Archives March 2023

Depression

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Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods.

Clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for weeks or more.

Considerations of Depression

Depression can occur in people of all ages:

Adults, Teenagers ,Older adults

Symptoms of depression include:

Low mood or irritable mood most of the time

Trouble sleeping or sleeping too much

A big change in appetite, often with weight gain or loss

Tiredness and lack of energy

Feelings of worthlessness, self-hate, and guilt

Difficulty concentrating

Slow or fast movements

Lack of activity and avoiding usual activities

Feeling hopeless or helpless

Repeated thoughts of death or suicide

Lack of pleasure in activities you usually enjoy, including sex

Remember that children may have different symptoms than adults. Watch for changes in schoolwork, sleep, and behavior.

If you wonder whether your child might be depressed, talk with your health care provider. Your provider can help you learn how to help your child with depression.

Types of Depression

Major depression: It occurs when feelings of sadness, loss, anger, or frustration interfere with daily life for 2 weeks or longer periods of time.

Persistent depressive disorder.: This is a depressed mood that lasts 2 years. Over that length of time, you may have periods of major depression, with times when your symptoms are milder.

Postpartum depression: Many women feel somewhat down after having a baby. However, true postpartum depression is more severe and includes the symptoms of major depression.

Premenstrual dysphoric disorder (PMDD).: Symptoms of depression occur 1 week before your period and disappear after you menstruate.

Seasonal affective disorder (SAD).: This occurs most often during fall and winter, and disappears during spring and summer. It is most likely due to a lack of sunlight.

Major depression with psychotic features: This occurs when a person has depression and loss of touch with reality (psychosis).

Bipolar disorder occurs when depression alternates with mania (formerly called manic depression). Bipolar disorder has depression as one of its symptoms, but it is a different type of mental illness.

Causes of Depression.

Depression often runs in families. This may be due to your genes, behaviors you learn at home, or your environment. Depression may be triggered by stressful or unhappy life events. Often, it is a combination of these things.

Many factors can bring on depression: 

Alcohol or drug use

Medical conditions, such as cancer or long-term (chronic) pain

Stressful life events, such as job loss, divorce, or death of a spouse or other family member

Social isolation (a common cause of depression in older adults)

When to Contact a Medical Professional

Call your provider if:

You hear voices that are not there.

You cry often without cause.

Your depression has affected your work, school, or family life for longer than 2 weeks.

You have three or more symptoms of depression.

You think one of your current medicines may be making you feel depressed.

DO NOT change or stop taking any medicines without talking to your provider.If you think your child or teen may be depressed!

You should also call your provider if:

You think you should cut back on drinking alcohol

A family member or friend has asked you to cut back on drinking alcohol

You feel guilty about the amount of alcohol you drink

You drink alcohol first thing in the morning

Diaper Rash

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A diaper rash is a skin problem that develops in the area under an infant’s diaper.

Causes

Diaper rashes are common in babies between 4 to 15 months old. They may be noticed more when babies begin to eat solid foods.

Diaper rashes caused by infection with a yeast (fungus) called candida are very common in children. Candida grows best in warm, moist places, such as under a diaper.

Candida diaper rash is more likely to occur in babies who:

Are not kept clean and dry

Are taking antibiotics or whose mothers are taking antibiotics while breastfeeding

Have more frequent stools

Other causes of diaper rash include:

Acids in the stool (seen more often when the child has diarrhea)

Ammonia (a chemical produced when bacteria break down urine)

Diapers that are too tight or rub the skin

Reactions to soaps and other products used to clean cloth diapers

Symptoms of Diaper Rash

You may notice the following in your child’s diaper area:

Bright red rash that gets bigger

Very red and scaly areas on the scrotum and penis in boys

Red or scaly areas on the labia and vagina in girls

Pimples, blisters, ulcers, large bumps, or sores filled with pus

Smaller red patches (called satellite lesions) that grow and blend in with the other patches

Older infants may scratch when the diaper is removed.

Diaper rashes usually do not spread beyond the edge of the diaper.

Exams and Tests

The health care provider can often diagnose a yeast diaper rash by looking at your baby’s skin. A KOH test can confirm if it is candida.

Treatment of Diaper Rash

The best treatment for a diaper rash is to keep the skin clean and dry. This also helps prevent new diaper rashes. Lay your baby on a towel without a diaper whenever possible. The more time the baby can be kept out of a diaper, the better.

Other tips include:

Always wash your hands before and after changing a diaper.

Change your baby’s diaper often and as soon as possible after the baby urinates or passes stool.

Use water and a soft cloth or cotton ball to gently clean the diaper area with every diaper change. Do not rub or scrub the area. A squirt bottle of water may be used for sensitive areas.

Pat the area dry or allow to air-dry.

Put diapers on loosely. Diapers that are too tight do not allow enough air flow and may rub and irritate the baby’s waist or thighs.

Using absorbent diapers helps keep the skin dry and reduces the chance of getting an infection.

Ask your provider or nurse which creams, ointments, or powders are best to use in the diaper area.

Ask if a diaper rash cream would be helpful. Zinc oxide or petroleum jelly-based products help keep moisture away from baby’s skin when applied to completely clean, dry skin.

Do not use wipes that have alcohol or perfume. They may dry out or irritate the skin more.

Do not use talc (talcum powder). It can get into your baby’s lungs.

Certain skin creams and ointments will clear up infections caused by yeast. Nystatin, miconazole, clotrimazole, and ketoconazole are commonly used medicines for yeast diaper rashes.

For severe rashes, a steroid ointment, such as 1% hydrocortisone, may be applied. You can buy these without a prescription. But first ask your provider if these medicines will help.

If you use cloth diapers:

Do not put plastic or rubber pants over the diaper. They do not allow enough air to pass through. Use breathable diaper covers instead.

Do not use fabric softeners or dryer sheets. They may make the rash worse.

When washing cloth diapers, rinse 2 or 3 times to remove all soap if your child already has a rash or has had one before.

When to Contact a Medical Professional

Contact your child’s provider if:

The rash gets worse or does not go away in 2 to 3 days

The rash spreads to the abdomen, back, arms, or face

You notice pimples, blisters, ulcers, large bumps, or sores filled with pus

Your baby also has a fever

Your baby develops a rash during the first 6 weeks after birth

Diarrhea

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Diarrhea is when you pass loose or watery stool.

Considerations

In some people, diarrhea is mild and goes away in a few days. In other people, it may last longer.

Diarrhea can make you feel weak and dehydrated.

Diarrhea inbabies and children can be serious. It needs to be treated differently than you would treat diarrhea in adults.

Talk with your health care provider if your child has diarrhea. There can be a lot to know. Your provider can help you learn how to recognize and treat diarrhea in babies and in children.

Causes of Diarrhea

The most common cause of diarrhea is the stomach flu (viral gastroenteritis). This mild viral infection most often goes away on its own within a few days.

Eating or drinking food or water that contains certain types of bacteria or parasites can also lead to diarrhea. This problem may be called food poisoning.

Certain medicines may also cause diarrhea, including:

Some antibiotics

Chemotherapy drugs for cancer

Laxatives containing magnesium

Diarrhea may also be caused by medical disorders, such as:

Celiac disease

Inflammatory bowel diseases (Crohn disease and ulcerative colitis)

Irritable bowel syndrome (IBS)

Lactose intolerance (which causes problems after drinking milk and eating other dairy products)

Malabsorption syndromes

Less common causes of diarrhea include:

Carcinoid syndrome

Disorders of the nerves that supply the intestines

Removal of part of the stomach (gastrectomy) or small intestine

Radiation therapy

People who travel to developing countries can get diarrhea from unclean water or food that has not been handled safely. Plan ahead by learning the risks and treatment for traveler’s diarrhea before your trip.

Home Care For Diarrhea

Most times, you can treat diarrhea at home. You will need to learn:

To drink plenty of fluids to prevent dehydration (when your body does not have the proper amount of water and fluids)

Which foods you should or should not eat

What to do if you are breastfeeding

What danger signs to watch out for

Avoid medicines for diarrhea that you can buy without a prescription unless your provider tells you to use them. These drugs can make some infections worse.

If you have a long-term form of diarrhea, such as diarrhea caused by irritable bowel syndrome, changes to your diet and lifestyle may help.

When to Contact a Medical Professional

Contact your provider right away if you or your child shows signs of dehydration:

Decreased urine (fewer wet diapers in infants)

Dizziness or lightheadedness

Dry mouth

Sunken eyes

Few tears when crying

Schedule an appointment with your provider if you have:

Blood or pus in your stools

Black stools

Stomach pains

Stomach pain that does not go away after a bowel movement

Diarrhea with a fever above 101°F or 38.33°C (100.4°F or 38°C in children)

Recently traveled to a foreign country and developed diarrhea

Also contact your provider if:

The diarrhea gets worse or does not get better in 2 days for an infant or child, or 5 days for adults

A child over 3 months old has been vomiting for more than 12 hours; in younger babies, call as soon as vomiting or diarrhea begins

What to Expect at Your Hospital Visit

Your provider will perform a physical exam and ask about your medical history and symptoms.

Lab tests may be done on your stools to find the cause of your diarrhea.

Over-the-counter supplements that contain healthy bacteria may help prevent diarrhea caused by taking antibiotics. These are called probiotics. Yogurt with active or live cultures is also a good source of these healthy bacteria.

The following healthy steps can help you prevent illnesses that cause diarrhea:

Wash your hands often, particularly after using the toilet and before eating.

Use alcohol-based hand gel frequently.

Teach children to not put objects in their mouth.

Take steps to avoid food poisoning.

When traveling to underdeveloped areas, follow the steps below to avoid diarrhea:

Drink only bottled water and DO NOT use ice, unless it is made from bottled or purified water.

DO NOT eat uncooked vegetables or fruits that do not have peels.

DO NOT eat raw shellfish or undercooked meat.

DO NOT consume dairy products.

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