September 2014 Health Bulletins

	Ask the Doc Dr. Davis Smith is an internist practicing in Connecticut and at Trinity College in Hartford. He specializes in the care of adolescents and GLBTQ patients.

“When is being tired all the time not okay?”
— Lea H*, New Jersey Institute of Technology
*name changed for privacy

Being tired all the time is not okay when it is affecting your academic, athletic, or social performance.  Is your tiredness hard to concentrate or even stay awake in class, or get your schoolwork done?  Is it affecting your ability to exercise or perform athletically at your usual level?  Is it leading you to miss social functions or negatively impacting your friendships or other relationships?  Alternatively, is worrying about your level of fatigue getting in the way of thinking about other things?

Check your tiredness:

• You might need medical assistance if you Answer yes to any of the questions above, or If the constant tiredness persists even after a week or so of catching up on your sleep, or If you’re also experiencing weight loss or night sweats, or You are falling asleep in atypical situations, such as while driving or during class (unless it’s Latin). 
• A helpful assessment tool is a standardized instrument called the Epworth Sleepiness Scale, available at various websites including the University of Maryland Medical Center.  A score outside the normal range indicates a need for medical evaluation.

The Usual Cause:
Most of the students who see me for this complaint just aren’t sleeping enough.  The brain really wants 8-10 hours a night of sleep with the same sleep and wake time every night of the week.

Medical Causes:
Sometimes, though, we uncover a different cause.  Sometimes it’s a disorder of sleep, such as snoring.  Other times it is some other condition that is sapping energy reserves, such as a subtle case of mono or indolent sinus infection.  Whatever the cause, if the symptoms are intrusive or you’re obsessively thinking about them, it’s worth seeing a provider.

	Ask the Counselor Peter Welch, M.A., is a wellness educator and counselor at the University of New Hampshire.

"I have a mental health issue. Will I be stigmatized if I seek treatment?"
— Mark S*, University of Southern Maine, Portland   
*name changed for privacy

You are not alone in your concerns. Feeling stigmatized because of a mental health condition may lead you to feel discouraged or ashamed. About 1 in 4 people in the US will struggle with a mental health condition at some point in their lives, and only about half will seek treatment, according to the National Alliance on Mental Illness (NAMI).

Federal law protects your privacy
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that ensures the privacy of an individual’s protected health information. Counselors and therapists are ethically and legally required to preserve your confidentiality.

Discuss your concern with a provider First, find a counselor or therapist at your university counseling center or health center. This professional help you to determine the parameters of your mental health condition through diagnosis and treatment. This will also be an emotionally safe space for you to discuss your concerns about stigma. Learning as much as you can about your mental health condition will also help you to feel empowered.

Look for community supports
Second, check out Active Minds. This are a national movement empowering students to speak out about their mental health in positive and productive ways that educate others within their college community. Your campus may have an Active Minds chapter (if not, consider starting one). Student ambassadors of Active Minds on some campuses are changing raising mental health awareness through education, advocacy, and support.

Keep in mind that nearly everyone is impacted in some way by mental health issues, either directly or through family and friends who have struggled with and managed their condition. Seeking professional is an important next step for your own self-care and wellbeing.

	Ask the Nutritionist Jenna Volpe, R.D., is a registered dietitian, certified group exercise instructor, and eating disorders specialist in Massachusetts.

“Are there reasons to become gluten-free even if I don't have an allergy to it?”
— Heather C., Binghamton University, The State University of New York

Gluten-free eating is a trend. Many food manufacturing companies are now promoting and selling products labeled “gluten free”.

What is Gluten?:
Gluten is a type of protein found in grains such as wheat, rye, barley, and sometimes oats, as well as their derivatives. A gluten-free diet excludes these grains and often replaces them with alternative grain products like corn, tapioca starch, potato flour, and quinoa.

Which medical conditions rule out gluten?:
This diet is recommended for people who test positive for a gluten allergy or intolerance, or an autoimmune condition called celiac disease. People with celiac disease, gluten allergy, or gluten intolerance might experience symptoms such as chronic gas, bloating, irritable bowels, acne or skin rash, extreme fatigue, irregular menstrual cycle, irritability, joint pain, or numbness in their hands/feet when they eat foods containing gluten.

What if we don’t have those conditions?:
A gluten-free diet is not recommended for those who are not gluten intolerant. People who cut out gluten from their diets are more likely to miss out on important vitamins, minerals, and fiber. Additionally, many gluten-free bread and dessert products can be higher in refined sugars and carbohydrates than conventional products are.

How can I know if I have a medical condition that rules out gluten?:
If you think you have a sensitivity or intolerance to gluten, ask your doctor about getting a blood test and/or biopsy to confirm whether or not you should go gluten-free. It is important not to go gluten-free until after you have been tested, or this can lead to false negative results.

More information.

	Ask the Relationship Educator Dr. Rick Hanson is a licensed psychologist and the director of the counseling center at Rockhurst University in Missouri.

Does being in a relationship make people happier?
— Ali W, Calvin College, Grand Rapids, Michigan

The simple answer is yes, we are happier when we are in healthy relationships in which we feel safe, secure, and inspired. We are likely to be unhappy and stressed when we are in relationships that are chaotic, demanding, controlling, or cause us to feel worse about ourselves. 

Identify the features of a happy relationship
The emphasis is on the characteristics of the relationship. Figure out what it is about relationships that makes you happy, then strive to find and create these types of relationships — whether in romantic relationships or friendships. We are social creatures. Both introverts and extroverts benefit from meaningful relationships.

Is it neurochemistry or real happiness?
It is important to remember that your happiness does not and cannot reside in someone else, no matter how attractive or fantastic that person is.  Romantic infatuation creates neurochemical changes in our brain and body that certainly feel good, and we associate this with being happy — but this is really the chemistry of attraction, not happiness. 

Real happiness is long-term
This temporary happiness, whether from a new relationship, a new pair of shoes, or a good grade, is like an energy drink. The short-term effect will pass. Lasting happiness must first be cultivated in oneself, then in relationships with others who honor, respect, and value you as a person and friend.  For more information on cultivating happiness, check out the University of Pennsylvania’s Authentic Happiness website.

While romantic relationships with the right person can certainly add to our life, it is dangerous to put all our eggs in one basket, and there is no evidence that romantic partners are more valuable to our happiness than are close friendships.  It is wiser to cultivate a network of friends with whom you can love, laugh, and create memories.

Getting wild with no regrets

By Kristen Pope

Settling into campus life comes with tons of things to do. Be sure to add “experiencing wilderness” to your list.

“Thousands of tired, nerve-shaken, over-civilized people are beginning to find out going to the mountains is going home, that wilderness is a necessity” — said the naturalist John Muir. Okay, so that was 113 years ago. But if wilderness was a necessity then, what is it now, with all the pressures of technology, social media, midterms, roommates, assignments, and internships?

This month is the 50th anniversary of the Wilderness Act, which permanently protects millions of acres of wilderness — and your space to exercise, de-stress, bond with friends, and experience the gorgeousness of America (and yourself) in different ways.

Take a few minutes now to learn about nature getaways near you. Then when you really want a break, you’ll know where to find it. Admission at national parks is free on September 27 (National Public Lands Day) and November 11 (Veterans Day).

What’s your nature?

Find your local wilderness and events honoring 50 years of the Wilderness Act.

• Find local events celebrating the 50th anniversary of the Wilderness Act
• Find volunteer events celebrating National Public Lands Day, September 27
• Find a wilderness
• Find a US National Park
• Find a US state park
• Find a free admission day
• Find out about the history of wilderness in the US
• Find a Canadian National Park, National Historic Site, or National Marine Conservation Area
  

Lifting the haze on hazing

By Kristen Pope

More than half of students involved in clubs, teams, and organizations experience hazing, according to StopHazing.org, a hazing prevention and research initiative based at the University of New Hampshire in Durham. Hazing is any activity associated with joining a group that involves degrading, abusive, risky, or illegal practices—like drinking games, sleep deprivation, paddling, or verbal abuse. Hazing has hit the headlines for causing physical and emotional harm (and, in some cases, death). Students with histories of mental health issues, abuse, and trauma are particularly vulnerable.

Student Health 101 talked with Susan Lipkins, PhD, a psychologist and author of Preventing Hazing (2006).

Here’s what you need to know:

• A typical hazing perpetrator is simply a senior student who had it done to him or her as a freshman.
• Hazing is rarely called hazing. You’re more likely to hear “rights of passage,” “ritual,” “tradition,” “pledging,” or “this is what we do.”
• Rumors of what goes on in a sports team or fraternity are usually true. But if you ask members, they are likely to lie, and you might get a worse hazing.
• As individuals, students who resist or object tend to get it worse.
• As groups, new students can arrange in advance that they will say “enough” and leave. This is effective only when the group sticks together.
• Don’t try to stop a hazing ritual unless you are in a position of social power.
• As groups, bystanders can moderate a hazing ritual. These lines are useful: “We don’t want to lose our team or scholarship”; “We don’t want to end up in jail or the hospital.”  Effective intervention can end with bystanders escorting the newcomers out.
• Is hazing a bonding experience? “It is bonding—in the same way that you can bond in a car accident together,” says Susan Lipkins.
• Most important: If you are in a position to report hazing, anonymously or not, do so.