Mental Health

Can I do anything to prevent nightmares?

DEAR DOCTOR K: Is there anything I can do to stop having terrible nightmares? They scare me, and ruin my sleep.

DEAR READER: There may be something you can do. The first thing you should know is that everyone has nightmares occasionally. That includes yours truly. Just as we don't really know why we sleep, we don't really understand nightmares. We also don't know why some people are more likely to have them.

Is dysthymia a form of depression?

DEAR DOCTOR K: My doctor says I suffer from "dysthymia." A friend says this is just a nice word for depression. What is dysthymia?

DEAR READER: Dysthymia is a type of depression. Periods of dysthymia tend to last longer than periods of depression. In fact, many people with dysthymia describe having been depressed as long as they can remember. Dysthymia typically is less severe than major depression; however, people with dysthymia are more likely to develop major depression in the future. Dysthymia is not quite as common as full-blown depression. During the course of a year, about two people out of every 100 will suffer from dysthymia. It is about twice as common in women as in men.

What is intermittent explosive disorder?

DEAR DOCTOR K: My son's doctor thinks he might have intermittent explosive disorder. I know my son has a bad temper, but I was surprised to hear that it might be a "disorder." Can you tell me more about this? What can I do to help my son?

DEAR READER: Under severe enough stress, any normally calm and collected person might become angry -- and might even be provoked to the point of violence. But some people lose their temper easily and repeatedly. In these people, tension mounts until there is an explosive release. This behavior pattern is called intermittent explosive disorder (IED).

How is OCD treated in children?

DEAR DOCTOR K: I think my 9-year-old son may have OCD. How is this condition treated in children?

DEAR READER: Before discussing treatment for OCD, it's important to describe what it is. You know, of course, but other readers may not. Children (and adults) with obsessive compulsive disorder (OCD) are troubled by repeated, intrusive, distressing thoughts (obsessions). These obsessions cause great anxiety. As a result, people with OCD often have a strong urge to repeat certain behaviors (compulsions) in order to reduce the anxiety. For example, people who have obsessive thoughts about germs may repeatedly wash their hands.

Is there a way to prevent delirium during a long hospital stay?

DEAR DOCTOR K: My elderly mother has a number of health conditions. Over the past year, she has ended up in the hospital four times. The last two times, she became delirious. Is there anything we can do to prevent delirium if she has to have another hospital stay?

DEAR READER: Unfortunately, delirium is common among older patients in hospitals, particularly after surgery or during a stay in an intensive care unit (ICU). One-third to two-thirds of elderly hospital patients develop delirium.

Where is the line between perfectionism and OCD?

DEAR DOCTOR K: I think of myself as a perfectionist. But more than one person has jokingly referred to me as "OCD." Where is the line between the two?

DEAR READER: Where is the line between a common way of behaving and a mental health disorder? It's a common question, and I'm not sure it can ever have a definite answer on which everyone would agree. First of all, when is perfectionism a good thing, and when is it a human tendency that goes overboard? My answer: Perfectionism is a good thing if the goal at hand absolutely requires it.

Does long term use of antihistamines cause dementia?

DEAR DOCTOR K: I've been taking over-the-counter antihistamines for years to control my allergies. Now I hear I may have to worry about dementia. How real is the concern?

DEAR READER: Antihistamine drugs have "anticholinergic" (an-tee-cole-in-ER-jik) effects. That means that they have some tendency to block the action of a natural substance called acetylcholine. This substance transmits messages in the nervous system. In the brain, it is involved in learning and memory; in the rest of the body, it stimulates muscles to contract.

What is borderline personality disorder?

DEAR DOCTOR K: My daughter is in her 20s. She had a hard time during her teenage years and was recently diagnosed with borderline personality disorder. Can you tell me what this is?

DEAR READER: Borderline personality disorder (BPD) is a mental health condition that involves poor self-image, a feeling of emptiness and great difficulty being alone. BPD is surprisingly common: About 6 percent of the U.S. population suffers from it at some point in their lifetime. People with BPD have intense moods and unstable relationships. They can be impulsive and have unsafe sex, drive dangerously, eat too much, drink too much and squander money.

Can dogs improve our health?

DEAR DOCTOR K: I'm on the fence about getting a dog. My wife claims that pets -- particularly dogs -- can improve our health. Is that true?

DEAR READER: When I was growing up, there was always a dog in the family. And I mean "in the family": They were a part of the family, often coming with us when we went on errands. Some of my friends never had a pet, so I once asked my mother why we always had a dog. She replied: "Dogs are good for us." I remembered that answer when I got your question.

Could my anger trigger a heart attack?

DEAR DOCTOR K: I have a bad temper. Could my anger trigger a heart attack?

DEAR READER: You've seen it in movies: A character shouts in anger -- then drops to the floor clutching his chest. But this isn't just a movie scenario. Research shows that in the two hours after an angry outburst, a person has a slightly higher risk of having heart trouble. By heart trouble, I mean chest pain (angina), a heart attack, or a dangerous heart rhythm that can lead to sudden death. The person also is at higher risk for having a stroke.