Lepage Associates Newsletter
Mental Health Matters
June 2009
Lepage Associates
Call: (919) 572-0000
In This Issue
Men's Health
Summer Services
Please click on each group for a flier with complete information to include description,
Relieving Stress Headaches
In recognition of National Headache Awareness Week, we want to point out the interface of medical and mental health. It is quite common for people to experience physical symptoms when they are feeling stressed or anxious. Among other symptoms, headaches are some of the most commonly occurring physical side effects of stress.
The most common type of headache is the tension headache, which is caused by stress, depression, anxiety, poor posture, and jaw clenching. These headaches are characterized by a mild to moderate pain which people often describe as feeling as if there's a tight band around their head. Tension headaches can last from 30 minutes to an entire week, but are considered chronic if they occur 15 or more days a month for at least 3 months. Signs and symptoms of a tension headache include: dull, aching head pain, sensation of pressure across the forehead, sides, or back of the head, tenderness on scalp, neck, and shoulder muscles, and loss of appetite.
What can you do to help prevent the pain? Below are suggestions found to be helpful by the Mayo Clinic:
1. Healthy Lifestyle Choices
  • Eat healthy foods and don't skip meals (especially breakfast).
  • Exercise regularly: During physical activity, the body releases chemicals that block pain signals to the brain.
  • Get enough sleep: Maintain a normal sleep schedule throughout the week.
  • Avoid excess caffeine: Although some caffeine can help curb headaches, heavy caffeine use can cause headaches and irritability.
2. Stress Control: Stress and tension headaches go hand-in-hand. This may mean setting aside 10 minutes each day to something that makes you feel good. Consider creating a 'happy list' of things you can do that involve different sensory experiences. What can you look at (movies), listen to (music), smell (flowers), taste (hot tea), do with your body (exercise), or have done to your body (massage) that helps you relieve stress?  

3. Ease muscle tension: Apply heat or ice to soothe sore neck and shoulder muscles if you feel tense. Try yoga or progressive relaxation exercises to loosen up your muscles.

4. Relax: Try a deep-breathing exercise or conscious relaxation of the muscles.

5. Keep a headache diary: To help you determine what triggers your headaches.
If you find through keeping a headache diary that your headaches are related to stressful events in your day, therapy can be helpful in learning skills to experience day-to-day life as less stressful, allowing you to have fewer headaches and feel more relaxed. 
You should also have a medical exam, if you have frequent headaches, to rule out medical illnesses and neurological problems.


The first two weeks of June are  
National Headache Awareness Week
National Men's Health Week.
Learn more about these topics
in the articles presented below.

Men's Health Awareness

As men age, the probability of health complications dramatically increases, which is why part of June is dedicated to men's health awareness. The purpose of this month is to alert men to possible health concerns and provide them with knowledge pertaining to visible symptoms, information about testing, treatment options, as well as prevention for future health risks.  
Prostate Health
Perhaps one of the most prevalent health concerns with aging men is a Benign Prostatic Hyperplasia (BPH), also known as an enlarged prostate. An estimated 50 percent of men have evidence of BPH by age fifty and more than 75 percent of men over the age of eighty.
Symptoms may include frequent urination, leaking or dribbling, or difficulty starting a stream of urine. It is recommended than men over 50 receive a yearly physical to examine their prostate for signs of growth and to check for a more serious health risk, prostate cancer. Symptoms for prostate cancer are very similar to that of BPH, but some of the differentiating symptoms include blood in the urine, pain when ejaculating, and unintended weight loss and/or loss of appetite.
There are two primary methods of testing for prostate cancer:  A rectal exam or a PSA. Examinations with your physician can determine if prostate cancer is present. The PSA test is less intrusive (by taking blood and measuring levels of prostate-specific antigens), but is also less accurate. Increased PSA levels can be caused by a much less serious problem such as an infection.
The first stage of treatment begins with an increased frequency of doctor visits and tests to measure the speed of cancer growth. This option, called "watchful waiting," is primarily for those whose symptoms are almost unnoticeable and whose cancer is growing very slowly. If the cancer shows signs of rapid growth, methods such as drug therapy, radiation, or surgery may be necessary.
Risk factors, both genetic and those in the environment, increase the likelihood of prostate cancer occurring. For example, studies have shown that African American males have a much greater chance for this type of cancer than Caucasians. Men with diets high in fat are found to be at a greater risk for prostate cancer. A family history, specifically in the brother or father, is perhaps the greatest indicator of possible risks.
Research is currently being conducted to discover new methods of preventing prostate cancer, or reducing the complications which arise from it. Proscar and Avodart are two medications which have been used to reduce the probability of prostate cancer occurring, ask your physician for more details. 
Coronary Heart Disease (CHD)
Due to work demands, time for exercise and eating healthy meals is limited and sometimes neglected, resulting in weakened muscle development of the heart and increased buildup of cholesterol and plaque. Coronary Heart Disease (CHD) is the result of fatty buildup on the walls of blood vessels. The increased strain on the heart can lead to heart pains caused by an obstructed artery, called angina, and possibly a heart attack. It is common that the victim not exhibit any of the symptoms up until the heart attack. This may be because the heart is capable of supplying blood to the body during rest, but during physical activity, the demand for oxygenated blood increases, and the supply cannot move quickly enough through clogged arteries.
The effects of CHD can be worsened by a number of factors such as:  Obesity or being overweight, lack of exercise, cigarette smoking and second-hand smoke, diabetes, high blood cholesterol, high blood pressure, advanced age, gender (being male), and family history of CHD or heart attack. Family history seems to be the strongest predictor of heart attacks due to CHD.
Although, some factors cannot be eliminated (e.g. genes), it is possible to reduce the chances of having a heart attack by limiting risk behaviors which contribute to the disease and increasing the number of protective factors which reduce the probability of a heart attack. Some examples of actions that can be taken to improve overall well-being are:  Drinking tea or consuming other foods with antioxidants, avoiding or reducing stressful activity, exercise, and reducing amount of fatty foods eaten (e.g. red meats).
It is often difficult to get motivated to make the changes necessary to help keep ourselves happy. If you, or someone you love, needs help a psychologist can assist in putting together a plan with your primary care physician to make those changes happen.
Prepare Your Child for Next Year! 
Summer should be FUN
and kids definitely deserve a break
and some down time from school!
However, summer is also an ideal opportunity to work on problems that may have had a negative effect on your child's performance during the last school year, so that next year they can enter school with these problems lessened or alleviated. Our individual, family, or group therapy formats for children and teenagers can help alleviate problems such as behavioral acting out, sadness, anxiety, social issues, etc.

Summer is also the ideal time to have any testing your child needs done. Some parents want testing to help with eligibility for special services, while other parents utilize testing simply to get a clearer view of their child's strengths and weaknesses, and recommendations to improve weaknesses. We will help you to determine what type of testing would be most useful to answer the question at hand.

Addressing your child's needs during the summer has the added benefit of not worrying about missing school for appointments, and, since the academic and social stresses of the school day are not present, it is a good time to work on improvements and growth to make next school year the best it can be!
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Monthly Reader
Each month we will recommend a book that someone at our practice has found useful. This month's book is:
Five Good Minutes: 100 Morning Practice to HelpYou Stay Calm and Focused All Day Long by Jeffrey Brantley, MD