- 5 Ways to Survive the Holidays With a Narcissist
- Ibuprofen May Not Be As Safe As You Think
- The Truth About What Alcohol Does to Your Heart
Posted: 14 Nov 2016 08:00 AM PST
Your mother wants to tell you how wrong you are for, well, everything involving your kids. Or your aunt wants to pry into your love life—and insult you about your single status. Maybe it’s a friend who needs to one-up you about everything (you just went away for the weekend? She’s planning on taking a luxurious tropical vacation. And flying first class). Or, your sister needs all the attention on her and throws a fit when she doesn’t get it.
Welcome to the holidays, the time of year when you’re forced to spend quality time with all the narcissists in your life.
While only 6% of the US population is thought to actually have narcissistic personality disorder, narcissism is really on a spectrum. “I think all of us have people in our family that meet some of the criteria for being a narcissist,” says Karyl McBride, PhD, licensed marriage and family therapist and author of Will I Ever Be Good Enough? Healing the Daughters of Narcissistic Mothers. (Learn the signs someone you know—or even you!—might be a narcissist.)
When you’re heading out to all the holiday parties and gatherings this year, you don’t have to run away from your narcissistic mother, uncle, or family friend. Here’s how to face them head on:
Don’t fight back
As hard as it can be, you shouldn’t try to compete with a narcissist. “Remember that they’re usually driven by an unconscious sense of shame or inferiority,” says Joseph Burgo, PhD, author of The Narcissist You Know: Defending Yourself Against Extreme Narcissists in an All-About-Me Age. For that reason, if you fight back, you’ll lose—and may make an enemy, he says. You can’t choose your family members, so it’s best to listen politely, then excuse yourself and join another conversation. But a friend? “You might want to look for different friends who take an interest in you, too,” Burgo says. Now that’s honesty. (Here are the two routes to a friend breakup.)
Remember this one word
Narcissists have a way of surprising you with their meanness. “They’re not in touch with their own feelings, so if they’re having a bad day, they’ll project that onto other people,” explains McBride. Whether they give you a backhanded compliment or deliver an outright insult, don’t get sucked in. Instead, shrug your shoulders and say this one word: “Interesting.” That’s McBride’s favorite go-to response when something comes at you out of the blue and you need time to think without reacting. It shows them that, nope, you’re not taking the bait and they can’t get to you.
Health.com: 11 Signs of Borderline Personality Disorder
Play the opposite role
The holidays are about spending time with loved ones and getting all the fuzzies from doing so. Sadly, narcissists love to gossip and put people down behind their backs. “It’s their way of making themselves bigger and better than everyone else,” says McBride. A good comeback when they tell you that they don’t like so-and-so because oh, gosh do you see how she dresses/acts/looks: give the person she just panned a compliment. Say, “Oh, I think she’s super smart with the way she runs her business,” or “she’s always been a really great friend to me.” End scene.
Stroke their ego
Narcissists have a way of holding onto a grudge. (Remember, everything is about them—and they remember being slighted even in the smallest ways for a long time.) “My advice often strikes people as cowardly, but there is no value in standing up for yourself or trying to explain,” says Burgo. The best option is to avoid them entirely if they’re still mad at whatever happened at the holiday party two years ago, but if that’s not possible, try to make them feel good about themselves, he says. What’s going on with their job? What else do they have planned for the holidays?
But don’t always give in
One time you should stand up for yourself is when your pesky relative wants to give you a bunch of unsolicited advice, whether about your job, love life, or diet. “Most people feel like this takes their power away, so I don’t think you should put up with it,” says McBride. Still, set a boundary with “kindness,” she says. Say something like, “I understand that that’s what you’d do, but I have my own way of handling my own life.” And, in the future, keep the convos superficial—don’t divulge info about yourself. Good topics: football, the weather, and the news.
Posted: 13 Nov 2016 01:45 PM PST
Over-the-counter and prescription drugs that control inflammation, like Advil, Aleve and Motrin, are among the most popular drugs people take. Without a prescription, they can relieve short-term pain from backaches and headaches, and at higher doses can reduce the inflammation behind chronic conditions like osteoarthritis or rheumatoid arthritis. But recent studies have questioned their safety, enough so that in 2015, the Food and Drug Administration (FDA) strengthened warnings on the drugs’ labels about their risk of heart attack and stroke.
But most concerning were the heart risks linked to a new class of these so-called nonsteroidal anti-inflammatory drugs (NSAIDs), the COX-2 inhibitors. These drugs were supposed to be kinder to the stomach and intestines, since NSAIDS typically activated chemicals that compromised the protective lining of these organs, leading to bleeding and pain. It turned out that the benefit for the intestines, however, came at a price to the heart. Two of the COX-2 inhibitors were removed from the market because studies showed they were linked to higher risk of heart attack and stroke.
That left one—celecoxib, or Celebrex—on the market, but the heart concerns led the FDA to require its maker, Pfizer, to pay for additional studies to ensure that celecoxib did not put people at increased risk of heart trouble. Now the results of the study show that contrary to what doctors and regulators expected, celecoxib does not lead to any higher rates of heart events than ibuprofen or naproxen. In fact, celecoxib may even cause fewer kidney problems than the other two NSAIDs.
“I would never have guessed these results,” says the study’s lead author, Dr. Steven Nissen, chair of cardiovascular medicine at the Cleveland Clinic. “The whole world has been saying for a decade now that if you must take an NSAID, you probably ought take naproxen because it’s the safest. We just don’t see that in these results. In almost every measure, ibuprofen looks worse, naproxen is intermediate and celecoxib is the best.”
The study, which is published in the New England Journal of Medicine and which Nissen will present at the American Heart Association annual meeting in New Orleans, involved more than 24,000 people with heart problems who needed to take an NSAID to treat conditions like arthritis and rheumatoid arthritis. They were randomly assigned to take one of the three drugs for nearly two years and followed for another three years for heart attacks, stroke or death. The people assigned to celecoxib did not show any higher rates of these events than those taking ibuprofen or naproxen. When Nissen and his team looked at kidney problems, they found lower risk among those taking celecoxib than among people taking ibuprofen.
“These results negate the preconceived notion—the present thinking—that COX-2 inhibitors are associated with increased heart risk,” says Dr. Nitin Damle, president of the American College of Physicians. “I think people may be more willing to start COX-2 inhibitors a little earlier because they see that heart risk is not increased.”
The previous concerns about COX-2 inhibitors and heart problems led many internists to prescribe NSAIDs like ibuprofen and naproxen as their first-choice therapies for people with osteoarthritis and rheumatoid arthritis, he says. They would only turn to celecoxib if people had stomach issues. Now that may change.
For people who take NSAIDs only occasionally, however, and for short periods of time, the findings shouldn’t make them worry that they’re putting their heart at risk. The study did not include healthy people who didn’t have a history of heart problems, and short-term use is not likely to have the same effect as longer term use typical of patients in chronic pain.
Nissen also notes that nearly 70% of the participants in the study stopped taking their assigned medication; that’s typical in a study of chronic pain in which people get frustrated when their symptoms aren’t relieved and switch from treatment to treatment. But the proportion who stopped their treatment in each group was about the same, meaning that the results were unlikely to have been drastically different if they had continued.
The study also doesn’t address people who take higher doses of any of the drugs; the people were assigned standard doses of 100mg celecoxib twice a day, 600mg ibuprofen three times a day, and naproxen 375mg twice a day.
Whether the findings will now push celecoxib to the front line of treatment for chronic pain conditions isn’t clear yet. Insurance companies cover ibuprofen and naproxen as first line treatments because studies show they are more effective in treating pain symptoms. The current study doesn’t address celecoxib’s efficacy compared to the other drugs, but does show that it’s as safe as they are for the heart.
That means that people who need to take anti inflammatory pain relievers for longer periods of time should consider celecoxib as a viable option, since it doesn’t increase risk of heart problems and may even lower risk of kidney issues. “I think this study really does change the impression we have that COX-2 inhibitors have increased heart risk,” says Damle. “Now it looks like they have similar risk than other non steroidals such as ibuprofen or naproxen.” For those who only take NSAIDs occasionally, the results shouldn’t deter them from seeking relief from the medications.
Posted: 13 Nov 2016 12:00 PM PST
Having a drink or two a day can be a good thing, at least as far as the heart is concerned. There are nearly 100 studies of large populations that support this — they show consistently that people who drink moderately tend to have fewer heart events and are less likely to die of heart disease.
The key is moderation. Alcohol can be both tonic and toxin, since excessive drinking can lead to liver problems and other psychological and behavioral issues that impair health. In the latest study presented at the American Heart Association meeting in New Orleans, researchers pinpoint one way that alcohol can benefit the heart — by keeping good cholesterol levels high.
The study involved more than 80,000 healthy Chinese adults, who answered questions about their drinking habits and who gave blood for analysis four times during the six year study so researchers could measure their HDL as well as liver function and inflammatory markers. Those who reported drinking moderate amounts of alcohol — about one serving a day for women and two for men — had the lowest drop in HDL levels. With age, good cholesterol levels tend to decline, but these people seemed to slow that decline with their drinking. Those who abstained or drank more heavily didn’t show the same benefit.
Dr. Eric Rimm, director of cardiovascular epidemiology at the T. H. Chan Harvard School of Public Health, says the findings support other studies that have found that at any age, people who drink moderately tend to have higher HDL levels than those who don’t. HDL is important for heart health since it can mop up excess LDL, which can build up within blood vessel walls and contribute to plaques that can trigger heart attacks.
In fact, research suggests that having one or two drinks a day can lower risk of heart events about the same as losing around 30 pounds through diet and exercise. However, he says, “I’m hesitant to make that comparison, since weight loss is much more beneficial for other health reasons, such as reducing risk of cancer, diabetes and other chronic diseases.” Drinking and driving is also a leading cause of health problems and death.
The author, Shue Huang at Pennsylvania State University, reports that the Chinese population mostly drank beer or spirits, so the study doesn’t shed light on the effects of wine, although previous work shows that the ethanol in different alcoholic beverages generally has the same health effects. “Almost without exception if you look at fatal and non fatal heart disease, people who drink in moderation have substantially lower rates than people who abstain,” he says. All the more reason to raise a glass — but probably not more than that.
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