Swallowing Disorders

If you have a swallowing disorder, you may have difficulty or pain when swallowing. Some people cannot swallow at all. Others may have trouble swallowing liquids, foods, or saliva. This makes it hard to eat. Often, it can be difficult to take in enough calories and fluids to nourish your body.

Anyone can have a swallowing disorder, but it is more common in older adults. It often happens because of other conditions, including:

• Nervous system disorders, such as Parkinson's disease and cerebral palsy
• Problems with your esophagus, including GERD (gastroesophageal reflux disease)
• Stroke
• Head or spinal cord injury
• Cancer of the head, neck, or esophagus

Medicines can help some people, while others may need surgery. Swallowing treatment with a speech-language pathologist can help. You may find it helpful to change your diet or hold your head or neck in a certain way when you eat. In very serious cases, people may need feeding tubes.

NIH: National Institute on Deafness and Other Communication Disorders

Sweat

Sweat is a clear, salty liquid produced by glands in your skin. Sweating is how your body cools itself. You sweat mainly under your arms and on your feet and palms. When sweat mixes with bacteria on your skin, it can cause a smell. Bathing regularly and using antiperspirants or deodorants can help control the odor.

Sweating a lot is normal when it is hot or when you exercise, are anxious, or have a fever. It also happens during menopause. If you often sweat too much, it's called hyperhidrosis. Causes include thyroid or nervous system disorders, low blood sugar, or another health problem.

Sweating too little, anhidrosis, can be life-threatening because your body can overheat. Causes of anhidrosis include dehydration, burns, and some skin and nerve disorders.

Teen Depression

What is depression in teens?

Depression in teens (ages 13-17) is a serious medical illness. It's more than just a feeling of being sad or "blue" for a few days. It is an intense feeling of sadness, hopelessness, and anger or frustration that lasts much longer. These feelings make it hard for you to function normally and do your usual activities. You may also have trouble focusing and have no motivation or energy. Depression can make you feel like it is hard to enjoy life or even get through the day.

Many factors may play a role in depression, including:

• Genetics. Depression can run in families.
• Brain biology and chemistry.
• Hormones. Hormone changes can contribute to depression.
• Stressful childhood events such as trauma, the death of a loved one, bullying, and abuse.

Depression can happen at any age, but often begins in the teens or early adulthood. Certain teens are at higher risk of depression, such as those who:

• Have other mental health conditions, such as anxiety, eating disorders, and substance use
• Have other diseases, such as diabetes, cancer, and heart disease
• Have family members with mental illness
• Have a dysfunctional family/family conflict
• Have problems with friends or other kids at school
• Have learning disabilities or attention deficit hyperactivity disorder (ADHD)
• Have had trauma in childhood
• Have low self-esteem, a pessimistic outlook, or poor coping skills

If you have depression, you have one or more of these symptoms most of the time:

• Sadness
• Feeling of emptiness
• Hopelessness
• Being angry, irritable, or frustrated, even at minor things

You also may also have other symptoms, such as:

• No longer caring about things you used to enjoy
• Changes in weight, such as losing weight when you are not dieting or gaining weight from eating too much
• Changes in sleep, such as having trouble falling asleep or staying asleep, or sleeping much more than usual
• Feeling restless or having trouble sitting still
• Feeling very tired or not having energy
• Feeling worthless or very guilty
• Having trouble concentrating, remembering information, or making decisions
• Thinking about dying or suicide

If you think you might be depressed, tell someone that you trust, such as your:

• Parents or guardian
• Teacher or counselor
• Doctor

The next step is to see your doctor for a checkup. Your doctor can first make sure that you do not have another health problem that is causing your depression. To do this, you may have a physical exam and lab tests.

If you don't have another health problem, you will get a psychological evaluation. Your doctor may do it, or you may be referred to a mental health professional to get one. You may be asked about things such as:

• Your thoughts and feelings
• How you are doing at school
• Any changes in your eating, sleeping, or energy level
• Whether you are suicidal
• Whether you use alcohol or drugs

Effective treatments for depression in teens include talk therapy, or a combination of talk therapy and medicines:

Talk therapy

Talk therapy, also called psychotherapy or counseling, can help you understand and manage your moods and feelings. It involves going to see a therapist, such as a psychiatrist, a psychologist, a social worker, or counselor. You can talk out your emotions to someone who understands and supports you. You can also learn how to stop thinking negatively and start to look at the positives in life. This will help you build confidence and feel better about yourself.

There are many different types of talk therapy. Certain types have been shown to help teens deal with depression, including:

• Cognitive behavioral therapy (CBT), which helps you to identify and change negative and unhelpful thoughts. It also helps you build coping skills and change behavioral patterns.
• Interpersonal therapy (IPT), which focuses on improving your relationships. It helps you understand and work through troubled relationships that may contribute to your depression. IPT may help you change behaviors that are causing problems. You also explore major issues that may add to your depression, such as grief or life changes.

Medicines

In some cases, your doctor will suggest medicines along with talk therapy. There are a few antidepressants that have been widely studied and proven to help teens. If you are taking medicine for depression, it is important to see your doctor regularly.

It is also important to know that it will take some time for you to get relief from antidepressants:

• It can take 3 to 4 weeks until an antidepressant takes effect
• You may have to try more than one antidepressant to find one that works for you
• It can also take some time to find the right dose of an antidepressant

In some cases, teenagers may have an increase in suicidal thoughts or behavior when taking antidepressants. This risk is higher in the first few weeks after starting the medicine and when the dose is changed. Make sure to tell your parents or guardian if you start feeling worse or have thoughts of hurting yourself.

You should not stop taking the antidepressants on your own. You need to work with your doctor to slowly and safely decrease the dose before you stop.

Programs for severe depression

Some teens who have severe depression or are at risk of hurting themselves may need more intensive treatment. They may go into a psychiatric hospital or do a day program. Both offer counseling, group discussions, and activities with mental health professionals and other patients. Day programs may be full-day or half-day, and they often last for several weeks.

Teen Health

As a teenager, you go through many changes. Your body is on its way to becoming its adult size. You may notice that you can't fit into your old shoes or that your jeans are now 3 inches too short. Along with these changes, you are probably becoming more independent and making more of your own choices. Some of the biggest choices you face are about your health.

Healthy habits, including eating a healthy diet and being physically active, can help you feel good, look good, and do your best in school, work, or sports. They might also prevent diseases such as diabetes, high blood pressure, heart disease, osteoporosis, stroke, and some cancers when you are older.

Telehealth

What is telehealth?

Telehealth is the use of communications technologies to provide health care from a distance. These technologies may include computers, cameras, videoconferencing, the Internet, and satellite and wireless communications. Some examples of telehealth include:

• A "virtual visit" with a health care provider, through a phone call or video chat
• Remote patient monitoring, which lets your provider check on you while you are at home. For example, you might wear a device that measures your heart rate and sends that information to your provider.
• A surgeon using robotic technology to do surgery from a different location
• Sensors that can alert caregivers if a person with dementia leaves the house
• Sending your provider a message through your electronic health record (EHR)
• Watching an online video that your provider sent you about how to use an inhaler
• Getting an email, phone, or text reminder that it's time for a cancer screening

Sometimes people use the term telemedicine to mean the same thing as telehealth. Telehealth is a broader term. It includes telemedicine. But it also includes things like training for health care providers, health care administrative meetings, and services provided by pharmacists and social workers.

Some of the benefits of telehealth include:

• Getting care at home, especially for people who can't easily get to their providers' offices
• Getting care from a specialist who is not close by
• Getting care after office hours
• More communication with your providers
• Better communication and coordination between health care providers
• More support for people who are managing their health conditions, especially chronic conditions such as diabetes
• Lower cost, since virtual visits may be cheaper than in-person visits

Some of the problems with telehealth include:

• If your virtual visit is with someone who is not your regular provider, he or she may not have all of your medical history
• After a virtual visit, it may be up to you to coordinate your care with your regular provider
• In some cases, the provider may not be able to make the right diagnosis without examining you in person. Or your provider may need you to come in for a lab test.
• There may be problems with the technology, for example, if you lose the connection, there is a problem with the software, etc.
• Some insurance companies may not cover telehealth visits

The types of care that you can get using telehealth may include:

• General health care, like wellness visits
• Prescriptions for medicine
• Dermatology (skin care)
• Eye exams
• Nutrition counseling
• Mental health counseling
• Urgent care conditions, such as sinusitis, urinary tract infections, common rashes, etc.

For telehealth visits, just like with an in-person visit, it is important to be prepared and have good communication with the provider.