Mind

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5 reasons art therapy is great for your mental health as you age

<p><span style="background: white;">We know how important it is to look after our<strong> </strong></span><a style="color: blue;" href="https://www.betterhealth.vic.gov.au/health/servicesandsupport/healthy-and-active-ageing"><strong><span style="color: black; background: white; text-decoration-line: none;">physical health</span></strong></a><span style="background: white;"> as we age, but our mental health is equally important. </span><a style="color: blue;" href="https://aifs.gov.au/resources/short-articles/normalising-mental-illness-older-adults-barrier-care"><strong><span style="color: black; background: white; text-decoration-line: none;">Studies have shown</span></strong></a><strong><span style="background: white;"> </span></strong><span style="background: white;">that besides the immediate impact on wellbeing, older people with untreated mental ill health are at risk of poorer overall health, increased hospital admissions, and an earlier transition into aged care.</span></p> <p><span style="background: white;">Art therapy is an excellent way to boost our mental wellbeing. In a nutshell, this type of therapy is when visual art, such as drawing, sculpting, or collage, is used in a<strong> </strong></span><a style="color: blue;" href="https://www.rtor.org/2018/07/10/benefits-of-art-therapy/"><strong><span style="color: black; background: white; text-decoration-line: none;">therapeutic context</span></strong></a><span style="background: white;">. And don’t be put off if you haven’t picked up a paintbrush since you were a kid. Art therapy is not about creating works of beauty but about the process. It’s a completely </span><a style="color: blue;" href="https://cata.org.au/faqs-myth-busters/#:~:text=The%20focus%20of%20Creative%20Art,%2C%20growth%20and%20self%2Dawareness.&amp;text=Reality%3A%20Creative%20Art%20Therapy%20does,to%20affect%20change%20and%20growth."><strong><span style="color: black; background: white; text-decoration-line: none;">judgement free zone</span></strong></a><strong><span style="background: white;">!</span></strong></p> <p><strong><span style="background: white;">Emotional release:</span></strong></p> <p><span style="background: white;">Growing up, many of us were never taught that it was okay to express how we’re feeling, especially emotions like anger and sadness. In that way, art therapy can be ideal us older folks who often feel stuck when it comes to expressing ourselves. Art therapy provides the opportunity to express our<strong> </strong></span><a style="color: blue;" href="https://creativityintherapy.com/2017/06/expressing-emotions-creativity-6-step-art-process/"><strong><span style="color: black; background: white; text-decoration-line: none;">inner experiences</span></strong></a><strong><span style="background: white;"> </span></strong><span style="background: white;">in a visual way. Through the act of creation, we can release pent-up feelings, reduce stress, and experience emotional release.</span></p> <p><span style="background: white;">Another challenging emotion that art therapy can help with is grief. As we age, we are more likely to experience the<strong> </strong></span><a style="color: blue;" href="https://www.nari.net.au/the-impact-of-prolonged-grief-in-older-people"><strong><span style="color: black; background: white; text-decoration-line: none;">loss of a loved one</span></strong></a><strong><span style="background: white;"> </span></strong><span style="background: white;">and we don’t get ‘used to it’. The hole it leaves in our hearts is just as dark. Through<strong> </strong></span><a style="color: blue;" href="https://www.vivianpaans.com.au/blog/healing-through-art-how-art-therapy-can-help-with-grief-and-wellbeing"><strong><span style="color: black; background: white; text-decoration-line: none;">creating art</span></strong></a><strong><span style="background: white;"> </span></strong><span style="background: white;">we can explore the feelings of grief and sadness in a safe, judgement-free space. It can also foster a sense of self-compassion and when we have more compassion for ourselves, it becomes easier to accept our emotions.</span></p> <p><strong><span style="background: white;">Stress relief:</span></strong></p> <p><a style="color: blue;" href="https://www.sane.org/information-and-resources/facts-and-guides/facts-mental-health-issues"><strong><span style="color: black; background: white; text-decoration-line: none;">Anxiety, depression, and past traumas</span></strong></a><strong><span style="background: white;"> </span></strong><span style="background: white;">can heavily impact on our daily lives. Risk factors over our lifespans may change but they don’t magically disappear once we hit a certain age. Illness, grief, financial stress, social isolation, and life transitions such as menopause can all be </span><a style="color: blue;" href="https://www.healthdirect.gov.au/older-people-and-mental-health"><strong><span style="color: black; background: white; text-decoration-line: none;">contributing factors</span></strong></a><strong><span style="background: white;"> </span></strong><span style="background: white;">of poor mental health for older adults. Creating art can ease symptoms as we refocus on what we’re creating and move thoughts away from overthinking and worry.<strong> </strong>Creating art releases </span><a style="color: blue;" href="https://www.rtor.org/2018/07/10/benefits-of-art-therapy/"><strong><span style="color: black; background: white; text-decoration-line: none;">dopamine</span></strong><span style="color: black; background: white; text-decoration-line: none;">,</span></a><span style="background: white;"> the chemical responsible for allowing us to feel pleasure and satisfaction. This further reduces bothersome symptoms of anxiety and depression.</span></p> <p><span style="background: white;">Also, participating in art therapy leads to a more creative brain. A creative brain is better equipped to create stress-relieving techniques for other areas of our lives. Through creating art, we draw the fears that are inside our minds. This takes them out of our heads and places them away from us, helping us feel more in control.</span></p> <p><span style="background: white;">Recovering from<strong> </strong></span><a style="color: blue;" href="https://www.interrelate.org.au/news-media/blogs/november-2021/how-art-can-heal-trauma"><strong><span style="color: black; background: white; text-decoration-line: none;">trauma</span></strong></a><strong><span style="background: white;"> c</span></strong><span style="background: white;">an be a lifelong process for many, and it’s important for someone dealing with it to find tools that will help this process. Art therapy can be one of those as it can give a sense of agency and self-understanding through the ability to express feelings symbolically. This can give </span><a style="color: blue;" href="https://anzacata.org/About-CAT"><strong><span style="color: black; background: white; text-decoration-line: none;">new perspectives</span></strong></a><strong><span style="background: white;"> </span></strong><span style="background: white;">of ourselves and our worldview which is essential in the recovery process. It can also help connect with deeply stored emotions and help process them.</span></p> <p><strong><span style="background: white;">Self-discovery:</span></strong></p> <p><span style="background: white;">When we are younger we are often so busy working, socialising, and raising a family many of us never get a chance to take the time out for<strong> </strong></span><a style="color: blue;" href="https://www.visionpsychology.com/starting-the-process-of-self-discovery/"><strong><span style="color: black; background: white; text-decoration-line: none;">self-discovery</span></strong></a><span style="background: white;">. Self-discovery is important in our lives as it gives us a clearer sense of purpose and direction in life. In turn, this leads to making better decisions that lead to our overall happiness.</span></p> <p><span style="background: white;">Some of us see our kids leave home and suddenly we’re left wondering, who am I when I don’t have a family to care for? Creating art can help us acknowledge and recognise feelings that have been suppressed in our subconscious. Through learning to use different techniques of art our minds open up to thinking more freely. Self-discovery comes from both the finished product we create as well as the process of making it.</span></p> <p><strong><span style="background: white;">Self-esteem:</span></strong></p> <p><span style="background: white;">As we age, it’s easy to look in the mirror and struggle to recognise the person we see. Our bodies are changing, and it can often feel like society doesn’t value us as much as when we were young. It can be a major shift in the way we view ourselves and lead to poor self-esteem. Art therapy teaches us how to use a variety of media to create something new. We can develop talents and see strengths as we master new materials and see the completion of projects. This sense of accomplishment can be a big leg up to our<strong> </strong></span><a style="color: blue;" href="https://artbusinessnews.com/2022/01/benefits-of-art-therapy/"><strong><span style="color: black; background: white; text-decoration-line: none;">self-esteem.</span></strong></a></p> <p><strong><span style="background: white;">A sense of community:</span></strong></p> <p><a style="color: blue;" href="https://likefamily.com.au/blog/what-is-loneliness-and-how-does-it-affect-someone/"><strong><span style="color: black; background: white; text-decoration-line: none;">Loneliness</span></strong></a><strong><span style="background: white;"> </span></strong><span style="background: white;">is a big contributor to poor mental health.<strong> </strong></span><a style="color: blue;" href="https://www.psychiatrist.com/news/study-why-older-people-feel-so-lonely/"><strong><span style="color: black; background: white; text-decoration-line: none;">Studies</span></strong></a><strong><span style="background: white;"> </span></strong><span style="background: white;">show two groups of people are most at risk: young adults and older people. With factors at our age such as children leaving home, not working as much or at all, living alone, and chronic illness, it’s easy to see how loneliness can creep into our lives. Group art therapy is a wonderful way to connect with others. We share a space with those who have similar interests, and it gives us a sense of belonging. For those who can't make a session in person due to distance or illness, some therapists offer </span><a style="color: blue;" href="https://www.artandplaytherapytraining.com.au/art_therapy"><strong><span style="color: black; background: white; text-decoration-line: none;">online group art therapy</span></strong></a><strong><span style="background: white;">.</span></strong></p> <p><span style="background: white;">You don’t need to see an art therapist to get the mental health benefits of creating art. But the advantage of that is they have the skills to work out what best suits your needs. They’ll also work with you through any tough emotions that may arise from your art therapy.</span></p> <p><span style="background: white;">So maybe it’s time to hide those new coloured pencils from the little ones, crack them open, and enjoy them yourself!</span></p> <p><span style="background: white;">If you’d like to find out more about art therapy sessions, the links below are helpful. They offer online, in person and group sessions.</span></p> <p><a style="color: blue;" href="https://www.zevaarttherapy.com/" target="_blank" rel="noopener"><span style="background: white; text-decoration-line: none;">https://www.zevaarttherapy.com/</span></a></p> <p><a style="color: blue;" href="https://www.alliedarttherapy.com.au/" target="_blank" rel="noopener"><span style="background: white; text-decoration-line: none;">https://www.alliedarttherapy.com.au/</span></a></p> <p><a style="color: blue;" href="https://www.solacecreativetherapies.com.au/" target="_blank" rel="noopener"><span style="background: white; text-decoration-line: none;">https://www.solacecreativetherapies.com.au/</span></a><span style="background: white;"> </span></p> <p><a style="color: blue;" href="https://cata.org.au/programs-ndis/online-creative-art-therapy/" target="_blank" rel="noopener"><span style="background: white; text-decoration-line: none;">https://cata.org.au/programs-ndis/online-creative-art-therapy/</span></a><span style="background: white;"> </span></p> <p><span style="background: white;">And for some more ideas on dabbling in art therapy on your own (or with a friend), check out Shelley Klammer’s amazing resources. She is US-based but has some online workshops that are also amazing:</span></p> <p><a style="color: blue;" href="https://www.expressiveartworkshops.com/expressive-art-resources/100-art-therapy-exercises/" target="_blank" rel="noopener"><span style="background: white; text-decoration-line: none;">https://www.expressiveartworkshops.com/expressive-art-resources/100-art-therapy-exercises/</span></a></p> <p><em>Article written by Kylie Carberry</em></p> <p><em>Image: Shutterstock</em></p>

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Kick up your heels – ballroom dancing offers benefits to the aging brain and could help stave off dementia

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/helena-blumen-1231899">Helena Blumen</a>, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</a></em></p> <h2>The big idea</h2> <p>Social ballroom dancing can improve cognitive functions and reduce brain atrophy in older adults who are at increased risk for Alzheimer’s disease and other forms of dementia. That’s the key finding of my team’s <a href="https://doi.org/10.1123/japa.2022-0176">recently published study</a> in the Journal of Aging and Physical Activity.</p> <p>In our study, we enrolled 25 adults over 65 years of age in either six months of twice-weekly ballroom dancing classes or six months of twice-weekly treadmill walking classes. None of them were engaged in formal dancing or other exercise programs.</p> <p>The overall goal was to see how each experience affected cognitive function and brain health.</p> <p>While none of the study volunteers had a dementia diagnosis, all performed a bit lower than expected on at least one of our dementia screening tests. We found that older adults that completed six months of social dancing and those that completed six months of treadmill walking improved their executive functioning – an umbrella term for planning, reasoning and processing tasks that require attention.</p> <p>Dancing, however, generated significantly greater improvements than treadmill walking on one measure of executive function and on processing speed, which is the time it takes to respond to or process information. Compared with walking, dancing was also associated with reduced brain atrophy in the hippocampus – a brain region that is key to memory functioning and is particularly affected by Alzheimer’s disease. Researchers also know that this part of our brain can undergo neurogenesis – or grow new neurons – <a href="https://doi.org/10.1073/pnas.0611721104">in response to aerobic exercise</a>.</p> <figure><iframe src="https://www.youtube.com/embed/unmbhUvnGow?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Research shows those who regularly dance with a partner have a more positive outlook on life.</span></figcaption></figure> <p>While several previous studies suggest that dancing has beneficial effects <a href="https://doi.org/10.1093/ageing/afaa270">on cognitive function in older adults</a>, only a few studies have compared it directly with traditional exercises. Our study is the first to observe both better cognitive function and improved brain health following dancing than walking in older adults at risk for dementia. We think that social dancing may be more beneficial than walking because it is physically, socially and cognitively demanding – and therefore strengthens a wide network of brain regions.</p> <p>While dancing, you’re not only using brain regions that are important for physical movement. You’re also relying on brain regions that are important for interacting and adapting to the movements of your dancing partner, as well as those necessary for learning new dance steps or remembering those you’ve learned already.</p> <h2>Why it matters</h2> <p>Nearly 6 million older adults in the U.S. and 55 million worldwide <a href="https://doi.org/10.1016/j.jalz.2019.01.010">have Alzheimer’s disease</a> or a <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">related dementia</a>, yet there is no cure. Sadly, the efficacy and ethics surrounding recently developed drug treatments <a href="https://doi.org/10.1080/21507740.2022.2129858">are still under debate</a>.</p> <p>The good news is that older adults can potentially <a href="https://doi.org/10.1016/S0140-6736(20)30367-6">lower their risk for dementia</a> through lifestyle interventions, even later in life. These include reducing social isolation and physical inactivity.</p> <p>Social ballroom dancing targets both isolation and inactivity. In these later stages of the COVID-19 pandemic, a better understanding of the <a href="https://doi.org/10.1177/23337214211005223">indirect effects of COVID-19</a> – particularly those that increase dementia risk, such as social isolation – is urgently needed. In my view, early intervention is critical to prevent dementia from becoming the next pandemic. Social dancing could be a particularly timely way to overcome the adverse cognitive and brain effects associated with isolation and fewer social interactions during the pandemic.</p> <h2>What still isn’t known</h2> <p>Traditional aerobic exercise interventions such as treadmill-walking or running have been shown to lead to modest but reliable improvements in cognition – <a href="https://doi.org/10.1177/1745691617707316">particularly in executive function</a>.</p> <p>My team’s study builds on that research and provides preliminary evidence that not all exercise is equal when it comes to brain health. Yet our sample size was quite small, and larger studies are needed to confirm these initial findings. Additional studies are also needed to determine the optimal length, frequency and intensity of dancing classes that may result in positive changes.</p> <p>Lifestyle interventions like social ballroom dancing are a promising, noninvasive and cost-effective path toward staving off dementia as we – eventually – leave the COVID-19 pandemic behind.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/194969/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/helena-blumen-1231899">Helena Blumen</a>, Associate Professor of Medicine and Neurology, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/kick-up-your-heels-ballroom-dancing-offers-benefits-to-the-aging-brain-and-could-help-stave-off-dementia-194969">original article</a>.</em></p> </div>

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Are young people smarter than older adults? My research shows cognitive differences between generations are diminishing

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/stephen-badham-1531316">Stephen Badham</a>, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent University</a></em></p> <p>We often assume young people are smarter, or at least quicker, than older people. For example, we’ve all heard that scientists, and even more so mathematicians, <a href="https://www.forbes.com/sites/nextavenue/2014/08/07/who-says-scientists-peak-by-age-50/">carry out their most important work</a> when they’re comparatively young.</p> <p>But my new research, <a href="https://www.sciencedirect.com/science/article/pii/S027322972400008X#:%7E:text=Highlights&amp;text=Three%20review%20studies%20measure%20secular,%2C%20education%2C%20and%20overall%20health.">published in Developmental Review</a>, suggests that cognitive differences between the old and young are tapering off over time. This is hugely important as stereotypes about the intelligence of people in their sixties or older may be holding them back – in the workplace and beyond.</p> <p>Cognitive ageing is often measured by comparing young adults, aged 18-30, to older adults, aged 65 and over. There are a variety of tasks that older adults do not perform well on compared to young adults, such as memory, spatial ability and speed of processing, which often form the basis of <a href="https://theconversation.com/the-iq-test-wars-why-screening-for-intelligence-is-still-so-controversial-81428">IQ tests</a>. That said, there are a few tasks that older people do better at than younger people, such as reading comprehension and vocabulary.</p> <p>Declines in cognition are driven by a process called <a href="https://www.nature.com/collections/cbjacdabdf">cognitive ageing</a>, which happens to everyone. Surprisingly, age-related cognitive deficits start very early in adulthood, and declines in cognition have been measured as dropping in adults as young as just 25.</p> <p>Often, it is only when people reach older age that these effects add up to a noticeable amount. Common complaints consist of walking into a room and forgetting why you entered, as well as difficulty remembering names and struggling to drive in the dark.</p> <h2>The trouble with comparison</h2> <p>Sometimes, comparing young adults to older adults can be misleading though. The two generations were brought up in different times, with different levels of education, healthcare and nutrition. They also lead different daily lives, with some older people having lived though a world war while the youngest generation is growing up with the internet.</p> <p>Most of these factors favour the younger generation, and this can explain a proportion of their advantage in cognitive tasks.</p> <p>Indeed, much existing research shows that <a href="https://theconversation.com/iq-tests-are-humans-getting-smarter-158837">IQ has been improving</a> globally throughout the 20th century. This means that later-born generations are more cognitively able than those born earlier. This is even found when both generations are tested in the same way at the same age.</p> <p>Currently, there is growing evidence that <a href="https://www.pnas.org/doi/10.1073/pnas.1718793115">increases in IQ are levelling off,</a> such that, in the most recent couple of decades, young adults are no more cognitively able than young adults born shortly beforehand.</p> <p>Together, these factors may underlie the current result, namely that cognitive differences between young and older adults are diminishing over time.</p> <h2>New results</h2> <p>My research began when my team started getting strange results in our lab. We found that often the age differences we were getting between young and older adults was smaller or absent, compared to prior research from early 2000s.</p> <p>This prompted me to start looking at trends in age differences across the psychological literature in this area. I uncovered a variety of data that compared young and older adults from the 1960s up to the current day. I plotted this data against year of publication, and found that age deficits have been getting smaller over the last six decades.</p> <p>Next, I assessed if the average increases in cognitive ability over time seen across all individuals was a result that also applied to older adults specifically. Many large databases exist where groups of individuals are recruited every few years to take part in the same tests. I analysed studies using these data sets to look at older adults.</p> <p>I found that, just like younger people, older adults were indeed becoming more cognitively able with each cohort. But if differences are disappearing, does that mean younger people’s improvements in cognitive ability have slowed down or that older people’s have increased?</p> <p>I analysed data from my own laboratory that I had gathered over a seven-year period to find out. Here, I was able to dissociate the performance of the young from the performance of the older. I found that each cohort of young adults was performing to a similar extent across this seven-year period, but that older adults were showing improvements in both processing speed and vocabulary scores.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=333&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=333&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=333&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=418&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=418&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=418&amp;fit=crop&amp;dpr=3 2262w" alt="The figure shows data for a speed-based task where higher scores represent better performance." /><figcaption><span class="caption">The figure shows data for a speed-based task where higher scores represent better performance.</span> <span class="attribution"><a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure> <p>I believe the older adults of today are benefiting from many of the factors previously most applicable to young adults. For example, the number of children who went to school <a href="https://education-uk.org/history/chapter12.html">increased significantly</a> in the 1960s – with the system being more similar to what it is today than what it was at the start of the 20th century.</p> <p>This is being reflected in that cohort’s increased scores today, now they are older adults. At the same time, young adults have hit a ceiling and are no longer improving as much with each cohort.</p> <p>It is not entirely clear why the young generations have stopped improving so much. Some research has <a href="https://doi.org/10.1016/j.intell.2016.10.002">explored maternal age, mental health and even evolutionary trends</a>. I favour the opinion that there is just a natural ceiling – a limit to how much factors such as education, nutrition and health can improve cognitive performance.</p> <p>These data have important implications for research into dementia. For example, it is possible that a modern older adult in the early stages of dementia might pass a dementia test that was designed 20 or 30 years ago for the general population at that time.</p> <p>Therefore, as older adults are performing better in general than previous generations, it may be necessary to revise definitions of dementia that depend on an individuals’ expected level of ability.</p> <p>Ultimately, we need to rethink what it means to become older. And there’s finally some good news. Ultimately, we can expect to be more cognitively able than our grandparents were when we reach their age.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229132/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/stephen-badham-1531316">Stephen Badham</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/are-young-people-smarter-than-older-adults-my-research-shows-cognitive-differences-between-generations-are-diminishing-229132">original article</a>.</em></p> </div>

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Terminal lucidity: why do loved ones with dementia sometimes ‘come back’ before death?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/diny-thomson-1519736">Diny Thomson</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Dementia is often described as “the long goodbye”. Although the person is still alive, dementia slowly and irreversibly chips away at their memories and the qualities that make someone “them”.</p> <p>Dementia eventually takes away the person’s ability to communicate, eat and drink on their own, understand where they are, and recognise family members.</p> <p>Since as early as the <a href="https://pubmed.ncbi.nlm.nih.gov/21764150/">19th century</a>, stories from loved ones, caregivers and health-care workers have described some people with dementia suddenly becoming lucid. They have described the person engaging in meaningful conversation, sharing memories that were assumed to have been lost, making jokes, and even requesting meals.</p> <p>It is estimated <a href="https://pubmed.ncbi.nlm.nih.gov/20010032/">43% of people</a> who experience this brief lucidity die within 24 hours, and 84% within a week.</p> <p>Why does this happen?</p> <h2>Terminal lucidity or paradoxical lucidity?</h2> <p>In 2009, researchers Michael Nahm and Bruce Greyson coined the term “<a href="https://pubmed.ncbi.nlm.nih.gov/21764150/">terminal lucidity</a>”, since these lucid episodes often occurred shortly before death.</p> <p>But not all lucid episodes indicate death is imminent. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.13667">One study</a> found many people with advanced dementia will show brief glimmers of their old selves more than six months before death.</p> <p>Lucidity has also been <a href="https://www.sciencedirect.com/science/article/pii/S0167494311001865?via%3Dihub">reported</a> in other conditions that affect the brain or thinking skills, such as meningitis, schizophrenia, and in people with brain tumours or who have sustained a brain injury.</p> <p>Moments of lucidity that do not necessarily indicate death are sometimes called <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12579">paradoxical lucidity</a>. It is considered paradoxical as it defies the expected course of neurodegenerative diseases such as dementia.</p> <p>But it’s important to note these episodes of lucidity are temporary and sadly do not represent a reversal of neurodegenerative disease.</p> <h2>Why does terminal lucidity happen?</h2> <p>Scientists have struggled to explain why terminal lucidity happens. Some episodes of lucidity have been reported to occur in the presence of loved ones. Others have reported that <a href="https://psywb.springeropen.com/articles/10.1186/s13612-014-0024-5">music can sometimes improve lucidity</a>. But many episodes of lucidity do not have a distinct trigger.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S0300957223002162">A research team from New York University</a> speculated that changes in brain activity before death may cause terminal lucidity. But this doesn’t fully explain why people suddenly recover abilities that were assumed to be lost.</p> <p>Paradoxical and terminal lucidity are also very difficult to study. Not everyone with advanced dementia will experience episodes of lucidity before death. Lucid episodes are also unpredictable and typically occur without a particular trigger.</p> <p>And as terminal lucidity can be a joyous time for those who witness the episode, it would be unethical for scientists to use that time to conduct their research. At the time of death, it’s also difficult for scientists to interview caregivers about any lucid moments that may have occurred.</p> <p>Explanations for terminal lucidity extend beyond science. These moments of mental clarity may be a way for the dying person to say final goodbyes, gain closure before death, and reconnect with family and friends. Some believe episodes of terminal lucidity are representative of the person connecting with an afterlife.</p> <h2>Why is it important to know about terminal lucidity?</h2> <p>People can have a variety of reactions to seeing terminal lucidity in a person with advanced dementia. While some will experience it as being peaceful and bittersweet, others may find it deeply confusing and upsetting. There may also be an urge to modify care plans and request lifesaving measures for the dying person.</p> <p>Being aware of terminal lucidity can help loved ones understand it is part of the dying process, acknowledge the person with dementia will not recover, and allow them to make the most of the time they have with the lucid person.</p> <p>For those who witness it, terminal lucidity can be a final, precious opportunity to reconnect with the person that existed before dementia took hold and the “long goodbye” began.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/202342/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/yen-ying-lim-355185"><em>Yen Ying Lim</em></a><em>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/diny-thomson-1519736">Diny Thomson</a>, PhD (Clinical Neuropsychology) Candidate and Provisional Psychologist, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/terminal-lucidity-why-do-loved-ones-with-dementia-sometimes-come-back-before-death-202342">original article</a>.</em></p> </div>

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Hope: A double-edged sword in the human experience

<p>Hope has long been cherished as a source of strength in times of adversity. Yet, as explored in this edited extract from his new book <em>The Human Condition</em> by author Tony Grey, this fundamental emotion is not without its complexities and potential pitfalls.</p> <p>---</p> <p>As in the host of challenges explored in <em>The Human Condition</em>, the feeling of expectation and desire for something beneficial to happen, which we call hope, is as fundamental to the human condition as the will to survive; they’re linked within the evolutionary imperative. As Cicero pointed out, “dum spiro spero” (while I breathe I hope). Hope is a rolling prayer to life as time moves on, a whisper to the soul that things will turn out all right. </p> <p>The sentiment is generally unchallenged. Why should it be? In times of trouble, we need the balm of hope. Samuel Johnson said, “Hope is a species of pleasure, and perhaps, the chief pleasure this world affords.”</p> <p>While usually positive about hope, Greek philosophers were sometimes ambivalent about it, citing its propensity, through wishful thinking, to encourage indolence or actually cause harm. In Sophocles’ play Antigone, the Chorus sings, “Hope whose wanderings are so wide is to many men a comfort, but to many a false lure of giddy desires.” Plato observes that hope breeds a confidence which can exacerbate a precondition of arrogance in the powerful, leading to serious wrongdoing. “It is among these men that we find the ones who do the greatest evils.” </p> <p>Napoleon and Hitler are examples. And so is the Japanese government responsible for the Pearl Harbour attack.  At the World War Two surrender on the deck of the USS Missouri, a Japanese general was heard to say when he looked at the sky blackened by Allied aircraft flying past and the sea bursting with warships, “How did we ever hope we could win?”</p> <p>On the other hand, Plato stressed the motivational properties of hope when directed towards a good aim. And Aristotle links hope with the virtue of megalopsychia (high-mindedness) resulting from its inspirational role.</p> <p>I have an experience of this in my family. My nephew was born to my sister with intellectual disability, and other difficulties. His condition seemed hopeless. Nevertheless, from the first, hope was my sister’s support; it gave her the energy to carry on. Through the gloom it afforded a glimpse into the future where progress beckoned. And all along she demonstrated that hope is ineluctably linked to love.</p> <p>Aided by her husband, the father, she worked day and night teaching and inspiring the boy. When old enough he went to a special needs school and gradually progressed, indefatigably supported at home. Over time his condition improved so that eventually he could take and keep a simple job, cook food, and have friends (similarly disabled), a state absolutely unforeseeable at his early stage of life. Throughout all the difficulties, frustrations and threats of despair, hope sustained my sister and guided her to the wonderful achievement of saving a human life.</p> <p>In most instances, hope is personal in the sense that something specific to the individual or those who are close is wanted. However, it can range far beyond that into areas involving others such as team sports, politics, economic activity, justice, national and tribal identity, international relations – notably war, and pandemics like Covid. Within these fields, hope calls out for the survival and well-being of humanity and its prospects for moral and material progress. Such hope embraces faith in something bigger than the individual. If human beings have a purpose, its linked to that, and its fulfillment is somehow bound up in hope.</p> <p>This approach cries out for exploring a whole array of other challenges inherent in the human condition.</p> <p><strong>ABOUT THE AUTHOR</strong></p> <p>Tony Grey is an accomplished author residing in Sydney. His latest book, <em>The Human Condition</em>, ambitiously explores the hurly burly of human existence, and is available now for purchase through Halstead Press Publishers. Tony is the founder of Pancontinental Mining, a former director of Opera Australia and the Conservatorium of Music, and a former trustee of the Art Gallery of New South Wales. Other books by Tony Grey include <em>Jabiluka</em>, <em>East Wind</em> and <em>Seven Gateways</em>. His writings have featured in the <em>Australian</em> <em>Financial Review</em>, <em>Quadrant</em> and the <em>Australian</em>. </p> <p><em>Image: Getty Images</em></p>

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7 things you need to know about fear

<p>Fear is an emotion that can be debilitating and unsettling. But it is a natural part of life and we are hardwired to experience it.</p> <p><strong>1. Fear can protect you</strong></p> <p>Experiencing fear elicits responses from your brain to your limbs. It is the body’s natural way of protecting itself. For our ancestors the fear was often more physical – such as being chased by a lion. Modern fear can range from physical danger (such as a spider or an intruder) or even from perceived danger (such as the worry that something will happen to our partner or child). Feeling fear doesn’t make you a weak person. In fact, not feeling any fear could mean that there are neurological issues present.</p> <p><strong>2. There are many levels of fear</strong></p> <p>Not everything that we fear is intense and paralysing. It can range from low levels of fear (such as worry about being robbed), to medium levels of fear (say if a loved one is in hospital) to high levels of fear (you are being chased by an attacker). Fear can also become stronger when we hear about events such as a terrorist attack or a natural disaster. It all relates back to how much the scary event will impact our lives.</p> <p><strong>3. Fear is not just instinctive</strong></p> <p>We become fearful due to three main factors: instinct, learning, and teaching. An example of instinctual fear is pain – we learn to be fearful of things that hurt us. Learned fear comes from being exposed to unpleasant or uncomfortable things and wanting to avoid them in the future. For instance, having a relative die in a car crash could make you fearful of driving in the future. Other fears are taught to us by our family, friends and even society. For example, some religions teach us to be fearful of other religions or customs.</p> <p><strong>4. Fear can arise without a real threat of danger</strong></p> <p>Fear can also be imagined, so it can be felt even when there is no danger present. If we feel this all the time it can lead to anxiety and depression. It’s important to think about whether the thing you are fearful of is real or likely to happen before you give it too much airtime.</p> <p><strong>5. Fear produces fear</strong></p> <p>If you are already in a state of fear, your response to more fear is heightened. For instance if you are watching a scary movie, a small noise from the next room could make you jump and scream. Your senses are on red alert, primed to act if the need arises.</p> <p><strong>6. Fear leads to action</strong></p> <p>Depending on the individual and the level of fear they are experiencing, there tend to be four main types of action as a result of fear: freeze, </p> <p>fight, flight, or fright. </p> <p>When you freeze it means you don’t move while you decide what to do (for instance you see a snake in your garden). From there you choose either fight (grab a shovel) or flight mode (walk away). If the fear is too much you might experience fright, where you do nothing and take no action (stand there screaming or worrying).</p> <p><strong>7. Real threats can lead to heroic actions</strong></p> <p>Imagined threats can cause us to live in a permanent state of fear and stress. But often we will do nothing about it (for instance being worried about sharks attacking us in the ocean). Compare this to the threat from a real and identifiable source, which will make you spring into action almost immediately. Often we don’t even make the decision to act, it just happens automatically (such as moving a child out of the way of an approaching car). </p> <p><em>Image credits: Getty Images</em></p>

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What is childhood dementia? And how could new research help?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/kim-hemsley-1529322">Kim Hemsley</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/nicholas-smith-1529324">Nicholas Smith</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/siti-mubarokah-1529323">Siti Mubarokah</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>“Childhood” and “dementia” are two words we wish we didn’t have to use together. But sadly, around <a href="https://doi.org/10.1093/brain/awad242">1,400 Australian children and young people</a> live with currently untreatable childhood dementia.</p> <p>Broadly speaking, childhood dementia is caused by any one of <a href="https://www.childhooddementia.org/what-is-childhood-dementia#what">more than 100</a> rare genetic disorders. Although the causes differ from dementia acquired later in life, the progressive nature of the illness is the same.</p> <p><a href="https://doi.org/10.1093/brain/awad242">Half</a> of infants and children diagnosed with childhood dementia will not reach their tenth birthday, and most will die <a href="https://www.childhooddementia.org/what-is-childhood-dementia#what">before turning 18</a>.</p> <p>Yet this devastating condition has lacked awareness, and importantly, the research attention needed to work towards treatments and a cure.</p> <h2>More about the causes</h2> <p>Most types of childhood dementia are <a href="https://academic.oup.com/brain/article/146/11/4446/7226999">caused</a> by <a href="https://www.genome.gov/genetics-glossary/Mutation">mutations</a> (or mistakes) in our <a href="https://www.genome.gov/genetics-glossary/Deoxyribonucleic-Acid">DNA</a>. These mistakes lead to a range of rare genetic disorders, which in turn cause childhood dementia.</p> <p><a href="https://doi.org/10.1093/brain/awad242">Two-thirds</a> of childhood dementia disorders are caused by “<a href="https://www.ncbi.nlm.nih.gov/books/NBK459183/">inborn errors of metabolism</a>”. This means the metabolic pathways involved in the breakdown of carbohydrates, lipids, fatty acids and proteins in the body fail.</p> <p>As a result, nerve pathways fail to function, neurons (nerve cells that send messages around the body) die, and progressive cognitive decline occurs.</p> <h2>What happens to children with childhood dementia?</h2> <p>Most children initially appear unaffected. But after a period of apparently normal development, children with childhood dementia <a href="https://doi.org/10.1016/j.pediatrneurol.2023.09.006">progressively lose</a> all previously acquired skills and abilities, such as talking, walking, learning, remembering and reasoning.</p> <p>Childhood dementia also leads to significant changes in behaviour, such as aggression and hyperactivity. Severe sleep disturbance is common and vision and hearing can also be affected. Many children have seizures.</p> <p>The age when symptoms start can vary, depending partly on the particular genetic disorder causing the dementia, but the average is around <a href="https://doi.org/10.1093%2Fbrain%2Fawad242">two years old</a>. The symptoms are caused by significant, progressive brain damage.</p> <h2>Are there any treatments available?</h2> <p>Childhood dementia treatments currently <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">under evaluation</a> or approved are for a very limited number of disorders, and are only available in some parts of the world. These include gene replacement, <a href="https://doi.org/10.1002/jmd2.12378">gene-modified cell therapy</a> and protein or <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1712649">enzyme replacement therapy</a>. Enzyme replacement therapy is available in Australia for <a href="https://australianprescriber.tg.org.au/articles/cerliponase-alfa-for-neuronal-ceroid-lipofuscinosis-type-2-disease.html">one form of childhood dementia</a>. These therapies attempt to “fix” the problems causing the disease, and have shown promising results.</p> <p>Other experimental therapies include ones that <a href="https://doi.org/10.3390/life12050608">target</a> faulty protein production or <a href="https://doi.org/10.1056/nejmoa2310151">reduce inflammation</a> in the brain.</p> <h2>Research attention is lacking</h2> <p>Death rates for Australian children with cancer <a href="http://www.childhooddementia.org/getasset/2WX39O">nearly halved</a> between <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/cancer-incidence-survival">1997 and 2017</a> thanks to research that has enabled the development of multiple treatments. But over recent decades, <a href="http://www.childhooddementia.org/getasset/2WX39O">nothing has changed</a> for children with dementia.</p> <p>In 2017–2023, research for childhood cancer received over four times more funding per patient compared to funding for <a href="https://www.childhooddementia.org/getasset/2WX39O">childhood dementia</a>. This is despite childhood dementia causing a <a href="https://doi.org/10.1093/brain/awad242">similar number of deaths</a> each year as childhood cancer.</p> <p>The success <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/cancer-incidence-survival">for childhood cancer sufferers</a> in recent decades demonstrates how adequately funding medical research can lead to improvements in patient outcomes.</p> <p>Another bottleneck for childhood dementia patients in Australia is the lack of access to clinical trials. An <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">analysis</a> published in March this year showed that in December 2023, only two clinical trials were recruiting patients with childhood dementia in Australia.</p> <p>Worldwide however, 54 trials were recruiting, meaning Australian patients and their families are left watching patients in other parts of the world receive potentially lifesaving treatments, with no recourse themselves.</p> <p>That said, we’ve seen a slowing in the establishment of <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">clinical trials</a> for childhood dementia across the world in recent years.</p> <p>In addition, we know from <a href="https://www.childhooddementia.org/join-us/professionals/impacts">consultation with families</a> that current care and support systems <a href="https://www.childhooddementia.org/getasset/44MLP8">are not meeting the needs</a> of children with dementia and their families.</p> <h2>New research</h2> <p>Recently, we were awarded <a href="https://www.premier.sa.gov.au/media-releases/news-items/major-funding-boost-for-research-into-childhood-dementia">new funding</a> for <a href="https://www.flinders.edu.au/giving/our-donors/impact-of-giving/improving-the-lives-of-children-with-dementia">our research</a> on childhood dementia. This will help us continue and expand studies that seek to develop lifesaving treatments.</p> <p>More broadly, we need to see increased funding in Australia and around the world for research to develop and translate treatments for the broad spectrum of childhood dementia conditions.</p> <p><em>Dr Kristina Elvidge, head of research at the <a href="https://www.childhooddementia.org/our-people">Childhood Dementia Initiative</a>, and Megan Maack, director and CEO, contributed to this article.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228508/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/kim-hemsley-1529322">Kim Hemsley</a>, Head, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/nicholas-smith-1529324">Nicholas Smith</a>, Head, Paediatric Neurodegenerative Diseases Research Group, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/siti-mubarokah-1529323">Siti Mubarokah</a>, Research Associate, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-childhood-dementia-and-how-could-new-research-help-228508">original article</a>.</em></p> </div>

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What’s the difference between ADD and ADHD?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/kathy-gibbs-1392051">Kathy Gibbs</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p>Around <a href="https://www.healthdirect.gov.au/attention-deficit-disorder-add-or-adhd#:%7E:text=Around%201%20in%20every%2020,have%20symptoms%20as%20an%20adult.">one in 20 people</a> has attention-deficit hyperactivity disorder (ADHD). It’s one of the most common neurodevelopmental disorders in childhood and often continues into adulthood.</p> <p>ADHD is <a href="https://www.psychiatry.org/psychiatrists/practice/dsm">diagnosed</a> when people experience problems with inattention and/or hyperactivity and impulsivity that negatively impacts them at school or work, in social settings and at home.</p> <p>Some people call the condition attention-deficit disorder, or ADD. So what’s the difference?</p> <p>In short, what was previously called ADD is now known as ADHD. So how did we get here?</p> <h2>Let’s start with some history</h2> <p>The <a href="https://www.guilford.com/books/Attention-Deficit-Hyperactivity-Disorder/Russell-Barkley/9781462538874">first clinical description</a> of children with inattention, hyperactivity and impulsivity was in 1902. British paediatrician Professor George Still <a href="https://pubmed.ncbi.nlm.nih.gov/26740929/">presented</a> a series of lectures about his observations of 43 children who were defiant, aggressive, undisciplined and extremely emotional or passionate.</p> <p>Since then, our understanding of the condition evolved and made its way into the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM. Clinicians use the DSM to diagnose mental health and neurodevelopmental conditions.</p> <p>The first DSM, published in 1952, did not include a specific related child or adolescent category. But the <a href="https://dsm.psychiatryonline.org/doi/abs/10.1176/appi.books.9780890420355.dsm-ii">second edition</a>, published in 1968, <a href="https://www.tandfonline.com/doi/full/10.1080/00207411.2015.1009310">included a section</a> on behaviour disorders in young people. It referred to ADHD-type characteristics as “hyperkinetic reaction of childhood or adolescence”. This described the excessive, involuntary movement of children with the disorder.</p> <p>In the early 1980s, the <a href="https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm/history-of-the-dsm">third DSM</a> added a condition it called “attention deficit disorder”, listing two types: attention deficit disorder <em>with</em> hyperactivity (ADDH) and attention deficit disorder as the subtype <em>without</em> the hyperactivity.</p> <p>However, seven years later, a revised DSM (DSM-III-R) replaced ADD (and its two sub-types) with ADHD and three sub-types we have today:</p> <ul> <li>predominantly inattentive</li> <li>predominantly hyperactive-impulsive</li> <li>combined.</li> </ul> <h2>Why change ADD to ADHD?</h2> <p>ADHD replaced ADD in the DSM-III-R in 1987 for a number of reasons.</p> <p>First was the controversy and debate over the presence or absence of hyperactivity: the “H” in ADHD. When ADD was <a href="https://www.guilford.com/books/Attention-Deficit-Hyperactivity-Disorder/Russell-Barkley/9781462538874">initially named</a>, little research had been done to determine the similarities and differences between the two sub-types.</p> <p>The next issue was around the term “attention-deficit” and whether these deficits were similar or different across both sub-types. Questions also arose about the extent of these differences: if these sub-types were so different, were they actually different conditions?</p> <p>Meanwhile, a new focus on inattention (an “attention deficit”) recognised that children with inattentive behaviours <a href="https://academic.oup.com/shm/article/30/4/767/2919401">may not necessarily be</a> disruptive and challenging but are more likely to be forgetful and daydreamers.</p> <h2>Why do some people use the term ADD?</h2> <p>There was a <a href="https://academic.oup.com/shm/article/30/4/767/2919401">surge of diagnoses</a> in the 1980s. So it’s understandable that some people still hold onto the term ADD.</p> <p>Some may identify as having ADD because out of habit, because this is what they were originally diagnosed with or because they don’t have hyperactivity/impulsivity traits.</p> <p>Others who don’t have ADHD may use the term they came across in the 80s or 90s, not knowing the terminology has changed.</p> <h2>How is ADHD currently diagnosed?</h2> <p>The three sub-types of ADHD, outlined in the DSM-5 are:</p> <ul> <li> <p>predominantly inattentive. People with the inattentive sub-type have difficulty sustaining concentration, are easily distracted and forgetful, lose things frequently, and are unable to follow detailed instructions</p> </li> <li> <p>predominantly hyperactive-impulsive. Those with this sub-type find it hard to be still, need to move constantly in structured situations, frequently interrupt others, talk non-stop and struggle with self control</p> </li> <li> <p>combined. Those with the combined sub-type experience the characteristics of those who are inattentive and hyperactive-impulsive.</p> </li> </ul> <p>ADHD diagnoses <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/children-mental-illness">continue to rise</a> among children and adults. And while ADHD was commonly diagnosed in boys, more recently we have seen growing numbers of girls and women seeking diagnoses.</p> <p>However, some international experts <a href="https://academic.oup.com/shm/article/30/4/767/2919401">contest</a> the expanded definition of ADHD, driven by clinical practice in the United States. They argue the challenges of unwanted behaviours and educational outcomes for young people with the condition are uniquely shaped by each country’s cultural, political and local factors.</p> <p>Regardless of the name change to reflect what we know about the condition, ADHD continues to impact educational, social and life situations of many children, adolescents and adults.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225162/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/kathy-gibbs-1392051">Kathy Gibbs</a>, Program Director for the Bachelor of Education, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-add-and-adhd-225162">original article</a>.</em></p> </div>

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Better sleep is a protective factor against dementia

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/andree-ann-baril-1494268">Andrée-Ann Baril</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> and <a href="https://theconversation.com/profiles/matthew-pase-1494296">Matthew Pase</a>, <a href="https://theconversation.com/institutions/monash-university-1065"><em>Monash University</em></a></em></p> <p>Dementia is a progressive loss of cognitive abilities, such as memory, that is significant enough to have an impact on a person’s daily activities.</p> <p>It can be caused by a number of different diseases, including <a href="https://alzheimer.ca/en/about-dementia/what-alzheimers-disease">Alzheimer’s</a>, which is the most common form. Dementia is caused by a loss of neurons over a long period of time. Since, by the time symptoms appear, many changes in the brain have already occurred, many scientists are focusing on studying the risk and protective factors for dementia.</p> <p>A risk factor, or conversely, a protective factor, is a condition or behaviour that increases or reduces the risk of developing a disease, but does not guarantee either outcome. Some risk factors for Alzheimer’s disease and dementia, such as age or genetics, are not modifiable, but there are several other factors we can influence, <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">specifically lifestyle habits and their impact on our overall health</a>.</p> <p>These risk factors include depression, lack of physical activity, social isolation, high blood pressure, obesity, diabetes, excessive alcohol consumption and smoking, as well as poor sleep.</p> <p>We have been focusing our research on the question of sleep for over 10 years, particularly in the context of the <a href="https://www.nhlbi.nih.gov/science/framingham-heart-study-fhs">Framingham Heart Study</a>. In this large community-based cohort study, ongoing since the 1940s, the health of surviving participants has been monitored to the present day. As researchers in sleep medicine and epidemiology, we have expertise in researching the role of sleep and sleep disorders in cognitive and psychiatric brain aging.</p> <p>As part of our research, we monitored and analyzed the sleep of people aged 60 and over to see who did — or did not — develop dementia.</p> <h2>Sleep as a risk or protective factor against dementia</h2> <p>Sleep appears to play an essential role in a number of brain functions, such as memory. Good quality sleep <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2793873">could therefore play a vital role in preventing dementia</a>.</p> <p>Sleep is important for maintaining <a href="https://www.science.org/doi/10.1126/science.1241224">good connections in the brain</a>. Recently, research has revealed that sleep seems to have a function similar to that of a garbage truck for the brain: <a href="https://doi.org/10.1016/j.mad.2023.111899">deep sleep could be crucial for eliminating metabolic waste from the brain</a>, including clearing certain proteins, such as those known to accumulate in the brains of people with Alzheimer’s disease.</p> <p>However, the links between deep sleep and dementia still have to be clarified.</p> <h2>What is deep sleep?</h2> <p>During a night’s sleep, we go through several <a href="http://ceams-carsm.ca/en/a-propos-du-sommeil/">sleep stages</a> that succeed one another and are repeated.</p> <p>NREM sleep (non-rapid eye movement sleep) is divided into light NREM sleep (NREM1 stage), NREM sleep (NREM2 stage) and deep NREM sleep, also called slow-wave sleep (NREM3 stage). The latter is associated with several restorative functions. Next, REM sleep (rapid eye movement sleep) is the stage generally associated with the most vivid dreams. An adult generally spends around 15 to 20 per cent of each night in deep sleep, if we add up all the periods of NREM3 sleep.</p> <p>Several sleep changes are common in adults, such as going to bed and waking up earlier, sleeping for shorter periods of time and less deeply, and waking up more frequently during the night.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=279&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=279&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=279&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=350&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=350&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=350&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">Sleep stages, and the role of deep sleep for brain health.</span> <span class="attribution"><span class="source">(Andrée-Ann Baril)</span></span></figcaption></figure> <h2>Loss of deep sleep linked to dementia</h2> <p>Participants in the <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2810957">Framingham Heart Study</a> were assessed using a sleep recording — known as polysomnography — on two occasions, approximately five years apart, in 1995-1998 and again in 2001-2003.</p> <p>Many people showed a reduction in their deep slow-wave sleep over the years, as is to be expected with aging. Conversely, the amount of deep sleep in some people remained stable or even increased.</p> <p>Our team of researchers from the Framingham Heart Study followed 346 participants aged 60 and over for a further 17 years to observe who developed dementia and who did not.</p> <p>Progressive loss of deep sleep over time was associated with an increased risk of dementia, whatever the cause, and particularly Alzheimer’s type dementia. These results were independent of many other risk factors for dementia.</p> <p>Although our results do not prove that loss of deep sleep causes dementia, they do suggest that it could be a risk factor in the elderly. Other aspects of sleep may also be important, such as its duration and quality.</p> <h2>Strategies to improve deep sleep</h2> <p>Knowing the impact of a lack of deep sleep on cognitive health, what strategies can be used to improve it?</p> <p>First and foremost, if you’re experiencing sleep problems, it’s worth talking to your doctor. Many sleep disorders are underdiagnosed and treatable, particularly through behavioural (i.e. non-medicinal) approaches.</p> <p>Adopting good sleep habits can help, such as going to bed and getting up at consistent times or avoiding bright or blue light in bed, like that of screens.</p> <p>You can also avoid caffeine, limit your alcohol intake, maintain a healthy weight, be physically active during the day, and sleep in a comfortable, dark and quiet environment.</p> <p>The role of deep sleep in preventing dementia remains to be explored and studied. Encouraging sleep with good lifestyle habits could have the potential to help us age in a healthier way.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222854/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/andree-ann-baril-1494268">Andrée-Ann Baril</a>, Professeure-chercheure adjointe au Département de médecine, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> and <a href="https://theconversation.com/profiles/matthew-pase-1494296">Matthew Pase</a>, Associate Professor of Neurology and Epidemiology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/better-sleep-is-a-protective-factor-against-dementia-222854">original article</a>.</em></p> </div>

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New studies suggest millions with mild cognitive impairment go undiagnosed, often until it’s too late

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/soeren-mattke-1484707">Soeren Mattke</a>, <a href="https://theconversation.com/institutions/university-of-southern-california-1265">University of Southern California</a> and <a href="https://theconversation.com/profiles/ying-liu-1221170">Ying Liu</a>, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a></em></p> <p>Mild cognitive impairment – an early stage of dementia – is widely underdiagnosed in people 65 and older. That is the key takeaway of two recent studies from our team.</p> <p>In the first study, we used Medicare data for about 40 million beneficiaries age 65 and older from 2015 to 2019 to estimate the prevalence of mild cognitive impairment in that population and to identify what proportion of them had actually been diagnosed.</p> <p>Our <a href="https://doi.org/10.1186/s13195-023-01272-z">finding was sobering</a>: A mere 8% of the number of cases with mild cognitive impairment that we expected based on a statistical model had actually been diagnosed. Scaled up to the general population 65 and older, this means that approximately 7.4 million cases across the country remain undiagnosed.</p> <p>In the second study, we analyzed data for 226,756 primary care clinicians and found that <a href="https://doi.org/10.14283/jpad.2023.131">over 99% of them underdiagnosed mild cognitive impairment</a> in this population.</p> <h2>Why it matters</h2> <p>Mild cognitive impairment is an early symptom of Alzheimer’s disease in <a href="https://doi.org/10.1001/jama.2019.2000">about half of cases</a> and progresses to dementia <a href="https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/mild-cognitive-impairment">at a rate of 10% to 15% per year</a>. It includes symptoms such as losing the ability to remember recent events and appointments, make sound decisions and master complex tasks. Failure to detect it might deprive patients of an opportunity to get treated and to slow down disease progression.</p> <p>Mild cognitive impairment can sometimes be caused by easily addressable factors, such as medication side effects, thyroid dysfunction or <a href="https://theconversation.com/vitamin-b12-deficiency-is-a-common-health-problem-that-can-have-serious-consequences-but-doctors-often-overlook-it-192714">vitamin B12 deficiency</a>. Since mild cognitive impairment has <a href="https://doi.org/10.1016/j.amjopharm.2008.06.004">the same risk factors as cardiovascular disease</a>, such as high blood pressure and cholesterol, medication management of these risks combined with diet and exercise <a href="https://doi.org/10.1016/S0140-6736(15)60461-5">can reduce the risk of progression</a>.</p> <p>In 2023, the Food and Drug Administration <a href="https://www.fda.gov/news-events/press-announcements/fda-converts-novel-alzheimers-disease-treatment-traditional-approval">approved the drug lecanemab</a> as the <a href="https://theconversation.com/what-the-fdas-accelerated-approval-of-a-new-alzheimers-drug-could-mean-for-those-with-the-disease-5-questions-answered-about-lecanemab-197460">first disease-modifying treatment</a> <a href="https://www.nia.nih.gov/health/alzheimers-causes-and-risk-factors/what-happens-brain-alzheimers-disease">for Alzheimer’s disease</a>, the most common cause of mild cognitive impairment. In contrast to previous drugs, which can temporarily improve symptoms of the disease, such as memory loss and agitation, this new treatment addresses the underlying cause of the disease.</p> <p>Lecanemab, a monoclonal antibody, <a href="https://www.news-medical.net/health/What-are-Amyloid-Plaques.aspx">reduces amyloid plaques</a> in the brain, which are toxic protein clumps that are believed to contribute to the progression of the disease. In a large clinical trial, lecanemab was able to <a href="https://doi.org/10.1056/NEJMoa2212948">reduce the progression</a> of early-stage Alzheimer’s disease. A similar drug, donanemab, also <a href="https://doi.org/10.1001/jama.2023.13239">succeeded in a clinical trial</a> and is expected to be <a href="https://www.medicalnewstoday.com/articles/fda-delays-approval-of-alzheimers-drug-donanemab-what-experts-think">approved sometime in 2024</a>.</p> <p>However, these drugs must be used in the early stages of Alzheimer’s disease, ideally when a patient has only mild cognitive impairment, as there is <a href="https://www.alz.org/alzheimers-dementia/treatments/lecanemab-leqembi">no evidence that they are effective in advanced stages</a>.</p> <figure><iframe src="https://www.youtube.com/embed/w3IbAscNjsQ?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">An earlier diagnosis leads to early treatment and better outcomes.</span></figcaption></figure> <h2>What still isn’t known</h2> <p>Many factors contribute to the <a href="https://doi.org/10.1002/alz.13051">lack of timely detection</a>. But researchers don’t have a good understanding of the relative importance of those individual factors or how to reduce the high rate of underdiagnosis.</p> <p>While distinct, symptoms are subtle and their slow progression means that they can be overlooked or misinterpreted as normal aging. A neurologist in China told our research team that diagnosis rates spike in China after the New Year’s holiday, when children who haven’t seen their parents for a year notice changes that are harder to pick up when interacting with someone daily.</p> <p>Doctors also commonly discount memory concerns as normal aging and doubt that much can be done about it. While cognitive tests to distinguish mild cognitive impairment from pathologic decline do exist, they take about 15 minutes, which can be hard to come by during the limited time of a doctor’s visit and may require a follow-up appointment.</p> <h2>What’s next</h2> <p>People, particularly those in their 60s and beyond, as well as their families and friends need to be vigilant about cognitive decline, bring it up during doctor’s appointments and insist on a formal assessment.</p> <p>The <a href="https://www.medicare.gov/coverage/yearly-wellness-visits">Medicare yearly “wellness” visit</a> is an opportunity to explore such concerns, but only about half of beneficiaries <a href="https://doi.org/10.1377/hlthaff.2019.01795">take advantage of it</a>.</p> <p>Just as physicians ask patients about unexplained weight loss and take those concerns seriously, we believe questions that explore a patient’s cognitive state need to become the norm.</p> <p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take on interesting academic work.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/216892/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/soeren-mattke-1484707">Soeren Mattke</a>, Director of the USC Dornsife Brain Health Observatory, <a href="https://theconversation.com/institutions/university-of-southern-california-1265">University of Southern California</a> and <a href="https://theconversation.com/profiles/ying-liu-1221170">Ying Liu</a>, Research Scientist, Center for Economic and Social Research, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/new-studies-suggest-millions-with-mild-cognitive-impairment-go-undiagnosed-often-until-its-too-late-216892">original article</a>.</em></p> </div>

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Stuck in fight-or-flight mode? 5 ways to complete the ‘stress cycle’ and avoid burnout or depression

<div class="theconversation-article-body"> <p>Can you remember a time when you felt stressed leading up to a big life event and then afterwards felt like a weight had been lifted? This process – the ramping up of the stress response and then feeling this settle back down – shows completion of the “stress cycle”.</p> <p>Some stress in daily life is unavoidable. But remaining stressed is unhealthy. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568977/">Chronic stress</a> increases <a href="https://pubmed.ncbi.nlm.nih.gov/32886587/">chronic health conditions</a>, including heart disease and stroke and diabetes. It can also lead to <a href="https://theconversation.com/were-all-exhausted-but-are-you-experiencing-burnout-heres-what-to-look-out-for-164393">burnout</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5137920/">depression</a>.</p> <p>Exercise, cognitive, creative, social and self-soothing activities help us process stress in healthier ways and complete the stress cycle.</p> <h2>What does the stress cycle look like?</h2> <p>Scientists and researchers refer to the “stress response”, often with a focus on the fight-or-flight reactions. The phrase the “stress cycle” has been made popular by <a href="https://www.penguin.co.uk/articles/2019/03/complete-stress-cycle-emotional-exhaustion-burnout">self-help experts</a> but it does have a scientific basis.</p> <p>The <a href="https://www.ncbi.nlm.nih.gov/books/NBK541120/">stress cycle</a> is our body’s response to a stressful event, whether real or perceived, physical or psychological. It could be being chased by a vicious dog, an upcoming exam or a difficult conversation.</p> <p>The stress cycle has three stages:</p> <ul> <li> <p><strong>stage 1</strong> is perceiving the threat</p> </li> <li> <p><strong>stage 2</strong> is the fight-or-flight response, driven by our stress hormones: adrenaline and cortisol</p> </li> <li> <p><strong>stage 3</strong> is relief, including physiological and psychological relief. This completes the stress cycle.</p> </li> </ul> <p>Different people will respond to stress differently based on their life experiences and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181835/#:%7E:text=The%20major%20findings%20regarding%20the,renin%2Dangiotensin%2Daldosterone%20system%20or">genetics</a>.</p> <p>Unfortunately, many people experience <a href="https://www.weforum.org/agenda/2023/01/polycrisis-global-risks-report-cost-of-living/">multiple and ongoing stressors</a> out of their control, including the cost-of-living crisis, extreme weather events and <a href="https://www.aihw.gov.au/family-domestic-and-sexual-violence/types-of-violence/family-domestic-violence">domestic violence</a>.</p> <p>Remaining in stage 2 (the flight-or-flight response), can lead to chronic stress. <a href="https://theconversation.com/how-chronic-stress-changes-the-brain-and-what-you-can-do-to-reverse-the-damage-133194">Chronic stress</a> and high cortisol can increase <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476783/">inflammation</a>, which damages our brain and other organs.</p> <p>When you are stuck in chronic fight-or-flight mode, you don’t think clearly and are more easily distracted. Activities that provide temporary pleasure, such as eating junk food or drinking alcohol are <a href="https://onlinelibrary.wiley.com/doi/10.1111/acer.14518">unhelpful strategies</a> that do not reduce the stress effects on our brain and body. Scrolling through social media is also not an effective way to complete the stress cycle. In fact, this is associated with an <a href="https://www.apa.org/monitor/2022/11/strain-media-overload">increased stress response</a>.</p> <h2>Stress and the brain</h2> <p>In the brain, chronic high cortisol can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561403/">shrink the hippocampus</a>. This can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1557684/#:%7E:text=The%20hippocampal%20formation%20plays%20a,%2C%20memory%2C%20motivation%20and%20emotion.&amp;text=Therefore%2C%20reduced%20hippocampal%20volumes%20should,in%20patients%20with%20major%20depression">impair a person’s memory</a> and their capacity to think and concentrate.</p> <p>Chronic high cortisol also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907136/#:%7E:text=The%20prefrontal%20cortex%20(PFC)%20intelligently,brain%20regions%20(BOX%201).">reduces activity</a> in the prefrontal cortex but <a href="https://www.sciencedirect.com/science/article/pii/S2352289514000101">increases activity</a> in the amygdala.</p> <p>The prefrontal cortex is responsible for higher-order control of our thoughts, behaviours and emotions, and is <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2014.00761/full">goal-directed</a> and rational. The amygdala is involved in reflexive and emotional responses. Higher amygdala activity and lower prefrontal cortex activity explains why we are less rational and more emotional and reactive when we are stressed.</p> <p>There are five <a href="https://www.penguin.co.uk/articles/2019/03/complete-stress-cycle-emotional-exhaustion-burnout">types of activities</a> that can help our brains complete the stress cycle.</p> <figure><iframe src="https://www.youtube.com/embed/eD1wliuHxHI?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">It can help to understand how the brain encounters stress.</span></figcaption></figure> <h2>1. Exercise – its own complete stress cycle</h2> <p>When we exercise we get a short-term spike in cortisol, followed by a <a href="https://www.health.harvard.edu/staying-healthy/exercising-to-relax">healthy reduction</a> in cortisol and adrenaline.</p> <p>Exercise also <a href="https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469#:%7E:text=Exercise%20in%20almost%20any%20form,distract%20you%20from%20daily%20worries.&amp;text=You%20know%20that%20exercise%20does,fit%20it%20into%20your%20routine.">increases endorphins and serotonin</a>, which improve mood. Endorphins cause an elated feeling often called “runner’s high” and have <a href="https://pubmed.ncbi.nlm.nih.gov/33396962/">anti-inflammatory effects</a>.</p> <p>When you exercise, there is more blood flow to the brain and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721405/">higher activity</a> in the prefrontal cortex. This is why you can often think more clearly after a walk or run. Exercise can be a helpful way to <a href="https://www.healthline.com/health/heart-disease/exercise-stress-relief">relieve feelings of stress</a>.</p> <p>Exercise can also increase the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041121/">volume</a> of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4915811/">hippocampus</a>. This is linked to better short-term and long-term memory processing, as well as reduced stress, depression and anxiety.</p> <h2>2. Cognitive activities – reduce negative thinking</h2> <p>Overly negative thinking can trigger or extend the stress response. In our 2019 research, we found the relationship between stress and cortisol was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6987429/">stronger in people with more negative thinking</a>.</p> <p>Higher amygdala activity and less rational thinking when you are stressed can lead to <a href="https://pubmed.ncbi.nlm.nih.gov/18628348/">distorted thinking</a> such as focusing on negatives and rigid “black-and-white” thinking.</p> <p>Activities to reduce negative thinking and promote a more realistic view can reduce the stress response. In clinical settings this is usually called <a href="https://www.healthdirect.gov.au/cognitive-behaviour-therapy-cbt">cognitive behaviour therapy</a>.</p> <p>At home, this could be journalling or writing down worries. This engages the logical and rational parts of our brain and helps us think more realistically. Finding evidence to challenge negative thoughts (“I’ve prepared well for the exam, so I can do my best”) can help to complete the stress cycle.</p> <h2>3. Getting creative – a pathway out of ‘flight or fight’</h2> <p>Creative activities can be art, craft, gardening, cooking or <a href="https://heartmindonline.org/resources/10-exercises-for-your-prefrontal-cortex">other activities</a> such as doing a puzzle, juggling, music, theatre, dancing or simply being absorbed in enjoyable work.</p> <p>Such pursuits increase <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2014.00761/full">prefrontal cortex activity</a> and promote flow and focus.</p> <p>Flow is a <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.645498/full">state of full engagement</a> in an activity you enjoy. It lowers high-stress levels of noradrenaline, the brain’s adrenaline. When you are focussed like this, the brain only processes information relevant to the task and ignores non-relevant information, including stresses.</p> <h2>4. Getting social and releasing feel-good hormones</h2> <p>Talking with someone else, physical affection with a person or pet and laughing can all <a href="https://theconversation.com/what-happens-in-our-brain-and-body-when-were-in-love-198885">increase oxytocin</a>. This is a chemical messenger in the brain that increases social bonding and makes us feel connected and safe.</p> <p>Laughing is also a social activity that <a href="https://neurosciencenews.com/laughter-physical-mental-psychology-17339/">activates parts</a> of the limbic system – the part of the brain involved in emotional and behavioural responses. This increases <a href="https://www.jneurosci.org/content/37/36/8581">endorphins</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/27439375/">serotonin</a> and improves our mood.</p> <h2>5. Self-soothing</h2> <p>Breathing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189422/">exercises</a> and meditation stimulate the parasympathetic nervous system (which calms down our stress responses so we can “reset”) via the <a href="https://theconversation.com/our-vagus-nerves-help-us-rest-digest-and-restore-can-you-really-reset-them-to-feel-better-210469">vagus nerves</a>, and <a href="https://www.tandfonline.com/doi/full/10.1080/17437199.2020.1760727">reduce cortisol</a>.</p> <p>A good <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4035568/#:%7E:text=We%20conclude%20that%2C%20in%20addition,self%2Dsoothing%20effects%20of%20crying.">cry can help too</a> by releasing stress energy and increasing oxytocin and endorphins.</p> <p><a href="https://www.medicalnewstoday.com/articles/319631#:%7E:text=Possible%20benefits%20of%20crying%20include,of%201.9%20times%20a%20month.">Emotional tears</a> also remove cortisol and the hormone prolactin from the body. Our prior research showed <a href="https://pubmed.ncbi.nlm.nih.gov/29096223/">cortisol</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9216608/">prolactin</a> were associated with depression, anxiety and hostility.<em><a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/susan-j-thomas-1293985">Susan J. Thomas</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <h2>Action beats distraction</h2> <p>Whether it’s watching a funny or sad movie, exercising, journalling, gardening or doing a puzzle, there is science behind why you should complete the stress cycle.</p> <p>Doing at least one positive activity every day can also reduce our baseline stress level and is beneficial for good mental health and wellbeing.</p> <p>Importantly, chronic stress and <a href="https://theconversation.com/are-you-burnt-out-at-work-ask-yourself-these-4-questions-118128">burnout</a> can also indicate the need for change, <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20311">such as in our workplaces</a>. However, not all stressful circumstances can be easily changed. Remember help is always available.</p> <p>If you have concerns about your stress or health, please talk to a doctor.</p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call <a href="https://www.lifeline.org.au/">Lifeline</a> on 13 11 14 or <a href="https://kidshelpline.com.au/">Kids Helpline</a> on 1800 55 1800.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/218599/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, Associate professor of Medical Sciences, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/susan-j-thomas-1293985">Susan J. Thomas</a>, Associate professor in Mental Health and Behavioural Science, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>Image </em><em>credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">original article</a>.</em></p> </div>

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How music is changing the way dementia patients think

<p dir="ltr">New research has proven that music truly is the universal language, with experts discovering how the power of music is helping those suffering with dementia. </p> <p dir="ltr">Music therapists have shown that music brings dementia patients back to the present, with some even finding their voice thanks to the nostalgic memories of the past. </p> <p dir="ltr">According to Registered Music Therapist and Managing Director of music therapy company Music Beat, Dr Vicky Abad, the power of music is not to be overlooked when it comes to degenerative diseases.</p> <p dir="ltr">“Music is a window into people’s pasts,” she said. “It builds on strengths and abilities against a disease that can strip a person of their dignity, abilities and quality of life.”</p> <p dir="ltr">The team at <a href="https://www.tricare.com.au/">TriCare Aged Care and Retirement</a>, who see the devastating impact of dementia each and every day,  also experience first-hand the impact music has on residents, with many noticing “unrecognisable” changes in personality when a nostalgic tune is played.</p> <p dir="ltr">Louis Rose, an 80-year-old dementia patient and TriCare resident, was diagnosed with dementia six years ago, and requires assistance with many aspects of day to day life. </p> <p dir="ltr">However, listening to music is one thing he can enjoy on his own.</p> <p dir="ltr">“I grew up in Mauritius and while we didn’t have a lot, we certainly had music. Listening to music has always been an escape for me and a way to relax,” Mr Rose said.</p> <p dir="ltr">“When your brain starts to slow down and you find yourself forgetting things, it can be quite frustrating and confusing. Listening to music has been a way to distract myself from what’s going on in my head, it has helped me so much.”</p> <p dir="ltr">Tamsin Sutherland is a regular live music performer at TriCare facilities across Queensland, and has been able to witness incredible moments with the residents as they come alive as soon as she starts to play. </p> <p dir="ltr">“Watching residents who are often non-verbal sing along to the words is incredible,” she said “It really is like they are coming back to life and reconnecting with who they once were. To be part of that is quite emotional for me.”</p> <p dir="ltr">According to Dr Abad, music can help prevent the restless behaviour that often leads to pacing and wandering, especially in the evenings, which are often difficult times for those battling the disease. </p> <p dir="ltr">“Sundowning usually occurs in the late afternoon as dusk approaches, a time that is also associated with what used to be a busy time period in people’s lives,” she noted. </p> <p dir="ltr">“Personalised music is a simple and effective tool to help residents feel validated in their emotions during this time and provides them an opportunity to experience a calmer state of mind”.</p> <p dir="ltr"><em>Image credits: Getty Images </em></p>

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10 ways to sneak in meditation into your everyday life

<p><em>Health experts share their tips and tricks on how to sneak meditation into your daily life without going on a yoga retreat.</em></p> <p><strong>Ways to meditate every day</strong></p> <p>Meeting deadlines at work, keeping up with friends, and trying to make time to exercise can be stressful – throw in a global pandemic and all its repercussions and it’s no wonder the majority of Australians feel that stress impacts their physical health (72%) and mental health (64%). But whatever the source of your stress, daily meditation can help you cope without having to change your schedule.</p> <p><strong>1. Try eating a meal without distractions</strong></p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2024/04/1-lunch-mindful-eating-GettyImages-1263611134-770.jpg" alt="" width="1280" height="720" /></p> <p>When was the last time you did this? According to Rebecca Weible, founder of Yo Yoga!, eating without your phone, tablet or a book creates real awareness. “Take the time to notice each bite, including the taste and texture of your food,” she says. “This is also great for digestion and portion control.”</p> <p><strong>2. Unplug and take a walk</strong></p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2024/04/2-walk-scooter-kids-parents-GettyImages-932349458-770.jpg" alt="" width="1280" height="720" /></p> <p>Sometimes slowing down is as easy as unplugging from the digital world, including your phone, social media and email and taking in your surroundings. Weible says to take notice of each step: “The first and last part of your foot to hit the ground with each step, your stride and your pace. See how long you can stay present.” Running is also a great way to unplug.</p> <p><strong>3. Try out some yoga moves</strong></p> <p><strong><img src="https://oversixtydev.blob.core.windows.net/media/2024/04/3-yoga-GettyImages-1051753046-770.jpg" alt="" width="1280" height="720" /></strong></p> <p>Anyone can do yoga, trust us! “Yoga is a moving meditation as you are encouraged to be mindful of each part of your body in every pose and how you are moving from pose to pose,” says Weible. In yoga, you are forced to focus on your breathing and muscle control, which makes you totally present in the moment – a key to good meditation.</p> <p><em>Ensure you have the yoga mat best suited to your needs, <a href="http://gaiam.innovations.com.au/p/gaiam-yoga/mats?affiliate=GAIAM60" target="_blank" rel="noopener">starting with this extensive range from Gaiam</a>.</em></p> <p><strong>4. Really wake up in the morning</strong></p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2024/04/4-waking-up-stretch-GettyImages-552008811-770.jpg" alt="" width="1280" height="720" /></p> <p>Sure, we all wake up in the morning, but before you hop out of bed for that shower or cup of coffee, Scott Rogers, principal advisor at Innergy Meditation, suggests you really wake before getting out of bed, which means sitting up and taking in your surroundings. “Notice the lighting, the temperature, how you feel,” says Rogers, “Close or lower your eyes for a few breaths – for a few minutes – and rest your attention on the sensations of your body breathing.”</p> <p><strong>5. Whenever you walk through a door, take a deep breath</strong></p> <p><strong><img src="https://oversixtydev.blob.core.windows.net/media/2024/04/5-walking-through-a-door-GettyImages-1063759498-770.jpg" alt="" width="1280" height="720" /></strong></p> <p>Another way to bring focus and calm is to take a deep breath every time you walk through a doorway. This forces you to look around, see where you are, and again bring focus into your daily life. “Such moments insert an important wedge of awareness that helps reduce stress and steady the mind,” says Rogers.</p> <p><strong>6. Use Post-It notes</strong></p> <p><strong><img src="https://oversixtydev.blob.core.windows.net/media/2024/04/6-post-it-note-GettyImages-85007668-770.jpg" alt="" width="1280" height="720" /></strong></p> <p>There is no wrong way or right way to meditate. A super-easy way is using Post-It notes. suggests Jackie Itzkowitz and Joel Granik, co-founders of Floating Lotus. “Put a Post-It note on your mirror in your bathroom to remind yourself to think about something you are grateful for,” explain Itzkowitz and Granik. “The fact you can walk, the exciting day you have ahead of you, or even the fact you are alive and well. Taking a moment to be mindful and aware of yourself and the things around you counts as meditating.”</p> <p><strong>7. Check your breathing</strong></p> <p><strong><img src="https://oversixtydev.blob.core.windows.net/media/2024/04/7-breathing-exercise-GettyImages-1143696586-770.jpg" alt="" width="1280" height="720" /></strong></p> <p>This is a really easy one. “Take a moment to sit up tall with both feet on the floor, hands in your lap. You can close the eyes or leave them open,” suggests Weible. “Take a deep breath in through your nose counting to three, then let it out through your nose counting to three. Take another breath in counting to four, let it out counting to four. Repeat this pattern using a five-count. You can take as many breaths as you like, but three mindful breaths can go a long way towards making you feel less stressed and more at ease.”</p> <p>Add the healing benefits of aromatherapy to your breathing exercises <a href="https://gaiam.innovations.com.au/p/gaiam-wellness/relax/27-73273-gaiam-wellness-usb-mini-diffuser?affiliate=GAIAM60" target="_blank" rel="noopener">with the help of a Gaiam Wellness Mini Diffuser</a>.</p> <p><strong>8. Practise mindfulness</strong></p> <p><strong><img src="https://oversixtydev.blob.core.windows.net/media/2024/04/8-smelling-flowers-roses-GettyImages-455252101-770.jpg" alt="" width="1280" height="720" /></strong></p> <p>This another meditation practice you can try anywhere. “Mindfulness meditation involves paying attention to our present moment experience and there is no time when we cannot be practising,” says Rogers. “But, we tend to forget or feel too busy to do so” So literally, slow down and smell the roses.</p> <p><strong>9. Try switching hands</strong></p> <p><strong><img src="https://oversixtydev.blob.core.windows.net/media/2024/04/9-yoghurt-spoon-GettyImages-1226825261-770.jpg" alt="" width="1280" height="720" /></strong></p> <p>Most people have one dominant hand so Rogers suggests switching it up. “When you are ready to eat, place your fork or spoon in your non-dominant hand for your first bite,” he says, “This will slow down the process and engage attention. As you take your first bite, notice the sensory richness of sight, smell and touch.”</p> <p><strong>10. Forget about worrying</strong></p> <p><strong><img src="https://oversixtydev.blob.core.windows.net/media/2024/04/10-meditation-GettyImages-1157178955-770.jpg" alt="" width="1280" height="720" /></strong></p> <p>This one is easier said than done but Itzkowitz and Granik say worrying is the one thing that can bring your meditating down. “Actually worrying about doing meditation wrong is the only thing you can do wrong,” they advise. “Be compassionate with yourself and let yourself relax.”</p> <p style="box-sizing: border-box; margin-top: 0px; margin-bottom: 1rem; background-color: #ffffff;"><span style="box-sizing: border-box;"><span style="color: #212529; font-family: -apple-system, system-ui, Segoe UI, Roboto, Helvetica Neue, Arial, sans-serif, Apple Color Emoji, Segoe UI Emoji, Segoe UI Symbol, Noto Color Emoji;"><span style="font-weight: bolder;">This article, written by </span><strong>Felissa Benjamin Allard</strong><span style="font-weight: bolder;">, originally appeared on</span></span></span><span style="color: #212529; font-family: -apple-system, 'system-ui', 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px; box-sizing: border-box; font-weight: bolder;"> <a style="box-sizing: border-box; color: #258440; text-decoration-line: none; background-color: transparent; transition: all 0.2s ease-in-out 0s;" href="https://www.readersdigest.com.au/healthsmart/conditions/mental-health/10-ways-to-sneak-in-meditation-into-your-everyday-life" target="_blank" rel="noopener">Reader's Digest</a>.</span></p> <p style="box-sizing: border-box; margin-top: 0px; margin-bottom: 0px; color: #212529; font-family: -apple-system, 'system-ui', 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px; background-color: #ffffff;"><em style="box-sizing: border-box;">Images: Shutterstock | Getty</em></p>

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How much stress is too much? A psychiatrist explains the links between toxic stress and poor health − and how to get help

<p><a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655">La<em>wson R. Wulsin</em></a><em>, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati </a></em></p> <p>COVID-19 taught most people that the line between tolerable and toxic stress – defined as persistent demands that lead to disease – varies widely. But some people will age faster and die younger from toxic stressors than others.</p> <p>So how much stress is too much, and what can you do about it?</p> <p>I’m a <a href="https://researchdirectory.uc.edu/p/wulsinlr">psychiatrist specializing in psychosomatic medicine</a>, which is the study and treatment of people who have physical and mental illnesses. My research is focused on people who have psychological conditions and medical illnesses as well as those whose stress exacerbates their health issues.</p> <p>I’ve spent my career studying mind-body questions and training physicians to treat mental illness in primary care settings. My <a href="https://www.cambridge.org/core/books/toxic-stress/677FA62B741540DBDB53E2F0A52A74B1">forthcoming book</a> is titled “Toxic Stress: How Stress is Killing Us and What We Can Do About It.”</p> <p>A 2023 study of stress and aging over the life span – one of the first studies to confirm this piece of common wisdom – found that four measures of stress all speed up the pace of biological aging in midlife. It also found that persistent high stress ages people in a comparable way to the <a href="https://doi.org/10.1097/PSY.0000000000001197">effects of smoking and low socioeconomic status</a>, two well-established risk factors for accelerated aging.</p> <figure><iframe src="https://www.youtube.com/embed/yiglpsqv5ik?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Children with alcoholic or drug-addicted parents have a greater risk of developing toxic stress.</span></figcaption></figure> <h2>The difference between good stress and the toxic kind</h2> <p>Good stress – a demand or challenge you readily cope with – is good for your health. In fact, the rhythm of these daily challenges, including feeding yourself, cleaning up messes, communicating with one another and carrying out your job, helps to regulate your stress response system and keep you fit.</p> <p>Toxic stress, on the other hand, wears down your stress response system in ways that have lasting effects, as psychiatrist and trauma expert Bessel van der Kolk explains in his bestselling book “<a href="https://www.penguinrandomhouse.com/books/313183/the-body-%20keeps-the-score-by-bessel-van-der-kolk-md/">The Body Keeps the Score</a>.”</p> <p>The earliest effects of toxic stress are often persistent symptoms such as headache, fatigue or abdominal pain that interfere with overall functioning. After months of initial symptoms, a full-blown illness with a life of its own – such as migraine headaches, asthma, diabetes or ulcerative colitis – may surface.</p> <p>When we are healthy, our stress response systems are like an orchestra of organs that miraculously tune themselves and play in unison without our conscious effort – a process called self-regulation. But when we are sick, some parts of this orchestra struggle to regulate themselves, which causes a cascade of stress-related dysregulation that contributes to other conditions.</p> <p>For instance, in the case of diabetes, the hormonal system struggles to regulate sugar. With obesity, the metabolic system has a difficult time regulating energy intake and consumption. With depression, the central nervous system develops an imbalance in its circuits and neurotransmitters that makes it difficult to regulate mood, thoughts and behaviors.</p> <h2>‘Treating’ stress</h2> <p>Though stress neuroscience in recent years has given researchers like me <a href="https://doi.org/10.1097/PSY.0000000000001051">new ways to measure and understand stress</a>, you may have noticed that in your doctor’s office, the management of stress isn’t typically part of your treatment plan.</p> <p>Most doctors don’t assess the contribution of stress to a patient’s common chronic diseases such as diabetes, heart disease and obesity, partly because stress is complicated to measure and partly because it is difficult to treat. In general, doctors don’t treat what they can’t measure.</p> <p>Stress neuroscience and epidemiology have also taught researchers recently that the chances of developing serious mental and physical illnesses in midlife rise dramatically when people are exposed to trauma or adverse events, especially during <a href="https://www.cdc.gov/violenceprevention/aces/ace-brfss.html">vulnerable periods such as childhood</a>.</p> <p>Over the past 40 years in the U.S., the alarming rise in <a href="https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html">rates of diabetes</a>, <a href="https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/overweight-obesity-child-H.pdf">obesity</a>, depression, PTSD, <a href="https://www.cdc.gov/nchs/products/databriefs/db433.htm">suicide</a> and addictions points to one contributing factor that these different illnesses share: toxic stress.</p> <p>Toxic stress increases the risk for the onset, progression, complications or early death from these illnesses.</p> <h2>Suffering from toxic stress</h2> <p>Because the definition of toxic stress varies from one person to another, it’s hard to know how many people struggle with it. One starting point is the fact that about 16% of adults report having been exposed to <a href="https://www.cdc.gov/violenceprevention/aces/fastfact.html">four or more adverse events in childhood</a>. This is the threshold for higher risk for illnesses in adulthood.</p> <p>Research dating back to before the COVID-19 pandemic also shows that about 19% of adults in the U.S. have <a href="https://doi.org/10.7249/TL221">four or more chronic illnesses</a>. If you have even one chronic illness, you can imagine how stressful four must be.</p> <p>And about 12% of the U.S. population <a href="https://blogs.worldbank.org/opendata/introducing-second-edition-world-banks-global-subnational-atlas-poverty">lives in poverty</a>, the epitome of a life in which demands exceed resources every day. For instance, if a person doesn’t know how they will get to work each day, or doesn’t have a way to fix a leaking water pipe or resolve a conflict with their partner, their stress response system can never rest. One or any combination of threats may keep them on high alert or shut them down in a way that prevents them from trying to cope at all.</p> <p>Add to these overlapping groups all those who struggle with harassing relationships, homelessness, captivity, severe loneliness, living in high-crime neighborhoods or working in or around noise or air pollution. It seems conservative to estimate that about 20% of people in the U.S. live with the effects of toxic stress.</p> <figure><iframe src="https://www.youtube.com/embed/WuyPuH9ojCE?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Exercise, meditation and a healthy diet help fight toxic stress.</span></figcaption></figure> <h2>Recognizing and managing stress and its associated conditions</h2> <p>The first step to managing stress is to recognize it and talk to your primary care clinician about it. The clinician may do an assessment involving a <a href="https://doi.org/10.1097/PSY.0000000000001051">self-reported measure of stress</a>.</p> <p>The next step is treatment. Research shows that it is possible to retrain a dysregulated stress response system. This approach, <a href="https://lifestylemedicine.org/">called “lifestyle medicine</a>,” focuses on improving health outcomes through changing high-risk health behaviors and adopting daily habits that help the stress response system self-regulate.</p> <p>Adopting these lifestyle changes is not quick or easy, but it works.</p> <p>The <a href="https://www.cdc.gov/diabetes/prevention/index.html">National Diabetes Prevention Program</a>, the <a href="https://www.ornish.com/">Ornish “UnDo” heart disease program</a> and the <a href="https://www.ptsd.va.gov/understand_tx/tx_basics.asp">U.S. Department of Veterans Affairs PTSD program</a>, for example, all achieve a slowing or reversal of stress-related chronic conditions through weekly support groups and guided daily practice over six to nine months. These programs help teach people how to practice personal regimens of stress management, diet and exercise in ways that build and sustain their new habits.</p> <p>There is now strong evidence that it is possible to treat toxic stress in ways that improve health outcomes for people with stress-related conditions. The next steps include finding ways to expand the recognition of toxic stress and, for those affected, to expand access to these new and effective approaches to treatment.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222245/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655"><em>Lawson R. Wulsin</em></a><em>, Professor of Psychiatry and Family Medicine, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-stress-is-too-much-a-psychiatrist-explains-the-links-between-toxic-stress-and-poor-health-and-how-to-get-help-222245">original article</a>.</em></p>

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What’s the difference between autism and Asperger’s disorder?

<p><em><a href="https://theconversation.com/profiles/andrew-cashin-458270">Andrew Cashin</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>Swedish climate activist Greta Thunberg describes herself as having <a href="https://www.theguardian.com/environment/2019/sep/02/greta-thunberg-responds-to-aspergers-critics-its-a-superpower">Asperger’s</a> while others on the autism spectrum, such as Australian comedian Hannah Gatsby, <a href="https://www.theguardian.com/stage/2022/mar/19/hannah-gadsby-autism-diagnosis-little-out-of-whack">describe</a> themselves as “autistic”. But what’s the difference?</p> <p>Today, the previous diagnoses of “Asperger’s disorder” and “autistic disorder” both fall within the diagnosis of autism spectrum disorder, or ASD.</p> <p>Autism describes a “neurotype” – a person’s thinking and information-processing style. Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.</p> <p>When these challenges become overwhelming and impact how a person learns, plays, works or socialises, a diagnosis of <a href="https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder">autism spectrum disorder</a> is made.</p> <h2>Where do the definitions come from?</h2> <p>The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria clinicians use to diagnose mental illnesses and behavioural disorders.</p> <p>Between 1994 and 2013, autistic disorder and Asperger’s disorder were the two primary diagnoses related to autism in the fourth edition of the manual, the DSM-4.</p> <p>In 2013, the DSM-5 collapsed both diagnoses into one <a href="https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596">autism spectrum disorder</a>.</p> <h2>How did we used to think about autism?</h2> <p>The two thinkers behind the DSM-4 diagnostic categories were Baltimore psychiatrist Leo Kanner and Viennese paediatrician Hans Asperger. They described the challenges faced by people who were later diagnosed with autistic disorder and Asperger’s disorder.</p> <p>Kanner and Asperger observed patterns of behaviour that differed to typical thinkers in the domains of communication, social interaction and flexibility of behaviour and thinking. The variance was associated with challenges in adaptation and distress.</p> <p>Between the 1940s and 1994, the majority of those diagnosed with autism also had an intellectual disability. Clinicians became focused on the accompanying intellectual disability as a necessary part of autism.</p> <p>The introduction of Asperger’s disorder shifted this focus and acknowledged the diversity in autism. In the DSM-4 it superficially looked like autistic disorder and Asperger’s disorder were different things, with the Asperger’s criteria stating there could be no intellectual disability or delay in the development of speech.</p> <p>Today, as a legacy of the recognition of the autism itself, the <a href="https://www.aihw.gov.au/reports/disability/autism-in-australia/contents/autism">majority of people</a> diagnosed with autism spectrum disorder – the new term from the DSM-5 – don’t a have an accompanying intellectual disability.</p> <h2>What changed with ‘autism spectrum disorder’?</h2> <p>The move to autism spectrum disorder brought the previously diagnosed autistic disorder and Asperger’s disorder under the one new diagnostic umbrella term.</p> <p>It made clear that other diagnostic groups – such as intellectual disability – can co-exist with autism, but are separate things.</p> <p>The other major change was acknowledging communication and social skills are intimately linked and not separable. Rather than separating “impaired communication” and “impaired social skills”, the diagnostic criteria changed to “impaired social communication”.</p> <p>The introduction of the spectrum in the diagnostic term further clarified that people have varied capabilities in the flexibility of their thinking, behaviour and social communication – and this can change in response to the context the person is in.</p> <h2>Why do some people prefer the old terminology?</h2> <p>Some people feel the clinical label of Asperger’s allowed a much more refined understanding of autism. This included recognising the achievements and great societal contributions of people with known or presumed autism.</p> <p>The contraction “Aspie” played an enormous part in the shift to positive identity formation. In the time up to the release of the DSM-5, <a href="https://xminds.org/resources/Documents/Web%20files/Aspie%20Criteria%20by%20Attwood.pdf">Tony Attwood and Carol Gray</a>, two well known thinkers in the area of autism, highlighted the strengths associated with “being Aspie” as something to be proud of. But they also raised awareness of the challenges.</p> <h2>What about identity-based language?</h2> <p>A more recent shift in language has been the reclamation of what was once viewed as a slur – “autistic”. This was a shift from person-first language to identity-based language, from “person with autism spectrum disorder” to “autistic”.</p> <p>The neurodiversity rights movement describes its aim to <a href="https://researchonline.jcu.edu.au/71531/1/JCU_71531_AAM.pdf">push back</a> against a breach of human rights resulting from the wish to cure, or fundamentally change, people with autism.</p> <p>The movement uses a “social model of disability”. This views disability as arising from societies’ response to individuals and the failure to adjust to enable full participation. The inherent challenges in autism are seen as only a problem if not accommodated through reasonable adjustments.</p> <p>However the social model contrasts itself against a very outdated medical or clinical model.</p> <p>Current clinical thinking and practice focuses on <a href="https://www.collegianjournal.com/article/S1322-7696(22)00122-6/fulltext">targeted</a> supports to reduce distress, promote thriving and enable optimum individual participation in school, work, community and social activities. It doesn’t aim to cure or fundamentally change people with autism.</p> <p>A diagnosis of autism spectrum disorder signals there are challenges beyond what will be solved by adjustments alone; individual supports are also needed. So it’s important to combine the best of the social model and contemporary clinical model.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223643/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/andrew-cashin-458270">Andrew Cashin</a>, Professor of Nursing, School of Health and Human Sciences, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-autism-and-aspergers-disorder-223643">original article</a>.</em></p>

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Why we need to stop being so judgemental – and the 4 steps to do it

<p>As a society, we've become increasingly judgmental. We tend to judge not only others but ourselves as well. From a person's physical appearance to their actions, we criticise and judge everything. Everyone is too fat, too thin, too old, or too young, creating an environment where nothing seems to be good enough. This constant pattern of judgment is now harming our mental, emotional, and physical well-being.</p> <p>When we judge, we compare ourselves to others, leaving us emotionally vulnerable. Through this judgement, we seek to establish a sense of security and control over our lives and surroundings, often without even realising it. However, by increasing our emotional resilience and sense of control, we become consciously aware of this behaviour and can take steps to change it. So, is it possible to become less judgemental? </p> <p>As an educator and researcher, I developed an Emotional Resilience language (ER). It introduces simple changes that can reduce judgment, foster empathy, compassion, and personal responsibility, and bolster emotional intelligence and resilience when integrated into everyday life. Using a driving metaphor, ER simplifies the intricate world of emotions, providing an innovative way to integrate emotional vocabulary into daily life. It enhances understanding and establishes new neural pathways and healthier thought patterns.</p> <p>The following outlines the initial steps of ER, which can effectively manage judgement towards yourself and others. Though the changes may appear simplistic, they are instrumental in establishing lasting transformation.</p> <p><strong>1. Removing judgement towards how you or others may feel:</strong> Instead of labelling emotions as good or bad, view them as rough or smooth emotional roads. Just as roads serve different purposes, so do emotions. Rough emotions build resilience, while smooth emotions promote well-being, removing the need to lift everyone off a rough road. This makes it easier to recognise and accept emotions without feeling like a failure when things aren't going smoothly. You don’t know why someone is on a rough road, so resist the temptation to judge them.</p> <p><strong>2: The metaphorical steering wheel</strong> in ER represents emotional control and the power of choice in navigating life's challenges. As in a car, you should be the only one controlling your emotional steering wheel. Rather than judging yourself and others, this logical approach empowers you to regain control over your focus, emotions, and destination. Just because someone else is on a rough road doesn’t mean you must join them, fostering resilience and responsibility. </p> <p><strong>3. Shifting judgement and blame to responsibility</strong> involves removing phrases such as "You are making me angry, " which inadvertently hands your emotional steering wheel to others. Replace it with, "I am choosing to feel angry in response to this situation." This subtle alteration, substituting "making" with "choosing," helps reclaim ownership of your steering wheel rather than relinquishing control to external factors. Assigning blame—"It's your fault, it's the government's fault, it's my partner’s fault"— leaves you feeling like a victim, and you then resort to judgement and retaliation to regain control. </p> <p><strong>4. The importance of taking control:</strong> Understanding that judgement cannot be contained nor emotional resilience built when you are out of control on either road is crucial. Out-of-control scenarios activate the amygdala, the brain's fight, flight or freeze mode, disabling the prefrontal cortex, which is responsible for thinking and creativity. It is only possible to discuss a situation once the involved parties have regained control and can access the thinking part of their brain. Therefore, regaining control is essential for reducing judgement, as then you can have productive discussions that help maintain emotional well-being. This includes your conversations with yourself, which can often be the harshest!</p> <p>ER helps reduce judgement by developing your emotional resilience. Awareness of the emotional state of yourself and others fosters emotional intelligence, while learning to regain control builds resilience. Recognising that navigating rough emotions is crucial for growth alleviates the pressure from always needing to be on a smooth road and judging yourself and others if they aren’t. It shifts focus from dwelling on challenges and comparing yourself to others to being able to understand and manage your responses. Incorporating language changes into daily life builds new neural pathways, creating new thought patterns that reduce judgment and blame. </p> <p>By avoiding the tendency to judge yourself or others, you take back control of your reactions to people and circumstances. This leads to better mental and emotional well-being and fosters positive relationships with yourself and others. Does this mean you will never judge again? Of course not. You’re human. It’s what you do with the judgment that can make all the difference. </p> <p><strong>Dr Jane Foster is a leading educator, researcher, presenter and author of <em>It’s In Your Hands; Your Steering Wheel, Your Choice</em>. Combining her educational skills with neuroscience and positive psychology, Jane equips people with strategies to help build emotional resilience and manage their daily stresses, successfully changing perspective and creating new neural pathways. For more information, visit <a href="https://www.emotionalresiliencetraining.com.au/" target="_blank" rel="noopener">www.emotionalresiliencetraining.com.au</a></strong></p> <p><em>Image: Getty</em></p>

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How can I stop overthinking everything? A clinical psychologist offers solutions

<p><em><a href="https://theconversation.com/profiles/kirsty-ross-1513078">Kirsty Ross</a>, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a></em></p> <p>As a clinical psychologist, I often have clients say they are having trouble with thoughts “on a loop” in their head, which they find difficult to manage.</p> <p>While rumination and overthinking are often considered the same thing, they are slightly different (though linked). <a href="https://www.apa.org/monitor/nov05/cycle">Rumination</a> is having thoughts on repeat in our minds. This can lead to overthinking – analysing those thoughts without finding solutions or solving the problem.</p> <p>It’s like a vinyl record playing the same part of the song over and over. With a record, this is usually because of a scratch. Why we overthink is a little more complicated.</p> <h2>We’re on the lookout for threats</h2> <p>Our brains are hardwired to look for threats, to make a plan to address those threats and keep us safe. Those perceived threats may be based on past experiences, or may be the “what ifs” we imagine could happen in the future.</p> <p>Our “what ifs” are usually negative outcomes. These are what we call “<a href="https://ccbhc.org/hot-thoughts-what-are-they-and-how-can-you-handle-them/">hot thoughts</a>” – they bring up a lot of emotion (particularly sadness, worry or anger), which means we can easily get stuck on those thoughts and keep going over them.</p> <p>However, because they are about things that have either already happened or might happen in the future (but are not happening now), we cannot fix the problem, so we keep going over the same thoughts.</p> <h2>Who overthinks?</h2> <p>Most people find themselves in situations at one time or another when they overthink.</p> <p>Some people are <a href="https://www.apa.org/monitor/nov05/cycle">more likely</a> to ruminate. People who have had prior challenges or experienced trauma may have come to expect threats and look for them more than people who have not had adversities.</p> <p>Deep thinkers, people who are prone to anxiety or low mood, and those who are sensitive or feel emotions deeply are also more likely to ruminate and overthink.</p> <p>Also, when we are stressed, our emotions tend to be stronger and last longer, and our thoughts can be less accurate, which means we can get stuck on thoughts more than we would usually.</p> <p>Being run down or physically unwell can also mean our thoughts are <a href="https://healthify.nz/hauora-wellbeing/m/mental-health-and-your-body/">harder to tackle</a> and manage.</p> <h2>Acknowledge your feelings</h2> <p>When thoughts go on repeat, it is helpful to use both emotion-focused and problem-focused <a href="https://link.springer.com/referencework/10.1007/978-1-4419-1005-9">strategies</a>.</p> <p>Being emotion-focused means figuring out how we feel about something and addressing those feelings. For example, we might feel regret, anger or sadness about something that has happened, or worry about something that might happen.</p> <p>Acknowledging those emotions, using self-care techniques and accessing social support to talk about and manage your feelings will be helpful.</p> <p>The second part is being problem-focused. Looking at what you would do differently (if the thoughts are about something from your past) and making a plan for dealing with future possibilities your thoughts are raising.</p> <p>But it is difficult to plan for all eventualities, so this strategy has limited usefulness.</p> <p>What is more helpful is to make a plan for one or two of the more likely possibilities and accept there may be things that happen you haven’t thought of.</p> <h2>Think about why these thoughts are showing up</h2> <p>Our feelings and experiences are information; it is important to ask what this information is telling you and why these thoughts are showing up now.</p> <p>For example, university has just started again. Parents of high school leavers might be lying awake at night (which is when rumination and overthinking is common) worrying about their young person.</p> <p>Knowing how you would respond to some more likely possibilities (such as they will need money, they might be lonely or homesick) might be helpful.</p> <p>But overthinking is also a sign of a new stage in both your lives, and needing to accept less control over your child’s choices and lives, while wanting the best for them. Recognising this means you can also talk about those feelings with others.</p> <h2>Let the thoughts go</h2> <p>A useful way to manage rumination or overthinking is “<a href="https://www.getselfhelp.co.uk/docs/Options.pdf">change, accept, and let go</a>”.</p> <p>Challenge and change aspects of your thoughts where you can. For example, the chance that your young person will run out of money and have no food and starve (overthinking tends to lead to your brain coming up with catastrophic outcomes!) is not likely.</p> <p>You could plan to check in with your child regularly about how they are coping financially and encourage them to access budgeting support from university services.</p> <p>Your thoughts are just ideas. They are not necessarily true or accurate, but when we overthink and have them on repeat, they can start to feel true because they become familiar. Coming up with a more realistic thought can help stop the loop of the unhelpful thought.</p> <p>Accepting your emotions and finding ways to manage those (good self-care, social support, communication with those close to you) will also be helpful. As will accepting that life inevitably involves a lack of complete control over outcomes and possibilities life may throw at us. What we do have control over is our reactions and behaviours.</p> <p>Remember, you have a 100% success rate of getting through challenges up until this point. You might have wanted to do things differently (and can plan to do that) but nevertheless, you coped and got through.</p> <p>So, the last part is letting go of the need to know exactly how things will turn out, and believing in your ability (and sometimes others’) to cope.</p> <h2>What else can you do?</h2> <p>A stressed out and tired brain will be <a href="https://mentalhealth.org.nz/resources/resource/stress-and-how-to-manage-it">more likely</a> to overthink, leading to more stress and creating a cycle that can affect your wellbeing.</p> <p>So it’s important to manage your stress levels by eating and sleeping well, moving your body, doing things you enjoy, seeing people you care about, and doing things that fuel your soul and spirit.</p> <p>Distraction – with pleasurable activities and people who bring you joy – can also get your thoughts off repeat.</p> <p>If you do find overthinking is affecting your life, and your levels of anxiety are rising or your mood is dropping (your sleep, appetite and enjoyment of life and people is being negatively affected), it might be time to talk to someone and get some strategies to manage.</p> <p>When things become too difficult to manage yourself (or with the help of those close to you), a therapist can provide tools that have been proven to be helpful. Some helpful tools to manage worry and your thoughts can also be found <a href="https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Anxiety">here</a>.</p> <p>When you find yourself overthinking, think about why you are having “hot thoughts”, acknowledge your feelings and do some future-focused problem solving. But also accept life can be unpredictable and focus on having faith in your ability to cope. <!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223973/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/kirsty-ross-1513078"><em>Kirsty Ross</em></a><em>, Associate Professor and Senior Clinical Psychologist, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-stop-overthinking-everything-a-clinical-psychologist-offers-solutions-223973">original article</a>.</em></p>

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War in Ukraine affected wellbeing worldwide, but people’s speed of recovery depended on their personality

<p><em><a href="https://theconversation.com/profiles/luke-smillie-7502">Luke Smillie</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>The war in Ukraine has had impacts around the world. <a href="https://mitsloan.mit.edu/ideas-made-to-matter/ripple-effects-russia-ukraine-war-test-global-economies">Supply chains</a> have been disrupted, the <a href="https://news.un.org/pages/wp-content/uploads/2022/06/GCRG_2nd-Brief_Jun8_2022_FINAL.pdf?utm_source=United+Nations&amp;utm_medium=Brief&amp;utm_campaign=Global+Crisis+Response">cost of living</a> has soared and we’ve seen the <a href="https://www.unhcr.org/hk/en/73141-ukraine-fastest-growing-refugee-crisis-in-europe-since-wwii.html">fastest-growing refugee crisis since World War II</a>. All of these are in addition to the devastating humanitarian and economic impacts within Ukraine.</p> <p>Our international team was conducting a global study on wellbeing in the lead up to and after the Russian invasion. This provided a unique opportunity to examine the psychological impact of the outbreak of war.</p> <p>As we explain in a new study published in <a href="https://www.nature.com/articles/s41467-024-44693-6">Nature Communications</a>, we learned the toll on people’s wellbeing was evident across nations, not just <a href="https://ijmhs.biomedcentral.com/articles/10.1186/s13033-023-00598-3">in Ukraine</a>. These effects appear to have been temporary – at least for the average person.</p> <p>But people with certain psychological vulnerabilities struggled to recover from the shock of the war.</p> <h2>Tracking wellbeing during the outbreak of war</h2> <p>People who took part in our study completed a rigorous “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2773515/">experience-sampling</a>” protocol. Specifically, we asked them to report their momentary wellbeing four times per day for a whole month.</p> <p>Data collection began in October 2021 and continued throughout 2022. So we had been tracking wellbeing around the world during the weeks surrounding the outbreak of war in February 2022.</p> <p>We also collected measures of personality, along with various sociodemographic variables (including age, gender, political views). This enabled us to assess whether different people responded differently to the crisis. We could also compare these effects across countries.</p> <p>Our analyses focused primarily on 1,341 participants living in 17 European countries, excluding Ukraine itself (44,894 experience-sampling reports in total). We also expanded these analyses to capture the experiences of 1,735 people living in 43 countries around the world (54,851 experience-sampling reports) – including in Australia.</p> <h2>A global dip in wellbeing</h2> <p>On February 24 2022, the day Russia invaded Ukraine, there was a sharp decline in wellbeing around the world. There was no decline in the month leading up to the outbreak of war, suggesting the change in wellbeing was not already occurring for some other reason.</p> <p>However, there was a gradual increase in wellbeing during the month <em>after</em> the Russian invasion, suggestive of a “return to baseline” effect. Such effects are commonly reported in psychological research: situations and events that impact our wellbeing often (<a href="https://www.researchgate.net/publication/237535630_Adaptation_and_the_Set-Point_Model_of_Subjective_Well-BeingDoes_Happiness_Change_After_Major_Life_Events">though not always</a>) do so <a href="https://www.researchgate.net/publication/7062343_Beyond_the_Hedonic_Treadmill_Revising_the_Adaptation_Theory_of_Well-Being">temporarily</a>.</p> <p>Unsurprisingly, people in Europe experienced a sharper dip in wellbeing compared to people living elsewhere around the world. Presumably the war was much more salient for those closest to the conflict, compared to those living on an entirely different continent.</p> <p>Interestingly, day-to-day fluctuations in wellbeing mirrored the salience of the war on social media as events unfolded. Specifically, wellbeing was lower on days when there were more tweets mentioning Ukraine on Twitter/X.</p> <p>Our results indicate that, on average, it took around two months for people to return to their baseline levels of wellbeing after the invasion.</p> <h2>Different people, different recoveries</h2> <p>There are <a href="https://pubmed.ncbi.nlm.nih.gov/31944795/">strong links</a> between our wellbeing and our individual personalities.</p> <p>However, the dip in wellbeing following the Russian invasion was fairly uniform across individuals. None of the individual factors assessed in our study, including personality and sociodemographic factors, predicted people’s response to the outbreak of war.</p> <p>On the other hand, personality did play a role in how quickly people recovered. Individual differences in people’s recovery were linked to a personality trait called “stability”. Stability is a broad dimension of personality that combines low neuroticism with high agreeableness and conscientiousness (three traits from the <a href="https://www.sciencedirect.com/topics/social-sciences/big-five">Big Five</a> personality framework).</p> <p>Stability is so named because it reflects the stability of one’s overall psychological functioning. This can be illustrated by breaking stability down into its three components:</p> <ol> <li> <p>low neuroticism describes <a href="https://www.pnas.org/doi/full/10.1073/pnas.2212154120">emotional stability</a>. People low in this trait experience less intense negative emotions such as anxiety, fear or anger, in response to negative events</p> </li> <li> <p>high agreeableness describes <a href="https://psycnet.apa.org/record/2018-63285-010">social stability</a>. People high in this trait are generally more cooperative, kind, and motivated to maintain social harmony</p> </li> <li> <p>high conscientiousness describes <a href="https://doi.org/10.1016/j.paid.2023.112331">motivational stability</a>. People high in this trait show more effective patterns of goal-directed self-regulation.</p> </li> </ol> <p>So, our data show that people with less stable personalities fared worse in terms of recovering from the impact the war in Ukraine had on wellbeing.</p> <p>In a supplementary analysis, we found the effect of stability was driven specifically by neuroticism and agreeableness. The fact that people higher in neuroticism recovered more slowly accords with a wealth of research linking this trait with <a href="https://pubmed.ncbi.nlm.nih.gov/10573882/">coping difficulties</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5428182/">poor mental health</a>.</p> <p>These effects of personality on recovery were stronger than those of sociodemographic factors, such as age, gender or political views, which were not statistically significant.</p> <p>Overall, our findings suggest that people with certain psychological vulnerabilities will often struggle to recover from the shock of global events such as the outbreak of war in Ukraine.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224147/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/luke-smillie-7502">Luke Smillie</a>, Professor in Personality Psychology, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/war-in-ukraine-affected-wellbeing-worldwide-but-peoples-speed-of-recovery-depended-on-their-personality-224147">original article</a>.</em></p>

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Mothers’ dieting habits and self-talk have profound impact on daughters − 2 psychologists explain how to cultivate healthy behaviors and body image

<p><em><a href="https://theconversation.com/profiles/janet-j-boseovski-451496">Janet J. Boseovski</a>, <a href="https://theconversation.com/institutions/university-of-north-carolina-greensboro-2069">University of North Carolina – Greensboro</a> and <a href="https://theconversation.com/profiles/ashleigh-gallagher-1505989">Ashleigh Gallagher</a>, <a href="https://theconversation.com/institutions/university-of-north-carolina-greensboro-2069">University of North Carolina – Greensboro</a></em></p> <p>Weight loss is one of the most common health and appearance-related goals.</p> <p>Women and <a href="https://www.cdc.gov/nchs/products/databriefs/db340.htm">teen girls</a> are <a href="https://www.cdc.gov/nchs/products/databriefs/db313.htm">especially likely to pursue dieting</a> to achieve weight loss goals even though a great deal of research shows that <a href="https://theconversation.com/what-thin-people-dont-understand-about-dieting-86604">dieting doesn’t work over the long term</a>.</p> <p>We are a <a href="https://www.duck-lab.com/people">developmental psychologist</a> and a <a href="https://psy.uncg.edu/directory/ashleigh-gallagher/">social psychologist</a> who together wrote a forthcoming book, “Beyond Body Positive: A Mother’s Evidence-Based Guide for Helping Girls Build a Healthy Body Image.”</p> <p>In the book, we address topics such as the effects of maternal dieting behaviors on daughters’ health and well-being. We provide information on how to build a foundation for healthy body image beginning in girlhood.</p> <h2>Culturally defined body ideals</h2> <p>Given the strong influence of social media and other cultural influences on body ideals, it’s understandable that so many people pursue diets aimed at weight loss. <a href="https://communityhealth.mayoclinic.org/featured-stories/tiktok-diets">TikTok</a>, YouTube, Instagram and celebrity websites feature slim influencers and “how-tos” for achieving those same results in no time.</p> <p>For example, women and teens are engaging in rigid and extreme forms of exercise such as 54D, a program to <a href="https://54d.com/">achieve body transformation in 54 days</a>, or the <a href="https://health.clevelandclinic.org/75-hard-challenge-and-rules">75 Hard Challenge</a>, which is to follow five strict rules for 75 days.</p> <p>For teens, these pursuits are likely fueled by trendy body preoccupations such as the desire for “<a href="https://www.nytimes.com/2024/02/06/well/move/tiktok-legging-legs-eating-disorders.html">legging legs</a>.”</p> <p>Women and teens have also been been inundated with recent messaging around <a href="https://theconversation.com/drugs-that-melt-away-pounds-still-present-more-questions-than-answers-but-ozempic-wegovy-and-mounjaro-could-be-key-tools-in-reducing-the-obesity-epidemic-205549">quick-fix weight loss drugs</a>, which come with a lot of caveats.</p> <p>Dieting and weight loss goals are highly individual, and when people are intensely self-focused, it is <a href="https://doi.org/10.1521/jscp.2000.19.1.70">possible to lose sight of the bigger picture</a>. Although women might wonder what the harm is in trying the latest diet, science shows that dieting behavior doesn’t just affect the dieter. In particular, for women who are mothers or who have other girls in their lives, these behaviors affect girls’ emerging body image and their health and well-being.</p> <h2>The profound effect of maternal role models</h2> <p>Research shows that mothers and maternal figures <a href="https://doi.org/10.1016/j.brat.2017.11.001">have a profound influence on their daughters’ body image</a>.</p> <p>The opportunity to influence girls’ body image comes far earlier than adolescence. In fact, research shows that these influences on body image <a href="https://www.teenvogue.com/story/how-toxic-diet-culture-is-passed-from-moms-to-daughters">begin very early in life</a> – <a href="https://doi.org/10.1016/bs.acdb.2016.10.006">during the preschool years</a>.</p> <p>Mothers may feel that they are being discreet about their dieting behavior, but little girls are watching and listening, and they are far more observant of us than many might think.</p> <p>For example, one study revealed that compared with daughters of nondieting women, 5-year-old girls whose mothers dieted <a href="https://doi.org/10.1016/S0002-8223(00)00339-4">were aware of the connection between dieting and thinness</a>.</p> <p>Mothers’ eating behavior does not just affect girls’ ideas about dieting, but also their daughters’ eating behavior. The amount of food that mothers eat <a href="https://doi.org/10.1016/j.appet.2018.04.018">predicts how much their daughters will eat</a>. In addition, daughters whose mothers are dieters are <a href="https://doi.org/10.1016/j.appet.2018.04.018">more likely to become dieters themselves</a> and are also <a href="https://doi.org/10.1016/j.eatbeh.2007.03.001">more likely to have a negative body image</a>.</p> <p>Negative body image is <a href="https://theconversation.com/mounting-research-documents-the-harmful-effects-of-social-media-use-on-mental-health-including-body-image-and-development-of-eating-disorders-206170">not a trivial matter</a>. It affects girls’ and women’s mental and physical well-being in a <a href="https://doi.org/10.1177/1359105317710815">host of ways</a> and <a href="https://doi.org/10.1016/j.brat.2011.06.009">can predict the emergence of eating disorders</a>.</p> <h2>Avoiding ‘fat talk’</h2> <p>What can moms do, then, to serve their daughters’ and their own health?</p> <p>They can focus on small steps. And although it is best to begin these efforts early in life – in girlhood – it is never too late to do so.</p> <p>For example, mothers can consider how they think about and talk about themselves around their daughters. Engaging in “fat talk” may inadvertently send their daughters the message that larger bodies are bad, <a href="https://doi.org/10.1016/j.bodyim.2020.07.004">contributing to weight bias</a> and negative self-image. Mothers’ fat talk also <a href="https://doi.org/10.1080/15267431.2021.1908294">predicts later body dissatisfaction in daughters</a>.</p> <p>And negative self-talk isn’t good for mothers, either; it is associated with <a href="https://doi.org/10.1177/1359105318781943">lower motivation and unhealthful eating</a>. Mothers can instead practice and model self-compassion, which involves treating oneself the way <a href="https://doi.org/10.1016/j.bodyim.2016.03.003">a loving friend might treat you</a>.</p> <p>In discussions about food and eating behavior, it is important to avoid moralizing certain kinds of food by labeling them as “good” or “bad,” as girls may extend these labels to their personal worth. For example, a young girl may feel that she is being “bad” if she eats dessert, if that is what she has learned from observing the women around her. In contrast, she may feel that she has to eat a salad to be “good.”</p> <p>Moms and other female role models can make sure that the dinner plate sends a healthy message to their daughters by showing instead that all foods can fit into a balanced diet when the time is right. Intuitive eating, which emphasizes paying attention to hunger and satiety and allows flexibility in eating behavior, is associated with <a href="https://doi.org/10.1007/s40519-020-00852-4">better physical and mental health in adolescence</a>.</p> <p>Another way that women and especially moms can buffer girls’ body image is by helping their daughters <a href="https://doi.org/10.1016/j.bodyim.2021.12.009">to develop media literacy</a> and to think critically about the nature and purpose of media. For example, moms can discuss the misrepresentation and distortion of bodies, such as the use of filters to enhance physical appearance, on social media.</p> <h2>Focusing on healthful behaviors</h2> <p>One way to begin to focus on health behaviors rather than dieting behaviors is to develop respect for the body and to <a href="https://theconversation.com/body-neutrality-what-it-is-and-how-it-can-help-lead-to-more-positive-body-image-191799">consider body neutrality</a>. In other words, prize body function rather than appearance and spend less time thinking about your body’s appearance. Accept that there are times when you may not feel great about your body, and that this is OK.</p> <p>To feel and look their best, mothers can aim to stick to a <a href="https://theconversation.com/whats-the-best-diet-for-healthy-sleep-a-nutritional-epidemiologist-explains-what-food-choices-will-help-you-get-more-restful-zs-219955">healthy sleep schedule</a>, manage their stress levels, <a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">eat a varied diet</a> that includes all of the foods that they enjoy, and <a href="https://theconversation.com/the-runners-high-may-result-from-molecules-called-cannabinoids-the-bodys-own-version-of-thc-and-cbd-170796">move and exercise their bodies regularly</a> as lifelong practices, rather than engaging in quick-fix trends.</p> <p>Although many of these tips sound familiar, and perhaps even simple, they become effective when we recognize their importance and begin acting on them. Mothers can work toward modeling these behaviors and tailor each of them to their daughter’s developmental level. It’s never too early to start.</p> <h2>Promoting healthy body image</h2> <p>Science shows that several personal characteristics are associated with body image concerns among women.</p> <p>For example, research shows that women who are <a href="https://doi.org/10.1016/j.bodyim.2020.02.001">higher in neuroticism</a> <a href="https://doi.org/10.1186/2050-2974-1-2">and perfectionism</a>, <a href="https://doi.org/10.3389/fpsyg.2022.983534">lower in self-compassion</a> or <a href="https://doi.org/10.1016/j.bodyim.2013.08.001">lower in self-efficacy</a> are all more likely to struggle with negative body image.</p> <p>Personality is frequently defined as a person’s characteristic pattern of thoughts, feelings and behaviors. But if they wish, <a href="https://doi.org/10.1002/per.1945">mothers can change personality characteristics</a> that they feel aren’t serving them well.</p> <p>For example, perfectionist tendencies – such as setting unrealistic, inflexible goals – can be examined, challenged and replaced with more rational thoughts and behaviors. A woman who believes she must work out every day can practice being more flexible in her thinking. One who thinks of dessert as “cheating” can practice resisting moral judgments about food.</p> <p>Changing habitual ways of thinking, feeling and behaving certainly takes effort and time, but it is far more likely than diet trends to bring about sustainable, long-term change. And taking the first steps to modify even a few of these habits can positively affect daughters.</p> <p>In spite of all the noise from media and other cultural influences, mothers can feel empowered knowing that they have a significant influence on their daughters’ feelings about, and treatment of, their bodies.</p> <p>In this way, mothers’ modeling of healthier attitudes and behaviors is a sound investment – for both their own body image and that of the girls they love.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221968/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/janet-j-boseovski-451496"><em>Janet J. Boseovski</em></a><em>, Professor of Psychology, <a href="https://theconversation.com/institutions/university-of-north-carolina-greensboro-2069">University of North Carolina – Greensboro</a> and <a href="https://theconversation.com/profiles/ashleigh-gallagher-1505989">Ashleigh Gallagher</a>, Senior Lecturer, <a href="https://theconversation.com/institutions/university-of-north-carolina-greensboro-2069">University of North Carolina – Greensboro</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/mothers-dieting-habits-and-self-talk-have-profound-impact-on-daughters-2-psychologists-explain-how-to-cultivate-healthy-behaviors-and-body-image-221968">original article</a>.</em></p>

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How people get sucked into misinformation rabbit holes – and how to get them out

<p><em><a href="https://theconversation.com/profiles/emily-booth-715018">Emily Booth</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/marian-andrei-rizoiu-850922">Marian-Andrei Rizoiu</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a></em></p> <p>As misinformation and radicalisation rise, it’s tempting to look for something to blame: the internet, social media personalities, sensationalised political campaigns, religion, or conspiracy theories. And once we’ve settled on a cause, solutions usually follow: do more fact-checking, regulate advertising, ban YouTubers deemed to have “gone too far”.</p> <p>However, if these strategies were the whole answer, we should already be seeing a decrease in people being drawn into fringe communities and beliefs, and less misinformation in the online environment. We’re not.</p> <p>In new research <a href="https://doi.org/10.1177/14407833241231756">published in the Journal of Sociology</a>, we and our colleagues found radicalisation is a process of increasingly intense stages, and only a small number of people progress to the point where they commit violent acts.</p> <p>Our work shows the misinformation radicalisation process is a pathway driven by human emotions rather than the information itself – and this understanding may be a first step in finding solutions.</p> <h2>A feeling of control</h2> <p>We analysed dozens of public statements from newspapers and online in which former radicalised people described their experiences. We identified different levels of intensity in misinformation and its online communities, associated with common recurring behaviours.</p> <p>In the early stages, we found people either encountered misinformation about an anxiety-inducing topic through algorithms or friends, or they went looking for an explanation for something that gave them a “bad feeling”.</p> <p>Regardless, they often reported finding the same things: a new sense of certainty, a new community they could talk to, and feeling they had regained some control of their lives.</p> <p>Once people reached the middle stages of our proposed radicalisation pathway, we considered them to be invested in the new community, its goals, and its values.</p> <h2>Growing intensity</h2> <p>It was during these more intense stages that people began to report more negative impacts on their own lives. This could include the loss of friends and family, health issues caused by too much time spent on screens and too little sleep, and feelings of stress and paranoia. To soothe these pains, they turned again to their fringe communities for support.</p> <p>Most people in our dataset didn’t progress past these middle stages. However, their continued activity in these spaces kept the misinformation ecosystem alive.</p> <p>When people did move further and reach the extreme final stages in our model, they were doing active harm.</p> <p>In their recounting of their experiences at these high levels of intensity, individuals spoke of choosing to break ties with loved ones, participating in public acts of disruption and, in some cases, engaging in violence against other people in the name of their cause.</p> <p>Once people reached this stage, it took pretty strong interventions to get them out of it. The challenge, then, is how to intervene safely and effectively when people are in the earlier stages of being drawn into a fringe community.</p> <h2>Respond with empathy, not shame</h2> <p>We have a few suggestions. For people who are still in the earlier stages, friends and trusted advisers, like a doctor or a nurse, can have a big impact by simply responding with empathy.</p> <p>If a loved one starts voicing possible fringe views, like a fear of vaccines, or animosity against women or other marginalised groups, a calm response that seeks to understand the person’s underlying concern can go a long way.</p> <p>The worst response is one that might leave them feeling ashamed or upset. It may drive them back to their fringe community and accelerate their radicalisation.</p> <p>Even if the person’s views intensify, maintaining your connection with them can turn you into a lifeline that will see them get out sooner rather than later.</p> <p>Once people reached the middle stages, we found third-party online content – not produced by government, but regular users – could reach people without backfiring. Considering that many people in our research sample had their radicalisation instigated by social media, we also suggest the private companies behind such platforms should be held responsible for the effects of their automated tools on society.</p> <p>By the middle stages, arguments on the basis of logic or fact are ineffective. It doesn’t matter whether they are delivered by a friend, a news anchor, or a platform-affiliated fact-checking tool.</p> <p>At the most extreme final stages, we found that only heavy-handed interventions worked, such as family members forcibly hospitalising their radicalised relative, or individuals undergoing government-supported deradicalisation programs.</p> <h2>How not to be radicalised</h2> <p>After all this, you might be wondering: how do you protect <em>yourself</em> from being radicalised?</p> <p>As much of society becomes more dependent on digital technologies, we’re going to get exposed to even more misinformation, and our world is likely going to get smaller through online echo chambers.</p> <p>One strategy is to foster your critical thinking skills by <a href="https://www.cell.com/trends/cognitive-sciences/abstract/S1364-6613(23)00198-5">reading long-form texts from paper books</a>.</p> <p>Another is to protect yourself from the emotional manipulation of platform algorithms by <a href="https://guilfordjournals.com/doi/10.1521/jscp.2018.37.10.751">limiting your social media use</a> to small, infrequent, purposefully-directed pockets of time.</p> <p>And a third is to sustain connections with other humans, and lead a more analogue life – which has other benefits as well.</p> <p>So in short: log off, read a book, and spend time with people you care about. <!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223717/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/emily-booth-715018">Emily Booth</a>, Research assistant, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/marian-andrei-rizoiu-850922">Marian-Andrei Rizoiu</a>, Associate Professor in Behavioral Data Science, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-people-get-sucked-into-misinformation-rabbit-holes-and-how-to-get-them-out-223717">original article</a>.</em></p>

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