Health care professionals tell us their patients’ most-asked questions.
Q: How do I know whether I’m depressed or just having an off week?
Dr. Valerie Taylor, Psychiatrist-in-Chief, Women's College Hospital in Toronto, says:
“The illness of depression is different from feelings of depression in that there’s a significant impairment in terms of your ability to function. That is, your symptoms cause distress and interfere with your ability to function in day-to-day life—working, parenting or socializing—for at least two weeks. Symptoms will represent a clear deviation from your normal patterns and may include a significantly low mood; a change in sleep patterns, such as insomnia or oversleeping; difficulty concentrating; a change in appetite; feelings of inappropriate guilt; or thoughts of self-harm. If you’re experiencing one or more of these things, ask someone close to you for a second opinion—sometimes family or friends are a better barometer than yourself—or take the PHQ-9, a free online assessment tool, at phqscreeners.com. If you’re concerned, schedule a visit with a mental-health professional.”
Q: I fractured my wrist doing the most ubiquitous task. Do I need to worry about osteoporosis?
Dr. Sandra Kim, medical director of the Centre for Osteoporosis & Bone Health at Women's College Hospital in Toronto says:
“A bone-mineral density test is recommended only for people aged 65 and older, unless there’s a risk factor, such as a history of low-trauma fractures or prolonged steroid use. Other indications could include a family history of osteoporosis—in particular, a parent who has suffered a hip fracture; having a medical condition associated with bone loss, such as an autoimmune disease; premature menopause [before age 45]; and use of high-risk medications, such as prednisone for inflammatory conditions. Whether or not you have one or more of these risk factors, be sure to practise good bone-health measures: Eat a balanced diet with adequate calcium and vitamin D, and engage in regular physical activity and exercise. Check out fitness guidelines at osteoporosis.ca. In addition, the elderly and those prone to falls should practise fall-prevention strategies and consider wearing a hip protector that may help cushion the impact from any falls.”
Q: Is insomnia common for menopausal women? What can I do to get back to sleep?
Dr. Ruth Heisey, Chief of the Department of Family and Community Medicine at Women's College Hospital in Toronto, says:
“When menopause hits, hot flashes and night sweats caused by low estrogen levels can wake women, who then may have difficulty falling back asleep. In addition, general anxiety and life stresses during this time can hinder sleep. The good news is that there are steps you can take to promote sleep. Exercise, manage stress and avoid alcohol and caffeine—especially in the late afternoon and evening. Before bedtime, taper off stimulating activities such as reading emails and begin a wind-down routine. Wear light layers or a comfy moisture-wicking T-shirt to bed; keep your bedroom cool; minimize screentime and keep your smartphone away from your nightstand; and install blackout curtains in your bedroom. If problems persist, your health-care provider may prescribe hormone therapy, antidepressants or other medications to help.”