Happiness is influenced by a complex interplay of various chemicals in our brain, particularly four key neurotransmitters, D.O.S.E or Dopamine, Oxytocin, Serotonin, and Endorphins. These chemicals, often referred to as "happiness chemicals," are responsible for creating feelings of joy, motivation, connection, and calm.

However, when there's a deficiency in any of these, it can significantly affect our mood, energy, and overall well-being. Let’s dive into what these four neurotransmitters are, how their deficiency impacts us, and how we can boost their levels naturally.

Dopamine: The Motivation and Reward Chemical

Dopamine is often called the "motivation molecule." It plays a major role in enabling motivation, learning, and the pleasure-reward system in the brain. When we accomplish something — whether it’s finishing a project, completing a workout, or achieving a goal — dopamine gives us that sense of satisfaction and determination to continue.

Deficiency Effects:

When dopamine levels are low, it can lead to procrastination, low self-esteem, lack of focus, and general fatigue. A person might feel anxious, hopeless, or experience mood swings because the brain isn’t getting the reward signals it needs.

Boosting Dopamine:

You can increase dopamine levels by setting and achieving small goals, exercising regularly, eating foods rich in L-Tyrosine (such as almonds, avocados, and eggs), and practicing mindfulness or meditation. Engaging in creative activities like writing or drawing also helps boost dopamine levels.

Oxytocin: The Bonding Chemical

Oxytocin is often referred to as the "love hormone" or "cuddle hormone" because it plays a major role in social bonding and trust. It’s released when we hug, touch, or engage in other forms of physical affection. Oxytocin fosters feelings of connection and emotional intimacy, making it essential for relationships, family bonding, and even team cooperation.

Deficiency Effects:

A lack of oxytocin can lead to feelings of loneliness, stress, anxiety, and difficulties in forming or maintaining relationships. Low oxytocin levels are associated with feelings of isolation and disconnection from others.

Boosting Oxytocin:

You can raise your oxytocin levels through physical touch, socialising, spending quality time with loved ones, and even engaging in activities like massage or listening to soothing music. Acts of kindness, such as helping others or volunteering, also help release oxytocin.

Serotonin: The Mood Stabiliser

Serotonin is responsible for feelings of well-being and contentment. It helps regulate mood, sleep, digestion, and even social behavior. People who have balanced serotonin levels often feel calm, confident, and emotionally stable. Serotonin is crucial in helping people feel valued and significant among their peers.

Deficiency Effects:

Low serotonin levels are linked to depression, low self-esteem, irritability, and mood swings. Individuals may feel overly sensitive to criticism, experience panic attacks, or struggle with social phobias when serotonin is deficient.

Boosting Serotonin:

You can boost serotonin by getting regular exercise, exposing yourself to sunlight, engaging in cold showers or massages, and practicing mindfulness. Simple activities like walking in nature, meditating, or doing yoga are also effective serotonin enhancers.

Endorphins: The Pain Reliever

Endorphins are the body’s natural painkillers. Released in response to stress, pain, or intense physical activity, they help alleviate discomfort and promote a sense of euphoria. Endorphins are what make you feel good after a workout or a hearty laugh, often referred to as the "runner's high."

Deficiency Effects:

Without enough endorphins, people may experience anxiety, depression, chronic pain, and insomnia. A deficiency in endorphins can make daily life feel overwhelming and physically draining.

Boosting Endorphins:

To boost endorphins, engage in laughter, exercise, and stretching activities. Eating spicy foods or dark chocolate can also stimulate endorphin production. Regular massage therapy and meditation are other ways to naturally elevate endorphin levels.

Many couples are battling infertility and are keen on opting for ARTs to conceive and fulfill the dream of parenthood. However, the country continues reeling under severe heatwave conditions. Currently, a large number of couples who are planning fertility treatments are becoming stressed regarding how heatwaves can impact IVF procedures and even the success rates. Patients frequently ask fertility consultants whether extreme outdoor heat can affect the IVF laboratory environment, embryos, sperm samples, or even egg quality. However, there is no need to panic, as labs are designed to function even under highly controlled conditions throughout the year, and it is possible for couples to conceive successfully.

In an interaction with Health and Me, Dr. Aswati Nair, Fertility Specialist, Nova IVF Fertility, Rajouri Garden, Delhi, spoke about how extreme temperatures can affect the IVF process and what the consequent impact is on the outcome.

Read more: Heatwaves And Toxic Air Create A Growing Health Crisis In Delhi

Does a heatwave affect the IVF lab?

Usually, all the IVF labs have Air Handling Units (AHUs), which maintain the internal condition of the lab throughout the year at the same condition and temperature, and all the parameters are maintained throughout the year with the help of this equipment and gadgets. So, the internal environment of the lab does not get affected by an external heatwave. Understand that the temperature-sensitive procedures that are carried out inside the IVF lab, such as handling eggs, sperm, and embryos, are performed in a controlled setting and are monitored constantly. Hence, external heatwaves do not directly impact the IVF lab environment or the development of embryos. But only from the patient's perspective; they need to be hydrated and careful when there is scorching heat outside.

Too much heat can lead to dehydration, weakness, fatigue, dizziness, and stress, which can impact the patient’s health during fertility treatment. Women undergoing IVF cycles are put on hormonal medications, and staying hydrated is necessary for everyone. It is the need of the hour for the patients to take charge of their well-being right away!

Read more: Heatwave In India: Temperatures Continuously Rising; Stay Hydrated, Says PM Modi

Precautions to take

The precautions that patients can take are to stay well-hydrated and adhere to a balanced diet with lots of fruits and seasonal fruits like watermelon and muskmelon, which can improve hydration. They can have coconut and lemon water and avoid beverages, carbonated drinks, caffeine, and alcohol. They can follow these crucial tips to stay healthy during the heatwave. Patients should be sure to follow the guidelines given by the fertility consultant.

Even if the heatwaves can lead to discomfort, it doesn’t affect the functioning of modern IVF laboratories. By paying attention to various factors such as hydration, nutrition, and self-care, patients can safely continue their fertility journey even if there is extreme heat outside.

Mrs. Radha Sharma, 78, was brought to the hospital with sudden confusion, irritability, and restlessness. She had no fever, no pain, and no typical urinary complaints. Her family worried it could be dementia or a brain-related issue. However, a simple urine test revealed the real cause— a urinary tract infection (UTI). With timely treatment, fluids, and care, she recovered within a few days. This is a common but often overlooked reality—UTIs in older adults don’t always look like UTIs.

In another case, 72-year-old Mr. Pankaj Verma had repeated UTIs over a year. Each time, antibiotics provided temporary relief, but the infection kept returning. On further testing, doctors found an enlarged prostate that was preventing his bladder from emptying fully. Once this was treated, his infections reduced significantly.

These examples show an important pattern: in the elderly, UTIs are often missed, misunderstood, or keep recurring because the root cause is not addressed.

Why Are UTIs So Common In Older Adults?

As we age, the body goes through changes that make infections like UTIs more likely. In women, menopause leads to a drop in estrogen levels. This weakens the natural lining of the urinary tract, making it easier for bacteria to grow. Women also have a shorter urinary passage, so that bacteria can reach the bladder more easily.

In men, an enlarged prostate is a common issue. It can block the flow of urine, causing some urine to remain in the bladder. This leftover urine becomes a breeding ground for bacteria. Other common reasons include weaker immunity, conditions like diabetes, urinary incontinence, use of catheters, reduced movement, and dependence on caregivers for hygiene.

Symptoms Are Not Always clear

Unlike younger people, elderly individuals may not complain of burning urine or urgency. Instead, the signs can be subtle and confusing, such as:

• Sudden confusion or unusual behavior
• Increased falls
• Weakness or tiredness
• Loss of appetite

These symptoms are often mistaken for ageing or dementia, which can delay treatment.

Men vs Women: What’s the Difference?

UTIs are more common in older women due to hormonal changes and bladder control issues. Many women also experience repeat infections. In men, UTIs are less common but usually more serious. They are often linked to problems like prostate enlargement or urinary blockage, which need proper evaluation. Chronic illnesses play a big role. Diabetes, for example, increases the risk because excess sugar in urine helps bacteria grow. Poor sugar control also weakens the body’s ability to fight infections.

Conditions that affect bladder control, such as stroke or Parkinson’s disease, can also lead to incomplete emptying of the bladder, increasing infection risk.

Diagnosis Needs Careful Attention

Not every bacterium found in urine needs treatment. Many older adults have bacteria in their urine without symptoms—a condition called asymptomatic bacteriuria. Treating this unnecessarily can lead to antibiotic resistance. Doctors usually rely on urine tests, cultures, symptoms, and medical history before deciding on treatment.

Treatment: More Than Just Antibiotics

While antibiotics are important, they are only one part of the solution. Repeated courses without finding the cause often lead to recurring infections.

Treatment should also focus on:

• Drinking enough fluids
• Managing diabetes or other health conditions
• Treating prostate problems in men
• Avoiding unnecessary catheter use
• Reviewing medications that may affect bladder function

Early treatment is crucial. Ignoring symptoms can allow the infection to spread to the kidneys, which can be serious. Recurrent UTIs are common in the elderly. This can happen due to:

• Incomplete treatment
• Underlying problems like prostate enlargement
• Ongoing issues, such as incontinence or catheter use
• Antibiotic resistance

Prevention: Simple But Effective Steps

Preventing UTIs doesn’t always require complex measures. Small daily habits can make a big difference:

• Encourage regular water intake
• Avoid holding urine for long periods
• Maintain proper personal hygiene
• Manage conditions like diabetes well
• Limit catheter use
• Consider probiotics or cranberry products (after medical advice).

Caregivers play a key role in ensuring these habits are followed, especially for elderly individuals who need assistance. Immediate medical attention is needed if there is:

• Fever or chills
• Sudden confusion
• Blood in urine
• Lower back pain

UTIs in the elderly are common but often not straightforward. They may present differently, recur frequently, and require more than just antibiotics. The key is early recognition, identifying the underlying cause, and taking simple preventive steps. With the right care, recurrent UTIs can be reduced—helping older adults live healthier, more comfortable lives.

(By Dr. Sunita Goyal, Senior Consultant – Obstetrician and Gynecologist, Cloudnine Group of Hospitals, Ludhiana)

Systematic Lupus Erythematosus (SLE), also known as Lupus, is a multisystem autoimmune disease in which one's immune system attacks the body. It is most common in women of reproductive age; however, in rare cases, it can present in men and patients of any age.

Lupus Symptoms: More Than Just Joint Pain

Symptoms for SLE can range from unexplained fever for days to months, to oral ulcers, malar rash, photosensitivity (after exposure to sun), hair loss, headache, stroke, seizure, abnormal behavior (psychiatry lupus). A large group of patients experiences joint swelling, pain, and fatigue. If the kidneys are affected in Lupus patients, they can pass blood with their urine.

Their urine output also decreases; their legs swell, and there is swelling around the eyes. Involvement of the heart, brain, and pancreas is also not uncommon. Lupus is one of the causes of multiple unexplained pregnancy losses, especially in the second trimester, but with proper treatment and observation, many patients do well and have an uneventful pregnancy and childbirth.

Common Myths About Lupus

Some very prominent myths about SLE need to be debunked. Many think SLE is contagious and that only women can get it, when in reality, neither is true. Being an autoimmune disease means it cannot spread by contact, and it impacts both men and women, although the incidence rate of SLE is higher for women. Many also believe in the common misconception that it affects only joints, when in reality it is a multisystem disease that can affect the kidneys, heart, brain, skin, and lungs.

There is a common myth that pregnancy is impossible or unsafe for women with Lupus; however, many women with Lupus can conceive and experience safe and healthy full-term pregnancies under the right medical guidance. Kidney biopsy, which is a required test for treating Lupus, is often deemed unsafe, but it is a safe test and is required to decide the stage of the disease and treatment.

Lupus: Warning Signs

Some symptoms that can be a cause of alarm in SLE are rapid rising serum creatinine, new onset seizure or psychosis, sudden onset shortness of breath associated with chest pain, blood in cough with low oxygen saturation, acute confusional state with fever, vision changes, severe abdominal pain, unexplained severe anemia, severe thrombocytopenia (platelet count < 20,000).

Managing Lupus

For accurate diagnosis and treatment, one needs a rheumatologist's consultation. Rheumatologists will decide the plan of treatment to manage symptoms, reduce inflammation, prevent flares of the disease, and minimize organ damage. Lifestyle measures like avoiding Sun exposure, quitting smoking, lowering stress, and engaging in some low-impact physical activities help patients to minimize the disease burden.

There is very little awareness about Lupus in society, and due to varied presentations and symptoms, patients often consult with multiple doctors of different specialties before consulting with rheumatologists. We need to push for more awareness in society about less talked-about ailments like Lupus, which needs efficient intervention and management, as it is a lifelong condition. Talking about it also helps reduce stigma and bust myths around it. Late diagnosis and delay in treatment can cause significant morbidity, disease progression, and mortality. With early diagnosis and optimal treatment.

Holistic care is possible, which goes a long way in helping individuals manage autoimmune conditions like Lupus

(By Dr Niharika Gill, Rheumatologist, Lilavati Hospital and Research Center, Mumbai)