F E B R U A R Y 2 0 1 7 | H E L P I N G A N D S U P P O RT I N G Y O U T O L I V E W E L L A N D S E R V E W E L L . . .

O H I O D E P A R T M E N T O F A D M I N I S T R A T I V E S E R V I C E S

A d d r e s s i n g t h e n e e d s o f O h i o ’ s d e d i c a t e d p u b l i c s e r v a n t s a n d t h e i r f a m i l i e s s i n c e 1 9 8 4

Depression and heart diseaseDepressive illness is a common condition and affects one in five individuals at some time in their lives. It is characterized by feelings of sadness, lack of pleasure or loss of interest in daily life. A depressed mood can be temporary with relatively mild symptoms and may improve without treatment. In its more serious form, major depression is a severe mood disorder that doesn’t change or improve unless treated, affects a person’s memory and concentration, causes sleep and appetite changes, and can lead to suicide.

How is depression treated?Once depression has been identified, there is help available. The two most effective kinds of treatment for major depression are antidepressant medication and counseling. Best results occur with a combination of these treatments.

How is this related to heart disease?Patients with chronic physical illness are at even higher risk than the general population to develop depressive disorders. It is often a common but treatable complication of chronic conditions.

The prevalence of depressive disorders in patients who have a history of heart attack is estimated to be from 40 to 65 percent.

18 to 20 percent of coronary heart patients without history of heart attack may experience depression.

It has been well documented by several groups that patients with coronary heart disease

who are depressed are at higher risk for cardiac events (heart attacks) than

are patients with comparable heart disease who are not depressed. Medical science is currently looking for the causes of this increased risk. One study, for instance, found

there is a high prevalence of smoking among depressed patients with heart disease. Depression also can cause chemical changes in the body.

Depression can increase symptoms related to medical illness, such as pain, fatigue and sleep difficulty.

People who survive heart attacks but suffer from major depression have a three to four times greater risk of dying within six months than those who don’t suffer from depression.

What to do if you or a loved one is depressed and have chronic coronary problems:

• See your doctor for an evaluation.

• Get a referral for counseling, if indicated.

• Seek a support group in the community.

By © liveandworkwell.com. All rights reserved.

What are the symptoms of major depression?

• Persistent sad or “empty” mood;

• Loss of interest or pleasure in ordinary activities;

• Decreased energy, fatigue, being “slowed down”;

• Sleep disturbances (insomnia, early-morning waking or oversleeping);

• Eating disturbances (loss of appetite and weight, or weight gain);

• Difficulty concentrating, remembering or making decisions;

• Feelings of guilt, worthlessness or helplessness;

• Thoughts of death or suicide, suicide attempts;

• Irritability;

• Excessive crying; and

• Chronic aches and pains that don’t respond to treatment.

A person who has five or more of these symptoms for more than two weeks should bring these symptoms to the attention of his or her doctor.

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Heart disease in women: Understand symptoms and risk factorsAll women face the threat of heart disease. But becoming aware of symptoms and risks unique to women, as well as eating a heart-healthy diet and exercising, can help protect you.

Although heart disease is often thought of as a problem for men, more women than men die of heart disease each year. One challenge is that some heart disease symptoms in women may be different from those in men. Fortunately, women can take steps to understand their unique symptoms of heart disease and begin to reduce their risk of heart disease.

Heart attack symptoms for womenThe most common heart attack symptom in women is some type of pain, pressure or discomfort in the chest. But it’s not always severe or even the most prominent symptom, particularly in women. Sometimes, women may have a heart attack without chest pains. Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:

• Neck, jaw, shoulder, upper back or abdominal discomfort;

• Shortness of breath;

• Right arm pain;

• Nausea or vomiting;

• Sweating;

• Lightheadedness or dizziness; and

• Unusual fatigue.

These symptoms can be more subtle than the obvious crushing chest pain often associated with heart attacks. Women may describe chest pain as pressure or a tightness. This may be because women tend to have blockages not only in their main arteries but also in the smaller arteries that supply blood to the heart — a condition called small vessel heart disease or microvascular disease.

Women’s symptoms may occur more often when women are resting, or even when they’re asleep. Mental stress also may trigger heart attack symptoms in women.

Women tend to show up in emergency rooms after heart damage has already occurred because their symptoms are not those typically associated with a heart attack, and because women may downplay their symptoms. If you experience these symptoms or think you’re having a heart attack, call for emergency medical help immediately.

Don’t drive yourself to the emergency room unless you have no other options.

Heart disease risk factors for womenAlthough the traditional risk factors for coronary artery disease — such as high cholesterol, high blood pressure and obesity — affect women and men, other factors may play a bigger role in the development of heart disease in women. For example:

• Diabetes increases the risk of heart disease significantly more in women than in men.

• Metabolic syndrome — a combination of fat around your abdomen, high blood pressure, high blood sugar and high triglycerides — has a greater impact on women than on men.

• Mental stress and depression affect women’s hearts more than men’s. Depression makes it difficult to maintain a healthy lifestyle and follow recommended treatment, so talk to your doctor if you’re having symptoms of depression.

• Smoking is a greater risk factor for heart disease in women than in men.

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‘Heart disease in women...’ continued from Page 2

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• A lack of physical activity is a major risk factor for heart disease and, as a group, women tend to be less active than men.

• Low levels of estrogen after menopause pose a significant risk factor for developing cardiovascular disease in the smaller blood vessels (microvascular disease).

• Pregnancy complications, such as high blood pressure or diabetes during pregnancy, can increase a woman’s long-term risk of high blood pressure and diabetes and increase the risk of development of heart disease in both the mother and in her children.

Is heart disease something only older women should worry about?No. Women under the age of 65, and especially those with a family history of heart disease, need to pay close attention to the heart disease risk factors. Women of all ages should take heart disease seriously.

What can women do to reduce their risk of heart disease?

There are several lifestyle changes you can make to reduce your risk of heart disease:

• Quit or don’t start smoking.

• Exercise 30 to 60 minutes a day on most days of the week, or 60 to 90 minutes if you need to lose weight.

• Maintain a healthy weight.

• Eat a diet that’s low in saturated fat, cholesterol and salt.

You also will need to take prescribed medications appropriately, such as blood pressure medications, blood thinners and aspirin. You will need to better manage other conditions that are risk factors for heart disease, such as high blood pressure, high cholesterol and diabetes.

Exercise to reduce the risk of heart disease in womenIn general, you should do moderate exercise, such as walking at a brisk pace, for 30 to 60

minutes most days of the week. If you can’t get all of your exercise completed in one session, it’s fine to break up your physical activity into several 10- to 15-minute sessions. You still will get the same

heart-health benefits. Some research has even shown that short bursts of very intensive exercise, such as a short run in the middle of a walk, may be an effective way to boost your metabolism. This may help you keep your weight down, which in turn, helps keep your heart healthy.

There are other small changes you can make to increase your physical activity throughout the day. You can take the stairs instead of the elevator, walk or ride your bicycle to do errands, or try some sit-ups or push-ups while watching television.

What’s a healthy weight?What’s considered a healthy weight varies from person to person, but having a normal body mass index (BMI) is helpful. This calculation helps you see if you have a healthy or unhealthy percentage of body fat. A BMI of 25 or higher can be associated with an increased risk of heart disease.

Waist circumference also is a useful tool to measure whether or not you’re overweight. Women are overweight if their waist measurement is greater than 35 inches (89 cm).

Losing even small amounts of weight can help by lowering your blood pressure and reducing your risk of diabetes — both of which increase your risk of heart disease.

Is the treatment for heart disease in women different than in men?Generally, heart disease treatment in women and in men is similar. Angioplasty and stenting, commonly used treatments for heart attack, are effective for both men and women. However, women who don’t have typical chest pain are less likely to be offered these potentially lifesaving options.

If a woman’s heart symptoms are mainly caused by microvascular disease, angioplasty and stenting may not be the most effective treatment choice.

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National Wear Red Day February 3

Taking aspirin to prevent heart disease in womenGuidelines from the American Heart Association (AHA) urge women to be more aggressive about cutting their cardiovascular disease risk. For some women, this includes a daily aspirin. But, the routine use of daily aspirin therapy to prevent heart disease in low-risk women younger than 65 years old isn’t recommended.

The AHA guidelines do recommend that women of any age consider taking between 75 and 325 milligrams of aspirin daily if they have diabetes or if they already have heart disease. The AHA also recommends that women

over 65 years can benefit from a daily 81-milligram aspirin if their blood pressure is controlled and the risk of digestive bleeding is low. Aspirin might also be considered for at-risk women younger than 65 years for stroke prevention.

But, don’t start taking aspirin for heart disease prevention on your own. Talk with your doctor about the risks and benefits of taking aspirin based on your individual risk factor.

By © 2014 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.

‘Heart disease in women...’ continued from Page 3

Wear red to support the battle against heart disease in womenThe American Heart Association has designated Friday, Feb. 3 as National Wear Red Day to raise awareness about the fight against heart disease, the number one killer of women. Please join your state co-workers and millions of people throughout the nation in wearing red. The Ohio Employee Assistance Program strongly supports this effort and hopes you will participate.

Employees wishing to take small group photos are encouraged to email their photos to takechargelivewell@healthways.com. These photos may be used as part of a Wear Red Day display.

Oxidative stress: Making good lifestyle choicesThe blessing of living in a free society is that we have the freedom to make choices about our lives. But making choices and making responsible choices are two different things. More and more research is indicating that the quickest growing health threat to all Americans is oxidative stress. You may not have heard of the term, but you have heard about diabetes, heart disease and cancer. Much of the disease process involved in these conditions are due to choices we make, such as choices about diet, exercise and coping with life, that lead to oxidative stress.

Oxidative stress, choice and the battle for our cellsYou may not have heard of the term oxidative stress or heard it and not know what it means.

Oxidative stress is the damage caused by destructive oxygen molecules called free radicals.Free radicals are produced in a number of ways, both good and bad. They are produced in excess when we do things like smoke or ingest too much fat or sugar, or subject ourselves to great stress.

Free radicals are broken down and eliminated by the body’s natural system unless there are too many with which to contend. When the numbers of free radicals become too great, no matter how well our body fights, we cannot win.

In military terms, think of oxidative stress as the siege of the Alamo.No matter how bravely Davey Crockett, Jim Bowie, and the men of Texas stood their ground, they were ultimately overwhelmed by Santa Anna’s army. Like the newly formed Texas republic, our body has great defense mechanisms and the ability to repel repeated assaults. But that does not mean it cannot be overrun if it is

attacked relentlessly from all sides.

If we are genetically susceptible to heart disease, diabetes, cancer and even

Alzheimer’s, oxidative stress

can be the trigger

that turns on those diseases.

The importance of lifestyle choicesAt present, there is no simple test that will clue you into how much oxidative stress your body is suffering. But what is becoming clearer and clearer is that we can get a pretty fair indication by examining our lifestyle choices.

If we are carrying extra weight and eating the wrong foods, we are losing the war against oxidative stress. If we are taking in sugars and eating foods rich in corn syrup, we are failing to protect our cellular walls. If we are smoking and drinking and letting stress dominate our lives, the free radicals will run amok in our bodies.

Let’s start making better choices about how we care for our bodies. The health of our nation is nothing without each of us maintaining our own health.

One way to be more mindful is to make a list of things you can do to improve your health. You can pick from the suggestions below or come up with your own:

• Make a pledge to give up smoking;

• Think a little more carefully about healthy eating;

• Be on the lookout for hidden sources of sugar in your diet, especially high fructose corn syrup;

• Cut back on drinking;

• Eat more of the fruits and vegetables that are rich with nutrition;

• Get a little more exercise weekly;

• Stop texting or talking when driving (Is anyone still not buckling up?);

• Find ways to cope with stress and anxiety; and

• Don’t let depression make decisions.

Make your own list of some better decisions you can make. It may seem like work, but as anyone who has served in our military can attest, freedom means little without responsible action.

Also, to get the support you need, or if any of the things on your to-do list are too hard to start on your own, find a professional who can help. You can use the Clinician Search tool at liveandworkwell.com (on the right side of the home page) to find the right counselor or therapist near your home. To access liveandworkwell.com, go to the site where you may register if you are new to the site, sign in if you already have registered or enter access code 00832 to enter as a guest.

Use your freedom wiselyTake action. Get educated. Make the right choices.

By @ liveandworkwell. All rights reserved.

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Your employee assistance program offers confidential help for personal problems and concerns. Concerned

about a troubled family member who won’t get help? Feel tired and exhausted, but don’t know if it’s burnout, loss of motivation, depression or all three? Late for work too often? Has the use of alcohol or drugs created a crisis you are facing right now? The bottom line, never wonder if your concern is appropriate to contact OEAP. So, if you’ve been putting off taking action to solve a serious issue that is weighing on you, give OEAP a call today.

Share Your Comments about Frontline FocusYour comments are important. Please share your comments about Frontline Focus via OEAP’s confidential email address: OEAP@das.ohio.gov. Your comments may be published in a future edition of Frontline Focus.

800-221-6327/614-644-8545 ohio.gov/eapAndy Bensing, OEAP Benefits Manager

OEAP training courses offered in FebruaryThe Ohio Employee Assistance Program (OEAP) offers educational and helpful training courses through the course catalog produced by the Ohio Department of Administrative Services’ Office of Learning and Professional Development.

Below are two OEAP courses offered this month. For more details about these and other courses, see the course catalog on the Learning and Professional Development home page, which is accessible from myOhio.gov under the Career Resources tab in the top menu.

Courses

ABC’s of OEAP Feb. 9, 9 to 11 a.m.Rhodes Tower (Columbus)

This course is designed to make employees aware of the OEAP benefits and services available to them and their families. It also includes information about the importance of early intervention and how to access services through OEAP. The services are confidential.

Confronting Workplace Violence and BullyingFeb. 28, 9 a.m. to noonRhodes Tower (Columbus)

Workplace violence can include bullying, hostility, threats, intimidation and revenge. This course provides you with a better understanding of common causes, early warning signs and intervention services available through OEAP.