Mental Health

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.

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).