Women want to be happy, but this can be elusive. Focusing on health and wellness as I talked about last week is important. In addition, I have observed several things that happy women have in common. Knowing what these are can help to make it obtainable.

Financial security

Most people think that if they had a ton of money they would be happy. Studies have found that the difference in happiness between those who make $5000 a year and $50,000 a year is huge. However there is no major difference in the level of happiness between those who make $50,000 a year and those who make $50 million dollars a year.

I have watched many women struggle over the last several years and those who have been able to use their creativity, ingenuity and imagination to find a way to improve their income have been the happiest and most successful. Having a sense of control over their destiny by finding a way out of their financial difficulties and designing their own jobs in some cases helped them to be happy.

Relationships

Feeling connected is another common feature of happiness. It is interesting that when parents are asked what gives them the greatest joy in their lives they usually say it is their children. However, when you ask them about day-to-day issues, their kids actually cause them a fair amount of grief (especially during adolescence). It is that close relationship, that special bond with our children and significant others that is important with all of the ups and downs. Being able to see that connection (even on tough days) helps to promote happiness.

Community

Having a sense of community is key. Women who have a group of friends and/or are involved with their community are generally happier than those who do not. Getting involved is easy even if you are not an extrovert. Volunteer at a food bank; join a house of worship or consider working for a political campaign group.

Give Back

When people give to others they are able to improve their health and wellbeing. They live longer too. When they are busy helping others they tend to forget their aches and pains AND it makes them happy. If you have not done it, try it in just small ways. Smile at a stranger, see where help is needed in your community, or donate money to your favorite charity. It is amazing what can happen.

Abolish Resentment and Anger

I heard a great quote from St. Augustine, “ Harboring anger and resentment is like taking poison and expecting the other person to die.” Anger can be productive in that it causes discomfort and helps us to change our circumstances. However when we hold on to it and it builds into resentment it only hurts us further. Happy people find a way to resolve situations when they find themselves getting upset and angry. If you find yourself holding on to anger it is time to get help. Exercise, learn to meditate, or consider seeing a therapist.

The Bottom Line

Happiness is something that we all want. We can have it by harnessing our creativity, nurturing relationships, and finding ways to give back to our community. To quote Aristotle, “ Happiness depends upon ourselves.”

Looking at the title of this blog you might wonder how I know anything about this subject. As a woman over 50 and a doctor to many, I feel qualified to answer this question at least as it regards health. Clearly we are all unique individuals and our wants and needs may vary but from my personal research these are the top three things that women want for their health and wellness.

1. A Healthy Brain

Most women who I speak with are most afraid of losing their minds. Alzheimer’s and dementia are diseases that touch us all in some way. None of us want to lose our memory and with that our memories. My advice has not wavered for a long time. The key to a healthy brain is to have a healthy heart. Eating a Mediterranean style diet and exercising, avoiding smoking and excessive alcohol, having preventive checkups that regulate blood pressure, cholesterol, weight and blood sugar will help to keep the arteries healthy and assure good blood supply to the brain. Taking supplements such as fish oil and folic acid can be helpful as well.

In addition, exercising the brain is important. Learn a new language, find new ways to get to work, avoid using the GPS on your phone and find your own way. And, there is more. An ongoing study of nuns has been illuminating. They have allowed themselves to be studied during their lives and have given permission to have autopsies after they die. What researchers have found is that there was a group of nuns who had Alzheimer’s disease on autopsy but showed no signs of it in life. The unifying feature of these women was that they had a positive attitude and lived a life with a sense of purpose.

How we live physically and spiritually is important for brain and overall health.

2. A Healthy Heart.

For many years, heart disease was ignored as a condition that was common to women. Research was focused on men because they were easier to study due to their lack of hormonal fluctuations. The results were extended to women and we were viewed as mini-men with periods.

Women are relatively protected from heart disease until we reach menopause as long as we do not have cardiac risk factors that include: high blood pressure, high cholesterol, diabetes, obesity, family history in a first degree relative, smoking, stress and depression, and a sedentary lifestyle. After menopause we rapidly catch up with men.

Fortunately, our hearts are now getting more attention since there is increased awareness that heart disease is the number one killer of men AND women. I know I am stating the obvious but we are different than men. We know that women with heart attack do not often have the classic symptom of an elephant sitting on the chest. Instead we may feel like we have a bad flu, jaw ache, overwhelming fatigue, nausea, sleep disturbance, shortness of breath and/or anxiety. One study found that 95% of women who had a heart attack when questioned afterwards actually had unusual symptoms during the month beforehand.

The key to a healthy heart is the same as those for a healthy brain. Eat healthy, exercise and prevent heart disease by seeing your doctor and being proactive by attending to cardiac risk factors.

3. Vitality
As our ovaries poop out, we often do too. Up to two thirds of women experience menopausal symptoms, which can be distressing for around 20% although it seems like more since we are a vocal group! How can you not get upset when you can’t sleep, your vagina dries out, you feel like your brain is fogged up and you seem to be igniting from the inside out. In addition, there may be weight gain and a redistribution of fat due to the rapid loss of muscle that occurs if you don’t do strength train.

All women will benefit from healthy eating, exercise, and a medical evaluation to review their symptoms and receive treatment if necessary. Some may need hormone replacement. Often there is something else going on such as hypothyroidism, which commonly occurs at menopause. The symptoms are similar so they are often missed.

For vitality it is important that we take this time in our life to become number one on the list. We often put our children, husband or significant other, job, house, pets, and essentially everyone and everything else first. That is probably the most common advice I give. Take care of yourself or you will not be able to take care of anyone else.

Finally, what women want is to be happy. That however, is something that requires its own blog. So tune in next week!

I wrote this blog back in June, but I think it time to repeat it. The holidays are over and all that good cheer and those good ideas for New Year’s resolutions have worn off. The regular day to day stresses are wearing many thin. So, I think this will be a good reminder to take a deep breath and think about what is important.

Have you ever had one of those weeks where every step you take, something or someone is making you angry? I was having one of those weeks until I heard a quote on a daytime talk show taken from St. Augustine: “Resentment and anger is like taking poison and expecting the other person to die”. First, this wisdom immediately deflated my anger and then it led me to question the point of anger in the first place.

Anger has been with us since the beginning of mankind. The emotion of anger has intrinsically been an impetus for change. It may cause discomfort, however when dealt with constructively, it moves us to act and improve the circumstance causing the discomfort. When dealt with destructively, anger can cause violence, self-loathing and depression.

As a physician, I see the physical effects of this on a daily basis. Depression, heart disease, and obesity (that can cause diabetes, high blood pressure and certain cancers) can often result from prolonged anger, resentment and hostility. Many patients I see heal and improve when we address the underlying anger and resentment in their lives.

With all that is going on in the world right now, it seems there is anger at every turn. The media is busy reporting various feuds; politicians are angry with one another, and the opposing parties. Doctors are angry with insurance companies, and patients are angry because they are not getting what they want from their doctors.

I think if we all stopped for a moment when we become angry and truly thought about what was going on internally, we could make great changes in ourselves and in the world. If we find that anger is consuming us, it is time to get help before it destroys us.

“The best work of the world is done in the tension between anger and control.” ~ G. Stanley Hall

If it seems that almost everyone you know is on antidepressants, your perceptions would be correct. Major depressive disorder affects up to 12% of men and 25% of women. Antidepressants can be effective in treating this disorder but only result in a remission in 30% of those treated. The response rate to medication (meaning there is some improvement) can be up to 70%.

The most popular antidepressants of choice are the selective serotonin reuptake inhibitors like Prozac and Zoloft. These medications block the reuptake of serotonin by the brain keeping up levels available to the central nervous system.

New research has found that there may be something out there that can augment and perhaps treat depression alone. It gets to the very core of the problem and believe it or not it is not a medication. It is a vitamin. I know this sounds too good to be true, but it is not. Let me explain.

Folic acid is an essential B vitamin. It is found in green leafy vegetables, eggs, cereals and fortified foods (to name a few). When you take in folic acid in your diet it is absorbed by the small intestine where it is converted by a series of enzymes and ultimately into L-methylfolate. This metabolite is used to make serotonin, norepinephrine and dopamine, which are all important for mood regulation.

Scientists have identified 40 mutations on the gene responsible for making the enzyme that converts folic acid into L-methylfolate. The most common genotype is known as C677T. If there is one mutation on this gene your ability to convert folic acid is reduced by 34%. If you have two mutations, it is reduced by 71%. Now you probably are seeing where I am going with this.

If you have a defective enzyme then you cannot convert folic acid to L-methylfolate properly and you will have lower serotonin, norepinephrine and dopamine levels. These gene mutations are extremely common. The treatment is simple. It is a prescription of L-methylfolate. This is a vitamin that is considered medicinal food. If given in the proper amounts (7.5 to 15 mgs) it can improve depression relatively quickly. In a study of elderly depressed patients, the response rate at 6 weeks was 81%. Results are often seen in just two weeks.

It is well tolerated with no more side effects than placebo. It does not interact with other medications. If an antidepressant has produced a positive response but the patient is still somewhat depressed L-methylfolate can help.

If you are depressed and/or on medication for depression, I recommend you ask your doctor to see if you have the genetic abnormality that I mentioned. The test is MTHFR. When I treat my depressed patients with this vitamin, I have seen amazing results. It just makes sense. If serotonin levels are genetically low then why not find a healthy way to boost them?

I give a lot of medical advice. Sometimes I feel like a broken record by repeatedly relaying the message that the secret of health is to maintain a healthy lifestyle. However, there is another more important secret that goes beyond the day-to-day choices that include food and exercise. It addresses personal power and what drives us. What I am talking about is having a sense of purpose.

I know to some this may sound like psychobabble. However, let me tell you about the nun study. Since 1986, a group of researchers has been studying nuns while they are alive and examining their brains after they die. They have been able to identify some of the risk factors for Alzheimer’s disease. They have found that those with a positive outlook who were continually exercising their brains were less likely to develop the disease.

The most interesting finding was that there were some nuns who died and then Alzheimer’s disease was found on autopsy, but they showed no signs of the disease in life. Those women had a positive attitude and a sense of purpose. That seemed to be enough to keep them healthy and functional.

A study of 155 senior citizens done in Chicago found that those seniors with a sense of purpose were 2.4% more likely to remain mentally sharp than those who did not. Those who were outgoing and self-satisfied were 50% less likely to develop Alzheimer’s. This attitude may boost the immune system and protect blood vessels.

There are so many things that we do not know. But, I am convinced that we all possess an amazing power. That is the power of our minds. It could be what is behind the placebo effect or perhaps it is just what overall wellness is about. Regardless, if you want to find the path to healing or maximum health, it is important to find your passion and you own personal path in life and then follow it!

It is a new year and you have decided this is the year you are going to get into good shape. You have it all figured out. You find a gym, a class, and you even have a cute workout outfit picked out. That is wonderful. What you need to know is that most people are motivated at the beginning of a fitness program but they tend to fall off the wagon after several weeks. The key is to stay motivated and adopt simple techniques that will serve you throughout the year and your life. Here are a few:

1. If you are mindful, you will begin to notice how much better you feel by eating healthy, moving and losing weight. That in and of itself will be motivating.

2. Set small, reachable goals. The best example of this was an interview I heard on the Today show. A woman who had lost 100 pounds said that she looked at her weight loss as losing ten pounds ten times. She basically set out to lose 10 pounds at a time. If she had looked at losing 100 pounds it would have felt impossible.

3. Reward yourself when you reach your goal with something other than food! It could be something small such as a CD or a new purse or briefcase. It could be big such as a vacation or money that you reward yourself with.

4. Don’t do it alone. It helps to have the motivation of your friends and family. Just as being overweight can be contagious so can improving attitudes towards food and lifestyle changes. Including a family member or friend in your program can increase your chance of success.

5. If you can’t find a friend or family member to join your program, consider using a trainer or nutritionist. Even if you only meet with them once a month, you will have someone to support you and to be accountable to. It can really help.

Good luck with your workout routine. Following these few small tips can make a big difference in how you feel and help you to succeed.

It is inevitable that as the New Year approaches most morning talk shows, magazine articles and radio shows are urging us to make our New Year’s resolutions. My lists were quite extensive in the past. As I have gotten older and wiser (I think) my lists have gotten shorter and much more realistic. It is a good idea to look back on the previous year and find ways to improve. I worry, however, that most of us set ourselves up for failure. So, here is my advice:

*If weight loss is your goal estimate the possibility of losing one pound a week. Thinking you can lose a tremendous amount of weight over a short period of time is unrealistic. Try for five to ten pounds at a time.

*For exercise, if you have been sedentary, start slow. Walk one block a day and add blocks from there. Get your doctor to help with an exercise program.

*If you are looking to become healthier, find a doctor or provider who can help you come up with a reasonable plan. Going to the vitamin counter of the local health food store without guidance is not a good idea. Natural is not necessarily safe.

*Plan out your health care goals by mapping out the preventive studies that you need and get them scheduled. Eye exams, blood pressure checks, BMI calculations, vaccines, and pap smears and mammograms for women, PSA’s and digital rectal exams for men, cholesterol profiles and fasting blood sugars are a good start.

*For fun: smile and laugh more, love more, give more of yourself by paying it forward, and eat chocolate on occasion in moderation of course!

The key is to put yourself first on the list. If you do not take care of yourself then you cannot take care of anyone else. Keep your list short, sweet and something that you can follow and achieve in 2012. Happy Healthy New Year!

Do you ever wonder if the new modern technologies are rotting your brain? Are you dependent on your car or cellphone GPS to get you where you want to go? You may want to re-think that.

Scientists have found that when you use your brain to navigate your route in your car or on foot that you use a map in your head or you find your way on autopilot. Either way you are using the hippocampus area of your brain. If you depend on the GPS you are not.

When scientists have examined the brains of taxi cab drivers in London where they are always looking for shortcuts, they found that their hippocampus was larger than those of non-taxi cab drivers. Older adults who do not use GPS and use maps to navigate have more grey matter than those who don’t.

It is possible by activating this part of the brain that we may be able to prevent dementia. This is one instance where it might make sense to do things the old fashioned way. If you need to find a new route to work or go to a place you have not been to in awhile, use a map and navigate on your own.

Another thing that can help is to start calling people the old-fashioned way. Remember their numbers and call them. Do not rely on your smart phone for directions or phone numbers. It can make you stupid!

We are living in tumultuous times. We have so many things that tend to pop up and cause worry. Finances, health, emotional and family problems are all common issues. Many people start to get a sense of helplessness and hopelessness. This impacts their health causing pain, disease, fatigue and depression. I care for many patients where this is the case.

In trying to help them, I have found something that works. That thing is becoming a helper. It costs no money and it improves their health by boosting the immune system and improving brain function. Doing something for others is the key to feeling better.

Studies have found that those who give of themselves experience joy and happiness. It can be something as simple as volunteering for the SMART program and reading to children or working at a food bank. The hospitals and many clinics welcome volunteers. For those who want to donate money there are infinite worthy causes.

People who help others have been studied. Researchers have found that they experience a surge in their endorphins similar to the high that runners experience. Giving to others in need decreases the intensity and awareness of pain, relieves stress, and activates positive emotions. All these things help to improve health. The results of a study done in 2700 men in Michigan found that those men who worked as regular volunteers had a two and a half times lower death rate than those who did not.

Amazing things happen when one goes from being the one who is helped to being the helper. It is nothing short of a miracle. Over and over I see people heal and feel good about themselves and what they are doing. It is easy to get wrapped up in our lives and ourselves, but stepping out of it and realizing that we each have something valuable to give can be good for us as well as others.

When I was growing up, my grandmother had a huge, heavy handbag. The reason I know this is because I was the designated shlepper of that handbag. Since that time, handbags have become purses and have gone through many size changes. We have seen the tiny purses; the medium purses, the backpack purses and we are now all lugging around the huge, heavy purses or handbags (which are really shoulder bags!) again. The more things change, the more things stay the same.

Designers are combining purses with computer bags, which can weigh up to ten pounds. As a result, doctors have been diagnosing women with shoulder strain because they are schlepping these bags. This can cause permanent shoulder damage and chronic pain. If women can keep their posture aligned while carrying their heavy bags, they have fewer problems. Those that do have shoulder pain may find relief with the use of anti-inflammatory medication, massage and physical therapy.

If you are a busy woman who keeps her closet, computer, and spare shoes in her purse, the best way to prevent this problem is to change things up. Keep your purse light and change the weight and size of the purse frequently. Be sensible and prevent “shlepper shoulder” today!