Top10MD Blog


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 2 years ago    Leave a comments (0)

Depression is not “one size fits all,” particularly when it comes to the genders. “Not only are women more prone to depression than men, but also the causes of female depression and even the pattern of symptoms are often different,” says Pat Rabjohn, MD, PhD of Rabjohn Behavioral Institute. Many factors contribute to the unique picture of depression in women—from reproductive hormones to social pressures to the female response to stress. Learning about these factors can help you minimize your risk of depression and treat it more effectively.

What is Depression?

Sadness or downswings in mood are normal reactions to life’s struggles, setbacks, and disappointments. Many people use the word “depression” to explain these kinds of feelings, but depression is much more than just sadness.

Some people describe depression as “living in a black hole” or having a feeling of impending doom. However, some depressed people don’t feel sad at all—they may feel lifeless, empty, and apathetic, or men in particular may even feel angry, aggressive, and restless.

Whatever the symptoms, depression is different from normal sadness in that it engulfs your day-to-day life, interfering with your ability to work, study, eat, sleep, and have fun. The feelings of helplessness, hopelessness, and worthlessness are intense and unrelenting, with little, if any, relief.

Common Complaints Include

  • Depressed mood
  • Loss of interest or pleasure in activities you   used to enjoy
  • Feelings of guilt, hopelessness, and worthlessness
  • Suicidal thoughts or recurrent thoughts of death
  • Sleep disturbance (sleeping more or sleeping less)
  • Appetite and weight changes
  • Difficulty concentrating
  • Lack of energy and fatigue

There are many effective treatments for depression, including therapy, medication, and alternative treatments. Learning about your options will help you decide what measures are most likely to work best for your particular situation and needs. If even the thought of tackling your depression seems overwhelming, don’t panic. Feeling helpless and hopeless is a symptom of depression—not the reality of your situation. It does not mean that you’re weak or you can’t change!

Dr. Patrick Rabjohn is a Mansfield, Texas Psychiatrist, and Board Certified by the American Board of Psychiatry & Neurology. Dr. Rabjohn is Medical Director of Rabjohn Behavioral Institute treating psychiatric conditions including depression, anxiety disorders, adult ADD and more. Dr. Rabjohn has been named Top10MD for two years an honor only 1-in-3 Doctors in the United States succeed with this recognition in the United States. To schedule your appointment contact Dr. Rabjohn at 817-539-2282.


 3 years ago    Leave a comments (0)

We all have a poor night’s sleep from time to time: those nights when you lie awake for hours trying desperately to go to sleep but can’t stop worrying about tomorrow. Or when you repeatedly wake up throughout the night, or can’t get back to sleep in the early hours of the morning.

One-third of the world’s population experience short-term sleeping difficulties. These usually last only a few weeks. A person with insomnia is unable to fall asleep, stay asleep, and/or wakes up too early at least three times a week for at least three months. This can lead to considerable distress.

Sufferers experience persistent tiredness, low energy and difficulties with concentration, attention and memory. They may feel down, stressed or anxious, not only about getting a good night’s sleep but about their ability to do their daily activities.

Interesting Insomnia Facts:

  • People today sleep 20% less than they did 100 years ago.
  • More than 30% of the population suffers from insomnia.
  • One in three people suffer from some form of insomnia during their lifetime.
  • More than half of Americans lose sleep due to stress and/or anxiety.
  • Between 40% and 60% of people over the age of 60 suffer from insomnia.
  • Women are up to twice as likely to suffer from insomnia than men.
  • Approximately 35% of insomniacs have a family history of insomnia.
  • 90% of people who suffer from depression also experience insomnia.
  • Approximately 10 million people in the U.S. use prescription sleep aids
  • People who suffer from sleep deprivation are 27% more likely to become overweight or obese.

 What Causes Insomnia?

Biological, social and psychological factors interact to trigger and maintain sleeping difficulties.

Biological factors include changes to the body’s natural 24-hour body clock, or circadian rhythms, which control the timing of when we feel sleepy and awake throughout the day. Circadian rhythms are sensitive to body temperature, light and physical alertness. When there is too much or too little of a combination of these factors, the body doesn’t release enough sleep-inducing hormones such as melatonin to feel sleepy.

Social factors, such as shift work or frequent international travel, can contribute by causing our body clock to become out of sync with the environment it’s in. Our bodies adjust slowly to these changes and depend on our being able to get sunlight exposure and exercise.

Psychological factors, including unhelpful thoughts (“I’m never going to get to sleep tonight”) and behaviors (watching the clock during the night), can reduce the amount and quality of sleep a person gets.

These factors interact in complex ways. Sleep sensitivity, or a family history of sleep disturbance, for example, make some individuals vulnerable to developing insomnia because they’re more likely to have their sleep disturbed by stressful events, such as a relationship breakdown.

Being unable to fall asleep often leads to bedtime worrying, which makes it even harder to fall asleep. To try to make up for a lack of sleep, you might then start going to bed earlier, sleep in or take daytime naps. Over time, these unhelpful thoughts and behaviors can create a cycle that makes the insomnia worse.

How Do You Treat Insomnia?

Successful treatment of insomnia requires getting help to change as many of the interacting factors as possible, rather than trying one or two things in isolation. This is what cognitive- behavioral therapy, or CBT, tries to do.

CBT re-trains people to view the bedroom as a place of sleeping instead of a place where they lie awake tossing and turning and worrying about not sleeping. CBT also helps people change their lifestyle and sleeping environment, learn relaxation skills and challenge the unhelpful worries and beliefs that contribute to insomnia.

CBT has been found to reduce sleeping difficulties by 50% on average, and reduces insomnia symptoms to a level where they are no longer considered clinically severe.

When people visit their General Practitioner for insomnia treatment, they’re often encouraged to use many of the techniques CBT uses. These skills are difficult to teach in a short consultation, so many patients don’t use them.

Sleeping medications may then be prescribed to help a person fall asleep and stay asleep when correctly used for a short period. But sleeping medications only provide short-term relief and can be harmful or addictive if used longer term.

To get a good night’s sleep, try to establish a relaxing bedtime routine. Limit the use of computer tablets and mobile devices before bed. If you can’t sleep, get up and do a relaxing activity, such as reading a book, and return to bed only when you feel sleepy again.

Online programs can help you to practice good sleep hygiene habits, change unhelpful sleeping patterns and reduce the worry that can contribute to insomnia, helping you to get a better night’s sleep.

If your symptoms persist, visit one of our Internal Medicine Specialists, Psychologists or Sleep Medicine Specialists for CBT Today.


 3 years ago    Leave a comments (0)

Researchers have done a lot of work over the past several years to conclude that there are several seemingly insignificant symptoms that can arise in different parts of the body that could be pointing to a heart issue. So now is the time to get informed in order to help catch and prevent any heart issues later on!

 1. Chest or Shoulder Pain  chest pain

Surprisingly, one of the most common signs of coronary heart disease (CAD) is Angina, which is pressure and pain in your chest. Unlike the sharp pain of a heart attack, Angina is typified with a deep ache and constricting feeling on your chest, that is often magnified when you take a deep breath. Sometimes this type of sign and symptom is often missed because people mistake it for heartburn. This pain can also spread to the arm, neck, shoulders and jaw, where it is further mistaken for muscle pain.

Unlike a pulled muscle, Angina typically manifests itself as a prolonged pain, rather than a pain that comes and goes eventually.

Angina Statistics

17 million people have Angina, according to the National Heart, Lung and Blood Institute, and it is roughly the same in men and women. Angina occurs when the arteries in the heart get clogged with plaque build-up and episodes can occur when the heart is under stress or when the body is exercising.

How Angina Is Treated

Your doctor will probably prescribe you a medication called Nitroglycerin, which relaxes the veins that are pumping blood to the heart, allowing them not to have to work so hard. They will also probably tell you to take it easy and rest if you feel an episode coming on.

2. Shortness of BreathShortness of breath

Shortness of breath is commonly an early sign of heart disease or lung disease and feels like compression on your chest as well as not being able to catch up with your breath. This type of labored breathing may also be experienced at night as well as any time you are laying down.

According to the Harvard School Medical Health Guide, 95% of women who have had heart attacks claimed they had experienced certain forms of labored breathing and unusual symptoms either a few weeks or months before their heart attack.

Shortness of breath occurs when there is not enough oxygen in your blood because the heart isn’t pumping strong enough. It feels similar to exerting yourself in high altitudes and you don’t feel like you can get enough oxygen in your lungs.

3. Sexual Problems

For doctors, a big alert to a progressive heart disease is the presence of erectile dysfunction in males and this is the first thing that should be ruled out when a doctor is seeing a patient with this issue. According to the Mayo Clinic, men in the age range of 40-49 who had erectile dysfunction were twice as likely to develop heart disease. Furthermore, in another study, results showed that 2 out of 3 men who were being treated for cardiovascular disease, also had a previous history of erectile dysfunction. With this being said, if you or a loved one has erectile dysfunction, they should have their heart checked as soon as possible.

4. Sleep Apnea or Snoring man snoring

A big complication to the heart is restricted breathing during sleep. According to the American College of Cardiology, those with sleep apnea were found to be 3x more likely of having cardiovascular disease. Because there is airway obstruction with sleep apnea and snoring, the heart has to pump twice as hard to support the lungs. If you have either of these, going to a sleep specialist and having a sleep study performed is the most proactive way to take care of your health.

5. Bleeding, Swollen or Sore Gums

These are all symptoms of periodontal disease, which occurs from exposure to bacteria within the mouth, causing gums to hurt and become inflamed, and then the gums start to separate from the teeth.

According to the American Academy of Periodontology, research has begun linking poor circulation in the heart to periodontal disease. And researchers continue to study whether there is a connection between plaque build up in the heart and gum disease, which could both be responses to the body’s prolonged inflammation.

Additional studies have also established a connection between periodontal disease and strokes, due to an oral infection in the mouth spreading to the heart.

If you have any of these symptoms, don’t wait to see a periodontist and even maybe a heart specialist to ensure you’re taking care of your mouth and heart.

Swollen legs and feet6. Swollen Legs & Feet

Ever notice that your shoes are tighter than normal? Or notice that your hands and wrists are puffy? Do you constantly have indentation marks from socks once you take them off? These could all be factors of fluid retention, and furthermore be a sign of cardiovascular disease or heart failure.

Why Does the Body Get Swollen & Puffy?

The body holds on to fluids when the heart doesn’t pump fast enough, and therefore waste products are not removed from tissue. If you notice any of these symptoms, report them to your doctor, who can determine if your heart is healthy.

7. Having an Irregular Heart Beat or Arrhythmia

Coronary artery disease, which restricts blood flow to the heart, is most commonly seen through symptoms of an irregular heartbeat. Heart failure is caused when the heart beats too hard and fast as it is trying to overcompensate from the arrhythmia (irregular heartbeat).

What to Do?

Go have an EKG performed, which measures the heart’s electrical activity. A stress test can also measure your heart rate, to make sure it is pumping properly.


 3 years ago    Leave a comments (0)

Here we are in the midst of it, shorter days, cloudy skies, bitter, cold weather and by the early evening, it’s already dark Tired & depressed businessmanoutside. If that’s not a recipe for getting a little down, I don’t know what is! But really, does the winter season magnify the symptoms of depression?

Depression Study in Netherlands

In 2011, the Netherlands set out to find out if this was the case by performing a case study on 6,000 people. They analyzed the effects the winter and seasonal changes had on individuals with anxiety, depression, or both anxiety and depression. Interestingly, those with depression showed little to no signs of changes in symptoms. Those with anxiety did experience a change in their symptoms slightly, with increased depressive symptoms. Similarly, the statistic in America is that about 6.7% of Americans who already suffer from depression & anxiety, find that their symptoms get worse during the winter.

Seasonal Affective Disorder (SAD)

Although that study concluded a small change in symptoms with those already with depression and anxiety, there is a another form of depression that occurs distinctly in the winter called, Seasonal Affective Disorder (SAD). SAD affects roughly 10 million Americans. It is typified by individuals falling into an emotional slump between the months of October through March or April. This disorder affects about 10-20% of the population on a minor level, and an additional 4-6% of the population is affected in a much more severe case of SAD. Most individuals with SAD report at least one relative with substance abuse or a severe depressive disorder, and SAD is more common the further north you live. Lastly, it typically doesn’t show up in individuals younger than 20 years old.

Depressed girl walkingSymptoms of SAD

  • Weight gain
  • Extreme fatigue
  • Getting too much sleep
  • Difficulty concentrating
  • Withdrawal from friends & family
  • Loss of interest in activities previously enjoyed
  • Decrease in sexual drive

Treatment for Winter Depression – Have A Game Plan!

  • Talk Therapy – this often involves finding a therapist you are comfortable with talking to and they will help you set goals and try to meet them whether it is relational and social goals, exercise etc.
  • Hormone melatonin – this will help with restless sleep
  • Exercise routine – Making a plan to stick to a small yet doable routine of even 3 activities a week is better than no activity at all. Schedule a walk with a friend, or schedule to meet a friend at a work out class, or walk your dog regularly.
  • Light therapy – This may be as simple as getting up early when it gets light and going for a brief walk
  • Antidepressant medication – because there are several other natural methods of treatment, this should only be coupled with one of those, if completely necessary, and not taken by itself as the only method to treat SAD.


 3 years ago    Leave a comments (0)

Although everyone seems to jump for joy at the thought of getting an extra hour of sleep when the time changes, there’s a real question we want to address. Does that extra hour of sleep you got over the weekend give you a health boost or does it hurt it?

Circadian Rhythms

There has been plenty of research done to suggest that the Spring forward time change is quite difficult on our body’s circadian rhythm, as well as lifestyle.  Taking it a step further, there is shown to be an increase in cyber surfing when we ought to be working, as well as an increase in suicides among men. An instructor of Psychiatry at University of Pennsylvania, Michael Grandner, says that the Fall time change is the more benign time change between the two. Interestingly, Grandner goes on to say that most people’s internal body clocks are closer to 24.5 hours a day rather than 24 hours a day. This means that it is a lot easier on the body to add time to the day, rather than take it away.

Increase in Getting Sick

Nevertheless, our body’s internal rhythm is still thrown off.  With the time change, we are more prone to getting sick this Fall. Dr. Alfred Lewy, director of the Sleep and Mood Disorders Laboratory at Oregon Health & Science University, further confirms that the difficulty our body has to the time change is because we are trying to shift our body to sleep later, as the sun and light are invading us earlier.  The sunlight and dark cycle is working opposite to what we need.

Increase in Car Accidents

Furthermore, there is even a greater risk in car accidents with the Fall time change. A&M University did a study that showed that there were as many as 14% more car accidents during the Fall time change because people are driving, groggily, behind the wheel. Running in MorningWe are also driving in the evening, for more hours in the dark than during the Spring and Summer. This is an added risk to car accidents as well.

Winter Blues

It’s always rough when you are leaving work and it’s completely dark outside. Yet, you still have a workout class and then dinner? How could there possibly be time for all that? It didn’t seem so weird to have that kind of a schedule during the Spring and Summer months, when it stayed light til 8 or 9pm. But somehow, during the Winter, when it seems to get dark as early as 4:45 or 5pm, it makes you feel like you just want to go home, thrown on the sweats, and get in bed.  The darker Winter months are definitely hard, for those more vulnerable to the Winter blues.  But, one of the best ways to stave off that sad mood is to expose yourself to the bright sunlight, first thing in the morning. At least this is one basic way to boost yours spirits.

So if you’re feeling a little “off” this upcoming week, keep in mind that your body is working hard to keep everything in check! Make sure to get plenty of sleep and stay alert on the road!


 3 years ago    Leave a comments (0)

Could delaying our school start times be the answer for our teens suffering from insufficient sleep? According to the nation’s largest pediatric group, there is a chronic sleep loss epidemic among teens, who have insufficient, erratic and delayed sleep patterns.  An effective countermeasure to this problem, could be to delay middle school and high school start times to 8:30 a.m., claims the pediatric group.

Negative Factors on Teen’s Sleep Patterns

There are several negative effects on teen’s sleep patterns. These include: lifestyle choices and busy schedules, academic demands, and disrupted sleep associated with puberty.

If the start time of school could be pushed back to 8:30 a.m., then teens are more likely to be able to get 8.5-9.5 hours of sleep a night, claims the American Academy of Pediatrics.

According to a poll conducted in 2006 by the National Sleep Foundation, only 1 of 5 adolescents get 9 hours of sleep a night and almost half of adolescents get less than 8 hours of sleep per night.  Judith Owens, director of sleep medicine at Children’s National Medical Center in Washington, D.C., says that as adolescents get older, they are less likely with each passing year to get a sufficient amount of sleep per night.

Owens claims that without our teens getting enough sleep, it could eventually become a public health crisis. With that in mind, parents, let’s encourage our children to get an earlier start on their post school activities and homework and help them start winding down earlier to get that necessary 8.5-9.5 hours of sleep a night!


 3 years ago    Leave a comments (0)

Are You In Need of A Detox?

Is it hard to remember the last time you had a good night’s sleep without waking up in the middle of the night?  How about your sugar cravings, are they through the roof?  And those allergies.. every year do they seem to be worse than before?  If so, you may be in need of a detox. According to Dr. Jeffrey Morrison, an integrative physician from New York, he can spot someone in need of a detox from a mile away!

By Detox.. We Don’t Mean A Weird Juice Concoction!

Oftentimes unique juice concoctions are void of protein and full nutrients and high in sugar, thus leaving your blood sugar levels and cravings on a wild roller coaster.  Further more, fatigue sets in when your typical daily diet crashes to a frightening low number of calories.

Through these 5 signs and symptoms, Dr. Jeffrey points out 5 specific targeting cures that fall more closely in line with homeopathic remedies that area available at pharmacies and specialty grocery stores.

5 Signs that You Are in Need of A Detox

1. Difficulty Staying Asleep: According to Dr. Morrison, a sign your liver is under stress is when you pop awake in the middle of the night. Whether it be from alcohol or medications, this is a sign that the liver is working harder than it should to detoxify chemicals in your body.

Short Term Remedy:  Glycine. This supplement helps produce GABA, which acts like a calming neurotransmitter. If mixed with water and drunk before bed, it can help you sleep

2. Sugar Cravings:  Part of the importance of a detox is not just eliminating toxins within the body but also helping to quit unhealthy habits like eating too much sugar.  It is important to realize that a juice cleanse is not going to help quitting on sugar consumption, says Dr. Morrison.

Short Term Remedy: 3 Tablespoons of apple cider vinegar in water helps eliminate sugar cravings, who knew?

3. Allergies: According to Dr. Morrison, if it seems like your allergy symptoms seem to be getting progressively worse,  it could very easily mean that your body is worn down, instead of the pollen actually getting worse.

Short Term Remedy: Local Bee Pollen.  Dr. Morrison states that as little as 1-2 granules of bee pollen before breakfast, while   slowly working up to a half teaspoon two times a day is a natural way to desensitize to local flowers. And it begins from the inside of your body, outward through this oral ingestion.

4. PMS: It’s not necessarily normal to get PMS symptoms like clockwork every month, says Morrison.  There are slight changes you can make to actually decrease crankiness and feeling bloated.  Simply doing this detox diet 50% of the time, people have seen considerable changes in their PMS symptoms says Morrison.

Short Term Remedy: Evening Primrose oil.  This seed oil has a lengthy track record for it’s anti-inflammatory properties. It can be taken 1-2 times per day.

5. Rashes: Our skin can oftentimes show what’s going on inside our body.  Especially something like itchy hives can tell you that your body is inflamed.  It could be that the main adjustment that needs to be made is eliminating inflammatory foods.

Short Term Remedy: Dr. Morrison recommends an anti-histamine called HistDao, which is an enzyme that breaks down histamines in the body and can be taken 2x per day.




 3 years ago    Leave a comments (0)

I get excited just thinking about all the benefits yoga has to offer! From improving your energy, mood and sleep, to enhancing your posture, and reducing food cravings, these are just a few of the benefits of yoga!

Mind & Body Connection

The mind and body connection during the yoga workout is the main distinguishing element of yoga compared to other exercises.  The act of consciously breathing is a huge anti-aging activity, according to Fitness advisory board member, Cyndi Lee.  This “yogic breathing” is said to oxygenate the body’s cells, helping them to get rid of toxins, as well as prevent illnesses.

Benefits Within The Body

The distinct yoga movements and poses help to work inside the body as well as outside the body, causing not only outward benefits of lean muscles and increased bone density, but also inward benefits of helping the digestive system, immune system and the reproductive system.

 Wringing Your Body Out Like A Washcloth

“Yoga is like wringing your body out like a washcloth,” says Cyndi Lee. “Its one of the best ways to keep things moving in the body. “ Now that’s a pretty great mental image! How great to be able to give our body a “wringing” by practicing yoga just two times a week!

Suffer From Migraines? Not If You Add Yoga To Your Routine!

Based off of research, in just three months of consistently practicing yoga, there has been found a significant reduction in migraines for people who suffer from them.  Although the cause of migraines is still not easily understood, we do know that the hunched over posture of looking at a computer screen or cell phone for long periods of time, can contribute to tension in the neck and shoulders which can be closely associated as one factor of migraines.

 Yoga Helps You Sleep Better

Once again, we keep coming back to stress.  Stress can cause the brain to spin over ideas and not slow down.  This can cause it to be very difficult to unwind and fall asleep. Because yoga significantly helps relieve stress, through breathing and mental exercises, it also has significant benefits to helping people get better sleep.

Yoga Can Even Help Fight Food Cravings

According to research from the University of Washington, a mindful awareness of both the emotional and physical sensations of eating is said to be brought about through the connection of breathing and the physical practice of yoga. Through strengthening the mind-body connection, this can help you become more aware of cravings when they come about and help you slow down to make better choices.

So next time you are deciding which physical activity you would like to do, grab your yoga mat and go to a class, or simply tune in to a session in the comfort of your own home from a Yoga workout on YouTube!


 3 years ago    Leave a comments (0)

Disruption of our sleep affects our brain, from disorders and poor habits and is likely the biggest health issue facing modern society, says Director of Sleep Medicine for Meridian Health in New Jersey, Carol Ash. She goes on to say that, “Sleep is a basic physiological need like water, food, and air, not getting enough of it can be lethal.

What is The Science Behind Much Needed Sleep?

Believe it or not, the brain is as active during sleep as it is when we are awake.  We have a circadian clock in our brain that controls our periods of sleepiness and wakefulness. Our body creates a sleep homeostasis, reminding our body to sleep and creating that drive to sleep so that we don’t overextend the time we are awake and in need of rest. Unfortunately, society today is pushing its boundaries onto sleep and is creating an environment of 24/7 activity.

How Much Sleep Should An Adult Get Per Night?

According to research, the amount of sleep a person needs depends on various factors and genetics, as well as how sleep deprived your body already may be.  7-9 hours of sleep per night is the recommended amount.

A common misconception is that people can get fewer than 7 hours of sleep per night and still function properly.  The problem with this is that although the immediate effects of getting less sleep may be unnoticeable, the long-term effects can take a toll on our physical and mental health.

Adverse Effects of Too Little Sleep

Based on research, studies show that those who get just 6 hours of sleep per night have a much lower performance level on tests, physical abilities, and overall mental performance.

Further adverse effects of getting too little sleep include weight gain, anxiety, depression, and insulin resistance.

Sleep & The Brain

Sleep has the benefit of allowing our brain to “reset” itself, which allows our brain to reorganize, restore, and strengthen itself to be ready again for daytime function.  It also helps our brain adapt more quickly to things during waking hours.  Other benefits of sleep and the “resetting” of the brain include improving our critical thinking skills, spatial reasoning, reaction times, judgment and overall emotional stability.

Ways To Ensure A Good Night’s Rest

Several factors affect a good night’s rest including darkness, where we sleep, and when we sleep.  An ideal environment would be dark, quiet, fresh and calm, with comfortable bedding and a lack of clutter in the room we are sleeping.  Even abstaining from electronics plays a critical role in our quality of sleep.  Trying to reduce our “screen time” on any electronic, including our phone, at least 30 minutes to an hour before going to bed, helps the brain unwind and slow down our constant over stimulation from electronics.

Natural Sleep Aids

Natural over the counter remedies for sleep may include Melatonin or Unisom.  Chamomile tea is another option that helps make you drowsy, along with tart cherries or cherry juice.

If you feel you are a candidate that needs to prioritize sleep in your life proactively and want help from a medical professional, schedule an appointment with one of our Top10MD Sleep Medicine Specialists today!


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