Blog

Ah summer! The time we slather on the sun tan lotion and spend hours in the hot sun. But as this redhead knows, tanning is a problem. Years from now, your skin will thank if you are cautious and exercise care.

Worried about that pale look? Consider Taylor Swift and Nicole Kidman–two beauties who do not drink the tanning Kool-Aid! Can we just thank them now for making pale skin chic?

I know. We like being in the sun. But melanoma is the most serious form of skin cancer and can kill you. According to the Mayo Clinic, exposure to ultraviolet (UV) radiation from sunlight or tanning lamps and beds increases your risk of developing melanoma. Melanoma is increasing in females age group (15-29) more so than males thanks to the pressure from media to have that summer glow. And indoor tanning increases the risk of melanoma by 75%.

For some people, an obsession with tanning can be dangerous. Ever heard of “tanorexic?” I treat anorexics, but this is different. A “tanorexic” is a person who ignores the health risks (skin cancers such as malignant melanoma). They may need intervention to stop because of habitual tanning. Tanorexia is not a DSM 5 (the diagnostic manual for psychiatry disorders) diagnosis but does act like a behavioral addiction. According to psychiatry professor, Dr. Bryon Adinoff at The University of Texas Southwestern Medical Center, tanning can be as addictive as drugs and alcohol.

So, I went to a tanning salon, sat in the lobby and watched people come and go for about 15 minutes. I know that was a little weird, but I wanted to see who goes to tanning places. And I wanted to know why.

Most of the customers I saw were teenage girls, but there was a steady stream of older women who came in for their regular appointments. The older women had very wrinkled skin, so I didn’t understand why they would want to add more damage to their already damaged skin? I had to ask. One lady said it made her feel good, another liked the look of the tan because she felt beautiful, another says she’s addicted. I think I found a few tanorexics!

In his study, Dr. Adinoff discovered that the ultraviolet radiation that we constantly try to block when we put on sunscreens, not only damages skin, but also turns on a reward switch in the brain like a cigarette does for a smoker and alcohol does for the alcoholic.

Dr. Adinoff divided tanners into two groups. One group tanned but the ultraviolet radiation was blocked. After the tanning session, this group was asked if they wanted to keep tanning. They indicated YES. They had the desire to continue. The other group was exposed to the ultraviolet radiation. The reward centers in their brains lit up like addicts. When asked if they wanted to continue to tan, they said NO because they had their fix. Like the smoker who takes a hit of nicotine to satisfy the craving, the ultraviolet radiation exposed group had had enough for the moment.

The thinking here is that indoor tanning can stimulate reward centers in the brain, making it difficult for people to stop. The UV light may be the rewarding property that prompts tanners to keep going even when it is unhealthy, and they are at risk.

Despite all the warnings about the harmful rays one is exposed to in tanning beds, people (around 30 million a year) continue to indoor tan. How many of those are addicted? We don’t know but don’t be surprised if you see a Tanning Anonymous group at some point.

For those of you spending hours in the sun looking for that tanning glow, slather up to protect your skin. Use at least 30 SPF or higher to protect your skin. Reapply every 2 to 3 hours. Remind yourself that someone dies from melanoma every hour of the day. Now, that should give you pause and be willing to use the protection. Then, get you to the dermatologist for a skin check. I do them every 6 months. Early detection makes a difference.

The good news is that tanning addiction or tanorexia can be treated but the damage to your skin caused by UV radiation is irreversible.

Have you ever met someone who is totally convinced that what they believe is true despite the lack of evidence? The person has what is called a delusion. For example, I had a patient who really believed bugs were crawling in her skin. There was no evidence of this being true but she heartily believed it. She had what is called a fixed delusion. A delusion is something you believe but is not true. It is a false belief.

A person with a delusion might believe the government is watching our every move, or that their neighbor wants to steal something from him. Sometimes people believe someone is in love with them when they are not. A person may think she has an extraordinary talent when there is no evidence of this (Think music audition shows!). No matter the type of delusion, something can happen and the person misinterpret that event to reinforce their belief. Then, they hold that belief with conviction.

The question is, how do you help someone with a delusionf? Here are a few guidelines:

Establish a trusting relationship. You won’t be able to talk the person out of a delusion. So focus first on developing a strong  and trusting relationship with the person. Then consider this: Delusions can be reflections of real fears or trauma. The false belief may be protective or adaptive related to deeper issues. Sometimes delusions can be a sane reaction to insane circumstances.

Listen for the content. Then try to understand the purpose behind such a belief. What is the feeling or tone of the delusion? Again, don’t try to convince the person the delusion isn’t real. It won’t work, but you won’t make it worse by talking about it. And you can try and understand what is important in that delusion. Why does the person need it and how does it protect the person? Is it functioning like an emergency response system for the person?

Determine if the delusion is interfering with the person’s life. How frequent is the delusion? Does it lead to fear or paranoia? If the delusion is harmful to the person, that is more of a problem. Consider if there is anything you can do to lessen the stress around the delusion. For example, if someone believes they are being watched, you might say, “What do you think would make that feel better?” Try to decrease stress around safety as that might help the person’s thinking. Let the person know that it must be difficult to believe what they do and feel safe.

Manage the environment. If the person is concerned about the neighbor being the FBI, suggest they avoid that neighbor for awhile. Or if they think, the government is listening to them through the TV, then suggest they don’t turn the TV on when they feel unsafe. The idea is to manage the environment as much as you can to reduce stress. If the delusion causes any self-harm, the person needs to be hospitalized.

Redirect or distract the person from the delusion. Listen but you don’t have to respond to what they are saying. Instead, try distracting them to other activities or things.

Overall, express your concern fo the person. Tell them how you see things differently and express concern as to how this belief is impacting their life. Maybe suggest talking to a therapist because of the distress involved. Professional help is probably needed. Delusions can be treated even though they might not be cured.