Category: Health x Body

You might have heard of Hashimoto’s disease, an endocrine disease that’s become more visible in the media over the past few years. Recently, celebrities like model Gigi Hadid and Jane the Virgin actress Gina Rodriguez have spoken up about the realities of life with Hashimoto’s.
Rodriguez in particular has spoken about how she’s struggled with depression, forgetfulness, fatigue, and fluctuating weight—all of which are symptoms of Hashimoto’s disease. Hadid has also shared on social media how difficult it is to live with Hashimoto’s while working in the modeling industry, where her weight is constantly under scrutiny.

Hadid and Rodriguez are not alone. According to Andres Palacio, MD, an endocrinologist with Tenet Florida Physician Services, Hashimoto’s disease can be found in up to 10 percent of the population. Studies indicate that Hashimoto’s may be up to eight times more common in women than in men.

But despite the fact that the condition is fairly common, many of us aren’t familiar with the signs and symptoms of Hashimoto’s. If you think you could potentially have Hashimoto’s disease, or if you’re simply curious and want to learn more, read on.

What is Hashimoto’s disease?

Hashimoto’s disease is an autoimmune disease, meaning that the body’s immune system attacks the bodily tissues. It’s also recognized as a chronic illness.
Hashimoto’s specifically affects the thyroid gland, which is a part of the endocrine system. The endocrine system is responsible for regulating the hormones throughout the body. According to Palacio, other than in cases caused by an iodine deficiency, Hashimoto’s disease is the most common cause of hypothyroidism.

Hashimoto’s disease can also cause thyroiditis, which is an inflammation of the thyroid. Because of this, Hashimoto’s disease might also be called Hashimoto’s thyroiditis. It’s important to note that thyroiditis isn’t always caused by Hashimoto’s disease, nor is it only linked to hypothyroidism. “[Thyroiditis] can be caused by viruses or autoimmune processes. It can present both as hyperthyroidism [producing too much hormone] or hypothyroidism [producing too little hormone],” Palacio notes.

Hashimoto’s disease is most likely to appear in people between the ages of 40 and 60. You’re also more likely to have Hashimoto’s disease if you have other health conditions such as Addison’s disease, rheumatoid arthritis, lupus, autoimmune hepatitis, vitiligo, pernicious anemia, and type 1 diabetes.

What are the symptoms of Hashimoto’s disease?

Because the disease attacks the thyroid gland, people with Hashimoto’s have low levels of thyroxine, a hormone made in the thyroid that is essential for many bodily functions such as digestion and brain development.  
Palacio notes that Hashimoto’s can sometimes include the development of a goiter. According to the American Thyroid Association, a goiter occurs when the thyroid swells, making it look like a large mass in the neck near the Adam’s apple. It’s important to note that a goiter could be caused by hypothyroidism or hyperthyroidism. As such, it can be caused by Hashimoto’s disease, but it can also be caused by conditions, such as Graves’ disease, that cause hyperthyroidism.

According to Mayo Clinic and the American Thyroid Association, the symptoms of Hashimoto’s disease include:

• Sore, stiff, or weak muscles
• Weight gain
• Fatigue
• Pale, dry skin
• Constipation
• A puffy face
• Menorrhagia (excessive or prolonged menstrual bleeding)
• Depression
• Brittle nails and hair loss
• Memory loss

Because hypothyroidism affects thyroid levels, Hashimoto’s can also lead to high cholesterol, which can in turn cause heart conditions.

How is Hashimoto’s disease diagnosed?

Hashimoto’s disease is diagnosed by measuring thyroid-stimulating hormone (TSH) along with thyroid peroxidase (TPO) antibodies, Palacio says. Since Hashimoto’s is an autoimmune disorder, it’s usually accompanied by a high amount of TPO antibodies.
Unfortunately, getting a diagnosis isn’t always easy.
Kathryne struggled to find a diagnosis for her extreme fatigue for 18 years before she was finally diagnosed with Hashimoto’s disease just three years ago. The 52-year-old strategist and mother says that “It became so extreme that I could barely walk up a short flight of stairs. At that time, I was only being seen by regular, general practice doctors. I didn’t have any idea what was going on, so I didn’t know that I should have pushed harder for answers. It was many, many months before they even thought to do a thyroid test,” she recalls. For the next 10 years, she was treated for hypothyroidism.

Despite the fact that her other symptoms seemed like Hashimoto’s disease, her doctors dismissed it. During this period, she developed a bald patch, found her hair thinning, and had a rash. When her rash flared up, she would experience extreme fatigue and pain. Yet she still couldn’t find someone who could provide her with effective treatment.

Both naturopaths and traditional medicine failed to help her. Eventually, she found a functional medicine doctor who ordered a full thyroid panel and confirmed that she had Hashimoto’s disease. Since then, she’s been able to find an effective form of treatment.

How can Hashimoto’s disease be treated?

Hashimoto’s is a chronic illness, meaning there is no cure. But it can be effectively treated with medication.
“The main recommendation for patients when they have Hashimoto’s is to take their medication appropriately—on an empty stomach, with water, and at least 60 minutes before having any food,” Palacio says.
The medication often prescribed for Hashimoto’s is levothyroxine, a synthetic version of thyroxine that ensures that hormones are at an optimum level. Palacio notes that people being treated will also have to have their hormone and antibody levels checked every six to 12 months.

Kathryne says that her doctor, a practitioner of functional medicine, has taken a different approach to her medication. Her doctor has reduced her levothyroxine dosage, prescribed liothyronine, and adjusts her medication based on both her lab results and symptoms.
“My doctor recently started me on LDN (‘low dose’ micro doses of naltrexone), and she is carefully monitoring my thyroid panel, including TPO, to make adjustments to my dosages of levothyroxine and liothyronine as necessary,” Kathryne explains. Naltrexone is an opiate antagonist, and LDN is a fairly common treatment for people with autoimmune disorders such as Hashimoto’s disease.

Many people try gluten-free diets if they have disorders like Hashimoto’s disease. This is because various studies suggest celiac disease is prevalent in people who have endocrine autoimmune disorders. While many people believe that a change in diet can help them, that’s not something Palacio personally recommends to his patients. “There is no scientific evidence that there is a need to change the diet if the patient has hypothyroidism,” Palacio explains.
That said, certain lifestyle changes could help manage the symptoms of Hashimoto’s disease. Healthy lifestyle changes are never a bad idea, but they’re especially imperative with a chronic illness such as Hashimoto’s disease. Kathryne says she feels best when she eats a Whole30 diet, practices yoga daily, gets regular exercise, and sleeps well.

As mentioned earlier, Hashimoto’s is linked to depression. Lifestyle changes might be necessary to address any mental health difficulties experienced as a result of Hashimoto’s. For those who do experience depression, psychotherapy (also known as talk therapy) might be useful.
Although Kathryne struggled to find an effective approach, she finally found a form of treatment that’s right for her. “I haven’t had a serious flare-up since then. My energy level is much better,” she says. “I still have to be careful about overexertion. I work very hard at maintaining a healthy balance of diet, exercise, and especially rest. I now feel better than I have in almost 20 years,” she says.
If you suspect you have Hashimoto’s disease, don’t let healthcare providers dismiss your symptoms without offering any explanation. It might take awhile to find a doctor who takes your symptoms seriously, as Kathryne’s case shows, but her story also shows that persevering is worth it.
“Don’t stop looking until you find a healthcare provider who really listens to you and looks at a wide array of test results,” Kathryne says. “Healing can take a long time, so don’t give up.”

The pain in my jaw was back, and it wasn’t going away this time. I went to the dentist to get it checked out and one of my deepest fears came to life: I’d need to get my wisdom teeth removed. Even worse: It wouldn’t be your standard dental office procedure—there were complications and I’d need to see a specialist. I asked him about how to find a doctor to help me, and he referred me to an oral surgeon. That’s when the real trouble began.
“You should have had this procedure done years ago,” scolded the oral surgeon during our consultation a few days later. “Why didn’t you have this done yet?”
I cowered in the chair, my jaw throbbing with pain, unsure of how to respond. He met with me for all of five minutes, during which he explained that the oral surgery would cost about $7,000 (a sum that I, a recent college grad, did not have) and told me I should speak with another staff member about taking out a loan. He left in a huff.
How could I trust this doctor, who chastised me and hardly explained the surgery, to take care of me with compassion during an invasive procedure?
I decided to shop around, but it turned out that the intricacies of healthcare in the U.S. make it extremely difficult to figure out how to find a doctor who fits your needs and your budget. Few medical offices reveal prices ahead of time, and ratings from patients are often mixed (if you can even find them).
After nearly two dozen unsuccessful calls to oral surgeons in the Bay Area drove me to tears, I ended up on the phone with the sweetest receptionist at an oral surgery office who explained that the doctor was an expert in this particular procedure and was willing to work with me on financing. I went to a consultation that lasted more than an hour, and the oral surgeon patiently explained exactly what would happen during the procedure and why it was important for my health.
This was a doctor I felt I could trust. The entire experience—from going under anesthesia and getting a bone graft to healing and eventually getting the stitches removed—went better (and cost less) than I had expected. What a relief!
A great oral surgeon is just one of many doctors we might need in our lives. No matter what type of care you’re looking for, you’ll need a solid strategy for how to choose a doctor. R. Ruth Linden, PhD, who helps people find medical experts in her role as health advocate and president of Tree of Life Health Advocates, a private health-advocacy firm in San Francisco, shares her insights on how to find a doctor you can trust.

How to Find a Doctor Who Can Help You With Your Goals

With so many factors involved in how to choose a doctor, it can be tough to know exactly where to start. Linden recommends coming up with a list of healthcare-related goals you’re hoping to achieve by working with a medical professional.
“What do you want to get out of the appointment, and the relationship? In order to get your needs met, you need to know exactly what they are. Ask yourself what your goals are,” she says.
Examples of goals might be successfully managing a chronic illness, improving your sleep habits, developing a healthier diet, or overcoming depression. These goals will not only give you (and your doctor) clarity about what you expect to achieve, but they’ll also inform the type of medical professional from whom you seek care.
Your first stop might be a primary care physician, internist, or family doctor. These types of doctors are trained in helping patients manage their general health, diagnosing diseases and illnesses, administering treatments, and dealing with everyday concerns. Most of these doctors hold MD (medical doctor) degrees, and they practice the form of medicine most Americans are familiar with, which is known as allopathic medicine.
A minority of doctors choose to get a DO (doctor of osteopathic medicine) degree. They undergo practically the same training as their MD colleagues, but they also spend another 200 hours or so learning more about the musculoskeletal system and osteopathic manipulation, a technique in which a doctor uses touch to diagnose and treat patients.
Both types of doctors undergo years of training and need to pass a licensing exam to earn their white coats. Whether you choose a DO or an MD depends on your preferences and who is available in your area.
Some health concerns require the intervention of a specialist. For example, most women choose to get birth control, screenings for sexually transmitted diseases, and Pap smears from an obstetrician-gynecologist (OB-GYN). Allergists and immunologists treat disorders of the immune system such as food allergies, asthma, and eczema. Otolaryngologists treat disorders and diseases in patients’ ears, noses, and throats. Dermatologists treat problems with the skin, nails, and hair. As for mental health, both psychologists and psychiatrists can help treat depression, anxiety, addiction, and other concerns, but only the latter can prescribe medications, like antidepressants.
The list of areas and treatment types doctors can specialize in runs long, and some people choose to see doctors who are trained in traditions outside of allopathic medicine. Naturopaths, for example, are doctors who use natural approaches, such as acupuncture and nutrition, to address health issues.
You may need to get a referral from your primary care physician to get treatment from a specialty doctor depending on your particular medical needs and insurance requirements. In most cases, they’ll recommend a handful of specialists for you to choose from. If for some reason you’re sent to a specialist you don’t want to work with going forward, you can explore options for seeing someone else with your insurer, or by asking for another referral from your PCP.

Finding a Doctor Who Takes Your Insurance

Once you come up with your list of goals and potential specialists who can address your particular concerns, the next step in how to find a doctor is thinking about your budget. If you’re insured, you’ll need to decide whether you want to work with someone in network with your health insurance.
“An in-network provider will reduce your out-of-pocket costs, but sometimes it’s challenging or even impossible to find a great doctor who takes your insurance,” says Linden.
You can usually find an up-to-date list of in-network providers on your insurance provider’s website. If nothing comes up, which is more likely to happen when you’re looking for a specialist, you’ll have to broaden your search—and consider your willingness to pay more.

How to Find a Doctor: Building a Short List

Once you’ve determined whether you’re going to use your health insurance, it’s time to come up with a list of candidates. A Google search for doctors is likely to yield an unwieldy array of options, which is why Linden recommends starting your search the old-fashioned way: by asking your friends, family, and colleagues for recommendations.
Online resources such as Yelp, ZocDoc, Healthgrades, and RateMDs can also give you an inside look at other patients’ experiences with particular doctors. But take those reviews with a grain of salt, says Linden.
“People use online review sites to comment on all kinds of irrelevant things, like parking, the elevator, the demeanor of the front desk staff. These are things you might want to be aware of, but many times, they’re not the doctor’s responsibility and don’t reflect on how they care for patients,” she says.
Qualifications play a big role in how to choose a doctor. Merely having an MD isn’t enough to prove that a doctor provides high-quality care, says Linden, who only refers her clients to board-certified professionals.
“It’s very important to see someone who’s board certified,” says Linden. “That credential assures you that the doctor has completed his or her training and passed a national exam. It’s a minimal standard, as far as I’m concerned.”
Doctors will typically share their certifications in the bio sections of their websites. You can cross-reference their board certifications with the Administrators in Medicine DocFinder, the American Board of Medical Specialties Certification Matters site, or the American Board of Family Medicine doctor finder.
Gender is another important factor in how to choose a doctor. Some patients feel indifferent about whether their physician is a man or a woman, while others may struggle to feel comfortable receiving care from someone of the opposite gender.
“I find that women tend to prefer to see women doctors, while men don’t care,” says Linden.
It takes a lot more than the right gender, a recommendation from a friend, and solid credentials to make a doctor the right fit for you, though. You also have to consider the logistics of working with any medical professional. Is their practice close driving or walking distance from where you live or work? Is the doctor accepting new patients right now? Can you get in for an appointment relatively soon? A “no” answer to any of these questions doesn’t make a doctor a poor choice for you, but you should think about whether or not it’s worth it to travel far or wait a long time to be seen at a practice.
“Long wait lists for an appointment are not a red flag. I referred a client to to the very best internist in her area, who had 4,000 five-star Yelp reviews. She couldn’t be seen for months because she’s in demand, but she’s worth waiting for if you don’t need to be seen right away,” says Linden.
All of these factors should help you narrow down your list of candidates to just a select few doctors. Then, go with your gut—if you’re naturally drawn to one of the physicians, it’s time to see if he or she is the right doctor for you. Call up the practice and schedule an appointment.

Finding The Right Match

Your relationship with your doctor will be an incredibly intimate experience. He or she will know some of the most personal details of your life, ranging from your family medical history and allergies to your sexual history and substance use. Getting the best personalized care depends on how open and honest you can be with your doctor.
“There’s a loop I like to work through with each client when introducing them to a new physician,” says Linden. “It consists of three legs: preparing for the appointment, asking questions during the appointment, and debriefing after the appointment.”
Get ready for your initial appointment by referring to your health goals and drafting a list of questions for the doctor. Think about what you hope to get from the appointment, says Linden, who offers several examples of potential inquiries for a doctor:

• I take blood pressure medication but I want to make some lifestyle changes so I no longer need the prescription. Is that something you can help me with?
• I’ve been feeling depressed. Can you talk to me about the pros and cons of starting an antidepressant?
• I want to lose 20 pounds. Can you provide nutritional guidance to help me?

“You can’t make a decision about whether that doctor is a match for you unless you understand your own expectations,” says Linden.
Meeting with the doctor gives you the opportunity to ask those questions and evaluate the physician’s communication style and bedside manner. Linden emphasizes the importance of asserting your preferences and needs during this initial appointment.
“You have to learn to advocate for yourself. We all become passive in a medical setting because of the power differential between doctor and patient, but you have to be assertive. If you need to be handled with special care, tell the doctor so they have the opportunity to treat you extra gently,” she says.
If the doctor frequently interrupts you, fails to address your preferences, or isn’t flexible in her handling of patients, she’s probably not the right fit for you. Take some time to reflect on how things went after the appointment.
“Did you feel your questions were answered? Did the doctor meet your expectations? What happened and how did you feel about it?” asks Linden.
Hopefully the legwork you did as you decided how to choose a doctor led you to a physician with expertise in your health concerns and a style that resonates with you. And if not, keep searching—it can be frustrating to try out different physicians, but it pays off tenfold when you finally find a doctor you trust.

When I was in my first year of university, I couldn’t figure out if I was miserable or depressed. I cried often, I struggled with my sleeping patterns, my immune system was weak, and I felt irritable and unmotivated all the time. Am I depressed? I wondered. Or am I just moody?
While I felt sad, it eventually became clear that it wasn’t a bad mood or a response to one specific life change—I had depression. And while help was available, I needed to acknowledge that I was depressed before anything could get better.

We often associate depression with sadness, and we often use the word depressing or depressed to mean very sad. Some people even use it to talk about relatively normal life events: “I’m so depressed he canceled our date!” or “This history class is so damn depressing.” For this reason, it can be difficult to tell whether you’re truly depressed or simply upset. Like me, you might be asking yourself, Am I depressed, or am I feeling sad, hopeless, or unmotivated?
While someone can experience sadness and depression at the same time, there is a big difference between being sad and being depressed. Sadness is a feeling, while depression is a medical condition. Depression is treatable, but before you begin treatment, it’s important to know what you’re dealing with.
Here’s what you need to know about the difference between depression and general sadness.

Am I depressed or am I sad?

Depression is a mental illness—a mood disorder, to be specific—while sadness is a mood or feeling. This distinction might seem simple, but if you’re struggling with a low mood, it can be hard to tell the difference.
That said, there are a few notable differences between depression and sadness or lack of motivation.
“In sadness, there are mostly feelings of emptiness and loss. In depression, there is a persistent depressed mood and inability to anticipate happiness or pleasure,” says Danielle Forshee, PsyD, LCSW, a practicing psychologist.
“Feelings associated with sadness are likely to decrease in intensity over the course of a few days or weeks and occur in waves,” Forshee adds. “These waves tend to be associated with thoughts or reminders of what it is that is making you sad. The depressed mood of depression is more persistent and not tied to specific thoughts. Usually thoughts in depression are associated with self-criticism or pessimism.”

In other words, when you’re sad, your sadness is associated with a specific issue. When you’re depressed, on the other hand, it’s chronic: It’s a lens that obscures the joy around you. Depression makes you struggle to find happiness or joy in your surroundings.
Something else to note, Forshee says, is that your self-esteem is usually relatively intact when you’re sad. With depression, on the other hand, it’s common to feel worthless or self-loathing.
If you’re asking yourself Am I depressed? consider which of those scenarios applies to you.
Finally, while you can overcome sadness with time, positivity, and the support of friends, depression is a real illness that needs to be treated proactively with the help of professionals.

What causes depression?

Another key difference between sadness and depression is its cause. Sadness is usually caused by a certain event or issue, and while depression can be triggered by a specific situation, the true cause of depression is extremely complex.
You may have heard that depression is caused by a “chemical imbalance” in the brain. Many experts have pointed out that while this explanation isn’t exactly wrong, it’s a little oversimplified. “Depression isn’t likely caused by just one thing, but rather a complex interplay of many things such as genetic predisposition to having low moods, trauma and negative experiences, levels of concentrations of certain neurotransmitters, nerve cell connection function, and nerve circuit functioning,” explains neuropsychologist Amy Serin, PhD, founder of the Serin Center.

“There is a difference between sadness, which is often a temporary acute reaction to a difficult life situation,” says Serin, “and depression, which is a longer-lasting state in which a person can experience a loss of pleasure in life, fatigue, sleep changes, physical symptoms, feelings of worthlessness and hopelessness, and even suicidality.”
[pullquote align=”center”]Depression is chronic: It’s a lens that obscures the joy around you.[/pullquote]
There can also be significant physiological differences between people who feel sad but are not struggling with depression and those who are depressed, including hormonal differences. “Stress plays a role in modulating depression,” Serin explains. “Individuals with emotional or physical stress produce more corticotropin releasing hormone (CRH), a hormone that is often elevated in depressed individuals. When CRH returns to normal levels, mood states improve and depression lessens,” she says.
It’s important to remember that there are a number of physiological factors that come along with depression. An effective treatment program will address multiple facets of your experience to make depression more manageable, and professionals who are qualified to help treat depression know it isn’t as simple as changing your attitude, which is important for you to keep in mind too.

I think I’m depressed, but I don’t feel sad all the time.

A common misconception about depression is that depressed people only experience sadness, all of the time. In reality, depression can include a range of negative emotions and even physical feelings including anger, numbness, lethargy, or irritability.
“Depression is a complex condition which may present differently across a range of people,” explains Lekeisha A. Sumner, PhD, a board-certified clinical psychologist. “Sadness may not be the most prominent symptom. For example, for some people it may present with more physical complaints or irritability than low mood.”
So, while depression is often accompanied by sadness, it’s certainly possible to feel other negative moods—annoyance, apathy, or demotivation, for example—more than sadness.

Instead of crying constantly, you might find yourself struggling to function and complete day-to-day tasks, or you might be easily annoyed or upset, or you might struggle to find the joy in the things that previously brought you pleasure.
Depression isn’t just about how you feel—it’s also linked to a number of physical symptoms. “Many people with depression show up in their doctor’s offices with vague pain that can include chronic joint pain, limb pain, back pain, gastrointestinal problems, fatigue, sleep disturbances, and appetite changes,” Serin notes.
Serin explains that while most people believe there’s a strong division between mind and body, mental illnesses like depression—and even moods, like sadness—can affect the body profoundly. “We know that invoking even a small amount of sadness will increase someone’s level of perceived pain, so it makes sense that individuals with depression literally feel more physical symptoms than non-depressed people, even in the absence of other medical causes,” she says.

This might feel very overwhelming, especially since depression is linked to such a wide array of physical, mental, and emotional effects. But it’s important to remember that there’s a lot of hope for those who are depressed, and effective treatment will address your physical and emotional symptoms.

How is depression diagnosed?

If you find yourself asking Am I depressed?, the best person to help you work your way toward an answer is a trained expert.
Sumner strongly recommends being evaluated by a professional if you think you may be depressed.
“A professional can determine the subtleties among symptoms of major depression, dysthymia, grief, and normal sadness,” Sumner explains. “If you have been experiencing persistent sadness for at least two weeks, you would likely benefit from a professional evaluation,” she says.
According to Forshee, to meet criteria for major depressive disorder, [linkbuilder id=”6503″ text=”symptoms of depression”] must have been present every single day for at least two weeks. The symptoms are:

1. Depressed mood most of the day (feeling sad, empty, hopeless)
2. Little or no pleasure in almost all activities that previously you derived pleasure from
3. Significant weight loss/decrease or increase in appetite nearly every day
4. Sleeping way too much or not sleeping at all
5. Feeling physically slowed down
6. Feeling very fatigued or having a loss of energy nearly every day
7. Feelings of worthlessness or excessive and inappropriate guilt nearly every day
8. Limited ability to think/concentrate or indecisiveness nearly every day
9. Recurring thoughts of death, suicidal thoughts without a plan, or a suicide attempt, or having a plan for committing suicide

Other types of depression include:

• Bipolar disorder
• Seasonal affective disorder (SAD)
• Postpartum depression
• Premenstrual dysphoric disorder (PMDD)

Even if you don’t consistently experience all the symptoms associated with major depression or don’t think you’ll be diagnosed with another type of depression, you should still talk to a professional if you’re struggling with your mental health. You don’t need a diagnosis in order to receive help; therapy can benefit people whether they have a diagnosed mental illness or not.

If I am depressed, how can my depression be treated?

Many people think they can simply cure depression on their own if they just have a positive attitude. While staying positive is a great start, depression is a medical condition and it should be approached as such. We all need a little help sometimes, and there’s no shame in seeking help if you think you may be depressed. Just as you wouldn’t (or shouldn’t) attempt to cure appendicitis on your own, it’s important to look for professional help if you have depression.

If you think you may be depressed, your first port-of-call should be a therapist of some kind. If you have health insurance, you should be able to search in-network providers online through your insurer’s provider directory. (Note that they may be listed as behavioral health professionals.) If you’re unsure which therapist to visit, look for reviews online, ask for a recommendation from your general physician or friends, or try an online therapy portal like BetterHelp or Talkspace. Psychotherapy—that is, talk therapy—is a great way to improve and maintain your emotional health, whether you have a mental illness or not.
[pullquote align=”center”]“If you have been experiencing persistent sadness for at least two weeks, you would likely benefit from a professional evaluation.”
—Lekeisha A. Sumner, PhD[/pullquote]
Sumner says that one of the most effective treatments for depression is cognitive behavioral therapy (CBT). “CBT is based on the premise that maladaptive cognitions, such as beliefs or paradigms about one’s world, surroundings, themselves, and the future, contribute to automatic thoughts that lead to distress,” she explains.
With CBT, a therapist can help you recognize these problematic beliefs, thought patterns, and behaviors so that you can change them. Changing your thought patterns and behaviors might help relieve your depression. Serin points out that CBT has been shown to literally alter the hippocampus in the brain, which provides further evidence that CBT is an effective treatment for those who are depressed.

Another possible facet of your treatment plan could be trying antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs). Serin says that serotonin, which regulates sleep, appetite, mood, and pain perception, is one of the many chemicals associated with depression. “SSRI antidepressants seem to work by changing serotonin transmission in the brain and possibly by increasing neurogenesis (the formation of new neurons) in areas such as the hippocampus—which is an important brain structure that is often smaller in individuals who are depressed,” Serin says. While antidepressants are often stigmatized, they can be life-saving.

So I’m depressed. What else can I do?

“It is important to note that neurochemicals associated with depression can be altered with treatments that are not medication,” Serin says. In other words, while medication can be necessary and life-saving for many people with depression, there are other treatment options that you can explore.
“Meditation, improved sleep, exercise, and other healthy behaviors have also been shown to reduce depression in many studies,” she says. Serin also recommends getting enough sleep, maintaining a healthy diet, and creating social connections with supportive people to maintain your mental health.

Of course, maintaining a healthy diet can be tough when you’re struggling with depression. Depression can affect your appetite, causing you to eat too much or too little. And even if you have an appetite, depression often means you don’t have the energy to cook healthy, filling food, causing you to resort to eating what the internet has lightheartedly dubbed “depression meals.”
When you have the energy to do so, you might find it helpful to stock your cupboard and fridge with easy-to-make food: tea, whole-grain bread, nut butter, protein shakes, fruit, and frozen veggies can all be your allies when it comes to addressing your depression. Try to freeze leftover soup and keep it in your freezer for emergencies. Don’t feel bad if you need to call for delivery, pick up takeout, or buy ready-made food: Eating anything is better than eating nothing at all.
If you find yourself wanting to focus on your feelings, Sumner recommends trying expressive writing through journaling, which can help you express and process your emotions. Some studies suggest that gratitude journaling can be used to boost one’s self-esteem and general well-being, not to mention writing your feelings down is a great way to remember what to discuss in your next therapy session!

Sumner also recommends getting at least 20 minutes of sunlight a day. According to the Mayo Clinic, getting enough sunshine is important in regulating your serotonin levels as well as your sleep patterns.
In addition to all of these suggestions, Sumner recommends engaging with positive, supportive people. She also suggests you increase the pleasurable activities you engage in throughout the day. Take time to do the things that make you feel relaxed, happy, or excited. This could include taking a walk, reading, or watching a funny show. It can be hard to get yourself out of the house or even respond to texts when you’re in the throes of depression, but if you’re feeling up to it, these small things can help lift your mood.
While depression sometimes seems impossible to deal with, it can be treated effectively. Many people who have depression still manage to have happy, full, exciting lives—they just need to take extra good care of their mental health.
[related article_ids=23440]

Mattress skin. Cottage cheese thighs. Orange peel tush. There are dozens of words we’ve come up with to avoid talking directly about the cellulite that starts cropping up on our bodies when we least expect it.
The reality is cellulite is simply a part of life—a normal part of life at that. As many as 80 to 90 percent of girls and women who are past the puberty stage have at least some cellulite somewhere on their bodies.
Unfortunately, being one of the girls doesn’t necessarily make us love our lumps. We live in a society where tabloids splash paparazzi shots of celebrity women across their covers with giant headlines labeling the stars “imperfect” and using arrows to point to a few dimples on their thighs. The implication (however false it may be) is clear: Cellulite is proof your body’s falling apart.
We’ve certainly internalized those headlines. In one survey performed on behalf of a company that develops laser treatments, women with cellulite rated their own appearance on average lower than the appearance of women without cellulite. Almost all (97 percent) of the participants with cellulite said they’d change their appearance if they could.
But while there’s almost no avoiding the lumpy fat that crops up on tummies, butts, and thighs of famous models and not-so-famous moms driving minivans around the neighborhood, cellulite treatments are out there if you want them. The problem for most women is sorting through the overhyped claims of fast fixes and overpriced offers to find cellulite treatments that can help us reclaim some of that smooth, pre-puberty skin.
That’s where we come in. We talked to the experts about the most popular cellulite treatments out there and found out what works, what doesn’t, and what you can do if you’re not feeling comfortable in the skin you’re in.

Cellulite: A Female Curse?

Before we even consider treating cellulite, did you ever wonder what the heck was going on down under your skin to make all those bumps and valleys? Let’s take trip back to high school science, shall we?
The skin has three layers: The epidermis is the outermost layer of skin. The dermis is the layer right beneath the epidermis. Below that is the subcutaneous layer, which is made up of fat and connective tissue.
“Throughout the fat layer, there are connective tissue septae, or bands, that run down from the skin and divide the fat layer into compartments,” explains Sejal Shah, MD, a board-certified dermatologist and RealSelf contributor from New York City. “Cellulite occurs when this underlying fat begins to push up against the overlying connective tissue and skin, while those septae pull down the skin, resulting in that characteristic dimpled appearance.”
Essentially, the fat that’s in our bodies sections off into little pockets deep underneath the skin, resulting in the dimples we know as cellulite. It typically begins sometime in a woman’s twenties or thirties—although it can happen earlier (some teenagers have cellulite) or later—and it’s most prevalent on the thighs, butt, and lower abdomen, although it can also appear on the arms.
While these fatty pockets can crop up on men’s bodies, it’s much rarer than it is in women. Just about 10 percent of cisgender men have cellulite, compared to more than 80 percent of cisgender women. There are a number of reasons for the gender divide, but the main thing? It’s yet another thing we can blame on our hormones, Shah says, specifically estrogen, the primary female sex hormone.
“Estrogen plays role in the development of cellulite,” Shah explains. “Women tend to have more body fat, and women’s fat is typically distributed in the thighs, hips, and buttocks, which are common areas for cellulite.”
Also at play in cellulite’s appearance is the way muscle develops in men versus women.
“In men, the connective tissue bands that connect skin and muscle are thicker, more in number, and form a crisscross pattern (unlike the vertical pattern in women), making it less likely for the fat to push through,” Shah notes.
Of course, not all women develop cellulite, and just why that happens and who it will happen to is still somewhat up in the air. Even scientists have yet to suss out exactly why some women wake up one day to cellulite while others never experience it at all.
“Because we don’t know exactly why people get cellulite, it’s not always possible to prevent it, especially since factors like genes and hormones play a role,” Shah says. But there are certain risk factors that tend to up your chances of taking a peek at your butt in the mirror and spotting some cellulite, including:

• Genetics (both being female and having a parent who had cellulite)
• A diet high in fat, carbohydrates, and salt, but low in fiber
• Lifestyle factors such as smoking, being sedentary, and lack of exercise (which results in low muscle tone)
• Poor circulation
• Hormonal imbalances or increased sensitivity to hormones
• Use of hormonal contraceptives
• Aging (as we age, the skin and connective tissues naturally weaken and lose elasticity, Shah says)
• Weight gain (but even thin people can have cellulite, Shah is quick to point out)

Of course, that all begs the question: What can you do about it?

Cellulite Treatments

If you have cellulite and it doesn’t bother you, you can stop reading right now. Okay, well hold up—not quite yet.
The truth is, cellulite is normal, Beverly Hills plastic surgeon Deepak Raj Dugar, MD, says. It’s not a disease. It’s not a reason to hit the emergency room. And while some of the potential causes (such as smoking or an unhealthy diet) can adversely impact your health, cellulite in and of itself is not going to hurt you and is not considered harmful to your health by the medical community.
If you want to let it be, there’s no reason to pay it any more attention. But what if you fall in the “I want it gone” camp?
There’s good news and bad news ahead. When asked if there are any means for cellulite treatment that are legitimate and backed by science, most doctors don’t pull any punches.
“Short answer is no,” Dugar says. “There have been no studies to ever show that a device, medication, or system was able to effectively reduce cellulite across the board.”
In fact, some body-contouring plastic surgery methods, such as liposuction, have actually been shown to make the appearance of cellulite worse. Okay, case closed, right? You’re stuck with orange peel thighs and cottage cheese tushie.
Not exactly. While there’s no magic pill that will address every single person’s cellulite issues, there are some options out there.
Here’s the real deal on the most popular cellulite treatments currently available.

Retinoid or Retinol Creams

Can cellulite treatment really be as easy as rubbing a cream on every day for a few weeks? Well, no, says Shah. “It won’t directly treat the cellulite, but [it] may improve skin texture and tightness, therefore reducing the appearance of cellulite.” Be wary of just any cream that you find in the drugstore or online that claims to get rid of cellulite, though. It’s only those with the active ingredients retinoid or retinol that offer that skin-tightening benefits.

Compression Stockings

Like creams, these seem like a fast and easy fix for cellulite woes, but they’re more cosmetic than a long-term solution, Shah says. Wearing support hose can reduce excess fluid, making the cellulite less apparent on your thighs, butt, and tummy. But once you’ve spent some time without that support, the dimpling effect will just return. The same goes for dry brushing and the “wraps” popular on Instagram. The compression effect can help in the short term, but it’s not a long-term cellulite treatment.

Cellfina

The first device to ever get FDA clearance for long-term treatment of cellulite literally cuts the connective tissue bands that pull down the skin and create the dimpled appearance of cellulite, Shah says. Performed by a doctor in an outpatient setting, Cellfina treatments use a small, needle-sized device that cuts those cellulite-causing bands just beneath the skin. The device is “minimally invasive,” according to the company, and side effects are typically limited to tenderness and bruising. The results are expected to last for up to a year, Shah says, although the company boasts patients can be cellulite free for as long as three years.

Cellulaze

Another treatment that can only be done by a doctor, Cellulaze is a cellulite treatment that’s performed in an office setting in an hour or two, allowing patients to go home immediately after treatment. “This [is] a laser treatment in which the laser is inserted just underneath the skin to cut the connective tissue bands that are causing the dimpled appearance,” Shah explains. Again, side effects tend to include tenderness and bruising, and the company notes there may be some leaking from the incision. Patients may have to wear compression garments for a short period of time after the procedure and avoid strenuous activity for as much as two weeks after treatment. The company behind the procedure promises results will improve over time and should last up to a year.

Other Laser Techniques

Cellulaze is a brand name (and one of the most popular treatments), but there are other radiofrequency lasers out there that are used to address the appearance of cellulite. Dugar says these devices use suction pulsing technology to help “separate the fibrous septa from the skin to reduce the herniation fat,” but warns that the efficacy of these is still low, and results are not permanent.

Fillers

Just as some people get fillers injected into their face to address fine lines and wrinkles, it’s possible to use injections to address cellulite. “These injectable treatments can be used to mask the appearance of cellulite by filling in the dimples,” Shah explains.

Brazilian Butt Lift

One of the most invasive cellulite treatments is less of a treatment and more of a way to mask the dimples by creating a barrier between the skin and the subcutaneous tissues below, Dugar says. A Brazilian butt lift involves liposuction, pulling fat from your flanks, abdomen, arms, and legs, and re-injecting that fat into your buttocks and thighs.
“When done properly, you can effectively create a barrier between the skin and the fibrous connective issues below, thereby reducing the appearance of the cellulite,” Dugar says. But, he warns, “this may only be temporary as studies have never shown that this is an effective treatment for cellulite. I have noticed that it can temporarily decrease the appearance of it.”

Diet and Exercise

No, it won’t eliminate all your cellulite, but it can have an impact, Shah says, at least on how your cellulite appears. “Being overweight may worsen cellulite because the more subcutaneous fat you have, the more likely it is to put stress on the connective tissue and bulge,” she explains.
Of course, cellulite can also happen in thin individuals, and exercise does not necessarily get rid of cellulite completely, but it can make it appear differently beneath the skin.
“As the connective tissue underneath the skin weakens or loses elasticity, it allows the fat to bulge,” Shah explains. “Strengthening the muscles in those areas will in turn tighten the skin (and burn excess fat overall), making the skin appear smoother and cellulite less noticeable.”
Any exercise is good exercise, but if you’re looking at your workout as a cellulite treatment, you’ll want to mix up your fitness routine.
“Combining aerobic activity with strength training is key to improving the appearance cellulite, and aerobic/cardio exercise alone is unlikely make much of a difference,” Shah says.
At the end of the day, cellulite may not be something that we can beat or even need to be that concerned about. But if you’re focusing on a healthy lifestyle, from diet to exercise to water intake to avoiding smoking, you may be able to help stave of developing more and help the cellulite that’s already there be just a little bit less apparent. If nothing else, a healthier lifestyle will equal a healthier you.

You know that you don’t want kids (or more kids) right now, or maybe ever. But you don’t want to have to worry about changing your lifestyle choices in order to avoid pregnancy. Instead you want the best birth control: something that is reliable at preventing pregnancy, doesn’t have nasty side effects, and fits in with your daily schedule.
Luckily, in 2018, you can have all those things.
For decades, birth control meant one option: the pill. Now, however, there are myriad choices. Women looking for the best birth control can chose low-hormone or even non-hormonal options. There are birth control options that you take daily, only use when needed, or get once and don’t have to think about again for years. You can even decide whether you want to have a monthly cycle or would prefer to skip your periods altogether.
All that choice is a wonderful thing because it allows you to find the best birth control for your body and lifestyle. Unfortunately, it can also be a bit overwhelming. Choosing the best birth control can mean doing a lot of research—and some soul searching—to decide what you really want.
HealthyWay spoke to women’s health experts about the advantages and disadvantages of the most common [linkbuilder id=”736″ text=”forms of birth control”], as well as what women should consider when trying to find the best birth control option for them. Here’s what they had to say:

What is the best birth control?

Finding the best birth control is individual to each woman, says GG Collins, MD, a fellow of the American Congress of Obstetricians and Gynecologists and a fertility specialist in Progyny’s provider network.
“There are benefits to each form of contraception, and matching the option that works best with your lifestyle and minimizes your side effects is the right choice,” she says.
Considering the effectiveness of the birth control, how long it is designed to last, and any side effects are all important when you’re trying to find the best birth control for you.
Here’s a breakdown of these factors for popular birth control options, arranged from most effective to least effective at preventing pregnancy.
As you consider what’s the best birth control for you, remember that most of these forms of birth control do not protect against sexually transmitted infections or diseases.

Copper IUD (ParaGard)

Effectiveness: Intrauterine devices (better known as IUDs) are the most effective form of birth control, preventing more than 99 percent of unwanted pregnancies. The copper IUD prevents pregnancy as soon as it is placed. It is also an extremely effective form of emergency contraception: If it is placed within five days of unprotected sex it will prevent pregnancy more than 99.9 percent of the time.
How It Works: All IUDs are t-shaped devices that sit in the uterus and disrupt how the sperm would normally get to an egg. With the sperm unable to reach the egg, pregnancy is unlikely to occur. The copper on ParaGard also provides an additional level of protection by creating an environment that is toxic to sperm and eggs.
This may be the best birth control for you if:

• You want effective, long-lasting birth control. The copper IUD can prevent more than 99 percent of pregnancies for up to 12 years.
• You do not want hormonal birth control. The copper IUD has no hormones, making it a popular choice for women who don’t want to disrupt their natural hormonal balance. “Many women choose the copper IUD because it does not have a hormonal component,” Collins says.
• You’re breastfeeding. The copper IUD can be used by breastfeeding moms.
• You need emergency contraception after having unprotected sex.
• You might want to become pregnant in a few years. Fertility returns quickly after any type of IUD is removed.

This may not be the best birth control for you if:

• Some women shy away from the copper IUD because it must be inserted by a physician. This can be uncomfortable, particularly for women who have not had children, Collins says.
• Some women also experience ongoing cramping or irregular bleeding, and more intense periods, Collins says. “The main reason for discontinuation tends to be due to heavier and more painful periods that occasionally occur with the copper IUD,” she explains.

Hormonal IUD

Effectiveness: Like ParaGard, hormonal IUDs (sold under the brand names Mirena, Kyleena, Liletta, and Skyla) prevent more than 99 percent of unwanted pregnancies. However, they can take up to seven days to start working fully, so be sure to use a back-up form of birth control in the meantime.
How It Works: Hormonal IUDs thicken cervical mucus and disrupt sperm’s journey through the uterus, making it less likely that sperm will reach an egg. In addition, these IUDs release the hormone progestin, which prevents the ovaries from releasing an egg. Depending on the brand, hormonal IUDs can prevent pregnancy for up to six years.
This may be the best birth control for you if:

• You want long-acting, effective birth control that you only need to think about once. “Once an IUD is in place, women don’t have to think about it,” says Jessica Grossman, MD, CEO of Medicines360. “It’s ‘set it and forget it’ contraception, a key benefit for women ages 20 to 40.”
• You have heavy periods. Unlike copper IUDs, hormonal IUDs make periods lighter or can stop them all together. You’ll also likely experience fewer cramps.
• You might want to become pregnant in a few years. Fertility returns quickly after any type of IUD is removed.

This may not be the best birth control for you if:

• Having a period gives you peace of mind: “Some women like to have a monthly period for social or personal reasons, and many women with the hormonal IUD do not have regular periods,” Collins says. You might also experience irregular spotting.

Tubal Ligation

Effectiveness: Tubal ligation, also known as female sterilization or having your tubes tied, is 99 percent effective at preventing pregnancy.
How It Works: During a surgical procedure, a doctor blocks or cuts the fallopian tubes, the pathway that an egg takes to get from the ovaries to the uterus. With the tubes blocked, sperm cannot reach the egg, so pregnancy can’t occur.
This may be the best birth control for you if:

• You are sure you don’t want to become pregnant in the future. This is a permanent procedure.

This may not be the best birth control for you if:

• You’re unsure about having kids, or you would like the option to have more kids in the future.
• You don’t like the idea of surgery. Unlike many long-lasting birth control options that can be placed in an office, tubal ligation is a surgical procedure that requires some anesthesia (it can be done with general or local anesthesia).

Birth Control Implant

Effectiveness: The birth control implant is more than 99 percent effective at preventing pregnancy. It is effective immediately if you get it within the first five days of your cycle. If not, use backup birth control (like condoms) for a week.
How It Works: The birth control implant is a rod the size of a matchstick that is implanted under the skin of your upper arm. It releases the hormone progestin, which stops an egg from being released, and also thickens the mucus around the cervix, making it harder for sperm to get into the uterus. The implant lasts for up to four years.
This may be the best birth control for you if:

• You want to avoid estrogen. While most hormonal birth controls contain estrogen, the implant provides highly effective birth control without it, making it a popular choice for women who want fewer hormones, Collins says.
• You want lighter periods or none at all. One third of women who use the implant stop getting a period within a year.

This may not be the best birth control for you if:

• You’re squeamish. Inserting and removing the implant is normally an easy procedure, but it does involve cutting the skin open. Sometimes the implant can migrate a few centimeters, making removal more difficult, Collins says.
• Most women don’t have many side effects with the implant, but some experience weight gain, cysts, or breast soreness.

The Birth Control Shot

Effectiveness: The birth control shot is 94 percent effective at preventing pregnancy with real-world use (which accounts for women who fudge a little on their shot schedules), but if you always get your shot on time, it is 99 percent effective.
How It Works: The shot contains progestin, which stops ovulation and thickens cervical mucus. You need to get the shot every three months.
This may be the best birth control for you if:

• You want long-term effectiveness without an implant or IUD.
• You don’t mind visiting the doctor. Although you need to go to the doctor every three months, getting the shot itself is quick, easy, and relatively non-invasive.

This may not be the best birth control for you if:

• You forget appointments. You must make an appointment every three months to get your shot in order to reliably prevent pregnancy.
• You want to get pregnant soon. Although you need the shot every three months to maintain peak effectiveness, there can be some delay in getting pregnant for up to 10 months after stopping this form of birth control.

The Birth Control Ring

Effectiveness: The ring is 91 percent effective. Because it must be inserted and removed, effectiveness depends upon your ability to put it in and take it out on time, as well as storing the ring properly (out of sunlight and sometimes in the refrigerator). Some antibiotics and other medications can also make the ring less effective.
How It Works: The small, flexible ring is inserted into the vagina for three weeks at a time, and then removed for a week. It releases the hormones estrogen and progestin, which thicken cervical mucus and stop an egg from being released each month.
This may be the best birth control for you if:
You don’t want to think about birth control daily. “Many women like this form of contraception if they would like a longer-acting form of contraception but do not want a long acting device placed like the IUD or implant,” Collins says.
You have other health concerns. The ring can help control acne, PMS, and cysts. It can also help you avoid bone thinning and iron deficiency.
This may not be the best birth control for you if:

• You’re not okay inserting it. “The ring placement requires you to be comfortable putting the ring in and removing it from the vagina,” Collins says.
• You’re forgetful. The effectiveness of the ring depends on you remembering to put it in and take it out on time.
• You’re on other medications. Since some medications can decrease the effectiveness of the ring, talk to your doctor about how your medications might interact with it.

Birth Control Pill
Effectiveness: The original form of hormonal birth control is 91 percent effective with typical use. For optimal effectiveness the pill must be taken at the exact same time every day. Medications and antibiotics can also reduce the effectiveness of the pill.
How It Works: The birth control pill stops ovulation. There are many brand names, but two main types of birth control pills:

• Combination pills contain estrogen and progestin that stop ovulation and thicken cervical mucus.
• “Mini pills” contain only progestin. They thicken the cervical mucus and stop ovulation, but not as consistently as combination pills. Because of this, mini pills are only about 87 percent effective at preventing pregnancy.

This may be the best birth control for you if:

• You’re looking for a simple solution. “The birth control pill tends to be a very popular option for most women due to its ease of use,” Collins says. Because it doesn’t have to be inserted or removed by a doctor, some women feel this is an easier birth control solution.
• You’re addressing other health issues. “Some women start the pill for contraception, but also use it to establish regular periods, to reduce acne, and potentially to reduce ovarian cysts,” Collins says.
• You need to avoid estrogen. The mini pill is a good option for breastfeeding moms, women over 40, women with gastrointestinal issues, and people who have had negative side effects on birth controls containing estrogen in the past, Collins says.

This may not be the best birth control for you if:

• Your schedule is unpredictable. Taking the pill at the same time each day is essential for effectiveness.
• You have other health concerns. “Due to primarily the side effects of the estrogen found in birth control pills, there are both absolute contraindications (meaning you should never take these medications) and relative contraindications (meaning speak to your physician before taking and decide if the benefits outweigh the risks),” Collins says. For example, women who have blood clots, impaired liver function, breast cancer, undiagnosed vaginal bleeding, or who are smokers over the age of 35 should never take a combination pill.

The Birth Control Patch

Effectiveness: The patch is 91 percent effective with real-world use. Some antibiotics and medication reduce its effectiveness. It can also fall off occasionally. In addition, the user must remember when to apply and remove the patch for it to be most effective.
How It Works: The patch contains estrogen and progestin that are released into the skin. A new patch is applied once a week for three weeks, then taken off for one week.
This may be the best birth control for you if:

• You want something you can apply yourself but don’t want to take a daily pill.

This may not be the best birth control for you if:

• You’re sensitive to estrogen. “The estrogen levels in women using the transdermal patch are higher than with most birth control pills,” Collins explains. In fact, the FDA now requires the patch to have a warning, since it exposes women to 60 percent more estrogen than the pill does.
• You weigh over 198 pounds, in which case the patch may not prevent pregnancy.

Fertility Awareness

Effectiveness: Fertility awareness methods—also known as natural family planning and the rhythm method—are between 76 and 88 percent effective.
How It Works: There are a variety of fertility awareness methods, but all share a common idea: You monitor your monthly cycles (using a chart or app) in order to know when you are most fertile. During that time you either avoid intercourse or use a backup birth control method like condoms, a diaphragm, or a sponge.
This may be the best birth control for you if:

• You want to avoid hormones or implants. Fertility awareness relies on your intimate understanding of your body, without any additional prevention methods.
• It wouldn’t be a huge issue if you got pregnant. Since fertility awareness methods are less reliable, they’re best for people who wouldn’t be upset if they became pregnant.
• You have a solid understanding of how your cycles work. “If you wish to pursue the natural family planning method, it would be worthwhile to consult with a reproductive endocrinologist to grasp a strong foundation in the menstrual cycle,” Collins says.

This may not be the best birth control for you if:

• You absolutely do not want to be pregnant. No matter how well you track your cycles, there is always room for error with this method, Collins says. “Natural family planning is the least effective form of contraception as [menstrual cycles often] vary and the peak fertility time periods may shift each month,” she explains.
• You have irregular cycles. That makes it even harder to regularly track your fertile window.

Condoms and Withdrawal

Effectiveness: Effectiveness ranges from 78 percent (for withdrawal, also known as pulling out) to 79 percent (for female condoms) to 85 percent (for male condoms).
How It Works: These are options that you are likely to use in the heat of the moment. Male condoms prevent pregnancy (and STIs) by preventing sperm from entering the vagina. Using the withdrawal method, a man does not ejaculate in the vagina, reducing the risk that sperm will meet with an egg and result in pregnancy.
Male condoms and withdrawal alone aren’t the best birth control since they are often ignored in the heat of the moment. “Condoms and the withdrawal method are the least effective forms of contraception as they are often forgotten at the time of intercourse,” Collins says.
Condoms are effective at preventing many STIs, and should be used even by people who are on other forms of birth control. “All patients, regardless of what contraception they are using, should consider the use of a condom from the beginning to protect against sexually transmitted infections,” Collins says.

How to Find the Best Birth Control for You

In addition to considering the information above, it’s a smart idea to book an appointment with your doctor to discuss what the best birth control for you is given your health history, lifestyle, and future reproductive plans.
“Each woman should have a discussion with either their gynecologist or their reproductive endocrinologist about their concerns and desires to match the best form of contraception with what would work best for her lifestyle,” Collins says.
When you’re talking to your doctor, consider these questions:
Do you plan to have children in the future? When?
This question can help you identify how long you would like your birth control to last.
Do you have other health concerns?
Sometimes a birth control method isn’t a good choice for women with certain health conditions. If you’re a smoker, have physical or mental health conditions, or have painful periods, these factors need to be part of your discussion with your doctor about the best birth control given your needs. You want one that is safe to use with your condition or can even help alleviate it, Collins says. In addition, it’s important to talk about any other medications that you’re currently taking, since some medications can affect the reliability of birth control.
If you’re particularly concerned about uterine cancer (perhaps due to a family history), the patch, pill, ring, and shot can offer some protection. The patch, pill, and ring can also help protect you from ovarian cancer.
Have you experienced positive or negative side effects from birth control in the past?
Think about your experiences with past birth control options. Have you gained weight on the pill, for example, or had your acne clear up? Perhaps you enjoyed not getting a regular period when you had an IUD. Think about what has worked well for you in the past (and what hasn’t), and discuss both good and bad side effects with your doctor.
What does your sex life look like?
Considering your sex life is a huge part of finding the best birth control for you. For example, if you have multiple partners, no matter what birth control method you use, you’ll also want to use a birth control method that prevents STIs, like male condoms, Collins says. If you rarely have sex, you might be more comfortable relying on as-needed methods, whereas if you are frequently sexually active, you might want a birth control form that you don’t need to think about in the moment.
If you try something new but suspect it might not be the best birth control for you, try to give it six months before changing, Collins recommends. Of course, if your symptoms are severe (like chest pain or shortness of breath) stop the birth control immediately and call your doctor.
Finding the best birth control for you can be an intensive process, but Grossman says it is important: “Knowing which method best suits your lifestyle is important to your overall health and well-being, and ultimately, for avoiding unintended pregnancy.”
[related article_ids=21584,1000990]

If you’re getting headaches nearly every day, you might think it’s fairly normal. Whether they go away after you pop a few ibuprofen or they turn into monstrous migraines, getting headaches on the regular can be debilitating, even when the pain isn’t severe. In some cases, they can be a sign of serious medical conditions.
While we can safely say that headaches are a common issue, it’s difficult to estimate the scale of the problem. The National Health and Nutrition Examination Survey found that 22.7 percent of adults reported having severe headaches within the last three months, while the 2011 National Health Interview Survey put the number at 16.6 percent. At least you know you aren’t alone.

Still, you might be wondering when you should seek medical treatment for headaches.
“As soon as the person develops headaches that are unusual, or if they’ve had headaches on a regular basis, they should see a doctor,” says Alexander Mauskop, MD, director of the New York Headache Center and a fellow of the American Academy of Neurology. “Or if they have a headache that’s accompanied by a fever, or if they start out of nowhere, and suddenly you’re having them daily.”
If that doesn’t sound like you though, it’s good to know that some types of everyday headaches can be successfully treated fairly quickly, once you’ve identified what’s triggering them. You might even be able to prevent your everyday headaches—and even some migraines—by committing to certain lifestyle changes.

What to Know When You’re Getting Headaches Every Day

Let’s get this out of the way: Getting severe headaches every day isn’t normal, so you should talk to your doctor, especially if they come on suddenly. Some headaches can indicate neurological disorders that require treatment, and sudden, severe headaches are always a cause for concern.

So, what’s a “severe headache” exactly? Most headaches fall into one of three general categories:

Tension Headaches

The most common type of headache, tension-type headaches can be described as a pressing or tightening pain. You might experience sensitivity to light or sound but nausea is less common.

Most people who experience tension headaches often don’t consult with doctors, and over-the-counter painkillers like ibuprofen and aspirin might be all you need to deal with these suckers. However, constant tension headaches may indicate an underlying medical condition, and they’re certainly debilitating for some people.

Migraine Headaches

The classic description of a migraine is “the worst headache you’ve ever had.” If you’re not sure whether or not you’re having migraines, you probably aren’t having them. Frequently misdiagnosed, migraines are usually characterized by severe pain that seems to start on one side of the head. Like tension headaches, light and sound sensitivity is common with migraines, but so is nausea. In addition to that, many people experience visual disturbances like shimmering lights or zigzagging lines, sometimes known as auras.

About 12 percent of the United States population experiences migraines. “Women are three times more likely to get migraine headaches than men,” Mauskop says. “It’s usually a genetic predisposition. On top of that, predisposition can be influenced by various triggers.”

Cluster Headaches

Think that cluster headaches are the same thing as migraines? Think again. Cluster headaches tend to occur along one side of the head or in a cyclic pattern behind the eyes or temples (hence the “cluster” name). They can occur for several weeks, and they’re often severe. However, cluster headaches are uncommon, particularly for women.

If you suffer from cluster headaches, you’ll want to see your doctor. While effective treatments are available, they include high-flow oxygen and subcutaneous injections, both of which need to be administered by a medical professional.

Since cluster headaches and migraines stem from neurological issues, they should be medically evaluated. They’re the “severe” headaches we referenced earlier.

If you’re suffering from tension headaches seemingly every day, or if you’ve had migraines in the past and they’re starting to occur slightly more often, you can try to reduce the frequency and severity of the headaches by making a few changes.
Just remember that if you’re not able to successfully treat the problem on your own, you’ll need to tell your doctor. There’s no good reason to live with any type of chronic pain.

Why You Seem to Get Headaches Every Day

A variety of triggers can cause or contribute to everyday headaches, but if you can’t figure out what those triggers are, you won’t have much luck fixing the issue
Some of the most common triggers include stress, dehydration, poor posture (yes, really), allergens, caffeine withdrawal, and nutritional deficiencies.

With tension headaches, experts believe that these triggers affect the skin, sinuses, blood vessels, and other structures more sensitive to pain or the muscles stretched across those structures, resulting in pain. In the case of migraines, the mechanisms are a bit more complex, but in the end, your goal is the same: Remove the triggers, and enjoy a (hopefully) headache-free life.

One of the most common headache triggers is stress, so we’ll address that first. Grab your comfy pants, because you’re going to need them.

Using Meditation to Control Everyday Headaches

People who suffer from migraines and tension headaches every day (or close to it!) are far more likely to use alternative medicine than those who don’t. Meditation seems most successful, but there’s also not much else that has substantial scientific support.
“Meditation can be very effective,” Mauskop says. “We’ve noticed significant improvements in patients who take on meditation as a part of their treatment.” If you’re getting headaches every day, consider starting meditation.

A 2014 study showed that getting migraines or tension-type headaches every day can lead to feeling stressed—wonder why! What’s more, the headache itself can cause stress, which in turn adds to the pain of the headache (thanks, brain). Exercise can effectively treat stress, but you probably won’t feel like going on a five-mile run while you’re nursing a bad headache every day, so try to get your exercise in before the headache strikes.
In addition to treating stress, exercise can “reduce the frequency and intensity of headaches and migraines,” according to the American Migraine Foundation. The key word here is regular, so commit to a certain amount of exercise per day and don’t let anything interfere with that time.

The Link Between Caffeine and Everyday Headaches

Does caffeine cause those constant headaches or does it cure them? The answer: both.
“Caffeine is a double-edged sword,” Mauskop says. “Over-the-counter medicines often include caffeine. However, headaches can worsen as a result of withdrawal mechanisms, as every regular coffee drinker probably knows. But it can help in small amounts.”
Caffeine causes the blood vessels to constrict, reducing blood flow, which is exactly the opposite of what happens when you’re having a headache or migraine. The pain-relieving effect is significantly improved when combined with acetaminophen and aspirin, which, thankfully, are over-the-counter painkillers.

However, too much caffeine can cause a rebound effect, which can trigger a headache. If you’re drinking multiple cups of coffee a day, that could be to blame if you’re getting a headache every day.
The National Headache Foundation recommends a daily caffeine intake of 200 milligrams or less. If you’re a regular coffee or tea drinker, you might want to monitor your intake to make sure that you’re under that number. A single cup of coffee can contain anywhere from 125 to 200 milligrams, so consider switching to a half-caff or decaf option if you’ve got a serious habit.

Changing Your Diet When You Get Headaches Every Day

Certain nutritional deficiencies seem linked to the development of severe, constant headaches, especially migraines.

“We often provide supplements to patients, for instance, magnesium supplements,” Mauskop says. “That can be dramatically effective.”

Magnesium supplements can effectively reduce the frequency of migraines. Magnesium may also play a role in the development of tension headaches, but there’s much less scientific support for that hypothesis.
Some migraine patients also show lower levels of folic acid, vitamin B6, and vitamin B12, and supplementing with these vitamins can reduce migraines. Before supplementing, consider whether you could naturally increase your intake of these vitamins by changing your diet. Good sources of folic acid, for example, include vegetables like avocado, lettuce, and spinach.

CoQ10 is an antioxidant that migraine sufferers may benefit from. While over-the-counter supplements are available, natural sources of CoQ10 include [linkbuilder id=”6681″ text=”soybean oil”], beef, broccoli, roasted peanuts, and certain fish. CoQ10 deficiencies are rare in people with varied diets, but if you’ve been eating a restricted diet and you’re getting headaches every day or noticing a change in the severity of your headaches, consider adding a little variety to your diet.
For tension-type headaches, vitamin D deficiency may be a trigger. Constipation is also thought to be a common trigger, and research indicates that resolving constipation can also resolve the headaches you’re getting every day (so load up on your fiber).
Finally, make sure you’re getting enough fluids. According to some sources, up to 75 percent of Americans suffer from chronic dehydration. On top of that, water deprivation is thought to be a major cause of both tension and migraine headaches.

A Unique Approach to Fixing Everyday Headaches

If you’re having trouble figuring out why you get headaches every day, try tracking information about your diet, water intake, and stress levels.

You might also add sleep time, exercise, and other factors that could potentially play a role in headache development. Be consistent; while keeping a diary might feel pointless at first, the information could prove vital when you’re looking for ways to treat the issue.

When Your Everyday Headaches Mean You Need a Doctor

If you’re unable to treat your constant headache issues on your own, see your doctor. Alternative treatments are tempting, but in severe circumstances, medical intervention is absolutely essential.
“Treatment options include abortive drugs that you take as needed, just as you would with an over-the-counter drug,” Mauskop says. “There are things like Imitrex and similar drugs in that category.”

What about migraines? A 2014 study published in The Journal of Headache and Pain found that Botox—yes, that Botox—“reduced the number of headache and migraine days, and increased the number of headache free days” while significantly improving patients’ quality of life.

If you’re skeptical about Botox, Mauskop says that patients will soon have other options. “There’s a new category of drugs coming out this summer that have been subjected to all of the phases of testing,” he says. “They’re called monoclonal antibodies, and they bind to a chemical that releases the headaches for up to three months.”
Monoclonal antibodies have been hailed as a “breakthrough migraine therapy,” and they’re part of a new class of immunotherapy treatments.
If you’re truly suffering from headaches every day, doctors have a variety of ways to help patients treat severe daily headaches. If you’ve tried meditation, exercise, and supplementation, and even OTC pain meds aren’t doing a thing, get to the doctor; it’s worth getting checked out.