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Did your aunt suggest treatment of depression using herbs again? They might help! Learn the causes of depression and treatment by experts at Meri Sehat.

Do Supplements and Herbs Cure Depression?

This article or video has been vetted and verified by Meri Sehat’s specialists. It contains citations and research from validated sources.

Do Supplements And Herbs Cure Depression?

Madeeha Syed

Can't Go To Sleep? Here’s Why And How To Fix It

Overview

You&rsquo;re lying in bed, trying to fall asleep. You&rsquo;ve tried everything: reading a book, taking a bath, meditating, nothing seems to work. If this sounds like you, don&rsquo;t worry, I&rsquo;m here to help. In this article, we&rsquo;ll explore some of the most common reasons why people can&rsquo;t fall asleep and what you can do about them. 
&nbsp;

trick your body into sleeping

It&rsquo;s hard to shut down the mind, but if you can allow yourself to be free of all thoughts, worries and overthinking, it&rsquo;s easier to get a good night&rsquo;s sleep. This is why meditation has become so popular as a way to relax and clear your mind.

If you are having trouble going to sleep at night because you have too much on your mind, try focusing on relaxing exercises, such as taking deep breaths for 10 minutes or listening to calming music before bedtime.

If you feel like there is simply too much for your mind to process before bedtime, try not to think about anything at all until after midnight (or whenever you plan on falling asleep). That means no worrying about things that happened earlier in the day or what needs doing tomorrow morning&mdash;just let everything go until it&#39;s time for bed!

&nbsp;

Your environment can also influence the quality of your sleep. If you are sharing a bed with a partner who snores, or have pets that are noisy at night, this can affect your ability to get into REM and deep sleep stages of sleep. If you suffer from these problems, try to keep your pets out during night time.

&nbsp;

If you nap during the day, this can make it harder to fall asleep at night. This is because napping reduces your total sleep time and delays your internal circadian rhythm. In other words, it makes for a long period of time with reduced sleep quality and quantity, which makes falling asleep at night even more difficult.

Napping during the day also makes you feel groggy when it&rsquo;s time to go to bed. It&rsquo;s like drinking coffee in the morning. Once the caffeine has worn off, you may find yourself struggling to stay awake until lunchtime, instead of the usual 3pm!

If you want an afternoon nap but don&rsquo;t want these side effects on your nighttime slumber, consider power naps (naps lasting between 15 minutes and 1 hour), instead of full-on snoozing sessions (which can last longer than 90 minutes). Naps are great if they help improve alertness or performance, however, they shouldn&#39;t be used as a substitute for nighttime sleep if that&rsquo;s what you need most!

&nbsp;

You may have heard that it&#39;s important to go to bed at the same time every night and wake up at the same time every morning. This is true, but even more important is your schedule on weekends and weekdays. If you get enough sleep every night, then it doesn&rsquo;t matter if you sleep in on Saturdays or stay up late on Sundays, your body will adjust to these changes when they happen.&nbsp;

However, if you&rsquo;re not getting enough sleep overall, especially if it&rsquo;s because of inconsistent nighttime habits, then your body might have trouble adjusting to irregular schedules.

&nbsp;

Imagine this scenario: you go to bed at 10pm as usual, but you&rsquo;re not tired. You try and get comfortable, but you can&rsquo;t stop thinking about all of the things that happened during the day &mdash; the conversations you had with colleagues, how much work is left to do tomorrow, or what your friends are doing right now. You start worrying about them and then feel guilty because they don&rsquo;t have time for a phone call when they could be sleeping.&nbsp;

Then another thought pops into your head: did I switch off my iron? Should I check? Now we all know that checking whether an appliance is turned off isn&rsquo;t going to help us sleep any better than worrying if our friends are safe (unless there&rsquo;s a fire nearby somewhere), but this process repeats itself over and over again until suddenly, it&rsquo;s 2am, and there&rsquo;s no hope for rest tonight either!

So how can we avoid these situations? The key is finding something else, anything else, to occupy our minds instead of keeping track of every single little thing that crosses our minds throughout the day.

&nbsp;

Pillow size is another important consideration. Your pillow should be firm enough to support your head and neck, but soft enough to mold around your head and neck as you sleep. A proper pillow will also allow you to keep your spine in alignment while sleeping on either side or on your back, which helps with good posture.

If you have been using the same old pillows for years, it may be time for an upgrade. If a new pillow doesn&rsquo;t work right away, try adjusting its height (keep adding or removing stuffing) until you find one that works for you 
&nbsp;

Don&rsquo;t forget about the other side of the bed - do not share a bed with someone if that person snores heavily. Snoring can really affect quality of life. If a partner snores loudly enough at night that it keeps other people awake or keeps them from getting enough sleep themselves, then this could lead to fights between couples over who gets up earlier so they don&rsquo;t disturb their spouse&#39;s slumber. This problem can be resolved by setting up separate bedrooms for each person or getting rid of noisy beds altogether by buying two twin mattresses instead!

&nbsp;

If you can&rsquo;t get to sleep, it could be for any number of reasons. There are a lot of things that can keep you from drifting off into blissful slumber.

<ul>
	<li>You have too much going on. If there&rsquo;s something weighing on your mind, or if you&rsquo;re in an environment that&rsquo;s too stimulating (like a loud restaurant or party), try taking a moment to reflect on everything that&rsquo;s stressing you out and how it might affect your sleep quality. Try jotting down some notes and setting aside time tomorrow to talk over those issues with someone else so they&rsquo;re not still bothering you when it&rsquo;s bedtime.</li>
	<li>You napped during the day or had too much caffeine/food/alcohol before bedtime. When we nap during the day, we tend to wake up feeling more alert than usual, and while this can be helpful if we have somewhere important to go after work and need the extra boost, it can also hinder our ability to fall asleep at night when all we want is rest.</li>
	<li>Your sleep schedule is off-kilter or irregularly shifted throughout the week due to travel changes etcetera. This will make it harder for us humans whose bodies are programmed over thousands of years by evolution just like all animals&rsquo; bodies, except ours has evolved way faster so now sometimes ours needs work done on them sometimes too. Thus, needing proper rest does matter, so here are some tips. 
	&nbsp;</li>
</ul>

If you are listening to music, watching TV, or playing video games, shut it off! Your brain may be losing focus and this makes it hard for you to sleep.

If you can&rsquo;t sleep, get up and do something else before going back to bed. The more time spent lying awake in bed the more difficult it becomes to fall asleep again.

&nbsp;

On a personal note, I have always <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle" target="_blank">struggled with sleeping</a>. When I was younger, I had to have my mom read me bedtime stories to help me fall asleep and would still be up way past midnight reading under my covers. These days, it&rsquo;s not as bad but there are still nights where my mind won&rsquo;t shut off and I find myself lying awake for hours. Sometimes it&rsquo;s because of something that happened earlier in the day or week; other times it&#39;s just a matter of getting enough rest.

As you can imagine, this can be frustrating when you want nothing more than to turn off your brain and go to sleep! But there are ways you can get better at falling asleep faster, and even staying asleep all night long if you want.

&nbsp;

Bottom Line

If you have tried all of these tricks and still can&rsquo;t sleep, there&rsquo;s nothing left to do but wait it out! Just remember, sometimes things happen in life that are out of our control. If you are lying there tossing and turning, just try to breathe deeply and stay calm. It may take some time for us humans to get back into a <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle">regular sleeping cycle</a> again, so don&rsquo;t be discouraged if you&rsquo;re stuck in bed all day without any hope of going anywhere else anytime soon!

Umna Salah

Humza Khizer

Baby Blues (Postpartum Depression): Is There A New Treatment?

The entire process of pregnancy is very rewarding, but what happens after you have delivered the baby? Your body that has gone through so many constant changes over the 9 months, reverses them all to get you back to normal. This process often leads to postpartum <a href="https://www.merisehat.pk/disease/depression">depression</a>.

About 11% of women in the United States suffer from postpartum depression (PPD).<a href="#accordion">[4]</a>&nbsp;PPD affects not just the life of the mother but also the infant. If left untreated, it can get worse and affect your spouse or other people close to you. So far, the treatment used for PPD has been very generic; similar to that of major depressive episode (MDE) consisting of conventional antidepressants like SSRIs, benzodiazepines, and tricyclic antidepressants. FDA has recently approved the first-ever drug targeted toward treating postpartum depression. 
&nbsp;

Understanding The Latest Treatment For Postpartum Depression

Postpartum depression is best explained as a worsened form of postpartum blues or baby blues. Baby blues are experienced a few days after delivery. Some new moms, however, experience a much more severe case of baby blues that can be classified as postpartum depression and it can go on for over a year.<a href="#accordion">[8]</a>&nbsp;PPD is characterized by:

<ul>
	<li>Feeling depressed and low</li>
	<li>Sleeping too little or too much</li>
	<li>Feeling tired all the time</li>
	<li>Doubting yourself as a mother</li>
	<li>Thinking that you do not want the baby</li>
	<li>Excessive crying</li>
	<li>Loss of appetite</li>
	<li>Anxiety and panic attacks&nbsp;</li>
	<li>Thoughts of harming yourself or the baby</li>
	<li>Unable to think clearly or make the right decisions</li>
	<li>Increased anger and irritability</li>
	<li>Overall reduced interest in everything</li>
</ul>

If you or anyone that you know are facing any of these symptoms, immediately contact your physician and get yourself screened through the Edinburg Postnatal Depression Scale (EPDS). It is one of the most common and quickest screening tools with high accuracy and allows your physician to assess the situation better through the score.&nbsp; 
&nbsp;

A lot of factors contribute to postpartum depression.The biggest factor that is not only responsible for PPD but also for the baby blues is the drastic change in hormones. During pregnancy, your estrogen and progesterone levels are very high. As soon as the baby is delivered, these levels are dropped drastically.

Since estrogen is directly linked to increasing serotonin levels in our brain&nbsp;and progesterone is known for stimulating dopamine release, the decrease in the production of these hormones coupled with some underlying mental issues or previous history of depression or anxiety becomes the most common and the biggest cause of PPD.<a href="#accordion">[2][3][7]</a> 
&nbsp;

While screening of postpartum depression can be done by several tools that are used for Major Depressive Episodes (MDE), the most universally acceptable tool targeted especially for PPD is Edinburgh Postnatal Depression Scale or EDPS. EDPS is a 10-item questionnaire with a response score of 0 to 3. If the total score is over 12, then there is a need for further in-depth assessment of the situation and severity of the condition.&nbsp;

PPD is best diagnosed by your medical practitioner through regular visits. Your doctor asks a series of questions every few days to assess your mental health and well-being. Another way to differentiate PPD from baby blues is to ensure that the patient has at least 3-5 of the symptoms that make up PPD. The generalized diagnostic criteria used for PPD are similar to the one used for Major Depressive Episode (MDE). Immediate attention is recommended to avoid any worsening of the symptoms and from transitioning of PPD to postpartum psychosis. 
&nbsp;

So far, the treatment of postpartum depression is similar to that of conventional major depressive disorder. Special attention is paid to the excretion of the drug and the concentration of the drug removed from the body through breast milk.

The following antidepressants are commonly used to treat postpartum depression due to their low levels of excretion in breast milk, making it safe for use if you are a breastfeeding mother:

<ul>
</ul>

<ul>
	<li>Fluoxetine</li>
	<li>Paroxetine</li>
	<li>Sertraline</li>
	<li>Bupropion</li>
	<li>Amitriptyline</li>
	<li>Doxepin</li>
	<li>Desipramine</li>
	<li>Tranylcypromine</li>
	<li>Trimipramine</li>
	<li>Desipramine</li>
	<li>Paroxetine</li>
	<li>Escitalopram</li>
</ul>

These antidepressants come with some common side effects that include nausea, vomiting, dizziness, sexual issues, diarrhea, blurry vision, weight gain, increased perspiration, etc.<a href="#accordion">[6]</a> 
&nbsp;

Brexanolone (under the brand name of Zulresso) got approved by the FDA as the first drug targeted toward PPD. Brexanolone is approved with a Risk Evaluation and Mitigation Strategy (REMS) which means that it is currently a controlled medicine available through a restricted distribution channel to carefully assess the conditions of the patients throughout the treatment. The program is currently known as Zulresso REMS Program.<a href="#accordion">[5]</a>&nbsp;Currently, to get Brexanolone administered to you for treating your PPD, you are required to enroll in the Zulresso REMS program.&nbsp; 
&nbsp;

<ul dir="ltr">
	<li>
	<h5>Mechanism Of Action</h5>
	</li>
</ul>

Brexanolone is a synthetic form of allopregnanolone. Allopregnanolone is a neurosteroid. Neuroactive steroids are a group of substances that change a receptor&rsquo;s response to a stimulus by binding to them.<a href="#accordion">[4]</a>&nbsp;Allopregnanolone is best understood as a metabolite of progesterone, which is a GABA-A receptor agonist. This means that progesterone is responsible for increasing GABA functions.

The exact mechanism of the drug and of allopregnanolone is still unknown. Their enhancement of the functions of GABA (Gamma-aminobutyric acid) means that it will inhibit neuronal excitability by blocking messages that are sent to our nervous system with the help of certain stimuli. This not only aids in dealing with depressive triggers but also helps with anxiety.<a href="#accordion">[1]</a> 
&nbsp;

<ul dir="ltr">
	<li>
	<h5>Dosage And Administration</h5>
	</li>
</ul>

Zulresso is administered intravenously. The dosage is determined by your doctor based on your weight and other factors. The drug is administered over a period of 2.5 days or 60 hours and requires constant monitoring due to the risk of unconsciousness.<a href="#accordion">[5]</a> 
&nbsp;

<ul dir="ltr">
	<li>
	<h5 dir="ltr">Adverse Effects</h5>
	</li>
</ul>

Since the drug is relatively new, there are a limited number of side effects reported so far. They include:

<ul>
	<li>Dry mouth</li>
	<li>Dizziness</li>
	<li>Flushed skin</li>
	<li>Losing consciousness</li>
</ul>

<h5 dir="ltr">Important!</h5>

FDA has advised to stop the treatment of Zulresso if more serious side effects occur that may include the worsening of PPD and suicidal thoughts especially in women under the age of 25. 
&nbsp;

Current research suggests that brexanolone may interact with other CNS depressants like opioids and benzodiazepines and increase the severity of the adverse effects with regard to sedation. Alcohol consumption is also not advised due to similar reasons.

During the clinical trials, patients who were taking antidepressants also showed a more severe case of sedation as compared to the ones who did not or were a part of the placebo studies. 
&nbsp;

Conclusion

Considering the rapid onset of action with brexanolone especially when compared to the long-term treatments offered by conventional antidepressants, it is believed that brexanolone can take over the go-to therapy for PPD. However, a much more convenient way of administration would be through oral pills instead of I/V. There are still many concerns left that can only be answered through long-term data in a lesser restricted environment as opposed to a clinical trial setting.&nbsp; 
&nbsp;

Key Points

<ul>
</ul>

<ul>
	<li>Current antidepressant therapies employed for PPD are based on&nbsp;long-term treatment.</li>
	<li>Brexanolone&rsquo;s onset of action is fast and has shown significant improvement in women of all ages suffering from PPD.</li>
	<li>Some women under the age of 25 were observed to experience severe side effects that even led to the worsening of their PPD.</li>
	<li>The drug is still under strict observation with the help of the REMS program.</li>
	<li>Administration coupled with the duration over which it has to be administered can make it difficult to commercialize as compared to drugs that are available in the form of oral pills.&nbsp;</li>
</ul>

[1] Allen B, Vespa PM. Antiseizure medications in critical care: An update. Curr Opin Crit Care. 2019;25(2):117-125

[2] ATP Science, 2021. HOW DOES PROGESTERONE CREATE A DOPAMINERGIC RESPONSE?. [Online] .

[3] Debra Fulghum Bruce, P., 2020. Postpartum Depression. [Online].

[4] Fala, L., 2019. Approved by the FDA Specifically for Postpartum Depression in Adults. [Online]

[5] Federal Drug Administration, 2019. FDA approves first treatment for post-partum depression. [Online]

[6] Fields, L., 2021. Which Antidepressants Treat Postpartum Depression?. [Online]

[7] Matthew Hoffman, M., 2021. Estrogen and Women's Emotions. [Online]

[8] Mayo Clinic, 2022. Postpartum depression. [Online]

This article or video has been recorded by a subject / domain specialists with a proven track record of excellence in their area. 

Should I Be Anxious About My IBS?

Introduction

<a href="https://www.merisehat.pk/disease/irritable-bowel-syndrome-62">Irritable Bowel Syndrome (IBS)</a> is defined as a type of gastrointestinal condition that causes problems in the digestive system. IBS affects 10 to 15 percent of the world&rsquo;s population. However, the symptoms are different for every person. While IBS is not a life-threatening condition, it can have a significant impact on one&rsquo;s well-being by affecting one&rsquo;s quality of life. The situation worsens when a person suffers from anxiety and IBS.

&nbsp;

Understanding Link Between Anxiety And IBS

Anxiety disorders is an umbrella term used for general anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD) and social anxiety disorder. A shared symptom of these disorders is excessive worry or anxiety.&nbsp; Physical symptoms of anxiety disorders include fast heart rate, sweating and fatigue. This may interfere with one&rsquo;s ability to get through normal everyday activities.&nbsp;

&nbsp;

IBS is a disorder of the digestive tract that causes abnormal bowel movements. Unlike Crohn&rsquo;s disease or ulcerative colitis, the physical structure of the digestive tract is unaffected, i.e. IBS is not a functional disorder. Common symptoms of IBS include diarrhea, constipation, and abdominal pain. Anxiety disorders affect more than a third of all U.S. adults while IBS affects 7% to 21% of the U.S. population. However, there is no reliable data for how many people experience both anxiety disorder and IBS. Some studies have shown that anxiety disorders are more common in people with IBS. According to a study assessing the prevalence of anxiety disorders and IBS, 44% of people with IBS had an anxiety disorder, compared to 8% of people without IBS.&nbsp;

&nbsp;

According to scientists, the mind and gut are intertwined. This is what scientists refer to as the gut-brain axis, which is a two-way signaling system between the gut and the brain. In response to our thoughts, feelings, and environment, our bodies release chemicals that affect different processes in our bodies. However, in the case of anxiety and IBS, whenever you feel anxious, your body releases stress-related chemicals in the gut causing inflammation leading to abnormal bowel movements, abdominal pain, and a change in gut bacteria.

Additionally, a poorly functioning gut has also been linked with mental health problems. Scientists explain that this is because our brain depends on the chemicals and hormones made by the bacteria in the gut for e.g. 90% of the serotonin (which is an important chemical that controls our mood and keeps anxiety levels low) is produced in our gut. Mental health problems are associated with increased and decreased production of serotonin.&nbsp;

&nbsp;

Unfortunately, the causative factors of IBS have yet to be elucidated. However, there is reason to believe that it may depend on a person&rsquo;s mental health. Anxiety and other health conditions may trigger IBS.&nbsp;

Certain other risk factors may increase one&rsquo;s risk of IBS, including:&nbsp;

<ul>
	<li>Having a family history of IBS&nbsp;</li>
	<li>Females are at a higher risk of developing IBS than males</li>
	<li>Being younger than 50 years of age</li>
	<li>History of severe gut infections&nbsp;</li>
	<li>Chronic psychological stress either caused by traumatic life events or alcohol addiction&nbsp;</li>
	<li>Smoking&nbsp;</li>
	<li>Certain medications that cause changes in the gut bacteria</li>
</ul>

&nbsp;

Studies have shown that keeping stress under control can help prevent or ease the symptoms of IBS. This is because the gut has a brain of its own, known as the enteric nervous system which is why you get butterflies in your stomach when you are nervous. Also, this &ldquo;second brain&rdquo; of yours also controls how food is digested. This second brain is in constant communication with your brain via the gut-brain axis. Thus, this connection can help manage your IBS. You can try and get rid of the tension by incorporating simple things in your daily routine, for example, going shopping, listening to music, reading, or talking to a friend. Other ways to alleviate stress and anxiety include:

&nbsp;

<ul>
	<li>
	<h5>Exercise&nbsp;</h5>
	</li>
</ul>

Exercising, for example, walking, swimming, running or other such physical activities can help you cope with anxiety and depression. Exercise also helps with normal bowel contractions.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Mind-Body Exercise, Mindfulness, And Meditation&nbsp;</h5>
	</li>
</ul>

Meditation can help trigger your body&rsquo;s relaxation response. You can either sign up for meditation, breathing or yoga classes offered online or in person. They will help you manage stress by targeting the gut-mind connection and changing the way you think.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Relaxation Exercises&nbsp;</h5>
	</li>
</ul>

Relaxation techniques, such as deep breathing, can help you feel calmer. The purpose of relaxation techniques is to learn about visualization and to imagine a peaceful scene. These techniques will also help you get enough sleep and eat well. You can also consider joining a self-help group for people with IBS or other digestive disorders. Members of the group will know what it is like to deal with IBS and may also be able to offer more meaningful support that you may not be able to get from even your closest friends.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Diet And Lifestyle Changes&nbsp;</h5>
	</li>
</ul>

The food we eat has a huge impact on our overall health. Your stomach and intestines are some of the first organs that feel the effect of the food you are eating. For treating IBS, you must start with your diet. There are specific foods that can trigger the symptoms of IBS. However, these triggers differ for everyone. Maintain a food/bowel movement journal wherein you can write about how different foods affect your bowel movements. This journal could also be helpful for discussing treatment options with your doctor. Research shows that avoiding certain foods can help prevent symptoms of IBS:&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Gas-Producing Foods</h5>
	</li>
</ul>

People with IBS are more sensitive to foods that make a person gassy for example, beans, bananas, and brussel sprouts. These foods may trigger discomfort after eating them.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Dairy&nbsp;</h5>
	</li>
</ul>

Even if lactose is not an issue for you, you may be sensitive to other milk proteins due to your IBS.&nbsp; Try using dairy-free alternatives, such as soy or oat milk to ease bloating and other stomach issues.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Foods High In FODMAPs</h5>
	</li>
</ul>

Foods high in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are short carbohydrates, such as fructose and sorbitol that appear in many fruits, vegetables, honey, and wheat. Studies have shown that these FODMAPs can linger in our guts, absorb water, and ferment, which can then cause irregular bowel movements. If you struggle with constipation, then it is recommended you stay well hydrated and eat 4-5 small meals regularly rather than eating 3 large meals a day. A diet high in fiber and soluble fiber, such as psyllium may also be helpful. Similarly, alcohol, tobacco, and caffeine aggravate symptoms of both IBS and anxiety, so reduce their consumption.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Cognitive Behavioral Therapy&nbsp;</h5>
	</li>
</ul>

Studies have shown that cognitive behavioral therapy is an effective treatment for IBS. However, before starting with CBT, practitioners need to rule out alternative diagnoses. The most important medical conditions to rule out include inflammatory bowel disease, Crohn&rsquo;s disease, and celiac disease. Baseline blood and stool tests are generally enough to rule out these conditions. The next step is to educate the patient about the gut-brain link and how stress can directly impact gut health.

The CBT practitioner will first help train the patient in relaxation techniques including deep belly breathing. Once the patients are able to use the relaxation techniques CBT is introduced. The focus of CBT is to educate the patient that the beliefs that affect our emotions negatively can be baseless. For example, if a person is embarrassed to go to the bathroom in a public place, it can be helpful to send them to a movie theater and have them sit at the back of the theater to count the number of people who get up to use the bathroom and return. The patient will be able to see two things: the frequency of people getting up to use the bathroom and the lack of reaction towards this behavior by the surrounding people. This will help the patient understand that it is not a big deal to get up and use the bathroom.&nbsp;

Similarly, CBT exposure therapy focuses on patients overcoming their fear of doing things that they have been avoiding. For example, if a person is afraid of long car trips, make them sit in a parked car for thirty minutes. Once this gets boring, drive them around the area. Once this gets easy, drive them a mile away from home and back. If the patient worries about not being able to &ldquo;hold it&rdquo;, experiment with them to &ldquo;hold it&rdquo; for 30 seconds, then a minute, and then 5 minutes. This will prove that they can hold it and worry is unnecessary.

&nbsp;

<ul>
	<li>
	<h5>Medications&nbsp;</h5>
	</li>
</ul>

If diet and lifestyle changes are not enough to curb the problem of anxiety and IBS, many medications will help relieve symptoms.

<ul>
	<li>Metamucil, or soluble fibers available over the counter, for constipation relief.</li>
	<li>Miralax helps pull water into the intestines and encourages bowel movements.</li>
	<li>Medications approved by the FDA for IBS-related constipation, Amtizia, Linzess, and Zelnorm.&nbsp;</li>
	<li>Antidepressants, including tricyclic antidepressants and selective serotonin reuptake inhibitors.</li>
	<li>Imodium is a popular over-the-counter medication that slows down gut and bowel movements and treats IBS-related diarrhea.&nbsp;</li>
	<li>Antispasmodics relax the muscles of the digestive system and relieve IBS-related abdominal pain.&nbsp;</li>
</ul>

&nbsp;

<ul>
	<li>Although there is no clear answer as to how anxiety affects your IBS or vice versa, both conditions are triggered by many different factors.</li>
	<li>If you have IBS, then there are many treatment options (medications, cognitive behavior therapy, etc.) and lifestyle changes that have been shown to help relieve symptoms and stress.&nbsp;</li>
	<li>You can discuss these treatment options with a healthcare provider and implement whatever works best for you.</li>
</ul>

&nbsp;

[1] Banerjee, A., Sarkhel, S., Sarkar, R. and Dhali, G.K., 2017. Anxiety and depression in irritable bowel syndrome. Indian journal of psychological medicine, 39(6), pp.741-745.

[2] Locke, G.R., Olden, K., Peterson, W., Quigley, E., Schoenfeld, P., Schuster, M. and Talley, N., 2002. Systematic review on the management of irritable bowel syndrome in North America. Am J Gastroenterol, 97, pp.S7-26.

[3] Camilleri, M., 2018, December. Management options for irritable bowel syndrome. In Mayo Clinic Proceedings (Vol. 93, No. 12, pp. 1858-1872). Elsevier.

[4] Johns Hopkins Medicine: "The Brain-Gut Connection."

[5] U.S. National Library of Medicine: "Irritable bowel syndrome treatment: cognitive behavioral therapy versus medical treatment."

Staff Writer

Are My Mental Health Symptoms Linked With HIV?

It is normal to feel depressed and sad when you have HIV, and if over time you feel the sadness is becoming worse, talk to your healthcare provider. You might require <a href="https://www.merisehat.pk/disease/depression">treatment for depression</a>.

&nbsp;

Understanding Mental Health Issues In HIV Patients

The symptoms of depression last for more than two weeks and include the following:&nbsp;

<ul>
	<li>Feeling anxious, sad, hopeless, and irritable</li>
	<li>Loss of weight or weight gain</li>
	<li>Insomnia or sleeping more than usual</li>
	<li>Difficulty in sitting still</li>
	<li>Slow-paced movement and walking</li>
	<li>Loss of interest in things you once enjoyed</li>
	<li>Tiredness</li>
	<li>Worthlessness and guilt</li>
	<li>Having a hard time concentrating</li>
	<li>Suicidal thoughts</li>
</ul>

&nbsp;

There are multiple mental health aspects that you deal with when you have HIV. Some of them are the challenges you face that are associated with HIV and its diagnosis. Moreover, suggestions on how to cope with them can also be irritating.

 
You may experience all or some of the following symptoms:

&nbsp;

<h5>1. Denial</h5>

When you are diagnosed with HIV, it can become very hard to admit the diagnosis for some people. They usually end up denying it and believe that the test results are wrong. This is a very natural and normal first reaction, but not dealing with it can be dangerous. You may end up failing at taking precautions for HIV or even starting your medication on time. So it is important to talk to your physician right away and begin the treatment, in addition to the support you need.

&nbsp;

<h5>2. Anger&nbsp;</h5>

Anger is the most common feeling when you are diagnosed with HIV. A lot of people get upset because they don&rsquo;t know how they got infected by the virus. Most of these feelings can lead to feeling overwhelmed and helpless. However, you can deal with the situation in the following ways:

<ul>
	<li>Talk to your healthcare provider about the treatment of depression, for example, therapy or medications.</li>
	<li>You should also start with HIV treatment if you haven&rsquo;t already and that will be a positive step towards treatment. Moreover, it will also help with depression.</li>
	<li>Joining a support group is also a good option because spending time with other people in a similar situation can help your feel at ease. If you don&rsquo;t want to do that, you can talk to your family and friends who are supportive.</li>
	<li>Avoid being in contact with people who make your condition worse.</li>
</ul>

&nbsp;

<h5>3. Sadness And Depression</h5>

It is completely normal to feel sad when you have HIV, and if the depression or sadness does not go away with time, you can talk to your healthcare provider. You might require treatment for depression. 
&nbsp;

<h5>4. Fear And Anxiety</h5>

When you don&rsquo;t know what to expect after being diagnosed with HIV, fear and anxiety may take a toll on your mental health. Furthermore, you may also fear telling people because you are unsure how they will treat you.&nbsp;

The fear of having the disease can make you anxious and disrupt your sleep. Moreover, anxiety can also make you feel agitated and nervous. You may also be afraid of telling people because you may fear how they will treat you after knowing that you have HIV.

You can manage the fear and anxiety in the following ways:

<ul>
	<li>Talk to a psychiatrist about the possible treatment for anxiety if the feelings are chronic and do not lessen with time, or get worse.</li>
	<li>Educate yourself about HIV.</li>
	<li>Start antiretroviral treatment or ART for HIV. When you take the required action to control your HIV, you will also protect yourself and your partners. Moreover, this can also help in lessening your fears about the future.</li>
	<li>Talk to your healthcare provider and family.</li>
	<li>Sign up for a support group.</li>
	<li>Volunteer at services that has people dealing with the same situation. This can help you in empowering yourself and can also lessen your fear.</li>
</ul>

&nbsp;

The medications that are used in the treatment of HIV and AIDS can affect your brain. When HIV infects the brain alone, it can create problems in thinking and movement. The symptoms of HIV-associated neurocognitive disorders are the following:

<ul>
	<li>Confusion</li>
	<li>Forgetfulness</li>
	<li>Sudden change in mood and behavior</li>
	<li>Weakness in the muscles</li>
	<li>Difficulty in paying attention</li>
	<li>Clumsiness</li>
</ul>

&nbsp;

<h5 dir="ltr">Important!</h5>

Tell your healthcare provider if you think you have HAND.

<ul>
	<li>Don&rsquo;t be scared to tell your healthcare provider if you feel something is wrong.</li>
	<li>Whenever you feel the symptoms are unusual, note them down and keep this information to show your doctor the next time you visit them.</li>
	<li>Building maximum support is helpful, which includes your friends, family, and healthcare providers. Although the treatment of HAND is possible, it does take some time for the symptoms to resolve or completely go away.</li>
</ul>

&nbsp;

<ul>
</ul>

<ul>
	<li>Depression and HIV are linked. Always inform your doctor if you have depression, or if you think you do. They will help you in planning the right treatment.&nbsp;</li>
	<li>Don&rsquo;t give up if one treatment does not work.&nbsp;</li>
	<li>Your healthcare provider can help you in formulating a plan which works best for you. For example,&nbsp;talk therapy, cognitive behavioural therapy, support groups, medications (including anti-depressants), and techniques to reduce stress.</li>
	<li>Remember, healing takes time.&nbsp;</li>
</ul>

&nbsp;

[1] Nanni, M.G., Caruso, R., Mitchell, A.J., Meggiolaro, E. and Grassi, L., 2015. Depression in HIV infected patients: a review. Current psychiatry reports, 17(1), pp.1-11.

[2] Tran, B.X., Ho, R., Ho, C.S., Latkin, C.A., Phan, H.T., Ha, G.H., Vu, G.T., Ying, J. and Zhang, M.W., 2019. Depression among patients with HIV/AIDS: research development and effective interventions (GAPRESEARCH). International journal of environmental research and public health, 16(10), p.1772.

[3] Bhatia, M.S. and Munjal, S., 2014. Prevalence of depression in people living with HIV/AIDS undergoing ART and factors associated with it. Journal of clinical and diagnostic research: JCDR, 8(10), p.WC01.

[4] Gonzalez, J.S., Batchelder, A.W., Psaros, C. and Safren, S.A., 2011. Depression and HIV/AIDS treatment nonadherence: a review and meta-analysis. Journal of acquired immune deficiency syndromes (1999), 58(2).

Home Remedies For Mosquito Bites

Bugs enjoy summer. They have more energy to disturb you and buzz around in warm weather. Most importantly, they become like small vampires that savor every drop of your blood, and in that quest also manage to spread diseases. Mosquito bites are more prevalent in either warm climates or during monsoon season.

&nbsp;

Also, a majority of the bites take place at dusk or dawn, as that&rsquo;s when mosquitoes are extremely active. Female mosquitoes are interested in blood, while male mosquitoes merely consume water and are harmless.

&nbsp;

Not all mosquito bites are harmful, though. Sometimes, the bite causes just a large, uncomfortable, or itchy lump on the skin from where they&rsquo;ve sucked the blood; it may not even be apparent for several hours. However, a lot of times the bites can lead to a more serious health issue. According to stats, every year, 700 million people are infected with mosquito-borne diseases, which also result in a million fatalities<a href="#accordion">[1]</a>.&nbsp;

&nbsp;

The majority of people are allergic to mosquito bites. Its symptoms are more than just bothersome for people with severe allergies; they can even be life-threatening.&nbsp; 
&nbsp;

<h5>Mosquito-Borne Diseases</h5>

Diseases transmitted by a mosquito bite are referred to as mosquito-borne diseases. The diseases that mosquitoes transmit to people include&nbsp;

<ul>
	<li>Zika Virus</li>
	<li>West Nile Virus</li>
	<li>Chikungunya Virus</li>
	<li><a href="https://merisehat.pk/disease/dengue">Dengue</a></li>
	<li><a href="https://merisehat.pk/disease/malaria">Malaria</a></li>
	<li>Encephalitis Virus&nbsp;</li>
	<li>Yellow Fever</li>
	<li>Skeeter Syndrome 
	&nbsp;</li>
</ul>

Understanding Home Remedies against Mosquito Bites

1.&nbsp;Wear protective clothing

2. Apply permethrin to clothing and accessories

3. Shut the doors and windows along with their screens

4. Use temperature controlling agents or AC

5. Sleep or relax with a bed net

6. Cover buckets or water storage units

7. Use generous amounts of repellents<a href="#accordion">[2]</a> 
&nbsp;

The United States Environmental Protection Agency has created a search tool that can assist individuals in choosing the right insect repellant based on several different factors. The registered insect repellents include the following active ingredients:

1. DEET (diethyltoluamide)&nbsp;

2. Picaridin&nbsp;

3. Lemon

4. 2-Undecanone

5. Citronella

6. Garlic

7. Neem

8. Essential oils 
&nbsp;

A mosquito bite&#39;s itching and discomfort might be alleviated with natural therapies. This article looks at potential at-home cures that could provide speedy relief.&nbsp; 
&nbsp;

<h5>1. Oatmeal</h5>

One of your favorite meals might also serve as a treatment for a pesky mosquito bite. No more itching, no more swelling, thanks to its skin-healing properties.&nbsp;

&nbsp;

<ul>
	<li>DIY Oatmeal Paste</li>
</ul>

Oatmeal and water should be combined in a bowl in equal parts to create a paste. Apply this paste to the inflamed skin, then cover it with the help of a clean piece of cloth, and leave it untouched for 10 minutes. After that, wash it with normal water.

&nbsp;

<ul>
	<li>DIY Oatmeal Bath</li>
</ul>

An oatmeal bath would probably be a more effective solution if you have multiple bites all over your body. Add 1 cup of oatmeal or ground oats to a bathtub filled with warm water. You might wish to wrap the oats up initially with a piece of muslin or another light fabric to prevent any plumbing issues. Imagine it as a large tea bag that you could just throw into the bathtub. Spend 20 minutes in the oatmeal water and you&rsquo;ll be amazed at how relaxed you feel. 
&nbsp;

<h5>2. Ice</h5>

Ice and cold temperatures help lessen inflammation. Additionally, the cold temporarily numbs the skin, providing you with some quick comfort. The American Academy of Dermatology (AAD) advises using an ice pack or a cold, moist towel to soothe mosquito bite irritation.&nbsp;

&nbsp;

Avoid putting ice directly on your skin because doing so could harm it. Instead, place the ice pack in a light towel or use a washcloth for ice cubes or crushed ice. Apply it for 5-10 minutes multiple times&nbsp; in a day to reduce itching. 
&nbsp;

<h5>3. Heat</h5>

Increasing the heat helps, too. Although no proof exists to support its efficacy, you can purchase a specialized instrument like BiteAway that provides direct, regulated heat to the bite. This is said to lessen edema and irritation. The procedure saves time since it only lasts a few seconds, but these gadgets are pricey.

&nbsp;

<ul>
	<li>DIY Heat Providing Tool</li>
</ul>

An alternative to expensive machines is to dip a clean cloth in water that feels as warm as you can bear, to achieve a comparable result (be careful not to burn yourself!). Then squeeze the water out and place the towel over the bite. Re-soak the material as often as necessary to maintain the desired temperature for up to 10 minutes. DO NOT use heat therapy in case of an open wound. 
&nbsp;

<h5>4. Honey</h5>

This delicious, sugary material is a natural remedy fan favorite. For centuries, honey has been the go-to remedy for medical issues like sore throats and dry skin because of its antibacterial and anti-inflammatory properties. Just ensure that the amount of honey you apply covers the bites and let it work its magic to reduce swelling. Also, the sticky mess you can make when you scratch honey-covered skin may lessen your desire to scratch. 
&nbsp;

<h5>5. Aloe Vera</h5>

Aloe vera gel has been demonstrated to promote healing and combat burns, especially sunburn. It might also work well in treating a bug bite. Cut a tiny portion of the plant and apply it to the affected area. If necessary, reapply after it dries. 
&nbsp;

<h5>6. Baking Soda</h5>

Baking soda can be found in almost every kitchen. It&rsquo;s famous for various tasks, including cleaning drains and baking bread, but it&rsquo;s equally capable of soothing a mosquito bite. A baking soda paste can be made quickly and used in a similar way to the oatmeal paste.&nbsp;

&nbsp;

According to the Centers for Disease Control and Prevention (CDC), combine 1 tablespoon baking soda with a small amount of water and mix it until it forms a paste. Then apply it to the affected area. Rinse after 10 minutes. However, if you experience any sensitivity, for example, redness, rashes, hives, breakouts, burning, and itching, then immediately rinse and do not use the baking soda mixture.&nbsp; 
&nbsp;

<h5>7. Basil</h5>

Did you know that the flavorful basil herb also doubles as a natural anti-mosquito-bite cure? The herb is utilized in herbal treatments for skin diseases, and the antioxidant content in basil leaves may help to lessen inflammation.

&nbsp;

<ul>
	<li>DIY Basil Solution</li>
</ul>

Simmer 2 cups of water, then add 1/2 ounce of dried basil leaves to produce a basil rub. Stir the mixture occasionally until it cools. Next, soak a clean cloth in the solution and gently press it onto the bites. Alternatively, you might finely cut some fresh basil leaves and apply them to your skin. Stop using this remedy if you feel irritation. 
&nbsp;

<h5>8. Vinegar&nbsp;</h5>

Apple cider vinegar has been utilized for generations as a natural treatment for various illnesses, varying from infections to issues with blood sugar. You can use a drop of vinegar to soothe itching bites and reduce blister spots. It can also be a natural disinfectant if you&#39;ve been itching too much.

&nbsp;

<ul>
	<li>DIY Vinegar Water Solution</li>
</ul>

Soak a clean towel in a mixture of cold water and vinegar, then put it onto the bite for relief. If there are numerous bites, you can prepare yourself a warm bath with 2 cups of vinegar and immerse in it for 20 minutes. Don&rsquo;t make it too hot as that will only exacerbate itching. Stop using this remedy if skin sensitivity develops. 
&nbsp;

<h5>9. Onion</h5>

Onions can not only make you cry, but they can also soothe mosquito bites. If applied to the bite, a newly sliced bulb can reduce the sting you feel and further prevent it from aggravating. Additionally, onions have antibacterial and antifungal qualities that help lower your risk of illness. No matter what variety of onion you use, cut a slice from it, leave it on the bite for a while, and then cleanse.&nbsp; 
&nbsp;

<h5>10. Thyme</h5>

The plant&#39;s little leaves are wonderful for various foods, including fish and potatoes. They might also be able to lessen a mosquito bite&#39;s itching. Thyme has long been used as a natural skin care solution. Its antibacterial characteristics mean it can help relieve pain and itching as well as reduce chances of any infection.&nbsp;

&nbsp;

<ul>
	<li>DIY Thyme&nbsp;</li>
</ul>

Finely minced fresh thyme leaves provide the greatest benefit. Place them on your skin as soon as you feel a mosquito bite and leave them that way for 10 minutes.&nbsp;

&nbsp;

Additionally, you can create a concentrated drink by heating some water and adding a few thyme sprigs. Let the sprigs steep till the water cools down. After that, rub the thyme-infused water onto the bites using a washcloth. Keep the washcloth in place for a while. Wrapping an ice cube in a washcloth soaked in thyme makes for some extra relief and a cooling effect. 
&nbsp;

<h5>11. Peppermint oil</h5>

Another age-old natural cure for itching relief is peppermint oil. According to a 2016 study, this oil may be able to treat chronic itching brought on by illnesses, including diabetes and liver disease. So, in theory, it might also be effective for transient conditions, like an insect bite.

&nbsp;

One ounce of carrier oil, such as coconut or olive oil, should be mixed with a few drops of peppermint oil. Carefully rub a tiny quantity of this mixture onto the insect bite. For a calming soak, you may add several drops of peppermint oil to a bathtub filled with lukewarm water. You should never apply peppermint oil to your skin undiluted.

&nbsp;

When using essential oils, exercise caution because they sometimes have unanticipated side effects or interactions with medicines. Conduct thorough research, consult your doctor beforehand, and abide by all safety instructions. In fact, young children should not receive this treatment. 
&nbsp;

<h5>12. Lemon Balm</h5>

A lemon balm is a leafy plant with a strong resemblance to mint. Historically, it has been used as a calming, all-natural remedy for conditions ranging from stress to upset stomach. An earlier 1999 study discovered that a lotion with lemon balm extract helped persons with cold sores who were also experiencing other symptoms of irritation and discomfort<a href="#accordion">[3]</a>.

&nbsp;

You can use freshly chopped lemon balm leaves to treat mosquito bites or purchase a lotion containing the herb Tannin. This is a natural astringent present in lemon balm. Lemon balm also includes polyphenols. These organic substances work as a unit to lower risk of infection, promote healing, and decrease inflammation. 
&nbsp;

<h5>13. Witch Hazel</h5>

Witch hazel ( a natural astringent) can be easily purchased&nbsp; in pharmacies and supermarkets. Similar to lemon balm, witch hazel contains tannins that, when applied topically, might lessen inflammation.

&nbsp;

Witch hazel by itself can be helpful for a wide range of skin irritations, from minor scrapes and cuts to hemorrhoids. Witch hazel cream can be used to reduce swelling, ease the stinging and itching the bite causes, and has the potential to speed up the healing process.

&nbsp;

A small amount of witch hazel applied with a cotton ball can be sufficient. Swipe or gently dab the cotton ball with witch hazel over the bite. Let it air dry and repeat as required. 
&nbsp;

<h5>14. Arnica</h5>

Another natural substance you may purchase to address minor skin issues is arnica. Although the herb is poisonous, it can be diluted and is available as drops, creams, and gels.

&nbsp;

Despite being a widely used home treatment, scientific research yields conflicting outcomes. However, many assert that arnica lessens bruising, discomfort, swelling, and inflammation when used topically. Rub or swipe a little amount of arnica lotion or gel with clean fingers on the bite. Do consult your physician or pharmacist for advice on selecting a high-quality arnica product. 
&nbsp;

<h5>15.&nbsp;Chamomile Tea</h5>

Chamomile, a flower from the daisy family, is considered a popular natural cure for many diseases and its oil is effective for reducing irritation and inflammation when applied topically. In a refrigerator, soak a tea bag containing the dried, chopped flowers in water for 30 minutes. Put the tea bag&#39;s excess liquid to your bite after squeezing it out. Give it 10 minutes to rest. With a moist piece of cloth, clean the spot. You can store the tea bag again in the refrigerator for future use.&nbsp;

&nbsp;

Although uncommon, some people may experience an adverse reaction to chamomile. 
&nbsp;

<h5>16. Garlic</h5>

Natural garlic treatments are well-known for everything from high blood pressure to heart disease. A simple home remedy for mosquitoes involves applying garlic to an itchy bug bite.&nbsp;

&nbsp;

Beware; applying chopped garlic directly to a skin wound or bite may result in burning or stinging. Instead, chop some fresh garlic finely and mix a tiny bit of it with some petroleum jelly or any odorless lotion. These creams and ointments will lower the potency of the garlic while allowing you to benefit from its inherent healing and antibacterial properties.

&nbsp;

Apply the mixture for 10 minutes and then wipe your skin clean. With a cool washcloth, dry the region. If the itching continues, repeat the process.&nbsp; 
&nbsp;

Of course, preventing being bitten completely is the greatest approach to getting rid of mosquito bite discomfort. Remember that all these insects are busier at night and in the evening. If you&#39;ve been bitten, use simple, inexpensive home treatments to immediately lessen swelling and itching. Avoid a home cure if you start experiencing irritation or other unpleasant effects.

&nbsp;

It&#39;s a good idea to visit a doctor if you know the specific countries you&#39;ll be visiting. Visiting a doctor is crucial when you&rsquo;re relocating or traveling through regions where bloodborne illnesses, like malaria and Zika, are prevalent. These illnesses can be passed from person to person by mosquitoes. For some of these illnesses, vaccinations are accessible. 
&nbsp;

<ul><li>Mosquito bites are more prevalent in warm climates and after the monsoon season.</li><li>Female mosquitoes are interested in blood, but male mosquitoes are harmless.</li><li>All mosquito bites are not harmful, but some cause serious and life-threatening diseases.</li><li>Everyone should take precautions against mosquitoes.</li><li>Going to the doctor is not always necessary; instead, you can use home remedies to get immediate relief from the discomfort of a mosquito bite.</li></ul>

[1] Caraballo H, King K. Emergency department management of mosquito-borne illness: malaria, dengue, and West Nile virus. Emerg Med Pract. 2014 May;16(5):1–4.

[2] Fostini AC, Golpanian RS, Rosen JD, Xue R-D, Yosipovitch G. Beat the bite: pathophysiology and management of itch in mosquito bites. Itch [Internet]. 2019;4(1).

[3] Koytchev R, Alken RG, Dundarov S. Balm mint extract (Lo-701) for topical treatment of recurring herpes labialis. Phytomedicine. 1999 Oct;6(4):225–30.

Neelam Asad

The Impact Of Stress On Weight Gain/Loss And Mental Health

In today&#39;s fast-paced and demanding world, <a href="https://merisehat.pk/disease/stress">stress </a>has become an inevitable part of our lives. Whether it&#39;s due to work pressure, relationship issues, financial concerns, or any other life challenge, stress affects us all at some point. Not only does stress take a toll on our mental well-being, but it can also have a profound impact on our physical health, particularly when it comes to weight gain or loss. 
&nbsp;

&quot;I always tell my clients to have fun when working out with me,&quot; says 33-year-old Ahsan Shah, a fitness trainer and consultant based out of Karachi with over 15 years of experience in managing fitness and weight loss with clients in both Karachi and Dubai. &quot;If they&#39;re not having fun and are stressed out, it will impact not only their motivation but also their cortisol levels,&quot; he says. &quot;This affects everything: whether they will be consistent in pursuing a healthy exercise and diet regimen and most importantly, how their body will respond to it.&quot;&nbsp;

&nbsp;

Weight gain and Stress

<h5>Weight Gain And Stress</h5>

Stress can significantly contribute to weight gain for various reasons. One of the main factors is the hormonal response triggered by stress. When we are under stress, our body releases cortisol, often referred to as the &quot;stress hormone.&quot; Cortisol plays a crucial role in regulating metabolism, blood sugar levels, and energy balance. However, prolonged or chronic stress can lead to consistently elevated cortisol levels, which can disrupt these processes.

Increased cortisol levels can cause an increase in appetite, particularly for foods that are high in sugar, fat, and calories. This can lead to overeating and indulging in unhealthy food choices as a way to cope with stress. Additionally, cortisol can promote the accumulation of fat, especially around the abdominal area, which is associated with an increased risk of various health problems, including cardiovascular diseases and<a href="https://merisehat.pk/disease/diabetes-type-1-and-2"> type 2 diabetes</a>.

Furthermore, stress can disrupt sleep patterns. Lack of sleep or poor-quality sleep is linked to weight gain as it affects hunger-regulating hormones, such as leptin and ghrelin. When we don&#39;t get enough sleep, ghrelin levels increase, stimulating hunger, while leptin levels decrease, reducing feelings of fullness. This imbalance can lead to excessive calorie intake and weight gain over time. 
&nbsp;

<h5>Weight Loss And Stress</h5>

On the other hand, stress can also lead to weight loss in some individuals. During stressful periods, some people may experience a loss of appetite or have difficulty eating due to digestive disturbances. This can result in inadequate nutrition and unintentional weight loss. Moreover, stress can increase metabolic rate and energy expenditure, causing some individuals to burn more calories than they consume, leading to weight loss. 
&nbsp;

<h5>Mental Health And Stress</h5>

The impact of stress on mental health is widely recognized. Chronic stress can contribute to the development or exacerbation of mental health conditions such as anxiety and depression. These conditions can have a profound effect on a person&#39;s overall well-being and can further contribute to weight gain or loss.

Stress and mental health are closely intertwined. For some individuals, stress can trigger emotional eating or binge eating episodes as a coping mechanism to alleviate negative emotions. This can create a vicious cycle where stress leads to unhealthy eating habits, resulting in weight gain, and in turn, worsening mental health symptoms.

Conversely, stress can also lead to loss of appetite, decreased interest in food, or even disordered eating patterns. In severe cases, chronic stress can contribute to the development of eating disorders like anorexia nervosa or bulimia nervosa, which can have serious consequences on both physical and mental health. 
&nbsp;

<h5>Managing Stress And Promoting Well-being</h5>

To mitigate the negative effects of stress on weight and mental health, it is crucial to implement effective stress management strategies. Here are some recommendations: 
&nbsp;

<ul>
	<li>Regular Exercise: Engaging in physical activity can help reduce stress levels, promote weight management, and enhance overall well-being. Exercise releases endorphins, the body&#39;s natural mood elevators, which can counteract the negative impact of stress hormones. 
	&nbsp;</li>
	<li>Balanced Diet: Adopting a balanced diet rich in whole foods, fruits, vegetables, lean proteins, and healthy fats can support both physical and mental health. Avoid using food as a coping mechanism for stress and opt for healthier stress-relief strategies. 
	&nbsp;</li>
	<li>Adequate Sleep: Prioritize good sleep hygiene and aim for seven to eight hours of quality sleep each night. Establishing a consistent sleep routine can improve stress resilience, aid in weight management, and enhance mental clarity. 
	&nbsp;</li>
	<li>Stress Reduction Techniques: Explore stress reduction techniques such as meditation, deep breathing exercises, yoga, or mindfulness practices. These techniques can help calm the mind, reduce cortisol levels, and promote relaxation. 
	&nbsp;</li>
	<li>Seek Support: Don&#39;t hesitate to reach out for support from friends, family, or mental health professionals. Talking about your stressors and emotions can provide relief and help you develop healthier coping mechanisms. 
	&nbsp;</li>
</ul>

bottom Line

Stress can have a significant impact on both weight management and mental health. It is important to recognize the interplay between stress, weight gain/loss, and mental well-being. By implementing effective stress management strategies and seeking support when needed, individuals can better navigate the challenges of stress and promote their overall health and well-being.

Weight Loss Supplements Exposed

Obsessed with quick fixes and instant results? Well, I don&rsquo;t blame you. Aren&rsquo;t we all? Especially when it comes to securing the hourglass shape worthy of glossy magazine covers. The only issue is &ldquo;we don&rsquo;t have time&rdquo; for the (tried and tested) diet/exercise route.&nbsp;

So now imagine if we were to go to a pharmacy and see weight loss supplements placed strategically next to the counter. Imagine the pharmacist saying we don&rsquo;t need a prescription and that they yield magnificent results. The allure is simply undeniable. But is it love at first sight or a scam at first sight?

How do we know if they deliver on their claims or if they are just another gimmick in a crowded market? Let&rsquo;s discover the real story of these pills and potions! 
&nbsp;

Understanding weight loss supplements

Over-the-counter (OTC) weight loss supplements are readily available in pharmacies, health food stores, and online platforms without a prescription. They come in various forms, including pills, powders, and teas, claiming to aid <a href="https://merisehat.pk/article/weight-loss-supplements-exposed">weight loss</a> through mechanisms such as fat burning, appetite suppression, or metabolism boosting.

For instance, if you&rsquo;re obese, then appetite supplements can make you feel full faster or lessen your appetite so that your calorie intake is reduced and you&rsquo;re able to lose weight. Alternatively, fat-burning supplements increase the resting metabolic rate and reduce fat absorption by your body.

One of the primary concerns surrounding over-the-counter weight loss supplements is their safety. Unlike prescription medications, these supplements are not subject to rigorous testing and regulation by health authorities. As a result, their safety profiles can be uncertain, with the potential for adverse effects ranging from mild digestive issues to serious health complications. 
&nbsp;

Studies have shown that some ingredients commonly found in these weight loss pills, such as caffeine and green tea extract, may have modest effects on weight loss when combined with diet and exercise. However, the magnitude of these effects is often small, and long-term sustainability is questionable. Simply put, more research is needed to corroborate these results.

Recently, there has been growing scrutiny and calls for stricter regulation of OTC weight loss supplements. Health authorities have raised concerns about misleading marketing claims, undisclosed ingredients, and contamination with harmful substances. Despite efforts to improve transparency and oversight, challenges remain in ensuring the safety and efficacy of these products. 
&nbsp;

Some popular OTC supplements available include:<a href="#accordion">[1][2][3]</a>

<ul>
	<li>Orlistat &ndash; According to a review of controlled trials, the medication is said to provide a significant decrease in body weight. Side effects of weight loss pills include gastrointestinal issues and risk of kidney damage. It is recommended with a low-fat, low-calorie diet for adults with a BMI of 25 or above.</li>
	<li>Garcinia Cambogia &ndash; One review showed mixed results, with some people losing weight and others not. Adverse effects include nausea, headaches, and risk of liver damage.</li>
	<li>Glucomannan &ndash; It&rsquo;s not confirmed whether this fiber supplement promotes weight loss or not. Side effects include feeling bloated. It is generally recommended for females, especially when combined with garcinia cambogia.</li>
	<li>Conjugated Linoleic Acid &ndash; Believed to promote weight loss, this supplement may also lower HDL cholesterol levels and some people have even experienced greater insulin resistance and heart attacks after taking it.</li>
	<li>Green Tea &ndash; Consumed as a pill or in beverage form, it reportedly aids metabolism. It may also have an antioxidant, anti-inflammatory, and anti-cardiovascular effect. However, there is little research on its long-term effectiveness for weight loss. 
	&nbsp;</li>
</ul>

Note: The FDA has banned certain drugs for consumer use, including sibutramine and lorcaserin. Check with your doctor before buying these drugs. 
&nbsp;

If you&rsquo;re considering any of these products, it&#39;s essential to approach them with caution and skepticism. Remember, they&rsquo;re not medicines that would help treat or cure your condition.

Consulting with a healthcare professional before starting any new supplement regimen is advisable, especially if you have any underlying health conditions and allergies or if you&rsquo;re taking medications. You should also reconsider buying and using weight loss supplements if you&rsquo;re pregnant or breastfeeding.<a href="#accordion">[1]</a>

You may need to take a few vitamins and minerals, such as B-complex, multivitamins, iron, and magnesium, to give your body the extra boost it needs to ensure it keeps functioning effectively for weight loss.<a href="#accordion">[3]</a>

However, focusing on sustainable lifestyle changes, such as a balanced diet and regular exercise, remains the cornerstone of successful weight management. According to the CDC, losing 1-2 pounds per week through lifestyle modifications is a more sustainable option than shedding weight quickly.<a href="#accordion">[4]</a> 
&nbsp;

While some ingredients may offer modest benefits, the overall landscape of over-the-counter weight loss supplements is fraught with uncertainty. As consumers, it&#39;s crucial to be informed and prioritize evidence-based approaches to achieve long-term health and wellness goals. 
&nbsp;

<ul>
	<li>Over-the-counter weight loss supplements are widely accessible in various forms, including pills, powders, and teas, marketed to aid weight loss through mechanisms such as fat burning, appetite suppression, or metabolism boosting.</li>
	<li>Unlike prescription medications, they are not subject to rigorous testing and regulation by health authorities, raising concerns about their safety. Adverse effects, ranging from mild digestive issues to serious health complications, may occur.</li>
	<li>Efforts to improve transparency and oversight are underway, but concerns persist.</li>
	<li>Consult your doctor before starting any new supplement regimen, especially if you have any underlying health conditions or are taking medications.</li>
	<li>Sustainable lifestyle changes, such as a balanced diet and regular exercise, remain the cornerstone of successful weight management.</li>
</ul>

[1] Malia Frey MA. Your complete guide to weight loss pills and supplements. Verywell Fit. Accessed April 2, 2024

[2] Kubala J. 12 over-the-counter appetite suppressants reviewed. Healthline. September 25, 2018. Accessed April 2, 2024.

[3] Cafasso J. What are the best nutrients to boost your metabolism? Healthline. February 6, 2023. Accessed April 2, 2024.

[4] A guide to the top weight loss supplements in 2024. Forbes. April 1, 2024. Accessed April 2, 2024.

Shermeen Zuberi

AL SHIFA CLINIC KARACHI

Syed Intisar Hussain

In Sickness And In Health

&ldquo;What did I even achieve?&rdquo;

&ldquo;Why can&rsquo;t I be how I want to be?&rdquo;

&ldquo;Is this it?&rdquo;

And a million other questions may arise when you are not feeling your best. 
&nbsp;

Depressive disorders, mood disorders, in fact the entirety of mental health, is a lesser understood subject. It&rsquo;s bad enough that mental health continues to be a taboo, at times shunned by the most educated even, but it&rsquo;s sadder that society has somehow categorised who should be &ldquo;allowed&rdquo; to have <a href="https://www.merisehat.pk/article/mental-health">mental health</a> problems. This scrutiny is done on the basis of gender, race, socioeconomic status and even profession. No matter how organised this categorisation sounds, it is incorrect, unfair and devastating. 
&nbsp;

Mental health is your psychological well-being that not only affects your personal, career and professional life, but also your health. Depression or any other mental health illness, can either directly affect your appetite and cause weakness, or bring your immune system down to an extent that it gets susceptible to harmful organisms. 
&nbsp;

Moreover, it is seen that symptoms, such as those in anxiety in particular, can alter the physiological processes of the autonomic nervous system i.e. respiration and heart rate. Thus, increasing the risk of certain malicious diseases.&nbsp; 
&nbsp;

Healthcare practitioners, including the nursing staff, paramedics, and all those involved in patient care are part of an extremely noble, but immensely stressful profession. Whether they are sick or healthy, patient care is an obligation they cannot ignore. Moreover, providing hope to patients who believe they will never recover is a major part of the job description. But do you ever think how scary it can be for healthcare professionals to provide this hope, regardless of their own fears?&nbsp; &nbsp; &nbsp;&nbsp;

&nbsp;

Understanding Mental Health Issues Faced By The Medical Community

According to the World Health Organization (WHO), in 2015, almost 4.4% of the global population was diagnosed with depression, which is around 320 million people<a href="#accordion">[1]</a>. Studies prove that except for the United States of America, where there are an equal number of depressed doctors as the general population, other countries report a greater incidence of depression among doctors and other related health professionals than the rest of the population.&nbsp; 
&nbsp;

Current statistics report the prevalence of depression as 27% in medical students, 29% in registrars and up to 60% in practicing doctors<a href="#accordion">[1]</a>.&nbsp;Furthermore, a study conducted using Beck&rsquo;s Depression Inventory, revealed that 30% of the primary healthcare workers in a public setup were moderate to severely depressed<a href="#accordion">[1]</a>. In China, where health workers&rsquo; mental health wasn&rsquo;t taken into consideration until the 21st Century, the prevalence of depressive symptoms varies between 31.7% to 65.3%<a href="#accordion">[2]</a>.&nbsp; 
&nbsp;

There are no set criteria that enables only a certain population to be exclusive to mental health disorders. It can happen to almost anyone, but there are sure factors that have been proved to put healthcare workers at a greater risk than others. These risk factors include: 
&nbsp;

<ul>
	<li>Working longer hours</li>
	<li>Extensive workload</li>
	<li>Ever-growing intensity and complexity of the job description</li>
	<li>Relentless contact with patient&rsquo;s ill health and emergencies</li>
	<li>Higher responsibilities</li>
	<li>Post-traumatic stress due to the severity of the patient&rsquo;s condition</li>
	<li>Feelings of guilt, failure, shame and low self-esteem due to fear of failure, or actually failing to execute a task&nbsp;</li>
	<li>Discrimination in their licensing procedures specifically</li>
</ul>

&nbsp;

One term to understand while discussing the mental health of healthcare workers is &lsquo;burnout&rsquo;. According to the International Classification of Diseases (11th edition), or ICD-11, burnout is a phenomenon seen in workplaces where excessive pressure from the office surroundings can drain a person to an extent that they can&rsquo;t function properly anymore.&nbsp; 
&nbsp;

Burnout is characterised by three aspects:

1. Being unnecessarily exhausted.

2. Having negativity related to the workplace, in this case around patients.

3. Major reduction in efficiency. 
&nbsp;

Further research reports that a reason exclusive to low- and middle-income countries is the unfair ratio of physicians to the general population. This increases the workload which in turn raises the risk of burnout in healthcare providers. Thus, ultimately affecting patient care. Many cross-sectional studies signify that burnt-out medical practitioners were twice as likely to make errors, and had a 17% risk of being sued for malpractice<a href="#accordion">[3]</a>. This reduced efficacy can in turn aggravate burnout, as well as instill a factor of guilt for not being efficient enough. 
&nbsp;

According to a study carried out in the US, in 2017, almost 44% of physicians showed at least one symptom of burnout while the number was 54% in 2014<a href="#accordion">[3]</a>.&nbsp;

&nbsp;

Moral injury is defined as the psychological distress which results from the actions, or the restricted ability of the practitioner, that may violate their moral or ethical code. A fine example is a doctor having to decide between saving one patient over the other, purely on practical grounds. This may put profound emotional and psychological stress. Although the moral injury is not a disease itself, it may shake a healthcare practitioner&rsquo;s core and lead to feelings of self-doubt, unnecessary yet strong guilt and ambiguity in their actions. For example, paramedics hold themselves accountable for not being able to do enough on-site, regardless of correctly analyzing the severity of the condition<a href="#accordion">[3]</a>.

&nbsp;

An unjust stereotype that prevails in our society is that a person who works in the healthcare industry is not allowed to be compromised medically themselves. This puts unnecessary pressure on the healthcare workers as it is idealised that their efficiency is subject to their own health. Due to the unfair perception set, medical workers not only feel frustrated, but they use alternative ways for instant gratification which in turn makes matters even worse for them.&nbsp; 
&nbsp;

Studies prove that alcohol misuse in healthcare providers was 49%, five times higher than the general population (9%)<a href="#accordion">[1]</a>. Furthermore, a survey conducted in the United States in 2016 revealed that although 50% of the female doctors acknowledged that while they met the criteria for a disturbed mental state, they did not consider starting appropriate treatment as they wanted to deal with it independently<a href="#accordion">[1]</a>. Or, because they believed the diagnosis was shameful or embarrassing 
.&nbsp;

Therefore, there is a dire need of changing perceptions<a href="#accordion">[1]</a>.

&nbsp;

The treatment is as complicated as diagnosing mental health disorders in healthcare professionals. The relevance lies with the fact that professionals who have dedicated their lives to serving patients find it hard to fit in the role of a patient themselves. Nevertheless, it is important to ensure appropriate treatment. The treatment plan includes a pharmacological and psychological approach. Antidepressants are the first-line medications. The most widely used antidepressants are selective serotonin re-uptake Inhibitors (SSRIs). These are usually initiated for 9-12 months in the beginning, irrespective of the reason.&nbsp; 
&nbsp;

Studies also prove that medical practitioners have a higher suicide rate than the general population. Hence, encouraging treatment plans is of utmost importance. The psychological approach includes cognitive behavioural therapy (CBT) and support groups to normalise the conception of being unwell. Moreover, exercises like adopting new hobbies, restricting alcohol intake, and taking up healthy challenges might be helpful in the process<a href="#accordion">[1]</a>.

&nbsp;

<h4>"Worried? Anxious? Head on over to the<a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank"> sehat scan</a> to check your stress level!" </h4>

The mental health of doctors or other healthcare professionals was already a neglected topic, but after the pandemic things took a turn for the worse. Numerous studies have recently been dedicated exclusively to the impact of COVID-19 on the mental health of healthcare providers.&nbsp; 
&nbsp;

As of 30th July, COVID-19 has caused more than 6.4 million global deaths<a href="#accordion">[4]</a>. The sudden patient influx, presence of unorthodox symptoms, and their management, along with the unpredictability of COVID-19 have further increased the burden on healthcare practitioners. A meta-analysis conducted across 65 studies, involving 97,333 health care workers from 21 countries, identified a high prevalence of moderate depression (21.7%), anxiety (22.1%), and PTSD (21.5%) during the COVID-19 pandemic<a href="#accordion">[3]</a>. Another survey reported trauma-related stress, with a prevalence ranging from 7.4% to 35%, particularly among women, nurses, frontline workers and workers who experienced physical symptoms<a href="#accordion">[3]</a>. In fact, nurses have shown a higher incidence of depression and PTSD than physicians<a href="#accordion">[3]</a>.

&nbsp;

Doctors are mere humans; as fragile or strong as any other person alive. Just because their job involves treating illnesses, doesn&rsquo;t mean that they are not bound to get ill themselves. The stereotype built for healthcare professionals restricts them to get diagnosed, and if they do, prevents them from getting treatment efficiently. 
&nbsp;

The statistics collected have been recent and alarming, yet not much attention has been paid to the situation. This needs to change not only for the sake of humanity but also for the stagnant progress of our healthcare industry. Having our medical workers burnt out does not only put patient care at risk but also aggravates their mental health itself. 
&nbsp;

<ul>
	<li>Mental health is your psychological well-being that not only affects your personal, career and professional life but also your health.</li>
	<li>&nbsp;Healthcare practitioners, including nursing staff, paramedics and all those involved in patient care are an integral part of the health system.</li>
	<li>Data proposed by the World Health Organization (WHO) in 2015 shows that almost 4.4% of the world&rsquo;s population is diagnosed with depression, which is around 320 million people.</li>
	<li>Prevalence of depression was found to be 27% in medical students, 29% in registrars and up to 60% in practicing doctors.</li>
	<li>Risk factors that make healthcare practitioners vulnerable to mental disorders are working longer hours, extensive workload, ever-growing intensity and complexity of the job description, relentless contact with patient&rsquo;s ill health and emergencies, higher responsibilities, post-traumatic stress due to the severity of patient presentation, feelings of guilt, failure, shame and low self-esteem due to fear of failure.&nbsp;</li>
	<li>According to ICD-11, burnout is a phenomenon seen in workplaces where excessive pressure from the office surroundings can drain a person to an extent that they can&rsquo;t function properly anymore.</li>
	<li>Burnout is characterised by being unnecessarily exhausted, having negative thoughts related to the workplace, and major reductions in efficiency.</li>
	<li>In 2017 almost 44% of US physicians showed at least one symptom of burnout, while the number was 54% in the year 2014.</li>
	<li>Many cross-sectional studies signify that burnt-out medical practitioners were twice as likely to make errors, and had a 17% risk of being sued for malpractice.</li>
	<li>Moral injury is defined as the psychological distress that results from actions, or the restricted ability of the practitioner, that may violate their moral or ethical code.</li>
	<li>A survey conducted in the United States in 2016 revealed that although 50% of the female doctors acknowledged the fact that they had met the criteria for a disturbed mental state, they did not consider starting appropriate treatment.</li>
	<li>&nbsp;The treatment plan for depression includes pharmacological and psychological approaches, in which antidepressants are the first-line medications.</li>
	<li>However, any medication should be started only after being officially prescribed by a certified healthcare practitioner.</li>
	<li>Studies also prove that medical practitioners have a higher suicide rate than the general population.</li>
	<li>Summarising 65 studies, involving 97,333 healthcare workers in 21 countries, a high prevalence of moderate depression (21.7%), anxiety (22.1%), and PTSD (21.5%) was present among them during the COVID-19 pandemic.</li>
</ul>

[1] Ignacio Mora-Magaña, Sherman A. Lee, Isaac Maldonado-Castellanos, Carlos Jiménez-Gutierrez, José Mendez-Venegas, Azareel Maya-Del-Moral, Margarita D. Rosas-Munive, Amanda A. Mathis, Mary C. Jobe. (2022) Coronaphobia among healthcare professionals in Mexico: A psychometric analysis. Death Studies 46:2, pages 280-289.

[2] Gong, Yanhong et al. “Prevalence of anxiety and depressive symptoms and related risk factors among physicians in China: a cross-sectional study.” PloS one vol. 9,7 e103242. 22 Jul. 2014, doi:10.1371/journal.pone.0103242

[3] Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority.

[4] Coronavirus cases: Worldometer.

Arbaz Ansari

Natural Remedies For The Cold, Flu And Cough!

The onset of winter is a great time to get some fresh air and exercise outside. The colder weather also brings with it colds, flu, and <a href="https://merisehat.pk/disease/whopping-cough">coughs</a>. While these are all very common ailments, they can be a nuisance. Fortunately, there are lots of natural remedies that you can use to help treat your symptoms without resorting to drugs or side effects. Read on for some great tips on how to manage this winter&rsquo;s common ailments. 
&nbsp;

Natural Remedies

<ul dir="ltr">
	<li>
	<h5 dir="ltr">Honey</h5>
	</li>
</ul>

Honey is a natural cough suppressant, which not only helps you to breathe better, but also feel better. If you have a tickle in your throat that just won&rsquo;t go away, try some honey for relief.

Honey has antibacterial and anti-fungal properties that help it to fight off bacteria in your mouth and throat. It&rsquo;s even been shown to kill MRSA (methicillin-resistant staphylococcus aureus) on the skin! When we say &ldquo;honey&rdquo;, we&rsquo;re talking about all kinds - beri honey from Pakistan, Manuka honey from New Zealand; acacia honey from Australia; chestnut honey from China; buckwheat honey from Germany; and blueberry blossom honey made by bees in Japan. 
&nbsp;

<ul dir="ltr">
	<li>
	<h5 dir="ltr">Lemon And Ginger Tea</h5>
	</li>
</ul>

Ginger and lemon tea is a great remedy for sore throats, coughs and colds. The combination of ginger and lemon works as an expectorant, which means that it helps the lungs to expel mucus through coughing.&nbsp;

Lemon also has antibacterial properties that can help fight infection. Ginger is an anti-inflammatory, making it helpful in reducing pain associated with sore throats or sore muscles after exercise. It also helps relieve nausea and vomiting.

I like to make my own herbal tea blends by adding honey, mint leaves and cinnamon sticks to boiling water just before drinking &mdash; this makes it more palatable as well as soothing to the throat! 
&nbsp;

<ul dir="ltr">
	<li>
	<h5>Onion And Garlic</h5>
	</li>
</ul>

Garlic is a well-known immune booster, and onions have anti-inflammatory properties. Both can be used to treat the common cold and flu. Although studies have been inconclusive on whether garlic can actually prevent illness, taking it in large quantities (one clove of fresh garlic daily) may substantially decrease the duration of an infection.

Although studies have been inconclusive on whether garlic can actually prevent illness, taking it in large quantities (one clove of fresh garlic daily) may substantially decrease the duration of an infection. 
&nbsp;

<ul dir="ltr">
	<li>
	<h5 dir="ltr">Chicken Soup</h5>
	</li>
</ul>

Chicken soup is a classic cure-all, not only because it&rsquo;s easy to make but also because it contains a variety of nutrients that the body needs when you&rsquo;re feeling under the weather.

Chicken soup is a great source of protein, and in fact, most soups are good for this since they&rsquo;re usually made with meat stock. Chicken soup has plenty of vitamins and minerals like potassium, which helps regulate your body&rsquo;s fluid balance; zinc which can help fight off cold symptoms; and vitamins A and C which support overall wellbeing.

It&rsquo;s also easy to find chicken broth at many grocery stores now, so making homemade chicken soup doesn&rsquo;t require much effort or time spent driving around looking for ingredients! 
&nbsp;

<ul dir="ltr">
	<li>
	<h5>Herbs</h5>
	</li>
</ul>

Herbs are often used as natural remedies for the common cold, flu and cough. They can help relieve symptoms and speed up recovery time.

Herbs can be used as alternatives to medication, or in conjunction with medication when needed. Herbal medicines don&rsquo;t have side effects like those caused by antibiotics or other drugs that are prescribed for respiratory problems:

<ul>
	<li>Antibiotics kill bacteria but may also kill off good bacteria in your body that may cause other health problems down the road if they&rsquo;re not replaced through probiotic supplements.</li>
	<li>Some over-the-counter medications such as antihistamines have side effects such as drowsiness and dry mouth, which you might want to avoid if you&#39;ll be spending time around children who need supervision at home or school during cold season. 
	&nbsp;</li>
</ul>

<ul dir="ltr">
	<li>
	<h5>Ginger Ale</h5>
	</li>
</ul>

Ginger ale is a great remedy for the common cold, flu and cough. It also works well for nausea and motion sickness. Ginger ale is often used as an ingredient in other drinks (like Moscow Mules), but you can also drink it straight as a home remedy.

Ginger root has been used for centuries as both medicine and food in Asia, Africa, and Europe. Its warming properties are thought to help relieve sore throats, congestion, and stomachaches by stimulating circulation. 
&nbsp;

<ul dir="ltr">
	<li>
	<h5 dir="ltr">Spicy Food</h5>
	</li>
</ul>

Spicy food can help clear mucus, congestion and sinus congestion. It can also clear chest, nasal, and throat congestion to help you breathe better.

Spicy foods that are good for your health include:

<ul>
	<li>Chili peppers (especially cayenne pepper)</li>
	<li>Cinnamon</li>
	<li>Ginger root 
	&nbsp;</li>
</ul>

Honey, lemon and ginger tea: Steep one teaspoon of fresh or dried ginger in boiling water for about 10 minutes. Add half a cup of honey and mix well until it dissolves. Strain through cheesecloth into a mug and add freshly squeezed lemon juice to taste.

Onion Soup: Chop one medium onion finely then saut&eacute; in 1 tablespoon butter until golden brown. Add 3 cups chicken broth (or vegetable if vegetarian) and simmer for 30 minutes on low heat until reduced by half.

Garlic: Crush two cloves of garlic using mortar and pestle or blender.

Chicken Soup: Cook some chicken pieces in water with chopped onions, carrots &amp; celery.

&nbsp;

The best thing you can do for your body when you&rsquo;re sick is to give it the proper rest and nutrition. The natural remedies above are great ways to do this! It&rsquo;s important not only to take care of yourself as soon as you feel a cold coming on, but also to maintain good health overall. This will ensure that if something like the flu does happen again in the future (because it probably will), your body will be able to fight it off more easily and quickly.

The Healing Wonders Of Pakistani Herbs And Spices: Nature's Remedies Unveiled

Desi moms are like at-home hakeems with all their medicines stashed in the kitchen cabinets. Their secrets are passed on through generations of South Asian women. Some are native to only their culture while others are adopted from multiple places and a lot of self-experimentation. Your mom has probably made an oil that smells like achar and can give you long healthy hair. She also might have given you only 2 solutions for every single ailment be it a scratch on the knee, severe dry cough or fever and that is Kalonji and Haldi doodh. 
&nbsp;

Even though there is lack of research and evidence about whether these actually work or not, we still indulge and sometimes even see results. These natural wonders not only add flavor and aroma to the vibrant Pakistani cuisine but also possess remarkable healing powers. In today&#39;s fast-paced world, the significance of traditional healing practices cannot be overstated. As scientific research continues to validate the efficacy of these herbs and spices, there is a growing interest in integrating them into modern medicine. Pharmacognosy is an entire field of study focused towards exploring the potential of these natural compounds, aiming to harness their healing powers in standardized medications for a global audience. Let&rsquo;s delve into the fascinating world of Pakistani herbs and spices, exploring the science behind their therapeutic properties and the age-old wisdom that continues to heal millions. 
&nbsp;

therapeutic properties of Herbs and Spices

<ul>
	<li>Turmeric (Haldi): One of the most celebrated spices in Pakistani cuisine and the easiest way to look like a Simpson on a fine day. Turmeric owes its vibrant colour to curcumin, a potent compound with anti-inflammatory and antioxidant properties. The western world got to know about turmeric and its wide array of properties not too long ago but its staining power especially on white skin did not let turmeric become a top natural ingredient for at-home skincare. It did make its way into commercially sold skincare products where they had to minimize its staining tendencies. 
	For us brown beauties, we do not have to worry about that. Turmeric leaves a very nice glow on our skin, making it look radiant from within. Research has shown that curcumin can alleviate symptoms of<a href="https://merisehat.pk/disease/arthritis"> arthritis</a>, improve brain health, and even help in preventing and treating cancer. 
	&nbsp;</li>
</ul>

<h5>DIY Turmeric Mask</h5>

You will need:

<ul>
	<li>Chickpea flour (besan)</li>
	<li>Turmeric</li>
	<li>Yogurt</li>
</ul>

Mix 1 teaspoon of turmeric powder with 2 tablespoons of chickpea flour. Add yogurt until it turns into a paste. Apply to your face and let it dry. 
&nbsp;

<ul>
	<li>Cinnamon (Dalchini): This sweet and warm spice is rich in cinnamaldehyde, an active ingredient that has been found to lower blood sugar levels, making it a valuable aid for individuals with diabetes. Additionally, cinnamon possesses anti-microbial properties, aiding in the prevention of infections. 
	However, too much of everything can be bad. Due to the presence of high levels of coumarin in cinnamon, people with liver issues are advised against its use in abundance. Cinnamon in excessive amounts is also known for inducing premature labor or uterine contraction during pregnancy. 
	&nbsp;</li>
</ul>

<h5>Cinnamon Tea</h5>

You will need:

<ul>
	<li>Cinnamon stick or &frac12; teaspoon ground cinnamon</li>
	<li>Water</li>
</ul>

Boil the cinnamon stick or ground cinnamon in water for 10 minutes. Strain and enjoy. 
&nbsp;

<ul>
	<li>Garlic (Lehsan): Garlic is a powerhouse of allicin, a compound renowned for its ability to reduce blood pressure and lower cholesterol levels. Its antimicrobial properties also make it effective against various infections, including the common cold.</li>
</ul>

<h5> 
Garlic For Cold</h5>

You will need:

<ul>
	<li>2-3 cloves of garlic</li>
	<li>Honey 1 teaspoon</li>
</ul>

Crush the cloves of garlic and mix it with honey. Consume the mixture daily. 
&nbsp;

<ul>
	<li>Fenugreek (Methi): Fenugreek seeds are a rich source of soluble fiber and have been traditionally used to regulate blood sugar levels in diabetic patients. They also aid in digestion, promote milk production in breastfeeding mothers, and possess anti-inflammatory properties. 
	&nbsp;</li>
</ul>

<h5>Methi Hair Oil</h5>

You will need:

<ul>
	<li>1/4 cup fenugreek seeds (methi seeds)</li>
	<li>1 cup of coconut oil, olive oil, or any carrier oil of your choice.</li>
</ul>

Crush the fenugreek seeds slightly to release their natural oils. Heat the carrier oil of your choice in a pan until it&#39;s warm, not boiling. Add the crushed fenugreek seeds to the warm oil. Let it simmer on low heat for about 5-10 minutes. Allow the oil to cool to room temperature. Strain the oil into an airtight container to remove the fenugreek seeds.

&nbsp;

<ul>
	<li>Ginger (Adrak): Gingerol, the bioactive compound in ginger, is responsible for its anti-inflammatory and antioxidant properties. Ginger has been used to alleviate nausea, reduce muscle pain, and lower blood sugar levels. 
	&nbsp;</li>
</ul>

<h5>Ginger tea</h5>

You will need:

<ul>
	<li>1 cup of water</li>
	<li>1 cup of milk</li>
	<li>1-2 teaspoons of tea leaves or tea bags</li>
	<li>1-2 teaspoons of grated ginger</li>
	<li>Sugar (to taste)</li>
</ul>

Boil water in a saucepan. Add grated ginger and tea leaves or bags. Let it simmer for 2-3 minutes. Add milk and sugar. Bring to a boil, then strain and serve.

&nbsp;

<ul>
	<li>Neem (Azadirachta indica): Neem is often referred to as the &quot;wonder tree&quot; due to its diverse medicinal properties. It is a natural antibacterial, antiviral, and antifungal agent. Neem leaves are used to purify the blood, treat skin disorders, and boost the immune system. 
	&nbsp;</li>
</ul>

<h5>Neem leaf drink</h5>

You will need:

<ul>
	<li>Neem leaves crushed into a powder</li>
	<li>Honey</li>
	<li>Water</li>
</ul>

Mix dried and ground neem leaves into a glass of warm water. Add a teaspoon of honey to improve the taste. Stir well and drink it in the morning on an empty stomach. 
&nbsp;

<ul>
	<li>Ajwain (Carom Seeds): Ajwain is a popular spice in Pakistani cuisine and is well-known for its digestive properties. It helps relieve indigestion, bloating, and stomach cramps. Additionally, ajwain seeds are used to treat respiratory problems, making them valuable in managing asthma and bronchitis.</li>
</ul>

&nbsp;

<h5>Ajwain Infusion</h5>

You will need:

<ul>
	<li>Ajwain seeds</li>
	<li>Black salt</li>
	<li>Water</li>
</ul>

Take 1-2 teaspoons of ajwain seeds. Dry roast them in a pan for a few minutes until they release a pleasant aroma. Crush the roasted ajwain seeds lightly. Mix the crushed ajwain seeds with a pinch of black salt. Consume this mixture after your meals with a glass of warm water. 
&nbsp;

<ul>
	<li>Basil (Tulsi): Holy basil, or tulsi, is revered for its adaptogenic properties, which help the body cope with stress. It is also a natural immune booster and has antiviral and antibacterial properties, making it effective against various infections.</li>
</ul>

&nbsp;

<h5>Tulsi Tea</h5>

You will need:

<ul>
	<li>Fresh tulsi leaves</li>
	<li>Water</li>
	<li>Honey or lemon juice</li>
</ul>

Take a handful of fresh tulsi leaves or 1-2 teaspoons of dried tulsi leaves. Boil them in a cup of water for 5-7 minutes. Strain the tulsi-infused water into a cup. Add a teaspoon of honey and a squeeze of fresh lemon juice. 
&nbsp;

The healing power of Pakistani herbs and spices is a testament to the profound wisdom of ancient healing practices. As science unravels the secrets behind these natural wonders, the world is awakening to the therapeutic potential they hold. Embracing the legacy of traditional medicine, Pakistan&#39;s herbs and spices continue to weave a story of health and vitality, offering a holistic approach to well-being that resonates across cultures and generations. In their essence, these herbs and spices are not just ingredients; they are nature&#39;s gifts, bestowing upon us the power to heal and thrive.

As predicted earlier by the World Health Organization (WHO), major depressive disorders now account for a major illness in the world<a href="#accordion">[1]</a>, especially since the emergence of <a href="https://www.merisehat.pk/disease/covid-19">COVID-19</a>. As the pandemic rapidly swept across the globe, it induced a considerable degree of fear, worry and concern in populations at large. Additionally, social isolation and loneliness worsened mental health worldwide.&nbsp; 
&nbsp;

Major depressive disorder is a major contributor to the incidences of suicide and ischemic heart disease. Moreover, it is the second leading cause of years lived with disability (YLDs) worldwide<a href="#accordion">[2]</a>. <a href="https://www.merisehat.pk/disease/depression">Depression</a> not only affects day-to-day activities but also decreases the quality of life and well-being of people. The mood disorder can present with mild to potentially debilitating and life-threatening symptoms.&nbsp;

&nbsp;

Over the years, the increase in the prevalence of psychiatric disorders, depression, anxiety, and insomnia has led to a search for more effective treatments. For this reason, people look to manage depression with more natural remedies. Hence, treatment (often self-treatment) with supplements and herbs continues to gain popularity. But natural does not always mean safe or effective.&nbsp; 
&nbsp;

Herbal formulas are commonly prescribed for the treatment of mental illnesses. More people are now turning to herbal medications because of the various side effects, high prices, and increased relapse rates associated with prescription medications. Over the past decade, several studies have been conducted on the mechanism of action of supplements and herbal medications for treating depression, anxiety, and insomnia.&nbsp;

&nbsp;

<h4>"Did you know that heart rate variability can detect stress levels? Head on over to our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan </a>and check your heart rate variability today!" </h4>

Understanding the role of natural remedies  in treating depression

Below are some supplements and herbs that are most widely used for the treatment of depression:&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Omega-3 fatty acids&nbsp;</h5>
	</li>
</ul>

Omega-3 fatty acids are essential fats that help with treating depression. A randomized control trial conducted on pregnant women in 2020 concluded that omega-3 fatty acids significantly improve symptoms of depression and postpartum depression<a href="#accordion">[3]</a>. Supplements containing the two omega-3 fatty acids eicosatetraenoic acid (ECA) and docosahexaenoic acid (DHA) are most effective. Omega-3 supplements containing 60% or more eicosapentaenoic acid (EPA) show an overall positive effect on treating depressing symptoms<a href="#accordion">[4]</a>. While there is a lack of research to support the argument, the supplement is a well-tolerated and considered healthy addition to your diet that may help treat the mood disorder.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>NAC (N-acetylcysteine)&nbsp;</h5>
	</li>
</ul>

NAC is a precursor of glutathione, an important antioxidant in your body. It is essential for protecting cells against oxidative damage and regulating inflammation<a href="#accordion">[5]</a>. Studies have shown that people with depression are more likely to have higher levels of inflammatory markers. Thus, taking NAC may reduce inflammation and relieve the symptoms of depression. Doses of 2 to 2.4 grams in a day are thought to help treat mental health conditions. 
&nbsp;

<ul>
	<li>
	<h5>Vitamin D&nbsp;</h5>
	</li>
</ul>

Vitamin D is an essential nutrient for the body. However, many people, especially in Pakistan don&rsquo;t have sufficient vitamin D. Studies have further shown that people with depression are deficient in vitamin D. Similarly, people with vitamin D deficiency have more severe depressive symptoms<a href="#accordion">[6]</a>. Vitamin D helps curb depression by reducing inflammation and regulating mood. A randomized control study highlighted that vitamin D supplements are beneficial for people with clinical depression<a href="#accordion">[7]</a>. Another study found that 300,000 IU of adjunctive vitamin D significantly improved the severity of illness and overall quality of life in people with clinical depression<a href="#accordion">[8]</a>. 
&nbsp;

<ul>
	<li>
	<h5>B vitamins&nbsp;</h5>
	</li>
</ul>

B vitamins play an essential role in the regulation of mood. These vitamins include folate, B12 and B6, and are needed to produce serotonin or the &ldquo;happy hormone&rdquo;. Studies have shown that a deficiency in vitamin B12 and folate increases the risk of depression. Whereas, supplementing vitamin B12 may help reduce depressive symptoms. According to a study published in 2020, low vitamin B12 levels are associated with a high risk of developing depression<a href="#accordion">[9]</a>.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Zinc&nbsp;</h5>
	</li>
</ul>

Zinc is an essential mineral for brain health and a deficiency in the mineral may increase the risk of depression and the severity of symptoms. Studies have further shown that zinc when used alongside antidepressant medications may reduce depressive symptoms.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Magnesium&nbsp;</h5>
	</li>
</ul>

Magnesium is an important mineral that may help with the symptoms of depression. A randomised study concluded that 248 mg of magnesium per day for 6 weeks can significantly reduce the symptoms of depression<a href="#accordion">[10]</a>.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Creatine&nbsp;</h5>
	</li>
</ul>

Creatine is an organic compound that is essential for maintaining brain energy, which has shown to be involved in the development of depression. Some studies have shown that supplementing creatine can help with the symptoms of clinical depression.&nbsp; 
&nbsp;

<ul>
	<li>Rhodiola Rosea&nbsp;</li>
</ul>

Rhodiola Rosea is a popular herb that has several health benefits when taken in the form of a supplement. In addition to helping the body cope with stressful situations, the herb is known to reduce symptoms of depression. The herb when used in combination with saffron can significantly reduce depression and anxiety symptoms of mild to moderate depression<a href="#accordion">[11].</a>&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Saffron&nbsp;</h5>
	</li>
</ul>

Saffron is a spice that is commonly used in Asian foods. The spice is packed with antioxidants that have been shown to improve the symptoms of depression. While the exact mechanism behind it is unknown, studies have shown that saffron increases levels of the &ldquo;happy hormone&rdquo; in the brain 
.

<ul>
	<li>
	<h5>Ginseng&nbsp;</h5>
	</li>
</ul>

The ginseng plant has been used by the Chinese for thousands of years to help reduce the effects of stress, and improve mental clarity and energy. Derived from the plant, ginseng supplements have properties that help with low energy and motivation levels in people with depression. However, currently, there are not many studies to support the benefits of ginseng for depression&nbsp;&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Chamomile&nbsp;</h5>
	</li>
</ul>

Studies have shown that chamomile is useful in the management of depression and anxiety. The herb provides significant relief from depressive symptoms. However, there is a need for further studies to support the benefits of chamomile to treat depressive symptoms.&nbsp;

&nbsp;

<ul>
	<li>While herbal and natural supplements may work for some people, they are not a substitute for conventional treatments. Especially, for people who also struggle with thoughts of self-harm or suicide.&nbsp;</li>
	<li>Depression is a treatable illness, and you may try different herbs and supplements, but they may have potential side effects.&nbsp;</li>
	<li>These herbs and supplements can also interact with other drugs, reducing their potency.&nbsp;</li>
	<li>If you struggle with depression or have thoughts of suicide or self-harm, seek professional help immediately.&nbsp;</li>
</ul>

&nbsp;

[1].Depressive disorder (depression). World Health Organization. Accessed May 18, 2023

[2].Ferrari, A.J., Charlson, F.J., Norman, R.E., Patten, S.B., Freedman, G., Murray, C.J., Vos, T. and Whiteford, H.A., 2013. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS medicine, 10(11), p.e1001547.

[3].Zhang, M.M., Zou, Y., Li, S.M., Wang, L., Sun, Y.H., Shi, L., Lu, L., Bao, Y.P. and Li, S.X., 2020. The efficacy and safety of omega-3 fatty acids on depressive symptoms in perinatal women: a meta-analysis of randomized placebo-controlled trials. Translational psychiatry, 10(1), pp.1-9.

[4].Liao, Y., Xie, B., Zhang, H., He, Q., Guo, L., Subramanieapillai, M., Fan, B., Lu, C. and McIntyre, R.S., 2019. Efficacy of omega-3 PUFAs in depression: a meta-analysis. Translational psychiatry, 9(1), pp.1-9.

[5].Šalamon, Š., Kramar, B., Marolt, T.P., Poljšak, B. and Milisav, I., 2019. Medical and dietary uses of N-acetylcysteine. Antioxidants, 8(5), p.111.

[6].Menon, V., Kar, S.K., Suthar, N. and Nebhinani, N., 2020. Vitamin D and depression: a critical appraisal of the evidence and future directions. Indian journal of psychological medicine, 42(1), pp.11-21.

[7].Vellekkatt, F. and Menon, V., 2019. Efficacy of vitamin D supplementation in major depression: A meta-analysis of randomized controlled trials. Journal of postgraduate medicine, 65(2), p.74.

[8].Vellekkatt, F., Menon, V., Rajappa, M. and Sahoo, J., 2020. Effect of adjunctive single dose parenteral vitamin D supplementation in major depressive disorder with concurrent vitamin D deficiency: a double-blind randomized placebo-controlled trial. Journal of Psychiatric Research, 129, pp.250-256.

[9].Sangle, P., Sandhu, O., Aftab, Z., Anthony, A.T. and Khan, S., 2020. Vitamin B12 supplementation: preventing onset and improving prognosis of depression. Cureus, 12(10).

[10].Tarleton, E.K., Littenberg, B., MacLean, C.D., Kennedy, A.G. and Daley, C., 2017. Role of magnesium supplementation in the treatment of depression: A randomized clinical trial. PloS one, 12(6), p.e0180067.

[11].Bangratz, M., Abdellah, S.A., Berlin, A., Blondeau, C., Guilbot, A., Dubourdeaux, M. and Lemoine, P., 2018. A preliminary assessment of a combination of rhodiola and saffron in the management of mild–moderate depression. Neuropsychiatric disease and treatment, 14, p.1821.