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Dr. Jones: A good marriage makes people healthier. We know that. An abusive marriage is bad for your health, but what if you have good days and bad days and so-so days in your marriage? This is Dr. Kirtly Jones from the Department of Obstetrics and Gynecology at University of Utah Health Care, and we're talking about marriage and your health on The Scope.

Announcer: Covering all aspects of women's health, this is the Seven Domains of Women's Health with Dr. Kirtly Jones on The Scope.

Dr. Jones: Marriage is a good thing for committed couples, right? Well, whatever your feelings about the institution of marriage, there is substantial research about what's called "the marriage benefit." Now this isn't a tax benefit. This is a psychological and health benefit. People, particularly men, are healthier when they're married, and they live longer. The marriage benefit in terms of longevity is somewhat less powerful for women, but it's still there. Now, these studies are pretty easy to do. You look up birth and death records and find out how long people lived, delete the people who died too early to get married, and find out whether the person being studied was married or not, and that's how you do the longevity part.

But there is research that gives some insight into the marriage benefit. A person in an MRI who is holding the hand of a beloved, trusted spouse has their brain and their blood pressure calm down, and holding the hand of a beloved, trusted spouse works as well for pain as moderate painkillers. But what if the spouse isn't beloved or trusted, or maybe just not today?.

The behavioral research group at BYU made national news in the New York Times by their study titled, are you ready? "It's Complicated: Marital Ambivalence on Ambulatory Blood Pressure and Daily Interpersonal Functioning." This study wasn't about marriages that go from loving to abusive, but more about the feeling that your partner is unpredictable in levels of support or negativity. They studied 94 heterosexual couples in our own Salt Lake City with questionnaires about how regularly they felt supported and championed by their spouse and how reliably they supported and championed their spouse..

These folks were heroic research participants. They wore a blood pressure monitor throughout the day, had their blood pressures measured twice an hour for a day, and they had to take a brief questionnaire minutes after their blood pressure was taken to find out what they were doing and how they were interacting with their spouse. These were couples who either didn't have kids or whose kids had left the home, probably because it only takes one cranky teenager to upset the blood pressure applecart. The couples had been married for an average of 5 years from 1 to 41 years..

Twenty-three percent of the couples were in supportive marriages with low levels of negativity. Seventy-seven percent gave mixed responses. That's good and bad news. Good because mixed is normal, bad because the people in a marriage that had levels of negativity, that snarky comment you directed at your spouse, had higher levels of blood pressure readings than those who were supportive..

We don't know if that means these couples will die sooner or get sicker or get divorced, but it does mean that unpredictable or ambivalent support from your spouse isn't good for you. All of us who have been on the receiving end of that snarky comment from a friend, spouse, or loved one know that it doesn't feel good. By the way, the Oxford Dictionary defines "snarky" as "of a person, words, or mood which is sharply critical, cutting or snide." So this study adds to the research about supportive relationships. The University of Utah found that being in a marriage with a cold and controlling argument was as predictive of poor heart health as smoking or having high cholesterol..

Another study found that wounds healed more slowly in a person in a relationship that has hostile arguments compared to couples who solve their problems more equitably. So what do you do? There's an old nursery rhyme, "Sticks and stones may break my bones, but words will never hurt me." Well, that may work on the playground as a comeback, but it isn't really true. Being occasionally snarky and unsupportive to your partner is common, but it's a choice and it can become a habit..

Try this little three-card exercise. You and your partner fill in the blank on the following sentences, one on each card. One: I feel loved and supported when you (blank); two: I feel hurt and sad when you do (blank); three: I wish you would do (blank). Exchange the cards. Have a conversation. It takes a healthy relationship to do this exercise, but it can be the beginning of a dialog about both of you and how to be kinder and more supportive in your relationship..

If it's too threatening to do this little exercise, then your relationship may need someone to help you work through this. Your home should be a safe place, but even more, it should be an emotional shelter from life's storms, and giving or receiving snarky comments in the kitchen isn't good for the receiver or the giver. We should work on being kinder. Thank you for joining us on The Scope.

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Announcer: Questions every woman wonders about her health, body, and mind. This is "Am I Normal?" on The Scope.

Interviewer: Am I Normal? Today we're talking with Dr. Kirtly Jones, the expert on all things woman. Dr. Jones, what exactly is normal?

Dr. Jones: That's a great question. There is normal in terms of your lab values perhaps, and then there's normal in terms of your body statistics. So, we you use the word normal for many, many things, but in science we really mean where about 90% of people lie in terms of their values or in terms of what they look like. So, normal is a statistical term.

Interviewer: Okay.

Dr. Jones: It also is an emotional and cultural term, so let's talk about body types, or height is a really good example. We certainly value height in our culture and people who are taller have more great jobs. In fact, most of our presidents for the last 30 or 40 years have been very tall. Women's heights also have a normal range. Women's heights may be, and I'm pulling it out of the air right now, it may be 5' 2" to 5" 10".

Interviewer: That's normal?

Dr. Jones: That's normal. So, women who are 5' 3" may consider themselves short, and women who are 5' 9.5" may consider themselves tall, but both of those women are normal.

Interviewer: Does family genetics go into this, because if my mom has always been short, and her mom has been short, and her mom has been short, chances are I'm going to be short, too. So, is that normal?

Dr. Jones: That's normal. When you have someone who is short and is shorter than normal, so you have a young person who's maybe 5' at their growth spurt and they are not looking like they're going to get much taller, the question is does this person have a growth hormone deficiency or are they malnourished, or do you look at their family and find that they're genetically all short.
And we figured that you have reached your maximum height and you're 4' 11", we would want to make sure that it wasn't just your family. And that's often what we call a rule out. You want to rule out thyroid disease. You may want to rule out malnutrition. You may want to rule out growth hormone problems before we say, gosh, your mom's short, your dad's short, everybody's short in your family; you've just got short genes.

Interviewer: And that's normal.

Dr. Jones: And that's normal for you.

Interviewer: Gotcha.

Dr. Jones: Normal for you.

Interviewer: And in emotions, is there anything mentally that people might think is normal?

Dr. Jones: Now you very graciously introduced me as all things women.

Interviewer: All things women.

Dr. Jones: All things women, and having spent about 35, almost 40 years now talking to women, women will say, "Gosh, I just think seem to tear up at everything. I cry at movies, I cry at McDonald's commercials. Is this normal?"

Interviewer: Sensitive.

Dr. Jones: And I'd say, do you have any other symptoms of depression? "No, I'm pretty happy." Are you anxious? "No, I'm fine." Then I would say you're sensitive. In which case I don't say you're overly emotional, but I think there are people who are sentimental and are brought to tears easily over things that are sentimental. And that's not abnormal.

Interviewer: I've always been kind of curious; why is that always associated with women?

Dr. Jones: Culturally, it's more difficult for men to express their tears, even as little boys. When boys fall down we discourage them from showing themselves emotionally; be a man, don't cry, you know, stuff it up, you can take it.
There are some very good reasons for women to feel and show their emotions, and that has to do with raising children. So, the places that children get their emotional intelligence is by looking at their mother's face, so it's important for mothers to be emotionally available to their children. All of us should be a little bit anxious about things, especially when we are responsible for families and children. However, when people are anxious all the time and they wake up at 3:00 in the morning, anxious every night about small things, or they're anxious about things, which are very unrealistic as to whether these are going to happen, then I think that kind of anxiety is no longer normal and needs to be investigated.

Interviewer: Okay.

Dr. Jones: So, when women have questions about their sentimental, tearful nature. They have questions about their anxiety. Some women have questions about whether being depressed is normal, and this is where there are some very, very well reproduced questionnaires, depression inventories, that good clinicians can use to determine whether someone's sadness is beyond normal.
And the last is people, often women, often feel more irritable or more anxious or more depressed before their periods. This is so common as to be considered normal. So, PMS, premenstrual syndrome, is so common as to be considered normal. But PMDD, which is premenstrual dysphoric disorder, is not so common. It may be only seen in only 2% or 3% of the population. It's where the degree of dysfunction before the period emotionally is so big that people consider suicide, they can't go to work. It's disrupting their family very substantially; it's disrupting their other relationships. So, PMDD, premenstrual dysphoric disorder, is several orders of magnitude greater than PMS, which is normal.

Interviewer: Any final thoughts?

Dr. Jones: Yes, of course there are final thoughts. Of course there are final thoughts. So, normal is something, once again we all want to be above average.

Interviewer: Yeah, I want to be above average.

Dr. Jones: Except in our weight. We don't want to be above average in our weight.

Interviewer: True.

Dr. Jones: I think all people would like to be special, but they don't want to be that special.

Interviewer: They don't want to stand out.

Dr. Jones: They don't want to stand out, and certainly not in physical ways. Often, people, when we consider bodies, they've seen only their body naked, and what's on the Internet isn't necessarily normal. So, if they've only seen their body naked and maybe a couple other women in the locker room, then their assessment of what is normal isn't as broad as a clinician's. So, your clinician's experience, educational background, and continuing education help them form the scientific basis of normal. So, if you're worried, ask your doctor and they'll know a little bit more about what is really normal.

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