Positive thoughts and feelings may help your heart thrive.

Depression, social isolation, anxiety, hostility, emotional stress. When it comes to heart disease, the negative aspects of psychological functioning have gotten most of the attention. They have been shown to increase the chances of developing various sorts of cardiovascular disease, and they can make existing diseases worse. What about the flip side? Can happiness or an upbeat approach to life protect the heart and blood vessels?

ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. 

Look for the silver lining...

Buddy DeSylva's upbeat lyrics to Jerome Kern's lovely tune provide an appealing call to a positive outlook on life, even in the face of adversity. Indeed, a cheerful disposition can help you get through the tough patches that cloud every life, but do people who see the glass half-full also enjoy better health than gloomy types who see it half-empty?

Light therapy and antidepressants help people who get depressed during the winter.

The gloom of winter seems to get inside some people, the dark affecting their mood as well as their days. In the late 1990s, the American Psychiatric Association (APA) recognized these winter blues as seasonal affective disorder, a name that seems to have been coined with its acronym, SAD, very much in mind.

According to the National Comorbidity Survey Replication, only about 40% of people with major depression receive adequate conventional treatment, so it's important to get a better understanding of the other measures depressed patients are taking. A survey of American women indicates that a high proportion of them use alternative and complementary medicines for depression.

Researchers analyzed a national telephone survey of more than 3,000 women, with Mexican Americans, Chinese Americans, and African Americans somewhat over-represented in order to get a picture of ethnic differences. Of these women, 220 said they had been medically diagnosed with depression in the previous year, and 54% of them had used alternative medicine to treat the symptoms. The authors point out that the percentage would have been even higher if they had been able to include depressed women who never received a medical diagnosis.

Everyone gets angry from time to time. It's a normal human response to unfair treatment and other injustices, and it's a common reaction to frustration and criticism, whether justified or not. But normal anger is one thing, excessive hostility quite another. Some people get angry without provocation, others react excessively to minor adversity, and still others experience inappropriately intense or prolonged anger to legitimate triggers.

Outbursts of anger are never pretty, and they can damage relationships and careers. Anger can also bring on heart disease. But older men are most vulnerable to heart disease, while younger men are more likely to have short fuses. Does youthful anger affect the mature heart? Studies of anger and heart disease say the answer is yes: Excessive anger at any age can take a toll on men in midlife and beyond.

The is the second part of "Treating opiate addiction". Click here to read Part I: Detoxification and maintenance.

Naltrexone

A different kind of drug treatment for opioid use disorder is the long-acting opiate antagonist naltrexone, usually taken once per day after detoxification. It neutralizes or reverses the effects of opiates, and triggers a withdrawal reaction in anyone who is physically dependent on opiates. A person who takes naltrexone faithfully will never relapse, but most people simply stop using it, or refuse to take it in the first place. A newer slow-release naltrexone injection is now available. However, it is too soon to know if it will have a better success rate than the oral form.

Post-traumatic stress disorder

In the aftermath of a life-threatening trauma, most people recover with the support of family and friends. But some develop post-traumatic stress disorder (PTSD), an anxiety disorder that may last a lifetime if appropriate help is not available. Many unwelcome and unanticipated life events, such as a spouse's betrayal or the loss of a job, can cause distressing emotional reactions, but most such events don't lead to Post Traumatic Stress Disorder (PTSD). Under the current official definition, PTSD is diagnosed only if you have been exposed to actual or threatened death or serious injury and responded with fear, helplessness, or horror.

However, the definition of PTSD is broadening, as mental health professionals gain more experience with the disorder. Individual traits and circumstances help determine how an event is perceived and how emotionally overwhelming it is. In making a diagnosis of PTSD, a mental health professional considers both the type of trauma and the individual's reaction. The point in a person's life when a trauma occurs may also predict her likelihood of developing the disorder.

Dozens of opiates and related drugs (sometimes called opioids) have been extracted from the seeds of the opium poppy or synthesized in laboratories. The poppy seed contains morphine and codeine, among other drugs. Synthetic derivatives include hydrocodone (Vicodin), oxycodone (Percodan, OxyContin), hydromorphone (Dilaudid), and heroin (diacetylmorphine). Some synthetic opiates or opioids with a different chemical structure but similar effects on the body and brain are propoxyphene (Darvon), meperidine (Demerol), and methadone. Physicians use many of these drugs to treat pain.

Opiates suppress pain, reduce anxiety, and at sufficiently high doses produce euphoria. Most can be taken by mouth, smoked, or snorted, although addicts often prefer intravenous injection, which gives the strongest, quickest pleasure. The use of intravenous needles can lead to infectious disease, and an overdose, especially taken intravenously, often causes respiratory arrest and death.

Studies show smoking high-tar unfiltered cigarettes, as opposed to medium-tar filtered cigarettes, greatly increases your risk of lung cancer. So, cigarettes labeled as low-tar or ultra light are an even safer choice, right? Wrong. A study comparing the lung cancer risks of different types of cigarettes found this seemingly logical assumption is false.

The study six years and involved over 900,000 Americans over the age of 30. The researchers compared the risk of death from lung cancer among men and women who were smokers, former smokers, or had never smoked. When analyzed according to the tar rating of cigarette smoked, the results of the study showed the risk of lung cancer death was greatest for smokers of high-tar unfiltered cigarettes. The risk of lung cancer death was no different among smokers of medium-, low-, and very low-tar cigarettes.