This is one scientific study that passes the sniff test.

A dog’s nose knows, almost always, when its humans are experiencing stress, according to UK researchers.

A recent study from Queen’s University Belfast suggests dogs can smell the difference in breath and sweat from people who are suffering the negative emotion with an accuracy of 93.75 per cent.

“This study demonstrates that dogs can discriminate* between the breath and sweat taken from humans before and after a stress-inducing* task,” said School of Psychology* PhD candidate and study author Clara Wilson.

“This finding tells us that an acute*, negative, psychological stress response alters the odour profile of our breath (and) sweat, and that dogs are able to detect this change in odour,” Ms Wilson said.

To test the theory, researchers collected samples of breath and sweat from people both before and after a fast-paced, complex maths problem.

They collected heart rate, blood pressure, and self-reported stress level measurements in the study, published in the peer-reviewed journal PLOS ONE.

Within three hours of collection, breath and sweat samples from 36 participants who reported stress were presented to four trained dogs of different and mixed breeds.

The animals detected stress in 675 of 720 trials, or 93.75 per cent of the time on average. Individual dogs ranged in performance from 90 per cent to 96.88 per cent accuracy.

The four dogs were aged between 11 to 36 months and included a male cocker spaniel, a female cockapoo, and two undetermined mixed breed rescue dogs similar to a lurcher and a terrier.

Ms Wilson and her colleagues believe the dogs, with their remarkable sense of smell and coevolution* with humans, can detect odours that show a change in “volatile organic compounds*” produced in response to stress.

The results suggest how hounds are able to support human psychological conditions such as anxiety*, panic attacks and post-traumatic stress disorder* (PTSD).

“Dogs were able to discriminate, with a high degree of accuracy, between human breath and sweat samples taken at baseline* and when experiencing psychological stress,” the study states.

“Establishing that dogs can detect an odour associated with stress sheds light on the human-dog relationship and adds to our understanding of how dogs may interpret, and interact with, human psychological states.”

GLOSSARY

  • discriminate: recognising difference, being able to distinguish between one thing and another
  • stress-inducing: conditions that bring about, prompt or give rise to stress
  • psychology: scientific study of the mind and behaviour
  • acute: very serious, extreme or severe
  • coevolution: evolutionary changes in two species that occur in a reciprocal way
  • volatile organic compounds: organic chemicals that are released into the air
  • anxiety: the body’s physical reaction to threat or perceived threat, including worried thoughts and pounding heart, tummy butterflies and rapid breathing
  • post-traumatic stress disorder: a set of reactions that can develop when someone has been through a terrible event
  • baseline: reasonable and defined starting point for comparison purposes, like a resting position

EXTRA READING

Classroom ‘doggie dates’ reduce stress

Top dog Elmo is in full flight

Dogs learn words as quickly as toddlers

The power of puppy love

QUICK QUIZ

  1. Dogs could smell the difference in people after stressful tasks using what two measures?
  2. The dogs detected stress in how many of a total of 720 trials?
  3. How many people and dogs were involved in the study?
  4. What dog breeds were used in the study?
  5. What was the range of accuracy for the performance of individual dogs?

LISTEN TO THIS STORY

CLASSROOM ACTIVITIES
1. Shorter, simpler
Rewrite this story in under 50 words. To do this, you may need to leave out precise facts and figures from the study and make more generalised statements about the results instead. Don’t forget to include a headline!

Time: allow 20 minutes to complete this activity
Curriculum Links: English

2. Extension
Write a persuasive paragraph to either support or refute the following statement:

“Dogs’ ability to detect stress in humans makes them an ideal classroom pet.”

Time: allow 15 minutes to complete this activity
Curriculum Links: English

VCOP ACTIVITY
Stretch your sentence
Find a “who” in the cartoon – a person or an animal. Write it down.

Add three adjectives to describe them better.

Now add a verb to your list. What are they doing?

Add an adverb about how they are doing the action.

Using all the words listed, create one descriptive sentence.

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"Slow down, you move too fast," Simon and Garfunkel once cautioned.

Today, that musical advice could be the anthem for self-care: the act of making our own health and well-being a priority.

While it could include kickin' down the cobblestones, as suggested in the duo's "59th Street Bridge Song (Feelin' Groovy)," good self-care covers far more.

"It's all-around well-being," said Dr. Helen Lavretsky, a professor in residence in the department of psychiatry at the University of California, Los Angeles. "Mental, physical, spiritual, emotional, environmental and societal -- self-care should address most of these components."

But self-care often falls to the bottom of the priority list. Experts say it should be at the top.

"Many times, people feel self-care is selfish and you're indulging yourself," said Dr. Laxmi Mehta, who co-wrote an opinion letter from the American Heart Association and other cardiology groups about physician well-being and the importance of preventing burnout. Mehta is faculty director of the Gabbe Health and Well-Being program and section director of preventive cardiology and women's cardiovascular health at the Ohio State University Wexner Medical Center in Columbus.

You're not being selfish, she said. "You're staying healthy so you can do all the things you want to do in your life."

Lavretsky agreed. "It's not a luxury, it's a must," she said.


        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        

 

The doctors offered these steps anyone can take to better manage their overall well-being.

Pay attention to your body

"The first step is to listen to your body's needs," Lavretsky said. "In Western society, we are taught we can run on empty forever. We create chronic disease by not listening to our bodies. You listen to your car, because it will not run if it's broken. We do not do this with our bodies."

That doesn't just mean going to the doctor if you feel sick. It includes getting regular health and wellness exams to check blood pressure, cholesterol and blood glucose levels, Mehta said. "Know those numbers and act upon them."

Move more

"Exercise is key," Mehta said. "It not only helps physical well-being, it helps mental well-being."

Federal physical activity guidelines call for at least 150 minutes a week of moderate-intensity aerobic exercise or 75 minutes a week of vigorous aerobic activity, or a combination of both. The guidelines also discourage people from being sedentary.

"If you are sitting eight to 10 hours a day, this is not good," said Mehta. "Chart out time to get up and walk around."

According to the Centers for Disease Control and Prevention, staying physically active can help people think, learn, problem-solve and maintain better emotional balance. If fitting regular exercise into a busy day is tough, the CDC suggests taking short walks, dancing in your home and doing squats or marching in place during commercial breaks while watching television.

        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        

 

Research suggests moving for just three minutes once an hour can help keep blood glucose levels under control.

Eat a healthy diet

"Diet is important," said Mehta, so eat healthy foods and avoid sugary beverages that can affect mood as well as physical well-being.

A Mediterranean-style eating pattern is among those supported by the AHA and federal dietary guidelines. It includes a lot of fruits, vegetables, whole grains, beans, nuts, seeds and olive oil and low to moderate amounts of dairy products, eggs, fish and poultry. This eating pattern is associated with overall better heart and brain health.

If finding the time to shop and cook meals during the workweek is a challenge, Mehta suggests planning on the weekends and prepping items that can be eaten throughout the week.

Breathe

Taking the time to focus on breathing lowers stress levels, heart rate and blood pressure, said Lavretsky, who teaches breathing techniques as part of her practice. "Even one minute of breathing gets you out of stress overdrive and into a more reflective and controlled state," she said. "You make wiser decisions and don't have knee-jerk reactions. It's a tool for self-regulation, and that's good for self-care."

Lavretsky teaches a technique called "box breathing" that involves breathing in for three seconds, holding the breath for three seconds, exhaling for three seconds and pausing for three more seconds before taking the next breath.

Tai chi, yoga and meditation all help people focus on their breathing, Mehta said. But simply taking a few minutes each day to take a few deep breaths will help.

Avoid harmful substances and excess anything

"The No. 1 thing to avoid is smoking," Mehta said. It is the leading cause of preventable death in the U.S. and is a major risk factor for numerous chronic illnesses, such as heart disease, stroke and cancer.

All nicotine products, including e-cigarettes, should be avoided, she said.

"Avoid excess of everything," Lavretsky said. That includes not eating too much, drinking too much alcohol or caffeine or working too much. Excessive eating and drinking can feel like a quick fix, she said, "but they will never make anybody happy."

And don't spend too much time on social media, said Mehta. "If you have time for this, you certainly have time for yourself."

Get enough sleep

The AHA recently added sleep duration -- from seven to nine hours a night for most adults -- to its list of key measures for good heart health, known as Life's Essential 8. The list also includes not smoking, eating a healthy diet, getting enough physical activity and maintaining blood pressure, weight, cholesterol and blood glucose levels in the normal range.

"Sleep is critical to being in your best physical and mental health," Mehta said.

Cultivate gratitude and joy

"Spend at least five minutes a day doing joyful things," said Lavretsky, who asks her patients to also practice gratitude every morning when they wake up. "Focus on what you have instead of what you don't have."

Research shows happiness and having a positive attitude can lead to healthier behaviors and a longer, healthier life.

Start now

"You don't have to wait until you are burned out," Lavretsky said. "You don't need to wait for a heart attack to start practicing yoga."

© 2022, American Heart Association Inc.

        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        



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What is Rootd? Well, it’s been called “anxiety and panic attack relief in your pocket.”

While there is no doubt that more and more people are opening up about their mental health, and that the stigma surrounding their inner turmoil has lessened over the past several years, there is still much more that we, as a society, need to learn and understand. It is estimated that about 1 in 5 American adults live with a mental illness, while approximately 6 million American adults are affected by anxiety and panic disorders. If you fall into the latter category, Rootd may offer you some welcome relief.

We all feel anxiety in our lives. Our job, family, finances, health, and other factors can send us into a tailspin if something goes awry or amiss. This is common. However, if you find yourself in a situation when you feel like you’re heart is racing, you’re having difficulty breathing, you’re feeling chest and stomach pains, accompanied with sweating, chills, and weakness or dizziness (in short, you think you’re having a heart attack) then chances are you are having a full-on panic attack. The exact causes of panic attacks are unknown although it is felt that genetics, major stress, PTSD, and even low self-esteem can be contributing factors.

Help can be sought through psychotherapy and medications. While undoubtedly both are useful, they are not always available at the time you need help the most. That’s where Rootd can help. Rootd is an app that aims to provide relief for people experiencing anxiety and panic attacks, with tools based on cognitive behavior therapy. Its features include a button you can press for immediate support during panic attacks through prompts, plus breathing exercises, active meditations and nature sounds, and psychoeducation about anxiety. Rootd allows you to keep a record of how you are progressing and how you feel to establish pattern recognition.

Rootd has been featured in Cosmopolitan, Healthline, Bustle, CNET, and more, and is highly rated on both the App Store and Google Play Store. As one satisfied customer raves, “[Rootd is] an excellent tool to help conquer pandemic worries or just anxiety in general, but the support here is also to be commended. Fast response to issues that were of my cause and you can tell this is a team that really cares about their users.

Normally valued at $149, you can get a lifetime subscription to Rootd today for only $59.99.

Prices subject to change.

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According to the Centers for Disease Control and Prevention, nearly half of American adults have hypertension, aka high blood pressure. Lifestyle changes can be made to help control it, such as losing weight, eating a healthy, low-sodium diet, and getting more exercise. However, many of us also have to use medication.

With hypertension being such a common issue, the scientific community has been diligently studying the situation. And research suggests there’s another way to reduce high blood pressure that doesn’t have anything to do with medication or major lifestyle changes.

Instead, the study indicates that training our diaphragm and other breathing muscles can help promote heart health and reduce high blood pressure.

How Breath Training Works

The Journal of Applied Physiology recently published a study about “high-resistance inspiratory muscle strength training (IMST)” and how it lowers blood pressure. Just like weightlifting at the gym can strengthen our triceps and glutes, the idea behind this study was that strengthening the muscles we use to breathe could have BP-lowering effects.

RELATED: Your Blood Type Matters More Than You Think, Especially When It Comes To Heart Health

After five pilot trials in healthy adults aged 18-82 years, researchers from the University of Colorado Boulder wrote that the results “provide the strongest evidence to date that high-resistance IMST evokes clinically significant reductions in SBP (systolic blood pressure) and DBP (diastolic blood pressure) and increases in PIMAX (maximal inspiratory mouth pressures), in adult men and women.”

Integrative physiologist Daniel Craighead explained to NPR that “the muscles we use to breathe atrophy, just like the rest of our muscles tend to do as we get older.” To find out what happens when you give your breathing muscles a workout, Craighead and his fellow researchers tested volunteers using a device called PowerBreathe for five minutes per day.

This hand-held machine is a breathing trainer that looks similar to an inhaler. When you breathe into it, the PowerBreathe creates resistance to make your diaphragm and other breathing muscles work harder.

“We found that doing 30 breaths per day for six weeks lowers systolic blood pressure by about 9 millimeters of mercury,” Craighead said. He noted that kind of reduction would be expected with walking, cycling, and other forms of conventional aerobic exercise.

It’s also the kind of reduction you could see from taking a blood pressure drug, according to Dr. Michael Joyner—a Mayo Clinic physician who studies how the nervous system regulates blood pressure.

In addition to lowering blood pressure, breath training with a PowerBreathe could possibly help prevent hypertension. Joyner wrote in the Journal of the American Heart Association that he believes the prospects of using this technique in preventive care are “promising”—especially for people who aren’t able to do traditional aerobic exercise.

He also pointed out what’s really appealing about this method—it’s so easy. Dr. Joyner explained that giving your breathing muscles a workout with high-resistance IMST “offers a new and unconventional way to generate the benefits of exercise and physical activity.”

Benefits Of Breath Training Surprised Researchers

Breath training may be new to the world of hypertension treatments, but strength training the breathing muscles through deep diaphragmatic breathing has long been used during meditation and mindfulness practices.

RELATED: Strong Butt, Strong Brain? The Surprising Science Behind Muscle Strength And Brain Health

This is why high-resistance IMST using a small machine like the PowerBreathe could actually benefit adults of all ages, no matter their health status. But just how big that benefit was came as a surprise to researchers.

“We were surprised to see how ubiquitously effective IMST is at lowering blood pressure,” Craighead said, adding they “saw robust effects” in study participants of all ages. He noted that these results could indicate that IMST may help prevent heart disease and high blood pressure that tends to happen when we age.

If you happen to be an elite, endurance athlete, Craighead also noted that six weeks of IMST could be very helpful in increasing aerobic exercise tolerance.

If you’re thinking that breath training can replace exercise, though, that’s not the case. It shouldn’t necessarily replace your medication, either, Craighead warns. This is definitely a discussion to have with your doctor. Especially when your blood pressure is so elevated that you’re at high risk of having a heart attack or stroke.

Instead, the researcher says, “it would be a good additive intervention for people who are doing other healthy lifestyle approaches already.”

Still, the initial research looks promising, and for just five minutes a day, considering adding the PowerBreathe to your health routine may be worth it.

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Approximately 1 in 13 people in the United States have asthma (per the Asthma and Allergy Foundation of America). However, no one actually knows the specific cause of asthma, according to WebMD. Researchers do know that asthma is an inflammatory disease that causes the airways to narrow when exposed to a trigger. More triggers can include tobacco smoke, dust mites, pests, mold, and even some food, explains the Centers for Disease Control and Prevention (CDC).

During an asthma attack, the airways begin to narrow, which then results in spasming of the muscles around the airway, explains WebMD. This can cause numerous symptoms of an asthma attack that include rapid breathing, chest tightness, pale and sweaty face, and trouble talking, among others. Essentially, an asthma attack feels like you are having an extremely hard time breathing, potentially reminiscent of an anxiety or panic attack. To stop an asthma attack, sit up straight and take one puff of a rescue inhaler every 30 to 60 seconds (per Medical News Today). If symptoms don't improve after 10 puffs, seek emergency help.

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If you experience sudden onset anxiety, you are not alone. The American Psychological Association (APA) found that U.S. adults who reported anxiety symptoms jumped more than 25% after 2020. If you suffer a sudden anxiety attack, the first to do is try to take a few deep breaths. The Counseling Center at the University of Toledo says that getting more oxygen to the brain can calm the fight or flight fear response, helping you feel safer and think more clearly. Medical News Today offers a handful of gentle and effective breathing exercises to help calm a pounding heart and loosen tense muscles. 

Lighting incense, a scented candle, or smelling calming essential oils can help you feel more relaxed and slow racing thoughts. Healthline recommends soothing scents like lavender, chamomile, or sandalwood to help further calm your body and mind. If you can, grab a pen and write your thoughts down on paper. Writing can help you get out of your mind and make the situation seem more manageable. 

These simple exercises can work in a pinch. However, you should talk to a therapist or counselor if you think you may have an anxiety disorder. And even if you only experience anxiety symptoms sporadically, talking to a therapist versed in cognitive behavioral therapy can help you cope when you need it most.

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Dogs are able to smell when a person is stressed, because the physiological processes associated with the acute psychological stress response produce changes in human breathing and sweating that are taken up by these animals.

Researchers from Queen’s University in the United Kingdom have concluded that dogs are able to detect these physical cues with an accuracy of 93.75 percent, and today they publish the results of their work in the journal Science. one more.

Because of dogs’ exceptional sense of smell, their close history of domestication with humans, and their use to support human psychological conditions such as anxiety, panic attacks, and post-traumatic stress disorder (PTSD), researchers wondered whether dogs Can sense chemical signals to respond to the psychological states of their owners; He concluded yes.

To do this, they collected breath and sweat samples from non-smokers who had not recently eaten or drank before and after a fast-paced arithmetic task, and some objective physiological measures, such as heart rate. Or check stress levels by blood pressure.

Those who showed more stress with those tasks experienced an increase in heart rate and blood pressure, and dogs—different breeds and mixes of breeds—were able to distinguish samples from those that showed this. during the test.

The authors, after confirming how dogs detect odors associated with stressful situations, have emphasized that this finding, in addition to delving into the relationship between humans and dogs, is important for training dogs. There may be important applications that are able to help people with anxiety or post-traumatic stress. disorders.

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Mental health issues are spreading like a forest fire among people. You can blame it on an unhealthy lifestyle but that’s not always the case. Not speaking up about your condition makes your mental health issue worse. Once the problem spirals out of control, it becomes tough to tackle it. You must be aware of panic attacks, which may seem really challenging to cope with. It can almost make you feel like your heart is going to pop out of your chest, but relax. There are healthy ways to deal with panic attacks..

What sometimes makes panic attacks even worse is that this condition has no fixed set of symptoms. However, one may experience breathlessness, sweat excessively, gastric issues, chills, shallow breathing, difficulty in speaking, hands and feet become cold and you may feel disconnected from what is happening around you. It’s like you’re in the grave, alive! This may scare you, but panic attacks are inherently such.

Health Shots reached out to Dr Kedar Tilwe, Consultant Psychiatrist, Fortis Hospital Mulund and Hiranandani Hospital, Vashi – A Fortis Network Hospital, who shared some tips to manage panic attacks. You can also use these suggestions to get some relief while you manage your anxiety levels.

how to stop panic attacks
Don’t take dizziness lightly, but don’t panic either. Image courtesy: Shutterstock

“Panic attacks and anxiety have begun affecting people of all ages. These can be due to the drastic lifestyle changes that have become a regular feature, especially in urban areas. While certain risk factors cannot be avoided, there are simple measures that one can take to prevent anxiety from taking a toll on their daily existence,” said Dr Tilwe.

Here are techniques that might help people tackle anxiety more strategically.

5 ways to stop panic attacks if you’re prone to it, according to Dr Tilwe:

1. Relaxation exercises

Progressive muscular relaxation exercises or controlled breathing techniques are incredible ways to prevent panic attacks. It is highly recommended that a person chooses relaxation or breathing techniques that relieve them of stress and anxiety in crucial moments. Keep these tips in mind while breathing:

  • Keep your eyes close
  • Try to focus on something else which can relax you
  • Breathe slowly and deeply
  • Practice breathing in through your nose and try to hold it in for 4-5 seconds and then release

2. Meditation

Meditation is a great way to reduce stress and help you relax. Dr Tilwe says, “This time-tested method of calming your mind is perhaps the best way of ensuring that unnecessary panic does not occur. Body-scan meditation can also help a person come to terms with the physical symptoms experienced during a panic episode while helping to prevent a full-blown attack.”

3. Mindfulness exercises

When done mindfully, the most simple and fun day-to-day activities can prevent a panic attack. Not only are they easy to implement and learn, but there are also various options, including grounding techniques, five sense exercises, mindful eating, mindful meditation and mindful breathing, among others. It involves:

  • Focusing your attention on what’s going on around you so that you can stabilize yourself in the present moment
  • You need to accept what’s you’re going through so that you can support yourself to find solution
  • Try to calm yourself down
how to stop panic attacks
Mindfulness is the key to getting in touch with your inner self. Image courtesy: Shutterstock

4. Cognitive Behavioral Therapy or CBT

By altering your thoughts and behaviours, CBT is a form of therapy that can assist you in managing your issues. Although it can be helpful for various mental and physical health issues, it is most frequently used to treat anxiety and depression. Dr Tilwe says, “No doubt understanding your inner thoughts, cognitive distortion and response patterns will empower you to curb panic attacks effectively.” To use this format, a person needs to work with a mental health counsellor to benefit from this method.

5. Medicines

If symptoms related to anxiety and mental stress are very distressing, there is the presence of anticipatory anxiety, or it is affecting your personal-social-occupational life, then medicines can be recommended by an expert. While they can help reduce the distress associated with panic attacks and substantially improve your lifestyle, they should never be taken without prior consultation from a doctor.

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HEALTH WATCH

 

 

A panic attack is a sudden, intense experience of fear coupled with an overwhelming feeling of danger, accompanied by physical symptoms of anxiety, such as a pounding heart, sweating, and rapid breathing. A person with panic disorder may have repeated panic attacks (at least several a month) and feel severe anxiety about having another attack. While many people experience moments of anxiety, panic attacks are sudden and unprovoked, having little to do with real danger.

Panic disorder is a chronic, debilitating condition that can have a devastating impact on a person’s family, work, and social life. Typically, the first attack strikes without warning. A person might be walking down the street, driving a car, or riding an escalator when suddenly panic strikes. Pounding heart, sweating palms, and an overwhelming feeling of impending doom are common features. While the attack may last only seconds or minutes, the experience can be profoundly disturbing. A person who has had one panic attack typically worries that another one may occur at any time.

As the fear of future panic attacks deepens, the person begins to avoid situations in which panic occurred in the past. In severe cases of panic disorder, the victim refuses to leave the house for fear of having a panic attack. This fear of being in exposed places is often called agoraphobia. People with untreated panic disorder may have problems getting to work or staying on the job. As the person’s world narrows, untreated panic disorder can lead to depression, substance abuse, and in rare instances, suicide.

Causes and symptoms

Scientists are not sure what causes panic disorder, but they suspect the tendency to develop the condition can be inherited. Some experts think that people with panic disorder may have a hypersensitive nervous system that unnecessarily responds to nonexistent threats. Research suggests that people with panic disorder may not be able to make proper use of their body’s normal stress-reducing chemicals.

People with panic disorder usually have their first panic attack in their 20s. Four or more of the following symptoms during panic attacks would indicate panic disorder if no medical, drug-related, neurologic, or other psychiatric disorder is found:

  • Pounding, skipping or palpitating heartbeat.
  • Shortness of breath or the sensation of smothering.
  • Chest pains or pressure.
  • Choking sensation or a ‘lump in the throat’.
  • Fear of dying.
  • Feelings of unreality or being detached.
  • Shaking and trembling.
  • Fear of losing control or going crazy.

A panic attack is often accompanied by the urge to escape, together with a feeling of certainty that death is imminent. Others are convinced they are about to have a heart attack, suffocate, lose control, or “go crazy.” Once people experience a panic attack, they tend to worry so much about having another attack that they avoid the place or situation associated with the original episode.

Diagnosis

Because its physical symptoms are easily confused with other conditions, panic disorder often goes undiagnosed. A thorough physical examination is needed to rule out a medical condition. Because the physical symptoms are so pronounced and frightening, panic attacks can be mistaken for a heart problem. Some people experiencing a panic attack go to an emergency room and endure batteries of tests until a diagnosis is made.

Once a medical condition is ruled out, a mental health professional is the best person to diagnose panic attack and panic disorder, taking into account not just the actual episodes, but how the patient feels about the attacks, and how they affect everyday life.

Treatment

Most patients with panic disorder respond best to a combination of cognitive-behavioral therapy and medication. Cognitive-behavioral therapy usually runs from 12–15 sessions. It teaches patients:

  • How to identify and alter thought patterns so as not to misconstrue bodily sensations, events, or situations as catastrophic.
  • How to prepare for the situations and physical symptoms that trigger a panic attack.
  • How to identify and change unrealistic self-talk (such as “I’m going to die!”) that can worsen a panic attack.
  • How to calm down and learn breathing exercises to counteract the physical symptoms of panic.
  • How to gradually confront the frightening situation step by step until it becomes less terrifying.
  • How to “desensitize” themselves to their own physical sensations, such as rapid heart rate.

 

At the same time, many people find that medications can help reduce or prevent panic attacks by changing the way certain chemicals interact in the brain. People with panic disorder usually notice whether or not the drug is effective within two months, but most people take medication for at least six months to a year. Several kinds of drugs can reduce or prevent panic attacks.

 

Alternative treatment

One approach used in several medical centers focuses on teaching patients how to accept their fear instead of dreading it. In this method, the therapist repeatedly stimulates a person’s body sensations (such as a pounding heartbeat) that can trigger fear. Eventually, the patient gets used to these sensations and learns not to be afraid of them. Patients who respond report almost complete absence of panic attacks. A variety of other alternative therapies may be helpful in treating panic attacks. Neurolinguistic programming and hypnotherapy can be beneficial, since these techniques can help bring an awareness of the root cause of the attacks to the conscious mind.

 

Prognosis

While there may be occasional periods of improvement, the episodes of panic rarely disappear on their own. Fortunately, panic disorder responds very well to treatment; panic attacks decrease in up to 90% of people after 6-8 weeks of a combination of cognitive-behavioral therapy and medication. Unfortunately, many people with panic disorder never get the help they need. If untreated, panic disorder can last for years and may become so severe that a normal life is impossible. Many people who struggle with untreated panic disorder and try to hide their symptoms end up losing their friends, family, and jobs.

 

(Author is a medical practitioner and can be reached on: [email protected])

 

 

 

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A man holds a dog in his lap as he sits in a roomShare on Pinterest
Experts say dogs can be a comfort to people who are feeling stressed. BONNINSTUDIO/Stocksy
  • Researchers say dogs can detect changes in odors that let them know when people are feeling stressed.
  • Experts say dogs can be trained to help reduce a person’s anxiety when they detect these scents.
  • They add that people should be fully aware of the responsibilities of owning a dog before they bring one home.

Stress smells and dogs know it.

A study published today in the journal PLOS ONE reports that dogs can detect an odor associated with the change in Volatile Organic Compounds (VOCs) produced by humans experiencing psychological stress.

Researchers examined samples of breath and sweat from non-smokers who had not recently eaten or drank. Samples were collected before and after a fast-paced arithmetic (ie., stress-inducing) activity. Other measures of stress including heart rate and blood pressure were also analyzed.

Participants who reported higher stress levels after the activity were introduced to dogs within the next three hours.

These dogs of different breeds were trained with a clicker-and-kibble method to sniff out stress and engage in an alert behavior. Researchers said the dogs demonstrated an accuracy of 93% in detecting stress.

“This study demonstrates that dogs can discriminate between the breath and sweat taken from humans before and after a stress-inducing task. This finding tells us that an acute, negative, psychological stress response alters the odor profile of our breath/sweat, and that dogs are able to detect this change in odor,” the study authors wrote.

Dr. Helen Egger, a child psychiatrist and co-founder of children’s mental health app Little Otter, says this finding shows how dogs can be trained to respond to human stress and distress.

“Currently, dogs are trained to identify visual cues, not odors related to stress and anxiety,” she told Healthline. “Detecting smell could be one of the ways a service dog detects signs of an anxiety attack or heightened stress.”

This could be helpful in cases where the dog could then be trained to fetch medication, get help, calm a person down, or even provide deep pressure therapy to soothe their owner, said Egger.

Dr. Sanam Hafeez, a clinical psychologist and neuropsychologist based in New York City as well as the director of Comprehend the Mind, notes that the only way dogs that sniff our stress can benefit a person is if the dog undergoes intensive training to know what to do when a human is stressed.

The dog will also need to be trained on understanding the difference between “ordinary” stress versus a panic attack or severe physical stress such as an oncoming heart attack or a seizure, Hafeez told Healthline.

“Pets appear to provide more benefits than merely companionship,” says Egger.

She says pets help people with serious mental health issues by:

  • providing empathy
  • providing connections that can assist in redeveloping social avenues
  • serving as “family” in the absence of or in addition to human family members
  • supporting self-efficacy
  • strengthening a sense of empowerment

Hafeez explains that the research ​​on dogs and mental health supports that having dogs as pets reduces depression, anxiety, and stress.

“Dogs can help mitigate anxiety,” she says. “When pet owners touch, hear, see or talk to their dogs, it often brings a sense of well-being and happiness.”

Dogs also motivate people to exercise, which further decreases stress and acts as a remedy for loneliness.

Hafeez adds that dogs can also offer a heightened sense of purpose as people age.

While there are clear mental health benefits to spending time bonding with a dog, actually bringing one into the family may not always be the best choice.

“A dog is a living, breathing creature that not only needs food, shelter, and walks, it also needs attention, care, grooming, and regular vet checkups, and sometimes medication and additional precautions for pre-existing medical conditions,” says Hafeez.

“Often, people bring a dog into the home because they only think about the cute and cuddly factor and what the dog can do for them,” she adds. “They may not realize that a dog (even an adult one) is like having a perpetual toddler in the home who is entirely dependent on you for its care.”

When it may not be the right time to adopt a dog:

  • You are living with serious mental health issues,
  • You are experiencing an active substance use disorder
  • You are struggling to care for your own basic needs

Only you can make the choice about what is right for your household, but Hafeez notes it may not be fair to bring a dog into a home where the owner may not have the psychological or physical capacity to tend to all of a dog’s needs.

Hafeez shares the following questions to consider before adopting a dog:

  • Do you have the financial means?
  • Is there anyone in your home or outside of the home who could take care of the dog in case of an emergency?
  • Do you feel responsible and mentally and physically able to care for the complete well-being of a pet?
  • Do you have issues that would preclude you from taking the dog for regular walks, feeding meals, grooming, and medical care?
  • What do you really expect out of owning a dog?
  • Are your expectations for what the dog will provide for you reasonable?
  • Is this a passing novelty or something you want in your life?

Egger says it’s important to distinguish between a pet and a service dog.

“Service therapy dogs can be indicated as an intervention that is part of a person’s mental health treatment plan. All service dogs have completed specialized training and are legally recognized by the Americans with Disabilities Act,” she says.

“The decision to get a service therapy dog should be explored with a mental health professional and organizations that specialize in service dogs,” says Egger.

However, pet dogs do make a difference, even if they are not trained as emotional support dogs, she says. For example, a 2015 study found an association between children with a pet dog and a decreased probability of childhood anxiety.

Egger comes to the topic from both a professional and personal perspective.

“Interestingly, I have a 26-year-old son with a brain illness and I am exploring whether a therapy dog would decrease his anxiety, provide social support, and help him engage in the world,” she says.

Egger reminds us that while dogs are wonderful for children, it is not realistic for parents to think that they are getting the dog for the child and they will do all of the care.

“As a parent, you need to be willing to care for the dog, too,” she notes.

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Today (Thursday ) is World Heart Day, and mental health charity Turn2Me is marking the day by highlighting the link between stress and heart conditions.

The charity said that chronic stress can lead to a stroke or heart attack, and that people should try to reduce their levels of stress for a healthier lifestyle.

“Stress is a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances,” said Suzanne Ennis, clinical manager at Turn2Me. “Some symptoms of stress can be elevated blood pressure, rapid heartbeat, sweaty palms, palpitations, cold hands and feet, dizziness, and chest pain. Chronic stress leads to serious health problems because it disrupts nearly every system in your body. Part of what makes chronic stress so insidious is its ability to become a 'normal' feeling, it becomes the familiar. This pattern of endurance is what makes chronic stress such a serious health issue.

“Poverty, trauma, general pressure from the demands of life, and more can all cause chronic stress,” she continued. “Chronic stress can lead to cancer, strokes, and heart attacks, as well as violent behaviour and even suicide. While under stress, your heart pumps faster, this can result in increased blood pressure, resulting in stroke or heart attack.”

There are many ways to better manage stress, including:

Relaxation techniques: These are activities that trigger the relaxation response, a physiological change that can help lower your blood pressure, heart rate, breathing rate, oxygen consumption, and stress hormones. These can include yoga, deep breathing, and stretching.

Cognitive behavioural therapy: CBT is based on the idea that changing unhealthy thinking can change your emotions. A CBT therapist will help you identify negative thinking and learn to automatically replace it with healthy or positive thoughts, reducing stress.

Realistic goal setting: Setting goals can have a positive effect, provide a sense of commitment, and help people feel in control and optimistic. Set goals in your career, relationships, creativity, play, and health can really help manage stress.

Exercise regularly: In addition to having physical health benefits, exercise has been shown to be a powerful stress reliever. Exercise releases endorphins — natural substances that help you feel better and maintain a positive attitude.

Daily reflection: Conduct daily check-ins, by asking yourself how you are. What do you need to help yourself? When you’re feeling overwhelmed, remind yourself of what you do well. Try to have a healthy sense of self.

Prioritise yourself: The more your actions reflect your beliefs, the better you will feel, no matter how busy your life is. It’s okay to say “no” to demands on your time and energy that will place too much stress on you. You don’t always have to meet the expectations of others.

Turn2Me has also highlighted the negative effect anxiety can have on the body.

“Anxiety is an emotion characterised by feelings of tension, worried thoughts, and physical changes,” Ms Ennis said. “The right psychotherapy will teach you to control your anxiety and will offer relief from anxiety in a matter of weeks. Underlying psychological causes or triggers for anxiety, such as those stemming from trauma, are not the target of management techniques; they require longer-term psychotherapy. However, anxiety-management techniques can offer relief, and offer it very speedily. The unpleasant symptoms most likely to be helped by medication are the very ones that your therapist can assist you to correct."

Anxiety symptoms fall into three typical clusters: the physical reaction that constitutes the terror of panic; the "wired" feelings of tension that correlate with being "stressed out" and can include pit-of-the-stomach doom; and the mental anguish of rumination - a brain that won't stop thinking distressing thoughts.

"A therapist armed with methods for addressing these clusters can offer their anxious client the promise of relief,” she added.

Turn2Me said that sometimes people who are going through an anxiety or panic attack think they are having a heart attack. The thought of suffering from a heart attack can be very frightening and make you more anxious. Therefore, it is important to know the difference. People who have persistent or frequent chest pain should contact their GP.

In a panic or anxiety attack, any pain is usually described as 'sharp', and tends to be felt over the heart. The pain is usually made worse by breathing and pressing the centre of the chest. This pain usually disappears within five to 10 minutes.

A person experiencing a heart attack may or may not have pain. Pain, when present, may include a 'crushing' feeling, as if someone is standing on your chest. Pain is not usually made worse by breathing or pressing on the chest, and is usually persistent, lasting longer than five to 10 minutes.

Turn2Me offers several free weekly support groups, and one-to-one counselling sessions are available to assist with managing stress, arming users with the tools they need to identify and reduce their levels of stress. For more information see turn2me.ie



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  • A new study found that a type of breathwork (or breath training) performed for 30 minutes per day can lower blood pressure.
  • A special device and a technique called high-resistance inspiratory muscle strength training (IMST) can lower systolic blood pressure by almost 10 mmHg and DBP by nearly 5 mmHg.
  • Daniel Harrison Craigheahd, Ph.D., breaks down his research and how the breathing technique actually works to lower blood pressure.

Taking a deep breath can do so much more than calm anxiety and lower your heart rate. A recent study found that a type of breath training, paired with an over-the-counter breathing device, can help lower blood pressure (BP) by almost 10 points.

The study, published in the Journal of Applied Physiology earlier this month, practiced breathwork, or breathing exercises, with a total of 128 healthy adults, aged 18 to 82, for six weeks.

Daniel Harrison Craighead, Ph.D., assistant research professor of integrative physiology of aging laboratory at the University of Colorado Boulder, and co-author of the study, says breathwork is a broad term that refers to any sort of conscious control of breathing. Many types have been shown to have effects on BP when performed regularly for 30 minutes per day, according to Craighead. The specific type of breathwork used in the study for lowering BP is high-resistance inspiratory muscle strength training, (IMST), which involves taking 30 resisted breaths a day for five to 10 minutes through a handheld device that provides resistance. The trick is that each of those 30 inhales is really challenging and requires a lot of effort, he says.

According to Craighead, initial reductions in BP are observed within two weeks, which is faster than the BP benefits usually seen with more conventional forms of exercise. And your BP will continue to decline over at least the first six weeks of training and may decline more with prolonged training, he says.

High blood pressure can lead to a slew of health issues, such as heart attack and stroke, as well as aneurysms, cognitive decline, and kidney failure. Recent research has even found Americans’ blood pressure has been on the rise and was significantly higher during the COVID-19 pandemic than pre-pandemic. So now, more than ever, it’s important to take preventative measures and stay on top of your health.

Ahead, Craighead breaks down everything you need to know about breath training for lowering blood pressure.

How does breath training lower blood pressure?

IMST likely lowers BP in a few different ways, he explains. One is by turning down the activity of the sympathetic nervous system—your fight-or-flight response. People with high BP tend to have this system overactivated and the deep breathing techniques with IMST likely lower the activity. Another main mechanism is by improving the health of endothelial cells—the cells lining the inside of blood vessels and are critical for cardiovascular health. IMST might lower BP by making these cells function better.

How does it work?

During a single session, users will perform 30 resisted inspirations through a handheld device (he used the POWERbreathe) featuring an end-piece that loosely resembles a snorkel; there is no resistance to exhaling. You breathe in through the mouthpiece as quickly and powerfully as possible, trying to make as full of a breath as you can. While doing this, the device is providing resistance, making the inhale very challenging. The study had people do five sets of six successive resisted inhales, with a one-minute break of unresisted breathing between each set. Craighead notes that the last set of six breaths is usually very challenging and users will struggle to overcome the resistance of the device.

Who should try it?

Everyone should consult with their physician before performing IMST to make sure it is safe for them. In general, though, IMST will be safe for most people. Most of the research on IMST has been done in healthy adults or in adults with high BP. Thus far Craighead says they’ve seen that the BP benefits of IMST aren’t really impacted by age, sex, or body weight, suggesting IMST will be generally effective at lowering BP in most people. He says researchers are still studying various patient populations though, as such, we don’t currently know how effective IMST is for people with serious chronic illnesses.

If you’re interested in trying breathwork for lowering blood pressure, consult your doctor before purchasing any devices and practicing at home.

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Dogs can smell when a person is feeling stressed and could be trained to ward off panic attacks, a study suggests.

The research sheds light on the canine ability to pick up on human emotions. It was known that dogs can detect distress in humans, yet exactly how they do so was not clear.

The new study appears to pin down the role played by odour, showing that dogs can detect the smell that humans emit as anxiety levels rise.

Clara Wilson, with Soot, who was one of the four dogs used in the study that were able to identify the odour of stress

Clara Wilson, with Soot, who was one of the four dogs used in the study that were able to identify the odour of stress

CLARA WILSON/QUEEN’S UNIVERSITY BELFAST/PA

Researchers believe that this could allow dogs to be trained more effectively to help people with conditions such as anxiety or post-traumatic stress disorder, which can involve panic attacks and flashbacks.

“These service animals are currently predominantly trained to respond to visual cues,” said Clara

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Many of us are familiar with the feeling of anxiety, especially ahead of important occasions. But those are usually one-offs, like a first date or a medical procedure. When that feeling of anxiety turns chronic and happens after specific triggers, it becomes a psychiatric disorder.

The Lancet estimates that about 76.2 million people worldwide have anxiety disorders – more than before due to the SARS-CoV-2 (COVID-19) pandemic. [1] this makes it more essential than ever that countries employ strong mental health support systems to aid people’s psychological well-being. But you can’t get treatment without first getting a diagnosis.

If you suspect you may be suffering from an anxiety disorder, here are 5 signs to watch out for.

What is an anxiety disorder?

Anxiety disorders are mental health conditions. It’s different from simple fear or nervousness, as it actively hinders your ability to function normally. There are often triggers (conscious or otherwise) that cause these feelings of panic and dread, and you cannot control your emotional response.

You may feel anxiety prior to a job interview or a significant test. Your anxiety may even be a positive response to a hazardous situation. But when that anxiety becomes chronic – or regularly triggered by some stimulus – and interferes with your daily life, that indicates a deeper underlying condition. [2]

Types of anxiety disorder

Anxiety disorders share common symptoms and manifestations, but emerge from different triggers. Some types of anxiety disorders include [3]:

  • Generalised anxiety disorder: This is a persistent feeling of unease or dread that interferes with your daily life. You may experience anxiety for prolonged periods of time, which affects your ability to function.
  • Phobias: Phobias emerge from a specific trigger, such as social situations (social anxiety), objects, or even other people.
  • Panic disorder: If a person suffers several panic attacks over a short period of time, they are diagnosed with a panic disorder.

Signs of an anxiety disorder

There are several symptoms of an anxiety disorder, which vary depending on the type of condition a person has. But here are 5 common ones that manifest in people. [4]

#1 – Feelings of panic or unease

A person suffering from anxiety will consistently and regularly feel sudden, intense panic or unease. There is usually a trigger, whether the person is aware of the trigger or not. 

For example, a person with generalised anxiety may feel triggered by their academic classes and tests. A person with social phobia may feel panicked at the thought of attending a wedding or presenting in front of their classmates and professor.

While on-off occurrences of panic and unease are normal in humans, persistent and uncontrollable panic is a sign of a genuine psychiatric issue.

A person suffering from anxiety will consistently and regularly feel sudden, intense panic or unease

#2 – Obsessive or intrusive thoughts

Intrusive thoughts tend to come out of nowhere, appearing unprompted in our minds. They may be related to the situation at hand, or they may be related to a previous experience that you suddenly remember. Intrusive thoughts tend to focus on violent or otherwise socially unacceptable concepts.

A person suffering from intrusive thoughts may get the sudden impulse to break a glass when they see one. That intrusive thought then triggers or adds to anxiety, since they recognise the wrongness of the concept and fear that they might act on it. [5]

#3 – Breathing and heart issues

Shortness of breath is a common sign of anxiety and may be a signal of an oncoming panic attack. A person suffering an anxiety attack may feel they are unable to breathe, as if their chest and lungs are constricted. In most cases it is harmless and will lift as soon as the anxiety passes.

Difficulty breathing leads to less oxygen in our bloodstream, which triggers an increased heartrate as your heart tries to pump more blood to your organs. This may also cause some chest pain and sweating. [6]

Shortness of breath is a common sign of anxiety, and may be a signal of an oncoming panic attack

#4 – Inability to calm down

For neurotypical persons, when they experience anxiety, they are often able to calm themselves down and mitigate the feeling. However, for those suffering an anxiety disorder, they are unable to regulate their breathing and lower their heartrate because the feeling is so intense and persistent.

Persons suffering an anxiety attack cannot simply “calm down” and feel better in a few minutes. The feeling of anxiety will persist, often even after the trigger has been removed or addressed.

#5 – Frequent dizziness and nausea

Shortness of breath and rapid heartbeats often lead to dizziness due to the lack of oxygen in your blood. People feel dizzy for a variety of reasons – dehydration or sleep deprivation, for example – but if your dizziness is paired with a strong feeling of unease or dread, that’s often a sign of anxiety.

Meanwhile, that fear may also trigger nausea. Your brain is experiencing a high level of stress, which affects many systems in your body – including your digestive system. You may feel like vomiting or like you’ve bloated, and you may even experience a stomach ache or acid reflux. [7]

Diagnosing anxiety

If you experience a combination of these symptoms over an extended period of time, there is a high chance you are suffering from an anxiety disorder. Speak to your healthcare provider and request that they refer you to a psychiatrist or psychologist. Your general practitioner may first attempt to rule out a physiological cause, such as a virus or bacterium.

A psychiatrist or psychologist will use specialised tests and assessment tools to diagnose your disorder. They may interview you closely and examine your symptoms to determine your diagnosis. It is especially important to emphasise the detriment your symptoms have on your daily life. [8]

Managing your anxiety

There are several strategies you can take to manage and mitigate your anxiety. Some involve self-coping mechanisms such as yoga, meditation and relaxation techniques. Adjusting your diet and exercise routines may also improve your symptoms. And of course, your psychiatrist may prescribe you medication to medically address your condition. [9]

Anxiety may affect your quality of life and ability to function, but you can take steps so it does not prevent you from living your life. If you suspect you may be suffering from an anxiety disorder based on these signs and others, consult your doctor at the soonest possible time. 

REFERENCES

[1] www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02143-7/fulltext
[2] psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders
[3] www.nimh.nih.gov/health/topics/anxiety-disorders
[4] uhs.umich.edu/anxietypanic#symptoms
[5] adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/unwanted-intrusive-thoughts
[6] www.medicalnewstoday.com/articles/326831#the-connection
[7] www.healthline.com/health/anxiety/anxiety-nausea#causes
[8] my.clevelandclinic.org/health/diseases/9536-anxiety-disorders#symptoms-and-causes
[9] adaa.org/tips

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A first-of-its-kind air-breathing weapon has been selected by the United States Air Force to be the latest addition to its growing hypersonic arsenal.

The USAF has announced its selection of the Hypersonic Attack Cruise Missile (HACM), an air-breathing scramjet, to be delivered by Raytheon Missiles & Defense and its partners Northrop Grumman Corporation as part of a contract aimed at producing operationally ready weaponry to aid in the USAF’s air defense efforts.

The hypersonic munition will be developed in tandem with a joint project arrangement between the United States and Australia called the Southern Cross Integrated Flight Research Experiment (SCIFiRE).

Wes Kremer, president of Raytheon Missiles & Defense, said his company “continues to be at the forefront of hypersonic weapon and air-breathing technology development.”

“With advanced threats emerging around the globe, the Hypersonic Attack Cruise Missile will provide our warfighters a much-needed capability,” Kremer said in a statement.

Scramjets, a variety of ramjet air-breathing jet engines, produce combustion within a stream of gas while being propelled at high speeds, which compresses incoming air forcibly and helps them to achieve sustained flight at hypersonic speeds of Mach 5 or more.

Thanks to their efficient design, hypersonic missiles like the HACM are designed to be able to avoid detection by defense systems on their way to their target by moving more quickly than traditional projectile weaponry can travel.

The HAWC, a USAF joint effort with the Defense Advanced Research Projects Agency (DARPA), was an outgrowth of the recognition that affordable but effective air-launched hypersonic cruise missiles will become a necessity in the years ahead. Part of their development has relied on emphasizing low-cost test flights to help validate essential technologies that can be quickly implemented into new designs and improvements.

Along with effectiveness and low cost, another key area of focus with the HAWC involves air vehicle feasibility, with additional focus on next-gen air vehicle designs to help optimize hypersonic flight, as well as research into the use of hydrocarbon scramjet-powered propulsion capabilities. Other features going into the design of the HAWC included high-temperature cruise capabilities and designs able to sustain a great degree of thermal stress.

Northrop Grumman Defense Systems corporate vice president and president Mary Petryszyn says her company’s scramjet technology “is ushering in a new era for faster, more survivable and highly capable weapons.” Petryszyn said in a statement that the HACM will represent “a new class of strategically important weapons” in the United States arsenal that will be of great strategic significance.

Mutual efforts between Northrop Grumman and Raytheon Technologies have been underway since 2019, as they combined Raytheon’s innovative air-breathing hypersonic weapons systems with optimized scramjet engines produced by Northrop Grumman.

Such designs, capable of travel exceeding a mile per second and able to withstand temperatures in the range of 2,000°F, have helped Northrup Grumman maintain its place as an industry leader in next-generation propulsion for military technologies.

“Their combined efforts enable both companies to produce air-breathing hypersonic weapons,” Northrop Grumman said in a statement, adding that their cooperation with Raytheon in producing the HAWK will represent “the next generation of tactical missile systems.”

Micah Hanks is Editor-in-Chief and Co-Founder of The Debrief. Follow his work at micahhanks.com and on Twitter: @MicahHanks.



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Editor's note: Find the latest long COVID news and guidance in Medscape's Long COVID Resource Center.

Long COVID: The name says it all. It's an illness that, for many people, has not yet stopped.

Eric Roach became ill with COVID-19 in November 2020, and he's still sick. "I have brain fog, memory loss," says the 67-year-old Navy veteran from Spearfish, SD. "The fatigue has just been insane."

Long COVID, more formally known as post-acute sequelae of COVID (PASC), is the lay term to describe when people start to recover, or seem to recover, from a bout of COVID-19 but then continue to suffer from symptoms. For some, it's gone on for 2 years or longer. While the governments of the U.S. and several other countries formally recognize the existence of long COVID, the National Institutes of Health (NIH) has yet to formally define it. There's no approved treatment, and the causes are not understood.

Here's what is known: Long COVID is a post-viral condition affecting a large percentage of people who become infected with the coronavirus. It can be utterly debilitating or mildly annoying, and it is affecting enough people to cause concern for employers, health insurers, and governments.

First, the Many Symptoms

According to the CDC, long COVID symptoms may include:

  • Tiredness or fatigue that interferes with daily life

  • Symptoms that get worse after physical or mental effort (also known as "post-exertional malaise")

  • Fever

  • Difficulty breathing or shortness of breath

  • Cough

  • Chest pain

  • Fast-beating or pounding heart (heart palpitations)

  • Difficulty thinking or concentrating (sometimes referred to as "brain fog")

  • Headache

  • Sleep problems

  • Dizziness when standing

  • Pins-and-needles feelings

  • Change in smell or taste

  • Depression or anxiety

  • Diarrhea

  • Stomach pain

  • Joint or muscle pain

  • Rash

  • Changes in menstrual cycles

"People with post-COVID conditions may develop or continue to have symptoms that are hard to explain and manage," the CDC says on its website. "Clinical evaluations and results of routine blood tests, chest x-rays, and electrocardiograms may be normal. The symptoms are similar to those reported by people with ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) and other poorly understood chronic illnesses that may occur after other infections."

Doctors may not fully appreciate the subtle nature of some of the symptoms.

"People with these unexplained symptoms may be misunderstood by their health care providers, which can result in a long time for them to get a diagnosis and receive appropriate care or treatment," the CDC says.

Health professionals should recognize that long COVID can be disabling,the U.S. Department of Health and Human Services says. "Long COVID can substantially limit a major life activity," HHS says in civil rights guidance. One possible example: "A person with long COVID who has lung damage that causes shortness of breath, fatigue, and related effects is substantially limited in respiratory function, among other major life activities," HHS says.

How Many People Are Affected?

This has been difficult to judge because not everyone who has had COVID-19 gets tested for it and there are no formal diagnostic criteria yet for long COVID. The CDC estimates that 19% of patients in the U.S. who have ever had COVID-19 have long COVID symptoms.


Some estimates go higher. A University of Oxford study in September 2021 found more than a third of patients had symptoms of long COVID between 3 months and 6 months after a COVID-19 diagnosis. As many as 55% of COVID-19 patients in one Chinese study had one or more lingering symptoms 2 years later, Lixue Huang, MD, of the China-Japan Friendship Hospital in Beijing, and colleagues reported in the journal Lancet Respiratory Medicine in May.

According to the CDC, age is a factor. "Older adults are less likely to have long COVID than younger adults. Nearly three times as many adults ages 50-59 currently have long COVID than those age 80 and older," the CDC says. Women and racial and ethnic minorities are more likely to be affected.

Many people are experiencing neurological effects, such as the so-called brain fog, according to Ziyad Al-Aly, MD, of the Washington University School of Medicine and the VA St. Louis Health Care System, writing in the journal Nature Medicine in September. They estimated that 6.6 million Americans have brain impairments associated with COVID infection.

"Some of the neurologic disorders reported here are serious chronic conditions that will impact some people for a lifetime," they wrote. "Given the colossal scale of the pandemic, and even though the absolute numbers reported in this work are small, these may translate into a large number of affected individuals around the world — and this will likely contribute to a rise in the burden of neurologic diseases."

Causes

It's not clear what the underlying causes are, but most research points to a combination of factors.Suspects include ongoing inflammation, tiny blood clots, and reactivation of what are known as latent viruses, or those that linger quietly in your body without causing damage. In May, Brent Palmer, PhD, of the University of Colorado School of Medicine, and colleagues found people with long COVID had persistent activation of immune cells known as T-cells that were specific for SARS-CoV-2, the virus that causes COVID-19.

COVID-19 itself can damage organs, and long COVID might be caused by ongoing damage. In August, Alexandros Rovas, MD, of University Hospital Munster in Germany, and colleagues found patients with long COVID had evidence of damage to their capillaries. "Whether, to what extent, and when the observed damage might be reversible remains unclear," they wrote in the journal Angiogenesis.

People with long COVID have immune responses to other viruses, such as Epstein-Barr -- evidence that COVID-19 might reactivate latent viruses. "Our data suggest the involvement of persistent antigen, reactivation of latent herpesviruses, and chronic inflammation," immunobiologist Akiko Iwasaki, PhD, of the Yale University School of Medicine, and colleagues wrote in a study posted in August that had not yet been peer-reviewed for publication.

This might be causing an autoimmune response. "The infection may cause the immune system to start making autoantibodies that attack a person's own organs and tissues," the NIH says.

There could be other factors. A study by Harvard researchers found that people who felt stressed, depressed, or lonely before catching COVID-19 were more likely to develop long COVID afterward. "Distress was more strongly associated with developing long COVID than physical health risk factors such as obesity, asthma, and hypertension," Siwen Wang, MD, a research fellow with Harvard University'sT.H. Chan School of Public Health, said in a statement. Plus, nearly 44% of those in the study developed COVID-19 infections after having been assessed for stress, Wang and colleagues reported in the journal JAMA Psychiatry.

Vaccine Protection

There's evidence that vaccination protects against long COVID, both by preventing infection in the first place, but also even for people who have breakthrough infections.

A meta-analysis covering studies involving 17 million people found evidence vaccination might reduce the severity of COVID-19 or might help the body clear any lingering virus after an infection.

"Overall, vaccination was associated with reduced risks or odds of long COVID, with preliminary evidence suggesting that two doses are more effective than one dose," Cesar Fernandez de las Penas, PhD, of King Juan Carlos University in Madrid, Spain, and colleagues wrote.

A team in Milan, Italy, found unvaccinated people in their study were nearly three times as likely to have serious symptoms for longer than 4 weeks compared to vaccinated volunteers. Writing in July in The Journal of the American Medical Association, Elena Azzolini, MD, PhD, an assistant professor atthe Humanitas Research Hospital, said the team found two or three doses of vaccine reduced the risk of hospitalization from COVID to 16% or 17% compared to 42% for the unvaccinated.

Treatments

With no diagnostic criteria and no understanding of the causes, it's hard for doctors to determine treatments.

Most experts dealing with long COVID, even those at the specialty centers that have been set up at hospitals and health systems in the U.S.,recommend that patients start with their primary care doctor before moving on to specialists.

"The mainstay of management is supportive, holistic care, symptom control, and detection of treatable complications," Trish Greenhalgh, MD, professor of primary care health sciences at the University of Oxford, and colleagues wrote in the journal The BMJ in September. "Patients with long COVID greatly value input from their primary care clinician. Generalist clinicians can help patients considerably by hearing the patient's story and validating their experience … (and) making the diagnosis of long COVID (which does not have to be by exclusion) and excluding alternative diagnoses."

Evidence is building that long COVID closely resembles other post-viral conditions -- something that can provide clues for treatment. For example, several studies indicate that exercise doesn't help most patients.

But there are approaches that can work. Treatments may include pulmonary rehabilitation; autonomic conditioning therapy, which includes breathing therapy; and cognitive rehabilitation to relieve brain fog. Doctors are also trying the antidepressant amitriptyline to help with sleep disturbances and headaches; the antiseizure medication gabapentin to help pain, numbness, and other neurological symptoms; and drugs to relieve low blood pressure in patients experiencing postural orthostatic tachycardia syndrome (POTS).

The NIH is sponsoring studies that have recruited just over 8,200 adults. And more than two dozen researchers from Harvard; Stanford; the University of California, San Francisco; the J. Craig Venter Institute; Johns Hopkins University; the University of Pennsylvania; Mount Sinai Hospitals; Cardiff University; and Yale announced in September they were forming the Long COVID Research Initiative to speed up studies.

The group, with funding from private enterprise, plans to conduct tissue biopsy, imaging studies, and autopsies and will search for potential biomarkers in the blood of patients.

Sources

CDC: "Long COVID or Post-COVID Conditions."

CDC National Center for Health Statistics: "Nearly One in Five American Adults Who Have Had COVID-19 Still Have 'Long COVID.'"

National Institutes of Health: "Long COVID," "Long COVID symptoms linked to inflammation."

PLoS Medicine: "Incidence, co-occurrence, and evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19."

The Lancet Respiratory Medicine: "Health outcomes in people 2 years after surviving hospitalisation with COVID-19: a longitudinal cohort study."

Angiogenesis: "Persistent capillary rarefication in long COVID syndrome."

PLoS Pathogens: "SARS-CoV-2-specific T cells associate with inflammation and reduced lung function in pulmonary post-acute sequalae of SARS-CoV-2."

Lancet eClinical Medicine: "Impact of COVID-19 vaccination on the risk of developing long-COVID and on existing long-COVID symptoms: A systematic review."

JAMA Psychiatry: "Associations of Depression, Anxiety, Worry, Perceived Stress, and Loneliness Prior to Infection With Risk of Post–COVID-19 Conditions."

U.S. Department of Health and Human Services: "Guidance on 'Long COVID' as a Disability Under the ADA, Section 504, and Section 1557."

Long COVID Research Initiative:"Introducing LCRI."

Nature Medicine: "Long-term Neurologic Outcomes of COVID-19."

The BMJ: "Long covid—an update for primary care."



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Turn2Me, a national mental health charity, has spoken about the link between stress and heart conditions ahead of World Heart Day, this Thursday, September 29.

The charity said that chronic stress can lead to a stroke or heart attack, and that people should try to reduce their levels of stress for a healthier lifestyle. 

“Stress is a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances.” Suzanne Ennis, Clinical Manager at Turn2Me, said.

“Some symptoms of stress can be elevated blood pressure, rapid heartbeat, sweaty palms, palpitations, cold hands and feet, dizziness, and chest pain. Chronic stress leads to serious health problems because it disrupts nearly every system in your body.

“Part of what makes chronic stress so insidious is its ability to become a “normal” feeling, it becomes the familiar. This pattern of endurance is what makes chronic stress such a serious health issue. 

“Poverty, trauma, general pressure from the demands of life, and more can all cause chronic stress,” Suzanne continued, “Chronic stress can lead to cancer, strokes, and heart attacks, as well as violent behaviour and even suicide.  

“While under stress, your heart pumps faster, this can result in increased blood pressure, resulting in stroke or heart attack.”

Suzanne Ennis

Suzanne stated there are many ways to better manage stress, including:

Relaxation Techniques: These are activities that trigger the relaxation response, a physiological change that can help lower your blood pressure, heart rate, breathing rate, oxygen consumption, and stress hormones. These can include yoga, deep breathing and stretching.

Cognitive Behavioural Therapy: CBT is based on the idea that changing unhealthy thinking can change your emotions. A CBT therapist will help you identify negative thinking and learn to automatically replace it with healthy or positive thoughts, reducing stress.

Realistic Goal Setting: Setting goals can have a positive effect, provide one with a sense of commitment, feel they're in control, and are optimistic. Set goals in your career, relationships, creativity, play, and health can really help manage stress.

Exercise Regularly:  In addition to having physical health benefits, exercise has been shown to be a powerful stress reliever. Exercise releases endorphins—natural substances that help you feel better and maintain a positive attitude.

Daily Reflection: Conduct daily check-ins, by asking yourself how you are. What do you need to help yourself? When you’re feeling overwhelmed, remind yourself of what you do well. Try to have a healthy sense of self.

Prioritise Yourself:  The more your actions reflect your beliefs, the better you will feel, no matter how busy your life is. It’s okay to say “No” to demands on your time and energy that will place too much stress on you. You don’t always have to meet the expectations of others.

Suzanne also spoke about the negative effect anxiety can have on the body -

“Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes.” Suzanne said.

“The right psychotherapy will teach you to control your anxiety and will offer relief from anxiety in a matter of weeks.

“Therapists know that eliminating symptomatology isn't the same as eliminating aetiology. Underlying psychological causes or triggers for anxiety, such as those stemming from trauma, are not the target of management techniques; they require longer-term psychotherapy. However, anxiety-management techniques can offer relief, and offer it very speedily.  

“The unpleasant symptoms most likely to be helped by medication are the very ones that your therapist can assist you to correct. They fall into three typical clusters:

- the physical reaction that constitutes the terror of panic.

- the "wired" feelings of tension that correlate with being "stressed out" and can include pit-of-the-stomach doom.

- the mental anguish of rumination - a brain that won't stop thinking distressing thoughts.

A therapist armed with methods for addressing these clusters can offer their anxious client the promise of relief.”

Turn2Me said that sometimes people who are going through an anxiety or panic attack think they are having a heart attack.

The thought of suffering from a heart attack can be very frightening and make you more anxious. Therefore, it is important to know the difference. Turn2Me also emphasised that people who have persistent or frequent chest pain should contact their GP.

Turn2Me listed the differences between a panic attack and a heart attack:

Anxiety / Panic Attack 

  • Any pain is usually described as 'sharp’
  • The pain tends to be felt over the heart
  • The pain is usually made worse by breathing in and out and pressing on the centre of the chest
  • Pain usually disappears within 5 - 10 mins

Heart Attack Pain

  • It may or may not be present.
  • If present, you may have a ‘crushing' feeling in your chest (like someone standing on your chest)
  • Pain is not usually made worse by breathing or by pressing on the chest.
  • Pain is usually persistent and lasts longer than 5 minutes.

Turn2Me have several free weekly support groups, and one-to-one counselling sessions available to assist with managing stress, arming users with the tools they need to identify and reduce their levels of stress.  

Sign up today



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Some health care providers in Arkansas are starting to offer services tailored to patients struggling to recover weeks or months after being diagnosed with covid-19.

An estimated one in five covid-19 survivors between 18 and 64 years old and one in four survivors 65 and older have a health condition related to their illness, according to a study released this year by the federal Centers for Disease Control and Prevention, which included 63.4 million individuals.

Another 2022 study published in the Journal of Infectious Diseases estimated millions of Americans -- about 1.7% to 3.8% of the U.S. population -- experienced new, long-term symptoms that limited daily activities one month or longer after covid-19 infection.

"Because the coronavirus can attack the lungs, heart, brain and other organs, there can be lasting internal damage," said Sheena CarlLee, director of the University of Arkansas for Medical Sciences' Long Covid Clinic, which opened Aug. 25 in Fayetteville.

Damage to vital organs can exacerbate long-term health problems such as heart disease, diabetes, kidney disease, blood disorders, neurological conditions and mental health disorders.

The new UAMS clinic brings together specialists in order to treat patients across the breadth of symptoms.

"We are seeing patients with a wide variety of symptoms that require a unique treatment regimen," CarlLee said. "Our long covid clinic offers extensive evaluation from a team of students and trained health care providers from the disciplines of medicine, pharmacy, nursing, physical therapy, occupational therapy and radiation sciences."

Some of the most successful long covid clinics in the country are team-based clinics, which can dive into a variety of symptoms and devise a detailed plan, according to CarlLee.

The clinic team also works closely with researchers at the UAMS campus in Little Rock, and patients may opt in to participate in that research, she said.

UAMS bills through insurance, and the cost for patients at the long covid clinic will be the same as a primary care clinic visit, according to CarlLee.

LONG COVID

CarlLee, a UAMS internal medicine doctor, and other doctors at various UAMS campuses have seen former covid-19 patients with prolonged symptoms related to the infection, she said.

Sometimes long covid symptoms develop for people who had little or no symptoms upon their initial positive test, but long covid tends to affect those who had a more complicated initial infection, she said.

Based on recent research, people who stayed in the ICU, were put on a ventilator, are unvaccinated or have underlying medical conditions all seem more likely to develop long covid, according to CarlLee. Women also may be disproportionately affected, she said.

Long covid is still being defined by the scientific community, according to health officials, but it generally signifies new or lingering symptoms of the virus occurring at least three or four weeks after a positive covid-19 test.

Because the term has yet to be precisely defined, data varies on the condition's prevalence, said Jennifer Dillaha, director of the Arkansas Department of Health.

The symptoms and conditions associated with long covid, which will likely affect many people in the coming years, are consistent throughout the scientific literature, Rachel Levine, U.S. assistant secretary for health, wrote last month in the Journal of the American Medical Association.

Symptoms such as shortness of breath, muscle aches, cough, fatigue, loss of taste or smell and problems with memory and concentration are among the more common symptoms. Heart palpitations, dizziness, diarrhea, stomach pain, rashes and joint or muscle pain have also been experienced post-covid, according to the federal Centers for Disease Control and Prevention.

Long covid isn't a singular case of long-term symptoms developing from viral infections, according to Dr. Marti Sharkey, Fayetteville's city health officer. Epstein-Barr virus is the cause of infectious mononucleosis, more commonly known as mono, she noted.

"It's not unusual to see prolonged systems. It's not surprising with a virus that has infected so many people," she said.

PATIENTS YOUNG AND OLD

In Central Arkansas, the Strong Hearts Rehabilitation Center by Arkansas Heart Hospital offers a rehab program for long covid patients at facilities in Little Rock, Russellville, Conway and Bryant.

The center enrolled its first post-covid patients in January shortly after the U.S. Centers for Medicare and Medicaid Services issued guidance allowing programs to treat lingering symptoms of the disease, said Amanda Xaysuda, director of the center.

"We had all of that planned before then but once Medicare was paying for that and more research was coming out that it was beneficial in this patient population, that's when we decided to go for it," she said.

Strong Hearts Rehabilitation Center's program focuses on pulmonary rehabilitation. Health care providers with the center help patients build their exercise tolerance and work on breathing exercises.

"Everything else we do is focused around the patient and what symptoms they are coming in with," said Xaysuda.

The program has helped post-covid patients dealing with postural orthostatic tachycardia syndrome, an abnormal spike in heart rate that occurs after sitting up or standing.

While the program's oldest patients have been in their 90s, the youngest was 16. Many patients are in their 30s and 40s, a demographic the Strong Hearts Rehabilitation Center isn't used to seeing.

"What we've always done is traditional cardiac rehab. Typically, our patients are Medicare age. They're 65 and older," said Xaysuda. "This is a whole new population of people."

Although Medicare and some private insurance companies cover pulmonary rehab for post-covid diagnoses, Xaysuda said Arkansas Blue Cross Blue Shield does not.

Other large Arkansas health care providers do not offer specialized clinics like the ones provided by UAMS and Arkansas Heart Hospital.

In a statement Thursday, spokesman Joshua Cook said CHI St. Vincent does not have a clinic dedicated to long covid treatment.

At Baptist Health, the prevalence of long covid is not high enough to warrant a specialty clinic, said Dr. Amanda Novack, medical director of infectious diseases in a statement Friday. Primary care physicians with Baptist Health nevertheless work with long covid patients to create personal care plans.

"These treatments might include specialized treatments such as physical therapy, nutritional support, cardiac or pulmonary rehabilitation," said Novack in the statement.

COMMUNITY RESPONSE

Sharkey, the Fayetteville city health officer, said preventing transmission should still be a goal of the community.

"Every time we get infected with this virus, there's another risk for long covid. Just because you haven't had long covid doesn't mean you won't," she said. "We have people who got covid on the first wave in winter of 2020 that are still suffering.

"We're definitely a lot better than where we were a year ago, but we're not at the end yet," she said.

Sharkey recommends people experiencing long-term covid symptoms visit a clinic with a team-based multidisciplinary approach, like the UAMS clinic.

"You need a team approach to assess multiple organ systems and have a very tailored approach to the symptoms of the person," she said.

Getting vaccinated will help fight transmission of the virus, Dillaha said.

"I'd encourage people to get primary vaccination doses, followed by at least one booster dose. Take reasonable steps to avoid getting infected. Especially if you're at high risk for severe illness," Dillaha said.

Dillaha worries people, especially parents, are not informed about long covid and do not consider the risks of infection when deciding whether to get themselves or their children vaccinated.

Even with mild symptoms, people should still get tested for covid-19, because they may be eligible for treatment with Pfizer's anti-viral drug Paxlovid and be able to minimize the risks of infection, according to Dillaha.

Arkansas' death toll from covid-19 topped 12,000 Tuesday. Nationally, more than 1 million people have died as a result of covid-19 infection, according to the centers.

Appointments

Residents can schedule an appointment at the UAMS clinic at 1125 N. College Avenue in Fayetteville by calling (479) 713-8701.

Source: University of Arkansas for Medical Sciences

 

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Some health care providers in Arkansas are starting to offer services tailored to patients struggling to recover weeks or months after being diagnosed with covid-19.

An estimated one in five covid-19 survivors between 18 and 64 years old and one in four survivors 65 and older have a health condition related to their illness, according to a study released this year by the federal Centers for Disease Control and Prevention, which included 63.4 million individuals.

Another 2022 study published in the Journal of Infectious Diseases estimated millions of Americans -- about 1.7% to 3.8% of the U.S. population -- experienced new, long-term symptoms that limited daily activities one month or longer after covid-19 infection.

"Because the coronavirus can attack the lungs, heart, brain and other organs, there can be lasting internal damage," said Sheena CarlLee, director of the University of Arkansas for Medical Sciences' Long Covid Clinic, which opened Aug. 25 in Fayetteville.

Damage to vital organs can exacerbate long-term health problems such as heart disease, diabetes, kidney disease, blood disorders, neurological conditions and mental health disorders.

The new UAMS clinic brings together specialists in order to treat patients across the breadth of symptoms.

"We are seeing patients with a wide variety of symptoms that require a unique treatment regimen," CarlLee said. "Our long covid clinic offers extensive evaluation from a team of students and trained health care providers from the disciplines of medicine, pharmacy, nursing, physical therapy, occupational therapy and radiation sciences."

Some of the most successful long covid clinics in the country are team-based clinics, which can dive into a variety of symptoms and devise a detailed plan, according to CarlLee.

The clinic team also works closely with researchers at the UAMS campus in Little Rock, and patients may opt in to participate in that research, she said.

UAMS bills through insurance, and the cost for patients at the long covid clinic will be the same as a primary care clinic visit, according to CarlLee.

LONG COVID

CarlLee, a UAMS internal medicine doctor, and other doctors at various UAMS campuses have seen former covid-19 patients with prolonged symptoms related to the infection, she said.

Sometimes long covid symptoms develop for people who had little or no symptoms upon their initial positive test, but long covid tends to affect those who had a more complicated initial infection, she said.

Based on recent research, people who stayed in the ICU, were put on a ventilator, are unvaccinated or have underlying medical conditions all seem more likely to develop long covid, according to CarlLee. Women also may be disproportionately affected, she said.

Long covid is still being defined by the scientific community, according to health officials, but it generally signifies new or lingering symptoms of the virus occurring at least three or four weeks after a positive covid-19 test.

Because the term has yet to be precisely defined, data varies on the condition's prevalence, said Jennifer Dillaha, director of the Arkansas Department of Health.

The symptoms and conditions associated with long covid, which will likely affect many people in the coming years, are consistent throughout the scientific literature, Rachel Levine, U.S. assistant secretary for health, wrote last month in the Journal of the American Medical Association.

Symptoms such as shortness of breath, muscle aches, cough, fatigue, loss of taste or smell and problems with memory and concentration are among the more common symptoms. Heart palpitations, dizziness, diarrhea, stomach pain, rashes and joint or muscle pain have also been experienced post-covid, according to the federal Centers for Disease Control and Prevention.

Long covid isn't a singular case of long-term symptoms developing from viral infections, according to Dr. Marti Sharkey, Fayetteville's city health officer. Epstein-Barr virus is the cause of infectious mononucleosis, more commonly known as mono, she noted.

"It's not unusual to see prolonged systems. It's not surprising with a virus that has infected so many people," she said.

PATIENTS YOUNG AND OLD

In Central Arkansas, the Strong Hearts Rehabilitation Center by Arkansas Heart Hospital offers a rehab program for long covid patients at facilities in Little Rock, Russellville, Conway and Bryant.

The center enrolled its first post-covid patients in January shortly after the U.S. Centers for Medicare and Medicaid Services issued guidance allowing programs to treat lingering symptoms of the disease, said Amanda Xaysuda, director of the center.

"We had all of that planned before then but once Medicare was paying for that and more research was coming out that it was beneficial in this patient population, that's when we decided to go for it," she said.

Strong Hearts Rehabilitation Center's program focuses on pulmonary rehabilitation. Health care providers with the center help patients build their exercise tolerance and work on breathing exercises.

"Everything else we do is focused around the patient and what symptoms they are coming in with," said Xaysuda.

The program has helped post-covid patients dealing with postural orthostatic tachycardia syndrome, an abnormal spike in heart rate that occurs after sitting up or standing.

While the program's oldest patients have been in their 90s, the youngest was 16. Many patients are in their 30s and 40s, a demographic the Strong Hearts Rehabilitation Center isn't used to seeing.

"What we've always done is traditional cardiac rehab. Typically, our patients are Medicare age. They're 65 and older," said Xaysuda. "This is a whole new population of people."

Although Medicare and some private insurance companies cover pulmonary rehab for post-covid diagnoses, Xaysuda said Arkansas Blue Cross Blue Shield does not.

Other large Arkansas health care providers do not offer specialized clinics like the ones provided by UAMS and Arkansas Heart Hospital.

In a statement Thursday, spokesman Joshua Cook said CHI St. Vincent does not have a clinic dedicated to long covid treatment.

At Baptist Health, the prevalence of long covid is not high enough to warrant a specialty clinic, said Dr. Amanda Novack, medical director of infectious diseases in a statement Friday. Primary care physicians with Baptist Health nevertheless work with long covid patients to create personal care plans.

"These treatments might include specialized treatments such as physical therapy, nutritional support, cardiac or pulmonary rehabilitation," said Novack in the statement.

COMMUNITY RESPONSE

Sharkey, the Fayetteville city health officer, said preventing transmission should still be a goal of the community.

"Every time we get infected with this virus, there's another risk for long covid. Just because you haven't had long covid doesn't mean you won't," she said. "We have people who got covid on the first wave in winter of 2020 that are still suffering.

"We're definitely a lot better than where we were a year ago, but we're not at the end yet," she said.

Sharkey recommends people experiencing long-term covid symptoms visit a clinic with a team-based multidisciplinary approach, like the UAMS clinic.

"You need a team approach to assess multiple organ systems and have a very tailored approach to the symptoms of the person," she said.

Getting vaccinated will help fight transmission of the virus, Dillaha said.

"I'd encourage people to get primary vaccination doses, followed by at least one booster dose. Take reasonable steps to avoid getting infected. Especially if you're at high risk for severe illness," Dillaha said.

Dillaha worries people, especially parents, are not informed about long covid and do not consider the risks of infection when deciding whether to get themselves or their children vaccinated.

Even with mild symptoms, people should still get tested for covid-19, because they may be eligible for treatment with Pfizer's anti-viral drug Paxlovid and be able to minimize the risks of infection, according to Dillaha.

Arkansas' death toll from covid-19 topped 12,000 Tuesday. Nationally, more than 1 million people have died as a result of covid-19 infection, according to the centers.

 

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In her mid-20s, Joanna Lumley experienced "a complete nervous breakdown". Quitting the play she was performing at the time, the young, single mum fled to her parents' home in Kent. "I was off [work] for six months," Lumley recalled. "I was pretty badly shaken up," she said of her anxiety. "My nerves were gone. I didn’t dare go to the shops. I had a really ropey old time. I was spending all day thinking, 'How will I get through the day?'"

Lumley told The Times: "I had those panic attacks when you think, 'Breathe in, breathe out, just keep breathing in. Study the flowers. What colour are the flowers?'

"Anything to stop your mind going mad. And I thought, 'I’ve got to get out of this, how do I?’"

Panic attacks

A panic attack "is a feeling of sudden and intense anxiety," the NHS explains.

Physical sensations can include: shaking, feeling disorientated, nausea, rapid heartbeat, breathlessness, sweating, and dizziness.

READ MORE: ‘Normal’ bowel habits – doctor’s guide to stool appearance and if something is abnormal

"The symptoms of a panic attack are not dangerous, but can be very frightening," the NHS adds.

"They can make you feel as though you are having a heart attack, or that you are going to collapse or even die."

Most panic attacks last between five minutes to half hour, but they will "always pass".

Professor Paul Salkovskis, Professor of Clinical Psychology and Applied Science at the University of Bath, discussed how you can effectively manage a panic attack.

DON'T MISS

"They can teach you ways of changing your behaviour to help you keep calm during an attack.

"You may need to see your GP regularly while you're having CBT so they can assess your progress."

Following her period of ill health, Lumley went on to star in the BAFTA award-winning sitcom Absolutely Fabulous alongside co-star Jennifer Saunders.

Joanna Lumley also stars in Absolutely Fabulous: The Movie, which airs on Saturday, September 24 at 11.40pm on BBC Two.



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