drmarcellestastny

Health

The contraceptive pill- blessing or curse?

Health

Is my Pill making me nuts? Easily half the ladies in my practice have horror stories of what has happened when they took the contraceptive Pill. Medical science has long minimised the mood effects of the Pill. It would argue that the patients in my practice are a skewed sample – they were already struggling with mood issues, which is why they came to see me in the first place. Taking the Pill was just another variable factor, not the underlying cause of their instability. Medicine has further held the line that you can’t accuse “the Pill” of causing depression…

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How much is too much alcohol? The moderation myth

Addictions

People see psychiatrists because they are struggling emotionally and mentally. Their lives feel overwhelming and out of control. So it is perhaps not surprising that I have to talk about alcohol with most of my new patients. I do not mean that all my patients are addicted to alcohol – that is, they don’t compulsively need to drink or have withdrawal symptoms when they try to stop (although a small percentage are  struggling with full blown addiction). Most aren’t even abusing alcohol. They are not driving drunk, or getting belligerent when drunk, or having memory gaps when drinking (although these…

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The weight issue- if diets don’t work, what does?

Diet

Diets don’t work. (www.drmarcellestastny.co.za/diets do not work) An obese woman has a one in 677 chance of achieving a normal weight in a year. An obese man has a one in 1 290 chance of being a normal weight in a year. A major risk factor for being 5kg heavier in a year from now is to be on a diet now. All recommendations seem to be that whatever you do it must be “simple, flexible and sustainable.” Kilojoule restriction for weight loss does not work. Permanent modifications to diet and lifestyle do work. If you have been gaining 2kg every…

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Diets do not work

Diet

You have had a look at yourself in the mirror and realised that you don’t like what you see. Your doctor has told you that you must lose weight. You have researched Atkins, Detox diet, Banting, Intermittent Fasting and a few others. You are ready to start your diet. Again. You probably feel that you don’t need to have your resolve weakened by reading a blog espousing that diets don’t work. Worse, a major risk factor for being 5kg heavier in a years time, is to be on a calorie restricting diet now. Dieting results in weight gain. Diets don’t work. A…

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Let’s talk about weight- why are we so fat?

Diet

Worldwide there is an obesity problem; they call it the “globesity epidemic”. In South Africa 70% of women are overweight and 40% obese (BMI over 30). A third of South African men are overweight. Despite what the “Fat and Proud”  counter-revolution and our defence mechanisms tell us, it’s not okay to be fat. Obesity results in numerous health problems. In the States, it’s the number 1 cause of preventable deaths. For generations, each generation has died older than the last. This trend is now being reversed because of obesity-related illnesses including diabetes, heart disease, metabolic syndrome, certain cancers and stroke. When…

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Let’s talk about the value of ideal weight

Diet

Ideal weight is such a sensitive issue. In my practice, almost every woman and many of the men are unhappy with their weight. I often wonder what it would be like if every person in the world woke up one day, happy with how they looked. I think a lot of diet and beauty industries would go bankrupt! What is “ideal weight”? Surprisingly, this concept is not that easy to define. First off, there seems to be a paradox in patients’ awareness. Next, doctors can not seem to agree as to what it is and how best to measure it.…

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Why am I so tired?

Health

I am not talking about feeling weary. I am talking about bone crushing fatigue even after a good night’s sleep or a relaxed holiday. The body is a wonderful structure. If something is a bit off kilter, it will tell us, we must just listen. Fatigue is a terrific teacher. We have no choice but to slow down and review.  If we take heed and make corrections, then the body will restore itself. It wants to be well and function optimally. So, if you are feeling tired all the time, it’s worthwhile trying to figure out why. The bulk of the…

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Going straight for the gut

Diet

We have always known that our mood affects our guts. My anxious patients complain of diarrhoea and my depressed patients of constipation. I could never have imagined how much of a role the gut microbiota plays in communicating with the brain and modulating behavior. I never took “gut feeling” literally! Our gut, the small intestine and the large intestine, is filled with over a kilogram of bacteria, the gut microbiota. That’s almost the weight of an average brain. These bacteria carry more than a hundred times the genes of the human genome. It is comprised of 150 common bacteria and…

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Let’s talk about sleep

Health

Almost all of my patients struggle with sleep problems. It stands to reason, a symptom of many mental illnesses is disturbed sleep. Furthermore, sleep disturbances destabilise mental illnesses and makes them worse.So, for many of my patients addressing sleep problems is a serious priority. It should be for you too. 40% of South Africans are not getting enough sleep. Sleep deprivation is linked with chronic illnesses like hypertension, heart disease and stroke. It drops your immunity, so you end up with constant colds and flus. Being sleep deprived makes you moody, depressed and leads to cognitive decline and memory problems.…

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Let’s talk about exercise

Health

In continuing thoughts about self care, let’s talk about exercise. Exercise makes us live longer. Exercise makes us healthier. Exercise improves our sex lives. It improves our energy. It makes us happier. It makes us look good. It helps us sleep well. It is the elixir of the gods. The neurobiology around exercise is amazing. It reduces stress hormones such as cortisol and adrenalin; making us calmer, more focused, more able to cope. It opens serotonin, dopamine and noradrenalin channels; boosting our sense of well being and even treating depression and anxiety. As our skeletal muscles work they release Brain…

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