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Diffuse large B-cell lymphoma (DLBCL) is a fast-growing cancer that starts in white blood cells called B lymphocytes. These cells are an important part of the immune system. DLBCL is the most common type of non-Hodgkin lymphoma .e60dc2a1-f33c-4a05-9b50-8e3e8e597629bbc40d16-0828-4bb7-822c-f8e99fd08cf7 About 30 percent of all non-Hodgkin lymphoma diagnoses in the United States are DLBCL. Although it is an aggressive cancer that can spread quickly, it is treatable.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ac7a70cb-fb9c-4090-8485-af1f3e6b64e3
Types of Diffuse Large B-Cell Lymphoma Types DLBCL is divided into subtypes based on how it looks, where it starts, and where it spreads. Many of these subtypes are rare:e60dc2a1-f33c-4a05-9b50-8e3e8e597629ef26c8cd-35a1-422f-ab01-a83da00282bbe60dc2a1-f33c-4a05-9b50-8e3e8e5976292eca3f88-d7cb-4955-a5de-d060cfd722f0 Primary mediastinal B-cell lymphoma: This type starts in the mediastinum, the part of the chest that sits between the lungs. The tumor can make it hard to breathe if it presses on the lungs. T-cell/histiocyte-rich B-cell lymphoma: Under a microscope, this rare type looks like a few cancerous B cells surrounded by many normal T cells (part of the immune system). The cancer is made up of more immune cells than abnormal B cells. Double-hit or triple-hit lymphoma: These cancer cells have either two (double-hit) or three (triple-hit) genetic changes, but the symptoms are the same as DLBCL. Primary DLBCL of the central nervous system: This type starts in the brain or eye. Secondary DLBCL of the central nervous system can occur if the lymphoma spreads to the brain or spinal cord. Primary cutaneous DLBCL, leg type: This type looks like a bluish-red growth or tumor on the skin of the lower legs, trunk, arms, or buttocks. It is especially aggressive, because it can spread from the skin to other parts of the body. Epstein-Barr virus–positive DLBCL: This rare type mainly affects people ages 50 and older who have tested positive for the Epstein-Barr virus . DLBCL not otherwise specified: This umbrella term includes DLBCL that doesn’t fit into any other subtype.
Signs and Symptoms of Diffuse Large B-Cell Lymphoma Symptoms The first symptom of DLBCL is often a painless lump in the neck, armpit, abdomen, or groin. The lump gets larger as B cells multiply inside the lymph node, and it can grow quickly. Other symptoms include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629e8d27e5a-9717-4947-ab4e-be34fc7c0464e60dc2a1-f33c-4a05-9b50-8e3e8e597629d6e912d0-00e2-465b-85b7-181967dc8c37 Cough Difficulty breathing Abdominal pain Fever Night sweats Unexplained weight loss Fatigue Appetite loss Nausea Diarrhea These can be symptoms of many different conditions. They don’t mean that you have DLBCL. Even so, contact your doctor if these symptoms don’t go away after a couple of weeks.
Causes and Risk Factors of Diffuse Large B-Cell Lymphoma Causes Like other cancers, diffuse large B-cell lymphoma starts when the DNA in cells changes in ways that allow the cells to multiply out of control. Researchers don’t know why this happens in most patients. A few factors increase the risk of DLBCL, including:e60dc2a1-f33c-4a05-9b50-8e3e8e5976294771f2a5-c8d4-4160-85fd-81776a4da698 Age: Although people of any age can get this kind of cancer, the average age when people are diagnosed is their mid-60s.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d06e1cf0-e0d4-477f-b0c7-5fb335c9e502 Sex: Men are slightly more likely to get this cancer than women. Race: White people are diagnosed more often than people of African or Asian descent. Immune system disorders: Having an autoimmune disorder like rheumatoid arthritis , Sjögren’s syndrome , or lupus weakens the immune system and increases the risk of DLBCL, as does taking antirejection drugs after an organ transplant. Infections: Human immunodeficiency virus (HIV) , Epstein-Barr virus , hepatitis B , and hepatitis C are all linked to an increased risk of this cancer. Family history: DLBCL isn’t an inherited disease, but you might be at slightly higher risk if one of your parents or siblings has had lymphoma. Personal history: You’re more likely to get this form of cancer if you’ve had lymphoma in the past. Obesity: A high body mass index (BMI) in young adults is linked to an increased risk. Toxic exposures: People who work or live around toxins like trichloroethylene or benzene may be more likely to develop DLBCL.
How Is Diffuse Large B-Cell Lymphoma Diagnosed? Diagnosis A biopsy is the test doctors use to confirm a diagnosis of diffuse large B-cell lymphoma. Your doctor will remove part or all of an enlarged lymph node. The cells from that lymph node will then undergo tests to identify certain proteins or other markers under a microscope.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292acb72cb-cae7-41ae-87f2-4918367598f0 Once you have a diagnosis, the next step is to stage your cancer, or figure out where it has spread, so your doctor can determine which treatments might be most effective against it. DLBCL has four stages:e60dc2a1-f33c-4a05-9b50-8e3e8e5976299f056de2-dc49-408f-af3b-d028eec73416 Stage 1: The cancer is in just one lymph node, one lymph structure (thymus, spleen, or tonsils), or one part of a single organ outside of your lymph system. Stage 2: The cancer is in two or more lymph nodes or lymph structures on the same side of your diaphragm. Stage 3: There is cancer in lymph nodes or structures on both sides of your diaphragm. Stage 4: The cancer has spread to other organs or tissues, such as the liver, lungs, or bone marrow. Tests used to stage DLBCL include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976299f056de2-dc49-408f-af3b-d028eec73416 Complete blood count: This and and other blood tests are also used to check for infections like HIV and hepatitis B and C. Imaging tests: These include positron emission tomography and computed tomography scans, which look for cancer in the body. Bone marrow biopsy: This is used to check for lymphoma cells in the bone marrow.
Treatment and Medication Options for Diffuse Large B-Cell Lymphoma Treatment Because DLBCL spreads quickly, it is important to get treatment as soon as possible. Which treatment your doctor recommends depends on the subtype you have, but generally you can expect to receive a targeted therapy combination of chemotherapy and the monoclonal antibody rituximab (Rituxan). The most commonly used combo is nicknamed R-CHOP, and it is given with the goal of remission, which many can achieve with DLBCL.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ff9b958b-abdf-40a4-9da5-c9990c4930e9 Medication Options The first treatment most people with DLBCL get is the drug combination R-CHOP, which includes:e60dc2a1-f33c-4a05-9b50-8e3e8e597629840b1508-71ab-4ee4-9f19-071bd5e18dab R: Rituxan, a monoclonal antibody C: Cyclophosphamide (Cytoxan), a chemotherapy drug H: Doxorubicin hydrochloride (Adriamycin), a chemotherapy drug O: Vincristine (Oncovin), a chemotherapy drug P: Prednisone, a steroid You get the R-CHOP regimen in cycles spaced three weeks apart. Sometimes this treatment is followed by radiation therapy. Although R-CHOP is most commonly used, a couple of other drug combinations are used in certain cases, such as for the customized treatment of a specific subtype or if you have another condition too (such as HIV). These other drug combinations (all a mix of monoclonal antibodies, chemotherapy, and a steroid) include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629ff9b958b-abdf-40a4-9da5-c9990c4930e9 R-EPOCH: Rituximab, etoposide, prednisone, Oncovin, cyclophosphamide, and doxorubicin hydrochloride Pola-R-CHP: Polatuzumab vedotin-piiq (Polivy), rituximab, cyclophosphamide, doxorubicin hydrochloride, and prednisone R-DHAP: Rituximab, dexamethasone, cytarabine, and cisplatine60dc2a1-f33c-4a05-9b50-8e3e8e597629695b4c15-5d79-4c34-9566-0fbe254d32f0 Stem Cell Transplantation If the cancer doesn’t respond to these medications or comes back after treatment, a stem cell transplant immunotherapy treatment might be an option. First, doctors will remove stem cells from your bone marrow or blood. These are the cells that develop into new blood cells. Then, you’ll get high-dose chemotherapy to wipe out all the cancer cells in your body. Finally, your stem cells will be returned to your body so they can produce new blood cells.e60dc2a1-f33c-4a05-9b50-8e3e8e597629addcd625-2809-44b2-9ce9-c8f4376f30f0 A stem cell transplant offers the best chance for a cure, according to the American Cancer Society.e60dc2a1-f33c-4a05-9b50-8e3e8e597629841ab011-f4e8-4d93-9a11-a7f4b626c87a Patients who are ineligible for a stem cell transplant may be eligible for a targeted combination therapy, such as tafasitamab and lenalidomide. Tafasitamab behaves as a monoclonal antibody, binding to the lymphoma cells and destroying them. Lenalidomide enhances the immune response. Clinical trials may also be an option.e60dc2a1-f33c-4a05-9b50-8e3e8e59762981491c84-e401-49b2-bad4-f7d683d375d6 Chimeric Antigen Receptor T-Cell Therapy Chimeric antigen receptor (CAR) T-cell therapy is another option if the cancer isn’t responsive to the initial treatment. In this immunotherapy treatment, immune cells called T cells are removed from your body and reengineered in a lab so that they can find and destroy lymphoma cells once they are returned to the bloodstream.e60dc2a1-f33c-4a05-9b50-8e3e8e597629addcd625-2809-44b2-9ce9-c8f4376f30f0 Potential side effects of CAR T-cell therapy are cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). ICANS has neurological effects, such as impaired speech and confusion, that are not fully understood. With CRS, the reengineered T cells release a large amount of cytokines (a chemical messenger). While this is a normal role for T cells, when done in abundance, it can cause fevers and large drops in blood pressure. CRS is serious, and it can be fatal. Cytokine-blocking drugs, such as tocilzumab, can be used to manage these side effects. CAR T-cell therapies are often used if the cancer doesn’t respond to the initial treatments, but they are being studied for use in earlier stages of the cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e597629781e35bb-91ef-47c6-be84-d2b3747b2985 Complementary Therapies Complementary therapies don’t treat lymphoma, but they can relieve symptoms and help you feel better during treatment. Examples of complementary therapies some people use for DLBCL include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976297af65a54-23d3-4e4a-8a82-72d566097352 Acupuncture : Very thin needles are placed at specific points in your body, stimulating nerves, muscles, or connective tissue in a way that is believed to produce an immune response and relieve pain. Acupuncture can be helpful for managing cancer fatigue and chemotherapy-related nausea.e60dc2a1-f33c-4a05-9b50-8e3e8e597629afe7e057-aa2e-4615-84ca-9feefa7958be Aromatherapy: Using essential oils from plants may help you relax and sleep better. You can inhale their scent or rub them onto your skin. Massage: A gentle massage could be helpful for promoting relaxation and sleep, as well as for easing stress. Mindfulness techniques: Meditation , deep breathing , yoga , and tai chi are other ways to help you relax. Before you try any new complementary therapy, check with the doctor who treats your cancer to make sure it’s safe to use with your medications.
Prevention of Diffuse Large B-Cell Lymphoma Prevention You can’t always prevent diffuse large B-cell lymphoma. Many of the risk factors, such as age, sex, race, and family history, are not under your control. But there are things you can do to reduce other risk factors for DLBCL. Protect yourself from infections. Get vaccinated against hepatitis B. Use condoms every time you have sex to prevent hepatitis C and HIV infection. Don’t share personal items like razors, toothbrushes, and needles. And take preexposure prophylaxis, or PrEP, if you’re at risk of contracting HIV.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f015eb9d-c914-4db7-a4eb-2b66b8728d3de60dc2a1-f33c-4a05-9b50-8e3e8e59762931a22c2b-5372-4dbe-9a3f-0d18177f7c3d Try to stay at a healthy BMI. Work with your doctor on your diet and exercise routine to keep your weight within the recommended range. Staying at a healthy BMI is especially important during your teens and early 20s, as a high BMI that continues into adulthood can increase the risk of cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e597629965d2a89-65a6-4071-b4fa-351ba0ae727e The optimal BMI range for an adult is 18.5 to 24.9, but note that this is a tool to help estimate body fat. It is not always an accurate representation of your health. Use this chart to help calculate yours.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c03935a3-826c-407a-a7bf-83eeca28ea0b Avoid toxic chemicals. Try to limit your exposure to substances like trichlorethylene (found in solvents and some household cleaning products) and benzene (found in tobacco smoke, industrial emissions, and some paints, among other products).e60dc2a1-f33c-4a05-9b50-8e3e8e5976293e4c63dd-85c3-4960-90b9-6336738824c3e60dc2a1-f33c-4a05-9b50-8e3e8e597629138c75ac-c6f2-4e6c-8f84-2d476bdba30ee60dc2a1-f33c-4a05-9b50-8e3e8e5976299ad1d02c-86fa-4183-af59-5b3b531857c6
Lifestyle Changes for Diffuse Large B-Cell Lymphoma Lifestyle Changes Lifestyle changes won’t treat DLBCL, but they can help you stay healthier during treatment. Eating a well-balanced diet, staying active, and managing stress can help you feel better while you’re undergoing therapy. Make Changes to Your Diet You need extra calories, protein, and nutrients to prevent weight loss, maintain muscle mass, and help your body heal from the cancer and its treatments. Lean meat, poultry, fish, eggs, beans, yogurt, and other dairy foods are good protein sources. Eating more fruits and vegetables can help ensure that you get adequate nutrition.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291b3c9c8e-8656-4437-b312-68958b1c2ea7 To get enough calories, add foods like these to your diet:e60dc2a1-f33c-4a05-9b50-8e3e8e5976296508b41b-3852-4271-9801-1ffcb83f3df9 Peanut butter or other nut butters, nuts, and seeds Avocado Ice cream Butter and olive oil Cream Full-fat Greek yogurt Whole-grain pasta and bread Avoid foods that don’t offer much nutritional benefit, like:e60dc2a1-f33c-4a05-9b50-8e3e8e597629716cb222-c649-47d9-b6dc-0bb277bcd7b8 Processed foods Sodas and other sugary drinks Fatty and processed meats (like bacon and sausage) White bread, pasta, and rice You may not feel like eating due to side effects of chemotherapy like nausea and appetite loss. Instead of eating three big meals, eat smaller meals and snacks throughout the day. If the smell of food cooking nauseates you, eat food cold or at room temperature. Add sauces and seasonings to make foods taste more palatable, and avoid dishes that taste strange because of chemo.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291cd4f600-848b-4e9c-8bb4-8a369c7306b6 Also, drink plenty of fluids like water, fruit juice, and smoothies to stay hydrated. Aim for 8 cups of fluid a day. You don’t have to drink it all at once. Carry a water bottle with you and take small sips throughout the day.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291cd4f600-848b-4e9c-8bb4-8a369c7306b6 If you have questions about your diet, consult with your hematologist/oncologist or a cancer nutritionist. Get Regular Exercise Exercise is just as important during cancer treatment as it was before you were diagnosed. In fact, a study found that people with lymphoma who were more physically active lived longer than those who were less active.e60dc2a1-f33c-4a05-9b50-8e3e8e597629249d7430-4fc6-44f9-adf7-2b7224e259c3 You might feel too tired or weak to work out, but exercise can give you more energy and help you sleep better. It also helps improve appetite. Do as much exercise as you can manage, even if it’s just taking a 10-minute walk.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296508b41b-3852-4271-9801-1ffcb83f3df9 Work up to a goal of 150 minutes a week of moderate-intensity aerobic exercise. Add in strength training, balance, and flexibility exercises for a well-rounded workout program.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293892f8e1-5b60-4019-b9ff-c2ebde75b0b3 Care for Your Mental Health Being diagnosed with cancer is a big adjustment. DLBCL can bring a lot of stress and anxiety into your life. Be gentle on yourself. Use techniques like meditation, yoga, tai chi , or art therapy to relax. If you feel overwhelmed, lean on friends and family. You can also get help from a mental health professional like a therapist or counselor, or join a support group for people with lymphoma.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296508b41b-3852-4271-9801-1ffcb83f3df9
Diffuse Large B-Cell Lymphoma Prognosis Prognosis and Outlook Diffuse large B-cell lymphoma is an aggressive cancer, but it is treatable. The initial treatment often puts it into remission, which means there are no longer any signs or symptoms of the cancer. Up to 60 percent of people are cured with the first treatment, meaning that there is no longer any cancer detected (whereas remission is a broader term, meaning that the cancer is responding to treatment, and signs and symptoms of the disease are lessening).e60dc2a1-f33c-4a05-9b50-8e3e8e5976297a38705b-009b-4219-a7f9-ff88a82e773ce60dc2a1-f33c-4a05-9b50-8e3e8e5976297a87d0d1-21bc-447f-9a17-d4ee2e5e7b54 DLBCL can come back months or years after treatment. Up to 40 percent of people who are successfully treated will have a recurrence.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ac020cad-6eb4-4ae1-9fef-5146ce1f56e3 If this happens, your doctor will treat you again. Worrying about whether your cancer will return can be stressful, but you’ll get regular follow-ups to ensure that if it does recur, your doctor can start you on another therapy quickly. DLBCL that doesn’t respond to the first treatment is more challenging to treat. But newer regimens like targeted therapies and immunotherapy are improving the outlook for those with treatment-resistant DLBCL.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fbe156a8-1a46-4df4-a8b6-60d7e8194f79 The survival rate depends on your cancer stage. Overall, people who are diagnosed with DLBCL are 65 percent as likely to be alive five years later as those without this cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293b7a1ead-7648-4685-8365-3e81f2fe4797 When the cancer is only in one lymph node, one lymph organ, or one organ outside the lymph system, the five-year relative survival rate is 73 percent. Once the cancer has spread to organs like the lungs or liver, that rate drops to 58 percent.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293b7a1ead-7648-4685-8365-3e81f2fe4797 Keep in mind that every person with DLBCL is different. These statistics can’t predict how well you will respond to treatment or how long you will live. Your cancer doctor can give you a better idea of your expected outlook.
Complications of Diffuse Large B-Cell Lymphoma Complications Diffuse large B-cell lymphoma affects the immune system and blood cells. Even with treatment, it can cause complications, including:e60dc2a1-f33c-4a05-9b50-8e3e8e597629a4b421d2-b44a-4e2b-b5e0-75df5386c5ee Infection Low blood cell count Kidney failure Spread of the cancer to the brain and spinal cord Chemotherapy and other treatments for DLBCL can cause side effects , such as:e60dc2a1-f33c-4a05-9b50-8e3e8e597629792c3225-ee9c-4f17-b208-bd3f125bc2ce Fatigue Nausea and vomiting Hair loss Increased risk of infection Mouth sores Brain fog, or “chemo brain” Nerve damage Your cancer treatment team can recommend treatments to manage any side effects you have.
Research and Statistics: How Many People Have Diffuse Large B-Cell Lymphoma? Research and Statistics DLBCL is the most common type of lymphoma. More than 1 in 4 lymphoma diagnoses in the United States are this type, and more than 25,000 people are newly diagnosed with DLBCL each year.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298f3e58bd-8306-4642-b15f-fdc610c19957
Conditions Related to Diffuse Large B-Cell Lymphoma Related Conditions Large B-cell lymphoma is linked to conditions that affect the immune system, including certain infections and autoimmune diseases like these:e60dc2a1-f33c-4a05-9b50-8e3e8e597629ea81a21a-84d7-4175-86e1-88ba8918c71c Epstein-Barr virus: This highly contagious virus causes mononucleosis and sometimes cancer. HIV: This virus attacks and damages the immune system. Hepatitis B and C: These viruses damage the liver. Rheumatoid arthritis: This inflammatory form of arthritis affects the joints and other organs. Lupus: This autoimmune disease attacks the joints and other body tissues.e60dc2a1-f33c-4a05-9b50-8e3e8e597629580d5627-301f-418e-b7aa-6418599278c4 Sjögren ’ s syndrome: This autoimmune disorder attacks the glands that produce saliva and other fluids, causing dry mouth and dry eyes.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d59813ab-ce45-4611-a263-158c94d4a21b
Support for Diffuse Large B-Cell Lymphoma Support Here are some organizations that offer support and resources for DLBCL: Leukemia & Lymphoma Society This is the largest nonprofit organization dedicated to blood cancers. It invests in leukemia and lymphoma research and offers free education and support services to people with these cancers and their families. Cancer Care This nonprofit organization has been around since 1944. Its mission is to help people navigate the emotional and financial challenges of a cancer diagnosis. It offers free support from oncology social workers, as well as other resources, to people with DLBCL.
The Takeaway Diffuse large B-cell lymphoma is the most common type of non-Hodgkin lymphoma in the United States. This cancer affects white blood cells called B lymphocytes, which are an important part of the immune system. DLBCL is an aggressive cancer, but it is treatable and even curable with a combination of chemotherapy and other medications. Because this cancer can come back after treatment, regular monitoring is important to catch a recurrence.
Resources We Trust Cleveland Clinic: Diffuse Large B-Cell LymphomaHealthTree Foundation: Real-World Data Shows Improved Outcomes for Black Patients With DLBCLCancerCare: Diffuse Large B-Cell LymphomaLymphoma Action: Exercise and Physical ActivityMayo Clinic: How to Make Life Easier During Diffuse Large B-Cell Lymphoma Treatments

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Seborrheic dermatitis (also known as dandruff or seborrheic eczema) is a common, noncontagious skin condition that primarily affects the scalp. It causes symptoms like skin inflammation, scaly patches, and persistent flaking.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292f75a892-662e-440c-bcfd-7b128f426223 The condition can develop at any age, but it’s most common in infants and people ages 30 to 60. Seborrheic dermatitis can flare up from time to time in response to certain triggers. You may need to use medicated shampoo or other treatments to manage symptom flares.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d2e94494-795d-49a6-8af2-5e3a62ccc3af
Types of Seborrheic Dermatitis Types The types of seborrheic dermatitis are characterized by age. They include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629dc2bd651-c86a-4386-aed6-7424459ad249 Infantile Seborrheic Dermatitis Seborrheic dermatitis in infants is commonly referred to as cradle cap. It looks like scaly, greasy patches on the scalp. It can also be found in the diaper area, back, chest, or anywhere the skin folds or creases. Adult Seborrheic Dermatitis In this age group, seborrheic dermatitis most often appears on the scalp, causing stubborn dandruff . It can also develop on the face or anywhere on the body with oily skin, except the palms and soles of the feet.
Signs and Symptoms of Seborrheic Dermatitis Symptoms The symptoms of seborrheic dermatitis can appear in many areas of the body, but most often affect the scalp. Signs and symptoms include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629dba6cb26-52a6-4b44-985d-8af9e6b215e2e60dc2a1-f33c-4a05-9b50-8e3e8e59762980830835-eef3-4e5a-9cfb-9a61e2fdefb1 Crusty yellow scales on an infant’s head (cradle cap) In adults, dandruff (itchy white flakes of skin) on the scalp, hair, eyebrows, mustache, or beard Oily skin patches covered in white or yellow flakes or crust on the scalp, eyebrows, face, sides of the nose, eyelids, armpits, chest, under the breasts, or groin Rash that may appear red in lighter skin tones or pink, purple, or lighter in brown or Black skine60dc2a1-f33c-4a05-9b50-8e3e8e59762917f3daac-ef5d-483b-b441-76eb4a29d6e0 Itchy skin (pruritus) Scales and redness around eyelids ( blepharitis ) Thick pinkish plaques or scales on the face Flaky, ring-shaped patches on the chest or hairline Redness in the groin, armpits, and beneath the breasts Hair follicle inflammation in the cheeks and chest
Causes and Risk Factors of Seborrheic Dermatitis Causes Experts don’t know the exact cause of seborrheic dermatitis, but they think several factors could play a role. These include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629a773c9de-7d66-42b0-9ba4-4e66218930d4e60dc2a1-f33c-4a05-9b50-8e3e8e5976299a36473c-7bc2-492a-93ca-de1b2f98b48e Inflammatory reaction to Malassezia (yeast) overgrowth on the skin High androgen hormone levels Increased skin lipids (fats) Risk factors for seborrheic dermatitis are wide-ranging and can trigger a flare. These may include genetics, chronic health conditions, environmental factors, and certain medications.e60dc2a1-f33c-4a05-9b50-8e3e8e59762904c91d38-b34a-4e32-9052-ffa1623601b4e60dc2a1-f33c-4a05-9b50-8e3e8e5976299a36473c-7bc2-492a-93ca-de1b2f98b48ee60dc2a1-f33c-4a05-9b50-8e3e8e597629f8f7e662-fbcd-43a2-8a9c-2c8b4b047146 Genetic Factors Genetic risk factors for seborrheic dermatitis include: Assigned male at birth Family history of seborrheic dermatitis and other skin disorders Down syndrome Chronic Health Conditions Chronic health conditions that raise your risk for seborrheic dermatitis include: Neurological disorders like Parkinson’s disease and epilepsy Immunosuppressive disorders like HIV/AIDS Other skin disorders like psoriasis , acne , or rosacea Alcohol addiction Depression Eating disorders Stroke or heart attack Stress and fatigue Environmental Factors Environmental risk factors for seborrheic dermatitis include: Seasonal changes Using alcohol-based lotions Use of harsh detergents, chemicals, soaps, or hairstyling products Medication Some medications can also put you at higher risk for seborrheic dermatitis, including lithium (a mood-stabilizing drug) and immunosuppressants.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f8f7e662-fbcd-43a2-8a9c-2c8b4b047146
How Is Seborrheic Dermatitis Diagnosed? Diagnosis Providers can often diagnose seborrheic dermatitis simply by asking about your or your baby’s symptoms and examining the affected areas. No blood, urine, or imaging tests are needed. In some cases, you may need to have a biopsy (a small piece of affected skin removed for examination), especially if your skin doesn’t respond to treatment. A skin biopsy can help rule out other skin conditions that may be causing your symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e59762923df511a-348a-49b2-94d3-7447cb078d79e60dc2a1-f33c-4a05-9b50-8e3e8e59762972437fa7-65a0-41a9-8052-53ca2273cbe7
Treatment and Medication Options for Seborrheic Dermatitis Treatment Seborrheic dermatitis in infants often needs no treatment. But for infants who seem uncomfortable and scratch at their scalp, consult a pediatrician or dermatologist. They may recommend a prescription shampoo or lotion in some cases.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c9b1bb18-8039-4fac-95bc-5270c2c27bbc Teens and adults with seborrheic dermatitis may need medicated shampoos, creams, or ointments to help manage their symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291c68512e-09a3-49fd-8927-c4fbe087c5fd Medication Options Many medication treatments for seborrheic dermatitis are available over the counter, but others require a prescription. Medicated Shampoos These contain compounds designed to manage flakes.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291c68512e-09a3-49fd-8927-c4fbe087c5fde60dc2a1-f33c-4a05-9b50-8e3e8e5976297b1809e9-b472-4221-807b-968751d7de77 selenium zinc pyrithione coal tar ciclopirox (Loprox) ketoconazole (Nizoral) clobetasol (Clobex) Topical Antifungals These treatment options help reduce yeast overgrowth on your scalp.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291c68512e-09a3-49fd-8927-c4fbe087c5fde60dc2a1-f33c-4a05-9b50-8e3e8e59762996ace89e-f13e-4153-941c-f84f48389d92 ciclopirox ketoconazole sertaconazole Topical Corticosteroids These drugs help decrease inflammation and manage flares. They’re only intended for temporary use because, over time, they can cause the skin to thin.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291c68512e-09a3-49fd-8927-c4fbe087c5fde60dc2a1-f33c-4a05-9b50-8e3e8e59762996ace89e-f13e-4153-941c-f84f48389d92 betamethasone valerate (Betnovate) desonide (Desowen, Desonate) fluocinolone (Capex, Synalar) hydrocortisone clobetasol (Clobex, Temovate) betamethasone valerate (Luxiq) fluocinolone solution (Synalar) Topical Calcineurin Inhibitors These drugs suppress the immune system, which helps reduce the inflammation that’s contributing to your symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291c68512e-09a3-49fd-8927-c4fbe087c5fd pimecrolimus cream (Elidel) tacrolimus ointment (Protopic) Nonsteroidal PDE-4 Inhibitors These drugs also suppress the immune system, which helps reduce the inflammation that’s contributing to your symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e59762925aac886-6376-44fd-933d-d914ac591e43 roflumilast (Zoryve) Treatments for Severe Seborrheic Dermatitis For severe cases of seborrheic dermatitis, a provider may recommend an oral medication or ultraviolet light therapy to decrease skin inflammation. During light therapy, a specific wavelength of ultraviolet light is administered to reduce skin inflammation.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291c68512e-09a3-49fd-8927-c4fbe087c5fde60dc2a1-f33c-4a05-9b50-8e3e8e5976297b1809e9-b472-4221-807b-968751d7de77
Complementary and Integrative Therapies Before trying a medication, some adults with seborrheic dermatitis first try a shampoo with tea tree oil or apply aloe vera gel to the affected areas. Since research hasn’t proven these are effective for seborrheic dermatitis, it’s always a good idea to check with your provider before trying anything new.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298a0c24d3-d119-44fc-9086-172fc874ea8d
Prevention of Seborrheic Dermatitis Prevention Seborrheic dermatitis can’t be prevented. However, there are a few lifestyle steps you can take to reduce your risk, including getting enough sleep each night, spending a few minutes out in sunshine each day (not midday sun, which has a higher risk for sunburn), and doing your best to manage stress .e60dc2a1-f33c-4a05-9b50-8e3e8e59762924a678da-73e2-4182-9887-4d88f605072d
Lifestyle Changes for Seborrheic Dermatitis Lifestyle Changes For infants with cradle cap, parents can apply mineral oil or petroleum jelly to scaly areas, which loosens them.e60dc2a1-f33c-4a05-9b50-8e3e8e59762959f56cd2-62da-455c-b311-ba734a5ab801 It also helps to wash their scalp once daily with baby shampoo and gently brush their hair with a soft brush several times a day. Try to avoid scratching the skin with a brunch, which can lead to an infection.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293618b619-2b93-48c8-b801-fb295bb84f71 To help prevent flare-ups, adults and teens can adopt the following lifestyle practices:e60dc2a1-f33c-4a05-9b50-8e3e8e59762929498aa5-9e30-4476-bf44-dcc5ebe26dde Wash your scalp and facial hair regularly. Avoid using hairstyling products if your symptoms are flaring up. Don’t use alcohol-based skin and hair products. Gently clean inflamed or scaly eyelids every night with baby shampoo. Try applying mineral oil, peanut oil, or olive oil to your scalp for one to three hours to soften flakes, then brush or comb your hair and wash it afterward to remove flakes
How Long Does Seborrheic Dermatitis Last? Prognosis and Outlook For infants, cradle cap and seborrheic dermatitis in other locations typically develops in the first three months of life. Most cases go away by the baby’s first birthday. In teens and adults, this skin condition flares up from time to time, but has no cure.e60dc2a1-f33c-4a05-9b50-8e3e8e59762986aaa615-706e-4bf1-80f2-6c5795f8583f These flare-ups can get better with or without treatment, and their frequency varies. Flare-ups happen most often in winter and early spring, but you may notice fewer symptoms in warm and humid weather.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d9828a00-7776-473b-8c6e-7e60e9e2dde9 Seborrheic dermatitis can cause irritation during flares, but it can be managed with treatment, and it causes no permanent hair loss.e60dc2a1-f33c-4a05-9b50-8e3e8e597629529c56e3-3920-4c1d-a68c-fe6bfa8f6e7f
Research and Statistics: Who Has Seborrheic Dermatitis? Research and Statistics About 1 in 10 people have seborrheic dermatitis. As mentioned, it’s most common in infants and adults aged 30 to 60.e60dc2a1-f33c-4a05-9b50-8e3e8e597629eac29feb-01fe-4333-90be-42630e5fce41 It’s especially common in adults age 50 or older.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ba522fcd-1afe-495d-834f-560e084a7026 Men experience symptoms more often than women.e60dc2a1-f33c-4a05-9b50-8e3e8e597629eac29feb-01fe-4333-90be-42630e5fce41 Research on the prevalence of seborrheic dermatitis by race or ethnicity varies. Some research suggests white people are more likely to get it, while other research suggests Black people have a higher risk.e60dc2a1-f33c-4a05-9b50-8e3e8e597629eac29feb-01fe-4333-90be-42630e5fce41e60dc2a1-f33c-4a05-9b50-8e3e8e597629ba522fcd-1afe-495d-834f-560e084a7026 For people with early HIV infection, 35 percent have seborrheic dermatitis, but this goes up to 85 percent once the virus progresses to AIDS.e60dc2a1-f33c-4a05-9b50-8e3e8e597629af1176c7-b84a-4b32-99aa-b09e6860fd99
Disparities and Inequities in Seborrheic Dermatitis Disparities Racial and ethnic disparities exist for many dermatologic conditions, including seborrheic dermatitis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629815dc6da-4015-46c6-a185-ee40c0385ace Research suggests that seborrheic dermatitis symptoms can appear differently in people with darker skin tones compared with people with lighter skin tones, and that not all dermatology practitioners have specific knowledge about these differences.e60dc2a1-f33c-4a05-9b50-8e3e8e59762919323c12-3d0c-4418-bc3b-6e0fc547eb9f People with darker skin tones are more likely to experience inequities in care based on socioeconomic factors and gaps in education about skin conditions. The underrepresentation of minority groups among dermatology professionals is also a contributor to these inequities.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bf302e85-f2ed-43da-a31c-b1b071b35860 In addition, research suggests that, when prescribing treatment, some providers may use a general approach without considering cultural factors that often affect treatment. For example, most antifungal shampoos are designed to be used several times per week, but many Black women with natural, nontraction hairstyles only need to wash their hair every 14 days, on average. Additionally, research shows people of Asian origin may have more sensitivity to irritants in topical medications compared with white people.e60dc2a1-f33c-4a05-9b50-8e3e8e597629815dc6da-4015-46c6-a185-ee40c0385ace It’s important for providers to speak openly with their patients of color and to tailor treatment to match their needs, lifestyle, and cultural factors as closely as possible.e60dc2a1-f33c-4a05-9b50-8e3e8e597629815dc6da-4015-46c6-a185-ee40c0385ace
Related Conditions Seborrheic Dermatitis Related Conditions Seborrheic dermatitis can cause similar symptoms to the following conditions:e60dc2a1-f33c-4a05-9b50-8e3e8e59762941cf61d4-47cb-4e3c-99a7-125f877e729c Psoriasis Rosacea Contact dermatitis Lupus Acne Darier disease (a rare genetic disorder causing wart-like bumps on the body) Staphylococcal blepharitis (an inflammation of the eyelids caused by a type of bacteria called Staphylococcus aureus ) The Takeaway Seborrheic dermatitis is a chronic, noncontagious skin condition that causes cradle cap among infants and, among adults, flaking on the scalp and other areas of the body, skin inflammation, and itching. Risk factors for seborrheic dermatitis include being male and having a family history of seborrheic dermatitis. It can also be triggered by depression, stress, season changes, and immunosuppressive or neurological health conditions, among other factors. To treat seborrheic dermatitis, providers may recommend medicated shampoos, lotions, or ointments. In more severe cases, oral medication or light therapy may be recommended. If you have symptoms of seborrheic dermatitis, let your healthcare provider know. They can help you develop a plan to keep your symptoms at bay.
Resources We Trust Mayo Clinic: Seborrheic Dermatitis: Symptoms and CausesCleveland Clinic: Seborrheic DermatitisNational Eczema Society: Seborrhoeic Dermatitis in AdultsNational Eczema Association: Seborrheic DermatitisAmerican Academy of Dermatology Association: Seborrheic Dermatitis: Overview

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Long dramatized in movies and novels, amnesia refers to a profound loss of memory that’s temporary, permanent, or progressive (gets worse over time). Depending on the type and cause of amnesia, the condition can affect your ability to recall information or past experiences or even form new memories and learn new skills, significantly impacting your independence and quality of life. In many cases, amnesia resolves on its own, and treatment usually focuses on addressing the underlying cause of the memory loss.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c85529cf-e32e-4f76-be5c-001c6f0a61d2
Types of Amnesia Types There are two broad categories of amnesia: retrograde and anterograde amnesia. If you have retrograde amnesia, you’ll be unable to recall some past events and information before some causative event or specific point in time. Often, retrograde amnesia affects more recent memories — you may not be able to remember what happened in the last few months or years, but you can remember what your childhood was like.e60dc2a1-f33c-4a05-9b50-8e3e8e59762915e21b4a-8f91-4efd-a86f-091367e726b5 Comparatively, anterograde amnesia would make it difficult for you to form new memories after the causative event, but you can remember what happened before that point in time. These two types of amnesia are not mutually exclusive, and you can experience being unable to remember past events while also struggling to form new memories. There are also other, more specific types of amnesia, including: Transient global amnesia: A sudden episode of memory loss that typically lasts for a few hours to a day. This type of memory loss primarily affects middle-aged and older individuals and involves both retrograde and anterograde amnesia.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bf1dd29d-648c-42eb-99ad-2a701acf9312 Dissociative amnesia : Memory loss caused by psychological trauma or stress, rather than a physical cause. It is part of a group of conditions called dissociative disorders, which involve a loss of awareness of surroundings or self and includes dissociative identity disorder.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297e180f5b-fd7f-4e8e-b468-024286a64c7d Post – traumatic amnesia : Temporary memory loss that develops after an injury, such as head trauma, making it difficult to form new memories and recall events that directly preceded or followed the event. How long it lasts is indicative of the severity of the brain injury.e60dc2a1-f33c-4a05-9b50-8e3e8e59762911aa6210-ecb1-4942-a721-8ea385733b1d Infantile amnesia : The natural inability to recall early childhood memories (typically the first two to three years of our lives). Infantile amnesia can also be thought of as the beginning or onset of memory.e60dc2a1-f33c-4a05-9b50-8e3e8e597629dbb89cd2-67a7-49be-8617-ade01e4d9b46
Signs and Symptoms of Amnesia Symptoms The signs and symptoms of amnesia differ depending on the type you have, and they include: Difficulty recalling past events or personal details Inability to form new memories Forgetting upcoming eventse60dc2a1-f33c-4a05-9b50-8e3e8e597629598e5650-b7ac-4fb9-8ba7-ea4e981d12c5 Trouble recognizing facese60dc2a1-f33c-4a05-9b50-8e3e8e597629ac36f7df-f878-4175-a1cb-7a6d0d93c185 Confusion or disorientation Repeating questions or statements Confabulation, or the subconscious invention of false memories to fill in gaps
Causes and Risk Factors of Amnesia Causes Some forms of amnesia, such as dissociative and post-traumatic amnesia, stem from psychological trauma or severe stress. More often, however, amnesia results from issues that can directly damage the brain, including: Traumatic brain injury Brain surgerye60dc2a1-f33c-4a05-9b50-8e3e8e5976292e17f428-17da-483d-9bac-299e5ae3c6c8 General anesthesia Electroconvulsive therapy Brain tumors Migraine , specifically with transient global amnesiae60dc2a1-f33c-4a05-9b50-8e3e8e59762960f0da52-e7cb-4cb6-a142-516f399f0408 Cerebral hypoxia (brain damage from lack of oxygen) Stroke Seizure Alzheimer’s disease and other forms of dementia Degenerative brain diseases, such as Parkinson’s disease and multiple sclerosis Encephalitis (viral infection of the brain) Chronic alcohol abuse , which causes a deficiency in thiamin (vitamin B1), resulting in Wernicke-Korsakoff syndrome, a condition affecting brain functioning and memorye60dc2a1-f33c-4a05-9b50-8e3e8e597629533af088-38c7-4f2f-a493-cb5dd2b6632f Certain drugs, such as heroin, barbiturates (depressant drugs sometimes used to treat epilepsy and seizures), and sedatives Carbon monoxide poisoning, heavy metal poisoning, and other forms of toxin exposure
How Is Amnesia Diagnosed? Diagnosis Diagnosis of amnesia begins with a general examination and review of your symptoms and medical and family history. Your healthcare provider will then run a series of diagnostic tests to determine the extent of your memory loss and what may be causing it, including: Cognitive and neurological tests of your memory, attention, language, and other brain functionse60dc2a1-f33c-4a05-9b50-8e3e8e597629bda1a0fa-1da4-4d62-b1ce-26ad21c12a62 Blood tests to identify any infections or vitamin deficiencies Electroencephalogram to measure the electrical activity in your brain and detect signs of seizuree60dc2a1-f33c-4a05-9b50-8e3e8e59762904aeec00-5709-4956-a81b-adb5be8aca76 Imaging tests to detect any brain damage, including head X-rays , magnetic resonance imaging (MRI) , and computed tomography (CT) Cerebral angiography, a type of X-ray scan that uses a special injected dye to visualize blood vessels and detect aneurysms , tumors, and other issuese60dc2a1-f33c-4a05-9b50-8e3e8e597629b99cce19-18ab-4047-8048-8c45fe9cf4b2 Spinal tap (lumbar puncture) to examine your cerebral spinal fluid for signs of infection in your brain
Treatment for Amnesia Treatment There is no single cure that can return your memory to normal if you have amnesia. Usually, your memory will return over time, in minutes to years, depending on the cause of memory loss. Treatment generally focuses on symptom management and correcting the underlying cause of the memory loss, such as by: Detoxifying from and avoiding alcohol Changing medications or their dosagese60dc2a1-f33c-4a05-9b50-8e3e8e597629f94efe5d-4255-45d8-aa98-79c95d753975 Treating infections Resting (if recovering from concussion )e60dc2a1-f33c-4a05-9b50-8e3e8e59762976a704e0-d0e2-4b31-900a-6f0c2d55d8ff Creating a safe, supportive environment to recover from psychological triggers and stress If a person is experiencing dementia-related amnesia, there is no cure for the underlying illness. But medications that support learning and memory, including donepezil, galantamine, and rivastigmine, may help.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fccbdc31-b428-430a-a370-57da15387877 Other therapies may help you retrieve lost memories, cope with memory loss, or improve memory and cognitive function, such as: Occupational therapy to learn new information or skills to replace what you lost and also strengthen memory and cognitive abilities Cognitive behavioral therapy to help you deal with psychological distress, manage stress, and improve your well-being (CBT is especially helpful for dissociative amnesia cases) Cognitive rehabilitation to improve memory, attention, problem-solving skills, and organizational skillse60dc2a1-f33c-4a05-9b50-8e3e8e59762991a9720b-eade-4ab4-a145-6eb57b3600ae
Prevention of Amnesia Prevention While there’s no surefire way to prevent amnesia, you can take some steps to reduce your risks of psychological and neurological issues that may cause amnesia. Protect yourself from head trauma, such as by using safety equipment in appropriate situations, for example a helmet while riding a bike and a seat belt while in the car. Manage your cardiovascular health to prevent stroke. Limit alcohol consumption. Seek timely treatment for infections or illnesses, especially eye or ear infections, which could spread to your brain. Reduce stress through mindfulness , therapy, and other modalities. Stay mentally fit, such as by learning a new skill, reading, and doing puzzles.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295cf82cf9-30af-4583-9345-d1b2c1693e40 Eat a balanced, nutritional diet. Stay active and maintain a healthy weight for you. Make sleep a priority. Nurture your social relationships.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291165201c-4d09-4b74-852b-cdc88ebd5920 Review and potentially change your medications with your provider, especially if you take sedatives.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f0cc9202-c92a-4cd5-9b09-11ebdf0c9676
Lifestyle Changes for Amnesia Lifestyle Changes If you’ve experienced some form of amnesia, certain lifestyle changes can help you better navigate life and compensate for memory issues. Keep a structured daily routine.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290fac1bbf-946d-46aa-af51-4e9e02b9a2ad Use reminders, notes, or digital apps for memory support. Engage in memory-enhancing activities like puzzles or reading. Stay socially active to stimulate cognitive function. Join support groups for people with memory loss or memory disorders. Adopt a healthy lifestyle with respect to diet, physical activity, sleep, and stress management. Keep your tasks as simple and straightforward as possible, breaking them down into smaller steps if necessary.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291e359290-bfe3-4793-8085-afc608fcb4e2
How Long Does Amnesia Last? Prognosis and Outlook The duration of amnesia varies. Transient global amnesia resolves within hours, while retrograde or anterograde amnesia may persist for years. Recovery depends on the underlying cause, your overall health, and how you respond to treatment, with some individuals regaining memories over time and others experiencing permanent gaps. Memory loss is more likely to be permanent if it’s caused by something that can irreversibly damage the brain, such as Alzheimer’s disease.e60dc2a1-f33c-4a05-9b50-8e3e8e597629965c1f32-27e1-4c7e-b5cf-67417883e517
Complications of Amnesia Complications Amnesia can significantly impact your quality of life and various aspects of it, including your: Personal relationships Employment Mental health and risks for conditions like anxiety and depression Independence
Research and Statistics: Who Has Amnesia? Research and Statistics It’s difficult to determine how many people have amnesia given its various forms and many causes. Notably, Alzheimer’s disease, a major cause of amnesia, affects an estimated 6.9 million Americans.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d3101ce0-fc4c-43f2-b592-08bae98f8ca1 Research suggests transient global amnesia affects 3.4 to 10.4 people per 100,000 annually. It mostly affects older adults age 50 to 80 years.e60dc2a1-f33c-4a05-9b50-8e3e8e59762955665bf0-7b81-4caf-abea-db16ba1120ab Dissociative amnesia, on the other hand, occurs in 0.2 to 7 percent of the general population in the United States.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fd0fe5aa-5ef9-415a-817e-28fdffe9e71b The Takeaway Amnesia can result from various causes, including head trauma and psychological stress. While there’s no specific treatment for amnesia itself, addressing underlying conditions like infections or managing risk factors such as alcohol abuse can aid recovery. For some types of amnesia, memory may return naturally over time. When it doesn’t, approaches such as cognitive rehabilitation and occupational therapy can help to maintain daily functioning.
Resources We Trust Cleveland Clinic: AmnesiaMayo Clinic: Memory Loss: 7 Tips to Improve Your MemoryMerck Manual: AmnesiasAlzheimer’s Association: 10 Early Signs and Symptoms of Alzheimer’s and DementiaAmerican Psychiatric Association: What Are Dissociative Disorders?

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Have you ever found yourself tossing and turning more than usual at night because you’re anxious about a big test coming up, a move, a medical procedure, or some other event? Worrying can make it hard for the brain to relax, even at night, when it needs to relax in order for you to be able to fall asleep. It happens to everyone from time to time, but if you have a mental health condition that causes constant worry or stress — as can be the case with anxiety or depression — it can trigger consistent problems with sleep or insomnia (t rouble falling asleep, waking frequently during the night or before you want to — and before you’ve had enough sleep — in the morning) , explains David Neubauer, MD , an associate professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine in Baltimore.
Insomnia Has a Bidirectional Relationship With Depression and Anxiety A Bidirectional Relationship Sleep patterns, including insomnia, are affected by any number of physical, mental, emotional, and even social issues. When it comes to the link between insomnia and mental health, the relationship may best be described as bidirectional, meaning one can worsen the other and vice versa. As with the proverbial chicken and egg, it’s not always easy to tell which came first. “The formula varies — some start off with insomnia that develops into depression, while others start off with depression that leads to insomnia,” Dr. Neubauer says. Bipolar disorder, depression, stress, or anxiety, all increase your likelihood of developing insomnia. ( 2 , 3 ) At the same time, as many as 40 to 50 percent of people with insomnia also have a mental health disorder. ( 4 ) A meta-analysis that collectively included 172,077 individuals found that those with insomnia had a twofold increased risk of developing depression compared with individuals without insomnia . ( 5 ) The important point to know about this bidirectional relationship is that whatever the initial cause and the symptoms (whether insomnia is causing a mental health problem or vice versa), either can make the other worse. That means if you started having trouble sleeping, it persisted, became insomnia, and as a result you developed a problem with constant anxiety — that anxiety can in turn make your sleep problems worse, too. “There does appear to be a circular relationship between sleep health and mental health,” says Neubauer. “Worse sleep or mental health can have a negative impact on the other.” The flip side is that addressing one of the problems (likely the one you started experiencing first) can help the other one go away, too. For instance, for that person who developed insomnia that triggered constant anxiety, getting treatment for that insomnia (that allows he or she to get back on a healthy sleep schedule) may help the anxiety symptoms get better, too. “The good news is that improvement in either can be beneficial for the other,” Neubauer says. And knowing about this relationship means that doctors can be on the lookout for one when they see the other. “When someone comes in with persistent insomnia, we should look for mental health issues,” says Neubauer.
Does Not Being Able to Sleep Mean I’m Depressed? If Insomnia Comes First Just because you’re having trouble sleeping doesn’t mean you have depression, anxiety, or any other mental illness, nor does it mean you’ll develop one of those problems. But sleep problems do increase your risk of developing a psychological condition, so it’s important to do what you can to address either problem so it doesn’t bring on other symptoms, Neubauer explains. While doctors know a lot about the anatomy of the nervous system and neurophysiology, biologically they don’t yet have a clear understanding of the exact brain processes responsible for regulating sleep and mood and anxiety levels, Neubauer says. “There are overlapping brain regions and neurotransmitters among these domains, but it is unknown exactly how they interact or cause difficulties for certain people,” says Neubauer. “And genetic influences and life experiences likely are prominent, too.” That means just because someone has insomnia, it doesn’t mean he or she will develop anxiety or depression, because more factors than just the sleep problems are related to mood disorders, says Neubauer. “But we know that the risk increases.” If you have insomnia, you may notice the following symptoms in addition to trouble sleeping that could be early warning signs of compromised mental health. All of these symptoms are ones you should discuss with your doctor or healthcare provider: Feeling sad or depressed Lack of interest in usual activities Lack of appetite Fatigue Stress and anxiety Feelings of worthlessness or guilt Difficulty concentrating Irritability Recurrent thoughts of death Your doctor can help you parse out the causes of your sleep or mental health problems, and suggest the best treatment strategies for you to try, as well as offer advice on how to mitigate potential problems before they get worse. “Early consultation may prevent significant future impairment,” says Neubauer. “A healthcare professional will help with education about good sleep habits and may recommend cognitive-behavioral therapy for insomnia or possibly the use of a medication.”
Does Having Depression or Anxiety Mean I Have Insomnia? If Anxiety or Depression Comes First Likewise, having a mental health problem doesn’t necessarily mean you’ll develop insomnia — it just adds one more factor that raises your risk. That means if you’re managing a mental health condition, such as anxiety, depression, bipolar disorder, or something else, it’s important to practice good sleep hygiene (practices that promote healthy sleep). This strategy helps mitigate your risk of developing sleep problems, Neubauer says. Good sleep hygiene means keeping regular bedtime and wake-up hours, allowing sufficient time in bed, developing a relaxing evening routine, avoiding caffeine in the afternoon and evening, and refraining from alcohol. ( 6 ) And if you find yourself tossing and turning in bed, worrying and frustrated about not sleeping, don’t make yourself lie there for hours. Instead, get up and do something soothing like meditating, doing yoga stretches, listening to soothing music, or even writing a to-do list, Neubauer suggests. “Avoid extended time in bed while [you’re feeling] frustrated and worrying,” he adds. He suggests writing down what you’re worried about or what you need to get done the next day so that you don’t have to think about these things once you’re in bed. It’s also worth keeping in mind that stress and anxiety cause sleep problems for everyone, whether or not you have insomnia. “We vary in how much stress and anxiety affect us, and the degree to which they lead to serious sleep difficulty,” says Neubauer. “Ideally, stressful situations resolve quickly and the associated anxiety and sleep disturbance rapidly improve.” But if you do start to have trouble with sleep, especially repeated problems, talk to your healthcare provider about other solutions. “Sometimes difficulty falling asleep or staying asleep persist independently after the initial stress has gone away,” Neubauer says. In these cases that worry can itself become a self-fulfilling prophecy, and can lead to insomnia that shifts from worrying about a particular problem to worrying about whether they will be able to sleep, he says. If that happens, you may want to speak with your doctor about ways to deal with your worry about your ability to fall asleep and stay asleep.

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