Q On a few occasions my doctor has told me my blood pressure is high and medication is prudent. Would tablets be for life? I’m not keen on the idea as I am only 47.
One in four people in the UK suffer with high blood pressure, so you are in a common situation.
I understand the idea of taking medication for life is not appealing: it can involve side effects, monitoring and extra appointments at the GP. And it also reinforces the idea of having a condition or disease, which is not a cheery prospect at the age of 47.
But on the other hand, high blood pressure is a well-known and proven risk for serious diseases, particularly strokes and heart attacks but also dementia. This is why we are so keen to treat it. Tablets are certainly effective and there is now a huge range we use.
Normally a GP will trial you on the optimum choice first to see how effective it is, but also to see if you suffer any side effects. This will involve a few monitoring appointments in the first instance.
You can also lower blood pressure by losing weight and exercising, as well as reducing salt in your diet, reducing alcohol and trying to relieve stress.
Exercising can involve walking for 30 minutes a day on most days: it does not have to involve an expensive gym membership.
Sometimes patients can avoid taking tablets by taking these lifestyle measures and that is fantastic.
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Q My 14-year-old is starting to develop teenage spots. She doesn’t have the best diet, but what else should I suggest she does aside from eating well?
Teenage spots are very common and really a normal part of adolescence. They are quite a cruel one though: just at the age when youngsters are struggling anyway with self-esteem and body image, along come spots on their face to make life even harder.
I really believe that teenagers should be given proper advice and help with dealing with spots, so they don’t have to suffer them and the knocks to their confidence. They have enough to deal with!
People talk about junk food being related to spots, but it isn’t. Of course, eating a bad diet has other risks, but neither that nor bad hygiene causes spots.
It is worth telling her that some make-up can cause spots – to avoid problems, she needs to use non-comedogenic products if any at all.
Concentrating on looking after her skin is a good start: people mistakenly think spotty skin needs to be dried out to get rid of the grease, but she mustn’t do that nor wash it more than twice a day.
You can tell her to get into the habit of using a regular wash and cream like Skin Genius, which is particularly suited for the treatment of teenage spots.
If that is not proving enough, the first line of medicated products would be a cream containing the drug benzoyl peroxide.
This is available to buy over the counter as a cream like Acnecide and also as a face wash.
Q My husband lost his job last year, but was coping well. Now he isn’t sleeping and I’m concerned he is depressed.
The symptoms of depression could certainly be expected in reaction to a big event like job loss. Men are not always good at acknowledging how they feel and even in a family there is still stigma around admitting mental health issues.
Not sleeping can be a sign of depression – it’s not just falling asleep or bad dreams that are the problem; when people are depressed they tend to wake up very early in the morning– long before the alarm – and cannot fall back to sleep.
There are also other signs that may tell you he is depressed: if he has no motivation for the fun things in life, and avoid plans or activities he usually loves.
A loss of appetite could also be significant – it can be a sign of physical or a mental health issue and is a classic symptom of depression. You may find he just forgets to eat, shows no interest in choosing food or even enjoying a great meal that you have prepared.
People with depression can have very low self-esteem, feeling they are a failure and totally useless in their own and other people’s eyes.
Often people can feel guilty too, for letting their family down and will mention repeatedly how useless they are, especially after a job loss.
If you recognise these symptoms, chat to him and persuade him to seek help.