TIME Research

Scientists Pinpoint Why Some People Are ‘SAD’ in Winter

"We believe that we have found the dial the brain turns when it has to adjust serotonin to the changing seasons"

Difficulty regulating a chemical in the brain may explain why some people suffer from season affective disorder (SAD), according to new research.

Scientists at the University of Copenhagen, who studied brain scans from more than 30 subjects, found that SAD patients had different levels of a neurotransmitter that regulates serotonin in their brains during winter and summer months, the BBC reports. Serotonin is thought to signal happiness in the brain, and, during the winter, the neurotransmitter that removes serotonin was present at higher levels.

“We believe that we have found the dial the brain turns when it has to adjust serotonin to the changing seasons,” lead researcher Brenda McMahon told the BBC.

The research confirms what other studies have suggested. “SERT fluctuations associated with SAD have been seen in previous studies,” European College of Neuropsychophar­macology professor Siegfried Kasper said. “But this is the first study to follow patients through summer and winter comparisons.”

[BBC]

TIME Research

4 Surprising Things Your Nose Can Tell You About Your Health

Nose
Getty Images

Not being able to smell well could signal the early stages of Alzheimer’s disease

No one appreciates their sense of smell when they pass a trash heap or accidentally step in dog poop. But your nose knows a lot—not just when things stink. In fact, your ability to smell, or not, can tell you a lot about your health. Here’s why you shouldn’t take your whiffing powers for granted.

A bad sense of smell can signal an early death

Feel like your sense of smell has gone south over the years? If it’s less than stellar, it could be a tip-off that you’re not in good health. A new study from the University of Chicago Medical Center found that not being able to detect certain odors had an increased risk of dying within five years. A whopping 39% of older patients who couldn’t pick up on scents like orange, rose, and peppermint died within that time frame, compared to only 19% of so-so smellers, and 10% of good smellers.

HEALTH.COM: How to Live to 100

Poor smell detection may be a sign of Alzheimer’s

Not being able to smell well could signal the early stages of Alzheimer’s disease, according a Harvard Medical School study. Participants with elevated levels of amyloid plaques (telltale proteins found in the brains of Alzheimer’s patients) who performed worse on an odor identification test also had greater brain cell death. Why? When the disease starts to kill brain cells, this often includes cells crucial for your sense of smell.

HEALTH.COM: 25 Signs and Symptoms of Alzheimer’s Disease

Smelling something weird could predict a stroke

Some people pick up on more scents than others, but brief episodes of smelling something completely off-base—like fish when there isn’t any around—may be a sign of stroke or a seizure. The American Academy of Neurology says these “olfactory hallucinations” are usually unpleasant smells, but they can differ from person to person, according to the Mayo Clinic. Contact your doctor right away if your nose seems to be going haywire.

HEALTH.COM: 10 Stroke Symptoms Everyone Should Know

Imagining odors can precede a migraine

While it’s relatively uncommon, people may also hallucinate a smell as part of a pre-migraine aura, according to a review of research done by the Montefiore Headache Center. Again, the scents were mostly unpleasant: the most common were of things burning or decomposing.

HEALTH.COM: 18 Signs You’re Having a Migraine

This article originally appeared on Health.com

TIME Surgery

Paralyzed Man Walks Again After ‘Miracle’ Surgery

Polish doctors used cells from patient's nose to heal spinal injury

A man who was completely paralyzed from the waist down has learned to walk again after Polish doctors transplanted cells from the patient’s nose into the damaged part of his spine. This pioneering research offers hope for treatment to millions of people around the world with spinal cord injuries.

The patient, 38-year-old firefighter Darek Fidyka from Poland, was left with a completely severed spinal cord after being stabbed four years ago. His doctors had given him a less than 1% chance of recovery but thanks to revolutionary surgery carried out in 2012 Fidyka is now able to walk again with a frame. “It’s an incredible feeling, difficult to describe,” he recounts in a BBC documentary to be aired Tuesday “When it starts coming back, you feel as if you start living your life again, as if you are reborn.” Fidyka has been able to resume an independent life and is even able to drive a car.

The procedure was carried out by Polish surgeons in collaboration with British researchers at University College London. Professor Geoffrey Raisman, who led the U.K. research team, called the breakthrough “historic” and said what had been achieved was “more impressive than man walking on the moon.”

[BBC]

MONEY Health Care

How to Save Lots of Money on the Health Tests You Need

Legs on scale at doctor's office
Scott M. Lacey

Catching medical problems early is good for your health—and your wallet. But don't go overboard. Learn to weigh the pros and cons of what the doctor orders.

The latest big push in health care is keeping you from getting sick in the first place. Insurers are sending you reminders to schedule regular exams. Employers are rewarding workers who quit smoking or lose weight. And a key provision in the Affordable Care Act, a.k.a. Obamacare, is full coverage for certain preventive care—with no out-of-pocket costs for you.

Getting a handful of basic tests ­every year can reap rich rewards. “So many diseases, such as hypertension and diabetes, are symptomless in the early stages, when they can be easily caught and controlled,” says Dr. Nieca Goldberg, director of the NYU Women’s Heart Center. So see your primary-care doctor annually once you reach your forties (until then, every two or three years is usually sufficient).

Even though fully covered tests are getting more common, for many ­others you will face co-pays or co-­insurance—and shoulder the full cost until you reach your deductible. To keep those costs to a minimum, we recommend two strategies.

First, look for ways to save on every test you take. Prices can vary widely for the same service, even when you stick with in-network doctors and facilities.

Start by checking your health insurer’s website—many list doctors that insurers believe offer quality care at fair prices. Keep in mind that MRIs, CT scans, and other imaging tests often cost much less at free­standing radiology centers. ­(Just be sure the facility is accredited by the American College of Radiology and that your doc will accept the results.) And when your doctor orders a blood test, ask about all your options, including outside the office. “Labs are so standardized, a $10 lipid panel will get the same results and same quality as a $200 lipid panel,” says Scott Matthews of Castlight Health, which helps big businesses manage their health care costs.

Second, learn which screenings are worth your health care dollars and which you can skip. Here’s what you need to know:

6 Essential Tests for Everyone

1) Skin exam

With skin cancer on the rise, it’s smart to have a dermatologist examine the skin over your entire body, looking for suspicious growths, moles, and lesions.

When to get it: At least once a year. “If you have risk factors, such as being fair, having a lot of moles, or having a family history of skin cancer, you may need to be seen as often as every three to six months,” says Dr. David Leffell, chief of dermatologic surgery at the Yale School of Medicine. You could go to your ­primary-care doctor, but dermatologists are better at diagnosing potentially cancerous lesions, studies show.

Cost: $50 to $150. Insurance covers the visit after you meet your deductible; your usual co-pay or co-insurance will apply.

2) Cholesterol check

This blood test, a.k.a. a lipid panel or profile, reports your total cholesterol, your LDL (“bad”) cholesterol, your HDL (“good”) cholesterol, and a type of fat in the blood called triglycerides. High levels of all but the good stuff raise your risk of heart disease and stroke.

When to get it: Men over 45 and women over 50 should be checked every one to three years, says Goldberg. (Until menopause, women have the protective benefits of estrogen.) At younger ages, test every four to six years. Among the reasons for more frequent screenings: Your results aren’t normal, there’s a family history of heart disease, or you have risk factors like being overweight, you smoke, or you have high blood pressure.

Cost: $110 to $305 for test alone. Cholesterol testing is often included in an annual physical, which insurance covers in full.

3) Blood-pressure check

High blood pressure raises your risk of heart disease, stroke, kidney failure, and other serious conditions.

When to get it: Every two years as part of a routine physical; once a year or more if your pressure is above 120/80.

Cost: $70 to $200 for a doctor’s visit, but insurance pays the full tab for your annual preventive checkups

4) Eye exam

Even if you think your vision is 20/20, have your eyes examined regularly—­especially after 40. As you age, you’re at risk for conditions such as glaucoma, which is symptomless. “An exam can also find signs of another disease that may be affecting your eyes, such as diabetes or high blood pressure,” says Dr. Rebecca Taylor, an ophthalmologist in Nashville and a spokesperson for the American Academy of Ophthalmology.

When to get it: Before age 40, Taylor suggests getting a full exam with an optometrist or ophthalmologist every five to 10 years (yearly if you wear glasses or contacts). After that, make it every two years. Reasons to get more frequent exams include a family history of eye disease, previous eye injuries or surgery, diabetes or high blood pressure, or you are over 65.

Cost: $75 to $200 with an ophthalmologist; $50 to $150 with an optometrist. Insurance coverage varies.

5) A1C blood test

This has become the screening test of choice for diabetes, as it measures your average blood glucose over roughly three months; the fasting blood glucose test tells doctors just what your level is at that moment.

When to get it: The standard recommendation is every three years starting at 45. The American Diabetes Association advises beginning earlier if you’re overweight and have certain risk factors, including high blood pressure.

Cost: $40 to $260 for test. If you have high blood pressure, insurance covers in full.

6) Colonoscopy

This exam is your best defense against colon cancer. While there are other screening tools, a colonoscopy is considered the gold standard: “It doesn’t just diagnose; if the doctor sees adenomas [potentially precancerous polyps], he can remove them then and there,” says Dr. Seth Gross, director of endoscopy at Tisch Hospital at NYU Langone Medical Center.

When to get it: Start at age 50, earlier if you’ve got other risk factors, such as a family history or if you have suspicious symptoms. If the test is negative, get one every 10 years.

Cost: $1,100 to $2,800. Insurance pays every 10 years for adults ages 50 to 75.

4 Essential Tests for Women

Insurance will cover the basic pelvic and breast exams that are part of your annual visit to a gynecologist. Other tests aren’t needed as often—and your insurance coverage will probably reflect that.

1) Pap smear

A Pap smear, also called a Pap test, is when your gynecologist collects cells from your cervix to screen for precancerous changes. Thanks to this test, the cervical cancer death rate declined by almost 70% between 1955 and 1992, according to the American Cancer Society (ACS).

When to get it: Every three years, provided your last test was normal; most women can stop at age 65.

Cost: $75 to $350. Insurance pays in full every three years from ages 21 to 65.

2) Mammogram

There’s been controversy in recent years about when to begin breast cancer screening and how often to do it, but the American Cancer Society and American College of Obstetricians and Gynecologists still recommend getting your first mammogram, an X-ray of your breasts, at 40— earlier if you have risk factors like a family history. Ask your doctor about 3-D mammography, now available at some major medical centers: It reduces false positives and slightly bumps up detection rates, according to a recent JAMA study.

When to get it: Once a year starting at age 40.

Cost: $150 to $375. Screening is covered every one to two years at age 40-plus. Most plans don’t cover more precise 3-D mammograms, so you may owe $40 to $60.

3) DEXA scan for bone density

An X-ray test to measure bone density, this screening is recommended for all women at age 65. But you may want to get one around menopause, when declining estrogen levels increase your risk of osteoporosis.

When to get it: Start at age 65, then consult doctor. With risk factors like smoking and osteoporosis in family, begin at menopause.

Cost: $60 to $385. Insurance pays in full when 65-plus; with preapproval, it often pays for younger postmenopausal women too.

4) HPV (Human – papilloma- virus) test

Typically done at the same time as a Pap, this checks for strains of HPV that are most likely to cause cervical cancer. Before age 30, nearly all sexually active people contract HPV at some point, according to the Centers for Disease Control. Most of the time, HPV is harmless and clears up on its own. But since HPV infection is less common in women over 30, a positive test result is more apt to signal a potential problem.

When to get it: Women ages 30 to 65 should get an HPV test paired with a Pap smear every five years.

Cost: $30 to $125. Insurance pays in full every five years from 30 to 65.

6 Tests You May Need

1) Vitamin D test

Vitamin D helps you absorb calcium and maintain strong bones. Since up to 75% of Americans have low levels (a 2009 study suggests), ask your doctor about adding this to your physical, advises Dr. Marianne Legato, professor emeritus of clinical medicine at Columbia University Medical Center.

Cost: $25 to $150; some, but not all, insurers cover

2) Thyroid-stimulating hormone test

Experts disagree about whether routine thyroid screening is necessary, but make sure to get your blood level of TSH checked if you have fatigue and unexplained weight gain.

Cost: $15 to $115; often covered. Deductible and co-pay or co-insurance apply.

3) Cholesterol particle tests

People whose particles of LDL cholesterol are mostly small and dense have a threefold greater risk of coronary heart disease. Ask your doctor about this test if your cholesterol is borderline, especially if you’re debating whether to go on cholesterol-lowering medications, Goldberg says.

Cost: $15 to $265; not usually covered for routine screening but may be covered in part if you have risk factors.

4) Coronary calcium scan

A CT scan of your heart is used to look for specks of calcium in your arteries that may indicate early signs of coronary artery disease. While this scan is not recommended for everyone, it can be useful if you’ve got a family history or other risk factors. “A score greater than 300 tells us that you’re at increased risk of cardiovascular events in the next five to 10 years,” Goldberg says.

Another heart exam—an exercise stress test—isn’t a useful screening tool if you’re low risk, she adds, due to a high rate of false positives. As a rule, it’s best reserved for people who have risk factors or symptoms such as chest pain or an irregular heartbeat.

Cost: $10 to $300; not usually covered for routine screening, but may be covered in part if you have risk factors.

5) CRP (C-reactive protein) test

This measures blood levels of CRP, an inflammatory protein associated with heart disease. It’s most predictive in men over 50 and women over 60, Goldberg says. In a 2010 study, people in these age groups who were at intermediate risk of heart disease and who had normal cholesterol but high CRP levels benefited from going on cholesterol-lowering medications.

Cost: $10 to $115; not usually covered for healthy patients but often covered in part if you have risk factors.

6) Prostate exam

Screening for prostate cancer used to be a must. Now it’s a maybe. “Intuitively, it makes sense to treat prostate cancers early,” says Dr. Richard Wender, chief cancer control officer at the American Cancer Society. “But some grow so slowly that they’d probably never be life-threatening, and the treatment would be worse for quality of life than the disease itself.” That said, a study published in The New England Journal of Medicine this past March found that men under age 65 who underwent surgery for early-stage prostate cancer (instead of watchful waiting) had better survival rates.

Bottom line: At 50, talk to your doctor about your risks (like a family history). If you decide to undergo a PSA (prostate-specific antigen) blood test and it’s under 2.5 ng/mL, you can wait at least another two years to retest. If it’s over that, test annually.

Cost: $25 to $125 and may be covered by insurance for men older than 50, or starting at age 40 if you face certain risk factors.

 

 

 

TIME health

I Covered the Early Days of AIDS and I’m Sad To Say Racist Media Hysteria Hasn’t Changed Much

Transmission Electron Micrograph (TEM) of the Ebola virus
Murphy /CDC—Getty Images/Photo Researchers RM

Ebola-mania has a really familiar sound to me. And I don’t mean that as a compliment

xojane

This story originally appeared on xoJane.com.

Wanna know how to clear out a room in five minutes these days?

Stand in the middle of that room, making sure that you get as close to as many people as possible, and yell the following:

I HAVE EBOLA!

If you want the room cleared in less than five, cough. Or pour some water over your head to simulate sweat before entering. You may cause a stampede, but you’ll get your empty room.

Now I admit that the scenario I’ve just proposed is really irresponsible, kind of mean, a little bit childish and plays on the paranoia that naturally occurs in these situations.

But so is running stories insinuating that you can get Ebola from weave hair. I saw that on CNN. Wish I were kidding.

Look, I’ll be honest. I have a lot of respect for Ebola for the same reason why I have a lot of respect for firearms: I respect anything that can kill me. Although we’ll have more flu deaths in the United States this year than we will Ebola deaths, when touching someone’s sweaty arm can kill you, you have to take it seriously.

I also understand the fear of the unknown it engenders. Roughly 90 percent of the people who have it or have died from it are from places most Americans can’t find on a map. Eight people have been treated for it here and of those eight, only two of them — nurses Nina Pham and Amber Vinson — contracted it here. There’s only been one American death, Thomas Duncan, and he contracted it before leaving his home in Liberia.

But while I understand fear, I have no tolerance for fear mongering and the ignorance that seems to accompany it. It gives people an excuse to make scapegoats of a population that already has enough problems dealing with (a) the less than generous people who say they rule their countries and (b) the resource gouging multinational corporations that actually do.

And fear mongering has become the rule of the day when it comes to Ebola. Between the CNN hair weave story, the college in Texas that sent letters to West African students denying them admission due to the disease, and the conspiracy theorists who have crawled out of the woodwork, getting any credible information about the disease has become next to impossible.

Kind of like it was in the early days of the HIV/AIDS crisis.

I got my start as a reporter covering HIV/AIDS for the Philadelphia Tribune, the nation’s oldest continuously publishing Black newspaper. For a while, it seemed like everyone I interviewed died, which led to a lot of assignments that ended with my sitting in my car with my head in my hands.

When you cover something like that you remember how it made you feel. So finding the parallels between Ebola and HIV weren’t hard to spot for me.

Like Ebola, HIV/AIDS was hitting the Black community like a sledgehammer.

Like Ebola, you had people who believed that (a) it was manmade, (b) it was a conspiracy to get rid of politically unpopular groups and (c) the Centers for Disease Control was lying about how it was transmitted.

And like Ebola, the community most impacted by it was greeted more with fear than with compassion.

For example, some believe that Ebola is President Barack Obama’s way of getting back at White people for slavery. Just ask radio host Rush Limbaugh…

“The danger we have now is that we elected people in positions of power and authority who think this or think like this in terms of this country being responsible, this country being to blame for things and it’s that kind of thinking that leads to opposition to shutting down airports from various countries,” Limbaugh said.

Not to be outdone, the Black community, which views all fatal diseases through the prism of the Tuskegee Experiment, in which scientists watched as a group of men slowly died of syphilis as they charted the disease’s progress, has its own conspiracy theorists, like, for example, singer Chris Brown.

“I don’t know…But I think that this Ebola epidemic is a form of population control,” Brown said via Twitter. “S—t is getting crazy, bruh…”

I wish that I could say that this was the worst of it, but I’d be lying.

So let me end by saying this.

You can only get Ebola from coming in contact with the bodily fluids of someone infected, or an infected animal. It is not an airborne disease, so you can’t get it from someone breathing in your general area — which means that closing the borders won’t help.

Hopefully, we’ll remember this for the next medical crisis.

Denise Clay is a journalist living in Philadelphia.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME ebola

The Psychology Behind Our Collective Ebola Freak-Out

Airlines and the CDC Oppose Ebola Flight Bans
A protester stands outside the White House asking President Barack Obama to ban flights in effort to stop Ebola on Oct. 17, 2014 in Washington, DC. Olivier Douliery—dpa/Corbis

The almost-zero probability of acquiring Ebola in the U.S. often doesn’t register at a time of mass fear. It’s human nature

In Hazlehurst, Miss., parents pulled their children out of middle school last week after learning that the principal had recently visited southern Africa.

At Syracuse University, a Pulitzer Prize–winning photojournalist who had planned to speak about public health crises was banned from campus after working in Liberia.

An office building in Brecksville, Ohio, closed where almost 1,000 people work over fears that an employee had been exposed to Ebola.

A high school in Oregon canceled a visit from nine students from Africa — even though none of them hailed from countries containing the deadly disease.

All over the U.S., fear of contracting Ebola has prompted a collective, nationwide freak-out. Schools have emptied; businesses have temporarily shuttered; Americans who have merely traveled to Africa are being blackballed.

As the federal government works to contain the deadly disease’s spread under a newly appointed “Ebola czar,” and as others remain quarantined, the actual number of confirmed cases in the U.S. can still be counted on one hand: three. And they’ve all centered on the case of Thomas Eric Duncan, who died Oct. 8 in a Dallas hospital after traveling to Liberia; two nurses who treated him are the only other CDC-confirmed cases in the U.S.

The almost-zero probability of acquiring something like Ebola, given the virus’s very real and terrifying symptoms, often doesn’t register at a time of mass paranoia. Rationality disappears; irrational inclinations take over. It’s human nature, and we’ve been acting this way basically since we found out there were mysterious things out there that could kill us.

“There are documented cases of people misunderstanding and fearing infectious diseases going back through history,” says Andrew Noymer, an associate professor of public health at the University of California at Irvine. “Stigmatization is an old game.”

While there was widespread stigma surrounding diseases like the Black Death in Europe in the 1300s (which killed tens of millions) and more recently tuberculosis in the U.S. (patients’ family members often couldn’t get life-insurance policies, for example), our current overreaction seems more akin to collective responses in the last half of the 20th century to two other diseases: polio and HIV/AIDS.

Concern over polio in the 1950s led to widespread bans on children swimming in lakes and pools after it was discovered that they could catch the virus in the water. Thirty years later, the scare over HIV and AIDS led to many refusing to even get near those believed to have the disease. (Think of the hostile reaction from fellow players over Magic Johnson deciding to play in the 1992 NBA All-Star Game.)

Like the first cases of polio and HIV/AIDS, Ebola is something novel in the U.S. It is uncommon, unknown, its foreign origins alone often leading to fearful reactions. The fatality rate for those who do contract it is incredibly high, and the often gruesome symptoms — including bleeding from the eyes and possible bleeding from the ears, nose and rectum — provoke incredibly strong and often instinctual responses in attempts to avoid it or contain it.

“It hits all the risk-perception hot buttons,” says University of Oregon psychology professor Paul Slovic.

Humans essentially respond to risk in two ways: either through gut feeling or longer gestating, more reflective decisionmaking based on information and analysis. Before the era of Big Data, or data at all, we had to use our gut. Does that look like it’s going to kill us? Then stay away. Is that person ill? Well, probably best to avoid them.

“We didn’t have science and analysis to guide us,” Slovic says. “We just went with our gut feelings, and we survived.”

But even though we know today that things like the flu will likely kill tens of thousands of people this year, or that heart disease is the leading cause of death in the U.S. every year, we’re more likely to spend time worrying about the infinitesimal chances that we’re going to contract a disease that has only affected a handful of people, thanks in part to its frightening outcomes.

“When the consequences are perceived as dreadful, probability goes out the window,” Slovic says. “Our feelings aren’t moderated by the fact that it’s unlikely.”

Slovic compares it to the threat from terrorism, something that is also unlikely to kill us yet its consequences lead to massive amounts of government resources and calls for continued vigilance from the American people.

“Statistics are human beings with the tears dried off,” he says. “We often tend to react much less to the big picture.”

And that overreaction is often counterproductive. Gene Beresin, a Harvard Medical School psychiatry professor, says that fear is causing unnecessary reactions, oftentimes by parents and school officials, and a social rejection of those who in no way could have caught Ebola.

“It’s totally ridiculous to close these schools,” Beresin says. “It’s very difficult to catch. People need to step back, calm down and look at the actual facts, because we do have the capacity to use our rationality to prevent hysterical reactions.”

Read next: Nigeria Is Ebola-Free: Here’s What They Did Right

TIME health

Why So Many Women Are Crying at the Gym

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Yoga mudra Stefano Oppo—Getty Images

For a generation of stressed-out working women, exercise is as much about emotional release as it is physical training.

“Let it out! Let out the sludge!”

It’s 7am on a Tuesday, at a small dance studio in Manhattan’s Tribeca neighborhood, and Taryn Toomey is stomping her feet into the floor like thunder. “Get rid of the bullsh*t!” she shouts. “Get rid of the drama!”

Two dozen women in yoga pants and sports bras sprint in place behind her, eyes closed, arms flailing. Sweat is flying. The Beastie Boys’ “Sabotage” is blaring in the background. There are grunts and screams. “Hell yes!” a woman bellows.

When the song ends, Toomey directs the group into child’s pose, torso folded over the knees, forehead on the floor, arms spread forward. Coldplay comes on, and there is a moment of rest. “Inhale. Exhale. Feel your center,” Toomey says. Heads slowly come up, and suddenly, tears are streaming down the faces of half the room. A woman in front of me is physically trembling. “I just let it all out,” a middle-aged woman in leggings and a tank top whispers.

This is “The Class”—one part yoga, two parts bootcamp, three parts emotional release, packaged into an almost spiritual… no, tribal… 75 minutes. It is the creation of fashion exec turned yoga instructor Toomey, and it is where New York’s high-flying women go for emotional release (if, that is, they can get a spot).

“During my first class I didn’t just cry, I sobbed,” says McKenzie Hayes, a 22-year-old New Yorker who has become a regular in the class. “Whether it’s your job or your relationships, I literally picture my emotional problems being slowly unstuck from my body and moved out.”

Toomey calls that “sludge”: it’s the emotional baggage we carry in our muscles that has nowhere else to go. She’s not a doctor. But week after week, she encourages participants to sweat, scream and cry out those emotions, in the company of a group of mostly women who are doing the same. “I’ve had classes where people are literally on all fours sobbing,” Toomey says. “But it’s not just my class, it’s happening everywhere. Emotional release in public can feel very uncomfortable. But I think there’s a growing movement of people who want to find a space for it.”

Indeed, the message to women has long been to hide your tears lest you look weak. (Among the tactics: jutting out your jaw. Breathing exercises. Chewing gum. Drinking water.) Yet while crying in the office may remain a feminine faux pas, tears at the gym seem to have lost their stigma — to the extent that there are a bevy of fitness courses that even encourage it.

For Asie Mohtarez, a Brooklyn makeup artist, it began in hot yoga. The music was on, the floor was warm, the instructor was standing over her encouraging her to let go. “I was in child’s pose and I just lost it,” she says. Then, two weeks later, it happened again – this time at Physique 57. The Dirty Dancing soundtrack came on and it was waterworks again. “There’s something about these classes that feel safe,” says the 33-year-old. “I can’t cry at work. I’m not emotionally distraught enough to cry in the shower. I can’t just burst into tears in front of my husband. So, what does that leave you with?”

You could go to therapy – or you could hit the gym. Women are getting teary in SoulCycle, and misty-eyed at Pure Barre. They are letting out wails in yoga and rubbing the shoulder of the weepy woman next to them at CrossFit. “I think people have started to notice that their clients are just showing up to class and just unloading, and so they’re tailoring their classes to create space for this,” says Hayes, who is a pilates instructor by day. “When I take private clients I end up feeling like a therapist for them.”

These fitness instructors aren’t trained in that, of course. But they’ve probably been there.

“I usually just go over to the student after class and quietly ask how they’re feeling,” says Kristin Esposito, a yoga instructor in Los Angeles who sees criers often. “My classes are focused on release so it feels pretty natural.”

Physiologically, it is: Exercise releases endorphins, which interact with serotonin and dopamine, the chemicals that impact mood. In yoga, deep hip openers – like the “pigeon pose” – are meant to stir emotions (yogis believe our emotional baggage lives in our hips).

But many of the newer courses are specifically choreographed to release emotion, too – making it all that much more intense. The lights are dim, candles flicker in the background. It’s not an accident that just as you’re starting to relax, coming down from the adrenaline, you’re blasted with a throaty ballad. Those playlists are meticulously constructed. “I’ve been teaching for almost 20 years, so I’ve basically seen it all: crying, laughing, throwing up, overheating,” says Stacey Griffith, a Soul Cycle instructor. “There are moments in the class that are directly programmed for that reason – but it’s not like we’re trying to get people to cry. We’re giving them the space to step outside of themselves.”

And indeed, that may be necessary. We’re busier, more stressed and more connected than we’ve ever been. Simply finding the time to have that “space” can be near impossible, making the release that these courses offer – packaged neatly into an hour – a kind of fix. “The night before, I can’t wait,” says Hayes of Toomey’s class. “I already know what will be the flood that I’m working through. And sometimes conversations with friends just don’t cut it.”

Getting those emotions out is a good thing – at least in moderation. Emotional tears contain manganese, potassium, and a hormone called prolactin, which help lower cholesterol, control high blood and boost the immune system. Crying reduces stress, and, according to one study, from the University of Minnesota, actually improves the mood of nearly 90 percent of people who do it. “You really do feel lighter after,” says Hayes.

“To me, it’s a sign of being present, it’s a sign of feeling your feelings, of being in the moment,” says Toomey, just after “the class” has ended. Plus, shoulder to shoulder in a hot room, there is almost a sense of communal release. Of high-charged emotional camaraderie. “I so needed this,” a woman tells her on the way out, with a hug. And, of course, with that much sweat, the tears are almost hidden anyway.

Read next: I Taught Fitness and Failed a Fat Test

TIME health

What Does It Mean for an Ebola Outbreak to End?

West Africa Ebola
A Nigerian port health official speaks to a passenger at the arrivals hall of Murtala Muhammed International Airport in Lagos, Nigeria, Aug. 6, 2014. Sunday Alamba—AP

And how does the World Health Organization decide when that happens?

Nigeria’s most recent outbreak of Ebola is over, the nation’s government and World Health Organization (WHO) announced on Monday.

But — with fear of Ebola continuing to grip the world — what does that even mean? How does the WHO know that Nigeria is in the clear?

The answer, it turns out, is very specific: The WHO says a country can declare their outbreak to be over when it makes it through 42 days without a new case. That’s two incubation periods for the Ebola virus, so as long as 42 days have passed, during which the country had in place active surveillance and diagnostics but discovered no new cases, the WHO says it’s enough time to confidently say an outbreak is over. For health care workers to be considered “in the clear” they have to be monitored for 21 days after their last possible exposure to the virus, even if they were wearing full protective gear. Health care workers’ date of last contact is considered the day when the final patient with Ebola tests negative for the disease.

“Recent studies conducted in West Africa have demonstrated that 95% of confirmed cases have an incubation period in the range of 1 to 21 days; 98% have an incubation period that falls within the 1 to 42 day interval,” said WHO in a statement. “WHO is therefore confident that detection of no new cases, with active surveillance in place, throughout this 42-day period means that an Ebola outbreak is indeed over.”

MORE: Nigeria is Ebola-free: Here’s What They Did Right

This is not the first time WHO has declared Ebola outbreaks over using this particular standard — Senegal was declared Ebola-free on Oct. 17, and the strategy has proven effective in prior, unrelated, outbreaks.

In 1995, there was an Ebola outbreak in the country then called Zaire (today’s Democratic Republic of the Congo); it was declared clear on Aug. 25 of that year. The New York Times reported at the time:

The World Health Organization declared today that an outbreak in Zaire of the deadly Ebola virus was officially over after killing 244 of its 315 known victims.

The United Nations agency, which is based here, said that 42 days, the equivalent of two maximum incubation periods, had passed without any new cases reported. It said it was still not known where the Ebola virus existed between human epidemics, although samples from some 3,000 birds and mammals collected in the Kikwit area, the center of the outbreak, were now being analyzed.

It’s important to have definitive parameters for declaring outbreaks over because, as the current and former outbreaks have shown, oftentimes an outbreak will appear to be extinguished, only to reappear in full force a couple weeks later. This past April, Guinea’s health ministry thought the outbreak was slowing, which turned out to be false; in the 1995 outbreak, public health experts were also fooled. As TIME reported:

For a while last week it looked as though the outbreak might soon be brought under control. The plague police-medical teams dispatched by who in Geneva, the Centers for Disease Control and Prevention (CDC) in Atlanta and other public health groups-had set up an effective isolation ward at the main hospital in Kikwit, where the first case had been identified. Belgium’s Doctors Without Borders (Medecins Sans Frontieres, or MSF) rushed in loads of gloves, gowns, masks and other essential equipment to restore hygiene to filthy clinics. But when the strike forces, aided by local medical students, fanned out through the countryside around Kikwit, trying to follow the path of the fever, it became clear that the danger was far from past.

In an announcement made Monday morning, WHO called Nigeria a “spectacular success story,” citing proof that Ebola can be contained. “The story of how Nigeria ended what many believed to be potentially the most explosive Ebola outbreak imaginable is worth telling in detail,” WHO says in a statement.

To read more about how Nigeria contained their most recent outbreak of Ebola, check out our coverage, here.

TIME Diet/Nutrition

6 Strange But True Health Tips

Plate, kinfe and fork made up of food
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Grabbing a 100-calorie snack pack of cookies or pretzels may seem virtuous, but it's more likely to make you hungrier than if you ate something more substantial

Many methods to improve your health are pretty straightforward: to lose weight, eat less and exercise more; to boost your energy, get more sleep; to prevent dehydration, drink more water. Others, however, are totally counterintuitive. The following tips really do work—but they may leave you scratching your head.

Drink coffee to have a better nap

In a Japanese study that examined how to make the most of a nap, people who took a “coffee nap”—consuming about 200 milligrams of caffeine (the amount in one to two cups of coffee) and then immediately taking a 20-minute rest—felt more alert and performed better on computer tests than those who only took a nap.

HEALTH.COM: 12 Surprising Sources of Caffeine

Why does this work? A 20-minute nap ends just as the caffeine kicks in and clears the brain of a molecule called adenosine, maximizing alertness. “Adenosine is a byproduct of wakefulness and activity,” says Allen Towfigh, MD, medical director of New York Neurology & Sleep Medicine. “As adenosine levels increase, we become more fatigued. Napping clears out the adenosine and, when combined with caffeine, an adenosine-blocker, further reduces its effects and amplifies the effects of the nap.”

For healthy teeth, don’t brush after eating

Don’t brush your teeth immediately after meals and drinks, especially if they were acidic. Acidic foods—citrus fruits, sports drinks, tomatoes, soda (both diet and regular)—can soften tooth enamel “like wet sandstone,” says Howard R. Gamble, immediate past president of the Academy of General Dentistry. Brushing your teeth at this stage can speed up acid’s effect on your enamel and erode the layer underneath. Gamble suggests waiting 30 to 60 minutes before brushing.

HEALTH.COM: 20 Things That Can Ruin Your Smile

To wear a smaller size, gain weight

Muscle weight, that is. If two women both weigh 150 pounds and only one lifts weights, the lifter will more likely fit into a smaller pant size than her sedentary counterpart. Likewise, a 150-pound woman who lifts weights could very well wear the same size as a 140-pound woman who doesn’t exercise. The reason: Although a pound of fat weighs the same as a pound of muscle, muscle takes up less space, says Mark Nutting, fitness director of SACO Sport & Fitness in Saco, Maine. “You can get bigger muscles and get smaller overall if you lose the fat,” he says. “The bulk so many women fear only occurs if you don’t lose fat and develop muscle on top of it.” Cut back on calories and add weight to your workout to lose inches.

To eat less, eat more

Grabbing a 100-calorie snack pack of cookies or pretzels may seem virtuous, but it’s more likely to make you hungrier than if you ate something more substantial, says Amy Goodson, RD, dietitian for Texas Health Ben Hogan Sports Medicine. “Eating small amounts of carbohydrates does nothing but spike your blood sugar and leave you wanting more carbs.” Goodson recommends choosing a protein such as peanut butter or string cheese with an apple. “They are higher in calories per serving, but the protein and fat helps you get full faster and stay full longer—and you end up eating fewer calories overall,” she says.

HEALTH.COM: 17 High-Protein Snacks That Speed Up Weight Loss

Skip energy drinks when you’re tired

Energy drinks contain up to five times more caffeine than coffee, but the boost they provide is fleeting and comes with unpleasant side effects like nervousness, irritability, and rapid heartbeat, says Goodson. Plus, energy drinks often contain high levels of taurine, a central nervous system stimulant, and upwards of 50 grams of sugar per can (that’s 13 teaspoons worth!). The sweet stuff spikes blood sugar temporarily, only to crash soon after, leaving you sluggish and foggyheaded—and reaching for another energy drink.

HEALTH.COM: 14 Reasons You’re Tired All the Time

Drink a hot beverage to cool off

Which will cool you off faster on a steamy summer morning: iced coffee or hot? Two recent studies say the latter—and so do others where drinking hot tea in hot weather is the norm, like in India. When you sip a hot beverage, your body senses the change in temperature and increases your sweat production. Then, as the sweat evaporates from your skin, you cool off naturally.

This article originally appeared on Health.com

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