "Spring Break Makeover for the Mind."

©2006 WebMD Inc. All rights reserved.

Vitamins: Separating Fact From Fiction

Vitamins: Separating Fact From Fiction
Experts cut through the hype about the health benefits of vitamin supplements.
By Richard Sine
WebMD Feature
Reviewed by Louise Chang, MD

There are enough myths around vitamins to make an ancient Greek blush, and it's easy to see why.

We all know that vitamins and minerals are essential to good health -- it says so right there on the cereal box. And we live in the more-is-better era of Hummers, Big Gulps, and McMansions. Which raises the obvious question: if taking 100% of the
Recommended Dietary Allowance (RDA) of, say, vitamin C is good enough to keep us going through the day, then why shouldn't taking 1,000% be enough to melt our fat, cure our blues, and let us leap tall buildings in a single bound?

Meanwhile, the $19 billion-a-year dietary supplement industry continually reminds us that we can get our vitamins from a pill. Which invites yet another question: Why should we bother choking down bushels of brussels sprouts when we could get the same effect by sprinkling supplement shavings over our Boston cream pie?

If life were only that easy. The broad consensus from nutrition experts -- or at least the ones who aren't buying Hummers with the proceeds from supplement sales -- is that while vitamins are indeed essential, big doses are usually pointless and can even be harmful. And no pill is likely to ever adequately substitute for a healthy diet.

Why They Matter

Vitamins and minerals are substances your body needs for normal growth and functioning. Some facilitate crucial chemical reactions, while others act as building blocks for the body.

Nutritionists call vitamins and minerals "micronutrients" to distinguish them from the macronutrients such as proteins, carbohydrates, and fats that make up the bulk of our food. While micronutrients are vital for the proper processing of macronutrients, they're needed in smaller quantities. Think of it this way: If macronutrients are the gas in your engine, then micronutrients are like the motor oil, coolant, and battery fluid.

Micronutrient deficiency can lead to acute diseases with exotic names like scurvy, pellagra, and beriberi. Deficiency diseases were common in the U.S. until the 1940s, when the FDA-mandated fortification of common foods like bread and milk. These diseases are still common in many poorer countries.

Maintaining a Healthy Diet

It's easy to get enough micronutrients from your food if you maintain a healthy diet, Audrey Cross, PhD, associate clinical professor of nutrition at Columbia's School of Public Health, tells WebMD. But most people fail that test; they'll eat two or three servings of fruits and veggies per day rather than the recommended five. That's why Cross (and many other nutritionists) suggest a multivitamin as a sort of nutritional safety net for many of their patients.

But it's just a safety net. So-called "whole foods" like veggies and whole grains contain fiber and a host of other important nutrients that can't be adequately delivered through pills. In fact, scientists are still finding new "trace elements" in whole foods that may someday be labeled essential to health -- but aren't found in any pill.

"There are literally thousands of these compounds, and we're just scratching the surface on knowing what their role is," says David Grotto, a registered dietitian and spokesman for the American Dietetic Association. "We're sending the wrong message if people believe they've got everything under control and if they're taking vitamins while eating a horrible diet."

Choosing a Supplement

It's easy to become overwhelmed when looking at the dietary supplement shelves of a health food store or even your local supermarket. While many of the health claims are unproven or downright bogus, some supplements may be useful for some groups.

Major multivitamin makers typically produce different varieties for men, women, children and older folks. Picking a pill that fits your group makes sense, says dietitian Grotto, as the optimal level of various nutrients varies by age and sex. For example, premenopausal women need more iron than children or the elderly, he says.

But the elderly have a harder time obtaining adequate amounts of vitamin B-12 from natural sources, so the need for supplementation may increase with age, says Lynn Bailey, a University of Florida nutritionist who teaches courses on vitamins.

Folate, or folic acid, is key to preventing birth defects (such as spina bifida), Bailey says. Bailey says all women of childbearing age should ensure they get 100% of the RDA of folic acid through fortified food or a multivitamin.

Calcium and Vitamin D

Calcium supplements are also important for certain age groups, Bailey says. The Institute of Medicine, part of the National Academy of Sciences, recommends that adolescents get 1,300 milligrams of calcium a day. One cup of milk or calcium-fortified orange juice contains about 300 milligrams of calcium.

Other sources of calcium include cheese, tofu, yogurt, vegetables, and beans. A typical calcium supplement may contain 500 milligrams or 600 milligrams of calcium. Bailey gives her 15-year-old son a daily calcium supplement at dinnertime. People over 50 should get 1,200 milligrams a day of calcium to ward off osteoporosis (thinning of the bones), Bailey says.

Federal dietary guidelines recommend that the elderly, the homebound, and people with dark skin boost their vitamin D intake with both fortified foods and supplements to reduce the risk of bone loss. Vitamin D helps with absorption of calcium; often calcium supplements will also contain vitamin D. (The full federal guidelines, updated in 2005, are available at www.health.gov/dietaryguidelines.)

Special groups such as smokers, pregnant women, or people recovering from traumatic injury may need additional supplements, Cross says. Decisions to take supplements beyond a multivitamin are best made with your doctor or registered dietitian, she says.

The evidence is strong that a healthy diet can ward off chronic diseases like cancer and heart disease. What's less clear is if big intakes of particular micronutrients can boost that preventive effect further.

There is promising evidence that the mineral selenium could prevent a variety of cancers, says Alan Kristal, DrPh, associate chief of cancer prevention at the Fred Hutchinson Cancer Research Center in Seattle. But beyond selenium, the data aren't promising, Kristal says. For example, there's no solid evidence that taking large doses of antioxidants like vitamins B or C have any beneficial effect.

Controversial Health Claims

As you seek the proper multivitamin or dietary supplement, it's best to keep your guard up. The supplement industry is relatively unregulated, and you can injure or even kill yourself with "natural" products bought at your neighborhood supplement store.

Many health claims attached to multivitamin formulations are doubtful, but harmless. Some men's multivitamins contain extra lycopene, a substance once thought to prevent prostate cancer. But Kristal, the cancer specialist, says support for that claim is waning. "If indeed lycopene did anything, [supplements] don't have enough to make a difference," he says. Multivitamins aimed at women are often spiked with green tea or ginseng extract; the effect of these on weight control is yet unproven.

More dangerous are recommendations of vitamin megadoses to treat obesity, depression, carpal tunnel syndrome or other problems. At best, megadoses are a distraction from real treatments for these problems, experts say. At worst, they can cause injury or death.

So-called fat-soluble vitamins -- that is, vitamins A, D, E, and K -- accumulate in the body, making overdosing a real threat. Vitamin overdoses have been associated with liver problems, weakened bones, cancers, and premature mortality.

Until recently, water-soluble vitamins such as B and C were considered nontoxic, even at high doses. But now evidence is emerging that B-6 megadoses can cause serious nerve damage, Bailey tells WebMD.

Despite the warnings, the quest for a magic pill plunges ahead. Cross chuckles when patients show her weight loss supplements that claim wondrous effects "when taken in combination with a sensible diet and exercise." Her response: Wouldn't a sensible diet and exercise do the trick even without the supplement?

Know Your Drinking Personality

What's Your Drinking Personality?
Experts explore the differences in alcohol-induced behaviors.
WebMD Feature

Does summer mean parties, heavy coolers, and plenty of pitchers on your favorite restaurant patio? First you may want to recall how your personality morphs after a few drinks too many.

WebMD talked to the experts to find out what's to blame for booze-related personality and behavioral changes, and whether it's possible to tame that other -- sometimes ugly -- persona that has a habit of rearing its head shortly after the drinks start flowing.

The Angry Drunk

For many people, alcohol creates an overall sense of happiness and camaraderie. But in others it has the opposite effect.
For some, "alcohol is like fueling a fire," says Dominic Parrot, PhD, assistant psychology professor at Georgia State University.

This reaction is not an inevitable reaction to alcohol consumption, experts believe. "Lots of people drink a lot, but not a lot of people become angry and aggressive," Parrot tells WebMD.

Parrot recently conducted a study to examine just who is at risk for starting a bar brawl. Here's what he found: "People who possess aggression-promoting personality traits are the most susceptible to alcohol's effects on aggression." In other words, if you tend to be a hothead when sober, alcohol will ratchet up the likelihood that you'll want to punch the first guy who smiles at your date.

Why does alcohol trigger an aggressive response in someone who ordinarily can squelch aggressive tendencies? "We believe alcohol disrupts cognitive functioning, making us unable to look at different problem-solving options," Parrot suggests.

When Drinkers Get Depressed

While most people report increasing feelings of friendliness when they consume alcohol, a small percentage -- 2%, according to one national survey -- wind up crying into their drinks while everyone around them is dancing on tabletops.

Why does alcohol, reported by many drinkers as a way to unwind and relieve stress, have just the opposite effect in others? No one knows for sure, but researchers do know that for some people, drinking increases responses to stress, sometimes manifesting as tears flowing into beer. Although the evidence is inconclusive, some scientists suggest that this depressive effect may mean a greater susceptibility to problem drinking. For others, the explanation may be simpler: the loss of inhibitions that comes after a few drinks may simply release the drinker's pent-up feelings.

Alcohol and Promiscuity

While some drinkers look for fights, others look to satisfy feelings of love -- or, more precisely, lust. "Our culture tells us that alcohol and sex go together, yet it is illegal to use alcohol to facilitate sex," says Aaron White, PhD, a psychiatrist at Duke University Medical Center.

Licentious behaviors linked to drinking range from mildly annoying to downright dangerous. Looping an arm around the shoulders of an acquaintance is one thing. Acting like a sexual predator is another thing altogether, and can escalate into an act of violence. White calls alcohol "the No. 1 date-rape drug." And he blames not only the perpetrators, but our culture at large.

"We don't view people as responsible when they've been drinking," White tells WebMD. "We live in a culture in which alcohol is used as an excuse for behaviors."

Cultural Influences on Drinking

That's not the case universally, says Stanton Peele, PhD, adjunct psychology professor at New School University and author of the book Seven Tools to Beat Addiction.

"In some cultures, intoxicated behaviors are heavily disapproved of. When people become drunk they don't act the same way [that Americans do]," he says. He cites southern European countries, where alcohol is typically introduced early, within the context of family gatherings. "It demystifies alcohol and, as a result, you don't see so much acting out. Instead, drinking alcohol is associated with meals and convivial good times," Peele tells WebMD.

In most U.S. households, parents take a vastly different approach. "We tell young adults never to drink. It gives them a tremendous excuse to act out when they do drink," Peele says.

A recent U.S. survey of 644 women aged 17 to 35 conducted by the American Medical Association backs this theory. When asked if they use drinking as an excuse for outrageous behavior, 74% responded in the affirmative.

Shifting Ideas About 'Normal' Consumption

Is it possible to change the widely held belief that it's OK to act stupid and irresponsible when drinking? Since it's a culturally accepted norm among many young adults, it stands to reason that such a change would require a "shift" in thinking about what's normal. That's exactly what social-norms marketing attempts to do.

Social-norms marketing identifies people's misperceptions about their peers' behavior and then educates them to correct these misperceptions. It's a concept that, when applied systematically, has effectively reduced heavy drinking and related harm at college campuses in the U.S.

Michael Haines, director of the National Social Norms Resource Center at Northern Illinois University, explains the logic behind social-norms marketing. "If I think everyone's getting drunk at a pub crawl, I'm going to, too," he says. "False norms create imaginary peer pressure."

In a study of more than 76,000 college students, Haines and associates found that more than 70% of college students overestimate the drinking norms at their school. Why is that relevant? Because these same researchers also found that students' perception of their campus drinking norm was the strongest predictor of personal alcohol consumption.

Misperceptions About Alcohol-Induced Behavior

When it comes to alcohol consumption and behavior, misperceptions abound -- and not just among the young and inexperienced. The most dangerous ones have to do with people underestimating their own level of incapacitation.

This all-too-common phenomenon was clearly illustrated by psychology professor Kim Fromme, PhD, who had a group of moms visit her "simulated bar laboratory" and drink as much as they wanted for a few hours. Fromme, a professor at the University of Texas at Austin, found that many of the subjects believed they were "OK to drive," even after consuming several drinks. After imbibing, the subjects expressed shock at how miserably they failed a simple balance test that required them to walk in a straight line.

Shifting Ideas About 'Normal' Consumption

Is it possible to change the widely held belief that it's OK to act stupid and irresponsible when drinking? Since it's a culturally accepted norm among many young adults, it stands to reason that such a change would require a "shift" in thinking about what's normal. That's exactly what social-norms marketing attempts to do.

Social-norms marketing identifies people's misperceptions about their peers' behavior and then educates them to correct these misperceptions. It's a concept that, when applied systematically, has effectively reduced heavy drinking and related harm at college campuses in the U.S.

Michael Haines, director of the National Social Norms Resource Center at Northern Illinois University, explains the logic behind social-norms marketing. "If I think everyone's getting drunk at a pub crawl, I'm going to, too," he says. "False norms create imaginary peer pressure."

In a study of more than 76,000 college students, Haines and associates found that more than 70% of college students overestimate the drinking norms at their school. Why is that relevant? Because these same researchers also found that students' perception of their campus drinking norm was the strongest predictor of personal alcohol consumption.

Misperceptions About Alcohol-Induced Behavior

When it comes to alcohol consumption and behavior, misperceptions abound -- and not just among the young and inexperienced. The most dangerous ones have to do with people underestimating their own level of incapacitation.

This all-too-common phenomenon was clearly illustrated by psychology professor Kim Fromme, PhD, who had a group of moms visit her "simulated bar laboratory" and drink as much as they wanted for a few hours. Fromme, a professor at the University of Texas at Austin, found that many of the subjects believed they were "OK to drive," even after consuming several drinks. After imbibing, the subjects expressed shock at how miserably they failed a simple balance test that required them to walk in a straight line.

"The psychoactive effects of alcohol are first evident at 0.05% blood alcohol. That's one to two drinks for most people. Judgment and reason are the first abilities to be negatively affected by alcohol. That said, it's too late for people to decide whether they're 'OK to drive' after they've already begun drinking," Fromme tells WebMD.

The same goes for any other behavior. After tossing back a few drinks, it's probably too late to decide whether your actions are acceptable -- particularly when they take place within an environment that condones irresponsible behavior as an inevitable part of drinking.

"It's amazing how much people really do want to conform," White says.

Life in A Bottle

Addiction: Life in a Bottle
Whether it’s alcohol, tobacco, or drugs, addiction’s grasp can be hard to shake -- but it’s possible, and it’s worth it.
By Dulce Zamora
WebMD Feature
Reviewed by Louise Chang, MD, MD

As an aspiring novelist in his early 20s, Carl (not his real name) equated the glamorous life of writing with boozing.

"Faulkner, Hemingway, Fitzgerald, and more contemporary writers were known as big boozers. If it was good for them, why can't it be good for me?" he thought.

But he didn't get the results that he wanted when he drank. The words wouldn't flow and plus, he realized that his attitudes related with drinking and writing had isolated him from the rest of society.

Because he felt "too good" for the mainstream work-world while he was an alcoholic, he thumbed his nose at an admission to law school, and didn't initially seek employment that would make use of his master's degree in writing. Instead, he worked as a taxi driver and eventually as an editorial assistant for a publishing company to make ends meet.

It wasn't until he started going to Alcoholics Anonymous (AA) meetings that Carl recognized how self-destructive he had become -- getting drunk with his passengers as a cabbie and calling in sick as an editorial assistant to cure a hangover or to quench his thirst for drink.

When he became sober, Carl felt a lot better about himself and felt a sense of belonging with the rest of the world.

"I began to bring my full energy to the workplace, and not hold myself in reserve because I was saving myself for a bigger life as a writer," says Carl, now in his 50s. He notes that his shift in attitude opened opportunities for him. He was promoted to an editor position, and one of the short stories he wrote as a hobby even won a literary award.

This story is not much different from others with addiction in that their obsession with something -- in Carl's case, alcohol -- controls their behavior and attitudes about life.

Addicts need to satisfy a hunger, and that need takes on a higher priority than other responsibilities, including work, says Lawrence S. Brown, Jr., MD, MPH, president of the American Society of Addiction Medicine.

This disregard for responsibility can be expensive for society. According to a study conducted by the National Institute on Drug Abuse (NIDA), and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), in 1995 alone, alcohol and drug abuse cost the economy an estimated $276.3 billion in decreased productivity, increased accidents, absenteeism, job turnover, and medical costs.

That figure could arguably swell once the cost for pain and suffering and other compulsive behaviors are factored in.

According to a review of studies by the Illinois Institute for Addiction Recovery, up to 3% of the U.S. population is addicted to gambling, up to 3% with food, up to 8% with spending, and 5% to sex.

Some symptoms of addiction include:

• A greater sense of isolation

• Diminished social interaction

• Reduced attention to personal hygiene

• More legal difficulties

• Change in eating and sleeping patterns

• Increased irritability

• Reluctance to change the compulsive behavior

In the workplace, the symptoms clearly manifest themselves. The U.S. Department of Health and Human Services reports that employees with substance abuse, when compared with non-addicted colleagues, were found more often to be late, be absent, use sick benefits, file for worker's compensation, and be involved in accidents.

For people who think they might have a problem with addiction, Brown recommends the following first steps of action:

• Check in with your company's Employee Assistance Program (EAP).

• Visit your primary health care provider for a screening and/or referral to a
specialist.

• Keep in mind that there are many resources for help with addiction, including mental health professionals, social workers, doctors specializing in addiction medicine, and private and not-for-profit programs.

• Remember how you got involved in the addiction in the first place, and try to avoid places, things, and people associated with it.

• If your job involves the activity that got you addicted in the first place, explore workplace alternatives.

• Take things one day at a time.

How To Quit Smoking

They say you have to want to quit smoking. But what smoker doesn’t want to quit?
By Arthur Allen
WebMD Feature
Reviewed by Jonathan L Gelfand, MD

I started smoking when I was a bored and lonely 17-year-old irrigating alfalfa fields in Utah for money and reading Zen and the Art of Motorcycle Maintenance for enlightenment. I smoked watching magpies splash in the ditch, and for 20 years I kept sucking those nasty things for reasons of self-loathing and distraction, and mainly because I couldn’t stop. In 1996, just before my son was born, I put a lid on it. I wasn’t going to contaminate my babies with second-hand smoke. And it wasn't hard to figure out how to quit smoking.

I was on the patch for a while. Then I chewed the little Nicorette pellets, stashing them in my car and my satchel and by the bed, finding chewed pieces stuck to my shirts and the inside of the clothes drier.

In 2001, I was hospitalized with a freaky bout of toxic shock for three weeks and was dialyzed, oxygenated through a tube, and fed 40 different medicines. That got the nicotine out of my system for good. Or so it seemed.

While spending the summer of 2004 in Tokyo, where everyone smokes, I started up again, telling myself I could leave the habit on that side of the Pacific. Duh!
So now I’m a five-a-day man — cigarettes, not packs — and I kick myself each time I light up. It’s a tiresome habit, and I’m going to quit smoking again. Real soon.

A good reason to quit smoking: If you smoke, your kids will
They say you have to want to quit smoking. The thing I’ve never really understood, though, is the meaning of “want to.” All smokers want to stop smoking. You’d have to be born on the moon not to know that smokes give you cancer and emphysema, cut years off your life, drive away pretty girls, and waste your money. I don’t want any of that.

I don’t even like smoking past the second drag and often toss the thing only halfway burned. I even smoke in secret if my kids are around. (Maybe I get some kind of pleasure from doing it — perhaps because it makes me feel like an outsider, residually cool, in touch with my feckless youth.) And yet, there is that moment of satisfaction when I light up — or to be precise, seven seconds later, the time it takes for the nicotine to reach my brain.

“What it boils down to is this,” says Robert Klesges, a clinical psychologist at the University of Tennessee Health Science Center in Memphis. “You have a list of reasons to quit, and that list has to be longer than the list of reasons to continue.” Then he says, “The best way to predict whether your kids are going to smoke is if you smoke. If you don’t want your kids to smoke, put that down on the list.”

Who is most likely to quit smoking?

So I guess it’s a matter of willpower — except that psychological predispositions matter too. Smokers are much more likely to be depressed than non-smokers, and among schizophrenics, the rate of smoking is close to 90%. Is it because smoking eases their pain, or is smoking a symptom of someone who, at some level, doesn’t think life is really worth living? Although I’m not particularly nuts, I do approach the question with a degree of fatalism. I’ve smoked about 75,000 cigarettes. Each one has left a poisonous black slick on my lungs. It’s hard not to feel that the damage is already done.

And “willpower,” as measured by the stated decision not to smoke, isn’t a deciding factor in how successful you’ll be at quitting smoking. “You absolutely have to decide to quit,” says Jonathan Foulds, director of the Tobacco Dependence Program at the University of Medicine and Dentistry of New Jersey. “But if you ask people when they start a program, ‘How much do you want to quit?’ usually their answer doesn’t predict success nearly as well as how addicted they are.”

The best indicator of whether you will be able to quit smoking, it turns out, is how long it takes before you fire up the first coffin nail in the morning. At Foulds’s clinic, which sees 500 to 600 prospective quitters a year, patients who light up within five minutes of waking have only a one-in-five chance of kicking the habit. People who can wait half an hour or more quit smoking a third of the time.

Another key question is the smoker’s ability to withstand discomfort. One scientist found that the longer a smoker could hold his breath, the more likely he was to be able to quit smoking. “Nicotine withdrawal is uncomfortable,” says Foulds. “People need to prepare themselves that, come hell or high water, nothing is going to get them to smoke.”

Number one tip: Don’t try to quit smoking alone

And of course, there are chemicals that make it less uncomfortable to stop. When smokers enter cessation programs, they generally get drugs or nicotine replacement therapy along with counseling. People who try to quit smoking without either have a 7% success rate. The rate doubles with pharmaceutical help and triples with pharmaceutical help and counseling, says Foulds.

“In our clinic, we use Zyban [an antidepressant shown to help people quit smoking] plus the patch plus one of the other replacement therapies,” says Foulds. “We figure it’s a lifesaving intervention, so why do it halfheartedly? These medicines are not very dangerous in themselves, so there’s no reason to hold back.”

It’s perfectly all right to be on nicotine replacement for as long as necessary to quit smoking. Nicotine has some obvious benefits — it makes you more alert and seems to decrease the risk of Parkinson’s and Alzheimer’s disease. And although it may increase blood pressure, its negative effects are trivial compared to the thousands of other poisons in cigarette “tar,” which is responsible for cancer, heart disease, and most other ill effects of smoking. “If it’s a question of smoking or spending your life on nicotine replacement, I choose the latter,” says Klesges.

Zyban, the brand name for bupropion, apparently works by activating reward centers in your brain similar to the way nicotine does. A new drug, varenicline, marketed as Chantix, blocks the receptors that get turned on when you smoke, making smoking less pleasurable.

Studies seem to show varenicline is more effective than Zyban, but with a cost. About a third of those who stayed on varenicline reported nausea. “A colleague of mine who did one of the early trials said he could tell which patients were getting the drug [and not the placebo] because they were turning green,” says Klesges. Still, varenicline may be an option for some people.

The “never borrow a cigarette” rule

Once you’ve stopped, obviously, it’s essential to stay stopped. Relapses are common, but Klesges has a system for keeping them to a minimum. The rule is never relapse on a borrowed cigarette. If you need a cigarette desperately, leave wherever you are and buy a pack at a store. Smoking is a sudden urge, one that can fade on the way to the 7-Eleven. If it doesn’t, throw away the 19 left in the pack that you don’t smoke.

“I’ve never had anybody follow these rules and relapse,” Klesges says. “But a lot of people don’t follow the rules.”

A footnote: Three days after I submitted this story, on my 48th birthday, I stuck a 14 mg nicotine transdermal patch on my arm. I’m on my second day. Wish me luck.

When An Exercise Becomes Addictive

Exercise Addiction
When exercise becomes too much
By Arthur Allen
WebMD Feature
Reviewed by Amal Chakraburtty, MD

Do you insist on rising at five to run each morning, even when your back is aching, black ice coats the streets, and your wife beseeches you to stay in bed? Do you only feel good when you’re training for triathlons? Is eating merely a way to replenish for the next race? Then you, my Spandex-clad friend, may have an exercise addiction.

Obligatory athletes

For the vast majority of us, exercise is a good that we don’t get enough of. But a small minority of perfectionist athletes are compulsive exercisers. Some call them exercise addicts, or obsessives, or “obligatory athletes.” As many as 10% of high-performance runners, and possibly an equal number of body builders, have an exercise addiction.

Thirty minutes a day of moderate physical activity is enough to help prevent things like diabetes, high cholesterol, and high blood pressure. Exercise addicts tend to think that a two-hour run makes them four times as healthy. It doesn’t work that way.

Too much exercise can lead to injuries, exhaustion, depression, and suicide. It can also cause lasting physical harm. Your adrenal gland, pumping out hormones as you pound the pavement, can only produce so much cortisol at a time. Suddenly, the heartbeat you’d lowered to a resting 48 is up to 80. You now run for two hours, then three hours. But you can’t improve your 10K times.

Extreme exercisers have an extreme need for control

You can distinguish healthy enthusiasts from exercise addicts by the following trait, says Ian Cockerill, a sports psychologist at the University of Birmingham, England:
“Healthy exercisers organize their exercise around their lives, whereas dependents organize their lives round their exercise.”

Excessive exercise, like extreme diets, attracts people who feel an extreme need for control in their lives. Like weight reduction, improved athletic performance is readily observable, Cockerill says.

But not everyone who likes to exercise a lot is an addict. At times, I thought my friend Matt was an exercise addict. In his 40s, he weighs what he weighed in college, and I often run into him at the local Starbucks after he’s just finished a 20-mile bike ride. But when I gave Matt the six-question Exercise Addiction Inventory, developed by British sports medicine expert Mark Griffiths, he fell far short of the cut.

Matt says, “My wife knows that if I don’t get a certain amount of biking in, I’m a pain in the ass.” He rides every Sunday for two hours with a group of friends, as well as two or three additional hours per week. But family comes first. And part of the pleasure he takes in biking is the opportunity it provides for socializing.

“Beer tastes better after exercise,” Matt says. “I think runners tend to be more solitary than bikers.”

Indeed, treatment for exercise addiction often includes encouraging patients to take up more social forms of exercise such as yoga and cycling instead of the solitary pursuits of running or going to the gym, which can be breeding grounds for perfectionist pathology.

Exercise addicts are high achievers

Psychiatrist Alayna Yates, MD, a professor emeritus at the University of Hawaii, has seen about 100 men and women she describes as “obligatory runners.” They’re an unusually high performing, smart bunch, with an average of 18 years of education.

“We need people like this,” Yates says, “but we need to help them diversify. These people are locked into their regimes. They eat one meal a day, or eat exactly the same foods at each meal every day. They measure everything — their caloric intake, how much starch they’re eating. They’re overly focused and overly serious about sport and it messes up the rest of their lives. There isn’t time or room for relationships.

They stop going to parties. They go to bed at eight so they can get up at four and run. There are divorces.”

It stands to reason that the best athletes would be exercise addicts — since their professional lives revolve around athleticism. But, says Yates, the best runners may or may not be the obligatory ones. “It’s just as likely to be the men who have jobs and go out running at night as it is the athletes. It has more to do with personality variables than profession.”

There seem to be as many definitions of addiction as there are addicts; but one thing they have in common is the repetition of a behavior past the point where it becomes self-injurious. In exercise, this means, quite literally, refusing to stop or even limit your regime when you’ve got an injury.

Addiction can also mean exercising at inappropriate times. “I have people who run in thunderstorms. I had a patient once who had to have a run while his wife was in labor,” says Yates

Still, it can be hard to diagnose exercise addiction in professional athletes: “I’ll say, ‘You have an Achilles injury. Why are you still running on that tendon?’” says Debbie Rhea, PhD, a professor of kinesiology at Texas Christian University. “And they’ll say, ‘I can’t stop because I’m injured. This is my job.’”

Society’s role in exercise addiction

Some over-exercisers have what psychiatrist Diane A. Klein, MD, of Columbia University’s College of Physicians and Surgeons, calls a “primary dependence.” Others are anorexics who run to help complete their obsession with food and weight control.

To be sure, the population of exercise addicts is a bit different from that of, say, cocaine addicts. Exercise, like being thin, is highly reinforced by society, says Klein. “So for people driven to achieve, to be perfectionists, and to be in optimal health, it’s kind of understandable that they become excessive.”

Rhea works with male body builders who are preoccupied with their looks. Unlike female anorexics, who always think they are too fat, men with muscle dysmorphia, as the condition is called, think they are too small and scrawny.

“They want to get bigger and bigger and bigger, not in fat but in muscle size,” Rhea says. And they often become so preoccupied with their strength exercises that they lose their jobs, lose their girlfriends and wives, and neglect their children.

Treatment for exercise addiction

Treatment for exercise addiction, say the therapists, involves getting the athletes to see they have a problem and that change is necessary. “You have to give them a sense of worth. Maybe they never had a good self-concept. Is it something that happened in childhood? Maybe there’s addiction in the family,” Rhea says.

Some runners who run into trouble start by becoming addicted to “runner’s high,” a feeling of elation caused by the release of hormones. Yates says, “There’s a change in the psyche — they talk about almost out-of-body experiences, feeling as if they can change the world.” But eventually, the adrenal gland burns out and they crash. “What was once gratifying becomes painful and controlling. It becomes a bad thing, but they can’t get out of it.”

Yates sees a cultural context for exercise addiction. “I think it has to do with very high expectations for autonomy and independence in the culture now. You have to move from place to place to get ahead in your job; you have to leave people behind who were significant to you. Many things make us need to be more independent than before.”

Yates tells her patients that “dependency is not a horrible thing. The expectations we have for ourselves and others may be off base. Autonomy is good. But when it gets carried too far, it can be unhealthy.” In other words, psychotherapy may be part of the path to getting off the treadmill. On the other hand, it may not be necessary in all cases.

For many athletes, obsessive exercising is a self-limiting condition, says Cockerill. “They tend to reduce their involvement to sensible levels themselves over time when their life, generally, is on an even keel.”

Anger Control for Men

Why we get angry — And why uncontrolled anger is a serious health threat
By R. Morgan Griffin
WebMD Feature
Reviewed by Amal Chakraburtty, MD

Life provides men with an endless supply of things to get angry about. There’s the sullen waitress who refuses to look in your direction while you wave desperately for the check. There’s the oaf who drifts across the road without ever using his blinker. There’s the dropped call, the tepid shower, the gum on the bottom of the shoe.

While it’s perfectly natural to get angry about any of these things, anger comes to some men more naturally than others. For the hot-tempered, the pettiest annoyance results in out-of-control anger. And some guys, despite the fact anger is listed among the deadly sins, genuinely like having a hot temper. It can be a source of pride and a badge of masculinity. Even if you’re not busting heads every weekend at a roadhouse, you might enjoy indulging your angry side. You might feel that anger helps you succeed and inspires respect.

But there’s a downside to the manful, short-fused Type A personality. “In researching people with this disposition, we found that anger and hostility may actually be lethal,” says Charles D. Spielberger, PhD, a distinguished research professor of psychology at the University of South Florida who’s been studying anger for 25 years. And he means lethal to the person who gets angry, not the one on the receiving end of the anger. The evidence that anger can detract from your health is mounting all the time. And of course, uncontrolled anger in men can leave your marriage and your career — not to mention your crockery — in pieces.

So what is this emotion that we all share but rarely think about? How do we know if our anger is out of control — and what is it doing to us?

Understanding anger

Is anger just an emotion? While we think of it that way, it’s really much more. “Anger is both psychological and physiological,” Spielberger tells WebMD. When you lose control of your anger during a traffic jam or at your son’s soccer game, your nervous system triggers a number of biological reactions:

• Levels of hormones, like cortisol, increase.

• Your breathing gets faster.

• Your pulse gets faster.

• Your blood pressure rises.

• As you heat up, you begin to sweat.

• Your pupils dilate.

• You may notice sudden headaches.

Basically, your body is gearing up for intense physical activity. This is the “fight” part of the “fight or flight” response. If we’re exposed to something stressful, our bodies get ready to do battle or run away.

Spielberger says that anger is common because it has an evolutionary advantage. “Anger isn’t just a human emotion,” he says. “Fear and rage are common to animals too. They developed over eons to help creatures fight and survive.”

Don’t have a coronary, dude! Health risks of uncontrolled anger

The problem is that, nowadays, your body’s full-blooded physical response to anger isn’t always so useful. It might have come in handy when our ancestors were trying to club a cave bear to death. But it really doesn’t help much when you’re standing in a line at the DMV.

In fact, uncontrolled anger is worse than useless: It’s bad for you. Several studies have found a link between anger and disease. For instance, a large study of almost 13,000 people found that those who had high levels of anger — but normal blood pressure — were more likely to develop coronary artery disease or have a heart attack. The angriest were three times as likely to have a heart attack as the least angry.

So how does anger turn into disease? Your body’s physical reaction to anger is intended for the short-term — it gives you the immediate boost you need to survive. But if this explosion of hormones is triggered too often, you can suffer long-term effects. Anger’s stress hormones may contribute to arteriosclerosis, the build-up of plaques in the arteries that can cause heart attacks and strokes. These hormones may also increase levels of C-reactive protein (CRP), which causes inflammation and may also contribute to cardiovascular risk. One 2004 study in Psychosomatic Medicine found that people prone to anger had levels of CRP twice or three times as high as others. Anger can even cause electrical disturbances in the heart rhythm.

Anger has also been linked with depression. People who report being frequently angry are less likely to take care of themselves. They’re more likely to smoke, drink to excess, and eat badly, and they’re less likely to exercise. While it’s hard to say that in these cases anger is the cause, it’s certainly linked with a lot of unhealthy behaviors. Anger can also be an expression of feelings of helplessness or depression.

Controlling your anger

But Spielberger doesn’t want anger to be demonized. It’s not evil. “Anger is a natural, human emotion,” Spielberger says. “There’s nothing abnormal about it.”

He points out that when it’s correctly channeled, anger can be constructive. It can drive people to speak out and solve problems. It’s the impulse behind much great literature and music. The white hot anger of the righteous has often been a powerful, positive force in our world. But the problem is that for every man who uses his anger constructively, there are a dozen brawling knuckleheads who waste their lives making appearances in the local paper’s police blotter.

Since anger is natural, what are we supposed to do with it?

Spielberger says that there are two wrong things to do with it. One is to think that it’s healthy and normal to have uncontrolled anger released in an explosive rage. Some guys just assume that screaming at people, throwing things, and punching walls is cathartic and will make them feel better. In fact, getting into a rage can just ramp up your reaction — making you even less in control of your anger.

Here’s the other wrong thing: to push down the bile and keep smiling. Some men think that any expression of anger is unhealthy or antisocial and should be suppressed.

Studies show that both approaches — noisily expressing your anger or soundlessly burying it — are equally harmful and may pose the same health risks, Spielberger says. But if neither corking up your anger nor blowing your stack is a healthy option, what’s an angry man to do?

There is another option. Let anger out, but control it, Spielberger says. The first step is to become self-aware. Don't let yourself fly into a rage. Instead, be conscious of your anger. It’s the only way to figure out exactly what is making you angry.

Once you can identify the real problem, you can try to solve it rationally instead of getting pointlessly furious. If you’re angry with someone, talk about it in an assertive — but not aggressive — way. If a certain situation predictably sparks uncontrolled anger, learn how to prepare for it. Better yet, learn how to avoid the situation altogether in the future, if possible. The advantage to channeling your anger in this way is that you get a concrete benefit: You’re actually trying to deal with the problem rather than just yelling about it, and you’re more likely to get the result you desire.

Chill out, man: Tips for cooling down

Since feeling angry is in part a physical process, you won’t be able to just talk yourself out of it logically. Instead, you need to calm yourself down physically. With these techniques, you can lower your heart rate and blood pressure as well as control your anger.

• Take a deep breath. Breathe in and out deeply from your diaphragm, which is under your chest bone. After a minute or so, you should feel some tension ebb away. The advantage to breathing exercises is that you can do them anywhere, says Spielberger. Once you’re good at them, you can even do them in the middle of a marital spat or a staff meeting.

• Take a break. If you feel your anger getting out of control, get a change of scenery. If possible, leave the room or go for a walk.

• Focus on something else. Count to 10. Try imagining yourself in a calm place. Or repeat a soothing word to yourself.

• Get some exercise. Building physical activity into your schedule can be a great stress reliever.

More serious problems with anger need to be treated. Yeah, the phrase “anger management” can sound pretty feeble and goofy. It’s often seen (and used) as a punishment, a humiliation to be endured — like doing community service picking up litter on the freeway — rather than anything you’d ever want to seek out on your own.

But if you think uncontrolled anger is interfering with your life, get help before it’s court mandated. Learn how to turn your rage into something useful. Because taming your uncontrolled anger won’t only benefit the people around you — it will make your life better and healthier too.

Like any other human emotion, it’s how you use — not abuse — anger that matters.

How To Relieve Stress in Men

Admit It, Men: You’re Stressed
How you can recognize and relieve stress
By Sean Elder
WebMD Feature
Reviewed by Amal Chakraburtty, MD

You probably think of yourself as an average guy. And you probably think you cope pretty well with everyday stress. Sure, the boss might be causing you stress at work and making you uneasy about how secure your job is. Yeah, and maybe your wife has been too busy or too tired lately to notice just how much stress you have to deal with. And look at how fast your daughter is growing up. It’s as if you’re watching her in time-lapse photography while your college-aged son is still stuck in high school. . .

But that’s all right. You’re cool. Except for those stressful moments when you snarl because your shirt buttons are too big, or you bust a blood vessel because some old lady is taking forever to get off the bus, or the blankety-blank CD, which you paid perfectly good money for, is shrink-wrapped so tightly that you break the case trying to open it. Whoa! Maybe it’s not the disc that’s wrapped too tight.

Do you think maybe you are feeling more stress these days? Maybe even more stress than a woman?

Suck it up? How men try to cope with stress

“I think women and men are equally stressed,” says Edward Hallowell, MD. “Men just deal with stress differently.” Hallowell is founder of the Hallowell Center in Sudbury, Mass., and author of Crazy Busy: Overstretched, Overbooked and About to Snap! Strategies for Coping in a World Gone ADD. “Men notoriously have trouble putting their feelings into words,” he says. “They bottle things up so they’re more subject to the damages of stress.”

But aren’t men just supposed to suck it up? “The essence of traditional masculinity is invulnerability,” says Terrence Real, MSW, a psychotherapist in Newton, Mass. Real is the author of I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression. “Vulnerability equals femininity,” he says. “Femininity equals unmanliness. And unmanliness equals disaster. The system that men organize their psychology around is built on a lie. We’re all trying to be little Al Haigs, saying, ‘I’m in charge here.’”

Not that women are any more in charge. They’re just given more leeway and are more apt to be forgiven if they throw up their hands and say, “I can’t handle it!” Hallowell believes they actually have a tougher time of it than men.

“Women’s stress often comes from working as well as having the primary caretaking responsibilities at home,” he says. In fact, the causes of stress may be the same for both genders — too much work and too little time for exercise or relaxation. But Hallowell thinks men are deprived of a crucial safety valve. “Men have trouble saying, ‘Gosh, this is hard,’ and asking for help. In that sense they have it harder than women. But the good news is they can do something to change that.”

Recognizing the symptoms of stress

Before you can change things, you have to recognize the symptoms of stress. Hallowell tells WebMD that stress symptoms may include any of these mild, non-specific afflictions:

• Feeling tired

• Forgetfulness

• Inability to sleep

• Irritability

• Lack of motivation

• Loss of concentration and an inability to complete projects

• Muscular and skeletal aches and pains (“A lot of men carry stress in their lower back or neck muscles,” Hallowell says.)

• Recurring headaches

• Starting to “drink or use to cope,” which puts men further behind and gets men into all kinds of trouble

Stress can also cause more severe medical conditions:

• Chest pains

• Digestive problems

• Elevated blood pressure

• Elevated heart rate at rest

• Sexual problems such as lack of desire, inability to have an erection, or premature ejaculation

• Skin eruptions

“Virtually every system of the body can be negatively impacted by stress,” says Hallowell. That includes your immune system. “And a depressed immune function,” he says, “increases the risk of cold and flu, as well as cancer, and — in the worst case — stroke and heart attack.” What that means is it really doesn’t pay to get anxious.

How men can prevent stress

If you’re someone who hates to be told not to worry, it may be because you haven’t heard Terry Real’s definition: “Worry is having your pain in advance,” he says. When you look at it that way, who wants to suffer twice? “You can learn to keep yourself in the present,” he says. “Don’t project into the future.”

Also, admitting vulnerability can be a way of preventing stress. “Men do not like admitting vulnerabilities,” says Real, “so we don’t go to the doctor.” Real asserts that this is the reason women live longer than men. “It has nothing to do with biology; it’s that men wait longer to go to a doctor than women do. And when we do, we don’t listen to them. That’s what denying your vulnerability gets you.” While not every health expert will agree with Real on his theory about lifespan and doctor visits, overcoming the vulnerability hurdle is still advice worth heeding.

Why work causes stress in men

When working with men, Real likes to use a variation of the serenity prayer, reminding men of all the things they cannot control. “What I do in helping men to reduce stress is tell them that you don’t decrease your helplessness by learning to control things better. You do it by having a more realistic sense of what you can control.” To illustrate, he plays a stress relief game, asking a man to move a box of Kleenex with his mind. Then he reminds him of how often men are asked to do the impossible in their jobs. Job stress can take a major toll on a man’s health.

“Men are taught to act as if we can control the impossible on a daily basis,” Real says, quoting such chestnuts as “I don’t care about your effort, I care about results” and “You’re going to deliver and if you can’t, I’ll find someone who can!”

“We are taught to accept responsibility for things we don’t have control over,” says Real. “Usually we get bent out of shape with what we can’t change and get so involved with that, we fail to step up to the plate and do the things we can. Procrastination is the most naked form of that.”

Three easy steps to reducing stress

If it’s too late to prevent stress, Hallowell has three simple steps you can take to help relieve stress. “Lead what I call a connected life,” he says, “not electronically connected, but interpersonally connected, where you have friends you rely on and talk with. Get physical exercise, a major stress reducer. And get enough sleep. Those three steps, which anybody can do, will make a big difference.”

What about men who say they don’t have time to relax or exercise? Hallowell has heard it before. “Most people are much more aware of how they spend their money than their time,” he says. “Most people waste at least three hours a week in what I call ‘screen sucking’ — mindless emailing, IMing, and surfing the net. If you just cut that out, there’s a workout for you and a lunch with a friend. If you include the time spent watching television, it probably adds another eight to ten hours.”

So stop reading this, get up, and go relax.