Lifestyle

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.…

Why can’t I shake this recurrent depression?

By the time patients come to me for the treatment of their depression, they have often been sick for some time. When we go into the history of the illness, it becomes clear that most have been depressed before.  If you have had two episodes, more than likely, you will have a third one. If you have had three episodes, there’s a 90 percent chance you will have a 4th. It seems that a single episode of depression is more the exception than the rule. The greatest predictor of a relapse of depression is stopping antidepressant treatment. More and more evidence…

Dementia. Darn, it’s on the tip of my tongue

I’ve noticed an alarming thing lately, although I should not be surprised. My patients are growing older. Teenagers I was helping with their self-destructive behaviours two decades ago are now anxious mothers. Anxious mothers whom I met 20 years ago are now looking at retirement. It shouldn’t be surprising; I am getting older too. So is the rest of the world. Life expectancy has been steadily increasing worldwide over the last two decades. This is largely due to better infant survival in poorer countries and less cardiovascular and infectious events in richer countries. The world life expectancy is 71.8 years,…

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…

Boundaries with social media

Social media, and how to relate to it, is still a relatively new phenomenon. We are still trying to figure it out. But it is influencing mental health. Several studies have shown a clear correlation between depression and excessive social media use. I have a young woman in my practice who has very intense friendships with two other women. While relationships of this nature are common for the age group, what adds a complicating dimension is WhatsApp.  These young women are in contact all the time; they live in each other’s pockets. In the past, a bit of distance could be naturally…

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…

Let’s talk about weight- why are we so fat?

Worldwide there is an obesity problem; they call it the “globesity epidemic”. In South Africa 70% of women are overweight and 40% obese (BMI over 30). A third of South African men are overweight. Despite what the “Fat and Proud”  counter-revolution and our defence mechanisms tell us, it’s not okay to be fat. Obesity results in numerous health problems. In the States, it’s the number 1 cause of preventable deaths. For generations, each generation has died older than the last. This trend is now being reversed because of obesity-related illnesses including diabetes, heart disease, metabolic syndrome, certain cancers and stroke. When…

Let’s talk about the value of ideal weight

Ideal weight is such a sensitive issue. In my practice, almost every woman and many of the men are unhappy with their weight. I often wonder what it would be like if every person in the world woke up one day, happy with how they looked. I think a lot of diet and beauty industries would go bankrupt! What is “ideal weight”? Surprisingly, this concept is not that easy to define. First off, there seems to be a paradox in patients’ awareness. Next, doctors can not seem to agree as to what it is and how best to measure it.…

Why am I so tired?

I am not talking about feeling weary. I am talking about bone crushing fatigue even after a good night’s sleep or a relaxed holiday. The body is a wonderful structure. If something is a bit off kilter, it will tell us, we must just listen. Fatigue is a terrific teacher. We have no choice but to slow down and review.  If we take heed and make corrections, then the body will restore itself. It wants to be well and function optimally. So, if you are feeling tired all the time, it’s worthwhile trying to figure out why. The bulk of the…

Let’s talk about sleep

Almost all of my patients struggle with sleep problems. It stands to reason, a symptom of many mental illnesses is disturbed sleep. Furthermore, sleep disturbances destabilise mental illnesses and makes them worse.So, for many of my patients addressing sleep problems is a serious priority. It should be for you too. 40% of South Africans are not getting enough sleep. Sleep deprivation is linked with chronic illnesses like hypertension, heart disease and stroke. It drops your immunity, so you end up with constant colds and flus. Being sleep deprived makes you moody, depressed and leads to cognitive decline and memory problems.…

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