Month: August 2010

Healthy Women, Sound Minds

During this past winter, I spoke to the ladies of Triumphant Tabernacle Church in Durham for their Empowered Women conference. I was given the theme of “Healthy Women, Sound Minds,” which was a timely topic to speak on and around. We had some fruitful conversations and I thought I’d share a bit about what these wonderful women shared with me.

To review, I’m a Family doctor, which means I care for the entire family, from newborns to the elderly. Since practicing in the Durham community for the past 2 years, I’ve seen a large amount of young and older black women for a variety of reasons. Recently with the economy failing and making a slow comeback, I’ve seen a rash of women, married and single, young and old, who all feel the weight of the world on their shoulders right now. Some of the medical and emotional trends that seemed to have spiked at this time include: domestic abuse, sexually transmitted disease, high blood pressure, depression, and anxiety. The STDs in particular seemed to be at a high during the summer for some reason. Because of my frustration and sadness as I saw these women and attempted to help in some way, I took a step back to see if I could find similarities with these patients and what research there is on the link between emotional and medical health.

I began my talk with the women at the conference about depression and anxiety and reviewed the cardinal signs and symptoms of depression in particular. You may have heard of the “SIGE- CAPS” method before as a screen for depression (using each first letter of the list to make up the acronym). Because we were discussing women specifically, I put a star (*) next to those that seem to appear in women more–

Sleeping problems*

Interest decreasing in social activities

Guilt and self-worthlessness*

Energy decrease or fatigue

Concentration problems

Appetite or weight changes (up or down) *increased appetite

weight gain

Psychomotor slowing (moving more slowly, decreased motivation)

Suicidal thoughts

1 out of 10 all Americans admit to some form of mental illness-depression, anxiety, schizophrenia, etc.-each year. Women suffer from depression 2 times more than men, which means 2 out of 10. Why is there a difference? Studies say a definitive answer is unknown. However, with research, I found similar theories, including the following: higher incidence of physical or sexual abuse in women, use of birth control and having hormones in general, and persistent psychosocial stressors (such as loss of job) affecting women more.

Untreated emotional or mental illness can lead to suicide attempts—more women attempt suicide, but more men complete it. The likelihood is 4 to 1 that a man will be “successful” with suicide. Why? My theory is women use it more as a cry for help than men do. Women also use self- poisoning or drug overdose as the usual tactic, and that’s 70% of the time. However, that does not mean we should ever take threats of suicide from a female patient any less serious than from male.

So what can we do to have healthy bodies and more sound minds? Together, with research and our discussion at the conference, we identified a couple of ideas.

a. The majority of medical studies confirm that spirituality or religion is associated with better outcomes in many cases.

b. Have your annual check ups! Take care of yourself!

c. Have a great support system—family, friends, faith group/community d. Get more exercise and movement.

e. Eat “happy foods”—less caffeine/alcohol, more omega 3 fatty acids (salmon, cod, sardines, nuts help brain and nerve cells), reduce intake of refined carbs that cause sugar highs and then severe crashes, and eat more veggies and vitamins.

f. Pay attention to yourself and your moods. Recognize your symptoms early!


: Am Fam Physician 1999;60:225-40, Depression in Women: Diagnostic and Treatment Considerations.

BIO–Dr. C.Nicole Swiner is currently a Family Physician in Durham, NC, and has worked in a clinic owned by the University of North Carolina since 2007, after completing her residency training there. She received her undergraduate degree from Duke University. She also serves as an Associate Professor at UNC and

has interests in minority health, gynecology, and pediatrics.

has interests in minority health, gynecology, and pediatrics.

Eyelash growth serums—all talk?

“Please excuse the mess as we try to expand” was the Facebook status I used a couple of months ago to explain the uncoordinated look of my eyebrows as I’ve let them grow out of their “manicured” shape. I’ve been plucking, waxing, and threading my eyebrows since my freshman year in college to get that certain look, and now that I’m in my 30’s, they won’t grow the way I want. When I asked cosmetologists and spa aestheticians about the issue, there appeared to be no real eyebrow growth product. Instead, I heard or read in magazines about olive oil, massage, or Minoxidil (ie. Rogaine). I really wanted to try Minoxidil, but my husband was worried when he read it was hormonally based. So, I became interested in these new products on the market myself as I became frustrated with the lack of growth, even with avoiding waxing for weeks. I did some research, and this is what I found.

Latisse, which is the first marketed product for eyelash growth, was actually found by mistake. Its main ingredient is called bromatoprost, which was and is the main ingredient in glaucoma eye drops, which had the side effect of making eyelashes grow longer. It’s a prostaglandin, or fatty acid, that helps build muscle and hair. How smart was it that someone discovered a way to isolate this ingredient and make an eyelash growth product!

To review the medical background with patients who may deal with a lack of or slowed hair growth, we have to review the definition of alopecia. Damaged hair follicles or lack of growth of hair on the face can be related to many causes—those medical, and those we cause ourselves. My experience had to do with too much waxing and threading, where others may have experienced actual alopecia. Alopecia, in general, is hair loss due to trauma or medical reasons, such as cancer, anemia, thyroid, or other hormonal issues. The most common type is alopecia areata, which occurs in 2% of the population, and is primarily on the head. It usually returns spontaneously on ½ of cases within a year. Alopecia universalis is when damaged hair follicles occur all over the body, including the eyebrows and eyelashes, and is generally longer lasting.

The most important thing to do, I think, is to first understand the natural growth cycle of hair on the face before figuring out how the marketed serums will work. Naturally, it takes a full‐grown eyelash about 6‐8 weeks to grown on its own. It takes an eyebrow about 4 months and hair on the scalp about 3‐4 years. Because I was more interested in re‐growing my eyebrows, I wanted something to shorten that length of time.  Unfortunately, there are no “eyebrow growth serums”, but there are those marketed specifically for eyelashes. Some of these serums can be used on the eyebrows also, understanding of course the longer growth cycle. What I’ve tried recently is use one of the marketed eyelash serums on both my eyebrows and my eyelashes. To avoid liability, I won’t say which one I’m using, but at least for these past couple of weeks I’ve not experienced any side effects, such as eye irritation, conjunctivitis, or skin changes. Do I think my eyebrows have grown longer than they would have without the serum? I’m not sure yet, but maybe. If you’re interested, try one and let me know what you think.

Be Healthy and Be Blessed,

Dr. Swiner


Canadian Family Physician, July 2000, p. 1469