Author Archives: Rachel Zimmerman

Blogger, CommonHealth Rachel Zimmerman worked as a staff reporter for The Wall Street Journal for 10 years in Seattle, New York and in Boston as a health and medicine reporter. Rachel has also written for The New York Times, the (now-defunct) Seattle Post-Intelligencer and the alternative newspaper Willamette Week, in Portland, Ore., among other publications. Rachel co-wrote a book about birth, published by Bantam/Random House, and spent 2008 as a Knight Science Journalism Fellow at MIT. Rachel lives in Cambridge with her husband and two daughters.

Summer Listening From The Checkup: High Anxiety, Revisited

Summer is supposed to be a happy time, right? But for many, it’s a very anxious time — particularly if you suffer from fear of flying and a long-distance vacation looms, or from intense parental anxiety as your children range farther off than usual.

So, for your summer listening pleasure, we offer you this favorite episode from among the best of The Checkup, the WBUR/Slate podcast: It explores three different aspects of that incredibly common (especially among CommonHealth co-hosts) psychiatric disorder: anxiety.

First, we get into Rachel’s fear of flying and how she (sort of) overcame it. For a fuller story, she wrote about it here, but the saga continues.

Then, we speak with Harvard Medical School’s Mohammed Milad about his research on an intriguing hormone-based hypothesis that might help explain why so many more women suffer from fear and anxiety disorders than men. For more, see Rachel’s full interview with him: “Why Do So Many Women Have Anxiety Disorders? A Hormone Hypothesis“.

And finally, we talk about parental anxiety and how we can try to manage it better through mindfulness techniques, featuring a recent book on the topic — “The Mindful Way Through Anxiety” — by Suffolk University professor Sue Orsillo. For more, the book’s website is here, and a sample chapter is here.

Elderly And Drugged: Far More Psych Meds Prescribed To Old Than Young

Evidence suggests that anti-anxiety medications like Xanax increase the risk of falls in older adults, which can cause a cascade of problems. (johnofhammond/Flickr, with edits by WBUR)

Evidence suggests that anti-anxiety medications like Xanax increase the risk of falls in older adults, which can cause a cascade of problems. (johnofhammond/Flickr, with edits by WBUR)

By Nell Lake
Guest Contributor

Are we over-treating the elderly with psychiatric drugs?

That’s the natural question arising from a recent report that found adults over 65 are receiving psychotropic medications at twice the rate of younger adults. The study, published in this month’s Journal of the American Geriatrics Society, also found that elders are much less likely to get their mental health care from psychiatrists or to receive psychotherapy.

What’s the problem? First, psychotropic drugs generally pose greater risks to the elderly than they do to younger patients, and non-drug approaches, from therapy to meditation, may be as effective as psychotropic medications for some seniors’ mental disorders, without the risks.

The findings suggest that physicians and insurers should reassess psychotropic drug use among the elderly, says lead author Donovan Maust, a geriatric psychiatrist and assistant professor of psychiatry at the University of Michigan.

Maust’s team used 2007-2010 data from the CDC’s National Ambulatory Medical Care Survey and from the U.S. Census to compare the rates at which older and younger adults — those 65 and older, and those 18-64 — get prescribed psychotropic medications during outpatient doctors’ visits. After analyzing more than 100,000 of these doctor visits, and taking into account the fact that the younger population is much larger than the older one, the researchers found that older adults were much more likely to be prescribed psychiatric drugs for anxiety, depression and other mental health conditions. Researchers also found that these seniors were less likely to receive other types of non-drug treatment for their mental distress.

The importance of all this is fairly clear: The elderly population is booming, and seniors use the health care system more than any other demographic. So, finding safe, effective and appropriate treatments for their mental health problems is critical — for the well-being of a large swath of people, and as a policy matter.

Too Many Meds, And The Wrong Kind?

Psychotropic drugs pose both direct and indirect risks to the elderly: First, the drugs themselves can be dangerous. The American Geriatrics Society lists many psychotropic medications as potentially inappropriate for elderly patients. Continue reading

Summer Listening From ‘The Checkup': Sexual Reality Check, Revisited

We can’t be reminded too often that the fantasies portrayed in bodice-buster novels and porn flicks bear only a vague resemblance to what happens (and how we look) in real life.

So here, as part of our summer-listening revival of the best of our WBUR/Slate podcast, The Checkup, is a favorite, particularly juicy episode, titled “Sexual Reality Check.” It includes surprises about penis size, stories of great sex over 70 and new insights on how both men and women are lied to about their sexuality.

In case you missed other recent episodes: “Teenage Zombies” explored the curious minds of adolescents, with segments on sleep, porn and impulsive choices; “Power to the Patient” looked at ways we can all feel in more control of our health care; and “High Anxiety” included reports on hormones, parenting and fear of flying.

Better yet, don’t miss a single episode and just subscribe now.

New Moms Cite Lack Of Advice From Docs On Key Issues: Sleeping, Breastfeeding

A new study found that about 20 percent of mothers said they didn’t receive advice from their baby’s doctors about breastfeeding or the current thinking on safe placement for sleeping newborns. (Mark Humphrey/AP)

A new study found that about 20 percent of mothers said they didn’t receive advice from their baby’s doctors about breastfeeding or the current thinking on safe placement for sleeping newborns. (Mark Humphrey/AP)

After I gave birth to my kids, I was bombarded with advice from family, bestselling books and even strangers on topics ranging from how to lose the baby weight, when to have sex again and which infant toys boost IQ.

But according to a new, NIH-funded study, many sleep-deprived, hormone-addled new mothers may not be getting enough advice on critical issues from a most important source: doctors and other health care providers.

When it comes to breastfeeding, infant sleep position, immunization and pacifier use, many new moms report they get no advice at all from their children’s doctors — despite medical evidence on the benefits of certain practices, like breastfeeding and placing babies on their backs for sleep.

The new study — published in the journal Pediatrics and conducted by researchers at Boston Medical Center, Boston University and Yale University — found that about 20 percent of mothers said they didn’t receive advice from their baby’s doctors about breastfeeding or the current thinking on safe placement for sleeping newborns. And more than 50 percent of mothers told investigators that doctors did not offer guidance on where the babies should sleep.

(Of course the whole issue of where newborns should sleep is controversial. Official recommendations now say babies should “room share” with parents but not “bed share.”)

The study, part of a larger national effort called SAFE (Studies of Attitudes and Factors Effecting Infant Care Practices), surveyed more than 1,000 new mothers across the country, inquiring about infant care advice they received from different sources: doctors, nurses, family members and the media.

Dr. Staci Eisenberg, a pediatrician at Boston Medical Center and lead author of the new study, said in an interview that the number of moms who reported no advice from across the board is surprising.

“These findings say to me, ‘Hmm, this is a time to stop and think carefully about how we communicate, and are we communicating in a clear, specific enough way, and are we being heard, especially by new moms — new parents — who are often tired and likely overwhelmed?’ ” she said. “Amidst this sea of information, what are the messages that need to be highlighted and communicated clearly?” Continue reading

‘I Don’t See Any Stigma': Father Fights Suicide In Black Community After Son’s Death

Joseph Feaster Jr. with a portrait of his son Joseph Feaster III. (Jesse Costa/WBUR)

Joseph Feaster Jr. with a portrait of his son Joseph Feaster III. (Jesse Costa/WBUR)

Joseph Feaster Jr. is not a minister. He’s a successful Boston attorney. But for the last five years he’s been doing a lot of preaching about a subject close to his heart.

“My ministry right now, because it’s even more personal — it involves my son — is around mental health,” Feaster says. “And if I can help the next person to understand it, to get through it, that’s my being.”

His son carried his name and was thereby Joseph Feaster III. He died by suicide in 2010, at the age of 27.

His death came at a triple-decker on Elmore Street in Roxbury, not far from Dudley Square. That’s where he had lived most of his life — first with his parents and sister, and then renting an apartment from his father.

His father recalls lots of times going with Joseph to Horatio Harris Park, less than a block from the family’s home. The elder Feaster doesn’t remember any signs of mental illness in his son as a child.

“No, not at all. I mean, he was a happy kid,” Feaster recalls. “He played here. He climbed the structures here. He would be with his sister and her friends. And he had a great smile.” Continue reading

‘It's No Longer Dark': Suicide Attempt Survivors Share Messages Of Hope

Mary Esther Rohman tried to take her own life many times when she was younger. But now, she's in a very different place. (Jesse Costa/WBUR)

Mary Esther Rohman tried to take her own life many times when she was younger. But now, she’s in a very different place. (Jesse Costa/WBUR)

Mary Esther Rohman, of Belmont, knows what it means to hit rock bottom — or worse. As she describes it, the bottom fell out. “They wanted to lock me up in a state hospital and throw away the key as being incurable,” Rohman recalls.

She tried to kill herself many times starting in her late 30s. But thanks to the right depression treatment, self-motivation and a sweet twist of fate, at the age of 67, Rohman is in a very different place.

“When I was 55 I met my soulmate, and I’m so happy!” Rohman says. “You never can tell what life is going to bring you. You’ve got to wait and see what the next chapter is going to be.”

Craig Miller, of Townsend, also knows the dark place of feeling suicidal. “I always had thoughts of suicide since I was 8 years old,” he says. “I always struggled with depression. I always struggled with mental health issues.”

Miller made several suicide attempts. But he recovered, turning his mental suffering into a force to help himself and others.

“It’s no longer dark, and it no longer hurts. And it’s no longer painful, and it no longer has this power over me that it used to have,” Miller reflects. Continue reading

Boston Moms: Let’s Spend Olympics Savings On Gym And Recess For Kids

(Steven Depolo/Flickr)

(Steven Depolo/Flickr)

By Kate Lowenstein
 and Ramika Smith
Guest contributors

We have a suggestion for how to spend some of the billions of dollars that Boston will likely save by not hosting the Olympics: How about we invest even 1 percent of that into the bodies and brains of our children by ensuring they get ample physical education and recess time?

Instead of spending billions to have elite adult athletes playing sports in our city, we can at least give our own Boston Public Schools kids the chance to run and play here.

Most parents of kids in the city’s public schools assume their children get recess every day, as we did when we were kids, but the reality turns out to be quite different. While the CDC recommends that all children get at least 60 minutes of vigorous exercise every day, and at least 30 minutes of school-time physical activity, many of our schools allow for as little as 20 minutes, if that.

Over the past two decades, accelerated by No Child Left Behind’s focus on testing, the tendency has been to reduce or eliminate physical education and recess. And our school administrators and legislators look the other way without recognizing the overwhelming amount of evidence that shows the significant academic and mental health benefits of these physical activity breaks.

Recess and physical education are as integral to a long school day as are Math, Science, and English.

In January of 2009, the journal Pediatrics published a groundbreaking study of 11,000 third-graders, comparing those who had little or no daily recess with those that had more than 15 minutes of recess per day. The findings show that children who have more recess time behave better in the classroom and are likelier to learn more.

In January of this year, The Boston Foundation released a report: “Active Bodies, Active Minds: A Case Study on Physical Activity and Academic Success in Lawrence, Massachusetts.” The report found that only 15 to 20 percent of Massachusetts children are meeting the 60-minute daily recommendation for physical activity and only 10.2 percent were meeting the school-time recommendation of 30 minutes.

It also underscored what we already know from many other studies; that children in schools that provide an adequate amount of time and opportunity (and encouragement) for daily physical activity, in the form of recess, gym classes and movement breaks, have higher MCAS scores in both math and ELA. Continue reading

Summer Listening At Candy Store Or Salad Bar: Scary Food Stories, Revisited

As summer enters its dog days, you can feel the great gears of the news machine slowing, slowing, slowing, like a locomotive as it pulls into a station. So now seems like a good moment to re-offer you some of the best of our WBUR/Slate podcast, The Checkup, for your listening pleasure on those long car trips and plane rides to vacationland.

In particular, in case you missed this delectable morsel, may we recommend our episode titled “Scary Food Stories”? It features three particular cautionary tales: on kale, chia seeds and sugar. Download it here before your next meal. Or if you don’t, don’t say we didn’t warn you…

In case you missed other recent episodes: “Teenage Zombies,” explored the curious minds of adolescents, with segments on sleep, porn and impulsive choices; “Power to the Patient” looked at ways we can all feel in more control of our health care; “High Anxiety” included reports on hormones, parenting and fear of flying; and “Sexual Reality Checks” examined penis size, female desire and aging.

Better yet, don’t miss a single episode and just subscribe now.

When And Where Do You Stress? Ambitious Project Aims To Map Daily Life, Whole City

Passengers squeeze aboard a Red Line train at the Porter Square MBTA station. (Robin Lubbock/WBUR)

Passengers squeeze aboard a Red Line train at the Porter Square MBTA station. (Robin Lubbock/WBUR)

By Marina Renton
CommonHealth intern

Would I make it to the train station in time? Or would I miss my train home? The concern gnawed at me as I fidgeted on the uncomfortably warm and crowded subway platform. As I anxiously scanned the tracks for approaching lights, the watch on my wrist buzzed. It was telling me to check my stress levels. I pulled out my phone. High, it said — surprisingly high.

That may sound like the first draft of a science fiction novel but, in fact, it’s describing events from last month, when I tried out a watch that has sensors to measure the autonomic nervous system, which regulates our fight-or-flight response.

Neumitra, a Boston-based startup, developed the technology, and plans to launch an ambitious project this fall that would use it to chart the stress not just of individuals but of professions and institutions — even of a whole city. It may be a no-brainer that catching a train is stressful, but how does stress at Harvard compare to stress at Northeastern? North Shore to South Shore? Emergency room at Boston Medical Center to Massachusetts General Hospital?

“We’re using data from the body and data from mobile phones to understand how everyone is affected by stress,” said Rob Goldberg, co-founder of Neumitra and a neuroscientist formerly at MIT. “Our aim here is for thousands of people in Boston to be using these technologies, so we can understand the difference between a veteran, a police officer, a student, a mother, a nurse — and sometimes you belong to multiple of these categories, so what are the combined effects?”

Sync To See Your Stress

“I’m so stressed!” is a frequent response to the innocuous, “How are you?” The exclamation, or variations thereof, can be heard at the office, between classes, at home…practically anywhere.

But it’s one thing to verbally express feelings of stress, and quite another to quantify those sensations. That’s where Neumitra comes in.

You can track your stress level in real time through an app that displays the data that the watch collects. The app syncs with your calendar and GPS, so you can also look back to see which events and locations cause the most stress. When your stress spikes, the watch vibrates — an alert that it might be time to take a step back and recalibrate.

“We don’t understand what we’re all struggling with on a day-to-day basis.”

– Neumitra co-founder Rob Goldberg

The app displays stress using a color gradient: Blue means relaxed or restful, orange and red signify increasing tension. During my entire subway ride, I was either in the dark-orange or red zone. Once I was back home, I spent more time in the blue regions. Exercise brought me back into the orange (among other things, the watch measures skin conductance and temperature, so physical exertion can register as stress), but it didn’t exceed the stress I demonstrated while standing (read: trying not to fall on anyone) in a crowded subway car.

This technology is certainly fascinating, but does it really tell us anything we didn’t already know? Goldberg’s answer is an emphatic yes. “We think we [know how we feel], but we’re very detached from that,” he said.

Science At A New Scale

In this age of “smart” or “connected” everything, we’re getting used to devices that monitor us, but Goldberg says Neumitra’s plans for the technology’s use on a large scale might lead to a whole new understanding of the effects of daily life on stress. Continue reading

Roxbury Center Targets Health Disparities In Boston’s Poorest Neighborhoods

Whittier Street Health Center opened its community vegetable garden on June 24. (Courtesy of Chris Aduama)

Whittier Street Health Center opened its community vegetable garden on June 24. (Courtesy of Chris Aduama)

By Marina Renton
CommonHealth Intern

When it comes to health in Boston, it’s hard to deny there’s a great divide across neighborhoods.

Need proof? A 2013 Boston Public Health Commission report found that, from 2000 to 2009, the average life expectancy for Boston residents was 77.9 years. But in the Back Bay, it was higher — 83.7 years — compared to Roxbury, where the average life expectancy was 74.

If you want to get even more local, you can analyze the same data by census tract, where life expectancy varies by as many as 33 years: 91.9 years in the Back Bay area between Massachusetts Avenue and Arlington Street, and 58.9 years in Roxbury, between Mass. Ave. and Dudley Street and Shawmut Avenue and Albany Street. That’s according to a 2012 report from the Center on Human Needs at Virginia Commonwealth University in Richmond.

The Whittier Street Health Center in Roxbury is trying to tackle the disparities in a very concrete way. With the launch of a new fitness club and community garden, the center is trying to make healthy food and exercise opportunities available and affordable to all, despite geography.

“What we’re trying to do is to remove those social determinants and barriers that are causing these [health] disparities,” said Frederica Williams, president and CEO of the health center.

‘If I Sweat, I’m Doing Something Right’

The fitness club and garden initiatives just launched June 27, but the Whittier Health and Wellness Institute is already drawing in community members.

Eight months ago, Wanda Elliott weighed 256 pounds. On a visit to her Whittier Street physician, she learned her blood pressure was high — high enough that she had to start taking medication. That was the wake-up call that motivated her to change her diet and start exercising.

“I was dragging,” she said.

Elliott began exercising at a local Y but joined the Whittier Street fitness club when it opened. In eight months, she has lost 52 pounds, leaving her 4 pounds shy of her 200 pound goal weight.

“I have two knee replacements, so I have to keep active every day,” she said. Trainers at the center helped her learn to use the exercise machines, and now it feels like a routine, she said.

“I feel addicted to working out. I feel like if I sweat, I’m doing something right,” she said. “From 256 to 204, I feel like a model. I can walk the runway; that’s how energized I feel now.”

Elliott is now off her blood pressure medication. She is working on making changes to her diet “slowly but surely,” drinking more water, eating more salad, and cutting back on red meat. Continue reading