FAZEENA SALEEM

THE PENINSULA

The health care system of the country has further improved this year, with the opening of new services and facilities. Several steps have been

taken and goals achieved with an aim to provide integrated and high quality health care to the people of Qatar.

The advancement of technology has dramatically changed the way in which healthcare services are delivered around the world, and Qatar embraced this change. It has introduced some of the world’s most advanced medical tech-nology and services across the healthcare system, all for the benefit of patients.

Hamad Medical Corporation (HMC) the main healthcare provider of the country, celebrated 40 years of deliv-ering safe, effective, and compassionate care to Qatar’s population since having been established by Amiri Decree in 1979.

HMC has expanded its capacity with the opening of many new hospitals throughout the past four decades and today operates 12 hospitals across Qatar. Additionally, the number of patients being cared for by its clinical teams has grown at an exponential pace.

“Under the direction of Qatar’s visionary leaders, we are proud to have delivered a wide range of health care services to millions of people throughout the past 40 years,” said H E Dr Hanan Mohamed Al Kuwari, Minister of Public Health.

“I am truly proud of Hamad’s journey and its transformation, not only in terms of capacity but quality as well. Hamad is now a health care provider that ranks alongside the world’s best and it is the tens of thousands of dedicated staff who have worked at Hamad over the past 40 years who have driven this success,” she added.

Despite treating greater numbers of patients each year for the past four decades, HMC has worked hard to not only meet this increasing demand but to also advance the quality of care it delivers to patients in all areas of service.

The Amir H H Sheikh Tamim bin Hamad Al Thani inaugurated HMCs new Trauma and Emergency Center, which is one of the largest centers in the region.

The state-of-the-art Trauma and Emergency Center was opened along with the new Hyperbaric Therapy Unit, which houses a cutting-edge hyperbaric

oxygen therapy chamber, the first of its kind in Qatar.

The new Trauma and Emergency Center is the largest in the region and marks a significant expansion of trauma and emergency services in Qatar. In addition to a new Emergency Department, it also offers trauma, urgent, and critical care services and features a dedicated ramp for ambu-lance arrivals at Hamad General Hos-pital. The Center’s state-of-the-art hyperbaric chamber can hold up to 18 people and provides oxygen therapy for a range of medical conditions as well as

decompression treatment for diving accidents.

HMC’s Hamad General Hospital has been completed the third and final phase of the hospital’s Surgical Intensive Care Unit (SICU). The completion of the SICU expansion marks the final phase in the Hamad General Hospital Operating Theater Expansion project, which began in 2013.

The SICU features a direct link to both the Hamad General Hospital Oper-ating Theater Suites and the new Sur-gical Specialty Center. It has 27 beds, four isolation rooms, including three

negative pressure rooms, and family waiting rooms.

“In addition to supporting HMC’s general surgical services program, the SICU will play a vital role in ensuring Trauma Center patients receive the best possible care and will complement the 19-bed Trauma Intensive Care Unit (TICU),” said Dr Abdulla Al Ansari, Acting Chief Medical Officer.

In addition to the 27-bed SICU, the 10,000 square metre Operating Theater Expansion project saw the commis-sioning of 20 state-of-the-art surgical theaters, a 19-bed TICU, the addition of a da Vinci Xi surgical robot, and real-time imaging capabilities through CT, MRI, Brain Lab and Artis Zeego imaging technology.

While, the Ministry of Public Health (MoPH) officially launched 2018-22 Strategic Framework for Combating Viral Hepatitis in Qatar.

The strategic framework aims to eliminate viral hepatitis in Qatar by 2030 by completely eliminating new infections among the community while reducing the spread of chronic infec-tions and reducing mortality rate caused by viral hepatitis.

The framework reflects a full com-mitment to the implementation of high-quality disease control interventions at the national level.

The most important interventions planned in the Strategic Framework are to maintain high levels of coverage of disease awareness and early screening services and to increase the number of beneficiaries of care and treatment services easily and at low cost especially among the most vulnerable groups of the disease.

The prevalence of type C viral hep-atitis is 0.8% among the entire popu-lation and this percentage is only 0.25% among Qatari nationals.

According to the World Health Organization (WHO), Qatar is a country with a low burden of viral hepatitis B, with a prevalence of less than 2 percent. International scientific reports have shown that Qatar is on track to elim-inate viral hepatitis C by 2030.

Several iconic conferences and forums were also held this year, including Qatar’s first Patient Experience Forum. It is considered one of the largest health care conferences in the region. The two-day event, dedicated to enhancing the patient experience and brought together more than 1,500 health care professionals.

Organised by HMC in partnership with internationally renowned US-based

health care consultants Planetree Inc., the forum highlights the importance of involving patients, their families and caregivers, in every decision that impacts the care they receive.

In another attempt to ensure health promotion and wellness for the popu-lation of Qatar, biennial ‘Qatar Public Health Conference,’ a first of its kind Public Health Conference was organised by the MoPH in collaboration with the World Innovation Summit for Health (WISH), a global initiative of Qatar Foundation.

The two-day conference is held under the theme, ‘10 Years of Public Health: Looking back, moving forward.’

Many key public health accomplish-ments achieved over the last decade were highlighted during the conference. It also emphasised on the importance of cooperating with all partners to address the public health challenges in the next decade.

Making a leap in pediatric care, sur-geons from Sidra Medicine and HMC performed Sidra Medicine’s first live-donor renal transplants. The surgeries also mark the launch of pediatric renal transplant services at Sidra Medicine. Both operations involved adult to child transplantation.

The first renal transplant patient, Mohammed, aged five, was in the final stages of renal failure and was under-going dialysis. His mother donated one of her kidneys to him to allow him to lead a healthier life.

Sidra Medicine’s renal transplan-tation approach is based on a multi-disciplinary pre-transplant evaluation process and post-transplant care including inpatient and outpatient care. The service is supported by allied health services including social, psychological and nutritional needs as well as appro-priate medical, surgical and intensive care management. The service includes transplantations from both living and deceased donors.

Also Sidra Medicine hosted the 6th World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS 2019), with the attendance of over 800 surgeons from more than 80 countries. The international congress,is being held for the first time in the Middle East and the conference aimed to improve the surgical care of children around the globe, driving collaboration, education and training beyond borders. It also aimed to ensure every child in the world has access to good quality healthcare and treatment by a pediatric medical or surgical specialist.

SPECIAL SUPPLEMENT THURSDAY 26 DECEMBER 2019

PAGE | 2 PAGE | 4-5

Public HealthSPONSORS

MAIN SPONSOR

ACTING MANAGING EDITORMohammed Salim Mohamed

EDITORIAL CONTRIBUTOR Fazeena Saleem

EDITOR-IN-CHIEFDr. Khalid Mubarak Al-Shafi

SUPPLEMENT COORDINATORAhmed Eltigani Idris

DESIGNAbraham Augusthy

Al Wakra Clinics & Urgent Care Unit of Al-Ahli Hospital always provide highest quality of care

‘Screen For Life’ encourages breast and

bowel cancer screening as a tribute to Qatar

National Day

Sustaining the health of a nation

Hamad Medical Corporation (HMC), the main

healthcare provider of the country, celebrated

40 years of delivering safe, effective, and

compassionate care to Qatar’s population since

having been established by Amiri Decree in 1979.

Public Health

THURSDAY 26 DECEMBER 2019

2

‘Screen For Life’, Qatar’s National Breast and Bowel Cancer Screening program, led by the Primary Health Care Corporation (PHCC) has urged the public to mark Qatar National

Day with a commitment to preventative breast and bowel cancer screening.

The call came as Dr Shaikha Abu Shaikha, Manager of Screening Programs at PHCC, dubbed regular screening as “a national duty” and a mark of respect for the government efforts made towards meeting the Qatar National Vision 2030 healthcare aims. The Program aspires to partic-ipate in achieving the health pillar’s objective, one of the four pillars of the National Vision.

“Screen for Life’ is an important initiative in line with the 2030 Vision of delivering a comprehensive world-class healthcare system whose services are accessible to the whole population,” explained Dr Abu Shaikha. “We in Qatar are extremely fortunate to have excellent permanent and mobile breast and bowel cancer screening facilities providing a pro-fessional and complimentary service that can lead

to survival of these two leading causes of cancer deaths within the country.

“In recognition of the efforts the government has made to ensure this exemplary service, cit-izens should ensure they are screened regularly and take preventative measures to protect their own health.”

‘Screen for Life’ offers complimentary screening at permanent suites in Al Wakra, Leabaib and Rawdat Al Khail Health Centers and through mobile unit that can take professional testing to all parts of

the country. Women in Qatar aged between 45- 60 are advised to undergo mammogram testing for breast cancer every three years while all men and women in Qatar aged between 50-74 are recom-mended to test for bowel cancer every year.

“It is important to undergo testing whether people have symptoms or not,” explained Dr. Shaikha. “Screening can significantly improve sur-vival rate by detecting the diseases as early as possible.

“Qatar National Day is a great occasion on which Qatari citizens can demonstrate their will-ingness to embrace the country’s ambitions by taking the lead with their own healthcare. A healthy population is a happier, more prosperous one,” added Dr Abu Shaikha.

Patients can book a breast or bowel cancer screening at any of the screening suites by taking a prior appointment to avoid any hassle. Appoint-ments can be booked by contacting the dedicated call center on 8001112. People can also visit the website www.screenforlife.qa for more information.

‘Screen For Life’ encourages breast and bowel cancer screening as a tribute to Qatar National Day “Personal preventative healthcare is a national duty”, says PHCC

We in Qatar are extremely

fortunate to have excellent

permanent and mobile breast

and bowel cancer screening

facilities providing a professional

and complimentary service that

can lead to survival of these two

leading causes of cancer deaths

within the country.

Public Health

THURSDAY 26 DECEMBER 2019

3

Pub

lic H

ealt

h4

Pub

lic H

ealt

h5

THU

RSD

AY

26 D

ECEM

BER

20

19TH

UR

SDA

Y 26

DEC

EMB

ER 2

019

With

a h

ighl

y tr

aine

d an

d qu

alifi

ed

team

of p

rofe

ssio

nals

, at A

l Ahl

i H

ospi

tal’s

Al W

akra

Clin

ics

and

Urg

ent C

are

Uni

t has

var

ied

spe-

cial

ties

in

o

rder

to

gi

ve

imm

edia

te tr

eatm

ent a

nd a

ssis

t-an

ce to

any

giv

en m

edic

al s

ituat

ion.

Th

e U

nit g

ives

pri

ority

to c

ases

in o

rder

to re

susc

itate

an

d st

abili

zed

them

at t

he e

arlie

st p

ossi

ble

time

with

the

high

est q

ualit

y of

car

e.Th

e U

rgen

t Car

e U

nit p

rovi

des e

mer

genc

y an

d no

n-em

erge

ncy

care

gue

sts i

n Al

-Wak

ra a

rea.

The

staf

f enh

ance

ef

ficie

nt tr

ansi

tion

into

the

hosp

ital b

y pr

ovid

ing

accu

rate

tr

iage

ass

essm

ent f

or a

ll pa

tient

s who

arr

ive

at th

e un

it.

“Our

aim

is to

del

iver

the

high

est s

tand

ards

of q

ualit

y an

d sa

fety

acc

ordi

ng to

the

need

s of e

ach

indi

vidu

al g

uest

. W

e al

so a

im to

pro

vide

dig

nity

, pri

vacy

and

con

fiden

tial-

ity fo

r pat

ient

s and

thei

r fam

ilies

” sai

d D

r Kha

lid A

l Fak

hri,

Clin

ical

Dir

ecto

r (E

R),

Con

sulta

nt S

urge

on a

t A

l A

hli

Hos

pita

l.

“The

urg

ent c

are

wal

k in

clin

ic in

Al W

akra

rese

mbl

e w

hat w

e ha

ve a

t the

mai

n ho

spita

l. W

e ha

ve d

uplic

ated

th

e sa

me

setti

ng in

Al W

akra

. We

have

hig

h st

anda

rd m

ed-

ical

and

nur

sing

ser

vice

s as

wel

l as

equi

pmen

t ava

ilabl

e to

pro

vide

bes

t car

e to

our

gue

sts.

“The

doc

tors

from

the

mai

n ho

spita

l wor

k in

rota

tion

at th

e Al

Wak

ra C

linic

s and

Urg

ent C

are

Uni

t. So

the

sam

e do

ctor

s w

ill b

e he

re a

t the

mai

n ho

spita

l thi

s m

onth

will

be

ava

ilabl

e at

the

Al W

akra

Urg

ent

Car

e U

nit

next

m

onth

,” h

e ad

ded.

A

l Ahl

i Hos

pita

l’s 'A

l Wak

ra C

linic

s and

Urg

ent C

are

Uni

t', c

ater

ing

to th

e he

alth

care

nee

ds o

f the

pop

ula-

tion

in th

e so

uthe

rn re

gion

of t

he c

ount

ry. T

he fa

cilit

y,

loca

ted

near

the

met

ro s

tatio

n at

Al W

akra

. “T

he t

eam

at

'Al W

akra

Clin

ics

and

Urg

ent

Car

e U

nit c

onsi

st o

f m

edic

al s

taff

spe

cial

ist i

n em

erge

ncy

med

icin

e. T

hey

are

high

ly q

ualif

ied,

and

ver

y w

ell

trai

ned.

The

y ar

e ca

pabl

e of

han

dlin

g em

erge

ncie

s in

al

l med

ical

, sur

gica

l and

sub

- sp

ecia

lty. T

hey

have

all

faci

litie

s ne

eded

from

Min

or o

pera

ting

thea

ter t

o fu

lly

equi

pped

lab

s fo

r em

erge

ncy

tes

ts, a

nd

radi

olog

y

depa

rtm

ent,”

sai

d D

r A

l Fak

hri.

“Tho

se w

ho c

ome

for u

rgen

t car

e w

ill b

e as

sess

ed,

stab

ilize

d an

d tr

ansf

erre

d to

the

Al-

Ahl

i Hos

pita

l or A

l W

akra

h H

ospi

tal d

epen

ding

on

the

pati

ent’s

con

di-

tion.

In c

ase

if th

e pa

tient

nee

ds to

be

tran

sfer

red,

they

ca

n co

me

by th

eir c

ar, b

y A

l Ahl

i Hos

pita

l’s a

mbu

lanc

e or

we

can

call

the

Em

erge

ncy

Med

ical

Ser

vice

for

am

bula

nces

,” h

e ad

ded.

A

l Ahl

i Hos

pita

l’s A

l Wak

rah

faci

lity

open

s its

clin

-ic

s fr

om 8

am to

4pm

and

Urg

ent C

are

Uni

t rec

eive

s pa

tien

ts u

ntil

mid

nigh

t, w

ith

a pl

an t

o op

erat

e th

e ur

gent

car

e se

rvic

e 24

x7 in

the

near

futu

re. T

he n

ew

faci

lity

incl

udes

a p

roce

dure

roo

m, u

rgen

t car

e un

it,

phar

mac

y, r

adio

logy

sec

tion

, lab

orat

ory

and

clin

ics

for i

nter

nal m

edic

ine,

den

tal,

gene

ral s

urge

ry, o

bste

t-ri

cs a

nd g

ynec

olog

y an

d pe

diat

ric.

“A

ll th

e do

ctor

s an

d st

aff a

re tr

aine

d an

d ca

pabl

e to

res

pond

to

any

emer

genc

y ev

en a

t th

e cl

inic

s. A

t pr

esen

t, se

rvic

es a

t W

akra

Clin

ics

and

Urg

ent

Car

e U

nit a

vaila

ble

at o

ne s

hift

. We

have

clin

ics

from

8am

to

4pm

. The

wal

k in

urg

ent c

are

clin

ics

oper

ates

from

4p

m to

mid

nigh

t. So

that

any

one

who

wal

ks in

to 'A

l W

akra

Clin

ics a

nd U

rgen

t Car

e U

nit t

hey

can

find

serv

-ic

es fr

om m

orni

ng to

mid

nigh

t,” s

aid

Dr

Al F

akhr

i. “O

n Fr

iday

s th

e cl

inic

s ar

e cl

osed

and

the

wor

k-in

g ho

urs

of th

e U

rgen

t car

e un

it ar

e be

twee

n 12

noon

to

mid

nigh

t. In

the

fut

ure

we

are

plan

ning

to

cove

r 24

x7,”

he

adde

d.

The

Urg

ent c

are

Uni

t of A

l Ahl

i Hos

pita

l in

Al W

akra

ha

s 16

bed

s, w

hich

is n

earl

y th

e sa

me

as th

e m

ain

hos-

pita

l. Bu

t at p

rese

nt o

nly

half

the

capa

city

is o

pera

tiona

l an

d th

e re

mai

ning

bed

s ar

e ex

pect

ed to

be

avai

labl

e as

the

serv

ices

exp

and.

Al-

Wak

ra C

linic

s an

d U

rgen

t Car

e U

nit

of A

l-A

hli

Hos

pita

l alw

ays

prov

ide

high

est q

ualit

y of

car

e

It’s im

port

ant t

o kn

ow th

e di

ffer

ence

bet

wee

n th

e em

erge

ncy

room

and

an

urge

nt c

are—

and

the

serv

ices

the

y pr

ovid

e.

Emer

genc

y ro

om a

nd u

rgen

t car

e ar

e se

rvic

es fo

r the

imm

e-di

ate

trea

tmen

t of

ser

ious

ly in

jure

d pe

rson

s an

d pe

rson

s ha

ving

oth

er h

ealth

con

ditio

ns. S

omet

imes

thes

e tw

o te

rms

are

cons

ider

ed th

e sa

me

as b

oth

serv

ices

are

for

emer

genc

y ne

eds.

B

ut t

he f

act

is t

hat

ther

e ar

e so

me

fund

amen

tal

diff

eren

ces

betw

een

the

two.

The

urg

ent c

are

cent

ers n

orm

ally

take

car

e of

non

-life

-thr

eat-

enin

g co

nditi

ons l

ike

brok

en a

rms o

r leg

s and

oth

er si

mpl

e he

alth

co

nditi

ons.

In u

rgen

t car

e ce

nter

s, th

ere

wou

ld n

ot b

e an

y fa

cil-

ities

for a

tten

ding

seri

ous c

ondi

tions

or l

ife-t

hrea

teni

ng c

ondi

tions

lik

e he

art f

ailu

re o

r str

oke.

The

em

erge

ncy

cent

ers

prov

ide

faci

l-iti

es fo

r lif

e-th

reat

enin

g co

nditi

ons.

The

emer

genc

y ce

nter

s ar

e av

aila

ble

24 h

ours

a d

ay a

nd p

ro-

vide

car

e fo

r al

l pat

ient

s. T

he f

acili

ties

in u

rgen

t ca

re a

re n

ot

avai

labl

e 24

hou

rs a

day

. Alm

ost a

ll th

e ur

gent

car

e ce

nter

s ha

ve

set t

imes

.Th

e em

erge

ncy

room

s hav

e ex

pert

med

ical

pra

ctiti

oner

s who

ar

e ab

le t

o pr

ovid

e m

edic

al a

ssis

tanc

e to

all

seri

ous

illne

sses

. Th

ey a

re a

lso

avai

labl

e 24

hou

rs a

day

and

pro

vide

car

e fo

r al

l pa

tient

s w

ho a

re a

dmitt

ed.

Som

e of

the

adva

ntag

es w

ith re

gard

to u

rgen

t car

e is

that

the

med

ical

pra

ctiti

oner

s w

ill b

e m

ore

fam

iliar

with

a p

atie

nt’s

med

ical

his

tory

. In

the

urge

nt c

are

faci

l-ity

, the

pat

ient

s ge

t im

med

iate

car

e.

One

can

vis

it em

erge

ncy

cent

ers

if th

ey h

ave

ches

t pai

n, d

iffic

ulty

in b

reat

hing

, unc

ontr

olle

d bl

eed-

ing,

sev

ere

pain

, per

sist

ent

vom

itin

g, c

onti

nuou

s di

arrh

ea, v

isio

n pr

oble

ms,

larg

e w

ound

s, m

ajor

in

juri

es, h

ead

inju

ry, s

pina

l inj

ury

and

maj

or b

urns

. A p

erso

n ha

s to

vis

it ur

gent

car

e in

cas

es o

f spr

ains

, m

inor

infe

ctio

ns, s

mal

l wou

nds,

min

or b

roke

n bo

nes,

min

or b

urns

, ras

hes,

and

pel

vic

infe

ctio

ns.

Emer

genc

y vs

Ur

gent

Car

e T

he

urg

en

t ca

re c

en

ters

no

rma

lly t

ake

ca

re o

f

no

n-l

ife

-th

rea

ten

ing

co

nd

itio

ns lik

e b

roke

n

arm

s o

r le

gs a

nd

oth

er

sim

ple

he

alt

h c

on

dit

ion

s.

In u

rge

nt

ca

re c

en

ters

,

the

re w

ou

ld n

ot

be

an

y

facil

itie

s f

or

att

en

din

g

se

rio

us c

on

dit

ion

s o

r li

fe-

thre

ate

nin

g c

on

dit

ion

s

like

he

art

fail

ure

or

str

oke

. Th

e e

me

rge

ncy

ce

nte

rs p

rovid

e f

acil

itie

s

for

life

-th

rea

ten

ing

co

nd

itio

ns.

The

urge

nt c

are

wal

k in

clin

ic in

Al

Wak

ra r

esem

ble

wha

t w

e ha

ve a

t th

e m

ain

hosp

ital.

We

have

dup

licat

ed

the

sam

e se

ttin

g in

Al W

akra

. We

have

hig

h st

anda

rd

med

ical

and

nur

sing

se

rvic

es a

s w

ell a

s eq

uipm

ent

avai

labl

e

to p

rovi

de b

est

care

to

our

gue

sts.

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Public Health

THURSDAY 26 DECEMBER 2019

6

A phobia is usually defined as the severe, unrelenting fear of a situation, activity, or thing that makes one to want to avoid it. The definition of

agoraphobia is the severe anxiety about being outside or otherwise being in a situation from which one either cannot escape or from which escaping would be difficult or embarrassing.

Phobias are often underreported and underdiagnosed, likely because many phobia sufferers find ways to avoid the situations to which they are phobic. The fact that agoraphobia often co-occurs with panic disorder makes it even more difficult to determine how often it occurs. Other statistics about agoraphobia include that researchers estimate it occurs from less than 1% to nearly 7% of the population. The age of onset for this condition is most often during the mid to late 20s.

WHAT CAUSES AGORAPHOBIA?

There are a number of theories about what can cause agoraphobia. One hypothesis is that agoraphobia develops in response to repeated exposure to anxiety-provoking events.

Mental-health theory that focuses on how people react to internal emo-tional conflicts (psychoanalytic theory) describes agoraphobia as being the result of a feeling of emptiness that comes from an unresolved Oedipal con-flict, which is a tension between the feelings the person has toward the opposite-sex parent and a sense of competition with the same-sex parent.

Although agoraphobia, like other mental disorders, is related to a number of psychological and environmental risk factors, it also tends to run in families, and for some individuals, may have a clear contributing genetic component.

Girls and women are more likely to develop agoraphobia compared to boys and men. For ethnic minorities in the United States, a number of factors influence the likelihood of developing agoraphobia or any other anxiety dis-order, like immigration from another country, language proficiency, feeling discriminated against, as well as the specific ethnicity of the individual.

WHAT ARE THE SYMPTOMS?

Symptoms of agoraphobia include anxiety that one will have a panic attack when in a situation from which escape is not possible or is difficult or humili-ating. Examples of such situations include using public transportation, being in open or confined places or being in crowds.

The apprehension or panic attacks that can be associated with agora-phobia, like all panic attacks, may involve symptoms and signs like intense fear, disorientation, shortness of breath, rapid heartbeat, dizziness, or diarrhea.

Agoraphobic individuals often begin to avoid the situations that provoke these reactions. Interestingly, the situ-ations that people with agoraphobia avoid and the environments that cause people with balance disorders to feel disoriented are quite similar. This leads some cases of agoraphobia to be con-sidered as vestibular function (related to balance disorders) agoraphobia.

WHAT ARE THE RISK FACTORS?

Agoraphobia tends to begin by adolescence or early adulthood. Girls and women and individuals who are either widowed, separated, or divorced are at increased risk of developing agoraphobia. However, people who have felt discriminated against are thought to be at higher risk

of suffering from a number of anxiety disorders, including agoraphobia. Having a history of panic attacks is a risk factor for developing agoraphobia.

Agoraphobic individuals are at increased risk for developing panic attacks, as well. Other anxiety disorders that tend to co-occur with agoraphobia include social anxiety disorder (social phobia) and generalized anxiety dis-order. Even the use of alcohol can result in severe, albeit temporary anxiety.

WHEN SHOULD ONE SEEK

MEDICAL CARE ?

Call a doctor when the signs and symptoms of anxiety are not easily, quickly, and clearly relieved.

��If the symptoms are so severe that medication may be needed

��If the symptoms are interfering with someone’s personal, social, or pro-fessional life

��If one has chest pain, shortness of breath, headaches, palpitations, diz-ziness, fainting spells, or unexplained weakness

�� If one is experiencing depression or feeling suicidal or homicidal

When the signs and symptoms suggest that anxiety may have been present for a prolonged period (more than a few days) and appear to be stable (not getting significantly worse), it’s advisable to make an appointment with a doctor for evaluation.

But when the signs and symptoms are severe and come on suddenly, they may indicate serious medical illness that needs immediate evaluation and treatment in a hospital’s emergency department.

WHAT TESTS DO PHYSICIANS USE?

Interestingly, physicians often diagnose and treat agoraphobia, like other phobias, when patients seek treatment for other medical or emo-tional problems rather than as the primary reason that care is sought.

As with other mental disorders, there is no single, specific test for ago-raphobia. The primary-care doctor or psychiatrist will take a careful history, perform or refer to another doctor for a physical examination, and order laboratory tests as needed.

If someone has another medical condition that he or she knows about or there has been exposure to a medi-cation, drug of abuse or other sub-stance, there may be an overlap of signs and symptoms between the old and the new conditions. Just determining that anxiety does not have a physical cause does not immediately identify the ultimate cause. Often, determining the cause requires the involvement of a psychiatrist, clinical psychologist, and/or other mental-health professional.

In order to establish the diagnosis of agoraphobia, the professional will likely ask questions to ensure that the anxiety of the sufferer is truly the result of a fear of being in situations that make it impossible, difficult, or embarrassing to escape rather than in the context of another emotional problem (for example, fear of being near people that remind one of an abuser in the case of

posttraumatic stress disorder or the fear of hearing voices that have no basis in reality as occurs in schizophrenia).

The evaluator will also seek to determine if the symptoms of agoraphobia have occurred most times that the sufferer has been exposed to the previously described anxiety-provoking sit-uations over at least a six-month period.

WHAT IS THE TREATMENT?

There are many treatments available for overcoming agora-phobia, including specific kinds of psychotherapy as well as several effective medications.

A specific form of psycho-therapy that focuses on decreasing negative, anxiety-provoking, or other self-defeating thoughts and behaviors (called cognitive behavioral therapy) has been found to be highly effective in treating agoraphobia.

In fact, when agoraphobia occurs along with panic disorder, cognitive behavioral therapy, with or without treatment with medication, is considered to be the most effective way to both relieve symptoms and prevent their return. In fact, sometimes patients respond equally as well when treated with group cog-nitive behavioral therapy or a brief course of that kind of therapy, as they do when treated with traditional cognitive behav-ioral therapy.

Psychotherapy for agoraphobia is also effective for many people when they receive it over the Internet, which is opti-mistic news for people who live in areas that are hundreds of miles from the nearest mental-health professional.

Another form of therapy that has been found effective in managing ago-raphobia includes self-exposure. In that intervention, people either imagine or put themselves into situations that cause increasing levels of agoraphobic anxiety, using relaxation techniques in each situation (systematic desensiti-zation) in order to master their anxiety.

When avoiding the cause of the anxiety is gradually, thoughtfully pre-vented as part of this mode of therapy, it is often referred to as exposure and response prevention. As people gain access to the Internet, there is increasing evidence that exposure therapy can also be done effectively through that medium.

A variety of mental-health spe-cialists treat agoraphobia. In this age of managed care, psychiatrists are often relegated to managing medication treatment for this condition despite the training these professionals receive in conducting therapy.

Other mental-health prescribers, like nurse practitioners and physician assistants, may also provide medication management for this condition. Psy-choanalysts of a variety of disciplines, as well as psychologists, social workers, and psychiatric nurses, are some of the specialists that may conduct psycho-therapy to treat agoraphobia.

ARE THERE HOME REMEDIES?

While people often explore and attempt to address anxiety with alter-native treatments, sometimes described as home remedies, there remains a lack of large-scale, controlled scientific research to indicate a clear benefit of such interventions.

Lifestyle interventions that may help decrease anxiety include adhering to a healthy diet, regular exercise, engaging in meditation, and yoga.

WHAT ARE THE COMPLICATIONS?

Agoraphobia increases the like-lihood that the person will also suffer from another anxiety disorder, like social or other phobias, panic disorder or anxiety associated with posttrau-matic stress disorder. Agoraphobia also predisposes sufferers to having more severe and difficult to treat anxiety dis-orders of any kind. People with agora-phobia are more at risk for developing alcohol or other drug use disorders.

Also, agoraphobia tends to occur more often in individuals who have a

number of different physical conditions, like irritable bowel syndrome (IBS) and asthma. If not treated, agoraphobia may worsen to the point at which the per-son’s life is seriously impacted by the disease itself and/or by attempts to avoid or hide it. In fact, some people have had problems with loved ones, failed in school, and/or lost jobs while trying to cope with severe agoraphobia or another severe phobia.

While there may be periods of spontaneous improvement of symptoms for people with agoraphobia, it does not usually go away unless the person receives treatment specifically for agoraphobia sufferers.

IS IT POSSIBLE TO PREVENT

AGORAPHOBIA?

As agoraphobia often develops as a fearful reaction to having panic attacks, prevention of agoraphobia usually focuses on developing ways to cope with the anxiety about the possi-bility of another panic attack without avoiding leaving one’s home.

www.medicinenet.com

Agoraphobia: Causes, symptoms and treatment

The stress you feel before a big test or job

interview can motivate you to succeed. It can

even save your life; stress from a dangerous

situation can provoke a fight-or-flight reaction

that raises your adrenaline and motivates you

to act quickly. Sometimes stress gives you the

quick pulse and alert mind you need to stay

out of danger.

Girls and women and individuals who are either

widowed, separated, or divorced are at increased

risk of developing agoraphobia. However, people

who have felt discriminated against are thought

to be at higher risk of suffering from a number of

anxiety disorders, including agoraphobia.

Public Health

THURSDAY 26 DECEMBER 2019

7

Give yourself a r o u n d o f applause: you h a v e q u i t smoking and taken steps to

better health. One of the biggest concerns of smokers who quit is weight gain, but your first pri-ority should remain stopping smoking. After that, you can con-tinue on your path to healthy living by reaching and main-taining a healthy weight.

We all know smoking is the number one risk factor for lung cancer. Smoking is also a risk factor for cancer of the mouth, nose, throat, larynx, esophagus, liver, bladder, kidney, pancreas, colon, rectum, cervix, stomach, blood, and bone marrow. It increases the risk for other lung disease as well as heart disease.

It’s not guaranteed you will gain weight when you quit smoking. For those who do gain weight, the gain is only about 6 to 8 pounds. Only about 10% of people who quit smoking gain 30 pounds or more. There are several reasons you may gain weight when you stop smoking, including:

��Hunger. When you first quit you may feel hungrier than you used to. This feeling will usually disappear after several weeks.

�� More snacking. Many people turn to snacks when they quit smoking.

�� Calorie burn returns to normal levels. When you smoke, your body burns calories faster because your heart rate rises. However, this is a temporary effect that is damaging to your heart. When you quit smoking, this short-term calorie burn goes away and you will burn slightly fewer calories.

It’s always a good idea to exercise and eat a balanced and healthy diet. However, when you are quitting smoking, focus on that goal first and foremost. Once you are smoke-free you can con-centrate on weight loss efforts.

ACCEPT YOURSELFDon’t dwell on weight gain,

if any. Quitting smoking will improve your health in so many

ways. You will notice:��More energy��Whiter teeth��Fresh breath�� Clothes and hair smell

cleaner��Fewer wrinkles��Skin looks healthier��Voice is more clear

REGULAR PHYSICAL ACTIVITY

Regular exercise is one of the best ways to prevent large weight gain when you stop smoking. Exercise also gives you energy and can act as a mood-booster. Once you quit smoking, you will likely find you can breathe more easily during physical activity.

Aim for about 30 minutes of moderate-intensity exercise nearly every day to prevent weight gain. It doesn’t have to be all at once – you can break it up into shorter sessions. You may need more than 30 minutes of exercise daily to lose weight.

IDEAS FOR BEING ACTIVEThere are ways you can

incorporate physical activity into each day without it being a long exercise session. Try these simple steps:

��Take a walk during lunch breaks or after dinner.

�� If you take the bus or subway get off one stop early and walk home (if you live where it is safe to do so).

�� Park your car further away from the entrance to stores so you can walk.

��Take the stairs instead of the elevator.

�� Sign up for fun classes such as dance or yoga.

��Ask a friend to join you when you exercise.

LIMIT SNACKINGIn addition to moving more,

you must watch what you eat to avoid weight gain when you quit smoking. Many former smokers turn to high-fat, high-sugar snacks or beverages when they quit. Don’t fall into that trap of replacing one bad habit with another. Follow these steps to make healthier choices about what you eat and drink:

�� Eat frequent, smaller

meals.��Eat enough to satisfy you,

but don’t overindulge.��Eat slowly to pick up on

your body’s signals that you are full – it usually takes about 20 minutes from the first bite for your body to start registering you have had enough.

�� Choose healthy snacks such as fruit, air-popped popcorn, or fat-free yogurt.

��If you want an occasional treat, have a small serving.

��Choose beverages that are sugar free and fat free instead of alcohol or soda.

It may be easier to prevent weight gain or to lose weight with some extra help from a pro-fessional. Look into seeing a reg-istered dietitian, nutritionist, or personal trainer to help with your diet and exercise goals.

WILL WEIGHT GAIN HURT MY HEALTH?Most of us don’t like to gain

weight, but the overall benefits of quitting smoking far outweigh the risks of a few extra pounds. When you quit smoking you lower your risk for numerous types of cancers, and other illness such as heart disease. When you embark on a smoking cessation program focus first on quitting. Once you have quit for good, then turn your energy to becoming physically active and eating a balanced diet to reach your desired weight.

WHAT IS SECONDHAND

SMOKE?

Secondhand smoke (also called environmental tobacco smoke, involuntary smoke, and passive smoke) is the combi-nation of tobacco smoke and exhaled smoke from the smoker. Nonsmokers can inhale sec-ondhand smoke, exposing them-selves to the same chemicals, such as nicotine and carbon monoxide, as the smoker. Sec-ondhand smoke exposure puts children at risk for health problems including severe asthma, breathing problems, and ear infections.

W H A T C A U S E S SECONDHAND

SMOKE?The most common source of

secondhand smoke is cigarette smoke. Cigars and pipes are also a source. Secondhand smoke can occur anywhere, at home, at work, and in public spaces.

More than 7,000 different chemicals have been identified in secondhand smoke. Of those, 250 have been identified as harmful, and 69 of those are known to cause cancer (carcino-genic). Some of the toxic chem-icals include arsenic, benzene, the toxic metal beryllium, cadmium, ethylene oxide, for-maldehyde, tolulene, and vinyl chloride. Secondhand smoke causes cancer. In addition to cancer, secondhand smoke causes serious cardiovascular and respiratory diseases, and other illnesses.

LUNG CANCERLiving with a smoker and

inhaling secondhand smoke can increase the risk of developing lung cancer by 20% to 30%, according to the US Surgeon general. There are approximately 3,000 lung cancer deaths in adult nonsmokers that result from exposure to secondhand smoke.

HEART DISEASEInhaling secondhand smoke

can harm the cardiovascular system and can increase the risk for heart attack, particularly in those who already have heart disease. Nonsmokers exposed to secondhand smoke have a 25-30% higher risk of developing heart disease. Exposure to sec-ondhand smoke causes an esti-mated 46,000 heart disease deaths each year. Risk of stroke is increased as well when sec-ondhand smoke is inhaled.

OTHER LUNG DISEASES AND

R E S P I R A T O R Y ILLNESSES

Secondhand smoke can irritate the lungs and can cause respiratory illnesses and breathing difficulties. Cough, chest congestion (phlegm), wheezing, shortness of breath, and even decreased lung function are all traceable to sec-ondhand smoke exposure.

In the US, among children 18

months and younger, sec-ondhand smoke exposure is responsible for 150,000 to 300,000 cases of bronchitis and pneumonia, and 7,500 to 15,000 hospitalizations each year.

OTHER EFFECTS ON CHILDREN

In addition to serious repar-atory infections children who are exposed to secondhand smoke are at higher risk for ear infec-tions, have fluid in their ears more often, and more frequently need operations to put in ear tubes for drainage. In children with asthma, even a small exposure to secondhand can trigger an asthma attack.

IS THERE A SAFE LEVEL OF

SECONDHAND SMOKE?There is no safe level of sec-

ondhand smoke. Even inhaling small amounts can be harmful, and extensive or long-term exposure increases the risk of medical problems. Avoiding sec-ondhand smoke is the best way to reduce health risk.

If you smoke, quit. Your family and friends will no longer be exposed to your secondhand smoke if you are not smoking.

HOW TO PROTECT YOURSELF

I F Y O U ’ R E A NON-SMOKER

Avoid secondhand smoke to protect yourself from the health risks associated with inhaling it. If you don’t smoke, don’t allow others to smoke in your home or car. Make sure smoking restric-tions are enforced where you work such as proper ventilation and smoking areas at least 25 feet away from entrances. Don’t allow anyone who is smoking near your child, as children are particularly vulnerable to the effects of passive smoke.

WHAT IS THIRDHAND

SMOKE?

Thirdhand smoke is a recent term that refers to the smoke residue that is left behind after being around people who are smoking. The smell in your clothes, curtains, carpet, fur-niture, and other items has an odor because of the tobacco toxins that remain. These toxins can be absorbed through the skin and mucus membranes of non-smokers, particularly infants and children. To prevent thirdhand smoke, you need to prevent sec-ondhand smoke.

TIPS TO END ADDICTION

Quitting smoking is a perfect idea! Get a powerful, motivating reason and do it now! Do it for yourself: to feel better and look younger, and to reduce your chance of getting lung cancer. Do it for your family: protect your loved ones from secondhand smoke.

It’s not common to success-fully quit smoking by stopping immediately. Most people who quit “cold turkey” end up smoking again. Nicotine addiction can require gradual tapering to avoid withdrawal symptoms.

T R Y N I C O T I N E -REPLACEMENT THERAPY:

Nicotine withdrawal can cause restlessness, depression, and can lead to frustration. Cravings can be overwhelming. Nicotine replacement treatments including nicotine gum, patches, and lozenges can help. Do not smoke while using nicotine replacements.

ASK ABOUT PRE-SCRIPTION PILLS: Discuss nic-otine replacement with your doctor. There are prescription medications that can reduce the craving for cigarettes and reduce withdrawal symptoms.

DON’T GO IT ALONE: Friends and family can encourage and support you while you are quitting smoking. Some find support groups and/or coun-selors helpful. Behavioral therapy is often used with success. When these methods are combined with nicotine replacement therapy, your odds of success in quitting can increase.

MANAGE STRESS: Stress reduction techniques are helpful when quitting smoking. Helpful methods can include yoga, tai chi, music, massage, and exercise.

AVOID TRIGGERS: Bev-erage can be a trigger that causes people to return to smoking. Similarly, coffee and meals can cause relapses. Find your triggers, and replace them with other activities. Some find it helpful to brush teeth or chew gum after eating.

CLEAN HOUSE: Clear your home of anything that reminds you of smoking. Remove ash-trays and lighters from your home and wash your clothes, upholstery, draperies, and carpets. Air fresheners will also help to eliminate that familiar smell.

TRY AND TRY AGAIN: Relapses are common. If you relapse into smoking, analyze your situation and what might have triggered you to smoke again. Redefine your com-mitment and set a “quit date” and do it!

GET MOVING: Exercise activity can reduce nicotine cravings and withdrawal symptoms. When you feel like smoking, go move and find an activity you enjoy. This can also help to keep your weight optimal.

EAT FRUITS AND VEGGIES: Don’t worry about dieting during the early stages of quitting smoking. Focus on eating healthy foods. Of note, vegetables, fruits, and low-fat dairy products tend to make cigarettes taste poorly, according to a Duke University study.

CHOOSE YOUR REWARD: Another benefit of stopping smoking is financial. Reward yourself by spending your extra money on something that you enjoy or saving for something you really want!

DO IT FOR YOUR HEALTH: The real reward in stopping smoking is improved health. Stopping smoking lowers your blood pressure, decreases your risk of heart attack and stroke, as well as lung and other forms of cancer.

www.medicinenet.com

How to quit smoking without

weight gain

Public Health

THURSDAY 26 DECEMBER 2019

8

If you need extra motivation for a test or meeting, stress could work to your benefit. Stress gets a bad rap for good reason. It can cause physical problems like skin rashes and high blood

pressure. It can lead to mental health problems too, like anxiety and depression. But we feel stress for a reason, and sometimes it is good for you.

The stress you feel before a big test or job interview can motivate you to succeed. It can even save your life; stress from a dangerous situation can provoke a fight-or-flight reaction that raises your adrenaline and motivates you to act quickly. Sometimes stress gives you the quick pulse and alert mind you need to stay out of danger.

Whether stress helps or harms your body depends on many factors. One is whether your stress is acute or chronic. You know acute stress when you feel it--the way your heart races right after a car crash, or the sudden jolt of energy you get when you see a snake or spider. Acute stress goes away soon after the stressful cause is gone.

But chronic stress is another story. The muscle pain that sets in after months of demanding work, the constant nausea you may feel during a financial crisis, and the uncontrolled weight gain you experience during a long, unhappy rela-tionship can all be signs of chronic stress.

STRESS VS. ANXIETY

Are you stressed out or anxious? Though we tend to use the words inter-changeably, stress and anxiety refer to two different things. Understanding the difference can help you manage both.

STRESS: Stress refers to any thought, situation, or event that provokes anger, nervousness, or frustration. Different things stress different people out. For some it could be a traumatic breakup. For others it could be a poor job per-formance. Still others may feel stress when something reminds them of a trauma.

ANXIETY: Anxiety is often provoked by stress, but they’re not the same thing. Anxiety is the uneasiness, fear, or worry you sometimes feel. Stress can bring on anxiety, but anxiety sometimes has no clear cause. Chronic anxiety can lead to several psychological disorders, including: Phobias (like claustrophobia, a fear of tight spaces); Panic disorder (sudden, recurring panic attacks); and Generalized anxiety disorder (uncon-trolled worry)

STRESS AND NERVOUS SYSTEM

When it comes to stress, everything begins in your brain. When you are con-fronted with danger, like nearly being hit by a car, your brain sends a distress signal to a part of the brain called the hypothalamus. This is where your brain calls the shots for your automatic func-tions, sending orders to the rest of your body. When you’re stressed, adrenaline

signals your body to rev up its heartbeat, blood pressure, and breathing. Your senses become sharper, and your brain becomes more alert.

This all happens in an instant. But stress causes long-term effects too. A hormone called cortisol is released, which keeps your body on high alert until the threat passes. For some situa-tions and some people, though, stress levels remain high even after a per-ceived threat is gone. This leads to chronic stress.

CORTISOL AND WEIGHT GAIN

Chronic stress can add pounds as well as worries. The chemical cortisol acts like a foot on the gas pedal of stress. It is also responsible for some of the physical changes stress can bring on, and some of these are unwanted, espe-cially when stress lingers for weeks or months.

Cortisol puts a high demand on your body’s resources. You need this in the face of danger. But in the modern world stress is more likely to be caused by money problems than dangerous animals. This causes problems that can lead to unwelcome weight gain.

Since cortisol taxes your body’s energy stores, it also makes you hungry — especially for sugary and fatty foods that give you a quick burst of energy. If your stress isn’t prompting physical exercise in response, you’re likely to gain weight. What’s more, cortisol encourages your body to store excess energy as fat.

How much cortisol causes weight gain likely varies from person to person. Tests on sheep show that some are more responsive to cortisol than others. These high-cortisol responders eat more than other sheep when stressed and also gain more weight. Some researchers think this could help identify people who are prone to stress-related obesity.

STRESS AND MUSCLES

Stress makes you tense up. That’s good if you’re facing down an angry predator. But if it persists, muscle tension causes several problems. Tension headaches and migraines can result, for instance. Tense muscles can provoke more serious anxiety disorders, too.

How you respond to stress could help determine how swiftly you recover from injury as well. If you become excessively fearful of reinjuring yourself, this can leave you in a state of chronic pain. Your muscles will seldom relax if you continue to feel fearful. This per-sistent tension can also lead to muscle atrophy, as it is difficult to move when you are intensely bound up by your own muscles. This is a problem that can get worse, as exercise is one of the most reliable means of relieving stress.

TAKING A BREATH

Constant worry affects your breathing. People under a lot of stress tend to take deeper breaths and to breathe more often than calm people. This is your body’s way of shoring up the oxygen it needs to respond to a physical stressor. That’s usually fine, but not always. If you have breathing problems like asthma or lung disease, all this breathing can make your problems worse.

HOW STRESS AFFECTS HEART

When your stress is sudden and lasts for a limited time (acute stress), your heart starts pumping faster right away. It’s part of the way your body adjusts to dangerous situations. That isn’t espe-cially hard on your body. But what if your “stress” lever gets stuck and you wind up with ongoing chronic stress?

Chronic stress keeps your heart rate up for long expanses of time. It also causes your blood pressure to increase. These put you at greater risk of major heart disorders such as heart attack and stroke.

The health problems stress brings to your heart don’t end there. Repeated episodes of acute stress or ongoing chronic stress could increase the inflam-mation in your circulatory system, espe-cially inside your coronary arteries. This could explain how intense stress can bring on heart attacks. In addition, stress may raise cholesterol levels in some people, which affects the circulation and heart as well.

STRESS AND DIABETES

Stress carries special risks for those vulnerable to type 2 diabetes. When stress causes your body to release cor-tisol and epinephrine, these chemicals send a message to your liver. The liver is told to produce more glucose, the sugar that fuels your body for its fight-or-flight response.

For most people, added glucose can be reabsorbed without trouble. But for someone with type 2 diabetes--whether diagnosed or undiagnosed--this can lead to dangerous consequences.

This condition causes extra glucose to back up into the bloodstream, causing a variety of problems like blurry vision, extreme fatigue, and infections. Type 2 diabetes is more common for people who are overweight, and who are over age 40.

FIGHTING OFF COLDS

WHILE STRESSED

Does stress make it harder to fight off infections? Colds, flus, and other communicable diseases may be fought off more easily if you experience certain kinds of stress. But other forms of stress can make it harder to beat that cold.

Mild, acute stress seems to prepare your body to fight off infections. Studies on lab rats show that as their stress hor-mones rise, the animals release immune

cells to the blood and skin. These are crucial places for immune cells to ward off diseases. However, if your stress is chronic, lasting for weeks or months, the opposite seems to be true. Chronic stress inhibits some of the body’s most important infection-fighters: T-cells. As a result, someone suffering from chronic stress is left vulnerable to infectious diseases.

STRESS AND STOMACH

Stress affects your digestive system in several ways. Almost everyone has felt “butterflies” in their stomach at the approach of a big test or an important meeting. If you experience more intense stress, though, those butterflies can transform into nausea or even vomiting. Very intense physiological stress, like the kind seen in cases of serious illness, can also cause stomach ulcers.

The stomach isn’t the only place along your digestive tract harmed by stress. Stress can also lead you to eat more and to eat poorly. This can cause heartburn, especially if you eat more fatty foods than normal, as well as acid reflux. These conditions are mostly felt inside your esophagus, which is more sensitive than your stomach. Stress can make the pain from these conditions worse as well.

STRESS AND BATHROOM HABITS

Stress can change the way your intestines absorb nutrients, and how quickly food moves through your body. In this way stress can lead to either con-stipation or diarrhea. It doesn’t help that stress provokes you to eat more greasy and sugary foods, often in the form of processed foods. These foods can make your gut leaky, causing additional problems like inflammation.

Chronic stress can change the bac-teria in your digestive system as well. Bad bacteria begin to replace the good bacteria, which can be killed off. With different bacteria available, the foods you eat begin to digest differently. One study showed that women with irritable bowel syndrome (IBS) experience worse digestive symptoms when stressed out, and that their stress is strongly asso-ciated with anxiety and depression.

The best ways to ward off these problems include exercising and main-taining a healthy diet (especially one containing fiber. However, until you get a handle on your stress, these problems are likely to continue.

HOW STRESS AFFECTS MEN

Studies show that stress tends to affect men and women differently. Men are more prone than women to “mental stress,” specifically regarding work. Men dealing with chronic stress are less likely than women to take care of their symptoms. They’re less likely to lean on friends and family for help, and are less likely to prioritize quality sleep. Clearly

men could learn a thing or two from women in this regard.

Hormones may be at play. While men and women release stress hor-mones in similar ways, there’s a big dif-ference in how oxytocin is released in response. Oxytocin promotes nurturing feelings and feelings of well-being. And women receive it in much higher doses when stressed than men do. Oxytocin may encourage women to look for help from others by nurturing and befriending, whereas men are more likely to flee from their stress or lash out in response to it.

HOW STRESS AFFECTS WOMEN

Women are stressed out in different ways, and from different causes, than men. While men are most likely to report that work causes stress, women are more likely to attribute their stress to financial worries. They’re also far more likely to report high levels of stress than men. In one survey, 28% of women said they experience stress at a level of eight to 10 on a 10-point scale, with only 20% of men reporting the same.

Women also handle their stress dif-ferently than men. Perhaps it’s oxytocin as mentioned previously, which women get in higher doses in reaction to stress. Women are more likely to confide in friends and family and to talk about their emotions more freely. That’s a good thing, as one way to cope with stress is to openly address it. What’s not so good for women, though, is that their stress is more likely to manifest in physical symptoms. Women are significantly more likely to report stress headaches, stomach complaints, and crying pro-voked by stress than men.

COPING WITH STRESS

Chronic stress takes its toll on a huge number of people. One survey found that more than 40% of American adults lose sleep with worry. There is good news though. Research shows that this painful and dangerous condition can be treated through behavioral changes, therapy, and sometimes medicine.

BEHAVIOR CHANGES TO

REDUCE STRESS

There are several steps you can take to help with stress management. Here are some:

� Learn how to say no to commit-ments that will sap your energy.

� Tell close family and friends you’re having a difficult time, and that you welcome and appreciate their support.

� Take small, simple steps to improve your health, such as exercising or improving your diet.

� Make quality sleep a priority.� Do your best to look at things

positively.� Don’t be afraid to reach out for

expert therapeutic help. www.medicinenet.com

Anxiety, stress, worry, and your bodyThe stress you feel before a big test or job interview can

motivate you to succeed. It can even save your life; stress

from a dangerous situation can provoke a fight-or-flight

reaction that raises your adrenaline and motivates you to

act quickly. Sometimes stress gives you the quick pulse

and alert mind you need to stay out of danger.