March 24, 2024 gbsvne

Life can be challenging: Build your own resilience plan

Colorful paper cutouts of a thunderstorm at sea with dark clouds, lightening, fish jumping, and a red and white boat bobbing in the waves; concept is resilience

Nantucket, a beautiful, 14-mile-long island off the coast of Massachusetts, has a 40-point resiliency plan to help withstand the buffeting seas surrounding it as climate change takes a toll. Perhaps we can all benefit from creating individual resilience plans to help handle the big and small issues that erode our sense of well-being. But what is resilience and how do you cultivate it?

What is resilience?

Resilience is a psychological response that helps you adapt to life’s difficulties and seek a path forward through challenges.

“It’s a flexible mindset that helps you adapt, think critically, and stay focused on your values and what matters most,” says Luana Marques, an associate professor of psychiatry at Harvard Medical School.

While everyone has the ability to be resilient, your capacity for resilience can take a beating over time from chronic stress, perhaps from financial instability or staying in a job you dislike. The longer you’re in that situation, the harder it becomes to cope with it.

Fortunately, it’s possible to cultivate resilience. To do so, it helps to exercise resiliency skills as often as possible, even for minor stressors. Marques recommends the following strategies.

Shift your thoughts

In stressful situations, try to balance out your thoughts by adopting a broader perspective. “This will help you stop using the emotional part of your brain and start using the thinking part of your brain. For example, if you’re asking for a raise and your brain says you won’t get it, think about the things you’ve done in your job that are worthy of a raise. You’ll slow down the emotional response and shift your mindset from anxious to action,” Marques says.

Approach what you want

“When you’re anxious, stressed, or burned out, you tend to avoid things that make you uncomfortable. That can make you feel stuck,” Marques says. “What you need to do is get out of your comfort zone and take a step toward the thing you want, in spite of fear.”

For example: If you’re afraid of giving a presentation, create a PowerPoint and practice it with colleagues. If you’re having conflict at home, don’t walk away from your partner — schedule time to talk about what’s making you upset.

Align actions with your values

“Stress happens when your actions are not aligned with your values — the things that matter most to you or bring you joy. For example, you might feel stressed if you care most about your family but can’t be there for dinner, or care most about your health but drink a lot,” Marques says.

She suggests that you identify your top three values and make sure your daily actions align with them. If being with family is one of the three, make your time with them a priority — perhaps find a way to join them for a daily meal. If you get joy from a clean house, make daily tidying a priority.

Tips for success

Practice the shift, approach, and align strategies throughout the week. “One trick I use is looking at my calendar on Sunday and checking if my actions for the week are aligned with my values. If they aren’t, I try to change things around,” Marques says.

It’s also important to live as healthy a lifestyle as possible, which will help keep your brain functioning at its best.

Healthy lifestyle habits include:

  • getting seven to nine hours of sleep per night
  • following a healthy diet, such as a Mediterranean-style diet
  • aiming for at least 150 minutes of moderate-intensity activities (such as brisk walking) each week — and adding on strength training at least twice a week
  • if you drink alcohol, limiting yourself to no more than one drink per day for women and two drinks per day for men
  • not smoking
  • staying socially connected, whether in person, by phone or video calls, social media, or even text messages.

Need resilience training?

Even the best athletes have coaches, and you might benefit from resilience training.

Consider taking an online course, such as this one developed by Luana Marques. Or maybe turn to a therapist online or in person for help. Look for someone who specializes in cognitive behavioral therapy, which guides you to redirect negative thoughts to positive or productive ones.

Just don’t put off building resilience. Practicing as you face day-to-day stresses will help you learn skills to help navigate when dark clouds roll in and seas get rough.

About the Author

photo of Heidi Godman

Heidi Godman, Executive Editor, Harvard Health Letter

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow … See Full Bio View all posts by Heidi Godman

About the Reviewer

photo of Howard E. LeWine, MD

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

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March 21, 2024 gbsvne

Is there a good side to drug side effects?

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Drug side effects are common, and often quite troublesome.

Major side effects, such as severe or even life-threatening allergic reactions, require immediate treatment and discontinuation of the drug. More minor symptoms may be tolerable when weighed against drug benefits. And sometimes, these go away on their own as the body gets used to the drug.

But there’s another type of side effect you hear much less about: ones that are beneficial. Though uncommon, they’re worth keeping in mind when you’re starting a new medicine.

Aren’t all side effects bad?

The term side effect is usually assumed to be a bad thing. And that’s typically true. But that leaves out the “good” side effects. Relatively little is published on this, so it’s not clear how common they are. But four notable examples include:

  • Minoxidil (Rogaine, Gainextra, other brands). Developed in the 1970s for high blood pressure, this drug also increased hair growth in study subjects. What was initially considered a bothersome side effect eventually became its primary use: topical forms of this drug are commonly used to treat hair loss.
  • Diphenhydramine (Benadryl or generic versions). This common treatment for allergic conditions has the side effect of drowsiness. For adults with allergy issues and trouble sleeping, the sedative effect can be helpful. Regular, long-term use of diphenhydramine is not recommended, as it may increase the risk of dementia.
  • Sildenafil (Viagra or generic versions). Originally developed as a treatment for high blood pressure and angina, it didn’t take long for male users to realize the drug could trigger erections within 30 to 60 minutes. The makers of sildenafil recognized that under the right circumstances, this could be a highly beneficial side effect. In 1998 it was approved as a treatment for erectile dysfunction.
  • Semaglutide (Ozempic, Wegovy, Rybelsus). This drug was developed to treat diabetes, but early users noticed reduced appetite and significant weight loss. Now, several formulations of these related drugs are approved for diabetes and/or weight loss.

In the best study I’ve read on the topic, researchers found more than 450 reports of serendipitous beneficial effects of various drugs since 1991. And that may be an underestimation, since report forms did not specifically ask for or label this type of side effect, according to the study authors.

Silver linings: Repurposing and repackaging drugs

While the discovery of helpful drugs can arise unexpectedly, drug developers are increasingly using a more intentional approach: using side effect profiles to look for new uses.

For example:

  • A drug reported to cause reduced sweating as a side effect may be effective for hyperhidrosis, a condition marked by excessive sweating.
  • Drugs reported to cause low blood pressure as a side effect might be effective treatments for high blood pressure (hypertension).
  • New treatments for breast cancer may include older medicines that have a similar side effect profile as known anti-cancer drugs.

The availability of large side effect registries has made this method of identifying drugs for repurposing a more realistic option. So, even negative side effects can have a silver lining.

Bad side effects and the nocebo effect

While side effects can be positive, most are not. Medication side effects are a common reason people give for not taking prescribed drugs regularly. And adverse reactions to medicines prompt up to 8% of hospital admissions, according to one analysis.

To make matters worse, in some cases the expectation of side effects seems to make them more likely to occur. Called the nocebo effect, it increases the chances of experiencing a negative side effect and seems due, at least in part, to expectations. Contrast this with the placebo effect, where a sugar pill or another inactive treatment can lead to benefit.

The bottom line

Many people avoid taking medications because they fear possible side effects. That’s understandable. But not taking a medication can mean missing out on its benefits. And anticipation or expectation of side effects can increase the chances you’ll have them.

So, while it’s important to be aware of the most common side effects caused by the medicines you take, it’s also important not to overestimate your chances of experiencing them. And remember: there’s always a chance you’ll have a side effect you actually welcome.

About the Author

photo of Robert H. Shmerling, MD

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. … See Full Bio View all posts by Robert H. Shmerling, MD

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March 6, 2024 gbsvne

5 great tips for sustainable summer living

illustration of a set of rounded-corner app-style icons on the theme of summer, showing ice cream, thermometer, sunglasses, beach ball, cold drink, flip-flops, starfish, and many others

Sustainable living treads lightly on natural resources and follows a rethink, reuse, repurpose mantra to minimize waste.

Big and small wallet-friendly tips can help you save money and befriend our planet this summer, says Dr. Wynne Armand, a primary care physician at Harvard-affiliated Massachusetts General Hospital, and associate director of the Mass General Center for the Environment and Health. Here are five great tips to get you started.

1. Embrace the 5 Rs

Refuse, reduce, reuse, repurpose, and only then recycle is a well-laid out sustainability strategy promoted online by the Cincinnati Recycling and Reuse Hub. Do you really want or need a shiny new object? Where can you share tasks or tools? What could you swap, give away, or buy used? How could you slim down your recycling stream?

Give yourself permission to start here: Nobody is perfect. We all have preferences and sustainability blind spots, fumbles, and “sorry, just no” feelings. Start where you are and add on when you can.

2. Cut down on cooling energy

Summer heat can endanger your health, and paring back on energy use isn’t always possible or wise. Still, it may be possible to:

  • Stay cooler naturally. Pull down shades during daytime hours to block out hot sun. Open windows at night if the temperature cools down, and to capture cross breezes if possible. Dress in loose cotton clothes and wear a shading hat when outdoors. Remember that sun bounces off lighter colors and is soaked up by black or darker colors. Make your own shade by carrying an umbrella on sunny — not just rainy — days. Prepare meals that don’t require cooking or baking, since that saves resources and keeps your home cooler,” advises Dr. Armand.
  • Seek shade and cool spots. If you don’t have air conditioning or you worry about the bills, green, leafy spaces like parks can help cool you down. Cities and towns often open cooling centers, splash pads, and public pools. Public buildings like libraries and malls are available during daytime hours for anyone trying to beat the heat.
  • Turn up the temperature. On air conditioning, that is. If you’re fortunate enough to have air conditioning at home, follow natural cues. When you’re shivering, sweater-seeking, or tucked up under blankets, push the temperature up to save energy and money.

3. Save resources

A sharp eye for energy savings may help pare down bills, too.

  • Electrify. Shrink your carbon footprint and help cut air pollution by using electric grills, mowers, and other landscaping tools. When tools or appliances need to be replaced, consider electric options.
  • Conserve energy. Turn off electrical equipment that is not in use in the office and at home, such as lights, TVs, computers, copiers, and printers. 
  • Go low when demand is high. “During peak electricity demand, ensuring stability of the grid is essential to public health,” says Dr. Armand. “Avoid using appliances like dishwashers, washers, or dryers during periods of high demand. Instead, do these chores — and charge your electric car, if you have one — late at night.” Some energy-hogging appliances have timers to help with this.
  • Sign up for Shave the Peak alerts. Know when to curb your electricity use to avoid times when your local electric grid is relying on nonrenewable, expensive, polluting fossil fuels.

4. Stay heat-aware and hydrated

Saving resources is a worthy goal, but not at the expense of staying safe and healthy when summer temperatures spike.

  • Make plans to stay cool. When summer swelters, having an affordable, personal plan to cool down — especially during heat waves — can be lifesaving.
  • Watch out for signs of dehydration. Drinking plenty of water and eating water-rich foods like lettuce, cucumbers, melon, and citrus fruits can help you stay well hydrated. Water-filling stations for reusable bottles cut down on single-use plastic bottles and help save money at the grocery store.
  • Know how to treat heat rash and more serious heat-related illnesses. The small, itchy red or darkened bumps of heat rash (prickly heat) occur when sweat ducts become blocked or inflamed. This makes it harder for children and adults to cool their bodies down. Generally, too much heat can harm our bodies, particularly if we work outdoors, take certain medicines, or have certain illnesses.

5. Kickstart sharing circles

Sharing circles can help you expand a wardrobe, tool shed, or taste in foods — all while building community.

  • Start local, then consider expanding. Brainstorm with a few friends on what you all might like to share or swap. Think seasonal: gardening tools, outside décor, summer sports (because not everyone needs to own a paddleboard). Local clubs, block associations, or public spaces like libraries and schools may be willing to host community swaps and shares. Some communities have swap sheds and some libraries loan gadgets and even appliances like a portable induction cooktop burner, tech and home-improvement tools, games, and much more.
  • Summer supper club. Perfect for those overloaded with summer harvests from window boxes, community gardens, or a CSA share. Build a theme around what’s fresh, local, and low-cost. Plant-forward menus are good for health and for the planet. Cultural inspiration always helps. And having one person cook — or stressing no-cook recipes — saves resources.
  • Cut your clothing allowance. Tired of your wardrobe? Gather friends for a summer clothes and accessories swap. Be sure to agree on rules: gently-used, carefully washed, no stains, and so on.
  • Hot spots. “Gathering at a friend’s or neighbor’s home for fun games and festivities on hot days is a great way to build community while saving on energy costs for cooling. And rotate for that next hot day!” says Dr. Armand. 

About the Author

photo of Francesca Coltrera

Francesca Coltrera, Editor, Harvard Health Blog

Francesca Coltrera is editor of the Harvard Health Blog, and associate editor of multimedia content for Harvard Health Publishing. She is an award-winning medical writer and co-author of Living Through Breast Cancer and The Breast Cancer … See Full Bio View all posts by Francesca Coltrera

About the Reviewer

photo of Howard E. LeWine, MD

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

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