Health

The Exercise Prescription

We all know that we need to get more exercise. In today’s technologically driven world we sit too much and move too little. Being a working mom, I am well aware of how I am always rushing around, but not physically moving very much. It is hard to find the time (and inclination) to exercise with dedication. Doctors have been telling their patients to exercise more since  Hippocrates said: “walking is man’s best medicine”.  A medical prescription is very clear as to the dosage, duration and frequency that is needed. The recommendations on how much and how often to exercise…

Going straight for the gut

I am taking a break over the holidays. For the next four weeks, I will be republishing a few of my favourite blogs. We have always known that our mood affects our guts. My anxious patients complain of diarrhoea and my depressed patients of constipation. I could never have imagined how much of a role the gut microbiota plays in communicating with the brain and modulating behavior. I never took “gut feeling” literally! Our gut, the small intestine and the large intestine, is filled with over a kilogram of bacteria, the gut microbiota. That’s almost the weight of an average…

Let’s talk about food

I am taking a break over the holidays. For the next four weeks I will be republishing a few of my favourite blogs. In continuing with thoughts about selfcare, I would like to talk about food. I hosted a dinner party the other night and there was a vegetarian, someone who was Banting-it and a gluten intolerant guest. We generally agreed that Trump was a disaster, wailed about corruption in SA politics and lamented the drought. But when we got to food, the opinions clashed and arguments got heated. I bet that Mrs Cavewoman host did not have these problems.…

Exam time: the outer rim of hell

It’s the time of the year when I, as a psychiatrist, find myself writing letters motivating for extensions, deferments and more time. Nobody likes exams; it’s hard work and the feeling of being evaluated can be unpleasant. But for some people exam time becomes a psychic hell. A patient came to me having continuous panic attacks. She was incapable of sleeping or studying. She had been procrastinating with exam preparations; once she started, she was overwhelmed by the sheer volume. She started working non-stop, breaking only to refill her coffee or buy some cigarettes. Initially, she made good headway. The problem began when she was…

The torture of sleep deprivation

A couple came to see me as the last stop before initiating divorce proceedings. Since the birth of their son 18 months before, their home had deteriorated into a war zone. Their baby had colic and was a particularly bad sleeper. Typically, the baby would squawk, and mom would jump up to try to settle him before he woke properly. Inevitably, he did wake and then stayed awake for hours. Mom would become tearful and desperate. Knowing this, dad would also jump up when baby stirred because he wanted to support mom. Both parents were exhausted. Mom was in a…

The Adolescent Brain- a treacherous frontier

My 10-year-old son is the sweetest, most easy going child. Recently, very occasionally and out of the blue, he has had a few moody days. It has been such a shock to me that I have been carefully listening to my friends and patients to hear what it is like to parent an adolescent. It seems as if most times adolescents are just wonderful. They are passionate, enthusiastic and eager to earn. But parents of adolescents also tell me of the dark side. The times when the teenager is moody, eye rolling and door slamming. When they push boundaries, lie and…

The contraceptive pill- blessing or curse?

Is my Pill making me nuts? Easily half the ladies in my practice have horror stories of what has happened when they took the contraceptive Pill. Medical science has long minimised the mood effects of the Pill. It would argue that the patients in my practice are a skewed sample – they were already struggling with mood issues, which is why they came to see me in the first place. Taking the Pill was just another variable factor, not the underlying cause of their instability. Medicine has further held the line that you can’t accuse “the Pill” of causing depression…

How much is too much alcohol? The moderation myth

People see psychiatrists because they are struggling emotionally and mentally. Their lives feel overwhelming and out of control. So it is perhaps not surprising that I have to talk about alcohol with most of my new patients. I do not mean that all my patients are addicted to alcohol – that is, they don’t compulsively need to drink or have withdrawal symptoms when they try to stop (although a small percentage are  struggling with full blown addiction). Most aren’t even abusing alcohol. They are not driving drunk, or getting belligerent when drunk, or having memory gaps when drinking (although these…

The weight issue- if diets don’t work, what does?

Diets don’t work. (www.drmarcellestastny.co.za/diets do not work) An obese woman has a one in 677 chance of achieving a normal weight in a year. An obese man has a one in 1 290 chance of being a normal weight in a year. A major risk factor for being 5kg heavier in a year from now is to be on a diet now. All recommendations seem to be that whatever you do it must be “simple, flexible and sustainable.” Kilojoule restriction for weight loss does not work. Permanent modifications to diet and lifestyle do work. If you have been gaining 2kg every…

Diets do not work

You have had a look at yourself in the mirror and realised that you don’t like what you see. Your doctor has told you that you must lose weight. You have researched Atkins, Detox diet, Banting, Intermittent Fasting and a few others. You are ready to start your diet. Again. You probably feel that you don’t need to have your resolve weakened by reading a blog espousing that diets don’t work. Worse, a major risk factor for being 5kg heavier in a years time, is to be on a calorie restricting diet now. Dieting results in weight gain. Diets don’t work. A…

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