James' World 2

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While plenty of health conditions make you painfully aware of their presence via any number of impossible-to-ignore symptoms, high blood pressure (a.k.a. hypertension) can be a sneakier beast. You can literally walk around all day, every day, without a clue that your blood pressure numbers are higher than they should be—many people don’t have physical symptoms that they can feel. Although people who have high blood pressure (which is nearly half of adults in the US) might not have any discomfort from it most of the time, it’s really serious. High blood pressure significantly ups your risk of heart attack and stroke, makes you more likely to develop kidney disease, and can even mess with your sex drive.

​Rampant as high blood pressure is, getting it under control can be a tricky business. Kathryn Harris, MD, a cardiology fellow and the fellows representative for the Association of Black Cardiologists, tells SELF that more than half of people treated for high BP don’t have it under control, meaning that it stays high despite treatment like medication. While the ideal reading is less than 120/80 mmHg (the top number is your systolic pressure and the bottom number is your diastolic pressure), BP that lingers above 140/90 mmHg typically requires both medication and lifestyle changes to rein it in, according to the American Heart Association (AHA).

If you’re one of the many people struggling to keep the beast of high blood pressure on a leash, let us make one thing crystal clear: Significantly lowering blood pressure is tough—and often requires taking medication (in many cases, more than one) and making some pretty serious changes to your lifestyle. It’s complicated stuff, and can take some trial and error.

Finding the right balance of medications and switching up your behaviors around food, exercise, and other key parts of the way you live your life can feel challenging for even those who can afford any prescriptions they need, shop at the health food store, and try out the latest fitness studio in town. And yet, many of the people with the greatest risk of high BP and its downstream effects live with limited access to heart-healthy food or medication that’s within their budgets, Estelle Darlyse Jean, MD, a board-certified non-invasive cardiologist with MedStar Heart & Vascular Institute, tells SELF.

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COVID-19 is becoming more like the flu and, as such, no longer requires its own virus-specific health rules, the Centers for Disease Control and Prevention said Friday alongside the release of a unified “respiratory virus guide.”

In a lengthy background document, the agency laid out its rationale for consolidating COVID-19 guidance into general guidance for respiratory viruses—including influenza, RSV, adenoviruses, rhinoviruses, enteroviruses, and others, though specifically not measles. The agency also noted the guidance does not apply to health care settings and outbreak scenarios.

“COVID-19 remains an important public health threat, but it is no longer the emergency that it once was, and its health impacts increasingly resemble those of other respiratory viral illnesses, including influenza and RSV,” the agency wrote.

The most notable change in the new guidance is the previously reported decision to no longer recommend a minimum five-day isolation period for those infected with the pandemic coronavirus, SARS-CoV-2. Instead, the new isolation guidance is based on symptoms, which matches long-standing isolation guidance for other respiratory viruses, including influenza.

“The updated Respiratory Virus Guidance recommends people with respiratory virus symptoms that are not better explained by another cause stay home and away from others until at least 24 hours after both resolution of fever AND overall symptom are getting better,” the document states. “This recommendation addresses the period of greatest infectiousness and highest viral load for most people, which is typically in the first few days of illness and when symptoms, including fever, are worst.”

“Residual risk”

The CDC acknowledged that the eased isolation guidance will create “residual risk of SARS-CoV-2 transmission,” and that most people are no longer infectious only after 8 to 10 days. As such, the agency urged people to follow additional interventions—including masking, testing, distancing, hygiene, and improving air quality—for five additional days after their isolation period.

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A view of the Centers for Disease Control and Prevention headquarters in Atlanta.

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Sociopaths are modern-day boogeymen, and the word “sociopath” is casually tossed around to describe the worst, most amoral among us. But they are not boogeymen; they are real people and, according to Patric Gagne, widely misunderstood. Gagne wrote “Sociopath,” her buzzy forthcoming memoir, to try to correct some of those misunderstandings and provide a fuller picture of sociopathy, which is now more frequently referred to as antisocial personality disorder. As a child, Gagne found herself compelled toward violent outbursts in an effort to try to compensate for the emotional apathy that was her default. As she got older, those compulsive behaviors turned into criminal ones like trespassing and theft. Eventually, she discovered that there was a name — that dreaded word — that could be used to describe and explain her experiences of remorselessness, criminality, and lack of empathy. The desire to destigmatize her experience and also to help others who may share it (Gagne previously worked as a therapist to those with the disorder and has also written about sociopathy) put Gagne on a path that led to “Sociopath.” “I’m not trying to say, ‘Sometimes we do bad things, but we’re really sweet on the inside,’” says Gagne, who is 48. “I’m saying there is more to this personality type.”

When I hear the word “sociopath,” I think of an antisocial, uncaring person who is interested only in satisfying his or her own desires. What’s a clearer picture? Sociopathy is a perilous mental disorder; the traits associated with sociopathy aren’t great. But that only tells part of the story. The part that’s missing is you can be a sociopath and have a healthy relationship. You can be a sociopath and be educated. That’s a very uncomfortable reality for some people. People want to believe that all sociopaths are monsters and that all monsters are easy to spot. 

In the book, you write about stabbing a classmate with a pencil when you were a kid, and then as you got older, trespassing  and stealing cars. You don’t succumb to those sociopathic compulsions anymore. How did you learn to control these urges? As a kid, I didn’t understand why I was acting out the way that I was. All I knew was I felt this pressure, and something in my brain was telling me, Punch that kid, and you’ll feel better. As I got older I understood, OK, there’s a name for this, there is a whole group of people who share this diagnosis. Once I understood that I wasn’t out in space untethered and going crazy, I was on the path to understanding that when I had those feelings of “go steal a car,” I could go, Yes, I could do that, but now I understand what’s going on. That understanding helped break the cycle — or at least redirect the compulsion toward something less destructive.

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By David Marchese Photo Illustration by Bráulio Amado

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