Mental Health

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.

Is it just fear or an actual phobia?

DEAR DOCTOR K: I have a terrible fear of heights, dogs and public speaking. My sister calls them "phobias" and says I should seek help. How do I know if my fears are normal, or if I need treatment?

DEAR READER: We all have things we worry about or are afraid of. And with most of them, we're right to be fearful. But in people with a phobia, the fear is persistent, excessive and unrealistic. As many as one in 10 people suffer from phobias at some time during their lives.

Can schizophrenia be treated?

DEAR DOCTOR K: There is a history of schizophrenia in my family. I'd like to learn more about it. Can it be treated?

DEAR READER: Schizophrenia is a long-lasting psychotic disorder. People with the condition have a hard time recognizing reality, thinking logically and behaving naturally in social situations. Having a parent or sibling with schizophrenia increases your risk of developing it.

What is mild cognitive impairment?

DEAR DOCTOR K: My father's doctor says he has mild cognitive impairment. What does that mean?

DEAR READER: Mild age-related memory loss -- "Where did I leave my keys?" -- is normal. But people with mild cognitive impairment (MCI) have memory loss and/or trouble thinking that are more persistent and severe than normal. There are two types of MCI. Amnestic MCI involves memory loss.

Could something other than depression be affecting my mood?

DEAR DOCTOR K: I've been feeling down and moody lately, but nothing out of the ordinary has happened in my life. And I've always been a happy and positive person. Could something other than depression be affecting my mood?

DEAR READER: Depression is a common problem, and it often is not recognized by either the person suffering from it or that person's doctor. In fact, I think undiagnosed and untreated depression is one of the most important health problems in the developed nations. It generates enormous emotional suffering -- on the part of the depressed person, and that person's family, friends and co-workers. It also leads to lost productivity.

What does neuropsychological testing involve?

DEAR DOCTOR K: My husband's doctor suspects that he has Alzheimer's disease and wants him to have neuropsychological testing. What will these tests involve?

DEAR READER: There is no single test that can diagnose Alzheimer's disease. In fact, a doctor cannot make the diagnosis with absolute confidence without studying the brain under the microscope, which is rarely done except in an autopsy. Alzheimer's disease is diagnosed presumptively by a combination of different types of evidence. The disease typically has a slowly progressive onset. Sudden confusion or speech problems, for example, are not caused by Alzheimer's.

Is there an effective treatment for OCD?

DEAR DOCTOR K: I've been struggling with obsessive- compulsive disorder for years. Is there any effective treatment for it?

DEAR READER: There are better treatments today than there were when I went to medical school. As you know, in obsessive-compulsive disorder (OCD), a person is troubled by persistent, intrusive, anxiety-provoking or distressing thoughts (obsessions). He or she feels pressure to carry out excessive, repetitive behaviors (compulsions).

Can writing in a journal help ease stress?

DEAR DOCTOR K: My therapist told me that regularly writing in a journal might help ease my stress and improve my mood. Is there any evidence to back this up?

DEAR READER: Yes, there is, if you are disciplined about it and do it the right way. Some of my patients and friends have kept a journal following a major and unexpected life stress -- say, a cancer diagnosis, a car accident or a layoff.

How can I change my pessimistic outlook?

DEAR DOCTOR K: I'm a "glass half-empty" type of person. I know that way of thinking adds to my stress and unhappiness. Is it possible to change the way I see things?

DEAR READER: Yes, there is. Through a type of "talk therapy" called cognitive behavioral therapy (CBT), you can learn to reframe negative thoughts. That, in turn, can help change how you feel. CBT can help you challenge overly simplistic, irrational, negative thoughts. It's easiest when the thoughts are patently untrue: "I never do anything right," for example. It's harder when there's an element of truth mixed in: "At my age, I'll never reach my goals." If your dream was to be a famous opera singer, that statement may apply. Most likely, though, there are other goals you did reach. And other goals you can still reach.

How can I calm myself when I’m angry?

DEAR DOCTOR K: What can I do to calm myself when I'm angry?

DEAR READER: Anger is often called "the fire inside." It is one of our most powerful and primal human emotions. But in the modern world, anger can get in the way of our work, relationships and social interactions. In his thoughtful, instructive and award-winning book, "Outsmarting Anger," my Harvard Medical School colleague, Dr. Joseph Shrand, and Leigh Devine explain how to recognize and manage your anger.