Does smoking increase anxiety and depression? If I quit, will I feel better?

By R. Ryan S Patel DO, FAPA, OSU-CCS Psychiatristrainbow cigarette (3)

Most students know about harmful effects of smoking cigarettes including the risk of cancer, stroke, heart disease, breathing problems (1). Students may also know that stopping smoking reduces these health risks (2-3).

Most people may not know that smoking contributes to anxiety and depression and that you can feel good and increase happiness by quitting smoking.

 

This study (4) analyzed mental health inforation across 26 studies and looked at positive and negative changes in mental health before and after quitting smoking cigarettes.

What did the study show?
When compared to smokers, 7 weeks to 9 years after quitting smoking, those who quit smoking reported a DECREASE in:
• Anxiety
• Depression
• Mixed anxiety and depression
• Stress
When compared to smokers, 7 weeks to 9 years after quitting smoking, those who quit smoking reported an INCREASE in:
• Psychological quality of life 0.22 Positive affect significantly 0.40
• This improvement occurred whether or not participants had anxiety or depression before quitting smoking.

But I thought people smoke to be less anxious and depressed?
• When they have not smoked for a while, smokers experience irritability, anxiety, and depression (6, 7)
• These feelings are relieved by smoking (5) thus creating the perception that smoking has psychological benefits, while in fact it is smoking that caused these psychological disturbances in the first place.

How can I quit smoking?

http://swc.osu.edu/alcohol-tobacco-other-drugs/quit-tobacco/

http://tobaccofree.osu.edu/resources/

http://smokefree.gov/
http://www.cancer.org/healthy/stayawayfromtobacco/guidetoquittingsmoking/index
http://www.cancer.org/cancer/cancercauses/tobaccocancer/smokelesstobaccoandhowtoquit/index

You may want to talk to your doctor/prescriber about medications and nicotine replacement as additional options that can help you quit.

Is smoking worth anxiety, depression and feeling bad? Is it zapping your energy level? How good will you feel after you stop smoking for good?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.
References
1. US Department of Health and Human Services. The health consequences of smoking: a
report of the Surgeon General. US Department of Health and Human Services, 2004.

2. US Department of Health and Human Services. The health benefits of smoking cessation.
US Department of Health and Human Services, 1990.

3. Pirie K, Peto R, Reeves G, Green J, Beral V. The 21st century hazards of smoking and
benefits of stopping: a prospective study of one million women in the UK. Lancet
2013;381:133-41.

4. Taylor G, et al. Change in mental health after smoking cessation: systematic review and meta-analysis. OPEN ACCESS. BMJ 2014;348:g1151 doi: 10.1136/bmj.g1151 (Published 13 February 2014)
5. Parrott AC. Does cigarette smoking cause stress? Am Psychol 1999;54:817-20.

6. Hughes JR. Effects of abstinence from tobacco: valid symptoms and time course. Nicotine
Tob Res 2007;9:315-27.

7. Guthrie SK, Ni L, Zubieta JK, Teter CJ, Domino EF. Changes in craving for a cigarette
and arterial nicotine plasma concentrations in abstinent smokers. Prog
NeuroPsychopharmacol Biol Psychiatry 2004;28:617-23.

Bothered by Winter? Could you have Seasonal Affective Disorder?

By R. Ryan Patel DO, FAPA OSU-CCS Psychiatrist

Job # 071125 Snow DEC-05-2007 Photo by Jo McCulty The Ohio State UniversityWinter can be a difficult time of year. For some students, it could be seasonal affective disorder (SAD).

What is SAD?
SAD is depressive symptoms that come and go during a particular time of year. SAD is now considered a subtype of either depression or bipolar illness (1).
Two seasonal patterns of SAD are fall-onset SAD and the summer-onset SAD. The fall-onset type, also known as “winter depression,” is more common; with depressive symptoms starting in the fall and improving by spring or summer. A spring-onset, fall-offset pattern is quite rare (2).

How common is SAD?
•SAD can occur in up to roughly 10% of the population across 20 retrospective studies (5) and a milder form among 10% to 20 % of the population (7).
• It is more common at higher northern latitudes (further away from the equator) (6), possibly because of less sunlight.
• People who relocate to higher latitudes from lower latitudes can be more vulnerable (5).

What are the symptoms of SAD?
Fall-onset tends to have what I call, “hypoactive type” symptoms depression (1,3), with symptoms of:
• Depressed mood AND
• Increased sleep, increased appetite with carbohydrate craving
• Increased weight
• Irritability
• Interpersonal difficulties (including sensitivity to rejection)
• Heavy, leaden feelings in arms or legs

Spring-onset SAD can have “hyperactive type” symptoms of depression such as insomnia, poor appetite, and weight loss.

What can students do to prevent or lessen SAD symptoms?
• Get active by exercising (check with your doctor first)
• Eat a healthy balanced diet of protein/veggies/fruit/whole grains, Omega 3’s
• Don’t isolate from family, friends, or colleagues and get involved on campus
• Take advantage of sunny days (open blinds, study near windows, time outside if possible, etc)
• Counseling
• Talk to your doctor about light therapy, medication options.

What are some of OSU’s campus resources for SAD?
Student Wellness center (Wellness coaching, nutrition)
• Exercise at the RPAC
•  Counseling and Consultation Service
Wilce Student health center

Are there any other helpful resources?

• Medline plus (4)
NAMI (National Alliance for Mental Illness)

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References
1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington, VA 2013
2. Wehr TA, Sack DA, Rosenthal NE. Seasonal affective disorder with summer depression and winter hypomania. Am J Psychiatry 1987; 144:1602.
3. Tam EM, Lam RW, Robertson HA, et al. Atypical depressive symptoms in seasonal and non-seasonal mood disorders. J Affect Disord 1997; 44:39.
4. http://www.nlm.nih.gov/medlineplus/seasonalaffectivedisorder.html
5. Magnusson A. An overview of epidemiological studies on seasonal affective disorder. Acta Psychiatr Scand 2000; 101:176.
6. Mersch PP, Middendorp HM, Bouhuys AL, et al. Seasonal affective disorder and latitude: a review of the literature. J Affect Disord 1999; 53:35.
7. Kasper S, Wehr TA, Bartko JJ, et al. Epidemiological findings of seasonal changes in mood and behavior. A telephone survey of Montgomery County, Maryland. Arch Gen Psychiatry 1989; 46:823.
8. Uptodate.com Seasonal Affective disorder. Accessed 2/3/2015.