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It's hard not to think about my bones being weak. How do I keep osteoporosis from interfering with my life?

Being told you have low bone mass or being diagnosed with osteoporosis can represent an opportunity for change. Rather than letting the news interfere with your life, think of it as an opportunity to make positive changes. Rather than feeling deprived or feeling old, let osteoporosis be a life-changing moment. Because osteoporosis is a "silent" disease, you probably did not know you had it. But some of the changes you make now can positively affect the rest of your life.

Once you are diagnosed, work to accomplish the following:

Stay positive. A recent study of midlife men and women linked happiness with health. The happier you are, the healthier you are.

Get organized. If you are on many medications and you are taking medication to prevent or treat osteoporosis, get yourself a pill-minder to make sure that you are taking your medication in the appropriate amount, on the correct day, and at the right time. Even if you only take a couple of medications, it's worth it to your peace of mind to get organized and use a pill-minder so that by lunchtime, you don't have to worry about whether you took your morning dose of osteoporosis or blood pressure medication.

Resolve to get healthy. Go to and evaluate the diet that is right for you. Read as much as you can about osteopenia and osteoporosis. Make sure that you are getting regular check-ups with clinicians for your overall health, including dentists and vision care professionals. If you take steroids, work with your clinician to reduce the dosage or find other therapies that can reduce bone loss (see Questions 87 and 88).

Develop goals directed at improving your bone health. Get enough calcium, vitamin D, and other substances necessary for good bone development. Make lifestyle changes that directly affect bone such as quitting smoking and reducing alcohol intake to a moderate level (see Question 86). Take your medication faithfully.

Evaluate your environment for the potential for falls. Falls can happen to anyone. Taking action to review the environment around you helps you and others (see Question 79).

Above all, keep moving! Develop an exercise routine that you can stick with. Find ways of staying active that you enjoy. Once you realize that osteoporosis doesn't have to interfere with your life, you can improve your bones while you improve your life!

In addition to osteoporosis, I have many health problems associated with midlife. I'm feeling very stressed. How can I keep from getting depressed?

It is not uncommon to feel stressed at midlife and into your senior years. If you are in perimenopause, there is a greater possibility of new depression during this time of your life. In fact, three times more women experience depression during perimenopause than at any other time prior to that. If you are a man at midlife, you may be having many of the same symptoms women experience during perimenopause and post-menopause, such as irritability, forgetfulness, and fatigue, or you may be experiencing the "midlife crisis" sometimes associated with disappointment after reviewing your life accomplishments.

Depression among older adults is common, too. In fact, depression and osteoporosis are physically and psychologically linked. Depression has been associated with low bone mass as well as increased risk of fracture. And if you fracture a bone, it is easy to become depressed from the lack of mobility, the social isolation, and the fear of falling or fracturing another bone (see Questions 2,18, and 78).

Medications, medical conditions such as thyroid disorders, nutritional deficiencies, or stressful life events also can cause depression. According to the National Institute of Mental Health, any of the following symptoms that persist for longer than 2 weeks should be addressed by a mental health professional:

• A persistent sad, anxious, or empty mood

• Feeling hopeless or pessimistic

• Feeling guilty, worthless, or helpless

• Loss of interest or pleasure in hobbies or activities that you usually enjoy, including sex

• Prolonged tiredness, lack of energy

• Difficulty concentrating, remembering, and making decisions

• Difficulty falling or staying asleep, early morning awakening, or oversleeping

Depression has been associated with low bone mass as well as increased risk of fracture.

• Appetite or weight loss, or overeating and weight gain (stress eating)

• Thinking about death or about killing yourself

• Feeling restless or irritable

• Persistent physical symptoms that do not respond to treatment, such as headaches or stomach upset.

When you start to feel overly stressed, it's not too late to manage the stress to prevent the need for a mental health professional. There are plenty of stress management techniques that have been proven effective. The following are just a few of the ways to manage your stress:

Breathe. Paced respiration can work well to keep you calm. Breathe in for the count of 4, hold your breath for 7 counts, and then breathe out for 8. Slow, rhythmic breathing can be done anytime.

Schedule time for yourself. Make time to do some things that you especially enjoy. Read, watch a favorite television show or movie, take a walk, work on a hobby, or go to the gym.

Get a good night's sleep. Lack of sleep feeds into the "stress-no-sleep" cycle, making stress worse.

Laugh loud and often. Laughter releases endorphins in the brain, which will improve your mood.

Eat well. A healthy diet can make you less irritable and more likely to resist stress and illness.

Exercise. While it may sound like exercise is the answer to everything, it really can decrease your stress level. Exercising releases endorphins, substances that are associated with mood—and in a good way! A daily exercise routine has been suggested as a way to feel younger and look younger, great incentives for using exercise to reduce stress. Exercise is an inexpensive and effective prescription for feeling better about yourself, and a great way to help in the prevention and treatment of depression.

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